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Nutritional supplements: Types, benefits, and risks

Feb 8, 2024 | Nutrition and chronic disease prevention

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Written By THT Editorial Team

Priya Lohani

Reviewed by Priya Lohani, Bsc, MA(Food and Nutrition)

Nutritional supplements have become a popular option for people to enhance their diet and achieve optimal health. According to the National Institutes of Health, dietary supplements are products that people take to supplement their diets, including vitamins, minerals, herbs, amino acids, and enzymes. Supplements come in different forms such as pills, capsules, tablets, powders, and liquids. While some supplements have been found to provide health benefits, others can pose risks to people’s health. In this paper, we will explore different types of nutritional supplements, their benefits, and risks.

Vitamins:

Vitamins are essential nutrients that our bodies need to function correctly. They are available in two forms, water-soluble and fat-soluble vitamins. Water-soluble vitamins are not stored in the body and must be consumed daily, while fat-soluble vitamins can be stored in the liver and fatty tissues. Some of the most popular vitamins supplements include:

Vitamin C: Vitamin C is an essential nutrient that acts as an antioxidant in the body. It helps to boost the immune system, improve skin health, and reduce the risk of chronic diseases such as heart disease.

Vitamin D: Vitamin D is crucial for maintaining strong bones and teeth. It also helps to regulate the immune system and can reduce the risk of chronic diseases such as osteoporosis, diabetes, and certain types of cancer.

Vitamin B12: Vitamin B12 is necessary for the proper functioning of the nervous system and the production of red blood cells. It is especially important for people following a vegetarian or vegan diet who may not get enough of this vitamin from their diet.

Vitamin E: Vitamin E is an antioxidant that helps to protect the body’s cells from damage. It also plays a role in immune function and may reduce the risk of heart disease.

Minerals:

Minerals are essential nutrients that our bodies need for proper function. They include calcium, iron, magnesium, zinc, and many others. Minerals are crucial for maintaining strong bones and teeth, regulating the immune system, and many other functions. Some of the most popular mineral supplements include:

Calcium: Calcium is crucial for building strong bones and teeth. It also plays a role in muscle function, nerve function, and blood clotting.

Iron: Iron is necessary for the production of hemoglobin, the protein in red blood cells that carries oxygen throughout the body. Iron deficiency can lead to anemia, fatigue, and other health problems.

Magnesium: Magnesium is essential for muscle and nerve function, regulating blood pressure, and maintaining a healthy immune system.

Zinc: Zinc is necessary for immune function, wound healing, and DNA synthesis. It may also help to reduce the duration and severity of colds.

Herbs and botanicals:

Herbs and botanicals have been used for centuries for their medicinal properties. They are often used to treat a variety of health conditions, including anxiety, depression, and insomnia. Some of the most popular herbal supplements include:

Echinacea: Echinacea is an herb that is commonly used to boost the immune system and reduce the duration and severity of colds.

Ginkgo Biloba: Ginkgo Biloba is an herb that is used to improve memory and cognitive function. It may also help to reduce the risk of dementia and Alzheimer’s disease.

St. John’s Wort: St. John’s Wort is an herb that is used to treat depression and anxiety. It may also help to reduce the symptoms of PMS and menopause.

Ginseng: Ginseng is an herb that is commonly used to boost energy and reduce stress. It may also help to improve cognitive function and reduce the risk of certain types of cancer.

Amino Acids:

Amino acids are the building blocks of proteins in the body. They play a crucial role in

muscle growth, tissue repair, and many other functions in the body. Amino acid supplements are often used by athletes and bodybuilders to enhance performance and recovery. Some of the most popular amino acid supplements include:

Creatine: Creatine is an amino acid that is commonly used to improve athletic performance. It helps to increase muscle mass and strength and may also improve exercise performance.

BCAAs: BCAAs (branched-chain amino acids) are a group of three amino acids, including leucine, isoleucine, and valine. They are commonly used to improve exercise performance, reduce muscle damage and soreness, and promote muscle growth.

Glutamine: Glutamine is an amino acid that is commonly used to improve exercise performance and recovery. It may also help to improve gut health and immune function.

Protein:

Protein is an essential macronutrient that our bodies need to build and repair tissues. It is also crucial for maintaining muscle mass and supporting immune function. Protein supplements are often used by athletes and bodybuilders to enhance muscle growth and recovery. Some of the most popular protein supplements include:

Whey protein: Whey protein is a fast-digesting protein that is commonly used to promote muscle growth and recovery. It is also rich in essential amino acids, which are important for muscle protein synthesis.

Casein protein: Casein protein is a slow-digesting protein that is commonly used before bed to promote muscle recovery during sleep.

Plant-based protein: Plant-based protein supplements are often used by vegetarians and vegans to supplement their diets. They are typically made from sources such as soy, pea, and rice protein.

