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Diet Therapy of DiseasesGeneral Research

NUTRITION INTERVENTIONS IN SICKLE CELL ANAEMIA

 

Sickle cell disease is an inherited blood disorder where red blood cells that carry oxygen assume a totally different shape from the normal. Normally, red blood cells assume a disc shape while flowing through blood vessels, but in sickle cell anemia, red blood cells assume a crescent like shape.

Devastating as the disease might be, no cure has been found yet.

Interestingly, through research and a bid to increase knowledge, it has been found out that nutritional problems are fundamental to the severity of the disease, thereby increasing interests to promote dietary supplementation for decreasing morbidity and to help improve the quality of patient’s life.
Several methods of treatment and management have been in use for quite a while now and they include:

MANAGEMENT OPTIONS
-Hydroxycarbamide (or hydroxyurea) This substance helps to reduce the number of painful episodes in Hbss patients.
-Blood transfusion: A number of observational and randomised controlled trials have established the pivotal role of transfusion therapy in the management of SCD, most notably in primary stroke prevention.
-Allogeneic HSCT and gene therapy: Allogeneic haemopoietic stem cell transplant (HSCT) is the only curative treatment for SCD and is successful in 85%–90% of patients. Transplantation offers disease-free survival and stabilisation of neurological lesions.
Features as growth retardation, impaired immune function, and delayed menarche do suggest a relationship between sickle cell disease and undernutrition. Also, a variety of micronutrient deficiency has been suggested in sickle cell disease.
– Several reports indicate that vitamin E levels are low in sickle erythrocytes. Since these abnormal red cells both generate excessive oxidation products and are more sensitive to oxidant stress, supplementation with vitamin E is advised in people with sickle cell anaemia.
– Complications of sickle cell disease as poor ulcer healing, growth retardation, delays in sexual development, immune deficiencies have been linked to zinc deficiency. It is also pertinent that zinc be supplemented in people with sickle cell.
– Deficiency of Vitamin D is common in sickle cell disease due to dark skin pigmentation, limited sun exposure, increased catabolism and decreased nutrient and energy intake. Vitamin D in it’s entirety is crucial for calcium homeostasis and essential for bone mineralization.

Therefore, a high dose of 100,000 International units (IU) (equivalent to 3,333 IU/day) versus the standard treatment 12,000 IU (equivalent to 400 IU/day) of oral vitamin D3 supplements might just help in reducing risk of respiratory infections.
– Amino acids like arginine and glutamine also play important roles in the synthesis of nitric oxide. Nitric oxide makes it possible for easy blood flow by dilating the blood vessels properly. Increased deficiency of the duo might lead to metabolic stress, increased resting energy expenditure (REE), muscle wasting and decreased immune function. Supplementing with 600mg/kg/day of glutamine showed improved nutritional status of glutamine.

EMERGING INTERVENTIONS
Recently, derivatives from plants has been studied to show their effects in treating people with SCD. Some plants which contain peculiar antioxidants are being studied and there might just be hope to managing SCD.
Exploration of extracts from Moringa oleifera (Moringa), Cajanus cajan (pigeon pea) , Zanthoxylum zanthoxyloides (artar root), and Carica papaya (paw paw) are all being studied to see their possible effects in treating oxidative stress in SCD patients.
With these ongoing experiments, it has been noticed that extracts from these plants could aid in the resistance of hemolysis and reduce the number of sickled red blood cells.

Also, it has been noticed that exercise might play an important role in SCD patients. Exercise helps in reducing oxidative stress and also in the release of nitric oxide which helps in the proper flow of blood through vessels.

CONCLUSION
The nutritional risks faced by SCD patients are usually high and mostly unnoticed. Its imperative to include nutrition as an adjuvant therapy for addressing chronic diseases related with SCD in order to aid effective management.

SOURCES: https://pubmed.ncbi.nlm.nih.gov/3551592/
https://www.dovepress.com/nutrition-in-sickle-cell-disease-recent-insights-peer-reviewed-fulltext-article-NDS
https://www.health.harvard.edu/a_to_z/sickle-cell-anemia-a-to-z
https://adc.bmj.com/content/100/1/48
https://www.todaysdietitian.com/news/042412_news.shtml

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Uncategorized

CONSTIPATION IN INFANTS: HOW TO CURB IT

It’s really very worrisome when baby stops or has trouble pooping. You get all worked especially when you’ve been expecting for some days and still ”No show”.
It’s important to note that bowel habits are unique from person to person and there is a wide range of “normal”. Also, there is always a change in bowel habits during the period of transition from only liquids to solid diet.
There are signs to watch out for before finalizing that your baby is constipated and they include:
– Pooping reduces to less than 3 times weekly
– Large poops difficult to pass (usually comes with discomfort and pain)
– Small dry and pellet like stools
– Baby releases gas more often than normal
– A poor appetite that reduces after the pooping

WHY DO BABIES GET CONSTIPATED?
Constipation in infants could be caused by different factors; either the type of food or because of a particular illness.
Factors like diet, certain medications, prematurity and illnesses leads to constipation in Infants.
Exclusively formula-fed babies are much more likely to have trouble from constipation. Formula can firm up poop much more than breast milk can.

DIET: The introduction of cow’s milk protein—and an allergy or intolerance to it—is probably the largest contributor to baby constipation. Almost always, a shift or change from liquid to solid foods, from breast milk to formula, or from transitioning to cows milk is the major cause of constipation in babies. When a child’s body sees milk protein as an enemy to fight against due to allergy, this also leads to constipation.

CERTAIN MEDICATIONS: High dose of iron supplements could lead to constipation. Make sure you are following your doctors prescription strictly.

ILLNESS: When the baby is down with illness, it affects the way they eat and drink. This could throw things out of proportion and cause constipation.

PREMATURITY: Premature babies tend to have more trouble with infant constipation than full-term babies. Since their digestive systems aren’t fully developed yet, food moves slower through the GI track and isn’t properly processed, which leads to dry, hard stools.

FAMILY HISTORY : Certain issues like Hirschsprung’s disease, cystic fibrosis, chronic constipation and celiac disease (which often can’t be diagnosed in children until they’re closer to age 3) can all also increase the likelihood of baby constipation.

HOW OFTEN SHOULD MY BABY POOP?
To figure out if your child has a bout of baby constipation, it’s helpful to know how often babies tend to produce stool. From newborn to 3 months, a breastfed baby might have anywhere from 5 to 40 bowel movements a week (3-4 daily). At 6 to 12 months, both formula-fed and breastfed babies will go down to 5 to 28 bowel movements a week
Frequency sometimes might not be the right clue for suspecting constipation but if it is hard to pass.

HOW DO I COMBAT CONSTIPATION?
No parent likes to see their child in discomfort, especially the one that comes with constipation. So here are some remedies to handle constipation:
– To arrest/prevent constipation, for babies from 6-12 months who are constipated, you can give apple or prune juice (2-4 ounces), sometimes, you might have to eliminate cows milk.
– Also, a change in diet for the mom or change in formula could help improve on constipation and increase water intake.
For babies eating solids, you can also offer certain foods to combat baby constipation. Try feeding:
– barley or oatmeal cereals,
– prunes,
– peaches,
– plums,
– apricots,
– chia seeds,
– pears
– yoghurt, and
– most vegetables.

