Health & Views –February 2020 – 1st issue By Harold Gunatillake
Written by Dr. harold Gunatillake FRCS (UK), MBBS (Cey), AM (Sing), FICS (US), FIACS (US)
“Man does not live by bread alone, even resliced bread.”
Bread is made from wheat flour, salt, yeast, oil, refined sugar, preservatives and white bread is enriched with some nutrients.
High intake of carbohydrate as in white bread can lead to weight gain, and a risk for diabetes, heart disease and other lifestyle chronic diseases.
Therefore, diabetics are recommended bread baked with unprocessed wholemeal wheat and limited to two slices.
The various types of bread made in different ways are addictive to the taste buds and the desire to eat another slice is tempting. Most dieticians recommend two slices and no more.
White bread is highly processed and easily digested but has little nutritional value. White bread does more harm by adding excess calories and few nutrients.
Unprocessed wheat flour is used to bake brown bread. They are digested and absorbed slowly causing no sugar spikes in your blood, unlike the processed white bread and provide vitamin B, fibre and minerals.
Brown bread is not always baked from unprocessed whole grain. In Sri Lanka people buy brown bread assuming to be more healthy than white bread and highly priced.
Molasses added to the white bread quite common in Sri Lankan bakeries, gives a brown colour and reading the ingredient list when printed, is important.
“Multigrain” bread isn’t whole meal. Always buy bread where the label states whole meal, which means that whole wheat grain is used, and the label should be read before purchasing. Whole meal bread has also high fibre and is removed in refined white bread.
You need to differentiate between “Enriched” bread and whole meal bread. Enriched means that vitamin B and iron are added back after processing and refining. Fibre may not be added back to enriched bread.
The label enrich is found on processed white bread made of refined grains. Refining is a process which makes the bread light, airy and gives it a longer shelf life. This is the reason the bread you purchase in your supermarket give a longer expiry date and could be kept on their shelves for a longer period. You need to check on the expiry date before purchasing the bread.
Storing bread in the fridge as some do will make it go stale quicker.
If you leave it exposed to the air, it will stay fresh for 2 to 4 days
If you need to store bread any longer than 2- 4 days, it is best to put in the freezer when it could be fresh for 2 to 3 months.
If you see green or black fuzzy spots on the slice of bread, it is advisable not to eat and better toss out the whole loaf.
The blue grey green fuzzy mould is okay because that fungus is the same fungus that produces penicillin.
When you eat bread, you eat lot of salt, too. A slice of wheat bread has about 147mg sodium when the daily requirement is less than 2.300 mg per day as recommended for the Americans
Eating bread in all three meals can raise blood pressure and put you at risk of heart disease and stroke.
Gluten is a protein found in wheat, barley and rye. Some people are intolerant to gluten and cause gastro-intestinal upsets, like bloating, diarrhea and stomach pain. They should avoid bread made with wheat flour and request for gluten-free breads made with white or brown rice flours and starches like arrowroot, potato and tapioca.
To lose weight.
Many people who don’t eat bread or on ketogenic diet lose much weight. You could live on foods without eating bread, and still you crave for it limit to two slices a day- brown or white.
Bread has little nutritional value, but it is delicious, and the tendency is to eat more.
Conclusion: Stick to eating wholemeal bread, and limit to two slices.
Some reference to food & recipes WebMD
Alzheimer’s disease is a degenerative disease of the brain described as early as 1906
by Dr. Alois Alzheimer.
There is progressive memory loss and loss of cognitive function.
Now what does cognitive function means?
Cognitive function.is an intellectual process by which one becomes aware of,
perceives, or comprehends ideas.
It includes multiple mental abilities, learning, thinking, reasoning, remembering,
problem solving, decision making and attention.
Alzheimer’s disease is the most common form of dementia.
Dementia is a general term for declining mental ability which affects the
performance of daily activities and routine.
Dementia became the leading cause of death in 2016 for Australian women,
surpassing heart disease.
It is the third cause of death for men.
In 2019, there is an estimated 4 hundred thousand Australians living with dementia.
Alzheimer’s disease is more specific and is the most common type of dementia accounting for 80% of cases.
Short term memory loss is one of the earliest symptoms.
