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Health Matters 5/28: Late Night Heartburn Could Be Gallstones

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By Tomer Davidov, MD

If heartburn keeps you up at night or occurs a few hours after a heavy meal, the problem may not be with acid reflux.

It can actually be gallstones.

Gallstones affect an estimated 10 to 15% of the US population, according to the National Institutes of Health (NIH), and can rest for years before causing symptoms.

If you are concerned about heartburn-like pain, see your doctor for a diagnosis. Once identified, gallstones can be treated easily, typically with a combination of diet and lifestyle changes and, if necessary, minimally invasive laparoscopic surgery.

Women at higher risk

Gallstones are formed when hardened deposits of bile form in your gallbladder, a small pear-shaped organ in your upper right abdomen. Bile is a liquid made by your liver to aid digestion.

They can have one or more gallstones, and they can range in size from as small as a grain of sand to as large as a golf ball.

Gallstones tend to run in families and are more common in women than men, according to the NIH. The risk of gallstones also increases with age and is greater in people who are overweight, have a high-fat diet, or have recently been pregnant.

Pain similar to heartburn

Gallstones don’t always cause symptoms, but when they do occur the pain is often mistaken for acid reflux or heartburn because the sensations are similar.

Gallstones can cause mild discomfort that lasts for several minutes or pain that is more intense and lasts for several hours.

In cases where a stone becomes lodged in the bile duct causing a blockage, there may be severe pain in the upper abdomen, sometimes with yellowing of the eyes.

Signs that you may have a gallbladder attack include:

• Sudden, worsening pain in the upper right abdomen or middle abdomen just below the sternum.
• Back pain between the shoulder blades or in the right shoulder.
• Nausea, vomiting, or a bloated feeling.
• Symptoms that worsen after eating fatty or fried foods, and often worsen at night.
• No improvement with antacids.
• yellowing of the eyes and skin.

If you experience any of these symptoms, see a doctor right away. Once you have a severe gallbladder attack, the more likely you are to have others.

Additionally, gallstones can cause complications, including:

• Inflammation or infection of the gallbladder.
• Blockage of the biliary tract and a dangerous infection of the liver.
• Gallstone pancreatitis, an inflammation of the pancreas caused by a blockage of gallstone that causes severe pain.

Surgery is often recommended

Gallstones are usually diagnosed with an ultrasound of the abdomen and, in some cases, can be treated by eating a low-fat, high-fiber diet without skipping meals.

Unfortunately, there are no drugs that can make gallstones go away.

If you have frequent or severe gallbladder attacks, surgery to remove the gallbladder is usually recommended. After the removal, the liver takes over the function of storing the bile.

In most cases, the surgery can be performed using a minimally invasive laparoscopic procedure, which takes about an hour under general anesthesia. Most people go home the same day and resume normal activities within a week to 10 days.

Reduce your risk

You can lower your risk of developing gallstones by eating a healthy diet and exercising regularly to achieve and maintain a healthy weight.

To avoid gallstones, avoid unhealthy fats, often found in fried foods and desserts, and eat the following:

• More high fiber foods like fruits, vegetables, beans, and whole grains.
• Less sugar and less refined carbohydrates, e.g. B. Food with white flour.
• Healthy fats like fish oil and olive oil help your gallbladder contract and empty regularly.

If you are unsure whether your heartburn is actually a gallbladder attack, contact your doctor. Also, see a doctor if over-the-counter medications do not eliminate symptoms, if symptoms occur more frequently, or if symptoms get worse.

To find a doctor at Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org

Tomer Davidov, MD, is a general practitioner and a member of the American College of Surgeons. He is a member of the medical staff at Penn Medicine Princeton Health.

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Whole Grains Health

How to Tell if Your Baby is Ready to Stop Drinking Formula – Cleveland Clinic

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Make the formula. Feed your sweetie. Wash, rinse, repeat. For parents of babies who drink infant formula, you did this dance several times a day (and night) for what felt like an eternity. But could the end finally be in sight? When do babies stop drinking milk?

