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General Research

ADRENAL FATIGUE: What it really is

OVERVIEW

Adrenal fatigue is a collection of nonspecific symptoms ranging from body aches, fatigue, nervousness, sleep disturbances and some digestive problems. These complaints somewhat mimic signs of adrenal diseases, syndromes and medical conditions.

Proponents always paint adrenal fatigue as a mild form of adrenal dysfunction, but it isn’t an accepted medical diagnosis. 

According to Mayo clinic, adrenal insufficiency can be diagnosed by blood tests and special stimulation tests that show inadequate levels of adrenal hormones. 

The unproven theory behind adrenal fatigue is that your adrenal glands are unable to keep pace with the demands of perpetual fight-or-flight arousal. As a result, they can’t produce quite enough of the hormones you need to feel good. Existing blood tests, according to this theory, aren’t sensitive enough to detect such a small decline in adrenal function — but your body is.

Most frustrating situation ever is having signs and symptoms wrongly diagnosed by unqualified practitioners. 

Unproven remedies for so-called adrenal fatigue may leave you feeling sicker, while the real cause — such as depression or fibromyalgia — continues to take its toll.

 

THE CONCEPT OF ADRENAL FATIGUE

Symptoms associated with ‘adrenal fatigue’ include fatigue, unexplained weight loss, low blood pressure and lightheadedness, darkening of the skin, loss of body hair, body aches, hormone imbalance, poor digestion, insomnia, sleep disorders, lowered immune system, inability to cope with stress and loss of concentration. 

According to a systemic review of adrenal fatigue literature, published in the journal of BMC Endocrine Disorders, with 58 analysed studies, testing used in most studies included direct awakening cortisol, cortisol awakening response and salivary cortisol rhythm.

Researchers found conflicting results and concluded there is no firm evidence that the condition exists. 

It is very important to note and understand the difference between adrenal insufficiency and adrenal fatigue, sometimes, the symptoms seem to overlap and look alike. People with adrenal insufficiency often experience joint pain, nausea, vomiting, diarrhea and dry skin asides fatigue.Adrenal insufficiency is diagnosed by a physician through ACTH Simulation and Insulin-Insulin Hypoglycemia tests.  

OTHER POTENTIAL EXPLANATIONS: 

These might include thr belief that the hallmark symptom of adrenal fatigue, which is fatigue may just be related to other diseases or presence of long term stress factors. For example, conditions that might mimic symptoms of AF include anaemia,  thyroid disease, growth hormone deficiency, depression, fibromyalgia, menopause etc.

It is adviceable that registered dietitians explore symptoms, medical history and lifestyle factors during nutrition assessment of a patient inquiring about adrenal fatigue. 

PROPOSED INTERVENTION: 

This includes moderate exercise, an adequate diet that supports adequate blood sugar regulation (diets rich in pulses, whole wheat, complex carbohydrates and protein (both plant and animal sources), adequate sleep, stress relief and management techniques.

Avoiding alcohol and caffeine is adviceable as they can trigger the production of cortisol which could cause a spike in insulin production and increase stress levels.

ADRENAL CONDITIONS:

There are so many conditions related to the adrenal glands, but to mention a few important ones, we have: 

  1. Addisons disease: primary adrenal insufficiency caused by insufficient steroid hormone production despite adequate adrenocorticotropic hormone (ACTH) levels. Low ACTH hormone levels are caused by a problem associated with the pituitary gland and are considered secondary adrenal insufficiency. Symptoms include low blood pressure, fatigue, loss of appetite, nausea and vomiting, dysregulation of blood glucose, darkening of skin. 
  2. Adrenal insufficiency: this happens when the adrenal glands do not produce enough cortisol; symptoms include fatigue and muscle weakness.
  3. Adrenal crisis: is caused by chronic adrenal insufficiency, addisons disease, tumors and severe sepsis. Symptoms include abdominal pains, confusion or loss of consciousness, loss of appetitie, dehydration.
  4. Cushings syndrome: this occurs when there is excessive levels of cortisol in the blood stream as a result of exogenous or endogenous factors. 

           Exogenous: steroids

           Endogenous: adrenal or pituitary gland 

tumour.

           Symptoms include weight gain, depression, 

           mucle loss. 

  1. Primary hyperaldosteronism: occurs when the adrenal glands produce too much of the hormone aldosterone (causing hypertension and low blood potassium levels), it can be caused by hyperactivity in one or both adrenal glands or sometimes related to an adrenal tumour.

Symptoms include high blood pressure, heartache, fatigue, low potassium levels and numbness.

Notice how fatigue is a symptom of all adrenal conditions? Stress management techniques should be learned and maintained by all and sundry to avoid stories that touches.

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Acidosis: causes, symptoms and treatment

Have you ever had a disruption in your bowels after taking a food you knew you shouldn’t have? 

That same way your face stays all day trying to live with the pain and discomfort is the same way your system feels when there is acidosis.

Metabolic acidosis happens when the chemical balance of acids and bases in your blood goes haywire. Most times, it might happen that your body:

  • Is making too much acid
  • Isn’t getting rid of enough acid
  • Doesn’t have enough base to offset a normal amount of acid

When any of these happen, chemical reactions and processes in your body don’t work right.

Although severe episodes can be life-threatening, sometimes metabolic acidosis is a mild condition. You can treat it, but how depends on what’s causing it.

Causes of Metabolic Acidosis

Different things can set up an acid-base imbalance in your blood

Ketoacidosis: When you have diabetes and don’t get enough insulin and get dehydrated, your body burns fat instead of carbs as fuel, and that makes ketones. Lots of ketones in your blood turn it acidic. People who drink a lot of alcohol for a long time and don’t eat enough also build up ketones. It can happen when you aren’t eating at all, too. Also, a prolonged keto diet could lead to build up of ketones if not supervised well; especially if it’s for the wrong purposes. 

Lactic acidosis: Lactic acid build up occurs when there is enough oxygen in the muscles to breakdown glycogen and glucose . This acid can build up, too. It might happen when you’reexercising intensely. Big drops in blood pressure, heart failure, cardiac arrest, and an overwhelming infection can also cause it.

Renal tubular acidosis:  This medical condition happens when there is accumulation of acid in the body due to the kidney’s failure to appropriately acidify urine. Healthy kidneys take acids out of your blood and get rid of them

Have you ever had a disruption in your bowels after taking a food you knew you shouldn’t have? 

