MANUAL MEASURES OF BODY MASS AND FAT MASS

Weight. Weight is a measure of the force of gravity acting as the total mass of an object. As such it reflects not only the overall size of the body but also the density of the combination of body tissues, including bone, muscle and body organs. Fat is lighter than water and therefore adipose tissue is lighter than muscle and organ tissue (which are mainly water) and both are lighter than bone. Increases in weight might therefore mean an increase in fat mass, muscle mass and/or fluid (remember, glycogen is stored with three times its weight in fluid). Over the long term, it’s true that changes in weight generally reflect changes in body fat, but in the short term the use of scales is not recommended as a measure of success of a fat loss program. Weight scales also vary significantly, from a sensitive bar balance or high quality electronic scale to the less sensitive but more often used bathroom-type scales.

The validity of weight as a measure of body fatness then is only fair, especially in certain types of individuals such as mesomorphic (muscular) males and elite athletes. Reliability of the measure on the other hand is quite high. Sensitivity is also reasonably high (i.e. around 0.8) detecting small changes in body mass. But, of course, this is not sensitive to fat as distinct from changes in other body tissue. Weight, therefore, is limited as a measure of fatness, except where combined with some other measures.

Myth-information. Weight loss through heat treatments such as saunas and steam baths represents fluid losses through sweat. These techniques have no permanent effect on fat loss.

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BABY AND CHILDHOOD URINARY TRACT DISORDERS: VAGINAL REGION INFECTIONS

In girls occasionally an irritation occurs in the vaginal region. Called vulvovaginitis, it may affect the vulva at the vaginal opening. There are many causes, ranging from a lack of hygiene, to infections from germs, to threadworms (which may have journeyed from the back passage and become lost in the vagina), to hormonal deficiencies. It sometimes indicates early diabetes.

There may be no symptoms at all. Or there may be a discharge from the vagina, or itch or irritation. The discharge may be whitish, or clear or stringy and slimey. Sometimes it is pussy if there is an infection present. A bloodstained discharge may indicate a foreign object has been pushed into the vaginal canal— this is not uncommon with youngsters.

Treatment

Any symptoms in this region should receive medical attention. With a few simple tests, the doctor can often diagnose the cause and order the correct treatment. Frequently, adequate cleanliness and hygiene will prevent these problems from taking place.

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BABY AND CHILDHOOD ILLNESSES: AUTISM

Childhood autism was first recognized in 1943 by Dr. L. Kanner, and since then has become a fairly well recognised problem. Only in the past few years has an increasing amount of interest been taken in the problem which affects about 5 children in every 10 000 under the age of 15 years.

It is believed that many of these children have brain damage, and more than half are severely mentally retarded. Autistic children have difficulty in relating and communicating with others, and their imaginative capacity is severely retarded. As a result the child tends to perform the same activities over and over, and will often repeat the same set of words frequently. Some children show reasonable levels of intelligence, and originally Dr. Kanner claimed that many were potentially of superior intelligence. Many seemed to have parents following professional occupations, even though they were cold rigid personalities. But this has since been cast into doubt by subsequent research.

Treatment

‘There is no medical treatment, but appropriate management and education can diminish behaviour problems and help bring out any latent abilities,’ the British Medical Journal stated recently in a leading article. The child’s future is closely linked with his ability to develop language, social awareness and useful skills.

‘Most autistic children need care all their lives,’ the Journal says, ‘but a few become independent, though eccentric adults. Very few develop a high level of skill in some special field, such as music, mathematics or art.’

There are now national societies which take a special interest in autistic children, and parents often gain much assistance in this manner. The Autistic Children’s Association of New South Wales is located at 545 Pacific Highway, Artarmon, Sydney, 2064.

DIRT EATING (PICA)

Some children seem to enjoy eating abnormal material that is not food. The range can be remarkable. It may include dirt, clay, snails, peeling paint, starch, and even ice! Some infants love playing with their bowel actions and may even eat this! A weird list of items have been recorded in the books of medical history. A craving for certain foods is more common, and it may include almost anything, from vegetables, to biscuits, sweets or fruits, to an abnormal extent. A few years ago an individual had a compulsive desire to eat ice, and devoured 9000 g a day, according to the Journal of the American Medical Association. Others have been known to eat newspapers and the pages from glossy magazines. One individual sustained a bowel blockage from the amount of newsprint in her intestinal system. If your child shows a propensity for eating odd objects please seek medical help. The child may be referred for assessment by a child psychiatrist.

Treatment

The case will be fully investigated. However, a large number are found to have an iron-deficiency anaemia. The simple use of preparations containing iron may completely reverse the strange compulsion, and the patient readily gets back to normal eating habits again.

‘Pica is quickly cured by therapy with iron, but this valuable information has been generally ignored,’ JAMA magazine recently reported. Do not scold your child—rather seek medical attention. The cure may be far more simple than you ever imagined.

