ACHIEVING A HEALTHY DIET

 

Staying healthy is an increasingly important goal as you get older.  Understanding food and eating sensibly are the best ways to meet this challenge.  At 50, you should be more concerned about the quality, rather than the quantity of food you consume.  Some foods are more valuable than others.  If you understand basic foods better, -- what they consist of, why you need them, which foods are rich in antioxidants, and how to read food labels -- it will help you make sensible food choices.  Proper food choices will help you stay healthy and look younger.

 

 

FOOD BASICS

 

Fibre, antioxidants, saturated fat, and cholesterol are often called only “good” or “bad.” To understand what is really meant, you first need to know that food is composed of chemical substances known as carbohydrates, fats, proteins, minerals, vitamins, and water.

 

  

CARBOHYDRATES

 

Most of the carbohydrates you eat daily are used up for fuel.  The primary dietary carbohydrates are: starch, sugar and fibre.  A starch is a complex carbohydrate molecule composed of a chemical combination of sugars.  It is broken down in the intestine into simple sugar, glucose, before it is absorbed into the body.   Starches are found in grains, vegetables, fruits, and legumes. Sugars are simple carbohydrates found in table sugar, honey and natural fruit.   The fibre component of carbohydrates, a partly indigestible component of plant  foods, helps to regulates bowel movement. It is great for weight loss.  More digestible fibre, a soluble fibre (fibre that is soluble in water), is found in legumes (beans, peas, and lentils), whole grains (bran and oat cereals, brown rice), peanuts and almonds, fruits (apples, pears, apricots, blueberries, oranges, prunes, raisins, strawberries) and vegetables (broccoli, brussel sprouts, cauliflower, carrots, yams, potatoes, spinach, tomatoes, cabbages).  Poorly digestible fibre,  insoluble fibre, is found in skins, peels, stalks and husks of fruits, vegetables, and grains.  Although our intestines can’t digest and absorb the fibres that pass on unused in bowel movements. They are useful in stimulating the intestine.  Fibre can also reduce cholesterol levels and slow the body’s absorption of sugars, reducing our craving for food. 

 

 

 

One gram of carbohydrate has four calories.  Carbohydrates are the best source of energy for all bodily functions.  As well, they help metabolize fat and promote the digestion and absorption of other foods. The healthiest diet includes foods in whole grains (wheat, oats, and bran), fruits and legumes.  Avoid refined sugar.

 

 

FATS

 

One gram of fat has nine calories.  One gram of carbohydrate has only four calories.  Fats are made up of building blocks called fatty acids, which are either saturated or unsaturated.

 

·        Saturated fatty acids (fats) are solid at room temperature.  They are found in beef, pork, and other animal fats, and in butter, cheese, and other dairy fats.

·        Unsaturated fatty acids (oils) are liquid at room temperature.  They are found in olive oil, canola and peanut oils, fish, and some nut oils.

·        Polyunsaturated fatty acids (unsaturated fatty acids with two or more empty spaces where hydrogen molecules can attach) are found in sunflower, corn, soybean, flaxseed, sesame, and most nut oils.

·        Unsaturated long-chain omega-3 and omega-6 fatty acids are essential fatty acids, meaning we have to eat them to survive. Omega-3 fatty acids are found in many oceanic fish and in flaxseed.  Omega-6 fatty acids are found in nuts (oils), seeds, and beans.  Unsaturated fatty acids are labeled “good” fats, since they tend to lower the blood level of (harmful) LDL-cholesterol and raise (good) HDL-cholesterol, preventing heart problems.

·        Hydrogenated or trans fatty acids do not occur naturally.  Trans fatty acids are produced by the hydrogenation of vegetable (polyunsaturated) oils to make them solid at room temperature, enhancing their use in a wide variety of foods.  Hard margarine for example may contain twenty to thirty percent trans fatty acids.  Other foods high in trans fatty acids include spreads, mayonnaise, salad dressings, baked goods, pizza crusts, many snack and convenience foods (such as potato and corn chips, cookies, crackers) and deep-fried items (such as french fries).  Trans fatty acids and saturated fatty acids are labelled “bad” fats, because they tend to raise (harmful) LDL-cholesterol, known to promote heart disease.

 

In addition to providing energy, fats are needed for special functions in the body such as absorption of vitamins, hemoglobin production, hormone synthesis, membrane functions,  and anti-inflammatory responses.  Our body converts extra food into fat and stores it under the skin.  While we need some food containing essential fatty acids, we should avoid eating fat-rich food, particularly those containing saturated and hydrogenated fats.  They are implicated in increasing our chances of developing heart disease and cancer.

 

Besides fatty acids, another fat-like, ring-structured chemical found  in every cell in our body is cholesterol.  Cholesterol is a major constituent of cell membranes, and is required for production of sex hormones, bile salts, and vitamin D. The liver and intestines generate large quantities of cholesterol, regardless of amount eaten, as part of the lipoproteins secreted into the blood stream.

 

Cholesterol is not found in any plant food.  Cholesterol is found only in animal-derived food.  It is abundant in animal meat, poultry, fish, eggs, and diary products (milk and cheese).  Like saturated fat, cholesterol is not an essential nutrient for the body.  Our liver manufactures it anyway. The liver usually regulates the cholesterol balance: the less we eat, the more is made.  Although the amount eaten has a variable influence on circulating cholesterol levels in the blood, eating food rich in cholesterol, especially in combination with excessive saturated fats, contributes to clogged arteries and heart diseases.

 

 

PROTEINS

 

Proteins constitute one-fifth of our body weight and are the main constituent of  our bodies’ cells.  Proteins are needed for replacement of our tissues, which constantly undergo destruction and re-synthesis, and to speed up cellular metabolic functions. Bones are made of proteins and minerals.  Proteins are made of building blocks called amino acids.  There are twenty amino acids, eight of which are essential, and can only be provided through dietary sources. (The others are produced by the body and are called nonessential).  Most common foods contain protein in various amounts.  The foods richest  in and containing all essential proteins are milk, meat, poultry, eggs, and fish.  The next in importance are the proteins in whole-grain cereals, nuts, and mealy vegetables (soy and other beans, peas).  These grain and vegetable proteins contain some essential protein elements, but not all.   Whole wheat contains some essential amino acids, while beans contain others. To supplement the proteins from milk, meats, fish, and eggs, we must eat a variety of whole grains and vegetables.  Soybeans are an excellent source of essential amino acids.  As we age, our protein consumption should include more fish and vegetable proteins, fewer eggs, and less red meat and milk products.  One gram of protein has four calories, the same as one gram of carbohydrate.

 

 

MINERALS

 

Minerals play a vital part in providing the structure of our skeletal system (bone and muscle), in maintaining the water and acid alkaline balance in our bodies, in promoting nerve impulses, and for many other functions.

 

Calcium, chlorine, magnesium, phosphorus, potassium, sodium and sulfur are abundantly available in all natural unrefined foods (fruits, vegetables, meats, whole grains, eggs, milk) and water.  (The hardness of bones and teeth depends on calcium and phosphorus.)  The other minerals, needed in very tiny amounts, are chromium (regulates blood sugar); iron and copper (for formation of red blood cells, which carry oxygen to all

 

 

parts of the body; selenium, an antioxidant that works with vitamin E to reduce free-radical damage; iodine, necessary in the functioning of the thyroid gland, and vanadium and zinc for our reproductive systems.

 

The balance of minerals is very important, and some minerals are more easily absorbed than others.  Natural foods provide the best balance for the optimal absorption of minerals.  For people turning 50, particularly women, there are often good reasons to supplement calcium, to guard against osteoporosis (see chapter 4).

Calcium occurs in small amounts in vegetables and some fruits but plentifully in milk and cheese.  Iron (to prevent anemia) is supplied by green, leafy vegetables, meats, fruits, whole grains, but more abundantly by egg yolk and liver.  Selenium, is found in fish, beef, pork, cashews, sunflower seeds, dried peas and beans, and whole-grain cereal.

 

 

VITAMINS

 

Vitamins are organic substances that play a vital role in the human body. They help regulate the chemical reactions that protect cells, and they convert food into energy and living tissue. Some vitamins are produced within the body: vitamin D, is manufactured in the skin during exposure to sunlight, and three other vitamins (K, biotin, and panthothenic acid) are made in the intestine resident bacteria.  Most vitamins must be ingested as part of the food you eat.  There are 13 known vitamins, and they are either fat soluble (vitamins A, D, E and K) or water soluble (all the Bs, C, and folic acid). The good natural sources of various vitamins are:

 

·        Vitamin A (beta-carotene): liver, egg yolks, milk, butter, margarine, dark-green leafy vegetables, carrots, spinach, squash, broccoli, red peppers, peaches, apricots, cantaloupe.

·        Vitamin B₁ (thiamine): pork, legumes, bran, dried yeast, oatmeal, enriched bread, peanuts, whole wheat, milk and milk products.

·        Vitamin B₂ (riboflavin): milk and milk products, calf liver, other organ meats, bran flakes, brewery yeast, pork , leafy green vegetables, enriched bread.

·        Vitamin B3 (niacin): grains, meat, poultry, fish, enriched bread, nuts, eggs, avocados, dates, figs, prunes.

·        Vitamin B5 (pantothenic acid): liver, yeast, eggs, salmon, milk, chicken, pork, lamb, peanuts, cauliflower, banana, avocado, oranges.

·        Vitamin B₆ (pyridoxine): meats, poultry, fish, cantaloupe, nuts, cabbage, whole-grain cereals, legumes, avocado, eggs.

·        Vitamin B₁₂ (cobalamin): beef liver, chicken liver, clams, oysters, tuna, lamb, milk, eggs.

·        Biotin: milk and milk products, beef liver, oatmeal, soybeans, clams, eggs, salmon, shrimp, chicken, avocado, beans, bananas, peanuts.

·        Vitamin C (ascorbic acid): citrus fruits and juices, red and green peppers, strawberries, melons, kiwi, raw cabbage, green leafy vegetables, tomatoes, potatoes.

·        Vitamin D (cholecalsiferol): butter, liver, fortified milk, fish-liver oils, egg yolk.

