Indirect Methods of Determining Body Composition

Under Weighing. This Method (called densimetric) is based on the fact that fat tissue is lighter than other body tissue-bones, muscle, blood, and water. The person is weighed while submerged underwater, with as much air as possible exhaled from the lungs. he or she is then weighed normally on the ground. By using a formula based on the two weights, the percentage of body fat can be determined.

Skin fold thickness. About 50 percent of back fat situated just below the skin, and by measuring folds of skin on certain part of the body, the percentage of body can be estimated. The most accurate measurement are obtained by using calipers; indicative body sites include the triceps (the skinfold on the back of the arm midway between the shoulder and elbow), the sub scapular area below the shoulders blades, and the area justa above the hip bone.

Total body water (hydrometry). Most fat free tissue (muscle) contains water, while fat tissue has very little. Therefore, measurement of total body water provides an estimate of Fat Free Mass (FFM). One approach to this measurement is taken by injecting a known amount of a substance that distributes itself throughout the body’s water compartments. A blood sample, taken after enough time elapsed for the substance to reach a stable concentration in the body, reveals the substance’s distribution in body water, allowing the tester to measure total body water and from that to calculate the amount of FFM. The result obtained by subtracting FFM from total body weight is the body fat content. Another approach is by putting two electrodes on a limb and measuring resistance to an electric current. The amount of electric impedence measures body water.

Whole body potassium. Almost all of the body’s potassium is contained in cells other than adipose tissue. A naturally occurring isotope of potassium exists as a fixed proportion to all potassium found in the body. The radioactive portion can be measured by counting the gamma rays it emits, and this can be used to estimate the total potassium. The greater the amount of potassium in relation to body size, the smaller the percentage of body fat.

Ensuring a Safe Water Supply

If the water streaming from the tap becomes unusually brown, cloudy, or otherwise murky looking, or if it develops a strange odor or un pleasant taste, immediately contact the local water utility or the local health department for information and assistance. In some instances, these authorities will test the water, or they can recommend a qualified laboratory.

Many toxic hazards are colorless, tasteless, and odorless. Laboratory analysis is the only way to be certain that drinking water meets safety standards. Since all municipal water supplies must, bylaw, be tested on a regular basis, first ask the local water superintendent for the latest test report.

Individual whose water comes from a private well, or those concerned about contamination by chemicals that are not included in routine testing, may want to have their water analyzed by a commercial laboratory, listed in the yellow pages under laboratories, testing,. Check with the state or local department of the environment or health to be sure that company has been approved by the state for testing drinking water.

Water treatment systems
Several types of home water-treatment systems are also available, but it’s important to realize that no one type may treat all water problems. For example, activated carbon filters can improve the taste and odor of water as well as remove many chemical, but they won’t remove bacteria or toxic metals such as lead. In fact, unless the carbon filters cartridges are changed regularly, they can provide a breeding ground for bacteria. All home water treatment devices should be thoroughly researched for use and performance before purchase.

Tips on Lowering High Cholesterol

• Lose weight if you are above the desirable range. Although high cholesterol levels are not always associated with excess weight, over weight individuals typically have higher readings than normal-weight ones. Most of the suggestions for lowering cholesterol will also assist in doing this.

• Use a low fat, low cholesterol cookbook for recipes or modify traditional ones to reduce saturated fat and cholesterol content. Reduce portion sizes of meat dishes, and always trim away visible fat. Cook meats so that fat can drain off, and discard or skim all fat from the drippings.

• Use vegetables, pasta, and other low-fat, cholesterol-free foods to add quantity and variety to meals.

• Markedly reduce consumptions or cholesterol-rich foods, such as eggs and organ meats(liver, brains, and kidney). The American Heart Associations recommends that a person consume no more than four egg yolks a week, including those used in baked goods.

• Don’t be misled by advertising claims of no cholesterol. Check the labels and avoid palm, palm kernel, coconut, lard, and other highly saturated fats and oils. Avoid excessive use of product with partially hydrogenated vegetable oils since such product contain high levels of trans fatty acids, which may raise cholesterol levels.

• Exercise regularly. Frequency exercise helps in weight control and helps raise the HDL level in the bloods.

• Some types of dietary fiber can help lower cholesterol. These include the sticky or soluble fibers, such as pectin (found in apples and other fruits), guar (used in gum and as a thickener), and the fiber in oat or corn brans and dried beans and other legumes. Include foods containing these fibers in your regular diet.

• Have meatless meals a few times each week, but avoid quiche and cheese, nut, and cream dishes that many be high in fat.

• The butterfat found in milk and cheese contains more cholesterol –raising saturated fats than does the fat in red meat or poultry. Therefore, use skim or 1-percent-fat milk. Substitute tub and liquid margarine for butter, and use cheese sparingly unless it is made from skim milk. (Even part-skim milk cheese tends to be high fat.)

