Better diets can mean healthier women

The last Healthy Woman Ladies Night Out event of the year, held on Dec. 3, was the best one of all (not counting the anniversary dinner in May), from my point of view. As someone who has a sensitive digestive system, I found Dr. Indraneel Chakrabarty’s talk, “Holiday Food for Thought: You Are What You Eat!” not only informative but also very helpful.

To get everyone thinking about their habits, Chakrabarty asked if we try to use better gas for our cars, better cleaning products for our possessions or better foods for our pets, and then he asked, “Do you do the same for your bodies?” Referring to food production in the US, he added, “I think there should be food reform; our bodies are in starvation mode [due to our diets].”

Next, since “you are what you eat,” he listed the diseases that are linked to food. They include some obvious and some not so obvious conditions: diabetes, coronary heart disease, gallstones, obesity, heartburn, stroke, dementia, kidney failure, hypertension, vascular disease and osteoporosis. The cancers on the list were colon, esophageal, pancreatic, liver, lung, and breast cancer.

Chakrabarty said the American diet is a business that “caters to your taste buds, so that you keep coming back for more; improved regulation of the food industry can solve the American healthcare dilemma.”

The American diet contains high sodium, fatty foods, greasy foods, excessive red meats, excessive alcohol, excessive sugars, artificial sugars, preservatives, trans fats (which are now being banned), a lack of antioxidants, and acidity. Because of this, he said 20 to 40 percent of adults have heartburn more than once a week.

Heartburn/gastroesophageal reflux disease (GERD) develops “when the reflux of stomach contents causes troublesome symptoms and/or complications.” According to Chakrabarty, $9.3 billion is spent each year for the evaluation and treatment of GERD.

Classic symptoms of heartburn are a burning sensation in your lower chest especially after meals, and acid regurgitation. Atypical symptoms include chest pain, sensation of a lump in the throat, nausea, dental erosions, sinus infection, chronic cough, asthma and laryngitis.

He provided a list of foods and drinks that trigger acid reflux.

Of course, I had heard some of it before and my stomach told me a long time ago what foods I should not eat: fatty or fried foods, high sodium foods, tomato products, onions, garlic, orange juice, chocolate, artificial sugars, mints, and donuts. There are also several items on the list that I don’t like so I did not have to give them up: alcohol, spicy foods, coffee, and cigarettes.

Other triggers of GERD are weight gain, (as added weight stretches the opening of the esophagus into the stomach allowing acid to enter the esophagus), hiatal hernia and lying flat soon after eating. Medications can also cause GERD; those include ibuprofen, aspirin, blood pressure medicines, sleeping pills, iron supplements, potassium supplements, psychiatric medicines, and antibiotics.

To treat heartburn without medications, (a refreshing approach), Chakrabarty recommended diet modification – avoiding all the foods and drinks that trigger the condition, especially bedtime snacks as well as eating no later than four to six hours before bedtime as that is how long it takes for food to pass through our stomachs.

He also advised giving up smoking and alcohol, and losing weight. Elevating the head of your bed, to raise your chest when lying down, also helps prevent acid reflux. He demonstrated what happens to the acid in your stomach when you lie down after eating by taking a bottle partially filled with water and laying it down – the liquid (acid) goes straight to the head of the bottle.

Medications include antacids and H2 blockers, but the most effective medicine, Chakrabarty said, are proton pump inhibitors (PPI) which include Prilosec, Protonix, Nexium, Aciphex and Dexilant. The most important information I learned was that food must be eaten 20 to 30 minutes after taking any of the first three medications for them to help. They are flushed out of our stomachs after that time period. I have been taking omeprazole (Prilosec) on and off for several years and nobody explained that to me.

The doctor’s talk also covered the effects of chronic acid which creates irregular tissue and eventually DNA mistakes which cause esophageal cancer. At the other end of the digestive tract, colorectal cancer (aka colon cancer) is the second leading cause of cancer deaths in the US. He said there are 150,000 cases diagnosed per year with 50,000 deaths a year. That is why colonoscopies are so important.

Chakrabarty said polyps can begin to form in the colon at age 50; they are slow growing, progressing to colon cancer in five to 10 years. Screening should begin at age 50; if two or less polyps are found, another colonoscopy is recommended in five to 10 years; if three or more are found, follow up checks are done every three years.

Chakrabarty thinks every five years is better as a doctor can miss a growth in the many folds of the intestine. Strong risks factors are family history, age and country; moderate risks include diet (especially red meat), previous colon cancer and if you have had inflammatory bowel disease, uterine or ovarian cancer, pelvic radiation, or certain infections. Modest risks are a fatty diet, alcohol consumption, and diabetes.

Protective factors reducing colon cancer risk include a high vegetable and fruit diet, exercise, use of NSAIDS, folate, calcium, selenium, hormone therapy, fiber, and cholesterol medications (statins).

Chakrabarty said he tries to make colonoscopies as painless as possible. He has his patients use a flavorless treatment (mixed in their choice of flavored water) to cleanse their colons beforehand. As anyone who has undergone this procedure or a similar one already knows, the preparation is the worst part.

He said he wants his patients to be comfortable so uses propofol; when the patient is relaxed the procedure is easier to do and goes faster. He added that it is a safe procedure with very small risks of complications.

Answering questions from the audience, Chakrabarty said that there have been no official studies done on probiotics, but if they help, you can use them. (Being lactose intolerant, I have been taking daily probiotics for years.) “If they don’t help, don’t use them,” he said. The same goes for yogurts that might help constipation. He also said gluten intolerance is not any more common now; we are just becoming more aware of the problem.

His basic advice to everyone was to eat healthier, especially getting more fiber into our diets, and to take fewer medications, definitely food for thought during the holidays.

For more information on the Healthy Woman program, visit http://www.fallbrookhospital.com or call (760) 731-8143.