Mina -- Following is the June issue of "Spotlight on Food." Hope you=20 enjoy it. Best regards, Kathrynne Spotlight on Food --nutrition news for people 60-plus Copyright 1996, Five Star Living, Inc., All Rights Reserved June 1996 -- Vol. 2, No. 6=20 Water Power--a natural force for better living! -------------------------------------------------------------------------= --------------------------- (Future Spotlights: Everything you ever wanted to know about fiber! --=20 Food that celebrates summer -- Give your body a "road test", Part II --=20 A cancer check that could save your life!) -------------------------------------------------------------------------= --------------------------- Dear Reader, =09 =09 What do you think would happen if I were to give a talk about a=20 precious substance that would carry life-giving minerals and vitamins=20 across the cell membranes of your body? That would rid your body of=20 wastes and toxic matter? That would help keep you from overheating in hot weather? That would=20 help prevent dry, itchy skin in cold weather? That helps prevent=20 constipation? Why, tickets to that talk would be sold out! Most folks=20 would ask, "Where can I buy this stuff? I'll pay anything!" Now--what if I told you that the stuff I'm talking about is=20 easy to find; cheap; available in your own home; and is commonly=20 ignored? What if I told you this precious substance is water? If I offered to give a talk about water, I guarantee no one=20 would come, not even if the talk were free! Water is so cheap, so=20 plentiful, and so easy to get, that I guess we take it for granted. Soda=20 pop, lemonade, coffee, iced tea and fruit juices taste so good that we=20 often ignore water. We forget all the special things about water that no=20 other drink can match. Water dissolves the vitamins and minerals we need. Then blood,=20 which is mostly water, carries them throughout the body. Water helps=20 lubricate our joints. Water acts as a shock absorber inside the eyes and=20 spinal cord.=20 And think what happens when we eat a meal. When the digestive=20 system changes the food into fuel for the body, many toxins and wastes=20 are produced. Water is the force that carries these wastes out of the=20 body in the breath, in the urine, and in fecal matter. If not for water,=20 the wastes would become poisonous, and we would die as a result of the=20 food we eat and the air we breathe! Truly, water is a miraculous=20 substance. There's nothing like it. Coffee, juices, and other fluids, as=20 well as most foods, contain water. But no substance can match all the=20 qualities of plain, pure water.=20 For example, coffee, tea, and many kinds of soda pop contain=20 caffeine. Because caffeine is an irritant, the body uses up some of its=20 precious store of water to flush the caffeine out of its cells. This=20 means that caffeine-containing fluids actually cause a slight=20 dehydration! This is also true of alcoholic drinks--that ice-cold beer=20 contains alcohol that will draw some water out of your body. Sweet drinks like lemonade, pop, and other sugary fluids are=20 different--they cause water to concentrate in the stomach and=20 intestines, instead of getting absorbed into the rest of the body, where=20 it's needed.=20 Is your skin dry and itchy? Especially in winter? Well, it could=20 be because your skin doesn't produce as much oil as it used to. But--if=20 we don't drink enough water, there won't be enough to supply all our=20 body's needs. The skin gets left out. It becomes dry, and itchiness=20 follows. Tip: Lay your right hand flat on the table, palm down. Then take=20 the finger and thumb of your left hand and pinch up some skin from the=20 back of the right hand. Hold it while counting to ten, then release. If=20 the pinched skin quickly flattens out, you're probably getting enough=20 water. But if it stays pinched up while you count to twenty, it's likely=20 you're dehydrated, and need to drink more water. How does water help constipation? In times when the body has too=20 little water, it will give top priority to organs like the brain, and=20 the kidneys. The brain needs water to keep its delicate balance. The=20 kidneys must have water to flush out body wastes. The colon's job is to=20 add water to the stool to keep it soft. But a hard stool is not=20 life-threatening, so the colon has a low priority on water. When there's=20 not enough to go around, some water is removed from the colon and given=20 to other organs. The stool becomes dry and hard, and difficult to pass,=20 resulting in constipation.=20 Constipation that lasts more than a few days can lead to fecal=20 impaction. This is a large mass of hard feces that cannot be passed from=20 the bowel. Fecal impaction can require hospitalization. Although there=20 are many other causes of constipation, without water, constipation is a=20 sure bet.