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| Sunday, 19 December 2004 |
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Features |  |
| News Business Features Editorial
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Are vegetarians prone to develop anaemia? by Dr. D. P. Atukorale What is anaemia? Anaemia literally means 'lack of blood'. More precisely the word is used to denote reduction in oxygen - carrying capacity of the blood which can be caused in three main ways:
(b) excessive red cell destruction; (c) defective red blood formation. Oxygen is held within the red cell (RBC) by the pigment haemoglobin (Hb) which transports oxygen from the lungs to body cells and returns waste carbondioxide (Co2) from the cells to the lungs. About 20 percent of oxygen used each day is used by the human brain. Fatigue and mental dullness occur when the brain does not get enough oxygen. If the Hb level drops the heart rate will speed up and you will start panting breath on mild exertion. Replacement of the Hb requires iron in the diet as well as vitamin B12 and folic acid. If any of these are inadequately present or are inadequately absorbed, anaemia will result. There are many kinds of anaemia, but the commonest type of anaemia is iron deficiency anaemia which is thought to be a nutritional problem. How can vegetarian diet prevent an anaemia? You may be surprised to know that despite the meat industry propaganda, the facts reveal that a healthy vegetarian diet is an excellent way to get all the iron and folic acid and vitamin C you need. Since anaemia can result from an inadequate intake of iron, vitamin B 12 and folic acid it is alleged that vegetarians are risking their health and are condemned to become anaemic. But is this true? Iron deficiency anaemia is uncommon in men but more widespread in women especially during child bearing period i.e. before menopause. Blood loss due to excessive bleeding during menstrual periods is the most common cause of iron - deficiency anaemia among the women, and iron deficiency anaemia is a problem affecting both vegetarians and non vegetarians alike in all countries including Sri Lanka. Other primates such as chimpanzees eat vegetarian diet and these animals don't get anaemia. Vegetarian and vegan diet is well capable of providing normal iron requirements which are normally obtained from dark green leafy vegetables and whole grain. Radical new evidence suggests that over-consumption of iron-rich foods such as red meat may in fact be a health hazard and that people with elevated blood iron (serum ferritin) are prone to heart attacks. Other dietary anaemias Besides iron, folic acid (vitamin B9) and vitamin B12 play an essential part in regular replacement of Hb in the blood. Folic acid deficiency is widespread globally and body does not store folic acid unlike iron. The good news for vegetarians is that folic acid is present in many common green leafy vegetarian foods and it is not present in most meat fish, milk and root vegetables. For all practical purposes, folic acid deficiency anaemia does not occur in vegetarians although folic acid supplements are given to both vegetarians and meat eaters during pregnancy to prevent neural tube defects in the foetus. Almost all Sri Lankan vegetarians are lacto-vegetarians who take milk, curd and milk products which contain vitamin B12. The amount of B12 needed in the diet is 1.5 micrograms (one million of a gram) per day. B12 deficiency does not exist in lacto-vegetarians. Vegan do not consume milk but B12 deficiency has not yet been documented in our vegetarians and vegan as far as I am aware. B12 is almost always manufactured by bacteria. The bacteria in our gut, mouth, around teeth and gums, nasal passages and around tonsils may all produce B 12. But it is advisable for vegans to take a vitamin tablet containing B12 periodically. The commonest type of B12 deficiency anaemia is pernicious anaemia which is caused by an inability to absorb vitamin B12 from our gut. Pernicious anaemia which is a relatively common haematological problem in the West, is extremely rare in Sri Lanka. In the West pernicious anaemia occurs among both vegetarians and non vegetarians and is not due to vegetarian diet. Science of nutrition just like any other branch of human knowledge is full of its own folklore. Majority of laymen and doctors both in Sri Lanka and abroad believe that vegetarians are likely to be anaemic and these fallacies are passed down from one generation of practitioners to another because they sound plausible, because no one bothers to check or question the original research in the field and if they do, they would be in for quite a shock. In summary (a) Iron deficiency anaemia is a widespread problem particularly in women (both vegetarian and non vegetarian) and commonly occurs before menopause. (b) Eating a vegetarian diet does not increase the risk of anaemia, and a healthy meat free diet includes several sources of iron such as lentils (dhal), spinach, 'gotukola', sesame seed (gingili), beet, cashew nutes, cabbage, molasses, soya, pumpkin, cocoa, wheat, lima beans and ginger root. (c) The body naturally regulates absorption of dietary iron according to our needs. Taking too much iron can cause disease. (d) Eating foods rich in vitamin C (such as fresh vegetables and fruits) will enhance iron-bio-availability, Vit C is available only in vegetarian diet and is not found in fish and meat. (e) Plant-based foods are superior to meat-based ones because they furnish us with all the iron normally necessary which naturally protects us from health hazards associated with iron overload such as coronary heart disease. ##### Teeth for a life time Dental caries and gum disease are the commonest causes of oral ill health in Sri Lanka. The following article answers some frequently asked questions on these diseases:
