目前分類:2.健康 養生 資訊轉貼 (957)

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24Drs好健康報:心情不好嗎?吃魚吧!


好健康熱頭條 ─ 心情不好嗎?吃魚吧! In a Bad Mood? Eat Your Fish 
好健康小單字─必需脂肪酸(Essential Fatty Acid,EFA) 
  好健康熱頭條 ─ 心情不好嗎?吃魚吧!
 
 
不管你是重度憂鬱或只是單純的心情不好,吃鮭魚或其他富含omega-3脂肪酸的食物就會讓你感覺好一點。


之前的研究顯示,血液中omega-3的含量低與許多嚴重的心理疾病有關,包括重度憂鬱症、躁鬱症、注意力不足症、甚至是精神分裂症;現在有最新的研究指出,omega-3能顯著影響每個人的心理健康。


匹茲堡大學醫學院的研究人員Sarah Conkin博士表示,在他們的研究中,血液中omega-3脂肪酸含量低的人比較會有輕度至中度的憂鬱症症狀、比較悶悶不樂、且比較衝動;相反地,血液中omega-3脂肪酸含量較高的人在標準試驗的結果是比較愉快的。


Conkin博士將研究結果於丹佛舉辦的第46屆美國身心學會科技年會上發表。


【魚與亞麻子】
美國心臟學會建議,每星期至少要吃兩份富含油脂的魚類,因為有許多證據顯示,魚內的omega-3脂肪有助於對抗心血管疾病。


這是第一次有人在心理研究中調查油脂,主導部分研究的研究人員表示,omega-3含量也對心理疾病有影響的證據目前還不足,但是有越來越多的趨勢。


全國酒精濫用中毒協會的精神病學家Joseph Hibbeln醫師表示,omega-3脂肪酸對心臟有益是非常明顯的,但是它對頭腦的好處仍在觀察中,這是個新興的公共衛生議題,但是他們目前還不知道結果。


EPA(二十二碳五烯酸)與DHA(二十二碳六烯酸)是兩種能在像是鮭魚、沙丁魚、鯖魚等富含油脂的魚類中所發現的omega-3脂肪酸,第三種則是ALA(α-亞麻油酸),它存在於亞麻子、大豆油、胡桃、以及芥花籽油等植物性食物中。


【Omega-3脂肪的影響】
這篇最新研究是針對106位沒有重度憂鬱症或被診斷出其他心理疾病的人進行研究,那些血液中omega-3脂肪酸含量較低的人,在心理、個性、衝動行為測試的分數上比含量較高的人低。


Conkin博士表示,ALA的含量低尤其與比較衝動有關,若表現得更衝動的話,就稱為注意力缺陷過動症(ADHD);這次的參與者都沒有注意力缺陷過動症,他們衝動的程度並沒有那麼嚴重,但是相較於研究中的其他人來說是比較衝動的。


研究中EPA與DHA含量低的人,比其他人可能會有輕度至中度的憂鬱症症狀;她向WebMD表示,很明顯地,需要做較大型的研究來了解行為與這些油脂間的關係,但是遵從美國心臟學會的建議,每星期吃兩餐魚肉能保護你的心臟與心理健康。


【大多數的人都吃不夠】
著有<Omega-3關係>的哈佛大學精神病學教授Andrew L. Stoll醫師表示,大多數的美國人覺得他們所吃的食物中,很難攝取足夠的omega-3脂肪酸。


他指出,典型的日式飲食比美國飲食所含有的omega-3脂肪多10倍,他建議成人要吃高品質的魚油膠囊,以增加他們的omega-3攝取量,並減少攝取含有omega-6脂肪的食物,像是用玉米油、花生油、或大豆油所油炸的食物。


他表示,在這種國家要攝取足夠的omega-3很難,在日本,吃富含omega-3的食物是文化的一部分,但在這裡就不是如此了。
  
  
  
  In a Bad Mood? Eat Your Fish 
 
 
Whether you're seriously depressed or simply in a bad mood, eating salmon and other foods high in omega-3 fatty acids just might help you feel better.
Earlier studies appear to link low blood levels of omega-3s to a host of serious psychological conditions, including major depression, bipolar disorder, attention deficit disorder, and even schizophrenia.


Now new research suggests that omega-3s can have a significant impact on everyone's mental health.
"People in our study who had low blood levels of omega-3 fatty acids were more likely to report mild to moderate symptoms of depression, more moodiness, and more impulsivity," says researcher Sarah Conkin, PhD, of the University of Pittsburgh School of Medicine.


Conversely, people with higher blood levels of omega-3s were found to be more agreeable, based on the results of standardized tests.


Conkin presented the findings at the 46th Annual Scientific Meeting of the American Psychosomatic Society in Denver.


Fish and Flaxseed
The American Heart Association recommends eating at least two servings of fatty fish each week, based on strong evidence that the omega-3 fats found in the fish help protect against cardiovascular disease.


The evidence that omega-3 levels also have an impact on mood disorders is less conclusive but growing, says a researcher who conducted some of the first psychological studies examining the fats.


"It is quite clear that omega-3 fatty acids are good for your heart," says psychiatrist Joseph Hibbeln, MD, of the National Institute on Alcohol Abuse and Alcoholism. "But it remains to be seen how good they are for your mind. It is an emerging public health question, but we don't yet know the answer."


Two types of omega-3 fatty acids are found in fatty fish like salmon, sardines, and mackerel -- eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA. A third omega-3, alpha-linolenic acid, or ALA, is found in plant foods such as flaxseed, soybean oil, walnuts, and canola oil.


Impact of Omega-3 Fats
In the new study involving 106 healthy people without major depression or any other diagnosed mood disorder, those who had low blood levels of omega-3 fatty acids scored worse than those with high levels on tests designed to assess mood, personality, and impulsive behavior.


Conklin says low ALA levels were specifically associated with higher levels of impulsivity, which in more extreme forms manifests as attention deficit hyperactivity disorder (ADHD).


"These were normal people who did not have ADHD," she says. "Their impulsivity was not clinically significant, but it was higher than others in the study."


People in the study with low blood levels of EPA and DHA were more likely than others to report experiencing symptoms of mild to moderate depression, Conklin adds.
"Clearly, larger studies are needed to understand the relationship between behavior and these fats," she tells WebMD. "But by following the AHA recommendations to eat two fish meals a week people may be protecting both their hearts and their mental health."


Most People Don't Get Enough
Harvard psychiatry professor Andrew L. Stoll, MD, who wrote the book The Omega-3 Connection, says most Americans find it difficult to get enough omega-3 fatty acids through the foods they eat alone.


He points out that the typical Japanese diet contains as much as 10 times the omega-3 fats as the typical American diet.


He recommends that adults take high-quality fish oil capsules to boost their omega-3 levels, and cut down on their consumption of foods containing omega-6 fats such as foods fried in corn, peanut, and soybean oils.


"It is just hard to get enough omega-3s in this country," he says. "In Japan it is just part of the culture to eat omega-3-rich foods, but that isn't the case here."


SOURCES: 64th Annual Scientific Meeting of the American Psychosomatic Society, Denver, March 1-4, 2006. Sarah Conklin, PhD, postdoctoral fellow, cardiovascular behavioral medicine program, department of psychiatry, University of Pittsburgh School of Medicine. Andrew L. Stoll, director of psycohopharmacology research, McLean University; associate professor of psychiatry, Harvard Medical School, Boston.


WebMD Medical News
by Salynn Boyles
Reviewed By Louise Chang
  
  
  
  好健康小單字─必需脂肪酸(Essential Fatty Acid,EFA)
 
 
必需脂肪酸是油脂合成的基本元素,為健康所必需,是一種人體無法自行合成而必須透過食物攝取的脂肪酸,可分為Omega-3及Omega-6兩大類;其主要功能有二:提供細胞膜的重要成份,及前列腺素(Prostaglanding)的合成;這些必需脂肪酸也是多元不飽和脂肪酸(polyunsaturate fatty acids),能幫助降低膽固醇、高血壓,以及減少罹患心臟疾病與中風的機率。
  
  
  
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24Drs好健康報:睡眠長度會影響糖尿病風險?!


好健康熱頭條 ─睡眠長度可能影響糖尿病風險 Sleep Length May Sway Diabetes Risk 
好健康小單字─胰島素抗性 (Insulin Resistance) 
  好健康熱頭條 ─睡眠長度可能影響糖尿病風險
 
 
睡眠縮減或在睡眠方面過份放縱,可能會更容易罹患糖尿病。


糖尿病照護期刊上的一項研究顯示,獲得較少睡眠(每晚最多五或六個小時)的男性,或睡很多(每夜晚超過八小時)的男性,可能比每晚獲得適度睡眠的男性要來得可能發展糖尿病。


這項研究包含了超過1,100位住在波士頓裡面或周圍的中年和老年男性;研究人員包括了耶魯大學醫學院的H.Klar Yaggi醫學博士、公共衛生碩士。


Yaggi的研究小組表示,睡太多或睡太少可能會是糖尿病的一個風險因子。


【睡眠和糖尿病】
當這項研究在1980年代後期開始的時候,沒有任何一位男性患有糖尿病。


他們提供了血液樣本而且接受面訪有關於他們的健康習慣,包括他們每晚平均睡眠幾小時;後續的面訪在1990年代中期和2002-2004年期間進行。


有90個新的糖尿病案例在研究期間被診斷出來。


Yaggi和同事表示,通常,那些睡眠期間落在極端值的人〔每晚睡最多達五小時和每晚睡超過八小時〕,比起那些表示每晚睡七小時的人,罹患糖尿病的風險更高。


儘管他們將其他可能增進糖尿病風險的因素也納入考量,但晚上睡眠的時數仍有很大的關係。


【睡七小時是最理想的?】
研究顯示,每晚睡七小時的可能對於緩和糖尿病風險是理想的。


相較於每晚睡七小時的男性,每晚睡眠較少(少於五或六個小時)的男性,糖尿病風險是兩倍高,而每晚睡很多(每晚超過八小時)的男性,罹患糖尿病風險是三倍高。


想到Goldilocks,來自神話故事的虛構人物,她在找尋一張不是太硬或太軟的床,和不太熱或太冷的粥;最恰到好處的水準是Goldilocks自己的目標,而且如果Yaggi的研究是正確的,七小時的睡眠可能是對於降低糖尿病最適當的。


然而,Yaggi的研究並不證明睡眠習慣會引起(或避免)任何一位男性的糖尿病;研究顯示,表示每晚睡眠七小時的男性也似乎是較年輕、較有學問、健康情況較佳,而且睾酮濃度較高的人。


他們附帶說明表示,睡眠對糖尿病風險的影響可能被睾酮濃度的改變而居中調解;其他的研究顯示了低的睾酮濃度已經與糖尿病風險因子,包括肥胖、身體脂肪分配和胰島素抗性有關。
  
  
  
  Sleep Length May Sway Diabetes Risk 
 
 
Skimping on sleep or overindulging in sleep might make diabetes more likely.


A study in Diabetes Care shows men who got little sleep (up to five or six nightly hours) or a lot of sleep (more than eight hours per night) were more likely to develop diabetes than men with moderate amounts of nightly sleep.


The study included more than 1,100 middle-aged and elderly men living in and around Boston. The researchers included H. Klar Yaggi, MD, MPH, of Yale University's medical school.


Getting too much or too little sleep could be a risk factor for diabetes, Yaggi's team reports.


Sleep and Diabetes
When the study started in the late 1980s, none of the men had diabetes.


They provided blood samples and were interviewed about their health habits, including their average hours of nightly sleep. Follow-up interviews were done in the mid-1990s and in 2002-2004.


Ninety new cases of diabetes were diagnosed during the study.


"Generally, those at the extremes in sleep duration [up to five hours and more than eight hours of sleep per night] had a worse risk profile in terms of diabetes risk than those who reported seven hours of sleep per night," Yaggi and colleagues write.


They took into account other factors that boost diabetes risk. Even so, nightly hours of sleep mattered.


Seven Hours Ideal?
Seven hours of nightly sleep might be ideal for taming diabetes risk, the study suggests.


Compared to men who slept for seven hours per night, diabetes risk was twice as high for men reporting little nightly sleep (less than five or six hours) and three times as high for men reporting lots of sleep (more than eight hours per night).


Think of Goldilocks, the fictional character from fairy tales. She hunted for a bed that wasn't too hard or too soft, and for porridge that wasn't too hot or too cold. The "just right" level was Goldilocks' goal, and if Yaggi's study is right, seven hours of sleep might be "just right" for lowering diabetes risk.


However, Yaggi's study doesn't prove that sleep habits caused (or prevented) diabetes in any of the men. Men reporting seven hours of nightly sleep also tended to be younger, more educated, in better health, and had higher testosterone levels, the study shows.


They add that the effects of sleep on diabetes risk may be mediated by changes in testosterone. Other studies have shown that low testosterone has been associated with risk factors for diabetes including obesity, body fat distribution, and insulin resistance.


SOURCES: Yaggi, H. Diabetes Care, March 2006; vol 29: pp 657-661. Reuters.


WebMD Medical News
by Miranda Hitti
Reviewed By Brunilda Nazario
  
  
  
  好健康小單字─胰島素抗性 (Insulin Resistance)
 
 
什麼是胰島素抗性?簡單來說,就是對胰島素作用有抵抗性或是胰島素作用有缺陷;這是週邊組織對胰島素降低生理反應的一種病理現象,其臨床表現包括血脂異常、高血壓、葡萄糖耐受不良或第二類型糖尿病、高尿酸血症或痛風、中心型肥胖、血液凝固系統缺損及高凝固力、維生素過多症、脂肪肝及冠狀動脈心臟病等病症。
  
  
  
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24Drs好健康報:飲食與生活習慣會影響眼睛健康?!


好健康熱頭條 ─ 飲食與生活習慣可能影響眼睛健康 Diet, Lifestyle May Affect Eye Health 
好健康小單字─ 老年性黃斑部病變(Age-Related Macular Degeneration,AMD) 
  好健康熱頭條 ─ 飲食與生活習慣可能影響眼睛健康
 
 
最新研究顯示,從你的眼睛可能可以看出你身體健康與否;刊載在營養學(Nutrition)中的報告顯示,飲食與生活習慣可能影響罹患老年性黃斑病變(AMD)的機率。


AMD在美國是造成視力喪失的主要原因,超過1千3百萬人有某些AMD的症狀,但是這種病比較不常見於55歲以下的人;最新研究顯示,飲食、抽菸、與身體質量指數(BMI)可能影響罹患AMD的機會。


根據最新研究顯示,吃得健康、不抽菸、不過重能讓你遠離老年性黃斑病變,研究人員包括哈佛醫學院與公共衛生學院的Johanna Seddon醫師。


【探索AMD】
Seddon醫師與同事們針對934位平均在67歲至71歲的老年人進行研究,其中一半的參與者是在波士頓的眼耳診所做檢查;另一半的人則在奧勒岡州波特蘭的眼科診所做檢查。


總共有184位參與者沒有AMD,201位是輕微的AMD,326位是中度的AMD,223位是重度AMD;參與者完成有關飲食與生活習慣的調查,也要抽血讓Seddon醫師的研究小組確認C-反應蛋白(CRP)與高半胱胺酸的含量,這兩種物質與心臟疾病風險增加有關。


研究人員表示,之前的研究指出,CRP與高半胱胺酸與老年性黃斑病變有關,這一次他們是要確認飲食與生活習慣是否會影響CRP與高半胱胺酸的含量,以及是否會影響AMD的風險。


沒有要求任何參與者要改變飲食或生活習慣,研究人員只是觀察這些參與者的習慣模式、血液中的化學物質、與AMD診斷結果。


【令人吃驚的數據】
研究人員發現,抽菸、過重、以及吃較少抗氧化物(許多蔬果中會發現的天然化學物質)的人CRP與高半胱胺酸含量較高。


例如,表示自己每週吃超過2次魚的人CRP含量較低,吃較多維他命C、β胡蘿蔔素、與葉黃素以及玉米黃素等抗氧化物的人也是如此,抽菸以及BMI較高的人CRP含量較高。


吃較多維他命E的人血液中含有較少的高半胱胺酸,而且這些人會吃較多抗氧化物與維他命B6,但是血液中維他命E較高也與CRP含量較高有關,所以Seddon醫師與同事們指出,這種矛盾應該進一步研究。


他們指出,整體來說,這些研究結果指出,如果你有抽菸、過重、與其他不健康的行為時,眼睛就有可能生病。


Seddon醫師在新聞稿中表示,AMD與免疫、發炎、以及其他心血管機制有關,而這些結果強調,為了你的眼睛以及全身著想,你需要健康的生活習慣。
  
  
  
  Diet, Lifestyle May Affect Eye Health 
 
 
Your eyes may be a window to your body's health, a new study shows.


