THE G.I. FACTOR: PREVENTING TYPE 2 DIABETES
Most people who develop type 2 diabetes have a tendency to be unable to produce enough insulin to control their blood sugar levels. Remember, high G.I. foods increase the amount of insulin the body needs, so, for those people susceptible to diabetes, eating carbohydrate with a high G.I. factor will only increase the demand on their already struggling pancreas.
Who is likely to be at risk? People who are over the age of 50, have a family history of diabetes, are overweight, have high blood pressure or have had diabetes during pregnancy (gestational diabetes) are at risk of developing type 2 diabetes. A reduction of the G.I. factor of their diet, reduces the demand on their pancreas to produce more insulin, perhaps prolonging its function and delaying the development of diabetes.
If you fit into one of these categories, you can reduce your chances of getting diabetes by controlling your weight, exercising more and eating more foods with a low G.I. factor.
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FAT LOSS – BEHAVIOURAL INFLUENCES: IMPLICATIONS
1. The purpose of counselling is to empower clients so that they can develop an awareness of their habits, prioritise those things to work on and be selective about those techniques most appropriate for the task.
2. Fat loss leaders need to develop a close liaison with professional psychologists for referring complex cases.
3. In dealing with habits, the first stage is to develop an awareness of the components of the habit.
4. There is a range of techniques for changing behavioural habit patterns including interrupting stimulus-response connections, changing the stimulus, reinforcement and self-monitoring. Not all techniques work for all people.
5. Negative thinking habits can be worked on using standard psychological techniques such as rational emotive therapy, positive thinking, etc.
6. Behaviour modification and cognitive therapy techniques need to be maintained over the long term and not just used in the initial stages of fat loss. This takes longer than most people anticipate and a realistic expectation is important.
7. It should be assumed that the majority, if not all, overfat problems require at least a modicum of change in habit patterns. The degree to which this is so and the types of approaches used to combat these will depend on the individual and the circumstances.
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MACRONUTRIENT BALANCE
There is some inter-conversion between nutrients such as protein being converted to glucose (gluconeogenesis) for release into the bloodstream, but under normal conditions, the capacity to convert one nutrient into another for storage is very limited. Also, humans have little capacity to ‘waste’ extra energy by burning it off. This process, which has been termed luxuskonsumption, is common in animals such as rats but is very limited in humans. Therefore, the examination of each macronutrient as a separate entity is necessary and is summarised below.
Carbohydrate. Carbohydrate stores (glycogen) are very small and tightly controlled in the body. Only relatively small increases in glycogen storage capacity can be gained, for example by the carbohydrate loading techniques employed by endurance athletes, which may increase stores by up to 2,5 times the normal amounts. Carbohydrate calories from the diet keep this small storage space topped up but are mainly used for current energy needs and displace fat as an energy source. Carbohydrate is, therefore, a second priority fuel for energy use, after alcohol. Unlike alcohol and fat, carbohydrate and protein are the main regulators of appetite by satisfying hunger and producing satiety. While the exact mechanisms for this are not known, parts of the complex cascade of responses are being discovered and they appear to involve stretch nerve fibres in the stomach, hormones released from the gut, increases and decreases of certain nutrients in the blood, and a whole series of neurochemical responses in the brain. The final target for appetite control is in the hypothalamus in the brain. Carbohydrate, like protein therefore, is ‘fully balanced’ by influencing both its own burning and satiety mechanisms.
Myth-information. ‘Fat metabolisers’, which are generally forms of amino acids, are often claimed to ‘convert fat to body fuel’. However, scientific assessment shows they are substances which are easily synthesised by the body and have no effect on body fat.
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BABY AND CHILDHOOD RESPIRATORY DISORDERS: HAY FEVER (ALLERGIC RHINITIS)
Hay fever may occur in the first year of life but is more common after one or two years. It commonly occurs at certain seasons when the child breathes in certain particles (usually pollens from grasses and trees) to which he or she is sensitive. At other times the child may be constantly allergic to other material regularly present in the air (such as house dust).
The common symptoms are an itch of the eyes, nose, throat and ear lobes. There may be coughing, sneezing, probably wheezing. This may be accompanied by heat of the affected parts. Attacks may come on suddenly, in certain seasons, or at certain times of the day. Headaches, nosebleed, recurrent sore ears may occur. Often there is a nasal discharge, and frequently the eyes smart and water.
