Many health practitioners who treat cancer with alternative methods insist that no supplements are needed, only pure, healthy foods, while others disagree and promote the use of supplements. Personally, I see a third way: a program based principally on dietary changes and whole foods plus the use of specially selected supplements that have shown particular activity against cancer. My selection of supplements is based on hard science and numerous clinical studies, as well as in my own personal experience. For example, we now know that the anticancer activity of the different forms of vitamin E varies considerably. Some forms of vitamin E, such as d- or dl-alpha-tocopheryl acetate, have very little anticancer activity, are poorly absorbed, and may in terfere with other nutrients, while the d-alpha-tocopheryl succinate form of vitamin E has powerful anticancer activity, is well absorbed, and has the greatest antioxidant activity. The same can also be said for synthetic beta-carotene compared to natural forms.
We should also appreciate that we still do not know all the components in edible plants, nor do we understand many of the functions of the food components that have been isolated. By using only extracts of these plants, we may be missing an as-yet unidentified anticancer nutrient. In addition, the process of extracting the known nutrients could destroy some of the mysterious component.
One of the big mysteries of nutritional cancer treatments is why it takes so many fruits and vegetables in the diet to have any anticancer effect. Ten servings of fruits and vegetables add up to a lot of produce. Closely connected to this mystery is the difference between the cells of animals and the cells of plants. Most of the nutritious components of plants are confined within their cells, which differ from animal cells in that they have tough cell walls surrounding their membranes. Unfortunately, humans do not have enzymes in their digestive tracts to dissolve these cell walls. As a result, we cannot absorb most of the nutrients in plants.
This leaves us with three ways to extract these locked-in nutrients. First, we can mechanically break the cell walls by chewing all our fruits and vegetables until they are fine mush. Un fortunately, most of us chew our fruits and vegetables just a few times and then swallow. Second, we can cook our fruits and vegetables, since the heating process breaks the cell wall down. The disadvantage of this method is that you also destroy some of the nutrients and wash others away. In addition, you neutralize many of the plant enzymes, which have been shown to play a part in the anticancer effects of plants. Finally, we can me chemically break down the cell walls by either juicing our fruits and vegetables or liquefying them in a blender.
I have been impressed by the number of people with advanced, near-terminal cancer who have survived after changing their diet to include blenderized or juiced fruits and vegetables. With what we know now concerning the science behind plant phytochemicals and cancer, it makes a lot of sense. People who juice or blenderize their fruits and vegetables get a much higher concentration of the anticancer chemicals than those who just eat fruits and vegetables. In addition, most of the people who go to this trouble choose fruits and vegetables that are high on the list of the most powerful edible anticancer plants.
As we shall see throughout this book, many phytochemicals have a differential effect in that they protect normal cells from the harmful effects of chemotherapy and radiation treatments while greatly enhancing the effectiveness of the conventional treatments against the cancer.
Thursday, October 16, 2008
Important to understand cancer process
In the past, before we understood why nutrition works, most of our information was based on anecdotal stories (case histories), studies of large populations of people (epidemiological studies), and word of mouth from those utilizing nutritional treatments outside the medial establishment. This presented two major problems. First, physicians hesitated to use nutrition because little proof or explanation existed for its mechanism of action. Second, cancer patients were often afraid to rely on a treatment method that was not endorsed by the scientific community.
Despite the tens of billions of dollars spent on the war on cancer, we have not found a cure for the disease, but we have learned a lot about the cancer process and how cancer cells differ from normal cells. It is this basic knowledge that elucidated for us what many early proactioners of alternative medicine knew all along: something in plants, both as foods and as herbs, has a beneficial effect in suppressing cancer growth.
It should also be appreciated that much of the scientific work was done in an experimental setting. While thousands of cancer patients have been treated successfully with nutritional treatments, few carefully controlled studies of these large populations of patients have been properly done, This is because such studies are very expensive and no one, until recently, has taken an interest in funding them. Recently, the National Institutes of Health (NIH) has begun several studies of the nutritional treatment of cancers in large numbers of people. It will be several more years before the final results of these studies appear.
For the cancer patient, waiting for the results of academic studies is not an option. I have used nutritional methods for at least twenty-four years, more so in the last five years, and I have seen undeniable benefits-and no harm-in my patients. There is no question that the patients using these methods tolerate their treatments better and have far fewer complications. They also respond much better to their conventional treatments.
As I will show in the following chapters, selected nutritional supplements affect the cancer cell at multiple steps in its metabolism in such a way as to significantly interfere with its ability to survive. They do this without interfering with the effectiveness of chemotherapy or radiation therapy. By using different ways to kill and suppress cancer cells, nutrition, in fact, enhances the effectiveness of the conventional treatments.
To kill cancer cells, or to at least force them into a dormant state, every mechanism on which the cancer cell depends must be interfered with. Nutritional supplements do this more effectively than either chemotherapy or radiation treatments, and with little or no effect on normal cells, except to make them stronger.
Changing your diet is a very difficult thing to do, especially if the changes are drastic. Most of us are so accustomed to eating foods that are full of artificial flavors, very sweet, or creamy in texture that eating foods without these qualities becomes a chore. Dietary compliance is the most difficult problem I face in treating cancer patients. This is especially so for the patients having the worst diets. For example, a person who lives for his barbecued ribs, french fries, and soft drinks will have great difficulty switching to a plate full of fresh raw vegetables, fruits, and pure water.
If understanding why nutrition is so important does nothing else, it at least helps cancer patients to stick to the new diet. The more you understand the mechanisms by which phytochemicals inhibit cancer growth and spread, the more you will appreciate why even minor variations in your diet can have significant effects on your cancer. There is serious question as to whether cancers are ever completely eradicated. If they are not, then sticking to the diet becomes even more important, since the dormant cancer can be reactivated by a bad diet.
The longer you adhere to the diet, the easier it will be for you to follow. Tastes change with time. People on low-salt diets find normally salted foods far too salty. The same is true for low sugar diets: people on low-sugar diets soon find foods and drinks containing sugar to taste too sweet. This readjustment process of the taste buds allows us to conform to a diet we previously thought would be unbearable. It's all what we get used to.
Despite the tens of billions of dollars spent on the war on cancer, we have not found a cure for the disease, but we have learned a lot about the cancer process and how cancer cells differ from normal cells. It is this basic knowledge that elucidated for us what many early proactioners of alternative medicine knew all along: something in plants, both as foods and as herbs, has a beneficial effect in suppressing cancer growth.
It should also be appreciated that much of the scientific work was done in an experimental setting. While thousands of cancer patients have been treated successfully with nutritional treatments, few carefully controlled studies of these large populations of patients have been properly done, This is because such studies are very expensive and no one, until recently, has taken an interest in funding them. Recently, the National Institutes of Health (NIH) has begun several studies of the nutritional treatment of cancers in large numbers of people. It will be several more years before the final results of these studies appear.
For the cancer patient, waiting for the results of academic studies is not an option. I have used nutritional methods for at least twenty-four years, more so in the last five years, and I have seen undeniable benefits-and no harm-in my patients. There is no question that the patients using these methods tolerate their treatments better and have far fewer complications. They also respond much better to their conventional treatments.
As I will show in the following chapters, selected nutritional supplements affect the cancer cell at multiple steps in its metabolism in such a way as to significantly interfere with its ability to survive. They do this without interfering with the effectiveness of chemotherapy or radiation therapy. By using different ways to kill and suppress cancer cells, nutrition, in fact, enhances the effectiveness of the conventional treatments.
To kill cancer cells, or to at least force them into a dormant state, every mechanism on which the cancer cell depends must be interfered with. Nutritional supplements do this more effectively than either chemotherapy or radiation treatments, and with little or no effect on normal cells, except to make them stronger.
Changing your diet is a very difficult thing to do, especially if the changes are drastic. Most of us are so accustomed to eating foods that are full of artificial flavors, very sweet, or creamy in texture that eating foods without these qualities becomes a chore. Dietary compliance is the most difficult problem I face in treating cancer patients. This is especially so for the patients having the worst diets. For example, a person who lives for his barbecued ribs, french fries, and soft drinks will have great difficulty switching to a plate full of fresh raw vegetables, fruits, and pure water.
If understanding why nutrition is so important does nothing else, it at least helps cancer patients to stick to the new diet. The more you understand the mechanisms by which phytochemicals inhibit cancer growth and spread, the more you will appreciate why even minor variations in your diet can have significant effects on your cancer. There is serious question as to whether cancers are ever completely eradicated. If they are not, then sticking to the diet becomes even more important, since the dormant cancer can be reactivated by a bad diet.
The longer you adhere to the diet, the easier it will be for you to follow. Tastes change with time. People on low-salt diets find normally salted foods far too salty. The same is true for low sugar diets: people on low-sugar diets soon find foods and drinks containing sugar to taste too sweet. This readjustment process of the taste buds allows us to conform to a diet we previously thought would be unbearable. It's all what we get used to.
Dietary Change In Cancer Patients
DIETARY CHANGES ON FIGHTING CANCER
Alcohol and cancer
Alcohol consumption significantly increases the risk of cancers of the mouth (oral/oropharyngeal cancer), throat (esophageal cancer), and voice box (laryngeal cancer), particularly in conjunction with cigarette smoking. Most studies documenting these associations also report that former drinkers have significantly lower risks for these cancers compared with current drinkers. Strong correlations between alcohol consumption and the risk of having liver cancer have also been reported.
Little is known about the effect of alcohol intake on the risk of female cancers other than breast cancer. Of the few published studies, findings have been inconsistent.
Fiber
Whole grains (such as rye, brown rice, and whole wheat) contain high amounts of insoluble fiber— the type of fiber some scientists believe may help protect against a variety of cancers. In an analysis of the data from many studies, people who eat relatively high amounts of whole grains were reported to have low risks of lymphomas and cancers of the pancreas, stomach, colon, rectum, breast, uterus, mouth, throat, liver, and thyroid. Most research focusing on the relationship between cancer and fiber has focused on breast and colon cancers.
Consuming a diet high in insoluble fiber is best achieved by switching from white rice to brown rice and from bakery goods made with white flour or mixed flours to 100% whole wheat bread, whole rye crackers, and whole grain pancake mixes. Refined white flour is generally listed on food packaging labels as “flour,” “enriched flour,” “unbleached flour,” “durum wheat,” “semolina,” or “white flour.” Breads containing only whole wheat are often labeled “100% whole wheat.”
Vegetarianism
The following two possibilities are both strongly supported by research findings:
• Some foods consumed by vegetarians may protect against cancer.
• Eating meat may increase the risk of cancer.
Compared with meat eaters, most, but not all, studies have found that vegetarians are less likely to be diagnosed with cancer. Vegetarians have also been shown to have stronger immune function, possibly explaining why vegetarians may be partially protected against cancer. Female vegetarians have been reported to have lower estrogen levels compared with meateating women, possibly explaining a lower incidence of uterine and breast cancers. A reduced risk for various cancers is only partly, not totally, explained by differences in body weight, smoking habits, and other lifestyle issues.
Fruits and vegetables
Consumption of fruits and vegetables is widely accepted as lowering the risk of most common cancers. Many doctors recommend that people wishing to reduce their risk of cancer eat several pieces of fruit and several portions of vegetables every day. Optimal intakes remain unknown.
Most doctors also recommend that people should not consider supplements as substitutes for the real thing. Some of the anticancer substances found in produce have probably not yet been discovered, while others are not yet available in supplement form. More important, some research, particularly regarding synthetic beta-carotene, does not support the idea that taking supplements has the same protective value against cancer as does consumption of fruits and vegetables.