The report, published in Nutrition, shows that diet and lifestyle might sway the odds -- for better or worse -- of developing age-related macular degeneration (AMD).


AMD is America's leading cause of vision loss. More than 13 million people in the U.S. show some signs of AMD, which is uncommon in people younger than 55. A new study shows that diet, smoking, and BMI (body mass index) may affect the chances of getting AMD.


Eating healthfully, not smoking, and not being overweight could help keep age-related macular degeneration at bay, according to the new study. The reverse also appears to be true, write the researchers. They included Johanna Seddon, MD, of Harvard Medical School and the Harvard School of Public Health.


Tracking AMD


Seddon and colleagues studied 934 people who were 67 to 71 years old, on average. Half of the participants were screened at a Boston eye and ear clinic. The others were screened at an eye clinic in Portland, Ore.


A total of 184 participants didn't have AMD. The rest had mild AMD (201 patients), moderate AMD (326 patients), or advanced AMD (223 patients).


Participants completed surveys about their diet and lifestyle. They also gave blood samples, which Seddon's team checked for levels of C-reactive protein (CRP) and homocysteine, which have been linked to increased risk of heart disease.


The researchers had previously reported that CRP and homocysteine are associated with age-related macular degeneration. This time, they checked how diet and lifestyle affected levels of CRP and homocysteine, as well as AMD risk.


None of the participants were asked to change their diets or lifestyles. The researchers just looked for patterns among the participants' habits, blood chemicals, and AMD diagnosis.


Eye-Opening Data


The researchers found that people who smoked, were overweight, and consumed fewer antioxidants (natural chemicals found in many fruits and vegetables) tended to have higher levels of CRP and homocysteine.


For instance, people who reported eating fish more than twice per week had lower CRP levels. This was also true for people who consumed higher levels of vitamin C, beta-carotene, and the antioxidants lutein and zeaxanthin.


CRP levels were higher for people who smoked or had higher BMI, the study also shows.


Lower homocysteine levels were seen in people with more vitamin E in their blood and those who consumed more antioxidants and vitamin B-6. But higher blood levels of vitamin E were also tied to higher CRP levels. That contradiction should be studied further, note Seddon and colleagues.


"Overall, these findings suggest that sick eyes may occur in sick bodies related to smoking, being overweight, and other unhealthy behaviors," they write.


"AMD is associated with immune, inflammatory, and other cardiovascular mechanisms, and these results emphasize the need to adhere to healthy lifestyles for your eyes and your body overall," Seddon says in a news release.


SOURCES: Seddon, J. Nutrition, April 2006; vol 22: pp 441-443. WebMD Medical Reference: "Understanding Macular Degeneration -- the Basics." News release, Massachusetts Eye and Ear Infirmary.


WebMD Medical News
by Miranda Hitti
  
  
  
  好健康小單字─ 老年性黃斑部病變(Age-Related Macular Degeneration,AMD)
 
 
老年性黃斑部病變為成年或老年人視力退化及失明的原因之一,是老化而產生視力退化的一種眼疾,發生原因是眼球裡的脈絡膜產生不正常的新生血管,此新生血管長至「黃斑部」的下方(黃斑部是負責微細中心視力及色彩的部位,因此患者常在視覺中心有暗影,但其周邊的視野並不受到影響),非常脆弱,容易反覆出血和滲水,結果破壞黃斑部的感光細胞,視力急速減退;可區分為兩種型態,一型為乾性或非新生血管性的黃斑部病變;另一型為溼性或新生血管性的黃斑部病變。
  
  
  
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24Drs好健康報:迷上曬黑了嗎?


好健康熱頭條 ─ 迷上曬黑了嗎? Hooked on Tanning? 
好健康小單字─紫外線輻射(Ultraviolet radiation;UV) 
  好健康熱頭條 ─ 迷上曬黑了嗎?
 
 
不能曬黑會讓你不舒服嗎?那你可能曬黑上癮了。


去年有篇針對常去海灘的人所做的研究顯示,這些曬許多太陽的人很像喝太多酒或是吃太多藥的人,也就是說,太常曬黑的人就像上癮了一樣;現在研究人員表示,經常曬黑並不只是「很像」上了癮,而是「真的」成癮了。


研究人員們觀察這些一個月曬8至15次的人,結果發現,如果給這些經常曬黑的人naltrexone(一種能限制麻醉劑類的藥物),他們曬黑時皮膚會產生戒斷症狀;但是不常曬黑的人服用naltrexone則不會有戒斷症狀。


Wake Forest大學Baptist醫學中心的皮膚科醫生Mandeep Kaur表示,開始時他們給常曬黑的人50毫克標準劑量的naltrexone,所有人都出現符合生理性的戒斷症狀:噁心、頭昏眼花、以及搖晃,所以他們必須停止那個研究。


Kaur醫師與同事們在最近的研究中找了8位經常曬黑的人,以及8位已經曬黑但不常這麼做的人進行研究,他們開始時都只給5毫克的naltrexone,再慢慢的增加劑量;當他們達到15毫克時,有四位經常曬黑的人有明顯的戒斷症狀。


Kaur醫師表示,有四位在結束時表示噁心或是緊張不安,其中有兩位在服用15毫克naltrexone後退出研究;不常曬黑的人則沒有任何戒斷症狀,而且沒有對麻醉劑上癮的人很少會對這麼低劑量的naltrexone產生這些副作用。


所以,Kaur醫師表示,他不認為這是naltrexone的副作用,他認為這是因為曬黑產生的生理性推縮。


研究結果刊載在2006四月號的美國皮膚醫學協會期刊(Journal of the American Academy of Dermatology)上。


【迷上曬黑者的快感?】
皮膚科醫生發現,曬黑會讓皮膚散發腦啡,這些類嗎啡的成分讓人覺得很好,它們就是讓馬拉松選手會有「跑者的快感」的原因,而這會是讓曬黑者有快感的原因嗎?


提出2005年報告的作者Richard Wagner Jr.醫師指出,經常曬黑可能是一種物質濫用,他是位於蓋文斯頓的德州大學醫學院皮膚外科主任兼皮膚系副主任;Wagner醫師表示,這個想法是從不想停止曬黑的皮膚癌患者而來。


Wagner醫師向WebMD表示,每一位皮膚科醫生都會告訴你,有些病患他們很關心,我們知道紫外線會導致皮膚癌,然而,我們看到皮膚癌患者還是一直在曬太陽,我們會告訴他們不要為了曬黑而去曬,有些人會說「但是醫生,我非常愛曬黑,它讓我覺得放鬆,我知道我已經有皮膚癌,但是我停不了。」


因此,Wagner醫師去海灘,對那些在做日光浴的人做上癮的問卷調查,有半數的人符合物質濫用障礙的心理標準,而這個物質就是曬太陽。


【所選的毒品:紫外線】
Wagner醫師與Kaur醫師懷疑經常曬黑的人是迷上因為在紫外光下曬黑所產生的腦啡,當皮膚接觸同樣會造成皮膚癌的紫外線時,就會產生腦啡。


Wagner醫師表示,曬黑的問題在於因為照紫外線而黑的生理反應,紫外線是腫瘤助長者,這也就是皮膚科醫生試著限制病患接觸紫外線的原因。


Kaur醫師的研究小組在研究中有兩張看起來一樣的曬黑機,其中一張用紫外線,另一張則沒有紫外線;研究人員找了8位經常曬黑的人與8位不常曬黑的人參與研究,他們要求參與者使用這兩張曬黑機,並要求他們比較偏好哪一張,接著他們給每一位參與者逐步增加劑量的naltrexone,或是沒有作用的安慰劑。


結果顯示,不常曬黑的人在產生腦啡的紫外線之下稍微偏好曬黑,naltrexone稍微降低了這種偏好;經常曬黑的人在紫外線之下非常喜歡曬黑,當他們用15毫克或25毫克劑量的naltrexone時,這種偏好會明顯的降低;而且就如同之前所述,有四位參與者顯示有生理性的戒斷徵兆。


你如何判斷是否有曬黑癮?Kaur醫師表示,要看你多常做日光浴或是去做曬黑美容,如果你無法不去做曬黑美容,而且一個月去8次以上的人要小心了,她也警告曬黑是有危害的。


Kaur醫師表示,如果你一個月要曬8次以上,又在早上10點至下午4點之間曬的話是會受到影響的,而且用曬黑機也一樣,雖然他們表示機器很安全,但是曬黑其實並不安全。


紫外線也不是都不好,皮膚接觸紫外線能製造維他命D,正常的接觸陽光能產生大量的維他命D,Kaur醫師表示,避免陽光的人要確定他們能有足夠的維他命D。
  
  
  
  Hooked on Tanning? 
 
 
Do you feel bad when you can't tan? You may be a tanning addict.


Last year, a study of beachgoers showed that people who tan a lot are much like people who drink or drug too much. That is, too-frequent tanners act a lot like addicts.


Now researchers report that frequent tanning isn't just like an addiction. It really may be an addiction.


The researchers looked at frequent tanners -- those who tan eight to 15 times a month. Their study shows that frequent tanners get withdrawal symptoms when given naltrexone, a drug that blocks a narcotic-like substance produced in the skin during tanning. But infrequent tanners who take naltrexone don't get withdrawal symptoms.


"In the beginning, we gave standard 50-milligram doses of naltrexone to frequent tanners," says researcher Mandeep Kaur, MD, a dermatologist at Wake Forest University Baptist Medical Center. "All of them developed symptoms consistent with physiological withdrawal: nausea, dizziness, and shaking. So we had to stop that study."


In their most recent study, Kaur and colleagues enrolled eight frequent tanners and eight people who tanned, but did so infrequently. They started them all on just 5 milligrams of naltrexone and gradually increased the dose. When they got to 15 milligrams, four of the frequent tanners got telltale withdrawal symptoms.


"Four of the eight frequent tanners ended up reporting nausea or jitteriness," Kaur says. "Two of them dropped out of the study after taking the 15-milligram dose of naltrexone."


None of the infrequent tanners got any withdrawal symptoms. And people who aren't addicted to narcotics rarely get these kinds of side effects from such a low dose of naltrexone.


"So I don't think it is a side effect of naltrexone. I think it is physiological withdrawal from tanning," Kaur says.


The findings appear in the April 2006 issue of the Journal of the American Academy of Dermatology.


Hooked on Tanner's High?


Tanning, dermatologists have found, makes the skin give off endorphins. These opioid compounds make a person feel good. They are the reason endurance runners report "runner's high." Could there really be such a thing as tanner's high?


The author of the 2005 report suggesting that frequent tanning may be a type of substance abuse is Richard Wagner Jr., MD, deputy chairman of dermatology and director of dermatologic surgery at the University of Texas Medical Branch at Galveston. Wagner says the idea came from skin cancer patients who couldn't stop tanning.


"Every dermatologist will tell you there are some patients we are concerned about," Wagner tells WebMD. "We know ultraviolet (UV) light can lead to skin cancer. Yet we all see patients with skin cancer who are always tan. We tell them not to tan on purpose, and some say, 'But doc, I like it too much. It makes me feel relaxed. I know I am getting skin cancer, but I can't stop.'"


So Wagner went down to the beach and gave addiction questionnaires to people who were sunning themselves. As many as half met the psychological criteria for substance-related disorder. That substance: sun tanning.


Drug of Choice: UV Light


Wagner and Kaur suspect that frequent tanners get hooked on the endorphins produced by tanning under ultraviolet light. The skin makes endorphins when it's exposed to UV light -- the same light that causes skin cancer.


"The problem with tanning is that the physiologic response of tanning is due to UV light," Wagner says. "UV light is a tumor promoter. That is why dermatologists try to limit their patients' exposure."


At their tanning research lab, Kaur's team has two identical-looking tanning beds. One uses UV light. The other does not.


The researchers enrolled eight frequent tanners and eight infrequent tanners in their study. They had them use both tanning beds and had them rate their preference. Then they gave each participant escalating doses of naltrexone or an inactive placebo pill.


The infrequent tanners slightly preferred tanning under the endorphin-producing UV light. Naltrexone slightly reduced this preference.


The frequent tanners greatly preferred tanning under UV light. This preference was markedly reduced when they were on 15-milligram or 25-milligram doses of naltrexone. And as noted above, four of these participants showed physical signs of withdrawal.


How can you tell if you're a tanning addict? Kaur says to look at how often you are sunbathing or visiting a tanning salon. Kaur says if you have an unlimited pass to a tanning salon and are going eight or more times a month, watch out. She also cautions about the hazards of tanning.


"If you are tanning yourself eight or more times a month, between the hours of 10 a.m. and 4 p.m. -- if you are baking yourself, this is going to affect you," Kaur says. "And that goes for tanning beds, too. They say they are safe, but there is no such thing as safe tanning."


UV light isn't all bad. Skin exposed to UV light makes vitamin D. Normal sun exposure generates plenty of vitamin D. Kaur says that people who avoid sunlight should make sure they get plenty of vitamin D.


SOURCES: Kaur, M. Journal of the American Academy of Dermatology, April 2006; vol 54: pp 709-711. Warthan, M.M. Archives of Dermatology, August 2005; vol 141: pp 963-966. Mandeep Kaur, MD, instructor in dermatology, Wake Forest University Baptist Medical Center. Richard Wagner Jr., MD, professor and deputy chairman of dermatology; director of dermatologic surgery, University of Texas Medical Branch, Galveston.