=20 Sweating means your hot, right? Wrong! Sweating means you're=20 cool. During the hot months of summer, water can make a life-or-death=20 difference. Water forms lifesaving perspiration that allows us to stay=20 healthy in hot weather.=20 How? When it's hot out, the body heats up, too. But water in our=20 tissues absorbs the heat. When the water has absorbed all the heat it=20 can hold, it leaves the body as perspiration. The evaporating sweat=20 takes the absorbed heat with it, leaving our insides cooler--a safe 98.6=20 .=09 And with summer coming up, that's important. Hundreds of people,=20 mostly older adults, died last summer from the heat. Most of those=20 deaths could have been prevented just by drinking plenty of water. If we don't replace perspiration by drinking extra water, heat=20 stays in the blood, and body temperature begins to rise. At about 105 =20 the body's mechanisms start to break down. Signs of heat stroke are:=20 flushed skin, headache, fatigue, confusion, and lessened sweating,=20 followed by unconsciousness. We can't depend on thirst to warn us to drink enough water.=20 You'd think we should eat when we're hungry, and drink when we're=20 thirsty. It's true that hunger is a timely reminder to eat. But for=20 some reason, our thirst mechanism doesn't work the same way. By the time=20 we feel thirsty, we're already dehydrated. And extreme heat affects the=20 brain, causing confusion. At this point, a person may not be able to=20 think clearly enough to drink water. Older adults are more at risk. The thirst mechanism slows down=20 with age. Also, older adults are more likely to take medications that=20 decrease sweating. Among these are drugs used to treat asthma, urinary=20 incontinence, and Parkinson's disease. Unless your doctor has ordered a fluid restriction, or other=20 dietary plan, the best bet is drink plenty of plain water, plus milk=20 and juices. Experts recommend at least two quarts (8 large glasses) of=20 water daily. If you drink coffee, tea, or other caffeine-containing=20 drinks, or alcohol, be sure to drink an equal amount of water. Tip: I use a one-quart sports bottle, the kind with a straw that=20 sticks out the top. I take it with me all day. It's an easy to make sure=20 I get my two quarts daily! But if you're not used to drinking water, start gradually adding=20 a glass or two a day, and work up to 8 glasses. Your system may take=20 some time to adjust. You could find that you retain water at first, but=20 gradually your body will release the extra fluids and stay at a=20 well-hydrated level.=20 Tip: For a free brochure, Hyperthermia: A Hot Weather Hazard for=20 Older People, send your name and address to: NIA Information Center,=20 P.O. Box 8057, Gaithersburg, MD 20898-8057. Fresh strawberries are in season, so here's a simple dessert=20 that's high in taste and easy to make. You can use different kinds of=20 fruit, like pineapple and orange slices; or experiment with other=20 flavors of yogurt. To lower sugar, try sugar-free yogurt. Strawberries on a couch 2 slices angel food cake 1 8-oz container lemon yogurt 1 banana, sliced 1 cup sliced strawberries Place cake slices on a pretty plate; spread =BD cup yogurt over each=20 slice. Divide banana slices between the two plates, then top with=20 strawberry slices. Makes two portions. Nutrition information per portion: 2 servings fruit =BD serving calcium -------------------------------------------------------------------------= --------------------------- I've had many requests from people who are concerned about=20 restaurant dining. Some travel a lot, others simply enjoy going out to=20 eat. They want to know whether they're getting healthful choices. My=20 advice is: if you dine out seldom, I=0Cwouldn't worry too much about the=20 salt and fat in the food. However, if you regularly eat at restaurants,=20 it's a good practice to make healthful choices. So I've put together a=20 sample one-day menu from some popular restaurant chains.=20 Food and Number of Servings from Food Pyramid Breakfast: McDonald's=09 Orange juice: 1 fruit Cheerios: 1 bread 1% milk: 1 calcium Apple-bran muffin (fat-free): 2 bread Lunch: Applebee's (This restaurant cooks some dishes to order; bring=20 your own salt substitute and ask the waiter to leave=20 out salt) Low-fat Veggie Quesadilla: 2 bread, 1 calcium, 2 vegetable Skinny Minny Carrot Cake Iced tea Dinner: Olive Garden (You can ask your waiter to bring low-fat salad =09 dressing; also bread sticks without the added=20 margarine) House salad with low-fat dressing: 2 vegetables Grilled Herb Chicken with Peppers: 1 protein, 1 vegetable 2 bread sticks: 2 bread Raspberry Sorbetto, Coffee or Tea Is this a balanced one-day menu? Well, it's close. We have seven=20 servings of bread, five of vegetables, and two calcium-rich foods. But=20 