NUTRITIONAL CARE FOR GOUT

What is gout?

Gout is a disorder of purine metabolism which results in the accumulation of high levels of uric acid in blood. Uric acid are the waste products created after the breakdown of purines. The symptoms of gout are similar to arthritis but in this case crystals of uric acid are formed within the joint tissues which causes inflammation. Gout is generally associated with sudden onset of localized pain that begins from the toe and continues up the leg.

Gout mostly occurs after the age of 35 and is more common in males. Other factors which are normally associated with gouty conditions are

• Obesity
• Diet rich in fats and proteins and low in carbohydrates.
• Certain medicines such diuretics, aspirin, levodopa.
• Deficiency of enzymes responsible for purine metabolism.

Role of purine in gout

Uric acids are formed from the breakdown of purines in body. A diet low in purine along with medicines should be encouraged to reduce inflammation which occurs as a result of gout. Foods that are rich in purine and should be avoided are

1. Beef
2. Organ meat such as liver, brains,kidney and heart.
3. High fatty fishes such as sardines and roe
4. Minced meat
5. Yeast

Purine is the type of proteins that is present in some vegetables also and should be eaten in small amounts (Not more 1/2 cup of any purine rich vegetables is allowed in a day). Those vegetables are

1. Mushrooms
2. Peas
3. Spinach
4. Lentils
5. Beans
6. Broccoli
7. Asparagus

Diet in Gout

Along with medicines , dietary modification is also essential to eliminate or inhibit uric acid synthesis, and reducing the recurring onsets of gout.

1. Caloric restriction in case of being overweight . Because gout is more likely to develop if a person is obese. Also losing weight helps to relieve overall stress on joints.
2. Excessive fluid intake (3L/day) should be encouraged in order to assist uric acid excretion.
3. Gout diet should be high in complex carbohydrates ,low in saturated fats and moderate in protein to ensure uric acid excretion.
4. Vitamin C may helps to lower uric acid levels. Take fruits and vegetables rich in vitamin C.
5. Sodium bicarbonate or baking soda is highly alkaline and may help to lower uric acid in blood. But it is not advisable for patients with hypertension. 1/2 tsp of sodium bicarbonate in lemon juice helps to relieve gout symptoms.
   

   ---

By,

Aliya Waqas

Food myths

Nutrition is mostly the favourite topic of discussion and these food myths are created either unintentionally based on personal experiences and word of mouth or intentionally as a marketing strategy in order to gain commercial benefits. Here we will discuss some of the popular beliefs about foods that are not true.

Apple and banana are rich in iron.

Apples and bananas are rich in iron as they turn brown when exposed to air. They turn brown because they contain an enzyme tyrosinase which when exposed to oxygen cause discolouration of fruits . The iron content of apple is 0.7 mg/100gm and banana is 0.4mg/100gm which is quite low as compared to other iron rich foods.

Hormones are injected in poultry.

Hormones are injected in poultry which is the main reason of early maturity or infertility, in girls, but the fact is hormones itself are far more expensive than chicken and it is not economical to give hormonal injections to chickens. Any hormones if present in food are denatured during cooking and in digestive track so there is no negative impact of eating poultry to the consumer.

Brown sugar and honey is better than sugar

Many people think that honey or brown sugar are better than sugar and can be taken if one is planning to restrict sugar in diet. However the only difference between them is the amount of micronutrients present. All three provide equal number of calories and there is not much difference in the reaction of these products in your body.

Eggs are bad for heart health

Eggs are rich in protein, fats, vitamins and minerals. One boiled egg contains about 5 gm of fat most of them are unsaturated . It also contains omega 3 fatty acids which is good for heart. As part of a healthy diet one can consume about 6 eggs in a week. Many people believe that cholesterol present in them may elevate blood cholesterol level. But the fact is ,cholesterol in egg has no effect on blood levels.

Egg whites are better than egg yolks

A popular belief is that egg yolks are harmful for elderly and young children,as they contain more fats and cholesterol than whites. However the truth is egg as whole is a combination of essential amino acids and fats and should be consumed regularly by all age groups. Also egg whites contains allergy causing amino acids and are not recommended for children before 10 months.

