Would you get enough magnesium in what you eat? Did you know it could aid the prevention of diabetes? Research suggests diabetes risk may fall as magnesium intake increases.

Dr. Ka He from the University of North Carolina at Chapel Hill and colleagues have realized that men and women who consumed the most magnesium from foods and vitamin supplements were about half as likely to develop diabetes over the next two decades as individuals who took in the least magnesium.

Inside their study, they viewed magnesium intake and diabetes risk in 4,497 men and women aged 18 to 30 years old, none of whom were diabetic in the study’s outset. During a 20-year follow-up period, 330 of the subjects developed diabetes.

People with the highest magnesium intake were 47 percent less likely to develop diabetes compared to those with the lowest intakes (average of 100 milligrams of magnesium per 1,000 calories).

The study noted, however, that large clinical trials testing the results of magnesium on diabetes risk are needed to determine whether a causal relationship truly exists.

The outcome of the study could explain why consumption of whole grains, which are an excellent source of magnesium, is linked to lower diabetes risk. Although whole grains are a common supply of magnesium, there are many other sources of magnesium to take into account.

Green vegetables including spinach are fantastic sources because the center of the chlorophyll molecule (which gives vegetables their color) contains magnesium. Some legumes (beans and peas), nuts and seeds, and whole, unrefined grains are also good sources.

Regular water can even be a source of magnesium, however the amount varies according to the water supply. Water that naturally contains more minerals is described as “hard.”

The proposed motives why an increased intake of magnesium could lower the risk for developing diabetes vary, but according to the National Institutes of Health, Magnesium plays an important role in carbohydrate metabolism. It may influence the release and activity of insulin, the hormone that helps control blood glucose (sugar) levels.

The lesson? Increasing magnesium intake might be necessary for improving insulin sensitivity, reducing systemic inflammation, and decreasing diabetes risk.

And you? What are you awaiting? Begin right now to introduce more magnesium rich foods as part of your daily diet!

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Sodium and potassium are two major electrolytes.  Potassium is the major intracellular cation. Total body potassium content is approximately 50
mEq per kilogram body weight.  Potassium assists in muscle contraction and in maintaining fluid and electroltyte balance in body cells.  Potassium is also important in sending nerve impulses as well as releasing energy from protein, fat, and carbohydrates during metabolism.

Due to illness, however, some people need to restrict their dietary potassium intake and some people may actually need to increase their intake.  In HYPOKALEMIA (condition in which the concentration of potassium in the blood is low), it is very necessary to increase the intake of potassium.  Also, in case of  HYPERKALEMIA (condition in which the concentration of potassium in the blood is high), potassium intake has to be restricted.

Therefore, it is very essential to know potassium content of foods.

Potassium content of vegetables per 100 gm of edible portion by Dietetics Department CMC, Vellore, India

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The Zone Diet is a weight loss regime designed by Dr. Barry Sears.  Zone Diet was popularized through the book “Enter the Zone” in 1995, which was written by Dr. Sears.  In Zone diet, it is suggested that the individual should obtain energy from Carbohydrate, Protein, and Fat in the ratio of 40:30:30 respectively at each meal.  This helps the individual to reduce weight.  Studies have shown that people on Zone Diet not only lost weight, but gained muscle mass and they experienced less fatigue and other adverse effects associated with weight loss regime.  It is also very effective for individuals with type 2 diabetes.  However Zone Diet is harmful for infants, children, adolescents, and pregnant and lactating women.  Zone diet is not beneficial for athletes.

Manuel Uribe of Mexico who weighed around 597 kgs was considered as heaviest man in medical history and by Guinness Book in 2006.  By October 2008, he lost several pounds with the help of Zone Diet and even got married on 26th October with his longtime girlfriend Claudia Solis.

Zone Diet includes foods like fresh vegetables and fruits, nuts, leafy green vegetables, sufficient amount protein, and eight glasses of water everyday.  Not like other weight loss regimes, Zone Diet does not restrict calories intentionally.  Instead the total amount of food eaten per day is based on the individual’s protein requirements determined by the dieter’s body weight, percentage of lean body mass, and level of physical activity.  Once the daily protein requirement has been calculated, the dieter must divide the total amount of protein among three meals and two snacks and determine his/her allowable amount of carbohydrate and fat intake .Dr. Sears suggests that Zone dieters should never go more than five hours without a meal and should try to eat no more than 500 calories per meal or 100 calories per snack.

FOODS ALLOWED:

• Proteins: Chicken , soy foods, legumes (includes protein from both animal and vegetable source but low in dietary fat)
• Fats: Olive oil, canola oil, avocados, oatmeal, evening primrose oil, borage oil, and fish oil.
• Carbohydrates: Fresh fruits and vegetables low in glycemic index, whole wheat flour products, etc.

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Ideal body weight (IDW)/desirable body weight (DBW) are terms used by the insurance companies to describe weights that are associated with least mortality.

