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Sunday, 1 June 2003  
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Compiled by Carol Aloysius

Chicken eggs and human health


Chicken eggs have played a vital role as an important dietary component all over the world. Chicken eggs meet the essential nutritional requirements for growth and maintenance of the human body.

Egg is considered to be of high biological value especially for patients who are recovering from chronic diseases such as Chronic Renal Failure (CRF). Egg protein is high quality protein that is efficiently used by the human body. Egg albumin is solely made out of protein which allows the supply of essential amino acids to the human body. Egg yolk also contains a great deal of important nutrients such as essential fatty acids B - carotene (precursor of vitamin A). calciferol (Vitamin D) tocopherol (Vitamin E) Vitamin B complex calcium and some of trace elements.

Resent research done on feeding eggs to patients with Alzheimer's disease (AD) at the Chicago Medical School has revealed that Alzheimer's disease (AD) patients improved within 48 hours of starting to eat a diet with special eggs. After two weeks, an assessment of their health condition showed a dramatical improvement. They were less irritable, less anxious and showed a considerable improvement in cognitive behaviour.

However, the consumption of chicken egg is still questionable due to its fat composition (Table-01).

Most doubts arising from regular egg consumption are due to the total composition of saturated fatty acids and cholesterol per egg which enhance plasma cholesterol level in threatened margin.

The saturated fat is "bad" fatty acids, which is the most important dietary factor influencing plasma cholesterol. All diets are designed to lower plasma cholesterol. It should contain low quantities of saturated fat. Saturated fatty acids are associated with high levels of total plasma cholesterol and LDL-cholesterol. Polyunsaturated fatty acids are "good" fatty acids, which are vital for human health especially n-6 or w-6 fatty acids and n-3 or w-3 fatty acids.

The currently recommended objective for a healthy diet is a P/S ratio of 0.4. With a P/S ratio of 0.6, egg fat is well above this recommendation. Egg fat has an n-6/n-3 ratio of 8.0, which compares favourably with the recommended ratio of 6 and is considerably lower than many components of our daily diet. However, we often forget that a single portion of any other animal product can contribute significantly more cholesterol to the diet than an egg. In terms of per unit weight of fat, the level of cholesterol in the egg is comparable with most other animal products and it is only half of the fat of liver.

Thus the misconceptions about egg consumption can be said to arise from a lack of adequate awareness of the nutritive value of chicken egg as well as its unfavourable effects.

If the public is aware of those facts properly, they can decide on the frequency and amount of eggs they should consum per week.

Furthermore in acceptable scientific literature, there is no evidence that the cunsumption of 3-4 eggs per week had caused a significant adverse effect on plasma cholesterol levels.


Atherosclerosis : Myths and facts

by Dr. D. P. Atukorale

Myth - 1

* Atherosclerosis (hardening of arteries) is a natural physiological consequence of ageing.

Myth - 2

* Breathing difficulties, chest pains or leg cramps are most often associated with atherosclerosis.

Many people have the mistaken idea, that, as one gets older, one's arteries harden, as through, after a limited number of years, the artery's inherited destiny is to become rigid, blocked and inflexible. This is not so. Hardening of the arteries while prevalent in the elderly, is the result of metabolic changes that actually start early in life.

You can have advanced atherosclerosis without the above symptoms. On the other hand you can have chest pain and not have heart disease. While exertion related chest pain, leg cramps (claudication pain) or shortness of breath are common symptom of atherosclerosis and coronary artery disease, many other conditions can cause these symptoms.

Gall-bladder disease, hiatus hernia, and shingles are three ailments in which pain can be remarkably similar to that of heart disease. Cardiospasm resulting from irritation to the lower end of oesophagu's is sometimes hard to distinguish from angina. Chest pain can stem from inflammation of the pleura or rib cartilage or from arthritis in the joints between the ribs and the spine or sternum.

