Health News and Information

Diabetes is a condition in which the pancreas gland fails to produce sufficient insulin and in which the insulin that is produced does not have its normal effects. Because of the poor insulin supply, too much sugar remains in the bloodstream and spills over into the urine.

There are about 3.5 million diabetics in the US alone, and it is estimated that there are half as many again undiagnosed. Diabetes is a family of conditions but there are two main types. Type 1 (formerly called juvenile diabetes) can occur at any age but is more frequently seen first in children and young people. Such diabetics need insulin for the rest of their lives. Type 2 diabetes is a disease of obese middle-aged people (usually women)-it only rarely occurs in children. In this latter condition there is probably a normal amount of insulin being produced but there is not enough to go round such a large, overweight body and an apparent shortage occurs and produces symptoms.

Both types of the disease are seen mainly in westernized countries and are rare among peasant agriculturists and other traditional-living people. Recent theories suggest that this difference is all to do with the food the different cultures eat. By and large it appears that a diet low in fat, low in sucrose, high in unrefined starches and high in fibre protects against the disease.

Diabetes is worth preventing because it produces a considerable number of illnesses and if untreated can be fatal. Before the discovery of insulin, all sufferers who would now be called insulin-dependent diabetics died. Now such early deaths are rare, though many diabetics die younger than they should because of their complications.

The earliest symptoms of diabetes are considerable thirst, excessive urination, feeling hungry, and-in spite of the latter-weight loss. There is a generalized weakness, a tendency to get infections (especially vaginal thrush in women), boils, blurred vision, numbness, dry mouth, tingling and cramp in the legs and, later on, impotence.

The diagnosis is easily made today and treatment means that most diabetics live nearly as long as anyone else.

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Oily fish such as sardines, salmon, herrings, mackerel, anchovies and tuna are great sources of EPA and DHA. Much of the fish in our oceans today is contaminated with high levels of heavy metals, such as mercury and cadmium, as well as pesticides and industrial chemicals. Therefore, j it is wiser to choose fish that is smaller, and lower down in the food chain. Larger fish at the top of the food chain have accumulated a lot of toxins in their bodies from all the smaller fish they have eaten. The healthiest fish are actually sardines and anchovies because they feed on plankton. However, if you can’t stomach certain species offish, you will still get benefits from eating any type you do like.

There are plenty of vegetarian sources of omega 3 fats; the best ones are:

•     Ground flaxseeds. You can add these to smoothies, yoghurt or sprinkle them on your cereal or fruit.

•     Flaxseed oil. This can be used as a salad dressing or added to smoothies. Make sure you never heat flaxseed oil, as it is very susceptible to oxidation.

•     Walnuts.

•     Green leafy vegetables.

•     Tofu.

Your body will have to convert the alpha-linolenic acid (ALA) in these foods to EPA and DHA.

If you feel that you need more omega 3 fats than your diet provides, you can take a fish or flaxseed oil supplement. An ideal dose would be three grams per day; this usually equates to three capsules.

Saturated fats are not as bad as you think. It is quite okay to include small amounts of them in your diet. Saturated fats are found predominantly in animal foods such as butter, full fat dairy products and red meat. Saturated fats have the following benefits:

•     They provide structure and integrity to our cell membranes. Phospholipids are the type of fats making up our cell membranes, and they are made of mostly saturated fatty acids.

•     They increase the satiety of a meal, helping to keep us full so that we don’t over eat or binge on sweets.

•     They enhance the function of our immune system.

•     They are usually found in foods with essential fat soluble vitamins, such as vitamins A and D.

•     They enhance our body’s ability to use essential fatty acids.

•     Even if you do not eat any saturated fats, your body will make them out of carbohydrate you ate.

•     They have been part of the human diet for many generations, at a time when heart disease was nowhere near as prevalent as it is now.

Monounsaturated fats help to keep your heart healthy. Olive oil is one of the richest sources of monounsaturated fatty acids. If you use vegetable oil m cooking, olive oil is a good choice because it withstands high temperatures well. Other great sources of monounsaturated fats are hazelnuts, macadamia nuts, almonds, Brazil nuts, cashews, avocado and sesame seeds. Try to include all of these in your diet regularly.

