fiber, dietary

What can high-fiber foods do for you?

• Support bowel regularity
• Help maintain normal cholesterol levels
• Help maintain normal blood sugar levels
• Help keep unwanted pounds off
  

What events can indicate a need for more high fiber foods?

• Constipation
• Hemorrhoids if related to straining from constipation
• High blood sugar levels
• High cholesterol levels

Excellent food sources of fiber include:

• turnip greens,
• mustard greens,
• cauliflower,
• collard greens,
• broccoli,
• Swiss chard, and
• raspberries.

Description
What is dietary fiber?
Dietary fiber is undoubtedly one of the most talked about nutrients for health promotion and disease prevention. In fact, even the United States Food and Drug Administration, the federal agency responsible for overseeing food labeling, has no formal, written definition of dietary fiber. For food labeling purposes and the determination of health claims, the FDA has adopted the analytical methods that the Association of Official Analytical Chemists uses for defining dietary fiber.

Although most experts agree that a key defining characteristic of dietary fiber is that it's derived from the edible parts of plants that are not broken down by human digestive enzymes, many people believe that this definition is too ambiguous and that a more clear, internationally-accepted definition is needed to ensure that the total fiber counts on food labels are consistent and accurate.

In recent years there has been a movement among various organizations to include the physiological benefits of dietary fiber in a new definition. For example, the American Association of Cereal Chemists proposed a new definition of dietary fiber that includes the statement "Dietary fibers promote beneficial physiological effects including laxation and/or blood cholesterol attenuation and/or blood glucose attenuation.

In addition, the Institute of Medicine at the National Academy of Sciences (the organization responsible for issuing Recommended Dietary Allowances) has proposed a new definition that differentiates between dietary fiber and added fiber. According to this definition, dietary fiber consists of nondigestible carbohydrates and lignin that are intrinsic and intact in plants.

Added fiber, which refers to fiber that is added to foods during food processing, consists of isolated nondigestible carbohydrates that have proven beneficial physiological effects in humans. For food labeling purposes, the Institute of Medicine defines Total Fiber as the sum of Dietary Fiber and Added Fiber.

Despite the controversy surrounding the exact definition of dietary fiber, experts agree on one important thing - dietary fiber is an important weapon in the fight against heart disease, colon cancer, diabetes, and obesity.

Categories of Dietary Fiber

1. Cellulose, found in bran, legumes, peas, root vegetables, cabbage family, outer covering of seeds, and apples
2. Hemicellulose, found in bran and whole grains
3. Polyfructoses (Inulin and Oligofructans)
4. Galactooligosaccharides
5. Gums, found oatmeal, barley, and legumes.
6. Mucilages
7. Pectins, found in apples, strawberries, and citrus fruits
8. Lignin, found in root vegetables, wheat, fruits with edible seeds (such as strawberries)
9. Resistant Starches, found in ripe bananas, potatoes

How it Functions
What is the function of dietary fiber?
Until very recently, the functions of a specific type of fiber were determined by whether or not the fiber was classified as soluble or insoluble. Soluble fibers, such as the type found in oat bran, are known to reduce blood cholesterol levels and normalize blood sugar levels.

On the other hand, insoluble fiber, such as the type found in wheat bran, are known to promote bowel regularity. Many commonly used plant sources of fiber contain both soluble and insoluble fibers. Psyllium husks, for example, contain a mixture of 70% soluble and 30% insoluble fibers. Despite the widespread use of the terms "soluble" and "insoluble" to describe the health benefits of dietary fiber, many medical and nutrition experts contend that these terms do not adequately describe the physiological effects of all the different types of fiber. These experts are now proposing the use of the terms "viscous" and "fermentability" in place of soluble and insoluble to describe the functions and health benefits of dietary fiber.

Reducing Cholesterol Levels
Like soluble fibers, viscous fibers lower serum cholesterol by reducing the absorption of dietary cholesterol. In addition, viscous fibers complex with bile acids, which are compounds manufactured by the liver from cholesterol that are necessary for the proper digestion of fat. After complexing with bile acids, the compounds are removed from circulation and do not make it back to the liver. As a result, the liver must use additional cholesterol to manufacture new bile acids. Bile acids are necessary for normal digestion of fat. Soluble fiber may also reduce the amount of cholesterol manufactured by the liver.

Normalizing Blood Sugar Levels
Viscous fibers also help normalize blood glucose levels by slowing the rate at which food leaves the stomach and by delaying the absorption of glucose following a meal. Viscous fibers also increase insulin sensitivity. As a result, high intake of viscous fibers play a role in the prevention and treatment of type 2 diabetes. In addition, by slowing the rate at which food leaves the stomach, viscous fibers promote a sense of satiety, or fullness, after a meal, which helps to prevent overeating and weight gain.

Promoting Bowel Regularity
Certain types of fiber are referred to as fermentable fibers because they are fermented by the "friendly" bacteria that live in the large intestine. The fermentation of dietary fiber in the large intestine produces a short-chain fatty acid called butyric acid, which serves as the primary fuel for the cells of the large intestine and helps maintain the health and integrity of the colon.

Two other short-chain fatty acids produced during fermentation, propionic and acetic acid are used as fuel by the cells of the liver and muscles. In addition, propionic acid may be responsible, at least in part, for the cholesterol-lowering properties of fiber.

In animal studies, propionic acid has been shown to inhibit HMG-CoA reductase, an enzyme involved in the production of cholesterol by the liver. By lowering the activity of this enzyme, blood cholesterol levels may be lowered.

In addition, fermentable fibers help maintain healthy populations of friendly bacteria. In addition to producing necessary short-chain fatty acids, these bacteria play an important role in the immune system by preventing pathogenic (disease-causing) bacteria from surviving in the intestinal tract.

As is the case with insoluble fiber, fibers that are not fermentable in the large intestine help maintain bowel regularity by increasing the bulk of the feces and decreasing the transit time of fecal matter through the intestines. Bowel regularity is associated with a decreased risk for colon cancer and hemorrhoids (when the hemorrhoids are related to straining and constipation).

Deficiency Symptoms
What are deficiency symptoms for dietary fiber?
There is no identifiable, isolated deficiency disease caused by lack of fiber in the diet. However, research clearly indicates that low intake of dietary fiber (less than 20 grams per day) over the course of a lifetime is associated with development of numerous health problems including constipation, hemorrhoids, colon cancer, obesity and elevated cholesterol levels.

