(Native American) One who loves to dance
Tivah, Tivva, Tivvah
Tivah, Tivva, Tivvah
The speciality of anaesthesia broadly covers its provision for SURGERY, intensive therapy (intensive care), chronic pain management, acute pain management and obstetric analgesia. Anaesthetists in Britain are trained specialists with a medical degree, but in many countries some anaesthetists may be nurse practitioners working under the supervision of a medical anaesthetist.
The anaesthetist will assess the patient’s ?tness for anaesthesia, choose and perform the appropriate type of anaesthetic while monitoring and caring for the patient’s well-being, and, after the anaesthetic, supervise recovery and the provision of post-operative pain relief.
Anaesthesia may be broadly divided into general and local anaesthesia. Quite commonly the two are combined to allow continued relief of pain at the operation site after the patient awakens.
General anaesthesia is most often produced by using a combination of drugs to induce a state of reversible UNCONSCIOUSNESS. ‘Balanced’ anaesthesia uses a combination of drugs to provide unconsciousness, analgesia, and a greater or lesser degree of muscle relaxation.
A general anaesthetic comprises induction, maintenance and recovery. Historically, anaesthesia has been divided into four stages (see below), but these are only clearly seen during induction and maintenance of anaesthesia using inhalational agents alone.
(1) Onset of induction to unconsciousness
(2) Stage of excitement
(3) Surgical anaesthesia
(4) Overdosage
Induction involves the initial production of unconsciousness. Most often this is by INTRAVENOUS injection of a short-acting anaesthetic agent such as PROPOFOL, THIOPENTONE or ETOMIDATE, often accompanied by additional drugs such as ANALGESICS to smooth the process. Alternatively an inhalational technique may be used.
Maintenance of anaesthesia may be provided by continuous or intermittent use of intravenous drugs, but is commonly provided by administration of OXYGEN and NITROUS OXIDE or air containing a volatile anaesthetic agent. Anaesthetic machines are capable of providing a constant concentration of these, and have fail-safe mechanisms and monitors which guard against the patient’s receiving a gas mixture with inadequate oxygen (see HYPOXIC). The gases are adminstered to the patient via a breathing circuit either through a mask, a laryngeal mask or via ENDOTRACHEAL INTUBATION. In recent years, concerns about side-effects and pollution caused by volatile agents have led to increased popularity of total intravenous anaesthesia (TIVA).
For some types of surgery the patient is paralysed using muscle relaxants and then arti?cially ventilated by machine (see VENTILATOR). Patients are closely monitored during anaesthesia by the anaesthetist using a variety of devices. Minimal monitoring includes ELECTROCARDIOGRAM (ECG), blood pressure, PULSE OXIMETRY, inspired oxygen and end-tidal carbon-dioxide concentration – the amount of carbon dioxide breathed out when the lungs are at the ‘empty’ stage of the breathing cycle. Analgesic drugs (pain relievers) and local or regional anaesthetic blocks are often given to supplement general anaesthesia.
Volatile anaesthetics are either halogenated hydrocarbons (see HALOTHANE) or halogenated ethers (iso?urane, en?urane, des?urane and sevo?urane). The latter two are the most recently introduced agents, and produce the most rapid induction and recovery – though on a worldwide basis halothane, ether and chloroform are still widely used.
Despite several theories, the mode of action of these agents is not fully understood. Their e?cacy is related to how well they dissolve into the LIPID substances in nerve cells, and it is thought that they act at more than one site within brain cells – probably at the cell membrane. By whatever method, they reversibly depress the conduction of impulses within the CENTRAL NERVOUS SYSTEM and thereby produce unconsciousness.