The Cleveland Clinic is a not-for-profit academic medical center. Advertising on our website helps support our mission. We do not endorse non-Cleveland Clinic products or services. politics

“A healthy baby should drink breast milk or formula up to the age of 1 year. Formulas are fortified with the vitamins and iron they need, ”says pediatrician Radhai Prabhakaran, MD. “In general, babies aged 9 months to 1 year should have at least 24 ounces per day. But once your baby is on a full diet of nutritious solid foods, switch to cow’s milk, which contains protein and vitamin D. “

Indicates your baby is ready to wean the formula

Whether babies are ready to board the milk express depends on their taste for table food. “Some babies get used to a mostly solid diet early (between 9 and 12 months) because they like it and they are okay with it. If you have a nutritionally balanced diet, it is okay to wean your baby from infant formula before the age of one. “

A healthy solid food diet for a baby should include:

  • Fruit.
  • Grains.
  • Protein from meat, eggs, or boiled beans.
  • Vegetables.

“Gradually reduce the amount of formula you drink as you eat more. Keep offering it to drink because sometimes babies are not full after eating solid foods, ”notes Dr. Prabhakaran. “But wait until they are 1 year old to introduce cow’s milk, even if they wean earlier.”

Signs your baby is NOT ready to wean the formula

Your baby should continue feeding if:

  • You’re not gaining weight.
  • Were born prematurely.
  • Have not established a balanced solid diet.
  • You need to proceed with the formula based on your doctor’s recommendation. (For example, if your baby has food allergies or has trouble digesting food or absorbing nutrients.)

Health conditions that affect how long babies drink formula

Certain underlying health conditions can affect how long it takes your baby to drink formula. Babies may need to stay on the formula longer if they:

“And if your doctor has already told you that your baby may need to be on a special diet, talk to him or her before weaning your baby off the formula,” adds Dr. Prabhakaran added. “They can help you come up with a nutrition plan that will make the transition safer.”

How to wean your baby off formula

If your baby likes the taste of cow’s milk:

  1. Start giving them a 2 to 4 ounce serving of milk for every two or three servings of formula.
  2. For up to 10 days over the next week, increase the servings of milk as you decrease the servings of the formula.
  3. Stop giving milk as soon as you have drunk the milk without any problems.

If your baby prefers the taste of formula:

  1. Build the formula as usual. Do not add cow’s milk to the milk powder.
  2. Mix together 2 ounces of prepared formula and 2 ounces of cow’s milk so you have a 4-ounce drink for your baby.
  3. Feed your baby the mixture.
  4. Over the next week to 10 days, add more milk and less milk to the mixture until it is all cow’s milk.

Bottle or cup?

Get ready to say goodbye to the bottle. Dr. Prabhakaran says that drinking from a bottle is a no-go from the age of 1. “Bottle feeding can affect tooth growth and cause tooth decay.”

Instead, switch your little one to a swallow, straw, or regular cup at around 9 months of age. “When you’re feeling adventurous, wean her off the formula and the bottle at the same time.”

Does my baby still need milk when he wakes up at night?

Dr. Prabhakaran notes that most babies of this age do not need to eat when they wake up at night. “When babies have doubled their birth weight (which happens after about 4 to 6 months) and are eating solid foods regularly, they generally don’t need extra calories and can sleep through the night. So encourage her to go back to sleep. “

Babies of this age also have the most milk teeth, so drinking milk or formula at night can lead to dental problems. Night feeding can also make them too full to eat what they need during the day.

But as always there are exceptions. “If your baby is not gaining weight, your doctor can give you other advice. Breast-fed babies can also take a little longer because the breast milk is digested more quickly. “

When to apply the brakes when stopping the formula

Dr. Prabhakaran says the transition to cow’s milk should be even slower once babies start drinking milk and experience:

  • Dramatic change in her bowel movements.
  • Abundance.

If these symptoms persist or worsen, speak to your baby’s pediatrician about a possible milk allergy. If necessary, your doctor can recommend safe milk alternatives for young children.

