Symptoms that could prevent you from doing physical exercises(1)

The Symptoms

Back pain

If you have been experiencing back pain for the last few months, accompanied by some urinary disturbances, such as more frequent urination and low abdominal discomfort, it is possible that you have been suffering from urinary tract infection (UTI). You need to consult a medical doctor, and, more often than not, he will request you to have examination of the urine, otherwise known as urinalysis. If it turns out that you haveUTI, then you will be prescribed with the most appropriate antibiotic(s).

If your back pain, however, is acute—that is, it happened so suddenly—then you need to consider compression of your spinal nerves. This consideration is most probable if you have a history of trauma or injury at the back. However, even if there was no trauma, you need to factor in spinal nerve(s) injury, and you need to consult a medical doctor who is either a general practitioner, neurologist, or rehabilitation medical doctor. If you have spinal nerve(s) injury, and you insisted on having your physical exercises, it is possible that you will injure yourself all the more, and you will aggravate your medical problem. Hence, prior to totally ruling out the possibility of spinal nerve(s) injury, you need to refrain from having physical exercises.

If it is confirmed that you have spinal nerve(s) injury, resulting from compression, the basic management is for you to have bed rest for at least seven days. It could be longer, depending on the severity of your medical problem. In addition, you will have sessions under the rehabilitation medicine department, wherein traction and physical therapy will be administered to you. You will be asked to report for physical therapy for around ten sessions—each session lasting for at least one hour. You will be taught how to perform the different physical therapies, and you will continue doing them at home.

Joint pain

If you have been experiencingjoint pain—whether acute or chronic—you need to refrain from having physical exercises. You need to consult a medical doctor first to find out what is your problem, and you will be prescribed with the necessary medications. If the pain is gone, then you can resume your physical exercises. If you insist to do your physical exercises, in spite of your joint pain, then you will aggravate your problem, and it will be harder to treat it.

Sudden weakness of one or more extremities

Sudden weakness of one or more extremities is a symptom that cannot be taken for granted. It could be a symptom of stroke (bleeding in the brain), especially if you have a history of hypertension and you have been taking medications for it—and worse, if you have not been taking medications in spite of knowing that you have hypertension. Immediately, consult a medical doctor so that your medical problem could be diagnosed at once. Refrain from doing your physical exercises because, if you do, you might aggravate your medical condition. Much worse, you will die from it.

Getting tired so easily

If you have been well and good, then suddenly in the last few days you have been experiencing easy fatigability or getting tired so easily, it is possible that your blood pressure has risen. Refrain from doing your physical exercises. Instead, consult a medical doctor, and have your blood pressure checked. If your blood pressure is higher than normal, then your medical doctor will surely prescribe you with the right medications. Take them regularly and faithfully! Once your blood pressure is controlled, you can return to the gym, and resume your workouts.

                                 (To be continued)

 

General guidelines on how to lose weight(2)

Limitation of fats in the diet

Operationalization

TDCR vs. TDCI

In the previous article [Powertec (136)], it was mentioned that your basis of subtracting the 500 calories should be from thetotal daily caloric intake(TDCI); however, in most instances, the computation of TDCI is so demanding and difficult for people, like you, who are on the go to keep up with the demands of daily living. In fact, you might need the help of a nutritionist-dietitian to compute for it.Thus, instead of TDCI, it is thetotal daily caloric requirement(TDCR)which is used.

Assuming that you opted to lose 1 pound per week, then you need to reduce your TDCR by 500 calories per day or 3,500 calories per week. Since you are moderately active, your TDCR should be 157 pounds x 15 giving a product of 2,355 calories; and since you are 38 years old, you need to subtract 100 from 2,355 giving a difference of 2,255[1]. If you have normal weight, the total number of calories that you need to take per day in order to maintain your normal weight is 2,255 calories; this is your TDCR; but since you are overweight, you need to reduce your TDCR by 500 calories per day [consult Powertec (136)for all the necessary tables].

