How to Write an APA Style Research Paper
General formatting rules are as follows:
- Do not put page breaks in between the introduction, method, results, and discussion sections.
- The title page, abstract, references, table(s), and figure(s) should be on their own pages.
- The entire paper should be written in the past tense, in a 12-point font, double-spaced, and with one-inch margins all around.
(see sample on p. 41 of APA manual)
- Title should be between 10-12 words and should reflect content of paper (e.g., IV and DV).
- Title, your name, and Hamilton College are all double-spaced (no extra spaces)
- Create a page header using the "View header" function in MS Word. On the title page, the header should include the following:
- Flush left: Running head: THE RUNNING HEAD SHOULD BE IN ALL CAPITAL LETTERS. The running head is a short title that appears at the top of pages of published articles. It should not exceed 50 characters, including punctuation and spacing. (Note: on the title page, you actually write the words Running head, but these words do not appear on subsequent pages; just the actual running head does. If you make a section break between the title page and the rest of the paper you can make the header different for those two parts of the manuscript).
- Flush right, on same line: page number. Use the toolbox to insert a page number, so it will automatically number each page.
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- No more than 120 words, one paragraph, block format (i.e., don’t indent), double-spaced.
- State topic, preferably in one sentence. Provide overview of method, results, and discussion
(Do not label as "Introduction." Title of paper goes at the top of the page—not bold)
The introduction of an APA-style paper is the most difficult to write. A good introduction will summarize, integrate, and critically evaluate the empirical knowledge in the relevant area(s) in a way that sets the stage for your study and why you conducted it. The introduction starts out broad (but not too broad!) and gets more focused toward the end. Here are some guidelines for constructing a good introduction:
- Don’t put your readers to sleep by beginning your paper with the time-worn sentence, Past research has shown....(blah blah blah) They’ll be snoring within a paragraph! Try to draw your reader in by saying something interesting or thought-provoking right off the bat. Take a look at articles you’ve read. Which ones captured your attention right away? How did the authors accomplish this task? Which ones didn’t? Why not? See if you can use articles you liked as a model. One way to begin (but not the only way) is to provide an example or anecdote illustrative of your topic area.
- Although you won’t go into the details of your study and hypotheses until the end of the intro, you should foreshadow your study a bit at the end of the first paragraph by stating your purpose briefly, to give your reader a schema for all the information you will present next.
- Your intro should be a logical flow of ideas that leads up to your hypothesis. Try to organize it in terms of the ideas rather than who did what when. In other words, your intro shouldn’t read like a story of "Schmirdley did such-and-such in 1991. Then Gurglehoff did something-or-other in 1993. Then....(etc.)" First, brainstorm all of the ideas you think are necessary to include in your paper. Next, decide which ideas make sense to present first, second, third, and so forth, and think about how you want to transition between ideas. When an idea is complex, don’t be afraid to use a real-life example to clarify it for your reader. The introduction will end with a brief overview of your study and, finally, your specific hypotheses. The hypotheses should flow logically out of everything that’s been presented, so that the reader has the sense of, “Of course. This hypothesis makes complete sense, given all the other research that was presented.”
- When incorporating references into your intro, you do not necessarily need to describe every single study in complete detail, particularly if different studies use similar methodologies. Certainly you want to summarize briefly key articles, though, and point out differences in methods or findings of relevant studies when necessary. Don’t make one mistake typical of a novice APA-paper writer by stating overtly why you’re including a particular article (e.g., "This article is relevant to my study because…"). It should be obvious to the reader why you’re including a reference without your explicitly saying so. DO NOT quote from the articles, instead paraphrase by putting the information in your own words.
- Be careful about citing your sources (see APA manual). Make sure there is a one-to-one correspondence between the articles you’ve cited in your intro and the articles listed in your reference section.
- Remember that your audience is the broader scientific community, not the other students in your class or your professor. Therefore, you should assume they have a basic understanding of psychology, but you need to provide them with the complete information necessary for them to understand the research you are presenting.
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The Method section of an APA-style paper is the most straightforward to write, but requires precision. Your goal is to describe the details of your study in such a way that another researcher could duplicate your methods exactly. The Method section typically includes Participants, Materials and/or Apparatus, and Procedure sections. If the design is particularly complicated (multiple IVs in a factorial experiment, for example), you might also include a separate Design subsection or have a "Design and Procedure" section. Note that in some studies (e.g., questionnaire studies in which there are many measures to describe but the procedure is brief), it may be more useful to present the Procedure section prior to the
Materials section rather than after it.
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- Total number of participants (# women, # men), age range, mean and SD for age, racial/ethnic composition (if applicable), population type (e.g., college students). Remember to write numbers out when they begin a sentence.
- How were the participants recruited? (Don’t say "randomly" if it wasn’t random!) Were they compensated for their time in any way? (e.g., money, extra credit points)
- Write for a broad audience. Thus, do not write, "Students in Psych. 280..." Rather, write (for instance), "Students in a psychological statistics and research methods course at a small liberal arts college…."
- Try to avoid short, choppy sentences. Combine information into a longer sentence when possible.
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Carefully describe any stimuli, questionnaires, and so forth. It is unnecessary to mention things such as the paper and pencil used to record the responses, the data recording sheet, the computer that ran the data analysis, the color of the computer, and so forth. If you included a questionnaire, you should describe it in detail. For instance, note how many items were on the questionnaire, what the response format was (e.g., a 5-point Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree)), how many items were reverse-scored, whether the measure had subscales, and so forth. Provide a sample item or two for your reader. If you have created a new instrument, you should attach it as an Appendix. If you presented participants with various word lists to remember or stimuli to judge, you should describe those in detail here. Use subheadings to separate different types of stimuli if needed. If you are only describing questionnaires, you may call this section "Measures."
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Include an apparatus section if you used specialized equipment for your study (e.g., the eyetracking machine) and need to describe it in detail.
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What did participants do, and in what order? When you list a control variable (e.g., "Participants all sat two feet from the experimenter."), explain WHY you did what you did. In other words, what nuisance variable were you controlling for? Your procedure should be as brief and concise as possible. Read through it. Did you repeat yourself anywhere? If so, how
can you rearrange things to avoid redundancy? You may either write the instructions to the participants verbatim or paraphrase, whichever you deem more appropriate. Don’t forget to include brief statements about informed consent and debriefing.
(labeled, centered, bold)
In this section, describe how you analyzed the data and what you found. If your data analyses were complex, feel free to break this section down into labeled subsections, perhaps one section for each hypothesis.
- Include a section for descriptive statistics
- List what type of analysis or test you conducted to test each hypothesis.
- Refer to your Statistics textbook for the proper way to report results in APA style. A t-test, for example, is reported in the following format: t (18) = 3.57, p < .001, where 18 is the number of degrees of freedom (N – 2 for an independentgroups t test). For a correlation: r (32) = -.52, p < .001, where 32 is the number of degrees of freedom (N – 2 for a correlation). For a one-way ANOVA: F (2, 18) = 7.00, p < .001, where 2 represents the dfbetween and 18 represents dfwithin. Remember that if a finding has a p value greater than .05, it is "nonsignificant," not "insignificant." For nonsignificant findings, still provide the exact p values. For correlations, be sure to report the r2 value as an assessment of the strength of the finding, to show what proportion of variability is shared by the two variables you’re correlating. For t- tests and ANOVAs, report eta2.
- Report exact p values to two or three decimal places (e.g., p = .042; see p. 114 of APA manual). However, for pvalues less than .001, simply put p < .001.
- Following the presentation of all the statistics and numbers, be sure to state the nature of your finding(s) in words and whether or not they support your hypothesis (e.g., "As predicted, …"). This information can typically be presented in a sentence or two following the numbers (within the same paragraph). Also, be sure to include the relevant means and SDs.
- It may be useful to include a table or figure to represent your results visually. Be sure to refer to these in your paper (e.g., "As illustrated in Figure 1…"). Remember that you may present a set of findings either as a table or as a figure, but not as both. Make sure that your text is not redundant with your tables/figures. For instance, if you present a table of means and standard deviations, you do not need to also report these in the text. However, if you use a figure to represent your results, you may wish to report means and standard deviations in the text, as these may not always be precisely ascertained by examining the figure. Do describe the trends shown in the figure.
- Do not spend any time interpreting or explaining the results; save that for the Discussion section.
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The goal of the discussion section is to interpret your findings and place them in the broader context of the literature in the area. A discussion section is like the reverse of the introduction, in that you begin with the specifics and work toward the more general (funnel out). Some points to consider:
- Begin with a brief restatement of your main findings (using words, not numbers). Did they support the hypothesis or not? If not, why not, do you think? Were there any surprising or interesting findings?
- How do your findings tie into the existing literature on the topic, or extend previous research? What do the results say about the broader behavior under investigation? Bring back some of the literature you discussed in the Introduction, and show how your results fit in (or don’t fit in, as the case may be). If you have surprising findings, you might discuss other theories that can help to explain the findings. Begin with the assumption that your results are valid, and explain why they might differ from others in the literature.
- What are the limitations of the study? If your findings differ from those of other researchers, or if you did not get statistically significant results, don’t spend pages and pages detailing what might have gone wrong with your study, but do provide one or two suggestions. Perhaps these could be incorporated into the future research section, below.
- What additional questions were generated from this study? What further research should be conducted on the topic? What gaps are there in the current body of research? Whenever you present an idea for a future research study, be sure to explain why you think that particular study should be conducted. What new knowledge would be gained from it? Don’t just say, "I think it would be interesting to re-run the study on a different college campus" or "It would be better to run the study again with more participants." Really put some thought into what extensions of the research might be interesting/informative, and why.
- What are the theoretical and/or practical implications of your findings? How do these results relate to larger issues of human thoughts, feelings, and behavior? Give your readers "the big picture." Try to answer the question, "So what?"
