Health File

The Importance Of Eating–Earnest!

Eating well–that is, getting the right balance of nutrition and calories–is not easy at the best of times, but it is especially important for the elderly. A study conducted Down Under showed just how vital a good diet is.

Researchers at Sydney, Australia’s Prince of Wales Hospital found that hospitalized elderly patients recovered much more quickly if their dietary care was improved by supervision, advice and nutritional supplements.

Dr. Terry Bolin, a gastroenterologist and professor at the University of New South Wales, led a team in studying 100 patients whose average age was in the 80s. After analyzing questionnaires about food habits and taking measures such as leg circumference around the calf muscle, the researchers found that four out of five patients were either malnourished or close to it. Bolin suggested that the seniors–even the ones who appeared healthy–were having trouble absorbing the nutrients from their food.

Fifty of the seniors were then randomly assigned to receive individual care from a dietitian and help with eating, along with protein and energy supplements. As a result, they were discharged from the hospital on average 10 days after admission; the other group, who were given standard meals, were discharged after an average of 19 days.

Bolin observed that more needs to be done about malnutrition in seniors–and that early intervention is key. “If one can identify them at a younger age, one may prevent many complications,” said Bolin. Not only would this be beneficial to seniors, he noted, but it would save the health-care system hundreds of millions of dollars.

Another study, conducted in the Maritimes, determined that simple changes to the way food is presented in nursing homes could make a big difference in reducing high rates of malnutrition. “It’s not the quality of food that’s at issue,” observed Gale West, a sociologist at Laval University in Quebec City who co-wrote the study with two nutritionists. “On a given day on a given plate, residents will only eat what they like and leave what they don’t like. So a lot of an otherwise balanced diet gets thrown out.”

Her suggestions for improving the residents’ nutrition included partly opening pre-packaged food items and improving the variety of the food. West observed, “If (residents) see the same food too frequently, they simply get bored and eat less.”

Spotlight On Mental Health

Just after Prime Minister Stephen Harper announced the board of directors for the new Mental Health Commission of Canada on Aug. 31, the World Health Organization highlighted the fact that, throughout the world, half of all people with severe mental disorders are not receiving any treatment. The lack of attention is even more pronounced for those who have mild to moderate disorders.

“The current situation means that people with mental illnesses are at best ignored and at worst actively discriminated against in many countries,” observed Dr. Benedetto Saraceno, WHO director of mental health and substance abuse. “We can only improve the services available to people with mental disorders if there is a major and rapid increase in investment in this area.”

A global study conducted by WHO researchers also found that depression is harder for people to bear than other chronic, non-fatal conditions such as asthma, arthritis, angina and diabetes. The study, which took into account self-reported health data for 245,404 adults from 60 countries, was published in the British medical journal, The Lancet. Lead author Saba Moussavi concluded, “Our findings are consistent with earlier studies that have shown a high degree of association between depression and disability.”

The Harper government committed $55 million over five years towards the Mental Health Commission, which has the goal of reforming mental health policies, improving services and working to diminish the stigma attached to mental illness. “The commission will improve quality of life for Canadians dealing with mental illness and their families,” declared Harper. “It will seek to ensure Canadians in every part of the country will have access to the best possible prevention, diagnosis and treatment practices.”

Michael Kirby is chairing the commission. One of his accomplishments during 22 years in the Senate was to produce Out Of The Shadows, the first-ever national report on mental health, mental illness and addiction.

Short-Term Shame, Long-Term Gain

It’s no secret that early screening is crucial in diminishing the possibility of developing cancer. Unfortunately, there is a lack of adequate screening when it comes to colorectal cancer, the second-deadliest form of cancer in Canada. Every year, some 8,700 Canadians die of this disease.

Even more unfortunate is the fact that thousands of those people could have been saved if the cancer had been detected and treated at an earlier stage. Embarrassment on the part of patients, reticence or ignorance on the part of doctors, and lack of a national screening program are a few of the factors that need to be overcome.

A recent editorial in the Canadian Medical Association Journal stated unequivocally that physicians must “address their own ignorance and reticence and accept their duty to begin informing and persuading their patients to be screened.” The editorial also noted that a considerable number of malpractice actions against primary care physicians “result from a delay in colorectal cancer diagnosis.”

The Canadian Task Force On Preventive Health Care recommends that people aged 50 and older and at average risk–with no family history of the disease, inflammatory bowel disease or other risk factors–should have a fecal occult blood test every year or two, or should undergo a periodic sigmoidoscopy. The former procedure detects blood in the stool, which is often the only warning sign of colorectal disease. A sigmoidoscopy enables a physician to check the lower part of the large intestine for polyps, tumours or other irregularities through the rectal insertion of a short, flexible tube with a light at one end.

A colonoscopy, where a long tube with a camera is inserted into the rectum to check the bowel from the inside, is even more invasive. But it is necessary to detect irregularities in the upper part of the intestine.

Fewer than 18 per cent of at-risk Canadians are being appropriately screened, according to a large study conducted by Dr. Ryan Zarychanski, a physician researcher at the Ottawa Health Research Institute. He and fellow researchers came to this conclusion after analyzing nearly 13,000 responses from the 2003 Canadian Community Health Survey. The responses came from residents of B.C., Saskatchewan, Ontario and Newfoundland and Labrador.

“The proportion of people at average risk who reported having colorectal cancer screening in Canada is exceptionally low,” commented Zarychanski. “This is true despite published guidelines and a widespread belief among physicians that screening for colorectal cancer is worthwhile.” He added that contact with a family physician increased the odds of screening.

Several provinces, including Alberta, Manitoba and Ontario, have announced screening programs, but no national strategy is in place. In the United Kingdom, where a national screening program is being rolled out, more than half of the eligible people are participating.

Besides visiting a doctor and getting screened, everyone–not just those over 50–can take steps to prevent colorectal cancer. The Colorectal Cancer Association of Canada recommends eating a high-fibre diet, getting regular exercise and maintaining a healthy weight. There is some evidence showing that calcium, vitamin D, folic acid and selenium may reduce the risk of developing colon cancer, but consult a doctor for advice on supplementation.