Monday, August 22, 2016
Sunday, August 21, 2016
DIETARY LISTS FOR HYPERCHOLESTEROLEMIA (HIGH CHOLESTEROL)
DIETARY CONTROL OF HYPERCHOLESTEROLEAMIA
HEALTHY FOODS
- unsaturated fats, such as olive oil,Avocado,nuts and canola oil.
- Whole grains, whole wheat bread and pasta, oatmeal, oat bran, and brown rice.
- Fruits and vegetables, which are high in fiber and can help lower cholesterol levels.
- Limit cholesterol in your diet. The highest amounts are found in egg yolks, whole milk products, and organ meats.
- Eat fatty fish. 2 servings of fatty fish (such as salmon or herring) each week.
- Eat nuts, seeds, vegetable oils, and fortified food products, such as orange juice, yogurt, and salad dressing.
- Eat fiber foods, especially oats, barley, and legumes, as well as fruits, vegetables, and other whole grains.
Balanced Diet for those with High Cholesterol:
Grains: 6
to 8 servings per day (half should be whole grains)
Vegetables:
3 to 5 servings per day
Fruits: 4
to 5 servings per day
Fat-free
or low-fat dairy: 2 to 3 servings per day
Lean
meat, Skinless poultry.
Fats and oils: (use unsaturated fats such as
olive oil or canola oil)
Nuts,
seeds, legumes: 3 to 5 servings per week
2
servings of fatty fish (such as salmon, herring, or lake trout) per week;
OTHERS
Restricting
sodium (salt, including salt already added to food)
Weight reduction
also important
Exercise at least 3-5 times a
week for 30-45 mins per day .
Diet Plans for Diabetes,
Hypertension Cardiovascular disease.
Food plays an important role in
the treatment of specific diseases like diabetes, hypertension, cardiovascular
diseases etc. The diet should be balanced and within the permissible calorie
limits. Food should be distributed into small frequent feeds. The daily
requirement should be well distributed between the different meals. Skipping a
meal or fasting is not really advisable.
Cholesterol rich foods (To be avoided by cardiac patients)
1.
Whole milk and milk products
2.
Egg Yolk
3.
Shellfishes like prawn, crab, lobster etc.
4.
Organ meats like kidney, liver, brain etc.
5.
Chicken, duck with skin.
6.
Sweet like pastries, ice creams etc.
7.
Butter, dalda, coconut oil, palmoil
8.
Fried foods like chips, Samosa etc.
9.
Alcoholic drinks, creams soups etc.
Sodium rich foods (To be avoided
by Hypertensive Patients)
Salt
(Avoid extra salt in food and table)
Baking
powder, baking soda, ajinomoto etc
Bakery
Products like biscuits, cakes, pastries, chocolates, bread, bun etc.
Salted
chips, nuts, popcorn etc
Pappads,
pickles, dried fish etc
Canned
and Salt preserved foods
Sauces,
soup cubes
Sausages,
lobsters, meat and yeast extracts
Carbonated
beverages (Soft Drinks)
Readymade
foods like cornflakes, noodles, fast foods etc.
Proprietary
drinks eg. Horlicks, complan, bournvita etc.
General Instructions
1.
Different cereals contain almost the same amount of carbohydrate and so the
quantity of cereal consumed should be noted rather than the type
consumed.
2.
Whole grain cereals are better, preferred for their fiber content and
satiety value.
3.
Fish can be included in the diet, in the curry form. Fried fish is the best
avoided. Shell fishes like prawns, lobsters etc should be avoided.
4.
Poultry (Without Skin) can be used occasionally. Beef, Pork, mutton, liver etc
should be avoided by cardiac patients. Trim off Excess fat (if any) before
cooking.
5.
Egg yolk has to be avoided by individuals with hyperlipidemia.
6.
Use skimmed milk whenever possible, otherwise cream has to be removed before
consumption.
7.
Include more vegetables (esp. raw salads and green leafy vegetables) in your
diet, as it is rich in fiber which in turn helps to reduce blood sugar and
cholesterol levels. Raw salads with sprouted pulses enhance the nutrient
composition.