A high intake of monounsaturated fat in Mediterranean countries is thought to be a reason they have such low rates of heart disease. This type of fat helps to lower cholesterol levels, and may offer some protection against cancer. Foods high in monounsaturated fat are often a good source of vitamin E as well.

Polyunsaturated fats are divided into two categories: omega 3 and omega 6. Omega 3 fats are highly beneficial and have been discussed above. The problem is that most people have far too much omega 6 fat in their diet. Vegetable oils high in omega 6 fatty acids include corn oil, soybean oil, cottonseed oil, sunflower oil and safflower oil. These are a fairly new addition to the human diet because of modern oil refining practices. These types of vegetable oils should never be used for cooking, as they are easily damaged by heat which causes them to be oxidized and act as free radicals in the body.

It is best to obtain polyunsaturated fats from whole foods, rather than refined oils. Suitable choices are sunflower seeds, pumpkin seeds, walnuts and sesame seeds. Flaxseed oil is high in omega 3 polyunsaturated fat and may be used as a salad dressing, in smoothies, or other ways as long as it is not heated.

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Pain in the head from any cause. Migraine is a very specific type of headache and is relatively uncommon, whereas headaches are extremely common-one of the most familiar of everyday pains.

Migraine is characteristically a one-sided headache and more than half of all sufferers have their first attack before the age of 20. Most people who have true migraine know when it is about to start. Often sufferers say that they feel exceptionally well a day or two before the attack. The senses are often generally sharpened at this time. Shortly before the headache itself begins there may be a sensation called an aura. This often takes the form of difficulty with or changes in vision. You might see flashing lights and you might even go blind for a while. There may also be peculiar smells, a feeling of nausea and you might even vomit. Some people lose their voice and have altered sensations of touch. The aura lasts for up to half an hour and then fades.

Next comes the headache, which can last from an hour up to a few days. It starts above or behind one eye and spreads to the back of the head on the same side. Many people feel nauseated and may even vomit. For many, sleep cures the headache but others wake with the headache still there.

Cluster headaches are not at all uncommon and are a sort of face-headache migraine. They come in bouts (clusters) with an attack every day for weeks and then nothing for months. This complaint is much less common than ordinary migraine and men have it more often than women. The individual attack starts at the same time each day (or more often, night) often in the spring or autumn. When an attack is at its peak it is very painful, usually being worst in the eye and the cheek. The eye on the affected side becomes red and watery and the nostril on that side blocked. Anti-migraine drugs can be useful but often the condition persists.

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Because each patient is different, I don’t believe in starting off with a “shopping list” of goals to be met. However, certain themes usually emerge.

One central theme is the patient’s relationship to food and the significance of eating in her life. Strangely, some professionals carry on therapy for months without once attacking the patient’s problem with food. They seem to think that just by exploring underlying issues-problems with parents, for example-her eating will improve.

Nonsense! That’s like treating a broken leg with aspirin: It might help the pain a little, but it ignores the bigger problem.

Therapy has to address the symptoms themselves, as well as the feelings of guilt and shame that may result from the cycle of bingeing and purging or self-starvation. It must also look at the reasons food has become the patient’s means of defense, a kind of “anesthetic” against emotional pain.

Another important theme is autonomy, by which I mean two things: self-government and independence.

Self-government means having control over impulses and desires, and not being prey to emotional whims. Ironically, people with eating disorders, especially anorexics, feel they are totally in control of themselves. The truth is that their disorder controls them. Bulimics, in contrast, usually realize they are caught in a cycle they can no longer control.

Independence means not relying completely on other people to satisfy one’s emotional and physical needs. Many of these patients have tried to please other people all their lives-their parents, their teachers, their friends and lovers. They devote themselves to others’ desires and ignore their own. They base their identity on the reactions they stir up in other people.

In therapy, the patient learns to trust her own instincts. She recognizes her feelings and accepts them as valid. Through acceptance comes control and self-mastery.

Another recurring theme in therapy is learning how to tolerate moods. Sure, we all have “down times,” when depression or feelings of failure creep in. An eating-disordered person seeks relief from these feelings by resorting to her symptoms-bingeing and purging, for example.