Carbohydrates from all sources makes you fat

One of the most common food myth is that all carbohydrates sources can lead to weight gain and obesity. This idea is mostly incorporated in minds by fad diet advocates who suggest to reduce carbohydrates to less than 50 grams per day. However the truth is carbohydrates should be consumed as the main source of energy . Carbohydrates is the form of energy that is present in all fruits and vegetables as well as in desserts and carbonated beverages, so choice of food is essential ,not restricting yourself to certain macronutrients.

Eating sugar can cause type 2 diabetes

Eating sugar does not directly cause elevated sugar levels in blood. It is a common misconception that a person who consume more sugar are more at risk of developing type 2 diabetes. Type 2 diabetes is a metabolic disorder in which many factors are involved which includes family history, obesity and lack of exercise and is not associated with consuming more sugars.

Supplement can cover all your nutrient needs

A healthy balanced diet is the best way to get all the vitamins and minerals needed to perform body functions. Vitamins and mineral supplements should only be used to cover any micronutrient deficiencies and when the diet is not adequate and lack of those nutrients.

Certain foods can detoxify your body from wastes.

Detoxification is the natural process constantly occurring in your body by liver and kidneys. No food has the ability to detoxify your body from wastes.

---

byAliya Waqas

DIET AND NUTRITION IN CHILDHOOD

The period of 1 year to puberty is the time of significant growth in terms of social cognitive and emotional areas. The physical growth may be less remarkable but continue to proceed steadily. Because children are growing and developing teeth, muscles and blood , they need more nutritious foods and are at more risk of becoming malnourished as a result of poor appetite and wrong selection of foods.

Nutrients need of children

The nutrient need of children are determined on the basis of their age , rate of growth and activities. For instance the dietary requirement of preschool children differ from school going children. They require high energy and nutrient dense foods in small frequent meals. School going children over the age of five should eat healthy, varied diet along with regular physical activity in order to maintain a healthy body weight.

• The dietary energy of children should be sufficient enough to meet the requirements and spare proteins from being used for energy. The recommended proportion of energy is 50-60 % from carbohydrates, 25 -30% from fats and 10-15% from proteins.
• Minerals and vitamins are essential for normal growth and development. Children between the age of 1-3 are at high risk of developing iron deficiency anaemia. Foods rich in iron should be introduced at this age. Calcium is essential for bone development and vitamin D is needed for calcium absorption. Zinc deficiency has also been reported in preschool and school going children which results in growth failure, poor appetite and difficulty in wound healing.

Dietary guidelines for adequate diet

Food is not just providing nutrients for growth and maintenance of the body, it also helps in the development of feeding skills and dietary habits. Following are some basic guidelines in order to ensure adequate diet and providing positive healthy eating patterns for future.

Breakfast

Experimental studies of healthy children have shown that learning difficulties have been observed more in children who fasted overnight and skipped breakfast than those who had a regular breakfast before going to school. A healthy breakfast should consist of a portion of proteins, cereals and fruits or vegetables.

Examples

1. An oatmeal with milk topped with fruits and nuts.
2. An egg with a slice of bread , a fruit and a cup of milk.

Snacks

Snacks such as crisps, biscuits and chocolates should be consumed infrequently and not on regular basis. Fruits , yogurts, sandwiches with a healthy filling such as egg, kebabs or vegetables should be encouraged. Foods rich in fats and sugars should be given less often or as a treat.

Lunch and dinner

For children lunch time or dinner is of great significance. Focus on variety of vegetables, wholegrain breads and pastas in the mealtime. A diet should be low in salt as it contributes to high blood pressure later in life.

Lunch or dinner should be a presented as a proper family meal as it is the primary influence in the development of food habits.

Nutritional concerns in children

• Obesity is a common problem which can lead to chronic diseases in later life. The main reason for obesity are increase consumption of fast foods and sugar with little or no physical activities. A change in dietary habits and increase in physical activities is essential in order to prevent obesity among children.
• Iron deficiency is one of the most common disorder in children. Good dietary sources such as mutton, beef, and fish should be included in diet.
• Underweight or weight loss in children is caused as a result of poor appetite, medications or lack of simple food.
• Dental caries may effect children who drink sweetened milk from bottles, as well as consume foods rich in sugars . Desserts and sweets should be given along with meals to reduce their affects on teeth.
• Food allergies are mostly observed in children with positive family history of allergies. Care should be given to responses of children after certain foods.

