sugar fix

Sweet as sugar Your Health http://www.telegraphindia.com/1140623/jsp/knowhow/story_18539752.jsp#.U65NG421Ybg DR GITA MATHAI Everyone likes their “sugar fix” -- a cup of tea to start the day, with a biscuit or two. Many are addicted to sugar (though they may not even be aware of it) and feel under the weather when their craving is not fulfilled. This is even more noticeable in children, who may move all day from one sugar fix to another. Many refuse to eat real food. They appear to survive on a nutritionally valueless yet high-calorie diet of snacks, colas, ice cream, biscuits and chocolates. Even the milk they drink is sweetened with health additives. Almost 50 per cent (by weight) of these flavoured powders is pure sugar or sugar substitutes. Our high sugar consumption has resulted in an epidemic of obesity, high triglycerides, weak bones, diabetes and heart disease. Fortunately, we are now aware of the problem and people (even those without diabetes), are trying to loose weight. The easiest way seems out is to cut down on sugar intake. And that doesn’t seem too difficult given that we have zero-calorie drinks, sugar-free cakes, biscuits and ice cream and diabetic chocolate. A wide variety of substances can be used to sweeten food instead of sugar. Some of them can be added before cooking or baking as they are heat stable while others can only be added to cooked food as they are destroyed or degraded by heat into bitter constituents. Many of these sweeteners are much more potent than sugar, so a small quantity is sufficient. However, sugar-free does not necessarily translate into calorie-free. Especially in the case of desserts, the calorific reduction in the dish due to the use of a sugar substitute may actually be negligible. Sugar substitutes fall into four categories -- artificial sweeteners, sugar alcohols, natural and novel sweeteners. Several products are often mixed together to provide the correct consistency and taste. Artificial sweeteners labelled “natural” may be derived from honey, corn syrup or dates. Saccharin is the oldest artificial sweetener. The recommended daily intake should not exceed 5mg/kg. It is so intensely sweet that most people do not consume anywhere near that amount. It was linked to bladder cancer in mice but now it is considered safe. It can cause allergic reactions particularly in people who already have a “sulpha” allergy. It can produce headache, breathing difficulty, skin rashes and diarrhoea. It is best avoided in children and pregnant women. Aspartame is very popular as it can be used for cooking. As much as 50 mg/kg can be consumed a day and it has only 13 calories per teaspoon (compared to sugar’s 20). It can however, cause abdominal pain, diarrhoea, blurring of vision and lead to depression and anxiety. Splenda contains sucralose, dextrose and maltodextrin and a cup of it has 92 calories and 30gm of carbohydrates. This means it is not really sugar-free. It is very sweet so only small amounts can be eaten and this may not make a difference to overall daily calorie consumption. Excessive use can cause abdominal bloating and diarrhoea. Stevia falls under the category of novel sweeteners. It is derived from the leaves of a plant and is called “meeta patta” in Hindi. It contains zero calories, is safe and has only a mild bitter taste. It is available as a powder. Sugar -- often disguised as fructose, corn syrup or molasses -- is hidden in all kinds of processed food such as chips, ketchup and health drinks. Unless you lead food labels carefully it is possible to consume sugar and calories without realising it. “Sweet” taste funnels a desire for more, so sugar substitutes may wind up making you eat more to reduce the craving. The calories reduced are insignificant and may be made up elsewhere. It is probably healthier to eliminate sugar in food altogether to reduce calories, eat less, control diabetes and lose weight. 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