·        Vitamin E (alpha tocopherol): peanuts, hazelnuts, almonds, sunflower seeds, whole-wheat and rye flours, vegetable oils, sweet potatoes, avocado, eggs.

·        Folic acid: raw spinach, romaine lettuce, liver, fish, poultry, legumes, broccoli, bananas, avocado, oranges, cooked beets, apricots.

·        Vitamin K (menadione): leafy green vegetables, corn, soybean oil, liver, cereals, cauliflower, dairy products, fruits.

Although we require only small amounts of vitamins, which are found in adequate amounts in a balanced diet, many of us swallow vitamin pills, at ten to twenty or even fifty times the recommended doses.  More and more of us are looking for quick fixes to alleviate stress, improve memory, sex, energy, and prevent an array of illnesses.

 

Vitamins do help in protecting our health.  But instead of depending on vitamin supplements, we should concentrate on a well-balanced daily diet.  Fruits, vegetables, soybeans, grains, poultry, fish and dairy products contain all the vitamins you need. 

 

 

ANTIOXIDANTS

 

Vitamins A, C, and E and Selenium act as antioxidants. Our bodies’ natural use of oxygen produces harmful byproducts called free radicals. Studies show that free radicals may damage DNA, altering biochemical compounds, damaging cell membranes, and killing cells.  Antioxidants react with free radicals to defuse the toxic molecules before they can damage the cell.  Vegetables and fruits are rich in antioxidants.  Other important compounds in food -- such as carotenoids, indoles, flavanoids and phenols -- may work as antioxidants and protect our health.

 

There is a wide range of foods that provide antioxidants: citrus fruits and juices, strawberries, cantaloupe, melons, grapes with seeds, peaches, apricots, kiwi, tea leaves, red and green peppers, carrots, squash, raw cabbage, broccoli, green leafy vegetables, avocado, tomatoes, potatoes, cauliflower, soybeans, peanuts, hazelnuts, almonds, cashews, sunflower seeds, vegetable oils, eggs, milk, beef, pork, fish, whole-wheat and rye flours, and whole-grain cereal.  

 

 

WATER

 

Water provides no calories or vitamins, but it is vitally important in the make-up and working of the body.  In adults, on average, 55 percent of the body’s weight is water.  We need three quarts of water daily, which is usually consumed, besides plain water, in the form of coffee or tea, soft drinks, soup and milk.  Most foods are largely composed of water too, and that is how we meet part of our daily requirement. Drinking enough fluids is essential.  With age, our thirst buds are not as active, and the monitoring of an adequate intake is even more important.

CALORIES

 

The fuel value of food is measured in calories.  Water and minerals have no calories -- they have no energy or fuel.  Fat is rich in calories.  One gram of fat has nine calories; carbohydrates and protein have only four calories each.  If the label on a can of food shows the contents as 10 g of carbohydrates, 10 g of protein, and 10 g of fat, a can  contains (4x10 plus 4x10 plus 9x10 calories = 170 calories) a total of 170 calories.   Out of 170 calories, 90 ( 53 percent) comes from fat.  Learn to read labels.  If you know that there are nine calories in every gram of fat, you can chose products that are truly low in fat, especially in hydrogenated fat.  “Low calorie” products are rarely low-fat calorie products.  

 

            High-calorie foods:

 

·        Butter, margarine, vegetable oil (high in fat);

·        Grains, cereals, breads (high in carbohydrates);

·        Starchy vegetables potatoes and corn (high in carbohydrates);

·        Beans (high in proteins and carbohydrates);

·        Meat, poultry, fish, eggs, cheese (high in proteins and fat);

·        Milk (high in fat, protein);

·        Bananas and dried fruit (high in carbohydrates).

 

Moderate-calorie foods:

 

·        Peas, beets, carrots, onions, parsnips, squash (carbohydrates);

·        Fresh and stewed fruit (high in natural sugars).

 

Low-calorie foods:

 

·        String beans, cabbage, cauliflower, celery, eggplant, spinach, tomatoes, lettuce, broccoli, and asparagus (no fat or cholesterol);

·        Apples, pairs, strawberry, peach, watermelon, cantaloupe, orange, grapefruit (no fat or cholesterol).

 

 

SENSIBLE EATING

 

Most people pay attention to their diets, and many are willing, even eager, to modify their eating habits to keep them healthy.  However, we are continually presented with new health products and news of their miraculous health benefits one day, and pronouncements of contradictory findings,  later by another study.  Just to take one example: the margarine-butter debate makes news almost every year.  It is not surprising that many of us are confused.

 

The principles of sensible eating, however, have not changed.  A healthy diet has always involved eating well-balanced food (all essential nutrients) in moderation.  Normally, the average active woman needs about 2,000 calories per day, and the average active man needs 3,300.   But we have become accustomed to processed and ready-made foods laden with artificial flavours, additives, preservatives, and especially, fats.  Our daily diet, particularly for people 50 and older, should contain 55 to 65 percent of calories from carbohydrates, 10 to 20 percent from protein, and only 15 to 25 percent from fat.  Most of us eat too much fat.  Do you know how much fat is in your diet?  For an eye-opener, check the fast-food sample below, and then look at the healthy food list.

 

 

Fast foods (daily)	Total Cal.	Cal. from Fat
Bacon, 2 slices	73	54
Egg, 1 large, fried	104	70
Pizza Supreme, 1 slice	294	135
Carbonated drink, 12 oz	152	0
Chocolate bar, 1 oz	145	81
Hamburger,qarterpounder	520	260
French fries, 1 small	210	90
Apple pie, 1/6	405	162
Beer, 12 oz	145	0
Total	2048	852 (42% of total Cal.)

 

 

 

Healthy foods (daily)	Total Cal.	Cal from Fat
Raisin-bran cereal, 1 cup	158	7
Milk, 2%, 1 cup	121	45
Coffee, 1 cup	4	0
Grapefruit ½	39	0
Egg, 1 large, scrambled	99	72
Apple, 1 medium	81	0
Water 1 glass	0	0
Wheat bread, 2 slices	130	14
Mozzarella cheese, 1 oz	80	45
Tuna, canned/water, 3 oz	143	9
Carrots, 1 raw	31	0
Tomato juice, ½ cup	31	0
Orange, 1	62	0
Pear, 1 medium	100	9
Tea, 1cup	0	0
Strawberries, raw 1 cup	47	5
Yogurt	79	18
Chicken breast, skinless, 1 or Sole, 6 oz	142	27
Beans, ½ cup	124	0
Vegetable, cooked, 1 cup	102	0
Potato, boiled, 1	148	0
Cantaloupe, ½	93	0
Brownie, ¾ oz	95	54
Cheese, cottage, ¼ cup	53	9
Club soda, 12 oz	0	0
Total	2067	314 (15% of total Cal.)

 

 

If you choose your foods from the “healthy foods” list, which you can easily modify to suit your tastes, you would not only have a wide variety, but would receive all the essential nutrients, and you could substantially reduce your intake of fat, the biggest culprit in unhealthy food habits.

 

To achieve a healthy diet, the number one message is

 

EAT LESS FAT

 

Here are some tips to help you reduce the consumption of hydrogenated and saturated fats:

 

·        Try to  stay away from potato chips, crackers, cookies, creamy cakes, salad dressings, margarine, meats, butter, and homogenized milk.

·        Avoid fast food meals and snacks.

·        Switch to skim milk, and low-fat yogurt.

·        Stop buttering or spreading bread.

·        Replace red meats with poultry.

·        Prepare or order boiled foods instead of fried foods.

·        With canned food (soups, etc.), discard the layer of fat floating on the top.

·        Substitute creamy cakes with fresh fruits such as bananas, cantaloupes, and apples.

·        Read labels and avoid products with a high-fat content.

To help you lessen the consumption of unsaturated (mono and polyunsaturated) fats found in olive, canola, corn, sunflower and nut oils:

 

·        Stop deep-frying food.

·        Cut down on oil in salads.

·        Switch to canola and olive oil (olive oil has a unique antioxidant).

·        Use less oil when preparing food.

·        Be bold, most receipts can be modified, especially in terms of fat and sugar content.

·        Adding lemon, vinegar, salt, and spices with pieces of cucumbers, green papers, apples, and tomatoes to green salad improves the flavour, so that the lack of oil is not noticable.

·        Many other salads such as carrot, canned beets, or chick peas do not need any oil. Adding lemon, chopped onions, parsley, and spices is enough.

·        Try serving fish instead of red meat.

·        Your greatest challenge could be modifying desserts.  When preparing cake, try cutting both butter and sugar content in half.  By adding nuts, raisins, apples, or cherries, you need less dough and you create a tastier cake.

 

Foods rich in the essential omega-3 and omega-6 fatty acids will benefit your health.  Eat fish instead of meat.  Use soybeans and soy products.  Replace chocolate snacks with an apple and a few unbleached almonds. 

 

 

DRINK ENOUGH FLUIDS

 

An average adult needs about three quarts of water a day, including amounts ingested from food.  This vital substance helps regulate body temperature and acts as a solvent, transport medium and tissue lubricant.  Water also keeps your skin smooth and elastic; it maintains healthy blood volumes for the distribution of oxygen and nutrients to every cell in every part of your body; it helps digestion, the elimination of toxins, and the maintenance of body temperature.  Water is considered the best anti-aging medicine.     Alternatives for water include juices, soup, milk, mild teas or other drinks. Both alcohol and coffee act as diuretics, which speed water elimination from the body.  They should be used in moderation.

 

 

ADD VARIETY

 

Eat differently coloured fruits and vegetables to get the required amounts of vitamins, minerals, and antioxidants. If you keep a bowl of mixed fruit, washed and ready to eat, on the kitchen counter, you and your family can be encouraged to resist searching for other snacks.  Eat fresh vegetables.  Make salads daily. Overcooking vegetables removes most of the valuable vitamins and minerals.  A two to three minutes boil is all that is needed for green vegetables.  Whole grains, milk, eggs, nuts, soy, and fish supply important vitamins and minerals; pills as supplements can never bring the right combination that natural food provides.  With a little sun exposure and healthy food choices, we do not need pill supplements, unless medically necessary.