- Final paragraph: Be sure to sum up your paper with a final concluding statement. Don’t just trail off with an idea for a future study. End on a positive note by reminding your reader why your study was important and what it added to the literature.
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Provide an alphabetical listing of the references (alphabetize by last name of first author). Double-space all, with no extra spaces between references. The second line of each reference should be indented (this is called a hanging indent and is easily accomplished using the ruler in Microsoft Word). See the APA manual for how to format references correctly. Examples of references to journal articles start on p. 198 of the manual, and examples of references to books and book chapters start on pp. 202. Digital object identifiers (DOIs) are now included for electronic sources (see pp. 187-192 of APA manual to learn more).
Journal article example:
[Note that only the first letter of the first word of the article title is capitalized; the journal name and volume are italicized. If the journal name had multiple words, each of the major words would be capitalized.]
Ebner-Priemer, U. W., & Trull, T. J. (2009). Ecological momentary assessment of mood disorders and mood dysregulation. Psychological Assessment, 21, 463-475. doi:10.1037/a0017075
Book chapter example:
[Note that only the first letter of the first word of both the chapter title and book title are capitalized.]
Stephan, W. G. (1985). Intergroup relations. In G. Lindzey & E. Aronson (Eds.), The handbook of social psychology (3rd ed., Vol. 2, pp. 599-658). New York: Random House.
Gray, P. (2010). Psychology (6th ed.). New York: Worth
There are various formats for tables, depending upon the information you wish to include. See the APA manual. Be sure to provide a table number and table title (the latter is italicized). Tables can be single or double-spaced.
If you have more than one figure, each one gets its own page. Use a sans serif font, such as Helvetica, for any text within your figure. Be sure to label your x- and y-axes clearly, and make sure you’ve noted the units of measurement of the DV. Underneath the figure provide a label and brief caption (e.g., ―Figure 1. Mean evaluation of job applicant qualifications as
a function of applicant attractiveness level‖). The figure caption typically includes the IVs/predictor variables and the DV. Include error bars in your bar graphs, and note what the bars represent in the figure caption: Error bars represent one standard error above and below the mean.
(see pp. 174-179 of APA manual)
When citing sources in your paper, you need to include the authors’ names and publication date. You should use the following formats:
When including the citation as part of the sentence, use AND: "According to Jones and Smith (2003), the…"
When the citation appears in parentheses, use "&": "Studies have shown that priming can affect actual motor behavior (Jones & Smith, 2003; Klein, Bailey, & Hammer, 1999)." The studies appearing in parentheses should be ordered alphabetically by the first author’s last name, and should be separated by semicolons.
If you are quoting directly (which you should avoid), you also need to include the page number.
For sources with three or more authors, once you have listed all the authors’ names, you may write "et al." on subsequent mentions. For example: "Klein et al. (1999) found that...." For sources with two authors, both authors must be included every time the source is cited. When a source has six or more authors, the first author’s last name and "et al." are used every time the source is cited (including the first time).
"Secondary source" is the term used to describe material that is cited in another source. If in his article entitled "Behavioral Study of Obedience" (1963), Stanley Milgram makes reference to the ideas of Snow (presented above), Snow (1961) is the primary source, and Milgram (1963) is the secondary source. Try to avoid using secondary sources in your
papers; in other words, try to find the primary source and read it before citing it in your own work. If you must use a secondary source, however, you should cite it in the following way:
Snow (as cited in Milgram, 1963) argued that, historically, the cause of most criminal acts...
The reference for the Milgram article (but not the Snow reference) should then appear in the reference list at the end of your paper.


Parents have a right to be concerned about their children’s exposure to lead. A potent neurotoxin, lead negatively and irreversibly affects the brain, kidneys and nervous system.
Highly toxic, lead-based paint was banned in the U.S. in 1978. Since then, the percentage of children with high levels of lead in their blood has plummeted from 88% to 1.6% in 2005. But despite these efforts, The American Academy of Pediatrics estimates that one in four children live in housing with deteriorated lead paint.
The most likely cause of a child’s lead poisoning is from a window painted with lead-based paint. Repeated opening and closing causes the paint to flake and release dangerous particles into the air. Old windows should be replaced entirely or the paint should be shaved off and repainted and the inside frame replaced with vinyl or aluminum. For other tips on how you can reduce your child’s exposure to lead, read our article about maintaining indoor air quality.
USA Today has an in-depth article about the fight against lead in the home. It’s a fascinating read for those interested in this hidden danger and the battle to eradicate it.


Many common dental problems are caused by plaque and other germs that are on the tongue; therefore, keeping your tongue clean and healthy can eliminate some of the problems that can arise if you have an unhealthy tongue. The tongue has long been considered one of the strongest muscles in the body, but it is actually made up of a group of muscles. These muscles serve many functions; the most obvious being the ability to taste food, swallow and talk. The tongue is covered with a tissue referred to as the mucosa. There are tiny bumps on the mucosa called the papillae. The papillae are covered with your taste buds which are the nerves that are connected to the nerves that transmit to the brain. It was once thought there was a “taste map” of the tongue and certain areas detected different tastes, but actually all parts of the tongue can detect the four common: taste, sweet, sour, salty and bitter.
There are a numerous conditions that can be associated with common tongue symptoms, such as halitosis. Any discoloration or tongue soreness can be an indicator of a deeper health issue also. Some symptoms can be associated with more serious problems, including AIDS, oral cancer, scarlet fever and vitamin deficiencies.
The adult mouth contains thousands of types of bacteria at any given time. Some is ingested and some comes through the saliva. Most of the bacteria are beneficial to your health but there also thousands of types of bacteria that can be harmful to your oral health which can also affect your overall health. A relatively clean mouth can have up to 100,000 bacteria on each tooth and even more on the tongue sitting in between the papillae. For those that do not maintain good oral hygiene habits, as many as 1 billion bacteria can be clogged in between the papillae on your tongue. The bacteria in your mouth are competing for food and places to grow on your tongue and in between your teeth. Unlike other places on or in your body, the tongue does not slough or diffuse the bacteria. Some of the bacteria will die but other types of bacteria can survive on your tongue for weeks. In their prime, these bacteria can cause major damage to your teeth and gums.
A person can never really get rid of all the germs and bacteria in their mouth. The bacteria are constantly being replenished by your own saliva, but it can be managed by regular brushing, flossing, rinsing and drinking plenty of water.
Understanding that the tongue is a vital muscle and making sure you have good tongue health is imperative to your overall health. Eating a healthy diet, reducing acid intake and caffeine can be preventive measures for your tongue health. In addition to a healthy diet, brushing your tongue daily and maintaining your twice yearly dental checkups helps keep your tongue healthy.
Dr. Cowdin and her staff are committed to your overall oral health, not just keeping up with your regular teeth cleanings. We treat your entire mouth and provide you with most up to date information available.


Seeing the Unseen: Breaking the Logjam of Undernutrition in Pakistan
Edited by: Lawrence Haddad, Zulfigar A. Bhutta and Haris Gazdar
Volume 44Number 3
After a lost decade, there is clearly a groundswell of momentum for nutrition in Pakistan, driven by a confluence of policy, evidence and events. This momentum needs to be sustained at the national level, reinforced at the provincial and sub-provincial levels, and converted into action.
The articles in this IDS Bulletin highlight some of the key features of undernutrition in Pakistan and its drivers. The correlates of undernutrition in Pakistan are no different than any other country: infection, poor diet quantity and quality, and unequal gender relations. High levels of poverty and fragility make the context for undernutrition reduction more difficult.Yet, the articles here also show that government nutrition interventions can work. But if the log jam of malnutrition in Pakistan is to be broken for good, malnutrition will have to be viewed as a development outcome – one that is a foundation for other outcomes such as economic growth and social cohesion – and this will only be achieved by viewing nutrition through a political-economy lens.
The collection of 12 articles in this issue represents a contribution to the potential moment of change. They do three things: (1) describe the nutrition status and its correlates and causes, (2) assess some of the interventions employed to combat undernutrition, and (3) analyse the political context within which these interventions emerged and will have to operate in the future. They aim to give additional definition to the debate of what it is desirable and possible to do to accelerate undernutrition reduction in Pakistan and why it is essential to do so.


The events that led up to the Brink’s-MAT Robbery in London in 1983 are fascinating because of their daring, intrigue, and criminal ingenuity. The heist, in which a group of armed men stole £26 million in gold bullion, diamonds, and cash from a Brink’s-MAT security warehouse, is widely regarded as one of the most audacious in British history.
The Brink’s-MAT Robbery is a great story because of the enormous number of players involved, the high stakes, and the intricate web of criminal relationships and events that followed. The actual robbery was carried out with military precision and brutal efficiency. The uniqueness of this crime, however, was in its aftermath, which saw violence, murder, and a trail of intrigue that spanned multiple countries as the stolen riches disappeared into the criminal underworld.
You can learn more about the thieves, their elaborate plans, and the tense moments as law enforcement raced against time in a book about the Brink’s-MAT Robbery. A book can shed light on the murky workings of criminal organizations, the intricate logistics of dealing with stolen commodities, and the struggle for control and supremacy among criminal gangs.


Role of neonatal team including nurses in prevention of ROP
Retinopathy of Prematurity (ROP) is a preventable cause of blindness in children. As smaller and sicker neonates are surviving in the neonatal intensive care unit (NICU), the incidence and severity of ROP is also on the rise. We are now facing the third epidemic of ROP; the first being in 1950s with liberal oxygen use, the second one in the developed world where smaller and smaller babies survived and the third epidemic in India/developing world, where ROP is additionally seen in bigger babies, for lack of optimal care and oxygen administration.1 It is time to identify the preventable causes of ROP and implement solutions that would result in reduction of incidence and severity of ROP. In this article we aim to identify the role of nurses and health staff in preventing ROP and in identifying at-risk babies in the NICU for effective screening of ROP.
