Diet - Drug interactions in upper Gastrointestinal tract disorders

Antacids: Neutralise gastric acid, aluminium containing antacids contribute aluminium to the diet and may cause constipation or lead to phosphorous deficiency. Longterm or inappropriate use can lead to Aluminium toxicity. Calcium containing antacids contribute calcium to diet and may cause constipation . Magnesium containing antacids contribute magnesium to diet and may cause diarrhoea. Longterm use may lead to magnesium toxicity.

Antiboitics: When amoxylin is given without regard to food nausea and diarrhoea are common side effects.It is better to take medicine with food to reduce nausea.

Clarithromycin: when taken it may cause taste alteration nausea and diarrhoea.

Metronidezol: May cause taste alterations and no alcohol should be used during treatment  if  alcohol is given and for 24 hrs afterwards alcohol can react with metronidezole and result in nausea , vomiting, headache, cramps .

Antisecretary agents:  Inhibit gastrophasis secretion . Citnitidine may increase formation of toxic metabollites. Nizartidine when taken with tomato based juices its potency is reduced.

Omeprazole and rebeprazole:  They inhibit secretion of acids may interfere with iron absorption. When iron supplements are necessary they should be given 2 hours before or after taking protonpump inhibitors.

Nutrition and Gastrointestinal disorders

The majority of the diseases of the Gastrointestinal tract are not fatal but are significant causes of poor health, responsible for significant proportions of patients attending hospitals and local medical services.
Some Gastrointestinal disorders, common symptoms and nutritional consequences:

Dyspepsia:   Some of the common symptoms include upper abdominal discomfort, bloating especially after meals. Increased concerns about diet, possible decreased intake of food in general or selected foods are some of the nutritional consequences.

Duodenal cancer: several hours after meals pain occurs, may be relieved by eating.Food intolerances may occur.

Gastric ulcer: Vague epigastric discomfort associated with eating. Decreased intake in general or selected foods.

Dumping syndrome: Bloating , nausea, satiety later symptoms such as reactive hypoglycemia and possibly cramping , diarrhea may occur. Decreased intake , malabsorption of nutrients , weightloss, micronutrient deficiencies.

GERD: Acid taste, increased belching, dry cough, burning sensation in upper middle of chest, sometimes spasm, difficulty swallowing , bloating may occur. Possible nutritional consequences include altered food choices, not eating evening meals, avoidance od acid foods, reduced quality and quantity of dietary intake.

Cancer of oral cavity, stomach or esophagus: Asymptomatic or difficulty chewing , swallowing, epigastric discomfort, delayed gastric emtying are some of the symptoms. Anorexia, decreased amount or number of foods, weight loss, change in food texture may require surgery, radiation, chemotherapy , enteral feeding.
General Nutritional guidelines of gastrointestinal disorders:
• Alcohol should be avoided.
• Smoking should be avoided.
• Allergic foods should be avoided.
• Very hot or very cold foods should be avoided.
• Foods should be thoroughly chewed.
• Heavy meals should be avoided. small frequent meals are good.
• Daily 8 to 10 glasses of water if good for health.
• Regularity in meal timings is essential.
• Spicy foods should be avoided.
• Consume adequate fiber.
• Avoid or restrict intake of fructose and sorbitol.
• Minimize consumption of caffeine.

Food Additives

A food additive is defined as a substance or a mixture of substances, other than basic food stuff, which is present in food as a result of any aspect of production, processing, storage or packaging. Food additives are added in order to improve texture, flavor, color and appearance. Food additives are classified as antioxidants, Preservatives, Food colors, food Flavors, Emulsifiers and stabilizers, anti caking agents, acids, bases and buffers, sweeteners, enzymes, leavening agents, anti foaming agents.