Limitation of fat intake

To fast track your weight reduction, you limit your fat intake to 10% of the TDCR; hence, 10% of 2,255 is 225.5 or 226 calories which is equivalent to 25 grams of fat per day, derived from dividing 226 by 9. You need to take only 25 grams of fat per day which means limiting your fat intake to 10% of the TDCR. This is the smallest amount of fatintake allowable to you; if you take less than 10%, you will suffer from some vitamin deficiencies, especially linked to the fat-soluble vitamins [1].

If you used to take 80 grams of fat per day, but now you are taking only 25 grams per day, then you are reducing your food intake by 495 calories per day derived from multiplying 55 (the difference of 80 – 25) grams of fatby 9 calories. If you multiply 495 by 7 days, then you are losing approximately 3,500 calories per week which could reduce your weight by 1 pound per week. This means that even if you will not reduce your protein and carbohydrate intake, the reduction in fat intake is enough to effect reduction in your weight.

In the preceding example, you limited your fat intake to 10%. If you want to use 20% or 30%, then it is also acceptable; however, you now need to reduce also your protein and carbohydrate intake, enough to give a total of 500 calories of daily reduction in your TDCR.

When you have reached your ideal weight, you now shiftto consumingyour total TDCR which is 2,255 calories. You need to take foods whose total caloric contribution will be 2,255. You do not need to reduce it; otherwise, you become underweight.

Ways of reducing fat intake

  1. Avoid deep-fried and fried foods;
  2. Take fatty meats, lard, butter, cheese, cream, whole milk, egg yolk, vegetable oils, nuts, chocolates, avocados, olives, and margarine [1] in moderate amounts;
  3. When buying packed foods, read the “Nutrition Facts” and find out the saturated fat It should contain less than 10% of saturated fat; and
  4. When buying packed foods, select those not containing trans-fatty acid and hydrogenated fats.

Reference:

  1. Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

General guidelines on how to lose weight(1)

Limitation of fats in the diet

One of the ways of facilitating your weight reduction is to focus on the limitation of fat intake. This is very effective because one gram of fats could give you 9 calories of energy whereas protein and carbohydrates could only give you 4 calories per gram. Thus, if you limit your intake of fats, your losing calories—and subsequently your weight—would be faster than when you solely restrict your protein or carbohydrate intake.

Steps

Determine how many calories you need to maintain your ideal weight. You can look at your ideal body weight in the ensuing Table 1[1]USDA Acceptance Weights for Adults

*The higher weights in the ranges generally apply to men, who tend to have more muscle and bone than women; the lower weights more often apply to women [1].

To find your calorie needs, multiply your ideal weight by 15 if you are moderately active or by 20 if you are very active[1].

From that total, subtract the following according to your age:

                              Age 25-34, subtract 0

                             Age 35-44, subtract 100

                             Age 45-54, subtract 200

                             Age 55-64, subtract 300

                              Age 65+, subtract 400[1]

To find your fat-gram allowance, multiply your daily calories by the percentage of fat desired (10%, 20%, or 30%); then divide by 9 calories/g[1].

Operationalization

Suppose you are male, 38 years old, with height of 5’ 4”,  with present weight of 170 pounds, and moderately active. Firstly, you want to find out if you are overweight, underweight, or with normal weight. So you look at Table 1, and you find out that the maximum weight that you should have is 157 pounds. Offhand, you are overweight by 13 pounds. Therefore, the program that you will need is weight reduction.

Ideally, you need to lose 1-2 pounds per week; thus, if you prefer to lose 1 pound per week, then you will need 13 weeks or approximately three months to normalize your weight. If you want to accelerate your weight reduction, you can target to lose 2 pounds per week, and you need around 6-7 weeks or 1 ½ months.

Before proceeding with the discussion, you need to understand two technical terms: (1) total daily caloric intake (TDCI), and total daily caloric requirement (TDCR). TDCI refers to the actual number of calories that you take each day, while TDCR refers to the number of calories that you should take each day to maintain your ideal weight [Please consult Powertec (20)].

