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Sickle-cell Anemia
Immune System
Heartfelt Vitamin E?
Keep Blood Pressure Down
Cholesterol Testing
See Your Doctor First
Cancer Prevention In The Gym
Weight Training And Exercise Addiction



Q: I am a black athlete who has a family history of sickle-cell anemia. Are there any special things I can do with my diet to help my situation?

A: As you already know, sickle cell anemia is a hereditary blood disorder found most frequently in blacks. The blood cells are crescent shaped and have a reduced ability to transport oxygen. Because of this, while these individuals frequently have normal iron stores, they can't utilize the iron properly.

You should have your doctor determine whether or not you have an iron deficiency. If your iron stores are high, avoid foods that contain a lot of iron or are highly fortified. Eat ascorbic acid foods, such as fruits, by themselves, as they promote iron absorption. Your diet, regardless of your iron stores, should be high in folate (400 micrograms a day) and zinc (15 to 30 milligrams). Before making any changes, consult you physician to determine if you have the sickle-cell disorder and then to decide on any alterations in diet.







Q: Is there any food I can eat to improve my immune system and keep me from getting sick?

A: While there is a strong link between good nutrition, diet and health, as yet there is no miracle nutrient that will raise you immune system. People who suffer from malnutrition do develop more infections than well-nourished people, and research shows that nutrition intervention can improve resistance to individuals. This is not the case with people who are already eating properly, however.

Maintaining a healthy diet and lifestyle is your best defense against illness. A balanced, lowfat, high carbohydrate diet that supplies adequate vitamins and minerals, along with moderate exercise and sufficient rest, should keep you immune system working at optimal condition. Studies indicate that exercise elevates the immune system when done at moderate levels. Excessive, intense training, on the other hand, lowers the immune system.

Excessive outside stress can also have a negative effect on your immune system, as can allergies. Rather than searching for a single cure-all take a look at your overall diet and lifestyle for the answer to how you can improve you immunity and resistance against colds. And illnesses.







Q: I recently read a newspaper article about how vitamin E supplements have a beneficial effect in protecting against heart attacks. As I have a family history of heart disease, would it be beneficial for me to take a vitamin E capsule every day?

A: The development of plaque in artery walls are the risk of heart disease from it are related to the amount of low-density-lipoprotein (LDL) cholesterol in your bloodstream. LDL, also known as the bad cholesterol, is found in both an oxidized and a non oxidized form. The oxidized form appears to be the culprit in the buildup of plaque and subsequent narrowing of arteries.

Vitamin E and other anti-oxidants, such as vitamin C and beta carotene, seem to lower the amount of oxidized LDL cholesterol in the bloodstream. Several studies are under way to determine whether taking supplements not only lower the amount of oxidized LDL in the bloodstream, but also lower the deposition of plaque in artery walls. Until the results of those studies are published, however, your best course is to continue to restrict saturated fat and cholesterol and make sure you eat plenty of fruits and vegetables that contain high concentrations of these natural anti-oxidants rather than randomly supplementing your diet with pills.











Q: I read one of your earlier articles about salt and hypertension. Since very few people are salt-sensitive, is there any other food I can cut out to keep my blood pressure down?

A: Sodium-restricted diets help reduce hypertension, or high blood pressure, in less than 20 percent of the population. The majority of people, like yourself, are what is termed non-sodium-sensitive hypertensive. While it has been found that limiting your fat intake will help control hypertension, new research suggests that another mineral, calcium, appears to have a beneficial effect on blood pressure. A recent study found that when subjects ate a diet that included one gram or more of calcium per day their risk of hypertension was reduced by 25 to 40 percent. Eating foods that are high in calcium may be your best bet for controlling your blood pressure and reducing your risk of hypertension.







Blood cholesterol levels are on indicator of cardiovascular fitness. High levels are associated with an increased risk of atherosclerosis and coronary heart disease. New techniques have been developed that require only a small amount of blood for analysis. The testing is very rapid and can be performed on the blood from a finger prick within minutes. Many of you may have seen companies offering this service at malls and shopping centers across the country. While this type of testing is very important, a recent article published in Lancet wars against using the results from only one test.

Differences in serum cholesterol in the same individual may be extreme enough to make it impossible to assess his or her risk on the basis of one sample. Demonstration of this problem is given in a report of blood sampling every 20 minutes for six hours in one subject. Cholesterol levels varied from a low of 189 mg/dl to a high of 211mg/dl. Had just these two samples been taken, they would have indicated a difference in risk of coronary heart disease of more than 20 percent. Eight of the subjects, 19 samples were more then 200mg/dl. If one test was performed and a high value received the subject would have received counseling and been called back for a retest, with possible referral to a physician for further testing. However, if one of the 11 low values were obtained, the individual would have been told his cholesterol levers was fine and did not need to be checked again for five years. This set of data shows the problem in basing the evaluation of one individual's risk of heart disease on one random measure.











