Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.^[1][2] Body mass index (BMI), a measurement which compares weight and height, defines people as overweight (pre-obese) if their BMI is between 25 kg/m² and 30 kg/m², and obese when it is greater than 30 kg/m².^[3]

Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, breathing difficulties during sleep, certain types of cancer, and osteoarthritis.^[2] Obesity is most commonly caused by a combination of excessive dietary calories, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.^[4][5]

Dieting and physical exercise are the mainstays of treatment for obesity. Moreover, it it important to improve diet quality by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fiber (Bhargava and Guthrie, 2002; Bhargava, 2006). To supplement this, or in case of failure, anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption. In severe cases, surgery is performed or an intragastric balloon is placed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.^[6][7]

Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century.^[8] Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.^[2][9]

Classification

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health.^[1] It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors.^[10][11] BMI is closely related to both percentage body fat and total body fat.^[12]

 

A “super obese” male with a BMI of 47 kg/m²: weight 146 kg (322 lb), height 177 cm (5 ft 10 in)

In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number, but in relation to a historical normal group, such that obesity is a BMI greater than the 95th percentile.^[13] The reference data on which these percentiles are based are from 1963 to 1994, and thus have not been affected by the recent increases in weight.^[14]

BMI is calculated by dividing the subject’s mass by the square of his or her height, typically expressed either in metric or US “customary” units:

Metric: BMI = kilograms / meters²

US customary and imperial: BMI = lb * 703 / in²

where lb is the subject’s weight in pounds and in is the subject’s height in inches.

The most commonly used definitions, established by the World Health Organization (WHO) in 1997 and published in 2000, provide the values listed in the table at right.^[3]

Some modifications to the WHO definitions have been made by particular bodies. The surgical literature breaks down “class III” obesity into further categories whose exact values are still disputed.^[15]

• Any BMI ≥ 35 or 40 is severe obesity
• A BMI of ≥ 35 or 40–44.9 or 49.9 is morbid obesity
• A BMI of ≥ 45 or 50 is super obese

As Asian populations develop negative health consequences at a lower BMI than Caucasians, some nations have redefined obesity; the Japanese have defined obesity as any BMI greater than 25^[16] while China uses a BMI of greater than 28.^[17]

Effects on health

Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, and osteoarthritis.^[2] As a result, obesity has been found to reduce life expectancy.^[2]

Mortality

Relative risk of death for men (left) and women (right) in the United States by BMI.[18]

Obesity is one of the leading preventable causes of death worldwide.^[8][19][20] Large-scale American and European studies have found that mortality risk is lowest at a BMI of 22.5–25 kg/m^2[21] in non-smokers and at 24–27 kg/m² in current smokers, with risk increasing along with changes in either direction.^[22][23] A BMI above 32 has been associated with a doubled mortality rate among women over a 16-year period.^[24] In the United States obesity is estimated to cause an excess 111,909 to 365,000 death per year,^[2][20] while 1 million (7.7%) of deaths in the European Union are attributed to excess weight.^[25][26] On average, obesity reduces life expectancy by six to seven years:^[2][27] a BMI of 30–35 reduces life expectancy by two to four years,^[21] while severe obesity (BMI > 40) reduces life expectancy by 10 years.^[21]

See also

• Maternal obesity

Notes

1. ^ ^{a b} WHO 2000 p.6
2. ^ ^{a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai} Haslam DW, James WP (2005). “Obesity”. Lancet 366 (9492): 1197–209. doi:10.1016/S0140-6736(05)67483-1. PMID 16198769.
3. ^ ^{a b} WHO 2000 p.9
4. ^ Kushner, Robert (2007). Treatment of the Obese Patient (Contemporary Endocrinology). Totowa, NJ: Humana Press. pp. 158. ISBN 1-59745-400-1. http://books.google.com/?id=vWjK5etS7PMC&pg=PA121&lpg=PA121&dq=measurement+of+metabolism+in+obese+Bessesen. Retrieved April 5, 2009.
5. ^ ^{a b} Adams JP, Murphy PG (July 2000). “Obesity in anaesthesia and intensive care”. Br J Anaesth 85 (1): 91–108. doi:10.1093/bja/85.1.91. PMID 10927998. http://bja.oxfordjournals.org/cgi/content/full/85/1/91.
6. ^ NICE 2006 p.10–11
7. ^ ^{a b} Imaz I, Martínez-Cervell C, García-Alvarez EE, Sendra-Gutiérrez JM, González-Enríquez J (July 2008). “Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis”. Obes Surg 18 (7): 841–6. doi:10.1007/s11695-007-9331-8. PMID 18459025.
8. ^ ^{a b} Barness LA, Opitz JM, Gilbert-Barness E (December 2007). “Obesity: genetic, molecular, and environmental aspects”. Am. J. Med. Genet. A 143A (24): 3016–34. doi:10.1002/ajmg.a.32035. PMID 18000969.
9. ^ ^{a b c d e} Woodhouse R (2008). “Obesity in art: A brief overview”. Front Horm Res 36: 271–86. doi:10.1159/000115370. ISBN 9783805584296. PMID 18230908. http://books.google.com/?id=nXRU4Ea1aMkC&pg=PA271&lpg=PA271&dq=Obesity+in+art:+a+brief+overview.
10. ^ Sweeting HN (2007). “Measurement and definitions of obesity in childhood and adolescence: A field guide for the uninitiated”. Nutr J 6: 32. doi:10.1186/1475-2891-6-32. PMID 17963490. PMC 2164947. http://www.nutritionj.com/content/6/1/32.

Colorectal cancer, also called colon cancer or large bowel cancer, includes cancerous growths in the colon, rectum and appendix. With 655,000 deaths worldwide per year, it is the fourth most common form of cancer in the United States and the third leading cause of cancer-related death in the Western world.^[1][2] Colorectal cancers arise from adenomatous polyps in the colon. These mushroom-shaped growths are usually benign, but some develop into cancer over time. Localized colon cancer is usually diagnosed through colonoscopy.

Invasive cancers that are confined within the wall of the colon (TNM stages I and II) are curable with surgery. If untreated, they spread to regional lymph nodes (stage III), where up to 73% are curable by surgery and chemotherapy. Cancer that metastasizes to distant sites (stage IV) is usually not curable, although chemotherapy can extend survival, and in rare cases, surgery and chemotherapy together have seen patients through to a cure.^[3] Radiation is used with rectal cancer.

On the cellular and molecular level, colorectal cancer starts with a mutation to the Wnt signaling pathway. When Wnt binds to a receptor on the cell, that sets in motion a chain of molecular events that ends with β-catenin moving into the nucleus and activating a gene on DNA. In colorectal cancer, genes along this chain are damaged. Usually, a gene called APC, which is a “brake” on the Wnt pathway, is damaged. Without a working APC brake, the Wnt pathway is stuck in the “on” position.^[3]

Signs and symptoms

The symptoms of colorectal cancer depend on the location of tumor in the bowel, and whether it has spread elsewhere in the body (metastasis). Most of the symptoms may occur in other diseases as well, and hence none of the symptoms mentioned here is diagnostic of colorectal cancer. Symptoms and signs are divided into local, constitutional (affecting the whole body) and metastatic (caused by spread to other organs).

Local

Local symptoms are more likely if the tumor is located closer to the anus. There may be a change in bowel habit (new-onset constipation or diarrhea in the absence of another cause), and a feeling of incomplete defecation (rectal tenesmus) and reduction in diameter of stool; tenesmus and change in stool shape are both characteristic of rectal cancer. Lower gastrointestinal bleeding, including the passage of bright red blood in the stool, may indicate colorectal cancer, as may the increased presence of mucus. Melena, black stool with a tarry appearance, normally occurs in upper gastrointestinal bleeding (such as from a duodenal ulcer), but is sometimes encountered in colorectal cancer when the disease is located in the beginning of the large bowel.

A tumor that is large enough to fill the entire lumen of the bowel may cause bowel obstruction. This situation is characterized by constipation, abdominal pain, abdominal distension and vomiting. This occasionally leads to the obstructed and distended bowel perforating and causing peritonitis. A large left colonic tumour may compress the left ureter and cause hydronephrosis.

Certain local effects of colorectal cancer occur when the disease has become more advanced. A large tumor is more likely to be noticed on feeling the abdomen, and it may be noticed by a doctor on physical examination. The disease may invade other organs, and may cause blood or air in the urine (invasion of the bladder) or vaginal discharge (invasion of the female reproductive tract).

Constitutional

If a tumor has caused chronic occult bleeding, iron deficiency anemia may occur; this may be experienced as fatigue, palpitations and noticed as pallor (pale appearance of the skin). Colorectal cancer may also lead to weight loss, generally due to a decreased appetite.

More unusual constitutional symptoms are an unexplained fever and one of several paraneoplastic syndromes. The most common paraneoplastic syndrome is thrombosis, usually deep vein thrombosis.

See also

• Hereditary nonpolyposis colorectal cancer
• Diet and cancer
• Bowel & Cancer Research
• Mouse models of colorectal and intestinal cancer

References

Hepatitis (plural hepatitides) is an inflammation of the liver characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar (ἧπαρ), the root being hepat- (ἡπατ-), meaning liver, and suffix -itis, meaning “inflammation” (c. 1727).^[1] The condition can be self-limiting (healing on its own) or can progress to fibrosis (scarring) and cirrhosis.

Hepatitis may occur with limited or no symptoms, but often leads to jaundice, anorexia (poor appetite) and malaise. Hepatitis is acute when it lasts less than six months and chronic when it persists longer. A group of viruses known as the hepatitis viruses cause most cases of hepatitis worldwide, but it can also be due to toxins (notably alcohol, certain medications and plants), other infections and autoimmune diseases.

