By Dr Harold Gunatillake FRCS- Health Writer

Nine out of 10 persons love eating seafood and especially shrimp. However, most shrimp lovers fear that the high Cholesterol in shrimp may produce artery blocking plaques – a main cause for heart attack. Even doctors have been advising old people not to eat shrimp.
As with all seafood, shrimp is high in calcium and protein, but low in food energy. A shrimp-based meal is also a significant source of cholesterol from 7 mg to 251 mg per 100 g of shrimp, depending on the method of its preparation.
However, many people do not know that Shrimp cholesterol actually reduces its bad counterpart l in our body and that they can enjoy tasting shrimp as part of their balanced diet.
Cholesterol travels through the blood stream in lipoprotein, commonly known as plump little fat and protein packages. The fat part of the cholesterol is “bad Cholesterol” or Low-Density Lipoprotein (LDL). The packages are “Good Cholesterol” or High -Density Lipoprotein (HDL).
Good Cholesterol helps to discharge cholesterol into the liver excreting and reducing total cholesterol level in the blood stream.
Cholesterol from food is harmful only if the body absorbs it. Saturated fat such as meat, eggs and dairy foods help speed up LDL and cholesterol absorbing process.
The high level of cholesterol in shrimp, however, has only slight saturated fat (1 gram per serving when compared to 20 grams in beef). The body cannot absorb easily the cholesterol in shrimp like it does with other high fat food. However, the reason is still unknown.
In the past, food scientists could not differentiate the cholesterol. Therefore, they measured all of them as ‘Cholesterol’. Today we can differentiate cholesterol from bad LDL and good HDL.
Eating shrimp will certainly increase the total cholesterol level in comparison to taking in a low cholesterol diet. Yet, shrimp cholesterol increases HDL more significantly than LDL and renders a better cholesterol balance between the two.
Food technologists have all agreed that a healthy diet may include shrimp. They however say to avoid deep-fried foods, limit the amount of oil and not to take much food with butter, tartar sauce, and mayonnaise.

By Dr Harold Gunatillake FRCS- Health writer

Heartburn is a descriptive term used commonly when one experiences a burning sensation behind the heart. Sometimes, one finds it difficult to differentiate between heartburn due to leakage of stomach acid into the gullet (oesophagus), and discomfort arising from angina pain with coronary blood floor insufficiency. Most patients run through tests to find out whether they have a heart problem and the doctor will then tell them that it is GERD (gastro-oesophageal reflux diseases). However, seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill-feeling.

Occasionally, GERD is also manifested as a chronic recurrent cough which can go undiagnosed for a long time. This symptom is due to the reflux of acid juice to the throat causing irritation and inflammation.

GERD or heartburn is made on a clinical diagnosis when your doctor ask you detailed questions about the nature and pattern of your pain. Is it worse after you eat a heavy meal or eating certain foods, such as high fat foods, dairy products, or spicy food, or drug related, as after taking aspirin? In most situations heartburn comes on when you sleep on your back or turning to your right side in bed. You would get heartburn pain when you bend and tie your shoe laces as well.

If your symptoms are typical for gastroesophageal reflux (GERD, or simply, reflux), the first step is usually to try a medication such as omeprazole or lansoprazole. If symptoms improve, you switch to a less powerful medication. That might be an H2-receptor antagonist (H2 blocker) such as cimetidine (Tagamet), ranitidine (Zantac), or famotidine (Pepcid), or an antacid containing at least one of the four ingredients: Sodium, Calcium, Magnesium and Aluminium.

Antacids make you feel better by increasing the pH balance in your stomach. The pH system is a scale for measuring the acidity or alkalinity of a given environment (in this case, your stomach). The scale goes from 0 to 14. A pH of 7 is neutral. Below 7 is acid. Above 7 is alkaline.

Normally, the acid level in your stomach is about 2 or 3. Trouble may start when your pH drops below those numbers. To make you feel better, an antacid does not bring the pH level all the way up to 7 (neutral), which would be a highly unnatural state for your stomach. All the antacid has to do is get you to 3 or 4. It does this by neutralising some of the excess acid.

Your doctor may suggest some tests to confirm the clinical diagnosis of GERD, or rule out other possible causes for your symptoms.

What is Omeprazole?
Omeprazole (Prilosec) belongs to group of drugs called proton pump inhibitors. It decreases the amount of acid produced in the stomach.
Omeprazole is prescribed for symptoms of Gastroesophageal Reflux Disease (GERD) and other conditions caused by excess stomach acid. It is also prescribed to heal erosive esophagitis (damage to your oesophagus caused by stomach acid).

Omeprazole may also be given together with antibiotics to treat gastric ulcer caused by infection with helicobacter pylori (H. pylori).
Omeprazole is not for immediate relief of heartburn symptoms.  It may also be given for other purposes.

You should not take this medication if you are allergic to omeprazole or to any other benzimidazole medication such as Albendazole or Mebendazole. Omeprazole is not for immediate relief for heartburn symptoms. (ref: healthinsite)

Ask a doctor or pharmacist if it is safe for you to take omeprazole if you have liver disease or heart disease, or low levels of magnesium in your blood.
Some conditions are treated with a combination of omeprazole and antibiotics. Use all medications as directed by your doctor. Read the medication guide provided with each medication. Do not change your doses without your doctor’s advices.

Take omeprazole for the full prescribed length of time even though your symptoms may improve before the infection is completely cleared.
Prilosec OTC (over-the-counter) should not be taken longer than 14 days in a row. Allow at least four months to pass before you start another 14-day treatment.

Some people taking omeprazole may have an increased risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly with people taking omeprazole long term or at high doses, and with people who are above age 50. Omeprazole may not be the actual cause of increased fracture risk. Before you take this medication, tell your doctor if you have a bone disorder.

What is Lansoprazole?

Doctors prescribe lansoprazole to east Gastroesophageal Reflux Disease (GERD) symptoms and to prevent further damage to the oesophagus. Lansoprazole is also prescribed to treat ulcers (sores in the lining of the stomach or intestine), to prevent more ulcers from already healed ones, and to decrease the risk of developing ulcers with people who are taking nonsteroidal anti-inflammatory drugs (NSAIDs). Doctors also prescribe lansoprazole to treat stomach producing too much acid, such as Zollinger-Ellison syndrome. It is prescribed with other medications to treat and prevent stomach ulcers caused by a certain type of bacteria (H. pylori). Over-the-counter lansoprazole is taken for frequent heartburn (occurs two or more days per week). Lansoprazole is in a class of medications called proton pump inhibitors. It decreases the amount of acid made in the stomach.

