Fat is either gained or lost by increases or decreases in the size of the lipid pool in large numbers of fat cells. These ‘fill up’ in good times, like a water tank after heavy rain, and ‘empty out’ in bad times, like in a drought.

Which cells fill up or empty out most, and in what order, is a function of a range of factors including genetics, gender, age, race and the number of existing fat cells. One thing is clear though: the last cells to fill up are likely to be the first to empty out. If someone gains extra fat around the waist for example, this will usually be the first place it goes from when the energy balance becomes negative.

Fat cell enlargement through expansion of existing cells is called hypertrophy. A less common way of increasing fat is through an expansion of fat cell numbers or hyperplasia. Hyperplasia is

thought to occur only at certain periods in life, in particular during growth spurts when all body cells are rapidly increasing in number, such as early infancy (1-2 years) and early adolescence (12-14 years). Inappropriate lifestyles at these times may lead to a greater increase in fat cell numbers than might otherwise occur. A third stimulus to hyperplasia which is now well recognised is a large increase in body fat. As existing fat cells ‘fill up’, new cells come into existence and form a bigger ‘maximum capacity’ which is then capable of storing a total greater volume of fat. In contrast to the 30-50 billion fat cells of the average person, an obese person may have 70-80 or even up to 100 billion adipocytes.

The basis for hyperplasia of fat cells consists of ‘baby fat cells, known as adipocyte precursors, which exist amongst other fat cells, as if waiting for the opportunity to spring into action and fill up with fat like their parent cells.

Not a lot is known about these precursors; whether they are actually small fat cells in waiting, or whether they are just other (’stem’) cells that can be called on to make any other form of cell if needed. Some research suggests that they spring into action during the growth spurts mentioned above if conditions are right, or when increases in body weight exceed around 170 per cent of ideal or average weight. Once they mature however, they are there for life. Animal research has shown that with severe dietary restriction, fat cells can shrink to the point where they are virtually unrecognisable as adipocytes, but when overfeeding begins again, the shrunken cells rapidly fill up with fat.

With the expansion of fat cells in the waist region, some men, in particular, develop a ‘hard’ fat belly and some a ’soft’ or ‘wobbly fat one. The reasons for this are not quite clear but it’s possible that the big, hard abdomen represents a larger degree of visceral fat within the abdomen, which then pushes out more on the inner surface of the abdomen. Fat which is more ‘wobbly’ may represent more subcutaneous fat, although the evidence for this is not currently clear.

Irrespective of the type of fat stored, it’s clear that it is easier to prevent obesity and overfatness beyond a certain level than to cure it. Obviously, the function of fat as an energy store means that the human body has a certain capacity for increases and decreases in fat stores without permanent change. In the long term and for the very obese, however, there may be more permanent changes in fat cell numbers, metabolism and other fat maintaining factors, which make it more difficult to reduce body fat levels. People in this situation and those with a strong genetic component may be structurally and functionally different to the mildly overfat and in fat loss programs their outcomes may not be as favourable. They might need different programs to achieve similar levels of success as programs aimed at mildly fat people.

*24\186\4*

BIRCHER-BENNER APPLE MCESLI

2 tbsp. old-fashioned rolled oats (not the quick-cooking kind)

2 medium-sized apples

2 tbsp. wheat germ

2 tbsp. condensed milk or ordinary milk, fortified with 1 tbsp. skim milk powder

2 tbsp. honey

1/2 lemon

2 tbsp. chopped hazel nuts or almonds

Soak oatmeal overnight in four tablespoons of water. In the morning, add lemon juice and milk; mix well. Shred apples, un-peeled but well washed, into the mixture. Add honey, wheat germ and nuts, and stir. Serve at once, as it will lose in taste and food value if apples darken (oxidize). This dish is a favorite at the famous Bircher-Benner biological clinic in Switzerland and is also very popular in health food restaurants in Europe.

FRUIT SALAD A LA AIROLA

1 bowl fresh fruits, organically grown if possible

1 handful raw nuts and/or sunflower seeds

3-4 soaked prunes or handful of raisins, unsulphured

3 tbsp. cottage cheese, preferably homemade, unsalted

1 tbsp. raw wheat germ

tsp. wheat germ oil

3 tbsp. yogurt

tsp. natural, unpasteurized honey

1 tsp. fresh lemon juice

Wash all fruits carefully and dry. Use any available fruits and berries, but try to get at least three or four different kinds. Peaches, grapes, pears, papaya, bananas, and fresh pineapple are particularly good for producing a delightful bouquet of rich, penetrating flavors. A variety of colors will make the salad festive and attractive to the eye.

