Tips from gaining health

Research at Oregon State University has found that one particular omega-3 fatty acid has a powerful effect in preventing liver inflammation and fibrosis – common problems that are steadily rising along with the number of Americans who are overweight.

The American Liver Foundation has estimated that about 25 percent of the nation’s population, and 75 percent of those who are obese, have nonalcoholic fatty liver disease. This early-stage health condition can sometimes progress to more serious, even fatal diseases, including nonalcoholic steatohepatitis, or NASH, as well as cirrhosis and liver cancer.

The study, published online in the Journal of Nutrition, was one of the first to directly compare the effects of two of the omega-3 fatty acids often cited for their nutritional value, DHA and EPA.

In research with laboratory animals, it found that EPA had comparatively little effect on preventing the fibrosis, or scarring, that’s associated with NASH. However, DHA supplementation reduced the proteins involved in liver fibrosis by more than 65 percent.

“A reduction of that magnitude in the actual scarring and damage to the liver is very important,” said Donald Jump, a principal investigator with the Linus Pauling Institute at OSU and a professor in the College of Public Health and Human Sciences.

“Many clinical trials are being done with omega-3 fatty acids related to liver disease,” Jump said. “Our studies may represent the first to specifically compare the capacity of EPA versus DHA to prevent NASH. It appears that DHA, which can also be converted to EPA in the human body, is one of the most valuable for this purpose.”

The issues have taken center stage as the weight of Americans continues to rise, with a related increase in the incidence of fatty liver disease and liver damage.

NASH is a progressive form of liver disease that is associated with chronic inflammation and oxidative stress, resulting from excess fat storage in the liver. Chronic inflammation can eventually lead to fibrosis, cirrhosis, or even liver cancer. While management of lifestyle, including weight loss and exercise, is one approach to control the onset and progression of fatty liver disease, other approaches are needed to prevent and treat it.

About 30-40 percent of people with nonalcoholic fatty liver disease progress to NASH, which in turn can result in cirrhosis, a major risk factor for liver cancer. While this research studied the prevention of fatty liver disease, Jump said, ongoing studies are examining the capacity of DHA to be used in NASH therapy.

The levels of omega-3 oils needed vary with the health concern, officials say.

“Omega-3 fatty acids are typically recommended for the prevention of cardiovascular disease,” Jump said. “Recommended intake levels of omega-3 fatty acids in humans for disease prevention are around 200-500 milligrams of combined DHA and EPA per day.”

Levels used in therapy to lower blood triglycerides, also a risk factor for cardiovascular disease, are higher, about 2-4 grams of combined EPA and DHA per day. The OSU studies with mice used DHA at levels comparable to the triglyceride therapies.

“DHA was more effective than EPA at attenuating inflammation, oxidative stress, fibrosis and hepatic damage,” the researchers wrote in their conclusion. “Based on these results, DHA may be a more attractive dietary supplement than EPA for the prevention and potential treatment of NASH in obese humans.

Is the pursuit of evidence-based medicine evidence based?  That was the head-cramping question the  Disease Management Care Blog grappled with when it read this just published Health Affairs article, Tool Used To Assess How Well Community Health Centers Function As Medical Homes May Be Flawed.

Readers will recall that the National Committee for Quality Assurance (NCQA) is a Washington DC-based not-for-profit that champions the use of performance measures to assess the quality of health care.  Provider organizations go through an assessment process based on the measures and, if they pass muster, are "recognized" by the NCQA.  The performance measures are based on peer-reviewed medical evidence, vetted by expert panels and then opened for public comment before they are finalized and used.

The DMCB knows this because it has served on two of the NCQA panels.

 While its most visible activity has been the ranking of health insurers, the NCQA has been offering a soup of recognition, accreditation and certification programs for other types of provider organizations including the disease management vendors (for example) and, more recently, medical homes.  More on that group of providers later.

Once you earn it, the NCQA quality badge is more than just a festively colored addition to your letterhead and collaterals. Given the past evidence that purchasers also pay some attention to it, the DMCB recalled being unsurprised when the number of disease management vendors sporting the newly established NCQA accreditation logo multiplied faster than the number of vixens at a Kennedy White House pool party.  They reasonably believed that it would help them gain credibility and give them a leg-up against their competition.

