Wednesday, February 10, 2016

Sexually Transmitted Infections

Key facts

More than 1 million sexually transmitted infections (STIs) are acquired every day worldwide.
Each year, there are an estimated 357 million new infections with 1 of 4 STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis.
More than 500 million people are estimated to have genital infection with herpes simplex virus (HSV).
More than 290 million women have a human papillomavirus (HPV) infection.2
The majority of STIs have no symptoms or only mild symptoms that may not be recognized as an STI.
STIs such as HSV type 2 and syphilis can increase the risk of HIV acquisition.
In some cases, STIs can have serious reproductive health consequences beyond the immediate impact of the infection itself (e.g., infertility or mother-to-child transmission)
Drug resistance, especially for gonorrhoea, is a major threat to reducing the impact of STIs worldwide.



What are sexually transmitted infections and how are they transmitted?

More than 30 different bacteria, viruses and parasites are known to be transmitted through sexual contact. Eight of these pathogens are linked to the greatest incidence of sexually transmitted disease. Of these 8 infections, 4 are currently curable: syphilis, gonorrhoea, chlamydia and trichomoniasis. The other 4 are viral infections and are incurable: hepatitis B, herpes simplex virus (HSV or herpes), HIV, and human papillomavirus (HPV). Symptoms or disease due to the incurable viral infections can be reduced or modified through treatment.

STIs are spread predominantly by sexual contact, including vaginal, anal and oral sex. Some STIs can also be spread through non-sexual means such as via blood or blood products. Many STIs—including chlamydia, gonorrhoea, primarily hepatitis B, HIV, and syphilis—can also be transmitted from mother to child during pregnancy and childbirth.

A person can have an STI without having obvious symptoms of disease. Common symptoms of STIs include vaginal discharge, urethral discharge or burning in men, genital ulcers, and abdominal pain.

Scope of the problem

STIs have a profound impact on sexual and reproductive health worldwide.

More than 1 million STIs are acquired every day. Each year, there are estimated 357 million new infections with 1 of 4 STIs: chlamydia (131 million), gonorrhoea (78 million), syphilis (5.6 million) and trichomoniasis (143 million). More than 500 million people are living with genital HSV (herpes) infection. At any point in time, more than 290 million women have an HPV infection, one of the most common STIs.

STIs can have serious consequences beyond the immediate impact of the infection itself.

STIs like herpes and syphilis can increase the risk of HIV acquisition three-fold or more.
Mother-to-child transmission of STIs can result in stillbirth, neonatal death, low-birth-weight and prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities. Syphilis in pregnancy leads to approximately 305 000 fetal and neonatal deaths every year and leaves 215 000 infants at increased risk of dying from prematurity, low-birth-weight or congenital disease.1
HPV infection causes 528 000 cases of cervical cancer and 266 000 cervical cancer deaths each year.2
STIs such as gonorrhoea and chlamydia are major causes of pelvic inflammatory disease (PID) and infertility in women.
Prevention of STIs

Counselling and behavioural approaches
Counselling and behavioural interventions offer primary prevention against STIs (including HIV), as well as against unintended pregnancies. These include:

comprehensive sexuality education, STI and HIV pre- and post-test counseling;
safer sex/risk-reduction counselling, condom promotion;
interventions targeted at key populations, such as sex workers, men who have sex with men and people who inject drugs; and
education and counseling tailored to the needs of adolescents.
In addition, counseling can improve people’s ability to recognize the symptoms of STIs and increase the likelihood they will seek care or encourage a sexual partner to do so. Unfortunately, lack of public awareness, lack of training of health workers, and long-standing, widespread stigma around STIs remain barriers to greater and more effective use of these interventions.

Barrier methods
When used correctly and consistently, condoms offer one of the most effective methods of protection against STIs, including HIV. Female condoms are effective and safe, but are not used as widely by national programmes as male condoms.

Diagnosis of STIs

Accurate diagnostic tests for STIs are widely used in high-income countries. These are especially useful for the diagnosis of asymptomatic infections. However, in low- and middle-income countries, diagnostic tests are largely unavailable. Where testing is available, it is often expensive and geographically inaccessible; and patients often need to wait a long time (or need to return) to receive results. As a result, follow up can be impeded and care or treatment can be incomplete.

The only inexpensive, rapid tests currently available for STIs are for syphilis and HIV. The syphilis test is already in use in some resource-limited settings. The test is accurate, can provide results in 15 to 20 minutes, and is easy to use with minimal training. Rapid syphilis tests have been shown to increase the number of pregnant women tested for syphilis. However, increased efforts are still needed in most low- and middle-income countries to ensure that all pregnant women receive a syphilis test.

Several rapid tests for other STIs are under development and have the potential to improve STI diagnosis and treatment, especially in resource-limited settings.

Treatment of STIs

Effective treatment is currently available for several STIs.

Three bacterial STIs (chlamydia, gonorrhoea and syphilis) and one parasitic STI (trichomoniasis) are generally curable with existing, effective single-dose regimens of antibiotics.
For herpes and HIV, the most effective medications available are antivirals that can modulate the course of the disease, though they cannot cure the disease.
For hepatitis B, immune system modulators (interferon) and antiviral medications can help to fight the virus and slow damage to the liver.
Resistance of STIs—in particular gonorrhoea—to antibiotics has increased rapidly in recent years and has reduced treatment options. The emergence of decreased susceptibility of gonorrhoea to the “last line” treatment option (oral and injectable cephalosporins) together with antimicrobial resistance already shown to penicillins, sulphonamides, tetracyclines, quinolones and macrolides make gonorrhoea a multidrug-resistant organism. Antimicrobial resistance for other STIs, though less common, also exists, making prevention and prompt treatment critical.

STI case management
Low- and middle-income countries rely on identifying consistent, easily recognizable signs and symptoms to guide treatment, without the use of laboratory tests. This is called syndromic management. This approach, which often relies on clinical algorithms, allows health workers to diagnose a specific infection on the basis of observed syndromes (e.g., vaginal discharge, urethral discharge, genital ulcers, abdominal pain).

Syndromic management is simple, assures rapid, same-day treatment, and avoids expensive or unavailable diagnostic tests. However, this approach misses infections that do not demonstrate any syndromes - the majority of STIs globally.