That same way your face stays all day trying to live with the pain and discomfort is the same way your system feels when there is acidosis.

Metabolic acidosis happens when the chemical balance of acids and bases in your blood goes haywire. Most times, it might happen that your body:

  • Is making too much acid
  • Isn’t getting rid of enough acid
  • Doesn’t have enough base to offset a normal amount of acid

When any of these happen, chemical reactions and processes in your body don’t work right.

Although severe episodes can be life-threatening, sometimes metabolic acidosis is a mild condition. You can treat it, but how depends on what’s causing it.

Causes of Metabolic Acidosis

Different things can set up an acid-base imbalance in your blood

Ketoacidosis: When you have diabetes and don’t get enough insulin and get dehydrated, your body burns fat instead of carbs as fuel, and that makes ketones. Lots of ketones in your blood turn it acidic. People who drink a lot of alcohol for a long time and don’t eat enough also build up ketones. It can happen when you aren’t eating at all, too. Also, a prolonged keto diet could lead to build up of ketones if not supervised well; especially if it’s for the wrong purposes. 

Lactic acidosis: Lactic acid build up occurs when there is enough oxygen in the muscles to breakdown glycogen and glucose . This acid can build up, too. It might happen when you’re exercising intensely. Big drops in blood prrssure,  heart failure, cardiac arrest, and an overwhelming infection can also cause it.

 

Renal tubular acidosis:  This medical condition happens when there is accumulation of acid in the body due to the kidney’s failure to appropriately acidify urine. Healthy kidneys take acids out of your blood and get rid of them in your pee. Kidney diseases as well as some immune system and genetic disorders can damage kidneys so they leave too much acid in your blood.

Hyperchloremic acidosis. Severe diarrhea, laxative abuse, and kidney problems can cause lower levels of bicarbonate, the base that helps neutralize acids in blood.

Respiratory acidosis also results in blood that’s too acidic. But it starts in a different way, when your body has too much carbon dioxide because of a problem with your lungs.

Symptoms

Although symptoms can differ, someone with metabolic acidosis will often:

  • Breathe fast
  • Have a fast heartbeat
  • Have a headache
  • Be confused
  • Feel weak
  • Feel tired
  • Have little desire to eat
  • Feel sick to their stomach
  • Throw up

Fruity-smelling breath (kasmaul breathing)is a classic symptom of diabetic ketoacidosis (DKA).

If you have these symptoms, call your doctor or visit the hospital immediately.  

Testing

Tests like anion gap, arterial blood gases and urine tests could help figure out if any of these acidosis occurs.

 

Prevention

You can’t always prevent metabolic acidosis, but there are things you can do to lessen the chance of it happening.

Drink plenty of water and non-alcoholic fluids. Your pee should be clear or pale yellow.

Limit alcohol. It can increase acid buildup. It can also dehydrate you.

Manage your diabetes, make sure you adhere to drug use by physician and also diet regimen by dietitian.

Follow directions strictly when you take your medications and do not self medicate no matter how small and familiar the symptoms might be.

 

Treatment

You treat metabolic acidosis by treating what’s causing it. If you don’t restore the balance, it can affect your bones, muscles, and kidneys. In severe cases, it can cause shock or death. DKA can put you in a coma.

The earlier you’re treated, the better. Common treatments include:

  • Detoxification, if you have drug or alcohol poisoning
  • Insulin, if you have DKA
  • IV fluids, given by needle through a vein in your arm
  • Sodium bicarbonate, by IV

You might have to go to a hospital.
your pee. Kidney diseases as well as some immune system and genetic disorders can damage
kidneys so they leave too much acid in your blood.

Hyperchloremic acidosis. Severe diarrhea, laxative abuse, and kidney problems can cause lower levels of bicarbonate, the base that helps neutralize acids in blood.

Respiratory acidosis also results in blood that’s too acidic. But it starts in a different way, when your body has too much carbondioxide  because of a problem with your lungs.

Symptoms

Although symptoms can differ, someone with metabolic acidosis will often:

  • Breathe fast
  • Have a fast heartbeat
  • Have a headache
  • Be confused
  • Feel weak
  • Feel tired
  • Have little desire to eat
  • Feel sick to their stomach
  • Throw up

Fruity-smelling breath (kasmaul breathing)is a classic symptom of diabetic ketoacidosis (DKA).

If you have these symptoms, call your doctor or visit the hospital immediately.  

Testing

Tests like anion gap, arterial blood gases and urine tests could help figure out if any of these acidosis occurs.

Prevention

You can’t always prevent metabolic acidosis, but there are things you can do to lessen the chance of it happening.

Drink plenty of water and non-alcoholic drinks, avoid fizzy drinks. Your pee should be clear or pale yellow.

Limit alcohol. It can increase acid buildup. It can also dehydrate you.

Manage your diabetes, make sure you adhere to drug use by physician and also diet regimen by dietitian.

Follow directions strictly when you take your medications and do not self medicate no matter how small and familiar the symptoms might be.

 

Treatment

You treat metabolic acidosis by treating what’s causing it. If you don’t restore the balance, it can affect your bones, muscles, and kidneys. In severe cases, it can cause shock or death. DKA can put you in a coma.

The earlier you’re treated, the better. Common treatments include:

  • Detoxification, if you have drug or alcohol poisoning
  • Insulin, if you have DKA
  • IV fluids, given by needle through a vein in your arm
  • Sodium bicarbonate, by IV

You might have to go to a hospital.

 

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Diet Trends: The ups and downs

DIET TRENDS

The previous year came with quite a handful of FAD diets, we don’t know what this year would bring us but lets take a review on those diets that got so much attention last year, shall we?

No carbs? No food? Which plans work best for weight loss and overall health

When it comes to diets and diet trends, the choices can be dizzying. With so many ways to lose weight, and so many online influencers and supplement peddlers out there, it’s hard to decipher which methods are healthy and actually work.

1. Ketogenic diet

The ketogenic diet is an extremely low-carbohydrate, high-fat diet. The goal of the diet is to maintain a state of ketosis, which means that by eating fewer carbs, the body’s fat-burning system relies mainly on fat instead of sugar for energy.

