Women’s Health

Archive for December, 2009

FOR a moment, keep your eyes focused on the last word in this sentence. Without moving your eyes, could you see some of the area above, below, and on either side of this magazine? Most likely you could, thanks to what is known as peripheral vision. This ability makes you aware of that suspicious-looking person who is approaching you from the side. It helps you to sidestep objects on the ground and avoid bumping into walls as you walk. And if you drive a car, peripheral vision can alert you that a pedestrian has stepped off the curb.

But even as you read this page, your peripheral vision could slowly be disappearing—without your even realizing it. Worldwide, an estimated 66 million people are affected by a group of eye diseases collectively known as glaucoma. Of that number, over five million have become totally blind, making glaucoma the third-largest cause of permanent blindness. “Yet even in developed countries with public educational programmes that target glaucoma, half of the individuals with glaucoma remain undiagnosed,” states the medical journal The Lancet.

Who is at risk of developing glaucoma? How is it detected, and how is it treated?

What Is Glaucoma?

First we need to understand a little about our eyes. A brochure produced by the Glaucoma Foundation of Australia explains: “The eye’s rigidity is obtained through pressure—the soft tissues of the eye are ‘pumped up,’ just like a car tyre or a balloon.” Inside the eye, a pump called the ciliary body moves a fluid known as aqueous humor from the blood vessels into the eye. “The aqueous circulates deep inside the eye, nourishing the living structures of the eye and returns to the blood stream through a strainerlike structure called the trabecular meshwork.”

If this meshwork becomes blocked or constricted for any reason, the pressure inside the eye will increase and eventually begin to damage the delicate nerve fibers at the back of the eye. This condition is called open-angle glaucoma and accounts for about 90 percent of all cases.

The pressure inside your eye, known as intraocular pressure (IOP), can vary from hour to hour and is affected by a variety of factors including your heartbeat, the amount of fluids you drink, and your body position. These natural variations cause no damage to your eye. High pressure in the eye is not by itself proof of glaucoma, since “normal” eye pressure varies from person to person. Still, high IOP is one of the indicators of glaucoma.

A rare form of this disease is called acute, or angle-closure, glaucoma. Unlike open-angle glaucoma, this type involves a sudden increase of pressure in the eye. It causes severe pain in the eye, along with blurred vision and vomiting. If not treated within hours of the onset of symptoms, it will often cause blindness. Another category is called secondary glaucoma. As the name implies, this type is triggered by such other conditions in the eye as tumors, cataracts, or eye injuries. A small group of people are afflicted by the fourth type, known as congenital glaucoma. This type is present at birth or shortly thereafter and is indicated if the infant has enlarged eyeballs and an increased sensitivity to light.

How It “Steals” Vision

Glaucoma could steal up to 90 percent of your vision in one eye without your being aware of it. How is that possible? All of us have a naturally occurring blind spot at the back of each eye. This spot on the retina, where your nerve fibers join together to form the optic nerve, is devoid of light-sensing cells. You are unaware of this blind spot, however, because your brain has the ability to “paint in” the missing bits of the picture. Ironically, it is the brain’s ability to do this that makes glaucoma so insidious.

Dr. Ivan Goldberg, a leading Australian ophthalmologist, told Awake!: “Glaucoma is called the sneak thief of sight because it doesn’t give you any symptoms. The most common kind of glaucoma is slow and steady and, without any warning, causes damage to the nerve structure that connects the eye to the brain. Whether your eyes water or they don’t, whether they are dry or not, whether they see clearly to read and write or they don’t has nothing to do with glaucoma. You can have perfectly comfortable eyes and have very bad glaucoma.”

Detecting the Thief

Unfortunately, there is no single comprehensive test for glaucoma. Using a device known as a tonometer, an eye specialist may start by checking the fluid pressure in your eyes. The instrument is used gently to flatten the cornea, or front part of your eye. The amount of force required to perform this task is measured, and in this way the pressure inside your eye can be gauged. The eye specialist may also look for signs of glaucoma by using instruments that identify damaged tissue in the nerve structure that connects the eye to the brain. Dr. Goldberg says: “We see if the nerve fibers or blood vessels at the back of the eye are unusual in shape, because that can be an indication that nerves are being damaged.”