A: There are two major dental diseases: Dental caries and Gum diseases. Q: How do these diseases occur? A: Dental caries: When one eats sugary food the bacteria in the mouth acts on the sugar forming an acid. The acid gradually dissolves the tooth tissue starting the process of caries. Gum Disease: Dental plaque is the main cause of gum disease. It is formed by bacteria acting on the food debris left in gum margins and between teeth. Dental plaque is a thin yellowish substance slippery in nature formed at the margin of gums and between teeth. Due to bacterial activity in the dental plaque toxins are released which causes an inflammation of the gum, starting the process of gum diseases. If dental plaque is not removed with time it hardens to form calculus or tartar. Dental plaque could be removed by correct tooth brushing but calculus could be removed only through proper dental treatment. Q: How will you recognise the first signs of these diseases? A: In the case of Dental Caries; A whitish or brownish patch will appear on the surface of the tooth. There can be a small cavity on a tooth which fills with food particles There can also be a very slight pain or sensitivity on that tooth specially when taking cool drinks. Gum Disease: is indicated when there is: Bleeding gums Redness of the gums Swollen gum margins Bad breadth Q: How would you prevent these diseases? A: Eat less sweets Reduce the number of times and amount of sweets you eat. If you like to take sweets eat only during main meal times. Train your children to eat fruits instead of sweets. Brush your teeth at least twice a day morning and night after meals. When brushing use a tooth brush with a small head and medium texture bristles. Dental plaque is mostly seen at gum margins and between teeth. Thus you should angle your tooth brush in to the gum margins to brush off the plaque. Always use a fluoridated toothphase It has been proved scientifically that fluoride reduces dental decay. Thus you should always use a fluoridated toothpaste. Periodic check ups with the Dentist If the Dental Diseases are detected at the early stages they can be easily treated and the teeth protected. Thus periodic check-ups and dental advise will help prevent dental diseases. If you practice these preventive methods you can preserve teeth for a lifetime. The first milk tooth erupts in six months or so after birth. The full set of twenty two teeth are completed in 2 1/2 - 3 years. At the age of six years the first permanent tooth erupts which is a permanent molar. When a person is 18 - 20 years old the full set of 32 teeth is completed. It is wrong to say that teeth drop off with old age as they can last a life time with proper care. Courtesy by the Health Education Bureau ####### Healing powers of water Water which is the most versatile medium for all kinds of body reactions constitutes the major portion of our bodies. Without water our life processes could not exist. If left out of a diet, life would cease in a matter of days' says Dr. D. P. Atukorale. Water is the perfect body medium for body processes because it enables chemical reactions to occur and water directly participates in many of these reactions. It makes about 50 per cent to 70 per cent of the body's weight (about 10 gallons or 40 litres) Lean muscle tissue contains about 73 per cent of water. Adipose tissue contains about 20 per cent of water. Thus as fat content of our body increases (and percentage of lean tissue decreases) in the body the total body content of water drifts towards 50 per cent. We lose about 2 litres of water daily and this should be replenished daily. We know the resulting constant demand for water as thirst. Depending on the amount of fat stores present, an adult can survive for about eight weeks without eating food but only a few days without drinking water. This occurs not because water is more important than carbohydrates, fat, proteins, vitamins and minerals but because we can neither store water nor conserve water as well as we can, the other components of our diet. Water flows in and out of body cells through cell membranes. Water inside cells forms part of the intracellular fluid and water outside cells or in the blood stream forms the extracelluar water. Water shifts freely in and out of cells. When blood volume decreases (e.g. after accidents where patient bleeds externally and internally or internally due to rupture of an ectopic pregnancy), water can move from the areas inside and around cells to the blood stream to increase the blood volume. The body controls