Signs that your baby may not tolerate cow’s milk include:

  • Constipation.
  • Diarrhea.
  • Rash.
  • Vomit.

What is the best milk for a 1 year old?

Experts consider whole cow milk to be the best milk for 1-year-olds after weaning. “The general rule is whole milk until they’re 2 years old, unless there are special circumstances,” says Dr. Prabhakaran.

Your doctor may recommend 2% milk instead if your baby:

  • Is difficult for her size.
  • Drink more than the recommended amount of milk (16 to 24 ounces per day or 2 to 3 cups).
  • Is blocked.

Milk alternatives for toddlers

Unsweetened soy milk is one of the best cow milk alternatives for toddlers because it has a similar protein content. But soy milk has fewer calories – which babies need to thrive – than whole milk. The calorie content of unsweetened rice milk is slightly higher, but it contains less protein and more added sugar.

The best way to make a decision, says Dr. Prabhakaran, is to look at your child’s overall diet. “There are so many milk alternatives and the diets of babies are very different. It’s impossible to have a blanket rule of what’s okay. Some children eat a lot of yogurt and cheese. Some babies are vegan. Talk to your baby’s doctor about the best alternative to help your child with certain deficiencies and general nutrition. “

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Meeting sleep recommendations can lead to smarter snacks

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Photo credit: CC0 public domain

New studies show that missing more than 7 hours of sleep each night, which is recommended, may lower the chances of choosing a treat than those who meet the guidelines with their eyes closed.

Analysis of data from nearly 20,000 American adults showed a link between failure to follow sleepy diet recommendations and snack-related carbohydrates, added sugar, fats, and caffeine.

The preferred food category without meals has been set – salty snacks, sweets and soft drinks are the same for adults. Sleep Habits However, people who sleep less tend to eat more total snack calories in a single day.

The study also revealed what appears to be a popular American habit, a dinner that is no matter how much we sleep.

Christopher Taylor, professor of medical nutrition and lead study author at Ohio State University School of Health and Rehabilitation Sciences, said:

“Not only do we sleep when we stay up late, but we also have all of these obesity-related behaviors: lack of physical activity, prolonged screening times, a variety of foods that we consume as snacks, not meals. Whether or not you meet your sleep recommendations will have a huge impact. “

Recommended by the American Academy of Sleep Medicine and Sleep Study Group Adults should regularly sleep at least 7 hours a night to promote optimal health. Sleep Less There is an increased risk of many health problems, including weight gain, obesity, diabetes, high blood pressure, and heart disease, than recommended.

“We know sleep deprivation is broadly linked to obesity, but it’s all these little behaviors that determine how it happens,” says Taylor. I did.

The abstract of the study is in the Journal of the Academy of Nutrition and Nutrition The study will be presented in a poster session on October 18, 2021 Food Nutrition Conference & Expo.

The researchers analyzed data from 19,650 American adults, ages 20 to 60, who participated between 2007 and 2018. National Health and Nutrition Examination Survey.

This study collects 24-hour meals from each participant, details what and when all foods are consumed, and asks about the average hours of sleep on weekdays.

The Ohio State University team ranked participants on whether they met sleep recommendations based on whether they reported more than 7 hours or less than 7 hours of sleep per night. Using the USDA database, researchers estimated participants’ snack-related nutrient intake and classified all snacks into food groups. Three snack time frames were established for the analysis. It’s from 2:00 a.m. to 11:59 a.m., 5:59 p.m., and 6:00 p.m. to 1:59 p.m. in the evening.

According to statistical analysis, almost everyone (95.5%) eats at least one snack a day, and more than 50% of the snack calories of all participants are soda and energy drinks and chips, pretzels, cookies, and pastries. It was of two broad categories including.

Participants who did not meet sleep recommendations were more likely to eat morning treats, less likely to have afternoon treats, and have more calories than participants who slept more than 7 hours at night. I have eaten a lot of low-nutrient snacks.

