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.

How to manage Infections, overdoses, side effects in modern medicine

Friendly bacteria keep under control harmful organisms that also are natives of the digestive tract. When friendly bacteria are killed off in large numbers, there is less competition for the harmful residents and they have a chance to multiply. The result may be super infection-a new and different infection that develops as a result of another's being treated. Again, the super infection is often mild and disappears once antibiotic treatment stops. 

But super infection sometimes can be severe.

What it comes down to is this: use of potent modern medications, not only antibiotics but many others, involves a calculated risk and alertness. Ideally, the physician uses them after careful consideration and upon arriving at the decision that the good to be gained outweighs any risks along the way-and uses them with caution, keeping alert to the earliest indications of any new trouble from the drugs which he may be able to overcome by change of dosage, switch of medication, addition of other medication, or when necessary discontinuance of treatment.

One of the major problems, though, has been the insistence of many patients upon willy-nilly prescription of medication. They may demand penicillin, for example, for a cold or any fever. They have the feeling that a visit to the doctor is not complete unless the doctor "gives" them something. Too often, this has put physicians on the spot; and to please patients, some have prescribed medication against their better judgment.

So far as your own health is concerned, you can do much to preserve it not just by seeking timely medical advice but by taking it-by avoiding insistence upon medications, by indicating to your physician that you are aware of the values and also limitations of medications, the need to use them wisely not indiscriminately, to use them when they are required and not otherwise.

DOSAGE PROBLEMS

A man who took double the prescribed dose of an anticoagulant-a drug that, in effect, acts to thin the blood to prevent clot formation-found himself in the hospital a few days later with severe nosebleedsand vomiting of blood.

 A woman with bronchial asthma was admitted to the hospital with heart palpitations after she had used, contrary to instructions, an isoprenaline (isoproterenol) spray repeatedly for several hours. Another patient, a 29-year-old man, who had decided to take 50 percent' more than his prescribed dose of a cortisone like drug, came- to the hospital with changed personality, considerable weight gain from fluid retention, and other effects. 

Modern Medicines is One of Major Successes, But it Also Includes Disasters

A SPECIAL WORD ABOUT MEDICINE TAKING 

THE HISTORY of modern medicines is one of major successes, but it also includes disasters. Tremendous benefits have followed the discovery of insulin for diabetes, agents for controlling high blood pressure, antibiotics and other anti-bacterial that kill or impede the growth of bacteria, cortisone and other steroid compounds that combat inflammation, tranquilizers and antidepressants for nervous and mentaldisorders, and drugs that slow the wild growth of some cancer cells. But there have been tragedies traceable to indiscriminate use and abuse of such powerful agents and of others. For one thing, no medication yet developed is fool proof-universally useful for even the condition for which it was developed, free of undesirable effects.

Virtually every drug, just as virtually every food, may produce unpleasant effects for at least a few individuals, and so it must be used with care. We hope in this chapter to provide a useful guide to medicine taking, one that will be helpful to you both in more effective treatment of any health problems that arise and also in preventing many problems. 

PRESCRIBING FOR YOURSELF 

A recent survey of a small but typical group of households carried out by a major university research institute found that the number of medications on hand varied from 3 to 88, with a mean of 30. Of the 2,539 medications observed, only 445 were prescription drugs. Each month in the United States, 750 out of every 1,000 adults 16 years of age and over experience a cold, headache, or other illness or  injury for which only 250 will consult a physician.

Thus, people control their own care in terms of whether and when to seek medical aid and when to prescribe for themselves. Virtually everyone on occasion does his own prescribing-and that can be a practical matter. Certainly every minor ache or pain does not require that a doctor be called. Nobody wishes to become a habitual patient. The medicines-variously known as "patent," "proprietary," and "over-the-counter" or "OTC"-which you can purchase in drugstores without a doctor's prescription are generally milder and have fairly broad safety margins. 

Persistent Cough may mean Infection, Obstruction, accumulation of fluid, or in lungs

Coughing may indicate only a minor temporary throat irritation. But a persistent cough may mean infection, obstruction, or accumulation of fluid in the air passages or lungs, and so it deserves medical attention.  

 The Promise and Nature of Preventive Medicine 50 does a cough that developed during a respiratory infection but then persists long afterward. 

Urinary changes: We have already noted that blood in the urine re- quires investigation. Frequent urination may be the result of infection or, in some cases, nervous irritability of the bladder. Frequent and voluminous urination may be an indication of a relatively rare type of diabetes, diabetes insipidus. In older men, the need to get up several times a night for urination may indicate an enlarging prostate.

Difficulty in starting urination may indicate sufficient prostate enlargement to require treatment to prevent backup of urine and impairment of kidney function. Actually, any marked change in the urine-in its volume, color, or number of times it must be passed-calls for medical study. 

Nausea may stem, of course, from a gastrointestinal disturbance, but it may also arise from an infection almost anywhere in the body or from disturbance of the balance mechanism in the ear. If the nausea is mild, you can delay a little before consulting a physician, for it may disappear in a short time and not return. But severe and persistent nausea, or nausea that keeps recurring, calls for medical attention.

Jaundice, or yellowing of the skin, may be due to a viralinfection and is especially likely to be seen in younger people. It may signal gallstones, and this is especially likely to be the case for middle-aged women. In older people, it sometimes is due to cancer of the pancreas or to cancer that has spread into the liver from elsewhere. The safe rule is always to regard jaundice as a signal calling for immediate medical attention. In some people with sallow complexion, jaundice may not be readily discernible on the basis of the appearance of the skin; in such cases, look at the whites of the eyes-if they are distinctly yellow, jaundice is present.