Prevent colorectal cancer with turmeric

Colorectal cancer is main cause of cancer deaths in western countries. It accounts about to 15% of all cancers. Aetiology of colon cancer is multi-factorial and complex but diet is one of the important factors to cause and prevent cancers, like high animal fat consumption is associated with an increase in rate of colon cancer and frequent consumption of vegetables and fruits, due to presence of bioactive food components, decreases the risk of human cancers. This observation has led to research focused upon chemopreventive agents, especially those obtained from the diet. Recently researches have been focused on identifying, dietary phytochemicals that have the ability to inhibit the formation of cancer. Researches have shown that extracts of plants or their ingredients possess inhibitory effects against chemically induced carcinogenesis. Although, nutritional intervention may not be sufficient to protect/or reduce risk of colon cancer in high risk individuals. A complementary approach for secondary prevention would be to recognise and distinguish between chemopreventive agents. The effectiveness of these various chemopreventive agents, together with nutritional interventions in high-risk individuals should then be assessed. Medicinal plants or their crude extracts have been traditionally used in the prevention and/or treatment of several chronic diseases by various different ethnic cultures world wide. In India the incidence rate of large and small bowel cancers are low, but rectal cancer is more common in India as compared to colon cancer. This low incidence of colon cancer in Indians can be due to high intake of starch and the presence of natural antioxidants such as curcumin, found in spice turmeric which is exclusively used in Indian cooking.

Diferuloylmethane, a yellow pigment more commonly known as curcumin, is one of the active phytochemical found in plants of species of Zingiberaceae. Plants like ginger, saffron and turmeric are some of the plants that have plenty of curcumin. In the Indian subcontinent and Southeast Asia, turmeric has traditionally been used as a treatment for inflammation, skin wounds, and tumours. Turmeric is a significant ingredient in most commercial curry powders. It is also used to give a yellow colour to some prepared mustards, canned chicken broth, and other foods, and is also used as a fabric dye.

HISTORY OF CURCUMIN

Turmeric is known as the poor man's saffron, it is an ancient spice whose use dates back to the time of the Egyptian pharaohs. Highly prized by both Muslims and Indo-Europeans for its medicinal uses, it is just coming into its own as a powerful natural medicine in the West where research is beginning to confirm the potent roles it plays as an anti-inflammatory, anticancer, anti-mutagenic and antioxidant remedy. A traditional remedy in Ayurvedic medicine, an ancient Indian healing system that dates back over 5,000 years, it has been used through the ages as an "herbal aspirin" and "herbal cortisone" to relieve discomfort and inflammation associated with an extraordinary spectrum of infectious and autoimmune diseases. Indian Materia Medica, a standard Ayurvedic reference, cites dozens of conditions in which turmeric can be helpful as an adjunctive therapy including tissue injury or irritation, microbial infections, fevers, allergies, sinusitis, gastritis, colitis, hepatitis, kidney disease arthritis dermatitis, phlebitis, tuberculosis and autoimmune disorders. It is also cited as a remedy for liver disorders accompanied by jaundice.

Topically, it can be used as a poultice to reduce inflammation and swelling due to sprains, cuts, bruises and superficial infections, including those of the eye -- which are treated with an eyewash containing turmeric that cools and soothes burning eyes. Another traditional use is to relieve congestion -- inhaling the fumes of burning turmeric directly into the nostrils is said to cause copious mucous discharge. Turmeric also is given to relieve diarrhoea and fevers, as well as vertigo, when applied directly to the scalp. Used for skin infections, colic, menstrual problems and congestion in China and Cambodia, the tuber also is used as a tonic, stimulant and diuretic in Madagascar. In Chinese traditional medicine it is known as "Jiang Huang," and used to eliminate flatulence; resolve liver and urinary problems, menstrual disorders, haemorrhage, and fever and chest pain; and prepared as a poultice for sores, wounds, bruises and infections. "There is also a vegetable which has all the properties of the true saffron, as well as the colour, and yet it is not really saffron" - Marco Polo, Thirteenth Century.

TIMELINE

Although the chemical structure of this remarkable spice, food preservative and dye was identified in 1910 it was only in the 1970s and 1980s that its many, varied health-promoting properties were identified. Recent, research is confirming what traditional healers have known all along, that the fresh juice of the root reduces swelling in bruises, wounds and insect bites and the dried powder kills parasites, relieves head colds and arthritic aches and pains. Research is also beginning to show that turmeric may be a valuable anticancer agent.

