Seasonal Affective Disorder (SAD): Symptoms, Causes, and Treatment

Seasonal affective disorder is a type of depression that occurs in the winter in countries that are far from the equator.

Also known as SAD, it is sometimes referred to as winter depression. As winter approaches, the mornings start later and the evenings begin earlier, so there is less sunlight each day. Experts say SAD is most likely caused by lack of sunlight alone and not by cold temperatures.

Depressive symptoms usually build up slowly as days start getting shorter, and they gradually subside in early spring, as the amount of sunlight rises each day.

Fast facts on SAD:

  • SAD did not receive a clinical name until the early 1980s.
  • The symptoms of SAD are similar to those of depression.
  • Common symptoms include low mood, lethargy, and social withdrawal.

What is SAD?

SAD (seasonal affective disorder) is a common seasonal issue affecting people who don't get enough natural sunlight.

SAD (seasonal affective disorder) is a subtype of depression.

SAD was first mentioned in scientific literature in 1845 but the condition did not get a clinical name until the early 1980s.

We know that seasonal variations in sunlight have an impact on animal behavior, for example, hibernation, reproduction, and seeking out a mate. Seasonal changes in sunlight affect our circadian rhythms, which are also referred to as our internal biological clocks.

SAD is thought to affect 4-6 percent of people in the United States and is more common among young adults with onset typically between 20-30 years of age. It is often seen in females more than males, although depression is more common, generally, in females.

It also occurs more in areas that are further north. For example, it is seven times more common in Washington State than in Florida.

Interestingly, people can have SAD during the summer, although this is rare.

Symptoms of SAD

The signs and symptoms of SAD are similar to those of depression, but they come on as winter approaches and go away during springtime. In the majority of cases, symptoms come back each year at around the same time.

Symptoms are usually mild as autumn advances, and they worsen as the number of daylight drops. The severity, characteristics, and patterns of SAD can vary considerably from person-to-person.

About four-fifths of people who experience SAD develop unipolar depression, while the rest have bipolar depression. Unipolar means they have persistent depressive symptoms, while bipolar involves swinging from high or manic periods to very low or depressive ones.

The signs and symptoms of SAD include:

  • anxiety
  • feeling guilty and worthless
  • feeling stressed
  • indecision
  • irritability
  • low moods and despair
  • reduced libido
  • crying
  • lethargy, fatigue, hypersomnia
  • increased appetite
  • social withdrawal
  • difficulty concentrating
  • weight gain

Symptoms of spring and summer SAD

Insomnia is a common symptom of spring and summmer SAD.

Insomnia is a common symptom of spring and summer SAD.

Rather than feeling depressed during the winter, some people have symptoms in the spring and summer. This type of SAD is rare, but symptoms can include:

  • insomnia
  • low mood
  • reduced appetite
  • weight loss
  • anxiety
  • agitation

Who has a higher risk of developing SAD?

There are factors that can affect who gets SAD and who is less likely to have the condition.

Sex – females are more likely than males to suffer from SAD, although this may be due to a greater prevalence of depression among women. Males may have more severe symptoms.

Geography – some studies suggest that the further someone lives from the equator, the higher the chances of developing SAD. Put simply, those who live in places where days are considerably shorter in winter are more susceptible.

Genetics – individuals with a close relative who has or had SAD have a greater risk.

Having, or having had depression – people with a history of depression or bipolar depression are more likely to develop SAD than those with no such history.

Causes of SAD

Experts are still unsure of the exact causes of SAD. However, studies have pointed to the following:

  • Circadian rhythm – our body clock. Each of us has an internal body clock that tells us when to be awake and asleep. Less sunlight in the winter is thought to disrupt our circadian rhythm, causing depressive symptoms.
  • Melatonin levels – melatonin is a hormone that influences our sleep patterns and mood. Experts believe that reduced exposure to sunlight through shorter days in winter disrupts our melatonin balance. People with SAD also have decreased serotonin levels during the winter months.
  • The hypothalamus – sunlight is thought to stimulate the hypothalamus, a part of the brain that controls sleep, mood, and appetite, all of which impact on how we feel. Similarly, production of serotonin, a brain chemical (neurotransmitter) that affects mood, may be affected by low sunlight.

Diagnosis of SAD

The doctor may carry out a physical exam and ask questions covering:

  • How long symptoms have been present, how severe they are, and how they affect daily activities.
  • What eating patterns are like.
  • General lifestyle questions.
  • Sleeping patterns and if they have changed.
  • How thoughts and behaviors change with the seasons.
  • Details about family medical history, such as depression, SAD, etc.

As there are several types of depression, diagnosing SAD accurately may take time. There is no medical or laboratory test that can diagnose the condition. The doctor may order some diagnostic tests, including blood tests, to rule out other illnesses or underlying conditions.

The American Psychiatric Association do not class SAD as a separate disorder under the DSM-5 criteria, but a “course specifier.” They refer to it as “depression with a seasonal pattern.”

