December 30, 2006

Womens Health - About Your Breasts

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Breast Basics
The breast is a gland that produces milk in late pregnancy and after childbirth.


What are breasts made of?
Each breast is made of lobes.
Lobes are groups of milk glands called lobules.
Lobules are arranged around thin tubes called ducts.
Ducts carry the milk to the nipple.
These lobules and ducts make up the glandular tissue.


What is the lymphatic system?
The breasts also contain lymph vessels, which carry a clear fluid called lymph.
The lymph vessels lead to small, round organs called lymph nodes. Groups of lymph nodes are found near the breast in the underarm, above the collarbone, in the chest behind the breastbone, and in many other parts of the body.


The lymph nodes trap bacteria, cancer cells, or other harmful substances that may be in the lymphatic system. Their job is to make sure harmful substances are safely removed from the body.

See your health care provider about a breast change when you have:
A lump in or near your breast or under your arm
Thick or firm tissue in or near your breast or under your arm
Nipple discharge or tenderness
A nipple pulled back (inverted) into the breast
Itching or skin changes such as redness, scales, dimples, or puckers
A change in breast size or shape
If you notice a lump in one breast, check the other breast. If both breasts feel the same, it may be normal. You should still see your health care provider for a clinical breast exam to see if more tests are needed.


Adapted from National Cancer Institute

December 29, 2006

Easy Weight Loss Tips

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know you are experiencing yo-yo dieting, but do not know how to stop it! It is time to get your balance back. The following easy weight loss tips will help you lose weight in a healthy way.

Tip 1: Find out how many calories you need

BMR (Basal Metabolic Rate)

BMR [kcal]
Body Weight [lb] x 15 + (moderate activity [mins/day] x 3.5)
Since you wish to lose weight, your target = BMR - 500 kcal

For instance, you weigh 140 lb and you perform 20 mins of moderate activity every day. BMR of this example = (140 x 15) + (20 x 3.5) = 2100 + 70 = 2170 kcal. BMR minus 500kcal; it would be 2170 - 500 = 1670 kcal. Therefore 1670 kcal is the target in this example to losing 1 lb per week.

Tip 2: Eat at least 5 servings of fruits and vegetables per day

Fruits and vegetables are packed with beneficial fibers, vitamins and antioxidants. They fill up your stomach fast so you feel full earlier. They are also low in calories and helps to keep your calorie count low.

Tip 3: Watch for Portion Size

One serving of pasta means 1/2 cup of cooked pasta. However, most restaurants serve a pasta dish with 4 servings of pasta!!! You do not need to finish and clean off the plate every time. You can simply ask to take home the leftover.

Tip 4: Do not Skip Meals

Eating small frequent meals help to balance your calorie intake throughout the day and also keeps your blood sugar level balanced. Instead of eating 3 big meals, try to eat 5 - 6 smaller meals throughout the day.


Breakfast items to avoid

Carrot Cake MuffinPerhaps the word "carrot" make it sound like a healthy breakfast item, but most commercial carrot cake muffins are high in fat and calories. One serving of this favorite breakfast muffin from a coffee chain store contains a whopping 680 kilocalories and 40 grams of fat! Indeed, most muffins and scones are high in fat. Scones, in particular, usually contain trans fat as well.
DoughnutsDoughnuts are fried breakfast foods. If you do not eat french fries for breakfast, why would you eat fried doughnuts? One piece of glazed doughnut from a doughnut chain store contains 200 kcal of empty calories with precious few nutrients. What is worse is that it contains four grams of trans fat per serving. That is already two times more than the recommended amount of trans fat a day. Doughnuts with fillings contain even higher amounts of calories and trans fat, so stay away from this breakfast treat!

Frozen WafflesSimilar to doughnuts, frozen waffles are another example of empty calories when it comes to breakfast foods. Most store-bought frozen waffles are basically refined grain combined with refined sugar and trans fat, lacking health-promoting vitamins, minerals and fiber. Most people add syrup and margarine on their breakfast waffles, hence adding even more calories and fat. Not a smart choice to start your day!
McDonald's Deluxe BreakfastWith such breakfast items as scrambled eggs, hash browns, sausages, pancakes and dressing and syrup, this deluxe breakfast contains a shocking 1,120 kcal and 61 grams of fat! With that much fat, it is like swallowing 13 teaspoons of vegetable oil in one setting! What is more shockingis that this breakfast item at McDonald's contains 11 g of trans fat, that is is 5 times more than the daily recommended amount of trans fat!
The recommended daily intake for dairy is three servings a day and whole grains is at least three servings daily. If you do not normally eat these foods for lunch or dinner, it is easier to include these items in breakfast. Hence, choose whole grains such as whole wheat bread, whole grain cereals or oatmeal if possible. In addition, include a serving of dairy such as low-fat milk or low-fat yogurt, which is rich in protein, calcium and potassium. In general, try including at least three food groups in your breakfast so that you do not need to prowl for a mid-morning snack.

Tip 5: Go for wholesome fresh foods

If possible, purchase fresh foods and avoid package (processed) and convenient foods such as fast food. Packaged and convenient foods are often higher in sodium and fat content. Many people we spoke to are amazed that they can easily lose weight by packing a home-cooked lunch to work instead of eating out.

Tip 6: Don't be overly-restrictive

Everyone has his or her favorite treats. Simply allow yourself a little indulgence, but watch out for the frequency and the quantity. Having a small treat once in a while can be rewarding to your weight loss experience. Cutting too much of your favorite treats usually lead to an early relapse.

Tip 7: Understand Food Claims and Labels

A product labelled with a fat-free claim does not mean that it is low in calories. Similarly a product labelled as low-sugar or low-carb does not mean it is low in fat or calories. Always read the nutrition label on the packaging.


Tip 8: Watch for the sugary drinks

Juices, pop, cream & sugar in your coffee or tea all add up. Opt for drinking at least 8 glasses of water a day. In addition to providing hydration to your body, it will also help you feel full.

Tip 9: Keep a food journal

Keeping a food journal helps you pin point your eating pattern and will enable you to easily modify it. If possible, have your Registered Dietitian review your journal.

Tip 10: Exercise, period

Most authorities recommend 30 - 60 minutes of physical activity a day to stay healthy. Also try adding weight-bearing exercises at least 2 times a week. This will help burn some of the unwanted calories.

Adapted from HealthCastle

Foods that helps in Weight Loss

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To give your weight loss program jumpstart, try to incorporate foods that actually help your body promote weight loss eating foods that make you feel less hungry. You will get surprisingly powerful results by incorporating exercise, lower calorie intake, COMBINED with eating foods that promote weight loss. Below are some foods that promote weight loss and are getting fantastic sustained results for many, many dieters.

Bee pollen

Bee Pollen, around 40% protein with a staggering composition of nutrients, enzymes and phytochemicals, is a virtually complete food. As well as a plethora of health benefits, it is said to stimulate the metabolism, speeding up the burning of calories, and its high content of lecithin can help to flush fat from the body. Bee pollen also functions as an appetite suppressant, containing the amino acid phenylalanine that is known to effect the area of the brain that deals with feelings of hunger and fullness. Unlike the chemical manmade derivative of phenylalanin called phenylpropanolamine used in commercial weight-loss products, phenylalanin is not addictive and has no negative side effects. Bee pollen also satiates the appetite and eliminates cravings because it is so nutrient-dense.

Nettles

Nettles contain serotonin, a mood enhancing neurotransmitter with a calming influence. Serotonin also plays a role in the feelings of satiation one experiences after eating, hence functions as an appetite suppressant. It is for this reason that serotonin supplements have been designed to tackle food cravings and aid slimming.Studies have shown a direct link between obesity (due to overeating) and decreased brain levels of serotonin. This is no doubt one reason why nettles have a traditional reputation for improving weight-loss. The late naturalist and wild-food forager Euel Gibbons claims, stinging nettle is very efficacious in removing unwanted pounds!.Nettles are incredible mineral dense and are cleansing and detoxifying for the body. They are also great for skin, hair and nails as they contain the beautifying mineral sulphur.

Chilli

The active ingredient in chilli called capsaicin is a thermogenic agent which helps to increase metabolism and the burning of calories and fat. This is why capsaicin is found in many natural weight loss formulas. Capsaicin is also believed to be an appetite suppressant. Two studies led by the same Japanese researcher (Yoshioka et al., British Journal of Nutrition; 1998, 1999), revealed the ability of cayenne to increase the metabolism of dietary fats in women as well as demonstrate modest reductions in appetite.In addition to weight loss properties, capsaicin has been shown to relieve pain, sinusitis, psoriasis, migraines and arthritis, improve circulation and stomach conditions and inhibit the growth of cancer cells.