As Marti, a twenty-nine-year-old woman, put it: “Some days I just can’t drag myself out of bed. I feel so hopeless-nothing is worth doing. I don’t care how I look. I don’t want to go anywhere or see anyone. Nothing cheers me up. Not the TV, not music, not even the comics in the newspaper. It all just seems so … so sad. The only thing I have energy for is eating. Once I start I just keep going. Cookies and leftover Halloween candy and stuff that’s been in the freezer probably since the Civil War. Anything. Then I puke. When I was a baby I comforted myself by sucking on my thumb. Now I do it by sucking food off a fork. Throwing up gives me the illusion that I’m in control. It’s pretty pathetic.”

Marti is describing feelings of depression, a mood she tries to lift by turning to food. For some people, food acts as a kind of substitute for the emotion itself. Others use food to calm themselves down after exploding in anger, or to soothe their guilt for feeling a “shameful” emotion, such as jealousy.

During therapy we explore these moods. We look at what causes them and how they disrupt the patient’s life. I try to help patients see that such moods are part of living. Expressing emotions is normal and nothing to be ashamed of. It’s what makes us human! However, in therapy we look for ways to avoid the things that trigger moods in the first place, and look for alternative ways to act when they do occur.

Coping with maturity is another topic that crops up often. As we have seen, anorexia causes the patient to regress to a preadolescent state. Her starving body loses its womanly shape and functions. In therapy I encourage the patient to examine her feelings about growing up, to find out what it is that frightens her so. Does she fear being abandoned by her parents? Is she scared of the responsibilities of adulthood? Is starving a way to avoid dealing with other people and the risk of being rejected? What is going on inside?

For the bulimic, too, food and eating substitute for mature relationships. As Enid, a twenty-six-year-old patient, told me, “Friends can say mean things. They’re not always around when you need them for support. You can sleep with a man and in the morning the bastard is gone and you never see him again. That’s not true with food. Food is always there. And if it isn’t, you can just go buy some.”

In a way, individual therapy provides a model relationship that the patient can use to explore these issues of maturity. If handled properly, the patient develops trust in her therapist. She learns she can reveal secrets or make mistakes without betrayal or rejection. In the process, she sees how to handle feelings without falling back on the symptoms of her disorder.

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Barb Rand never thought much about her lifestyle until she spent a year in Kuala Lumpur, Malaysia. There, she discovered how a simpler life could help her slim down.

While a newspaper reporter in Kansas City, Missouri, Barb grew fond of the local cuisine—especially the huge cuts of beef served in )and the barbecued chicken and ribs. Because she was fairly active, playing tennis and jogging on occasion, her waistline didn’t suffer as much as it could have. Still, she eventually carried 130 pounds on her 5-foot-5-inch frame, and she was used to being a lot leaner.

Then, cued by her social conscience, Barb signed on as a volunteer abroad with a nonprofit organization. Her assignment took her to Kuala Lumpur, where she was to help local women start their own businesses. Once she arrived, she couldn’t help but notice the vast differences between Malaysia and the United States, especially in terms of diet and lifestyle.

In Malaysia, for example, beef isn’t an everyday food. It’s used only sparingly in special-occasion dishes. Eggs and processed foods are also rarities. Instead, Malaysians eat meals of rice or noodles topped with small helpings of stir-fry or curry. They also enjoy a rich array of native fruits, including bananas, starfruit, and bright red, spiny rambutans.

Barb embraced the traditional Malaysian diet. She found that she could eat as much as she wanted without widening her waistline. And she walked almost everywhere. By the time she came home a year later, she discovered that she had dropped 20 pounds without even trying.

“It was easy to lose weight in Malaysia because of the normal lifestyle,” Barb says. “It made me realize how excessive we are in America. We regularly eat huge portions of foods that are considered luxuries in other parts of the world. And we drive everywhere. In Malaysia, people walk a lot more.”

Upon returning to the United States in 1988, Barb resolved not to gain back the weight that she had lost. So she incorporated much of what she had learned in Malaysia into her American lifestyle. To this day, she eats lots of grains but very few meats, eggs, or dairy products. She tries to buy fresh, organically grown produce when-

ever possible and has cut down on processed foods. She even planted a backyard garden so she could raise some of her food on her own. For exercise, she resumed jogging, and she plays tennis and basketball with her 7-year-old son.

Since adopting a simpler, healthier lifestyle, Barb has had no trouble keeping off those 20 pounds. At age 43, she maintains her weight at 110 pounds. “I have a lot more energy, too,” she says.

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