Healing Practices & Traditional Asian Health Beliefs

This newsletter introduces our community of readers to some of the basic concepts behind the traditional medicines and healing practices of Asian cultures. People belonging to these Asian cultures are accustomed to relying on distinct health practices and beliefs that are significantly different from those of native born Americans and other immigrants. As patients’ health beliefs can have a profound impact on clinical care, it is important for American medical professionals to be familiar with the concepts introduced here.

This topic is expansive, so links for further study are embedded throughout the article. We will be focusing on the health beliefs and practices of people from Southeastern Asia (i.e. Vietnam, Thailand, Cambodia, Laos, Burma as well as East Asian countries (i.e. China, Japan, and Korea. A brief explanation of the interrelatedness of the primary traditional medicine practices if followed by a brief description of each.

 

East Meets West

In the 17th century, traditional Vietnamese and Chinese practitioners began identifying their medicine as Dong Y to distinguish their medicine from the Western colonial medicine. Similarly, people in the West began to use the term “Oriental medicine” to differentiate Eastern medical practices from Western ones. Today, the terms Eastern medicine and Asian medicine are more commonly used in this country, and perhaps they are the better terms. The use of oriental has shifted to refer to home furnishings, carpets especially, and certainly in the field of cross-cultural communications, the word oriental is never used as a category of culture.

Many Americans quickly associate Chinese herbal remedies and acupuncture with Eastern “alternative” medicine, but are largely unfamiliar with other common practices from across Asia. The philosophies of health and illness causation at the root of Eastern medicines are even less understood and just as important. Traditional Chinese medicine, or TCM, is the best known Asian medicine practiced in the U. S., but it is not the only traditional medicine worthy of our attention. Traditional Vietnamese medicine (TVM) actually evolved together with traditional Chinese medicine and arguably the development of the two are so-intertwined that it is impossible to separate them. However, there are differences. Closely related to both are Japanese and Korean traditional medicines. Historically speaking, many societies in Eastern and Southeastern Asia have been part of the Chinese cultural sphere due to trade, migration, and occupation. Thus it is safe to say that the healing traditions of most Asian cultures are intertwined to some extent, much as their religious philosophies are.

Beliefs and Practices Briefly Described

Traditional Chinese Medicine

TCM is inextricably linked to Chinese Cosmology, as system of beliefs that can be summed up as follows: all of creation is born from the marriage of two polar principles, Yin and Yang. Examples are earth and heaven, winter and summer, night and day, cold and hot, wet and dry, inner and outer, body and mind. These pairs of opposites are connected via a circular harmony. The yin and yang symbol is helpful in representing this concept. Harmony means health, good weather, and good fortune, while disharmony leads to disease, disaster, and bad luck. The strategy of Chinese medicine is to restore harmony. Each human is seen as a world in miniature, and every person has a unique terrain to be mapped, a resilient yet sensitive ecology to be maintained. Like a gardener uses irrigation and compost to grow robust plants, the doctor uses acupuncture, herbs and food to recover and sustain health. 

Health Beliefs and Clinical Care

The greatest challenge for Western healthcare professionals once they’ve grasped the basics of different cultural remedies and treatments is to understand the beliefs and attitudes about sickness that drive these ancient practices. Health beliefs can have a profound impact on the clinical care of Asian patients in the United States, affecting the accuracy of health histories and compliance with treatment recommendations from Western providers. Because the principles behind the Western medical model are so different from those of Eastern medicine, it is difficult for American providers to shift gears when talking to Asian patients and consider a mind-set where health is seen as a state of balance between the physical, social, and super-natural environment. Western medicine tends to approach disease by assuming that it is due to an external force, such as a virus or bacteria, or a slow degeneration of the functional ability of the body. Disease is either physical or mental. The Eastern approach assumes that the body is whole, and each part of it is intimately connected. Each organ has a mental as well as a physical function. Perhaps a melding of the two belief systems would be ideal, but it isn’t easy in hectic settings or crisis situations to bring such divergent belief systems together during medical consultation and care.

 

Tibetan Medicine

It is known as gSo-ba Rigpa in Tibetan, meaning ‘the science of healing’. The basic principle is to balance the three principal energies of the body. The practitioner employs the ancient tools of pulse diagnosis and urine analysis, to find the root causes of disease. Treatment is carried out through diet, lifestyle adjustments and herbal medicines grown naturally in Tibet and the Himalayas. Tibetan Medicine is based on Buddhist principles and the close relationship between mind and body.

Traditional Vietnamese Medicine

The distinguishing feature of TVM is the emphasis on nourishing the blood and vital energy, rather than concentrating on specific symptoms. TVM views building up the blood and energy as the key to good health. The main treatments employed by TVM are herbal medicine, acupuncture, and moxibustion.The cornerstone of its theories is based on the observed effects of Qi (energy) in the body. Qi can be inherited from one’s parents or it can be extracted from food. It is also blood and “fuel” gathered and stored by the body.

