Feeling unwell? Pop an over the counter pill and wait till you feel better. What if you don’t get better? Go see your doctor and take the prescribed medications. Sounds familiar? I guess most of us are in the same boat.

For the past 11 years of being a Dietitian-Nutritionist, I noticed that disease management has evolved from exclusively using traditional or conventional medicine into a more holistic approach called integrative medicine. Think of integrative medicine as a one stop shop that offers everything needed to address the health and well-being of a person rather than focusing only on the disease. It combines practices from conventional medicine and alternative medicine to cure or prevent the onset of diseases.

The National Center for Complementary and Alternative Medicine (NCCAM), the agency that funds scientific research on complementary and alternative medicine classified this type of approach into five categories:

Whole medical systems – involves ancient healing systems like Ayurveda from India and Chinese medicine; homeopathy; and naturopathy which includes massage, acupuncture, herbal remedies, exercise and lifestyle counseling.

Mind-body medicine – includes meditation, prayer, relaxation and art therapies.

Biologically based practices – includes the use of dietary supplements and herbal remedies.

Manipulation and body-based practices – includes chiropractic and osteopathic methods as well as massage therapy.

Energy medicine – includes reiki. therapeutic touch, qi gong and magnet therapy. These therapies focus on the invisible energy glow in our body.

Health professionals from all over the world have valid but varied and sometimes conflicting opinions about the effectivity of combining conventional medicine with complementary and alternative medicine in treating or preventing diseases.

Let’s talk about the specific category involved in my field of practice: Dietary supplements. It would be wrong for me to say that supplements are all good or all bad for our health. There are guidelines that we need to follow to ensure the safety and efficacy of these supplements. Overdosing is simply not beneficial or may even pose a threat to our health.

According to the Dietary Supplement Health and Education Act (DSHEA), dietary supplements refer to a broad range of products: vitamins, minerals, herbs or botanicals, amino acids, enzymes, hormones, concentrates, extracts and metabolites.

Let’s get one thing clear though. No amount or type of dietary supplement can replace the perfect combination of vitamins, minerals, phytonutrients, fiber and other substances we can get from “real” foods. Although, supplements can help improve nutrient deficiencies from poor appetite, very low caloric intake, diseases and malabsorption of nutrients.

Who needs to supplement?

• Women of child-bearing age can benefit from taking folic acid, a synthetic form of folate. Folate is abundant is fruit, vegetables and legumes.

• Women with heavy menstrual flow may need to take iron supplement. It should be taken on an empty stomach with water and vitamin C rich foods like citrus fruits to enhance absorption.

• Pregnant or lactating women may need more iron, folate and calcium if food intake is not sufficient.

• Menopausal women will benefit from calcium and vitamin D supplement to prevent osteoporosis.

• A person on a very low calorie or restrictive diet would need vitamin and mineral supplementation because he or she won’t likely get optimum nutrition from food intake.

• A vegetarian may need calcium, iron, zinc, Vitamin B12 and Vitamin D if intake of meat and dairy products are not enough.

• A person with lactose intolerance or very limited sunlight exposure will need calcium and Vitamin D supplementation.

• A person with a health condition that affects nutrient absorption due to medications, surgeries, injuries and etc. will need prescribed dietary supplements.

Before taking any dietary supplement, it is better to consult your nutritionist-dietitian and physician to prevent any health problems.

For comments email [email protected] or visit www.cheshireque.com. Twitter: CheshireQue

Almost everyone has taken a pill or two in their lifetime. When we’re sick, we just take the medication and pray that we get well soon. Little do we know that the medications we are taking may actually be detrimental to our health when paired with the wrong type of food or nutrient. As a Dietitian-Nutritionist, it is my duty to make sure my client’s food intake will support the efficacy of his or her prescribed medications. Today, I am sharing some common drug-nutrient interactions to you.