there's only one serving of fruit and one of protein. However, the=20 quesadilla has cheese, which contains protein as well as calcium, so=20 there's enough protein for the day. It can be difficult, though, to get two or more servings of=20 fruit when eating at restaurants. If you eat most or all your meals at=20 restaurants, I encourage you to pack some grapes, bananas, apples, or=20 other fruits, to eat as snacks between meals. Fruit is rich in nutrients=20 that other foods don't have. Of course, many restaurants offer fruit selections, and I'd=20 certainly take advantage of these whenever you can. Also any dark-green,=20 leafy or yellow vegetables. Restaurant dining has gotten some hard=20 knocks, but I think we should all enjoy dining out--it's fun, relaxing,=20 and can be perfectly healthful. Bon appetit! -------------------------------------------------------------------------= --------------------------- Nonessentials: "It is proverbial of the American people that they bolt=20 their food whole, washing it down with various fluids, thus forcing the=20 stomach to perform not only its own duties, but also those of the teeth=20 and salivary glands. This manner of dispatching food...is not without=20 its baleful consequences, for the Americans are called a nation of=20 dyspeptics." The People's Common Sense Medical Adviser, pub. 1886. -------------------------------------------------------------------------= --------------------------- You and your doctor=20 This month a family practitioner talks about Parkinson's=20 disease. Dr. William J. Thieman, M.D., has been a family practitioner=20 for 15 years. He understands and treats the health needs of older=20 adults, including hypertension, diabetes, arthritis and impotence. Is it really Parkinson's disease? Parkinson's disease is a=20 disorder that results from damage to the brain. Doctors don't yet know=20 what causes it, but the signs of Parkinson's disease include trembling=20 in the arm, hand, or leg; rigid posture; and unbalanced, shuffling=20 walk. As the disease progresses, there may be shaking of the head and a=20 stooped posture. Everyday activities, like bathing and dressing, become=20 difficult to perform. Now, the National Institute on Aging reports on medications that=20 may produce symptoms like Parkinson's disease. Researchers have found=20 that several commonly-prescribed drugs can produce effects that are much=20 like Parkinson's--so similar, in fact, that some people have been=20 wrongly diagnosed with Parkinson's disease. For example, sometimes people have nausea or vomiting during=20 cancer treatment. The drug Reglan (metoclopramide) is often prescribed=20 to prevent this stomach upset, allowing the patient to eat normally.=20 Reglan may also be used for heartburn.=20 Although Reglan is a useful medication, some older adults=20 experience reactions, especially if they use it for a long time, or use=20 large doses.Undesirable reactions to Reglan include rigidity, trembling,=20 or mask-like faces.=20 Doctors may believe the patient has Parkinson's, and begin=20 prescribing drugs for Parkinson's disease. Certain tranquilizers taken=20 for nervous disorders can also cause Parkinson-like symptoms in some=20 older adults. The National Institute on Aging cautions older adults to be=20 aware of possible side effects of these and other drugs. If you or=20 someone you know begins to have symptoms after starting a new=20 medication, it's important to let your doctors know. Your family doctor can be very helpful in dealing with other=20 specialists. You must tell your family doctor about all the medications=20 you receive from other physicians. And it's important to explain the=20 symptoms you experience. New and better medications are being developed each year,=20 providing relief from Parkinson's disease, and other illnesses. However,=20 older adults are more likely than younger persons to experience=20 undesirable reactions from drugs. Your doctor wants to choose the=20 medication that's best for you. So it's important to work closely=20 together.=20 Be extra alert to side effects when starting any new medication.=20 It helps to inform those near to you--a spouse, a neighbor, a loved=20 one--so that they can be on the lookout for unusual behavior, too. And=20 it may help to bring that person with you when you go to the doctor.