This concept is actually nothing new. There’s a lot of research, going back to the early 1900s, that ketogenic diets help with certain neurologic conditions like epilepsy in children. But it’s relatively a new strategy for weight loss.

Benefits

If your weight loss goals are more immediate, a ketogenic diet may be able to help you achieve those results. It’s been shown to be very effective for short-term weight loss — more so even than low-fat diets.
Additional benefits may include preventing certain types of chronic disease. There’s been some suggestion that there may be benefits as far as other brain disorders such as Parkinson’s disease, Alzheimer’s disease, multiple sclerosis and even brain cancer. No definitive studies to prove this yet though.

Setbacks

Some health experts believe eating a large amount of fat and protein from animal sources can increase your risk of heart disease and certain cancers.
On the ketogenic diet, you can, for instance, eat all the bacon, red meat and sausages you want; that obviously goes against what we’ve always known to be healthy, we have to be careful about the effect of this diet on people with liver, kidney and heart disease.
The diet is also really strict. It’s an extreme diet, cutting out almost all carbohydrates, which may in turn risk the gut microbiota. That means giving up or limiting conventionally healthy foods like fruit, whole grains and some vegetables which help keep the gut healthy.
Very low-carbohydrate diets may also be associated with more side effects than a low-fat diet, including headaches, fatigue and bad breath.

2. Whole30 diet
The Whole30 diet is a commercial diet marketed as a  30-day nutritional reset.; so they claim.
During those 30 days, you are to avoid sugar, alcohol, grains, legumes and dairy. The diet does permit meat, seafood, eggs, veggies, fruit, and natural fats like vegetable oils, coconut oil and tree nuts.

Benefits

What’s nice is that the Whole30 has a built-in support system on social media. That can be helpful for people who need to keep themselves accountable. Also, there’s no counting or restricting calories.

Setbacks

The company behind the Whole30 diet claims that it can improve or “cure” many medical problems, such as asthma, depression and Lyme disease, but the claims are unfounded; there’s no independent research to verify them.

3. Low-FODMAP diet

Some people are sensitive to certain carbohydrates that are poorly absorbed in the intestines and can cause bloating. These carbs are known as fermentable oligo, di, monosaccharides and polyols — or FODMAPs — and are found in certain grains, vegetables, fruits and dairy products.

A low-FODMAP diet is often recommended for people with irritable bowel syndrome (IBS), a common disorder that causes symptoms like cramping, abdominal pain, bloating, gas, and diarrhea and/or constipation.

Benefits

Studies demonstrate a definite improvement in IBS symptoms in people who use the low-FODMAP.
Many patients with IBS who have done really well on this diet and even go into remission has been recorded.

Setbacks

The low-FODMAP diet is not a weight loss diet. It’s really just for people with IBS.So the studies haven’t shown any benefit for people who don’t have IBS.
It’s also not very easy to follow because the list of low-FODMAP foods is not intuitive. For example, broccoli is a low-FODMAP food, and cauliflower is a high-FODMAP food. So you have to have the list of foods with you at all times.

4. Intermittent fasting diet (time-restrictive eating)
Intermittent fasting is a term for an eating pattern that cycles between periods of eating very little or nothing, and eating regular meals.

Some people intermittently fast for 16 hours a day and then eat all their food in an eight-hour time span; others fast for 24 hours at a time, maybe twice a week. This plan isn’t specific about which foods to eat, but rather when you should eat them.

Benefits

The intermittent fasting diet works well for people with busy schedules because it doesn’t really require planning.
It is quite easy to adhere to if you are very diligent; because it doesn’t restrict and food groups at all.

Setbacks

In a 2018 U.S. News & World Report article where 40 diets were ranked, intermittent fasting was one of the lowest on the list.
The criticism is mostly based on the fact that there’s no guide on what to eat during the nonfasting days. People could end up eating really unhealthily on those days; I had to speak to someone once, and he said he uses 2 sharwama and a bottle of coke to break his fast without putting into consideration the items in the shawarma and their calories.

This diet is also not recommended for people with diabetes because fasting could lead to low blood sugar that may require medication adjustment. People who have a history of eating disorders should also steer clear of this diet, and long-term compliance can be an issue as well.
Fad diets and going to extremes by cutting out major food groups — like carbs — simply aren’t sustainable strategies.

5. The Mediterranean diet

A Mediterranean diet emphasizes eating fruits, vegetables, whole grains, beans, nuts, olive oil and very little red meat.

Benefits

This diet was tied for No. 1 — along with the DASH diet below — for the best overall diet in 2018 by U.S. News & World Report in large part due to its many health benefits. Studies have shown reductions in fatal heart attacks, strokes, cancers, Parkinson’s and Alzheimer’s for people who follow a Mediterranean diet.

Setbacks

There are not any known health drawbacks. It should be noted with caution that some of the studies are short-term, and the exact reason for the health benefits is not clear.

6. The DASH diet

The DASH diet is designed to lower high blood pressure. The acronym in the name stands for Dietary Approaches to Stop Hypertension. It’s a diet rich in fruits, vegetables, legumes and low-fat dairy products, and low in snacks, sweets, meats, and saturated and total fat.

DASH also stresses limiting salt intake. Definitely, an intake of not more than 2,300 mg a day of salt, but ultimately you should strive to stay under 1,500 mg daily.

Benefits

Tied for No. 1 alongside the Mediterranean diet in U.S. News & World Report, a low-sodium DASH diet has been proven to decrease blood pressure. It also reportedly decreases LDL (“bad”) cholesterol, and possibly lowers the risk of stroke and heart disease.

Setbacks

Although the DASH diet was not developed specifically as a weight-loss diet, it may cause some weight loss (which could also be seen as a benefit). And some people might find that limiting salt makes food taste bland.
The good news is that there are plenty of other healthy options for flavoring, like herbs, spices and citrus juices.

7. The MIND diet

The MIND diet, which stands for the Mediterranean-DASH Intervention for Neurodegenerative Delay, developed at Rush University Medical Center, combines foods from the Mediterranean and DASH diets. It focuses on 10 food groups that support brain health, including leafy greens, berries, poultry, beans and nuts.

Benefits

The diet has been shown to benefit brain health and protect against dementia, according to a few studies.
In fact, the MIND diet can help lower the risk of Alzheimer’s disease by as much as 53 percent in people who adhere to the diet rigorously, and by about 35 percent in those who follow it moderately well.

