Iron Deficiency Anemia)

A CURA DEL DOTT. GUARDO S. RAUL

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1 Nutrition and Women's Health By Dr. Raul Guardo Salinas

Proteins are essential for life!

Protein comes from the greek word "protos" meaning "first element". Proteins are essential for growth and repair, to maintain functionality and structure of the body and of all living cells. Hormones, like insulin, check blood sugar levels; enzymes such as amylase, lipase and protease, are crucial in the digestion of food; antibodies help us fight infection while muscle proteins make contraction possible, etc.. So proteins are absolutely essential for life!

Amino acids; the bricks

Proteins consist of amino acids (the building blocks) linked together. An average protein may contain 300 or more amino acids. Each protein has a specific number of amino acids, arranged in a precise sequence. The shape of the molecule is important because it often determines the function of the protein. There are about 20 amino acids commonly found in plants and animals.

The protein cycle

After we eat, proteins are broken down through digestion into amino acids. The amino acids are then absorbed and used to build other proteins in the body. An adequate daily intake of protein and energy ensures the continuation of this cycle.

Dietary sources

Proteins are found in different types of food. Animal protein sources, such as meat, poultry, fish, eggs, milk, cheese and yogurt, provide proteins of high biological value. Vegetables protein sources, such as legumes, cereals, nuts, seeds and vegetables provide a low biological value in proteins. However, since the limiting amino acid tends to be different in a variety of plant

proteins, a combination of proteins from different vegetable sources in a meal (ex. vegetables or

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legumes with cereals), often results in a blend greater biological value. These combinations are 2 generally found in recipes of traditional dishes from different continents (ex. beans with rice, pasta or cassava bread with chickpeas, lentils and potatoes, etc.). Omnivorous diets (containing foods derived from animals and plants) in the developed world provide adequate amounts of protein. However, subgroups of the population who avoid eating animal based foods may have difficulty in achieving an adequate protein intake.

General Recommendations

In order to maintain a balanced protein level (protein accretion) required for sufficient growth and repair of body tissues, 10-15% of our calorie intake should come from protein.

Carbohydrates (carbs)

Whenspeaking of carbohydrates, we refer primarily to starch or foods like pasta, bread, rice, potatoes, which are also considered to be the main opponents of fitness and are, therefore, the first to be drastically reduced (even eliminated), when undergoing a self-prescribed weight -loss diet.

From a chemical point of view, carbohydrates can be divided into: monosaccaride, or carbohydrates consisting of a single molecule including the presence of glucose and fructose, disaccharides, which consist of two carbohydrate molecules, including maltose ( formed from two glucose molecules, mainly present in barley and corn), sucrose (made up of one molecule of glucose, one of fructose and lactose, such as is found in sugar cane and sweeteners in general) and lactose (formed by one molecule of glucose and one galactose, as in milk sugar); polysaccharides, or carbohydrates formed of many molecules, contain starch cultivated from corn seeds, legumes and potatoes, as well as cellulose which is one of the fundamental components of the structure of plant cells. In general, carbohydrates are considered an important and fundamental source of energy for all living organisms. From this statement we can conclude that it is vital that man maintain a regular daily intake of carbohydrates, and the common belief of carbohydrates as a hinderance to fitness is certainly reduced. In fact, the right amount of carbohydrates may even be necessary to defeat excessive fat . The first point to make is that all carbohydrates, including the disaccharides and polysaccharides, are transformed during the metabolic process in mono, and one each of these molecules play then goes to a precise function. Carbohydrates, besides being an immediate source of energy are essential to our body to digest proteins and lipids to destroy. The reason why carbohydrates are often viewed with fear is that, if taken in quantities exaggerated, high blood sugar can stimulate insulin accelerates the formation of new fat cells and creating a sense of weariness and fatigue. Rich foods complex carbohydrates like pasta, bread and rice or disaccharides such as sugar and milk, or the many vegetables that contain simple carbohydrates, should therefore not be excluded from a healthy diet, even if it has as goal

weight loss, but are simply made in such quantities that carbohydrates can raise their energy,

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burn fat. 3 In conclusion then simply pay a minimum of attention to the quality and quantity of carbohydrates in food.

