Osteoporosis : Prevention, Maintenance Bones, Food to Avoid

A. What is osteoporosis?



Osteoporosis is a condition that causes thinning and weakening of normal bone. The definition of osteoporosis is a decrease of the density of bone mass. When this occurs, a patient with osteoporosis will have weaker bones and have a higher risk of bone fracture. Osteoporosis is not arthritis, which leads to problems within joints due to cartilage wear. Instead, osteoporosis is a problem of the bone, and its ability to adequately support the weight of your body. There are two main categories of osteoporosis, Type I and Type II.
Type I osteoporosis occurs only in post-menopausal women, and is due to estrogen deficiency. Type II osteoporosis occurs in both men and women (about two times more frequently in women), and is due to aging, and calcium deficiency over many years.

B. What causes osteoporosis?

As people age, the amount of bone in their body steadily decreases. Women are especially prone to developing thin bone because they don't develop as much bone while younger, and the rate of bone loss in women is greater than men. Because of this, age and gender are the most important risk factors for developing osteoporosis. Both men and women achieve their "peak bone mass" in the third decade of life. After that time, bone mass gradually, but steadily decreases. In pregnant and l

From Jonathan Cluett, M.D.,
Your Guide to Orthopedics.

How Does Pregnancy or Breastfeeding Affect the Risk of Osteoporosis?

During pregnancy, the developing fetus accumulates about 30 grams of calcium to build its own skeleton. That’s 30,000 mg of calcium that must be transferred from the mother’s body to the fetus. During breastfeeding, another 300 to 400 milligrams of calcium are removed from the mother’s body daily in the form of breast milk. In fact, a woman breastfeeding twins can lose as much as 1,000 milligrams of calcium daily through milk production.

A Woman’s Body Can Conserve Calcium

With such substantial demands on calcium during pregnancy and breastfeeding, researchers have investigated how having children might affect a woman’s risk of osteoporosis later in life. Fortunately, when a woman is pregnant, her body becomes more efficient at absorbing calcium from foods and her kidneys adapt by decreasing calcium losses in the urine.

Even with these adjustments, there is typically some bone loss during the last months of pregnancy. During breastfeeding, additional bone loss occurs, even with a high calcium intake. After weaning, bones can increase their uptake of calcium and rapidly restore calcium back to pre-pregnant levels if adequate calcium is present in the diet.

In the vast majority of normal healthy women, pregnancy and breastfeeding a baby results in a temporary loss of calcium from bones that is rapidly replenished after breastfeeding is finished.

Consequently, there is typically no effect on the long-term risk of osteoporosis.

Some Rare Problems for Bones

Although it is uncommon, some women have experienced low bone density and bone fractures during or shortly after pregnancy or during breastfeeding. Little is known about the causes of these rare occurrences, but they may be related to a woman having low bone density at the start of pregnancy. If bone density is too low, her bones may be unable to tolerate the normal temporary losses of calcium that occur. Researchers also think that unusual hormone fluctuations can be involved in some cases.

An old adage says that a woman should expect to lose a tooth for every child she has. If calcium intake is limited, there may be a touch of truth to this. A study published in the January 2007 issue of the Journal of Periodontology reported that female rats were more likely to lose supportive bone around the teeth when they were nursing their young and consuming a lower calcium diet. It makes sense to take a hint from the rats and keep up the calcium in your diet during breastfeeding.

Pregnant Teens causes Osteoporosis?

A pregnant teenager has high calcium needs for her own skeletal development. Consequently, there is some concern that the demands of fetal development could compromise the accumulation of peak bone mass for the teen mother. This concern is controversial, but provides extra reasons to encourage overall good nutrition and adequate calcium intake.

The Bottom Line

Bone density and fracture incidence are about the same in women who have had many children and those who have never been pregnant. A woman’s bones are well designed to deal with the demands of pregnancy as long as her diet provides an adequate supply of all nutrients.

_Sources

_{Bone Health and Osteoporosis: A Report of the Surgeon General. (2004), U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General. (Report)}

_{Kovacs, Christopher S. “Calcium and Bone Metabolism During Pregnancy and Lactation.” Journal of Mammary Gland Biology and Neoplasia 10 (2005): 105-18. (Article Abstract)}

_{Shoji, Kanako, et al. “Effects of Lactation on Alveolar Bone Loss in Experimental Periodontitis.” Journal of Periodontology (2007): 152-56. (Article Abstract)}

Genetics and Race Play Important Roles

Many things affect your odds of developing osteoporosis. But your genetic and racial background can be significant risk factors. Osteoporosis does run in families, so if your family has a history of the condition, it is even more important for you to take steps now to have healthy bones throughout your life.

Scientists Narrowing in on Genetic Testing

Scientists are steadily gaining an understanding of which genes affect bones. A day will come when genetic testing will be able to rank an individual’s risk for osteoporosis. It may not be too far in the future. But, even if you knew that your risk of osteoporosis is low, it is still worth it to keep up activities that promote bone health -- such as exercise and eating calcium-rich foods -- because those things often reduce the risks of other diseases, as well.

Does Race Affect the Risk of Osteoporosis?

Although there are racial differences, the disease occurs in all racial groups. However, generally, whites have a greater risk of bone fracture than Asians and Asians have a greater risk than blacks.

Making racial comparisons is complicated because people of different races generally differ from each other by more than just their genes. Besides the genetic differences, they may have very different diet, lifestyle, and environmental factors. For this reason, studies that investigate the effects of diet and exercise on bone health must compare people of similar racial makeup for the study conclusions to be valid.

For example, I have seen faulty claims that since whites have the highest incidence of osteoporosis and consume more milk products than other races, it proves that milk is not good for your bones. The poor logic of this statement was well illustrated by a study that was part of a large study conducted by T. Colin Campbell and colleagues from Cornell University. His group measured the bone mineral density (BMD) of morethan 800 Chinese women from five different counties in China. They found that the women with the greatest BMD resided in a pastoral district where milk was a common part of the diet. Their milk consumption resulted in significantly greater consumption of calcium, phosphorus, and protein. So, with all things being genetically similar, increased intake of these nutrients translated into better bones.

The Bottom Line

Regardless of your family and genetic risk, it is still beneficial to to maintain healthy behaviors that are known to reduce the risk of osteoporosis, such as lifting weights and eating adequate amounts of calcium-rich foods.

_Sources

_{Huang, Qing-Yang and Annie Wai Chee Kung. “Genetics of osteoporosis.” Molecular Genetics and Metabolism 88 (2006): 295-306.}

_{Hu, Ji-Fan, Xi-He Zhao, Jian-Bin Jia, Banoo Parpia, and T. Collin Campbell. “Dietary calcium and bone density among middle-aged and elderly women in China.” American Journal of Clinical Nutrition 58 (1993): 219-27.}

Osteoporosis - Overview and Tips On Maintaining Bone Strength

Osteoporosis is a disease characterized by progressive loss of bone density. This results in thinning of bone tissue making one more susceptible to fractures, or broken bones. Although the incidence of osteoporosis is greater in women, men are also affected. Over ten million individuals in the United States today are affected by osteoporosis. It is a disease that is responsible for greater than 1.5 million fractures annually, making it a significant health care issue.

Osteoporosis occurs when the body fails to produce enough new bone or when too much bone is reabsorbed by the body. Throughout life, new bone is formed and old bone is reabsorbed. During infancy, childhood, and adolescence new bone is developed faster than old bone is removed. As a result, bone strength is maintained and may also become denser.

This process occurs until approximately age thirty. At this point peak bone mass is achieved. After this stage, bone re-absorption occurs in excess of bone formation resulting in weaker bone tissue.

Various risk factors are associated with the development of osteoporosis. These can be categorized into modifiable and non modifiable factors. Non modifiable risk factors include gender, ethnicity, body type, age, and past family history. Women are more susceptible to developing osteoporosis than men as are the elderly versus the young. Small “thin boned” body types are more at risk than larger “big boned” types. Caucasians and Asians are also at higher risk for developing osteoporosis than other ethnicities. Modifiable risk factors include inactive lifestyles, cigarette smoking, diets low in calcium and vitamin D, and low estrogen levels such that occur after menopause.

