Herbal Health

A high carbohydrate diet is a must for optimum sports performance because it produces the biggest stores of muscle glycogen. As we have previously described, the carbohydrate we eat is stored in the body in the form of glycogen in the muscles and liver. A small amount of carbohydrate (about 1 teaspoon) circulates as glucose in the blood. When you are exercising at a high intensity, your muscles rely on glycogen and glucose for fuel. Although the body can use fat when exercising at lower intensities, fat cannot provide the fuel fast enough when you are working very hard. The bigger your stores of glycogen and glucose, the longer you can go before fatigue sets in.

Unlike the fat stores in the body which can release almost unlimited amounts of fatty acids, the carbohydrate stores are small. They are fully depleted after two or three hours of strenuous exercise. This drying up of carbohydrate stores is often called ‘hitting the wall’. The blood glucose concentration begins to decline at this point. If exercise continues at the same rate, blood glucose may drop to levels which interfere with brain function and cause disorientation and unconsciousness. Some athletes refer to this as a ‘hypo’ and in cycling it is known as ‘bonking’.

All else being equal, the eventual winner is the person with the largest stores of muscle glycogen. Any good book on nutrition for sport will tell you how to maximise your muscle glycogen stores by ingesting a high carbohydrate training diet and by ‘carbohydrate loading’ in the days prior to the competition. In this chapter we provide instructions for increasing muscle glycogen as well as using the G.I. to your advantage in sport.

It was not until a highly respected British endocrinologist, professor David Jenkins, published the first list of G.I. Values that people began to listen. Now working in Canada, he and his colleagues showed that many foods containing starch gave blood sugar responses almost as high as an equivalent load of glucose. Further research showed that many sugary foods had lower blood sugar rises than starchy foods. In other words, scientists and medical practitioners all over the world had it the wrong way round. Unfortunately, many still do.

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1. There is a need to take a wider view of the causes of overfatness and obesity than simple fat and/or energy imbalances.

2. Examine the influences in both the macro and micro environment that limit an individual’s ability to successfully reduce body fat; list these and attempt to plan counter approaches to them.

3. If possible, get spouses and partners involved in the modification of the micro environment for reducing body fat levels.

4. Keep fatty foods either out of the household environment, or not easily accessible.

5. Encourage the use of ‘person power’ through physical activity and ‘incidental activity’, rather than using machinery.

6. Modify the food supply at the micro-environmental level if this can’t be changed at the macro level, e.g. through reading food labels, learning appropriate shopping techniques, etc.

7. Increase awareness of, and access to, facilities for increasing levels of physical activity such as recreation centres, parks, playgrounds, walkways, cycle tracks and stairways in buildings.

8. Encourage walking rather than the use of vehicles where possible (i.e. park away from the destination, walk up the stairs instead of using escalators).

9. Get group support to facilitate physical activity (e.g. walking with a friend or group).

10. Encourage an attitude which regards movement as an ‘opportunity’, rather than an ‘inconvenience’.

11. Discourage the use of labour saving electronic equipment in the home such as remote controls for the TV, automatic garage doors, electronic can openers, toothbrushes etc.

12. Don’t commence a fat loss program at times when social support is likely to be least, i.e. at the end of the week or end of the year in particular.

13. Recognise the potential for environmental change and support individual and public health programs.

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Energy can take a number of forms: nuclear, light, chemical, electrical, mechanical, thermal, magnetic and potential.

According to the laws of thermodynamics, all forms of energy are interchangeable and energy is neither gained nor lost, it merely changes form. With respect to humans this means that the body cannot create or destroy energy, but it can convert one form of energy to another. Humans use chemical energy from food for synthesis and other metabolic processes. The chemical energy from food is converted to various forms such as mechanical energy which results in movement, chemical energy to make hormones, or electrical energy to conduct nerve impulses. Unless energy is stored in the body, it is eventually lost, mainly as heat (thermo-genesis). Since living organisms are governed by the laws of thermodynamics, an energy balance equation has been used to forecast changes in body mass when changes in energy intake or expenditure occur, although this is not as clear cut as was once thought.