It may also help substantially slow cognitive decline in stroke survivors, according to preliminary research presented at the American Stroke Association’s International Stroke Conference 2018.
Those are big reasons why MIND has been ranked No. 5 in U.S. News & World Report’s list of best diets for three consecutive years.
Setbacks

There aren’t any health risks with MIND, but like the Mediterranean diet, the food needed to follow the diet can be costly.
To diet or not to diet

Fad diets and going to extremes by cutting out major food groups — like carbs — simply aren’t sustainable strategies.
For long-term weight maintenance and overall health, you should adhere to the following sensible approaches to a healthy diet:
• Choose whole foods, such as whole grains, fruits and vegetables.
• Eat fewer processed or packaged foods, like hot dogs, chips or artificial sweeteners.
• Spend more time in the produce section of the grocery store rather than the packaged food aisles.
• Get more fiber, since the conventional diet is generally sorely lacking in fiber.
• Avoid foods with unrecognizable and unpronounceable words on the list of ingredients.
Diets are not one-size-fits-all, so what works for one person may not work for another. It’s best to figure out your individual weight loss goals and nutrition priorities by talking with your  registered dietitian.
And focus on making other lifestyle changes for yourself and your family, including getting plenty of sleep, exercising regularly and managing stress. All of those things will help not only with maintaining a healthy weight, but with your overall health and well-being with physical activity.

Really, the questions we should ask before embarking on any of these diets is if they are sustainable over a long period of time.

 

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CONSTIPATION:ALL YOU NEED TO KNOW

Constipation is broadly defined as an unsatisfactory defecation characterized by infrequent stools, difficult stool passage or both.

PHYSIOLOGY OF COLONIC FUNCTION
Water absorption
The colon receives approximately 1.5 L of liquid effluent daily from the small intestine, with 200 mL to 400 mL excreted in the stool. The functions of the colon are to absorb fluid from residual food and transport waste to the rectum, where it is expelled or stored until defecation is convenient.
The amount of fluid contained in a diet determines the state of one’s stool.
Removal of water from the fecal slurry is time dependent and actively regulated, and can be substantially increased in dehydration states. Sodium is actively reabsorbed from luminal content through several active transport channels, with water following passively in response to osmotic gradients. Conversely, colonic secretion is mediated through chloride channels (eg, cystic fibrosis transmembrane conductance regulator [CFTR]), which are generally quiescent, leading to a net reabsorption of electrolytes and fluid. Thus, stool that remains in the colon longer will become drier, which can lead to scybalation (pebble-like stools) and impaction if the stool becomes too large and hard to pass through the anal canal.

POOR DIET AND CONSTIPATION
If stool remains in the colon for too long, it could become dry and hard.
A diet that contains enough water and fiber would help moisten the faeces and make it easier to pass through the anorectal region.
Fiber-rich foods are generally made from plants. Fiber comes in soluble and insoluble forms. The soluble fiber can dissolve in water and creates a soft, gel-like material as it passes through the digestive system.
Insoluble fiber retains most of its structure as it goes through the digestive system. Both forms of fiber join with stool, increasing its weight and size while also softening it. This makes it easier to pass through the rectum.

Stress could also be a factor that would lead to constipation, other routines that would slow muscle contraction of the colon could also lead to hardening of stool.
Underlying medical problems
Possible medical conditions that could lead to constipation:
• certain diseases, such as stroke, Parkinson’s disease, and diabetes
• problems with the colon or rectum, including intestinal obstruction, irritable bowel syndrome (IBS), or diverticulosis
• overuse or misuse of laxatives (medications to loosen stools)
• hormonal problems, including an underactive thyroid gland

SIGNS OF CONSTIPATION
-An excruciating pain experienced while trying to defecate.
– bowel movements restricted to 3 per week.
-feeling of fullness after passing stool.
– passing hard dry stools.
– feeling like your rectal areas are blocked.

MANAGEMENT OF CONSTIPATION
– Drink more water. At least 3 litres per day.
– Add more fiber to your diet; either soluble or insoluble fibre. Examples include wheat, bran, dark green leafy vegetables, oats, seeds, some fruits with roughages.
– Do exercises.
– Eat probiotic and prebiotic containing foods or you can use their supplements. Examples of foods in this category include plain yoghurt, banana, onions and garlic.
– Over the counter drugs like bulking agents
– Try magnesium citrate
– Eat prunes: prunes contain the sugar alcohol sorbitol which has a laxative effect. About 7 pieces twice a day is recommended (50g).
Constipation could be uncomfortable for anyone, these home remedies suggested would really help get you relieved, but if symptoms persists, see your doctor (as every drug would indicate).

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DIVERTICULITIS AND DIVERTICULOSIS

DIVERTICULOSIS refers to the presence of small out-pouching(called diverticula) or sacs that can develop in the wall of the gastrointestinal tract.
• While diverticula can be present anywhere in the intestines, they are most common on the left side of the large intestine, the area known as the Descending and Sigmoid Colon.
When one or more of these pouches become inflamed or infected, the condition is called DIVERTICULITIS.

EPIDEMIOLOGY OF DIVERTICULAR DISEASES
• Diverticulosis is a common disorder, especially in older people.
• The condition is uncommon in people under the age of 30 years of age, and is most common in those over 60.
• Diverticulosis may be somewhat more common in men than in women.

CAUSES/PATOPHYSIOLOGY OF DIVERTICULAR DISEASE 
• No one knows for certain why diverticulosis develops; however, a few theories have been suggested;
• Some experts believe that abnormal intermittent high pressure in the colon due to muscle spasm or straining with stool may cause diverticula to form at weak spots in the colon wall.
• Historically, low-fibre diets were felt to play a ,major role in the development of diverticulosis. However, recent studies suggest that this is not only the case.

There also appears to be a genetic predisposition to diverticulosis; that is, if your parent or sibling has diverticulosis, you may be more likely to develop it than someone who does not have a family member with diverticulitis.