Signs and symptoms

[edit] Acute

Initial features are of nonspecific flu-like symptoms, common to almost all acute viral infections and may include malaise, muscle and joint aches, fever, nausea or vomiting, diarrhea, and headache. More specific symptoms, which can be present in acute hepatitis from any cause, are: profound loss of appetite, aversion to smoking among smokers, dark urine, yellowing of the eyes and skin (i.e., jaundice) and abdominal discomfort. Physical findings are usually minimal, apart from jaundice in a third and tender hepatomegaly (swelling of the liver) in about 10%. Some exhibit lymphadenopathy (enlarged lymph nodes, in 5%) or splenomegaly (enlargement of the spleen, in 5%).^[2]

Acute viral hepatitis is more likely to be asymptomatic in younger people. Symptomatic individuals may present after convalescent stage of 7 to 10 days, with the total illness lasting 2 to 6 weeks.^[3]

A small proportion of people with acute hepatitis progress to acute liver failure, in which the liver is unable to clear harmful substances from the circulation (leading to confusion and coma due to hepatic encephalopathy) and produce blood proteins (leading to peripheral edema and bleeding). This may become life-threatening and occasionally requires a liver transplant.

[edit] Chronic

Chronic hepatitis often leads nonspecific symptoms such as malaise, tiredness and weakness, and often leads to no symptoms at all. It is commonly identified on blood tests performed either for screening or to evaluate nonspecific symptoms. The occurrence of jaundice indicates advanced liver damage. On physical examination there may be enlargement of the liver.^[4]

Extensive damage and scarring of liver (i.e. cirrhosis) leads to weight loss, easy bruising and bleeding tendencies, peripheral edema (swelling of the legs) and accumulation of ascites (fluid in the abdominal cavity). Eventually, cirrhosis may lead to various complications: esophageal varices (enlarged veins in the wall of the esophagus that can cause life-threatening bleeding) hepatic encephalopathy (confusion and coma) and hepatorenal syndrome (kidney dysfunction).

Acne, abnormal menstruation, lung scarring, inflammation of the thyroid gland and kidneys may be present in women with autoimmune hepatitis.^[4]

Alcoholic hepatitis

Ethanol, mostly in alcoholic beverages, is a significant cause of hepatitis. Usually alcoholic hepatitis comes after a period of increased alcohol consumption. Alcoholic hepatitis is characterized by a variable constellation of symptoms, which may include feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests. Alcoholic hepatitis can vary from mild with only liver test elevation to severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure. Severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories is 50% within 30 days of onset.

Alcoholic hepatitis is distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. Patients who drink alcohol to excess are also more often than others found to have hepatitis C.^{[citation needed]} The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis.

Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is the occurrence of fatty liver in people who have no history of alcohol use. It is most commonly associated with obesity (80% of all obese people have fatty liver). It is more common in women. Severe NAFLD leads to inflammation, a state referred to as non-alcoholic steatohepatitis (NASH), which on biopsy of the liver resembles alcoholic hepatitis (with fat droplets and inflammatory cells, but usually no Mallory bodies).

The diagnosis depends on medical history, physical exam, blood tests, radiological imaging and sometimes a liver biopsy. The initial evaluation to identify the presence of fatty infiltration of the liver is medical imaging, including such ultrasound, computed tomography (CT), or magnetic resonance (MRI). However, imaging cannot readily identify inflammation in the liver. Therefore, the differentiation between steatosis and NASH often requires a liver biopsy. It can also be difficult to distinguish NASH from alcoholic hepatitis when the patient has a history of alcohol consumption. Sometimes in such cases a trial of abstinence from alcohol along with follow-up blood tests and a repeated liver biopsy are required.

NASH is becoming recognized as the most important cause of liver disease second only to hepatitis C in numbers of patients going on to cirrhosis.^{[citation needed]}

Ischemic hepatitis

Ischemic hepatitis is caused by decreased circulation to the liver cells. Usually this is due to decreased blood pressure (or shock), leading to the equivalent term “shock liver”. Patients with ischemic hepatitis are usually very ill due to the underlying cause of shock. Rarely, ischemic hepatitis can be caused by local problems with the blood vessels that supply oxygen to the liver (such as thrombosis, or clotting of the hepatic artery which partially supplies blood to liver cells). Blood testing of a person with ischemic hepatitis will show very high levels of transaminase enzymes (AST and ALT), which may exceed 1000 U/L. The elevation in these blood tests is usually transient (lasting 7 to 10 days). It is rare that liver function will be affected by ischemic hepatitis.

See also

• World Hepatitis Day
• Hepatocellular carcinoma

References

Pneumonia is an inflammatory condition of the lung.^[1] It is often characterized as including inflammation of the parenchyma of the lung (that is, the alveoli) and abnormal alveolar filling with fluid (consolidation and exudation).^[2]

The alveoli are microscopic air filled sacs in the lungs responsible for gas exchange. Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs. Its cause may also be officially described as unknown when infectious causes have been excluded.

Typical symptoms associated with pneumonia include cough, chest pain, fever, and difficulty in breathing. Diagnostic tools include x-rays and examination of the sputum. Treatment depends on the cause of pneumonia; bacterial pneumonia is treated with antibiotics.

Pneumonia is common, occurring in all age groups, and is a leading cause of death among the young, the old, and the chronically ill.^[3] Vaccines to prevent certain types of pneumonia are available. The prognosis depends on the type of pneumonia, the treatment, any complications, and the person’s underlying health.

Pneumonia can be caused by microorganisms, irritants and unknown causes. When pneumonias are grouped this way, infectious causes are the most common type. The symptoms of infectious pneumonia are caused by the invasion of the lungs by microorganisms and by the immune system‘s response to the infection. Although more than one hundred strains of microorganism can cause pneumonia, only a few are responsible for most cases. The most common causes of pneumonia are viruses and bacteria. Less common causes of infectious pneumonia are fungi and parasites.

Signs and symptoms

Pneumonia fills the lung’s alveoli with fluid, keeping oxygen from reaching the bloodstream. The alveolus on the left is normal, while the alveolus on the right is full of fluid from pneumonia.

Main symptoms of infectious pneumonia, click play to hear the sounds of an actual Pneumonia Patient.

	Crackles Crackles heard in the lungs of a person with pneumonia using a stethoscope.
Problems listening to this file? See media help.

People with infectious pneumonia often have a cough producing greenish or yellow sputum, or phlegm and a high fever that may be accompanied by shaking chills. Shortness of breath is also common, as is pleuritic chest pain, a sharp or stabbing pain, either experienced during deep breaths or coughs or worsened by them. People with pneumonia may cough up blood, experience headaches, or develop sweaty and clammy skin. Other possible symptoms are loss of appetite, fatigue, blueness of the skin, nausea, vomiting, mood swings, and joint pains or muscle aches. Less common forms of pneumonia can cause other symptoms; for instance, pneumonia caused by Legionella may cause abdominal pain and diarrhea, while pneumonia caused by tuberculosis or Pneumocystis may cause only weight loss and night sweats. In elderly people, manifestations of pneumonia are seldom typical. They may develop a new or worsening confusion (delirium) or may experience unsteadiness, leading to falls. Infants with pneumonia may have many of the symptoms above, but in many cases they are simply sleepy or have a decreased appetite.^[9]

See also

• List of pneumonia victims

References

1. ^ pneumonia at eMedicine Dictionary
2. ^ pneumonia at Dorland’s Medical Dictionary
3. ^ “Causes of death in neonates and children under five in the world (2004)”. World Health Organization.. 2008. http://www.who.int/entity/child_adolescent_health/media/causes_death_u5_neonates_2004.pdf.
4. ^ ^{a b c d} Table 13-7 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). Robbins Basic Pathology (8th ed.). Philadelphia: Saunders. ISBN 1-4160-2973-7.
5. ^ “UpToDate Inc.”. http://www.uptodate.com/online/content/topic.do?topicKey=pedi_id/18313&selectedTitle=1~1&source=search_result.
6. ^ Krause DC, Balish MF (February 2004). “Cellular engineering in a minimal microbe: structure and assembly of the terminal organelle of Mycoplasma pneumoniae”. Mol. Microbiol. 51 (4): 917–24. doi:10.1046/j.1365-2958.2003.03899.x. PMID 14763969.
7. ^ Girard TD, Bernard GR (March 2007). “Mechanical ventilation in ARDS: a state-of-the-art review”. Chest 131 (3): 921–9. doi:10.1378/chest.06-1515. PMID 17356115.

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The Nutrimeal ™ meal replacement drink mix is a lowglycemic, balanced mealrelacementdrink that includesquality proteins, carbohydrates,dietary fiber, and manymicronutrients.Who can Benefit• People whose lifestyle isfast-paced and very active• People who desire toachieve and maintain their ideal weightWhy USANA’s Nutrimeal• Nutrimeal is low glycemic with an index score of only 23.• High in fiber and low in saturated fat• Provides 15 grams of protein.• Ingredients promote sustained energy.How to UseFor a rich and creamy shake, combine (3) three scoops with10-12 ounces of cold water to taste, and throughly mix in ablender or blender bottle for 45 seconds..

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Health Basics

• 8 grams of dietary fiber
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Nutrimeal Difference

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Did You Know?

• Nutrimeal has a low-glycemic index to help reduce carbohydrate cravings and provide sustained energy and greater satiety throughout the day.*

Dutch Chocolate Nutrimeal
Fast food or no food. Too often this is a choice we’re forced to make. We know you want exceptional nutrition in everything you eat. We also know that you are incredibly busy. Between work, exercise, and a list of errands a mile long, the last thing you want to do in the morning before you run out the door is cook breakfast! But breakfast is where a healthy lifestyle begins. That’s why USANA developed tasty and convenient Nutrimeal™ shakes.