Prevention of ROP
Prevention of ROP includes improved care in the NICU. Improved care results in reduced morbidities and reduced risk factors that put a neonate at-risk for developing ROP. Improved neonatal care is the domain of pediatricians, medical officers, resident doctors and neonatal nurses who are involved in the care of these babies. Any intervention to improve quality care of a newborn can contribute to reducing the incidence of ROP in developing countries.
Judicious oxygen therapy
Oxygen is a drug and it should be administered in a quantity that is appropriate to the need. Each neonatal care unit should have a written policy outlining appropriate use of oxygen therapy. Oxygen level in the blood should be continuously monitored using a pulsoximeter. A target of 90-95% SpO2 in all newborns on any respiratory support, including oxygen therapy, should be maintained.2 One should avoid 100% oxygen in the labour room and use a blender to target SpO2. The most important tool at hand today is control of oxygen saturation. It is also important to avoid fluctuations in SpO2 especially at high levels.
Judicious use of blood transfusions Transfusion of packed RBCs is another ROP risk factor. Adult haemoglobin has α2β2 chains which have low affinity for oxygen as compared to the haemoglobin of preterm babies, hence more tissue delivery of oxygen results in hyperoxia. Adult RBCs are rich in 2, 3 Diphosphoglyceric acid (DPG) and this binds with deoxyhemoglobin and stabilises the low oxygen carrier state making it difficult for oxygen to bind, resulting in more release of oxygen to the retinal tissue. Significantly low haemoglobin or platelets on the other hand can also worsen ROP. Hence written guidelines for transfusion in the NICU will help in restricting adult blood transfusions.
Use of prenatal steroids is a well-known approach to prevent respiratory distress and intraventricular haemorrhage, two important risk factors of ROP. All women expected to deliver between 24 to 34 weeks of gestation should be given a course of either betamethasone or dexamethasone intramuscularly at-least 24 hours before the delivery of the baby.3
Postnatal weight gain predicts risk of retinopathy of prematurity. Poor weight gain in postnatal period increases the risk of severe ROP.4,5 Insulin-like growth factor 1 (IGF-1) controls VEGF-mediated vascular growth, which is important for retinal vasculature. Hence both increased nutrition and adequate IGF-1 concentrations seem to be necessary for postnatal growth and reduction in risk of ROP.6 Ensuring early administration of colostrum, exclusive and aggressive use of mothers own milk or donor milk, human milk fortification, kangaroo mother care, mothers involvement in baby care are some of the interventions in improving the nutritional status of preterm infant.
Infections Neonatal infections, particularly fungal infections, are also risk factors for ROP. A systematic review and meta-analysis of eight studies found that systemic fungal infection in very low birth weight infants was significantly associated with ROP and severe ROP.7 Neonatal bacteremia is associated with severe retinopathy of prematurity in extremely low gestational age neonates. The increased risk associated with infection might be partly due to systemic inflammation, which could act synergistically with hyperoxia. Chorioamnionitis is often associated with higher levels of circulating proinflammatory cytokines which could act with postnatal infections resulting in higher cytokines and later development of ROP. Some of the Do’s and Don’ts in prevention of neonatal infections are described in Table 1.
Table 1 Achievements of Mission Roshni in two years
|Hand hygiene||Excessive use of antibiotics|
|Aggressive use of enteral feedsmadrasas||Evasive ventilation|
|Restricted oxygen||Central lines|
|Bundles of care (eg. VAP, CLABSI)|
|Optimal nurse : patient ratio|
|Good house keeping|
To summarise, prevention of ROP by reducing risk factors that disrupt normal retinal vascularisation is likely to be more effective than late treatment of neovascularisation. This is not only with respect to vision, but also with other co-morbidities of a premature birth. Careful control of oxygen saturation, normalisation of serum IGF-1 concentrations, provision of adequate nutrition, curbing the negative effects of infection and inflammation, judicious use of oxygen in delivery room and the NICU, and a reduction in blood transfusion in the NICU could promote adequate postnatal growth and improve neural and vascular development of the retina. Nurses in the NICU are the backbone of all NICUs across the world. All the nurses should promote quality care and developmentally supportive care in the NICU.
Secondary prevention of ROP: early case detection and treatment
The unit should have protocols that cover all steps of screening and management of ROP.
- The simplest method to ensure that all eligible infants are examined at an appropriate time is to identify them when they are first admitted to the NICU. A nurse can help by entering details into a book or electronic database, noting the date of the first examination and subsequent examinations. This helps in ensuring no baby is missed for ROP screening.
- Deciding when examinations are complete and organising timely treatment and long-term follow-up also remains a challenge. Nurses can help in establishing clear communication between neonatologists, resident doctors and ophthalmologist in the NICUs and, importantly, with parents.
- ROP prevention is a team responsibility, and parents must be seen as equal partners in that team. Good communication is at the heart of the relationship between the baby’s present medical caregivers and the parents, the future caregivers. Nursing staff inevitably spend the maximum time talking to parents. They are often the most trusted members of the team, so their input into written material and how it is presented is vital.
- Good awareness of communication problems, clear-cut organisational responsibilities and most importantly, working closely with parents as equal partners should prevent most of the difficulties in ROP screening.
Nurses role in prevention can be summarised in the following manner
Specialist knowledge in clinical management
Nurses should be aware of all the risk factors known to be associated with ROP. They should form the core team in implementing good practices such as target oxygen saturation, encouraging breastfeeding, hand hygiene and asepsis to reduce infections, and support for nutrition to achieve good weight gain. These would help in reducing ROP in the unit.
Nurses are primary care givers in a neonatal ICU. They can also advocate for providing best practices in the NICU. Some of these include kangaroo care, thermal care, infection prevention and breastfeeding. Advocating for the adjustment of environmental factors (minimal handling, noise and light) and developmental care are core components of nursing. That will maximise the chances of healthier developmental outcomes in extremely preterm newborns, including vision, hearing and cognitive function.
Leadership and mentoring
For sustainable change, leadership from within the nursing profession for policies on educational opportunities and competency-based training programmes is needed. Experienced nurses can coach the young nurses to improve quality care in the NICU.
Nurses are key personnel who counsel parents regarding breast milk and kangaroo care. They provide emotional support and motivate parents in developmental care, adherence to ROP screening and follow-up. Using innovative strategies such as ROP appointment and follow up cards for parents or using mobile applications can ensure timely management of ROP.
Neonatal nurses are pillars of the NICU. Their knowledge and clinical skills help in providing the best practices to prevent ROP in preterm babies. Nurses ensure that services for preterm and low birth weight (LBW) babies include timely eye screening and organisation of follow up services.
Table 2 Ready reckoner for nurses in prevention and management of ROP
|Identify newborns at risk of ROP at admission to the NICU. Note the expected screening date and time on the case file.|
|Encourage communication with the obstetrician for improving the coverage of antenatal steroid usage.|
|Restrict oxygen use in the NICU. Monitor saturations in all babies on oxygen and set targets between 90 to 95%.|
|Restrict usage and duration of antibiotics, intravenous fluids, parenteral nutrition and continuous positive airway pressure.|
|Encourage mothers of preterm babies to use kangaroo mother care, continue with breastfeeding and aggressive enteral nutrition and developmentally supportive care.|
|Co-ordinate with the neonatal and ophthalmology team in timely preparation of the newborn (pain relief and eye dilatation) for ROP screening.|
|Monitor the newborn during the screening procedure.|
|Play an active part in communication with the parents on screening outcomes and need for treatment when needed.|
|At discharge brief the mother on the need for subsequent screening for ROP, hearing and neuro-development.|
- Gilbert C. Retinopathy of prematurity: A global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008;84:77-82
- Askie LM, Darlow BA, Davis PG etal. Effects of targeting lower versus higher arterial oxygen saturations on death or disability in preterm infants. Cochrane Database Syst Rev. 2017 Apr 11;4
- Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No.: CD004454. DOI: 10.1002/14651858.CD004454
- Hellström A, Engström E, Hård AL, Albertsson-Wikland K, Carlsson B, Niklasson A, Löfqvist C, Svensson E, Holm S, Ewald U, Holmström G, Smith LE. Postnatal serum insulin-like growth factor I deficiency is associated with retinopathy of prematurity and other complications of premature birth. Pediatrics. 2003;112(5):1016–1020
- Fortes Filho JB, Bonomo PP, Maia M, Procianoy RS. Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies. Graefes Arch Clin Exp Ophthalmol. 2009;247:831-836
- Can E, Bülbül A, Uslu S, Cömert S, Bolat F, Nuhoğlu A. Effects of aggressive parenteral nutrition on growth and clinical outcome in preterm infants. Pediatr Int. 2012 Dec;54(6):869-74
- Bharwani SK, Dhanireddy R. Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review. J Perinatol. 2008;28:61–66


Soybean is an important food, oil and feed crop worldwide. However, soybean production is very limited in China. To increase the soybean yield, there is an urgent need to develop soybean varieties that can grow and adapt to the vast areas of saline, alkaline and arid lands.
A research team led by Prof ZHANG Jinsong from the Institute of Genetics and Developmental Biology (IGDB) of the Chinese Academy of Sciences (CAS) reported the roles and mechanisms of a transcriptional regulator GmZF351 in salt and drought stress tolerance in stable transgenic soybean plants.
ZHANG's group previously discovered that the gene is highly expressed in soybean seeds and promotes oil accumulation in developing seeds. This gene shows little or no expression at the seedling and/or vegetative stage. However, under salt and other stresses, the gene is activated for stress tolerance in soybean.