 

 

ADD FIBRE

 

Increase your fibre intake from potatoes, brown rice, and whole-grain products, vegetables, and fruits.  Oat and wheat bran are particularly good sources of fibre.  With a proper mix of carbohydrates, particularly from fruits and whole grains, we reduce the risk of  weight gain. Weight gain from pies, chocolate, cakes, and other high-fat foods is harder to lose.

 

·        Reduce your consumption of sugar.  Where needed, substitute honey or fruit.  

 

We need two to three ounces of protein rich food per day. Good protein sources include legumes, nuts, most cereals, fish, chicken, and low fat cottage cheese. Fruits and vegetables also contain some protein.  For vegetarians, soy beans and other soy products are great substitutes for cheese and meat in providing vitamins and minerals.

 

 

USE MODERATION

 

At 50, we need less but better-balanced food for daily eating.  Achieve an appropriate body weight and strive to maintain it.  Resist big meals with sauces, gravies, and desserts.  Adding a soup to your meals gives you a low-calorie, nutritious liquid; it also makes you less hungry, so it’s easier to cut down on other portions.  Opt for fresh fruit for desert or a fruity desert.  

 

·        Limit your alcohol to one drink per day and coffee to two cups per day.  Try tea instead of  coffee. 

 

Before embarking on a dramatic weight-loss diet, consult your doctor or a professional dietitian.  Many fad diets lack essential nutrients and can lead to problems later.

 

 

FOOD AND DISEASE PREVENTION

 

More and more scientists are examining the power of diet on cancer prevention and other diseases. The latest research suggests that starch and fibre from plant foods have many health benefits and may reduce the risk of colon and other cancers. Starch and fibre are found in cereals, grains, bananas, yams, rice, potatoes and legumes.

Lowering blood cholesterol reduces the incident of coronary heart disease and may prevent heart attacks.  Saturated and hydrogenated fatty acids are harmful because they increase the blood level of (harmful) LDL cholesterol.  Polyunsaturated fatty acids are beneficial because they tend to lower the blood levels of (harmful) LDL cholesterol. Long-chain omega-3 fatty acids found in salmon, sole and other cold-water and oceanic fish may protect the heart and cardiovascular system. Eating fish is known to lower heart-attack risk in some populations by reducing the blood’s clotting action. Low in saturated fats, fish also provide high-quality protein and may reduce the risk of some cancers.

 

·        Olive oil is a unique antioxidant with health-promoting properties. 

 

Vitamins and mineral-rich foods can improve your chances of avoiding disease.  Fruit such as blueberries, strawberries, plums, oranges, red grapefruit, and vegetables such as kale, spinach, brussels sprouts, broccoli, beets, carrots -- all of which contain antioxidants -- may lower your risk of developing breast, lung, colon and other cancers, heart disease and stroke.  Vitamins A, C and E, and selenium,  acting as antioxidants appear to be able to defuse toxic chemicals (free radicals) in the body, which play a major role in the development of ailments like cancer, heart or lung disease, and cataracts.  The vitamin niacin is a possible cancer inhibitor, and folic acid may protect against cervical dysphasia.

Proper foods are powerful deterrents to many ailments.  But for overall wellness, you should pay attention to exercise and other aspects of your lifestyle, physical and emotional.

 

MAINTAINING HEALTH

 

At 50, we are all very concerned about our health.  Consequently, we devour health-related information form eclectic sources -- books, medical journals, newspapers, television, doctors, shamas, and neuropaths.  We swallow health supplements, prescription and non-prescription drugs, herbs, minerals and vitamins, all in an effort cure our fatigue, less than optimal digestive system, creaking joints, overweightness, menopausal symptoms, migraines, and daily stresses.  But to have a better chance of good health and a long life, you should adopt a lifestyle and a diet that will support those goals.  Activity, nutritious foods, and risk-avoidance are the best ways of reducing your chances of becoming ill  and lowering  stress.  If you do become ill, you should find proper medical care.

 

 

FAMILY DOCTOR

 

The need for medical care, particularly specialists’ care increases as we age. You should have a check-up with your family doctor once a year.  If you don’t have a family doctor, you should carefully choose one soon. Don’t wait until you are sick or need emergency care.  You want to be able to build a rapport with your doctor by discussing health concerns openly.  Knowing your medical history, your concerns and your circumstances will make diagnosis and treatment easier and quicker, if something does go wrong. You should be able to ask for a second opinion on any matter, and be able to refuse your doctor’s advice without jeopardizing your doctor-patient relationship.

 

Here are some of the qualities you should look for when choosing a doctor.  He or she should:

 

·        have up-to-date knowledge and skill

·        provide a relaxed environment where you feel free to express your concerns,

·        be a good listener,

·        be technically competent,

·        answer all your questions clearly

·        be willing to refer you to a specialist when needed, follow up with test results, and fully explain diagnoses, treatment options, and likely prognoses.

 

If your doctor is willing to make an occasional house call, you are in luck.

 

Health-care experts advise that you bring a list of the topics you want to discuss during your visit with the doctor.  Doctors appreciate honesty in sharing information about your health and lifestyle. You should keep appointments, return for follow-up when requested, and comply with medication instructions.  Proximity to your home can be important: travelling long distances when you are sick is difficult.  Your doctor’s availability is also crucial.  What if you need medical care in off-hours?  Using hospital emergency departments for non-emergent treatment is an abuse of the health-care system.  Walk-in clinics have their place and are wonderful but they do not, and can not, provide continuity of care.  They may over-prescribe medications (including antibiotics), provide inadequate follow-up, and duplicate services when you are seen later by your family doctor.  However, walk-in-clinics are convenient, require no appointment, and are usually open when doctors’ offices are closed.

 

Although North Americans have an increasing life expectancy, many of us worry unduly about our health.  Often at the patient’s demand, doctors give yearly comprehensive physical examinations, with unnecessary tests and laboratory analysis that do not improve their health. We should schedule regular medical check-ups and ask for specific testing, if at risk for specific diseases.

 

For most healthy fifty-year-old, medical authorities agree on the need for:

 

·        A complete medical history to determine individual health risks;

·        Blood-pressure measurements. Treating moderately-high to high blood pressure is known to reduce the risk of stroke and heart attacks;

·        Annual dental check-ups;

·        Annual clinical breast examinations for women by a competent health-care professional, and a mammogram approximately every two years.  After 50, one in eight women will develop breast cancer; 

·        Annual PAP (Papanicolaou) tests for women to detect premalignant conditions or cancer of the cervix;

·        Assurance of adequate natural calcium intake and supplemental calcium, if necessary, to protect against osteoporosis. 

·        Blood cholesterol tests for both women and men with cardiac risk factors: extreme obesity, high blood pressure, diabetes;

·        Test for prostate cancer for men. The chance of a man developing prostate cancer increases after 50;

·        Counsel on health risks with smoking and alcohol.

 

Of course, you should report any troubling symptoms to your doctor promptly; generally you should learn to modify your lifestyle in ways that prevent illness and maximize health.

 

DEALING WITH STRESS

 

We frequently complain of being stressed out, exhausted, and hardly able to cope with our daily demands. We complain that we have no time for ourselves, and we blame everyone else but ourselves.  Often, we don’t confront those things that bother us the most.  We keep busy all the time, to avoid problems and unpleasant situations. But this doesn’t make us happy.  For those people who try to do everything, be everywhere, and please everyone, good relaxation may alleviate most of the stress. Your body knows how to relax, if you let it.  However, for those whose stresses are more serious, a week’s holiday, a new diet, or a good exercise program may help, but it is not going to completely remove it.  The only way to deal with serious stress is to confront the problems and start resolving them.  That is not easy.  But it’s worth trying.

 

 

PHYSIOLOGY OF STRESS

 

Our bodies possess ways of dealing with stress.  If there is imminent danger, our heart pounds faster, increasing blood pressure, and sending extra blood to the brain, muscles, heart, and lungs to work harder, faster. The digestive track and other organs that are not in the front-line of the fight slow down.  This fight-or-flight reaction is splendid for dealing with life-threatening situations such as escaping fire or avoiding traffic accidents, but it is not helpful when dealing with the perpetual stress of modern life. 

 

Even if we have never encountered a lion in the woods, we have all experienced that rush of adrenaline that causes sweaty hands and pounding heart in emotionally stressful situations such as job interviews, weddings, or public speaking.   Often these short stress stimuli improve our performance.  Some temporary excitement in whatever we do can bring better results.  However, stresses can be extremely harmful if they happen on a continuous basis.   Muscle tension and injury, headaches, stomach problems, teeth clenching, insomnia are all directly attributed to continuous stress. Excessive stress can result in panic attacks, depression, and emotional instability.  Stress can deplete our immune systems, which can increase our vulnerability to serious illnesses such as heart disease and cancer.

 

Chronic stress, whether major or minor, should be recognized and alleviated before it produces negative physical and psychological reactions.

MANAGING STRESS

 

Most of our stresses come from trying to do too much (self-imposed stress, prevalent in women). We are so busy trying to survive in our competitive work world that we don’t stop and think what we want out of life.  We have to learn to make time to release the pressure.  We know what makes us relax.  Take a moment to think about this: “I would really love to ...”.  You probably did not come up with an impossible idea, but rather with something quite simple, something you remembered you did when you were younger that made you happy, something as trivial as going to see a movie or a show, a good game of tennis, a hair style change, going to a cafe with friends or to a nearby park or a stroll near a lake.  Now, you may not be able to do so at this moment, but you can certainly start planning.  Just the planning and anticipation can boost your spirit, decrease your stress.  Go and do it.

 

Our friends invited us to their home for a 2000 New Year’s Eve party.  The hostess knew that I like to organize things, so she asked me if I would like to coordinate the food for the evening.  At first I thought I would just tell everyone to bring a specific dish, but as I was listening to the radio, hearing about how people were going to celebrate New Year’s Eve in fancy halls and restaurants, I got the idea to make up a program that would give us time for dinner, dancing, singing, champagne, and surprises.  By making a few door prizes, a bottle of wine, a decorative candle, and bright red panties, we would have three happy winners and lots of laughs and excitement.  And, best of all, I had fun doing it.