Flavonoids
Flavonoids are found in virtually all herbs and plant foods. Consumption of flavonoid-rich onions and apples contain large amounts of one flavonoid called quercetin. Consumption of flavonoids in general, or quercetin-containing foods in particular, has been associated with protection against cancer in some, but not all, preliminary studies. Tomatoes Tomatoes contain lycopene —an antioxidant similar in structure to beta-carotene. Most lycopene in our diet comes from tomatoes, though traces of lycopene exist in other foods. Lycopene inhibits the proliferation of cancer cells in test tube research. A review of published research found that higher intake of tomatoes or higher blood levels of lycopene correlated with protection from cancer in 57 of 72 studies. Findings in of these 35 studies were statistically significant. Evidence of a protective effect for tomato consumption was strongest for cancers of the prostate, lung, and stomach, but some evidence of a protective effect also appeared for cancers of the pancreas, colon, rectum, esophagus (throat), mouth, breast, and cervix.
Cruciferous vegetables
Cabbage, Brussels sprouts, broccoli, and cauliflower belong to the Brassica family of vegetables, also known as “cruciferous” vegetables. In test tube and animal studies, these foods have been associated with anticancer activity, possibly due to several substances found in these foods, such as indole-3-carbinol, glucaric acid (calcium D-glucarate), and sulforaphane. In a preliminary human study, people who ate cruciferous vegetables were reported to have a lower-than-average risk for bladder cancer.
Fish
Fish eaters have been reported to have low risks of cancers of the mouth, throat, stomach, colon, rectum, pancreas, lung, breast, and prostate. The omega-3 fatty acids found in fish are thought by some researchers to be the components of fish responsible for protection against cancer.
Coffee
Years ago, researchers reported the greater the consumption of coffee in a country, the higher the risk of pancreatic cancer in that country. An analysis of data from studies published between 1981 and 1993 did find some association between high consumption of coffee and an increased risk of pancreatic cancer. Surprisingly, however, the same report found that people drinking only one or two cups of coffee per day had, on average, a lower risk of pancreatic cancer compared with people who never drink coffee.
Most, but not all, published reports have shown coffee drinkers are at increased risk of bladder cancer, though in one case the relationship was found only in men. In another study, the association was found only with caffeinated coffee. A review of trials found a small (7%) increased risk of bladder cancer in coffee drinkers compared with people not drinking coffee— a difference not statistically significant.
Calories
Scientists have known for many years that severe restriction of calories dramatically reduces the risk of cancer in laboratory animals. Scientists speculate that caloric content of the human diet may also affect cancer rates, though much less is known about the effect, if any, of moderate caloric restrictions in humans. In one report, adults with cancer were more likely to have consumed more calories during childhood compared with healthy adults. In other reports, attempts to find associations between reduced intake of calories and cancer have produced mixed results.
Only severe restriction in caloric intake provides significant protection in animal studies. As most people are unlikely to severely restrict calories, the association between caloric restriction and protection from cancer may ultimately prove to only be of academic interest.
Dietary fat
In studying data from country to country, incidence of ovarian cancer correlates with dietary fat intake. According to preliminary research, consumption of saturated fat, dietary cholesterol (as found in eggs), and animal fat in general correlates with the risk of ovarian cancer. Preliminary studies suggest dietary fat may correlate with the risk of uterine cancer. Some of the excess risk appears to result from increased body weight that results from a high-fat diet. Many years ago, researchers reported that animals on a high-fat diet formed skin cancers more rapidly than did other animals. Although some preliminary human research has found no relationship between dietary fat intake and the risk of skin cancer, 58 patients with basal cell and squamous cell skin cancers who were put on a low-fat diet for two years were reported to show a significant decrease in the number of new skin cancers compared with patients who maintained a high-fat diet. Similarly, precancerous lesions of the skin have been prevented in people put on a low-fat diet.
Polyunsaturated fats A chain of carbon atoms in which several are not attached to the maximum possible amount of hydrogen is called “polyunsaturated”––in other words, unsaturated with hydrogen in several places. When nutrition researchers talk about polyunsaturated fatty acids, they are often referring primarily to linoleic acid— a fatty acid found in nuts and seeds and most vegetable oils.
In animal research, the consumption of polyunsaturated fatty acids increases the risk of some cancers. However, in humans, most, though not all, reports do not find an association between polyunsaturates and cancer risks.
Sugar
A preliminary study has reported an association between an increasing intake of sugar or sugar-containing foods and an increased risk of gallbladder cancer. Whether this association exists because sugar directly promotes cancer or because sugar consumption is only a marker for some other dietary or lifestyle factor remains unknown.
Salt
In preliminary research, increasing intake of salt correlates with increased risk of stomach cancer. Associations between foods preserved with salt and the risk of cancers of the head and neck have also been reported. Animal studies suggest that the antioxidant or immune-enhancing effect of whey protein may produce anti-cancer effects. Preliminary human case reports suggest that 30 grams per day of whey protein may improve responses to anti-cancer medications, but more research is needed.
Alcohol and cancer
Alcohol consumption significantly increases the risk of cancers of the mouth (oral/oropharyngeal cancer), throat (esophageal cancer), and voice box (laryngeal cancer), particularly in conjunction with cigarette smoking. Most studies documenting these associations also report that former drinkers have significantly lower risks for these cancers compared with current drinkers. Strong correlations between alcohol consumption and the risk of having liver cancer have also been reported.
Little is known about the effect of alcohol intake on the risk of female cancers other than breast cancer. Of the few published studies, findings have been inconsistent.
Fiber
Whole grains (such as rye, brown rice, and whole wheat) contain high amounts of insoluble fiber— the type of fiber some scientists believe may help protect against a variety of cancers. In an analysis of the data from many studies, people who eat relatively high amounts of whole grains were reported to have low risks of lymphomas and cancers of the pancreas, stomach, colon, rectum, breast, uterus, mouth, throat, liver, and thyroid. Most research focusing on the relationship between cancer and fiber has focused on breast and colon cancers.
Consuming a diet high in insoluble fiber is best achieved by switching from white rice to brown rice and from bakery goods made with white flour or mixed flours to 100% whole wheat bread, whole rye crackers, and whole grain pancake mixes. Refined white flour is generally listed on food packaging labels as “flour,” “enriched flour,” “unbleached flour,” “durum wheat,” “semolina,” or “white flour.” Breads containing only whole wheat are often labeled “100% whole wheat.”
Vegetarianism
The following two possibilities are both strongly supported by research findings:
• Some foods consumed by vegetarians may protect against cancer.
• Eating meat may increase the risk of cancer.
Compared with meat eaters, most, but not all, studies have found that vegetarians are less likely to be diagnosed with cancer. Vegetarians have also been shown to have stronger immune function, possibly explaining why vegetarians may be partially protected against cancer. Female vegetarians have been reported to have lower estrogen levels compared with meateating women, possibly explaining a lower incidence of uterine and breast cancers. A reduced risk for various cancers is only partly, not totally, explained by differences in body weight, smoking habits, and other lifestyle issues.
Fruits and vegetables
Consumption of fruits and vegetables is widely accepted as lowering the risk of most common cancers. Many doctors recommend that people wishing to reduce their risk of cancer eat several pieces of fruit and several portions of vegetables every day. Optimal intakes remain unknown.
Most doctors also recommend that people should not consider supplements as substitutes for the real thing. Some of the anticancer substances found in produce have probably not yet been discovered, while others are not yet available in supplement form. More important, some research, particularly regarding synthetic beta-carotene, does not support the idea that taking supplements has the same protective value against cancer as does consumption of fruits and vegetables.
Flavonoids
Flavonoids are found in virtually all herbs and plant foods. Consumption of flavonoid-rich onions and apples contain large amounts of one flavonoid called quercetin. Consumption of flavonoids in general, or quercetin-containing foods in particular, has been associated with protection against cancer in some, but not all, preliminary studies. Tomatoes Tomatoes contain lycopene —an antioxidant similar in structure to beta-carotene. Most lycopene in our diet comes from tomatoes, though traces of lycopene exist in other foods. Lycopene inhibits the proliferation of cancer cells in test tube research. A review of published research found that higher intake of tomatoes or higher blood levels of lycopene correlated with protection from cancer in 57 of 72 studies. Findings in of these 35 studies were statistically significant. Evidence of a protective effect for tomato consumption was strongest for cancers of the prostate, lung, and stomach, but some evidence of a protective effect also appeared for cancers of the pancreas, colon, rectum, esophagus (throat), mouth, breast, and cervix.
Cruciferous vegetables
Cabbage, Brussels sprouts, broccoli, and cauliflower belong to the Brassica family of vegetables, also known as “cruciferous” vegetables. In test tube and animal studies, these foods have been associated with anticancer activity, possibly due to several substances found in these foods, such as indole-3-carbinol, glucaric acid (calcium D-glucarate), and sulforaphane. In a preliminary human study, people who ate cruciferous vegetables were reported to have a lower-than-average risk for bladder cancer.
Fish
Fish eaters have been reported to have low risks of cancers of the mouth, throat, stomach, colon, rectum, pancreas, lung, breast, and prostate. The omega-3 fatty acids found in fish are thought by some researchers to be the components of fish responsible for protection against cancer.
Coffee
Years ago, researchers reported the greater the consumption of coffee in a country, the higher the risk of pancreatic cancer in that country. An analysis of data from studies published between 1981 and 1993 did find some association between high consumption of coffee and an increased risk of pancreatic cancer. Surprisingly, however, the same report found that people drinking only one or two cups of coffee per day had, on average, a lower risk of pancreatic cancer compared with people who never drink coffee.
Most, but not all, published reports have shown coffee drinkers are at increased risk of bladder cancer, though in one case the relationship was found only in men. In another study, the association was found only with caffeinated coffee. A review of trials found a small (7%) increased risk of bladder cancer in coffee drinkers compared with people not drinking coffee— a difference not statistically significant.
Calories
Scientists have known for many years that severe restriction of calories dramatically reduces the risk of cancer in laboratory animals. Scientists speculate that caloric content of the human diet may also affect cancer rates, though much less is known about the effect, if any, of moderate caloric restrictions in humans. In one report, adults with cancer were more likely to have consumed more calories during childhood compared with healthy adults. In other reports, attempts to find associations between reduced intake of calories and cancer have produced mixed results.
Only severe restriction in caloric intake provides significant protection in animal studies. As most people are unlikely to severely restrict calories, the association between caloric restriction and protection from cancer may ultimately prove to only be of academic interest.
Dietary fat
In studying data from country to country, incidence of ovarian cancer correlates with dietary fat intake. According to preliminary research, consumption of saturated fat, dietary cholesterol (as found in eggs), and animal fat in general correlates with the risk of ovarian cancer. Preliminary studies suggest dietary fat may correlate with the risk of uterine cancer. Some of the excess risk appears to result from increased body weight that results from a high-fat diet. Many years ago, researchers reported that animals on a high-fat diet formed skin cancers more rapidly than did other animals. Although some preliminary human research has found no relationship between dietary fat intake and the risk of skin cancer, 58 patients with basal cell and squamous cell skin cancers who were put on a low-fat diet for two years were reported to show a significant decrease in the number of new skin cancers compared with patients who maintained a high-fat diet. Similarly, precancerous lesions of the skin have been prevented in people put on a low-fat diet.
Polyunsaturated fats A chain of carbon atoms in which several are not attached to the maximum possible amount of hydrogen is called “polyunsaturated”––in other words, unsaturated with hydrogen in several places. When nutrition researchers talk about polyunsaturated fatty acids, they are often referring primarily to linoleic acid— a fatty acid found in nuts and seeds and most vegetable oils.
In animal research, the consumption of polyunsaturated fatty acids increases the risk of some cancers. However, in humans, most, though not all, reports do not find an association between polyunsaturates and cancer risks.
Sugar
A preliminary study has reported an association between an increasing intake of sugar or sugar-containing foods and an increased risk of gallbladder cancer. Whether this association exists because sugar directly promotes cancer or because sugar consumption is only a marker for some other dietary or lifestyle factor remains unknown.
Salt
In preliminary research, increasing intake of salt correlates with increased risk of stomach cancer. Associations between foods preserved with salt and the risk of cancers of the head and neck have also been reported. Animal studies suggest that the antioxidant or immune-enhancing effect of whey protein may produce anti-cancer effects. Preliminary human case reports suggest that 30 grams per day of whey protein may improve responses to anti-cancer medications, but more research is needed.
