Stomach and digestive problems and preventive care

 1. LUMINATION

 Choose a time, shortly to defecate whether or not you have "the urge." Allow ten minutes. Relax, be comfortable, read if you like-the important thing is not to feel tense or hurried. Prop your feet on a footstool so your knees are close to your chest. If you choose to go before breakfast, it will help to drink a glass or two of fluid upon getting out of bed; it can be warm or cool water, fruit juice, tea, or coffee. Teaching your bowels to move regularly is a little like training yourself to wake up at a given hour every morning; it can be done, with patience, and once acquired the habit persists.

 2. DIET. 

The residue of foods you eat is easier to eliminate if it contains some roughage in the form of fibers, lubricants in the form of fats or oils, and fluid. These should be included in the diet of healthy people. (In some disease states, there may be an inability to tolerate roughage; in such cases, a physician will so advise.) To cure or prevent constipation, make certain your diet includes: For breakfast: 1/2 to 1 glass of tomato, grapefruit, prune, or orange juice. 

Also include one item from each of the following, (a) through (e): (a) Mixed dried or stewed fruits-prunes, apricots, figs (b) Cooked, whole-grain cereals with milk-barley, brown rice, oats, wheat (c) Margarine (d) Whole-grain bread (e) Beverage For lunch, dinner or supper, some of the following: Green leafy vegetable--beet greens, spinach, escarole, lettuce, turnip greens, dandelion greens, mustard greens Baked potatoes (eat the skins) Margarine, salad oils Dried or stewed fruits-especially for dessert at evening meal Take two glasses of fluid between meals and at least eight all told during the day. 

Drink an extra amount of water in summer because part of it is lost in perspiration.

3. EXERCISE. 

Strong abdominal muscles help elimination. If you do not have a firm, well-toned abdominal wall, start the exercises described on page 89. If your job requires much sitting and very little physical activity, you should indulge in regular sports or other forms of exercise. You will feel better generally as well as have fewer tendencies toward constipation.

 4. LIVE SENSIBLY. 

Try as much as you can to avoid the stresses and strains of modern living. Get relaxation to help temper those stresses and strains. Don't worry about constipation. If your physician gives you a clean bill of health on your regular visits, and you follow our suggestions for home checkups (page 33), constipation is not going to harm your health. Usually, these suggestions are enough to prevent or cure constipation. If they are not, and failure to move the bowels causes real discomfort, you may:

5. TAKE AN ENEMA. 

Use a pint of warm water containing a level tea- spoonful of table salt. If you use an enema bag, hold it about two feet above the toilet seat; if you use a bulb, do not press it too hard-the water should flow under gentle pressure. This should help soften the stool so it can be passed easily. You may take an enema every day-but remember that this is a crutch and the sooner you discard it, the better. If an enema does not help, your physician can show you how to insert olive oil into the rectum at night through a catheter, which will soften the stool and make it easier to pass in the morning.

6. LAXATIVES. 

If you cannot take an enema, use a mild laxative such as petrolatum and agar, aromatic cascara sagrada, or milk of magnesia. Do not do this until you have given your bowels a chance to work by themselves. An important step in curing constipation may be to stop taking all laxatives and cathartics. Strange as it seems, laxatives are frequently the cause of constipation and seldom are necessary in its cure. As noted above, mineral oil may be of value. A final warning: Don't give a laxative to a child, and don't take one yourself, if there is any fever, nausea, pain, or general feeling of illness associated with the constipation. It can cause fatal consequences if the condition is caused by appendicitis.

Exercises time and play, Basic principles of excercises

Exercise should become part of your daily routine. That means setting aside 30 minutes to an hour a day about five times a week. The daily activity period, or periods, should be considered as being as essential a part of your life as eating, sleeping, bathing, and dressing. Pick a time, or times, most suitable for you. If it is convenient for you to carry out much or all of your activity in one period each day, fine; divided periods of activity can also serve the purpose. Some people, early starters, like to exercise before breakfast. For others, this is impossible. Many men find it convenient to exercise late in the afternoon or before lunch. Never perform any exercise sooner than one hour after a meal.