There are multiple ways to prevent the development of osteoporosis. Having a diet high in calcium and vitamin D is one important preventative measure. Calcium is important to maintain bone strength, however vitamin D plays a role in the absorption of calcium thus both are needed. Weight bearing exercises are another way to assist in maintaining strong bones. Bone tissue responds to the forces placed on them during exercise by becoming stronger. Lastly, avoiding cigarette smoking and alcohol consumption is one more way to prevent the onset of osteoporosis.

In fact, all nutritional treatments for osteoporosis and bone health include calcium and vitamin D, but they also include other elements like ground flax seeds, ipraflavone, vitamin K, natural hormones, reduction of smoking, caffeine, and alcohol, and just as important is the use of resistive exercise to increase bone strength.

Prevention Easier than Treatment for Osteoporosis

It is much easier to build healthy bones while we are young, than try to repair them when we are old. After the age of 30, it becomes increasingly difficult to build new bone, so the younger you start, the better:

• You should get at least 1200 milligrams of calcium per day from your diet or supplements. Studies show that the calcium from dairy products is the most absorbable form of dietary calcium, however you can also get calcium from anchovies, salmon (with bones), and calcium-fortified foods. If you don’t get enough calcium from your diet, take a calcium supplement. Other minerals like magnesium, and boron are important for bone health too. If you aren't sure if you need more calcium, take this screening test.
• Don’t Smoke. There are so many reasons not to smoke, and this is just another one. Smoking leads to an increase in the risk of bone fractures. If you smoke, you need to quit. If you don’t smoke, don’t start.
• Watch the caffeine. Caffeine may be linked to calcium loss from bones, so limit your intake of caffeinated beverages.
• Get out in the sun. Your body needs vitamin D to properly absorb calcium. Your body makes vitamin D from sun exposure. You don’t need to be a sun-worshipper; just a few minutes a day is enough. If you live in the northern latitudes, you might want to add vitamin D as a supplement in the winter months.
• Get some exercise. For kids, this is easy. Keep them active and they will build strong bones. As an adult, you need some resistive exercise, like weight lifting to put stress on the bones. This type of stress is good stress because it signals the bones to keep the much-needed calcium and other minerals in your bones.

If you are past the age of 30, and you are concerned about bone loss. See your doctor to have a test done that will determine how strong your bones are. If your bones are not as strong as they should be for your age, ask a nutritionist to help you set up an intensive diet and supplement program to repair your weakened bones.

Why Would Cola-Type Sodas Affect Bones?

It's not known precisely why soda-like drinks were linked to higher bone loss in women in this study, and the authors note that more research is needed. But other studies have proposed that people who drink plenty of sodas are likely to drink fewer calcium-containing beverages like milk. However, this study did not find this to be the case.

Two components found in cola -- but not in most other soda flavors -- are phosphoric acid and caffeine. Again, it's unclear if these two chemicals are the culprits.

The phosphorus part of phosphoric acid is a major component of bone mineral content, along with calcium. However, if phosphorus content of the diet is too high compared to calcium, it can alter hormone levels in a way that could increase bone loss. This should not be a problem if calcium intake is adequate.

Furthermore, caffeine can cause a very small reduction in calcium absorption. Some studies reported that caffeine also increases calcium loss in the urine, however this was later shown to be untrue when evaluated over longer periods of time. Bone health researcher Dr. Robert Heaney, professor of medicine at Creighton University in Omaha, Neb., put the caffeine issue into perspective, saying, “...the solution is not to decrease the caffeine intake of the Western world, but to provide adequate sources and intakes of calcium.”

Is Carbonation of Beverages Bad for Bones?

Carbonation (the addition of carbon dioxide gas to beverages) does not appear to have any effect on bone health. This is not surprising, since the body produces large amounts of carbon dioxide and is very efficient at releasing it in expired air. The amount of carbon dioxide in a carbonated beverage is rather minor compared to the amounts that the body produces.

Is Fructose in Soft Drinks Bad for Bones?

Some studies have indicated that high intake of fructose (from high fructose corn syrup) and other sugars can temporarily increase calcium loss in the urine. However, fructose does not affect total calcium loss when evaluated over a 24-hour period. So, as long as overall calcium intake is adequate, fructose is unlikely to be a significant factor.

To Drink or Not To Drink?

Therefore, the question is, “To drink or not to drink soda?” It is unlikely that sodas have a significant impact on bones because of their ingredients. Any harm to bone health is most likely due to what sodas do not contain: important bone minerals like calcium.

Non-cola sodas do not appear to have any negative effect on bones – especially if they are diet sodas. The cola-type sodas generally contain caffeine that temporarily increases calcium loss in the urine, but has no effect on 24 hour losses.

Keeping adequately hydrated is an important component of good nutrition for just about every function of the body.

If you are the type of person who just doesn’t like to drink enough water, adding a few diet sodas in your daily diet is unlikely to have negative effects on your bones. However, this assumes that the sodas are not displacing an adequate intake of foods, drinks, and/or dietary supplements that provide all the needed bone nutrients.

Sources :
Heaney, Robert P. “Effects of Caffeine on Bone and the Calcium Economy.” Food and Chemical Toxicology 40 (2002): 1263-70.

Heaney, Robert P. and Karen Rafferty. “Carbonated Beverages and Urinary Calcium Excretion.” American Journal of Clinical Nutrition 74 (2001): 343 - 347.

Tucker, Katherine L., et al. "Colas, but not Other Carbonated Beverages, Are Associated with Low Bone Mineral Density in Older Women: The Framingham Osteoporosis Study." American Journal of Clinical Nutrition 84 (2006): 936 - 942.

Milne, David B. and Forrest H. Nielsen. "The Interaction Between Dietary Fructose and Magnesium Adversely Affects Macromineral Homeostasis in Men." Journal of the American College of Nutrition 19 (2000): 31-7.

Bones Need To Get Enough Calcium

Providing your bones with enough calcium each day is one of the major components of a bone health regimen. For each day that you don’t absorb enough calcium to meet your needs, there is a net loss of calcium from your bones. If you fail to meet your needs day after day, there will be a steady decline in bone density and your risk of osteoporosis increases over time.

How Calcium Gets To the Bones

Getting calcium from your food to your bones requires a series of steps that involve digestion of food and freeing calcium from various food components that bind it. If the calcium remains bound up, it never gets into the body. The calcium just passes through the intestinal tract and your bones never see it.

When calcium can break free from other components in food, it has a good chance of being taken up (absorbed) by the cells along the intestinal tract. These intestinal cells can then release the calcium into the blood. Typically, about 30 percent of the calcium in food is taken up into the blood. However, the amount of calcium absorbed depends on the type of food consumed. The amount of calcium absorbed from a food can range from about 5 to 50 percent of the quantity in the food.

How To Get Enough Calcium To Your Skeleton

Don’t ask, “How much calcium is in that food?” Ask, “How much calcium can I absorb from that food?” In the U.S., the recommended daily calcium intake for adults (age19 to 50 years) is 1000 mg. This recommendation is based on the assumption that people can absorb about 300 mg of calcium from a diet that contains 1000 mg of calcium. This recommendation also assumes that the diet is composed of foods common to the U.S. diet, including milk products. If 300 mg of calcium is absorbed from the daily diet, it is likely enough calcium to replace all the calcium lost from the body that day. Consequently, there would be no net loss of calcium from the bones.

What Makes a Food a Good Source of Calcium?

For a food to be labeled a “good source” of calcium, U.S. food labeling law requires the legal serving size to contain at least 100 mg of calcium. That’s one tenth of the total daily recommended calcium intake (adults 19 to 50). However, there is a better way to think about this that takes into account how much calcium you can ABSORB from a food.

