U The Caribbean Health Digest - Issue 35

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OCT DEC 2016 / ISSUE 35 / TT$35.00 US$5.99


What is



PARENTING & WELLNESS finding balance



among one of the h healthiest th lthi t foods

SWIMMING Water based exercises & your health

D E N TA L IMPLANTS Changing the face of dentistry! 9 772218 501006


Sherine Mungal Stuart Fraser


Eidetic Publishing

Editorial Director

Sherine Mungal

Managing Editor

Roslyn Carrington


Michelle Ash Maia Hibben Carol Quash Leah Lewis Tian Watson Kerina Antoine Richard Allen Vernon Khelawan

Our Intention candles are hand-poured purposefully crafted to inspire your senses. We use blends of only one hundred percent pure therapeutic essential oils in combinations that have been researched and proven to soothe, calm and relax. Creative Director

Assembled using all natural soy wax which are free for all toxins and wicks constructed from natural, cotton threads and contains no lead, zinc or other metals.

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Healing Blend Lavender • Eucalyptus • Sage Purify your mind and body with the healing candle. The essential oils of lavender and refreshing eucalyptus soothe the body while reducing physical and mental fatigue. Combined with sage, the “sacred herb,” anxiety can be relieved and euphoria can ensue. Detoxify, energize and release what doesn’t serve you any longer.

Prosperity Blend Cinnamon • Bergamot • Petitgrain The prosperity candle will release negativity to create and receive abundance with the aromatic blend of cinnamon, bergamot and petitgrain essential oils. This spicy blend is grounding and powerful to welcome success and a sense of stability.

Inspiration Blend Lavender • Spearmint • White Spruce Restore yourself to a place of restoration and calmness with the cooling floral blend found in the inspiration candle. Combined with the essential oil of spearmint, this candle will revatilize your mind and body while increasing your energy and mental clarity. Let your creativity flow and be inspired.

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Gratitude Blend White Spruce • Rosewood A comforting blend of white spruce and rosewood essentials oils. The gratitude candle is a great gesture of giving thanks to someone special or to light when one wants to honor their blessings in their own life. Take a few moments every day to feel what you are most grateful for and it will shift your energy immediately to a place of peace and joy.

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Medical Advisory

Stuart Fraser Eidetic Cindy Singh Lorraine Biran Shutterstock iStockPhoto Bigstock AdobeStock Dr. Neil Singh


Healthy Blend Eucalyptus • Basil • Lemongrass These inviting smells of basil and refreshing orange will delight your sense of health and well-being. Feel confident in your healthy decisions in life to stay energized and focused with this invigorating blend of neroli, basil and lemongrass essential oils.

Clarity Blend Litsea Cubeba • Peppermint The cleansing fragrance of this clarity candle will clear your mind while stimulating and energizing your mood. The essential oil of litsea cubeba, combined with refreshing peppermint oil will increase your concentration and help uncover solutions in times of fatigue or stress.

e: info@tortugahills.com

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This information is of a general nature only and is not intended as a substitute for professional health advice and no person should act in reliance on any statement contained in the information provided and at all times should obtain s p e c i f i c a d v i c e f ro m a h e a l t h professional. Eidetic Publishing has made reasonable efforts to ensure that the health information contained herein is accurate and up to date. To the extent permitted by law, Eidetic Publishing, their employees, agents and advertisers accept no liability

(even if negligent) for any injury, loss or damage caused by reliance on any part of this information. U also contains information supplied by third parties. This information is identified with the name of the source and has been chosen for publication because we believe it to be reliable. To the extent permitted by law, Eidetic Publishing, their employees, agents and advertisers accept no liability (even if negligent) for any injury, loss or damage caused by reliance on any part of this information.

U The Caribbean Health Digest is published 4 times a year by Eidetic Publishing, Gaston Court, Gaston Street, Lange Park, Chaguanas, Trinidad & Tobago. Distribution is handled by Eidetic Limited.

Entire contents are copyright. Reproduction in part or whole is prohibited. Eidetic Publishing is in no way affiliated with companies or products covered in U. Produced and printed in Trinidad & Tobago.

stands for coming soon Miami Cancer Institute at Baptist Health South Florida is changing the face of cancer care with a new state-ofthe-art, $430 million facility – spreading its mission of hope, caring and innovation through a powerful alliance with Memorial Sloan Kettering Cancer Center, a comprehensive team therapy center in South Florida. That’s a big breakthrough

make C stand for cure.

For more information call 786-596-2373, contact us at International@BaptistHealth.net or visit MiamiCancerInstitute.com

12 What is Good Health Care? Now, here’s a subject that can be both controversial and relative to each individual or health care provider. Contemplate the ideas in this piece written by Leah Lewis, and it may just put things into perspective.

16 Dental Implants For some people, bridges and dentures are simply uncomfortable, and sometimes not even possible. Dental implants are a treatment option that brings a whole new dimension to dentistry, to how people look, and to how they feel about their teeth and smile. In this article, Dr. Jason Warner explains more to U writer, Maia Hibben.

28 Dropsy Talk about a misconception; if there ever was one, well, this would be it. In the Caribbean, we always thought of the word “Dropsy” as having something to do with falling asleep on oneself, and while this can be linked to other serious health conditions, Dropsy refers to something completely different. Learn more in this article.

30 Viral Croup When it comes to our children, it’s always important that we are able to tell the difference between one condition and the other. In other words, not every runny nose is the flu, and shouldn’t be treated as such. While Viral Croup has similar symptoms to the common cold, here’s what you should look for to get the best diagnoses and treatment for your child.

32 Recipe – Abi & U 22 Swimming and Your Health Unarguably, swimming is one of the best ways to tone muscles, get your cardio groove on, and relax all at the same time. Tian Watson, a water baby himself, takes a look at the direct benefits associated with this form of exercise.

24 Parenting and Wellness For some, parenting comes quite naturally, but not many people can say that it’s simply a breeze. Writer Kerina Antoine shares some of her own experiences on how to manage the day to day activities so that both parents and children maintain a healthy and balanced lifestyle.

One of the most versatile vegetables — well, technically a fruit — makes its way to you in the Abi & U Kitchen in this simple recipe for roasted aubergine.

34 Corn Boil it, roast it, put it in your soup or eat it raw; the versatility of corn is limited only by your imagination. It has been a dietary staple for humans for about 7,000 years, evolving from a strange, wispy plant to the robust ears of corn we love today. And happily, as this article shows, it’s good for you!

