HEALTHY DIET.

• A healthy diet helps protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including diabetes, heart disease, stroke and cancer.
• Unhealthy diet and lack of physical activity are leading global risks to health.
• Healthy dietary practices start early in life – breastfeeding fosters healthy growth and improves cognitive development, and may have longer-term health benefits, like reducing the risk of becoming overweight or obese and developing NCDs later in life.
• Energy intake (calories) should be in balance with energy expenditure. Evidence indicates that total fat should not exceed 30% of total energy intake to avoid unhealthy weight gain with a shift in fat consumption away from saturated fats to unsaturated fats  and towards the elimination of industrial trans fats.
• Limiting intake of free sugars to less than 10% of total energy intake is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits.
• Keeping salt intake to less than 5 g per day helps prevent hypertension and reduces the risk of heart disease and stroke in the adult population.
• WHO Member States have agreed to reduce the global population’s intake of salt by 30% and halt the rise in diabetes and obesity in adults and adolescents as well as in childhood overweight by 2025.

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Overview

Consuming a healthy diet throughout the lifecourse helps prevent malnutrition in all its forms as well as a range of noncommunicable diseases and conditions. But the increased production of processed food, rapid urbanization and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars or salt/sodium, and many do not eat enough fruit, vegetables and dietary fibre such as whole grains.

The exact make-up of a diversified, balanced and healthy diet will vary depending on individual needs (e.g. age, gender, lifestyle, degree of physical activity), cultural context, locally available foods and dietary customs. But basic principles of what constitute a healthy diet remain the same.

For adults

A healthy diet contains:

• Fruits, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice).
• At least 400 g (5 portions) of fruits and vegetables a day. Potatoes, sweet potatoes, cassava and other starchy roots are not classified as fruits or vegetables.
• Less than 10% of total energy intake from free sugars which is equivalent to 50 g (or around 12 level teaspoons) for a person of healthy body weight consuming approximately 2000 calories per day, but ideally less than 5% of total energy intake for additional health benefits. Most free sugars are added to foods or drinks by the manufacturer, cook or consumer, and can also be found in sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
• Less than 30% of total energy intake from fats. Unsaturated fats (e.g. found in fish, avocado, nuts, sunflower, canola and olive oils) are preferable to saturated fats (e.g. found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard). Industrial trans fats (found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines and spreads) are not part of a healthy diet.
• Less than 5 g of salt (equivalent to approximately 1 teaspoon) per day and use iodized salt.

For infants and young children

In the first 2 years of a child’s life, optimal nutrition fosters healthy growth and improves cognitive development. It also reduces the risk of becoming overweight or obese and developing NCDs later in life.

Advice on a healthy diet for infants and children is similar to that for adults, but the following elements are also important.

• Infants should be breastfed exclusively during the first 6 months of life.
• Infants should be breastfed continuously until 2 years of age and beyond.
• From 6 months of age, breast milk should be complemented with a variety of adequate, safe and nutrient dense complementary foods. Salt and sugars should not be added to complementary foods.

Practical advice on maintaining a healthy diet

Fruits and vegetables

Eating at least 400 g, or 5 portions, of fruits and vegetables per day reduces the risk of NCDs and helps ensure an adequate daily intake of dietary fibre.

In order to improve fruit and vegetable consumption you can:

• always include vegetables in your meals
• eat fresh fruits and raw vegetables as snacks
• eat fresh fruits and vegetables in season
• eat a variety of choices of fruits and vegetables.

Fats

Reducing the amount of total fat intake to less than 30% of total energy intake helps prevent unhealthy weight gain in the adult population.

Also, the risk of developing NCDs is lowered by reducing saturated fats to less than 10% of total energy intake, and trans fats to less than 1% of total energy intake, and replacing both with unsaturated fats.

Fat intake can be reduced by:

• changing how you cook – remove the fatty part of meat; use vegetable oil (not animal oil); and boil, steam or bake rather than fry;
• avoiding processed foods containing trans fats; and
• limiting the consumption of foods containing high amounts of saturated fats (e.g. cheese, ice cream, fatty meat).