Using available information about the amount of calcium that is absorbed from various foods (fractional absorption), it is possible to determine “good sources” of calcium based on the ABSORBABLE calcium you need each day. So, if you should absorb about 300 mg of calcium each day, a “good source” should provide 10 percent of that or 30 mg of ABSORBABLE calcium in a customarily consumed amount of the food.

The table below lists some good food sources of absorbable calcium and shows what percentage of the calcium is typically absorbed from each food.

Some Good Food Sources of Absorbable Calcium

Type of Food & Amount	Calcium per Serving (mg)	Percent Absorbed	Amount Absorbed per Serving (mg)
Plain lowfat yogurt (1 cup)	448	32	144
Fruit flavor lofat yogurt (1 cup)	338	32	108
Milk, skim (1 cup)	316	32	101
Milk, 2% fat (1 cup)	285	32	91
Orange juice, calcium fortified (1 cup)	300	25	75
Cheese, mozzarella, part skim (1.5 ounces)	310	32	100
Soymilk, calcium fortified (1 cup)	300	24	72
Chinese Mustard Greens, cooked (0.5 cup)	212	40	85
Chinese Cabbage, cooked (0.5 cup)	79	54	43
Sardines, canned in oil (3 ounces)	324	27	88

Source

Titchenal, C. Alan and Joannie Dobbs. “A system to assess the quality of food sources of calcium.” Journal of Food Composition and Analysis (in press, corrected proof)) Available online 7 September 2006.

Getting Enough Calcium In

Choosing good calcium sources isn't as easy as it might seem.

Simple lists of the amount of calcium in foods can be misleading. Many factors can affect the amount of calcium the body can obtain from those foods.

Foods containing calcium that our bodies can absorb readily are considered to be highly bioavailable sources of calcium. Foods with compounds that interfere with calcium absorption are considered to have poor calcium bioavailability. For example, spinach is high in calcium, but only about five percent of that calcium can be absorbed due to a conflicting food component known as oxalate. Other foods with low calcium bioavailability are rhubarb, most beans, nuts, and seeds. These foods all contain calcium, but only limited amounts can make it to the bones.

For example, almonds are frequently listed as a food source of calcium. After all, one ounce of almonds contains 80 mg of calcium, about twice as much as one ounce of milk. But due to the limited absorption of calcium from almonds and their high calorie content, you need to consume about 1000 calories of almonds to absorb 100 mg of calcium. Instead, you could absorb this much calcium from 90 calories of non-fat milk or about 100 calories of calcium-fortified soy milk or orange juice.

Some foods are not predictable sources of calcium. A good example is tofu which is available in many different types and forms. The calcium in tofu is well absorbed, but you must check the nutrition label to see if the brand you buy contains a significant amount of calcium.

Milk is the classic high calcium food because it is a concentrated calcium source that is readily absorbed. Other good sources include some green vegetables and calcium fortified foods.

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Coronary Artery Disease | Coronary Heart Disease Causes, Symptoms and Treatments

What Is Coronary Artery Disease?

Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become hardened and narrowed. The arteries harden and narrow due to buildup of a material called plaque (plak) on their inner walls. The buildup of plaque is known as atherosclerosis (ATH-er-o-skler-O-sis). As the plaque increases in size, the insides of the coronary arteries get narrower and less blood can flow through them. Eventually, blood flow to the heart muscle is reduced, and, because blood carries much-needed oxygen, the heart muscle is not able to receive the amount of oxygen it needs. Reduced or cutoff blood flow and oxygen supply to the heart muscle can result in:

* Angina (AN-ji-na or an-JI-na). Angina is chest pain or discomfort that occurs when the heart does not get enough blood.

* Heart attack. A heart attack happens when a blood clot develops at the site of plaque in a coronary artery and suddenly cuts off most or all blood supply to that part of the heart muscle. Cells in the heart muscle begin to die if they do not receive enough oxygen-rich blood. This can cause permanent damage to the heart muscle.

Over time, CAD can weaken the heart muscle and contribute to:

* Heart failure. In heart failure, the heart can’t pump blood effectively to the rest of the body. Heart failure does not mean that the heart has stopped or is about to stop. Instead, it means that the heart is failing to pump blood the way that it should.

* Arrhythmias (a-RITH-me-as). Arrhythmias are changes in the normal beating rhythm of the heart. Some can be quite serious.

CAD is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.

Heart disease is also referred to as coronary artery disease, atherosclerosis, atherosclerotic heart disease or hardening of the arteries. It is a condition in which fatty substances gradually build up in your blood vessels, causing the vessels to become more narrow and restricting the flow of blood through the vessel. This buildup is common in the small arteries of the heart, brain, kidneys, legs and neck.

The arteries in your heart (coronary arteries), which are about the size of a strand of spaghetti, are blood vessels that carry oxygen and nutrients that feed the heart muscle. At birth the inside walls of the arteries are smooth, like the inside walls of a new water pipe, allowing blood to flow easily through the vessel.

Just as water pipes may gradually develop a buildup of minerals and debris on the inside surface causing the water to flow more slowly, the arteries may gradually develop a buildup of plaque on the inside surface of the arteries, restricting the blood flow. Plaque is made up of cholesterol, which is fatty deposits, and fibrous tissue, which is scar tissue that forms where an artery has been damaged. Plaque may have begun to build up in your arteries when you were young; however you may not notice any problems or effects until later in life. Usually symptoms begin when there is at least a 75 percent blockage in your artery. Plaque may also build up in more than one place in your artery.

The narrowings that result from the buildup of plaque in heart disease are also known as plaques, lesions, clogged areas, atherosclerosis and arteriosclerosis. When plaque builds up, it restricts the flow of blood to the heart, thereby restricting the amount of oxygen and nutrients that the heart receives from the blood. If you increase your heart activity with any exercise, exertion or mental or emotional stress, you are increasing your heart' s need for oxygen, which is already in limited supply. If the heart does not receive enough oxygen, it is experiencing ischemia, which may cause heart pain known as angina or a heart attack.

Symptoms of Coronary Artery Disease

The amount of buildup and the location of the blockages determine the symptoms you will experience when you have heart disease (coronary artery disease/atherosclerosis). Symptoms of heart disease include angina and heart attacks. Each of these has its own symptoms as well.

If you have experienced the symptoms of heart disease, such as chest pain, shortness of breath or dizziness, you should consult your physician. There are several tests your physician can run to help diagnose coronary artery disease, as well as the severity of the disease, if you are found to have it. Your physician may run one or more tests. Click on one of the tests listed in the more info section for a more detailed description of each procedure, as well as information about preparation, length and the effects of each test.

Coronary Artery Causes, Incidence, and Risk Factors:

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women. According to the American Heart Association, about every 29 seconds someone in the U.S. suffers from a CHD-related event, and about every minute someone dies from one.

The lifetime risk of having CHD after age 40 is 49% for men and 32% for women. As women get older, the risk increases almost to that of men. (See also heart disease and women.)

There are many factors that increase the risk for CHD. Some of the risks are based on family history (genetics), and others are more controllable. Risk factors include:

* Family history of coronary heart disease (especially before age 50)
* Male gender
* Age (65 and greater)
* Tobacco smoking
* High blood pressure
* Diabetes
* High cholesterol levels (specifically, high LDL cholesterol and low HDL cholesterol)
* Lack of physical activity or exercise
* Obesity
* High blood homocysteine levels
* Menopause in women
* Infection that causes inflammation in the artery wall. (There is some evidence that suggests this, but the theory is being studied.)

Coronary Artery Treatments

Regulate your cholesterol levels.

Cholesterol levels are one of the most modifiable risk factors you could have for developing atherosclerosis and coronary artery disease.

Ideally, you would want your total cholesterol levels to be below 200 mg/dL and your LDL cholesterol levels to be below 100 mg/dL (the new guidelines designate that certain high risk individuals should have this number at or lower than 70 mg/dL. Your HDL cholesterol (also known as the "good" cholesterol) should be above 40 mg/dL. Having high levels of HDL is a good thing, since it can exert a cardioprotective effect. Research has shown that aggressively treating cholesterol levels may prevent heart disease.