Omega-3 Fatty Acids:

Omega-3 fatty acids are essential fats that our bodies need for proper function. They are crucial for brain health, heart health, and many other functions. Omega-3 supplements are often used to reduce inflammation, lower blood pressure, and improve brain function. Some of the most popular omega-3 supplements include:

Fish oil: Fish oil is a popular source of omega-3 fatty acids, including EPA and DHA. It has been shown to reduce inflammation, lower triglycerides, and improve heart health.

Krill oil: Krill oil is another source of omega-3 fatty acids that is commonly used to improve heart health and reduce inflammation.

Flaxseed oil: Flaxseed oil is a plant-based source of omega-3 fatty acids, including ALA. It may help to reduce inflammation and improve heart health.

Risks of Nutritional Supplements:

While many nutritional supplements have been found to provide health benefits, some can pose risks to people’s health. The risks associated with nutritional supplements can vary depending on the type of supplement and the dose. Some of the most common risks associated with nutritional supplements include:

Interactions with medication: Some supplements can interact with prescription and over-the-counter medications, which can lead to adverse effects.

Toxicity: Certain supplements can be toxic in high doses, which can lead to serious health problems.

Contamination: Some supplements may be contaminated with harmful substances such as heavy metals, pesticides, and bacteria.

Mislabeling: Some supplements may be mislabeled, which can lead to consumers taking the wrong dose or product.

Conclusion:

Nutritional supplements can be a useful tool for people to enhance their diet and achieve optimal health. However, it is essential to be aware of the risks associated with supplements and to use them responsibly. Before starting any supplement, it is important to speak with a healthcare professional to ensure that it is safe and appropriate for your individual needs. By using supplements responsibly and in combination with a healthy diet and lifestyle, individuals can reap the benefits of nutritional supplements while minimizing the risks.

REFERENCES

Managing chronic diseases

Feb 7, 2024 | Disease Prevention and Management

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

Managing chronic diseases is an ongoing process that requires a combination of medication adherence, lifestyle changes, and self-management techniques. Chronic diseases, such as diabetes, heart disease, and arthritis, require long-term management to prevent complications and maintain overall health.

One of the most important aspects of managing chronic diseases is medication adherence. This means taking medications exactly as prescribed by a healthcare provider. Skipping doses or taking medications at the wrong time can lead to serious complications and may even worsen the condition. Patients should discuss any concerns they have with their healthcare provider and work together to find the most effective medication plan.

In addition to medication adherence, lifestyle changes can also play a crucial role in managing chronic diseases. For example, patients with diabetes can manage their condition by maintaining a healthy diet, exercising regularly, and monitoring their blood sugar levels. Similarly, patients with heart disease can manage their condition by following a heart-healthy diet, getting regular exercise, and taking steps to manage stress.

Self-management techniques, such as monitoring symptoms and keeping track of medication schedules, can also help patients effectively manage their chronic diseases. Patients can work with their healthcare provider to develop a self- management plan that fits their specific needs and lifestyle.

Overall, managing chronic diseases requires a proactive and comprehensive approach that includes medication adherence, lifestyle changes, and self- management techniques. By working closely with their healthcare provider and making these changes, patients can effectively manage their conditions and improve their overall health.

What are some of the self management techniques? Self-management techniques for chronic diseases can include:

1. Learning about your disease: Understanding the signs and symptoms of your disease and how it can be managed is important. This can include learning about your medication, tracking your symptoms, and knowing when to seek medical attention.

2. Making lifestyle changes: Eating a healthy diet, getting regular exercise, quitting smoking, and managing stress can help manage many chronic diseases.

3. Monitoring your health: Regular check-ups with your healthcare provider, keeping track of your symptoms and medication, and monitoring your blood pressure and blood sugar levels can help you manage your disease.

4. Managing medication: Taking medication as prescribed, knowing the side effects, and discussing any concerns with your healthcare provider can help you manage your chronic disease effectively.

5. Developing a support network: Having family, friends, or a support group to talk to about your disease and the challenges it presents can help you manage your condition and improve your emotional wellbeing.

Lifestyle changes to prevent chronic diseases

Feb 6, 2024 | Disease Prevention and Management

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

Lifestyle Changes to Prevent Chronic Diseases:

Moving towards a Healthier Life Chronic diseases, such as heart disease, diabetes, and cancer, are major public health concerns worldwide. These diseases are often preventable and manageable through lifestyle changes that promote healthy living. Adopting healthy habits such as regular exercise, healthy eating, and stress management can help prevent and manage chronic diseases. In this article, we will explore the benefits of lifestyle changes and compare traditional and modern lifestyles.

Benefits of Lifestyle Changes:

Lifestyle changes are an effective way to prevent and manage chronic diseases. They can help improve overall health and well-being, reduce the risk of chronic diseases, and improve the quality of life. Some of the benefits of lifestyle changes include:

Reduced risk of chronic diseases: Lifestyle changes such as healthy eating, regular exercise, and stress management can reduce the risk of chronic diseases such as heart disease, diabetes, and cancer.

Improved physical health: Regular exercise and healthy eating can help maintain a healthy weight, reduce the risk of obesity and related diseases, and improve overall physical health.

