Sexual Concerns

Decreased sexual desire

Sexual desire is that which cause one to be receptive to or initiate sexual activity. For women, the quality of the relationship and the emotional and the physical satisfaction she receives from that relationship appear to be critical elements.

Desire requires androgens such as testosterone and DHEAs, neurotransmitters, and the sensory system. Starting in the twenties, there is a progressive decline of physiologically available androgens for both men and women, which can contribute to decreased sexual interest. Interest in sexual activity can be disrupted by psychosocial, physiological, physical, environmental, cultural factors. Fatigue, depression, side effects from medications, self-esteem, and body image concerns can all interfere with sexual interest. Addressing relationship issues through counseling, supplementing androgens, treating depression, and assessing medication side effects are all important. More important for good sexual desire is attending to scheduling the time and setting the environment for sexual activity, using the senses to the fullest, and incorporating seduction.

Decreased arousal

Arousal difficulties leading to delayed vaginal engorgement, reduced vaginal lubrication, pain with intercourse, and decreased vaginal, clitoral, and orgasmic sensation can be caused by or exacerbated by atherosclerotic disease. Screening laboratory testing should include lipid profile, glucose with or without insulin levels, thyroid stimulating hormone (TSH) and androgen levels (DHEAs and free testosterone).

Lifestyle changes are critical and should include moderation of alcohol intake, exercise, smoking cessation, weight loss, and stress management. Medications that can be discontinued or reduced in dosages should be changed. Additionally, just as psychotropic agents can significantly reduce sexual interest, they can produce a secondary effect on arousal.

Many excellent sexual lubrication are available over the counter. They can offset changes in vaginal lubrication brought about by age or chronic illnesses and/or their medical treatment and can enhance sensuality in general.

Difficulties with orgasm

Difficulties with orgasm are related most often to lack of understanding of what sort of sexual stimulation is required, difficulty communicating this needs to one’s partner, or lack of the partner’s initiative to provide this stimulation. Additionally medications, most notably psychotropic agents, can prolong arousal, making orgasm very difficult to attain. Androgen deficiency is believed to contribute to the higher threshold required for orgasm and the intensity for orgasm.

Exploring the woman’s desire and arousal phases, including quality of her relationship, is important because sexual health comorbidities are likely. Supplementation of androgens should be undertaken if needed. The woman should be encouraged to enhance her self-awareness about what sensual and physical stimulation she requires for orgasm through self-stimulation.

Reference

1. Butcher, J. ABC of sexual health: female sexual problems II: sexual pain and sexual fears. Br. Med. J. 1999 

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Skin cancer

There are approximately 50 000 cases of melanoma in women and men in the USA, making it the sixth most common cancer in women and seventh in men, with more than one million cases of basal-cell and squamous-cell cancers identified yearly. Melanoma is ten times more likely in Caucasians than African-Americans.

Excessive exposure to radiation, excessive tanning and burning, and fair complexions are risk factors. Occupational exposures to coal tar, arsenic, radium, pitch, and creosote also increase the risk of skin cancer. Prevention includes limiting exposure to the sun by covering up with a hat and clothes, wearing sunglasses, and using sunscreen.

Any skin growth that is changing shape or color is suspicious for skin cancer. Asymmetry, border irregularity, non-uniform pigmentation, and diameter greater than 6 mm increases the likelihood of a malignancy. Treatment is surgery for basal-cell or squamous-cell carcinoma, and cure is likely. Melanoma needs more aggressive surgery and treatment.

Reference

1. American Cancer Society. Cancer Facts and Figures 2002. Atlanta. 

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Eating disorders

Eating disorders are associated most commonly with teenagers and young adults. Anorexia nervosa rarely persists into later life, but without successful treatment it may be fatal. When anorexia does last into mid-life, serious health consequences can arise due to prolonged malnutrition. These include heart failure, liver damage, and hypokalemia-induced arrhythmias.

In contrast, bulimia and binge eating can persist for years and may be associated with obesity. Purging is less common in mature women than in adolescents and may take different forms. Self-induced vomiting is unlikely to be continued into mid-life and would likely result in severe dental damage if it were. Laxative and diuretic abuse may be more likely in this age group.

Underweight patients are easy to identify and question further about eating habits. Because many bulimics are normal weight or heavier, they are more difficult to recognize. Routine questions may be helpful in identifying patients for more targeted questioning, such as:

1. Are you concerned about your weight?
2. Do you ever binge or feel out of control when eating?

A positive response should trigger further assessment of intake, purging, exercise, and use of laxatives or diuretics.

Patients with eating can often benefit from counseling, whether or not they are willing to attempt to “cure” their problem. True anorexia nervosa generally requires a multidisciplinary team approach to management. Some women, while not meeting strict criteria for anorexia, maintain an unhealthy fixation on weight and may over-restrict their intake. Providers can work with these patients to identify a healthy body weight and encourage a balanced, varied diet.  

REFERENCE

1. Hu, F.B., Manson, J.E and Willett, W.C. Types of dietary fat and risk of coronary heart disease; a critical review. J. Am. Nutr. 2001

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Ways to improve diet of patients with cancer.

Malnutrition is the most frequently identified determinant of severity of ill-ness and death among cancer patients. Cancer patients with adequate nutrition have been shown to fare better in general, and specifically have a higher tolerance for side effects related to therapeutic interventions. Many factors determine the severity of side effects, including the type and location of the tumor, and the type, length, and dose of treatment.