Myth - 3

* The cause of heart attacks is always blocked circulation caused by an atherosclerotic plaque.

This is false. The degree of arterial blockage has never been correlated with either heart attacks or symptoms of coronary artery disease, although mechanical blockage of the arteries is one important factor.

Heart attacks may be triggered either by a mechanical blockage (a clot, or a plaque rupture or embolism) that causes complete cut off of the blood supply to the portion of heart muscle or by coronary artery spasm which can cause sudden blood stoppage or by both or by both events occurring simultaneously, with spasm superimposed on a pre-existing plaque. In both events, malfunction of the heart results from compromised blood flow and reduced oxygen supply causing heart muscle cell death (myocardial infarction) which can cause severe angina, or dangerous arrhythmia (palpitations), heart failure, shock or cardiac arrest. Sometimes cardiologists come across patients who get heart attacks with perfectly normal coronary arteries.

Myth - 4

* Low cholesterol diets reduce the risk of atherosclerosis

Cholesterol not only enters as food but is predominantly manufactured internally by the liver and other organs. Much of the cholesterol deposited in the atherosclerotic plaque is produced within the body. What is not widely known is that cholesterol is harmless if the cholesterol is not oxidized. Only oxidized cholesterol is harmful.

Myth - 5

* Vigorous sports and physical activity will protect against developing atherosclerosis.

Post mortem examinations performed on highly active people including marathon runners have disclosed far advanced atherosclerosis with extensive arterial plaque build-up although these people rarely exhibited symptoms of disease.

Exercise promotes collateral circulation around the blocked arteries and causes compensatory enlargement of the plaque filled arteries.

People who take regular exercises have less sudden deaths from coronary disease inspite of having extensive arterial plaques.

Myth - 6

* Consumption of margarine prevent atherosclerosis All solid margarines have significant amounts of trans-fatty acids which increase atherosclerosis.

Myth - 7

* Hardening of arteries begins with build-up of calcium deposits to form plaques. The initial in arterial disease is damage to the inner lining (endothelium) of the artery resulting from blood flow stress, routine wear and tear or free radical damage. The arterial wall cells mutate in response to free radical damage to the genes contained in the nucleus.

The tumour (atheroma) is an unwelcome space occupying mass on the inside of the artery which accumulates collagen, elastin, and other connective tissue constituents eventually, growing to block the flow of blood.

When this growth exceeds its blood supply of oxygen and nutrition, it begins to break down in the centre becoming decayed and necrotic and gradually gather deposits of cholesterol and calcium.

As it grows into what we call a plaque it becomes progressively firm and more rigid and calcified. Calcification is a late occurrence in plaque formation and not the initial event.


Mother's health: key to newborn's well-being'

Recent studies have underlined the close link between the health of the mother and her newborn child. The following article taken from a safe motherhood publication, discusses this important aspect.

Since the health of the newborn is so closely linked with that of the mother, it is important that the mother should be as fit and well as possible during pregnancy, delivery and the postpartum period - both for her own and her baby's sake. The woman's body needs extra stores of micronutrients both to help the foetus develop and to nourish the newborn as it breast-feeds.

While micronutrient supplementation is important for all pregnant women, it is absolutely essential where women are poorly nourished or anaemic.

Lack of Iodine can makes a child mentally retarded. However, women who live in places where there is very little iodine in the environment can protect themselves and their babies by taking iodized salt or oil. Iodine deficiency may cause goitre, permanent brain damage and mental retardation (often called cretinism). Supplementation with iodine completely protects against these consequences.

Vitamin A is essential for growth, development and normal functioning. This applies especially during pregnancy and the newborn period. Newborn infants get their vitamin A from their mother's breast milk. In countries where vitamin A deficiency is endemic, pregnant women may have symptoms such as night blindness that continue during the early period of lactation. If mothers are already deficient in Vitamin A, their breast milk is not likely to have enough of the vitamin to build up vitamin stores in the young infant. Vitamin A supplements given to the mother during pregnancy and the six months afterwards help nourish the child and may make the mother healthier too.

