Mens Health Blog. Medical Blog

Popular diets are usually based on weight loss, which over the short term may predominantly reflect changes in body water balance and metabolically active tissue. However, the focus should be on sustainable fat loss. Fad diets are those that cause short term weight losses, but no long term sustainable effects. Like any fad, they go into and out of fashion according to the media attention paid to them at any particular time. As such, they play on the vulnerabilities of the target group, who regard themselves at fault for the long term failure of the diet.

Advertising and ‘Fad Diets’.

Some typical concepts used in fad diet advertising include:

• 4100 per cent guaranteed’

• ‘instant’ and ‘phenomenal results’

• ‘x kg weight loss in one month’ (usually a lot)

• ’100 per cent natural and Dr Recommended’

• ‘secret ingredients’

• ‘supported by Doctors and Dietitians’

• ‘lose inches (cm) while relaxing’

• ‘secret of the . . . Aztecs, Incas, Hunzas’ (insert an ancient tribe of your choice).

Myth-informations. The idea that fasting helps fat loss and ‘cleanses toxins’ has been clearly disproven. Any weight loss is quickly regained through physiological adaptation and Jew if any of the minerals lost in sweat are ‘toxins’.

Heat pads and electrical devices, although promoted for fat loss, are banned from advertising as such by the Australian Slimming Advertising Code.

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Links between reproductive function, mood and behaviour have been proposed for many years. Mothers who experience severe and persistent anxiety and depression after giving birth have been described as having postpartum depression. Women who consistently experience symptoms such as irritability, anxiety, aggression, depression and loss of concentration during the two weeks between ovulation and menstruation may be diagnosed as having premenstrual syndrome (PMS). And after a hysterectomy, women with heightened levels of depression may be said to have ‘post-hysterectomy depression’ syndrome. While not disputing that disturbances of reproductive function can affect mood and behaviour, and that the obverse may also apply, it must be said that many of the associations suggested to date seem oversimplified.

Doctors have suggested for many years that menopausal depression is a depressive disorder occurring specifically in the mid-life years and that it is different from other depressive disorders. Little evidence has, however, been found to support this idea. Studies have actually found high levels of well-being among women during mid-life. And, as far as hysterectomised women are concerned, there is little evidence that they are any more prone to depression after hysterectomy than before. In those cases where menopausal women are diagnosed as having psychiatric symptoms, there is a stronger association with important life events, relationships with children, and marital status than with cessation of menstruation. Furthermore, some women experience physical symptoms such as hot flushes without any psychiatric symptoms, while the reverse is true for others.

There is still much to learn about these associations as many of the studies carried out to date have involved small numbers of self-selected women rather than large random samples. The Melbourne Women’s Midlife Health Project is an attempt to overcome some of these deficiencies. It aims to help rectify a situation where the linkages described are, in the words of the United States Office of Technology Assessment, ‘based on myths, unwarranted assumptions and conclusions derived from outdated, poorly constructed studies’.

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Another possible explanation of why we sleep is the chemical theory. We are all aware of the fact that certain chemical substances induce sleep; we have all heard of sleeping pills. When we take a sleeping pill, the drug is absorbed into the blood and acts on the brain. The drug induces sleep. When the drug wears off and is eliminated from the body, we wake up.

Is there a sleep-inducing, naturally occurring chemical in the body? Also, does this chemical accumulate in the day like a waste product from our metabolism and require elimination? When the chemical reaches a certain threshold, does the brain become drugged and cause us to fall asleep? Whilst asleep, is this chemical eliminated from the body, causing us to wake up refreshed? A French scientist in 1913 called this hypothetical chemical sleep poison or hypnotoxin.

The answers are all no. This is shown in the example of Siamese twins. Siamese twins are two twins born together with some parts of their bodies attached. They share the same blood circulation. It is observed that one twin can be wide awake whilst the other is fast asleep. If there is a chemical in the blood causing sleep, then the two twins should be waking and sleeping at the same time. This clearly demonstrates that ‘natural sleep’ is not due to a chemical or a drug circulating in the blood. On the other hand, if one twin is given an appropriate dose of sleeping pill, after this is absorbed into the blood the two twins sleep at the same time. This shows that sleep induced by sleeping pills is very different from natural sleep, and the chemical theory is unable to explain why we need to sleep.

