Friday 27 December 2013

Low glycaemic index or low glycaemic load diets for overweight and obesity

In the study to assess the effects of low glycaemic index or load diets for weight loss in overweight or obese people, showed that overweight or obese people on LGI lost more weight and had more improvement in lipid profiles than those receiving Cdiets. Body mass, total fat mass, body mass index, total cholesterol and LDL-cholesterol all decreased significantly more in the LGI group. In studies comparing ad libitum LGI diets to conventional restricted energy low-fat diets, participants fared as well or better on th LGI diet, even though they could eat as much as desired. Lowering the glycaemic load of the diet appears to be an effective method of promoting weight loss and improving lipid profiles and can be simply incorporated into a person's lifestyle. Further research with longer term follow-up will determine whether improvement continues long-term and improves quality of life(1).


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(1) "Low glycaemic index or low glycaemic load diets for overweight and obesity" by Thomas DE, Elliott EJ, Baur L.

Women and Heart Disease (Coronary Microvascular Disease (MVD))

Heart disease is defined as a condition in which the heart's inner lining of blood vessels is served damage that can impede the function of transportation of oxygen and nutrition of the heart to other cells and organ in the body. Everyday, more than 2,000 Americans die as a result of heart diseases. Approximately 60 million Americans have heart disease.
Believe or not, 1 in 4 women in US dies from the heart diseases and coronary heart disease (CHD) is the most common type of heart disease in women and men.

What is coronary heart disease
Coronary heart disease is a result of plague build up in the inner lining wall of the arteries, by mostly cholesterol, fat and other minerals. In a prolonged period of time, these build up can block and impeded the inner lining wall, leading to the narrower blood flow to the muscles of the heart. In some case, the rupture of plague can cause blood clots blocking the flow of blood to the blood muscle, causing heart attack.

What is coronary microvascular disease (MVD)
Instead of affects the arteries, coronary microvascular disease (MVD) affects the heart's smallest coronary arteries. according to findings from the National Heart, Lung, and Blood Institute’s (NHLBI) Women’s Ischemia Syndrome Evaluation (WISE) study, In women with this condition, called coronary microvascular syndrome, plaque accumulates in very small arteries of the heart, causing narrowing, reduced oxygen flow to the heart, and pain that can be similar to that of people with blocked arteries, but the plaque does not show up when physicians use standard tests. As a result, many women go undiagnosed.

Symptoms
1. Leg cramps during walking
Leg cramps during exercise might be caused by dehydration. It is important to drink a lot of fluid during exercise. Leg cramps occur when the muscle suddenly and forcefully contracts. The most common muscles to contract in this manner are muscles that cross two joints. Leg cramps during walking might be an indication of heart disease caused by arteries in your leg being clogged up by cholesterol as a result of not enough oxygen being delivered to the cells in your leg. If this symptom persists, please consult with your doctor.

2. Chest pain
Chest pain is caused by blood vessels in the heart temporarily blocked up or by inadequate oxygen supply to the heart muscle or coronary . The persistence of chest pain would be an early indication of heart diseases.

3. Shortness of breath
Shortness of breath (dyspnea) is the major symptom of the left ventricular insufficiency. People with shortness of breath are four times more likely to die from a heart disease related cause than individuals without any symptoms.

4. Headaches
People see sparkling zigzag lines or loss of vision before a migraine attack may be at particular risk of future cardiovascular problems. Generally headaches do not cause heart diseases but a sudden, explosive onset of great pain might be.

5. Dizziness
Dizziness can have many causes including low blood count, low iron in the blood stream and other blood disorders, dehydration, and viral illnesses. Since there are many different conditions that can produce these symptoms, anybody experiencing episodes of severe headaches or dizziness ought to be checked by your doctor.

6. Palpitations
Palpitations is an extremely common symptom of heart disease. Palpitations are skips in the heart beats and irregular heart beats.

7. Loss of consciousness
It is a common symptom, most people pass out at least once in their lives. However, sometimes loss of consciousness indicates a dangerous or even life-threatening condition such as heart disease so when loss of consciousness occurs it is important to figure out the cause.

8. Etc.

Causes and risk factors
1. Diet high in saturated and trans fat
Diet high in saturated and trans fat increases the risk of cholesterol build up in the arteries and accumulated in very small arteries of the heart, causing narrowing, reduced oxygen flow to the heart.

2. High blood pressure
Blood pressure is the force of blood pushing against the walls of the arteries to regulate the blow flow for transporting oxygen and nutrients to the body's cell and organs. if plague build-up over prolong period of time, it can narrow the arteries and very small arteries of the heart, causing high blood pressure that can lead to heart disease.

3. Diabetes
Diabetes can increase diabetes-related fatty material deposite in the walls of coronary arteries as a result od prolonged period of high blood glucose in the blood stream. According to the article of Diabetes Overview by National Diabetes Information Clearinghouse (NDIC) indicated that women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of being a woman in her child-bearing years.

4. Insulin resistance
In a study of Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease by Pyorala K. 1979 researcher found that hyperinsulinemia is a predictor of coronary artery disease (CAD).

5. Central waist Obesity
Abdominal fat accumulated to the central waist area can increase the production of bad cholesterol, causing plague deposited on the inner lining of blood vessel walls.

6. Age
The decreased levels of estrogen due to aging are associated with increased risk of coronary microvascular disease.

7. Lack of physical exercise
In astudy of studied 223 children -- 123 boys and 100 girls -- with an average age of 9.8 years, assessing their physical activity levels over four days from a team of researchers from Sweden and Denmark found that children who were more physically active had a lower composite risk factor score for cardiovascular disease (CVD) than the children with lower amounts of moderate to vigorous physical activity and vigorous physical activity.

8. Family history
Increased risk of developing the disease if one of the direct family member have the disease

9. Heredity
Inherited heart muscle diseases may increase the risk of coronary microvascular disease (MVD).

10. Smoking
Cigarette contains high amount of harmful chemical substances attacked to the arterial wall, causing plague build-up, hardening the arterial wall that can lead to coronary microvascular disease.

Preventions
A. How to avoid
1. Stop smoking
2. Reduce intake of saturated and trans fat
3. Moderate exercise
4. Diabetes controlled
5. Life style change
6. Eating a health diet (see over 100 Healthy Foods List)
7. Etc.