How do you get heartburn?

Normally, a muscular valve called the lower oesophageal sphincter (LES) opens to allow food into the stomach (or to permit belching); then it closes again. Then the stomach releases strong acids to help break down the food. But if the lower oesophageal sphincter opens too often or does not close tight enough, stomach acid can reflux or seep back into the oesophagus, damaging it and causing the burning sensation we know as heartburn.

Not only can stomach acid in the oesophagus cause heartburn, but it can also cause ulcers, strictures (narrowing) of the oesophagus, and cancer of the oesophagus.

Lifestyle changes necessary Over-eating especially the night meal may cause heartburn in bed. Have a light meal early and retire to bed late. Eat small meals more frequently like the Chinese to neutralise the gastric juice.
Eating certain foods, including onions, chocolate, peppermint, high-fat or spicy foods, citrus fruits, garlic, and tomatoes or tomato-based products may cause heartburn.

Drinking certain beverages, including citrus juices, alcohol, caffeinated drinks, and carbonated drinks may cause heartburn.

Getting slim is important. Obese people’s valve mechanism at the junction of oesophagus and stomach may not work properly, (cardiac may not function efficiently in obese subjects).

Smoking increases acid secretion, so give it up totally.

Wearing tight clothes, tightening with a waist belt may exacerbate episodes.
Always rest your head on at least three pillows. Sitting up position relieves the condition.

Alcohol and certain medications like anti-inflammatories, and aspirin can bring about heartburn.

Avoid constipation and straining in the toilet. Eating high fibre diet and fruits may help.

Most people can control their GERD taking the necessary precautions and change in lifestyles. A few may need surgery.

Surgery for GERD may become necessary:
• When medical or drug treatment has failed to control symptoms
• When the sphincter muscle is unable to work properly
• When oesophageal cancer develops from chronic GERD
Stay slim and active.
Avoid diets that bring it along.
(Courtesy:WebMD)

By Dr Harold Gunatillake FRCS- Health writer

Tropical countries are blessed with a miraculously functional versatile tree and its every part is beneficially useful to the mankind. The nature protected it even with the Tsunami on December 26 few years ago. Why these tall swaying flexible palm trees grow specifically in the tropics and the Pacific basin is something to think about: it never grows or grown in the US and the UK.

In the United States prior to the 1950s people cooked and baked with the mported coconut oi and some USA food industries used coconut oil to their productions. In 1958 Ancel Key, a scientist, making a research called ‘Seven Countries study’, has told that saturated fats were a major cause of heart diseases.

Keys encouraged people to eat less saturated cholesterol free fat to prevent heart attacks. Due to his continuous propaganda he became very famous. He once said to show how famous he was, “There’s a little hotel in Brussels that my wife and I stop at now and then, and every time I go in there the maître d’, a lady in her sixties, says, ‘Ah, Monsieur Cholesterol!’”

Since Coconut oil is considered a saturated fat, it became very unpopular especially because the propaganda spread by Soy and Corn oil producing giants. They stated that both corn and Soy oils are unsaturated and they were quite heart healthy. Sale of coconut oil in the United States dropped to less than one percent and they were taken only by the soap and cosmetic industries.

Today the table has turned over, when MaryEnig, Nutritionist and consulting editor to the Journal of the American College of Nutrition said that the coconut industry has suffered more than five decades of abusive rhetoric from the American Soybean and Corn Associations and other members of the edible oil industry, and from those in the medical and scientific community.

Coconut oil, medium chained fatty acids, has been now proven to cause no cholesterol increase in the body giving it more health benefits. The US food industry now takes coconut oil to their products and the Americans take coconut oil for their domestic purposes.

Even coconut diets for slimming are now advertised in USA newspapers and women’s magazines.

The USA has gone even further promoting coconut water as a refreshing drink that reduces heart disease. More than 71% coconut water drinkers have controlled their blood pressure and today for many, it is a popular sports energy drink as well.

Drinkng Coconut water   rejuvenates feeling, especially in the tropics where people become dehydrated pretty fast.

Green coconut shelled young fruits (kurumba), seem more refreshing than the orange coloured ones (tambili, King coconut) freely available on the wayside boutiques in bunches. The green coconuts are rarely seen on the wayside as they are taken to extract milk from its meat for domestic purposes and to produce oil from the dried meat (copra). People put even coconut water into dishes.

The young coconut water offers a long and growing list of health benefits.
It is a powerhouse having natural electrolytes, vitamins, minerals, trace elements, amino acids, enzymes, antioxidants and phytonutrients. Water in both green and orange coconuts gives the same nourishment.

Coconut water is about 95 percent clear water. It is secreted by the meat (endosperm or kernel), the white thick fleshy meat inside of the shell. The kernel or the endosperm is soft and jelly like in the young coconut and becomes more hard and fibrous with time. People scrape off it and extract the milk out of it for curry preparations.

Jelly like meat of the young green coconut with the coconut water is a most nourishing drink, especially when cooled in the refrigerator for a few hours.
‘Thambili’, (king coconut), common in Sri Lanka, is smaller than other coconuts. Sri Lankans regard its nuts as a living pharmacy since it is the most versatile and medically practical, easily available coconut. Daily, Sri Lankans sell and consume thousands of them.

Compared to the artificially coloured and flavoured aerated water the natural coconut drink refreshes and purifies more the body. In many Sri Lankan Ayurveda remedies that are taken to clear out impurities in the system the king coconut is a significant part.

King coconut water has been taken from time immemorial as an Ayurvedic cure. One of the most common cures is a mixture of ‘aralu’ powder (myrobalan) with the water of a king coconut. This concoction acts as a very effective laxative. The blood purifying wonder was discovered centuries before the modern chemical and herbal alternatives were found.

Since the king coconut water is naturally sterile it is a good substitute for saline. In World War II, American and Japanese military doctors injected king coconut water to patient instead of injecting them sterile glucose solutions.
In 1960s, Sri Lanka ran short of saline and the doctors gave dextrose intravenously for dehydration and for other medical conditions. I can recall infusing into the veins of patients including nine-month-old children green coconuts to rehydrate them.