The earliest scientific paper on curcumin was published in year 1976 Sharma O P proposed the antioxidant activity of curcumin and related compounds. Gupta B et al, (1980) published Mechanism of Curcumin induced gastric ulcer in rats. Role of curcumin as an anti-inflammatory was demonstrated by Rao T S et al in 1982 and Mukhopadhyay A et al in 1982. In early 1983 a paper by Jiang T L et al, demonstrated effects of curcumae species on human tumour stem cell assay, however curcumae were relatively ineffective on the human tumours tested by him. However two years later in 1985 Kuttan R et al, saw inhibition in ovary cells of Chinese Hamsters by curcumin. A new model for evaluating nonsteroidal anti-inflammatory drugs (NSAIDs) was described by Satoskar R R et al in 1986. In the end of year 1989 researchers from Amala Cancer Research Centre, India demonstrated inhibition of chemical carcinogenesis by curcumin. There was no looking back after this year, a decade of research work on curcumin and turmeric suggested it as a potent anti-cancer and chemo preventive phytochemical. Recent studies are also suggesting curcumin as potent herbal remedy to fight against breast, colon, hepatic, skin and other cancers of gastric tract. Newer studies have suggested that curcumin inhibits HIV replication by blocking the long-terminal repeat region on HIV's genes.

CONCLUSION

Mechanism of curcumin is poorly known and many varied theories have been suggested about its action. But from these studies we can infer that curcumin inhibits carcinogenesis in large bowels.

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CHRONIC KIDNEY DISEASE (CHRONIC RENAL FAILURE / END STAGE RENAL DISEASE) AND ITS DIETARY MANAGEMENT

End stage renal disease (ESRD) occurs when chronic kidney disease worsens to the point at which kidney function is less than 10 % of normal. The kidneys fail to function at a level needed for day-to-day life. Kidneys main function is to remove wastes and excess of water from the body, which gets accumulated in renal failure leading to toxicity. The treatment includes kidney transplant or dialysis with dietary management.

ESRD always follows a chronic kidney disease; the most common cause is diabetes and high blood pressure. Other causes are –

1. Diseases affecting arteries reaching or leaving the kidneys.
2. Congenital abnormalities of kidneys
3. Polycystic kidney disease
4. Too much abuse of pain medications or other drugs
5. Toxic chemicals
6. Autoimmune disorders like systemic lupus erythematosus  (SLE), scleroderma
7. Injury
8. Glomerulonephritis
9. Kidney stones and secondary infections
10. Reflux nephropathy
11. Various other kidney diseases

Symptoms include –

1.      General ill feeling and fatigue

2.      Pruritis (itching) and dry skin

3.      Weight loss without effort

4.      Headache

5.      Loss of appetite

6.      Nausea and vomiting

7.      Swelling

8.      Bone pains

9.      Bad breath

10.  Abnormally dark skin

11.  Changes in nails

12.  Bleeding easily – bruises, nosebleed, blood in stool

13.  Impotence

14.  Restless leg syndrome

15.  Sleeplessness

16.  Excessive thirst

17.  Frequent hiccups

18.  Amenorrhea

19.  Drowsy and confused state

20.  Cannot concentrate or think clearly

21.  Numbness in different parts of the body

22.  Cramps or twitching of muscles.

23.  Abnormal health and lung sounds

24.  Diminished or no urine production

ESRD leads to buildup of waste products and fluid in the body, which affects most body systems and functions, including, blood pressure control, red blood cell production, electrolyte balance, vitamin D and calcium levels and thus bone health. Hence the patient on dialysis needs to undergo various tests often to manage the condition -

1.      Sodium

2.      Potassium

3.      Phosphorus

4.      Calcium

5.      Magnesium

6.      Albumin

7.      Cholesterol

8.      Electrolyte

9.      Complete blood count (CBC)

10.  Erythropoietin

11.  Parathyroid hormone (PTH)

12.  Bone density test

Treatment and management -

Management and treatment of ESRD includes kidney transplant or dialysis and dietary management, it is essential for the patient to know and understand everything about the treatment especially about dialysis and its types.

Why dialysis – dialysis helps to remove and maintain waste products, fluid and the electrolyte balance in the body. A special diet is important as dialysis alone does not effectively remove all the waste products. And dietary management also helps minimize the amount of waste build up and to maintain the fluid, electrolyte and mineral balance in the body between the dialysis.

One needs to do lots of changes in their diet –

ESRD patients need high protein, low sodium, potassium and phosphorus diet and a restricted fluid intake. Lets consider each in little details -

Fluid  –

Urine out put drops during kidney failure. Most dialysis patients urinate very little or not at all, and therefore fluid restriction between treatments is very important. Without urination, fluid will build up in the body and cause excess fluid in the heart, lungs, and ankles.

Your nutritionist will calculate the daily required amount of fluid on the basis of –

• The amount of urine output in 24 hours
• The amount of weight gain between the dialysis treatment
• Amount of fluid retention
• Levels of dietary sodium
• Whether you are suffering from congestive heart failure.