Chinese Herbal Medicine

Herbal medicine is an important part of Traditional Chinese Medicine (TCM). Herbs are prescribed holistically according to the patient’s individual condition (not only on the basis of current symptoms). Herbal medicines are used to regulate the natural balance of the body and restore health. They come in the form of pills, powders, tinctures and raw herbs taken internally or as balms for external use. Chinese herbal medicine has been used for centuries to treat most health conditions and as a preventative dietary supplement. They can also be used safely in conjunction with many western therapies. Diagnosis is made by talking to the patient, looking at physical characteristics and employing the ancient arts of tongue and pulse diagnosis.

Japanese Herbal Medicine

Kampo is Japanese herbal medicine, which has a long history of clinical application. Kampo uses precisely measured herbs to treat illness, based on the skillful use of well-known formulas, valued for their impact on clear as well as vague conditions. (Kampo does not use rare or endangered plant or animal products). The distinguishing feature of Kampo is it’s method of diagnosis through abdominal palpation. Kampo medicine is based on the theory that diseases arise because of a disharmony in the flow of Qi (Chi). By stressing prevention, Kampo helps the patient to maintain good health according to natural principles.

Acupuncture

Acupuncturists insert tiny needles into specific points on the energy channels of the body, to promote healing and stimulate the free flow of energy in the body and mind. It is used to treat many conditions including muscular pain, headaches, asthma, gynecological problems, digestive complaints, as well as anxiety and depression. Acupuncture is also useful for preventative health care.

Moxibustion, Coin Rubbing & Cupping

Moxibustion is a therapy utilizing moxa, or mugwort herb. It plays an important role in the traditional medical systems of China, Japan, Korea, Vietnam, Tibet, and Mongolia. Suppliers usually age the mugwort and grind it up to a fluff; practitioners burn the fluff or process it further into a stick that resembles a (non-smokable) cigar. They can use it indirectly, with acupuncture needles, or sometimes burn it on a patient’s skin.

Coin Rubbing in Chinese is called Gua Sha, or literally “to scrape away fever.” It is an ancient technique used to scrape away disease by allowing the disease to escape as sandy-looking objects through the skin.” The Vietnamese term for this practice is cạo gió (pronounced “cow zaw”), meaning roughly to “scrape wind.” It is also used in Indonesia.

Cupping Fire, or simply cupping, is a form of traditional medicine found in several cultures. It involves placing glass, plastic, or bamboo cups on the skin. This technique, in varying forms, has been found in the folk medicine of China, Vietnam, the Balkans, Iran, Mexico, Russia and Poland. In traditional Chinese medicine (TCM), cupping is a method of applying acupressure by creating a vacuum next to the patient’s skin. The therapy is used to relieve what is called “stagnation” in TCM terms, and is used in the treatment of respiratory diseases such as the common cold, pneumonia, and bronchitis. Cupping is also used to treat back, neck, shoulder, and other musculoskeletal pain.

 

Conclusion

This brief introduction to traditional medicines of Asian cultures no doubt leaves many questions unanswered and so it seems appropriate to invoke Ben Franklin’s caution, “a little learning is a dangerous thing.”  This article is meant to assist clinicians by providing a general framework, a baseline for learning.  No hard and fast rules about interacting with Asian patients and families are being offered. Becoming fully familiar with the normative cultural values affecting interactions with patients from different cultures is a process that takes time and experience. Using the links provided for further study, consulting colleagues from other ethnic groups, and speaking to interpreters and community members are all ways to learn more about the practices and health beliefs one encounters that are different from one’s own. It is also important to learn to ask patients questions in a culturally sensitive way, understanding that fear of making mistakes in communicating with them blocks the exchange of vital information.  There have been instances where practices such as coining and cupping have been misinterpreted by conscientious healthcare workers and reports of child abuse made in error. Thorough efforts at communication might have prevented these erroneous reports which traumatized families.

A cross-cultural mindset requires understanding one’s own health beliefs and behaviors first and then applying that baseline of understanding as a means of making effective comparisons across cultures. Clinicians should keep in mind that individuals subscribe to group norms to varying degrees. Factors such as socio-economics, education, degree of acculturation and English proficiency have an enormous impact on an individual’s health beliefs and practices. Searching out and really trying to understanding the individual patient is crucial.

Complementary and Traditional Health Practices

The integrative, complementary and traditional health practices field is a fascinating world where science, ancient healing traditions, modern medical systems, psychology, philosophy and even technology meet to create a thrilling universe of possibilities for promoting and restoring health and creating wellness.