Since you are overweight, it is safe to assume that your TDCI has been very much higher than your TDCR. You have been taking more calories than what you need, or more than what you can burn. Thus, the excess calories are stored and deposited in your body making you heavier than your ideal weight. Therefore, in your weight reduction, the basis of subtracting the number of calories that you need to slice off each day should be from the TDCI.

 

Reference:

  1. Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

Definition of, and lifestyle intervention measures for, prediabetes

Definition

Prediabetes is defined as a medical condition wherein your fasting blood sugar is over the normal values, but you are not yetclassified asdiabetic[1]. It is therefore a stage wherein you are about to enter the population of diabetic patients. While it is true that you are not yet adiabetic, this is the right time to implement some intervention measures so that your medical condition will not get worse and will not be transformed into Type 2 diabetes mellitus, when the management is more complicated and more expensive.

To find out if you are a prediabetic or not, you can request your medical doctor to prepare for you a laboratory order for blood chemistry examination, wherein fasting blood sugar (FBS) is one of the tests. If the result of your FBS is between 70-105 mg/dl, then you have normal values. If the value is equal to or greater than 126 mg/dl, then you might have diabetes mellitus. If the value lies between 105 and 125 mg/dl, then you are a prediabetic.If you are a prediabetic, you can do a number of things so that your condition will not get worse—if not lowering your fasting blood sugar to normal level.

Lifestyle intervention measures

Engage in regular physical exercisesand burn your excess abdominal fat[1]

If your waist circumference is 35 inches or longer if you are a woman or 40 inches or longer if you are a man, it is highly probable that you have abdominal fat which needs to be shed off. (Consult Powertec 112, 113, 114, 115). You need to do some abdominal exercises and regular walking. If you would like to do some other forms of physical exercises that you enjoy, then do them! For as long as you can afford to do a particular physical exercise, you are not restricted to do it because as a prediabetic you really need to have regular and periodic physical exercises. By doing this, you will burn your excess abdominal fatand you will increase the competence of your insulin—a substance needed by your cells to pick up your sugar in the blood.

 

 

Reduce your weight if you are overweight[1]

If you are overweight, then you need to do some dietary and physical exercises programs that will lower your weight. Consult Powertec 20, 21, 22on how to implement these programs. Being overweight predisposes you to acquire Type 2 diabetes mellitus.

Reduce your fat intake[2]

If you are a prediabetic, you need to have dietary modification which includes reduction in yourfat intake. As much as possible, yourfat intake is composed mainly of the unsaturated fatty acids which include both the monounsaturated and polyunsaturatedones. (Consult Powertec 63). You can take some amount of saturated fatty acids, though, because you also need them to maintain your health.

Increase fiber in your diet[2]

If you are overweightand prediabetic, it is recommended thatyou increase the amount of fibers in your diet. Foods rich in fibers are apples, peaches, plums, prunes, bananas, oats, barley, dried peas, beans, lentils, vegetables, brown rice, nuts, and seeds. (Consult Powertec153). If the amount of fibers in your diet is relatively significant, unknowingly, you will reduce the number of calories that you will take in every meal, thereby helping in your weight reduction.

Avoid simple carbohydrates

You need to avoid simple carbohydrates, such as candies, chocolates, cakes, honey, soft drinks, ice cream, and table sugar. Avoid putting sugar in your coffee. If you are very fond of fruits, avoid the sweet ones, such as grapes, mangoes, and pineapple. If you take a lot of simple carbohydrates, your blood sugar will immediately rise up.

 

References:

  1. http://www.mayoclinic.org/diseases-conditions/prediabetes/basics/definition/con-

20024420

  1. Pratley RE, Matfin G. Pre-diabetes: clinical relevance and therapeutic approach. British Journal of Diabetes and Vascular Diseases. 2007;7(3):120-129.

http://www.medscape.com/viewarticle/562039_8

The relationship between saturated fatty acids and cholesterol

Medical importance of saturated fatty acids and cholesterol

In the development of diseases of the heart and blood vessels, otherwise known as cardiovascularproblems, two substances take the center stage. These are: (1) saturated fatty acids, and (2) cholesterol. Their relationship on how they could possiblywreak havoc toyourcardiovascular system will be examined in this article.

