Prevention of Stroke(Part 2)

Prevention 

Have medical check-up regularly

Even if you have not been experiencing a medical problem in the last few months or years, it is necessary that you see your physician for medical check-up. In this process, one of the things that he will evaluate is the condition of your heart. He could listen to your heart sounds, and he could find out if you have the so-called atrial fibrillation (AF). If he suspects that you have AF, he will request for electrocardiogram (ECG) test, and it will confirm if you really have the said problem. If so, your physician will either give you medicine to control your AF, or he will refer you to a cardiologist. There is a need to control your AF because, as mentioned in the preceding, it could cause stroke due to cerebral embolism.

Have your blood pressure checked regularly

As mentioned in the preceding, your blood vessels in the brain are so thin that they cannot withstand high blood pressure. Thus, it is necessary that you must check your blood pressure regularly. If elevated and above the normal values, you need to take some medications. During your medical check-up, bring up the matter to your physician for proper and necessary prescriptions. You need to control your blood pressure at all times to avoid having stroke due to ruptured blood vessel in the brain.

Have annual evaluation of your blood chemistry

In your medical check-up, one of the important things that your physician will request you to do is to have blood chemistry examination. The basic components of this test are: fasting blood sugar, blood urea nitrogen, blood creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood uric acid, and the lipid profile test which determines the levels of your cholesterol, triglycerides, high-density lipoprotein, and low-density lipoproteincholesterol. Under the topic of preventing stroke, however, the most important  components of blood chemistry that you need to pay attention to are the fasting blood sugar and the lipid profile. If you have a family history of diabetes mellitus, you should know the level of your fasting blood sugar annually, and keep track of the trend. If it increases every year, then you need to alter and modify your lifestyle, such as your diet and your daily physical exercises.Under the lipid profile test, you should know the level of your blood cholesterol; and if it is elevated, consult your physician for dietary advice and prescription(s) of necessary drugs.

Refrain from smoking

Cigarette smokinghas been scientifically established as the root cause of several medical problems, such as cancer in the lungs. In relation to stroke, however, it has been established, too, that it accelerates the development of the so-called atherosclerosis, which is the deposition of fatty substances along the inner lining of your blood vessels. Consequently, you will develop hypertension which could lead to stroke. If you have not started smoking yet, never start doing it. If you have been smoking, stop the habit as soon as possible.

Refrain from taking high-salt and high-fat diet

If youtake meals and foodsrich in salt, or sodium, your blood pressure will rise up—much more if you are over 40 years old. Thus, before you take any food item, especially the packed ones, look at the sodium content listed on the pack.  If it is greater than 7%, avoid taking that food(s). If you have been eating in a restaurant, then you find that a certain recipe is high in salt, stop taking that food! Your blood pressure may also rise up if you take  foods rich in fats. Hence, avoid them.

(To be continued)

Prevention of Stroke (Part 1)

Definition

Your brain needs a lot of oxygen and nutrients being carried by your blood, and your blood reaches it through a network of blood vessels which  serve as its passageways.  When one of these passageways is blocked, thereby preventing the arrival of blood in a certain area of yourbrain, stroke takes place. Deprivation of blood is not the only cause of stroke. When a particular blood vessel in your brain ruptures, and the blood goes into its substance,  this is also called stroke.

Types of stroke

Due to cerebral thrombosis

Your blood vessels in the brain are not spared from the deposits of cholesterol and other forms of fats. If you are prone to having these deposits, all your blood vessels will have the same tendency to have them. Hence, when the opening of your blood vessel in the brain is narrowed by these deposits which have been accumulating for years, these blood vessels are prone to be blocked by blood clots which have been traveling in your bloodstream. Since the opening of the blood vessel is narrowed, it could easily be plugged by a clot which had been admixed with your blood.  With the blockage, blood could not pass through, and a certain area of your brain is suddenly deprived of blood, resulting in stroke, which is now considered as due to a cerebral thrombosis. Had it not been for the narrowed blood vessel, stroke could not have happened.

