FitSugar

Nellie's Nest Eggs

FitSugar — Wed, 04 Apr 2007 11:45:00 -0700

The other morning I went to the grocery to pick up some eggs to hard boil so I could decorate them with my girls, and they were out of Pete and Gerry's Organic Eggs.

I freaked for half a second, but then noticed another brand right next to them. I picked up a 6-pack of Nellie's Nest Eggs and read the label. Just like my other favorite eggs, Nellie's are also Certified Organic and Certified Humane.

Nellie's Nest Eggs are also Cage Free. Their eggs come from hens that are kept in spacious chicken coops, where they can roam, scratch, perch, and nest as they please. Their hens are fed all natural vegetarian grain with no animal by-products, hormones, or antibiotics.

I was so psyched to find another egg company I could trust and feel happy to support.

Eggs are nutritious, providing 6 grams of protein per egg. One egg also contains approximately 200 mg of Omega-3 fatty acids which are known to have health benefits such as prevention of heart disease and Type 2 diabetes.

Fit's Tips: The American Heart Association recommends consuming no more than 300 mg of cholesterol a day . One of Nellie's Nest Eggs contains about 215 mg, so it's OK to eat an egg a day for breakfast, as long as you aren't eating it with cholesterol-loaded bacon and sausage too.

Label-Able: Certified Humane Raised & Handled

FitSugar — Thu, 16 Nov 2006 14:30:00 -0800

The Certified Humane Raised & Handled label certifies that animals raised for dairy, lamb, poultry and beef products are treated in a humane manner. This includes that the animals have access to clean and sufficient food and water as well as a safe and healthy environment from birth through to their last day. This term is used on beef, chicken, lamb, pork, turkey and eggs.

Certified Humane Raised & Handled also means that growth hormones are prohibited and that the animals are raised without antibiotics. (A big plus!) Furthermore, the producers must comply with environmental standards. While the processors must meet The American Meat Institute Standards.

Fit's Tip: Buying products with the Certified Humane Raised & Handled label is not only better for the animals but also is widely believed to be better for your health as you are not ingesting unnecessary growth hormones and antibiotics. Because the egg industry can be so twisted and hard to navigate, I always look for eggs with the CHR&H label as it is one of the few determinants in where the eggs came from.

Label Able: Certified Humane

FitSugar — Tue, 03 Apr 2007 17:15:00 -0700

If you are conscious about what goes into your body and you have respect for all creatures great and small, you need to be on the lookout for this Certified Humane food label. This label that makes it easier for conscious consumers to choose egg, dairy, meat, or poultry products that were produced with the welfare of the animal in mind.

A team of veterinarians and animal scientists created the Animal Care Standards to ensure that farmers, producers, and processors keep their animals in conditions that meet high standards of animal care.

If you see a product with this "Certified Humane" label, you know that the animals:

Were allowed to engage in natural behaviors.
Had sufficient space, shelter, and gentle handling to limit stress.
Had ample fresh water and a healthy diet without added hormones or antibiotics.

Humane Farm Animal Care is the independent non-profit organization that conducts regular inspections to make sure businesses are upholding these high standards.

Fit's Tips: Check out this list to find out which businesses and restaurants you want to support. Pete and Gerry's Organic Eggs and Echo Farm are proudly on the list.

Omega-3 fatty acids

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Overview

Omega-3 fatty acids are considered essential fatty acids. They are essential to human health but cannot be manufactured by the body. For this reason, omega-3 fatty acids must be obtained from food. Omega-3 fatty acids can be found in fish, such as salmon, tuna, and halibut, other marine life such as algae and krill, certain plants (including purslane), and nut oils. Also known as polyunsaturated fatty acids (PUFAs), omega-3 fatty acids play a crucial role in brain function as well as normal growth and development. The American Heart Association recommends eating fish (particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) at least 2 times a week. It is advised that pregnant women and mothers, nursing mothers, young children, and women who might become pregnant not eat several types of fish, including swordfish, shark, and king mackerel. These individuals should also limit consumption of other fish, including albacore tuna, salmon, and herring. They can take omega-3 fatty acids in quality dietary supplements that are certified mercury-free by a reputable third-party lab.

There are three major types of omega 3 fatty acids that are ingested in foods and used by the body: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Once eaten, the body converts ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used by the body. Extensive research indicates that omega-3 fatty acids reduce inflammation and help prevent risk factors associated with chronic diseases such as heart disease, cancer, and arthritis. These essential fatty acids are highly concentrated in the brain and appear to be particularly important for cognitive (brain memory and performance) and behavioral function. In fact, infants who do not get enough omega-3 fatty acids from their mothers during pregnancy are at risk for developing vision and nerve problems. Symptoms of omega-3 fatty acid deficiency include extreme tiredness (fatigue), poor memory, dry skin, heart problems, mood swings or depression, and poor circulation.

It is important to maintain an appropriate balance of omega-3 and omega-6 (another essential fatty acid) in the diet, as these two substances work together to promote health. Omega-3 fatty acids help reduce inflammation, and most omega-6 fatty acids tend to promote inflammation. An inappropriate balance of these essential fatty acids contributes to the development of disease while a proper balance helps maintain and even improve health. A healthy diet should consist of roughly 2 - 4 times more omega-6 fatty acids than omega-3 fatty acids. The typical American diet tends to contain 14 - 25 times more omega-6 fatty acids than omega-3 fatty acids, and many researchers believe this imbalance is a significant factor in the rising rate of inflammatory disorders in the United States.

In contrast, however, the Mediterranean diet consists of a healthier balance between omega-3 and omega-6 fatty acids, and many studies have shown that people who follow this diet are less likely to develop heart disease. It also contains another fatty acid, omega-9 fatty acids, which have been reported to help lower risks associated with cancer and heart disease. The Mediterranean diet does not include much meat (which is high in omega-6 fatty acids) and emphasizes foods rich in omega-3 fatty acids, including whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well as moderate wine consumption.

Uses

Clinical studies suggest that omega-3 fatty acids may be helpful in treating a variety of health conditions. The evidence is strongest for heart disease and problems that contribute to heart disease, but the range of possible uses for omega-3 fatty acids include:

High cholesterol

Those who follow a Mediterranean-style diet tend to have higher high density lipoprotein (HDL or "good" )cholesterol levels. Similar to those who follow a Mediterranean diet, Inuit Eskimos, who consume high amounts of omega-3 fatty acids from fatty fish, also tend to have increased HDL cholesterol and decreased triglycerides (fatty material that circulates in the blood). In addition, fish oil supplements containing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been reported in several large clinical studies to reduce low density lipoprotein (LDL or "bad") cholesterol and triglyceride levels. Finally, walnuts (which are rich in alpha linolenic acid or ALA) have been reported to lower total cholesterol and triglycerides in individuals with high cholesterol levels.

High blood pressure

Several clinical studies suggest that diets or supplements rich in omega-3 fatty acids lower blood pressure significantly in individuals with hypertension. An analysis of 17 clinical studies using fish oil supplements found that supplementation with 3 or more grams of fish oil daily can lead to significant reductions in blood pressure in individuals with untreated hypertension.

Heart disease

One of the best ways to help prevent and treat heart disease is to eat a low-fat diet and to replace foods rich in saturated and trans-fat with those that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids). Clinical evidence suggests that EPA and DHA found in fish oil help reduce risk factors for heart disease including high cholesterol and high blood pressure. There is also strong evidence that these substances can help prevent and treat atherosclerosis by inhibiting the development of plaque and blood clots, each of which tends to clog arteries. Clinical studies of heart attack survivors have found that daily omega-3 fatty acid supplements dramatically reduce the risk of death, subsequent heart attacks, and stroke. Similarly, people who eat an ALA-rich diet are less likely to suffer a fatal heart attack.

Strong evidence from population-based clinical studies suggests that omega-3 fatty acid intake (primarily from fish) helps protect against stroke caused by plaque buildup and blood clots in the arteries that lead to the brain. In fact, eating at least 2 servings of fish per week can reduce the risk of stroke by as much as 50%. However, people who eat more than 3 grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal type of stroke in which an artery in the brain leaks or ruptures.

Diabetes

Individuals with diabetes tend to have high triglyceride and low HDL levels. Omega-3 fatty acids from fish oil can help lower triglycerides and apoproteins (markers of diabetes), and raise HDL, so people with diabetes may benefit from eating foods or taking supplements that contain DHA and EPA. ALA (from flaxseed, for example) may not have the same benefit as DHA and EPA because some people with diabetes lack the ability to efficiently convert ALA to a form of omega-3 fatty acids that the body can use readily. There have been slight increases reported in fasting blood sugar levels in patients with type 2 diabetes while taking fish oil supplements.

