Health, Nutrition & Fitness: 05/10/11

May 10, 2011

8 tips for eating well

These practical tips can help you make healthier choices. The two keys to a healthy diet are eating the right amount of food for how active you are and eating a range of foods to make sure you're getting a balanced diet.
A healthy balanced diet contains a variety of types of food, including lots of fruit, vegetables and starchy foods such as wholemeal bread and wholegrain cereals; some protein-rich foods such as meat, fish, eggs and lentils; and some milk and dairy foods.

1. Base your meals on starchy foods

Starchy foods such as bread, cereals, rice, pasta and potatoes are a really important part of a healthy diet. Try to choose wholegrain varieties of starchy foods whenever you can.
Starchy foods should make up about a third of the food we eat. They are a good source of energy and the main source of a range of nutrients in our diet. As well as starch, these foods contain fibre, calcium, iron and B vitamins.
Most of us should eat more starchy foods - try to include at least one starchy food with each of your main meals. So you could start the day with a wholegrain breakfast cereal, have a sandwich for lunch, and potatoes, pasta or rice with your evening meal.
Some people think starchy foods are fattening, but gram for gram they contain less than half the calories of fat. You just need to watch the fats you add when cooking and serving these foods, because this is what increases the calorie content.

Why choose wholegrain foods?

Wholegrain foods contain more fibre and other nutrients than white or refined starchy foods.
We also digest wholegrain foods more slowly so they can help make us feel full for longer.
Wholegrain foods include:

Wholemeal and wholegrain bread, pitta and chapatti
Wholewheat pasta and brown rice
Wholegrain breakfast cereals

2. Eat lots of fruit and veg

Most people know we should be eating more fruit and veg. But most of us still aren't eating enough.
Try to eat at least 5 portions of a variety of fruit and veg every day. It might be easier than you think.
You could try adding up your portions during the day.
For example, you could have:

a glass of juice and a sliced banana with your cereal at breakfast
a side salad at lunch
a pear as an afternoon snack
a portion of peas or other vegetables with your evening meal

You can choose from fresh, frozen, tinned, dried or juiced, but remember potatoes count as a starchy food, not as portions of fruit and veg.

More on fruit and veg including a portion guide

3. Eat more fish

Most of us should be eating more fish - including a portion of oily fish each week. It's an excellent source of protein and contains many vitamins and minerals.
Aim for at least two portions of fish a week, including a portion of oily fish. You can choose from fresh, frozen or canned - but remember that canned and smoked fish can be high in salt.

What are oily fish?

Some fish are called oily fish because they are rich in certain types of fats, called omega 3 fatty acids, which can help keep our hearts healthy.

How much oily fish?

Although most of us should be eating more oily fish, women who might have a baby one day should have a maximum of 2 portions of oily fish a week (a portion is about 140g). And 4 is the recommended maximum number of portions for other adults.
Examples of oily fish
Salmon, mackerel, trout, herring, fresh tuna, sardines, pilchards, eel
Examples of white or non-oily fish
Haddock, plaice, coley, cod, tinned tuna, skate, hake
Shark, swordfish and marlin
Don't have more than one portion a week of these types of fish. This is because of the high levels of mercury in these fish.
Anyone who regularly eats a lot of fish should try to choose as wide a variety as possible. Eating a wider variety of fish and shellfish will also help reduce the environmental impact.
For more information on fish and for advice - including recommended limits - for children, women who are pregnant, breastfeeding or trying for a baby, see the link below.

4. Cut down on saturated fat and sugar

Fats

To stay healthy we need some fat in our diets. What is important is the kind of fat we are eating. There are two main types of fat:

saturated fat - having too much can increase the amount of cholesterol in the blood, which increases the chance of developing heart disease
unsaturated fat - having unsaturated fat instead of saturated fat lowers blood cholesterol

Try to cut down on food that is high in saturated fat and have foods that are rich in unsaturated fat instead, such as vegetable oils (including sunflower, rapeseed and olive oil), oily fish, avocados, nuts and seeds.