NUTRITION IN CANCER PREVENTION AND TREATMENT
NUTRITION IN CANCER PREVENTION AND TREATMENT
The ability of nutrition to prevent the occurrence of cancer is now beyond dispute. In a paper appearing in the journal of the American Dietetic Association, Dr. K. A. Steinmetz and his coworkers found by reviewing 206 of the best human cancer surveys and 22 animal studies that of all the dietary factors considered in relation to reducing cancer development, at all of its stages, the most important was the intake of fruits and vegetables.
In fact, over all, the cancer rates were reduced 50 percent in the people who ate the most fruits and vegetables, with the greatest reduction being in cancers of the esophagus, oral cavity, larynx, pancreas, stomach, colon, rectum, bladder, cervix, ovary, endometrium, and breast. Even better protection was seen with some types of cancer.
The greatest fall in cancer rates in humans has been with cancer of the stomach, attributed almost solely to a higher intake of vitamin C-containing foods. To better appreciate the power of phytochemicals in foods in preventing cancer, let us look at a study done in Japan. It was found that people eating the most yellow-green vegetables had a stomach cancer incidence 65 percent lower than those eating significantly fewer of these vegetables. If that is not impressive enough, another study found that persons eating citrus fruits just twice a month or less had a sixteen-times higher risk of developing stomach cancer than those eating fruits at least once a week or more.
Today we hear a lot about cancer of the pancreas. It took the lives of President Jimmy Carter's sister and actor Michael Landon, as well as of 28,200 people in the year 2000 alone. It has a mortality rate of more than 90 percent. Yet, its occurrence appears to be strongly related to our diet. In one study, it was found that people who ate no vegetables had a fourfold higher risk of developing pancreatic cancer than those who ate five or more servings of vegetables. Reducing the pancreatic cancer risk depended mostly on eating vegetables and fruits high in beta carotene and especially lycopene, the red pigment in tomatoes, pink grapefruit, and watermelon.2
This same red pigment appears to play a leading role in pre venting prostate cancer, with the risk being lowered 35 to 45 percent in those eating a lot of such fruits and vegetables.3 Vitamin E, especially when combined with selenium, also dramatically reduces the risk of this cancer.
While we are learning more about how these nutrients inhibit cancer, something even more exciting is occurring in the world of science. We are now finding that the very same nutrients can be used to inhibit the growth, invasion, and metastasis of cancers that already exist, and that when we combine these nutrients with conventional cancer treatments, such as radiation therapy or chemotherapy, the conventional therapies work significantly better. If that were not enough, an increasing number of studies have demonstrated that vitamins, minerals, and other phytonutrients can protect patients from the harmful side effects of these conventional treatments.
Numerous anticancer components are found in foods. A partial list includes:
● Allicin
● Antiestrogens and antiprogestins
● Carotenoids, folate, niacinamide, and vitamins A, D, K, and B12
● Coenzyme Q1o
● Ellagic acid
● Fiber
● Flavonoids (some .5,000 have now been identified)
● Glucosinolates
● Glutathione
● Glycolipids and glycoproteins
● Immune-enhancing polysaccharides
● Indole-3-carbinol
● Isothiocyanates
● Magnesium
● Phytates
● Protease inhibitors
● Saponins
● Selenium (principally in an organic form)
● Sterols and sterolins (plant steroids)
● Sulphoraphanes
● Zinc
Most patients dread the effects of chemotherapy and radiation treatments as much as, and sometimes more than, their cancer. This is especially so for patients who already have had to go through several rounds of chemotherapy treatments. Today, it is not uncommon for cancer patients to undergo such treatments for as long as a year. Overwhelming fatigue, nausea and/or
vomiting, diarrhea, loss of appetite, and severe bone marrow depression can make life seem hopeless and, for many, hardly worth living.
To be physically ill every day for months is very difficult. Yet my experience, confirmed now by many studies, has shown that patients do not have to suffer to receive benefit from the conventional treatments. The vast majority of the complications and side effects of the conventional treatments can be avoided by using simple nutritional methods.
While I do recommend many special supplements, the central and most important part of the treatment program is diet. As you shall see throughout this book, diet can mean the difference between success and failure. Many of the phytonutrients I will discuss are not available as separate nutrients, but are obtained by eating selected fruits and vegetables. By combining the two-special supplements and diet-you can supply your body with a very powerful brew of cancer-fighting nutrients.
I always tell my patients that if they try to depend on supplements alone and not change their diet, they will ultimately fail. It is estimated that as many as 70 percent of all cancers are related to the diet. To continue eating the same foods that led to your cancer in the first place is to travel down the road to disaster because, as you shall see, foods often contain extremely powerful cancer-causing and -promoting substances as well. The typical Western diet-high in red meats, bad fats, food additives, and carbohydrates-is a perfect cancer brew. Below we can see the effects that different dietary excesses can have on prostate cancer:
● High red-meat intake-200 percent increased risk
● High caloric intake-190 percent increased risk
● High dessert intake-180 percent increased risk
This brew not only causes cancer, but can promote the growth of existing cancers as well. This is especially true of fats. Certain fats, called omega-6 fatty acids, not only stimulate cancer growth, but also powerfully suppress the immune system at the same time. I tell my patients that eating these fats is like adding fertilizer to crab grass. Throughout the book I will describe other cancer fertilizers.
Another problem I see when discussing diet changes with my patients is what most people consider eating lots of fruits and vegetables to be. To many, it means eating their favorite vegetable or fruit. If they like green beans and bananas and eat them several times a day, they consider this to be eating a lot of fruits and vegetables. The beans often come from a can and have very little nutrition left plus have high levels of toxic metals. And the bananas, while having some important nutrients, are very high in sugar, a cancer growth-promoting nutrient. We see that regular consumption of these foods and a high total caloric intake dramatically increases men's risk of prostate cancer. Additional risk factors include milk consumption and a low intake of the omega-3 oils combined with a high intake of the omega-6 oils.
When I analyze most of my patients' diets, I find that the majority do not eat even two servings of fruits and vegetables a day. Most studies confirm this observation. For example, one survey found that Americans eat five or more servings of fruits and vegetables less than 25 percent of the time. The statistics are even worse for children.
In terms of health benefits (mainly in terms of antioxidants), eating fewer than five servings of fruits and vegetables a day does very little good. The health benefits begin at five servings, and for people below the age of fifty, they reach a maximum at ten servings. For those over the age of fifty, adding two additional servings-that is, consuming a total of twelve servings a day-provides the maximum health benefits. So, up to a limit, we gain greater benefit by eating more fruits and vegetables. Several studies have shown that eating large amounts of fruits and vegetables, especially vegetables, not only retards the growth of cancers, but can convert very aggressive cancers into much more benign tumors. This is a remarkable finding. In the past, we thought that once a cancer formed, its prognosis was always in one direction: Aggressive cancers stayed aggressive and less aggressive cancers could become more aggressive, but never the reverse. Newer studies are even showing, at least experimentally, that some cancer cells can be changed into normal cells using specific nutrients. So, instead of directing all our efforts into figuring out how to kill cancer cells without harming normal cells, we can simply change cancer cells back to normal cells.
The ability of nutrition to prevent the occurrence of cancer is now beyond dispute. In a paper appearing in the journal of the American Dietetic Association, Dr. K. A. Steinmetz and his coworkers found by reviewing 206 of the best human cancer surveys and 22 animal studies that of all the dietary factors considered in relation to reducing cancer development, at all of its stages, the most important was the intake of fruits and vegetables.
In fact, over all, the cancer rates were reduced 50 percent in the people who ate the most fruits and vegetables, with the greatest reduction being in cancers of the esophagus, oral cavity, larynx, pancreas, stomach, colon, rectum, bladder, cervix, ovary, endometrium, and breast. Even better protection was seen with some types of cancer.
The greatest fall in cancer rates in humans has been with cancer of the stomach, attributed almost solely to a higher intake of vitamin C-containing foods. To better appreciate the power of phytochemicals in foods in preventing cancer, let us look at a study done in Japan. It was found that people eating the most yellow-green vegetables had a stomach cancer incidence 65 percent lower than those eating significantly fewer of these vegetables. If that is not impressive enough, another study found that persons eating citrus fruits just twice a month or less had a sixteen-times higher risk of developing stomach cancer than those eating fruits at least once a week or more.
Today we hear a lot about cancer of the pancreas. It took the lives of President Jimmy Carter's sister and actor Michael Landon, as well as of 28,200 people in the year 2000 alone. It has a mortality rate of more than 90 percent. Yet, its occurrence appears to be strongly related to our diet. In one study, it was found that people who ate no vegetables had a fourfold higher risk of developing pancreatic cancer than those who ate five or more servings of vegetables. Reducing the pancreatic cancer risk depended mostly on eating vegetables and fruits high in beta carotene and especially lycopene, the red pigment in tomatoes, pink grapefruit, and watermelon.2
This same red pigment appears to play a leading role in pre venting prostate cancer, with the risk being lowered 35 to 45 percent in those eating a lot of such fruits and vegetables.3 Vitamin E, especially when combined with selenium, also dramatically reduces the risk of this cancer.
While we are learning more about how these nutrients inhibit cancer, something even more exciting is occurring in the world of science. We are now finding that the very same nutrients can be used to inhibit the growth, invasion, and metastasis of cancers that already exist, and that when we combine these nutrients with conventional cancer treatments, such as radiation therapy or chemotherapy, the conventional therapies work significantly better. If that were not enough, an increasing number of studies have demonstrated that vitamins, minerals, and other phytonutrients can protect patients from the harmful side effects of these conventional treatments.
Numerous anticancer components are found in foods. A partial list includes:
● Allicin
● Antiestrogens and antiprogestins
● Carotenoids, folate, niacinamide, and vitamins A, D, K, and B12
● Coenzyme Q1o
● Ellagic acid
● Fiber
● Flavonoids (some .5,000 have now been identified)
● Glucosinolates
● Glutathione
● Glycolipids and glycoproteins
● Immune-enhancing polysaccharides
● Indole-3-carbinol
● Isothiocyanates
● Magnesium
● Phytates
● Protease inhibitors
● Saponins
● Selenium (principally in an organic form)
● Sterols and sterolins (plant steroids)
● Sulphoraphanes
● Zinc
Most patients dread the effects of chemotherapy and radiation treatments as much as, and sometimes more than, their cancer. This is especially so for patients who already have had to go through several rounds of chemotherapy treatments. Today, it is not uncommon for cancer patients to undergo such treatments for as long as a year. Overwhelming fatigue, nausea and/or
vomiting, diarrhea, loss of appetite, and severe bone marrow depression can make life seem hopeless and, for many, hardly worth living.
To be physically ill every day for months is very difficult. Yet my experience, confirmed now by many studies, has shown that patients do not have to suffer to receive benefit from the conventional treatments. The vast majority of the complications and side effects of the conventional treatments can be avoided by using simple nutritional methods.
While I do recommend many special supplements, the central and most important part of the treatment program is diet. As you shall see throughout this book, diet can mean the difference between success and failure. Many of the phytonutrients I will discuss are not available as separate nutrients, but are obtained by eating selected fruits and vegetables. By combining the two-special supplements and diet-you can supply your body with a very powerful brew of cancer-fighting nutrients.
I always tell my patients that if they try to depend on supplements alone and not change their diet, they will ultimately fail. It is estimated that as many as 70 percent of all cancers are related to the diet. To continue eating the same foods that led to your cancer in the first place is to travel down the road to disaster because, as you shall see, foods often contain extremely powerful cancer-causing and -promoting substances as well. The typical Western diet-high in red meats, bad fats, food additives, and carbohydrates-is a perfect cancer brew. Below we can see the effects that different dietary excesses can have on prostate cancer:
● High red-meat intake-200 percent increased risk
● High caloric intake-190 percent increased risk
● High dessert intake-180 percent increased risk
This brew not only causes cancer, but can promote the growth of existing cancers as well. This is especially true of fats. Certain fats, called omega-6 fatty acids, not only stimulate cancer growth, but also powerfully suppress the immune system at the same time. I tell my patients that eating these fats is like adding fertilizer to crab grass. Throughout the book I will describe other cancer fertilizers.
