Saturday, October 25, 2008

UNDERWEIGHT: CAUSES AND REMEDIES

The term underweight refers to a human who is considered to be under a healthy weight. The definition is usually made with reference to the body mass index (BMI). A BMI of under 18.5 is usually referred to as underweight. It is important to note that the BMI is a statistical estimate and some individuals classified as underweight may be perfectly healthy. In fact, caloric restriction may be a viable means of increasing the lifespan, and it can easily lead to a BMI of less than 18.5. This medical definition of underweight may differ from other uses of the term, such as those based on attractiveness.

Causes


The most common cause of a person being underweight is primarily malnutrition caused by the unavailability of adequate food, which can run as high as 50% in parts of sub-Saharan Africa and south Asia. The effects of primary malnutrition may be amplified by disease; even easily treatable diseases such as diarrhea may lead to death.
In the presence of adequate food resources, being underweight can sometimes be the result of mental or physical disease. There are hundreds of possible medical causes for excessive weight loss or a person being underweight. Some of the more prevalent include:
Poverty
Famine
Torture

Cancer or Cancer Treatment
Tuberculosis
Hyperthyroidism
Type 1 Diabetes
Anxiety and depressive disorders
Drug abuse
Inflammatory bowel disease
Malfunctioning digestive organs
Dental pain
Over-training (endurance sports)
HIV/AIDS
Genetics
Stimulant use
Naturally light weight.

Problems

The most immediate problem with underweight is that it might be secondary to, and/or symptomatic of, an underlying disease. Unexplained weight loss requires professional medical diagnosis.
Underweight can also be a primary causative condition. Severely underweight individuals may have poor physical stamina and a weak immune system, leaving them open to infection. According to Robert E. Black of the Johns Hopkins School of Public Health, "Underweight status ... and micronutrient deficiencies also cause decreases in immune and non-immune host defenses, and should be classified as underlying causes of death if followed by infectious diseases that are the terminal associated causes." People who are malnutrative underweight raise special concerns, as not only gross caloric intake may be inadequate, but also intake and absorption of other vital nutrients, especially essential amino acids and micronutrients such as vitamins and minerals.
In women, being grossly underweight can result in amenorrhea (absence of menstruation) and possible complications during pregnancy. It can also cause anemia and hair loss.
Underweight is an established risk factor for osteoporosis even for young people. This is a particular insidious consequence, because the affected persons do not notice the danger, they can feel fit and may be brilliant for example in endurance sports. After the occurrence of first spontaneous fractures the damage is often already irreversible.

How to Gain Weight ?

If an individual is severely underweight to the point where problems with his or her health develop, it may be necessary for the person to make a concentrated effort to gain weight. The treatment for an underweight individual is to increase the food energy intake so that more food energy is consumed than is being used as work. It is usually suggested that weight training is also to be undertaken to increase muscle mass.
If weight loss results from a disease, resolving the illness and consuming adequate calories can bring many underweight individuals to a healthy body weight.


DIETING AND ITS EFFECTS


Dieting is the practice of ingesting food in a regulated fashion to achieve or maintain a controlled weight. In most cases the goal is weight loss in those who are overweight or obese, but some athletes aspire to gain weight (usually in the form of muscle) and diets can also be used to maintain a stable body weight.

Types of dieting

There are several kinds of diets:
Weight-loss diets restricts the intake of specific foods, or food in general, to reduce body weight. What works to reduce body weight for one person will not necessarily work for another, due to metabolic differences and lifestyle factors. Also, for a variety of reasons, most people find it difficult to maintain significant weight loss over time — among individuals that have lost 10% or more of body weight, only 20% are able to maintain that weight loss for a full year.
Many professional athletes impose weight-gain diets on themselves. American football players may try to "bulk up" through weight-gain diets in order to gain an advantage on the field with a higher mass.
Individuals who are underweight, such as those recovering from anorexia nervosa or starvation, may adopt weight-gain diets which, unlike those of athletes, have the goal of restoring normal levels of body fat, muscle, and stores of essential nutrients.
Many people in the acting industry may choose to lose or gain weight depending on the role they are given.
As more cultures scrutinize their diets, many parents consider putting their children on restricted diets that actually do more harm than good. This is extremely harmful to a young child's health because a full and balanced diet (fats, carbohydrates, protein, vitamins, minerals, fiber, etc.) is needed for growth. A doctor should be consulted before putting any child on a specialized diet.
Research also shows that putting children on diet foods can be harmful. The brain is unable to learn how to correlate taste with nutritional value, which is why such children may consistently overeat later in life despite adequate nutritional intake.