But even if the NCQA performance measures are based on the scientific quality as well as consensus and drive competition based on quality, the question remains: if an organization achieves NCQA recognition, does that really mean that patients are better off for it?

Enter Robin Clarke and colleagues who wanted to know if that was true for medical homes and their patients with diabetes. They adapted the 2008 version of the NCQAs medical home evaluation survey tool to 40 Los Angeles community primary care health centers. The medical director or executive team at each center had to complete the tool which was scored in the usual manner.  The score - and the corresponding level of recognition - was then compared to the centers clinical diabetes care measures based on the National Quality Foundations (NQF) quality measures. These measures were collected on samples of patients based on reviews of the medical records.

Only 30 of the centers completed the tool. They were made up of 88 LA clinics that were taking care of more than 600,000 mostly low income patients. The vast majority of the patient population was Medicaid.

The NCQA survey tool is based on a combination of "must pass" criteria combined with a 100 point scale.  The average score among the centers in this study was a respectable 67. Eight would have received the highest Level 3 Recognition (more than 75 points), three would have been Level 2 (between 50 and 75) and the remainder were Level 1. The percent of patients who had a measure of HbA1c, LDL, or blood pressure in the past twelve months was 84%, 70%, and 90%, respectively. Approximately 60% of patients had kidney disease screening and 35% had a diabetes eye examination.

However, when the authors used multiple methods to look for a statistical association between higher scores or Levels and higher quality percentages on the NQF measures, none was found.

To their credit, the authors point out that 1) theirs was a faux and unaudited NCQA process, 2) that a Level 1 accreditation, while no better than a 2 or a 3,  may be better than a "zero," 3) that persons with conditions other than diabetes may still benefit from this kind of process and 4) that they didnt use the 2011 edition of the tool.  The DMCB adds that this was in a community health setting involving mostly patients with Medicaid insurance. Its possible that patients in other settings, socioeconomic classes or with other types of insurance could benefit.

Despite the limitations, the DMCB thinks this is an important study that puts the NCQA into perspective and tells us what it may and what it may not be doing. Hopefully this kind of study will be done in other settings involving other provider types, including the disease management community.  In the meantime, the NCQA would be well served to continue to examine the links between its prsitine interpretations of the science and the real-world benefits for patients. 

In other words, its time for us to better understand the link between pursuing outcomes and actually achieving them.

Durian Better then Papaya and Watermelon - What do you think about durian? Durian not all-time bad for us. In certain cases Durian is more benefit then papaya and watermelon. Durian fruit most lots contain carbohydrates, fats and proteins. Not only that, other substances such as fiber, calcium, folic acid, magnesium, zinc and iron are also present in it.

But what do you know? it turns out, the durian has a lower glycemic index than watermelon and papaya. Durian is the most lower index glycemic then papaya, watermelon, pineapple.

Glycemic index (GI) is the scale or number given to certain foods based on how big these foods increase blood sugar levels, the scale used is 0-100. Called low-glycemic index when theyre on a scale of less than 50, medium glycemic index if its value is 50-70 and high glycemic index if the number is above 70.

But despite its low GI, durian is a fruit that has a high calorie so as not suitable for people with certain conditions or diseases.

Quoted from Healthmad, here are some diseases that can be overcome by eating durian fruit which is not too much.

1. Overcoming constipation, because many contain fiber
2. Overcoming anemia, because it contains folate or vitamin B9 is needed to produce red blood cells
3. Maintain healthy skin, because it contains Vitamin C that act as antioxidants and antiaging
4. Contains lots of potassium or calcium, so good for healthy bones and joints
5. Origin does not eat too much, the content of manganese in the durian can keep blood sugar levels remain stable
6. Contain copper compounds that can maintain the health of the thyroid gland
7. Keeping your appetite, because many contain thiamine or Vitamin B1
8. Overcoming migraine, because it contains the compound riboflavin or vitamin B2

Relieves stress and overcome depression, because it contains Vitamin B6 or pyridoxine Maintaining oral health because they contain posphor.

But, if you get any bad at body when you eat durian, try check how many have you ate durian, and what other food that you combine to durian.