SYMPTOMS OF DIVERTICULAR DISEASES
• Most patients with diverticulosis have no symptoms or complications, and will never know they have the condition.
• But when symptoms occur they are usually mild and includes; Pain in the belly (abdomen), Bloating, Constipation (less often, diarrhoea) and Cramping.
• This symptoms are not specific to diverticulosis only they can be general to all diseases of the digestive tract.
Unless it is discovered during an endoscopic or radiographic (X-ray) examination, some people with diverticulosis become aware of the condition only when acute diverticulitis occurs.
• Diverticulitis is a more serious condition and causes symptoms in most people with the condition that include:
• Pain in the abdomen, usually in the lower left side
• Bleeding, bright red or maroon blood may appear in the stool, (a symptom of rectal bleeding). Bleeding is often mild and usually stops by itself; however, it can become severe.
• Fever
• Nausea
• Vomiting
• Chills
Constipation (less often, diarrhoea). d

DIAGNOSIS OF DIVERTICULAR DISEASES
• Diverticular disease is generally discovered through one of the following examinations:
• Barium enema: This x-ray test involves putting liquid material into the colon through a tube placed in the rectum. The x-ray image shows the outline of the colon, and can identify if diverticula, large polyps or growths are present.
• Colonoscopy: This test uses a thin, flexible tube with a light and camera to view the inside of the colon. Diverticula as well as polyps and other abnormalities can be seen with this instrument.
CT scan: This radiology test takes multiple cross-sectional pictures of the body. It is not generally performed to make a diagnosis of diverticulosis, but this type of exam, when done for other reasons, may identify diverticular.

MANAGEMENT OF DIVERTICIULAR DISEASES
• The best way to treat diverticulosis is to avoid constipation.
• Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre (25 – 38g/day).For patients with diarrhoea as symptoms a low fibre of 10-15g/day is prescribed for few days then gradually increased to RDA
• Drink plenty of fluids, because fluids and fibre work together.
• Get some exercise every day.
• Take a fibre supplement, such as Citrucel or Metamucil, every day if needed.
Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when you are having a bowel movement.

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EATING DISORDERS

In a society where every one seemingly feels like the best way to be fit is to be thin, adoption of different feeding patterns has led to malnutrition in so many individuals.

The term ‘eating disorder’ doesn’t only relate to food but also to complex mental health condition.

There are 6 types of disorders, their symptoms and management,  that would be highlighted in this article.

EATING DISORDERS

They are a group of mental disorder that are marked by an obsession with food or body shape. Mostly prevalent among young women.

This obsession however comes with heavy food restrictions, induced vomiting or stooling and extreme measures during workouts.

 

causes

Several factors might lead to the development of eating disorders; factors like personality traits, genetics (ongoing research with twins)

Other potential causes might include perceived pressures to be thin, cultural preferences for thinness, and exposure to media promoting such ideals i.e modelling agencies, influencers etc.

1. Anorexia nervosa: A very common eating disorder which makes people obsess about what they eat and their weight.

It is characterised by distorted body weight and an unwarranted fear of being overweight.

symptoms
Symptoms include trying to maintain a below-normal weight through starvation or too much exercise.

People may experience:
Whole body: dehydration, dizziness, fainting, fatigue, feeling cold, low blood pressure, low body temperature, osteoporosis, or water-electrolyte imbalance
Behavioural: binge eating, compulsive behaviour, hyperactivity, impulsivity, or social isolation
Weight: extreme weight loss and thinness, underweight, or weight loss
Mood: anxiety, apprehension, or guilt
Gastrointestinal: constipation or vomiting
Menstrual: absence of menstruation or irregular menstruation
Developmental: delayed puberty or slow growth
Also common: brittle nails, bruising, depression, dieting, dry hair, dry skin, headache, sensitivity to cold, or slow heart rate.
2. Bulimia nervosa: A potentially life-threatening eating disorder characterised by binge eating.
People may experience:
Behavioural: binge eating, compulsive behaviour, impulsivity, lack of restraint, self-harm, or vomiting after overeating
Whole body: dehydration, fatigue, food aversion, hunger, or water-electrolyte imbalance
Mood: anxiety, general discontent, guilt, or mood swings
Mouth: bad breath, dental cavities, or dryness
Gastrointestinal: constipation, heartburn, or inflamed oesophagus
Weight: body weight changes or weight loss
Menstrual: absence of menstruation or irregular menstruation
Also common: abnormality of taste, depression, poor self-esteem, or sore throat.
3. Binge eating: unlike the other two that involves restricted feeding patterns, this involves over eating and adopting compensatory measures as induced purging or vomiting.
Some individuals with BED might be obese and prone to have cardiovascular diseases.
The causes of BED might not be related to any underlying disease.
4. Pica: people with this disorder tend to eat things rhat are not consideredto be food.
Non food substances like chalk, cement, cornstarch, soap, paper, ice, nzu, uro.
Mostly common among young women and pregnant women.

5. Rumination Disorder:is another newly recognized eating disorder.

It describes a condition in which a person regurgitates food they have previously chewed and swallowed, re-chews it, and then either re-swallows it or spits it out.

This rumination typically occurs within the first 30 minutes after a meal. Unlike medical conditions like reflux, it’s voluntary.

This disorder can develop during infancy, childhood, or adulthood. In infants, it tends to develop between 3–12 months of age and often disappears on its own. Children and adults with the condition usually require therapy to resolve it.

If not resolved in infants, rumination disorder can result in weight loss and severe malnutrition that can be fatal.

Adults with this disorder may restrict the amount of food they eat, especially in public. This may lead them to lose weight and become underweigh.

6.Avoidant food/ restrictive intake : is a new name for an old disorder.

The term replaces what was known as a “feeding disorder of infancy and early childhood,” a diagnosis previously reserved for children under 7 years old.

Although ARFID generally develops during infancy or early childhood, it can persist into adulthood. What’s more, it’s equally common among men and women.

Individuals with this disorder experience disturbed eating either due to a lack of interest in eating or distaste for certain smells, tastes, colors, textures, or temperatures.

Common symptoms of ARFID include:

  • avoidance or restriction of food intake that prevents the person from eating sufficient calories or nutrients
  • eating habits that interfere with normal social functions, such as eating with others
  • weight loss or poor development for age and height
  • nutrient deficiencies or dependence on supplements or tube feeding

It’s important to note that ARFID goes beyond normal behaviors, such as picky eating in toddlers or lower food intake in older adults.

Moreover, it does not include the avoidance or restriction of foods due to lack of availability or religious or cultural practices.

other eating disorders

Includes purging disorder and night eating disorder.

management.