If you’re worried about constipation, you should eliminate banana and rice as both are binding agents.
As for preventing constipation, there is really little/ or nothing you can do. Make sure you consult with a pediatrician and dietitian before trying a baby constipation remedy.
SOURCE: https://www.thebump.com/a/baby-constipation-signs-causes-remedies
https://www.parents.com/baby/health/constipation/constipation-in-babies-signs-causes-and-cures/

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Women’s Health

IS DIET HELPFUL IN ENDOMETRIOSIS?

Endometriosis occurs when non-cancerous tissues that resemble the ones lining your uterus , begin to grow outside of the uterus in places like the ovaries, the fallopian tube, pelvis and bowel. 

It is a hormone dependent type of condition (especially steroid based hormone estrogen).

The tissues in the uterus becomes  thicker than normal, breaks down and leave the body during menstruation, but these tissues that grow outside of the uterus also thicken and break down but cant leave the body thereby leading to pain, inflammation, formation of scar tissue and most likely, potential fertility problems. 

According to a study, about 70 million women all over the world  are affected by endometriosis. Surprisingly, the disease is even more common than breast cancer and diabetes.

Endometriosis usually occurs during active menstruation when there is still much release of estrogen (i.e it is hormone dependent), it rarely occurs after menstruation. 

WHAT ARE THE SYMPTOMS? 

Symptoms always vary from one woman to another, might come in as mild or moderate or severe.

The degree of pain doesn’t always equate the severity of the condition; you might have very excruciating pains and it’s a mild condition. 

Symptoms involved in endometriosis include: 

  • excruciating pains during period
  • pain experienced in the lower abdomen and back either before or during menstruation 
  • cramps around menstruation week
  • heavy bleeding 
  • infertility problems 
  • pain after sexual intercourse
  • Diarrhea or constipation 
  • Bloating 

WHAT EXACTLY CAUSES ENDOMETRIOSIS? 

The etiology behind endometriosis is not known yet, but according to some theories put forward, these suggested causes might be linked to the condition: 

  • Genetics: the condition most likely runs in families and affects people of some ethnic groups more
  • Retrograde menstruation: this happens when some of the womb lining flows up back through the fallopian tubes and hangs on to some organs of the pelvis instead of leaving the body as period.
  • When the immune system is malfunctioning 

These suggested theories don’t fully explain the causes of endometriosis; it is a condition caused by many factors put together.  

RISK FACTORS 

Some other factors include: 

  • AGE: usually affects women from the ages of 25-40, symptoms can be seen from puberty though. 
  • FAMILY HISTORY
  • PREGNANCY HISTORY: pregnancy might have the tendency of decreasing the risk of endometriosis, those who haven’t had children might have higher risks of endometriosis.
  • MENSTRUATION HISTORY:  issues associated with this can include shorter cycles, heavier and longer periods and might place the individual at higher risks. 

HOW CAN I PREVENT ENDOMETRIOSIS?

Sadly, there is no known way to prevent endometriosis. The possible ways are to create awareness, ensure early diagnosis and management to help slow down or halt the natural progression of the disease. 

HOW IS IT DIAGNOSED? 

Endometriosis can be suspected from history; tender masses might be visible on the vagina and cervix during pelvic examination. 

TREATMENT OPTIONS 

Even though there is no known treatment option for endometriosis, it can be managed to help reduce symptoms. Possible ways to help manage endometriosis includes: 

  • nutritional therapy
  • exercise
  • pain medication
  • hormone therapy
  • surgery

These options totally depend on the severity of the condition. 

HOW ENDOMETRIOSIS MAY BE LINKED TO DIET 

Diet may have a potential role in the cause of endometriosis through its influence on hormones derived from cholesterol. Hormones like oestrogen which are cholesterol based are the major culprit in endometriosis. So, studies have shown that a plant-based and high fibre diet increase oestrogen secretion and reduce the availability of oestrogen, and this might help reduce endometriosis progression. This diet would help to modify the risk of endometriosis by altering the metabolism of cholesterol based hormones. 

FOODS THAT MAY NEGATIVELY AFFECT ENDOMETRIOSIS 

Endometriosis can be influenced by your lifestyle, and this determines the severity of the condition and the pain experienced. 

The following factors might negatively influence the condition: 

  • High intake of transfat : research has it that women who consumed high amounts of transfat especially from fried and processed foods had a higher rate of diagnoses. 
  • Red meat consumption
  • Gluten: A study showed that most women experienced a decreased pain while they went on a gluten free diet
  • High FODMAP diet: low FODMAP diets are majorly prescribed to people who has irritable bowel syndrome (IBS). A research found out that those with IBS and endometriosis that followed a low FODMAP diet had reduced symptoms

Alcohol, caffeine, gluten, red meat, saturated and trans fat can negatively affect hormone regulation in people with endometriosis as they lead to progression of the disorder. So, they should be totally avoided 

FOODS THAT MAY POSITIVELY AFFECT ENDOMETRIOSIS 

A nutrient dense and well adequate diet can help to reduce symptoms from endometriosis. you should consider: 

  • A high fibre diet: a diet high in fibre helps reduce the production of oestrogen which is implicated in the mechanism of endometriosis, and also helps to reduce insulin production, which relates to the progression of endometriosis. foods high in fibre includes green leafy vegetables, legumes and whole grains. 
  • iron-rich foods, such as dark leafy greens, broccoli, beans, fortified grains, nuts, and seeds
  • foods rich in essential fatty acids, such as salmon, sardines, walnuts, chia, and flax seeds
  • antioxidant-rich foods found in colorful fruits and vegetables, such as oranges, berries, dark chocolate, spinach, and beets. Studies has linked oxidative stress to the progression of the disease, so its important to also consider these antioxidant rich food sources. 

SUPPLEMENTS ALSO HAVE A ROLE TO PLAY

Apart from an adequate diet, nutritional supplements also have unique roles to play while managing endometriosis. 

For example, supplementing with 1200 IU of vitamin E and 1000 IU of vitamin C was shown to reduce pelvic pain in some women with endometriosis after a clinical trial. 

Also, curcumin, vitamins A and D proved to help in the management of endometriosis

EXERCISE AND OTHER ALTERNATIVES 

 Exercise could help to manage endometriosis as it reduces the production of estrogen and helps in the release of serotonin “the feel good hormone”. Some relaxation techniques can be explored

  • meditation
  • yoga
  • accupunture
  • massage

SUMMARY 

Lifestyle changes and dietary patterns could help to reduce the symptoms associated with endometriosis, you can speak to a dietitian and a doctor to help you through this condition as everyone’s body’s are different and should be handled individually.

 

SOURCES

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941414/
  2. https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342065/all/Endometriosis
  3. Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med 2020; 382:1244-56.
  4. Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 2019(4):354-64.
  5. https://www.researchgate.net/publication/247770015_Diet_-_A_New_Approach_To_Treating_Endometriosis_-_What_Is_The_Evidence
  6. Harris, H. R., Chavarro, J. E., Malspeis, S., Willett, W. C., & Missmer, S. A. (2013). Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study. American Journal Of Epidemiology, 177(5), 420-430.
  7. Missmer, S. A., Chavarro, J. E., Malspeis, S., Bertone-Johnson, E. R., Hornstein, M. D., Spiegelman, D.,  Hankinson, S. E. (2010). 
  8. A prospective study of dietary fat consumption and endometriosis risk. Hum Reprod, 25(6), 1528-1535.