Although many physiological factors are involved in the relationship between sleep and health, Taylor says that behavior modification, particularly avoiding the nose at night, not only helps adults adhere to sleep guidelines, but also improves their diet. Said it could help you.

“Following sleep recommendations helps to meet certain sleep needs that are relevant to our health, but it is also related to the fact that we are not doing anything that could harm our health. “Says registered nutritionist Taylor. “The longer you stay up, the more chances you have to eat. At night, these calories come from treats and sweets. Every time you make these decisions, you increase your risk of developing chronic diseases. Here are some calories and foods that are relevant and we don’t have whole grains, fruits, or vegetables.

“If you’re in bed trying to sleep, at least you won’t eat in the kitchen. So if you can go to bed yourself, that’s the starting point. ”

How to sleep well in 2021

For more informations:
E. Potosky et al., Differences in Snack Intake by Meet Sleep Recommendations, Journal of the Academy of Nutrition and Nutrition (2021). DOI: 10.1016 / j.jand.2021.06.145

Provided by
Ohio State University

Quote: Smarter snacks from https://medicalxpress.com/news/2021-09-smarter-snacking.html on September 20, 2021 (September 20, 2021).

This document is subject to copyright. No part may be reproduced without written permission except in fair transaction for personal investigation or research. The content is provided for informational purposes only.

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How to optimise healthy eating habits

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“Good nutrition is essential for optimal health throughout our lives,” replies Maria van der Merwe, President of ADSA, The Association of Dietetics in South Africa.

“Meeting our changing nutritional needs from infancy to old age increases resilience, helps us control our weight, and prevents nutritional deficiencies and the development of a variety of chronic health conditions. Should we fall ill, a balanced diet can (also) contribute to our recovery. “

But isn’t good food expensive?

As many South Africans are feeling the economic impact of the pandemic, registered nutritionist Dr. Nazeeia sayed that healthy meals are still achievable on a tight budget. “If you focus on seasonal vegetables and fruits, whole grains like oats, and more plant-based protein sources like beans and lentils instead of meat, you will save money,” she advises.

What about nutritional supplements?

With vitamins and minerals flying off the shelves, Nazeeia says it is important to note that “There is no scientific evidence that any particular food, supplement, or diet can prevent COVID or other infections. It is best to stick to healthy eating guidelines and make sure your family enjoys a variety of foods every day.

How does home cooking help?

“When we cook from scratch at home, we can use unprocessed or minimally processed foods (foods in their natural state) as the basis of our meals … (These) foods are often nutritious and good sources of vitamins, minerals, and fiber,” comments Maria . “If we cook our meals ourselves, we can also determine how much fat, salt and sugar – if available – are added when preparing the meals.”

Nazeeia agrees, adding that home cooking is a way to especially involve children in conversations about where the food comes from. It also inspires us to try new recipes and cuisines, and lays the foundation for healthy habits that can last a lifetime.

So what are some tips for getting more preventative nutritional benefits on a tighter budget?

  • Focus on eating a variety of affordable foods so that you get a wider range of beneficial nutrients.
  • Prioritize unprocessed foods, including seasonal vegetables and fruits, whole grains, dried beans and lentils.
  • Eat fewer take-away meals, which are often high in salt and fat, and budget that budget on whole foods that you can prepare at home.
  • Replace sugary drinks like sodas, fruit juices, and energy drinks with plenty of clean, safe water – you’ll be amazed at how much you save!
  • Cut down on your meat consumption and instead focus on more plant-based diets. Inexpensive dried beans and lentils are a tasty substitute for meat dishes or can be added as an additional ingredient to lengthen your meat dishes.
  • When meat options get too expensive, switch to other cheaper animal protein sources like eggs, maas, and yogurt.
  • Plan your meals and grocery purchases in advance. Look out for specials and work with family, friends, and neighbors to shop in bulk together.
  • Grow your own products. Spinach, kale, and traditional vegetables like marog are just as easy to grow as onions, beans, beetroot, carrots, and tomatoes.

Information provided by ADSA. To find a registered dietitian near you, visit www.adsa.org.za

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