Toxicity Symptoms
What are toxicity symptoms for dietary fiber?
Intake of dietary fiber in excess of 50 grams per day may cause an intestinal obstruction in susceptible individuals. In most individuals, however, this amount of fiber will improve (rather than compromise) bowel health.

Excessive intake of fiber can also cause a fluid imbalance, leading to dehydration. Individuals who decide to suddenly double or triple their fiber intake are often advised to double or triple their water intake for this reason.

In addition, excessive intake of nonfermentable fiber, typically in supplemental form, may lead to mineral deficiencies by reducing the absorption or increasing the excretion of minerals, especially when mineral intake is too low or when mineral needs are increased such as during pregnancy, lactation, or adolescence.

Impact of Cooking, Storage and Processing
How do cooking, storage, or processing affect dietary fiber?
Many whole foods contain 5 or more grams of fiber, and in their whole, unprocessed form, would be highly supportive of health. When foods are processed, however, most or all of this fiber is often lost.

For example, most breads sold nationally in the United States use a 60% extraction process in which 60% of the original wheat grain is kept in the flour, but 40% is discarded. The discarded part of the wheat includes the bran and the germ; these two components of the grain contain virtually all of its fiber.

As a result, 60% extraction wheat flour contains almost no fiber, even though the whole, unprocessed wheat grain contains an ample amount. Fruit juices and vegetable juices are also good examples of products which started out high-fiber in their whole, unprocessed state but ended up with virtually no fiber as a result of processing.

Factors that Affect Function
What factors might contribute to a deficiency of dietary fiber?
Even though fiber is often defined as the "undigestable" part of food, a certain amount of healthy digestive function is important for realizing the health benefits of this nutrient.

Inadequate chewing can prevent the health benefits of fiber from being realized, since fibers that cannot be solubilized (like lignins, celluloses, and some hemicelluloses) require extra chewing in order to participate in biochemical processes.

Drug-Nutrient Interactions
What medications affect dietary fiber?
Dietary fiber, especially the fiber found in fruit, beans, and oat bran, reduces the absorption of a class of cholesterol-lowering medications called HMG-CoA reductase inhibitors (for example, lovastatin) by binding to the drug in the gastrointestinal tract.

Dietary fiber decreases the absorption of hydralazine, digoxin, and lithium.

Diets high in dietary fiber may improve glucose control in people with type 2 diabetes, thereby reducing the dose of insulin or oral glucose lowering medications needed to control blood sugar.

Certain medications, including pain medications (for example, codeine) and calcium channel blockers (for example, verapamil) can cause constipation.

Increased intake of dietary fiber can reduce the constipation caused by these medications.

Nutrient Interactions
How do other nutrients interact with dietary fiber?
Foods high in nonfermentable fiber, or the fiber that passes all the way through the intestines unchanged, may reduce the absorption and/or increase the excretion of several minerals, including calcium and iron.

Health Conditions
What health conditions require special emphasis on dietary fiber?
A diet high in fiber may play a role in the prevention and/or treatment of the following health conditions:

• Breast cancer
• Cardiovascular disease
• Colon cancer
• Constipation
• Diabetes
• Diverticulitis
• Gallstones
• High cholesterol
• Irritable bowel syndrome
• Obesity
• Syndrome X

Form in Dietary Supplements
What forms of dietary fiber are found in dietary supplements?
As a dietary supplement and over-the-counter medication, fiber is available in powders that can be mixed with water or juice. These products often contain psyllium as the source of fiber, but may also contain pectin or guar gum. In addition, oat bran is available as a fiber-rich food ingredient that can be added to baked goods or hot cereal.

Food Sources
What foods provide dietary fiber?

• Excellent food sources of dietary fiber include: turnip greens, mustard greens, cauliflower, collard greens, broccoli, Swiss chrd and raspberries.
• Very good sources of dietary fiber include romaine lettuce, celery, spinach, fennel, green beans, eggplant, cranberries, strawberries and flax seeds.
• Good sources of dietary fiber include cucumber, apricots, navy beans, grapefruit, rye, sweet potato, beets, buckwheat, shiitake mushrooms and oats.

Public Health Recommendations
What are current public health recommendations for dietary fiber?
In its most recent 2005 public health recommendations for fiber (published as the Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients), National Academies Press, 2005), the National Academy of Sciences established an Adequate Intake (AI) level of 38 grams of total daily fiber for males 19-50 years of age and 25 grams for women in this same age range. It also noted that individuals in this age range in the United States only get about half this much fiber each day.

References

1. American Association of Cereal Chemists. The definition of dietary fiber. Cereal Foods World 2001; 46(3), 112-127 2001.
2. American Dietetic Association. Health implications of dietary fiber - - Position of the ADA. Journal of the American Dietetic Association 1997; 97:1157-1159 1997.
3. Burton-Freeman B. Dietary fiber and energy regulation. J Nutr 2000 Feb;130(2S Suppl):272S-5S 2000. PMID:15360.
4. Cohen LA. Dietary fiber and breast cancer. Anticancer Res 1999 Sep-1999 Oct 31;19(5A):3685-8 1999. PMID:15370.
5. Davy BM and Melby CL. The effect of fiber-rich carbohydrates on features of Syndrome X. J Am Diet Assoc 2003 Jan;103(1):86-96 2003.
6. Fernandez ML. Soluble fiber and nondigestible carbohydrate effects on plasma lipids and cardiovascular risk. Curr Opin Lipidol 2001 Feb;12(1):35-40 2001.
7. Flamm G, Glinsmann W, Kritchevsky D, et al. Inulin and oligofructose as dietary fiber: a review of the evidence. Crit Rev Food Sci Nutr 2001 Jul;41(5):353-62 2001. PMID:15310.
   Garcia Peris P, Camblor Alvarez M. [Dietary fiber: concept, classification and current indications]. Nutr Hosp 1999 May;14 Suppl 2:22S-31S 1999. PMID:15380.
8. Groff JL, Gropper SS, Hunt SM. Advanced Nutrition and Human Metabolism. West Publishing Company, New York, 1995 1995.
9. Institute of Medicine. Dietary Reference Intakes: Proposed Definition of Dietary Fiber. National Academy Press, Washington DC, 2001 2001.
10. Lininger SW, et al. A-Z guide to drug-herb-vitamin interactions. Prima Health, Rocklin, CA, 2000 2000.
11. Mahan K, Escott-Stump S. Krause's Food, Nutrition, and Diet Therapy. WB Saunders Company; Philadelphia, 1996 1996.
12. McIntosh M, Miller C. A diet containing food rich in soluble and insoluble fiber improves glycemic control and reduces hyperlipidemia among patients with type 2 diabetes mellitus. Nutr Rev 2001 Feb;59(2):52-5 2001.
13. Meseguer Soler I, Martinez Para MC, Farre Rovira R. [Dietary fiber (and II). Metabolism and physiologic implications]. Med Clin (Barc) 1998 Jan 17;110(1):32-7 1998. PMID:15390.
14. Pereira MA, Ludwig DS. Dietary fiber and body-weight regulation. Observations and mechanisms. Pediatr Clin North Am 2001 Aug;48(4):969-80 2001. PMID:15320.
    Pereira MA, Pins JJ. Dietary fiber and cardiovascular disease: experimental and epidemiologic advances. Curr Atheroscler Rep 2000 Nov;2(6):494-502 2000. PMID:15350.
15. Swanson KS, Fahey GC. New developments in the area of dietary fiber. Nutrition in Complementary Care Newsletter 2001; 4(1):5,12 2001.
16. Zhao X, Yang Y, Song Z et al. Effect of superior fiber complex on insulin sensitivity index and blood lipids in non-insulin dependent diabetes mellitus rats. Zhonghua Yu Fang Yi Xue Za Zhi 2002 May;36(3):184-6 2002.

