Carvings February 15, 2025

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In the news

The flu season isn’t over yet.

            This week San Diego County lost a fourth teenager to influenza, a tragedy that illustrates three important facts about this disease. First, we are still in the middle of the influenza season. Second, unlike COVID, which rarely took the lives of persons below the age of nineteen (about 1,000 children in that age range died during the entire epidemic and most of those had an underlying health problem) influenza can be fatal in children. Third, those with underlying medical disorders such as heart or lung disease are particularly at risk.

            As most people are aware, the influenza vaccine has to be configured differently every year to accommodate the significant mutations that render previous years’ vaccines less protective. Even when the immunologists prognosticate correctly, most flu vaccines are fully protective only about half the time, sometimes much less so. What is important to consider, however, is that although the flu vaccine is not fully protective, it almost always prevents severe disease or the need for hospitalization. In an era when hospital-acquired infections take the lives of 75,000 to 100,000 Americans every year, that is an enormous advantage. Of note: the four teenagers who succumbed to influenza in San Diego had not been vaccinated.

            Complications associated with the influenza vaccine are tragic but they are extremely rare. The most common serious side effect is a type of paralysis that occurs once or twice in a million vaccine recipients but is almost always temporary, and only very rarely life-threatening.

            More than 100 San Diegans have died of influenza this season. Don’t add to that list by failing to get the influenza vaccine.

Lifestyle

(Decaf) coffee anyone?

            Year after year, coffee looks better and better as a health food. The reason? Antioxidants. That family of nutritious chemicals used to come from the generous intake of plant foods that once upon a time comprised almost all the calories ingested by our distant ancestors. Now that our daily intake of fruits and vegetables is a paltry fraction of what nature intended for us, we lack many of the plant-based nutrients such as phenols, flavonols, flavones, etc. that protect us from the DNA-damaging effects of free radicals. Those are the rogue chemicals that result from sunlight, radiation, infection and even normal metabolism that contribute to tissue damage and the aging process.

            Antioxidant foods have three major characteristics. They are highly colored, highly aromatic and highly flavorful, just like coffee (and red wine and chocolate!). Decaf coffee, which has about 97 percent of its caffeine removed, retains all those colorful, aromatic and flavorful ingredients. Coffee in both forms is the major source of antioxidants in the United States. A number of studies have shown that a moderate intake of coffee, i.e., two to four cups a day, is associated with better cardiovascular health. It has been suggested that decaf coffee is better for the heart than the regular stuff, whose jolt may not be so good for the heart at high intakes, i.e., 8-10 cups per day. On the other hand, caffeine has been recognized for centuries as a cognitive booster. (Does anyone remember taking No Doz during finals?)

            I enjoy three cups of decaf every day. My fourth dose of antioxidants comes in a glass with a long stem.

Carvings February 1, 2025

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Why vaccines fail

            One of the major factors in the steep rise in life expectancy that occurred between 1900 and 2000 was the development of childhood vaccines. Today’s young physicians may never see a child with measles, polio, some forms of bacterial meningitis or chickenpox. Even the oldest physicians among us have likely never seen a child dying agonizingly from whooping cough or tetanus or diphtheria, those diseases having been vanquished before World War Two. If these diseases occur in the United States – and they do sometimes – it is usually because the patient came from a country where medical care is poor and immunization rates are much lower than they are here, or because parents have been caught up in the anti-vaxx hysteria that has been increasingly common in the twenty-first century.

            But sometimes a vaccine does fail to provide infection from the disease that almost always prevents the disease against which it is targeted. One reason is that some vaccines must be kept at specified refrigerator temperatures. When the measles vaccine was released in 1963 pediatricians noted occasionally that vaccinated children developed measles. Investigation showed that some pediatricians’ staff had placed the vaccine on a door shelf of the refrigerator instead of deep inside, which had been recommended. The slight increase in the temperature of vials kept on the door shelf was high enough to weaken the live vaccine, rendering it ineffective. The oral polio vaccine, a live form developed by Albert Sabin, has the advantage of not requiring needles and syringes that are prohibitively costly in developing countries, but it requires a “cold chain” that is also expensive in order to prevent degradation of the vaccine.