Coconut water is rich in natural vitamins, mainly B vitamin, minerals and trace elements, zinc, selenium, iodine, sulfur and manganese.

Mainly the kernel of a carbohydrate fruit contains amino acids, enzymes, antioxidants and phytonutrients. It is very rich in magnesium and potassium, hence it is cardio-protective and it regulates blood pressure, improves circulation, reduces plaque formation in arteries.

It is low in sugar, fat free and low in calorie, suitable for dieting and also an ideal drink for diabetics for thirst and dehydration.

The water contains cytokinins or plant hormones, anti-ageing and anti-cancer properties.

Natural electrolytes

Saline infusion is a man-made electrolyte sterile solution, but the coconut water has inorganic compounds (electrolytes) that becomes ions in solution and has the capacity to conduct electricity. Fresh coconut water is one of the richest natural sources of electrolytes and can be used to prevent dehydration from strenuous exercise, vomiting, or diarrhea. People lose electrolytes (especially sodium and potassium) when they sweat, which must be replenished with food and water intake. Since coconut water naturally contains so many electrolytes, it’s called ‘Nature’s Gatorade’.

The tourists who visit Sri Lanka during the Xmas holiday will surely drink daily plenty of coconut water. They must keep in mind that drinking coconut water definitely helps them to feel fresh and hydrated, thus making their holiday enjoyable even if they suffer from gastric upsets by taking in too much Sri Lankan spicy food.

Who said, “I always take life with a grain of salt, plus a hot chili curry and a shot of old arrack with coconut water”
Some reference to Help your heart,  Dr Mercola Nov 27,1211

By Dr Harold Gunatillake

Natural sugar in excess in any delicious food like ice cream, fruit salads, pudding and cakes, among others, can turn ‘poisonous’ in your body. It contains extra calories, causes stress on insulin secretion from the pancreas gland, adds to your weight problem, and you partly become dependent on it – that ‘sweet tooth’ you refer to. People are in search of sugar substitutes, and there are many of them. Which one will you choose to be compatible with your  taste buds?

Some of these artificial sweeteners are:
Aspartame (Equal)
Acesulfame potassium
Saccharin (Sugar Twin)
Sucralose (Splenda)
Neotame

Most people having weight problems seem to start on artificial sweeteners to drop a few calories. For most people diets tend to fail due to a lack of self-control and the desire to indulge oneself, and the most ‘trigger food’ that contain excess calories are foods high in sugar content. Artificial sweeteners seem to provide people trying to watch their figure with an escape for their sweet tooth.

On the other hand, artificial sweeteners may lead to weight gain and abnormal insulin response when consumed according to some studies on rats.
One benefit of artificial sweeteners is that they do not contribute to tooth decay and cavities, unlike natural sugar.

Natural sugar contributes to weight problems. Each gram of regular table sugar contains 4 calories. A 12 ounce can of a sweetened cola contains 8 teaspoonfuls of added sugar, or about 130 calories. So, one of the appealing aspect of artificial sweeteners, being non-nutritive, is that you would not put on weight as they virtually have no calories.

Diabetes: Artificial sweeteners may be a good alternative to sugar if you have diabetes. As they are not carbohydrates the artificial sweeteners do not raise blood sugar levels.
 

Concerns: Critics of artificial sweeteners say that they cause a variety of health problems, including cancer. Saccharin was linked to bladder cancer studies dating to the 1970s.

But according to the National Cancer Institute in the US and other health authorities there is no sound scientific evidence that any artificial sweeteners approved for use in the US cause cancer or other serious health problems.
Studies have been conducted on the safety of several artificial sweeteners, including saccharin, aspartame, acesulfame potassium, sucralose, neotame, and cyclamate.

Equal, NutraSweet

This sweetener is available in most coffee shops on the table round the world and is quite popular. It is added to drinks, gum, yoghurt, cough drops. It has no calories. The chemical in it is Aspartame. Aspartame has been accused of causing everything from weight gain to cancer.

However, since being approved by the FDA in 1981, studies have found no convincing evidence and the FDA, the World Health Organization, and the American Dietetic Association say aspartame in moderation poses no threats. People with the disease phenylketonuria an inherited disorder should avoid aspartame.

In 2005, a laboratory study found more lymphomas and leukemias in rats fed very high doses of aspartame (equivalent to drinking 8 to 2,083 cans of diet soda daily). However, there were some inconsistencies in the findings. For example, the number of cancer cases did not rise with increasing amounts of aspartame as would be expected. An FDA statement on this study can be found on the Internet at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108650.htm

Subsequently, NCI examined human data from the NIH-AARP Diet and Health Study of over half a million retirees. Increasing consumption of aspartame-containing beverages was not associated with the development of lymphoma, leukemia or brain cancer.

High Fructose corn-syrup

This popular syrup in the Western world is not available in Sri Lankan super-markets. It has 17 calories per teaspoon, found mostly added to sodas, desserts and cereals.

It is obvious that beverages sweetened with high fructose corn-syrup may contribute to obesity, if regularly consumed. It is advised to limit its consumption.

Some consider it is a good alternative to natural sugar as there are fewer calories.

High fructose corn syrup (HFCS) is a calorie-providing sweetener used to sweeten foods and beverages, particularly processed and store-bought foods. It is made by an enzymatic process from glucose syrup that is derived from corn. A relatively new food ingredient, it was first produced in Japan in the late 1960s, and then entered the American food supply system in the early 1970s. HFCS is a desirable food ingredient for food manufacturers because it is equally as sweet as table sugar, blends well with other foods, helps foods to maintain a longer shelf life, and is less expensive than other sweeteners. It can be found in a variety of food products including soft drinks, salad dressings, ketchup, jams, sauces, ice cream and even bread.

Sucralase (Splenda)

Displayed as a “table-top sweetener” in coffee shops, it is commonly added to packaged foods and beverages. It is 600 times as sweet as sugar and is pleasantly tasty in hot and cold teas, but may have a metallic aftertaste. Splenda is used in baking mixed with sugar, as in cookies.

People with a rare condition known as phenylketonuria (PKU) cannot break down phenylalanine, so it can accumulate to toxic levels; thus, people with PKU must avoid all foods containing phenylalanine, including aspartame.
Sucralase has been known to impair the functioning of thyroid glands. Additionally, artificial sweeteners are recognized by the body as foreign substances and are therefore metabolized differently, making your liver and kidney function more than they would normally do.

