Tag: diet

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Lactose Intolerance is Usually Permenant in Some Adults

Lactose intolerance commonly develops after adolescence. It is estimated that between 30 and 50 million Americans are lactose intolerant.

Certain ethnic and racial populations are more widely affected than others. As many as 75 percent of all African Americans and American Indians and 90 percent of Asian Americans are lactose intolerant. The condition is least common among persons of northern European descent.

Lactose is a natural sugar found in milk and dairy products. Lactose intolerance means inability to digest lactose. This inability results from a shortage of the enzyme lactase, which is normally produced by the cells that line the small intestine.

Function of lactase is to break down milk sugar into simpler forms that can then be absorbed into the bloodstream. Lactose is broken down in the intestine by lactase to glucose and galactose. These simple sugars are easily absorbed through the intestinal wall and enter the blood stream to be transported to the liver. Galactose is further broken down in the liver into glucose.

At birth large amount of lactase may be present in the intestine. But as the child grows the level of lactase may fall and by adolescence the level may be low enough that the milk can no longer be digested.

Lactase deficiency may be congenital. Or the deficiency may be acquired. It may occur temporarily after a bout of gastroenteritis. Certain digestive diseases and injuries to the small intestine can reduce the amount of enzymes produced. But for most people, lactase deficiency is a condition that develops naturally over time.

Absence of lactase will make lactose ferment in the intestine and cause symptoms.
Common symptoms include nausea, cramps, bloating, gas, and diarrhea. The severity of symptoms varies depending on the amount of lactose each individual can tolerate.

Most individuals will be diagnosed by the typical symptoms they experience. You may be asked to keep a diary for few days of what you eat and the symptoms you get. You may be advised to completely quit dairy products and see if the symptoms disappear. Then you will be asked to go back on the dairy products. If the symptoms reappear then the diagnosis is confirmed.

The most common tests used to measure the absorption of lactose in the digestive system are the lactose tolerance test, the hydrogen breath test, and the stool acidity test.

Lactose intolerance is usually permanent in adults. The symptoms can be completely relieved by eliminating lactose from the diet by avoiding milk and milk products. Others can use lactase liquid or tablets to help digest the lactose. Other option would be to drink lactose-reduced milk available at supermarkets. This milk contains all the nutrients found in regular milk.

Milk is an important source of calcium in our diet. We need calcium for growth and repair of bones. If milk and milk products are avoided then consult your dietitian or physician to suggest other sources of calcium for your body.

Although lactose intolerance is widespread, it does not pose serious threat to our health.

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Role of Calcium and Milk Products in Prostate Cancer

Dear Dr. B: We are in Arizona for the winter. My husband and I have always taken calcium and Vitamin D. There seems to be a lot of controversy here with several people who feel that calcium for men is putting them at high risk for prostate cancer.
Apparently this warning was on T.V. and in the newspapers. What is the truth, doctor?

Answer: Nobody knows exactly what causes prostate cancer. There are a variety of factors implicated in this process. There are some factors (diet and weight) you can change but others like age, ethnicity and family history cannot be changed.

As we know, prostate gland is present only in man. Any normal man can develop prostate cancer because normal men have male hormones (testosterone). Lack of testosterone due to any cause can reduce the risk of prostate cancer.

Age is an important factor. Prostate cancer is rare before the age of 45. As one gets older, the risk increases. Men of African or Caribbean ancestry have the highest risk.

What has race to do with prostate cancer? Scientists are not sure about that. There may be subtle genetic, dietary, environmental and hormonal differences. Another interesting fact is that dark skin absorbs less sunlight than light skin, which may contribute to the higher incidence of prostate cancer among men of African or Caribbean ancestry because of lack of vitamin D.

Family history is important. If your father or brother has had prostate cancer you are approximately two to two and half times more likely than the average man to be diagnosed with the disease during your lifetime. Having two first-degree relatives with prostate cancer increases your risk to about five to 10 times that of a man with no family history, and your risk soars to almost 100 per cent if three or more first-degree relatives have had prostate cancer.

Diet is linked to prostate cancer. A low fat diet may help prevent prostate cancer. Foods rich in saturated fats have been associated with increased risk of prostate cancer, possibly because they are metabolized into testosterone. Fish oils may protect against prostate cancer especially omega-3 fatty acids found in fatty fish like trout, anchovies, bluefish and white albacore tuna.

What about the role of milk, cheese and calcium? The American Cancer Society website article of 2001says, “Experts say excessive calcium intake may be unwise in light of recent studies showing that high amounts of the mineral may increase risk of prostate cancer.”

Here is a dilemma. There is a reasonable evidence to suggest that calcium may play an important role in the development of prostate cancer but evidence also shows calcium may lower the risk of colon cancer and age-related thinning of the bones.

The recommended daily allowance (RDA) of calcium is 1,000 mg per day for men and 1,500 mg for women. Important thing to remember is the words, “excessive calcium intake.” It is also critical to remember that this evidence is not conclusive. The word “may” is used quite often in this context.

You can have milk, cheese and other dairy products in moderation. An 8-ounce glass of milk contains about 300 mg of calcium, an ounce of cheese has about 200 mg, and a serving of yogurt has about 312 mg of calcium. Men should stay within 1000 mg of calcium per day. And don’t forget your vitamin D 1000 to 2000 IU per day especially in winter months. Vitamin D has an important role in preventing prostate cancer and other cancers.

A balanced diet, combined with regular exercise, is always a good idea.