They found that histone demethylation may be involved in such a transition. Under normal conditions, the histones are highly methylated at the promoter region of the GmZF351 gene. Upon salt treatment, two histone demethylase genes, JMJ30-1 and JMJ30-2, are activated, resulting in the removal of the histone H3K27me3 at the GmZF351 promoter and thus activation of the gene.
The researchers further analyzed the cis-elements bound by the zinc finger protein GmZF351. The element contains two of the motif CT(G/C)(T/A)AA for recognition. All the downstream genes involved in oil biosynthesis and stress tolerance have such features in their promoter regions. However, the GmZF351 activated different sets of genes for lipid accumulation in soybean seeds and in response to salt and drought stress.
For plants, it is costly and energy intensive to resist stress and survive for future generations. Therefore, stress tolerance and yield/storage accumulation must be fully considered during plant growth and development to complete the life cycle.
The newly identified gene GmZF351 can promote both oil accumulation in seeds and stress tolerance in seedlings, balancing these two important biological processes in different organs and at different developmental stages.
Understanding the dual functions of GmZF351 may shed light on the balancing mechanism of a crop for seed yield/storage and survival during crop domestication, and provide inspiring basis and insights for developing new soybean varieties suitable for unfavorable saline lands and environments.
This study was supported by the National Natural Science Foundation of China and the Key Project of CAS.
Performance of the GmZF351 transgenic soybean plants and its working model in stress tolerance. A. Performance of the GmZF351 transgenic plants under salt stress. Jack is the original control cultivar. Null is segregated from heterozygous transgenic plants and without transgene insertion. OE-34/40/73 indicate independent homozygous transgenic lines; B. Performance of the transgenic plants under drought stress; C; Comparison of water loss in detached leaves at different times; D. A working model of GmZF351 in stress response. Under normal well-watered condition, the histones H3K27 is highly methylated at the promoter region of GmZF351, blocking gene expression. Under stress, the histone demethylase JMJ30 is induced and the methylation of H3K27 is reduced, allowing activation of GmZF351 and subsequent downstream gene expression for stomata closure and stress tolerance. (Image by IGDB)


Cave Dwellings of Scotland
From Cliff Castles and Cave Dwellings of Europe by S. Baring-Gould, M.A.
Sir Arthur Mitchell describes some troglodytes in Scotland. ["The Past in the Present," Edin. 1880, pp. 73-7.] "In August 1866, along with two friends, I visited the great cave at the south side of Wick Bay. It was nine at night, and getting dark when we reached it. It is situated in a cliff, and its mouth is close to the sea. Very high tides, especially with north-east winds, reach the entrance and force the occupants to seek safety in the back part of the cave, which is at a somewhat higher level than its mouth.
"We found twenty-four inmates--men, women, and children--belonging to four families, the heads of which were all there. They had retired to rest for the night a short time before our arrival, but their fires were still smouldering. They received us civilly, perhaps with more than mere civility, after a judicious distribution of pence and tobacco. To our great relief, the dogs, which were numerous and vicious, seemed to understand that we were welcome.
"The beds on which we found these people lying consisted of straw, grass and bracken, spread upon the rock or shingle, and each was supplied with one or two dirty, ragged blankets or pieces of matting. Two of the beds were near the peat-fires, which were still burning, but the others were further back in the cave where they were better sheltered.
"On the bed nearest the entrance lay a man and his wife, both absolutely naked, and two little children in the same state. On the next bed lay another couple, an infant, and one or two elder children. Then came a bed with a bundle of children, whom I did not count. A youngish man and his wife, not quite naked, and some children, occupied the fourth bed, while the fifth from the mouth of the cave was in possession of the remaining couple and two of their children, one of whom was on the spot of its birth. Far back in the cave--upstairs in the garret, as they facetiously called it--were three or four biggish boys, who were undressed, but had not lain down. One of them, moving about with a flickering light in his hand, contributed greatly to the weirdness of the scene. Beside the child spoken of, we were told of another birth in the cave, and we heard also of a recent death there, that of a little child from typhus. The Procurator-Fiscal saw this dead child lying naked on a large flat stone. Its father lay beside it in the delirium of typhus, when death paid this visit to an abode with no door to knock at.
"Both men and women, naked to their waists, sat up in their lairs and talked to us, and showed no sense of shame. One of the men summoned the candle-boy from the garret, in order that we might see better, and his wife trimmed the dying fire, and then, after lighting her pipe, proceeded to suckle her child.
"In the afternoon of the next day, with another friend, I paid a second visit to this cave, when we found eighteen inmates, most of whom were at an early supper, consisting of porridge and treacle, apparently well cooked and clean. One of the women was busy baking. She mixed the oatmeal and water in a tin dish, spread the cake out on a flat stone which served her for a table, and placing the cake against another stone, toasted it at the open fire of turf and wood. This was one of three fires, all situated about the centre of the wider part or mouth of the cave, each with a group about it of women and ragged children.
"There was no table, or chair, or stool to be seen, stones being so arranged as to serve all these purposes. There was no sort of building about the entrance of the cave to give shelter from the winds, which must often blow fiercely into it. Yet this cave is occupied both in summer and winter by a varying number of families, one or two of them being almost constant tenants.
"I believe I am correct in saying that there is no parallel illustration of modern cave life in Scotland. The nearest approach to it, perhaps, is the cave on the opposite or north side of the same bay. Both of these caves I have had frequent opportunities of visiting, and I have always found them peopled. Only occasional use is made of the other caves on the Caithness and Sutherland coasts. Of these, perhaps the cave of Ham, in Dunnet parish, is the most frequented. It is the nearness to a large town which gives to the Wick caves their steady tenants. The neighbouring population is large enough to afford room for trading, begging, and stealing--all the year round.
"The occupants of the Wick caves are the people commonly known by the name of Tinkers. They are so called chiefly because they work in tinned iron. The men cut, shape, hammer, while the women do the soldering.
"The Tinkers of the Wick caves are a mixed breed. There is no Gipsy blood in them. Some of them claim a West Island origin. Others say they are true Caithness men, and others again look for their ancestors among the Southern Scotch. They were not strongly built, nor had they a look of vigorous bodily health. Their heads and faces were usually bad in form. Broken noses and scars were a common disfigurement, and a revelation at the same time of the brutality of their lives. One girl might have been painted for a rustic beauty of the Norse type, and there was a boy among them with an excellent head. It is possible that one or both of these may yet leave their parents, from dissatisfaction with the life they lead."
These cave-dwellers of Wick were the offscourings of society, such as might be found in any town slum. "Virtue and chastity exist feebly among them, and honour and truth more feebly still; they neither read nor write; they go to no church, and have scarcely any sort of religious belief or worship. They know little or nothing of their history beyond what can be referred to personal recollection."
These, like the slum dwellers of a town, are recruited from outside, they do not constitute a race; they are the dregs of a race--persons who have dropped out of the line of march.
An interesting account of the excavation of two caves at Archerfield, in Haddingtonshire, is given in the Proceedings of the Society of Antiquaries of Scotland for 1909. Both caves are natural, but one had been walled up in front, with a doorway and window and with oven; both had paved hearths in the centre, and there was evidence that they had been tenanted some time after the Roman occupation of Britain, as among the fragments of pottery found was some Samian ware. It would appear that both had been inhabited simultaneously, but not consecutively, for a lengthy period, and no doubt can exist that they were mere rock refuges. In a note to the article we read: "On the coast of Island Magee (Ireland) there is a cave, south of the Gobbins, which has been frequently used as a place of refuge. So late as 1798 it was inhabited by outlaws, who constructed a kind of fortification at the entrance, the remains of which still exist." [Footnote: Cree (J. R.), "Excavation of Two Caves," in "Proceedings of the Soc. of Arch. of Scotland," Edin., 1909, vol. xliii.]
A cave in the Isle of Egg, one of the Hebrides, has a very narrow entrance, through which one can creep only upon hands and knees, but it rises steeply within and soon becomes lofty, and runs into the bowels of the rock for 225 feet. The stony, pebbly bottom of this cavern was for long strewn with the bones of men, women and children, the relics of the ancient inhabitants of, the island, two hundred in number, of whose destruction the following account is given. "The Macdonalds, of the Isle of Egg, a people dependent on Clanranald, had done some injury to the Lord of Macleod. The tradition of the isle says that it was by a personal attack on the chieftain, in which his back was broken; but that of the two other isles bears that the injury was offered by two or three of the Macleods, who, landing upon Egg and behaving insolently towards the islanders, were bound hand and foot, and turned adrift in a boat, which the winds safely conducted to Skye. To avenge the offence given, Macleod sailed with such a body of men as rendered resistance hopeless. The natives, fearing his vengeance, concealed themselves in the cavern; and, after strict search, the Macleods went on board their galleys after doing what mischief they could, concluding the inhabitants had left the isle. But next morning they espied from their vessels a man upon the island, and immediately landing again, they traced his retreat by means of a light snow on the ground to the cavern. Macleod then summoned the subterranean garrison, and demanded that the inhabitants who had offended him should be delivered up. This was peremptorily refused. The chieftain thereupon caused his people to divert the course of a rill of water, which, falling over the mouth of the cave, would have prevented his purposed vengeance. He then kindled at the entrance of the cavern a large fire, and maintained it until all within were destroyed by suffocation." [Footnote: Lockhart's "Life of Sir Walter Scott," Edin., 1844, p.285.]
In Pitscottie's "Chronicles of Scotland," and in Holinshed's "Scottish Chronicle," at the end of the reign of James II there is a story of a brigand who is said to have lived in a den called Feruiden, or Ferride's Den, in Angus, who was burnt along with his wife and family for cannibalism, the youngest daughter alone was spared as she was but a twelvemonth old. But when she grew up she was convicted of the same crime, and was condemned to be burnt or buried alive.