Fat loss versus muscle loss

Weight loss typically involves the loss of fat, water and muscle. A dieter can lose weight without losing much fat. Ideally, overweight people should seek to lose fat and preserve muscle, since muscle burns more calories than fat. Generally, the more muscle mass one has, the higher one's metabolism is, resulting in more calories being burned. Approximately 14 kilocalories are burned per pound of muscle at rest. Since muscles are more dense than fat, muscle loss results in little loss of physical bulk compared with fat loss. To determine whether weight loss is due to fat, various methods of measuring body fat percentage have been developed.
Muscle loss during weight loss can be restricted by regularly lifting weights (or doing push-ups and other strength-oriented calisthenics) and by maintaining sufficient protein intake. According to the National Academy of Sciences, the Dietary Reference Intake for protein is "0.8 grams per kilogram of body weight for adults."
Those on low-carbohydrate diets, and those doing particularly strenuous exercise, may wish to increase their protein intake which is necessary. However, there may be risks involved. According to the American Heart Association, excessive protein intake may cause liver and kidney problems and may be a risk factor for heart disease.There is no conclusive evidence that moderately high protein diets in healthy individuals are dangerous, however; it has only been shown that these diets are dangerous in individuals who already have kidney and liver problems.

How the body gets rid of fat

All body processes require energy to run properly. When the body is expending more energy than it is taking in (e.g. when exercising), the body's cells rely on internally stored energy sources, like complex carbohydrates and fats, for energy. The first source the body turns to is glycogen (by glycogenolysis). Glycogen is a complex carbohydrate (in total about 2000 kcal). 65% is stored in skeletal muscles and the rest in the liver. It is created from the excess of ingested macronutrients, mainly carbohydrates. When those sources are nearly depleted, the body begins lipolysis, the mobilization and catabolism of fat stores for energy. In this process, fats, obtained from adipose tissue, or fat cells, are broken down into glycerol and fatty acids, which can be used to make energy. The primary by-products of metabolism are carbon dioxide and water; carbon dioxide is expelled through the respiratory system.
Fats are also secreted by the sebaceous glands (in the skin).

EXERCISE


Physical exercise is any bodily activity that enhances or maintains physical fitness and overall health. It is performed for many different reasons. These include: strengthening muscles and the cardiovascular system, honing athletic skills, and weight loss or maintenance. Frequent and regular physical exercise boosts the immune system, and helps prevent diseases of affluence such as heart disease, cardiovascular disease, Type 2 diabetes and obesity. It also improves mental health and helps prevent depression.

Types of exercise

Exercises are generally grouped into three types depending on the overall effect they have on the human body:
Flexibility exercises such as stretching improve the range of motion of muscles and joints.Aerobic exercises such as cycling, swimming, walking, rowing, running, hiking or playing tennis focus on increasing cardiovascular endurance.
Anaerobic exercises such as weight training, functional training or sprinting increase short-term muscle strength.