Another problem I see when discussing diet changes with my patients is what most people consider eating lots of fruits and vegetables to be. To many, it means eating their favorite vegetable or fruit. If they like green beans and bananas and eat them several times a day, they consider this to be eating a lot of fruits and vegetables. The beans often come from a can and have very little nutrition left plus have high levels of toxic metals. And the bananas, while having some important nutrients, are very high in sugar, a cancer growth-promoting nutrient. We see that regular consumption of these foods and a high total caloric intake dramatically increases men's risk of prostate cancer. Additional risk factors include milk consumption and a low intake of the omega-3 oils combined with a high intake of the omega-6 oils.
When I analyze most of my patients' diets, I find that the majority do not eat even two servings of fruits and vegetables a day. Most studies confirm this observation. For example, one survey found that Americans eat five or more servings of fruits and vegetables less than 25 percent of the time. The statistics are even worse for children.
In terms of health benefits (mainly in terms of antioxidants), eating fewer than five servings of fruits and vegetables a day does very little good. The health benefits begin at five servings, and for people below the age of fifty, they reach a maximum at ten servings. For those over the age of fifty, adding two additional servings-that is, consuming a total of twelve servings a day-provides the maximum health benefits. So, up to a limit, we gain greater benefit by eating more fruits and vegetables. Several studies have shown that eating large amounts of fruits and vegetables, especially vegetables, not only retards the growth of cancers, but can convert very aggressive cancers into much more benign tumors. This is a remarkable finding. In the past, we thought that once a cancer formed, its prognosis was always in one direction: Aggressive cancers stayed aggressive and less aggressive cancers could become more aggressive, but never the reverse. Newer studies are even showing, at least experimentally, that some cancer cells can be changed into normal cells using specific nutrients. So, instead of directing all our efforts into figuring out how to kill cancer cells without harming normal cells, we can simply change cancer cells back to normal cells.
What do I need to know about Cancer Prevention
Cancer refers to a large number of diseases categorized by unregulated replication of cells. Cancer is the second leading cause of death in Americans. We have known for more than a century that people who eat a diet consisting mostly of fruits and vegetables have a cancer rate much lower than those consuming few of these healthy foods. Only recently have we begun to understand the scientific basis of this protection, however. New techniques for measuring bio chemical events on a molecular level have allowed us to map out the many ways the components of fruits and vegetables inhibit cancer formation.
Even more exciting is the discovery that many of the chemicals found in edible plants can turn cancer cells into normal cells, meaning that food components may indeed be used to re verse cancer itself. In addition, these same plant chemicals can reduce the complications associated with the conventional cancer treatments and enhance, sometimes dramatically, the effectiveness of these treatments.
WHAT DO I NEED TO KNOW?
Self-care for cancer prevention can be approached in a number of ways— but it can be hard to know just where to start. To make it easier, our doctors recommend trying these simple steps first:
a) Get regular checkups
Many cancers can be prevented or discovered in the early stages with screening tests available through your healthcare provider
b) Go vegetarian
Eat more vegetables (especially tomatoes and cruciferous vegetables), fruits, whole grains, and legumes to help optimize body weight, immune function, hormone regulation, and to avoid
c) meat-related carcinogens, all of which may influence cancer risk Focus on fiber Eat foods rich in fiber, especially those made with whole grains, to help reduce the risk of several cancers Find healthy fats More meals containing olive oil or fish help protect against cancer, and avoiding fat from meat, dairy, and processed foods, may decrease cancer risk Avoid alcohol Use alcoholic beverages in moderation or not at all to reduce the risk of many cancers meat-related carcinogens, all of which may influence cancer risk
d) Focus on fiber Eat foods rich in fiber, especially those made with whole grains, to help reduce the risk of several cancers
e) Find healthy fats
More meals containing olive oil or fish help protect against cancer, and avoiding fat from meat, dairy, and processed foods, may decrease cancer risk
f) Avoid alcohol
Use alcoholic beverages in moderation or not at all to reduce the risk of many cancers
Even more exciting is the discovery that many of the chemicals found in edible plants can turn cancer cells into normal cells, meaning that food components may indeed be used to re verse cancer itself. In addition, these same plant chemicals can reduce the complications associated with the conventional cancer treatments and enhance, sometimes dramatically, the effectiveness of these treatments.
WHAT DO I NEED TO KNOW?
Self-care for cancer prevention can be approached in a number of ways— but it can be hard to know just where to start. To make it easier, our doctors recommend trying these simple steps first:
a) Get regular checkups
Many cancers can be prevented or discovered in the early stages with screening tests available through your healthcare provider
b) Go vegetarian
Eat more vegetables (especially tomatoes and cruciferous vegetables), fruits, whole grains, and legumes to help optimize body weight, immune function, hormone regulation, and to avoid
c) meat-related carcinogens, all of which may influence cancer risk Focus on fiber Eat foods rich in fiber, especially those made with whole grains, to help reduce the risk of several cancers Find healthy fats More meals containing olive oil or fish help protect against cancer, and avoiding fat from meat, dairy, and processed foods, may decrease cancer risk Avoid alcohol Use alcoholic beverages in moderation or not at all to reduce the risk of many cancers meat-related carcinogens, all of which may influence cancer risk
d) Focus on fiber Eat foods rich in fiber, especially those made with whole grains, to help reduce the risk of several cancers
e) Find healthy fats
More meals containing olive oil or fish help protect against cancer, and avoiding fat from meat, dairy, and processed foods, may decrease cancer risk
f) Avoid alcohol
Use alcoholic beverages in moderation or not at all to reduce the risk of many cancers
What you should eat if you encounter spinal cord injury?
What you should eat if you encounter spinal cord injury?
By
Dr Leow Chee Seng
MBA (UPM), DBA (UBI), FBIH (UK), MMIM (Mal), MIHRM (Mal), MIM-CPT (Mal),CAHRP (Consultant) Mal), Certified E-Commerce Professional (Mal),Certified Professional Trainer (MIM, PSNB),Certified Stress Management (IACT, USA),Certificate Qualitative Research (Georgia, USA), Certificate in Homeopathy Medicine (Mal)
Practicing Cognitive, Behavioural Therapist
Practicing Nutrition Consultant
Dr Leow Chee Seng
MBA (UPM), DBA (UBI), FBIH (UK), MMIM (Mal), MIHRM (Mal), MIM-CPT (Mal),CAHRP (Consultant) Mal), Certified E-Commerce Professional (Mal),Certified Professional Trainer (MIM, PSNB),Certified Stress Management (IACT, USA),Certificate Qualitative Research (Georgia, USA), Certificate in Homeopathy Medicine (Mal)
Practicing Cognitive, Behavioural Therapist
Practicing Nutrition Consultant
Yale Consultancy Sdn Bhd
Nutrition Therapy Unit
73-3, Amber Business Plaza,
Jalan Jelawat 1,
Batu 3 1/2,
56000 Kuala Lumpur
www.yaleconsultant.cm
Email: nutrition@yaleconsultant.com
INTRODUCTIONNutrition Therapy Unit
73-3, Amber Business Plaza,
Jalan Jelawat 1,
Batu 3 1/2,
56000 Kuala Lumpur
www.yaleconsultant.cm
Email: nutrition@yaleconsultant.com
Adequate nutrition and balanced nutrition is everyone concerned, not just those with a spinal cord injury. A well-balanced diet provides the nutrients your body needs to run properly and carry out normal body processes. It also provides energy and keeps your immune system strong.
When you have a spinal cord injury, not following a balanced diet increases your chance for developing pressure sores. A poor diet will also hinder your body’s ability to heal sores and fight infection, and you will become fatigued more easily.
Being overweight is another concern because excess weight makes transfers more difficult. In addition, excessive pressure and rubbing on skin puts you at risk for pressure sores. Obesity is associated with diabetes, high blood pressure, and increased levels of blood fats. A spinal cord injury does not necessitate a huge change in diet, unless your diet before your injury was not adequate.
Defining A Well-Balanced Diet:
According to the 2005 Dietary Guidelines for Americans, a well-balanced or “healthy” diet is one that:
· Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products;
· Includes lean meats, poultry, fish, beans, eggs, and nuts; and
· Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
According to the New Food Guide Pyramid, more specific recommendations have been made for each of the food groups:
Grains
Eat at least 3 oz of whole grain bread, cereal, crackers, rice, or pasta every day
Look for “whole” before the grain name on the list of ingredients
Vegetables
Eat more dark green veggies
Eat more orange veggies
Eat more dry beans and peas
Fruits
Eat a variety of fruit
Choose fresh, frozen, canned, or dried fruit
Go easy on fruit juices
Oils
Make most of your fat choices from fish, nuts, and vegetable oils
Limit solid fats like butter, stick margarine, shortening, and lard
Milk
Go low-fat or fat-free
If you don’t or can’t consume milk, choose lactose-free products or other calcium sources
Meat and Beans
Choose low-fat or lean meats and poultry
Bake it, broil it, or grill it
Vary your choices--with more fish, beans, peas, nuts, and seeds
FOOD SUPPLIES 6 KEY NUTRIENTS
Carbohydrates
-Source of energy (calories)
-Supplies fiber to aid in elimination
-Consume more complex carbohydrates (starches and fiber) and less simple (sugar) carbohydrates
Sources: Breads, cereals, fruit, vegetables, crackers, pasta, oats, barley, legumes
Protein
-Composed of 8 essential amino acids
-Builds and maintains healthy body cells
-Provides antibodies to fight infections
-Helps prevent skin breakdown
Sources: Meat, fish, poultry, eggs, dried peas, legumes, soybeans, nuts, cheese
Fat
-Source of energy (calories)
-Supplies essential fatty acids
-Provides and carries vitamins A, E, D & K
-Protects vital body organs
-Consume in moderation
Sources: Butter, margarine, oils, salad dressings, meats, nuts
Vitamins
-Function in the absorption and utilization of food
-Act as biochemical catalysts in all the body cells
-Water soluble (B and C) or fat soluble (A, D, E and K)
Sources: Fruits, vegetables, grains
Minerals
-Help build blood, bones and teeth
-Regulate body fluids
-Aid in vital body functions such as those of the nerve and muscles
Sources: Fruits, vegetables, meats, legumes, nuts
Water
-Essential for life
-Major element of every cell in the body-Necessary for all processes of digestion
-Carrier of nutrients and waste
Sources: Water, tea, juices, diet soda, Jello, soups, cranberry juice
2005 DIETARY GUIDELINES ACCORDING TO FDA (FOOD DIETARY ALLOWANCE)
ADEQUATE NUTRIENTS WITHIN CALORIE NEEDS
· Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.
· Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the U.S. Department of Agriculture (USDA) Food Guide or the Dietary Approaches to Stop Hypertension (DASH) Eating Plan.
WEIGHT MANAGEMENT
· To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended.
· To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity.
PHYSICAL ACTIVITY
· Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight.
o To reduce the risk of chronic disease in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week.
o For most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or longer duration.
o To help manage body weight and prevent gradual, unhealthy body weight gain in adulthood: Engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements.
o To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements. Some people may need to consult with a healthcare provider before participating in this level of activity.
· Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.
FOOD GROUPS TO ENCOURAGE
· Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 2½ cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level.
· Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.
· Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains.
· Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.
FATS
· Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible.
· Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
· When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.
· Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils.
CARBOHYDRATES
· Choose fiber-rich fruits, vegetables, and whole grains often.
· Choose and prepare foods and beverages with little added sugars or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH Eating Plan.
· Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently.
SODIUM AND POTASSIUM
· Consume less than 2,300 mg (approximately 1 teaspoon of salt) of sodium per day.
· Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables.
ALCOHOLIC BEVERAGES
· Those who choose to drink alcoholic beverages should do so sensibly and in moderation—defined as the consumption of up to one drink per day for women and up to two drinks per day for men.
