HEALTH TRIBUNE Wednesday, August 23, 2000, Chandigarh, India
 

Eat chillies for healthy reasons
By Dr K.C. Kanwar
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HILLIES (chilli pepper red pepper paprika hot pepper bell pepper) are the bitter (hot or pungent) fruit pods of the annual herb, capsicum sp, native to the Americas. Chillies have been a part of the Eastern culinary practices since time immemorial. By volume, red pepper products are the most consumed spice and a dominant ingredient of the Indian curry powder famous all over the world. 

A wonder drug's fallout
By Dr N.K. Goel and Dr C.S. Gautam
N
ORMAL erectile function occurs as a result of vasodilation in the penile blood vessels, probably involving the release of nitric oxide (NO) in the corpus cavernosum, which activates the enzyme that produces cyclic GMP (Guanosine monophosphate). Viagra, or sildenafil, inhibits the degradation of cGMP and helps in maintaining the relaxation of smooth muscle in the corpus cavernosum. Viagra lacks direct effect, but enhances the effect of nitric oxide. It is also a phosphodiastrase V inhibitor.

When prevention is risky
By Dr S.M. Bose
I
t is a fact that radiation is used for the treatment of cancer and at the same time it can induce cancer because of continued exposure. The dropping of atomic bombs over Hiroshima and Nagasaki not only killed people on the spot and caused devastation but because of the presence of radioactivity in the area produced a higher incidence of cancer. Leukaemias, the cancer of breast, the lung, the large intestine and the skin etc.

 
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Eat chillies for healthy reasons
By Dr K.C. Kanwar

CHILLIES (chilli pepper red pepper paprika hot pepper bell pepper) are the bitter (hot or pungent) fruit pods of the annual herb, capsicum sp, native to the Americas. Chillies have been a part of the Eastern culinary practices since time immemorial. By volume, red pepper products are the most consumed spice and a dominant ingredient of the Indian curry powder famous all over the world. No other cultivated spice is used in as many ways as red pepper: as vegetable, as pickle, as spice, as condiment and also for medicinal and ornamental purposes. Till now, only the poor had been the main consumer of the hot chillies.

Lately, however, the scenario has changed. These are now acceptable to the elite who, so far, either spurned or used these only sparingly. Chillies have been held, though mythically, a contributory factor for many gastrointestinal irritations and even linked with increased risk of oral, pharyngeal, laryngeal and stomach cancers. But not any more.

The nutritionists now unhesitatingly recommend their use in view of their unique nutritional and anti-cancer attributes discovered recently.

The "heat" in the chillies comes from capsaicin — a fat soluble bitter compound. Various varieties of chillies are varyingly hot. Capsaicin is concentrated mainly in the white ribs and seeds of the fruit. The hottest red pepper in the world is Habanero — a Chinese variety of capsicum.

Hot and flavoury chillies are the most packed source of vitamin C and the carotenoids — the precursors to vitamin A. on a weight to weight basis, these constitute perhaps one of the richest source of vitamin C; fresh green chillies contain twice and when turn red thrice as much of vitamin C as an orange. In certain cultivars of paprika, (a close variant of "Shimla mirch"), the vitamin C content "touches 340 mg/100 grams of fresh pepper fruit". But since chillies constitute only a fraction of our total food intake, these are not a potent source of this vitamin. Moreover, dried chillies are almost bereft of vitamin C, having lost it during processing and storage. Try to consume chillies picked fresh from the plant to derive maximally their nutritive bounty. Besides being rich in carotenoids, red pepper has considerable commercial significance as a colorant in food and cosmetic industries. The red pigment of chillies is rich in bioflavonoids — the most powerful antioxidants which are credited with preventing many diseases including cancer and CVDs, by neutralising the effect of free radicals — the inescapable metabolic villains of human health in general — the concentration of vitamin E is the inescapable metabolic villain of human health. The concentration of vitamin E in red pepper, however, is moderate compared to other vegetables but the loss of atocopherol (vitamin E) during dehydration is minimal.

Bell pepper ("Shimla mirch") is a variant of hot chillies and shares the nutritive virtues of the latter. Since these are not excessively bitter, as are chillies, one can consume these as much as needed to reap fully their vitaminic and antioxidant bounty.

Chillies, mainly the pungent type (rich in capsaicin), have been valued high by the herbalists for their numerous other therapeutic applications. "These remain one of the most widely used of all natural remedies," says the review by Palevitch and Cracker. (cf. Journal of Herbs, Spices & Medicinal Plants, Vol 3 1995).

