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Beer in different languages Language Word(s) Afrikaans bier Albanian birrë Arabic beereh (biræ) Azerbaijani pivo Basque garagardoa Belorussian piva Bengali beer Breton bier Bulgarian bira Catalan cervesa Chechenian jij Chinese (Mandarin) pi jiu Croatian pivo Czech pivo Danish øl Dutch bier English beer, ale Esperanto biero Estonian õlu Faeroese øl, bjór Finnish olut, kalja Flemish bier French bière Frisian bier Gaelic (Scotland) leann (lionn), beòir Galician (Galego) cerveja / cervexa German (High) Bier German (Low) Beer Greek mpíra (bira), zýthos Hawaiian pia Hebrew beera Hindi beer Hungarian sör Icelandic öl, bjór Ido biro Indonesian bir Interlingua bira Irish (Gaeilge) beoir Italian birra Japanese biiru Korean mek-ju Kurdish bîre Lappish (Sámi) vuola Latin cerevisia, cervisia Latvian alus Lithuanian alus Luganda bbiya Macedonian pivo Malay bir Manx (Gaelg Vannin) lhune, beer Neo biro Nepali biyar, jad Norwegian (bm & nn) øl Occitan (Provencal) bièra, cervesa Persian (Farsi) ab'jo Police Motu bia Polish piwo Portugese cerveja Quechua sirbisa Rheto-Rumansch biera Romanian bere Russian pivo Serbian pivo Sesotho jwala Slovak pivo Slovene pivo Spanish cerveza Swahili bia, pombe Swedish öl Tagalog (Pilipino) serbesa Thai bia Turkish bira Ukrainian pivo Vietnamese bia Volapük bil Welsh cwrw Xhosa ibhiye Yiddish bir Zulu utshwala How to order beer in 50 languages Afrikaans A beer, ah-suh-bleef! American Brewski here, please! Arabic Waheed beera, meen fadleek! Basque Garagardo bat, mesedez! Belarusian Ad-no pee-vah ka-lee lah-ska! Bengali Eka handoiya, doya koray! Bulgarian Edna beerra, molya! Catalan Una cervesa, si us plau! Cheyenne Nok hee-sevo-tamah-peh, mas-eh-met-ah-no! Chinese Ching gay woh ee bay pee joh! Czech Pee-vo, pro-seem! Danish Yay vil geh-neh heh en url! Dutch Un beer, ahls-yer-bleeft! Egyptian (Ancient) Wekha henqet! Esperanto Unu bieron, mi petas! Estonian Ooks ur-loo, pah-lun! Finnish O-loot moolek kee-tos! French Une bière, s'il vous plait! German Ein Bier, bitte! Greek Mee-a beer-a paraka-loh! Hawaiian 'Ekahi pia, ho'olu! Hindi Eka biyara, krupaya! Hungarian Edj pohar shurt kayrek! Icelandic Ay-dn byohr, tahk! Interlingua On bira, per favor! Irish Byohr awoyn, lyeh doh hull! Italian Una birra, per favore! Japanese Bee-ru ip-pon, ku-da-sai! Korean Mayk-joo hahn-jahn, joo-se-yoh! Kurdish Dan min yek bire! Lakota (Sioux) Wan-jee m'nee-pee-gah, ee-yo-kee-pee! Latin Cervisiam, sodes! Lithuanian Pra-shau vie-na, al-lows! Norwegian Ehn url, tahk! Old English An beor, nu! Pig Latin One-ay eer-bay, ease-play! Polish Yed-no peev, proshe! Portuguese Uma cerveja, por favor! Romanian Oh beh-reh ver rohg! Scots Gaelic Lyawn, mahs eh doh hawl eh! Serbo/ Croatian Yed-no pee-vo, mo-lim! Slovene Eno pee-vo, pro-seem! Spanish Una cerveza, por favor! Swahili Moja pombe, tafadhali! Swedish Ehn irl, tahk! Twi Mah-me bee-ye bah-ko, mee pow-che-oo! Turkish Beer beer-ah, luht-fen! Welsh Koo-roh ohs gwel-ookh-un-thah! Yiddish A beer, zeit a-zoy goot! “I would give all my fame for a pot of ale and safety.” – Shakespeare, Henry V “We old folks have to find our cushions and pillows in our tankards. Strong beer is the milk of the old.” – Martin Luther “24 hours in a day, 24 beers in a case. Coincidence?” – Stephen Wright “Give me a woman who loves beer, and I will conquer the world.” – Kaiser Wilhelm “He was a wise man who invented beer.” – Plato “Remember: I before E, except in Budweiser.” – Anonymous “I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts, and beer.” – Abraham Lincoln “Sometimes when I reflect back on all the beer I drink, I feel ashamed. Then I look into the glass and think about the workers in the brewery and all of their hopes and dreams. If I didn't drink this beer, they might be out of work and their dreams would be shattered. Then I say to myself, 'It is better that I drink this beer and let their dreams come true than be selfish and worry about my liver.'” – Jack Handy “You can't be a real country unless you have a beer and an airline. It helps if you have some kind of a football team, or some nuclear weapons, but at the very least you need a beer.” – Frank Zappa
“Without question, the greatest invention in the history of mankind is beer. Oh, I grant you that the wheel was also a fine invention, but the wheel does not go nearly as well with pizza.” – Dave Barry
From the makers of award-winning indie hits, "ICU Bed #7" and "Saan Nagtatago si Happiness?" comes a new short film from Cinemalaya best director Rica Arevalo entitled, "Gusto Kita Too." Shot in the USA, this romantic comedy casts Fil-Am talents Brian Reyes and Casey Pascual as they pursue true love in this funny Pinoy style courtship. Produced by Mediarevolution Film Productions with Maan dela Cruz as editor and original music by Jerrold Tarog. "Gusto Kita Too" is an added attraction, screening back to back with Will Fredo's sensational film, "Sa Pagdapo ng Mariposa" at IndieSine Robinson's Galleria starting May 21, 2008.