B. Diet
1. Fresh water algae
Fresh water algae contains chlorophyII-rich foods that is a powerful antioxidant for protection of build up of free radicals and restoring DNA of damaged cells. It also contains high amounts of Omega 3 and 6 fatty acids that can help to maintain normal blood pressure as well as cholesterol levels. Omega 3 and 6 fatty acids also inhibit blood clotting that causes the blockage of arteries and heart diseases.

2. Onions and garlic
Garlic and onions contain high amounts of sulfur compounds that not only help to improve circulation of blood but also help to keep your platelets from clumping together. Daily consumption of both garlic and onions help to keep blood pressure and cholesterol levels in healthy range. Be sure to talk to your doctor if you are taking any blood thinner medicines.

3. Nuts and seeds
Nuts and seeds contain high amounts of unsaturated fat and vitamin E. Unsaturated fat helps to prevent clots of arteries and lower cholesterol levels. Vitamin E, and the antioxidants beta varotene on the other hand stops bad cholesterol LDL from building up in the arteries, decreasing the risk of heart attacks.

4. Vegetables and fruits
Vegetable and fruits contain high amounts vitamins A, E, C and B. Vitamin E, the antioxidants beta carotene and vitamin C help to strengthen your small blood vessels and thins your blood so it can flow smoothly in result of lowering the risk of heart disease and strokes. Plums, tomatoes, and watercress are the best choices.

5. See over 100 Healthy Foods List), Etc.

C. Nutritional supplements
1. L-Arginine
L-Arginine helps to increase the production of nitric oxide in our body, this has an anti-angina and anti-stress effect upon the arteries enabling the muscles in the arterial walls to relax. L-Arginine also helps to prevent the build up of plaque on the arterial walls. L- Arginne taken either orally or intravenously has been found to prevent and reverse atherosclerosis, improving the functional status of heart failure and increasing blood flow in heart disease patients.

2. L- Carnitine
L-Carnitine working with vitamin E will help the body to recover quickly from fatigue. L-Carnitine helps the body convert fatty acids into energy, which is used primarily for muscular activities throughout the body. When working with vitamin E, L-carnitine will help the body to recover quickly from fatigue and combat heart diseases.

3. Lecithin
Lecithin supplies the body with needed inositol, choline and phosphatidyl choline that help to maintain healthy arteries. Lecithin also helps to reduce plaque in the arteries, lower blood pressure and ameliorate angina pectoris.

4. Niacin
Niacin a B3 vitamin, helps decreases blood levels of cholesterol and triglycerides which may reduce the risk of atherosclerosis. Niacin can only be taken under medical supervision because of it's side effects.

5. Selenium
Selenium deficiency will cause increase in high blood pressure.

6. Taurine
Taurine is an amino acid that acts as an antioxidant helping to fortify cardiac contraction and enhance the outflow of blood from the heart. Intake of taurine will reduce the risk of congestive heart failure and arteriosclerosis.

7. Calcium and potassium
Calcium and potassium deficiency may result in heart palpitation.

8. Magnesium
Magnesium helps to improve blood circulation by permitting the muscles in the arterial wall to rest.

9. Lutein
Lutein is one of the carotenoids, yellow and orange pigments found in many fruits and vegetables. Lutein supplementation has already been proven in helping prevent muscular degeneration, the most common cause of irreversible blindness in the elderly. Study shows that increased dietary intake of lutein may protect against the development of early atherosclerosis. It also helps explain why diets rich in fruits and vegetables are associated with reduced risk of heart disease.

D. Herbs

1. Flax seeds
Flax seeds contain high amounts of alpha-linoenic acid that helps to lower high blood pressure and the risk of stroke. Eating too much flax seeds will cause gas to build up if you are not used to it.

2. Ginkgo biloba
Ginkgo biloba helps to to make blood less sticky and prevents blood clotting and stroke. Unlike aspirin, Ginkgo biloba will not cause upset stomach and internal bleeding. Also, Ginkgo biloba can improve blood circulation. Be sure not to take Ginkgo seeds because they are toxic and can cause seizures.

3. Cayenne
Cayenne stimulates blood flow, and strengthens the heart's metabolism. It also helps to improve blood circulation as well as the digestive and immune systems. Cayenne contains high amounts of beta-carotene, cobalt, essential fatty acids, niacin and zinc that helps circulatory stimulation, blood purification, detoxification and fatigue.

4. Mistletoe
Mistletoe can stimulate the heartbeat and increase cardiac output. It can help to relieve heart strain, stimulate circulation, and lower blood pressure. Do not overdose and eat mistletoe berriea, because it is toxic.

5. Hawthorn berry
Hawthorn berry contains high amount of flavonoids that help to provide direct nourishment to the heart as well as dilate the coronary arteries.

6.Bugleweeds
Bugleweeds help to alleviate heart palpitation and high blood pressure. Study shows that bugleweeds act chiefly on the blood vessels, and is especially useful in plethoric and inflammatory states, particularly internal inflammations, and cardiac diseases.

7 Motherwort
Motherwort can be used in secure cardiac electrical rhythm. Be sure to talk to your doctor before taking motherwort supplements.

8. Tansy
Tansy is used to help heart palpitations and also helps to improve blood circulation.
Remember that herbs help to lower high blood pressure and cholesterol levels will also help to prevent heart diseases and stroke.

F. Chinese herbs
1. Nu zhen zi (privet fruit):
Nu zhen zi is the ying kidney and liver tonic that is the significant immune enhancement agent. Nu zhen zi also helps ying deficiency such as dizziness, floater, weak knee and enhancing heart blood.

2. Hong hua (safflower):
Hong hua is one of the Chinese herbs that have been used to break up blood stagnation and improve blood circulation. It is also used to unblock uterine stagnation.

3. Ru xiang (frankincense)
Ru xiang is used for thousand of years in treating joint pain, alleviating chest pain as well as breaking up blood stagnation and improving blood flow to the heart.

4. Mao yao (myzzh)
Mao yao contain elements that help to break up stagnation of blood resulting in improved blood circulation in our body.

5. Fu ling (poria)
Fu ling is a fungus that helps to enhance the immune system's ability to fight off viruses. It is used in Chinese medication for heart calming and palpitation smoothing.

6. Yin yang hou horney (goat weed)
Goat weed helps to lower high blood pressure and heart calming.

7. Du zhong (rubber tree bark)
Du zhong is consider the primary herb used to increase the yang function in the body resulting in benefits of the heart.

There are many more Chinese herbs that can help to lower bad cholesterol levels and high blood pressure as well as preventing and curing heart diseases such as Xian Fu, Wu Wei Zhi, and Da Zhao.