At the end of surgery any muscle relaxant still in the patient’s body is reversed, the volatile agent is turned o? and the patient breathes oxygen or oxygen-enriched air. This is the reversal or recovery phase of anaesthesia. Once the anaesthetist is satis?ed with the degree of recovery, patients are transferred to a recovery area within the operating-theatre complex where they are cared for by specialist sta?, under the supervision of an anaesthetist, until they are ready to return to the ward. (See also ARTIFICIAL VENTILATION OF THE LUNGS.) Local anaesthetics are drugs which reversibly block the conduction of impulses in nerves. They therefore produce anaesthesia (and muscle relaxation) only in those areas of the body served by the nerve(s) affected by these drugs. Many drugs have some local anaesthetic action but the drugs used speci?cally for this purpose are all amide or ester derivatives of aromatic acids. Variations in the basic structure produce drugs with di?erent speeds of onset, duration of action and preferential SENSORY rather than MOTOR blockade (stopping the activity in the sensory or motor nerves respectively).
The use of local rather than general anaesthesia will depend on the type of surgery and in some cases the unsuitability of the patient for general anaesthesia. It is also used to supplement general anaesthesia, relieve pain in labour (see under PREGNANCY AND LABOUR) and in the treatment of pain in persons not undergoing surgery. Several commonly used techniques are listed below:
LOCAL INFILTRATION An area of anaesthetised skin or tissue is produced by injecting local anaesthetic around it. This technique is used for removing small super?cial lesions or anaesthetising surgical incisions.
NERVE BLOCKS Local anaesthetic is injected close to a nerve or nerve plexus, often using a peripheral nerve stimulator to identify the correct point. The anaesthetic di?uses into the nerve, blocking it and producing anaesthesia in the area supplied by it.
SPINAL ANAESTHESIA Small volumes of local anaesthetic are injected into the cerebrospinal ?uid through a small-bore needle which has been inserted through the tissues of the back and the dura mater (the outer membrane surrounding the spinal cord). A dense motor and sensory blockade is produced in the lower half of the body. How high up in the body it reaches is dependent on the volume and dose of anaesthetic, the patient’s position and individual variation. If the block is too high, then respiratory-muscle paralysis and therefore respiratory arrest may occur. HYPOTENSION (low blood pressure) may occur because of peripheral vasodilation caused by sympathetic-nerve blockade. Occasionally spinal anaesthesia is complicated by a headache, perhaps caused by continuing leakage of cerebrospinal ?uid from the dural puncture point.
EPIDURAL ANAESTHESIA Spinal nerves are blocked in the epidural space with local anaesthetic injected through a ?ne plastic tube (catheter) which is introduced into the space using a special needle (Tuohy needle). It can be used as a continuous technique either by intermittent injections, an infusion or by patient-controlled pump. This makes it ideal for surgery in the lower part of the body, the relief of pain in labour and for post-operative analgesia. Complications include hypotension, spinal headache (less than 1:100), poor e?cacy, nerve damage (1:12,000) and spinal-cord compression from CLOT or ABSCESS (extremely rare).... anaesthesia
Habitat: A tree occurring in salt marshes and tidal creeks.
English: White mangrove.Ayurvedic: Tuvara.Siddha/Tamil: Kandal.Folk: Tivaria (Gujarat), Upattam (Tamil Nadu).Action: Stem/bark—astringent. Pulp of unripe fruit—used for healing skin lesions of smallpox; fruits and immature seeds, used as cicatrizant of abscesses and ulcers.
The bark contains 5% tannin, tri- acontanol and triterpenoids. Kernels contain lapachol, which possesses an- titumour activity. Aerial parts yield beta-sitosterol, friedelin, lupenone, lu- peol, betulinic and ursolic acids.... avicennia officinalisNutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Potassium, iron
About the Nutrients in This Food Brussels sprouts are high in dietary fiber, especially insoluble cellulose and lignan in the leaf ribs. They are also a good source of vitamin A and vitamin C. One-half cup cooked fresh brussels sprouts has three grams of dietary fiber, 1,110 IU vitamin A (48 percent of the R DA for a woman, 37 percent of the R DA for a man), 47 mcg folate (16 percent of the R DA), and 48 mg vitamin C (64 percent of the R DA for a woman, 53 percent of the R DA for a man). Brussels sprouts also contain an antinutrient, a natural chemical that splits the thiamin (vitamin B1) molecule so that it is no longer nutritionally useful. This thiamin inhibitor is inactivated by cooking.