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 | Be a Man: Talk about Male Contraception | for everyone |
Be a Man: Talk about Male Contraception
By Katherine Mae M. Lopez
ALMOST 89 million people currently live in the Philippines, as revealed by the 2007 Census. Although it showed the lowest population growth rate since the 1960s, the number is still alarming given the already congested Metro Manila and looming food crisis. If the population continues to grow, sooner or later, we will find ourselves competing for resources such as food and land on which to build our homes.
In almost every discussion on overpopulation almost always, the issue of contraception and birth control, as a solution to retard the growth rate comes up . Women can choose from a variety of contraceptive methods available to them – from birth control pills to intrauterine devices (IUDs). Men, on the other hand, are left with the two most popular methods of male contraception: condoms and vasectomy.
A 2005 research made by the United States Agency for International Development about male involvement in family planning says that “including men in family planning programs can improve contraceptive acceptance, continuation, client satisfaction and efficacy.” Moreover, male involvement in family planning reinforces a partnership between the male and the female in a matter that concerns them both.
Vasectomy
One of the contraceptive methods available to men is vasectomy. “It is a semi-permanent form of contraception, and almost always 100 percent effective if it is properly done,” says Dr. Dante P. Dator, chair of the Urology Department in National Kidney Transplant Institute (NKTI). The goal of vasectomy, he adds, is zoospermia, or to have zero sperm.
In a vasectomy, Dator explains that the vas deferens, the tube that carries the sperm from the testicle to the ejaculatory duct, is cut.
Dator says that there are some cases wherein the male underwent vasectomy, but the partner still got pregnant. He explains that this is because the couple engaged in sexual intercourse a few days after the vasectomy was done. “That’s why about one month after the procedure, we do a sperm count,” says Dator.
Other methods
Dator says other methods for male contraception, such as the male pill and the oral tablets, are still in their experimental stage and they are not yet available commercially.
The male pill is a hormone that is supposed to block the sperm, Dator explains. It is either in injectable form or an implant, he adds. On the other hand, oral tablets make the muscles of the vas deferens contract.
But Dator says the problem with these methods are that they are not reliable, not 100 percent effective and there is no assurance of safety.
Meanwhile, No Scalpel Vasectomy (NSV) is also another method of male contraception. Dator explains that this is done by palpating the vas deferens and tying it off. “It is reliable by those who are trained to do it,” says Dator.
Are Pinoy men ready?
A 1993 survey among spouses in the Philippines about their views of contraception revealed that 73 percent of husbands in the country “strongly approves” of contraception. On the other hand, the 2006 Family Planning Survey showed that vasectomy has a 10.4 percent prevalence rate, while condom use is prevalent by 2.8 percent.
Dator thinks that Filipino men are ready for male contraception but they are not open to it. “Yes they are ready in a sense that they are aware of the problems of overpopulation, but they are not open because they fear that it will decrease their libido,” he explains, adding that the latter is not true because there is no relation between vasectomy and maintaining an erection.
Contributor Katherine Mae M. Lopez is a Journalism student from the University of the Philippines.
| The Truth About Circumcision | for everyone |
The Truth About Circumcision
By Katherine Mae M. Lopez
CIRCUMCISION is regarded as “rite of passage” to being a man. A study published in 2005 in the American Journal of Epidemiology says that the prevalence rate of circumcision in the Philippines is 92.5 percent. On the other hand, the prevalence rate in Spain is only 1.8 percent, 6.9 percent in Columbia, 7.4 percent in Brazil and 13.3 percent in Thailand.
Before Jesus Christ was born, circumcision was practiced by Hebrews as their way of establishing their covenant with God. A verse in the book of Genesis 17:11 says, “And ye shall be circumcised in the flesh of your foreskin; and it shall be a token of a covenant between Me and you.” Circumcision, therefore, was practiced for religious purposes.
But what really is circumcision?
“The penis, at birth, is covered by a skin called a foreskin,” says Dr. Dante P. Dator, chairman of the Department of Urology at the National Kidney Institute in Quezon City. “It is a procedure wherein the foreskin is slit to expose the glands to facilitate its cleaning.”
Dator explains that the foreskin accumulates dirt and shed skin.
“While most males in the world are uncircumcised, there have been reports saying that circumcised males have lower risk of contracting HIV, penile cancer and infections,” he says, adding that the HIV virus penetrates the inner skin of the foreskin because it has bigger pores.
Complications may arise if circumcision is not done properly, says Dator. These complications include incomplete circumcision wherein you have to do the circumcision again, and there is over circumcision which distorts the cosmetic appearance of the penis.
Dator adds that the patient may also suffer from pain, bleeding and infection which can cause inflammation, or the so called “nangangamatis.”
In taking care of the circumcised penis, Dator recommends the use of antibiotic for dressing the circumcised area. Three days after the circumcision, Dator says the boy may already be given a bath, with the circumcised area being washed with regular water and soap. “It’s no longer as tedious as before,” he says.