Here are some of the suggestion;

• If immune function is compromised, avoid uncooked meats, unpasteurized dairy products, raw vegetables such as sprouts, and herbal nutrient supplements.
• Because fever expends considerable energy, adequate intake of carbohydrates, fats, and vitamins should be encouraged, especially during episodes of infection.
• During chemotherapy treatments, meat often seems to have a very bad taste and smell for the patient. One way to counteract this is to use fruit or fruit juice when preparing or serving meat.
• Dry mouth symptoms can be alleviated by rinsing with a saline mouthwash before meals. Mouthwash can be made from one tea teaspoon salt and one teaspoon baking soda added to about a liter of water. Commercial mouthwashes and alcoholic and acidic beverages can aggravate an irritated mouth.
• For patients with mouth or throat soreness, bland, lukewarm, or cool foods can be soothing. Acidic, spicy, or salty foods may be irritated.
• Drinking enough fluids will help counteract the constipation often caused by analgesics. If the gastrointestinal tract is not too tender, then constipation may be alleviated by high-fiber foods such as whole-grain breads, raw fruit and vegetables, dried fruits, seeds, and nuts.
• Diarrhea due to chemotherapy or radiation may be alleviated by a soft diet and avoidance of whole grains, legumes, dried fruit, and raw fruit and vegetables. Limiting intake of high-fat foods may also help.
• Patients reporting difficulty in swallowing solids should be advised to drink thick fluids such as soups, high-calorie or protein drinks, yogurt, ice cream, and milk shakes to meet the patient’s nutritional needs.
• The primary concern in vomiting patients is dehydration. Frequent fluid intake should be advised. Clear, light, and cool drinks may be tolerated well than icy or hot drinks.

An important aspect of nutrition during chemotherapy is that if the treatment causes an immediate negative gastrointestinal reaction (nausea, vomiting, or diarrhea), food eaten just before treatment may cause an aversion reaction thereafter. It is best, therefore, not to eat a favorite food just before chemotherapy.

Reference

1. Hu, F.B., Manson, J.E and Willett, W.C. Types of dietary fat and risk of coronary heart disease; a critical review. J. Am. Nutr. 2001
2.  

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Healthy Stretching Exercises

So far, in this blog we’ve focused on activities that burn calories and improve fitness. What about activities that increase flexibility, such as stretching exercise or yoga? Some athletes believe that doing stretching exercises before a workout reduces the risk of injury. So far, there’s not much scientific evidence to support that idea. And stretching is not going to strengthen your heart and muscles. But that doesn’t mean it’s not important. We’re convinced that stretching exercises help people stay active by keeping joints and muscles flexible. Obviously, maintaining the ability to reach and bend is important in everyday life.

The Yoga Option

Yoga is one of the oldest physical disciplines in the world. The age-old practice combines meditation, breathing exercises, and postures that are thought to focus physical and mental energy. Yoga has been shown to have many health benefits. These include reducing stress and anxiety and easing depression. Yoga is typically not an aerobic activity, so it doesn’t count towards meeting exercise recommendations for moderate activity. But some forms of yoga do improve muscle strength and flexibility and thus can help you stay active and healthy.

Yoga has been around for long that a variety of forms have evolved:

• Hatha yoga - the traditional practice of posture designed to improve flexibility, balance, and strength while focusing the mind and body.
• Ashtanga yoga - sometimes called power yoga because it emphasizes powerful movements that require strength and stamina.
• Iyengar yoga - a combination of slow, controlled movements.
• Kundalini yoga - rapid movements accompanied by meditation, chanting, and breathing exercises.
• Bikram yoga - popularly known as hot yoga because it is performed in warm rooms in order to boost flexibility.

Most practitioners combine several approaches. For more information on yoga classes, check out your local fitness centers or community recreation programs.

References

1. American Yoga Association at www.americanyogaassociation.org
2. Yoga in Canada at www.yogadirectorycanada.com

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Healthy Stretching Options

Keep in mind that time spent on stretching exercise doesn't count toward meeting your activity goals. Still, these exercise are a great way to get ready for activity or to cool down afterward. They’re also a great way to relax if you find yourself under stress.

Quadriceps stretch

This exercise stretches the muscles of the front of the thigh. Place your left hand against a chair, wall, or tree for balance and then grab your right ankle with your right hand and pull it up and back towards your buttocks until you can feel a stretch leg back and towards your buttocks. Keep your back straight and your right knee pointing towards the ground. The standing leg should have a slightly bent knee. Hold the stretch for 10 to 20 seconds, and repeat with the left leg.

Lower-back stretch

This exercise stretches the muscles of the lower back. Lie flat on the floor on your back with your legs extended, and pull the right knee up to your chest. Bend your left knee slightly and press your back to the ground. Hold the position 10 to 20 seconds, and repeat with the left knee.

Hurdler stretch

This exercise stretches the muscles of the back of the thigh. From a seated position bend your left knee and place the sole of left foot on the inside of your right knee. With your right knee very slightly bent, lean over your right leg, reaching toward your toes on your right foot. Keep your head and back straight as you move into the stretch. Hold 10 to 20 seconds, and repeat. Switch legs and repeat again.

Achilles tendon and calf stretch

This exercise stretches the heel cord and the back of the lower leg. Stand 2 or 3 feet (61-91 cm) from a wall or tree with both toes pointed forward as you lean toward the wall with your left leg forward with knee slightly bent and your right leg in back and straight, partly supporting yourself with your hands. Keep both heels flat to stretch the calf. Hold 10 to 20 seconds, and repeat.

With this stretching exercises guidelines in mind, you can do this when you first wake up or between TV commercials.

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Tools for early detection of breast cancer

Screening 

There are several methods of screening - self breast examination (SBE), clinical breast examination (CBE) (by doctor or health worker), and mammography. None of these methods, except mammography, has been shown by randomized, controlled trials (RCTs) to be an effective tool for early detection. Combinations of these and newer methods such as ultrasound and computed tomography (CT) scanning are also used.

Self-breast examination

Women who used self-breast examination did not find smaller or more curable tumors than those who did not. In fact, there were significantly more biopsies that proved negative in women who used self-breast examination. Studies have found that tumors found in those women who used self-breast examination were similar in size to those found in women who did not use self-breast examination. Thus, there is no good evidence of benefit, and evidence of harm, in teaching self-breast examination to women of all ages.

Clinical breast examination

The efficacy of clinical breast examination is dependent on the amount of time the provider spends. Its sensitivity has been estimated at 54%, with a specificity of 94%. In women aged 50-59 years, one large randomized, controlled trials found that clinical breast examination alone was as effective as mammography, although mammography was more sensitive in detecting small cancers.

Mammography

Mammography has been recommended as the most efficient method of screening in women over age 50 years. The Health Insurance Plan Breast Cancer Screening Project completed in 1963 after it had followed more than 60 000 women aged 40-64 for more than ten years was the first study to find that women in the screening group had a 30% reduction in breast cancer mortality. Six of seven subsequent large randomized, controlled trials that differed somewhat in methods found significant reduction in mortality rates in those women who were screened with mammography.