Foods high in saturated fat

Try to eat these sorts of foods less often or in small amounts:

meat pies, sausages, meat with visible white fat
hard cheese
butter and lard
pastry
cakes and biscuits
cream, soured cream and crème fraîche
coconut oil, coconut cream or palm oil

For a healthy choice, use just a small amount of vegetable oil or a reduced-fat spread instead of butter, lard or ghee. And when you are having meat, try to choose lean cuts and cut off any visible fat.

How do I know if a food is high in fat?

Look at the label to see how much fat a food contains. Generally the label will say how many grams (g) of fat there are in 100g of the food.
Some foods also give a figure for saturated fat, or 'saturates'.
Use the following as a guide to work out if a food is high or low in fat.
Total fat - what's high and what's low?
High is more than 20g fat per 100g
Low is 3g fat or less per 100g
If the amount of fat per 100g is in between these figures, then that is a medium level of fat.
Saturated fat - what's high and what's low?
High is more than 5g saturates per 100g
Low is 1.5g saturates or less per 100g
If the amount of saturates per 100g is in between these figures, then that is a medium level of saturated fat.
Remember that the amount you eat of a particular food affects how much fat you will get from it.
Try to choose more foods that are low in fat and cut down on foods that are high in fat.

Sugar

Most people in the UK are eating too much sugar. We should all be trying to eat fewer foods containing added sugar, such as sweets, cakes and biscuits, and drinking fewer sugary soft and fizzy drinks.
Having sugary foods and drinks too often can cause tooth decay, especially if you have them between meals. Many foods that contain added sugar can also be high in calories so cutting down could help you control your weight.

How do I know if a food is high in added sugar?

Take a look at the label. The ingredients list always starts with the biggest ingredient first.
But watch out for other words used to describe added sugars, such as sucrose, glucose, fructose, maltose, hydrolysed starch and invert sugar, corn syrup and honey. If you see one of these near the top of the list, you know the food is likely to be high in added sugars.
Another way to get an idea of how much sugar is in a food is to have a look for the 'Carbohydrates (of which sugars)' figure on the label. But this figure can't tell you how much is from added sugars, which is the type we should try to cut down on.
High is more than 15g sugars per 100g
Low is 5g sugars or less per 100g
If the amount of sugars per 100g is in between these figures, then that is a medium level of sugars.
Remember that the amount you eat of a particular food affects how much sugars you will get from it.
Sometimes you will only see a figure for total 'Carbohydrates', not for 'Carbohydrates (of which sugars)', which means the figure also includes the carbohydrate from starchy foods.

5. Try to eat less salt - no more than 6g a day

Lots of people think they don't eat much salt, especially if they don't add it to their food. But don't be so sure!
Every day in the UK, 85% men and 69% women eat too much salt. Adults - and children over 11 - should have no more than 6g salt a day. Younger children should have even less.
Three-quarters (75%) of the salt we eat is already in the food we buy, such as breakfast cereals, soups, sauces and ready meals. So you could easily be eating too much salt without realising it.
Eating too much salt can raise your blood pressure. And people with high blood pressure are three times more likely to develop heart disease or have a stroke than people with normal blood pressure.

How do I know if a food is high in salt?

Check the label to find out the figure for salt per 100g.
High is more than 1.5g salt per 100g (or 0.6g sodium)
Low is 0.3g salt or less per 100g (or 0.1g sodium)
If the amount of salt per 100g is in between these figures, then that is a medium level of salt.
Remember that the amount you eat of a particular food affects how much salt you will get from it.

