Diet and Nutrition

This report presents the findings of a consultation exercise of diet and nutrition of older adults, aged 50 years and over, living within the North Staffordshire area. The consultation was carried out between August and October 2001.

The aim of the report is to identify and highlight the comments and views of older people in North Staffordshire on food, shopping and consumption in order to develop a practical strategy for the effective promotion of dietary change for older people on the basis of people’s perspective.

From the recommendations and practical strategy/s put forward, a development of partnerships with older people and relevant agencies will be implemented in order to effect change.

The consultation forms part of the Beth Johnson Foundation’s ongoing health promotion work.

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5 Secrets For Weight Loss Success

First of all, a few words about me. I used to be much heavier than I am now and this is how I used to look on the left - on the right was me a few weeks ago. I have since lost even more weight.

Some of my friends say I am half the man I used to be! I have been overweight since I was 7 years old. I have been overweight since I was 7 years old. And I have constantly tried losing weight ever since. Over the years I tried just about everything. Now, I cannot say I have really tried everything - for example I have not tried extract of Himalayan Flame-tree (or maybe I have under a different name!): but if I did it did not work, so I do not remember it.


I do not think there is much point in going over what did not work, listing quick weight loss programs where I lost weight and put it back on as quickly as I lost it, or all the starvation techniques, or exercise programs I treid and failed with over 40 years and more. The secrets I give away here are all part of what has worked for me - not only to lose weight (which i have done many times before) but also to keep it off, which is far harder. And, more importantly, I have done so without any risks to my health - which is paramount to me, since I am a Type 2 Diabetic! FREE details of my experience living with diabetes can be found on a different.

If this is an issue that affects you, be sure to visit the site. At the same time, I have spent over 30 years of daily work on techniques and disciplines for self-transformation and growth. These inner disciplines are what has enabled me to succeed in the end, though it has been quite a battle at times, believe me! Just ask yourself this: do you want to change your life entirely? You can, and I will help you, free of charge. But I will only tell you how to do it. You have to decide what to change, and why.

My freedom of choice is of over-riding importance to me, so I respect your freedom to choose likewise. To help you to be free to choose to do anything at all, you may also be interested in my money-making opportunity. In the following pages you can find links to all these websites, where you can find out more about what I talk about here. Please feel free to visit any of them at any time, under no obligation at all.

Contents
Introduction - About me.
Secret 1 Eating all the foods you want and still keep losing weight.
Secret 2 Safe & affordable exercise.
Secret 3 Healthy low-calorie snacking.
Secret 4 Healthy eating out in food-courts and restaurants
Secret 5 Balanced nutrition & weight control.
Bonus Further Little Secrets.

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High Blood Pressure

High blood pressure, also called hypertension, is, simply, elevated pressure of the blood in the arteries. Hypertension results from two major factors, which can be present independently or together:

• The heart pumps blood with excessive force.
• The body's smaller blood vessels (known as the arterioles) narrow, so that blood flow exerts more pressure against the vessels' walls.

Although the body can tolerate increased blood pressure for months and even years, eventually the heart may enlarge (a condition called hypertrophy), which is a major factor in heart failure. Such pressure can also injure blood vessels in the heart, kidneys, the brain, and the eyes.

Two numbers are used to describe blood pressure: the systolic pressure (the higher and first number) and the diastolic pressure (the lower and second number). Health dangers from blood pressure may vary among different age groups and depending on whether systolic or diastolic pressure (or both) is elevated. A third measurement, pulse pressure, is becoming important as an indicator of severity.

Blood pressure is measured in millimeters of mercury (mm Hg). For example, excellent blood pressure would be less than 120/80 mm Hg (systolic/diastolic). Blood pressure is now categorized as optimal, normal, high normal, and hypertensive. The hypertensive category is further divided, according to severity. [See Table Blood Pressure and Its Treatments.]

American expert groups recommend that any blood pressure above normal should be treated. Some experts are concerned, however, that such guidelines may unnecessarily increase the use of anti?hypertensive drugs.