However, in spite of this, there is still considerable research taking place to examine the possibility of the presence of hypnotoxin. Claims were made that extracts of spinal fluid from sleep-deprived animals when injected into waking animals would induce sleep. US scientists called this substance in the spinal fluid factor S (S for sleep) and Japanese scientists called it sleep-promoting substance or SPS. Sleep-deprived animals were used for the source of this substance as it was believed that factor S or SPS accumulated greatly in these animals, since only sleep could eliminate it.

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Some people make the various steps in sexual knowledge and experience from childhood to maturity much more easily than do others. In this respect the shy introvert typically has greater difficulties that his more robust extrovert contemporaries. The introvert, either boy or girl, is inclined to be timid and embarrassed by matters of sex. As a result he withdraws from it. His knowledge is incomplete, and his emotional and physical contacts with the other sex are limited. He tends to fill in the gaps in his knowledge by daydreaming. His uncertainties and perplexities are increased, and the general level of his anxiety remains high. Strange as it may seem, such a pattern established in adolescence may later persist through marriage.

In an attempt to put an end to his complicated feeling in the matter, the shy introvert not infrequently decides to have a sexual experience. This usually lacks any spontaneous naturalness, and is often preceded by much thought and determination to bring himself to do it. The whole matter is out of character with his general personality, and instead of making things better the experience almost always has the reverse effect. The tension which accompanies it makes it physically difficult, and the sensitivity of the introvert adds guilt to his anxiety. Experience in psychotherapy with young people shows quite clearly that the inhibited introvert of either sex is greatly helped by talking over these matters with an experienced physician or psychiatrist.

I recently had come to me a young woman who was very shy—very nice, attractive in her quiet way, well-mannered, but painfully shy. Her brother is a doctor, and her sister happily married. Her parents, successful and easy in company, were socially ambitious for the girl. But she was held back; she just could not be natural with people. Then with tears and great distress she told me how a boy had touched her sexually, but really quite innocently. “I can never forgive myself.” Then when she had pulled herself together, “How do you know where to draw the line?”

This is a problem that we all must face. She is twenty, but so timid and shy that she draws the line too high. And in her present state this must necessarily be so. We must not forget that different people need different solutions to similar problems according to their individual personality.

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The simple answer to this question is ‘yes.’

Professor H Hippius, formerly chair of psychiatry in Munich, writes:

The 1996 German list of available drugs, the Rote Liste, includes 28 Hypericum preparations. Since these preparations are not chemically defined single-substances or combination preparations, but whole extracts of the St John’s Wort plant, it cannot automatically be assumed that the various medicinal preparations from various manufacturers have the same composition and therefore the same therapeutic efficacy at the same dosage.

I agree with Professor Hippius. In other words, since we do not know which substances in St John’s Wort are responsible for its anti-depressant effects, we cannot assume that all plant preparations are equivalent, even if the amount of hypericin, which is supposedly standardized across different preparations, is the same. I say ‘supposedly’ based on my experience with the use of certain generic anti-depressants. Generic anti-depressants are supposed to have the same amount and quality of the active compound in them as the original brand-name products. Yet I have often observed a relapse of depressive symptoms in patients who have previously been doing very well when they switch from a certain brand-name anti-depressant to its generic counterpart. If different brands of a synthetic compound produced under the supervision of the US Food and Drug Administration result in different clinical effects, how much more reason do we have to doubt the equivalency of different herbal products with their complex combinations of active substances and produced under much looser regulatory conditions? Consider, for example, how wines that are made from the same type of grape will vary in taste not only from one country or region to another but even from vintage to vintage. The substances in the wine that imbue it with its special bouquet and flavour will change with the soil, the amount of sunshine and the rainfall. A similar situation can be expected to apply to the composition of an extract of St John’s Wort, where the variable of interest is not the flavour but rather the anti-depressant effects or the side-effects of the preparation.

