Carbohydrates, the latest dietary villain

A few years back, dietary fats were the scourge of weight reduction efforts. Numerous low-fat and fat-free products appeared on the grocery shelves with claims to help with weight loss. Despite the popularity of these products, obesity rates in the U.S. continued to climb. Today, the blame for the failure for losing weight seems to be directed toward carbohydrates. In fact, many nutritionists believe that cutting carbohydrates is not only the key to addressing obesity, but also to reversing the increasing incidence of heart disease, Type 2 diabetes and hypertension.

Nevertheless, carbohydrates have been an essential component of the human diet since the "hunter and gatherer" days of our ancient ancestors. The FDA food pyramid made carbohydrate-rich foods, such as bread, pasta, rice, cereal, fruits, potatoes and other vegetables the foundation of our diets. Even the FDA's newer "ChooseMyPlate" campaign has fruits, vegetables, and grains constituting approximately three-fourths of our diet. Surely, carbohydrates can't all be bad.

It has been known for some time that carbohydrates do not all behave the same way after we eat them. Some are much more likely than others are to raise our blood sugar, which stimulates the pancreas to produce higher amounts of insulin. Over time, this can lead to insulin resistance in which the body becomes less effective at lowering blood sugar. Insulin resistance and the subsequent development of a condition known as "metabolic syndrome", appears to be responsible for the increased rates of obesity, type 2 diabetes, hypertension, and high cholesterol that we are seeing today.

The glycemic index (GI) provides a way to measure the effect on blood sugar of various carbohydrate-rich foods. The GI ranks carbohydrates based on their effect on blood sugar and insulin levels. For example, a baked russet potato has a relatively high GI and raises blood sugar to higher levels than a similar sized portion of baked sweet potato. By eating carbohydrates with a lower GI we can avoid the marked fluctuation in blood sugar and insulin, which for many people, is the key to sustainable weight loss.

A wealth of information about the glycemic index and glycemic load can be found at the website of the Glycemic Index Foundation. A simple summary of their recommendations for eating healthier carbohydrates are as follows:

• Use breakfast cereals based on oats, barley and bran
  
  
• Use breads with wholegrains, stone-ground flour, sour dough
  
  
• Reduce the amount of potatoes you eat
  
  
• Enjoy all other types of fruit and vegetables
  
  
• Use Basmati or Doongara rice
  
  
• Enjoy pasta, noodles, quinoa
  
  
• Eat plenty of salad vegetables with a vinaigrette dressing

Unfortunately, it appears that the emphasis on reducing fat in our diets from a few years back resulted in increased consumption of carbohydrates, and particularly those with a lower GI. Along with the failure of this type of diet to improve obesity rates, carbohydrates became the latest dietary villain.

Carbohydrates should remain as one of the major components of our diets. They are as important to our health as fats and protein. The problem with carbohydrates appears to be the types and amounts of them that people choose to eat, not carbohydrates themselves.

First Aid for Dog and Cat Bites

An estimated 4.7 million dog bites and 400,000 cat bites occur annually in the United States. Although it is commonly thought that a dog's mouth is cleaner than a human's and less likely to cause infection, dogs, cats, as well as humans all harbor bacteria that can cause infection. This is one of the main reasons why treatment of a dog or cat bite (or human for that matter) should be dealt with promptly.

Which is worse, a dog or a cat bite? The types of injuries inflicted by dogs and cats differ considerably. Dogs, with stronger jaws and relatively dull teeth, create shallower wounds or crushing-type injuries. Cats, on the other hand, have sharp teeth that produce puncture wounds. Bacteria from the cat's mouth may be deposited in the bottom of these punctures that can be difficult to remove with washing. This sets the stage for an infection, potentially affecting deeper structures such as bones, tendons, or joints. While both dogs and cats can inflict serious injuries, cat bites are much more susceptible to becoming infected.

What should one do if bitten by a dog or cat? For most dog or cat bites, taking the following steps will help to ensure an uneventful outcome:

1. If the wound is bleeding, apply direct pressure with a clean, dry cloth until the bleeding stops.
   
   
2. Wash the area of the bite with soap and water as soon as possible. Scrub the wound for several minutes in order to remove as much of the bacteria-containing saliva as possible.
   
   
3. Following cleansing with soap and water, rinse with an antiseptic, such as hydrogen peroxide or iodine solution. Once the wound is dry, apply an antibiotic ointment and gauze dressing.
   
   
4. Following the steps above, it is best to seek medical attention right away for bites on the face, neck or hands, or for large or deep bite wounds.
   
   
5. Request proof of rabies vaccination if the dog's owner is present. If a pet's immunizations are not current, report the incident to the animal control department and arrange for the pet to be observed for the next 10 days to check for rabies. If bitten by a stray or unvaccinated animal that could have rabies, consideration should be given to starting anti-rabies treatment immediately.
   
