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Dr. Jonah's Book on Nutrition & Health

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Dr. Stevenson's Book on Preventive Nutrition

 

Nutrition that helps to:

Prevent or Reduce Risk Factors for Certain Diseases and Cancers

Slow Down Aging and Increase Life Expectancy

Forestall Few Sexual Dysfunctions

Curtail Few Socio-economic Problems

 

 

Jonah David Stevenson, Ph.D.

 

 

 

Copyright © Jonah David Stevenson 2001

 

ISBN 976-8171-70-7

 

Cover Photograph Credit

Jonah David Stevenson

 

 

 

All rights reserved. No part of this book may be reproduced or used in any form, electronic or mechanical, including photocopying or retrieval system without the written permission of the author. However, few sentences can be used as quotes in speeches or dissertations as long as reference is given.

 

 

 

 

Foreword

Dr. Jonah Stevenson hails from an educated and religious family in India. He has done extensive research in the field of Public Health Nutrition. He lectured to the students at the Bachelor, Master and Doctorate degree level in the field of health and nutrition. He has written and published articles on health and nutrition. He possesses excellent knowledge in the same field.

 

This book covers nutritional preventive aspects of certain diseases and cancers of the various systems in the body, slowing down of aging, few sexual dysfunctions and few socio-economic problems.

This book will enlighten anyone who reads, digests and follows the advice and suggestions regarding preventive nutrition. You will have no regrets for purchasing this publication because it will bless you to lead a healthy life.

 

I highly recommend this book to everyone for the prosperity of his or her health.

 

Dr. M.J.Rao, M.D

Physician

Andrews Memorial Hospital , Kingston , Jamaica

 

Preface

 

Most of us very well know that we have to always stay in good health. But how do we achieve it? There are many factors that interplay to maintain good and positive health. Good nutrition is one of those factors.

We know the adage, Prevention is better than cure. This is true in every discipline. Thus, we have put to practice the nutritional knowledge that helps to prevent various diseases. We should know what nutrients, if taken too much or too little can support to cause diseases and cancers, and what nutrients help to prevent or reduce risk factors for them.

One should know what type of nutrition could significantly slow down the aging process and increase life expectancy. Brain and sex hormones play a major role in sexual functions. However, other factors, physical, psychological and social, can cause sexual dysfunctions. Nutritional situations can be a sexual turn off or turn on. Some food items when ingested can support to cause socio- economic problems and others may help to curtail few problems. Thus, the author of this book throws light on nutrition that helps prevent various diseases and cancers, slows down the aging process and that can contribute to prevent certain sexual dysfunctions. It can aid to prevent certain social problems. This book does not support any nutritional fallacies.

This book is useful for everyone who wants to stay healthy, younger in physical and mental health, who wants to have a happy sex life and have less socio-economic problems.

The author had earned Ph.D. in Anthropology with specialization in Public Health Nutrition.

 

Jonah David Stevenson  

 

 

 

Contents in Detail

 

 

Part 1

Nutrition and Prevention of Diseases and Cancers  

 

Chapter 1

Nutrition and Various Nutrients  

Chapter 2

Nutritional Fallacies and Frauds

Chapter 3

Communicable and Non Communicable Diseases  

Chapter 4

Prevention of Diseases  

Disease Prevention

Eradication or avoidance of causes

Modification of risk factors

Blocking the routes of transmission

Role of immunity and immunization

Role of nutrition

Assessment

Nutritional status assessment

Levels of Prevention

a.        Primary prevention

b.       Secondary prevention

c.        Tertiary prevention

Significance of Health and Nutritional Education  

 

Chapter 5

The Role of Nutrition in Prevention or Reduction of Risk Factors for Certain Diseases and Cancers

 

A.      Symptoms/Diseases of the Digestive System  

1. Caries 2. Constipation 3. Cirrhosis (alcoholic) 4. Diarrhea 5. Diverticulosis and Diverticulitis 6.Dyspepsia 7. Eructation 8. Flatulence 9. Fluorosis 10. Gallstones 11. Gingivitis 12. Hemorrhoids 13. Hiatus Hernia 14. Irritable Bowel Syndrome 15. Pancreatitis 16. Peptic Ulcers 17. Scurvy 18. Vomiting 19. Water borne and Food borne Diseases

a.        Bacterial Diseases-Cholera, Typhoid

b.       Leptospiral Disease- Weils Disease

c.        Protozoal Diseases-Amoebiasis, Giardiasis

d.       Viral Diseases-Hepatitis A, Poliomyelitis

e.        Helminthic Infestations- Hookworm, Roundworm and Tapeworm

 

B.       Symptoms/Diseases of Cardiovascular System  

1.        Anemias a. B12 deficiency anemia b. Folic Acid deficiency anemia c. Iron deficiency anemia d. Pernicious anemia

2.        Angina Pectoris 3. Atherosclerosis 4. Fatigue 5. Hemorrhage 6. Hypertension 7. Myocardial Infarction

 

C.       Symptoms/Diseases of the Endocrine System  

1. Diabetes Mellitus 2. Hypothyroidism 3. Menstrual Problems a. Amenorrhea b. Oligomenorrhea c. Premature Menopause

 

D.      Symptoms\Diseases of the Urinary System  

1.        Nephrotic Syndrome 2. Chronic Renal Failure 3. Urinary calculi

 

E.       Nervous and Mental Symptoms\Diseases  

1.        Anorexia Bulima 2. Anorexia Nervosa 3. Dementia 4. Headache and Migraine 5. Hypersomnia 6. Insomnia 7. Neurolathyrism 8. Psychogenic Vomiting 9. Stress 10. Stroke or Hemiplegia 11. Unconsciousness and coma

 

F.       Symptoms\ Diseases of Skeleto-Muscular System 

1.        Gout 2. Osteoporosis 3. Rickets

 

G.       Symptoms \Diseases of the Eye  

1.        Bitots spots 2. Keratomalaica 3. Night blindness 4. Xerosis

 

H.      Nutritional Deficiencies and Toxicities  

 

I.         Cancers  

1. Bladder cancer 2. Breast cancer 3. Colorectal cancer 4. Esophagus cancer 5. Liver cancer 6. Oral cancer 7. Pancreatic cancer 8. Pharyngeal cancer 9. Prostate cancer 10. Stomach cancer 11. Uterus cancer

 

J.        Food Allergies  

 

K.      Food Poisoning  

1. Botulism 2. Mushrooms 3. Salmonella food poisoning 4. Foods contaminated with rat and cockroach poisons

 

L.       Weight problems  

1. Overweight and Obesity 2. Underweight

 

M.     Symptoms\Diseases involving Miscellaneous Systems  

1.        Beri-beri 2. Fetal alcoholic syndrome 3. Low birth weight 4. Kwashiorkor 5. Marasmus 6. Pellagra 7. Skin Problems a. Acne vulgaris b. Other skin problems

 

N.      Genetic Disorders

1.        Galactosemia 2. Phenylketonuria

 

O.      Nutritional Side Effects due to Medications  

 

Part 2

Nutrition and Slowing Down of Aging  

 

Chapter 6

Etiology of Aging  

Chapter 7

Nutrition that Aids to Slow Down Aging and Increase Life Expectancy  

Chapter 8

Secrets of Longevity  

 

Part 3

Nutrition and Prevention of a Few Sexual Dysfunctions  

 

Chapter 9

Reasons of a Few Sexual Dysfunctions  

A. Hypoactive Sexual Desire Disorder 1. Physical reasons 2. Psychological and Social reasons 3. Nutritional reasons 4. Medications

B. Impotence 1. Physical reasons 2. Psychological and Social reasons 3. Nutritional reasons 4. Medications

Chapter 10

Nutrition that Contributes to the Prevention of a Few Sexual Dysfunctions  

Chapter 11

Do Aphrodisiacs Really Work?  

Chapter 12

Can Nutrition Act as a Sexual Turn On?  

 

 

Part 4

Nutrition and Prevention of Few Socio-economic Problems  

 

Chapter 13

Etiology of Few Socio-economic Problems  

Chapter 14

Nutrition that can Abet to Cause Few Socio-economic Problems  

Chapter 15

Nutrition that Helps Prevent Few Socio-economic Problems  

 

 

 

References  

 

 

 

Part 1

Nutrition and Prevention of Diseases and Cancers

 

Chapter 1

Nutrition and various Nutrients

Chapter 2

Nutritional Fallacies and Frauds

Chapter 3

Communicable and Non Communicable Diseases

Chapter 4

Prevention of Diseases

Chapter 5

The role of Nutrition in Prevention or Reduction of Risk Factors for Certain Diseases and Cancers


Chapter 1

Nutrition and Various Nutrients

 

Nutrition is a significant factor for man to live. By the way, what is nutrition? Nutrition is a process where the body ingests, digests, absorbs, utilizes the food and also excretes the waste of it. In other words, nutrition is the study of food and how it is used for the needs of the body.

 

What is health? According to WHO (World Health Organization) Health is a complete state of the physical, mental and social well-being and not merely an absence of disease or infirmity.

 

What is nutritional status? It is the state of the body determined by the nutritional process. The state of the body could be normal nutrition or under-nutrition or over-nutrition.

 

Nutrients are substances that nourish the body. The nutrients can be classified as follows:

a. macro-nutrients

micro-nutrients

Macro-nutrients are water, carbohydrates, lipids and proteins. Micro-nutrients are vitamins and minerals. One should know the functions, sources and the recommended dietary allowances of the nutrients in order to prevent or reduce risk factors for diseases and cancers and live healthily. The main functions of the nutrients in the body, sources and requirements of nutrients along with energy requirements and eating variety of foods are discussed in this chapter.

 

Macro-nutrients

Water

Water is the largest macro-nutrient in the body. Water constitutes nearly 60% of the total body weight of an adult. The functions of water are as follows:

Water transports the nutrients to their cells.

The foods we eat are generally mixed with saliva when we chew, which in turn, assists to digest the food.

Water acts as a lubricant. It avoids friction in the various parts of the body.

The bodys wastes are excreted through water.

The body maintains moisture, for example, in mucus, tears and saliva.

Water also helps in the regulation of temperature by excreting or evaporating water in the skin.

Water aids in function of every cell in the body.

Water is a component of blood and lymph fluids.

9. It acts as solvent.

 
 
The sources of water

 

Water, which we drink everyday, should be purified and without the presence of any chemicals and pathogenic micro-organisms. Apart from drinking water, even ingested food has about 500-1000ml of water. The metabolic water in the body is about 300ml. The water, which we take in, either through liquids or solid foods, will be used and there will be loss of water through urine, perspiration, evaporated water from the lungs and through feces.

 

The daily requirements of water

 

Every normal adult must drink about 1.5 to 2 liters of water everyday. Adults living in very hot places must drink more than 2.5 liters of water everyday.

 

Carbohydrates

 

Carbohydrates are the second largest macro-nutrients in the body. The chemical elements of carbohydrates are carbon, oxygen and hydrogen. Carbohydrates can be classified into simple carbohydrates and complex carbohydrates. Simple carbohydrates are monosaccharides (single sugar) and disaccharides (double sugars). Complex carbohydrates are polysaccharides (starches and dietary fibers). Examples of monosaccharides are glucose, fructose and galactose and those of disaccharides are sucrose, maltose and lactose. The examples of polysaccharides are starch, dextrin and dietary fibers.

 

Ethanol is produced by fermenting carbohydrates in foods and it is an alcohol chemically. Alcohol gives 7 kcals of energy per gram or 5.6 kcals per millilitre. Throughout this book, alcohol is discussed as a part of nutritional problems because of its addictive nature and adverse effects on health.

 

The functions of carbohydrates in the body

 

The main function of carbohydrates is to provide energy. It gives 4 kcals per 1 gram. Carbohydrates have chemical structures that combine with hydrogen to manufacture non-essential amino acids. Carbohydrates form part of some structures like cartilage, bone and nervous tissue. Carbohydrates help to complete the cellular-metabolism of fats. Carbohydrates are also known as protein sparers, in other words, they spare the protein from giving energy because carbohydrates give energy. Fibers have several functions in the body. Though dietary fiber is not digested in the intestinal tract, it helps the feces to be softer and bulkier. Dietary fiber absorbs and holds water in the colon. It also aids to avoid constipation. Another function of dietary fiber is it assists indirectly in the prevention of certain diseases. Since dietary fiber inhibits absorption it can indirectly help to prevent obesity. It can also aid to prevent colon cancer and atherosclerosis. Dietary fibers can be further classified into water insoluble dietary fibers and water soluble dietary fibers. The examples of water insoluble dietary fibers are cellulose and hemi-cellulose. The examples of water soluble fibers are pectins, gums and mucilages.

 

The Sources of Carbohydrates

 

The sources of simple carbohydrates are fruits, vegetables, sugar cane, honey and milk. The sources of complex carbohydrates are legumes, vegetables and whole grain cereals. The sources of water insoluble dietary fibers are wheat bran, seeds, nuts, carrots and leafy vegetables. The food sources of water soluble dietary fibers are oat bran, barley, legumes, oatmeal and all citrus fruits like oranges and grapes.

 

Requirements of carbohydrates

There is no recommended dietary allowance for carbohydrates. However, about 60% of the total dietary intake should come from carbohydrates. The daily intake of dietary fiber is 25 grams per 2000 kcals.

 

 
Proteins

 

Proteins contain carbon, hydrogen, oxygen and nitrogen. Nitrogen makes about 1/6th of the protein. The basic structure of proteins is amino acids. In other words amino acids are the building blocks of proteins. Amino acids are divided into essential amino acids and nonessential amino acids. Essential amino acids are called so because they can be acquired only through diet. Some examples of amino acids are lysine, phenylalanine and tryptophan. Nonessential amino acids can be synthesized by the body, apart from being received through the diet. Some examples of them are cystine, proline and tryosine.

 

The functions of proteins in the body

 

Every cell has proteins as its essential component. Collagen is a major structural protein in the blood vessels, skin walls, bones, ligaments, and tendons. Regulatory materials of the body contain proteins. Chromosomes are examples of nucleo-proteins. Insulin and thyroxine, which are hormones, are also made up of proteins. Proteins help in transportation. Examples of which are lipoproteins, hemoglobin and transferrin. Proteins give energy. One gram of protein gives 4 kilocalories.

 
Sources of protein

 

The sources of complete proteins are basically from animal and dairy products like eggs, meat, milk, chicken and fish. The food sources of incomplete proteins are beans, nuts, grains, and peas.

 

Requirements of protein

The RDA of protein for men (25-50 years) is 63 grams and for women of the same age group is 50 grams. The RDA or estimated safe and adequate daily dietary intakes (ESADDI) for various nutrients in this book is taken from Recommended Dietary Allowances, 1989, by the National Academy of Sciences, Washington DC.

 

Lipids

They can be classified into simple, compound and derived lipids. Lipids are basically fats and oils. The chemical elements of lipids are carbon, hydrogen and oxygen. Nevertheless, they have less proportion of oxygen when compared to carbohydrates. There are few lipids, which contain phosphorus, proteins, carbohydrates and nitrogen. The major structural constitution in lipids is fatty acids. The examples of simple lipids are fats and oils. The examples of compound lipids are phospholipids and glycolipids. The examples of derived lipids are sterols like cholesterol and sex hormones.
The functions of lipids in the body

Lipids give concentrated energy in the body. One gram of fat gives 9 kilocalories. Lipids act as insulators and they protect the body from cold and maintain constant body temperature. Lipids also support organs in the body such as the liver and the kidneys. The essential fatty acids are good for the growth of the skin. Linoleic acid is required for healthy skin for both children and adults. Cholesterol, which is an example of derived lipids, has vital functions in the body. Cholesterol is another constituent of the tissues, like in the formation of the brain and nervous tissues. It is a precursor of sex hormones.

 

Sources of Lipids

The sources of visible lipids are oils, butter, fat around organ meats and skin of chicken. Sources of invisible lipids are egg yolk, cheese, whole milk, yogurt, ice cream and cakes.

 

Requirements of lipids

 

Less than 30% of the daily diet should come from fat and out of this percentage less than 10% should come from saturated fat and the other should come from mono-unsaturated and poly-unsaturated fat. High saturated fat & trans fat intake is detrimental to health.

 

Micro-nutrients

Vitamins and minerals are classified as micro-nutrients because they all add up to a very small percentage of the body weight.

 

Vitamins

Vitamins are divided into fat soluble vitamins and water soluble vitamins.

 

Fat Soluble Vitamins

The fat soluble vitamins are vitamins A, D, E and K. These vitamins are called fat soluble vitamins because they are soluble in fat solvents.

 

 
 
 
Vitamin A

 

Vitamin A basically has a role in vision. It also helps indirectly in the growth of the bone, teeth and in the maintenance of epithelia. Vitamin A can be divided into two groups, namely, retinoids (preformed vitamin A) and carotenoids (vitamin A precursors). Carotenoids are antioxidants. The RDA for vitamin A is 1000 micrograms RE and 800 micrograms RE for men and women respectively. See Appendix 1.

 

The sources of Vitamin A

 

The sources of retinoids are found in animal foods like whole milk, cheese, butter and egg yolk. The sources of carotenoids are vegetables like pumpkin, carrots; fruits like mangoes, papayas; and green leafy vegetables like spinach, turnips and green tops of beets.

 
 
Vitamin D

 

It helps in the absorption of calcium and also phosphorous. It helps in the mineralization of the bones. Vitamin D influences the kidneys absorption of calcium and phosphorous. RDA is 10 micrograms for children and pregnant women.

 

 

Sources

The sources are fish liver oil, tuna, salmon, fortified milk and sunlight.

 

Vitamin E

Vitamin E can be divided into two groups, which are tocopherols and tocotrienols. The functions of vitamin E are that it is an antioxidant and it protects red blood cells. It inactivates free radicals. The RDA for men is 10mg alpha-TE and 8mg alpha-TE for women.