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Jaundice means the skin and the whites of the eyes turn yellow. All degrees may exist, and often it is so light as to be barely detectable. It invariably indicates liver disease. Generally speaking, liver disease (as occurring in adults) is quite rare in infants and children. The free use of alcohol is one of the major reasons why so many adults are prone to disorders of this vital organ; fortunately, infants have not yet learnt of this beverage. Some unwise mothers who imbibe freely during pregnancy give birth to severely damaged children (mentally and physically) who suffer from the so-called foetal alcohol syndrome—often the babies perish soon after birth.

Infectious hepatitis is a virus infection of the liver which can produce serious illness, but it is usually mild and recovery is common.

Jaundice of the newborn

Jaundice of the newborn, also called physiological jaundice, occurs commonly in normal babies. In fact, it is claimed that about 10 per cent of babies show this. It comes on during the first week of life, but usually not before the first 36 hours. It vanishes just as rapidly after the first week, leaving no aftermath.

The red blood cells of the body are continually being manufactured and broken down. When destroyed, they yield a product called haemoglobin, and this is disposed of by the liver. A baby’s liver is not always geared to cope with the fairly large amounts it has to dispose of in early life, so the by-products build up as a substance called bilirubin.

Other forms of jaundice

If the baby is jaundiced at birth, or if physiological jaundice persists beyond a week, the doctor will seek out other causes. It is a cardinal sign of liver disease, and the cause must be found. If large amounts of bilirubin (the material that causes the yellow discoloration) are allowed to remain in the blood, serious and permanent adverse effects are probable. A condition called kernicterus may take place. This comes from the Greek words meaning kernel (of the brain) and icterus (jaundice). Staining and damage of the vital brain centres may occur. It may cause death at worst, or it may leave the infant with permanent brain palsy, deafness and mental retardation.

A serious and fairly common cause of this in bygone days was the so-called haemolytic disease of the newborn, caused by the blood group Rh factor. It occured in some women who were Rh negative producing a Rh positive child, and whose systems had been sensitized by an Rh baby previously. With each subsequent Rh pregnancy, the condition became more severe and serious. Total blood transfusions were carried out on affected babies in an attempt to save them, and many were highly successful. However, with the ready availability of Rh immunization for these women, given within 72 hours after producing an Rh positive child, this risk has now largely vanished.

There are various other causes but these come within the orbit of obstetricians and paediatricians caring for babies when they are born. The condition is usually picked up and treated at once.

Hepatitis A (infectious hepatitis)

The more common variety is also called Hepatitis A, or viral hepatitis. It is more likely in adults, but may occur in children and infants. It is caused by a virus and is believed to be transmitted by flies which infect food, but there may be other ways of contamination as well.

It takes about two to six weeks for the germ to incubate and produce symptoms. Often it is sub-clinical, meaning no obvious symptoms occur. The child merely feels off-colour. Frequently, as the liver becomes infected, the cells swollen and the normal flow of fluids through the system affected, jaundice occurs. This may be mild, with only a staining of the whites of the eyes. Or it may be more pronounced, and the whole body becomes an obvious yellow.

It may have a rapid onset, with fevers, chills, malaise, lack of appetite, vomiting, headache, and aches and pains all over the system. Jaundice of the eyes and skin may occur; and if so, the skin often becomes very itchy, the child starts scratching and may break and abraid the surface. Sometimes the lymph glands of the body swell and become tender. These may be in the neck, under the jaw, in the armpits and groin. Often the liver and spleen also swell and are tender. The liver, in the right-hand side of the abdomen, may be felt protruding from under the rib cage. On the left-hand side is the spleen, a large organ associated with blood production.

An infection with jaundice occurring during childhood, and with the symptoms listed, is most likely infectious hepatitis. However, see the doctor for a confirming diagnosis and be guided by the doctor’s recommendations for treatment.

Treatment of hepatitis A

Most cases are mild and may be managed at home. Children prefer to stay in bed for the first few days at least, and maybe longer. It depends on how quickly they start to recover.

There are no restrictions on food intake. Giving a good nutritious diet is advisable, if the patient is inclined to take this. Fat-containing foods may be unacceptable because the patient experiences nausea. (The old idea of withholding fats for medical reasons no longer applies.) All the child’s usual foods may be given. However, from a practical side, small portions of attractively served foods along the lines of the patient’s favourites are probably the best idea. Plenty of fluids are recommended, for these help to wash toxins and debris from the system and always help in recovery of any infection.