   
6. If needed, get a tetanus shot. The general recommendation is to receive a tetanus booster every 10 years. If a person has not had a tetanus shot in 5 years, however, a tetanus booster is usually recommended within 24 hours of a break in the skin, such as a dog or cat bite.
   
   
7. Observe the wound for several days, checking for signs of infection. These include warmth around the wound, swelling, redness, pain, and discharge of pus. If bites become infected, treatment with a prescription antibiotic may be needed.

What kinds of infections are caused by dog or cat bites? Pasteurella bacteria, present in the mouths of dogs and cats, are responsible for most bite-associated infections. Typically, these infections develop within a day or two after the bite and involve the skin and subcutaneous tissue in the area of the bite. Other secondary infections of dog and cat bites are due to Strep or Staph bacteria. Bites to the hand are particularly bothersome since there is less blood circulation in these areas making it harder for the body to fight infection. The most serious bite-associated infection is rabies. Rabies is a viral infection that can be transmitted by an infected animal through bites or scratches. Fortunately, rabies in humans has become rare with an average of only five cases being reported annually. If suspected, injections of the rabies vaccine are given as soon as possible following the bite to prevent the disease from developing.

Can the risk of dogs biting humans be reduced? The American Veterinary Medical Association offers the following suggestions to help dog owners minimize the risk of their dog biting someone:

• Carefully select your pet. Puppies should not be obtained on impulse.
  
  
• Make sure your pet is socialized as a young puppy so it feels at ease around people and other animals.
  
  
• Don't put your dog in a position where it feels threatened or teased.
  
  
• Train your dog. The basic commands "sit," "stay," "no," and "come" help dogs understand what is expected of them and can be incorporated into fun activities that build a bond of trust between pets and people.
  
  
• Walk and exercise your dog regularly to keep it healthy and provide mental stimulation.
  
  
• Avoid highly excitable games like wrestling or tug-of-war.
  
  
• Use a leash in public to ensure you are able to control your dog.
  
  
• Keep your dog healthy. Have your dog vaccinated against rabies and preventable infectious diseases. Parasite control and other health care are important because how your dog feels affects how it behaves.
  
  
• Neuter your pet
  
  
• If you have a fenced yard, make sure the gates are secure.

Improving Memory - Part 2: Tips to Boost Memory

"Memory... is the diary that we all carry about with us." -Oscar Wilde

Last week we looked at some of the causes for people's memory to "slip". These included medication side effects, ageing, medical conditions, and unhealthy lifestyle choices. By addressing the underlying cause, it is possible that memory can be improved. For example, if medications are responsible for the memory problem, discontinuing or changing medications can have a beneficial effect. Even memory deficits related to getting older can be helped. This occurs through a process known as "neuroplasticity" that allows the brain to form new pathways or alter existing connections. Today we'll look at a few "tricks" for boosting memory as well as some of the supplements that have been touted to help.

Challenge your mind. The saying "use it or lose it" applies equally well to the mind as it does to our muscles. The more you work out your brain, the better you'll be able to remember information. One scientific study showed that older Americans can improve their memory by instituting a memory-improvement plan that included regular mental exercises, such as working crossword puzzles. A second study found that elderly individuals who frequently engaged in leisure activities such as reading, playing board games, playing a musical instrument, or dancing were less likely to develop dementia in the future. The best brain exercising activities challenge you to develop and use new brain pathways. Activities that appear to be particularly helpful include those that are new or unfamiliar and those that take some mental effort to perform.

Learn "tricks" to help boost memory. Here are a few examples:

• Put frequently misplaced items, such as your wallet or purse, keys, and glasses in the same place each day.
• Use a date book or electronic organizer to keep track of appointments, telephone numbers, or "things to do".
• Repeat the names of people when you meet them.
• Use mnemonics to help you remember. In a name mnemonic, the first letter of each word in a list of items is used to form a name of a person or thing. For example, using the first letter of the colors of the spectrum makes the name, Roy G. Biv.
• Visual association operates on the contention that to remember a new piece of information, it helps to associate it with something else. For example, to remember that Robert's last name is Green, you could visualize him wearing green clothes while putting a green ball on a golf green.
  
• "Chunking" breaks a long list of numbers, such as a telephone number, or other types of information into smaller, more manageable chunks. A common example involves breaking down a 10-digit telephone number in to three sets of numbers.
  
• Remembering by Not Trying. Sometimes trying to remember too hard can inhibit memory. Performing a relaxation technique, such as deep breathing, or just thinking about something else can help bring a buried thought to the surface.
  
• Rhyming is one of the oldest methods in memorization. The rhyme "30 days hath September, April, June, and November..." is a well known examples of this technique to remember the number of days in each month.