WebMD Medical News
by Daniel DeNoon
  
  
  
  好健康小單字─紫外線輻射(Ultraviolet radiation;UV)
 
 
紫外線輻射(Ultraviolet radiation;UV)是許多太陽能量其中的一種,而一般我們常常說的紫外線有三種類型:紫外線A(UV-A)、紫外線B(UV-B)、和紫外線C (UV-C),它們分別穿透肌膚的不同深度。


UV-A-波長介於320~400nm,可自由穿透大氣層不受臭氧層的影響;UV-B-波長介於280~320nm,臭氧在此波段有很強的吸收帶,若大氣中臭氧減少,則到達地面的UV-B將會增加;UV-C-波長小於280nm,此段波長完全被大氣吸收,因此無法在地面監測到。
  
  
  
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24Drs好健康報:茶可以對抗卵巢癌與乳


茶可以對抗卵巢癌與乳癌 Tea May Fight Ovarian, Breast Cancers
好健康小單字─ 類黃酮 (Flavonoids) 
  茶可以對抗卵巢癌與乳癌
 
 
綠花椰菜、羽衣甘藍也是對抗癌症的類黃酮有效來源。


最新研究顯示,茶中有效的化學物質有助於避開卵巢癌與乳癌。


哈佛公衛系的博士候選人Margaret Gates表示,綠花椰菜與羽衣甘藍也是富含對抗癌症類黃酮的來源,她有在研究這些食物與卵巢癌的關係;一般相信類黃酮具有抗氧化與抗發炎的活性,她的研究指出,女性增加攝取山奈酚這種類黃酮的量可以降低40%的卵巢癌風險。


第二篇研究顯示,女性攝取富含其他種類黃酮的飲食,尤其是黃酮、兒茶素與木質素,可以將罹患乳癌的風險降低26%到39%。


研究人員向WebMD表示,如果你無法記住這麼多專有名詞,別擔心,它基本上存在於相同的東西中;Gates表示,茶對於降低卵巢癌的風險特別重要;北卡羅來納大學教堂山分校的博士候選人Brian Fink表示,茶也是能夠預防乳癌的重要物質。


這兩篇最新的研究都在美國癌症研究學會的年會中發表。


【山奈酚對抗卵巢癌】
Gates分析66,384位參與護士健康研究的女性,在研究開始時沒有人罹患卵巢癌,從1984年開始,每幾年就會要這些女性填寫詳細的問卷,詢問她們有關攝取120種以上食物的情形。


研究人員用這些資料計算每位參與者攝食的五種類黃酮含量,分別是楊梅素、山奈酚、檞黃素、木犀草素、與芹菜素,另外也有計算總類黃酮含量;從1984年到2002年間,有344位女性罹患卵巢癌。


Gates表示,總類黃酮的攝取量與卵巢癌之間沒有關係,楊梅素、檞黃素、木犀草素、與芹菜素也沒有明顯的影響;攝取越多的山奈酚(大部分是從茶、綠花椰菜、以及羽衣甘藍而得),罹患卵巢癌的機率就越低。


那麼,要攝取多少山奈酚才夠呢?Gates表示,每天10毫克至12毫克就有預防效果了,這個量等於每天4杯茶或是2杯綠花椰菜,綠茶與紅茶都有用。


Gates表示,她希望能在這部分有更多的研究,如果經證實,攝取類黃酮就能有效的預防卵巢癌。


為了解類黃酮與卵巢癌之間的關係,Fink探究於1990年中期針對紐約長島的女性所做的乳癌機率與風險因子的大型研究數據,在1996年與1997年,有近3千位參與者接受家庭訪問,詢問她們的生活習慣,並請她們做有關吃的東西以及攝取量的問卷。


研究結果顯示,停經後的女性如果攝取最多類黃酮,就能比吃最少的女性減少46%罹患乳癌的機率,但是有效的化學物質對於停經後女性的風險沒有作用。


當研究人員探討停經後女性所攝取的類黃酮時,他們發現黃酮能降低39%、兒茶素能降低26%、木質素能降低31%的乳癌風險;Fink表示,除了茶以外,綠色沙拉、蕃茄、蘋果都是富含類黃酮的良好來源,其他像是黃烷酮、異黃酮素、與花青素等類黃酮則跟癌症風險無關。


他表示,化學結構的微小差異能決定這種類黃酮是否有預防效果,也需要有更多的研究。


【研究中有希望的部分】
加州大學聖地牙哥分校的預防醫學專家Cedric Garland表示,類黃酮是預防癌症的希望,他強調,類黃酮也可以用補品的方式取得;問題是,研究剛開始做,所以他們還不知道建議量是多少,最好就是用一杯茶吞下一盤綠花椰菜。
  
  
  
  Tea May Fight Ovarian, Breast Cancers
 
 
Potent chemicals found in tea can help ward off ovarian and breast cancers, new research suggests.


Broccoli and kale are also rich sources of cancer-fighting flavonoids, says Margaret Gates, a doctoral candidate at the Harvard School of Public Health who has been studying their link to ovarian cancer. Flavonoids are believed to have antioxidant and anti-inflammatory activity. Her research suggests that women who increase their consumption of kaempferol, a type of flavonoid, can lower their risk of ovarian cancer by nearly 40%.


A second study shows that women who consume a diet rich in other types of flavonoids - specifically, flavones, flavan-3-ols, and lignans -- can reduce their chance of developing breast cancer by 26% to 39%.


If you can't keep all those scientific names straight, no worries: It basically comes down to the same thing, the researchers tell WebMD.


For lowering ovarian cancer risk, "tea in particular may be important," Gates says.


For breast cancer protection, "tea again is the predominant contributor," Brian Fink, MPH, a doctoral candidate at the University of North Carolina at Chapel Hill.


Both new studies were presented at the annual meeting of the American Association for Cancer Research.


Kaempferol Fights Ovarian Cancer


Gates analyzed data on 66,384 participants of the Nurses' Health Study, none of whom had ovarian cancer at the start of the study. Every few years, beginning in 1984, the women filled out detailed questionnaires that asked about their consumption of more than 120 foods.


Using the data, the researchers calculated each participant's intake of five different flavonoids -- myricetin, kaempferol, quercetin, luteolin, apigenin -- and of total flavonoids. Between 1984 and 2002, 344 of the women were diagnosed with ovarian cancer.


Gates says there was no link between total flavonoid consumption and ovarian cancer. Nor did myricetin, quercetin, luteolin, or apigenin significantly affect risk.


But the greater the consumption of kaempferol -- which the nurses got mostly from tea, broccoli, and kale -- the lower their chance of developing ovarian cancer.


So just how much kaempferol is enough? Gates says 10 milligrams to 12 milligrams a day, the amount found in four cups of tea or two cups of broccoli daily, appears to be protective. Both green tea and black tea will do the trick, she adds.


Gates says she'd like to see further research in this area. "If confirmed, flavonoid consumption would provide an important target for ovarian cancer protection," she says.


To look at the flavonoid-breast cancer link, Fink studied data from a large study of breast cancer rates and risk factors conducted among women living on Long Island, N.Y., in the mid-1990s. In 1996 and 1997, nearly 3,000 participants were interviewed at home about their lifestyle habits and given questionnaires that asked what they ate and how much they ate.


The study showed that postmenopausal women who consumed the most flavonoids were 46% less likely to develop breast cancer, compared with those who consumed the least. But the potent chemicals had no effect on risk in premenopausal women.


When the researchers looked at specific flavonoids in the postmenopausal women, they found that flavones reduce breast cancer risk by 39%, flavan-3-ols by 26%, and lignans by 31%.


In addition to tea, green salad, tomatoes, and apples are good sources of the breast cancer-fighting flavonoids, Fink says.


Other flavonoids, such as flavanones, isoflavones, and anthocyanidins, showed no relationship to cancer risk.


"Tiny differences in chemical structure could determine why one flavonoid is protective and one is not," he says. "More study is needed."


Promising Area of Research


Cedric Garland, DrPH, a preventive medicine specialist at the University of California, San Diego, says flavonoids are a promising area of research for cancer prevention. He notes that flavonoids are available in supplement form.


The problem: "The research is only beginning to be done so we don't yet know how much to recommend," he tells WebMD.


In the meantime, your best bet may be a plate of broccoli washed down with a cup of tea.


SOURCES: American Association of Cancer Research annual meeting, Washington, April 1-6, 2006. Margaret Gates, Harvard School of Public Health. Brian Fink, MPH, University of North Carolina at Chapel Hill. Cedric Garland, DrPH, University of California, San Diego.


WebMD Medical News
by Charlene Laino
  
  
  
  好健康小單字─ 類黃酮 (Flavonoids)
 
 
類黃酮存在於植物體內,包括黃酮、黃酮醇、二氫黃酮、甲基黃酮等,是一群頗具發展潛力的天然抗氧化劑,可抑制食物氧化及提供動物有益的代謝作物;而除了具有抗氧化能力以外,生物類黃酮在體內還有其他益處;有研究顯示,生物類黃酮具有抗病毒、抗發炎、抗過敏,甚至於對抗致癌物的能力。
  
  
  
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24Drs好健康報:薯條中有多少反式脂肪?


好健康熱頭條 ─ 薯條中有多少反式脂肪? How Much Trans Fat in Those Fries? 
好健康小單字─反式脂肪(Trans Fat) 
  好健康熱頭條 ─ 薯條中有多少反式脂肪?
 
 
醫生在新英格蘭醫學期刊(The New England Journal of Medicine)中表示,你在紐約的麥當勞與肯德基所買的雞塊與薯條,所含有的反式脂肪可能比在法國、倫敦、或是俄羅斯買的高。


Steen Stender醫師與同事們在寫給期刊的信中表示,全世界麥當勞與肯德基的雞塊與薯條中反式脂肪含量都不同,有時在同一個國家也有差異。


任職於赫勒烏普市Gentofte大學醫院的Stender醫師在2004年11月至2005年9月為了其他因素旅遊時,與同事們在美國及其他國家共43處麥當勞或肯德基點了大份的薯條(171克)與雞塊(160克),他們分析這些食物的總脂肪與反式脂肪含量。


【追蹤反式脂肪】
反式脂肪或是反式脂肪酸(TFA)是存在於部分添加氫化油或是用氫化油油炸的蔬菜油、某些瑪琪琳、與許多加工食品內;根據食品藥物管理局表示,反式脂肪就像飽和脂肪與飲食中的膽固醇一樣,會增加低密度脂蛋白(壞的)的膽固醇,造成心臟疾病的風險增加。


Stender醫師與同事們指出,食品藥物管理局建議要盡量減少攝取反式脂肪;他們表示,丹麥與德國的反式脂肪酸含量不到1公克;紐約(麥當勞)的含量是10公克;匈牙利(肯德基)的含量是24公克;這些數字包含雞塊與薯條的反式脂肪量。


【反式脂肪含量不同】
對於麥當勞的產品來說,反式脂肪含量前三名的地點在紐約、祕魯、與亞特蘭大,除此之外,結果並沒有包括其他美國城市的麥當勞;對於肯德基的產品來說,前三名的地點在匈牙利、波蘭、與祕魯,名單中美國唯一的地點是紐約,排名第八。


研究人員指出,美國與秘魯麥當勞薯條所用的油分別含有23與24%的反式脂肪酸,許多歐洲國家所用的油只含有約10%的反式脂肪酸,有些國家甚至低到5%(西班牙)或1%(丹麥)。


那麼法國的薯條呢?反式脂肪含量在中間值(麥當勞的薯條是15%;肯德基的薯條是8%);這篇研究並未包含所有分店,研究結果可能不適用於其他城市或其他分店,這篇研究也沒有做麥當勞與肯德基的比較。


【麥當勞的回應】
WebMD告知麥當勞與肯德基公司的媒體反應部門他們的評論,麥當勞公司藉由電子郵件發表聲明回應,該公司是由麥當勞的全世界品質系統及食品安全營養副總裁Catherine Adams博士負責。


聲明中指出,麥當勞非常認真的看待反式脂肪的問題,事實上必須強調的是,這封給編輯的信從麥當勞的網站上抓了很多資訊,這代表他們的網站對於這個問題是絕對透明化的。


研究人員給期刊的信中有五點補充說明,其中一點是引用麥當的營養成分。


聲明中還表示,麥當勞很努力的在降低薯條中的TFA含量,但是在美國降低的速度比他們之前聲明的日期來得久,然而,他們持續在做試驗,並決定要立刻讓他們的顧客知道。


肯德基以電子郵件向WebMD表示,他們所提供的產品為了反應當地口味嗜好性,因此每個國家都不一樣,而且他們有讓顧客了解營養成分。
  
  
  
  How Much Trans Fat in Those Fries? 
 
 
You may get more trans fat in chicken nuggets and french fries bought at McDonald's and KFC restaurants in New York City than in France, London, or Russia, doctors report in The New England Journal of Medicine.


In a letter to the journal, Steen Stender, MD, and colleagues show that trans fat levels vary worldwide -- and sometimes within the same country -- for McDonald's and KFC chicken nuggets and french fries.


Stender works at Gentofte University Hospital in Hellerup, Denmark. While traveling for other reasons between November 2004 and September 2005, Stender and colleagues ordered a large serving of french fries (171 grams) and chicken nuggets (160 grams) at McDonald's or KFC restaurants in 43 U.S. and international locations.


The researchers analyzed the foods' total fat and trans fat content.


Tracking Trans Fat


Trans fat, or trans fatty acids (TFA), are fats found in foods such as vegetable shortening, some margarines, and many processed foods made with or fried in partially hydrogenated oils.


Trans fat, like saturated fat and dietary cholesterol, raises the LDL (or "bad") cholesterol that increases your risk for heart disease, according to the FDA.


"It is recommended that the consumption of trans fat be as low as possible," write Stender and colleagues.


Stender's team writes that "the content of trans fatty acids varied from less than 1 gram in Denmark and Germany, to 10 grams in New York (McDonald's) and 24 grams in Hungary (KFC)."


Those numbers combine trans fat content for the chicken nuggets and french fries.


Trans Fat Levels Varied


For the McDonald's items, the top three locations for trans fat content were New York, Peru, and Atlanta. The results for McDonald's restaurants didn't include other U.S. cities.


For the KFC foods, the top three locations for trans fat content were Hungary, Poland, and Peru, the study shows. The only U.S. location on the list -- New York -- ranked eighth.


"The cooking oil used for French fries in McDonald's outlets in the United States and Peru contained 23% and 24% trans fatty acids, respectively, whereas the oils used for French fries in many European countries contained only about 10% trans fatty acids, with some countries as low as 5% (Spain) and 1% (Denmark)," the researchers write.


What about french fries in France? Trans fat content was in the middle of the range (15% for McDonald's fries and 8% for KFC fries).


The study doesn't cover every restaurant in every location. The findings may not apply in other cities or restaurants. The study didn't do a head-to-head comparison of McDonald's and KFC foods.


McDonald's Replies


WebMD called the media relations offices of McDonald's Corporation and KFC for their comments.


McDonald's replied by emailing a statement the company attributed to Catherine Adams, PhD, RD, McDonald's vice president of Worldwide Quality Systems, Food Safety & Nutrition.


"McDonald's takes the matter of trans fatty acids seriously," the statement reads. "In fact, it is important to note that this Letter to the Editor itself draws heavily from information provided by McDonald's web site -- a clear example of our commitment to transparency on this issue."


One of the five footnotes in the researchers' letter to the journal cites McDonald's nutritional information.


"McDonald's continues to work diligently on ways to reduce TFA levels in our fries," McDonald's statement continues. "Our reduction in the U.S. is taking longer than anticipated, as we have previously announced. However, we continue to progress in our testing and we are determined to get it right for our customers."


KFC sent an email to WebMD stating that "our product offerings vary from country to country to reflect local taste preferences, and we do make nutritional information available to our customers."


SOURCES: Stender, S. The New England Journal of Medicine, April 13, 2006; vol 354: pp 1650-1652. FDA: "Trans Fat Now Listed with Saturated Fat and Cholesterol on the Nutrition Facts Label." McDonald's Corporation, emailed statement attributed to Catherine Adams, PhD, RD, vice president, Worldwide Quality Systems, Food Safety & Nutrition.