6. Get active and try to be a healthy weight

It's not a good idea to be either underweight or overweight. Being overweight can lead to health conditions such as heart disease, high blood pressure or diabetes. Being underweight could also affect your health.
Check if you are the right weight for your height using the link below.
If you're worried about your weight, ask your GP or a dietitian for advice. But if you think you just need to lose a little weight, the main things to remember are:

only eat as much food as you need
make healthy choices - it's a good idea to choose low-fat and low-sugar varieties, eat plenty of fruit and veg and wholegrains
get more active

It's also important to eat a variety of types of food so you get all the nutrients your body needs.
Physical activity is a good way of using up extra calories, and helps control our weight. But this doesn't mean you need to join a gym.
Just try to get active every day and build up the amount you do. For example, you could try to fit in as much walking as you can into your daily routine. Try to walk at a good pace.
Whenever we eat more than our body needs, we put on weight. This is because we store any energy we don't use up - usually as fat. Even small amounts of extra energy each day can lead to weight gain.
But crash diets aren't good for your health and they don't work in the longer term. The way to reach a healthy weight - and stay there - is to change your lifestyle gradually. Aim to lose about 0.5 to 1kg (about 1 to 2lbs) a week, until you reach a healthy weight for your height.

7. Drink plenty of water

We should be drinking about 6 to 8 glasses (1.2 litres) of water, or other fluids, every day to stop us getting dehydrated.
When the weather is warm or when we get active, our bodies need more than this. But avoid drinking soft and fizzy drinks that are high in added sugar.

Alcohol

There is nothing wrong with the occasional drink. But drinking too much can cause problems. Alcohol is also high in calories, so cutting down could help you control your weight.
Women can drink up to 2 to 3 units of alcohol a day and men up to 3 to 4 units a day, without significant risk to their health.
A unit is half a pint of standard strength (3 to 5% ABV) beer, lager or cider, or a pub measure of spirit. A glass of wine is about 2 units and alcopops are about 1.5 units.
For good health, it's a good idea to spread your drinking throughout the week and avoid binge drinking. Drinking heavily over a long period of time can damage the liver.

8. Don't skip breakfast

Breakfast can help give us the energy we need to face the day, as well as some of the vitamins and minerals we need for good health.
Some people skip breakfast because they think it will help them lose weight. But missing meals doesn't help us lose weight and it isn't good for us, because we can miss out on essential nutrients.
There is some evidence to suggest that eating breakfast can actually help people control their weight.
So why not go for a bowl of wholegrain cereal with some low-fat milk and sliced banana and a glass of fruit juice for a healthy start to the day?

Household Insecticides May Be Linked to Autoimmune Diseases

(HealthDay News) — New research suggests a link between women’s exposure to household insecticides — including roach and mosquito killers — and the autoimmune disorders rheumatoid arthritis and lupus.

The scientist did not find a direct cause-and-effect relationship between insecticide exposure and the illnesses, and it’s possible that the women have something else in common that accounts for their higher risk. But epidemiologist Christine Parks, lead investigator of the study, said the findings do raise a red flag.“It’s hard to envision what other factors might explain this association,” said Parks, an epidemiologist with the National Institute of Environmental Health Sciences who was to present the study over the weekend at the American College of Rheumatology annual meeting in Philadelphia.
Previous research has linked agricultural pesticides to higher risk of rheumatoid arthritis and lupus, two diseases in which the immune system goes haywire and begins to attack the body. Farmers, among others, appear to be vulnerable.
Parks and her colleagues wanted to find out whether smaller doses of insecticides, such as those people might encounter at home from either personal or commercial residential use, might have a similar effect.
The researchers examined data from a previous study of almost 77,000 postmenopausal women aged 50 to 79. Their findings were to be released Monday at the American College of Rheumatology’s annual scientific meeting in Philadelphia.
Women who reported applying insecticides or mixing them — about half — had a higher risk of developing the two autoimmune disorders than women who reported no insecticide use. This was the case whether or not they had lived on a farm. Those who used or mixed the insecticides the most — judged by frequency or duration — had double the risk.
Even so, the risk of developing the diseases remained very low. Overall, Parks said, about 2 percent of older adults develop the conditions.
Parks said the insecticides that the women used included insect killers, such as those designed to eradicate ants, wasps, termites, mosquitoes and roaches. They didn’t include insect repellents.
There are some caveats to the research. For one, it’s not clear exactly what products the women used or when. “Over time, there have been major changes in what products were available for home use,” Parks said.
And while researchers tried to take into account the influence of factors like age that may boost a woman’s risk of getting autoimmune diseases, it’s possible they missed something that boosted the risk of illness.
Could gardening, which often entails insecticide use, be a contributing factor? That’s possible. But Parks said a lot of insecticide use takes place inside the home, not outside in the garden.
For now, she said, the findings indicate the need for “more research on environmental risk factors and better understanding of what factors might explain these findings, what chemicals might be associated with these risks.”
She declined to speculate on how insecticides might cause problems in the body.
“I would recommend that people read the labels and take precautions to minimize their personal exposure” to insecticides, she said. “This is the case regardless of whether these results are implicating a chemical that’s on the market now or was before.”