Realizing the potential health benefits of circumcision, Dator says he’s beginning to be inclined to doing it to a patient.
“It’s a different situation in other countries. People from other cultures may be hard to convince, he says.
| Pinoy parents board flight, forget toddler at airport | for everyone |
Pinoy parents board flight, forget toddler at airport
OTTAWA: Tickets, check. Passports, check. Luggage, check. Baby ... oops.
A family boarded a flight on Monday in westernmost Canada, and forgot their tot at the Vancouver international airport, media said Tuesday (Wednesday in Manila).
The 23-month-old boy's family had just arrived in Canada from the Philippines, but they were forced to repack their overweight bags before catching a connecting flight to Winnipeg, causing them to run late.
In their sprint to the gate, the family became separated.
The boy's father Jun Parreno, told local media he had thought his son was with his wife and the boy's grandparents, who ran ahead. They thought the boy was with his dad.
On the plane, the family members were seated separately and so did not immediately realize they had left the child behind.
Later, a security guard found the boy, who speaks no English, wandering near the departure gate, and Air Canada officials tracked down his shocked parents on the flight.
Because the boy was so young, he was not issued a boarding pass and would have sat on a parent's lap during the flight, so airline personnel did not notice a passenger was missing.
According to the Vancouver Sun, airport security found a Tagalog-speaking Air Canada agent who looked after the child while his father flew 2,300 kilometers back to Vancouver to pick him up and then return to Winnipeg to rejoin the immigrant family on their first day in Canada.
The baby was kept in Air Canada's offices and staff found him some toys, said local media.
"Air Canada took good care of him," Parreno told the daily Winnipeg Free Press upon arrival. "I'm grateful." AFP
| The Arsonist | for everyone |
Say goodbye to the world losing it all
Slowly eyes open to the night
Heaven now seems so far
My tears flow like the rivers
I die tonight.
Paint the streets in blood red.
Burn the streets tonight
We’re losing it all
We’re burning it all
Let it burn.
Why do we paint our lives
With patterns of loneliness?
Make me believe again
We make believe
Let’s make believe that
sleep will come in the morning.
Let it burn down
We light up
Watching my world come crumbling
The end is coming
Time is running out.
Paint the streets in blood red.
Watching the world that I love crumbling down
Hurting the ones that I love
See their tears falling down
I am weak I have failed you again
I am weak I have failed you again
I have failed you again
I have failed you again.
| Chinese tortoise craves nicotine fix | for everyone |
Chinese tortoise craves nicotine fix
BEIJING: A tortoise that enjoys a good smoke has been discovered in northeast China's Jilin Province, a local newspaper reported.
The smoking tortoise is the pet of a Chinese man surnamed Yun from Yongji County. He has kept the animal as a pet for nearly four years, according to the City Evening News.
Yun, himself a smoker, teased the tortoise by putting a cigarette butt into its mouth one day. To his surprise, it smoked, the paper said. From then on, he often shared his cigarettes with his pet.
"It seems to have become addicted," Yun was quoted as saying. "Whenever I smoke in front of it, it will stick its head out of the water and fidget about until I give it the stub."
To prove his claim, Yun put a cigarette into the tortoise's mouth in the presence of the paper's reporter and his neighbors, said the report.
To everyone's surprise, the animal finished smoking the cigarette in less than four minutes, even faster than most men do and seemed to be enjoying the process.
Tang Jingwen, the deputy secretary-general of the Wildlife Conservation Society of Jilin City, said he was quite surprised by the news.
He knew about monkeys who smoked out of imitation of human beings, but had never heard of a tortoise lighting up. XINHUA
| Kiss Your Way To Health | for everyone |
Kiss Your Way To Health
By Howard R. Hernandez, MD
MWAH! Smooch! Thwack! Slurpee! Peach! Plum! Prune! Alfalfa!--These are just some of the sounds a kiss can make (the last one innocently playful and maybe not as sexy as the others). A peck, buss, smack, smooch, osculation, a mouth-to-mouth, a deep kiss, a French kiss, a soul kiss, an Eskimo kiss, a butterfly kiss, an X (together with an O for hug)--so many terms and types for that one ethereal act--a kiss.
Definition and the study of kissing
What is a kiss anyway? Let’s have one little miniexperiment. First, pucker up your lips. Slowly lean forward in a fluid motion and then press them onto your closed-fist hand. The closing of eyes and the tongue movements are optional but highly encouraged. Bravo! You’ve done it. That's what you call a kiss! Did you get a kick out of it? If you did, you may need some professional help. Consult your nearest psychiatrist or expert in philematology (the science of kissing). Just kidding, folks!
These kissing scientists, referred to as philematologists (pronounced as fil-em-a-tol-o-jists), study the anatomy, physiology, history--every nuance of kissing. It is quite intriguing how they have come up with innovative theories on how our actual being is profoundly affected just by a passionate smacker.
How do you kiss?
If you want to be technical about the simple yet complex act of kissing, its exact mechanism is this: The highly coordinated facial muscles around the mouth (specifically the orbicularis oris muscle, a.k.a. the kissing muscle) contract to squeeze together. Other muscles of the face follow suit and move. The agile and versatile sixteen-muscled tongue can play a role too and be an important part of the kiss. Unless you
are not human or animal, a certain signal goes to the brain via the facial muscles. In turn, your brain releases neurochemicals and orders the body to produce substances, which makes you feel just great.
Feel like kissing yet?