Chop or slice bigger fruits, but leave grapes and berries whole. Place them in a large bowl and add prunes and nuts (nuts and sunflower seeds could be crushed). Make a dressing with one teaspoon of honey (or more if most of the fruits used are sour), one teaspoon of lemon juice, and two tablespoons of water. Pour over the fruit, add wheat germ, and toss well. Mix cottage cheese, yogurt, wheat germ oil, and one teaspoon of honey in a separate cup until it is fairly smooth in texture and pour it on top of the salad. Sprinkle with nuts and sunflower seeds. Serve at once.

This is not only a most delicious dish but it is the most nutritious and perfectly balanced meal I know. It is a storehouse of high-grade proteins and all the essential vitamins, minerals, and enzymes you need for optimum health. This salad should be a daily must for the beauty-conscious and health-conscious alike.

WAERLAND FIVE-GRAIN KRUSKA (for 4 persons)

1 tbsp, whole wheat

1 tbsp. whole rye

1 tbsp. whole oats

1 tbsp. whole barley

tbsp. whole millet

tbsp. wheat bran

2 tbsp. unsulphured raisins

Take five grains and grind them coarsely on your own grinder. Place in a pot with one to one and a half cups of water and add bran and raisins. Boil for five to ten minutes, then wrap the pot in a blanket or newspapers and let it stand for a few hours. Experiment with the amount of water used—kruska must not be mushy, but should have the consistency of a very thick porridge. Serve hot with sweet milk and homemade applesauce or stewed fruits.

Kruska is an extremely nutritious dish and should be taken as a meal in itself.

*138\58\2*

All minerals are important for the health of the hair, especially calcium, magnesium, potassium, phosphorus, iron, copper, and iodine. Vitamin D (cod liver oil) is important for the proper assimilation of the minerals in the intestines. (Remember: you are not what you eat, but what you assimilate.)

Iodine is a trace mineral which is found in foods and water in extremely small quantities. It is needed by the thyroid for its healthy functioning. It has been observed that iodine deficiency in the diet causes dryness, thinness and poor growth of hair. Iodine has a direct action on the activity of the thyroid gland. When the thyroid gland is functioning to its fullest capacity, the general metabolism is speeded up, which has a favorable effect on the quality and growth of the hair. It is also believed that iodine has something to do with keeping hair from turning gray.

The best natural source of iodine is kelp. Kelp is a dried and powdered seaweed, and can be obtained from health food stores in tablet or powder form. One or two kelp tablets usually contain a minimum daily requirement of iodine.

Remember that the diets of people known for their healthy, thick hair—the Chinese, Italians, Japanese, Eskimos, etc.—are rich in iodine, which is procured from sea foods and seaweed. Seaweed is a staple food in many countries, notably in Japan.

A few years ago sheep farmers in the Great Lakes region complained that they were having trouble growing wool on their sheep. Iodine is lacking in the soils of this area, as in many other inland regions of the United States. When the farmers added iodine to the sheep’s rations, the quality and quantity of wool improved immediately.

Kelp is also rich in many other minerals necessary for healthy hair growth, such as calcium, magnesium, phosphorus, and potassium. One or two kelp tablets with each meal is a good protective dosage.

Lecithin is very rich in choline, inositol, and phosphorus—all acknowledged hair-growth stimulants. Lecithin is a modern wonder food, indeed, and much scientific research is available which shows that it is essential for many vital functions of the body. It is extremely important for the health of the nerves. It is vital for the brain—28 percent of the brain is lecithin. It is credited with the ability to break up fat and prevent fatty deposits in the arteries—one of the plagues of modern man. It rejuvenates the endocrinal glands which are involved in the growth of hair.

Commercial lecithin, available at health food stores, is made from soybeans. It comes in granular, liquid, or tablet form. Take two to three teaspoons, or the equivalent in tablets, each day.

*113\58\2*

(a) Nose—Left iris 52′, right iris 8′ approx.

(b) Throat and larynx—Left iris 45′-47′, right iris l3′-15′.

(c) Trachea—Right iris 12′-14′ only.

(d) Bronchi—Left iris 15′-17′, right iris 43′-45′.

(e) Lungs—Left iris 10′-15′, right iris 45′-50′ respectively, from the muscle zone outwards.

(f) Pleurae—Left iris and right iris, 15′-19′, 41′-45′- (Strictly speaking, the pleurae do not belong to the respiratory organs, but as is well known, are often disturbed together with the lungs, thus requiring them to be mentioned here.)

1. Inflammation of the upper respiratory passages ((a) to (c)): as may occur especially in the form of mucous membrane catarrh following chill—shows as white flakes or clouds in the specified areas. White wisps, running outwards to the iris margin, indicate an acute catarrhal discharge.

