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| Sunday, 4 January 2004 |
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Features |  |
| News Business Features Editorial
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Non-surgical treatment for heart patients
Unlike in the past, cardiologists are now opting for non-surgical treatment for heart patients. CAROL ALOYSIUS spoke to DR. TRIPTI DEB, Senior Cardiologist of the Apollo Hospitals on a relatively new non-surgical intervention. She believes the key to preventing heart problems is to avoid Hurry, Worry and Curry. Q: What type of non-surgical procedure is currently gaining popularity among cardiologists? A: We now treat patients with heart problems with the help of Catheters i.e. tubes that carry tiny balloons and stents into the heart and clear the blockages, instead of operating on them. Q: Can this procedure be used for every heart patient. A: No. It is used more often in suitable patients where the open heart surgery and by-pass surgery can be avoided without complications. Q: Is the technique applicable only to heart patients? A: Not really. The same catheter assisted techniques (i.e. coronary intervention through needle puncture only can be used for blockages of kidneys, and brain. The technique used is simple, just like a diagnostic cardiac catheterization. Q: Is it safer than a surgical procedure? What kind of complications can follow? A: It is a very safe procedure and post-procedure complications are very few with the precautions and new techniques of smaller sized catheters being used. Q: How long does a patient have to be hospitalised after a non-surgical procedure to treat a heart ailment? A: Upto 48 hours. He can be discharged even in one day depending on how soon he recovers. Q: How can you prevent another heart attack once this technique is used.? A: By preventing further blockages into the blood circulation i.e coronaries and brain blood circulation in a very aggressive way. The total cholesterol level should be below 130 m.g, and the LDL cholesterol should be below 90 m.g. the good cholesterol (HDL) should be kept above 45 mg. Q: How does one improve one's good (HDL) cholesterol? A: With regular exercise for at least 30 to 45 minutes daily for at least five days of the week. And a good healthy diet. Q: I understand that younger patients are being admitted to hospitals today because of heart problems. Is this true? A: Yes, we are now seeing young people between 20 to 30 years being admitted to hospitals for heart problems. This is tragic since they are in the prime of their lives, and are already vulnerable to a disease that can cause sudden death. Many of them suffer from blockages in blood circulation as a result of bad lipid profile. Only a few cases are related to genetic factors i.e. when a close relative like parents, grandparents or uncles have had heart attacks below the age of sixty years. Q: Why are such young persons now vulnerable to a disease that was once more or less considered a disease of the elderly? A: For several reasons. One of them is the sedentary lifestyle of many young persons. Most of them are desk bound and sit in front of typewriters or computers and doing paper work all day, instead of running about and exercising their bodies. Another cause is the fast foods they consume regularly which are highly refined, contain fats and sugar as well as salt which hardens the arteries. Yet another cause is the lack of high fibres, green vegetables, fruits and natural foods in their daily diet. Q: Are there any other factors that contribute to heart disease in young persons? A: I would say lack of exercise and stress from childhood. Children today are growing in a highly competitive world and even at a very young age they are caught up in the rat race for survival. Q: What do you foresee in the incidence of heart and related diseases in the near future? A: I believe that at least 65 percent of the population above 40 years of age in the South Asian region including Sri Lanka will suffer from CAD i.e. Coronary Arterial Disease by 2020. There will also be an increase in the number of patients with diabetes and blood pressure. Q: Is this inevitable or can these diseases be prevented? A: They can be prevented both in this generation and the next generation with the right kind of interventions starting from as early as age two years. Q: Such as ..? A: Exercise, a moderate lifestyle and a diet with low fat, high fibre and natural food. Sports should be a priority starting at the age of two years and very young children should be taught to do exercises, eat natural low fat foods and watch their weight as obesity from childhood can lead to a problem in adulthood leading to diabetes and hypertension. The ideal Body mass Index should be below 23-25 weight in kg according to the height. Young people starting with toddlers should be encouraged to engage in healthy recreational activities instead of simply sitting in front of the T.V. Q: Can mental exercises like yoga and meditation also help to prevent these conditions? A: Yes, yoga and meditation can help one to relax mentally and