So who or what do we kiss?
More often than not, kissing involves one person kissing another person. Adults kiss children, children kiss adults, children kiss children, adults kiss adults and people kiss their pets. For some reason, grandparents kiss their grandchildren by smelling them at the same time, too!
Sometimes, people kiss inanimate things, too! These objects range from anything to medals, trophies, amulets, icons and a plethora of other things. I know someone who kisses her hand-held mirror all the time. Some people even kiss the ground that they walk on (usually after a turbulent airplane ride or a seemingly interminable voyage at sea!).
The evolutionary history of kissing
Before the advent of Gerber, Cerelac, and kitchen appliances like blenders and food processors, scientists widely believed that prehistoric human parents used to mince up food in their mouths for their baby to be fed. Mothers, after shifting from breastfeeding to semi-solid food, may have chewed food and passed it from their mouths into those of their toothless offspring. Mothers soon discovered how pressing their lips against their toddlers’ cheeks continued to comfort their infants. Other scientists think that kissing was a way to get close to someone and check out their ID, as proof of recognition if they are friend or foe.
Regardless of its history, most of us will claim that kissing is indeed a unique human trait.
8 good reasons to kiss
1. Kissing removes stress. Your hectic schedule at work is really enough to test anyone’s sanity. To prevent crashing and burning, begin a day with a kiss. It will give you that needed positive attitude boost. Kissing gives you an adrenaline rush, which counters hydrocortisone, a hormone that is produced when the body is stressed. Kissing relieves stress by soothing the
mind and having the effects of a great relaxation technique.
2. Kissing fights against tooth decay. Kissing is nature's own mouth-cleaning process. Deep kissing increases the flow of saliva, which contains substances that fight bacteria, viruses and fungi. This in turn keeps the mouth, teeth and gums healthy. While kissing shouldn’t be a
replacement for brushing your teeth, it does fight plaque and cavities because of the calcium and phosphorous in the saliva. Still, you should have your routine visits to your dentist twice a year. You can kiss more often as well.
3. Kissing burns calories. Kissing burns kilojoules. The more passionate the kiss, the greater
the basal metabolic rate. A kiss increases fitness levels by improving your cardiovascular circulation. The excitement produces adrenaline into the bloodstream and your heart pumps more blood effectively in your body. Kissing may lead to more passionate kissing. More passionate kissing could lead to more sultry sex, thereby creating a “kiss-sexercise” cycle. Kissing is not exactly a cardiovascular workout like running on a treadmill, but it certainly is a dandy way to add to a healthy and active lifestyle.
4. Kissing tones facial muscles. Kissing can give your lips, tongue, cheeks, face, jaw and neck muscles quite a workout. As the dozens of little face muscles exercise, they increase blood circulation which helps smoothen out wrinkles and slow the aging process. Some say these exercises could keep you looking younger, invigorated, and certainly looking happier. Kissing makes you smile, too. Didn’t we all learn at a young age how frowning makes your skin sag?
5. Kissing enhances the immune system. Exposure to the “good” germs that inhabit your partner’s mouth beefs up your immune system. By exchanging bacteria through a kiss you are stimulating your internal defense mechanism. It has to be in amounts just enough to stimulate your immune system to be stronger. There are some cultures that share spit in other ways, through community meals and “special” beverages. This leads to a shared immune response, and makes a group more robust and healthier as a whole.
6. Kissing boosts your morale. When our well-being improves, our self-esteem increases. The possibilities of self-improvement through the beneficial effects of kissing and what follows are endless. There's nothing better than a passionate kiss for a major dose of feel-good factor. In theory, when you're kissing, you're happy. And when you're happy, you feel good about yourself. We feel more secure and better about ourselves, and our outer persona reflects it. Don’t you ever wonder how people find out the following morning why you look so relaxed and composed after a good bout of kissing the night before?
7. Kissing is a form of meditation. Kissing induces the same brain wave and physiological changes that meditation does. Kissing quiets the mind and, in that sense, it is much like meditation as it quells all the yackity-yak. If your mind still buzzes and chatters inside while you are kissing someone, then you may be kissing the wrong person. Try to find the right partner to give you that inner peace.
8. Kissing induces emotional bonding. Kissing your partner is a fun, pleasurable and important part of physical intimacy and helps maintain a sense of togetherness and love. It is commonly accepted by biological anthropologists that evolution has selected for humans to form strong emotional bonds with other people. Evolution selected sensitive lips for reasons other than kissing. They were so sensitive, that they were easily adapted to being used in a physical expression of emotional bonding.
A little stern warning
Kissing offers many health benefits, but may also transmit a number of disease-causing bacteria and viruses. Bacteria and viruses in the saliva or blood of one person can be spread to another person by kissing. Kissing can transmit many germs, including those that can cause cold sores, glandular fever (infectious mononucleosis a.k.a. kissing disease) and tooth decay. A lot of diseases have been implicated as contractible through intimate kissing. These include genital warts, herpes and syphilis to name a few.
There is no need to give up kissing for the sake of your health and that of your loved ones. We just have to keep things in perspective. While disease-causing bugs can be transferred during a kiss, most won’t cause diseases, and the risk of serious diseases is small.
Prevention tips
There are a number of things you can do to reduce the risk of passing on, or catching an infection while kissing. You should:
Avoid kissing when you are sick or the other person is sick.
Cough and sneeze into a handkerchief or tissue to prevent spread of the disease.
