Alimentarydeficiencydiseases

ALIMENTARYDEFICIENCYDISEASES

 

                               САНКТ-ПЕТЕРБУРГ

 

     2019

 

Составители: Могилева И.И., Гальфанович И.Л., Дайнеко М.Ю., Константинова Ю.А., Слободчикова М.П., Тюмина Л.М., Бранис И.Е.

 

Пособие включает: часть 1. Питание и здоровье – общая информация и распространенные проблемы (Плохой аппетит, ожирение). Часть2. Витамины. Часть 3. Рахит. Часть 4. Заболевания крови (анемия разных видов, гемофилия, тексты о крови, переливании) и трансплантации пупочной крови и ее стволовых клеток). Большинство текстов 1-4 частей сопровождаются лексическими упражнениями и предназначены для активного обсуждения изложенной в них информации обучающимися.Часть 5. Грамматические упражнения (35). Часть 6. Тексты о зависимостях (курение, алкоголь, наркотики). Часть 7. Лексические тесты по пройденному материалу. Часть 8

 Тексты разнообразной медицинской тематики для изложения, дискуссии, ролевых игр.

ALIMENTARY DEFICIENCY DISEASES

I. NUTRITION AND HEALTH

(General Information, Common Problems)

NUTRITION, MALNUTRITION AND IMPROPER DIET

Nutrition is one of the most important factors affecting people’s health and working capacity. Normal development of a child very largely depends on proper nutrition. Nutrition is one of the most therapeutic agents in medical practice. Nutrients coming from food are essential to us. With these, we can move about, see, hear, taste, speak, smell, feel, think, learn and remember, sing, walk, run, play and enjoy life. Without all the 40 to 45 nutrients none of these things so characteristic of human life is possible.

 

The quantity and composition of food required by a person depends on his or her age, stature, character of work etc. In making up a diet it is necessary to consider the need of the organism not omly in proteins, carbohydrates and fats, but also in vitamins and mineral salts. According to the contemporary classical medical notion, the diet must contain the different nutrients in different proportions. It must contain proteins and fats of animal origin, but vegetable fats and proteins must not be excluded either. One should keep it in mind that different foodstuffs are differently assimilated. A combination of various food best satisfies all the requirements of rational nutrition, or well-balanced diet.

Assimilation of food depends on how it is cooked, and under what conditions and how many times

a day it is ingested. Palatable delicious food taken at definite time is digested better and more rapidly. A lot of various diets have been invented to solve health problemsAs medical knowledge increases and the range of diseases changes with time, new ones keep appearing, each of them excluding certain kinds of food as harmful.

Millions of people, most of them children, suffer from diseases associated with malnutrition in Africa and other poor countries. In children poor food supply retards both mental and physical growth and development. In addition, malnutrition severely impairs the body’s resistance to infections or toxins coming not only from food, but also from the environment. The poor nutrition of the majority of developing countries population results in higher mortality and more severe disease cases than in the industrialized countries.

However, even in countries with a good food supply improper, poorly balanced, diet has been shown to be associated with quite a few conditions causing either deficiencies or overnutrition affecting a child’s health. In case of surplus food obesity and both physical and mental problems may result from it. Moreover, certain diet defects during pregnancy or childhood proved to harm health severely in the later life.

 

 

Diet, nutrition and the prevention of chronic diseases
Report of the joint WHO/FAO expert consultation

Executive summary

The WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases met in Geneva to examine the science base of the relationship between diet and physical activity patterns, and the major nutrition-related chronic diseases.

Recommendations were made to help prevent death and disability from major nutrition-related chronic diseases. These population nutrient intake and physical activity goals should contribute in the development of regional strategies and national guidelines to reduce the burden of disease related to obesity, diabetes, cardiovascular disease, several forms of cancer, osteoporosis and dental disease. They are based on the examination and analysis of the best available evidence and the collective judgement of a group of experts representing the global scope of WHO’s and FAO’s mandate.

Key findings include:

Obesity: the imbalance between declining energy expenditure due to physical inactivity and high energy in the diet (excess calories whether from sugar, starches or fat) is the main determinant of the obesity epidemic. Increasing physical activity, plus reducing intakes of foods high in fat and foods and drinks high in sugars, can prevent unhealthy weight gain. Taking these simple goals to concrete action requires major social and environmental changes in order to effectively promote and support healthier choices at the individual level.

Diabetes: excess weight gain, overweight and obesity and physical inactivity account for the escalating rates of type 2 diabetes, worldwide. Diabetes leads to increased risk of heart disease, kidney disease, stroke and infections. Increased physical activity and maintaining a healthy weight play critical roles in the prevention and treatment of diabetes.

Cardiovascular diseases: cardiovascular diseases, the major killers worldwide, are to a great extent due to unbalanced diets and physical inactivity. Risk of their main forms, heart disease and stroke, is reduced by eating less saturated and trans fats, and sufficient amounts of (n-3 and n-6) polyunsaturated fats, fruits and vegetables and less salt, as well as by physical activity and controlling weight. Reduction of salt intake helps reduce blood pressure, a major cause of cardiovascular diseases.

Cancer: tobacco is the number one cause of cancer, but dietary factors contribute significantly to some types of cancer. Maintaining a healthy weight will reduce the risk for cancers of the oesophagus, colorectum, breast, endometrium and kidney. Limiting alcohol intake will reduce risk for cancers of the mouth, throat, oesophagus, liver and breast. Ensuring an adequate intake of fruit and vegetables should further reduce risk for oral cavity, oesophagus, stomach and colorectal cancer.

Osteoporosis and bone fractures: fragility fractures are a problem of older people. Adequate intakes of calcium (500 mg per day or more) and of vitamin D in populations with high osteoporosis rates helps to reduce fracture risk, so does sun exposure and physical activity to strengthen bones and muscles.

Dental disease: caries is preventable by limiting the frequency and amount of consumption of sugars and by appropriate exposure to fluoride. Erosion of teeth by dietary acids in beverages or other acidic foods may contribute to tooth destruction.