Diagrammatic representation of a blood vessel in the brain which has been deposited with cholesterol and fats (A) and then a blood clot that plugs its opening (B). Figure 1. Diagrammatic representation of a blood vessel in the brain which has been deposited with cholesterol and fats (A) and then a blood clot that plugs its opening (B).

Due to cerebral embolism

While your brain is left undisturbed for so many years, in other parts of your body, blood clots may have been formed. Some of these are attached to the inner structures of your heart.When your heart is behaving properly, they remain where they are, without producing any trouble at all. However, when it suddenly misbehaves, its rhythm is greatly disturbed that it is now out of sync. Consequently, its pumping becomes erratic and produces vibration that it is now medically described as fibrillating. When this takes place, blood clots from its inner chambers are thrown out in the blood which goes into circulation. When these blood clots reach the brain, they could block a blood vessel, resulting in stroke which is due to a cerebral embolism.

Figure2.Diagrammatic representation of a blood vessel in the brain which was never deposited with cholesterol and fats (A) but then a blood clot arrives plugging its opening (B). The diameter of the opening decreases as its location moves away from the heart—hence, very much prone to plugging.

Figure2.Diagrammatic representation of a blood vessel in the brain which was never deposited with cholesterol and fats (A) but then a blood clot arrives plugging its opening (B). The diameter of the opening decreases as its location moves away from the heart—hence, very much prone to plugging. 

Due to ruptured blood vessel

The wall of the blood vessels in your brain is very thin. This structural design is meant to allow easier transfer of oxygen from the blood to yourbrain and the transfer of carbon dioxide from yourbrain to the blood. In short, it is meant to allow easier exchange of gases. With this design, however, it cannot withstand high blood pressure. Thus, it is necessary that you always maintain your blood pressure at normal level because if you do not, a blood vessel in your brain could rupture, and you will suffer from stroke.

Figure 3. Diagrammatic representation of a normal blood vessel in the brain (A) and the ruptured blood vessel in (B) where the blood goes out  through the leakage.

Figure 3. Diagrammatic representation of a normal blood vessel in the brain (A) and the ruptured blood vessel in (B) where the blood goes out  through the leakage.

(To be continued)

What is metabolic syndrome?(Part 4)

Management

Changes in lifestyle

The underlying factors that contribute to the development of MS are obesity, physical inactivity, and atherogenic diet[1]. If you analyze closely   the three factors, they can be mitigated by lifestyle changes, such as engaging in more physical exercises, taking the right number of food calories,  and shifting to non-atherogenic diet. Some of these were discussed in Powertec (170).

Attain ideal body weight

Depending on your height, sex, and degree of physical activity, you have what we call as the ideal body weight (IBW). IBW refers to your body weight which is good for your health. If your weight is higher than your IBW, then you can be classified as overweight. If less than yourIBW, then you can be categorized as underweight. Being overweight or underweight is bad for you! You need to correct it as soon as possible! In line with the present topic, being overweight is more of your concern because it will lead to obesity, or you have been obese for some time now. If you are obese, then you are prone to develop metabolic syndrome (MS).

The first step then is to find out if you have the right body weight by computing for your IBW. The formula to be used in computing for this is well discussed in Powertec (20). If you are overweight, you need to shed off your excess weight through physical exercises and modification of your diet. The different methods of doing these strategies are well discussed in Powertec (21 and 22).

Treating and preventing  aggravating diseases

If you have elevations of  LDL-Cholesterol, blood pressure, and glucose, then treatments need to be directed to these abnormalities. If you still do not have medical doctor at this stage, then you need to find one. Look for a  family doctor for initial evaluation and management; and if hefinds  that you need to be referred to other medical doctors, he might advise you to see a cardiologist  and/or an endocrinologist. If your problem is more on the LDL-Cholesterol and blood pressure, he might refer you to a cardiologist. If you have elevation of blood glucose, he might refer you to an endocrinologist. More often than not, especially if you were caught at the earlier stage of the diseases, your family doctor could very well manage your problems.

