Eye Problems Beyond the Diet

While it may seem like deteriorating vision is an inevitable part of aging, eating an antioxidant-rich diet can prevent or combat many eye problems. Age-related macular degeneration (ARMD) is one of the most common causes of blindness in seniors. It entails a gradual, painless deterioration of the macula, the tissue in the central portion of the retina. The first symptom is usually blurring of central vision but eventually side vision can also become limited.

Cataracts develop when the lens, the transparent membrane that allows light to enter the eye, yellows. This hinders the passage of light rays, making your vision hazy, cloudy, or blurry. It’s like looking through a frosty or fogged-up window. Cataracts can develop in one or both eyes, and most are the result of getting older. During middle age, however, cataracts are often small and don’t impair vision. As they grow, your ability to see things clearly diminishes and reading and driving, especially at night, become more difficult. If untreated, the lens may become completely opaque, resulting in blindness.

QUICK TIP:
-Start your day with fruit
-Whether your breakfast staple is eggs, cereal, or pancakes, add a vision-saving burst of antioxidants to your morning meal with a glass of orange or tomato juice, grapefruit, kiwi, strawberries, or cantaloupe.

Nutrition Connection
-Choose antioxidant-rich vegetables and fruits. While carrots are good for your eyes, you’ll get more peeper-protecting antioxidant vitamins such as A, C and E, lutein, and zeaxanthin from dark leafy greens, corn, and red pepper.
-Maintain a healthy weight. Carrying around too many pounds may increase your risk for cataracts. Eat a healthy diet, watch your calorie intake, and exercise to lose weight and keep the pounds off.
-Take a multivitamin every day. A major study suggested that if every American at risk for ARMD took daily supplements of antioxidant vitamins and zinc, more than 300,000 people could avoid the associated vision loss over the next five years. Other studies found that women who took vitamin C supplements for at least 10 years were 77% less likely to show initial signs of cataracts than those who took no supplemental C.
-Eat fish at least twice a week. A study from Australia involving more than 3,500 older adults found that eating fish just one to three times per month appeared to protect them against ARMD.
-Cut back on saturated fats. Research shows that a diet high in saturated fats, including foods (such as fatty red meat, butter, and cheese) increases the risk of ARMD. Scientists theorize that saturated fats may clog the arteries in the retina in the same way that they contribute to atherosclerosis in larger blood vessels.

Beyond the Diet
-Shade your eyes. Wear sunglasses and a wide-brimmed hat or cap to protect your eyes from ultraviolet rays, which may contribute to the development of age-related eye problems.
-Stay slim and active. Being severely overweight may cause these diseases to progress more rapidly. You can reduce your risk of ARMD by 54% if you are active (even walking or gardening) 1 to 2 hours a day. -Keep your blood pressure and cholesterol low. High blood pressure and high cholesterol increase your risk of developing ARMD.
-Quit smoking. If you don’t, your chances of developing cataracts increase.

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Ketogenic Diet for Epilepsy

Epilepsy refers to recurrent seizures triggered by abnormal electrical impulses in the brain. Some seizures are so mild and fleeting that they are barely noticeable; others last for several minutes, during which the person falls down and is seized by convulsive movements. The frequency of seizures also varies from person to person.

Neurologists generally discount any link between diet and epilepsy, but there are exceptions. Those with epilepsy who have migraine headaches that are triggered by certain foods often cease to have seizures when those foods are eliminated. Some diabetics suffer seizures when their blood sugar levels drop suddenly. Large amounts of alcohol consumed in a short time can cause seizures. There have been rare reports of aspartame triggering seizures in people with epilepsy.

Another exception: The ketogenic diet has helped halt seizures in the 20% of children whose attacks cannot be controlled by drugs.