Stop smoking!

Many correlate smoking with lung cancer, however, nicotine addiction can be closely linked to another significant condition: heart disease. Smoking raises LDL cholesterol, lowers HDL cholesterol, and increases platelet aggregation. When this is coupled with the irritation smoking exerts on the arterial lining, it is a recipe for a potential disaster. According to the World Health Organization, you could cut your risk of CHD by half after quitting for one year, and with each subsequent year, your risk drops lower.

Check your blood pressure

Hypertension is a silent killer that also places you at risk for heart disease. Many people do not know they have high blood pressure until a routine visit to their health care practitioner. It doesn't necessarily affect cholesterol levels, but if it is ignored its effects can be deadly.

Eat healthy

Maintaining a healthy diet plays an important role in good heart health. This would include consuming a diet high in whole grains, fiber, fruits, and vegetables while limiting your consumption of saturated fats and trans fats (these are fats found in many cookies and snack foods).

Get some exercise.

Your heart is a muscle and exercise can benefit this. Moderate exercise can raise HDL levels, lower LDL levels, lower blood pressure, and prevent weight gain. During the week, you should exercise about 30 minutes 5 to 6 days out of the week. Even if you are not a marathon runner or a gymnast, you would be surprised how much benefit you can derive out of running up those steps instead of taking the elevator, or taking a brisk walk on a nice day.

Lose weight

If you are obese, losing 5-10% of your body weight can improve your cholesterol levels. Being overweight places you at risk for not only high cholesterol levels, but also type II diabetes mellitus. These two conditions are major risk factors for developing heart disease. By controlling your weight, you are also controlling your cholesterol and helping your heart to stay healthy.
How Is Coronary Artery Disease Treated ?

Treatment for coronary artery disease (CAD) may include lifestyle changes, medicines, and special procedures. The goals of treatment are to:

* Relieve symptoms
* Slow or stop atherosclerosis by controlling or reducing the risk factors
* Lower the risk of having blood clots form, which can cause a heart attack
* Widen or bypass clogged arteries

Lifestyle Changes

Making lifestyle changes can help treat CAD. For some people, these changes may be the only treatment needed:

* Eat a healthy diet to prevent or reduce high blood pressure and high blood cholesterol and to maintain a healthy weight
* Quit smoking, if you smoke
* Exercise, as directed by your doctor
* Lose weight, if you are overweight or obese
* Reduce stress

Coronary Artery Medicines

In addition to making lifestyle changes, medicines may be needed to treat CAD. Some medicines decrease the workload on the heart and relieve symptoms of CAD. Others decrease the chance of having a heart attack or dying suddenly and prevent or delay the need for a special procedure (for example, angioplasty or bypass surgery).

Several types of medicine are commonly used to treat CAD.

* Cholesterol-lowering medicines help to reduce your cholesterol to a doctor-recommended level.

* Anticoagulants (AN-te-ko-AG-u-lant) help to prevent clots from forming in your arteries and blocking blood flow.

* Aspirin, and other antiplatelet medicines, help to prevent clots from forming in your arteries and blocking blood flow. Blood contains small cells called platelets which clump together to form clots. Antiplatelet medicines reduce the ability of platelets to form clots. Aspirin may not be appropriate for some people because it increases the risk of bleeding. Discuss the benefits and risks with your doctor before starting aspirin therapy.

* ACE (angiotensin-converting enzyme) inhibitors help to lower blood pressure and reduce strain on your heart. They also may reduce the risk of a future heart attack and heart failure.

* Beta blockers slow your heart rate and lower your blood pressure to decrease the workload on your heart. Beta blockers are used to relieve angina and may also reduce the risk of a future heart attack.

* Calcium channel blockers relax blood vessels (arteries and veins) and lower your blood pressure. These medicines can reduce your heart's workload, help widen coronary arteries, and relieve and control angina.

* Nitroglycerin widens the coronary arteries, increasing blood flow to the heart muscle and relieving chest pain.

* Long-acting nitrates are similar to nitroglycerin but are longer acting and can limit the occurrence of chest pain when used regularly over a long period.

* Glycoprotein IIb-IIIa inhibitors are very strong antiplatelet medicines that are used in hospitals during and after angioplasty or to treat angina.

* Thrombolytic agents dissolve the clots that can occur during a heart attack. Thrombolytic therapy is administered in the hospital. Thrombolytic therapy and other treatments for heart attack are more effective the sooner they are given after a heart attack starts. You need to get to a hospital as soon as possible if you think you are having a heart attack.

Coronary Artery Surgery Special Procedures



* Angioplasty. This procedure opens blocked or narrowed coronary arteries. It can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Sometimes a device called a stent is placed in the artery to keep the artery propped open after the procedure.

* Coronary artery bypass surgery. In this procedure arteries or veins from other areas in your body are used to bypass your narrowed coronary arteries. Bypass surgery can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.

Angioplasty or bypass surgery may be used to treat CAD if:

* Medicines and lifestyle changes have not improved your symptoms.
* Your symptoms are getting worse.



Some people may need to have angioplasty or bypass surgery on an emergency basis during a heart attack to limit damage to the heart.

Cardiac Rehabilitation

Your doctor may prescribe cardiac rehabilitation (rehab) for angina or after bypass surgery, angioplasty, or a heart attack. Cardiac rehab, when combined with medicine and surgical treatments, can help you recover faster, feel better, and develop a healthier lifestyle.



Almost everyone with CAD can benefit from cardiac rehab.

Cardiac rehab often begins in the hospital after a heart attack, heart surgery, or other heart treatment. Rehab continues in an outpatient setting after you leave the hospital.

The cardiac rehab team may include:

* Doctors
o Your family doctor
o A heart specialist
o A surgeon
* Nurses
* Exercise specialists
* Physical therapists and occupational therapists
* Dietitians
* Psychologists or other behavior therapists

Rehab has two parts:

* Exercise training. This helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your individual ability, needs, and interests.

* Education, counseling, and training. This helps you understand your heart condition and find ways to reduce your risk of future heart problems. The cardiac rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and to deal with your fears about the future.

For more information on cardiac rehab, consult "Recovering from Heart Problems Through Cardiac Rehabilitation: Patient Guide" from the Agency for Healthcare Research and Quality.
How Can Coronary Artery Disease Be Prevented or Delayed?

Preventing or delaying coronary artery disease (CAD) begins with knowing which risk factors you have and taking action. Remember, your chances of developing CAD increase with the number of risk factors you have.

Know your family history of health problems related to CAD. If you or someone in your family has CAD, be sure to tell your doctor. Make sure everyone in your family gets enough exercise and maintains a healthy body weight.

By controlling your risk factors with lifestyle changes and medicines, you may prevent or delay the development of CAD.

CAD can cause serious complications, but by following your doctor's advice and changing your habits, you can prevent or reduce the chance of:

* Dying suddenly from cardiac problems
* Having a heart attack and permanently damaging your heart muscle
* Damaging your heart because of reduced oxygen supply
* Having irregular heartbeats (arrhythmias)

Home Remedies and Alternative Therapies for Coronary Artery Disease

There is no substitute for medical care when considering a serious—even potentially fatal—condition such as coronary heart disease. The first thing to do if you notice any symptoms of a heart problem, including chest pain, is to see your doctor. Medical treatment may be required to prevent heart attack. However, your doctor may recommend nonmedical measures, such as:

* exercise conditioning,
* relaxation techniques such as yoga, and
* a low-fat diet.

These measures may help ease the symptoms of coronary heart disease, especially angina, and may help ease the effects of some risk factors. For example, relaxation techniques may help you overcome stress and block pain impulses by refocusing your concentration. These techniques include meditation, yoga, biofeedback training, and self-hypnosis. For maximum benefit, you should choose a relaxation technique that you are comfortable with and practice it for 20 minutes once or twice a day. In addition to the direct positive effect on your cardiovascular system, relaxation techniques may help you make other lifestyle changes such as stopping smoking and contribute to a general sense of well-being.