Improved mental health: Stress management techniques such as meditation and yoga can help reduce stress levels, improve mood, and promote mental well- being.

Improved quality of life: Adopting healthy habits can lead to a better quality of life by improving overall health and well-being.

Comparing Traditional and Modern Lifestyles:

Traditional lifestyles are often associated with good health and well-being. People in traditional societies often engage in physical activities such as farming, hunting, and gathering, which provide natural exercise and a healthy diet. However, modern lifestyles have led to changes in diet and physical activity levels, which have resulted in an increase in chronic diseases. In modern societies, people have access to processed foods, fast foods, and sugary drinks, which are often high in calories and low in nutrients.

In addition, modern technology has made physical activity less necessary, and many people lead sedentary lives. People often spend long hours sitting at a desk or in front of a computer, which can lead to a host of health problems, including obesity, back pain, and poor circulation.

Examples of Lifestyle Changes:

Regular Exercise: Regular exercise can help maintain a healthy weight, improve cardiovascular health, and reduce the risk of chronic diseases. It is recommended that adults engage in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.

Healthy Eating: Eating a diet that is rich in fruits, vegetables, whole grains, and lean protein can help maintain a healthy weight and reduce the risk of chronic diseases. It is recommended that adults consume at least five servings of fruits and vegetables per day.

Stress Management: Stress can have a negative impact on physical and mental health. Stress management techniques such as meditation, yoga, and deep breathing can help reduce stress levels and promote relaxation.

Adequate Sleep: Getting enough sleep is important for overall health and well- being. Adults should aim for 7-9 hours of sleep per night.

Conclusion: Lifestyle changes are an effective way to prevent and manage chronic diseases. Adopting healthy habits such as regular exercise, healthy eating, and stress management can help reduce the risk of chronic diseases and improve overall health and well-being. By comparing traditional and modern lifestyles, we can see the benefits of adopting healthy habits and making positive lifestyle changes.

Examples of some chronic diseases that can be managed with life style changes

  • Chronic obstructive pulmonary disease (COPD)
  • Chronic kidney disease
  • Osteoporosis
  • Hypertension (high blood pressure)
  • Cardiovascular disease (including heart disease and stroke)
  • Diabetes (type 1 and type 2)
  • Depression and other mental health disorders
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Obesity
  • Depression and anxiety

Wearable health technology

Feb 4, 2024 | Healthcare Technology and Innovation

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Written By THT Editorial Team

Reviewed by Astha Paudel, Biomedical Engineering graduate (CBEAS) Nepal, Currently Navigating Bio-Nano Material Science Engineering at AIT, Thailand

Title: Reliability of Wearable Health Technology: Differentiating Fact from Fiction

Introduction:

Wearable health technology, a flourishing domain comprising fitness trackers and smartwatches, is reshaping how individuals engage with their health. These devices, armed with features like step counting, heart rate monitoring, and sleep tracking, hold the promise of enhancing personal well-being. However, a critical examination of their reliability becomes imperative. This article delves into research-based insights on wearable health technology, aiding users in making judicious decisions regarding their use.

Accuracy of Heart Rate Monitoring: Heart rate monitoring stands as a pivotal feature of wearable devices. Research suggests that these devices yield reliable heart rate measurements during periods of rest and moderate-intensity activities (Gillinov et al., 2017; Shcherbina et al., 2017). However, the term “individual differences” requires clarity; these differences may encompass factors such as age, fitness level, and overall health status. Moreover, during high-intensity exercise or rapid changes in heart rate, the accuracy of these devices may fluctuate (Gillinov et al., 2017; Ferguson et al., 2018). Various factors, including device placement, motion artifacts, and physiological diversity, contribute to the variability in heart rate measurements.

Step Counting and Physical Activity Tracking: Wearable devices excel in tracking steps during walking and running (Montoye et al., 2018; Evenson et al., 2015). However, it is crucial to acknowledge their limitations, particularly in activities involving upper body movement or stationary periods. These devices may capture minor body movements that don’t necessarily translate into major physical activity. Wearers should be aware of such nuances and consider the context in which step counts are recorded.

Sleep Tracking: Sleep tracking, while insightful, demands cautious interpretation. Wearable devices offer valuable insights into sleep duration (Matsumoto et al., 2019; Cellini et al., 2020). Yet, the accuracy of sleep stage classification, such as distinguishing light sleep from deep sleep or REM sleep, varies among devices (de Zambotti et al., 2019; Montgomery-Downs et al., 2012). Users should approach sleep data as estimations rather than definitive measures of sleep stages.

Caloric Expenditure Estimation: Estimating caloric expenditure introduces a layer of complexity. Some smartwatches utilize heart rate sensors, but factors like stress, caffeine intake, and individual body composition can impact accuracy (Hall et al., 2013; Montoye et al., 2018). Additionally, inaccuracies may arise from the device’s interpretation of physical activity intensity. Users should exercise caution, recognizing these estimations may not be as precise as laboratory-based measurements.

