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Medicine is to heal from the inside

Iron Deficiency Anemia Treatment

As stated in my previous post about anemia, Anemia is common condition that affected population, especially in developing countries. The commonest cause of anemia is iron deficiency.

Iron deficiency anemia can be caused by: low intake of iron or excessive loss of iron. Low Intake of Iron means that dietary iron is insufficient related to demand, thus impacts the blood formation. Increased demand of iron can be found in conditions such as during pregnancy or breastfeeding, and growing children. Therefore, iron intake should be increased to fulfill iron demand. Another condition that often correlates with low iron intake is vegetarian. Even, iron also can be found in green leaf vegetables, but iron absorption from vegetable is lower or more difficult than from meat or animal sources.

Iron Deficiency anemia

Iron metabolism in our body is very effective, iron is being recycle to prevent depleted iron storage. But, some pathological conditions especially bleeding whether from menstruation, bleeding piles, gastric ulcer, etc. lead to loss of iron. The more chronic and severe that pathological conditions, the more iron is lost.

Iron deficiency not only effects blood formation but also in cognitive development, endocrine function, and immune system. Based on WHO publications about iron deficiency, iron deficiency can impair cognitive performance at all stages of life. These children will have delayed psychomotor development, and when they reach school age they will have impaired performance in tests of language skills, motor skills, and coordination, equivalent to a 5 to 10 point deficit in IQ.

Iron supplementation and milk or cereal fortification among deficient children
has been reported to reduce morbidity from infectious disease. Iron deficiency alters the production of triiodothyronine (T3) and thyroid function in general, and the production and metabolism of catecholamines and other neurotransmitters. This results in impaired temperature response to a cold environment.

Treatment of Iron Deficiency Anemia
Prior to treat the anemia, someone have to be evaluated about the cause of iron deficiency. Then the management of iron deficiency can be divided into two:
1. Increasing Iron Intake
There are several ways in order to increase iron intake, such as using iron fortifier food, promoting diversified food, and taking iron supplementation.
Another way is by avoiding iron absorption inhibitors while consuming high iron content food, such as tea, coffee, and milk. And promoting the usage of iron enhancer such Vitamin C, to help iron absorption.
High Iron contained Foods

2. Stop or Control Abnormal Bleeding
Identify the bleeding source is important in order to minimized iron lost. Heavy periods, bleeding piles, gastric ulcer, etc. have to be consulted to the experts.

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Body Fat not Always Bad

Most of the women dream are having a good, sexy, body shape, which associated with slim body. Well, it has been accepted that beauty woman has slim body. Thus makes women try to make their body slim, and avoid to be fatty.

"Women are happier when they know that they lose their weight rather than increase of the body weight"

Because of that, most of the women do everything to get slimmer, such as extreme diet, liposuctioning, drugs, exercises, etc.
When women are slimmer, they are more confident, and easier to attract male.

But, the body fat not always bad for our health and our body.
Slim body

Women and Fat
Women tend to have more fat than men—about five percent more. By nature, a woman's body is developed to protect her and a potential fetus. As a result, women have more enzymes for storing fat and fewer enzymes for burning fat. Additionally, the estrogen women have activates fat storing enzymes and causes them to multiply. The minimum percent bodyfat considered safe for good health is 12% for females. The average adult body fat is closer to 22%-25% for women.

Eventhough women store more fat compare to men, but men are more prone to obesity related complications. Because women have high estrogen level, estrogen is responsible for fat storage in women. Estrogen mobilize fat and store in hips and legs, thus give a women body shape like a spanish guitar (pear-shaped).
While in men, fat deposition is not well controlled thus store in belly (apple-shaped).

Heredity is one: Scientists have identified a number of genes that help determine how many fat cells an individual develops and where these cells are stored. Hormones are also involved. At menopause, estrogen production decreases and the ratio of androgen (male hormones present in small amounts in women) to estrogen increases — a shift that’s been linked in some studies to increased abdominal fat after menopause. Some researchers suspect that the drop in estrogen levels at menopause is also linked to increased levels of cortisol, a stress hormone that promotes the accumulation of abdominal fat.

As the evidence against abdominal fat mounts, researchers and clinicians are trying to measure it, correlate it with health risks, and monitor changes that occur with age and overall weight gain or loss.
Body Fat Deposition

Central obesity is associated with cardiovascular complications and diabetes mellitus, since fat in belly, is rapidly metabolized thus increases serum cholesterol and lipid fat. While, the estrogenic storage fat (hips and legs) are slow to metabolized, usually use in hormone production. Thus women that have less fat in hips and legs associated with menstrual complaints.