Vitamins

Are among the micronutrients that should be taken daily because they cannot be synthesized in the body. According to their solubility, they are classified as:  soluble vitamins, (meaning soluble in fats): these include vitamins A, D, E and K;  water-soluble vitamin: are vitamins C, B1, B2, B5, B6, PP, B12, Bc and H.

Discovery

The discovery of vitamins began with the observation that a diet consisting of carbohydrates, lipids, proteins ad mineral salts was not enough to ensure proper development and growth of an organism. Certain vital growth factors had to be added. The necessary amount of vitamins varies from one species to another. For example, humans are the only species that require Vitamin C in their diet.

Classification

Vitamins come in a variety of chemical structure. At present, they are divided into two groups: Water soluble vitamins (vitamins B and C) and Fat soluble vitamins (vitamins A, E, D and K).

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4 Use Vitamins should be taken regularly over a period of time. Only some have a specific required daily amount (vitamins A, D, PP, folic acid, B1, B2, B6 and B12). Vitamin requirements depend on the physiological and/or pathological state of the individual. Age, sex and whether the individual is pregnant or nursing.

Vitamin deficiencies and the diseases that occur from them, such as pellagra, beriberi and rickets, are a major problem in developing countries. These are caused either by malnutrition or the fault of unhealthy food taboos that exist in these countries. Developed countries must deal with hypervitaminosis caused by an imbalanced and excessive diet that lacks certain vital nutrients. A restricted or vegetarian diet often does not supply the body with the vitamins that it needs, while high-calorie diets often lead to an overdose in other substances that may wash out the fat and water soluble vitamins. Even some medications or the excessive use of industrial products may interfere with the absorption or activity of some vitamins. Some methods of food preparation and cooking may result in the deterioration of vitamin nutrients (although susceptibility to physical or chemical agents is the same for all vitamins). But even these procedures will not diminish the concentration of a vitamin below 50%. It is difficult to accumulate water- soluble vitamins in the body because they are quickly eliminated along with urine while the fat-soluble vitamins are stored as tissue and used up at a slower rate. This allows the possibility of toxicity and also explains why it is wise to never exceed the recommend dosage. It is also known that, if the recommended dosage is exceeded by over 10 times, it may cause additional negative pharmacological effects.

Enzymes

Enzymes are proteins that catalyze (increase the rate of) chemical reactions. The molecules at the beginning of the process are called substrates, and the enzyme converts them into different molecules, called the products. Enzymes work by lowering the activation energy for a reaction, thus dramatically increasing the rate and temperature of the reaction. Enzymes are not consumed by the reactions they catalyze, nor do they alter the equilibrium of these reactions.

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5 They are produced by living cells. Some substrates are homogeneous (consisting of only one cell group) while others are compound (made of groups linked by the protein protease). Each enzyme acts on a single substrate and partakes in only one step of the reaction. Metabolic or complex reactions require the coordinated activity of several types of enzymes. In fact, every individual contains more than 2000 different enzymes. Through these reactions we can recognize six macro-groups of enzymes: oxidoreductases, transferases, hydrolysis, lyase, ligase, and isomerase.

 Raw and unpasturized foods are much easier to digest because they already contain the necessary enzymes in them for the digestive process.

 Our stomach is made up of differnent functional areas: the upper area of the stomach, where the ingested food rests temporarily without being attacked by acids or enzymes, is where the food begins a process of auto-digestion of itself. This can only happen with raw and biological foods.

 According to the american enzymologist, Edward Howell, this area of the stomach, through the auto-digestive process (in which enzymes partake) then releases carbohydrates at 50% , protein at 30% and fat at 10%.

This autodigestive process of food is, according to Howell, extremely important because it protects our pancreas from a stressful overload and allows our organism to benefit from the use of enzymes for the activity of our immune system, energy production, etc.

Better digestion not only allows quality nutrient assimilation but it also prevents the production of indigested macromolecules that, having escaped the intestinal wall, are transformed into strong allergens which can cause a series of internal and external diseases.