The crucial role of physical activity as part of nutrition and health was acknowledged. Physical activity is a key determinant of energy expenditure, and thus fundamental to energy balance and weight control. The beneficial effects of physical activity on the metabolic syndrome are mediated by mechanisms beyond controlling excess body weight.

Physical inactivity is already a major global health risk and is prevalent in both industrialized and developing countries, particularly among the urban poor in crowded mega cities. Measures and policies required to promote healthier food consumption patterns and facilitate a physically active life share common grounds and are mutually interactive in determining healthier behaviours.

Healthy diets and physical activity are key to good nutrition and necessary for a long and healthy life. Eating nutrient dense foods and balancing energy intake with the necessary physical activity to maintain a healthy weight is essential at all stages of life. Unbalanced consumption of foods high in energy (sugar, starch and/or fat) and low in essential nutrients contributes to energy excess, overweight and obesity. The amount of the energy consumed in relation to physical activity and the quality of food are key determinants of nutrition related chronic disease.

Not all fats are the same, it pays to know the difference. The scientific complexities of these issues should not obscure the simple messages required to orient and guide consumers. People should eat less high-calorie foods, especially foods high in saturated or trans fats and sugar, be physically active, prefer unsaturated fat and use less salt; enjoy fruits, vegetables and legumes; and select foods of plant and marine origin. This consumption pattern is not only healthier but more favourable to the environment and sustainable development.

To achieve best results in preventing nutrition-related chronic diseases, strategies and policies should fully recognize the essential role of both diet and physical activity in determining good nutrition and optimal health. Policies and programmes must address the need for change at the individual level as well as the modifications in society and the environment to make healthier choices accessible and preferable.

In communities, districts and nations in which widespread, integrated interventions have taken place, dramatic decreases in NCD-related death and disability have occurred. Successes have come about where people have acknowledged that the unnecessary premature deaths that occur in their community are largely preventable and have empowered themselves and their civic representatives to create health-supporting environments.

This has been achieved most successfully by establishing a working relationship between communities and governments; through enabling legislation and local initiatives affecting schools and the workplace; involving food producers and processing industry. Beyond the rhetoric, this epidemic can be halted – the demand for action must come from those affected. The solution is in our hands.

This report is only the first step in a process that includes consultations with governments, as well as other public and private sector stakeholders in all geographic regions, to culminate in the formulation of a Global Strategy on Diet, Physical Activity and Health, to be considered by the World Health Assembly.

LACK OF APPETITE

 

 

One of the most frequent complaints mothers make to doctors is that their child has lost his appetite. The mother’s anxiety over her child‘s poor appetite is well-founded, as every mother knows that a healthy appetite is a sign of the child’s health. Lack of appetite is associated with many illnesses of childhood, but then there are also other signs which mother usually notices. If the cause is some illness the doctor will diagnose it and prescribe treatment, and the child’s appetite will improve as his health improves. However, feeding problems mostly arise in perfectly healthy children as the result of mismanagement of nutrition, feeding and care.

To understand the causes leading to loss of appetite one must understand the nature of appetite itself. To-day it has been proved by the experiments of Ivan Pavlov and his followers that digestion is regulated by the nervous system. There is in the child’s brain, as in the adult’s brain, a food centre the condition of which determines whether the individual feels hungry or full. If the food centre is in an excited state the person feels hungry. If the food centre is in a state of repression, or inhibition, the desire for food – the appetite - will deteriorate or disappear. Both excitation and inhibition of the food centre are associated with changes in the constituents of the blood flowing in this area of the brain. Depletion of the blood of nutritive substances stimulates the digestive centres; this stimulation or excitation is transmitted to the salivary glands and the glands secreting gastric juices, and also to the corresponding muscles.

 It is important to feed children at definite times over strictly definite intervals differing in children of different ages. If a definite feeding schedule is not observed and the baby has his food irregularly, he will not be hungry and refuse his food at the feeding hours. A particularly harmful effect on appetite is produced by sugar and various sweets when given to children before or between meals. An important point in serving the meals of older children is setting the table. If mothers set the table attractively and make preparations for the meal, the activity of the digestive glands will be stimulated, and the child’s appetite will improve. Normal appetite depends to a great extent on a properly managed schedule. Children must play outdoors, sleep and eat at fixed hours. If children do not spend much time in the fresh air, they are commonly poor eaters.

 Children must not be overfed, neither must they be given too much high-calorie food or fats in excess. Fat, if there is too much of it, will inhibit gastric juice secretion, disturb protein digestion, and thus finally will impair the appetite. Poor appetite may be connected with a decreased function of the salivary glands. In such cases children keep their food in the mouth for a long time, not being able to swallow it. These children should be taught to take their food in very small amounts at a time; they should also be given a little water to drink during the meal; the moistened food will be easier to swallow. As the child becomes older his appetite usually becomes normal; however all measures should be taken to ensure a healthy appetite at all meals.

Active Words to remember:

Lack; to lose appetite; to associate; to notice; nutrition; loss; to prove; to be excited; desire; inhibition; juice; harmful; to improve; to a great extent; impair; properly; 

to manage; to feed (overfeed); to disturb; to decrease; to moisten; to ensure; meals; to flow.                            

 

 EXERCISES

1. Answer the following questions:

 

1.Why are mothers anxious over the poor appetite of their children? 2. What may lack of appetite be connected with? 3. What is the nature of appetite? 4. When do we feel hungry or full? 5. What are excitation and inhibition of the food center associated with? 6. What stimulates the digestive center? 7. What factors does normal appetite depend on? 8. What may poor appetite be connected with? 9. Why is it not good to give children fats in excess?

 

 

II. Put all possible questions to the following sentences:

 

1. Mothers often complain to doctors that their children have lost their appetite. 2. To understand the cause leading to loss of appetite one must understand the nature of appetite itself. 3. If the food center of the brain is in a state of inhibition the child does not feel hungry. 4. Children must play outdoors, sleep and eat at fixed hours. 5. It is most harmful to give children various sweets between or before meals. 6. The sight of the attractively set table stimulates the activity of the digestive glands and improves the child’s appetite. 7. Normal appetite depends on a properly managed daily feeding schedule.