fake drugs

Beware of fake drugs

Your Health DR GITA MATHAI

India has the largest "fake drug" industry in the world. The government estimates fake drugs to be four per cent of the total industry while media and the drug industry itself claims its closer to 30 per cent. Drugs that are counterfeit, spurious, mislabelled, uplabelled (showing a higher concentration on the package) or illegal can be called fake. A drug is counterfeit if it is produced in a shoddy and unhygienic way. It may contain minuscule quantities or none of the genuine ingredient. The rest, (if you are fortunate) may be ingredients such as milk or starch powder or (if you are unlucky) rat poison or powdered glass. If a spurious drug is injected, it can produce abscess or fatal reactions. The black market for fake drugs is very lucrative. They are manufactured for a fraction of the cost of the real medication, often in unhygienic factories but are sold at the same price. Obviously, spurious medication does not work. The blame usually falls on the medical professional. Dissatisfied, the patient may begin to doctor shop. Expensive investigations -- often invasive -- follow as medical professionals attempt to arrive at a diagnosis. If the fake drugs were taken for an infection, the bug that caused the disease soon becomes resistant to the antibiotics. Expensive potent drugs are then given in an attempt to tackle the problem. The patient may succumb to the infection. Sometimes the patient recovers, but antibiotic resistant bacteria are released into the environment to attack other unsuspecting individuals. Drug resistant TB is a major public health problem worldwide. Initially, it was blamed on the fact that patients did not continue with the treatment or finish the long time frame for which the medicine needs to be taken. Now, however, it has been found that fake and substandard medication for tuberculosis (TB) is in the market. Almost 10 per cent of the prescribed medication was faulty. It was apparently labelled correctly, but close inspection revealed faulty packaging, the drugs were pass the expiry date or "fake", with spelling mistakes. Many batches were found to have been uplabelled. The most lucrative market for spurious medication is in the treatment of infections, cancer, sexually transmitted diseases, impotency, glucose strips for the testing of diabetes and psychiatric medication. Generic medication is much cheaper than branded products. They are stocked and used in government hospitals to provide effective but inexpensive treatment to the underprivileged. For the first four years after companies obtain a license to supply institutions, the products are checked by a central agency. After that it is the individual state's responsibility. The testing agencies are underfunded, inadequately staffed and overworked. It leaves many loopholes, which can be exploited and also provides scope for bribery and corruption. In developed countries, the bulk of spurious drugs are sold through an unregulated Internet market, directly to customer. No prescription is required. We have not reached that stage in India yet. However, many friendly neighbourhood pharmacies do sell spurious and substandard drugs at rates lower than the MRP to unsuspecting customers. They often lure the customer with the argument that "this brand is cheaper!" Stay safe • Do not buy medication without a prescription and a bill. You might pay more as VAT (tax) is added. On the other hand, bills require that the batch number year of manufacture etc. be clearly recorded minimizing chances of fraud. • Do not buy or use a medicine that has been substituted. If your physician has prescribed a medication take only that and not something "which is the same but is cheaper!" • Check the expiry date and packaging. If it looks corroded, smashed or discoloured do not buy it. Other danger signals are spelling mistakes on the labels, with "e " instead of "i" etc. • Vaccines should preferably be supplied and injected by the doctor. They may be fake or of reduced potency if bought from a pharmacy and then carried to the doctor's premises. The cold chain may not be maintained.

cancer

The incidence of cancer seems to be on the increase among the Indian population. Deaths from heart disease also seem to be on the increase. This is a fallacy. It only appears so as Indian life expectancy has increased dramatically from 45 years it was in 1964. People, who earlier died at a young age because of infections, now live long enough to succumb to these diseases.

We age because the DNA in our cells progressively breaks and becomes shorter. It also mutates and changes. This is not always a bad thing. Some good changes occur. It is the fundamental process of evolution and it has brought us from having been apes and cavemen to where we are today. Sometimes the mutated DNA has errors and abnormalities. It escapes from central control, the cells multiply and these abnormalities are passed on to daughter cells. This can give rise to cancerous tumours.

Sometimes the changes in the DNA can be passed on. This is because the cancer starts and kills after the person has already had children and passed on the defective genes. People may inherit genes like the BRAC1 or BRAC2 which predisposes women to breast and ovarian cancer, the FOX MI gene associated with prostate cancer, the multiple genes associated with colon cancer and the Philadelphia chromosome associated with chronic myeloid leukemia (CML). These genes trigger cancer at a certain age or when the environmental factors are conducive.

The trigger may be repeated exposure to cancer-causing chemicals such as the ones present in tobacco or asbestos. Despite the presence of risk factors, lifestyle and diet changes can make a difference in the battle against cancer. We are what we eat. Our food choices can make a difference in susceptibility to cancer and the ability to withstand and fight off the disease. The best preventive diet is a predominantly vegetarian diet. This means fruits, nuts and vegetables. These have less fat, fibre, and more cancer-fighting nutrients. These three elements work in cohesion to support the immune system and help ward off cancer.

When food is served, only a third of the normal sized plate should consist of meat, fish or cheese. Another third should be grains like rice, wheat, corn or ragi. The rest should be vegetables.

Eat vegetables of as many different colours as possible. The colours are pigments which contain immunity boosting antioxidants. Vegetables are stripped of nutrients when they are peeled, boiled or fried. The less they are altered from their natural state, the better they are. Indian spices like turmeric are also cancer fighting.

It is better to eat the fruit than drink the juice. Essential fibres are removed as fruit is juiced. Even in this, in India we have to be careful. Artificial colouring (often carcinogenic) is added to fruits and vegetables to make them more appealing. Fruits are artificially ripened to make a profit. The chemicals used to do this are also poisonous.