Antibiotics and Probiotics – Diarrhea and destruction of normal GI flora (good bacteria) in the gut causing depletion of B Vitamins are the side effects of antibiotic therapy. Probiotic drinks like Yakult, kefir and the like can help prevent these. However, it should be taken a few hours after ingestion of the drug as it contains live bacteria which will be killed by the antibiotic rendering the probiotic drink useless.

Antidiabetes and Vitamin B12 – Vitamin B12 helps maintain nerve cells and red blood cells. We get it from meat, fish and dairy products. The antidiabetic drug Metformin interferes with the absorption of Vitamin B12 intrinsic factor complex. The intrinsic factor is a protein that binds with Vitamin B12 to be absorbed in the small intestine. Calcium supplementation and annual injection of Vitamin B12 can correct this deficiency.

Aspirin and the 3Gs and 2Fs – I call them the 3Gs: garlic, ginger and gingko; and the 2Fs: Fish oil and Flaxseed oil. High doses of these supplements including Vitamin E can increase the risk of bleeding when taken with aspirin.

Antidepressants and Tyramine – Chocolate, alcohol, aged cheese, fermented food, processed meats, smoked fish, avocado and banana contain tyramine which interacts with Monoamine Oxidase or MAO inhibitors causing the blood pressure to dangerously rise.

Antihypertensives and Caffeine – Coffee, tea, caffeinated beverages and supplements do not cause hypertension but may oppose the effects of antihypertensive drugs giving inaccurate blood pressure readings. The blood pressure may temporarily increase within 30 minutes of consumption, peak in one to two hours and may last for more than four hours before blood pressure drops down to accurate reading. Avoid caffeine prior to having your blood pressure checked.

Anticoagulant and Vitamin K – Green leafy vegetables are rich in Vitamin K which causes our blood to clot when we get injured. Increased consumption of Vitamin K rich foods will counteract the effects of the blood thinning agent Coumadin (Warfarin). This condition can be life threatening.

Lipid lowering drugs and Grapefruit juice – Lipitor (atorvastatin) and Zocor help lower cholesterol levels. Grapefruit juice inhibits the breakdown of these drugs causing drug levels to rise in the blood for up to four days. All cholesterol lowering drugs interfere with the absorption of fat soluble vitamins A,D,E,K. There should be an interval of four to six hours when you take these drugs and vitamin supplements.

There are so many foods that interact with medications. It is best to consult your physician and seek the advice of a Registered Dietitian-Nutritionist to ensure that you are getting the right amount of nutrients to prevent nutrient deficiencies without compromising the therapeutic effects of your medications.

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Ten years ago, I was diagnosed with hyperthyroidism. My overactive thyroid was producing excessive hormones which made me lose so much weight, experience tremors, increased heart rate and made my eyes bulge (exophthalmos). It was horrible. I had to undergo Radioactive Iodine treatment to destroy the overactive thyroid tissues in my body. Sounds easy right? Well it wasn’t. The worst part was when I had to remove seafood and salt from my diet two weeks before my treatment. For someone who was highly dependent on salt to satisfy one’s palate, it was pure torture. My food tasted like paper.

All types of salt contain iodine a mineral that is needed by the thyroid glands to produce the hormone thyroxine. This regulates metabolism and growth. According to the World Health Organization (WHO), iodine deficiency is one of the three most common forms of micronutrient malnutrition affecting one-third of the world’s population.

Iodine deficiency can lead to irreversible effects such as mental retardation, impaired growth or low IQ among children born of mothers with this condition. It can also cause women to stop ovulating thus causing infertility. Lack of iodine in the diet can cause the thyroid to work harder which causes goiter characterized by neck swelling or bulging.

The Department of Health implemented the ASIN Law (RA 8172) in 1995 to promote salt iodization nationwide and eliminate Iodine Deficiency Disorder in our country. Ordinary salt is fortified with iodine. Fortification is a process of increasing the nutritive value of a food by adding a specific vitamin or mineral which will benefit the public.

