Editorial

Security

Politics

World

Letters

Sports

Obituaries

Archives

Health guide
Compiled by Shanika Sriyananda

Anaemia, still a public health problem

by Dr. Chandrani L. Piyasena, Head, Department of Nutrition, Medical Research Institute, Colombo 08

It has been estimated globally that a total of 2,150 million people are anaemic or iron deficient. Prevalence rates are higher in developing countries. The most affected groups are reproductive age women, pre-school children and school age children.

Anaemia, chiefly of iron deficiency is a major nutritional problem in Sri Lanka. In 2001 the national survey on anaemia status revealed that steady decline in prevalence in all physiological groups in comparison to prevalence in 1995. In spite of numerous interventions carried out over the years, still anaemia prevails as a public health problem in Sri Lanka.

There was significant variation in the prevalence of anaemia between the provinces. The pre-school children between the ages 6 months to 5 years show a prevalence of 30 percent while prevalence for primary school children was 21 percent. The prevalence of anaemia in pregnancy was 30 percent.

The causes of anaemia are many. In addition to iron deficiency, deficiencies of folate and vitamin B12 also result in anaemia. Other micronutrients such as vitamin A have an impact on iron status. Iron deficiency is largely due to the low absorption of iron from foods. Parasitic infections such as hook worm and malaria are also significant causes of anaemia.

For infants, most iron comes from breast milk in which iron is highly absorbable but present in low concentrations. Most of the iron in our diets comes from rice, legumes, and vegetables, from which the absorption is 5 percent or less. Absorption can be increased three to seven-fold by eating acidic foods with meals, especially those rich in vitamin C, along with iron containing foods.

The organic acids found in fruits and vegetables such as malic, tartaric, and citric and lactic acids enhance iron absorption. Tea and coffee can severely inhibit iron absorption when taken at the same meal. The low absorption of iron in the diet double the requirement for iron intake.

Iron rich food

Green leafy vegetables, pulses like cow pea, lentils, and beans, fruits and vegetables (in addition contain organic acids which helps the body absorb iron from food), fish and meat. Drinking tea and coffee with meals can inhibit iron absorption.

Inhibitory action of food items in relation to iron absorption would be reduced to a great extent by the process of fermentation which is commonly used in food preparation (hoppers and thosai), by germination (soaking in water and allowing to sprout) (green gram, beans, etc.) and by malting.

Fortification

Fortifying widely consumed foods with micronutrient is another way to prevent certain deficiencies. Iodized salt has been the main method of successfully preventing iodine deficiency in many countries.

Vitamin A has been successfully added to butter, margarine and sugar. Flour and infant food can be fortified with iron.

The strength of nations today is measured in terms of how healthy, well nourished and educated its people are. The use of multiple strategies to improve micronutrient status benefits the women's health, pregnancy outcome and child health.

For all women of reproductive age who are deficient, increasing micronutrient intake will reduce anaemia with benefits to their health and work output. Increasing intake improves overall health status, improves immunity, and reduces severity of such infections as malaria and such chronic diseases as coronary heart disease.

World Diabetes Day tomorrow :

Diabetes and foot care

The theme for 2005 is diabetes and foot care, completing the series of themes on diabetes complications that began in 2001. The year marks the beginning of a year-long focus for the campaign. Rather than directing all our efforts on November 14, International Diabetes Federation (IDF) is spreading activities over the year in order to extract maximum benefit from the awareness-raising opportunities that present themselves.

Preparing for an annual campaign will allow IDF to draw greater attention to the theme of World Diabetes Day and will ensure that materials reach our membership in a timely fashion. The slogan for this year's campaign is: Put Feet first Prevent amputations Diabetes and the foot.

Diabetes is a serious chronic disease. In 2003 the global prevalence of diabetes was estimated at 194 million. This figure is predicted to reach 333 million by 2025 as a consequence of longer life expectancy, sedentary lifestyle and changing dietary patterns.

Although many serious complications, such as kidney failure or blindness, can affect individuals with diabetes, it is the complications of the foot that take the greatest toll. Of all lower extremity amputations, 40-70% are related to diabetes. In most studies the incidence of lower leg amputation is estimated to be 5-25/100,000 inhabitants/year: among people with diabetes the figure is 6-8/1,000.

Lower extremity amputations are usually preceded by a foot ulcer in people with diabetes. The most important factors related to the development of these ulcers are peripheral neuropathy, foot deformities, minor foot trauma and peripheral vascular disease.

The spectrum of foot lesions varies in different regions of the world due to differences in socio-economic conditions, standards of foot care and quality of footwear.The diabetic foot is a significant economic problem, particularly if amputation results in prolonged hospitalization, rehabilitation, and an increased need for home care and social services.