If your fasting blood glucose  is still normal, then you need to observe dietary regimen geared  towards the prevention of  diabetes. Firstly, avoid simple sugar and take more of the complex carbohydrates with fibers, such as bread and brown rice. Secondly, take more of vegetables and fish. If your blood pressure falls in the borderline values, then avoid meals high in  salt and fat. Avoid saturated fats which are  found in meat and cooking oil derived from animals. In addition, avoid trans fats which are found in cookies, doughnuts, and frozen pizza. You can read more on transfatsby consulting Powertec (103, 104, and 105).

Implications of MS

The recognition of MS at the earliest possible time is of utmost importance because, if unchecked and untreated for a considerable period of time, it will lead to heart diseases, bleeding in the brain (stroke), or diabetes. To avoid having these complications,   you should reduce your weight if you are overweight, increase your physical activity, and  eat a heart-healthy diet which is rich in whole grains, fruits, vegetables, and fish. In addition, you need to take medications to control your blood pressure, blood cholesterol and triglyceride levels, and your blood sugar[1].

(End of a series of 4)

Reference:

  1. AHA/NHLBI Scientific Statement. Diagnosis and Management of Metabolic Syndrome. http://circ.ahajournals.org/content/112/17/2735.full

What is metabolic syndrome?(Part 3)

Diagnosis

There are several ways of diagnosing metabolic syndrome (MS). However, the criteria being used by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III, otherwise known as ATP III, starting in 2001 is the simplest and best understood. In this criteria, if you have 3 of the 5 abnormalitiesfound in MS, then you can be considered as suffering from the syndrome[1]. This means that if you will not seek medical consultation as soon as possible, you may suffer and die from the so-called atherosclerotic cardiovascular disease (ASCVD), such as heart attack (myocardial infarction) and bleeding in the brain (stroke). These medical problems could kill you; therefore, if you are diagnosed as having MS, your medical condition needs periodic medical attention and your utmost cooperation.

ATP IIImentioned the following abnormalities as the components of MS:

  1. Abdominal obesity
  2. High triglycerides in the blood
  3. Low HDL-Cholesterol
  4. High blood pressure
  5. High fasting blood sugar.

If you have at least 3 of the above abnormalities, then you are suffering from MS[1].

Management

Changes in lifestyle

The underlying factors that contribute to the development of MS are obesity, physical inactivity, and atherogenic diet. If you look closely at the three factors, they can be mitigated by lifestyle changes, such as engaging in more physical exercises and shifting to non-atherogenic diet.

Increase physical activities

It is a well-known fact that physical exercises are needed by your body. If you engaged in it, among other beneficial effects, your high blood pressure will go down, and your body weight will not increase that much as compared to not having physical exercises at all. By not having excess weight, you will be removing one of the components of MS which is abdominal obesity.

The least that you can do is to have walking for at least 30 minutes—daily. If you cannot do this, then you need to contrive on having physical exercises, such as parking a little bit far from your point of destination, then walk! Have shopping then while transferring from one place to another, you do a brisk walking! You can think of other ways of giving yourself physical exercises. However, ensure that you can afford to do them.

Shift to non-atherogenic diet

A diet is said to be atherogenic when it is rich in saturated fats (SFs). They are found in meats, coconut, palm oil, palm kernel oil, butter, egg yolks, milk, and milk products (except fat-free) [2]. It has been established from researches that if your diet is high in SFs, the level of your low-density lipoprotein (LDL) cholesterol is also high [3]. You should remember that LDL cholesterol is also known as the bad cholesterol, because it carries cholesterolmolecules away from   your liver and deposit them to far-away structures, such as the blood vessels. When LDL cholesterol is deposited in the internal lining of the blood vessels, atherosclerosis takes place, and the blood vessels become inelastic, leading to the development of hypertension. {You can read on Powertec(144)}.