Vaccines and other biomedical interventions

Safe and highly effective vaccines are available for 2 STIs: hepatitis B and HPV. These vaccines have represented major advances in STI prevention. The vaccine against hepatitis B is included in infant immunization programmes in 93% of countries and has already prevented an estimated 1.3 million deaths from chronic liver disease and cancer.

HPV vaccine is available as part of routine immunization programmes in 65 countries, most of them high- and middle-income. HPV vaccination could prevent the deaths of more than 4 million women over the next decade in low- and middle-income countries, where most cases of cervical cancer occur, if 70% vaccination coverage can be achieved.

Research to develop vaccines against herpes and HIV is advanced, with several vaccine candidates in early clinical development. Research into vaccines for chlamydia, gonorrhoea, syphilis and trichomoniasis is in earlier stages of development.

Other biomedical interventions to prevent some STIs include adult male circumcision and microbicides.

Male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60% and provides some protection against other STIs, such as herpes and HPV.
Tenofovir gel, when used as a vaginal microbicide, has had mixed results in terms of the ability to prevent HIV acquisition, but has shown some effectiveness against HSV-2.
Current efforts to contain the spread of STIs are not sufficient

Behaviour change is complex
Despite considerable efforts to identify simple interventions that can reduce risky sexual behaviour, behaviour change remains a complex challenge. Research has demonstrated the need to focus on carefully defined populations, consult extensively with the identified target populations, and involve them in design, implementation and evaluation.

Health services for screening and treatment of STIs remain weak
People seeking screening and treatment for STIs face numerous problems. These include limited resources, stigmatization, poor quality of services, and little or no follow-up of sexual partners.

In many countries, STI services are provided separately and not available in primary health care, family planning and other routine health services.
In many settings, services are often unable to provide screening for asymptomatic infections, lacking trained personnel, laboratory capacity and adequate supplies of appropriate medicines.
Marginalized populations with the highest rates of STIs—such as sex workers, men who have sex with men, people who inject drugs, prison inmates, mobile populations and adolescents—often do not have access to adequate health services.
WHO response

WHO develops global norms and standards for STI treatment and prevention, strengthens systems for surveillance and monitoring, including those for drug-resistant gonorrhoea, and leads the setting of the global research agenda on STIs.

Our work is currently guided by the Global Strategy for the Prevention and Control of Sexually Transmitted Infections: 2006-2015, adopted by the World Health Assembly in 2006, and the 2015 United Nations Global Strategy for Women's, Children's and Adolescents’ Health, which highlight the need for a comprehensive, integrated package of essential interventions, including information and services for the prevention of HIV and other sexually transmitted infections. WHO is developing 3 new 2016-2021 Global Health Sector Strategies for HIV/AIDS, Viral Hepatitis, and STIs.

WHO works with countries to:

Scale-up effective STI services including:
STI case management and counseling
syphilis testing and treatment, in particular for pregnant women
hepatitis B and HPV vaccination.
Promote strategies to enhance STI-prevention impact including:
integrate STI services into existing health systems
promote sexual health
measure the burden of STIs
monitor and respond to STI antimicrobial resistance.
Support the development of new technologies for STI prevention such as:
point-of care diagnostic tests for STIs
additional drugs for gonorrhoea
STI vaccines and other biomedical interventions.

Wednesday, January 27, 2016

How Lifestyle Impacts Your Health

Starting in the mid-20th century, the primary causes of death worldwide shifted from infections to chronic conditions, such as heart disease and cancer. The School has meticulously documented this change, standing at the forefront of both basic and applied research. Its discoveries in nutrition, exercise, and other individual risk factors have reconfigured the public health landscape.

The Nurses’ Health Study I, ­ a collaboration begun in 1976 among School scientists and researchers at Brigham and Women’s Hospital and the Channing Laboratory, ­ was the first of a series of prospective cohort investigations, now among the largest and oldest in the world. The study produced a lengthy list of surprising findings. Among these: that a high-fat diet increases colon cancer risk but not breast cancer risk; that weight gain after adolescence raises death rates in midlife; and that light smoking more than doubles the risk of heart disease. The Physicians’ Health Study showed that an aspirin a day reduces the risk of heart attack.

The School’s Department of Nutrition, founded in 1942, was the first such department in a medical or public health school in the world. Its groundbreaking research includes work on the health benefits and hazards of proteins and fats; the components of a well-balanced diet; and clinical aspects of obesity. School scientists created the first animal model for hypercholesterolemia and demonstrated the protective nature of HDL cholesterol and the blood vessel-damaging potential of LDL cholesterol.

In the 1970s, School scientists helped map the government’s Dietary Guidelines for Americans; decades later, they proposed an alternative Healthy Eating Pyramid based on the Mediterranean diet and including recommendations for daily exercise and weight control. In 2006, when the U.S. Food and Drug Administration ordered that nutrition labels for packaged foods list all harmful trans fatty acids, it signified a victory for School scientists, led by Walter Willett. A vigorous public health advocate, Willett not only amassed evidence that these solid fats raise the risk of coronary artery disease, type 2 diabetes, and other ills, but also waged a campaign to label and ultimately eliminate the ingredient from manufactured food products and restaurant meals.

Established in 1988, the Center for Health Communication has used entertainment media and mass communication to shift social norms in healthier directions. Among its innovations, it worked with Hollywood to incorporate the Swedish-originated designated-driver concept into entertainment programming, which decreased alcohol-related traffic crashes. So successful were the School’s efforts that the Random House Webster’s College Dictionary (1991 edition) added “designated driver” to the American lexicon.

In a similar vein, School faculty have led the charge for worldwide tobacco control, providing the scientific expertise to convince nations in Europe and Asia to pass smoking bans for public places. In a pair of 2008 studies, School investigators revealed a deliberate strategy among tobacco companies to recruit and addict young smokers by manipulating menthol content and by heavily advertising in places that cater to youth.

In 2008, School researchers published the largest and longest-running study to estimate the impact of a combination of lifestyle factors on mortality. The study concluded that not smoking, maintaining a healthy weight, regular physical activity, and a nutritious diet dramatically lowered the risk of dying from all causes during the 24 years of the study. In 2009, resolving a long-simmering scientific and popular debate, School investigators found that diets that reduced calories led to weight loss, ­ regardless of the proportion of carbohydrates, protein, or fat.

How Lifestyle Impacts Your Health

Lifestyle includes the behavior and activities that make up your daily life. This includes:
• the work you do
• your leisure activities
• the food you eat 
• your interaction with family, friends, neighbors,coworkers and strangers. 