38 Oral Health and Chronic Disease Did you know that poor oral hygiene can lead to many other serious chronic diseases? Some of this may not only surprise you, but will certainly encourage to take better care of your teeth.

Time Flies… There hasn’t been another year that this applies to more than 2016, and though that’s not literally what the saying means, life just happens and we feel like time is taken away from us so quickly that we just don’t get to do the things we really want to do. Just another reason to laugh more, love more, live better, and stay healthier. As we approach the last quarter of the year, wind down, plan how to spend the holidays, and reflect and prepare for the year ahead, let us be sure to make our health and wellbeing a priority. Here’s a taste of what’s in store for this issue, which will surely help you in doing just that. As our cover story suggests, we want to always keep you smiling, so we’re sharing with you this piece on the evolution in dentistry and technology that brings an alternative to dentures: dental implants. Good health care is one of the most desired services the world over, but how do you define it? Leah Lewis gives us some tips on what we can look for. Also, our staff writer looks at the history of corn or maize, a fruit (or veggie, depending on your point of view) enjoyed everywhere, all year round. Among the line-up of great articles is Tian Watson’s piece on how you can swim your way to good health. This and much more in another enlightening issue of U. Happy reading, and see you all again in 2017.





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“Treat me the way that I deserve to be treated!” commented one gentleman when asked what good healthcare meant to him. A fair statement, do you agree? How about you? What is your reaction to the thought of seeking healthcare services in your country, whether publicly or privately? Do you become concerned and look for the best alternative? Or is it no worry to you? Which words come to mind?


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Throughout the Caribbean, healthcare services may appear to be painted with different brushes, depending on who the artist may be. From a layman’s perspective, words like “inept”, “poor”, “frightening” and “okay” may sound familiar. On the other hand, from an institutional perspective, words like “improving”, “developing” and “people-centred” are common as well. One word that balances the coin is “QUALITY”. It’s quite easy to say that your own healthcare services are of a good or bad quality, but do we even know what that means? What is quality? What makes healthcare good or bad? For one thing, we must have a clear understanding of what quality in healthcare is, before we can judge whether or not the service is good. Let’s define quality. Now, this is a bit tricky, since quality in care can be looked at from many angles. For instance, at the clinical level, you can be looking at the technological competence of staff, efficiency and effectiveness of treatment, environmental as well as personal safety, clinical standards and accreditation, personnel training, physical infrastructure…the works. But here, we will look at the human aspects of healthcare: what and how we feel, as clients. Now, healthcare is a basic human right. Everyone deserves quality healthcare. In that respect, quality can be defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” – according to the Institute of Medicine of the National Academies. In other words, healthcare providers give patients the best treatment possible, with the dignity that they deserve, regardless of age, ethnicity or social background, for their overall benefit.

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Now that we have a better idea of what quality healthcare actually is, let’s break it down a bit.

HOW DO YOU KNOW IF YOU ARE RECEIVING GOOD QUALITY HEALTHCARE? Here is a basic checklist that you can use to identify its traits. Make sure that your healthcare is: Safe – Your healthcare should not cause harm. No injuries should result from a treatment that should help you. Effective – Your healthcare should fit your needs and likings. It should be right for your illness and include only the medical tests and procedures that you need. Patient-centred – You ought to be treated respectfully, and your needs, preferences and values taken into consideration for all decision-making. Timely – Your healthcare should be given without unnecessary delays. Waiting should be reduced and harmful delays ought to be minimal. Efficient – Equipment, supplies, ideas, and energy should not be wasted. They should neither be overused nor underused. Equitable – Your healthcare should be fair and not be influenced by parameters such as your age, gender, language, colour, or income.

Let’s get even more personal. We obviously want to feel like we are being treated the way that we deserve to be treated. It’s important that we feel secure in seeking healthcare, for our own good, as well as for the good of our loved ones. Well, some researchers at the University of Oxford felt the same way, and so they took the decision to speak with the average English citizen to find out how persons truly perceive good healthcare, without the


fancy definitions and formalities. As I highlight some of the main findings, you will realise that you, too, can relate to them, and if you’re a healthcare provider, you should pay close attention:

7. Efficient sharing of information – It is considered to be useful when individuals have a written record of what has happened to them for easy reference by various doctors or nurses.

1. Warmth and friendliness – patients like it when doctors and nurses are interested in them as individuals who have feelings and families. They also like when their health concerns are taken seriously.

8. Being a part of the picture – Patients want to be involved in decisions about their own healthcare. They want health professionals to help them to care for themselves; and, when it comes to choosing a treatment, listen to them and pay attention to what is important to them. Patients also want to be able to refuse a treatment.

2. Understanding how life is affected – Patients want to be asked how their problem may affect their work, hobbies and relationships. 3. Seeing a familiar face – It is comforting for individuals to see a doctor or nurse who they like and trust, and who already know their medical history. 4. Difficult conversations made easy – When it comes to bad news, patients want to be told with kindness, warmth, and honesty. They want to feel at ease talking about embarrassing things. And when it comes to telling others about their problem, health professionals help them to do it. 5. Answering questions and explaining things – Patients find it to be good service when doctors and nurses take the time to explain why they may have developed a problem. They are told what a treatment should do and what its side effects may be; and they are told about the different steps involved in their care. 6. Pointed in the right direction – Patients want to be told about further sources of help, such as self-help groups, support groups or given benefits advice. They want to be told who to contact in case of emergencies; and be informed of other health professionals whose services may be helpful to them.



So there we have it. Good healthcare from the human perspective. Now that we understand what quality healthcare is, we can make sure that we receive the best healthcare when we or our loved ones are sick or hurt. But it doesn’t end there. There is always something that we as individuals can do to help ourselves and to help our doctors and nurses to help us. For instance, it helps when we create a list of questions about our problem, treatment or operation before we visit the doctor. Carrying a family member or close friend to our visit may also be useful; as well as talking to our doctors and nurses about what we need and how we feel. It may be beneficial to make a list of all medications that we take to share with our doctors; and it’s always a good idea to obey their instructions by taking our medicines as we’re told to. Now you can be the judge of your own healthcare services. Whether you use the services or provide them, be sure that you can recognise what good healthcare is.