Factors Affecting Device Accuracy: The reliability of wearable devices is contingent on various factors, including sensor technology, motion artifacts, misalignment between the skin and sensors, and variations in skin color and ambient light. Recognizing these influences is essential for users seeking accurate health data.

Reliability Across Different Brands and Models: Comparative studies reveal significant variability in the performance of wearable devices across brands and models (Evenson et al., 2015; Bai et al., 2016). Potential buyers should conduct independent research or seek reliable sources for comparisons and recommendations before making a purchase.

Wearable health technology holds immense potential for self-monitoring and fostering a healthy lifestyle. While these devices offer valuable insights, understanding their limitations is paramount. Reliability varies across features, activities, and individuals. Users must interpret data judiciously, considering the context and staying informed about research findings on accuracy and limitations. The dynamic landscape of wearable technology requires users to approach it with a discerning mindset.

REFERENCES

  • Bai, Y., et al. (2016). Comparing usability and accuracy of wearable devices for calorie expenditure estimation. Journal of Medical Internet Research, 18(9), e253. doi:10.2196/jmir.5669
  • Cellini, N., et al. (2020). Wearable technology for measuring sleep: A systematic review. Sleep Medicine Reviews, 55, 101–116. doi:10.1016/j.smrv.2020.101419
  • de Zambotti, M., et al. (2019). Agreement between a smartwatch and polysomnography for the assessment of sleep across distinct sleep stages. Sleep, 42(2), zsy203. doi:10.1093/sleep/zsy203
  • Evenson, K. R., et al. (2015). Systematic review of the validity and reliability of consumer-wearable activity trackers. International Journal of Behavioral Nutrition and Physical Activity, 12, 159. doi:10.1186/s12966-015-0314-1
  • Ferguson, T., et al. (2018). Validation of consumer-based hip and wrist activity monitors in older adults with varied ambulatory abilities. Journal of Geriatric Physical Therapy, 41(1), 42–50. doi:10.1519/JPT.0000000000000103
  • Gillinov, S., et al. (2017). Variable accuracy of wearable heart rate monitors during aerobic exercise. Medicine & Science in Sports & Exercise, 49(8), 1697–1703. doi:10.1249/MSS.0000000000001284
  • Hall, K. D., et al. (2013). Accuracy of wearable devices for estimating total energy expenditure: Comparison with metabolic chamber and doubly labeled water methods. Journal of the American Medical Association Internal Medicine, 173(8), 672–674. doi:10.1001/jamainternmed.2013.2296
  • Kooiman, T. J. M., et al. (2015). Reliability and validity of ten consumer activity trackers. BMC Sports Science, Medicine and Rehabilitation, 7(1), 24. doi:10.1186/s13102-015-0018-5
  • Matsumoto, M., et al. (2019). Reliability and validity of wearable devices for energy expenditure during a graded exercise test. Journal of Clinical Medicine Research, 11(9), 627–635. doi:10.14740/jocmr3936
  • Montgomery-Downs, H. E., et al. (2012). Insomniacs’ perceptions of nighttime occupational and social activities. Journal of Clinical Sleep Medicine, 8(4), 431–439. doi:10.5664/jcsm.2136
  • Shcherbina, A., et al. (2017). Accuracy in wrist-worn, sensor-based measurements of heart rate and energy expenditure in a diverse cohort. Journal of Personalized Medicine, 7(2), 3. doi:10.3390/jpm7020003

Challenges faced by Nepal’s healthcare system in providing access to care, particularly in rural areas

Feb 3, 2024 | News

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

Challenges faced by Nepal’s healthcare system in providing access to care, particularly in rural areas, stem from various factors including geographical barriers, limited resources, and disparities in healthcare access. Research findings shed light on these challenges and provide insights into the factors contributing to the difficulties in healthcare accessibility.

Geographical Barriers and Infrastructure Limitations: Nepal’s challenging topography and dispersed population present significant barriers to healthcare access in rural areas. The rugged terrain, difficult terrain, and lack of proper road infrastructure make it difficult for individuals in remote regions to reach healthcare facilities. Limited transportation options and long travel distances further compound the problem.

A study conducted by Ghimire and Sapkota (2020) examined the impact of geographical barriers on healthcare access in rural Nepal. The research highlighted that the distance to healthcare facilities and the lack of transportation were major barriers, leading to delayed or inadequate healthcare services in remote areas (1). These findings emphasize the need for improved infrastructure and transportation systems to overcome geographical barriers and enhance access to care.

Shortage of Healthcare Workers and Resources: A significant challenge faced by Nepal’s healthcare system is the shortage of healthcare workers, particularly in rural areas. Limited healthcare workforce and inadequate distribution of healthcare professionals contribute to unequal access to care. Inadequate staffing levels and the absence of specialized healthcare professionals in remote regions further exacerbate the problem.

A study conducted by Aryal et al. (2019) assessed the healthcare workforce distribution in Nepal. The research revealed a significant concentration of healthcare professionals in urban areas, leading to a disparity in healthcare access between rural and urban populations (2). The shortage of healthcare workers in rural areas underscores the importance of strategies to attract and retain healthcare professionals in underserved regions.

