Upcoming presentation

Monday, November 5, 1:30 Tuberculosis, a colorful history of the White Plague. Carlsbad-by-the-Sea Retirement Community, 2855 Carlsbad Blvd., Carlsbad. Tuberculosis was a leading cause of death for millennia. Its victims included famous artists, writers, actors, composers and politicians. Learn what made it so devastating and why the medical community is worried about its resurgence. Sponsored by Osher – to register see their website http://www.csusm.edu/el/olli.

In the news

Second hand smoke: the picture worsens.

A recent study by a group of Canadian pediatricians reported that children that are exposed to second hand smoke are more likely to have symptoms of depression. That prompted me to review the medical literature on second hand smoke and the results are – well, depressing!

It has been known for decades that non-smokers who are exposed to tobacco smoke in their homes or workplaces are much more likely to develop lung cancer. More recently it has been found that they are more likely to develop COPD (Chronic Obstructive Pulmonary Disease), heart disease, stroke and hearing loss.

Sudden Infant Death Syndrome (SIDS), a heart-wrenching tragedy, is more common in the households of smokers. The risks to children whose parents smoke are especially concerning because they only appear later in life: asthma, obesity, COPD and heart disease. Before they get to high school the children that are exposed to second hand smoke experience more infections, including meningitis, and are more likely to experience complications of influenza. They also have slower language development and poorer cognitive development.

Fewer than half as many Americans smoke today than a generation ago but one in five – the current estimate – is still too many, especially when that figure includes pregnant women and teenagers. Besides encouraging ditching the habit, we should ensure that persons who do smoke should not do so when children are in the home or the car.

Lifestyle

Preventing Alzheimer’s disease and dementia – another step

Keep your blood vessels healthy. After all, brain cells need a steady supply of nutrients and a way to whisk away waste products. Regular exercise sends pulses of blood into every part of the body and that keeps blood vessels open and flexible.

Trans fats and saturated fats damage the lining of blood vessels and so does cooking oil that has been heated over and over. (Like those French fry vats at your local fast food place.) Blood vessels whose lining is damaged form scars and deposits of fat and calcium, limiting blood flow and resulting in the death of brain cells.

Blood vessels undergo constant renovation so the replacement materials need to be perfect. However if blood sugar levels are repeatedly elevated those excess sugar molecules attach themselves to and distort the protein building blocks of blood vessels. The result? Blood vessels that are narrow, distorted and leaky. Organs that are rich in blood vessels, the eye, the kidney – and the brain, become unable to function properly. That’s why blindness, kidney failure, stroke and dementia are so common among persons with diabetes. As the brain shrinks, so does memory. The solution is simple: keep blood sugar low and physical activity high.

Typhus in L.A.

Typhus, usually associated with deplorable living conditions, is in the news. Nearly 100 cases have been reported in and around Los Angeles so far this year. Is it something for us to worry about?

The disease – not to be confused with typhoid – produces fever, chills, rash and stupor, and is sometimes fatal. In the past it has been associated with wars and severe crowding. It decimated the army of Napoleon during his futile campaign against Russia. It tragically caused the death of Anne Frank just weeks before World War Two ended.

Historically, typhus was spread from one person to another by body lice. The L.A. outbreak is different in that it is being spread by fleas, and especially among the homeless. Fleas breed among rats and both critters thrive in garbage-strewn neighborhoods. Feral cats carry infected fleas that can spread to household pets and then to humans.

Those who own cats and dogs usually monitor and treat their animals for fleas but that is especially important if you live in suburban areas where feral cats, rats and opossums are present. Getting close to any wild animal risks diseases that are even worse than typhus.

Some pet owners have found that sprinkling brewer’s yeast on dog and cat food helps to prevent flea infestation but others claim that it doesn’t work. It might be worth trying it for about a month. Maybe it depends on the breed. The upside is that yeast contains nutrient vitamins and won’t harm your pet.  (Note – the preparation that contains yeast plus garlic should not be given to cats.)

Lifestyle

Another step to avoid Alzheimer’s disease and dementia – omega-3 fats.

Omega-3 fats are the healthy fats – physicians refer to them as “essential fats” – that are especially important for normal brain and eye development in infants but we never outgrow the need for them. They are most abundant in fish, including shellfish, and in some plant foods such as walnuts, peas, Brussels sprouts, chia seeds and flaxseeds.