Salt, sodium and potassium

Most people consume too much sodium through salt (corresponding to an average of 9–12 g of salt per day) and not enough potassium. High salt consumption and insufficient potassium intake (less than 3.5 g) contribute to high blood pressure, which in turn increases the risk of heart disease and stroke.

1.7 million deaths could be prevented each year if people’s salt consumption were reduced to the recommended level of less than 5 g per day.

People are often unaware of the amount of salt they consume. In many countries, most salt comes from processed foods (e.g. ready meals; processed meats like bacon, ham and salami; cheese and salty snacks) or from food consumed frequently in large amounts (e.g. bread). Salt is also added to food during cooking (e.g. bouillon, stock cubes, soy sauce and fish sauce) or at the table (e.g. table salt).

You can reduce salt consumption by:

• not adding salt, soy sauce or fish sauce during the preparation of food
• not having salt on the table
• limiting the consumption of salty snacks
• choosing products with lower sodium content.

Some food manufacturers are reformulating recipes to reduce the salt content of their products, and it is helpful to check food labels to see how much sodium is in a product before purchasing or consuming it.

Potassium, which can mitigate the negative effects of elevated sodium consumption on blood pressure, can be increased with consumption of fresh fruits and vegetables.

Sugars

The intake of free sugars should be reduced throughout the lifecourse. Evidence indicates that in both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake provides additional health benefits. Free sugars are all sugars added to foods or drinks by the manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity.

Sugars intake can be reduced by:

• limiting the consumption of foods and drinks containing high amounts of sugars (e.g. sugar-sweetened beverages, sugary snacks and candies); and
• eating fresh fruits and raw vegetables as snacks instead of sugary snacks.

How to promote healthy diets

Diet evolves over time, being influenced by many factors and complex interactions. Income, food prices (which will affect the availability and affordability of healthy foods), individual preferences and beliefs, cultural traditions, as well as geographical, environmental, social and economic factors all interact in a complex manner to shape individual dietary patterns. Therefore, promoting a healthy food environment, including food systems which promote a diversified, balanced and healthy diet, requires involvement across multiple sectors and stakeholders, including government, and the public and private sector. Stay healthy always. 

CHILDREN AND MALNUTRITION

Malnutrition is responsible, directly or indirectly for about one third of deaths among children under five. Well above two thirds of these deaths, often associated with inappropriate feeding practices, occur during the first year of life.
Nutrition and nurturing during the first years of life are both crucial for life-long health and well-being. In infancy, no gift is more precious than breastfeeding; yet barely one in three infants is exclusively breastfed during the first six months of life.
The response
The World Health Organization recommends that infants start breastfeeding within one hour of life, are exclusively breastfed for six months, with timely introduction of adequate, safe and properly fed complementary foods while continuing breastfeeding for up to two years of age or beyond.
Promoting sound feeding practices is one of the main programme areas that the Department of Nutrition for Health and Development focuses on. Activities include the production of sound, evidence-based technical information, development of guidelines and counselling courses, provision of guidance for the protection, promotion and support of infant and young child feeding at policy, health service and community levels, production of appropriate indicators and maintenance of a Global Data Bank on Infant and Young Child Feeding.

CIRRHOSIS OF THE LIVER: AN OVERVIEW

Cirrhosis occurs in response to damage to the liver. Each time the liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function.

Decompensated cirrhosis is the term used to describe the development of specific complications resulting from the changes brought on by cirrhosis. Decompensated cirrhosis is life-threatening.