Vitamins and minerals supplements

Vitamin and minerals supplements are usually not recommended as long as the needs are fulfilled from diet . However in certain situations it becomes necessary for children to be supplemented with additional vitamins and minerals. This include

• Children belonging to low socioeconomic groups.
• Children with poor eating habits, anorexia and poor appetite.
• Children consuming strict vegetarian diets.
  

  ---

By

Aliya Waqas

DIET FOR SPORTS AND EXERCISE’

During recent decades special interest have been seen in physical fitness programs and sports, The dietary goal for individuals involved in different sports and exercises is to obtain adequate nutrition in order to carry out physical activities. Many nutritional supplements and dietary regimen are sometimes taken by the fitness-conscious individuals in hope of getting maximum benefits from the exercise plans. Unfortunately most of the diet plans are based on misinformation and food myths.

A healthy and balanced diet during exercise is essential and will provide you with all the nutrients needed by the body to carry out physical activity.

Nutritional requirements in exercises

Nutrient requirement for individuals carrying out physical activities vary with weight, height, age, sex and with the type , frequency, intensity and duration of exercise.

Fluids

During exercise it is essential to drink plenty of fluids in order to maintain a normal body temperature and prevent dehydration which results from sweating. Dehydration or not drinking enough water directly effect performance. Some useful tips for proper hydration are

• Drink at least 1 -2 glass of water 2 hours before and after exercise.
• Drink 1 glass of water after every 20 min during exercise.
• A replacement drink containing sodium and glucose is required to prevent dehydration in strenuous exercises and sports that lasts for more than an hour.
• Drink should be cool.

Carbohydrates

Carbohydrates are an important source of energy that body needs in order to perform any activity. In general more carbohydrates are needed for more vigorous activities because the first source of fuel for exercising muscles are its own carbohydrates stores. A diet low in carbohydrates results in lack of energy and low blood sugar levels.

Depending upon the training regimen , a special attention should be given on type and quantity of carbohydrates. Healthy sources of carbohydrates include wholegrain bread and cereals and fruits.

Proteins

The popular belief about proteins among those involved in physical exercises and body building is that it increases strength and enhances performance. Protein supplements are also taken by some athletes, however this should be discouraged as it puts additional stress on liver and kidneys.

In general the amount of proteins consumed by a normal individual is sufficient enough to meet the requirement of proteins during exercise and sports.

Fats

People involved in strenuous physical activities should consume 20-30% of their total calories from fats. For individuals who need to lose weight can limit consumption of dietary fat. Doing this eliminates excess calories but not nutrients.

Vitamins and minerals

The vitamins and minerals levels should be carefully monitored in order to avoid micronutrient deficiencies and sports anaemia.

Exercise and weight management

Exercise along with balanced diet is extremely important part in weight management. In order to lose weight it is essential to keep an eye on your intake after exercise. Physical activities often leave you feeling quite hungry and at that time proper choice of food is essential. Eating deliberately after exercise and wrong choice of food will eventually result in weight gain rather than weight loss.

---

By ,

Aliya Waqas

BENEFITS OF FIBER IN DIET

What is dietary fiber

Fiber is the type of carbohydrates which is derived mostly from plant cell and is not digested by enzymes in digestive track. Although not absorbed by the body , fiber is an extremely important nutrient with many health benefits. The daily recommended allowance of fiber is 30 grams for a healthy adult.

Benefits of dietary fiber

• Fiber in diet help to keep your digestive system run smoothly and prevents constipation by regulating bowel movement.
• A high fiber diet lower the risk of hemorrhoids and aids in the treatment of piles.
• Soluble fiber in vegetables, legumes oats and flaxseed inhibits and delay absorption of glucose and cholesterol and helps to lower their blood levels.
• Fiber also aids in weight management as fiber containing foods are digested slowly and make one feel full for longer periods of time.