Our Section, founded over 20 years ago as a Special Primary Interest Group, is an ever-growing community of practice that recently gained Section status within APHA. Our membership is a vibrant, diverse association of professionals and students dedicated to promoting public health aspects of integrative, complementary and traditional health practices, including health care professionals, researchers, academics, policy advocates, and trainees A thriving international membership gives our Section a global reach, which enhances the potential for multidisciplinary interaction, facilitates the development of a wider perspective of the field and bolsters collaboration.

The Section cherishes student members and offers mentorship opportunities for professional enrichment and career development. We value student participation in all activities and committees and are cognizant of the fundamental role that new generations play in creating a shared vision, promoting creativity and invigorating the field

We publish a vibrant quarterly newsletter that fosters professional development and participation, featuring articles on academic exchange and policy, training and continuing education announcements, networking and collaborating opportunities, as well as contributions for and by students. The Section also develops a stimulating scientific program for each APHA Annual Meeting and Exposition, often in collaboration and fellowship with other Sections..

We warmly invite you to be in touch with us and collaborate in policy undertakings and scientific program development. Together, we can work toward the goal of creating a health care system that includes wellness as a right, not a privilege.

Taking Care of Your Baby And You While You're Pregnant

Is prenatal care important?

Prenatal care is very important. To help make sure that you and your baby will be as healthy as possible, follow some simple guidelines and check in regularly with your doctor.

How much weight should I gain during pregnancy?

Talk to your doctor about how much weight you should gain. It's different for everyone, but most women gain about 25 to 30 pounds. If you don't weigh enough when you get pregnant, you may need to gain more. If you're overweight when you get pregnant, you may need to gain less.

What will happen during prenatal visits?

After you find out you are pregnant, you should make an appointment with your doctor. Your first prenatal visit will likely be when you are 6 to 8 weeks pregnant. Your doctor will probably start by talking to you about your medical history and how you've been feeling. You'll be weighed and have your blood pressure taken. These measurements will most likely be taken during each doctor's visit.

On your first visit, you'll also have a pelvic exam to check the size and shape of your uterus (womb) and a Pap smear to check for abnormalities of the cervix (the opening of the uterus).

Urine and blood tests samples will be taken on the first visit and again at later visits. Other tests are performed, such as urine tests to check for bacteria in your urine, high sugar levels (which can be a sign of diabetes) and high protein levels (which can put you at risk for preeclampsia, a type of high blood pressure during pregnancy). Blood tests to check for low iron levels (anemia), blood cell count, infectious diseases (such as syphilis and hepatitis) and blood type are also performed.

Sometimes, an ultrasound may be done to help figure out when your baby is due or to check on your baby's growth and position in your uterus. An ultrasound uses sound waves to create an image of your baby on a video screen.

Other tests may be needed if you or your baby are at risk for any problems.

What should I eat?

Eating a balanced diet is one of the most important things you can do for yourself and your baby. There are a few foods that you should be more careful about eating while you are pregnant. Meat, eggs and fish that are not fully cooked could put you at risk for an infection. Do not eat more than 2 or 3 servings of fish per week (including canned fish). Do not eat shark, swordfish, king mackerel or tilefish. These fish sometimes have high levels of mercury, which could hurt your baby. If you eat tuna, make sure it is light tuna and eat no more than 6 ounces per week of albacore tuna and tuna steaks. It is safe to have 12 ounces per week of canned light tuna.

Wash all fruit and vegetables. Keep cutting boards and dishes clean. Eat 4 or more servings of dairy foods each day. This will give you enough calcium for you and your baby. Do not drink unpasteurized milk or eat unpasteurized milk products. Soft cheeses such as Brie, feta, Camembert, blue cheese and Mexican-style cheeses such as queso fresco may have bacteria that can cause infections.

If you drink coffee or other drinks with caffeine, do not have more than 1 or 2 cups each day.

It is okay to use artificial sweeteners such as aspartame (some brand names: Equal, NutraSweet) and sucralose (brand name: Splenda) while you are pregnant, but you should use them in moderation. If you have a genetic disease called phenylketonuria, or PKU, you shouldn't use aspartame at all.

Should I take vitamins?

You should take 1,000 mcg (1 mg) of folic acid every day during your pregnancy. Folic acid can help prevent problems with your baby's brain and spinal cord. It is best to start taking folic acid before you get pregnant.

Your doctor might want you to take a prenatal vitamin. If you do take a prenatal supplement, make sure you're not taking any other vitamin or mineral supplement along with it unless your doctor recommends it.

Is it okay to take medicine?

Check with your doctor before taking any medicine, including pain relievers or other over-the-counter medicines. Even medicine you can buy without a prescription may cause birth defects, especially if it's taken during the first 3 months of pregnancy.

How long can I keep working?