Avoid kissing anyone if you or they have active ulcers, warts, or cold sores around the lips or in the mouth.
Maintain good oral hygiene.
Consult your doctor about vaccines that are able to prevent communicable diseases.
Kiss your ill feelings goodbye.
His pupils are widely dilated as they stare into your own tantalizing receptive eyes. You wrap your arm around his waist and pull him in close. He touches your face and you lean in, tilt your head slightly--either to the right or left, of course--and your lips touch. There is nary a thought that comes to your mind. What an incredible feeling to kiss all your worries goodbye!
I mentioned 8 good reasons to kiss, but I can think of just one simple reason to sum it all up--it just feels so darned good! A gentle and warm kiss has all the sensuality and pulchritude to temporarily transcend us from the mundane and take us into a dimension of the extraordinary.
I wish you all the good life and better health. That said, I seal and end this article with an X O X O.
| Historic or Confusing? Medics joust over names of diseases | for everyone |
Historic or Confusing?
Medics joust over names of diseases
PARIS: Strange but true: If you are a doctor, one of the greatest honors to which you can aspire is to have a nightmarish disease named after you. Hundreds of so-called eponyms dot the medical textbooks, enshrining the name of a man or woman (Alzheimer, Parkinson, Hodgkin and so on) who became the first to identify some horrible ailment, describe symptoms or devise a new diagnostic test. But the time-honored practice is under threat, judging by a fierce debate in the latest issue of the British Medical Journal (BMJ). Anti-eponymists are lobbying for the tradition to be given the elbow. Names, especially when it comes to obscure conditions or procedures, can sow confusion and often are historically untruthful, write British renal physician Alexander Woywodt and US rheumatologist Eric Matteson. Many doctors are unable to remember what an eponym stands for, and some eponyms are understood differently by different people, they say. For instance, de Quervain's disease can mean either an inflammation of hand tendons, or a rare thyroid disorder. And, say Woywodt and Matteson, some names are quite inappropriate, for they fail to honor others who contributed to the medical breakthrough or are tainted by history. This is the case of Hans Reiter and Friedrich Wegener, who are remembered respectively for the discovery of a form of arthritis and a skin infection called granulomatosis. Reiter took part in atrocious Nazi experiments on humans, while Wegener was a student of the Nazi doctrine of racial "purity." Nonsense, retorts pro-eponymist Judith Whitworth, director of the John Curtin School of Medical Research in Canberra, Australia. Eponyms bring colour, tradition and culture to medicine--and also provide a useful shorthand. "Do we really want to speak of congenital cyanotic heart disease due to ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy and aortic dextroposition, rather than Fallot's tetralogy?" she asks. "Eponyms are here today to stay," she says. In other words -- it's Hobson's choice. AFP
| Terrible twins: OBESITY AND DIABETES | for everyone |
Terrible twins: OBESITY AND DIABETES
By Patricia B. Gatbonton, MD
The two most serious health problems of this millennium are the deadly duo: Obesity and Type 2 Diabetes Mellitus. By the year 2030, the International Diabetes Federation (IDF) predicts that there will be more than 380 million people worldwide with diabetes and the majority will be from the Asia Pacific region. This pandemic is due to the shift in traditional healthy lifestyle choices in our part of the world: rice, vegetables and fish protein to western diets primarily calorie laden, artery clogging fast food. This is what eminent diabetes expert and epidemiologist, Dr. Paul Zimmet from the International Diabetes Institute from Melbourne, Australia, refers to as diabesity, and its cause, the “coca-colanization” of the world.
In a webcast from the medical website, www.medscape.com in July 2007, Dr. Zimmet decries the problem as, “Diabesity—The Biggest Epidemic in Human History.” He continues, “What HIV/AIDS was in the last 20 years of the 20th century, diabetes and obesity and their consequences will almost certainly be in the first 2 decades of the 21st century.”
The rise in the number of overweight and obese individuals parallels the rise in the number of persons with diabetes (PWD). Our sedentary lifestyles tip the energy balance toward weight gain. The world’s children are at the center of this explosive problem. Type 2 diabetes now occurs at progressively younger ages, and ironically, because improved medical care has extended life expectancy, these children will have to live with the complications of diabetes far longer than their grandparents did, a generation ago.
But there is more. The triple threat is a triad of the deadly duo plus Hypertension. The deadly quartet is the triple threat plus dyslipidemia (low HDL-C, the good cholesterol; high LDL-C, the bad cholesterol; high triglycerides or fat), what physicians refer to as the metabolic syndrome—the perplexing clustering of metabolic abnormalities with motley other cardiovascular and life-habit risk factors—that are a major cause of disease.
The more risk factors you have, the higher the likelihood you will die from a heart attack or stroke.
There is even more. Among the top ten countries with diabetes by 2030, six are from Asia (neighbors India, number 1; China, number 2; Indonesia, Pakistan, Bangladesh, and Japan). The Philippines ranks number 9, definitely a top 10 that we as a nation, should not aspire too. The 6th National Nutrition Health Survey of 1993 warns us that its time to wake up!
Diabesity is a global health threat, so much so, that the United Nations General Assembly fast-tracked a unanimous resolution in December 2006—with lobbying from the International Diabetes Federation (IDF), Paul Zimmet, one of its most ferocious and passionate proponents—“declaring diabetes an international public health issue, only the second disease after HIV/AIDS to attain that unenviable status.”
As the world collectively commemorates November 14 as World Diabetes Day annually, each country should take a long hard look at itself, and what it is not doing, to protect its citizens against the tsunami that is diabesity.