Ultrasonography

Ultrasonography has been the radiologic examination of choice in evaluation of breast lumps and abnormalities in younger women, especially those under 25 years. Used with mammography, especially in women with dense breasts, ultrasound significantly increase the detection of small cancers and those at smaller size and lower stage.

References

1. Lawson, H. Henson, R., Bobo, J.K. and Kaesar, M.K. Implementing recommendations for the early detection of breast and cervical cancer among low income women. Morb. Mortal. Weekly Report. 2000
2. Blamey, R. W., Wilson, A. R. M. and Patnick, J. ABC of breast diseases: screening for breast cancer. Br. Med. J. 2000. 

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Exercise prescription for healthy fitness - Yoga

The type of exercise depends on the desired goal. If a person wants to build muscular strength, then resistance training is appropriate. Endurance training (walking, running, cycling, swimming) is required if a person wants to improve her cardiovascular health and endurance.

Alternative therapies, such as yoga, have also demonstrated positive improvement in health. Yoga involves various standing, seated, and supine postures and breathing and relaxation techniques designed to enhance functioning of the various physiological system by supporting a natural posture. Young and old men and women have performed yoga for centuries in Eastern countries. Yoga has been purported to focus concentration and relax the body.

Yoga practice has been shown to improve muscular strength, endurance, flexibility, and aerobic capacity. In men, evidence suggests that yoga practice reduces sympathetic activity, improves aerobic capacity, reduces perceived exertion after maximal exercise, and reduces heart rate and left-ventricular end-diastolic volume at rest. Similar benefits would be expected for women; however, there is a paucity of research dealing with women, Additionally, Yoga practice may retard the progression and increase the regression of atherosclerosis in patients with coronary artery disease.

Empirical scientific evidence has demonstrated the positive benefits of exercise, such as improved strength, reduced anxiety, improved blood lipid profile, and decreased risk of cardiovascular disease. The modality required to obtain these benefits can vary from a structured exercise program (resistance training and walking/running) and alternative therapy (yoga) to daily physical activity (moving the lawn and climbing stairs).

A certified yoga instructor should be consulted for more information on the styles of each.

Regular exercise has a significant impact in the human body.

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Walking Works Wonders

Studies show that being active makes people feel more energetic. There are probably many reason for this. For one, moving around helps get blood flowing so you feel alert. In addition, many people say they feel better about themselves when they are regularly active than when they are sedentary. They feel more in control, more capable, and more motivated. Moderate exercise increases heart rate and breathing, which can improve overall fitness. The fitter you are, the more you have for physical activity. As you become fit, your body improves its ability to use oxygen, and your heart improves its ability to supply blood to all parts of the body.

One thing you may notice as you become fit is that your heart rate at rest slows down. It takes less effort to pump the same amount of blood to your brain and muscles when you’re fit than when you’re unfit. A strong heart and cardio-respiratory system mean greater stamina and a decreased chance of heart attack and heart disease.

Dozens of studies have confirmed the many health benefits associated with walking. Some of them include;

• Weight control. In general, people who successfully lose weight and keep it off incorporate physical activity into their weight-management plan. Even moderate-intensity activities such as brisk walking boost the calories you burn every day.
• Good health. Many studies show that walking every day significantly reduces high blood pressure. Surprisingly, moderate activity seems to lower blood pressure better than vigorous exercise.
• Bright spirits. Getting up and walking can help fight the blues. Some studies have shown that regular physical activity can help relieve stress and symptoms of depression.
• High odds of staying healthy. People who make moderate activates such as walking part of everyday life run less risk of developing heart disease, colon cancer, and other chronic illnesses.

NOTE: The total number of calories you burn is the same whether you do three 10-minute bouts of activity or one 30-minute session (as long as the intensity remains the same). Finding opportunities for short activities is often easier than finding an uninterrupted half hour. If you are overweight or obese, it may be easier to accumulate shorter bouts during the day.

Now it’s time to commit to a plan. Identify where you can fit in a few minutes’ walk. Here are my suggestions; during a coffee break is one possibility, during commercials for your favorite TV show is another. Maybe you can park the car at the far end of the lot or get off the bus a stop earlier and walk the rest of the way or if you are a new parent you can strap on a baby carrier and take a walk.

Remember the goal is to add a little more physical activity to your daily life.

Reference

Department of Health and Human Service. 2008. Physical activity guidelines for Americans. 

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Health and Safety Training.

Health and safety training is a vital, moral and legal requirement upon all employers no matter what their business activity. All staff must be aware of occupational hazards and systems developed to reduce risks and prevent accidents.

Developing a positive safety culture

It is important to develop within the organization a safety culture to maintain health and safety, to save time and money in preventing accidents and decreased time off work. Achieving this require time and effort to create a caring, committed and well-organized management that understands the benefits of good health and safety practice.

The safety policy is the essential basic foundation on which to build. Once this policy has been developed, control of workplace hazards is possible, and this involves getting systems and procedures under way. This is a vital part of staff training.

Periodic review of system will be necessary to further develop health and safety, which constantly changes. Reviews should be actioned on a regular basis: when workplace systems change, when new equipment is installed, and so on.Staff facilities and welfare of all employees at a place of work is the responsibility of the employer. Facilities should be provided that are both safe and beneficial.

Safety programs

Training and information - Such program instruct staff in how to handle materials safely, use equipment correctly and detect symptoms of illness.

Medical examinations - Some problems can be detected early and before they become serious. Employees should have regular check-ups. This will depend on their age and position within the organization.

Early treatment - If any unusual symptoms appear, the employee should inform their line manager, then report to the health and safety officer and seek medical advice. Early investigation and treatment can be most effective.

Monitoring illness patterns - Health professionals, such as occupational health nurses, record cases of illness, take samples from contaminated areas and keep medical records.

Implementing health and safety measures doesn't have to be expensive, time consuming or complicated. In fact, safer and more efficient working practices can save money and greatly improve working conditions for your employees.

If you have five or more employees you will need to write down your health and safety policy. This sets out how you manage health and safety in your organization. It needn't be overly complicated, but should be something that is meaningful and useful to you and your staff.