This depends on whether you have any problems with your pregnancy, what kind of work you do and if you're exposed to anything at work that could harm your baby. For instance, lifting heavy objects or standing for long periods can be hard on your body. Radiation, lead and other heavy metals, such as copper and mercury, could be damaging to the baby. However, working in front of a computer screen is not thought to cause harm to an unborn baby. Talk with your doctor about your work environment.

What about exercise?

Unless you have problems in your pregnancy, you can probably do whatever exercise you did before you got pregnant. Exercise can help ease discomfort during pregnancy. Try to get at least 30 minutes of exercise each day. Talk to your doctor about any special conditions that you may have.

Some women say exercising during pregnancy makes labor and delivery easier. Walking and swimming are great choices. If you didn't exercise before pregnancy, start slowly. Don't overdo exercise. Listen to your body. Call your doctor if you have symptoms such as blurred vision, dizziness, chest pain or abdominal pain while you are exercising. Don't get overheated. Be sure to drink plenty of water so that you don't get dehydrated. It's best to avoid anything that could cause you to fall, such as water skiing or rock climbing. It's also best to avoid contact sports such as basketball or soccer.

Is it okay to have sex?

Yes, unless your doctor believes you're at risk for problems. Don't be surprised if you're less or more interested in sex while you are pregnant. As you get larger, you may find you need to try different positions, such as lying on your side or being on top. If you have oral sex, tell your partner not to blow air into your vagina. This could force air inside you, which could cause an air embolism. Air embolisms can cause permanent brain damage and even death to a pregnant woman and her baby.

What can I do to feel better?

Here are the most common discomforts of pregnancy and some tips for handling them:

Morning sickness. Nausea or vomiting may strike anytime during the day (or night). Try eating frequent, small meals and avoid greasy foods. Keep crackers by your bed to eat before getting up.

Talk to your doctor if morning sickness lasts past the first 3 months of pregnancy or causes you to lose weight.

Tiredness. Sometimes tiredness in pregnancy is caused by anemia, so tell your doctor. Get enough rest. Take a daytime nap if possible.

Bleeding gums. Brush and floss regularly, and see your dentist for cleanings. Don't put off dental visits because you're pregnant, but be sure to tell your dentist you're pregnant.

Stuffy nose. This is related to changes in the levels of the female hormone estrogen. You may also have nosebleeds.

Edema (retaining fluid). Rest with your legs up. Lie on your left side while sleeping so blood flows from your legs back to your heart better. Don't use diuretics (water pills). If you're thinking about cutting down on salt to reduce swelling, talk with your doctor first. Your body needs enough salt to maintain the balance of fluid and cutting back on salt may not be the best way to manage your swelling.

Leg cramps. Gently stretch the calf of your leg by curling your toes upward, toward your knee.

Constipation. Drink plenty of fluids. Eat foods with lots of fiber, such as fruits, vegetables and bran cereal. Don't take laxatives without talking to your doctor first. Stool softeners may be safer than laxatives.

Hemorrhoids. Don't strain during bowel movements. Try to avoid becoming constipated. Clean yourself well after a bowel movement (wet wipes may be less irritating than toilet paper). Take several warm soaks (sitz baths) a day if necessary.

Urinating more often. You may need to urinate more often as your baby grows because he or she will put pressure on your bladder. This can't be helped.

Varicose veins. Avoid clothing that fits tightly around your legs or waist. Rest and put your feet up as much as you can. Move around if you must stand for long periods. Ask your doctor about support or compression hose, which may help ease or prevent varicose veins.

Moodiness. Your hormones are on a roller coaster ride during pregnancy. Plus, your life is undergoing a big change. Don't be too hard on yourself. If you feel very sad or think about suicide, talk to your doctor.

Heartburn. Eat frequent, small meals. Avoid spicy or greasy foods. Don't lie down right after eating. Ask your doctor about taking antacids.

Yeast infections. The amount of discharge from the vagina increases during pregnancy. Yeast infections, which can also cause discharge, are more common during pregnancy. It's a good idea to talk with your doctor about any unusual discharge.

Skin changes. Stretch marks appear as red marks on your skin. Lotion with shea butter can help keep your skin moist and may help reduce the itchiness of dry skin. Stretch marks often can't be prevented, but they often fade after pregnancy.

Other skin changes may include darkening of the skin on your face and around your nipples, and a dark line below your belly button. Staying out of the sun or using a sunscreen may help lessen these marks. Most marks will probably fade after pregnancy.