Treatments in conventional medicine
The main goal of the treatment is to reduce the risk factors which have contributed to the diseases
1. Improve cholesterol levels
Medine statins are the types of drugs used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the regulation of the production of cholesterol by the liver.

2. Angiotensin-converting enzyme (ACE) inhibitors (captopril, enalapril, lisinopril, and ramipril)
Angiotensin-converting enzyme (ACE) inhibitors are a group of drugs used to inhibit the renin-angiotensin system (RAS) is a hormone system that regulates blood pressure and water balance.

3. Beta blockers
A study of beta Blockade after myocardial infarction: systematic review and meta regression analysis" by Freemantle N, Cleland J, Young P, Mason J, Harrison J (June 1999), researchers ofund that β Blockers are effective in long term secondary prevention after myocardial infarction, but they are underused in such cases and lead to avoidable mortality and morbidity.
In other study of "Beta blockers in hypertension" by Cruickshank JM (August 2010), researcher found that β blockers, at least in non-smokers (70% of whole), have been shown to reduce the risk of myocardial infarction by about 35—50% in men (MRC mild hypertension, IPPPSH, MAPHY studies). Also, as Webb and colleagues indicate, the risks of myocardial infarction and heart failure are related to the difference and not the variation in SBP, and the most effective way to lower SBP in younger or middle-aged people with hypertension is via β1 blockade (bisoprolol)
to lower blood pressure and decrease the heart's workload.

4. Aspirin, copy frommy previous article "Heart Diseases---Aspirin: Friend or Foe ?"
a. Aspirin indeed helps your blood from clotting. If you suffer any bleeding, taking aspirin will make bleeding harder to stop. Study show that aspirin might increase the bleeding complication. If you are taking any blood thinner medication or you have an ulcer, please consult with your doctor before taking aspirin. For people suffering from hemorrhages (this is the loss of blood from the circulatory system or internal bleeding taking aspirin) they would do more harm than good.

b. Aspirin increases the risk of bleeding and hemorrhagic strokes that are caused by blood vessels bursting in or around your brain. Therefore do not assume that taking an aspirin a day would do no harm. Please consult with with your doctor before starting aspirin therapy.

c. Study shows that aspirin does not work well with people with high cholesterol levels. People with cholesterol levels over 220 respond poorly to aspirin therapy. Therefore, if your cholesterol level is over 220 you might need to find some other therapy to lower the risk of heart diseases.
Aspirin also causes some side affects such as heartburn, indigestion and mild-to-moderate abdominal or stomach cramps.

5. Nitroglycerin
Nitroglycerin is also used medically as a vasodilator to treat heart conditions, such as angina and chronic heart failure by relaxing the blood vessels, improving blood flow to the heart muscle, etc..

6. Etc.

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Psychological interventions for overweight or obesity

In the study to assess the effects of psychological interventions for overweight or obesity as a means of achieving sustained weight loss, indicated that people who are overweight or obese benefit from psychological interventions, particularly behavioural and cognitive-behavioural strategies, to enhance weight reduction. They are predominantly useful when combined with dietary and exercise strategies. The bulk of the evidence supports the use of behavioural and cognitive-behavioural strategies. Other psychological interventions are less rigorously evaluated for their efficacy as weight loss treatments(1).


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(1) "Psychological interventions for overweight or obesity" by Shaw K, O'Rourke P, Del Mar C, Kenardy J.

A green tea extract high in catechins reduces body fat and cardiovascular risks in humans


In the study to investigate the effects of  a green tea extract (GTE)   in the body fat reducing effect and reduction of risks for cardiovascular disease by a green tea extract (GTE) high in catechins, Data were analyzed using per-protocol samples of 240 subjects (catechin group; n = 123, control group; n = 117). Decreases in body weight, body mass index, body fat ratio, body fat mass, waist circumference, hip circumference, visceral fat area, and subcutaneous fat area were found to be greater in the catechin group than in the control group. A greater decrease in systolic blood pressure (SBP) was found in the catechin group compared with the control group for subjects whose initial SBP was 130 mm Hg or higher. Low-density lipoprotein (LDL) cholesterol was also decreased to a greater extent in the catechin group. No adverse effect was found(1).


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(1) "A green tea extract high in catechins reduces body fat and cardiovascular risks in humans"by Nagao T, Hase T, Tokimitsu I.

Drinking water is associated with weight loss in overweight dieting women


In the study to test for associations between absolute and relative increases in drinking water and weight loss over 12 months, secondary analyses were conducted on data from the Stanford A TO Z weight loss intervention on 173 premenopausal overweight women (aged 25-50 years) who reported <1 l/day drinking water at baseline. Diet, physical activity, body weight, percent body fat (dual-energy X-ray absorptiometry), and waist circumference were assessed at baseline, 2, 6, and 12 months. At each time point, mean daily intakes of drinking water, noncaloric, unsweetened caloric (e.g., 100% fruit juice, milk) and sweetened caloric beverages, and food energy and nutrients were estimated using three unannounced 24-h diet recalls. Beverage intake was expressed in absolute (g) and relative terms (% of beverages). Mixed models were used to test for effects of absolute and relative increases in drinking water on changes in weight and body composition, controlling for baseline status, diet group, and changes in other beverage intake, the amount and composition of foods consumed and physical activity(1).


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(1) "Drinking water is associated with weight loss in overweight dieting women independent of diet and activity" by Stookey JD, Constant F, Popkin BM, Gardner CD.

Impact of water intake on energy intake and weight status

In the study to review of studies reported in the English-language literature was performed to compare the effects of drinking water and various beverage alternatives on energy intake and/or weight status, studies comparing non-nutritive sweeteners with water were also relatively consistent and found no impact on energy intake among adults (DeltaTEI, -1.3; range, -9 to 13.8). Much less conclusive evidence was found in studies replacing water with milk and juice, with estimated increases in TEI of 14.9% (range, 10.9 to 23.9%). These findings from clinical trials, along with those from epidemiologic and intervention studies, suggest water has a potentially important role to play in reducing energy intake, and consequently in obesity prevention. A need for randomized-controlled trials to confirm this role exists(1).

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(1) "Impact of water intake on energy intake and weight status: a systematic review" by Daniels MC, Popkin BM.