Planning for Pregnancy

Two to three months before a woman plants to become pregnant, it is recommended that she visit her obstetrician/gynecologist and discuss the following topis:

• Contraception (when to discontinue)
• Diet (weight gain/loss; intake of artificial sweeteners, caffeine, and alcohol; vitamin/mineral supplementation)
• Exercise
• Drugs (use of over-the-counter, prescription, and recreational drugs)
• Smoking
• Immunization (especially rubella)
• Medical condition (chronic diseases, sexually transmitted diseases, environmental or occupational hazards, family history)
  

Adapted from environmental Nutrition Newsletter, January 1986.

CERVICAL DYSPLASIA

The last word any woman wants to hear following a Pap smear is “abnormal.” It is not, however, a reason for panic. “Abnormal” findings are extremely common and are usually due to easy-to-treat conditions such as inflammation, an infection or cervical erosion. It’s also possible to learn that you have what doctors call cervical dysplasia.

This condition often causes no symptoms––it’s simply the growth of abnormal cells on the cervix. (The cervix, located deep within the vagina, is the opening to the uterus.) But because some kinds of cervical cancer, doctors often treat cervical dysplasia aggressively, removing the cells in moderate or severe cases and, in mild cases, either removing cells or monitoring them closely with frequent Pap smears. (The cells may revert to normal or become increasingly abnormal.)

Protecting Yourself

Unlike heart disease or lung cancer, cervical cancer––and its precursor, cervical dysplasia––isn’t generally though of as a “lifestyle” disease. But population studies do link an increased risk for cervical cancer with some factors that are within your control. Following these tips will help you reduce your risk.

Get regular Pap smears. “The biggest risk factor for invasive cervical cancer is infrequent Pap smears,” says Ruth Peters, Sc.D., a professor of preventive medicine at the University of Southern California School Medicine in Los Angeles.

Most experts recommend that you begin getting Pap smears as soon as you become sexually active. After you’ve had three consecutive annual Pap smears that show all is normal, you shouldn’t need another for three more years. If the test shows that something cancerous may be brewing, more frequent testing is highly advisable, says Dr. Peters.

One study by researchers at the University of Washington found that women who hadn’t had a Pap test in ten years or more had 12 times the cancer risk of women who got checked more regularly.

Make it monogamous. The more sexual partners you’ve had, the higher your risk for cervical cancer. And if you’re faithful but he’s been sleeping around, your risks also shoot up. Why? Chances are you, through your mate, have been exposed to a virus associated with cervical cancer. “Strains of human papillomavirus (HPV) have been found in more than 90 percent of cervical cancer tissue samples.” Says Ralph Richart, M.D., director of the Division of Gynecological Pathology and Cytology at Columbia Presbyterian Medical Center in New York City.

Wait till you’re twentysomething. Because it may expose cervical cells to the sexually transmitted factor (perhaps HPV) at a time when they are particularly vulnerable, sex at an early age ups your risk for developing cervical cancer later, Dr. Peters says. “In one recent study, one partner before age 20 tripled a woman’s risk, and three or more sexual partners before age 20 increased the risk tenfold,” she says.

Use barrier methods of birth control. Condoms and diaphragms protect the cervix from contact with lots of potential irritants, including the HPV virus. In her study, Dr. Peters also found contraceptive creams, jellies and foams reduced cancer risks. Why? “They kill sperm, and they probably also kill whatever else might be transmitted,” she says.

Douche with discretion. Don’t douche your doctor tells you to. There is a misperception among many women that regular douching keeps you fresh and clean. Instead, it seems to reduce the body’s natural ability to fight off disease. “In one recent study, douching five or more times a month tripled the risk of cervical cancer,” says Dr. Peters.

Ditch your butts, and hi, too. Studies show that smoking triples your risk for cervical cancer, Dr. Peters says. “Nicotine and other chemical from cigarette smoke are concentrated in the cervical fluids,” she says. Those same toxins also end up in a man’s semen.

One study showed that women exposed to passive cigarette smoke for 3 or more hours a day had a threefold increase in cervical cancer.

Eat better. Numerous population studies have linked the development of cervical cancer with poor nutrition. Adequate intake of vitamins E and C, beta-carotene and folate seems protective.

Get Proper Treatment

What do you need to know if you are told you have cervical dysplasia? In a sense, you should be delighted that your doctor has found these abnormal cells. Early treatment can prevent them from turning into cancer.

Next you should be aware that your diagnosis should not be based on a Pap smear alone. “A Pap smear is a screening test, not a method of diagnosis,” says Robert Kurman, M.D., a professor and director of gynecologic pathology at John Hopkins Hospital in Baltimore.

An abnormal Pap smear indicating dysplasia should be followed by a biopsy of the cervix done with a colposcope, a viewing instrument that provides a magnified view of the cervix and allows the doctor to see any actual lesions, Dr. Kurman says. The biopsy removes small bits of tissue that are examined under a microscope. At the same time, the doctor may also scrape cells from the opening to the uterus, a procedure called endocervical curettage. Based on the examination of these two tissue samples, the doctor will decide how much cervical tissue needs to be removed and how it should be removed.