 

Sources

The sources are dark green leafy vegetables, legumes, whole grains and margarines.

 

Vitamin K

It helps in blood clotting. It forms prothrombin for normal blood clotting. The RDA for men is 80 micrograms and for women 65 micrograms.

 

Sources

The sources are dark green leafy vegetables and liver of chicken, goat and sheep.

 

 

 

 

 

Water Soluble Vitamins

 

B complex vitamins, niacin, folic acid, biotin, and vitamin C are known as water soluble vitamins because they are soluble in water.

 

Vitamin B1

 

It is also known as thiamin. Its main function is as a co-enzyme. The co-enzyme thiamin pyrophosphate (TPP) helps in the breakdown of glucose for energy. It helps in good digestion, improved appetite and contributes to healthy nerves and good mental outlook. The sources are found in whole grain, cereals, rice, milk, eggs, sunflower seeds and peas. The RDA for thiamin is 0.5 mg per thousand kcals for adults.

 

Vitamin B2

 

This is also known as riboflavin. The main function of riboflavin is as a co-enzyme for protein and glucose metabolism. Another role is it helps in healthy skin and normal vision in bright light. The sources of riboflavin are dark leafy vegetables, meat, milk and whole grains. The RDA for riboflavin is 1.7mg for men and 1.3 mg for women.

 

 
 
Vitamin B6

 

The other name for Vitamin B6 is pyridoxine. The chief function is that it helps in protein metabolism. It aids to convert tryptophan to niacin. The sources of B6 are meat, dark leafy vegetables, and whole grain cereals. The RDA of B6 is 1.6mg for a woman and 2.0mg for men.

 

 

Vitamin B12

 

Vitamin B12 is also known as cobalamin. It helps in the formation of mature red cells and synthesis of DNA. The RDA is 2 micrograms for adults. One should note that B12 is found only in animal foods. It is found in milk, meat, fish and eggs. However, some of the legumes contain a little B12 in them because it is produced by the reaction of the bacteria in the legumes.1 Of course, one can get vitamin B12 from enriched sources like soymilk.

 

 

Pantothenic Acid

 

Pantothenic acid is also known as vitamin B5. The chief role of it in the body is that it helps in the synthesis of fatty acids and heme. The sources of B5 or pantothenic acid are found in whole grain cereals, legumes and flesh foods. There is no RDA for pantothenic acid, however, there is an estimated, safe and adequate daily dietary intake (ESADDI) which is 4-7mg for adults.

 

Niacin

Niacin is also known as nicotinic acid and nicotinamide. The functions of niacin are varied. It helps in the growth of healthy skin and a healthy nervous system. It also helps in energy metabolism. The sources of niacin are dark leafy vegetables, whole grains, bread, cereals and fish. The RDA for adults is 6.6 mg niacin equivalent per thousand kcals.

 

Folic Acid

 

Folic acid is also known as folate. The main functions are assisting in the maturation of red blood cells and the synthesis of DNA and RNA. The sources are dark leafy vegetables, flesh foods and whole grain cereals. The RDA is 200 micrograms for men and 180 micrograms for women.

 

Vitamin C

It is known as ascorbic acid. It helps in collagen and hormone synthesis. It also helps in absorption of iron. It aids in wound healing. It acts as an antioxidant. The sources are all citrus fruits, green leafy vegetables and tomatoes. The RDA is 60mg for adults.

 

 
 
Biotin

 

The chief function of biotin is that it is a component of co-enzyme in energy metabolism. The main sources of biotin are basically flesh foods and egg yolk, along with nuts and legumes. There is no RDA for biotin; however, there is an estimated, safe and adequate daily dietary intake which is 30 to 100 micrograms for adults.

 

 
 
Minerals

 

Minerals are classified as macro-minerals and micro-minerals. How is the classification done? One method that is used is based on the percentage of the minerals found in the body. Macro-minerals are greater than 0.005% of the body weight and micro-minerals are less than 0.005% of the body weight.2

 

 

 

Macro-minerals

 
Calcium

 

Calcium helps in maintaining permeability of cell membranes so that materials can easily pass through and leave. Calcium is essential for nervous activity such as heart contraction. It strengthens the bones and teeth. The majority of calcium is found in bones and teeth. The sources of calcium are milk, cheese, leafy vegetables and fish. Its also found in hard water. The RDA for calcium is 800 mg for adults over 25 years. However, the author does not agree with the RDA for the older women, which is still at 800 mg. He suggests for menopausal women about 1000 to 1200 mg. This is because they are susceptible to osteoporosis.

 

Phosphorus

 

Phosphorus aids in the transportation of fat. It is part of various compounds for metabolism and protein synthesis. Nearly 90 % of it is found in bones and teeth. The RDA is 800 mg for adults. The sources of phosphorus are milk, cheese, flesh foods, whole grains and legumes.

 

Magnesium

 

Magnesium is involved in the transmission of nerve impulse, muscle contraction, and assists various enzymes for energy metabolism. The RDA for men is 350 mg and for women it is 280 mg. The sources of magnesium are milk, meat, legumes and green leafy vegetables.

 

 
 
Sodium

 

Sodium is involved in acid-base and water balance. It promotes nerve stimulation and muscle contraction. The sources are table salt, salt fish and some vegetables. There is no RDA for sodium but there is a minimum requirement of 500mg.

 

Sulfur

 

Sulfur aids in acid-base balance. The sources of sulfur are flesh foods, legumes and nuts. There is no RDA for sulfur. If the diet is adequate in proteins, then sulfur is also received in adequate measures.

 

Potassium

 

Potassium is involved in intra-cellular fluids and the synthesis of protein and glycogen. The sources of potassium are fruits like banana, fruit juices, meat and less quantities are found in vegetables. There is no RDA for potassium. However, the minimum requirement is 2000 mg for adults.

 

Chloride

 

It is a major ion of extra cellular fluid and an anion of hydrochloric acid in the stomach. The major sources of chloride are table salt and some vegetables. It is also present in eggs and fish. The minimum requirement of chloride in the body for adults is about 750 mg.

 
 
 
 
 
Micro-minerals (trace minerals)

 

Iron

 

The chief function of iron is in the formation of hemoglobin. It carries oxygen to the cells. It is a cofactor of enzymes for releasing energy. Iron can be divided into heme iron and non heme iron. The sources of heme iron are only from animal sources especially from the liver of goat, sheep and chicken. The sources of non heme iron are from animal and plant sources. The plant sources are whole grain cereals, legumes, green leafy vegetables and dried fruits. The RDA for adult males is 10 mg and for women it is 15 mg.

 

Iodine

 

The major function of iodine is to help in the formation of thyroxine in the thyroid for energy metabolism. The sources of iodine are salt water fish, dairy products and iodized salt. The RDA for adults is 150 micrograms.

 

Fluoride

 

Fluoride helps in the growth of teeth and helps to prevent tooth decay. The sources of fluoride are basically found in seaweed, fluoridated water and toothpaste, which is enriched with fluoride. There is no RDA for fluoride but the estimated safe and adequate daily dietary intake should be about 1.5 4.0 mg for adults.

 

Copper

 

Copper helps in the metabolism of iron. It is involved in the formation of myelin sheaths of nerves. The sources of copper are found mainly in the liver of animals, shellfish, legumes and whole grain cereals. There is no RDA for copper but the estimated safe and adequate daily dietary intake is 1.5 3.0 mg.

 

 
 
Zinc

 

The function of zinc is that of helping in sexual maturation. It helps in the tasting of food. The sources of zinc are legumes, greens and meat. The RDA for males is 15 mg and 12 mg for females.

 

Selenium

 

It is an antioxidant. The other functions are not clear. The sources are fish, eggs, organs like kidney, liver and whole grains. The plants that are grown in selenium-filled soil would contain some amounts of selenium.

The RDA of selenium for adult males is 70 micrograms and for females 55 micrograms.

 

Manganese

 

Manganese is found in all cells especially in the mitochondria. It aids in energy metabolism and cholesterol synthesis.

The sources of manganese are found mainly in plant foods. Soil concentration of manganese helps in the plants if they are grown in it. The sources are whole grain plants, legumes, vegetables and fruits. There is no RDA for manganese; however, the ESADDI is 2-5 mg for adults.

 

Chromium

 

The exact function of chromium is not fully understood. Chromium may be important for the maximum metabolism of glucose. Other possible functions of chromium are in the synthesis of cholesterol and RNA. The sources of chromium are mainly from whole grains and meats. There is no RDA for chromium but the estimated and safe daily dietary intake is about 50-200 micrograms.

 

Molybdenum

 

The exact function of molybdenum is not clear, however it aids in the action of some enzymes. The sources are grains, nuts and beans. There is no RDA for molybdenum but the estimated safe and adequate daily dietary intake is about 75-200 micrograms.

 

 

 

Energy Intake Requirements

The energy needs of a person depend upon basal metabolic rate (BMR), physical activity and the effect of metabolizing the food. The US Department of Agriculture advises that the weight of the body (in pounds) is to be multiplied by a factor determined by the type of physical activity of the individual. For women the factors are 14, 18, and 22, for sedentary, moderately active and very active respectively. For men the factors are 16, 21, and 26, for sedentary, moderately active and very active respectively.

The National Academy of Sciences, Washington in 1989, had recommended for males (25-50 years and

doing light to moderate activity) 2900 kcal per day and for females (25-50 years and doing light to moderate activity) 2200 kcal per day. For pregnant women (2nd and 3rd trimesters) and lactating mothers 300 and 500 kcal should be added respectively.

The recommended energy intakes for people living in different nations vary. Hence, people living in their own nations should follow the recommended energy intakes of their nations.

 

 

Variety of Foods

Eating a variety of foods in moderation is good for health. The US Department of Agriculture has recommended eating food items from various food groups in its Food Guide Pyramid. The Department recommends 6 -11 servings from bread, cereal, rice and pasta group; 3-5 servings from vegetable group; 2-4 servings from fruit group; 2-3 servings from milk, yogurt and cheese group; 2-3 servings from meat, poultry, fish, dry beans, eggs and nuts group; and fats, oils and sweets are to be used sparingly.

 

 


Chapter Two

Nutritional Fallacies and Frauds

 

Since ancient history, there had been many nutritional fallacies. They are found even today and will continue in future. What is a fallacy? A fallacy is a mistaken idea or false information. There are fallacies in every subject and nutrition is no exception. There are many unscrupulous persons who try to propitiate their theories or market a particular item and cheat people. They bring out many fallacies to produce items in the market. Some concoct some recipes, which they claim to be panacea.

 

There are some persons that manufacture food items and intentionally want to cheat the people so they concoct a lot of nutritional recipes. They are guilty of fraud. Just because someone calls himself/herself a nutritionist and says something interesting does not make it the gospel truth. One would have to verify and find out if what he or she says is nutritionally correct or incorrect. One has to find out from persons who are educated in the matters of nutrition. As a matter of fact, one should check out the nutritional facts with educated nutritionists, medical professionals, registered dieticians and health educators to make sure that the nutritional information is true or false.

 

There are many pills, which are sold as weight loss pills and they may not really be for such. Some of the pills may be placebos and nothing to do with actually helping to lose weight. There are some individuals who sell juices or recipes of some food items that they inform can cure cancer. Nutrition cannot cure cancer, but it may help to prevent or reduce risk factors for cancer. Just because somebody gives a testimony that he/she has eaten something and have lost about 20 lbs or has been cured of cancer doesnt mean that it is a nutritional fact. If it is a nutritional fact, it should work on almost every other person and not on only one or two persons who volunteer their testimonies. There are some persons paid by advertisers to give testimonies on television or in magazines or newspapers just to sell the product. Therefore, one has to find out what is a nutritional fallacy and nutritional fact. One has to expose the fallacies and frauds when he/she gets a chance to do so. 

 

Top


Chapter 3

 

Communicable and Non communicable Diseases

 

 

Disease is sickness or abnormality. Disease is a pathological process affecting a part or the whole body and having characteristic signs and symptoms. The cause, the treatment and prognosis can be known or sometimes one of them may not be known. The diseases can be divided into two groups, which are communicable diseases and non communicable diseases. Communicable disease is that which can be communicable or spread from one person to another. Where as non communicable disease is that which cannot be spread from one person to another. Most of the communicable diseases are caused by pathogenic microorganisms. The pathogenic microorganisms are viruses, bacteria, rickettsiae, fungi and protozoa.

 

The communicable diseases can be transmitted through body secretions and fluids like saliva, sputum, semen, vaginal secretions, urine and feces. There are vectors such as mosquitoes that can help to transmit diseases like malaria. The non communicable diseases are like hypertension, diabetes mellitus, coronary heart disease and hemiplegia. Nutrition can help to boost the immunity of the body but it can never prevent infectious diseases when the pathogenic agent has already attacked the body. Nutrition can help the immunity system to fight against the microorganism, but if the microorganism invades the body, nutrition cannot destroy or kill the microorganism. If an infected mosquito with the protozoan plasmodium falciparum bites a human being and when he is infected with cerebral malaria, then nutrition cannot prevent this disease.

 

However, nutrition can help to prevent some water borne and food borne diseases, if proper nutritional principles are followed. Water borne diseases are like hepatitis A, cholera and typhoid. The causative microorganisms of these above diseases can be found in contaminated food and water. If the water is boiled then these microorganisms will die. Therefore, when people drink boiled water there are less chances of suffering from diseases like hepatitis A, cholera and typhoid. The food borne diseases are like cholera and hepatitis A. If food is properly heated before eating, and properly stored so that no flies and other insects can contaminate the food, then these nutritional principles can prevent food borne diseases.

 

Diseases like diabetes, hypertension and coronary heart disease have multi-factorial causes and faulty nutrition is just one among them. Nutrition can help to prevent diabetes and hypertension provided the other causes are stalled or inhibited. If the other causes are not prevented then these diseases can set in. However, if the other causes can be prevented, then proper nutrition can avert those diseases. There are some non communicable diseases for which the causes are not known or idiopathic. In those kinds of diseases it is very hard to forestall them. But whenever nutrition plays a role in the causation of diseases, they can be prevented nutritionally, provided the other causes or risk factors are checked.

 

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Chapter 4

Prevention of Diseases

 

 

A. Disease Prevention

 

 

 

In order to prevent diseases several measures have to be taken. The various measures will be discussed step by step.

 

Eradication or Avoidance of Causes

 

The first measure that should be taken is to eradicate the causative agent or the cause. If this cannot be eradicated, then the cause should be avoided. The study of causes of diseases is called etiology. It also includes all the risk factors for diseases or cancers. The causative agent whether it is a bacterium or a virus can be eradicated by killing through various means. For example, if the microorganism is in the water one can kill it by boiling the water. Discovering the causative agent for the infectious disease is very important because it is the first link in the chain of causation of a disease. Diseases that are non communicable such as diabetes mellitus and hypertension do not have a causative agent like the microorganism. Instead of microorganism there are risk factors.

 

 

Modification of Risk Factors

 

There are many risk factors for non communicable diseases. The exact cause of hypertension is not known but there are risk factors involved. The risk factors could include smoking, eating food with high saturated fat and salt, physical inactivity and stress. However, there are some non-modifiable risk factors which cannot be modified such as age, gender and genetic factors. One cannot change ones age and genetic factors. One cannot change the genes that were acquired from ones parents. However, if a couple is planning to have a child they can have genetic counseling to find out if they are carrying any faulty gene that could cause some genetic diseases or syndromes. As it relates to gender one cannot change gender easily. Therefore, age, gender and genetic factors are non-modifiable risk factors.

 

The modifiable risk factors include diet, dietary habits, drinking alcohol, smoking and physical inactivity. Hence, the whole life style can be modified to prevent disease. Whenever nutrition factors are risk factors for disease, then those faulty nutritional factors could be modified or avoided and prevent the disease nutritionally provided other factors do not interplay. Therefore good nutrition can prevent hypertension to a certain extent provided that other causes like stress are not involved.

 

Throughout this book, the author will present all the causes or risk factors or both under etiology but will discuss only preventive nutrition in the prevention of diseases or other problems.

 

c. Blocking the Routes of Transmission

Another measure to prevent disease is blocking the transmission. If one cannot eradicate the cause or avoid the cause, the next step is to block the transmission. For example, mosquito is the route of transmission for malaria, then that route should be blocked. Hence, if all the mosquitoes have been killed by spraying pesticide or if they have been completely avoided from entering the house through wire meshes, and if people sleep under the nets, then route of transmission of malaria is blocked. Some diseases like hepatitis A and gastroenteritis can have water as their medium for transmission. The water can be boiled or the city water is to be purified with chemicals to destroy the pathogenic microorganisms. And therefore the route of transmission is interrupted and the diseases are prevented. Other factors such as washing ones hands, adequate cooking of food and good refrigeration can all help to interrupt the routes of transmission.

 

d. Role of Immunity and Immunization

 

The body has white blood cells, which forms the immune system of the body. The white blood cells like lymphocytes can fight against foreign pathogenic microorganisms. Sometimes, the immunity of the body is not enough, so one needs to have active immunity like vaccination.

Suppose there is cholera or typhoid out break the health departments would immunize the people by administering vaccinations. It is known as active immunization because one is boosting the immunity of a man or a woman who is at risk for a disease. However, for non communicable diseases like coronary heart disease and hypertension there is no vaccination that can prevent these diseases.

 

e. Role of Nutrition

 

If there is good nutrition it can boost the immunity of the body. A strong body may be able to fight diseases like pulmonary tuberculosis. Therefore, proper nutrition is good for everyone in order to help to fight certain diseases. If nutrients are deficient, then the body is vulnerable to diseases. Once the disease like pneumonia attacks the body then nutrition cannot prevent the disease. Nutrition can not prevent most of the communicable diseases.