Dietary tea catechins increase fecal energy

In the study to investigate the role of tea catechins on the utilization of dietary energy sources in rats, suggesting that tea catechins increased the fecal excretion of these energy nutrients. Of the gross energy that the rats consumed from their respective diets during the fecal collection period, 1.6% (for control diet) and 5.8% (for tea catechin diet) were estimated to be excreted in feces. The energy loss originating from carbohydrate should contribute to the overall amount of energy in the feces, followed by protein. Intake of tea catechins suppressed the intestinal absorption of energy nutrients via the inhibition of digestive enzymes, which may at least partially influence the body fat reduction by tea catechins(1).

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(1) "Dietary tea catechins increase fecal energy in rats" by Unno T, Osada C, Motoo Y, Suzuki Y, Kobayashi M, Nozawa A.

Beverage consumption and adult weight management

In the review of  the effect of beverage consumption on short-term (i.e., meal) energy intake, as well as longer-term effects on body weight. Specific beverages addressed include water, other energy-free beverages (diet soft drinks, coffee and tea), and energy-containing beverages (soft drinks, juices and juice drinks, milk and soy beverages, alcohol), suggested that suggests that encouraging water consumption, and substituting water and other energy-free beverages (diet soft drinks, coffee and tea) for energy-containing beverages may facilitate weight management. Energy-containing beverages acutely increase energy intake, however long-term effects on body weight are uncertain. While there may be health benefits for some beverage categories, additional energy provided by beverages should be compensated for by reduced consumption of other foods in the diet(1).

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(1) "Beverage consumption and adult weight management: A review" by Dennis EA, Flack KD, Davy BM.

Green tea catechin consumption enhances exercise-induced abdominal fat loss

In the study to evaluate the influence of a green tea catechin beverage on body composition and fat distribution in overweight and obese adults during exercise-induced weight loss, participants (n = 132 with 107 completers) were randomly assigned to receive a beverage containing approximately 625 mg of catechins with 39 mg caffeine or a control beverage (39 mg caffeine, no catechins) for 12 wk. Participants were asked to maintain constant energy intake and engage in >or=180 min/wk moderate intensity exercise, including >or=3 supervised sessions per week. Body composition (dual X-ray absorptiometry), abdominal fat areas (computed tomography), and clinical laboratory tests were measured at baseline and wk 12. There was a trend (P = 0.079) toward greater loss of body weight in the catechin group compared with the control group; least squares mean (95% CI) changes, adjusted for baseline value, age, and sex, were -2.2 (-3.1, -1.3) and -1.0 (-1.9, -0.1) kg, respectively. Percentage changes in fat mass did not differ between the catechin [5.2 (-7.0, -3.4)] and control groups [-3.5 (-5.4, 1.6)] (P = 0.208). However, percentage changes in total abdominal fat area [-7.7 (-11.7, -3.8) vs. -0.3 (-4.4, 3.9); P = 0.013], subcutaneous abdominal fat area [-6.2 (-10.2, -2.2) vs. 0.8 (-3.3, 4.9); P = 0.019], and fasting serum triglycerides (TG) [-11.2 (-18.8, -3.6) vs. 1.9 (-5.9, 9.7); P = 0.023] were greater in the catechin group(1).
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(1) "Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults" by Maki KC, Reeves MS, Farmer M, Yasunaga K, Matsuo N, Katsuragi Y, Komikado M, Tokimitsu I, Wilder D, Jones F, Blumberg JB, Cartwright Y.

Beverage intake among preschool children and its effect on weight status

In the study to evaluate the beverage intake among preschool children who participated in the National Health and Nutrition Examination Survey 1999-2002 and investigate associations between types and amounts of beverages consumed and weight status in preschool-aged children. Dr. O'Connor TM, and the research team at Baylor College of Medicine showed that On average, preschool children drank less milk than the 2005 Dietary Guidelines for Americans recommendation of 16 oz/day. Only 8.6% drank low-fat or skim milk, as recommended for children who are older than 2 years. On average, preschool children drank < 6 oz/day 100% fruit juice. Increased beverage consumption was associated with an increase in the total energy intake of the children but not with their BMI. Prospectively studying preschool children beyond 2 to 5 years of age, through their adiposity rebound (approximately 5.5-6 years) to determine whether there is a trajectory increase in their BMI, may help to clarify the role of beverage consumption in total energy intake and weight status(1).
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(1) "Beverage intake among preschool children and its effect on weight status" by O'Connor TM, Yang SJ, Nicklas TA.

Association between 100% juice consumption and nutrient intake and weight of children aged 2 to 11 years


In the study to investigate the associations between 4 categories of daily 100% juice consumption (0 fl oz, > 0 to < or = 6 fl oz; > 6 to < 12 fl oz; and > or = 12 fl oz) and nutrient and food group intake and weight in children, Dr. Nicklas TA, and the scientists at the Baylor College of Medicine indicated that on average, children consumed less than the maximum amounts of 100% juice recommended by the American Academy of Pediatrics. One hundred percent juice consumption was associated with better nutrient intake than in the nonconsumption group and was not associated with weight status or the likelihood of being overweight in children 2 to 11 years of age(1).

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(1) "Association between 100% juice consumption and nutrient intake and weight of children aged 2 to 11 years" by Nicklas TA, O'Neil CE, Kleinman R.

Excess fruit juice consumption by preschool-aged children is associated with short stature and obesity

In the study to evaluate, in a population-based sample of healthy children, fruit juice consumption and its effects on growth parameters during early childhood, Dr. Dennison BA, and the research team at the Mary Imogene Bassett Research Institute, Cooperstown found that Consumption of > or = 12 fl oz/day of fruit juice by young children was associated with short stature and with obesity. Parents and care takers should limit young children's consumption of fruit juice to less than 12 fl oz/day(1).

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(1) "Excess fruit juice consumption by preschool-aged children is associated with short stature and obesity" by Dennison BA, Rockwell HL, Baker SL.

Thursday 26 December 2013

Fruit and vegetable intake in young children

In the observation to determine, in a sample of healthy children, the extent to which young children's diets include the recommended numbers of fruit and vegetable servings per day, Dr. Dennison BA, and members in the research team at the Mary Imogene Bassett Research Institute, found that preschool-aged children consumed, on average, about 80% of the recommended fruit servings/day, but only 25% of the recommended vegetable servings/day. Low intakes of fruits and vegetables were associated with inadequate intakes of vitamin A, vitamin C, and dietary fiber, in addition to high intakes of total fat and saturated fat(1).