Saccharine

Saccharine is the oldest of the non-nutritive sweeteners and has been in use for about 50 years. Saccharine is 300-400 times as sweet as sugar. It is heat stable and can therefore be used for cooking and baking. Another advantage is that it has a long shelf life. Unfortunately, saccharine has a slightly bitter metallic aftertaste, so it is often combined with other non-nutritive sweeteners. In 1977, the Food and Drug Administration (FDA) in the US placed a ban on the use of saccharine because animal research implicated saccharine as a weak carcinogen that caused bladder cancer in rats. This ban was withdrawn in 1991. The use of saccharine by pregnant women and young children should be limited. The current recommendation for saccharine intake is 500 mg for children/day and 1000 mg for adults/day.

Safe use of artificial sweeteners

Many sweeteners are chemicals, and would not occur naturally in food. It is therefore advised that sweeteners be used in moderation. Remember that you may be consuming large amounts of sweetener in ‘diet’ or low sugar cool drinks, jellies, sweets and biscuits, as well as flavoured mineral water. If you add up the total amount of sweetener used in these foods and drinks, as well as that added to tea, coffee etc., your total daily intake of sweetener may be quite high.

First part published on April 7

Therefore, the readers need not worry about rodent carcinogens in the natural and synthetic foods we eat since only tiny levels are found in them.
These foods become carcinogens only when they are given to rodents in large doses over a lifetime.

Benzo(a)pyrene from barbecues
Charcoal grilling or open flame meat cooking such as beef, chicken and pork causes them to become impregnated with a pro-carcinogen called benzo(a)pyrene in concentrations greater than 3ug/kg (Established safe limit 1ug/kg)
(Journal of Agricultural and Food Chemistry 31.867 1983)

Cancer promoters and inhibitors
Natural unrefined whole food diets have a protective effect against cancer induced by carcinogenic exposure though some natural foods contain promoters and co-carcinogens and may be found in high concentration in animal protein and fat. Protective nutrients include ascorbic acid (vitamin C), vitamin E and selenium. (Nutrition and Cancer 5: 107-19 1983)

Acrylamide from Carbohydrates
Reports from U.S. Food Standard Agency indicate that frying or overheating carbohydrates foods, such as French fries and potato chips generates the known animal carcinogen acrylamide. Their effects and potential risk to human health are being studied.

Polycyclic hydrocarbons in barbecuing meat
Barbecuing meat on an open fire creates polycyclic hydrocarbons such as benzopyrenes – one of the main constituents in cigarette smoke that cause lung cancer. High intake of fried and broiled food can increase the risk of breast, distal colon, prostate and pancreas cancers.
There are many more naturally occurring carcinogens in food plants in addition to the aforementioned list.

Tannins in tea, coffee
For example tannins occur widely in plant foods such as tea, coffee and cocoa. Experiments on animals have shown that tannic acid causes liver tumours in animals and may be linked to oesophageal cancer tumours.
Safrole in tea, cinnamon, nutmeg
Safrole, a liver carcinogen in rats, is found in sassafras tea, cinnamon, cocoa, nutmeg, and other herbs and spices.
Tests on mice have proved black pepper to be carcinogenic.

Children more at risk
Children have more risk of exposure to carcinogens in food as they consume more foods, drink more liquids, and take in more air than do adults. According to leading paediatricians, half of a lifetime’s consumption of carcinogens from food is eaten by age five. They affect rapidly growing organ systems, like the central nervous system and brain.

Tips to avoid potential food carcinogens

• Look for brands of uncured nitrate-free meat products such as bacon.
• Avoid saturated fats included vakes, biscuits and cookies.
• Wash in clean water or in special washing liquids vegetables and fruits before consumption.
• Eat organically grown vegetables and fruits since it limits one’s exposure to pesticides.

Worst foods

Hotdogs: They usually contain sausages processed with sodium nitrate, mayonnaise loaded with saturated fats, and bread made from refined flour. The Cancer Prevention Coalition recommends that children should not eat more than 12 hotdogs per month because of the risk of cancer. If you cannot do without eating hotdogs, make them at home with sausages that do not have sodium nitrite listed among their ingredients.

Processed meats and bacon: They invariably contain sodium nitrite. Bacon is also high in saturated fat, which contributes to the risk of cancers including breast cancer. If need them, buy them from health food stores and make sure that no nitrates listed on ingredient labels.

Doughnuts: The average American’s favourite breakfast, doughnuts, is probably the worst. It contains hydrogenated oils, white flour, sugar, and acrylamides. Reader’s Digest calls doughnuts ‘disastrous’ as a breakfast and experts agree that it is one of the worst cancer foods.

French fries: Sliced potatoes fried at high temperatures in hydrogenated oil clog arteries with saturated fat and trans fats. Not only that, they also contain acrylamides. For added flavour, many chips contain mono sodium glutamate, a chemical unsuitable for children. No wonder dieticians say French fries are the worst food for children.

Crackers and cookies: Loaded with white flour, refined sugar and trans fats, cookies and biscuits are often considered to be an easy option for children’s snacks. However the high percentage of trans fats and the presence of acrylamide (formed when these floury products are baked at high temperatures) make them an unhealthy eating choice.

Cancer-fighting fruits and vegetables
Fruits and vegetables are the most important protective factors of diet. They are full of antioxidants such as vitamin C, vitamin E, carotenoids, flavonoids, selenium, plant phenols etc. The anti-cancer effect of lycopene found in tomatoes is two times stronger than carotene (full in carrots, tomatoes, citrus fruits and other foods). Lycopene has significant effect against prostate, lung and stomach cancers. It is also effective against pancreas, colon, breast and uterine cancers.

Vitamin C can prevent the synthesis of nitrite, which can be converted into powerful carcinogen nitrosamine. Dietary fiber can promote defecation reducing the absorption of carcinogens. Sulfur compounds and carotenoids can inhibit DNA and protein synthesis, and promote normal cell differentiation. Retinol can also increase the body immunity against cancers. Vitamin E may also regulate apoptosis.

Grapes contain trans-resveratrol which helps destroy cancer cells and prevent spread of the disease. Carotene exists in carrots can reduce the incidence of lung cancer. Lentinan that exists in lentinan mushrooms has been proven an effective cancer inhibitor.