Haemoglobin

Both the red badge of courage and the blue blood of the aristocrat are due to haemoglobin, the pigment that gives blood its colour. Take it away, by removing the blood cells, and the resulting plasma is a very pale yellow.

Haemoglobin combines with oxygen, enabling blood to carry 70 times more than if the oxygen were simply dissolved. Animals that are physically active and larger than a pea could scarcely survive without it. ‘But for haemoglobin's existence, man might never have attained any activity which the lobster does not possess, or had he done so, it would have been with a body as minute as the fly's’ (J. Barcoft).

Haemoglobin, contained in the red cells of the blood and constituting the main site of iron in the body, is present in all vertebrate species. In the human adult it is synthesized in the developing red cells in the bone marrow. Many worms have haemoglobin, but others and also most molluscs have different and more primitive oxygen-carrying pigments, which have not survived into higher forms of evolution.

Haemoglobin not only distributes oxygen as it is required by the tissues but is also an important store of the gas. Healthy humans have about 15 g of haemoglobin per litre of blood, and this can bind with 200 ml of oxygen per litre. With the body at rest the tissues only remove about one-quarter of the available oxygen reaching them in arterial blood, the other three-quarters remaining in the venous blood returning to the lungs. This constitutes an important reserve of oxygen supply which can be called on in conditions of work and exercise. In a typical total blood volume of 5 litres, even though more than half is in the veins, we thus have about 0.75 litre of oxygen combined with haemoglobin in the blood, and we have about the same amount as gas in the lungs. If we stop breathing, for example by holding our breath, these stores will maintain the functions of the brain for at the most a few minutes — but without them brain function would cease almost immediately.

The amount of oxygen free in solution in the blood plays no important role in carriage of oxygen to the tissues. The amount depends on the pressure of the gas in the lungs (see figure). If we breathe pure oxygen the amount in solution rises almost seven-fold and it can become a significant contribution to the body. If we were to breathe pure oxygen in a chamber at a pressure of three atmospheres, all the oxygen we need could be carried in solution and we would not need haemoglobin. This treatment is used for some conditions when haemoglobin is seriously deficient, but there are significant hazards of breathing high-pressure oxygen.

Each haemoglobin molecule consists of four iron-containing parts (haems) and four protein chains (globins). The fact that blood contained iron was discovered in 1747 by Menghini, who showed that if blood was burnt to an ash, iron-like particles could be extracted by a magnet. Chemical analysis of haemoglobin began in the mid nineteenth century and culminated in one of the great early triumphs of molecular biology, when in the 1960s the full chemical structure of haemoglobin was worked out.

Each haemoglobin molecule can combine with four oxygen molecules, but with no more. The complete combination is called oxygen saturation. The degree of combination depends on the pressure of the gas; in healthy humans the pressure in the alveoli of the lungs is above that needed for saturation. If the alveolar oxygen pressure is increased, for example by breathing more deeply or by inhaling pure oxygen, the haemoglobin in the blood will not take up any additional oxygen (see figure). However in patients with arterial blood not saturated with oxygen, for example with lung or heart disease, stimulation of breathing or administration of oxygen should increase the oxygen carriage in the blood and be beneficial or life-saving.

The combination of oxygen with haemoglobin is not related linearly to the oxygen pressure, and this is crucially important in its function. As oxygen pressure reduces below that required for full saturation, haemoglobin is relatively little desaturated until and unless the oxygen pressure reaches about the level which blood normally encounters in the oxygen-using tissues: it then parts with it readily. Thus in breath-holding, or in disease, or at altitude, alveolar oxygen pressure can approach half its normal value before haemoglobin saturation declines steeply in the blood leaving the lungs; and saturation is not itself halved until the oxygen pressure is reduced by almost two-thirds. Thus the properties of haemoglobin defend the oxygen supply against interruptions of breathing or shortage of oxygen in the atmosphere, whilst promoting its off-loading around the body.

The combination of haemoglobin and oxygen is weak, and oxygen can be pulled from the blood if the surrounding pressure of oxygen is low; indeed a vacuum will extract all the oxygen from a sample of blood. When blood flows through the capillaries of tissues which are using oxygen for metabolism, the low oxygen pressure in the tissue cells draws oxygen from its combination with haemoglobin and the gas flows into the cells. The resulting venous blood contains less than its full oxygen saturation, and the haemoglobin is partly ‘deoxygenated’. Such haemoglobin does not have the bright red colour of saturated haemoglobin, but is more blue. Thus conventionally arterial blood is red and venous blood is blue. In cyanosis tissues are bluish because their blood is deficient in oxygen.

Haemoglobin can also combine with carbon dioxide to form carbaminohaemoglobin, and this is one way in which this gas is carried round the body. The two gases have a complex chemical interaction with haemoglobin. When in metabolizing tissues carbon dioxide enters the blood, its combination with haemoglobin results in a weaker affinity for oxygen, which is split off and enters the cells. The reverse happens in the lungs. Temperature has a similar effect: if local temperature rises oxyhaemoglobin splits more easily. Both mechanisms help to match gas exchange to changing activity.