Chocolate


Cacao (aka pure chocolate), contains chemicals that increase levels of serotonin in the brain, and as such has appetite suppressing properties. Serotonin levels are raised in part due to the amino acid tryptophan in cacao as well as the action of monoamine oxidase enzyme inhibitors (MAO inhibitors). These decrease our bodys ability to break down serotonin so that more of this neurotransmitter remains in the brain remains, creating feelings of fullness for longer.Cacao is also exceptionally high in antioxidants, has potent aphrodisiac properties, healthy minerals and mood-boosting compounds such as PEA the love chemical.Pure, unrefined chocolate contains none of the detriments of commercial products such as sugar, hydrogenated fats, milk, additives, agro-chemicals and solvents.

So basically a little long term planning, dicsipline, exercise and positive can-do attitude are key in losing weight. Knowing that certain foods ( Low GI ) and Beverages ( wu-long , oolong tea) are actually going to help you lose weight should also be encouraging ( Dieters are reporting 2-3 pound loss per week following these types of programs.) Many people are favoring these types of diet approaches over many of the more stringent diets that ban all carbs and only allow protiens. Its easier and more realistic because you have the freedom to eat a wide variety of protiens and carbs.. even milk chocolate and ice cream is ok within limits!
For the serious dieter, eating foods that promote weight loss should yield great results because youll never get the feeling you cant enjoy eating...it is defintely a lifestyle-longterm dieting approach.

Adapted from: GreenTeaPortal
Instant Foods
Buy 'instant' foods that can quickly be made into meals. Good buys are canned foods like tuna; low-fat, low-sodium ready-to-serve soups; beans like kidney beans, black beans and navy beans; chopped tomatoes; sliced mushrooms; and baby potatoes. Buy tomato-based pasta sauces, salsa,low-fat mayo, soy sauce, teriyaki, Tabasco and chili sauce to add flavor to grilled chicken breasts and stir-frys.

Prepped or Frozen Foods
Buy a variety of your favorite salad ingredients, pre-washed bags of lettuce, cherry tomatoes, cucumber, onion, fresh vegetables - pre-washed and ready to use, or buy frozen vegetables and fruits. Choose tomato or vegetable juices, or unsweetened fruit juices.

Dairy
Stock your refrigerator with low-fat shredded cheese, cheese strings, low-fat yogurt, 1 percent milk, cottage cheese, Cool Whip, and eggs (keep some cooked for snacks).
MeatsChicken breasts, ground steak and a range of deli-sliced cold meats, like turkey, chicken and lean ham.

Grains and Carbs
Choose whole wheat cereals, pasta, basmati rice, low-sugar cereal bars, soft-flour tortillas, corn tortillas, whole wheat pita, English muffins and whole wheat bread. For nutritious snacks buy a range of nuts, seeds, dried fruit and fresh fruit.

How to Create Fast Healthy Meals


The next thing is learning how to combine these foods to create healthy, weight-conscious meals in minutes. Here is a sample day's eating:

Breakfast (2 minutes)
- Bowl of whole wheat cereal with 1 percent milk, topped with tbsp chopped nuts- Glass of Unsweetened Orange Juice

Snack (1 minute)
- 1 apple - 1 low-fat cheese string

Lunch (4 minutes)
- Whole wheat sandwich: low-fat mayo, lean ham/chicken, lettuce, tomato, cucumber- 8 oz pot low-fat yogurt

Snack (1 minute)
- Cereal bar- Handful dried apricots or apple rings- 2 Brazil nuts

Dinner (5 minutes preparation)Chicken Enchilada
- 1 Soft-flour enchilada- 1 cooked chichen breast- 2 tbsp salsa- 2 tbsp shredded cheese- Salad leaves, tomatoes, sliced onion, cucumber- 2 tbsp low-fat dressing
Spread soft-flour tortilla with salsa, top with some sliced cooked chicken and shredded cheese. Place in hot oven for 10 minutes and serve with some salad.

Snack (1 minute)
Dip some strawberries in a pot of low-fat chocolate Jell-O Pudding

Fast Healthy Food

The above 3 meals and 3 healthy snacks take a total of 14 minutes to prepare. Which is no slower than most fast-food restaurants. But unlike junk-food, the above foods help you stay healthy and manage your weight.

ANNE COLLINS WEIGHT REDUCTION PROGRAM
All the best foods for weight loss should generally be....
Fresh natural food
Nutritionally dense
High in fiber
Low in calories
Low in fat
Low in refined sugars
Low in sodium

Many good weight loss foods may also contain...
Complex carbs
High quality protein
Fiber
High water content

Examples of some of the best foods for losing weight...
Fruit
Vegetables
Legumes
Wholegrain foods (muesli, oatmeal, wholemeal pasta, etc)
Baked potato
Boiled brown rice
Fresh fish

Adapted from: Weightloss4all

December 28, 2006

Obesity

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The most important part of being a normal weight isn't looking a certain way - it's feeling good and staying healthy. Having too much body fat can be harmful to the body in many ways.

The good news is that it's never too late to make changes in eating and exercise habits to control your weight, and those changes don't have to be as big as you might think. So if you or someone you know is obese or overweight, this article can give you information and tips for dealing with the problem by adopting a healthier lifestyle.

Being obese and being overweight are not exactly the same thing. An obese person has a large amount of extra body fat, not just a few extra pounds. People who are obese are very overweight and at risk for serious health problems.

To determine if someone is obese, doctors and other health care professionals often use a measurement called body mass index (BMI). First, a doctor measures a person's height and weight. Then the doctor uses these numbers to calculate another number, the BMI.
Once the doctor has calculated a child's or teen's BMI, he or she will plot this number on a specific chart to see how it compares to other people of the same age and gender. A person with a BMI above the 95th percentile (meaning the BMI is greater than that of 95% of people of the same age and gender) is generally considered overweight. A person with a BMI between the 85th and 95th percentiles typically is considered at risk for overweight. Obesity is the term used for extreme overweight. There are some exceptions to this formula, though. For instance, someone who is very muscular (like a bodybuilder) may have a high BMI without being obese because the excess weight is from extra muscle, not fat.


Causes
People gain weight when the body takes in more calories than it burns off. Those extra calories are stored as fat. The amount of weight gain that leads to obesity doesn't happen in a few weeks or months. Because being obese is more than just being a few pounds overweight, people who are obese have usually been getting more calories than they need for years.


Genes - small parts of the DNA that people inherit from their parents and that determine traits like hair or eye color - can play an important role in this weight gain. Some of your genes tell your body how to metabolize food and how to use extra calories or stored fat. Some people burn calories faster or slower than others do because of their genes.

Obesity can run in families, but just how much is due to genes is hard to determine. Many families eat the same foods, have the same habits (like snacking in front of the TV), and tend to think alike when it comes to weight issues (like urging children to eat a lot at dinner so they can grow "big and strong"). All of these situations can contribute to weight gain, so it can be difficult to figure out if a person is born with a tendency to be obese or overweight or learns eating and exercise habits that lead to weight gain. In most cases, weight problems arise from a combination of habits and genetic factors. Certain illnesses, like thyroid gland problems or unusual genetic disorders, are uncommon causes for people gaining weight.

Sometimes emotions can fuel obesity as well. People tend to eat more when they are upset, anxious, sad, stressed out, or even bored. Then after they eat too much, they may feel bad about it and eat more to deal with those bad feelings, creating a tough cycle to break.
One of the most important factors in weight gain is a sedentary lifestyle. People are much less active today than they used to be, with televisions, computers, and video games filling their spare time. Cars dominate our lives, and fewer people walk or ride bikes to get somewhere. As lives become busier, there is less time to cook healthy meals, so more and more people eat at restaurants, grab takeout food, or buy quick foods at the grocery store or food market to heat up at home. All of these can contain lots more fat and calories than meals prepared from fresh foods at home.


Risk Factor
The number of people who are obese is rising. About 1.2 billion people in the world are overweight and at least 300 million of them are obese, even though obesity is one of the 10 most preventable health risks, according to the World Health Organization. In the United States, more than 97 million adults - that's more than half - are overweight and almost one in five adults is obese. Among teenagers and kids 6 years and older, more than 15% are overweight - that's more than three times the number of young people who were overweight in the 1970s. At least 300,000 deaths every year in the United States can be linked to obesity.
In the United States, women are slightly more at risk for becoming obese than men. Race and ethnicity also can be factors - in adolescents, obesity is more common among Mexican Americans and African Americans.