the amount of water in intracellular and the extracelluar compartments mainly by controlling ion concentration. Ions have electrical charges and so are called electrolytes and water is attracted to ions such as sodium chloride, potassium chloride, magnesium phosphate and calcium. By controlling the movement of ions in and out of cells the body maintains the appropriate amount of water in each compartment. Water has a great ability to hold heat and thus water changes the body temperature slowly. It takes much more energy to heat water than it takes to heat fat. Foods with very high water content heat up and cool down slowly. The human body secretes fluid in the form of perspiration which evaporates through skin pores. To evaporate water, heat energy is required and as perspiration evaporates, heat energy is taken from the skin, cooling it in the process. Each litre of perspiration evaporated represents about 600 k cals of energy lost from the skin and surrounding tissue. Therefore fever increases one's need for energy. Perspiration is the primary way to prevent overheating of our body and if it could not be dissipated the body temperature would rise enough to prevent enzyme systems from functioning efficiently. Water removes waste products Water is an important vehicle for ridding the body of waste products such as urea (which is a by-product of protein metabolism). More protein we eat, in excess, of our needs, more nitrogen we excrete in the form of urea in urine. similarly, the more sodium we consume (in the form of sodium chloride or common salt), more sodium we excrete in the urine. By limiting excess protein and sodium intake, it is possible to limit urine output, a useful practice in space flights. This type of low salt, low protein diet is used to treat certain kidney diseases such as renal (kidney) failure. A typical urine volume is about 1-2 litres (1-2 quarts) per day depending on the amount of fluid, protein and sodium intake. If you secrete less than 600 millilitres (2 1/2 cups), kidneys secrete a very concentrated urine and the urine is very dark yellow, and heavy ion concentration increases your risk of developing kidney stones if you are one who is susceptible. Males are more prone to kidney stones than females. Water helps to form the lubricants found in knees and other joints of the body. Water is the basis of saliva, bile and amniotic fluid (which acts a shock absorber surrounding the growing foetus in the mother's womb). How Much Water Do We Need? Adults need roughly one millilitre of water per K. calorie expended. We consume about 1 litre (1 quart) of water a day in various liquids such as fruit juice, coffee, tea, soft drinks, king coconut water and water itself. Foods supply another litre of fluids. Many beverages, fruits and vegetables are more than 80 per cent water. Water as a by-product of metabolic processes, provides approximately 350 millilitres (1 1/2 cups) of additional water. This yields a total of about 2-4 litres (10 cups) of water for a 2400 kcal diet or about 1 millilitre per kcal expended. One way to determine if water intake is adequate, is to observe the colour of one's urine; it should be pale yellow. Of the 2.4 litres of water needed, about 1.4 litres is used to produce urine. The rest about 1 litre compensates for typical water losses through the lungs (400ml). It is noteworthy that a large amount of water is used to lubricate the gastrointestinal tract, and the loss of water only 150 millilitres per day through the faeces is remarkable. About 8000 millilitres of water enters the secretions from mouth, stomach, intestine, pancreas and other organs, while the diet supplies an additional 2000 millilitres or more. The kidneys also greatly conserve water. They re-absorb about 97 per cent of water filtered from waste products. Anti-diuretic hormone (ADH) is secreted by the pituitary gland and that acts on the kidney to cause a decrease in water excretion. Aldosterone on the other hand is produced by the adrenal gland and acts on the kidneys to cause water and sodium conservation. Alcohol inhibits the action of ADH, and so when a person drinks excessive amounts of alcohol he or she passes too much of urine and one reason people feel so weak the day after heavy drinking sessions is that they are very dehydrated. Once the body registers a shortage of available water it increases fluid conservations, the pituitary gland secrets ADH and force kidneys to conserve water and kidneys respond by reducing its urine flow. At the same time, fluid volume decreases in the blood stream, blood pressure falls and this eventually triggers the release of the hormone, aldosterone which signals the kidneys to retain more sodium and more water. By the time a person loses 1 per cent to 2 per cent the body weight in fluid, he or she will be thirsty and the person feels tired. At 4 per cent loss of body weight muscle loses strength. At 10 per cent or 12 per cent heat tolerance is decreased and weakness results. At a 20 per cent reduction, coma or death may soon follow. |
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(a) loss of blood (e.g. haemorrhoids, heavy menstrual periods;
Q: What are the major dental diseases?