Exercise benefits


A common elliptical training machine.
Physical exercise is important for maintaining physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system.
Frequent and regular aerobic exercise has been shown to help prevent or treat serious and life-threatening chronic conditions such as high blood pressure, obesity, heart disease, Type 2 diabetes, insomnia, and depression. Strength training appears to have continuous energy-burning effects that persist for about 24 hours after the training, though they do not offer the same cardiovascular benefits as aerobic exercises do.
There is conflicting evidence as to whether vigorous exercise (more than 70% of VO2 Max) is more or less beneficial than moderate exercise (40 to 70% of VO2 Max). Some studies have shown that vigorous exercise executed by healthy individuals can effectively increase opioid peptides (aka endorphins, a naturally occurring opiate that in conjunction with other neurotransmitters is responsible for exercise induced euphoria and has been shown to be addictive), positively influence hormone production (i.e., increase testosterone and growth hormone), benefits that are not as fully realized with moderate exercise.
Exercise has been shown to improve cognitive functioning via improvement of hippocampus-dependent spatial learning, and enhancement of synaptic plasticity and neurogenesis. In addition, physical activity has been shown to be neuroprotective in many neurodegenerative and neuromuscular diseases. For instance, it reduces the risk of developing dementia. Furthermore, anecdotal evidence suggests that frequent exercise may reverse alcohol-induced brain damage.
Physical activity is thought to have other beneficial effects related to cognition as it increases levels of nerve growth factors, which support the survival and growth of a number of neuronal cells.
Both aerobic and anaerobic exercise also work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). Such changes are generally beneficial and healthy if they occur in response to exercise.
Not everyone benefits equally from exercise. There is tremendous variation in individual response to training: where most people will see a moderate increase in endurance from aerobic exercise, some individuals will as much as double their oxygen uptake, while others will never get any benefit at all from the exercise. Similarly, only a minority of people will show significant muscle growth after prolonged weight training, while a larger fraction experience improvements in strength. This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population. Studies have shown that exercising in middle age leads to better physical ability later in life.

Targeted fat reduction

Spot reduction is a myth that exercise and training a particular body part will preferentially shed the fat on that part; for example, that doing sit-ups is the most direct way to reduce subcutaneous belly fat. This is false: one cannot reduce fat from one area of the body to the exclusion of others. Most of the energy derived from fat gets to the muscle through the bloodstream and reduces stored fat in the entire body, from the last place where fat was deposited. Sit-ups may improve the size and shape of abdominal muscles but will not specifically target belly fat for loss. Such exercise might help reduce overall body fat and shrink the size of fat cells.

Nutrition and recovery

Proper nutrition is at least as important to health as exercise. When exercising, it becomes even more important to have a good diet to ensure that the body has the correct ratio of macronutrients whilst providing ample micronutrients, in order to aid the body with the recovery process following strenuous exercise. Proper rest and recovery are also as important to health as exercise; otherwise the body exists in a permanently injured state and will not improve or adapt adequately to the exercise. Hence, it is important to remember to allow adequate recovery between exercise sessions. It is necessary to refill the glycogen stores in the skeletal muscles and liver. After exercise, there is a 30 minute window critical to muscle recovery. Before doing anything else, one should drink something for recovery. Liquids are ideal after exercise and there are several studies that show low-fat milk and chocolate milk as being effective recovery beverages because of its ideal 4:1 combination of carbohydrate and protein that fuels and replenishes our muscles the best. The above two factors can be compromised by psychological compulsions (eating disorders such as exercise bulimia, anorexia, and other bulimias), misinformation, a lack of organization, or a lack of motivation. These all lead to a decreased state of health.
Delayed onset muscle soreness can occur after any kind of exercise, particularly if the body is in an unconditioned state relative to that exercise.

Categories of physical exercise

Aerobic exercise
Anaerobic exercise
Strength training
Agility training
Sometimes the terms 'dynamic' and 'static' are used. 'Dynamic' exercises such as steady running, tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly.

Aerobic exercise
Anaerobic exercise
Strength training
Agility training
Sometimes the terms 'dynamic' and 'static' are used. 'Dynamic' exercises such as steady running, tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly.

DIETARY MINERALS


Dietary minerals are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen present in common organic molecules. The term "mineral" is archaic, since the intent of the definition is to describe ions, not chemical compounds or actual minerals.
Dietitians may recommend that minerals are best supplied by ingesting specific foods rich with the element(s) of interest. Sometimes minerals are ingested as mineral dietary supplements, the most common being iodine in iodized salt.
The dietary focus on minerals derives from an interest in supporting biochemical reactions with the required elemental components. Appropriate intake levels of certain chemical elements are thus required to maintain optimal health. According to nutritional experts, the requirements are met simply with a conventional balanced diet.