· Alcoholic beverages should not be consumed by some individuals, including those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.
· Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery.
FOOD SAFETY
· To avoid microbial foodborne illness:
o Clean hands, food contact surfaces, and fruits and vegetables. Meat and poultry should not be washed or rinsed.
o Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods.
o Cook foods to a safe temperature to kill microorganisms.
o Chill (refrigerate) perishable food promptly and defrost foods properly.
o Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw sprouts.
SKIN INTEGRITY
Adequate pressure relief, good skin hygiene and proper nutrition are essential for decubitus ulcer prevention.
Nutritional Keys to Healthy Skin
Maintain Ideal Body Weight
Excess weight leads to increased pressure on the skin resulting in breakdown.
Being underweight increases the risk of pressure ulcer development due to inadequate skin covering over bony prominences
Eat a balanced diet of a variety of foods
Follow the Dietary Guidelines for Americans and use the Food Guidance System tool
Adequate Protein Intake
Protein is needed by the body for tissues maintenance and building. Without adequate protein intake, the body cannot fight off infections and wounds heal poorly.
Good food sources include: lean meat, fish, poultry, eggs, milk and milk products, cheese, dried beans and peas, and peanut butter
Try to incorporate 1 good protein source at each meal
Your protein intake will need to increase if you have a pressure sore
Fluid! Fluid! Fluid!
Dehydration can increase susceptibility to skin breakdown.
The goal is 10-12 cups of fluid each day. Half of this should come from water.
Caffeinated beverages and alcohol can aggravate dehydration because they act as diuretics
Aim for fluids that have 10 calories or less per 8 oz serving to prevent unnecessary weight gain.
Vitamins and Minerals
A diet with a variety of foods provides adequate levels of vitamins and minerals
Vitamins and minerals are important in the prevention and healing of skin wounds and anemia.
Skin breakdown results from inadequate oxygenation of the tissues. Anemia causes low levels of hemoglobin, which carries oxygen to the tissues. It can be caused by a deficiency of Vitamin B12, Folate, or Iron. Supplementation will be necessary.
During times of wound healing, supplementation of Vitamin C and Zinc may be indicated for additional support.
VITAMIN AND MINERAL SUPPLEMENTATION
A Multivitamin may be warranted to cover any areas that your diet may be lacking. Food is the best place to get your nutrients because many compounds naturally found in foods cannot be found in a supplement. Research has shown that a multivitamin is a cheap and safe way to ensure your diet is adequate.
Supplementation: Centrum, One-A-Day, Flintstones, Generic
Vitamin C is needed for collagen synthesis. It hastens healing of wounds and increases resistance to infection.
Food sources: Citrus fruits, tomatoes, peppers, broccoli and greens
Supplementation: 500 mg taken twice per day will help keep your urine acidic.
Zinc is necessary for connective tissue synthesis and immune system function.
Food sources: Meat, liver, eggs, legumes, milk and seafood
Supplementation: 15-40 mg of elemental zinc may be warranted for a couple weeks to help with wound healing. Taking too much zinc for a long period of time can reduce copper and iron absorption, decrease your immune system, and lower HDL-C (good cholesterol). Also, additional zinc will do nothing if you are not already zinc deficient.
Vitamin A assists formation and maintenance of skin and mucous membranes, thus increasing resistance to infections.
Food sources: Dark green and deep yellow vegetables, milk, liver and egg yolk
Supplementation: Do not supplement with more vitamin A than what is already contained in your multivitamin. Your best bet is to focus on vitamin A rich foods.
Folate is needed for DNA and RNA synthesis and the production of new cells.
Food sources: green leafy vegetables, legumes, whole grain cereals
Supplementation: Do not exceed 1000 mcg of folic acid per day because this could mask a B12 deficiency. It is advised to have your B12 level checked before taking folic acid supplements if you are over 50 years old. If you supplement with extra folate, make sure your supplement also contains B12.
Iron assists in hemoglobin production, which is responsible for carrying oxygen to the cells of your body
Food sources: Meat, poultry, dried beans, fortified cereals
Supplementation: Do not take iron supplements unless advised by your health care professional because too much iron in supplement form may be harmful. If you do take iron supplements, take them with a vitamin C rich food and separate them from your calcium supplement or multivitamin by 2 hours.
Vitamin B12 is necessary for the synthesis and maintenance of nerve cells and red blood cells.
Food sources: Meat, eggs, cheese, fish, milk and milk products, brewer’s yeast
Supplementation: What you receive in your multivitamin should be adequate if you eat meat.
Vitamin D is necessary for the maintenance of strong bones. Vitamin D is naturally synthesized on the skin when exposed to sunlight. You may be at risk for deficiency if you do not receive adequate sun exposure.
Sources: Sun, fortified milk, fatty fish
Supplementation: If you are 50 years or older, 800-1000 IU’s of cholecalciferol may be warranted. You will probably find calcium and vitamin D together in a supplement such as Citracal or Catrate.
FLUIDS
Fluids are necessary to prevent dehydration, which increases your susceptibility to skin breakdown. Dehydration also increases your chances for urinary tract infections and kidney stones. A high fluid intake flushes the urinary tract of unwanted materials and bacteria in addition to keeping the urine dilute.
Your fluid intake should coincide with your bowel regimen; however, there are times when fluid needs may need to be increased. Fluid losses can be significant when pressure sores are present, therefore water and apple juice may be prescribed at that time. Cranberry juice is often given for good urinary tract health.
While on intermittent catheterization program, fluid intake is initially limited to prevent over-distention of the bladder, 120 cc every two hours. Fluid intake will be increased as voiding occurs reflexively and residual decrease. Once voiding occurs reflexively and the bladder is emptying sufficiently, fluid intake is no longer limited or restricted.
Recommended fluid intake is 3,000 cc of fluids (10-12 cups) daily with at least half of that coming from water. Although they count as fluids, caffeinated beverages and alcohol can aggravate dehydration because they act as diuretics. Only 4 oz of cranberry juice is needed per day to prevent UTI’s. If you have a UTI, then 16-32 oz may be taken to help it resolve.
Watch Those Liquid Calories
Sources of fluids:
Water Ice Cream
Coffee Popsicles
Soda Soup
Juice Tea
Milk Pudding
Gelatin Sherbet
Remember that fluids can be a significant amount of calories, which may result in unwanted weight gain. Drinks that contribute calories but are not very nutrient dense are really the ones to watch out for. For example, one cup of skim milk and 1 cup of regular soda have about the same calories, but soda does not have the same nutrient content of milk. Juices also contribute to fluid intake, but also contribute to calories (for example, 1 cup of cranberry juice as 260 calories...one with breakfast and another with dinner would add more than 500 calories per day!)
Calorie Cutting Tips
Ø Stick to drinks that contain 10 calories or less per cup (8 oz)
Examples: Crystal Light, Propel, Fruit2O, Diet Snapple
Ø Dilute your drinks with seltzer or water
Ø Dilute regular soda with diet soda
Ø Try diet beverages sweetened with Splenda
Ø Flavor water with lemon juice, cucumber, or lime juice
HERBS AND BOTANICALS
The use of complimentary and alternative medicine is on the rise, with about 1/3 of the US population having used such therapies within the past year. Recent surveys have shown that 16% to 18% (~15 million) of adults in the US use herbal or dietary supplements concurrently with prescription medicines, potentially putting them at risk for herb-drug interactions.
It is vital that you discuss herbal use with your healthcare team. This is even more crucial if you:
Ø Have diabetes
Ø Have high blood pressure
Ø Have heart disease
Ø Are taking medications
Ø Are having surgery
Herbals can increase or decrease the usefulness of some of your prescription medications. Some examples of herbals that interact with medicines include:
Ø Gingko
Ø Ephedra
Ø Ginseng
Ø St. John's Wort
Ø Echinacea
Ø Kava Kava
All herbal products need to be stopped 2-3 weeks before surgery. They can increase your heart rate, blood pressure, and risk of bleeding.
HOW TO BE SAFE:
v The term "natural" does not mean that the product is safe
v Herbal products should only be used for a few months at a time
v Follow the dosing guidelines. More is not better.
v Choose single herb products. Avoid mixtures
v Look for products marked with USP or Consumer Lab seals. These seals mean the products are tested for quality and content
v Stop all herbal products 2-3 weeks before surgery
v Report side effects to your health care team and the FDA
v Look for products with an expiration date
v Avoid foreign products unless quality is known
v Avoid companies making sensational claims
WEIGHT MANAGEMENT
Maintenance of "ideal body weight” is especially important to persons with spinal cord injury. How do you know if you’re within your “ideal body weight” range? You can use a tool called the Body Mass Index, or BMI. The BMI is a ratio that compares a person’s height to their weight. Here’s how to calculate your BMI:
BMI = (Weight, in pounds * 703) / (Height, in inches)2
A BMI of 19 or below classifies as “underweight,” and a BMI above 25 is considered “overweight.” There are dangers to being either above or below your ideal body weight range.
Being overweight decreases a person's energy level and ability to perform activities of daily living, thus decreasing independence. Excess weight can also cause increased pressure and irritation in skin areas where decubitus ulcers - pressure sores - may develop. Obesity is associated with diabetes, high blood pressure, and increased levels of blood fats.
Weighting less than the calculated "ideal body weight" or being underweight can pose problems as well for the spinal cord injured person. The risk of decubitus ulcer development increases due to inadequate skin covering over bony prominences. Being underweight increases susceptibility to fatigue and decreases resistance to infection.
Balancing diet (calorie intake) and exercise (Energy expenditure) is the key to weight control!
Suggestions to lose weight:
Limit the size of your food portions
Avoid second servings
Try not to skip breakfast or lunch and try to avoid overeating at dinner
Avoid using food as a way of dealing with boredom, anger, fatigue, or anxiety
Consciously choose food with a view to its nutritive value
Avoid keeping high-calorie, low-nutrient snacks around the house
Eat less sugar and sugary foods
Know the danger period during the day when you tend to overeat. Be prepared with other alternatives
Suggestions to gain weight:
Consume at least three balanced meals per day
If you have a decreased appetite, eat six small meals per day
Add extra margarine, peanut butter, jelly, or jam to bread and crackers
Use thick gravies and cream sauces
Eat high-calorie snacks between meals, such as dried fruit, nuts, ice cream, and milk shakes
TIPS FOR DINING OUT
As a beverage choice, ask for water or order fat-free or low-fat milk, unsweetened tea, or other drinks without added sugars.
Ask for whole wheat bread for sandwiches.
In a restaurant, start your meal with a salad packed with veggies, to help control hunger and feel satisfied sooner.
Ask for salad dressing to be served on the side. Then use only as much as you want.
Choose main dishes that include vegetables, such as stir fries, kebobs, or pasta with a tomato sauce.
Order steamed, grilled, or broiled dishes instead of those that are fried or sautéed.
Choose a “small” or “medium” portion. This includes main dishes, side dishes, and beverages.
Order an item from the menu instead heading for the “all-you-can-eat” buffet.
If main portions at a restaurant are larger than you want, try one of these strategies to keep from overeating:
Order an appetizer or side dish instead of an entrée.
Share a main dish with a friend.
If you can chill the extra food right away, take leftovers home in a “doggy bag.”
When your food is delivered, set aside or pack half of it to go immediately.
Resign from the “clean your plate club” – when you’ve eaten enough, leave the rest.
To keep your meal moderate in calories, fat, and sugars:
Ask for salad dressing to be served “on the side” so you can add only as much as you want.
Order foods that do not have creamy sauces or gravies
Add little or no butter to your food.
Choose fruits for dessert most often.
On long commutes or shopping trips, pack some fresh fruit, cut-up vegetables, low-fat string cheese sticks, or a handful of unsalted nuts to help you avoid stopping for sweet or fatty snacks.
BOWEL MANAGEMENT
Proper nutrition is essential in establishing an effective bowel regime. Loss of muscle tone, lack of exercise, and change in schedule and environment can contribute to problems with elimination.