Since different fruits and vegetables contain different anti-cancer substances, the right way is to eat a variety of fruits and vegetables rather than looking for a certain kind of anti-cancer vegetables.

Some ref: to CopperWiki 3.1.2009
American Council on Science and Health,
New York- Tuesday, October 12,2004

By Raisa Wickrematunge - 

Located on Hotel Road, La Rambla’s clean white façade is a welcome oasis from the tropical nights.

Click Here To See Full Page

By Dr Harold Gunatillake -

The people eating natural fresh foods for health reasons will have shockwaves running through their spine when they start reading this article.

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By S. Ratnajeevan H. Hoole

In Hri by the Southasia Trust (http://www.hrisouthasian.org) (this link will be updated by Friday evening in Colombo) we show that Arumuka Navalar has been built up by Tamil Saivite extremists – Tamils’ Bodu Bala Sena. The Rev. Peter Percival, a great Tamil scholar, founded the Wesleyan Mission School (later Jaffna Central College) in 1834 and held the first Chair in Vernacular Literature at Madras University. But he was a Christian. To advance their notion noted by Prof. K. Sivathamby that anything good in Tamil must have Saiva inspiration, Percival’s accomplishments are claimed as Navalar’s. His 1850 revision of the 1840 Revised Tamil translation of the Bible by C. T. E. Rhenius, is claimed as Navalar’s. That revised Percival revision was further claimed as the first Tamil translation ever to inflate Navalar. Percival, a priest to the end, they add, lost his Christian faith because of Navalar. To make four year old Navalar Percival’s Tamil teacher, Percival is mislocated from Trinco and Bengal to Jaffna. Little about Navalar can be believed. Harvard trained Dennis Hudson (Smith College) – besides Bernard Bate (Yale), and John Carman (Harvard) – is a rare western scholar who has examined Jaffna Hindu responses to Christian missions. He correctly interprets the work of Navalar as a response to Christianity. His interpretation, however, rests on sources of doubtful reliability. All three have paternalistically built up Navalar, repeating myths by ill-educated Saiva nationalists. They are then assiduously cited by nationalists to prove their own concoctions.
This article shows further fake aspects of Navalar – his portrait, caste and name, and perhaps religion too.

Navalar’s Appearance

The popular image of Navalar in a Colombo National Gallery portrait, is of a dark, bare-bodied man wearing prayer beads and liberally-daubed holy ash. Chaivap-periyaar Sivapathasundaram whose Navalar biography imaginatively embellishes myths like Professor Percival learning Tamil from high school dropout Navalar, however, admits the portrait to be a fake, saying that it is “of recent origin” and “no more gives his true form than the images of the Samaya guravas in temples give their true forms.” It is a friend’s.
The government declared Navalar a National Hero, issuing a stamp with this fake image. No actual image of Navalar is available. Why? Because of his real appearance? Navalar’s adulating nephew T. Kailasapillai and Peradeniya academic, the Oxford-trained P. Poolohasingam, describe Navalar as looking like a tadpole with small limbs and a huge head. Kailasapillai adds that Navalar had tiny ears and a big forehead on a huge head, thin hands and legs, strong facial hair, and huge body without any strength. Chaivap-periyaar tells us that Navalar “had a delicate constitution and he never took any kind of bodily exercise. His head alone was massive.” These descriptions do not match the portrait.

We may safely assume that under Percival Navalar wore trousers and coat and no holy ash. The Jaffna Freeman (March 1, 1871) shows that wearing symbols of the Saiva faith was prohibited at mission schools on pain of expulsion.

Navalar’s Religion

Prof. Sivathamby says that Navalar’s father Canthan was an Aratchy at the Kachcheri, a lowly government servant fluent in Portuguese, Dutch and English. Indeed, the Rev. William Howland says the Dutch made “assent to the Helvetic confession of faith necessary to the holding of any office of profit or trust under the government.” Canthan therefore must have been baptized.
Did Canthan baptize his children under the more tolerant British? Navalar’s brothers included two Notaries, an Udaiyar and an Aratchy, all serving loyally in the colonial service.  Why did Canthan send all his sons to Percival at the Wesleyan Mission where the best would become Christian ministers?
Dr. Poolohasingam quotes one Veerasamy Mudaliyar as stating that Navalar lived as a Christian and was sent by Christian missionaries to Chennai to observe and learn how the Christian missions converted Hindus. It is untrue that Navalar translated the Bible but those who claim so must cede he was a Christian Pastor! For St. John’s College’s Rev. David Good of the Bible translation committee describes mission policy as having as many as four European missionaries and six “ordained, educated, able” natives, two each from the American, Anglican and Methodist missions, on the committee.
Navalar’s Name and Caste

Navalar has gone by many names. His confusion about his own name reflects his inability to complete high school after 6 years in Tamil school and 13 years under Percival.

Navalar’s Vellala caste is broad, ranging from the DMK’s Karunanithi’s Isai Vellalas (called Nattuvar in Jaffna) to the Karkaththa Vellalas claiming superiority. But not in Jaffna where there are simply Vellalas. Dominating Jaffna’s cultural life, Vellalas, as people who labour, are Sudras, the lowest of the caste groups of Brahmin, Kshatriya, Vaisya and Sudra. (Dennis Hudson says Navalar’s caste is elite, something that Vellalas must have told him). Prof. Bryan Pfaffenberger calls Vellala control of Jaffna “Sudra Domination.” (Vellalas are a living contradiction, at once claiming to be high caste and also that the four-fold classification is North Indian and therefore not ours – a classic case of not wanting to be low Sudras and not wanting to give up their high status within Sudras. Caste is from North India and Vellalas need to take it or leave it.) The power of Saiva Vellalas is seen in Tamil Nadu classifying them as forward while classifying the equivalent Telugu Reddys as backward, whereas Kerala regards Saiva Vellalas as backward.  Another Vellala problem is our traditional Sudra names being short whereas generally short names, particularly those ending with the letter n, denote a low-caste status. Thus the Tamilized Chuppan is low caste while pluralized Chuppar conveys a little respect, its longer form Chuppiramaniam is higher, Subramaniam is even higher, and the fully Sanskritized Subrahmaniam is Brahmin. Thus we had a Hensman (a descendant of the first Jaffna Anglican priest who adopted that English name) going as Hensmar for respectability. Similarly C.W. Thamotharampillai’s parents with their good Tamil names Vayiravi and Periyai in his baptismal records are recast in Saiva histories as Wyravanather and Perunthevi.

