By L. Malir. California College of Podiatric Medicine. 2019.
A practical modification of this method has been proposed naproxen 500 mg without a prescription arthritis upper back exercises, which consists of mixing samples of the diaphragmatic pillars of 20 to 25 hogs from the same source buy discount naproxen 250 mg arthritis medication options. If trichinae are found in the composite sample 500 mg naproxen otc arthritis joint pain, a 50–100 g sample of diaphragm muscle tissue from each individual pig is examined. One of the drawbacks of this test was the high proportion of false positives (about 15%). This drawback has been surmounted by the use of purified antigens (Gamble and Graham, 1984). Control: The purpose of a control program should be to reduce and eventually eradicate the infection in swine, whose meat is the main source of human infection. However, compliance with this regulation is very difficult to ensure, and, therefore, the results are not always satisfactory. The trichinosis problem in some Latin American countries centers on the small rural farms raising a few pigs fed with household or restaurant scraps. These farms are very difficult to supervise, and pigs are slaughtered by the farmers without vet- erinary inspection. Continuous education of the population could at least partially remedy the situation. Trichinoscopy, which is practiced in slaughterhouses in Argentina, Chile, and other countries, has been shown to be effective in protecting the population. Although its sensitivity and cost leave much to be desired, when correctly executed, it protects the consumer against massive infections. Hopes are founded on implementing automated immunologic or molecular biology tests. At the individual level, humans can avoid the infection by abstaining from eating pork or pork products of dubious origin, without veterinary inspection. Pork or pork products that have not been inspected can be submitted to several processes to destroy the trichinae. This temperature turns the raw pork, which is pink and semi-translucent, whitish and opaque. Special care should be taken with rib roasts, pork chops, and pork sausages, which are not always sufficiently cooked, particularly close to the bone. The use of microwave ovens is not recommended because they heat unevenly and they may leave live parasites in portions of the meat. Trichinae are also destroyed by freezing the meat at –15°C for 20 days or at –30°C for 6 days, as long as the piece is not thicker than 15 cm. The meat of wild animals should be cooked; this is the only sure method of destroying the larvae in the Arctic. Proceedings of the Fourth International Conference on Trichinellosis, August 26–28, 1976, Poznan, Poland. Epidemiological and clinical studies on an outbreak of trichinosis in central China. Recent news on trichinellosis: Another outbreak due to horsemeat consumption in France in 1993. Detection of a circulating parasitic antigen in acute infections with Trichinella spiralis: Diagnostic significance of findings. Prospective rheumatological study of muscle and joint symptoms during Trichinella nelsoni infection. Prevalence and risk association for Trichinella infection in domestic pigs in the northeastern United States. Outbreak of trichinosis in Ontario sec- ondary to the ingestion of wild boar meat. Immunodiagnosis of human trichinellosis and identification of specific antigen for Trichinella spiralis. Comparison of human trichinellosis caused by Trichinella spiralis and by Trichinella britovi. Distribution of sylvatic species of Trichinella in Estonia according to climate zones. Aspectos serológicos, clínicos y epi- demiológicos de un brote de triquinosis en Azul, Provincia de Buenos Aires. Diagnosis of porcine trichinellosis: Parasitological and immunoserological tests in pigs from endemic areas of Argentina. Brote de triquinosis en la Comuna de Purranque, Región X, Chile, octubre-noviembre, 1992. Etiology: The agents are several species of the genus Trichostrongylus (nema- tode) that inhabit the small intestine and stomach of sheep, goats, and bovines, and sometimes infect other domestic and wild animals or man. The species are difficult to differentiate, and human case histories often indicate only the genus and not the species. Among these are three cases caused by Haemonchus contortus in Australia, one in Brazil, and one in Iran; two cases caused by Ostertagia ostertagi in Iran and one in Azerbaijan; and one case caused by O. Trichostrongylids are short parasites, measuring 1 cm or less in length, and are as slender as an eyelash, and therefore, difficult to see. This is a free-living worm that makes its home in the soil and feeds on organic waste or small organisms; it quickly molts into a sec- ond-stage larva, which is also free-living; then it molts into a third-stage larva, which is infective to the host. The infective larva can develop in just a week; when ingested by a host, it matures into the adult stage in close contact with the intestinal or gastric mucosa, mates, and begins to produce eggs during the fourth