Making Decisions about the Way You Live:
People make decisions based on beliefs, attitudes,and values. Our life experience and interaction with others also shapes our thoughts and actions.Personal behavior is affected by the information you learn at home and school, and from the radio,newspapers, and television. The good news is:

you can change the way you live

Thinking about changing your lifestyle?
• Pay attention to the way you live (or your lifestyle and health habits) and the work you do every day. 
• Talk with friends and family about lifestyle and health decisions.
• Discuss what you may want to change with them.
• Improve the quality of life for you and your family



Make a Healthy Choice Today!

Making Decisions about the Foods We Eat:
The foods we eat affect on our health. Many studies show that good nutrition lowers the risk for many diseases. Our food habits can bring on heart disease, stroke, some types of cancer, diabetes, and osteoporosis …or help prevent them!

You may like to eat foods from your family’s country of origin, following their customs and traditions. You can usually improve traditional family recipes for better health by substituting ingredients.


Make a Family Recipe Book: 
• Collect family recipes in a booklet.
• Share the recipes with a nutrition expert and find out which recipes are healthy ones. 
• Ask how to change some ingredients of old favorites that are sort of unhealthy. 
• Make those changes to the recipes and taste them with your family.
• Share the book of healthier recipes with everyone in your family

Change the way you eat. It can be fun and tasty


Work and Leisure Activities
The work we do affects our health. Apart from exposure to environmental hazards such as UV radiation and toxic chemicals like smoke, asbestos or pesticides, certain types of work involve prolonged repetitive actions and/or reduced levels of activity that may lead to muscular or skeletal problems, strained vision, and other health problems

Even the person with the busiest schedule can make room for stretching, physical activity, and having fun. Before or after work or before meals might be a good time to do this. Think about your daily schedule and look for ways to be more active


Tips for Becoming More Active:
• Walk as much as possible 
• Park the car farther away 
• Take the stairs instead of the elevator or escalator
• Try gardening or home repair activities
• Dance!

Studies have shown that regular mild aerobic exercise four times a week may help lower cholesterol, reduce the risk of heart disease, and improve diabetes management.

Leisure activities such as reading, playing cards, listening to music, and other pastimes have also been shown to have a positive impact on health by reducing stress.


Steps to Healthy Eating:
• Make good nutrition part of every day living. 
• Eat healthy at home, work and play. 
• Eating healthier will make you be and feel healthier.


Tips for Healthy Eating: 
• Eat at least 5-9 servings of fruits and vegetables every day. Try them canned, frozen, or as juice. 
• Choose whole grain bread and cereal. 
• Choose low-fat milk and cheeses. 
• Choose lean meats, poultry, fish. 
• Eat more beans and grains 
• Use less salt, sugar, alcohol, and saturated fat. 
• Drink lots of water between meals.

Other Things You Can Do to Stay Healthy: 
• If you smoke now, quit! 
• Get a handle on stress! 
• If you drink alcohol, beer, or wine only drink in moderation



Lifestyle-based analytics hold promise for proactive care

Lifestyle-based analytics may be an "emerging" predictive health model, but experts note that it's "simply taking data that we already have at our fingertips" and analyzing it in ways that weren't possible before.

The benefit? “Moving from a reactive mode to a proactive mode” in healthcare, says Chris Stehno, senior manager at Deloitte Consulting.

In the past, predictive healthcare modeling has used claims data, but the majority of the population doesn’t have good data – making predictions about life events and diseases difficult.

Stehno says their model uses consumer spending data, which is “chock-full“ of information on how individuals lead their lives. This data also provides high correlations for lifestyle-based diseases, which account for 75 percent of the total medical dollars spent in the U.S.

As Bill Preston, a principal at Deloitte, points out, when a person changes addresses, he or she starts getting bombarded with offerings for new siding – because consumer data indicates they're a new home buyer. Preston says their model takes that same data and it mines it for “specific variables that will be indicative of a particular situation or disease.”

For instance, Preston and Stehno note studies that have shown that individuals with a commute of 90 minutes or longer round-trip are 20 percent more likely to become diabetic or obese.

“Where in claims data you know for sure that they have a condition,” in the lifestyle based analytics, “this information doesn’t tell you that [this individual] has diabetes it tells you that they have an elevated risk for diabetes," says Stehno.

Preston notes that this can allow health insurers and providers to be proactive and not wait to do something until they are sick, which lowers overall healthcare spending.

But the model can also indicate an individual's “willingness to change.” For example, says Stehno, if an individual is seen to have purchased weight loss training products, it suggests that he or she has “change behavior” in mind. This can help identify people at risk when the chances of helping them can be maxmized, he says.

With the diagnoses codes changing due to healthcare reform and ICD-10, predictive modeling will have to be rebuilt, Preston notes.

"Lifestyle based analytics gives them a way to bridge that gap while this work is being done,” he explains.

For health insurers and providers, “the biggest hurdle,” says Stehno, is changing their “mindset and strategy” about how they approach people, and how they will use their existing programs to talk to people and reach out to them.

Saturday, January 16, 2016

Things to Avoid During Menstrual Period

For women, having their menstrual period every month is like a burden. It comes with the untimely emotional bursts. There is a change to the hormones, metabolism and other body parts. Menstrual period is like a monthly update of your body. Some women have their period at the same time and date every month which makes it easier for them. 


But there are some things that you should avoid while you are on your period and these includes

1. Running 
Running won't be beneficial since you will only feel bloated

2.  Taking a shower
A warm bath will do if you don't want to stand up while taking a shower. 

3. Get out of the bed
It is okay to stay on your bed for a couple of days while you're on your red flag

4. Do housechores
Don't make yourself suffer if you really could not stand at all. Those chores could wait. 

5. Start Arguments
Since you are on your period you tend to say things that you really don't mean so let the things pass by. 


6. Watch chick-flicks
It will just make you emotional missing the life that you do not have right now. 

7. Eating lots of chocolates
You can eat a little, but eating a lot will just make you gain weight

8. Exercise
It would just ruin the exercise clothes that you have. You can start exercising if your period is already done. 

9. Use Phones
If you get too emotional you might end up talking to someone that you don't want to and say things that you don't mean. 

10. Cook 
Handling sharp objects such as the knife is not advisable since it can be dangerous for someone who is emotional.

India Introduces Injectable Polio Vaccine

From April, 2016 the trivalent polio vaccine that is currently administered will be replaced by the bivalent variety to reduce incidence of vaccine-derived polio virus. 


