8. Béo phì và dinh dưỡng

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A diabetic patient

Student nurse: The new patient has had diabetes since childhood, his notes say.
Nutritionist: Uh huh. He has type one, then?
Student nurse: What's that?
Nutritionist: There's type one diabetes and there's type two. Type one usually appears before the age of eighteen. Does he inject himself with insulin?
Student nurse: Yes, daily.
Nutritionist: Uh huh. OK. He's on a special diet, is he?
Student nurse: Yes, but he's not overweight.
Nutritionist: No. Type one diabetes is not linked to obesity.
Student nurse: So obesity is linked to type two, is it?
Nutritionist: Yes. Type two is the common one.
Student nurse: This patient has a special machine to check levels of glucose in his blood. And he shouldn't eat sugar, right.
Nutritionist: Well, no, it's not true that diabetics shouldn’t eat sweet things. Actually, what's important is balance. A diabetic like your patient should eat the same amount of food at the same time of day. He needs to count the calories in his meals, and he should have snacks, not big meals - specially before bed.
Student nurse: Oh, why is that?
Nutritionist: To avoid hypoglycaemia.
Student nurse: Hypoglycaemia - not enough glucose in the blood, right?
Nutritionist: Right.

An eating disorder
Staff nurse: The new patient's name is Anita Josephs. Anita is sixteen. She fainted and an ambulance brought her in, so we are keeping her in for a forty-eight-hour observation. Anita is very underweight. She weighs 38.8 kilos.
Nurse: That puts her BMI in the danger zone.
Staff nurse: Yes, her mother believes she has anorexia. She told me about Anita's personality changes and mood swings…
Nurse: A typical teenager?
Staff nurse: To a point, yes. But Anita is obsessed with dieting. She doesn't eat, so she gets stomach pains, frequent constipation, and attacks of dizziness.
Nurse: What does Anita say?
Staff nurse: She says she feels miserable all the time, but she doesn't know why. However, she doesn't believe she has a weight problem. She told me that she eats the same as everyone else. And she doesn't think her weight loss is abnormal. However, she does say she has difficulty sleeping, and is losing her hair, and she has also stopped having periods.

Body bits

1. Vitamin C is needed to help the skin repair itself when it is cut or damaged. It is found in fruit, especially citrus fruit like oranges and grapefruit.
2. The B-vitamins keep the nervous system healthy and help reduce stress. They are found in foods like wholegrain bread and cereals.
3. Vitamin A keeps the eyes healthy and is important for good vision. It is found in fatty foods like butter, cheese, whole milk, and yoghurt.
4. Vitamin D is needed for healthy bones and teeth because it helps the body absorb calcium. Our body makes Vitamin D when our skin is exposed to sunlight.
5. Calcium is needed for children’s boness and teeth to grow. It is found in foods like milk, cheese, and yoghurt.
6. Iron helps your blood carry oxygen. If you don’t get enough iron, you will be pale and tired and you may get anaemia. Iron is found in red meats, especially liver.
7. Zinc makes your immune system stronger so that you can fight colds and infections. It is found in shellfish, nuts, and shells.
8. Omega-3 is an essential fatty acid which helps your brain function well. It is found in oily fish like mackerel, sardines, salmon, and tuna.
9. Protein builds up, maintains, and replaces the tissues in your body. Your muscles, your organs, and your immune system are made up mostly of protein.
10. Carbohydrates are sugars which are broken down by organs then stored in the muscles as a source of energy. Grain products such as rice, bread, and pasta are sources of carbohydrate.
11. Fats fuel the body and help absorb some vitamins. They are also the building blocks of hormones, and they insulate nervous system tissue in the body. Unsaturated fats, found in oils and nuts, for example, are believed to protect the cardiovascular system.
194 million people worldwide suffer from diabetes. In the USA, it is the sixth most common cause of death.
Diabetes occurs when your body does not produce enough insulin, a hormone that controls the level of glucose in the blood. One type of diabetes appears in childhood, the other type appears after the age of eighteen. It is very common for very overweight people to get diabetes, so the illness is linked to obesity. For this reason, it is important to get the right balance between food and exercise. It is important to be active, and to eat a healthy diet containing plenty of fruit and vegetables. Nutritionists say snacks better than big meals.
BMI means Body Mass Index. It is used to assess whether a person's weight is healthy or not. To calculate a patient's BMI you use the formula:

      weight in kilograms
        height in metres2
  • BMI of 18.5 to 24.9 is the right weight
  • BMI below 18.5 is the underweight
  • BMI of 25 to 29.9 is the overweight
  • BMI over 30 is obese.
In 2003, American film maker Morgan Spurlock made a film about the effects of eating only hamburgers, pizzas, and fries for a month. The idea came to him when two overweight American girls took legal action against a famous fast-food company .The girls accused the company of making them fat .The company also said their food was nutritious and good for you.
The girl's legal action failed, but Morgan Spurlock decided to test what the company said about their food. For a month he ate only fast food, three times a day, and took the daily exercise of an average American. He filmed himself during this month and the film he made records the changes that happened to him.
When Spurlock started making the film, he was healthy and slim. On the second day, he had his first fast-food stomach ache and vomited. Over the following thirty days, he gained 24.5 lb (11.1kg). He also had other problems-depression, headaches, and lethargy. He had cravings for a fast-food meal-only this would relieve the symptoms. A doctor told Spurlock he was addicted.
Towards the end of the month, doctors warned him that the food was causing life threatening liver damage, and said he should stop. It took five months on a vegetarian diet to get back to a normal weight.
The film he made is called Super-size me . It was nominated for an Academy Award for best documentary in. The film's message was that the fast-food industry was probably as bad as the tobacco industry- it made a lot of money by encouraging illness.
The idea of human beauty changes over the time. At the beginning of the 20th century, Lillian Russel, a Hollywood star, weighed over 200 pounds (91 kilos).
Obesity now contributes to the death of more than 360,000 Americans a year. The incidence of childhood obesity now at epidemic levels.
Tom Harkin
American politician