 

f. Assessment

 

In order to prevent a disease a person should have his/her body and mind assessed from time to time. If a person desires to know whether he is healthy or not, or if he is going to suffer from a disease or he is suffering the disease, his body should be assessed through blood, urine and stool samples. There are other measures to assess a person, that is, like assessing the body through X- rays or ultrasound. Some diseases are psychosomatic like peptic ulcers. Assessment of the mind is also needed. There should be psychological analysis for psychosomatic diseases and mental disorders. Therefore, assessment is necessary. There should be assessment of environmental factors that contribute to the etiology of diseases so that they can be rectified, if not avoided.

 

g. Nutritional Status Assessment

 

In order for a person to know if he is suffering from any nutritional disease or deficiency, the person should be nutritionally assessed. To perform nutritional assessment, there are three types of indicators. The first type of indicators is known as Direct Indicators. The direct indicators are as follows:

1. Biochemical examinations

2. Anthropometric measurements

3.      Clinical signs examination

4.      Dietary intake assessment

 

The second type of indicators is known as Indirect Indicators. There are mortality and morbidity rates statistics. The third type of indicators is Socio-economic Factors. The social factors are like housing conditions, education and the number of children. Economic factors include occupation, employment status (employed or unemployed) and the salary for the month or annum. All these factors can show how they indirectly affect the nutritional status.

 

Biochemical assessment is to check the blood for hemoglobin estimation, hemotocrit and also to test for total cholesterol. It also includes checking the blood for sugar level, in order to find if a person is diabetic or not. Other tests could be for estimation of various fat-soluble vitamins.

 

The anthropometric measurements which are good to evaluate a persons nutritional status are height, weight, skinfold measurements at biceps, triceps and at supra iliac region. The body mass index (BMI) is also significant. See Appendix 2. To interpret these anthropometric measurements one should use the standard anthropometric measurements and percentiles of ones country or region.

 

The clinical signs examination is shown in appendix 3. The dietary intake methods are 24-hour recall, food frequency questionnaire, weigh as-you-eat, food record and diet history. The indirect indicators are morbidity and mortality rates statistics of the assessed persons country. These statistics will show the health and nutritional status of the people living in that country. The socio-economic indicators are educational status, family size, occupation, employment or unemployment, housing conditions and the availability of medical care services. Climatic conditions play a role in availability of food also. These factors will play a significant role indirectly on the nutritional status of a person.

Therefore, to prevent diseases the nutritional status of a person should be assessed.

 

B. Levels of Prevention

 

There are several levels of prevention of diseases. They will be discussed one by one.

 

 
 
a. Primary Prevention

 

The first level of prevention is known as primary prevention. It is a measure or measures taken to prevent the disease before its onset. Primordial prevention is really a refined primary prevention. This prevention can be followed by good lifestyle. The W.H.O has recommended some procedures to achieve primary prevention for chronic diseases where risk factors are known. They are primordial prevention, population strategy and high-risk strategy.3

In order to prevent hypertension one should start the prevention from childhood itself. The risk factors for hypertension should be avoided from early age, for e.g. smoking, alcoholism and eating a diet with high saturated fat and cholesterol should be avoided.

Primary prevention can be followed by anyone and by communities or populations.

 

b. Secondary Prevention

 

Secondary prevention is trying to stop the progression of the disease at its early stage. The goal here is to check the disease so that it will not run its full course after it has set in. So this can be done by early diagnosis of the disease and medical treatment.

If there are epidemics, epidemiologists should be called to find out the distribution and the determinants of the epidemics. They will use the principles of epidemiology to prevent epidemics or diseases. There should be enough financial support for programs to conduct secondary prevention.

 

 

c. Tertiary Prevention

 

The goal of this level of prevention is to see that the disease does not have recurrence in the host or does not lead to disabilities in the patient. For e.g. a patient, who survived myocardial infarction, should not experience recurrence or should not suffer from a disability like hemiplegia or stroke. The recurrence can be avoided by constant health monitoring and avoiding risk factors. If there are disabilities they can be mitigated through rehabilitation.

 

C. Significance of Health and Nutritional Education

 

Health and nutritional education should start at birth and end at death. A person should be inculcated health and nutrition principles from childhood. All should be taught what are the causes and symptoms of various diseases and cancers. All should be taught from childhood good dietary habits and what constitutes good nutrition. They should be taught the nutritional risk factors of various diseases. The Holy Bible says in Proverbs 22:6, Train up the child in the way which he should go, and when he is old he shall not depart from it. This principle should be practiced and not only taught.

Schools, colleges and universities should have health and nutrition in their curricula. Communities must receive health and nutrition education through various methods like house visiting, posters, radio, television, plays and seminars. Two-way communication method like home visiting by health workers or nutritionists is ideal.

 

The good lifestyles of older individuals can be a health education for the younger ones. The significance of exercise should be demonstrated in peoples lives. The evil and harmful effects of alcoholism, smoking and drug addiction should be inculcated from childhood. These evil habits, which are detrimental and lethal to ones health, should be completely avoided.

Therefore, health and nutrition education has a significant role in preventing diseases and cancers. 

 

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Chapter 5

The Role of Nutrition in Prevention or Reduction of Risk Factors for Certain Diseases and Cancers

 

A.     Symptoms and Diseases of the Digestive System

 

1. Caries

 

Caries is the decaying of the teeth. It is a dental disease. The author had decided to place caries under digestive system because teeth are used for chewing the food.

 

Etiology

Caries is caused because of poor dental hygiene. When the teeth are not brushed after every meal and flossed every morning and evening, then plaque would be deposited slowly on the teeth. Due to the plaque bacteria would accumulate and attack the teeth. This could cause caries. Children who eat highly refined foods like sweets, ice cream and chocolate (these food items would be stuck between the teeth and will not be easily removed by brushing), would be vulnerable for caries.

 

Nutritional Prevention

In order to prevent dental caries, children should be taught not to always eat foods like ice cream, chocolate, sweets and cakes. However, this doesnt mean that they should not eat ice cream, chocolates and cakes, but they should not eat too much and too often. Another advice is that when children eat this highly refined food, they should immediately brush and floss the teeth. If this is not done, then bacteria will multiply on the accumulated food particles between the teeth and the gums and attack the teeth. As a rule everybody should follow proper oral hygiene or else it may cause other problem like halitosis (bad breath).

 

 

2. Constipation

 

Constipation is either incomplete or no evacuation of the feces by the bowel.

 

Etiology

The most common causes of constipation are very low dietary fiber, poor bowel habits, some abnormalities like hemorrhoids, systemic diseases like hypothyroidism, neurological problems like Parkinsons syndrome, multiple sclerosis, hemiplegia and some medications like narcotics and antacids.

 

Nutritional prevention

In order to prevent constipation nutritionally a person should ingest plenty of dietary fiber. Dietary fiber is divided in to two types:

1.      Water insoluble dietary fiber

2.      Water soluble dietary fiber.

Water insoluble dietary fibers are cellulose and hemicellulose, on the other hand, water-soluble dietary fiber are gums, pectins and mucilages. These soluble and insoluble fibers increase peristalsis of the bowel so that constipation is avoided unless there are some structural abnormalities. The rich food sources of water insoluble fibers are whole wheat, wheat bran, nuts and vegetables especially leafy vegetables. The rich sources of water-soluble fiber are apples, citrus fruits like oranges and grapes, oat bran, oatmeal and legumes. The other advice is to drink lot of water, do exercise and follow regular bowel habits.

 

 

 

3. Cirrhosis of the liver (alcoholic)

It is a deteriorating and degenerative change in the liver, which is caused because of over ingestion of alcohol. This could lead to death of the patient.

 

Etiology

As already mentioned, it is due to alcohol.

 

Nutritional prevention

The author advises people not to drink alcohol at all. He does not support moderate drinking of alcohol, since moderate drinking would lead to addiction of alcohol. A Chinese proverb states, First the man takes a drink, then the drink takes another drink, finally the drink takes the man. The Bible also condemns the drinking of alcohol in all its forms. And those who are trying to give up alcoholism can read the authors book Dr. Stevensons Solutions to A to Z Problems in Life. This book will help one to give up alcoholism.

 

 

4. Diarrhea

Diarrhea is a passage of stools, which are either liquid or semi-solid, more frequently. Along with the diarrhea there might be abdominal pains, cramps and malaise.

 

Etiology

The causes of acute diarrhea are indigestion, invasion of pathogenic microorganisms like E.coli, anxiety and food poisoning. Other problems that can cause diarrhea are intestinal cancer, radiation therapy, AIDS, stress, laxative abuse and also malabsorbtion diseases.

 

Nutritional prevention

 

Nutrition can prevent diarrhea only if faulty nutrition is the cause of diarrhea. However, if there are some other causes like protozoa, AIDS and cancer, then nutrition cannot prevent diarrhea. When there is a nutritional factor that causes diarrhea, then that factor should be corrected. For example, if over eating is the cause then it should be avoided. If food poisoning is the cause, then that should be avoided. For prevention of food poisoning, please check that topic.

 

 

 

5. Diverticulosis and Diverticulitis

Diverticulosis is formation of sacs in the intestinal wall, especially that of the colon. These sacs are known as diverticula. Diverticulitis is the inflammation of the diverticula, which are sacs or pouches. Diveticulitis is usually found in older people.

 

Etiology

The causes of diverticulosis could be old age and eating food that has no or little fiber. Since the diet has no fiber there is pressure on the lining of the intestine and this pressure can cause formation of sacs and pouches. These pouches or diverticula are inflammed again due to no or little fiber in the diet and infections.

 

Nutritional prevention

In order to prevent diverticulosis and diverticulitis, a diet, which is high in fiber, should be taken. The sources that are rich in dietary fiber are whole wheat, wheat bran, nuts, dark leafy vegetables, citrus fruits, oatmeal, oat bran, barley and also legumes.

 

 

6. Dyspepsia

 

Dyspepsia is indigestion. There could be host of abdominal symptoms like pain, discomfort, regurgitation and flatulence.

 

Etiology

There are many causes of dyspepsia. They include over eating, fatty food, drug intolerance (aspirin, antibiotics) gastro-intestinal infections, dysfunctions like gastroesophageal reflux, stomach cancer, biliary tract disease, diabetes mellitus and hypothyroidism.

 

Nutritional Prevention

To prevent dyspepsia, one should not eat too much. One should not eat too much of fatty food. Diabetes mellitus and hypothyroidism must be controlled.

 

7. Eructation

Eructation is belching. It is expulsion of gas with sound from the stomach through the mouth.

 

Etiology

1.Swallowing of air (areophagia)

2.Rapid eating

3.Gum chewing

4.Smoking

5.Drinking carbonated drinks

6.Nervousness (It will induce areophagia)

7.Ill-fitting dentures

 

Nutritional Prevention

There are several ways to prevent eructation, which are as follows:

1.      Do not drink carbonated drinks if you are suffering from chronic belching; instead drink natural fruit juices which are not carbonated.

2.      Do not use straw while drinking any liquid.

3.      Do not chew bubble gum if you are suffering from chronic belching.

4.      Do not eat food rapidly.

5.      Do not smoke (smoking is not a part of diet but the author advises every person not to smoke).

6.      Ill-fitting dentures should be corrected.

 

8. Flatulence

Flatulence is formation of gas in the digestive system especially in the bowel. A flatus is a gas that is expelled from the bowel. Flatus, colloquially, is known as a fart. To produce a little amount of gas is normal.

 

Etiology

Flatus could be caused from swallowed air and bacterial fermentation of undigested food. The majority of air that is not belched would pass through the intestine as gas. When there is bacterial fermentation of undigested food, it would produce hydrogen and also methane. Most of the gas production takes place in the colon. Gas produced from undigested plant food sources usually have relatively little smell. However, gas from flesh foods and foods high in proteins like eggs tend to smell bad.

Other causes of gas production are poor and irregular bowel habits, over eating, eating high fatty and protein food, poor absorption of lactose and diseases like celiac sprue.

 

Nutritional prevention

Do not eat too much food at one time. The next point is do not eat too much food, which is high in protein, especially eggs and red peas. In order to avoid gas formation or flatulence, there are foods, which one should not eat in plenty. They are eggs, cauliflower, cabbage, onions, beans, red peas, alcohol, beer, and also carbonated beverages. To prevent too much gas production, activated charcoal, which can absorb the gas, can be used. Another advice is to have regular elimination of the feces.

 

9. Fluorosis (Dental)

Dental fluorosis is mottling or the discoloration of the teeth. The discolorization might eventually turn into brown or black color. The mottling of the teeth is usually seen in the incisors of the upper jaw of the affected persons.

 

Etiology

The main cause of dental fluorosis is drinking water that contains excessive amount of fluorine in it. In some places in Karnataka State in India , there is water which contains excessive amount of fluorine. It may contain about 3-5 mg of fluorine per liter.

 

Nutritional Prevention

One of the goals of prevention is not to drink water that has high content of fluoride. Usually running water has less quantity of fluoride than ground water supply like wells. If people living in endemic areas for dental fluorosis, then their sources of drinking water must be chemically treated to de-fluoride the water. Usually to de-fluoride the water one has to use lime and alum in sequences followed by sedimentation and filtration.4 And people living in areas where there is high content of fluoride in the water, should not use fluoride toothpaste, since it would actually compound the problem.

 

10.Gallstones

Gallstones are calculi formation in the biliary duct. It is known as cholelithiasis. Gallstones can cause biliary colic. Bile juice is produced by the liver and stored in the gallbladder.

 

Etiology

Gallstones formation could be because of super saturation of the bile with cholesterol. Fatty food can be a predisposing factor. Usually persons with four Fs are susceptible to gall stones. The four Fs are female, fat, fair and forty years and above.

 

Nutritional prevention

Since gallstones are due to supersaturation of bile with cholesterol, and fatty food is a risk, eating diet that is high in cholesterol and fat should be avoided. The foods like cheese, butter, eggs, fried foods and organ meats should not be eaten often and in large amounts. Cholesterol is only found in animal foods. So it good to eat more vegetables and fruits and less flesh foods and dairy products. Obesity should be prevented since fat persons are vulnerable for gallstones. Persons, who are over 40, should be careful in not eating fatty foods. Nutritional education regarding the causes and prevention of gallstones will help individuals and general public.

 

 

11.Gingivitis

Gingivitis is the inflammation of gingiva. Gingiva is other name for gums. It could also mean connective tissue that surrounds the neck of the teeth.

 

Etiology

Poor oral hygiene

2.Vitamin C deficiency

3.Food impactation. This is where food is stuck between the teeth and the gums; and between the teeth.

4.The gums could be swollen during puberty, menstruation and pregnancy because of hormonal changes in some females.

5.Some systemic diseases. Gingivitis could be an early sign of systemic diseases like primary herpes simplex, diabetes mellitus, leukopenia and AIDS.5

 

Nutritional prevention

Vitamin C should be taken in plenty through diet. Adults should take about 60 mg of vitamin C per day. Children between ages of 7 to 10 should take about 45 mg per day. There should be good oral hygiene. Systemic diseases that cause gingivitis should be prevented.

 

12.Hemorrhoids

In common term, hemorrhoids are known as piles. Hemorrhoids are dilated veins in the rectum. Hemorrhoids could be either external or internal. There could be pain during defecation and bleeding can occur also.

 

Etiology

There are several factors that could cause hemorrhoids. Some of the factors are as follows:

1.      Diet with low fiber.

2.      Straining while defecating.

3.      Drinking very little water.

4.      Very poor and irregular bowel habits.

5.      Benign tumors and cancer in the rectum.

 

Nutritional prevention

The best way to prevent hemorrhoids is to have a diet, which has high fiber in it. Foods like wheat, wheat bran, oatmeal, oat bran, barley, and legumes like beans and peas could be good because all of them have high content of fiber and this could help the stool to be bulkier. Another way to prevent hemorrhoids nutritionally is to drink a lot of water. When lot of water is taken, the stool becomes softer and when less water is taken, the stool becomes harder and impacted.

 

Another nutritional principle is to have regular bowel elimination. Persons should not strain while defecating. One should not eat too much of high fatty food items fried in oil and butter like fried chicken and fried eggs or omelets since these can make the stool harder and pass through the gut slowly. This could cause constipation and in turn it could cause straining during defecation. People who are over 40 should have digital examination of the rectum to rule out if there are any tumors.

 

 

13. Hiatus Hernia

Hiatus hernia is a protrusion or a prolapse of a part of the stomach through the esophageal opening in the diaphragm.

 

Etiology

Hiatus Hernia is caused by weakened muscles near the opening of the diaphragm which allows the esophagus to enter the stomach. People who are obese and who are over 45 years of age are vulnerable.

 

Nutritional prevention

As already shown, obese people are prone to hiatus hernia. It is good for one not to become obese. It is good to maintain the right weight for height. One should not eat high fatty foods on a daily basis lest they become obese and in turn become vulnerable to hiatus hernia. Persons who are 45 years should not do vigorous abdominal exercises.

 

14. Irritable Bowel Syndrome

 

Irritable bowel syndrome is a condition where there is irregular bowel motility. There could be abdominal pain, diarrhea or constipation, distention, bloating, dyspepsia and headache. This is a chronic relapsing syndrome.

 

Etiology

The exact cause of this syndrome is idiopathic. However, there are factors linked to this syndrome which are as follows:6

1.      Stress and emotional upsets

2.      Certain foods can trigger the syndrome in few persons.

3.      Inadequate fluid intake

4.      Excessive caffeine

5.      Laxative abuse

6.      Irregular sleep habits

7.      Irregular bowel habits

 

Nutritional prevention

Persons should not drink coffee because it contains caffeine, which is not good for health. Ellen G White in her book Temperance has stated in page 80, Tea and coffee drinking isinjurious indulgence. One should not eat food items that contain caffeine. There should be no laxative abuse. One should drink a lot of water and have regular bowel elimination.

