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High on Calories

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Obese people are not able to regulate high-calorie food intake because of changes in their brain.
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If your overweight children binge eat, blame it on their flawed brain circuitry. Scientists have now found that despite the desire to cut their food intake, obese individuals will not be able resist junk food, which is very high in calories. That’s because their persistent eating behaviour has precipitated changes in the brain similar to that found in heavy smokers and drug addicts. The study appeared yesterday in the journal Nature Neuroscience.

After spending years studying brain changes associated with drug abuse and smoking, Paul Kenny — a neurobiologist at the Scripps Research Institute in Florida, the US — recently turned his attention to obesity. He and his graduate student, Pal Johnson, wanted to understand the strong yet not-so-easy-to-fathom link between obesity and depleted levels of dopamine or D2, a brain chemical associated with feelings of pleasure.

Scientists in the past had observed that obese individuals have reduced levels of dopamine, but weren’t sure if it was triggered by obesity. It was also known that food intake was associated with dopamine release and the degree of pleasure from eating correlates with the amount of chemical released. Evidence has shown that in comparison to lean people, obese individuals have fewer dopamine receptors in the brain. And people with fewer dopamine receptors need to take in more of a rewarding substance — such as food or drugs — to get an effect that others get with a lesser amount. But the underlying mechanisms are poorly understood.

“What we have achieved is proven in our experiments with laboratory rats that obesity can elicit these brain changes,” Kenny told KnowHow over the telephone.

For this, the Florida scientists embarked upon a series of meticulously planned experiments. In the first, they offered rats — which were grouped into three categories — different menus. While the first group had access solely to less-appetising but healthier chow, the other two were offered a choice of high-calorie food such as bacon, sausage, cake and chocolate in addition to chow, but for varying durations. Some rats had access to the rich fare for just one hour, while the other group could gorge on it most part of the day. The animals were fed this way for 40 days. All of them were wired to record even the slightest change in their D2 levels.

The rats in the first set — which were fed only chow — maintained their weight, while those belonging to the second set — which had restricted access to rich food — exhibited insignificant increase in their body weight. On the contrary, the third group — which had unlimited access to calorie-rich food — gained weight rapidly. These animals were found to be gobbling up twice as much as the other two groups. As the days wore on, their dopamine levels plummeted, requiring them to consume higher quantities of high-fat food to get the feeling of satiation. This is quite like the case of a smoker who has to puff away more cigarettes to get the same high that he or she earlier got with one. Or a drug addict who has to continuously increase the dose for getting a kick.

A second set of experiments with the rats showed that this blunting of the reward sensitivity does not return for a good two weeks even after the high-calorie food was withdrawn.

A true addict, whether rat or human, will compulsively consume the addictive substance even when it is clearly detrimental to health. In the third experiment the scientists tested this hypothesis. To do this, the team trained the rats to expect painful foot shocks upon seeing a light signal. Although the normal rats stopped eating even the most delicious junk food when the light came on, the obese ones used to a high-calorie diet simply ignored the cue and kept feeding.

Anoop Misra, head of internal medicine at Fortis Hospitals in New Delhi, says this explains why obese people find it difficult to modulate their junk food eating habits.

“The US scientists’ experiment has substantiated many assumptions associated with obesity and dopamine levels in the brain fairly well,” says Nihal Thomas, an endocrinologist at the Christian Medical College, Vellore. “The exercise and methodology followed are exquisite.” The findings may help develop drugs that may target dopamine receptors to treat obesity, he observes.

Source : The Telegraph (Kolkata, India)

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Hunger for Air

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“I can’t breathe,” said the woman, panic stricken and one hand clutched at her chest. Her forehead was lined with sweat and fear of death etched on her face. Breathing, after all, is essential for life.

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We take breathing or respiration for granted. It is an involuntary, autonomous and automatic reflex that is present from birth to death. We can consciously take deep or shallow breaths, but we cannot stop breathing at will. In short, you cannot commit suicide by voluntarily ceasing to breathe.

Breathing difficulty is a perception. Some people may have fairly severe lung restriction, but be able to continue their normal activities. Others may feel breathless with the slightest unaccustomed exertion. This is more likely to occur if the person is unfit, obese and unaccustomed to exercise. A sudden “panic attack” owing to an external factor can be “breath stopping”. High altitudes and high temperature can also cause similar problems.

Breathing difficulty can occur suddenly because of a foreign body like a peanut which has got lodged in the food pipe. This then becomes a medical emergency. Immediately stand behind the person, make a fist with both hands and exert a sudden forceful upward thrust in the stomach area below the chest bone (sternum). This is called a “Heimlich maneuver” and it has saved many lives.