Focus on High-Fiber Foods
What is fiber?
Fiber is the portion of plant material that humans are not able to digest. There are two kinds of dietary fiber, soluble and insoluble. Both are important for proper bowel function.
SOLUBLE FIBER:
● Soluble fiber dissolves in water,
forming a gel in the intestines.
● It may help lower the level of
cholesterol and may help control
the level of sugar in your blood.
Sources: oatmeal, barley, kidney beans, fruits and vegetables
INSOLUBLE FIBER:
● Insoluble fiber passes through the digestive
system almost intact, adding bulk to the stool
and acting as a sponge to absorb water.
● It may help prevent constipation as well as 2
intestinal diseases, diverticulosis and
hemorrhoids.
Sources: Wheat bran, whole grains, many vegetables and skins of fruit
Note: Fiber is not found in any animal products, such as meat, cheese or eggs.
How much fiber should I have each day?
20-35 grams/day is recommended. Some people can tolerate even more. If you don’t eat a lot of fiber now, increase fiber by small amounts (a few grams) each day. This will help to decrease uncomfortable symptoms of bloating, gas and diarrhea. Make sure to drink plenty of water as well, to prevent constipation.
High: 4 or more grams fiber/serving Medium: 2-4 grams fiber/serving
Food Amount Grams Food Amount Grams
All Bran ½ cup 9.7 Soybeans ½ cup 3.8
Prunes ½ cup 8 Carrots, raw 1 cup 3.8
Lentils ½ cup 7.8 Wheat germ ¼ cup 3.8
Flaxseed 2 T, ground 7 Apple 1 med 3.7
Artichoke 1 med 6.5 Popcorn 3 cups 3.6
Chickpeas ½ cup 6.2 Potato 1 w/skin 3.4
Figs ¼ cup 6 Almonds 1 oz (~24) 3.3
Kidney beans ¼ cup 5.6 Strawberries 1 cup 3.3
Bran flakes ¾ cup 4.6 Prunes ¼ cup 3
What foods are high in fiber?
How do I add fiber to my diet?
For breakfast:
Eat a high fiber cereal, like All-Bran, Bran Flakes, or Shredded Wheat
Add some raisins to your cereal or oatmeal
For lunch:
Use 100% whole wheat bread with sandwiches
Add kidney beans and chick peas to your salads
For dinner:
Eat a baked potato with the skin
Add spinach, corn, lima beans or Brussels sprouts to your plate
For snacks:
Choose raw fruits instead of fruit juice
Eat a bowl of popcorn, air-popped or popped in canola oil
Increase fluid intake
Why? Fluid helps soften the stool to facilitate ease of bowel movements. It is particularly important to increase fluid intake with a high fiber diet, or constipation may result. If you have diarrhea, you should still continue to drink plenty of fluids, as dehydration may result if you don't replace the fluid lost in the stool.
Try to get 10-12 cups of fluids each day.
Here are some examples:
Water (more than half of your fluid intake should be as plain water)
Ice chips
Herbal tea, milk
Sugar-free gelatin and popsicles
Caffeine-free coffee and tea
Calorie-free and “Diet” flavored waters, teas and juices
Getting plenty of fluids and fiber is very important for establishing a good bowel regime. It’s also important to try to eat consistently and regularly – try to eat similar foods at about the same times every day!
FOOD AND BOWEL MANAGEMENT
Vegetables and legumes that may cause gas include…
Beans ¨ Brussels sprouts ¨ Cauliflower ¨ Kohlrabi ¨ Onions
Peppers ¨ Radishes ¨ Sauerkraut ¨ Shallots ¨ Scallions ¨ Soybeans ¨ Peas
Turnips ¨ Broccoli ¨ Cabbage ¨ Corn ¨ Cucumbers ¨ Leeks ¨ Lentils Pimentos ¨ Rutabagas
And fruits…
Apples ¨ Cantaloupe ¨ Watermelon ¨ Avocados ¨ Honeydew melon
Food Groups and Their Effects on Bowel Management
Food Group
Foods that Harden Stools
Foods that Soften Stools
Milk
Milk, yogurt made without fruit, cheese, cottage cheese, ice cream
Yogurt made with seeds or fruit
Bread and Cereal
Enriched white bread or rolls, saltine crackers, refined cereals, pancakes, waffles, bagels, biscuits, white rice, enriched noodles
Whole grain breads and cereals
Fruits & Vegetables
Strained fruit juice, applesauce, potatoes without the skins
All vegetables except potatoes without the skin
Meat
Any meat, fish or poultry
Nuts, dried beans, peas, seeds, lentils, chunky peanut butter
Fats
None
Any
Desserts & Sweets
Any without seeds or fruit
Any made with cracked wheat, seeds or fruit
Soups
Any creamed or broth-based without vegetables, beans or lentils
Soups with vegetables, beans or lentils
CHOLESTEROL
Heart disease has increased in the spinal cord injured population. This is partially because the changes the body often undergoes following injury can lead to high cholesterol levels. The food we eat can have an impact on our cholesterol levels. Eating a diet high in healthy fats and fiber, low in unhealthy fats, and limited in refined carbohydrates and alcohol can help you achieve healthy blood cholesterol levels.
What is cholesterol?
Cholesterol is a white, waxy fat found naturally in your body and produced by your liver. Too much cholesterol in your blood can clog your arteries and eventually choke off the blood supply to you heart. This is why having high cholesterol is a leading risk factor for heart disease.
What do the numbers mean?
There are four terms associated with blood cholesterol. Here’s what they are:
HDL = High Density Lipoprotein
“Healthy” or “happy” cholesterol that helps remove the bad (LDL) cholesterol from the blood and takes it to the liver to be removed.
Higher is better; it’s raised by physical activity
>40 mg/dL is ideal for men, >50 for women
LDL = Low Density Lipoprotein
“Unhealthy” or “lousy” cholesterol that leads to clogged arteries
Lower is better; it’s lowered by eating healthy fats and raised by eating unhealthy fats
<100 mg/dL is ideal
TG = Triglycerides
A type of fat circulating in the blood
Related to Very Low Density Lipoproteins (VLDL), equal to VLDL x 5
Lower is better; they’re lowered by cutting back on refined sugars and alcohol
<150 mg/dL is ideal
TC = Total Cholesterol
Sum of HDL + LDL + VLDL
Lower is better, lowered by eating more healthy fats and fiber, fewer unhealthy fats, refined sugars and alcohol; and by doing more physical activity.
<200 mg/dL is ideal
CHOOSE MORE “HEALTHY FATS”
Monounsaturated Fats
Lower total cholesterol, but do not lower HDL levels
Sources: Canola and olive oils
Polyunsaturated Fats
Found in foods of plant origin
Lower your total cholesterol, LDL, and HDL cholesterol
· Sources: Corn, safflower and sunflower oils; soybeans
Omega-3 Fatty Acids
Type of polyunsaturated fats
Not made by the body (must come from food) so are called “essential”
Lower total cholesterol and triglycerides
May have other health benefits, such as reducing inflammation
· Sources: Fatty fish and shellfish such as sardines, mackerel, blue fin tuna, salmon, bluefish, trout, crab, mussels, lobster, shrimp, scallops, cod and founder
CHOOSE FEWER “UNHEALTHY FATS”
Saturated fats
Raise LDL cholesterol and total cholesterol
12-15 grams/day is a healthy limit
Sources: All animal foods (butter, red meat, ice cream, whole milk, cheese, etc.) and in palm oil, coconut oil, hydrogenated soybean and cottonseed oil, and cocoa butter.
Trans-Fats
Man-made fat formed when plant oils are hydrogenated (hardened)
Look for the words “partially hydrogenated oils” on a food’s ingredient list or “trans-fat” on the Nutrition Facts Label.
Try to keep intake of trans-fats to as little as possible (0 grams/day if you can)!
Sources: Processed foods like cookies, crackers, pastries and cereal bars and in deep fat fried foods.
Note: Dietary cholesterol is a substance found in all foods of animal origin such as meat, poultry, egg yolks, butter and dairy products. The cholesterol found in these foods does not have nearly as large an impact on blood cholesterol as saturated and trans-fats do. Just try to limit your intake of organ meats (like liver) to once per month, and egg yolks to 3 per week.
AIM FOR 25-30 GRAMS DIETARY FIBER EACH DAY
TRY TO CUT OUT REFINED SUGARS (IN THE FORM OF SODA AND JUICE) AND DRINK ALCOHOL IN MODERATION IF YOU HAVE HIGH TRIGLYCERIDE LEVELS.
STEPS YOU CAN TAKE TO LOWER HIGH CHOLESTEROL
Too much fat and cholesterol in your diet can lead to higher weight and obesity, and higher risk for heart disease. Both can make other diseases worse. Follow these steps to help you reduce the cholesterol in your diet.
♥ Use olive and canola oil in your cooking
♥ Use spreads that have no trans-fats (look at the food label)
♥ Broil, roast, boil, steam, grill bake or stir-fry foods instead of deep-frying
♥ Avoid fatty cuts of beef, pork, lamb, veal and goat; organ meat, cold cuts, hot dogs, sausage, bacon, pepperoni, spare ribs, and friend, breaded or oil-packed fish.
♥ Instead, choose chicken or turkey (white meat, no skin), pork tenderloin, “round” cuts of beef, or 90% fat-free or leaner hamburger
♥ Eat fish 2-3 times per week for those essential omega-3s
♥ Limit eggs to 2 to 3 a week or use only egg whites or egg substitutes.
♥ Choose low fat dairy products: Choose 1% or skim milk, fat-free yogurt, low fat or fat-free cheeses and cottage cheese, low fat or fat-free ice cream and frozen yogurt.
♥ Check the food labels on your crackers, chips, pies, cakes, cookies and other high-fat desserts – if they have trans-fats, avoid them!
♥ Eat more fruits and vegetables: Most are very low in fat and high in fiber. Fiber can help control blood cholesterol levels. Dry beans and peas are great too!
♥ Read food labels: Start reading food labels for grams of fat per serving. Try to limit fat intake to less than 50-60 grams per day, with only 12-15 coming from saturated fat.
SUMMARY
As you can see, the importance of good nutrition cannot be underestimated. Being nutrition conscious can help prevent potential complications and/or problems of spinal cord injury.
Following the Dietary Guidelines for Americans and using the Food Guidance System Tool is the best way to ensure the nutritional adequacy of your diet. Ideal body weight must be maintained for ease of transfers and mobility and prevention of pressure ulcer formation. Fiber and fluids facilitate proper elimination. Adequate fluid intake aids in preventing urinary infection and stones. An effective defense against high blood cholesterol is a calorically balanced eating pattern that is low in fat, saturated fat and dietary cholesterol, and high in complex carbohydrate. A nutrient rich diet plays a key role in pressure ulcer prevention and healing.
What you eat can have a tremendous influence on your health. A healthy diet is preventative medicine!
If you need further information, please walk into our nutritional therapy unit at
Yale Consultancy Sdn Bhd
Nutrition Therapy Unit
73-3, Amber Business Plaza,
Jalan Jelawat 1,
Batu 3 1/2 ,
56000 Kuala Lumpur
Wednesday, October 15, 2008
Do you really need mineral supplements?
Do you really need mineral supplements?
By
Dr. Leow Chee Seng
MBA (UPM), DBA (UBI), FBIH (UK), MMIM (Mal), MIHRM (Mal), MIM-CPT (Mal),CAHRP (Consultant) Mal), Certified E-Commerce Professional (Mal),Certified Professional Trainer (MIM, PSNB),Certified Stress Management (IACT, USA),Certificate Qualitative Research (Georgia, USA), Certificate in Homeopathy Medicine (Mal)
Practising Cognitive, Behavioural Therapist
Practicing Nutrition Therapist
When we walk into a pharmacy, the sale executive introduces different supplement to us. They explain the functions and benefits of each supplement. However, have we ever thought if the supplement needs by our body?
Practicing Nutrition Therapist
When we walk into a pharmacy, the sale executive introduces different supplement to us. They explain the functions and benefits of each supplement. However, have we ever thought if the supplement needs by our body?
