NUTRITION FOR PEOPLE WITH TYPE II DIABETES: FIBRE One of the hottest topics in diabetes nutrition in recent years is the role of dietary fibre.Let’s start by saying fibre is good for you and can help lower both your blood glucose and your blood fat levels, especially if you have Type II diabetes.Now, let’s get into the details. First, what is fibre? There are two types of fibre. One is water soluble; the other is water insoluble.Fibre is found in plants, not animals. Some plants, such as vegetables and fruits, contain more fibre than others. Some are high in water-soluble fibre, some are low. All have some amount of water-insoluble fibre.Water insoluble fibre provides bulk within your digestive tract and helps your intestine to move the remains of digested food out of your body. You use this fibre to stay “regular” and to avoid constipation.Water-soluble fibre, however, has a more direct role in your life as a diabetic. This type of fibre binds with other foods, primarily carbohydrates, in the digestive tract and slows down the process of converting this food to glucose and entering the bloodstream. The result is a slower and a lower rise in blood glucose levels after eating a meal that contains a lot of fibre-rich foods.High fibre foods include dried beans, wholegrain cereals, bran and many fruits and vegetables. Each of these foods will have a different effect on your blood glucose levels. And, to make matters worse, their effects will vary when you combine them with other types of foods in a meal. Once again, you need to use your blood glucose meter to learn what effect each of these foods has on your blood glucose.Don’t rush into a high fibre diet. Too much too soon of high-fibre foods will result in a deal of digestive distress and flatulence. Be moderate and patient as you slowly build up your fibre intake.*18/210/5*
MANAGING STRESS TO AVOID CARDIOVASCULAR DISEASESome scientists have noted a relationship between CVD risk and a person’s stress level, behavior habits, and socioeconomic status. These factors may affect established risk factors. For example, people under stress may start smoking or smoke more than they otherwise would. Other studies have challenged the apparent link between emotional stress and heart disease. Although it was once widely assumed that the Type A personality who suffered from high stress levels was a time bomb ticking toward a heart attack, this theory has not been proven clinically.Researcher-physician Robert S. Eliot demonstrated that approximately one out of five people has an extreme cardiovascular reaction to stressful stimulation. These people experience alarm and resistance so strongly that, when under stress, their bodies produce large amounts of stress chemicals, which in turn cause tremendous changes in the cardiovascular system, including remarkable increases in blood pressure. These people are called hot reactors. Although their blood pressure may be normal when they are not under stress – for example, in a doctor’s office – it increases dramatically in response to even small amounts of everyday stress.Cold reactors are those who are able to experience stress (even to live as Type As) without reacting with harmful cardiovascular responses. Cold reactors may internalize stress, but their self-talk and perceptions about the stressful events lead them to a non-response state in which their cardiovascular system remains virtually unaffected. Some research indicates that people who have an underlying predisposition toward a toxic core personality (in other words, who are chronically hostile and hateful) may be at greatest risk for a CVD event.*15/277/5*
CANCER: SKIN TYPE – CAUSE OF MALIGNANT MELANOMAThere are many ways of considering different skin types.TYPE 1. White skin, never tans, always burns.TYPE 2. White skin, burns initially, tans with difficulty.TYPE 3. White skin, tans easily, burns rarely.TYPE 4. White skin, never burns, always tans, Mediterranean type.TYPE 5. Brown skin.TYPE 6. Black skin.Broadly, types 1 and 2 are those that are associated with the greatest risk of a melanoma. Types 4, 5 and 6 are pretty safe, and type 3 is probably intermediate in risk. It follows that individuals should be aware of their skin type and build this awareness into their thinking about whether it is worth their while to adopt the simple preventative measures that we will propose.As well as the overall type of the skin, we have to consider the various freckles and moles that people get. Most of us have lots of ordinary moles, which are simple pigmented areas of little consequence. However, people with an excessive number of moles have an increased risk of malignant melanoma. Young people who have more than a hundred moles are at an increased risk. Again, possession of lots of moles should alert people to the need to take some precautions. A particular type of mole can be associated with melanoma. These are so-called ‘dysplastic’ moles. They are larger than usual and irregular, and tend to have variable density of colour. Possession of these can indicate a higher risk of melanoma, particularly in the presence of a family history of melanoma.*71\194\4*
Sexually transmitted diseases (STDs) are a group of communicable diseases which are usually transmitted by sexual contact. They are a major public health problem in all countries.
Since the second edition of the Handbook in 1982, the field of STD has undergone major change with the appearance of Acquired Immune Deficiency Syndrome (AIDS) in 1981 and the subsequent recognition of human immunodeficiency virus (HIV) infection.
The appearance of this disease brought into focus the sexual transmission of disease among homosexual men and the effect on disease patterns of changes in sexual behaviour. It has also highlighted the importance of counselling and confidentiality in the management of these diseases.
*1/56/1*
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In accordance with the laws of nature, we may presume that in fifty years from now the Amazon Indians will no longer die from measles, since by then they will have developed the immunity which we already have. As long as the Indians retain their traditional lifestyle and can avoid the detrimental effects of an ever-encroaching civilisation, they will not have to worry about many of our other so-called ‘diseases of civilisation’ either. The number of deaths resulting from gout, diabetes, obesity, cancer and multiple sclerosis will continue to be negligible among the Indian tribes of the Amazon.
