Newsletter "Your Health"
- Triglycerides. The forgotten fat.
- Alcohol. How much is safe?
- Sleeping pills. Do you really need them?
- Miscarriage. Is it your fault?
- Your testicles. A user’s guide
- Eczema. The dreaded winter itch
- Sexual health. A guide for adolescents
- Dietary fibre is vital
- Banana and raisin bran muffins
.Most people know about cholesterol and it’s role in heart disease. However, many Australians have raised triglycerides and are unaware of the harm they can cause.
Triglycerides (TGs) are a type of lipid (fat) found in the blood. They come from the food we eat as well as being produced by the body. Triglycerides are broken down by the body and used for energy when needed.
Being overweight, drinking alcohol and making poor food choices are the main causes of elevated triglycerides.
Why are they important?
Like cholesterol, excess triglycerides can cause hardening and narrowing of the arteries which increases the risk of cardiovascular disease, such as heart attack and stroke. Very high levels can also cause severe inflammation of the pancreas gland.
People with type 2 diabetes are at special risk from the health effects of raised triglycerides. Their TG levels are higher than those of the non-diabetic population.
The health risks are also much higher when elevated triglycerides are combined with abdominal obesity, raised blood pressure, low levels of good cholesterol (HDL) and raised blood glucose, a condition known as metabolic syndrome.
What is your level?
All healthy adults from 45 years should have a triglyceride test, at least every 5 years. Those with other risk factors (e.g. smoking, diabetes, blood pressure, overweight) are tested every 1-2 years. This involves a simple blood test after fasting for 12 hours.
The National Heart Foundation recommends a triglyceride target of less than1.5 mmol/L.
How to lower triglycerides
The first step in lowering your TGs is to make some healthy lifestyle changes:
- Lose weight if you are overweight
- Reduce your alcohol intake. Even small amounts raise TG levels.
- Choose more mono- and poly-unsaturated fats and less saturated and trans fats.
- Reduce sugary foods
- Exercise regularly, at least 30 minutes on most, preferably all, days of the week
If your TG level remains high in spite of these changes, your doctor may recommend a fibrate (e.g. fenofibrate or gemfibrozil) to reduce your cardiovascular risk. Fibrates are especially beneficial in type 2 diabetes and metabolic syndrome patients that have elevated TGs or low HDL. Sometimes these medications to lower your TGs may be added to a statin (a type of drug that is used to lower cholesterol).
Nicotinic acid (a form of vitamin B) and fish oil capsules may also be recommended by your doctor to lower triglycerides.
Ask your GP if you are due for a test.
The new Australian drinking guidelines recommend that both women and men drink no more than 2 standard drinks a day to reduce the risk of harm over the long term.
People under 18 years and women who are pregnant or breastfeeding are advised not to drink at all.
The guidelines from Australia’s peak health body, the National Health and Medical Research Council are the result of 3 years of analysis of the best scientific evidence.
The guidelines are based on a ‘standard drink’ which contains 10g of alcohol. Add up your daily standard drinks using the table above. However, be careful. Drink serving sizes are often more than one standard drink!
The health effects of alcohol
Excessive alcohol causes high blood pressure, many cancers, liver disease, obesity, mental health problems, birth defects and numerous other health conditions and social problems.
Consumption of alcohol at any level increases your risk of illness or death due to alcohol. The risk triples when your intake increases from 2 to 3 standard drinks per day. Every additional drink after that raises your risk further.
What about ‘binge drinking’?
A maximum of 4 standard drinks is recommended on any one occasion for both men and women.
Four drinks in one session more than doubles the risk of injury in the 6 hours afterwards, due to accidents, violence and risk taking. This risk increases further with each additional drink.
It’s up to you
The guidelines are not telling you what you can or can’t do. They simply explain the risks of alcohol so you can make an informed choice about how much risk you want to take.
Speak to your GP if you are finding it difficult to cut down or stop drinking.
For more information, go to www.nhmrc.gov.au or www.alcohol.gov.au.
SLEEPING PILLS. DO YOU REALLY NEED THEM?
Sleeping pills are prescribed in most cases for short term use (up to a week or two). It is best to avoid long-term use if at all possible. Sleeping pills or ‘hypnotics’ are taken for insomnia (difficulty falling or staying asleep).