Like everything about Navalar, his name for caste reasons is also manipulated. Dr. Poolohasingam gives Navalar’s pre-Saivite Christian name as Pairaat. The Rev. John Walton asserts that Navalar’s real name as a youth was Ca. Arumukan (ending in n not m). In an early written reference to himself, Navalar signed a letter (Morning Star, 18.11.1841) as Canthar-kumaran Arumugaven – literally “Son of Canthar, Arumugaven.” This reflects the absence of surnames. We already see the common Canthan rendered as the plural Canthar. The Morning Star (1847) on Navalar leaving Percival protesting the admission of a Nalava boy refers to him simply as Aroomoogayar – we may note the status enhancing ending in r, changing from the previous n. Navalar signed off as C. Arumuka Navalar on a letter dated Aug. 31, 1872, one of his last documents.

Navalar has spelled his father’s name Canthar with K sometimes:  His notice in the Ceylon Patriot (06.01 1872) is signed off as M.R. Ry. K. Arumukha Navalar. Many now write Kanthar and Kandhar. His petition to the governor (15.12.1852) is signed C. Arumugam with a status enhancing Sanskritized g in the middle of Arumugam. After receiving the title Navalar – “Him of the powerful tongue” – Navalar who had never been sure of his name, wanted to reject a letter from Rev. Walton addressed to Arumukam.

Claiming Caste through Names

Adding to confusion are western scholars who are fed false information by their Saiva Vellala informers. Thus Prof. Dennis Hudson, although said to have been fluent in Tamil, incorrectly explains to us that Navalar means “The Learned” and that his real name at birth was Nallur Arumuga Pillai. The unreliable Kailasapillai gives a letter from Madras where Navalar signs as “Yalpaanam Nallur-Arumukanavalar.” But the tradition of village name as part of one’s name is not of Jaffna. The additional Pillai by Hudson is also fiction. It was common for Tamils like Navalar travelling to India to add pillai to their name, more usually as a suffix as done by Thamotharampillai and Viswanathapillai (two of Jaffna’s most eminent persons as the first two graduates of Madras University) to show themselves off as from the Pillai caste because Indians often assumed Jaffna Tamils to be Dalits (outcasts below Sudras). Pillais are landowning Vellalas, feebly aspiring to be trader-caste Vaisyas using their property.

Adjectival Names

To impute respectability to Navalar’s biographer Kanakarattinam, writers use Kanakarattina Pillai or Kanakarattina Upattiyayar (Teacher).  Kanakarattina is an adjective. But westerners who do not know Tamil refer to him as Kanakarattina and, worse, scholars who are Tamil follow and do the same. We note that Prof. Dennis Hudson mistakes the adjectival Kanakarattina for a name, and uses the title Pillai as a standalone last name without the adjectival Arumuka. Similarly in Arumuka Navalar, Arumukam as adjective becomes Arumuka. Then foreign scholars like Eugene Heideman pronounce Navalar’s name to be Arumuga.

Conclusion

Little about Navalar is true. The problem with history is that once a mistake is committed to writing, the document remains in circulation even after it is corrected. Further theories are tested by reference to past writings. Thus I am afraid that these Navalar myths are here to stay.

By Dr Harold Gunatillake Health writer

When you are 300kilograms in body weight or more, you have no other option than surgery to lose weight. Dieting will not help. Exercise is not possible due to the excessive weight you carry, clothes do not fit, and every step in your life is a misery.

In this situation, Gastric bypass and other weight loss surgeries are inevitable options you need to think of. Such procedures will limit the amount you eat, or by reducing the absorption of nutrients or both, and the loss of bulk are gradual, and results are pleasing, if you can go through the regime. After such procedures you still have to maintain your metabolism by adjusting your vitamins and micronutrients as required.

There are many types of weight loss surgeries designed for you in various specialised centres, and the choice is yours to select the best procedure for you after consulting many opinions.

Most surgeons prefer gastric bypass techniques because it generally has fewer complications that do other weight loss procedures.

These are all major procedures, taking many hours in the theatre, and during the post-op management period may pose many serious risks and side effects. Also, you may need to change your diet and get regular exercise to help ensure long-term success of bariatric surgery.

Most of these procedures are done today using minimally invasive laparoscopic surgery and hospital stay is also minimised.

In US the most common procedure done in most hospitals is Roux-en-Y gastric bypass. The Mayo Clinic seems to be very popular for these procedures.
As the diagram reveals about two thirds of the stomach is isolated and the small cap of stomach tissue remaining attached to the gullet is anastomosed end to side with a segment of the small intestine. The proximal segment attached to the distal stomach is also anastomosed end to side with the distal small gut connected direct to the stomach stoma, so that the bile and pancreatic enzymes can still digest the food entering the distal gut. The isolated distal stomach is also sutured to form a closed pouch. Food consumed bypasses the main bulk of the stomach, directly into the small bowel.
The Mayo Clinic has modified the standard R-en Y procedure, as shown in the second diagram. This procedure differs from the standard Roux-en-Y in that the bypassed segment of intestine containing the digestive juices is attached to the food-carrying intestine closer to the large intestine. This further restricts nutrient and calorie absorption.

Gastric Banding

In this procedure an inflatable band encircles the upper end of the stomach to restrict the amount of food you can consume.

This procedure is adjustable and reversible. This is a new technique, quite popular, and the procedure is called ‘Laparoscopic adjustable gastric banding (LAGB). Two types of banding are available i.e. Lap-Band and Realize Band.
Banding is a less risky and less invasive weight loss surgery than gastric bypass.

Sleeve Gastrectomy

This procedure involves surgically removing the left side (greater curvature) of the stomach leaving a much smaller segment the size of a large banana.

