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Updated Guidelines for Pregnancy and Weight Gain areLargely Unchanged

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The long-awaited revision of the 1990 recommendations puts a cap on the amount an obese mother should gain and places more emphasis on exercise. Some doctors wanted to see a lot more.

Panel members said women and their doctors must try harder to help the women reach a normal weight before pregnancy and avoid excessive weight gain during pregnancy.

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More than 60% of U.S. women of childbearing age are overweight or obese — a significant increase from 20 years ago. And recent studies strongly suggest that either too much or too little nutrition in utero can increase a fetus’ chance of becoming an overweight child and overweight adult.

Such data on the increasing girth of pregnant women and the growing rates of obesity in children led to pressure on the Institute of Medicine to revise a set of 1990 guidelines that were written primarily to prevent excessively low infant birth weights. Numerous medical journal articles in recent years have called the guidelines irrelevant to today’s obstetrics patients.

On Thursday, the institute’s advisory committee — a task force of doctors and researchers — issued the updated recommendations. But with few exceptions, such as putting a limit on how much weight obese women should gain, the new guidelines are the old guidelines wrapped up in a lecture.

The panel said that the existing guidelines were essentially fine. It’s women and their doctors, the members said, who need to try harder — often much harder — to help the women reach a normal weight before pregnancy and avoid excessive weight gain during pregnancy.

Although not dramatically different, fully implementing the guidelines will represent a change in the care provided to women of childbearing age,” said Kathleen Rasmussen, chairwoman of the committee and a professor of nutrition at Cornell University.

The report was requested by six major health organizations so that doctors could better advise and care for their patients. Although nothing in the report is mandatory, healthcare professionals are expected to acknowledge and implement at least some of the panel’s recommendations.

But several leading experts on maternal obesity and child health expressed disappointment with the document. A growing contingent of doctors says that obese women — which includes one in every five pregnant women — should gain little or no weight.

“In my opinion, the Institute of Medicine is missing an opportunity to address the issue of the obesity epidemic and the contribution that pregnancy makes to that epidemic,” said Dr. Raul Artal, chairman of the department of obstetrics, gynecology and women’s health at St. Louis University.

The recommendations call for a gestational weight gain of 28-40 pounds for underweight women, 25-35 pounds for women of normal weight, 15-25 pounds for overweight women and 11-20 pounds for obese women. The only change is for obese women, who were previously advised to gain at least 15 pounds, with no upper limit.

The problem is not the guidelines, but the failure to adhere to them and to address obesity in reproductive-age women, said Dr. Maxine Hayes, state health officer for the Washington State Department of Health and chairwoman of a 2006 panel that urged a reexamination of the guidelines. “If we wait for every woman to be advised about weight gain after they become pregnant, it’s too late. It puts women and their babies on a trajectory that is unhealthy.”

During the two-year process of reexamining the guidelines, committee members tried to balance the health needs of the fetus with the health needs of the mother, Rasmussen said, ultimately deciding that the recommendations were largely up-to-date already.

Not all experts in maternal-fetal health are convinced.

“We have been doing this same recommendation for 19 years, and it has been very unsuccessful,” said Susan Y. Chu, a senior epidemiologist at the Centers for Disease Control and Prevention who has studied gestational weight gain. “But they did what was most critical, which was to put a cap on the obese category.”

Several studies suggest that obese women may require little weight gain as long as it’s clear that the fetus is growing.

“We have determined that overweight and obese women can benefit and have better pregnancy outcomes if they limit their weight gain,” said Artal, the author of several studies on obese pregnant women. “The committee was cautious. They were concerned they might cause harm. But by maintaining the status quo, I think that may cause more harm.”

A study in the June issue of the Journal of the National Medical Assn. found that obese pregnant women who followed well-balanced diets and gained little or no weight had better outcomes — as did their babies — than women who gained more weight.

That study’s lead author, Dr. Yvonne S. Thornton, a professor of obstetrics and gynecology at New York Medical College, said the committee may have feared an increase in births of underweight infants if more pregnant women were placed on restricted diets. “This is a litigious society,” she said. “If we did restrict calories and there was an untoward outcome, people might say, ‘Well, you didn’t feed me enough.’ ”

The suggested weight range of 11 to 20 pounds for obese women is aimed at women in the lower ranges of the obesity category, defined by a body mass index of 30 to 35, Rasmussen said. There is little data to guide recommendations for women in the higher ranges of obesity, she said. About 8% of women of childbearing age are morbidly obese, with a BMI of 40 or more.