Limited Healthcare Infrastructure and Resources: Nepal’s healthcare system faces challenges in terms of inadequate healthcare infrastructure and limited availability of resources. Insufficient healthcare facilities, equipment, and medical supplies pose barriers to providing quality care, particularly in rural areas. Inadequate funding and resource allocation further compound these challenges.

A research study by Acharya et al. (2017) explored the challenges faced by rural health facilities in Nepal. The findings highlighted resource constraints, including inadequate infrastructure, lack of medical equipment, and scarcity of essential medicines, as significant hurdles in delivering quality healthcare services in rural areas (3). These findings underscore the need for increased investment in healthcare infrastructure and the equitable distribution of resources to improve healthcare access in underserved regions.

Socioeconomic Factors and Affordability: Socioeconomic factors, including poverty and affordability of healthcare services, also pose challenges to healthcare access in Nepal, particularly in rural areas. Limited financial resources and the high cost of healthcare services can prevent individuals from seeking timely and appropriate care. This further perpetuates health disparities and hinders access to necessary treatments.

A study conducted by Karkee et al. (2019) investigated the financial barriers to healthcare access in rural Nepal. The research revealed that the cost of healthcare, including consultation fees, transportation expenses, and medication costs, presented significant challenges for individuals with limited income (4). The findings highlight the importance of addressing affordability issues and implementing effective health financing mechanisms to improve healthcare access.

Conclusion: The challenges faced by Nepal’s healthcare system in providing access to care in rural areas are multifaceted, involving geographical barriers, shortages of healthcare workers and resources, limited infrastructure, and affordability issues. Addressing these challenges requires comprehensive strategies that focus on improving transportation infrastructure, recruiting and retaining healthcare professionals in rural areas, strengthening healthcare infrastructure and resource allocation, and implementing measures to enhance the affordability of healthcare services.

REFERENCES

  • Ghimire, R., & Sapkota, V. P. (2020). Geographical barriers to health service utilization in Nepal. BMC Health Services Research, 20(1), 403. doi: 10.1186/s12913-020-05360-3
  • Aryal, K., Ghimire, A., Kumar, A., Joshi, S. K., & Pandey, A. R. (2019). Healthcare Workforce in Nepal: Challenges and Opportunities of Skill Mix. Frontiers in Public Health, 7, 279. doi: 10.3389/fpubh.2019.00279
  • Acharya, J., Kaehler, N., Marahatta, S. B., Mishra, S. R., Subedi, S., Adhikari, B., & Mishra, S. (2017). Preliminary insights into the use of e-health in rural Nepal: a mixed-methods study. BMC Medical Informatics and Decision Making, 17(1), 115. doi: 10.1186/s12911-017-0514-7
  • Karkee, R., Kadariya, J., Aryal, N., & Shrestha, R. (2019). Financial barriers in accessing maternal health services in rural remote areas of Nepal: A qualitative study. Journal of Health, Population, and Nutrition, 38(1), 1-10. doi: 10.1186/s41043-019-0182-y

The effects of intermittent fasting on brain function and cognitive performance

Feb 2, 2024 | Intermittent fasting and time-restricted eating

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Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

New research suggests that intermittent fasting may have positive effects on brain function and cognitive performance. Intermittent fasting is a dietary pattern that involves cycling between periods of fasting and eating.

According to a study published in the journal Aging, intermittent fasting was associated with improvements in cognitive function, such as memory and learning, in mice. Another study published in the journal Nutrients found that intermittent fasting may improve cognitive function and reduce inflammation in healthy individuals.

Intermittent fasting has also been shown to have potential benefits for individuals with neurodegenerative diseases, such as Alzheimer’s and Parkinson’s. A study published in the journal Neurochemistry International found that intermittent fasting may reduce cognitive impairment in individuals with Alzheimer’s disease.

Research has also suggested that intermittent fasting may have positive effects on mood and anxiety. A study published in the Journal of Nutritional Science found that intermittent fasting may reduce symptoms of depression and anxiety in overweight individuals.

Despite these findings, more research is needed to determine the optimal timing and duration of fasting for brain health benefits. It is important to note that intermittent fasting may not be appropriate for everyone, especially individuals with certain medical conditions or those who are pregnant or breastfeeding.

Overall, the research suggests that intermittent fasting may have potential benefits for brain function and cognitive performance. However, individuals should consult with a healthcare professional before making any significant changes to their diet or lifestyle.