week of infection. Geographic Distribution and Occurrence: Trichostrongylids are very common parasites of domestic ruminants and their distribution is worldwide. In general, the prevalence is very low, but where people live in close contact with ruminants and food hygiene conditions are inadequate—as in nomadic communities—high rates of infection can occur. In a total of 52,552 stool samples examined in a hos- pital in Seoul, Republic of Korea, 0. In Australia, 5 cases were found out of 46,000 coprologic examinations (Boreham et al. Endemic areas are dispersed; in particular, they cover southern Asia from the Mediterranean to the Pacific, and the Asian areas of the former Soviet Union, where nomadic tribes are still found. In some localities in Iraq, up to 25% of the popula- tion has been found to be infected. The infection is very common in some areas of Korea and Japan, as well as in parts of Africa, such as the Democratic Republic of the Congo and Zimbabwe. In Chile, 45 cases were diagnosed between 1938 and 1967, and 17 cases were found among 3,712 persons examined in the province of Valdivia between 1966 and 1971. Infections are usually asymptomatic or mild and are discovered in coprologic exam- inations carried out to diagnose other parasitoses. In acute infections, with several hundred parasites, there may be transitory eosinophilia and digestive disorders, such as diarrhea, abdominal pain, and weight loss; sometimes, slight anemia is observed. The clinical picture in man has not been studied very much and is difficult to define, since other species of parasites are generally found in an individual infected with trichostrongylids.
Hyperosmolarity (> 308 mOsms/L recommended as threshold for most sensitive detection of dry eye) b order naproxen 500mg without prescription best foods arthritis relief. Loss of epithelial integrity: punctate epithelial erosions or large epithelial defect B discount naproxen 250mg visa arthritis pain comes in waves. Obtain care for dry mouth and oral complications of xerostomia Additional Resources 1 buy 250mg naproxen with mastercard rheumatoid arthritis quality of life. Production and activity of matrix metalloproteinase-9 on the ocular surface increase in dysfunctional tear syndrome. Filaments are composed of degenerated epithelial cells and mucus in variable proportions 2. Seen in various corneal conditions which have in common an abnormality of the ocular surface and altered tear composition B. Common symptoms include: foreign body sensation, ocular pain (may be severe), photophobia, blepharospasm, increased blink frequency, and epiphora 2. Symptoms tend to be most prominent with blinking and alleviated when the eyes are closed C. Filaments stain with fluorescein and rose bengal dyes, facilitating identification 2. Often a small, gray, subepithelial opacity will be present beneath the site of corneal attachment 4. Associated with superior limbic keratoconjunctivitis, ptosis, or other causes of prolonged lid closure b. Associated with keratoconjunctivitis sicca, pharmacologic dry eye, or exposure keratopathy ii. Filaments after penetrating keratoplasty typically reside on the graft, at the graft-host interface or at the base of the suture on donor side 6. Any condition associated with irregularity (including desiccation) of the ocular surface 1. Mechanical removal of filaments (temporary measure; care should be taken not to disrupt underlying epithelium) 2. Superior conjunctival resection or cauterization if secondary to superior limbic keratoconjunctivitis V. Mechanical removal of filaments - epithelial defect with secondary infection, may serve as a receptor site for new filaments 1. Removal of filaments/use of mucolytics may be successfully employed, but are not definitive treatments C. Continue with aggressive topical lubrication (if not possible to eliminate underlying process) Additional Resources 1. Meibomian gland dysfunction is a result of progressive obstruction and inflammation of the gland orifices 2. Seborrheic blepharitis is a chronic inflammation of the eyelid, eyelashes, forehead and scalp skin 3. Rosacea is a skin disease characterized by dysfunction of meibomian glands and/or other cutaneous sebaceous glands of the skin of the face and chest B. It mainly develops in patients between ages 30 and 60 years but can affect all age groups including children 2. Abnormal meibum after expression of glands (with slight pressure on lid margin with Q tip or finger) h. Masquerade syndrome (eyelid neoplasm - rare, but should be considered in chronic unilateral blepharitis) D. Daily eyelid hygiene (warm compresses, eyelid massage, and eyelid scrubbing) with commercially available pads, washcloth or cotton-tipped applicators soaked in warm water +/- dilute baby shampoo 2. Complications of topical corticosteroids, if used (including glaucoma and cataract) B. Side effects related to systemic tetracyclines, if used (ex: enamel abnormalities in children, photosensitivity) V. The international workshop on meibomian gland dysfunction: report of the clinical trials subcommittee. The international workshop on meibomian gland dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. The international workshop on meibomian gland dysfunction: report of the subcommittee on tear film lipids and lipid-protein interactions in health and disease. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee. Occur near the limbus, bulbar conjunctiva, plica, caruncle Rarely in the fornix or tarsal conjunctiva e. Typically noted in the first two decades of life, stable, unlikely to develop into malignancy i. May increase in size and pigmentation with hormonal changes (puberty, pregnancy, menopause) f. May result from inflammation, ocular surface surgery, infection, chalazion, foreign body 4. Dilated lymph channels seen as sausage like clear or hemorrhagic conjunctival cystic lesions b. May be associated with local venous hypertension (thyroid eye disease, orbital apex syndrome, cavernous sinus thrombosis, carotid-cavernous fistula), increased vascular permeability (allergy), local lymphatic scarring 6. Consists of irregular cyst like channels with clear fluid or intralesional hemorrhage (chocolate cysts) 7. Thought to be due to irritative (periocular inflammation, chalazia, conjunctivitis, chemical injury) or antigenic stimulus (from microorganisms, allergens, drugs) e. It may be primary (idiopathic) or secondary (to some chronic disease) and familial or nonfamilial 9. Infectious (parasitic, fungal, cat scratch disease) or noninfectious (foreign bodies, rheumatoid arthritis, sarcoidosis) 11. Some lesions may regress, some may remain stationary, and others may progress to malignancy. There may be systemic associations, systemic evaluation should be performed when indicated B. Observation with slit lamp drawings and/or slit lamp photos initially frequently then 6-12 months as indicated. Excisional biopsy is performed for small and intermediate sized lesions that may be symptomatic or suspected to be malignant.
Contact management will be coordinated by local public health staff Immunisation Recommended for Aboriginal children at 1 year and 18 months of age buy 500 mg naproxen amex arthritis in neck how to treat, see Appendix 1 purchase naproxen 250 mg with mastercard arthritis in the knee home remedies, some travellers and occupational groups – refer to doctor 18 Communicable disease guidelines 2017 Edition Hepatitis B (Hepatitis B virus) H Notifable – discuss with your local public health unit staff cheap naproxen 500mg fast delivery arthritis relief lower back. Symptoms include malaise, abdominal pain, loss of appetite, nausea, fever, jaundice, dark urine and pale faeces. Transmission Blood-to-blood; sexual contact; during birth mother-to-baby Incubation 45 to 180 days (average 60 to 90 days) period Infectious Weeks before to months after onset. Symptoms include fever, loss of appetite, nausea, vomiting, joint pains, malaise and jaundice. Transmission Blood-to-blood; rarely sexual; mother-to- baby during delivery Incubation 2 weeks to 6 months (usually 6 to 9 weeks) period Infectious Weeks before to months after onset. Symptoms include vesicles (blisters) around the mouth or the genital areas, fever and malaise. Transmission Direct contact with weeping vesicles Incubation 3 to 10 days period Infectious 2 to 7 weeks period Exclusion Not excluded if the person can maintain hygiene practices to minimise the risk of transmission. Transmission Usually by walking bare foot in soil contaminated by faeces from an infected person Incubation A few weeks to several months period Infectious Not communicable person-to-person. Larvae period may survive in soil for several months Exclusion* Exclude until diarrhoea has ceased Treatment Treatment available – refer to doctor Contacts Do not exclude Immunisation None available * If ill person works or attend day care exclude until 48 hours after diarrhoea has ceased. Transmission Airborne or droplet; direct contact with contaminated nose or throat secretions; mother-to-baby Incubation 5 to 15 days period Infectious Unknown period Exclusion Do not exclude Treatment Varies with symptoms Contacts Do not exclude Immunisation None available 24 Communicable disease guidelines 2017 Edition Impetigo (School sores) I A common, acute bacterial infection of the skin caused by staphylococcal or streptococcal bacteria. Transmission Direct contact with skin lesions Incubation Usually 4 to 10 days period Infectious As long as there is discharge from untreated period lesions Exclusion Exclude for 24 hours after antibiotic treatment commenced. Young children unable to comply with good hygiene practices should be excluded until the sores are dry Treatment Antibiotic treatment available – refer to doctor Contacts Do not exclude Immunisation See Appendix 1 25 Communicable disease guidelines 2017 Edition Influenza I (Flu) Notifable – discuss with your local public health unit staff. Symptoms include fever, malaise, chills, headache, muscle pain, sore throat and cough. Transmission Airborne or droplet Incubation Usually 1 to 4 days period Infectious Usually 1 day before