Wednesday, June 30, 2010

probiotic prebiotic antibiotic

Cup of magic
YOUR HEALTH
DR GITA MATHAI

Curd reduces infections as well as the duration of illnesses
Probiotics, prebiotics, antibiotics. The words often cause confusion because they sound similar. But, of course, they mean very different things, although all three are derived from the Greek word “bios”, meaning “life”.

Most people would love a magic pill that would put an end to all their health problems. Preferably one that contains prebiotics (meaning “before life”) and probiotics (“helping life”), along with a few trace elements, minerals, antioxidants and vitamins.

Probiotics are defined by the World Health Organization as microorganisms, which when administered alive in adequate amounts, confer a health benefit to the host. They are advertised by the pharma industry as protective, anti-infection agents that give the body’s natural reserves a boost against disease. They are sold as capsules and powders containing organisms like Lactobacillus bulgaricus and Streptococcus thermophilus. The products are much hyped, and have fancy names and expensive packaging.

However, what advertisements do not mention is that to be effective, there should be at least 75 million live organisms in each capsule. Food and chlorine in water kill these organisms. They therefore have to be swallowed with non-chlorinated water on an empty stomach. The intestines need to be populated with these organisms. So initially, the capsules have to be swallowed four to six times a day. The minuscule numbers contained in commercially available capsules are insufficient and do not confer any real health benefit.

Probiotics are not new products; they have been around for centuries. Fermented dough and curd (yogurt) contain natural, healthy probiotics. Commercially available yogurt may not contain live lactobacillus (probiotics) unless specifically mentioned on the package.

Natural probiotics like curd have many medicinal properties that are being rediscovered now. Curd starts to act in the mouth itself. It reduces the number of plaque forming bacteria, and prevents bad breath, tooth decay and mouth ulcers.

In the stomach, curd helps neutralise gastric acidity, reducing belching, burning and dyspepsia. It prevents infections, particularly the growth and multiplication of H. pylori, which is implicated in gastric ulcers and stomach cancer.

In the intestine, probiotics live with other protective intestinal flora, reducing gas formation and diarrhoea. The immunological effects reduce the incidence and symptoms of Crohn’s disease (inflammatory condition of the intestines that may affect any part from the mouth to the anus) and ulcerative colitis. Bowel habits become regular and the incidence of colon cancer reduces in those who eat curd regularly.

The action of the probiotics on digested food results in the synthesis of B-complex vitamins. This reduces vitamin deficiencies. Children who are given curd in addition to milk have less diarrhoea than those given milk alone.

Many Indians are relatively lactose intolerant and develop bloating, abdominal pain and diarrhoea when given to drink milk. They thus tend to curtail their milk intake and in the absence of calcium supplementation become susceptible to osteoporosis. In curd, however, the milk is already partially digested, and this reduces the symptoms of intolerance. As little as one cup of curd a day is beneficial in the prevention of osteoporosis.

Studies have also shown that eating curd regularly prevents the development of candidiasis, a common vaginal fungal infection. Other studies have shown conflicting results with no real benefit. But this has not prevented pharmaceutical companies from advocating lactobacillus capsules and vaginal pessaries for candidial infection. Curd also boosts the immune system. Regular eaters swear by it, saying it reduces infections as well as the duration of illnesses.

Prebiotics, on the other hand, are soluble fibres and non-digestible food ingredients that remain in the colon. They selectively stimulate the growth and activity of beneficial microorganisms already present in the large intestine. Prebiotics are found in oats, wheat, onions and garlic. When probiotics and prebiotics are combined, they form “synbiotics”. This probably confers the best health benefits with probiotics acting in the small intestine and prebiotics in the large.

Antibiotics are used to kill harmful microorganisms in the intestine, bloodstream and the various organs. They should be used appropriately in the correct dosage and duration. Unlike probiotics and prebiotics, antibiotics are specific for a particular infection. They are not health supplements.

Antioxidants are found in coloured fruits and vegetables. Oxidation is essential for cell metabolism. During this process a few cells die releasing harmful free radicals. This is prevented by antioxidants.

