In the news

Vaccine benefits that most people are unaware of.

          The United States may soon lose its measles-free status as we are close to a record number of measles cases. Almost all the victims have not been immunized at all. Outbreaks are occurring because of the arrival of infected persons from other countries. Besides saving lives through the near-universal immunization of our population we ought to consider some unexpected benefits of vaccines.

As we age we are vulnerable to heart attack and stroke but persons who receive the influenza vaccine lower their risk of these killers in the months that follow vaccination. On the other hand, persons who develop influenza have an increased risk of heart attack and stroke in the six months or so following infection. The flu season has begun. The current vaccine’s effectiveness is unproven but if it follows the pattern of the past, even though it is not completely protective it does lower the risk of hospitalization – and a hospital, with all those superbugs, is NOT the place to be for us seniors.

Rotavirus infection causes diarrhea in children and it is a major cause of death in developing countries. America’s kids are safer because of the quality of our medical care but those who receive the rotavirus vaccine get another benefit: a lower risk of type 1 diabetes. Formerly known as juvenile diabetes because most of its victims are below the age of 20 years, it is often triggered by an infection. Before the development of the mumps vaccine that infection was often the prelude to type 1 diabetes. It looks like rotavirus may also predispose to type 1 diabetes in persons with a familial tendency for that disease. Victims of type 1 diabetes require daily insulin for the rest of their lives. It’s great to know that some people can be spared that burden by preventing one of its causes .


Is the Keto Diet worth trying?

When you drastically reduce carbohydrates in your diet your body will begin to burn fat for energy, making you lose weight. That makes sense and most people will lose weight on the keto diet in the first few weeks. After that, not so much.

Pediatricians began putting kids on the ketogenic diet about a century ago to control epileptic seizures, as they were known back then. It often worked but it drove the parents crazy! Trying to keep a child on a diet that consisted largely of cream, bacon and similar foods while eliminating bread, cookies, fruit and sweets, etc., while the rest of the family enjoyed these things resulted in the kind of battle you could predict.

Dr. Robert Atkins’ low-carbohydrate diet was immensely popular a couple of decades ago but it was really hard to maintain for long, and controlled studies showed that after a year or so it was no better than other fad diets. The typical adherent lost an average of twelve pounds in twelve months. As my kids would say: “Big whoopee!”

The ketogenic diet is back, but this time in so many forms that confusion is rampant. There is no official definition and “low-carb” can range from 20 to 60 grams a day of carbohydrate. Hardly anyone can stay on that kind of diet for long and if they do they are likely to encounter the classic symptoms of ketosis: fatigue, bad breath, constipation or diarrhea, nausea, vomiting, muscle cramps, headaches and difficulty falling asleep.

One slice of whole wheat bread and a glass of milk will put you over the limit of carbs for the day, so will a single banana. One apple plus a serving of Trader Joe’s low-fat Greek yogurt will too.

Now we’re learning that those who maintain a ketogenic diet – which includes some not-so-healthy stuff like red meat, processed meats, salty foods, cheese, processed oils, etc. and few healthy items like most fruits and vegetables — have a lower life expectancy. A recently associated risk is atrial fibrillation, which can lead to stroke.

My choice of diets is the true Mediterranean diet, which includes fruits, vegetables, a little pasta, fish, chicken and of course, a glass of red wine!



Upcoming presentation

Friday September 13th at 1:00 p.m. at the Temecula Learning Center.  Avoid the annoyances of aging. Growing older is inevitable but many of the physical and mental challenges that seniors face are not. More than twenty such topics that range from decreased energy to liver spots, irregular sleep to poor memory can be postponed or even avoided completely. Sponsored by Osher Lifelong Learning Center. To register see their web site at or call 800-500-9377.

In the news

A recent study involving more than 23,000 people from Norway who were followed for two decades confirmed what we have been preaching for many years: folks who exercise live a lot longer than those who don’t. Couch potatoes had an overall death rate more than twice as high as exercisers and nearly THREE times the risk of dying from heart disease.