 GADGETS Keep equipment to a minimum It's a good idea to avoid complicated apparatus and overreliance on weights, pulleys, and other devices.

BASIC PRINCIPLES Whatever program of activity you propose to engage in, check with your physician to be certain it is suitable for you. And your physician may.

Have valuable suggestions for activities particularly suited to you. Start slowly. Rush in without preparation and lift 200 pounds over your head-or even try to--and it may be your last act on earth. Take on a routine of mild setting-up exercises and you may feel a bit better, but this is far short of what you can get out of well-planned activity. What is needed is a program that follows certain key principles. Tolerance is one. There should be no sudden demand on your body or burst of tremendous effort.

Excessive straining beyond the level your body is ready for accomplishes nothing and may produce injury. Overload is another. Easy workouts continued endlessly day after day value but it is limited value. You have to push yourself just easily, then gradually begin to work a little harder, working 8 I Building General Health as Preventive Therapy just slightly beyond the first feeling of tiredness, but still within your limits of tolerance. 

Your body has more capacity than it is called upon to use. Give it a bit more load than usual and it can handle it. Progressively, it will become able to handle more. Progression is another important principle. As you maintain' a regular schedule of exercise and your strength and endurance grow, your activities will become easier for you. Continue them at the same level and you will maintain the improvement. To go beyond, you can make the work- outs progressively more strenuous, if your physician indicates this is desirable, until you arrive at a level of fitness you want to achieve. 

Who need excercises? - How muscle activity helps?

DO YOU NEED EXERCISE?

The chances are that, like most of us, you are getting too little daily exercise. If you need specific clues to the fact that you can benefit from more activity, here are some: heart pounding or hard breathing after relatively slight exertion; a long time required for your heartbeat to return to normal after heavy exertion (you can measure the heart rate by the wrist pulse); stiffening of legs and thighs after climbing stairs; aching muscles after such activities as gardening or furniture moving; waking up from sleep as tired as before; frequent restlessness. 

Your physician, as part of his preventive medicine program for you, will be glad to determine with you, on the basis of your specific present condition, daily activities, and other personal factors, whether you need more exercise, how much time you need to devote to it, what kinds of activities would be best suited for you.

OPPORTUNITIES FOR ACTIVITY

Undoubtedly you will benefit from a soundly planned regular exercise schedule, even if it occupies no more than just a few minutes a day- and more on this shortly. Along with such a schedule, you can, and should, find other opportunities for increasing your activity. For one thing, it is possible to find opportunities for physical recreation that can supplement scheduled exercises and provide enjoyment. The list is almost endless: fishing trips, family outings, evenings of dancing, bowling in an office or neighborhood league, walking, etc. 

For another thing, there are opportunities for stepping up daily activities-and little bits of action add up in their good effects. It's a matter of attitude, of recognizing that it is good to use the body As much as possible and of seeking chances to do so.

Walk up a flight Physical Activity in 85 or more of stairs instead of relying entirely upon the elevator; walk part III much or sometimes all the way to the market, to the office. Interrupt sedentary work with little bursts of activity, even if no more than getting lip out of the chair and bending, stretching, moving about, flexing the  squatting, imitating a few golf swings. 

WHEN TO EAT? TIMING MATTERS

WHEN TO EAT

Meal patterns generally are dictated by custom, work schedule, and personal preference. Most people eat a light breakfast, moderate lunch, and hearty evening meal. If you have a preference, however, for more but smaller meals, there is certainly nothing wrong with eating that way. 

In fact, we believe that, where feasible, more but lighter meals are desirable since they are easier to digest and put fewer loads on the body. The fact is that there is a limit to what the body's chemistry can take on at any one time. 

One can add to a fire a reasonable amount of wood The Food You Eat I 53 or coal and have a vigorous flame. But if too much fuel is added, the fire huffs and puffs, smokes and smolder’s inefficiently.

So, too, with the body when it is burdened with dealing with a big evening meal,

 For example, Quite possibly, too, if a large amount of fat or cholesterol is consumed at one sitting, the body may not be able to metabolize it completely, and it may overflow into vital areas such as the arteries. 