In modern medicine, capsaicin is considered not only as external counter irritant but also for its carminitive action. In addition, capsaicin lately has also emerged as a potent anti-inflammatory, and analgesic agent for external human use. Apart from that capsaicin also shows antioxidant and anti-tumour activity and "may just help prevent cancer" (TOI- Sunday Health). Capsaicin-sensitive neurones release glutamate and a number of neuropeptides such as substance P, neurokinin, and stomatostatin.

Capsaicin is known first to "activate and then to desensitise the sensory neurones on a short as well as a long-term basis". Such an activation is responsible for the initial pain, inflammation and hypersensitivity suffered following the first application of capsaicin. Repeated treatments, however, prove soothing and anti-inflammatory in action. Capsaicin - induced activation and later desensitisation is hypothesised to be based on "neuropeptide release followed by their depletion".

Capsaicin produces a burning sensation in the mouth, makes the eyes water and the nose run. Scientists now feel that chillie-based watering of the nose "may help clear blocked airways by thinning down the mucous in the sinuses thereby relieving congestion".

So far, chillies had been considered notorious for irritating and corroding stomach lining. Now researchers think just the opposite. It is claimed that "eating chillies may cause the stomach to secrete more mucus which protects its lining against corrosion by irritants such as acid, aspirin or alcohol" and thereby help prevent ulcers. Recently, a large case control study of stomach cancer linked higher consumption of chillies with a decreased risk of stomach cancer (Food, Nutrition and Prevention of Cancer: a Global Perspective"). Capsaicin is also considered to jumpstart the digestive process by stimulating salivation, gastric secretions and gut motility.

There are reports which indicate that chillies also act as "anti-coagulants and may also help to lower the blood pressure and blood cholesterol levels" (Foods that Harm and Food that Heal — a Reader's Digest publication). According to an American psychologist, the burning sensation produced by chillies in the mouth actually stimulates the brain to produce and release endorphins — the natural pain-killing endogenous morphine-like substances which modulate pain and can produce a sensation of pleasure. Chillies, say experts, "give a wake-up call to heat-dampened appetites in summer". Along with garlic and onion, these are said to be helpful in alleviating cold.

According to another report, doctors in the West now are prescribing capsaicin-based creams to minimise the agony of chronic pain associated with "post-herpetic neurologic and diabetic neuropathy and other pain syndromes".

This write-up is meant to update the public with the nutritional and medicative profile of chillies. Moderation in dietary practices is the hallmark of good nutrition. Whereas the use of chillies in moderation is good, their excessive use may irritate the G.I tract and may as well cause itching in the anal region in the susceptible subjects, and hence it is contraindicated for those suffering from piles or colitis.

Dr Kanwar is a former Chairman of the Department of Biophysics, Panjab University, Chandigarh.
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A wonder drug's fallout
By Dr N.K. Goel and Dr C.S. Gautam

NORMAL erectile function occurs as a result of vasodilation in the penile blood vessels, probably involving the release of nitric oxide (NO) in the corpus cavernosum, which activates the enzyme that produces cyclic GMP (Guanosine monophosphate). Viagra, or sildenafil, inhibits the degradation of cGMP and helps in maintaining the relaxation of smooth muscle in the corpus cavernosum. Viagra lacks direct effect, but enhances the effect of nitric oxide. It is also a phosphodiastrase V inhibitor.

Dysfunction culprits

(a) Diabetes, hypertension, high blood cholesterol.

(b) Spinal cord injury, multiple sclerosis, stroke, surgery for colon or prostate.

(c) Certain drug-use, e.g, antihypertensives, etc.

(d) Cigarette smoking, alcohol and drug abuse.

(e) Psychological conditions, e.g anxiety, stress, depression etc.

Viagra (sildenafil citrate) has been marketed in several countries across the world and is a much talked-about drug today. It is a boon for adult males having erectile dysfunction, which may be due to organic, psychological or both causes.

The drug was launched in the USA in March, 1998, and by July that year 3.6 million prescriptions had been dispensed. However, 123 deaths had also been reported, many of which were due to cardiac events.

It reduces the blood pressure and if by any chance the patient is on nitrates, it acts synergistically with them (because both act through cGMP) leading to a fall in blood pressure to alarming limits with reflex increase in the heart rate which can be detrimental for a patient of angina, hypertension, acute myocardial infarction, coronary artery disease, etc., because the reflex increase of the heart rate further increases the oxygen demand of the myocardium. Studies conducted in the European countries have clearly revealed that the cause of death in these patients, was, largely, a stroke or a cardiovascular event. Nitrates are an absolute contraindication for use of Viagra.