 

 

III. Group the following words into pairs with opposite meanings:

 

1. decrease                                          a. useful

2. improve                                          b. full

3. healthy                                                c. irregular

4. harmful    d. disappear

5. inhibition                     e. impair

6. hungry                     f. increase

7. regular                                                 g. rarely

8. stimulate

appear                    i. impair

10. frequently                                           j. sick       

 

OBESITY

 

 

Obesity in children is actually more frequent than those cases when  overweight children come for treatment. Parents are inclined to overlook obesity in a young child and to resent having attention to it.

Pathogenesis. Children grow fat when they persistently eat more than they need. At the same time there is usually marked physical inactivity. Obesity is only the symptomatic expression of some underlying disturbance in the weight-regulatory mechanism. In most children the reflex tends to persist into adult life.

Symptoms. Physical complaints due directly to the burden of weight are relatively rare in otherwise normal obese children. However, we know obesity to be a troublesome complication in children with cardiac conditions, diabetes and orthopedic disorders. Increase in blood pressure is frequently associated with severe degrees of obesity. Fatigue, perspiration, poor coordination and shortness of breath may be due to overweight, but these symptoms may also be related to emotional factors. Their real suffering is experienced in the field of social relations. They often become objects of ridicule and are excluded from the activities of their age group. The social and psychological problems which obesity creates for a child become more serious with increasing age. Obesity in an adolescent may lead to his or her complete withdrawal.

 

Treatment. As a physiological problem the treatment of an obese child is simple. Doctors suppose diet restriction alone or combined with increased physical activity to invariably result in a predictable loss of weight. In a rapidly growing child who is only moderately overweight, it may not be necessary or desirable to plan for weight reduction. It may be preferable merely to retard or arrest the rate of gain until the child grows up to his weight. Caution should be exercised in employing complete starvation as a therapy for obesity. It may be done only under a strict doctor’s supervision.

 

Metabolic Syndrome, an Epidemic of the 21^st Century

Obesity is closely associated with a so-called metabolic syndrome which has been recognized to be an epidemic of the 21^st century. The metabolic syndrome is a condition combining a group of risk factors leading to heart diseases, stroke, diabetes. The syndrome presents as a complex metabolic, hormone and clinical disorders. The metabolic syndrome depends on the tissue resistance to insulin. One of the basic signs of the metabolic syndrome is considered the presence of extra fatty layer in the waist area (visceral obesity). The adipose (fatty) tissue is a large endocrine organ. It is a source of diabetogenic, atherogenic and pro-inflammatory biologically active substances. The therapy of the metabolic syndrome focuses on the efforts to lose weight, especially in case it is accompanied by high blood pressure.

 

Active words to remember:

 

Obesity, to be inclined, avoidance, to persist, to respond, to achieve, to justify, to predispose, perspiration, to experience, adjustment, restriction, to retard, to arrest, caution, starvation, withdrawal.

 

EXERCISES

 

I.. Fill in the gaps with suitable words from the list in brackets.

 

(in spite of; either … or; not only … but also; both … and; that; after; and; before; if; for;)

 

1.Eating … … serves to appease bodily hunger … … is charged with emotional significance. 2. … the mother’s diet is insufficient, the milk will be poor in quality. 3. Parents should know … obesity may develop at any age. 4. The typical obese patient tends to be … broader … taller than his age peers. 5. This child is … in a state of blooming health with excellent nutrition … suffers from obesity.6. The child’s health was poor … … … the fact that he was carefully nursed. 7. Avoidance of fats is not necessary … in most individuals they inhibit gastric emptying and delay the onset of hunger. 8. In some instances there is colic … some food is ingested to which the patient is allergic. 9. Parents’ questions concerning hygienic … general care of infants engage an increasing proportion of the time of the pediatrician. 10. A baby must learn to creep … he begins to walk.

 

 

II. Translate sentences into Russian.

 

1.Excessive eating and avoidance of activity influence the child’s personality development and life experiences. 2. An evaluation of the emotional problems of an obese child and an appraisal of the difficulties inherent in his family interrelationships constitute a necessary part of the diagnostic study. 3. Mere weight reduction without attention to underlying problems will almost invariably be followed by another increase in weight. 4. Vitamin deficiency is to be prevented. 5. Although opinion as to how often to feed the baby varies, most doctors seem to favour a three or four hour schedule. 6. Obesity is the result of positive energy balance. 7. Caloric intake is regulated in accordance with energy expenditure. 8. Food requirements of individuals are affected by several factors: muscular activity, age, weight, pathologic conditions, climate etc. 9. The most rapid growth period in a child’s life is the first months.

 

II. VITAMINS

 

Vitamin A

Its chemical names are: retinol, retinal, and four carotenoids, including beta carotene. Its deficiency may cause night-blindness and an eye disorder that results in a dry cornea. Its good sources are believed to include: liver, butter, cheese, milk, egg, cod liver oil, orange vegetables and fruit (carrots, pumpkin, apricot, melon), broccoli and some types of cabbage (kale), spinach.

Vitamin B

There is a group of Vitamins B which are known to be important for the functioning of our nervous system. Their chemical names are: thiamine (B1), riboflavin (B2), pantothenic acid (B5), folic acid (B9) etc. They are found in yeast, whole grains (milling removes the vitamin), cereals, sunflower seeds, meat, liver, heart, kidneys, some fish (tuna, salmon), eggs, asparagus, kale, cauliflower, broccoli, avocado, tomatoes, bananas, nuts, shellfish and beer (to a moderate extent). Freezing, drying and canning can reduce the content of vitamins.                                                               Vitamin B1 deficiency can cause beri-beri (a kind of neuritis) and Wernicke-Korsakoff syndrome. Vitamin B3 deficiency may lead to pellagra with symptoms of diarrhea, dermatitis and mental disturbances. Vitamin B5 deficiency may result in  paresthesia, or "pins and needles." Vitamin B6.deficiency may cause anemia, peripheral neuropathy, or damage to parts of the nervous system other than the brain and spinal cord.. IVitamin B7 deficiency may lead to dermatitis or enteritis, or inflammation of the intestine. Vitamin B9 deficiency during pregnancy is associated with birth defects. Pregnant women are encouraged to supplement folic acid for the entire year before becoming pregnant. IVitamin B12 deficiency may result in megaloblastic anemia, a condition where bone marrowproduces unusually large, abnormal, immature red blood cells

Vitamin C

Its chemical name is: ascorbic acid. Its deficiency may lead to megaloblastic anemia, its long deficiency is known to have produced scurvy. Its good sources include: fresh fruit and vegetables. Liver also has high levels of this vitamin. Cooking and storing destroy vitamin C.