However, a recent study raised the question of whether women could be given too much vitamin A. Findings from research in the USA on mothers who had babies with birth defects or neural tube defects (both associated with the harmful effects of vitamin A) suggest that increased intake of the vitamin increases the risk of defects. The researchers questioned whether it is really safe to give vitamin A supplements to fertile women whose diet already contains enough of the vitamin, or even to those whose diet is deficient.

In order to clarify this issue, in June 1996 WHO brought together a group of experts to develop guidelines on vitamin A supplements. The group looked specifically at vitamin A supplementation during pregnancy and the first six months postpartum. A summary of their guidelines is as follows.

* If the woman is eating well there is no demonstrated benefit from additional Vitamin A. However, if she does take vitamin A during pregnancy, it should not exceed 10,000 IU per days.

* Mothers who are breast-feeding and their nursing infants will benefit from a single high dose supplement given to the mother any time upto eight weeks after delivery.

Vit D - is also important for pregnant women and helps in the absorption of calcium and phosphorous and the proper formation of bones and teeth.

Vit E - Helps in the Clotting of blood, While Vit B1 and B2 helps to produce energy from carbohydrates.

Folic Acid - Prevents certain types of birth defects of the brain and spinal cord.

Vitamin C - helps in the formation of collagen an essential component of bones, tendons, blood vessels, gums etc. Calcium and iron are also a very important component in the expectant mother's diet. The chief sources of calcium are milk and dairy products as well as small fish. Liver, kidney and plant foods such as nuts, seeds and dark green leaves that are rich in iron.


Recognition of problem personalities

by Dr. R. A. R. Perera, Consultant Psychologist

About ten percent of psychological references are labelled as personality and behavioural disorders'.

The World Health Organisation defines personality disorder as a person with deeply engrained, maladaptive patterns of behaviour generally recognisable by the time of adolescence or earlier and continuing through most of adult life'.

What is normality?

What is considered a personality disorder by one observer may be considered normal by another.

It may be difficult to distinguish stress-related reactions and unacceptable behaviour from personality disorder.

In patients with problem personalities, evidence of serious, repeated or long-standing problems will be found. For example;

* Problem at school work, with the police or in marriage.

* Rage of fighting

* Prostitution/Vagrancy

* Running away from home

* Persistent lying

Such people also show irresponsibility, lack of concern for others, inability to profit from past experience and an inability to form and maintain close, warm relationships.

The individual naturally 'plays down' this history but inconsistencies at the interview, followed up by direct questioning and tactful confrontation will usually reveal the problem.

A family history of personality disorder, absence of or rejection by parental figures in early life, and limited opportunities for early close relationships and for identification with satisfactory models, are common associations.

Violent problem personalities report punitive, rejecting, alcoholic or persistent anti-social parents, excessive physical punishment and problem-solving by violence.

Childhood fire setting and cruelty to animals is significant and repeated violence as an adult and associated jealousy makes future violence more likely. Such persons may be brought into a psychologist because of -

* A chance association of physical and mental illness

* Consequences of their behaviour, such as injury or intoxication

* Psychological complains, tension, boredom, depression, feelings of rejection and loneliness. These may be complicated by maladaptive impulsive behaviour, for example self-poisoning and self-mutilation.

Acute stress reactions and short-lived conduct disorders may resemble as a personality disorder, especially when the patient is emotional.

Organic brain disease, mental handicap or alcohol intoxication can present as behaviour difficulties when compounded by lack of satisfactory history and difficulties in communication.

Sometimes a psychosis or a neurosis may present as a personality disorder. The individual who comes to the psychologist may hope for an immediate answer to his life problems, and an unstable relationship may be all that can be achieved. Lack of close, deep relationships does not mean relationships never occur. In fact there are many fleeting, demanding contacts with one or two individuals.