REFERENCES Health Experiences Research Group. What is ‘good’ healthcare? University of Oxford. 17.02.2

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WHAT ARE DENTAL IMPLANTS? A dental implant is a prosthetic replacement for a missing tooth. In a nutshell, the implant mimics the tooth root. It is usually made of titanium and other materials that adapt well to the human body. It is surgically placed into the jaw, beneath the gum line, and over time fuses into the bone to provide a stable base for the new crown, which is then attached onto it. It is the closest replacement to a natural tooth and it is permanent and can’t become loose like a denture can.

WHY DO PEOPLE GET IMPLANTS? Implants provide a treatment option for the replacement of missing teeth. Endodontist, Dr. Jason Warner, based in San Fernando and Woodbrook, explains that globally, millions of people lose their teeth every year because of accidents, heredity problems, gum disease (periodontitis) and poor oral hygiene. Although there are other options for replacing teeth, such as removable partial dentures and bridges, implants are considered the most successful treatment for missing teeth as they provide teeth that look, feel and function like normal teeth. They can be used to replace a single tooth, several teeth, or all teeth if necessary! Dr. Warner explains that dental implants really provide a means of improving the quality of someone’s life.

Advantages of having dental implants can include: • Improved aesthetics • Improved function and speech • Improved health — with dental implants, all the foods required for a healthy, balanced diet can be eaten FACT: What is an endodontist? A dentist who specialises in procedures such as root canals and implants, which involve the soft inner tissue of the teeth, called the pulp. This is specialised dentistry, and endodontists typically study for several more years after qualifying as a dentist.

WHAT IS THE PROCEDURE FOR DENTAL IMPLANTS? The procedure for implants can vary depending on the patient, the type of implant, and the tooth being replaced. Some implants can be fully placed in one day, but most implants involve two or three steps. The first procedure involves a small incision being made in the gum where the implant will be placed. A hole is then drilled in the bone, the implant placed into the hole and the

incision stitched closed. It can then take between three and six months for the implant to fuse with the jaw bone. Once this has been achieved an extension called an abutment is attached to the implant. In some cases, the implant and abutment are placed together during the initial surgery. In others, a second surgery may be needed to attach the abutment to the replacement tooth. Once healed, the implant and abutment act like a foundation for the new tooth onto which a crown, made in the right size, shape and colour to match the natural teeth, can then be attached.

WHAT ARE THE RISKS OF HAVING DENTAL IMPLANTS? Like any surgery, dental implant surgery poses some health risks. Some people may not be suitable candidates for implants. To help avoid these risks and identify suitable candidates, a comprehensive examination is performed by the dental expert, which reviews not only the patient’s dental history, but also and most importantly, their medical history. To be a good candidate for implants, you need to be in good general and oral health. You also need to have adequate bone support in the jaw. Often, people who do not have sufficient bone or weakened bone in the jaw require a bone grafting procedure before implants can be fitted. Chronic illnesses, such as

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diabetes, can interfere with healing after surgery and prevent successful implant placement. Other risk factors include poor bone quality, smoking, long-term use of bisphosphonate medications, and low oestrogen levels. Dr. Warner highlights some of the potential risks of having dental implants, which can include: • Infection at the site of implant placement • Bruising and bleeding at the implant site • Damage to vital structures — nerves, blood vessels, adjacent teeth • Sinus problems — if an implant placed in the upper jaw perforates one of the sinus cavities • Peri-implant infections — a condition involving soft tissue inflammation, bleeding and suppuration (pus) which can progress to fairly rapid bone loss. This condition, if left unchecked, can ultimately lead to implant failure.

ARE DENTAL IMPLANTS A COMMON PROCEDURE IN TRINIDAD AND TOBAGO? The question was posed to Dr. Warner. “I would say yes, it is a fairly common procedure in Trinidad and Tobago for a number of years now. Its popularity is steadily increasing for two reasons: 1. Due to an increase in oral health awareness and 2. Due to an increase in the number of general dentists placing implants. Traditionally, this procedure was performed by oral surgeons (worldwide). However, other dental specialties such as

Prosthodontics and Periodontics started incorporating implants into their training programs and now there are numerous training courses in dental implants available to dentists. Most of our local dentists have attended training courses in the USA.” Dr. Warner postulates that there are around 350 registered dentists in Trinidad and Tobago and that of those, at least 50 are actively providing dental implants. Dr. Warner further explains that “the acceptance and popularity of this treatment modality is still slow, mainly due to lack of knowledge, apprehension about the treatment, fear of having a surgical procedure done, fear of dentists, and one of the major restraining factors — cost. The price of dental implants varies throughout the country and due to the high cost; most insurance plans will not cover the price of a dental implant”.

THE DENTAL IMPLANT INDUSTRY • There are over 100 different implant systems on the market • Many implant systems are considered major, international systems, readily available, and are expected to remain so for the long term • No brand is clearly superior to all the others • The major factors determining success of implants are the experience, abilities and judgement of the dentist and the needs of the patient. Source: The American Academy of Implant Dentistry Website



FACTS AND FIGURES ON DENTAL IMPLANTS • More than 35 million Americans are missing all their teeth in one or both jaws, according to prosthodontists • 15 million people in the U.S. have crown and bridge replacements for missing teeth • 3 million have implants and that number is growing by 500,000 a year • 10 percent of all US dentists place implants, but that is increasing • The estimated US and European market for dental implants is expected to reach $4.2 billion by 2022 • The success rate of dental implants has been reported in scientific literature as 98% Source: The American Academy of Implant Dentistry Website

It is clear from these current statistics, and from the expertise of Dr. Warner, that dental implants are becoming an increasingly popular procedure, not just in T&T, but globally. Whether it is done to repair trauma, increase the functionality of the teeth and jaw, or simply to improve the aesthetics of a smile, dental implants are changing the face of dentistry and changing the quality of people’s lives in the process.

Dr. Jason Warner Endodontist, D.D.S (U.W.I), M.Sc. Endo (Manchester)

Practice locations: 63 Rushworth Street, San Fernando and 5 Roberts Street, Woodbrook.

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OXYGEN This odourless, colourless gas has eight protons in the nucleus, and is pale blue in its liquid and solid states. Interesting Oxygen Facts: One fifth of the Earth's atmosphere is made up of oxygen and it is the third most abundant element in the universe by mass.