onset of symptoms period until 7 days after Exclusion Exclude until symptoms resolved Treatment Varies according to symptoms. Antiviral treatment available as recommended by doctor Contacts Do not exclude Immunisation Refer to Appendix 1 26 Communicable disease guidelines 2017 Edition Lice L See Head lice Measles (Morbilli virus) M Notifable – discuss with your local public health unit staff. Symptoms include lethargy, malaise, cough, sore and swollen eyes and nasal passages, fever and rash – must be confrmed with laboratory testing. Transmission Airborne or droplet Incubation 8 to 14 days (usually 10 days) period Infectious 24 hours prior to onset of symptoms period (e. Exclusion Exclude for 4 days after the onset of the rash, in consultation with public health unit staff Treatment Varies with symptoms Contacts Do not exclude vaccinated or previously infected contacts. Susceptible (unimmunised, non-immune) contacts should be excluded until 14 days after the onset of the rash in the last case occuring at a facility. Contact management will be coordinated by public health unit staff Immunisation See Appendix 1 27 Communicable disease guidelines 2017 Edition Meningococcal disease M Notifable – discuss with your local public health unit staff. Symptoms include fever, vomiting, headache, neck stiffness, muscle and joint pain, rash, drowsiness, irritability, confusion and diarrhoea. Transmission Airborne or droplet Incubation About 1 to 4 days period Infectious Until Neisseria meningitidis bacteria are no period longer present in nose and throat secretions Exclusion Exclude until antibiotic treatment has been completed Treatment Hospitalisation is usually required Contacts Do not exclude. Contact management will be coordinated by public health unit staff Immunisation See Appendix 1 28 Communicable disease guidelines 2017 Edition Molluscum contagiosum M A common, acute, viral infection of the skin. Transmission Skin-to-skin contact with an infected person or contact with contaminated clothing or linen Incubation Days to months period Infectious As long as lesions persist period Exclusion Do not exclude Treatment Lumps will eventually disappear without treatment. However, if it gets into the body it can cause a range of infections including skin infections such as boils and abscess or more serious infections like osteomyelitis and bloodstream infection. Any lesions on exposed skin should be covered with a waterproof dressing Treatment Antibiotic treatment available – refer to doctor Contacts Do not exclude Immunisation None available 30 Communicable disease guidelines 2017 Edition Mumps M Notifable – discuss with your local public health unit staff. Symptoms include painful, swollen salivary glands, fever, headache, painful testicles or ovaries. Transmission Airborne or droplet; direct contact with saliva from an infected person Incubation About 12 to 25 days (usually 16 to 18 days) period Infectious 2 days prior to 5 days after parotitis period (swollen salivary glands) Exclusion Exclude for 5 days after onset of symptoms. Consult with your public health unit staff Treatment Varies with symptoms Contacts Do not exclude Immunisation See Appendix 1 31 Communicable disease guidelines 2017 Edition Parvovirus B19 P (Erythema infectiosum, ‘Fifth’ disease, ‘Slapped Cheek’ Syndrome) A common, acute, viral infection. Symptoms include fever, red cheeks and neck, itchy lace-like rash on the body and limbs. Transmission Airborne or droplet; direct contact with contaminated nose or throat secretions; mother-to-baby Incubation 1 to 2 weeks period Infectious Not infectious after the rash appears period Exclusion Exclusion not necessary Treatment Varies with symptoms Contacts Do not exclude. Pregnant women who may have been exposed to parvovirus B19 should consult their doctor Immunisation None available Pediculosis See Head lice 3232 Communicable disease guidelines 2017 Edition Pertussis (Whooping Cough/Bordetella pertussis) P Notifable – discuss with your local public health unit staff. Transmission Airborne or droplet; direct contact with contaminated nose or throat secretions Incubation About 7 to 10 days period Infectious From onset of runny nose to 3 weeks period (21 days) after onset of cough Exclusion Exclude until 5 days after an appropriate antibiotic treatment, or for 21 days from the onset of coughing Treatment Antibiotics as recommended by doctor Contacts Contact management will be coordinated by public health unit staff Immunisation See Appendix 1 Vaccination is recommended for health care workers and childcare workers including pregnant women in the thrid trimester (i. Symptoms include perianal (around the anus) itch, disturbed sleep, irritability, secondary infection of the skin from persistent scratching. Transmission Faecal-oral; indirect contact through clothing, bedding, food or articles contaminated with eggs Incubation 2 to 6 weeks period Infectious As long as eggs are excreted. Eggs remain period infective for up to 2 weeks Exclusion Do not exclude Treatment Treatment available – refer to doctor