8. Cardiac
and hypertensive patients can take 3-4 servings of fruits. Whenever possible
consume fruits with edible skins eg. apple.
guava etc.
9. Cardiac and hypertensive
patients should minimize their intake of sugar and sweets.
10.
Garlic, curry leaves, oatbran etc have blood sugar and cholesterol loosing
efforts. Ginger, foods in rich with Vit- E and B Carotene reduces the risk of
cardiac diseases.
11. Alcohol
intake injurious to health, 1 ml of Alcohol contains 7 calories. Alcohol can
cause hypoglyemia and can increase triglycerides which can be harmful for the
heart.
12. Cooking
oil used should be minimized and may be restricted to 10-15 ml/day. (2-3 tsp).
Use cooking methods that require little or no fat.
13.
Hidden fat in bakery products and snacks should also be taken into
account.
14. Preferably
use a combination of cooking oils like sesame. ground nut, sunflower, rice
bran, corn oil etc. use of coconut and palm oil should be maintained at minimum
levels.
15. Dinner
should be enjoyed two hours before retiring.
16. Include
foods from all the different food groups and thus consume a balanced diet.
17.
Regular exercise is most useful but physical strain after a meal should be
avoided.
Thursday, August 18, 2016
Pneumonia can be deadly in children
Pneumonia is the second major killer of
children after malaria in Nigeria. It accounts for about 17 per cent of
total infant mortality recorded yearly in the country.
The rate at which Nigerians,
particularly children, lose their lives to pneumonia is alarming as the
disease kills no fewer than 150, 000 children yearly.
This is unacceptable for a disease that
simple measures such as breastfeeding, immunisation and good hygiene can
help to prevent.
Unfortunately, the majority of Nigerians are still ignorant of its causes and prevention.
A school nurse recently referred a
patient to my centre and the referral form read, “A six-year-old basic 2
girl came down with a day history of cold, cough and fever. She also
complained of stomachache. When her parents were informed about her
illness, they consented that she be transferred to the school
retainership hospital.”
At the hospital, she appeared quite
pale. She also had catarrh, even as her breathing became shallow and
fast. She was diagnosed with pneumonia based on the history (from her
mum), signs, symptoms and chest examination.
A chest X-ray was ordered to confirm the
diagnosis and rule out any other chest abnormality. The X- ray result
confirmed right lobar pneumonia, (pneumonia involving the right part of
the chest). Following this the hospital placed her on admission and
commenced with an intravenous antibiotics.
She was in hospital for about five days
but had to take three or four more rounds of antibiotics to clear the
congestion in her lungs. She was out of school for almost two weeks.
After this experience, the nurse said
she would like to advise parents to take sick children to the doctors
for advice immediately and would want parents to be aware that pneumonia
can present itself in different forms.
Definition: Pneumonia
in a layman’s language is defined as chest infection and it happens when
the deepest part of the tissue in the lungs becomes infected and
inflamed.
The inflammation affects the small airways and the air sacs (alveoli or parenchyma) at the very end of this system.
This makes the body less effective at moving gases such as oxygen and carbon dioxide into and out of our bloodstream.
Causes: Most Nigerians
are ignorant about the factors responsible for pneumonia, contrary to
the belief that pneumonia is caused by exposure to cold weather and cold
water and rainwater. The disease is communicable; usually caused by
bacteria, but it also can be caused by certain viral infections.
Often, people who develop pneumonia may have another illness or injury, but it also often affects otherwise healthy people.
It is highly contagious and can last from a few days to weeks.
Signs and symptoms:
Fever, feeling unwell, coughing (with at times pus-coloured phlegm,young
children usually swallow any phlegm they may cough up), shortness of
breath, fast breathing, post-tussive vomiting (vomiting after an episode
of cough), noisy breathing, wheezing and right abdominal pain.
Investigations: A simple chest X- ray will usually confirm the diagnosis of pneumonia. Other tests like Sputum and blood tests are supportive.
How to manage noisy breathing in children
A mother recently complained to me that
her four-year-old baby usually breathes heavily at night. She was
worried because her son always opens his mouth and the loud noise was
becoming embarrassing.