=20 Sometimes a second person can bring a different perspective or=20 explanation. Always be sure your family doctor knows of any new symptoms you=20 have after starting a new medication. Together, you can find a treatment=20 that's best for you. -------------------------------------------------------------------------= --------------------------- Exercise your potential ! =20 Ever wondered just how fit you are? Thinking of starting an=20 exercise program? If you're planning strenuous activity, your doctor may=20 suggest a medical evaluation, including exercise testing, before you get=20 started. Here's up-to-date information from the director of an acclaimed=20 cardiac rehabilitation program.. This is the first of a two-part series. Giving your body a =91Road Test.' Barry Franklin, Ph.D. What is exercise=20 stress testing? It's a medical procedure that measures how your heart=20 and blood vessels respond to increasing exercise. Testing your heart as=20 you exercise can be more revealing than a test done while you're at=20 rest. A stress test gives your heart, lungs, and blood vessels a "road=20 test," so to speak. There are several reasons why your doctor might recommend a=20 stress test: 1) to help detect heart disease; 2) to check your physical=20 fitness; 3) to see if it's safe for you to exercise vigorously; or 4)=20 to measure your heart's response to various medical treatments. During the test you'll pedal a stationery bicycle or walk on a=20 treadmill. Throughout the test--which usually lasts 8 to12 minutes--you=20 gradually pedal faster or walk harder until you are too tired to=20 continue or until you show signs of significant heart strain. A doctor or technician monitors your blood pressure and heart=20 with a blood pressure cuff and an electrocardiograph (ECG). The ECG=20 shows whether something is wrong with the way your heart is beating, and=20 helps to determine whether you have heart disease. Is it dangerous to push yourself to maximum effort during a=20 stress test? Serious problems, like heart attacks, are very rare,=20 because you are carefully monitored. Occasionally, patients may become=20 dizzy or faint, or may feel chest pain or tightness during the test. But=20 these effects are rare. The test is remarkably safe, in spite of its=20 strenuous nature. How can the test help to diagnose heart disease? Blockage of=20 the arteries that supply blood to the heart can cause heart attacks. An=20 oxygen supply-demand imbalance can often be detected with a stress test.=20 At rest, the blockage may not be severe enough to deprive the heart of=20 oxygen. During exercise, though, the reduced blood supply may cause=20 chest pain or changes on the ECG. Exercise stress testing best detects heart disease in people at=20 increased risk of heart problems. Those at risk include middle-aged or=20 older people who have one or more major risk factors (such as high=20 cholesterol, high blood pressure, cigarette smoking, or an inactive=20 lifestyle) or symptoms (such as chest pain, left arm pain with exertion,=20 dizziness, shortness of breath, or fatigue). Sometimes heart disease may not show up on an ECG. Or the ECG=20 may suggest heart disease when none exists. So doctors use other medical=20 findings in addition to the stress test to interpret its results.=20 Next month: Exercise safety. Dr. Franklin is Director, Cardiac=20 Rehabilitation and Exercise Laboratories, William Beaumont Hospital, and=20 Professor of Physiology, Wayne State University, School of Medicine. -------------------------------------------------------------------------= --------------------------- Ask an RD=20 Now you can get personal nutrition information from a registered=20 dietitian. Kathrynne Holden, MS, RD, will answer your questions. Your=20 age, height and weight, plus any medications you take, are helpful.=20 Write to Five Star Living, Inc. (address on back page). Q: I'm an 86-year-old man with high triglycerides and high blood sugar.=20 I'm taking atenolol, Capoten, furosemide, gemfibrozil, and, since last=20 month, Glucotrol for blood sugar. My cholesterol is OK, but what are=20 triglycerides, anyway? A: Triglycerides are a type of fat found in fatty foods. The body also=20 makes triglycerides from the food we eat. Normally, we store extra=20 triglycerides as fat. But sometimes these fats stay in the blood. This=20 can happen when we eat too many starches or sugar, or too much fat.=20 Frequently triglyceride levels rise as we age. Weight gain can also=20 cause increased triglycerides, as can stress. Normally the blood level of triglycerides should be around=20 40-160 for men, a bit lower for women. Your doctor is concerned about=20 your triglyceride level because many people with coronary heart disease=20 also have high levels of triglycerides in the blood. However, not everyone with high triglycerides has heart=20 disease.Your doctor considers your age, blood pressure, fluid =20 retention, medical history, and other factors, in treating your=20 condition. Many people find that weight loss will lower their=20 triglycerides. Other good practices are to limit or eliminate alcohol;=20 limit sweets and fatty foods; and, unless you have food allergies or=20 other conditions, eat plenty of high-fiber foods, fish, and seafood. I=20 encourage you to eat at least three to five servings