Based on the very good medical book of Simon C., et al, Oxford Handbook of General Practice, Oxford Medical Publications, 2nd edition, 2005. www.oup.com

• Calcium supplements and Vitamin D decrease the incidence of osteoporosis and fractures due to osteoporosis. Calcium may decrease blood pressure and prevent colon cancer. There isn’t sufficient evidence that excessive calcium with milk can cause nephrolithiasis.

• Zinc, Vitamin C, propolis (a substance of bees) and Echinacea (a herb) shorten duration of common cold. Propolis, lemon and honey are said to help sore throat. Vitamin C may decrease Blood Pressure. For nasal congestion you can find eucalyptus or Echinacea nasal spray. For improving nasal breathing you can buy special nasal strips (such as Breath RightR) that flatten nasal nostrils making breathing easier.

• Follate supplements prevent embryonic neural tube defects if taken by pregnant and also prevent coronary heart disease. Vitamins B12 and B6 also prevent coronary heart disease such as fish oil, regular exercise, controlling diabetes and hypertension, smoking cessation, decreasing weight if overweight or obese, decreasing alcohol, saturated fats (especially trans) and salt intake and increasing vitamin E (e.g. olive oil) fruit and vegetable intake (5 portions per day). Increased fiber intake also prevents cancer such a colon cancer. Rich in fibers are fruits with skin, beans, greens and generally fruits, vegetables, pulses and whole bran cereals. Avoid hidden sugar e.g. in alcohol and prepared foods.

• About obesity, BMI is [weight in Kg / (height in m)2 ]. 18.5 – 24.9 is normal. 25 – 29.9 are overweight. 30 – 39.9 are obese. More than 40 is morbid obese. Less than 18.5 have a risk for malnutrition. Obese have a low life expectance. Obesity increases the risk of many diseases such as cardiovascular disease, cancer, osteoarthritis, hypertension, diabetes, stroke, sleep apnea, gallbladder stones, stress incontinence, problems in pregnancy, menstrual irregularities etc. BMI more than 30 triples the risk of mortality.

• Regular exercise prevents cardiovascular disease. Regular exercise is 30 min (or more), 5 (or more) days per week. Examples: swimming, cycling, walking/ jogging, rowing etc.

• Excessive alcohol can induce hypertension; however in regular amounts (less than 21 units for male and less than 14 units for males) it decreases the risk of coronary heart disease. 1 unit is equal with 8 gr of alcohol or ? pint of beer or small glass of wine/sherry. 1 measure of spirits (in Scotland) is 1.2 units. 1 bottle of wine is 9 units. 1 – 3 units of alcohol per day decrease the risk of stroke and cardiovascular disease. Red wine has also antioxidatives. However excessive alcohol induces numerous of diseases such as coronary heart disease (it increases cholesterol), hypertension, stroke, neuropathy, myopathy, sexual dysfunction, cardiomyopathy, gastritis, pancreatitis, obesity, diabetes, fetal damage, interactions with drugs, cancer of mouth/ larynx/ breast and esophagus, nutritional deficiency (thiamine, B12 etc), family conflicts (and pathologic jealousy), accidents, fights, liver insufficiency and liver cancer, fatal esophageal varices hemorrhage, cirrhosis and hepatic encephalopathy, fatty liver, hepatitis, hemopoietic dyscrasias etc.

• Management of hypertension (i.e. BP equal or more than 140/ 90) is essential for preventing cardiovascular disease. Aim to decrease blood pressure (BP) less than 140/85 (for patients with diabetes target BP is less than 130/80).

• High homocysteine and lipoprotein are risk factors for coronary heart disease. Homocysteine is decreased with follate and B12 supplements.

• Diabetes mellitus is a major risk factor for atherosclerosis and cardio/ cerebrovascular disease, blindness, foot gangrene and renal failure.

• Vitamin E has cardioprotective role (prevents coronary heart disease) and may also prevent dementia.