Unhealthy alliance between the saturated fatty acids and cholesterol

Biochemically, saturated fatty acids promote the formation of the so-called very lowdensity lipoproteins (VLDLs) which containrelatively more cholesterol, and they are used by the body at slower rate than the bigger lipoproteins [1]. Since theVLDLsare not immediately used by the body, the cholesterol molecules that they are carrying willbe depositedin the peripheral tissues instead, leading eventually to diseases in the heart and blood vessels.

The strongest link between saturated fatty acid and cholesterol has been established by some epidemiological studies wherein it was found out that high intake of saturated fatty acids led to increased level of the low-density lipoprotein (LDL) cholesterol[2]which is considered as “bad” because it brings and deposits cholesterol in the peripheral tissues, such as the muscles and blood vessels—among other organs.

To avoid the unhealthy effects of saturated fatty acids, therefore, it is recommended that they should be substituted with unsaturated fatty acids in the diet[1]. In Powertec (63), concreteexamples of the different sources of each type of fatty acid were written; all you have to do is to take more of the foods containingunsaturated fatty acids and less of the saturated ones.

It has to be emphasized, however, that total and absolute removal of saturated fatty acids from the diet is not recommended because if that is resorted to, you may experience some forms of chronic diseases which could be due to lack of intake of saturated fatty acids. There are different kinds of saturated fatty acids, and until now there are still questions on how each one contributes to the maintenance of your health. It is unwise, therefore, that you completely remove them from your diet[2].

 

Recommended apportionment of your food groups

To meet your daily energy and nutritional requirements—and thus reducing your risk of developing chronic deficiency disorders—the National Academies Institute of Medicine recommends the following breakdown of apportioning the different food groups as sources of your energy: 45-65% of your calories must come from carbohydrates, 20-35% from fat, and 10-35% from protein[2].

To give you hint on how you could implement the aforestated recommendation, it is necessary and highly recommended that you undergo blood chemistry examination, complete blood count, and urinalysis. You may consult your medical doctor, and request him to prepare laboratory order for you. Submit this order to any certified medical laboratory so that the tests will be performed. Upon receiving the results, you go back to your medical doctor for his prescriptions and/or advise.

Nutritionally, however, if the level(s) of your cholesterol and/or triglycerides is/are high, then limit your fat intake to 20%, instead of the maximum recommended value of 35%. In addition, as much as possible, that 20% of fat should consist mainly of the unsaturated fats—which could be in the form of monounsaturated or polyunsaturated fats {Consult Powertec (63)}.

If the level(s) of your cholesterol and/or triglycerides are normal, your blood pressure is normal, and your liver enzymes (SGPT and SGOT) are normal, you can afford to take dietary fat at a maximum level of 35%.To help you prepare your diet, you can consult a certified nutritionist-dietitian. He/she can help you select the proper kind and quantity of foods that you need to take to meet the 20% or 35% of fat in your diet.

 

References:

  1. Murray, Robert K., Daryl K. Granner, Peter A. Mayes, and Victor W. Rodwell. Harper’s Biochemistry. Appleton and Lange: Stamford, Connecticut, 2000.
  2. Bruce J, Dillard, CJ. Saturated fats: what dietary intake? The American Journal of Clinical Nutrition. September 2004;80(3):550-559. http://ajcn.nutrition.org/content/80/3/550.full#sec-17.

Nutritional guidelines to prevent heart diseases(Part 2)

Limit your intake of salt

As mentioned and discussed in Powertec 152, increased intake of salt during yourelderly life may increase your blood pressure (hypertension) because your kidneys could not eliminate as much salt as they used to be from your body. When you start to experienceit and it remains unchecked and untreated for several number of years, your heart enlarges, and you have what is called in medicine as cardiomegaly. When you have this medical condition and still you refuse to take the necessary medications or fail to take them, your heart will eventually fail, and you have the condition medically known as heart failure. You may die from it.