Some doctors criticized the report’s call for diet and exercise counseling as unrealistic. Few health insurance plans pay for such counseling, and doctors do not have the time to provide it, Hayes said.

However, the report was praised for its emphasis on exercise. “One can’t look at diet alone,” Artal said. “Exercise is very much a part of a healthy lifestyle during pregnancy.”

The committee also called for more studies on gestational weight gain, including asking states to adopt a birth certificate that gathers information on weight before and during pregnancy.

Sources: Los Angeles Times

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Cranberries — Good for What Ails

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Some informations about the tart fruit’s healing abilities.…….European settlers first put cranberries on the Thanksgiving table because the local fruit lasted through winter and enhanced the flavor of gamy meat. The settlers had picked up on the berry’s culinary potential from Native Americans, who survived cold winters by filling up on pemmican, a cake of cranberries, nuts and dried venison or bear meat.

Both groups also prescribed cranberries for fevers, gastrointestinal problems and dropsy — a term used to describe any swelling or inflammation. Turns out, they were onto something. In the last few decades, scientists have begun to confirm and explain the cranberry‘s ability to fight infections of the urinary tract and gut and its potential to fight gum disease, heart disease and cancer.

“For over a hundred years, women have known that cranberry juice can prevent urinary tract infections,” says Amy Howell, associate research scientist at the U.S. Department of Agriculture-supported Marucci Center for Blueberry and Cranberry Research at Rutgers University in Camden, N.J. “They thought it was due to acidity, but that’s actually not the case.”

Cranberry’s antibacterial properties are due to a class of chemical compounds called proanthocyanidins. Ten years ago, Howell’s research group isolated the compounds and demonstrated how they work: Proanthocyanidins bind to harmful bacteria such as E. coli, forming a “Teflon-like” coating around them. The coating prevents the bacteria from sticking to gastrointestinal and urinary tract walls, impeding infections.

The nonstick properties of proanthocyanidins may explain the results of several clinical trials that showed that cranberry juice can reduce the frequency of urinary tract infections.

For example, a study published in the British Medical Journal in 2001 showed that women who drank a couple of ounces of cranberry juice daily for six months had a 20% lower risk of urinary tract infections, compared with women in a control group. A study published in the Canadian Journal of Urology in 2002 showed that just 20% of women who drank three glasses of cranberry juice daily for a year experienced urinary tract infection symptoms, compared with 32% of women who drank a placebo.

And last month, a study in the journal Urology found that two glasses of cranberry juice a day reduced the frequency of urinary tract infections by 41% among pregnant women.

Proanthocyanidins also appear to keep the bacterium H. pylori, which causes ulcers, from sticking to the linings of the stomach and intestines. A 2005 study of 189 adults with H. pylori infections in the journal Helicobacter, showed that two glasses of cranberry juice daily for three months reduced the degree of infections, compared with those who drank a placebo.

And a study in the journal Nutrition this year showed that a daily glass of cranberry juice eliminated H. pylori infections in 16% of infected children; a placebo eliminated only 1.5%.

Other research suggests that the compounds could keep plaque-forming bacteria at bay. In lab experiments, cranberry proanthocyanidins stopped oral streptococci and other bacteria from sticking to surfaces. But researchers warn against using the juice as a mouthwash because of its sugar content and acidity.

Cranberries are high in vitamins A, E and C, iron, calcium, potassium and antioxidants. The last may explain the fruit’s possible anti-cancer and anti-heart-disease effects. Cranberry impedes the growth of liver and breast cancer cells in lab dishes, says Jie Sun, a scientist at General Mills who previously researched the fruit’s anti-cancer effects at Cornell University.

And in 2006, Canadian researchers published suggestive findings in the British Journal of Nutrition showing that drinking a glass of cranberry juice a day increased concentrations of good HDL cholesterol by 8% in overweight men. (The study was funded by the Canadian Cranberry Growers Coalition.)

But the tart red berries may not be for everyone. Gorging on too many or guzzling too much juice can result in an upset stomach or diarrhea. A couple of reports indicate that cranberry juice may increase the risk of kidney stones in people prone to them. And there’s conflicting evidence that cranberries may interfere with blood thinning drugs, such as warfarin.