After I examined the boy, I noticed that
his tonsils were inflamed, a condition called tonsillitis. The X-ray
done also showed an enlargement of the adenoids. The two conditions are
called adenotonsilitis and are responsible for the boy’s noisy
breathing.
Adenoids are the two infection-fighting
glands at the back of the nostrils and above the tonsils. Adenoid
enlargement refers to the increase in the size of the adenoids.
Noisy breathing is associated with
breathing through the mouth, bad breath, snoring, fast breathing and
cough. Adenoid enlargement is a major cause of noisy breathing in
children.
Other conditions that cause abnormal
breathing include asthma, poor dentition and abnormality in the mouth.
The adenoids, along with the tonsils, help prevent agents such as
bacteria and viruses from entering the body. When infection or
inflammation occurs, the adenoids become swollen preventing air from
flowing in and out of the nostrils freely.
To breathe, they have to inhale and exhale via mouth. The adenoids also shrink, as a child grows older.
Causes
The exact cause of enlarged adenoids is
not always clear. Chronic infection of the upper respiratory tract and
allergies may cause the adenoids to enlarge.
Symptoms
When adenoids cause obstruction, the
child now develops snoring (noisy breathing) because of the obstruction
of the passage of the nose at the back, will have bad breath with bad
odour and will not gain weight as expected since he uses a lot of energy
to breath. Most of the children will have recurrent catarrh, low to
high-grade fever, cough, noisy breathing from birth.
Diagnosis
Diagnosis of adenotonsilitis begins with
a history and physical exam. The tonsil can be viewed via direct light
source when the child opens his mouth. Adenoids cannot be seen by
looking in the mouth directly. The doctor can see them by using a
special mirror in the mouth or a flexible tube (called an endoscope)
placed through the nose. In young children, the easiest way to find an
enlarged adenoid is with an X-ray called postnasal X-ray.
Complications: It may result in Otitis
media (infection of middle ear), Chronis sinusitis, obstruction of the
airway, recurrent chest infection and sleep problems like sleep apnea.
It may also affect the facial appearance of the child, which in medical
terms is referred to as adenoid faces.
Prevention
Effective treatment of allergies may
prevent some cases of adenoidal hypertrophy. Many times, the condition
cannot be prevented. There is the need to prevent children from dusty
environment and things like smoking, frying things, sweeping, sharing of
items with mates in the school.”
Treatments: Use antibiotics,
anti-inflammatory (analgesics), oral corticosteroids and anti-allergy
drugs, among others. Surgical removal of the adenoids (adenoidectomy) is
sometimes necessary for those who do not respond to medicine.
According to MayoClinic.com, babies can
have as many as 10 upper respiratory infections–better known as the
common cold–before age 2. It’s also common for newborn babies to have
some nasal congestion in the first two months of life. All of that
sniffling and stuffiness can make your baby uncomfortable and interfere
with his sleep, making for a sad and grumpy little one.
Call the doctor
Newborns can become dehydrated quickly,
and colds can easily develop into croup or pneumonia. If your newborn is
having trouble breathing, has a runny nose, sounds “stuffy” or has a
rattling or raspy sound coming from her chest, call your pediatrician.
Chances are it’s just normal newborn congestion or simply a cold, but
with newborns, it’s best to err on the side of safety.
Clear congestion
A stuffy nose can make it hard for your
newborn to suck, so keeping his nasal passages clear is important. If
your pediatrician approves, use a mild nasal saline spray, available at
most drug and baby supply stores. Follow the directions on the bottle
and gently spray it into one nostril at a time. A drop of breast milk in
each nostril may help clear the congestion as well. Use a bulb syringe,
also available at drug stores and sometimes given out at the hospital
where you gave birth, to suck out the mucous. Squeeze the bulb of the
syringe, insert just the tip into baby’s nostril and slowly let the bulb
re-inflate, drawing the mucous out. Clean the syringe well with hot
water after each use, and make sure it’s fully dry before using it
again.