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Fire Precautions

Fire safety requires constant vigilance to reduce the risk of a fire, using the provision and detection and alarm systems, and well-practiced emergency and evacuation procedures in the event of fire.

Some of the fire precautions are;

• Identified hazards must be removed or reduced so far as is reasonable. All persons must be protected from the risk of fire and the likelihood of a fire spreading.
• All escape routes must be safe and used effectively.
• Means for fighting fires must be available on the premises.
• Means of detecting a fire on the premises and giving warning in case of fire on the premises must be available.
• Arrangement must be in place for action to be taken in the event of a fire on the premises including the instruction and training of employees.
• All precautions provided must be installed and maintained by a competent person.

Fire safety

Every employer has an explicit duty for the safety of his or her employees in the event of a fire. The Regulatory Fire Safety Order 2005 places a greater focus on fire prevention. It places responsibility for the fire safety of the occupants of premises and people who might be affected by fire, on a defined responsible person, usually the employer.

The responsible person must:

• Make sure that the fire precautions, where reasonably practicable, ensure the safety of all employees and others in the building.
• Make an assessment of the risk of and from fire in the establishment: special consideration must be given to dangerous chemicals or substances, and the risks that these pose if a fire occurs.
• Review the preventative and protective measures.

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Stress-related disorders

Although there is no inherent pathology associated with the stress response, stress presents a generalized health risk factor and is implicated in a wide range of medical, psychological and behavioral disorders.

Early warning signs, symptoms and asymptomatic risk factors can lead to frank and serious strain. Stress-related disorders fall into three broad categories: medical, psychological and behavioral. Because stress is a generalized, systemic response of the mind-body, it is not easy to predict which category of stress-related disorder a specific may manifest.

Medical strain. Stress is implicated in or a direct contributing factor to at least five common and sometimes serious forms of medical strain.

Medical strain and symptoms arising from stress

• Cardiovascular disease, including hypertension, elevated heart rate and blood pressure; increased risk of heart attack during extreme stress; type A. (coronary-prone) behavior creates self-induced stress.
• Back pain triggers a bracing response in the large muscles, causing contraction and tension, particularly in the muscles of the back, abdomen and upper thighs.
• Tension headaches may be of musculoskeletal origin from the contraction of the large muscles in the upper back, shoulders, neck and scalp.
• Cancer is indirectly influenced by stress; there may be predisposition to possible malignancy because of lowered immunity; stress can inhibit the curative process.
• Stress is thought to be a factor in irritable bowel syndrome and is possibly implicated in peptic disease.

While these medical conditions may have other primary or secondary causes, each may have a stress-related component.

Psychological strain. Psychology plays a central role in the stress process, and physicians should consider partnering with mental health professionals whenever stress-related problems of a more serious nature are suspected. Stressful events, chronic stress and trauma are all important health risks for psychological strain.

Psychological strain and symptoms arising from stress.

• Varying degrees of depression.
• Burnout from chronic stress and prolonged striving can lead to emotional exhaustion and reduced personal accomplishment.
• Anxiety disorders may develop, including acute stress disorder, post-traumatic stress disorder, panic disorder, agoraphobia, social phobia, obsessive-compulsive disorder and generalized anxiety disorder.
• Conversion reactions can trigger psychogenic conditions, such as acute blindness and hard or arm paralysis.
• Work-family stress may trigger interpersonal conflicts, physical abuse or sexual dysfunction.

Behavioral strain. Behavioral forms of strain are most often dysfunctional attempts to cope with stress and trauma.

Behavioral forms of strain

• Substance abuse; tobacco, alcohol and drugs.
• Violence, manslaughter and suicide.
• Increased susceptibility to accidents.
• Prolonged recovery times from accidents and injuries.
• Eating disorders; overeating leads to obesity, with its associated cardiovascular and musculoskeletal problems; under eating may result from loss of appetite, which is often associated with depression.   

Also read Ten steps to staying healthy in times high stress

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Ten steps to staying healthy in times of high stress

In this blog post I will extend and elaborate four basic skills into ten steps to staying healthy in times of high stress, trauma or tragedy. They are at the core of excellent self-care and good preventive stress management. The four basic skills and ten steps should serve as a firm foundation for building strength and managing vulnerability and risks.

1. Remember to drink plenty of water and eat regular and healthy meals.
2. Keep some physical activity in your routine.
3. If the high-stress situation results from a tragedy, pace your exposure to media accounts or conversations about it. Plan how much time you need to watch, listen or read about the tragedy before taking a break.
4. Breathe - deep breathing and relaxation practice are valuable ways to inoculate yourself against strain, especially during high-stress periods.
5. If loss or tragedy causes the high stress, expect to go through a grieving process. Feelings will likely include rage, deep sadness, fear for safety, maybe even ‘survivor’s guilt’. Know that this is a natural process.
6. It’s a good idea to write down your deepest thoughts and feeling about highly stressful and/or traumatic events. Doing this for as little as 15-20 minutes will allow your emotions to settle and will facilitate healing.
7. Take extra care to drive defensively and become especially focused in the moment as you drive. If the high-stress situation is affecting your whole community, remember that stress or fear may distract other drivers too.
8. If you have religious beliefs, pray for others who are in the high stress situation with you - for those whose lives have been turned upside-down, for those responding to the trauma, and for leaders who need to make wise decisions and take action. Pray also for your physical emotional and spiritual health in difficult times.
9. Maintain your regular routine and healthy activities. Go about your work and your life without getting stuck in a rut. Act in defiance of other people attempting to control your life, by continuing to truly live.
10. Watch for ways in which your mind or body is showing the tension it is experiencing as a result of the high stress. If appropriate, do not hesitate to call for professional help and guidance from a licensed or accredited healthcare specialist.

  

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3 Essentials for Good Health and Fitness

The maintenance of good health is essential to each and every individual. To keep physically fit, adequate rest, exercise, fresh air and a wholesome diet are essential.