Once we acknowledge that herbal preparations are likely to vary in their composition, where does that leave us in terms of choosing the best preparation? At this point there have been no actual studies comparing one type of St John’s Wort preparation to another. Yet most of the research in which the anti-depressant effects of St John’s Wort have been established has been performed using the brand called Jarsin™ produced by the leading German manufacturer of the herbal remedy. This has led clinician and researcher Hans-Peter Volz of Jena in Germany to conclude that ‘taken in sum, the anti-depressive action of Hypericum is only sufficiently documented for Jarsin™.’

The good news is that Jarsin™ is now available over the counter under the brand name of Kira™. It is essentially identical to the German compound and is clearly the brand of choice at this time.

Another reason to use an herbal product known to be made under carefully supervised conditions is that you can feel more confident that there are no potentially toxic contaminants in the preparations, such as have been known to occur in other food supplements. The contaminant in L-tryptophan that resulted in several fatalities in the US was a particularly dramatic case in point.

Some local brands of St John’s Wort are less expensive than Kira™ and for certain individuals the cost difference may be a significant consideration. If this is the case, I would suggest at least starting with the Kira™ brand. If your depression does not respond, you can then be more confident that it is not because of the brand of the herbal remedy but for other reasons. Once your depression does respond to Kira™, if cost is a significant consideration you might then try to switch to a less expensive brand and see if you maintain the same level of anti-depressant response.

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A tumour arising within the brain understandably causes great anxiety-perhaps more so than with tumours elsewhere in the body, as a brain tumour may appear to strike at the very centre of one’s soul and being. Many people with simple headaches due to anxiety or stress believe that they have a brain tumour which is causing their headache. However, the incidence of primary tumour is very low (10 per 100 000 per year). It is, however, true that tumours can cause epilepsy. This is much more likely to happen in adults than in children.

Brain tumours are either primary or secondary. A secondary tumour is one that has been carried in the blood to the brain from another site. Cancers of the lung (bronchus) or breast are by far the most common of these. Usually the site of the original cancer is known, and the appearance of seizures in such a patient is an ominous sign indicating that a secondary tumour has arisen within the brain. Sometimes, however, the original cancer has not been discovered at the time of the first seizure, and a careful clinical examination will reveal a small tell-tale lump in the breast, or the lung cancer will be seen on a chest X-ray.

Primary tumours of the brain do not arise in nerve cells. They either arise in the supporting cells between nerve cells which play an active role in their nutrition (glial cells) or in the meninges, the covering membranes of the brain. These tumours are called gliomas and meningiomas. There are other types of primary cerebral tumours, such as those arising from the cells lining the cavities of the brain, or from blood vessels, but these are rare.

Primary brain tumours are not like cancer of the breast, or bowel, or bronchus. They show no tendency to develop blood-borne secondary deposits in other organs. This is fortunate, but there are other characteristics which hinder effective treatment. The gliomas infiltrate normal brain extensively, so there is no apparent margin beyond which one can be quite certain that no abnormal cells have reached. This makes recurrence after surgical excision very likely. Meningiomas, however, are encapsulated tumours, and can often be removed completely, with a good chance of complete eradication. However, meningiomas often have an extensive blood supply, so complete removal may be technically very difficult.

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Mr. G.Y. of Texas writes: “I found out about CMO through a friend … Even though I really could not afford it, I decided that I had to give it a try.

“I am a 57 year old man. I have had three colon surgeries that left me with only 18″ of colon. I had arthritis in my back, hips, and legs. I also had arthritis in my hands and they were always swollen. I had to sleep on my knees in a crouched position because the pain and discomfort of arthritis was driving me crazy. I was really bad off and the doctors told me to get my affairs in order because I didn’t have long on this earth. I was willing to try CMO as a last resort. What did I have to lose except the cost of it if it didn’t work. This is the result after … CMO.

“My sleeping has improved by at least 85%. Now I can sleep in any position I want and stretch out on the bed. My arthritis pain and swelling in my hands is gone and there is no more pain in my back, hips or legs. I am also suffering from emphysema and have noticed an improvement, I’d say at least 40%. It seems to be getting better every day. I can walk and do my shopping now and not have to stop every few steps to catch my breath. I have gained back most of my health in more ways than I can explain. CMO seems to be the one thing I needed 10 years ago. I am getting better every day. [Editor's comment: Many people find that the healing process continues long after they finish their CMO capsules.]