When obesity is a problem, the practice of eating five or six small meals daily may be helpful. There are fewer tendencies to overeat when smaller portions are taken more often-and fewer tendencies to indulge in snacks. When you know you will be eating again in two hours or so, the temptation to snack is not so great. 

HOW MUCH TO EAT - A word about food

FOOD CAUSES

It is better to eat no more than eighty per cent of your capacity. A Japanese proverb has it that eight parts of a full stomach  ache sustain the man; the other two sustain the doctor."

So one of the Zen masters is quoted in the book Three Pillars of Zen (Beacon Press, Boston, 1967)

The advice is relevant. That Americans generally consume too many calories for the amount of physical energy they expend is a matter of record and of increasing concern as the energy expenditure tapers off even more. Every five years, the National Research Council, which serves as scientific adviser to the United States government, publishes recommended dietary allowances.

After recommending, in 1963, a cut of 100 calories per day for men and women, it recommended another 100-calorie reduction in 1968. In its calculations, the Council uses a "reference" man and woman-each 22 years old, weighing 154 pounds and 127 pounds respectively, living in a mean temperature of 68 degrees, and engaging in light physical activity. 

Such a man, the Council now figures, needs 2,800 calories a day; the woman 2,000. The Council also recommends that caloric intake be cut below these levels with age-by 5 percent between ages 22 and 35, by 3 percent in each decade between 35 and 55, and by 5 percent per decade from 55 to 75.

This brings the figure for the woman, for example, to 1,900 by age 35, to 1,843 by age 45, to 1,788 by age 55, to 1,699 at 65 and to 1,614 at 75. These, of course, are general guidelines, leaving room for individual variations, and your physician may well have suggestions of value for you. It is a measure of good health, and a contribution toward maintaining it, to reach and keep a desirable weight. 

For that, an effective balance between food intake and energy output is needed. If you are currently at ideal weight (see table on page 61), your intake and output are in balance---which is fine if you are getting adequate amounts of exercise. Exercise, of right kind and in adequate amounts, is a vital element in health for many reasons (see Chapter 8). If you should need to increase your physical activity, you will need to increase intake to maintain desirable weight.

WHAT IS A BALANCED DIET?

Understanding Balanced Diet

Nearly 50 nutrients; including amino-acids (the constituents of proteins), carbohydrates, vitamins, and minerals are now known to be essential for health. A balanced diet is one that can supply all the essentials. It is almost certain that as time passes still other essential elements in foods will be isolated. This is added reason why a balanced and varied diet makes sense; if it is balanced and varied, it can supply all known requirements and others still unknown. 

The currently known essential nutrients have their specific functions. Briefly, because muscles, heart, liver, kidney, and other organs are composed chiefly of proteins, proteins are needed for development and growth of these organs during childhood and adolescence. After growth is over, body tissues, which are continually being worn out, must be   replaced by new materials, So ample dietary protein is essential at all times. 

Meat, fish, milk, and eggs are among the main sources of protein. Bones are composed chiefly of mineral substances such as calcium and phosphorus which are required both for original bone formation and for maintenance. Milk-fresh, canned, dried, skim, or whole-is a major source. Calcium also is supplied by American and Swiss cheese, molasses, turnip tops, dandelion greens.

And cereals, meat, and fish contain phosphorus. 

The fuel of life-what the body burns for energy-is sugar. Carbohydrates, which include both sugars and starches, provide the fuel most readily, for in the body starches are quickly converted to sugar. Fats and proteins also supply the fuel for metabolism-not as quickly, but they can be stored by the body as reserves, for use as needed. Vitamins help to convert foodstuffs into body tissues-skin, bones, muscles, nerves. Although required only in minute amounts, their role is obviously vital, and it is suspected that trace elements and perhaps still other materials yet to be isolated may perform similar functions.

A well-balanced diet-for young and old, active or sedentary, tall or short-can be supplied daily from four basic food groups: Milk and milk products- 2 servings for adults; 3 to 4 for children; 4 or more for teen-agers. One serving equals an 8-oz. glass of whole or skimmed milk; 1 oz. (1 slice) of hard cheese; or 1/2 cup of cottage cheese.