Nutrition Connection
There is no one set diet for those with epilepsy, but some of these nutritional approaches may be helpful in controlling the disease:
-Consider the ketogenic diet for children. Neurologists at Johns Hopkins Hospital have refined a dietary treatment for severe epilepsy. The ketogenic diet causes the body to break down fats instead of carbohydrates for energy. For children, the diet begins with 2 to 3 days of fasting in a hospital, and then the foods are introduced gradually. It provides about 75% of the calories generally recommended for healthy children, most of them from fats. A small amount of protein is added to allow for at least some growth, but carbohydrates are kept to a minimum. Fluid intake is restricted. The diet must be carefully tailored and then followed exactly, as even small changes can cause seizures. Although difficult, there’s a payoff: Most can resume a normal diet and still be seizure-free after 2 to 3 years.
-Make diet changes. Adults can also try the ketogenic diet if they don’t respond to drugs. But this diet isn’t recommended for adults because of its very restrictive nature. Johns Hopkins researchers have also developed a modified Atkins diet, which is a low-carbohydrate, high-fat diet. Studies have shown that the diet lowers seizure rates in nearly half of adults who try it. Speak to your doctor before changing your diet.

Beyond the Diet
People with epilepsy can lead a fulfilling life. Keep the seizures under control by following these guidelines: -Stay on top of your medications. Although dealing with side effects can be difficult, it is imperative to take the right doses as frequently as directed by your doctor. If the side effects bother you, speak to your doctor. -Get good sleep. Not getting enough rest can trigger a seizure. Aim for 7 to 8 hours a night.
-Wear a medical alert bracelet. This can alert medical personnel effectively and save your life.
-Inquire about other therapies. Depending on your situation, surgery or other therapies may be advisable. Speak to your doctor about your options.
-22% of stroke patients may develop epilepsy.

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Treatments for Eczema, Beyond the Diet

Eczema is an itchy, scaly rash often caused by sensitivity to foods, certain chemicals, or environmental conditions such as dryness. The rash is not always a true allergic reaction, but an immune system reaction to a normally harmless substance. Symptoms can appear anywhere from a few minutes to several hours after exposure to the offending food or substance. Eczema runs in families, often along with a tendency to develop asthma, hay fever, or hives.

The most common type of eczema is atopic dermatitis; the term “atopic” refers to a personal and family tendency to develop eczema, asthma, or hay fever. Other types include contact dermatitis, which occurs after a substance damages the skin, and seborrheic eczema, which is better known as dandruff, or greasy, scaly patches on the skin or scalp.

Nutrition Connection
While some foods may help alleviate eczema, some foods may trigger it. 
Note these guidelines:
-Test for allergies. Common culprits include eggs, dairy products, seafood, walnuts, and pecans. Cow’s milk can cause eczema in babies and small children; goat’s milk or soy milk may be better tolerated. Many children outgrow their sensitivities by the age of six, but others have lifelong recurrences.
-Consume more antioxidants. Dryness may cause eczema by triggering the formation of free radicals and therefore may be countered by antioxidants such as beta-carotene. Brightly colored fruits and vegetables including apricots, squash, mangoes, carrots, pumpkin, and sweet potatoes are good choices.
-Eat foods rich in essential fatty acids. Foods like vegetable oils, fatty fish, and flaxseed may decrease swelling by helping to generate hormone-like substances called prostaglandins, which reduce inflammation.

QUICK TIP:
-Drink oolong tea
-Three cups of oolong tea may help relieve the symptoms of eczema. The polyphenols in the tea suppress allergic responses.
-Get lots of vitamin B6. Some researchers believe a diet rich in vitamin B6 protects against sensitivity rashes. Good sources include oily fish, meats, legumes, bananas, brown rice, wheat germ, and leafy green vegetables.

Beyond the Diet
There are many potential causes of eczema that don’t pertain to food. Here are some general recommendations to avoid flare-ups:
-Avoid known triggers. If your rash becomes worse in either hot or very cold weather, avoid extremes of temperature. Buy soaps, detergents, and toilet papers that are free of dyes and perfumes.
-Evaluate external causes. Common offenders include nickel, which is often used for making costume jewelry; latex, which is used in household and industrial rubber gloves; woolen clothing; skin care products based on lanolin, the natural oil that is found in wool; and acrylic adhesives, used in applying acrylic nails or in sneakers.