Vitamin therapy may also work in conjunction with your medical treatment. High doses of niacin can lower blood cholesterol levels, reducing the buildup of fatty deposits in the arteries. In addition, recent studies indicate that vitamin E, an antioxidant vitamin that also inhibits blood clotting, may help reduce the risk of heart attack. However, do not take any more than the Recommended Dietary Allowance (RDA) of any vitamin without first consulting your doctor; some vitamins in high doses can have toxic effects.

Other more controversial, alternative therapies include garlic, which may be consumed as deodorized pills, and fish oil (omega-3 fatty acid) supplements. Ongoing studies indicate that large amounts of garlic may have a modest cholesterol-lowering effect. Any benefits of fish oil supplements are offset by the increased calorie and fat intake. Thus, experts recommend eating one or two servings of salmon, cod, or other cold-water fish a week rather than taking fish oil pills.

Still other alternative therapies provide no benefit and should be avoided. These include chelation therapy, a technique used to remove heavy metals such as lead from the blood.

Read More.....

Gastroesophageal Reflux Disease (GERD)/Heartburn

What Causes GERD?

Under normal conditions, when you eat and drink, the muscle at the bottom of your esophagus closes off so food and liquids will remain in your stomach. This muscle is the lower esophageal sphincter (LES).

However, GERD occurs chiefly because of the following three reasons: The esophagus's normal defenses are overwhelmed by the acid content of the stomach, the contents of the stomach are too acidic, or the food is not cleared from the esophagus fast enough.

When "refluxed" stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. The fluid may even reach the back of the mouth, and this is called acid indigestion. Occasional heartburn is common but does not necessarily mean one has GERD. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems.

From : Sharon Gillson
Your Guide to Heartburn / GERD

Definition Of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a condition in which food or liquid travels backwards from the stomach to the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

Alternative Names Peptic Esophagitis; Reflux esophagitis; GERD; Heartburn - chronic Causes

Gastroesophageal reflux is a common condition that often occurs without symptoms after meals. In some people, the reflux is related to a problem with the lower esophageal sphincter, a band of muscle fibers that usually closes off the esophagus from the stomach. If this sphincter doesn't close properly, food and liquid can move backward into the esophagus and may cause the symptoms.

The risk factors for reflux include hiatal hernia, pregnancy, and scleroderma.

Symptoms of GERD

* Heartburn
o Involves a burning pain in the chest (under the breastbone)
o Increased by bending, stooping, lying down, or eating
o Relieved by antacids
o More frequent or worse at night
* Belching
* Regurgitation of food
* Nausea and vomiting
* Vomiting blood
* Hoarseness or change in voice
* Sore throat
* Difficulty swallowing
* Cough or wheezing

GERD Exams and Tests

* A positive stool guaiac
* Continuous esophageal pH monitoring showing reflux
* Endoscopy showing ulceration or inflammation of the esophagus
* Esophageal manometry showing abnormal sphincter pressure
* A barium swallow showing reflux
* A positive Bernstein test for gastric acid reflux


Treatment of GERD ( Gastroesophageal Reflux Disease )

General measures include:

* Weight reduction
* Avoiding lying down after meals
* Sleeping with the head of the bed elevated
* Taking medication with plenty of water
* Avoiding dietary fat, chocolate, caffeine, peppermint (they may cause lower esophageal pressure)
* Avoiding alcohol and tobacco

Medications that alleviate symptoms include:

* Antacids after meals and at bedtime
* Histamine H2 receptor blockers
* Promotility agents
* Proton pump inhibitors

Anti-reflux operations ( Nissen fundoplication ) may help a small number of patients who have persistent symptoms despite medical treatment. There are also new therapies that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach) for reflux.

Outlook (Prognosis) of GERD

The majority of people respond to nonsurgical measures with behavioral modification and medications.

Possible Complications

* Inflammation of the esophagus
* Stricture
* Esophageal ulcer
* Hoarseness, bronchospasm
* Chronic pulmonary disease
* Barrett's esophagus (a change in the lining of the esophagus that can increase the risk of cancer)

When to Contact a Medical Professional

Call your health care provider if symptoms worsen or do not improve with lifestyle changes or medication.
Prevention

Avoid foods and activities that worsen symptoms. Maintain a healthy weight.

Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology

Gastroesophageal reflux disease image



A band of muscle fibers, the lower esophageal sphincter, closes off the esophagus from the stomach. If the sphincter does not close properly, food and liquid can move backward into the esophagus and cause heartburn and other symptoms known as gastroesophageal disease (GERD). To alleviate symptoms dietary changes and medications are prescribed. For a patient who has persistent symptoms despite medical treatment, an anti-reflux operation may be an option.

Normal anatomy


The esophagus is a narrow, muscular tube that leads from the mouth to the stomach. The esophagus carries food from the mouth to the stomach. A sphincter at the junction of the esophagus and the stomach prevents reflux of food and acid from the stomach into the esophagus.

Indication


When the lower esophageal sphincter doesn't function properly, acid and food can reflux up from the stomach into the esophagus. This can lead to pain (heartburn) and damage to the lower esophagus. This damage can cause strictures (narrowing) of the esophagus, and eventually, cancer of the esophagus. Frequently, dysfunction of the lower esophageal sphincter is associated with a hiatal hernia, in which the lower esophagus and upper part of the stomach slips up into the chest.

From Sharon Gillson,
Your Guide to Heartburn / GERD.

6 Steps To Preventing Heartburn-
related Complications

There are several complications that can occur with long-term heartburn / acid reflux. These complications include Barrett's esophagus, esophageal cancer, esophagitis, and esophageal strictures. There are, however, six steps you can take that can drastically reduce your chances of developing one of these complications.

1. Make the necessary lifestyle changes
Heartburn symptoms can often be relieved if sufferers make a few lifestyle changes. Many people can significantly reduce the occurrence of symptoms by avoiding heartburn triggers and behaviors that contribute to acid reflux flare-ups.

2. Watch what you eat
If you suffer from acid reflux, you need to know what foods are safe to eat and what foods to avoid. Most heartburn sufferers indicate their heartburn is worse after eating. If you can reduce the occurrences of food-related heartburn, this can go a long way in reducing the risk of complications. For example, drinking carbonated drinks may increase your risk of esophageal cancer. There are the foods with little risk of causing heartburn, foods that can be consumed in moderation, and foods that should be avoided completely. Also, knowing how to prepare foods will reduce heartburn. Check out this recipe index for heartburn-free recipes. Another resource to help you with your dietary needs as a heartburn sufferer is the Dining Out Guide For Heartburn Sufferers.

3. Keep track of your heartburn triggers
When you experience chronic heartburn, the first step to controlling your heartburn is to record what may trigger your attacks, the severity of the attacks, how your body reacts, and what gives you relief. The next step is to take this information to your doctor so the both of you can determine what lifestyle changes you will need to make and what treatments will give you maximum relief, and prevent complications. You can use this heartburn record as an example of what to track.

4. Learn how to prevent heartburn before it happens
Here are a few tips to significantly reduce the occurrence of acid reflux symptoms, and in most cases prevent the acid reflux before it starts. With less acid reflux episodes, there is less chance of esophageal damage.

5. Reduce nighttime heartburn
Nighttime heartburn can be the most dangerous. If frequent nighttime heartburn occurs, the risk of complications increases. There are several reasons reasons for this. For example, refluxed acid tends to remain in the esophagus for longer periods, allowing it to cause more damage to the esophagus. There are, however, a few ways to prevent nighttime heartburn.

6. Take prescribed medications
You should always contact your doctor if your heartburn occurs two or more times a week. While under the care of your physical, he or she may prescribe prescription medications or suggest over-the-counter remedies. There are alternative "home" remedies for easing heartburn. Discuss these with your doctor also.

10 Lifestyle Changes That Can Prevent Heartburn

Heartburn symptoms can often be relieved if sufferers make a few lifestyle changes. Follow these ten suggestions to significantly reduce the occurrence of acid reflux symptoms.