Vitamin D

Its chemical name is: ergocalciferol. Its deficiency may cause rickets and osteomalacia, or softening of the bones. Its good sources consist in: exposure to ultraviolet radiation(through sunlight or other sources).This causes vitamin D to be produced in the skin. It is also found in fatty fish, cod liver oil, eggs, beef liver, and mushrooms.

Vitamin E

Its chemical name is: tocopherol. Its deficiency is uncommon, but it may cause hemolytic anemia in newborns. This is a condition where blood cells are destroyed and removed from the blood too early. Its good sources include: kiwi fruit, almonds, avocado, eggs, milk, nuts, leafy green vegetables, unheated vegetable oils, and whole-grains.

Vitamin K

It is fat soluble. Its deficiency may cause bleeding diathesis, an unusual susceptibility to bleeding. Its good sources include: leafy green vegetables, avocado, kiwi fruit. Parsley also contains a lot of vitamin K.

Avitaminosis caused by a long deficiency of a vitamin is considered a disease. Examples of them are rickets, beri-beri, pellagra and scurvy. Any avitaminosis is likely to be accompanied by general symptoms like: rapid fatigue, muscular weakness, low work capacity, increased susceptibility to infections, retarded growth in children. Well-balanced diet containing various food with all kinds of vitamins in proper amounts can prevent vitamin deficiencies.

Explanatory Notes:

viz. – videlicet = namely

etc. – et cetera = and so on; eg. – exempli gratia = for example 

 

 

Active Words to remember:

 

Substance; connection; growth; development; kind; responsible; various; eruption; source; heart failure; a few; as well as; capacity; to reduce; fatigue; sharp; to obtain.

 

EXERCISES.

 

I. Group the following words into 3 groups: nouns, adjectives and adverbs:

 

Nutrition, natural, different, connection, especially, growth, development, responsible, deficiency, serious, widely, various, defective, inflammation, eruption, naturally, weakness, available, special, importance, preventive, quickly, treatment, resistance.

 

II. Give Russian equivalents of the following word-combinations:

 

In connection with; to be responsible for; minute quantities; skin eruptions; to be present in; to a greater or lesser degree, to result in, to be available in, cod-liver-oil; to be of importance; as well as; to be used for; a lack of vitamins; reduced working capacity; rapid fatigue; insufficient amount; retarded growth; a breakdown in the organism.

 

III. Form nouns adding the following suffixes to the given words, translate thegiven and the resultant words intoRussian:

 

(-ment, -th, -ence, -(t)ion, -sion, -ness, -ity)

 

Restless, treat, infect, resist, connect, responsible, exist, mortal, develop, grow, enlarge, erupt, disturb, prevent, ail, appear, contribute, anxious, congest, hoarse, occur, irritable, transmit.

 

IV. Form adjectives adding the following suffixes to the given words, translate the given and the resultant words:

 

(-al, -ant, -ent, -ic, -ive, -ous)

 

Differ, vary, connect, infect, resist, system, result, prevent, experiment.

 

VII. Form adverbs adding ‘ly’ to the following adjectives, translate the pairs obtained:

 

Wide, natural, serious, necessary, easy, correct, particular, active, severe, sufficient, consequent, gradual, total, vital, constant.

 

V. Give the singular of the following words (Some of them are Latin!):

 

Teeth, feet, children, quantities, cavities, possibilities, varieties, foci, data, bacteria, bases, fungi, analyses, strata, bacilli, phenomena, cocci, avitaminoses.

 

VI. In the line find the word nearest in the meaning to the given one:

 

1. to continue: a) to last, b) to shorten, c) to terminate, d) to diminish.

2. to complete: a) to decrease, b) to delay, c) to check, d) to finish.

3. nowadays: a) whenever, b) any way, c) at present, d) by means of.

4. to care for: a) to watch, b) to take care of, c) to note, d) to train.

5. direction: a) incidence, b) institution, c) contribution, d) contraction.

6. immediately: a) gradually, b) regularly, c)at once, d) promptly.

7. available: a) obtainable, b) considerable, c)suitable, d) advisable.

8. to cause: a)to produce, b)to obtain, c) to reach, d) to require.

9. efficiently: a) largely, b) effectively, c) consequently, d) particularly.

10. to vary: a) to offer, b) to involve, c) to change, d) to include.:

 

Sources of vitamins

The 2015-2020 U.S. Dietary Guidelines focus on the overall diet as the best way to get enough nutrients for good health. Vitamins should come firstly from a balanced and varied diet with plenty of fruit and vegetables.However, in some cases, fortified foods and supplements may be appropriate.A health professional may recommend vitamin supplements for people with certain conditions, during pregnancy, or for those on a restricted diet.Those taking supplements should take care not to exceed the dose indicated, as health problems can result. Some medications can interact with vitamin supplements, too.

VitaminNeeds

 

 

Certain organic substances present in the food are essential to the maintenance of the tissues and

regulation of normal functioning of the body.They are classified as vitamins.Chemically these

substances have no particular relationship to one another,but they have many functional similiarities.In general, vitamins are needed in very small amounts. They are related to function

of most cells of the body. Vitamins are important to life.

Normal healthy individuals should obtain their vitamins from food. Drugstore vitamins should

be taken only under medical supervision for special needs. When vitamin deficiency is overcome

the usual food should be relied upon as the vitamin source.

People eficiency of vitamins causes specific destructive diseases. The deficiency is actually a disease.