It is clear from the preceding section that too much intake of salt from your diet could lead to a heart disease; therefore, immediately after knowing that you cannot afford to take excess salt, you need to exert extra caution and effort in determining which food(s) to take and not to take.

Increase your intake of foods rich in fiber

Beneficial effects

Dietary fibers are substances present in foods which are not digested in your gastrointestinal tract (GIT). This means that they stay in, and pass through, your GIT without being digested and transformed into another substance. They remain as they are, without contributing any substance, vitamins, or minerals to your body. However, they have the following important functions:(1) they increase the bulk of your stool, leading to promotion of your bowel movement, and thus preventing constipation and colon cancer, (2) prevent the absorption of cholesterol, which is incriminated as one of the causes of diseases in your heart and blood vessels[1], and (3) lower the total food calories that you will take each daycausing you to lose weight and have lower blood glucose.

Since the fibers remain undigested in your GIT, they form greater portion of your stool; since your GIT is sensitive to the volume of your stool, the bulkier your stool is, the more your GIT will contract, and your stool will be finally squeezed out into the outside. Hence, if you have on and off constipation, taking adequate amount of fibers daily will help you overcome it. When you have regular bowel movement, the time contact between your stool and the inner lining of your intestine is shortened. With this, the chance that your food—which could be an unhealthy food—willinduce the start of cancer in your intestine will be lessened. Hence, you will be protected from it. In addition to your protection from constipation and cancer, fibers will help you avoid being overweight and having high blood glucose. These take place because more fibers in the diet will make you feel full from the food that you have been eating sooner than when there are no adequate fibers.As a result, you will eat less than when your diet is fiber-free.

Types of fibers

Although dietary fibers could not be digested, some of them could be dissolved in water, while others remain undissolved. Hence, there are two types of fibers: (1) water-soluble, and (2) water-insoluble. Examples of each type are listed in Table 1 below:

Food sources of dietary fibers                             (End of a series of 2)

Reference:

  1. Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

Nutritional guidelines to prevent heart diseases(Part 1)

Eat foods low in saturated fat and cholesterol

The quantity and quality of foods that you take play a great role in the development of medical problems, such as heart diseases, andit has been established in several researches that foods rich in fatsand cholesterol are notorious and paramount in doing so. However, only the saturated fatshave been found to contribute in the development of heart diseases—and not all forms of fats. The so-called unsaturated, consisting mainly of themonounsaturated and polyunsaturated fats, are not incriminated as possible causes of the said diseases; therefore, they can be taken in moderate amounts.

Cholesterol is a fatty substance (lipid) which is either produced in the body or taken from foods. Biochemically, they can be formed in your body from saturated fats that you have previously taken in. This is the reason why you are often advised to limit your intake of red meat, such as beef, pork, and lamb, because they contain a lot of saturated fats. Another way of having increased cholesterol in your body is taking a lot of foods rich in it, such as quail and chicken eggs, animal-derived cooking oil, cookies and butter, and many more.

To help you avoid taking foods rich in saturated fat and cholesterol, every time you buy a packed food from a supermarket or a store, always look at the “Nutrition Facts”, and find out the saturated fat and cholesterol contents of the food stuff. Select the foods that contain the least amount of saturated fat and cholesterol. Therefore, it is not advisable that you go shopping for foods with very limited time to do it! Allot adequate time for your shopping, especially if your intention is to buy foods for yourself and your family members.

Limit your intake of salt

As you grow older, the capacity of your kidneys to eliminate excess salt that you took in from your diet is decreased. For this reason, you will reach a certain age wherein you retain unwanted salt because your kidneys could not eliminate them. When the concentration of salt in your blood is higher than what is normally needed, water which is normally inside your different cells will now enter your blood vessels, and this movement of water will increase your so-called intravascular volume—the blood volume inside your blood vessels—leading to increase in your blood pressure. Thus, when you realize that you cannot afford to take in more salt than what you used to do, limit your salt intake.