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No Science Behind Colon Cleansing and Detox Diets

Colonoscopy cartoon. (Hemera/Thinkstock)
Colonoscopy cartoon. (Hemera/Thinkstock)

Much has been written about colon cleansing and detox diets as a way of “detoxifying” your body. On Friday, January 30, Medicine Hat News published a letter to the editor (Take ‘proactive/preventive’ wellness approach) which says the following:

“Articles in American Medicine and others state colonic irrigation is the most effective measure to relieve chronic constipation, nervous diseases, especially neurasthenia, chronic bone diseases of joints, diseased blood and forms of chronic nephritis. Systematic colon treatments and dietary changes are definitely effective in the control of high blood pressure as well. Other journals including the Ohio State Medical Journal, New England Journal of Medicine also corroborate cures of many other diseases with the use of colonic irrigation.”

Now, that is a very strong statement. But the letter writers do not provide any specific references so people like me can look them up and learn something new. I would certainly like to prescribe these treatments to my patients if somebody can show me scientific evidence that colon irrigation and detox diets do help and cause no harm.

I googled American Medicine and was unable to find a journal of that name. I was unable to find any scientific articles on the therapeutic effects of colon irrigation and detox diets in two other journals mentioned in the letter.

In my desire to find something positive about colon cleansing and detox diets, I went to three reliable sources on the Internet: the Mayo Clinic website (www.mayoclinic.com), the Harvard Medical School website (www.health.harvard.edu), and WebMD (www.webmd.com).

The Mayo Clinic gastroenterologist, Michael Picco, M.D., says, “Although doctors may recommend colon cleansing in preparation for a medical examination of the colon, most don’t recommend colon cleansing for better health or to prevent disease.”

He says it is unnecessary and it may be harmful because your colon absorbs water and sodium to maintain your body’s fluid and electrolyte balance. Some colon-cleansing programs disrupt this balance, causing dehydration and salt depletion. Long-term or excessive cleansing programs can lead to problems such as anemia, malnutrition and heart failure.

He further says that if constipation is your concern, you can help prevent constipation without colon cleansing. Drink plenty of water and eat a diet rich in fiber.

On detox diets, Dr. Picco says, “There is no evidence, however, that detox diets actually remove toxins from the body. Most ingested toxins are efficiently and effectively removed by the kidneys and liver and excreted in urine and stool.”

The doctor on the Harvard University website says, “The human body can defend itself very well against most environmental insults and the effects of occasional indulgence. If you’re generally healthy, concentrate on giving your body what it needs to maintain its robust self-cleaning system – a healthful diet, adequate fluid intake, regular exercise, sufficient sleep, and all recommended medical check-ups. If you experience fatigue, pallor, unexplained weight gain or loss, changes in bowel function, or breathing difficulties that persist for days or weeks, visit your doctor instead of a detox spa.”

WebMD website reflects what has been already said. I need to see something very scientific about the benefits of colon cleansing and detox diets before I will tell my patients that these “treatments” are safe.

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Controlling Hypertension Means Preventing Stroke

When was the last time you had your blood pressure checked?

Last week, I wrote in my column that we should learn to recognize early signs of stroke because if you receive clot busting medications within three to 4.5 hours then your chance of survival and living without disability is considerably improved.

So, what can you do to prevent stroke?

There are many things you can do to prevent stroke. One of the most import things you can do is to keep your blood pressure under control. Especially, in the current worsening economic situation.

We know that anxiety does not cause permanent high blood pressure but it can cause dramatic temporary spikes of high blood pressure which can cause damage to our blood vessels and vital organs like heart and kidneys. It can damage the brain and retina. Persistent or recurrent anxiety can make us prone to picking up bad habits like smoking, drinking or eating too much unhealthy food. Combination of these factors can increase our risk of high blood pressure.

Nearly two-thirds of all cases of stroke and one-half of all cases of coronary heart disease are directly related to hypertension. What is scarier is that most cases of hypertension either go undiagnosed or untreated. That is why it is called a silent killer. You may have high blood pressure but may not have any symptoms.

World Health Organization says that hypertension causes seven million premature deaths worldwide each year. Hypertension affects 22 percent of Canadians. It is estimated that 25 percent of the 42 million people with high blood pressure in the United States are unaware that they have hypertension. It is a ticking but silent time bomb ready to explode any time.

The incidence of hypertension increases with age. Most elderly Canadians have high blood pressure – probably due to thickening of blood vessels. No cause is identified in 80 to 95 percent of people with hypertension. This is known as idiopathic or essential hypertension. Others have hypertension due to primary disease of kidneys or due to certain hormonal disorders.

We eat too much and we do not exercise enough. Our blood vessels become harder and less compliant with age. When the blood is pumped out of the heart into less compliant blood vessels, the blood pressure goes up. So the heart has to work harder – and eventually it becomes tired, weak and fails. It silently causes damage to our vital organs and eventually results in heart attack, congestive heart failure, stroke, kidney failure and blindness.

Normally, systolic blood pressure should be less than 140 mm Hg (mercury) and diastolic pressure of less than 90 mm Hg. Blood pressure is lowest in the early morning, rises as the day progresses, and then dips down during the night and earliest hours of the morning.

Hypertension can be prevented and treated with lifestyle changes – with or without medication. Eat a healthy diet, lose weight if you are overweight, do not smoke, limit alcohol intake, eat a low salt diet, minimize sugar intake, do regular exercise, relax and learn to manage stress with laughter and meditation.

If your doctor wants you take pills to control your blood pressure then make sure you take it regularly. Research has shown that 50 per cent of the patients with high blood pressure discontinue their antihypertensive medications by the first year. This is no good.

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