Eat smaller, more frequent meals.
Large meals expand your stomach and increase upward pressure against the esophageal sphincter.

Limit your intake of acid-stimulating foods and beverages.
Eat foods that rarely cause heartburn and avoid those foods that will often cause heartburn.

Don't lie down for about two hours after you eat.
Gravity helps to keep the stomach juices from backing up into the esophagus and assists the flow of food and digestive juices from the stomach to the intestines.

Elevate your head a few inches while you sleep.
Lying down flat presses the stomach's contents against the LES.

Maintain a reasonable weight.
Obesity increases abdominal pressure, which can then push stomach contents up into the esophagus. According to some statistics, approximately 35% of overweight persons experience heartburn. The good news is that for many people, as little as a 10% decrease in weight will improve their heartburn symptoms.

Don't smoke.
Nicotine relaxes the esophageal sphincter. Smoking also stimulates the production of stomach acid. Read this article to learn other ways smoking can worsen heartburn.

Don't drink alcohol.
If you still want to drink alcoholic beverages, follow these tips.

Relax.
While stress hasn't been linked directly to heartburn, it is known that it can lead to behaviors that can trigger heartburn. Follow these relaxation tips to alleviate stress, and thus make stress-related heartburn less likely.

Don't wear belts or clothes that are tight fitting around the waist.
Clothing that fits tightly around the abdomen will squeeze the stomach, forcing food up against the LES, and cause food to reflux into the esophagus. Clothing that can cause problems include tight-fitting belts and slenderizing undergarments.

Keep a heartburn record.
Record what triggered your acid reflux episodes, the severity of each episode, how your body reacts, and what gives you relief. The next step is to take this information to your doctor so the both of you can determine what lifestyle changes you will need to make and what treatments will give you maximum relief. To get you started, you can use this Heartburn Record

From Sharon Gillson,
Your Guide to Heartburn / GERD.

Read More.....

Diabetes Disease Diet | High Fiber Diet for Diabetes Disease

Sugar substitutes, can reduce calorie intake and help weight loss efforts. Sugar substitutes are so much sweeter than sugar that very small amounts are needed to create a sweet taste. That is what keeps the calories of the substitutes at a minimum. They also contribute almost no carbohydrates to foods, so diabtetics can enjoy more sweet foods without affecting blood glucose levels. There are five FDA approved artificial sweeteners; Saccharin, aspartame, acesulfame-k, sucralose, and neotame.

The Three Major Diabetes Food Plans:

There are three main food plans that people with diabetes use to manage their eating -- the exchange plan, the counting carbs plan, and the continuous carbohydrate plan. Why do you need a food plan? Using a food plan helps you keep track of your food intake, and eating close to the same amount of carbs, proteins and fats everyday helps you figure out how your body reacts to food. Knowing how foods affect your blood sugar gives you the tools to maintain better control. Keeping track of carbohydrates is something that people with either Type 1 or Type 2 diabetes should do.

Before You Start:

Carbohydrates are the most important part of the food you eat. They directly affect your blood glucose almost immediately after you eat them. All three plans detailed below help you keep your carbs in balance. For each of the plans, 15 grams of carbohydrate equals one carb choice. How do you know what 15 grams of carbs is? It's not always easy. First, set up an appointment with a dietitian, if you can. Also, most food labels list nutrition facts like carbs.

Exchange Meal Plan:

This plan divides food into six categories: starches, fruits, vegetables, milk, meat and fats. The serving sizes listed have similar amounts of calories, proteins, carbohydrates and fats. There is a food list to help you see what category your food falls into. It's called the exchange plan because it offers you the flexibility to trade one food on the list for a similar food. For example: exchanging 3/4 cup of cold cereal for a half of an English muffin. Exchange food lists are available from your dietitian.

Counting Carbohydrates Food Plan:

Counting carbohydrates is a more flexible plan. It only keeps track of your carbs. Carbs affect blood glucose levels quickly. Insulin works with the carbs and breaks them down for energy. You adjust your dose according to the amount of carbs you are going to eat at that meal. The units of insulin per grams of carbs is figured out by your doctor or dietitian based on your body's response to carbs. This requires careful tracking and blood glucose testing to see how carbs affect your blood sugar.

Constant Carbohydrate Food Plan:

This plan is the simplest to use and is the choice for many when they are first starting out. You only need to keep track of the carbohydrates in your diet. A dietitian or your doctor will help you establish how many carbs you should eat everyday. Usually insulin or other diabetes medication doses also remain constant. You keep the number of carb choices the same at each meal. Try to keep your daily eating and exercise routine the same.

Summing It Up:

No matter which plan you use, remember to check blood glucose levels often and write down the numbers and also how many carbs you have eaten that day. Good record keeping will give you and your doctor an accurate picture of how effective your food plan and medication schedule are. And that helps you maintain good control and keep your numbers in a good range for you.

Sources:

Clark RD, LD, Amanda, Stephanie Kovarick, RD, LD, CDE, Melissa Voigt, BA, and Joy Hayes, MS, RD, LD, CDE. "Using the MyPyramid.gov Website as a Tool for Diabetes Self-Management Education." Diabetes Spectrum 2006 19:122-126. 11 Jan. 2006.

FIBER AND DIET for DIABETES

Eating Right for Diabetes Nutrition and Health

Although it has been shown that fiber intake does not seem to have an affect on colon cancer risk, it does reduce the risk of developing other serious conditions such as heart disease and diabetes.

Experts recommend eating between 20 and 35 grams of fiber every day. Sometimes it’s hard to get enough fiber, especially when so many foods today are processed for the sake of convenience.

What can you eat that will give you the fiber you need?

* Whole grain breads and cereals. Make sure that whole grain is the first ingredient, for example, a loaf of wheat bread should have “whole wheat flour” as it’s first ingredient.
* Brown rice. Brown rice still has the bran layer intact. White rice is polished so that the bran layer is removed.

Brown rice takes longer to cook than white rice, about 45 minutes.

* Dried beans and peas. Soak beans overnight in cool water. The next day, drain off the water, add fresh water and cook until tender.
* Fresh fruits and vegetables. Leave the skin on, whenever possible, for even more good fiber.

Increase your fiber intake gradually to avoid discomfort. Drink 6-8 glasses of water each day to keep things moving.

From Debra Manzella, R.N.,

Getting Fiber on a Low Carb Diet

Is It True that Low Carb Diets Are Low in Fiber?:

It is a common misconception that reduced carbohydrate diets are automatically low in fiber. In fact, most non-starchy vegetables and low sugar fruits are quite high in fiber, and a well-constructed low carb diet emphasizes vegetables and other sources of fiber. Unfortunately, most people, at least in the US, don’t get close to the recommended amounts of daily fiber, no matter how many carbs they are eating! But there is no reason for you to be one of those people.

What is Fiber?:

Fiber is that part of plant food that is indigestible by humans. It passes through our digestive systems without being broken down and absorbed into our bloodstreams as other food components are. Think of a cow eating grass – that cow needs extra stomachs, chews its cud, etc, to digest the grass. We can’t digest grass because we don’t have specialized digestive systems. That indigestible stuff is fiber.

How is Fiber Beneficial?:

When people think of the benefits of fiber, they usually think of preventing constipation. It’s true that fiber bulks up our stool and tends to make people more “regular”. But fiber has other benefits as well, some of which are very pertinent to low carb diets, including lowering the impact of sugars and starches on blood glucose. A high fiber diet is associated with lower risk for heart disease, Type 2 diabetes, and diverticular disease.

What Are the Different Types of Fiber?:

Fiber has three different properties that matter to human health. The property most nutritionists talk about is solubility, the ability to disperse in water.. Soluble and insoluble fiber are the labels most commonly used to describe fiber. However, there are two other properties of fiber that are turning out to be important: fermentability (how easily the fiber ferments in the colon), and viscosity (the ability to gel with water) of the fiber, which may be more important than solubility.

