The Gulf Today - Time Out - - HEALTH WATCH - Dr Asheesh Me­hta In­ter­nal Medicine Spe­cial­ist

What we eat mat­ters to our health and eat­ing right should ind a place in one’s health res­o­lu­tions for the New Year. Count­less stud­ies have shown the beneits of a healthy diet in help­ing pre­vent a wide va­ri­ety of ill­nesses in­clud­ing heart dis­ease, di­a­betes, obe­sity, high blood pres­sure, gout, many types of can­cer, nutri­tional de­icien­cies, etc

The New Year is the time for health res­o­lu­tions and hope­fully it will be a healthy year for most of us. Res­o­lu­tions of all sorts of­ten suf­fer from the fa­tal law of our not fol­low­ing through with them. Mo­ti­va­tion or more of­ten, prac­ti­cal prob­lems of life, lead to our drop­ping them one af­ter the other in the irst few weeks or even days af­ter mak­ing them. Quite a few peo­ple do not even bother to make res­o­lu­tions af­ter hav­ing failed to abide by them in the past. None­the­less, mak­ing res­o­lu­tions sig­ni­ies that we re­al­ize the need for them and iden­ti­fy­ing ar­eas in our life that need changes is surely im­por­tant. It is a good idea to make res­o­lu­tions that are achiev­able rather than those that are ideal for us but which may be im­prac­ti­cal or un­achiev­able. As far as health res­o­lu­tions go, the aim for ev­ery­one is ob­vi­ously to be healthy now and to re­main healthy in the fu­ture also. Un­for­tu­nately, main­tain­ing op­ti­mum health and it­ness re­quires ef­fort. That the ef­fort is well worth mak­ing does not need stress­ing.

What we eat mat­ters to our health and eat­ing right should ind a place in one’s health res­o­lu­tions for the New Year. Count­less stud­ies have shown the beneits of a healthy diet in help­ing pre­vent a wide va­ri­ety of ill­nesses in­clud­ing heart dis­ease, di­a­betes, obe­sity, high blood pres­sure, gout, many types of can­cer, nutri­tional de­icien­cies, etc. Ide­ally, one should be eat­ing 3 to 4 small meals rather than one or two large meals on a daily ba­sis. Also, one’s diet needs to be bal­anced with a fair rep­re­sen­ta­tion of the three main nu­tri­ents, car­bo­hy­drates, pro­teins and fats. Com­plex car­bo­hy­drates in the form of polysac­cha­rides are much to be pre­ferred and con­sump­tion of sim­ple sug­ars is best re­stricted to be­low 37.5 gm for men and 25 gm for women on a daily ba­sis. This works out to about 9 and 6 tea­spoon­ful re­spec­tively. Con­sid­er­ing that a 330 ml can of Coke or Pepsi con­tains up­wards of 35 gm sugar, it is very easy to ex­ceed this limit un­less one is fairly vig­i­lant. Fruit juice is also best avoided. One glass of about 300 ml or­ange juice con­tains more than 30 gm sugar and a sim­i­lar quan­tity of grape juice con­tains more than 55 gm sugar and th­ese re­fer to “no sugar added” va­ri­eties. Pro­teins are good for us but the rec­om­mended daily al­lowance is only 0.8 gm per KG. Also, red meat such as beef and lamb which of­ten serve as sources of pro­tein in our diet need to be lim­ited. We also need fats in our diet for health but trans fats are un­doubt­edly harm­ful. Th­ese are of­ten present in pro­cessed foods as they ex­tend shelf life of foods. The con­sump­tion of sat­u­rated fats is also best con­trolled to a rea­son­able ex­tent. Un­sat­u­rated fats are con­sid­ered healthy for the heart and ex­am­ples in­clude sun­lower oil, olive oil, corn oil and canola oil. Veg­eta­bles and fruits are highly de­sir­able com­po­nents in our diet and the rec­om­men­da­tion is for 5 por­tions to be con­sumed daily. For ref­er­ence, one por­tion is about half a cup of cooked veg­etable or a cup of a leafy veg­etable or a medium sized fruit such as an ap­ple or or­ange. Fruit juice is, how­ever, best avoided. To sum­ma­rize, the res­o­lu­tion should be to eat 3 to 4 small meals daily which are bal­anced in their con­tent, re­strict sugar, co­las, fruit juice and red meat and to eat 5 por­tions of fruits and veg­eta­bles. It is equally im­por­tant for the res­o­lu­tion to in­clude lim­it­ing to­tal calo­ries con­sumed so as to main­tain weight within de­sir­able lim­its. Obe­sity is a ma­jor health prob­lem world­wide and this has par­tic­u­lar rel­e­vance in the Mid­dle East.

An­other worth­while health res­o­lu­tion is to ex­er­cise reg­u­larly. Both aer­o­bic ex­er­cises and non­aer­o­bic ex­er­cises are good for us. Aer­o­bic ex­er­cises in­clude walk­ing, jog­ging, swim­ming and cy­cling. For most of us a good com­bi­na­tion will be 5 days of aer­o­bic ex­er­cises and 2 days of mus­cle strength­en­ing ex­er­cises ev­ery week. Us­ing steroids to bulk up mus­cles is not a good idea at all. Half an hour of ex­er­cis­ing daily is a tar­get that is prac­ti­cal for most of us and has also been found to of­fer sub­stan­tial health beneits in the long-term. Deinitely a health res­o­lu­tion worth mak­ing.