Mucous secretions — watery in case of viral infections and allergy, and thick and viscous in case of secondary bacterial infection — can clog the nasal passages and bronchi. Some of these secretions can drip backwards into the throat, causing a post nasal drip with a sense of suffocation.

The nasal passages can be cleared with nose drops. It is important to use saline nasal drops. This is commercially manufactured by many companies. It needs to be used every two hours. Nasal drops containing chemicals may provide faster relief. But as the effect wears off, they may cause “rebound congestion” with worse blockage. Long-term frequent usage of chemical nose drops may cause habituation, wherein the body stops responding to the medication. If the nasal block is due to an allergy, prescribed locally acting steroid nasal sprays are very effective.

The bronchi can narrow in response to exposure to ingested allergens like peanuts and food colour, or inhaled ones like cigarette or wood smoke, room fresheners and mosquito repellents. This is called reactive airways disease or asthma.

Smokers may have damaged their lungs structure permanently, causing a disease called COAD (chronic obstructive airways disease). This sets in around 20-30 years after the first puff. It attacks people in their 40s and 50s. They become breathless with exertion and sometimes even at rest. Some require continuous artificial oxygen supply.

Initially — that is, before damage sets in — airway constriction is reversible. Inhalers or rotahalers deliver relief producing bronchodilating medication directly to the bronchi. The respite is immediate and sustained if the medication is “puffed” as prescribed. Direct delivery systems make medication more effective and are less likely to cause side effects.

The rate of breathing increases during pregnancy because of the oxygen demand of the baby. Moreover, pregnancy causes the uterus to enlarge which pushes the abdominal contents upwards. This may cause a feeling of inadequacy while breathing. This is self-limited and disappears with delivery.

Congenital heart disease, heart failure and myocarditis (disease of the heart muscles) can cause difficulty in breathing and a feeling of air hunger. This is because a failing heart provides inefficient circulation of blood and insufficient oxygenation to the tissues of the body. The blood carrying capacity of the body itself may be compromised because of anaemia. Specific medication for the diseases will help with the problem.

Breathlessness needs to be evaluated if:

The difficulty occurred suddenly for no apparent reason

• It was accompanied by chest discomfort, pain or pressure

• It comes with a slight exertion or at rest

• There is an inability to lie down flat and sleep

• It is accompanied by fever

• There is pressure, fullness or a squeezing pain in the chest.

Good breathing techniques require the co-ordinated use of intercostals (groups of muscles that run between the ribs, and help form and move the chest wall), diaphragm and stomach muscles. As the breath goes in, the intercostals and stomach expand and the latter moves outwards. And as we breathe out, the chest contracts, the diaphragm moves up and the stomach moves in. Breathing is a natural response and occurs normally and naturally in children. As age advances, we tend to lose the ability to breathe efficiently.

Long hours at work seated in a sloppy posture, obesity or an inactive life without the mandatory one hour of aerobic activity (running, swimming, jogging or cycling) results in inefficient and inadequate breathing, even in a normal individual.

Place a hand on your abdomen, stand in front of a mirror and breathe in and out to check if your breathing is correct. Consciously correct deficiencies and practise breathing exercises (yoga pranayam) for a healthier tomorrow.

Source: The Telegraph (Kolkata, India)

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Cancer on Sale

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Many Indians like to chew paan — meetha or khatta — after a good meal. It aids digestion, freshens the breath and acts as a mild stimulant. The soporific effects of the heavy meal are counterbalanced. Best of all, it is also believed to have aphrodisiac properties when mixed with the right spices in the right proportion. This may be the reason why it is often offered after a traditional wedding feast to the newlyweds and departing guests.
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Paan may be prepared at home or bought from the ubiquitous paan shop. Making a good paan involves smearing mineral slaked lime (calcium hydroxide) on betel leaves, and then adding spices, flavouring substances and pieces of supari or areca nut. After that, the leaf is folded around these ingredients and held together by a clove. Tobacco may also be added. Some habitual paan consumers push the prepared leaf into the cleft between the cheeks and the gums and leave it there. Chewing paan is dangerous, but when the stuff is mixed with tobacco, it is lethal.

Sometimes tobacco may be flavoured and chewed alone without a betel leaf. Such stuff is known by various names such as paan masala and gutka. Pieces of supari may also be sweetened and eaten separately.

Supari, paan and chewing tobacco are often considered harmless and non-addictive. Nothing could be further from the truth. Such stuff suppresses appetite and produces a “high”. What’s more, the nitosamines (cancer causing chemicals found in tobacco, betel leaves and supari) released can precipitate type 2 diabetes.