Effects
Obesity is bad news for both body and mind. Not only does it make a person feel tired and uncomfortable, it can wear down joints and put extra stress on other parts of the body. When a person is carrying extra weight, it's harder to keep up with friends, play sports, or just walk between classes at school. It is also associated with breathing problems such as
asthma and sleep apnea and problems with hips and knee joints that may require surgery.
There can be more serious consequences as well. Obesity in young people can cause illnesses that once were thought to be problems only for adults, such as
hypertension (high blood pressure), high cholesterol levels, liver disease, and type 2 diabetes, a disease in which the body has trouble converting food to energy, resulting in high blood sugar levels. As they get older, people who are obese are more likely to develop heart disease, congestive heart failure, bladder problems, and, in women, problems with the reproductive system. Obesity also can lead to stroke, greater risk for certain cancers such as breast or colon cancer, and even death.
In addition to other potential problems, people who are obese are more likely to be depressed. That can start a vicious cycle: When people are overweight, they may feel sad or even angry and eat to make themselves feel better. Then they feel worse for eating again. And when someone's feeling depressed, that person is less likely to go out and exercise.


Prevention
The best way to avoid these health problems is to maintain a healthy weight. And the keys to healthy weight are regular exercise and good eating habits.
To stay active, try to exercise 30 to 60 minutes every day. Your exercise doesn't have to be hard core, either. Walking, swimming, and stretching are all good ways to burn calories and help you stay fit. Try these activities to get moving:
Go outside for a walk.
Take the stairs instead of the elevator.
Walk or bike to places (such as school or a friend's house) instead of driving.
If you have to drive somewhere, park farther away than you need to and walk the extra distance.
Tackle those household chores, such as vacuuming, washing the car, or cleaning the bathroom - they all burn calories.
Alternate activities so you don't get bored: Try running, biking, skating - the possibilities are endless.
Limit your time watching TV or playing video games; even reading a book burns more energy.
Go dancing - it can burn more than 300 calories an hour!
Eating well doesn't mean dieting over and over again to lose a few pounds. Instead, try to make healthy choices every day:
Soft drinks, fruit juices, and sports drinks are loaded with sugar; drink fat-free or low-fat milk or water instead.
Eat at least five servings of fruit and vegetables a day.
Avoid fast-food restaurants. If you can't, try to pick healthier choices like grilled chicken or salads, and stick to regular servings - don't supersize!
If you want a snack, try carrot sticks, a piece of fruit, or a piece of whole-grain toast instead of processed foods like chips and crackers, which can be loaded with fat and calories.
Eat when you're hungry, not when you're bored or because you can't think of anything else to do.
Eat a healthy breakfast every day.
Don't eat meals or snacks while watching TV because you'll probably end up eating more than you intend to.
Pay attention to the portion sizes of what you eat.


Treatments
Before you start trying to lose weight, talk to a doctor, a parent, or a registered dietitian. With their help, you can come up with a safe plan, based on eating well and exercising. Remember that teenagers need to keep eating regularly. Don't starve yourself because you won't get the nutrients you need to grow and develop normally.
You may also want to keep a food and activity journal. Keep track of what you eat, when you exercise, and how you feel. Changes can take time, but seeing your progress in writing will help you stick to your plan. You might also want to consider attending a support group; check your local hospital or the health section of a newspaper for groups that meet near you. Above all, surround yourself with friends and family who will be there for you and help you tackle these important changes in your life.

Adapted from Nemours Foundation

Mood Enhancement

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Introduction

Amphetamines, barbiturates, benzodiazepines, and other ‘mother’s little helpers’ have long been used to improve the moods of healthy people. However, the high potential for addiction and tolerance with these drugs dissuades most people from using them (Farah & Wolpe, 2004). Classic antidepressants, while presenting no such risks, have unpleasant side effects that limit their appeal only to those suffering from clinical depression.

Since the introduction of Prozac (fluoxetine) in the late eighties of the last century, a number of so-called selective serotonin reuptake inhibitors (SSRIs) – the ‘new antidepressants’- have been developed and introduced. Originally developed for the treatment of major depression and other emotional problems so disabling as to indicate the presence of mental illness, such mood-enhancers presently are also, and increasingly, prescribed for people whose problems are not so severe and whose neurochemistry may not be abnormal (President’s Council on Bioethics, 2003). The SSRIs have relatively narrower neurochemical effects and consequently fewer side effects then classical antidepressants.

Most people using SSRIs meet DSM IV criteria for some psychiatric disorder, although not necessarily major depression: dysthymia (a mild depression), social phobia (an extreme form of shyness and self-consciousness), premenstrual dysphoric disorder (a recurrent negative mood associated with PMS) and various eating disorders respond well to SSRIs (Farah & Wolpe, 2004). And, as said, some people using SSRIs have no recognised illness and feel, in Peter Kramer’s words, ‘better than well’ when taking an antidepressant (Kramer, 1993). People who use Prozac and the other SSRIs say that they feel energized, more alert, better able to cope with the world, and better able to understand themselves and their problems (Elliott, 1999).

SSRIs
Neurologically, SSRIs alter the brain’s handling of serotonin. Like other neurotransmitters, serotonin is released from one neuron to bind with and activate another. The brain recycles serotonin after each release, gathering it up again by means of a ‘reuptake system’. SSRIs inhibit the serotonin reuptake system, thus increasing the concentration of serotonin available to the receiving neurons – hence the name ‘serotonin reuptake inhibitor’. When given to patients diagnosed with mood disorders, SSRIs brighten or stabilize moods in most of them, presumably as a result of the increased availability of serotonin in certain crucial places in the brain. Scientists do not yet know how inhibiting the reuptake of serotonin alters the mental state. What serotonin does, how it functions, and even whether it is a serotonin problem that causes depression in the first place, remain largely unknown (President’s Council on Bioethics, 2003).

Beyond psychopharmaceuticals
Using ‘cosmetic psychopharmaceuticals’ like SSRIs is one way to promote mood enhancement (Elliott, 1999). Technical advances in non-pharmaceutical methods for altering brain function are also creating potential enhancement tools (Farah & Wolpe, 2004). Transcranial magnetic stimulation (TMS) and, more rarely, vagus nerve stimulation and deep-brain stimulation have already been used to improve mental function or mood in patients with medically intractable neuropsychiatric illnesses (Berghmans & De Wert, 2004). Research on the effects of non-pharmaceutical methods on brain function in normal individuals has been limited to the relatively less invasive TMS (Farah & Wolpe, 2004).

It is, however, to be expected that in the near future the combination of data from advanced biochips and brain imaging will accelerate the development of neurotechnology (Lynch, 2004). Growing knowledge in the neurosciences, enhanced by exponential advances in neurotechnologies (forms of technology that make it possible to monitor and manipulate the brain’s electrochemistry) are rapidly moving brain research and clinical applications beyond the scope of purely medical use (Sententia, 2004). So-called neuroceuticals, used for therapy and enhancement, and used to improve different aspects of mental health, will become possible. Unlike today’s psychopharmaceuticals, neuroceuticals are neuromodulators that have high efficacy and negligible side effects. By being able to target multiple subreceptors in `specific neural circuits neuroceuticals will create the possibility for dynamic intracellular regulation of an individual’s neurochemistry (Lynch, 2004).

Ethics
The enhancement of mood raises the following ethical questions

At first glance, enhancement of mood does not seem to be a morally objectionable goal. What can be wrong with striving after the promotion and pursuit of happiness, if the means used do not involve risks or harms?The proliferation of mood-enhancers, particularly outside the domain of recognised mental disorders such as clinical depression, however, raises a number of moral issues. Three sets of concerns seem particularly salient.

The first set of concerns relates to issues of safety; the second is related to less easy to articulate concerns resulting from the many ways in which neuroscience-based enhancement intersects with our understanding of what it means to be a person, to be healthy and whole, to do meaningful work, and to value human life in its imperfection (Farah & Wolpe, 2004). These concerns are related to our self-understanding.A third set of concerns relates to issues of justice, fairness and equity.

1. Safety
Safety is a concern with all medications and procedures. In comparison with other enhancement procedures such as cosmetic surgery or growth hormone treatment, neuroscience-based mood enhancement involves intervening in a far more complex system. So far, medications such as SSRIs have good safety records, and their long-term effects may even be positive. Nevertheless, drug safety testing does not routinely address long-term use, and relatively little evidence is available on long-term use by healthy subjects (Farah & Wolpe, 2004). Recent concerns about SSRIs are about the possible risk of suicide connected to their use, particularly in children and adolescents (Wong et al., 2004), but also in adult patients (Healy & Whitaker, 2003). It thus remains an open empirical question whether the net effects of these or other yet-to-be developed drugs and other non-pharmaceutical interventions will be positive or negative.

2. Self-understanding
Using mood-enhancers for non-medical reasons may alter our self-understanding as individuals and as society as a whole. This self-understanding relates to issues of personal identity and personality, authenticity, emotional estrangement, and to mechanisms of medicalization and ‘democratization’ of mood, emotions and temperament.