Weight loss

Many individuals who are overweight suffer from poor blood sugar control, diabetes, and high cholesterol. Clinical studies suggest that overweight people who follow a weight loss program that includes exercise tend to achieve better control over their blood sugar and cholesterol levels when fish rich in omega-3 fatty acids (such as salmon, mackerel, and herring) is a staple in their low-fat diet.

Arthritis

Most clinical studies investigating the use of omega-3 fatty acid supplements for inflammatory joint conditions have focused almost entirely on rheumatoid arthritis. Several articles reviewing the research in this area conclude that omega-3 fatty acid supplements reduce tenderness in joints, decrease morning stiffness, and allow for a reduction in the amount of medication needed for people with rheumatoid arthritis.

In addition, laboratory studies suggest that diets rich in omega-3 fatty acids (and low in the inflammatory omega-6 fatty acids) may benefit people with other inflammatory disorders, such as osteoarthritis. In fact, several test tube studies of cartilage-containing cells have found that omega-3 fatty acids decrease inflammation and reduce the activity of enzymes that destroy cartilage. Similarly, New Zealand green lipped mussel (Perna canaliculus), another potential source of omega-3 fatty acids, has been reported to reduce joint stiffness and pain, increase grip strength, and enhance walking pace in a small group of people with osteoarthritis. In some participants, symptoms worsened before they improved.

An analysis was conducted of 17 randomized, controlled clinical trials assessing the pain relieving effects of omega-3 fatty acid supplementation in patients with rheumatoid arthritis or joint pain caused by inflammatory bowel disease (IBS) and painful menstruation (dysmenorrhea). The results suggest that omega-3 fatty acids are effective treatment, along with conventional therapies such as anti-inflammatory drugs, for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea.

Osteoporosis

Clinical studies suggest that omega-3 fatty acids such as EPA help increase levels of calcium in the body, deposit calcium in the bones, and improve bone strength. In addition, studies also suggest that people who are deficient in certain essential fatty acids (particularly EPA and gamma-linolenic acid [GLA], an omega-6 fatty acid) are more likely to suffer from bone loss than those with normal levels of these fatty acids. In a study of women over 65 with osteoporosis, those given EPA and GLA supplements experienced significantly less bone loss over 3 years than those who were given a placebo. Many of these women also experienced an increase in bone density.

Depression

People who do not get enough omega-3 fatty acids or do not maintain a healthy balance of omega-3 to omega-6 fatty acids in their diet may be at an increased risk for depression. The omega-3 fatty acids are important components of nerve cell membranes. They help nerve cells communicate with each other, which is an essential step in maintaining good mental health. In particular, DHA is involved in a variety of nerve cell processes.

Levels of omega-3 fatty acids were found to be measurably low and the ratio of omega-6 to omega-3 fatty acids were particularly high in a clinical study of patients hospitalized for depression. In a clinical study of individuals with depression, those who ate a healthy diet consisting of fatty fish 2 - 3 times per week for 5 years experienced a significant reduction in feelings of depression and hostility.

Bipolar disorder

In a clinical study of 30 people with bipolar disorder, those who were treated with EPA and DHA (in combination with their usual mood stabilizing medications) for 4 months experienced fewer mood swings and recurrence of either depression or mania than those who received placebo. Another 4-month long clinical study treating individuals with bipolar depression and rapid cycling bipolar disorder did not find evidence of efficacy for the use of in EPA in these patients.

Schizophrenia

Preliminary clinical evidence suggests that people with schizophrenia experience an improvement in symptoms when given omega-3 fatty acids. However, a recent well-designed study concluded that EPA supplements are no better than placebo in improving symptoms of this condition. The conflicting results suggest that more research is needed before conclusions can be drawn about the benefit of omega-3 fatty acids for schizophrenia. Similar to diabetes, individuals with schizophrenia may not be able to convert ALA to EPA or DHA efficiently.

Attention deficit/hyperactivity disorder (ADHD)

Children with attention deficit/hyperactivity disorder (ADHD) may have low levels of certain essential fatty acids (including EPA and DHA) in their bodies. In a clinical study of nearly 100 boys, those with lower levels of omega-3 fatty acids demonstrated more learning and behavioral problems (such as temper tantrums and sleep disturbances) than boys with normal omega-3 fatty acid levels. In animal studies, low levels of omega-3 fatty acids have been shown to lower the concentration of certain brain chemicals (such as dopamine and serotonin) related to attention and motivation. Clinical studies that examine the ability of omega-3 supplements to improve symptoms of ADHD are still needed. At this point in time, eating foods high in omega-3 fatty acids is a reasonable approach for someone with ADHD. A clinical study used omega-3 and omega-6 fatty acid supplementation in 117 children with ADHD. They study found significant improvements in reading, spelling, and behavior in the children over the 3 months of therapy. Another clinical study found that omega-3 fatty acid supplementation helped to decrease physical aggression in school children with ADHD. More studies, including comparisons with drug therapies (such as stimulants), should be performed.

Eating disorders

Clinical studies suggest that men and women with anorexia nervosa have lower than optimal levels of polyunsaturated fatty acids (including ALA and GLA). To prevent the complications associated with essential fatty acid deficiencies, some experts recommend that treatment programs for anorexia nervosa include PUFA-rich foods such as fish and organ meats (which include omega-6 fatty acids).

Burns

Essential fatty acids have been used to reduce inflammation and promote wound healing in burn victims. Animal research indicates that omega-3 fatty acids help promote a healthy balance of proteins in the body -- protein balance is important for recovery after sustaining a burn. Further research is necessary to determine whether omega-3s benefit people in the same way.

Skin disorders

In one clinical study, 13 people with a particular sensitivity to the sun known as photo dermatitis showed significantly less sensitivity to UV rays after taking fish oil supplements. Still, research indicates that topical sunscreens are much better at protecting the skin from damaging effects of the sun than omega-3 fatty acids. In another study of 40 people with psoriasis, those who were treated with medications and EPA supplements did better than those treated with the medications alone. In addition, many clinicians believe that flaxseed (which contains omega-3 fatty acids) is helpful for treating acne.

Inflammatory bowel disease (IBD)

When added to medication, such as sulfasalazine (a standard medication for IBD), omega-3 fatty acids may reduce symptoms of Crohn's disease and ulcerative colitis -- the 2 types of IBD. More studies to investigate this preliminary finding are under way. In animals, it appears that ALA works better at decreasing bowel inflammation than EPA and DHA. Plus, fish oil supplements can cause side effects that are similar to symptoms of IBD (such as flatulence, belching, bloating, and diarrhea).

Asthma

Clinical research suggests that omega-3 fatty acid supplements (in the form of perilla seed oil, which is rich in ALA) may decrease inflammation and improve lung function in adults with asthma. Omega-6 fatty acids have the opposite effect: they tend to increase inflammation and worsen respiratory function. In a small, well-designed clinical study of 29 children with asthma, those who took fish oil supplements rich in EPA and DHA for 10 months had improvement in their symptoms compared to children who took a placebo pill.

Macular Degeneration

A questionnaire administered to more than 3,000 people over the age of 49 found that those who consumed more fish in their diet were less likely to have macular degeneration (a serious age-related eye condition that can progress to blindness) than those who consumed less fish. Similarly, a clinical study comparing 350 people with macular degeneration to 500 without the eye disease found that those with a healthy dietary balance of omega-3 and omega-6 fatty acids and higher intake of fish in their diets were less likely to have this particular eye disorder. Another larger clinical study confirms that EPA and DHA from fish, 4 or more times per week, may reduce the risk of developing macular degeneration. Notably, however, this same study suggests that ALA may actually increase the risk of this eye condition.

Menstrual pain

In a clinical study of nearly 200 Danish women, those with the highest dietary intake of omega-3 fatty acids had the mildest symptoms, such as hot flashes and increased sweating, during menstruation.

Colon cancer

Consuming significant amounts of foods rich in omega-3 fatty acids appears to reduce the risk of colorectal cancer. For example, Eskimos, who tend to follow a high-fat diet but eat significant amounts of fish rich in omega-3 fatty acids, have a low rate of colorectal cancer. Animal studies and laboratory studies have found that omega-3 fatty acids prevent worsening of colon cancer while omega-6 fatty acids promote the growth of colon tumors. Daily consumption of EPA and DHA also appeared to slow or even reverse the progression of colon cancer in people with early stages of the disease.

Clinical studies have reported that low levels of omega-3 fatty acids in the body are a marker for an increased risk of colon cancer.

However, in an animal study of rats with metastatic colon cancer (in other words, cancer that has spread to other parts of the body such as the liver), omega-3 fatty acids actually promoted the growth of cancer cells in the liver. Until more information is available, it is best for people with advanced stages of colorectal cancer to avoid omega-3 fatty acid supplements and diets rich in this substance.

