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 much and What foods we have to take?

Cereals and breads

4 servings of enriched or whole grain cereals and breads

One serving equals 1 slice of bread; 1 small biscuit or muffin; 1 cup of potatoes, pasta, or rice; 3/4 to 1 cup of flaked or puffed cereal; or 1/2 cup of cooked cereal.

Fruits and vegetables

4 servings, including one of citrus fruit or tomatoes and one of dark green or leafy vegetable

One serving equals 1/2 cup of canned or cooked fruit; 1 fresh peach, pear, etc.; 1 cup of fresh berries or cherries; 1/2 cup of cooked vegetables; or 1 cup uncooked leafy vegetables.

Meat and protein rich foods- 2 servings of meat, fish, poultry, eggs, or cheese

 Occasionally nuts, dried beans, peas may be substituted for the meats. 

One serving equals 3 oz. of lean, cooked meat; or 3 eggs; or 3 slices (ounces) of cheese. Foods selected each day from each of the four groups provide balance; and by varying the choices within each group, you can expect to achieve a desirable averaging of intake of trace elements as well as other essential nutrients. 

For the same reason, it is a good idea, we suggest, for you to sample unusual foods whenever you can-internal organs such as liver, kidney, heart, sweetbreads, sea-foods, Italian and Chinese vegetables, and other national dishes. 

How Your Food Causes illnesses and remedies

THE FOOD YOU EAT IS THERE 

someone food or class of foods with special value for preventing disease? The science of nutrition has much to offer for health but it does not take the form of a panacea food or food combination. The one fact that stands out most clearly as new advances are made is that except for certain specific problems-disease states for which special diets have been definitely established as helpful-the healthiest diet has two basic characteristics: it is balanced and it is varied.

NEW REASONS

FOR BALANCE AND VARIETY One of today's most exciting research stories have to do with investigations into the role of trace elements in health and disease. It has long been known that an amount of iron that would bulk up no bigger than a couple of nails stands between us and suffocation, for iron is an essential part of the blood substance hemoglobin, which carries oxygen to body tissues. But it now seems that many other elements in minute amounts-each constituting at most 1/10,000 of body weight and very often far less- may play significant roles.

Recent studies have suggested that lack of adequate zinc in the diet can delay wound healing and may be a factor in diseases of the arteries. In one investigation, zinc supplements were given to some Air Force men who had undergone surgery. Their surgical wounds healed in less than half the time required in other men who had had the same surgery but did not receive zinc supplements. The results not only demonstrated zinc's role in speeding healing; they suggested that the diet of these airmen may well have been Zinc-deficient.  

Building General Health as Preventive Therapy In a later study, investigators treated with zinc supplements a group of patients who had skin sores that refused to heal. Of the 17 patients in the group, 11 were found to be deficient in zinc, and in all 11 the chronic skin ulcers healed with zinc treatment. The remaining was not zinc- deficient, and although they received the same treatment, their wounds still did not heal. Although the relationship between zinc deficiency and hardening of leg arteries that can block circulation and cause gangrene is not clearly established, some patients who were deficient in zinc and had advanced degeneration of the arteries have shown improvement with zinc therapy. 

How drugs Interacts with our body mechanism? And Outdated Medicines

OUTDATED MEDICINES

 If your physician has prescribed a drug for you and instructs you to discontinue its use before the supply is all gone don't save what is left over for another time. Discard it. It may seem like a waste to throw away expensive medication; actually, it is an important safety precaution. Some drugs lose potency with time; some gain potency. Either way, their use after a lapse of time can be dangerous.

 Moreover, it has become clear that some drugs, in the process of aging, not only change in potency; they undergo marked chemical changes that can make them dangerous. Not long ago, for example, physicians at three New York hospitals reported on several patients who had suddenly experienced nausea and vomiting and then developed symptoms like those of diabetes. The trouble in each case was traced to chemical deterioration of an antibiotic, a tetracycline, taken long after it should have been thrown away.

DRUG INTERACTIONS 

when one medication is being used, the addition of another sometimes can be helpful but sometimes can be harmful. When two agents used in concert do not harmonize, the interaction or interference can cause trouble. Moreover, even effects on dosage requirements must be considered when two or more medicines are being used. Recently, for example, a patient who had had a heart attack and recovered from it was released from the hospital. 

Ten days later, an alarming condition developed. While in the hospital the patient had received an anticoagulant medication as part of treatment-a compound aimed at preventing clotting. At home, he continued as directed to take the same compound in the same dosage. But now the drug was thinning.

 The blood too much

 Something had changed. It had indeed: in the hospital, the patient had been given phenobarbital upon retiring. The sedative, in the course of its activity in the body, had stimulated certain liver chemicals which broke down the anticoagulant faster. At home, without the phenobarbital, the anticoagulant activity continued longer and was more potent. In effect, without the sedative, the patient was getting an overdose of.

The anti-coagulant

The matter, once understood, was quickly adjusted. But it illustrates what is coming to be virtually a new science in medicine, concerned with understanding and taking into account inter- actions between medicines. This, of course, is not the place to go into complex technical details. 

But as indications of how important interaction can be, here are some recent findings: When a patient is taking aspirin, addition of an anticoagulant drug may lead to bleeding. If a patient is receiving a medication such as amitriptyline for mental depression and is also given guanethidine for high blood pressure, the antihypertensive activity of the latter is lost. 