Priorities set by patient, such as finance, housing, police or marital problems, may need to be dealt with as a first step.

Triggers to outbursts of disturbed behaviour should be sought at an early stage.

Overwhelmed by a strong emotional reaction, the patient takes refuge in problem behaviour. The patient must be made aware of the link between the trigger and the impulse for maladaptive behaviour. Avoidance or control of triggering situations should be promoted. Repeated detailed 'thinking through' of the consequences of actions should approach impulsiveness.

Reminders of past and present achievements and respect shown by others in words and actions can reduce depressive feelings.

Self-mutilation, such as repeated wrist slashing, requires exclusion of psychosis and attempted suicide. Self-mutilation is reinforced by effective reduction of tension following cutting and the inevitable medical and personal attention shown by the family.

Loyal, sometimes battered wives may be the mainstay for years until the spouse eventually settles down'. Such partners may need help with their reactive distress, ambivalence and unrealistic hope. Dealing with these problems due to choice or impossible behaviour requires services of volunteer or state social services participation on long-term basis.


You & Your Doctr by - Dr. Sampath R. Nanayakkara.


Q: I am suffering from a chronic allergy for the past one month. I was given various drugs prescribed by my doctor. All these drugs have not fully cured my allergic condition.

I am a heart patient of age 78 years. I am taking several drugs. Could you please tell me the cause of my allergic condition? Also could you please tell me why some people are allergic to foods like Balaya fish, Pineapple etc. while others are not?

- R. C. A. Fonseka

A: Allergy means an altered reaction of body tissues to a specific substance from outside the body. Those substances are called Allergens.

Among common allergens are inhalants such as dust, pollen, fungus, smoke, odours of plastics etc.

Foods - Wheat, eggs, milk, chocolate, pineapples, strawberry etc.

Drugs - Aspirin, antibiotics, some injection of blood products.

Infectious agents - Bacteria, Viruses, Animal Parasites.

Contactants - Chemicals, animals, plants, metals, insect bites

Physical agents - Heat, cold, light, pressure, radiation. Very often it is not possible to decide which allergen is responsible for a particular allergy. Among the symptoms of allergy are, skin rash, profuse catarrh, swelling of the 'voice box' (larynx), choking, wheezing in chest and swelling of whole body.

Sometimes this condition is genetically determined. That's why only some people get it. Actually allergy is not a deficiency state - in fact the presence of excessive substance called antibody which causes the reaction.

Once an allergen enters your body it stimulate your system, to form a Template which is capable of producing antibodies against the allergen. As long as you have the antibody to that particular allergen, your are going to prove the same allergic reaction in subsequent contacts with the latter. The template will make more and more antibodies.

Only way you could get out of this problem is try to identify the allergen and avoid it as far as possible. But it is not an easy task. No drug can cure it permanently.



Q: Dear Dr. I am now 74 years and since 1998 I have been getting severe attacks of sinusitis once a year or so, which last for about 2.-3 months in spite of medication.

Could you please tell me, what causes it and the 'Do' and 'Don'ts' to prevent a recurrence. I thank you. - P. N. F. (Galmuruwa)

A: You have air filled cavities in your head bones, in close relation to the passages of the nose. There are four pairs in number and they are called sinuses.

All of them open into the nasal passages. Often these cavities get invaded by germs, in the conditions known as sinusitis. As a result the lining of the sinuses become inflamed and swollen, so that the narrow openings to the nose is blocked. The cavity may then become heavy and later may fill with liquid. The symptoms of sinusitis, would be pain over face, headache, nose stock, running nose, fever. As a precaution, do not have baths in the evening, avoid 'ice cool drinks', stop smoking, do not expose yourself to early morning breeze, use a hat when going in the sun.

Get yourself regularly checked by your family doctor for any other abnormalities in the nasal passages. Do not try to stop sneezing in the morning, because it is a protection mechanism.

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