Call your doctor if you have:

• Blood or fluid coming from your vagina
• Sudden or extreme swelling of your face or fingers
• Headaches that are severe or won't go away
• Nausea and vomiting that won't go away
• Dizziness
• Dim or blurry vision
• Pain or cramps in your lower abdomen
• Chills or fever
• A change in your baby's movements
• Less urine or burning when you urinate
• Any illness or infection
• Anything that bothers you

Warnings

"Don't do this, don't do that." You've probably heard every old wives' tale. Here are some warnings worth heeding:

• Don't smoke. Smoking raises your risk for miscarriage, premature birth, low birth weight and many other problems.
• Don't use drugs. Cocaine, heroin, marijuana and other drugs increase your risk of miscarriage, premature birth and birth defects. Your baby could also be born addicted to the drug you've been abusing, which can cause serious health problems.
• Don't drink alcohol. Drinking alcohol during pregnancy is the major cause of preventable birth defects, including fetal alcohol syndrome.
• Don't clean your cat's litter box or eat raw or undercooked red meat. You could get toxoplasmosis, a disease that can cause birth defects.
• Don't sit in a sauna or hot tub. The high heat raises your risk of miscarriage and birth defects.
• Don't douche. Douching could force air into the vagina, which can cause an air embolism. The vagina doesn't require cleansing in addition to normal bathing. Douching disrupts the helpful bacteria that keep the vagina clean.

five eating own weight in sugar for Children

The average five-year-old consumes the equivalent of their body weight in sugar in the course of a year, health officials have warned.

Parents are being urged to take control of their children’s habits, as the Government prepares to publish its strategy on child obesity, amid calls to introduce a tax on sugary drinks and foods.

The new campaign by Public Health England (PHE) warns that five-year-olds should only be consuming the equivalent of five sugar cubes a day.

On average, child are having three times their recommended maximum daily intake, which rises to six cubes for six to ten-year-olds, and seven cubes for anyone of the age of 11.

Over the course of a year, a child aged between four and 10 will consume around 5,500 sugar cubes – or three and half stone - the average weight of five year old, PHE said.

Officials have launched a new free app, which reveals how much sugar is in everyday food and drink in a bid to encourage parents to take control of their families’ sugar consumption.

It works by scanning the barcode of products and showing the total sugar in each product in cubes and grams.

Tooth decay has become the most common reason that five-to-nine year olds are admitted to hospital, with a 14 per cent increase in admissions in three years.

In total, 25,812 children aged between five to nine-years old were admitted to hospital with a primary diagnosis of dental caries in 2013/14, official figures show, with almost half of eight-year-olds suffering decay.

One in five children is overweight or obese by the age of five – rising to one in three by the age of 11.too much sugar, three times the maximum recommended amount. This can lead to painful tooth decay, weight gain and obesity, which can also affect children’s wellbeing as they are more likely to be bullied, have low self-esteem and miss school.”

Obesity costs the NHS £5.1 billion per year which is projected to rise to £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year.

There are now 2.5 million people suffering from Type 2 diabetes, 90 per cent of whom are overweight or obese.

This month the Government is due to publish its strategy on childhood obesity.

Ministers are expected to unveil plans to clamp down on marketing and advertising of unhealthy foods, with restrictions on TV ads during “family viewing” times, and a crackdown on “two for one” deals on junk fare.

David Cameron has so far resisted calls for a “sugar tax” on drinks and foods, despite calls from PHE, celebrity campaigner Jamie Oliver and the Commons health select committee.

Health officials have previously urged families to cut back on fruit juice and smoothies, which are pushing up sugar intake in some families.

PHE have said that a single 150ml glass of fruit juice a day is the most anyone should drink.

Fruit juices and fizzy drinks are the largest source of sugar for children aged between four and 18, the National Diet and Nutrition Survey by Public Health England found.

Last year, Government scientific advisors halved the recommended daily sugar limits, amid warnings about spiralling obesity rates.

The new advice says sugar should make up no more than 5 per cent of daily calories – which means about 30g of sugar a day for adults – less than the contents of one can of Coca Cola.

The targets for children mean those aged four to six should have no more than 19g sugar daily.

Super foods that will help spice up your sex life!

Erectile dysfunction (ED) has become a common problem among men nowadays. However, research has shown that eating right and a diet rich in fruit, vegetables and whole grains can help decrease the likelihood of ED.

Here are a few foods that can help improve your sexual stamina and overcome erectile dysfunction:

Leafy green vegetables: Leafy green vegetables such as spinach, fenugreek, celery may increase circulation due to their high content of nitrates, which have beneficial effects on erectile dysfunction.

Beetroot: Beetroot has been found to be really high in nitrates and is one of the best foods for erectile dysfunction. Sometimes, beetroot is refered to as nature’s Viagra as it works in a similar way as the popular ED drug.

Dark Chocolate: Favonoids in dark chocolate are found to improve circulation. Poor circulation can cause erection problems. Flavonoids are naturally-occurring antioxidants that protect plants from toxins and help repair cell damage.