Breast cancer

Although not all experts agree, women who regularly consume foods rich in omega-3 fatty acids over many years may be less likely to develop breast cancer. In addition, the risk of dying from breast cancer may be significantly less for those who eat large quantities of omega-3 from fish and brown kelp seaweed (common in Japan). This is particularly true among women who substitute fish for meat. The balance between omega-3 and omega-6 fatty acids appears to play an important role in the development and growth of breast cancer. Further research is still needed to understand the effect that omega-3 fatty acids may have on the prevention or treatment of breast cancer. For example, researchers speculate that omega-3 fatty acids in combination with other nutrients (namely, vitamin C, vitamin E, beta-carotene, selenium, and coenzyme Q10) may prove to be of particular value for preventing and treating breast cancer.

Prostate cancer

Laboratory and animal studies indicate that omega-3 fatty acids (specifically, DHA and EPA) may inhibit the growth of prostate cancer. Similarly, population based clinical studies of groups of men suggest that a low-fat diet with the addition of omega-3 fatty acids from fish or fish oil help prevent the development of prostate cancer. Like breast cancer, the balance of omega-3 to omega-6 fatty acids appears to be particularly important for reducing the risk of this condition. ALA, however, may not offer the same benefits as EPA and DHA. In fact, one recent clinical study evaluating 67 men with prostate cancer found that they had higher levels of ALA compared to men without prostate cancer. More research in this area is needed.

Other

Although further research is needed, preliminary evidence suggests that omega-3 fatty acids may also prove helpful in protecting against certain infections and treating a variety of conditions, including autism, ulcers, migraine headaches, preterm labor, emphysema, psoriasis, glaucoma, Lyme disease, systemic lupus erythmatosus (lupus), irregular heart beats (arrhythmias), multiple sclerosis, and panic attacks. Omega-3 fatty acid supplementation may also help to reduce stress and the effects it has on the body.

Dietary Sources

Fish, plant, and nut oils are the primary dietary source of omega-3 fatty acids. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in cold-water fish such as salmon, mackerel, halibut, sardines, tuna, and herring. ALA is found in flaxseeds, flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil. Other sources of omega-3 fatty acids include sea life such as krill and algae.

Available Forms

In addition to the dietary sources described, EPA and DHA can be taken in the form of fish oil capsules. Flaxseed, flaxseed oil, fish and krill oils should be kept refrigerated. Whole flaxseeds must be ground within 24 hours of use, otherwise the ingredients lose their activity. Flaxseeds are also available in ground form in a special mylar package so that the components in the flaxseeds stay active.

Be sure to buy omega-3 fatty acid supplements made by established companies who certify that their products are free of heavy metals such as mercury, lead, and cadmium.

How to Take It

Dosing for fish oil supplements should be based on the amount of EPA and DHA in the product, not on the total amount of fish oil. Supplements vary in the amounts and ratios of EPA and DHA. A common amount of omega-3 fatty acids in fish oil capsules is 0.18 grams (180 mg) of EPA and 0.12 grams (120 mg) of DHA. Five grams of fish oil contains approximately 0.17 - 0.56 grams (170 -560 mg) of EPA and 0.072 - 0.31 grams (72 - 310 mg) of DHA. Different types of fish contain variable amounts of omega-3 fatty acids, and different types of nuts or oil contain variable amounts of a-linolenic acid. Fish oils contain approximately 9 calories per gram of oil.

Children (18 years and younger)

The precise safe and effective doses of all types of omega-3 fatty acid supplements in children have not been established. Omega-3 fatty acids are used in some infant formulas, although effective doses are not clearly established. Ingestion of fresh fish should be limited in young children due to the presence of potentially harmful environmental contaminants, including mercury. Fish oil capsules should not be used in children except under the direction of a health care provider.

Adults

Individuals taking more than 3 grams daily of omega-3 fatty acids from capsules should do so only under the supervision of a health care provider due to an increase risk of bleeding.

For healthy adults with no history of heart disease: The American Heart Association (AHA) recommends eating fish at least 2 times per week.

For adults with coronary heart disease: The American Heart Association (AHA) recommends an omega-3 fatty acid supplement (as fish oils), 1 gram daily of EPA and DHA. It may take 2 - 3 weeks for benefits of fish oil supplements to be seen.

For adults with high cholesterol levels: The American Heart Association (AHA) recommends an omega-3 fatty acid supplement (as fish oils), 2 - 4 grams daily of EPA and DHA. It may take 2 - 3 weeks for benefits of fish oil supplements to be seen.

Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications, including warfarin (Coumadin) or clopidogrel (Plavix), because excessive amounts of omega-3 fatty acids may lead to bleeding. In fact, people who eat more than three grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal condition in which an artery in the brain leaks or ruptures.

Fish oil can cause flatulence, bloating, belching, and diarrhea. Time-release preparations may reduce these side effects, however.

People with either diabetes or schizophrenia may lack the ability to convert alpha-linolenic acid (ALA) to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the forms more readily used in the body. Therefore, people with these conditions should obtain their omega-3 fatty acids from dietary sources rich in EPA and DHA. Also, individuals with type 2 diabetes may experience increases in fasting blood sugar levels while taking fish oil supplements. If you have type 2 diabetes, only use fish oil supplements under the supervision of a health care provider.

Although studies have found that regular consumption of fish (which includes the omega-3 fatty acids EPA and DHA) may reduce the risk of macular degeneration, a recent study including 2 large groups of men and women found that diets rich in ALA may substantially increase the risk of this disease. More research is needed in this area. Until this information becomes available, it is best for people with macular degeneration to obtain omega-3 fatty acids from sources of EPA and DHA, rather than ALA.

Similar to macular degeneration, fish and fish oil may protect against prostate cancer, but ALA may be associated with increased risk of prostate cancer in men. More research in this area is needed.

Fish (and fish oil supplements) may contain potentially harmful contaminants, such as heavy metals (including mercury), dioxins, and polychlorinated biphenyls (PCBs). For sport-caught fish, the U.S. Environmental Protection Agency (EPA) recommends that intake be limited in pregnant or nursing women to a single 6-ounce meal per week, and in young children to less than 2 ounces per week. For farm-raised, imported, or marine fish, the U.S. Food and Drug Administration recommends that pregnant or nursing women and young children avoid eating types with higher levels of mercury (such as mackerel, shark, swordfish, or tilefish), and less than 12 ounces per week of other fish types. Unrefined fish oil preparations may contain pesticides.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA), without first talking to your health care provider.

Blood-thinning medications -- Omega-3 fatty acids may increase the effects of blood thinning medications, including aspirin, warfarin (Coumadin), and clopedigrel (Plavix). While the combination of aspirin and omega-3 fatty acids may actually be helpful under certain circumstances (such as in heart disease), they should only be taken together under the guidance and supervision of a health care provider.

Blood sugar lowering medications -- Taking omega-3 fatty acid supplements may increase fasting blood sugar levels. Use with caution if taking blood sugar lowering medications, such as glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase or Diabeta), glucophage (Metformin), or insulin, as omega-3 fatty acid supplements may increase your need for the medication(s).

Cyclosporine -- Taking omega-3 fatty acids during cyclosporine (Sandimmune) therapy may reduce toxic side effects, such as high blood pressure and kidney damage, associated with this medication in transplant patients.

Etretinate and topical steroids -- The addition of omega-3 fatty acids (specifically EPA) to the drug therapy etretinate (Tegison) and topical corticosteroids may improve symptoms of psoriasis.

Cholesterol-lowering medications -- Following certain nutritional guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may allow a group of cholesterol lowering medications known as "statins", including atorvastatin (Liptor), lovastatin (Mevacor), and simvastatin (Zocor) to work more effectively.

Nonsteroidal anti-inflammatory drugs (NSAIDs) -- In an animal study, treatment with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin or Advil) and naproxen (Alleve or Naprosyn). More research is needed to evaluate whether omega-3 fatty acids would have the same effects in people.

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Review Date:
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Meningitis

FitSugar — Wed, 08 Oct 2008 17:35:11 -0700

Overview

Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis/Possible Complications
Following Up
Special Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Meningitis results from the inflammation of the meninges (the thin membranes surrounding the brain and spinal cord). It is usually caused by a viral or bacterial infection. Most cases of meningitis are viral, but it can be hard to tell the difference without medical tests. It is extremely important to determine the type of infection (and bacteria), because bacterial meningitis tends to be much more serious and requires emergency treatment. Viral meningitis usually clears up on its own and does not cause any permanent harm. Bacterial meningitis can cause brain damage, learning disabilities, hearing loss, or even death without treatment for the specific type of bacteria. Meningitis can also be caused by fungal infections (cryptococcus), but that is rare.

Signs and Symptoms

Early symptoms of meningitis can easily be mistaken for the flu.