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(1) "Fruit and vegetable intake in young children" by Dennison BA, Rockwell HL, Baker SL.

Dietary guidelines and the results of food consumption surveys

In the review focuses on dietary guidelines regarding fruit and vegetable consumption; sources of the antioxidant micronutrients, beta-carotene and vitamin C; and survey data on the US population's actual consumption of these foods, Dr. Block G. at the National Cancer Institute stated that the dietary Guidelines for Americans recommended consumption of five or more servings of vegetables and fruits daily, as did the 1989 Diet and Health report, which also emphasized fruits and vegetables rich in vitamin C and carotenoids. In contrast with these recommendations and strong evidence for a beneficial effect, very few individuals in the United States even approach the recommended levels of intake. In the US NHANES II data, 41% of the population had no fruit on the survey day; only one fourth had a fruit or vegetable rich in vitamin A or in vitamin C. Only 10% consumed the recommended five servings. Efforts to increase consumption of these foods are needed to improve the diet and health of the population(1).

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(1) "Dietary guidelines and the results of food consumption surveys" by Block G.

Women and Stroke

What is stroke?
Stroke is defined as condition in which the brain function is interrupted rapidly due to the loss of blood supply as a result of the blockage of blood such as thrombosis and arterial embolism, or leakage of blood causes of the death of brain cells, according to the article of Mitochondria, oxidative metabolism and cell death in stroke by Sims NR, Muyderman H (September 2009). Stroke is caused by cholesterol build up in the arteries and high blood pressure. In other words, if cholesterol building up in the arteries is blocking the circulation of blood in any part of the body causing oxygen not to be delivered to the brain, resulting in some cells in the brain to die off and are unable reproduce,
Besides cancer and heart diseases, stroke is the third leading cause of death. Approximate 1/4 of all stroke victims die as a direct result of the stroke or it's complications.

Women and stroke
According to the statistic of the Heart and Stroke Foundation, strokes kill 45% more women than men in Canada. In the study, published in the journal Neurology, researchers from the University of California at Los Angeles monitored 17,000 people over a period of six years. They found the incidence of stroke rising faster among women than men.When women reach the age of 45, the risk of stroke begins to rise rapidly, it may be due to levels of estrogen has dropped significantly at age 45 and onward.

Types of stroke
1. Ischemic stroke
This is the most common type of stroke accounting for almost 80% of all strokes. The brain depends on its arteries to bring fresh blood from the heart and lungs. The blood carries oxygen and nutrients to the brain, and takes away carbon dioxide and cellular waste. If an artery is blocked then the brain cells may not receive enough oxygen. They then cannot make enough energy and will eventually stop working.

a) If blood clots from the inside of the arteries of the brain, we have thrombotic stroke.
Study shows that this type of stroke is responsible for almost 50% of all strokes. The most common problem is narrowing off the arteries in the neck or head.

b) If blood clotted in other parts of the body's arteries subsequently entering the brain, we have embolic stroke. In this case the clot was formed somewhere other than in the brain itself.
The clot then travels the bloodstream until they become lodged and can not travel any further. This naturally restricts the flow of blood to the brain and results in embolic stoke.

2. Hemorrhagic strokeHemorrhagic stroke occurs when a blood vessel bursts inside the brain, causing an increase of the fluid pressure on the brain and harms the brain by pressing it against the skull. Hemorrhagic stroke is associated with high blood pressure, which stresses the arterial walls until they break.

Symptoms
1. Sudden trouble in standing
Sudden trouble in standing is an early symptom of stroke as a result of circulation of blood that carries oxygen to suddenly deplete caused by narrowing of arteries and high blood pressure.

2. Dizziness and loss of balance
The brain coordinates information from the eyes, the inner ear, and the body's sense to maintain balance. If the cells of that part of the brain get damaged in result of depleted oxygen will cause dizziness and loss of balance.

3. Sudden confusion
A sudden onset of confusion means that something is potentially going wrong with the brain. Almost all conditions that affect the brain are life-threatening. It might be caused by a tumor or low levels of oxygen in the cells of the cerebral cortex in your brain that affect your ability to think with your usual speed or clarity. It might also be caused by lowered blood sugar, as is the case of diabetes.


4. Having trouble speaking and understanding
Having trouble speaking and understanding occurs when the brain cells in the area of the broca, wernicke and angular ayrus in the left hemisphere area begin to die because they stop getting the oxygen and nutrients they need to function.

6. Sudden severe headaches
Headache is a condition of pain in the head, sometimes neck or upper back pain may also be interpreted as a headache. It ranks amongst the most common local pain complaints and may be frequent for many people but sudden severe headaches may be caused by an early symptom of heart disease as we mentioned in previous articles, by rupturing a brain vessel or depletion of oxygen in some parts of the brain.

7. Sudden trouble seeing
This may be an early indication of stroke when the oxygen in the blood supply to the part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into cells that control the vision area of the cerebral cortex in the brain.

8. Etc.

Risk Factors
1. Age
Human aging is the biological process that is unavoidable but controllable. Starting at age 40, the cells in our body begin this process causing the deterioration of some functions of our body. Most people of this age group already have some form of cholesterol building up in their arteries and high blood pressure resulting in an increased risk of stroke.

2. Heredity
People with a family history of stroke have a greater chance of stroke than those do not have such a family history.

3. Race
Because of frequent high blood pressure in African Americans, they have a significantly higher risk of stroke than their Caucasian counterparts.

4. High blood pressure
High blood pressure causes hardening and thinning of arterial walls and makes our heart work harder to pump blood throughout our body resulting in heart diseases as well as increasing the risk of stroke.

5. Smoking
Smokers may be exposed to toxic cadmium, causing high blood pressure and heart diseases as well as contributing to a higher risk of stroke.

6. Excessive alcohol consumption
Drinking one cup of wine for women and 2 cups of wine for men might help to increase the circulation of blood as well as providing more oxygen for cells. However, excessive drinking not only damages the normal function of liver but also raises high blood pressure, increasing the risk of stroke.

7. Diabetes
Diabetes with unhealthy diet causes high levels of glucose in the bloodstream. Diabetics have a greater risk of stroke, because high levels of glucose damage the arterial wall as well as clotting the arteries and blood vessels.

8. Gender
Males have a 20% greater risk of stroke than females, but when women reach the age of 45, the risk of stroke begins to rise rapidly, it may be due to levels of estrogen has dropped significantly at age 45 and onward.