India is all set to introduce injectable polio vaccine (IPV) in its universal immunisation programme (UIP) in a phased manner from November. This will be over and above the oral vaccine. From April, 2016 the trivalent polio vaccine that is currently administered will be replaced by the bivalent variety to reduce incidence of vaccine-derived polio virus. India eliminated wild polio virus infection in January last year. In the first phase of IPV introduction, 17 high-risk states and four Union Territories will be covered. These are Bihar, Chandigarh, Delhi, Gujarat, Haryana, Punjab, Rajasthan, Uttar Pradesh, Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Tripura, Assam, Madhya Pradesh, Andaman and Nicobar islands, Lakshadweep, Dadra and Nagar Haveli and Daman and Diu. -


IPV is one of the three vaccines that were approved by the government for inclusion in the UIP more than a year back on the recommendation of the National Technical Advisory Group on Immunisation. The other two vaccines, measles-rubella and rotavirus are still in the works. “From November we will introduce IPV in the UIP schedule, in three phases, starting with the high-risk states. The single dose of the vaccine will be administered with the third dose of the DPT vaccine at 14 weeks. This is as per the global endgame strategy and also in preparation for our own switch to bivalent oral polio vaccine next year. For now, the administration of the oral vaccine will continue,” said a senior official in the Health Ministry. Oral polio vaccine is made of live attenuated polio virus of all three strains of polio – P1, P2 and P3. India currently uses the trivalent vaccine. The other variety, the bivalent one that India will introduce next year has only attenuated P1 and P3 strains. India eradicated P2 in1999 — the last case was in Aligarh — but the most number of cases of vaccine-derived polio happen because of P2. Till date about 44 such cases of polio derived from the vaccine have been reported in the country. That is why the switch to bivalent oral vaccine. IPV on the other hand is made up of killed polio virus and will give a child immunity from all three strains. There is no risk of vaccine-derived polio either.


In May 2012, The World Health Assembly endorsed the Polio Eradication and Endgame Strategic Plan 2013-18, calling on countries to strengthen routine immunization programmes and introduce at least one dose of IPV in all countries using only oral polio vaccine. IPV is to be given in addition to the existing oral polio vaccine, in order to boost population immunity. For the first year GAVI, which is an international vaccine alliance, has given about 28 million vaccine doses to India. This is against India’s original demand for 40 million doses to account for wastage, transportation etc. India’s total annual birth cohort is 27 million. The first instalment is not sufficient to cover all states but the government is hopeful of further support from GAVI. The target is to cover all states in the next seven-eight months. Continuing IPV without GAVI support will entail a cost of approximately Rs 200-250 crore.

Compared to oral form of polio vaccine, the IPV is also expensive with each dose costing anywhere between Rs. 100 and Rs. 120. According to estimates, the State and Central governments will be incurring an additional expenditure of Rs. 7.50 crore per year to administer the inactivated form of polio vaccine.

“Apart from completing the training part, we are almost through with the logistics part. The Government of India has given clear cut instructions to switch to IPV by April 25 and we will be able to meet the deadline in Telangana State,” says Chief Programme Officer, National Health Mission (NHM) in Telangana, G. Srinivasa Rao.

The existing oral polio vaccine, which is cheap and can be easily administered, uses live but weakened forms of the poliovirus. However, live vaccine viruses can occasionally revert to virulence and there is always a chance of having a ‘live’ polio virus in the community. With IPV, however, there are no such risks because the virus is already deactivated, doctors here clarified.

Senior paediatricians have also stressed on the importance of training workers on handling IPV and maintaining the cold chain, which is necessary, while the drug is being transported.



Tuesday, January 12, 2016

Age and Infertility

The average chance of becoming pregnant each cycle is only 20%.It takes 5 to 6 months for the average fertile couple to conceive. One out of every six couples has trouble conceiving and/or carrying a child to term. Over 1.2 million deliveries worldwide using assisted reproduction.

Women are born with all the eggs they will ever have. Some are ovulated, but several hundred are pre-programmed to die each month. Accelerated egg loss happens due to- smoking, ovarian  surgery, pelvic radiation, chemo agents.Irrespective of whether the patient is undertaking any fertility related treatment or not, there will be a decline in the ovarian reserve with age and its rapid especially after 30 years of age.That’s why the success of an fertility treatment is dependent of the age of the female partner.To determine fertility potential, we as clinicians are dependent upon the clinical,biochemical and sonological parameters that’s called as Ovarian Reserve Assessment(quality and quantity of eggs in a particular age range)

Trends
* Many women today are attempting pregnancy at older ages, when they are biologically less fertile.
* Pregnancy rates sharply decline after age 35.
* The exact age at which a  women can no longer conceive varies widely.
The trend in delaying fertility may be due to a greater emphasis on establishing a career, later marriages, and remarkable improvements in the area of contraception

Pregnancy rates related to age of female-
Woman’s Age (y)        % Conceiving in 12 Months
20-24                            86
25-29                            78
30-34                            63
35-39                            52

15 – 20% of  all couples will experience difficulties with conception, but this increases up to 50% at age 35 – 40.

Reasons Of Decreased Pregnancy chances with age-
* Conception rate of normal fertile couples (~ 20% /month)
Probability of clinical pregnancy following intercourse on most fertile day of cycle:
19-26 yrs old         50%
27-34 yrs               40%
35-39 yrs               30%
*Poor quality of aging oocytes
*Chromosomal abnl., morphologic abnl.
*Decreased ovarian reserve
*Altered hormonal environment- ovulatory dysfunction
* More conditions in older women- polyps,endometriosis, fibroids…
Sexual factors- decreased coital frequency

Treatment Options-
* Ovarian hyperstimulation with IUI generates more eggs and sperm to be present at the optimal time of conception.
* IVF (in-vitro fertilization)- vital to older when time         is critical , tubal pathology (live birth rate drop from 32% in women<35 10="" 41-42="" in="" nbsp="" p="" to="" women="" yrs="">
* Oocyte donation- option for older women Pregnancy rates are determined by age of donor, but   pregnancy complications by age of mother.
* Delaying childbearing may increase infertility and the chance of developing chronic medical conditions.
* If no pregnancy after 6 months of trying, refer to specialist!! Time is vital for these patients.