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Diabetes is a complex and complicated disease. The evidence on new technologies and therapeutic treatments is rapidly expanding our knowledge and ability to manage diabetes and its complications, which is the first step in taking control. Must of this care is “Self-managed,” meaning you must take day-to-day responsibility for your own care. The information we have provided on this website is for you to learn as much as you can about diabetes including care information for your convenience and to help improve your quality of life with diabetes.
Diabetes is a chronic disease that results from the body’s inability to sufficiently produce or properly use insulin. Insulin is a hormone that is secreted from beta cells in the pancreas and needed to convert sugar, starches and other food into energy needed for daily life. Without insulin, the cells of the body cannot absorb sufficient glucose from the bloodstream. Diabetes occurs in several forms, but Type 1 and Type 2 are the two most common forms and represent about 10% and 90% respectively of the total diabetic population in Finland.
Prevalence and Impact
In Finland there are about 300 000 people diagnosed with diabetes. There are, however, numerous people whose diabetes is yet to be diagnosed. Diabetes is more common within male population. An average of 15 000 new cases of diabetes are diagnosed every year and diabetes is spreading in alarming numbers, for example, the current number of people with type 2 diabetes is tenfold to the one of mid 1900’s.
Type I and Type II Diabetes
Type I Diabetes
Type 1 diabetes is when your body does not produce insulin at all and may account for 5 to 10% of all diagnosed cases of diabetes. A person with Type 1 diabetes needs insulin shots to use glucose from the food they eat. Without insulin, your body can't use sugar and fat broken down from the food you eat. When sugar can't get into your cells, your blood glucose rises and it's this high blood glucose level that damages your body.
Type 1 diabetes develops most often in children or young adults but can occur at any age. It can come on suddenly, often after an illness. There is no cure for Type 1 diabetes, but because of new knowledge about the disease and new medical advances, good self-care is now possible. A person with diabetes can live a healthy life and avoid or experience few complications from the disease.
Characteristics of Type 1 diabetes
- Most common in children
- Quick onset with thirst, frequent urination, weight loss developing and worsening over days to weeks
- Usually no known family history
- No major risk factors; risk is increased if there is a strong family history
- Insulin shots required to control diabetes
- Blood glucose levels are sensitive to small changes in diet, exercise, and insulin dose
Type II Diabetes
Type 2 diabetes, previously known as non-insulin dependent diabetes, is when your body does not produce enough insulin and it doesn’t use insulin properly, typically begins after age 40. People with Type 2 need diabetes pills or insulin shots to help their bodies use glucose for energy. Type 2 diabetes is the most common type of diabetes, accounting for 90 to 95 percent of all diabetes.
Type 2 diabetes is a progressive disease that can cause significant, severe complications such as heart disease, kidney disease, blindness and loss of limbs through amputation. Treatment differs at various stages of the condition. In its early stages, many people with Type 2 diabetes can control their blood glucose levels by losing weight, eating properly and exercising. Many may subsequently need oral medication, and some people with Type 2 diabetes may eventually need insulin shots to control their diabetes and avoid the disease's serious complications.
The onset of Type 2 diabetes is a two-stage process: (1) resistance to insulin's action, often exacerbated by obesity, followed by (2) the pancreas failing to increase insulin enough to compensate adequately. Life expectancy is reduced by 5 to 10 years in middle-aged people with Type 2 diabetes.
Characteristics of Type 2 Diabetes
- Most common in adults, although more younger people are developing this type
- Usually slow onset with thirst, frequent urination, weight loss developing over weeks to months
- Usually runs in families
- Most people who get this type are overweight or obese
- Treatment usually begins with diet and exercise, progressing to use of oral medications and later to insulin as the disease advances
- Blood glucose levels may improve with weight loss, change in diet and increased exercise
- May be prevented or delayed in high-risk individuals by moderate weight loss and exercise
Pregnancy and Diabetes
Some women, about 3 to 5 percent of all pregnant women, get this form of diabetes during pregnancy, which is also known as gestational diabetes. It is defined as hyperglycemia with onset or first recognition during pregnancy.
Gestational Diabetes happens when the body doesn't make enough insulin and resists the action of insulin because of hormones. The condition develops about midway through the pregnancy. It usually ends when the baby is born, but some women who have gestational diabetes go on to develop diabetes when they get older. Some studies have reported that almost 40 percent of women who have gestational diabetes will go on to develop Type 2 diabetes. Although most women with this condition are treated with diet, some women may need insulin. The problem can't be treated with pills because the medication can harm the baby.
Gestational diabetes usually doesn't cause birth defects, but one of the problems is the possibility of having a baby that is considerably larger than normal. There is also the risk that the baby might have low blood glucose right after it's born.
Children and Teens with Diabetes
Diabetes mellitus is the most common endocrine disease and one of the most common chronic conditions in children. Type 2 diabetes and other types of diabetes, including genetic defects of beta cell function such as maturity-onset diabetes of the young, also known as MODY, are increasing in frequency and should be considered when clinical presentation is atypical for Type 1 diabetes. Fortunately today, advances in treatment and monitoring of blood glucose levels have made diabetes far less difficult to deal with than it used to be. Still, it is a serious condition with potentially critical complications and requires lifelong monitoring and treatment.
While the majority of children with diabetes have Type 1 (a.k.a. juvenile diabetes), a growing number of kids and teens are being diagnosed with Type 2 diabetes, which was once considered an “adults only” disease.
A major modifiable risk factor for the development of Type 2 diabetes for children is obesity. As parent, it’s important to give them the autonomy they need to own their own diabetes, while simultaneously staying close enough to their treatment to ensure their safety. It can be a difficult balance, and one that constantly shifts along with developmental changes in your child.
It’s important to remember that children mature at different rates; what one child can handle at age seven another may be ready for at age four. In addition, each child’s individual emotional and physical development can also progress at varying speeds. For example, you preschool-aged child may have the mental capacity to test her own blood glucose levels, but lack the fine motor skills to do the job. However, even the smallest child can be empowered to take part in her diabetes care by reading a blood glucose monitor screen, unzipping a supply case, or choose an injection or testing site.
Here are some basic diabetes management skill sets, and general guidelines on when your child may be ready to take them on:
- Self-testing blood glucose levels. Somewhere between ages 5 and 7 children may start expressing an interest in testing their own blood glucose levels. As long as their testing method is correct, there’s no reason not to pass along this task to your child. By age 8, most children should have this task mastered (unless they’re newly diagnosed). Parents should remind children to test at the appropriate times and should help interpret blood glucose readings.
- Counting carbohydrates. Between ages 7 and 9 children may begin asking about carbohydrates and engaging in simple carb counting. Child-geared systems that use visual aids such as flashcards and refrigerator magnets may help your child understanding carb counting earlier.
- Taking insulin. Between the ages 8 and 12 most children should be able to administer injections; parents should oversee dose calculation and drawing up of the insulin, although doing so in a hands-off manner will help your child build the skills and confidence she needs to take over the task permanently. The same goes for regulating insulin pump therapy.
Type I Diabetes
Type I diabetes is more common among whites than Asian, Hispanic, Native and African Americans. If you have a close relative with the disease, you are more likely to develop Type I.
Type II Diabetes
Type II diabetes also tends to run in families. In fact there seems to be even stronger evidence for some kind of genetic cause for Type II than for Type I diabetes. Type II is more common among Asian, Hispanic, Native and African Americans.
Although Type II diabetes usually develops after age 40, about half of all people diagnosed with the disease are older than 55. This may be because as people age, they tend to become more sedentary and to gain weight. Eating too much food and being inactive can make you obese and you are more likely to develop Type II diabetes if you are obese. Obesity is, by far, the greatest risk factor for this kind of diabetes.
Where the weight is distributed seems to be a factor, too. If you tend to have an apple-shaped body in which you store fat around the tummy, you are more at risk for Type II diabetes. Those with a pear shape in which fat is stored in the hips are somewhat less at risk.
Any woman can develop gestational diabetes during pregnancy, but some women are more at risk than others. Some risk factors include obesity, a family history of diabetes, having previously given birth to a very large baby, a stillbirth, a child with a birth defect or having too much amniotic fluid. Women who are older than 25 are at higher risk than younger women.
- Obesity – with Body Mass Index (BMI) of 30 or over
- Family history of Type II diabetes
- If you are an older mom – age 35 or over
- If you previously delivered larger babies (between 3,8 kg and 4,5kg)
- If you have high blood pressure
- You are Hispanic, African American, Native American, South or East Asian, or of Pacific Island descent.
Type 1 Diabetes Symptoms
Symptoms of Type 1 diabetes usually appear suddenly and require immediate medical attention. They include:
- being exceptionally thirsty
- dry mouth
- the need to urinate often
- weight loss (even though you may be hungry and eating well)
- feeling weak and tired
- blurry vision
Type 2 Diabetes Symptoms
Sometimes, people with Type 2 diabetes don't notice any symptoms or the symptoms are experienced gradually. They include:
- blurry vision
- cuts or sores that are slow to heal
- itchy skin, yeast infections
- increased thirst
- dry mouth
- need to urinate often
- leg pain
Diabetes is a serious condition with potentially devastating complications that affects all age groups worldwide. Both Type 1 and Type 2 diabetes are associated with long-term complications that threaten life and the quality of life. The disease is the leading cause of adult blindness, end-stage kidney disease (ESRD) and amputations (as a result of nerve disease). People with diabetes are two to four times more likely to have coronary heart disease and stroke than people who don't have it. Diabetes complicates pregnancy and results in more birth defects than babies born to women without the disease.