LIQUID OXYGEN Virtually every hospital needs bulk supplies of oxygen and the most economical way to store large quantities is in its liquid form. Oxygen liquefies at -183°C and to keep it in its liquid state a specific type of storage tank is required. Other than the cost considerations, there are additional advantages to keeping oxygen in liquid form. In particular, liquid oxygen takes up significantly less volume than in its gaseous state, it requires minimal maintenance and is easy to access and use.


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Most living things need oxygen to survive and oxygen’s importance in the field of healthcare cannot be underestimated. Oxygen is widely used

in every healthcare setting, with applications from resuscitation to inhalation therapy. Medical oxygen is used to: • provide a basis for virtually all modern anaesthetic techniques • restore tissue oxygen tension by improving oxygen availability in a wide range of conditions such as cyanosis, shock, severe hemorrhage, carbon monoxide poisoning, major trauma, cardiac/respiratory arrest • aid resuscitation • provide life support for artificially ventilated patients • aid cardiovascular stability • provide hyperbaric oxygen therapy for divers with decompression illness Massy Gas Products (Trinidad) Ltd. supplies medical gases and supplies for virtually every aspect of medical therapy. Massy Gas Products (Trinidad) Ltd. also supplies and installs medical systems: - Bulk storage system (cryogenic and gaseous) - Medical vacuum and air systems - Medical gas delivery manifolds and automatic changeover manifolds - Medical gas piping and outlets







“So many people along the way, whatever it is you aspire to do, will tell you it can’t be done. But all it takes is imagination. You dream. You plan. You reach.” – Michael Phelps, Olympic swimmer and multi Olympic gold medallist.

If you’re still searching or trying to find your fitness groove, swimming and water-based exercises are without doubt a viable option to consider. Not only is it an ideal way to stay in shape, but you can also constantly test your improvement by entering any of the swimming competitions hosted by the various swimming clubs that take place in Trinidad and Tobago thought the year. First, let us take a look at some of the direct benefits of regular swimming or other workouts done in the water.


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Even at a low intensity level, this choice of exercise can quickly increase heart and lung capacity. As your intensity increases, so, too, will your overall cardiovascular fitness level. This result can easily be on par with other aerobic exercises such as jogging if executed at the correct level of intensity. For the average person, this can be achieved by swimming laps in a 25 m pool anywhere between 25 to 45 minutes at a pace that will continuously keep your heart rate up.

For those of us new to this realm of exercise, you should start slowly and rest as needed between laps until your body adapts. As you get more proficient, your workout can gradually become longer, incorporate different strokes, and fluctuate between speeds.

SWIMMING, BLOOD SUGAR AND BLOOD PRESSURE There have been studies that show how swimming directly influences better blood sugar management, which includes insulin sensitivity. This was found to be the case with swimmers who weigh more and whose bodies comprise more body fat than their counterparts who may predominantly run or cycle. So, not only does swimming satisfy your aerobic workout needs, but the resistance offered by the water would contribute to building muscle, which in turn assists with blood sugar management. Other studies in this field have also shown that swimming and water-related workouts help participants manage blood pressure levels.


THE GREY AREA OF SWIMMING AND WEIGHT CONTROL This area of research brings with it varied conclusions. It is true that swimming burns a lot of calories (approximately 600/hr, dependant on stroke and intensity). However, recreational swimmers seem to lose less weight when compared to recreational athletes from other sporting disciplines such as running or cycling. One rationale is that cold water dissipates more body heat than air. This leads to swimmers having increased appetites during the immediate hours after swimming. With this being said, a swimmer with a focus on burning calories can do so most efficiently by doing the butterfly stroke, or a high-intensity level freestyle stroke. Runners-up to these would be the breaststroke and backstroke, followed by the sidestroke. Keeping this in mind, a well-balanced program should incorporate an effective mix of these different strokes. To achieve this, it would be advisable to train/practice with a coach and swimming club. In Trinidad and Tobago there are quite a few to choose from. Most of them go all the way up to the Masters age group. The above are points to consider if weight loss is your primary objective; nonetheless, swimming will certainly reduce body fat and trim the waistline. It will also tone your major muscle groups such as legs, pectorals, shoulders and arms. Swimming is also an excellent method of cross training for most sporting disciplines, since it incorporates so many different muscle groups.

MUSCULOSKELETAL ISSUES AND ARTHRITIS Studies in the field of sport therapy and rehabilitation seem to be pro swimming and other forms of water workouts, such as water aerobics, for persons with arthritis and musculoskeletal issues. It is especially effective if the individuals in question are overweight. These routines can also be adapted to suit the circumstances. This can be exemplified by exercising in warm water. This particular adaptation can help relieve joint



stiffness and pain, while increasing flexibility. In this particular instance, it will be easier for participants to move about in water, and will also reduce impact on knees and other joints.

BACK PAIN Yet another area where water routines can be a great help is to alleviate back pains. A study conducted by a Turkish medical team in 2009 concluded that water routines were more effective for the relief of back pain than land-based routines. Studies undertaken in Belgium and Sweden concur with these findings. The Swedish research also had a focus on the positive impact water exercise can have on back pain experienced by pregnant women. In all cases it was concluded that reduction in stress on the spine, overall muscle relaxation and overall joint flexibility were all significant advantages of these water-based exercises.

FOR THE MORE ADVENTUROUS Fortunately, in Trinidad and Tobago, we are blessed with warm tropical waters. When our seas are not experiencing turbulence, swimming and other water-based exercises can be extended to our shores. This option fosters variety or deflects from the monotony factor which some individuals may be experiencing during their exercise routines. This change of environment can do a lot to keep individuals motivated and adhere to their objectives. This is, without a doubt, a different category of swimming. Athletes can, however, still gauge their abilities and level of improvement by entering some of the annual open water events such as the Gasparee Swim or the Maracas Open Water Swim.

ONE MAJOR CRITIQUE Although swimming and water-based exercises do bring all of the benefits discussed above, one major criticism would be that they are not weight-bearing by nature. As a result, they will do little to strengthen your bones as compared to activities such as running or weight lifting. This should be a factor to consider when you are clear about your fitness objectives.

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Being a parent can be as rewarding as it is challenging, and having a full-time job doesn’t make it any easier to spend quality time with your family while maintaining a healthy lifestyle.

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It seems like these days we have less free time than we used to, and our personal health and wellness are often put aside for things that we think are more important. We rarely practice good eating habits and eventually gain a whole laundry list of health issues, which ends up costing us more in the long run.