Contacts Do not exclude Immunisation None available 34 Communicable disease guidelines 2017 Edition Pneumococcal disease (Streptococcus pneumoniae) P Notifable – discuss with your local public health unit staff. A common, acute, bacterial infection that can cause septicaemia (blood poisoning), pneumonia, or ear infections. Transmission Airborne or droplet Incubation About 1 to 3 days period Infectious Until Streptococcus pneumoniae bacteria period are no longer present in nose and throat secretions (usually 24 hours after antibiotic commencement) Exclusion Exclude until 24 hours after commencement of antibiotics Treatment Antibiotics as recommended by doctor – refer to doctor Contacts Do not exclude. Contacts do not require antibiotic treatment or vaccination Immunisation See Appendix 1 35 Communicable disease guidelines 2017 Edition Ringworm R (Tinea) A common fungal infection of the skin that usually affects the scalp, skin, fngers, toenails and feet. Transmission Skin-to-skin contact with an infected person, infected animals or contaminated articles Incubation Varies with the site of infection period Infectious As long as lesions are present period Exclusion Exclude until person has received anti-fungal treatment for 24 hours Treatment Antifungal treatment available – refer to doctor. Cats/dogs should be examined and treated as necessary Contacts Do not exclude Immunisation None available 36 Communicable disease guidelines 2017 Edition Roundworm (Ascariasis) R A parasite that infects the small intestine. Transmission Faecal-oral Incubation 4 to 8 weeks period Infectious As long as eggs are excreted in faeces period Exclusion Do not exclude Treatment Treatment available – refer to doctor Contacts Do not exclude Immunisation None available 37 Communicable disease guidelines 2017 Edition Rubella R (German measles) Notifable (including congenital rubella syndrome) – discuss with your local public health unit staff. Symptoms include fever, sore eyes, swollen glands (especially behind the ears), generalised rash. Transmission Airborne or droplet; direct contact with contaminated nose or throat secretions; mother-to-foetus Incubation 14 to 21 days. Usually 17 days period Infectious From 7 days before to at least 4 days after period the onset of rash Exclusion Exclude for 4 days after onset of rash Treatment Varies according to symptoms Contacts Do not exclude. Refer pregnant contacts to their doctor Immunisation See Appendix 1 Note Women should be tested for immunity to rubella if pregnancy is contemplated, before every pregnancy, or early in the pregnancy irrespective of a previous positive rubella test 38 Communicable disease guidelines 2017 Edition Scabies (Sarcoptes scabiei) S An uncommon, acute, parasitic infection, caused by a mite which burrows beneath the surface of the skin. Symptoms include intense itching between the fngers or on the wrists, elbows, armpits, buttocks and genitalia. Transmission Skin-to-skin contact with an infested person or contact with infested clothing, towels or bedding Incubation 2 to 6 weeks before onset of itching if not period previously infested. People who have been previously infested may develop an itch 1 to 4 days after re-exposure Infectious Until mites and eggs are destroyed period Exclusion Exclude until the day after treatment has commenced Treatment Treatment available – refer to doctor. Bed linen, towels and clothing used in the previous 5 days should be washed in hot water Contacts Do not exclude.
Together purchase 500mg naproxen mastercard arthritis treatment honey and cinnamon, you prevented generic naproxen 500 mg without a prescription severe arthritis in upper back, so these should come up with a plan and timetable for reaching your goal buy naproxen 250 mg otc dr oz arthritis in fingers. M onitoring your blood pressure at hom e between visits to your doctor can be helpful. H aving a fam ily m em ber who knows that you have high blood pressure and who under- • Eat foods with stands what you need to do to lower your blood pressure often m akes it easier to m ake less sodium (salt). If you have high blood pressure, following these steps will help you control your blood pressure. This brochure is designed to help you adopt a healthier lifestyle and rem em ber to take prescribed blood pressure-lowering drugs. Following the steps described will help you prevent and control high blood pressure. Losing even 10 pounds can lower your blood pressure— and losing weight has the biggest effect on those who are overweight and already have hypertension. And being overweight or obese increases your chances of developing high blood cholesterol and diabetes— two m ore risk factors for heart disease. It gives an approxim ation of total body fat— and that’s what increases the risk of diseases that are related to being overweight. Another reason is that too m uch body fat in the stom ach area also increases disease risk. A waist m easurem ent of m ore than 35 inches in wom en and m ore than 40 inches in m en is considered high. If you fall in the obese range according