Two particularly interesting points came out of this study. First the amount of exercise: 2 and ½ hours of moderate exercise a week, that’s enough to break out a sweat, did the trick. Those who had really intense aerobic exercise (running, biking, swimming, etc.) for only an hour and a quarter a week saw the same good results. (Note – that’s what the statisticians found but such infrequent, intense exercise is not very practical and hard to maintain on a regular basis.)

A really interesting finding was that persons who were inactive but got religion and got the optimal amount of exercise on a regular basis got real results – a life expectancy increase between that of non-exercisers and moderate exercisers.

The take-home message? All exercise matters even if you are a late starter and it doesn’t take a long daily workout to become healthier

What this study didn’t address but others have – exercisers simply have more comfortable lives, with less shortness of breath, fatigue, loss of energy, arthritis, depression and stronger immune systems. What’s that worth?


Your mother was right! Eating slowly is better for you but not for the reasons I heard when I was a kid: “Don’t eat so fast! You’ll choke on your food.” “It’ll make you sick.” Well, that second part was right but the sickness would take years, even decades to develop.

When we eat fast we eat more. That’s because it takes about 15 or 20 minutes for our hard-wired appetite-control mechanism to let us know that we’ve eaten enough. It was once thought that this was a simple mechanism brought into play by a hormone called cholecystokinin that was released when the stomach was full. We should have known! Nothing is really that simple in matters of biology. Scientists now know that there are several mechanisms, some regulated by hormone-like chemicals that control appetite.

Some of this came to light after lots of people had a portion of the stomach removed to lose weight. They didn’t get as hungry as they should have when portion sizes were limited to something about the size of a golf ball. The part of the stomach that had been removed contained cells that produced one of the hunger-causing hormones.

The bottom line: follow Mom’s advice and eat slowly. You’ll end up eating less, especially if your meals consist largely of fiber-rich vegetables.


In the news

Never microwave eggs!! And watch those tea bags!

Microwave ovens have been around so long that perhaps some younger persons aren’t aware of the hazards that are associated with them. An example is the story about the 22-year old woman in the U.K. who suffered painful face burns when she made hard-boiled eggs in the microwave, following directions on a recipe website.

The website advised adding salt to the cooking water to prevent bursting. Nope! Microwaving a raw egg in the shell or a hard-boiled egg that has had the shell removed is dangerous. Either can explode after they have been removed from the oven. BTW – that “salted water” recipe is still on the Internet.

Does poking a hole in one end of the shell make it safe? Maybe, but there is also a problem with the yolk, which might still explode because it has a membrane around it. Some recipes advise poking a hole in the yolk after breaking the egg into a microwave-safe container. Others recommend poking several holes into the yolk AND the white (???). I found one recipe that suggests placing plastic wrap over the open container – another bad idea. Some plastic wrap is labeled “microwave safe” but even then it shouldn’t be in contact with the food.

And about those tea bags. When you boil water for tea in a microwave it gets superheated and when you touch the tea bag to the surface of the water in your cup it may erupt. (Ask me how I know!) Several people have suffered serious burns as a result – I was lucky.

FYI – microwave cooking was discovered by accident when an engineer working near a radar transmitter noted that a Mr. Goodbar in his shirt pocket melted during an experiment. And the second food they cooked in a newly-invented microwave oven was an egg – that exploded in an engineer’s face!!



DOMS – Delayed Onset Muscle Soreness

       Is it pain or just soreness? When you work a muscle hard, especially if it’s the first time in a long while, you know how sore it feels the next day and possibly for several days. That is normal and it is known as Delayed Onset Muscle Soreness (DOMS). You can avoid it if you begin an exercise program – or a new type of exercise – with very low weight. I recommend that you go through a routine with no weight at all in your hands for at least two weeks to open up existing blood vessels and grow new ones. Walkers and runners should start with low speeds and short distances. That won’t completely eliminate DOMS but it sure will help.

The specific reason for starting with light weights and walking for only a few minutes is that you will rupture (yes – rupture) only a few muscle cells, so that there won’t be much pain. “Rupture” is meant in the healthy sense because by breaking down muscle cells it will lead to their regrowth that makes them larger and stronger.

Pain is different from soreness. It sometimes comes on suddenly during or after an exercise, and it’s usually asymmetric – involving only one side of the body, e.g., one shoulder.