Ideal body weight (IDW)/desirable body weight (DBW) can be calculated by using:

BROCA’S INDEX:

IBW FOR ADULT MALES = Height in Centimeters minus 100

IBW FOR ADULT FEMALES = (Height in Centimeters minus 100) minus 10 % of (Height in centimeters minus 100)

SECOND FORMULA FOR IBW:

IBW FOR ADULT MALES = Height in meter square X 23 X 1.1

IBW FOR ADULT FEMALES = Height in meter square X 23

Table of IBW of Female & Male

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Esophagitis usually occurs in the lower esophagus as a result of irritating effect of acidic gastric reflux on the esophageal mucosa.  The common symptom is heartburn (burning epigastric substernal pain).  Other symptoms are regurgitation and dysphagia.

Types of Esophagitis:

Acute Esophagitis: Caused by ingestion of an irritating agent, viral inflammation, or incubation of Ryle’s tube.

Chronic Esophagitis: It is a result of recurrent gastroesophageal reflux owing to hiatal hernia, reduced LES pressure, increased abdominal pressure, and recurrent vomiting.  LES pressure is reduced due to pregnancy and also in women taking progesterone containing oral contraceptives.  Certain foods like alcohol, peppermint, spearmint, chocolates, and caffeine-containing beverages lower the LES pressure.

The severity of the Esophagitis resulting from gastrointestinal reflux is influenced by the content of the gastric reflux, mucosal resistance, and clearing rate of esophagus as well as the rate of gastric emptying.

Nutritional Management of Esophagitis:

The objectives of nutritional care are to

• Prevent irritation of the inflamed esophageal mucosa in the acute phase.
• Prevent esophageal reflux
• Decrease the irritating capacity or acidity of gastric juice.

Measures:

• Avoid foods that are known to cause heart burn.
• Eat small, frequent meals to prevent stomach distention and resultant gastric acid secretion.
• Avoid high-fat meals and decrease fat in diet.
• Avoid chocolate, alcohol, and caffeine containing beverages such as tea, coffee, cola drink, etc.
• Avoid peppermint and spearmint oils.
• Avoid lying down, bending over immediately after meals.
• Avoid eating with 2-3 hours of going to bed.
• Avoid tight fitting clothing especially after meals.
• Reduce weight if overweight.
• Avoid or quit cigarette smoking.

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Pernicious anemia is a macrocytic (larger than normal RBC) and megaloblastic (immature, abnormal RBC progenitors in the bone marrow) anemia.  Pernicious anemia is caused by a deficiency of vitamin B12 (Cobalamin).  Generally, vitamin B12 deficiency occurs due to lack of Intrinsic Factor –IF.  Intrinsic Factor is a glycoprotein in the gastric juice that is necessary for the absorption of dietary Vitamin B12. It is very rare that B12 deficiency occurs due to lack of dietary intake because of it is wide spread occurrence in all animal foods and synthesis by intestinal flora.

Intrinsic Factor is secreted by parietal cells of gastric glands. It helps in the absorption of B12 by binding it tightly. In the bound state the B12 is protected from digestion by the gastrointestinal enzymes. In the bound state the Intrinsic Factor binds to specific receptor sites on the brush border membranes of the mucosal cells in the Ileum. Finally B12 is transported in to the blood by the process of pinocytosis carrying the Intrinsic factor and the vitamin B12 together through the membrane.

Once B12 has been absorbed from the gastrointestinal tract it is stored in large quantities in the liver & then released slowly as needed to the bone marrow and other tissues of the body .The total amount of vitamin B12 required each day to maintain normal red cells maturation is about 5 micrograms and the normal store in the liver and other body tissues is about 1000 times this amount . Therefore as many as 4 to 5 years of defective B12 absorption are required to cause Pernicious anemia.

Deficiency of vitamin B12 can result in a deficiency of Folic Acid by causing the entrapment of Folate as 5-methyltetrahydrofolate. The methyl group of 5-methyltetrahydrofolate is transferred to Cobalamin (B12) to form Methyl Cobalamine and the folate is returned to the folate pool to further take part in one carbon transfer reactions . In case of deficiency of B12 folate remain trapped with the methyl group it’s further functioning is impaired.

Due to B12 & folic acid inter related roles in the protein synthesis a deficiency of either B12 or Folic Acid will result in megaloblastic anemia. However in B12 deficiency there is an impairment of microbicidal activity of leukocytes .The function of leukocytes is not impaired in Folic acid deficiency. Also due to B12 deficiency gastrointestinal tract, peripheral & nervous system are also affected .Numbness & tingling in the hands & feet, poor muscular coordination, poor memory & hallucinations are some symptoms of B12 deficiency. If the deficiency continues long enough, the nervous system damage may be irreversible even with treatment.

Nutritional Care in Pernicious Anemia:

A high protein diet (1.5 Gm/Kg of body weight) is desirable. Green leafy vegetables should be included in diet. In non vegetarian food items, liver is the richest source of vitamin B12 so it should be included in diet. Beef and pork, eggs, milk and milk products are good sources of vitamin B12, although the cholesterol content should be considered.

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