In the news

 How well prepared are you?

No region of the country is free from the possibility that a natural or man-made disaster will force us to leave our homes, at least for a day or two. If it hasn’t happened yet to you, someone in your circle of friends, relatives or co-workers has probably had to leave their home and nearly all that they own behind on extremely short notice. Wildfires, floods, tornados, earthquakes, hurricanes and landslides are Mother Nature’s doing; gas leaks, chemical plant explosions and the like are the price we pay for technology.

What valuables and living essentials could you gather up with ten-minutes warning – or less? What if you couldn’t use your vehicle? How much could you carry? And what would you carry it in?

As prepared as Pat and I are with our “bug-out bags” that would allow us to survive outdoors for about three days, when we were recently threatened by wildfires and were the next neighborhood that would receive orders to evacuate, that ten minutes went by really fast! But we were ready.

If you are taking prescription medicines be sure to include those. Do you have credit cards, cash and checkbooks within reach? (I almost forgot the last but Pat didn’t.) How about what your pets will need?

You can find emergency evacuation kits on the Internet but it’s easy to make your own. Hint: a wheeled carry-on will hold most of what you need.


How much water should you drink in a day?  “Ounces per pound per day” is meaningless. During a Santa Ana in San Diego when the humidity is less than 10 percent while you’re puttering around the yard it will take a lot more water than sitting in front of the TV on a chilly day. The best indicator is simple: your urine should be light yellow with little odor. If it’s dark and smelly you not only run the risk of developing kidney stones, but being only 2% dehydrated will make your thinking fuzzy. If your urine is almost as clear as tap water you’re overdoing it, and several hours of that might cause a seizure.

It’s not being overzealous to have a bottle of water available in the car, and a glass on the countertop when you’re at home. Stainless steel water bottles only cost about $15 and they will last longer than you will.

How does all this fit it with dieting? What passes for hunger is often thirst, and by drinking 6-8 ounces of water you can usually make the hunger pangs go away. If that doesn’t work, have a piece of fruit – not a handful of jellybeans!

Something to keep in mind: back in the Stone Age there was no beverage but water. That worked out fine for a couple of million years.

Another point: the single most important factor in excess weight gain in America is sweetened drinks. And the average size is now 20 ounces!!


In the news

Fish eat worms and vice-versa

Over the past few years there have been several reports of live or dead parasitic worms in fish that is sold in supermarkets, big box stores and in restaurants that specialize in sushi.  The past couple of months have seen more stories. This is not really news. I learned in medical school that we should avoid undercooked Great Lakes whitefish because of the possibility that an uncooked tapeworm might take up residence in our intestines. Uncooked is the key word. Thoroughly cooked and no longer alive, parasitic worms and their eggs are no threat to our health.

Worms are the largest parasites that live in the bodies of the animals that we have relied on for food for thousands of generations. Fresh water fish often contains the above-mentioned tapeworm’s eggs that hatch in the human digestive tract. Salt-water fish contain several species of worms, and salmon that spend their lives in both salt and fresh water carry them as well. Commercial cod fishermen often find their catch riddled with worms. When sushi is made from fish that has not been frozen there is a risk that a worm within it might make some customer’s stomach its new home.

The term parasite comes from the Greek words for alongside food and they recognized that such creatures were quite common in our food supply. In developing countries parasites are so common that virtually one hundred percent of the population carries them in the intestinal tract. That might explain why autoimmune diseases seldom occur in those groups. A new field of medical research, helminthic therapy, is exploring the ways in which certain parasitic worms favorably influence the course of multiple sclerosis, ulcerative colitis, celiac disease and asthma.

To be sure, parasitic worms are responsible for a host of diseases. Patients infected with fish tapeworm may develop anemia. Sushi lovers sometimes encounter worms that cause severe pain and discomfort when they attach themselves to the lining of the stomach. Trichinosis used to be fairly common when pigs were fed infected meat from other pigs; it still occurs among hunters who eat improperly cooked bear meat.