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Regular exercise can have a positive impact on your everyday life. It allows you to be fit enough to perform daily tasks more effectively and efficiently. Exercise can be a great way to stay active and spend much needed time with friends and loved ones. The key to balancing parenting and wellness outside of work time is effective time management and planning. Choose one day to write down everything you do (yes, every single thing). This will help you cut out unnecessary habits in order to adjust routines, which will allow you to have more time to spend where you need to. HERE ARE A FEW WAYS TO HELP YOU WITH YOUR FAMILY AND WELLNESS GOALS: PLAN YOUR WEEK Create and review your schedule. Putting activities into categories and allotting time to them will put things into perspective for you. WORK SMARTER How does your body’s clock work? Are you a morning or night person? If you do more on mornings, give yourself a morning sweat session. This will give you the extra energy needed to keep you pumped throughout the day. If you are a night person, try night-time workouts; you will sleep better.

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SET GOALS AND STICK TO THEM Write down your personal goals; make sure they are attainable and measurable. Most people set

goals that are unrealistic and uninspiring, which leads to failure. DON’T GO OUT FOR LUNCH Pre-plan and package meals the night before; this will help you stick to good nutrition and avoid skipping meals. MAKE WEEKENDS FAMILY DAYS Do fun things together, like hikes, or go on nature trails. Take a walk up to the Bamboo Cathedral in Macqueripe; go to the beach and play volleyball; take a brisk walk or even jog around the Savannah. Just make family time fun. This way, you’re killing two birds with one stone: you stay fit and create fun memories with your family. DO YOUR CHORES You may not have time to go to the gym, but you always have household chores! Some chores for burning calories are: • Cleaning windows • Moving around furniture • Sweeping • Scrubbing the bathroom GET THE KIDS INVOLVED Everyone needs a support group. Allow the children to gently remind you of your goals if they see you going for unhealthy snacks. GET ENOUGH SLEEP Turn of the all devices at the same time every night, and go to bed. Try having a banana before you sleep; magnesium and potassium are natural muscle relaxants and can help you sleep better. If you don’t like bananas, you may have a few cherries. They contain melatonin, which helps control your body’s internal clock.


DON’T MAKE EXERCISE A CHORE Exercise should be fun. There are many ways to keep fit. If you get bored with going to the gym and using the same machines like I do, try dance classes. Just do something fun and switch things up sometimes. MEDITATE Always make time in each day to make peace with yourself, whether it is by prayer or just a few minutes of quiet time. We all want physical strength, but we need to be mentally strong to face all the challenges we do on a day-to-day basis. TEA TIME Caribbean people have a love affair with a variety of herbal brews and teas, and there are many myths and half-truths surrounding these infusions. These include the claims made by the purveyors of so-called “weight-loss teas” and “cleanses”. There is very little solid evidence that teas are helpful in achieving either goal; in fact, laxative teas can dehydrate you and upset the balance of your electrolytes. We strongly caution you against embarking on any such regime without the advice of your doctor.



However, there is definitely some benefit to be had from enjoying a good cuppa, and there are many delicious options and blends available. Chamomile is well known for its relaxing properties, and ginger and peppermint are good for digestion and combatting nausea. Valerian is a popular sleep aid, while Echinacea has a reputation as an immunity booster. But do your research, as some teas may interact negatively with certain medications or exacerbate some conditions. Be particularly cautious if you are pregnant, as some teas, including those labelled “pregnancy teas”, may, in fact, be harmful. EAT CLEAN To stay healthy, we need to eat clean. This means staying away from processed foods. Leave the candy bars on the grocery shelves. Instead, go to the closest market and get fresh fruits and vegetables. Get delicious recipes for healthy eating so you won’t get tired of eating the same foods. We all know old habits die hard, but the first step to ensuring success in your attempt to balance parenting and wellness is trying. There is no greater feeling than knowing that you accomplished something you set out to do.

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Remember the days when your mother or grandmother accused you of having “dropsy” because you kept falling asleep all the time, even during a conversation? Do you know that dropsy had very little or nothing to do with your falling asleep? If truth be told, dropsy is a condition wherein a person’s body or body part experiences swelling or has an excessive accumulation of fluid. In medical terms, it is called oedema. It can manifest as swelling in the legs and ankles, bloating of tissues, and weight gain. You may want to know where the word “dropsy” came from. Medianet.com says, “The Middle English word, ‘dropsies’, came through the Old French ‘hydropsies’, from the Greek ‘hydrops’, which in turn originated from the Greek ‘hydor’, meaning water.” Oedema (dropsy) is often more prominent in the lower legs and feet, especially in the evening, because liquid tends to pool there due to prolonged standing or sitting during the day, especially in hot weather. It may also be a case of the weakening in the vascular system of the legs, making it more difficult for the veins to pump blood back to the heart. Varicose veins are also possible.

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Increased pressure in the blood vessels, resulting from lung conditions such as emphysema and chronic bronchitis, can also cause this swelling, as can congestive heart failure.

Pregnant women often experience oedema, thanks to the pressure exerted by the growing uterus upon the vena cava, which serves the lower body. Unfortunately, this swelling of the legs and feet can also be due to a more serious condition during pregnancy: preeclampsia. In severe cases, preeclampsia may lead to miscarriage. Upon awakening, some sufferers notice swelling around the eyes. This is called periorbital oedema, and may be due to infection or inflammation, or any number of conditions including sinusitis, hyperthyroidism, hypothyroidism or ocular disease. Malnutrition, in particular a dangerous reduction in the level of proteins such as albumin, can reduce the body’s ability to retain salts and water within the cells. This water then leaks into tissues, especially those in the legs and feet. Liver and kidney disease are also factors that lead to this condition, as these organs help to process and excrete sodium from the body. High levels of sodium, naturally, influence water retention. Obesity may result in oedema because the excess body fat causes compression of the veins.


One particularly vexing type of oedema, common in women under the age of 50, is called idiopathic oedema. The word “idiopathic” simply means that the cause is undetermined. While it’s a relief to know that the bloating and weight gain has nothing to do with any serious underlying condition, it is of little comfort when your jeans won’t zip up and that lovely new pair of high heels don’t fit! When checking for oedema, your doctor may gently but firmly press a thumb on the affected area. If an indentation remains when the pressure is relieved, this is a fairly good sign that the condition exists. This indentation, by the way, is also known as pitting oedema. Your doctor may want to do further tests to identify the cause of the oedema, such as blood tests to check kidney function, while a chest x-ray or electrocardiogram (EKG) can help identify cardiovascular disease. The location of the swelling may also provide some hints as to the cause. For example, in the case of liver disease, the swelling is seen near the legs and abdomen, and in heart disease swelling occurs in the lower part of the body and is more definitive in the evening. Those with kidney problems may see swelling around the eyes and face.