The tissue is most often removed by freezing (cryosurgery) or carbon dioxide laser surgery, both simple outpatient procedures. If the abnormal cells have invaded underlying tissue, a more radical surgical procedure, or radiation therapy, may be required.

A newer technique that uses a thin, electrically charged wire loop to scoop out areas of abnormal cells may be better than either cryosurgery or laser surgery, though, Dr. Richart says. “The procedure is easy to teach and learn,” he says. “It requires less expensive equipment than other methods of removal, allows biopsy and treatment to occur at the same time, which saves patients an additional office visit, and gives a complete tissue sample for examination, which will do away with missed diagnosis of invasive cancer.”

RESTLESS LEGS SYNDROME

They describe their legs are tingling . . . writing with worms––crawling with ants. Or as one sufferer puts it, “a drives-you-nuts kind of thing” Something that gives your limbs an uncomfortable urge to get up and move while the rest of your body is begging for sleep.

Doctors agree that this condition, known as restless legs syndrome, causes some unusual, and extremely uncomfortable, sensations. In fact, it makes doctors uncomfortable, too. That’s because they don’t know what causes it. They aren’t sure how to treat it. They even have trouble describing it.

Just ask Doughlas K. Ousterhout, D.D.S., M.D., a plastic and reconstructive surgeon in San Francisco who has had restless legs syndrome since he was a teenager. “You really can’t describe what it feels like,” says Dr. Ousterhout. “Your legs ache. You want to get up and walk or get up on your toes and get your legs going up and down that will help, but when you stop moving, it comes right back, of course.” Sometimes it comes back for just a few minutes, he adds. Sometimes it lasts for hours.

Mild or Maddening

In a way, restless legs syndrome resembles an itch deep inside one or both legs. An itch that often begins in the evening when you’re sitting or lying down. An itch that may be mildly annoying during the day but distressingly disturbing at night, when you’re trying to sleep. The only solution is to “scratch” the itch, says Lawrence Z. Stern, M.D., professor of neurology at the University of Arizona health Sciences Center and medical consultant for the Muscular Dystrophy Association. Most of the time, just getting your legs moving will help.

The severity of restless legs syndrome, and the frequency of attacks, varies widely, Dr. Stern says. Some people experience it every night––their legs can sometimes jerk or kick involuntarily. For others––and Dr. Ousterhout one––it occurs occasionally. In most cases, “It’s something people will complain about if their doctor asks them, but it’s not the reason they actually go to the doctor,” Dr. Stern says. For others, of course, just reading a book, watching a movie or sitting at the dinner table can be torture: They just have to walk around. In fact, some people stay up all night because their restless legs won’t cal down.

Taking Out the Kick

Eventually your restless legs may take you to the doctor’s office for a checkup. When you go, here’s what your doctor will probably find: nothing. This is because most people with restless legs have nothing detectably wrong. Oh, your doctor may test your blood and, if he’s a neurologist, your nervous system. But most people with restless legs have nothing wrong with them that seems to account for their problem––nothing, that is, except an itch too deep to scratch.

Fortunately, there are some things you can do to calm your restless legs.

Hit the track. Regularly exercising your legs, whether by walking, running or doing in-place toe lifts, is probably the best way to ease your restless legs, Dr. Stern says. Dr. Ousterhout agrees. “When I was in high school, I used to go running at night,” he remembers. “It was about all I could do that would make it feel better.”

Knead your knee. Or whichever part of your big is giving you grief. While rubbing your legs isn’t a cure for restless legs, Dr. Stern says, some people say that it helps.

Take a jolt. Don’t be alarmed if your doctor sends you home with a rented black box and instructions to plug yourself in. Some researchers believe that TENS treatments––TENS stands for transcutaneous electrical nerve stimulation––can significantly relieve the symptoms of restless legs. With TENS, electrodes are placed on the skin over the affected parts of your legs. Small amounts of electricity then are directed into the underlying muscles and nerves. Essentially, your legs become too distracted by the electricity to continue being restless.

A Mystery with Clues

Although the cause of restless legs syndrome remains unknown, it is not a medical mystery without some clues, Dr. Stern says. Doctors do know, for example, that restless legs gets worse at night and with advancing age. Pregnant women are prone to it. So are people with kidney problems and rheumatoid arthritis. Restless legs syndrome has also been linked to iron deficiency, diabetes and Parkinson’s disease. In fact, a common drug used to treat Parkinson’s called levodopa (Sinemet) seems to work for restless legs in one study, 26 people who took levodoopa for two years said their symptoms were much relieved. Other prescription drugs such as clonazepam (Klonopin), carbamazepine (Tegretol), primidone (Mysoline) and bromocriptine (Parlodel) can help.

But many doctors believe the potential side effects of drug therapy may outweigh the benefits of treating this relatively harmless condition, Dr. Stern says. Unless your problem is really severe, your doctor will most likely want to try other therapies before prescribing any medications.

Until more is learned about this malady, it’s important for people to know that their restless legs syndrome, while mysterious, isn’t imaginary, says Dr. Stern. “I think people often are grateful to learn that restless legs is a recognized clinical entity and that they’re not going crazy.”