            Children who are born with a severe immune deficiency or those whose immune system is weakened by chemotherapy will not respond to the stimulus of a vaccine agent. Obesity may be a factor in the adult population, not only because obesity or its accompaniment, type 2 diabetes, degrades the immune system but because ordinary-length needles fail to reach the muscle tissue deep within a layer of fat. The result is that the patient cannot develop adequate antibodies or immune cells.

            Vaccines vary tremendously in their duration of protection. Diphtheria and tetanus vaccines provide nearly lifelong immunity but the mumps virus fails to protect after just a few years. The disturbing occurrence of numerous mumps outbreaks among young adults has prompted a reevaluation of that vaccine. Yet more evidence that mother nature keeps throwing curveballs!

Carvings  January 15, 2025

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In the news

Wine wars

            Recent headlines: Wine has health benefits. Red wine in moderation is good for the heart. Any amount of alcohol is unhealthy. Why I stopped drinking alcohol.

            There is overwhelming evidence that wine – and I’m excluding for this discussion beer and liquor, for several reasons that will be part of a future blog – has properties, mainly in the form of phytochemicals, that benefit the heart. First, it has anti-inflammatory properties. Because inflammation is a driver of heart disease, stroke, cancer, and osteoporosis, the thousands (yes thousands) of plant-based phytonutrients in every glass of wine could be expected to have health benefits. One of these phytochemicals is resveratrol, a chemical formed in the skin of red/purple grapes that protects the fruit against fungal growth and lowers the harmful form (LDL) of cholesterol in humans. Ingredients in wine also inhibit the blood clotting system, providing another mechanism for protecting the heart and the brain. Some phytochemicals also protect DNA from damage, thus limiting the development of cancers.  

            Several studies in recent years have denied the benefit of these effects, pointing out that even small amounts of alcohol, less than a glass of wine per day, are associated with a shortened lifespan. A drawback of some studies is that they rely on self-reporting, that is, the research subjects gave a falsely low estimate of their wine intake. Because having on average more than two drinks a day is associated with health problems that include high blood pressure and cancer, it thus may appear that even moderate drinking is harmful. The hazards of such studies are well-known, revealing the tendency of people to understate their wine or food intake, often by margins of fifty to one hundred percent. At least one recent positive study relied instead on the measurement of a chemical in the subjects’ urine that accurately provided data on actual wine intake and showed that in a particular population, those who drank about one glass of wine per day had a fifty percent lower risk of heart disease.

            One study showed that exercising several days a week actually offset the harmful effects of alcohol. As a daily exerciser and daily wine drinker I’d love to see that study confirmed!

            But is it the wine that leads to less heart disease and other conditions? Maybe not. Only occasionally mentioned in these studies is the fact that wine drinkers simply have a healthier lifestyle than persons who don’t drink at all, or who drink beer or spirits. Wine drinkers tend to exercise more, eat a healthier diet, visit their doctor more often, maintain normal weight and avoid junk food.

            Now that’s a real recipe for a long, healthy life.

Carvings January 1, 2025

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Happy New Year! Is this the year of the tipping point?

                I’m sure that many of you have read or at least have heard about Malcolm Gladwell’s The tipping point. From the Amazon description: The tipping point is that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire. I’m encouraged by ONE DAY’S headlines from the Microsoft news site, sixteen in all by the time I stopped scrolling. Here are just a few.

            Nine worst foods for your cholesterol.

            Four foods linked to memory loss.

            Is ultraprocessed food causing colon cancer? New study suggests it’s possible.

            Eating these foods lowers dementia risk.

            There is a link between the meat you eat and a chronic disease.

            Cardiologists say these are the worst foods for your heart.

            Ten American favorites that other countries have outlawed.

            Eating processed meats raises type 2 diabetes risk.

            I hope that this plethora of dietary warnings reflects an awareness that the modern Western diet, not aging, is the direct cause of the leading causes of death, especially cardiovascular disease and cancer.