Do not try to “work through” DOMS or pain. In the former it’s just not worth the discomfort and in the latter you are likely to make the injury worse.












Upcoming presentations

Saturday, August 17th, 2:00 p.m. at the Encinitas Library, The Health benefits of wine and chocolate. This has been the all-time favorite of my 75 PowerPoint presentations. I wonder why!

Thursday, August 22nd, 1:00, OASIS Center, Grossmont Center. Shingles: how a new vaccine will help you to avoid a condition that will affect many persons who reach their 80s. Sponsored by OASIS. To register see their web site at

In the news

Ultra-processed foods – more of a hazard than you think

The most recent issue of Nutrition Action makes clear what many in the healthcare field have suspected for a couple of decades: our modern diet of highly processed foods contributes to weight gain, type 2 diabetes and all the  conditions that follow from them.

What are ultra-processed foods? You can probably guess: sugary drinks, cookies, pastries, breakfast cereals, flavored yogurt, fish sticks, frozen pizza, sausage, hot dogs, instant soups, ice cream (darn!)

Unprocessed foods include fresh and frozen vegetables, fresh fruit, plain yogurt, poultry, seafood, meat, milk, eggs, beans, pasta (Yay!)

For one month, volunteers lived in a research facility and their keepers measured every bite. They had all the food they wanted. The results were no surprise. The persons who ate ultra-processed foods took in about 500 more calories a day and they gained weight. Ultra-processed food has more sugar and sodium and is easier to chew. Unprocessed food has more fiber, giving the subjects a feeling of fullness – but there’s more! It takes longer to eat unprocessed food, giving the body’s satiety hormones time to kick in.

By gradually switching from ultra-processed foods to the kinds that our grandparents had, we’ll be on our way to good health, leaner, livelier and longer-lived!


What’s with sea salt?

       Sea salt and Himalayan salt have become the darlings of gourmet cooks – and they have become the target of some exaggeration as well.

Salt used in cooking can come from a variety of sources: salt mines tend to produce the plainer stuff. Salt from the sea can include many other things depending on the source and the degree of refinement. Sea salt that is unrefined can contain various trace minerals and even some organic material that gives it the characteristics that cooks look for – texture and flavor. But is it healthier? Probably not, because those trace minerals – “trace” is the tip-off – are present in such small amounts, and we use so little salt in any given dish, that it really doesn’t make as much of a difference in preventing disease as it does in enhancing the flavor of certain foods.

Himalayan salt sounds exotic, but it’s just another variant, with chemical differences that are noticeable but confer no documented health benefits.

Grocery store table salt contains a nutrient that most sea salt and Himalayan salt do not: iodine.  Those of us who are quite long in the tooth can remember friends and neighbors with large swelling of the neck called goiter – massive enlargement of the thyroid gland that furiously tried to make up for a lack of iodine in the diet. That condition vanished when the government mandated that commercial salt had to contain iodine.













Not the usual blog post

Last week Pat and I with three other members of our church community became certified in the Stop the Bleed® program. We are part of a growing number of persons who acknowledge that we face risks that are rare but life-threatening: mass shootings. In the minutes between the time that an assailant has been neutralized and the arrival of the first ambulances, some victims in such attacks have not survived because of severe bleeding.

Shortly after the Sandy Hook tragedy at Newtown, Connecticut, the American College of Surgeons and several federal agencies developed Stop the Bleed®, a program designed to train non-medical persons in the simple steps that can effectively prevent severe loss of blood, the most common cause of death in mass shootings. Bleeding injuries that are sometimes fatal also occur under more ordinary circumstances: workplace accidents, hunting accidents, falls through glass and motor vehicle collisions.

Even the best-trained responders may be limited in what they can do if the proper materials are not immediately available. You are no doubt familiar with wall-mounted cabinets that contain an Automated External Defibrillator (AED) at many public venues such as airports, fitness centers, libraries and medical offices. They are already being paired with similar-looking cabinets that hold public access bleeding control stations that contain dressings, tourniquets and other supplies that can stop serious bleeding quickly.

The shooting that occurred during Passover at the Chabad Synagogue in Poway, just a few miles from our neighborhood, was our wake-up call. Our church now has a Medical Response Team consisting of physicians, nurses, paramedics, EMTs and military corpsmen and medics, all of whom are committed to respond in case of an attack. They will have access within seconds to several caches of medical supplies such as those in bleeding control stations that have been prepositioned at various places in the church buildings.

