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    Archive for the ‘anemia’ Category

    When A Blood Test Isn’t Enough

    If you’re looking to get a firm grasp on your iron status, a simple blood test won’t do.

    Most routine blood tests exclusively report levels of hemoglobin, which only help detect iron-deficiency anemia.

    Remember: you can have iron deficiency without anemia.  Whie iron deficiency is a less-serious condition, it nevertheless causes specific symptoms and certainly needs to be treated.

    Keeping in mind that approximately 75 percent of the world’s population is estimated to be iron deficient, it is a good idea to ask your doctor for a more accurate test.

    Next time you are due for a blood test, request to have your transferrin saturation and ferritin levels tested.

    Although ferritin is useful by itself, I strongly recommend you ask for both since ferritin can lead to false positives (inflammatory states can affect values).

    If these tests show you have iron deficiency, the solution is rather simple — include more iron in your diet.

    Fortunately, dietary interventions usually lead to improved iron levels in as little as three weeks.

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    An Experiment to Remember

    In November of 1944, Physiologist Ancel Keys and some colleagues at the University of Minnesota conducted a fascinating study known as The Minnesota Experiment.

    It consisted of 36 healthy anti-war young males in good mental and physical health who were put on starvation diets to the point of losing a quarter of their body weight, and then refed.

    Although the original intent was to examine how starvation, and subsequent refeeding, affected World War II soldiers, this study shed fascinating light on what happens on semi-starvation diets.

    For the first 3 months, participants consumed 3,200 – 3,500 calories a day (the amount needed to maintain their weight at the time), eventually cutting down to 1800.

    The last 3 months, men were assigned different caloric levels to observe what changes the body undergoes during refeeding.

    Keep in mind that throughout the entire study, regardless of how many calories they were taking in, the men burned approximately 3,000 calories a day.

    By the way, when these men significantly cut their caloric intake — resulting in losing a quarter of their body weight, as evidenced by photos in which their ribcages stick out — their diet consisted mainly of carbohydrates, including white bread, potatoes, and jello.

    I would love to hear how Gary Taubes and his fervent low-carb supporters explain this within their framework of “carbohydrates make you fat, calories are irrelevant, and exercise has nothing to do with weight loss.”

    Anyhow, back to reality.

    The results of The Minnesota Experiment were published in 1950 in a 1,385-page tome titled The Biology of Human Starvation.

    It clearly demonstrates the immense psychical and psychological toll that starvation diets took on these men.

    Anemia, edema, dizziness, guilt, self-inflicted harm, shoplifting, loss of sex drive, and “semi-starvation neurosis” were experienced pretty much across the board.

    The more repressed food was, the more it was on these men’s minds, to the point of unhealthy obsession.

    It took at least a year for most of the participants to truly feel physically and psychologically recovered.

    For more information on this fascinating study, I highly recommend reading this summary.

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    You Ask, I Answer: Iron/Vegetarianism

    For women with low iron stores, [who therefore] need to consume beef, does [soy ground beef] contain iron that can help keep the stores up?

    — Micah and Katie
    (Via the blog)

    Great question!

    Let’s start with a few basics.

    Iron is located in hemoglobin, a protein within our red blood cells (pictured at left).

    Hemoglobin is responsible for delivering oxygen from the lungs to various body tissues so other cells – which rely on oxygen — can use it.

    Low hemoglobin levels are therefore problematic, as they result in cells not having enough oxygen delivered to them to perform their required tasks.

    The recommended dietary allowance for iron is set at 8 milligrams for men and women over 50, but vegetarian men of all ages and women over 50 should be consuming approximately 15 milligrams a day.

    The reason? There are two types of iron – heme and non-heme.

    Heme is found in animal sources of iron, non-heme in vegetarian contributors.

    Non-heme iron is not absorbed as easily, so 10 milligrams of purely non-heme iron is not sufficient.

    This is not to say that vegetarian diets are inadequate; simply that they require a higher intake of iron.

    This is not too difficult to do, especially given the high amount of fortified vegetarian products that provide plenty of iron.

    Beans and dried fruits are also great sources of this mineral.

    Keep in mind that women who menstruate have higher iron needs.

    Those on omnivore diets are recommended to consume 18 milligrams a day. Vegetarian women falling into this category should be taking in 30 to 35 milligrams a day.

    The issue of low iron stores is an interesting one because it often gets mixed up with iron-deficiency anemia, although they are two very different things.

    Iron stores run a gamut, from “inadequate” to “excessive”.

    In the middle of that spectrum lies the “adequate/healthy” point.

    Anemia is actually the “end stage”, or lowest point, of iron deficiency.

    The condition of anemia is diagnosed by looking at hemoglobin, mentioned above, and hematocrit (the number and size of red blood cells).

    In anemia, there simply isn’t enough iron present to form hemoglobin. In turn, cells are not receiving enough oxygen.

    Now here’s where things get interesting.

    Someone falling in between adequate stores and anemia has what is known as “iron deficiency.”

    Iron deficiency is diagnosed by looking at levels of the transferrin — a protein that binds to and transports iron – receptor and transferrin saturation (in other words, the percentage of molecules of transferrin that are saturated with iron).

    The bad news is that standard blood tests only show hemoglobin and hematocrit.

    Hence, you could very well be iron deficient and not know it.

    You need to specifically ask for transferrin receptor and transferrin saturation blood labs.