All said and done, health does not come packaged as an expensive magic capsule containing probiotics and antioxidants to be drunk with a glass of artificial fibre. For good health,

Eat four to five helpings of fresh fruits and vegetables daily. The green, yellow, orange and red ones contain antioxidants

Eat one tablespoon of homemade curd first thing in the morning on an empty stomach

Eat chappatis four or five times a week

Give these health ingredients an extra boost by exercising one hour everyday.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Monday, June 7, 2010

lousy life

Lousy problem
YOUR HEALTH
DR GITA MATHAI

A young girl gets lice removed mechanically
Itchy scalp? Scratching in public? And people looking askance at you? The problem could be dandruff or seborrhic dermatitis. Or worse, it could be lice.

Lice (singular: louse) are ectoparasites — that is, they live on the outside. Each insect is about the size of a sesame seed, with six legs and no wings. Human lice cannot survive on other animals such as cats, dogs and birds. They are also specific to the area they infest. They may live on the head (head lice). A slightly different variety lives in the genital area (pubic lice). A third type (body lice) lives only on the body.

School-going children are particularly likely to pick up head lice. In India, 60 per cent of girls in the age group of five to 11 are infested. This is, however, wrongly attributed to poor hygiene and low socioeconomic status. The social stigma attached to lice infestation and accusing letters from school authorities add to the psychological trauma of the child and her parents.

Lice feed on human blood and live for 30 days. If they fall off the body, they can survive on clothes, combs, crash helmets, bed sheets or pillows for two days. Each pair of lice lays about 100 eggs. These characteristics make them a tough species. They have managed to survive unchanged for more than 2,000 years. Archaeologists have found evidence of lice on Egyptian mummies, which are identical to the ones seen today.

The spread of lice occurs only if there is close contact with infested persons or their personal belongings. A louse cannot jump or fly. It has to crawl to its next victim. Once the insect has settled, it immediately starts to bite and feed. Lice release chemicals from their saliva which can cause intense scratching. This introduces bacteria to the skin which may cause secondary infection. The lymph nodes may become enlarged and appear as painful lumps in the neck.

There are many home remedies for lice. Mixtures of oils or ghee are sometimes applied in the hope that it will smother the lice. Others may shampoo frequently, thinking it will drown or wash away the insects. These, however, do not work.

The “lice comb” is a traditional and effective method. The comb may be made of metal, plastic or wood. Combing has to be done every day for two to three months. When the adult lice fall off, they have to be killed. Removing nits with a comb is difficult, tedious, time consuming and somewhat painful. Moreover, the child may not cooperate.

There is another effective method. Often in traditional families, all the members get their heads tonsured under some religious pretext. No hair, no lice.

Many chemicals are known to eradicate lice. Kerosene, for example, is effective when applied to the whole head and left for two or three hours. The head should be tied up securely in a cloth. But the method is dangerous as kerosene is highly inflammable.

Medicated “lice treatment” shampoos and lotions contain malathion, lindane and permethrin and can be applied to the hair. These chemicals paralyse the lice. The motionless insects must then be removed by washing or combing as they can recover movement in two or three hours.

The medications, however, do not remove all the lice. Only about 20 per cent are susceptible to the commonly used chemicals. The tough survivors mutate, thrive and multiply even in the presence of these chemicals. Higher concentrations offer no greater benefit. Instead, they seep through the skin and may build up to toxic levels. Also, the chemicals cannot be used in pregnant women and children under one. Treatment has to be repeated after 10 days to kill any newly hatched lice before they start to reproduce. Body and pubic lice respond poorly to lotions and shampoos.

In all the three types of lice infestation, relapse, recurrence and re-infection are common. This makes dealing with the parasite both embarrassing and frustrating.

Commercially advertised “herbal” products appear safer than chemicals and gullible sufferers opt for them. A few harmless ingredients like neem and tulasi are mentioned on the package. The rest are not. Their sale and production are not regulated. Their safety is questionable and side effects undocumented.

Lice can be effectively eradicated using an oral dose of 200 µgm/kg body weight of the tablet Ivermectin. It cannot be given to pregnant women or children whose weight is less than 15kg. The medicine acts only on live lice. A repeat dose is required on the eighth day when the eggs hatch.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in