National Vital Statistics
The prevalence of fasting hyperglycemia in the 1993 survey is 4.6 percent, an increase from the previous prevalence of 4 percent. Ninety four percent of the population has a blood sugar with in the normal range. The prevalence of impaired fasting glucose (blood sugar between 101 and 125 mg. percent)—a pre-diabetic condition—is 3.2 percent. This means based on an estimated population of 85 M, approximately 6 million Filipinos have abnormal blood sugars.
Body beautiful
How is the Filipino body habitus changing? Small, lithe and lean is the traditional body type—but given the abundance of nutrition and interactions between different gene pools—the Filipino is now taller, and is more likely to be bulkier than a generation ago.
Of the several ways to measure degree of obesity available to us, the simplest would be a body mass index (BMI), the waist circumference and the waist/hip ratio. Although not a direct measure of adiposity, the BMI is most widely used method. It is calculated from the height
and weight as follows:
BMI = body weight (in kg) ÷ square of stature (height, in meters)
BMI defines the degree of risk for cardiovascular morbidity. A BMI between 25 and 30 kg/m2 is low risk, above 30 kg/m2 is moderate risk. A BMI between 25 and 30 is significant and requires therapeutic intervention when other risk factors like hypertension and glucose intolerance co-exist.
The survey says that five percent of the population has a BMI greater than 30, and 19.6 percent are overweight. Twenty four percent of the population is overweight or obese, an increase from 20 percent in 1998. Seven percent of the obese are women, and 3 percent are men. Obesity is most prevalent among those aged 40-59 years.
Classification of weight by BMI in adult Asians (WHO-Western Pacific Region 2000)
| Classification | BMI kg/m2 | Risk of co-morbidities |
| Underweight | <18.5 | Low (but increased risk of other clinical problems) |
| Normal | 18.5-22.9 | Average |
| Overweight | ³ 23 | |
| At risk | 23-24.9 | Increased |
| Obese I | 25-29.9 | Moderate |
| Obese II | ³ 30 | Severe |
The sweet definition
The IDF defines “diabetes mellitus” as a
chronic condition where the pancreas does not produce enough insulin or the body cannot effectively use the insulin produced. The result is hyperglycemia—abnormally high concentration of glucose in the blood.
The World Health Organization defines diabetes as a metabolic disorder with defects in insulin secretion, action or both resulting in chronic hyperglycaemia producing long-term damage, dysfunction and failure of various organs.
The diagnosis of diabetes requires a fasting plasma glucose (FPG) level of over 126 mg/dL on two separate occasions. A single random blood sugar (taken regardless of the last meal) of more than 200 mg d/L with the three classic P’s (polyuria (frequent urination especially at night), polydipsia (frequent drinking) and polyphagia (frequent eating), also defines diabetes.
An oral glucose tolerance test (OGTT) is the gold standard for diagnosis. A non-pregnant adult takes 75 grams of glucose and his FBS, 1 hour and 2-hour sugar levels are measured. A FBS more than 126 mg/dL or a 2-hour sugar level more than 200 mg/dL also confirms diabetes. Values between 101 and 125 mg percent of FBS and a 2-hour post glucose level of 140-200 mg/dL is impaired glucose tolerance (IGT), a pre-diabetic condition.
Sugar, sugar, everywhere
How does diabetes come about?
Rice, bread, potatoes—any carbohydrate we eat—is broken down in our stomachs by digestive enzymes into glucose. This is sugar’s simplest form, the raw material that generates the body’s energy. Protein and fat are alternative glucose sources which are stored in muscle and fat tissue and mobilized when we are fasting.
Normally, after a meal, the sugar in our stomach triggers sensors that alert the pancreas, a small factory that lies behind the curve of the stomach. Special cells, the b-cells of the islets of Langerhans, discharge stored insulin in two bursts, an immediate tall spike that lasts approximately 10 minutes, followed by a second, smoother curve that releases insulin in a steady stream (but smaller amplitude) that brings down glucose levels to normal.
Insulin is a hormone, a chemical messenger that docks on insulin receptors on every cell in the body—especially in insulin sensitive tissues: the liver, muscle and fat cells—and sets off a complicated chain reaction that allows specific transporters to pick up glucose waiting outside the cell doors. Once inside the cell, glucose undergoes a chemical cycle in the mitochondria, the cell’s powerhouse, which generates energy so our hearts can pump, so we can breathe, think, see, and speak, live.
When insulin receptors are less responsive to the effect of insulin, a state of insulin resistance results. Higher-than-normal amounts of insulin are necessary to maintain blood sugars at normal levels. In spite of the high levels of insulin, the insulin signal inside the cell is weak and fewer transporters travel to the cell wall to pick up the waiting glucose. Much less glucose enters the cell.
Because of insulin resistance, the pancreas works overtime to produce extra insulin. Unfortunately, the pancreas cannot keep this up for long, and the compensatory mechanism fails. Eventually, the b-cells are exhausted, insulin production drops and fasting blood glucose levels rise above 126 mg percent—the diagnostic cut off for diabetes. At diagnosis, pancreatic ß cell function is only about 50 percent, and declines about 4 percent per year.
This deficiency in b-cell insulin production together with a resistance to the effect of insulin in the body’s tissues, results in Type 2 diabetes mellitus.