Usually there is no medication given, for the liver would then have to cope with drugs and it is already inflamed and battling itself. Additional vitamins (especially the vitamin B series) can help strengthen the liver.

This infection is usually self-limiting, and recovery is the usual result. Most patients suffer minimum or no jaundice, but sometimes there is major and serious yellowing which may indicate a severe degree of the disease.

If one member of the family has infectious hepatitis, a good deal of protection for the other members may be gained by an injection of gamma globulin. The doctor arranges and administers this.

Hepatitis B (serum hepatitis)

Today this is better known as Hepatitis B, and it is also caused by a virus. In children it is much rarer. It is transmitted by infected blood and for this reason it occurs in persons receiving injections with needles previously used by an infected person—so is more probable in drug addicts. Hepatitis B used to occur occasionally after blood transfusions, but now, with screening tests for blood, this is unlikely in this country; the infection is more common overseas, especially with commercially bought blood. However, it is claimed that the virus can also be transmitted via breast milk and various other body fluids. It is worth noting that many cases have occurred in young people after they have been tattooed and also in girls (often children) after they have had their ears pierced; on checking, it has been found that the instruments used were not completely sterilized. Now that pre-sterilized studs are widely used for ears, the incidence has been reduced, but parents should still be careful to check that this is so if their children intend having their ears pierced.

It may take six months or more for symptoms to develop from the time of infection. The illness is serious and many deaths have occurred.

Treatment of hepatitis B

It is essential that treatment be under full medical supervision. This is best carried out in a major hospital, where clinics are geared for diagnosis and treatment of this unfortunate illness.

For any case of obvious jaundice, treatment must be under proper medical supervision. Although certain cases may be treated quite satisfactorily at home, proper diagnosis in the first place is essential. After this, it is important to be guided by the doctor’s suggestions. The advice offered in this section is to be used only as a general guide, to give some idea of the nature of therapy that will probably be recommended. The only medication, if any, to be taken is that prescribed by your doctor. Drugs given are usually minimal, and then only for the more serious forms of the disease. Parents should not self-medicate, for this could aggravate the disorder and prolong convalescence.

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‘Ideally the less medication you take the better, for it is often transmitted to the baby via breast milk. But make certain you take only medicine that is prescribed by me, as your doctor. Small amounts of tea, coffee or even alcohol are fairly innocuous. But smoking is bad news, and I strongly recommend any young mother who smokes to stop right now. Ideally, she will have stopped before she became pregnant, for the hazards during pregnancy are high. Poisons may be transmitted via the milk, and the baby’s system is not geared to the toxins in cigarette smoke. A lot of research confirms this.

‘Karen, a close relationship between you and your baby is the ideal. Although this is best achieved when breast feeding, it can also become established with artificial feeding. It is best to weigh all options, to try breast feeding to begin with and persist with it for as long as practical,’ I said.

‘Does demand feeding continue right throughout the feeding business?’ Karen asked.

‘Very soon your baby will establish her own alarm system and will settle down to regular feeding schedules. So whether you feed by the clock or on demand, it makes very little difference long term. Many arguments are still being waged about the benefits and disadvantages of each system—in reality it matters little. If the baby is gaining weight and obviously growing normally, the method in use is satisfactory. If there is any doubt, have her weighed at the clinic and you will soon discover if there is anything wrong.

‘There is no need to let the baby rule your life, incidentally. So many mothers tire themselves out needlessly by letting the new arrival rule not only their own life but the total running of the home. This is foolish. Stick to sensible time schedules, but you must live your own life at the same time.

‘At about three months, the baby will sleep right through the night, and the tiring night feeds will come to an end. You can then give a sigh of relief, for this makes life so much easier for everyone.’

‘What are some of the pitfalls of feeding Joanna? I’m sure there are many I will discover,’ Karen said.

‘Yes, feeding difficulties will certainly happen. Babies that are highly strung may present the greatest number; they tend to demand a lot of attention. Wind, colic and bowel upsets are common in the superactive baby. Many are difficult when their nappies are wet or if they are left alone for a while.

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