 

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General Research

ALOPECIA

Almost 60% of all women experience hair loss when they approach age 60 and this could lead to low self-esteem, increased stress levels, and increased psychological distress.

Only about 50% of all women maintain a full hair through their life span. Hair loss in women total presents itself differently from men; women lose the volume of their hair due to thinning while men lose it due bald patches or receding hairline.

This article would help to investigate the possible the impacts of nutrition and lifestyle on acute and chronic hair loss in women.

So many factors put together or individually could actually lead to hair loss, and this most times makes it a very challenging situation. Age, weight loss, genetics, diet, stress, medications, illness, ethnicity, hair styles, and the use of hair styling tools and cosmetics all contribute to hair growth and equally loss.

According to the American Academy of Dermatology, typical daily hair loss is between 50 to 100 strands. Any amount higher than this is clinically termed telogen effluvium. Sometimes, excessive hair shedding can be last for a short while (less than four months) following a state of stress or trauma, and might increase in its span, but might return to the normal hair growth cycle. Anagen effluvium is a totally different phenomenon which occurs when hair stops growing.

Hair loss is totally different than hair thinning when you consider their biological processes. Hair loss in women start initially from the middle part with an overall thinning of hair follicles. This phenomenon makes it hard to hide the loss.

Other factors also cumulatively affect the process of hair loss and they include weather conditions, humidity, ultraviolet rays and wind. These factors put together, can decrease hair density, growth, and texture. “White and Asian women are more susceptible to damage from weathering, while African Americans are more prone to damage from styling methods, chemical relaxers, and other products”

WHAT ARE THE STAGES OF HAIR GROWTH?
There are 3 stages of hair growth and each strand of hair has a particular timeline it follows. The stages are:
The anagen, or growth, cycle: lasts 2-8 years
-The catagen, or transition/regression, cycle: lasts 4-6 weeks and hair stops growing at this phase
-The telogen, or rest, cycle: hair falls out in this stage and it lasts 2-3 months
On average, 80% to 90% of hair is in the anagen phase at any given time, with 1% to 2% in the catagen phase, and the remaining 10% to 20% in the telogen phase.
The growth can be influenced by both chronologic aging (related to genetics and other fixed variables) and biologic aging, which is affected by diet quality and dietary patterns.

The type of hair loss experienced by any woman can be ascertained by cross-examining the dietary history, medical history, and performing a physical examination on the hair and scalp. To accomplish this, a team comprising a dietitian, primary care physician, and hair care specialist would be involved

CAN I INCREASE THE INTIAL STAGE (ANAGEN)?
How long the anagen stage lasts totally depends on how long your hair is and the ability for you’re the cells at the base of your follicle to multiply and become hair cells.
Research is still ongoing on ways to “switch on” the anagen stage, but until then, there are ways which can help promote healthy hair growth during the anagen stage.
Your hair is made of keratin and dead skin cells. Although there might not be any direct ways to help hair grow rapidly, your dietary choice can help it grow in a healthy way.
These ways would help to make your hair healthy and probably last longer:

1. DIET: an inadequate intake of nutrients affects hair loss. Your choices pertaining to diet can totally determine the strength, quality and health of your hair.
Paying attention to your diet would go a long way to ensuring healthy hair growth.
Vitamins like vitamin B5 and biotin, vitamin D and C, iron, zinc, omega 3 and 6 are important to maintain a healthy hair.
An adequate diet with a variety of proteins, vitamins, and minerals supports the metabolic functions necessary to support hair growth and prevents every possible deficiencies relate with loss or thinning

2. ESSENTIAL OILS: applying essential oils to the scalp could benefit hair growth. Studies show that pumpkin seed increases hair count for men with hair loss by 40 percent. Oils like jojoba oil, peppermint oil and rosemary oil also have their benefits.

3. TOPICAL OINTMENTS: this could be beneficial especially for people with alopecia. A list of ointments that could influence hair growth/loss includes:
– topical melatonin reduces hair loss and increases hair density
– topical minoxidil 5% slows hair loss
– Propecia
– ketoconazole shampoo

4. TRY KETATIN SUPPLEMENTS: there aren’t much studies to support this but One study looked at a product that had 500 milligrams of keratin and other vitamins and minerals. The group that took the supplement showed:
• 12.5 percent reduction in hair loss
• 5.9 percent improved in hair strength
• improved hair brightness and luster

5. USE PROTEINS: Protein helps with hair growth and could prtect the hair from environmental and chemical damage. Taking the right amounts of protein is paramount for any bodily growth process. Ensure to incorporate both from plant and animal sources.

6. CAFFEINATE YOUR HAIR: Studies are still new on the effects of caffeine on hair growth, but a cell studyTrusted Source found that caffeine may have growth-promoting effects on hair. Trying out products with caffeine might just help.

ARE THERE CONDITIONS RELATED TO HAIR LOSS?
oh surely, there are some conditions that supports rapid hair loss especially in women
Hair loss, especially alopecia, is linked to several disease states and endocrine disorders. This section examines hair loss’ relationship with metabolic syndrome, hypothyroidism, type 2 diabetes, and polycystic ovarian syndrome (PCOS).

Dietary Implications
Either directly or indirectly, nutrition plays an important role in hair loss or growth. Some nutrients supports the very process involved in hair growth.Common nutrient deficiencies that affect hair growth include iron and vitamins A, B, and D.1 Zinc, selenium, and biotin also are associated with hair loss in patients with low serum values of these minerals.

Iron
The role iron plays in hair loss is totally complex and not fully understood, but one theory is that it regulates many of the genes present in hair follicles.
Iron can either be heme or non heme and could be found in a variety of foods ranging from vegetables, to beef and fortified foods. For better absorption by the body, ensure to take with vitamin c sources.

Vitamin A
Vitamin A is functions entails stimulating the growth of hair follicle stem cells. Commonly consumed sources of vitamin A include fortified cereals with skim milk, eggs, and dark green, orange, or yellow produce rich in beta-carotene.

Vitamin D
Vitamin D is the primary nutrient involved in the growth phase of the hair follicle and affects the cells that form the outer root sheath.11 Rodent studies have indicated a potential link between rickets—a form of vitamin D deficiency—and hair loss, and these results were replicated in a study conducted involving women with either telogen effluvium or FPHL. Topical application of a solution containing vitamin D (calcipotriol) for three months resulted in full hair regrowth and no loss at six months in a 7-year-old boy with alopecia areata.

Zinc
Zinc deficiency has been linked to telogen effluvium and changes in hair structure, but a reversal is possible with adequate dietary consumption. Animal proteins, particularly oysters, red meat, and poultry, as well as a few plant foods such as fortified cereal and baked beans, are good to excellent sources of dietary

zinc.
In a study published in Annals of Dermatology, serum zinc was compared in four different hair loss patient groups: alopecia areata (44 men, 50 women); male pattern hair loss (84 men, 0 women); FPHL (0 men, 77 women); and telogen effluvium (11 men, 36 women). All four groups were compared with a control group of 32 healthy individuals not suffering from hair loss (14 men, 18 women). Mean serum zinc concentrations across all four hair loss groups was 84.33 ± 22.88 mcg/dL, while the control group exhibited a significantly higher zinc value of 97.94 ± 21.05 mcg/dL. When directly compared, the alopecia areata and telogen effluvium groups had the lowest zinc concentrations.