Heart Disease and Stroke
Having diabetes puts you at increased risk for heart disease and stroke. This is the biggest cause of death for people with diabetes. The disease process changes your body and can make you prone to fatty deposits in your arteries. These deposits can cause a heart attack. Diabetes can also make your blood more likely to clot and this can result in heart attack and stroke. The disease also puts you at risk for high blood pressure, which is a major cause of both heart disease and stroke.
Diabetic Kidney Disease and Hypertension
Diabetes is the most common cause of kidney failure. However, it's also true that most people with diabetes don't go on to have end-stage kidney disease (ESRD). Early in diabetes, the blood-filtering units of the kidneys are damaged. This means important proteins are lost in the urine. A urine test that measures protein can show beginning diseases. Later in the disease, the kidneys can't remove waste products from the blood.
Hypertension is not just a cause of kidney disease, but it's also a result of damage created by the kidney disease. Physical changes in the kidneys contribute to high blood pressure creating a dangerous spiral.
Diabetic Eye Disease
Diabetic eye disease refers to a group of eye problems that people with diabetes may have as a complication of the disease. All of these diseases can cause vision loss or even blindness. They include diabetic retinopathy, damage to the vessels of the retina; cataract, clouding of the eye's lens and glaucoma, an increase in fluid pressure inside the eye that leads to optic nerve damage and vision loss. Diabetic retinopathy is the most common eye disease associated with diabetes and it's the leading cause of blindness in American adults.
Diabetic neuropathy is a nerve disorder caused by diabetes. Sometimes it involves numbness and pain in hands, feet or legs, but nerve damage can also affect other systems in your body. Neuropathy can come on suddenly and cause problems with digestion, gastroparesis, heart problems, bladder infections, impotence, weight loss and weakness.
About 20 percent of the people with Type 1 diabetes develop this disorder in which the stomach takes too long to empty. People with Type 2 diabetes get it also, but less often. Diabetes damages the vagus nerve, which is the nerve that keeps food moving through the digestive tract. Gastroparesis can cause food to harden into solid masses and can cause blockages and bacteria problems. The fact that the stomach isn't working properly can also disturb the absorption of glucose and make it harder to control blood glucose.
Diffuse neuropathy is a kind of nerve problem that affects many parts of the body. There are two types of diffuse neuropathy. Peripheral neuropathy affects the feet and hands and autonomic neuropathy affects the internal organs. Autonomic neuropathy can affect a lot of body processes and systems, everything from sexual response in both women and men, digestive problems that cause weight loss, even regulation of body temperature and sweat.
This kind of diabetic neuropathy appears suddenly and affects specific nerves, most often in the torso, leg or head. Symptoms can include severe pain in an area of the body, eye and hearing problems or even paralysis on one side of the face called Bell's palsy. Carpel tunnel syndrome is a common symptom of focal neuropathy. This type of neuropathy is unpredictable and most often occurs in older people who have mild diabetes. Although it's painful, it tends to improve by itself without causing long-term damage.
If your blood glucose drops below about 3,3 mmol/l, you can have a low blood glucose reaction called hypoglycemia. It may occur once or twice a week if you have Type 1 diabetes. Hypoglycemia is much less common with Type 2 diabetes, but it can happen especially with certain oral medications, missed meals, and exercise without proper precautions. The typical threshold for hypoglycemia is 3,9 mmol/l, although it may be higher or lower depending on a patient’s individual blood glucose target range.
Symptoms include erratic heartbeat, sweating, dizziness, confusion, unexplained fatigue, shakiness, hunger, and potential loss of consciousness. People who have tight control of their diabetes are more at risk for low blood glucose and so are the elderly. Once a low is recognized, it should be treated immediately with a fast-acting carbohydrate such as glucose tablets or juice.
Too much sugar in the blood is called hyperglycemia. This is a problem that, left uncontrolled, can damage eyes, kidneys, heart, nerves and blood vessels. Causes include eating too much food, too little insulin or other medication, forgetting to take insulin or medication, skipping normal exercise, feeling sick or stressed. If your blood glucose is over 18,3 mmol/l, you may test your urine for ketones, which are made when your body burns fat instead of glucose for energy. You should drink lots of fluids, check your glucose frequently and call a doctor or nurse. If your blood glucose is more than 27,8 mmol/l and there are signs of ketones in your urine, get to a hospital immediately.
Often there are no signs with hyperglycemia. But if the blood glucose is extremely high, you may experience headache, blurry vision, thirst, hunger, frequent urination, dry skin, upset tummy or a fruity smell on the breath.
Extremely high blood glucose levels can lead to one of two conditions — diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS; also called hyperglycemic hyperosmolar nonketotic coma). Although both syndromes can occur in either Type 1 or Type 2 diabetes, DKA is more common in Type 1 and HHNS is more common in Type 2.
This is a severe complication associated with hyperglycemia. When your body lacks insulin, two things happen. Blood glucose levels rise, which causes excess urination as the body excretes water in order to try to dissolve the glucose. This can lead to increased urination and dehydration, and ketosis starts slowly and gradually builds up. Common symptoms include loss of appetite, stomach pain, nausea and vomiting, and deep and rapid breathing. Others signs are a flushed face, dry skin and mouth, fruity breath odor, a rapid and weak pulse, and low blood pressure. You may test for ketones in your urine with special test strips that are available in drugstores.
Second, because the body cannot metabolize glucose, it begins to burn fat for energy. Normal byproducts of fat metabolism are acidic substances called ketones. When fats are the main source of energy, ketones accumulate in the blood and in urine. They change the body’s chemical balance to the acidic range, a condition known as ketoacidosis. It is life threatening but reversible with prompt treatment. You should drink fluids and inject insulin right away. If you are unable to keep fluids down because of nausea or vomiting, it can become a critical medical emergency. Patients who do not get fluids and insulin right away may lapse into a coma.
Monitoring and Testing
Home blood glucose testing is an important part of controlling blood glucose for diabetics. One important goal of diabetes treatment is to keep the blood glucose levels near the normal range of 3,9 to 6,7 mmol/l before meals and under 7,8 mmol/l at 2 hours after eating. Blood glucose (BG) levels are usually tested before and after meals, and at bedtime. The blood glucose level is typically determined by pricking a fingertip with a lancing device and applying the blood to a glucose meter, which reads the value. Since blood glucose levels can fluctuate widely, even frequent home glucose testing may not accurately reflect the degree of success in controlling blood glucose.
Self Monitoring Blood Glucose Test
Self-monitoring of blood glucose (SMBG) levels through home testing is a fundamental tool of diabetes management which most people with diabetes can benefit from. Potential benefits, including A1C improvement, avoidance and identification of hypoglycemia and increased lifestyle flexibility, are enhanced when individuals receive self-management education that enables them to adjust their dietary choices, physical activity and medication in response to SMBG values.
The frequency of SMBG should be determined individually, based on the type of diabetes, the treatment prescribed, the need for information about BG levels and the individual’s capacity to use the information from testing to modify behaviors or adjust medication. Your diabetes health care professional will help you to set the target range fro your glucose levels. They will also help you determine when and how often to test your blood glucose. Some suggested times are:
People with Type 1 diabetes and pregnant women taking insulin are recommended to test their blood glucose levels at least 3 times a day. People with Type 2 diabetes who take multiple injections of insulin daily should also test 3 or more times a day. Testing before and after meals is associated with improved glycemic control compared to testing before meals alone.
Testing should be frequent enough to achieve blood glucose goals, and both Type 1 and Type 2 patients should test more often when:
- You add or adjust your medication for diabetes
- You think your blood glucose levels may be too low or too high
- You are ill, or feeling uncomfortable over long periods of time
Meters are available that allow SMBG using blood samples from sites other than the fingertip, such as the forearm, palm of the hand or thigh. Accuracy of results is variable across sites. During periods of rapid change in BG levels such as, after meals, after exercise and during hypoglycemia, fingertip testing has been shown more accurate glycemic status than other sites. In comparison, blood samples taken from the palm near the base of the thumb demonstrate a closer correlation to fingertip samples at all times of day, and during periods of rapid change in BG levels.
Hemoglobin A1c (HbA1c) test
The hemoglobin A1c test - also called HbA1c, glycated hemoglobin test, or glycohemoglobin - is an important blood test used to determine how well your diabetes is being controlled. Hemoglobin A1c provides an average of your blood glucose control over a six to 12 week period and is used in conjunction with home blood glucose monitoring to make adjustments in your diabetes medicines.
Hemoglobin is a substance within red blood cells that carries oxygen throughout your body. When your diabetes is not controlled, sugar builds up in your blood and combines with your hemoglobin, becoming "glycated." Therefore, the average amount of sugar in your blood can be determined by measuring a hemoglobin A1c level. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. The amount of hemoglobin A1c will reflect the last several weeks of blood glucose levels, typically encompassing a period of 120 days.
In most labs, the normal range is 4-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it's less than 7.0%.
|Level of Control||A1C Number|
|Normal Range||4 – 5.9%|
|Well Controlled||7% or Lower|
|Take Action||Higher than 8%|
The benefits of measuring A1c is that it gives a more reasonable view of what's happening over the course of time, generally the last 3 months, and the value does not bounce as much as finger stick blood glucose measurements.
People with diabetes should have this test every three months to determine whether their blood glucose levels have reached the target level of control. Those who have their diabetes under good control may be able to wait longer between the blood tests, but experts recommend checking at least 2 times a year.
A ketone test checks for ketones in your blood or urine. Ketones are substances that are made when the body breaks down fat for energy. Normally, your body gets the energy it needs from carbohydrate in your diet. However, stored fat is broken down and ketones are made if your diet does not contain enough carbohydrate to supply the body with glucose for energy or if your body cannot use blood glucose properly.
Ketone testing is recommended for all individuals with Type 1 diabetes during periods of acute illness accompanied by elevated blood glucose level. If blood glucose levels remain elevated (> 14.0 mmol/L) or when symptoms such as nausea, vomiting or abdominal pain are present, ketone testing should be considered because it may mean you have diabetic ketoacidosis, a potentially life-threatening condition.