Essential minerals


Sixteen minerals are required to support human biochemical processes by playing roles in cell structure and function as well as electrolytes:
Calcium is needed for muscle, heart and digestive system health, builds bone, supports synthesis and function of blood cells. Dietary sources of calcium include dairy products, canned fish with bones (salmon, sardines), green leafy vegetables, nuts and seeds.
Chloride is needed for production of hydrochloric acid in the stomach and in cellular pump functions. Table salt is the main dietary source of chloride.
Cobalt - vitamin B12. See pernicious anemia.
Copper is required component of many redox enzymes, including cytochrome c oxidase.
Iodine is required for the biosynthesis of thyroxine. See also Iodine deficiency.
Iron is required for many proteins and enzymes, notably hemoglobin. Dietary sources include red meat, leafy green vegetables, fish (tuna, salmon), eggs, dried fruits, beans, whole grains, and enriched grains. See also iron deficiency (medicine).
Magnesium is required for processing ATP and for bones. Dietary sources include nuts, soy beans, and cocoa. See also magnesium deficiency (medicine).
Manganese is a cofactor in enzyme functions.
Molybdenum - xanthine oxidase and related oxidases.
Nickel - urease
Phosphorus is a component of bones (see apatite) and energy processing and many other functions.
Potassium is a systemic electrolyte and is essential in coregulating ATP with sodium. Dietary sources include legumes, potato skin, tomatoes, and bananas.
Selenium, a cofactor essential to activity of antioxidant enzymes like glutathione peroxidase.
Sodium is a systemic electrolyte and is essential in coregulating ATP with potassium. Dietary sources include table salt (sodium chloride, the main source), sea vegetables, milk, and spinach.
Sulfur - cysteine and methionine
Zinc is pervasive and required for several enzymes such as carboxypeptidase, liver alcohol dehydrogenase, and carbonic anhydrase

Malnutrition


Malnutrition is a general term for a medical condition caused by an improper or insufficient diet. It most often refers to undernutrition resulting from inadequate consumption, poor absorption, or excessive loss of nutrients, but the term can also encompass overnutrition, resulting from overeating or excessive intake of specific nutrients. An individual will experience malnutrition if the appropriate amount of, or quality of nutrients comprising a healthy diet are not consumed for an extended period of time. An extended period of malnutrition can result in starvation, disease, and infection.

Malnutrition is the lack of sufficient nutrients to maintain healthy bodily functions and is typically associated with extreme poverty in economically developing countries. It is a common cause of reduced intelligence in parts of the world affected by famine. Malnutrition as the result of inappropriate dieting, overeating or the absence of a "balanced diet" is often observed in economically developed countries (eg. as indicated by increasing levels of obesity).

Most commonly, malnourished people either do not have enough calories in their diet, or are eating a diet that lacks protein, vitamins, or trace minerals. Medical problems arising from malnutrition are commonly referred to as deficiency diseases. Scurvy is a well-known and now rare form of malnutrition, in which the victim is deficient in vitamin C.


Survivors of Mauthausen-Gusen concentration camp after the liberationCommon forms of malnutrition include protein-energy malnutrition (PEM) and micronutrient malnutrition. PEM refers to inadequate availability or absorption of energy and proteins in the body. Micronutrient malnutrition refers to inadequate availability of some essential nutrients such as vitamins and trace elements that are required by the body in small quantities. Micronutrient deficiencies lead to a variety of diseases and impair normal functioning of the body. Deficiency in micronutrients such as Vitamin A reduces the capacity of the body to resist diseases. Deficiency in iron, iodine and vitamin A is widely prevalent and represent a major public health challenge. An array of afflictions ranging from stunted growth, reduced intelligence and various cognitive abilities, reduced sociability, reduced leadership and assertiveness, reduced activity and energy, reduced muscle growth and strength, and poorer health overall are directly implicated to nutrient deficiencies. Also, another, although rare, effect of malnutrition is black spots appearing on the skin.

Hunger is the normal psychological response brought on by the physiological condition of needing food. Hunger can also affect the mental state of a person, and is often used as a metonym for general undernourishment.

According to the World Health Organization, hunger and malnutrition is the gravest single threat to the world's public health and malnutrition is by far the biggest contributor to child mortality, present in half of all cases.