Approximately 3-4% of all people with diabetes have a foot problem and use 15-25% of the healthcare resources available for diabetes. In addition to these costs, there are indirect costs due to loss of productivity to consider. If cost estimates are broadened to include the costs to the individual and loss of quality of life, then the estimated cost of the diabetic foot in the USA is some US$4 billion a year.

Foot complications are one of the most serious and costly complications of diabetes. However, through a care strategy that combines: prevention; the multi-disciplinary treatment of foot ulcers; appropriate organization; close monitoring, and the education of people with diabetes and healthcare professionals, it is possible to reduce amputation rates by between 49% and 85%.

It is this objective that should motivate the advocacy work of those fighting to make a difference for those living with diabetes around the world.It is imperative that we increase awareness among carers at all levels of healthcare services worldwide.

It is imperative that we reduce the unnecessary suffering that foot complications can bring. It is imperative that we act now!

Karel Bakker

Chair of the International Working Group and IDF Consultative Section on the Diabetic Foot.

Foot Facts

* Every 30 seconds a leg is lost to diabetes somewhere in the world.

* Up to 70% of all leg amputations happen to people with diabetes.

* In developed countries, up to five per cent of people with diabetes have a foot problem.

* Foot problems are the most common cause of admission to hospital for people with diabetes.

* In developing countries, it is estimated that foot problems may account for as much as 40% of healthcare resources available for diabetes.

* Most amputations begin with a foot ulcer.

* One in every six people with diabetes will have a foot ulcer during their lifetime. Each year 4 million people worldwide get a foot ulcer.

* In most cases diabetic foot ulcers and amputations can be prevented. It is estimated that up to 85% of amputations could be avoided.

* Significant reductions in amputations can be achieved by well-organised diabetic foot care teams, good diabetes control and well-informed self care.

Gaze - following , amazing feat of infants

Infants begin pulling off an amazing feat sometime in the final three months of their first year of life. They learn an important social interaction by following the gaze of an adult, a step that scientists believe gives babies a leg up on understanding language.

University of Washington psychologists Rechele Brooks and Andrew Meltzoff have pinpointed this developmental step as beginning somewhere in the 10th or 11th month of life, and have found that infants who are advanced in gaze-following behaviour before their first birthday understand nearly twice as many words when they are 18 months old.

Writing in the current issue of the journal Developmental Science, Brooks and Meltzoff provide further evidence for the importance of eyes in human social interactions and trace how gaze-following develops in infants. Three years ago they reported that 12- 14- and 18-month-old infants are much more likely to look at an object when a person turns toward it with open eyes rather than closed eyes.

"Our work shows that babies can look where an adult is looking but that it isn't easy, particularly at home where there are a lot of distractions," said Brooks, who is a research associate at the UW's Institute for Learning and Brain Sciences. "We have found that at 9 months babies are beginning to do this by following the movement of the head.

At 10 and 11 months they are following the head and the eyes. The eyes add important information and the babies are more consistently following the head when the eyes are open. It is as if a light is going off in their head.

This is a clear shift and an important advance." Brooks and Meltzoff refer to the behaviour of a baby (or an adult) looking where another has just looked as "gaze-following." Psychologist have known for some time that among adults detecting the direction of another's glance is a crucial component of human social interaction.

"This line of research is important because following another person's line of sight is crucial for understanding the emotions of other people and, as we are now showing, learning about language," said Meltzoff, who is co-director of the institute and a professor of psychology.

The new study is part of an effort by UW researchers to understand the development of gaze-following in babies. To do this, they tested 96 normally developing infants. There were 32 infants at each of three ages, 9, 10 and 11 months. Equal numbers of boys and girls in each age group were randomly assigned to eyes open or shut conditions.

Each infant was seated in a parent's lap, across a small table from a researcher. Parents were instructed not to move their head or talk during the experiment. The researcher played with an infant before placing two identical toys on pedestals to the left and right of the table.

Then the researcher resumed playing with the child before starting four head-turning trials. In the trials the researcher made eye contact with the infant before silently turning her head toward either the toy on the left or the one on the right.

In the eyes-open condition, the researcher kept her eyes open and turned her head from the child to one of the toys for about seven seconds before turning back to the child. The procedure was the same in the eye-closed trials, except the researcher shut her eyes before turning toward one of the toys and didn't open them again until she was facing the infant.

In a follow-up interview when the infants were 18 months old, parents were asked to check off on a list how many words their child understood.

There were marked differences in the babies' ability to gaze-follow based on age. The 9-month-olds turned their heads toward a toy nearly as often in the closed-eyes condition as in the open-eyes conditions. However, the 10- and 11-month-olds looked at a toy significantly more often when the researchers turned with her eyes open than when she turned with her eyes closed.