People may have various degrees of vitamin deficiency. In a mild form symptoms are difficult to recognize and the results of treatment are hard to determine. Frequently vitamin deficiency produces no obvious symptoms, but may have an adverse effect upon general health and efficiency. An actual disease caused by lack of vitamins is called a deficiency disease or avitaminoses.

An excess of vitamins can also produce a disease.The body can excrete water-soluble

Vitamins, but it does not excrete excessive amounts of fat-soluble vitamins like A and This can

result in a serious disease and even in death.

 

The ABCD’s of Vitamins

 In this presentation we will explain what vitamins are and their functions in the body. We will be taking a closer look at four of these vitamins, their function and the consequences when we are deficient in any of them. We all remember taking vitamins as kids, but what exactly are these vitamins and what do they do? Vitamins are essential nutrients needed by the body in small amounts to allow it to grow develop and function normally. In total there are thirteen vitamins needed by the body. Vitamins come in two types that are transported and stored differently in the body. These are water-soluble and lipid-soluble vitamins. Water-soluble vitamins dissolve in water and are able to move around freely in the body through the blood. These vitamins are found in the watery portions of fruits, vegetables and grains. Water-soluble vitamins are not stored in the body. The body takes the vitamins needed from our food and the remainder is disposed of through the kidneys. This means that water-soluble vitamins need to be regularly replenished as part of our daily diet. Fat-soluble vitamins on the other hand need fat in order to dissolve. These vitamins require special carrier proteins to be transported in the blood. Unlike water-soluble vitamins, fat-soluble vitamins are stored in fat cells when excess vitamin is present and the diet to be used at a later time. Now let's take a look at two water-soluble vitamins: vitamins B and C. We’ll now be talking about one common water-soluble vitamin - vitamin B. There are eight types of vitamin B and most of them come from our diet. Due to the various types of vitamin B they can be found in a variety of sources. In terms of the roles, vitamin B performs two main functions in the human body: one to make energy from the ingested food and two to make red blood cells. It is important to note that some vitamin B types only perform one of these functions, but there are also other types that are involved in both functions. Deficiency in vitamin B can lead to one or more diseases depending on a number of types of vitamin B deficiency. For example, deficiency in vitamin B12 and vitamin B6 can cause anemia, which is insufficient red blood cells. On the other hand, deficiency in vitamin B1 and B3 can lead to mental confusion. Now we will take a look at another water-soluble vitamin - vitamin C. Vitamin C has various functions in the body. One of its most important functions is to protect the body from infections. It also contributes to the growth and repair of tissues. Not those kind of tissues. The tissues in your body like your bones, your teeth and your skin. Now you may be wondering where you can find vitamin C. Well the best sources of vitamin C are fruits and vegetables. Peppers and broccoli have the highest vitamin C content among the many kinds of vegetables. Now it is commonly believed the oranges are the best source of vitamin C among fruits however this is not actually the case. The fruit that is the best source of vitamin C is actually guava. In second place it is papaya and Kiwis are the third best source of vitamin C among fruits. Oranges are actually the fourth highest. So what happens when you don't consume enough vitamin C. Well vitamin C deficiency can lead to a disease called scurvy. Scurvy was a disease that many pirates and sailors used to have when they were out at sea for long periods of time without access to fresh fruits and vegetables. You see vitamin C is necessary to produce collagen. Collagen is the main protein component of the tissues in your body and collagen alone makes up 35% of the whole body's protein content. Scurvy has many symptoms, such as brown spots in the skin, bleeding from different mucous membranes, spongy gums, loss of teeth and even death. Now look at two fat-soluble vitamins: vitamins A and D. We will first take a look at vitamin A. Vitamin A’s main role in the body is maintaining and protecting vision. Vitamin A is critical for vision, because it's a component of rhodopsin - a protein, that detects and absorbs light in the eyes. There are two main sources of vitamin A. The first is in foods from animal sources, which includes fish, meat, liver and eggs. The second is in leafy green vegetables, orange and yellow vegetables and fruit. The top three choices are squash, carrot and spinach. A deficiency in vitamin A is usually rare, since most foods contain at least a small amount of it. Vitamin A deficiency is usually much more prevalent in developing countries like Nigeria and India, where access to food is much more restricted. Deficiency is more common during periods of high nutritional demand, such as during infancy and childhood. One of the most common symptoms of vitamin A deficiency is xerophthalmia or the inability to see in low light or in darkness. The second fat-soluble vitamin we will be talking about is vitamin D. Vitamin D is also known as the sunshine vitamin, because it's produced in your skin in response to sunlight. You can also get vitamin D from supplements and a very small amount comes from some foods like salmon. Vitamin D works to promote bone growth and bone strength. This is important since vitamin D regulates the absorption of calcium and phosphorus, which are two essential components for developing the structure and strength of your bones. So even if you eat lots of foods, that contain calcium and phosphorus without enough vitamin D, you can't absorb them into your body. Vitamin D is also an important factor in making sure your muscles, heart, lungs and brain work well and that your body is able to fight infection. Too little vitamin D results in the softening of the bones. This disease is known as rickets in children and osteomalacia in adults. Vitamins are essential nutrients needed by the body to grow, develop and function normally. The two types of vitamins are fat-soluble and water-soluble vitamins. We discussed two water-soluble vitamins: vitamin B, involved in the production of energy and red blood cells, and vitamin C, which is associated with tissuegrowth and repair. We also discuss two fat-soluble vitamins: vitamin A, which plays a role in vision, and vitamin D, which is involved in bone growth and strength.

 

VITA MEANS LIFE

 

 For centuries, scurvy was a real scourge among seamen and explorers, and no one knew how to combat it. Rickets, which afflicted small children, pellagra, beriberi and other diseases also remained an enigma.

In 1881, Nikolai Lunin, a Russian physician, put forward the hypothesis of the existence of some substances that are essential for life. These substances were isolated in their pure form more than 30 years later by K.Funk, a Polish researcher, who called them vitamins - “carriers of life”. Today we know some 30 vitamins and vitamin-like substances. Scurvy, rickets, beriberi and pellagra have been established to be all avitaminoses, i.e., diseases caused by the lack or deficiency of one vitamin or another in the organism.