Risks to the prospective pregnancy-
There are various ways to quantify the risks associated with advancing maternal age-
There are multiple tests today to quantify a women’s risk of chromosomal abnormality:
* nuchal translucency
* first trimester serum screening
* quad screen in 2nd trimester
* invasive testing- CVS , amniocentesis

What patients need to know ?
As doctor, we are supposed to give clear picture to the patient about impending risks of adverse outcome of pregnancy in the form of
* preterm birth
* growth restriction
* stillbirths
Besides that we should discuss the risks of Hypertension, Diabetes mellitus, low  socioeconomic class….all influence outcome

Conclusion-
* Advanced maternal age is associated with reduced fertility and increased risk of adverse pregnancy outcomes.
* Associations are due to poor oocyte quality, age-related changes in uterine/hormonal function.
* Fortunately, the prospects for couples to conceive are better than ever with advancing age with advancement of science and introduction of ART and especially the Third Party Reproduction

Abnormal periods

If you have problems with your periods, talk to your GP as there may be treatments that can help.
Period problems include: 
absent periods (amenorrhoea)
heavy periods (menorrhagia)
irregular periods
painful periods (dysmenorrhoea)
Absent periods (amenorrhoea)
If a woman stops having periods altogether, it's known as absent periods or amenorrhoea. It usually means no eggs are being produced. If you don't produce eggs (ovulate), you can't get pregnant.
There are many possible causes of absent periods, including:
severe stress or illness
extreme weight loss or extreme exercise
various medications
polycystic ovary syndrome (PCOS)
Treating the underlying cause often leads to your periods resuming.

Heavy periods (menorrhagia)
The amount of blood lost during a period varies from woman to woman.
However, see your GP if your periods are so heavy that they're disrupting your life and making you feel miserable. Treatment may help.
You might have heavy periods if:
you're using many tampons or sanitary towels
blood leaks through to your clothes
you need to use a sanitary towel and a tampon to prevent leaking
you become anaemic – leading to tiredness, shortness of breath, feeling faint, or hair loss

Irregular periods
Periods can last between two and eight days. The menstrual cycle (the time from the start of one period to the day before the next one) usually lasts 24 to 35 days.
If you have irregular periods, the gaps between your periods will vary, as will the amount of blood you lose and how long your period lasts.
Irregular periods are caused by irregular ovulation, so there are many possible causes. They may be normal in puberty or shortly before the menopause, or may be caused by progesterone-based contraceptives. The other possible causes are similar to those of absent periods.
Treatment for irregular periods depends on the underlying cause.

Painful periods (dysmenorrhoea)
Most women experience painful periods at some point in their lifetime. The pain can be in your lower abdomen (tummy), pelvis, lower back, thighs and vagina shortly before and during your period.
The pain can vary from mild to very severe. Speak to your GP if the pain is severe and you're finding it difficult to cope.
Painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs) can be used to treat painful periods.

Menstrual Cycle

Menstruation, also known as a period or monthly, is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. Up to 80% of women report having some symptoms prior to menstruation. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. These symptoms interfere with normal life, and therefore qualify as premenstrual syndrome, in 20 to 30% of women. In 3 to 8%, symptoms are severe.

The first period usually begins between twelve and fifteen years of age, a point in time known as menarche. However, periods may occasionally start as young as eight years old and still be considered normal. The average age of the first period is generally later in the developing world and earlier in developed world. The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women and 21 to 31 days in adults (an average of 28 days). Menstruation stops occurring after menopause which usually occurs between 45 and 55 years of age. Bleeding usually lasts around 2 to 7 days.

The menstrual cycle occurs due to the rise and fall of hormones. This cycle results in the thickening of the lining of the uterus and production of an egg which is required for pregnancy. The egg is released around day fourteen in the cycle and the thickened lining of the uterus is to provide nutrients for a potential developing baby. If pregnancy does not occur, the lining is released in what is known as menstruation.

A number of problems with menstruation may occur. A lack of periods, known as amenorrhea, is when periods do not occur by age 15 or have not occurred in 90 days. Periods also stop during pregnancy and typically do not resume during the initial months of breastfeeding. Other problems include painful periods and abnormal bleeding such as bleeding between periods or heavy bleeding.Menstruation in other animals occurs in primates, such as apes and monkeys, as well as bats and the elephant shrew.

A period is the part of the menstrual cycle when a woman bleeds from her vagina for a few days. In most women this happens every 28 days or so.
It's common for women to have a cycle slightly shorter or longer than this (from 24 to 35 days).
Girls have their first period during puberty. Most girls begin puberty between the ages of 8 and 14, with 11 being the average age. The first period is called the menarche.

A woman's periods continue until the menopause, which usually occurs when a woman reaches her late 40s to mid-50s (the average age is 51). 

The menstrual cycle

Each menstrual cycle starts on the first day of your period (day one) and lasts until the day before your next period begins.
The reproductive organs inside a woman's body consist of:
two ovaries – where eggs are stored, developed and released
the womb (uterus) – where a fertilized egg implants and a pregnancy develops
fallopian tubes – the two narrow tubes that connect the ovaries to the womb
the cervix – the lower part of the womb that connects to the vagina
the vagina – a muscular tube leading from the cervix to outside the body
During each menstrual cycle levels of the hormone estrogen rise as an egg develops and is released by the ovary (ovulation). Your womb lining thickens in preparation for a possible pregnancy.
The egg travels down the fallopian tube and if it meets a sperm and is fertilized, a pregnancy can occur.
The egg lives for about 24 hours. If it isn't fertilized, it will be absorbed into your body. The lining of your womb will come away and leave your body through the vagina mixed with blood. This is a period, also sometimes referred to as the menstrual flow or menses.


Symptoms associated with periods 

During your period you'll bleed from your vagina for a few days. The bleeding will usually be the heaviest in the first two days.
Your period can last between three and eight days, but will usually last for about five days.
The amount of blood you lose during your period depends on how heavy they are. It's usually about 30 to 72 milliliters (5 to 12 teaspoons), although some women bleed more heavily than this.
When the period is at its heaviest, the blood tends to be red. On lighter days, it may be pink, brown or black.
If you have heavy periods, there are a number of treatment options available. If your bleeding isn't too severe, you could try using a sanitary towel or tampon with a higher absorbency.
There are also a number of medications to help reduce bleeding. For example, the levonorgestrel-releasing intrauterine system (LNG-IUS) is a small plastic device that's inserted into your womb and releases a hormone called progesterone. It prevents the womb lining growing so quickly.
Alternatively, tranexamic acid tablets work by helping the blood in your womb clot.