How to increase fiber intake

1. Replace refined carbohydrates with whole grains. Use whole grains cereals, bread and chapatti instead of refined carbohydrates as they are natural source of fiber. Try starting your day with whole grain porridge or bread. Consume at least half of your carbohydrates as whole grains. Examples of whole grains are, oatmeal, whole wheat, brown rice, barley and popcorn.
2. Consume variety fresh fruits, for example apples, strawberries,prunes, pears and oranges . Use them as a snack or with meals.
3. Beans , peas and legumes are rich source of fiber. Try adding one serving of any of these in a day.
4. Vegetables are the healthiest of all food groups and great source of fiber. It is essential to add 5-8 servings of fruits,vegetables and legumes in daily diet.
5. Use whole wheat grains instead of refined flour in your home baking.
6. Psyllium husk (isapghol) is an excellent source of fiber. 1tbsp of husk daily helps to relieve constipation, diarrhoea and helps to lower cholesterol.

High fiber foods are good for health, but excessive fiber intake can promote intestinal gas, bloating and abdominal cramping. It is essential to increase fiber gradually in your diet. Drink plenty of water as it helps in absorption of fiber and increases stool weight.

Antioxidants

STRESS MANAGEMENT THROUGH DIET

Stress is basically a state of emotional or mental tension which results from adverse circumstances. When a body is under stress it releases a a complex set of hormones like adrenaline, cortisol and norepinephrine, which prepares the body for physical action.

Effects of stress on human body

Stress and depression directly affects ones health. Prolonged stress can lead to heart diseases, diabetes, high blood pressure, irritable bowel syndrome, ulcers , alopecia, and can even lead to obesity, muscle and joint pains. The most common problems that individuals suffers in stress are

• Sleeplessness or insomnia
• Memory problems
• Depression
• Anxiety
• Frustration
• Panic
• Chest pain
• Increased heart beat
• Indigestion
• High blood pressure
• Hyperglycaemia
• Frequent urination
• Eating disorders, anorexia or binge eating

Diet and stress

Stressand diet are directly related to each other. The person under stress either eats too much or stops eating, which can lead to either obesity or weight-loss. Feeling stressed can lead to the increase in levels of cortisol hormones which ultimately contributes in weight gain and linked to the tendency of body to store fat around stomach. In order to combat stress , individuals normally opt for foods rich in sugar and fat which also results in weight gain.

Many studies reveal that individuals taking healthy and balanced diet are less stressed than those on poor diet. A good diet also helps to reduce your stress levels.

• Eating small frequent meals can keep your metabolism on the go and help to minimise your stress.
• A diet rich in Magnesium helps to reduce anxiety and are muscle relaxers.
• B-vitamins provides you with energy needed to fight in times of stress
• Vitamins C are largely stored in adrenal glands which are responsible for the secretion of cortisol, a stress hormone.

Stress relieving foods

Many people claims that eating high fatty foods and desserts relieves stress. However it is essential to avoid such high sugar foods, because along with obesity it causes irritability and put an extra strain on the body. An increase consumption of hydrogenated fats food can result in increase in depression.

The foods that help to reduce stress are

• Complex carbohydrates such as whole wheat grains, cereals such as oat meals tend to increase the level of serotonin in blood. The imbalance of serotonin in blood results in depression.
• Fruits and vegetables provide more nutrients, vitamin and minerals to the body which are needed in large amounts in times of stress
• Foods rich in calcium such as low fat milk, yogurt,cheese and eggs helps to reduce muscle tension and anxiety.
• Omega 3 and omega 6 found in high fat fish, flaxseeds, walnuts and pumpkin seeds help to lower the release of corticosteroids ( hormones released in stressful conditions) and thus lowers mental and physical stress.

Some examples of stress busting foods are

• Oatmeal
• Green leafy vegetables
• Almonds
• Walnuts and pistachios
• Fish
• Yogurt
• Dark chocolate
• Milk

Along with a healthy diet , good night sleep and exercise also help to lower stress levels.

