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| HEALTH & FITNESS |
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How to handle eating problems of children
Don’t panic if you have baggy eyelids
Cancer: Watch for symptoms Health Notes
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How to handle eating problems of children One often comes across a mother complaining that her child refuses to eat and meal times have become battle times. An examination reveals that the child is healthy and well-nourished with height and weight securely within normal limits. Toddlers generally have small appetites and very firm likes and dislikes. Feeding and eating difficulties frequently result from excessive parental insistence on eating and the subsequent anxiety of the parents. The child’s negative reaction often results from undue mealtime stress. This calls for an improvement in parent-child relationship. Eating habits during the first and second year of life distinctly affect those of the subsequent years. How eating problems begin A toddler’s feeding problems may start because the parents can have unrealistic ideas about how much and what sort of food the child needs. The following can be the reasons:
2. Insufficient time for eating. 3. Food dislikes of other members of the family. 4. Poorly prepared, unattractively served food. 5. Past history of force-feeding. 6. Irregular meals — asking the child to eat when he or she is not hungry. 7. Unsuitable meals 8. Unreasonable large portions 9. Multiple opportunities for distraction. 10 Most importantly, how much does the child eat between meals? A well-nourished child is getting food from somewhere. Not all parents regard sweets and other such things as being food. Some mothers, while concerned about their child’s apparently poor food intake, provide little variety in the child’s diet. Food fads Some children eat food prepared and presented in a certain way only and develop strong likes and dislikes, which frequently change. These food fads are one of the ways children try to assert themselves as individuals. Fads are rarely a danger to health. Tips to help the child As long as they are offered wholesome food, children are remarkably good at eating. They eat an appropriate quantity of food when allowed a free chance. l As it is impossible to force a child to eat, avoid confrontation at mealtime. l Develop a relaxed atmosphere. Mealtimes should be happy times with a conversation concerning subjects of interest to the entire family. ll Use favourite food as a reward. l Reduce eating between meals if necessary, though many children prefer small, frequent snacks. l A comfortable chair of proper height with a foot-rest is helpful. l The child’s appetite should be respected. There should be no persuasion to eat more. l Adults should realise that eating habits are taught better by example than by formal explanation. Points to ponder A child will eat when hungry. A healthy child who refuses to eat is not hungry and does not need food at that particular time. A healthy child will not starve to death through stubborn food refusal.The writer is a consultant paediatrician at Rungta Hospital, Jaipur. Email: drvivek_sharma@rediffmail.com
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Don’t panic if you have baggy eyelids Surinder, 50, was horrified to look at his face in the mirror this morning when he noticed that his lower eyelids were swollen and baggy on both sides. He had heard about the relationship between swollen lids and kidney failure and high blood pressure, and this made him feel weak and panicky. He suddenly felt sick and old. He met an eye specialist and raised many questions. The doctor looked at him with a smile on his face, and told him that nothing serious had happened. This obviously gave him solace. “Baggy eyeids are not a sudden occurrence; these have come slowly with ageing. Fat expansion in the eye socket is considered the primary culprit,” the doctor explained. As skin ages, it gradually loses its elasticity. A lack of elasticity combined with the constant pull from gravity causes excessive skin to collect in the upper and lower eyelids. Excess skin on the lower eyelid causes wrinkles and bulges and on the upper eyelids an extra fold of skin forms which can hang over the eyelashes and obstruct vision. Typically, bags under the eyelids may be related to other causes besides ageing — thyroid malfunction, fatigue, depression or deprivation, lack of sleep, over-exercising, fluid retention as in kidney or heart failure, smoking, allergies, etc. Wrinkles, bags, droopy eyelids and loss of skin elasticity and glow can also result from unhealthy lifestyle. Be careful. Who is a good candidate for eyelid surgery? The best candidates for blepharoplasty are individuals with good physical and mental health who have realistic expectations. The procedure involves removal of excess skin, muscle and the underlying fatty tissue. While it is primarily a cosmetic procedure, it is also an effective method for improving sight in older patients whose sagging upper eyelids obstruct their vision. Blepharoplasty will not eliminate dark circles under the eyes or remove the crow’s feet or other facial wrinkles. It is often performed in conjunction with other facial surgery procedures such as laser-resurfacing or forehead lifts. However, it will not stop your eyes from aging. How is the procedure performed? If you’re having all four eyelids done, the surgeon will probably work on the upper lids first. The surgeon will usually make incisions following the natural lines of the eyelids. Through these incisions, he will separate the skin from the underlying tissue and remove the excess fat, skin and muscle. The incisions are then closed with very small sutures. There will be sutures in both upper lids that will remain there for five-six days. The lower lids may or may not require sutures depending upon the technique used. Some post-operative problems can occur like bleeding, infection, dry eyes, abnormal discoloration of the skin of the eyelids, eyelid skin that folds in or out abnormally, inability to fully close the eyes, a pulled-down lower lid lash line or a possible loss of vision. Can non-surgical measures help prevent or treat the baggy eyes? Regular exercise and use of green vegetables and fruits can keep you youthful for a longer time. Even the use of vegetable juices can help to some extent. Some of the other skin-smoothening foods include beans, olive oil and nuts. Certain foods offer skin protection due to their having high levels of antioxidants such as vitamins A, C and E. The skin is a “major target of oxidative stress”. However, any food or exercise cannot assure prevention of baggy eyes or ageing in general. The benefits of food or vitamins may be marginal. The writer is a Chandigarh-based senior eye specialist.Email:drrkumar16@gmail.com
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Cancer: Watch for symptoms
Cancer is an increasing problem in older people globally. Such cases of cancer are rising in India. Nearly 60 per cent of cancer cases are related to those aged 65 years or older.