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How to Treat Diverticulitis, Beyond the Diet

Diets lacking in dietary fiber, which are common in industrialized countries, can cause constipation, which may provoke unnatural contractions of the large intestine, which in turn leads to the formation of diverticula. This condition, called diverticulosis, can develop into diverticulitis when the diverticula become inflamed or infected. The specific cause remains unknown, but the disease mostly affects people who are over age 60 and overweight. It can be painful and may lead to complications such as abscesses, intestinal obstruction, or perforation of the intestinal wall. In addition to abdominal cramps and pain, other symptoms include gas, fever, and rectal bleeding. Constipation may alternate with diarrhea.

Old School
People with diverticulitis must avoid nuts and seeds.
New Wisdom
There is no scientific evidence to support the association between nuts and seeds diverticulitis.

The type of care you receive depends on the severity of your symptoms. Talk to your doctor about what to expect and treatment options, which range from home care and liquid diets to different types of surgery.

Nutrition Connection
These dietary guidelines can help prevent or delay diverticulosis and diverticulitis.
Try the following:
-Eat more fiber, rich fruits, vegetables and whole grains. Diverticulitis is known to be less common among vegetarians than those who include meat in their diet, as vegetarian diets are typically higher in fiber-rich foods, such as berries, apples, pears, bananas, figs, bran, brown rice, barley, lentils, black beans, split peas, and artichokes. However, it is important to increase fiber intake gradually. If you have diverticular disease, do not start taking fiber supplements without first talking with your doctor.

QUICK TIP:
-Go “exotic” once a month
-Once a month, add a new type of grain to your diet. This will help slowly introduce more fiber to your diet, which helps diverticulitis. Mix in some amaranth, bulgur, or wheatberries into steamed carrots and broccoli, toss with olive oil and a bit of Parmesan or feta cheese, maybe throw in a can of tuna or a couple of ounces of cut-up chicken, and you’ve got dinner.
-Drink fluids. Along with a high-fiber diet, at least eight glasses of clear liquids like water, tea, or broth every day produces bulky, soft stools that move easily through the intestinal tract. Not enough fluids can lead to constipation.
Keep notes. Make note of foods that cause inflammation or pain and avoid them.

Beyond the Diet
Diverticulosis sufferers should keep track of their symptoms and follow these recommendations:
-Go to the bathroom when you have to. If you have diverticular disease, constipation can increase your risk of a diverticulitis flare-up because it increases pressure within your colon.
-Exercise. Exercise reduces pressure inside your colon and encourages normal bowel movements.

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Diarrhea Diet, Nutrition Connection

Diarrhea—the frequent passage of loose, watery stool—is not a disease but a symptom of an underlying problem. It is most commonly brought on by food poisoning, especially among travelers. Transient looseness can be caused by overconsumption of laxative foods (such as prunes), heavy use of sugarless chewing gum sweetened with sugar alcohol (such as sorbitol), and some medications. Emotional stress that causes irritable bowel syndrome may disrupt the normal bowel pattern with alternating diarrhea and constipation; similar symptoms occur in colitis and Crohn’s disease, both inflammatory bowel disorders. In many instances, diarrhea develops without any identifiable cause, but unless the problem persists or recurs often, this is not a cause for concern.

Acute infectious diarrhea is one of the world’s most common ailments. An estimated five billion cases occur every year, and in North America, diarrhea is runner-up only to the common cold as a cause for absences from work. Although diarrhea causes fatalities due to dehydration, it is seldom a threat in affluent, well-nourished societies, except to vulnerable groups: babies, the elderly, and invalids.