2. Chronic catarrh of the upper respiratory organs: is shown by dark grey wisp-signs.

3. Lacunae = weakness-signs: in the area for the upper respiratory passages, indicate a weakness of these organs and permanent catarrhal tendencies. More important than the signs in the areas for the upper respiratory passages are those which show in the area for bronchi, lungs and pleurae.

The bronchi very often became involved together with disturbances of the upper respiratory organ, in which case, the signs described above are also found in the bronchial areas.

*22\78\2*

TROUBLESOME MISERIES-CLUMSINESS

If you suffer from the aching miseries, then life at school can frequently be very difficult. To be suddenly and inexplicably clumsy can have dire results, especially if you are usually neat and deft. Your handwriting may degenerate, no matter how hard you try to keep it tidy, with the result that you get lower grades and teachers disapprove. You may be suddenly unco-ordinated, so that you walk into desks instead of round them, or do badly at games, or you become a menace in the science labs. That doesn’t improve your popularity either, which in its turn will make you feel even more upset and vulnerable and off-balance.

If you’re clumsy like this, one trick is to try to do everything slowly. Breathe in a lower, deeper gear as described and take a few minutes to relax as much of your body as you can. You’ll find the more relaxed you are, the less clumsy you are likely to be. Try to make a joke of your clumsiness if you can. But above all, keep that chart going, so that you can predict your clumsy times and try to avoid some of the more tricky situations. Obviously it’s a good idea to keep out of harm’s way as much as you can. It’s not a good time of the month to be working backstage, or putting in overtime in the labs or shifting PE equipment about. But most important of all, let your ally on the staff know what you’re doing. Show her the chart. She could be the one who will explain to your other teachers that you are not being lazy or bolshie, or going out of your way to produce poor work, or letting the side down, or whatever it is.

*66\177\2*

Laboratory tests are used by doctors to help identify illnesses, to determine what particular type of infectious organism is causing a problem, and to learn how serious a disease may be. Some procedures can be performed right in the doctor’s surgery, others must be done in a laboratory where more complex equipment is available. Some common tests and procedures are described here.

Urinalysis means analysis of a specimen of urine, the liquid form of body waste. Urine tests can reveal infections in the kidneys, the bladder, and the rest of the urinary tract. The chemical and cell content of urine can also show how well the digestive system is working.

Urine can be tested in four different ways. First, it can be examined visually for color and texture. Normal urine is a clear yellow; if it is cloudy, reddish, or some other color, an infection or an injury may be present in the body. Second, the water content of the urine can be measured. This shows how well the kidneys are doing their job of filtering the body’s wastes. Third, the chemical content of the urine can be analyzed, to find out if the body is discarding necessary chemicals that should be retained. Finally, the urine can be examined under a microscope to find out what cells, bacteria, and other material are present. This is done to identify an infection or disease more exactly.

Chemical analysis of urine is often used as a screening test for diabetes, a disease in which the body does not properly use the carbohydrates (sugars and starches) that are its chief sources of energy. To test for diabetes, the amount of glucose (a form of sugar) in the urine is measured by dipping a chemically treated stick in the urine and comparing the color of the stick with a color chart. If the glucose is above a certain level, diabetes may be the cause. Additional blood tests are then done to verify the diagnosis.

*268/84/5*

Blisters are a buildup of clear or almost clear fluid between layers of the skin. They may be caused by heat burns; chemical burns; rubbing (friction); infection by bacteria; viruses; hand, foot, and mouth disease; funguses; allergy to insect bites; or allergy to certain plants. Blisters range from the size of a pinhead to several centimeters across.

Signs and symptoms

Blisters are obvious from their typical appearance – a raised bubble of skin containing clear fluid. The cause of blisters is sometimes determined by their location. When blisters appear on the palms or heels, they are usually due to rubbing; most blisters of the feet are caused by ill-fitting shoes or by not wearing socks. Blisters on the soles and toes may be caused by a fungus. Blisters on the cuticles or backs of fingers almost always mean an infection.

Home care

Do not break open blisters caused by rubbing or by burns. Protect them with gauze and bandages. If a blister is accidentally opened, trim away the major portion of loose skin, cleanse with soap and water, and bandage. If the blister becomes infected (redness and increasing tenderness are signs of infection), it should be soaked in an Epsom salts solution. An infected blister should be checked by a doctor.

Precautions

• Red streaks spreading from a blister indicate spreading infection. If red streaks appear, see your doctor.

• Soaking unbroken blisters in too weak a solution causes marked enlargement of the blisters (suggested Epsom salts solution is at least 110 grams salts to a liter of water).