1. Sleep and relaxation - Every person require adequate sleep and relaxation as they are on the move all the time. Especially those employed in the kitchens who often are subjected in a hot atmosphere where the tempo of work may be very fast. Frequently, the hours are long or extended over a long period of time, as with split duty, or they may be extended into the night. In off-duty periods it may be wise to obtain some relaxation and rest rather than spend all the time energetically. The amount of sleep and rest required depends on each person’s needs - the variation between one person and the next is considerable.
2. Exercise and fresh air - People working in conditions of nervous tension, rush, heat and odd hours need a change of environment and particularly fresh air. Swimming or walking or cycling in the country may be suitable ways of obtaining both exercise and fresh air.
3. Wholesome food and pure water - A well diet, correctly cooked, and pure water will assist in keeping an individual fit. The habit of ‘picking’ (eating small pieces of food while working) is bad; it spoils the appetite and does not allow the stomach to rest. Meals should be taken regularly; long periods without food are also bad for the stomach. Pure water is ideal for replacing liquid lost in perspiring in hot conditions like a hot kitchen, or soft drinks may be taken to replace some of the salt as well as the fluid lost in sweating. 

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This is what happens when a fly lands on your food

• Flies can’t eat solid food, so to soften it up they vomit on it.
• Then they stamp the vomit in until it’s a liquid, usually stamping in a few germs for food measure.
• Then when it’s good and runny they suck it all back again, probably dropping some excrement at the same time.
• And then, when they've finished eating, it’s your turn.

Pest control

• The best methods of controlling pest are through maintaining high hygiene standards including:
• The food premises to be kept clean and in good repair.
• Food stocks to be inspected and rotated regularly.
• Windows and other openings to the outside environment to be fitted with insect-proof screens in food rooms.
• No food scraps o be left lying around.
• Dustbins and swill bins to be covered with tight-fitting lids and emptied regularly, especially in summer.
• It is also good practice to employ a pest control contractor to regularly inspect the site and give advice.

To control flies, the best method is to eliminate their breeding place, As they breed in rubbish and in warm, moist places, dustbins in summer are ideal breeding grounds; correct control and disposal of waste is paramount. Other ways to control flies are to:

• Screen windows to keep flies out of kitchens.
• Install ultra-violet electrical fly-killers
• Use sprays to kill them (only where there is no food present)
• Employ a pest control contractor.

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The 12 ways of cooking foods.

Cooking and processing food is the use of chemical technology to create a harmonious product using color, smell, taste, texture and mouth-feel. A knowledge of basic ingredients and their chemistry will help the chef both develop new recipes and dishes, and give him/her a knowledge of how to correct dishes when things go wrong.

Method of cooking and its effect on foods.

1. Boiling - Gentle boiling helps break down the tough fibrous structure of certain foods which would be less tender if cooked by other methods. When boiling meats for long periods the soluble meat extracts are dissolved in the cooking liquid. Cooking must be slow to give time for the connective tissue in tough meat to be changed into soluble gelatin, so releasing the fibers and making the meat tender. If the connective tissue gelatinizes too quickly the meat fibers fall apart and the meat will be tough and stringy. Gentle heat will ensure coagulation of the protein without hardening. Vegetables should be boiled for the shortest time possible otherwise their nutrient content will be reduced or lost.
2. Poaching - Helps to tenderize the fibrous structure of the food, and the raw texture of the food becomes edible by chemical action.
3. Stewing - In the slow process of cooking in gentle heat, the connective tissue in meat and poultry is converted into a gelatinous substance so that the fibers fall apart easily and become digestible. The protein is coagulated without being toughened.
4. Braising - Causes the breakdown of tissue fiber in the structure of certain foods, which softens the texture, thus making it tender and edible.
5. Steaming - The structure and texture of food is changed by chemical action and become edible.
6. Baking - Chemical action caused by the effect of heat on certain ingredients (e.g. yeast, baking powder) changes the raw structure of many foods (e.g. pastry, bread) to an edible texture.
7. Roasting and spit-roasting - The surface protein of the food is seared by the initial heat of the oven and improves the appearance, but not necessarily the palatability. This does not necessarily prevent the escape of the natural juices as was once thoughts to happen. When the food is highly browned, the oven temperature is reduced to cook the inside of the food without hardening the surface.
8. Grilling - Because of the speed of cooking there is maximum retention of nutrients and flavor because the effect of fierce heat on the surface of meat rapidly coagulation and seals the surface protein, thus helping to retain the meat juices.
9. Shallow-frying - The high temperature produces almost instant coagulation of the surface protein of the food. Some of the frying medium will be absorbed by the food being fried, which will change the nutritional content.
10. Deep-frying - Foods coated with flour, eggs, milk, breadcrumbs or a batter absorb the minimum amount of fat because the surface is sealed by the coagulation of the protein, Uncoated foods, such as chips, absorb a huge amount of fat, thus affecting their texture and nutritional content.
11. Paper bag cookery - Because the food is tightly sealed in oiled greaseproof paper or foil, no steam escapes during cooking and maximum natural flavor and nutritive value are retained.
12. Microwave cookery - A method of cooking and heating food by using high-frequency power. The microwave disturbs the molecules or particles of food and agitates them, thus causing friction, which has the effect of cooking the whole of the food. This method of cooking causes the food to become edible by the heat generated. Proteins become denatured, starches are gelatinized, with most of the moisture and flavor being retained.

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The Nature of Alcohol and how it affects the body

Alcohol is classed as a drug because, when consumed, it alters the physical, mental and emotional state of the drinker.

Where the alcohol by volume is over 0.5 per cent, the drink is classed as alcohol for the purpose of licensing law.

Strength of alcoholic drink

The strength of an intoxicating drink depends on how much alcohol it contains. The amount of alcohol contained is expressed as percentage alcohol by volume. The formula for expressing alcohol by volume on labels is: alc.  vol. or % vol. So a fortified wine, such as sherry or vermouth, labeled as alc. 18% vol. means that 18 per cent of any given quantity is pure alcohol. Most spirits are around 40 per cent alcohol by volume whereas, wines vary from 8 per cent to 16 per cent alcohol by volume. Beers range from 3 per cent to 9 per cent alcohol by volume and ciders range from 3 per cent to 8.5 per cent alcohol by volume.

Alcohol-free and low-alcohol drinks

To be classified as alcohol-free, a drink must contain no more than 0.05 per cent alcohol by volume. To be classified as low alcohol, no more than 1.2 per cent alcohol by volume. Both must be labelled accordingly.