Exercise-related sudden death is a tragic occurrence; fortunately, it happens infrequently. Careful cardiovascular evaluation of both competitive athletes and recreational exercisers directed at symptoms and sight of potentially hazardous conditions is primary step toward decreasing the likelihood of such an event. Those found to have significant cardiovascular disease or high-risk conditions need further specific evaluations and recommendations regarding their exercise programs. Individuals without significant cardiovascular disorder can be reassured about their exercise safety.

Besides a general medical exam and blood test, and exercise ECG should be considered for certain individuals before beginning a vigorous exercise program. Those individuals include anyone in the following categories:

1)Men 45 years of age or older

2. Women 55 years of age or older

3. Men under 45 and women under 55 who have significant risk factors for coronary heart disease.

Some of the risk factors for CHD include: abnormal serum lipid levels (total cholesterol greater than 250 mg % or HDL-C less than 30mg % ), hypertension, cigarette smoking, diabetes mellitus, or a family history of premature CHD. For individuals in this category, performing an exercise ECG depends on age and on the severity of the risk factor. Besides those individuals falling into one of the categories listed about , if you have any doubts about your ability to perform and exercise program or sporting activity you should take caution and see your doctor first.







Q: A friend of mine recently had a baby who suffers from galactosemia. What is this disease, and is it the same as lactose intolerance?

A: Galactosemia is a congenital problem with carbohydrate metabolism in which the body cannot use the monosaccharide galactose. Galactose is found in mild and dairy products. Lactose, or milk sugar, is made up of glucose and galactose molecules bound together.

There are three enzymes required to convert galactose to glucose; with people who have galactosemia, one of the enzymes is missing or defective. When infants who have galactosemia are given milk-which contains a galactose unit in each molecule of lactose-they vomit and get diarrhea. The unmetabolized galactose accumulates in the blood and causes growth failure, liver enlargement, kidney failure and cataracts. Early introduction of galactose-restricted diet prevents most of these symptoms, and since galactose is found only in dairy products, this is usually easy to accomplish.

Galactosemia differs from lactose intolerance in that the latter is not congenital but rather develops later in life. People who are lactose intolerant have a deficiency of the enzyme lactase, which coverts lactose to glucose and galactose. Most people who have lactose intolerance can tolerate some milk products, since there is some lactase in their intestines. If someone who has lactose intolerance eats large quantities of dairy products, he or she will generally develop bloating, gas and, at worst, diarrhea. The person will not however, develop any systemic diseases, as occurs with galactosemia.









While we know that diet plays a profound role in the growth or prevention of cancer, it's not clear whether there's a similar link between exercise and cancer. Even so, several studies have shown a reduced risk of estrogen-sensitive cancers in women who exercise regularly. A recent study that looked at more than 5,000 female college graduates found that the former athletes in the group had significantly fewer breast and reproductive system cancers than their sedentary counterparts. All of these findings point to the benefits of regular exercise beginning at an early age.

Other recent findings relating to exercise and disease prevention include a strength-training study of men that found a significantly asseverated gastrointestinal transit time in those who weight trained three days per week, an effect that could reduce the risk of constipation, diverticulosis, hemorrhoids and colon cancer.









Bodybuilders, as well as all other dedicated athletes, are in constant danger of exercise addiction. Psychologists often call it "exercise bulimia" or "athletic body image disorder."

"Exercise bulimia is a new twist on the binge-purge syndrome that has only recently come to light," said Adrienne Restler, head of the eating disorder clinic at the Florida Medical Center in Fort Lauderdale.

In the beginning a fitness program fills empty time, but if it becomes an obsession, the workout "victim" can be overcome with guilt if even one workout is missed.

Exercise can be a healthy compulsion, according to Doris Zachary, director of anorexia and bulimia therapy at the Center for Counseling Services in Plantation, Florida, but pushed to the extreme it can also cost jobs and destroy families and relationships.

Counseling is usually the only way to help the exercise-compulsive, "What we do in therapy is show them that when people define themselves as what they do, they are in trouble," Zachary said. "You must separate people from their behaviors. People are also feelings and value systems. There has to be a balance of behaviors."

Unfortunately, balance seems like an unattainable goal to many fitness enthusiasts whose lives revolve around working out. This one-interest existence is a very dangerous state of mind because it can lead to loneliness, a distorted value system and physical abuse.

Don't get caught in the exercise addiction trap. Strive for a balanced life with a variety of activities and interests.