They are low glycemic, meaning that the ingredients are formulated to produce only small fluctuations in blood glucose levels for sustained energy and to keep you satisfied longer. Each serving of Nutrimeal contains 8 grams of dietary fiber, which can help maintain a healthy heart and circulatory system. Each serving also provides 15 grams of soy, whey, and other proteins. Soy helps maintain cardiovascular health, diastolic blood pressure, and HDL-cholesterol levels, provided they are healthy to begin with. Soy protein is a complete protein, containing all of the essential amino acids in optimal ratios and in a highly digestible form. Whey protein, which is also easily digestible, is an excellent source of amino acids essential for building a healthy body. Try the rich flavor of Dutch Chocolate for breakfast, or any time you want a healthy meal you shake!

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212- Nutrimeal™ Wild Strawberry

Health Basics

• 8 grams of dietary fiber
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Nutrimeal Difference

• Free of artificial flavors and sweeteners

Did You Know?

• Nutrimeal has a low-glycemic index to help reduce carbohydrate cravings and provide sustained energy and greater satiety throughout the day.*

Wild Strawberry Nutrimeal
Fast food or no food. Too often this is a choice we’re forced to make. We know you want exceptional nutrition in everything you eat. We also know that you are incredibly busy. Between work, exercise, and a list of errands a mile long, the last thing you want to do in the morning before you run out the door is cook breakfast! But breakfast is where a healthy lifestyle begins! That’s why USANA developed tasty and convenient Nutrimeal™ shakes.

They are low glycemic meaning that the ingredients are formulated to produce only small fluctuations in blood glucose levels for sustained energy to keep you satisfied longer. Each serving of Nutrimeal contains 8 grams of dietary fiber, which can help maintain a healthy heart and circulatory system. Each serving also provides 15 grams of soy, whey, and other proteins. Soy helps maintain cardiovascular health, diastolic blood pressure, and HDL-cholesterol levels, provided they are healthy to begin with. Soy protein is a complete protein, containing all of the essential amino acids in optimal ratios and in a highly digestible form. Whey protein, which is also easily digestible, is an excellent source of amino acids essential for building a healthy body. Try the sweet flavor of Wild Strawberry Nutrimeal for breakfast, or any time you want a healthy meal you shake!

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About | Human Body | Degenerative Diseases | Multimedia

Nutritional Concept, The Enterprise Center – HSBC Bldg., Makati City, Philippines 1200
Customer Service: Click here for inquiry
For administrative purposes only. Not a direct contact to a doctor. The information on this site is provided for educational and entertainment purposes only. It is not intended as a substitute for professional advice of any kind.
Please address your comments/inquiry in English.
© 2009 – 2010 . All Rights Reserved.

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Healthy Lifestyle

Dr. Ray Strand

(Specialist in Nutritional Medicine)

Health Concepts – Overview

Our first thought when we become hurt or ill is to immediately turn to medication hoping for relief of our problem or symptoms.

Few of us, however, seriously consider the poor lifestyle habits that may be the underlying cause of the problem. Excessive weight alone may account for painful knees, painful hips, high blood pressure, diabetes, increases in reflux acid symptoms, and fatigue. Smoking causes increased risks in high blood pressure, heart disease, emphysema, and lung cancer. Poor eating habits contribute to high cholesterol, high blood pressure, and diabetes. Lack of physical activity can lead to osteoporosis, obesity, diabetes, high blood pressure, decreased immune function, and high stress levels. When people come to the physician’s office for help after developing these problems, invariably they are placed on medication while little attention is given to the underlying lifestyle that may be the main culprit.

Attitudes are changing. I believe the pendulum is swinging toward a more proactive approach to improve one’s lifestyle with less reliance on medication. Dr. Mark Nelson reported in the American Journal of Hypertension that 42% of patients with hypertension could get off their medication if they would follow simple lifestyle changes. Growing medical evidence is showing us that heart disease; cancer, diabetes, elevated cholesterol, osteoporosis, and several other diseases may be prevented or even reversed by healthy lifestyles.

Still, there is tremendous confusion in the arena of wellness and preventive medicine today. Every individual who makes a decision to change his or her lifestyle will find confusing and conflicting information. It’s frustrating for those who have spent time and effort in trying to learn what they need to do to accomplish this goal.

The American public has long displayed an avid interest in the relations of diet and health, and its expectations for guidelines on nutrition and exercise are becoming more and more sophisticated. With just a little encouragement, approximately 80% of my patients choose to make healthy lifestyle changes that may improve their underlying medical condition or protect their health.

However, the authority whom patients most wish to consult for this information and guidance; their physician, usually remains insufficiently informed about the role of diet, exercise, and nutritional supplementation in the prevention and treatment of these diseases.

I have spent the last 7 years studying the medical literature in regards to what patients can do to. protect their health. I have applied these principles in my clinical practice that now focuses on nutritional medicihe.

It has become apparent to me during my research that there are three distinct aspects to a healthy lifestyle that are all needed to offer you the absolute best protection for your health: 1. A healthy diet, 2. A ‘modest exercise program, and 3. High quality, complete and balanced nutritional supplements. When you make one or two of these lifestyle changes, I guarantee your health will definitely improve. However, when you make all three lifestyle changes the results are phenomenal.

Traditional Preventive Medicine

The health care community likes to pride itself in the fact that it promotes preventive care. Physicians encourage patients to have roytine physicals in order to maintain health. However, a closer look quickly leads one to conclude that physicians are primarily trying to detect disease earlier. Pap smears; PSA’s, mammograms, blood work, and physical exams are merely trying to find a silent disease the patient may already have. Obviously the earlier you detect diseases the better it is for you, btit nothing has been prevented.

By following the simple guidelines detailed here under Health Concepts in this booklet, you can take charge of maintaining your health. Choose to enjoy the life God has given you. This choice

requires motivation and commitment, but unlike prescription medicine, the benefits far outweigh the risk and you can practice true prevention. Make the right changes–ones that truly provide you with desired health benefits.

Health Benefits of a Healthy Diet

•             Weight loss

•             Decreased risk of diabetes

•             Decreased risk of heart disease

•             Decreased risk of almost all cancers

•             Decreased risk of high blood pressure

•             Lower cholesterol levels

•             Enhanced immune system

•             Increased sensitivity to insulin

•             Increased energy and ability to concentrate

What we eat has an enormous affect on our overall health. Thousands of studies support the idea that diet is highly correlated with the risk of developing various chronic degenerative diseases. Food is our greatest drug. It can either be used incorrectly and cause great problems or when used correctly, will protect our health.

Recent studies have shown that by eating a healthy diet and exercising moderately we can significantly reduce the risk of developing diabetes, heart disease, cancer, and host of other chronic degenerative diseases. When you add cellular nutrition to this healthy diet and modest exercise program, you give yourself the absolute best chance of protecting your health or regaining your health if you have already lost it. The diet I recommend will take into consideration all of these diseases. If you already are suffering from one of these chronic degenerative diseases, it will offer you the best of hope of regaining your health.

Carbohydrates

Carbohydrates are simply long chains of sugars that are released at various rates in our bodies. These include foods like fruits, vegetables, grains, and sugars. It has been assumed for the past one hundred years that the more simple the sugar, i.e. table sugar, candy, or soda pop one consumes, the faster the sugar is absorbed into the blood stream and the quicker one’s blood sugar rises. This has given rise to the concept of simple sugars versus complex sugars (having long sugar chains). Medical research has since shown us that this theory was totally wrong. In the past 20 years, medical evidence now suggests the most important consideration is the glycemic index. Few of us realize that highly processed carbohydrates like white bread, white flour, rice, and pasta also release their sugars faster than table sugar. These foods are considered high-glycemic carbohydrates, because they release their sugars very quickly into our blood stream.

On the other hand, carbohydrates such as: cauliflower, beans, asparagus, apples, oranges, and grapes release their sugars more slowly, thus keeping blood sugars from spiking. These are considered low-glycemic carbohydrates. These carbohydrates also contain high amounts of fiber—the indigestible portion of our food.

Fiber

Fiber passes through the gastrointestinal tract without being absorbed, allowing not only our nutrients to be absorbed at a much slower pace, but also helping to eliminate toxins as it cleanses the colon. An increased amount of fiber is very important in our overall diet and can be found in fruits, vegetables and whole grains.

I recommend between 35 & 50 grams of fiber each day. Most Americans only consume 8 to 10 grams of fiber each day and if we have a bowel movement every other day, we feel like heroes. Our paradigm is limited. Perhaps a broader worldview would prove enlightening.

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Dr. Burkitt, a surgeon, famous for the disease, “Burkitt’s Lymphoma,” practiced in Africa for over 20 years. While in Africa, he did not see a single case of colon cancer, diverticulitis, hemorrhoids, gall bladder disease, or even appendicitis among the native population. He attributed this remarkable finding to the fact that his native African patients consumed 60 to 70 grams of fiber per day and typically had three to five bowel movements every day. When Dr. Burkitt returned to the United States, he spent most of his time promoting the health benefits of a high fiber diet.

Constipation is a $3 billion business in the United States alone. Patients in the U. S. think they are heroes when they have a bowel movement every other day. When I refer a patient to the gastroenterologist, I can count on the fact that he or she will recommend my patient to eat more fiber. The fiber in low-glycemic carbohydrates provides most of this necessary fiber, however, many of us need to supplement our diet with additional fiber in order to obtain the 35 to 50 grams needed each day. I guarantee the tremendous health benefits reaped by making this intentional effort will prove worthwhile.

Sugars

Glucose (the basic sugar that is used by the body and that all carbohydrates eventually become in the body) is extremely easy for the body to absorb and in turn raises blood sugar rapidly. The rate at which the blood sugar increases (the glycemic index) is rated at 100. Fructose (which is found in fruits and honey), on the other hand, is more difficult for the body to absorb and is therefore considered low-glycemic with an index of 23. White table sugar has a glycemic index of 65 because it is a disaccharide (made up of two molecules: on molecule of glucose and one molecule of fructose).