Changes in your periods
Your periods can change – for example, they may last longer or get lighter. This doesn't necessarily mean there's a problem, but it does need to be investigated. You can go to see your GP, or you can visit your nearest women's clinic or contraceptive clinic.
Bleeding between periods, bleeding after having sex or bleeding after the menopause needs to be checked by a doctor. It might be caused by infection, abnormalities in the cervix (the neck of the womb) or, in rare cases, it could be cancer.

If you miss a period and you've had sex, you could be pregnant. See your GP if you're not pregnant and you've missed two or three periods. Find out about taking a pregnancy test.

Thursday, January 7, 2016

Steroids can cause Male Infertility

Male infertility is sole contributing reason for the couple’s failure to conceive. 1 in every 3 men is suffering from infertility problem.Infertility is not “just a female problem” as there is a male infertility component in approximately 50% of couples.

Anabolic Steroids (Steroids) are synthetic substances similar to the male sex hormone testosterone. If used consistently from a young age they can be detrimental to the users health because they upset the body's hormonal balance.Anabolic Steroids are known to have a variety of harmful side effects, are out of bounds for athletes and users are required to only take them under prescription of a medical doctor. Yet many people take them for the short term benefits they provide - for athletes to improve performance or to enhance physical appearance.

These drugs are often sold on the black market and because their short term benefits are so attractive users tend to ignore the dangerous and possible long term side effects. Users do not consider the effects these substances may have on their fertility health.

Due to unavailability of appropriate diagnosis and analysis methods the actual reason behind infertility left unnoticed. But now the advancement of medical science has made it possible to know the exact reason and cure of infertility. It has been observed that Male infertility is sole contributing reason for the couple’s failure to conceive and approximately 1 in every 3 men is having infertility problem more or less. There has been rapid increase seen in number of childless couples, deprived of parenthood just because the male partner is incapable of making woman pregnant due to infertility. Infertility as the failure of a couple to become pregnant after one year of regular unprotected sexual intercourse.

Generally this kind of problem occurs due to less count and degeneration of sperm which is ideally required for pregnancy. In such cases the sperm can’t reach inside the fallopian tube, hence female partner gets unable to conceive in spite of countless attempts. The major reason behind this problem is Male Infertility.

There are various factors which leads Male to Infertility, the prime reason is smoking and excess drinking. In most instances the young boys start taking steroids and medicines in order to have good physique due to which they have to suffer from infertility problem in later age. Much Physical exercise and starvation for the sake of dieting is also a cause which affects male fertility. The rapidly increasing Tension & Depression among youngsters and moreover Pollution, Anemia due to sedentary lifestyle are much contributing to the causes of male Infertility. The most complicated condition related with infertility is when the sperm doesn’t generate in semen. That condition is called Azoospermia. Approximately 1% percent male population is affected by this problem in India.
The Couple suffering from Infertility problem has to go through physical as well as mental stress. As most often either the sperm count is less or motility of the sperm is very low. Hence sperms are incapable of fertilizing the female partner’s egg. But now the science and technology has made the impossible come possible. There are promising solutions available for couples having such medical condition.

Now there are various treatments available helpful in overcoming the infertility. Oligospermia is the condition when sperm count is very less and Azoospermia is defined as entire absence of sperm in semen sample. With Azoospermia, a man produces no sperm in his ejaculate, giving him a zero sperm count. Azoospermia can result from a problem with sperm production or sperm delivery. It is diagnosed by semen analysis. Semen sample is required for performing the analysis, which is done to measure the count, size and activity of sperms.

There are number of men whose sperm count is zero. The common conditions that cause Azoospermia are hormonal misbalance, Injury, Testicular failure or infection. In some condition sperms are occurring in testes but unable to come out in semen due to obstruction in the vast.
Varicocele is also one of the reasons behind non development of sperm which can be cured through surgery. Few years ago those men without sperm or less sperm, didn’t have any option. He could not father a child of his own naturally.

He had to either use donor’s sperm or would adopt a child. Now, through incredible Stem Cell Technology advancement of medical science it has become possible to produce sperm in laboratory. Sperms are produced in laboratory by using the stem cells of the patient, then fertilized with egg and transplanted in the ovary through In Vitro fertilization. This is how the female partner may get pregnant.

Men with Azoospermia have a number of approaches available with them. Basically individual factors need to be considered for the choice of treatment. Treatment with Stem Cell Therapy promises much hope for the future.

Cancer Fighting Spices Herbs

Spices and herbs have long been used for medicinal purposes, such as fighting indigestion and other digestive problems. Although science is uncertain about the direct benefits of consuming certain spices and herbs with regard to protecting against and fighting cancer and its side effects, their indirect beneficial effects may be more easily recognized.

One such effect is their unique flavor profile, which ranges from strong to mild, with only small amounts needed to create a whole new taste sensation. When cancer-related loss of appetite and taste changes occur, which can lead to undesirable weight loss, adding herbs and spices to your cooking may help stimulate your taste buds and reinvigorate your appetite.


Ginger
It is a herbaceous perennial which grows annual stems about a meter tall bearing narrow green leaves and yellow flowers. Ginger is indigenous to south China, and was spread eventually to the Spice Islands, other parts of Asia and subsequently to West Africa.[2] Ginger was exported to Europe via India in the first century AD as a result of the lucrative spice trade and was used extensively by the Romans.India is now the largest producer of ginger.

Other members of the family Zingiberaceae include turmeric, cardamom, and galangal. The distantly related dicots in the genus Asarum are commonly called wild ginger because of their similar taste.
Ginger has long been used in folk medicine to treat everything from colds to constipation. Ginger can be used fresh, in powdered form (ginger spice), or candied. Although the flavor between fresh and ground ginger is significantly different, they can be substituted for one another in many recipes. In general, you can replace 1/8 teaspoon of ground ginger with 1 tablespoon of fresh grated ginger, and vice versa.

Consuming ginger and ginger products, in addition to taking any anti-nausea medications as prescribed, may provide some comfort for a queasy stomach during cancer treatment.