The brain-healthy effect of omega-3 fats has been determined from large population groups, from studies in animals and from their beneficial effect in a variety of neuropsychiatric problems that range from depression to behavior disorders.

A Dutch study showed that fish eaters had less cognitive decline than fish-avoiders. Persons living in Framingham, Massachusetts with the highest levels of DHA, an omega 3-fat found in fish, had a 47 percent (!) lower likelihood of dementia compared with those with the lowest levels. Finally, Alzheimer’s patients have low levels of omega-3 fat in their brains.

These findings should encourage you to include fish in your diet three to four times a week. (Sorry – fish sticks won’t do.) Fish oil is a perfectly good substitute but it doesn’t have the extra benefit of protein, a nutrient that many seniors lack in their diet.

Your mother was right: fish is brain food.

A day in the life of a Gold Rush physician. Saturday, October 6, 10:00 a.m., OASIS Grossmont Learning Center, La Mesa. Go to http://www.oasisnet.org/sandiego for registration details and class description.

Regain your youthful memory. Monday October 8, 12:00 a.m. OASIS Escondido Senior Center. 210 E. Park Ave. Go to http://www.oasisnet.org/sandiego for registration details and class description.

How to lose weight after 40. Tuesday, October 23, 12:30. Carlsbad Dove Library. Go to http://www.oasisnet.org/sandiego for registration details and class description.

All about salt. Saturday October 27, 1:00 p.m. San Diego Archaeological Center, San Pasqual Valley Road (same as Hwy. 78, just past Safari Park) $30, non –member, $20 members. Local wine and inspired foods will be served after the lecture. See https://sandiegoarchaeology.org for further information.

In the news

Influenza vaccine – there’s more to the story.

There are few topics in medicine that are more controversial than the influenza vaccine. The media focus on its failure to prevent disease. Depending on the year the effectiveness ranges from about 20 to 60 percent. That sounds like a reason not to bother, doesn’t it? In those disparaging articles there is usually acknowledgment near the last paragraph that even if the vaccine does not prevent infection, those who receive it have a significantly lower risk of requiring hospitalization. That fact has been documented repeatedly.

The last place you want to be at any time is in a hospital, where infections, often from antibiotic-resistant bacteria, kill nearly 100,000 persons every year. The influenza virus has long been known to weaken the immune system. Most people who die during an attack of influenza are brought down by secondary infection to which they have become more susceptible, not the virus. When you put together the age-related decline in immunity, the further weakening incurred by the influenza virus and the high risk of hospital exposure to several species of dangerous bacteria, a perfect storm emerges.

But wait – there’s more! Physicians have known for decades that the risk of dying from a heart attack is greater during and in the weeks after infection with the influenza virus. We now know why: release of inflammatory chemicals, disruption of plaques within the walls of blood vessels and increased tendency to form artery-plugging blood clots. Another perfect storm.

One more thing: you cannot get influenza from the influenza vaccine. The virus is dead – period! And the intense scrutiny of the vaccine production process, driven by attorneys who dread a vaccine-induced infection, makes it highly unlikely that any live virus particles will make it to you.

The flu season has begun. ‘Nuf said.

Preventing Alzheimer’s disease and dementia: antioxidants.

The human body evolved to require many kinds of nutrients and about 4,000 of these are antioxidants. Nature provides them to plants and animals in order to counteract the damage inflicted by free radicals, chemicals that result from exposure to radiation, sunlight, infection, exercise or even normal digestive processes. Animals can manufacture only a handful of antioxidants, that’s why we need a high intake of fruits and vegetables.

Plant products that are high in antioxidants have three characteristics: they are highly colored, highly aromatic and highly flavored. Think carrots, beets, garlic, coffee, red wine and dark chocolate.

Antioxidants don’t act alone. That’s why, as in the case of vitamins, studies on single chemicals such as curcumin are not convincingly conclusive. What we do know is that persons who have a diet high in natural antioxidant-containing fruits and vegetables have a lower risk of dementia. In part that’s because they are less likely to eat refined grains and sugars or to get their protein from red meat. Antioxidants reduce inflammation, which plays a large role in Alzheimer’s disease and dementia.

There is plenty of evidence that a high intake of antioxidants has many health benefits. This is confirmed by studies of the Mediterranean Diet revealing that those who adhere to this diet have a thicker layer of gray matter in the brain, preventing or postponing cognitive decline, especially memory.