Finding a live worm – or several – in a package of store-bought fish can be unnerving and the product should be discarded (or returned for a refund). Cooking destroys worms that might not have been noticed, and so does freezing. Sushi restaurants usually – but not always – freeze their fish before it is prepared and served.

And who knows? Well-cooked worms might be good for you!

Exercise Tips

      Humans have a natural aversion to physical activity. It’s actually hard-wired in us because it’s a survival mechanism: if we expend less energy we will retain more stored energy in the form of fat or glycogen*. Even hunter-gatherers of today rest whenever they are not engaged in something.

Our modern levels of physical activity are so low that we should go out of our way to burn off calories whenever possible. Persons on a diet should seek out ways to do that, even if the movement is not strenuous. Use your car as little as possible. When you do drive, park at the farthest corner of the lot. Takes the stairs instead of the elevator. Those few extra burned calories a day will add up.

Don’t go more than three or four days without moderate exercise, even if it’s only a half-hour walk in your neighborhood. Do a few push-ups while you’re watching the evening news.

* – Glycogen is also known as animal starch. It is composed of chains of glucose molecules and is stored mainly in the liver and muscles.


Upcoming presentations

Upcoming presentations in the San Diego area are scheduled for the Osher Lifelong Learning Center, Cal State San Marcos ( and the OASIS Adult Learning Center ( Dates, times and locations are posted on their websites.

Avoiding modern diseases –  Osher Lifelong Learning Center at the Temecula Higher Education Center,  February 19 and 26, March 5 and Mission San Luis Rey, March 22 and 29, April 5. Topics include Ten steps to avoid cancer, Baby Boomer blindness and Ten ways to avoid dementia and Alzheimer’s disease.

Sleep, light and health, Mission Valley Library (OASIS) February 20, 1:00 p.m.

Dieting Guidelines

Cravings occur because sheer survival is built into our behavior. Survival is an overriding instinct, so don’t feel guilty when you have cravings, even when they make you do irrational things like raiding the refrigerator when everyone else is asleep.

You can avoid cravings by snacking on foods that are high in fiber and low in calories, such as most fruit. Don’t be concerned about fruit sugar; a normal piece of fresh fruit usually has only about 70-80 calories but the fiber will satisfy your appetite. Protein snacks, such as protein food bars, will also help to prevent cravings but they should contain only small amounts of carbohydrate and fat.

A hint: eat snacks slowly. That’s especially true of nuts, a small handful of which will usually contain a little more than 100 calories but that is very filling – if you eat them slowly!

In the news

Tiny turtles – cute but dangerous.

Many of us had little turtles as kids, usually from the local Five-and-Dime with an American flag painted on the shell. But for decades those pets have been responsible for thousands of cases of illness due to various strains of Salmonella. The germ usually only causes diarrhea but in the very young and the very young it can cause serious bloodstream infection and even death.

The Centers for Disease Control has banned the interstate sale of small (carapace less than four inches in diameter) turtles since 1975 because of the high risk. Salmonella bacteria are common in turtles and the water of the tanks in which they are kept – and kids love to pet and kiss those cute critters.

Banned or not, tiny turtles continue to cause outbreaks, the latest in November of 2017 that spread to fourteen states. More than a third of the victims were below the age of five years.


Area presentations

Area Presentations

Upcoming presentations in the San Diego area are scheduled for the Osher Lifelong Learning Center, Cal State San Marcos ( and the OASIS Adult Learning Center ( Dates, times and locations are posted on their websites.

Avoiding modern diseases –  Osher Lifelong Learning Center at the Temecula Higher Education Center,  February 19 and 26, March 5 and Mission San Luis Rey, March 22 and 29, April 5. Topics include Ten steps to avoid cancer, Baby Boomer blindness and Ten ways to avoid dementia and Alzheimer’s disease.