How much is drug overdose? How to measure medicine intake?

With many common sleeping medicines, it is possible to get a 3/4 grain size as well as 1-1/2 grain so

that one of each may be used. For Amy talit there is also a 1 grain size, which many women find is just the right amount. Some men like to take two of the 1 grain capsules and find that this dosage gives them a pleasant night's sleep. 

Delicate assaying of dosage is often possible with liquid medications -for instance, tincture of belladonna, an old standby for stomach cramps and indigestion. Some doctors say, arbitrarily, take 15 or 20 drops.

The expert therapist uses a different approach. His instructions to a patient may go something like this: "1 want you to get the full effect, which is just short of the beginning of toxic symptoms which are dryness of the mouth and blurring of vision. 

So start with 15 drops just before each meal and at bedtime. Then, each day, increase by 1 drop so Ih.,1 you will be taking 16 drops four times a day the second day, 17 A Special Word About Medicine Taking / 41 drops the third day, and so on. Keep increasing until you notice one of the toxic symptoms.

Then drop back by 1 drop each day until there are no toxic manifestations. You may settle on 18 drops or you may need 22, or some other amount. The strength of the tincture may vary slightly from drugstore to drugstore, and sometimes the size of the drops varies too. 

Once you have standardized the dosage you need, keep it and use the same bottle and get the prescription refilled by the same• drugstore." Thus, what seemed like a simple prescription turns out to be some- thing of a scientific experiment. But for you, such experimenting to find exactly the right dose you as an individual need may mean the difference between having and not having disagreeable dyspeptic symptoms. 

Administering Drugs with care - Preventive adverse and side effects

First read the label when you take the drug container from the medicine cabinet; read it again when you take the drug itself; and finally, read the label a third time when you put the container away. That last reading is an extra check to make certain you read the label properly the first two times. If you did happen to make a mistake, you have a chance to do something about it at once.

  

TRICKS FOR PROPER DOSAGE made by machines that produce attractive roundedness

 For the most part, are more attractive-looking and less expensive than those that were made individually by a druggist to a special prescription of a physician. The trouble with machine-made articles of medicine, as with mass- produced clothes, is that tailoring to each individual's needs cannot be built in. Thus, it's known that the amount of medicine required varies almost directly with the weight of a person.

Most machine-made capsules and pills are made for a standard person of about 150 pounds so they are apt to contain just a bit too much for most women, a bit too little for most men. Doctors have learned how to adjust dosages even with the limitations of machine-made medicines. For example, consider pills of phenobarbital often prescribed for nervousness, tension, headaches with a psychogenic component. Phenobarbital is commonly available in 1/8, 1/4, and 1/2 grain sizes. Suppose phenobarbital in 1/4 grain dosage is prescribed for a woman and it helps her tension but makes her just a bit too forgetful and drowsy to do her work properly.

The doctor tries 1/8 grain, but that doesn't help her tension enough. The solution lies in going back to the 1/4 grain dosage and proper use of a fingernail file. The patient is instructed to consider a tablet as a circle, and to gently file away one fourth of the circle, to get a tablet that is just halfway between 1/8 and 1/4 grain sizes. 

Usually, the patient "plays around" a bit and finds just the right tailor made size for her needs. When it comes to capsules-especially of sleeping medicines such as Nembutal, Seconal, and Amy talit's a help to learn how to take apart a capsule gently and pour out a portion to adjust the dosage to individual needs, then rejoin the capsule.

 Many people find a standard 1-1/2 grain capsule ineffective; on the other hand, when they take two capsules, they may experience hangovers. One full capsule and half of another may be the right dosage. 

Penicillin overdose side effects! How to avoid it?

A Special Word about Medicine Taking of many people that if a little is good, more is better. With potent agents, excessive dosage can produce real trouble. Similarly, under dosage can cause problems. Inadequate antibiotic dos- age, for example, carries its own risk. One common example is the patient with a "strep" throat who takes penicillin, improves, stops treatment, then gets the sore throat back again.

Once more, he takes some penicillin but not the full prescribed amount. Again the sore throat dis- appears only to recur after a short time. And so a disease that can be eradicated by continued administration of penicillin for eight to ten days is converted into one that drags on with repeated remissions and relapses. Physicians have, in fact, long suspected that many failures of anti- biotic treatment stem simply from failure of patients to keep taking medication as prescribed. A recent study uncovered disturbing evidence that many parents may be risking their children's health by failing to make certain they take their medication as long as necessary.

Actually, in acute "strep" infections, penicillin treatment for 10 days is considered essential to prevent rheumatic fever. Yet in a follow-up of 59 children for whom a 10-day course of penicillin had been prescribed, investigators found that 56 percent of the youngsters had stopped taking the drug by the third day, 71 percent by the sixth day, and 82 percent by the ninth day. When a doctor prescribes medication, the first thing to do is to get the prescription filled immediately. The value may be lessened, or even lost completely, if you delay.

Then follow directions of the doctor to the letter. If you are not certain you understand them, ask him for clarification-even for instructions in writing as to exactly what you are to do. Take all the medicine pre- scribed, not some amount you arbitrarily settle on. Don't decide, if you begin to feel better, that you can stop or reduce dosage. Sometimes, illnesses require several prescriptions. Very much worth noting here is an old principle taught to nurses: read every label three times. You can use that principle to advantage at home. 

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.