9. Atrial fibrillation
Risk of stroke increases by 5% for people with atrial fibrillation (poor blood flow)


Cause of stroke in women
There are similar causes of stroke and heart diseases, but in stroke the result is more severe. Any delay of rescuing will result in death of the victim. Here are some causes of stroke:
1. Unhealthy diet
A diet high in saturated and trans fats causes bad cholesterol to build up in your blood vessels in the brain, blocking oxygen needed for the cells thus increasing the risk of stroke. Also unhealthy diet causes high blood pressure making your heart work harder to pump blood to your body in result of heart diseases. High blood pressure also causes the blood vessels in your brain to harden and thin, increasing the risk of stroke.

2. Smoking
Smoking not only has a devastating effect on the health of the smoker but also to anyone that inhales its toxic fumes. Cigarettes contain high levels of cadmium that causes the blood to clot activity of cells in result of blocking blood flow and damaging the blood vessels in the brain.

3. Excessive drinking
Moderate drinking is good for your heart, but excessive drinking can raise levels of some fats in your blood causing cholesterol to build up in the arteries and blood vessels in the brain resulting in increase of the risk of stroke.

4. Diabetes
People with diabetes tend to develop heart disease or have strokes at an earlier age than other people. Diabetes with unhealthy diet causes high blood glucose levels that damage nerves and blood vessels, leading to complications such as heart disease and stroke, the leading causes of death among people with diabetes.

5. Obesity — a body mass index of 30 or higher
Study shows that even after adjusting for other stroke risk factors such as high blood pressure, diabetes, high cholesterol, smoking, cardiac diseases, moderate alcohol consumption, and physical activity; obesity is still associated with a greatest risk of stroke in men and women.
.
6. Use of birth control pills
Birth control pills contain estrogen and one of two other hormones, lynestrenol or norethisterone that increase the risk of blood clotting, which can lead to ischemic stroke especially in woman who smoke and who are older than 35.

7. Migraines
According to the article published in the journal Neurology, Dr. Kurth and his colleagues looked at 27,798 female health professionals ages 45 and older, including 3,568 who had migraines, from the Women's Health Study, researchers found that women with once-a-week-migraines with auras -- who made up 5 percent of the women with migraines -- were four times as likely to have had a stroke during the 12-year study as women without migraines, And women who had migraines with auras less than once a month (75 percent of the group) were more than twice as likely as migraine-free women to have a heart attack, and almost twice as likely to have had a heart procedure, such as bypass surgery. Overall, only 2.5 percent of women in the study had experienced a stroke, heart attack, or related problem.

8. Pre-eclampsia
In the article of Preeclampsia and Stroke: Risks during and after Pregnancy by Cheryl Bushnell and Monique Chireau, researchers indicated that although women with cerebrovascular manifestations of preeclampsia are thought to be out of danger when the baby is delivered, accumulated data show that women with preeclampsia are at risk for stroke and cardiovascular disease well after the postpartum period and child bearing years....... From a clinical perspective, preeclampsia should be regarded as a risk factor for stroke in pregnancy as well as a harbinger of future cerebrovascular disease, although there are many gaps in our knowledge about who is at risk and when, as well as how to best prevent preeclampsia and stroke in women.

9. Estrogen and progestin HRT
In a sudy of Hormone replacement therapy and stroke, by Billeci AM, Paciaroni M, Caso V, Agnelli G., researchers concluded that there seems to be no indication for hormone replacement therapy in the prevention of stroke in women. Further studies are needed to discover why estrogen have different effects on the heart and brain. Conventional risk-factors which could increase the risk of estrogen therapy need to be identified and as well as more restrictive inclusion and exclusion criteria such as coagulation parameters and intimal thickness should be adopted before new randomized trials are started.

10. Etc.

Diagnosis and tests
After recording you family history and a complete physic exams, including the neurological examination and blood pressure reading. The neurological examination is done in your doctor office to check for any sign of stroke including, awareness, speech, language, and memory function, eye movements, movement in the face arms and legs, reflexivity, walking and balancing, etc.
1. Blood test
Blood test is usually the first test that your doctor orders to check for levels of cholesterol, blood coagulation disorder and levels of glucose.

2. X-ray computed tomography scan
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details.The pictures are viewed by your doctor to see the extent of the bleeding inside the brain.

3. Magnetic Resonance Imaging (MRI)
MRI (magnetic resonance imaging is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of narrowing or blockage of blood vessels in the brain and surrounding areas.

4. Transcranial Doppler (TCD)
It is a test that measures the velocity of blood flow through the brain's blood vessels by using the ultrasound probe to emit a high-pitched sound wave in to the testing areas, then measure the bounces off wave by the same probe. The blood flow velocity frequency is recorded and analysis. The change of freduency of the blood flow can provide a clear evidence of emboli, stenosis, vasospasm from a subarachnoid hemorrhage.

5. Etc.

Preventions
A. How to avoid
1. A healthy Diet
Uncontrolled diet that is high in saturated fat and trans fat results in cholesterol building up in the arteries and blood vessels obstructing the flow of blood and damaging brain cells because of lack of oxygen causing stroke. If we can consume less of processed foods, fatty animal meats and avoid artificial chemicals and consume more healthy vegetables and fruits, we can reduce the risk of stroke.

2. Put on a happy face
Study shows that people with depression have an increased risk of stroke. Experts also found that people with elevated levels of depression will increase the risk of stroke by 73%.

3. Exercise
Regular moderate exercise will help to improve circulation of blood flow and lessen the risk of stroke that is caused by clogged blood vessels by 30% because regular walking helps to lower high blood pressure and increase levels of HDL.

4. Quit Smoking
Cigarettes contain toxic chemicals cadmium together with heavy metals that cause blood clotting in the arteries resulting in increased high blood pressure and risk of heart diseases as well as stroke.

5. Reduce intake of alcohol
Excessive drinking increases high blood pressure, thus increasing the likelihood of stroke.

6. Etc.

B. Nutritional Supplements
1. B-complex
Three B-vitamins: folate, B-6, and B-12 can lower homocysteine, an amino acid that is found naturally in the body and study shows that the higher the level of homocysteine in the blood, the higher the risk of stroke.

2. Beta-carotene
Beta-carotene is an antioxidant that may reduce oxidative stress to brain cells. Such stress occurs when highly volatile forms of oxygen damage cell structure. Study shows that beta- carotene helps to reduce the risk against cerebral infraction and stroke.