Older people must watch for different symptoms — difficulty in swallowing, change in bowel or urinary bladder habits, hoarseness of voice or cough that does not go away, weight loss with no known reason, feeling weak or tired, unusual bleeding or discharge, or a lump or thickening in any part of the body. These symptoms are a pointer towards the possibility of cancer. Every system in the human body undergoes changes as we grow old. As a result, elderly people present with non-specific symptoms. They may have an atypical presentation of their illness. It is important to identify atypical presentation of the illness allowing early detection. Under-reporting of the symptoms is due to the belief that the symptoms are because of old age, fear of hospitalisation and concern about the family. The aim of management of an elderly person with cancer is to maximise the benefit and minimise the risk of treatment. It is important to recognise those patients who may benefit the most from standard treatment, identify those in whom the risks are more than the potential benefit, and institution of measures that will improve the tolerance to various treatment modalities. Healthy older patients can obtain equal benefit from therapy as younger patients. Under-treatment must be avoided if the best possible outcome is to be achieved. Anti-cancer chemotherapy can be as beneficial to an older patient as it is to younger patients provided it is administered in adequate doses and with appropriate care. The vulnerability in older cancer patients is due to the progressive loss of physiological and functional reserve. Cancer specialists need to select appropriate therapies that will minimise morbidity, maintain the quality of life and provide relief from the symptom. Good results depend on careful preoperative evaluation, balancing the risks and benefits of surgical intervention. Chronological age is not a good marker of appropriateness for therapy. It is unwise to defer surgery on the basis of age alone as unnecessary delay may result in the aggravation of the underlying problem with its attendant complications. An urgent intervention may have an unfavourable outcome. Comprehensive geriatric assessment is the tool that can influence treatment planning. It tests the functional status, comorbid medical condition, concomitant medications, cognitive function, and psychological state and social support. The need for assistance during the activities of daily life (bathing, dressing, eating, going to the toilet, etc) is one indication of a reduced functional status. In cancer patients, activities like shopping, telephoning, managing finance and the ability to take medicines are more useful for assessing the functional status. The goal of therapy in older cancer patients is to avoid under-treatment, as this may worsen prognosis. Surgery is the most effective treatment for many cancers. Most surgical procedures are associated with relatively low mortality in healthy older patients. Low mortality rates support the utility of complex cancer surgery in the elderly. Following surgery, these patients live an active and good quality of life, both mentally and physically. Comprehensive cancer care for older patients is a part of the practice and responsibility of every surgeon. If fit for surgery, they should go in for it. Planned surgery is well tolerated. An emergency surgical procedure is associated with increased complications and mortality. Treatments used in younger patients are safe and work just as well in older patients. Under-treatment must be avoided. The writer is a former Professor and Head, Department of General Surgery,
PGI, Chandigarh.
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Health Notes Washington: Taking up smoking results in epigenetic changes associated with the development of cancer, UK scientists have reported. Scientists have suspected that smoking causes so-called epigenetic changes such as methylation which alter gene expression without causing changes to the actual DNA sequence. “Until now, however, there has been no direct evidence that smoking induces DNA methylation in humans. Cross-sectional surveys restricted to patients with cancer have revealed that aberrant methylation of several tumor suppressor genes is associated with smoking. But such surveys cannot distinguish those epigenetic changes that are a consequence of the disease process from those which are directly attributable to smoking,” said Dr Yuk Ting Ma from the UK Institute of Cancer Studies, Birmingham. — ANI Clinical trials show effective weight loss strategies Washington: A new study has suggested that lifestyle interventions, including physical activity and structured weight loss programmes, can result in significant weight loss. In a one-year intensive lifestyle intervention study of diet and physical activity, Bret H. Goodpaster of the University of Pittsburgh, randomised a group of 130 severely obese adult individuals without diabetes in two groups to assess weight loss for a period of one year. One group was randomised to diet and physical activity for the entire 12 months while the other group had the identical dietary intervention, but with physical activity delayed for six months. The study was conducted from February 2007 with follow-up through April 2010. — ANI Chemicals in mother’s blood linked to child’s obesity Washington: A team of scientists has revealed that babies whose mothers had relatively high levels of the chemical DDE in their blood were more likely to both grow rapidly during their first six months and to have a high body mass index (BMI) by 14 months. DDE, an endocrine disrupter, is a byproduct of the pesticide DDT. Scientists based in Barcelona, Spain, examined data collected between 2004 and 2006 on a representative sample of 518 Spanish women in their first trimester of pregnancy. Laboratory studies have suggested that “exposure to chemicals with endocrine-disrupting properties might promote shifts in appetite regulation, but may also promote obesity through metabolic changes,” report lead author and epidemiologist Michelle A. Mendez of the Centre for Research in Environmental Epidemiology and her colleagues said. — ANI
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1. Too much confusion at mealtime.