What is Insoluble Fiber?: Insoluble fiber is what we usually think of when we think “fiber” or “roughage”. Wheat bran and most vegetables are examples of sources of insoluble fiber. It is tough, and doesn’t easily break down. Insoluble fiber tends to increase the “speed of transit” through our digestive systems, and increases regularity of bowel movements.

What is Soluble Fiber?: A lot of soluble fiber is viscous, allowing it to absorb and retain water, forming a gel. This type of soluble fiber actually slows digestion down. Because of this, it has a tendency to stabilize blood glucose, and permit better absorption of nutrients. It tends to reduce blood cholesterol. It also increases satiety, so people aren’t inclined to eat as much. Sources of soluble fiber include flax, beans, peas, oatmeal, berries, apples, and some nuts and seeds.

What is Fermentable Fiber?:
Some fiber will ferment in the colon, producing compounds that help support colon health, and possibly have other benefits. There is some evidence that it is this type of fiber that may reduce the risk of colon cancer. Most soluble fiber is highly fermentable. Pectins (found in apples and berries) and the fiber in oats are examples of fiber with a large fermentable component. Inulin and oligofructose are also highly fermentable, as is resistant starch.

Does Fiber “Count” as a Carbohydrate?:

Although most fiber sources are carbohydrates, fiber doesn’t raise blood glucosem so low carb diets don’t “count” fiber. (Fiber can provide calories, but not as glucose, but as products of fermentation in the colon.) In fact, fiber helps to moderate the effect of “usable carbs” on the bloodstream, so it furthers the goals of low carb diets. To the extent that is creates satiety, it may also help prevent weight gain, and aid in weight loss.

How Much Fiber Should a Person Eat?:

Generally, recommendations for adults are between 25 and 40 grams per day, and that 20-30% of the total fiber intake be soluble fiber. Most people have a much lower fiber intake than is recommended. Researchers who study the diets of our prehistoric ancestors say that they ate upwards of 100 grams of fiber per day, so we probably can handle very high amounts of fiber without difficulty.

Do I Have to Eat Fiber in Food? Can’t I Just Take Pills? :

While fiber supplements can be helpful additions to a high-quality nutritious diet, they should never stand in for high-fiber foods, which are also rich in antioxidants and other nutrients essential to health. There is some evidence that simply taking pure fiber as a pill, or sprinkling high fiber additions over your food doesn’t carry all the same benefits as when it is in food. Also, some high-fiber additives such as wheat bran contain compounds (phytates) which block the absorption of some nutrients, so large amounts of this should be avoided.

Guidelines for Consuming Fiber

* If you are unused to eating a lot of fiber, increase amounts gradually to prevent intestinal distress.
* Make sure you drink lots of water when taking fiber supplements or eating high-fiber foods, as all fiber absorbs at least some water. Fiber can, in rare cases, cause intestinal blockage if eaten with insufficient fluid.
* Since large amounts of fiber can reduce absorption of some medications, it is best to take medication either an hour before or two hours after the fiber.
* Chitin and chitosan come from the shells of crustaceans and should be avoided by people allergic to seafood.

What Low Carb Foods are High in Fiber?

As stated above, vegetables and fruits that are low in carbs tend to be also high in fiber. Flax is very high in fiber and very low in carbohydrate. Some bran cereals are good choices, such as All Bran. Possible supplements include those that are psyllium-based.

Fiber Counts in Low Carb Foods

Fiber Counts in Common Low Carb Foods Interestingly, almost all the non-starchy vegetables and low-sugar fruits are the ones that are highest in both fiber and nutrients. So if you just want a list of high-fiber vegetables and fruit, you just have to look at the lists of those which are low in carbohydrates. If you are looking for numbers, one good guide for those limiting carbs is to look at the ratio of usable carb (or effective carb compared to fiber – in other words, how much carbohydrate do I have to eat to get a gram of fiber? Here is a list, roughly in order on this carb/fiber scale. For foods not on this list, I recommend Nutritiondata.com. Note: I know there are discrepancies here. These are taken from Version 18 of the USDA Database. For an explanation of some of the incongruities, see Understanding Carb Counts.

Almost All Fiber

Flax!! There is almost no usable carbohydrate in flax seeds. It is very high in both soluble and insoluble fiber (about one third of the fiber is soluble), and has a pile of nutrients to boot. Flax is just could be the ultimate low carb fiber source. 1 T ground flax has 2.0 grams of carbohydrate, 1.9 of which is fiber.

Vegetables that are close to all fiber: Mustard Greens, Chicory, Endive
More Fiber Than Usable Carbohydrate
Wheat Bran

* ¼cup raw, 3 grams usable carb, 6 grams fiber

High Fiber Cereals

* Check the labels carefully, but a few high fiber cereals are also low or fairly low in carbohydrate. Examples: All Bran with Extra Fiber; Fiber One

Collard Greens

* 1 cup chopped, cooked, 4 grams usable carb, 5 grams fiber

Avocado, Hass

* 1 medium avocado, 3 grams usable carb, 12 grams fiber

Spinach and Chard

* 1 cup chopped, cooked – 3 g usable carb, 4 g fiber
* Frozen 1 10 oz package – 3 g usable carb, 8 g fiber
* 6 cups of raw spinach or chard=about 1 cup cooked

Broccoli

* 1/2 cup chopped, cooked, 1 gram usable carb, 3 grams fiber
* 1 cup chopped, raw, 4 grams usable carb, 2 grams fiber

Cauliflower

* ½ cup pieces, cooked,1 gram usable carb, 2 grams fiber
* 1 cup raw, 2 grams usable carb, 2.5 grams fiber

Blackberries

* 1 cup, raw, 6 grams usable carb, 8 grams fiber

About as Much Usable Carb as Fiber

Asparagus

* 1/2 C pieces, 2 grams usable carbs, 2 grams fiber

Celery

* 1 cup chopped, 1.5 grams usable carb, 1.5 grams fiber

Eggplant

* 1 cup raw, cubed, 2 grams usable fiber, 3 grams fiber
* 1 cup cubed, cooked, 5 grams usable carb, 3 grams fiber

Lettuce, Romaine

* 1 cup shredded, .5 gram usable carb, 1 g fiber

Mushrooms

* 1 cup, sliced, raw, 1 gram usable carb, 1 gram fiber

Radishes

* 1 cup raw, sliced, 2 grams usable carb, 2 grams fiber

Red Raspberries

* 1 cup, raw, 7 grams usable carb, 8 grams fiber

High Fiber, but Not As Much Fiber as Usable Carb

Rice Bran

* 1/4 cup – 8 grams usable carb, 6 grams fiber

Cabbage

* 1 cup raw, chopped, 3 grams usable carb, 2 grams fiber
* 1/2 cup cooked, chopped, 2 grams usable carb 1 gram fiber

Bell Peppers

* 1 cup chopped, raw, 4 grams usable carb, 3 grams fiber

Snow Peas (edible pod)

* 1 cup whole, raw, 3 grams usable carb, 2 grams fiber

Zucchini Squash

* 1 cup cooked, sliced, 4 grams usable carb, 3 grams fiber

Strawberries

* 1/2 cup sliced, 5 grams usable carb, 2 grams fiber

From Laura Dolson,
Your Guide to Low Carb Diets.


Where is The Sugar Hiding?

Sugar is everywhere in your supermarket! It's in plain sight in many foods, such as cereals, cakes, cookies and candy. But it's also lurking under many different names in products that you might never suspect. Foods such as canned soup and spaghetti sauce can also be heavy on the sugar.

Even though sugar and other simple carbohydrates can play a part in a well balanced diabetes diet, hidden sources of sugar can wreak havoc with the best laid nutritional plans.

Sugar travels incognito under many different aliases. Here are just a few. There are the usual suspects such as table sugar, brown sugar, powdered sugar, cane sugar, corn syrup, and sorghum, honey and maple syrup.These are common forms of sucrose.