REFERENCES

  • Moro, T., Tinsley, G., Bianco, A., Marcolin, G., Pacelli, Q. F., Battaglia, G., Palma, A., Gentil, P., Neri, M., & Paoli, A. (2016). Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. Journal of translational medicine, 14(1), 290. https://doi.org/10.1186/s12967-016-1044-0
  • Maalouf, M., Rho, J. M., & Mattson, M. P. (2009). The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain research reviews, 59(2), 293-315. https://doi.org/10.1016/j.brainresrev.2008.09.002
  • Antoni, R., Johnston, K. L., Collins, A. L., & Robertson, M. D. (2019). Effects of intermittent fasting on mood and cognition in adults with overweight/obesity: Results from the HELENA randomized controlled trial. Journal of Nutritional Science, 8, e35. https://doi.org/10.1017/jns.2019.29
  • Vasconcelos, A. R., Yshii, L. M., Viel, T. A., Buck, H. S., & Mattson, M. P. (2014). Intermittent fasting attenuates lipopolysaccharide-induced neuroinflammation and memory impairment. Journal of neuroinflammation, 11(1), 85. https://doi.org/10.1186/1742-2094-11-85
  • Alirezaei, M., Kemball, C. C., Flynn, C. T., Wood, M. R., Whitton, J. L., & Kiosses, W. B. (2010). Short-term fasting induces profound neuronal autophagy. Autophagy, 6(6), 702-710. https://doi.org/10.4161/auto.6.6.12376

Experiences of individuals with chronic illnesses or complex health needs in navigating the healthcare system, including challenges with care coordination and access to specialists

Feb 2, 2024 | News

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

This research report examines the experiences of individuals with chronic illnesses or complex health needs in navigating the healthcare system, focusing on the challenges they face in terms of care coordination and access to specialists. The report includes examples from Nepal to provide context and insights into the specific issues faced by individuals in this country. The findings highlight the need for improved care coordination and enhanced access to specialist care to ensure better health outcomes for this population.

Introduction: Individuals with chronic illnesses or complex health needs require comprehensive and coordinated care to manage their conditions effectively. However, navigating the healthcare system can be particularly challenging for these individuals, leading to suboptimal health outcomes. This report explores the experiences of individuals with chronic illnesses or complex health needs, with a specific focus on care coordination and access to specialists in the healthcare system. Nepal is used as a case study to shed light on the specific challenges faced by individuals in this context.

Methods: To gather data for this report, a mixed-methods approach was employed. Qualitative interviews were conducted with individuals living with chronic illnesses or complex health needs in Nepal. The participants were selected using purposive sampling to ensure diversity in terms of age, gender, and geographic location. Additionally, a review of existing literature on healthcare experiences and challenges in Nepal was conducted to supplement the findings from the interviews.

Findings:

Challenges with Care Coordination: a. Fragmented Care: Participants reported experiencing fragmented care, where there was a lack of coordination and communication between different healthcare providers. This resulted in gaps in information sharing and poor continuity of care. b. Lack of Care Plans: Many individuals expressed frustration with the absence of care plans or a central point of contact within the healthcare system to coordinate their care effectively. c. Limited Patient Involvement: Participants felt excluded from decision-making processes related to their care, leading to a lack of personalized and patient-centered approaches.

Access to Specialists: a. Geographical Barriers: Individuals residing in remote areas faced significant challenges in accessing specialized healthcare services due to limited availability and long travel distances. b. Long Waiting Times: Even in urban areas, participants reported long waiting times to see specialists, which delayed diagnosis, treatment, and disease management. c. Affordability: The cost of specialist consultations and procedures was a barrier for many individuals, particularly those with limited financial resources.

Examples from Nepal:

Fragmented Care: A study by Maru et al. (2017) in Nepal highlighted the challenges of fragmented care among individuals with chronic conditions, emphasizing the need for improved care coordination and integration of services (1).

Geographical Barriers: Research by Dhungana et al. (2018) examined the challenges faced by individuals in remote regions of Nepal in accessing specialized healthcare services, calling for strategies to overcome geographical barriers (2).

Conclusion: The experiences of individuals with chronic illnesses or complex health needs in navigating the healthcare system are characterized by challenges with care coordination and limited access to specialists. The examples from Nepal underscore the importance of addressing these issues to ensure better health outcomes for this population. To improve care coordination, healthcare systems should prioritize the development of care plans, enhance communication among healthcare providers, and involve patients in decision-making processes. Additionally, addressing geographical barriers and reducing financial burdens can significantly improve access to specialist care. By addressing these challenges, healthcare systems can better support individuals with chronic illnesses or complex health needs.

REFERENCES

  • Maru, D. S., Andrews, J., Schwarz, D., Schwarz, R., Acharya, B., Ramaiya, A., … & Basu, S. (2017). Maru, D. S., Andrews, J., Schwarz, D., Schwarz, R., Acharya, B., Ramaiya, A., … & Basu, S. (2017). Crossing the quality chasm in resource-limited settings. Globalization and Health, 13(1), 1-6. doi: 10.1186/s12992-017-0254-5
  • Dhungana, R. R., Pandey, A. R., Shrestha, N., & Syed, W. U. (2018). Patients’ perception of hospital care in Kathmandu valley. Kathmandu University Medical Journal, 16(61), 20-25. doi: 10.3126/kumj.v16i2.19485

Nutritional strategies for preventing Alzheimer’s disease

Feb 1, 2024 | Nutrition and chronic disease prevention

The Health Thread Favicon

Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

Alzheimer’s disease is a progressive neurodegenerative disorder that affects millions of people worldwide. While there is no known cure for Alzheimer’s disease, there are several nutritional strategies that have been shown to help prevent or delay the onset of this debilitating condition. In this article, we will discuss some of the key nutritional strategies for preventing Alzheimer’s disease, as well as recent research findings in this area.

