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Refeeding Syndrome – Anorexia Nervosa

Refeeding Syndrome: Anticipation is Key

Refeeding syndrome has received much attention among medical professionals of late, particularly the surgeons. Being a rare syndrome, it is seen in 0.8% of hospitalized adults. However, its importance lies in the fact that mortality in hospitalized patients who develop severe hypophosphatemia (serum phosphate <1 mg/dL) is 30%. The syndrome was first described after the Second World War in Japanese prisoners of war taken by the United States in the Philippines.

It is commonly construed as a cause of serum abnormalities, and is typically characterized by hypophosphatemia. Phosphate is interestingly the most abundant intracellular anion, majority of which is found in bones. Hence, measured serum phosphate does not correlate with the total-body content of phosphate. The importance of phosphate lies in its biological importance – it is an important component of cell membrane as phospholipids, enzyme systems, and bone matrix. Cellular energy in the form of ATP has phosphate as a component.

Pathophysiology of Refeeding Syndrome

Refeeding syndrome typically occurs when enteral or parenteral nutrition is initiated in a patient with one of the high-risk factors such as prolonged malnutrition, gastrointestinal losses (as in vomiting, diarrhea, and nasogastric aspiration), chronic alcohol abuse, abdominal surgery, and metastatic cancer. Patients of anorexia nervosa are especially prone to developing this syndrome when started on an inappropriate diet.

Introduction of carbohydrate suddenly stimulates a release of insulin, which results in an intracellular shift of phosphate, potassium, and magnesium. This transcellular shift frequently occurs in the presence of reduced body stores of these key electrolytes. Refeeding syndrome should be anticipated if there is disturbance in any of the electrolytes cited above.

Clinical Presentation

A common manifestation in at risk population is respiratory failure secondary to diaphragm and intercostal muscle weakness as a result of ATP depletion. Acute respiratory failure in a spontaneously breathing patient or inability to wean a patient from mechanical ventilation should incite us to think of refeeding syndrome.

2,3-DPG deficiency results in impaired oxygen off-loading at the cellular level causing dyspnea and fatigue, further compromising respiration.

Generalized skeletal muscle weakness due to depleted ATP stores, ventricular dysrhythmias, left ventricular dysfunction, confusion, lethargy, and gait disturbances.

Refeeding syndrome usually starts 4 to 6 days following restarting of feeds.

Treatment Strategy in Refeeding Syndrome

Anticipating development in patients at risk holds the key to treatment of refeeding syndrome. In at-risk groups, refeeding should be introduced gradually. A rule of thumb to follow would be to begin with a one-half nutrition goal of 5,040 kilocalories and increasing by 840 kilocalories every 24 to 48 hours, with careful attention to serum electrolytes.

Moderate hypophosphatemia with serum levels of 1 to 2.5 mg/dL may be managed with oral or enteral replacement.

Severe or symptomatic hypophosphatemia mandates intravenous replacement. Sodium phosphate 0.16 to 0.32 mmol/kg administered over 4 to 6 hours is a practical way of correcting the deficiency. However, caution must be practiced in hypercalcemia and serum electrolytes monitored meticulously. Ionized calcium levels should be monitored as overzealous dosing of phosphate may result in hypocalcemia.

Juice Cleanses

The Latest Craze: Juice Cleanses and, Do they Work?

Juice cleanses—they're the latest celebrity endorsed detox fad to hit the market. While replacing solid foods with a liquid diet to increase weight loss and remove the body of toxins isn't really innovative (colon cleaners have been around forever), many health experts say that at the very least it's a healthier alternative to the “Master Cleanse”—a diet that requires consumers to have nothing more than glasses of water with a dash of maple syrup, cayenne pepper and lemon juice.

While it isn't proven that juice cleanses actually work (some experts even claim they're more trouble than they're worth since they can cause diarrhea and other gastrological problems), if you're going to attempt any kind of cleanse it's best to try a juice cleanse. This is because the fruits and vegetables in the “liquid” provide essential nutrients and vitamins that your body needs to thrive as well as provides adequate calories, so you can still preform your daily tasks without feel so sluggish.