5 Steps to Take If Heartburn Won't Quit

Content http://www.health.com/

When acid reflux persists

By Karen Pallarito
Proton pump inhibitors, or PPIs, curb stomach acid production, keeping gastric juice from backing up into the esophagus and causing heartburn.

But they don’t always work—sometimes because heartburn has been misdiagnosed. Even when PPIs do work, up to 40% of people can still have breakthrough symptoms from time to time.

Fortunately, there are things you can do to prevent and minimize breakthrough symptoms.

Make sure you're taking medication correctly

If you don’t know how and when to take your meds, call your doctor for specific instructions.

“Typically, the proton pump inhibitors are given 30 to 60 minutes before breakfast,” says David A. Johnson, MD, a professor of medicine and the chief of gastroenterology at Eastern Virginia Medical School, in Norfolk, Va., and past president of the American College of Gastroenterology.
However, some people do better taking two doses a day to stave off nighttime symptoms, he adds.

Don’t hit the sack on a full belly

Lying down within three to four hours of consuming a large meal, particularly a late-evening feast, could spell trouble.

"My big push is to keep the patients away from late eating, large meals, and recumbency," says Dr. Johnson. Such a triple threat may pose too large of an insult on the body, one that even PPIs—the gold standard in GERD treatment—can’t handle.
For nighttime symptoms, Dr. Johnson suggests elevating the head of the bed with blocks or using a bed wedge to elevate the upper torso.

Shed a few pounds

A 2006 study in the New England Journal of Medicine found that overweight and obese women were two to three times as likely as thinner women to have frequent reflux symptoms.

Moderate weight gain, even in normal-weight people, may exacerbate reflux symptoms, according to the survey of more than 10,500 people.

"A reduction of even 2.5 pounds may be enough for some patients to decrease or eliminate their reflux symptoms," Dr. Johnson points out.

Try an over-the-counter drug

Drugs like Tagamet HB, Pepcid AC, Axid AR, and Zantac 75 are very effective in knocking out acid, says Joel Richter, MD, the chair of the department of medicine at Temple University, in Philadelphia.

The paradox is they’re not very effective when taken daily, because people develop a tolerance to the drug, he adds.

"What I suggest to my patients is that they take an over-the-counter H2 blocker when they have their breakthrough symptoms," he says. "That seems to give them better control."

Know your triggers

If jalapeños or onions always get you, consider skipping them. If you’re going to eat spicy food, taking an H2 blocker an hour or so before may help stop symptoms.

But if you make changes and still have heartburn, get help.

“If people are having residual symptoms several times per week, and certainly if they’re having residual symptoms to the point that it’s interfering with their ability to sleep…or function on a day-to-day basis, they should definitely talk to their physician about it,” says William D. Chey, MD, director of the gastrointestinal physiology laboratory at the University of Michigan Health System, in Ann Arbor.

10 Alternative Therapies for Rheumatoid Arthritis

Content http://www.health.com/
By Anne Harding

Coping with RA

If you’ve got rheumatoid arthritis, the single best way to fight the disease is with medication. Still, as effective as RA drugs are, they can’t do everything.
Several nondrug treatments out there can help you where medication can’t. And exercise is at the top of the list, according to Sharon L. Kolasinski, MD, a professor of clinical medicine at the University of Pennsylvania, in Philadelphia. Even though the prospect of exercising may seem painful, the right kind of activity can help prevent RA-related pain and disability. Here's a roundup of a few other therapies that may be worth a try.