Nowadays doctors come across avitaminoses comparatively rarely. Other problems connected with vitamins attract much more attention.

Our scientists are of the opinion that nucleic acids play the main part in the process of growth and propagation of cells. They proved that vitamin C (ascorbic acid) regulates one of the stages in the formation of desoxyribonucleic acid – the famous DNA.

Vitamin K, one of the “youngest” vitamins, discovered only some 30 years ago, is of great importance for the proper coagulation of blood. It is essential for the formation of prothrombin, a proteic substance necessary for clotting a blood vessel to stop a hemorrhage.

In 1942, Academician Al.Palladin, a prominent Russian biochemist, and his staff synthesized vikasol, a new preparation, which contains an analogue of vitamin K. During World War II, vikasol won a good repute for itself among army doctors. Injected intramuscularly or intravenously, it quickly stops various hemorrhages.

Now it is used as a preparation against inflammation and as a means for increasing the resistance of organisms to radioactive irradiation. But vitamin K is essential not only for blood clotting. It plays an active role in the so-called tissue breathing of the organism’s cells, in the metabolism. It is as necessary for each living cell as air is vital for man.

The doctors use vitamins on a wide scale of treatment – with the aid of vitamins they influence the metabolism in the direction they want, and increase the resistance of the organism to various diseases.

For instance, orotic acid, a substance which possesses vitamin-like properties, and which is a factor for growth, is used to intensify the contracting function of the myocardium, when the latter has been disrupted by prolonged stress.

The preparation Kalium orotium is used to treat such a grave and dangerous disease as a large-focal infarct of the myocardium (heart failure). The use of this preparation (in combination with folic acid and vitamin B12) at the clinic made it possible to decrease the number of deaths from this disease. Apart from this, the patients’ blood pressure improves and they recover much more quickly and are even able to go back to their usual work.

Good results have been obtained by administrating Kalium orotium to patients with other cardio-vascular disorders.

The researchers think, that this preparation will possibly be used to treat ulcers of the stomach and duodenum, to speed up the healing of wounds and burns and also other diseases and traumas, when the organism needs an accelerated synthesis of protein.

 

Active words and expressions.

 

Scurvy, beriberi, pellagra, deficiency, avitaminosis, to inject, to play an active role, inflammation, to obtain, wound, burn, to improve, to accelerate, resistance.

 

VITAMIN A

 

   Vitamins are dietary substances required by the body in very small amounts for normal biochemical function. There are two major groups: water-soluble vitamins (the B vitamins and vitamin C), and the fat-soluble vitamins A, D, E and K. Intensive research into their sources, their function and our requirements for them has been going on over the last sixty years or so and we now know a great deal about them.

Vitamin A. The term vitamin A covers several fat-soluble compounds including retinol, which is the most important component, and two lesser components, retinal and retinoic acid. Vitamin A is only found in animal produce but various vitamin-A-type compounds, the most important of which is beta-carotene, are found in vegetables, and these are water-soluble.

All of them are fat-soluble, are sensitive to light and are easily oxidized.

Though the deficiency signs of vitamin A were recognized in ancient Egyptian times, it was only in the 20^thcentury that its chemical nature was elucidated. Two researchers recognized a substance described as “fat-soluble A” as being a growth-promoting factor in animals. Later it was shown that vitamin A activity was present in plants in the yellow pigments known as carotenes.

What it does.

The most important and well-known role of vitamin A is in relation to eye function. Vitamin A is necessary to prevent drying of the eye (xerophthalmia) and corneal changes; also, the normal function of the retina, the part of the eye involved with vision, and particularly the function of the light-sensitive areas of the eye, are dependent upon there being sufficient vitamin A. Vitamin A is involved in a number of other bodily functions. It is important in maintaining the stability of cell membranes and this may be clinically important. Furthermore, beta-carotene is the most effective receptor of free radical oxygen and this may be relevant in situations involving cancer, inflammatory disease and atherosclerosis, in which free radical mechanisms are thought to play a part.

A connection between vitamin A and zinc metabolism has been described by several researchers. It appears that in severe zinc deficiency the formation of the protein which carries vitamin A, retinolbinding protein, is decreased. Zinc is an important constituent of many enzymes, including one found in the retina that is involved in vitamin A metabolism. Night blindness which does not improve with vitamin A supplements has been described in zinc deficient individuals, particularly in alcoholics with liver disease who are often vitamin A and zinc deficient.

In diseases such as alcoholic cirrhosis, pancreatic disease and cystic fibrosis, zinc and vitamin A and other deficiencies also often occur together.

Food sources:

The major dietory sources are from animal produce, which provides vitamin A-retinol – usually combined with a fatty acid. As vitamin A is stored in animal and fish livers, these provide the most concentrated sources. Others include kidneys, eggs, milk and butter. Margarine is, by law, fortified with vitamin A. Good vegetable sources include any green, yellow or orange-pigmented produce; the darker the colour, the higher the content of beta-carotine. Carrots, spinach, cabbage and orange and yellow fruits are the best sources.

Deficiency symptoms and signs.

Vitamin A deficiency, one of the commonest and most serious world-wide nutritional deficiencies, occurs in people who have malabsorption states. In particular, anyone with fatty stools caused by pancreatic disease, biliary obstruction, or small bowel disease, is at risk.

The earliest symptoms of vitamin A deficiency include night blindness (difficulty in seeing well in dim light) and dryness of the eyes.

Skin signs of vitamin A deficiency include follicular hyperkeratosis, a condition in which the whole hair follicle and its adjacent skin is raised by a plug of horny keratin. Dryness of the skin can be a feature of vitamin A deficiency but this may be due to an associated  essential fatty acid deficiency or a deficiency of other micronutrients such as vitamin B complex.

Vitamin C and zinc are involved in fatty acid metabolism. Deficiency can occur without skin signs.

In general vitamin A deficiency is associated with poor growth and development, and impaired resistance to infection.