Treatments for SAD

According to the American Psychiatric Association, people may alleviate SAD symptoms by boosting their exposure to sunlight. For example, going for long walks outdoors when there is still some sunlight could help.

The National Institute for Health and Care Excellence (NICE) in the United Kingdom recommend that SAD treatment should be the same as for other types of depression, involving psychosocial and antidepressant medication.

Bright light therapy

If symptoms are so severe that they affect a person’s daily life, light therapy is sometimes recommended. Bright light therapy, also known as phototherapy, can help restore circadian rhythm.

With this kind of therapy, a person sits in front of a special light for 30-90 minutes each day. It is important to purchase a light box that is designed for treating SAD. UV lamps, full-spectrum lights, and tanning lamps will not do the same job.

In general, light therapy is required from 30 minutes to 2 hours per day, depending on the strength of the light. Doctors say exposure in the mornings tends to give the best results.

A similar treatment is known as dawn simulation when a special light in the bedroom is programmed to get slowly lighter in the mornings, to simulate dawn.

Experts say this type of phototherapy also helps restore brain chemistry balance. Nobody is sure how all this occurs.

Psychotherapy

Although SAD involves a change in a person’s brain chemistry, therapy that focuses on mood and behavior can also help.

Cognitive behavioral therapy (CBT) is based on the premise that it is how a person thinks and reacts to things that cause unhappiness rather than the situation. For example, if the way a person perceives certain situations can be altered, their behavior will change, and their symptoms will be reduced.

CBT usually includes an individual program of self-help, and another for the person and their partner, if appropriate. Sometimes a group program can also be helpful.

Medication

A doctor may prescribe an antidepressant, usually a selective serotonin reuptake inhibitor (SSRI), which raises serotonin levels.

Antidepressants do not work straight away; they can take from 10 days to 1 month to work well. Experts say antidepressants for SAD are more effective if taken at the beginning of the SAD season before symptoms appear. Usually, they are taken daily until springtime.

People should always follow their doctor’s instruction when taking these drugs.

Self-help

Some people have found that making their environment sunnier and brighter helps alleviate symptoms. Examples include opening blinds and curtains, trimming trees around the house, and sitting closer to the window during daytime.

Even in winter, the sun still comes up, and there is more sunlight outdoors than indoors. So, getting out every day for a long spell in the open air may help.

Similarly, exercise is not only good for the health but alleviates symptoms of anxiety and aids proper sleep. Exercises can also help people nurture a better self-image, which tends to lift their mood.

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10 Aloe Vera Uses You Probably Didn’t Know About

Aloe vera, also known as Aloe barbadensis, has been a staple resource in many cultures around the world for thousands of years. While the plant originated in southern Africa, you can find it growing around the world in places as varied as the Mediterranean and the southern United States. Traditional uses for aloe vera include soothing burns, moisturizing skin, and helping small wounds heal.

There are a lot of nutrients and potential health benefits packed into this easy-to-maintain plant—over 200 different biologically active substances. Because of its impressive profile, it’s used in lotions, ointments, creams, sunburn remedies, and many other types of cosmetics. Many people even apply it to acne, and that’s just the tip of the iceberg. Let’s take a look at some uses you may not know about.

1. Aloe Vera Supports the Immune System

Your immune system requires oxygen-rich blood. Aloe vera supports nutrient absorption from the gut; this includes iron absorption. Iron carries free oxygen molecules from your lungs around the body, and proper iron absorption is a key factor in maintaining blood-oxygen levels. One of the ways aloe helps you absorb nutrients is by keeping the digestive tract clear of debris through bowel regularity. This allows the food you’ve eaten to better come into contact with the intestinal lining, increasing nutrient exposure and absorption.

Aloe also acts as an adaptogen, which helps keep your cells and tissues in balance. It makes the immune system’s job easier by protecting cells from oxidative stress and other factors that disrupt their function.

Aloe vera is a rich source of polysaccharides. Research shows these complex sugars improve the efficiency of the immune system. Aloe is also rich in the antioxidants that protect cells from free radical damage.

2. Aloe Vera Supports Normal Digestion

Aloe vera contains two enzymes—amylase and lipase—that help encourages normal digestion. The plant also helps keep your stomach acid levels balanced to support a normal gut environment.

Aloe contains acemannan. Acemannan and other polysaccharides are prebiotics that supports probiotics in the gut. When you have these ‘good guys’ in your gut, you’re apt to digest your food better, get more nutritional value from it, and enjoy better overall health. A University of California, Davis study found that people who consumed aloe vera were able to more efficiently absorb vitamins C and B-12.

3. Eases Digestive Discomfort

Common digestive concerns like gas, diarrhea, constipation, and abdominal pain affect a lot of people. If you’re looking for a natural solution to ease your digestive discomfort, then aloe vera may be able to help. Studies show decreased gas, bloating, and discomfort in those who take regular aloe supplements.

Some preliminary research suggests aloe may also help with certain types of intestinal ulcer. In a clinical trial, 30 patients suffering from the condition were given aloe vera by mouth. Fourteen of the thirty patients reported some form of improvement; only four patients in the placebo group reported improvement.