The common cranberry’s benefits still seem to outweigh its drawbacks, but despite this, most Americans limit their consumption to a single day of the year. The reason for this may have been best summed up by writer and naturalist Henry David Thoreau more than 150 years ago: Cranberries, he wrote, were easy to harvest, but their taste was “a little bitterish.”

Sources: Las Angles Times

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How to Live Till a 100

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Want to live till 100 years of age? Well, do regular exercises, be married, wash hands and brush your teeth everyday.

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That’s what a new book, ‘The Long Life Equation’, by Dr Trisha Macnair suggests. In the book, the author has listed activities that add years to your life.

Macnair said washing your hands adds two years, and good dental hygiene can add six more years in your life.

But smoking, fast food, no exercise and a stressful life can strip away 20 years.

“There’s no doubt younger people take life and health for granted – more than any generation before, they idle time away watching TV or playing computer games, ignoring the activities that keep them healthy or develop meaning in their lives,” Courier Mail quoted Macnair, as saying.

“As we get older and start to feel the years slipping away, we suddenly realise how precious it is.

“But by then we may have already established habits (smoking, drinking, obesity, lack of exercise, stressful occupations) which take their toll and are difficult to reverse.

“Still, it’s never too late to change. Also, our attitudes to older age are changing so there is more freedom now to do things later in life if we are healthy and able,” she added.

A 2006 study from University of California in Los Angeles showed that men and women live healthier, wealthier, happier and longer lives when they are in a stable partnership

The study confirmed that married couples were more likely to live to an old age than their divorced, widowed or unmarried counterparts.

A stable partnership can actually add on seven years to life.

Regular exercise also adds as much as two or more years to your life.

A Harvard Alumni Study, which took into account more than 71,000 men who had graduated from Harvard University and the University of Pennsylvania between 1916 and 1954, found that those men who regularly burned 8400kJ a week while exercising lived, on average, two years longer than sedentary types.

But cigarette smoking can actually reduce 8 years from your life

Tobacco smoke contains more than 4000 chemicals, many of which are highly toxic.

A divorce can also strip away 3 years from your life, as it takes longer-lasting, emotional and physical toll on former spouses than virtually any other life stress.

Recent studies indicate that divorced adults have higher rates of emotional disturbance, accidental death and death from heart disease.

The divorced also have higher rates of admission to psychiatric facilities and make more visits to doctors than people who are married, single or widowed.

Sources: The Times Of India

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Red Hot Medicine

Chilli peppersImage via Wikipedia

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A chemical found in chillies protects the plant from a fungus as well as our guts from bacterial infections.

Biologist Joshua Tewksbury has peeked into an aeons-old war between a plant and a fungus in rural Bolivia, and completed a long-standing puzzle about chillies. In a study of wild capsicum plants native to eastern Bolivia, Tewksbury has shown that the plants are loaded with a chemical that appears uniquely designed to protect them from a fungus called Fusarium.

Human taste buds have long been familiar with the chemical — capsaicin. It is the ingredient from chillies that goes into hundreds of dishes from cuisines worldwide — from Andhra chicken curry to Gaeng Phed, a spicy red curry from Thailand, to spicy Mexical lentils. Capsaicin in chillies provides the spicy taste to dishes. For plants, Tewksbury — of the University of Washington in Seattle — has found, capsaicin is self-defence against a microbe.

Microbes, it turns out, may help explain two elements of a puzzle about chillies. Why are chillies spicy? Why did humans begin to eat chillies — a spicy, even painful, fruit — in the first place?

One question was solved 10 years ago. Jennifer Billing, an undergraduate at Cornell University, scanned dozens of cookbooks and compiled a list of more than 4,500 recipes representing meat-based cuisines from 36 countries.

Then Billing and Paul Sherman, a professor of neurobiology and behaviour at Cornell, analysed temperature and rainfall patterns and cultivation ranges of 43 spice plants in each of those countries, and the anti bacterial properties of each plant.

The exercise threw up a distinct pattern on the map. The world appeared to have a hot zone — a band on either side of the equator where temperatures are high and the food tends to be spicy hot.

India, Thailand and Malaysia were at the top of the hot climate and hot food list. Sweden, Finland and Norway were the coldest countries with the least spicy food. The scientists also found that spices were microbe killers. Garlic, onion and oregano were the most efficient, wiping out virtually all bacteria, followed by cinnamon, cumin and thyme that kill 80 per cent of bacteria. Capsicum and chillies eliminate about 75 per cent of bacteria.