There are many ways of avoiding taking in more salt that what you need. Firstly, avoid eating out as much as possible. The reason for this is that you cannot control the amount of salt that is mixed in your meals in the restaurants and other establishments which cater to serving foods to customers, in contrast to what is cooked at home wherein you could instruct your cook to limit the amount of salt admixed in it. Secondly, if you are eating out and find out that the food(s) you ordered is(are) very salty, discontinue taking it (them)! It seems that you would be wasting money when you do it! However, it is good for your health, and it will prevent you from having your blood pressure increased! Thirdly, whenever you buy packed food, always look at the “Nutrition Facts”, and look at the salt or “sodium” content. Select food(s) with the least amount of salt—less than 7% as much as possible. Expect, however, that when you are buying processed food(s), that the salt content is relatively high; thus, as much as possible, resort to buying fresh foods and cook them at home—if needed.

(To be continued)

Health benefits from eating broccoli

Nature of broccoli

Broccoli belongs to the family of cruciferous vegetables. Brussel sprouts, cauliflower, and cabbage are some of its close relatives in the said family. Although it containslow calories, it is rich in essential vitamins and minerals, aside from having significant quantity of fiber. A cup of the vegetable provides vitamin C equivalent to an amount coming from an orange. It also contains vitamins B1, B2, B3, B6, iron, magnesium, potassium and zinc [1].

Health benefits

Fighting cancer

A number of literature have claimed that taking broccoli willprevent the development of cancer. This effect is attributed to the substance sulforaphane which broccoli contains in high quantity. Based on research findings, sulforaphane could inhibit the enzyme histone deacetylase (HDAC) which has been incriminated to promote the progression of cancer cells.Hence, all foods containingsulforaphane could possibly impede the growth of cancer[2].

Based on epidemiological studies, apopulation who has been taking a lot of cruciferous vegetables, such as broccoli, has low incidence of cancer. In addition, based on in-vitro and animal studies, it was found out that phytochemicals, such as sulforaphane, reduce the frequency, size, and number of tumors [3].

Improving bone health

If your intake of calcium is low, you will be prone to suffer from bone fractures. This happens because you at the same time have low intake of vitamin K which promotes the absorption, and reduces the urinary excretion, of calcium. If you take one cup of chopped broccoli, you receive 92 micrograms of vitamin K and 43 milligrams of calcium [2], thereby protecting you from bone fractures.

Looking younger

Frequent intake of broccoli makes you look younger. This is attributed to its high content of vitamin C which is a very essential antioxidant, fighting skin damages caused by too much exposure to the elements, such as the sunray andvarious air pollutants. When you take a lot of vitamin C, wrinkles on your face will be reduced and the overall skin texture will be improvedbecause vitamin C promotes the production of collagen which serves as the supporting structure of your skin. Unknown to most of you, broccoli provides 81 milligrams of vitamin C per one cup of the vegetable. Hence, good source of vitamin C is not solely confined to the citrus fruits[2].

Improving digestion and natural detoxification

Broccoli contains a lot of fibers necessary to provide bulk in your stool. With this condition, your bowel movement becomes regular, and constipation is prevented. Consequently, different kinds of toxins produced in your large intestine—and which could have been absorbed—are regularly eliminated, preventing the development of colon cancer which is attributed to thesetoxins[2].

Preventing the occurrences of chronic diseases

Increased fibers in the diet, brought about by increased intake of broccoli, will also lead to the prevention of coronary heart diseases, stroke, hypertension, diabetes, and gastrointestinal diseases. It will also lower the levels of blood pressure and cholesterol. Since adequate intake of dietary fibers will ultimately lead to decrease in your total caloric intake, your weight may go down as well, helping you to reduce your weight [2].