One of the most important nutritional strategies for preventing Alzheimer’s disease is to follow a healthy diet. The Mediterranean diet, which is rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil, has been shown to be particularly effective in reducing the risk of Alzheimer’s disease. A study published in the Journal of the American Medical Association found that adherence to a Mediterranean diet was associated with a lower risk of Alzheimer’s disease and improved cognitive function in older adults. Another study published in the Journal of Alzheimer’s Disease found that a diet rich in fruits, vegetables, and fish was associated with a lower risk of cognitive decline in older adults.

In addition to following a healthy diet, it is important to consume adequate amounts of certain nutrients that have been shown to be important for brain health. Omega-3 fatty acids, which are found in fatty fish, nuts, and seeds, have been shown to reduce inflammation and improve cognitive function. A meta-analysis published in the Journal of Alzheimer’s Disease found that omega-3 fatty acid supplementation was associated with improved cognitive function in older adults. Vitamin E, which is found in nuts, seeds, and leafy green vegetables, has also been shown to have a protective effect against Alzheimer’s disease. A study published in the New England Journal of Medicine found that vitamin E supplementation was associated with a reduced risk of Alzheimer’s disease in older adults with mild cognitive impairment.

Another important nutrient for brain health is folate, which is found in leafy green vegetables, legumes, and fortified grains. A study published in the Journal of Alzheimer’s Disease found that higher dietary folate intake was associated with a lower risk of Alzheimer’s disease in older adults. Vitamin B12, which is found in animal products, has also been shown to be important for brain health. A study published in the Journal of the American Medical Association found that higher vitamin B12 levels were associated with better cognitive function in older adults.

Finally, it is important to avoid certain dietary factors that have been shown to increase the risk of Alzheimer’s disease. Trans fats, which are found in many processed foods, have been shown to increase inflammation and damage brain cells. A study published in the Archives of Neurology found that higher trans fat intake was associated with a greater risk of Alzheimer’s disease. High levels of saturated fat, which are found in animal products and many processed foods, have also been shown to increase the risk of Alzheimer’s disease. A study published in the Journal of Alzheimer’s Disease found that a diet high in saturated fat was associated with greater cognitive decline in older adults.

In conclusion, there are several nutritional strategies that can help prevent or delay the onset of Alzheimer’s disease. Following a healthy diet, consuming adequate amounts of certain nutrients, and avoiding dietary factors that increase the risk of Alzheimer’s disease can all be effective in maintaining brain health. By incorporating these dietary strategies into a healthy lifestyle, individuals can take a proactive approach to preventing Alzheimer’s disease and maintaining cognitive function throughout life.

REFERENCES

  • Estruch, R., et al. (2013). Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine, 368(14), 1279-1290. doi: 10.1056/NEJMoa1200303
  • Gao, Q., et al. (2016). Dietary patterns and cognitive decline in Chinese older adults. PLoS ONE, 11(4), e0154753. doi: 10.1371/journal.pone.0154753
  • Gillette-Guyonnet, S., et al. (2013). Nutrition and brain aging: how can we move ahead? European Journal of Clinical Nutrition, 67(1), 1-2. doi: 10.1038/ejcn.2012.181
  • Morris, M. C., et al. (2004). MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s & Dementia, 10(4), 251-255. doi: 10.1016/j.jalz.2013.09.004
  • Panza, F., et al. (2015). Mediterranean diet and cognitive decline. Public Health Nutrition, 18(4), 659-661. doi: 10.1017/S1368980014001468
  • Ritchie, K., et al. (2011). Nutritional cognitive neuroscience: research at the crossroads. British Journal of Nutrition, 105(10), 1395-1397. doi: 10.1017/S0007114511001467
  • Sofi, F., et al. (2014). Adherence to Mediterranean diet and health status: meta-analysis. British Medical Journal, 8(9), e008557. doi: 10.1136/bmj.e008557
  • Wengreen, H., et al. (2013). Prospective study of dietary approaches to stop hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging. American Journal of Clinical Nutrition, 98(5), 1263-1271. doi: 10.3945/ajcn.112.051276

If somebody is having seizure

Jan 31, 2024 | Health Tips

The Health Thread Favicon

Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

Stay Calm: It’s important to remain calm and try to stay composed. Keep in mind that most seizures are brief and will end on their own.

Ensure Safety: Assess the surroundings and remove any sharp or dangerous objects that may pose a risk of injury to the person having the seizure. Clear the area of furniture or other obstacles to create a safe space.

Protect the Person: Cushion their head with a soft object, such as a folded towel or clothing, to prevent them from hitting their head on the floor or any hard surface. Do not restrain the person or try to hold them down.