In newborns, signs and symptoms include the following:

Irritability
High-pitched cry
Poor feeding
Vomiting
Fever
Seizures
Bulging fontanelle ("soft spot" in the skull) or stiff neck (less common)

In children and young adults, signs and symptoms include the following:

High fever
Severe headache
Vomiting or nausea
Stiff neck
Sensitivity to light
Drowsiness
Skin rash (in cases of meningococcal meningitis -- see section titled What Causes It?)
Confusion
Seizures
Clouding or loss of consciousness

Older adults may have no signs or symptoms other than altered mental state and lethargy. Often they have no fever.

What Causes It?

Bacterial meningitis is not as common as viral meningitis, but it is more serious. Several types of bacteria can cause meningitis. Knowing the right type is crucial for proper treatment:

Neisseria meningitidis causes meningococcal meningitis, a common form of meningitis in children and young adults, and the only type that occurs in outbreaks. It is highly contagious.
Haemophilus influenzae was the most common cause in infants and children under 6 years old before 1986, when a vaccine (HiB) was introduced. The vaccine has mostly eradicated this kind of meningitis in countries where it is given to infants.
Streptococcus pneumonia is the most common cause of bacterial meningitis in children. It may occur along with an ear or sinus infection or pneumonia.
Listeria monocytogenes is a common form of bacteria that can be found all around us. It does not tend to infect most people, but the very young and very old, as well as pregnant women, can be at risk.
Staphylococcus aureus may be seen following a head injury or brain surgery.

Viral meningitis can be caused by several types of viruses, but by far the most common are enteroviruses (which cause stomach flu and multiply in the intestinal tract). Other viruses that can cause meningitis include:

Arboviruses -- carried by arthropods, such as ticks or mosquitoes
Mumps virus -- seen in children between age 5 - 9 who have not had the MMR vaccine
Herpesviruses
Human immunodeficiency virus (HIV) -- meningitis may be the first sign a person is infected with HIV.

Who's Most At Risk?

These conditions and characteristics increase the risk for bacterial meningitis:

Living in a crowded setting, such as a dormitory or child-care facility (for meningococcal meningitis)
Age -- children, young people and older adults are more likely to develop meningitis.
Significant head injury, skull trauma, or cerebrospinal rhinorrhea (flow of cerebrospinal fluid from the nose after a head injury)
A suppressed immune system (for pneumococcal meningitis)
Never receiving the HiB vaccine (see section titled What Causes It?)
Doing laboratory work that requires handling rats, hamsters, and mice; or working with animals on a farm or ranch (for listeria)

What to Expect at Your Provider's Office

If you or your child has symptoms of meningitis, seek emergency treatment. Early diagnosis is the key to treating meningitis successfully. Doctors will ask for a detailed medical history and may order a lumbar puncture (spinal tap). In this test, doctors remove cerebrospinal fluid from the spine through a needle so that the fluid can be tested for infection and to identify the kind of bacteria responsible. If your doctor suspects bacterial meningitis, your doctor may start you on antibiotics right away, even before the test results are available.

Treatment Options

Prevention

Children should be vaccinated against H. influenzae and mumps. People over 65 and those whose immune systems are compromised should receive a pneumococcal vaccine (PPV). A meningococcal vaccine may be given to control epidemics in dormitories, for example. Because meningitis is usually contagious, practicing good hygiene, such as washing your hands frequently -- and teaching children to do the same -- can reduce your risk of catching the disease.

Drug Therapies

The length and type of treatment varies depending on the kind of meningitis being treated, ranging from one to three weeks. The treatment for most cases of viral meningitis is aimed at reducing symptoms of fever and aches; sometimes acyclovir, an antiviral drug, may be given. If bacterial meningitis is suspected, antibiotics must be started immediately, even before results from lab tests have been returned. Some of the medications used for bacterial meningitis are:

Antibiotics, often in combination, including ampicillin, cephalosporins, gentamicin, vancomycin, or trimethoprim-sulfamethoxazole
Corticosteroids to reduce inflammation
Diazepam or phenytoin if seizures occur
Rifampin is given to family members to reduce their risk of contracting the disease.

Complementary and Alternative Therapies

Bacterial meningitis must be treated with conventional medical therapies, especially antibiotics. Because it is usually impossible to distinguish between bacterial and viral meningitis without lab tests, you should always seek conventional medical care for symptoms of meningitis. Complementary and alternative therapies should be used only with conventional treatment, not in place of it, and only with the guidance of a qualified health professional. Some supplements and herbs may help strengthen the immune system, and homeopathic remedies may help relieve symptoms that accompany meningitis.

Nutrition and Supplements

Several nutrients can help strengthen the immune system, possibly helping to prevent meningitis or to build up the immune system after meningitis has been treated, though scientific studies have not examined these nutrients specifically for meningitis. Talk to your doctor before taking any supplements, and never treat a child without talking to your doctor first.

Vitamin A (up to 10,000 IU per day for adults)
B complex vitamins (dose varies)
Vitamin C (1,000 mg two to six times per day for adults. Lower dose if diarrhea develops.)
Quercetin (400 - 500 mg per day), an antioxidant found in plants
Omega-3 essential fatty acids (found in fish oil, 1 - 2 g per day)

Herbs

Some herbs may help support your immune system, although there is no evidence they can prevent or treat meningitis. Meningitis is a medical emergency and should never be treated with herbs alone.

American ginseng (Panax quincefolius, 100 - 300 mg two times per day) -- may have anti-inflammatory and antibacterial effects. Ginseng interacts with several medications and other herbs, so talk to your doctor before taking it. Do not take ginseng if you take blood-thinning medication, have diabetes, high blood pressure, or heart disease.
Astragalus (Astragalus membranaceus, 4 - 7 g per day) --preliminary test tube studies suggest astragalus may stimulate the immune system. It is often taken as a tea -- steep 1 tsp. root in one cup boiling water, strain, and cool. Drink three or four times per day. Do not take astragalus if you have diabetes or high blood pressure, or if you take blood-thinning medication or diuretics (water pills).
Garlic (Allium sativum, 600 - 1,200 mg per day in two or three divided doses) -- has antibacterial properties and can help support the immune system. In laboratory tests, it has also been shown to stop the growth of and even kill the fungus Cryptococcal neoformans. A small study of five people with cryptococcal meningitis suggested that it may be effective in people, but more research is needed. Do not take garlic is you take blood-thinning medication.
Echinacea (Echinacea purpurea, 200 mg two times per day) -- is traditionally used for immune system support. In animal studies, echinacea significantly reduced the amount of bacteria and increased survival rate for those infected with L. monocytogenes. It's not clear whether the same would be true in humans.
Elderberry (Sambucus nigra) -- has antiviral properties. It is usually taken as either tincture (alcohol extract) or glycerite (glycerin extract). Doses vary with different preparations, so consult your health care provider to establish a dose that's right for you.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies to help alleviate symptoms of meningitis, in addition to standard medical care. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for each individual.

Apis mellifica --for meningitis in children with such intense head pain that they bore their heads into a pillow
Arnica montana --for meningitis following surgery or an injury to the head. This remedy is most appropriate for individuals who often insist that there is nothing wrong with them.
Belladonna --for a sudden onset of high fever which accompanies meningitis. This remedy is most appropriate for individuals who are hot and flushed with wide pupils, and may have nightmares and delusions.
Bryonia --for meningitis with impaired consciousness and a characteristic movement of the mouth in which the jaw moves side to side quite rapidly in a somewhat contorted manner
Helleborus --for meningitis with impaired consciousness and stupor. Individual may also be anguished and pleading for help. Shaking or rolling of the head may also occur.
Hyoscyamus -- for meningitis with violent spasms that occur with shrieking and grinding of the teeth

These treatments must not be used for meningitis without direction and supervision by an appropriately trained and certified homeopathic doctor.

Prognosis/Possible Complications

About 25 - 30% of people with bacterial meningitis die from it. Sixty percent of infants who survive bacterial meningitis have brain damage, hearing problems, or developmental difficulties. Most people who get viral meningitis recover completely without any problems.

Complications of meningitis may include hearing loss, seizures, cerebral edema (brain swelling), weakness on one side of the body, speech problems, visual impairment or blindness, difficulty coordinating movements, trouble breathing, respiratory arrest, and recurring meningitis.

Following Up

For the first 1 - 2 days, patients should be monitored in the intensive care unit to be sure that the medication is working, to watch for any seizures, and to watch for breathing difficulties. If signs and symptoms do not improve after 1 - 2 days, health care providers should check the cerebrospinal fluid again.

Special Considerations

Pregnant women often carry L. monocytogenes and S. agalactiae without having symptoms and may pass these infections to their children during birth. Pregnant women should not take rifampin to prevent meningitis because it is not clear whether this drug may harm the fetus.

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Swartz MN. Bacterial meningitis. In: Cecil Textbook of Internal Medicine. Vol. 2. 21st ed. Philadelphia, Pa: W.B. Saunders Company; 2000:1645-1654.