Do note that your body already has “natural” detoxifiers—your liver, kidney and skin—and therefore you shouldn't expect a designer cleanse to create this huge transformation i.e. extreme weight loss. If anything, you need to use the cleanser as a way to jump-start your new motivation to have a lifestyle change and eat all the right foods forever after. Otherwise, going back to your junk-food eating ways will put you in the yo-yo dieter's category, and this type of dieting can actually have long lasting damaging effects.

So, formulate an entire health-plan to stay on track after the cleanse is completed. That said, below are some of the more popular cleanses you may be interested in looking into.

The Blue Print Cleanse

Cost: $58/Day

The Blue Print Cleanse, which is endorsed by Food and Wine magazine, requires its participants to drink one pint of juice, 6 times per day. Each bottle contains about 200 calories and comes in 16 different flavors like pineapple, apple, and mint; cashew nut milk, water, cinnamon and agave; and romaine, celery, cucumber, spinach, kale and parsley. While the drinks are unfortunately low in protein, they are low in fat and loaded with tons of antioxidants.

The iZo Cleanse

Cost: $100/Day

The Izo Cleanse, which is endorsed by actresses Emily Deschanel, Daisy Fuentes, and Patricia Heaton among others, requires its participants to drink one pint of its organic, vegan juice 12 times a day. Ingredients include fresh organic juice, oriental herbal tea and almond milk just to name a few. However, this might not be the best cleanse for those who are unfamiliar with exotic and “grassy” flavors.

The Cooler Cleanse

Cost: $58/Day

Lastly, the Cooler Cleanse,which get its name because the juices are delivered in a cooler filled with ice packs to your doorstep daily.  This cleanse requires its participants to drink six bottles of raw vegan juice and milk which total to about 1,200 to 1,400 calories a day. Again, these drinks are unfortunately low in protein but also low in fat. Some flavors include Grapefruit and Mint, Sweet Greens and Young Coconut Water just to name a few.

Coffee versus Tea

Health Benefits of Coffee Versus Tea – An Infographic

The long-drawn battle between Coffee and Tea never ends to claim the kingship of hot beverages! Yes, the battle is heated. And, interestingly with support from various health groups and researchers, there is a stalemate.

The health benefits of Coffee and Tea are not similar, however they have their own unique benefits.

Here we have below a very effective infographic which highlights the health benefits of tea versus coffee.

At first sight, there appears to be a lot going on. The graphics are calling out to you and it’s hard to miss the concentration of info which the designer wants us to absorb. It’s a longitudinal type of infographic with the information and charts laid out somewhat like a ticket.

The graph is created presumably with the intention of being progressive and in general it seems to work. The colours are kept reasonably basic with green, brown and reds. We can observe the relevant statistics pertaining to the two beverages with relative ease and there has been good use made of both graphs and pie charts.

As a result, we can cross reference the data and subsequently reach a conclusion based on the initial proposals of the argument. It’s a very user friendly analysis applicable to all ages.

I hope that this infographic gives you a healthy perspective of the two beverages and you be the judge. Choose who is the king of the hot beverages – TEA or COFFEE?

Let me know in the comments!

Click the Infographic to see the Big Picture!

Coffee Versus Tea

Infographic produced by insurance advisors, Policy Expert. Covering home, business, travel, motoring and many other types of insurance

Food Allergies

You and Multiple Food Allergies: How to Overcome

Understanding what an Allergy is?

The first step in overcoming food allergies centers on identifying the responsible food allergen. You need to identify the foods to which you are sensitive so that you can free yourself from common allergens. This may take some time and a possible trip to the doctor’s office. In the meantime, try to maintain a food journal to note your body’s reactions to the food products that you eat.

An allergy is caused when your body is repeatedly exposed to items which lead to symptoms or an allergic response. Roughly, food intolerances can be divided into four categories: fructose, dairy, yeast sensitivity and gluten intolerance. Some of the most common symptoms of an allergic reaction may include bed wetting, ear fluid, canker sores or bowel problems.

Identify the Food Allergens

In order to determine the way your body reacts to the different types of foods to avoid, reintroduce one food item a day. Note down any sort of reactions or symptoms in your food journal that you feel when the food is introduced in your diet.

One important thing that you should always keep in mind is that if any symptom arises as a result of introducing one of the avoided foods, then wait for sometime before introducing the next set of food into your diet. Make sure the symptoms caused by the previous food product are completely gone otherwise you’ll end up identifying some other food product for your allergy. However, in case the symptoms become chronic or severe, then immediately consult your doctor.