For a healthy people, supplements help us to
· Prevent vitamin and mineral deficiencies when the diet does not provide adequate nutriens of all necessary nutrients.
· Supply amounts of nutrients larger than the diet can provide
· Protect against future disease
However, different individual takes supplement for various reasons. Recent nutrition surveys in United States has identified the deficiency supplement among their citizen includes calcium, iron, zinc, magnesium, copper and manganese. In general, there are few groups of people need special concern on nutrition, early people premenopausal women, athletes and special care patients. Besides, weight-loss, pure vegetarian, macrobiotic, and several other diets can also place some people at risk of deficiencies that vary with the type of diet. Dietary deficiencies increase the risk for diseases.
Tips
Elderly people always stay at home. They would face deficiency of vitamin D, vitamin A, vitamin E, calcium, vitamin B1, vitamin B2, and zinc.
Premenopausal women have found have low amount of consumption on calcium, iron, Vitamin A and Vitamin C.
Scientific prove on different vitamins
a) Vitamin A and beta-carotene.
A lot of people assume beta-carotene and vitamin A are the same. In fact, beta-carotene is a precursor to vitamin A. However, beta-carotene and vitamin A have different role in human health. When we shop in a pharmacy, it is not easy for us to buy vitamin A. Most of the supplement for vitamin A is sold in the form of beta-carotene. Deficiency of vitamin A is uncommon among healthy people except for older age groups. Several researches have proven that vitamin A is important for building our immune system but vitamin A supplementation did not help prevent infections in elderly people living in nursing homes. Bare in mind that never take vitamin A in the form of retinol more than 10,000 IU because it leads to birth defects and bone loss.
Beta-carotene increases the number of white blood cells and enhance-fighting immune functions in healthy people who take 25,000 to 100,000 IU per day. In contrast, there are some research that was conducted among smokers reported that supplements of synthetic beta-carotene increases the risk of both heart disease and lung cancer. However, a few of trials found that there is no positive and negative relationship between synthetic beta-carotene and other diseases including cancer, diabetes, angina pectoris, age-related eye disease, and intermittent claudicating. In practical, I always encourage people to take natural food as the source of beta-carotene instead of synthetic. Research has found that synthetic beta-carotene even is similar to synthetic beta carotene but only natural beta-carotene is able to reverse precancerous changes, which synthetic beta carotene does not. No studies have done to investigate if natural beta carotene could be more effective than synthetic form in preventing other diseases, but the potential harm for taking synthetic beta-carotene it should avoided by smokers.
b) Vitamins B
Vitamin B is subcategories into B1 (thiamine ), B2 (riboflavin) , B3(niacin) , B5(pantothenic acids ) B6(pyridoxine), B12(cobalamin). Western diet has adequate supply of vitamin B except vitamin B5 and B6 because the nutrition is added to white flour products and other food. There is a study shows that 49% of a group of male and female adolescents were found deficiency of vitamin B5. Vitamin B6 deficiency is common among geriatric population in western. Vitamin B12 deficiency is not common among healthy young people except vegans who also avoid daily and eggs. In US, there is about 15% of population face deficiency problem of this vitamin. One of the possibility of deficiency of vitamin B12 is due to people who take acid-blocking drugs or antacids for a long period of time. For old people, the deficiency of vitamin B12 is often related to degenerative that causing malabsorption of vitamin B12 from food among them. Another vitamin, biotin is produced by intestinal bacteria in amount that, along the typical dietary biotin intake, to prevent deficiency of nutrients.
There is no scientific research has done if vitamin B prevent disease. However, nutritionist believe that vitamin B6 is able to prevent heart disease by regulate blood homocysteine level in blood. However, there is no other research on preventive effect of vitamin B6 supplement on health. Vitamin B12 is important for control of homocysterine level in blood. Elevated homocysterine levels are associated with heart disease, stroke, Alzheimer’s disease and osteoporosis, and some, even not all, research suggests that homocysteine has a direct role in causing those diseases.
In practice, 100 mcg per day of vitamin B12 was adequate to reverse vitamin B12 deficiency in healthy elderly people. Besides, daily supplementation with 400 mcg of folic acids, 10mg of vitamin B6 and 50mcg of vitamin B12 lowers elevated homocysteine levels in most people. Some research have shown that supplementing with one or more of these vitamins helps preventing or reverse hardening of arteries and may reduce the risk of bone fracture.
c) Folic Acids
Folic acids deficiency is quite common throughout the world. In United States, about 11% of healthy people are affected by deficiency of folic acids. Hence, the US Food and Drug Administration (FDA) mandated that some grain products provide supplemental folic acids to reduce the prevalence of deficiency of folic acids. However, this increase of folic acids in food does not have effect on preventive measures for heart disease and birth defects.
The usage of folic acids in Obstetrics and gynecology clinic is common because requirement of folic acids double during pregnancy. The insufficient intake of folic acid has been associated to the low birth weight and increase in incidence of neural tube defects in newborns. Specialist would usually provide 400mcg per day of folic acid prior to and short conception to overcome of neural tube defects in newborns.
d) Ascorbic acids / vitamin C
Deficiency of vitamin C is rare in Asia but for those who consume Western diets, but insufficiency is found 6% of healthy adults especially among college students and smokers. For preventive purposes, a person is encouraged to take at least 90 to 100mg per day. Excessive concentration of vitamin C does not have any effect on concentration of vitamin C in the blood. Hence, a small amount of vitamin C is needed for prevention of disease.
e) Vitamin D
God provides us with free vitamin D everyday when exposing to sunlight, but sources can be insufficient especially for old people who seldom go out. Besides, deficiency of vitamin D also faces by vegans during winter month. In United States, there is 6% - 14% of population of healthy adult who has problem with deficiency of vitamin D. Vitamin D insufficiency is associated with bone loss and fractures in older people. In a double blind study, supplement of 800 IU per day of vitamin D prevented bone loss more effectively than 200 IU per day in postmenopausal women. Remember, vitamin D is known to be toxic in very high amounts, up to 2 000 IU per day is considered safe.
f) Vitamin E
It is reported that 27% of the US population had low blood levels of vitamin E. Research has found that 400 to 800 IY of vitamin E per day lowered risk of nonfatal heart attacks, but no fatal ones. Besides, there is another double blind trial found no beneficial effect from 400 IU per day of vitamin E supplementation on risk of nonfatal heart attacks, while another research found that 50 IU per day had no effect on heart attack. However, some double blind research has found that 50 IU per day of vitamin E is association with the reduction of risk of prostate cancer among smokers. Another recent research found that large amount of vitamin E (400IU per day or more) may result in a small increase in all-cause mortality, which another shows that there is an increase of heart failure. From all the research, some doctors are advising people not to take large amount of vitamin E.
In nutrition industries, mixed tocopherols, as opposed to the more w widely used alpha-tocopherols, may be safer and beneficial on heart-disease prevention. Supplementing of 100 IU per day of vitamin E is associated with lowered risk of heart disease
g) Vitamin K
Vitamin K is believed to help in blood clotting. Deficiency of vitamin K can cause bleeding problem but it is rare among healthy people. Besides blood clot, low vitamin K in blood is always associated to osteoporosis. In nutrition point of view, at least 1mg per day of vitamin K is used to reduce bone loss among women.
h) Calcium
Deficiency of calcium is more obvious among women. Good calcium nutrition throughout life is essential for achieving peak bone mass and preventing deficiency-related bone loss. Besides, scientific research has proven that high calcium level I the blood could reduce the possibility of bone fractures. However, very few researches conclude the effect of calcium on the protection of bones.
The needs of supplementing calcium for postmenapausal women, 800 to 1000mg is generally added to dies that commonly between 500mg to 700mg of calcium per day.
i) Phosphorus
Phosphorus plays essential roles in maintaining our health. However, our diets no matter the West or the East have adequate in this mineral. Some organisation proposed that the high level of phosphorus is hazardous to calcium and affects the metabolism of the bones. In general population, we do not need to take supplement of calcium. Hence, most multivitamins in the supplements do not add phosphorus as one of the element. However, for elderly there might be an exception because phosphorus level is associated to calcium level in our body. Hence, older person who is taking calcium supplement could be benefited when taking phosphorus supplement to increase absorption of the nutrients.
j) Magnesium
Magnesium deficiency is more commonly seen among elderly people. As the rule of thumb, at least 250mg per day may help preventing of bone lose.
k) Potassium
Modern diets have lower potassium level as compared to primitive diets. However, true deficiencies are uncommon. Some research has identified the role of potassium on preventing high blood pressure. Other research proposed that higher potassium level in diets can prevent stroke. Unfortunately, supplemental potassium allowed in each pill is only 99mg which is far below the recommended amount (2 400mg per day). However, multiple of potassium pills are recommended because it could cause stomach upset. Hence, in order to increase potassium level in the blood, the best method is to increase the frequency of taking fruits, vegetables or their juices.
l) iron
Deficiency of iron is more commonly among vegetarians, menstruating girls and women, pregnant women, female and adolescent athletes. Iron plays important roles in synthesis red blood cells (erythrocytes) in our body. Excessive of iron increases the risk factors for heart diseases, some cancers, diabetes, rate of infection and exacerbation of rheumatoid. In practice, iron supplements should be avoided unless they have been diagnosed with having, or being high risk of iron deficiency.
m) Iodine
Iodine deficiency is a major problem in many developing countries. Western countries have taken initiation to introduce iodized salt and the iodine is added to many foods. However, iodine intake has decrease in recent years. The deficiency is higher among countries where iodized salt is not available. Most people do not have problem regards to iodine unless they are avoiding seafood and sea vegetables. Patients with thyroid disease should check their doctor before using the iodine supplements.
n) Zinc
Zinc deficiency is not common but it has higher prevalence among countries with low incomes. Zink supplements (10mg per day) have prevented growth impairment in deficient American and Canadian children. Research has shown that 25mg to 150mg of zinc per day increases immune function among healthy people. Extreme level of zinc supplement impare the function of immune function and some healthcare professional recommend no more than 30mg to 50mg per day. There is a significant relationship between zinc level in blood and absorption of copper. Hence, when a person is taking zinc supplement, we would recommend them to take copper supplement to avoid zinc-induced copper deficiency.
o) Copper
The average dietary copper intake in the States has been found to below the accepted standards. Copper supplement helps to prevent bone loss. Since zinc can interfere with copper absorption, copper should be taken whenever zinc supplement are used for more than a few weeks.
p) Manganese
Although the content of manganese is low in processed food, but the dietary intake of the nutrient is adequate. Manganese deficiency has been associated with osteoporosis in unpublished studies. A double-blind trial found that a combination of mineral supplements including manganese prevented bone loss in postmenopausal women. Iron can reduce manganese absorption and cause lower body levels of manganese. So, manganese may be important to include when iron is supplemented. However, there is no other studies have studied the effect of manganese supplement to health.
q) Chromium
There is a disagreement about the extent of chromium deficiency in Western society because chromium nutrition has been difficult to study because of technical problems in analyzing foods and human body fluids for chromium content. Chromium deficiency has been associated with blood sugar and cholesterol abnormalities. A common observation is that the level of chromium in our body reduces during aging. Therefore, chromium supplements have not been tested of their ability to prevent diabetes and cardiovascular diseases. Healthcare professionals recommend the supplement of chromium as a reasonable precaution because a few single case report have described possible side effects in people taking large amounts of chromium, from 600 to 2 400mcg per day, although it is not clear whether chromium was responsible for these reactions.
r) Selenium
Selenium deficiency is rare among US Citizen. According to Recommended Dietary Allowance (FDA), 70mcg per day of selenium is recommended in the diet. However, a double blind studies found that people with 200mcg of yeast based selenium per day for four and a half years had a 50% drop in the cancer death rate over seven years compared with the placebo group. For healthy people, higher amount of selenium has been used for the cancer preventive effect. The upper end of safe long-term selenium intake has been estimated to 350 – 400 mcg per day.
s) Molybdenum
Molybdenum is an essential mineral with low potential of toxicity. The deficiencies of Molybdenum is rare, estimated requirement are based on what a person usually received in their diets. A study was conducted in China found that there is no benefit for a supplement containing vitamin C and molybdenum for cancer and cardiovascular disease. There is no other study has been conducted on investigating disease prevention with molybdenum supplements.