Yonekura K, Kawakita T, Mitsuyama M, et al. Induction of colony-stimulating factor(s) after administration of a traditional Chinese medicine, Xiao-chai-hu-tang (Japanese name: Shosaiko-to). Immunopharmacol Immunotoxicol. 1990;12(4):647-667.

Yonekura K, Kawakita T, Saito Y, Suzuki A, Nomoto K. Augmentation of host resistance to Listeria monocytogenes infection by a traditional Chinese medicine, Ren-shen-yang-rong-tang (Japanese name: Ninjin-youei-to). Immunopharmacol Immunotoxicol. 1992;14(1-2):165-190.

Review Date:
12/17/2006
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

HIV and AIDS

FitSugar — Wed, 08 Oct 2008 17:34:55 -0700

Overview

Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
Treatment Options
Special Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Acquired immunodeficiency syndrome (AIDS) is a chronic and potentially fatal disease of the immune system caused by the human immunodeficiency virus (HIV), which attacks a specific type of white blood cells known as T-lymphocytes. These cells are measured in the blood as the CD4 count. The lower the CD4 count, the weaker the immune system. As the immune system grows weaker, people with HIV and AIDS are susceptible to infections and cancers that the immune system would ordinarily fight off. About 31 million adults and 2.5 million children worldwide are infected with HIV. A massive research effort has produced better treatments, resulting in longer survival and improved quality of life for those with access to the treatments. But there is still no vaccine or cure.

Signs and Symptoms

Symptoms of infection with HIV can vary. Often a flu-like syndrome occurs in 50 - 80% of those who contract HIV within the first 2 - 6 weeks, including a combination of the following symptoms:

Fever
Sore throat
Swollen lymph nodes
Joint pain
Muscle aches
Rash
Mouth ulcers
Nausea
Diarrhea
Headache

After infection with HIV, you may remain relatively symptom-free for years, or the disease may progress more rapidly. In this stage, the CD4 count is below 500/microliter. You may develop infections or chronic symptoms, including:

Swollen lymph nodes
Diarrhea
Weight loss
Fever
Cough and shortness of breath
Low platelet count, which may manifest as easy bruising, bleeding gums, or nose bleeds

During the last stage of the disease, HIV infection may meet the official criteria for AIDS, which is the presence of an opportunistic infection (such as Pneumocystis carinii pneumonia, or PCP) or a CD4 count below 200/microliter. At this stage, symptoms may include:

Pneumonia, including PCP
Tuberculosis
Night sweats
Persistent fatigue
Extreme weight loss and wasting, exacerbated by diarrhea. Up to 90% of HIV patients worldwide experience diarrhea
Meningitis and other brain infections
Fungal infections
Syphilis
Malignancies such as lymphoma, cervical cancer, and Kaposi's sarcoma (affects the skin and oral mucosa and may spread to the lungs. Kaposi's sarcoma can actually occur in earlier stages of HIV as well)

What Causes It?

HIV infection causes AIDS. HIV is spread primarily through sexual contact, and also through blood-to-blood contact, needle sharing among intravenous drug users, and, in pregnant women, from mother to child. About 75% of HIV transmission occurs through sexual contact. Blood transfusions and blood products caused many infections in the early years of the epidemic, but screening procedures have nearly eliminated this risk in the United States and other developed countries. A mother can spread the virus to a newborn during delivery and through breastfeeding, although drug therapy available in the developed world can greatly reduce the risk to infants.

Risk factors include:

Having unprotected sex (without using a condom) and having more than one partner, whether you are heterosexual or homosexual
Having another sexually transmitted disease
Using intravenous drugs and sharing needles

What to Expect at Your Provider's Office

If your health care provider suspects HIV infection, you may receive a "rapid test," which can provider results in 20 minutes. If the test is positive, your health care provider will order a blood test to detect antibodies against the virus. If this test is positive, the doctor will order a CD4 count (see above) and a viral load (an indication of the amount of virus present). This information, along with your symptoms, helps the doctor see what stage the disease is in and determine the best course of treatment for you, including the appropriate tests and medications. For example, if you are experiencing shortness of breath, your doctor will order a chest x-ray, particularly if your CD4 count is low. Some symptoms and tests may require evaluation in the hospital.

HIV tests may not be accurate immediately after you are infected, because it can take up to 12 weeks for your body to develop antibodies against the virus. If you suspect you have been infected and your test is negative, you may need to be retested after a short time to confirm the result.

If you do test positive for HIV, you will be asked to tell your sexual partners immediately so they can also be tested.

Treatment Options

Many valuable medications can slow the progression of HIV infection to full-blown AIDS. Generally, a combination of these medicines, including a type called protease inhibitors, is used. In addition, antibiotics and other therapies are used to prevent or treat specific complications. It is important to have your care directed by a doctor who specializes in HIV. Your health care provider will know the most effective treatment for you, including the most current medical regimen, what alternative treatments are safe, and which combinations may be harmful. If you are using any alternative therapies to complement your medical regimen, be sure to share this information with your doctor.

Drug Therapies

A combination of drugs is used to treat HIV very aggressively, with the aim of reducing the amount of virus in your blood to very low or undetectable levels and to suppress symptoms for as long as possible.

Antiretroviral drugs help slow the progression of HIV by inhibiting the reproduction of the virus in your blood. It's important to keep a steady dose of antiretroviral drugs in your body to prevent the virus from developing resistance to the drugs. Antiretroviral medications include:

Protease inhibitors (PIs) stop an HIV enzyme from replicating. This class of drugs includes saquinavir (Invirase), nelfinavir (Viracept), ritonavir (Norvir), tipranavir (Aptivus), indinavir (Crixivan), amprenavir (Agenerase), and atazanavir (Reyataz). Another medicine, darunavir (Prezista), is used in combination with other drugs for people who have not responded to treatment. A combination of ritonavir and lopinavir (Kaletra) is among the most prescribed protease inhibitors. Protease inhibitors are considered the most powerful of HIV drugs and often interact with other medications, so they must be monitored carefully.
Nucleoside analogue reverse transcriptase inhibitors (NRTIs) also stop a particular HIV enzyme from replicating. These drugs were among the first to be developed and include zidovudine or azidodeoxythymidine (Retrovir or AZT), lamivudine (Epivir), didanosine (Videx), abacavir (Ziagen), stavudine (Zerit), and zalcitabine (Hivid). Emtricitabine (Emtriva) is a newer drug in this class and is taken with at least two other HIV medications. Combinations of several other drugs are also available. All have side effects that must be monitored by your doctor.
Nucleotide reverse transcriptase inhibitors (NtRTIs) work similarly to NRTIs but act more quickly. So far there is only one drug in this class, tenofovir (Viread), which seems to be effective in people who develop resistance to NRTIs.
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) stop the virus from making DNA, so that it can't replicate itself. There are three drugs in this class: nevirapine (Viramune), efavirenz (Sustiva), and delavirdine (Rescriptor). They are often used if people cannot tolerate the side effects of protease inhibitors, want to delay protease inhibitor therapy, or if they have taken protease inhibitors but did not experience a drop in levels of the virus. Many of these drugs are cross-resistant, meaning that if you develop resistance to one drug in this class it's likely you will be resistant to all.
Fusion inhibitors prevent the HIV membrane from fusing with the membrane of healthy cells in your body. Enfuvirtide (Fuzeon) is often used in combination with other drugs in people who have become resistant to other medications. It must be administered by injection.
Combination drug therapies also exist. Epzicom is a combination of abacavir (Ziagen) and lamivudine (Epivir). Truvada is a combination of tenofovir (Viread) and emtricitabine (Emtriva).

In addition, any opportunistic infections are treated with the appropriate medications, or in some cases medications are given to prevent the infections from occurring (prophylaxis).

Complementary and Alternative Therapies

Many people with HIV turn to complementary and alternative therapies to reduce symptoms of the virus, lessen side effects from medications, improve overall health and well-being, and for a sense of empowerment by being actively involved in their own care.

Different therapies are used to:

Inhibit the virus
Treat symptoms of the virus or side effects of medication
Treat or prevent opportunistic infections
Improve function of the immune system

Since the major impact of HIV is that it leaves patients vulnerable to opportunistic infections, making adjustments to ensure your overall health through improving stress reduction, exercise, and building a social support network can significantly boost immune function. In fact, these actions are some of the most powerful tools a person has to impact the course of the disease. Other changes, such as improving oral and general hygiene and limiting exposure to environmental pollutants, can also bolster your health and vitality. These small steps can add up to a longer and healthier life for many people.

However, HIV should never be treated with alternative therapies alone. It is extremely important that you share information on your use of complementary and alternative therapies with your doctor, so that your doctor can help you determine what is safe and appropriate.