Aloe is loaded with vitamins, minerals, and antioxidants, including:

  • Vitamin A (beta-carotene): Important for healthy skin, teeth, bones, and eyes.
  • Vitamin C: Vital for metabolism, skin health, and immune function.
  • Vitamin E: Protects the skin from UV damage.
  • Vitamin B12: Keeps nerve and brain cells healthy. Necessary for DNA replication.
  • Folic acid: Essential for brain function, liver health, and metabolism.
  • Choline: Supports metabolism and the production of neurotransmitters responsible for memory, focus, and a positive mood.
  • Calcium
  • Chromium
  • Copper
  • Selenium
  • Magnesium
  • Manganese
  • Potassium
  • Sodium
  • Zinc

5. Aloe Vera Is a Great Source of Nutrients and Enzymes

Aloe vera is often called a superfood because, in addition to vitamins and minerals, it offers more than 200 other bioavailable nutrients. It’s especially rich in the following enzymes, which support metabolism, hormone function, digestion, and detoxification:

  • Alliinase
  • Alkaline phosphatase
  • Amylase
  • Bradykinase
  • Carboxypeptidase
  • Catalase
  • Cellulase
  • Lipase
  • Peroxidase

There is a group of nutrients known as secondary metabolites which are found in aloe and other plants. Some of these include aloe emodin, chrysophanol, aloesin, and aloin. Research shows these nutrients can offer a number of other significant health benefits which include antioxidant support.

6. Aloe Supports Cardiovascular Health

Aloe vera is a rich source of beneficial plant compounds called phytosterols. Phytosterols promote normal lipid levels and support cardiovascular health. In a five-year study of 5,000 heart disease patients, researchers found those who consumed aloe vera and another plant called Husk of Isabgol had better lipid and blood sugar levels.

7. Aloe Vera Boosts Dental Health

A recent study involving 345 participants suggests aloe makes an effective mouthwash that supports healthy teeth and gums. Other research indicates that aloe vera gel can help resist Candida albicans, a common oral yeast.

8. Aloe Resists Harmful Organisms

Some plants contain a variety of chemicals and compounds that help suppress harmful organisms. Aloe vera itself contains six separate antiseptic agents: lupeol, salicylic acid, urea nitrogen, cinnamic acid, phenols, and sulfur.

9. Aloe Vera Is Ultra Soothing

Aloe vera is ultra-soothing for cuts, sunburns, and scrapes. Whether it is a topical gel, lotion, or just breaking open a fresh leaf and rubbing it onto a problem area, aloe helps calm red, swollen, and irritated skin. One reason for its soothing properties is an enzyme called bradykinase that helps soothe agitated tissue.

10. Aloe Vera May Have Anti-Aging Properties

Aloe vera does more than soothing and moisturize. It also offers anti-ageing benefits that smooth the appearance of wrinkles from the inside out. In one study, 30 women over the age of 45 took an aloe vera gel supplement for 90 days. By the end of the study, the appearance of facial wrinkles softened, and their skin looked healthier.

History of Aloe Vera

While the benefits of aloe are impressive, they’re not entirely new to us. We are only rediscovering what our ancestors already knew. Egyptians prized the plant over 6,000 years ago. One of the first mentions of aloe vera appears in the Papyrus Ebers around B.C. 1550, which shows 12 formulas for using aloe vera therapeutically. It proved so useful that it was known as the “Plant of Immortality.” People would even present aloe vera as a burial gift to deceased pharaohs. It is widely believed that Egyptian queens Nefertiti and Cleopatra used aloe vera cosmetically.

Egypt was not the only part of the world that found value in the aloe vera plant. As early as 600 BC, there’s record of Arab traders bringing aloe vera to India—which they called “desert lily.” Arabs were already separating the inner gel and sap from the outer rind, even grinding the leaves into powder. This aloe powder was highly valued. In fact, records from as early as the 17th century show the East India Trading Company relied heavily on aloe for its commercial value.

With such amazing historical uses, aloe vera has earned nicknames from all around the globe–names like the “silent healer”, “sabila” “burn plant”, “ghai kunwar”, “elephant’s gall”, “isha irazu”, “cape aloe”, the “medicine plant”, and the “first aid plant”. And, while there are many other aloe species, none are so heavily utilized as aloe vera.

Today, aloe vera gel is a common additive in beauty products and used for a wide arrange burns, cuts, and other skin concerns. Many people drink aloe vera juice for its nutritional value. You can even find edible gels from the inner leaf of the plant in many grocery stores, and it has gained popularity as a smoothie ingredient.

Choosing the Right Aloe Vera

As more and more aloe products arrive on the market—gels, lotions, creams, juices, and capsules—it’s easier than ever to access the benefits of the plant. When choosing a supplement, always check the ingredients. Some products include fillers and may not contain the nutrients, ingredients, or concentrations you expect.