3. Vitamin E
Vitamin E is an antioxidant that helps to reduce arterial clotting.

4. Selenium
Selenium is a powerful agent that helps to keep tissues and arteries elastic. It also helps to reduce the stickiness of the blood and decreases the risk of clotting, in turn lowering the risk of heart attack and stroke. Selenium increases the ratio of HDL (good) cholesterol to LDL (bad) cholesterol.

5. Pycnogenol
Pycnogenol helps to keep collagen elastic and soften the blood platelets, making blood flow more efficiently.

6. Co enzyme Q-10
Co enzyme is a strong antioxidant that not only protects low density lipoprotein LDL against oxidants, but also helps for getting oxygen to the cells.

7. Lecithin
Lecithin is a fat-like substance called a phospholipid that helps to remove bad cholesterol and other lipids from the body. It also protects the arteries and organs from the build up of fatty tissue that can lead to stroke or heart attack.

8. Melatonin
Melatonin is a neurohormone produced in our body by the pineal gland. It is a powerful antioxidant that easily penetrates the blood-brain barrier and is used to treat thrombotic stroke.

9. Vitamin C
Vitamin C helps to strengthen the arterial wall, lowering the risk of heart diseases and stroke.

10. Etc.

C. Herbs
1.Ginkgo biloba
The herb is extracted from the leaves of the ginkgo biloba tree and was first used medicinally in China more than 4,000 years ago. Ginkgo biloba has the ability to increase the oxygen content to the brain and other bodily tissues, improving circulation of blood and improving cerebral tolerance to hypoxia. Study shows that taking Ginkgo and other blood thinner medications together may increase the risk of heart diseases and stroke. Be sure to consult with your doctor before taking ginkgo biloba.

2. Hawthorn
Hawthorn contains cardiotonic amines, polyphenols, and is a source of Vitamins C, B, and many other nutrients that help in relaxing and dilating arteries, increasing the flow of blood and oxygen to and from the heart and maintaining healthy blood pressure resulting in lowered risk of stroke.

3. Garlic
Garlic contains high amounts of antioxidants and elements that help to improve blood circulation. It is dangerous to take garlic extract together with blood thinner medications as we mentioned in a previous article.

4. Cayenne
Cayenne contains an active ingredient called capsaicin that has the abilities to lower blood pressure and cholesterol levels as well as preventing heart diseases and stroke.

5. Blueberries
Blueberries are one of the richest food sources of natural antioxidants readily available, having more than twice the levels of other berries that helps to prevent heart disease, stroke and internal bleeding.

6. Pigweed
Pigweed is an excellent plant-source of calcium. It helps lower one-third of the risk of succumbing to heart attack. Personally, I believe these results also apply to ischemic strokes, because they are biologically so similar to heart attack.

7. Willow bark
Willow bark has been shown in several studies to reduce the risk of ischemic stroke by about 18 percent. Study shows that willow bark has the aspirin's ability to prevent heart attacks, and also shows a slight increase in risk of hemorrhagic stroke from taking willow bark daily but the increase was small and not statistically significant.

8. Ginger
This is another herb proven to have anti-clotting abilities and has the same function as garlic.

9. Etc.

D. Chinese acupuncture and herbs
1. Acupuncture
Acupuncture is the most popular treatment modality for stroke patients in China, used effectively on 85% of the stroke patients there. The recently acceptance of acupuncture by western medical practitioners allows one more effective method in curing diseases especially stroke. Study shows that acupuncture helps to facilitate nerve regeneration, decrease blood viscosity, as well as helping surviving nerve cells find new pathways, effectively bypassing damaged parts of the brain resulting in decreased risk of stroke.

2. Ginkgo biloba (bai guo ye).
Ginkgo biloba improves mental functioning as well as preventing blood cells from forming blood clots in the brain. Study shows that ginkgo improves blood circulation and lowers plasma cholesterol concentrations that help to lower the risk of stroke.

3. GastrodiaGastrodia was listed in the ancient Shennong Bencao Jing (ca. 100 A.D.) and was later classified by Tao Hong as a superior herb, meaning that it could be taken for a long time to protect health and prolong life, as well as for treating illnesses. Gastrodia is used by Chinese herbalist in treating stroke and chronic weaknesses of Qi that eventually blocks the flow of blood to the brain.

4. Cinnamon bark
True Cinnamon is one form of the common spice. As we discussed before, cinnamon helps to lower blood sugar by mimicking insulin, activating insulin receptors and working with insulin in the cells to reduce blood sugar by up to 20%. Also cinnamon has some antioxidant benefits that helps to find new pathways for surviving nerve cells after stroke.

5. Angelica
Angelica can help to warm up the chest-yang to remove obstruction of blood flow in the heart vessels as well as brain vessels.

6. Dragon's Blood
Dragon's Blood is used for increased power, purification, protection, consecration, and the development of strong ritual energy. It also helps to relieve pain in the heart due to blood stagnation and stimulate blood circulation to the brain resulting in decreased risk of stroke.

7. Etc.

Treatments
Depending to the location of the occurrence
A. Ischemic stroke
1. Thrombolysis
The aims of thrombolysis is to resolve the blood clot to improve the blood flow to prevent further damage to tissue and organs in the body as the medicine break down the blood clot by stimulating fibrinolysis through infusion of a protein involved in the breakdown of blood clots called tissue plasminogen activator.

2. Mechanical thrombectomy
As it name, it is the mechanical to remove the blood clot directly by inserting a catheter, a long, into the large arteries in the thigh, then directing it into the blood vessels supplying blood the brain to dissolve the blood clot thus effectively restoring blood flow., by applying a with a corkscrew-like clot-removing device. The mechanical thrombectomy is used when the patient for what ever reason can not tolerate the thrombolysis.

3. Anticoagulation
According to the study of Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation by Hart RG, Pearce LA, Aguilar MI, researchers found that Adjusted-dose warfarin and antiplatelet agents reduce stroke by approximately 60% and by approximately 20%, respectively, in patients who have atrial fibrillation. Warfarin is substantially more efficacious (by approximately 40%) than antiplatelet therapy.

4. Etc.

B. Hemorrhagic stroke
Since Hemorrhagic stroke involves bleeding within the brain, which damages nearby brain tissue, therefore the use of anticoagulant can make the matter worse. In most cases, it requires neurosurgical evaluation to locate before the cause before it can be treated effectively such as occupational therapy, physical therapy, speech therapy, etc.