Antioxidants: A substance when added to food prevents oxidative deterioration . Some of the anti oxidants added in different foods are gallic acid, resin guiace, citric acid, tartaric acid, octyl gallate, dodecyl gallate, propyl gallate, ethyl gallate, butytlated hydroxyanisole and tertiary butyl hydro quinone.
Preservatives: These are substances when added to food inhibit, retard or arrest the activity of microorganisms such as fermentation, acidification and decomposition of foods. Some of the preservatives are common salt, dextrose, honey, spices, sugar, vinegar, edible vegetable oils, glucose syrup, nisin, sodium diacetate, nitrates, nitrites, lactic acid, sorbic acid, acid calcium phosphate.
Food colours: These food colours are used to enhance colors that occur naturally but at levels weaker than usually associated with a given food. There are natural and synthetic food colours. The natural sources are turmeric, saffron, caramel, beta carotene. The artificial colours are Red, yellow, blue and green.
Flavorings agents:  Flavorings agents add flavor to foods. There are natural and artificial flavours.
Emulsifying agents: Substances which are capable of facilitating a uniform dispersion of oils and fats in aqueous media.
Anticaking agents: Substances that pick up moisture without themselves becoming wet. These are added to products such as table salt and dry mixes to a maximum level of 2%.
Anti foaming agents: The anti foaming agents are added to retard decorative changes and foaming height during heating of edible oils and fats.
Buffering agents: These are agents used to counter acidic and alkaline changes during storage or processing of the food, thus improving the flavour and increasing the stability of foods.

Organic Foods

Most of the people do not have clear cut idea regarding the organic foods. Organic foods are those foods that are produced, processed and packaged without using chemicals. Organic foods are free of pesticides. They doesn’t have any synthetic additives. They are natural foods have grown with more conscious for health of soil, the plants and people who consume them. They have significantly higher levels of nutrients and supply to the body when we eat . Organic foods retains the nutrients for longer periods of time. The problem with today’s diet they are filled with refined and junk foods which contain more amount of empty calories and harmful chemicals. And so your body nutritional requirements are not met and it ends up with obesity and diseases. The quality of health and quantity of life can be improved by organic foods.
Health Benefits of organic foods:

• Organic foods are more nutritious as they supply high level of nutrients required by the body. They are richer in vitamins, minerals and essential fatty acids.
• Organic foods contain more antioxidants: Fruits and vegetables grown organically show higher levels of cancer-fighting antioxidants. These fresh Fruits and vegetables are more juicy and full- flavored. They also taste better than non - organic foods.
• Organic foods ensures environment safety as these foods doesn’t contain any harmful chemicals in farming , there is minimal soil, air and water pollution.
• Organic foods are free of additives, flavourings and preservatives used in processing.
• Eating organic foods reduces the amount of toxic substances that you are exposing to your body. It reduces your susceptibility to cancer, Parkinson’s ,allergies etc.
• Organic meat, eggs, dairy products are produced from animals that are fed organic feed. Livestock and poultry are given all organic feeds. No antibiotics, feed grown with pesticides and hormones given to animals.
• Organic foods do not contain genetically modified organisms.
• Children are more susceptible to the harmful effects of chemicals, and prone to various diseases as their immune system is not at developed .Eating organic foods provides health benefits to children.

IMPORTANT ORGANIC FOODS TO EAT AND THEIR MAIN NUTRIENTS ARE PRESERVED:
As we know we are what we eat. Eating safe foods, free from pesticides keeps us healthy. Here are some of the foods which we may have to choose organic -

1. Milk: In today’s some of the commercial brands available are loaded with growth hormones and antibiotics. Make sure milk and other dairy products is from organically fed cows.
2. Apples: still pesticides are used are on apples .Eat only organic apples. The main nutrient of apple is vitamin c.
3. Straw berries: The main nutrient vitamin C.
4. Spinach: The main nutrient iron, vitamins A and C.
5. Peaches: The main nutrient A and C.
6. Cherries: The main nutrient Vitamin C.
7. Pears: Main nutrients are Vitamin A, Potassium
8. Green Beans: Carotenoids ,potassium

Above mentioned are only some the examples that we should eat organic foods. As organic foods are free from pesticides the main nutrients like Vitamin A, C, Iron, Potassium, Carotenoids etc. are not destroyed.