Nutrition and Supplements

These nutritional tips may help reduce symptoms:

Eliminate suspected food allergens, such as dairy (milk, cheese, and ice cream), wheat (gluten), soy, corn, preservatives, and chemical food additives. Your health care provider may want to test you for food allergies.
Eat foods high in B-vitamins, calcium, and iron, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell peppers).
Avoid refined foods, such as white breads, pastas, and especially sugar.
Use quality protein sources, such as organic meat and eggs, whey, and vegetable protein shakes, as part of a balanced program aimed at gaining muscle and preventing weight loss that can sometimes be a side effect of therapy. Try to eat fewer red meats and more lean meats, such as chicken and fish, tofu (soy, if no allergy), or beans for protein.
Use healthy oils in foods, such as olive or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, 5 days a week. Talk to your health care provider about how much exercise you can tolerate.

You may address nutritional deficiencies with the following supplements:

A daily multivitamin containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 3 tbs. oil, one to three times daily, to help decrease inflammation and help with immunity. Cold-water fish, such as salmon or halibut, are good sources but not substitutes for supplementation.
Whey protein, 10 - 20 grams daily mixed in favorite beverage, when needed as a protein supplement for support of immunity and weight gain or creatine, 5 - 7 grams daily, when needed for muscle weakness and wasting. Talk with your health care provider.
N-acetyl cysteine, 200 - 800 mg daily, for antioxidant effects.
Probiotic supplement (containing Lactobacillus acidophilus among other strains), 5 - 10 billion CFUs (colony forming units) a day, when needed for maintenance of gastrointestinal and immune health. Some probiotic supplements need refrigeration for best results - check labels carefully.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune activity.
Vitamin C, 500 - 1,000 mg one to three times daily, as an antioxidant and for immune support. Some doctors will use higher doses in HIV and AIDS therapies. Check with your health care provider.
L-glutamine, 500 - 1,000 mg three times daily, for support of gastrointestinal health and immunity.
Melatonin, 2 - 5 mg 1 hour before bedtime, for sleep and immune protection. Ask your health care provider about potential drug interactions with the use of melatonin.
Dehydroepiandrosterone (DHEA), 200 - 500 mg per day, for hormonal balance. DHEA is a hormone that is often low in people with HIV. One study found that DHEA supplements improved minor depression with no serious side effects. Because DHEA is a hormone, you should not take it without your doctor's supervision.

Weight loss can be a serious problem for people with HIV. This symptom may begin early in the course of the disease and can increase the risk for developing opportunistic infections. Weight loss is exacerbated by other common symptoms of HIV and AIDS, including lesions in the mouth and esophagus, diarrhea, and poor appetite. Over the last several years, weight loss has become less of a problem due to the new protease inhibitors used for treating HIV. Reduction of muscle mass, though, remains a significant concern. Working with a registered dietitian to develop a meal plan to prevent weight loss and muscle breakdown is extremely helpful. Resistance training (lifting weights) can also protect against muscle breakdown and increase lean body mass.

Preventing diarrhea and ensuring that the body absorbs enough protein to maintain muscle strength has become a major goal of HIV/AIDS preventative care. One program for combating diarrhea includes using soluble fiber (not insoluble fiber, such as Metamucil and psyllium husks). For some people, soluble fiber can help food stay in the digestive tract for longer periods of time, increasing the amount of nutrients that are absorbed, and lessening bowel frequency. Good sources of soluble fiber include apple pectin, oat bran, and flax seed. Because diarrhea can be a potentially life-threatening situation, use soluble fiber therapy only under the strict supervision of a trained professional.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day.

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Fermented wheat germ extract, 1 packet dissolved in favorite beverage once daily, for immune effects. Ask your health care provider for more information about this supplement.
Bitter Melon (Momordica charantia) standardized extract, 200 mg two to three times daily, for antiviral and immune support. Higher dosages may be needed in HIV and AIDs therapy. A health care provider can help with dosages.
Maitake mushroom (Grifola frondosa) standardized extract (D-fraction), 600 mg twice daily, for immune and antiviral effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Garlic (Allium sativum), standardized extract, 400 mg two to three times daily, for antibacterial or antifungal and immune activity.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for immune and antiviral activity.

You may use herbs as supportive therapies, but never use them alone to treat HIV or AIDS. Tell all of your health care providers about any treatments, conventional or alternative, you are taking so they can monitor interactions and side effects, and provide the best care.

Herbs you should avoid until more studies are done include St. John's wort (Hypericum perforatum), which has a negative effect on indinavir and could lead to developing resistance to the drug. You should also aovid echinacea (Echinacea spp.) and astragalus (Astragalus membranaceus). These two substances show conflicting evidence of enhancing immune function and strengthening replication of the HIV virus in test tubes.

Homeopathy

No specific scientific research supports the use of homeopathy for HIV or AIDS. A licensed, certified homeopathic doctor would evaluate you individually to assess the value of homeopathy for reduction of symptoms or side effects from medication as an adjunct to standard medical treatment.

Physical Medicine

Exercise is another way to help develop a general sense of well-being, improve mental attitude, decrease depression, diminish weight loss, and increase lean body mass. Resistance or weight training is particularly useful to increase strength and enhance lean body mass.

Acupuncture

People with HIV have used acupuncture to improve general well-being, alleviate symptoms such as fatigue, insomnia, and night sweats, and to minimize side effects from medications, such as nausea. Some people also find relief from peripheral neuropathy, caused occasionally by certain medications used for HIV, reporting less pain, increased strength, and improved sensation.

In China, acupuncture and moxibustion (a heat treatment performed by the acupuncturist over points where the needles are placed) are the standard treatments for HIV-related diarrhea.

Acupuncture can also be used to treat the neuropathic (nerve) pain associated with certain HIV medications. Inserting needles bilaterally in the hand and foot points known as Baaxie and Bafeng, respectively, can lessen neuropathic pain.

Massage

Massage can relieve chronic muscle tension and stress, which may help the immune system.

Special Considerations

If you are HIV-positive and pregnant, taking certain antiretroviral medications will reduce the likelihood of you transmitting the virus to your baby. Your doctor will determine which medicine is best for you and safe for your baby. Depending on your own condition, you and your health care provider may decide to postpone treatment until after your first trimester to reduce the risk of birth defects. The drug efavirenz (Sustiva) should be avoided throughout pregnancy. If you are HIV-positive, you should not breastfeed because of the risk of transmission to your baby.

Supporting Research

Faintuch J, Soeters PB, Osmo HG. Nutritional and metabolic abnormalities in pre-AIDS HIV infection. Nutrition. 2006;22(6):683-90.

Harris A, Bolus NE. HIV/AIDS: An update. Radiol Technol. 2008;79(3):243-52.

Hendricks MK, Eley B, Bourne LT. Colecraft E. HIV/AIDS: nutritional implications and impact on human development. Proc Nutr Soc. 2008;67(1):109-13.

Highleyman L. Nutrition and HIV. BETA. 2006;18(2):18-32.

Hoppe C, Andersen GS, Jacobsen S, et al. The use of whey or skimmed milk powder in fortified blended foods for vulnerable groups. J Nutr. 2008;138(1):145S-161S.

Joy T, Keogh HM, Hadigan C, et al. Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era. AIDS. 2007;21(12):1591-600.

Liu JP, Manheimer E, Yang M. Herbal medicines for treating HIV infection and AIDS. Cochrane Database Syst Rev. 2005;(3):CD003937.

Suttajit M. Advances in nutrition support for quality of life in HIV+/AIDS. Asia Pac J Clin Nutr. 2007;16 Suppl 1:318-22.

Tabi M, Vogel RL. Nutritional counselling: an intervention for HIV-positive patients. J Adv Nurs. 2006;54(6):676-82.

Yeh SS, Lovitt S, Schuster MW. Pharmacological treatment of geriatric cachexia: evidence and safety in perspective. J Am Med Dir Assoc. 2007;8(6):363-77.

Review Date:
2/25/2008
Reviewed By:
Steven D. Ehrlich, NMD, private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources.

A.D.A.M. Copyright

adam.com

The Counter: Healthier Burgers You Custom Build

FitSugar — Tue, 28 Oct 2008 11:45:00 -0700

I am not in the habit of eating at fast-food joints regularly, but when traveling sometimes I just can't avoid them. Next time I'm on the road, I will be looking to feed my family at The Counter. New on the fast food scene, The Counter is going to revolutionize the way we eat burgers. With over 312,120 possible burger combinations, this restaurant allows you to customize your meal anyway you like.

Using a clipboard menu, you build the burger exactly how you want starting with the protein: certified humane beef, turkey burger, veggie burger, or grilled chicken. There are 10 cheese options, and you also get to choose five toppings from a long list including carrot strings, dried cranberries, hardboiled eggs, avocado, and sun-dried tomatoes. Further customize your burger by selecting a sauce and bread. I love that there are healthy choices in each category so you're not just stuck with beef high in saturated fat, iceberg lettuce, and a white flour bun.