The lime in paan acts to keep the active ingredients (polyphenols, alkaloids and tannins) in the betel nut in its freebase form. The tobacco contains nicotine and polycyclic aromatic hydrocarbons. Paan may also contain sugar. One of the chemicals in the nut — called arecoline — promotes salivation. This facilitates rapid absorption of this chemical cocktail from under the tongue.

Paan turns the saliva orange red which stains the lips and teeth. Also, the sugar and various other chemicals destroy the enamel of the teeth. They eventually turn black and get ground down to the gums.

The chemicals released while chewing paan irritate the lips and cheeks. They cause changes in the cells, leading them to become precancerous. The lining of the inner cheek turns white (leukoplakia). It may start to bleed or form an ulcer that eats away into the flesh and opens out into the cheek. A tumour may form and protrude into the mouth. As the carcinogen-laden saliva proceeds towards the stomach through the esophagus (tube leading to the stomach), its lining becomes affected and cancer can occur there as well.

Chewing paan is an ancient tradition. The habit leads to cancers of the mouth or esophagus, which set in when the consumer is between 50 and 60 years. Generally, such people also follow an unhealthy lifestyle, a diet with little or no fresh fruits and vegetables, and inadequate exercise. Such cancer is the most commonly diagnosed cancer in males in Assam. For Indian women in general, it is the second biggest reason for cancer. Mouth and esophageal cancer is relatively rare in other parts of the world.

Esophageal cancer is difficult to diagnose in the early stages as the symptoms are often vague and non-specific. Tiredness and fatigue may make the person lethargic. There may be chest pain or unexplained loss of weight which may make the person appear ill. Later, as the tumour grows, it blocks the lumen of the esophagus causing difficulty in swallowing solids.

Treatment of mouth and esophageal cancer involves surgery, radiation and chemotherapy. Stents may have to be placed to prevent blockage. In the case of esophageal cancer, a part of the intestine may be used to replace the esophagus. Sometimes a feeding tube may have to inserted through the stomach to bypass the esophagus. Treatment is expensive and long-drawn. Results are fairly good if the ailment is diagnosed early. Unfortunately, this is often not the case.

An expert committee formed by the government in September 1997 recommended a blanket ban on the manufacture, distribution and sale of all forms of chewing tobacco like paan masala, gutka and zarda. Unfortunately, supari was left out of the committee’s purview. However, despite legislation these products are openly sold. What’s worse is that teenagers too are becoming addicts.

The government has been dragging its feet over enforcing legislation to regulate use of these carcinogenic and addictive products. This is partly because the paan, supari and zarda industries collectively employ over 50 million people in its raw material procurement, manufacture and distribution networks. These people constitute a large vote bank which successive governments are reluctant to lose. But this is a very dangerous  situation for millions and millions other common people.

The choice is therefore yours — a healthy and happy life or harmful substances that may lead to cancer.

You may click to see:->
Cultural Aspects of Smokeless Tobacco Use and the Impact of Chewing Pan Masala in the Oral Cancer Scenario :

Source: The Telegraph (Kolkata, India)

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Health Problems & Solutions

Some Health Quaries & Answers

 

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A: The manufacturers of Today claim 89 to 91 per cent efficiency, if used correctly. It is a spermicide — that is, it kills any sperm that comes into contact with it. It has to be inserted prior to intercourse and left inside for a minimum of six hours. Independent consumer surveys have placed the efficiency at around 65 per cent. The effectiveness increases to 99 per cent if used with condoms.

Invasive thymoma
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Q: I had a cough. When a chest X-ray was taken, I was found to have “invasive thymoma”. What is that?

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A: The thymus is a gland situated in front of the chest. It usually involutes and disappears after puberty. However, it can persist and grow, forming a “thymoma”. This can present at any age but is commoner after the age of 50. It causes no symptoms in a third of the people (as in your case) and is picked up only during a routine X-ray. As it is situated close to the heart, lungs and large blood vessels in the chest, it can penetrate and invade these structures forming an “invasive thymoma”.Treatment involves surgery radiation and chemotherapy. Take your doctor’s advice and go to a tertiary care hospital that specialises in cancer treatment.

Gay matter
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Q: My cousin is a homosexual. Is there any medication that can be given to him?

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A: The reason for sexual orientation is still tentative and not proven. It is probably the result of a combination of genetic, hormonal and environmental factors. There have been some articles recently in biology journals speculating that sexual orientation depends on whether the person has a preponderance of male or female receptor pheromones. This is genetic. Sexual orientation is established in early childhood. This gives credence to the genetic theory. There is no scientific evidence that abnormal parenting, sexual abuse or other adverse life event influences sexual orientation. Being “gay” is not due to a chemical imbalance in the brain. There is no medication to change it.

Always tearful…click & see
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Q: My mother has tears rolling out of her left eye all the time. Please help.