    This is crucial because iron deficiency affects brain function, particularly short-term memory, concentration, and cognitive processes.

    What is important to know is that iron deficiency has nothing to do with the type of iron you are consuming.

    If anyone tells you you need to eat meat to increase your iron stores, feel confident to tell them to read the literature.

    The solution to increasing iron reserves is simply to consume more iron.

    In the case of soy ground beef, two ounces contain 2 milligrams of non-heme iron. That same amount of ground beef contains approximately 1.6 milligrams of the heme variety.

    Another interesting tidbit: runners — especially vegetarian ones — need even MORE iron.

    When we exercise, we undergo a miniscule amount of internal bleeding (which is normal), thereby increasing blood loss — and our chances of developing anemia if we are already iron deficient.

    Again, what is important thing to keep in mind is that increasing body stores can be done with animal or vegetarian sources as long as the right amounts are being consumed.

    There are also certain food combinations worth keeping in mind.

    Vitamin C helps with absorption of non-heme iron.

    So, a soy-based meal accompanied by a tomato salad or glass of orange juice will be beneficial.

    There are also some components of food that will have the reverse effect and inhibit the body’s ability to absorb non-heme iron.

    These include oxalates (found in spinach, quinoa, collard greens, peanuts, and strawberries), tannins (found in tea and coffee) and, more strongly, phytates (found in whole grains).

    Therefore, a soy patty in a whole wheat bun with a side of spinach salad isn’t the most efficient way to include more iron in your diet.

    Here’s some good news, though. Since sprouted whole grains have lower levels of phytates, you’re better off enjoying Ezekiel 4:9 bread products than standard whole wheat varieties.

    Many, many thanks to Dr. Domingo Piñero of New York University’s Department of Nutrition, Food Studies, and Public Health for providing a private iron 101 mini-lesson earlier today to help me answer this question as exhaustively — and accurately — as possible.

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    You Ask, I Answer: B Vitamins

    How much energy do B vitamins provide?
    — Michael Gardner

    Buffalo, NY

    Ah, yes, the “vitamins give energy” myth. I can understand why many people would think so, given the misleading advertising witnessed in vitamin and energy drink advertisements.

    Centrum Performance multivitamins, for example, state that they use “higher levels of five essential B vitamins” to help create a blend for “the vitality of your mind and body.” Monster Energy drinks boast about their high B vitamin level content.

    From a metabolic standpoint, energy is exclusively derived from the three calorie-containing nutrients: carbohydrates, fats, and protein. Vitamins (and minerals) do not contain calories, and therefore can not be used to produce energy.

    So what’s all the B vitamin hype about?

    Well, the B vitamins play a major role in energy metabolism. Without them, our bodies wouldn’t be able to get sufficient energy from our food.

    In the United States, though (and other developed nations), deficiency of the B vitamins is practically unheard of.

    Remember, the Enrichment Act of 1942 mandates that thiamin (B1), riboflavin (B2), and niacin (B3) be added to bread products, while a 1996 ruling by the Food and Drug Administration resulted in the required fortification of folic acid (B9) in enriched bread products.

    Additionally, B vitamins are found in fruits, vegetables, legumes, meats, and dairy products. They are certainly not hard to come by!

    The one group of people who are at risk for a vitamin B12 deficiency are vegans.

    This deficiency results in a condition known as pernicious anemia (in which the body is unable to produce enough red blood cells, thereby causing fatigue), but can be prevented through adequate supplementation.

    If your B vitamin intake already meets the recommended values, extra B vitamins will not provide more energy. Since they are water soluble (like Vitamin C), they will simply be excreted in your urine.

    If you are eating sufficient amounts of food and lethargy and lack of energy have been a problem for several weeks, be sure to get a blood test. Chugging energy drinks loaded with B vitamins will do nothing but provide empty sugar-laden calories to your day.

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    All-Star of the Day: Shrimp

    Although small in size, shrimp are one of nutrition’s biggest kahunas.

    Like eggs, they spent some time on the “Do Not Eat” list in the fat-phobic 90’s due to their high cholesterol. But, as you faithful readers now know, dietary cholesterol doesn’t have much of an effect on our blood cholesterol.

    And, considering all the health benefits shrimp provide, it would be a shame to put a dunce cap on them and make them face the corner.

    For one thing, shrimp contain omega-3 fats – the anti-inflammatory kind that help prevent blood clots, lower bad cholesterol, and have been linked with lower risks of cardiovascular disease and certain cancers.

    Despite their high nutrient volume, shrimp are low when it comes to calories. Three ounces (considered to be one serving) provide 84 calories, just .8 grams of fat, 17.8 grams of protein as well as 15% of our iron and 48% of our daily selenium requirements!

    Although obscure in the mainstream press, selenium is a crucial mineral with antioxidant properties. Many clinical research trials show a promising link between it and the repair of damaged cells in our bodies as well as a significant reduction in the multiplying of already existing cancerous cells.

    It’s also smart to be aware of good sources of iron, especially considering that 12% of women aged 12 to 49 in the United States are living with iron-deficiency anemia.

    It goes without saying that in order to reap all these benefits, shrimp should be grilled or sauteed. Three ounces of popcorn shrimp clock in at 281 calories, 16.2 grams of fat, and 586 milligrams of sodium (as opposed to 190 for plain grilled shrimp).

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