“After using the product I can say that it is well worth the cost. I would pay ten times the price if I ever need it again. If you think you can’t afford it, think again. For what it does for your body and health, you can’t afford not to get it if you really want to be helped. CMO does what it says and much more.”

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Home care

A child with mono needs rest, aspirin or paracetamol, and a general diet as tolerated. Although mono is contagious, it’s not necessary to isolate the child and it’s unlikely that other family members will contract the disease. The child can return to school as soon as the weakness and fatigue disappear and the child feels well enough. If the spleen is enlarged, however, the child’s activity should be restricted. An enlarged spleen protrudes beneath the ribs, which normally protect it, and is susceptible to injury or rupture. In this situation, the child should not take part in contact sports or other energetic activity until the spleen returns to its normal size; this can take weeks or months.

Precautions

• If your child is being treated with antibiotics for a strep infection but the condition does not improve within 24 to 48 hours of starting the medication, inform your doctor. The doctor will order tests for mono.

• If the child’s spleen is enlarged, contact sports and other strenuous activity should be avoided.

Medical treatment

Your doctor will examine the child thoroughly, paying special attention to the lymph nodes, liver, and spleen. The doctor will also take a throat culture. If the throat culture reveals a strep infection, the child will be given penicillin or another antibiotic. Although most cases of mono can be treated at home with proper rest, diet, and a medication such as aspirin or paracetamol, some severe cases require hospitalization. This would be the case where the child needed to be given fluids intravenously or other types of supportive care.

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Eczema is an itchy dermatitis that is usually allergic in origin and occurs in families. It usually starts with patches of dry, itchy skin which in babies and young children (the commonest sufferers of the condition) are behind the ears and knees, in the body creases at the elbows and the neck, on the face and on the trunk or scalp. When the eczema is bad the skin is red, raw, weeping and crusted and may become infected.

Eczema is not infectious and most babies grow out of their infantile eczema. For a few, though, allergic eczema can persist throughout life. About three children in a hundred suffer from it and many of these have a family history of eczema, asthma, hay fever or other allergies.

What causes it?

• There is no doubt that there is a familial susceptibility.

• As eczema is much more common in bottle-fed as opposed to breastfed babies there is little doubt that an allergy to cows’ milk plays a part in many children. Some children are allergic to other foods too.

• Scratching makes it worse, so it is best to avoid wool and nylon next to the skin because these make the skin hot and sweaty.

• Feathers, down and wool bedding make it worse.

Prevention

• The single greatest preventive measure is undoubtedly to breastfeed a baby right from the very start and not to give him or her even one bottle of cows’ milk. This will need very careful supervision because it is still the practice in many maternity hospitals to take babies away from their mothers at night and to feed them the odd bottle of cows’ milk formula.

• The way round this is to talk to your family doctor and midwife before the baby is due to ensure that everyone knows that you have a baby that is ‘at risk’ and is to be totally breast-fed from birth. If eventually you find breastfeeding impossible (which is rare with good advice) then you will have to use a soy-based milk. There are several on the market.

Aim to feed your baby breast milk exclusively for at least four months and preferably longer. The protective effect is greater the longer you continue but after about six months you should add in other (non milk-containing) foods.

Unfortunately, even this way of feeding a baby may not prevent all eczema. This comes about for two reasons. First, the child may be allergic to some other allergen, such as the house-dust mite; and second, antigens in the mother’s diet may be transmitted to the baby via her milk. Recent research suggests that eating large quantities of certain allergens during pregnancy can sensitize a susceptible child in utero. The answer here is to take all foods in moderation during pregnancy, especially foods that are likely to induce allergies in children. These include cows’ milk and all its products, eggs, wheat, nuts, fish, tomatoes and colourings and preservatives. If you have a family history of allergy, and especially of eczema, it makes sense to avoid these foods as much as possible during pregnancy and breastfeeding, or at least certainly never to binge on them. Don’t worry about the calcium you will be missing-it can be eaten in other forms, and you can take zinc and calcium supplements (Sandocal effervescent tablets are good) which more than compensate for the calcium loss in dairy products. Start weaning your solely breast-fed baby at about 5-6 months and be sure to breastfeed after each meal until the end of the first year of life. Introduce vegetables and fruit first of all and then add milk-free margarine. Over a few weeks add in foods that are ‘safe’ (not on the above list of common culprits) and see how it goes. If ever a food seems to precipitate eczema stop giving it and don’t try it again until the child is 2. If a child is allergic to eggs he or she might also be allergic to chicken, so beware.