Recommended safe limits of alcohol

Moderate drinking can be beneficial to health; excessive drinking can be detrimental to health. Recommended safe limits of alcohol, as recommended by the government and other organizations such as the Portman Group are as follows:

• Men should drink no more than three to four units a day and no more than 21 units per week.
• Women should drink no more than two to three units a day and no more than 14 units per week.

What is a sensible alcohol drinking limit?

Keep to the recommended sensible limits if you want to avoid damaging your health. As noted above, the recommended sensible limit is up to 21 units for men and up to 14 units a week for women, with one or two drink-free days. Remember, there are times when even one or two drinks can be too much - for example, if you are going to drive or operate machinery. It can be dangerous to drink alcohol if you are taking certain types of medicine.

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Are You a Healthy Weight?

One of the biggest problems facing the Africa and other developed countries is obesity. Obesity is a condition in which abnormal or excessive fat accumulation in adipose tissue impairs health. Obesity is one of the most visible and, until recently, mostly neglected public health problem.

Body weight is influenced by energy intake (from food) and energy expenditure (needed for basal metabolism such as keeping the heart beating) and for physical activity. If a person regularly consumes more energy (calories) than they use, they will start to gain weight and eventually become overweight or obese. If a person regularly consumes less energy than they use they will lose weight. Extra energy is stored in the blood as fat. Balancing energy intake and output to maintain a healthy weight has many benefits, otherwise, there are many risks involved if you don’t keep your weight in check.

One of the risks is diabetes. Obese people also have a higher risk of developing diabetes. Diabetes develops when the body cannot use glucose properly. On 2014, around 1.4 million people in the world were diagnosed with diabetes. In addition, there are a large number of people who may have unrecognized diabetes.

Eating a healthy balanced diet, taking regular physical exercise, and maintain a healthy body weight can help to prevent or delay the onset of type 2 diabetes. People with diabetes should try to maintain a healthy weight and eat a diet that is low in fat (particularly saturated fats) and salt, but that contains plenty of fruit and vegetables (at least five portions a day), and starchy carbohydrates foods such as bread, rice and pasta (particularly wholegrain versions).

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Special and Healthy Diet

There will be occasions when one will be asked to provide some special diets or to cater for a guest with special dietary needs. Such people and their respective diets ma include;

Vegetarian and other ethical diets.

Should avoid food like meat or fish of any type, or dishes made with or containing the products of animals. Check for ‘vegetarians’ who occasionally eat fish and/or meat (semi-vegetarian or demi vegetarians), do not eat milk and dairy products (ovo-vegetarian), do not eat eggs (lacto-vegetarian), do not eat any food of animal origin, including honey, dairy products, egg (vegan-vegetables, fruits, grains, legumes, pasta made without eggs, soya products and other products of plans are acceptable to vegans), eat only fruit, nuts and berries (fruitarian or fructarian)

Some 10 per cent of 15-18-year-old girls claimed to be vegetarian or vegan. Vegetarians, and vegans in particular, need to carefully balance their food intake to ensure that they do not go short of iron, vitamin B12, zinc, vitamin D and calcium. The less restricted the diet the better. However, vegetarians have a lower risk of heart disease, stroke, diabetes, gallstones, kidney stones and colon cancer; they are also less likely to become overweight or to have raised cholesterol levels.

Pregnant and breastfeeding women.

Food to avoid: do not eat soft, mold-ripened cheese, pate, raw or partially raw eggs, undercooked meat and poultry, tuna, swordfish or marlin, liver or liver-containing foods, alcohol or more than two portion of oily fish a week.

Also see Therapeutic diets

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Therapeutic Diets

Special and healthy diet.

Today, there is a body of opinion within the medical profession which suggests that a regular diet of fresh fruit and vegetables can help to eliminate a number of diseases and certain types of cancers. Also it is advisable to reduce fat intake, eat more fish, wholegrain breads, pulses and rice.

Some therapeutic suggestions to consider in order to achieve this are;

Foods to Avoid

Diabetes: dishes that are high in sugar and/or fat (low-calorie sweeteners can be used to sweeten desserts)

Low cholesterol and saturated fat: liver, egg yolks and shellfish (which are high in cholesterol), beef, pork and lamb (which contain saturated fats), butter, cream, groundnut oil, margarine (use oils and margarines labelled high in polyunsaturated fats)

Low fat: any food that contains fat, or has been fried or roasted.

Low salt: foods and dishes that have had salt added in cooking or processing (including smoked and cured fishes and meats, and hard cheeses), or that contain monosodium glutamate.

Low residue: whole meal bread, brown rice and pasta, fried and fatty foods.

Milk-free: mil, butter, cheese, yogurt and any pre-prepared foods that include milk products (check label).

Nut allergy: nuts, blended cooking oils and margarine (since these may include nut oil; use pure oils or butter), and any dishes containing these (check label)

Gluten-free: wheat, whole-meal, whole-wheat and wheat-meal flour, wheat bran, rye barley and oats (some doctors say oats are permitted, the Coeliac Society advises against), and any dishes made with these, including pasta, noodles, semolina, bread, pastries, some yoghurt (e.g. muesli), some cheese spreads, barley-based drinks, malted drinks, beer, some brands of mustard, proprietary sauces made with flour (use corn flour to thicken; potato, corn and sage are also acceptable).

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What to Eat for Breakfast

Ingredients.

Onions

Potatoes

Eggs

Parsley

Salt to taste

Pepper (optional)

Cooking oil

Steps of preparation.

Chopped onions, chopped potatoes, eggs, and fresh parsley.

Fry the potatoes like fries, sauté the onions.

In a bowl mix the onions, eggs, potatoes, parsley, salt and pepper.

Put in a pan and let it simmer 4 minutes per side.

End result. Piece of the sweetness.

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Healthy Meat Substitutes

Don’t know what to use in place of meat in your favorite recipes? There are now widely available alternatives to just about every type of meat. Here are some of the top alternatives for you.

Texture vegetable protein (TVP)

Courtesy of Bobs Red Mill

This is a meat substitute manufactured from protein derived from wheat, oats, cottonseed, soya beans and other sources. The main source of TVP is the soya bean, due to its high protein content.

TVP is used chiefly as a meat extender, varying from 10-60 percent replacement of fresh meat. Some caterers on very tight budgets make use of it, but its main use is in food manufacturing.