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6 Minerals in food

Minerals in food make up only a handful of grams. For this reason they are commonly referred to as “trace substances”. But even though they are needed only in small quantities, they are still essential for life and good health of a human. It is estimated that they account for about 4-5% of a person’s weight. These are inorganic, non-energetic materials that ensure the continuity of various human body functions to continue. For example, they make up the “plastic function” that provides strength to bone tissue, they play a role in regulating the acidity in soft tissue and act as catalysts in many chemical reactions. Body development can only occur when there are adequate amounts of minerals present: cells and tissues can only grow if the minerals are allowed to penetrate the cells and expel the waste products. Finally, an adequate supply of minerals is the “condition sine qua non” for the main parenchyma (type of tissue) of the heart and nervous system to perform its functions properly. Unlike other nutrients, such as lipids, minerals do not provide

energy. However, they are still essential in allowing chemical reactions to occur, which, in turn, produce their own energy. Like some amino acids, minerals must be expelled from the body because they cannot be absorbed. Supplies of minerals in food sources can be found in regular meals, drinks and food dressings. As with all other nutrients, in order to maintain a good level of minerals in the blood, there must be a regular intake because they are constantly being removed through the body’s excretory process. Once again, it is very important to maintain a diet that is both balanced and filled with variety. Keep in mind that a balanced diet, which consists of fruit, vegetables, cereals and certain quantities of meat and fish, is able to provide your organism with the salts that are necessary to it’s growth, development and overall health.

Calcium

Calcium is mainly found in the skeleton and teeth, the rest is dispersed in the cells and blood. A correct dosage of calcium allows muscle contraction, blood clotting and the transmission of nerve impulses. Calcium is found in dairy products, such as milk, eggs, cheese, fish and legumes. The average daily recommended intake is about 800 mg. A deficiency of calcium causes bone disease, such as rickets, osteroporosis and tetanus. Too much calcium can result in nausea, vomiting, drowsiness and kidney stones.

Phosphorus

Phosphorus is widely distributed in the bones and teeth and is also found in muscular tissue and blood. It plays a key role in the production of energy. Foods containing high levels of phosphorus are milk, cheese, meat, fish and legumes. The daily intake amount recommended is the same as that of calcium. A deficiency in phosphorus commonly results in weakness, bone demineralization and malaise while too much causes calcification and ossification of soft tissue.

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7 Magnesium

Like phosphorus and calcium, it’s found primarily in the bones but is also present in both nervous and muscular tissue. The daily intake amount recommended is 250-350 mg for adults. Nuts, cocoa, tea leaves, almonds and spices such as ginger and cloves contain high quantities of magnesium. A deficiency leads to anorexia, vomiting and increased excitability. To the contrary, a lack of magnesium in the body can cause heart and breathing problems.

Sodium

Joins together with potassium to form the potassium-sodium pump which is important for the nutrient trade between cells. Salt, cheese and sausages are all rich in this mineral. A daily intake of more than 4 grams promotes hypertension while a deficiency can lead to anorexia, nausea and vomiting.

Potassium

Potassium maintains equilibrium between the salt-water and acid-base balance. It is also essential in nerve transmission and the regulation of arthritic pressure. Beans, peas, spinach, asparagus, potatoes and bananas are all rich in potassium. The average daily intake amount is about 3 grams. A lack of potassium commonly causes muscle cramps and, more often, abnormal heart rhythm. An excess may even lead to cardiac arrest.

Chlorine

Chlorine is found primarily in the stomach, where it participates in the digestion of the food bolus. It can also be found throughout nature, particularly in rock or mountain salt which is then used as table salt. Daily recommended chlorine intake is between 1-5 grams. A lack of chlorine is mostly pronounced in muscle cramps and, when in excess, vomiting.

Sulfur

Sulfur is essential in hair, nail and cartilage development and growth. It’s contained primarily in animal protein.

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Anemia (Iron Deficiency Anemia)

Anemia from an iron deficiency occurs when the body lack the iron it needs for the biosynthesis of haemoglobin. Among the main causes of anemia, there is reduced nourishment, low absorption, an increased recommended daily intake and blood loses. Even a generic alteration has been recognized to assist iron-deficiency anemia.