Aside from being a good source of iodine, salt contains 40 percent sodium. An electrolyte that maintains fluid balance in the body. It also plays a great role in transmitting nerve impulses or signals and muscle contraction and relaxation.

Considering the benefits we get from salt, does that give us the go signal to eat foods high in sodium? Of course not! Excessive sodium intake can damage the kidneys, heart and liver. It can also cause high blood pressure. How much sodium do we need then? Limit sodium intake to 2,300 milligrams or one teaspoon salt per day. For ages 51 years and over, the maximum amount is 1,500 milligrams or 2/3 teaspoon of salt per day. We get sodium from various food sources like dairy products, meat and seafood. Even vegetables contain sodium! Most foods have natural or inherent sodium and most processed foods have additives that contain sodium (example: bread).

To limit sodium intake, use herbs and spices to add flavor when cooking and refrain from putting additional salt and seasoning on the table. It is also important to read nutrition or food labels of processed foods so let me help you understand the following sodium label lingo:

Sodium free – contains less than 5 mg of sodium per serving.

Unsalted or no salt added – means no salt has been added but may still contain inherent or natural sodium.

Low in sodium – contains 140 mg of sodium or less per serving.

Very low in sodium – contains 35 mg of sodium or less per serving.

Reduced sodium or less sodium – contains 25 mg of sodium or less compared to a similar product that has regular amount of salt added.

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There are countless information about nutrition and its role in disease treatment and prevention. Recently, nutrition is being recognized as something vital in promoting not only wellness but beauty as well. Thus the coined term Beautrition. There are a lot of tips on skin nutrition. However, not much information can be found on the consequences of nutrient deficiencies in relation to the health of our nails. Nails and nutrients? What do I care? You say.

According to the Mayo Clinic, your fingernails can provide clues to your overall health. Nail pitting characterized by small depressions on nails can be a sign of Psoriasis and other autoimmune diseases. Nail clubbing, the enlargement of the nail tips causing it to curve, can be a sign of low oxygen in the blood or lung disease. Spoon-shaped nails have depressions that can hold a drop of water and is a sign of iron deficiency anemia. Beau’s lines or indentations across nails can be a sign of zinc deficiency. White spots on nails can be indicative of iron or zinc deficiency. Detached nails can be a sign of thyroid problems. What i’m actually talking about right now is just the tip of an iceberg.

I regularly have my nails done. A habit I got from my late grandmother. I also love caviar. I eat it regularly. My eye cream and hand treatment have caviar on them too. So I was amazed when I discovered a place in Dasmarinas Village, Makati called St. Nails and their “caviar nails”. Intrigued, I had my nails covered in “caviar” textured nail polish for the first time. I happily went home thinking: “I’m blessed to have healthy and pretty nails!” It may seem shallow but for someone who had nail infection and brittle nails like I did many years ago when I was battling thyroid problems, you’d also be grateful when your nails are healed, healthy and pretty.

So how can we make sure that our nails get the right nutrients? Make a conscious effort to eat nail-friendly foods that are rich in iron, zinc, calcium, protein, Vitamin A, Vitamin C, Vitamin B12, folic acid and biotin everyday. These nutrients are essential in keeping our nails strong and healthy.

Here are some nail-friendly foods:

• Lean meat, fish and chicken

• Egg yolk and egg whites

• Milk and dairy products

• Green leafy vegetables

• Citrus fruits

• Legumes

Aside from eating these nail-friendly foods, it is recommended for you to drink about eight to 12 cups of water every day to help keep your nails well hydrated.

So whether you are a man or a woman and whether you like putting nail polish or not, always take time to thoroughly examine your fingernails. If you notice any peculiar changes or abnormalities, consult your physician. You might just be suffering from nutrient deficiencies. A nutritionist-dietitian can help you carefully make healthy food choices to correct and prevent any nutritional deficiency.

Say good-bye to ugly and unhealthy nails now!

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It was New Year’s eve and all I could eat was toasted bread. The toilet was my most favorite part of the house for days. I had food poisoning.