The diabetic has sugar everywhere but the body cannot use it properly. In the midst of plenty the body starves for glucose. The liver, the hub of glucose production, makes even more sugar from glycogen, its storage form. Once its own stores have run out, the liver pulls out protein and fat stores and manufactures more sugar. The problem is, all that extra sugar is useless and inflates the glucose levels further. It is a destructive cycle. Excess glucose is toxic to cells; it damages small and large arteries, oxidizes blood and lipids, leaks out in the urine, drawing water along with it causing frequent urination. Because the body wastes all its energy and cannot store any, the patient loses weight and has to eat voraciously to replenish himself.
By the time the full clinical spectrum of diabetes (frequent urination, extreme thirst and hunger) is manifest—some 10 to 15 years after the problem begins—the diabetic has numerous accompanying complications (hypertension, abnormal cholesterol levels, heart disease, kidney disease, etc).
Why is having diabetes such a big deal?
Counting complications and costs
Diabetes is a disease that affects the entire body. It is not only about the blood glucose; other metabolic markers like cholesterol and lipids are also abnormal. The chronically high blood sugar damages small blood vessels of the retina and kidneys, and the large vessels of the heart and aorta, which can lead to heart attack and stroke.
Diabetic complications fall into two groups: short-term and long-term complications.
Short-term (acute) complications include low blood sugar, diabetic coma, lactic acidosis, and infections.
Low blood glucose (hypoglycemia): When the blood glucose drops too low (as the result of too much insulin, too much exercise or not eating enough food), a person cannot function
normally. He may feel light headed, be sweaty, his hands could shake, and if his blood sugar is too low, he may become disoriented, drowsy or lapse into a coma. Eating some sugar, sucking on a sweet or drinking half a glass of soda or juice can rapidly reverse the problem. If the PWD is unconscious, he should not receive anything by mouth. He should be rushed to the nearest Emergency Room.
Diabetic ketoacidosis (DKA), or diabetic coma, is a severe condition resulting from a lack of insulin. It affects mainly people with Type 1 diabetes. Some usual causes include missing medication (insulin or tablets) and an infection. DKA may also herald diabetes in up to a third of patients. The patient is typically dehydrated, has trouble breathing, may complain of abdominal pain, has very high sugar levels and an acidic blood pH. Physicians may sometimes smell acetone on the breath. The patient requires intensive care, insulin, salt, potassium and water replacement. Identifying and treating infections with the appropriate antibiotics is important.
People with diabetes, especially if blood sugar is not well controlled, are more prone to bacterial and fungal infections. Bacterial infections include styes and boils. Fungal infections include athlete’s foot, ringworm and vaginal infections. Physicians will often prompt a search for diabetes in patients with wounds that heal slowly, or have infections that deteriorate rapidly. Another problem is that infections in PWD are often from multiple types of bacteria, which do not usually cause infection and are resistant to broad-spectrum antibiotics.
Long-term complications are a consequence of high blood glucose over a long period.
Glucose toxicity damages large and small blood vessels and nerves. Left unchecked, this can cause the following complications:
Eye disease: Retinopathy (new blood vessel formation in the retina of the eye) is the major cause of blindness and visual impairment in adults. About 2 percent of all people who have had diabetes for 15 years become blind, while about 10 percent develop a severe visual impairment, including cloudy lenses (cataracts).
Kidney disease: Kidney disease, or nephropathy, is a major threat to people with diabetes.
By the age of 50, about 40 percent of people with type 1 diabetes develop severe kidney disease that may require dialyses and/or kidney transplant. One third of new dialysis cases in the United States are PWD. The earliest sign of nephropathy is evidence of protein in the urine.
Nerve disease: Diabetic nerve disease, or neuropathy, affects at least half of all people
with diabetes and reduces sensation in the legs and feet in the classic stocking and glove distribution. Patients are prone to injury, ulceration and amputation. Diabetes is the most common cause of lower-limb amputation that is not the result of an accident. Diabetic nerve disease can also lead to impotence or erectile dysfunction in more than 50 percent of men.
Cardiovascular disease: Disease of the circulatory system is the leading cause of death, the risk of heart disease or stroke increases two to five times in people with diabetes. Two out of every three persons with diabetes will die from a cardiovascular complication. Poor circulation in the legs (peripheral vascular disease) together with neuropathy, might lead to amputation.
In the Philippines, the average PWD has no comprehensive health insurance and must shoulder his own expenses for consultation and medication. Compliance is a major problem, mainly because of economic factors. Patients consult only when their health problems are severe. By then it often too late to ward off complications.
No quick solutions
The solution to diabetes and obesity is not simple. Therapeutic lifestyle changes: making the right choices from meal-to-meal and getting more physical are the foundation of the rest of the patient’s life. Though pharmacotherapy may be necessary at some point, medications are only adjuncts to lifestyle. It’s not a quick fix; diabetes and obesity require a change in lifestyle to address the problem.
Burn fat, drop kilos
Weight loss is huge. More than any lifestyle variable, the loss of even 5-10 percent of initial body weight improves and may even reverse all the risk factors of the metabolic syndrome. It improves blood pressure, lipid abnormalities and blood sugar control.
However, this is easy to say and hard to do. To lose weight, the body needs to burn more energy than we take in as food. We need to restrict the amount of food we eat overall.
The key change to make is to increase servings of fruits, vegetables, and high-fiber whole grains, fish and low-fat dairy products that are nutrient-dense and low energy foods to displace the intake of low-nutrient, high-calorie foods.
