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| Lifestyle diseases |
 Health problems associated with a poor diet |
| Obesity & Weight Loss |
| Diabetes |
| Glucose and insulin |
| Type 1 and type 2 diabetes |
| High blood pressure |
| Lifestyle changes |
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| Health problems associated with a poor diet |
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Poor diet can cause significant health problems, since it is high in fat, salt, and sugar and is apt to be low in fiber and other vital nutrients. Even though most of us have healthy food options available, we tend to make poor food choices. Poor dietary habits, in combination with lack of exercise and high stress, have been connected to health problems such as obesity, coronary heart disease, high blood pressure and diabetes.
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| Obesity & Weight Loss |
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How to Calculate your BMI
Your Body Mass Index ("BMI") measures your height/weight ratio. Compute it by dividing your weight in kilograms by the square of your height in meters.
For instance, if your height is 1.65 meters (5' 6" - 165 cms), the divisor of the calculation will be 1.65 * 1.65 = 2.72. If your weight is 65 kilograms, then your BMI is 23.90 ( 65 / 2.72 ).
Recommended BMI Chart:
Underweight : BMI less than 18.5
Ideal : BMI 18.5 to 25
Overweight : BMI 25 to 30
Obese : BMI 30 to 40
Very obese : BMI greater than 40
How to Measure your Waist
Measuring your waist is easy, if you know exactly where your waist really is. Wrap a flexible measuring tape around your midsection where the sides of your waist are the narrowest. This is usually even with your navel. Make sure you keep the tape parallel to the floor.
Low-fat diets
By including lesser fats in your diet, you will be eating lesser calories since a gram of fat provides more than twice the calories compared to a gram of carbohydrate or protein. But following a low-fat diet does not mean that you can eat more of carbohydrate and protein. You have to be mindful of the fact that the total calorie intake for the day must be controlled, even if the diet is low in fats. Too many calories from any source will lead to gaining weight.
Low-carb diets
People following low-carb diets eat lesser amount of carbohydrate in their diet. Since carbohydrates are a major source of energy for the body, supplying less carbs would induce a different metabolic state called ketosis, whereby the body uses its stored fats as fuel. This results in weight loss.
But people eating low-carb diets tend to increase intake of protein. This high-protein and low-carb diet is known to have many problems like increased load on kidney, increase in cholesterol levels, osteoporosis and cancer. Low-carb diets are also not easy to follow in the long term and as a result people tend to regain the weight that they have lost after a year.
Low Glycemic-index diets
Glycemic index ranks carbohydrates based on the effect they have on blood sugar. The higher the Glycemic index of carbohydrates, the faster the surge in glucose levels in the blood. Similar to low-carb diets, low GI diets work by lowering the blood sugar levels leading to burning of body fat for energy. Over the long term, it may be better to choose low GI carbs as our primary our carbohydrate source.
Meal Replacements
Meal replacements provide about 200-300 calories per meal and are nutritionally complete. With this plan, you can replace one or two meals (like breakfast or lunch) a day with the meal replacement shake or a meal replacement bar. You also have to eat healthy meals for the rest of the day. For weight loss and weight maintenance, meal replacements can be effective as traditional calorie controlled diets.
With meal replacements, it may be easier to comply with your calorie controlled diet. Meal replacements are also convenient and come in many flavors and forms like shakes and nutrition bars.
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| Diabetes |
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Diabetes mellitus ("sugar diabetes") is a long-term condition where the body is not able to control the amount of glucose in the blood. It develops when there is an insufficient amount of the natural hormone insulin. If untreated, the symptoms include excessive thirst, frequent urination and weight loss. Poorly controlled blood sugar can also be a major threat to health including increased risk of heart disease and strokes, nerve damage and blindness.
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| Glucose and insulin |
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Glucose, a simple form of sugar, enters the blood from the intestines where it is absorbed from food and sugary drink as a natural part of digestion. It is also produced by the liver which acts as a storehouse of energy.
One of the many functions of the blood is to carry glucose around the body. When it reaches various body tissues, such as the muscle cells, it is converted into energy. The precise concentration of glucose in the blood is automatically regulated. Crucial to this is the hormone insulin, which is secreted into the blood by the pancreas – a gland found behind the stomach.
Insulin is required for the conversion of glucose into energy. With the digestive system and liver working normally, a shortage of insulin causes glucose level to build up in the blood, leading to the symptoms of diabetes.
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| Type 1 and type 2 diabetes |
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There are two main types of diabetes - type 1 and type 2.