• Fish oils (ω3, EPA, DHA) decrease triglycerides and also decrease pain and symptoms of rheumatoid arthritis.

• Garlic decreases cholesterol and has antithrombotic and antihypertensive effects and may prevent cancer.

• Statins are anti – hyperlipidaemic drugs that prevent coronary heart disease even in absence of hypercholesterolemia. Side effects are myopathy and increased liver function tests. Niacin (a vitamin) and fibric acid decrease triglycerides. They also have side effects.

• Also plant stanols and sterol esters may decrease cholesterol and are added in many deserts such as yogurt and milk or butter (e.g. Becel).

• Aspirin prevents coronary heart disease, stroke (e.g. on AF) and dementia. Use 75 mg enteric coated preparation once daily, with food for prevention of coronary vascular disease. Aware of contraindications and side effects. Alternative: clopidogrel.

• Glucosamine decreases pain and symptoms of osteoarthritis.

• Vitamin A prevents cancer. It is contraindicated on pregnant who should avoid eating for example liver.

• Vitamin B6 may help premenstrual syndrome and perhaps autism. However avoid excessive amounts (more than 2000 mg/dl) that can cause peripheral neuropathy (a condition that happens also in B12 and B6 deficiency).

• Probiotics are useful microbial cell preparations or components that help the good function of intestines and may help in infective diarrheas, inflammatory bowel disease, irritable bowel syndrome, atopy etc. Acidophilus is also used for good intestinal function. Source of these good bacteria for the intestine is yogurt (better eat original yogurt that has skin on its surface) but prefer low fat skimmed yogurt. Many companies have yogurt desserts with probiotics e.g. Actimel.

• Ginger may decrease nausea.

• Honey in wounds improves wound healing. It’s also useful in sore throat.

• Soya decreases menopausal symptoms. Soya protein also decreases cholesterol, LDL and triglycerides.

• Walnuts and olive oil (Vitamin E) decrease cholesterol too, but avoid eating too much because they have excessive calories. Eat max 3 soup spoons.

• Vegetarians and especially vegans have the risk of iron and B12 deficiency that cause anemia. Vitamin B12 deficiency causes also and polyneuropathy and psychiatric problems.

• Black chocolate has many antioxidants. However the antioxidant epicatechin is annulled if drinking milk at the same time.

• Cranberry juice may help in urinary tract infections, however the data is insufficient.

• Gingko Biloba may prevent dementia and may help intermittent claudication and perhaps tinnitus (ear buzzing).

• Xylitol may decrease bacterial infections. It is currently used in chewing gums for prevention of caries.

• Avoid fatty meat products (such as sausages, salaam, beef and lamp), butter, cream milk, fat cheese, spreads, crisps, cakes, biscuits, cookies, butter, salted peanuts, canned or pre – prepared food with high salt or sugar. The above increase the risk of coronary heart disease, diabetes, stroke and cancer (e.g. of colon). Prefer steaming instead of other cooking methods. It keeps most of vitamins. Eat plenty of fiber such as all bran cereals, oat porridge, pulses, beans, whole meal bread, rice etc. Also eat oil fish rich in ? 3 fatty acids (mackerel, herring, pilchards, salmon) at least 1 – 2 times per week. Eat more than 5 pieces of fruits or/and portions of vegetables per day. Prefer low fat skimmed milk, yogurt and cottage cheese (no hard yellow cheese). Avoid sugar and salt (they are also hidden in many pre – prepared products). Drink daily 2 – 3 lt of fluids (preferably water rather than alcohol and tea or coffee). Use starchy foods (such as whole meal bread, rice, potatoes) for main energy source, however restrict main intake to 1 meal per day because of the risk of decreasing calcium intake and iron absorption. Increase fluid intake with a diet high in non starch polysaccharides (e.g. 8 cups daily) that are the main form of what we call fibers. About meet, avoid red meat, remove visible fat and prefer poultry without skin. Avoid eating fried foods. Avoid eating many eggs and prefer them boiled. Prefer steamed food. Buy a steam cooker. Avoid snacks, cookies and sweets. Prefer vegetable protein such as pulses and soya, instead of meat.