Physicians, biologists and nutritionists who are aware of these dangers advocate a return to a natural way of life and to eating natural wholefoods as a protection against modern diseases. Like a voice crying in the wilderness, they sound the alarm again and again, appealing to us to change our life-style to a more natural one. Notable among them was the late Dr Joseph Evers, who treated thousands of people suffering from multiple sclerosis. They all hoped to find some relief from their hard lot in life. Nonetheless, it would be better to do something about preventing the illness rather than painfully trying to overcome it, because in spite of every effort made and care given, a cure is not always guaranteed. Krankheitsgeschehens (Changes in the Development of Disease), which is published by Karl-Haug-Verlag, is so impressive that even a healthy person, after reading it, will change his life-style and diet without delay and almost subconsciously. Any reasonable person reading the book will take note of the clear and logical arguments presented by this experienced researcher. Dr Evers proves to the reader that nature has a greater share in increasing our life span than the achievements of orthodox medicine.
*154/28/1*
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Many children attend playgroup before they start a more formal preschool such as kindergarten. Playgroups are sometimes organised by the maternal and child health or community nurse, or the local council or community. Sometimes they are organised on a more informal basis by neighbours or friends, usually in someone’s house.
Generally playgroups are a good idea. They allow youngsters the opportunity to play together and provide them with important socialisation experiences. Parents can benefit too from talking, swapping notes, and generally supporting each other. Many parents find that talking to other parents who have children the same age gives them confidence, as they realise that there are child-rearing issues and difficulties that seem common to all parents. Sometimes playgroups are organised to give the parents in turn a few hours to themselves. This can also be invaluable.
Parents must also be prepared for the hassles that are inevitable in playgroups. Often the children are at an age where they are still learning to play with other children. Some may resent no longer being the centre of attention, while many have not yet learned the idea of sharing. There will usually be arguments about possessions.
Some parents are competitive about the achievements of their offspring, and this can undermine the confidence of other parents. Be aware of this, and do not hesitate to seek the reassurance of your nurse or doctor if you have any concerns. It is important to remember that all young children are individuals and unique in their superior intelligence or accelerated development — it often just indicates a bragging parent. If you cannot tone down a parent’s boastful comments by discussion and gentle feedback, and if this continues to undermine your confidence, you may wish to switch to a different playgroup.
*112\90\8*
The reason for starting with the mechanical question is to get it out of the way so that you can look at the more important relationship issues, for these are the areas where disease and handicap have their most profound influence. If we keep taking our banged-up cars into body shops for repair without looking at how we drive in traffic, we will end up with more and more banged-up cars. So it is with disease that, as one paraplegic man stated, “The system is more important than the thing.”
“I just sort of became the chicken-soup type. I mean, I turned over my life to everyone else. My wife became a caretaker, and caretakers are not supposed to screw their patients.” This statement from a husband with multiple sclerosis illustrates the importance of sexual self-concept. Try to answer question two not in terms of skill or attractiveness but on the basis of “how” you are as a person when you are trying to be intimate. If you are experiencing disease, what has the disease process done to your relationship skills. Have you become more dependent, more aggressive, less assertive, more or less withdrawn? What has been the major impact of your illness on you as a person? How people experience disease and illness tells more about how they really are as persons than how they experience health.
I have my patients who are experiencing disease calculate their “N/S Quotient.” This is the balance between nurturance—taking care of someone else—and succorance—being taken care of by another person—that I discussed in Chapter Four. One of the most healing of human experiences, one of the healthiest things you can do, is to help somebody else. When you are sick, you must continue at some level to help others. How would you say your balance is? Do you still profit, even if you are sick, from all the good healing internal chemicals that come from the joy of supporting and helping someone else?
There have been research articles (not many) describing the impact of disease on sexuality. There have been very few articles about the impact of sexuality on disease, on sex as healer, on sexual shamanism. Maintaining and enhancing intimacy throughout the challenge of disease is not only possible but necessary for getting better. Remaining sexually active can actually slow some aging orocesses, protect the genitals to some degree from aging changes, and possibly offer a boost to your immune system. Research has clearly shown that immunoefficiency increases when you love and are loved.
*263\97\8*
Masters and Johnson presented a sexual problem-solving book that quickly became the spark for an entirely new form of couples therapy. In Human Sexual Inadequacy and in The Pleasure Bond, they suggest techniques for slowing men down and speeding women up in their sexual response. They present sensate focus, a technique for learning to touch and be touched, and describe the “tease technique” and the “squeeze technique” to help with impotence and premature ejaculation respectively. Their diagnostic categories are based on time, on coming too soon, taking too long, or not spending enough time. Women may have problems having orgasm, but men are always orgasmic if they ejaculate, preferably “on time” for the female. For the first time, we had individual diagnosis based on two people; men were premature, but women were never postmature. Sex clinics proliferated following their work, as Masters and Johnson gave unwilling birth to the Arthur Murray “sex” studios of the seventies. While Masters and Johnson trained only a few teams, their educational programs were offered to hundreds who in turn felt themselves to be “Masters and Johnson” qualified, franchised sexperts. Unlike the first and second perspectives, this third perspective was being directly interpreted for us on talk shows and in popular magazines, each preaching the same “time-frame sex” of this third view of sexuality. Perhaps a society that now had more time to recreate and less need to procreate was more than ready for a perspective on sex that stressed efficient, effective use of our sex time.
There is no question that Masters and Johnson made a significant and lasting contribution to “democratizing” sex. Their treatment program was for couples, and even though their sexual-response model was based on the individual, they treated couples with treatment teams, and saw marriage as much more than a natural state or convenience. They saw it as a challenge, a potential for pleasure and sexual satisfaction as well as companionship, a place where time could be better controlled. In my view, the most significant contribution of Masters and Johnson was not their flawed sexual-response model, which modified the original Ellis model. Their contribution was to focus on a system, an interaction. They were a team, a man-and-woman team, and that allowed the feminist balance so lacking in the first two perspectives. They started the systerns approach to sex that I emphasize in the super marital sex perspective.
*101\97\8*
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