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)

What are strengthening physical exercises?(Part 3)

Muscle groups and their corresponding functions

Calf muscles [1,2]

When you are talking about the calf muscles, you are actually referring to: (1) the gastrocnemius, and (2) the soleus muscles. Both of them are located at the back of your lower legs, and play important role when you walk, run, jump, and stand at the balls of your feet. These two muscles are attached to your heel bone by the so-called Achilles tendon.When you overwork your Achilles tendon, you will have inflammation on it, and this is called tendinitis[1].

Strengthening exercises for the calf muscles using body weight

Toe raises[2]

Face the wall and place one hand against it to support you. Slowly raise your whole body on your toes then slowly return your heel to the floor. Perform two or three sets of 10 to 20 toe raises. In between, you can have a 1-minute rest. As your legs get stronger, you can hold additional weights in your hands or place barbell over your shoulders behind the neck to increase the resistance[2].

Hamstrings[1,2]

The hamstrings are muscles that occupy the back portion of your thigh. One of these is calledthe biceps femoris which is a two-headed muscle. One of its heads is attached to the ischiumwhich is the lower and back part of the hip bone and the other one is attached to the femur which is the main bone of your upper leg. The other hamstring muscles are the semitendinosus and the semimembranosus. Lumping the three muscles togetherinto one, their main actions are to flex the knee and extend the hip. In addition to these main functions, however, the biceps femoris is involved in the internal and external rotation of the legs [1].

Strengthening exercises for the hamstrings using body weight

Hamstring curls[2]

Stand in front of a table or any other object whose height is at the level of your thigh and which could serve as your support. Place your hands on the supporting table and bend backward your one leg at the knee, maintaining that your thigh is still aligned with your upper body. Slowly raise your foot towards your buttocks as far as you can and slowly return to the starting point. Finish two or three sets of 20 with each leg[2].

Back muscles[1,2]

The three muscles at the back are the following: (1) multifidus, (2)longissimus, and (3) spinalis.The multifidus muscle stabilizes and supports the spinal column. Thus, it provides stiffness to it[1].The longissimus muscles, on the other hand, flex the head and neck on the same side, and they extend the vertebral column [3]. Finally, the spinalis muscle extends and laterally bends the neck and the trunk [1].

Strengthening exercises for the back muscles using body weight

Back extensions[2]

Lie flat on yourfront abdomen with your hands under your shoulders as if you are about to do push-ups. Slowly raise your chest up using solely your back muscles and slightly assisted by your arms. As your chest goes up, exhale and pause at the top of the exercise. Go down slowly and inhale as you do it. Complete two or three sets of 10 [2].

Alternate extensions[2]

Lie flat on your front abdomen with your arms extended in front of you. Rest your forehead on a folded towel on the floor. Raise one of your arms simultaneously with the opposite leg. Maintain it for three seconds and then slowly lower it down to the starting position. Complete ten repetitions for each.

(To be continued)

References:

  1. http://www.healthline.com/human-body-maps/abdomen-muscles#seoBlock
  2. Glover B, Shepherd J, Glover SF. Strengthening. In: The Runner’s Handbook. 2nd revised ed. New York: Penguin Books USA Inc.; 1996:578-597.

https://en.wikipedia.org/wiki/Longissimus

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)