Surprising to many, wheat and white bread actually have a very high glycemic index (even higher than table sugar) because of its physical structure. The fine particle size and the exploded structure caused by the leavening action of the yeast makes the surface of wheat starch extremely accessible to digestive enzymes. They actually are worse for our bodies than table sugar because of how quickly their absorption raises blood sugar. Rice cakes, one of our favorite diet foods, have one of the highest glycemic indexes of any food.

The average dietitian does not utilize the glycemic index, which was introduced in the early 80′s. However, a recent study in the Journal of American Medical Association points out the potential serious outcomes of America’s and the industrialized nation’s tremendous use of high-glycemic foods. Problems like hypertension, obesity, elevated cholesterol and triglycerides, heart attacks, str,okes, and diabetes are primarily related to our diet.

Dr. Walter Willet, head of nutrition and preventive medicine at Harvard, in his book, Eat, Drink, and be Healthy (Simon and Schuster, 2001) believes white bread, white flours, pasta, rice, and potatoes should be placed at the top of the food pyramid with sweets and snacks. In turn, I encourage my patients to eat less bread (or to choose heavy multigrain, stone-ground brands) and more carbohydrates high in fiber. By simply eating more whole foods—fruits and vegetables, you are not only going to get the good fiber but also these foods are primarily low glycemic. Please read the discussion on glycemic index to better understand this concept and learn why glycemic load is also important.

Low-glycemic carbohydrates need to be balanced with good proteins and fats. When protein and fat are combined with low-glycemic carbohydrates during a meal, the absorption of sugar is slowed and the release of glucagons (this hormone is the opposite of insulin) is stimulated. All of the bad metabolic changes that occur with elevated blood levels of insulin (high blood pressure, elevated triglycerides, lower HDL cholesterol, central obesity) are actually reversed by increasing the levels of glucagons.

Protein

Protein has been maligned over the years due to the tremendous focus on low-fat diets. Since most of the “bad” fats are contained in proteins, we have thrown the protein out with the fat. People have been led to believe that a high-carbohydrate, low-fat diet is the healthiest diet we can eat. However, amino acids only found in proteins are essential for all of our body’s functions, especially our immune syst6m. We must choose good protein sources.

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Vegetable proteins are the very best proteins we can eat; the greatest advantage of plant protein being the fact that it contains less environmental toxins and chemicals than animal protein. Because of the highly commercialized production of animal protein, it now contains significantly greater amounts of hormones, antibiotics, and toxins.

Our bodies require 10 essential amino acids and vegetable protein is sometimes criticized for not being complete. I don’t find any problem with this because you can easily mix ana combine many different plant proteins. Some examples are soy protein, nuts, legumes, and certain whole grains.

Cold-water fish offers the next best source of protein. Cold-water fish, like salmon, mackerel, sardines, and tuna not only gives you a good source of protein but also a needed sources of omega-3 essential fatty acids, which I will discuss more under fats. Again, be aware of toxins these fish may contain because of industrial pollution of our waters. Mercury poisoning as well as many other toxins are increasing in all fish species. Shellfish and larger saltwater fish are the worst. Knowing the source of the fish is helpful.

Fowl are the next best source of protein. Chicken and turkey are the best because the fat accumulates on the outside of the meat rather than on the inside. Since most toxins found in these animals accumulate in the fat, you can easily avoid them by removing the skin and fat from the meat leaving an excellent source of protein. Organically grown fowl is a great choice if you have it available.

Animal products are less desirable sources of protein due to high levels of saturated fat marbled inside red meat. I encourage my patients to keep their consumption of red meat to a minimum, knowing that some of us simply like to have a good steak once in a while. I recommend for those patients who eat red meat to choose the leanest cut they can get. Remember, no one needs to eat the 24-ounce cut. Eat small, fine cuts of steak along with tasty low-glycemic vegetables. You do need to avoid meats like bacon, hot dogs, salami, and lunchmeats. Organ meats (liver, brain, and kidney) should also be avoided due to high toxin concentrations.

Dairy products are the least desirable protein source because they have the highest concentration of saturated fats. Milk, eggs, cheese, butter, and buttermilk are ranked among some of the unhealthiest foods that we eat. The problem is that they make our recipes taste so good. You can markedly improve your diet by eating low-fat or non-fat milk and cheese. If you eat eggs, consider eating more egg whites than egg yolks. Though range fed chickens produce eggs that contain helpful omega-3-fatty acids, we will all be much healthier by keeping the total amount of saturated fat to a minimum.

Fats

Proteins have been given a bad rap, but not nearly as much as fats. The consumption of fats in our diet has certainly been the talk of this past half-century. Still, people are as confused about fats today as they were a generation ago. In fact, in many ways they are even more confused. The bottom line is that our bodies need fat to thrive and live healthy. Fat is needed for many aspects of the cell but especially in the formation of the cell membrane. Fat is also needed for the production of many of our hormones, natural anti-inflammatory, and basic energy needs. Not only must we decipher between good and bad fats, but also we need to know how and when to consume what kind of fats for good health.

Saturated Fats

Saturated fats come primarily from animal fat and dairy products. These are the worst fats that we can consume. These saturated fats increase total cholesterol and LDL or “bad” cholesterol and lower HDL ‘or “good” cholesterol. Most Americans and people in the industrialized nations consume the majority of their fats in the form of saturated fats. Numerous studies reveal that the actual consumption of cholesterol does little to increase our cholesterol levels; however, the consumption of saturated fats and high-glycemic carbohydrates play a large part in elevating cholesterol and triglyceride levels. Most nutritionists now realize that it is not simply the fat in our diet causing problems; but rather, the types of fats we are consuming.

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Polyunsaturated Fats

In the 1950′s, polyunsaturated fats became popular as a “healthy” substitute for saturated fats. For example, vegetable oils were made into margarine as a substitute for butter. Vegetable oils primarily contain what is known as polyunsaturated fats. These fats do in fact lower LDL or “bad” cholesterol, but the problem is that they also lower HDL or “good” cholesterol. Polyunsaturated fats are also vulnerable to oxidation and easily transform into “trans-fatty acids”, which are rancid fats. These fats make poor building blocks for our cell membranes and are anything but healthy. Many vegetable oils are now subjected to a process called partial hydrogenation. The reason food manufactures go to the trouble of this process is to improve taste, spread ability, pleasurable sensation in the mouth, and to extend shelf life. It has nothing to do with making a “healthy” alternative.

To hydrogenate oils, manufactures heat the oils to high temperatures under pressure with hydrogen gas. This process is stopped before it is completed or all the fats would become saturated. However, this abbreviated process provides a mixture of fats–saturated, polyunsaturated, with a high concentration of trans-fatty acids. When you look at food labels you will be amazed how many processed foods are made of partially hydrogenated fat. The medical evidence is growing that these partially hydrogenated fats or what is becoming known as rancid fats are probably the worst fats you can eat. I recommend avoiding these kinds of fats all together.

Monosaturated Fats

These fats are found in many of our vegetables, nuts, and certain vegetable oils. These are considered healthy fats because they actually help lower total cholesterol and LDL cholesterol while maintaining HDL cholesterol levels. They are found in foods like cashews, almonds, avocados, olive oil, and pistachio nuts. Virgin olive oil is a very good source of these types of fats. Canola and peanut oils are also high in these types of fat. Even though these fats do not contain the essential fatty acids, they appear to be much healthier and in some ways protective against heart disease. You must however be careful not to heat these oils because they can become rancid fats very easily. If you do use them in your cooking, you need to use very low heat and use a high quality virgin olive oil.

Essential Fats: Omecja-3 and Omecia-6 Essential Fatty Acids

These essential fats are just that—essential. Our body cannot make them, so we need to get them from our diet. They are critical in the production of hormones called prostaglandins, which control inflammation, cell growth and differentiation, blood clotting, and key aspects of our immune system. We get plenty of omega-6 fatty acids in the Western diet, however; almost all of us are deficient in the omega-3 fatty acids.

Omega-6 fatty acids produce hormones (prostaglandins) that promote inflammation, cell growth, and blood clotting. Omega-3 fatty acids produce hormones (prostaglandins) with just the opposite affect. In the event that you are injured, you need to have a good inflammatory response to bring about quicker healing–the inflammatory response brings blood and immune cells to the wounded area. However, if you have not been hurt, an inflammatory response can damage tissue and cause major problems, i.e. asthma, arthritis, and heart disease, Therefore, it is critical that these essential fats are consumed in a balanced fashion so that the hormones they produce will also occur in balance. If these prostaglandins are not kept in balance they can cause serious health problems such as cancer, heart disease, inflammatory diseases, and autoimmune diseases.

Omega-6 fatty acids are found in meats, margarines, peanuts, poultry, and many of our processed foods. Omega-3 fatty acids are found in cold-water fish, flaxseed, soybeans, organic eggs, walnuts, and oils made from flaxseed, walnuts, and soybeans. It is most beneficial to consume these essential fats in a ratio of 2 omega-6 fatty acids to 1 omega-3 fatty acid (2:1 ratio). However, Americans consume an estimated ratio of 20:1 and in some cases, 40:1 omega-6 fatty acids to omega-3 fatty acids. Is it any wonder we are in a health crisis?

It is imperative that you make a concerted effort to consume foods high in omega-3 fatty acids in order to balance out these two essential fats. Eating adequate quantities of the omega-3 fatty

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acids will actually lower your total cholesterol and LDL cholesterol. Most people simply need to supplement their-diet with cold-pressed flax seed, sunflower, pumpkin seed oils or fish oil.

I realize most people will eat saturated fats and at times even partially hydrogenated fats. Still, it is important to get the majority of your fats from essential fatty acids and monosaturated fats. Many researchers now argue that fat is not the problem, rather the types of fats we are consuming is the major contributor to elevated cholesterol levels.