WebMD Medical News


by Miranda Hitti
  
  
  
  好健康小單字─反式脂肪(Trans Fat)
 
 
所有動植物油脂都是由脂肪酸所組成,天然的脂肪酸都是順式的,植物油因含有多量不飽和脂肪酸而容易氧化,在加工過程所採取的氫化技術,可確保油質安定、耐高溫油炸、不易腐敗、易於久存,但植油物的脂肪酸 結構也由順式變為反式,成「反式油脂」。


反式脂肪是植物油氫化過程的產物,會提高血液中低密度脂蛋白膽固醇(有害膽固醇)濃度,增加心血管疾病、動脈阻塞硬化風險;生活中常見的反式脂肪來源有人造奶油、起酥油和由這些油品做出來的食物,包括了餅乾、甜點、零食等。
  
  
  
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24Drs好健康報:纖維不只對你的腸道好而已


好健康熱頭條 ─ 纖維不只對你的腸道好而已 Fiber Good, and Not Just for Your Gut 
好健康小單字─膳食纖維(Dietary Fiber) 
  好健康熱頭條 ─ 纖維不只對你的腸道好而已
 
 
最新研究指出,纖維不只是對你的腸道有益,它還能對抗心臟疾病與糖尿病;還有更好的消息呢,你不必強迫自己吃大量討厭的蔬菜,每日建議攝取20至35克纖維就足以對全身有益了。


沒有參與研究的匹茲堡大學醫學中心運動營養主任Leslie Bonci研究員表示,現在營養學家更有理由強調纖維的重要性;他向WebMD表示,當人們想到纖維,就會想到腸道,也就是只對身體下半部有效果;但是現在令人興奮的是,纖維也對身體上半部有益,所以纖維是對從頭到腳都有幫助的,人們需要它。


【纖維有助心臟健康】
位於烏斯特的麻州大學醫學院Yunsheng Ma醫師針對524為健康成人追蹤一年,在研究開始時,研究人員每三個月要抽血做實驗,並收集參與者所吃的詳細資料。


大部分的參與者攝取量都不足,平均一天只攝取16克,吃最少纖維的20%參與者每天攝取10克多;吃最多的20%參與者每天吃22克以上,在建議量之內。


和那些吃最少纖維的人相較之下,吃最多的人C反應蛋白(CRP)含量高的情形少63%,雖然這個關聯性比其他研究都強,但是CRP含量高一直被認為會增加心臟病與中風的風險,也是有糖尿病風險的徵兆。


Ma醫師向WebMD表示,研究顯示,膳食纖維能預防心臟疾病與糖尿病,因為纖維有預防作用,所以人們要吃水果與蔬菜;Ma醫師的研究刊載在四月號的美國臨床營養期刊(American Journal of Clinical Nutrition)。


【纖維讓過重/肥胖者對抗糖尿病】
過重者得到最常見的第二型糖尿病風險會增加;位於德國Nuthetal的德國人類營養協會Martin O. Weickert醫師建議,纖維可能有幫助,吃大量麥麩等穀物纖維比較不會有糖尿病。


他的研究小組針對17名過重或肥胖的女性進行研究,連續三天每天吃三次白麵包,一半的女性吃純的白麵包;另一半女性吃加了10.4克燕麥纖維的麵包。


那些過重者身體在一段時間後都變得對控制血糖的胰島素越來越不敏感,缺乏敏感度會讓某些人有糖尿病;Weickert醫師與同事們發現那些吃燕麥纖維的女性,在經過這短短三天後,就變得對胰島素比較敏感。


這是怎麼回事?穀物纖維也稱為非水溶性纖維,它不能被消化,但是卻能讓幫助排便,所以它是非常好的食物,但是Weickert醫師指出,增加攝取非水溶性纖維會導致腸道末端發酵,引發連鎖反應改變了身體對胰島素的反應方式。


Weickert醫師向WebMD表示,在攝取了非水溶性穀物纖維後,這個分子機制是否會讓胰島素敏感性增加目前還不清楚,他計劃作更大型的臨床實驗來找出解答;Weickert醫師的研究刊載在四月號的糖尿病照顧(Diabetes Care)期刊中。


【哪兒有纖維】
Bonci表示,人們需要非水溶性纖維與水溶性纖維,兩種都要吃,不要只吃麥麩;一般食物兩種纖維都有,像是蘋果皮中就有非水溶性纖維,果肉中則有水溶性纖維,所以從食物是比從維他命取得纖維更好的方法。


含有大量水溶性纖維的食物包括:
•燕麥片
•堅果與種子
•豆科植物(豌豆、豆莢、扁豆)
•蘋果
•梨
•草莓
•藍莓


含有非水溶性纖維的食物包括:
•全麥麵包
•全麥早餐穀物
•小麥糠
•種子
•許多蔬菜,像是胡蘿蔔、黃瓜、南瓜、芹菜、蕃茄等。
  
  
  
  Fiber Good, and Not Just for Your Gut 
 
 
Fiber isn't just for good for your gut. It fights heart disease and diabetes, new studies suggest.


There's more good news. You don't have to force yourself to eat massive quantities of unpleasant foods. The full-body benefit comes from eating the 20-35 grams of fiber per day recommended by dietary guidelines.


Now nutritionists have even more reason to stress the importance of fiber, says Leslie Bonci, MPH, RD, director of sports nutrition at the University of Pittsburgh Medical Center. She was not involved in the study.


"When people think fiber, they think gut -- it is just having an effect on the lower part of my body," Bonci tells WebMD. "But now it is very exciting to realize that fiber is having an effect in the upper body, too. Fiber is a head-to-toe body benefit. People need it."


Fiber for Heart Health


Yunsheng Ma, MD, PhD, of the University of Massachusetts Medical School in Worcester, followed 524 healthy adults for one year. At the beginning of the study -- and every three months -- the researchers drew blood for lab tests and collected details about what the volunteers were eating.


Most of the study participants were getting far less fiber than they should. They averaged only 16 grams of fiber a day. The 20% of study subjects who ate the least fiber got a little more than 10 grams a day. The 20% who ate the most got more than 22 grams a day -- within recommended levels.


Compared with those who ate the least fiber, those who ate the most were 63% less likely to have high levels of C-reactive protein (CRP). Although this relationship was stronger than other studies, consistently high CRP levels have been shown to predict an increased risk of heart disease and stroke. High CRP levels are also a sign that a person is at risk of diabetes.


"This study shows that dietary fiber prevents heart disease and diabetes," Ma tells WebMD. "The fiber offers protection. So people need to get their fruit and vegetables."


Ma's study appears in the April issue of the American Journal of Clinical Nutrition.


Fiber Fights Diabetes in Overweight/Obese People


People who are overweight are at an increased risk of type 2 diabetes, the most common kind. Fiber might help, suggests Martin O. Weickert, MD, of the German Institute of Human Nutrition in Nuthetal, Germany. Weickert noted that people who eat a lot of cereal fibers, such as bran, are less likely to get diabetes.


His research team studied 17 overweight or obese women. For three days, three times a day, the women ate some white bread. Half the women got plain white bread. The other half got bread spiked with 10.4 grams of oat fiber.


Over time, the bodies of overweight people become less and less sensitive to insulin, the hormone that controls blood sugar levels. This lack of sensitivity results in diabetes in some people. Weickert and colleagues found that the women who ate the oat fiber over the short three-day time period became significantly more sensitive to insulin.


What's going on? Cereal fiber is also called insoluble fiber. It can't be digested, but it does give bulk to the stool. That's good in and of itself. But Weickert suggests that increased insoluble fiber leads to more fermentation at the lower end of the bowels. This might set off a chain reaction that changes the way their body responds to insulin.


The molecular mechanisms leading to improved insulin sensitivity after consumption of insoluble cereal fibers are not clear at present," Weickert tells WebMD.


He's planning a larger clinical trial to answer this and other questions.


Weickert's study appears in the April issue of Diabetes Care.


Where to Find Fiber


People need both insoluble fiber and soluble fiber, Bonci says.


"You have to mix it up. Don't put all your bran in one box," she says. "Foods tend to have both. Apples, for example, have insoluble fiber in their skins and soluble fiber in their flesh. So foods are a better way to get fiber than supplements. You get the whole package with foods."


Foods with a lot of soluble fiber include:
• Oatmeal
• Nuts and seeds
• Legumes (peas, beans, and lentils)
• Apple
• Pears
• Strawberries
• Blueberries


Foods packed with insoluble fibers include:
• Whole-grain bread
• Whole-grain breakfast cereals
• Wheat bran
• Seeds
• Many vegetables, including carrots, cucumbers, zucchini, celery, and tomatoes


SOURCES: Ma, Y. American Journal of Clinical Nutrition, April 2006; vol 83: pp 760-766. Weickert, M.O. American Journal of Clinical Nutrition, April 2006; vol 29: pp 775-780. Yunsheng Ma, MD, PhD, University of Massachusetts Medical School, Worcester. Martin O. Weickert, MD, German Institute of Human Nutrition, Nuthetal, Germany. Leslie Bonci, MPH, RD, director of sports nutrition, University of Pittsburgh Medical Center.
WebMD Medical News
by Daniel DeNoon
  
  
  
  好健康小單字─膳食纖維(Dietary Fiber)
 
 
膳食纖維是一種天然纖維的提煉物,存在於植物細胞壁及細胞內,它是不能被人體消化酵素所分解的物質,成份也是碳水化合物,可增加腸胃的飽足感、增加腸道蠕動,有助於控制飲食及促進排便;其生理功能主在發揮於消化道,對消化道的生理有重要的影響,間接也影響到體內的代謝和免疫,可分為非水溶性纖維及水溶性纖維兩類。
  
  
  
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24Drs好健康報:癌症預防藥物Tamoxifen無法延長性命?


好健康熱頭條 ─ Tamoxifen作為預防藥的疑問 Tamoxifen as Prevention Questioned 
好健康小單字─ 雌激素(EstrOgen) 
  好健康熱頭條 ─ Tamoxifen作為預防藥的疑問
 
 
最新研究顯示,大多數乳癌高風險的女性在服用癌症預防藥物tamoxifen後無法延長性命。


研究人員推斷,只有非常高風險的女性服用這種預防藥物能延長平均壽命;他們計算,美國高風險的女性如果要購買tamoxifen來延長壽命,每年將會花費130萬美元的巨大費用;這種藥在加拿大賣得比較少,每年用來救命的花費估計約為美國的十分之一。


研究人員使用電腦產生的模式讓一組假定乳癌高風險婦女來預估剩餘壽命,她們不一定有服用tamoxifen來降低風險。


加州戴維斯大學的研究人員Joy Melnikow醫師向WebMD表示,這個模式顯示,tamoxifen對於死亡率的影響力比預期少,因為它無法避免大多數因雌激素引發的致死性乳癌。


Tamoxifen是一種選擇性雌激素受體調節物(SERM)藥物,功用如同抗雌激素;雌激素會促進大多數乳癌細胞生長,所以這種藥物會針對有結合雌激素的癌細胞中所含的雌激素受體作用;它廣泛作為乳癌治療物,於1998年由藥物食品管理局核准作為乳癌高風險女性降低乳癌風險的藥物。


Melnikow醫師表示,之前從未想過事實上藉由tamoxifen以及raloxifene預防的癌症都比較容易治療,而且預後較好。


【數據】
Tamoxifen被核准作為預防藥物,依據一份政府的重大研究結果顯示,相較於沒有服藥的婦女來說,高風險婦女服藥五年能降低49%的乳癌發生率;高風險的定義是依據標準化的風險評估工具GAIL模式評估,在五年內罹患乳癌風險至少有1.67%。


然而,在最新的研究中,研究人員估計這種風險程度的女性若是缺乏雌激素受體乳癌時,死亡率確實會增加一點,缺乏雌激素受體乳癌並不是由磁激素所引起的,因此用tamoxifen沒有效。


同時,服用tamoxifen與子宮癌有關,也與增加會威脅性命的嚴重血栓風險,以及白內障有關;研究人員指出,這可能會讓乳癌風險比從tamoxifen所獲得的益處還多3%。


已經做子宮切除的女性不論風險多大,這個模式都無法顯示服用tamoxifen能讓死亡率減少多少的益處,這些服用tamoxifen的女性並未有子宮癌風險增加的情形。


Melnikow醫師與同事們在美國癌症協會於9月1日出刊的癌症(Cancer)期刊中表示,女性服用tamoxifen所獲得的預期效益接近乳癌的風險閾值1.67%,這是非常少或是根本不存在的。


Melnikow醫師向WebMD表示,在五年內有乳癌風險的女性中,不到2.5%或3%女性可能沒有服用tamoxifen,尤其是如果她們沒有做子宮切除的話更不可能服用。


【Tamoxifen與Raloxifene】
國家乳癌與大腸癌輔助性治療計劃的乳癌預防研究人員D. Lawrence Wickerham醫師向WebMD表示,少有高風險的婦女服用tamoxifen來作為預防藥物。


Wickerham醫師與同事們最近發表一篇期待已久的研究,比較更年期婦女將tamoxifen與raloxifen作為乳癌預防藥物的情形,他向WebMD表示,這篇tamoxifen與raloxifen研究(STAR)顯示,兩種藥物都同樣有效,如預期地能降低約一半的乳癌,但是raloxifen的數據顯示比較安全,導致子宮癌、血栓、以及白內障的風險較低。


Raloxifen是由Eli Lilly所製造,並以Evista品牌銷售,是普遍的骨質疏鬆症處方藥,但是尚未核准為乳癌預防藥物。


【副作用較少?】
Wickerham醫師表示,他們認為raloxifene比較好,並不是因為它比較有效,而是因為副作用比較少,Raloxifen能讓預防性治療既實用又有效,但是乳癌專家William J. Gradishar醫師並不確定,他在STAR的評論中指出,這兩種藥物的副作用差異不大,而且tamoxifen似乎能比raloxifene更能預防比較非侵入性的乳癌。


Gradishar醫師指出,雖然媒體對於之前STAR試驗數據所做的報導指出,raloxifene明顯比較好,但是臨床數據以及病患所表現出的症狀顯示兩者不相上下。


【勉強服藥】
西北大學婦科教授向WebMD表示,女性與她們的主治醫師已經減少用tamoxifen來預防癌症,他並不認為一旦raloxifene被核准後大家會改用raloxifene。


他表示,我們詢問女性是否願意每天服用一種昂貴的藥物連續五年,來降低不一定會發生的癌症風險,結果少有女性願意這麼做。


他表示,大多數人可能都不願意,除非副作用較少的乳癌預防藥物變得較為普遍,或是有比較好的方式鑑定出哪些女性比較容易罹患乳癌。


如果你想要服用這些藥物,告訴醫師有關你的乳癌風險為何。
  
  
  
  Tamoxifen as Prevention Questioned 
 
 
Most women with an elevated risk for breast cancer will not live longer if they take the cancer prevention drug tamoxifen, a new study shows.


Researchers concluded only very high-risk women benefit in terms of life expectancy when they take the drug for prevention.


They calculated that women at the lower end of the high-risk scale would spend a whopping $1.3 million per year of life added if they purchased tamoxifen in the United States. In Canada, where the drug sells for much less, the cost per year of life saved was estimated to be about one-tenth that amount.


The researchers used a computer-generated model to predict life expectancies for a hypothetical group of women at high risk for breast cancer who did and did not take tamoxifen to lower their risk.


Researcher Joy Melnikow, MD, of the University of California-Davis, tells WebMD the model showed tamoxifen had less of an impact on mortality (death) than expected because it does not protect against the most deadly breast cancers -- those not fueled by estrogen.


Tamoxifen is a selective estrogen receptor modulator (SERM) drug that works as an antiestrogen. Estrogen promotes the growth of most breast cancer cells. So the drug targets estrogen receptors on the cancer cells, which blocks estrogen from them. It is widely used as a breast cancer treatment, and was approved in 1998 by the FDA to lower breast cancer risk in women at high risk.


"The fact that the cancers prevented by tamoxifen and (the SERM) raloxifene are easier to treat and have a better prognosis really hasn't been considered before," Melnikow says.


All in the Numbers
Tamoxifen was approved for prevention, based on findings from a landmark government study in which high-risk women who took the drug for five years had a 49% reduction in breast cancer incidence, compared with women who did not.


High risk was defined as having at least a 1.67% risk of developing breast cancer within five years, based on a standardized risk assessment tool known as the GAIL model.


In the latest study, however, researchers estimated that mortality rates would actually increase slightly in women with this level of risk when the impact of estrogen-receptor negative breast cancers was considered. Estrogen-receptor negative breast cancers are not fueled by estrogen and therefore not helped with tamoxifen.


Meanwhile, tamoxifen use is associated with an increased risk for uterine cancer. Tamoxifen is also associated with increased risk for serious blood clots that can be life-threatening, and for cataracts.