Cooking broccoli

Cooking broccoli is not that hard and difficult. After cutting off the heads from the main branch, you wash them, and you can start cooking with water steam. In short, the vegetable is not mixed with, and submerged in, water; rather, it is the steam coming from the water that will cook it. However, if you want to improve the taste, you can cook the vegetable with a little water, then add shrimps, or meat, or sliced squid which was previously sautéed.

References:

  1. http://www.healthyeating.org/Healthy-Eating/All-Star-Foods/Vegetables/Article-Viewer/Article/91/health-benefits-of-broccoli.aspx
  2. http://www.medicalnewstoday.com/articles/266765.php
  3. http://www.phytochemicals.info/phytochemicals/sulforaphane.php

What is endothelium?(Part 4)

Ways of preventing injury to the endothelium

Avoiding or stopping smoking

One of the products of smoking is nicotine, and this substance injures the endothelium which ultimately leads to atherogenesis. Specifically, smoking promotes the oxidation of the low-density lipoprotein (LDL) which—aside from decreasing the concentration of nitric oxide {Consult Powertec (149)}—promotes the migration of the white blood cells (monocytes) in the midst of endothelium, thereby injuring it[1]. Hence, avoid, or stop, smoking as soon as possible.

Simplified steps in protecting your endothelium

  • Consult a medical doctor and have your blood pressure checked;
  • If your blood pressure is elevated, your medical doctor will prescribe youwith medication(s). If so, take them regularly. After two weeks or one month, go back to your medical doctor, and have your blood pressure checked again. If your blood pressure is still high, he will add another medication. If already controlled, he will advise you to continue your medication(s);
  • If you have elevated blood pressure, aside from giving you the necessary medication(s), your medical doctor will request you to have blood chemistry examination, complete blood count, and urinalysis.The blood chemistry examination will consist of the fasting blood sugar, blood urea nitrogen, creatinine, uric acid, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the lipid profile. The lipid profile, in turn, will consist of the total blood cholesterol and triglyceride, high-density lipoprotein, low-density lipoprotein, and the vey low-density lipoprotein;
  • The lipid profile test is very important because it will tell you if you need additional medication(s). If your total cholesterol, and/or your total triglyceride, and/or your LDL cholesterol is (are) high, you need to take drug belonging to the statins. If the predominant elevation falls on the triglycerides, you need to take drug under fenofibrates;
  • If your fasting blood sugar is elevated, it is possible that you are suffering fromdiabetes mellitus. Initially, your medical doctor may design for you dietary therapy and try it for some months. If it does not work after giving a try, you will be prescribed with anti-diabetic drug(s).
  • If your blood pressure is elevated and/or you have abnormalities with your blood lipids and/or your blood sugar is elevated, you need to be very careful with your diet. Avoid high salt and high fat diet. Avoid taking simple carbohydrates like candies, chocolates, sugar, ice cream, and soft drinks. Limit your intake of rice to one cup per meal, and take a lot of foods rich in fibers, such as corn, vegetables, fruits, and cereals;
  • Have a regular and periodic physical exercises. If you are over 50 years old, a 30-minute walking, three times per week, will do you a lot of good! If you are below 50 years old, you can do more than what is prescribed for the elderly. In addition to walking, you can run and you can do bicycling;
  • Stop, or avoid, smoking.

Implement preventive measures with dispatch

The secret of successful preventive measures is to implement them as early as possible. The moment you realized that you have hypertension, and/or hyperlipidemia, and/or diabetes mellitus, you need to start implementing all the measures that have been enumerated in the preceding. The reason for this is that as you withhold doing the preventive actions, complications of the disease have been setting in. Physically, you will not feel it (them)! However, in the recesses of your different organs, such as your heart, kidneys, and blood vessels—be it small, medium, or large—structural destructions have been going on! By the time you want to do something, it is too late! Hence, act without delay!

(End of a series of 4)

Reference:

  1. Powell JT. Vascular damage from smoking: disease mechanisms at the arterial wall. Vasc Med. 1998;3(1):21-8.http://www.ncbi.nlm.nih.gov/pubmed/9666528.