The good news is that visceral fat yields fairly easily to exercise and diet, with benefits ranging from lower blood pressure to more favorable cholesterol levels. Subcutaneous fat located at the waist — the pinchable stuff can be frustratingly difficult to budge, but in normal-weight people, it’s generally not considered as much of a health threat as visceral fat is. In fact, a study published in the New England Journal of Medicine in 2004 found that liposuction removal of subcutaneous fat (up to 23 pounds of it) in 15 obese women had no effect after three months on their measures of blood pressure, blood sugar, cholesterol, or response to insulin. Weight loss through diet and exercise, on the other hand, triggers many changes that have positive health effects.

Conclusion
Too little body fat can cause physiological complications, too much body fat is also harmful. For women over 32% fat, there is a dramatic correlation with illness and disease. Obesity has become a serious health threat for women at every stage of life.

Women dream to Have a slim body, but it should be without any fat, since fat is needed in our body physiology.

Abdominal fat is the most harmful fat storage and but it easier to lose it by diet or exercise.



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Nutrition in Pregnancy

Introduction
Pregnancy is a unique process of women's life, pregnancy also becomes a transition for a woman to be a mother. Thus pregnancy besides physical changes, also gives an emotional, psychological changes to a woman. During pregnancy, women are worried about their offspring inside their womb.
Those feelings usually occurs and should accepted gratefully.

Normally, pregnancy should be between 37-42 weeks in durations or about 9 months, during that period the fetus keep growing inside woman's womb. During that period many factors contribute to successful pregnancy, such as genetics, mother's conditions, nutritional factors, etc.

In this article, i gonna write about the nutritional support in pregnancy, one of the major concern of pregnant women. Pregnancy is associated with physiologic changes that result in increased plasma volume and red blood cells and decreased concentrations of circulating nutrient-binding proteins and micronutrients. In many developing countries, these physiologic changes can be aggravated by undernutrition, leading to micronutrient deficiency states, such as anemia, that can have disastrous consequences for both mothers and newborn infants.
pregnancy and nutrition

Nutrition is important in pregnancy, because not only mother but also the offsprings need the nutrients. Eventhough the offspring is protected by unique mechanisms, thus makes it minimally effected by nutritional depletion but some nutritional deficiencies could resulted in congenital anomalies.

Nutrition and Pregnancy
Pregnancy increases the demand both energy and nutrients, but the requirements maybe different from each woman, and trimester. For well-nourished women, only a small amount of additional energy is required because the body adapts to the increased energy requirements and becomes more energy efficient through reduced physical activity and a lowered metabolic rate. Recent evidence suggests, however, that infants who are small or disproportionate at birth have increased health risks later in life. The hypothesis is that such infants have had to adapt to a limited supply of nutrients and that in so doing their physiology and metabolism are permanently changed, although the rationale for this hypothesis has been challenged.

Deficiencies can exist because of losses or malabsorption associated with disease or inadequate intakes, lack of knowledge about adequate prenatal nutrition, or dietary taboos associated with pregnancy, with potential adverse consequences for both mothers and newborn infants. Anemia in pregnancy and pregnancy-induced hypertension are common and thought to contribute significantly to maternal mortality and morbidity in developing countries.

Vitamins and Minerals
As a component of prenatal care, micronutrient supplementation might reduce maternal morbidity and mortality directly by treating a pregnancy-related illness or indirectly by lowering the risk of complications at delivery.

Nevertheless, the effectiveness of supplementation programs notably of iron and folate has tended to focus on infant outcomes, perinatal mortality, preterm delivery, and low birth weight. When infant outcomes are discussed, however, a distinction needs to be made between the teratogenic effects of deficiency at periconception and deficiency in later pregnancy. The former includes folate deficiency resulting in fetal neural tube defects and iodine deficiency that causes cretinism, whereas the latter includes intrauterine growth retardation and other pregnancy-related and delivery complications.