Medical treatment

Your doctor will determine the cause of the blister and look for signs of possible infection. Infected blisters are opened and the fluid cultured to determine the type of infection. Soaks or oral antibiotics may be prescribed individually or in combination.

*22/84/5*

Refined carbohydrate foods

These foods include sugar and foods with very high sugar content, and are unsuitable to include in the diet.

Sugar – White, brown, raw, icing, castor, coffee crystals etc.

Commercial flavoured milks – e.g. Big ‘M’

Flavoured mineral water

Glucose Powder

Jam, marmalade, lemon butter, sweet spreads

Honey, Golden syrup, treacle

Lollies, chocolates, toffee etc.

Powdered drinks, e.g. Fruit Saline, Tang

Sauces e.g. tomato, mint, barbecue

Soft drinks and cordials (ordinary sweetened)

Sugar coated breakfast cereals

Sweet desserts, jelly crystals

Sweetened condensed milk

Sweetened tinned fruits, glace fruit

Sweet Sherry, liqueurs, port, stout, sweet wines

Tonic water

Toppings and syrups

Sweetening agents & dietary products

Excessive use of any type of sweetening agent is unnecessary and not recommended. Try to educate your child to prefer less sweet foods. Why not learn to have unsweetened tea and coffee? Sweetening agents can be divided into two (2) groups.

1. Energy – Free Sweeteners

These sweeteners do not provide any energy (kjoules/calories) and include agents such as saccharin and cyclamate. They are usually purchased in liquid or tablet form – e.g. Sugarine, Sucaryl, Hermesetas, Nutrasweet, Equal.

Saccharin and Cyclamate are frequently used in the manufacture of low calorie or low joule dietary products which are suitable for people with diabetes.

Aspartame also has very low energy content.

2. Energy Providing

These sweeteners provide the same amount of energy (kjoules/calories) per gram as sugar (sucrose). However they do not influence blood glucose levels in the same way.

Those commonly used in the manufacture of dietary products include fructose, sorbitol, and mannitol.

Products prepared with these sweetening agents are often labeled ‘Carbohydrate Modified’.

The use of products containing fructose, sorbitol, mannitol in the diet must be limited for the following reasons:

a. When taken in excess fructose, sorbitol, mannitol may cause diarrhea.

b. Excessive intake may interfere with glucose metabolism.

c. Many carbohydrate modified products are high in fat – e.g. chocolate and should be only used occasionally.

d. The total energy content is often very similar to products prepared with sugar (these products are not low in energy [kjoules/calories] and are not recommended for use by the overweight diabetic).

Examples of products sweetened with fructose, sorbitol or mannitol include:

(Ingredients are generally printed on the label.)

Carbohydrate Modified Jams e.g. Mrs. Trewins

Diabetic Chocolate

Blizzards or SL’s – all flavours

Sugarless Chewing Gum

Diabetic/Carbohydrate Modified Biscuits

Carbohydrate Modified Ice-cream

The carbohydrate exchange list provides information for the inclusion of a variety of normal biscuits and ice-cream, making these products unnecessary.

Note: A small range of powdered sweeteners using a combination of mannitol and cyclamate is available e.g. Sweetaddin and Slim Line. In moderation they are suitable for use in cooking except where weight control may be a problem. A substitution of 1/3-1/2 cup for 1 cup sugar is generally satisfactory.

*107/54/5*

Close to 95,000 men a year die of lung cancer, compared to 66,000 women. Nearly twice as many men as women die of cirrhosis of the liver. And males are three times as likely to be killed in accidents. The reasons are obvious. Men smoke more, drink more, and take more unnecessary risks than women.

“Add to that the fact that men eat more meat, fat, dairy products, eggs, and high-calorie foods than women, while women eat more fruits, vegetables, whole grains, and low-calorie foods,” says Dr. Crose. “It’s small wonder that men’s lives are cut short.”

And cut is exactly the word to describe the often sudden ends that men come to, says Dr. Kawachi. “The biggest killer of men in their prime is heart attack. Men also die of sudden death more frequently than women. They have no inkling that they have heart disease, and then they get ventricular fibrillation and drop dead,” he says.

One way to avoid getting stopped in your tracks is to have annual physicals. Another is to make small lifestyle adjustments to keep healthier and safer. Here are doctors’ top tips.

Terminate tobacco. Whether you chew it or smoke it, tobacco use dramatically raises your risk for cancer, Dr. Goldberg says. Chewing tobacco causes oral cancer. Smoking is responsible for almost 90 percent of lung cancers among men and significantly raises a person’s risk for developing cancer of the pancreas, kidney, bladder, and esophagus.