The researchers concluded it would take a breast cancer risk of greater than 3% to derive a potential mortality benefit from tamoxifen.


The model did show a mortality benefit for tamoxifen users at all levels of risk if the women had had hysterectomies. The increased risk of uterine cancer from using tamoxifen does not exist for these women.


"The projected benefits of tamoxifen for women at or near the threshold risk for breast cancer of 1.67% are very small or nonexistent," Melnikow and colleagues conclude in the Sept. 1 issue of the American Cancer Society journal Cancer.


Melnikow tells WebMD that women with a five-year breast cancer risk of less than 2.5% or 3% should probably not take tamoxifen, especially if they have not had hysterectomies.


Tamoxifen vs. Raloxifene
Breast cancer prevention researcher D. Lawrence Wickerham, MD, of the National Surgical Adjuvant Breast and Bowel Project (NSABP), tells WebMD that very few women at the low end of the high-risk scale are taking tamoxifen for prevention.


Wickerham and colleagues recently reported findings from a long-awaited study comparing tamoxifen to raloxifene for breast cancer prevention in postmenopausal women.


He tells WebMD that the Study of Tamoxifen and Raloxifene (STAR) showed both drugs worked equally well, reducing breast cancers to about half of what would have been expected. But raloxifene was found to have a better safety profile, with a lower risk of causing uterine cancer, blood clots, and cataracts.


Raloxifene, which is manufactured by Eli Lilly and sold under the brand name Evista, is widely prescribed for osteoporosis, but it has not yet been approved for breast cancer prevention.


Fewer Side Effects
"We viewed raloxifene as the winner, not because it was more effective, but because it was as effective as tamoxifen with fewer side effects," Wickerham says. "Raloxifene may prove to be the drug that makes prevention treatment both practical and effective."


But breast cancer specialist William J. Gradishar, MD, is not yet convinced. In an editorial evaluating the STAR results, Gradishar noted that the difference in side effects between the two drugs was slight and that tamoxifen seemed to prevent more noninvasive breast cancers than raloxifene.


"Although media coverage of the early release of data from the STAR trial suggests a clear winner in raloxifene, the data from clinical end points and patient-reported symptoms suggest a less clear conclusion," Gradishar wrote.


Reluctance to Use Drug
The Northwestern University oncology professor tells WebMD that women and their primary care physicians have been slow to embrace tamoxifen for cancer prevention. He does not see them flocking to raloxifene once it is approved for this use.


"We are asking women to take a costly drug with potential side effects every day for five years to lower their risk for a cancer than may or may not occur," he says. "Not many women have been willing to do that."


And large numbers probably won't, he says, until better breast cancer prevention drugs with fewer side effects become available or there are better ways of identifying the women who are likely to get breast cancer.


If you're considering using one of these drugs, talk to your physician about what your breast cancer risk is.


SOURCES: Melnikow, J., Cancer, Sept. 1, 2006; vol 106: online edition. Joy Meinikow, MD, MPH, Department of Family and Community Medicine, University of California-Davis, Sacramento, Calif. D. Lawrence Wickerham, MD, associate chair of the National Surgical Adjuvant Breast and Bowel Project, National Institutes of Health. William J. Gradishar, MD, Division of Hematology/Oncology, Northwestern University, Feinberg School of Medicine, Chicago.
WebMD Medical News
by Salynn Boyles
  
  
  
  好健康小單字─ 雌激素(EstrOgen)
 
 
雌激素又稱為動情素,是一類主要的女性荷爾蒙,包括雌酮、雌二醇等,對女性第二性徵發育扮演重要角色。好的雌激素可經由製造好的膽固醇,減少壞的膽固醇使血管保持彈性;從血流中幫助回收鈣,避免骨質疏鬆;在泌尿系統中,雌激素可增進水分滯留,保持上皮的潤滑;而當壞的或化學合成的雌激素到達乳房與乳房上皮細胞之受器相連結,則會直接影響這些上皮細胞,讓這些細胞分裂更迅速,加速乳癌細胞的生成。
  
  
  
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24Drs好健康報:減少熱潮紅 黑升麻無效!?


好健康熱頭條 ─ 黑升麻對熱潮紅無效  Black Cohosh a Bust for Hot Flashes 
好健康小單字 – 荷爾蒙補充療法(Hormone Replacement Therapy,HRT) 
  好健康熱頭條 ─ 黑升麻對熱潮紅無效 
 
 
數百萬名婦女曾經服用黑升麻來減少熱潮紅與其他更年期相關症狀,但是這篇有史以來對草藥補充品最嚴謹的研究顯示,沒有證據證明黑升麻有效。


這篇聯邦政府贊助的試驗是比較黑升麻與其他草藥補充品、傳統荷爾蒙療法、和不做治療對於更年期症狀的效果。


結果顯示,荷爾蒙療法是唯一能明顯減少熱潮紅、盜汗、與其他相關症狀的方法;研究結果刊載在內科醫學年鑑(Annals of Internal Medicine)上。


研究人員Katherine M. Newton博士向WebMD表示,他們發現,黑升麻沒有效將會讓許多婦女失望,以荷爾蒙療法這種明顯有效的方式替代是不錯的選擇。


【尋找替代方法】
大多數婦女在接近更年期時會有熱潮紅等相關症狀,通常會在45歲至55歲之間發生。


用雌激素或雌激素加上黃體激素的荷爾蒙療法對於減少熱潮紅非常有效,但基於安全顧慮,有數萬名婦女要放棄這種療法。


那些顧慮顯然在上個週末出現美國婦女乳癌急遽下降的新聞後得到認同,雖然下降的原因還不清楚,但是許多專家推測,它與2002年發表女性健康倡導研究後荷爾蒙使用量降低有關,這個研究發現使用者乳癌和心臟問題都有增加。


許多有症狀的婦女在停止服用荷爾蒙後改用黑升麻和其他草藥補充品,但是為評估這些產品有效性而設計良好的臨床試驗卻很少。


【研究更年期症狀的治療方法】
Newton博士和西雅圖衛生保健系統的團體醫療保險合作醫院的同事們徵召了351位更年期婦女和剛停經的婦女參與研究,這些婦女在參加試驗時的年齡為45歲至55歲之間,所有人每天都至少有兩種更年期相關的症狀。


所有參與者在不知道自己是哪種治療方法的情況下,於一年之中用以下五種療法的其中一種治療:
* 只用黑升麻(每天160毫克)
* 綜合多種草藥補充品,包括每天200毫克黑升麻、加上苜蓿、硼、當歸、人參、和其他草藥補充品。
* 綜合多種草藥補充品,不包括黑升麻,但有建議增加攝取大豆成分的食物。
* 傳統的荷爾蒙療法
* 對照組


研究人員發現,除了荷爾蒙療法之外,其他治療對於婦女每天的熱潮紅次數減少沒有顯著差異,服用草藥補充品的婦女比對照組平均減少半次熱潮紅,但這數量並不認為有意義,經過比較,使用荷爾蒙療法的婦女每天約減少四次熱潮紅。


【你可以做些什麼?】
因此,不想要用荷爾蒙療法的婦女可以怎麼避免熱紅潮呢?有些證據顯示,某些抗憂鬱劑有幫助,Newton博士表示,生活方式能產生很大的差異,包含:
* 多穿幾層衣服,以便於感到熱潮紅時可以脫掉。
* 身邊放些冰水或電扇。
* 在涼快的臥室睡覺。
* 避免刺激物,包括辛辣的食物、酒精、或熱的飲料。


全國老化協會的Sherry Sherman博士表示,感覺自己需要荷爾蒙療法的婦女,應該在最短的必要時間內服用最低的有效劑量。


她向WebMD表示,也許荷爾蒙療法對某些婦女較為危險,他們很樂意去辨別哪些人服用雌激素是安全的;不過,在這篇最新研究中,並未評估那些最近常被媒體關注的慣用組合荷爾蒙。


最近有位女演員兼作家Suzanne Somers在兜售生物特性相同的荷爾蒙,它是比傳統荷爾蒙療法更安全的替代選擇;但是Sherman博士表示,如果這種荷爾蒙像傳統的荷爾蒙療法一樣有效的話,他們大概具有同樣的風險。


Sherman博士是全國老化協會的老化生殖荷爾蒙研究主任,她表示,只因為你有服藥卻不知道風險,並不代表那些風險不存在。
  
  
  
  Black Cohosh a Bust for Hot Flashes 
 
 
Millions of women have taken black cohosh to reduce hot flashes and other menopause-related symptoms, but the most rigorous study of the herbal supplement ever conducted shows no evidence that it works.


The federally funded trial was designed to compare black cohosh to other herbal supplements, traditional hormone therapy, and placebo treatment for menopausal symptoms.


Hormone therapy was the only treatment that clearly reduced hot flashes, night sweats, and other related symptoms.


The study appears in the Dec. 19 issue of the journal Annals of Internal Medicine.


"Our finding that black cohosh did not work will be disappointing news to many women," researcher Katherine M. Newton, PhD, tells WebMD. "It would be nice to find a clearly effective alternative to hormone therapy."


Looking for Alternatives
Most women experience hot flashes and related symptoms around the time of menopause, which typically occurs between ages 45 and 55.


Hormone therapy involving estrogen or estrogen plus progestin is very effective for reducing hot flashes, but concerns about safety have caused millions of women to abandon the treatment.


Those concerns appeared to be bolstered late last week with the news of a dramatic drop in breast cancers among American women.


Although the reason for the drop is not yet clear, many experts speculate that it is related to the decline in hormone use following the 2002 publication of the Women's Health Initiative study, which found an increase in both breast cancers and heart problems among users.


Many symptomatic women turned to black cohosh and other herbal supplements when they stopped taking hormones, but few well-designed clinical trials have been done evaluating the effectiveness of these products.


Studying Treatments for Menopause Symptoms
In an effort to address this, Newton and colleagues with the Seattle-based health care system Group Health Cooperative recruited 351 menopausal and newly postmenopausal women for their study.


The women were between the ages of 45 and 55 when they entered the trial, and all were experiencing at least two menopause-related symptoms a day.


Without knowing which treatment they were getting, all of the women took one of five therapies for a year. The treatments were:
• Black cohosh alone (160 milligrams daily)
• A combination herbal supplement that included 200 milligrams of black cohosh daily, plus alfalfa, boron, dong quai, ginseng, and other herbal ingredients
• A combination herbal supplement that did not include black cohosh but did include recommendations to increase the consumption of soy-based foods
• Traditional hormone therapy
• Placebo


The researchers found no significant difference in the number of daily hot flashes experienced by women on any of the treatments, with the exception of hormone therapy.


Women taking herbal supplements had an average of half a hot flash a day less than women taking placebo -- an amount not considered significant. By comparison, the women on hormone therapy had about four fewer hot flashes a day.


What Can You Do?
So what can women who don't want to take hormone therapy do to avoid hot flashes? There is some evidence that certain antidepressants help some. And lifestyle measures can make a big difference, Newton says. These include:
• Dressing in layers so that you can take off clothing when you feel a hot flash coming on.
• Keeping ice water or a fan nearby.
• Sleeping in a cool bedroom.
• Avoiding triggers, which may include spicy food, alcohol, or hot beverages.


Women who feel they need hormone therapy should take it in the lowest effective dosage for the shortest time necessary, says Sherry Sherman, PhD, of the National Institute on Aging (NIA).


"It may be that hormone therapy is more risky for some women than for others," she tells WebMD. "We would love to be able to identify those women who can safely take estrogen and those who shouldn't."


Those custom compounded hormones that have been the subject of much recent media attention were not evaluated in the new study.


Bioidentical hormones are being touted by some, including actress and author Suzanne Somers, as being safer alternatives to traditional hormone therapy.


But Sherman says if the hormones are as effective as traditional hormones, they probably carry the same risks.


Sherman is director of clinical aging and reproductive hormone research at NIA.


"Just because you take a drug and don't know the risks doesn't mean those risks don't exist," she says.


SOURCES: Newton, K.M. Annals of Internal Medicine, Dec. 19, 2006; vol 145: pp 869-879. Katherine M. Newton, PhD, associate director of research, Group Health Center for Health Studies, Seattle. Sherry Sherman, PhD, director, clinical aging and reproductive hormone research, National Institute on Aging, National Institutes of Health, Bethesda, Md.
WebMD Medical News
by Salynn Boyles
Reviewed By Louise Chang
  
  
  
  好健康小單字 – 荷爾蒙補充療法(Hormone Replacement Therapy,HRT)
 
 
HRT,稱為荷爾蒙補充療法或是荷爾蒙替代療法,是指針對更年期或停經期婦女,給予適當的女性荷爾蒙【雌激素,雌素酮(Estrone, E1)、雌素二醇(Estradiol, E2)以及雌素三醇(Estriol, E3)】及黃體素【天然黃體素(C17類)以及合成的黃體素(C19及C21類)】補充,以緩解不適症狀,或預防一些中老年疾病的發生及惡化;除了一些絕對禁忌症外,絕大多數的婦女均可以使用。
 
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24Drs好健康報:宿醉頭疼的救兵


好健康熱頭條 ─宿醉頭疼的救兵  Hangover Headache Help 
好健康小單字 – 宿醉 (Hangover) 
  好健康熱頭條 ─宿醉頭疼的救兵 
 
 
真正的宿醉靠家人沒什麼用,唯一能治癒真正宿酒的方法是死亡。-- Robert Benchley, 美國幽默作家。


前一天晚上,再多喝杯香檳似乎是個好主意;但第二天早上,陣陣的頭痛就不是這麼回事了;上次發生這種事的時候,你或許有發誓下次絕不喝這麼多,那是可行的;但有些人每次都那麼說,那你就不適合發誓了。


許多人都是如此,1992年丹麥調查發現,有近四分之三的成年人偶而會宿醉頭痛,這使得它成為最常見的頭疼原因;對於欠缺節制力的人來說,有防止飲酒過量而頭疼的方法嗎?有治療的方法嗎?


紐約羅斯福醫院頭疼學會的神經學專家Christine Lay醫師表示,的確有許多可以做的方法。Lay醫師與同事Christina Sun醫師把這種情況以文章發表在美國頭痛協會即將出刊的頭痛(Headache)期刊中。


【為什麼我們會宿醉頭疼】
大部分的宿醉都會伴隨著可怕的頭疼,但不須喝太多也會宿醉頭痛;Lay醫師表示,不常喝酒、喝不多的人比喝很多的人更容易頭痛;她表示,你不需要喝過量,甚至於只要稍微沾一點就可能會頭疼,這是因為酒精對頭疼有直接和間接的影響。


酒精導致的第一件事就是脫水,因為酒精會開啟體內抗脫水機制,造成頻尿;而且酒精會壓迫肝臟,使它較不容易製造葡萄糖;葡萄糖是驅動身體每個細胞的能量來源,腦細胞若缺少這種能量特別容易受影響。


酒精也會影響體內細胞用來彼此溝通的化合物,前列腺素就是其中之一,它能調節你感覺痛苦與其它感覺的方法;最後,酒精會影響發炎反應,使血管膨脹,這就是為什麼某些人不必等到早上就感到頭疼。


酒精主要的間接影響來自於乙醛,乙醛是身體處理含酒精飲料的產物,這種化合物的功效就像藥物,會使人冒汗和臉紅、心跳加速、和胃部作嘔,如果體內囤積足夠的乙醛就會嘔吐。


酒精的另一個間接影響是干擾睡眠,這就是為什麼這麼難用睡眠來解除宿醉。


Lay醫師表示,當喝太多時會想要睡覺,但是整夜都是半睡半醒的;酒精會妨礙快速眼動睡眠,而且常會醒來,睡睡醒醒造成頭疼。


【防止宿醉頭痛】
就如作家Benchley所述,如果喝了太多酒,只有死能讓你免於嘔吐,但是如果你有計畫適量的喝,就能避開頭疼。


Lay醫師表示,首先,喝酒前吃一頓油膩的餐食;油膩的食物會粘在胃壁,減緩酒精的吸收,大多數油膩的食物都含有充足的碳水化合物,在體內能轉換成糖類,額外補充酒精所造成糖類下降。


當你選擇酒精飲料時,先考慮透明的飲料,像是紅酒或威士忌等深色的飲料含有較多所謂congeners的美味物質,這些酒精發酵的天然副產品也許會造成過敏反應,惡化酒精性頭痛。


喝酒的時候不要牛飲,慢慢地啜飲,給你的身體一些時間來處理酒精;在喝酒時,至少要喝一大杯不含酒精的飲料。


白開水最好,像是蕃茄汁與蔓越梅汁等果汁也有助於補充體內因為酒精所失去的葡萄糖;不含酒精的飲料或許也可以,這些飲料中的咖啡因有助於對抗酒精所造成的小血管膨脹。


如果你喝含咖啡因的飲料,請務必增加喝水量,咖啡因會導致身體流失水分,在喝酒的時候,沒有比避免脫水更重要的事了。


Lay醫師強調,不要抽菸,抽菸會讓你的腦部無法得到所需要的氧氣,而且如果你還不知道藥物對你有沒有好處,聽著,不要喝酒和服藥。


如果你正在服用處方藥物,那麼喝酒前先和醫生談談,要討論兩件事:酒精會阻止或提升藥物的作用嗎?藥物治療會增加酒精的作用嗎?