Selenium
Selenium helps in the formation of hair follicles and protection against damage; deficiency is not very common in healthy adults living in developed countries. More research is needed.

Fatty Acids
An absence of omega-3 and omega-6 fatty acids in the diet or an inadequate intake of them is associated with hair loss both from the scalp and eyebrows and lightening of hair color. Consumption of dietary polyunsaturated fatty acids has been linked to hair growth due to proliferation of hair follicle cells and a mechanism similar to that of the FDA-approved drug finasteride, which is used to treat alopecia.

Role of the RD
The role of a dietitian is to help access nutrient deficiencies and combat them with dietary means. Since treatment approach to hair loss is a multidisciplinary way, dietitians should ensure that they manage every nutrient deficiencies noticed.
Hope Remains
A Brazilian study found that women had an equivalent fear of experiencing a heart attack and baldness, and Glamour magazine reports that more than 50% of women feel that a bad hair day can make them feel unattractive. For better results, women with possibilities of having hair loss should be encouraged by health professionals on adequate measures to take to curb the possible effects.

SOURCES:
https://www.healthline.com/health/beauty-skin-care/grow-hair-faster#hair-growth-tips
https://pubmed.ncbi.nlm.nih.gov/24836650/
https://www.hindawi.com/journals/tswj/2014/641723/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606321/

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LifeStyleUncategorized

ARE MY THYROID GLANDS CAUSING MY WEIGHT TO FLUCTUATE?

Ever wondered if any of your internal organs could affect your weight? Maybe due to its overactive nature or underactive nature?

Well, it is actually possible for an organ to affect your metabolism, growth and weight patterns and that organ is the thyroid.

Globally, 1.6 billion people are currently at risk of developing thyroid related diseases.

In this write-up, we’re going to see how the thyroid affects weight, for those who want to gain weight or lose it, if your thyroids are mal-functional, then you might just experience some difficulties with your weight.

WHAT IS THE THYROID?
The thyroid gland looks like a butterfly and is  located at the front of the neck right below the voice box (larynx).

The thyroid is small, but functions and affects all other organs in the body. It is involved in the regulation of fat and carbohydrate metabolism, respiration, body temperature, brain development, cholesterol levels, the heart and nervous system, blood calcium levels, menstrual cycles, skin integrity, and more.

WHAT IS THE IMPORTANCE OF THE THYROIDS?
The thyroid controls almost every major metabolic function in the body.
The hormones present in the thyroid glands are responsible for the regulation of the metabolic rate of all cells, as well as the processes of growth of cells, tissue differentiation, and reproductive function.
These hormones are also necessary for (and promote) protein metabolism when enough carbohydrates and fats are available.

When the amount of thyroid hormones is excessive or when energy from food is deficient, thyroid hormones (T3 and T4) promote protein breakdown. This processes in turn totally affects weight management.

WHY AM I FINDING IT DIFFICULT TO LOSE/GAIN WEIGHT

HYPOTHYROIDISM
It would be difficult for you to lose weight if you have the condition called hypothyroidism, or underactive thyroid.

Hypothyroidism is usually caused by an autoimmune response known as Hashimoto’s disease (a condition in which your immune system attacks your thyroid) or autoimmune thyroiditis (inflamed thyroids).

What happens in this disease is that your body mistakenly sees its own tissues as an invader and starts fighting against it. This process prevents the thyroid from releasing adequate hormones for the proper functioning of the body.

The lack of these hormones can slow down metabolism and cause weight gain, fatigue, dry skin and hair, and difficulty concentrating. Hypothyroidism affects women more than it affects men and is common in middle aged people. Also, women may also experience thyroid inflammation after pregnancy.

Some symptoms associated with hypothyroidism includes:
• tiredness, fatigue, lethargy
• depression and losing interest in normal activities
• forgetfulness
• dry hair and skin
• puffy face
• slow heart rate
• intolerance to cold
• constipation
• brittle nails
• muscle cramping
• changes in menstrual cycle

HYPERTHYROIDISM
A very common condition related with thyroid is hyperthyroidism or overactive thyroid gland. Hyperthyroidism is caused by an autoimmune response of the body in the form of Graves’ disease.

In Graves’ disease, the body produces too much of thyroid hormones and makes it seems like your body is revving so fast in response to these hormones.

This could also lead to weight loss, high blood pressure, and a rapid heartbeat. Graves’ disease also disproportionately affects women and typically presents before the age of 40.
Hyperthyroidism as an autoimmune diseases and have strong genetic links which are also associated with other autoimmune diseases as type 1 diabetes, rheumatoid arthritis, lupus and celiac disease.

The most common symptoms associated with hyperthyroidism includes:
• racing heart and palpitations
• trouble sleeping
• tremor and nervousness
• weight loss
• hair loss
• muscle aches and weakness
• diarrhea and over-active digestive system
• sweating and trouble tolerating heat
• exophthalmos (bulging eyes)

A goitre is the most common and evident symptom of chronic hypothyroidism. Some might have it, but not all.
Also, chronic or severe disease can manifest with dull facial expression, drooping eyelids, hoarse speech, thinning or dry and brittle hair, dry skin, myxedema (swelling of the skin and soft tissues), menstrual disorders, constipation, depression, anemia.

HOW DO I KNOW IF MY THYROID IS UNDERACTIVE/OVERACTIVE?
You can go for a thyroid function screening if you’re up to 40. A blood test is used to measure thyroid stimulating hormone (TSH).

WHAT ARE THE RISK FACTORS?
Gender. Majorly occur in women, especially those who had small weight at birth
Age.

Risk of hypothyroidism increases with age.
Genetics.
Psychological stress
Smoking
Iodine: excess dietary iodine intake and iodine-rich medication (amiodarone) may lead to hyperthyroidism.

IS HYPOTHYROIDISM/HYPERTHYROIDISM TREATABLE?
Yes it can’t! It can be treated medically by a hormone replacement therapy, administering oral thyroid hormones, and addressing iodine deficiency with potassium iodide.

CAN I STILL MANAGE MY WEIGHT WHILE WITH A DYSFUNCTIONAL THROID HORMONE?
Certainly you can! With the right approach, and evaluation of your hormones by specialists, also treating every imbalance, you can still lose or gain weight. Knowing the right type of dietary choices, the foods allowed and the foods to avoid makes it easy to lose weight.

A dietitian would help calculate your caloric needs and place you on a sustainable dietary pattern to help achieve your goals with your hormone therapy and exercise regimen.