Identity and personality
If a person undergoes a striking transformation on medication but feels more ‘like himself’, is this then a metamorphosis to a new, ‘better self’, or the restoration of a ‘true self’ that has been masked by pathology? (Elliott, 2003) The use of SSRIs raises questions about personal identity and personality change. Kramer, the author of Listening to Prozac, found that some of his patients who were shy and withdrawn, or who were rather compulsive, or who had poor self-esteem or were just chronically sad, when put on Prozac underwent a kind of personality transformation. The controlling, compulsive types became laid-back and easy-going; shy people became more self-confident and assertive (Elliott, 1998).Philosophical questions concerning the relationship between mental disorder and personal identity are little researched. Even less reflected upon is the relationship between pharmacological mood changes and personal identity and personality. Obviously, in this regard empirical questions (for instance the self-evaluation of people taking mood-enhancing drugs) have relevance for philosophical analysis.

Authenticity
Related to concerns over identity and personality is the issue of authenticity or the ‘authentic self’. The ideal of authenticity says that if a person is not living a life as him- or herself, than he or she has missed out on what life has to offer (Elliott, 2003). This does not imply that an authentic life is a happier life; an authentic life is considered to be a higher life, because it is a life in which a person knows who he or she is and lives out his/her sense if his- or herself. Authenticity presupposes self-discovery and self-understanding (leaving aside the philosophical question whether there is a ‘core’ or ‘authentic self’, or whether it is more adequate to talk about ‘multiple selves’). The already mentioned transformations which may result from mood-enhancers may be seen as chemical makeovers (suggesting inauthenticity), or, alternatively, as chemical self-discoveries, which contribute to a sense of authenticity.A serious concern with regard to mood enhancers is connected to personal truthfulness and genuinity. Using artificial means to change psyches and mental states involves a kind of ‘taking over’: the experiences of the person can be considered neither true, nor truly his (President’s Council on Bioethics, 2003). In human affairs people care about the difference between ‘the real’ and ‘the merely appearing’.

Emotional estrangement
A worry is that using artificial means to change mental states may prevent the individual from being genuine and true. A central concern with mood-enhancing drugs is that they will estrange people emotionally from life as it really is, preventing them from responding to events and experiences, whether good or bad, in a fitting way. A danger may be that mood-enhancers will keep people ‘bright’ or impassive in the face of things that ought to trouble, sadden, outrage or inspire them.

Medicalization and ‘democratization’
The use of mood enhancers outside the domain of ‘classical’ mental disorders such as depression raises concerns about the medicalization of ‘normal’ behaviour (President’s Council of Bioethics, 2003). Hand in hand with the medicalization of mood changes and feelings of unhappiness goes a ‘democratization’ of depression and depressive or low mood (Pieters, te Hennepe & de Lange, 2002). Both trends have implications for the self-understanding of individual persons, but above that for society as a whole.The Diagnostic and Statistic Manual of Psychiatric Disorders (DSM-IV) of the American Psychiatric Association is the golden standard for the diagnosis of mental disorders in many western countries. This implies that DSM serves as guiding principle in distinguishing between normality and illness, between depression and mere sadness. From a historical perspective, the different versions of DSM go hand in hand with a proliferation of a growing number of diagnostic categories (Pieters, te Hennepe & de Lange, 2002).The democratization of psychic pain and suffering involves the de-tabooization of mental distress (depressive mood, fear).

From a historical perspective, mental distress was associated with feelings of guilt and shame, and stigma was connected to its expression. Nowadays, clinical depression as well as less severe forms of low mood and psychic distress are normalized in the sense that professionals and mass media make an effort to characterize them as ‘normal’ states-of-affairs for which the individual has no moral responsibility. By describing depressive mood as a form of illness (comparable to somatic illnesses), feelings of guilt and shame are to be prevented. It is to be expected that this form of ‘democratization’ of depression will have repercussions for the individual and societal perception and valuation of mood-enhancing interventions, as it will lower the threshold for such interventions and stimulate social acceptance of their use.Underneath the use of psychopharmaceuticals to address different kinds of human misery lies a particular, mechanistic view about psychological and emotional states (Freedman, 1998). It is connected to biological reductionism. Thanks to the efficacy of mood brightening agents, and of psychotropic drugs more generally, there may well be a temptation to redefine and to treat what are currently considered normal emotions, moods, and temperaments on the model of mental illness, and mental illness as a matter purely of bodily (and ultimately of molecular) character and causation (President’s Council on Bioethics, 2003).

This view may endanger our dignity as responsible persons who owe it to ourselves to struggle toward insight through dialogue, and may alter the assignment of moral responsibility for any improper behaviour, not only in criminal matters, but in all interpesonal relations.

3. Justice and fairness:
competitive advantageThe nontherapeutic use of mood-enhancing drugs or other interventions also raises questions of unfair advantage and suggests that when one person is perceived as having such an advantage, others will be compelled to use it (Blank, 1999). To the extent that mood enhancers actually confer a competitive advantage, their use by some people will result in pressure on nonusers to become users, or else to accept what amounts to a handicap in the social competition (Whitehouse et al., 1997). Self-medication may become the social norm, and may create new anxieties about mental health, creating new problems in the realm of social justice.

References
Berghmans, R.L.P. & De Wert, G.M.W.R., Wilsbekwaamheid in de context van elektrostimulatie van de hersenen. [Mental competence in the context of deep brain stimulation] Nederlands Tijdschrift voor Geneeskunde, 2004 Jul 10; 148(28): 1373-5Blank, R.H., Brain policy. How the new neuroscience will change our lives and our politics. Washington, D.C.: Georgetown University Press, 1999.Elliott, C., The tyranny of happiness: ethics and cosmetic psychopharmacology. In: Parens, E. (Ed.), Enhancing human traits. Ethical and social implications. Washington, D.C.: Georgetown University Press, 1998, p. 177-188.Elliott, C., A philosophical disease. Bioethics, culture and identity. New York/London: Routledge, 1999.Elliott, C., Better than well. American medicine meets the American dream. New York: W.W. Norton & Company, 2003.Farah, M.J. & Wolpe, P.R., New neuroscience technologies and their ethical implications. Hastings Center Report. May-June 2004, 35-45.Freedman, C., Aspirin for the mind? Some ethical worries about psychofarmacology. In: Parens, E. (Ed.), Enhancing human traits. Ethical and social implications. Washington, D.C.: Georgetown University Press, 1998, p. 135-150.Healy, D., Whitaker, C., Antidepressants and suicide: risk-benefit conundrums. Journal of Psychiatry and Neuroscience 2003; 28(5): 331-337.Kramer, P.D., Listening to Prozac. New York: Penguin, 1993.Lynch, Z., Neurotechnology and society (2010-2060). Annals of the New York Academy of Sciences, 2004, 1013:229-233.Parens, E. (Ed.), Enhancing human traits. Ethical and social implications. Washington, D.C.: Georgetown University Press, 1998.Pieters, T., te Hennepe, M. & de Lange, M., Pillen & psyche: culturele eb- en vloedbewegingen. Medicamenteus ingrijpen in de psyche. Den Haag: Rathenau Instituut, 2002; Working document 87.President’s Council on Bioethics, Beyond therapy. Biotechnology and the pursuit of happiness. New York: ReganBooks, 2003.Slob, M. (red.), Een ander ik. Technologisch ingrijpen in de persoonlijkheid. Diemen: Veen Magazines / Rathenau Instituut, 2004.Whitehouse, P.J., Juengst, E., Mehlman, M., Murray, T.H., Enhancing cognition in the intellectually intact. Hastings Center Report, 1997, 27(3):14-22.Wolpe, P.R., Treatment, enhancement, and the ethics of neurotherapeutics. Brain and Cognition, 2003, 50:3870-395.Wong, I.C., Besag, F.M., Santosh, P.J., Murray, M.L., Use of selective serotonin reuptake inhibitors in children and adolescents. Drug Safety, 2004; 27(13): 991-1000.

Winning the War on Fat

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Want to fight the battle of the bulge in your clan? Then here's your war plan: Identify the enemy, build a fat-fighting arsenal and win the support of your allies (that would be your family members). After all, you don't want to find yourself trapped in some caloric quagmire., men and children are bigger, but not better than ever, while women at least have held firm in the weight department -- not a major accomplishment, since a third of them are already obese.

So who's to blame and what to do?

"We won't likely be able to define a single cause nor a single solution. But together, the environment has changed to promote increased food intake and reduced activity," says Dr. William Dietz, director of the nutrition and physical activity division of the Centers for Disease Control and Prevention.That means you'll have to wage a multipronged attack:

Enemy -- Supersizing: "Portion sizes have insidiously increased," says Dr. Lisa Hark, Director of the Nutrition Education and Prevention Program at the University of Pennsylvania School of Medicine and host of the TLC network’s new family-nutrition makeover show, 'Honey, We’re Killing the Kids.' "You look at a fast-food burger compared to 20 years ago and it’s bigger, and the fries are bigger. The smallest drink you can get at a movie theater looks like a large, doesn't it? You can’t even get small portions now."