Watermelon: Studies suggest that watermelon may have effects on erectile dysfunction similar to Viagra and may also increase sexual desire. This wonder summer fruit is also high in L-citrulline and lycopene, two components vital for boosting male sexual health. Both citrulline lycopene help blood vessels to relax and promote blood circulation helping to keep an erection for longer.

Pistachios: Studies suggest that eating a handful of pistachios everyday can improve sexual desires, including erectile dysfunction. This may be due to the presence of a protein called arginine in pistachios may help relax blood vessels. Arginine also improves good cholesterol level and lowers blood pressure, both of which are important for a good erection while delaying the onset of erectile dysfunction.

How to enjoying a healthy sex life as you get older?

A healthy sex life is the most fulfilling aspect of life! But as you age, sex isn't the same as it was. When you were young and agile, you were open to new experiences and experimentation. But when you get older, you tend to feel discouraged by issues connected with the aging process. That's where you go wrong! Definitely, it won't be the same as it was but it can certainly be satisfying. Sex isn't just for the young because sex is all about intimacy and desire and has nothing to do with age.

You need to overcome the challenges of aging and enjoy sex for as long as you want. Here are a few tips that will get you through:

Communicate with your partner

You should be able to communicate your thoughts, fears, and desires with your partner. Be frank with your partner and encourage them too to be open with you. Holding back or hiding certain things will only dampen your spirits.

Be open to new ideas and experiment

Just because you are growing old, doesn't mean you can't expand your horizons. Be open to new ideas and discuss them freely with your partner. Don't hesitate and put your creative mind to use. If erectile dysfunction is an issue for you, try sex with the woman on top, as hardness is less important. Try those sexual positions which are pleasurable and comfortable for both of you.

Eat right and exercise

High blood pressure and cholesterol can cause the vascular problems that lead to trouble with your erections. It is important to maintain a healthy lifestyle by exercising and keeping your weight in check.

Go for psychological counseling

Sexual issues such as low libido and erectile dysfunction generally crop up when men age. And unfortunately, most men link these issues with self-esteem which damages their emotional health. In such a case, you can go for psychological counseling and freely talk about it to your psychologist.

Avoid alcohol and smoking

It's no news that both alcohol and smoking can hinder a man's ability to achieve an erection. If you are having sexual difficulties, consider abstaining from smoking and alcohol.

Remember sex is just not about intercourse

You need to broaden your definition of sex. Holding each other, gentle touching, cuddling, kissing, and sensual massage are also ways which will fulfill you. Try oral sex or masturbation as substitutes to intercourse.

Signs of Diabetes

"It's not like you wake up one day and all of a sudden you're thirsty, hungry, and [going to the bathroom] all the time," says Melissa Joy Dobbins, RD, a certified diabetes educator in Illinois and a spokesperson for the American Association of Diabetes Educators. "It picks up gradually." Indeed, "most people are unaware that they have diabetes in its early or even middle phases," says Aaron Cypess, MD, assistant professor of medicine at Harvard Medical School and staff physician at Joslin Diabetes Center. Just because you're not keyed in doesn't mean you're immune from problems associated with diabetes, he adds. The longer you go without controlling diabetes, the greater your risk for heart disease, kidney disease, amputation, blindness, and other serious complications. "We recommend that people with risk factors for diabetes, such as a family history or being overweight, get evaluated on a regular basis," Dr. Cypess says. If you've been feeling off, talk to your doctor about getting a simple blood test that can diagnose the disease. And pay attention to these subtle diabetes signs and symptoms.

Your vision seems blurry

Don't be alarmed: This is not diabetic retinopathy, where the blood vessels in the back of the eye are getting destroyed, says Dr. Cypess. In the early stages of diabetes, the eye lens is not focusing well because glucose builds up in the eye, which temporarily changes its shape. "You're not going blind from diabetes," Dr. Cypess says he assures patients. "In about six to eight weeks after your blood sugars are stabilized, you’re not going to feel it anymore; the eye will adjust."

You're taking more bathroom breaks

When you have diabetes, your body becomes less efficient at breaking food down into sugar, so you have more sugar sitting in your bloodstream, says Dobbins. "Your body gets rid of it by flushing it out in the urine. That's why you're going to the bathroom a lot." Most patients aren't necessarily aware of how often they use the bathroom, says Dr. Cypess. "When we ask about it, we often hear, 'Oh yeah, I guess I’m going more often than I used to,'" he says. But one red flag is whether the need to urinate keeps you up at night. Once or twice might be normal, but if it's affecting your ability to sleep, that could be a symptom to pay attention to.

You've lost a little weight

Considering that being overweight is a risk factor for diabetes, it sounds counterintuitive that shedding pounds could be a sign of the disease. "Weight loss comes from two things," says Dr. Cypess. "One, from the water that you lose [from urinating]. Two, you lose some calories in the urine and you don’t absorb all the calories from the sugar in your blood." Once people learn they have diabetes and start controlling their blood sugar, they may even experience some weight gain—but "that's a good thing," says Dr. Cypess, because it means your blood sugar levels are more balanced.