            Another book worth mentioning is the latest edition of The Blue Zones by Dan Buettner. This new version makes for pleasant reading because of its generous use of photographs that reinforce the text. The latter describes the planet’s longest-lived people, whose eating habits and lifestyles are sensible and practical. From Okinawa to Loma Linda, Costa Rica to Greece, Sardinia to Singapore, the commonality is clear: more plant foods, zero processed foods, lifelong physical activity and strong social relationships are the keys to a long, healthy life. What could be simpler?

            Another factor that will hopefully push us past the tipping point is economics. Type 2 diabetes, which was almost nonexistent a little more than a century ago and which is now among the leading causes of death, costs this country more than a third of a trillion dollars a year. Lurking in the political shadows are proposals to tax products containing refined grains and sugar, Draconian measures to be sure, but perhaps inevitable. The old adage, “If you want to get rid of something, tax it” may well apply.

            It will take at least a generation to reverse the unhealthy trends of the past century, but I feel that the tipping point is near.

Carvings December 15, 2024

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In the news

A deadly trend

          There have been several articles in the past couple of months about the rise in colon and rectal (colorectal) cancer among younger persons, even those in their thirties, actually doubling since the 90s. As a result of this trend, some medical authorities now recommend that screening for colorectal cancer should begin at the age of 45, or even earlier.

            The gold standard for the identification of colon cancer is a colonoscopy, not a trivial procedure but hardly a painful or risky one. Even the so-called “bowel prep”, which sometimes requires long sessions sitting on the commode, has become less onerous. New methods of non-invasive screening that identify blood and abnormal DNA in a stool sample are convenient and cost a fraction of that for a colonoscopy.

            I have read several media articles describing this worrisome trend, and those writers who point to diet blame junk or highly processed food. This is probably one cause but more important, I believe, is what is not in the diet: plant food. Everyone is aware that the fiber in fruits and vegetables promotes bowel activity but few understand why that matters. Simply put, when fecal material that may contain cancer-causing substances (carcinogens) stays in prolonged contact with the lining of the colon it may initiate DNA damage that leads to cancer. But there is another factor. Plant foods contain salicylates, one form of which is aspirin. The inflammation-reducing effect of aspirin/salicylates is obvious; we have used it for centuries to reduce the inflammation of infection and injury. Such inflammation promotes cancer, and it may explain why vegans are at lower risk of colorectal cancer than consumers of the Standard American Diet (SAD).

            Young persons are notoriously lax in their intake of fruits and vegetables. The average teenager eats less than one serving per day – a documented 0.9 servings – instead of the recommended ten, thus losing out on the myriad of nutrients such as vitamins, minerals and phytonutrients that our bodies have evolved to require.

            We can seriously slow down this cancer surge by making some simple dietary changes, educating people about the nature of the disease and promoting early screening. Is that asking too much?

Lifestyle

Pizza – the good, the bad and the ugly

            Would it surprise you to learn that I consider pizza a health food? With caveats, of course.

            First – the good. The toppings make all the difference. The crust, usually made of refined flour, is not a great source of nutrients but the (usually) most common topping is tomato sauce, sometimes with chunks of tomato as well. Cooking tomato enhances the absorption of lycopene, a carotene, and some studies have shown that it reduces the risk of cardiovascular disease and prostate cancer.

            Other nutritious toppings include bell pepper, which is rich in antioxidants, and onions, which are also rich in antioxidants and may be helpful in preventing cancer. Mushrooms are a good source of vitamin D and are known to improve immune function, possibly because of the vitamin D content and numerous phytonutrients. Olives are a Mediterranean staple for a good reason. They are rich in monounsaturated fats and vitamin E; the latter is associated with a documented reduced risk of osteoporosis. Eggplant, very much underappreciated, is rich in vitamins and antioxidants. Pineapple is a newcomer to the pizza world but it is rich in fiber. And of course, there is garlic, whose cardiovascular and anticancer benefits have been studied for decades.