The Most Nutritious Way to Serve This Food Fresh, lightly steamed to preserve the vitamin C and inactivate the antinutrient.
Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet
Buying This Food Look for: Firm, compact heads with bright, dark-green leaves, sold loose so that you can choose the sprouts one at a time. Brussels sprouts are available all year round. Avoid: Puff y, soft sprouts with yellow or wilted leaves. The yellow carotenes in the leaves show through only when the leaves age and their green chlorophyll pigments fade. Wilting leaves and puff y, soft heads are also signs of aging. Avoid sprouts with tiny holes in the leaves through which insects have burrowed.
Storing This Food Store the brussels sprouts in the refrigerator. While they are most nutritious if used soon after harvesting, sprouts will keep their vitamins (including their heat-sensitive vitamin C) for several weeks in the refrigerator. Store the sprouts in a plastic bag or covered bowl to protect them from moisture loss.
Preparing This Food First, drop the sprouts into salted ice water to flush out any small bugs hiding inside. Next, trim them. Remove yellow leaves and leaves with dark spots or tiny holes, but keep as many of the darker, vitamin A–rich outer leaves as possible. Then, cut an X into the stem end of the sprouts to allow heat and water in so that the sprouts cook faster.
What Happens When You Cook This Food Brussels sprouts contain mustard oils (isothiocyanates), natural chemicals that break down into a variety of smelly sulfur compounds (including hydrogen sulfide and ammonia) when the sprouts are heated, a reaction that is intensified in aluminum pots. The longer you cook the sprouts, the more smelly compounds there will be. Adding a slice of bread to the cook- ing water may lessen the odor; keeping a lid on the pot will stop the smelly molecules from floating off into the air. But keeping the pot covered will also increase the chemical reaction that turns cooked brussels sprouts drab. Chlorophyll, the pigment that makes green vegetables green, is sensi- tive to acids. When you heat brussels sprouts, the chlorophyll in their green leaves reacts chemically with acids in the sprouts or in the cooking water to form pheophytin, which is brown. The pheophytin turns cooked brussels sprouts olive or, since they also contain yel- low carotenes, bronze. To keep cooked brussels sprouts green, you have to reduce the interaction between chlorophyll and acids. One way to do this is to cook the sprouts in a lot of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the hydrogen atoms can float off into the air, but this allows the smelly sulfur compounds to escape, too. The best solution is to steam the sprouts quickly in very little water, so they retain their vitamin C and cook before there is time for reaction between chlorophyll and hydrogen atoms to occur.
How Other Kinds of Processing Affect This Food Freezing. Frozen brussels sprouts contain virtually the same amounts of vitamins as fresh boiled sprouts.
Medical Uses and/or Benefits Protection against cancer. Naturally occurring chemicals (indoles, isothiocyanates, gluco- sinolates, dithiolethiones, and phenols) in brussels sprouts, broccoli, cabbage, cauliflower and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by pre- venting the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the transformation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. In 1997, the Johns Hopkins researchers discovered that broccoli seeds and three- day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated. Lower risk of some birth defects. Up to two or every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their mothers’ not having gotten adequate amounts of folate during pregnancy. NOTE : The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends * Brussels sprouts will lose as much as 25 percent of their vitamin C if you cook them in water that is cold when you start. As it boils, water releases oxygen that would otherwise destroy vitamin C. You can cut the vitamin loss dramatically simply by letting the water boil for 60 seconds before adding the sprouts. 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becoming pregnant and continuing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss.
Adverse Effects Associated with This Food Enlarged thyroid gland (goiter). Cruciferous vegetables, including brussels sprouts, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condi- tion or are taking thyroid medication. Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in brussels sprouts and produce gas that some people find distressing.