Battle Plan: Hark suggests always sharing entrees when eating out; stop eating before you feel full; use smaller plates at home.

Enemy -- Takeout Mania: "People are eating out more," says Hark. "You get bigger portions, more calories."Battle Plan: Cook at home! "Eat more fruits, vegetables and whole grains," says Hark, who co-authored the new book, 'The Whole Grain Miracle Diet.' Hark recalled the first family refrigerator she investigated on 'Honey.' "It was all take-out containers and packaged, processed foods. I said to them, 'You see these bins down here? These are fruits and vegetable bins.' Empty."


How Does Your Family Rate?
Enemy -- The Tube: Where are kids not burning calories these days? In front of the TV, whether they're just watching or playing video games. "The TV has become the central focus of the family," says Hark. "Parents and children are watching six to 10 hours a day. Many families have more TVs than people."


Battle Plan: Get moving every day -- at least one hour of physical activity. "Try to get the children to do anything from dancing in the house to hula hooping to jumping rope to running around and playing tag to rollerblading, biking, badminton, baseball, walking. Anything," says Hark.


Enemy -- Sweets: "Sugar is everywhere," says Hark. "Americans are consuming 130 pounds a year. In a child's one-day diet, they can be eating 10 servings -- they really should only be getting one: about 10 teaspoons.


Battle Plan: "Consume water instead of soft drinks," says Dietz, "particularly in children, where soft drinks account for a significant portion of calories." Hark, meanwhile, recommends a one-sweet-treat-a-day limit. "If you’re going to have that Pop Tart, then that’s it," and remember, Hark says, "the body doesn’t secrete sugar."



Adapted from AOL

Obesity: A Worldwide Issue

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Here are what is reported the world over concerning Obesity

Toronto, C-Health (online publication): While news stories dwell on the alarming trend toward obesity in North American children, the rest of the world appears to be following suit. More than 1.2 billion people in the world are now officially classified as overweight, according to the World Health Organization (WHO). Since the publication in the British Medical Journal of new standards for evaluating children's weight, health officials around the world have begun estimating their childhood obesity rates. The Chinese government calculates that 1 in 10 city-dwelling children are now obese. In Japan, obesity in nine-year-old children has tripled. The WHO reports that approximately 20 per cent of Australian children and adolescents are overweight or obese.

London, BBC (international broadcaster): Child obesity due to poor nutrition and lack of exercise is a “ticking time bomb” for life expectancy levels, the UK’s food watchdog has warned. The Food Standards Agency (FSA) chairman, Sir John Krebs, said the trend meant young people today would not live as long as their parents… Sir John, in an interview with the Observer newspaper, called for changes to food marketing and an end to celebrity endorsements of unhealthy meals and snacks. "What we are faced with is a situation where, if nothing is done to stop the trend, for the first time in a 100 years life expectancy will actually go down," he told the newspaper. "[That] is an extraordinary reversal of the general gains in health. "We're all looking forward to a longer and healthier old age, and that trend could be reversed." The FSA, whose own research shows advertising influences children's eating habits, wants some food packaging to carry health warnings. It is concerned that popular entertainers and cartoon characters are promoting foods that contain dangerously high levels of fat or salt.

Beijing, Xinhua News Agency (government-owned): Experts have called for increased awareness of and concern about the rising numbers of obese children in China, a highlighted balanced diet, and rational nutrition and physical exercises to help control the weight of kids. Official statistics show that 10 percent of the children in China suffer from obesity and the number is increasing by eight percent per year. Some 14.8 percent of boys in primary schools in China are obese, and some 13.2 percent of them are overweight, with the proportions for girls standing at nine percent and 11 percent, respectively. Some 13.2 percent of children in northeast China are obese, the largest proportion in the country, followed by 12.2 percent in east China and 10 percent in central and south China. In big cities like Beijing and Shanghai, there is an average of one obese child in every five. Taking less outdoor exercises and indulging in watching TV and playing games at home are the main reasons behind the child obesity, said experts. Experts warned that obese children are vulnerable to weakened intellectuality, autistic personality, unhealthy sexual development, and high incidence of chronic diseases like arteriosclerosis, hepatocirrhosis, diabetes, and hypertension.

Chennai, The Hindu (independent): The world is round and so are a growing number of its inhabitants. In fact, obesity is spreading at an alarming rate, not just in industrialised countries but also in developing countries, where obesity often sits next to malnutrition. …Scientists are documenting the global "fat" problem from China, to Australia, to Egypt, to remote islands of the Pacific, and beyond…In developing countries, it is now estimated that more than 115 million people suffer from obesity-related problems, including Type II Diabetes, heart disease and obesity-related cancers. In the US alone, child obesity has increased by more than 1 per cent per year over the past decade with an estimated 99.2 billion dollars in future health care costs, according to the National Institutes of Health. …Among poorer nations, adoption of industrialized foods and food preferences, together with drastically decreased physical activity levels are the basic ingredients for accelerating obesity, especially among children and adolescents…Within developing countries, shifts to urbanization, non-manual labour, high calorie foods, and higher levels of sedentary living are all contributing to this growing problem, often in conjunction with undernourished segments of the population. We assume in developing countries that the problem is one of under-nutrition rather than over-nutrition, but many countries now have both…In South Africa, overall environmental differences were more important in predicting child weight than family income, so that even children of comparatively poorer parents in Cape Town were fatter than the children of well-off parents in the poorer rural areas.

Melbourne, The Age (centrist): Tips on which foods children should eat and how much exercise they need will be sent to parents as part of a $100 million push to tackle childhood obesity. And 150,000 children - about 10 per cent of those with a weight problem - will get after-school exercise sessions up to three times a week…With an estimated 1.5 million under-18’s overweight or obese, Prime Minister John Howard recently announced the four-pronged strategy at a child obesity meeting in Launceston. Mr. Howard said Australia could overcome the "huge problem" of childhood obesity by encouraging more exercise and better eating at all ages. "In the end, it's a challenge to parents because it's parents who determine and set the eating habits of their children and... we'll be encouraging parents to set the example to their children," he said. "It's a paradox in this country. We love sport and pride ourselves on our sporting prowess and yet more and more of us are watching sport and not exercising ourselves." …Australian Medical Association president Bill Glasson said the nation would pay "physically and financially" if it did not tackle the issue of obesity urgently. Educating parents on what their children should be eating and how much exercise they should have was vital, he said. "Mum and dad have to set an example. If they eat badly and watch hours and hours of television instead of doing exercise, kids follow their parents," he said. "Fat kids often have fat parents. We have to break that cycle." Australian Divisions of General Practice president Rob Walters said the problem could cost Australia dearly if left unchecked. "If we don't start teaching our children wise eating habits, we are going to end up with massive health problems in adulthood and with blowout numbers of people with diabetes and heart disease," he said.

London, Middle East Online (English-language): Obesity ratio in Saudia Arabia, Kuwait, Bahrain, Qatar, the United Arab Emirates, the Sultanate of Oman and the Republic of Yemen (GCC countries) has reached 60 per cent and is more common among women, a Gulf study revealed. Director of the environmental and biological research program at Bahrain Center for Studies and Research Dr. Abdul Rahman Mosaiqer pointed out that his study, along with other studies, proved that obesity is more common in women than men in GCC countries compared to some European countries. He also stated that the obesity percentage among married women ranges from 50 to 70 per cent and among married men from 30 to 50 per cent, adding that the percentage ranges from 5 to 10 per cent among pre-school kids and increases to range from 10 to 15 per cent among primary school children. As for the reasons of obesity in GCC countries, Mosaiqer noted that these reasons lie in the lack of sport and physical activities, over quantities of fatty food as well as the repetition of pregnancy among women without having enough intervals between giving birth and pregnancy.

Jerusalem, Jerusalem Post (conservative): Former World Health Organization secretary-general Dr. Gro Harlem Brundtland said at an international conference a few weeks ago that until recently, blood pressure, cholesterol, tobacco, alcohol and obesity - and the diseases linked to them - were thought to be concerns only for industrialized countries. But she noted that they are becoming more prevalent in developing nations. In many Third World countries, obesity rates have risen dramatically - threefold or more in some parts of Eastern Europe, the Middle East, Pacific Islands, Australia and China since 1980…An interdisciplinary study carried out over the past decade at Kosra, a tiny Micronesian island where life expectancy is, at 55, among the lowest in the world, helps explain what goes wrong. The residents are not poor, and don't lack modern medical care. But almost all of them are obese and most suffer from Type II diabetes and heart disease. The 3,000 people of Kosra are descended from Polynesian Asiatics who arrived during the First Century CE. In 1824, when the first white men came from America and Europe to hunt whales, they introduced diseases to which the locals had never been exposed. Many died from those, as well as from typhoons and other natural disasters that left a meager diet and a population of only 300. The survivors - genetic mixtures of the original Polynesians and the white whalers - subsisted on fruit and fish until 1945. But an economic boom followed the end of World War II, and a US military base introduced the American way of life. The Kosra people began to drink beer and eat steaks instead of fruit and fish. Residents who had been "chosen" by evolution to survive famine because their bodies were able to make the best use of the meager food available were doomed in a time of plenty in an industrialized society. And this is what has helped make 21st century man obese.