But then it can get a little bit tricky. There are other sugars that also end in "ose" just like sucrose does.
Glucose, (aka dextrose), lactose, maltose and fructose are in many products. Even though fructose doesn't affect blood sugar as easily as sucrose, it is still a sugar and must be counted as a simple carbohydrate when you're keeping track.

Even more sneaky are the "ols" which are basically sugar alcohols. A lot of chewing gums and breath mints have these sugars in them. You may have seen sorbitol, xylitol, mannitol and maltitol listed in the ingredients for these and other products.

How can you defend yourself against these masked marauders? Be aware and read the labels. If it ends in "ose" or "ol", it's most likely a sugar.

From Debra Manzella, R.N.,
Your Guide to Diabetes.

Read More.....

Living Longer Diet - Diet with Fruits and Vegetables

It's hard to get through your first cup of morning coffee without reading a headline about food. Eat blueberries! Such antioxidant-rich foods will clear your arteries and help prevent the buildup of Alzheimer's plaque in your brain. Add in a cup of green tea in the morning and swish down an ounce or two of dark chocolate with a glass of red wine in the evening and you will be nicely tanked up on healthy fuel for the day.

Or will you? Almost every day, it seems, new studies emerge on the antiaging properties of various foods. One day, soy is good; the next, we find out soy's health benefits may have been oversold. To add to the confusion, this year The Journal of the American Medical Association (JAMA) published a study that found caloric restriction—eating about 25 percent less than normal—could extend your life.

So which headlines should we believe? And why should we believe them? The answers lie in research that shows exactly how various foods work at the cellular level. In particular, antioxidant-rich fruits and vegetables are emerging as powerful medicine in the fight against cellular aging.

Here's how it works. In the normal process of metabolism, cells produce unstable oxygen molecules—called free radicals—that damage cells. Worse still, the older we get, the more free radicals we produce. Recent studies suggest that the havoc free radicals wreak "plays a central role in virtually every age-related disease, including cardiovascular diseases such as stroke and atherosclerosis, Parkinson's disease, Alzheimer's, and type 2 diabetes," says Mark Mattson, Ph.D., chief of the Laboratory of Neurosciences at the National Institute on Aging at the National Institutes of Health.

It sounds pretty grim, but in this battle there are, thankfully, superheroes. Enter the vibrant world of antioxidants—substances that bind with free radicals and inhibit them from damaging cells. They are abundant in the most colorful fruits and vegetables, including spinach, broccoli, spirulina (blue-green algae), red apples, cranberries, blueberries, cherries, and grapes, as well as in chocolate and red wine. When you hear doctors say that eating five helpings of fruits and vegetables a day is good for you, antioxidants are the main reason. In the past five years an impressive body of research has emerged showing how antioxidants may protect the body and brain against the ravages of aging.

Paula Bickford, Ph.D., a researcher at the University of South Florida Center of Excellence for Aging and Brain Repair, is particularly interested in the role of antioxidants in brain health. The brain is a good place to study the benefits of antioxidants, says Bickford, because it has one of the highest percentages of fats of any organ in the body, and it is in our fats that free radicals inflict much of their damage.

As we age, "communications between neurons become damaged, kind of like what happened to the Tin Man in The Wizard of Oz," she explains. "Oxidative damage caused the Tin Man to grow rusty—until Dorothy came along and oiled him." Similarly, antioxidants help to "regrease the lines of communication" in the cells in our brain, says Bickford.

To measure how the communication between cells was affected when groups of rats ate different diets, Bickford and her colleagues placed electrodes in the brains of 20-month-old rats—the equivalent of 60-year-old humans. She then fed one group of rats a diet supplemented with spirulina, another with apples, and a third with cucumbers, which lack the antioxidant qualities of spirulina and apples. Bickford and her colleagues were surprised by the robustness with which "both the spirulina and apple groups demonstrated improved neuron function in the brain, a suppression of inflammatory substances in the brain, and a decrease in oxidative damage." By contrast, there was no improvement in rats fed a diet containing cucumbers. Bickford, who calls the findings "dramatic," reproduced her results in another study, in which rats fed a spinach-rich diet had a reversal in the loss of learning ability that occurs with age.

Most recently, Bickford examined whether eating a diet high in antioxidant-rich spinach and blueberries makes a difference in lab animals suffering from stroke and Parkinson's. "We've seen very positive effects with both of these diseases, as well," she says. "We believe that antioxidants can help people either to delay the onset or to slow the progression of a range of diseases that we tend to get as we age."

Tempting though it may be now to go out and gorge on antioxidant-rich dark chocolate, resist the urge. The hottest discovery in the search to find the fountain of youth through the foods we eat is to—gulp!—eat a lot less of them. A 2006 article in JAMA caused a stir by announcing that in both men and women, caloric restriction—as spartan as 890 calories a day—resulted in a decrease in fasting insulin levels and body temperature, two biomarkers of longevity. Why? Because restricting calories also helps to eliminate those nefarious free radicals. Mattson explains: "When you overeat and more energy comes into the cells than you burn off by being active, you are going to have more excess free radicals roaming around." Still, he advises, don't panic over the idea of having to subsist on 890 calories a day. Mattson, who calls such a diet "starvation," believes we can all gain the benefits of healthy eating with a lot less pain.

Richard Miller, M.D., Ph.D., a researcher and professor of pathology at the University of Michigan, agrees. He has spent the last 20 years studying the ways in which dietary and genetic changes can slow the aging process. The research has shown that mice, rats, and monkeys that have undergone severe caloric restriction demonstrate all kinds of mental and physical benefits such as better mental function, less joint disease, and even fewer cases of cataracts. But it's unrealistic to try to replicate that in humans. "To copy what's happening in the lab, a man weighing 200 pounds would have to decrease his caloric intake by 40 percent for life, which would put him at about 120 pounds," Miller explains. "That's just not tenable."

Instead, Mattson and Miller advocate a more moderate approach. According to the Centers for Disease Control and Prevention, the average man in the United States consumes about 2,475 calories a day. That's roughly 500 more, on average, than he really needs. Likewise, the average American woman consumes 1,833 calories, yet probably needs only about 1,600. One way to ratchet down your caloric consumption would be to follow this simple equation: men should aim for about 500 calories at both breakfast and lunch, while women should strive for about 300 at each meal. Both sexes can then shoot for 1,000 calories at dinner.

Bickford, who prefers to think of caloric restriction as caloric selection, underscores the importance of getting as much of your caloric intake as you can not only from antioxidant-rich fruits and vegetables but also from nuts and flaxseed, which are loaded with vitamin E and omega-3 and omega-6 fatty acids. In fact, Bickford takes a page out of her own lab studies and starts her day with an antioxidant smoothie. You can try it at home by blending together one cup of frozen blueberries with half a tablespoon of spirulina (available in any health food store), half a cup of nonfat plain yogurt, one teaspoon of ground flaxseed, one tablespoon of almond butter or a half-handful of almonds, and a dash of soy milk. Consider what's in that blender as a gas tank full of high-antioxidant fuel for the day.

Of course, one can't help but ask: what's the fun of living to 102 if you're subsisting on spirulina shakes? Not to worry. If you splurge on a stack of pancakes with eggs, bacon, and sausage—packing in 2,000 calories before 10 a.m.—you can always take heart in new data about to emerge from Mattson's lab, which show that periodic fasting—skipping a meal here and there—can also help to eliminate free radicals quite beautifully. "From an evolutionary standpoint we just aren't used to constant access to food," he explains. "Our bodies are used to going days without eating anything. Yet all of a sudden, we are taking in calories all day long."

In other words, we have gone from thousands of years of intermittently restricting our calories and eating a high-antioxidant diet to, in the past century, constantly eating a low-antioxidant diet. And that means more free radicals and more disease. So indulge in the pancakes or the cheese steak, but not both. Then skip a couple of meals and make your next one an all-out antioxidant feast. It may be counter to the don't-skip-meals philosophy our mothers all taught us; yet as it turns out, Mother Nature just might know better.

By Donna Jackson Nakazawa

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