 

15. Pancreatitis

 

Pancreatitis is the inflammation of the pancreas. There could be undigested fat, protein and starch present in the stools of the patients. If this is not corrected, it would lead to undernourishment.

 

Etiology

Alcohol abuse is the most common cause of acute and chronic pancreatitis. The other reasons are biliary disorders for acute pancreatitis and cystic fibrosis and malnutrition for chronic pancreatitis.7

 

Nutritional prevention

To prevent acute and chronic pancreatitis, one should completely avoid alcohol. Moderate drinking of alcohol is not advised since it leads to addiction. One should not suffer from undernourishment.

 

16. Peptic Ulcers

Peptic ulcer is erosion of gastrointestinal lining.

 

 

Etiology

Hypersecretion of gastric juice

Stress whenever there is stress there could be hyper secretion of gastric juice.

Non steroid anti inflammatory drugs, chronic H pylori infection and Zollinger-Ellison Syndrome8

Cigarette smoking could increase the risk of developing peptic ulcers.

Spicy and fatty food

Irregular eating habits

 

Nutritional prevention

In order to prevent peptic ulcers nutritionally, one should not eat diet high in spices and fat. Spicy food can irritate the stomach lining. One should eat at regular times, which should be followed always. When food is not eaten at regular times, the gastric juice would be released and act on the stomach wall because it is made of protein. This in turn on the long run can cause an ulcer on the wall of the stomach.

 

17. Scurvy

Scurvy is a vitamin C deficiency condition where there are symptoms like bleeding and swelling of the gums. The patient could also suffer from fatigue or tiredness.

 

Etiology

The cause of scurvy is vitamin C deficiency.

 

Nutritional prevention

A diet that is rich in vitamin C should be eaten daily. The rich food sources of vitamin C are citrus fruits like grapes and oranges, strawberries, tomatoes and raw green vegetables.

 

18. Vomiting

Vomiting are contents that are ejected from the stomach through the mouth. These contents that are ejected are known as vomitus. Vomiting is known as emesis.

 

Etiology

There are many causes of vomiting or emesis which include:

1.                  Mechanical obstructions malignancy of the esophagus or stomach

2.                  Morning sickness

3.                  Diseases like diabetes mellitus, acute pancreatitis, and peptic ulcers (hematemesis (vomiting of blood) in peptic ulcers)

4.                  Irritants like alcohol

5.                  Myocardial infarction

6.                  Water borne and food borne diseases like cholera, typhoid and hepatitis A

7.                  Food poisoning

8.                  Motion sickness

9.                  Overeating

 

 

 

Nutritional prevention

Nutritional prevention is to avoid food poisoning. Food items that are not stored and preserved properly should not be ingested because it may lead to vomiting and disease like botulism. Drinking water should be purified by boiling or by chemicals to prevent all water borne diseases. Food should be properly heated and cooked to kill the microorganisms that cause food borne diseases. Food handlers should always practise good personal hygiene like washing hands properly before handling food. One should not eat too much food at one time. One should not drink alcohol. The smell of ginger or lime fruit can prevent vomiting in some persons.

 

 

 

19. Water borne and food borne diseases

Water borne and food borne diseases can be divided according to the microorganisms and helminths that cause the diseases.

Bacterial diseases -- cholera and typhoid

Leptospiral disease Weils disease

Protozoal diseases amoebiasis, giardiasis

Viral diseases hepatitis A and poliomyelitis

Helminthic infestations -- hookworm, roundworm and tapeworm infestations.

The mentioned diseases are classified as water borne and food borne diseases because they are transmitted to other persons through contaminated water or food.

 

Etiology

The causes of these water borne and food borne diseases are as follows:

Cholera --Vibrio cholerae

Typhoid -- Salmonella typhi

Weils disease -- Leptospira ictero-hemorrhagiae

Amoebiasis -- Entamoeba histolytica

Giardiasis -- Giardia lamblia

Hepatitis A -- Hepatitis A virus (HAV)

Poliomyelitis Poliovirus.

Helminthic infestationHookworm, roundworm

 

The water borne diseases are notifiable diseases. They should be notified to the health authorities lest epidemics like cholera and typhoid might break out. The water could be contaminated because of improper sanitation. When toilets are not kept clean, diseases like hepatitis A and amoebiasis can spread. They can be spread through fecal-oral route. When drinking water is not purified, it could assist to transmit water borne diseases. When food is contaminated through flies and insects, then that food can abet to transmit food borne diseases. When food handlers are not practicing proper hygiene, then food borne diseases can be spread. If vegetables like cabbage, lettuce, and carrots are watered with sewage and other dirty water, they could harbor the ova and larvae of the helminths like roundworms and hookworms. When these vegetables are eaten raw, they can abet to transmit helminth infestations.

 

 

 

Nutritional prevention

The first goal of preventing water borne diseases is to drink pure water. Drinking water can be purified either by boiling or by some chemicals. As rule, whether you are travelling, working, visiting or staying at home always drink purified water. Drinking water from filters is not safe because the viruses can pass through the pores of the candles of a filter. But boiling the water will kill all the microorganisms. Hence, boiling is the best method to purify water.

 

The bathrooms and toilets should be disinfected and cleaned or else diseases like hepatitis A and amoebiasis could be spread. Vegetables like cabbage, lettuce and carrots that are grown in a dirty and filthy environment where there is leakage of sewage water could be contaminated with ova and larvae of roundworms and hookworms. When these vegetables are eaten raw, they could abet to transmit helminth infestations. Hence, these vegetables should be boiled in order to kill the ova and larvae of the helminths. However, if vegetables are grown in ones backyard and they are not contaminated, then they can be eaten raw. One should not eat pork because pigs can harbor tapeworms. Food should be properly cooked, stored and preserved in order to prevent food borne diseases. Children should be taught not to eat food items that are contaminated by flies.

 

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B. Symptoms and Diseases of the Cardiovascular System

 

1. Anemia

Anemia is a condition where there is deficiency in either the quality or quantity of red blood cells.

Nutritional anemias can be divided as follows:

B12 deficiency anemia

Folic acid deficiency anemia

Iron deficiency anemia

Pernicious anemia

 

 

B12 deficiency anemia

B12 deficiency anemia is a condition where there is a deficiency of B12. B12 is also known as cobalamin. Vitamin B12 deficiency patient will have macrocytic red blood cells.

 

Etiology

People who are strict vegetarians or vegans since B12 is only found in animal foods.

Chronic alcoholism

When vegan mothers breastfeed their infants, then the infants can be B12 deficient.

Malignancy of the digestive system

Celiac sprue

Helminth infestation

Hypothyroidism and diseases of the liver and kidney can increase the requirement of B12 and thus in turn cause B12 deficiency.

 

Nutritional prevention

In order to prevent B12 deficiency, a diet rich in B12 should be ingested. The food sources of B12 are only found in animal sources. However, as already mentioned in chapter one, legumes contain some amount of this vitamin because of the action of bacteria. Animal foods like meat, organ meats, chicken, fish, eggs and milk are good sources of B12. The recommended dietary allowance of B12 for adults is 2.0 micrograms per day. The authors advice for strict vegetarians or vegans is to ingest soy milk enriched with B12 or take B12 supplement. A person who has stopped eating flesh foods when he was over 20 years may not need B12 for a few years because he has enough stores of it. Alcoholics should stop drinking alcohol. Persons who are infested with helminths should be dewormed since the parasites would be competing with the host for B12.

 

Folic Acid Deficiency Anemia

It is an anemia caused by folic acid deficiency. The patient will have macrocytic red blood cells.

 

Etiology

Dietary deficiency of folic acid.

Malabsorption and celiac sprue.

Pregnancy (during pregnancy there could be increased demand for folic acid)

Some drugs like phenytoin and sulfasalazine 9

Dialysis will put the patient at risk for folic acid deficiency.

 

Nutritional prevention

There should be sufficient intake of foods which are rich in folic acid or folate. The foods that are rich in folic acid are all dark green leafy vegetables, fruits, legumes, whole grain cereals, chicken and eggs. The recommended dietary allowance for adults is 180-200 micrograms per day. During pregnancy, women should increase their intake of folic acid especially during the first two trimesters. The RDA during pregnancy is 400 micrograms per day and if she is lactating, during the first six months it is 280 micrograms and during the second six months of lactation it is 260 micrograms per day.

 

Iron deficiency anemia

This anemia is due to iron deficiency. The patient will have hypochromic and microcytic red blood cells.

 

Etiology

Deficiency of iron in the diet

Malabsorption of iron in the body

Pregnancy and lactation (there would be increased demand of iron during these physiological changes)

Blood loss through peptic ulcers and menstruation (menorrhagia-heavy bleeding)

Helminth infestation (roundworm, hookworm and tapeworm)

Donation of copious blood can put at risk for iron deficiency

 

Nutritional prevention

The foremost goal to prevent iron deficiency anemia is to ingest sufficient amount of iron through diet. There are two types of iron which are heme and non-heme. The heme iron is part of the hemoglobin and the myoglobin molecules, which are present in animal foods only. Non-heme iron is present in animal and plant foods. In the animal foods about 40% is heme and 60% is non-heme. The iron present in plant foods is 100% non-heme. Usually about 23% of heme is available for absorption whereas only 2-20% of non-heme is available for absorption.10  

The sources of heme iron are liver of chicken, goat, sheep; eggs and meats. The animal sources of non-heme iron are meat, poulty and fish and the plant sources of non- heme are whole and fortified grains, nuts, legumes, dried fruits like raisins and all dark green leafy vegetables. The RDA of iron for male adults is 10 mg per day while for females it is 15 mg per day and for pregnant women is 30 mg per day. Women who are having heavy menstrual bleeding must take iron supplements and increase their dietary iron intake, in order to make up the loss of iron through the menstrual blood. Patients who are suffering from helminth infestation should be dewormed. Persons who have donated blood should take iron supplements. Patients with peptic ulcers should also take iron supplements.

 

Pernicious anemia

Pernicious anemia is a condition where there is non absorption of vitamin B12 because of the lack of intrinsic factor which is normally found in the digestive system. Pernicious anemia could be fatal. The patients of pernicious anemia are found in different parts of the world but they are predominantly found in the Scandinavian countries.

 

Etiology

Persons who lack the intrinsic factor would suffer from pernicious anemia. The intrinsic factor helps to absorb vitamin B12 which is ingested.

 

Nutritional prevention

In order to prevent pernicious anemia, the person who lacks intrinsic factor should be administered with intra-muscular injections of 100 micrograms of B12 in each dose. This dose is given daily for the first week then it is given weekly during the first month and after that it should be given monthly for life.11 B12 is not given orally because the oral tablets will not be absorbed because of the lack of intrinsic factor.

 

 

2. Angina pectoris

Angina pectoris is a condition where there is chest pain due to insufficient blood supply to the heart.

 

Etiology

Obstruction of the coronary artery

Atherosclerosis

Spasm of the coronary artery

Coronary embolism

Too much physical exertion in some persons

Severe bouts of anger, stress and depression can trigger angina pectoris

 

Nutritional Prevention

The nutritional prevention is basically to avoid atherosclerosis (hardening and narrowing of the arteries). Atherosclerosis is caused because of high fatty food especially which is loaded with cholesterol, which in turn can add plaque on the walls of the arteries and narrow the lumen. How to prevent atherosclerosis please check under the nutritional prevention of atherosclerosis.

 

3. Atherosclerosis

Atherosclerosis is a condition where there are fatty material and plaque, which are deposited on the walls of the arteries which leads to the hardening and narrowing of their lumen.

 

Etiology

Fatty food

High fatty food especially which is loaded with cholesterol & trans fat would cause fatty deposits and plaque to accumulate on the walls of arteries. Lipoproteins are forms in which fats are transported in the blood. There are different types of lipoproteins in the blood. The HDL (high density lipoproteins) is good cholesterol whereas LDL (low density lipoproteins) is bad cholesterol. VLDL is very low density lipoproteins which is also bad. The author conducted a research study on 419 patients and their cholesterol levels. It was found that 68% suffered from elevated cholesterol.12 See figure 1 in appendix 5. Elevated triglycerides would be risk factor for atherosclerosis. The author conducted a study on 211 patients, and it was found that 59.7% suffered from elevated triglyceride levels. See figure 2 in appendix 5.

Cigarette smoking

Alcoholism

Lack of exercise

Obesity

 

Nutritional prevention

The nutritional prevention is not to eat diet, which is high in fat especially with cholesterol and saturated & trans fat. Foods that should not be eaten too much are egg yolk, chicken with skin, liver, kidney, shrimps, whole milk, ice cream, cheese and butter.

Adults should take less than 100 mg of cholesterol per thousand kilocalories and saturated fat intake should be less than 10% per day. They should also take diet which is high in fiber especially water soluble fiber which are like gums, pectins and mucilages. These fibers can inhibit the absorption of cholesterol by binding with it. The food which is high in water soluble dietary fiber are oat, oat bran, fruits like citrus fruits and vegetables.

The amount of fat per day should be about 30%. Less than 10% should be from saturated fat and the other amount should come from monounsaturated and polyunsaturated fat. The oils which have high content of polyunsaturated fat are sunflower and safflower oils. Coconut oil has nearly 92% of saturated fat. Therefore coconut oil should be completely avoided in the diet. Garlic can lower cholesterol levels. Antioxidants like vitamins C and E and beta-carotene can aid to lower LDL. Niacin can also lower cholesterol levels. One should avoid drinking alcohol since it puts a person at risk for atherosclerosis. Obesity should be prevented because it is another risk for artherosclerosis. Exercise is very important to burn out the extra calories. People should exercise from childhood to death provided their health conditions permit. One should follow what the Bible says in Deuteronomy 8:3, which states, Man shall not live by bread alone but by every word that proceedeth from the mouth of the Lord. If one follows this principle, one will eat to live and not live to eat. 1st Corinthians 6:19 says What? Know ye not that your body is the temple of the Holy Spirit. Since the body is the temple of the Holy Spirit, one should not defile it by drinking alcohol, smoking cigarette or eating faulty diet which is high in cholesterol.

 

4. Fatigue

Fatigue is the state of weariness or tiredness. There could be mental disinclination or extreme exhaustion following physical activity or mental effort.

 

 

 

Etiology

 

There are many causes of fatigue which include the following factors:

1. Overwork or over exertion

2. Inadequate sleep

3. Obesity

4. Undernourishment

5. Stress

6. Depression

7. Excessive sleep

8. Anemias

9. Lack of physical activity

10. Some of the diseases that can cause fatigue are:

a. Hyperthyroidism 

b. Hypothyroidism

c. Cardiac diseases

d. Infections like hepatitis A and B

e. Respiratory diseases like pneumonia, tuberculosis and flu

f. Cancers 

g.AIDS

11. Smoking

12. Alcoholism

13. Drug side effects

 

There is a syndrome known as chronic fatigue syndrome. In this case the fatigue would last for more than six months along with symptoms like low-grade fever and swelling of lymph nodes for which the exact cause is not known.

 

Nutritional prevention

The nutritional prevention is to preclude nutritional anemias. The nutritional anemias, that are B12 deficiency anemia, folic acid deficiency anemia, iron deficiency anemia and pernicious anemia, should be prevented. How to prevent them are discussed under the topic anemias. The next nutritional prevention is to prevent obesity, underweight, and nutritional deficiencies. How to prevent them are discussed under the respective topics.

 

 

5. Hemorrhage

Hemorrhage is bleeding. It is the escape of blood from the blood vessels either internally or externally due to some abnormalities.  

 

Etiology

 

There could be many factors that can cause hemorrhage. These include:

Sclerosis of the liver

Peptic ulcers

Menstruation problems

During child birth

Cancers

Hemorrhagic fevers

Hemorrhoids

Vitamin K deficiency for prolonged time

 

Nutritional prevention

If the peptic ulcers have been caused due to nutritional reasons like not eating on time and eating high spicy food, then those reasons should be prevented. If hemorrhoids have been caused due to diet that is high in fat and less in fiber, then the diet which is high in fiber and very less in fat should be consumed. It is good to prevent peptic ulcers and hemorrhoids nutritionally. If a woman is suffering from menorrhagia (heavy bleeding) then she should take iron supplements daily and eat diet rich in iron. The persons suffering from bleeding problems should take diet which is rich in vitamin K because this vitamin helps in clotting of the blood. Foods rich in vitamin K are dark green leafy vegetables like spinach, turnip, lettuce, broccoli and cabbage.

 

 

6. Hypertension

Hypertension is high blood pressure that persists. But there are controversies as to what really constitutes high blood pressure. However, it is commonly agreed that when a persons systolic pressure is equal or higher than 140mm\Hg and the diastolic pressure is equal or higher than 90mm\Hg then that person is said to be hypertensive. Of course, there are different types of hypertension like essential hypertension, secondary hypertension and malignant hypertension.

 

Etiology

The exact cause of hypertension is idiopathic. However, there are some risk factors, which are as follows:

High fatty food intake especially with high cholesterol --- A study conducted by the author revealed that 40% of 286 patients with elevated cholesterol suffered from hypertension.13 See figure 3 in appendix 5.

High salt intake

Smoking

Alcoholism

Physical inactivity

Obesity

Emotional problems like stress, depression, fear and anxiety

 

Nutritional prevention

The nutritional prevention is to eat a balanced diet. The diet should not contain more than 2 grams of salt per 2000 kilocalories. High fatty food which contains a lot of cholesterol and saturated fat should not be ingested. Fat content should not be more than 30% and saturated fat should be less than 10% and the remaining of the 30% should come from monounsaturated and polyunsaturated fats. Cholesterol intake should not be more than 100 mg per thousand kilocals per day. In addition people should do a lot of exercise to burn extra calories. For more information on how to prevent hypertension, please read the authors book, Dr. Stevensons Solutions to A to Z Problems in Life.