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A: There is a small opening in the lower eye lid near the bridge of the nose which leads into the lachrymal (tear) duct and also opens into the nose. The opening near the eye lid seems to have become blocked . This is commoner in women after menopause and can occur for a variety of reasons. An ophthalmologist can determine if it is due to an infection or if debris has blocked it. Medical treatment for the infection involves massage, drops and ointments. If these do not work, surgery may be required.

Lump near genitalia
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Q: I have a lump on the right side of my penis. It hurts when I stand up but I cannot feel it when I lie down….click & see

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A: It sounds like you have inguinal hernia. Since it disappears when you lie down, it means the hernia is still reducible and has not become obstructed. You need to see a surgeon to have it corrected. It is not a tumour or cancer.

Source: The Telegraph (Kolkata, India)

 
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Stress is to be Blamed

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Your body is aching all over, and you are suffering from acidity and indigestion. Curiously, medical tests show there is nothing wrong with you. If you are flummoxed, give this idea some thought — is it possible that your suffering is actually a manifestation of stress?

One out of two people in India suffers from stress. Such people are physically, mentally and emotionally unable to cope with the demands that life makes on them.

It is not just men — very often the sole breadwinner of a family — who suffer from stress. It also affects working women who have to balance a career and home and housewives who have to take care of budgets that go haywire because of inflation. It doesn’t spare children either. Stress affects the young who are in an increasingly competitive academic world.

Any physical, chemical or emotional factor that causes mental tension can be defined as stress. It can play an important part in the cause of disease. Continuous stress sets in motion a train of physical events which can eventually precipitate disease. This is particularly so in the case of people medically “sitting on the fence”. These individuals do not as yet have overt diseases such as high blood pressure or diabetes, but months of stress push them over the edge.

Stress invokes a “fight or flight reaction” in the body. It results in a surge of chemicals, predominant among which are the neurotransmitters adrenaline and nor-adrenaline. These act on every organ in the body causing a rapid heart rate, palpitation and a cold, clammy skin. At night, they keep the person awake, tossing and turning in bed. This results in insomnia, one of the commonest early symptoms of stress.

Eventually, other symptoms appear. The person’s temper becomes short and he or she becomes touchy and irritable. Relationships with family members and peers are affected. After all, no one wants to be around a bad tempered person. This disrupts support systems that may actually be beneficial in coping.

Marriages begin to suffer as the libido decreases. There is loss of interest in sex and in children and family activities. Nausea, vomiting and diarrhoea may produce an aversion to food. In some people satiety may be affected, resulting in overeating and food binges.

In such a condition, muscles may go into a spasm and fail to relax. There may be headaches, neck and shoulder pain, and backaches. The skin may break out in rashes.

Unable to relax or sleep, the person may turn to drugs or alcohol to relax. The dependence is not necessarily on hard core drugs such as heroin or cocaine — it may also be on painkillers such as propoxyphene. Many pharmacies may provide anxiolytics (anti anxiety drugs) or addictive sedatives like diazepam or alprazolam without a prescription.

Stress usually builds up over time, although it can be triggered by sudden, unexpected pressure. It is aggravated by long hours of work, lack of job security, long journeys to and from work, and extended periods of exertion with no breaks or holidays.

Short-term stress, however, has certain plus points. It often brings out the best in an individual so that tasks are completed efficiently and on time. By and large, long-term stress is detrimental to physical well-being.

The pressures of work and life cannot be escaped. The stress generated can and should be managed.

Time management is most important. It is best to prioritise tasks and not be sidelined by mundane everyday chores. Do only what needs to be done. Try to finish your work on time. Long hours do not necessarily add up to increased or better production.

Eat meals regularly and on time. Eat healthy, non-greasy food and if necessary get it from home. Add around four to five helpings of fresh fruit and vegetables. The vitamins and antioxidants will give your body a natural boost so that you can avoid all the extra cups of coffee and tea. Excessive caffeine does not really help to keep you alert or active. It might produce more palpitations and tremors.

Exercise is a great stress buster. Around 30-45 minutes of walking, running, jogging or swimming releases natural mood elevating chemicals from the calf muscles. You will not only have more stamina, but will also be rejuvenated. Exercise should be completed an hour before bedtime. Otherwise the chemicals released will keep you awake. The best results are obtained if the exercise is combined with relaxation techniques. Yoga for about 20 minutes a day is ideal. Otherwise deep breathing with the eyes shut and the mind emptied of all thought for five to 10 minutes may be sufficient. Constant stress may make you a high achiever, but unless balanced with diet and exercise, it might push you towards an early heart attack. Such a situation is not worth it and to a large extent avoidable.

Source: The Telegraph (Kolkata, India)

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