What is endothelium?(Part 3)

Ways of preventing injury to the endothelium

Correcting yourhigh level of LDL-cholesterol

It has been reported that if the level of your LDL-cholesterol is very much above the normal ranges, the production of nitric oxide (NO) by your endotheliumwill be reduced[1]. When this takes place, the following complications will follow {other complications were discussed in Powertec (148)}:

Leukocyte adhesion[1]

As mentioned inPowertec (148), there are three types of cells in the blood. One type of these cells is called the white blood cells (WBCs). The WBCs are also called the leukocytes.When the production of NO is depressed, the adhesion of leukocytes to each other and to other substances is very much increased, conducive to the formation of clots and plugs that will obstruct the passageway of blood. In fact, this change in the property of the leukocytes will further accelerate the formation of the so-called plaques which attach themselves in the endothelium, leading to the narrowing of the tubular blood vessels.

Oxidative stress[1]

When the LDL-cholesterol is oxidized, the formation of the substance called caveolin-1 leads to decrease in the concentration of NO. This biochemical mechanism has been considered as the initial and primary cause of atherosclerosis. Since NO is known to prevent the oxidation of LDL-cholesterol, its availability in your blood should always be high. If its level is low and the level of yourLDL-cholesterol is high, the probability that the lipoprotein will be oxidized is high. Thus, the level of yourLDL-cholesterol should always be checked and controlled.

Drug of choice to correct your elevated LDL-cholesterol

To correct your high level of LDL-cholesterol, your medical doctor will prescribe you with a class of drug known as statins. Generic names belonging to this class of drug are rosuvastatin, atorvastatin, and fluvastatin—to mention some. Your medical doctor needs to prescribe you with this class of drug because statins have been found to not only lower your LDL-cholesterol but it has other beneficial effects for the improvement of your endothelial function[1].

 

Correcting your blood sugar

The other disease which could be injurious to your endothelium is diabetes mellitus (DM)[3]. If you have DM, your blood sugar is very much increased—also called hyperglycemia in medical parlance. As much as possible, when you have detected for the first time—with the help of your medical doctor—that your blood sugar is increased, that you have immediately taken action to correct it. If your medical doctor prescribed you with a certain drug, or set of drugs, you should have taken them regularly and religiously.If your blood sugar is left unchecked for a considerable number of years, it will enhance the attachment of plaques in your endothelium, leading to the development of atherosclerosis, hypertension, and other cardiovascular complications of diabetes. However, up to the present time, a detailed explanation, in terms of biochemical and cellular connections, between high blood glucose levels and complications in the cardiovascular structures remains incompletely understood [2].

While there has been no clear and detailed explanation on the link between hyperglycemia and endothelial dysfunction, it is known that in diabetic state there is an increased tendency for oxidative stress and oxidation of lipoproteins, especially the LDL-cholesterol[2]. As mentioned in the preceding, these two factors have been established as possible causes ofNO depletion. Hence, hyperglycemia has a big role in the destruction of endothelium, and there is a need to control it.

The simplest way to find out if your diabetes has more or less adversely affected the competence of your endothelium is to request for urinalysis. If protein, specifically albumin, is detected in your urine, it is possible that endothelial dysfunction has started[2], and you really need to control your blood sugar.

(To be continued)

References:

  1. Davigon J, Ganz, Peter. Atherosclerosis: evolving vascular biology and clinical implications, role of endothelial dysfunction in atherosclerosis. Circulation. 2004;109: III-27-III-32. doi: 10.1161/01.CIR. 0000131515.03336.f8.
  2. Hadi H, and Suwaidi J. Endothelial dysfunction in diabetes mellitus. Dovepress, Vascular Health and Risk Management. 2007;Dec; 3 (6):853-876.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2350146/

  1. Preston RA, WencheJy, Jimenez, JJ, Mauro, LM, Horstman, LL, Valle, M, Aime, G, and Ahn, YS. Effects of severe hypertension on endothelial and platelet microparticles. Hypertension. 2003;41:211-217. doi: 10.1161/01.HYP.0000049760.15764.2D.