Glascow, The Scotsman (independent, moderate): The largest international study carried out into teenage behaviour has found that children in Scotland have among the highest consumption of sugary soft drinks in the world. The survey of 162,000 youngsters from 35 countries revealed that Israel was the only country whose children consume more sugary drinks. The new research, published by the World Health Organisation (WHO), will fuel already grave concerns about Scotland’s growing obesity problem. Scotland’s chief medical officer, Dr. Mac Armstrong, has described the report as "an international alarm bell." Public-health experts have pointed to the consumption of sugary drinks as a key factor in the rise of obesity, and last year Dr. Armstrong called for a ban on the sale of carbonated sugared drinks in schools. A study in the British Medical Journal also found that rates of obesity were much lower among children actively discouraged from such beverages. According to the WHO study, called Health Behaviour in School-Aged Children, more than half of Scottish 15-year-old boys - 53.9 per cent - consume a sugary soft drink each day, compared with an average of 34.5 per cent for youngsters from other countries. The relative figures for 15-year-old girls were 45.2 per cent and 25.8 per cent. Scottish 11 and 13-year-olds also ranked second in consumption of sugary drinks after Israel. And nearly half of all children aged 13 in Scotland eat sweets on a daily basis. Dr. Candace Currie, the international co-ordinator for the WHO study, said that such high consumption could be related to availability. "Consumption is very low in Scandinavian countries, and I think they have tougher laws about the promotion of snacks," she said. Other findings in the WHO report, which included European countries, America, Russia and Israel, showed that one in three young Scots watched television for at least four hours every day. The country ranked seventh in the league table for 15-year-olds who spent the most time in front of the television. In Scotland, nearly two-thirds of boys of 15 in the study failed to meet the guidelines for physical activity. This rose to 77.2 per cent for girls. However, all countries achieved a similar average. Meanwhile, fruit consumption in Scotland, still too low, was also similar to the international average. In all countries, girls reported eating more fruit, although for both genders this decreased with age. Dr. Armstrong said: "It is clear that if we are going to make any impact on Scotland’s appalling health record, we have to start with our young people.

Sydney, The Sydney Morning Herald (centrist): Slim meals, fat camps, diet pills and even surgery – there’s nothing American parents won’t try to downsize their kids. There was a time when people would not have used the words “diet” and “child” in the same sentence. Now the two go together, in advertisements. “Nobody really likes to think of putting children on diets,” said Arthur Gunning, whose company, Zonekids, offers chubby New York children three home-delivered “healthy meals a day.” “But parents were coming to us, saying: ‘Can you help? Our kids are overweight. We don’t know what to do.’ It’s easy to say take them out and make them exercise,” said Gunning. “But parents these days are working all the time. Kids go home to empty houses, they play video games, watch TV. They just don’t move enough.” The result is that one in three kids in the US is now fat, one in five is obese and some have serious health problems.

Adapted from WorldPress

Food that enhances your mood

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A lack of zinc can cause infertility and impotence, and while moderate amounts of alcohol can help people to feel relaxed.
Caffeine in coffee, tea and cola drinks can reduce libido.

There are certain foods that are not only delicious but also contain the necessary nutrients to maintain your reproductive health and your libido. These will contribute to your healthy sexuality by maintaining your system in good condition, helping you to regulate your hormonal cycles and boosting your fertility. Besides, the fast pace of modern life leads to stress, tiredness and sometimes a lack of sexual energy.

These includes;

Mood Enhancers

Foods like oysters really can ignite passion in the bedroom. How? They're good for your heart. And what's good for your heart is good for your libido, too. After all, if your arteries are clogged, getting blood to flow down south can be problematic, says Bonnie Dix, M.A., R.D., of the American Dietetic Association. Here are some more romance-enhancing wonders:

Oysters

Since the tale of Aphrodite emerging from the sea on an oyster shell, this sexy shellfish has been hailed as an aphrodisiac. Oysters and other fatty fish such as salmon, scallops and sardines are loaded with healthful monounsaturated fats called Omega 3s. And they carry a hefty dose of testosterone-boosting zinc.

Champagne

So you've already heard the buzz that a daily glass of wine raises good cholesterol and helps prevent arteries from clogging. But alcohol, especially champagne, can also improve your health and your sex life. Like many mind altering substances, a glass or two of champagne will lower inhibitions and help ease any couple into an amorous mood.

Pine Nuts

Pine nuts have more protein than any other nut. Besides providing protein to help increase stamina, pine nuts are heavy in healthful monosaturated fats, zinc and other nutrients that are linked with increased sexual desire. Sexier than your average peanut, pine nuts are often present on many fine-dining menus.

Artichoke

This nutrient-dense, peculiar plant was once considered such a powerful aphrodisac that women were banned from eating it. According to Martha Hopkins, co-author of 'Inter-Courses: An Aphrodisiac Cookbook,' part of the appeal of the artichoke may be that you have to work hard to "get past the spiked leaves to get to the velvety-smooth heart."

Spices

The right spices not only heat things up on the tongue, but also in the bedroom. "Chili pepper and ginger help improve circulation," says Dix, "and hot spices like cayenne, curry and cumin help warm the body." The intoxicating aromas of exotic spices help infuse romance into the atmosphere.

Avocado

According to the Doctrine of Signatures, food aids the part of the body it resembles. In fact, the Aztecs valued the avocado as an aphrodisiac and named it ahuacale or testicle because they grow in pairs. Though science can neither confirm nor deny that this fruit will get your fire going, it will give you fuel in the form of healthy fats, protein and potassium.

Chocolate

Don't skip dessert: Eating chocolate causes the release of mood-boosting, stress-reducing serotonin. The sweet stuff also causes a release of phenylethylamine, which causes changes in blood pressure and blood-sugar levels leading to feelings of excitement. Just make sure to choose antioxidant-rich dark chocolate.




Adapted from AOL

Treatment of Infertility

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If you think that you are having difficulty becoming pregnant, you should seek the assistance of your physician. There are several types of treatment. Appropriate treatment depends on your particular situation or underlying medical or surgical condition largely depends on the reason thought to be responsible for difficulty in becoming pregnant.These treatments may range from the simple like appropriate timing of intercourse to the complex, high-tech therapies like in vitro fertilization (IVF) in which medications are given to induce the production of eggs that can be collected and then put together with sperm in the laboratory so that fertilization occurs. The fertilized eggs can then be cultured for 3 to 5 days followed by embryo transfer to the uterus.

IVF (In Vitro Fertilization)
IVF has been used safely and effectively for more than two decades. In a typical IVF procedure, a woman is treated with fertility drugs to regulate her menstrual cycle and stimulate the development of higher-quality eggs. This process helps to ensure that a sufficient number of healthy eggs are available for fertilization. Eggs are then "retrieved" or collected and prepared for insemination using sperm from the male partner or a donor. Fertilization occurs in a laboratory dish specially prepared with a culture medium that supports and nourishes the fertilized eggs. Within about 72 hours after fertilization, embryos are transferred into the woman's uterus.


Since the introduction of IVF, there have been many other important developments that have made infertility treatment even more effective for both men and women:

In vitro fertilization with endometrial cell co-culture is a special technique for couples with poor embryo quality where cells from the woman's uterus are used to enhance development of fertilized eggs. CRMI refined this procedure using the woman's own endometrial cells rather than cells from animals.

Intracytoplasmic sperm injection (ICSI) is a procedure where a single sperm is selected and delivered directly into a woman's egg. ICSI is an effective option for men with low sperm count or sperm that cannot reach the egg successfully.

Cryopreservation is the ability to freeze and store embryos that are not transferred right away. This process can allow couples to achieve a pregnancy later, either after a first birth or following medical treatments that might affect fertility such as chemotherapy for cancer treatment.

Preimplantation genetic diagnosis (PGD) can be used to identify embryos that do not carry the gene for certain inherited diseases (such as cystic fibrosis and sickle cell anemia). This capability greatly reduces the risk that these diseases will be passed on to children.For male factor infertility, our comprehensive services include microsurgical repair of obstructions and vasectomy reversals, surgical repair of varicoceles, and epididymal and testicular sperm retrieval for use with IVF and ICSI.


Diet & Lifestyle modifications

There are several important lifestyle changes that you can do that will not only improve your overall health but may also positively increase your chances for a successful pregnancy. Good lifestyle choices and habits promote good health for years to come.