The level of ketones, and not just the presence of ketones, may be important to your doctor as well. Many conditions can change ketone levels. Fasting usually causes only mild increases in the level, but ketone levels in diabetic ketoacidosis are much higher. Your health professional will discuss any significant abnormal results with you in relation to your symptoms and medical history.
A urine test is the most commonly used method of measuring ketones, but blood test may be preferred over urine test, as they have been associated with earlier detection of ketosis and response to treatment.
Other Laboratory Glucose Tests
Fasting Plasma Glucose Test
This is the test that screens for diabetes by measuring the level of glucose in a person's blood plasma after a period of fasting (not eating). The fasting plasma glucose test is given to nonpregnant adults who are at high risk for diabetes. It is a carbohydrate metabolism test which measures plasma, or blood glucose levels after you have gone at least 8 hours without eating. Fasting stimulates the release of the hormone glucagon, which in turn raises plasma glucose levels. In people without diabetes, the body will produce and process insulin to counteract the rise in glucose levels. In people with diabetes this does not happen, and the tested glucose levels will remain high. Most people have a level between 3,9 and 6,1 millimoless of glucose per liter of blood. A level of 7,3 mmol/l or higher on two tests given on two different days confirms a diagnosis of diabetes. Individuals with a fasting plasma glucose level less than 7,3 mmol/l but greater than or equal to 6,1 mmol/l are classified as having impaired fasting glucose.
Random Plasma Glucose Test
This is the test generally as a screening for diabetes when a patient has had food or drink and therefore cannot do a fasting plasma glucose test or oral glucose tolerance test. It is performed with a small blood draw taken at any time of the day, which is sent to the lab for analysis. In general, the glucose level under 11,1 mmol/l is considered normal for this test. Levels higher than 11,1 mmol/l, along with the presence of symptoms of diabetes, indicate a diagnosis of diabetes. It is recommended that the diagnosis be confirmed with a subsequent retest on a different day. The retest should be an oral glucose tolerance test or the fasting plasma glucose test if possible.
Oral Glucose Tolerance Test
This is the test for diabetes that occurs with pregnancy, and it is usually done during the 24th to the 28th week of pregnancy. It measures your blood glucose levels four or five times over a 3-hour period after you have gone at least 8 hours without eating, smoking or drinking coffee. You will be asked to drink a sweet glucose syrup of about 75 to 100 grams, which should cause glucose levels to rise in the first hour, and then fall back to normal within three hours as the body produces insulin to normalize glucose levels. On average, normal glucose levels typically peak at 8,89 – 10 mmol/l from 30 minutes to 1 hour after administration of the oral glucose dose, and should then return to fasting levels of 7,78 mmol/l or less within a 2- to 3-hour period. Because the OGTT is a more sensitive test than the fasting plasma glucose test, and involves multiple blood draws to monitor insulin production, it can often detect cases of diabetes that may be missed by the fasting test.
If you have Type 1 diabetes, your body doesn't make insulin which helps sugar from food be turned into energy. If you have Type 2 diabetes, your pancreas does not make enough insulin and your body can't use it properly. Sometimes, eating a healthy diet and getting enough exercise will control Type 2 Diabetes. Sometimes, your doctor will give you medication. However, diabetes medications that lower blood glucose level never take the place of healthy eating and exercise. Some people, after a few years of taking oral medication, will need to begin taking insulin.
Insulin lowers blood glucose by moving sugar from the blood into the cells of your body. Once inside the cells, sugar provides energy. If you take insulin, you'll need to eat on time and match your insulin injections to your meals. Your insulin should peak at the same time blood glucose levels from meals are also peaking.
Most people with diabetes need at least two insulin shots a day for good blood glucose control. Some people take three or four shots a day to have a more flexible plan. You should take insulin 30 minutes before a meal if you take regular insulin alone or with a longer-acting insulin. If you take lispro (Humalog), or insulin aspart (Novolog), two insulins that works really fast, you should take your shot just before you eat.
A rough guideline to remember is that one unit of insulin lowers blood glucose by 50 mg/dL and covers about 10 to 15 grams of carbohydrate.
Usually, people with Type 1 diabetes don't use oral medications. These medications work best in people with Type 2 diabetes who have had high blood glucose for less than ten years and who have normal weight or obesity. It's not uncommon for oral medication to control blood glucose well for years and then stop working. Some people who begin treatment with oral medications eventually need to take insulin. You should also pay closer attention to possible side effects that these oral medications may have.
Sulfonylureas act to force your pancreas to make more insulin, which then lowers your blood glucose.
For this medication to work, your pancreas has to make some insulin. The correct time to take these medications varies.
The generic name of this drug is metformin. It helps lower blood glucose by making sure your liver doesn't make too much sugar. Metformin also lowers the amount of insulin in your body. You may lose a few pounds when you start to take metformin. This weight loss can help you control your blood glucose. Metformin can also improve blood fat and cholesterol levels, which are often high if you have Type 2 diabetes. It is normally taken two to three times each day with a meal.
There are now two alpha-glucosidase inhibitors, acarbose and miglitol. Both medications block the enzymes that digest the starches you eat. This action causes a slower and lower rise of blood glucose through the day, but mainly right after meals.
Acarbose and Miglitol are taken three times daily, at meals, although your doctor might ask you to take the medication less often at first. It should be taken with the first bite of a meal.
The generic names for these medications are pioglitazone and troglitazone. The medication works by helping make your cells more sensitive to insulin. The insulin can then move glucose from your blood into your cells for energy.
Pioglitazone is usually taken once a day at the same time, with or without a meal. Trosiglitazone is taken either once or twice a day, at the same time each day, with or without a meal.
This is a new type of diabetes medication. Repaglinide is a generic name for one of the meglitinides. This medication helps your pancreas make more insulin right after meals, which lowers blood glucose. Your doctor might prescribe repaglinide by itself or with metformin if one medication alone doesn't control your blood glucose. A good thing about repaglinide is that it works fast and your body uses it quickly. This fast action means you can vary the times you eat and the number of meals you eat more easily than you can with other diabetes medications. These work like short acting sulfonylureas.
Your doctor will tell you to take repaglinide before you eat a meal. If you skip a meal, you shouldn't take the dose. Repaglinide is taken from 30 minutes before to just before a meal. It lowers blood glucose the most one hour after it's taken, and it is out of the bloodstream in three to four hours.
Diet and Exercise
Diabetes and exercise go hand in hand. Whether you’re scaling mountains, working out with a trainer at the gym, or taking long walks around your neighborhood, making exercise a part of your daily routine can help you enjoy a healthier diabetes life.
A Healthier Weight and Lifestyle
Reaching and maintaining a healthy weight is important for everyone with diabetes. Weight control is extremely important in treating Type 2 diabetes because extra body fat makes it difficult for people with Type 2 diabetes to make and use their own insulin. If you are overweight, losing just 5-10Kg may improve your blood glucose control so much that you can stop taking or reduce your medication.
Moderating Sugar, Fat and Carbohydrates
The body breaks down different types of foods at different rates. Carbohydrates typically take from five minutes to three hours to digest, whereas protein takes three to six hours and fat can take eight or more hours. That's why different foods have different effects on blood glucose, such as why ice cream raises blood glucose levels more slowly than potatoes. But people with diabetes don’t always have to forgo desserts and sweets. They just have to be sure not to eat moderate amounts more than once or twice a week.
Sometimes, it may seem easier to pop a pill or even take a shot than to put on your walking shoes and hit the trail. But the truth is that exercise, in combination with a healthy diet, is one of the best things you can do to take care of yourself if you have diabetes.
- Exercise burns calories, which will help you lose weight or maintain a healthy weight.
- Regular exercise can help your body respond to insulin and is known to be effective in managing blood glucose. Exercise can lower blood glucose and possibly reduce the amount of medication you need to treat diabetes, or even eliminate the need for medication.
- Exercise can improve your circulation, especially in your arms and legs, where people with diabetes can have problems.
- Exercise can help reduce your cholesterol and high blood pressure. High cholesterol and high blood pressure can lead to a heart attack or stroke.
- Exercise helps reduce stress, which can raise your glucose level.
- It can lower your risk for heart disease, reduce your cholesterol levels and your blood pressure.
In some people, exercise combined with a meal plan, can control Type 2 Diabetes without the need for medications.
Tips for start exercising
- If you're planning to walk or jog, be sure your shoes fit well and are designed for the activity you have in mind. Be alert for blisters. Wear new shoes for a bit each day until they're comfortable and not as likely to cause blisters. Remember, always wear socks.
- Start slowly with a low-impact exercise such as walking, swimming, or biking.
- Build up the time you spend exercising gradually. If you have to, start with five minutes and add a bit of time each day.
- Always wear an ID tag indicating that you have diabetes to insure proper treatment in case there's a problem when you're exercising or you have an injury.
- Avoid lifting very heavy weights as a precaution against sudden high blood pressure.
- If you have foot problems, consider swimming or biking, which is easier on the feet than jogging.
- Stretch for five minutes before and after your workout regardless of how intense you plan to exercise.
Try to exercise at the same time every day for the same duration. This will help control your blood glucose. Exercise at least three times a week for about 30 to 45 minutes.
If your blood glucose level is over 16,7 mmol/l, if you are sick, short of breath, have ketones in your urine or are experiencing any tingling, pain or numbness in your legs, don't exercise. Also if your medication is peaking, it's better not to exercise.
What you eat is one of the most important aspects of managing diabetes. Don't fight against good nutrition. Find tips and ideas to make healthful eating a part of your busy lifestyle.