You're thirstier than usual

Urinating a lot will also make you feel parched. A common symptom Dobbins sees with patients is that they use drinks like juices, soda, or chocolate milk to quench their thirst. These sugary beverages then pack the bloodstream with excess sugar, which can lead to the problem all over again.

Your feet tingle

Elevated sugar levels can cause complications well before you realize you have diabetes. One of these is mild nerve damage, which can cause numbness in your feet, says Cypress.

You feel shaky and hungry

It's not uncommon for patients to suddenly feel unsteady and immediately need to reach for carbs, says Marjorie Cypress, a nurse practitioner at an endocrinology clinic in Albuquerque, New Mexico, and 2014 president of health care and education for the American Diabetes Association. "When you have high blood sugar, your body has a problem regulating its glucose," she explains. "If you've eaten something high in carbohydrates, your body shoots out a little too much insulin, and your glucose drops quickly. This makes you feel shaky, and you tend to crave carbs or sugar. This can lead to a vicious cycle."

You're tired all the time

Of course you're exhausted every now and then. But ongoing fatigue is an important symptom to pay attention to; it might mean the food you're eating for energy isn't being broken down and used by cells as it's supposed to. "You're not getting the fuel your body needs," says Dobbins. "You're going to be tired and feel sluggish." But in many cases of type 2 diabetes, your sugar levels can be elevated for awhile, so these symptoms could come on slowly.

You're moody and grumpy

When your blood sugar is out of whack, you just don't feel well, says Cypress, and might become more short-tempered. In fact, high blood sugar can mimic depression-like symptoms. "You feel very tired, you don't feel like doing anything, you don't want to go out, you just want to sleep," Cypress says. She'll see patients who think they need to be treated for depression, but then experience mood improvement after their blood sugar normalizes.

Your cuts and scrapes heal more slowly

The immune system and the processes that help the body heal don't work so well when your sugar levels are high, explains Dr. Cypess.

You're more prone to urinary tract and yeast infections

Higher levels of sugar in urine and the vagina can become a breeding ground for the bacteria and yeast that cause these infections. Recurrent infections are particularly worrisome. "Usually when you keep getting infections, doctors will check for diabetes if you don't already have it," says Cypress. "Even women who go to the emergency room for urinary tract infections are often checked."

7 things health experts said were bad for you in 2015

1. Sitting may be worse for us than smoking. A study revealed that remaining sedentary

for extended periods can dramatically increase the risk for chronic health issues,

including heart disease, diabetes, and depression. Not only that, but the negative

effects of prolonged sitting aren't offset by intense exercise before or after work.

People with desk jobs should be on their feet for at least two hours daily, either by

taking occasional strolls or using a standing desk. "We are creatures of habit," says

co-author Gavin Bradley, "and we have come to the wrong conclusion, that sitting is

the optimum way of conducting office work.

2. High heels can cause sprained ankles and feet as well as broken bones. Injuries

involving high-heeled footwear doubled in the U.S. between 2002 and 2012, researchers 

learned, during which time American women suffered more than 123,355 mishaps severe

enough to warrant a trip to the emergency room. Those fashionable pumps and strappy

sandals can affect gait, balance, and range of foot motion, warns lead investigator

Gerald McGwin, and it's important to "understand the risks and the potential harm that

precarious activities in high-heeled shoes can cause.

3. Belly fat is a serious health concern, even if you're thin. Men and women with

excess weight around the middle are significantly more likely to die from heart

disease than adults whose fat is more evenly distributed, a Mayo Clinic study

revealed, no matter where they tip the scales. Even in people with a "normal" body

mass index — a weight-height ratio — belly blubber is linked to a buildup of deeper

visceral fat that wraps around internal organs, increasing the risk for heart attack,

stroke, and type 2 diabetes. "We need to talk about waist loss," says cardiologist

Paul Poirier, "not weight loss.

4. Shift work can be unhealthy, increasing the risk of heart disease, obesity, and

metabolic disorders. Researchers in Finland tracked airline employees and found that

people who worked nights or irregular hours slept less than peers who were scheduled

for the regular business day. Beyond that, "it seems that shift work itself strongly

affects workers' eating habits," says study leader Katri Hemio, noting they ate fewer 

vegetables and consumed more fat. One way to address the problem, experts say, is to 

stock workplace vending machines with healthier foods and provide refrigerators, so 

employees can bring healthier meals from home.