            The bad: cheese (Sorry!) The amount of cheese on a single slice of American pizza would be enough for a Mediterranean family of four for a couple of days, because they use it only as a garnish, not as a main meal ingredient. You’ll find a standard serving of cheese in only two slices, with plenty of saturated fat. And if you’ve wondered why you’re so thirsty after eating pizza it’s because of the salt. A single slice of pizza contains more than 500 milligrams of sodium, so two slices (without the sausage or pepperoni) will provide you with nearly half of the recommended dietary allowance. Is it any wonder why more than half of Americans have high blood pressure?

            Pizza without cheese?? No way! But if you ask for half the usual amount of cheese, you’ll still enjoy the full flavor of America’s favorite comfort food, and if you ask for a “no cheese pizza” you’ll certainly confuse your server but you’ll still enjoy it if you add all those other veggie toppings.

            The ugly: sausage and pepperoni. These processed meat products have been classified by the World Health Organization as a Group 1 carcinogen, and strongly associated with cancer of the stomach and colon. Their high concentration of nitrites and nitrates has the European Union pushing for their reduction in food products.

            Putting pizza in perspective. As mentioned above, the toppings make all the difference. Ask for lots of the good, less of the bad, and none of the ugly.

            And here’s a bonus for readers in San Diego’s North County: Jay’s Gourmet Restaurant in Carlsbad (at the intersection of Carlsbad Village Drive and Carlsbad Boulevard), has the best pizza in town: seafood pizza loaded with fish, scallops, mussels, calamari and clams. All excellent sources of lean protein and omga-3 fatty acids. You’ll never again miss the pepperoni.

Carvings December 1, 2024

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            The outbreak of the week – what’s going on?

            Ground beef, onions, sprouts, carrots, cantaloupe, eggs – is anything safe? The short answer is “No.” Any food product can be contaminated with bacteria such as E. coli, Salmonella and Listeria – they are simply part of our environment. The good news is that we can avoid becoming ill from these organisms by taking a few simple steps.

            It’s a fact of life that most of the animals that we depend on for food are swarming with bacteria, most of which are harmless but some of which can be deadly, especially for the very young, the very old, and those with medical conditions that weaken their immune systems. Depending on the local circumstances, about 40 percent of chickens are contaminated with Salmonella bacteria; for beef it’s a similar percentage that is contaminated with E. coli. Listeria bacteria, which are especially dangerous for pregnant women and small infants, contaminate a wide variety of plant foods.

            Thorough cooking provides the best defense against contaminated chicken, beef or shellfish. As much as you might enjoy steak tartare or raw oysters, those foods carry some risk. So do bean sprouts, which are often served raw on salads or sandwiches. If you serve bean sprouts at home, make sure that they’re fresh, keep them refrigerated and cook them thoroughly.

            All fruits should be washed thoroughly as soon as you bring them home from the market or fruit stand. I always use soap and ignore the questionable advice of some nutritionists who warn us about the chemicals in soap. Bah! Just be sure that you rinse them thoroughly. Be particularly assiduous about cantaloupe – that rough skin makes it hard to remove bad bacteria. The knife with which you cut melons or other fruit can carry bacteria into it.

            Buying pre-cut fruit is not a great idea. Aside from the possibility that the preparers might not follow good hygiene practices, if it has been sitting in the cooler for several hours that allows bacteria to grow and gather in greater numbers. The “convenience” isn’t worth the risk.

            About 45 million Americans become ill from contaminated food each year. You can avoid being one of them.

Lifestyle

            What to do about leg cramps?

            Almost everyone gets leg cramps, usually in the calf. They have a myriad of causes and there is no simple way to prevent them or to provide immediate relief, but there are some things to consider.

            If you get leg cramps frequently, several times a month, or if muscles in other parts of the body cramp up, that’s an indication for a thorough medical exam. If there is local swelling, or the pain is persistent, don’t delay. I have consistently recommended that everyone should have a thorough physical exam and basic blood tests every year, especially after the age of 40, because conditions such as high blood pressure, kidney disease and diabetes show no symptoms until significant damage has occurred.

Dehydration is a common but subtle condition, especially among seniors, and it may be the cause of leg cramps. Be sure to have at least one glass of water between dinner and bedtime. (Yes, I know – that probably means at least one visit to the bathroom at night but it’s a small price to pay.)