Red cells also contain 2, 3-diphosphoglycerate (DPG), a substance that increases the readiness with which haemoglobin gives up its oxygen. The DPG is increased in exercise and at high altitude, which facilitates the supply of oxygen to the tissues. Unfortunately this process takes several hours. Stored blood loses its DPG and is therefore less effective on transfusion than fresh blood, although there are ways to treat it that restore the DPG.

Although the haem is the essential part of the haemoglobin molecule to enable it to combine with oxygen, it is the four globin molecules which determine the amount of binding or affinity for haemoglobin and oxygen. The globins are identified by Greek letters, and a very large number have been discovered, many of them related to diseases of the blood. Healthy human adults have two a-globins and two b-globins. Fetuses have two a-and two g-globins. As a result fetal haemoglobin has a stronger affinity for oxygen than does the adult form. When maternal blood flows through the placental circulation, oxygen diffuses across the placental barrier into the fetus and, because of the difference between the two haemoglobins, the fetus extracts a proportionally higher amount of oxygen. This success in parasitism is clearly to the advantage of the fetus. After birth the fetal haemoglobin is slowly replaced by the adult version.

The way in which blood takes up oxygen, in relation to its partial pressure. The S-shaped curve on the left refers to the normal situation, when at rest: blood leaves the lungs with its haemoglobin saturated with oxygen; in the tissues 25% of the oxygen leaves the arterial blood; venous blood is 75% saturated. The graph is extended on the right to show the effect of breathing progressively higher percentages of oxygen, up to 100%: there is an increase only in dissolved oxygen (broken line).

In healthy humans, haemoglobin is only found in erythrocytes, the blood red cells. The advantage in confining the haemoglobin in cells is threefold:

• First, if the haemoglobin were free in solution it would give the blood a treacle-like consistency, and the heart would be unable to force it fast enough through the capillaries.
• Second, the chemical environment in the red cell, including for example the presence of DPG, allows the haemoglobin to take up and release oxygen with greatest efficiency. And
• third, if the haemoglobin were free in solution it would be excreted and lost in the kidneys.

Patients with red cell breakdown, for example in malaria, pass haemoglobin into the urine, where it is broken down to the brown pigment methaemoglobin; hence one form of malaria is called ‘black-water fever’.

A few animals — some of the worms mentioned earlier — do have free oxygen-carrying pigments in the blood, but their molecular sizes are 40 times that of haemoglobin, so they are not excreted. One species of antarctic fish is said to lack both red cells and haemoglobin, but it lives in a cold environment and its metabolism and oxygen requirement must be very low.Human red cells live on average about 120 days in the bloodstream, and then they become fragile and are broken up, especially by scavenger cells in the spleen and liver. The haemoglobin is not released into the blood, but is immediately broken down into haem and globins. The haem is in turn split into iron, which forms chemical compounds as part of the blood iron pool available for future haemoglobin synthesis, and an amber pigment, bilirubin, which contributes to the pale colour of plasma. Bilirubin combines with albumin in the blood, and the large size of this combined molecule prevents it from being excreted in the kidneys. Instead it passes to the liver, where it is excreted in the bile, contributing to its colour. When it reaches the intestines it is acted on by bacterial flora, and forms the brown pigment stercobilinogen. Most of the stercobilinogen appears in the faeces, giving it its characteristic colour (but not its odour), and the rest is reabsorbed into the bloodstream. Here a proportion recirculates in the bile but most, now called urobilinogen, is excreted in the urine. Thus not only does haemoglobin provide the colour of the blood, but its breakdown products are largely responsible for the colours of plasma, bile, faeces, and urine. Jaundice is due to an excess of bilirubin in the blood and tissues.There are many diseases caused by abnormal haemoglobins. In all of them it is the globin part of the molecule which is abnormal. Not only may haemoglobin be unable to combine normally with oxygen, but since the haemoglobin is an integral part of the structure of the red cell, these cells may be deformed. An example is sickle cell disease, where the red cells become rigid and deformed and break down more readily, leading to anaemia. Another common disease is thalassaemia, where there is a defect in the synthesis of the b-globin chains. Less common conditions are the persistence of fetal haemoglobin long after birth, and abnormalities in the enzymes associated with haemoglobin (e.g. DPG) that affect its affinity for oxygen.

— John Widdicombe

Homeostasis

(1) The tendency of an organism or a cell to regulate its internal conditions, usually by a system of feedback controls, so as to stabilize health and functioning, regardless of the outside changing conditions
(2) The ability of the body or a cell to seek and maintain a condition of equilibrium or stability within its internal environment when dealing with external changes
Supplement
In humans, homeostasis happens when the body regulates body temperature in an effort to maintain an internal temperature around 98.6 degrees Fahrenheit. For example, we sweat to cool off during the hot summer days, and we shiver to produce heat during the cold winter season.
Word origin: from the Greek: homeo, meaning unchanging + stasis, meaning standing. Related forms: homeostatic (adjective).

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Homeostasis is the maintenance of equilibrium, or constant conditions, in a biological system by means of automatic mechanisms that counteract influences tending toward disequilibrium.

The development of the concept, which is one of the most fund mental in modern biology, began in the 19th century when the French physiologist Claude BERNARD noted the constancy of chemical composition and physical properties of blood and other body fluids. He claimed that this "fixity of the milieu interieur" was essential to the life of higher organisms. The term homeostasis was coined by the 20th-century American physiologist

Walter B. Cannon, who refined and extended the concept of self-regulating mechanisms in living systems. Homeostatic mechanisms operate at all levels of organization in living systems, including the molecular, cellular, organismic, and even populational levels.

In complex organisms, such as humans, it involves constant monitoring and regulating of numerous factors, including the gases oxygen and carbon dioxide, nutrients, hormones, and organic and inorganic substances. The concentrations of these substances in body fluid remain unchanged, within limits, despite changes in the external environment.

At the molecular level, a homeostatic mechanism called feedback inhibition operates to limit the amount of chemical product produced by an enzyme system. An enzyme system consists of several enzymes that act sequentially to convert a metabolite into an end product which the organism needs.

Overproduction of the end product is prevented by the inhibitory effect of the end product on the first enzyme in the sequence, the regulatory enzyme. As the end product is used up in subsequent metabolic conversions, however, its inhibitory effect on the regulatory enzyme decreases, so that more end product can be formed by the enzyme system. In this manner, the level of end product is maintained at a fairly constant level.