Glaucoma is also detected by visual-field testing. Dr. Goldberg explains: “A person looks into a bowl of white light, and there is a brighter white light that is shone at a little spot inside that bowl. The person responds by pressing a button when he or she can see the little white light.” Failure to recognize the white light when it is at the outer edge of your visual field could indicate glaucoma. New instruments are being developed that might simplify this rather tedious procedure.

Who Is at Risk?

Paul is a healthy man in his early 40’s. He says: “I went to the optometrist to be tested for a new pair of glasses, and during the visit he asked me if I had a family history of glaucoma. I did some investigating and discovered that both an aunt and an uncle had this condition. I was referred to an eye specialist, who confirmed that I had glaucoma.” Dr. Goldberg explains: “If your mother or father has it, your risk of getting glaucoma goes up three to five times. And if you have a brother or a sister with glaucoma, then your risk of getting it goes up between five and seven times.”

Dr. Kevin Greenidge of the Glaucoma Foundation in the United States highlights other risk factors, saying: “If you are over 45 and of African descent, or if you have any of these risk factors—family history of glaucoma, nearsightedness, diabetes, a previous eye injury or regular use of cortisone/steroid products—get your eyes tested every year.” Even if you have no risk factors and are under 45, the foundation recommends that you still have your eyes checked for glaucoma every four years. If you are over 45, you should have this checkup every two years.

Your risk of developing glaucoma increases if:

You are of African descent
Someone in your family has glaucoma
You have diabetes
You are nearsighted
You are a regular, long-term user of cortisone/steroid—used in some medical creams and asthma sprays
You have a previous eye injury
You are over 45 years of age

Treat It and Beat It

The treatment for Paul’s glaucoma includes the use of special eye drops once a day. Paul says: “The drops I use inhibit the production of the aqueous fluid in the eyeball.” Paul also underwent a treatment in which a laser beam was used to “drill” about ten tiny holes in the front of his eyes near where the natural drain holes occur. He says: “When I had my first eye treated with the laser, I was quite tense and nervous, and this magnified the discomfort that I felt. However, when my second eye was treated a few days later, I knew what to expect. I was far more relaxed, and the doctor had virtually finished the operation before I realized it.” Treatment has helped stabilize the pressure in Paul’s eyes.

Paul’s outlook is thus positive. He says: “My retinas have only been slightly damaged, and thankfully, I still have my full peripheral vision. If I remember to use my eye drops each day, it is likely to stay that way.”

Is the “sneak thief of sight” stealing your vision? If you have never had your eyes checked for glaucoma—and especially if you are in one of the risk groups—it would be wise to ask your doctor for a glaucoma examination. As Dr. Goldberg says, “much of the damage from glaucoma can be prevented by timely and appropriate treatment.” Yes, you can thwart this thief of sight!
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During the holiday season do you spend more time casting longing glances at the dessert buffets and high-calories cocktails than you spend enjoying the company of your loved ones?

If so, you are not alone. A “Prospective Study of Holiday Weight Gain” published in the New England Journal of Medicine in 2000 suggests that Americans gain an average of about one pound during the holiday season between Thanksgiving and New Year’s.

Who could possibly be more susceptible to this weight gain than high-end chefs and food personalities? They live and breath gourmet treats all day, every day as they prepare celebratory dinners, desserts and cocktails for the imbibing, indulging, gourmet-minded masses.

For famous chefs like Jeff Tunks and Michael Psilakis, spending too much time in the kitchen started to add on the pounds. Like many of their comrades, these two chefs have to work to find new ways to beat the bulge while they are cooking, eating and snacking.

So who better to give advice on how to lose weight? Vow to watch your waistline this holiday season and well into the new year as some well-known chefs share their best weight loss tips for you to enjoy!

Take Control

Satiate your cravings before you head out to big events and meals. Take control of what you eat by fixing a low-fat, high-fiber snack before you head out for the evening.