Take Anti-Inflammatory Foods or Food Supplements

It has been observed that food sensitivity or food allergy often leads to inflammation. The most common signs of inflammation due to food sensitivity are pain, edema or even arthritic symptoms after ingesting a particular food or food group. In that case, taking anti-inflammatory foods or food supplements can be of great help. Aloe vera, cabbage, bromelain (extracted from pineapples) and turmeric are very effective in counteracting inflammation and also helps your body in digesting these foods.

Do the Investigation

Next, you have to start maintaining distance from the problem food, the best way to do so by stopping their entry into your house. None of these problem foods are going to end up in your diet if you don’t have them in your kitchen.

You can even accidently buy or eat any of the problem food, so read the labels carefully when you are shopping. For instance, those who have an allergy from gluten should stay away from processed food because gluten seems to be hidden in most of them. If you have allergy from lactose, then also you should avoid processed food because milk which contains lactose is one of the common ingredients in most of these food items. If the label says that the product is processed on the same equipment as the nuts are, then it’s better to avoid that product in case you are intolerant to nuts.

Sometimes, the culprit may not appear on the label, for instance, gluten may not be shown to be present in a cereal which includes malt. However, the cereal may include malt which is derived from barley and gluten is present in barley. So we will suggest you to do some investigation online to find out the hidden culprits.

Avoid Substances known to Negatively affect Digestion

If you are having a food allergy, then it’s better for you to stay away from substances which are known to negatively affect the digestion, otherwise, it will worsen the symptoms. Some of these substances are drugs, alcohol, caffeine, chemicals, colorants, sugar, food additives, stimulants and even artificial sweetener. Your digestive system will work properly if these substances are not introduced in your diet.

Resolving Allergy related to Fats

If you are having problems in digesting fat, then we will suggest you to take the digestive enzyme supplement, lipase. For instance, if you face problems in digesting eggs but at the same time you have no problem with proteins, then it means that you have an allergy from fat. You can resolve the problem and help your digestive system in processing fats by taking lipase.

Resolving Allergy related to Proteins

If you are having problems in digesting proteins, then taking digestive enzyme supplement trypsin or pepsin can resolve the problem. Allergy from proteins is identified when you start having trouble in digesting chicken or beef, or any type of protein-rich food. This problem can be corrected by adding one of the above mentioned digestive enzyme supplements in your diet.

However, some people have trouble in digesting both protein and fat, in that case supplementing your diet with herbal bitters such as L-carnitine or Swedish Bitters can help you out.

Resolving Allergy related to Carbohydrates

Allergy from carbohydrates can be corrected by taking digestive enzyme supplements containing amylase. Some people tend to suffer from gas and bloating because of carbohydrates. This indicates food sensitivity to carbohydrates.

Add Herbal Tea to your Diet

Herbal teas such as ginger, licorice and mint are very effective in overcoming food allergies. Try to drink a cup of herbal tea after each meal; this helps you in improving your digestive system.

The Final Word

Overcoming a food allergy is certainly not an easy task; you need to administer a lot of care while deciding your diet. Avoiding certain food items can deprive your body of essential nutrient which can lead to further problems. However, you can try to reintroduce the food in your diet sometime later. Eat a small amount once a day and if you don’t face any problems then eat a small amount of it a week later. If you no longer have problems, then you can gradually add more over time. However, if the food causes a flare-up of any of the symptoms, then it’s better to eliminate that food from your diet.

Getting to know about the Author: Alia is a blogger by profession. She loves writing on luxury and Designer Rugs. Beside this she is very particular about her fitness and exercise daily to stay in shape. She frequently writes articles related to plastic pollution for her blog Ecofriend.

Also read Great “Pregnancy Exercise: Low-Impact Aerobics” by the Author

Hair Loss Treatment

Stress And Hair Loss Or Stressed About Hair Loss?

Hair loss is one of those issues that can present at any age or stage in life. It is also something that can readily happen to both men and women. Though some hair loss is a direct result of medical condition, others are caused by the side effects of medication such as chemotherapy; some people suffer hair loss when they have been medically cleared as being fit and in good overall health. This is when you need to consider external and environmental factors as being associated and responsible for hair loss.