Foods to avoid for hypothyroidism includes:
– refined carbohydrates and caffeine
– energy bars and genetically modified organisms (GMO) foods
– gluten-containing foods, such as wheat, rye and oats
– cruciferous vegetables like broccoli and kale.
– Soy and millet

Foods to include in hypothyroidism:

-vitamin B12 food sources like sardines, salmon, organ meats such as liver, muscle meat, and dairy

– foods rich in iodine like seaweed, iodized salt,
– Whole grains
– Legumes, eggs (especially egg white), nuts, nut butter
– Oily fish, flaxseeds, extra virgin olive oil and avocados will help balance your lipid

-brazil nuts, crabs and tuna fish which contain selenium
– incorporate healthy bacteria (probiotics) from pap, yoghurt. Kimchi and sauekrat

Foods to include in hyperthyroidism includes:
• non-iodized salt
• coffee or tea (without milk or dairy- or soy-based creamers)
• egg whites
• fresh or canned fruit
• unsalted nuts and nut butters
• homemade bread or breads made without salt, dairy, and eggs
• popcorn with non-iodized salt
• oats
• potatoes
• honey
• maple syrup
• Cuciferous vegetables might reduce how your body uses iodine and they include: bamboo shoots, bok choy, broccoli, Brussels sprouts, cassava, cauliflower, collard greens, kale, mustard, rutabaga

It is important to do away with the following seafood and seafood additives:
• fish
• seaweed
• prawns
• crabs
• lobster
• sushi
• carrageen
• agar-agar
• algae
• alginate
• nori
• kelp

Other foods that contain iodine includes:
• milk and dairy
• cheese
• egg yolks
• iodized salt
• iodized water
• some food colorings

Furthermore, foods that contain gluten, soy and caffeine should be avoided as they cause inflammation and can interfere with hyperthyroidism treatments.

It’s also important to note that, following a strict exercise regimen with your eating pattern is important. People with hypothyroidism would gain from lifting weights and dumb bells, and strength training.

DO I NEED TO GO ON A SPECIAL TYPE OF DIET?
One of the major concern in managing hashimoto’s disease is to look for a suitable type of diet to help manage and relieve symptoms. Hashimoto disease (hypothyroidism) is an auto-immune disease (ATD), so is gluten sensitivity and gluten intolerance. Research has shown the possibilities of using a gluten free diet in managing hashimoto’s disease as it helps to reduce the amount of thyroid antibodies.
A gluten diet involves the elimination of some certain types of foods that contain the protein gluten. Foods include wheat and its derivatives, bran and rye. This foods most times are re-introduced after symptoms has been optimally managed.

FOOD SUPPLEMENST AND INTERACTIONS
People with hashimoto’s are likely to de deficient in certain nutrients like vitamin B12 and vitamin D and would gain from supplementing with these nutrients.
Also, some anti-inflammatory supplements like selenium, fish oil, magnesium and zinc would also be beneficial to people with hashimoto’s as they help improve thyroid functions, reduce inflammation and improve overall health.
Remember that supplements are not meant to replace a nutrient dense and healthy diet.
For those on thyroid medications, it is important to note their interactions with some nutrients. Calcium supplements and chromium picolinate (used in weight loss and glucose control) both interfere with proper absorption of thyroid medications.
They should be both taken 4 hours apart from the time of administering thyroid medications as both can’ be stopped but are important in individuals with poor thyroid functions.

SUMMARY AND RECOMMENDATIONS
– Stay active
– Get rest when you’re tired. Don’t push it
– Stay hydrated always
– Stay away from caffeine and alcohol as much as you can
– Try yoga if you can
– Spend time outside
– Engage in stress reducing activities when you can.

SOURCES
1. Mahan LK & Escott-Stump S. Eds. Krause’s Food, Nutrition, & Diet Therapy. 11th ed. Saunders Publishing, Philadelphia, PA. 2004.
2. Beers MH, Berkow R eds. Merck Manual. 17th ed. Merck Research Laboratories. Whitehouse Station, NJ. 1999.
3. Teas J, et al. Seaweed and soy: companion foods in Asian cuisine and their effects on thyroid function in American women. J Med Food 2007;10:90-100.
4. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160(4):526-534.
5. Graves’ Disease. Bethesda, MD: National Endocrine and Metabolic Diseases Information Service, US Dept of Health and Human Services; 2008. NIH Publication No. 08-6217.
6. Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004;24(1):1-13.
7. Duntas LH, Brenta G. The effect of thyroid disorders on lipid levels and metabolism. Med Clin North Am. 2012;96(2):269-281.
8. Dean S. Medical nutrition therapy for thyroid and related disorders. In: Mahan KL, Escott-Stump S, eds. Krause’s Food, Nutrition, & Diet Therapy. 13th ed. Philadelphia, PA: Saunders; 2008: 711-724.
9.https://www.medicinenet.com/cancer_101_pictures_slideshow/article.htm
10.https://www.healthline.com/health/hyperthyroidism-diet#takeaway

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General Research

Are antibiotics making me fat?

Recently the FDA issued a report; which centered on the increasing use of antibiotics in pigs, chicken, cows and seafood between 2009 and 2013. Antibiotics are usually administered into the animals we eat and they are mostly given in low doses to promote faster growth or prevent diseases.

New research from New Zealand has found children given antibiotics in the first one to two years of their life may be at a greater risk of having a higher body-mass index (BMI) or becoming obese by the age of four or five.

Now, this action is a major concern for both the FDA and Centers for disease control and Prevention (CDC). They have claims that these constant use of antibiotics give rise to the multiplication of harmful bacteria due to bacteria resistant after long periods of abuse. But, apart from this concern, scientists are also searching to see if humans would also gain weight from the prolonged use of antibiotics as animals would.

HOW DO ANTIBIOTICS CHANGE A PERSON’S MICROBIOME?

Our intestinal microbiome is all the microorganisms in our digestive tract, and you have to look at it like a human organ, just as important as your heart, brain and lungs. Our digestive tract (gut) contains about over 100 trillion bacterial cells of many types. Usually, there is always an equilibrium of species; they help our bodies digest food and function well. Antibiotics change this gut flora, by creating a imbalance between good and bad bacteria.

How does this affect my weight?

Many types of bacteria in your gut affect how your body absorbs calories. Creating an imbalance of bacteria- especially the type that breaks food down into energy—you may be absorbing more calories from the same amount of food you eat than you would normally d because of this effect.
Research shows that obese people have a different mix of bacteria in their gut than lean people.
Most times though, it might not be direct contact with antibiotics but indirect contact from animals (food) that has been fed with antibiotics or even water treated with antibiotics.

Which foods have the most antibiotics in them?

Mostly animal products carry substantial amounts of antibiotics; and they are administered o them directly or added to their feeds if they would be commercialized.
Pigs have the most antibiotics in their meat, then chicken, then beef, according to research from the National Academy of Sciences. Also, farmed seafood like shrimp, fish (especially commercially farmed salmon) contain high levels of antibiotics because the drugs are needed to prevent disease in the farming pens. Even organic vegetables have antibiotics in them because about 75 percent of antibiotics fed to livestock are excreted out, and in the manure used to fertilize fields.

How can this be curbed?

The only real solution to this is if there is a strong rule stating that the use of antibiotics be stopped by farmers or food producers.

So, what can I do?

1. Reduce your intake of unprescribed antibiotics (that’s a good place to start at least).
2. Always look out for food labels stating about the use of antibiotics . visit supermarkets that sell whole foods and not processed or prepackaged foods.
3. Increase your intake of prebiotics and probiotics so your gut flora would be at equilibrium. Examples include yoghurt, kitchen, sauekrat,  fermented corn starch made into pudding (pap) etc.
4. Reduced intake of pork, farmed shrimps and sea foods.