Sleep, light and health, Mission Valley Library (OASIS) February 20, 1:00 p.m.

In the news

After a few decades of being warned of the danger of cholesterol in eggs Americans are now being told that hen’s fruit is not the risk that we thought that it was. First, not all cholesterol is bad. “High cholesterol” is a meaningless term. It usually refers to the total cholesterol level but there are several different forms of cholesterol. High-density lipoprotein (HDL) is a beneficial marker of heart health while low-density and very low density lipoproteins (LDL and VLDL) should be the targets of treatment. It is these latter two forms of cholesterol that are clearly linked to the risk of coronary artery disease and heart attack but that is not the whole story. Persons whose blood cholesterol levels are normal often are victims of heart attack. Several other factors, especially high blood pressure, are part of the picture. Inflammation, largely due to excess body fat, plays an important role in heart attack and stroke.

Second, unless the intake is very high, cholesterol in the diet does not raise the level of cholesterol in the blood. The more cholesterol we eat the less the liver manufactures. This feedback mechanism ensures that we will maintain enough cholesterol to produce hormones, vitamin D, bile (needed for digestion) and other vital components. It also keeps blood levels from going too low, a condition that is associated with significant neurological problems, including depression and aggressive behavior.

Eggs have been part of the human diet since the Stone Age and our ancestors had a huge variety of birds’ eggs compared to chicken eggs, our only one. Even so, chicken eggs are a valuable source of protein, vitamins, calcium and iron.

When we eat eggs they are almost always part of a meal that includes saturated fat, the real cause of elevated cholesterol. Bacon, sausage, ham and other “egg helpers” that include butter and hash brown potatoes are hardly heart-healthy. On the other hand, an omelet made with assorted vegetables eliminates the saturated fat and includes healthy fiber, more vitamins and antioxidants.

Is there a limit to the number of eggs that we can safely eat in a week? One or two eggs most days of the week will have zero effect on your blood cholesterol. The exception might be persons with a genetic trait that keeps their cholesterol levels abnormally high. For the rest of the population, enjoy those veggie omelets – without the saturated fat!


Hypertension, type 2 diabetes and colon cancer share some important characteristics. They affect large numbers of people, they are silent for long periods, they are difficult if not impossible to cure when they become established and they can be identified in their earliest stages with non-invasive screening tests. To be sure, there are other conditions such as coronary artery disease that kill more Americans but in that specific example there is no simple, reliable, non-invasive test that can identify its victims. In fact, among the 1,000 persons who die each day of sudden cardiac arrest, death is the first symptom of heart disease.

Yet, many heart disease victims’ lives could have been extended, perhaps for decades, if they had been screened for high blood pressure. Hypertension usually develops gradually over several years and it causes almost no symptoms. It is the single most important treatable cause of heart disease and stroke and it often begins in early adolescence. Everyone should have an annual blood pressure check starting in childhood, especially those who have a family history of heart disease or stroke, or who are overweight or obese.

Blood pressure devices are so inexpensive, reliable and easy to use that every family should have one. Since a single blood pressure reading is not diagnostic, especially in the stressful atmosphere of a physician’s office, measuring it a couple of times a day over several days is worth the time and effort. The upper number (systolic) should be less than 125 and the lower (diastolic) less than 80. It’s true that blood pressure increases with age but that is not normal; it is simply common.

We are in the midst of an epidemic of type 2 diabetes. Everyone should be screened with an annual fasting blood sugar starting at age 40. For those with a family history of the disease, obese individuals or any non-Caucasian, screening should start in adolescence. More than half of those who have type 2 diabetes have at least one complication at the time of diagnosis. The blood test can identify persons with pre-diabetes, half of whom will develop full-blown disease within a decade.

Colon cancer screening begins with a test for blood in the stool, done once yearly from age 50. A colonoscopy should be done at that time and repeated at 60. Yes, the preparation is uncomfortable but sedation makes the procedure itself quite tolerable. It can be a lifesaver.