For a supplement with the full nutritional force of aloe, I recommend Aloe Fuzion™. It’s a highly bioavailable aloe vera supplement made from organic inner leaf aloe vera gel. It contains the most acemannan content of any aloe product available and the feedback has been outstanding.

Food as Medicine: Mango (Mangifera indica, Anacardiaceae)

History and Traditional Use

Range and Habitat

Mangifera indica (Anacardiaceae) is a tropical tree that grows from 33 feet to 131 feet in height and produces large, oval-shaped fruits that are red and gold when ripe, though some cultivars are green or yellow.1 The smooth-edged leaves of the mango tree are reddish when young, becoming dark green and shiny as they mature. The tree produces small pinkish-white flowers that precede the fruit.2,3 The mango fruit is a drupe, or stone fruit, containing a large single seed surrounded by fleshy pulp and a thin, leathery skin.4 The mango tree begins to bear fruit four to six years after planting and continues to produce fruit for about 40 years.3,4 Trees older than 10 years tend toward alternate or biennial bearing, producing fruit every other year.5

While the most commonly used part of the plant is the fruit, the mango tree has a variety of traditional uses that make use of the roots, peel, stem bark, leaves, flowers, and seed kernels. These parts typically contain greater amounts of bioactive compounds, including mangiferin, then the fruit.4 Belonging to the same plant family as the cashew (Anacardium occidentale) and pistachio (Pistacia vera), the mango is native to India and Burma, and has been cultivated since 2000 BCE.2 The mango was introduced to Africa about 1,000 years ago and to tropical America in the 19th century.1,2 Wild fruits have a minimal resemblance to the cultivated mangos, having a much smaller size and unpleasant turpentine-like taste. Currently, mangos are grown in tropical and warm temperate climates.3 India remains the largest producer, growing 65% of the world’s mango crop.5

Phytochemicals and Constituents

The macro- and micro nutrient composition and bioactive compounds present in M. indica contribute to its many health benefits. Mango fruits are a rich source of vitamins A, B and C. Mangos are also a good source of both soluble and insoluble fiber.3 Soluble fiber can help prevent cardiovascular disease and improve gastrointestinal health.

Mango is a source of many pharmacologically and medically important chemicals, including mangiferin, mangiferin acid, hydroxy-mangiferin, flavonoids, phenolic acids, and carotenes.6 Different parts of the plant have different chemical compositions. The bark, for example, contains catechins, amino acids, and phenolic and triterpenoid compounds.7,8 Due to these constituents, mango bark extract has shown antioxidant, immune system-enhancing, anti-inflammatory, antibacterial, antiviral, and antifungal activities, which correspond to many of mango’s traditional medicinal uses.7 The xanthone mangiferin is found in many different plants across the Anacardiaceae family and shows promising results in the areas of antitumor, anti-diabetic, and anti-microbial actions.

The health benefits of the fruit pulp are due to its high concentration of antioxidant nutrients and phytochemicals, such as carotenoids. Carotenoids play an important role in protective health mechanisms against some forms of cancer, cardiovascular disease, and macular degeneration, as well as improving immune health.9 Specifically, mangos are high in beta-carotene, a precursor of vitamin A. Mango also contains smaller amounts of lutein and zeaxanthin, two carotenoids important for maintaining eye health and preventing macular degeneration. These phytochemicals are antioxidants, meaning that they slow or prevent the oxidative process, thereby preventing or repairing damage to cells in the body.10

The polyphenols that have been identified in the mango fruit include gallic acid, Gallo-tannins, quercetin, isoquercitrin, mangiferin, ellagic acid, and beta-glucogallin. These polyphenols have powerful antioxidant activity as well as other potential therapeutic effects. Gallic acid, for example, is known to have anti-inflammatory and antitumor activities, while ellagic acid has been found to exhibit antimutagenic, antiviral, and antitumor effects.4

The most biologically active compound that has been studied in the mango tree is mangiferin. Mangiferin is synthesized by the plant as a chemical defense compound.6,11 Plant parts that contain the highest amounts of mangiferin include the leaves, stem bark, heartwood, and roots. Currently, researchers are investigating potential methods of processing mango bark and peel into a palatable ingredient or food additive. Mangiferin (not to be confused with the previously mentioned mangiferin) is one of a number of enzymes present in mangos that improves digestion. Others include catechol oxidase and lactase.3

Historical and Commercial Uses

Mangifera indica has been used in Ayurveda, India’s primary system of traditional medicine, for more than 4,000 years. The mango was thought to have aphrodisiacal properties and is still viewed as sacred today.3A variety of the plant’s parts are used as a paste or powder for cleaning the teeth, and the juice of the mango is considered a restorative tonic, as well as a treatment for heat stroke.6 Numerous parts of the mango tree are used in Ayurvedic medicine as an antiseptic, an astringent to tone lax tissues, a laxative, a diuretic, and to increase sweating, promote digestion, and expel parasitic worms or other internal parasites.12 The seeds have been used as an astringent and as a treatment for asthma. Fumes from the burning leaves are used as an inhalant to relieve hiccups and sore throats.6 The bark is used as an astringent in diphtheria and rheumatism (disorders of the joints and connective tissues), and the gum was used in dressings for cracked feet and for scabies (an infestation of the skin by the human itch mite [Sarcoptes scabiei var. hominis]).