Rosemary
Rosmarinus officinalis, commonly known as rosemary, is a woody, perennial herb with fragrant, evergreen, needle-like leaves and white, pink, purple, or blue flowers, native to the Mediterranean region.Rosemary is a hearty, woody Mediterranean herb that has needlelike leaves and is a good source of antioxidants. Because of its origin, rosemary is commonly used in Mediterranean cooking and you’ll often see it included as a primary ingredient in Italian seasonings. You can use it to add flavor to soups, tomato-based sauces, bread, and high-protein foods like poultry, beef, and lamb.Rosemary may help with detoxification; taste changes; indigestion, flatulence, and other digestive problems; and loss of appetite. Try drinking up to 3 cups of rosemary leaf tea daily for help with these problems.



Turmeric
Turmeric is a rhizomatous herbaceous perennial plant of the ginger family, Zingiberaceae.It is native to southwest India, requiring temperatures between 20 and 30 °C (68 and 86 °F) and a considerable amount of annual rainfall to thrive.Plants are gathered annually for their rhizomes and propagated from some of those rhizomes in the following season.Turmeric is an herb in the ginger family; it's one of the ingredients that make many curries yellow and gives it its distinctive flavor. Curcumin appears to be the active compound in turmeric. This compound has demonstrated antioxidant and anti-inflammatory properties, potentially protecting against cancer development.Turmeric extract supplements are currently being studied to see if they have a role in preventing and treating some cancers, including colon, prostate, breast, and skin cancers. Although results appear promising, they have largely been observed in laboratory and animal studies, so it’s unclear whether these results will ultimately translate to humans.



Chile Peppers
The chili pepper is the fruit of plants from the genus Capsicum, members of the nightshade family, Solanaceae. In Britain, Australia, Ireland, New Zealand, South Africa, Pakistan, India, and other Asian countries, it is usually known simply as the chilli.Chile peppers contain capsaicin, a compound that can relieve pain. When capsaicin is applied topically to the skin, it causes the release of a chemical called substance P. Upon continued use, the amount of substance P eventually produced in that area decreases, reducing pain in the area.But this doesn’t mean you should go rubbing chile peppers where you have pain. Chile peppers need to be handled very carefully, because they can cause burns if they come in contact with the skin.

Therefore, if you have pain and want to harness the power of chile peppers, ask your oncologist or physician about prescribing a capsaicin cream. It has shown pretty good results with regard to treating neuropathic pain (sharp, shocking pain that follows the path of a nerve) after surgery for cancer.

Another benefit of chile peppers is that they may help with indigestion. Seems counterintuitive, right? But some studies have shown that ingesting small amounts of cayenne may reduce indigestion.



Garlic
Allium sativum, commonly known as garlic, is a species in the onion genus, Allium.Its close relatives include the onion, shallot, leek, chive,and rakkyo.With a history of human use of over 7,000 years, garlic is native to central Asia, and has long been a staple in the Mediterranean region, as well as a frequent seasoning in Asia, Africa, and Europe. It was known to Ancient Egyptians, and has been used for both culinary and medicinal purposes.Garlic belongs to the Allium class of bulb-shaped plants, which also includes chives, leeks, onions, shallots, and scallions. Garlic has a high sulfur content and is also a good source of arginine, oligosaccharides, flavonoids, and selenium, all of which may be beneficial to health. Garlic’s active compound, called allicin, gives it its characteristic odor and is produced when garlic bulbs are chopped, crushed, or otherwise damaged.Several studies suggest that increased garlic intake reduces the risk of cancers of the stomach, colon, esophagus, pancreas, and breast. It appears that garlic may protect against cancer through numerous mechanisms, including by inhibiting bacterial infections and the formation of cancer-causing substances, promoting DNA repair, and inducing cell death. Garlic supports detoxification and may also support the immune system and help reduce blood pressure.



Peppermint

Peppermint is a hybrid mint, a cross between watermint and spearmint. The plant, indigenous to Europe and the Middle East, is now widespread in cultivation in many regions of the world.It is found wild occasionally with its parent species.Peppermint is a natural hybrid cross between water mint and spearmint. It has been used for thousands of years as a digestive aid to relieve gas, indigestion, cramps, and diarrhea. It may also help with symptoms of irritable bowel syndrome and food poisoning. Peppermint appears to calm the muscles of the stomach and improve the flow of bile, enabling food to pass through the stomach more quickly.

If your cancer or treatment is causing an upset stomach, try drinking a cup of peppermint tea. Many commercial varieties are on the market, or you can make your own by boiling dried peppermint leaves in water or adding fresh leaves to boiled water and letting them steep for a few minutes until the tea reaches the desired strength.

Peppermint can also soothe a sore throat. For this reason, it is also sometimes used to relieve the painful mouth sores that can occur from chemotherapy and radiation, or is a key ingredient in treatments for this condition.



Chamomile
Chamomile or camomile  is the common name for several daisy-like plants of the family Asteraceae that are commonly used to make herb infusions to serve various medicinal purposes. Popular uses of chamomile preparations include treating hay fever, inflammation, muscle spasm, menstrual disorders, insomnia, ulcers, gastrointestinal disorder, and hemorrhoids.Chamomile is thought to have medicinal benefits and has been used throughout history to treat a variety of conditions. Chamomile may help with sleep issues; if sleep is a problem for you, try drinking a strong chamomile tea shortly before bedtime.

Chamomile mouthwash has also been studied for preventing and treating mouth sores from chemotherapy and radiation therapy. Although the results are mixed, there is no harm in giving it a try, provided your oncologist is not opposed. If given the green light, simply make the tea, let it cool, and rinse and gargle as often as desired.

Chamomile tea may be another way to manage digestive problems, including stomach cramps. Chamomile appears to help relax muscle contractions, particularly the smooth muscles of the intestines.

Winter Self Care Tips

You begin to sneeze and sniffle from a runny nose as the temperature plummets in the early morning and night.

Your skin turns flaky and dry, your lips have chapped and you are showing signs of depression. You have turned into a couch potato and you feel hungrier than ever; you tend to gorge on foods adding kilos. Yes, winter is truly here and you surely need some self-care to feel and look good this season.

SKIN AND HAIR WOES

The dry winter air can make your skin dry, flaky and scratchy. Your lips chap, your soles crack. Soaps containing glycerine, vaseline, lanolin, vitamin E oil, milk or honey can help retain moisture in the skin. According to a research, putting baking soda in your bath water can help soothe the winter itch.