In 2009 the number of Australians with dementia was estimated to be 245,000. Due to our ageing population, the incidence of dementia is estimated to rise above 1.1 million by 2050. Every five years after the age of 65, the likelihood of living with dementia doubles and the disease affects one in four people aged 85 and over.
There are two types of Alzheimer’s disease, sporadic and familial (hereditary). In the sporadic form, the disease is usually diagnosed after the age of 65 and is by far the most common form. In the less common familial form, the disease runs in families and usually affects people in their 40s or 50s.
Anatomy of the brain
Brain is full of cells called neurons.
Each neurone has a body which contains the genetic blueprint that directs and regulates the cell’s activities.
Dendrites are the branches of the brain cells which collect information from other neurons.
Axon the 3rd part of the neurone is a cable which transmits messages to other neurones.
In Alzheimer’s disease many neurones stop functioning, lose connections with other neurones, and die.
When neurones and their connections are destroyed, it involves memory, including hippocampus. Hippocampus lies below the temporal lobes of the brain.
Later it affects areas in the cerebral cortex responsible for language, reasoning and social behaviour.
Over time, a person with Alzheimer’s gradually loses his or her ability to live and function independently. Ultimately, the disease is fatal.
Let’s talk about Amyloid plaques.
Beta- amyloid protein involved in Alzheimer’s comes in several different molecular forms that collect between neurons.
In the Alzheimer’s brain, abnormal levels of this naturally occurring protein clump together to form plaques that collect between neurons and disrupt cell function.
Let’s talk about the Neurofibrillary Tangles Neurofibrillary tangles are abnormal accumulations of a protein called tau that collect inside neurons. This is a protein an important component of nerve cell, helping to maintain their function and structure: in the brain, distortions in the protein’s molecular shape is associated with the onset of Alzheimer’s disease.
Healthy neurons, in part, are supported internally by structures called microtubules, which help guide nutrients and molecules from the cell body to the axon and dendrites. In healthy neurons, tau normally binds to and stabilizes microtubules. In Alzheimer’s disease, however, abnormal chemical changes cause tau to detach from microtubules and stick to other tau molecules, forming threads that eventually join to form tangles inside neurons. These tangles block the neuron’s transport system, which harms the synaptic communication between neurons.
It appears that abnormal tau collects in certain regions of the brain that are involved in memory.
So, the Beta-amyloid clumps into plaques between neurons and the tau seems to spread throughout the brain.
There are scavenging cells called glial cells in the brain to help keep the brain free of debris. One type of glial cells is called microglia and another called Astrocytes. They destroy waste and toxins in a healthy brain.
In Alzheimer’s disease these cells fail to clear away the waste, debris and protein collections, including beta-amyloid plaque.
There is a gene called TREM2. Normally, TREM2 tells the microglia cells and astrocytes, to clear beta-amyloid plaques from the brain and helps fight inflammation in the brain.
In the brains of people where this gene does not function normally, plaques build up between neurons.
There is an abnormal build-up of a protein called beta amyloid which forms plaques outside the brain cells and disrupts its functions.
Tau is an important protein component of nerve cell, helping to maintain their function and structure: in the brain, distortions in the protein’s molecular shape is associated with the onset of Alzheimer’s disease.
These microglia and astrocytes collect around the neurons but fail to perform their debris-clearing function.
In all these situations the brain cells seem to dysfunction and die.
That is the story of Alzheimer’s disease.
So far, we know how Alzheimer’s disease builds up, but no solutions have been found to arrest the damage to the brain cells.
People who live a healthy lifestyle, especially from mid-life onwards, are less likely to develop Alzheimer’s disease.
This includes doing regular physical exercise and keeping to a healthy weight, not smoking, eating a healthy balanced diet and drinking alcohol within the limits recommended by your doctor.
Keeping physically, mentally and socially active will help to reduce the risk of developing dementia.
We at the eLanka team wish our eHealth writer Dr Harold Gunatillake a very Happy 90th Birthday, and thank you for all your support and contributions to eLanka!
Dilani wife of HE. Nimal Bandara -Consul General of Sri Lanka in Sydney, had her birthday celebrations, at their residence in Strathfield, Sydney, on 3rd January 2020. With the staff of the Consulate Office.
Invited guests: Jaya Jayawardena, his wife and Dr. Harold Gunatillake and his wife Irangani.