About one-third of the infants in the open-eyes condition also made simultaneous sounds such as "ah" or "hmm" when they engaged in gaze-following. Babies at this age are unable to speak but can make very simple sounds.

Typically developing babies experience a burst of language between 18 and 24 months of age. In this study, the babies who simultaneously followed the eyes of the researcher and made vocalizations when they were 10 or 11 months old understood an average of 337 words at 18 months old while the other babies understood an average of 195 words.

"The sounds they are making are very simple, but some children are looking and making these sounds spontaneously," said Brooks. "They are creating a social interaction or a link. There seems to be something special about the vocalization when they are looking at the toy. They are using social information to pick out what we are focusing on.

They can't vocalize words, but they are carefully watching where we are looking.

We think they are using social information and getting a boost in figuring out the social and language world together." "Although the babies are too young to talk to us, those individual babies who are most attuned to our eye gaze are the same babies who pick up language faster more than half a year later," said Meltzoff.

Newswise

Dish rag, dirtiest in kitchen

We like to think of kitchens as being clean, relatively germ-free places. But health experts have a different opinion.

"Salmonella, E. Coli, listeria monocytogenes, campylobacteria," reeled off Dr. Philip. That's because it's the perfect environment for germs. For instance, grandma always said to let hot food cool down before popping it in the refrigerator. That's a myth, however. "Bacteria grow from about 45 degrees to 140 degrees Fahrenheit. That means, the quicker you can cool down the foodstuff the better off you are," Tierno said. Sharon Franke, food appliances director at Good Housekeeping, agrees.

"What we would suggest is that you ladle it into smaller containers because it's going to cool down much more quickly in smaller containers than in this big container," she said.

What about the concept that you want the flavours to mix you want the food to just sit for a bit? "I think that's a myth. The flavours are going to meld even in the refrigerator, that's why leftovers taste so good sometimes," Franke said.

And another common kitchen myth: a sponge is the perfect way to keep your kitchen clean. False, said Franke. "It's very easy to take the bacteria that's in the sponge and recontaminate other areas of the kitchen," she said. Tierno agreed. "A sponge or a dishrag, the equivalent of a sponge, is the dirtiest individual item in most homes," he said.

Tierno and Franke said a mild bleach solution of one ounce per quart of water your can decontaminate a dirty sponge or dishrag. "Then you really should let it stand for about 10 minutes to make sure that you really killed the bacteria," Franke said.

And Tierno recommends that you wash a sponge every time you handle food.

(Reuter Health)

Holistic Healing :

Remedies for skin ailments

by Dr. Danister L. Perera

There are many herbs that can heal the skin and restore the normalcy. Most of the herbs are considered to be blood purifiers and detoxifiers, which deal with micro-circulatory system of the body. Neem or Margosa (Kohomba) is a very effective remedy for skin diseases and it can be taken internally as well as used externally.

It is renowned for its antimicrobial effect and blood purifying properties. Home remedies involve application of neem leaves paste over the affected parts, one hour before a bath. Neem is one of the most powerful plant products that has potent therapeutic properties which provide protective and preventive care for skin irritations and acne with amazing results.

Indian gallnut and neem are traditional detoxifiers, cleansing the body of toxins. Turmeric has been used since the ancient times to cleanse, purify and heal the body internally as well as the skin externally.

Heart-leaved Moonseed (Guduchi) or Rasakinda is said to be the only herb that helps eliminate both types of impurities in the body; Internal impurities due to improper digestion or metabolism (Amavisha), and external toxins from environmental pollution and preservatives, colouring or other chemical additives in our food (Garavisha).

Worldwide research is beginning to show that this herb has excellent properties as an immuno-modulator. Red Sandalwood (Rat-handun) and Khus Khus Grass (Savendara), balance Pitta in the skin (sensitivity) and help keep the skin clear. Classical ayurvedic herbs and fruits such as Amla skin rasayanas - herbs that have an overall positive effect on skin, hair, health and appearance.

Nelli or Amalaki (Indian Gooseberry) is very nourishing for the skin and hair as well as it has powerful antitoxidant properties, enhances the digestion, and supports all the layers of the skin. Tulsi (Holy Basil) is another well-known ayurvedic skin rasayana. Tulsi's special quality is that it helps boost the body's ability to withstand the effects of environmental pollution.

Phytochemicals or chemicals occurring naturally in plants - have shown to have potent antitoxidant power. Research has also shown that your skin can benefit from topically applied antitoxidants just as it does from the antitoxidants in the foods you eat.