Thus, you need to avoid taking a lot of foods rich in SFs; instead, shift to the monounsaturated and polyunsaturated fats which are found in canola oil, olive oil, peanut oil, nuts, avocados, sardines, safflower oil, soybean oil, sunflower oil, soybeans, tofu, and fish [2]. Hence, you need to use the cooking oil as prescribed and stated in the preceding so that you will take more of the unsaturated fats (monounsaturated and polyunsaturated). In a nutshell, avoid using cooking oil derived from animals and take more of fish, instead of meat. {You can read on Powertec (63)}.

(To be continued)

References:

  1. AHA/NHLBI Scientific Statement. Diagnosis and Management of Metabolic Syndrome. http://circ.ahajournals.org/content/112/17/2735.full
  2. Roth, Ruth. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.
  3. Siri-Tarino, P., et. al. (2010). Saturated fatty acids and risk of coronary heart disease: modulation by replacement nutrients. http://www.ncibi.nlm.nih.gov/pmc/articles/pmc2943062/

What is metabolic syndrome?(Part 2)

Causes

Overweight and obesity[1]

If you are overweight and obese, very likely, you will developmetabolic syndrome(MS). Hence, you need to compute for your ideal body weight (IBW) every now and then so that you will know if your weight is falling beyond the normal and accepted figures; if overweight, you need to shed off some of your weight. The formula to be used in computing for your IBW is discussed in Powertec (20).

Inactive lifestyle[1]

Inactive lifestyle—that is, you lack physical exercises for a long time—will also lead to the development of MS. The reason for this is that if your life is largely sedentary, you will gain weight and become overweight.

Insulin resistance[1]

Normally, when you take your foods rich in carbohydrates, the glucose level in your blood rises. Consequently, your insulin which is responsible for the cellular absorption of your glucose will also increase. With the action of your insulin, the glucose molecules enter your cells, and it will be used as source of energy. If there is insulin resistance, your cells will not positively react to the presence of glucose even if insulin is around and available. Hence, glucose is not absorbed by your cells[2].

Age[1]

As you grow older, the possibility that you will develop MS increases.This is one of the factors that you cannot control. Therefore, if you have been having hypertension since the middle period of your life, and if you have been gaining weight, you might develop it.

Genetics[1]

Your predisposition to develop MS is also beyond your control. Among its causes,insulin resistance is one of the genetically acquired. It runs in your family; hence, if one or more of your siblings has(have) it, you will, by and large, develop it,too. As early as possible, submit yourself to some laboratory tests.

Excessive blood clotting[1]

There are indications that when you have excessive blood clotting, you are prone to have MS. Thus, if there were occasions in medical settings beforethat you were found to have this medical disorder, search for the indications of other components of MS because, by and large, you have them, too.

Low-grade inflammation throughout the body[1]

When you have inflammation in a certain part of your body, such as in your knee joints, you will experience pain; depending on its severity, you will correspondingly experience a particular intensity of pain—the more severe it is, the more painful it will be. In the case of MS, you have been experiencing low-grade inflammation throughout your body, but   you may not be able to feel and experience the pain; instead, some complications have been taking place in your different organs. With generalized inflammation, the small blood vessels—known as coronary arteries—in your heart may have been reacting to it, and the diameter of their openings may have been reduced, promoting the occurrences of heart attack or myocardial infarction. Your kidneys may also react to the inflammation, and their filtrating structures, known as glomeruli, may be damaged. Since it is generalized, no part of your body would be spared from its adverse effects.

Others

The following may also cause MS: fatty liver, polycystic ovarian syndrome, gallstones, breathing problems during sleep. Right now, these possible causes of MS are still under investigation[1].

Symptoms

The symptoms of metabolic syndrome are related to its complications. Hence, if you already have hypertension, you may experience headache and dizziness; if diabetes has been present, you may experience frequent urination, weakness, and thirst[1]; if the increased levels of triglycerides and cholesterol have taken their toll, you may experience chest pain upon exertion.