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POISONING

Poisoning occurs when substances harmful to the normal functioning of the body are swallowed, inhaled, absorbed into the skin or injected. Signs that poisoning has occurred include abdominal pain, nausea, vomiting, drowsiness, burning pains from the mouth to the stomach, difficulty in breathing, congestion in the chest, headaches, ringing in the ears, blurred vision and sudden collapse. If possible the type of substance which has been ingested should be determined before giving first aid. Vomiting should not be induced if corrosive or petroleum based substances have been swallowed, nor in cases where the source of poisoning is unknown.

Food poisoning or gastroenteritis is usually caused by bacteria which inflame the lining of the stomach and intestines. The bacteria salmonella and staphylococcus are among the most common culprits and their growth is encouraged by reheating or half cooking food. It is important to practise good personal hygiene, especially washing hands, when handling food and to keep utensils and food preparation areas clean. Frozen food should be defrosted properly before cooking and not refrozen after it has thawed out. Previously reheated food should be cooked at a high temperature. Hot, cooked food should not be left in a cooling oven or other warm place. Bacterial growth develops. Food poisoning also occurs with contaminated seafood.

Symptoms of food poisoning are vomiting, diarrhoea and abdominal cramping, sometimes accompanied by sweating and fever. Diarrhoea and vomiting can lead to fluid loss, so dehydration may follow.

To treat food poisoning, fluid should be replaced by drinking small amounts of water, flat lemonade or diluted fruit juice frequently. Often the stomach will not tolerate solid foods. Taking garlic capsules can help fight infection. Peppermint tea is helpful in cases of nausea.

Poisoning can also occur as a result of absorption of various toxic metals in the environment. Lead, cadmium, mercury and aluminium are widely used by industry and our environment is now permanently polluted by them. These metals cannot be biodegraded into the environment. Lead poisoning can be caused when sanding off old lead based paint during renovations. The bioflavonoid, quercitrin, contained in the juice of citrus fruits, is a good chelating agent for lead, and gradually removes it from the body.

Cadmium is found in tobacco and cigarette paper and in superphosphate fertilisers. Usually found in conjunction with zinc, the ratio of cadmium to zinc is much higher in refined flour and white bread than in the same wholewheat products. Eating wholewheat products and not smoking reduce exposure to cadmium. Vitamin C, glutathione and the trace element selenium all help to alleviate cadmium toxicity.

Mercury is another highly poisonous metal. Apart from pollution of the environment, the consumption of seafoods and fish is a major source of mercury. Mercury is concentrated in algae in the ocean and becomes progressively more concentrated as it progresses up the food chain. Selenium is a natural defence against mercury. It is found in wheat which is grown in selenium rich soils.

During the 1970s evidence emerged that aluminium could be harmful to humans when people in Scotland using home dialysis for kidney failure suffered a type of dementia which was traced to the town water supply which was being used in the dialysis and which had been clarified with alum. There has been some evidence to link aluminium with Alzheimer’s disease, but this is still controversial. The consumption of aluminium is increased when food is prepared in aluminium utensils.

Some herbs can cause poisoning when taken in large amounts. It is therefore important to consult a qualified herbal practitioner when taking herbal remedies.

Water contamination by algal blooms, becoming more common with the pollution of our freshwater lakes and rivers, is another source of poisoning. Microcystis, a type of blue-green algae, produces hepatotoxins which cause bleeding and breakdown of the liver, sometimes inducing tumours. In 1981 several people in Armidale, New South Wales, showed signs of liver problems after drinking water from a reservoir contaminated by microcystis blooms.

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JAMES’S REQUEST: DON’T ‘PRESCRIPTIONIZE’ ST JOHN’S WORT

James, a 50-year-old professional, wrote to me as follows:

I have had one form or another of depression for over 10 years. My depression has greatly affected my life in many ways. Most notably, my relationship with my wife has suffered and my relationship and reactions to daily work circumstances have been greatly and negatively affected. Many of my attempts to deal with my depression failed.

James describes how he first underwent six months of psychotherapy, which was of no help, followed by a course of Lustral, which helped his depression slightly but caused him chronic diarrhoea, a liability far greater than its minimal benefit in relieving his depression. After he broke his foot, this side-effect became even more inconvenient as he had difficulty getting to the toilet in time. He decided to discontinue the medication and his depression returned with full force.

