Obesity - the problem keeps growing

By Manjula FERNANDO

An alarming 15 per cent of children in Colombo schools suffer from obesity, a situation almost similar to that of Western countries, Dr. Harns Pathirage, a Consultant Physician attached to the Panadura Base Hospital warned, addressing the parents of a leading girls' school.

You may feel this is a negligible number when compared to 22 million overweight children under-five-years worldwide. There are 300 million clinically obese adults among a frightening one billion overweight adults, in the world (World Health Organization).

But as Sri Lanka ostentatiously elevated itself from a 'poor country status' to a middle income nation, we might as well tighten our belts and brace for more of such discouraging news - health-wise.

The World Health Organization (WHO) warns "The problem of childhood obesity is global and increasingly extending into the developing world; for example, in Thailand the prevalence of obesity in children of 5 to 12 years rose from 12.2% to 15.6% in just two years." This is a serious public health issue in the 21st Century and already epidemic in some areas and on the rise in others, says WHO.

It seems almost correct to say the number of multinational Fast food outlets in cities determine the degree of development of a country, just as well the population frequenting these junk food outlets think of it as a means of showcasing their aptness to belong in the 'high class'.

Paedeatricians in Sri Lanka warn obesity in children may become a problem for Sri Lanka which is an issue at confined to selected urban populace.Unlike in any other health issue, parents must be directly held accountable in the case of childhood obesity, a preventable disease.

Obese child, often than not, is the result of an ignorant parent and their bad eating habits. A small percentage of children get obese due to hereditary problems.

WHO says, "The likelihood of developing Type 2 diabetes and hypertension rises steeply with increasing body fatness. Confined to older adults for most of the 20th century, this disease now affects obese children even before puberty.

Approximately 85% of people with diabetes are type 2, and of these, 90% are obese or overweight." Dr. Pathirage says the children's addiction to fast food and soft drinks is one of the main causes for this condition among children in Sri Lanka.

Childhood obesity leads to many short and long-term effects. Short-term effects include physical problems such as pains in the joint, back and hip as well as exercise intolerance where the child will try to keep away from outdoor activities which are essential to mould his leadership qualities.

This can also lead to lethargy, a factor which impairs the overall performance of a student in school. Among the more acute long-term effects are increase in the chances of bad cholesterol levels, blood sugar and high blood pressure.

Parents complain that children refuse to eat nutritious food but according to Dr Pathirage this is a lame excuse.

"It's not true; you must introduce nutritious food at a tender age. Variety is the secret". He stressed that fast food should 'never' complement the meals of very young children.

"Children by nature are reluctant to try new food. It is the parents who first get them to eat junk food. Later they complain at this hard-to-undo mistake," he said.

Among the other contributors to child obesity are irregular meals and excessive fat and carbohydrate contents in the meal. Parents must insist on a fixed time for the main meals and try to abide by this rule at all times, except in the case of a rare emergency.

Dr. Pathirage says fast food and soft drinks contain a lot of artificial agents like taste enhancers, emulsifiers, colouring and preservatives. as well as added sugar, salt, and high fat and carbohydrate contents. "These are all the perfect ingredients for growing up children to become sick adults." He is of the view that it is best to stick to Sri Lankan fruits over imported and impressive foreign 'stuff' that has been chemically treated to stay fresh 'forever'.

"Fresh fruit juices made with local products and home made meals are ideal for your child's health." According to him this nutritious meal could be an exciting home made 'club sandwich'. Mothers should not always think in terms of 'kola kenda' or red-rice and curry.

Obesity in childhood and adolescence can be related to: poor eating habits, overeating, lack of exercise, family history of obesity, medical illnesses (endocrine, neurological problems) medications (steroids, some psychiatric medications) stressful life, events or changes (separations, divorce, moves, deaths, abuse) family and peer problems, low self-esteem, depression or other emotional problems. What are risks and complications of obesity?

There are many risks and complications with obesity. Physical consequences include:

Increased risk of heart disease, high blood pressure, diabetes, breathing problems, trouble sleeping Child and adolescent obesity is also associated with increased risk of emotional problems.

How can obesity be managed and treated? Thorough medical evaluation by a paediatrician or family physician to consider the possibility of a physical cause. In the absence of a physical disorder, the only way to lose weight is to reduce the number of calories being eaten and to increase the child's or adolescent's level of physical activity. Lasting weight loss can only occur when there is self-motivation.

Ways to manage obesity in children and adolescents include: start a weight-management program, change eating habits (eat slowly, develop a routine) plan meals, eat less fatty foods, avoid junk and fast foods, control portions and consume less calories, increase physical activity (esp. walking) and have a more active lifestyle, eat meals as a family instead of while watching television, or at the computer do not use food as a reward.

(Source: American Academy of Child and Adolescent Psychiatry)

Alzheimer's disease and treatment

Alzheimer's disease is the most common cause of dementia in the United Kingdom, responsible for about 60% of the 800,000 cases of dementia currently being treated. Most cases of Alzheimer's disease develop in those aged 65 or over. Under the age of 65, Alzheimer's disease is rare, affecting about one person in 1,000. Over the age of 65 about one in 20 are affected. The risk of developing Alzheimer's disease continues to increase with age, doubling every 5 years, so that by the age of 85 nearly one in 2 people will have the disease.