Remember that “dropsy” in and of itself is not a disease but a manifestation of other underlying conditions. The symptoms themselves can be relieved somewhat by taking simple steps, such as avoiding salt in your diet, thus decreasing water retention, or keeping legs and feet elevated, thus allowing blood to flow freely to the heart under the influence of gravity. In the case of oedema in the legs, wearing support stockings and taking periodic walks to trigger blood flow may help. If you are considering the use of a diuretic to reduce water retention, be sure to consult your doctor, as these may cause dehydration or interact with other medications you may be taking. Of course, an even more effective solution would be to directly address the causes of swelling, whether they be renal, cardiac, metabolic, nutritional or otherwise, because fundamentally, your oedema is your body’s cry for help, and you would do well to listen.

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ral C oup ugh

ny se

All children get the common cold, some more frequently than others. But some of these symptoms — the nagging cough, runny nose, fever, sore throat — can also be symptoms of viral croup, an infection of the voice box, bronchial tubes and wind pipe, which causes the vocal cords to become swollen and the airway to narrow. It is usually more common among children from six months to three years old, but anyone can contract it.

“Croup often begins as a typical cold. If there is enough inflammation and coughing, a child will develop a loud barking cough. This often is worse at night, and is further aggravated by crying and coughing, as well as anxiety and agitation, setting up a cycle of worsening symptoms. Fever and a hoarse voice are common, too. Your child's breathing may be noisy or laboured,” says medicinenet.com.

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One of the main causes of viral croup is the Human Parainfluenza Virus (HPIV) 1 and 2. Just like the common cold, viral croup is contagious and can be spread through the air when an infected person coughs or sneezes; through close personal contact; or by touching objects, such as toys, furniture, door knobs and other surfaces contaminated with the virus and then touching the eyes, nose, or mouth. The viral infection is most contagious during the first few days of contraction, and children can return to their regular activities once their temperature returns to normal.

Viral croup can present itself in two distinct ways. “The more common variety has symptoms of fever (100 – 103 degrees F), mild hoarseness and sore throat two to three days after virus exposure. Quick to follow is the characteristic dry 'barking seal' cough that may be associated with a harsh, raspy sound during inspiration. This sound, called 'stridor,' has been noted to resemble the breathing of the Star Wars character Darth Vader. The symptoms commonly last for four to seven days,” explains medicinenet.com. “The alternative and less frequent presentation is called 'acute spasmodic croup'. These children will appear totally well when put to bed at night only to awaken their parents in the middle of the night with the above-described barky cough and stridor. Fever and sore throat are not noted in these children, and the symptoms commonly resolve within eight to ten hours from onset, and the child appears totally well until this same acute onset recurs the following night. This on/off pattern may occur over three to four nights in a row and then morph into symptoms more characteristic of








the common cold — mucus-like nasal discharge and a 'wet' cough for several days.” Unlike the flu, there is no vaccination to prevent viral croup. Fortunately, the majority of croup cases are mild and can be treated at home. However, the rare cases of severe croup can become life-threatening. A child with a severe case of viral croup will find it difficult to lie down as a result of their struggle to breathe. They may breathe at an unusually fast pace, become anxious and exhausted, and may begin to drool and have difficulty swallowing. They may also develop cyanosis, bluish/greyish skin around the nose, mouth or fingernails; dehydration; as well as an unusual pulling in of the skin between the ribs and just above the collar bone with every breath. These are all indications that you should take your child to the hospital immediately. Mild cases of viral croup can be treated with over-the-counter drugs and simple home remedies. However, the American Academy of Pediatrics advises that combination cough and cold medicines should be avoided in the treatment of mild cases, as research has proven them to be ineffective in children. According to kidshealth.org, “Breathing in moist air may help kids feel better, and pain medicine

(ibuprofen or acetaminophen) may make them more comfortable. Kids should drink plenty of fluids to prevent dehydration, and rest often. The best way to expose a child to moist air is to use a cool-mist humidifier or run a hot shower to create a steam-filled bathroom where the child can sit with an adult for ten minutes. Breathing in the mist will sometimes stop a child from severe coughing. In cooler weather, taking the child outside for a few minutes to breathe in the cool air may ease symptoms. You also can try taking your child for a drive with the car windows slightly lowered. In certain kids, doctors will prescribe steroids to decrease airway swelling. For severe cases, kids will be put on a breathing treatment that contains a medicine called epinephrine. This medicine quickly reduces swelling in the airways. Sometimes kids with croup will need to stay in a hospital until they’re breathing better.” As with all illnesses, prevention is better than cure. The same steps used in the prevention of colds and flus can be used to stave off viral croup. Ensure that your children have a healthy diet, and get enough exercise and rest. Remind them to wash their hands frequently, and to sneeze into their elbows, and try as much as possible to keep them away from direct contact with people who show symptoms of the cold and flu. 31 | u





Aubergine /Eggplant




Aubergine Sea Salt Black Pepper Garlic Olive Oil Parmesan Parsley

2 medium 2 Tbs 1 Tbs 2 cloves 2 Tbs 2 Tbs ¼ cup

Slice aubergine 1-inch thick, sprinkle with salt, and let sit for half an hour, to draw water out of aubergine so that it’s not oily or soggy, but crispy. Take a paper towel and dry aubergine slices.

Preparation Time 35 Minutes Cook Time 20 Minutes Serves 4 People

On a baking tray, drizzle slices with olive oil, black pepper, crushed garlic, and a little salt, and bake at 400°F for 15 minutes or until brown, then flip and return to the oven for another 5 minutes. When done cooking, sprinkle with fresh parmesan cheese and fresh chopped parsley. Eggplant is very low in calories and fat but rich in soluble fibre. It’s also a good source of minerals like manganese, copper, iron and potassium.

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Eggplant is a very good source of dietary fiber, vitamin B1 and copper.