We don’t really think much about the way our food was prepared or handled as long as it tastes good. Only when we get stomach upset do we question and start to be more conscious about food safety and sanitation.

The United States Department of Agriculture defined food-borne illness or food poisoning as an illness that comes from eating contaminated food which presents itself as flu-like symptoms: nausea, vomiting, diarrhea or fever.

It is essential to be aware and share knowledge on how to prevent food poisoning to our family members and food handlers (e.g. cook, helpers).

Here are some tips on food safety and sanitation:

HAND WASHING – Let’s get back to basics. There is a reason why we were taught how to wash hands before eating when we were in nursery school – to prevent getting sick! Before and after handling any food, wash hands under running water with soap for 20 seconds. Rub your fingers, fingernails and all the way up to your wrists. Wipe your hands with a clean dry towel or disposable napkins.

CLEAN – Sanitize kitchen counters and sink with hot water before and after food preparation. Wash utensils properly before and after using. Use warm water and soap to clean chopping boards or anything that came in contact with raw meat or food. Wash fruits and vegetables in running water. Remove outer layer of leafy vegetables before serving. Scrub firm-skin fruits like melons before cutting. Before opening canned foods and drinks, wash with soap and water.

SEPARATE – Prevent cross-contamination by using different chopping boards, plates and utensils in preparing raw, dry and cooked food. Have one chopping board for fresh produce only and another one for meat and seafood. Separate items in your grocery cart and the refrigerator. I put two baskets in my grocery cart: one for fresh produce and one for meat and seafood. This will prevent meat juices from dripping onto fruits and vegetables.

TEMPERATURE – Keep cold foods cold (below 40°F) and hot foods hot (above 140°F). Thaw frozen food in the refrigerator overnight. Cold water or microwave can also be used but food must be cooked immediately. After purchasing meat and seafood, separate in small containers before storing within two hours. This will prevent a cycle of thawing and storing when you need to cook small portions only. When marinating, keep in the refrigerator until cooking time. When reheating sauces, make sure you bring it to a boil. Cook eggs until firm. Never eat eggs that are undercooked or runny. I have clients who said their “quack” doctor prescribed six raw eggs a day. Salmonella alert!! Raw eggs should never be eaten! Inspect for cracks, wash eggs and remove dirt before cooking. Discard eggs with cracks. Chances are they’re contaminated. Store fresh eggs in the refrigerator and consume within three weeks.

Always remember: it’s better to be safe than sorry. Practice food safety wherever you are.

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Are you allergic to the word EXERCISE? You’re not alone. It feels good to lie down on the couch, watch TV and eat popcorn right? Some clients come to my clinic and say: “I don’t want to exercise!”

We don’t want to exercise due to a number of reasons.  Lack of time tops the list. We all know we need to exercise but we can’t seem to find the time to do it. Cost is another reason because we think that exercising is all about enrolling in an expensive fitness program. Low self-esteem is another culprit because we get self-conscious when we start to compare our bodies with other people who look good in their workout clothes. Lack of motivation or indifference make us fail to see the benefits of exercise.

According to WHO, 60 to 85 percent of people in the world—from both developed and developing countries—lead sedentary lifestyles, making it one of the more serious yet insufficiently addressed public health problems of our time. Approximately two million deaths per year are attributed to physical inactivity, prompting WHO to issue a warning that a sedentary lifestyle could very well be among the 10 leading causes of death and disability in the world.

Physical activity refers to any body movement that requires energy expenditure or burning of calories. On the other hand, exercise is a planned and structured type of physical activity.

Don’t expect a sedentary person to start exercising two hours every day. One’s mind and body need to be properly conditioned and slowly adjusted to a more active lifestyle. Having an intense workout when you’re not used to it will be detrimental to your health. Take it one step at a time. Start with 10 minutes of physical activity everyday until you build strength and stamina so you can increase the duration and intensity of your physical activity. Brisk walking, climbing the stairs, dancing, video exercises, cleaning the house, washing the car, grocery shopping, biking are good examples.