Elderly people always stay at home. They would face deficiency of vitamin D, vitamin A, vitamin E, calcium, vitamin B1, vitamin B2, and zinc.
Premenopausal women have found have low amount of consumption on calcium, iron, Vitamin A and Vitamin C.
Scientific prove on different vitamins
a) Vitamin A and beta-carotene.
A lot of people assume beta-carotene and vitamin A are the same. In fact, beta-carotene is a precursor to vitamin A. However, beta-carotene and vitamin A have different role in human health. When we shop in a pharmacy, it is not easy for us to buy vitamin A. Most of the supplement for vitamin A is sold in the form of beta-carotene. Deficiency of vitamin A is uncommon among healthy people except for older age groups. Several researches have proven that vitamin A is important for building our immune system but vitamin A supplementation did not help prevent infections in elderly people living in nursing homes. Bare in mind that never take vitamin A in the form of retinol more than 10,000 IU because it leads to birth defects and bone loss.
Beta-carotene increases the number of white blood cells and enhance-fighting immune functions in healthy people who take 25,000 to 100,000 IU per day. In contrast, there are some research that was conducted among smokers reported that supplements of synthetic beta-carotene increases the risk of both heart disease and lung cancer. However, a few of trials found that there is no positive and negative relationship between synthetic beta-carotene and other diseases including cancer, diabetes, angina pectoris, age-related eye disease, and intermittent claudicating. In practical, I always encourage people to take natural food as the source of beta-carotene instead of synthetic. Research has found that synthetic beta-carotene even is similar to synthetic beta carotene but only natural beta-carotene is able to reverse precancerous changes, which synthetic beta carotene does not. No studies have done to investigate if natural beta carotene could be more effective than synthetic form in preventing other diseases, but the potential harm for taking synthetic beta-carotene it should avoided by smokers.
b) Vitamins B
Vitamin B is subcategories into B1 (thiamine ), B2 (riboflavin) , B3(niacin) , B5(pantothenic acids ) B6(pyridoxine), B12(cobalamin). Western diet has adequate supply of vitamin B except vitamin B5 and B6 because the nutrition is added to white flour products and other food. There is a study shows that 49% of a group of male and female adolescents were found deficiency of vitamin B5. Vitamin B6 deficiency is common among geriatric population in western. Vitamin B12 deficiency is not common among healthy young people except vegans who also avoid daily and eggs. In US, there is about 15% of population face deficiency problem of this vitamin. One of the possibility of deficiency of vitamin B12 is due to people who take acid-blocking drugs or antacids for a long period of time. For old people, the deficiency of vitamin B12 is often related to degenerative that causing malabsorption of vitamin B12 from food among them. Another vitamin, biotin is produced by intestinal bacteria in amount that, along the typical dietary biotin intake, to prevent deficiency of nutrients.
There is no scientific research has done if vitamin B prevent disease. However, nutritionist believe that vitamin B6 is able to prevent heart disease by regulate blood homocysteine level in blood. However, there is no other research on preventive effect of vitamin B6 supplement on health. Vitamin B12 is important for control of homocysterine level in blood. Elevated homocysterine levels are associated with heart disease, stroke, Alzheimer’s disease and osteoporosis, and some, even not all, research suggests that homocysteine has a direct role in causing those diseases.
In practice, 100 mcg per day of vitamin B12 was adequate to reverse vitamin B12 deficiency in healthy elderly people. Besides, daily supplementation with 400 mcg of folic acids, 10mg of vitamin B6 and 50mcg of vitamin B12 lowers elevated homocysteine levels in most people. Some research have shown that supplementing with one or more of these vitamins helps preventing or reverse hardening of arteries and may reduce the risk of bone fracture.
c) Folic Acids
Folic acids deficiency is quite common throughout the world. In United States, about 11% of healthy people are affected by deficiency of folic acids. Hence, the US Food and Drug Administration (FDA) mandated that some grain products provide supplemental folic acids to reduce the prevalence of deficiency of folic acids. However, this increase of folic acids in food does not have effect on preventive measures for heart disease and birth defects.
The usage of folic acids in Obstetrics and gynecology clinic is common because requirement of folic acids double during pregnancy. The insufficient intake of folic acid has been associated to the low birth weight and increase in incidence of neural tube defects in newborns. Specialist would usually provide 400mcg per day of folic acid prior to and short conception to overcome of neural tube defects in newborns.
d) Ascorbic acids / vitamin C
Deficiency of vitamin C is rare in Asia but for those who consume Western diets, but insufficiency is found 6% of healthy adults especially among college students and smokers. For preventive purposes, a person is encouraged to take at least 90 to 100mg per day. Excessive concentration of vitamin C does not have any effect on concentration of vitamin C in the blood. Hence, a small amount of vitamin C is needed for prevention of disease.
e) Vitamin D
God provides us with free vitamin D everyday when exposing to sunlight, but sources can be insufficient especially for old people who seldom go out. Besides, deficiency of vitamin D also faces by vegans during winter month. In United States, there is 6% - 14% of population of healthy adult who has problem with deficiency of vitamin D. Vitamin D insufficiency is associated with bone loss and fractures in older people. In a double blind study, supplement of 800 IU per day of vitamin D prevented bone loss more effectively than 200 IU per day in postmenopausal women. Remember, vitamin D is known to be toxic in very high amounts, up to 2 000 IU per day is considered safe.
f) Vitamin E
It is reported that 27% of the US population had low blood levels of vitamin E. Research has found that 400 to 800 IY of vitamin E per day lowered risk of nonfatal heart attacks, but no fatal ones. Besides, there is another double blind trial found no beneficial effect from 400 IU per day of vitamin E supplementation on risk of nonfatal heart attacks, while another research found that 50 IU per day had no effect on heart attack. However, some double blind research has found that 50 IU per day of vitamin E is association with the reduction of risk of prostate cancer among smokers. Another recent research found that large amount of vitamin E (400IU per day or more) may result in a small increase in all-cause mortality, which another shows that there is an increase of heart failure. From all the research, some doctors are advising people not to take large amount of vitamin E.
In nutrition industries, mixed tocopherols, as opposed to the more w widely used alpha-tocopherols, may be safer and beneficial on heart-disease prevention. Supplementing of 100 IU per day of vitamin E is associated with lowered risk of heart disease
g) Vitamin K
Vitamin K is believed to help in blood clotting. Deficiency of vitamin K can cause bleeding problem but it is rare among healthy people. Besides blood clot, low vitamin K in blood is always associated to osteoporosis. In nutrition point of view, at least 1mg per day of vitamin K is used to reduce bone loss among women.
h) Calcium
Deficiency of calcium is more obvious among women. Good calcium nutrition throughout life is essential for achieving peak bone mass and preventing deficiency-related bone loss. Besides, scientific research has proven that high calcium level I the blood could reduce the possibility of bone fractures. However, very few researches conclude the effect of calcium on the protection of bones.
The needs of supplementing calcium for postmenapausal women, 800 to 1000mg is generally added to dies that commonly between 500mg to 700mg of calcium per day.
i) Phosphorus
Phosphorus plays essential roles in maintaining our health. However, our diets no matter the West or the East have adequate in this mineral. Some organisation proposed that the high level of phosphorus is hazardous to calcium and affects the metabolism of the bones. In general population, we do not need to take supplement of calcium. Hence, most multivitamins in the supplements do not add phosphorus as one of the element. However, for elderly there might be an exception because phosphorus level is associated to calcium level in our body. Hence, older person who is taking calcium supplement could be benefited when taking phosphorus supplement to increase absorption of the nutrients.
j) Magnesium
Magnesium deficiency is more commonly seen among elderly people. As the rule of thumb, at least 250mg per day may help preventing of bone lose.
k) Potassium
Modern diets have lower potassium level as compared to primitive diets. However, true deficiencies are uncommon. Some research has identified the role of potassium on preventing high blood pressure. Other research proposed that higher potassium level in diets can prevent stroke. Unfortunately, supplemental potassium allowed in each pill is only 99mg which is far below the recommended amount (2 400mg per day). However, multiple of potassium pills are recommended because it could cause stomach upset. Hence, in order to increase potassium level in the blood, the best method is to increase the frequency of taking fruits, vegetables or their juices.
l) iron
Deficiency of iron is more commonly among vegetarians, menstruating girls and women, pregnant women, female and adolescent athletes. Iron plays important roles in synthesis red blood cells (erythrocytes) in our body. Excessive of iron increases the risk factors for heart diseases, some cancers, diabetes, rate of infection and exacerbation of rheumatoid. In practice, iron supplements should be avoided unless they have been diagnosed with having, or being high risk of iron deficiency.
m) Iodine
Iodine deficiency is a major problem in many developing countries. Western countries have taken initiation to introduce iodized salt and the iodine is added to many foods. However, iodine intake has decrease in recent years. The deficiency is higher among countries where iodized salt is not available. Most people do not have problem regards to iodine unless they are avoiding seafood and sea vegetables. Patients with thyroid disease should check their doctor before using the iodine supplements.
n) Zinc
Zinc deficiency is not common but it has higher prevalence among countries with low incomes. Zink supplements (10mg per day) have prevented growth impairment in deficient American and Canadian children. Research has shown that 25mg to 150mg of zinc per day increases immune function among healthy people. Extreme level of zinc supplement impare the function of immune function and some healthcare professional recommend no more than 30mg to 50mg per day. There is a significant relationship between zinc level in blood and absorption of copper. Hence, when a person is taking zinc supplement, we would recommend them to take copper supplement to avoid zinc-induced copper deficiency.
o) Copper
The average dietary copper intake in the States has been found to below the accepted standards. Copper supplement helps to prevent bone loss. Since zinc can interfere with copper absorption, copper should be taken whenever zinc supplement are used for more than a few weeks.
p) Manganese
Although the content of manganese is low in processed food, but the dietary intake of the nutrient is adequate. Manganese deficiency has been associated with osteoporosis in unpublished studies. A double-blind trial found that a combination of mineral supplements including manganese prevented bone loss in postmenopausal women. Iron can reduce manganese absorption and cause lower body levels of manganese. So, manganese may be important to include when iron is supplemented. However, there is no other studies have studied the effect of manganese supplement to health.
q) Chromium
There is a disagreement about the extent of chromium deficiency in Western society because chromium nutrition has been difficult to study because of technical problems in analyzing foods and human body fluids for chromium content. Chromium deficiency has been associated with blood sugar and cholesterol abnormalities. A common observation is that the level of chromium in our body reduces during aging. Therefore, chromium supplements have not been tested of their ability to prevent diabetes and cardiovascular diseases. Healthcare professionals recommend the supplement of chromium as a reasonable precaution because a few single case report have described possible side effects in people taking large amounts of chromium, from 600 to 2 400mcg per day, although it is not clear whether chromium was responsible for these reactions.
r) Selenium
Selenium deficiency is rare among US Citizen. According to Recommended Dietary Allowance (FDA), 70mcg per day of selenium is recommended in the diet. However, a double blind studies found that people with 200mcg of yeast based selenium per day for four and a half years had a 50% drop in the cancer death rate over seven years compared with the placebo group. For healthy people, higher amount of selenium has been used for the cancer preventive effect. The upper end of safe long-term selenium intake has been estimated to 350 – 400 mcg per day.
s) Molybdenum
Molybdenum is an essential mineral with low potential of toxicity. The deficiencies of Molybdenum is rare, estimated requirement are based on what a person usually received in their diets. A study was conducted in China found that there is no benefit for a supplement containing vitamin C and molybdenum for cancer and cardiovascular disease. There is no other study has been conducted on investigating disease prevention with molybdenum supplements.
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