---

by

Aliya Waqas

DETOX DIET (Another food myth)

Detox diet, detox water and detox tea, all these terms are getting popular these days for weight loss .
The detox diet advocates claims that by drinking cucumber water with a hint of lemon, ginger and honey and other fruits and vegetables and juices can clean your body, boost your metabolism, and help you to lose weight.
In order to understand the pros and cons of detox diet it is essential to know the real concept behind detoxification.

What is detox diet

Detoxification is the process of removal of the negative toxins from the body by the enzyme systems in the liver and immune tissue located in the gut.
Detox diet advocates claims that this diet removes toxic substances from the body through intermittent fasting followed by the diet high in fruits, vegetables and juices. The science behind the detox diet is to get rid of toxic substances in the body through colon and intestinal cleansing.
The healthy body, with healthy liver and kidneys are automatically detoxifying your body against all toxic and foreign compounds, so there is hardly any need of detoxification from diet.
The important features of detox diets are

• Intermittent fasting
• Eating only fruits and vegetables
• Restricted cereal and grains intake
• Avoiding tea and coffee
• Limited or no dairy
• Drinking detox solutions, tea water and juices

Advantages of detox diet.

Detox diet offers wide range of fruits and vegetables which are an important part of healthy and balanced diet. It provides you with vitamins, minerals and antioxidants needed by the body to perform functions. Also detox diet encourages to drink more water, and discourages eating refined carbohydrates, processed food,sugars and fats. This is the reason why people on detox diets initially feel more focussed and energetic. It also encourages you to cut down your caffeine intake from tea and coffee which has several negative impact on your body.

Disadvantages of detox diet

There are several disadvantages of detox diet ;

• The diet is deficient in whole wheat grains and carbohydrates, which may lead to vitamins and minerals deficiency.
• The restrictions in diet makes it difficult to follow and one gains weight as soon as it stops dieting.
• Severe energy deficiency may lead to lower immunity and malnourishment and can lead to irritability, and headache.
• The strict diet pattern may result in craving for food items and ends up in developing eating disorders.

Conclusion

Detox diets are basically another food fad and strategy by the companies to promote their so-called detox waters, tea and potion rather than a reality.
One can keep himself healthy by taking a balanced diet with 5 portions of fruits and vegetables a day, avoiding caffeine containing beverages, and processed meat.
No detox teas , juices or waters have magical effects by which you can lose extra pounds in weeks.

---

by Aliya Waqas

HEALTHY SNACKING

Snacking is generally a term used for eating something between meals. It is normally is associated with eating high fat crisps, biscuits or other bakery products. But it is not true . The snacking can be a healthy habit and may provide certain health benefits if proper choices about the kind and quantity of food can be made. It gives body the energy and nutrients it requires to perform functions throughout the day.
Normally there are 6 -7 hours gap between each meals, and going for a longer period of time without food may lowers blood sugar levels of some individuals and cause irritability in their systems. So sometimes in certain situations it is essential to break the gap by eating or drinking in order to satisfy hunger and keeping the blood sugar level normal.

Tips for healthy snacking.

• Foods normally referred as snacks such as crisps, french fries, confectionery like biscuits, cakes and pastries are rich in fats and sugars and low in vitamins and minerals can lead to obesity and other health problems. Try to use these foods occasionally.
• A proper food choice is essential for healthy snacking. Put more emphasis on using fruits and vegetables as a snacks. As they are nutrients dense and low in calories.
• A glass of milk ,juice or a cup of tea or coffee sometimes satisfy hunger pangs . So always take a drink before snacking.
• Try snacking only when you are hungry, between long meal gaps.
• When buying foods, focus more on fruits , low fat yogurts ,unsalted nuts. Try to avoid buying biscuits, crisps and bakery as snacks

Examples of healthy snacks

• An apple, a small banana, a peach , grapes or a cup of fruit salad.
• 12 -14 almonds or a small handful of nuts.
• A hard boiled egg
• Carrots and cucumbers .
• A small bowl of pop corns.
• A slice of bread with a small layer of honey or butter on it.
• 1-2 whole wheat biscuits.
• A cup of low fat unsweetened yogurt with fruits.
• Roasted chickpeas.