5. Dietary supplements can land you in the hospital. They're responsible for at least 

23,000 emergency room trips and 2,100 hospital admissions in the U.S. every year, a 

study found, suggesting these loosely regulated "natural" substances aren't always 

safe. After analyzing 10 years of data, researchers established that 65 percent of

these ER visits were prompted by chest pain, palpitations, and dizziness. The worst

offenders were herbal formulas promising to accelerate weight loss, boost energy, or

enhance sex drive, all of which are laced with stimulants. "Many Americans take

dietary supplements in an effort to stay healthy," says study author Andrew Geller of  

the Centers for Disease Control and Prevention, "but these products can cause harm.

6. Belly fat is a serious health concern, even if you're thin. Men and women with

excess weight around the middle are significantly more likely to die from heart

disease than adults whose fat is more evenly distributed, a Mayo Clinic study

revealed, no matter where they tip the scales. Even in people with a "normal" body

mass index — a weight-height ratio — belly blubber is linked to a buildup of deeper

visceral fat that wraps around internal organs, increasing the risk for heart attack,

stroke, and type 2 diabetes. "We need to talk about waist loss," says cardiologist

Paul Poirier, "not weight loss.

6. Loneliness increases the risk of death by up to 14 percent, a University of Chicago

study found. The stressful pangs of unwanted solitude trigger the "flight or fight.

response, causing inflammation and cellular changes that disrupt the production of

white blood cells that protect the body from illness. Social isolation does improve

the body's ability to fight harmful bacteria, but it also makes people more

susceptible to viral infections. "The lonelier one is and the longer one is lonely,"

author John Cacioppo says, "the greater the negative effects.

7. Zip lines are dangerous. As more and more people soar above ground while suspended 

from a wire, an alarming number are getting hurt. A study of a Consumer Product Safety 

Commission database revealed that the injury rate from zip lines surged by more than 

50 percent between 2009 and 2012. Most accidents occurred at commercial courses, but 

roughly 30 percent were on amateur "backyard" setups. Young children accounted for 

almost half the injuries, which usually involved broken bones sustained during falls 

or collisions. The rate and severity of zip line injuries, says researcher Tracy 

Mehan, suggests "this activity is much more like an adventure sport.

Fantastic Foods to Keep Your Eyes Healthy

Everybody knows that eating right is the way to keep your heart healthy. The good news is that the same diet that helps your heart is probably also good for your eyes. A diet low in fat and rich in fruits, vegetables and whole grains can pay benefits not only to your heart but to your eyes. The connection isn't surprising: your eyes rely on tiny arteries for oxygen and nutrients, just as the heart relies on much larger arteries. Keeping those arteries healthy will help your eyes.  

Some foods stand out as particularly helpful for eye health. Here are four you should make sure are part of your diet.

Kale. Leafy green vegetables, like kale, are high in lutein and zeaxanthin, two nutrients found in the healthy eye that are believed to lower your risk for age-related macular degeneration (AMD) and cataracts. One large study showed that women who had diets high in lutein were 23 percent less likely to develop cataracts than women whose diets were low in this nutrient. Not a big fan of kale? Not to worry. Other dark leafy green vegetables, like spinach, romaine lettuce, collards and turnip greens, also contain significant amounts of lutein and zeaxanthin. Eggs are also a good source of these nutrients, as are broccoli, peas and corn.

Salmon. Some studies suggest that diets rich in omega-3 fatty acid from cold-water fish like salmon, tuna, sardines and halibut reduce the risk of developing eye disease later in life. A 2010 study from Johns Hopkins found that people who had a diet high in omega-3 fatty acid were much less likely to develop AMD.

Oranges. Oranges and all of their citrus cousins — grapefruit, tangerines, and lemons — are high in vitamin C, an antioxidant that is critical to eye health. Scientists have found that your eyes need relatively high levels of vitamin C to function properly, and antioxidants can prevent or at least delay cataracts and AMD. Lots of other foods offer benefits similar to oranges, including peaches, red peppers, tomatoes and strawberries.

There are lots of other great food choices to keep your eyes healthy. Among them, the one most people think of first: carrots. Carrots are high in beta-carotene, a nutrient that helps with night vision, as are other orange-colored fruits and vegetables like sweet potatoes, apricots and cantaloupe. Making them a part of a colorful diet can help you keep your eyes healthy.

Black-eyed peas. Legumes of all kinds, including black-eyed peas, kidney beans, lima beans, and peanuts contain zinc, an essential trace mineral that is found in high concentration in the eyes. Zinc may help protect your eyes from the damaging effects of light. Other foods high in zinc include oysters, lean red meat, poultry and fortified cereals.

There are lots of other great food choices to keep your eyes healthy. Among them, the one most people think of first: carrots. Carrots are high in beta-carotene, a nutrient that helps with night vision, as are other orange-colored fruits and vegetables like sweet potatoes, apricots and cantaloupe. Making them a part of a colorful diet can help you keep your eyes health