Combining Carbohydrates, Proteins, and Fats

It is critical that you have a portion of carbohydrate, protein, and fat with each meal or snack. Every time we eat, we need to be sure that we are taking in good nutrition and that we are not going to be spiking our blood sugar. We need to eat for hormonal control and not calorie control. Insulin is our “storage” hormone and most of us do not want to store any more fat than we already have.

Glucagons, on the other hand, actually utilize fat as an energy source. I explain to my patients that are overweight that this lifestyle of eating actually has a side effect of fat loss. If you don’t need to lose any weight, then you won’t on this diet. You simply just feel better and become healthier.

I believe that around 40 to 50% of our calories should come from low-glycemic carbohydrates, 25 to 30% of our calories from good protein, and 25 to 30% of our calories should come from good fat. There are many different ratios, which will accomplish this same overall goal. Barry Sears in his book, The Zone, recommends the 40/30/30 (40% carbohydrates, 30% protein, and 30% fat) and other diets recommend 50% carbohydrates, 30% protein, and 20% fat.

All of these diets accomplish the same desired hormonal results, which is necessary for healthy lifestyle. Always avoid unhealthy weight loss diets that are out of balance such as the Atkins’ Diet (all protein and fat with no carbohydrates) or Dr. Ornish’s Diet (all carbohydrates with very little to no fat). The desired goal is to keep insulin and glucagon levels within a healthy zone. The body needs both to maintain health and to assure that your cells are getting proper nutrients.

A good ratio is combining 20 grams of low-glycemic carbohydrate, 10 to 12 grams of good protein, and 4 to 6 grams of good fat. You can eat as much as you want; however, be sure the ratios stay the same (40 grams of carbohydrates, 24 grams of protein, and 8 to 10 grams of fat).

You should eat five to six small meals each day. Eat breakfast within one hour of awakening and a meal or snack every four hours throughout the day to keep your metabolism going and blood sugars stable. I find weighing foods is not necessary, although reading nutritional labels is essential.

I teach m.y patients to not get caught up in anything too complicated—like weighing foods. Simply use your hand as a guide. The palm of the hand (circumference and thickness) = 1 protein serving (red meat—use 1/2 the palm of your hand). 1 fist (1 1/4 cups) = fruit serving (carbohydrate). 2 fists (2-4 cups) = vegetable serving (carbohydrate). Tip of the thumb (1 tsp.) = 1 fat serving

A typical meal should contain two servings of carbohydrates, one serving of protein, and one serving of fat. If your body frame is large, you may need double this amount, still the balance of carbohydrates, fats, and proteins must be maintained. The actual amount that you consume will depend on your body size and whether this is a main meal or snack. Remember the key is to keep portions balanced even when eating snacks.

Here are some principles to help you enjoy food and keep you on track:

• Be careful not to take in too many high-glycemic carbohydrates with any particular meal especially when eating out. Don’t eat bread, potatoes and dessert all at the same meal.

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In fact, recent research reveals it would be best to avoid high-glycemic foods all together.

• Be creative with your snacks and be sure that they contain the right balance of good carbohydrates, good fat, and good protein.

• Always have healthy snacks readily available. If you don’t, you will eat whatever is around when you get hungry.

• Purchase lean bars, balance bars, and lean drinks, which already have the proper balance and have them readily available.

• You will tend to have some withdrawal from a high carbohydrate diet, However, once you become consistent with this diet you will feel much better with a marked increase in energy.

Health Concepts – Healthy Exercise Program

Health Benefits of a Modest Exercise Program

• Weight loss

• Lower blood pressure

• Stronger bones and decreased risk of osteoporosis

•             Lower cholesterol levels

• Elevated levels of “good” HDL cholesterol

• Decreased levels of “bad” LDL cholesterol

•             Decreased levels of triglycerides—-the other fat in the blood

• Increased strength and coordination, which leads to decrease risk of falls •      Improved sensitivity to insulin

• Enhanced immune system

• Overall increase in the sense of well-being

(The Surgeon General of the United States issued a statement in the early 1980′s listing all these major health benefits that result from having a modest exercise program.)

Everyone is aware that moderate, consistent exercise is essential to a healthy lifestyle. But how many Americans put this good knowledge to use?

The best type and duration of exercise is always a continual debate among exercise gurus. However, as a physician, I have a different attitude about how one should approach developing an exercise program.

• It is more important to exercise consistently than to worry about how to exercise. Any exercise program is better than none.

• Choose an exercise program in which you can remain consistent. You need to enjoy as much as possible the exercise program so you will stay with it.

• Schedule workouts instead of trying to work an exercise program into your existing schedule.

• It is very important that you not hurt yourself when starting an exercise program. Don’t overdue it, most of us have not been in good shape for years, if ever.

•             Start slowly and gradually increase the length and intensity of your workouts. It is not a race. Your strength and endurance will increase.

• If my patients have any joint or musculoskeletal problems, I have them see a physical therapist who can guide their exercise program and help protect them from injury.

• If you have any risk of coronary artery disease or are over 40, you need to see your physician and obtain an exercise stress test by a cardiologist before beginning any exercise program.

Benefits of Strength/Resistance Training

The benefits of aerobic exercise have been well publicized over the last several decades. But many people still react negatively to strength or resistance training, thinking only of bodybuilding or training just for athletes. What is not widely known is the positive fitness and health benefits of strength or resistance training for ordinary adults of all ages.

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In a well-designed program, resistance training can provide increased stress to the long bones of the upper extremities, the spine, pelvis and ribs. This can produce positive results for those who may have, or who are prone to osteoporosis.

When losing weight many are not concerned whether they lose muscle mass along with the fat mass; they just want to “lose weight.” Resistance training can prevent the loss of muscle mass while aiding in your fat loss effort. Since muscle is the furnace that burns the fuel (glucose), the more muscle mass that you have, the easier it is to maintain your optimal body weight (mass).

Exercise, including strength training, helps to make the body more sensitive to its natural insulin not only during, but following exercise sessions. This is a great benefit to those who have diabetes mellitus or for those who want to avoid becoming diabetic.

It was once believed that the loss of muscle mass, especially in the upper body, was a normal part of the aging process. This is far from the truth. Strength training not only helps prevent the loss of muscle mass associated with aging but can actually increase muscle mass in those even in their 80′s and 90′s. It is a known fact, that we begin losing muscle mass after age 35 unless we are involved in strength training.

Studies also indicate that healthy, elderly individuals who are stronger are less likely to have frequent falls. An appropriately designed resistance program can also help maintain flexibility and balance. Adding stretching exercises may enhance the benefits of an exercise program. A well-designed work out can also have significant cardiovascular benefits. Resistance training plays a vital role in preventing heart attacks by conditioning the cardiovascular system to cope more efficiently with sudden changes in blood pressure and heart rate.

Needless to say, it is important to get a balance of aerobics, resistance training and stretching into your exercise program. I recommend modest aerobics at least two to three times a week and strength training two to three times a week. Giving your body a chance to rest is also an essential aspect to health. Our bodies actually become stronger during rest. When you’re tearing down muscle and building up your aerobic capacity, your body needs some time off to rest. You should try to have at least one or two days off each week.

Health Concepts – Nutritional Supplement Program The Health benefits of Nutritional Supplements

• Enhances the immune system

• Enhances the antioxidant defense system

• Decreases the risk of heart attacks, strokes, and cancer

• Decreases the risk of arthritis, macular degeneration, and cataracts

• Decreases the risk of asthma and hay fever

• Decreases the risk of Alzheimer’s dementia, ° Parkinson’s disease, and many other chronic degenerative diseases

The final aspect of a healthy lifestyle is nutritional supplements. For years I told my patients they could get everything they need from their diet. However, after researching the medical literature for the past seven years on this subject, I am convinced that every man, woman, and child needs to be taking nutritional supplements in order to better protect their health.

Our bodies are created with a complicated and sophisticated antioxidant defense systems to protect us from the devastating damage of oxidative stress. Because this generation is under greater attack from the toxins in our environment, our stressful lifestyles, and poor eating habits than any other previous generation, we need to optimize these defense systems: Eating a healthy diet is a good a start. However, there is no way we can obtain the optimal levels of the nutrients our bodies need from our diet alone. We must supplement our diet to best protect our health.

Physicians are usually negative about their patients taking any kind of supplements. However, once you understand that oxidative stress is the root cause of almost all of our major chronic degenerative diseases, you will agree that supplementing your healthy diet with high-quality supplements is essential and worth fighting for.

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Cellular Nutrition

I encourage my patients to take the Usana Essentials (Mega Antioxidant and Chelated Mineral) and Active Calcium, which provide what I refer to as “Cellular Nutrition”. Cellular nutrition is providing all of the nutrients the cell needs to function at optimal levels (not RDA levels), which have been shown to provide a health benefit in the medical literature. This allows the cell to decide what it needs and does not need. You no longer have to worry about nutritional deficiencies, since you will replenish any nutritional deficiency and will enhance all the other nutrient levels to their optimal levels within 6 to 9 months on this program. I encourage you to read my book, What Doctors Don’t Know About Nutritional Medicine Nay Be Killing You, to fully understand these concepts of supplementation. However, Usana Health Sciences has developed a full line of nutritional supplements, which are pharmaceutical-grade and provide this cellular nutrition in a complete and balanced fashion. This improves compliance and makes the goal of achieving “cellular nutrition” very easy.

Essential Fats and Fiber

Supplementing your diet with essential fats and fiber is usually critical. 80% of the people in the U. S. and Canada are deficient in omega-3 fatty acids. Most people are also significantly deficient in fiber in their diet. Even though the average American only consumes approximately 8 to 10 grams of fiber per day it is strongly advised that you eat a minimum 35 to 50 grams of fiber each day. (See discussion of fiber and essential fats under healthy diet). This is why I strongly recommend that everyone add Usana’s Fibergy and Optomega or Biomega-3 to the Essentials and Active Calcium. This assures me that my patients will be providing the cell optimal levels of all of these nutrients.