The goal of dietary therapy is an energy deficit of 500-1000 kcal/d, leading to a weight loss of no more than 1-2 lb/wk. This way you keep weight off slowly, but surely.
Everyone benefits from regular physical exercise. By itself, exercise produces much less weight loss than restricting calories alone. Moderate physical exercise—between 30-60 minutes a day—optimizes maximum oxygen uptake, increases basal energy expenditure and improves cardiovascular fitness. The US Surgeon General advocates brisk walking of 3 miles a day and resistance training 3 times a week.
For an exercise program to be sustainable the activity should be fun and something the patient enjoys, ideally incorporated into his daily activities.
A comprehensive physical activity prescription should include warm-up and cool-down periods, with exercises that help:
Improve cardiovascular fitness
Increase strength with resistance training
Enhances flexibility through a wide range of motion
Heavy cross, sweet life
Diabetes and obesity co-exist in more than 50 percent of patients. It’s almost a chicken-and-egg quandary to which came first. Obesity and diabetes are chronic illnesses, a lifetime burden, and heavy crosses to carry.
Once the PWD accepts the life-altering diagnosis and recognizes his responsibility, educates himself about the disease, follows nutrition and exercise recommendations, takes his medication regularly and sees his physician faithfully, he can achieve good control over his diabetes.
Though the diagnosis of diabetes is forever, there still can be a sweet happily-ever-after. And although desirable body weight may be an elusive goal, tolerance, understanding and a little encouragement goes a long way in helping the vertically challenged someday reach not for the sky, but for their toes.
To Paul Zimmet, the bottom line is, “Tackling diabetes and obesity is likely to be one of the most important challenges for the global public health community in the 21st century. It is a battle that we can and must win.”
For the sake of our children, and our children’s children, still unborn, we must win.
| Cancer Cells in Our Body? | for everyone |
Cancer Cells in Our Body?
Health@Heart
Philip S. Chua, M.D., FACS, FPCS
THE internet is recently flooded with a medical claim that is scaring the public. Circulating in the email world is the statement that says “normally, we all have dormant cancer cells in our body.” Implied is the assertion that all healthy people are walking around with a time bomb within them, ready to explode.
This senseless and unkind fabrication is obviously the work of someone with an ignorant, or confused, if not twisted, mind.
The healthy person does not carry any cancer cell in their body, period. If every tissue in the body of a normal person is biopsied, or if a person who dies of any non-cancerous disease, like heart attack or stroke, or trauma, is autopsied from head to foot, no cancer cells will be found. The only exception to this is if the person had an undiagnosed cancer, which is incidentally found on autopsy, a finding that excludes this person from being healthy in the first place.
Therefore, all healthy individuals, from birth to adulthood to their death, do not normally carry, or have, any cancer cells in their body, unless they develop a malignancy. If they abuse themselves and subject their body to carcinogens, substances or toxins that cause cancers, then the tissues of the organs involved (like the lungs among smokers, the esophagus or food pipe, and the liver, among alcoholics) could be so irritated and damaged by the toxic agent for the cells of those tissues to change into cancer cells.
Normal cells
The normal cells our body came with when we were born have a pre-determined growth pattern and final adult size, from infancy to adulthood. As the cells, tissues and organs attain their normal number and size, the cell growth ceases at the right time. That is why our organs, our body as a whole, have the average sizes and shapes, according to our genetic make-up. There is no run-away, uncontrolled, growth in cases of normal cells. Muscle cells are greater in mass and stronger among those who exercise daily, especially among body builders. Fat cells increase in number and size when we overeat and become overweight. But even these “growths” are still within the expected “norm.”
From time to time, as our activities and lifestyle “damage” our cells as a result of the wear and tear in our body, our older cells (including blood cells) die and are replaced by new cells efficiently and automatically. An example of this is our dead skin, which flakes off, to be replaced instantly by new skin. Worn out or dead cells in a normal body are constantly replaced with new ones almost every day. But all this happens in an organized, systematic, orderly, and “disciplined” process. Our body system’s self-protective and auto-control mechanisms are always in control maintaining our health. If we do something that will adversely alter this natural internal balance and harmony, then disease sets in.
Cancer cells are something else
Cancer cells are different. They grow and divide with blatant disregard for the body’s needs and limitations. They do not stop reproducing. There is random multiplication and replication that it out of bounds, without order and direction. These cells become very aggressive, attacking tissues and organs nearby, as in malignant tumors, where in many cases even spread to, and destroy, distant organs (like in cancer of the lungs with metastases to the brains, bones, adrenals, etc).
Unless cancer cells are treated effectively to induce cure or remission when they first form, they are unstoppable in their growth and aggressiveness. This behavior and characteristic of cancer cells alone are a self-evident proof that normal healthy bodies do not have what is claimed as “dormant cancer cells.” If any cancer cell forms in a person’s body, it will continue to grow and multiply unceasingly and be clinically obvious in a matter of weeks or months in almost all cases.
Oncogenes
Normal (non-cancerous) cells have a regulated, well-controlled, cell division and growth, thanks to the genes that produce proteins that provide such auto-regulation and control. These are the proto-oncogenes and tumor-suppressor genes, which regulate the cell cycle and keep the cells in good control. Tumor-suppressor genes produce proteins that prevent the uncontrolled cell growth and abnormal cell division.
When the cells are constantly exposed to cancer-causing agents (either toxic substances, chemicals in food or drinks, excess sunlight, radiation, etc.), the body produces an abnormal proteins called oncogenes which cause the cells to lose their ability to control their regul