For anorexia nervosa, restoration of normal body weight with the help of a dietitian is adviseable.

For bulimia nervosa, management of any serious physical or health complications.

For binge eating, treating like both anorexia and bulimia and also focusing on psychotherapy.

conclusion 

Eating disorders pose a huge threat to the health of any individual that is involved. So therefore, its highly important you see a health provider; most likely a dietitian before starting any type of diet.

 

 

 

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General Research

Postprandrial somnolence

Most times we feel drowsy after eating some foods. This might occur as a result digestion patterns and sleep cycles. Some researchers has come up with theories as to why this happens; but they still agree it’s a natural response and not a cause for alarm.
Drowsiness after eating is due to an increase in energy levels which could be termed ‘postprandrial somnolence’.
Postprandial somnolence (colloquially known as the itis food coma, after dinner dip, or postprandial sleep) is a normal state of drowsiness following a meal (regardless of the time of the meal). Postprandial somnolence has two components: a general state of low energy related to activation of the parasympathetic nervous system in response to mass in the gastrointestinal tract, and a specific state of sleepiness. While there are numerous theories surrounding this behavior, such as decreased blood flow to the brain, neurohormonal modulation of sleep through digestive coupled signaling, or vagal stimulation, very few have been explicitly tested.
Physiology
Insulin, large neutral amino acids, and tryptophan
When foods with a high glycemic index are consumed, the carbohydrates in the food are more easily digested than low glycemic index foods. Hence, more glucose is available for absorption; and the more the glucose, the more the amount off insulin for absorption. Insulin stimulates the uptake of valine, leucine, and isoleucine into skeletal muscles, but not uptake of tryptophan. This however, lowers the ratio of these branched chain amino acids in the bloodstream relative to tryptophan (an aromatic amino acid), making tryptophan preferentially available to the large neutral amino acid transporter at the blood–brain barrier. Uptake of tryptophan by the brain thus increases. In the brain, tryptophan is converted to serotonin (the hormone responsible for moods and sleep cycles) which is then converted to melatonin. Increased brain serotonin and melatonin levels result in sleepiness.

Insulin-induced hypokalemia
Insulin also can cause postprandial somnolence via another mechanism. Insulin increases the activity of Na/K ATPase, causing increased movement of potassium into cells from the extracellular fluid. The large movement of potassium from the extracellular fluid can lead to a mild hypokalemic state. The effects of hypokalemia can include fatigue, muscle weakness, or paralysis.

Some health experts also suggests that food coma could be caused by a slight shift in blood flow away from the brain to the digestive organs. Eating helps activate the parasympathetic nervous system.
The PNS regulates certain processes in your body like slowing the heart rate and regulating blood pressure and digestion. The PNS is triggered when the stomach expands from accommodating a large meal. As a result of this, blood flow is directed to the working digestive organs and less to the brain. This slight diversion may cause you to feel drowsy and fatigued.

Why do people feel tired after eating?
Apart from the physiology explained above, a person may feel tired after eating due to what, when and how much the person consumes per sitting.
A large meal would obviously lead to a rush of insulin to help in absorption and moving of glucose to cells where they are needed.
A person’s circadian rhythm might affect how they feel after eating; well, that doesn’t mean calories know time.
The National Sleep Foundation reports that people naturally have a lull in energy 2.am and again at 2pm which might explain why you have to take a nap after lunch. Meal timing are very essential.

Remedy?
• Small but frequent meals are preferable to very heavy meals.
• Quality sleep matters.
• Light exercise after eating would help. A walk would do.
• Avoid drinking alcohol with meals.
• Do more of fluids.

 

Sources: https://www.medicalnewstoday.com/articles/323379.php#seeing-a-doctor

 

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Diet Therapy of Diseases

Gastroenteritis: All You Need to Know

Gastroenteritis is an inflammation/irritation of the gastrointestinal tract (the pathway responsible for digestion that includes the mouth, oesophagus, stomach, and intestines). Gastroenteritis is majorly caused by a viral or bacterial infection and not an influenza.
Who is at risk for gastroenteritis?
Anyone can get the disease. People who are at a higher risk include:
• Children in day-care
• Students living in dormitories
• Military personnel
• Travellers
People with immune systems that are weakened by disease or medications or not fully developed (i.e., infants) are usually affected most severely
What causes gastroenteritis?
As stated earlier, gastroenteritis can be caused by viral, bacterial, or parasitic infections. Viral gastroenteritis is contagious and is responsible for the majority of outbreaks in developed countries.
Common routes of infection include:
• Food (especially seafood)
• Contaminated water
• Contact with an infected person
• Unwashed hands
• Dirty utensils
In less developed countries, gastroenteritis is more often spread through contaminated food or water.
Actually, the most common cause of gastroenteritis is a virus. Many types of viruses can be responsible for the flu but the main types are rotavirus and norovirus.
Also, often times, bacteria such as E.coli and salmonella can also trigger the stomach flu.
Another bacteria, shigela, is often passed from one child to another in day-care centres; especially through contaminated food and water.
Another way to contact gastroenteritis is through parasite (very rare and uncommon) as giardia. You can pick them up from contaminated swimming pools.
Other unusual ways to get gastroenteritis are:
1. Heavy metals (arsenic, cadmium, lead, or mercury) in drinking water.
2. Eating a lot of acidic foods like citrus foods and tomatoes.
3. Medications such as antibiotics, antacids, laxatives, and chemotherapy drugs.
What are the symptoms of gastroenteritis?
The main symptom of gastroenteritis is diarrhea. When the colon (large intestine) becomes infected during gastroenteritis, it loses its ability to retain fluids, which causes the person’s faeces to become loose or watery. Other symptoms include:
• Abdominal pain or cramping
• Nausea
• Vomiting
• Fever
• Poor feeding (in infants)
• Unintentional weight loss (may be a sign of dehydration)
• Excessive sweating
• Clammy skin
• Muscle pain or joint stiffness
• Incontinence (loss of stool control)
Because of the symptoms of vomiting and diarrhea, people who have gastroenteritis can become dehydrated quickly. It is very important to watch for signs of dehydration, which include:
• Extreme thirst
• Urine that is darker in color, or less in amount
• Dry skin
• Dry mouth
• Sunken cheeks or eyes
• In infants, dry diapers (for more than 4-6 hours)