Current Ayurvedic practices use various parts of the mango for different ailments. For diarrhea, mango leaves are pounded together and taken with rice water.13 For nosebleeds, the juice of the mango seed is placed into the nostrils. For an enlarged spleen, ripe mango juice is consumed with honey. To treat gonorrhea, mango bark is pounded and added to milk and sugar. In some tropical countries, mango is actually used as a meat tenderizer, due to the power of the proteolytic enzymes that break down proteins.3In traditional ethnoveterinary medicine, all parts of the mango are used to treat abscesses, broken horns, rabid dog bites, tumors, snake bites, stings, heat stroke, miscarriage, bacterial illness, blisters and wounds in the mouth, inflammation of the inner ear, colic, diarrhea, liver disorders, excessive urination, tetanus, and asthma.14

Among the Tikunas, an indigenous people of Brazil, Colombia, and Peru, a mango leaf decoction was used as a contraceptive and abortifacient. Reportedly, taking a cupful on two successive days during menstruation acted as a contraceptive, and taking it for three days caused abortion.11,15

Mango fruit is processed at two stages of maturity. Green fruit is used to make chutney, pickles, curries, and dehydrated products like dried mango, amchoor (raw mango powder), and Panna (green mango beverage). Ripe fruit is processed into canned and frozen slices, pulp, concentrate, juices, nectar, jam, purée, cereal flakes, toffee, and various dried products.4

Modern Research

Studies indicate that M. indica possesses myriad therapeutic properties, including antidiabetic, antioxidant, antiviral, cardiotonic, hypotensive, and anti-inflammatory.6 Each of the mango’s parts — fruit, pulp, peel, seed, leaves, flowers, and bark — can be used therapeutically.

A 2000 study found that mango stem bark extract showed a powerful scavenging activity of hydroxyl radicals and acted as a chelator of iron.6 Although iron is an essential mineral, it is toxic in excessive amounts. Iron chelators could be an important approach to lessen iron-induced oxidative damage and prevent iron accumulation in diseases in which accumulation is prevalent, such as hemochromatosis, a metabolic disorder in which the body absorbs too much iron, and thalassemia, a rare, inherited blood disorder caused by a lack of hemoglobin, which results in fewer healthy red blood cells.4 This same study found a significant inhibitory effect on the degradation of brain cell membranes in an animal model and prevented DNA damage caused by some chemotherapy treatments.6,16

Polyphenolic compounds and related bioactivity are higher in the mango peel than the fruit, and higher still in the leaves and stem bark.4 The bark is one of the main parts of the tree used for medicinal purposes. A standardized aqueous extract of M. indica stem bark called Vimang (LABIOFAM Entrepreneurial Group; La Habana, Cuba) has been developed in Cuba. This extract has shown antioxidant, anti-inflammatory, and immunomodulatory properties and has been used in many countries for the treatment of heavy menstrual bleeding, diarrhea, syphilis, diabetes, scabies, cutaneous infections, and anemia.4,7

Much of the current research looks at extracts of mango bark or seed. There is a limited amount of literature that looks into the consumption of the mango fruit itself. However, a 2011 study looked at the consumption of freeze-dried mango fruit and its effects on weight loss and glucose tolerance, compared to hypolipidemic and hypoglycemic drugs, in mice fed a high-fat diet.17 In the study, consumption of freeze-dried mango prevented the increase in fat mass and the percentage of body fat. Compared with controls, mice given the freeze-dried mango had improved glucose tolerance and lowered insulin resistance.

Functional and medicinal properties of the non-fruit portions of the mango provide promising data for future uses of the plant and may allow for less waste of the non-edible parts of the mango. The mango peel, for example, constitutes about 15-20% of the mango fruit and typically is discarded prior to consuming the fruit. In commercial processing, the discarded peels become a wasteful by-product.18 A 2015 study conducted chemical analysis and determination of the bioactive compounds in a flour made from green mango peel.19 The mango peel flour had 54 g of total dietary fiber per 100 g of dry sample, compared to 1.8 g of total dietary fiber in wheat flour. The mango peel flour also contained 21.7 mg/g of total phenolic contents and 22.4 mg/g of total flavonoid contents.

The results of this study suggest that the mango peel flour exhibited functional properties similar to wheat flour, and could serve as an acceptable substitute in baked goods and other flour-containing foods. Dietary fiber in mango peel has been shown as a favorable source of high-quality polysaccharides due to its high starch, cellulose, hemicellulose, lignin, and pectin content combined with its low-fat content.18 In Vitro starch studies suggest low glycemic responses from mango peel fiber, which suggests a potential use for diabetic individuals.