 

 

 

7. Myocardial Infarction

Myocardial infarction is a necrosis of the myocardium due to the abrupt reduction of coronary blood flow to the heart. In lay mans term myocardial infarction is known as heart attack. The symptoms of myocardial infraction or heart attack varies from person to person. However, the usual symptoms are pain or tightness in the chest especially near the substernal region which could radiate to the back, neck, jaw and left arm. There could be shortness of breath or dyspnea and sweating. Other symptoms like nausea, vomiting and fear of the approaching doom could be present. Some patients might go to the toilet to urinate or defecate.

 

Etiology

The exact cause of myocardial infarction is abrupt reduction of blood to the myocardium. There are reasons why there could be a sudden reduction of blood flow through the coronary artery to the heart. Those reasons are due to risk factors which are as follows:

High cholesterol intake

Atherosclerosis

Hypertension

Smoking

Alcoholism

5. Diabetes mellitus

Obesity

Lack of exercise

Genetic predisposition

Choleric temperament

Menopausal conditions

Severe emotional problems like phobia, stress and depression

Side effects of drug addiction

 

Nutritional prevention

The nutritional prevention is to avoid high cholesterol intake through food. The foods which are high in cholesterol are butter, cheese, egg yolk, organ meats, shrimps, crabs, oysters and whole milk. For more information, on how to prevent the intake of cholesterol, please check nutritional prevention of atherosclerosis. The other nutritional preventive measures are to preclude obesity, prohibit alcoholism, take less salt (2 grams of salt per 2000 kilocals), prevent diabetes mellitus and hypertension and do plenty of exercises.

 

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C. Symptoms and Diseases of the Endocrine System

 

1. Diabetes Mellitus

Diabetes mellitus is a disease where there is hyperglycemia from either no or little production of insulin or insulin non-action. There are different types of diabetes mellitus. These include insulin dependent diabetes mellitus (IDDM) and non insulin dependent diabetes mellitus (NIDDM). Insulin dependent diabetes mellitus is type 1 and non insulin dependent diabetes mellitus is type 2. Initially as a person become diabetic, there may not be symptoms but later there could be symptoms of excessive thirst, excessive hunger, excessive urination and fatigue. Diabetes mellitus is one of the leading causes of death in Western countries.

Etiology

The under lying cause of diabetes mellitus is insulin deficiency which is absolute in IDDM patients and partial in NIDDM patients. There could be several reasons as to why insulin is deficient. The reasons are as follows:

Pancreatic disorders

Inflammation of the islets of langerhans

Defects in the formation of insulin

Dysfunctions of beta cells

Viral or chemical agents

Mutation of the genes controlling insulin.

 

There are several risk factors that can make a person vulnerable for diabetes mellitus which are as follows:

1.      High carbohydrate and fatty diet

2.      Alcohol intake (1g of alcohol gives 7 kilocalories or 1ml gives 5.6 kilocalories)

3.      Obesity

4.      Lack of exercise

5.      Viral infections like viral rubella

6.      Genetic predisposition

7. Some socio-economic factors like occupation and educational status can inter play.

Nutritional prevention

In order to prevent diabetes mellitus nutritionally, one should not eat a diet that is high in carbohydrate and fat. Simply put, it means not to take excessive calories than your body needs. One gram of carbohydrates gives 4 calories whereas 1gram of fat gives nine calories. Foods that should not be eaten in plenty are butter, cheese, egg yolk and highly refined foods like cakes, sweets and ice creams. The recommended energy requirements should be according to ones age, sex, work and exercise. Obesity should be prevented. There should be no physical inactivity but rather an individual should be involved in exercise to burn out extra calories. One should not eat too much at any time. One should completely avoid drinking alcohol.

 

 

 

2. Hypothyroidism

Hypothyroidism is a condition where there is a deficiency of thyroid functions in the body. Patients of hypothyroidism have the following symptoms:

a.       Intolerance to cold

b.      Putting on weight in spite of eating less

c.       Anorexia

d.      Fatigue

e.       Weakness

f.        Constipation

g.       Reproductive females may suffer from menorrhagia

h.       Depression

i.         Lethargy

 

Etiology

Hypothyroidism may be due to the primary disease of the gland itself

It may be due to lack of pituitary thyroid stimulating hormone.

Iodine deficiency in the diet

Genetic thyroid defects

Goitrogenic drugs---methinazole and sulfanomides

Goitrogenic foods like cabbage, cauliflower, turnips and lettuce, if eaten in plenty for a long period of time.

 

Nutritional prevention

The first preventive measure is to take enough iodine in the diet or else it may lead to goiter. Goiter is the swelling of the thyroid gland which is located in front of the neck. The RDA of iodine for adults is 150 micrograms. The rich sources of iodine are found in seafood, for example, shellfish, seaweed and salt fish. Plants that are grown along the seacoast also contain iodine. Another good source of iodine is iodized table salt.

 

 

The second preventive measure is to avoid eating too much of goitrogenic food. The foods that are goitrogenic are cabbage, cauliflower, turnips and lettuce. If these vegetables are eaten everyday in large quantities, they can increase the risk for goiter. Hence, one can eat them in little quantities but not in large quantities over a long period of time.

 

3.      Menstrual Problems

 

Amenorrhea

Amenorrhea can be divided into two types, namely, primary amenorrhea and secondary amenorrhea. Primary amenorrhea is a condition where the female has never menstruated in spite of passing the normal puberty age. Secondary amenorrhea is a condition where the female had menstruated but later the menstruation stopped because of some reasons.

 

Etiology

The author will discuss the causes of both primary and secondary amenorrhea together.

 

Amenorrhea could be caused because of the following reasons:

Anatomical abnormalities like imperforate hymen

Hypothalmic dysfunctions

Anorexia nervosa

Weight loss

Undernourishment

Pituitary dysfunctions like hypopituitarism

Genetic defects like Turners Syndrome

 

Nutritional Prevention

Amenorrhea can be in a way caused by eating very little food or undernourishment. Eating disorders like anorexia nervosa can contribute to either primary or secondary amenorrhea. How to prevent anorexia nervosa is discussed under the topic anorexia nervosa. All females of the reproductive age must eat balanced diet and should not be undernourished.

 

Oligomenorrhea

Oligomenorrhea is a condition where there is skipping of monthly periods and\or scanty bleeding.

 

Etiology

Hormonal imbalance

Problems of the ovaries

Hypothalmus dysfunctions

Pituitary glands and ovary gland disturbances

Poor intake of food resulting in under nutrition

Excessive exercise

 

Nutritional prevention

The females of reproductive age must eat balanced diet in order to prevent under nutrition. Females should not do very vigorous and excessive exercises for a long period of time since excessive exercise contributes to oligomenorrhea. Professional sports women and female athletes do suffer from oligomenorrhea.

 

Premature Menopause

Premature menopause is cessation of menstruation before the normal time (which is 45 to 50 years). Premature menopause usually takes place before the age of 40 years.

 

Etiology

The main cause why women have premature menopause before they reach age forty is not really known. However, there are some associations with premature menopause. These associations are as follows:

Women who live in high altitude areas

Poor nutritional status

Alcoholism

Smoking

 

Nutritional prevention

The nutritional prevention for premature menopause is that women should eat balanced diet in order to avoid a poor nutritional status. Women should maintain good eating habits and should not be underweight or emaciated. Women should not drink alcohol. Though smoking is not part of nutrition, the author advises not only women, but also everyone not to smoke. Premature menopause is not good because women can suffer from osteoporosis and hot flushes at an earlier age.

 

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D. Symptoms and Diseases of the Urinary System

 

Nephrotic Syndrome

Nephrotic syndrome is a condition where there is severe prolonged increase in glomerular permeability in the kidneys for albumins. Basically this syndrome causes albuminuria (presence of albumins in urine).

 

Etiology

This syndrome is a phase of progression of some diseases like the following: 14

Chronic glomerularnephritis

Diabetic nephropathy

Hypertension

The secondary causes of this syndrome are hepatitis B, cancers and lupus erythromatosus.

 

 

Nutritional prevention

Since diabetes mellitus and hypertension could lead to this syndrome, one should avoid being diabetic and hypertensive. One should also have regular check ups especially after age 40 to detect any cancers of the urinary tract or digestive system.

 

2. Chronic Renal Failure

Chronic renal failure is a gradual loss of kidney function. There would be no urinary output eventually.

 

 

Etiology

Chronic urinary failure has several secondary causes, which are as follows:

Diabetic nephropathy

Acute kidney failure

Extensive atherosclerosis of the urinary arteries

 

 

Nutritional Prevention

Since chronic renal failure is due to secondary causes like diabetes and atherosclerosis, it is good to prevent those diseases. How to prevent those diseases were already discussed.

 

 

3. Urinary Calculi

Urinary calculi is the formation of stones in the urinary system. The urinary calculi or stones can be found in the kidneys, ureters, bladder and urethra. When small stones pass through the ureters or urethra there may not be much pain. However, when large stones try to pass through the ureters and urethra there could be severe pain due to the blockage. There could be chills, fever, nausea, vomiting along with severe pain.

 

 

 

Etiology

Presence of calcium oxalates

Presence of uric acid and cystine

Excess intake of vitamin D

Excess intake of calcium

Very little intake of drinking water

Hypothyroidism

Metastatic cancers

Gout

 

Nutritional Prevention

The nutritional prevention is not to take excessive calcium and vitamin D in the diet and through supplements. Fish liver oil should not be ingested in plenty. For RDAs of calcium and vitamin D, check chapter 1 under the respective nutrients or see appendix 1. Patients who suffer from urinary calculi should not eat cabbage, tomatoes and tamarind because they contain oxalates. They should drink plenty of water to inhibit the formation of calculi.

 

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E. Nervous and Mental Symptoms and Diseases

 

Anorexia Bulimia

Anorexia bulimia is an eating disorder where there are episodes of binge eating and purging. The patients throw up later because they feel guilty and also they do not want to put on weight.

 

Etiology

Basically the cause of this eating disorder is psychological. It is also due to poor nutritional knowledge. The psychological reasons are:

1.      Stress

2.      Depression

3.      Fatigue

4.      Guilt

 

 

Nutritional Prevention

Nutritional principles should be taught from childhood. The patients of this eating disorder must be treated by psychotherapy. During psychotherapy, the importance of nutritional education must also be emphasized. The nutritional principle like eating adequate amounts at regular intervals should be inculcated. There should be no overeating and purging since they have adverse effects on the gastrointestinal system. They should maintain normal weight for their height.

 

2. Anorexia Nervosa

Anorexia nervosa is an eating disorder where the patients have morbid fear of obesity and suffer from loss of appetite. The anorexics do not want to put on weight and would starve themselves. If they are forced to eat, they would vomit after eating when nobody is around.

They would wear baggy or layered clothing and avoid food-related social activities.15

 

Etiology

The causes of anorexia nervosa are basically psychological. The anorexics try to be perfectionists. Another cause is the patients want to punish their parents for their strict upbringing, but ironically, they are punishing themselves. The morbid fear of putting on weight is another reason. The anorexics have poor nutritional knowledge.

 

 

Nutritional prevention

Nutritional principles should be taught from childhood. During psychotherapy, they should be inculcated the importance of good nutrition principles. It is not easy to treat these patients. The patients should know that normal weight should be maintained or else they could be emaciated and eventually be vulnerable to all kinds of diseases, which could lead to death. They should be shown that they are not punishing their parents but punishing themselves unduly. For more information about anorexia nervosa, you can read the authors book, Dr. Stevensons Solutions to A to Z Problems in Life.

 

3. Dementia

Dementia is progressive deterioration of the mental functions, which are irreversible. The mental functions that are affected are memory, judgement, personality and emotional control.

 

Etiology

Dementia has so many causes, which are as follows:

B12 and folic acid deficiencies

Hyperglycemia

Hypothyroidism

Alzheimers disease

Brain trauma

Huntingtons disease

Multiple sclerosis

Parkinsons syndrome

Meningitis

Encephalitis

HIV-related diseases

Pellagra

Nutritional prevention

The nutritional prevention for dementia is to preclude the nutritional anemias, hyperglycemia and hypothyroidism. The nutritional prevention of these conditions has already been discussed. Pellagra is caused because of niacin deficiency. Hence, niacin should be sufficiently taken through diet. The sources of niacin are chicken, eggs, fish and meat.

 

4. Headache and Migraine

Needless to say headache is an ache. Migraine is a severe headache, which is usually to one side of the head, and it could be accompanied with nausea, vomiting and visual disturbances.

 

Etiology

Headache can be caused because of a primary reasons and secondary reasons. The reasons will be mentioned together. They are stress, eyestrain, nasal congestion, alcoholic beverages, tumors in the brain, head injuries, severe hypertension and diseases of the eye, throat, ear and vertebrae.

The causes of migraine are head injuries, emotional problems and drinking red wine and other alcoholic beverages.

 

Nutritional prevention

The preventive nutrition for headaches and migraines is to completely avoid red wine and other alcoholic beverages. One should prevent hypertension. One should not eat certain foods that can irritate the stomach like nitrite-containing foods, which in turn, can cause headaches.

 

 

5. Hypersomnia

Hypersomnia is excessive sleep. It is sleeping more than 25% of the normal sleep in any given 24 hours.

 

 

Etiology

Intracranial pressure problems

Abuse of hypnotic drugs

Depression

Hyperglycemia

Hypothyroidism

Anemias

Epilepsy

Multiple sclerosis (sometimes)

 

Nutritional prevention

The preventive nutrition is to avoid being hyperglycemic. Diabetic patients should control their hyperglycemic state. Patients who are anemic nutritionally and those who suffer from hypothyroidism should correct their conditions. One should learn the causes of anemia, hypothyroidism and diabetes mellitus and how to prevent them. The causes and the nutritional prevention are discussed under the respective topics.

 

 

6. Insomnia

Insomnia is a condition where there is sleeplessness.

It is a condition where a person is not able to sleep normally.

 

 

Etiology

Anxiety

Depression

Severe pain

Stimulants like coffee

Poor sleeping habits

Sleeping for some time during the day

Excess alcohol

Jet lag

Damage to hypothalamus region

Addiction to sedative drugs

Excessive drinking of water at nights

Diuretic drugs for hypertension

Lack of exercise

 

Nutritional Prevention

Do not drink excessive water or fluids at night, especially before sleep. If one does this, the person would get up in the night and this would disturb the sleep process and later cause insomnia. One should not drink coffee because it acts as a stimulant and one should not drink alcohol. Individuals should try to prevent hypertension at all costs or else they would be forced to take diuretic drugs, which in turn, will boomerang on their sleep.

 

Everybody should do exercise during the day so that it could induce sleep in the night. For some people, drinking a warm cup of milk before sleeping could induce sleep. Lastly, the author advises to leave all your cares at the feet of the Lord Jesus and ask Him to give you good sleep. This advice is not nutritional but it is a very important one. For more on insomnia please read the authors book, Dr. Stevensons Solutions to A to Z Problems in Life.

7. Neurolathyrism

Neurolathyrism is a paralysing disease. It is a nervous systemic disease where there is gradual spastic paralysis of the lower limbs, occurring mostly in adults.

 

Etiology

The cause is a toxin known as Beta oxalyl amino alamine (BOAA) which is found in Lathyrus sativus.16 Neurolathyrism has been reported in Spain , Algeria and India .

 

 

Nutritional prevention

The nutritional prevention is not to grow the crop of Lathyrus sativus. Although it has good content of protein, it also has the deadly toxin. This sativus should not be ingested. The government of the concerned countries where there is the presence of neurolathyrism should ban the growing of this crop. If this cannot be done, then measures have to be taken to remove the toxin. It can be removed by boiling in hot water because it is soluble in water. Before boiling, it should be soaked in limewater. Nutritional education should be given to the farmers regarding the harmful effects of this sativus.

 

 

8. Psychogenic vomiting

Psychogenic vomiting is throwing up of food voluntarily and not because of physiological reasons. The author is not dealing with the anorexia bulimia and anorexia nervosa in this section.

 

Etiology

Some people throw up or vomit because the food is not tasteful, while others will do so because the food is not culturally accepted, for example, eating a snake or a dog which is alien to their culture. Sometimes a child might throw up purposely to show his tantrum.

 

Nutritional prevention

Nutritional education should be imparted to all people regarding what is good to eat and what is not. Persons should not eat anything, which they find to be alien or repulsive. They should be taught that some foods might not be tasty but are good for health. Children should be taught not to use food to show their anger or tantrums.

 

9. Stress

Stress is a condition where the physical and mental functions can be affected adversely.

 

Etiology

Physical reasons diseases, cancers and nutritional problems like diabetes mellitus and nutritional habits like alcoholism

Psychological reasons depression, anxiety and phobias

Social reasons marriage problems, caste and class problems, crime and violence, smoking, and drug addiction

Economic reasons unemployment, working conditions, financial constraints and lack of money

 

Nutritional Prevention

When people suffer from nutritional problems like diabetes mellitus, atherosclerosis, coronary heart disease, hemorrhoids, nutritionally related cancers like oral cancer, liver cancer and colorectal cancer, these problems will definitely stress them out. Hence, these nutritional problems and diseases should be prevented. Some persons reason that if they drink alcohol, it will remove the stress but they are wrong. After the effects of alcohol are over, they will be more stressed and they will drink more. This is a vicious cycle. Hence, alcohol should not be ingested. If some persons are stressed when they eat outside their homes like in a restaurant, then they should carry their own food and water. For more information, please read the authors book, Dr. Stevensons Solutions to A to Z Problems in Life.