Exercise

“Exercise is really critical for everybody with arthritis,” says Dr. Kolasinski. “Arthritis causes you not just pain; it causes you to use your joints in a way that stresses other structures. It’s really important to maintain flexibility and strength. The only way to do that is to exercise.”
That doesn’t mean it’s easy. She recommends choosing an activity that you enjoy, and not overdoing it. Options include walking, aquatic exercises, biking, yoga, and tai chi.
Exercise has other benefits for RA patients, too, Dr. Kolasinski adds. RA increases your risk of developing osteoporosis, and weight-bearing exercises can help keep your bones strong. Physical activity also heads off depression, which can plague anyone coping with a chronic illness, including RA.

Physical therapy

Your doctor may prescribe physical therapy to help heal and strengthen a body part or an area that’s “acting up” and giving you problems.
A physical therapist will use heat, ice, transcutaneous electrical stimulation, range-of-motion exercises, gentle strengthening moves, and more to help ease swelling and inflammation and get you back into shape. Physical therapy is typically a short-term option. You might go a few times a week for several weeks, until you’re feeling better.
PT is also a terrific bridge to an exercise program, Dr. Kolasinski says. You can work with your physical therapist to come up with a workout plan that’s right for you.

Occupational therapy

This type of therapy can also be a good bridge to a regular exercise plan. The idea of OT is to help a person live as independently and fully as possible, no matter what his or her age or condition.

An occupational therapist will work with you to identify problem areas in your daily life and figure out ways to eliminate them, or work around them. For example, your hands and wrists could be swollen and painful from typing on a keyboard all day long. The therapist can help you modify your work area so you can use the computer more comfortably and avoid overuse injuries.

Occupational therapists can also help identify assistive devices that can make your everyday tasks much easier.

Mind-body therapies

This is a catchall term for therapies that, essentially, help you use your mind to make your body feel better.

Mind-body approaches can include mindfulness meditation, biofeedback, breathing exercises, and guided relaxation. Certain types of exercise—such as yoga, qi gong, and tai chi—also encourage you to focus your mind in ways that can help you cope with pain, and improve strength and flexibility at the same time.

Studies suggest that meditation and tai chi may improve mood and quality of life, and there’s evidence that mind-body therapies are helpful for chronic pain and other types of arthritis as well, Dr. Kolasinski says.

Counseling

Cognitive behavioral therapy, a type of psychotherapy that helps people identify problems in the way they think and act and encourages them to change their behavior, can be helpful if you have RA, especially if you are suffering from depression.
Counseling can also help you cope with the other stresses and strains of chronic illness.

Fish oil

Fish oil can ease pain and inflammation in people with rheumatoid arthritis. Fish-oil capsules may, in fact, be as effective for relieving pain and inflammation as nonsteroidal anti-inflammatory drugs (like ibuprofen and naproxen), according to Dr. Kolasinski.

RA patients in the studies that found fish oil helpful took high doses, typically 4 grams a day or four standard fish-oil capsules. Most people consuming fish oil for overall health take one or two capsules daily.

But there's no strong evidence that other dietary supplements or herbs, such as glucosamine or evening primrose oil, have any benefit in RA patients. “The herbals are really not where it’s at,” Dr. Kolasinski says.

Also, be sure to tell your physician and pharmacist about any nonprescription remedies you use.

Hot and cold treatments

One of the simplest home remedies is also one of the best: heat.

A 15-minute hot bath or shower can help you relax and soothe painful joints and muscles. You can also try applying heat to an area with a heating pad, or chilling out with an ice pack or ice water. Alternating hot packs with cold ones can also offer powerful relief.

But as with exercise, don’t overdo it; talk to a health-care provider about how to use heat and cold safely.