  1. Management of Gastroenteritis
    There are three ways to manage the stomach flu which are:
    • Palliative method
    • Medications
    • Dietary approach.
    palliative method:  involves fluid replacement, oral rehydration therapy, intravenous therapy.
    medications like antibiotics and antidiarrheal drugs are administered during gastroenteritis. Examples are loperamide hydrochloride, acetaminophen, zinc supplements
    Dietary approaches involves some restrictions like staying off tea and caffeine, staying of hot and spicy foods (bland diet), dairy foods, sugar, soda, gluten, artificial sweeteners. Some research suggests that the BRAT diet (banana, rice, applesauce and toast), could help in treating the stomach flu. Taking of probiotics (plain unsweetened yoghurt).
    Conclusion
    It is important to practise good hygiene in order to stay away from stomach flu; food safety is also of the essence. Make it a habit to always wash fruits and vegetables thoroughly before eating them, make sure you boil meats and other animal products very well before consumption, wash your hands during preparation of meals and after using the toilet.

Sources: https://my.clevelandclinic.org/health/diseases/12418-gastroenteritis
https://Medicinenet.com/stomachflu

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LifeStyle

Hypertension: alternate spices

19 natural salt alternatives

Herbs and spices

Every now and then, so many people get scared of the common table salt because it seemingly is a dreaded name when it comes to heart problems.

There are better options which alternate the sodium chloride with potassium chloride; but this alternatives might also pose a huge threat on the kidneys when abused.

Salt (whether potassium or sodium) isn’t bad; but the right balance between minerals is really important.

The right levels of sodium helps your muscles contract. They also help regulate fluid levels to prevent dehydration.

Adequate amount of potassium helps coordinate normal heart rythms.

Herbs and spices are the healthy go-to nowadays when it comes to seasoning foods; both local and intercontinental.

Lets take a look at a list of  preferably healthier alternatives when it comes to seasoning.

1. Mint leaves

It has a bit of the menthol feel in the mouth.

  • Uses: Great in salads, on pasta or in couscous. It’s tasty with carrots, peas or broad beans.
  • Could also be used in smoothies.

2. Rosemary

  • Rosemary
  • Taste: An aromatic herb with a pine-like fragrance. Use sparingly; it can overpower other flavours.
  • Preparation: Roast whole sprigs with root vegetables (carrot, parsnip, sweet potato). If using dried rosemary, crush it first.
  • Uses: Add to roast or grilled meats, bread, homemade pizza, tomato sauce, beans, potatoes or egg dishes.

3. Nutmeg

  • NutmegTaste: Sweet and pungent flavour. Works well in baked foods with cinnamon and cloves.
  • Preparation: Freshly grated nutmeg has a much better flavour than ground.
  • Uses: Add nutmeg with black pepper to homemade white and cheese sauces. It also adds warmth and flavour to homemade potato, cabbage and cauliflower soups.
  • Could also be added to your local jollof rice.

4. Basil

  • BasilTaste: Sweet and peppery.
  • Preparation: Fresh basil retains more flavour and aroma than dried.
  • Uses: Basil is traditionally used in Mediterranean cooking, in tomato-based pasta sauces, pizzas and bolognese. Use lemon, Thai and holy basil in South Asian and Thai dishes.

5. Cardamon

  • Cardamon
  • Taste: A warm, aromatic spice.
  • Preparation: Add whole cardamom pods to your dishes or use the seeds inside, either whole or ground.
  • Uses: Commonly added to Asian spice mixes and curry pastes. Cardamom also works well in baked goods and sweet breads, with cloves and cinnamon, for a taste of Scandinavia.

6. Chilli/Cayenne

  • ChilliTaste: Chillis vary quite a lot in strength, so add a little at first and taste your dish. Cayenne is a specific type of chilli.
  • Preparation: Chilli can be bought whole (fresh or dried), as dried flakes, powder, or as hot sauce. Chilli sauce may be high in salt (or sugar in the case of sweet chilli sauce), so stick to powder, flakes or whole chillies.
  • Uses: It works well in most dishes, including vegetable or seafood stews or vegetable soup. Please don’t add too much of this pepper😢 so it wont end in tears.

7. Cinnamon

  • CinnamonTaste: Mostly used in sweet treats like cake and apple crumble, but works with savoury dishes too.
  • Preparation: Sold as cinnamon sticks (grate or add whole to dishes like curries or stews) or ground.
  • Uses: Cinnamon is an important spice in Turkish and Middle Eastern cooking, where it is used to flavour chicken and lamb dishes. Use it to deepen the flavour of cottage pie, curries, tagines, casseroles, roast vegetables, bolognese sauce or stewed fruit.

8. Chives

9. Coriander

  • CorianderTaste: Coriander leaves have a distinct earthy and lemony flavour, while coriander seeds have a warm, spicy, citrus flavour when crushed.
  • Preparation: Use coriander leaves raw or add to foods at the end of cooking. Coriander seeds are commonly used in Indian dishes. Fry them in a dry pan and add them whole or crushed.
  • Uses: Add coriander leaves to salads, soups (eg carrot and coriander soup), salsas, curries and fish and chicken dishes, or combine it with lime and chilli in stir fries.

10. Dill

  • DillTaste: Dill has a strong taste, often compared to fennel, star anise and celery.
  • Preparation: Use fresh rather than dried if possible – use the leaves only and discard the stem.
  • Uses: Popular in Russian, Eastern European, Greek and Scandinavian cooking, dill is a welcome addition to cottage cheese, low-fat cream cheese, omelettes, seafood, steak, potato salad and cucumber dishes. Try adding dill to broad beans and rice and serve with koftas (made from lean minced meat), as found in Iranian cooking.

11. Cumin

  • CuminTaste: Earthy and smoky.
  • Preparation: Fresh cumin seeds, dry roasted and then ground, provide a richer flavour than cumin powder.
  • Uses: After black pepper, cumin is the most-used spice worldwide. Goes well with indian and Mexican dishes.

12. Ginger

  • GingerTaste: Peppery, lemony and slightly sweet, with a sharp aroma.
  • Preparation: Buy ground or fresh (as a ginger root, which can then be chopped or grated).
  • Uses: Ginger enhances sweet and savoury dishes. Fresh ginger can be grated into stir fries and curries during cooking, or sprinkled over meat before baking or barbecuing.