This distinction is important because many pregnancies in developing countries are unplanned; the use of prenatal care services, in which iron or iron and folate supplements are generally provided or prescribed, is less than optimal, and the cost-effectiveness of the programs promoted needs to be considered. Even in developed countries, prenatal care providers have reservations about the widespread and indiscriminate use of prophylactic minerals and vitamins because of unproven benefits in well-nourished populations, risks of teratogenicity, and side effects. These concerns need to be considered in the context of developing countries.

The Deficiency
Pregnant women in developing countries are associated with malnutrition, thus the demand of nutrients supplementation is quite high. WHO create the programs in antenatal care with the supplementation of folate, iron and iodine
to reduce pregnancy related mortality and morbidity.

Iron deficiency resulting mainly from poor dietary iron bioavailability causes anemia and has been associated with maternal mortality. Iron deficiency is known to affect immune status by reducing the delayed-type hypersensitivity reaction, graft rejection, and cytotoxic activity of phagocytes. Thus, iron may be important for maintaining maternal health and reducing the risk of infection.
The problems raised related to prophylactic iron supplementation. Which populations need those supplementation, recent recommendations for iron supplementation during pregnancy for developing countries. In other countries, iron supplementation is recommended only for anemic women with proven iron deficiency anemia, as in Great Britain, or for women with low prepregnancy iron stores, as in Canada. Iron overload leads to impairment of body function, this conditions commonly found in thalassemia patients that having frequent transfusions.
Thus iron supplementation should be give only for the women that need it, such as anemic women.

Folate deficiency is due to inadequate dietary intakes, cooking habits that exacerbate losses, food taboos, inadequate food storage, and intense erythroid hyperplasia in the bone marrow (eg, sickle cell anemia, chronic hemolytic anemia, or homozygous ß-thalassemia); deficiency is associated with megaloblastic anemia, low birth weight, and potential fetal anomaly.
The findings of folic acid roles in pregnancy to reduce the number of births with neural tube defects, is significant, from the literatures folic acid supplementation could reduce up to 75% neural tube defects. Thus, folic acid administration is recommended as standard prenatal care. Except for women taking anticonvulsant drugs, who may have coexisting vitamin B-12 deficiency, there is no evidence that folate supplementation in pregnancy is unsafe.

Inadequate iodine intakes during pregnancy result in fetal loss, stillbirths, cretinism, and mental retardation of the newborn infant In regions of moderate to severe iodine deficiency, pregnant women need iodized salt before or iodized oil before or during pregnancy. This regimen reduces reproductive loss, morbidity, and adverse fetal outcomes.

There are others vitamin and minerals that the demands increase during the pregnancy, such calcium, phosphorus, zinc, vitamin A, vitamin C, etc. Eventhough the demand is increase but the incidence of deficiency isn't quite high, so daily consumption of dietary products can meet the demands.
pregnancy

At the end, nutritional support is important for fetal development besides others factors such as mother's conditions, genetic, placenta, etc.
Pregnant women with anatomical and physiological changes, increase the demands of certain nutrients. Thus proper supplementation during pregnancy is needed. Well-nourished women basically, need less supplementation or maybe don't need at all compare to undernourished women.

"Being pregnant not only means that you're being bless, but also you have chosen to receive the responsibility"
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Kangaroo Mother Care

Introduction
Nowadays, with the advanced in medical science and technology especially in perinatalogy. The amount of infant death rate is being reduced significantly. But, we are facing a more complicated newborn e.g. low-birthweight and premature baby. Since most infant deaths occurs in neonatal period about 2/3 total of infant death. And low-birthweight infants have higher risk of death since its related to its immaturity.

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Breastfeeding: An Ideal food for your Baby

Breast Milk is the ideal food for normal full-term babies, but unfortunately in many Western societies its advantages are not fully utilized. The advantages of breastfeeding can be considered as those for the baby and those for the mother, although these are of course interrelated.
breastfeeding

Advantages to the baby
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Walking Lower Women Stroke Risk

In April 2010, US researchers published their study about healthy lifestyle and stroke risk, in this case is walking and related to women stroke risk. Women who walked two or more hours a week or who usually walked at a brisk pace (3 miles per hour or faster) had a significantly lower risk of stroke than women who didn't walk, according to a large, long-term study reported in Stroke: Journal of the American Heart Association.
Walking woman

This study is a long term observational study with a nearly 12-year follow-up, women who walked two or more hours per week had a significantly lower risk of stroke than women who didn’t walk. Also reported that women who walked at a brisk pace also had a significantly lower risk of stroke than non-walkers


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