The American Heart Association recommends a total of 150 minutes moderate physical activity (eg. walking) and 75 minutes vigorous activity (running) per week. 10 to 15 minute cycles three times a day or 30 minute cycles five times a week makes it easier for busy people to include exercise in their daily routine.

I came across a social mobilization project called “Be Fit Kahit Busy Galaw Galaw Pag May Time.” This campaign was initiated by a group of graduate Development Communication students from the University of the Philippines Open University to encourage people to stay fit despite hectic working schedule through proper and simple exercises that can be conveniently done in the workplace.

“We launched this campaign using the social networking sites with the desire that this becomes viral and shall be accessible to all those employees trying to maximize work with a time to be fit without having to miss responsibilities at work,” explained Leonard Calma, team leader of the DEV208 Master in Development Communication class.

What are you waiting for? Get Moving!

Visit https://www.facebook.com/BeFitKahitBusy for guidelines and updates.

For comments and suggestions, email [email protected] or visit www.cheshireque.com. Twitter: CheshireQue

Sunday noon, I got a frantic phone call and all I heard was “V-tach” short for Ventricular Tachycardia, a life-threatening condition. I thought: “Oh God, please make my aunt Remy live. She’s too young to die!” I felt weak as I remembered my mom suffering from the same condition and being confined in the ICU for weeks until we finally found a Cardiac Electrophysiologist who was able to correctly diagnose and treat her condition. Doctors specializing on this heart condition come few and far between in our country.

Think of the human heart as a peaceful two-storey home made of four rooms called heart chambers. The “parents” give orders from the “second floor” and the “children” take orders from the “first floor.” Each regular heartbeat starts with electric signals sent by the sinoatrial node or “the parents from the second floor.” V-tach occurs when the “children in the first floor” rebel and start firing electric signals causing a fast heart rate. The heart doesn’t have enough time to fill with blood thus failing to pump blood throughout the body.

Normal heart rate is 60 to 100 beats per minute. My mom and aunt both had 200 plus beats per minute! Common symptoms are dizziness, lightheadedness, unconsciousness and cardiac arrest which happens when the heart stops pumping blood effectively.

V-tach has various causes such as lack of oxygen in the heart due to some blockage or decreased coronary artery blood flow, distortion of the heart’s structure or cardiomyopathy, medications and inflammatory disease.  It can also be idiopathic or unknown.

How can you mend a broken heart?

There are various modes of treatment but I will just talk about the one I’m familiar with since my mom had undergone this procedure years ago. According to the American Heart Association, Transcatheter Ablation is rapidly becoming the treatment of choice. A team of doctors conducts an electrophysiologic study to find the “rebellious children from the first floor” that’s causing chaos. A catheter or a long cord is inserted all the way to the heart. This allows the doctors to find and silence the “rebellious children” by performing electrocautery. Have you ever tried having facial warts removed by your dermatologist using cautery? Go figure.

V-tach is a type of arrhythmia or heart rhythm problems causing the heart to beat too fast, too slow or irregularly. It is often caused or worsened by a weak or damaged heart. the Mayo Clinic recommends a heart-healthy lifestyle to reduce risk of arrhythmia.

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“Adapt a heart-healthy lifestyle by eating heart-friendly foods that are low in saturated fat and cholesterol; high in fiber; high in Omega-3; rich in potassium, magnesium and calcium. Regularly eat whole grains, soy products, non-fat dairy products, fatty fishes, fruits and vegetables.

Avoid substances that may cause irregular heartbeat: caffeine and alcoholic beverages; tobacco, appetite suppressants; and street drugs.”

Be healthy, be heart-friendly!

For comments and suggestions: email [email protected] or visit [email protected]. Twitter: CheshireQue.

Wellness beyond weight loss

From the bottom of my heart’s fats…