(To be continued)

References:

  1. National Heart, Lung, and Blood Institute, US Department of Health and Human Services. http://www.nhlbi.nih.gov/health/health-topics/topics/ms/causes
  2. Mayo Clinic, Diseases and Conditions, Metabolic Syndrome. http://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/basics/definition/con-20027243

What is metabolic syndrome?(Part 1)

Definition

Metabolic syndrome (MS) refers to a medical condition wherein you have a combination of abnormal findings in your health profile. These are: 1. increased blood pressure{systolic blood pressure of 130 millimeters of mercury (mmHg) or greater, or diastolic blood pressure of 85 mmHg or greater}, 2.a high fasting blood sugar {100 mg/dl or greater}, 3.excess body fat around the waist {waist circumference of 40 inches or over in men, and 35 inches or over in women}, 4. the level of HDL cholesterol is less than 40 mg/dl in men or less than 50 mg/dl in women, and 5.abnormal triglyceride levels {150 milligrams per deciliter of blood (mg/dl) or greater}. To label you as having MS, you should have at least three of these abnormalities in your medical profile[1,2].

Stricter definition

Based on the report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition, however, there were six components of MS which were identified. These are (1) abdominal obesity, (2) atherogenic dyslipidemia, (3) raised blood pressure, (4) insulin resistance with or without glucose intolerance, (5) proinflammatory state, and (6) prothrombotic state[3].

Abdominal obesity[3]

This refers to the increased waistline circumference as described in the preceding.

Atherogenic dyslipidemia[3]

When a substance is considered as atherogenic, this means that it can be deposited along the internal lining of your   blood vessel wall. When this takes place, your blood vessels become inelastic and rigid that eventually your blood pressure increases. Thus, as much as possible, these substances (cholesterol and triglycerides) need to be at normal levels in your blood in most of the times.

In the cholesterol profile, the factor which is more important is the level of the so-called HDL-cholesterol which is otherwise known as the “goodcholesterol. This is considered as “good” because it is responsible for the reverse cholesterol transport whose main function is to carry allcholesterol molecules from the different organs of your body back to the liver for elimination. If this is low, more cholesterol stays in your peripheral circulation, promoting possible attachment in the internal lining of your blood vessels. This becomes an atherogenic factor which should be addressed at the soonest possible time.

Raised blood pressure[3]

This refers to the elevation of your blood pressure as described in the preceding. Have your blood pressure checked regularly. When you find out that it is elevated, you need to consult your medical doctor for proper medication(s). It has to be lowered as soon as possible so that complications will not set in.

Insulin resistance [3]

The substance responsible for the absorption of glucose in your cells is the protein known as insulin. If you are suffering from MS, glucose is no longer sensitive to the action of insulin. Thus, in spite of having enough concentration of insulin in your cells, glucose is not absorbed and therefore not used.

Proinflammatory state[3]

If you are obese and your C-reactive protein (CRP) is elevated,aside from having inflammatory diseases, such as rheumatoid arthritis, it is greatly possible that you have MS. There are a number of causes of the CRP elevation, but obesity is one of the causes because excess adipose tissue releases inflammatory substances that will cause elevation of CRP[3].

Prothrombotic state[3]

When your plasma plasminogen activator inhibitor (PAI)-1 and your fibrinogen are elevated[3], then very likely you have MS. These are additional substances which indicate that some inflammatory substances are highly elevated in your body, promoting the development of cardiovascular diseases.

(To be continued)

References:

  1. Mayo Clinic, Diseases and Conditions, Metabolic Syndrome. http://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/basics/definition/con-20027243
  2. American Heart Association. http://www.heart.org/HEARTORG/Conditions/More/MetabolicSyndrome/About-Metabolic-Syndrome_UCM_301920_Article.jsp#.VsxroH197IU
  3. NHLBI/AHA Conference Proceedings. Circ.ahajournals.org/content/109/3/433.full

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

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)

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.