Systolic Blood Pressure. The systolic pressure (the first and higher number) is the force that blood exerts on the artery walls as the heart contracts to pump out the blood. High systolic pressure is now known to be a greater risk factor than diastolic pressure for heart, kidney, and circulatory complications and for death, particularly in middle?aged and elderly adults. The wider the spread between the systolic and diastolic measurements, the greater the danger.

In fact, elevated systolic pressure may pose a significant danger for heart events and stroke events even when diastolic is normal ?? a condition called isolated systolic hypertension. Isolated systolic hypertension is the most common form of hypertension in people older than fifty. In one study it comprised 87% of hypertension cases in people between ages 50 and 59.

Diastolic Blood Pressure. The diastolic pressure (the lower and second number) is the measurement of force as the heart relaxes to allow the blood to flow into the heart. High diastolic pressure (the second and lower number) is a strong predictor of heart attack and stroke in young adults. [See Hypertension Categories, below.]

Pulse Pressure. Pulse pressure is the difference between the systolic and the diastolic readings. It appears to be an indicator of stiffness and inflammation in the blood?vessel walls. The greater the difference between systolic and diastolic numbers, the stiffer and more injured the vessels are thought to be. Although not yet used by physicians to determine treatment, evidence is suggesting that it may prove to be a strong predictor of heart problems, particularly in older adults. Some studies suggest that in people over 45 years old, every 10?mm Hg increase in pulse pressure increases the risk for stroke increases by 11%, cardiovascular disease by 10%, and overall mortality by 16%. (In
younger adults the risks are even higher.)

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Exercise, Obesity, and Weight Control

It is ironic that while millions of people are dying of starvation each year in most parts of the world, many Americans are dying as an indirect result of an overabundance of food. Further, billions of dollars are spent each year overfeeding the American public, which then leads to the spending of billions of dollars more each year on various weight loss methods. This review will investigate various aspects of overweight and obesity, and show how they are affected by physical activity. But first, we must define and differentiate between the terms overweight and obesity.

The terms overweight and obesity are often used interchangeably, but this is technically incorrect as they have different meanings. Overweight is defined as a body weight that exceeds the normal or standard weight for a particular person, based on his or her height and frame size. These standards are established solely on the basis of population averages. It is quite possible to be overweight according to these standard tables and yet have a body fat content that is average or even below average. For example, almost all college and professional football players are overweight by these tables, but few are overfat. There are also people who are within the normal range of body weights for their height and frame size by the standard tables, but who have, in fact, excessive body fat.

Obesity is the condition in which the individual has an excessive amount of body fat. This means that the actual amount of body fat, or its percentage of a person’s total weight, must be assessed or estimated. A number of laboratory and field assessment techniques can provide reasonably accurate estimates of a person’s body composition. xact standards for allowable fat percentages, however, have not been established. But there is general agreement among clinicians and scientists that men over 25% body fat and women over 35% should be considered obese, and that relative fat values of 20% to 25% in men and 30% to 35% in women should be considered borderline obese.

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How To Maintain Your Perfect Weight, Health & Still Eat Your Favorite Foods

How many times have you lost weight and gained the weight right back after a couple of weeks? It can be a little discouraging to gain the weight after all your hard work and dedication. We tend to go back to eating our favorite foods and completely stop exercising. Well, this report will give you a solution on balancing your food intake and minimal exercise to maintain your perfect weight and health and still eat your favorite foods.

Eat variety of foods to minimize repeated exposure to food toxins, sprays, etc. All foods are handled differently in different parts of the country. (See Natural Foods List Below) If you eat conventional fruits and vegetables, be extra cautious on what you put into your body, repeatedly.

Conventional foods contain pesticides and other chemicals. It is always best to eat organic foods which are grown naturally without any chemicals. Eat organic foods if you can. Certain foods are laced with dangerous pesticides. Wash all fresh foods thoroughly especially melons, as there have been several cases of salmonella poisoning found from cutting into the melons before washing them. Grow your own if possible. When selecting organic foods at your local grocery store look for the “organic” label on each produce in the organic section. Conventional produce can be larger and look better than organic produce. Organic foods are somewhat expensive, however, it is better to pay now than later on the operating table.