As soon as you feel a cramp starting, get up immediately, stretch the calf by leaning forward flat-footed or by pulling your toes toward you, or by massaging the calf. Sometimes chewing on one or two Tums tablets will relieve the cramp almost immediately, so have a bottle of Tums handy if that seems to have worked for you. Standing on a cold tile floor may also help; sometimes walking around provides relief.

A variety of vitamin and mineral inadequacies have been blamed for leg cramps but there is no nutrient that seems to work consistently. The Standard American Diet (SAD!) is so poor that even the American Medical Association advocates a multivitamin/multimineral supplement for everyone. Whole grains, fruits and vegetables, especially leafy greens, should be part of everyone’s daily diet.

If you have had good results with anything that I have not mentioned here, feel free to share your experience with me at drphilg@cox.net.

Carvings November 1, 2024

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In the news

The resurgence of tuberculosis. Should we worry?

            During the 19th century tuberculosis (TB) was the leading cause of death throughout the world. Three of my own grandparents died of the disease and the fourth undoubtedly had it, as did many, if not most of the population of that era. 

            Although the bacterium responsible for TB can invade any part of the body, it usually affects the lungs, producing a chronic cough that allows it to spread continually to others, especially in crowded conditions. In healthy persons who become infected, only 5-10% will develop actual disease. Most infected persons recover naturally but the organism commonly finds sanctuary in the lungs, staying viable, and breaking free when the host’s immune system falters because of age, poor nutrition, HIV infection, chemotherapy or a variety of other factors.

Tuberculosis is a disease of the poor, as evidenced by the huge number of cases in Africa and Asia. Fewer than 20,000 cases occur annually in the United States and the majority of these victims were born outside of this country. Now that the COVID pandemic has subsided TB has regained its place as the leading infectious cause of death worldwide.

Why are so many health authorities concerned? A major source of anxiety is the fact that in developing countries the uncontrolled use of anti-tuberculosis drugs has led to strains that are resistant to nearly all currently available antibiotics. Millions of persons cross our borders each year as visitors, students, documented workers and those who arrive without permission, most of whom come from countries where tuberculosis is present in at least a quarter of the population.

Persons born in this country are at low risk of infection and even lower risk of illness. The classic hallmarks of the disease are persistent cough, fever, nightsweats, weight loss and bloody sputum. Disease can occur with milder symptoms, and all persons who work in the healthcare field, or with children or the elderly, should receive a tuberculosis skin test every year. 

Lifestyle

Cold season is here. Do supplements help you to avoid them or shorten them?

            It’s likely that you will endure one or two colds this winter. For those of you who are old enough to be on Medicare it should be a little consolation that your decades of encounters with a variety of cold viruses have left you with some degree of immunity, and if we take steps to maintain our immune system and overall health, we are far less likely to experience as many colds as our grand- and great-grandchildren.

            There are many supplements that have been touted over the years as cold preventatives or modifiers, including vitamin C, elderberry, zinc, garlic, echinacea, etc. That there are so many should be a clue that there is no magic bullet among them. Many studies have been poorly done but their “results” have found enthusiastic audiences notwithstanding. On the other hand, some quality studies have found value from certain supplements but none has been very significant. Shortening cold symptoms for half a day may be statistically accurate but practically useless. On the other hand real benefit has been found when persons are deficient in the supplement in question, e.g. zinc, vitamin C, vitamin D.

            The best cold preventative is a healthy diet, rich in antioxidants, plenty of fruits and vegetables, whole grains and omega-3 fish oil.

            And a little red wine, of course.

Carvings October 15, 2024

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In the news

Don’t trust the COVID vaccine? Okay, but don’t let that keep you from getting the vaccines you need.

            A University of Pennsylvania study describes three major misconceptions that Americans hold about the COVID vaccine:

            COVID vaccines have contributed to thousands of deaths.

            Getting COVID is less risky than getting the COVID vaccine.

            COVID vaccines will change your DNA.