Some regular users become ‘drug dependent’ and get withdrawal symptoms when they cut down or stop their pills. Symptoms may include sweating, dizziness, anxiety, sleeplessness and headache.
Others suffer from ‘rebound insomnia’ and their sleep worsens after reducing or stopping their medication. This makes it hard to break the habit and may occur from as little as 2 weeks use.
Side-effects may include memory loss, confusion and slurred speech. Sleepiness can also occur the next day, especially if taken with alcohol or other sedating medication, e.g. antidepressants.
Are they worth the risk?
Some people with severe insomnia will benefit from continuing treatment. However in many other cases the potential side-effects outweigh the benefits, especially for older people. Hypnotics increase sleep time by only 25 minutes on average and become less effective over time.
Talk to your doctor about whether you should stop your sleeping pills. It is vital for long-term users to reduce slowly to avoid withdrawal symptoms, usually over 6-8 weeks.
If you can’t stop, at least try to reduce your dose or avoid taking a pill every night. It is also very important not to take more than the prescribed dose and to avoid using hypnotics with other sedatives or alcohol as this may cause side-effects.
For more about sleep: www.sleepeducation.com and www.sleepfoundation.org.MISCARRIAGE. IS IT YOUR FAULT?
During the first trimester (the first 3 months of pregnancy) about one in five pregnancies ends in a miscarriage (loss of the baby).
The warning signs of miscarriage may include:
- Severe pain in the lower abdomen
- Cramping
- Vaginal bleeding
What should you do?
If you have these symptoms you should call your doctor who may examine you and arrange an ultrasound and/or blood test. However, there is no treatment to prevent miscarriage once it has started.
Your doctor may advise resting and waiting for the pregnancy to pass naturally, while using sanitary pads. Sometimes, a small surgical procedure under an anaesthetic to empty the uterus (D&C) may be recommended. However, mild symptoms do not always lead to a miscarriage. In many cases, the pregnancy will go on to produce a healthy baby.
Why does it happen?
It is common to blame yourself or feel guilty after a miscarriage. However, the loss of a pregnancy is rarely related to anything you have done. Stress, working and normal day to day activities have no proven link to miscarriage.
Miscarriage is usually just the body’s natural way of rejecting a pregnancy in trouble.
A miscarriage can be a very emotional experience, causing intense grief, sadness and anger. Talking to your partner, friends or doctor can help you come to terms with the loss.
When you are ready, wait till you have a normal period and try again. 95% of women who have a miscarriage go on to have a healthy baby.
YOUR TESTICLES. A USER’S GUIDE
The testicles are a pair of firm, oval-shaped glands that hang in a pouch of skin (scrotum) under the penis. They are also known as testes (single is testis) or ‘balls’.
Testicles make sperm for reproduction and testosterone, the male sex hormone.
What is normal?
Normal testicles come in a wide range of sizes and one is often a little larger than the other. Nearly all men have one testicle that hangs lower than the other - usually the left one.
Testicles are positioned outside the body because they work better when cooler. In cold weather and at times of stress they are pulled up closer to the body to keep warm.
Fertility matters
Infertility is not just a female problem. It also affects about 1 in 20 men, usually due to sperm that are low in number or poor quality. A semen sample can be examined under the microscope to see if the sperm are normal.
Sperm production can be reduced by damage to the testicle, for example from mumps, injury or torsion (twisting of the testicle).
Testicular cancer
Cancer of the testicle is rare but is most common in young men between 20-40 years. The first sign is usually a hard, painless lump, but there may be swelling, tenderness or pain.
Fortunately, testicular cancer responds well to treatment and, like the cycling champion Lance Armstrong, nearly all cases are cured.
Should I check myself regularly?
Testicle self-examination (TSE) for cancer is controversial. Most experts do not recommend it. There is no evidence that it increases the chance of survival from testicular cancer.
Cancer Council Australia recommends that men simply become familiar with the usual feel of their testicles. See you doctor promptly if you notice any change.
ECZEMA. THE DREADED WINTER ITCH
Eczema (atopic dermatitis) is a common, itchy skin condition which can make children miserable. It is often worst in winter.
Eczema usually starts in the first year of life in infants with dry, sensitive skin. Red, scaly, patches develop, typically on the face, fronts of elbows, backs of knees, wrists and ankles.