to the guidelines in box 4, you are at increased risk for heart disease and need to lose weight. You also should lose weight if you are overweight and have two or m ore heart disease risk factors. This is the healthiest way to lose weight and offers the best chance of long-term success. Just how m any calories you burn daily depends on factors such as your body size and how physically active you are. So, to lose 1 pound a week, you need to eat 500 calories a day less or burn 500 calories a day m ore than you usually do. It’s best to work out som e com bination of both eating less and being m ore physically active. As you lose weight, be sure to follow a healthy eating plan that includes a variety of foods. All you need is 30 m inutes of m oderate-level physical activity on m ost days of the week. Exam ples of such activities are brisk walking, bicycling, raking leaves, and gardening. For instance: Use stairs instead of an elevator, get off a bus one or two stops early, or park your car at the far end of the lot at work. If you already engage in 30 m inutes of m oderate-level physical activity a day, you can get added benefits by doing m ore. Engage in a m oderate-level activity for a longer period each day or engage in a m ore vigorous activity. M ost people don’t need to see a doctor before they start a m oderate-level physical activity. You should check first with your doctor if you have heart trouble or have had a heart attack, if you’re over age 50 and are not used to m oderate-level physical activity, if you have a fam ily history of heart disease at an early age, or if you have any other serious health problem. A healthy eating plan can both reduce the risk of developing high blood pressure and lower a blood pressure that is already too high. It is also high in potassium , calcium , and m agnesium , as well as protein and fiber. The num ber of servings that is right for you m ay vary, depending on your caloric need. Those foods are high in fiber, and eating m ore of them m ay tem porarily cause bloating and diarrhea. N ote whether you snack on high-fat foods while watching television or if you skip breakfast and eat a big lunch. If you’re trying to lose weight, you should choose an eating plan that is lower in calories. It can tell you if there are certain tim es that you eat but aren’t really hungry or when you can substitute low-calorie foods for high-calorie foods. The number of daily servings in a food group may vary from those listed, depending upon your caloric needs. Daily Servings Food Group (except as noted) Serving Sizes Grains and grain 7–8 1 slice bread products 1 cup ready-to-eat cereal* 1/2 cup cooked rice, pasta, or cereal Vegetables 4–5 1 cup raw leafy vegetable 1/2 cup cooked vegetable 6 ounces vegetable juice Fruits 4–5 1 medium fruit 1/4 cup dried fruit 1/2 cup fresh, frozen, or canned fruit 6 ounces fruit juice Lowfat or fat free 2–3 8 ounces milk dairy foods 1 cup yogurt 1 1/2 ounces cheese Lean meats, 2 or fewer 3 ounces cooked lean meat, poultry, and fish skinless poultry, or fish Nuts, seeds, and 4–5 per week 1/3 cup or 1 1/2 ounces nuts dry beans 1 tablespoon or 1/2 ounce seeds 1/2 cup cooked dry beans Fats and oils† 2–3 1 teaspoon soft margarine 1 tablespoon lowfat mayonnaise 2 tablespoons light salad dressing 1 teaspoon vegetable oil Sweets 5 per week 1 tablespoon sugar 1 tablespoon jelly or jam 1/2 ounce jelly beans 8 ounces lemonade * S erving sizes vary between 1/2 cup and 1 1/4 cups. Have two servings of fruits and/or vegetables at each meal, or add fruits as snacks. Here are some examples: To increase fruits: • Eat a medium apple instead of four shortbread cookies. To increase lowfat or fat free dairy products: • Have a 1/2 cup serving of lowfat frozen yogurt instead of a 1 1/2-ounce milk chocolate bar. And don’t forget these calorie-saving tips: • Use lowfat or fat free condiments, such as fat free salad dressings. Items marked lowfat or fat free are not always lower in calories than their regular versions. Som e people, such as African Am ericans and the elderly, are especially sensitive to salt and sodium and should be particularly careful about how m uch they consum e. The 6 gram s includes all salt and sodium consum ed, including that used in cooking and at the table. Before trying salt substitutes, you should check with your doctor, especially if you have high blood pressure. These contain potassium chloride and m ay be harm ful for those with certain m edical conditions. Box 9 offers some tips on how to choose and prepare foods that are low in salt and sodium. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt. Cut back on frozen dinners, pizza, packaged mixes, canned soups or broths, and salad dressings—these often have a lot of sodium. There’s no reason why eating less sodium should m ake your food any less delicious! Shopping for Foods That Will Help You Lower Your Blood Pressure By paying close attention to food labels when you shop, you can consum e less sodium. But processed foods account for m ost of the salt and sodium that Am ericans consum e.