Type 1 diabetes is also known as Insulin-Dependent Diabetes Mellitus (IDDM), because insulin is needed to treat it. It can develop at any age, although it usually develops in children and young adults and is also referred to as juvenile-onset diabetes. The affected person does not produce any of their own insulin and needs to take it by injection every day.
Type 2 diabetes occurs later in life and is sometimes known as late-onset diabetes or Non-Insulin-Dependent Diabetes Mellitus (NIDDM), because insulin treatment is not always needed.
The cause
Type 2 diabetes develops when the body becomes resistant to insulin. This happens when the body's tissues, such as muscle, do not respond fully to the actions of insulin, so it cannot make use of glucose in the blood. The pancreas responds by producing more insulin. In addition the liver, where glucose is stored, releases more glucose to increase the amount of glucose available.
Eventually the pancreas becomes less able to produce enough insulin and the tissues become more resistant to insulin. As a result, blood glucose levels slowly start to rise.
It can take several years for the blood sugar to reach a level that causes symptoms.
Who is at risk of type 2 diabetes?
Type 2 diabetes usually develops in men or women over 40 years of age. The average age for developing the disease is 52, but this is now dropping and some very overweight children are affected.
People who are overweight (with a BMI over 25) and not physically active are more at risk of type 2 diabetes. In particular, people who are an "apple-shape" - with lots of fat around the abdomen - are at greater risk of developing diabetes.
Type 2 diabetes runs in families, and is particularly common among people of African-Caribbean or Asian origin.
Having high blood pressure or high cholesterol increases the risk of acquiring type 2 diabetes.
Symptoms
Up to two-thirds of people with type 2 diabetes have no symptoms. If present, the most common ones are:
 | increased production of urine (the body is trying to get rid of the excess glucose in the urine)
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| unusual thirst
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| tiredness (because the glucose is "going to waste" and not being converted into energy)
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| loss of weight
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| increased appetite
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| feeling sick
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| blurred vision
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| infections such as thrush or irritation of the genitals
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Some people simply feel a bit unwell or assume they are just ageing.
High blood glucose
A high level of glucose in the blood is harmful. Even though the symptoms are not immediately severe (see symptoms, above), over time, uncontrolled high blood sugar can damage the smaller blood vessels, leading to complications including irreversible damage to the eyes and kidneys. Nerves can also be damaged, which can affect internal organs as well as the ability to feel sensations and pain. Uncontrolled diabetes increases the risk of cardiovascular diseases such as heart attack and stroke.
Diagnosis
Doctors diagnose type 2 diabetes after listening to a description of any symptoms, doing a physical examination and doing a blood test to measure the level of blood glucose. Most people are asked to fast for eight hours before the blood sample is taken.
A glucose tolerance test may be done to assess the body's ability to handle glucose. For this test, the person drinks a specific amount of glucose and the levels are measured in blood samples over a period of several hours.
Type 2 diabetes may be diagnosed during a routine medical check-up.
Treatment
In many cases, type 2 diabetes can be controlled by lifestyle changes alone.
Diet
A healthy diet is essential for people with type 2 diabetes. This is the same as the normal, balanced diet that's recommended for good health - low in saturated fat; sugar and salt; high in fiber; vegetables and fruit.
Carbohydrates should be spread throughout the day to prevent high blood sugar levels after a meal. Carbohydrates include starchy food such as pasta, potatoes, bread and cereals and sugary foods including fruit, sweets and biscuits.
Exercise
Regular physical activity helps the body use insulin more efficiently. Half an hour of activity on most days of the week is recommended.
Medicines
If lifestyle changes do not reduce glucose levels, antidiabetic tablets may be prescribed to increase the production of insulin and strengthen its effect. The standard treatments include:
| Drugs called Sulphonylureas which encourage the production of insulin from the pancreas. These include glibenclamide and glipizide.
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| A drug that improves the effectiveness of insulin by reducing the amount of glucose released from the liver and improving the way glucose is used by the muscles. This drug is called Metformin and is the routine treatment for people who are overweight. It is sometimes combined with other antidiabetic medicines or insulin.
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| Other drugs such as Acarbose, Nateglinide, Pioglitazone or Rosiglitazone (Avandia), can be used in addition to the standard antidiabetic tablets.
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Insulin injections
If lifestyle changes and medicines still do not adequately control blood glucose levels, insulin injections may have to be started in addition to, or instead of, oral treatments. Insulin injections may be temporary or for the rest of the person's life.
Insulin injections are usually self-administered two or four times a day, using either a traditional needle or a "pen" type syringe with refillable cartridges. There are different kinds of insulin that work at different rates and for different lengths of time.