EFFECTS: Mortality due to malnutrition
According to the World Health Organization, hunger is the gravest single threat to the world's public health.[2] According to Jean Ziegler (the United Nations Special Rapporteur on the Right to Food for 2000 to March 2008), mortality due to malnutrition accounted for 58% of the total mortality in 2006: "In the world, approximately 62 millions people, all causes of death combined, die each year. One in twelve people worldwide are malnourished. In 2006, more than 36 millions died of hunger or diseases due to deficiencies in micronutrients". The World Health Organization estimates that one-third of the world is well-fed, one-third is under-fed and one-third is starving. Every 3.6 seconds someone dies of hunger.
Hunger and malnutrition have an even bigger impact on children’s health than was previously thought. According to the World Health Organization, malnutrition is by far the biggest contributor to child mortality, present in half of all cases. Underweight births and inter-uterine growth restrictions cause 2.2 million child deaths a year. Poor or non-existent breastfeeding causes another 1.4 million. Other deficiencies, such as lack of vitamin A or zinc, for example, account for 1 million. According to The Lancet, malnutrition in the first two years is irreversible. Malnourished children grow up with worse health and lower educational achievements. Their own children also tend to be smaller. Hunger was previously seen as something that exacerbates the problems of diseases such as measles, pneumonia and diarrhea. But malnutrition actually causes diseases as well, and can be fatal in its own right. This is the impact The Lancet seeks to identify.

Thursday, October 23, 2008

The Nutrition Challenge










Eating truly healthy foods in proper balance is a challenging task. Our fast-paced and hectic lifestyle compels us to sacrifice nutritional value of foods on a daily basis. Rather than eating those foods for their nutritional value we eat foods for reasons other than nutrition.

Taste: We usually choose foods for their taste, rather than their nutritional value.

Eating –Out: Our fast-paced modern lifestyle does not allow us to prepare nourishing meals all the time. We conveniently tend to eat-out, resulting in less control on the nutritional value of our meals.

Skipping Meals: Many of us do not stick to regular meal times and often skip breakfast or lunch. We try to make amends by snacking up or over-eating later. These are poor eating habits.

Processing: Much of the food we buy today has been processed. Frozen vegetables often contain 50% less vitamin C than fresh ones; polished rice can lose upto 90% of its original B-vitamin content.

Effect of lifestyle choices: Dieting, medication, birth-control pills, smoking, alcohol consumption, excessive coffee and tea intake are all lifestyle factors which rob our body of essential vitamins & minerals.
Different Nutritional Needs For Different Life-stages

Childhood: Nutrient needs increase throughout childhood for optimal physical and mental growth.


Adolescence: This is a phase of rapid growth, both physical and mental. During this lifestage, the need for protein, calcium, iron and Vitamin A, C, E and B is the greatest. Supplementation is especially beneficial during this stage, due to poor nutrition. Pregnant and lactating women: To maintain the health of the expecting mother as well as the newborn baby, adequate quantities of vital nutrients like calcium, iron and folic acid are needed.

Nutrient needs for the elders: Ageing impairs absorption of foods into the system; our dental health detoriate, while the intake of medicines increases. All this necessitates the increasing need for certain nutrients while decreasing the need for calories.

Who needs supplementation?

Anyone not eating a balanced diet consisting of at least five servings of fruits and vegetables a day, as well as whole grain, low fat dairy products and small servings of lean meat, poultry, fish or pulses may not be getting enough protein, vitamins and minerals. As we age, the inability to chew and ageing itself may make the absorption and utilization of certain nutrients more difficult. Problem nutrients for older people are vitaminC, D, B6, B12 and folic acid, as well as some minerals, including zinc. Women of childbearing age needs iron, folic acid and calcium daily. Supplementation is the best way to get enough iron and folic acid due to better absorption by the body than when found naturally in foods.

Teenagers, especially teenage girls, do not consume enough iron. Iron supplementation during adolescence can prevent a decline in their body’s iron stores. Children need extra nutrition for their growing bodies. Children can be given special chewables and tasty multivitamin and mineral supplements along with protein and vitamin drinks and shakes.

Vegetarians, who do not consume animal products, may not get enough protein, iron, vitaminB12, zinc and calcium. People on low calorie diets, and persons who are heavy drinkers or smokers, are likely to be deficient in their requirement of vitamins and minerals.