Iron is an essential nutrient to our body. It is found primarily in red meat, in fish, in dark chicken meat and turkey, nuts, seeds, dried fruit, vegetables and breakfast cereals. The World Health Organization estimates that 600-700 million people worldwide suffer an iron deficiency, making this the most common nutritional health problem. This is true especially true in developing countries. While blood loss (for ex. By infection) may be the at the root of the problem, in Western Europe iron deficiency is usually the result of a poor mineral intake in regular diet. The effects of a poor intake of iron are far reaching. In order for haemoglobin (the red pigment in blood) to successfully continue to transport oxygen to all the cells in the body, it is essential that it can rely on a strong iron level. The first symptoms of Anemia are tiredness and fatigue. Women who eat little chicken and fish or choose a solely vegetarian diet are at a greater risk of being affected by this deficiency. Even if a girl seems outwardly healthy, low levels of iron have a very negative impact on concentration ability, for example, which then results in poor school performance. Neo-vegetarians must be especially careful, as they often exclude meat from their diet without knowing what to replace it with. It’s important that dieting or vegetarian women understand that they must eat foods rich in iron or replace them with food supplement pills. Research now also shows that a lack of iron reduces brain functionality, resulting in poor memory and learning ability. It could therefore be very important to enhance iron intake for those, both adult and adolescent, that run the risk of not meeting the required iron level through their diet. Not only does the brain suffer from a lack of iron in the blood, but even pregnant women and elderly should be careful. If a pregnant mother suffers an iron deficiency it could be passed on to her unborn child who may, in return, potentially suffer slow cerebral growth because of it. In the elderly a poor diet and a reduced ability to absorb iron through the digestive tract usually determines their state of anemia.

Whatever the age or sex of the individual, an iron deficiency, in the long run, will lead to a loss of sense of pain, it will interfere with the mechanisms that control body temperature, result in hair loss, and decreases the efficiency of the immune system, allowing vulnerability to infection. For all these reasons it's important to keep a close watch on your iron intake.

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9 How to recognize an iron deficiency

To determine the cause of these symptoms, a doctor must prescribe blood tests to assess the level of hemoglobin.

The absorption of iron

Our body absorbs about 25% of the iron contained in meat, fish and poultry. Absorption from cereals, vegetables and fruit is significantly less then that from meat, etc. but it increases when taken together with vitamin C (found in citrus fruits, grapes, kiwis, bell peppers, potatoes, fructose and meat and fish proteins). Iron absorption is greatly reduced when these foods that are rich in iron are eaten along with eggs, wheat bran and tea.

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Tuscan food pyramid (PAT)

Level 1. Fruit and vegetables

In terms of health, fruits and vegetables have a protective role known and confirmed by decades of studies on the populations of all continents. Eating fruits and vegetables in large quantities several times during the day, while reducing meat consumption, helps to prevent obesity, diabetes, certain cancers, and helps to increase life expectancy. Moreover, among the most frequent consumers of fruit and vegetables, we find less frequent damage to the arteries and reduced heart attack and stroke risks. When choosing fruit, it’s advisable to select the ones in their season that are produced locally and that have an intense and vibrant colour (yellow, orange, red, bright green) because they contain a greater amount of protective substances. Pay attention, however, to the high sugar fruits like figs, bananas and grapes. These contain a large amount of calories, which is hardly a risk if coupled with sufficient physical activity. As for vegetables, cooking them in water may damage some antioxidants more than cooking them in steam. From this point of viewsteamed vegetables are healthier than boiled vegetables, because the cooking water , containing the antioxidants, is not removed. It is best to alternate between raw and cooked vegetables. For boiled vegetables it's best to try steaming or quick cooking. Fruit follows the same recommendation as the vegetables: seasonal, local produce and beautiful bright colors. Products in order of the food pyramid are: apples (in Tuscany, "), black grapes (in Tuscany, Sangiovese, Morellino, Colorino), oranges and lemons, raspberries, blueberries, blackberries, strawberries, cherries (Tuscany, Pistoia mountain blueberry, cherries of Lari), peaches, apricots (in Tuscany, Tuscan fishing quince, peach queen of Londa), kiwi, melon (Tuscany, the Val di Cornia melon), cabbage (in Tuscany, curly kale from Tuscany); cauliflower, broccoli (Tuscany, Florence cauliflower); Tomatoes (in Tuscany, Florence ribbed tomatoes, tomato basket, Pisanello tomatoes, tomato smooth rod by Serbian Tuscan) carrots, red peppers, yellow and green, or endive lettuce, chard, spinach (Tuscany, four seasons vinata lettuce, spinach Valley Cornia), artichokes (in Tuscany, Tuscan artichoke purple), zucchini, pumpkin (in Tuscany, Florence round zucchini, zucchini long Florentine, Pisan blackberry zucchini, winter squash Tuscan), onions, garlic, leek (Tuscany, Tuscan red onion , Certaldo Onion, onion Treschietto), rosemary, sage. The traditional products of Tuscany:

vitigno ad uva nera Sangiovese piccolo precoce; vitigno ad uva nera morellino; vitigno ad uva nera morellino di Scansano; mela rugginosa della Valdichiana;