If one is a smoker, a res­o­lu­tion to stop smok­ing is prob­a­bly the best gift to self and fam­ily. The ill ef­fects of smok­ing are so well known that re­peat­ing them is re­dun­dant. Even pas­sive smok­ing causes thou­sands of deaths. Yes, it is di­fi­cult to give up smok­ing but con­sider the health beneits and maybe even the money saved in cost of cig­a­rettes and doc­tors’ fees and make the res­o­lu­tion. Even more im­por­tant, ad­here to the res­o­lu­tion and give up smok­ing per­ma­nently. And this ap­plies to all forms of to­bacco use in­clud­ing chew­ing to­bacco, va­p­ing, pipe and shee­sha.

An­other worth­while res­o­lu­tion for the New Year is to go for a health check-up. High blood pres­sure and di­a­betes are ram­pant even in peo­ple in their 20s and 30s. Obe­sity and a seden­tary life style have much to do with it. For many years th­ese ill­nesses are silent. How­ever, even though there may not be any symp­toms, ab­nor­mal blood pres­sure or sugar dam­age vi­tal or­gans such as the heart, kid­neys and eyes. Screen­ing for high blood pres­sure or high sugar is sim­ple and eco­nomic in terms of time, cost and re­sources. Other dis­eases worth screen­ing for on a reg­u­lar ba­sis in­clude high choles­terol, breast can­cer and colon can­cer. High choles­terol lev­els are well known to be a ma­jor risk fac­tor for heart dis­ease and stroke. The el­e­vated choles­terol it­self does not cause any symp­toms. How­ever, it leads to atheroscle­ro­sis with nar­row­ing of ar­ter­ies and de­posits within them, af­fect­ing cir­cu­la­tion through them. Choles­terol lev­els can only be known from the re­sults of a blood test. The main rea­son for high choles­terol lev­els is ge­netic and ex­cept for med­i­ca­tions to con­trol el­e­vated lev­els, other mea­sures are just sup­port­ive. Peo­ple with pre­ex­ist­ing prob­lems such as di­a­betes or high blood pres­sure, those above 40 years of age and those with a sig­ni­icant fam­ily his­tory of high choles­terol, heart dis­ease or stroke are ap­pro­pri­ate can­di­dates for a screen­ing lipid proile to eval­u­ate the level of serum choles­terol and of the good HDL and bad LDL com­po­nents. For peo­ple al­ready hav­ing any of th­ese dis­eases the res­o­lu­tion should be to con­tinue reg­u­lar treat­ment to keep them un­der con­trol.

Screen­ing for breast can­cer and for colon can­cer is also worth­while. Both are rel­a­tively com­mon can­cers and both re­spond ex­cel­lently when treated early. Also, fairly ef­fec­tive screen­ing meth­ods are avail­able for both th­ese can­cers. Screen­ing meth­ods for breast can­cer in­clude self-ex­am­i­na­tion, clin­i­cal ex­am­i­na­tion by a trained health­care worker, ul­tra­sound ex­am­i­na­tion and mam­mog­ra­phy. Although all th­ese meth­ods are be­dev­iled by false pos­i­tives and false neg­a­tives, they do de­tect ma­jor­ity of early breast can­cers. MRI scan is more re­li­able but cost fac­tors pre­vent it from be­ing con­sid­ered a true screen­ing modal­ity for breast can­cer. Gen­eral rec­om­men­da­tions are for all women above 40 years of age to be screened but con­sid­er­ing how com­mon breast can­cer is and the pro­por­tion of women de­vel­op­ing it at an ear­lier age this cut off limit ap­pears to be too con­ser­va­tive. In any case, women with a fam­ily his­tory of breast can­cer need to start screen­ing ear­lier. Re­sults of treat­ment of breast can­cer at stage I and II are re­ally ex­cel­lent and should mo­ti­vate one to make a res­o­lu­tion to book an ap­point­ment for screen­ing. Colon can­cer is the other can­cer which is well worth screen­ing for. Test­ing for oc­cult blood in stools is one of the screen­ing tools but a colonoscopy is far more re­li­able. The dis­ad­van­tage is the in­con­ve­nience and the cost. Colon can­cer starts as a be­nign tu­mour called an ade­noma. Not all ade­no­mas be­come can­cer­ous. How­ever, the chances are much higher in larger ade­no­mas. The ad­van­tage of colonoscopy is that ade­no­mas or early can­cers can be re­moved dur­ing the same pro­ce­dure and tis­sue sam­ple can be ob­tained to de­ter­mine if any le­sion de­tected is can­cer­ous. For early can­cer the screen­ing pro­ce­dure can be a cu­ra­tive pro­ce­dure. There is, how­ever, a risk for can­cer to arise from other ar­eas of the colon even when the in­dex le­sion has been com­pletely re­moved. Hence, th­ese pa­tients re­quire reg­u­lar fol­lowup with colonoscopy. For the ini­tial screen­ing colonoscopy, the gen­eral rec­om­men­da­tion is that it start at 50 years of age.

So the de­sire should be for the New Year be a happy and pros­per­ous one but res­o­lu­tions are also re­quired to en­sure that it is a healthy one.

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