 

Different things make people feel good, but whatever it is, try to do it. Most of us get satisfaction from small things: a bike ride, going to church or meditating, visiting an art gallery, listening to music, or buying yourself flowers.  Sometimes, people like to be alone, have time for themselves.  Sometimes you just want to sleep longer and relax, doing nothing.  To release stress, do something you enjoy, that will make you feel better, that will boost your spirits.

 

Not all the stresses can be diminished by relaxation or a walk in the park.  Statistics show that over 40 percent of the population have serious enough personal and family problems that, added to job stress, can seriously undermine health.

 

A friend, a woman family doctor, has seen so much health deterioration on working women of our age, that she concluded that it is unlikely that these women will necessarily live any longer than men.  The diseases related to stress at work, once only male diseases, are now also female diseases.  The stress outside the home, combined with the stress at home -- dealing with confused adolescents, with weak elderly, aging and stressed partners -- takes their toll on women.  We may find that, in the next twenty or thirty years, today’s female life expectancy (to live considerably longer than men) may not be true.     

 

Continuous dissatisfaction at work and in relationships, health problems, and financial uncertainties are powerful stresses and often, if not dealt with promptly, can lead to additional problems such as overuse of alcohol or drugs which only serves to increase the mental and physical strain.

 

Worries, particularly about money on a day-to-day basis, are among the few things that can really cause constant anxiety.

One friend has made several foolish decisions investing his money.  Like many who want a get-rich-quick way, he took a big risk and lost everything.  Now, the constant strain on him and his wife, because of the lack of money, is effecting their health.  They are unfortunately taking new medications for health, instead of dealing with and solving their financial situation.    

 

In surveys, twice as many women as men say that they often or always suffer from work stress.  But we frequently cause our own stress by setting ourselves ridiculously high standards.

 

My sister-in-law, who was getting high recognition at work and lucrative job promotions, kept spending unhealthy amounts of time at work, but suffered constantly for not spending enough time with her children.  With raising demands from family and work, she became visibly stressed, physically and emotionally.  Finally, she decided to put a stop to it, and she made arrangements with the same company to work as a consultant, which gave her, for the first time, some control over her time and her life.  Her courage to act and make changes made her life much better and more satisfying.     

 

Although men complain less about stress at work, many feel that their jobs are not satisfying; that they work under high pressure, deadlines, or other difficult conditions; that they do not share responsibility in decision-making,  have conflicts or disagreements with a boss or workmates, and see no career or promotion opportunities.  In addition to those work stresses, at 50, we are increasingly concerned about job security.  We have less confidence in finding new employment easily. Work in our society is synonymous with self-esteem and identity.  Unemployment, especially for those in mid-life (even those whose financial security is not threatened) can have a profound effect on one’s sense of self-worth, and can engender anxiety, depression, and increased risk of illness.  Problems not shared or addressed can often lead to alcoholism, smoking, and absenteeism.  Getting counselling at your workplace could be a solution.  When under stress, for whatever reason, talk over your problem with someone you can trust.  A family or friend’s support is very important, especially in situations that you cannot change, that are out of your control.

 

Managing stress is something that only you can do for yourself, and it takes commitment. The only effective way to lower the stress level before it negatively affects your mental, emotional and physical well-being is to (a) realize what is causing your stress, (b) start thinking about making changes, (c) set a firm goal, and (d) work towards that goal.  It is futile to wait for someone else to make things better for you.

 

 

PREVENTING COMMON AILMENTS

 

The U.S. Guide to Clinical Preventive Services suggests: “The greatest promise for preventing illness lies in helping people to alter their health-endangering behavior via medical counseling and to use each and every illness or doctor visit as an occasion to advise people on disease prevention.”  Because most family doctors do not have time to educate their patients about the dangers of today’s many preventable killer diseases (heart disease, stroke, diabetes etc.), we should aim for prevention by becoming better educated about these diseases and making the necessary changes to our unhealthy lifestyles.  You can drastically reduce your chances of contracting many of the common ailments that affect people over 50, if you stop smoking, start exercising, eat nutritious food, limit your alcohol intake, get proper sleep, and reduce stress.  Prevention is the best method.

   

 

ALZHEIMER’S DISEASE

 

Alzheimer’s is an irreversible, progressive disorder of the brain.  It affects memory and learning, judgment, time orientation, language expression, perception, judgment, and the ability to think clearly.

 

Incidence:  Alzheimer’s disease often hits in the middle years, although it occurs predominantly in later life.  Women develop Alzheimer’s roughly one and a half times as frequently as men.  It effects nine percent of the population over 65.

 

Causes: These remain a mystery, although genetics play a part  in some forms of the disease. Acquired factors such as head injury and people with certain gene variants  are associated with increased risk.  Other theories are that it may be triggered by an unusual or slow-acting virus, or by the toxic effects of substances in our environment, especially aluminum. 

 

What happens:  There is a gradual breaking down of brain cells at an above-average rate in the regions that control memory and perception.  This results in a slow decline in intellectual and motor ability.

 

Signs and Symptoms:  At early stages when symptoms are mild, diagnosis may be confused with other dementias.  The main clues that lead to a suspicion of Alzheimer’s are repeated lapses in memory and failure in intellectual tasks uncharacteristic for the person involved.  Short-term memory is affected first, so that new tasks become more difficult to master.  Typical mental changes are increasing forgetfulness and the loss of the ability to calculate, loss of language skills, difficulty in remembering  how to carry out simple motor acts like dressing, disorientation, and loss of ability to make sensible decisions.  Some victims go through marked behavioral changes, become fearful of darkness and being alone, keep pacing or rummaging, develop a short temper with anger often directed towards the care giver, and decline in personal grooming habits. 

 

General treatment:  This usually consists of managing the gradually worsening symptoms with medication such as anticonvulsants, tranquilizers, antidepressants, mood stabilizers, sleep aids, anti-anxiety drugs.  Treatment also includes psychiatric counselling for the patient and caregivers.  The role of new cognitive-enhancement drugs, hormone replacement (for women), anti-inflammatory drugs, and vitamin E are all under study.

 

Tips for prevention:

 

·        keep stimulating the brain;

·        avoid head injuries.

 

ARTHRITIS

 

Arthritic originates from Greek, arthros, (joint) and itis, (inflammation).  The most common forms are  rheumatoid arthritis (RA), which involves joint inflammation, and osteoarthritis (OA), which is a degenerative condition. If diagnosed early, much can be done to relieve suffering.

 

Incidence:  Arthritis, one of the most common chronic diseases in North America, afflicts one in seven people.  RA strikes about one in a 100 persons -- more women than men, young as well as old. OA, the commonest type of arthritis, affects about 20 percent of people over 60, slightly more women than men, especially the obese.  OA is a degenerative condition that occurs to some degree in almost everyone over 65.

 

Causes:  The causes of arthritis are unknown.  Some scientists believe that RA may be triggered by bacteria or viral infections such as hepatitis, dysentery, or gonorrhea, or a flaw in the body’s immune system, or hereditary factors.  OA is probably caused by the wear and tear of joints, perhaps following some injury or exercises that affects these joints.  Climate is not connected to the development of arthritic diseases, although symptoms in some individuals may worsen with weather (barometric ) changes.  Excess weight puts strain on joints and should be reduced.

 

What happens:  In RA, inflammation causes a thickening of the lining of joints, and fluid build-up in the joint cavity, with consequent swelling and pain.  Inflammation may spread to the ligaments (binding structures) causing more pain.  In OA, cartilage deteriorates, leaving bone ends to rub painfully against each other. 

 

Signs and Symptoms: Typically, RA starts in the feet and toes, but then, if severe, spreads to many other joints (finger, knuckles, wrist, elbow and knee joints).  Due to pain, the person often feels tired, even exhausted.  RA may persist or go into remission for variable periods of time.  OA, however, often goes unnoticed, giving little discomfort until its more advanced stages.  Frequent joint cracking and stiffness, especially early in the morning, are common symptoms.  The ache in the joint decreases with rest.   

 

General treatment: Depending on the type of arthritis and its severity, treatment can include: heat; aspirin or other anti-inflammatory, non-steroidal drugs; physiotherapy, psychological, and occupational therapy.  Anyone taking steroidal, anti-inflammatory medications should be under close medical supervision.

 

Tips for prevention:

 

·        control your weight, (extra weight puts additional strain on the joint); 

·        swim.  This and other water exercises are excellent because water lends support to the joints;  

·        watch for signs of stiffness, hot swellings, pain, joint redness, or loss of movement in the fingers, toes, wrists, knees and hips, and lower back.

 

If you experience any of these symptoms, educate yourself about rheumatoid conditions and see your doctor.

 

ATHEROSCLEROSIS

 

Atherosclerosis means thickening and hardening of artery walls.  Lesions on the walls of arteries lead to formation of fatty deposits and fibrous plaques, which narrow the arteries and obstruct the flow of blood.  Atherosclerosis is the principal cause of heart attacks, stroke, and gangrene of the extremities.

 

Incidence:  More men than women suffer from hardening of arteries, and it is responsible for 50 percent of North American mortality rates. 

 

Causes:  An improper diet is the major cause of atherosclerosis.  Strong risk factors are high blood-cholesterol levels and high blood pressure.  Since the arteries become less elastic and more susceptible to arteriosclerosis with age, the older you are the more you need to reduce other risk factors.  A history of heart disease and stroke in the family also substantially increases the chances of developing these illnesses.

 

What happens:  As fatty streaks in the arteries accumulate they form fibrous plaques, which may impede the flow of blood.  Cholesterol, if its concentration in blood becomes excessive also accumulates in fibrous plaques, narrowing the passageway, and further reducing the blood flow.  Cholesterol is carried in the blood by lipoproteins: low density lipoproteins (LDL), and high density lipoproteins (HDL). Increase in blood cholesterol of the LDL type “bad cholesterol” contributes significantly to atherosclerotic changes in arteries, forming part of the arterial deposits and crusty thickening.  Increase in HDL cholesterol “good cholesterol”  prevents the disease, by taking cholesterol away from the arteries to the liver, where it is metabolized into bile acids and excreted. 