Nutritional Supplementation for Children

According to the Journal of Pediatrics, less than 1% of the children today receive even the minimal amount (RDA’s) of the required nutrients. It becomes very obvious that each of our children also need to be improving their diet, activity level, and taking nutritional supplements. I recommend to my mothers that children from age18 months to 4 years should take 1 Usanimal daily. Children from age 5 to 8 years old should be taking 2 Usanimals daily. Children from age 9 to 16 years old should begin taking Body Rox (3 tablets daily unless they are very small children, in which case 2 tablets daily may be more appropriate). Mothers should also consider giving their children 1 to 2 tsps of OptOmega (depending on their age), additional fiber via Fibergy or the Fiber bar, and additional calcium via Active Calcium (which may be crushed) or Active Calcium Chewables. Additional calcium is critical for children prior to puberty to increase overall bone density. These children need to be taking at least 800 to 1000 mg of supplemental calcium.

Recommended Daily Allowance (RDA)

Research studies reveal standards of recommended daily allowance (RDA’s) have absolutely nothing to do with chronic degenerative diseases. RDA’s were developed to avoid what are known as acute deficiency diseases like scurvy (deficiency of vitamin C), rickets (deficiency of vitamin D), and pellagra (deficiency of niacin). In other words, if you consumed the RDAs for vitamin C, vitamin D, and niacin, you would not develop any of these illnesses.

Admittedly, the RDA’s have done their job—how many people do you know suffer from these diseases? RDA’s first developed in the 1920′s and 1930′s. The list of nutrients included in the RDAs grew over the next two decades and in the early 1950s, the definition of RDAs expanded to include the amounts of nutrients needed for normal growth and development. Despite the fact that RDAs have proved useful, most physicians and laypeople tend to assign more meaning to RDA standards than they should.

After researching medical literature on the topic of oxidative stress and the amount of nutrients needed to prevent it, I found the optimal levels of nutrients known to provide health benefits are significantly greater those suggested by RDA levels. For example, the optimal level of vitamin E is 400 IU. The RDA is only 30 IU. That being the case, you may consider eating 400 IU of vitamin E. You would only need to eat 33 heads of spinach, or 27 pounds of butter; 80 avocados will do, or an alternative 5 pounds of wheat germ each and every day to obtain that level of vitamin E.

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Similarly, the optimal level of vitamin C is approximately 1200 to 2000 mg daily, while the RDA is only 60 mg. To eat the optimal levels of vitamin would need to consume 18 oranges, or 17 kiwifruit, or 160 apples. Put in this perspective, it becomes clear that the only way to obtain these levels of nutrients is to supplement our diet. And this requires more than a generic multiple vitamin. One-a-day multiple vitamins are primarily based on RDA levels, thus providing no measurable health benefits. Significantly more potent supplements are needed each day to provide the optimal levels to provide cellular nutrition. This booklet will explain why I personally believe the Usana Nutritional Supplements offers my patients the most complete and balanced as well as the highest quality cellular nutrition on the market today.

The “Magic Bullet” Approach

Most scientific studies done on nutritional supplements are approached in the traditional way of testing drugs—hoping to discover a “magic bullet”. A disease is isolated and targeted by one specific drug. The pharmaceutical results of that drug are then measured.

Research trials have been similarly conducted for nutritional supplements. For example, calcium and vitamin D have been tested for their effects on osteoporosis; vitamin E for heart disease, magnesium for irregular heartbeats or selenium to reduce the risk of cancer.

One problem remains, however: vitamins such as C, D and E are not drugs. They are natural nutrients that our bodies get from our foods. The various antioxidants and supporting nutrients work on different types of free radicals and in different parts of the body. Vitamin E is the best antioxidant within the cell membrane. Vitamin C is most effective within the plasma. Glutathione is works most efficiently within the cell itself. Literally dozens of antioxidants are at work in various parts of the body and are effective against particular types of free radicals. They work together—synergistically– to control oxidative stress. This means that 1 plus 1 does not equal 2, but 8 or 10. Medical research separates these nutrients out and tries to study their individual effect. The amazing fact remains that the overwhelming majority of studies actually does show a health benefit with even an individual nutrient. However, since oxidative stress.is the underlying problem we must concern ourselves with, it is important to realize that all of these nutrients work together—synergy.

Vitamin C actually replenishes vitamin E and intracellular glutathione so it can be used over and over again. Alpha lipoic acid also regenerates vitamin E and glutathione. In addition, these antioxidants need optimal levels of the B vitamins—folic acid, vitamin B1, B2, B6, and B12—in order to perform at optimal levels. They also need the so-called antioxidant minerals such as: selenium, manganese, copper, and zinc to do their job right. If you have all the glutathione in the world available but are depleted in selenium, which glutathione needs to work, there will be very. little health benefit.

When all of the necessary nutrients are provided to the cell in a complete and balanced nutritional supplement, the combined effect is phenomenal. The potency of these nutrients in optimizing our body’s natural antioxidant, immune, and repair systems when this synergy is achieved is maximized. Oxidative stress can be controlled and our health will be protected.

I also apply these principles for my patients who are already suffering from a major chronic degenerative disease. I provide them with the same basic cellular nutrition I recommend for all my patients and then I add additional potent antioxidants, which I refer to as optimizers, to the regime tailored to each specific disease. When physicians take advantage of the most tremendous healing asset, the host—our bodies, and support it rather than denying its importance in the healing process, amazing clinical improvement is possible.

Cellular nutrition is about health, not disease. “Attacking” the root cause of chronic degenerative disease is true preventive medicine. By applying these same principles, you who are in good health can decrease the risk of developing these chronic degenerative diseases.

Oxidative Stress

Oxygen is essential for life itself. But did you know it is also inherently dangerous to our existence? I call this the “dark side” of oxygen. And as a result, we are essentially rusting both inside and out. The same process that causes a cut apple to turn brown or iron to rust is the cause of all the chronic degenerative diseases we fear and even the aging process itself.

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Consider the aging of our skin. Oxidative stress is the cause of wrinkles, sagging skin, and age spots. The next time you_are with a large gathering of people of different ages, observe closely the change you see.in people’s skin. Aging is a process we all take for granted, but when you look more closely, and compare a baby’s face, to that of a grandparent’s, the effects of our largest organ being exposed to all the pollutants in the air, sunlight, and cigarette smoke is baffling. This aging of the skin is an outward manifestation of “oxidative stress,” which is occurring within every cell in your body.

Over the past 7 years, I have reviewed well over 2,000 medical and scientific studies in regards to nutritional supplements and their affect on your health. These studies appearing in medical journals like the New England Journal otMedicine, Journal of the American Medical Association, British Lancet, and Annuals of Internal Medicine report that beyond any doubt the “root” cause of well over 70 chronic degenerative diseases is “oxidative stress.” These are the “who’s who” of diseases we all fear and want to avoid; diseases like heart attacks, strokes, diabetes, cancer, arthritis, Alzheimer’s dementia, macular degeneration, lupus, MS, fibromyalgia, and chronic fatigue. “So what,” you may be wondering, “is ‘oxidative stress’?”

Within every cell of the body is a furnace called the mitochondria. As oxygen is utilized within the furnace of the cell to create energy and life itself, occasionally a charged oxygen molecule is created, called a “free radical.” This free radical has at least one unpaired electron in its outer orbit essentially giving it an electrical charge. If this free radical is not readily neutralized by an antioxidant it can go on to create more volatile free radicals, damage the cell wall, vessel wall, proteins, fats, and even the DNA nucleus of our cells, Chemically this reaction has been shown to be so volatile that it actually causes bursts of light within our bodies!

Imagine yourself in front of a crackling fireplace and I’ll give you the best illustration I have to explain the process of oxidation. The fire burns safely and beautifully most of the time, but on occasion out pops a hot cinder that lands on your carpet and burns a little hole in it. One cinder by itself doesn’t pose much of a threat; but if this sparking and popping continues month after month, year after year, you will have a pretty “ratty” carpet in front of your fireplace.

The fireplace represents the furnace of the cell (the mitochondria), the cinder is the charged “free radical,” and the carpet is your body. Whichever part of your body receives the most free radical damage will be the first to wear out and potentially cause one of these degenerative diseases. If it’s your arteries, you could develop a heart attack or stroke. If it is your brain, you could develop Alzheimer’s dementia or Parkinson’s disease. If it’s your joints, you could develop arthritis.

Through biochemical research we’re learning that we are not defenseless against this attack on our body by free radicals. Antioxidants are like the glass doors or fine-wire mesh we place in front of our fireplace. The sparks are still going to fly but our carpet will then be protected. As you begin to imagine the war that is taking place within every cell in your body, you can envision the two opposing forces: the enemy—free radicals; and your allies—antioxidants and their supporting nutrients.

Living a healthy life becomes a matter of balance. You must have enough antioxidants available to readily neutralize the number of free radicals your body produces. If you don’t, “oxidative stress” will occur. When this oxidative stress is allowed to persist over a prolonged period of time, you will most likely develop a serious chronic degenerative disease.

Each of us must ask, “Am I getting enough antioxidants from my diet to protect myself from this onslaught of free radicals or do I need to be taking nutritional supplements?” This is the question that I’ve had to ask myself as I have spent countless hours researching medical literature. You see I was taught in medical school that you don’t need supplements—that you can get everything you need from a good, healthy diet. And this is what I told my patients for years, I was wrong.

Since balance is the key, we need to look closely at the individual players that are at war within. The number of free radicals you produce each and every day is never the same. All the pollutants in our air, food, and water dramatically increase the number of free radicals we produce. Enormous stress, excessive exercise, cigarette smoke, sunlight, radiation, and every drug prescribed greatly increase the number of free radicals produced in the body. In fact, there has never been a generation on this planet subjected to more oxidative stress than this present one.