physically. Avoidance of anger and tension too can lead to less stress. Q: Could you sum up your advice in a brief sentence to your patients? A: Avoid the following - Hurry, Worry and Curry! ######## Chocolate and heart disease by Dr. D.P. Atukorale Chocolate is a confection made from cocoa beans and is used to make candy and beverages. Fermented beans are roasted and ground, then mixed with cocoa, butter, sugar and milk powder. Cocoa butter is rich in fat and cocoa powder contains proteins (25 percent), fat (30 percent) and carbohydrate (45 percent). Dark chocolate and preparations containing cocoa powder are rich in bioflavonoids which have antioxidant action. Oxidants The term oxidant is used to include not only free radicals such as superoxide and hydroxyl radicals, but also non-radicals such as hydrogen-peroxide (H2O2) and hypochlorous acid (HOCL) which are powerful oxidizing agents formed during tissue reactions. Free radicals play a crucial role in the patho-physiology of broad spectrum of cardiovascular disease, congesture heart failure and valvular heart disease. Antioxidants are substances such as alpha-tocopherol (Vit, E), betacarotene (Provitamin A) and Vit, C which are believed to prevent damage to cells and tissues by oxidants mentioned earlier in diseases such as cancer and ischaemic heart disease. Antioxidants can prevent diseases such as cancer and heart disease. Certain enzymes such as SOB (Superoxide-bismuthase) present in human tissues remove free radicals such as superoxide and hydroxyl radical and convert these radicals to hydrogen peroxide which in turn are removed by other enzymes. Antioxidants The antioxidants such as Vit. E, carotenoids, Vit C, flavonoids (which are polyphenolic antioxidants present in vegetables, fruits, wine, tea, coffee and cocoa) inhibit oxidation of LDL and also reduce the clotting tendency of blood. If the oxidation process of fats were to go on with nothing to stop, it will eventually destroy body cells completely. Fortunately many antioxidants protect our cells and tissues from the ravages of fat oxidation. Bioflavonoids in dark chocolate and cocoa powder also provide better protection against oxidative damage than other antioxidants such as vitamin E, vitamin C and betacarotene. Bioflavonoids in dark chocolate have been shown to decrease chemically induced DNA damage and lipid peroxidation. In summary cocoa powder and dark chocolate consumption gives rise to a decreased risk of cardiovascular disease and incorporation of dark chocolate and cocoa powder into diet is one means of effectively increasing antioxidant intake. Furthermore, the inclusion of dark chocolate and cocoa powder in a diet that is rich in other food sources of antioxidants such as fruits, vegetables, tea and wine results in a high antioxidant intake and may consequently reduce the risk of cardiovascular disease. An important recommendation is that chocolate be incorporated sensibly and prudently in a healthy diet and should emphasize the intake of fruits, vegetables whole grain, skim-milk, reduced fat dairy products, lean meat, fish and poultry. ####### Cholesterol and fats Mono-unsaturated fats. Poly-unsaturated fats ... Saturated fats .... Cholesterol.... We have heard all of these terms going back and forth in the doctor's office, in supermarkets, in the media and our homes, but what does it all really mean ? More importantly how can we make an informed decision on what to buy the next time we walk down that supermarket isle or to the grocery store ? Here are a few Have-To-Know facts that will shed some light.... FAT FAT is one of the three main constituents of food (the others being protein and carbohydrates). Fats are a group of chemical compounds that contain fatty acids. All fatty acids are molecules composed mostly of carbon and hydrogen atoms. The fatty acids that have the maximum amount of hydrogen atoms are the unhealthiest. There are three main types of fatty acids, saturated, poly-unsaturated and mono-unsaturated. WHAT DOES FAT DO ? The human body uses fat primarily as a major source of energy. Fat also aids in the absorption of vitamins A,D,E and K. When eaten in moderation fat is important for proper growth development and maintenance of good health. Parents should also be aware that fats are an especially important source of calories and nutrients for infants and toddlers (up to the age of 2 years) who have the highest energy needs. So everybody needs a moderate amount of fat in his or her system. WHAT IS CHOLESTEROL? Both fat and cholesterol belong to a larger family of chemical compounds called lipids. All the cholesterol the body needs is made by the liver. It is used to build cell membranes as well as brain and nerve tissue. Cholesterol also help the body produce steroid hormones needed for body regulation, including processing food and bile acids needed for digestion. Cholesterol is transported in the bloodstream in large molecules of fat and protein called lipoproteins. Cholesterol carried in low-density lipoproteins are called LDL - cholesterol; most cholesterol is of this type. Cholesterol carried in High-density lipoproteins is called HDL - cholesterol. LDL cholesterol and HDL cholesterol act differently in the body. Too much of LDL cholesterol increase the risk of heart disease and is known as "bad cholesterol". On the other hand an elevated level of HDL cholesterol seems to protect the body against heart disease and is therefore known as "good cholesterol". DOES EVERYBODY NEED SOME FAT ? YES, everybody needs fat in their bodies, and a good amount of it. Fat and oils are used by the body mainly as an energy source. When they are consumed they yield approximately twice as much fat as carbohydrates do without taking up much too much space in the body. Poly unsaturated and mono unsaturated fats are also used as a bonding material which is key in forming the membrane and even walls of the cells that go to making up the body itself. It is recommended that a healthy diet consist of approximately 30% of calories from fat. However, the important thing to keep in mind is that it should be 30% of calories from healthy fat. SATURATED FATS Saturated fats are a variety of fats that are very high in LDL, which is harmful to the body as they keep cholesterol in the blood stream, which can result in clogged arteries leading to potentially fatal conditions such as diabetes and heart disease. Saturated fats can be largely found in meats, certain dairy products and a few vegetable oils such as palm oil and coconut oil. In comparison to the harmful saturated fats poly-unsaturated fats are better than saturated fats as they lower blood cholesterol to a healthier level by lowering the LDL cholesterol levels. However one disadvantage of polyunsaturated fats is that while lowering the LDL they also lower the levels of HDL cholesterol. Monounsaturated fats are so far the best step to healthy fats. When it is substituted for either saturated or polyunsaturated fats monounsaturated fats manage to lower blood cholesterol to a healthier level by lowering the LDL levels and without lowering the levels of HDL cholesterol. Mono-unsaturated fats can be found in nuts, avocado, olive products and canola products, such as margarines and cooking oil. Canola is a vegetable oil obtained from the seeds of the canola flower. Canola oil can be used in most applications and is considered healthy because it is low in saturated fat, high in monounsaturated, and has an ideal balance of omega fatty acids and is also a good source of Vitamin E. Canola is unique because no other oil provides all these benefits. A study done in 1995 concluded that regular substitution of Canola oil for other dietary fats and oils may reduce the likelihood of sudden cardiac death and assist in reducing the high mortality of cardiac disease. It was also noted that canola contains benefits not found with other common vegetable oils. ######## Cancer update : Daily aspirin tied to cancer Women who take an aspirin a day - which millions do to prevent heart attack and stroke as well as to treat headaches - may raise their risk of getting deadly pancreatic cancer, US researchers said. The surprising finding worried doctors, who say women will now have to talk seriously with their physicians about the risk of taking a daily aspirin. Pancreatic cancer affects only 31,000 Americans a year, but it kills virtually all its victims within three years. - Reuters ####### Eggs protect against breast cancer by Dr. A. Nandakumar Eating eggs may protect woman from breast cancer. Researchers at Harvard Medical School found evidence to suggest that teenage girls who regularly eat eggs are less likely to develop breast cancer in later life. This study was conducted among 121,700 women. The study was started in 1976 from age group of 30-55 and 40-65. It was found increased consumption of eggs was associated with decreased risk of breast cancer. The relative risk (RR) was less as 0.82 per increase of one serving per day. When specific nutrients were examined, increased consumption of both vegetable fat and dietary fibre was associated with decreased risk of breast cancer. Consumption of butter was positively associated with increased risk of breast cancer (RR=1.06). It was interesting to note that the (RR) was found high in food items such as milk, butter, cabbage, spinach and beef. These studies were published recently under the topic "Adolescent Diet and Risk of Breast Cancer". Researchers stressed that these finding are preliminary and more research is needed. Another interesting findings about eggs was, Eggs have a lipid that lowers cholesterol absorption. In a study undertaken at Kansas State University, it was revealed the phospholipids or lecithin in eggs markedly inhibits the cholesterol absorption. The inhibition is not 100 per cent, some cholesterol is absorbed but it is significantly reduced in the presence of this phospholipid. Researcher Koo says people with normal cholesterol levels and family history of cardiovascular diseases should not worry about eating one egg a day. There is overall nutritional benefit than harm to be gained from eating "Nutrient Dense" eggs in moderation, he says. Source: Breast Cancer Research and Kansas State University. |
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