如果你沒有胃部或出血問題,而且醫生說沒問題的話,也許要考慮服用阿斯匹靈或NSAID類止痛藥,像是naproxen或ibuprofen,這些藥物會抑制調節痛感的前列腺素,並且有助於抵制酒精的前列腺素增進效果。


Lay醫師表示,有些NSAID類藥物在抑制前列腺素上特別有效,其中一種是稱為Ponstel的NSAID處方藥;另一種稱為Clotam的藥物與Ponstel很類似,美國買不到,在英國有賣;1983年有個小型臨床試驗顯示,服用Clotam的人在喝酒和睡覺前的宿醉頭痛會較輕微。


Lay醫師表示,這些藥物是跟著宿醉者的,然而,Ponstel並未被核准作為宿醉療法,除非醫生特別說你可以服用,否則不能因為這個原因而吃它。


此外,不要服用Tylenol品牌或沒有品牌的藥物acetaminophen,它跟酒在一起會造成肝臟負擔。


【治療宿醉頭痛】
如果你的頭在你看到這篇文章時就疼痛的話,要防止頭疼已經太晚了。


很幸運地,現在做某些事讓自己好過些還不太晚,Lay醫師表示,最重要的是脫水問題,所以喝些水吧。


即使你還在控制之下,一頓油膩的餐食在這個時候並不是個好主意,但是你的胃裡需要一些東西;Lay醫師建議,吃些清淡、含有蛋白質和碳水化合物的食物,像是土司夾蛋就應該不錯,再攝取一些糖份,酸性果汁不是很好,但是一點點蕃茄汁或蘋果汁會不錯。


如果你的胃能處理,而且如果沒有潰瘍潰瘍或有流血疾病的話,可以服用阿斯匹靈、naproxen、ibuprofen、或其他NSAID類藥物,再次強調,不要服用Tylenol。


Lay醫師表示,如果你有偏頭痛,就很難判斷是酒精性頭痛還是偏頭痛,但如果你有triptan類的治療偏頭痛處方藥,吃一顆也許有用。


那麼那些不用處方的宿醉治療法呢?Lay醫師認為有些可能有效,她表示,大多數的治療都含有抗發炎藥物,不論是阿斯匹靈或NSAID,這些藥物有很多都含有咖啡因,而且很多都有糖類副產品。


但是,她提醒,大多數人最好是喝酒要節制,吃點東西、攝取足夠糖份、或許再攝取一些咖啡因;如果你服用這些藥物沒有副作用的話,就配合吃一些阿斯匹靈(或NSAID)等之前使用的備用藥。
  
  
  
  Hangover Headache Help 
 
 
A real hangover is nothing to try out family remedies on. The only cure for a real hangover is death. -- Robert Benchley, American humorist.


The night before, one more glass of champagne seemed like a great idea. Next morning, your throbbing head suggests otherwise.


The last time this happened, you swore off overdrinking for good. That plan would have worked. But being someone who loses count from time to time, it was not the plan for you.


Many, many others are in the same boat. A 1992 Danish survey found nearly three-fourths of adults there occasionally suffer hangover headache, making it the most common form of headache reported.


Short of abstinence, is there any way to prevent a headache from too much alcohol? Is there a cure?


There is, indeed, quite a lot you can do, says neurologist Christine Lay, MD, of The Headache Institute, Roosevelt Hospital, in New York City.


Lay and colleague Christina Sun, MD, authored a forthcoming article on this condition in Headache, the journal of the American Headache Society.


Why We Get Hangover Headaches
Hangovers almost always come with a hideous headache. But you don't have to drink too much to get a hangover headache.


Lay says infrequent, light drinkers are more likely than heavy drinkers to suffer such headaches.


"You don't necessarily have to overdo it. Even dipping in just a little bit can cause a headache," she says.


This is because alcohol has both direct and indirect effects that contribute to headache.


The first thing alcohol does is cause dehydration. Alcohol switches off an anti-dehydration mechanism in the body, causing you to urinate more often than you should.


Alcohol also stresses your liver, making it less able to produce glucose. Glucose -- sugar -- is the fuel that drives every cell in you body. Brain cells are particularly susceptible to a shortage of this fuel.


Alcohol also affects the chemicals that cells in your body use to communicate with each other. One of these chemicals is prostaglandin, which regulates the way you feel pain, among other things.


Finally, alcohol has an inflammatory effect, making your blood vessels swell. This is why some people don't have to wait until morning for their headache.


The main indirect effects of alcohol come from a chemical called acetaldehyde, made as your body processes the booze.


This chemical works like a drug, making you sweat and flush, your heart race, and your stomach turn nauseous. If enough acetaldehyde accumulates in your body, you vomit.


Another indirect effect of alcohol is disturbed sleep. This is why it's so hard to "sleep off" a hangover.


"When you drink too much, you feel like going to sleep -- but there is a paradoxical awakening during the night," Lay says. "Alcohol interferes with rapid-eye movement sleep; and people wake frequently. This waking contributes to headache."


Preventing Hangover Headache
Like Benchley wrote, nothing short of death will keep you from getting sick if you drink huge quantities of alcohol. But if you plan to drink moderately, there are some things you can do to fend off a headache.


First, Lay says, eat a greasy meal before drinking.


Greasy foods coat the stomach and slow absorption of alcohol. And most greasy foods are full of carbohydrates, which turn into sugar in your body. That gives you an extra supply of the sugars alcohol causes to drop.


When choosing an alcoholic beverage, consider clear ones.


Dark beverages, such as red wine and whiskey, contain more of the flavorful substances called congeners. These natural byproducts of alcohol fermentation may contribute to the inflammation that worsens alcohol headaches.


When drinking, don't guzzle. Sip alcoholic beverages slowly. Give your body time to process the alcohol.


Between drinks, have at least one big glass of a nonalcoholic beverage.


Water is excellent. Fruit juices, such as tomato juice and cranberry juice, help your body replace the glucose it has losing due to alcohol. Soft drinks may also help in this way -- and the caffeine in some of these drinks may help counteract the swelling of small blood vessels caused by alcohol.


If you do consume caffeine, be sure to increase your water intake. Caffeine causes your body to lose water -- and nothing is more important than avoiding dehydration when drinking.


Lay off the cigarettes. Lay notes that smoking keeps your brain from getting the oxygen it needs.


And if you didn't already know that drugs aren't good for you, hear this: Don't drink and take drugs.


If you are taking prescription medications, talk to your doctor BEFORE you take a drink. Find out two things: Does alcohol block or enhance the effects of your medication? Does your medication enhance the effects of alcohol?


If you don't have stomach or bleeding problems -- and if your doctor says it's OK -- you might consider taking aspirin or one of the NSAID family of pain relievers, which includes naproxen and ibuprofen. These drugs inhibit prostaglandin -- that pain regulator -- and help counteract the prostaglandin-enhancing effects of alcohol.


Lay says some NSAIDs are particularly effective at inhibiting prostaglandin. One is a prescription NSAID called Ponstel. Another close relative of Ponstel -- not available in the U.S. -- is sold as Clotam in the U.K. A small 1983 clinical trial showed that people who take Clotam before drinking and before going to bed have milder hangover headaches.


"These drugs go after the bad guy in the hangover," Lay says.


However, Ponstel is not approved for use as a hangover remedy. Do not use it for this purpose unless your doctor specifically says you can do so.


DO NOT take either brand-name Tylenol or the generic brand, acetaminophen. In combination with alcohol, this drug stresses the liver.


Curing Hangover Headache
If your hair hurts as you read this, it's too late to prevent your headache.


Fortunately, it's not too late to do something to make yourself feel better.


"The most important thing is dehydration," Lay says. "Drink some water."


Even if you could manage it, a greasy meal isn't a good idea at this point. But you need something in your stomach.


Lay advises something bland, with protein and carbs -- a poached egg on toast should do the trick.


And take in some sugar. Acidic juices aren't going to go down well -- but a little tomato juice or apple juice would be great.


If your stomach can handle it -- and if you don't suffer from ulcers or bleeding disorders -- take aspirin, naproxen, ibuprofen, or another NSAID. Again, do NOT take acetaminophen (Tylenol).


If you suffer migraine headaches, it may be hard to tell whether you have an alcohol headache or a migraine. But if you have a prescription for one of the triptan family of migraine drugs, taking one might help, Lay says.


What about all those over-the-counter hangover cures? Lay says some of them can work.


"Most of these cures contain an anti-inflammatory drug -- whether aspirin or an NSAID," she says. "A lot have caffeine; and a lot have sugar byproducts in them.


"But most people might just as well drink in moderation, eat, get enough sugar, and maybe get some caffeine," she counsels. Along with that old standby, aspirin (or an NSAID), if you're not at risk of side effects, she says.


SOURCES: Sun, C. and Lay, C. Headache, 2007; manuscript received ahead of publication. Kaivola, S. Cephalalgia, March 1983; vol 3: pp. 31-36. Christine Lay, MD, The Headache Institute, Roosevelt Hospital, New York City.
WebMD Medical News
by Salynn Boyles
Reviewed By Louise Chang
  
  
  
  好健康小單字 – 宿醉 (Hangover)
 
 
宿醉主要是過度攝入酒精的症狀,包括脫水及中毒引起,喝酒速度過快、同時飲用不同的酒,以及空腹飲用烈酒都比較容易宿醉;宿醉產生的效應包括頭痛、噁心、嘔吐、口渴、嘴乾、發抖、暈眩、疲勞以及肌肉痙攣,還經常伴有認知與視覺空間感的下降;一般認為是酒精戒斷的早期階段,這個階段可能會輕微顫抖與流汗,有些人甚至會產生幻覺。
  
  
  
想看更多好健康的資訊嗎? 請上24Drs國際厚生

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119健康電子報:常見的錯誤醫療觀念與緊急處置


臺北市政府消防局忠孝高級救護分隊 王珏瑋


目前科技發達,相當多的網路郵件轉寄,散播未經證實的自我醫療處置,這也使得錯誤的醫療觀念與處置,散播遍及全年齡層。尤其是一些攸關人命的緊急處置,一個錯誤的小動作就斷送了一條寶貴的生命。筆者在緊急救護現場就見到患者的家屬,自行的錯誤急救動作害死了自己的家人,經告知與解釋還有到院後醫師給予的證實之後,家屬自責的痛哭失聲。


常見燙傷的錯誤處理


各縣市消防局與各大醫院一直在大力宣導,燙傷時的五個要訣:「沖、脫、泡、蓋、送」。燙傷最重要的處理機制就是降溫與保護傷口,沖、脫、泡就是要降溫,蓋、送就是要保護傷口避免感染。
建議家裡冰箱內放一瓶寶特瓶裝的冰水,外貼標籤寫著「燙傷專用,勿飲」,作為燙傷時第一時間的降溫使用,讓熱能不會持續往皮膚下層傳導,擴大深層燙傷垂直範圍,也抑制表面的溫度擴散,將傷害限制於直接接觸熱源的部位。


避免直接用冰塊冰敷,造成降溫過度形成凍傷,當然也不要將寶特瓶放在冷凍庫。常見單純的熱水、蠟燭、熱油燙傷時,若現場第一時間迅速確實的降溫,沖水十到二十分鐘,對於傷口的癒合相當有幫助,甚至不會有什麼疤痕,而不是什麼都不做,結果讓皮膚的熱源持續擴散,趕快送去醫院,到院後原本二度灼傷變成三度灼傷。


但是顏面若遭受燙傷時不能用水沖洗,可能會因緊張而由鼻孔吸入冰水造成嗆傷,顏面灼傷用濕毛巾覆蓋且避開鼻孔後需立刻就醫,因為顏面灼傷可能會有呼吸道腫脹傷害的疑慮,造成窒息。


目前還是有許多人會用牙膏、醬油、凡士林、油性藥膏、擦酒精等錯誤方式讓燙傷傷勢加劇。一片遭受燙傷的皮膚,其表面的防護組織都被破壞,若用牙膏以為涼爽視為降溫的話,牙膏的氟化物及其他分解性化學物質,將造成傷口的侵蝕與劇痛;而醬油及其它非純水液體,會嚴重的造成傷口感染形成傷口潰爛。凡士林、油性藥膏、消炎粉、痱子粉等感覺好像是涼爽的物質,但這些東西在燙傷的表面會形成保溫蓄熱的作用,對傷口都是在增加傷害。酒精擦在正常的皮膚上會有涼爽的感覺,但那是因為體表下吸收了熱量,所以體表上才感覺是涼的,並沒有降溫而且還會升溫。


癲癇發作時錯誤的處理


「癲癇」,俗稱叫「羊癲」、「羊角癲」或「羊癲瘋」,也有人稱「豬母癲」。癲癇是因為腦部神經細胞過度活躍(放電)而引起的臨床表現,就像電線走火般,突然電線短路而起火花似的,大腦內不正常的放電,致使腦部電位混亂。


會發生癲癇的原因多為腦部有某種病變或傷害存在,還有許多疾病不管是直接或間接腦部傷害,都有可能導致癲癇的發作。一旦有了癲癇的病史,在日常生活中就可能隨時誘發癲癇的發作,包括:發燒、喝酒、月經前後、睡眠不足、餓得太厲害、服用某些藥物等。


癲癇發作時大多呈現肢體抽動、牙關緊閉、閉眼或眼球上吊、急喘、冒汗、口吐白沫等明顯症狀,而詳細症狀還包括其他十多種。
所表現出來的徵象都讓人恐懼,發作時間從一分鐘到數十分鐘都有可能,但常見的癲癇大多數都在數分鐘內結束。


一般人看見有人癲癇發作時,第一個直覺就是要扳開患者的嘴巴,給予塞入毛巾等異物,這是相當危險與錯誤的方法,會給予口咬的主要原因乃多源於咬舌自盡的說法,擔心癲癇發作的人咬到舌頭而造成死亡,在冷笑話當紅的現在,應該也要把「咬舌自盡」列為其中。