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11 mela stayman aretina; mela rotella della Lunigiana; vitigno ad uva nera Sangiovese forte; vitigno ad uva nera Sangiovese montanino; vitigno ad uva nera colorino del Valdarno; mirtillo nero della montagna pistoiese; ciliegia di Lari; pesca cotogna toscana; pesca regina di Londa; spinacio tipico della Val di Cornia; carciofo empolese; carciofo del litorale livornese; zucchina tonda fiorentina; zucchina lunga fiorentina; zucchina mora pisana; zucca lardaia; cipolla rossa toscana; melone della Val di Cornia; cipolla di Certaldo; cavolo nero riccio di Toscana; cipolla di Treschietto; cavolfiore fiorentino tardivo; pomodoro costoluto fiorentino; pomodoro canestrino di Lucca; pomodoro pisanello; pomodoro pallino; lattuga quattro stagioni.

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12 Level 2. Cereals

Although cereals are vegetables, they deserve to be talked about separately because they are almost always eaten as the primary ingredient in transformed products such as bread, pasta, and baked goods. Studies show that eating whole wheat cereals, and less refined cereals such as "white" flour, is effective in protecting one from cardiovascular diseases, some kinds of cancers, diabetes and hypertension. For this reason, products containing whole wheat cereals are considered a daily nutritional foundation of recommended diets of the more industrialized countries. Therefore whole wheat cereals could be consumed at almost every meal, but we must pay extra attention to baked goods (for example: crackers, breadsticks, biscuits) that, along with the "goodness" of whole wheat, they can carry a lot of fats that aren't recommended. Besides the newly re-discovered barley, the use of whole wheat is very limited in our region and it's for this reason that it is important that the consumer understands the importance of returning to cereals that are not refined or transformed by the industry. At this level we also find extra virgin olive oil, in addition to being one of the greatest ambassadors of Tuscany in the world, it possesses beneficial virtues in preventing cardiovascular diseases, cancers, hypertension, diabetes and certain skin diseases. It is therefore recommended that one use extra virgin olive oil for both cooking and seasoning: with moderation, of course, considering of the high level of calories typically found in oils and fats. The products at this level of the food pyramid are: large bread (in Tuscany: Tuscan bread, bozza di Prato, bread from Montegomoli, bread from Vinca); pasta, long and short, barley wheat, rice (in Tuscany: barley from Garfagnana, Maremma rice), tomato soup, ribollita (Tuscan soup), pasta and beans, oil (in Tuscany: Tuscan extra virgin olive oil, extra virgin olive oil terre di siena, extra virgin olive oil from Lucca, extra virgin olive oil classic Chianti).

products of Tuscany:

olio extravergine di oliva toscano IGP; olio extravergine di oliva terre di Siena DOP; olio extravergine di oliva Lucca DOP; olio extravergine di oliva Chianti classico DOP; pane toscano; bozza pratese;

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13 pane di Montegemoli; pane di Vinca; torta di farro della Garfagnana.

Level 3. Legumes, dried fruits, nuts and milk

Dried fruit, in particular nuts, hazelnuts and almonds--although up to a few years ago was not appreciated for it's high content of calories and fats--is rich in a particular type of fat, omega-3 (which causes a ideal balance between good and bad cholesterol) and have other useful actions for our body. Pay attention however: this group does not include dried fruit that does not have a shell such as: figs, pineapple, dried apricots. Chestnuts are, however, included in this group: even though their characteristics are very different from nuts, they are often eaten with pine nuts or walnuts and can be considered a good source of certain important micronutrients and therefore they should not be left out. The question of milk and yogurt today is a bit controversial; it appears that they can help protect from certain types of cancers, to boost the immune system, reduce intestinal problems and strengthen the bones.

fagiolo cannellino; fava lunga delle Cascine; castagna del Monte Amiata IGP; farina di castagne del Pratomagno; marrone del Mugello IGP; farina di neccio della Garfagnana DOP; pinolo del Parco di Migliarino-San Rossore; noce aretina; fagiolo zolfino cece piccolo del Valdarno; cecina.