Acupuncture

This is an ancient Eastern healing technique of stimulating certain points in the body—usually by inserting very thin needles and leaving them in place for between several minutes and an hour—to promote the flow of qi, or life force, through the body.
While proponents say that acupuncture can trigger the body to release the “feel-good” hormones known as endorphins, thus reducing pain, skeptics believe any benefit from the needle piercing is due to the placebo effect.
Only a handful of small studies have shown that acupuncture can help with RA symptoms. Still, many people swear by acupuncture, and there’s really no downside to giving it a try—unless you’re scared of needles.

Massage

Depending on how your body is feeling, massage can be wonderful—or agonizing.
If your joints and muscles aren’t feeling too tender, it can be very beneficial in easing muscle tension related to joint stress, and just helping you relax and feel better. You will be the best judge of whether massage can help you on a particular day, or not.
Give it a try, if you think it might help your body feel better. But make sure your massage therapist has experience in treating people with RA.

Rest

One of the most important things for you to do if you have rheumatoid arthritis is not to overdo it.

When you need a rest, take it. Pushing yourself too hard can only make fatigue worse

Connect

Having a chronic illness can be isolating.

But being open with your family and friends about your condition so you feel comfortable asking for help when you need it—or just having a shoulder to cry on—can make a big difference in how you feel, both physically and mentally.

There are also online and real-life support groups where you can meet other people with RA and share coping strategies.

FDA committee recommends 2nd new hepatitis C drug for approval

A Food and Drug Administration advisory committee is unanimously recommending approval of a second new treatment–in as many days–for hepatitis C genotype 1 infection in adults with liver damage who have not been treated or whose treatment failed. Hepatitis C is a chronic viral disease that causes inflammation and swelling of the liver.

The drug, telaprevir, is a new class of protease inhibitor manufactured by Vertex Pharmaceuticals. It too would be used in combination with ribavirin and peginterferon–the current standard of care. Telaprevir also prevents the virus from replicating, and studies show the three-drug cocktail is more effective than the two-drug regimen.
"We are thrilled with today's FDA Committee decision," said Dawn Kalmar, a Vertex spokeswoman. "This is an important step in our more than 15 year effort to bring telaprevir to people living with hepatitic C."
Wednesday, the committee unanimously approved boceprevir, a similar protease inhibitor manufactured by Merck & Co.
According to Vertex, about 79% of study patients who hadn't been treated and 85% of those who were treated but relapsed showed significant improvement when treated with telaprevir. The drug is administered orally 3 times a day with food.
"It's a stunning achievement that we will be able to cure nearly 80% of naive patients and probably close to the same number of relapsers," said Dr. Lawrence S. Freidman, Chair, Department of Medicine Newton-Wellseley Hospital. "There are so many positive aspects of this drug and for those of us who have been in the field, this is a very exciting time."
"The benefits far outweigh the risks," said Patrick Clay, Director, Dybedal Center for Clinical Research, Kansas City University of Medicine. "This is yet another step and that's all it is. This is a marathon not a sprint."
As with boceprevir, data for hard to treat patients like African Americans, Hispanics and Latinos was very limited but those involved in the studies responded extremely well to therapy.
The most common side effects, according to Vertex and the FDA were rash and anemia. While panelists expressed concern, all felt the risks were manageable and stressed the importance of management programs that educate both patients and physicians.
Risks were not enough to sway KellyAnn Mann Hester, a mother of 4 and grandmother of 5 who was diagnosed with hepatitis C almost 20 years ago. Hester had a number of failed treatments and said she was once told she would not see her 5 year old son graduate high school. She participated in the telaprevir study and gave an impassioned plea for approval. "I had no hope left that I was going to live with this disease. I was living to die," said Hester. "Now I'm living until I die because now I have many windows and avenues available to me that I did not have before. Please approve this drug."
The FDA will now consider the committee's recommendation and decide if one or both of these drugs will be approved.

Health, Nutrition & Fitness