The liver damage done by cirrhosis generally can't be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

Symptoms

Cirrhosis often has no signs or symptoms until liver damage is extensive. When signs and symptoms do occur, they may include:

    Fatigue
    Bleeding easily
    Bruising easily
    Itchy skin
    Yellow discoloration in the skin and eyes (jaundice)
    Fluid accumulation in your abdomen (ascites)
    Loss of appetite
    Nausea
    Swelling in your legs
    Weight loss
    Confusion, drowsiness and slurred speech (hepatic encephalopathy)
    Spiderlike blood vessels on your skin
    Redness in the palms of the hands
    Testicular atrophy in men
    Breast enlargement in men


Causes
A wide range of diseases and conditions can damage the liver and lead to cirrhosis. The most common causes are:

    Chronic alcohol abuse
    Chronic viral hepatitis (hepatitis B and C)
    Fat accumulating in the liver (nonalcoholic fatty liver disease)

Other possible causes include:

    Iron buildup in the body (hemochromatosis)
    Cystic fibrosis
    Copper accumulated in the liver (Wilson's disease)
    Poorly formed bile ducts (biliary atresia)
    Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
    Genetic digestive disorder (Alagille syndrome)
    Liver disease caused by the body's immune system (autoimmune hepatitis)
    Destruction of the bile ducts (primary biliary cirrhosis)
    Hardening and scarring of the bile ducts (primary sclerosing cholangitis)
    Infection such schistosomiasis
    Medications such as methotrexate

Complications

Complications of cirrhosis can include:

Complications related to blood flow:

    High blood pressure in the veins that supply the liver (portal hypertension): Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood from the intestines and spleen to the liver.
 
 Swelling in the legs and abdomen: Portal hypertension can cause fluid to accumulate in the legs (edema) and in the abdomen (ascites). Edema and ascites also may result from the inability of the liver to make enough of certain blood proteins, such as albumin.
 
  Enlargement of the spleen (splenomegaly): Portal hypertension can also cause changes to the spleen. Decreased white blood cells and platelets in your blood can be a sign of cirrhosis with portal hypertension.
   
Bleeding: Portal hypertension can cause blood to be redirected to smaller veins, causing them to increase in size and become varices. Strained by the extra load, these smaller veins can burst, causing serious bleeding. Life-threatening bleeding most commonly occurs when veins in the lower esophagus (esophageal varices) or stomach (gastric varices) rupture. If the liver can't make enough clotting factors, this also can contribute to continued bleeding. Bacterial infections are a frequent trigger for bleeding.

Other complications:

    Infections: If you have cirrhosis, your body may have difficulty fighting infections. Ascites can lead to spontaneous bacterial peritonitis, a serious infection.
 
 Malnutrition: Cirrhosis may make it more difficult for your body to process nutrients, leading to weakness and weight loss.
 
  Buildup of toxins in the brain (hepatic encephalopathy): A liver damaged by cirrhosis isn't able to clear toxins from the blood as well as a healthy liver can. These toxins can then build up in the brain and cause mental confusion and difficulty concentrating. Hepatic encephalopathy symptoms may range from fatigue and mild impairment in cognition to unresponsiveness or coma.
 
 Jaundice: Jaundice occurs when the diseased liver doesn't remove enough bilirubin, a blood waste product, from your blood. Jaundice causes yellowing of the skin and whites of the eyes and darkening of urine.
   
Bone disease: Some people with cirrhosis lose bone strength and are at greater risk of fractures.
   
Increased risk of liver cancer: A large proportion of people who develop liver cancer that forms within the liver itself have cirrhosis.
 
 Acute-on-chronic liver failure: Some people end up experiencing multiorgan failure. Researchers now believe this is a distinct complication in some people who have cirrhosis, but they don't fully understand its causes.

CLEAN EATING

The latest buzz word among health-conscious consumers, “eating clean,” is a concept that stresses healthy, whole, unprocessed foods. And, although the phrase is relatively new, the principles of this plan are not.

The principles are based on current nutrition science and are similar to recommendations made by public health organizations. This sound approach to eating and living well maximizes your energy and optimizes your health, making it more than just a diet. It’s a lifestyle, with built-in flexibility, meaning it can be adapted to fit most any kind of routine.