Tips –

• Avoid or minimize eating food with too much of water like – soups, jell-o, popsicles, ice creams, grapes, melons, palm fruit, coconut water, lettuce, tomatoes and celery.
• Use smaller glasses.
• Take sips of water
• Minimize sodium intake. Avoid salty food
• Freeze juices in an ice tray and suck them to minimize thirst (do count these ice cubes in your daily fluid intake)
• Avoid getting too hot, going out in sun.

Sodium balance –

As said above ESRD patient need to avoid high sodium diet. Hypertension in ESRD is mostly due to positive sodium balance and volume expansion (accumulation of too much of fluid in the body). ESRD patients on dialysis can effectively treat or control hypertension without antihypertensive drugs just by having a low sodium diet (2 g/day). Also low sodium diet will make you feel less thirsty and thus help avoid gulping extra fluids.

Tips –

·        Avoid – canned, processed food, processed smoked meat.

·        Avoid food with salt topping viz – chips, nuts etc.

·        Read labels carefully – select one that reads – low sodium, no salt added, sodium free, unsalted.

·        Avoid foods that list salt near the beginning of the ingredient list.

·        Choose food which contains salt less than 100 mg per serving.

·        Remove salt shaker from the table.

·        Cook food without salt instead use herbs for flavoring.

·        Avoid preserved foods – ketchups, sauces, pickles, popadums

·        Do not use salt substitutes, they contain potassium. And potassium is also restricted in kidney disease.

Potassium balance –

Normally a high potassium diet is recommended to control hypertension and thus minimize the risk of stroke and heart failure, but in case of ESRD, they cannot tolerate high potassium diet as they cannot excrete potassium from their body. High potassium levels in blood will lead to life threatening hyperkalemia induced arrhythmia.

Tips –

·        Avoid fruits high in potassium – banana, musk melons, cantaloupes, kiwis, honeydew, prunes, nectarines, coconut water, tomatoes, avocado, oranges and orange juice, raisins and dried fruits.

·        Have fruits like – peaches, grapes, pears, cherries, apples, berries, pineapple, plums, tangerines and watermelon.

·        Avoid vegetables high in potassium – spinach, pumpkin, winter squash, sweet potato, potatoes, asparagus.

·        Choose vegetables like – broccoli, cabbage, carrots, cauliflower, celery, cucumber, eggplant (aubergine/brinjal), green and waxed beans, lettuce, onion, peppers, watercress, zucchini and yellow squash.

·        Avoid legumes, milk and bran cereal.

·        Limit intake of potassium up to 2 gm per day.

Iron –

Patients with ESRD will also need extra iron.

Tip –

·        Consume food high in iron levels – lima and kidney beans, beet root, green leafy vegetables (avoid spinach), finger millet, chicken, liver, pork.

·        Eat iron fortified cereals

·        Take iron supplements as advised by your physician or dietician.

Calcium and phosphorus –

In ESRD phosphorous levels are high as it cannot be excreted from our body. Even in early stages of renal disease, phosphorus levels can become too high. High phosphorus levels will lead to itching, vascular calcifications, secondary hyperparathyroidism and low calcium levels. Thus the calcium deposited in the bones is used up leading to osteoporosis. Hence a phosphate restricted diet is recommended.

Tips –

·        Limit intake of dairy foods – milk, yogurt and cheese.

·        Can consume dairy products like – margarine, butter, cream cheese, full fat cream, brie cheese, and sherbet as they are low in phosphorus.

·        Consult your dietician and take calcium and vitamin D supplement, helps control calcium phosphate levels.

·        Avoid caned processed food.

If phosphorus levels are not managed with diet, your physician may prescribe you phosphorus binders.

Weight Management –

ESRD patient’s loose weight without any reason, thus their weight needs to be monitored and managed with proper balanced diet. ESRD patients average calorie intake reduces to lower than 30-35 kcal/kg/day leading to malnutrition. To prevent malnutrition related morbidity and mortality, ESRD patients on dialysis need to undergo a periodic nutrition screening and tests, comparing initials body weight with usual and ideal body weight, dietary reviews, and food diary assessment.

Protein –

You must be confused when I say ESRD patients need high protein, as most known fact is patients with renal diseases should limit their protein intake. True as when protein breaks down in our body urea is formed this cannot be excreted in urine and is toxic when it builds up in the blood stream. This limited protein diet is until patient is put on dialysis. As protein losses are higher in patients undergoing dialysis, they need to consume a high protein diet. Recommended dietary protein in hemodialysis patients is 1.2 g/kg body weight/day and 1.2-1.3 g/kg body weight /day for patients on peritoneal dialysis. If dietary protein – calorie intake is not adequate, patients should take dietary supplements under the guidance of a nutritionist, and if required they should be tube feed or parenteral nutrition should be provided.