Will taking supplements help with memory? Despite claims that various products can improve memory, the research supporting the use of most of these is suggestive at best. The following are some of the memory-promoting supplements that you may have heard about:

• Ginkgo Biloba - While some smaller studies of ginkgo for memory enhancement have had promising results, the larger, more rigorously conducted studies have not shown a beneficial effect. Additionally, a study funded by the National Center for Complementary and Alternative Medicine found it ineffective in lowering the overall incidence of dementia and Alzheimer's disease in the elderly.
  
• Sage - Two small studies suggest that taking black sage (Salvia officinalis) or broad-leafed sage (Salvia lavandulaefolia) may improve mood and mental performance in healthy young people and memory in older adults. Results of another small clinical study suggests that sage extract was better than placebo at enhancing thinking and learning in older adults with mild to moderate Alzheimer's disease.
  
• Prevagen (apoaequorin) - Marketed as a "memory loss supplement", apoaequorin is a protein derived from jellyfish. Its distributor claims that taking Prevagen will help to improve memory loss and protect the brain by keeping cells alive longer. Unfortunately, there does not appear to be any compelling scientific evidence to support the manufacturer's claims.

Improving Memory - Part 1: Is there a reason that your memory is slipping?

The brain manages memory in a manner similar to a computer. There is an area of the brain that handles short-term memory much like a computer's RAM, and an area that stores remote or long-term memory like the hard drive. A number of conditions may affect the way the brain stores information, causing problems with short-term or long-term memory. These include certain illnesses, ageing, medication side effects, and poor lifestyle choices. Today's Health Tip addresses medical and lifestyle issues that can affect memory. Next week we'll look at some of the "tricks" available to help improve memory.

Address medical issues responsible for memory loss - Medical conditions, including high blood pressure, thyroid disease, depression, and alcoholism can cause memory problems. Often, the memory deficit can be reversed by treating the underlying problem. For example, if insufficient production of thyroid hormone (hypothyroidism) is responsible for the memory deficits, taking thyroid replacement usually helps.

Memory deficits related to hypertension usually develop gradually, and may or may not be reversible. High blood pressure often affects memory through damage to the brain's white matter, the nerves that are covered with a substance called "myelin". Damage to these nerves, called "demyelination", affects the way that they conduct messages, including those involved in memory. Hypertension can also affect memory following a series of small strokes from untreated or inadequately treated high blood pressure. This is known as "vascular dementia". The risk of either of these causes for memory loss can be reduced by lowering high blood pressure, stopping smoking, treating high cholesterol, and controlling diabetes.

Medication side effects is one of the most common cause for memory problems. The list of medications that have been reported to do this is long and includes anti-anxiety medications (Ativan, Valium, Xanax), pain medications (Codeine, hydrocodone, others), sleep aids (Ambien), seizure medications (Neurontin, Tegretol), and corticosteroids (Prednisone).

Improve lifestyle to maintain memory - A strong memory depends on the health of your brain. Controlling stress, exercising regularly, getting enough sleep, eating a good diet, and cutting down on alcohol are some of the important lifestyle adjustments you can make to help promote brain vitality and protect your memory.

• Exercise - Research has found that aerobic exercise helps to maintain short-term memory. This is the type used extensively in recalling names, directions, and telephone numbers. It appears to do this by building new cells in an area of the brain that is associated with age-related decline in memory. In addition, people who exercise regularly are much less likely to develop Alzheimer's dementia.
  
  
• Get plenty of sleep - Getting a good night's sleep can improve memory. This is the time that the brain "files away" newly acquired information for later retrieval. In addition to affecting memory, sleep deprivation compromises your problem solving ability, creativity, and critical thinking.
  
  
• Eat "memory foods" - Evidence is accumulating regarding the benefits on brain health of eating foods containing omega-3 fatty acids. Examples of foods that are high in omega-3 fatty acids include cold water fish (salmon, tuna, sardines, and herring), walnuts, flaxseed oil, and soybeans. Foods high in antioxidants may also help maintain memory. Colorful fruits and dark leafy vegetables are particularly good sources. Foods that contain high amounts of saturated fats can cause blockages in arteries and adversely affect memory. The primary sources of saturated fat in the American diet include red meat, whole milk, butter, cheese, and ice cream.
  
  
• Manage stress - Chronic stress can affect an area of the brain called the hippocampus, where memories are stored. There is some evidence to support the role of meditation in helping to reduce stress and improve memory. Yoga, exercise, massage, prayer, deep breathing, visualization exercises, and listening to soothing music are other healthy ways of managing stress.
  
  
• Avoid excessive alcohol consumption - Alcohol can produce detectable impairments in memory after only a few drinks. These impairments are usually reversible in the occasional drinker. In alcoholics, on the other hand, memory problems can become persistent, due to permanent damage to the brain.