Children are born predisposed to eczema. However, the condition can be aggravated by overheating, soap, sand, wool, nylon, dust, perfumes and chlorinated pools. Food allergy may play a role in some children.
General skin care
Although there is no cure, eczema can usually be well controlled with good care.
- Wear cotton clothes (avoid wool, nylon)
- Use a bath oil in the bath every day
- Avoid soap, shampoo, bubble baths. Use ‘soap substitutes’ instead
- Use a moisturiser 1-2 x daily e.g. aqueous cream, glycerol 10% in sorbolene cream.
Are you afraid of steroid creams?
Steroid (cortisone) creams/ointments are the cornerstone of treatment for eczema. Used as directed they are very safe and effective.
However, some parents have unwarranted fears about side-effects, such as thinning of the skin, impaired growth and damage to the immune system. These problems are very uncommon with correct use.
Always start as soon as you see a red, scaly patch and stop when the rash clears.
Your doctor may advise a stronger cream for a flare-up, changing to a weaker preparation once the rash improves. Weaker steroids are generally used for the face, armpits and groin and more potent ones for other areas.
Another cream, pimecrolimus, is sometimes used for milder cases. In more severe eczema, wet wraps, ultraviolet light therapy and drugs to suppress the immune system may be tried.
www.eczema.org.auSEXUAL HEALTH. A GUIDE FOR ADOLESCENTS.
Sexually active teenagers should know these key facts about sexual health.
Contraception (preventing pregnancy)
Condoms are a good choice as they also provide protection from sexually transmitted infections. It is best to combine them with another contraceptive, such as the Pill.
The Pill is safe for young women and makes periods regular, lighter and less painful. However, it must be taken every day. Some girls prefer a long-acting method such as the
- Contraceptive implant (3 years)
- Vaginal ring (3 weeks per month) or
- Contraceptive injection (every 3 months)
Withdrawal or ‘pulling out’ before the man ‘comes’ or ejaculates can still lead to pregnancy and is not recommended.
Don’t forget ‘emergency contraception’ for a broken condom or missed pill. You can use it up to 5 days after sex but earlier is better.
Sexually transmitted infections (STIs)
Safer sex is about reducing the risk of STIs. This means using a condom with all new partners, at least until you are both tested.
Chlamydia is a very common STI and can lead to infertility. It usually does not cause symptoms. If you are sexually active and under 25 years, you should have a test every year.
Be sure to have your school immunisations: hepatitis B (boys & girls, 10-13) and HPV (girls 12-18). Girls also need a Pap smear every 2 years, starting 1-2 years after first intercourse.
For more information
Your GP is keen to help and can give you accurate advice. Remember, what you discuss with your GP is strictly confidential.
Most Australians do not eat enough dietary fibre (the part of plant food not digested in the small intestine).
Fibre has an impressive range of proven health benefits. It reduces the risk of diverticular disease, haemorrhoids and bowel cancer. It relieves constipation, lowers cholesterol and improves diabetes. High fibre foods are also filling and this can help with weight control.
Eat more wholegrain bread, high fibre cereals, fruits (with the skins), vegetables, brown rice, nuts, dried beans, lentils. Increase your fibre intake slowly.
www.goforyourlife.gov.vic.au
BANANA AND RAISIN BRAN MUFFINS
These high-fibre, low-fat muffins are great to freeze for school lunchboxes.
Makes 15. Time: 35 mins. Cost: 38c each.
Ingredients
Spray oil, if using non-stick pans
2 cups self-raising flour
2 cups unprocessed bran
¾ cup raisins; 3 bananas, mashed
1 teaspoon baking soda
1½ cups trim milk
50g reduced-fat spread (at least 60% fat)
6 tablespoons golden syrup
2 eggs, lightly beaten
Method
Step 1. Preheat oven to 190ºC. Spray pans with oil, if using.
Step 2. Place flour, bran, raisins and banana in a bowl. Dissolve baking soda in milk.
Step 3. Melt spread and golden syrup in a microwave or saucepan. Add liquid ingredients and eggs to dry ingredients. Mix until blended. Do not over-mix.
Step 4. Spoon into non-stick muffin pans. Bake for 15-20 minutes, or until skewer comes out clean.
Per serve: Energy 750kJ (179 cals), total fat 4g, sat fat 1g, fibre 4g
Source: Australian Healthy Food Guide