To see a sample of their menu read more.

Pretty inventive, huh? With all these choices it's possible to create a uniquely delicious burger that's also healthy. Locations are cropping up all over the US so I'd definitely choose The Counter over Mickey Dee's any day. Have you eaten at The Counter? If yes, tell me what you thought in the comments section below.

Genetic counseling

admin — Thu, 04 Sep 2008 18:51:05 -0700

Overview

Alternative Names
Information

Illustrations

Genetic counseling and prenatal diagnosis

HEALTH GUIDE REFERENCE FROM A.D.A.M

Alternative Names

Prenatal diagnosis

Information

For over 4000 years, people have noticed that certain diseases run in families. However, the "why" was unknown until modern science showed how genetic information is transmitted.

Present-day medicine recognizes that genetic diseases are inherited based on the nature of DNA, genes, and chromosomes. Now that the human genome has been completely sequenced, scientists are better able to study how changes in DNA cause human disease. This will ultimately help in diagnosing and treating genetic disorders.

Many diseases that involve a single gene defect can now be diagnosed very early in pregnancy. Prenatal diagnosis looks at fetal cells in the mother's blood, amniotic fluid, or chorionic villi. This may detect problems while the baby is still growing or after birth. In late pregnancy, tests may examine blood from the umbilical cord.

Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD). The procedure is done in the lab after artificial insemination about 3 - 4 days after fertilization.

Laboratory scientists remove a single cell from each embryo and screen the material for specific genetic disorders. According to the American Society for Reproductive Medicine, PGD can help parents decide which embryos to implant. This decreases the chance of passing a disorder to a child. The technique is controversial and not offered at all centers.

Genetic counseling and prenatal diagnosis provides parents with the knowledge to make intelligent, informed decisions regarding possible pregnancy and its outcome. Some parents choose to become pregnant and have the disease status of the fetus determined early in the pregnancy. The pregnancy is continued if the fetus is disease-free.

If a genetic defect is found in the fetus, parents who decide to continue the pregnancy may be better prepared to care for the infant by educating themselves about the disease in advance. For example, if a baby has a genetic disease that leads to diet problems, both the mother and baby may need to be treated with special diets.

However, until science has the knowledge to treat some of the more serious, sometimes deadly genetic disorders, the best option is prevention. Based on genetic counseling, some parents (in the face of a possibly deadly genetic disease) have chosen to adopt instead of getting pregnant. Others have opted for egg or sperm donation from an anonymous donor who is not likely to be a carrier of the disease.

Infant - newborn development

admin — Thu, 04 Sep 2008 18:50:29 -0700

Overview

Information

Illustrations

Skull of a newborn

Infantile reflexes

Developmental milestones

Moro reflex

HEALTH GUIDE REFERENCE FROM A.D.A.M

Information

Infant development is usually divided into the following areas:

Fine motor (holding a spoon, pincer grasp)
Gross motor (head control, sitting, walking)
Language
Sensory (sight, hearing, etc.)
Social

The physical development of the infant begins at the head, then progresses to other parts of the body (for example, sucking comes before sitting, which comes before walking).

Physical milestones:

Newborn - 2 months
- The infant can lift and turn the head when lying on its back.
- The neck is unable to support the head when the infant is pulled to a sitting position.
- The hands are fisted, the arms are flexed.
- Primitive reflexes include:
  - Babinski reflex -- toes fan outward when sole of foot is stroked
  - Moro reflex (startle reflex) -- extends arms then bends and pulls them in toward body, accompanied by a brief cry, often triggered by loud sounds or sudden movements
  - Palmar hand grasp -- infant closes hand and "grips" your finger
  - Placing -- leg extends when sole of foot is stimulated
  - Plantar grasp -- infant flexes the toes and forefoot
  - Rooting and sucking -- turns head in search of nipple when cheek is touched and begins to suck when nipple touches lips
  - Stepping and walking -- takes brisk steps when both feet placed on a surface, with body supported
  - Tonic neck response -- left arm extends when infant gazes to the left, while right arm and leg flex inward, and vice versa
3 - 4 months
- Enhanced eye-muscle control allows the infant to track objects.
- Hand and feet actions begin to come under willed control, but are not fine-tuned. The infant may begin to use both hands, working together, to accomplish desired effects. The infant is still unable to coordinate the grasp, but swipes at objects to bring them closer.
- Increased vision allows the infant to distinguish objects from backgrounds with minimal contrast (such as a button on a blouse of the same color).
- Infant raises up (upper torso, shoulders, and head) with arms when lying face down (on his tummy).
- Neck muscles are developed enough to allow the infant to sit, with support, and keep head up.
- Primitive reflexes have either already disappeared, or are in the process of doing so.

5 - 6 months
- Able to sit alone, without support, for only moments at first, and then for up to 30 seconds or more
- Infant begins to grasp blocks or cubes using the ulnar-palmar grasp technique (pressing the block into palm of hand while flexing or bending wrist in). Does not yet use thumb opposition.
- Infant rolls from back to stomach. When on tummy, the infant can push up with arms to raise the shoulders and head above surface and look around or reach for objects.

6 - 9 months
- Infant can walk while holding an adult's hand
- Infant is able to sit steadily, without support, for long periods of time
- Infant learns to sit down from a standing position
- Infant may pull into and maintain a standing position while holding onto furniture

9 - 12 months
- Infant begins to balance while standing alone
- Infant takes steps and begins to walk alone

SENSORY DEVELOPMENT

Hearing -- begins before birth, and is mature at birth. The infant prefers frequencies of the human voice.
Touch, taste, smell -- mature at birth; prefers sweet taste.
Vestibular (inner ear) senses -- the infant responds to rocking and changes of position.
Vision -- the newborn infant can see within a range of 8 - 12 inches. Color vision develops between 4 - 6 months. By 2 months, can track moving objects up to 180 degrees, and prefers faces.

LANGUAGE DEVELOPMENT

Crying is a vitally important means of communication. By the third day of life, mothers can tell their baby's cry from others. By the first month of life, most parents can tell if their baby's cry means hunger, pain, or anger. Crying also causes a nursing mother's milk letdown. The inherent biological response in most humans to crying insures the infant's survival.

The amount of crying in the first 3 months varies in a healthy infant, from 1 - 3 hours a day. Infants who cry more than 3 hours a day are often described as having colic.Colic in infants is rarely due to a problem with the body.

Excessive crying can be associated with child abuse. Regardless of the cause, it is a complex problem that deserves a medical evaluation.

BEHAVIOR

The behavior of the newborn is characterized by six states of consciousness:

Active crying
Active sleep
Drowsy waking
Fussing
Quiet alert
Quiet sleep

The ability to move smoothly from one state to another is one of the most reliable signs of nervous system maturity and health. Heart rate, breathing, muscle tone, and body movements vary with each state.

Many bodily functions are not stable in the first months after birth. This variability is normal and differs from infant to infant. Stress and stimulation can affect:

Bowel movements
Gagging
Hiccupping
Skin color
Temperature control
Vomiting
Yawning

Periodic breathing, in which breathing starts and stops again, is normal and is not a sign of SIDS (sudden infant death syndrome). Some infants will vomit after each feeding, but have nothing physically wrong with them. They continue to gain weight and develop normally.

Other infants grunt and groan distressfully while making a bowel movement but produce soft, blood-free stools, and their growth and feeding remain good. This is due to immature abdominal muscles used for pushing and does not require any intervention.

Sleep/wake cycles vary and do not stabilize until a baby is 3 months old. These cycles occur in random intervals of 30 - 50 minutes at birth and gradually increase as the infant matures. By age 4 months, most infants will have one 5-hour period of uninterrupted sleep.

Breast-fed infants will feed about every 2 hours. Formula-fed infants should be able to go 3 hours between feedings. During periods of rapid growth, they may feed more often.

Giving the child water is not necessary. An infant who is drinking enough will produce 6 - 8 wet diapers in a 24-hour period. Teaching the infant to suck a pacifier or his or her own thumb provides comfort between feedings.

SAFETY

Safety is very important for infants. Base safety on the child's developmental stage. For example, around age 4 - 6 months, the infant may begin to roll over. Therefore, take extreme caution while the baby is on the changing table.