            Although these beliefs are incorrect, they carry strong emotional weight with lots of people, so I won’t bother to address them further. However, beliefs such as this and the vile theory that the MMR vaccine causes autism have dissuaded many parents from giving their children basic childhood vaccines, and kept adults from getting the vaccines they need to prevent death or serious illness.

            Hundreds of cases of measles and thousands of cases of pertussis (whooping cough) have occurred in the past few years because of poor compliance with childhood vaccination guidelines. I have a deep fear that it’s only a matter of time before we begin to see two diseases that I saw many times in my early, pre-vaccine pediatric career – Hemophilus influenzae meningitis and epiglottitis. The latter is a swiftly moving, often deadly infection.

            Some adults are reluctant to get two vaccines that are intended for them, the pneumococcal and shingles vaccines. The former prevents what was once a common cause of pneumonia, especially among the elderly, and I have seen the consequences of shingles – blindness and near-constant, severe pain.

            I addressed the influenza vaccine in earlier posts. I remind you that the flu season is underway and the virus is circulating in San Diego. Be warned.

Lifestyle

            In the course of grocery shopping at Albertson’s and Walmart last week I again had to run the gauntlet of cookies and cakes, augmented by Halloween sweets, cleverly positioned to greet shoppers as they enter the store. A reminder that much of the American diet is obesogenic and diabetogenic. With the holiday season little more than a month away it’s time to strengthen our mindset to avoid, or at least limit, the foods that provide us with energy and nothing else. I’d like to share a couple of steps that I have taken to bolster that resolve.

            At a banquet a couple of days ago the table was set with a healthy-looking salad, alongside which was a scrumptious-looking chocolate dessert – a genuine work of art. Knowing that I won’t always be able to resist the temptation in the coming weeks, I gave my resolve a kick-start by leaving it alone.

            Today’s lunch at the old folks’ home in which I reside included a seafood club sandwich. I asked them to leave out the bacon. I do have to admit that I missed it!

            Caring friends will soon stop by with plates and boxes of Christmas cookies, etc. It’s OK to have a taste and to toss the rest in the trash a week later. (Wow! Did Phil really say that?) Better there than on your waistline.

            Go ahead and have as much as you want at Thanksgiving. After all, it is a Feast Day!

            I hope that this short list will have given you some ideas as we enter our overly tempting holiday season. But it’s okay to enjoy some of these treats that only come along once a year. (Note the word “some” in that last sentence.)

Carvings October 1, 2024

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In the News

The flu season begins today

          Today marks the official start of the influenza season and this post is a reminder that it should be a top priority for everyone, especially those of us who are old enough to be on Medicare.

From a prior post: The influenza vaccines that have been developed over the last half-century are far from perfect, but to quote an old saw: “The perfect is the enemy of the good.” Some vaccines have low efficiency, perhaps about 25 percent, but some are much better and it will take a few months before we know how effective the latest version is. As I have noted numerous times over the past several decades, the flu vaccine might not keep you from getting that disease but the evidence has been consistent that it will keep you out of the hospital, and from dying. Remember that influenza weakens the immune system, which is why nearly all influenza-related deaths are not due to the virus itself but to secondary bacterial invaders, many of which are now resistant to almost all antibiotics. The problem of antibiotic-resistant bacteria continues to worsen and many of these are circulating in hospitals.

           Another benefit: a nine-year study involving more than four million adults showed that the influenza vaccine reduced the incidence of all forms of stroke by about 25 percent. Previous research indicated that there is a similar reduction in heart attacks in vaccinees. Conversely, there is a significantly greater risk of heart attack and stroke following natural influenza virus infection.

            As of this week there is almost no influenza activity in the U.S., but you should plan on getting the vaccine no later than the end of October. It remains effective for about six months, which will take you through the end of the flu season in the Spring.

Lifestyle

Vitamin C deficiency versus inadequacy

            If your car runs out of gas (deficiency) it stops. If you fill the tank with poor quality gas it will sputter and barely make it up a steep grade (inadequacy). A publication in the journal Nutrients revealed that the same concept applies to vitamin C.