An example of homeostasis:

• in cells is the phenomenon called contact inhibition, in which division in a population of cells stops when they become so numerous that they touch each other.

It is believed that, a chemical "messenger" that inhibits further cell division is passed from cell to cell. In contrast, cultured, or artificially produced, cancer cells continue dividing even after cells touch. Thus, cancer cells appear to have lost the homeostatic mechanism of contact inhibition.

Homeostasis in organisms is exemplified by the operations of the endocrine system. The hormone-synthesizing activities of the endocrine glands are regulated by events occurring in the systems that the hormones regulate. For example, a rise of blood-glucose levels stimulates the pancreas to secrete insulin, which acts to accelerate the removal of glucose from the blood by conversion into the storage products glycogen and fat.

The sensations of hunger and thirst are also homeostatic mechanisms; they help the organism maintain optimum levels of energy, nutrients, and water.

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WHAT IS HOMEOSTASIS?

Homeostasis is the maintenance of a constant internal environment (the immediate surroundings of cells) in response to changes in:

• the changing conditions of the external environment.
• the changing conditions of the internal environment.

Homeostasis is a self adjusting mechanism involving feedback where the response to a stimulus alters the internal conditions and may itself become a new stimulus.

Homeostasis works to maintain the organism's internal environment within tolerance limits - the narrow range of conditions where cellular processes are able to function at a level consistent with the continuation of life.

HOW IS HOMEOSTASIS ACHIEVED?

To maintain cells, tissues and entire organisms within their biological tolerance limits, various mechanisms have evolved.

These may be

• structural: the animal or plant has particular physical features which help its survival in an otherwise hostile environment.
• functional: the metabolism of the animal or plant is able to adjust to changes in conditions as they are detected.
• behavioral: the actions and interactions of the individual, either alone or with others, help it to survive in its particular environment.
  

Homeostasis is really the combined result of all of these, a failure of any one of them can result in the death of an individual.

FEEDBACK MECHANISMS

Feedback mechanisms are the general mechanism of nervous or hormonal regulation in animals. Essentially, feedback occurs when the response to a stimulus has an effect of some kind on the original stimulus. The nature of the response determines how the feedback is 'labeled'.

Negative feedback is when the response diminishes the original stimulus. Positive feedback is when the response enhances the original stimulus.

Negative feedback is most common in biological systems. Examples of this are:

• Blood glucose concentrations rise after a sugary meal (the stimulus), the hormone insulin is released and it speeds up the transport of glucose out of the blood and into selected tissues (the response), so blood glucose concentrations decrease (thus decreasing the original stimulus).
• Exercise creates metabolic heat which raises the body temperature (the stimulus), cooling mechanisms such as vasodilation (flushed skin) and sweating begin (the response), body temperature falls (thus decreasing the original stimulus).
  

Positive feedback is less common, which is understandable, as most changes to steady state pose a threat, and to enhance them would be most unhelpful. However, there are a few examples:

• A baby begins to suckle her mother's nipple and a few drops of milk are released (the stimulus). This encourages the baby and releases a hormone in the mother which further stimulates the release of milk (the response). The hungry baby continues to suckle, stimulating more milk release until she stops. (Positive feedback, it would not have helped the baby if suckling decreased milk flow, as in negative feedback!)
• A ripening apple releases the volatile plant hormone ethylene (the stimulus). Ethylene accelerates the ripening of unripe fruit in its vicinity so nearby fruit also ripens, releasing more ethylene (the response). All the fruit quickly becomes ripe together. ("One 'bad' apple has ruined the whole lot." The biological explanation - positive feedback - for an old saying!)

FEEDBACK LOOPS

Regardless of whether the feedback is positive or negative, feedback mechanisms have certain essential components.
Students should be able to identify each of these and explain their role.

• Stimulus: The change from ideal or resting conditions.
• Receptor: The cells or tissue which detects the change due to the stimulus.
• Relay: The transmission of the message, via nerves or hormones or both, to the effector.
• Effector: The cells or tissue, usually a gland or muscles, which cause the response to happen.
• Response: An action, at cell, tissue or whole organism level which would not have occurred in the absence of the stimulus.
• Feedback: The consequence of the response on the stimulus. May be positive or negative.
  

These feedback loops, as they are often called, are usually well illustrated in textbooks.

Human Anatomy

Human Major organ systems

1. Circulatory system: pumping and channeling blood to and from the body and lungs with heart, blood, and blood vessels.
2. Digestive System: digestion and processing food with salivary glands, esophagus, stomach, liver, gallbladder, pancreas, intestines, rectum, and anus.
3. Endocrine system: communication within the body using hormones made by endocrine glands such as the hypothalamus, pituitary or pituitary gland, pineal body or pineal gland, thyroid, parathyroids, and adrenals or adrenal glands
4. Integumentary system: skin, hair and nails
5. Immune system: the system that fights off disease; composed of leukocytes, tonsils, adenoids, thymus, and spleen.
6. Lymphatic system: structures involved in the transfer of lymph between tissues and the blood stream, the lymph and the nodes and vessels that transport it.
7. Musculoskeletal system: movement with muscles and human skeleton (structural support and protection with bones, cartilage, ligaments, and tendons).
8. Muscular system: the system that moves the body with muscles, ligaments, and tendons.
9. Nervous system: collecting, transferring and processing information with brain, spinal cord, peripheral nerves, and nerves
10. Reproductive system: the sex organs; in the female; ovaries, fallopian tubes, uterus, vagina, mammary glands, and in the male; testes, vas deferens, seminal vesicles, prostate, and penis.
11. Respiratory system: the organs used for breathing, the pharynx, larynx, trachea, bronchi, lungs, and diaphragm.
12. Skeletal system:the system that holds the body together and gives it shape; composed of bones, cartilage, and tendons.
13. Urinary system: kidneys, ureters, bladder and urethra involved in fluid balance, electrolyte balance and excretion of urine.
14. Vestibular system : contributes to our balance and our sense of spatial orientation.

Vitamin B Complex Benefits

Vitamin B complex benefits refer to the benefits of the various B vitamins from thiamine (B-1) to niacin (B-3) to cobalamin (B-12). B complex vitamins are water soluble and interact with the body on different levels, providing the necessary nutrients for healthy living. Taking regular supplements helps people to reap the full benefits of vitamin B complex.