Nutrition Connection
Most cases of diarrhea are minor and short-lived and can be managed at home with simple dietary measures, such as:
-Stop solid food and rehydrate. Start by eliminating all solid foods and sipping warm or tepid drinks to prevent any further dehydration. Drinking half a cup of fluid every 15 minutes or so is usually enough. Suitable drinks include water, mineral water, herbal teas, and ginger ale. Clear broths also help replace the salts and other minerals lost in a bout of diarrhea. You can make your own rehydration fluid by mixing ½ tsp (1 mL) of baking soda, a pinch of salt, and ¼ teaspoon (1 mL) corn syrup or honey in an 8-oz (250-mL) glass of water. Commercial sports drinks may help, but avoid ones with more than 10% sugar, which can worsen diarrhea.
-Slowly introduce low-fiber foods. When you feel like eating (but preferably not within the first 24 hours), start with low-fiber foods such as crackers, toast, rice, bananas, cooked carrots, boiled potatoes, and chicken. Often doctors will recommend bananas, rice, applesauce, and toast (called the BRAT diet), especially for children. Apples and other fruits high in pectin (a soluble fiber) help counteract diarrhea; that’s why unsweetened applesauce is a traditional home remedy. Cooked carrots are also high in pectin. Other suitable foods include salted crackers and chicken soup, which help to replenish depleted sodium and potassium reserves.
-Avoid milk products until the symptoms disappear. Some of the organisms that cause diarrhea can temporarily impair the ability to digest milk.
-Avoid apple juice. While apples or applesauce can help ease diarrhea, apple juice, can have the opposite effect. The leftover carbohydrates in apple juice that aren’t absorbed in the small intestine are fermented by bacteria in the colon, potentially leading to diarrhea. In fact, drinking too much fruit juice of any kind is often the cause of diarrhea in toddlers.

Beyond the Diet
Address diarrhea as soon as possible using the following suggestions:
-Try over-the-counter (OTC) remedies. OTC antidiarrheal drugs may give some relief when diarrhea has no obvious cause or is due to a minor illness such as flu. Never use a nonprescription antidiarrhea product for more than 2 days without consulting your doctor.
-Call a doctor if it’s recurring. Some people may have chronic diarrhea due to malabsorption of a nutrient, such as lactose intolerance; consult a physician. Other signs of illness that need medical attention include appearance of blood, mucus, or worms; severe abdominal pain; or diarrhea accompanied by vomiting or fever.

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Glycemic Index VS Glycemic Load

Like gas for a car, food is your fuel. Just as some gas is higher octane, some foods provide better fuel. To gauge how efficiently food works its way through your digestive system to affect your blood sugar, researchers at the University of Toronto developed the glycemic index (GI). The faster a food is digested and absorbed into your bloodstream, the higher its GI. High-GI foods cause a rapid increase in blood sugar, which is dangerous, especially for people with diabetes.

But GI was based on a standard measurement (50 g of carbohydrates) for all foods. In real life, people don’t tend to eat the same amounts of sugar as they do pasta or carrots.

So scientists used a little math wizardry to translate the glycemic index into more practical terms. What emerged is the glycemic load (GL). This tool considers the type of carbohydrate in the food and the amount of carbohydrate in a standard serving. By this new criterion, sugar and starchy foods and some fruits have high GL values whereas most vegetables and fruits have low GL values, meaning they are less likely to make your blood sugar spike.

Today, there are more than 750 published GL values of various foods. However, you should take all GL lists as a general guide only. As it turns out, one person’s glycemic response can differ from another’s. It may vary even in the same person from day to day. Also, the state of food can change its GL.

For example, small differences in a banana’s ripeness can double its GL. Plus, when foods are eaten together (adding butter or sour cream to a baked potato, for instance, or having the potato with a serving of meat) the GL of the combined foods becomes much different from the GL of the potato by itself. The reason is that fat and protein slow down digestion, making the GL of the whole dish different than the GL of just a single food.