Women have a slightly greater chance of developing Alzheimer's disease than men.

Causes: While the causes of Alzheimer's disease remain a mystery, its effects on the brain are clear. The levels of acetylcholine, a chemical that acts as a messenger in the brain, fall dramatically. At the same time, nerve endings and brain cells begin to die. This causes the brain to shrink and gaps to appear in important areas. The areas commonly affected are those involved in receiving and storing information. Age seems to be the biggest factor implicated in the development of Alzheimer's disease, but some people are more likely to develop the disease because of particular genes they have inherited. The risk of developing Alzheimer's disease is also increased if you have suffered a severe head injury, or have Down's Syndrome. Things that increase the risk of heart disease such as smoking, high blood pressure and high cholesterol levels may also increase the risk of Alzheimer's disease..

Symptoms: Alzheimer's disease is a progressive disease, gradually getting worse over time. Alzheimer's disease typically begins with lapses in memory, difficulty finding the correct words for everyday objects and mood swings. These mild symptoms are often mistaken for the natural signs of ageing, however after six months or so, a pattern will start to emerge.

Appointments will be routinely forgotten, names and faces get muddled, and shopping or driving can become an ordeal when money makes no sense, and left and right get mixed up. Personality changes can occur, and sufferers often burst into tears for no apparent reason. In more advanced cases, inhibitions are often lost and the person's behaviour becomes more unsettling.

Wandering around the streets in undone pyjamas is not uncommon. The person affected may become severely confused and may experience hallucinations, often becoming demanding and sometimes violent. Personal hygiene may be ignored, and incontinence of urine and faeces is common.

The final stages of Alzheimer's disease see the disintegration of the personality, and sufferers become completely dependent on their carers. Death usually occurs from other complications, such as pneumonia, brought on by the person's frail condition.

Treatment: There is no cure for Alzheimer's disease and none is likely in the near future. Treatment is aimed at slowing down the rate of mental decline. Scientific evidence confirms that drugs licensed for dementia may provide initial improvements and stabilisation of symptoms for the majority of people with Alzheimer's disease.

The drugs may help to improve memory or slow memory loss. Other benefits include improving alertness and motivation. It may take several months of treatment before there is a noticeable improvement, but many people report improved mood and an ability to do things that they had forgotten how to do.

Three drugs, known as anticholinesterases, are currently recommended on the NHS for the treatment of people with moderate Alzheimer's disease. The three drugs are donepezil, galantamine and rivastigmine and appear to work by maintaining levels of the transmitter acetylcholine in the brain by preventing its breakdown.

A fourth drug, memantine, which works in a different way to the anticholinesterases is also available for the treatment of moderate to severe Alzheimer's disease but is not allowed on the NHS for newly diagnosed patients.

Apart from medicines, it seems that the best way of combating the effects of Alzheimer's disease is to establish and maintain a structured routine, and to try and lead as normal life for as long as you can. Mental activity such as puzzles, crosswords and reading all appear to help. As the disease progresses people will need more support and supervision, and eventually nursing care.

When to consult your doctor: Consult your doctor if you are concerned about someone who is close to you and are worried that they may have Alzheimer's disease.

The doctor will carry out a physical examination and ask a series of questions to test the person's thinking and memory.

If the doctor suspects Alzheimer's disease, the person will be referred to a consultant with special experience of dementia who will be able to confirm the diagnosis and assess the severity of the condition.

Treatment has to be started by the specialist, but can be continued by the person's doctor provided the person's mental condition is reviewed every six months.

Under the terms of the NHS, a doctor may continue to prescribe donepezil, galantamine and rivastigmine for people newly diagnosed with moderate Alzheimer's disease. Patients already taking donepezil, galantamine or rivastigmine for mild Alzheimer's disease or memantine for moderate to severe Alzheimer's disease should be able to carry on having treatment.

The Independent

Superfoods: What every woman should know

NEW YORK - How would you like to fight heart disease or lower your risk of cancer? The key to doing so might be on your dinner plate.

But for women who lead hectic lives, there isn't always much time for healthy eating. That's why nutrition experts are advising that there are six incredible "superfoods" that every woman should know about.

Yes, it can be a challenge for women to eat healthy when they are always on the go. But even when there is time, doctors say you don't need to do much to reap the health benefits if you choose superfoods.

"Superfoods are foods that, in addition to their rich vitamin and mineral content, they're also important in fighting a number of diseases and preventing diseases as well," said CBS 2's Dr. Holly Phillips.

The first superfood on the list is low fat yoghurt.

It's high in calcium and protein, and may decrease the risk of getting breast cancer, irritable bowel syndrome and other digestive track disorders.

Just stick to low or non-fat unsweetened yoghurts.