Low Fat diet

A diet low in fat is called low fat diet. Some dietary fat is actually necessary. In certain medical conditions the body cannot tolerate much fat. So, a low fat diet may help people with these medical conditions. Some of the medical conditions where low fat diet is prescribed is Gall bladder disease, Delayed stomach emptying, Fatty liver and malbsorption syndrome.

Gall bladder secrets bile which helps to break down and absorb fat. When Gall bladder diseases or Gall stones are present there is not enough bile secreted or no bile produced by the gall bladder and so fat from food cannot be digested properly and this may cause diarrhea. A low fat diet allows your gall bladder adequate rest. Due to excess of cholesterol in the bile Gall stones are formed.
Gastroparesis is also known as delayed stomach emptying. In this disease the stomach empties food into intestine very slowly. When high amount of fats are present in foods we eat then this delays stomach emptying and cause gastroparesis. So low fat diet is good for gastroparesis.
Malabsorption and low fat diet: steatorrhea which is due to malabsorption of fat , where more than 6% of dietary fat is excreted in stool. In pancreas and small intestine diseases, patients have trouble in absorbing nutrients from diet, that include fat. A low fat diet helps may help to control symptoms.
Fat is normally not stored in liver. Due to number of reasons fat may accumulate in the liver and this may damage to liver. A low fat diet may be helpful.
List of low fat foods:
Non stick cooking spray, puddings with skim milk, soy milk, Low fat yogurt, whole wheat pasta, Brown rice, Whole wheat bread, Popcorn, Millets, Muesli, Whole Rye, Whole wheat tortillas, Oat meal, Black beans, Chick peas, Green peas, Lentils, Lima beans, Kidney beans, White beans, soy beans, Navy beans, Egg whites, Lean pork Lean lamb, skinless chicken, Liver, Skinless turkey, Rabbit, sea foods ,fresh vegetables and fresh fruits, Low fat tofu.
Tips To Follow Low Fat Diet:

• Avoid fried foods.
• Avoid carbonated beverages.
• Drink low fat milk or low fat dairy products.
• Drink plenty of water.
• Avoid alcoholic beverages and stop smoking.
• Increase physical activity.
• Include more number of fruits and vegetables in your diet.
• Substitute one egg with two egg whites.
• Eat lean meat.
• Avoid fried chicken.
• Avoid fast foods.
• Use cooking spray instead of oil.

Knee Pain

The knee joint is a largest hinge synovial joint consisting of 4 bones and is also a major weight bearing joint of the body. The 4 bones are femur (thigh bone on the top), the tibia (shin bone below), fibula (outer shin bone), and patella (knee cap in front). Knee injuries are most common during sports.
Causes:
• Knee pain may occur due to Knee injury, Fractures, Inflammation of lateral/medial ligament of knee, Twisting injuries to knee, Bursitis, Ligament sprains, Repetitive strain injury, Overuse syndrome, Osteoarthritis, Rheumatoid arthritis, Patellar fracture, Excessive jumping, Muscle strain, Tendonitis, Meniscus tears.
Symptoms:
• Pain, Swelling, Stiffness, Weakness, Redness and Warmth on the knee.
• Pooping/Crunching sounds in the knee while movement.
• Pain /Inability to straighten the knee or Locking while straightening the knee.
• Painful knee movements and Difficulty while walking. Any deformity/ Unusual symptoms of knee.
Diagnosis:
• X ray, MRI (magnetic resonance imaging), Menisci tear can be diagnosed through arthroscopy, arthrography.
Treatment:
NOTE: The treatment to the fractures, severe pain and post-operative cases should be followed by the advice of the doctor.
• R I C E treatment program is to be followed for pain reduction.
  1. Rest the knee. Using of knee caps while walking gives stability.
  2. Ice application to the painful knee area is to be done for 15-20 min with certain gap.
  3. Elevation of the knee joint helps reduce swelling and induce healing.
• Analgesics , Anti-inflammatory drugs, Cortisone injections given under doctor’s supervision.
• Joint mobilization , Soft tissue massage, Electrotherapy modalities done by the physiotherapist.
• Strengthening exercises
  1. Quadriceps

- Sit in a chair comfortably at its edge. Slowly lift the feet off the floor keeping knee extended and straight along with tightening of thigh muscles. Hold and relax.