Tips –

·        Eat high quality protein – fish, pork, eggs, kidney beans, Bengal gram, and soy for every meal.

·        Add egg white or egg white powder or protein powder to your diet.

Carbohydrates - 

If you are overweight and have diabetes, then you have to limit your carbohydrate intake, however if you are losing weight you need to take high carbohydrate diet. As carbohydrates are good source of energy. Your physician or dietician will recommended the amount of carbs required in your diet.

Tips –

·        Include – fruits, vegetables, breads and grains, as they are high in fiber, minerals, vitamins and a good source of energy.

·        If you are advised a high calorie diet, consume – hard candies, sugar, honey, jelly, pies, cakes, cookies.

·        Avoid desserts made from dairy, chocolate, nuts and bananas.

Fats –

ESRD patients on dialysis are recommended to limit intake of saturated fats and cholesterol as they are at high risk of developing coronary artery disease. They mostly have high triglyceride levels, high LDL (low density lipoproteins) and low HDL (high density lipoproteins). Though you are recommended to eat a high calorie diet, you need to avoid foods that raise your triglycerides and cholesterol levels

Tips –

·        Include foods that are high in monounsaturated and polyunsaturated fats and little of saturated fats. Like – sesame seed oil, flaxseeds, olive oil, and cotton seed oil.

·        Avoid canola oil, coconut oil, fats, poultry and chicken with skin.

Micronutrients –

ESRDS patients are recommended to have low fat diet and restricted fluid intake. Thus many patients need to take a vitamin supplement as fat soluble (A, D, E and K) vitamins and water soluble vitamins cannot be absorbed adequately form the diet and water soluble vitamins are also lost during dialysis treatment. Mostly these vitamins are given through vein during the dialysis treatment.

To manage all the above nutrients in the right quantity to suit your needs is not an easy task and it cannot be done own your own. DO NOT SELF DIET it can risk your health. This article is for your information and knowledge. Consult a nutritionist who can design a diet fit for your special needs. Always take your family along to understand your dietary needs so they can help you follow your diet. If you follow proper diet and physical activity as recommended by your physician and your nutritionist will help you feel good and lead a relatively healthy life with the ESRD.

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Keep Autism at Bay with Right Diet

The prevalence of “Autism” is increasing day by day. Autism spectrum disorder is only detected after 1-2 years of age and there is no indication that your child might be autistic before this age. Some of the factors that are increasing the chances of the child becoming Autistic may be due to changing lifestyle, imbalanced diet, canned processed food, stress, vaccinations, also increased habit of smoking and drinking especially in women. As old belief goes “PREVENTION IS BETTER THAN CURE” Autism can be prevented by being little cautious and leading a healthy life style.

Precaution starts from day you start planning for a child. The moment you start planning start Folic acid supplement (dosage as per your physician’s advice), folic acid is one of the major vitamin which helps prevent neural defects. Next utmost important step to be taken is STOP SMOKING AND HARD DRINKS. Avoid junk food, canned processed food,aerated drinks and canned juices. Avoid red meat and minimize non vegetarian diet, include fresh water fish to other sources of sea food. Drink plenty of water minimum 2.5 to 3 liters of water a day. Eat plenty of fresh fruits and vegetables. Include nuts and seeds like Brazilian nut, hazelnut, walnut, pecans, almonds, flaxseeds, sesame seeds, black dates in your daily routine.

Once you conceive, make sure you eat a balanced diet in terms of proteins, fats, carbohydrates, vitamins and minerals. Of course need for each nutrient increases and is different in different trimester of pregnancy. Consult a Qualified Nutritionist who will guide you through your pregnancy. Try to do activities that keep you happy and help you sleep well, take care of your self, avoid high heels – be cautious don’t get into an accident. And DO NOT FORGET “NO SMOKING AND HARD DRINKS”.

Post delivery; make sure you BREAST FEED your child for one year. As Breast Milk is the best and a complete Nutrients available to your infant. Do not self diet to loose weight and get in shape, while you are breast feeding your child. Eat a well balanced diet, consult a Nutritionist she will advise you. Remember what you eat will go to your child through breast milk. When your child is six months old introduce food in their diet along with Breast feeding; your child is growing and only breast milk will not suffice their needs. A Qualified Nutritionist will be the right person to advice the food that suits your baby.

Feed your child a balanced home cooked food till they are 7 year old. Do not introduce junk food, aerated drinks, canned, ready to eat processed food till the age of 7 years. This will help improve their immunity and help build a strong healthy base for a healthy life ahead…..

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