Jeff Tunks, co-owner and executive chef at DC Coast and Ceiba in Washington, D.C., has learned over the course of a remarkable 85-pound weight loss that he needs to eat before he goes to work if he wants to manage the late-night snack attack that can overtake a chef at the end of a long dinner shift.

Step 2Keep Control

Stay in command of your diet by making conscious choices about food throughout the day. Here are some fun, engaging ways to get started:

Organize your kitchen with small plates, dishes, forks and spoons to regulate your portion size.
Eat slowly and chew often. Aim to chew each bite of food 20 times before you swallow.
Dine with chopsticks instead of flatware; the unfamiliar utensils will certainly reduce your eating speed.
Write down what you eat each day in a food journal. It will help you get a handle on exactly how many calories you consume each day.

Step 3No Excuses

Set your weight loss goal, identify possible obstacles, and work out ahead of time how to overcome them. Don’t hide behind excuses and rhetoric. For a long time there was a saying in the restaurant industry: “You can’t trust a skinny chef”. Professionals from Mario Batali and Paula Deen to Michael Psilakis (Bon Appetit’s 2008 Chef of the Year) used the adage to overindulge and disassociate from their health.

Recently the gourmet world has realized that if you don’t want to pack on the pounds, a skinny chef make be the only kind you can trust. The excuse for excess weight was eliminated and now chefs are making a wide-ranging effort to lose weight and cut fat from their dishes so their customers can lose weight as well.

Lay Off the Sugar

Rocco DiSpirito recently told Time Magazine, “If everyone reading your article gave up sugar, they would lose 10 lbs. in a month. It’s nasty, nasty stuff.” Trust the professionals. Sugar is metabolized into fat in your body and over-consumption leads to energy spikes, mood swings and dehydration. It can also be a contributing factor in more serious medical conditions such as diabetes.

Cut down your sugar intake by limiting processed sweets such as pastries, cookies and cakes and by cutting back on alcohol consumption.

Eat Less Meat

Eat leaner cuts of meat and more meat substitute products. Lee Anne Wong, a contestant on the first season of Top Chef, contributes her weight loss after leaving the show to cutting down on red meat and eating more soy products.

Even steak house chefs such as Michael Lomonaco of Porter House New York are beginning to prepare more fish dishes in their restaurants. If you really want to chow on cow, pick the lean cuts: chuck, loin, sirloin and round are usually good bets.

Quick Tips for Dinner Time

Relax while you are getting ready for dinner, knowing that you have these great tools at your disposal to help keep calories to a minimum during your meal:

Start your meal with a vegetable soup - it will help you fill up before the main course. If the soup looks oily, fill a plastic bag with ice and drag the bag across the surface of the soup. The fat and oil will cling to the cold plastic. Genius!

Serve seconds only of vegetable dishes when you are eating a family-style meal. The fiber will fill you up without adding a lot of calories.

Order a coffee, tea or fresh fruit during dessert when you are out to dinner. It lets you feel that you are indulging without ruining your diet.

Easy Swaps

Recognize the calories in everyday foods and start to make conscious decisions to reduce the amount of fat, salt and sugar you ingest. Some easy swaps and substitutions recommended by top chefs:

Nonfat yogurt for sour cream. Ellie Krieger, host of the Food Network’s Healthy Appetite, says this simple switch cuts 4 grams of fat per serving. Mix it into sauces or use it to top off a baked potato. Strain the yogurt through a paper towel for a thicker, creamier texture. And don’t just stop at substituting it for sour cream. Jeremy Emmerson, a private chef based out of New York City, says that he eat nonfat Greek yogurt with fruit and nuts for a healthy, high energy breakfast.

Butter for canola oil. Switch out half or one-quarter of the butter in a dessert for canola oil, high in monosaturated fat and better for your heart. Improve the health benefits even further by cutting out the butter completely and cooking with a mix of canola oil and applesauce, substituting them at a 50/50 split and in the equivalent amount of butter in the recipe.

Skip salt as flavor. Use lemon, vinegar, mint, rosemary, garlic, ginger, sesame seeds, curry powders and spice blends when you are cooking instead of loading up dishes with salt and butter. Added bonus: many spices have medicinal benefits.
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