"It also has probiotics, the healthy bacteria which is important to keep a healthy gut," said nutrionist Keri Glassman. "A healthy guy is important for many reasons, including boosting our immune system." Fatty fish is the second superfood. This nutritional powerhouse is loaded with omega 3 fatty acids that may help prevent cardiovascular disease. Look for fish like salmon or canned fish, like sardines, which have DHA and EPA fatty acids listed on the label.

Superfood 3: Beans. They may lower cholesterol and even stabilise female hormones.

"Beans are actually a great meat substitute," said Phillips. "They're rich in protein and rich in fibre. They also may fight a number of diseases, including breast cancer and heart disease." Bright red tomatoes and fruits like watermelon are also considered a superfood.

"Tomatoes are a great source of the antioxidant vitamin lycopene, which has actually been shown in recent research to be important in fighting breast cancer." said Phillips.

Colourful berries are superfood 5. They make the grade because they're high in antioxidants. Blueberries are especially powerful for keeping our skin and brains young.

The last superfood on the list is food fortified with vitamin D, like low fat milk. And it's not just for bone health.

"It's also been shown to be protective against tumors, multiple sclerosis and diabetes," said Glassman.

If you don't like dairy, you can still get health benefits of vitamin D - just choose fortified orange juice.

Blood pressure pill action urged

Blood pressure becomes a serious problem for many people as they grow older.

This article from the BBC news Health News site explains that people over 55 should be taking blood pressure medication and can also use natural cures for high blood pressure to reduce the risk of stroke and heart attacks.

"Everyone aged 55 and over should be taking drugs to lower their blood pressure, a London-based expert says. Epidemiology expert Professor Malcolm Law said blood pressure drugs cut the risk of heart attack and stroke even for those with normal blood pressure.

His conclusion, published in the British Medical Journal and backed by other experts, is based on a review of 147 studies, involving 464,000 people. However, the Stroke Association warned the drugs could have side-effects.

The research found most types of blood pressure drugs cut the risk of heart attacks and heart failure by around a quarter and the risk of stroke by about a third.

The studies looked at the effect on two blood pressure measurements; systolic - the pressure when the heart beats while pumping blood - and diastolic - the pressure when the heart is at rest between beats.

The lowered risk estimates were based on lowering systolic blood pressure by 10mm Hg or diastolic blood pressure by 5mm Hg.

Professor Law, an expert in epidemiology at the Wolfson Institute at Barts and The London School of Medicine, said: "Beyond a certain age, we're saying everyone would benefit from taking drugs that lower blood pressure.

"Beyond a certain age, we all have high blood pressure and we would all benefit from lowering it.

"What we call 'normal' blood pressure is actually high, and what we call high blood pressure is actually higher." Professor Law said the universal use of blood pressure drugs should be seen as analogous to vaccinating the entire population in the event of a flu pandemic.

There was no case for trying to assess who was a top priority, he said, when everybody was potentially at risk.

In fact, Professor Law said giving everybody blood pressure drugs would minimise the risk that people would be alarmed when told they needed to take the medication."

It is commonly known that men ignore their health symptoms and often don't go to the doctor before it's almost too late. Many men, in the past, even avoided going to the doctor at all.

There are early warning signs for many diseases that men should become acquainted with and learn all the facts about their health.

Times of India

Fighting ageing by cutting calories

Want to live longer, look better as you age? Research has found that eating less and therefore consuming less calories seems to help as far as anti-aging goes. According to BBC news on how a reduction of calories will benefit you as you age and this is true for both men and women.

"Cutting calories may delay the aging process and reduce the risk of disease, a long-term study of monkeys suggests.

The benefits of calorie restriction are well documented in animals, but now the results have been replicated in a close relative of man over a lengthy period. Over 20 years, monkeys whose diets were not restricted were nearly three times more likely to have died than those whose calories were counted. Writing in Science, the US researchers hailed the "major effect" of the diet.

It involved reducing calorie intake by 30% while maintaining nutrition and appeared to impact upon many forms of age-related disease seen in monkeys, including cancer, diabetes, cardiovascular disease and brain atrophy. Whether the same effects would be seen in humans is unclear, although anecdotal evidence so far suggests people on a long-term calorie-restricted diet have better cardiovascular health.

The precise mechanism is yet to be established: theories involve changes in the body's metabolism or a reduction in the production of "free radical" chemicals which can cause damage.Seventy-six rhesus monkeys were involved in the trial, which began in 1989 and was expanded in 1994. Half had their diets restricted, half were given free rein at feeding time.

The rate of cancers and cardiovascular disease in dieting animals was less than half of those permitted to eat freely.

While diabetes and problems with glucose regulation were common in monkeys who ate what they wanted, there were no cases in the calorie controlled group. In addition, while most brains shrink with age, the restricted diet appeared to maintain the volume of the brain at least in some regions. In particular, the areas associated with movement and memory seemed to be better preserved. "Both motor speed and mental speed slow down with ageing," said Sterling Johnson, a neuroscientist at the University of Wisconsin-Madison School of Medicine.

"Those are the areas which we found to be better preserved. We can't yet make the claim that a difference in diet is associated with functional change because those studies are still ongoing." It seems to hold true that reducing caloric consumption is a major factor for age management for men and women.

(T.I.)