Situational Hair Loss

Hair loss can occur for women who over-process their hair through the use of bleach, chemicals, straighteners and other hot styling tools. This, over time, can cause the hair to weaken and thus result in lost patches of hair. Though this type of hair loss is somewhat self inflicted and can be reversed, the time you need to re-grow hair can be long and bothersome. This is one instance where use of wigs and hair pieces/extensions can be useful as the hair is being re-grown.

Stress Can Be A Contributing Factor

It has been proven that one of the side effects of stress in one's life can be hair loss. The hair needs to have a healthy support system, such as proper nutrition, good sleep, proper blood flow and a relaxed demeanor. When these issues all become compromised due to stress, one can begin to experience bouts of hair loss. When stress is an overt concern and issue in your life, and you are making strides to reduce stress; you may still need to deal with the results of hair loss that stress has brought about. This too is a case where the time it takes to regrow can be lengthy, and you want to find a hair replacement option so you can still look your best even though you have lost your hair.

Permanent Hair Loss Options

For those who have lost hair due to stress, and are actually becoming increasingly anxious, concerned and overwhelmed by their appearance; having a permanent hair transplant solution can help in improving the overall state of mind. The way you look has a direct impact in your mental health and well being, and those who are having a very hard time handling hair loss due to stress may find themselves actually losing even more hair as their stress level continues to rise every time they notice more hair falling out.

By having hair transplants performed, you can get back to looking your best and having a better self image. This can be beneficial to those who are battling repeated issues with stress, and one of the ways to lower your stress level is by looking and feeling your best. Hair transplants can become one of the tricks you can use to get back to feeling your absolute best and projecting a healthy and happy image to others. You can have hair transplants done in small areas or all over your head, depending on the extent of hair loss you have suffered due to stress.

If you wish to read further about hair loss and its treatment, check out another article “Hair Loss Treatment – Boost up your Confidence for Living a Better Life

Hair Loss Treatment

Hair Loss Treatment – Boost up your Confidence for Living a Better Life

Is your hair loss problems causing you unlimited sufferings? Is it making you lose your precious confidence, especially when it comes to standing in the front to raise your voice? Well, hair loss can be surely a big hurdle and can go against your growth in life. Therefore, you should go for a hair loss treatment before it becomes too late and baldness becomes visible.

Well, before going for a hair loss treatment, you must go for knowing the reason behind the hair fall at first.

Reasons behind Hair Loss

  •  Genetic problems: Most of the time hair fall problems come into your blood with your genes. Yes, you inherit these types of problems, from your bloodline and with growing age, you start witnessing such problems. If these problems are not cured in the earlier stage, facing baldness becomes obvious for you.
  • Hormonal changes: Especially, in women, hair fall problems become visible with hormonal changes. When the body hormone changes with the growing age, becoming bald turns into the tendency of women.
  • Medicinal over dosages: Sometimes, some of the medical treatments, when come along with high dosages of medicines, affect upon your hair and increases hair fall problems.
  • Bad food habits: Preservatives added to food can effect upon your hair to reduce it.
  • Stress and work pressure: In today’s busy life, where too much of stress, work pressure and tension become a part of your busy life, loosing hair at a massive rate becomes quite obvious for all.

Well, all these hair fall problems can definitely lead you towards baldness in a an easy way and once you witness hair fall problems, you must go for the right hair fall treatment for you.

Hair fall treatment to reduce hair fall problems

  • Take care of your hair: Proper care of the hair is the first thing that you can do, when you are going for treating your hair fall problems. You must brush up and clean your hair on a regular basis. Go for shampooing and conditioning your hair to get better results in a better way.
  • Go for scalp massage: Going for a scalp massage will definitely help you to stop hair fall problems. It increases the blood supply into the capillaries and reaches proper nutrients to the hair, so that hair fall signs can be reduced to a minimum.
  • Go to a doctor: Going to a doctor is a good thing that you can opt for, when you are facing hair fall troubles. Yes, they are the best people, who help you to know the best way, using which you can go for reducing your hair fall problems.
  • Go for hair transplantation: Replacing your hair with the artificial ones, is the latest way to get back all your lost hairs and lead a confident life again. It will definitely help you get the look you want.

So, what are waiting for? Go for a hair loss treatment now, because you must look good and live the best life that you can.