Drink plenty of water to get that shine back onto your skin. And do not forget to make use of sun screen 15 SPF or more to protect your skin from the UV rays, especially during the hot sunny day. Winter air can give you `bad' hair days. The dull frizzy hair makes you look so unkempt! The dry skin on the scalp causes exces sive flaking resulting in infection or dandruff. The hair tends to become brittle and keeps breaking off.Scratching can cause bruises on the scalp. Experts advice a hair wash twice in a week using a mild shampoo with lukewarm water. Eating foods rich in protein, vitamin A, B1 and B12 help in improving skin and hair health. An intake of foods full of antioxidants, help in building up the defence mechanism in your body and stall the ageing process.

ALLERGIES AND COLD

The cold weather comes with all kinds of allergies that can trigger or worsen asthma and other respiratory illnesses such as cold, cough, bronchitis or those pesky irritants such as dust mites, pet dander, smoke, gas fumes and many more.You tend to catch a cold, cough, sore throat and even mild fever. The cool winter air can give you headaches too.Painkillers help relieve pain. The best way to prevent winter headache, is to protect your head and ears from the cool air. The dry winter air can irritate your nasal passages and throat causing pharyngitis or sore throat. The dry scratchiness and painful swallowing in the throat makes you feel miserable. An unresolved common cold may even lead to sinusitis; inflammation and infection of the sinuses. Dry coughs and bronchitis are common during this season and can be irritating. Colds are generally self-limiting.However, OTC nonsteroidal antiinflammatory medications can help soothe muscle aches and pains. Antihistamines can help in allergic coughs. Cough syrups, decongestant nasal sprays, etc, help relieve the symptoms. Salt-water gargles, sucking on throat lozenges, drinking plain warm water or with honey and lemon, help.

Interestingly, certain foods may get you through the cold and cough with ease. Spicy foods may just be a remedy for a stuffy nose. Sipping on hot soups with pepper may clean your sinuses. Hot tea can even soothe a sore throat besides relieving a stuffy nose. Scientists have put chicken soup to test and they say that it does relieve cold and flu symptoms. The chicken broth does help relieve nasal congestion when you have the flu symptoms - cough, cold and fever.

Intake of vitamin C, an antioxidant in the form of citrus fruits, strawberries, broccoli, green peppers, can taloupe, parsely, turnips, apples, guavas, potatoes, etc, help boost your immunity.When you have cold, wash your hands often, cover your mouth with a tissue when you cough or sneeze.Get plenty of rest for your own good and also to reduce the chances of infecting others.

THE BLUE MOODS

Winter depression medically termed as seasonal affective disorder (SAD) can make you feel low, depressed and sleepy during the day. You turn into a loner and crave for starchy foods. Severe cases may need antidepressants, cognitive behavioural therapy and artificial light treatment.Indulging in a hobby, keeping busy and exercising can certainly help.

WINTER HEALTH

Avoid fried foods, cakes, candies and sweets. Instead gorge on hot soups, veggies, fruits, nuts, protein-rich foods and plenty of fluids such as hot chocolate, herbal tea, green tea, broths, juices and smoothies not too cold.

Consume complex carbohydrates as in potatoes, pasta, brown rice, which help raise serotonin, a chemical neurotransmitter in the brain thus improving your mood. Get a good night's sleep. Control your room temperature and make use of a humidifier. Do not be a couch potato.Aerobics, walking, jogging, yoga can put you in good shape Arthritis can flare up in the elderly. They need to remain bundled up in sweaters, shawls and woollen caps. Young children too need to be kept warm Try not to get stressed this winter as stress weakens the body's immunity.

Foods That Fight Inflammation and Belly Fat

Doctors are learning that one of the best ways to quell inflammation lies not in the medicine cabinet, but in the refrigerator.Your immune system attacks anything in your body that it recognizes as foreign such as an invading microbe, plant pollen, or chemical. The process is called inflammation. Intermittent bouts of inflammation directed at truly threatening invaders protect your health.

However, sometimes inflammation persists, day in and day out, even when you are not threatened by a foreign invader. That’s when inflammation can become your enemy. Many major diseases that plague us—including cancer, heart disease, diabetes, arthritis, depression, and Alzheimer’s—have been linked to chronic inflammation.

One of the most powerful tools to combat inflammation comes not from the pharmacy, but from the grocery store. “Many experimental studies have shown that components of foods or beverages may have anti-inflammatory effects,” says Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health.

Choose the right foods, and you may be able to reduce your risk of illness. Consistently pick the wrong ones, and you could accelerate the inflammatory disease process.

Fruits and vegetables
All fruits and vegetables, due to their rich nutrient and fiber content, help to combat chronic inflammation, so make sure to include adequate amounts of these foods daily. Some types of fresh produce, however, are even more potent than others.

Some terrific anti-inflammatory fruits and vegetables to include in your meal plan include apples, berries, broccoli, mushrooms, papaya, pineapple, and spinach.


Green tea
This mild beverage is great for helping shrink your waistline as well as for decreasing inflammation. The flavonoids in this tea have natural anti-inflammatory properties. And the compound EGCG in green tea has been shown to help reduce body fat.

Monounsaturated fats
These heart-healthy fats help raise your healthy HDL cholesterol levels and reduce overall inflammation. Great sources include olive oil, almonds, and avocado.

Omega-3 fatty acids
Research has shown that a diet with a high percentage of omega-3 fatty acids and a low percentage of omega-6 fatty acids has been linked with decreased inflammation. Food sources of omega-3s include walnuts, flaxseed, and fish, such as wild Alaskan salmon.

Spices
Certain spices, including garlic, turmeric, cinnamon, ginger, and chili peppers, have potent inflammation-reducing capabilities, so try adding them to meals as often as possible.

Water
Staying hydrated is essential to flushing inflammation-causing toxins out of your body. Aim for 64 ounces of water per day. Remember: Add an additional 8 ounces of water for every 30 minutes of exercise as well.


Whole grains
Rich in fiber, whole grains help control the insulin response in your body. The high B vitamin content of whole grains also helps reduce the inflammatory hormone homocystine in the body.



Foods that inflame

Try to avoid or limit these foods as much as possible:

refined carbohydrates, such as white bread and pastries
French fries and other fried foods
soda and other sugar-sweetened beverages
red meat (burgers, steaks) and processed meat (hot dogs, sausage)
margarine, shortening, and lard

Developing a healthy eating plan can sometimes seem difficult but like anything that is new, it becomes second nature over time. And the payoff is well worth it: with a proper diet, you can take a proactive stance against inflammation and disease by incorporating these superfoods into your life.

With diet and lifestyle choices that support your health, you'll fight disease, illness and the signs of aging!