After doing some research on the herb, James decided to take St John’s Wort on his own; within six weeks of starting to take 300 mg three times a day, his feelings of depression began to subside. ‘My depression is now manageable and I would have to say almost non-existent,’ he concludes. T hope St John’s Wort remains available without a prescription and that the … medical professionals do not attempt to “prescriptionize” it… I hope my short personal history regarding my depression and travels towards St John’s Wort will help to keep it available to the general public’

*10\75\2*

ALCOHOLISM

We are so imbued with psychological explanations of alcoholism that it seems strange to consider this problem as related to food or chemical susceptibility. Frequently, however, an alcoholic is not a mentally sick person, in the conventional sense, but a very advanced food addict. In fact, alcoholism could well be called the acme, or pinnacle, of the food-addiction pyramid.

It is usually assumed that the alcoholic craves the ethyl alcohol in his drink. In most discussions of the problem, however, a significant fact is overlooked: few people would choose to drink pure ethyl alcohol, even if given the chance. Alcohol is almost invariably found mixed with other ingredients or fractions, many of them related to common foods. Starting in the mid-1940s, I began to accumulate evidence that it was principally these foods, rather than the alcohol itself, to which many alcoholics were addicted.

This insight was related to developments in food allergy. It was Herbert J. Rinkel, the same man who discovered “masking” and “unmasking” of food allergy, who first diagnosed allergies to corn, in the 1940s. I confirmed Rinkel’s observations in my patients, and together we published a series of lists of foods containing corn or corn products.

Allergy to corn turned out to be the most common food allergy in North America. Why, then, had its discovery waited until the 1940s, years after the other common allergies were described? The answer lay in the very fact of corn’s popularity. Because it was present in practically every meal in one form or another, obvious or disguised, it was extremely difficult to unmask. It was only when we had compiled a fairly complete list and ferreted out the corn in numerous products, in the form of corn syrup, corn starch, corn oil, and so forth, that we could perform adequate tests.

Soon after this, I began to notice that many of my alcoholic patients had corn allergies. Some patients, for example, told me that they became drunk on only one or two glasses of beer or a couple of shots of bourbon. Such patients were invariably highly susceptible to corn or to other ingredients in these beverages, such as wheat or yeast. It dawned on me that it might be these substances, rather than the alcohol per se, which perpetuated the craving for alcoholic beverages and which caused the bizarre behavioral changes associated with alcohol consumption. Since alcohol is rapidly absorbed into the bloodstream, it was likely that these food fractions were rapidly absorbed along with it, creating problems for the susceptible.

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THE BASIC CONCEPTS OF ALLERGIES: COMBUSTION PRODUCTS OF FUELS

Another serious problem is posed by the combustion products of home fuel systems. This source of danger is largely dependent on the type and location of the furnace, rather than on the type of fuel used.

The warm-air furnace is most frequently implicated as the source of chronic illness. When a chemically susceptible patient moves out of a home with such a furnace and into an ecologically sound environment, he often experiences an improvement in health. Returning to the home heated with warm air similarly may result in a decreased level of health.

The furnace of a warm-air system may pollute the air of the basement in which the furnace is located by releasing combustion products each time it is turned on. Leaks in such systems are common, and warm-air furnaces produce more dust and general agitation of the environment than some other types of systems. This is complicated by the fact that the warm-air system forces heated air throughout the whole house, thus naturally spreading dust and fumes.

Chemically susceptible people in homes with warm-air heat react with remarkable rapidity to the turning on of the heat. In fact, they begin to develop symptoms more quickly, sometimes, than the fumes could possibly spread from the basement. A psychological reaction? Not necessarily. Upon investigation, it was found that these patients were also susceptible to dust, a common source of allergic reactions; any dust which landed on the hot furnace was burned and then spewed in minute particles around the house. This “fried dust” was then stirred up every time the furnace was activated, and spread more quickly than the fumes.

The location of the furnace can be particularly important. A person who lives directly above a furnace is more likely to feel its effects than one who is sleeping in an area removed from the source of heat. The worst housing arrangement is probably the ranch-style house, with the furnace right in the center of the main floor. The next worse is to have an open utility room on the same floor as the living quarters. Either of these designs will subject the inhabitants to a daily dose of pollutants every time the furnace starts up.

Essentially, the only completely safe way to handle a furnace is to put it outside the house. It can be placed in a garage, in a separate room between the house and the garage, or in a separate area adjacent to the house which can only be entered from the outside. The only opening between this room and the house itself should be a well-insulated hole through which the hot water or steam pipes pass. Once the heating is thus arranged, it does not really matter if one uses coal, oil, or gas, as long as warm water or steam central heating is employed to convey the heat.

The gas range is the most common source of indoor pollution, but the most dangerous is probably the unvented gas-burning room wall-heater. Although this pernicious device is becoming less common, it is still found throughout the American Southwest. It is certainly ironic that people like Ellen Sanders should flee to the land of sunshine only to find a worse source of pollution in their new homes.