 

 

III. RICKETS

 

RICKETS

 

Rickets is a deficiency disease of infancy and childhood characterized by a disturbance of the normal process of ossification of bones with resultant deformity. Rickets is a diseaseof a growing body, most commonly it occurs during the first year of life.

Causes. The conditionspredisposing to rickets are rapid growth, prematurity and genetic factors. The disease may be caused by the deficiency of vitamin D and calcium in the diet, by the deficiency of sunlight. Usually the disease occurs in autumn or winter when it’s rarely sunny and when parents don’t walk with their babies long.                                                  Symptoms. Early signs of rickets appear frequently at the age of two-three months, in pre-term babies they may be seen at the end of the first month of life. These are: unrest, excitability – the child gives a start(jerk) at a sudden loud sound or bright flash of light, its sleep becomes superficial and anxious. The baby sweats badly, particularly while crying, feeding or falling asleep. The sweat irritates the skin, causing itching and heat rash. In this case the kid rubs its head against the pillow rubing its hair off the back of its head. Softening of the bones of the skull in the first few months of life may be an early sign. child’sLater, during the second half of the first year, the child’s appearance changes. The head becomes larger in its upper part, the face seems small, the chest gets deformed, the legs curved. The teeth may appear late. The child’s motor development is delayed.

II is the disturbed structure of the ends of the long bones in the epiphysis that is a common finding. Diagnosis. The diagnosis is easily made clinically, it may be confirmed by the blood test for vitamin D, calcium and phosphorus amount or by an X-ray examination of long bones.

Prognosis. Commonly the child does recover. Complications accompanying rickets include muscular weakness, bronchitis, pneumonia, gastroenteric disturbances, enlarged liver and spleen and anemia.

Prevention and Treatment. Prevention of rickets should be thought of before the baby is born The future baby must get vitamin D, sunlight and a sufficient amount of mineral salts through his mother’s body. Consequently, prospective mothers should spend more time outdoors, eat more raw vegetables, fruits, berries. Breast milk, juices, fresh air, sunlight, suitable clothing and physical activity – all these antirachitic factors may prevent rickets in children. But if the disease does develop, the doctor prescribes vitamin D or cod-liver oil as a specific treatment..

Non-specific measures of both prevention and treatment are extremely important because the disease does not always result from vitamin D deficiency. Calcium, phosphorus and protein should be provided in sufficient amounts, as well as vitamin D. The child’s diet depends on its age and the deficiencies revealed. Breast fed infants should get vegetable and fruit juices at the age of 3-4 months if there is no family history of allergy. Egg yolk and cottage cheese are introduced earlier than usual. Long walks outdoors, physical activity and massage are necessary for the child. Loud sounds or bright light should be avoided.

 

Active words to remember:

 

Rickets; during; susceptibility; sweating; vomiting; to diminish; to gain in weight; enlargement; to decay; sufficient; consequently; raw; suitable; cold liver oil.

 

EXERCISES

 

 

I.

I. Group the words with the same root.

 

During, common, to inhibit, recovery, to appear, to enlarge, prevention, insufficient, large, appearance, uncommonly, duration, resultant, disappearance, to prevent, to recover, commonly, inhibition, result from, enlargement, sufficiently, uncommon, result in, disappear, insufficiently, preventive, sufficient.

 

 

II. Choose the appropriate adjectives for the nouns in the right column:

 

a. direct                                1. sweating

b. rapid                                 2. bone

c. fresh                                 3. vegetables

d. profuse                             4. light

e. long                                  5. action

f. sufficient                          6. amount

g. raw                                   7. air

h. ultraviolet                         8. growth

i. common                            9. finding

 

III. Group the synonyms:

 

1. disease; to occur; commonly; rapid; finding; to have to; to terminate; to associate with; prevention; amount.

2.quick; to end; prophylaxis; disturbance; must; usually; to take place; sign; to connect with; quantity.

 

III. Group the antonyms:

 

A)normal; commonly; rapid; to increase; susceptibility; early; to include; long; upper; to appear; sufficient; more.

B) To diminish; slow; late; abnormal; insufficient; less; unusually; to disappear; resistance; to exclude; lower; short.

 

IV. Give English equivalents of the following word-combinations:

 

Желудочно-кишечные расстройства; увеличение печени; достаточное количество; проводить больше времени на свежем воздухе; характеризоваться чем-либо; в настоящее время; нарушение нормального процесса окостенения; встречаться наиболее часто; в течение первых лет жизни; получать хорошие результаты; при лечении рахита; мышечная слабость; недостаток витамина Д; подвергать действию; чувствительность кожи; заметное улучшение; общее состояние больного.

 

V. Translate the following sentences into English:

 

1.Рахит чаще всего встречается у детей именно в первые годы жизни. 2.Причины заболевания рахитом очень разнообразны Недостаток витамина Д и кальция в питании, а также солнечного света и свежего воздуха самые главные из них. 3. При появлении потливости, рвоты, поноса, при отсутствии аппетита ребенка нужно немедленно показать врачу. 4. Обычное явление при рахите – изменение структуры концов длинных костей в эпифизе. 5. После рахита могут быть серьезные и опасные осложнения – воспаление легких, бронхит, желудочно-кишечные расстройства, увеличение печени, селезенки, мышечная слабость, анемия. 6. Рахит можно предотвратить. Дети должны как можно больше находиться на свежем воздухе и есть как можно больше свежих фруктов и овощей. 7. Врачи прописывают облучение ультрафиолетовыми лучами, витамин Д или рыбий жир именно при рахите.

 

VI. Make up your own talks on the following situations using the given words and expressions:

 

1. You are a pediatrician. One of your patients was a rachitic baby. Make up a case-report of his illness: (family history, premature, to stay indoors, to be afraid of her child catching cold, physical examination revealed…, symptoms, X-ray examination, to prescribe a course of treatment, improvement in the child’s condition).

2. A mother brought her sick child to the clinic. Having examined the child the doctor diagnosed rickets and prescribed the proper treatment: (complain of, poor appetite, profuse sweating, to change clothes, to examine carefully, to prescribe cod liver oil, to advise).