Mango kernel oil has recently attracted attention due to its unsaturated fatty acid composition.18 Mango kernel oil has been widely researched for its function as an antioxidant and antimicrobial agent due to its high polyphenolic content.4 The major phenolic compounds in mango seed kernels are (in order of decreasing concentration): tannins, vanillin, coumarin, cinnamic acid, ferulic acid, caffeic acid, gallic acid, and mangiferin, all providing antioxidant protection.

Health Considerations

Possibly explained by its distant relation to poison sumac (Toxicodendron vernix, Anacardiaceae) and poison ivy (T. radicans), mango peel may be irritating to the skin,3 particularly to people who are highly sensitive to these plants. This is due to the presence of alk(en)ylresorcinols, a mixture of substances that can cause contact dermatitis to those who are allergic or sensitive to it.20 Alk(en)ylresorcinol is similar to urushiol, the toxic resin that causes an itchy rash in those who come into contact with poison ivy. These allergens are more prevalent in the peel than the flesh. In one study, four patients developed hives and eczematous rash after exposure to mangos or mango trees. Children and other persons with food allergies should take caution when handling and consuming mango. Although allergy to mango is infrequent, mango has been identified as an allergy-provoking food in some individuals with other food allergies.


Nutrient Profile21

Macronutrient Profile: (Per 1 cup mango fruit)

99 calories
1.35 g protein
24.7 g carbohydrate
0.63 g fat

Secondary Metabolites: (Per 1 cup mango fruit)

Excellent source of:
Vitamin C: 60.1 mg (100.2% DV)
Vitamin A: 1,785 IU (35.7% DV)

Very good source of:
Folate: 71 mcg (17.75% DV)
Dietary Fiber: 2.6 g (10.4% DV)
Vitamin B6: 0.2 mg (10% DV)

Good source of:
Vitamin K: 6.9 mcg (8.63% DV)
Potassium: 277 mg (7.9% DV)
Vitamin E: 1.48 mg (7.33% DV)
Niacin: 1.1 mg (5.5% DV)

Also, provides:
Magnesium: 16 mg (4% DV)
Riboflavin: 0.06 mg (3.53% DV)
Thiamin: 0.05 mg (3.33% DV)
Phosphorus: 23 mg (2.3% DV)
Calcium: 18 mg (1.8% DV)
Iron: 0.26 mg (1.44% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000 calorie diet.

Recipe: Mango and Watermelon Salad

Adapted from Mango.org22

Ingredients:

  • 2 large, ripe mangos, peeled, pitted, and diced
  • 1 cup watermelon, diced
  • 1/4 cup red onion, finely diced
  • 1 jalapeño pepper, stemmed, seeded, and finely diced
  • 12 cherry tomatoes, cut in half
  • 1 cup fresh arugula, washed and dried
  • 1 clove garlic, minced
  • 2 tablespoons fresh lemon juice
  • 1 tablespoon extra-virgin olive oil
  • 2 teaspoons honey
  • 1/2 teaspoon kosher salt
  • 3 tablespoons cilantro, chopped

Directions:

  1. Combine mango, watermelon, onion, pepper, tomato, and arugula in a large bowl. Toss to combine.

  2. Whisk together remaining ingredients and taste, adjusting seasoning if necessary. Drizzle dressing over the salad, toss to

    combine,

    and serve.