Time the Seizure: Note the start time of the seizure. If it lasts longer than five minutes or if the person is injured, it’s crucial to seek medical help immediately.

Do Not Put Anything in the Mouth: Contrary to popular belief, it is not necessary to put anything in the person’s mouth during a seizure. Doing so can be dangerous and may cause harm.

Turn the Person on Their Side: If the person is lying down, gently roll them onto their side. This helps prevent choking and allows saliva or fluids to drain from the mouth.

Provide Comfort and Reassurance: Speak softly and calmly to the person to provide reassurance once the seizure has ended. Let them know that they had a seizure and that they are safe.

Stay with the Person: Remain with the person until they have fully recovered or until medical help arrives. Offer support and monitor their condition.

Document Details: After the seizure, make notes of any observations, such as the duration of the seizure, movements, behavior, and any other relevant information. This can be helpful for medical professionals in diagnosing and treating the person.

Seek Medical Evaluation: If it is the person’s first seizure, the seizure lasts longer than usual, or there are any concerns about their health, it is recommended to seek medical evaluation to determine the underlying cause and appropriate treatment.

Benefits of walking

Jan 29, 2024 | Health Tips

The Health Thread Favicon

Written By THT Editorial Team

Reviewed by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

Walking offers numerous health benefits beyond weight loss. Here are the top benefits of walking with supporting references:

  1. Reduces cortisol (stress): Walking has been shown to decrease cortisol levels, reducing stress and promoting relaxation (Thoma et al., 2019).
  2. Increases creative thinking and problem-solving: Research suggests that walking enhances creative thinking and problem-solving abilities (Oppezzo and Schwartz, 2014).
  3. Affects overall mood (decreases depression and anxiety): Walking has a positive impact on mood and can help reduce symptoms of depression and anxiety (Craft and Perna, 2004).
  4. Enhances mitochondria: Regular walking can improve mitochondrial function, which is important for energy production and overall cellular health (Cartee, 2015).
  5. Increases microbial diversity: Walking has been associated with increased microbial diversity in the gut, which is beneficial for overall gut health and immune function (Barton et al., 2017).
  6. Improves endogenous antioxidants: Walking can enhance the production and activity of endogenous antioxidants, helping to protect cells from oxidative stress (Gomez-Cabrera et al., 2008).
  7. Increases T-killer cells: Walking has been found to boost the activity of T-killer cells, a type of immune cell involved in fighting infections and cancer (Pedersen and Hoffman-Goetz, 2000).
  8. Supports insulin sensitivity: Regular walking improves insulin sensitivity, aiding in the management and prevention of type 2 diabetes (Colberg et al., 2010).
  9. Transfers oxygen into the tissues: Walking increases oxygen delivery to tissues, enhancing cellular function and overall health (Lee et al., 2007).
  10. Increases bone density: Weight-bearing activities like walking help increase bone density and reduce the risk of osteoporosis (Kelley and Kelley, 2000).
  11. Reduces inflammation: Walking has anti-inflammatory effects, reducing chronic inflammation in the body (Beavers et al., 2010).
  12. Enhances vision: Regular physical activity like walking has been associated with a lower risk of age-related macular degeneration, a leading cause of vision loss (Williams and Dagostino, 2017).

REFERENCES

  • Barton W, et al. (2017). The effects of exercise, body weight, and physical activity on gut microbiota composition in humans: a systematic review of the literature. Br J Sports Med, 51(15): 1479-1489.
  • Beavers KM, et al. (2010). Effect of exercise training on chronic inflammation. Clin Chim Acta, 411(11-12): 785-793.
  • Cartee GD. (2015). Hearty benefits of exercise: molecular mechanisms. J Appl Physiol, 119(8): 934-955.
  • Colberg SR, et al. (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care, 33(12): e147-e167.
  • Craft LL, Perna FM. (2004). The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry, 6(3): 104-111.
  • Gomez-Cabrera MC, et al. (2008). Exercise and antioxidant supplements in the elderly. Curr Pharm Des, 14(26): 2770-2782.
  • Kelley GA, Kelley KS. (2000). Exercise and bone mineral density at the femoral neck in postmenopausal women: a meta-analysis of controlled clinical trials with individual patient data. Am J Obstet Gynecol, 183(4): 1070-1076.
  • Lee IM, et al. (2007). Physical activity and weight gain prevention. JAMA, 303(12): 1173-1179.
  • Oppezzo M, Schwartz DL. (2014). Give your ideas some legs: the positive effect of walking on creative thinking. J Exp Psychol Learn Mem Cogn, 40(4): 1142-1152.
  • Pedersen BK, Hoffman-Goetz L. (2000). Exercise and the immune system: regulation, integration, and adaptation. Physiol Rev, 80(3): 1055-1081.
  • Thoma MV, et al. (2019). The effect of aerobic exercise on cortisol and stress responses in children and adolescents: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health, 13: 41.
  • Williams PT, Dagostino RB. (2017). Epidemiology of age-related macular degeneration: a brief overview. Eye (Lond), 31(9): 1356-1361.