In the news

Ignore those life expectancy numbers

Life expectancy is a number that is useful to actuaries who deal with population statistics, to healthcare planners and to the journalists who write about it. It has nothing to do with how long you will live. Life expectancy in the United States is more than eighty for women and somewhat less (seventy-six) for men. The not-so-good news is that life expectancy has decreased for two years in a row, the fall attributed to the rampant abuse of opioids. If drug-related deaths do not decrease this year and the flu season is worse than most years we can expect another decline, shattering a record that will provide much hand-wringing at all levels of government, in the halls of academia and in the media. The steady increase in drug-related deaths does demand our attention because it mostly affects those in mid-life, destroying families and ending productive careers. Perhaps the most frustrating aspect of the opioid problem is that these deaths are entirely preventable. Influenza deaths are also largely preventable. Although the influenza vaccine is far from perfect it does reduce mortality at both extremes of life, the very young and the very old, whose deaths are almost always due to secondary bacterial infection, not to the virus itself.

Although heart disease is still the leading cause of death in the United States, improvements in diagnosis and treatment have slowed its climb. Diabetes reportedly accounted for fewer than 80,000 deaths in 2015 but that is a misleading statistic. Type 2 diabetes now affects nearly ten percent of the population and contributes to heart disease and stroke, a fact that is not usually reflected in death certificates. Obesity is not listed as a cause of death in official records but it is a very important contributor to coronary artery disease and it is linked to more than a dozen cancers. Chronic lower respiratory disease, third on the list, is almost entirely the result of smoking.

As individuals it is within our power to postpone if not to avoid six of the seven leading causes of death: heart disease, cancer, lower respiratory disease, accidents (nearly half of which include drug/opioid victims), stroke and type 2 diabetes. Persons who maintain normal weight and do not smoke or use drugs don’t have to pay attention to life expectancy figures. Good habits will help you to exceed those numbers by a couple of decades.


In the news


Avoid false blood pressure readings

High blood pressure is the single most important factor in heart disease and it is a major factor in stroke. Another consequence is a significantly greater risk of dementia.  In the past a reading below 130/80 (systolic/diastolic) was considered normal; a reading above 140/90 was diagnostic of abnormally high blood pressure (hypertension).  The new guidelines lower those numbers so that nearly one-half (forty-six percent) of Americans are now considered to be hypertensive. According to the newest guidelines from the American College of Cardiology and the American Heart Association, persons whose blood pressure is 130/80 or more (either number) are considered to have high blood pressure. A blood pressure less than 120/80 is the new normal.

Taking one’s blood pressure is not as easy as it looks, even with the latest automatic devices, and falsely high readings are common. White coat hypertension results from anxiety and even physicians are not immune from this distortion. A few minutes of rest, both physical and and mental, are helpful. The check-in routine in most medical offices thwarts the process. Minor factors that each push the numbers up can lead to a false diagnosis of hypertension and unnecessary treatment. A cuff that is too small gives erroneously high readings; the arm should be on the same level as the heart and resting on a table, desk or the armrest of a chair; the legs should be uncrossed and both feet flat on the floor. The cuff should be placed on the bare arm, not over clothing. It helps to avoid caffeine and alcohol in the hours prior to the visit to the doctor’s office. Even when the measurement is done correctly the diagnosis of hypertension, unless other factors dictate otherwise, should await a second measurement on a different day.

There are numerous prescription medications that lower blood pressure but all of them have side effects and of course, are expensive. Persons with mild hypertension can almost always bring it back to normal with a few simple measures: losing a few pounds, lowering salt intake and increasing potassium intake by adding several servings of fruits and vegetables to the daily menu. For most people, taking the time for moderately intense exercise at least four days a week for about one hour is the most difficult step but it is perhaps the most effective.

Digital devices for home monitoring are inexpensive and are recommended in the new guidelines.