By partially replacing the meat in certain dishes - such as casseroles, stews, pies, pasties, sausage rolls, hamburgers, meat loaf and pate - it is possible to reduce costs, provide nutrition and serve food that is acceptable in appearance.

According to bobsredmill.com 

Textured Vegetable Protein is a highly nutritious soy product. It is incredibly wealthy in complete protein and contains no fat, so it is an excellent alternative to meat. TVP® is made from defatted soy flour that has been cooked under pressure and then dried. TVP® is naturally gluten-free and is handled and packaged in our separated, dedicated gluten-free facility. It is routinely tested for cross contamination using R5 ELISA testing protocol to ensure its gluten-free status.
Although TVP® doesn't add much flavor, it's low in fat and calories, contains a wealth of complete soy protein and it's a good source of dietary fiber. Soy contains complete protein with all the amino acids essential to human nutrition, which must be supplied in the diet because they cannot be synthesized by the human body. It is also a good source of iron, magnesium and phosphorus.

Mycoprotein: Brand name Quorn.

This meat substitute is produced from a plant that is a distant relative of mushroom. Mycoprotein contains protein and fiber, and is the result of a fermentation process similar to that used in the production of yogurt. It may be used as an alternative to chicken or beef, or in vegetarian dishes.

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The Effects of Cooking on Nutrients

Some foods are best eaten when freshly harvested, without further preparation or cooking. Fruit such bananas, and vegetables such as tomatoes and lettuce fall into this category. Cooking and storage over prolonged periods reduces the nutritional value of these foods.

Cooked vs. Raw Foods

Why it is that live food gives us the best effect in terms of cutting down our caloric intake and maximizing the quality of our food intake? One of the keys to this is pointed out by Viktoras Kulvinskas in his book, Survival into the 21st Century. Viktoras, who is considered one of the founders of the modern live hood movement, estimates that the overall nutrient destruction when you cook food is 80%. Although there is some variation in the research findings, most agree that at least 50% of the B vitamins are destroyed by cooking. B1 and B12 losses have been recorded up to 96%, folic acid losses up to 97%, and biotin losses up to 72%. Vitamin C losses are approximately 70-80%. The well-known Max Planck Institute for Nutritional Research in Germany found only 50% bioavailability in proteins that have been overcooked. This study found that cooking alters proteins into substances that disrupt cellular function and speed up the aging and disease process.

With the above exceptions, the digestibility of most foods is enhanced through cooking.

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Kenyan Soft Layered Chapati

Ingredients for soft layered chapati

• 3 cups of All Purpose Flour (not self-rising)
• 1 ½ cups of warm water
• 1 teaspoon of salt
• 1 teaspoon of sugar
• Vegetable oil

Method of preparing chapati

• Step 1. In a bowl, measure three cups of flour.
• Step 2. In another bowl, mix salt, sugar, 2 tablespoon of oil and 1 cup of water. Stir until the salt and sugar dissolves.
• Step 3. Pour the liquid mixture above (step 2) in the flour bowl and mix well. Keep adding the remaining water until the dough becomes soft.
• Knead the dough for five minutes and add flour if needed.
• Step 5. Transfer the dough on a flat surface and continue kneading and adding flour when needed for 10 minutes. Add more flour to make it thicker but not too hard. (I love kneading my dough on a flat space until I have attained the right elasticity).
• Step 6. Return the ready chapati dough in a bowl, add some oil and knead to mix it up until it soft and not sticky. Cover the dough and leave it for 40 minutes
• Step 7. After the 40 minutes, divide the dough into 10 to 13 equal parts making ball like shapes. This will make them round in shape.
• Arrange them in a flat surface dusted with flour.
• Step 8. Right away, pick one of the balls and place it on a flat surface
• Step 9. With a rolling pin, roll the ball to a circular shape.
• Step 10. Brush the circular chapati with oil on top.
• Step 11. At the side that faces you, start folding and rolling the oiled chapati with both hands as if you are rolling a rode away from your direction.
• Step 12. Once you have a shape that looks like a rope, create a coil like shape
• Step 13. Make a coiled ball and with your palm, press the ball down to make it flat.
• Step 14. Next, with a rolling pin make a circular shape again.
• On a hot pan, place the rolled out circular chapati and fry each side until its golden brown on medium heat.
• (Repeat step 8 to 15 until you finish the rest chapati dough balls).

Put your cooked chapati in plastic wrap or container and cover. Serve after 20 minutes.

All the best.

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Recipe makes 6 muffins

These little egg muffins are filled with protein from the eggs and ricotta, and radiate color because they're loaded with summer tomatoes. It's just an added bonus that these couldn't be easier to make, and they're incredibly delicious!

I made them with rosemary, but use whatever herbs you really enjoy. Just whip them up, bake them, and refrigerate until ready to reheat on your way out the door, so you can start the day with flavor and convenience!

Ingredients:

6 large eggs (preferably organic)

2 tablespoons unsweetened almond milk

1 cup halved cherry tomatoes

½ cup whole milk ricotta

1 tablespoon rosemary, roughly chopped

½ teaspoon sea salt

½ teaspoon white or black pepper

2 teaspoons olive oil

Instructions:

Preheat oven to 350 degrees. 

In a large bowl, whisk the eggs and milk together. Add the ricotta, tomatoes, rosemary, salt and pepper. Stir well to combine. 

Grease 6 muffin tins with olive oil. Then, pour the batter ¾ of the way up of each muffin cup. 

Bake for 35-40 minutes until golden brown and cooked through. 

Let cool and refrigerate. To reheat, microwave for 1 ½ minutes on high.

So many of you have been asking for grab and go food options. Breakfast is almost always a meal I eat on the fly as I'm sure it is for you too! Still, it's so important that meal 1 aligns with the kind of work one does. Eat Your Way. Eat enough food in the morning to give you energy and keep you craving-free all day long!

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Health problems that strike the sweet food enthusiasts

Sweet is the common taste of food. Sweet food connoisseurs are also very numerous. The reason being sweet foods can soothe and serves as an effective mood booster. This kind of food may include candy, cookies, cake and many others.

Most people View sugary foods as tasty, satisfying, and irresistible treats. But I believe that there are three words that can more accurately describe sugar: toxic, addicting, and deadly.