Healthy Digestion
B complex vitamins aid in the digestion and processing of glucose to energy. Since all B complex vitamins are water soluble, high amounts can aid digestion without becoming toxic. However, taking more than the recommended daily amounts can cause a stomach ache.

Increased Energy
Vitamin B-12, found in most protein sources, increases energy and helps to boost the mood. Vitamin B complex helps the body convert glucose into energy during digestion.

Stress Reduction
Due to the water soluble nature of Vitamin B complex, stress depletes the body's vitamin B unless it is maintained regularly through diet or supplement. Thiamine, riboflavin, niacin, B-6, folic acid, B-12, pantothenic acid, biotin and choline all help to calm the body and the mind by improving cell regeneration and repair.

Improved Memory
Regular vitamin B-complex supplements increase concentration and memory. Elderly patients notice a definite improvement in their ability to focus and remember when taking regular supplements. Niacin is also known as vitamin B-3 and is found in every cell of the body; depleted amounts of niacin can have a profound impact on the memory.

Healthy Development
Folic acid is an important part of a healthy pregnancy. Studies show that women who are pregnant or nursing need over 400 milligrams a day of folic acid (also known as folate) in order to promote healthy development of infants. Folic acid deficiencies can lead to growth problems and learning disabilities.

Avoid Trans Fat..

Atherosclerosis is a Vitamin C Deficiency Disease

Every year half a million people die from coronary heart disease. In a recent CNN article discussing a new study based on the data from the Framingham study concludes: The study "reaffirms the notion that coronary heart disease is the 800-pound gorilla of disease in this country, now and for the foreseeable future," says cardiologist Dr. Stuart Seides. Heart attacks were virtually unknown before the turn of the century. Our diets, especially in "developed" countries have gone through dramatic changes in this period. There is a very real connection between this new disease and our new diets.

As we discuss in the Primer section, Vitamin C is required for tissue integrity. Tissues that are under constant stress are particularly vulnerable to degradation from C deficiency. This is certainly true of our arteries.

Shortly before his death at 93, Linus Pauling and Matthias Rath had completed work on the link between atherosclerosis and Vitamin C (please see the link in the side bar). They had concluded that chronic Vitamin C deficiency lead to a serious compromising of our arterial system. Our bodies respond to this situation with a healing process. Let me explain.

Imagine your arterial wall to be like a stone dam. This is a reasonable analogy since your cells are like the stones and the water being held by the dam is similar to the blood under pressure in our arteries. Now, if the cement between the rocks is inferior, leaks could occur. Likewise in our arteries, if the ground substance between our cells is inferior due to lack of the proper development of collagen and fibrils as a result of inadequate Vitamin C, the arterial wall may be susceptible to seepage.

When arteries are compromised, our systems produce a specialized, sticky form of low-density lipoprotein (yes, there is a link with cholesterol. Please read the side bar) called Lp(a) which attaches itself to the arterial wall to prevent blood seepage. This is consistent with where arterial plaque is found - where there are lesions and where there is particular stress (i.e. at branches, in arteries, not veins, due to the pressure and in coronary arteries due to the stress of the constant motion).

A study, Vitamin C Deficiency and Risk of Myocardial Infarction (Heart Attack) was published in the March 1997 issue of the British Medical Journal. The Aceology Medical Review states this conclusion:

This study looked at the association between blood vitamin C concentration and risk of heart attack in 1605 men from eastern Finland who did not have evidence of coronary artery disease on exercise testing between 1984 and 1989.

Seventy of the men had a fatal or a non-fatal heart attack between 1984 and 1992. Among men with the vitamin C deficiency 13.2% had a heart attack compared to 3.8% in those who were not deficient in Vitamin C.

This study concludes that vitamin C deficiency may be a risk factor for coronary artery disease and heart attack.

The Stage is Set - One More Element is Required to Produce a Heart Attack

The vast majority of cardiac events (heart attacks) are caused by a thrombus (blood clot) that gets stuck in an already narrowed (occluded) coronary artery. Blood flow to that section of heart muscle is cut off and the starvation of oxygen is the heart attack. If the lack of oxygen (ischemia) lasts very long, cells will die, leaving permanent heart injury or very commonly, death.

Vitamin E (see, I can discuss other things besides C) is our body's natural anti-thrombin. It prevents the blood cells from aggregating, without the side affects of blood-thinning drugs (possibly blindness from macular degeneration).

Understanding that most heart attacks are a combination of both restricted blood vessels AND a blood clot, not getting a blood clot would seem a very good thing! If a blood clot gets lodged in a vessel in the brain, that's a stroke - also something to avoid.

In Richard Passwater's book Supernutrition for Healthy Hearts, he discusses his studies of 17,884 cases for evidence of alpha-tocopherol's (vitamin E) impact on heart disease. Of most interest is one subgroup, those that had taken 400 IU or more of tocopherol for ten years or more. There were 2508 people in this group. Government statistics would indicate that of these 836 would be expected to have heart disease. The actual number reported was four! That is less than 1/2 of 1% of statistical expectations. A December 6, 1998 article at About.com discusses

Vitamin E and Heart Disease.

Vitamin E also increases our cells ability to utilize oxygen. That is the primary reason it is used on burns. It allows more cells that were not killed, but are getting marginal nutrition due to circulatory damage in the area, to survive. This property of vitamin E also helps those with circulatory problems. This can include the minimization of angina (heart pain), cramps, and even have a positive effect on senility, which is very-much circulation related.

Good Nutrition

...To understand what good nutrition is...

What Is Homocysteine?

Homocysteine is an amino acid in the blood. Epidemiological studies have shown that too much homocysteine in the blood (plasma) is related to a higher risk of coronary heart disease, stroke and peripheral vascular disease.

Other evidence suggests that homocysteine may have an effect on atherosclerosis by damaging the inner lining of arteries and promoting blood clots. However, a direct causal link hasn’t been established.

Plasma homocysteine levels are strongly influenced by diet, as well as by genetic factors. The dietary components with the greatest effects are folic acid and vitamins B6 and B12. Folic acid and other B vitamins help break down homocysteine in the body. Several studies have found that higher blood levels of B vitamins are related, at least partly, to lower concentrations of homocysteine. Other recent evidence shows that low blood levels of folic acid are linked with a higher risk of fatal coronary heart disease and stroke.

Several clinical trials are under way to test whether lowering homocysteine will reduce CHD risk. Recent data show that the institution of folate fortification of foods has reduced the average level of homocysteine in the U.S. population.