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Ok, as corny as this headline may sound, there are some interesting and amazing facts that many people may not know about the unassuming corn or maize and its nutritional value. First, is it a fruit or vegetable? Well, in the Caribbean we mainly consume corn as a fruit. After all, who can resist passing by that vendor with a big pot of boiled corn soaking in salted water and chadon beni, or even a “roast corn”, charred on that homemade grill over good old-fashioned coals — my personal favourite, even though it blackens my teeth. The rest of us consume corn as a vegetable; whether it be a soup or salad, as baby food, or in a pie, we love its taste and texture. Corn or maize belongs to the Poaceae family, and botanists classify it as a fruit, along with tomatoes, sweet peppers and cucumbers.

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Although there are six types of corn, or even more, here in the Caribbean we are mainly familiar with popcorn and sweet corn. Whether its origin is Canada (as some vendor signage may suggest) or not, we have found many creative ways to enjoy this sweet tasting and peculiar looking fruit.


The origins of corn



It is believed that corn was developed by the people of what is now central Mexico at least 7,000 years ago. In fact, corn would not even exist today if it weren’t for them, so you can almost say that humans “invented” corn. Corn would never be found in the wild and depends greatly on us humans to cultivate and protect it in order to survive, very much like people back then depended on corn for much of their food and livelihood. While corn today looks nothing like the corn back then, which was somewhat spindly and scrawny, it must have had some similarities in taste for people to have kept it around this long.

The health benefits of corn Corn is one of the most widely consumed cereal grains; it’s rich in vitamins, minerals, and fibre, and contains a good amount of antioxidants and carotenoids. Yellow corn in particular may promote eye health. Although the eaten varieties of corn are mainly popcorn and sweet corn, we may consume the refined varieties as ingredients in many types of foods, such as cornflour, corn oil and corn syrup.

Nutrition facts Corn contains varying amounts of water and is composed mainly of carbohydrates and small amounts of protein and fat. Here is a look at a detailed nutrition fact sheet for 100 grams of yellow boiled corn.

Vitamins Vitamin A Vitamin C Vitamin D Vitamin E Vitamin K Vitamin B1 (Thiamine) Vitamin B2 (Riboflavin) Vitamin B3 (Niacin) Vitamin B5 (Panthothenic acid) Vitamin B6 (Pyridoxine) Vitamin B12 Folate Choline


AMOUNT 13 μg 5.5 mg 0 μg 0.09 mg 0.4 μg 0.09 mg 0.06 mg 1.68 mg 0.79 mg 0.14 mg 0 μg 23 μg 29.1 mg

%DV 1% 6% ~ 1% 0% 8% 4% 11% 16% 11% ~ 6% 5%

Calcium Iron Magnesium Phosphorus Potassium Sodium Zinc Copper Manganese Selenium

AMOUNT 3 mg 0.45 mg 26 mg 77 mg 218 mg 1 mg 0.62 mg 0.05 mg 0.17 mg 0.2 μg

%DV 0% 6% 7% 11% 5% 0% 6% 5% 7% 0%

Fast facts on corn • Mainly contains carbs, and scores low to medium on the glycaemic index, which means that corn should not cause large sugar spikes. • High in fibre; in fact, one bag of regular popcorn (like the ones at the cinema) may contain a large amount of the recommended daily intake. • Contains a fair amount of low-quality protein • Relatively low in fat • Good source of vitamins and minerals • Popcorn is a type of corn that pops when exposed to heat. The water trapped at the centre of the kernel turns to steam, creating internal pressure and making the kernel explode. • Contains high amounts of antioxidants and is especially rich in eye-healthy carotenoids. • Contains phytic acid, a plant compound that may reduce the absorption of minerals such as zinc and iron. However, soaking, sprouting and fermenting the corn can reduce the levels of phytic acid.

So, it turns out that the corn isn’t all that dull and boring after all. It has history, all 7,000 years of it, and a character that brings flavour, colour and taste to any dish you care to invite it to be a part of. In summary, as with most things, moderate consumption of whole grain corn, such as popcorn or sweet corn, may fit well into a healthy diet, and I have a feeling that corn is here to stay!

Ref. Authoritynutrition.com

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A Mental Health Care Service That Caters to You WRITTEN BY RICHARD


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With today’s advances, and modern approaches to mental health care in other countries such as Canada and Australia, Trinidad and Tobago unfortunately continues to trail behind, with poorly managed resources, and little effort being put forward to improve the current conditions at the St. Ann’s Psychiatric Hospital and other publicly assessable facilities. Needless to say, the underserved population that accesses care through these facilities places an immense strain on an already burdened system that has very few resources to efficiently achieve the complex, yet critically mandated task of mental health care. An efficient and effective mental health care system could seamlessly integrate all their available resources, with the expectation of providing the best patient care outcomes possible. Oftentimes, the patients who seek out help through the public health care system complain of gross mismanagement of resources and unnecessary bureaucracy, making an essential service inaccessible in a timely manner, which sometimes significantly contributes to a “revolving door syndrome”. Amid the increasing burdens that the public mental health care system carries, it has managed to birth many proficient and passionate mental health professionals and advocates, who continue to collaborate and strive for better within the field of mental health. One such establishment is Integrō Curis Limited. Integrō’s vision was realised from the need to connect mental health patients, their families, relatives, and loved ones with locally available resources that can empower them to achieve continued mental health and wellbeing. Integrō places emphasis on striving to be the premier mental health care service provider that demonstrates intellective, innovative and integrative delivery of quality holistic, patient-centred and goal-oriented patient mental health care.



Their multidisciplinary team of mental health care service providers includes persons from disciplines such as psychiatry, general medicine, psychology, nutrition, psychiatric nursing and exercise and fitness. In a nutshell, this approach may be better described as community mental health services. Community mental health services support, treat and care for people with mental health complaints, issues or problems in a community-based setting, instead of a psychiatric hospital (asylum), commonly referred to as a “mad house”. For this community-based setting approach, Integrō‘s range of mental health services varies, and focuses on a system of care that is tailored to meet each patient’s unique needs. Community services include full or partial supervision, psychiatric wards of general hospitals (including partial hospitalization), local primary care medical services, day centres, community mental health centres, and self-help groups for mental health. These services can be provided by government organizations and mental health professionals, including specialized teams providing services across a geographical area, such as mental health first aid teams. They may also be provided by private or charitable organizations. The World Health Organization states that community mental health services that are easily accessible and effective lessen social exclusion, and are likely to hold less potential for the neglect and violations of human rights that are often encountered in psychiatric hospitals. We believe that our approach as a community mental health care provider will drastically alter the delivery of mental health services and inspire a new age of optimism in mental health care.