“People tire of hearing it, but quitting smoking is the best thing you can do for yourself,” Dr. Kawachi says. “If you’re a lifetime smoker, you have a one in four chance of dying from a disease related to that habit, especially before age 65.” No matter how old you are when you quit, you lower your risk of cancer and heart disease almost immediately, Dr. Kawachi says. Research shows that your risk of having a heart attack drops within the first 24 hours. And within the first five years, your risk of dying from lung cancer is cut in half.

Drink, but think. Once you have a few, you’re well past the point of thinking about your drinking. So try doing what women-who are frequently designated drivers-do. Before you start, think about what you’re going to drink and what you’re going to do afterward. Then limit yourself to just a couple. “While there’s evidence that moderate drinking may be good for the heart, excessive booze is bad for it. Plus it increases your risk for cancer and cirrhosis of the liver,” Dr. Goldberg says. Booze is partly to blame for five times as many men as women drowning, though more men know how to swim, and for men being almost 2H times more likely to die in a car accident than women, he says.

Flip-flop fiber and fat. Most men eat more fat than they should, and they’re often eating more than they realize. To get less artery-clogging fat in your diet, make a point to choose fibrous foods over fatty foods whenever possible, says Dr. Kawachi. That means if there’s a choice between a baked potato and fries, go with the baked potato.

“This is often harder for men than for women,” Dr. Crose says. “Women become concerned about food at an early age, which is a problem regarding eating disorders, but it can be helpful in preventing chronic diseases later in life.” By keeping this rule in mind, you’ll almost automatically eat more fruits, vegetables, and grains and less processed high-fat foods.

*17/36/5*

A study published in the Annuals of Internal Medicine compared the effect on weight loss and hyperlipidaemia (elevated blood fats) of a low carbohydrate ketogenic diet and a low fat diet. A ketogenic diet is where carbohydrate intake is severely restricted to between 20 and 40 grams per day; this means the diet is mainly composed of lean meat, fish, chicken and eggs, with small amounts of salad vegetables. In this study participants on the low carbohydrate diet kept carbohydrate intake to less than 20 grams per day; the low fat group kept fat intake to below 30% of calories, (this equates to less than 67 grams of fat per day for the average person who consumes 2000 calories per day). The low fat diet group had to eat less than 300mg of cholesterol daily, and both groups participated in exercise.

The results showed that a greater number of people in the low carbohydrate group stuck with the diet than people in the low fat group (76%o versus 57%). After 24 weeks, weight loss was greater in the low carbohydrate group than the low fat group (average weight loss of 12.9% versus 6.7% of body weight). The interesting point is that triglycerides came down by 0.84mmol/L in the low carbohydrate group, and only 0.31mmol/L in the low fat group, and HDL cholesterol increased by an average of 0.14mmol/L in the low carbohydrate group, and actually decreased by 0.04mmol/L in the low fat group.

In basic terms, triglycerides decreased more, and HDL increased more in the low carbohydrate group compared to the low fat group. The low carbohydrate diet used here was quite extreme; it is not necessary to lower carbohydrate intake so severely to obtain good results. Another study published in the Journal of the American Medical Association compared a low glycaemic diet with a low fat diet. In the study 39 overweight or obese patients between the ages of 18 and 40 participated. Weight loss results were similar in this study; however participants in the low glycaemic group experienced less hunger, less insulin resistance, lower triglycerides, lower C-reactive protein and lower blood pressure than those on the low fat diet. Clearly lowering the amount of carbohydrate you eat can help you to feel less hungry, lose weight and improve your blood fats.

The effect carbohydrates have on liver function

Eating more carbohydrate than we need results in its storage as body fat. The liver is the main fat metabolizing organ in the body, and excess carbohydrates are converted into fat in the liver; you will remember that most cholesterol in our body is manufactured in the liver. Over time, a high carbohydrate diet clogs our liver with fat and we can develop what is known as fatty liver disease; also known as non-alcoholic steatohepatitis. This is an extremely common condition, and affects an average of 20 percent of the population. Most people do not develop a fatty liver because they eat too much fat, they get it from eating too much sugar, bread, pasta, cereals, soft drinks, and other foods high in sugar which their liver turns into fat. Hydrogenated vegetable oil, which contains trans fatty acids also contributes to the development of fatty liver.

When we develop a fatty liver, it often causes us to have raised liver enzymes; this indicates that there is inflammation occurring in our liver. C-reactive protein is manufactured in the liver in response to inflammation, and it promotes further inflammation in the rest of our body, including our artery walls.

*20/53/5*