*32\110\2*

DYSLEXIA IN CHILDREN

Dyslexia, also known as “developmental dyslexia” or “specific developmental dyslexia,” is a type of learning disability that affects a child’s ability to learn to read. It is more common in boys than in girls. It’s not known exactly what causes the problem. Dyslexia often runs in families, but no specific genetic defect has been found to account for it. Some children with dyslexia may have had an accident that caused an undetected brain injury, but others have no such history. It is known, however, that dyslexia is not a form of mental retardation. And dyslexia is not related to low intelligence, physical handicaps, cultural disadvantages, low social or economic status, or brain damage.

A child with dyslexia often has no difficulties until entering school. Then the child finds that he or she cannot do things that other children can do easily. This experience can be embarrassing and painful. The child often finds it impossible to explain the problem and may become so frustrated that he or she either disrupts classes or becomes overly quiet and withdrawn. Other children may brand the dyslexic child as “stupid”; teachers and parents may consider the child lazy or unmotivated. The dyslexic child may, in fact, be very intelligent and may be trying extremely hard to learn to read. Pressure from teachers and parents to “work harder” can be confusing and frustrating and can lead to anger and rebellion. Some children with dyslexia find other activities that they can do well, such as sports or music. This may help them to adjust and feel more comfortable.

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SEX AS AN AGE EXTENDER: BOP TILL YOU DROP

There are two ways of looking at the picture. First, robust sexuality keeps you in a better position to stay disease-free. Second, avoiding disease-especially cardiovascular disease and diabetes-is the best thing you can do for your long-term sex life. So not only is sex healthy but also health is sexy.

And while abundant sex won’t guarantee that you live to be 96, consider this advice from our experts. As you’re preparing to live into your nineties as a result of other information you’ve gleaned from these pages, schedule in enough sex time.

You’re going to want it for the same reasons you want it now. It’s a way of having special intimacy with your partner, it’s an excellent form of relaxation, and it’s the best outlet for your horny desires.

“There’s no specific decline in libido with age,” says Alan Brauer, M.D., founder of the Brauer Total Care Medical Center in Palo Alto, California, and co-author of ESO: The New Promise of Pleasure for Couples in Love. “Sexual interest doesn’t change, even in men in their eighties and nineties.” And even at that age, you’ll probably be not only willing but also able. “Erection capacity in healthy men should remain-in fact, does remain- into their nineties,” Dr. Brauer says.

The key word there is healthy. Age per se doesn’t wilt your weapon, no matter what you’ve heard to the contrary. But disease does.

“The graph that shows progressive increases of erectile dysfunction with advancing age is from data taken from hospital populations, people with vascular disease, heart disease, diabetes, alcoholism, and so forth,” Dr. Vinik points out. “You take a population of healthy aging people, and that’s not going to occur.”

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BREAST LUMPS: GOING HOME AFTER OPERATION

Some time after your operation you will be visited on the ward by a hospital doctor to check that all is well.

Before you are discharged from hospital, the nursing staff will need to be sure that you will be able to manage. If you do not have help at home, and you are concerned about managing on your own, do tell one of the nurses before your operation so that some arrangement can be made for you. For some people, such as students who are returning alone to student accommodation, or elderly women who live on their own, a longer stay in hospital may be necessary until they are better able to cope.

By the time you are discharged from hospital you should have only slight pain or discomfort, your wound will be healing, and any drains will have been removed.

Driving

You should not drive yourself home after your operation, and should probably avoid driving for at least 2 weeks. Your car insurance is likely to be invalid for at least 48 hours after a general anesthetic: you may feel all right, but your reactions in an emergency would be slower than normal.

Even if you have not had a general anesthetic, do not drive until you are sure you can make an emergency stop without being hindered by pain from your wound. If you are in any doubt, your GP will be able to advise you about this.

Discharge letter

Before you leave hospital you will be given a letter to take to your GP’s surgery. This will contain a report of the operation and anything your GP may need to know about your treatment, and should be delivered as soon as possible – on your way home from hospital if this is feasible. The letter may be posted to your GP if you leave hospital before it has been written.

Follow-up clinic visits

Before you leave the hospital, nursing staff will arrange your next clinic visit – within a week or two of your operation. Time will be allowed for the results to be received from the examination of your breast tissue which always follows an operation on the breast.

If the stitches in your wound are non-absorbable, these will either be removed at the clinic visit or, if nursing staff think your wound will have healed sufficiently beforehand, you will be asked to make an appointment at your health centre or GP’s surgery so that they can be removed there.

Although the anxiety you and your family will feel while you await this next visit to the clinic is well understood by the nursing and medical staff, they must be sure that the results from the laboratory will have been received first.

Visit from the breast care nurse

If your hospital has a specialist breast care nurse, she will visit you on the ward before you leave. Do tell her if you are concerned about anything, or if there is anything you do not understand. She may be able to arrange a date to visit you at home if you would like her to do so, and will probably continue to see you as often as necessary, either at home or in her clinic.

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