However, erectile dysfunction attributable to cardiovascular disease and sexual activity are a further risk factor. A recent issue of Lancet (1998, 352: 9501-8) reported a death in the Netherlands in which a 65-year-old man without a history of cardiovascular disease had an acute myocardial infarction attack within an hour of taking the drug without engaging in sensuous activity.

Viagra is hijacked by compulsive drug abusers world wide. Several deaths have been reported in patients abusing amphetamine along with Viagra. Drug-abusers may be a soft target using other party stimulants, where Viagra is a contributory factor of drug cocktail, thus endangering their lives.

Viagra should not be taken by men on nitrates, which should be avoided for 24 hours after the last dose of Viagra because it has a half life of 3.5 hours and is metabolised to an active metabolite which is excreted in the faeces. The metabolism of Viagra involves cytochrome P450 3A4, so its clearance is further reduced by cimetidine, erythromycin and ketoconazole. The dose (25-100 mg/day orally) is reported to be well tolerated in comparison to placebo-treated groups. However, concomitant use of Viagra with rifampin will decrease plasma levels of Viagra.

Other reported side effects of Viagra are headaches, flushing, dyspepsia, nasal congestion, abnormal vision and diarrhoea.

In the case of an overdose, standard supportive measures should be adopted as required. Dialysis is not beneficial as sildenafil is highly protein-bound, and is not eliminated in the urine.

Prescribers should continue to assess patients with erectile dysfunction so that other disorders are not overlooked. The patient's problem may be due to other drugs he is taking. It thus justifies the proverb that "all that glitters is not gold".

Professor Goel heads the Department of Pharmacology at Government Medical College, Chandigarh; Dr Gautam is a Reader in the same department.

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When prevention is risky
By Dr S.M. Bose

It is a fact that radiation is used for the treatment of cancer and at the same time it can induce cancer because of continued exposure. The dropping of atomic bombs over Hiroshima and Nagasaki not only killed people on the spot and caused devastation but because of the presence of radioactivity in the area produced a higher incidence of cancer. Leukaemias, the cancer of breast, the lung, the large intestine and the skin etc.

Cancer risk-prevention from radiation can be reduced by:

1. Minimising the x-ray examination to essential needs.

2. Taking safety measures while working in the environment of increased radiation, e.g the X-ray department laboratories using radioactive isotopes, and industries using radiation energy.

3. Avoiding X-rays during pregnancy during the first three months of pregnancy as it is likely to be harmful for the foetus.

Smoking: As mentioned earlier, tobacco is the biggest offender in this respect and it has been linked to cancers of many tissues and organs. Smoking is directly linked to lung cancer, and the number of cigarettes smoked per day, the duration for which smoking is being continued and the quality of the tobacco used in the cigarettes are the factors that have a direct link to the development of lung cancer. It should be clearly understood that all those who smoke do not develop lung cancer and similarly lung cancer does occur in people who have never smoked in their life; but the fact is that smoking definitely increases the cancer risk.

The avoidance of smoking is the single important factor that can prevent lung cancer to a great extent. It is difficult to stop smoking but this is the only way to reduce the chances of getting lung cancer. Short of quitting smoking , the important preventive factors are— cut down smoking; do not inhale tobacco smoke; use a good brand of tobacco; always use cigarettes with filters; do not smoke in a closed environment like a closed room , a bus or a compartment of a train.

It is also known that the persons who may not be actually smoking but are inhaling the smoke because of their proximity to smokers ( e.g. the spouses of the smokers) also have a definite risk.

Similarly the avoidance of the chewing of tobacco can reduce the chances of developing mouth cancer.

Professor Bose is the writer of the little "anti-cancer Bible". He is a renowned teacher and clinician. He is based at the PGI, Chandigarh.

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Taking health-care to little-known Karsan with love

Sentiment and principle are often mistaken for each other. Sentiment is the virtue of ideas; principle the virtue of action. A divine alchemy brings the two together. The ultimate result is intellectualised emotion, the kind of which has made the dream of the Dr B.C. Roy award-winner, Dr (Brig) M.L. Kataria (in his own words, a "servant of rural India and slums) come true. Karsan, near Ram Darbar, in Chandigarh, has got the gift of sanitation and health, thanks to the sentiment, idea and material contribution of Chartered President Lion Ranvir Uppal (seen in the picture with spectacles), and Charity's twin sister, Mrs Usha Saboo, a relentless supporter of ailing senior citizens (seen at the mike). The slum has a well-equipped health centre constructed with his earnings by Lion Uppal, and looked after by Dr Kataria's team. Let charity glorify every slum: this is what Swami Pitambarananda, the caring monk, says in his missionary manner as he visits the area. We say: Amen.

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