Besides being able to cause health problems such as weight gain, to diabetes, there are many diseases that would normally be encountered by food connoisseurs’ sweet or commonly called sweet-teeth person. As Quoted by indiatimes.com, here is the explanation.

Headache

According to some studies, those who have a habit of eating sweet foods tend to easily experience headaches when they do not eat them for a long time. This symptoms are similar to when you are addicted to something.

Decreased immune system

Did you know that most of the sugar in the body can weaken the immune system? As a result, your body tends to be easily hurt.

Toothache

Toothache is a common disorder that affects sweet food connoisseurs. Toothache will also continue to appear even if you are diligent about brushing your teeth. Because the germs that cause tooth pain often hide inside the mouth where the toothbrush does not cover when brushing.

Dullness

Too much sugar in the body also can make the skin becomes dull or acne.

Dehydration

Sweet food addicts often feel thirsty because his rapid dehydration due to the sugars that accumulate.

Eating sugary foods is actually legitimate. But not too much because it is able to cause a series of health problems such as described above. So, if you include people who are fond of eating sweet foods, then cut back consumption of these foods.

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Healthy Breasts

Almost every woman wants to have a beautiful body shape. One of the supporters of the beauty of the female body shape is healthy breast, solid, strong and beautiful. But 90% of women pay less attention to the health and beauty of the breast, especially those who have been pregnant, after breastfeeding, thus unwittingly breast sagging, withered and began to wrinkle. The cause is due to the shrinking of the mammary gland, also due to the weakening of the connective tissue supporting the breast and the breast skin elasticity is reduced.

Studies shows that women who are married and have given birth to at least one child are the ones most affected by breast cancer. Such women tend to be reluctant in paying attention to their own beauty and beauty of their breast. Breast cancer is a kind of cancer that develops from breast cells. Breast cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma.

Experts are not definitively sure what causes breast cancer. Two Major Causes of Breast Cancer are;

1. Genetic
2. Lifestyle factors

Genetic:

Breast cancer may be genetically inherited. However, a relatively small percentage, which is 5-10%. Women who have a close relative who has/had breast or ovarian cancer are more likely to develop breast cancer

The characteristics of breast cancer caused by a genetic are:

• Suffered at age <40 years
• Suffered at age <50 years, and there is one or more first-degree relatives (parents, siblings or children) suffering from breast or ovarian cancer (ovarian),
• Suffered at any age, and there are two or more first-degree relatives with breast cancer,

 Lifestyle factors:

The lifestyle is very influential on health, including breast health. Some high-risk conditions that influenced the lifestyle are:

• Obesity
• After menopause increases breast cancer risk from the effects of estrogen and progesterone is greater. 
• Smoking (cigarette smoke in addition to having direct toxic and carcinogenic effects, might also influence chronic disease risk through hormonal mechanisms).
• Alcohol (alcohol increases estrogen levels thus increasing the activity of endogenous tumor).

Also read Tools for early detection of breast.

Much has been said and demonstrated on how to check if breast cancer has started developing in an individual. If a woman detects any of the breast cancer signs and symptoms described below, she should speak to her doctor immediately. The doctor, often a primary care physician (general practitioner, GP) initially, will carry out a physical exam, and then refer the patient to a specialist if he/she thinks further assessment is needed.

•      The size or the shape of the breast changes
•     The nipple-skin or breast-skin may have started to peel, scale or flake.
•     A lump in a breast
•     A pain in the armpits or breast that does not seem to be related to the woman's menstrual period
•     Pitting or redness of the skin of the breast; like the skin of an orange
•     A rash around (or on) one of the nipples
•     A swelling (lump) in one of the armpits
•     An area of thickened tissue in a breast
•     One of the nipples has a discharge; sometimes it may contain blood
•     The nipple changes in appearance; it may become sunken or inverted

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Tips for a comfortable and healthy journey

If you are prone to motion sickness during journeys, including; plane take-off, landing, speeding motors or in the event of turbulence, focus on a fixed object. Some people believe that applying pressure to your earlobes can reduce nausea.

To reach your destination feeling fresh, relaxed and rejuvenated here are tips for healthy travel you have to consider when traveling.

Sleep. Whatever means of transport you will be using try to get a good night’s sleep before your travel day, at least 6 - 8 hours of good sleep will do. When traveling using aircraft or ship sometimes you will be forced to travel across time zones, your body’s sleep rhythms can become disrupted, leading to insomnia, loss of appetite and fatigue. Prepare your body clock by getting a good night’s sleep before your flight or boarding on a ship. Try to give yourself a couple of relaxed days to adjust to new night and day cycles when you arrive. 

Eating habits. Whatever means of transport you are using be sure to eat a light meal and take some gentle exercise before traveling. Avoid too much salt, sugar and dairy products. Try to steer clear of fizzy drinks and moderate your intake of alcohol, tea and coffee.

Dressing. Always mind how you dress. This is mostly very vital when you are traveling by air. Wear loose, comfortable clothing always and shoes that are not restrictive.

Drinks. On longer journeys drink plenty of water and fruit juice (keeping alcohol, tea and coffee to a minimum). When traveling on road be sure if the bus will make interval halt on the way for passengers to answer the call of nature otherwise you will be under unnecessary pressure which can bring harm to your health at last. Drink lots of water while flying. Drinking little and often is the best. If possible, remove contact lenses and apply skin moisturizer and lip balm for women when traveling on air. Try breathing through a handkerchief soaked in water.

Safety. Please watch the safety demonstration before take-off. For flights refer to the leaflet in your seat pocket. For buses and ships refer to the respective notice boards available. Smoking is prohibited on almost all means of transport. For flights, electronic devices may not be used during taxing, take-off climbing, descent and landing.

Keep fit. When traveling using aircraft, keep your circulation going by standing up and walking in the aisle when possible. Sluggish circulation causes tiredness, muscle cramps and water retention (the cause of swollen feet). It can also result in blood clots, which are potentially dangerous. Avoid all these by standing up and walking, flex different muscles in your feet, legs, arms, shoulders and neck irrespective the mode of transport you are using.

After journey adjustments. On arrival at your destination spend as much time as possible outside on the sun and free circulation of air. Sunlight will allow your body to adjust to the new time schedules you are facing after traveling across time zones.

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