USE THE GI AND GL TO SELECT FOODS
Studies have found that people who eat diets with a high GL have a higher rate of obesity, diabetes, heart disease, and cancer. One study found that men who typically ate foods with a high GL had a 40% higher chance of developing diabetes. In the Nurses’ Health Study, women who ate diets with a high GL had a 37% greater chance of getting type 2 diabetes over the 6-year span of the study. Yet another study found that swapping just one baked potato per week for a serving of brown rice could reduce a person’s odds of developing type 2 diabetes by up to 30%.

Many large health organizations, including both the Canadian and American Diabetes Associations, support the use of the GL and GI as a complement to carbohydrate counting for managing diabetes. Both are useful—GI helps you choose better carbs while GL helps with portion sizes.

GLYCEMIC INDEX VS. GLYCEMIC LOAD
Below are a few common foods and their GI and GL values. Note the differences and how the GL becomes a better way to look at the effect that foods have on blood sugar.

FOOD GI SIZE GL

Grains and Cereals
Bagel, white 72 2 ½ oz (70 g) 25
Barley, pearled 25 5 oz (150 g) 11
Bread, white 71 1 oz (30 g) 10
Bread, whole grain, pumpernickel 46 1 oz (30 g) 5
Bread, whole wheat 67 1 oz (30 g) 8
Cereal, All-Bran 50 1 oz (30 g) 9
Cereal, cornflakes 80 1 oz (30 g) 21
Cereal, muesli 66 1 oz (30 g) 16

Fruits
Apple 39 4 oz (120 g) 6
Apple juice, unsweetened 41 8 ½ oz (250 ml) 12
Banana 46 4 oz (120 g) 12
Grapefruit 25 4 oz (120 g) 3
Grapes 43 4 oz (120 g) 7
Orange 40 4 oz (120 g) 4
Peach 42 4 oz (120 g) 5
Watermelon 72 4 oz (120 g) 4

Vegetables
Baked potato 60 5 oz (150 g) 18
Baked potato, mashed 74 5 oz (150 g) 15
Carrots 92 3 oz (80 g) 5
Kidney beans 29 5.2 oz (150 g) 7
Lentils 29 5.2 oz (150 g) 5
Peas 51 3 oz (80 g) 4
Soybeans 15 5.2 oz (150 g) 1
Sweet potato 48 5 oz (150 g) 16

THE BOTTOM LINE
• Remember, GI and GL only evaluate food based on how it affects your blood sugar, and shouldn’t be used as the only ways to gauge your diet’s impact on health. Other principles of a healthy diet—variety, balance, and moderation—still apply.
• While a low-glycemic diet will include many foods recommended in a healthy diet—fruits and vegetables, whole grains, and legumes—some high-glycemic foods, such as potatoes, contain many essential nutrients and are good sources of energy, too.

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Beyond the Diabetes Diet, Nutrition Connection

Diabetes mellitus is a serious metabolic disease that affects the body’s ability to derive energy from blood sugar, or glucose. It results when the body cannot produce or properly use insulin, a hormone needed for glucose metabolism. Because all human body tissues need a steady supply of glucose, diabetes can affect every organ. In particular, it can lead to heart disease, kidney failure, blindness, and nerve problems.

Old School
Those with diabetes have to give up sweets entirely.
New Wisdom
In moderation, an occasional sweet treat is fine.

About 10% of diagnosed diabetes cases are type 1, also called juvenile-onset diabetes because the disease often develops in children. In this autoimmune disease, body does not produce adequate insulin. People with type 1 diabetes must take insulin daily. They must also strictly control their diet and phywsical activity to maintain near-normal blood glucose levels.

More than 90% of those with diabetes have type 2 diabetes, or non-insulin-dependent diabetes mellitus. Also called adult-onset diabetes, this form typically occurs in older adults who are usually overweight but is increasingly being diagnosed in children and adolescents. Although these people often have adequate or even high levels of insulin, their bodies cannot use the hormone properly. An appropriate diet can prevent or delay consequences of type 2 diabetes.

The effects of hormonal changes and weight gain during pregnancy increase demands on the pancreas and can lead to gestational diabetes with potential complications for both mother and baby.