The Cornell biologists proposed that humans began to add spices to their food centuries ago — without realising it — to lower the risk of food-borne microbial infections. Some bacteria that might enter human stomachs through food have the potential to kill. The taste for spicy food, Sherman and Billing postulated, was a trait that would be beneficial — culturally and genetically.

“People who enjoyed food with anti bacterial spices probably were healthier, especially in hot climates,” said Sherman. “They lived longer, they left more offspring — and they taught their offspring how to cook food (with spices).”

The new study has solved the second botanical puzzle about chillies. A spicy fruit on first analysis is perplexing to evolutionary biologists. A plant makes fruit to lure insects and animals to eat and disperse its seeds to facilitate reproduction. “So it doesn’t make sense for a fruit to be painfully hot,” said Douglas Levey of the University of Florida, Gainesville, who was part of the six-member team that studied Bolivian chillies.

The researchers found that capsaicin significantly slows microbe growth and protect the fruit from Fusarium. Their findings were published recently in the Proceedings of the National Academy of Sciences.

Eastern Bolivia was the ideal locale for this study. A variety of wild capsicum grows there along a stretch of some 1,600 kilometres. Some are spicy and pungent, while others lack capsaicin and are less or not at all spicy.

Scars left by insects feeding on capsicum are used by the fungus as gateways into the fruit. The researchers counted the insect scars, analysed rates of fungal attack and levels of capsaicin in the plants. They found that hot plants were hotter with higher levels of capsaicin in areas where fungal attacks were common. In areas with few insects — and thus less danger of fungal attack — the plants were less spicy.

The studies consistently showed that a high level of capsaicin was associated with lower seed mortality from fungal attack. The findings appear to be general and could also be applicable to chillies grown elsewhere, including India, said Tewksbury. “There are reasons to suspect that fungi and microbes are general targets of these capsaicins,” Tewksbury told KnowHow.

But while capsaicin slows microbial growth and protects the fruit from Fusarium, it doesn’t interfere with seed dispersal. “Birds don’t have the physiological machinery to detect the spicy chemical and continue to eat peppers and disperse the seeds,” Levey said.

The study shows that the use of chillies by humans appears to mirror the evolutionary function of capsaicin. “The capsaicin in chillies may have protected early humans from microbial infections,” said Tewksbury.

Researchers argue that before the advent of refrigeration, it was probably beneficial to eat chillies, particularly in the hot tropics. Studies suggest that all chillies originated in South America, and explorers carried the plants to Europe and elsewhere. Today, scientists estimate, one in four humans worldwide consumes chillies daily. “The use of chilli peppers as a spice has spread to nearly every culture within 20 degrees of the equator,” said Levey, “and it tends to decline as you move toward the poles.”

Sources
: The Telegraph (Kolkata, India)

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Neutritional Value of Fresh Fruit Vs Cut and Dried Fruit

There are pluses and minuses,” said Christina Stark, a nutritionist at Cornell University. “The main difference is that taking out the water concentrates botnutrients and calories.”

This could be an advantage if you are hiking and want more calories that are easy to store and carry, she said. It could be a disadvantage if you are trying to lose weight.

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The heat used in drying fruit also decreases the amount of some of the heat-sensitive nutrients, like vitamin C.

As for how much to eat, she said, the general recommendation is two cups of fresh fruit a day, the more variety the better. A half cup of dried fruit counts as a cup of fresh.

Percentages of water, calories and amounts of vitamins and minerals vary by type of fruit.

For example, for apricots, a cup of fresh halves is 86 percent water, with 74 calories, and a half cup of dried fruit is 76 percent water, with 212 calories. Fresh apricots have 3.1 grams of fiber versus 6.5 for dried; 0.6 milligrams of iron versus 2.35 milligrams; 15.5 milligrams of vitamin C versus 0.8 milligrams; and 149 retinol activity equivalents of vitamin A versus 160.

A cup of fresh Thompson seedless grapes is 80 percent water, with 104 calories, and a half cup of raisins is 15 percent water, with 434 calories. The grapes have 1.4 grams of fiber, versus 5.4 grams for the raisins; 0.54 milligrams of iron versus 2.73 milligrams; 288 milligrams of potassium versus 1,086 milligrams; and 16.3 milligrams of vitamin C versus 3.3 milligrams.

Sources: The New York Times

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