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14 Fish and poultry

Even molluscs and shellfish are good choices but they should not replace fish in one's diet. Meat from farm animals, especially chickens and turkeys, better if they're free-range, is preferable to red meat. This is because poultry contains minor quantities of a particular fat that, according to research, it tends to increase the worst kind of cholesterol (cholesterol LDL). In any case, if one eats meat, these are the preferred choices, especially fish. Products at this level of the food pyramid are: anchovies, sword fish, sea bass, gilthead and trout (in Tuscany: palamita, trout fario appenninica): chicken (in Tuscany: chicken of Valdarno).

Traditional products of Tuscany:

palamita; trota fario appenninica del Casentino; pollo del Valdarno.

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15 Level 5. Cheese, eggs and potatoes

The consumption of the food products on the second last level should be occasional. These are: cheeses (particularly aged), eggs and potatoes. Cheese is a good source of calcium, which is useful for bone growth and formation. On the other hand, they are also rich in saturated fat, which tilts the balance of the ratio between good cholesterol (HDL) and bad cholesterol (LDL) towards the bad. The same applies to eggs, if they are consumed in excess. The potato is the only product from the vegetable world that is found so high in the food pyramid. It is recognisable from the other vegetables because it is rich in starch and low in fibbers. For this reason it should be eaten occasionally and not replace vegetables. The products at this level of the food pyramid are: cheese (in Tuscany: Tuscan pecorino cheese, raw milk pecorino, Tuscan ricotta cheese, raveggioli); eggs, potatoes (in Tuscany: red potato from Cetica).

The traditional products of Tuscany:

pecorino toscano; pecorini a latte crudo; ricotta toscana; raviggiolo; patata rossa di Cetica

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16 Level 6. Salami and sweets

Red meat, sausages and cakes should be treated as precious things: a few, but quality. Meat, especially red, is a major source of saturated fats, that are harmful for the heart and blood circulation. We should place even more moderation in our use of cold cuts, because of their high salt content, that they're harmful for blood pressure and, in some cases, the amount of fat is very high. Other elements found in sausages are linked to the risk of some cancers. Between cold cuts, the less fatty ones are preferable, such as ham and dried beef. Also cooked meat isn't free from risks, especially grilled or fried, which should therefore be limited. Sweets should be consumed in moderation for their high content of fats and sugars, that cause calorie imbalance in the overall diet. The less elaborate sweets are recommended. Homemade or craft sweets are far better than industrial. Breakfast cookies, snacks that are not salty should all be considered "sweets". Also commercial and soft drinks, which contains too much sweetening, are also found at this level of the pyramid. It's best to avoid risks and consume these products occasionally, only a few times a week, and carefully selecting the quality. The products at this level of the food pyramid are: croissant, brioche (In Tuscany: schiacciata alla Fiorentina); cakes, pies (in Tuscany: schiacciata con l'uva, cenci); biscuits (in Tuscany: zuccherini, frittelle di San Giuseppe); Florentine steak, salami, finocchiona, sausage (in Tuscany: Tuscan salami, Tuscan finocchiona).

The traditional products of Tuscany:

finocchiona toscana; schiacciata alla fiorentina; schiacciata con l’uva; cenci; zuccherini del Mugello; salame toscano.

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17 Physical activity

People who adopt an active lifestyle are less likely to develop chronic diseases such as heart diseases and blood circulation, some cancers, diabetes, bone problems, etc. With an physically active life it is also easier to maintain normal body weight, preventing obesity and overweight that are important factors in causing many diseases. It does not matter to work out excessively. It is sufficient to perform a physical activity at moderate levels of intensity: even just a walk of 30 minutes a day can improve both physical and mental state. It's advised to walk or ride a bike during every day tasks, such as going to work or shopping. And once or twice a week, at least an hour of more intensive activity.