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| High blood pressure |
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Blood pressure measures the force that the blood applies to the walls of the arteries as it flows through them. It's normal for blood pressure to increase when you exert yourself, or when you feel stressed or anxious. But if the blood pressure is consistently higher than normal at rest, it is called as high blood pressure, also known as hypertension.
Blood pressure and health
As blood is pumped around the body, it carries oxygen and nutrients that are essential for life. As a result of the pumping action of the heart and the size and flexibility of the arteries that carry blood, the blood is under pressure. This blood pressure is an essential and normal part of the way the body works.
Measuring blood pressure is one way of assessing your risk of health problems, particularly the risk of having a heart attack or stroke. Blood pressure tends to rise with age.
When a nurse or doctor takes your blood pressure, the result is expressed as two numbers, such as 120/80 ("one hundred and twenty over eighty"). The top figure - the systolic blood pressure - is a measure of the pressure when your heart muscle is contracted and pumping blood. The bottom figure - the diastolic blood pressure - is the pressure when the heart is relaxed and filling with blood.
Normally, high blood pressure is defined as a systolic blood pressure of 140 or over and/or a diastolic blood pressure of 90 or over. If your blood pressure is around this level, your doctor will probably want to monitor it regularly.
People with hypertension have an increased risk of major illnesses including:
| cardiovascular disease such as angina, heart attack and stroke
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| kidney damage
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| eye problems
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| circulation problems in their legs, which could eventually lead to gangrene
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However, the risk of cardiovascular disease is linked to other factors including whether or not you smoke, have diabetes or high cholesterol. Slightly raised blood pressure may not need to be treated so aggressively if other risk factors do not apply to you.
Types of hypertension
Most people with high blood pressure - 95% - have what's called primary or essential hypertension. This means that there's no single clear cause of it.
Although it's known that some factors to do with lifestyle can contribute to hypertension (see above), we don't precisely understand why some people get it and others do not.
However, hypertension can run in families, and you are more likely to be affected if your close relatives are too.
But you are also more likely to develop hypertension if you:
| are obese (very overweight)
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| drink a lot of alcohol
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| eat a lot of salt
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| are under a lot of stress
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Secondary hypertension
You may be among the other 5% of people with high blood pressure who have what's known as secondary hypertension. This means your condition can be linked to a recognised cause - in fact, it may be a symptom of another underlying disease
Secondary hypertension can be caused by:
| kidney disease
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| adrenal gland disease
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| narrowing of the aorta
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Secondary hypertension can also be caused by the contraceptive pill (rarely), steroids, or by pregnancy causing pre-eclampsia.
Diagnosis
Most people with hypertension don't have any symptoms. In fact, you may not even know you have a problem - most people are diagnosed when they have their blood pressure taken as part of a medical examination. That's one good reason to have a regular check-up with your doctor.
You may have heard that people with high blood pressure experience headaches and dizziness. However, in most cases, that's not so. Only people with severe hypertension or a rapid rise in blood pressure are likely to experience warning headaches, blurred or impaired vision, fits or blackouts.
Before starting on any course of treatment for hypertension, your doctor will give you a physical examination. You may be asked to get back for repeated measurements over a number of weeks to check that the high reading is an ongoing problem and not a one-off.
You may also need some tests, to see if hypertension is having an effect on the rest of your body. These may include
| analysis of your urine (protein in your urine may be the first sign of a kidney problem)
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| a blood test, to check the condition and working of your kidneys
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| a chest X-ray, to identify any enlargement of the heart muscle
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| an ECG (electrocardiogram), to look for any heart strain
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| eye checks
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Treatment
If you have severe hypertension, you may need to be admitted in hospital for initial treatment. But it's much more likely that you will be cared for by your GP and/or a nurse specialist, or the practice nurse, based on the surgery.
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| Lifestyle changes |
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First, your doctor or nurse is likely to discuss lifestyle changes which might help. He or she might, for example, advise you to:
| start to lose any excess weight
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| get some regular moderate exercise
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| cut down on salt and alcohol intake
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| stop smoking
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| have stress management or relaxation therapy
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Medicines
If your blood pressure remains high, one or more of the following antihypertensive drugs may be prescribed for you.
Vision problems
The eye is like a big screen television. The eye muscles, cornea and lens are constantly adjusting in order to focus the light on the retina, the light-sensitive membrane at the back of the eyeball.
Specialised nerve cells in the retina, known as rods and cones, convert light energy into nerve impulses, and these are transmitted at lightning speed through the optic nerve to the back of the brain.