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We are literally under attack from our polluted environment, stressful lifestyles, and .overmedicated society.

This ongoing attack is depriving us of our most precious gift—our health. But God did not leave us defenseless against this onslaught by free radicals. In fact, we actually have our own army of antioxidants, which are able to neutralize free radicals and render them harmless. In generations past, these defense systems were sufficient. Unfortunately this is no longer the case. Our bodies’ defense systems need additional allies.

Most antioxidants come from vegetables and fruit. This creates a gap in our protection, because our foods have become significantly depleted in their content of antioxidants and supporting minerals as a result of mineral depletion in our soils, green harvesting, cold storage, foods that are highly processed, our poor food choices and food preparation.

At a time when we are under the heaviest attack from the environment around us, our natural defense systems are becoming overwhelmed and depleted. We must do all we can to rebuild our antioxidant systems with a healthy diet, but too you need to learn how complete and balanced nutritional supplementation with high quality supplements (cellular nutrition) is our best hope in winning this war within and protecting our health.

• Conclusion

Therefore, I encourage ALL of my patients to take Usana’s Essentials, Proflavanol, Hepasil, CoQuinone, Procosa, Active Calcium, Visionex, Fibergy or Nutrimeal, and either Optomega or Biomega-3. This provides optimal “cellular nutrition” in a convenient and cost effective manner. Usana Health Science’s commitment to quality and scientific approach to nutritional supplementation makes my job very easy. When you combine a healthy diet, modest exercise program, and nutritional supplementation together, you are giving yourself the absolute best chance of protecting your health. If you have already lost your health, I would refer to my specific recommendations for your particular disease or problem. You will quickly see that I simply begin adding potent “Optimizers” to this basic concept of cellular nutrition as an effective means of helping you regain and take back control of your health.

• WHY CHOOSE USANA

Why I recommend USANA Products

I personally believe USANA Health Sciences has developed and produced the most complete and balanced nutritional products on the market today. In fact, all the clinical case study results documented in my new book, What Your Doctor Doesn’t Know About Nutritional Medicine May Be Killing You, were achieved by using products developed and manufactured by USANA. Based on Dr. Myron Wentz’s knowledge of human cell culture technology, USANA has developed the most impressive science-based products available.

USANA strictly follows pharmaceutical-grade Good Manufacturing Practices (GMP). This means they not only purchase pharmaceutical-grade raw products, but also manufacture the products according to tough pharmaceutical-quality guidelines. In addition, USANA Health Sciences follows USP guidelines for potency, uniformity, and dissolution of the tablet. In a nutshell, USANA manufactures their products to the strict standards of over-the-counter drugs even though not required to do so assuring all of their customers and associates that what is on the label is actually in the tablet. I am also duly impressed (as any physician should be) that USANA is one of the only nutritional supplements listed in the Physicians Desk Reference (PDR-U.S) and Master Index of Medical Specialties (MIMS-Asian).

-USANA BEST OF THE BEST NUTRITIONAL FOODS & SUPPLEMENTS-

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Filed under: Blood ]]> http://ardymotos.wordpress.com/2010/03/18/dr-ray-strand/feed/ 1 14.552762 121.022300 14.552762 121.022300 Motzky RayStrand copy http://i287.photobucket.com/albums/ll123/jackstoyz/bordergreen.gif http://i287.photobucket.com/albums/ll123/jackstoyz/bordergreen.gif icb.gif (150×201) http://ardymotos.wordpress.com/2010/01/27/tuberculosis-tb/ http://ardymotos.wordpress.com/2010/01/27/tuberculosis-tb/#comments Wed, 27 Jan 2010 07:37:10 +0000 Engr. Ardy Motos http://ardymotos.wordpress.com/?p=430 ]]> TUBERCULOSIS (TB)

Tuberculosis or TB (short for Tubercle Bacillus) is a common and often deadly infectious disease caused by mycobacteria, usually Mycobacterium tuberculosis in humans.^[1] Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air, when people who have the disease cough, sneeze, or spit. Most infections in humans result in an asymptomatic, latent infection, and about one in ten latent infections eventually progresses to active disease, which, if left untreated, kills more than 50% of its victims.

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Watch closely…

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TB - Infected

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The classic symptoms are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss. Infection of other organs causes a wide range of symptoms.Diagnosis relies on radiology (commonly chest X-rays), a tuberculin skin test, blood tests, as well as microscopic examination and microbiological culture of bodily fluids.Treatment is difficult and requires long courses of multiple antibiotics. Contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in (extensively) multi-drug-resistant tuberculosis. Prevention relies on screening programs and vaccination, usually with Bacillus Calmette-Guérin vaccine.

A third of the world’s population are thought to be infected with M. tuberculosis,^[2] and new infections occur at a rate of about one per second.^[3] The proportion of people who become sick with tuberculosis each year is stable or falling worldwide but, because of population growth, the absolute number of new cases is still increasing.^[3] In 2007 there were an estimated 13.7 million chronic active cases, 9.3 million new cases, and 1.8 million deaths, mostly in developing countries.^[4] In addition, more people in the developed world are contracting tuberculosis because their immune systems are compromised by immunosuppressive drugs, substance abuse, or AIDS. The distribution of tuberculosis is not uniform across the globe; about 80% of the population in many Asian and African countries test positive in tuberculin tests, while only 5-10% of the US population test positive.^[1]

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Classification

Signs and symptoms

TB-Signs & Symptoms

When the disease becomes active, 75% of the cases are pulmonary TB, that is, TB in the lungs. Symptoms include chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks. Systemic symptoms include fever, chills, night sweats, appetite loss, weight loss, pallor, and often a tendency to fatigue very easily.^[3]

In the other 25% of active cases, the infection moves from the lungs, causing other kinds of TB, collectively denoted extrapulmonary tuberculosis.^[7] This occurs more commonly inimmunosuppressed persons and young children. Extrapulmonary infection sites include the pleura in tuberculosis pleurisy, the central nervous system in meningitis, the lymphatic system in scrofula of the neck, the genitourinary system in urogenital tuberculosis, and bones and joints in Pott’s disease of the spine. An especially serious form is disseminated TB, more commonly known as miliary tuberculosis. Extrapulmonary TB may co-exist with pulmonary TB as well.^[8]

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Cancer affects people at all ages with the risk for most types increasing with age.^[1] Cancer caused about 13% of all human deaths in 2007^[2] (7.6 million).^[3]

Brain Cancer Cell

Cancers are caused by abnormalities in the genetic material of the transformed cells.^[4] These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may randomly occur through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers is usually affected by complex interactions between carcinogens and the host’s genome.

Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are typically activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. Tumor suppressor genes are then inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system.

Definitive diagnosis requires the histologic examination of a biopsy specimen, although the initial indication of malignancy can be symptomatic or radiographic imaging abnormalities. Most cancers can be treated and some cured, depending on the specific type, location, and stage. Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy. As research develops, treatments are becoming more specific for different varieties of cancer. There has been significant progress in the development of targeted therapy drugs that act specifically on detectable molecular abnormalities in certain tumors, and which minimize damage to normal cells. The prognosis of cancer patients is most influenced by the type of cancer, as well as the stage, or extent of the disease. In addition, histologic grading and the presence of specific molecular markers can also be useful in establishing prognosis, as well as in determining individual treatments.

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Classification

Cancers are classified by the type of cell that resembles the tumor and, therefore, the tissue presumed to be the origin of the tumor. These are the histology and the location, respectively. Examples of general categories include:

• Carcinoma: Malignant tumors derived from epithelial cells. This group represents the most common cancers, including the common forms of breast, prostate, lung and colon cancer.
• Sarcoma: Malignant tumors derived from connective tissue, or mesenchymal cells.
• Lymphoma and leukemia: Malignancies derived from hematopoietic (blood-forming) cells
• Germ cell tumor: Tumors derived from totipotent cells. In adults most often found in the testicle and ovary; in fetuses, babies, and young children most often found on the body midline, particularly at the tip of the tailbone; in horses most often found at the poll (base of the skull).
• Blastic tumor or blastoma: A tumor (usually malignant) which resembles an immature or embryonic tissue. Many of these tumors are most common in children. Tumor – A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic).^[1] Tumor is not synonymous with cancer. A tumor can bebenign, pre-malignant or malignant, whereas cancer is by definition malignant. Neoplastic tumor of the cheek skin, here a benign neoplasm of the sweat glands called Hidradenoma. —>>>

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How Cancer develop???

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Malignant tumors (cancers) are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ of origin as the root. For instance, a cancer of the liver is calledhepatocarcinoma; a cancer of the fat cells is called liposarcoma. For common cancers, the English organ name is used. For instance, the most common type of breast cancer is called ductal carcinoma of the breastor mammary ductal carcinoma. Here, the adjective ductal refers to the appearance of the cancer under the microscope, resembling normal breast ducts.

Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name as the root. For instance, a benign tumor of the smooth muscle of the uterus is called leiomyoma (the common name of this frequent tumor is fibroid). Unfortunately, some cancers also use the -oma suffix, examples being melanoma and seminoma.

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Signs and symptoms

Roughly, cancer symptoms can be divided into three groups:

• Local symptoms: unusual lumps or swelling (tumor), hemorrhage (bleeding), pain and/or ulceration. Compression of surrounding tissues may cause symptoms such as jaundice(yellowing the eyes and skin).
• Symptoms of metastasis (spreading): enlarged lymph nodes, cough and hemoptysis, hepatomegaly (enlarged liver), bone pain, fracture of affected bones and neurologicalsymptoms. Although advanced cancer may cause pain, it is often not the first symptom.
• Systemic symptoms: weight loss, poor appetite, fatigue and cachexia (wasting), excessive sweating (night sweats), anemia and specific paraneoplastic phenomena, i.e. specific conditions that are due to an active cancer, such as thrombosis or hormonal changes.