Before people develop diabetes, they are frequently diagnosed with prediabetes, defined by having higher than normal blood sugar levels; insulin resistance, in which the body does not use insulin properly; or metabolic syndrome, a cluster of risk factors that include excess belly fat, high blood pressure, and high blood sugar levels and that together increase your risk of diabetes, heart disease, and stroke.

Nutrition Connection
Diet is the cornerstone of diabetes management for all types of diabetes, though there are slightly different considerations. Those with diabetes should consult a registered dietitian, especially if cholesterol, blood pressure, or other health issues are a concern.

Here are general guidelines:
-Eat balanced meals and snacks. To maintain healthy blood glucose levels, meals and snacks should be balanced to provide a mixture of carbohydrates, fats, and proteins.
-Seek high quality carbohydrates. Carbohydrates, the basic currency of glucose, should account for 45 to 60% of daily calories spread evenly through the day. Low glycemic load carbohydrates such as whole grains provide vitamins, minerals, and fiber. Limit sugars and sweeteners, which provide mostly calories. -Seek fiber-rich foods. Because the fiber content of carbohydrates slows down the release of glucose, high-fiber starches, such as barley, oats, beans, peas, and lentils, are recommended to help suppress any sharp increases in blood sugar levels after meals.
-Follow a low-fat diet. High-fat diets contribute to obesity, heart disease, and kidney disease. Saturated fats from animal foods and hydrogenated fats in packaged foods should also be limited. On the other hand, monounsaturated and polyunsaturated fats—such as those found in vegetable oils, nuts, fish, and avocados—are good for the heart, slow the digestion process, and may also reduce insulin resistance.
-Limit foods that have a high glycemic index (GI), or load (GL). GI and GL is a measurement of how readily foods are converted to blood glucose. (For more information about GL.) Limit intake of high-glycemic foods, such as potatoes, rice cakes, cornflakes, soft drinks, pretzels, and crackers. Conversely, research has found that eating foods with a low glycemic index or load can improve blood sugar control in those with diabetes. Incorporate more low-glycemic foods, which include peas, beans, lentils, apples, pears, and oranges, barley, bran cereals, whole grain pasta, milk and yogurt.
-Add supplements wisely. A deficiency of the trace mineral chromium, found in foods such as wheat bran, whole grains, chicken breast, mushrooms, and blackstrap molasses, has been associated with reduced glucose tolerance. Research using chromium supplements has shown that they may provide a beneficial effect on blood glucose control for those with diabetes. If you choose to take a chromium supplement, take no more than 200 mcg per day, or speak to your doctor.
-Limit alcohol. Alcohol can cause swings in blood sugar levels. If you use insulin or take oral diabetes medication, speak to your doctor about the use of alcohol. If you do drink, consume alcohol with food.

Beyond the Diet
In conjunction with dietary changes, a healthier lifestyle can help control diabetes or reverse prediabetes symptoms. Consider the following:
-Exercise every day. Exercise can keep blood sugar levels stable. For many, diet and exercise alone can provide effective treatment. Exercise lowers your risk of prediabetes and type 2 diabetes.
-Commit to losing weight. Researchers found that those who lost modest amounts of weight cut their diabetes risk by 58%, even more for people over the age 60.
-Take care of your teeth. Those with diabetes may be prone to gum disease.
Talk to your doctor about medications.
-Talk to your doctor about immunizations. Diabetes can affect immune system, so flu shots and pneumonia shots, among others, may be recommended.
-Get regular blood tests. Early treatment can prevent critical damage to organs. Adults over the age of 50 should have their blood sugar levels tested every two years, or more often if they are overweight or have a family history of diabetes.
-Get a blood test if you are pregnant. Pregnant women should get a blood test between the 24th and 28th weeks of pregnancy. If gestational diabetes is diagnosed, the mother will need to modify her diet and monitor weight gain. Although this type of diabetes usually disappears almost immediately after childbirth, women who have had it are at high risk for type 2 diabetes in later years.

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