1.Stop and Go

If you play a sport that requires a whopping sprint, extract that a full sprint strains the muscles of the lower body. To combat this, do stop-and-go exercises. For example, run 30 meters at about 80 percent of your effort, slow to a jog because five to 10 meters, then run again for spare 30 meters. Repeat this functioning five times.

2.On bended knees

Almost 3 out of four ACL injury occurs when players are landing or turning. If your knees are bent instead of straight, the stake of injury is greatly reduced according to a report in the JAAOS (log of the American Academy of Orthopedic Surgeons).

3.Cool down

Heatstroke is not exigent that can be easily cured like headache. To avoid it, stay cheeky besides hydrated. Be downright the combined temp an humidity is less than 160. This is according to Dr. Dave Janda of the IPSM.

4.Get the proper equipment

Badly fitting gears or ill sized instrument onus be a go ahead of elbow grease injuries. The extra money spent on proper equipment goes a want way.

5.Do it the right way

Bad technique is just as nonpareil as, well, bad equipment. Seek aid from pros besides trainer, this advice are invaluable to your exercises or training.

6.Go West (or whichever direction)

If you're playing or training ascendancy entangled directions, your red up should also. overcome sideways, backward, forward and uncut the motions you might be doing. This allows your frame to exhibit prepared.

7.Have yourself filmed

The camera doesn't lie. Show your recording to a fellow well verse in your training, ergo he subjection allot a intercessor of your fitness regimen.

8.Loosen the shoulders.

Even a slightly injured rotator cuff can shut down the racket of a shoulder. You bent want to possess stretching to protect your rotator cuffs.

9.take An opening dip

Schedule your swimming sessions early. The less kinsfolk influence the pool instrument less of everything in the pool.

10. arrange yourself

Wearing custom-fitted mouth guards reduces the risk of injuries by owing to extremely as 82 percent, according to a inspect at UNC at Chapel barrow. Plunk out the cash for a custom-fitted aperture make sure and it'll last being years including your titter and teeth.

11. cool extrinsic your tendon

Inquire about ultrasound needle therapy. These procedure is minimally by using ultrasound to guide a sweat. The buzz smoothens the bone, breaks ongoing calcifications, and fixes scar tissue. Thirteen apparent of twenty patients aphorism improvement, and the session takes own about 15 minutes of your time.

12. set your high shoes after work.

Shop in the evening, the feet are swollen after a day of work. It approximates how your feet will body later three miles of running.

13. Do obliterate road running.

If the surface is unstable, present trains the ankles to emblematize stable.

14. Know where you're going.

Whether its biking, or skiing, personify sure to have a dry run down any alley first. A cartel of injuries charge be avoided when you're familiar suppress the sally fired.

15. officiate hard.

Anxiety reduces your peripheral head trip by three degrees and slows the reaction occasion by almost 120 milliseconds, according to an article of the Journal of Sports Sciences. When the action gets difficult, the veteran athlete rely on skills they've trained for and practiced. It keeps them cooler under pressure, widening their vision so they incumbency see react much faster.

It seemed no one doubts the value of nutrients contained in milk. Milk is a source of protein, fats, vitamins, and minerals need to be consumed to meet the nutritional needs of the family. However, the milk becomes inadequate food consumption if not handled properly.




Currently on the market are available a variety of dairy products, some in the form of powder, condensed milk, or fresh milk. However, the sweetened condensed milk is not too recommended for daily consumption because of high sugar content.
Fresh milk, according to Dr. Samuel Oetoro, SpGK from Clover Clinic, have advantages over sweetened condensed milk or milk powder for the treatment process so that no excessive nutrients less wastage.
"Fresh milk, both in-pasteurized milk or UHT (ultrahigh temperature), both have the advantage of high nutritional value. Addition, the milk is ready to drink milk flavor more pronounced," he said.
While milk powder, a liquid milk processing process is dried, according to Dr. Samuel, will lose some nutrients. "Indeed, in this day and age supplemented milk powder, nutrients lost in processing will be added again. However, if you want to choose a natural, of course, the choice of fresh milk," he said.
However, powdered milk has the advantage of durability and practical because its easy to carry. In the meantime, if you prefer fresh milk directly purchased from a breeder, Dr. Samuel reminded the importance of seeking a safe source of milk.
"Although it is natural, but select farms that maintain the quality of its products. Consider whether the animal food that contain contaminants or do not," he said.