 

10. Stroke or Hemiplegia

Hemiplegia is paralysis of one side of the body. If the left side of the body is paralyzed, then the right side of the brain is affected. This disease is a cerebrovascular disease. In laymans term it is called a stroke.

 

Etiology

The actual cause of hemiplegia could be a cerebral thrombosis (blood clot), cerebral hemorrhage (bleeding in the brain) or cerebral ischemic condition (insufficient blood supply).

The risk factors of hemiplegia or stroke are as follows:

Hypertension

Diabetes mellitus

Atherosclerosis

Obesity

Smoking

Glucose intolerance

Clotting diseases

Oral contraceptives

Hypochondria

Alcoholism

Drug overdose

 

Nutritional prevention

In order to prevent stroke, one has to avoid the risk factors like hypertension, diabetes mellitus, atherosclerosis and obesity. Please check the causes and the nutritional prevention under the respective topics. One should completely stop drinking alcohol if they are alcoholics and if they are not, then they should never try to taste alcohol.

 

11. Unconsciousness and Coma

Unconsciousness is a state where a person is not conscious. Deep unconsciousness for a long time is known as coma.

 

Etiology

Causes of unconsciousness and coma:

1.      Concussion in the brain

2.      Tumors or cancers of the brain

3.      Hemorrhage in the brain

4.      Ischemic conditions in the brain

5.      Injuries to the head

6.      Diseases like epilepsy, diabetic acidosis

7.      Hysteria

8.      Hyperglycemia

9.      Hypoglycemia

10.  Alcohol abuse

11.  Drug overdose

12.  Atherosclerosis

13.  Hypertension

Nutritional prevention

In order to prevent unconsciousness and coma nutritionally, one has to avoid diabetes mellitus, atherosclerosis and hypertension. Please see the respective topics for the causes and nutritional prevention. One should not drink alcohol. The diabetics should control their hyperglycemic state (too much glucose in the blood) and hypoglycemic state (very less glucose in the blood).  

 

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F. Symptoms and Diseases of the Skeleto-muscular System

 

1. Gout

Gout it is a disease where there is an abnormal urea metabolism. There is reduced ability to excrete uric acid. There will be severe pain and inflammation in the joints of the patients.

Etiology

The cause of gout is the idiopathic. Some medical scientists are of the opinion that it is genetic. The secondary causes of gout are as follows:

1.                  Carcinoma of the urinary tract system

2.                  Kidney diseases

3.                  Alcoholism

4.                  Diabetes insipidus

5.                  Obesity

 

Nutritional prevention

Since people, who are obese, are vulnerable to this disease, they should avoid being so. How to prevent obesity, please check under its topic. One should not drink alcohol. Patients suffering from gout should not eat foods which is high in purine content of food like mushrooms, sardines, meat, liver, kidney and other organ meats.

 

2. Osteoporosis

Osteoporosis is a progressive demineralization of the bone. There will be loss of bone material, which will make it vulnerable for factures.

 

Etiology

Calcium deficiency

Phosphorus deficiency

Vitamin D deficiency

Late menarche

Menopause

Alcohol usage

Coffee drinking

Eating anything which contains caffeine

Cigarette smoking

Genetic predisposition

 

Nutritional prevention

In order to avoid osteoporosis, one should ingest sufficient calcium, phosphorus and vitamin D on daily basis. The RDA for calcium for male adults is 800 mg per day and for female adults is 1000 mg per day. The author recommends for menopausal women to take 1000-1200 mg per day if they are not suffering from urinary calculi. The food sources that have high content of calcium are cheese, ice cream, cabbage and green leafy vegetables. For vitamin D, 5 micrograms is recommended per day for both adult males and females. The good sources of vitamin D are fortified milk, fish liver oil and exposure to sunlight. For phosphorus, the ideal is about 800mg per day for adults. But the author recommends at least 1200mg per day for postmenopausal women. The food sources for phosphorous are ice cream, cheese, milk, fish, nuts and legumes. To avoid osteoporosis, one should try not to eat or drink anything that contains caffeine. One should not drink alcohol.

 

3. Rickets and Osteomalacia

Rickets is a disease in children where there is deformity of the bones due to vitamin D deficiency. It is called osteomalacia in adults.

 

Etiology

Vitamin D deficiency

 

Nutritional prevention

To prevent rickets, one should take sufficient vitamin D in the diet. The RDA is 10 microgram per day. The good sources of vitamin D are fortified milk, fish liver oil and also exposure to sunlight. People who live in places where there are long winters, should take vitamin D supplements. Muslim women who cover themselves from head to toe must also take vitamin D supplements, if their diet does not have sufficient supply of vitamin D. 

 

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G. Symptoms and Diseases of the Eye

 

1. Bitots Spots

Bitots spots are white foamy spots in the cornea. These spots are named after Paya Bitot, a French physician who first observed this problem.

 

Etiology

 

Vitamin A deficiency

 

Nutritional prevention

To prevent bitots spots, people should eat diet, which has a sufficient amount of vitamin A from infancy. The RDA for vitamin A during infancy is 375 micrograms retinol equivalents. For adult males, it is 1000 micrograms retinol equivalents and for adult females it is 800 micrograms retinol equivalents. Vitamin A can be found in two types, namely, retinol (pre-formed vitamin A) and carotene (pre-cursor for vitamin A). The good sources of retinol are liver, and kidneys of animals, egg yolk, butter, fortified margarine and cheese. The sources of carotene are carrot, pumpkin, sweet potato, mango, papaya, green leafy vegetables like spinach and turnips. For patients who are suffering from bitots spots, injections of vitamin A should be administered to avoid further destruction of the eyes.

Keratomalacia

It is the ulceration of the cornea of the eye and this would lead to blindness.

 

Etiology

Severe vitamin A deficiency

 

Nutritional prevention

The nutritional prevention is to follow the advice and suggestions made under bitots spots. Keratomalacia is best to be prevented because it could be irreversible and it will lead to blindness.

 

3. Night blindness

Night blindness is known as nyctalopia. It is a visual impairment during dusk time. The eyesight becomes poor during dusk time and whenever there is insufficient light.

 

 

 

Etiology

Vitamin A deficiency and sometimes congenital defects

 

Nutritional prevention

The nutritional prevention is to eat diet which has sufficient vitamin A. Sometimes when the diet lacks vitamin A, it is good to take vitamin A supplements.

 

4. Xerosis

Xerosis is a condition where the conjunctiva is dry and lustreless.

 

Etiology

Vitamin A deficiency

 

Nutritional prevention

The nutritional prevention mentioned under bitots spots should be followed.

 

 

 

 


H. Nutritional Deficiencies and Toxicities

 

Nutrients

Deficiencies

Toxicities

Water

Dehydration, risk for urinary stones

Edema in some patients

Carbohydrates

Hypoglycemia

Dietary fiber -- atherosclerosis, colorectal cancer, breast cancer, hemorrhoids, obesity, constipation

 

Overweight, obesity, diabetes mellitus

Fibergas, diarrhea

Lipids or fats

Eczema, phrenoderma

Overweight, obesity, hypertension, atherosclerosis, risk for colorectal, prostate and breast cancers

Proteins

Kwashiorkor, marasmus

Interferes with calcium absorption

Vitamins

(fat-soluble)

 

 

Vitamin A

Night blindness, keratomalacia, xerosis, bitots spots

Vomiting, peeling of skin and hair

Vitamin D

Rickets in children, osteomalacia in adults

Stomach upsets

Vitamin E

Red cell hemolysis in undernourished children

Headaches, fatigue

Vitamin K

If deficiency is prolonged, it leads to hemorrhage

Anemia, jaundice

 

Nutrients

Deficiencies

Toxicities

Water Soluble

 

 

Vitamin B1

Beriberi, fatigue, depression, poor appetite and neuritis of legs

Headache, cardiac arrhythmias, convulsions

Vitamin B2

Cheilosis, scaly skin, inflammation of conjunctiva

Not reported

Vitamin B6

Gastrointestinal upsets, nervousness, convulsions

Numbness in hands and feet, tingling sensation

Vitamin B12

Macrocytic red blood cells, anemia, pernicious anemia

Not reported

Vitamin C

Scurvy, poor wound healing, gastrointestinal upsets, gingivitis

Nausea, vomiting, diarrhea, formation of urinary calculi

Folic Acid (folate)

Macrocytic red blood cells, anemia especially during pregnancy

Interferes with absorption of zinc, may mask pernicious anemia

Niacin

Pellagra

Flushing and redness of the skin

Biotin

Loss of appetite and hair, deficiency occurs if raw egg-white is eaten in large amounts

Not reported

Panthothenic Acid

Neuritis of arms and legs

Not reported

Minerals

Macrominerals

 

 

 

Nutrients

Deficiencies

Toxicities

Calcium

 

Osteoporosis, fractures

Urinary calculi, interferes with other mineral absorptions

Phosphorus

Irritability, weakness

Poor bone health

Magnesium

Muscle pain, weakness

Weakness

Sodium

Muscle cramps, hypotension, dehydration, confusion

Hypertension

Sulfur

Not reported

Not reported

Potassium

Loss of appetite, muscle cramps

Slow heartbeat

Microminerals

 

 

Iron

Anemia, fatigue, hypochromic microcytic red blood cells

Toxicity in small children

Iodine

Goiter

Interferes with thyroid function

Fluoride

Risk for dental caries

Mottling and discolourizati-on of teeth

Selenium

Muscle pain, risk for heart disease

Nausea, vomiting, hair loss, weakness, liver disease

Zinc

Poor sexual maturity, delayed wound healing, diminished taste

Diarrhea, cramps, poor absorption of iron

 

In order to prevent the deficiencies and toxicities of various nutrients, their RDAs should be followed and a balanced diet should be ingested. Foods that have nutrient density must be eaten and not foods that have nutritional empty calories.

 

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I. Cancers

 

Cancer is a malignant growth in a tissue or organ. There are different types of cancers. Carcinoma is cancer of the epithelium tissues; sarcoma is cancer of the connective tissues like in bone and muscles; leukemia and lymphomas are cancers of the blood-forming organs and melanoma is cancer of the skin. Cancerous growth is a proliferation of growth of cells where it is uncontrolled and could invade surrounding tissues and other parts of the body through lymph and blood fluids. It can cause metastasis to other parts of the body. If not treated early, the ultimate result is death.

 

Cancer is the second leading cause of death in the United States and nearly 5 million have died since 1990.17 One out of every 2 to 3 persons in the US will develop some type of cancer during their lifetime.18 The leading cancer among men is prostate cancer, breast cancer among women and among both is lung cancer.

 

It is a great miracle of Lord Jesus if one does not have cancer because one of every two persons can develop cancer. Whether one believes in the existence of God or His miraculous works or not, His truth is not divided. When some persons suffer from cancer, they promise God to serve Him if they are healed. When they are healed, they say it is a miracle and give their life to Lord Jesus. What the author is conveying is that not suffering from cancer is itself a miracle, so why doesnt one give his/her life to Lord Jesus and serve Him instead of suffering from cancer at a later time and pray to be healed then. Many cancers are idiopathic, so not having cancer is a blessing. Psalm 150:6 states Let everything that has breath praise the Lord. Praise the Lord. Therefore, we have the breath, and it is not cancer tainted. We ought to be grateful to God. Those who have cancers should realize that God has His own plan, even though He did not cause the cancer in the body, He permitted it and can still do a miracle if it is His will. However, the cancer patient should follow the medical regimen and leave the rest to God. The cancer patients should advise others who are not suffering from cancer to stay close to God because He is very gracious to them.

 

Etiology of Cancer

The causes of most cancers are idiopathic (not known). The development of cancer usually takes place in stages. First there is initiation, where there is genetic mutation occurring in the cell. This cell turns into a latent cancerous cell. The affected cell may immediately start developing to the next stage or may lie dormant for months or years. The second stage is promotion. Stimulation of the initiated cell by a promoting agent will lead to the progression of a latent cancer cell; which multiplies uncontrollably and leads to malignancy. Sometimes the promoter may not act as an initiator but there are agents known as complete carcinogens, which can cause cancer. They can both initiate and promote cancer.

 

Oncogenes will produce cancerous cells. Research has shown that there are mutations in DNA sequences that can lead to the initiation of cancer cells. There are internal and external risk factors for cancers.

 

Internal Risk Factors

The internal risk factors are genetic, age, sex, race and immunological.

 

1. Genetic Factors

Many cancer patients exhibit chromosomal abnormalities like deletions, inversions and translocations. Patients with chronic myelogenous leukemia may have the Philadelphia chromosome which is 22p- chromosome. Downs syndrome patients are susceptible to cancers.19 Other genetic predispositions of cancer are familial polyposis and breast cancer.

 

2. Age

As people age, they are more risks for cancer.

3. Sex

Cancer affects both sexes with breast cancer leading among females and prostate cancer among males. Lung cancer affects both.

 

 

4. Race

Blacks have more incidences of cancer because of low socio-economic factors that may prevent early detection and may even increase exposure to environmental carcinogens. Whites are vulnerable to skin cancers.

 

5. Immunological

Immunosuppresion increases susceptibility to cancers.

 

External Risk Factors

  1. Chemical carcinogens: These include arsenic, asbestos, benzene and polycyclic hydrocarbons.
  2. Radiation: Ionizing radiation of all kinds can be carcinogenic, for example x-rays and nuclear radiation. Fair skinned people are vulnerable to skin cancers because of ultra violet radiation.
  3. Viruses: Research has shown that several viruses can cause cancers. The cytomegalovirus (CMV) can cause Kaposis sarcoma. Epstein-Barr virus can cause Burkitts lymphoma. Hepatitis B virus can cause hepatocellular carcinoma. Human papilloma viruses can cause cervical carcinoma.20
  4. Diet: Faulty diet, that is, diet high in fat and low in fiber has been associated strongly with colorectal, breast and prostate cancers.

Smoked food like smoked fish, jerk chicken and pork can be a risk for stomach cancer since smoke can be carcinogenic. Ellen White in her book Counsels on Diet and Foods, page 388, stated, Cancers, tumors and all inflammatory diseases are largely caused by meat eating.

Alcohol is carcinogenic to the liver. It has been associated with liver cancer, esophageal cancer and colorectal cancer.

  1. Cigarette Smoking: Smoking is an evil habit because tobacco contains nicotine and produces carbon monoxide when smoked, which is carcinogenic and leads to cancer of the lung. Cigarette smoking has also been implicated in cancers of the mouth, pharynx and bladder. Pipe smoking is associated with lip cancer.
  2. Drug Carcinogens: Some drugs like alkylating agents, oxymetholone and diethylstilbestrol can be carcinogenic.21

 

 

Certain Cancers and Diet Associations

 

Bladder Cancer---the specific dietary involvement with this cancer is non nutritive alternative sweetener saccharin, which has produced bladder cancer in some animals.22 It is thought that it can also cause bladder cancer to humans, but this has not been proven yet. Possible associations with alcohol and coffee.

Breast Cancer---high fat,23 low fiber and alcohol

Colorectal Cancer---high fat especially cholesterol and saturated fat,24 low fiber and alcohol

Esophagus Cancer--- alcohol and plenty of hot spices

Liver Cancer---alcohol, aflatoxins in spoiled grains and peanuts

Oral Cancer---chewing of betel leaves and nuts along with lime powder, tobacco and drinking alcohol

Pancreatic Cancer---alcohol

Pharyngeal cancer---alcohol, chewing betel nut and leaves along with lime powder, and hot spices

Prostate Cancer---high fat and low fiber

Stomach Cancer---smoked food25 like smoked fish, jerk chicken and jerk pork and foods containing nitrites

Uterus Cancer--- high fat and low fiber

 

Preventive Nutrition for Cancers

Good nutrition can only cut or reduce risk factors for cancers. It cannot prevent cancers completely because there are many other factors that interplay in the causation of cancers. Cancer prevention nutritionally should start from birth and end at death.

 

Nutritional prevention is based duly on the premise that food eaten should cut risk factors and inhibit the promotion of cancers. The author has made nutritional suggestions.

 

1. Eat foods that are rich in antioxidants, which can inhibit the promotion of cancers.

 

The antioxidants are carotenoids, vitamin E, vitamin C, and microelement selenium. These antioxidants act as scavengers to inactivate certain chemical substances known as free radicals which are atoms or molecules with one or more unpaired electrons in their outer orbits. This imbalance makes them highly reactive. Free radicals are produced all the time in the body as by-products of normal metabolism. Free radicals because of their unstable conditions, they try to react with other cells and cause damage to them.

 

a) Carotenoids and Retinoids

Carotene inhibits cancerous growth. Carotenoids are antioxidants which can inactivate free radicals which damage the cells of the body. Carotenoids are found in yellow vegetables like carrots, pumpkins, sweet potatoes; yellow fruits like mangoes, papaya, apricot; green leafy vegetables like turnips, spinach, broccoli; red fruits and vegetables like tomatoes and red sweet pepper.

 

Retinoids have been shown through research in vivo and vitro that they can act and regulate cellular growth. They also suppress leukoplakia, which is a pre malignant lesion. Cancer patients should eat a lot of retinoids which is a pre-formed vitamin A, as it inhibits cancerous growths. Foods rich in Vitamin A are found in plant foods, whole milk, butter cream, egg yolk and cheese. It is not good to take excess of butter and egg yolk as this may lead to atherosclerosis.

 

b) Vitamin C

Vitamin C can also aid to prevent the promotion of cancer. Vitamin C can prevent nitrites from combining with amines to produce nitrosamines (which could be carcinogenic to the stomach). Foods rich in vitamin C are all citrus fruits, strawberries, tomatoes, broccoli and raw green vegetables. It is better to eat fruits whole than to make juice, because making juice rids the fruits of dietary fiber.