People with diabetes should pay careful attention to nutrition and diet as part of your treatment program. Nutrition experts say that there is no one diet for diabetes, but people with diabetes should follow the nutrition guidelines, while paying special attention to carbohydrate intake. People with diabetes should also eat about the same amount of food at the same time each day to keep blood glucose levels stable.
If you've never attempted to eat a healthy, well-balanced diet before your diabetes diagnosis, it can be difficult to know where to get started. Some tips include:
- Eat more starches such as bread, cereal, and starchy vegetables. Aim for six servings a day or more. For example, have cold cereal with nonfat milk or a bagel with a teaspoon of jelly for breakfast. Another starch-adding strategy is to add cooked black beans, corn or garbanzo beans to salads or casseroles.
- Eat five fruits and vegetables every day. Have a piece of fruit or two as a snack, or add vegetables to chili, stir-fried dishes or stews. You can also pack raw vegetables for lunch or snacks.
- Eat sugars and sweets in moderation. Include your favorite sweets in your diet once or twice a week at most. Split a dessert to satisfy your sweet tooth while reducing the sugar, fat and calories.
If you smoke and have been diagnosed with diabetes, your doctor will recommend that you quit because smoking makes problems caused by diabetes worse. People with diabetes can experience blood flow problems in the legs and feet, which can sometimes lead to amputation, and smoking can decrease blood flow even more. Smoking can also worsen sexual impotence in men, cause high levels of LDL cholesterol, and can raise the risk of heart attack and stroke. (lifeclinic) Each year, 45,000 Canadians die of smoking-related illnesses.
Smoking is a habit that hurts everyone, smokers and non-smokers alike. Smokers are insulin resistant, show signs of insulin resistance syndrome, and are at an increased risk – 50% in men and women – for developing Type 2 diabetes. Those who smoke second-hand, even if they don’t mean to, are at risk of developing cancer, breathing problems, and heart disease. These people are more susceptible to colds and flu, and may even die younger than those who don’t breathe second-hand smoke.
Smoking can also aggravate many problems that people with diabetes already face, such as heart and blood vessel disease. Smoking can:
- cut the amount of oxygen reaching tissues, which can lead to a heart attack, stroke, miscarriage, or stillbirth.
- increase your cholesterol and other fat levels and the levels, raising your risk of a heart attack.
- damage and constrict the blood vessels, which worsen foot ulcers and lead to blood vessel disease and leg and foot infections.
- increase your risk for limited joint mobility.
- cause cancer of the mouth, throat, lung, and bladder.
- increase your blood pressure.
- raise your blood glucose level, making it harder to control your diabetes.
People with diabetes who smoke are three times as likely to die of cardiovascular disease than other people with diabetes. Those with Type 1 and Type 2 diabetes who smoke are at risk for micro- and macrovascular complications, as well as diabetic nephropathy, retinopathy, and neuropathy.
Whether you’ve been smoking for a lifetime or have just started, quitting smoking is the best thing you can do to decrease your risk of diabetic complications. It is never too late to get on the road to good health.
Trips often hold surprises, delays and changes that can affect what you eat, when you eat, when you monitor your blood glucose levels, and the amount of physical activity you engage in. Think about your regular daily schedule, and try to stick to it as closely as possible. This is especially important if you are traveling to a different time zone. So, before your trip, talk to your doctor and diabetes educator to plan your timing for medication, testing, food, and activity.
A few common-sense preparations can help make a heart patient's travel both safe and enjoyable. Discuss your travel plans with your doctor ahead of time, including:
- What medical equipment or devices you need to take with you
- Physical exertion
- Trips to high altitudes
- Exposure to very cold or very hot climates
Other tips to help assure a smooth trip:
- If you have frequent or severe symptoms, don't travel alone.
- Include frequent breaks to avoid fatigue, especially when traveling by car.
- Take an adequate supply of your prescription drugs; if you will run out of one during the trip, get an extra supply before you go, since you may not be able to get your prescription refilled in another state or country.
- Carry your prescription drugs in your carry-on luggage so they won't get separated from you.
- Arrange for special meals or a wheelchair (if needed) with your travel agent or airline representative when you make a reservation.
When flying or riding in a car, reduce the risk of blood clots in the legs by doing "ankle pumps" while you're seated: point your toes out as far as possible and then pull them as far toward your skin as you can.
- Move around every one to two hours to increase comfort and reduce risk for blood clots.
- Tell at least one person traveling with you about your diabetes.
- Never go barefoot, even in the shower or pool.
- Be careful about food safety when traveling in some countries.
- Use bottled water to brush your teeth.
- Drink bottled water with no ice.
- Eat only cooked vegetables and fresh fruit that can be peeled.
- Only consume pasteurized dairy foods.
- Don’t eat food from street vendors.


Change is situational. Transition, on the other hand, is psychological. it is not those events, but rather the inner reorientation or self-redefinition that you have to go through in order to incorporate any of those changes into your life. Without a transition, a change is just a rearrangement of the furniture. Unless transition happens, the change won't work, because it doesn't "take".
-- William Bridges, Transitions: Making Sense of Life's ChangesThis quote hangs in my office as a daily reminder that we must honor the transition process if we truly desire authentic change.
it is hard to imagine a change in education that does not directly impact kids and teachers. Whether it's a new resource, structural or environmental shifts, or a different teaching method, both kids and teachers have to process the transition that the change brings, even when it is a desired change. Moreover, it may require that kids and teachers redefine themselves and their relationships with each other -- not necessarily an easy thing to do.
An example might be if teachers decided to solicit and use student feedback in an action research cycle over the course of a school year to improve student engagement. Assume that both teachers and kids were excited about the project -- there is still a process through which both groups have to transition to new roles, and perhaps even redefine identities that break free of the traditional teacher-student hierarchy. If the status quo paradigm is not shifted, it is likely the innovation will not "take".
Another example might be buying flexible or more "interactive" furniture for your classroom or learning environment. If teacher internal reorientation about he or she might now teach, and student internal reorientation about he or she might now learn, doesn't take place, it is likely that the furniture will end up being used in more traditional settings instead of expanding potential.
As we look to redefine the components of education, we need to pay attention to how we will also internally redefine ourselves. And, we need to make sure that we take the time to allow, support, and nurture that transition.
Join the conversation...
How have you processed the transition for change in your life, either personally or professionally?
Thanks for reading,
P.S. For more on identity and change, click here.


(NaturalNews) Would you knowingly eat rat poison or drink gasoline? Obviously not, as it will harm and perhaps kill you. Yet many people today are consuming the poisonous foods I list in this article without giving it a second thought. They are doing this because they've been successfully deceived by the media, the culture or family traditions into thinking that these ingredients don't require a second thought.
Regardless of the reason, the "garbage in garbage out" principle is still true. The illnesses that people you know and love suffer from are just the result of their body being fed this garbage. Prevention is still the best medicine. Therefore, the way we achieve the health and healing that the body was designed for is to prevent this junk food garbage from going in our body in the first place; then we won't have to deal with the garbage coming out (in the form of disease, etc.).
All food is not created equal
One of the popular yet toxic foods is caffeine. Coffee is fine, but the caffeine is the problem. Why is caffeine so toxic? Research shows that caffeine is one of the toxic chemicals produced by some plants as a defense mechanism against being eaten or disturbed. In fact, these chemicals (of which, caffeine is one) work to produce neurological damage in plant-eating animals. Yet, companies harvest and package this addictive chemical as an ingredient in various foods and sell it to the public. But if it can promote neurological damage in animals, just imagine what it's doing to humans over the long term. Herbal coffee (i.e. real coffee) and herbal tea are healthier alternatives.
White table salt and white sugar are some more toxic ingredients. Consuming these can weaken the immune system's defense against a cold or flu as well as lead to type 2 diabetes, arthritis, obesity, emotional problems, tooth decay, dehydration, kidney failure, hypertension, heart disease, cancer, etc. If the ingredients label just says "salt," "sugar" or "evaporated cane juice," it's safe to assume that it's the processed kind. Now the body does need salt, but it needs the natural, unprocessed salt (still containing its trace minerals) which is pink in color. A source of healthy natural sugar (which the body also needs) comes from fruit and vegetables (preferably organic). Stevia, xylitol and raw honey are healthier sugar substitutes as well.
Consuming processed grains such as white flour, white rice and packaged cereals can contribute to heart disease, abdominal fat, constipation and more. Look for sprouted and whole grains (quinoa, brown rice, etc). In addition, numerous studies like the China Study show that consumption of dairy and excessive animal products has contributed to physical problems like cancer, osteoporosis, heart disease, obesity and more.
Due to space constraints for this article, I can only mention one more category of poison foods: genetically modified (GM) foods. This is a broad topic, but suffice it to say that studies show a strong link associating the consumption of GM crops (e.g. corn, soy, alfalfa) and the animals that eat these crops with the rise of food allergies, pregnancy complications, reduced fertility in humans and more. In addition, evidence shows that some GMOs produce their own built-in pesticides which have caused health problems in laboratory animals. Unless the food/ingredient is non-GMO-verified or organic, it may be a GM food.
Though they should, ultimately it's not the job of the food industry to warn consumers of the dangers of toxic food/ingredients; it's your responsibility. Read the ingredients labels, and get informed so you can avoid the toxins that will put you on a path away from optimal health.
About the author: Jay Ricci is a resident of Massachusetts, gospel minister, certified health minister/coach and has been a health writer, researcher and lecturer for years. He has taught one day health seminars and Hallelujah Acre's nine week health course called Get Healthy Stay Balanced. Jay continues to educate all interested parties about empowering our self-healing bodies and experiencing the optimal health we were created for as outlined in 3rd John 1:2 in the New Testament.
Subscribe to his free health newsletter packed with health recipes, coupons, personal testimonies and more here: https://yourcompletehealthnow.wordpress.com
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