Eat more fiber to speed dangerous toxins through the intestinal tract and to bind and neutralize them before they can do any harm. Fiber should be part of every meal. It is found in whole grains, beans, legumes, vegetables, and fruits. Processed foods lack fiber, be sure and add fresh food to every meal. Fiber also cuts down on food reactions and blood sugar fluctuations, in addition to preventing constipation.

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Relationship Between Weight Loss and Body Image

Obesity is a serious health problemworldwide. In the United States, the number of obese people (defined as BMI>30) has reached epidemic proportions, affecting approximately one-quarter of the American population. The prevalence of obesity is increasing worldwide, and the percentage of people who are overweight has steeply risen more than 30% since 1980 (Bray, 1998). Data fromthe National Center for Health Statistics indicate an uneven distribution of obesity, with African-American and Mexican-American females most affected (Flegal, Carroll, & Kucfzmarski, 1998). Children and adolescents are not immune to this epidemic. Data suggest that over 20% of children are currently overweight, and 30% of these individuals become obese adults later in life.

Excess weight increases the risk of serious medical consequences such as hypertension, diabetes, coronary heart disease, and some forms of cancer. It has been argued that the “preponderance of evidence suggests that even mild overweight is probably associated with some increase in mortality risk" (Solomon, Willett, & Manson, 1995). In addition to the tremendous health risks, the financial cost of obesity is staggering. Obesity-related problems are estimated to cost the United States 39.3 billion dollars annually (Colditz,
1998). Given this backdrop, it is not surprising that the study of obesity has received an increasing amount of attention fromlocal and federal policy-makers, health care professionals, and researchers.

Despite the well-established relationship between medical risks and obesity, the relationship between psychological functioning and obesity remains less clear. Common beliefs implicating psychological distress as a contributing factor in the development of obesity has not been well supported by research (Hill & Williams, 1998). Several large- scale studies, each involving at least 500 subjects, found no consistent evidence to support the claimthat severely obese persons show higher levels of psychopathology than normal-weight controls (Moore, Standard, & Srole, 1996; Silverstone, 1968; Hallstrom& Noppa, 1982; Kittel, Rustin, Dramaix, DeBacker, & Kornitzer, 1978; Hill & Williams, 1998; Stunkard &Wadden, 1992). Wadden, et al. (2001) contend that a substantial minority of extremely obese patients seeking bariatric surgery present with significant emotional complications.

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Brachytherapy for The Treatment of Prostate Cancer

Brachytherapy is the implantation of radioactive sources in or near tumours. When used in the treatment of prostate cancer, radioisotopes are inserted directly into the prostate gland guided by a transrectal ultrasound probe as a single day-patient or overnight stay procedure. The radioactive sources have a localised effect and, when the placement and dosage are planned appropriately, destroy tumour cells of the prostate gland without significantly irradiating adjacent normal tissue. The total radiation dose is about twice that from conventional external beam radiotherapy (EBRT), and about 50 per cent higher in terms of biological equivalence.

There are two types of prostate brachytherapy permanent implants (using small iodine 125 (I 125) or palladium 103 (Pd 103) seeds) and temporary implants (using iridium 192 wires via temporary catheters). Only permanent implants using I 125 are the subject of this application. Palladium implants are not currently available in Australia.

Brachytherapy has been proposed to offer a more efficient treatment (shorter treatment, in-hospital and recovery time) for localised prostate cancer with the additional advantages of limiting the side-effects to adjacent tissues that occur with EBRT and the surgical risks associated with radical prostatectomy (RP). However, the procedure may be associated with short- and long-term complications.

Contents
Executive summary
Introduction
Background
The procedure

Intended purpose
Clinical need/burden of disease
Existing procedures
Comparators
Marketing status of the device/technology
Current reimbursement arrangement

Approach to assessment

Review of literature
Expert advice

Results of assessment

Is it safe?
Is it effective?
What are the economic considerations?

Conclusions

Safety
Effectiveness
Cost-effectiveness

Recommendation
Appendix A MSAC terms of reference and membership
Appendix B Advisory Panel
Appendix C Studies included in the review
Appendix D Defining the Clinical Question
Appendix E Estimated costs of brachytherapy treatment - translated from the United Kingdom and direct Australian estimates
Abbreviations
References.

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