Problems
Dumping Syndrome

One of the major problems with these procedures is the Dumping Syndrome which is a group of symptoms that are most likely to develop if you have had surgery to remove all or part of the stomach or the stomach has been bypassed as in bariatric surgery. It is also called rapid gastric emptying. It occurs when the undigested contents of your stomach move too rapidly into the small bowels. The earliest notable symptom would be cramps, nausea and diarrhoea after eating food within 30 minutes. Other symptoms are feeling of fullness, flushing, dizziness and light-headedness and palpitations (rapid heart rate). The side effects can come later a few hours after eating. This is due to large amounts of sugars entering the small bowels causing ‘hyper-glycaemia’. The body responds by releasing large amounts of insulin from the pancreas leading to low levels of sugars (hypo-glycaemia). Eating too much of rice will cause this syndrome.

Symptoms of late dumping syndrome are sweating, hunger, fatigue and fainting, in addition to the previous symptoms mentioned.
It may be necessary to adjust your diet and may need medication or further surgery.

Obesity with type 2 diabetes

Obesity alone in itself is a major medical risk after bariatric procedures. But obesity with type 2 diabetes raises added risk of heart attacks, strokes, and infections (sepsis). Anyhow, it is observed that though the risk is greater, for those who survive the operation itself could be a cure for diabetes, normalising their blood sugar without taking any medication.

“We can put diabetes into remission, and even if this is only for a few years, it will delay the development of complications,” lead author Sangeeta R. Kashyap, MD, from the Endocrinology and Metabolism Institute, Cleveland Clinic, Ohio, told Medscape Medical News. Dr. Kashyap and colleagues reported their findings online on February 25 in Diabetes Care.

She explained that, “bariatric surgery allows the pancreas to make insulin again and normalizes blood sugar with fewer or no medications.” The results of this study are particularly pertinent because the participants were only moderately obese (body mass index [BMI] range of 27 to 43 kg/m2), in contrast with most studies of weight-loss surgery, which have examined morbidly obese subjects, she noted.

The findings also point to Roux-en-Y gastric bypass (RYGB) being a markedly better option for these patients than sleeve gastrectomy, she said. Although the 2 surgical procedures resulted in the same amount of weight loss, gastric bypass “was most impressive in metabolic terms, having a unique and powerful effect on belly fat and increasing the function of the pancreas 5-fold,” Dr. Kashyap noted.

“I would say the gold standard surgical technique is Roux-en-Y gastric bypass. I truly consider it metabolic surgery for people with diabetes,” she told Medscape Medical News.

Dr. Kashyap said those who underwent sleeve gastrectomy experienced relapses. After one year, a quarter of them had come off all medications, but by two years this figure was down to 10%. “People (who had had sleeve gastrectomy) fell out of remission even though they were able to sustain the weight loss,” she remarked.

She added, however, that sleeve gastrectomy “is not terrible. It’s often used as a transitional procedure for the very sick, but the better option is bypass.”

Postoperative Infections

The benefit of bariatric surgery resulting in profound weight loss brings with it consequences in the form of postoperative complications that can have profound effects on morbidity and mortality in these patients. The incidence of infection is as much as 15%, which is considered similar for obese people undergoing non-bariatric surgeries.

Primary defence against pathogens is oxidative killing by neutrophils, which is critically dependent on tissue oxygen tension. Obese patients have decreased tissue oxygen tension at the wound site which increases the chances of getting infections.

However, there is an important factor, why these patients are more prone to infections in Sri Lankan hospitals. It is known that in Colombo, surgeons are performing these operations in public hospitals; for reasons I believe, the patients find it difficult to pay exorbitant fees for these major procedures in the private hospitals. Furthermore, these procedures are done in the public hospitals in theatres where other surgical procedures are done, using the same nursing staff and surgical instruments.

In more developed countries, there are separate clinics established to perform bariatric surgery. The administrative staff, nursing staff and the surgeons are all specialised and focused to render competent care to conditions such as bariatric surgery. In such a scenario, the incidence of sepsis would be minimal, and with specialised trained staff to care for these patients, other complications are also minimised.

Anatomical leak occurs after bariatric surgery and is considered one of the most life-threatening complications of bariatric surgery. According to statistics anatomical leak occurs in up to 5.8% of bariatric surgeries and is considered life threatening unless detected early for further intervention.
Intra-abdominal sepsis, a complication often associated with anastomotic leak, is an important, life-threatening complication of any abdominal surgery. Early recognition of intra-abdominal sepsis can be a challenge in obese patients owing to the misleading absence of abdominal signs due to large masses of subcutaneous abdominal tissue. It is emphasised that these procedures need to be done in separate clinics with trained staff more aware of detecting these events.

In Sri Lanka, the surgeons seem to have too much of surgical burden, hopping from one private hospital to another operating late hours, leaving these major operated cases in the hands of untrained staff to care for them. In such situations postoperative complications may not be detected early enough for intervention. There are situations when surgeons go abroad immediately after performing major surgery in private hospitals, leaving the care of the patient to the registrars, and overlooked by a colleague. Patients have died with such arrangements and the surgeon who performed the surgery is not liable for negligence as arrangements are made for colleagues to overlook, without responsibility.

These are deficiencies in the system of healthcare on the island, and it is the responsibility of the government healthcare administrators to look into these shortfalls. To prevent further morbidity and mortality after operations on these unfortunate patients, separate specialised centres, with specially trained teams would be the solution for minimising bad events. Specialised training and knowledge gained from overseas centres also has to be considered.

By Dr Harold Gunatillake Health writer

Diabetes is a very serious disease, one has to remember and a strict discipline needs to be exercised if you wish to live like the non-diabetics and enjoy a comparable life style. People having diabetes type 1 (juvenile type) have to be more careful from the time it’s diagnosed, whilst the majority who suffer late onset diabetes (type 11), in their sixties and after, need to adhere to a strict disciplined life style, too.

Twenty-six million Americans have chronic kidney disease, which has a number of causes – most often diabetes and high blood pressure. As the kidneys begin to fail, the body’s waste products build up in the bloodstream, leading to anemia, nerve damage, heart disease and other ailments.
People having diabetes run the risk of getting complications than most others, such complications as skin infections, vascular disease leading to amputations of limbs, hypertension, heart disease, stroke, cancer and kidney disease, among others. These complications are avoidable through a planned discipline.