 

Signs and Symptoms: Although there may be no obvious  symptoms, atherosclerosis can lead to a sudden heart attack that may be fatal or may irreversibly damage the heart.  Some early signs may appear in the form of circulatory disturbances.  Hindered circulation in the brain causes headaches, dizzy spells, memory problems, fainting spells, or the inability to speak or see properly.  Atherosclerosis in legs causes pain while walking.  Angina, which occurs when the blood vessels leading to the heart are temporarily blocked, is much more frightening.  High blood pressure is often a sign of hardened and narrowed arteries.  Since the terminal event can be so devastating, prevention of arteriosclerosis is vital and must start well before the crisis stage.

 

General treatment:  Lowering LDL blood cholesterol is the first essential step.  This can best be done if you achieve and maintain healthy weight, exercise regularly, and reduce dietary fat to recommended levels. 

 

Tips for prevention:

 

·        reduce obesity;

·        exercise regularly;

·        eat fish instead of beef, lamb or port, and reduce your intake of dairy products;

·        switch to olive or canola oil;

·        increase fibre intake (from oat or wheat bran and legumes);

·        consider cholesterol-lowering drugs only as a last resort, if diet and other methods fail to bring down LDL levels.

 

BACK PAIN

 

Following the common cold, backaches are the next most frequent reason for visits to the doctor.  Fortunately, most back injuries resolve themselves in a few days or several weeks, with or without treatment.  Most back problems are manageable by simple corrective measures, posture improvement, and a daily exercise routine.

 

Incidence:  Almost 90 percent of North Americans aged 29 to 65 have back pain at some time in their lives.   Men and women are equally affected.  People in jobs requiring heavy lifting may be more prone to back injuries.

 

Causes:  The normal wear and tear of aging is most to blame for ordinary back problems. However, many back problems are related to chronic misuse and overuse of back muscles and spinal column.  Obesity, improper posture, or poor physical condition all put undue pressure on the back muscles and increase susceptibility to injury.  With aging, osteoporosis and arthritis are also contributing factors. Back injuries are most likely to occur from lifting heavy objects improperly, causing sciatica.  Sciatica is an irritation or inflammation of the sciatic nerve, usually resulting from compression, causing muscle strain, spasm, or a bulging disk.  In older people, sciatica is more likely the result of collapsing vertebrae, which continually irritates the nerve.  The collapse is often due to poor muscle support.

What happens:  The spine is a gently curved column composed of 33-flat surfaced, circular bones (the vertebrae) stacked on top of each other, separated by disks (little oval pads made of fibrous tissue outside, and a soft tissue inside) that act as shock absorbers.  These shock absorbers act like a cushion to allow the vertebrae to move smoothly.  Without them, movement would be painful, and bone would rub abrasively against bone.  Through  wear and tear, discs may thin down, or bulge and press on the nerve.  Muscle spasm, (a natural reaction that tries to immobilize the back and prevent injury from worn joints and bulging disks), is responsible for much ordinary back pain. Pain from an irritated nerve in the back may radiate down to the legs and feet.

 

Signs and Symptoms:  Back pain is often characterized by soreness and aching anywhere along spine from the neck to the tailbone.  Lower-back injuries are most commonly due to constant strain of back muscles, causing irritation to a nerve, which can be very painful.

   

General treatment:  While most back pain resolves spontaneously, acute episodes are usually treated with medications that reduce the pain, followed by physiotherapy. With rest, heat and pain medication 90 to 95 percent of back sufferers are better within eight weeks. The only therapy for lower-back pain is a few days of bed rest for tissues to heal, with the resumption of normal activities as soon as possible. Fewer than five percent of hard-core sufferers need surgery.  Since emotional reactions and pain tolerance vary widely, treating back pain often includes the mental as well as the physical aspect.  Ignoring the psychological factor can hinder progress.  Anxiety over the injury can develop into depression, which can linger long after the backache. 

 

Tips for prevention:

 

·        learn to stand, sit, lift, and bend correctly;

·        learn proper posture and movement;

·        lift objects close to the body (back straight and knees bent);

·        cross your knees to relieve spinal pressure when seated;

·        do not arch your back when reaching;

·        avoid obesity;

·        do a few daily exercises to strengthen your abdominal and back muscles;

·        avoid heavy chores if your back hurts.

 

DIABETES MELLITUS

 

Diabetes is a disease that makes it difficult for the body to process sugar properly.  In North America, 80 to 90 percent of those with the disease have non-insulin dependent diabetes mellitus, where the body’s cells cannot respond normally to insulin (the hormone that regulates blood sugar) controls.  This form (adult onset type) usually develops in middle age, mostly among the obese and under-exercised.  It often responds well to dietary management, rarely requiring insulin therapy.

Incidence:  Diabetes mellitus tends to develop in later life, usually over age 40.  By age 65, it affects one in ten North Americans, of both sexes, but affecting slightly more women.

 

Causes:  The strongest predisposition factors for diabetes mellitus is being overweight, and a family history of diabetes, the risk being almost directly proportional to body weight.  Although almost 80 percent of those diagnosed with diabetes are overweight, the disease can sometimes develop in lean individuals.

  

What happens: Too little insulin is produced, or the body cells are resistant to it.  

 

Signs and Symptoms: Many carriers stay unaware of the problem -- sometimes for years -- until complications appear. Owing to the diuretic effect of elevated blood glucose, frequent urination may be the first symptom.  Constant fatigue, itchy skin, and blurred vision are other indicators.

 

General treatment: About one-third of those with diabetes can control the disorder through weight loss and diet alone; the rest need oral medications.  Diabetes treatment begins with  education about the disease, regulated meal plans, weight control, adequate exercise, adherence to medications, and psychosocial counselling.    

 

Tips for prevention:

 

·        control weight, obesity exacerbates insulin sensitivity;

·        use a diet free of simple sugars and high in complex carbohydrates and fibre; 

·        increase physical activity;

·        educate yourself about diabetes, it is a serious disease.

 

GLAUCOMA

 

Glaucoma is the frequent cause of blindness in people over age 50.  Glaucoma is a group of eye diseases usually resulting from an increase in pressure in the eyeball.  Primary open glaucoma, the most common type, accounting for 80 percent of all cases, increases with age and appears in a slow, hardly noticeable manner. Early discovery and prompt treatment can prevent sight loss.  If left untreated, glaucoma inevitably leads to vision loss and, ultimately, blindness.

 

Incidence:  Two million North Americans suffer from glaucoma, with visual problems that are often severe enough to label victims as legally blind. Glaucoma affects 2 to 4 percent of North Americans over age 50, and 5 percent of those over age 75.  Primary open glaucoma tends to be more severe among blacks.  People whose parents have glaucoma are at higher risk.  Those with diabetes, high blood pressure, and strong short-sightedness are also at elevated risk. 

Causes: Glaucoma generally involves a build-up of eye pressure resulting from blocked fluid outflow.  The rise in eyeball (intraocular) pressure causes progressive damage to the optic nerve fibers (which carry visual messages from the eyes to the brain). Glaucoma affects both eyes, and progresses slowly and painlessly over many years.   

 

What happens:  The front part of the eyeball is full of a liquid called aqueous humour, or watery fluid, which bathes the eye’s lens and which carries nutrients to the lens (focuses the light onto the retina) and other eye tissues.  For the nerve and other eye tissues within the eye to function properly, the aqueous humour is kept at a constant pressure, by fluid inflow and constant outflow or drainage.  A fault in the eye’s drainage system allows pressure to build up which compresses and damages the optic nerve.  The pressure build-up may also reduce the blood supply, so that the nerve fibers wither and die.

 

Signs and Symptoms: Glaucoma often creeps up unnoticed, giving no obvious sign until it reaches an advanced stage when much sight may already have been irrevocably lost.  So, everyone should have regular eye exams after age 45, even in the absence of vision complaints. Peripheral or side vision goes first, leaving only central or “tunnel vision.”  When central vision disappears, the result is blindness.  Glaucoma can be generally discovered at a routine eye examination.

 

General treatment:  Treatment of glaucoma aims to lower eye pressure, relieve optic nerve compression, and stop sight loss.  When diagnosed, the first treatment usually involves medication given as eye-drops or pills.  Some eye-drops lower pressure by increasing drainage.  Other eye-drops decrease fluid production.  There are also anti-glaucoma pills.  Sometimes a combination of different eye drops and anti-glaucoma pills may be prescribed.  Medications must be taken regularly to prevent further visual deterioration and possible blindness.

 

Because glaucoma medication must be taken regularly, and since glaucoma medication taken in combination with other drugs can cause serious side-effects, it is important to tell any attending health care professional about your glaucoma medication.

 

There is, fortunately, a new and successful use of lasers for glaucoma treatment.  Laser treatment is now a common surgical procedure for glaucoma, done in about 15 minutes, in which laser heating of the eye’s drainage system allows fluid to flow out.  Laser surgery doesn’t always permanently alleviate the problem.   The pressure may rise again after several years, necessitating repeat laser or alternative treatment.  When medication and lasers fail, classical surgery may be the only remedy.

 

Tips for prevention:

 

·        get regular eye check-ups after age 45;

·        adhere to the prescription, if you have glaucoma, remember, once the vision is lost, nothing can restore it.

 

HEART DISEASE

 

The heart is one the body’s most vital organs, ensuring that blood and oxygen are supplied to every cell.  The heart muscle contracts 80 times a minute every hour of every day without resting. Heart failure is a condition that develops if the heart muscle weakens, and is most common in the elderly.  Heart attack, which is the number one killer of people in their early 50s, is a condition in which a part of heart muscle is deprived of blood and oxygen for a long enough period for cells to die.  This occurs because the blood vessels develop deposits that build up throughout your life which can eventually block the flow of blood.  Education on prevention of heart attacks could save many lives.