Use a humidifier in your newborn’s room
to help keep the air moist and ease congestion. Keep it away from the
crib or bassinet so the mist doesn’t spray directly on the baby, and
make sure the cord is kept well out of baby’s reach. Change the water
every day to ensure that mold doesn’t grow in the tub. Sitting with your
newborn in the bathroom with the hot water running and the door closed
may help loosen congestion as well. Let the steam fill the room and sit
with your baby for a few minutes, but be sure he doesn’t get too warm.
If his cheeks start to get red or he looks more uncomfortable, move to a
cooler room.
Letting your baby sleep partially
reclined in a car seat or swing can help his breathing if his chest is
congested. Be sure he’s buckled in and that the seat is on the floor and
can’t be knocked over.
In conclusion, parents should release
their children for necessary surgery that may be beneficial to such
children at adulthood. The failure to do this make the patients to snore
heavily later in life. It may also affect their speech.
High cholesterol is dangerous, prevent it!
During the last festive period, a woman
in her middle age developed partial stroke and was admitted in the
hospital. She recovered fully but the family felt that the problem might
not be stroke since the woman’s blood pressure had never been high and
her blood sugar level had always been within the normal range, meaning
she was not hypertensive or diabetic.
Her blood sample, which was sent to the
lab for investigations, showed elevated blood cholesterol, a condition
called hypercholesterolemia. It was later found that high cholesterol
was responsible for the first stroke she suffered.
Hypercholesterolemia, or high
cholesterol, occurs when there is too much cholesterol in the body.
Cholesterol is a soft, waxy, fat-like substance that is a natural
component of all the cells in the body. The body makes all the
cholesterol it needs. However, added cholesterol, which comes from the
foods eaten, may cause harm. High cholesterol raises the risk for
heart disease, heart attack, and stroke. When there is too much
cholesterol circulating in the blood, it can create sticky deposits
(called plaque) along the artery walls. Plaque can eventually narrow or
block the flow of blood to the brain, heart, and other organs. Blood
cells that get caught on the plaque form clots, which can break loose
and completely block blood flow through an artery, causing heart attack
or stroke.
While heredity may be a factor for some
people, the main culprits are lack of exercise and diets high in
saturated fat. High cholesterol can be prevented, sometimes with
lifestyle changes (diet and exercise) alone. If these do not work, your
doctor may recommend medications to lower your cholesterol levels.
Signs and symptoms
In the early stages, there are usually
no symptoms of high cholesterol. The only way to tell if the cholesterol
is high is through a blood test.
Causes
In some cases, high cholesterol levels
may be inherited; the liver may make too much cholesterol, or the body
may not remove bad cholesterol from the blood efficiently. High
cholesterol and elevated triglycerides can also be associated with other
diseases, such as diabetes. But often, high cholesterol is caused by
eating foods high in saturated fat and not getting enough exercise. High
cholesterol is more common in people who are overweight or obese.
Risk factors: Being
overweight or obese, eating a diet high in saturated fat and trans fatty
acids (found in processed and fried foods); not getting enough
exercise; family history of heart disease; high blood pressure; smoking;
and diabetes.
Diagnosis: Most people
do not have any symptoms of high cholesterol. A blood test is the only
way to check levels of cholesterol in the blood. If the levels are above
200 mg/dL, the doctor will do a fasting lipid profile, a test performed
after you abstain from food for nine to 12 hours.
Lipid profile
A lipid test generally determines four
distinct numbers: total cholesterol, LDL, HDL and triglycerides. The LDL
or low-density lipoprotein and the HDL or high-density lipoprotein are
the two fundamental “cholesterol types”. The LDL is known to be negative
(bad) when in excess. Therefore, minimising it will be much better.
HDL, known to be the positive (good), is better when elevated. In
addition, the lipid profile appraises the triglycerides (whole fat in a
person’s body). They have an impact on the health in the same manner
cholesterol does. At last, the total cholesterol (sum of HDL, LDL and 20
per cent of triglycerides) is integrated as well in the results.
It is important to say at this juncture
that people with chronic conditions like hypertension, diabetes,
obesity, among others, should have their lipids check periodically.