Care and rehabilitation
A. The impotant of care and rehabilitation of stroke patient
1. In a study of The Care and Rehabilitation of Stroke Patients One Year Following the Event N. Bentur, M. Davis, J. Brodsky, J. Gindin, B. Habot, Z. Haklai, A. Shemesh, researchers found that
significant differences among wards and hospitals, and highlight the need to develop criteria, standards, and clinical guidelines for the diagnosis and treatment of stroke patients. The brevity of the hospital stay and the small quantity of community rehabilitation services, along with the complexity of stroke, emphasize the need to determine the best discharge destination. The findings of this study were discussed by the National Geriatric Council and served as a basis for discussions in the Ministry of Health. The Ministry has instructed the health plans and hospital directors not to send individuals who need rehabilitation to long-term care institutions, so that patients can maximize their functional potential after stroke. The finding that rehabilitation services in the community are limited, emphasizes a need to examine the reasons for barriers to these services, as well as how to expand them and develop alternative patterns of rehabilitation in the community. The study also identified a need to examine National Health Insurance Law regulations on the rehabilitative services that the health plans are obligated to provide. Thought should be given to the health plans’ activity in this area, so as to ensure that services are appropriate.

2. In a study of The efficacy of self-care education on rehabilitation of stroke patients. Sahebalzamani M, Aliloo L, Shakibi A, researchers found that Self-care education of stroke survivors can improve patient's performance, and change them from a dependent to an independent person.

3. Etc.

B. Post-Stroke Rehabilitation. Clinical Practice Guideline
I will leave this article, for a link where you can find the charter 16 - Post-Stroke Rehabilitation by The Agency for Health Care Policy and Research (AHCPR) was established in December 1989 under Public Law 101-239 (Omnibus Budget Reconciliation Act of 1989) to enhance the quality, appropriateness, and effectiveness of health care services and access to these services.
Since this publication is dated in may -1995, and is provided for historical reference only and the information may be out of date or incorrect.


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Children's growth parameters vary by type of fruit juice consumed

In the study to evaluate, in a sample of healthy young children, whether the associations between fruit juice intakes and growth parameters differ by the type of fruit juice consumed, Dr. Dennison BA, and the research team at Columbia University College of Physicians and Surgeons indicated that the associations between high fruit juice intakes and obesity were observed with apple juice intakes only. Because most of the fruit juice mixtures were classified as single fruit juices, the findings, especially those with grape juice, need to be cautiously interpreted. High intakes of fruit juice, however, appear to be associated with growth extremes in young children. Thus, it would seem prudent for parents and caretakers to moderate the fruit juice intakes of their young children(1).


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(1) "Children's growth parameters vary by type of fruit juice consumed" by Dennison BA, Rockwell HL, Nichols MJ, Jenkins P.

Simple obesity in children. A study on the role of nutritional factors

In the study to examine the effectiveness of dietary treatment in children with simple obesity on the basis of thorough analysis of their state of nutrition, method of nutrition and eating habits and the impact of other environmental factors, Dr. Weker H. at Instytut Matki i Dziecka, ul. Kasprzaka indicated that 1. Simple obesity in children aged 3-15 yrs is connected with familial and environmental factors, including incorrect eating habits. 2. Dietary treatment consisting in the lowering of energetic value of the diet through the reduction of fat consumption and quantity and quality changes with respect to carbohydrates consumption decreased the children's obesity, and was more effective in the older age group (7-15 yrs). Dietary treatment normalizes the lipid profile in children. 3. Significant body mass loss has been observed in children in whose diet the amount of proteins and their share in the total energy value only slightly differs from the level before the dietary treatment. The amount of proteins in the children's diet was within the range of physiological recommendations(1).

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(1) "[Simple obesity in children. A study on the role of nutritional factors]" by Weker H.

Greater weight loss and hormonal changes after 6 months diet with carbohydrates eaten mostly at dinner


In the study to investigate the effect of a low-calorie diet with carbohydrates eaten mostly at dinner on anthropometric, hunger/satiety, biochemical, and inflammatory parameters. Hormonal secretions were also evaluated. Seventy-eight police officers (BMI >30) were randomly assigned to experimental (carbohydrates eaten mostly at dinner) or control weight loss diets for 6 months, found that a simple dietary manipulation of carbohydrate distribution appears to have additional benefits when compared to a conventional weight loss diet in individuals suffering from obesity. It might also be beneficial for individuals suffering from insulin resistance and the metabolic syndrome(1).


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(1) "Greater weight loss and hormonal changes after 6 months diet with carbohydrates eaten mostly at dinner" by Sofer S, Eliraz A, Kaplan S, Voet H, Fink G, Kima T, Madar Z.

Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers


In the study to compare the DASH diet alone or combined with a weight management program with usual diet controls among participants with prehypertension or stage 1 hypertension (systolic BP, 130-159 mm Hg; or diastolic BP, 85-99 mm Hg), showed that For overweight or obese persons with above-normal BP, the addition of exercise and weight loss to the DASH diet resulted in even larger BP reductions, greater improvements in vascular and autonomic function, and reduced left ventricular mass(1).



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(1) "Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study" by

Weight lifting for women at risk for breast cancer-related lymphedema


In the study of Clinical guidelines for breast cancer survivors without lymphedema advise against upper body exercise, preventing them from obtaining established health benefits of weight liftingof a total of 134 participants completed follow-up measures at 1 year. The proportion of women who experienced incident BCRL onset was 11% (8 of 72) in the weight lifting intervention group and 17% (13 of 75) in the control group (cumulative incidence difference [CID], -6.0%; 95% confidence interval [CI], -17.2% to 5.2%; P for equivalence = .04). Among women with 5 or more lymph nodes removed, the proportion who experienced incident BCRL onset was 7% (3 of 45) in the weight lifting intervention group and 22% (11 of 49) in the control group (CID, -15.0%; 95% CI, -18.6% to -11.4%; P for equivalence = .003). Clinician-defined BCRL onset occurred in 1 woman in the weight lifting intervention group and 3 women in the control group (1.5% vs 4.4%, P for equivalence = .12), indicated that In breast cancer survivors at risk for lymphedema, a program of slowly progressive weight lifting compared with no exercise did not result in increased incidence of lymphedema(1).


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(1) "Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial" by
Schmitz KH, Ahmed RL, Troxel AB, Cheville A, Lewis-Grant L, Smith R, Bryan CJ, Williams-Smith CT, Chittams J.