Summary
Keep your gut healthy, do more of real foods and add as much sources of probiotics to your diet as you can. You should be in charge of your health.

Sources
1. https://www.google.com/search?q=gut+flora&rlz=1C1SQJL_enNG936NG936&oq=gut+flora&aqs=chrome..69i57j0i512l9.1898j0j7&sourceid=chrome&ie=UTF-8
2. http://a-healthy-body.com/are-antibiotics-making-us-fat/

3.https://www.google.com/amp/s/theconversation.com/amp/the-link-between-antibiotics-and-obesity-in-children-doesnt-mean-you-need-to-avoid-antibiotics-130392

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General Research

 

Sickle cell disease is an inherited blood that affects the shape of red blood cells.

Normally, red blood cells assume a disc shape while flowing through blood vessels, but in sickle cell anemia, red blood cells assume a crescent like shape.
Devastating as the disease might be, no cure has been found yet.
Interestingly, through research and a bid to increase knowledge, it has been found out that nutritional problems are fundamental to the severity of the disease.  The need for increasing interests to promote dietary supplementation in order to help reduce morbidity and to help improve the quality of patient’s life.

METHODS OF TREATMENT 

Several methods of treatment and management have been in use for quite a while now and they include:
-Hydroxycarbamide (or hydroxyurea) This substance helps to reduce the number of painful episodes in Hbss patients.
-Blood transfusion: A number of observational and randomised controlled trials have established the pivotal role of transfusion therapy in the management of SCD, most notably in primary stroke prevention.
-Allogeneic HSCT and gene therapy: Allogeneic haemopoietic stem cell transplant (HSCT) is the only curative treatment for SCD and is successful in 85%–90% of patients. Transplantation offers disease-free survival and stabilisation of neurological lesions.
Features as growth retardation, impaired immune function, and delayed menarche do suggest a relationship between sickle cell disease and undernutrition.

IS NUTRITION RELATED?

A variety of micronutrient deficiency has been suggested in sickle cell disease.
– Several reports indicate that vitamin E levels are low in sickle erythrocytes. Since these abnormal red cells both generate excessive oxidation products and are more sensitive to oxidant stress, supplementation with vitamin E is advised in people with sickle cell anaemia.
– Complications of sickle cell disease as poor ulcer healing, growth retardation, delays in sexual development, immune deficiencies have been linked to zinc deficiency. It is also pertinent that zinc be supplemented in people with sickle cell.
– Deficiency of Vitamin D is common in sickle cell disease due to dark skin pigmentation, limited sun exposure, increased catabolism and decreased nutrient and energy intake. Vitamin D in it’s entirety is crucial for calcium homeostasis and essential for bone mineralization. Therefore, a high dose of 100,000 International units (IU) (equivalent to 3,333 IU/day) versus the standard treatment 12,000 IU (equivalent to 400 IU/day) of oral vitamin D3 supplements might just help in reducing risk of respiratory infections.
– Amino acids like arginine and glutamine also play important roles in the synthesis of nitric oxide. Nitric oxide makes it possible for easy blood flow by dilating the blood vessels properly. Increased deficiency of the duo might lead to metabolic stress, increased resting energy expenditure (REE), muscle wasting and decreased immune function. Supplementing with 600mg/kg/day of glutamine showed improved nutritional status of glutamine.

EMERGING INTERVENTIONS
Recently, derivatives from plants has been studied to show their effects in treating people with SCD. Some plants which contain peculiar antioxidants are being studied and there might just be hope to managing SCD.
Exploration of extracts from Moringa oleifera (Moringa), Cajanus cajan (pigeon pea) , Zanthoxylum zanthoxyloides (artar root), and Carica papaya (paw paw) are all being studied to see their possible effects in treating oxidative stress in SCD patients.
With these ongoing experiments, it has been noticed that extracts from these plants could aid in the resistance of hemolysis and reduce the number of sickled red blood cells.
Also, it has been noticed that exercise might play an important role in SCD patients. Exercise helps in reducing oxidative stress and also in the release of nitric oxide which helps in the proper flow of blood through vessels.

CONCLUSION
The nutritional risks faced by SCD patients are usually high and mostly unnoticed. Its imperative to include nutrition as an adjuvant therapy for addressing chronic diseases related with SCD in order to aid effective management.

SOURCES: https://pubmed.ncbi.nlm.nih.gov/3551592/
https://www.dovepress.com/nutrition-in-sickle-cell-disease-recent-insights-peer-reviewed-fulltext-article-NDS
https://www.health.harvard.edu/a_to_z/sickle-cell-anemia-a-to-z
https://adc.bmj.com/content/100/1/48
https://www.todaysdietitian.com/news/042412_news.shtml

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LifeStyle

EMOTIONAL EATING: WHAT IT IS AND HOW TO NAVIGATE THROUGH IT

Sometimes we might just ask ourselves questions like:
How can I stop eating out of boredom?
“How do I resist the urge to snack all day especially when I’m stressed out?”
“How do I take control of my overeating when I feel depressed?”
“Why do I turn to food when I am happy, sad or stressed?”
If one of these questions is familiar with you, then this article is a must read for you.
This article enlightens you on emotional eating, its types and how you can understand and navigate through it.

WHAT IS EMOTIONAL EATING?
Inarguably, eating has emotions attached to it. Culturally, for kids especially, emotions depict they are hungry; if a child cries too much, it shows they’re hungry and they are fed immediately.
But, on a basic level though, ultimately, food is for nourishment, then maybe pleasure could come in, but also sometimes comfort to. The idea of using food to soothe emotions isn’t inherently a “bad thing”.
Turning to food when you’re hungry is your body saying there’s something that should be addressed, and that’s surely a coping tool.

SO WHY FOOD?
Negative emotions comes with a feeling of emptiness, and for some people, food could help them feel a sense of temporary wholeness.
Other factors might include:
• retreating from social support during times
of emotional need
• not engaging in activities that might otherwise
relieve stress, sadness, and so on
• not understanding the difference between physical and emotional
hunger
• using negative self-talking that’s related to bingeing
episodes. This can create a cycle of emotional eating
• changing cortisol levels in response to stress, leading to
cravings.

UNDERSTANDING TYPES OF EMOTIONAL EATING
There are four main avenues to emotional eating:
1) Breaking a food rule: this happens when you set a rule about some foods which you’re not supposed to eat but still find yourself eating those foods or one of them which could cause distress.
For example, you eat a cookie, feel bad about the act, but still go ahead to finish it and even more than expected.
2) Experiencing a strong emotion that reduces appetite: Like if you’re really anxious, you might feel a bit sick and not want to eat. So you eat less.
3) The backlash of restriction: happens when boredom, stress or loneliness causes you to start eating those foods you already termed “bad” in the past without control. According to research, it is more prevalent among dieters (obsessed with weight loss) than non-dieters.
4) Comfort eating: this happens when you find yourself eating to distract yourself from unpleasant or uncomfortable situations. This automatically leads to overfeeding.
The manner we were raised, either by societal values or individual perspectives affects our ability to cope effectively with what life throws at us. Your parents approach to frustration and disappointments, and how they trained you to coping with those situations matters a lot.