 

 

 

c) Vitamin E

Vitamin E is a very good antioxidant, which can scavenge the free radicals. Sources for vitamin E include salad oil, shortenings, legumes, whole grains, nuts and green leafy vegetables.

d) Selenium

Sources of selenium are meat, egg, fish, seafood and whole grains.

 

2. Eat diet that has high fiber

High fiber in the diet can inhibit the promotion of cancer. They can help to reduce the risks for colorectal, breast, prostate and uterus cancers. Dietary fiber inhibits the absorption of saturated fats and cholesterol. Foods rich in fiber are wheat, wheat bran, oats, oat bran, legumes, beans, citrus fruits like oranges and grapes and vegetables. Adam and Eve were eating only fruits in the Garden of Eden before any disease was known. So fruits are very good for health as they have dietary fiber, beta-carotene and Vitamin C which all act as antioxidants. But don't ingest too much fiber as it can cause flatulence, diarrhea and poor mineral absorption.

3. Eat foods that are low in fat

Fatty foods are known to promote cancer growths.

High fatty foods should not be eaten often and in plenty rather these foods should be eaten sparingly. The total fat intake should be less than 30% of the total dietary intake per day. Less than 10% of total fat should come from saturated fat and the remaining percent of the fat from monounsaturated and polyunsaturated fats. Cut down flesh foods.

 

4. Avoid eating smoked food

People should not eat smoked foods, as smoke is carcinogenic. These foods include jerk chicken, jerk pork and smoked fish.

 

5. Completely abstain from alcohol in all its forms

Alcohol has been associated with cancer of the liver, mouth, esophagus and colon. If alcohol is ingested moderately, it will lead to addiction. Therefore, alcohol must be completely avoided.

 

6. Do not eat food items that are very spicy and betel leaves and nuts

Foods that contain high spices can put a person at risk for esophageal and stomach cancer. Betel leaves and nuts are risk factors for oral cancer. Although smoking is not part of diet, the author advises smokers to give it up because it predisposes one to lung cancer and bladder cancer. The others who dont smoke, it is best for them not to try.

 

7. Follow Biblical nutritional principles

One should follow God's commandments. 1 Corinthians 6:19 says Know ye not that your body is the temple of the Holy Spirit. So let us keep our bodies holy and healthy by eating fruits, vegetables and foods high in dietary fiber. Nowadays, a lot of cattle are having diseases and these can be spread through meat eating. It is good to eat more fruits and vegetables and less flesh foods. Ezekiel 47:12 states, and the fruit thereof shall be for meat and the leaves thereof for medicine. This clearly states that fruits should be emphasized in our diet. The Bible shows the importance of eating pulses and drinking water. Daniel and his friends in the Bible refused alcohol and flesh foods and ate pulses and drank water. They were more intelligent and stronger physically than the other persons who ate meat and drank alcohol. We should decrease salty and spicy foods.

Regarding alcohol, the Bible clearly says in Habakkuk 2:5 that drinking wine is a sin and in Isaiah 28:7, it states They erred through wine and strong drinks and are out of the way. So we can see that people have sinned by drinking alcohol. Ephesians 5:18 says, Be not be drunk with wine wherein is excess but rather be filled with the Spirit of God. Galatians 5:21 reveals that if people are drunk with alcohol they cannot inherit the kingdom of God . Let us follow what is advised in 1 Corinthians 3:17, which states, If any man defiles the temple of God , him shall God destroy for the temple of God is holy. Let us try to please God by keeping our bodies clean lest God destroy us. When we drink alcohol, we are destroying our bodies and the Holy Spirit will not dwell in us. Prevention is better than cure.

 

8. Nutritional education

The causes, symptoms and nutritional prevention of cancers must be inculcated from childhood. The nutritional education should not only be preached but must be practised by all.

 

Secondary Prevention of Cancer

Secondary prevention is early detection of cancer and medical treatment. When detected early, lives can be saved.

 

To help in early detection, the acronym CAUTION can be followed.

C- Changes in bowel and bladder movements

A- A sore that doesn't heal

U- Unusual bleeding or discharge

T- Thickening of lump in breast or elsewhere

I- Indigestion or difficulty in swallowing

O- Obvious change in wart or mole

N- Nagging cough or hoarseness

 

If any of these signs is noticed, one should immediately see a medical doctor to rule out cancer or be treated early for cancer. Once metastasis takes place, there is no chance of survival.

 

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J. Food Allergies

Food allergy is an adverse reaction due to food components that is immunologically mediated and can cause functional changes in the targeted organ. Food allergies are usually common in infants and decline as they grow. Sometimes, the development of allergy is related to hereditary conditions, immune response of the body and gastrointestinal functions. The gastrointestinal symptoms of allergies include burning, swelling of mouth, lips, tongue and pharynx. It can also lead to joint pains. There could also be systemic anaphylaxis or severe allergic reactions that can be very dangerous and fatal to people.

 

 

Etiology

Most food allergies involve IgE-mediated response. Food proteins act as antigens and bind to IgE which is attached to mast cells on the surface. When this contact happens, the antigen-antibody reaction takes place with a release of mediators like histamine and prostaglandins. These cause symptoms of food allergies. Reactions can be immediate or delayed. Usually the gastrointestinal symptoms are common. There may be respiratory effects such as nasal congestion, sneezing and wheezing; skin symptoms like urticaria and eczema. The common foods that can trigger allergies are shellfish, eggs, salt fish, soybeans, peanuts, cashew nuts, cows milk, wheat and eggplant.

 

Nutritional Prevention

The patient is the best person to find out what type of food he or she is allergic to. That person should have a diet history to find out if anyone else in the family is suffering from that allergy. Sometimes the same foods cause allergies in the family, other times different foods but the fact that it is a familial problem can be ascertained. There should be a food and symptom diary, a detailed record of which foods are eaten and what symptoms occur. Those foods should be avoided by elimination from the diet. After a few months, they should challenge the food by taking little at a time because sometimes the allergies disappear. If the food still causes severe allergic reactions, they are to take immunological testing and should be treated by a medical doctor who is a specialist in treating allergies.

 

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K. Food Poisoning

 

1. Botulism

This is a severe case of food poisoning and it is caused because of the neurotoxin botulin produced by clostridium botulinum.

The symptoms of botulism are double vision, drooping eyelids, slurred speech, difficulty in swallowing, weakness and eventual paralysis.27

 

 

 

Etiology

As already mentioned, it is because of the toxin botulin produced by clostridium botulinum. This particular microorganism is found in soil, dust and enter foods as spore. The foods that are mostly responsible for botulism are smoked or pickled fish, home made pickles, canned vegetables and low acidic food due to improper preservation.

 

Nutritional Prevention

Severe heat can kill the microorganism and destroy the neurotoxin. So any canned food, when opened must be heated so that the microorganism and the neurotoxin, if any, are destroyed. Since pickles are not heated, they should be properly preserved. Food handling should be done hygienically. If pickles at any time have a funny smell or unpleasant look, it is best not to eat them. Homemade food could be heated to kill microorganism.

 

2. Mushroom Poisoning

This is poisoning due to noxious mushrooms. Some of the dangerous species of mushrooms are Amanita virosa, Amanita verna and Gyromitra esculenta.28


 

Etiology

Cytotoxin known as amatoxin produced by the above mushrooms is the cause.

When a part of these poisonous mushrooms is eaten, it could be so detrimental to health and can even cause death. It would cause death by necrosing masses of the kidneys, liver and skeletal muscles.

 

Nutritional Prevention

Nutritional education regarding mushrooms should be imparted so that people can identify good and bad mushrooms. When one goes out to eat, and one is not sure of the mushroom whether it is safe, then it is best not to eat it. Its better not to eat it than be stressed later wondering if the mushroom was poisonous or not. When picking mushrooms, an experienced person must accompany others. The brownish and more colorful ones are poisonous. Mushrooms sold in supermarkets are good ones because they have been inspected.

 

 

 

 

3. Salmonella Food Poisoning

Salmonellosis is an animal disease but humans also acquire it through farm animals through contaminated milk, meat and eggs.

 

Etiology

This is caused by the microorganism Salmonella enteritidis or Salmonella typhimurium.

 

Nutritional Prevention

Since the transmission of salmonellosis is through contaminated food, this route should be blocked. Transmission can be facilitated through improper food handling, cooking, processing and storage. There should be hygienic slaughtering and milking. Milk should be pasteurized. There should be proper disposal of liquids and waste. Health education and training should be provided to the workers in poultries and farms. Food should be properly cooked in order to be safe. These diseases should be prevented among livestock and poultry.

 

 

 

 

4. Foods contaminated with rat and cockroach poisons

 

Foods can be contaminated with the poisons used to kill rats and cockroaches, if they are not properly used.

 

Etiology

The poisons used for killing rats are barium compounds. Previously, thallium was used. When improper techniques are followed while using these poisons, then food and water can be contaminated.

 

Nutritional Prevention

First of all, there should be nutritional education on how to use these poisons. All foods and water containers are to be kept away from the site of the poisoning areas. Gloves should be worn and poisons placed in strategic positions such as crevices. Afterwards, the poison should be completely washed off. For rats, it is better to use a trap in order to get rid of them. If the houses are kept clean always, then cockroaches and rats may not be found.

 

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L. Weight Problems

 

1. Overweight and Obesity

 

Overweight is a condition where a persons weight is between 10-20% over the reference weight for height according to sex in the persons country or region. Obesity may be defined as abnormal growth of adipose tissue either because of an increase of fat cells or increase in cell size or both. Obesity is more than 20% of the reference weight for height according to sex in the persons country or region. See Appendix 4a and 4b for the reference weight for height for Americans. Females and males with body mass index between 25 and 30 are classified as overweight and who are over 30 are obese.

 

Etiology

The cause of obesity is not known but risk factors are known.

 

Non-modifiable risk factors

The non-modifiable risk factors are age, where obesity increases with; sex, where obesity can affect both sexes. Usually males put on weight in the abdominal region (android obesity which is apple shaped) while women put on weight on the hips, buttocks and thighs (gynoid obesity which is pear shaped). Studies have shown that there is genetic predisposition for obesity.

 

Modifiable risk factors

Diet: Persons who ingest high concentrations of refined carbohydrates, fat (especially saturated fat and cholesterol) and excessive intake of calories tend to put on weight.

 

Physical inactivity: People, who are not involved in physical activity and dont burn up extra calories end up putting on weight.

Stress and other psychological problems: Persons with psychological problems such as depression and frustration, sometimes, tend to over eat.

Alcohol intake: Persons who drink alcohol may tend to put on weight.

Socio-economic factors: Socio-economic factors like high income and social class may contribute to obesity.

Hormonal problems: Patients with hypothyroidism and patients who use corticosteroids for a long period of time can become obese.

 

Obesity Assessment

 

1. BMI

One of the best ways to assess obesity is to calculate the Body Mass Index. The formula is

BMI = Weight in kgs

Height in m2

Females and males with BMI between 25 and 30 are classified as overweight and with BMI over 30 as obese.

 

2. Broca Index

There is another index known as the Broca Index, which can be used. The formula for this is:

Height in cm - 100

For example, if a person is 180 cm tall, then you are to minus 100 from 180, which is 80. This 80 should be taken as weight in kgs, which should be the desirable weight for that person.

 

3. Corpulence Index

Corpulence Index =Actual weight

Desirable weight

 

If this is more than 1.2, then the person is said to be obese.

 

Checking weight for height reference standards of the country can also be used for obesity assessment. Skin fold measurements at the biceps and triceps can also be used and compared to the 50th percentile of the standard reference of the country from which one hails. If a country does not have reference anthropometric standards, then those of the region should be used. The skin fold measurement above the supra iliac crest is good indicator for determining if a person is obese or not. This skin fold measurement is done one inch above the crest and is compared to the 50th percentile of the reference standards for that age and sex. One can also measure mid-arm circumference, then compare with the 50th percentile of the reference standard of the country from which one hails.

 

 

Nutritional Prevention

The author is not going to discuss how one should lose weight or what are the techniques for reducing weight for those who are obese since this book focuses on nutritional prevention. In order to prevent being overweight and obese, one needs nutritional education from childhood. One should be inculcated on how to maintain normal weight and how not to be obese. This is basically primordial and primary prevention, that is, prevention before the onset of the problem. When children are taught by parents what are right foods to eat and importance of exercise, then this upbringing will help them grow with a normal weight. Children who are born fat have to cut down on excessive intake of fatty foods and high carbohydrate foods such as ice cream, cakes and chocolate. These children must exercise or play active games regularly. It is easy to put on weight but very hard to get rid of the adipose tissue, therefore putting nutritional education into practice is very important.

 

Children with obese parents must take extra precaution. Children should not be encouraged to think that they can eat as much as they can and later in life reduce weight. What extra weight one puts on in a month may at least take a year to reduce it. This is because burning up of calories gained from fat is not easy. Exercise involving long duration and endurance can burn up the calories gained from the fat. Always remember that prevention is better than cure. Children and youth should eat balanced diet and check weights and calculate BMI regularly. They should be motivated in schools to keep fit and live healthy lifestyles. Children should live a life conducive to maintaining normal weight so that they can avoid being overweight and obese. One should eschew alcohol. One should try to stay away from junk food and high-calorie foods if at all one has to maintain a normal weight. Visiting restaurants everyday should be avoided as the foods served there are rich in fat and can easily promote obesity. Lastly, one must follow Gods ways and instructions. One should eat to live and not live to eat.

 

Underweight

Underweight is a condition where a person weighs much below the reference standard weight for height according to sex, of ones country. Females are said to be underweight if their BMI is less than 19 and males if less than 20.

 

Etiology

Eating very less food will give inadequate calories, which in turn, can cause underweight. More expenditure of calories than the calorie intake is another factor. Ignorance of nutritional principles is another reason. Eating disorders like anorexia nervosa, diseases like hyperthyroidism, cancers, AIDS can cause underweight. Symptoms like fever and diarrhea can inhibit appetite.

 

 

 

Underweight Assessment

The same procedures used for overweight and obesity assessment can be used for underweight assessment. These include height, weight (please check Appendix 4a and 4b), mid-arm circumference, skin fold measurement at biceps, triceps and the supra iliac. If these fall below reference standards, then the person is said to be underweight. If they fall below the 10th percentile, then the person is extremely underweight.

 

Nutritional Prevention

There should be an increase of calorie intake. Meals should be well balanced. People who are underweight should eat foods rich in fat because 1g of fat gives 9 kilocalories. Foods high in fat include ice cream, cake, butter, oils and fried foods. However, they shouldnt be eaten too much at one time as these fatty foods can cause dyspepsia or constipation. Dietary fiber should be eaten as it prevents constipation. Lots of fluids should be taken.

Light exercise is recommended for underweight persons. Moderate to heavy exercise will burn up calories while light exercise will tone up muscles and keep the individual fit and can increase appetite. There are tonics that increase appetite which can be taken. Those who are deficient in vitamins and minerals should take multivitamin and multimineral supplements to make up for the deficiencies. Underlying diseases such as hyperthyroidism and eating disorders should be treated. If not treated, attempts to put on weight will fail. Symptoms like fever and diarrhea should also be managed. Underweight persons need adequate sleep to put on weight. They should avoid alcoholic drinks, smoking and stress, which can interrupt normal eating. Skipping meals should not be practised.

 

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M. Symptoms and Diseases involving Miscellaneous Systems

 

1. Beriberi

It is a nutritional disease that is a result of thiamin deficiency. It attacks the gastrointestinal, cardiovascular and the nervous systems. Symptoms vary and these may include loss of appetite, fatigue, depression, slim and painful extremities, numbing of feet and weakness of legs. Beriberi is common in countries where most energy is received from carbohydrates, especially from refined and polished rice.

 

Etiology

As already mentioned, it is due to thiamin deficiency.

 

Nutritional Prevention

Nutritional education must be imparted and well balanced diet should be eaten. Good sources of thiamin are dry beans, peas, peanut butter, parboiled rice or undermilled rice, milk and eggs. People should avoid eating refined and polished rice. The RDA for men is 1.5 mg and for women is 1.1 mg.

 

2. Fetal alcohol syndrome

This syndrome affects babies born to women who drink a lot of alcohol during pregnancy.

 

 

 

Etiology

The alcohol ingested by the pregnant mother crosses to fetal circulation and affects the fetus. Oxygen supplied to the fetus is reduced. Fetal cells are also reduced. Babies with this syndrome are born with a small head circumference and face, and suffer from retarded physical growth, impaired nervous system and mental retardation.

 

Nutritional Prevention

It is to completely avoid alcohol during pregnancy.

 

3. Low Birth Weight

Babies who are born with a weight less than 2500 grams are classified as underweight in developing countries. There are more cases of low birth weight in developing countries and fewer cases in developed countries.

 

Etiology

The causes are multifactorial. The causes could be mothers poor nutritional health, illnesses during pregnancy, smoking, alcoholism, poor spacing between births and multigravida.

 

 

Nutritional Prevention

The pregnant woman should take enough of calories and nutrients. Nutritional requirements increase during pregnancy. The woman who usually takes 50 grams of protein should take 60 grams when pregnant. Her calorie intake should be increased by 500 kcals. If she is not eating good diet, then she should take supplements of minerals and vitamins so as not to be deficient. Females who are very young should not become pregnant as they themselves are still growing. Their physical needs and demands are greater and will compete with the fetus. Alcohol should be avoided. Any disease during pregnancy should be treated.

 

4. Kwashiorkor

This is a condition where there is protein undernourishment. The baby between 18 and 24 months could be affected. This usually happens when an infant is weaned. Usually the suffering child will have edema, diarrhea, round face, enlarged liver and hair is easily plucked.

 

Etiology

Insufficient intake of proteins

 

Nutritional Prevention

In order to prevent kwashiorkor, the mother should start giving the child supplementary diet to breast milk from about 4 to 6 months. The mother should also space the next baby. The infants supplement food should have enough protein and also multi minerals and vitamins. Milk formulae normally have these requirements.