Exercise Tips

If you are not already exercising, consider that until the development of mechanized transportation and labor-saving devices, the average human burned 4 or 5 thousand calories a day in finding food and getting the chores done.

Some basic facts about exercise:

Your body is designed to be moderately active almost every day.

“Exercise” doesn’t only mean the things we do at the fitness center.

It is absolutely impossible to become musclebound.

The benefits of exercise include much more than losing weight or                                        avoiding a heart attack.

No one is too old to exercise.

Almost no one is too sick to exercise.

Using about 500 calories per week is not an ordeal and it will result in the loss of about one pound per week if they are not replaced with food.


Area Presentations

Upcoming presentations in the San Diego area this winter are scheduled for the Osher Lifelong Learning Center at Cal State San Marcos ( and at the OASIS Adult Learning Center ( Dates, times and locations are posted on their websites.

Scheduled presentations include: Being a kid in the Stone Age, Ten ways to prevent dementia and Alzheimer’s disease, Ten ways to prevent cancer, How to prevent blindness as you age, Health benefits of wine and chocolate, and more. We’ll keep you posted.

If you are looking for a speaker for your organization there are more than sixty-five PowerPoint presentations listed at

In the news

A better shingles vaccine

Herpes zoster, known as shingles, is a very late complication of chickenpox, a disease that was common when today’s seniors were kids but that is now almost nonexistent because of the chickenpox vaccine. Shingles begins when the chickenpox virus that has lain dormant within nerves of the spinal cord emerges because of an aging or compromised immune system. It begins with an itchy or tingling sensation, usually on one side of the chest or abdomen. Over several hours the pain increases and a rash appears in the form of small blisters that may form an angry red cluster. After about a week the rash begins to disappear but some patients have pain in the area that can last for years. When the rash involves the face it may result in eye damage, even loss of vision.

If an antiviral drug is taken during the first twenty-four hours the attack may be halted but vaccines are now available that can prevent the disease or at least modify it considerably. The first of these was released in 2006. Although it prevented the disease in only a little more than fifty percent of patients it did make the disease milder in most recipients.  A new vaccine, Shingrix, was approved in October 2017. It is almost twice as effective as the older vaccine but it requires two doses, two to six months apart. Side effects such as pain, redness and swelling at the injection site may occur and some persons experience headache, fatigue and generalized muscle pain. These short-lived and generally mild symptoms must be counterbalanced against the risk of severe, long-lasting pain and occasional blindness that occur with shingles. It’s estimated that about one out of three people over the age of sixty will develop shingles; for those over the age of eighty-five the risk is more than fifty percent.

Persons over the age of sixty should be vaccinated even if they received the earlier vaccine and even if they have had shingles in the past. The new vaccine, in addition to being ninety percent effective, provides protection for at least nine years.

Some pharmacies expect to start receiving the new vaccine in December but it will probably not be available until January or February in most areas.  Most private insurance plans cover the cost of the vaccine and so does Medicare Part D. Some plans may require payment by the patient.

Only about thirty percent of eligible persons received the old vaccine. Shingles is a debilitating illness that no one should endure, especially in the golden years.

The Osteoporosis Cocktail – bottoms up!

Calcium is important for strong bones and the prevention of osteoporosis but it’s only a start. Important bone-building nutrients include protein, magnesium, boron, omega-3 fats, vitamins A, C, K and D as well as trace minerals such as copper, manganese, zinc and others.

The good news is that almost all these nutrients are present in a diet that includes whole grains, fruits, vegetables and fish. The bad news is that only four percent (!) of Americans get the recommended amount of all these nutrients every single day AND also get a moderate amount of bone-building exercise at least four times a week. That’s why  a daily multivitamin/multimineral is good insurance, especially for older persons.

Osteoporosis is not inevitable just because we get older but it seems that way because it’s so common. It simply doesn’t happen even among the oldest modern-day hunter-gatherers.