Kidney disease

This discussion is mainly focused on kidney disease as a complication of diabetes.
Blood pressure needs to be watched weekly, whether you suffer from high blood pressure, or otherwise. Purchase your own blood pressure apparatus.
There are no early signs of kidney failure, and you need to check your kidney functions through blood and urine examination, annually. This is crucial that everyone with diabetes- and their doctors- watch for signs of kidney problems.
“Unfortunately, many people having diabetes don’t realize that they have kidney disease,” says Robert Stanton, MD, chief of nephrology at the Joslin Diabetes Center Clinic and associate professor of medicine at Harvard Medical School. “The obvious symptoms don’t appear until the kidneys are failing.” This complication is also called diabetic nephropathy and can lead to kidney failure

The obvious signs of kidney problems appear after there has been significant damage to the kidneys.  They may include foamy urine, weight gain, water retention, loss of appetite, and feeling unwell. Anyone with those symptoms needs to see a doctor right away.

You need to understand your disease by reading books on diabetes and questioning your doctor, when you visit him regarding your specific problems. Some patients are too intimidated to ask questions or request a clarification.
They may regard all medical matters to be the doctor’s purview. Or they may be fatalists who assume whatever will be, will be. In Sri Lanka the common talk among most lay people is that the specialists may not like you’re asking questions, and in most situations get angry.

Though diabetes is a serious chronic illness, you could be the master and the doctor and take charge the control and lead quite a normal healthy life.
There is good news:  Simple tests can monitor kidney function and detect early diabetic kidney disease. Treating early disease can make a huge difference. Medications, dietary changes, and good control of glucose levels and blood pressure can slow down or prevent kidney damage.

Studies have shown that strict control of your blood sugar can delay the onset of kidney disease. Your doctor may put you on insulin injections for easier and better control of your blood sugar. Control with tablets lowering blood sugar may not be sufficient when kidney damage is detected.
There are various types of insulin in the market, varying from quick acting rapid ones, to those that stabilize blood sugar levels up to 24 hrs.
The kidneys filter the blood.  They get rid of wastes (creatinine, urea, urates, chlorides (Cl), excess potassium (K) and Sodium (Na) in the body through urine, while the cleaned blood is sent back into the body.

In people with diabetes, the kidneys may be damaged so they don’t filter blood as well. Small amounts of protein start to leak into the urine. This is referred to as micro-albuminuria. Blood pressure goes up, further stressing the kidneys, and larger amounts of protein are found in the urine. As these changes occur, the kidneys lose even more ability to filter the blood and waste products start to build up in the blood.

High blood glucose levels – the defining symptom of diabetes can damage cells in the kidneys over time. Diabetes may be associated with other causes of kidney damage too, says Janet B. McGill, MD, an endocrinologist and professor of medicine at the Washington University School of Medicine, St. Louis.

Investigations

Blood electrolytes such as sodium level (Na), Potassium level (K); will be requested by your doctor

Blood urea, urates levels also help in assessing the situation.
In kidney failure the creatinine level may rise due to the poor excretion of creatinine (normal range 40120umol/L), through the kidneys.
A blood test called eGFR (for estimated glomerular filtration rate, a measure of kidney function- normal over 60 mL/min), is routinely done.
Urine tests for protein, creatinine, and albumin.
When the kidneys are damaged, tiny amounts of protein begin to leak into the urine.  Your doctor can test your urine to check for the presence of protein, creatinine, and albumin.

While getting an accurate reading used to mean collecting your urine for 24 hours, which is no longer necessary. You just need a single sample- spot check.
Creatinine/ albumin ratio in the urine is also tested- normal below2.5mg.mmol)

Micro albumin

Your urine needs to be checked for any leakage of albumin (protein) into the urine. Under normal conditions a trace may be present in the urine. Presence of micro albumin in the urine is an early sign of diabetic kidney disease.You should have your urine checked for micro albumin every year.
Certain drugs and dyes are toxic to the kidneys and should be avoided by people with kidney disease. The drugs include painkillers like acetaminophen, aspirin and ibuprofen; laxatives and antacids that contain magnesium and aluminum (Mylanta and Milk of Magnesia); ulcer drugs like Tagamet and Zantac; decongestants like Sudafed; enemas that contain phosphorus (Fleet); and Alka-Seltzer, which is high in salt. Contrast dyes used for certain tests, like angiograms and some M.R.I.’s, can also be harmful to kidney patients.
When kidney disease progresses, patients can develop symptoms like changes in urination; swelling in the legs, ankles, feet, hands or face; fatigue; skin rashes and itching; a metallic taste in the mouth; nausea and vomiting; shortness of breath; feeling cold even when it is warm; dizziness and trouble concentrating; and back or leg pain. If any of these occur, they should be brought to a doctor’s attention without delay.

Treatment for Diabetes and Kidney Damage

•    Lifestyle changes. Eating a healthier diet (low GI foods) and exercising more can have a dramatic impact on blood glucose levels. Some people benefit from a diet that’s low in protein. If you smoke, quit. Controlling lipids — cholesterol and triglycerides — may not have a direct effect on kidney function, but it can help lower the risk of heart disease.
•       Home monitoring. In addition to checking your blood glucose at home, you may need to closely monitor your blood pressure, too.
•     Medications. Drugs called ACE-inhibitors and angiotensin receptor blockers (ARBs) can help slow or prevent kidney disease in those with high blood pressure.
End stage kidney disease or kidney failure is treated with dialysis or a transplant. While kidney failure is a serious risk of diabetes, most people with diabetes never develop kidney failure. With good treatment, even people who do have severe kidney disease can sometimes delay dialysis for many years

Keep Your Blood Pressure in Balance

High blood pressure (or hypertension) can damage your kidneys. You may want to check your blood pressure at home to be sure it stays lower than 130/80. Have your health care provider check your blood pressure at least 4 times a year. Your doctor may have you take a blood pressure pill, called an ACE inhibitor, to help protect your kidneys.

Conclusions

If you have signs of early kidney disease with diabetes, remember to check the following and adhere to a healthy life style.
•    Check your blood pressure weekly
•    Check your blood and urine for kidney functions at least yearly.
•    ACE-inhibitors and angiotensin receptor blockers (ARBs) are the drugs of choice for early diabetic nephropathy.
•    Exercise daily. That helps to bring down blood sugar level, too
•    Keep your weight within the normal range.
•    Check blood sugar level daily and take insulin injections according to the readings. Short acting insulin’s like Act rapid and Novo rapid would be the best to control blood sugar levels until stabilized, and kidneys show stability in eGFR and creatinine levels.
•    Neglect of any of the above may end up with ‘end stage kidney failure’ and dialysis becomes imminent.