So what can you do to manage emotional eating?
To understand emotional eating, first you’d have to understand its roots, which could be as check lists:
1. Have you eaten enough?
The real reason behind emotional eating is still hunger. Most times, you don’t get to eat enough, so you term it ‘emotional eating’. If you don’t get enough food to eat during the day, there’ll surely be a drive to eat, and when you eat thereafter, you’re likely to eat beyond what feels comfortable. When this happens, they start out with compensatory behaviors like over-exercising and heavy restrictions which would later backfire.
What can you do? Fill your belly first! Hunger can present itself in mood, reduced energy levels, and lightheadedness.
A few tips for you to consider:
a. Eat at least 3 meals a day, and snack regularly with snacks and vegetables for easier satiety?
b. Have a balanced proportion of carbohydrates, proteins and fats in each meal.
c. Increased your physical activity, be active!
2. Can you identify what you’re feeling?
This might seem futile for you especially if you’re used to bottling your emotions or suppressing them. You have to identify if you’re sad, depressed, if you fee self-pity, irritated etc.
3. Identify coping tools
For almost everyone, eating could be part of their coping tools, and removing it might cause a stir. So, its better to look for other coping tools to add to food.
Get a jotter and make lists as:
– people you can call when you feel emotional and want to vent or just talks (parent, friend, close pal etc.)
– Good options to relax like taking a stroll, taking a hot bath, read a book etc.
– places you go could go to calm down (e.g. your bed, outdoors, to the beach, a park etc).
– things you can say to yourself (“you’ve got this”, “this feeling will pass”).
– activities you can do to distract yourself (e.g. start a puzzle, watch a film etc).

Conclusion
Emotional eating isn’t inherently bad. Most times it’s a clue your body is giving you to respond to its urgent need, you just need to learn how to know what that need is.
If you’re looking to improve your relationship with food and manage emotional eating, you could always speak to a dietitian.

SOURCES
https://www.healthline.com/health/emotional-eating#What-causes-someone-to-eat-because-of-their-emotions?

How to Navigate Emotional Eating

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General Research

NUTRITION AND CANCER: IS THERE A LINK?

The link between cancer and your diet is as mysterious as the genesis of the disease and how it spreads. So many research work has pointed to how nutrients may help prevent or conversely, lead to cancer.
While there are many factors you can’t change that increase your cancer risk, such as genetics and environment, there are others you can control.
According to the statement above, we’ll discuss so risk factors and importance of nutrients and how they could prevent cancer or lead to it.

CALCIUM
Some evidence suggests higher calcium intake can lower the risk for cancer, especially colorectal cancer. Researchers believe calcium binds to bile acids and fatty acids in the gastrointestinal tract. This acts as a shield to protect cells from the damaging stomach acids.
However, other research has shown that extra calcium—2,000 milligrams (mg) or more per day—may be linked to a higher risk of prostate cancer.

EXCESS CONSUMPTION OF ENERGY (CALORIES)
Excess consumption of calories without matching amount of physical activity would lead to an overload of unused energy thereby leading to obesity.
It was estimated in a recent study, from a prospective cancer prevention cohort, that overweight and obesity accounted for 14 percent of all cancer deaths in men and 20 percent of those in women. Significant positive associations were found between obesity and higher death rates for the following cancers: esophagus, colon and rectum, liver, gallbladder, pancreas, kidney, stomach (in men), prostate, breast, uterus, cervix, and ovary.

GLUCOSE METABOLISM
Refined sugar which is a high energy, low nutrient density foods is commonly present in foods termed ‘junks’. This also has been associated with different types of cancers especially colo-rectal cancer.

LOW FIBRE
A diet void of unrefined plant foods would be low in fiber. This type of diet has been linked to high risks of rectal cancer.

ALCOHOL INTAKE
Alcohol is an antagonist of folate. Folate is a B vitamin which helps in DNA synthesis. Over consumption of alcohol leads to low levels of folate in both men and women and this could lead to colon cancer in men and cervical cancer in women.

ANTIOXIDANTS
These are available to help prevent free radicals that damage cells within the body. Its important to consume a variety of fruits and vegetables as they contain different types of antioxidants.

PROCESSED RED MEAT
Processed meat is any meat that has been smoked or fermented or includes added salt and nitrites to enhance flavor. The mechanism is not yet known but the connection between cancer and processed red meat is consistent.
The reaction between nitrites and heme-iron in red meat might just lead to cell mutations.

PROBIOTICS
Probiotics are friendly bacteria contained in foods like yoghurt, kefir, sauerkraut etc. they are beneficial to their host and help balance the gut environment. Probiotics produce short chain fatty acids in the colon, which acidify the environment. Lower colon pH is associated with lower incidence of colon cancer.

VITAMIN D
Vitamin D is produced primarily from the exposure of the skin to sunshine. Even casual exposure of the face, hands, and arms in the summer generates a large amount of vitamin D.
The concentration of the active hormonal form of vitamin D is tightly regulated in the blood by the kidneys. This active hormonal form of vitamin D has the potent anti-cancer properties.

HIGH AMOUNTS OF SALTED FOODS
Eating large amounts of salted foods, such as salt preserved fish, is associated with an increased risk; this might be caused by the salt itself or by carcinogens derived from the nitrites in many preserved foods. Salted food might increase the risk of Helicobacter pylori infection (an established cause of stomach cancer.

SUMMARY
Your food choices and lifestyle could probably predispose you to the risk of developing various types of cancers, especially gut related cancers .
Lifestyle modification can’t really be over emphasized when it comes to healthy living.

SOURCES: https://www.bmj.com/content/368/bmj.m511
https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-3-19
https://www.health.harvard.edu/cancer/cancer-and-diet-whats-the-connection

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Diet Therapy of Diseases

Cholelithiasis: treatment options

Stones form in different organs in the body due the retention of excess types of minerals in the body that can easily crystallise if there is insufficient fluid around to dissolve them.
Cholelithiasis is one condition that affects the bile duct and gall bladder. In cholelithiasis, hard stones composed of cholesterol or bile pigments form in the gall bladder (choleccystolithiasis) or in the bile duct (choledocholithiasis). In the US alone, about 9% of women and 6% of men have gallstones, and most are asymptomatic. While in the south western region of Nigeria, Ibadan, the prevalence of cholelithiasis is 2.1%.
When the concentration of cholesterol rises to the point of supersaturation, crystallization occurs. In other parts where stones form, stones could be composed of calcium, oxalate, uric acid, struvite. But in this case, stones are composed of cholesterol. A sludge containing cholesterol, mucin, calcium salts, and bilirubin forms, and, ultimately, stones develop. This occur when the concentration of cholesterol rises so high to the point of supersaturation. Normally, in bile, cholesterol leves are at equilibrium with bile salts and phosphatidylcholine.
Although gallstones are typically asymptomatic (they show no symptoms), some cause biliary colic, in which stones intermittently obstruct the neck of the gallbladder and cause episodes of abdominal pain. Chronic obstruction may result in cholecystitis (infection and inflammation of the gallbladder) or cholangitis (infection and inflammation of the common bile duct). Both of which are very serious and, if untreated, may result in sepsis, shock, and death.