"Clean Eating" dates back to the natural health food movement of the 1960s, which shunned processed foods for the sake of moral and societal values (rather than health and nutrition issues).  Eventually it landed in gyms, where it gained momentum among body builders and fitness models. Recently, however, it made the jump into mainstream America, rejuvenating and inspiring a new generation of healthy eaters.

With each move, the clean eating concept became more refined and developed.  Here are the seven core principles of today:

1. Choose whole, natural foods and seek to eliminate or minimize processed foods.
Processed foods are anything in a box, bag, can, or package, and although there are always a few exceptions to the rule (like a bag of fresh green beans), the majority of your foods should be fresh.

2. Choose unrefined over refined foods.
While it may not be possible all the times, you can up your intake of whole grains like brown rice, millet, amaranth, and quinoa. Beans and legumes are also important. Clean sugars include honey, maple syrup, and dehydrated sugar cane juice.

3. Include some protein, carbohydrate and fat at every meal.
Most of us typically do well with carbohydrates and fat, but we often lack protein, especially in the early part of the day, like at breakfast and lunch. Protein is an important muscle-builder, and it can also help curb your appetite. When eaten throughout the day, it keeps us feeling full longer. Be aware of the kinds of meals you put together and space out your protein.

4. Watch out for fat, salt, and sugar.
This is easier than you think, particularly if you’ve cut out processed foods, which are responsible for most of our excess calories and high levels of fat, sugar, and salt. Clean foods are usually naturally low in all of these ingredients.

5. Eat five to six small meals throughout the day.
This usually pans out into three main meals and two or three hefty snacks. Eating this way prevents you from skipping meals and overeating. It also keeps your blood sugar levels steady so energy doesn’t lag.

6. Don’t drink your calories.
High calorie drinks like specialty coffees and soft drinks, on average, tack on an extra 400 to 500 calories a day. Choose water first, or my personal favorite, unsweetened tea (any flavor). Other clean drinks: low-fat or skim milk and 100 percent fruit juice diluted with sparkling water.

7. Get moving.
Regular physical activity is a must for many reasons. Not only does it decrease fat, strengthen and build muscle, and help you burn more energy at rest, it keeps your heart, lungs, and bones healthy and strong.

ALCOHOL AND DEHYDRATION

Excess alcohol consumption can cause dehydration in a variety of ways. Firstly, alcohol decreases the body's production of anti-diuretic hormone, which is used by the body to reabsorb water. With less anti-diuretic hormone available, your body loses more fluid than normal through increased urination. Drinking excessive amounts of alcohol can also cause vomiting, which depletes the body of fluids and can cause further dehydration .
The effects of alcohol vary from person to person, but in general the less a person weighs the less alcohol it takes to cause dehydration or vomiting. The National Health and Medical Research Council recommends that men and women drink no more than four standard drinks on any single occasion. Drinking more than this amount is considered excessive, and can increase the risk of alcohol‐related injury.

What are the signs and symptoms I should be aware of?
If you are concerned that you may become dehydrated while consuming alcohol, look out for the following symptoms:
A dry, sticky mouth
Sleepiness or tiredness
Thirst
Decreased urination
Headache
Dizziness or light headedness

How can I prevent dehydration if I know I will be drinking alcohol?
Drinking water along with alcoholic beverages can help to prevent dehydration. Have a glass of water before you start drinking alcohol and alternate alcoholic beverages with water throughout the evening. Drinking a glass of water before you go to bed will also help to relieve dehydration. A good alternative to water is an
electrolyte solution which provides not only the water but valuable electrolytes.

How do I treat the symptoms of dehydration after I've had excess alcohol?
Even if you feel fine the morning after heavy drinking, alcohol has long lasting effects that will reduce your ability to function at your best. Electrolyte replacement solutions and broths are ideal for replacing the sodium and potassium that is lost during alcohol consumption. Drink plenty of fluids, especially rehydration drinks and try to rest as much as possible.

REMEMBER TO ALWAYS STAY HEALTHY.