Have your blood checked today.I will like to say that eating food containing fat or cholesterol does not lead to high cholesterol (hypercholesterolemia) since the body needs it for normal body metabolism. However, evidenced-based medicine shows that reducing the amount of food containing cholesterol is healthy and beneficial to all, especially those with hypercholesterolemia, hypertension and other heart-related disorders.
High blood cholesterol is treated with
lifestyle changes and medicines. The main goal of treatment is to lower
the low-density lipoprotein cholesterol level enough to reduce the risk
for coronary heart disease, heart attack, and other related health
problems. I once saw a patient with high cholesterol, after due
explanation, I wrote in his case note TLC for three months. The patient
asked the nurse about the cost of TLC. The nurse explained to him that
TLC was an abbreviation for Therapeutic Lifestyle Changes and that it
was a do-it-yourself treatment and with no fee charged for it.
Therapeutic Lifestyle Changes: TLC
helps in lowering the LDL cholesterol. TLC is a three-part programme
that includes a healthy diet, weight management, and physical activity.
It is for anyone whose LDL cholesterol level is high.
Healthy diet: A
dietician once said this “your diet is a bank account; good food choices
are good investments.” With the TLC diet, less than seven per cent of
the daily calories should come from saturated fat. This kind of fat is
found in some meats, dairy products, chocolate, baked goods, and
deep-fried and processed foods.
Not more than a quarter of our daily
calories should come from all fats, including saturated, trans,
mono-unsaturated, and poly-unsaturated fats. Mono-unsaturated and
poly-unsaturated fats are healthier and cholesterol free examples
include olive oil, groundnut oil and soybean oil. Foods high in soluble
fibre also are part of the TLC diet.
These foods include whole-grain cereals
such as oatmeal and oat bran. A diet rich in fruits and vegetables can
increase important cholesterol-lowering compounds in your diet. Such
fruits are apples, bananas, oranges, pears.
Legumes include kidney beans, lentils,
and cowpeas. A healthy diet also includes some types of fish, such as
salmon, tuna (canned or fresh), and mackerel. These fish are a good
source of omega-3 fatty acids.
These acids may help protect the heart
from blood clots and inflammation and reduce the risk of heart attack.
Red meat, (beef), goat meat, and porks, among others, have high
cholesterol and may be avoided while Skinless poultry can be substituted
for meats. Avoid fried meat. You can grill, roast or boil your meat.
Frying with the oil increases the amount of cholesterol in the meat. You
also should try to limit the amount of refined sugar or sodium (salt)
that you eat. Try limiting alcohol intake.
Too much alcohol will raise the blood
pressure, cause weight gain and raise triglyceride level. (Triglycerides
are a type of fat found in the blood.)
Weight management: If you are overweight or obese, losing weight can help lower LDL cholesterol. Maintaining a healthy weight is especially important if you are at risk for heart disease and other health problems, such as diabetes and stroke. Obesity is associated with metabolic risk factors, which are a large waistline (abdominal obesity), a high triglyceride level, a low HDL cholesterol level, high blood pressure and high blood sugar.
Weight management: If you are overweight or obese, losing weight can help lower LDL cholesterol. Maintaining a healthy weight is especially important if you are at risk for heart disease and other health problems, such as diabetes and stroke. Obesity is associated with metabolic risk factors, which are a large waistline (abdominal obesity), a high triglyceride level, a low HDL cholesterol level, high blood pressure and high blood sugar.
Physical activity: Routine
physical activity can lower LDL cholesterol and triglycerides and raise
your HDL cholesterol level. People gain health benefits from as little
as 60 minutes of moderate-intensity aerobic activity per week. It is
advisable to do moderate exercise 30 minutes a day five days in a week
or one can register in a gym. The more active you are, the more you will
benefit.
Cholesterol-lowering medicines: In
addition to lifestyle changes, medicines can help control high blood
cholesterol, but they do not cure it. Thus, you must continue taking
your medicine to keep your cholesterol level in the recommended range.
Cholesterol-lowering medicines are statins. These medicines are safe for
most people. They are strictly prescription drugs and cannot be got
over the counter. In conclusion, while managing your cholesterol, take
steps to manage other heart disease risk factors too. For example, if
you have high blood pressure, work with your doctor to lower it.
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