• Having done your best to prevent eczema at source dress your child with soft cotton next to the skin-never wool or nylon. These latter will make him or her hot and sweaty, which makes any early eczema likely to progress further than it otherwise would. Choose loose clothing styles that keep the child neither too hot nor too cold.

• Disposable nappies may irritate -use soft terry nappies. Change nappies frequently and clean the child’s bottom well. Avoid plastic pants if there is any sign of nappy rash. Never wash nappies in biological detergents because very allergic babies are allergic to the enzymes in them. Drying clothes out of doors helps destroy house-dust mites and bacteria. Avoid feather, down and wool bedding because these can irritate eczema. Use duvets filled with synthetic filler and cotton cellular blankets and cotton sheets. Change bedding twice a week at least, and damp-dust and vacuum the child’s room daily.

• Join a self-help group to help you cope with the day-to-day problems and prevent family discord. Having a baby or child with severe eczema can be exhausting for all the family and you will be grateful for tips on how to cope.

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Macmillan nurses

The Cancer Relief Macmillan Fund (CRMF) was set up in 1911 to provide care and support for cancer patients. This national charity now helps to improve the quality of life for cancer patients and their families at home, in hospitals and in special cancer units.

The CRMF has trained more than 1000 Macmillan nurses who work in the community and in hospitals around Britain. It continues to fund these specially trained nurses for up to 3 years in posts in hospitals, after which the health authority takes over the financial responsibility.

A GP or district nurse may suggest involving a Macmillan nurse to help care for a woman with incurable breast cancer. Macmillan nurses play a similar role to that of hospice-based nurses, giving advice and emotional support to women and their families, and working closely with other medical professionals to advise about pain relief and symptom control as necessary. They are also involved in the training of doctors and nurses to help them develop the special skills required for the care of cancer patients and, with hospice staff, have been largely responsible for the increased awareness of other health professionals to the particular care these patients need.

Other treatment centers

The effects of complementary or alternative therapies are difficult to assess, in part because they are often only resorted to by people for whom conventional medicine has no more to offer in terms of cure.

There are a few private centers in Britain which advocate special non-medical therapies to help people ‘fight’ or live with cancer. Your GP, consultant or a specialist nurse should be able to give you details of such centers in your area, or you can contact one of the associations whose addresses are given in Appendix I. Although alternative therapy centers are not funded by the NHS, some have trust funds to help meet the costs for those who cannot afford them.

One such complementary treatment centre is The Bristol Cancer Help Centre which, despite some bad publicity based on inaccurate reports, has been responsible for helping many people with cancer to lead full and satisfying lives and to come to terms with their disease. An increasing number of people contact the centre for advice when their cancer is first diagnosed, and the current climate in Britain which encourages people to play an active role in their own health care is in part responsible for this.

The Cancer Help Centre provides support to cancer sufferers and teaches a holistic approach to cancer therapy based on looking at ways of improving people’s mental, spiritual and medical health. It emphasizes the learning of coping devices such as meditation, relaxation and visualization techniques to help people deal with the stress in their lives, as well as encouraging them to eat highly nutritious diets – both of which strategies are aimed at helping to improve the ability of the body’s immune system to fight disease and to respond to medication. The highly nourishing diets the centre recommends and the use of vitamin and other dietary supplements are based on the generally accepted findings of research into the effects of diet on the development and course of disease.

The Bristol Cancer Help Centre is just one example of centers throughout Britain which offer a complementary approach to cancer therapy which can be practiced alongside conventional surgical and medical treatment.

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