 

Incidence:  Heart attacks occur both in men and women, but women after menopause become more vulnerable to heart disease.  

 

Causes: The main cause for most heart problems is a bad diet, consisting of an excess of saturated fat, salt and sugar.  Lack of exercise can lead to the heart receiving an insufficient supply of oxygen, resulting in fatty deposits in the coronary arteries.  Risk of heart disease increases with smoking and high blood pressure.  Constant stress is one of the most dangerous conditions for the heart.  Susceptibility to heart disease may also run in the family.

 

What happens:  A heart attack occurs when the flow of blood into your heart stops. The muscle cells in heart depend on blood to bring oxygen and sugar. Without a blood supply, muscle cells in your heart will start to die, unless the blood supply can be restored.

 

Signs and Symptoms:  A great number of heart attacks occur without pain and very few symptoms, appearing as a sudden chest constriction or pressure, which leaves the person feeling weak.  Outbreaks of perspiration, sudden weakness, nausea and vomiting are sometimes the only signs.  Heart attacks tend to occur during periods of physical or emotional stress.  Any chest pain that lasts longer than two minutes should be treated as an emergency.  Heart attacks can occur with very little warning, but they can end in sudden death.

 

General treatment:  In bypass surgery new vessels implanted in your heart will allow blood to get around the clogged arteries. Heart attacks generally develop as a result of fat (cholesterol) build-up in the blood vessels.  To avoid the recurrence of a heart attack, a change in nutrition is required.  It is possible to slow, even stop, hardening of the arteries by choosing a predominantly vegetarian diet.

Tips for prevention:

·        cut down on saturated fats (found in meat, chicken, and dairy products);

·        replace animal protein with fish or plant protein (beans and tofu);

·        exercise regularly;

·        stop smoking;

·        avoid stress.

 

HYPERTENSION

 

Hypertension is caused by an above-normal pressure of the blood against the walls of the arteries.  If the pressure remains high for an extended period various, organs can be damaged.  Prompt and appropriate control of hypertension can dramatically lessen its toll.

 

Incidence:  About 10 to 12 percent of North Americans suffer from a degree of high blood pressure.  Hypertension afflicts far more blacks than whites; a genetic predisposition may account for the fact that about one in four black Americans over 18 has high blood pressure.

 

Causes:  Its origins remain a mystery.  Among suspected reasons are obesity, lack of exercise, stress, an excessive sodium intake and other dietary factors, and genetics.  Hypertension is closely allied to our society’s modes of work and living.  Many primitive, non-industrialized populations remain unaffected by hypertension and do not experience a rise in blood pressure as they age. 

 

What happens: With hypertension, the increased force of the blood against the artery wall stretches and can rupture the vessel (as in stroke); or the arteries lose elasticity, become rigid, narrow and constricted (as in atherosclerosis) thus restricting transportation of oxygen, which can cause degeneration of organs. The kidneys, eyes, brain, heart and blood supply to the legs and peripheral tissues are most often affected.  Even a small rise in blood pressure over several years increases the chances of premature death from strokes, heart disease, and kidney failure.  Mortality rates increase if the hypertension is  accompanied by other risk factors such as cigarette smoking or high blood cholesterol.

 

Signs and Symptoms:  Hypertension is insidious, often giving no hint of its presence.  Blood pressure can rise and cause extensive damage even in people who feel fine.  The symptoms (dizziness, fatigue, shortness of breath, headache, and chest pains) often do not

appear until harm to the organs has occurred.  Because there are no early warning signs, the only way to stop hypertension is to have your blood pressure monitored. 

 

General treatment:  Most doctors believe that the only really effective non-drug method to reduce hypertension is to limit sodium intake and control weight.  Treatment with medications involve a trial approach, trying first one drug then another until the right combination is found.  The key with drugs is to stay on medication and not use them sporadically.

 

Tips for prevention:

·        control weight;

·        exercise regularly;

·        go easy on caffeine, salt, and fats;

·        get enough rest;

·        reduce stress.

 

INSOMNIA

 

A sleep-wake routine is in tune with the sun’s 24-hour cycle, and it requires check points such as meals and regular retiring and rising times.  Disruption of either waking or sleep patterns is called insomnia. Most of us suffer the odd sleepless night when we stay awake due to excitement, worry, jet lag, shift work or overuse of caffeine.  These don’t last long and are usually harmless.

 

Incidence: Insomnia affects one-third of the population.  Although there is no magic number, on average people need seven to eight hours of rest.  As we grow older, sleep quality normally decreases.

 

For many  women, menopause causes sleep problems, due to interruption of sleep caused by waking up from hot flashes.  For men, frequent nocturnal urination disrupts the sleep cycle.  Chronic sleep problems are more frequent with people who have emotional problems, and the condition can be triggered by upsetting events or illness. Those who tend to ponder problems at night, and people taking certain drugs have trouble sleeping.

 

Causes:  The common causes of insomnia are emotional and psychological.  Excess worry about someone or something, grief and stress. Depression and other psychiatric disorders often cause long-term sleeplessness. Worry about the sleep often lowers the chances of good sleep.  People who take sedatives tend to depend on them, and by mixing alcohol, instead of helping, the problem becomes much bigger.  Sleep difficulties can also be provoked by certain drugs such as the hypertensive medication, propranolol.

 

What happens:  Sleep is an active cyclic process, regulated by various brain areas and transmitter chemicals. There are two main phases: non-rapid-eye movement (nonREM) and rapid-eye movement (REM) that start once we pass the short, pre-sleep, drowsy period.  Sleep normally starts with nonREM, deep and slow sleep.  After 80 to 90 minutes of deep, nonREM sleep, a short, 5 minute phase of REM sleep takes place, followed by similar cycles of non-REM and REM sleep during the night.  The REM phase, lasting up to 15 minutes and during which we have dreams, is marked by an increased heart rate, higher respiration, a rise in blood flow, elevated oxygen consumption and  blood flow to the brain, marked prohibition of movement, and penile erections.  If  awakened during some of the REM phases, we may recall vivid dreams or parts of them.  However, dreams are often forgotten by the morning.  Suppression of REM sleep and dreams is caused by various drugs, such as barbiturates, antidepressants, and alcohol.  

 

Signs and Symptoms:  Having problems or being unable to fall asleep, being bothered by lights or noise, waking up frequently remembering dreams “nightmares,” or waking up early and not being able to fall asleep again are signs of sleep disorders.  Lack of sleep
usually leads to feeling fatigued the next day, irritability, and not being able to cope with stresses and emotional pressure.  

 

General treatment:   Problems are solved not by taking sedatives and alcohol, but by controlling sleep habits, allowing the body time to rest and rejuvenate. Insomnia, caused by physical pain, emotional stress, worries, medications, financial problems, overwork or excitement about the future, usually lasts two to three weeks needs little or no therapy.  Once the pain, worry, and overwork disappear, so does the insomnia.  To reduce anxiety and prevent the condition turning into a long-term sleeping problem, doctors may occasionally prescribe a sleep remedy for a short time.  Alcohol has a negative effect on sleep.  It interferes with the REM phase and disturbs the natural cycle.  Long-lasting insomnia is much harder to deal with.  The first approach is to improve sleep habits.  Failing that a doctor may have to do a thorough medical examination, analysis of psychosocial, alcohol, and drug history.

 

Tips for prevention:

 

·        go to bed at a regular time;

·        exercise daily, especially in the evening;

·        provide a comfortable, dark, sleep environment;

·        keep a good bedroom temperature (about 18 degrees C);

·        relax before going to bed;

·        try avoiding daytime naps and oversleeping;

·        reduce use of tobacco, alcohol and drugs;

·        don’t consume caffeine in the evening and before bedtime;

·        do not go to bed very hungry or after a big meal;

·        do not continually use tranquilizers;

·        try not to go to bed excited, worried, or stressed;

·        try  not to go to bed angry, exhausted or overworked.

 

 

MALE SEX PROBLEMS

 

Almost everyone who is sexually intimate with another person experiences some sex problems.  Closer sharing of likes and dislikes and better communication between partners usually resolves the problem.  For those approaching 50, the most common male sex problem is impotence or erectile dysfunction.  Usually caused by a physical condition (such as diabetes, arteriosclerosis, smoking, alcohol consumption, obesity, or the use of certain medications), it is often worsened by anxiety and performance fears.  Fortunately, many promising new drugs, devices, and surgical procedures, as well as counselling can help to overcome the problem.  It is important to remember, however,  that sexual pleasure for both partners can be achieved in countless other ways besides intercourse.

 

Incidence: Studies have reported that 16 to 34 percent of healthy young men have occasional erectile failure.  In older men the percentage is higher, very often due to underlying physical reasons. The most common male sex problem is impotence (erectile dysfunction during intercourse).  Less common sexual disorders in men include premature ejaculation; genital pain before, during and after intercourse; inability to be aroused; a disinterest in sexual activity or in a specific partner; and inability to achieve orgasm during intercourse.

 

Causes:  There could be physical and psychological reasons for erectile failure.  Blood-vessel disorders that restrict penile blood flow (artery-narrowing due to arteriosclerosis or veins that don’t close off properly) cause penile collapse.  Smoking is a major reason for erectile failure, because nicotine causes spasms in small penile arteries.  Another major cause is alcohol, leaving men unable to have an erection.  Drinking excessive amount of  alcohol may cause shrinkage of the testes and impair the mechanism that shunts blood into the penis.  Other physical reasons are prostate disorders, kidney impairment, liver cirrhosis, alcoholism, Parkinson’s disease, multiple sclerosis, and diabetes.  Hormonal imbalances such as low testosterone output, thyroid and adrenal gland disorders, and damage to the nerves responsible for erection (spinal cord injury or prostate gland surgery, bladder, or rectum) can cause erectile failure.  A long list of medications can effect erection, including antihistamines, antidepressants, marijuana, muscle relaxants and blood pressure medications.  Up to 40 percent of men on diuretics and other blood-pressure pills have erectile problems.  Other reasons include depression, anger, stress fatigue, performance anxiety, job loss, lack of privacy at home, poor communication with a partner, lack of intimacy, or a negative sex encounter that leaves men full of self-doubt about his sexual competence.  Even though a man may be perfectly capable of attaining erection, feelings of inadequacy may make him hesitate to attempt intercourse.  The longer anxiety lingers, the greater the chance of a sex problem.