Consider the following important safety tips:

Be aware of potential poisons (household cleaners, cosmetics, medications, and even some plants) in your home and keep them out of the infant's reach. Use drawer and cupboard safety latches. Post the national poison control number -- 1-800-222-1222 -- near the phone.
Do not allow older infants to crawl or walk around in the kitchen while adults or older siblings are cooking. Block the kitchen off with a gate or place the infant in a playpen, highchair, or crib while others cook.
Do not drink or carry anything hot while holding the infant to avoid burning the infant -- infants begin waving their arms and grabbing for objects at 3 - 5 months.
Do not leave an infant alone with siblings or pets. Even older siblings are seldom prepared to handle the potential emergency situations that may arise. Pets, even though they may appear to be gentle and loving, may react unexpectedly to an infant's cries or grabs, or may actually smother an infant by lying too closely.
Do not leave an infant unattended on a surface from which the child can wiggle or roll over and fall off.
For the first 5 months of life, always place your infant on his or her back to go to sleep. This position has been shown to reduce the risk of SIDS (sudden infant death syndrome). Once a baby can roll over by himself, the maturing nervous system greatly reduces the risk of SIDS.
Know how to handle a choking emergency in an infant by taking a certified course through the American Heart Association, the American Red Cross, or a local hospital.
Never leave small objects within an infant's reach -- infants explore their environment by putting everything they can get their hands on into their mouth.
Place infant in a proper car seat in every car ride, no matter how short the distance. Use a car seat that faces backwards until the infant is at least 1 year old, or longer if possible. Then you can safely switch to a forward facing car seat. The safest place for the infant's car seat is in the middle of the back seat. It is vitally important for the driver to pay attention to driving -- not playing with the infant. If an infant needs assistance, safely pull the car over to the shoulder and park before trying to help the infant.
Use gates on stairways, and block off rooms that are not "child proof" -- remember, infants may learn to crawl or scoot as early as 6 months.

CALL YOUR HEALTH CARE PROVIDER IF:

The infant does not look good, looks different from normal, or is not consolable by holding, rocking, or cuddling.
The infant's growth or development does not appear normal.
Your infant seems to be "losing" developmental milestones. For example, if your 9-month old was able to pull to standing, but at 12 months is no longer able to sit unsupported.
You are concerned at any time.

Review Date: 4/7/2008

Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz, Kelli A. Stacy, ELS. Previously reviewed by Rachel A. Lewis, MD, FAAP, Columbia University Pediatric Family Practice, New York, NY. Review provided by VeriMed Healthcare Network (11/12/2007).

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Doctor of medicine profession (MD)

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Overview

Alternative Names
Information

Illustrations

Types of health care providers

HEALTH GUIDE REFERENCE FROM A.D.A.M

Alternative Names

M.D. profession

Information

The practice of medicine in the United States dates back to colonial times (early 1600s). At the beginning of the 17th century, medical practice in England was divided into 3 distinct groups: the physicians, the surgeons, and the apothecaries.

Physicians were viewed as elite and usually held a university degree. Surgeons, in contrast, were typically apprenticed and hospital-trained, and often served the dual role of barber-surgeon. Apothecaries also learned their roles (prescribing, making, and selling medicines) through apprenticeships, sometimes within hospitals.

This distinction between medicine, surgery, and pharmacy did not survive in colonial America. University-prepared MDs from England, upon their arrival in America, were expected to also perform surgery and prepare medicines. The class distinctions and snobbishness associated with physicians over surgeons quickly became diluted.

The New Jersey Medical Society, chartered July 23, 1766, was the first organization of medical professionals in the colonies. It was developed to "form a program embracing all the matters of highest concern to the profession: regulation of practice; educational standards for apprentices; fee schedules; and a code of ethics." Later this organization became the Medical Society of New Jersey and, having survived numerous obstacles, remains the oldest medical society in the United States.

The regulation of medical practice, by examining and licensing practitioners, was initiated by professional societies through provincial legislatures as early as 1760. By the early 1800s, the establishment of regulations, standards of practice, and certification of doctors was firmly in the hands of the medical societies.

A natural next step was for such societies to develop their own training programs for doctors. These society-affiliated programs were called "proprietary" medical colleges.

The first of these proprietary programs was the medical school of the Medical Society of the County of New York, founded March 12, 1807. Proprietary programs began to spring up everywhere and attracted a large number of students because they eliminated 2 features of university-affiliated medical schools: a long general education and a long lecture term.

To address numerous abuses within medical education, a national convention was held in May 1846. Proposals from that convention included the following:

The creation of a national medical association
The adoption of uniform higher educational standards for MDs, including suitable courses of premedical education
A standard code of ethics for the profession

On May 5, 1847, nearly 200 delegates representing 40 medical societies and 28 colleges within 22 states and the District of Columbia convened and resolved themselves into the first session of the American Medical Association (AMA). Nathaniel Chapman (1780-1853) was elected as the first president of the association. The AMA was maintained and has grown to become a formidable organization capable of exerting a great deal of influence on issues related to health care within the United States.

Initial educational standards for MDs, set by the AMA, included the following:

A liberal education in the arts and sciences
A certificate of training completion from the preceptor over apprenticeship prior to medical-college entrance
An MD degree that encompassed 3 years of study, including two 6-month lecture sessions, 3 months devoted to dissection, and a minimum of one 6-month session of hospital attendance

In 1852 the standards were revised to incorporate additional requirements:

Medical schools had to provide a 16-week course of instruction that included anatomy, medicine, surgery, midwifery, and chemistry.
Graduates had to be at least 21 years of age.
Students had to complete a minimum of 3 years of study, 2 of which were under an acceptable practitioner.

Between 1802 and 1876, 62 fairly stable medical schools were established. In 1810, there were 650 students enrolled and 100 graduates from medical schools in the United States. By 1900, these numbers had risen to 25,000 students and 5,200 graduates. Nearly all of these graduates were white males.

Daniel Hale Williams (1856-1931) was one of the first black MDs. After graduating from Northwestern University in 1883, Dr. Williams practiced in Chicago and was later a primary force in establishing Provident Hospital, which still serves Chicago's South Side.

Elizabeth Blackwell (1821-1920), upon graduating from Geneva College of Medicine in upstate New York, became the first woman granted an MD degree in the United States.

The Johns Hopkins University School of Medicine opened in 1893. It is cited as being the first medical school in America of "genuine university-type, with adequate endowment, well-equipped laboratories, modern teachers devoted to medical investigation and instruction, and its own hospital in which the training of physicians and healing of sick persons combined to the optimal advantage of both." Johns Hopkins Medical School served as a model for the reorganization of medical education. After this, many sub-standard medical schools closed.

By 1930, nearly all medical schools required a liberal arts degree for admission and provided a 3- to 4-year graded curriculum in medicine and surgery. In addition, many states also required candidates for medical licensure to have completed a 1-year internship in a hospital setting in addition to possessing a degree from a recognized medical school.

The emergence of specialization within American medicine did not take root until the middle of the 19th century. People who objected to specialization said that "specialties operated unfairly toward the general practitioner, implying that he is incompetent to properly treat certain classes of diseases" and that specialization tended "to degrade the general practitioner in the view of the public." However, as the base of knowledge within medicine continued to grow and many doctors chose to do more of what they were interested in and good at, specialization became inevitable.

Economics may have also played an important role as the specialists typically enjoyed higher incomes than did the generalist physicians. The debates between specialists and generalists continue and have recently been fueled by issues related to modern health care reform.

Medicine was the first of the professions to require licensure. State laws specific to the licensure of medicine outlined the activities of "diagnosis" and "treatment" of human conditions strictly within the domain of medicine. Any individual who professed to diagnose or treat as part of the profession could therefore be charged with "practicing medicine without a license." As a result of strict licensure laws that were issued by the various medical societies, conventional Western medicine was able to establish itself as a monopoly over the health care of the American populace.

SCOPE OF PRACTICE

The practice of medicine includes the diagnosis, treatment, correction, advisement, or prescription for any human disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real or imaginary.

PRACTICE SETTINGS

MDs may be found within a wide range of practice settings, including private practices, group practices, hospitals, health maintenance organizations, teaching facilities, and public health organizations.

REGULATION OF THE PROFESSION

Medicine, like many other professions, is regulated at 2 different levels:

Licensure is a process that takes place at the state level in accordance with specific state laws.
Certification is established through national organizations with requirements for minimal professional practice standards being consistent nationally.

Licensure: All states require applicants for MD licensure to be graduates of an approved medical school and complete the USMLE (United States Medical Licensing Exam) Steps 1 - 3. Steps 1 and 2 are completed while in medical school and step 3 is completed after some medical training (usually between 12 - 18 months, depending on the state). People who obtained their medical degrees in other countries also must satisfy these requirements before practicing medicine in the United States.

With the inception of telemedicine, there has been concern as to how to handle state licensure issues when medicine is being shared between states through telecommunications. Laws and guidelines are being addressed.

Certification: MDs who wish to specialize must complete an additional 3 - 4 years of postgraduate work within their area of specialty, then pass board certification examinations. Doctors who claim to practice within one of the specialties should therefore be board-certified within that specific area of practice.

Review Date: 1/22/2007

Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

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