Recent findings suggest that laboratory testing for plasma homocysteine levels can improve the assessment of risk. It may be particularly useful in patients with a personal or family history of cardiovascular disease, but in whom the well-established risk factors (smoking, high blood cholesterol, high blood pressure) do not exist.

Although evidence for the benefit of lowering homocysteine levels is lacking, patients at high risk should be strongly advised to be sure to get enough folic acid and vitamins B6 and B12 in their diet. Foods high in folic acid include green, leafy vegetables and grain products fortified with folic acid. But this is just one risk factor. A physician taking any type of nutritional approach to reducing risk should consider a person's overall risk factor profile and total diet.

Uric Acid / Purine ~ Gout

"Uric acid is a chemical created when the body breaks down substances called purines. Purines are found in some foods and drinks, such as liver, anchovies, mackerel, dried beans and peas, beer, and wine.

Most uric acid dissolves in blood and travels to the kidneys, where it passes out in urine. If your body produces too much uric acid or doesn't remove enough if it, you can get sick. High levels of uric acid in the body is called hyperuricemia"

Intake of foods containing purines is directly linked to the body's production of uric acid. In most cases, the body is able to dispose of uric acid, regardless of how much is made. However, in some cases, uric acid cannot be properly processed, which can lead to a very painful condition called gout. A person who is suffering from gout should either eliminate or severely limit certain purine-rich foods in his diet because these foods produce too much uric acid.

Relationship

Purines are found in all plant and animal cells. When the cells die after they are consumed in foods the body metabolizes the purines, converting them to uric acid. In most cases, the uric acid is expelled from the body as waste. However, if a large quantity of purine-rich foods is consumed, the uric acid levels in the body rise. This can be a problem for certain people whose systems are not equipped to handle the increase in uric acid.

Gout

Gout attacks develop when high levels of uric acid are not properly controlled by the body. When uric acid remains the body, it crystallizes around the joints of the toes, ankles, fingers and wrists. These crystals lead to painful redness, stiffness and swelling that lasts for five to 10 days. Gout strikes without warning, but can sometimes by controlled by monitoring the intake of purine-rich foods.

High-Risk

Certain foods contain such a concentrated amount of purine that they are exceptionally high-risk for those with gout. This category of foods includes organ meats and certain fish and seafood, such as herring and mussels. It also includes mushrooms and yeast. Those who are concerned about having elevated uric acid levels should avoid these foods.

Moderate-Risk

Some foods pose a moderate uric-acid risk, but can still be consumed by those with gout. These items include turkey, anchovies, asparagus, bacon, liver, trout, goose, scallops, pheasant and mutton. Those with gout may choose to eat these items on a very limited basis, or just eliminate them altogether.

Alcohol

Alcoholic beverages contain a low-to-moderate amount of purines, but they can also affect the body's ability to process uric acid efficiently. Therefore, most doctors recommend that anyone who already has an increased risk for gout should not drink alcohol. Beers contain the highest level of purines, but all types of alcohol can bring on a gout attack.

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Gout (podagra or uric acid)

What is gout?

Gout, otherwise known as podagra or uric acid arthropathy is a rheumatic complaint, that usually attacks a single joint at a time.

The disease has a preference for the big toe of middle-aged men - it swells, turns red and becomes sore. The soreness is such that just walking through a room can cause severe pain.
It is more common in men than women by a factor of 10 to 1.

What is the cause of gout?

The disease is caused by the deposition of sodium urate (uric acid) crystals in the joints. Uric acid is a by-product of the body's metabolism.

Normally the uric acid is removed when urinating, but among patients with a predisposition for gout, the uric acid accumulates in the blood.

Among some of these patients, the concentration in the blood is so high that the uric acid 'overflows' and settles in the joints and possibly in the skin.

How do you get gout?

The are two kinds of gout.

Primary hyperuricaemia and gout

Hyperuricaemia means an increased level of uric acid in the blood. It is usually caused by an hereditary abnormality in the system that changes the nucleic acid into uric acid. In this case the body is incapable of excreting uric acid fast enough even during normal circumstances.

Secondary hyperuricaemia and gout

Is caused by another disease or because of consumption of certain medicines (eg diuretic preparations, which increase the output of urine, and acetylsalicylic acid derivatives including aspirin). In these cases, the problem is that the body produces such large quantities of uric acid that the kidneys cannot keep up.

What are the signs of gout?

Prior to the onset of symptoms of gout, there is usually a latent period of several years in which the concentration of uric acid in the blood has gradually increased. This condition is called asymptomatic hyperuricaemia.

Some 95 per cent of the people with this condition never develop gout.

The first gout attack is often at night. Typically, the afflicted person wakes up in the middle of the night with extreme pain near the joint of the big toe (if the pain is in the knee it is called gonagra). The joint is swollen and may turn a shining purple.

Even the smallest stimuli produce severe pain, for instance a blanket on the toe. The first attack usually subsides after about a week.

About 10 per cent of sufferers will never again experience gout whereas others will experience more frequent and longer lasting attacks if they are not treated.

If it is not treated, repeated cases of gout over several years can produce permanent damage in the joint.

If no preventive treatment is undertaken, over time, sodium urate will collect under the skin. In this case the crystals are seen as small bumps near the joints or on the outer side of the ear called tophi.

Occasionally they rupture or ooze out yellowish chalky materials.

Who is at most risk?

Gout attacks are brought on by several factors including:

• overconsumption of alcohol, especially beer.
• some foods with a high content of protein and purines, such as liver, kidneys, sardines, and anchovies.
• being overweight.
• haemorrhages in the gastrointestinal canal.
• bodily trauma with extensive tissue destruction.
• major surgery.
• conditions in which there is a high rate of cell turnover, eg leukaemia, lymphoma, psoriasis.

Good advice

• Cut down on alcohol consumption.
• Avoid food that you know can cause attacks.
• Watch your weight.

The uric acid crystals can be secreted in the urinary system as calculi (stones). Therefore you have to drink plenty of water, preferably 10 to 12 glasses a day, in order to wash out the urinary system and prevent any stones from developing.

How does the doctor diagnose gout?

The diagnosis is usually made from the way the patient presents the symptoms, plus the clinical picture.

In order to rule out other rheumatic complaints, the doctor will usually take a blood sample to measure the concentration of uric acid. He may also undertake an X-ray examination and an examination of the synovial fluid (found within joints), where uric crystals will be visible by using special equipment.