Diet
Your diet should include a variety of selections from the 5 basic food groups.
Meat, fowl, legumes, (peas, beans)
Dairy
Grain, cereal, pasta, rice
Fruits
Vegetables
Approximately 1600 to 1800 calories a day is a good range for most women to stay in without gaining wait.


Basic rules for a good weight reducing diet include:

Don't eat less than 1200 calories a day
Drink plenty of water (8-10 glasses a day)
Eat a balanced diet with reduced fat intake
Don't skip meals
Reduce alcohol intake
Avoid fad diets
Exercise
Consult your physician before dieting
When dieting goes too far it can lead to being too thin and can lead to very serious eating disorders, anorexia nervosa and bulimia, which are also associated with difficulty becoming pregnant.
Anorexia nervosa is characterized by a morbid fear of fatness that leads to drastic dieting to the point of self starvation. Bulimia is characterized by binge eating (overeating) and purging (forced vomiting). These eating disorders can be treated with counseling and sometimes medication for depression which often is associated with eating disorders.


If you are unsure whether you have an eating disorder the following questions may be helpful:
Do you have regular menstrual periods?
How many times a day do you weigh yourself?
Have you lost or gained a significant amount of weight in the past 3 months?
Do you use laxatives or diuretics regularly to help you loose weight?
Do you often eat large amounts of food in secret?
Do you make yourself vomit after a large meal?
Do you exercise excessively to lose or keep off weight?


Adapted from WomenFitness

Infertility - from Africa Perspective

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Infertility is of particular concern in Africa because of the extent of the problem and the social stigma attached to it. The highest prevalence of infertility in Africa occurs south of the Sahara, but 5-8% of couples are estimated to experience infertility at some point in their reproductive lives (50-80 million people worldwide). The average infertility in Africa is 10.1% of couples, with a high of 32% in some countries, and certain tribes have high infertility rates. While primary infertility is higher in other regions of the world, secondary infertility is more common in Africa, and secondary infertility rates are very complicated to determine. The World Health Organization Task Force on the Diagnosis and Treatment of Infertility instituted a standardized approach to studies of infertility which was adopted in 33 countries. Between 1978 and 1982, a pilot study of this approach examined 8504 couples and found that less than 50% of male and female infertile partners were primarily infertile, and 66% did achieve a pregnancy within the union. The cause of infertility was not determined for 35% of the women and 50% of the infertile men in the sample. Infertility was accounted for by endocrine factors (usually menstrual or ovulatory disturbances) in 35% of infertile cases and tubal factors (such as unilateral or bilateral tubal occlusion, pelvic adhesion, and other abnormalities) in 32%. About 66% of African women experienced tubal factors compared to about 33% worldwide. About 9% of women reported a history of sexually transmitted disease (STD), and 8% reported abortion complications. 46% of men in sub-Saharan Africa reported a history of STDs. About 24% of women with primary infertility and 40% of women with secondary infertility had no previous history of pelvic inflammatory disease or STDs and had tubal disease. African infections are common due to inadequate health services, improper use of antibiotics, and penicillin-resistant strains of gonorrhea. Public health programs should be implemented to prevent infection-related infertility.

Worldwide patterns of infertility: is Africa different?

The World Health Organisation sponsored a multicentre, collaborative investigation of a standard approach to evaluating infertile couples. The study was conducted between 1979 and 1984 in thirty-three medical centres in twenty-five countries throughout the developed and developing world. Over 5800 couples completed the investigation. African centres had a pattern of infertility different from those in other developing regions or the developed countries. African couples were more likely than those from elsewhere to have secondary infertility or longer duration, a history of sexually transmitted diseases or pregnancy complications, and infertility diagnoses (such as bilateral tubal occlusion or pelvic adhesions) suggestive of previous genital infections.


Analysis of data from a World Health Organization-sponsored collaborative investigation of infertility indicates that Africa may have a pattern of infertility quite different from that in other regions of the world. The study, which involved over 5800 couples that had been infertile for at least 1 year, was conducted in 33 medical centers in 25 countries throughout the developing world in 1979-84. African couples were more likely to have a wide age disparity between men and women, secondary infertility of longer duration, and a history of either sexually transmitted diseases (STD) or pregnancy complications. Africa was the only region where a majority of couples (52%) had secondary infertility; secondary infertility rate was 29% in developed countries evaluated and 16-40% in the other 3 regions of the developing world. Whereas 46% of couples in developed countries sought medical evaluation for infertility before waiting 2 1/2 years, over 2/3 in developing countries (70% in Africa) had been trying to conceive for more than 2 1/2 years. 9% of African women reported a history of STD compared to 3% in developed countries and 1% of those in the other 3 regions of the developing world. Pregnancy complications, largely due to infection, were reported by 8% of African women and 7% in Latin America but by only 2% in developed countries and in Asia and the East Mediterranean. The pattern of specific causes of infertility further differentiated Africa from the other regions. Over 85% of African women had diagnoses attributed to infection, most notably bilateral tubal occlusion and pelvic adhesions. The preponderance of infection-related causes of infertility in African couples suggests a need for public health programs to reduce these causes, including STD control and education programs.


Adapted from National Library of Medcine

Evaluation/Test of Female Infertility

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Infertility Evaluation process involves several steps. The steps in the evaluation portion of the process will include a complete history, physical examination and specific tests that should be clearly outlined by your physician at your first visit.The physician should provide her patient with the following information:The 4 Goals In The INFERTILITY EVALUATION for women are:

To determine potential causes so that effective therapy can be given.
To dispel misinformation and provide accurate information.
To create an environment of emotional support.
To determine the proper time of discontinuing investigation and treatment.


1) To determine potential causes so that effective therapy can be given.
Inability to conceive can be very frustrating & depressing , more so when the "trying time" has been going on for too long . We completely understand that motherhood is a blessing for every women. In the light of the same WF health & fitness experts will try in the best of their capacity to answer your innumerable doubts and questions through this article so as to facilitate you in taking a decision to overcome this crisis .


To understand the possible causes it is important that you consult a doctor who will go into a complete medical, surgical, sexual, social and family history, as a part of initial evaluation.
Possible questions your doctor might ask includes;


Your medical history includes questions concerning illnesses or diseases you & your partner have had or have including what medications, both prescription and over-the-counter preparations you currently use.
Consumption of tobacco products, alcohol, marijuana or other street drugs. Also the amount of caffeinated beverages you drink may be asked as all of these may adversely affect reproduction.
Questions about your previous contraceptive practices such as use of an Intrauterine Device (IUD) .Your occupation and your potential exposure to environmental hazards such as pesticides, heavy metals like mercury and lead, organic solvents, hot tubs and saunas.
Frequency of sexual intercourse.
How long you have been attempting pregnancy .
Your partners inability to achieve or sustain an erection (impotence) can also be a factor, as can pain on ejaculation if you experience or pain with intercourse, which is called (dyspareuia).
A history of previous pelvic infections or sexually transmitted diseases .
Your physician will also ask you questions concerning your menstrual history such as how old were you when you got your first period, when was your last period, how often does it come and how many days does it usually last. You may also be asked whether you experience premenstrual symptoms called molimina, which usually indicate ovulatory (egg release from the ovary) cycles. Moliminal symptoms often include breast tenderness, fluid retention (swelling) and irritability and pelvic discomfort experienced approximately 2 weeks before your period (mid-cycle pain or Mittleshmeritz) may also indicate ovulation. If you experience this, you will be asked if you take medications for this mid-cycle pain.
Questions concerning your bowel and bladder habits and whether you experience pain or bleeding with these .
How you and your partner are dealing with the intense emotional issues involved with infertility as it can be a life crises for many couples.


2) To dispel misinformation and provide accurate information.
It must be the goal of a health provider to help patient in doing away with the misconceptions regarding fertility/infertility and provide them easy to understand accurate information. To begin with they need to be listened to, before starting upon any advice . It is very important to understand patient's state of mind, put their doubts at rest and provide them with essential information.


3) To create an environment of emotional support.
Emotional support is an essential part of every therapy , more in the case of women suffering from this life crisis. Feeling alone, anxious, or even out of control are common reactions. The woman should be convinced that her behavioral reactions are normal and unpreventable .It might seem hard to seek out emotional support because of the fear of being left emotionally out of control at a time when they are already experiencing an enormous loss of control around their body’s ability to perform a basic function.


Try to come out with your problem and discuss it with your friend or a counselor. For some meeting with a group of individuals struggling with infertility is more comfortable. A counselor can help with questions about multiple pregnancy, pregnancy loss, and when and whether to start or stop treatment. Having a regular place to “leave” your emotional burdens can also help free you up to enjoy life more fully and spend less time obsessing about infertility


Whatever you decide, know that you are not alone in this struggle if you don't want to be, and feel free to talk with us about your frustrations and fears.


4) To determine the proper time of discontinuing investigation and treatment.
Treatment prescribed by the gynaecologist might need to be repeated in 6-7 cycles. If results are not achieved, your doctor might advice to other treatments options available.