 

What happens:  While organic reasons underlie many types of erectile dysfunction, the problem usually also has psychological overtones.  For example, a man with atherosclerotic build-up in his penile arteries may experience occasional erectile failure, which in turn leads to anxiety about non-performance, exacerbating the problem. 

 

Signs and Symptoms:  Inability to achieve and sustain erection for the purpose of sexual intercourse.   

 

General treatment:  If the erectile problem is mainly physical, drugs, hormones, or devices may be the answer.  If the condition has psychological aspects, sex therapy and counselling may help.  If the erectile problem can’t be traced to a definite reason, men may be offered drug therapy, devices and counselling, regardless of the cause.  For some men, mechanical devices or drugs, can restore enough confidence to sustain erections, then be discontinued.  Since drugs and devices won’t overcome intimacy problems, sex therapy is also often suggested.

 

Tips for prevention:

 

·        reduce smoking;

·        reduce alcohol consumption;

·        watch for negative effects of medications;

·        improve communication with your partner;

·        eliminate stress and anxiety;

·        concentrate on enjoying sexual pleasures other than intercourse.

 

OBESITY

 

Nearly one-quarter of North Americans are overweight.  Well over half (40 million) are women.  People are considered obese if they are 20 per cent or more above their “ideal” weight as stated on standard weight/height tables.  More accurately, obesity is measured by a body mass index (BMI), which is your weight (in kilograms) divided by your height (in meters squared).

 

For example, a person 1.8 m (6 ft.) tall and weighing 82 kg (180 lbs.) would have a BMI of  [82/(1.8 x1.8)] = 25.3.

 

A BMI of 19 to 26 is within healthy limits.  A BMI over 28 qualifies someone as “obese,” with a four-fold increase for the risk of diabetes, stroke, and heart attack;  BMIs of 30 plus give a 50 to 60 percent increased risk of early death.  Serious weight problems usually stem from long-term lack of exercise.  Changing these behaviours is difficult, but will bring lasting results.

 

Incidence:  Most common among poor, and uneducated people.  More women than men have weight problems.

 

Causes:  Many factors cause obesity including genetic makeup, food composition (proportion of fat and carbohydrate eaten), physiological (fat cell) changes, hormonal and brain transmission signals, psychological and environmental influences.  Weight problems are often directly related to deeper mental, emotional and social stresses. Researchers agree that an unhealthy lifestyle with too much dietary fat and little or no exercise is the most common cause of obesity.  Only rarely is obesity related to an actual physical disorder.

 

What happens:  Body weight is regulated by the complex interplay of many mechanisms involving hunger cues, appetite-stimulant and appetite-suppressing brain signals, the action of various hormones, and the constant feedback from gastric tract and fat tissue. Overfeeding raises the metabolic rate and the body’s heat production.

 

Signs and Symptoms:  Excess weight will often result in problems that affect the feet, knees, ankles, hips, and lower back.  Obesity commonly leads to circulatory disturbances, including water retention around ankles.

 

General treatment:  There are no easy solutions, but a healthy, active lifestyle, a positive attitude, and good eating habits form an excellent foundation. Think about the serious health hazards connected with various diet drugs, and the risk associated with taking them.  Make a decision and to find the motivation to change your eating patterns and to exercise more.  These are the best approaches.

 

Tips for prevention:

 

·        consult your doctor or registered dietitian about a weight-control program;

·        go for gradual weight loss;

·        moderate your portion sizes; 

·        choose diets rich in fruit, vegetables, and fibre;

·        reduce fat as much as possible (study food labels for fat content);

·        walk briskly every day for at least 20 minutes;

·        find activities that you enjoy and that rejuvenate you;

·        educate yourself and your children in obesity prevention.

 

OSTEOPOROSIS

 

Osteoporosis is a common and disabling disease in which gradual loss of bone tissue leaves aging bones porous, weak, brittle, and easily breakable.  As osteoporosis progresses, many people over 50 sustain wrist, hip, and spinal fractures.  For women, preventing or slowing down osteoporosis after menopause can be achieved by taking estrogen.  For both sexes a change to a calcium enriched diet can help.      

 

Incidence:  Osteoporosis afflicts men and women of all ages, but it is more common in women over 50.  At 60 years of age, 25 percent of men and women develop osteoporosis.

 

 

Causes: Potential causes are: a family history of osteoporosis, low-calcium diet (especially during adolescence and early adulthood), lack of regular exercise, increasing age, smoking, being a female near or past menopause, heavy use of alcohol, being Caucasian (white race), or being underweight for your height.

 

What happens:  Bone mass (bone density) gradually reduces as you age.  Bone is a living tissue that rebuilds itself.  For the first 40 years, bones are at their thickest, declining in density thereafter.  For men, it reduces at the rate of about 1 percent. For women, it is also 1 percent, but only until menopause.  Then it jumps to 3 to 5 percent a year, caused by the drop in estrogen.

 

Signs and Symptoms:  The most common fractures occur in the hips and vertebrae.  Loss of height and deformities in the upper back are signs of osteoporosis.  Collapsing vertebrae can pinch nerves to cause lower-back or sciatica pain.

 

General treatment:  Estrogen supplements for women after menopause are recommended.  Adequate calcium and regular exercise are very important. Calcium is a mineral essential to bone health.  The recommended calcium intake is 1,500 mg daily for an estrogen-deprived women (post-menopausal are not receiving hormone replacement therapy).  Calcium may be added by your diet (milk, cheese, and yogurt are rich in calcium) or, if you are not sure you are receiving adequate calcium through diet alone, by making up the shortfall with a supplement.  Calcium carbonate should be taken with or near a meal.  Avoid taking calcium with high-fibre meals or with iron supplements.  Do get  at least 15 minutes of sunshine daily if you can. You body needs vitamin D to help absorb calcium.  Muscle-strengthening exercises, and weight-bearing activities (walking, running, activities where body weight is carried) are bone-forming stimulants.  Mechanical forces enhance bone density (for example the racquet arm of a tennis player has much denser bone than the unused arm). Back exercises are also very important.

 

Exercise keeps your muscles strong and improves your co-ordination and sense of balance - all important factors in preventing falls.

 

Tips for prevention:

 

·        have your bone density measured at your next check-up, if you feel you are at risk;

·        exercise regularly (walk or swim), avoid skipping and jumping;

·        be sure to have 1,000 mg of calcium daily (milk, cheese, and yogurt are the best sources because they are most easily absorbed);

·        take supplements of calcium, vitamin D, fluoride, or estrogen if recommended by your doctor;

·        stop smoking and heavy alcohol use.

 

SKIN PROBLEMS  

 

The most common skin problem is sunburn.  Although sun rays activate the synthesis of vitamin D in the skin and heal many skin conditions, too much sun can damage and prematurely age the skin, producing wrinkly, leathery skin.  In the long term, it can cause skin cancer. To retain a youthful look and prevent skin problems, protect yourself while outdoors (see “tips” below).

 

Incidence:  Especially at risk are people with pale complexions, who have less melanin and burn more easily. The ability to tan or form melanin is genetically controlled.

 

Causes:  Ultraviolet (UV) rays from sun or artificial sources cause the skin to brown or to burn.  The melanin in the skin, which produces brown pigment, is activated by UV rays and protects the skin from UV damage.  Prolonged sun exposure destroys the elasticity of the skin’s connective tissue and its structure, which is the first step towards skin cancer.

 

What happens:  When UV rays contact human skin, some are reflected, some are absorbed, and some are scattered. To counter the assault of UV rays, the skin’s outer layer thickens and darkens.  The epidermal cells rapidly divide to form a covering that scatters and bounces back the attacking rays.  The other line of defense is pigmentation or tanning.  The real function of tanning is to reduce UV rays penetration and prevent cell injury.  People who tan easily are better protected than those who burn or freckle.  With excessive sun exposure, no defensive action can stop the skin changes that occur such as wrinkling, colour flaws, and other irreversible changes that may ultimately lead to cancerous growths.

 

Signs and Symptoms:  At first, skin becomes pink to fiery red, feels tight, slightly swollen, and hot.  At night, the skin may burn painfully. Blistered skin indicates a more serious burn, in which UV rays have caused some harm.  The damaged skin later peels away in sheets. 

 

General treatment:  Sunburn, should be treated like any other burn, depending on it’s severity.  To avoid further burns, use sunscreens (those containing one or more UV ray-absorbing chemicals should be applied to reduce potential skin damage.) Avoiding  direct exposure to the sun, especially between 11 a.m. and 3 p.m., is highly recommended, even for people who tan more easily.  

 

Tips for prevention:

 

·        wear a brimmed hat; protect a bald scalp;

·        wear dark (UV-protected) glasses to prevent eye damage;

·        avoid mid-day rays;

·        stay in the shade if prone to sunburn;

·        use suitable sunscreens before and during exposure to sunlight;

·        examine skin regularly for any unusual changes.

 

 

STROKE

 

Strokes are caused by a sudden interruption of the blood supply to the brain by either a blockage or a rupture of blood vessels.  A stroke, like a heart attack, is a serious arterial condition. 

 

Incidence: A stroke can occur at any age but is more common in older adults. Both men and women are equally affected.  Forty percent of women die from heart disease and stroke.  Menopause greatly increases the risk of heart disease and stroke in women.

 

Causes  A high-fat, low nutrient diet is the single most important risk factor in strokes. And the risk increases sharply if you have high blood pressure (hypertension), hardening of the arteries (atherosclerosis), heart disease, or diabetes. 

 

What happens: A stroke occurs when a blood clot travels to the brain, interrupting the supply of blood and the oxygen it carries to the nerve cells in that area.  As a result, the cells may die. This can happen quickly -- it takes about four minutes for the nerve cells in your brain to die from lack of oxygen and glucose.  Less commonly, a stroke occurs because of a rupture of a blood vessel in the brain.