• Relaxation and stress management may have a role in preventing numerous of diseases such as coronary heart disease, stroke and cancer.

• A multivitamin with minerals is useful. Take one daily with food. Avoid vitamins with more than 100% of the substance. Many vitamins are dangerous if taken in excessive amounts. Vitamin D excess causes liver problems and increase calcium causing many problems. Spirulina is a seaweed product rich in aminoacids useful for athletes.

• Valerian is a famous herb that helps decreasing symptoms of stress, insomnia and irritable bowel syndrome. Many companies combine it with passion flower, hops and B1, 2, 3 vitamins.

• An ionizer is useful for clearing the room’s atmosphere. Also a water filter with active carbon cleans the water and devices that have also IR beams, sterilize the water.

There are many antioxidant foods that neutralize free radicals that cause aging, cancer, and many other diseases. Such nutritional substances are: garlic, green tea (helps also in obesity), melted tomato (e.g. juice), beetroot, cauliflower, Brussels cabbage, the herb crategus, the herb Ginkgo Biloba, red wine, black chocolate etc.
Fish oil from fatty fish lower triglycerides. Also soya protein and walnuts decrease cholesterol, as well as plantar sterols and stanol (the last 2 are added from some companies to yogurt, milk and bread). Folic acid also protects our heart.
About the proper combination of foods, to put it in a nutshell, the main rule is that all food combination is improper, except adding vegetables. So, milk & biscuits, pasta & meat, meat & potatoes, fish and potatoes, rice & meat/fish and hamburgers are all wrong. Prefer to eat a single food e.g. chicken (skinned) instead of a variety of foods (potatoes, dressings, etc). Add only vegetables. Also fruits, fruit juices and sweets are better to be eaten alone from the main meals. However avoid drinking acid fruit juices (e.g. orange) with empty stomach. By the way, grape fruit interacts with many medications, so avoid it if taking drugs (ask your pharmacist).

NOTE

Further information about healthy diet you can find on my text ‘REVIEW: CORONARY HEART DISEASE (CHD) AND CEREBROVASCULAR ACCIDENT (CVA) PREVENTION’, on the chapter ‘HEALTHY DIET’ on www.aboutmedicine.tk

NOTE

There are several antioxidants that may help in preventing cancer, aging and many diseases. Very good antioxidants are the substances resveratrol (a kind of plant hormone), flavonoids, polyphenols and procyanidins. A great proportion of these antioxidants are contained in red wine (however be careful not to drink too much wine, because it is harmful, the max daily dose is 3 small ‘wine’ glasses – I recommend 1 small glass). The above antioxidants are contained also in green coffee, black chocolate, green tea, coffee, olive oil (has also vitamin E), honey, grains, blackberries, blueberries, cranberries (these also help patients with urinary tract infections), cherries, palms, cabbage, broccoli, etc. Also many antioxidants are found in beetroots, garlic, cauliflower, melted tomato, and onion. Excellent antioxidants are grapes and pomegranate (the last is said to help people with hematological problems).

The consumption of all the above nutrition is strongly recommended, however a healthy diet should be followed by a daily exercise (such as jogging, cycling or quick walking), weight loss (diet & exercise +_ drugs +_ surgery if morbid obesity), smoking cessation (nicotine or drugs such as buproprion), BP & high cholesterol control (diet and exercise help, avoid salt, sweets, fried foods and fats), and glucose control if diabetic (diabetes mellitus is a great factor for obstructing the vessels, leading to heart attack stroke, renal failure, blindness and gangrene).

REFERENCE

1) Oxford Handbook of Clinical Medicine, 6th edition, M. Longmore, I.B. Wilkinson, S. Rajagopalan, oxford university press, 2004.
2) Oxford Handbook of General Practice, C. Simon, H. Everitt, T. Kendrick, 2nd edition, Oxford University Press, 2005.