You will see a clear and sharp image if the light is focussed - through neat orchestration of the lens, cornea, eye muscles and pupil size (controlling the light intensity) - precisely on the retina. If not, either distant objects or close-up ones (or both) may look blurry.
With prescription glasses or contact lenses or surgery, most people with blurry vision are able to see clearly again.
Vision problems can include short-sightedness (myopia), far-sightedness (hypermetropia), astigmatism, presbyopia, floaters and flashes, macular degeneration and retinitis pigmentosum.
Short-sightedness or myopia
A short-sighted person can see nearby objects clearly but distant objects are blurred. The light is focused in front of the retina because the eyeball or the cornea is too rounded, like a soccer ball squashed from the bottom and top.
Short-sightedness is a very common problem: nearly one in three people are short sighted. It is often inherited, and generally develops before age 20 and then stabilises. In most cases it is first detected in school children, when the child has trouble seeing clearly on the chalkboard or a TV screen a few meters away.
You may need to wear glasses or contact lenses all the time, or only while watching a movie, or driving or when you need to look at distant objects. It is also possible to alter the shape of the cornea with laser surgery, but only after progression has stopped in the early or mid-twenties.
Check your prescription: if you are severe short-sighted and the first number is more than -4.00 D in either eye, you should see your ophthalmologist for a retinal examination at least once a year.
Far-sightedness or hypermetropia
In far-sightedness, nearby objects tend to be blurred, and distant objects can be seen clearly. The light is focused behind the retina because the eyeball is not round enough, but almost shaped like an upright rugby ball.
It tends to run in families. It is present from birth, but symptoms only appear later in life, when the eye loses some of its focusing power of accommodation, which initially compensates for far-sightedness.
Common vision screenings are ineffective to detect far-sightedness. A comprehensive optometric examination is necessary.
Glasses or contact lenses can restore clear vision.
Astigmatism
Astigmatism is a common problem where distant and nearby objects are equally blurred due to irregularities in the shape of the cornea. The uneven curves of the cornea, which should be spherical, prevent the proper focusing of light on the retina.
Most people have some degree of astigmatism. People with mild astigmatism may experience blurred vision at certain distances, eyestrain, fatigue or headache. Severe astigmatism causes blurred vision.
Almost all people with astigmatism can see clearly with prescribed glasses or contact lenses. In some cases laser surgery may be an option to alter the uneven curves of the cornea.
Presbyopia
Presbyopia is what happens to your eyes when you grow older and need to hold a book or newspaper at arms length to read. It is a natural part of the ageing process. It may seem to occur suddenly when you are in your mid-forties. However, the focussing power of the eye gradually weakens with age as crystalline lens loses its flexibility over years.
Reading glasses, bifocals, multifocals or contact lenses may solve the problem but as the loss of focussing power continues with age, these need to be strengthened slightly every few years.
Macular degeneration
The characteristic of macular degeneration is the loss of central vision. It is common for the cells of the macula – the central part of the retina – to stop functioning efficiently with age.
In most cases the disease is slowly progressive. The condition eventually stabilises. In some people macular degeneration – usually the cases due to formation of abnormal blood vessels under the retina – will progress more rapidly. You will notice a central grey spot in your field of vision.
Reading will become more difficult as well as recognising people’s faces. People over sixty, those very short-sighted, and those with a family history of this disease, are most at risk.
If diagnosed early, some cases of macular degeneration can be treated by laser surgery to seal leaky blood vessels and inhibit their growth, so preventing further deterioration of eyesight.
There are no eye drops, tablets, spectacles, operations or alternative therapies proven to restore the vision that has been lost. However, you will keep your peripheral vision and will not go blind.
Floaters, flashes of light and retinal tears
Floaters are small specks of spots, lines or strands that seem to float across your field of vision. They are caused by small particles of protein or other matter trapped in the clear jelly-like fluid inside your eyeball during the formation of your eye.
They move when your eyes move, and seem to dart away when you try to look at them directly. Floaters are more noticeable when one looks at a featureless surface like a piece of paper or a clear sky.
Most floaters are harmless. Very rarely floaters may be very troublesome or obstruct your view. In some cases, floaters can be indicative of more serious problems, like a retinal tear.
See your ophthalmologist within 48 hours if you experience a change or increase in floaters, or a sudden shower of dot-like floaters, or if it obstructs your view. Your ophthalmologist may be able to seal the tear with a laser and so prevent a retinal detachment from occurring.
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What is healthy lifestyle?
Lifestyle diseases