References

  1. Van Wyk B-E. Food Plants of the World. Portland, OR: Timber Press; 2006.
  2. The National Geographic Society. Edible: An Illustrated Guide to the World’s Food Plants. Washington, DC: National Geographic Society; 2008.
  3. Murray M, Pizzorno J, Pizzorno L. The Encyclopedia of Healing Foods. New York, NY: Atria Books; 2005.
  4. Masibo M, He Q. Mango bioactive compounds and related nutraceutical properties: A review. Food Rev Int. 2009;25:346-370.
  5. Morton JF. Mango. In: Morton JF. Fruits of Warm Climates. Miami, FL: J.F. Morton; 1987:221-239.
  6. Shah KA, Patel MB, Patel RJ, Parmar PK. Mangifera indica (Mango). Pharmacogn Rev. 2010;4(7):42-48.
  7. Wauthoz N, Balde A, Balde ES, Damme MV, Duez P. Ethnopharmacology of Mangifera indica L. bark and pharmacological studies of its main c-glucosylxanthone, mangiferin. Int J Biomed Pharma Sci. 2007;1(2):112-119.
  8. Hamid K, Algahtani A, Kim MS, et al. Tetracyclic triterpenoids in herbal medicines and their activities in diabetes and its complications. Curr Top Med Chem. 2015;15(23):2406-2430.
  9. Hewavitharana AK, Tan ZW, Shimada R, Shaw PN, Flanagan BM. Between fruit variability of the bioactive compounds, B-carotene and mangiferin, in mango. Nutrition and Dietetics. 2013;70:158-163.
  10. Johnson EJ. The role of carotenoids in human health. Nutr Clin Care. 2002;5(2):56-65.
  11. Schultes RE, Raffauf RF. The Healing Forest: Medicinal and Toxic Plants of the Northwest Amazonia.Portland, OR: Dioscorides Press; 1990.
  12. Johnson EJ. The role of carotenoids in human health. Nutr Clin Care. 2002;5(2):56-65.
  13. Amra (Mangifera indica) National R&D Facility for Rasayana website. Available here. Accessed May 19, 2016.
  14. Williamson EM. Major Herbs of Ayurveda. London, UK: Elsevier Science Limited; 2002.
  15. Duke JA, Vasquez R. Amazonian Ethnobotanical Dictionary. Boca Raton, FL: CRC Press; 1994.
  16. Martinez G, Delgado R, Perez G, Garrido G, Nunez Selles AJ, Leon OS. Evaluation of the in-vitroantioxidant activity of Mangifera indica L: extract (Vimang). Phytother Res. 2000;14:424–7.
  17. Lucas EA, Li W, Peterson SK, et.al. Mango modulates body fat and plasma glucose and lipids in mice fed a high-fat diet. Brit J Nutr. 2011;106:1495-1505.
  18. Tiwari BK, Brunton NP, Brennan CS. Handbook of Plant Food Phytochemicals: Sources, Stability and Extraction. West Sussex, UK: John Wiley & Sons, Ltd; 2013.
  19. Abidin NSA, Mohamad SN, Jaafar MN. Chemical composition, antioxidant activity and functional properties of mango (Mangifera indica L. var Perlis Sunshine) peel flour. Appl Mech Mater. 2015(754-755):1065-1070.
  20. Knödler M, Reisenhauer K, Schieber A, Carle R. Quantitative determination of allergenic 5-Alk(en)ylresorcinols in mango (Mangifera indica L.) peel, pulp, and fruit products by high-performance liquid chromatography. J Agric Food Chem. 2009;57:3639-3644.
  21. Basic Report, 09176, Mangos, raw. Agricultural Research Service, USDA website. Available here. Accessed May 19, 2016.
  22. National Mango Board. Mango and watermelon salad. Mango.org website. Available here. Accessed May 18, 2016.

Flatal Incontinence and Women: What is it and Why does it Happen?

Uncontrollable gas (flatus or flatulent gases) is known as flatal incontinence. This condition is defined as involuntary flatulence at least once or more per week. The big problem: it can happen anywhere. Involuntarily ‘breaking wind’ while at the store, restaurant or at the office creates embarrassing situations. It can erode self-confidence. It can negatively impact one’s relationships. Worse yet, the feeling of being powerless to control oneself can stress and isolate an individual. Unfortunately, it’s a problem that afflicts women around the world.

Pregnancy, Childbirth, and Uncontrollable Gas

During pregnancy and natural childbirth, the anal sphincter (the muscle that controls the anus) and the perineum muscles (the muscles of the pelvic area) suffer trauma. As a result, many women experience a loss of control over bowel movements and gas immediately following childbirth. While this is very common, it certainly isn’t desirable.

Studies have found that nearly 1 in 3 women who deliver vaginally report experiencing uncontrollable gas. For some women, the problem occurs for only a short time. For others, the problem becomes chronic.

Researchers have sought to identify why this affects some women, but not others, particularly after pregnancy and delivery. One study linked the use of instruments, such as forceps or vacuum delivery, to an increased risk of trauma to the perineal muscles, resulting in flatal incontinence.

The use of instruments during delivery doesn’t alone explain the problem. It has been noted that women who have multiple natural births report a higher incidence of flatal incontinence. While this might suggest a C-section might offer a way to prevent this problem, researchers have found C-sections did not offer protection against flatal incontinence.

Maybe Childbirth is Not the Cause…

One study of Korean women and post-delivery anal and flatal incontinence did deliver an interesting result. The Korean women in this study experienced the trauma typical to a natural delivery, with lacerations to the sphincter occurring. Vacuum extraction was also used. Yet, the study reported flatal incontinence occurs nearly 20% less in Korean women than in women from Western countries, despite similar risk factors.

Of course, that leads to the question…

What Other Factors Contribute to Flatal Incontinence

Age appears a contributing factor to the problem of controlling gas. As the Korean study shows, the problem exists globally. Researchers from several countries report that about 1 in 3 women ages 30 and older suffer from the involuntary release of gas.

Another study identified menopause, obesity and an increased occurrence of urinary incontinence as factors that increased the likelihood of flatal incontinence. This suggests additional factors can impact the ability of the perineal and anal muscles from functioning properly.

Research supports this idea. One study of women ages 18-50 reported stress significantly increased the chance of an involuntary release of flatus. While childbirth has long been associated with a cause, this continued research demonstrates that the problem of flatal incontinence extends beyond birthing as a simple explanation.

Hope for Women Suffering from Flatal Incontinence

The research has shown factors beyond childbirth can cause flatal incontinence in women. This problem should not be ignored or ‘lived with.’ For those suffering from this unpleasant and potentially embarrassing condition, understand many women suffer from it.

Manuka Honey

The market for Manuka honey has recently exploded, thanks to the perceived benefits of its natural antibacterial properties. But what evidence is there to support the claims?