Presenting symptoms include episodic right-upper-quadrant or epigastric pain, which often occurs in the middle of the night after eating a large meal and may radiate to the back, right scapula, or right shoulder. Diaphoresis, nausea, vomiting, dyspepsia, burping, and food intolerance (especially to fatty, greasy, or fried foods; meats; and cheeses) are common. More severe symptoms, including fever and jaundice, may signify cholecystitis or cholangitis.

What Are the Possible Risk Factors?
1. Family history: there is every tendency to develop gallstones if there is a family history. In short, it is twice as more in rates.

2. Increasing age: Gallstones are mostly very common in individuals above the age of 40.

3. Female sex: with the presence of the hormone estrogens in female, they are more likely to develop gall stones at all age groups. This increased risk is most notable in young women, who are affected 3-4 times more often than men of the same age.

4. Elevated estrogen and progesterone: During pregnancy, oral contraceptive use, or hormone replacement therapy, estrogen and progesterone induce changes in the bile duct that predispose one to gallstones.

5. Obesity: Due to the elevated secretion and production of cholesterol in obese individual, they are at high risk of developing gall stones.

6. Rapid weight loss: Bariatric surgery and very-low-calorie diets adopted for weight loss regimes can increase risk of gallstone formation, possibly due to increased concentrations of bile constituents.

7. Diabetes mellitus: Hepatic insulin resistance and high triglycerides may increase risk of gallstones.

8. Gallbladder stasis: When bile remains in the gallbladder for an extended period, supersaturation can occur. Gallbladder stasis is associated with diabetes mellitus, total parenteral nutrition (probably due to lack of enteral stimulation), vagotomy, rapid weight loss, celiac sprue, and spinal cord injury.

9. Cirrhosis: Cirrhosis i.e scarring of the liver tissues, increases the risk of developing gall stones 10 times more.

10. Medications: Drugs implicated in the development of cholelithiasis include clofibrate, octreotide, and ceftriaxone.

11. Physical inactivity: Exercise may reduce gallstone risk. Findings from the Health Professionals Follow-Up Study suggested that the risk of symptomatic cholelithiasis could be reduced by 30 minutes of daily aerobic exercise. Young or middle-aged men (65 years or younger) who were the most physically active had half the risk for developing gallstones, compared with those who were least active. In older men, physical activity cut risk by 25%. Physical activity is also associated with reduced gallstone risk in women.

How can it be Diagnosed?
Laboratory tests include complete blood count (CBC), liver function tests, amylase, and lipase.

– Right-upper-quadrant (trans-abdominal) ultrasound will reveal the presence of gallstones and show evidence of cholecystitis, if present.

– Hydroxy iminodiacetic acid (HIDA) scan is sometimes indicated to rule out cystic duct obstruction and acute cholecystitis.

– Endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP) assesses the presence of gallstones within the bile ducts. ERCP can also be used to extract stones when they are found, preventing the need for surgery.

Are there Treatment options?
Asymptomatic gallstones are generally not treated. Cholecystectomy (surgical removal of the gall bladder) is the treatment of choice for symptomatic disease.

Oral bile acids (e.g., ursodeoxycholic acid) can be used to dissolve small stones and stone fragments. However, they are not really efficient as the stones typically reoccur.

It is helpful to avoid large, fatty meals, as a large caloric load is the most likely trigger for biliary colic symptoms.

Long-term statin use has been associated with a reduced risk of gallstone development.

Nutritional Considerations
Gallstones are strongly related to high-fat, low-fibre diets. In areas like Asia and Africa populations which have plant-based diets as traditional diets. An abundance of high protein and high saturated fatty diets are risk factors to developing gallstones. Diets low in dietary fibre, especially the westernized diets play a major role in the development of gall stones. The following factors are associated with reduced risk of gallstones:

– Plant-based diets: Both animal fat and animal protein may contribute to the formation of gallstones. According to research, up to 90% of gallstones are cholesterol. This totally suggests that a change diet (e.g., reducing dietary saturated fat and cholesterol and increasing soluble fibre) may reduce the risk of gallstones.
“Vitamin C, which is found in plants and is absent from meat, affects the rate-limiting step in the catabolism of cholesterol to bile acids and is inversely related to the risk of gallstones in women”
In a 12-year prospective cohort study among US men, individuals consuming the most refined carbohydrates have a 60% greater risk for developing gallstones, compared with those who consumed the least. Conversely, in a 1998 cross-sectional study of men and women in Italy, individuals eating the most fiber (particularly insoluble fiber) have a 15% lower risk for gallstones compared with those eating the least.

– Avoidance of excess weight: staying within a healthy BMI results in reduced risks of developing gall stones as obesity is a huge factor to increased risk. Those with BMI above 30 kg/m2 should endeavour to shed some few extra pounds to reduce their risk.

– Weight cycling: simply meaning repeatedly intentionally losing and unintentionally regaining weight. This cycle increases the likelihood of cholelithiasis.

– Moderate alcohol intake: alcohol consumption, especially when it is too much, has always been linked to different types of ailments; gallstone formation isn’t left out.

SUMMARY
Adopting western diets totally puts you at risk of developing gall stones. A diet rich in antioxidants, fibre, anti-inflammatory substances keeps you at reduced risk rate.
Stones make life very unbearable, you should be very conscious about your diet and lifestyle.

SOURCES
Biddinger SB, Haas JT, Yu BB, et al. Hepatic insulin resistance directly promotes formation of cholesterol gallstones. Nat Med. 2008;14(7):778-82. [PMID:18587407]
Leitzmann MF, Giovannucci EL, Rimm EB, et al. The relation of physical activity to risk for symptomatic gallstone disease in men. Ann Intern Med. 1998;128(6):417-25. [PMID:9499324]
Leitzmann MF, Rimm EB, Willett WC, et al. Recreational physical activity and the risk of cholecystectomy in women. N Engl J Med. 1999;341(11):777-84. [PMID:10477775]
Erichsen R, Frøslev T, Lash TL, et al. Long-term statin use and the risk of gallstone disease: A population-based case-control study. Am J Epidemiol. 2011;173(2):162-70. [PMID:21084557]
Bodmer M, Brauchli YB, Krähenbühl S, et al. Statin use and risk of gallstone disease followed by cholecystectomy. JAMA. 2009;302(18):2001-7. [PMID:19903921]
Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172-87. [PMID:22570746]
Ahmed A, Cheung RC, Keeffe EB. Management of gallstones and their complications. Am Fam Physician. 2000;61(6):1673-80, 1687-8. [PMID:10750875]
Pixley F, Wilson D, McPherson K, Mann J. Effect of vegetarianism on development of gall stones in women. Br Med J (Clin Res Ed) . 1985;291:11-12.
Tsai CJ, Leitzmann MF, Willett WC, et al. Fruit and vegetable consumption and risk of cholecystectomy in women. Am J Med. 2006;119(9):760-7. [PMID:16945611]
Simon JA, Hudes ES. Serum ascorbic acid and gallbladder disease prevalence among US adults: the Third National Health and Nutrition Examination Survey (NHANES III). Arch Intern Med. 2000;160(7):931-6. [PMID:10761957]

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