Future prospects

About 60 per cent of the people who experience a gout attack will have a similar or more severe attack within the next year.

The disease can become complicated with calculi (stones) in the urinary system.
With modern treatment it has become much easier to relieve gout.

How is gout treated?

Treatment is concentrated on three areas:
during the actual attack the most important thing is to soothe the pain with non-steroidal anti-inflammatory drugs (ordinary analgesics like paracetamol will not relieve the pain, and aspirin must not be used). Colchicine is used to relieve the pain in people who cannot take NSAIDs.
once the attack has passed, you are offered preventive treatment, usually with allopurinol (eg Zyloric), which will reduce the level of uric acid in the blood. The preventive treatment can - if it is used during an active attack of gout - actually aggravate an attack, because it causes a large quantity of uric acid to be released at the same time.

finally it is important to change your lifestyle, as described above.

The goals of the treatment are to remove the pain and the swelling, prevent further episodes, prevent and treat tophi and to stop the production of stones in the urinary system.

Dangers of Smoking

There are many dangers of smoking to the body, to the immediate family, to the society, to the environment and to the economy. More than 700 chemical additives are found in cigarettes. Some of them are classified as toxic and are not allowed in food.

Once lit, a cigarette reaches a temperature of nearly 2,000 degrees Fahrenheit. This high heat helps release thousands of chemical compounds, including:

• poisons like carbon monoxide
• poisons like hydrogen cyanide
• at least 43 carcinogens, and
• numerous mutagens.

All of these are drawn into the body when a smoker inhales.

Dangers Of Smoking With Nicotine

One of the main dangers of smoking is due to Nicotine. Nicotine is found naturally in tobacco. It has no odor and no color. It is, however, both physically and psychologically addictive, and it causes those who use it to want to smoke one cigarette after another.

Nicotine enters the body as tiny droplets resting on particles of tar in cigarette smoke. Inhaled into the lungs, the drug passes quickly into the bloodstream, reaching the brain within about 10 seconds. In another 5 to 10 seconds the nicotine has spread to all parts of the body.

The nicotine raises both the heart rate and blood pressure. The smoker quickly feels more alert and relaxed. In less than 30 minutes, however, about half of the nicotine has left the bloodstream, and the smoker starts feeling less alert, more edgy.

So he or she reaches for another cigarette to get a new “hit” of nicotine. Over time, the smoker starts needing more cigarettes throughout the day to satisfy the craving.

Dangers Of Smoking With Tar

There are other dangers of smoking as well. The tar from tobacco smoke starts to accumulate on the bronchial tubes leading to the lungs. The hot smoke burns the tiny hairlike projections (called cilia) that trap harmful particles before they enter the lungs.

Carbon Monoxide

One more of the dangers of smoking are Carbon monoxide. Smoking also increases the level of carbon monoxide in the lungs. This poisonous gas is quickly absorbed into the blood, reducing its capacity to carry oxygen.

As a result,

• the smoker has to exert more physical effort to attain a given task than does a nonsmoker.
• The heart in particular must work harder, particularly during rigorous exercise.
• Increased levels of carbon monoxide in the blood can impair vision, perception of time, and coordination.

Diseases

Smoking is the one of the main cause of death every year. Smoking cause number of smoke related diseases such as

• lung cancer (Smoking and Lung Cancer),
• respiratory problems and
• heart ailments

and these dangers of smoking are increasing yearly.

Certain breathing disabilities are also the dangers of smoking. It could also result in a decreased capability to enjoy physical capabilities because of the ailment or side effects like breathing problems. Smoking leads to reduction in life expectancy.

Over the years a smoker will be more likely to develop respiratory ailments:

• thickening of the arteries,
• blood clots,

cancer of the:

• lung,
• cervix,
• larynx,
• mouth,
• esophagus,
• bladder,
• pancreas and kidney, and
• emphysema,

as well as exhibit symptoms such as:

• reduced stamina,
• poor athletic performance,
• wheezing,
• coughing,
• dizziness, and
• nausea.

In time, a smoker suffers:

• increased resistance to the flow of air into the lungs and
• reduced lung capacity.

Besides these serious problems, prolonged tobacco use leads to:

• stained teeth and fingers and
• bad breath.

Even a smoker’s clothes and living quarters tend to smell of tobacco.

Smoking Is A Costly Affair

Smoking is a costly affair. An ordinary smoker invites enormous cost to maintain this unhealthy lifestyle and the costs do not affect exclusively to him. The most apparent cost of smoking is the daily, weekly and monthly expenditure of an ordinary smoker.
The average cost of pack of Cigarettes is $4.00. Imagine a smoker burning a pack per day, $4.00 per day. Annually the money spent on smoking would be around $1500. This money could have spent on some thing good like a decent out-of-town vacation.

Medical Expenditure

Medical expenditures will also have to be addressed as most, if not all, smoke related diseases require treatment, services and medication. Health care services do not always come free.
At the same time, due to illness the smoker has to refrain from work and forced to retire to the hospital be. This leads to reduce in income level and there after, instead of bringing in more money to the household, the money had to be taken out.

Secondhand Smoking

Another one of the dangers of the smoking is that smoking not only diminishes the health of the smokers but also diminishes the health of the non smokers around him through secondhand smoking

Facial Charm

Bad breath brought about by smoking would require gum or mints to overcome the odor. The smoker may also opt for breath fresheners, which are even more expensive. Cigarette components stain the teeth.

Having yellow teeth means extra charge from the dentist aside from the usual cleaning. Smokers were also found to have darkened gums. Smoking could also effect the wrinkling of the skin earlier than the usual.

Other Dangers Of Smoking

• Smoking gives a higher risk of starting a fire. Many fires had been discovered to originate from a cigarette left lit.
• It also leads to air pollution due to the constant release of carbon monoxide in the proximate vicinity.
• Presently, the insurance companies are charging more premium for smokers.
• Smokers who die early do not get to enjoy the fruits of their pensions. This means less social security benefits.
• Cigarette smoking also affects the overall aesthetics of the person.
• Smoking also leads to breakups with their loved ones.
• Smoke makes clothes dirty and the resulting in increase in money spent on dry cleaning.
• The smoke can also result in bad smell in the skin and hair (Bad Breath and Smoking).

Smoking also has emotional costs. The dependence to smoking when one gets addicted can be very restricting. There is also the pressure to quit smoking as the smoker realizes the harmful effects to himself and to his or her family