 

5. Marasmus

This is a condition where the infant has deficiency of protein and calories. This disease could affect infants between 6 and 12 months. A child with kwashiorkor has a deficiency of proteins but has adequate calories, whereas a child with marasmus has a deficiency of both proteins and calories. Theres also a lack of multi vitamins and minerals. The infant with marasmus will suffer from wasting and wrinkling of the skin. The infant will not have edema and round face. However, in kwashiorkor, there is edema. Another symptom of marasmus is diarrhea. Hair color does not change and the hair is not easily pluckable.

Etiology

Deficiency of proteins and calories

 

 

Nutritional Prevention

Nutritional education should be given to nursing mothers and would be mothers. At 4 to 6 months, the infants meals should be high in fortified dry cereals, mixed cereals, which are high in protein, strained meats and mashed cooked egg. Therefore, the infant should be fed with a lot of calories and proteins along with multiple vitamins and minerals, which should be received through the food and milk formulae.

 

6. Pellagra

It is a disease which has 4 classic Ds: diarrhea, dementia, dermatitis and death. The symptoms are sore and swollen tongue and dermatitis, which is usually symmetrical. The affected part of the body becomes sensitive to sun. One may also suffer depression, dementia and disorientation and if no treatment is received, then death can result.

 

Etiology

Niacin deficiency or failure of tryptophan to be converted to niacin

 

 

Nutritional Prevention

The preventive nutrition is to eat a diet with sufficient supply of niacin. The good sources of niacin include meat, fish and chicken. Some niacin is also present in vegetables such as the dark, green and leafy ones. It could be found even in enriched whole grain cereals. Tryptophan which is found in protein can be converted to niacin in the body. The RDA of niacin is 6.6 mg for 1000 kilocalories. If a person is ingesting 2000 kilocalories, then the requirement is 13.2 mg per day. If people eat maize, then milk should also be included because it is a good source of tryptophan, which helps to absorb the maize.

 

 

7. Skin Problems

a) Acne Vulgaris

It is an inflammation of sebaceous glands. It affects the face, the chest and the back. It mostly affects adolescents.

 

Etiology

The inflammation of the sebaceous glands could be due to infections, obstruction of the channels and poor personal hygiene. High fatty food can contribute to the problem.

 

Nutritional Prevention

Proper nutritional education should be inculcated in the children and adolescents. Persons vulnerable to this problem should avoid eating diet which is high in fat such as ice cream, butter, cheese and oily foods. Good personal hygiene should be maintained.

 

b) Various skin problems

Various skin problems like scaly skin, purpura, petechiae, eczema and pallor may be due to nutritional deficiencies. Please check appendix 3 to see the clinical signs and possible nutrient deficiencies. The concerned nutrients which cause these skin problems should be taken adequately through diet.

 

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N. Genetic Disorders 

1. Galactosemia

 

This is an inborn error of metabolism where there is inability to convert galactose to glucose. The baby usually experiences diarrhea, vomiting, edema and liver failure.

 

Etiology

The cause is absence of the liver enzyme necessary to convert galactose to glucose. It is genetically inherited.

 

Nutritional Prevention:

Nutrition cannot prevent any genetic disorder. However, further complications can be curtailed through nutrition provided it can be done so.

 

To prevent brain damage of the patient suffering from galactosemia a diet free of glucose and galactose should be given. Since milk from all mammals contain lactose, soy-based formulae can be used as substitute. All foods containing milk should be avoided. Organ meats contain galactose and should also be avoided. Therefore all foods containing lactose or galactose are to be avoided.

 

Phenylketonuria

It is a hereditary disease where there is a defect in the metabolism of the amino acid phenylalanine. High levels of phenylalanine in blood can cause mental retardation, irritability, eczema and there could be convulsions.

 

Etiology

The liver enzyme phenylalanine hydroxylase which is necessary to convert phenylalanine to tyrosine is absent or inactive. The phenylalanine is accumulated in the blood and the phenylketones are excreted in urine.

 

 

 

Nutritional Prevention

As mentioned earlier, nutrition cannot prevent it. However, nutritional modification should be embraced to prevent complications of this disease. The goal is to control blood phenylalanine levels by giving foods low in phenylalanine. The sweetener aspartame is to be avoided as phenylalanine is the basic component in it. Any food containing this sweetener is to be avoided as well. The levels of phenylalanine in blood and food should be closely monitored.

 

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O. Nutritional side effects due to medication

Some medications and drugs cause nutritional side effects when taken. A diet should be taken to prevent nutritional side effects as much as possible. The author will mention a few examples. The antibiotic erythromycin can cause stomach upsets like vomiting and diarrhea. So to prevent further problems, this antibiotic should be taken with food. Because of the interactions of antibiotics, it is advisable for some patients to take multi vitamins and minerals along with antibiotics.

If a menopausal woman is taking estrogen replacement, she may experience nausea, vomiting, abdominal pain and edema. The patient should take estrogen with food, decrease sodium intake and take in plenty of water.29

If a person is taking ketoprofen, which is anti inflammatory, analgesic and antipyretic, it can cause gastrointestinal side effects, like nausea, vomiting and flatulence. It is better to take this drug with little food as more may reduce bioavailability.30 It is better to avoid foods such as broccoli, cabbage, beans and red peas as they will increase flatulence.

 

It is good to ask doctors advice regarding nutrition when taking drugs. One may also consult a dietician to find out what foods are best, what is to be increased, replaced and decreased while taking medications.

 

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Part 2

Nutrition and Slowing Down of Aging

Chapter 6

Etiology of Aging

Chapter 7

Nutrition that aids to Slow Down Aging and Increase Life Expectancy

Chapter 8

Secrets of Longevity


 

Chapter 6

 

Etiology of Aging

The study of physical and psychological changes in old persons is called gerontology. The treatment of diseases and health promotion in the elderly is known as geriatrics or clinical gerontology. The term old age is highly subjective. But old age must be regarded as a normal, inevitable and biological event. No one can escape aging, if one lives long.

 

The causes of aging are multifactorial and not fully understood. Definitely genetics has a big role in aging. Theres no doubt about it. Why do some flies live for 90 days, a mouse for 2-5 years, a dog 15-20 years, an elephant 60-65 years, 31 and a bristle cone pine a thousand years? The answer is genetics. All the above are programmed genetically to live for a particular period of time. The fly cannot live for 60 years and the elephant cannot live for a thousand years. There are many theories as to the causation of aging. The author will discuss a few of these theories that can be divided into genetic theories and non-genetic theories.  

 

Genetic Theories

i)                    Genetic program theory

It states that every cell is genetically programmed to function and when the program is over, the cell dies.32 However, environmental factors can influence this program and can shorten the length of it.

 

ii)                   Genetic damage or error theory

It states that DNA controls functioning of cells through enzymes. When there is mutation in DNA, there could be errors in the message to respective cells, which will cause damage to the body.33

 

Genetics definitely play a role in aging because the genetic disorder progeria is caused by faulty genes that causes premature aging. Each year is like a decade to patients with progeria. When they are 6 years old, they look middle aged. When 10, they look very old and by 13, they usually die. There is another genetic disorder known as Werners syndrome where there is progressive physical deterioration and other aging problems. These two disorders show that genes do play a role in aging.

 

Non-Genetic Theories

i)                    Free-radical damage theory

It states that there would be incomplete cellular oxidative processes, which result in formation of free radicals which cause damage to cells and diminish their functions.34 Free radicals are highly unstable atoms or molecules, which have unpaired electrons in their outer orbits. They could react with any cell and inflict damage to that cell. They react in an attempt to gain stability but end up damaging the cell, thus diminishing its function.

 

ii)                   Collagen cross-link theory

As age increases there will be no soluble collagen but insoluble collagen that is stiffer and harder. These stiffer collagen molecules would cross-link. Skin then will wrinkle, muscles will not be toned and blood vessels lose elasticity.35 Collagen is a building material of tissues in muscle, bone and skin.

 

 

There are many theories, and not one can explain all the aspects of aging. There are even psychological theories of aging. However, genes and free radicals play their role in aging.

 

Ever since Adam and Eve sinned in the Garden of Eden, the problem of aging began. Menopause is one of the signs of aging; this is usually between the ages 45-50 in women. The protective function of estrogen is reduced and women become more prone to osteoporosis and heart problems. As aging takes place, people are highly vulnerable to many sicknesses such as osteoporosis, hypertension, diabetes mellitus, coronary heart disease hemiplegia, renal failure, hearing loss, eye problems and sexual dysfunctions.

 

There are external factors that contribute to aging.

 

External Factors

 

1. Faulty diet

Diet high in fat (saturated fat, trans fat and cholesterol) can cause atherosclerosis, which in turn, will lead to a host of diseases that will shorten life. High fatty foods lead to more formation of free radicals.36

Diet low in fiber and with no antioxidants makes people vulnerable to nutritional related cancers that will cut short life.

 

2. Radiation

Ionizing radiation can hasten the aging process. These can shorten the life span and cause early death.

 

Diseases and Cancers

They can weaken the body by damaging cells and tissues and bring death at early age.

 

High Temperature

The higher the temperature, the faster the metabolic rate, thus the higher the chances of aging faster. Studies have shown that in animals, the lower the temperature, the slower the metabolic rate and those animals live a little longer.

 

5. Obesity

Studies have shown that obesity shortens life. There is an adage which is The longer your waistline, the shorter your life line. Obese persons are more vulnerable to diabetes mellitus, myocardial infarction, hypertension and hemiplegia, which can cause death at an early age.

 

6. Addiction

People who are addicted to drugs, alcohol and smoking will suffer from quicker aging, diseases and finally death.

During smoking the combustion of tobacco promotes the oxidation of polycyclic aromatic hydrocarbons and produces free radicals.37 These free radicals hasten aging process.  

 

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Chapter 7

Nutrition that Aids to Slow Down Aging and Increase Life Expectancy

 

Nutrition can never prevent the aging process but it can aid to slow it down. According to the free radical damage theory, the free radicals that are unpaired react and damage other cells, thus they have a detrimental effect on health. Studies have shown that antioxidants can inactivate these free radicals. The following nutritional suggestions are made.

 

1. Eat diet that is rich in antioxidant nutrients

 

The nutrients that are antioxidants are vitamin E, carotenoids, vitamin C and the micromineral selenium. These act as scavengers and inactivate free radicals before they inflict damage to the cells.

 

Vitamin E: Food sources are salad oils, margarines, whole grains, dark leafy vegetables, legumes and nuts.

 

Carotenoids: Food sources are yellow vegetables like carrots, sweet potatoes and pumpkin; deep yellow fruits such as mangoes, papaya and apricot; green leafy vegetables such as spinach, turnips and red fruits and vegetables such as tomatoes and red sweet pepper.

 

Vitamin C: Food sources include all citrus fruits, strawberries, tomatoes, broccoli and raw green vegetables. Citrus fruits such as oranges and grapes are good and should not be squeezed into juice as this rids them of dietary fiber, which is very important.

 

Selenium: Food sources are seafood, whole grains, eggs, fish and meat. Vegetables that are grown in selenium rich soil will also contain the vitamin.

 

2. Eat diet that can help the function of collagen

 

Collagen cross-linking can be slowed down by consumption of vitamins C, E; selenium, calcium and phosphorus. Since collagen is found in the bones, muscles and skin, the diet should be rich in calcium to prevent osteoporosis and bone fracture. Sources of calcium are milk, mustard, broccoli, cabbage and greens. Foods rich in phosphorus are milk, cheese, meat, whole grains, cereals, nuts and legumes. These strengthen collagen. Niacin, riboflavin or B2 and essential fatty acids are good also for healthy skin. Good sources of niacin are dark leafy vegetables, enriched whole grains, bread, cereals and rice. Good sources of vitamin B2 are dark leafy vegetables, enriched whole grains, rice, milk, meat and dried cereals. Good sources of essential fatty acids are found in legumes, nuts, and vegetable oils like sunflower, corn oil and soybean oil.

 

3. Increase dietary fiber

Fiber helps to prevent constipation, hemorrhoids, atherosclerosis and cancers like colorectal and breast cancer. The fiber sources are from plant sources. Wheat, wheat bran, oat, oat bran, all citrus fruits and vegetables are good sources of fiber.

 

The author had conducted case studies on 20 old persons ranging from 60 to 90 years. The emphasis of the study was on diet and longevity relationship. Results show that there was more percentage of persons in this age group who ate more vegetables and fruits and less flesh foods than the persons who ate more flesh foods and less vegetables and fruits. See figure 4 in appendix 5.

 

 

4. Eat foods that are less in fat

Cut down high fatty food especially those high in saturated fat and cholesterol. Foods high in cholesterol will cause atherosclerosis. Low density lipoproteins (LDL) are very dangerous to blood vessels. Foods high in cholesterol must be reduced and examples of these include egg yolk, liver, kidney, cheese, ice cream and butter. Cut down flesh foods.

 

5. Complete avoidance of alcohol

Alcohol destroys liver and brain cells, which in turn cause other problems. It is good to completely abstain alcohol. Drinking once in a while is not good because it leads to tolerance and addiction. As mentioned earlier in the book, there is a Chinese proverb that says, First the man takes the drink, then the drink takes another drink, finally the drink takes the man. In order to live long and have long life expectancy, one must completely avoid alcohol. Drug addiction and smoking must be avoided as well, as these habits are also detrimental to health. The author conducted case studies on 20 old persons (60-90years) and found that 60% of males and 70% of females did not drink alcohol. See figure 4 in appendix 5.

 

6. Avoidance of foods that either promote cancer or contain carcinogens

 

Foods like smoked fish, jerk chicken, jerk pork are not good because they may be carcinogenic. Food containing nitrites can contribute to cancer of the stomach. Salt preserved food like pickles and salt dried fish lead to hypertension. Caffeine and artificial sweeteners like saccharin is best if avoided.

 

 

7. Drink a lot of water

Water is very good. More than 60% of body weight is water. People must learn to drink plenty water from childhood. Water helps in dissolving and excreting body wastes. It has a lubricating effect to prevent friction; it also maintains body temperature. Knowing all these functions of water should encourage one to drink enough water everyday. At least 2 liters of water should be consumed daily. It is good to drink safe water, that is water free from all pathogenic microorganisms. If water containing pathogenic microorganisms is ingested, then water-borne diseases such as hepatitis A, cholera, typhoid and helminthic infestation may result. These diseases can in turn work against the body. It is best to drink clean and purified water. If one is not sure of the purity of the water, then it is wise to boil the water.

 

8. Preclude obesity

Another important thing is to preclude obesity from childhood, because obesity puts one at risk for coronary heart disease, hypertension, diabetes mellitus, stroke and cancers of the uterus, prostate, colon and breast. Obesity will cut short life expectancy because of the health hazards.

 

Exercise

Exercise is included here as a factor because it is one of the principles in nutritional health. Research shows that exercise aids a person to be healthy and to live long. Exercises that are good for the body are aerobic ones. Aerobic exercises like jogging, climbing steps, swimming, biking and dancing will increase life expectancy. Aerobic activities increase the respiration rate, so oxygen is provided for metabolism of fat and carbohydrates. With exercise, fat stores are used for energy and lean body mass is increased; and muscle tone also improves. Exercise gives anyone, an inclination to live long and lead a happy life. Patients with certain diseases should consult a doctor before starting an exercise program because some of the exercises can hamper their health status. Fitness can assist a person to maintain good physical, mental, social and spiritual health.

 

10. Practise nutritional education

Education regarding nutrition is very essential. People should know what constitutes good health. A balanced diet should be maintained to live long and slow down aging. It is good to know what are the causes and preventive measures of obesity, hypertension, diabetes mellitus, stroke and others. The authors book itself can be a useful book for the readers on how to prevent various diseases nutritionally. When they know the importance of nutritional education, they should follow it, as it will benefit their health. It is important to teach nutrition from childhood, so that one can lead healthy life and increase life expectancy. Above all one is to follow the principles of God and remember that the body is the temple of the Holy Spirit.

 

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Chapter 8

 

Secrets of Longevity

 

The following secrets of longevity have been revealed after the author conducted interviews with people whose age was more than 80 years.

 

The first secret and second secret are in relation to spiritual life style. If you detest being spiritual, you don't have to read first and second secrets.

 

he first secret is to do the will of God. If we do the will of God, we will receive eternal life. Mathew 7:21 says, Not all who call Lord, Lord shall enter the kingdom of heaven but he that doeth the will of My Father which is in heaven. So we must do the will of God. We can do His will by keeping His 10 commandments. In John 14:15, Lord Jesus says, If you love Me, keep My commandments. We are to keep His commandments for they can prolong life. The fifth commandment in Exodus 20:15 states, Honor thy father and thy mother that thy days may be long upon the land which God giveth thee. Hence, we are to honor our parents and obey God. Acts 5:29 states, We ought to obey God rather than man.  

 

The second secret is to read the Holy Bible and pray to Lord Jesus. When you read & follow the Bible and pray you will get happiness in life because reading the Bible is spiritual food. Therefore, read the Bible and pray. When you read the Bible, you can find golden instructions and advice of diamond. Matthew 6:33 states, Seek ye first the Kingdom of God and His righteousness, and all these things shall be added unto you. All these things may mean happiness, financial support, peace of mind and long life. Research studies have shown persons with sound faith and patients with belief in God survive longer than those who have no faith whatsoever.

 

 

The third secret of longevity is eating a balanced diet. When you eat balanced diet, youll maintain good body weight and not suffer from obesity or under weight. Eat diet with contains high fiber, rich supply of nutritional antioxidants and low fat. This helps to prevent a lot of diseases.

 

The fourth secret is to drink lots of water.