Food/Drug Interactions Anticoagulants Brussels sprouts are rich in vitamin K, the blood-clotting vitamin produced naturally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of drained, boiled brussels sprouts contains 219 mcg vitamin K, nearly three times the R DA for a healthy adult.... brussels sprouts
Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Low Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Calcium (moderate)
About the Nutrients in This Food All cabbage has some dietary fiber food: insoluble cellulose and lignin in the ribs and structure of the leaves. Depending on the variety, it has a little vitamin A, moderate amounts of the B vitamin folate and vitamin C. One-half cup shredded raw bok choy has 0.1 g dietary fiber, 1,041 IU vitamin A (45 percent of the R DA for a woman, 35 percent of the R DA for a man), and 15.5 mg vitamin C (21 percent of the R DA for a woman, 17 percent of the R DA for a man). One-half cup shredded raw green cabbage has 0.5 g dietary fiber, 45 IU vitamin A (1.9 percent of the R DA for a woman, 1.5 percent of the R DA for a man), 15 mcg folate (4 percent of the R DA), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man). One-half cup chopped raw red cabbage has 0.5 g dietary fiber, 7 mcg folate (2 percent of the R DA), and 20 mg vitamin C (27 percent of the R DA for a woman, 22 percent of the R DA for a man). One-half cup chopped raw savoy cabbage has one gram dietary fiber, 322 IU vitamin A (14 percent of the R DA for a woman, 11 percent of the R DA for a man), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man). Raw red cabbage contains an antinutrient enzyme that splits the thiamin molecule so that the vitamin is no longer nutritionally useful. This thiamin in hibitor is inactivated by cooking.
The Most Nutritious Way to Serve This Food Raw or lightly steamed to protect the vitamin C.
Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet
Buying This Food Look for: Cabbages that feel heavy for their size. The leaves should be tightly closed and attached tightly at the stem end. The outer leaves on a savoy cabbage may curl back from the head, but the center leaves should still be relatively tightly closed. Also look for green cabbages that still have their dark-green, vitamin-rich outer leaves. Avoid: Green and savoy cabbage with yellow or wilted leaves. The yellow carotene pig- ments show through only when the cabbage has aged and its green chlorophyll pigments have faded. Wilted leaves mean a loss of moisture and vitamins.
Storing This Food Handle cabbage gently; bruising tears cells and activates ascorbic acid oxidase, an enzyme in the leaves that hastens the destruction of vitamin C. Store cabbage in a cool, dark place, preferably a refrigerator. In cold storage, cabbage can retain as much as 75 percent of its vitamin C for as long as six months. Cover the cabbage to keep it from drying out and losing vitamin A.
Preparing This Food Do not slice the cabbage until you are ready to use it; slicing tears cabbage cells and releases the enzyme that hastens the oxidation and destruction of vitamin C. If you plan to serve cooked green or red cabbage in wedges, don’t cut out the inner core that hold the leaves together. To separate the leaves for stuffing, immerse the entire head in boiling water for a few minutes, then lift it out and let it drain until it is cool enough to handle comfortably. The leaves should pull away easily. If not, put the cabbage back into the hot water for a few minutes.
What Happens When You Cook This Food Cabbage contains mustard oils (isothiocyanates) that break down into a variet y of smelly sulfur compounds (including hydrogen sulfide and ammon ia) when the cabbage is heated, a reaction that occurs more strongly in aluminum pots. The longer you cook the cabbage, the more smelly the compounds will be. Adding a slice of bread to the cooking water may lessen the odor. Keeping a lid on the pot will stop the smelly molecules from floating off into the air, but it will also accelerate the chemical reaction that turns cooked green cabbage drab. Chlorophyll, the pigment that makes green vegetables green, is sensitive to acids. When you heat green cabbage, the chlorophyll in its leaves reacts chemically with acids in the cabbage or in the cooking water to form pheophytin, which is brown. The pheophytin gives the cooked cabbage its olive color. To keep cooked green cabbage green, you have to reduce the interaction between the chlorophyll and the acids. One way to do this is to cook the cabbage in a large quantity of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the volatile acids can float off into the air, but this allows the smelly sulfur compounds to escape too. The best way may be to steam the cabbage ver y quickly in ver y little water so that it keeps its vitamin C and cooks before there is time for the chlorophyll/acid reaction to occur. Red cabbage is colored with red anthocyanins, pigments that turn redder in acids (lemon juice, vinegar) and blue purple in bases (alkaline chemicals such as baking soda). To keep the cabbage red, make sweet-and-sour cabbage. But be careful not to make it in an iron or aluminum pot, since vinegar (which contains tannins) will react with these metals to create dark pigments that discolor both the pot and the vegetable. Glass, stainless-steel, or enameled pots do not produce this reaction.