13. Oregano

  • OreganoTaste: Oregano has a warm, aromatic, slightly bitter taste and a potent aroma.
  • Preparation: Fresh oregano leaves can be chopped into foods or added whole.
  • Uses: Popular in Greek and Mediterranean cooking. Use it to marinate meats, poultry and seafood before grilling, in egg dishes, breads, casseroles and salads. It’s also great in spaghetti bolognese and tomato salsas.

14. Paprika

  • PaprikaTaste: Paprika is milder and sweeter than cayenne pepper.
  • Preparation: Available as a red powder made from ground sweet and hot dried peppers.
  • Uses: For a Hungarian twist, team paprika with caraway, coriander, cinnamon and dill. Combine with garlic for a Spanish flavour. Paprika goes well with lamb, chicken and fish dishes, on baked sweet potato wedges, or in beans or scrambled egg.

15. Parsley

16. Sage

  • SageTaste: From the Mediterranean coast, sage is like rosemary, with more lemon and eucalyptus.
  • Preparation: Best used fresh and in small amounts. Unlike some herbs, sage does not lose its flavour with prolonged cooking.
  • Uses: Sage is traditional in Italian and French cooking, added to meats, poultry and stuffing, and is often chopped and stirred into pasta and gnocchi.

17. Tarragon

  • TarragonTaste: Adds a distinctive, bittersweet liquorice-like flavour to foods, and has an aroma similar to star anise.
  • Preparation: Tarragon should be added near the end of cooking time, as heat reduces its flavour.
  • Uses: Native to Siberia and western Asia, tarragon is a key herb in French cooking. It goes well with poultry, fish, egg dishes, beef and vegetable soups. It can also be added to salad dressings.

18. Thyme

  • Thyme
  • Taste: A strong earthy, slightly minty flavour with a subtle aroma. Lemon thyme is another variety and goes well in soups and vegetable dishes.
  • Preparation: Depending on the variety you’re using, thyme can be finely chopped or added as a whole sprig. Unlike most herbs, thyme needs a long cooking time to release its full flavour.
  • Thyme:Thyme works well with other herbs like rosemary, parsley, sage, savoury and oregano. It can flavour most meats, including chicken and game (as a marinade or in a sauce) and is a tasty addition to roast vegetables. Pair thyme with paprika, oregano and cayenne pepper for Cajun cuisine, and with cinnamon, nutmeg and cayenne pepper for Caribbean meals.

19. Turmeric

  • TurmericTaste: Has a distinctive yellow colour so is sometimes used as a cheaper alternative to saffron, although it tastes quite different.
  • Preparation: Turmeric is an ingredient of curry powder and is in many South Asian dishes.
  • Uses: For a hint of North Africa, use turmeric
  • with ginger in meat and vegetable dishes, or flavour rice with it. A little turmeric goes a long way; as it cooks, its flavour intensifies.

It’s really a healthier option to stick to these herbs and spices whenever you’re cooking because they really don’t pose any health threats as they are natural.

A pinch of salt, with any of these herbs would still bring out the savoury taste of any local or intercontinental dish.

 

Source: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/herbs-and-spices

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LifeStyle

Lemon and water: myths debunked

Lemon water might not be the magical drink that some make it out to be.

Even though the duo could be a  pretty great alternative to sugary sodas, juices, and energy drinks, many high claims about its accelerated weight loss or boosting liver function are exaggerated at best and inaccurate at worst.

Lets see these six myths about the benefits of lemon water that just aren’t true.

Shall we?

MYTH 1: Lemon water will help speed up your weight loss efforts.

Some funny roadside nutritionist and social media influencers claim water with lemon is the secret to speeding up your weight loss process, but these claims are often inflated.

The bitter truth is that; the duo of lemon and water wont help speed up weight loss.

Lemons contain a fibre called pectin; this fibre  can help you feel full and satisfied without additional calories. By squeezing a medium sized lemon into your water,  only trace amounts of this fiber – (which mostly exists in the rind and  not the juice) remains – thus doing little to nothing for your satiety levels.

MYTH 2: It helps “wake up” your digestive system.

Staying hydrated with  3-3.5 litres of water daily is what your digestive system needs;  adding lemon won’t make a huge difference. I’m sorry to burst your bubbles.

Water helps break down food particles in our system making it easy for digestion and action of enzymes.

Although the lemon could add some flavor or zest to your drink, plain water could essentially provide the same digestive benefits.

Adding lemon to your water should be because you find plain water boring.

MYTH 3: It cleanses or “detoxifies” your body.

If you’re hoping that lemon would help detoxify your system when you add them to your diet, maybe you should rethink because, there’s really no need for that.

“This claim really does not have any scientific back up so i wonder why people really embark on it at all. According to a research, lemon water might even deprive you of some nutrients.

In most cases, your body handles its detoxification process so far as your internal organs are in right working conditions.

MYTH 4: Lemon water will help balance your pH levels.

You got to be kidding me now.

Well, the pH level of your body determines the proper functioning of your liver and kidneys; but adding lemon water to your diet has no significant role in balancing the pH of your body really.

According to Web MD, “Nothing you eat is going to substantially change the pH of your blood. Your body works to keep that level constant”

MYTH 5: It will boost your metabolism.

Lemon water doesn’t actually have much of an impact on your metabolism.

Your body’s metabolism rate wont be doubled or tripled simply because you added lemon to your diet.

Theories that back up metabolism boosting effects are really exaggerated because its a very temporary one.

MYTH 6: Lemon juice will help your skin look younger.

Lemon water contains vitamin C, which can serve as a natural skin brightener and can help to rid skin of antioxidants and damage.

But you’d likely have to drink a lot of lemon water to reap these benefits in any measurable way. Lemons contain the most vitamin C in their peel, which typically isn’t what you drink. You’d actually get more vitamin C from freshly squeezed orange juice.

Myth 7: lemon water would help against skin acne

According to an interview by insider with board-certified dermatologist Dhaval G. Bhanusali, MD,  you can develop a rash called phytophotodermatitis when lemon water is applied to the skin and it is then exposed to direct sunlight.

I hope this changes your perspective.

 

Source: https://www.google.com/amp/s/amp.insider.com/does-drinking-lemon-water-really-work-2018-11

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