            Scurvy is a debilitating and often fatal disease caused by an absolute deficiency of vitamin C and was the scourge of seafarers until a British naval physician convinced the admiralty to provision its ships with fruit, especially citrus (hence “limeys”, a term describing British sailors). The Nutrients article notes that persons with inadequate levels of vitamin C are 2.3 times more likely to suffer from coronary artery disease than those with normal levels.

            During the recent pandemic it was noted that severe, sometimes fatal infections were associated with “vitamin C deficiency”. (Note: even researchers misuse the term “deficiency” when they really mean “inadequacy”, as embarrassingly noted in the article.)

            Vitamin C is a critical nutrient that helps to control inflammation, which is a driver not only of heart disease, but also of cancer, stroke and osteoporosis, among other maladies. Further, it is necessary for the proper maintenance of connective tissue, the element that literally holds our cells and tissues together. When it fails the result is bleeding in the gums and other tissues, tooth loss, neurologic disorders, weakness and death – the hallmarks of scurvy.

            It’s well-known that organized medicine, with a few exceptions, claims that vitamin supplementation is foolish. Yet a report from the University of Colorado points to the occurrence of frank scurvy among children, most of whom have poor eating habits. Those researchers also observe that the nutrient value of today’s mega-farmed plant foods is considerably lower in vitamins, minerals and protein than those grown 75 years ago.

The lesson: vitamin deficiencies are not common but vitamin inadequacies are. Even the American Medical Association, in a pair of landmark publications in 2002, (Journal of the American Medical Association June 19, 2002, Vol. 287, No. 23, P. 3127) urged that everyone should take a multivitamin/multimineral every day, a position completely opposite that of earlier recommendations and sadly still espoused by some physicians today.

Carvings September 1, 2024

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In the news

Salmonella with a twist

            A couple of times over past several years I have written about the spread of Salmonella bacteria, which cause simple diarrhea in most people but that can be fatal in small children, elderly persons and those with compromised immune systems. A large number of outbreaks as well as random cases have been associated with those little three-inch novelty turtles that kids love to fondle and kiss. Interstate shipment of these critters has been banned for decades but now there are some new players in the game: bearded dragons.

            Exotic pets are nothing new. I remember having a horned toad, for which I traded a neckerchief slide at a national Boy Scout jamboree about 75 years ago. Unfortunately, or perhaps fortunately, the poor thing died before I got back home. It was also too ugly to kiss, which might have spared me a bout of abdominal cramps and diarrhea.

            A very high percentage of reptiles and amphibians regularly have various species of Salmonella in their droppings. So do birds, which are evolutionarily related to reptiles. Their aquariums, terrariums, cages and pens are coated with a layer of Salmonella, even if those items appear to be clean.

            Toddlers should be kept away from all these animals. CDC guidelines recommend that anyone touching them (the animals, not the toddlers) should wash their hands thoroughly with soap and water before touching anything else. That’s good advice, but better advice is to not have these kinds of pets in the home in the first place.

Lifestyle

To veg or not to veg

            A diet that consists almost entirely of plant foods is overwhelmingly more healthful than one that contains lots of meat, but all vegetarian diets are not the same. That is especially true when young people, who are not inclined to seek the advice of their elders, decide to  “go vegan” , a choice that may leave them with serious deficiencies.

            A purely vegan diet is likely to be deficient in two major nutrients: protein and vitamin B12. It takes careful menu planning to avoid protein deficiency and strict vegans must take a vitamin B12 supplement in order to avoid pernicious anemia and permanent damage to the nervous system. Vitamin B12 is found only in foods of animal origin and swallowing an occasional bug with your salad won’t get the job done.

            A strict vegan diet may lead to fractures, including a more than two-fold increased risk of hip fracture. The problem may be related to a deficiency of certain amino acids, even in the face of a normal total protein intake. It has been noted in a study from Europe that 16.5% of vegan men and 8.1% of vegan women had a diet that was deficient in protein.

            For those who are determined to avoid red meat, several servings a week of fowl, seafood and eggs will provide all the amino acids necessary for maintaining good health. If these sources of protein are not acceptable, be sure to get the advice of a nutritionist.