Water

Doctors, nutritionists and dieticians recommend drinking at least one or two litres of water a day, because this is the quantity of liquids that we eliminate daily. The body has no reserves of water and for this reason it's important to replenish its supplies drinking a lot and eating fruit and vegetables. It's especially important to drink during and after physical activity or in the hot seasons to make sure to replenish the fluids lost daily. Even tap water is good: it's cheap, does not pollute because it has no packaging and is safely checked.

Wine

The main Tuscan ambassador in the world has no place in the food pyramid, but beside it, because it is not an essential food, but a good "stimulant". A moderate use is advisable because it contains alcohol, a dangerous substance in many points of view. Healthy adult men should not consume more than two cups of wine a day and women no more than one, for the reason that they are more susceptible to the dangers of alcohol. It is best consumed during meals. It should never be given to children or consumed during pregnancy, before driving a vehicle, during a dangerous job or while taking medication that affects the nervous system. While paying attention to these factors, wine can be a part of our diet because it also has protective qualities for one's health, especially for cardiovascular diseases. And also it's a part of our cultural identity. However, if one is not in the habit of drinking wine, he should not be encouraged to start.

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- Visita ginecologica Presidio - Consulenza psicologicaPONSACCO Distrettuale - Ambulatorio ostretico – ginecologico Attività - Pap - test consultoriali ATTIVITA’ TERRITORIALITel 0587-273907

- Rilascio/rinnovo esenzione ticket per patologia Attività medico - Autorizzazione trasporti Distrettuali - Vaccinazioni adulti - Ecc… - Medicazioni ambulatoriali - Consegna referti - Ecc… - Prelievi ematici nelle seguenti sedi:  Ponsacco Attività  Crespina Infermieristiche  Chianni  Lari  Casciana Terme  Cenaia Tel. 0587/273802 Dal lunedì al venerdì 7.15-11.30 Martedì e Giovedì Attività 14.30 17.00 Amministrative Sabato 8.30-11.30 Tel. 0587/273804-806 Segretariato sociale: Ponsacco - Martedì 14.30 - 17.30 - Mercoledì 10.00 – 12.00 Crespina - Venerdì10.00 – 12.00 Attività sociali Chianni e Casciana Terme

- Lunedì 10.00-12.30 - Mercoledì 10.00 – 12.00 Lari - Lunedì 10.00 – 12. 00 Tel.0587/273817-819 Si eseguono le seguenti attività specialistiche: - Cardiologia Attività - Oculistica specialistiche - Dermatologia - Pediatria Vaccinazioni - Vaccinazioni - Visita ginecologica - Consulenza psicologica Attività - Ambulatorio ostretico - ginecologico consultoriali - Pap- test C/o Pubblica assistenza di Ponsacco, Tel 0587 735177

Presidio LA ROSA TERRICCIOLA Distrettuale

ATTIVITA’ TERRITORIALI

- Rilascio/rinnovo esenzione ticket per patologia Attività medico - Autorizzazione trasporti sanitari Distrettuali - Vaccinazioni adulti - Ecc… - Consegna referti - Attività infermieristiche ambulatoriali - Ecc… - Prelievi ematici nelle seguenti sedi:  La Rosa Attività  Peccioli Infermieristiche  Capannoli  Forcoli  Lajatico  Palaia  Terricciola Tel. 0587/273853 Dal lunedì al venerdì 9.00 – 12.30 Lunedì e Venerdì 15.00-18.00 Attività Giovedì Amministrative 10.00-11.00 Sabato 9.00 – 12.00 Tel. 0587/273875- 865 Segretariato sociale Forcolì Terricciola - Martedì 10.00 – - Lunedì 9.00 – 12. 00 11.00 Peccioli Capannoli - Martedì 10.00 – - Martedì 10.00- 12.00 Attività sociali 12.00 Lajatico La Rosa - Mercoledì 11.00 – - Mercoledì 10.00 – 13.00 12.00 - Venerdì 10.00 – Tel.0587/273860 – 861 - 862 12.00 Si eseguono le seguenti attività specialistiche: - Cardiologia - Oculistica - Dermatologia Attività - Pediatria (vaccinazioni) specialistiche - Ecografie - Ginecologia - Odontoiatria - Ostetricia - Visita ginecologica Attività - Ambulatorio ostretico - ginecologico consultoriali - Pap- test Tel. 0587-273857