TEST OF INFERTILITY IN FEMALE

There are many potentially useful tests that can be obtained as part of the infertility evaluation for women. However, therapeutic options largely depend on the results of three fundamental tests:
Uterine Structural Tests (i.e. for patency of fallopian tubes and anatomy of uterus)
Hysterosalpingography (HSG)
Office Hysteroscopy
Sonohystogram


Ovarian Reserve Testing
This includes a Cycle Day 3 FSH or preferably, a Clomiphene citrate Challenge Test.
There are several additional tests that have been used to evaluate infertility.


Tests for Ovulation


Problems of ovulation (egg release from the ovary) account for approximately 25% of infertility and may be suggested on the basis of the history and physical examination.If your menstrual periods occur at monthly intervals and you also have breast tenderness, fluid retention, irritability and menstrual cramps, then your cycles are usually ovulatory, but not necessarily.


Therefore some test of ovulation is necessary:
Urine LH Testing
Blood LH Testing
Basal Body Temperature Graph (BBTG)
Ultrasound Monitoring
MidLuteal Progesterone Testing
Endometrial Biopsy


More Tests in the Female
There are many tests that have been designed to evaluate potential causes of infertility in women. Very few of these tests, however have been well standardized or even definitively associated with infertility. Definitive therapy relating to abnormal test results is also lacking. The following tests although sometimes suggested are generally no longer recommended as part of the basic infertility evaluation:
Post Coital Test (Sims-Huhner Test, PK)
Cervical Mucus Penetration
Cervical Cultures
Immune Testing
Hormone Testing
Laparoscopy
Diagnostic tests are guided by the history and physical examination and include simultaneous analysis of both you and your partner. Testing implies that the knowledge of the result can be used to guide therapy leading to a successful pregnancy.

There are many tests that have been suggested. However, perhaps the most cost-effective and arguably the most clinically useful are a semen analysis, an intrauterine structural study and a test of ovarian age (ovarian reserve) and tubal patency tests.


Infertility testing in women is designed primarily to determine anatomical factors, most commonly abnormalities within the uterine cavity, and problems with ovarian function and tubal patency.


Adapted from WomenFitness

Infertility and Possible Causes

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Infertility is the inability to naturally conceive a child or to carry a pregnancy to full term. There are many reasons why a couple may not be able to conceive, or may not be able to conceive without medical assistance.

The International Council on Infertility Information Dissemination (INCIID) considers a couple to be infertile if

they have not conceived after 12 months of unprotected intercourse, or after 6 months if the woman is over 35 years of age. The reduced duration for women over 35 is because there is a rapid decline in fertility after this age and help should be sought sooner.
there is incapability to carry a pregnancy to term.



The World Health Organization (WHO) estimates that approximately 8-10% of couples experience some form of infertility problem. On a worldwide scale, this means that 50-80 million people suffer from infertility. However, the incidence of infertility may vary from region to region.



Factors affecting conception
The chances of achieving pregnancy for a couple in a given cycle depend upon many factors, and the most important ones are:


The age of the woman: As age increase the number of eggs and their quality starts decreases. After puberty, women become less fertile as they age. Fertility declines sharply after the age of 35, then again between 37 and 40. If possible, women should start to build a family in their twenties or early thirties. In addition, fertility treatments tend to be more successful in younger women, so seek treatment as soon as infertility is suspected. Older women who are infertile can have success with donor eggs.


Frequency of intercourse: couples who have less frequent intercourse have diminished chance of conceiving. A couple is only fertile for about six days each month. Using the basal body temperature, vaginal secretions, and other fertility signs, a couple can be certain that they are having intercourse when the woman is most likely to conceive. Much is made of using the correct position and elevating the woman's pelvis, but during the most fertile times of the month, sperm are able to swim up to the uterus from any position. However, many consider the missionary position (man on top, face to face) the most successful because it allows deep penetration. The woman can elevate her pelvis with a pillow during intercourse and for about 15-20 minutes afterward so that gravity can assist the sperm in reaching their goal. After 20 minutes, all of the motile sperm will have made the trek. Any "leakage" won't reduce the likelihood of pregnancy.

Possible Causes of infertility

There are numerous causes of infertility. In men, these include environmental and hormonal factors that affect the production of healthy, motile sperm and normal semen, as well as blockages that affect the delivery of sperm. In women, the causes are more varied since she plays a greater role in reproduction. First, one of the organs involved in reproduction may be absent, mal-formed or non-functional such as damaged fallopian tubes. Less frequent causes include, for example, endometriosis and hyperprolactinemia.. Second, the organs may be normal, but the complex hormonal feedback system that is necessary to support follicular development, ovulation and implantation of the fertilized egg may be disrupted.

Other causes;

Body weight

Women who are significantly overweight or underweight can face difficulties in getting pregnant. Low weight or excessive weightloss can lead to decrease in important hormonal "messages" that the brain sends to the ovaries in women and testes in men. Gonardotropin releasing hormone(GnRH) is produced in the part of the brain called Hypothalamus. The release of GnRH leads to release of hormonal messangers LH and FSH by the pitutary glands. LH and FSH are critical for the development of eggs in ovaries and sperm in the testes.Similarly being overweight or obese can affect the hormonal signals to the ovaries and testes. Increased weight can also increase insulin levels in women which in turn may cause the ovaries to overproduce the male hormones and stop releasing eggs. Weight loss is the best plan of action in such cases supported with clomiphene or gonadotropins. Body fat plays a critical role in human reproduction. Both excess and deficiency of body fat lead to reproductive failure. Body weight disorders is one of the first potential causes of reproductive failure in both men and women. This is a problem that can be corrected by the affected individual and the infertile couple.


Diet & exercise

Foods rich in manganese (oats, wheat germ, rye bread and peas) promote the action of oestrogen, and vitamin B's (wholegrains such as brown rice, wheat germ, pulses oats and green vegetables), involved in oestrogen metabolism. Their deficiency can hamper pursuing pregnancy. Soya beans and wholemeal bread will provide magnesium.Infertility is associated with low vitamin D, and PMS can be completely reversed by addition of calcium, magnesium and vitamin D. Vitamin D supports production of estrogen in men and women. PMS has been completely reversed by addition of calcium, magnesium and vitamin D. Menstrual migraine is associated with low levels of vitamin D and calcium. Ten minutes of daily exposure of the arms and legs to sunlight will supply us with all the vitamin D that we need as humans can manufacture vitamin D from cholesterol by the action of sunlight on the skin.


Proper diet and exercise is essential to maintain a healthy weight. At the same time extreme exercise can lead to reduced sperm production in men and lack of ovulation in women by decreasing the brain message to the testes and ovaries. It is impossible to know how much exercise for a person is too much. Generally running more than 10 miles a week is considered too much when trying to conceive. Try bringing about modifications in your exercise routine in order to treat reproductive problems.

Smoking


Smoking is a known contributor to infertility problems in women and can lead to an increased rate of miscarriage. Women who smoke regularly also may enter menopause at an earlier age because of the damaging effect of tobacco smoke on ovaries. Men who smoke may have diminished sperm function.

Drugs and Alcohol

Alcohol is known to cause structural and developmental defects in a fetus. This group of disorders is termed the "Fetal Alcohol Syndrome." It is best to avoid drinking alcohol during the course of your infertility treatment or during pregnancy. Marijuana use in men leads to poor sperm counts that take many weeks to recover after exposure. Other recreational drugs can lead to other significant problems for pregnancy. At the same time it is desirable to limit the intake of tea, coffee, soft drinks which contains caffeine.


Women who take folic acid before they conceive reduce their risk of neural tube defects in the fetus by 50%. It is recommended that all women undergoing infertility treatment take at least 0.4 mg of folic acid (folate) before they conceive and during the course of their pregnancy. Some high potency vitamins may have a detrimental effect in pregnancy (i.e. too high level of vitamin A).


Regular medications of modern medicine in certain ailments like ulcer, high blood pressure etc, causes low sperm count & negative side effects that causes infertility problems in both man & woman.

STDs & PID

Pelvic inflammatory disease (PID) is a major cause of infertility in women. Any sexually transmitted disease (STD), such as gonorrhea or syphilis, may cause PID, which can lead to infertility. Prevent STDs by abstaining from sexual intercourse for unmarried or by being faithful to your partner if you are married.


Does stress cause infertility or does infertility cause stress? Most doctors agree that reducing stress won't ensure pregnancy, but it may help a couple cope with infertility and making treatment decisions.

Eating Disorders

The eating disorders anorexia and bulimia can have long lasting impacts (several years) on fertility. Women with these conditions may not ovulate even if they menstruate. Eggs may not develop properly. In these cases, treating the disease is essential to restoring fertility.
Adapted from WomenFitness