In this article, we explore what Manuka honey is, what its properties are, and how it differs from other types of honey.

We also look at the evidence available to assess whether Manuka honey really is the next great superfood.

Historical use of honey

Honey has been used to treat wounds since ancient times, as detailed in a document dating back to 1392. It was believed to help in the fight against infection, but the practice fell out of favor with the advent of antibiotics.

As we face the challenge of a growing worldwide resistance to antibiotics, scientists are examining the properties and potential of honey.

Qualities of Manuka honey

The leaves of the Manuka tree, also known as a tea tree, have been known for centuries among the indigenous tribes of New Zealand and southern Australia for their healing powers.

Bees that collect nectar from this tree make Manuka honey, which harbors some of the healing properties.

All Honey contains antimicrobial properties, but Manuka honey also contains non-hydrogen peroxide, which gives it an even greater antibacterial power.

Some studies have found Manuka honey can also help to boost production of the growth factors white blood cells need to fight infection and to heal tissue.

Manuka honey contains a number of natural chemicals that make it different:

  • Methylglyoxal (MGO): This has been shown to be effective against several bacteria, including Proteus mirabilis and Enterobacter cloacae.
  • Dihydroxyacetone (DHA): This is found in the nectar of Manuka flowers and converts into MGO during the honey production process.
  • Leptosperin: This is a naturally occurring chemical found in the nectar of Manuka plants and a few close relatives.

Manuka honey and wound care

Medical grade honey, used by healthcare professionals as part of a wound dressing, can help some kinds of wounds to heal.

Experts believe that because Manuka honey has added antibacterial and healing properties, it may be even more effective. At the moment, however, there is little evidence to support the theory.

A Cochrane Review looked at all the evidence available to support the use of honey in wound care. Published in 2015, the study said the differences in wound types made it impossible to draw overall conclusions about the effects of honey on healing.

The study found strong evidence that honey heals partial thickness burns around 4 to 5 days more quickly than conventional dressings. There is also evidence indicating that honey is more effective than antiseptic and gauze for healing infected surgical wounds.

Another study concluded that honey has rapid diabetic wound healing properties, but recommended more research to confirm that honey can be used as the first line of treatment for these types of wounds.

While some research does show that honey can help improve certain conditions, more studies are needed to confirm honey’s benefits for:

  • mixed acute and chronic wounds
  • pressure ulcers
  • Fournier’s gangrene
  • venous leg ulcers
  • minor acute wounds
  • Leishmaniasis

Manuka honey and bacteria

Antibiotics are used to prevent and treat bacterial infections all over the world. However, the bacteria the drugs are deployed to kill can adapt and become resistant.
Manuka honey has antibacterial properties and may be able to fight superbugs resistant to most standard antibiotics.

This resistance is currently happening all over the world, and a growing number of infections are becoming harder to treat. This leads to longer hospital stays, higher medical costs, and ultimately, more deaths.

The World Health Organization (WHO) has listed resistance to antibiotics as the one of the biggest threats to global health, food security, and development.

The natural antibacterial properties of honey may be useful in this fight. In the lab, Manuka honey has been shown to be able to inhibit around 60 species of bacteria. These include Escherichia coli (E. coli) and salmonella.

Some studies have shown that Manuka honey can fight so-called superbugs that have become resistant to antibiotics. These include Staphylococcus aureus (MRSA-15) and Pseudomonas aeruginosin.

This line of investigation is still in its infancy. These have been small, lab-based tests which combined medical grade Manuka honey with antibiotics.

There is still a lot of work to be done before scientists can come to a conclusion.

Other health benefits

There are many other potential health benefits of Manuka honey. These include:

  • reducing high cholesterol
  • reducing inflammation
  • reducing acid reflux
  • treating acne

There is, however, limited evidence for its use in these areas.

Using Manuka honey

The medical grade honey used to dress wounds is very different from the honey sold in stores.

Medical grade honey is sterilized, with all impurities removed, and prepared as a dressing. Wounds and infections should always be seen and treated by a healthcare professional.

Store-bought Manuka honey can be used in the same manner as any other honey: on toast, on porridge, or to sweeten drinks.

There is no clear evidence that people who consume Manuka honey in this way will notice any benefit to their health. It is not clear how the active ingredients that provide Manuka honey with its healing properties survive in the gut.

Risks

Honey is usually around 80 percent sugar, mainly supplied by glucose, fructose, and sucrose, so moderate intake is recommended. This is particularly true if you have diabetes.

Due to the recent trend for Manuka honey, it can be expensive, so it is important to make sure you know what you are looking for.

When buying Manuka honey from the store, look for the Unique Manuka Factor (UMF) mark. This means the honey has been produced by one of the 100+ beekeepers, producers, and exporters licensed by the UMF Honey Association.

The number displayed next to the UMF mark represents the quantity of Manuka key markers, leptosperin, DHA, and MGO. Consumers are advised to choose UMF 10+ and above.