Carrot oil, for example, which is included in many natural sun protection formulations, contains carotenoids that enhance your skin's ability to resist damage caused by the sun's harmful ultraviolet rays. Ayurvedic herbs such as Gotu Kola have been shown in research studies to support collagen synthesis and heal skin conditions such as varicose veins when taken internally and applied topically.

Triphala (Aralu, Bullu, Nelli) is a traditional internal cleanser that helps cleanse the physiology of toxins. That's a boon especially for persons with oily skin, because oily skin needs stringent cleansing to stay clear and healthy.

Triphala, the well-known classical ayurvedic formulation, makes an excellent skin tonic. And because Triphala is tridoshic - equally balancing for Vata, Pitta and Kapha - it is useful for all skin types. Vata skin is typically dry and delicate, and tends to lose tone and plumpness prematurely unless nourished on a regular basis. Triphala nourishes the skin both directly and indirectly.

Nelli, one of the three ingredients in Triphala, is the richest known natural source of vitamin C, that helps in the production of collagen, which is necessary to keep skin supple and thick. Triphala also contains calcium that helps enhance skin clarity and brings dull, tired skin back to life.

Also, by removing ama, the digestive toxic matter that clogs the channels of the body, Triphala enables your body and your skin to better absorb, assimilate and utilize the nutrients from the foods you eat. Finally, because Triphala balances the agni - metabolic mechanism - of the skin and opens up the channels of the skin with its cleansing action, it enhances your skin's ability to absorb nutrients from any topical nutritional material, such as oils, pastes and creams.

You can maximize the nourishment you give your skin and get the full benefit of Triphala's nourishing quality by eating a balanced, wholesome diet composed of foods that are good for your skin-type and by using pure, nutrient-rich massage oils, creams and cleansers on your face and body.

Pitta skin is generally sensitive, especially to the sun, and needs protection to stay in balance. Triphala has powerful antioxidant properties.

Besides vitamin C, Amla also contains carotenoids, flavonoids and other antitoxidants. Triphala thus helps enhance the skin's natural resistance to free radical damage. In research studies, Amla has been shown to have anti-bacterial and anti-inflammatory properties.

Triphala is therefore helpful for improving the skin's natural immunity and resistance to hypersensitivity. Triphala also helps improve the skin's natural resilience to photosensitivity by helping to balance Bhrajaka Pitta, the metabolic mechanism of the skin.

Triphala includes the three tastes that pacify the fire element - bitter, sweet and astringent. When the fire element in the physiology is balanced, resistance to photosensitivity increases.

Although Nelli, an ingredient in Triphala, contains the sour taste, which normally increases heat, the sourness in Nelli gets neutralized when the fruit comes into contact with the saliva and digestive enzymes. Thus Triphala helps pacify Pitta and decreases the skin's vulnerability to photosensitivity.

Toxins are the bane of people with Kapha skin. Because of its oily nature, Kapha skin attracts impurities like a magnet. Unless cleansed from the inside and the outside, Kapha skin breaks out because of toxin build-up. Each of the three ingredients in Triphala plays in role in cleansing the skin.

Nelli helps cleanse toxins from the different tissues - blood and fat tissue in particular - and thus helps to keep the skin clear. It also enhances the natural immunity of the skin. Bulu balances lipid levels in the skin. When lubrication becomes excessive, the channels of the skin get clogged with toxins.

By balancing lipid levels, Bulu helps keep skin clear of toxic build-up. Harada helps to cleanse the colon, which in turn helps in purifying the fat tissue. For the skin, this means that the sweat glands get purified, and the skin is better able to flush toxins out through the sweat.

The pores stay clear, and less toxic matter accumulates in the skin. Harada also clears and opens up the micro-circulatory channels of the skin. The skin's natural ability to self-detoxify is enlivened when the channels are clear.

While Triphala's cleansing action is effective, it is not harsh. Triphala's action does not drain the skin of nutrients. Because it is powerfully rejuvenating as well as cleansing, Triphala preserves and enhances the skin's reservoir of available nutrients and the skin's ability to use those nutrients while cleansing the skin of toxins.

To help your skin make the most of Triphala's cleansing power, avoid eating too many heavy, deep-fried foods or rich desserts, especially if you have Kapha skin.

Light, easy-to-digest foods, cleansing foods such as sweet juicy fruits and lots of pure water help Triphala work at deeper levels of the physiology to cleanse gently yet effectively.

www.ceylincoproperties.com

| News | Business | Features | Editorial | Security |
| Politics | World | Letters | Sports | Obituaries | Junior Observer |

Produced by Lake House
Copyright 2001 The Associated Newspapers of Ceylon Ltd.
Comments and suggestions to :Web Manager