- Lie on the back bending one (left) knee to 90 degrees and foot flat on the floor. Keeping another leg (right) straight, slowly lift it up to a certain height. Hold and relax.

- Sit/Lie on the floor/bed. Keep your leg straight and place a rolled towel underneath your thigh. Then slowly raise your foot off the floor pressing the towel with the thigh. Hold and relax.

  2. Hamstrings

- Sit/ Lie on your back. Bend one of your knees to 45 degrees keeping only toes off the floor. Then slowly pull your heel back towards your buttock as if sliding/ digging the heel into the floor. Hold at a point and relax.

       - Lie on your stomach. Slowly lift one foot off the floor tightening the back thigh muscles. Hold and relax.

- Place left foot on the heel of the right foot. Then slowly try to lift your right heel towards your buttocks with the resistance of the left one (press the left foot to the right heel against each other to resist).

       - Backward walking also strengthens hamstrings resulting in giving less strain to your knees.
  3. Hip adductors (inner quadriceps)
  4. Hip abductors
• Stretching exercises
1.    Quadriceps stretch              2. Hamstrings stretch
• Balancing exercises
Stand straight and take support of the chair. Stand with one leg for one minute and switch to other side. Slightly increase your balance removing the chair support.

Nutrition Basics » Cholesterol

Cholesterol is a fat like substance that occurs naturally in the body. Most of the body’s Cholesterol is produced by liver. Since cholesterol is synthesized in the body, it is not a dietary essential. Dietary sources of cholesterol include meat, poultry, fish, ghee, butter, eggs and prawns. Cholesterol produces certain hormones. Body uses cholesterol to protect nerves and make cell tissues. High intakes of cholesterol increase blood cholesterol. These high levels of blood cholesterol can increase risk of heart disease. Cholesterol cannot dissolve in blood. There are two types of cholesterol LDL and HDL .

LDL cholesterol: LDL is low density lipoprotein.LDL cholesterol is bad cholesterol. When too much of cholesterol circulates in the blood, it builds up slowly in the inner walls of arteries and form a plaque, this can narrow the arteries and known as atherosclerosis.
HDL cholesterol: HDL cholesterol is high density lipo protein. It is known as high density lipoprotein. High levels of HDL cholesterol protect against heart disease and low levels of HDL cholesterol increase the risk of heart disease.
Triglycerides: Triglyceride is a form of fat made in the body. People with high triglyceride levels can have high total cholesterol.

Diet Plans

calorie

1000 Calorie - Diet Plan	1200 Calorie - Diet Plan
1400 Calorie - Diet Plan	1500 Calorie - Diet Plan
1800 Calorie - Diet Plan

Renal - Diet Plan

1200 Renal Kilocalories - Diet Plan

1400 Renal Kilocalories - Diet Plan

Heart Healthy - Diet Plan

1200 Kilocalories Heart Healthy - Diet Plan

1500 Kilocalories Heart Healthy - Diet Plan

Diabetic - Diet Plan

1200 Kilocalories Diabetic- Diet Plan	1500 Kilocalories Diabetic- Diet Plan 1
1500 Kilocalories Diabetic- Diet Plan 2
1800 Kilocalories Diabetic- Diet Plan 1	1800 Kilocalories Diabetic- Diet Plan 2

Nutrition and Celiac disease

Celiac disease: In celiac disease one cannot digest gluten properly. It is an autoimmune disorder of small intestine. Symptoms of celiac disease include diarrhea and fatigue. In celiac disease absorption of all the macronutrients is reduced.