舌頭斷裂而致命是不太可能的事,癲癇發作時會牙關緊閉,在發作那一瞬間就咬下去了,而且都會咬到舌根的邊緣,就像吃東西咬到舌頭一樣,若強行將嘴巴扳開,給予異物口咬,扳開的過程當中造成嘴唇撕裂傷、門牙的斷裂、牙齦的摩擦所流的血,都比舌根咬到的多,所造成的傷害遠比舌根咬到更嚴重,在扳開時若不小心滑掉牙齒再度閉合,只是害癲癇患者舌根又多咬了一下。而癲癇的患者身體大量抽動,耗氧量相當的大,在救護現場曾經看過癲癇學生嘴巴被同學塞滿襪子,患者整個臉部已經發黑,老師教官還拿課本替患者在搧風擦汗。


癲癇發作時幾個很簡單動作就可以保護患者:
◆發作的當時先打119叫救護車,以防止當發生癲癇重積狀態時延誤就醫。
◆要將患者身邊可能會接觸撞擊的危險物品移開。
◆必要時解開或移除患者身上的領帶、眼鏡、尖銳髮飾等。
◆不要強行約束或壓制患者,會造成雙方的傷害。
◆必須確保患者呼吸道的暢通。


當救護車到達時癲癇也差不多停止了,若超過十分鐘以上的癲癇或者是三十分鐘內癲癇三次,則為所謂的癲癇重積狀態,這會有生命危險需立刻就醫。癲癇發作後的患者都會有短暫失憶的現象,讓患者安靜休息就能恢復正常。關於癲癇的詳細病因與預防,許多醫療資訊都相當豐富,錯誤的處理就算沒有致命的危機也會造成患者生理與心理的傷害。


放血的迷思


在實證醫學上放血的動作,對於疾病的治療尤其是緊急病症的救治,並不會有什麼明顯的療效,但在民俗療法中則是一件常見的作為。就中醫的角度而言,放血能“治療”許多病症,但是是否能“治癒”病症,在醫學上也很難認定。


當然這不是本文討論的重點,只是當接獲民眾打119求救時,我們到達現場許多必須立刻就醫的疾病,家屬都已在家先進行放血、熱敷、疼痛刺激等許多民俗療法無效後才報案求救,甚至是惡化之後發現方法錯誤,才願意就醫。


一些以訛傳訛的民俗療法,民眾貪圖一時的便利對自己的家人進行民俗療法,造成家人的終身傷害甚至是致命,其實都是不值得的,也有更要不得的情況,替別人進行民俗療法,使別人病症加重。


當一個人生病時不想接受西醫的藥物治療時,一定要尋求合格的中醫師診斷後,由中醫師進行治療,切勿自行有樣學樣,在沒有中醫師的指示下自行進行“治療”,造成延誤就醫而加重病情,實在得不償失。

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119健康電子報:綠茶漱口可預防流行性感冒


一名根據日本學者的研究,用綠茶漱口即可有效防止流行性感冒。


台灣面臨多濕天氣,流行性感冒盛行之際,基本上預防的方法包括避免出入人多的公眾場所,勤於洗手、漱口,並且獲得充分休息與補充營養。


日本昭和大學細菌學教授島村中勝指出,綠茶有防止流行性感冒病原體與人類細胞結合的抗菌效果,不論使用綠茶漱口或直接飲用都有防止流行性感冒的作用。


島村教授提倡的綠茶漱口方法有:


1.回到家裡或喉嚨感到有異狀時,即予漱口,次數可不必太多。


2.將所泡的茶降溫到不燙傷的溫水程度,漱口至喉嚨深部後吐掉即可,通常比喝茶濃度淡一半即可。


3.不使用第一泡茶水,以第二、三杯為宜。


4.除了漱口以外,如果養成喝綠茶習慣,即可經常有潤喉作用,增強抗菌作用。


5.即使已感染流行性感冒,綠茶漱口還可減輕症狀,避免惡化並對周圍人們也有防止感染效果。

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119健康電子報--能消除氧化壓力的綠茶多酚


在眾多抗氧化劑中,植物多酚是一群相當具有消除氧化壓力的成份,在這 堭N介紹茶葉中含量相當多的綠茶多酚(兒茶素)。


茶是從Camellia sinensis的葉子及葉芽乾燥而成,在市面上可分綠茶、紅茶及烏龍茶;無發酵茶是綠茶,半發酵茶即烏龍茶,全發酵茶為紅茶。


綠茶多酚之所以用“綠茶”代表而不以紅茶稱之,是因為綠茶中的多酚化合物含量最多,包括黃烷醇類(flavanols)、 類黃酮(flavonoids)及一些酚酸(phenolic acids),其中綠茶多酚化合物以黃烷醇類為主,這類化合物就是所謂的兒茶素(catechins)(一般稱“茶單寧”,也是茶葉苦澀味的來源),佔綠茶葉乾重的30∼42%。


這些兒茶素都有很強對身體有益的生物活性(bioactivity),其中在皮膚科學中,已有許多文獻證明它們有非常強效的護膚效果,並且研究顯示兒茶素也具有瘦身的效果,如此一來補充兒茶素不僅有美容養顏的功效,更有瘦身功用,因此綠茶多酚(兒茶素)應是窈窕淑女美容養顏不可或缺的化妝保養品成份之一。


綠茶多酚抗紫外線A之功效


“紫外線A”波長是320∼400 nm,皮膚受A波侵襲後,紫外線A將可從皮膚表皮穿透,深入真皮層中,造成存在皮膚表皮底部黑色素細胞製造過多黑色素而使膚色變黑;若深入真皮中將可使真皮中的纖維母細胞製造出金屬螯合蛋白酶(MMP),金屬螯合蛋白酶是一種分解膠原蛋白的酵素,釋放至真皮中會將膠原蛋白分解,使真皮中的膠原蛋白消失,皮膚支撐力因而降低,造成皮膚外表深層皺紋的產生。


兒茶素如EGCG及ECG在文獻中已報導,它們可防止因照射紫外線A造成表皮角質細胞及真皮纖維母細胞的死亡,並且對於未死亡的細胞,可抑制因紫外線A誘導出的活性氧分子的產生,再加上兒茶素本身抗氧化性質可消除已產生的活性氧分子(特別如過氧化氫及超氧負離子),減少皮膚受活性氧分子的傷害,如此也將減少活性氧分子刺激表皮基底層黑色素細胞製造過多黑色素;並且紫外線A藉由活化皮膚細胞膜表面的表皮生長因子受體,及藉由活性氧分子加強金屬螯合蛋白酶的產生路徑,會被兒茶素阻斷減少蛋白酶的產生,減少膠原蛋白的流失,因此兒茶素抗紫外線A的傷害與一般抗紫外線A的防曬劑有不同的作用方式,但有異曲同功之妙。


另外在動物及人類的實驗中也證明,兒茶素或綠茶萃取物可防止利用紫外線A進行光化學療法(PUVA),治療乾癬等皮膚疾病所引起的光化學損傷副作用(例如發紅、角質過度增生及水腫)。


綠茶多酚抗紫外線B之功效


紫外線B(波長290∼320 nm),是最早被人類知道要防禦的紫外線,雖然比紫外線A穿透力弱,但因為它會造成皮膚立即的發紅及曬傷,因此人們很怕它造成的灼傷,而且過分的照射會使皮膚黑色素細胞及非黑色素細胞變性,造成黑色素細胞癌及非黑色素細胞癌(基底細胞癌及鱗狀細胞癌)的產生。


人們在很早以前就想盡辦法防禦紫外線B傷害,例如早期使用副作用大的防曬成分“對氨苯甲酸”(PABA),就是用來抵抗紫外線B的傷害,綠茶多酚(兒茶素)對抗紫外線B的功效也很早被學者深入研究,例如皮膚被紫外線B照射後,皮膚細胞會成為曬傷細胞(sunburn cells),進一步產生凋亡現象,使用兒茶素已有許多證據顯示,紫外線B引起細胞凋亡現象會被抑制下來,並且可減少紫外線B引起的發炎反應,例如發炎物質前列腺素(PGE2)的釋放、白血球的浸潤現象(leukocyte infiltration)及髓性過氧化氫 坌V色活性(Myeloperoxidase;MPO);由於可抑制白血球的浸潤,所以可減少白血球所產生的活性氧分子,另外紫外線B所引起類似紫外線A的MMP增加現象也可以被抑制下來,減少膠原蛋白被分解;進一步的研究顯示兒茶素可防止皮膚內酵素型抗氧化分子的消失,減少紫外線 B的傷害,一些研究也顯示兒茶素可減少細胞核內的去氧核醣核酸受到紫外線B的破壞(核酸分子內的pyrimidine鹽基變成雙合體的產生)。


雖然在許多研究兒茶素之皮膚保護效果都用綠茶萃取物當研究對象,然而在一項以紅茶萃取物的研究中也證實,紅茶萃取物也有抗紫外線B的光傷害現象,這個研究表示當綠茶被氧化發酵後,萃取物仍會有抗紫外線B曬傷及皮膚增厚之效果。


綠茶多酚如何應用在皮膚保養


綠茶雖然含大量的綠茶多酚(兒茶素),但是否能夠飲用大量綠茶來美容養顏呢?答案可能是掃興的,因為要使體內達到美容抗癌的濃度,可能一天要喝到1∼1.5公升,而這麼大量的綠茶,平均一杯就可能含有75毫克的咖啡因,如此與咖啡因有關的副作用(如心悸、睡不著等症狀)可能就會產生。


因此皮膚保養可能就需要用外用的方法,而且儘量使用含濃度足夠的綠茶萃取物(1%∼10%)或含純成分的兒茶素(如EGCG或ECG等),許多研究也確實證明外用綠茶萃取物或兒茶素確可達到皮膚抗光老化的效果。


由上述可了解兒茶素有抗氧化及抗發炎作用,並且進一步具抗癌效果,所以綠茶多酚在皮膚保養品中是一種不可或缺的成分,而且是在擦上傳統防曬劑前,值得您先使用的護膚成分。

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119健康電子報--過敏常識問答


秀傳紀念醫院副院長陳明豐


隨著社會文明的進步,過敏性疾病有逐漸增加的趨勢。事實上,過敏性疾病的發生與遺傳及後天環境因素有關,只要及早預防,不但可以減少過敏性疾病的發生,也可減輕過敏的嚴重度。


本文的目的是透過一問一答方式,介紹過敏的基本小常識,讓您知道過敏反應是如何發生的,及過敏疾病是如何進行的。如果您父母親之一或您本身曾罹患過敏性疾病,那麼您就必須對此文的內容有充分的瞭解,並且切實執行,因為這關係到您的一生,也關係到您的下一代是否會成為過敏兒的預備軍呢!


什麼是「過敏反應」?


答:所謂過敏反應乃是人體接觸外來物質時,免疫系統出現超乎尋常的反應。譬如說大部份的人接觸花粉時,頂多只是打個噴嚏而已,可是有些特殊體質的人一旦吸入花粉,不僅會引起嚴重的咳嗽,甚至會引起致命的氣喘。


此種超乎尋常的免疫反應被稱作「過敏反應」,而能誘發人體產生「過敏反應」的物質就被稱為「過敏原」。


人體的「過敏反應」是如何發生的?


答:人體的「過敏反應」與體內一種肥滿細胞有密切關係。顧名思義,肥滿細胞長得胖嘟嘟的,其內部裝滿了一袋袋的化學物質,就好像地壘內部裝滿炸藥一樣。肥滿細胞大多分佈在外物侵入人體的入口處,如眼結膜、鼻黏膜、氣管黏膜、腸黏膜及皮膚底下,就如同地雷被埋設在敵人侵入口附近一樣。


當外來的過敏原接觸到肥滿細胞表面的接受體(稱IgE抗體)時,肥滿細胞會立刻釋放出其內部的化學物質,就好像地雷被敵人誤踏而引起爆炸一樣。被釋放出來的大量化學物質會引起血管擴張、血管壁滲透性增加、氣管平滑肌收縮,產生種種過敏的症狀。


「過敏反應」常引起哪些症狀及哪些疾病?


答:「過敏反應」出現在不同的器官則出現不同的疾病及不同的症狀,如出現在眼結膜則引起結膜炎,其症狀是眼睛紅腫、眼睛癢、流眼淚;出現在鼻黏膜則引起過敏性鼻炎,其症狀是打噴嚏、鼻塞、流鼻水;出現在氣管則引起氣喘,其症狀是咳嗽或呼吸困難;出現在皮膚則引起濕疹、異位性皮膚炎或蕁麻疹,其症狀是皮膚癢疹或水泡。


另外,有些小孩常腹痛、下痢,有時是過敏的反應。有些人在感冒後一直咳嗽不停,尤其是三更半夜時特別嚴重,也可能與過敏有關。


是不是只要有「過敏原」就一定會引起「過敏反應」?


答:不是的。過敏反應的出現必須有兩項重要條件:一是過敏體質;二是環境中存在的過敏原。必須有過敏體質的人接觸到特殊的過敏原,才會出現「過敏反應」。沒有過敏體質的人,即使接觸到過敏原,也不會有任何不良反應。


另一方面,有過敏體質的人若未接觸到過敏原,就不會引起「過敏反應」。除此之外,同樣是「過敏體質」的患者其過敏的對象卻可能不同。有些人對牛奶、蛋過敏,有些人則只對花粉過敏。


過敏體質會遺傳嗎?怎麼知道自己有過敏體質?


答:過敏體質是會遺傳的。根據統計,父母親中若有一人曾罹患過敏性疾病,則其親生子女罹患過敏性疾病的機會,約為三分之一左右。而若父母親雙方都罹患過敏性疾病,則其親生子女罹患過敏性疾病的機會,約為三分之二左右。


因此,我們若要知道自己是否有過敏體質,一方面要探討雙親或祖父母是否曾罹患過敏性疾病,另一方面則要瞭解本身過去,從小到大是否罹患過敏性疾病。除此之外,抽血檢查血清中的過敏免疫球蛋白(IgE抗體)是否有偏高現象,也是輔助瞭解過敏體質的方法。
常見的「過敏原」有哪些?怎麼知道自己對什麼「過敏原」過敏?
答:常見的吸入性過敏原,有家塵、塵 牷B羽毛、狗皮屑、貓皮屑、黴菌、花粉和蟑螂等。常見的食物性過敏原則,包括牛奶、蛋白、蝦子、螃蟹、蚌殼、海鮮等。另外,有些藥物如盤尼西林、消炎退燒劑等也是常見的過敏原。


在台灣地區,以家塵及塵 珙偃怚D要的過敏原。事實上,家塵中最重要的成分是塵 猁滷うn物。因此,也可以說塵 珙O國人最重要的過敏原。塵 珙O一種肉眼不易見到的小型節肢動物,經常在家庭中的地毯及床褥中發現。


要知道自己究竟對什麼物質過敏,最理想的方法就是接受「過敏原檢查」。「過敏原檢查」有很多種方法,有皮下注射試驗、皮內注射試驗及抽血檢查等。目前最常被使用的是利用抽血檢驗,其原理乃測定血清中對某些過敏原特殊反應之IgE抗體的濃度。


本院使用的方法(MAST),一次抽血檢查即能檢查三十六種過敏原,是相當方便的方法。當然不一定所有的過敏原都能輕易地檢查出來,有些食物性的過敏原,無法靠抽血檢查測出,必須靠長期、反覆的觀察才能確定。

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119健康電子報--血脂肪


都市人生活緊張,飲食過於豐盛,卻又普遍缺乏運動,血液中的脂肪濃度越來越高,加速動脈硬化,可能導致中風、心絞痛、心肌梗塞、主動脈瘤和尿毒症等。


什麼是血脂肪、脂蛋白?