How Other Kinds of Processing Affect This Food Pickling. Sauerkraut is a fermented and pickled produce made by immersing cabbage in a salt solution strong enough to kill off pathological bacteria but allow beneficial ones to sur- vive, breaking down proteins in the cabbage and producing the acid that gives sauerkraut its distinctive flavor. Sauerkraut contains more than 37 times as much sodium as fresh cabbage (661 mg sodium/100 grams canned sauerkraut with liquid) but only one third the vitamin C and one-seventh the vitamin A. * According to USDA, if you cook t hree cups of cabbage in one cup of water you will lose only 10 percent of t he vitamin C; reverse t he rat io to four t imes as much water as cabbage and you will lose about 50 percent of t he vitamin C. Cabbage will lose as much as 25 percent of its vitamin C if you cook it in water t hat is cold when you start. As it boils, water releases ox ygen t hat would ot her wise dest roy vitamin C, so you can cut t he vitamin loss dramat ically simply by lett ing t he water boil for 60 seconds before adding t he cabbage.
Medical Uses and/or Benefits Protection against certain cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in cabbage, brussels sprouts, broccoli, cauli- flower, and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by preventing the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the trans- formation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. In 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss. Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becom- ing pregnant and through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.
Adverse Effects Associated with This Food Enlarged thyroid gland (goiter). Cruciferous vegetables, including cabbage, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to pro- duce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condition or are taking thyroid medication. Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in cabbage, producing gas that some people find distressing.
Food/Drug Interactions Anticoagulants Cabbage contains vitamin K, the blood-clotting vitamin produced natu- rally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of shredded common green cabbage contains 163 mcg vitamin K, nearly three times the R DA for a healthy adult; one cup of drained boiled common green cabbage contains 73 mcg vita- min K, slightly more than the R DA for a healthy adult. Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyra- mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. If you eat a food such as sauerkraut which is high in tyramine while you are taking an M AO inhibitor, you cannot effectively eliminate the tyramine from your body. The result may be a hypertensive crisis.... cabbage
Habitat: Tidal creeks and mangrove swamps of India.
Folk: Orchaa (Bengal), Tivar, Chipi (Maharashtra).Action: Fruit—fermented juice is used for arresting haemorrhage. Juice of unripe fruit is given in cough. Fruit is also used as a poultice in sprains and swellings. Fruit wall—vermifuge.
The stem bark and root bark contain 9-17 and 11.0 to 11.9% tannin of the pyrogallol class.The fruit yields 11% pectin on dry basis.... sonneratia caseolarisNutritional Profile Energy value (calories per serving): Moderate (fresh figs) High (dried figs) Protein: Low Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Very high Sodium: Low (fresh or dried fruit) High (dried fruit treated with sodium sulfur compounds) Major vitamin contribution: B vitamins Major mineral contribution: Iron (dried figs)
About the Nutrients in This Food Figs, whether fresh or dried, are high-carbohydrate food, an extraordinarily good source of dietary fiber, natural sugars, iron, calcium, and potassium. Ninety-two percent of the carbohydrates in dried figs are sugars (42 percent glucose, 31 percent fructose, 0.1 percent sucrose). The rest is dietary fiber, insoluble cellulose in the skin, soluble pectins in fruit. The most important mineral in dried figs is iron. Gram for gram, figs have about 50 percent as much iron as beef liver (0.8 mg/gram vs. 1.9 mg/gram). One medium fresh fig has 1.4 g dietary fiber, six grams sugars, and 0.18 mg iron (1 percent of the R DA for a woman, 2 percent of the R DA for a man). A similar size dried, uncooked fig has 0.8 g fiber, four grams sugars and the same amount of iron as a fresh fig.