Dietary guidelines:

• Iron deficiency anemia is common with celiac disease. optimize dietary sources with iron.
• The gluten free diet are low in iron, calcium, zinc, magnesium , vitamin b12 and fiber. Hence daily vitamin and mineral supplementation is necessary.
• Eat sprouted nuts and seeds.
• Add omega 3 rich foods in your diet.

Foods to eat:

• Rice
• Rice bran
• Arrowroot
• Flax seeds
• Soy
• Legumes
• Potato
• Corn
• Sago
• Sorghum
• Amaranth
• Tapioca
• Millets
• Malt vinegar

Therapeutic Diets » High Fiber diet

A fiber diet contains foods that have a lot of fiber. High fiber diet has many health benefits. High fiber diet is recommended in the treatment of digestive problems such as diarrhea, constipation, hemorrhoids, diverticulitis and irritable bowel syndrome. Eating high fiber foods helps in proper digestion also helps in absorption of nutrients. When you eat the diet rich in fiber the daily intake of water should be adequate as liquids help your body to digest fiber. Recommendations for adults are between 25 and 40 grams per day. Dietary fiber adds bulk to your diet.

Health benefits of high fiber:

• A diet rich in fiber controls Diabetes by maintaining the blood glucose levels. It actually slows down the digestion and it doesn’t raise the blood sugar levels too fast. It takes more time than it takes time when the food does not contain fiber. As the glucose is not released into blood too fast, pancreas doesn’t secrete insulin too fast and blood sugars are in control.
• High fiber diet protects against colon cancer.
• A diet rich in fiber lowers cholesterol levels. Fiber absorbs the water as it moves through digestive tract. And this increases the stool bulk, which causes the intestine to pass them more quickly. As the stool passes more quickly there is less chance for any harmful substances they contain to harm the cells lining the intestine. Fiber also helps as it traps cancer causing agents in colon.
• It improves bowel regularity.
• It increases satiety and controls appetite.
• It also enhances immune system.
• Prolonged contraction of the colon may result in diverticulitis. This increase in pressure cause small and larger ballooning pockets to form. Usually this doesn’t cause any problems. But sometimes they can become infected or also cause inflammation when the pockets are perforated. As the diet rich in fiber increases bulk in the stool and this reduces the pressure in the colon. And so the formation of pockets is stopped.
• Fiber helps in treatment of irritable bowel syndrome. The increased amounts of fiber in diet produces soft and bulky stools. But IBS patients should be careful in selecting the amount and type of fiber. The reason is that the increased amount of soluble fiber may cause health benefit by growing the good bacteria, if too much of soluble fiber is consumed intestinal gas can occur.
• High fiber diet lowers the risk of heart disease and controls the cholesterol levels and triglycerides.
• High fiber diet is good weight management.

TIPS TO INCREASE FIBER IN YOU DIET:

• Eat Fruits with skin instead of fruit juices.
• Do not sieve whole wheat flour while you prepare rotis.
• Instead of white rice choose brown rice.
• Choose complex carbohydrates than simple sugars like whole grain cereals, whole grain breads.
• Eat the skin on baked or mashed potatoes.
• Eat unrefined foods.

Food sources: Excellent sources:

• Horse gram
• Rajmah
• Dry peas
• Drum sticks
• Drum stick leaves
• Curry leaves
• Fenu greek leaves
• Colocasia leaves
• Broccoli
• Turnip greens
• Mustard greens
• Rasberries
• Red gram dal

Very good sources:

• Ragi
• Bengal gram ,whole
• Barley
• Soya bean
• Double beans
• Flax seed
• Green gram, whole
• Straw berries
• Lettuce
• Spinach
• Cranberries
• Celery
• Fennel
• Cow pea
• Cluster beans

Good sources:

• Jowar
• Whole wheat flour
• Maize, dry
• Bitter gourd
• Field beans
• Amaranth
• Tamrind leaves
• Carrot
• Sweet potato
• Mango ginger
• Radish
• Capsicum
• Cucumber
• Apricots
• Oats
• Mushrooms
• Rye
• Grapes