主要包括膽固醇、三酸甘油酯及磷脂。人體攝入的脂肪,要能夠在血液中循環,一定要能溶於血中才行,因此利用溶於水的蛋白質來攜帶不溶於水的脂肪。此種血脂肪在血液中與蛋白質結合在一起的結合體,即稱之為「脂蛋白」。


血液中的脂蛋白主要包括:乳糜小滴、極低密度脂蛋白、中密度脂蛋白、低密度脂蛋白及高密度脂蛋白,此五種脂蛋白的來源、所攜帶的脂肪量與疾病的關係均各有所不同,其中低密度脂蛋白(LDL)和高密度脂蛋白(HDL)與血管動脈關係密切,因此做健康檢查時,除了做膽固醇及三酸甘油酯之外,還應該做脂蛋白測定,才能對可能發生的疾病有更正確的預測。


怎樣才算是血脂肪過高?


在做抽血檢查之前,請注意以下幾點,以便使結果確實可靠:


1.  空腹12小時後才抽血。


2.身體狀況正常。


3. 未服任何藥物。


4.  並無節食減肥。


血脂肪數值容易受食物和其他因素影響,因此必須經過2-3次檢驗,才能真正確定結果。若經過多次檢查,確實血脂肪過高,就必須查看是不是疾病造成。


為什麼血脂肪會過高?


血脂肪過高可能肇因於「原發性血脂肪過高」或「續發性血脂肪過高」。患有「原發性血脂肪過高」的人,多半來自家族遺傳,因此其雙親及其他血親有此症者,都應提高警覺,定期檢查。


至於「續發性血脂肪過高」,起源於以下疾病或因素:


1. 高膽固醇血症
遺傳、攝取過多的膽固醇和飽和脂肪酸、糖尿病、腎病症候群、甲狀腺機能低下、阻塞性肝病和服用利尿劑。


2.  高三酸甘油酯症
遺傳、飲食、腎病症候群、沒有控制好的糖尿病、尿毒症及服用利尿劑、降壓藥等。


3.  偏低的高密度脂蛋白膽固醇
遺傳、肥胖、運動不足、抽煙、服用類固醇、降壓藥等。


血脂肪過高帶來身體危害


血脂肪過高,在日積月累下,會加速動脈硬化,引發腦中風、心臟病、胰臟炎、糖尿病、甲狀腺機能低下、破壞腎功能引發尿毒症,還可能經常腹痛、生成主動脈瘤等嚴重後果。


注意事項


除了前面所述,不可以一次的診斷就判定異常。在接受藥物治療前,還必須注意「飲食治療」、「減肥」、「運動」和「戒煙少喝酒」、「放鬆心情」等非藥物治療。建議高血脂症者,最好也要同時檢查肝機能、尿酸和血糖,以防止服用降血脂藥物可能產生的副作用。


由於降血脂藥物可能發生副作用,因此找有經驗的醫師及定期檢查,才可防止副作用的發生,達到治療的效果。


飲食保健


一、從改變飲食戰勝血脂肪過高


1.熱量的平衡
熱量攝食過多,會導致肥胖,而肥胖的人,其血中膽固醇及三酸甘油酯容易升高,危險性也就高。因此應當保持熱量的出人平衡,每餐不過飽,儘量避免吃高熱量食物,如肉類、蛋糕、冰淇淋、蛋黃酥、鳳梨酥等,以維持理想體重。


2. 脂肪的限制
脂肪的攝取應以不超過總熱量的30%為限,並增加食用不飽和脂肪酸的食物,如花生油、黃豆油等植物性油類(椰子油、棕櫚油除外)。至於飽合脂肪酸的攝取最好減少,如豬油、牛油等動物性脂肪,以降低血中膽固醇,防止血管硬化。但兩者脂肪酸比例亦不宜相差太懸殊,以免有致癌及老化之慮。


3.限膽固醇飲食
控制每天三百毫克以下的膽固醇攝取量,並減少容易引起高膽固醇濃度的食物,如肥肉、內臟類(腦、肝、腰子)、香腸、培根、蝦、蟹、墨魚、魷魚、魚卵、鰻魚、草魚、蛋黃、動物油脂等。


4. 多吃植物性蛋白質
植物性蛋白質比動物性和乳類蛋白質,更能降低血中膽固醇,宜多吃。但也並非完全就不吃動物性和乳類蛋白質,適量攝取對身體仍是有益。含植物性蛋白質食物有:黃豆、毛豆、麥胚芽、糙米、豌豆等。


5.  纖維質攝取
纖維質可促使血清中膽固醇含量降低,所以每日飲食中,一定不能減少纖維質的攝食,如蔬菜、水果、根莖類、莢豆類、糙米、燕麥等。


6.  其他
此外,少吃油膩、刺激性食物,多吃易消化食物,並減少鹽的攝取量,因為高鹽飲食易引起高血壓;並且大蒜、香茹、紅棗及礦物質中的鈣、鎂,據研究也有不錯的防治效果。


二、從生活習慣常保血脂肪健康


1. 平時多運動,加強身體的鍛鍊,對高密度脂蛋白(優良的血贍固醇)的產生有很大幫助。


2. 養成良好進餐習慣,一定要照三餐吃,且在愉快情境中用餐,並維持營養的均衡。


3. 不抽煙、少喝酒、少喝咖啡,少吃點心。


4.適量的飲酒可增加高密度脂肪酸,但大量飲酒反增加血中三酸甘油酯。


5. 儘量減少應酬。


6. 避免常到外面餐廳吃大餐,如果非不得已須在外用餐,最好選擇合適的餐廳,並儘量挑選清淡食物食用。


7.工作中,儘量勿讓自己陷於緊張情緒中。


8.養成正常的作息時間,不要熬夜,睡眠要充足。


9. 注意自身三酸甘油酯、膽固醇的數值,最好主動做檢查。


 

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119健康電子報--血脂肪


都市人生活緊張,飲食過於豐盛,卻又普遍缺乏運動,血液中的脂肪濃度越來越高,加速動脈硬化,可能導致中風、心絞痛、心肌梗塞、主動脈瘤和尿毒症等。


什麼是血脂肪、脂蛋白?


主要包括膽固醇、三酸甘油酯及磷脂。人體攝入的脂肪,要能夠在血液中循環,一定要能溶於血中才行,因此利用溶於水的蛋白質來攜帶不溶於水的脂肪。此種血脂肪在血液中與蛋白質結合在一起的結合體,即稱之為「脂蛋白」。


血液中的脂蛋白主要包括:乳糜小滴、極低密度脂蛋白、中密度脂蛋白、低密度脂蛋白及高密度脂蛋白,此五種脂蛋白的來源、所攜帶的脂肪量與疾病的關係均各有所不同,其中低密度脂蛋白(LDL)和高密度脂蛋白(HDL)與血管動脈關係密切,因此做健康檢查時,除了做膽固醇及三酸甘油酯之外,還應該做脂蛋白測定,才能對可能發生的疾病有更正確的預測。


怎樣才算是血脂肪過高?


在做抽血檢查之前,請注意以下幾點,以便使結果確實可靠:


1.  空腹12小時後才抽血。


2.身體狀況正常。


3. 未服任何藥物。


4.  並無節食減肥。


血脂肪數值容易受食物和其他因素影響,因此必須經過2-3次檢驗,才能真正確定結果。若經過多次檢查,確實血脂肪過高,就必須查看是不是疾病造成。


為什麼血脂肪會過高?


血脂肪過高可能肇因於「原發性血脂肪過高」或「續發性血脂肪過高」。患有「原發性血脂肪過高」的人,多半來自家族遺傳,因此其雙親及其他血親有此症者,都應提高警覺,定期檢查。


至於「續發性血脂肪過高」,起源於以下疾病或因素:


1. 高膽固醇血症
遺傳、攝取過多的膽固醇和飽和脂肪酸、糖尿病、腎病症候群、甲狀腺機能低下、阻塞性肝病和服用利尿劑。


2.  高三酸甘油酯症
遺傳、飲食、腎病症候群、沒有控制好的糖尿病、尿毒症及服用利尿劑、降壓藥等。


3.  偏低的高密度脂蛋白膽固醇
遺傳、肥胖、運動不足、抽煙、服用類固醇、降壓藥等。


血脂肪過高帶來身體危害


血脂肪過高,在日積月累下,會加速動脈硬化,引發腦中風、心臟病、胰臟炎、糖尿病、甲狀腺機能低下、破壞腎功能引發尿毒症,還可能經常腹痛、生成主動脈瘤等嚴重後果。


注意事項


除了前面所述,不可以一次的診斷就判定異常。在接受藥物治療前,還必須注意「飲食治療」、「減肥」、「運動」和「戒煙少喝酒」、「放鬆心情」等非藥物治療。建議高血脂症者,最好也要同時檢查肝機能、尿酸和血糖,以防止服用降血脂藥物可能產生的副作用。


由於降血脂藥物可能發生副作用,因此找有經驗的醫師及定期檢查,才可防止副作用的發生,達到治療的效果。


飲食保健


一、從改變飲食戰勝血脂肪過高


1.熱量的平衡
熱量攝食過多,會導致肥胖,而肥胖的人,其血中膽固醇及三酸甘油酯容易升高,危險性也就高。因此應當保持熱量的出人平衡,每餐不過飽,儘量避免吃高熱量食物,如肉類、蛋糕、冰淇淋、蛋黃酥、鳳梨酥等,以維持理想體重。


2. 脂肪的限制
脂肪的攝取應以不超過總熱量的30%為限,並增加食用不飽和脂肪酸的食物,如花生油、黃豆油等植物性油類(椰子油、棕櫚油除外)。至於飽合脂肪酸的攝取最好減少,如豬油、牛油等動物性脂肪,以降低血中膽固醇,防止血管硬化。但兩者脂肪酸比例亦不宜相差太懸殊,以免有致癌及老化之慮。


3.限膽固醇飲食
控制每天三百毫克以下的膽固醇攝取量,並減少容易引起高膽固醇濃度的食物,如肥肉、內臟類(腦、肝、腰子)、香腸、培根、蝦、蟹、墨魚、魷魚、魚卵、鰻魚、草魚、蛋黃、動物油脂等。


4. 多吃植物性蛋白質
植物性蛋白質比動物性和乳類蛋白質,更能降低血中膽固醇,宜多吃。但也並非完全就不吃動物性和乳類蛋白質,適量攝取對身體仍是有益。含植物性蛋白質食物有:黃豆、毛豆、麥胚芽、糙米、豌豆等。


5.  纖維質攝取
纖維質可促使血清中膽固醇含量降低,所以每日飲食中,一定不能減少纖維質的攝食,如蔬菜、水果、根莖類、莢豆類、糙米、燕麥等。


6.  其他
此外,少吃油膩、刺激性食物,多吃易消化食物,並減少鹽的攝取量,因為高鹽飲食易引起高血壓;並且大蒜、香茹、紅棗及礦物質中的鈣、鎂,據研究也有不錯的防治效果。


二、從生活習慣常保血脂肪健康


1. 平時多運動,加強身體的鍛鍊,對高密度脂蛋白(優良的血贍固醇)的產生有很大幫助。


2. 養成良好進餐習慣,一定要照三餐吃,且在愉快情境中用餐,並維持營養的均衡。


3. 不抽煙、少喝酒、少喝咖啡,少吃點心。


4.適量的飲酒可增加高密度脂肪酸,但大量飲酒反增加血中三酸甘油酯。


5. 儘量減少應酬。


6. 避免常到外面餐廳吃大餐,如果非不得已須在外用餐,最好選擇合適的餐廳,並儘量挑選清淡食物食用。


7.工作中,儘量勿讓自己陷於緊張情緒中。


8.養成正常的作息時間,不要熬夜,睡眠要充足。


9. 注意自身三酸甘油酯、膽固醇的數值,最好主動做檢查。


 

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119健康電子報--血壓檢查


高血壓是血壓超過正常範圍。也就是收縮壓超過140毫米水銀柱,或舒張壓超過90毫米水銀柱。


l  血壓是什麼?    血壓是血流衝擊血管壁引起的一種壓力。


l  收縮壓是什麼?  心臟收縮時,所測得血管壁所承受的壓力。


l  舒張壓是什麼?  心臟舒張時,所測得血管壁所承受的壓力。舒張壓值小於收縮壓值。


l  正常血壓的範圍是什麼?        收縮壓在130毫米水銀柱以下,舒張壓在85毫米水銀柱以下。


l  收縮壓在130至139毫米水銀柱,舒張壓在85至89毫米水銀柱之間者稱為正常但偏高之血壓。


高血壓患者注意事項


l 定期做血壓的檢查。


l 注意自己的體重,使其維持在理想體重範圍內。


l 食用限鈉、低油飲食,並增加鉀的攝取量。


l 不要吸菸、喝酒。


l 經常保持大便通暢,預防便秘發生。


l 不要用太冷、太熱的水洗澡或浸泡過久。


l 做適度的運動。


l 要有充份的睡眠與休息,不要焦燥激動。


高血壓與飲食


根據流行病學研究,鈉的攝取量與高血壓罹患率成正比,也就是說鈉量攝取過多時,高血壓的罹患率相對地提高。而肥胖也是造成高血壓的因素之一,因此鈉量的限制及理想體重的維持是預防高血壓的重點。


鈉是什麼?


鈉是礦物質的一種,是人體調節生理機能不可或缺的元素。攝取過多時,易罹患高血壓,攝取太少或缺乏時,會有疲勞、虛弱、倦怠的現象。鈉可以從自然食物、加工食品、調味品或芋些藥物中獲得,而其最主要來源是食鹽,食鹽中約含有40%的鈉,即一公克食鹽中含有400毫克的鈉。


烹調限鈉飲食的小小提示


l   酸味
在烹調時使用醋、檸檬、蘋果、鳳梨、蕃茄等,可增加風味。


l   糖醋
烹調時使用糖醋來調味,可增添食物甜酸的風味。


l 油脂
使用植物油來炸或炒然後再加上檸檬片,可增添食物的風味。


l    甘美味
使用香菜、草菇、海帶來增添食物的美味。


l  鮮味
用烤、蒸、燉等烹調方式,保持食物的原有鮮味,以減少鹽及味精的用量。


l  中藥材與香辛料
使用人參、當歸、枸杞、川芎、紅棗、黑棗等中藥材及香辛料,可以減少鹽量的添加。


l 焦味
可以使用烤、燻的烹調方式,使食物產生特殊的焦味,再淋上檸檬汁,即可降低因少放鹽的淡而無味。


l 低鹽佐料
多用酒、蒜、薑、胡椒、八角、花椒及香草片等低鹽佐料,或味道強烈的蔬菜,如洋蔥,利用其特殊香味,達到變化食物風味的目的。


l 低鈉調味品
可使用含鈉量較低的低鈉醬油或食鹽來代替調味,但須按照營養師指導使用。


一、適當運動的重要性


1. 增進心肺功能。


2. 消除情緒緊張。


3. 避免便祕。


二、高血壓病人可以做的運動


1.室內運動


l  握拳運動
將手指伸直,再握拳用力,然後慢慢地放鬆手指,反覆重作,依體力及症狀,決定運動時間、次數。


l  屈腿運動
俯臥,儘可能彎曲小腿,放下,左右腳交互做。


l  腹部肌肉收縮運動
站立,雙手自然下垂,全身放鬆,吸氣時腹部肌肉用力外張;呼氣時,腹部肌肉用力收縮,反覆地做,每次做2至3分鐘。


l 甩手運動
雙足站立,雙手不停地上下左右甩動,約3至5分鐘。


2.室外運動


l 散步


l 慢跑


l 高爾夫球


l 園藝工作


三、運動的時間


 每日上、下午各作約20分鐘,要有恆心及規律。


四、出現下列情形不宜繼續運動:


l  胸部不舒服。


l  臉色潮紅。


l  出汗過多。


l  脈搏跳動超過每分鐘120次。


l  頭痛、頭暈。


調味品中的鈉含量如何換算呢?


 1茶匙食鹽=2湯匙醬油
 1茶匙食鹽=5茶匙味精
 1茶匙食鹽=5茶匙烏醋
 1茶匙食鹽=12 ½茶匙番茄醬

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