The Most Nutritious Way to Serve This Food Dried (but see How other kinds of processing affect this food, below).
Diets That May Restrict or Exclude This Food Low-fiber, low-residue diets Low-sodium (dried figs treated with sulfites)
Buying This Food Look for: Plump, soft fresh figs whose skin may be green, brown, or purple, depending on the variety. As figs ripen, the pectin in their cell walls dissolves and the figs grow softer to the touch. The largest, best-tasting figs are generally the ones harvested and shipped in late spring and early summer, during June and July. Choose dried figs in tightly sealed airtight packages. Avoid: Fresh figs that smell sour. The odor indicates that the sugars in the fig have fer- mented; such fruit is spoiled.
Storing This Food Refrigerate fresh figs. Dried figs can be stored in the refrigerator or at room temperature; either way, wrap them tightly in an air- and moistureproof container to keep them from los- ing moisture and becoming hard. Dried figs may keep for several months.
Preparing This Food Wash fresh figs under cool water; use dried figs right out of the package. If you want to slice the dried figs, chill them first in the refrigerator or freezer: cold figs slice clean.
What Happens When You Cook This Food Fresh figs contain ficin, a proteolytic (protein-breaking) enzyme similar to papain in papayas and bromelin in fresh pineapple. Proteolytic enzymes split long-chain protein molecules into smaller units, which is why they help tenderize meat. Ficin is most effective at about 140 –160°F, the temperature at which stews simmer, and it will continue to work after you take the stew off the stove until the food cools down. Temperatures higher than 160°F inac- tivate ficin; canned figs—which have been exposed to very high heat in processing—will not tenderize meat. Both fresh and dried figs contain pectin, which dissolves when you cook the figs, mak- ing them softer. Dried figs also absorb water and swell.
How Other Kinds of Processing Affect This Food Drying. Figs contain polyphenoloxidase, an enzyme that hastens the oxidation of phenols in the fig, creating brownish compounds that darken its flesh. To prevent this reaction, figs may be treated with a sulfur compound such as sulfur dioxide or sodium sulfite. People who are sensitive to sulfites may suffer serious allergic reactions, including potentially fatal ana- phylactic shock, if they eat figs that have been treated with one of these compounds. Canning. Canned figs contain slightly less vitamin C, thiamin, riboflavin, and niacin than fresh figs, and no active ficin.
Medical Uses and/or Benefits Iron supplementation. Dried figs are an excellent source of iron. As a laxative. Figs are a good source of the indigestible food fiber lignin. Cells whose walls are highly lignified retain water and, since they are impossible to digest, help bulk up the stool. In addition, ficin has some laxative effects. Together, the lignin and the ficin make figs (particularly dried figs) an efficient laxative food. Lower risk of stroke. Potassium lowers blood pressure. According to new data from the Harvard University Health Professionals Study, a long-running survey of male doctors, a diet rich in high-potassium foods such as bananas may also reduce the risk of stroke. The men who ate the most potassium-rich foods (an average nine servings a day) had 38 percent fewer strokes than men who ate the least (less than four servings a day).
Adverse Effects Associated with This Food Sulfite allergies. See How other kinds of processing affect this food.
Food/Drug Interactions MAO inhibitors. Monoamine oxidase (M AO) inhibitors are drugs used as antidepressants or antihypertensives. They inhibit the action of natural enzymes that break down tyramine, a nitrogen compound formed when proteins are metabolized, so it can be eliminated from the body. Tyramine is a pressor amine, a chemical that constricts blood vessels and raises blood pressure. If you eat a food rich in one of these chemicals while you are taking an M AO inhibitor, the pressor amines cannot be eliminated from your body, and the result may be a hypertensive crisis (sustained elevated blood pressure). There has been one report of such a reaction in a patient who ate canned figs while taking an M AO inhibitor.... figs
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