ō Curis Limited’s For more information about Integrō services, you can visit our website at www.integrocuris.com or email your questions to info@integrocuris.com.

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MPH (Health Policy/Health Admin), PgCert (Diabetes Education), Dip, RD


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Our mouths are full of bacteria. Germs in the mouth use the sugar in food to make acids. Over time, the acids can attack the tooth, creating decay, leading to a cavity. These bacteria, along with mucus and other particles, constantly form a sticky, colourless film (called plaque) on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form tartar, which brushing doesn’t clean. Only professional cleaning by a dental health professional can remove tartar. The longer plaque and tartar are on teeth, the more harmful they become. Untreated decay can become so advanced that the tooth must be extracted. Inflammation of the gums by bacteria is called gingivitis. In gingivitis, the gums become red and swollen, and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dental health professional. This form of gum disease does not include any loss of bone and tissue that hold teeth in place. Untreated gum disease can advance to periodontitis (which means “inflammation around the tooth”). In periodontitis, gums pull away from the teeth and form spaces that become infected. The body’s immune system fights the bacteria as the infection spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. Otherwise functional teeth may eventually become loose and have to be removed. Poor oral health is significantly connected to some major chronic diseases.

Cardiovascular disease

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Many health practitioners are already aware that tooth infections can be warning sign for heart

disease. People with bleeding gums from poor dental hygiene could have an increased risk of heart disease. The theory behind this link is that bacteria from the mouth are able to enter the bloodstream when bleeding gums are present. That bacteria can stick to platelets and subsequently form blood clots. This interrupts the flow of blood to the heart and may trigger a heart attack.

Respiratory disease Substantial research has been building steadily on respiratory health and its connection with oral health. Pneumonia is one of the more researched conditions associated with poor oral hygiene. The theory behind the link to respiratory disease is that the bacteria in plaque can travel from the mouth to the lungs, causing infection or aggravating existing lung conditions.

Adverse pregnancy outcomes Pre-term birth has been shown to have a significant link to dental health. Infection with bacteria from periodontal disease in the mouth may affect the health of the pregnant uterus, leading to low birth weight and premature contractions. Babies born prematurely are at risk of developing serious and lasting health problems, and have an increased risk of death. One study by researcher Jeffcoat showed that women with clinical evidence of periodontal disease were 7.5 times more likely to have premature, low-birth-weight infants.

Diabetes Persons living with diabetes may already be aware of the many other effects on the body, and know that special attention must be paid to their feet and eyes, for example. However, special care of the teeth needs to be added to that list. People with diabetes are more prone to infections, especially when their blood sugar is not under control. High blood sugar can cause too much bacteria to accumulate in the mouth, which can then lead to tooth decay and other oral health problems.



Aside from gum disease, persons living with diabetes are at a higher risk for other oral problems such as: • Cavities • Dry mouth • Bad breath • Burning sensation in the mouth • Thrush, a type of fungus that causes painful white patches to grow inside the mouth Furthermore, the presence of periodontal disease, along with the condition of diabetes, makes it even more difficult to manage blood sugar. Severe periodontal disease can increase blood sugar levels. This puts persons with diabetes at an even greater risk for other health complications.

relatively new area of study, and exact cause and effect relationships have not yet been fully studied. Some other mouth-body connections under current investigation are rheumatoid arthritis, obesity, and dementia and Alzheimer’s disease.

If you do have diabetes, make a reminder to check your mouth and teeth regularly for any problems. Tell your dentist if you have pain, ulcers that don’t heal, or a loose tooth. Also, watch for any of the following signs of gum disease: • Bleeding, red, or swollen gums • Receding gums • Pus between your gums and teeth • Lingering bad breath or taste • Discomfort or a difference in how your teeth feel when you bite down Always be sure to tell your dentist if you may have diabetes. If your blood sugar is not under control, you may need to postpone some dental work until your blood sugar is lowered.

Here are some basic tips for a healthy mouth: • Brush your teeth every day. Ideally, you should do so after you wake up, after every meal, and before bedtime. Use toothpaste that contains fluoride. It can help prevent gum disease. • Floss at least once daily, or use a dental pick. Both help remove plaque for cleaner teeth. • Eat a healthy diet. Limit foods that are high in sugar. They can promote plaque build-up, and hence, tooth decay. • Drink tap water, to benefit from the added fluoride • Reduce tobacco and alcohol consumption • Make regular dental visits • Ensure that underlying medical conditions are managed properly. For example, if you are on medicine for your diabetes, take it as you normally would before any dental visits.

Kidney disease For persons with chronic kidney disease (CKD), changes in the mouth, such as periodontal disease and loss of teeth, can be a warning sign for impending worsening health. As decreased oral health appears in persons with CKD, other health complications such as malnutrition, along with muscles wasting away, tend to coincide.

Further studies on oral health and other conditions The impact of oral health on the body is a


Good oral hygiene is a critical component of health that may actually be the key to preventing many of the common ailments of the body from occurring. Oral health is, however, often easily overlooked. Collaboration should be encouraged among the various disciplines of medicine and allied health care to break down barriers that may prevent a holistic approach to the provision of oral health care in clinical settings and community programs.

References: • University of Rochester Medical Center’s Health Encyclopedia • Ioannidou, Efthimia Effie and Swede, Helen, "Tooth Loss Strongly Associates With Malnutrition in Chronic Kidney Disease" (2014). Articles — Research. Paper 273. • Links between oral health and general health — the case for action by Dental Health Services Victoria, Australia (2011)

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THE NEXT U January to March


Dementia Feel like you're loosing your mind and your memory? May be early signs of Dementia! Benefits of Eating Raw Foods Another way you can get the most out of your meals! Agave This plant is used in making Tequila, also a sweetener?

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Specifics All accepted articles will be accompanied by the byline and monetary compensation as set out in our writers’ contract. Letters to the editor We encourage Letters to the Editor commenting on recent articles published in our magazine. They are not peer reviewed as such, but are assessed in-house to make sure they are factual and non-inflammatory, etc. Submit all comments, letters and/or subscription requests to: U The Caribbean Health Digest, Gaston Court, Gaston Street, Lange Park, Chaguanas, Trinidad & Tobago or email us at register@uhealthdigest.com www.uhealthdigest.com Advertising. P: 868-665-6712 + 5994 + 4428 F: 868-672-9228


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