of cooked dried=20 beans each week, for their fiber, protein, minerals, and other=20 nutrients. I'd use whole grains as much as possible, too, like oatmeal,=20 whole wheat bread, and cereals like Shredded Wheat. The atenolol prescribed by your doctor should be used with a=20 low-sodium, low-fat diet. It can raise levels of triglycerides. The=20 Capoten and furosemide are also best taken with a low-sodium, low-fat=20 diet. Both these drugs can raise blood sugar. The gemfibrozil should help lower your triglycerides; it should=20 be combined with a low-fat diet with limited sugar. It, too, can raise=20 blood sugar. The Glucotrol may help control your blood sugar. Be sure to eat=20 within 30 minutes of taking Glucotrol. It's important to space your=20 meals 4-6 hours apart, and to limit sugary foods. You don't say how long you have had high triglycerides or high=20 blood sugar. It could be that some of your medications may be causing=20 these conditions. If you see more than one doctor, be sure that each one=20 is aware of all the drugs you use. A doctor may want to change or stop a=20 drug, depending on those other doctors have ordered. And I'd ask your=20 doctor whether you're getting enough exercise. It can help lower blood=20 sugar, blood pressure, and weight. If you follow the kind of menus in Spotlight, you're on the=20 right track--they're moderate in fat, sodium, and sugar. Here's to your=20 good health! -------------------------------------------------------------------------= --------------------------- TOP TIP: Ever go into the doctor's office and forget everything=20 you had prepared to ask about? The National Institute on Aging has a=20 free new booklet that will help! Entitled Talking With Your Doctor: A=20 Guide for Older People, it helps solve the kind of problems you=20 sometimes have with your doctors. Topics like Tips for good=20 communication; Getting started with a new doctor; How to talk about your=20 health issues; and many more, will help you get more out of your=20 checkups. Call NIA weekdays from 8:30 AM-5:00 PM EST: 1-800-222-2225 for=20 your free booklet. -------------------------------------------------------------------------= --------------------------- Serving sizes from the food guide pyramid: Bread (complex carbohydrate) group 6-11 servings daily 1 slice bread; 1 oz dry cereal; =BD cup cooked cereal, rice or pasta; 4=20 small crackers;=20 2 large crackers; =BD bagel or English muffin Vegetable group 3-5 servings daily =BD cup cooked vegetables; =BD cup chopped raw veg.; 6 oz vegetable juice= ; 1 cup raw leafy greens Fruit group 2-4 servings daily 1 medium apple, banana, or orange; =BD cup fresh berries; 15 grapes; =BD = cup=20 applesauce 1/4 cup dried fruit; 3/4 cup fruit juice Calcium (dairy) group 2-3 servings daily 4 oz canned sardines; 1 cup cooked spinach; 2 cups cooked navy beans 1 cup milk or yogurt; 1-1/2 oz cheese; 2 cups cottage cheese Protein (meat) group 2-3 servings daily 2-3 oz cooked meat, fish or poultry; 1 cup cooked dry beans; 2 large=20 eggs 4 TB peanut butter Fats, oils, & sweets Use sparingly Fats: Butter, margarine, sour cream, mayonnaise, salad dressing, oil Sweets: sugar, jam, jelly, honey, syrup, soft drinks, desserts. Send your questions, comments, and opinions to: Five Star Living, Inc.=20 at this address -- we look forward to hearing from you!!=20 Five Star Living, Inc. =09 604 East Pitkin =09 Fort Collins CO 80524 Tel: 970-493-6532 Fax: 970-493-6538 E-mail: [log in to unmask] URL: http://www.fortnet.org/~fivstar E-mail subscription: $12.00 per year.=20 Spotlight on Food=99 (ISSN 1083-3056) is published monthly by: Five Star=20 Living, Inc., 604 East Pitkin, Fort Collins CO 80524. Tel: 970-493-6532=20 Fax: 970-493-6538 E-mail: <[log in to unmask]> URL:=09 <http://www.fortnet.org/~fivstar> Please contact this office if you have questions for "Ask an RD" or=20 about a subscription. Editor: Kathrynne Holden, M.S., R.D. Contributing=20 Editor: Barry Franklin, Ph.D. Editorial advisor: William J. Thieman,=20 M.D.=20 Spotlight on Food is intended to provide timely nutrition information of=20 a general nature. Mention of a product by brand name does not=20 constitute an endorsement of that product. Spotlight on Food cannot=20 offer medical services, and is not intended to substitute for medical=20 services. Readers are encouraged to seek professional medical advice for=20 their personal health needs. Copyright 1996 Five Star Living, Inc., all=20 rights reserved. Photocopying, reproduction, or quotation in whole or in=20 part is forbidden without the publisher's written permission. --=20 Kathrynne Holden, MS, RD Editor-in-Chief, "Spotlight on Food--nutrition news for people 60-plus" Tel: 970-493-6532 Fax: 970-493-6538=20 http://www.fortnet.org/~fivstar Contact Better Business Bureau of the Mountain States, < [log in to unmask]>