3.Two mothers are talking in the waiting-room. One of them whose child has been cured for rickets is comforting the other one who has a baby suffering from it: (not to worry, to obtain good results, to expose to the action of the sun’s rays, to prescribe, one teaspoonful twice a day, raw vegetables, fresh air).

 

 

Vitamin D deficiency in UKis  a ‘major problem of the present’

Nowadays vitamin D supplements are recommended for people at risk of deficiency. They include all pregnant and breastfeeding women, children under five and the elderly. However, in UK 74 per cent of parents know nothing about the recommendation and more than half of healthcare professionals are also unaware.

Rickets is known to be associated with Vitamin D deficiency. Unlike the most characteristic signs of rickets, muscle weakness, delay in walking, bone pains are less common symptoms. Parents ignore the efficiency of Vitamin D and apply for medical assistance only at severe end of the disease. Vitamin D deficiency is described as a ‘major problem’ in UK at present.

Historically the fact that Vitamin D prevents rickets has been known for about 100 years. About a century ago most children in London suffered from the disease. Rickets was later eradicated due to supplements. Then in the 1950s there was concern that children were getting too much Vitamin D in food supplements and cod liver oil, and supplements were stopped in UK. This differed fromthe situation in other Western countries where they continued to supplement Vitamin D. Dr. Jacobs, a consultant pediatrician, supposes that this cancellation of the supplement was a major mistake. He says that parents are unaware of the risk of the condition, while health professionals are often taught that rickets is a disease of the past.

Dr. Jacobs mentions that over the past 10 years an increasing number of children with Vitamin D deficiency has been found out. Unfortunately, the majority of doctors, health visitors, midwives, nurses are not aware enough of the problem. Taking drops or tablets of Vitamin D is suggested, but experts are also looking into food supplementation.

Many health professionals such as midwives, GPs and nurses, now give advice on supplements, and it is critical that they continue to offer this advice as a part of routine. It is important to raise awareness of this issue, to remind health professionals of the need to prescribe and recommend Vitamin D supplements to groups at risk. The Department of Health has also asked the Scientific Advisory Committee on Nutrition to review the important issue of current dietary recommendations on Vitamin D.

 

 

IV. BLOOD DISORDERS

 

Anemia

Disorders of the blood are grouped as follows: lack of hemoglobin, which causes anemia; disorders in clotting, which cause bleeding and bruising (hemophilia); cancerous changes in the white cells, which cause leukemia; disorders in the production of blood cells in the bone marrow; and disorders that affect the lymphatic system.

Anemia is defined as a decrease in either hemoglobin or the number of red blood cells to below the normal level. Iron is an essential ingredient in hemoglobin. If there is not enough iron in the body, there cannot be made enough hemoglobin. This form of anemia is called iron-deficiency anemia. There are some types of anemia caused by deficiency: iron, B12 and folic acid deficiency anemia. A severe shortage of vitamin B12 in the body also affects the production of red blood cells. This is called B12 deficiency anemia. Lack of folic acid in the body has the same effect, and this is called folic acid deficiency. There is also  hemolytic anemia when the red blood cells are destroyed more quickly than they normally would be and the number of red blood cells in the body may fall well below normal. Inherited defects of the blood such as sickle-cell anemia cause the body to produce abnormal hemoglobin.

All these types of anemia may be found in children but the most common one is iron-deficiency anemia. Insufficient iron in the body causes an adequate production of hemoglobin, and therefore leads to iron-deficiency anemia.

Normally, extra iron is stored in the body and then used to produce hemoglobin in newly developed red blood cells. Most of this iron is recovered as old red blood cells are destroyed. The small amount of iron lost from the body is replaced by iron absorbed from the diet. If the person loses more iron than he is able to absorb he may become anemic. There are three general causes for a lack of iron reserves: there may not be enough iron in the diet; the digestive system may be unable to absorb iron, even though there may be enough of it in the diet; and an excessive loss of blood.

The most frequently observed type of anemia among very young children is anemia caused by faulty nutrition. Such anemia is rarely seen in breast-fed infants. If an infant receives a monotonous milk or cereal dietary and has not enough vitamins he will develop anemia; therefore bottle-fed babies chiefly suffer from anemia.

Anemia associated with some disease is not uncommon in young children Such anemias are either a result of the direct action of the bacterial toxin on the bone marrow, or are caused by the monotonous and restricted diet employed for the treatment of the basic disease.

The most typical form of anemias among children of preschool ages are those caused by a worm diseases or by faulty hygiene.

The disease in older children would not have developed provided they had not neglected fresh air and sun, physical training and sports.

The characteristic symptoms of anemia include paleness, fatigue, weakness, fainting, breathlessness and palpitations. And no doctor will ever risk diagnosing or treating anemia unless he first does blood test.Nowadays tests:

• check the size and shape of the red blood cells with a microscope check the amount of hemoglobinand iron in the blood
• check how fast new RBCs are being made
• To make a complete differential diagnosis a doctor should check for any inherited anemias and check other cells made in the bone marrow (such as white blood cells).

Anemia is treated by means of numerous excellent drugs the pharmaceutic industry provides us with. However, one form of treatment is irreplaceable in all types ofsevere blood loss: this is blood transfusion.

Anemia, as any other disease, is easier to prevent than to cure. A most important condition for preventing anemia is proper management of nutrition from the very first days of the baby’s life. The best food for infants is breast milk. As the child grows older his food must become varied. No less important are proper hygiene, hardening procedures and fresh air.

 

 

 

Words to remember:

 

Pale(ness), skin, invisible, entire, surface, life span, to carry, to develop, faulty, to neglect, to harden, to explain, numerous, to prevent, to cure, therefore.

 

 

EXERCISES

 

I. Answer the following questions:

 

1.What is blood? 2. What does blood consist of? 3. What is anemia? 4. In what way are the red blood cells related to anemia? 5. How is anemia diagnosed? 6. What are the most frequently observed types of anemia in very young children? 7. What types of anemia are typical for preschool ages? 8. What does the treatment of anemia depend on? 9. What measures usually prevent anemia?

 

II. Complete the following sentences choosing the right ending  from below:

 

1. An