It was a private and homely event with traditional foods and lavish home-made dinner.
This is a question that comes to one’s mind when you become a victim.
It is totally a preventable disease like heart disease. One could say that these are “Life-Style” diseases that people create for themselves.
Risk factors can be reduced by making lifestyle changes.
Age is a factor. People tend to have a stroke over the age 65. But younger people also can get.
You should be extremely careful if any close relatives like your parents had a stroke, then your risk is likely to be higher.
Strokes are common among men more than women, obviously, heavy drinking and eating the wrong foods are the main reasons. If you are pot bellied and overweight- sure you are a candidate for a stroke, or a heart attack.
I am here to give you good advice and please listen to me. I am a party goer too, and I could see how our people indulge in the type of food they get to eat at these social events and the volumes of alcohol they drink.
Most of our so called youthful healthy adults are ‘pot-bellied’ and they have no shame to go about with such an unhealthy profile.
These pot bellies are due to visceral fat that give out toxins to harm your heart and cause stroke.
They are also referred to as “sugar bellies”, because eating too much of food containing carbs, deserts and beverages with added sugar are stored as fat in your belly.
Avoid those deep-fried tasty foods that also gives you the flavours and desire to eat more.
A stroke belt has been identified in the Atlantic coastal plain countries of North and South Carolina, and Georgia in the US. where it has been observed that consumption of high fried foods by the black Americans and consequently, the death rate seems to be high.
Eat more foods cooked with water like our mothers did. All curries were cooked with water with added spices to get the flavour.
Today, most Asian foods are deep fried even before they are made into curries.
Look after your blood vessels.
Eating fatty food with added sugar, calorie dense foods can increase your fat in your blood vessel lining. These are roads or pathways in your body to transport digested food to provide energy for the survival of each cell in your body.Just imagine a truck carrying loads of rubbish for disposal, drops the rubbish on the roadside on the way,We refer to these dropped rubbish as ‘plaques’ that get deposited and grows in your main arteries.
This causes reduced blood supply to organs.
In this discussion, it is the part of the brain that is prevented from getting oxygen and
nutrients. Brain cells begin to die.
Such loss of blood supply to the brain due to a blockage of an artery is referred to as an ‘Ischaemic stroke’.
Some people may have a temporary disruption of blood flow to the brain, and that would be referred to as a transient ischaemic attack (TIA), that does not cause permanent damage to brain cells, provided immediate medical intervention is given in hospital.
In such a situation, a small piece of the plaque in your carotid arteries in the neck can get dislodged and cause a temporary blockage to the blood supply and cause a stroke.
Or, a blood clot can be released from the plaque that can travel to the brain and cause the temporary episode.
These TIA’s are warning signs for a bigger attack, unless immediate steps are taken to dissolve the clot through clot dissolving regimes.
The other type of major episode is called haemorrhagic stroke in contrast to the ischaemic stroke already briefed.
In this condition, the bleeding occurs in the brain vessel due to bursting of a vessel. The main cause for such episode is high blood pressure, the commonest cause in old people when the blood pressure has not been checked regularly.
In some situations, you are born with minute bulges in the brain vessels called berry aneurysms.
As said earlier, stroke is preventable. It is a lifestyle disease. By reversing to a healthy lifestyle is the solution.
Eat home cooked foods cooked with water and use very little oil in the process.
Limit your alcohol consumption, only a social drink or two weeklies.
Exercise daily- 25,000 steps brisk walk be ideal for older people.
Keep your weight within the normal range.
If you are a diabetic, enjoy a low carb diet and tight control of blood sugar with medication. Check your blood pressure regularly. Reduce your stress factors. Maintain a good lovable relationship with your immediate family and socialise with friends at least once a week.
See your family doctor for regular medical check-ups. Conclusions:
Hope this talk was useful. Please be health conscious daily to improve your life to give your health and happiness. What more can we expect?
Also surf my website: www.Doctorharold.com
There are many health benefits and uses of Parsley. You could grow them in pots on your balcony- needs full sun and needs watering daily.
This is a herbal plant native to the Mediterranean. There are two most common kinds- French curly and Italian flat-leaf.
Today, it is widely used to treat high blood pressure, allergies, and inflammatory diseases due to the health benefits of its micronutrients. Please watch the video and enjoy with your family and friends.