 

Signs and Symptoms:  Sudden weakness, numbness and/or tingling in the face, arm, or leg.  These signals may only be brief.  Other signs can include temporary loss of speech or trouble understanding speech; sudden vision loss, particularly in one eye, or double vision; sudden, severe, and unusual headaches, and unsteadiness or sudden falls, especially with any of the above signs.  Unfortunately, since symptoms can be short-lived and confusing, they are often ignored.

 

General treatment:  The treatment and rehabilitation of stroke sufferers depends on the severity of the stroke and its effects.  Stroke rehabilitation aims to help people recover as fully as possible and adapt to their functional handicap(s) so that they can return to near normal activities.  Rehabilitation is a multidisciplinary process, involving doctors, occupational  therapists, speech therapists, nurses, psychologists, social workers, and other experts.  Movement therapy is a key part of rehabilitation.  Cognitive (thought) therapy retrains the ability to concentrate and focus attention.  The patient and caregivers must be “active” members of the rehab team and participate in the recovery process, not just passively give or accept advice.  With good rehabilitation methods and time, many victims can develop  alternative ways to carry out daily activities and hobbies. 

 

Tips for prevention:

 

·        have your blood pressure checked regularly;

·        eat high-fibre, low-fat foods;

·        don’t smoke;

·        maintain a healthy weight;

·        keep physically active;

·        take time to relax;

·        learn the warning signs of a stroke and, if needed, get emergency medical attention immediately.

 

UNDERSTANDING MENOPAUSE

 

The word menopause comes from the Greek words meno (month) and pausis (halt or stop) and means the cessation of menstruation.  As women age, ever-decreasing levels of estrogen reach a point where periods stop altogether.  Clinically, when a woman has gone twelve months without a period she has experienced menopause.  The average age for this transition -- from reproductive ability to a non-childbearing state -- is 51.4, although it can happen any time from 40 to 60, and even this range has some exceptions.  The ease of transition can also vary greatly from hardly noticeable to traumatic.  For example, in a tale of two sisters, it was so unobtrusive for one that she could barely recall her passage, while the other opted for her physician’s recommendation of a hysterectomy.  On average, 75

 

percent of women experience some physical discomfort associated with the myriad effects of menopause.   Some of the most common effects are as follows.

 

Changes in menstrual flow can occur as an abrupt stoppage, a gradual lessening, or even an increase in frequency.  The volume of flow may be lighter to heavier in varying degrees; sometimes huge clots are passed, and pads must be changed hourly.   Also, the duration of the monthly flow may become shorter or longer.  Heavy periods or spotting are often due to fibroids or polyps in the uterus, however, other causes may be endometrial or cervical cancer, so it is important to check unusual patterns with your gynecologist.  Heavy menstrual bleeding may also be due to a vitamin A deficiency, which can be alleviated by adding apricots, and yellow and leafy green vegetables to your diet. An iron deficiency may lead to anemia, which can also result in heavy bleeding.

 

Hot flashes affect about 70 percent of menopausal women, predominantly women in Western countries.  (Japanese women rarely suffer from this complaint.)  They happen because blood vessels become overly reactive due to changes in the nerve pathways that control temperature. Hot flashes can be triggered by hot drinks, alcohol, stress, environment, certain foods -- or nothing at all.   They usually last three to four minutes.  They may be infrequent or occur up to 48 times in a 24-hour period.

The skin’s blood vessels dilate suddenly sending blood rushing to the surface, which can cause reddening of the face, neck, and chest.  The body’s temperature rises causing a wave of heat, which is often followed by sweating or chills.   The experience has no effect on blood pressure, and although debilitating at times, it is not dangerous at all.  Night sweats (hot flashes at night) can leave some women soaking with sweat.

A cold drink at the onset of the hot flash may help. Dressing in layers allows for easier shedding of clothes, and cotton underwear allows perspiration to dissipate better than synthetics. Avoiding the triggers will obviously reduce the frequency of hot flashes, and practical things like a cool shower often work well.  Applying natural progesterone cream is also successful.  Black Cohosh has also been effective in reducing the effects of hot flashes. On average, hot flashes stop around two years after the last menses.

 

Vaginal dryness occurs when the decrease in estrogen causes the walls of the vagina to become thinner, resulting in dryness and itchiness.  Cervical secretions of mucous lessen, reducing lubrication levels, which may result in painful intercourse.  However, the best cure is regular sex, which stimulates vaginal lubrication.  Over-the-counter lubricants or vegetable oils work well; in more bothersome cases, estrogen cream inserted into the vagina works well.  Natural progesterone vaginal cream will counteract dryness.

 

Insomnia can be alleviated by establishing regular sleeping habits.  There are many herbal remedies that help with insomnia including lemon balm and valerian.  Nutritional supplements, specifically calcium, magnesium, and vitamin B complex often give good results.  One of the oldest remedies is simply a glass of warm milk and honey.  Milk contains tryptophan, which, when converted to serotonin in the body, induces sleep.

Urinary tract problems resulting from thinning of the urethra may exacerbate bladder infections or even create incontinence or changes in both frequency and urgency.

Magnesium and vitamin E help build muscles.  Magnesium is found in almonds, cashews, figs, whole grains, fish, and dark green vegetables.

 

Migraines can worsen in women who habitually suffer from them.  For others, migraines appear for the first time.  Your doctor is the best person to give you the treatment options for migraines.   Some women find relief in herbal remedies such as Ginkgo Biloba, feverfew, chamomile or ginger tea, and St. John’s wort. Nutritional supplements such as evening primrose oil, vitamin C with bioflavonoids, magnesium, and vitamin B complex may prevent or ease migraines.

 

Other symptoms that may affect some women are skin problems, hair loss, gastrointestinal discomfort, dry or burning mouth, and joint pain to list but a few.  Emotional changes may show up as irritability, mood swings, depression, lack of concentration, and memory loss.  Many of the women interviewed for this book feared the changes in their recall ability.  As one woman commented, “Sometimes I feel I am losing my mind.”  Although hormonal changes may be partially to blame, other social factors can effect our emotional well-being, such as stress-related circumstances. 

 

Culture plays an important role in how we perceive mid-life changes.  For example, in  cultures where women are valued for reasons over and above child-rearing and domesticity, menopause appears less traumatic.  American women seem to have a more ambivalent attitude, which can be traced to their culturally more-independent attitudes, professional working lives and high self-esteem.  In other cultures, for example in China, age brings status and a new sense of freedom; while in the Middle East, it can bring fewer restrictions in social relationships with men.  There is no doubt that women from cultures that view age negatively suffer with more menopausal problems and look on menopause as a disease rather than an integral part of a women’s journey through life.  After crossing over to the post-menopausal state, most women revel in new-found energy, freedom, and increased self-esteem.

 

HORMONE REPLACEMENT THERAPY (HRT)

 

This therapy first appeared in the early 1960s, promoted as a method of using estrogen supplements to reduce the discomforts of menopause.  It later moved towards a preventive measure for the common “diseases” associated with menopause.  Now, it is promoted by the medical profession as a regime for healthy women to counteract the increased risks of heart disease and osteoporosis, which haunt post-menopausal women.  For optimal benefit, HRT is recommended at the start of menopause and for at least 5 to 10 years -- or even a lifetime -- so that bone loss may be prevented or, at least, slowed down.  The long-term effects of HRT are not yet known.  (Previous statistics were based on women who took estrogen and not the combined estrogen-progestin therapy now used).  The known benefits are in preventing hot flashes, urinary tract/bladder problems, maintaining vaginal moistness, combating heart disease and stroke, preventing osteoporosis and improving brain functions.  The known down-side is increasing your chances of gallbladder disease, endometrial cancer, cervical cancer, and breast cancer.

 

I have hot flashes, and I have them galore.  I also remember my mother having them for a long time.  They come in the middle of the day, in the middle of a party, and especially during the night usually five to six times.  Then there are days when I do not have them at all.  My gynecologist insisted I go on HRT.  I refused.  I remember asking my sister in-law, who is an internist, a few years ago, what she thought about HRT.  She said categorically “no, we internists know better how the body works.”  She is a bit younger than me and her menopause had not started yet at that time.  I personally couldn’t imagine taking pills every day, because I have difficulty taking painkillers for my migraine episodes.  Besides, both my grandmothers lived passed 90, one was tiny and the other was big and bony, and neither of them ever heard of hormones, let alone estrogen.  So, I made decision not to go on it.  I will sweat it out, and believe me I am sweating it out.  A year ago, I noticed that my sister-in-law, the internist, was getting red faced and wiping sweat from under her nose.  I asked her when it began and how she was doing?  She said, “I may go on HRT.”  What happened to the categorical no?  “Well,” she said, “the more I read about it the more it makes sense.  The benefits outweigh the risks.”  I still feel comfortable with my decision.  The real comfort is that the Society of Gynecologists recommends reviewing your health choices with your doctor from time to time.  Besides, it is not a one-time deal.  You have the choice to never take it, take it now, or take it later.

 

Doctors, especially women doctors, stress that the increase of heart disease and osteoporosis is significant with the onset of menopause, and should be taken seriously.  Those who are not taking estrogen should be vigilant in doing everything to prevent heart disease and osteoporosis. They should exercise more, take enough calcium, quit smoking, eat sensibly, and avoid stress.

 

There are ways to increase estrogen levels other than HRT: food intake, for example, eating soy products, licorice-root extracts, health-food supplements, Chinese medicine and herbal remedies, homeopathy and tissue salts. To recap, vitamins C, B complex, E and calcium are especially important. Vitamin E enhances estrogen production and regulates the estrogen levels in the body.  It is important to keep calcium levels up and a 2:1 ratio of calcium and magnesium will prevent bone loss.  The Chinese medicine dong quai also balances the estrogen levels in the body, and natural progesterone cream is helpful both with hot flashes and vaginal dryness.  Evening primrose oil is also beneficial.  In summary, HRT therapy is not for everyone, and the benefits and risks involved should be discussed with your gynecologist, or alternative medicine practitioner.