Every symptom in the above list can be caused by a variety of conditions (a list of which is referred to as the differential diagnosis). Cancer may be a common or uncommon cause of each item.

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Causes

Active Cancer Cell inside the body!

Cancer is a diverse class of diseases which differ widely in their causes and biology. Any organism, even plants, can acquire cancer. Nearly all known cancers arise gradually, as errors build up in the cancer cell and its progeny (see mechanisms section for common types of errors).

Anything which replicates (our cells) will probabilistically suffer from errors (mutations). Unless error correction and prevention is properly carried out, the errors will survive, and might be passed along to daughter cells. Normally, the body safeguards against cancer via numerous methods, such as: apoptosis, helper molecules (some DNA polymerases), possibly senescence, etc. However these error-correction methods often fail in small ways, especially in environments that make errors more likely to arise and propagate. For example, such environments can include the presence of disruptive substances called carcinogens, or periodic injury (physical, heat, etc.), or environments that cells did not evolve to withstand, such as hypoxia^[5] (see subsections). Cancer is thus aprogressive disease, and these progressive errors slowly accumulate until a cell begins to act contrary to its function in the animal.

The errors which cause cancer are often self-amplifying, eventually compounding at an exponential rate. For example:

• A mutation in the error-correcting machinery of a cell might cause that cell and its children to accumulate errors more rapidly
• A mutation in signaling (endocrine) machinery of the cell can send error-causing signals to nearby cells
• A mutation might cause cells to become neoplastic, causing them to migrate and disrupt more healthy cells
• A mutation may cause the cell to become immortal (see telomeres), causing them to disrupt healthy cells forever

Cancer Cell being attached by the immune system!

Thus cancer often explodes in something akin to a chain reaction caused by a few errors, which compound into more severe errors. Errors which produce more errors are effectively the root cause of cancer, and also the reason that cancer is so hard to treat: even if there were 10,000,000,000 cancerous cells and one killed all but 10 of those cells, those cells (and other error-prone precancerous cells) could still self-replicate or send error-causing signals to other cells, starting the process over again. This rebellion-like scenario is an undesirable survival of the fittest, where the driving forces of evolution itself work against the body’s design and enforcement of order. In fact, once cancer has begun to develop, this same force continues to drive the progression of cancer towards more invasive stages, and is called clonal evolution.^[6]

Research about cancer causes often falls into the following categories:

• Agents (e.g. viruses) and events (e.g. mutations) which cause or facilitate genetic changes in cells destined to become cancer.
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• The precise nature of the genetic damage, and the genes which are affected by it.
• The consequences of those genetic changes on the biology of the cell, both in generating the defining properties of a cancer cell, and in facilitating additional genetic events which lead to further progression of the cancer.

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Pathophysiology

Cancer is fundamentally a disease of regulation of tissue growth. In order for a normal cell to transform into a cancer cell, genes which regulate cell growth and differentiation must be altered.^[29] Genetic changes can occur at many levels, from gain or loss of entire chromosomes to a mutation affecting a single DNA nucleotide. There are two broad categories of genes which are affected by these changes. Oncogenes may be normal genes which are expressed at inappropriately high levels, or altered genes which have novel properties. In either case, expression of these genes promotes the malignant phenotype of cancer cells. Tumor suppressor genes are genes which inhibit cell division, survival, or other properties of cancer cells. Tumor suppressor genes are often disabled by cancer-promoting genetic changes. Typically, changes in many genes are required to transform a normal cell into a cancer cell.^[30]

There is a diverse classification scheme for the various genomic changes which may contribute to the generation of cancer cells. Most of these changes are mutations, or changes in the nucleotide sequence of genomic DNA. Aneuploidy, the presence of an abnormal number of chromosomes, is one genomic change which is not a mutation, and may involve either gain or loss of one or more chromosomes through errors in mitosis.

Large-scale mutations involve the deletion or gain of a portion of a chromosome. Genomic amplification occurs when a cell gains many copies (often 20 or more) of a small chromosomal locus, usually containing one or more oncogenes and adjacent genetic material. Translocation occurs when two separate chromosomal regions become abnormally fused, often at a characteristic location. A well-known example of this is the Philadelphia chromosome, or translocation of chromosomes 9 and 22, which occurs in chronic myelogenous leukemia, and results in production of the BCR-abl fusion protein, an oncogenic tyrosine kinase.

Small-scale mutations include point mutations, deletions, and insertions, which may occur in the promoter of a gene and affect its expression, or may occur in the gene’s coding sequence and alter the function or stability of its protein product. Disruption of a single gene may also result from integration of genomic material from a DNA virus or retrovirus, and such an event may also result in the expression of viral oncogenes in the affected cell and its descendants.

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Glossary

The following closely related terms may be used to designate abnormal growths:

• Tumor or tumour: originally, it meant any abnormal swelling, lump or mass. In current English, however, the word tumor has become synonymous with neoplasm, specifically solid neoplasm. Note that some neoplasms, such as leukemia, do not form tumors.
• Neoplasm: the scientific term to describe an abnormal proliferation of genetically altered cells. Neoplasms can be benign or malignant:
  • Malignant neoplasm or malignant tumor: synonymous with cancer.
  • Benign neoplasm or benign tumor: a tumor (solid neoplasm) that stops growing by itself, does not invade other tissues and does not form metastases.
• Invasive tumor is another synonym of cancer. The name refers to invasion of surrounding tissues.
• Pre-malignancy, pre-cancer or non-invasive tumor: A neoplasm that is not invasive but has the potential to progress to cancer (become invasive) if left untreated. These lesions are, in order of increasing potential for cancer, atypia, dysplasia and carcinoma in situ.

The following terms can be used to describe a cancer:

• Screening: a test done on healthy people to detect tumors before they become apparent. A mammogram is a screening test.
• Diagnosis: the confirmation of the cancerous nature of a lump. This usually requires a biopsy or removal of the tumor by surgery, followed by examination by a pathologist.
• Surgical excision: the removal of a tumor by a surgeon.
  • Surgical margins: the evaluation by a pathologist of the edges of the tissue removed by the surgeon to determine if the tumor was removed completely (“negative margins”) or if tumor was left behind (“positive margins”).
• Grade: a number (usually on a scale of 3) established by a pathologist to describe the degree of resemblance of the tumor to the surrounding benign tissue.
• Stage: a number (usually on a scale of 4) established by the oncologist to describe the degree of invasion of the body by the tumor.
• Recurrence: new tumors that appear at the site of the original tumor after surgery.
• Metastasis: new tumors that appear far from the original tumor.
• Median survival time: a period of time, often measured in months or years, over which 50% of the cancer patients are expected to be alive.^[93]
• Transformation: the concept that a low-grade tumor transforms to a high-grade tumor over time. Example: Richter’s transformation.
• Chemotherapy: treatment with drugs.
• Radiation therapy: treatment with radiations.
• Adjuvant therapy: treatment, either chemotherapy or radiation therapy, given after surgery to kill the remaining cancer cells.
• Prognosis: the probability of cure after the therapy. It is usually expressed as a probability of survival five years after diagnosis. Alternatively, it can be expressed as the number of years when 50% of the patients are still alive. Both numbers are derived from statistics accumulated with hundreds of similar patients to give a Kaplan-Meier curve.
• Cure: A cancer patient is “cured” if they live past the time by which 95% of treated patients live after the date of their diagnosis of cancer. This period varies among different types of cancer; for example, in the case of Hodgkin’s disease this period of time is 10 years, whereas for Burkitt’s lymphoma this period would be 1 year.^[94] The phrase “cure” used in oncology is based upon the statistical concept of a median survival time and disease-free median survival time.^[95]

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Notes

1. ^ Cancer Research UK (January 2007). “UK cancer incidence statistics by age”. Retrieved 2007-06-25.
2. ^ WHO (February 2006). “Cancer”. World Health Organization. Retrieved 2007-06-25.
3. ^ American Cancer Society (December 2007). “Report sees 7.6 million global 2007 cancer deaths”. Reuters. Retrieved 2008-08-07.
4. ^ Kinzler, Kenneth W.; Vogelstein, Bert (2002). “Introduction”. The genetic basis of human cancer (2nd, illustrated, revised ed.). New York: McGraw-Hill, Medical Pub. Division. p. 5. ISBN 978-0-07-137050-9.
5. ^ Nelson DA, Tan TT, Rabson AB, Anderson D, Degenhardt K, White E (September 2004). “Hypoxia and defective apoptosis drive genomic instability and tumorigenesis”. Genes & Development 18 (17): 2095–107. doi:10.1101/gad.1204904. PMID15314031.
6. ^ Merlo LM, Pepper JW, Reid BJ, Maley CC (December 2006). “Cancer as an evolutionary and ecological process”. Nat. Rev. Cancer 6 (12): 924–35. doi:10.1038/nrc2013. PMID 17109012.
7. ^ ^{a b} Sasco AJ, Secretan MB, Straif K (August 2004). “Tobacco smoking and cancer: a brief review of recent epidemiological evidence”. Lung cancer (Amsterdam, Netherlands) 45 Suppl 2: S3–9. doi:10.1016/j.lungcan.2004.07.998. PMID15552776.
8. ^ Biesalski HK, Bueno de Mesquita B, Chesson A, et al. (1998). “European Consensus Statement on Lung Cancer: risk factors and prevention. Lung Cancer Panel”. CA: a cancer journal for clinicians 48 (3): 167–76; discussion 164–6.doi:10.3322/canjclin.48.3.167. PMID 9594919.
9. ^ O’Reilly KM, Mclaughlin AM, Beckett WS, Sime PJ (March 2007). “Asbestos-related lung disease”. American family physician 75 (5): 683–8. PMID 17375514.
10. ^ Seitz HK, Pöschl G, Simanowski UA (1998). “Alcohol and cancer”. Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism 14: 67–95. PMID 9751943.