Treatment
It is another form of allergic reaction, and avoiding as much as possible the known troublemakers is the best idea. Keep away from house dust (if known to cause symptoms); avoid venturing outdoors as much as possible on dusty windy days, particularly when pollens to which the child is sensitive are in the air. Spring and summer, and maybe autumn, are often trouble times—it depends largely when the offending pollens are in the atmosphere in the greatest quantities. Frequently pollens may come from grassing areas many hundreds of kilometres away; these may be carried to city areas by prevailing winds and upper air currents in an amazing manner.
Give the child plenty of fluids to drink. They tend to dilute or wash away histamine from the system, the chemical that is liberated by the allergens and the basic cause of the adverse reactions.
Cold packs to affected areas can often give relief. Icy cold packs to the eyes, ears, skin and itchy irritating areas may assist. Applying anti-itch creams and lotions can also bring relief—for example, Eurax cream, Calistaflex, or Liniment calamine containing benzocaine 3 per cent (be sure to keep it away from eyes).
Antihistamine tablets or liquids for younger children often neutralize the histamine and reduce symptoms. But this often makes the child drowsy, so care in avoiding accidents is essential afterwards. Often a good long sleep will follow, which in itself may be beneficial.
In recent years, excellent preventive measures have become available. As with asthma, sodium cromoglycate capsules placed in an insufflator (a rubber bulb) enable the powder to be inhaled into the nose. Long-term use (at the critical times when symptoms most commonly appear) may often reduce their frequency and severity.
More recently, beclomethasone dipropionate (Beconase inhaler) may similarly reduce the severity when inhaled. It takes up to 14 days for these preventive measures to exert their full benefit. They will not give immediate relief from an attack, and they are not designed to. They are to be used as a preventive measure.
Ephedrine was often used in the past, and may still be used by some doctors for mild cases. Various synthetic derivatives are now often used instead of ephedrine itself.
Some doctors find that discovering the allergen by performing allergy tests and then desensitizing the patient is a successful way in which to increase the body’s inbuilt immunity to future attacks. In the main, however, this system is not popular, for it involves regular weekly or bi-weekly visits to the doctor for injections—not a popular pastime for children of any age, as most parents would agree.
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BABY AND CHILDHOOD ILLNESSES: LEARNING DIFFICULTIES (INCLUDING HYPERACTIVITY AND DYSLEXIA)
All children are born with a basic urge to learn. What happens is governed both by inherited capability and by local, external influences. A person’s intellect grows and it is a cumulative process. Early stimulation is vital, and ideally the child is exposed to a variety of stimulating experiences from birth. Education starts at home, and the years before school commences are probably the most important in the entire life of the child.
The most frequent cause of serious delay and difficulty in learning is mental subnormality. But another important cause is a slowness in maturation. Some children learn to acquire some skills much quicker than other skills, and much more rapidly than other children. Children with a late puberty are often slower at learning.
Sometimes learning difficulty may be associated with a condition called minimal cerebral dysfunction, claimed to be a consequence of inadequate oxygen reaching the brain at birth. This may result in the so-called hyperkinetic syndrome (commonly known as hyperactivity). The child is often restless, on the move all the time, has a short attention span, is impulsive and clumsy and emotionally unstable. He or she rejects discipline and finds ordinary duties irksome. Often it is very difficult to cope with these fellows at school. (See below under Hyperactivity)
Some children have difficulty with words. Many normal persons have been through a stage of stammering (but have ultimately done all right), simply because for them piecing words together was difficult—just as other children were perhaps slow in learning to walk or to control their urine or to ride a bike. Sometimes the stuttering persists, and in certain cases it may represent a mild degree of brain damage.
Dyslexia means difficulty in reading; dysphasia is difficulty in learning how to speak; dysgraphia is difficulty in writing. There are all manner of variations to these disorders.
Treatment
It is essential that any speech difficulty be carefully checked by a doctor to establish whether there is any neurological disability. Then an assessment by an educational psychologist who can manage the child is essential. There are many problems and difficulties, but a reasonable outcome is often possible.
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