Stop the Bleed® courses are available throughout the country, usually at no cost. The class lasts only about one hour during which students learn the basic steps of bleeding control: pressure, packing and tourniquet use. Go to where you will find class locations and registration information as well as a detailed description of the program and how it began.

My reason for making this blog post goes beyond the desire to inform you about the Stop the Bleed® program. It’s my hope that those of you with contacts in your community will not only spread this message but will organize teams such as ours in your own faith communities, places of business and schools. I encourage you to pass this blog to everyone you care about.

If you would like more information, feel free to contact me at or 760-732-1414

“The only thing more tragic than a death from bleeding…is a death that could have been prevented.” (From the Stop the Bleed® handbook, What Everyone Should Know to Stop Bleeding after an Injury.)









Upcoming presentations

Wednesday, July 17, Body fat: all that jiggles is not the same. OASIS Grossmont Center, La Mesa 1:00 p.m. Sponsored by OASIS. To register see their web site at 

Saturday, July 20 11:00 a.m. Ten ways to prevent cancer, Penasquitos Library

In the news

Spend some time with nature

A study published last month in the journal Scientific Reports confirmed what health authorities have been telling us for decades: spending time outdoors is good for your health.  We shouldn’t be surprised. After all, humans have lived close to nature for all but the last couple hundred years or so of their existence, first as hunter-gatherers for a few million years and then as farmers for a few thousand. Now that we have central heating, air conditioning and electric lights – and just recently computers and TV – it’s just so comfortable to stay indoors. We have evolved to spend most of our time outdoors and we pay a price for not doing so.

The first thing that comes to mind is vitamin D. It’s important not only to maintain a strong skeleton but we need it for a healthy immune system.  The researchers note that health benefits come from only about two hours a week outdoors – and that will give us plenty of time to make the vitamin D we need – as long as it’s during the day and with no sunscreen, with our head and arms exposed.

Indoor air is not healthy air, for reasons that we don’t have space to delve into in this blog, and breathing outdoor air refreshes our lungs, reducing the risk of asthma, allergies and heart disease. Of course, getting some exercise while you’re outside helps in the matter of heart disease.

Finally, a casual stroll at the beach, at a park or just around the neighborhood reduces stress, decreases blood pressure and improves our sense of well-being.

But you need to leave your cell phone at home!


Floaters and dry eyes

By the time we reach seventy most of us have dry eye syndrome, sometimes to the degree that we need medical help. Some of it is due to aging and our tear production slows down. However, there are some non-natural causes that we can do something about.

Are you getting enough vitamin A? Sweet potatoes, carrots, collard greens, spinach and cantaloupe are good sources but do you get several servings a week? Beef and chicken liver are great sources but they have just about disappeared from the American diet. True vitamin A deficiency is rare in the U.S. but inadequacy may not be.

Some prescriptions medicines such as antihistamines, blood pressure drugs and antidepressants contribute to dry eye syndrome. Hours of computer use and exposure to tobacco smoke also are factors.

Maybe it’s not a single cause. Each of the factors above might add up. In any case, if it’s enough to make you uncomfortable it’s time to see an ophthalmologist.

And about those floaters. They are usually benign and look like dots or webs, sometimes other shapes. As we age – there I go again – fragments of cells or particles of protein drift around inside the eyeball.

Sometimes floaters indicate serious eye problems and should not be ignored. If lots of them appear suddenly, especially if accompanied by flashes of light or changes in your peripheral vision, they may be a sign of retinal detachment, a condition that requires immediate treatment.







In the news

May was Vision Month – Baby Boomers take notice!

Vision is critical to survival so it’s no wonder that we flinch when something comes close to our eyes and that the cornea is so sensitive to any foreign material.

On the other hand, chronic conditions that could lead to severe visual impairment, especially as we get older, often don’t give us any warning symptoms. For that reason everyone should have a vision exam by an ophthalmologist starting at the age of forty; for African-Americans it should start at twenty (!), especially if there is a family history of glaucoma. The reason? Glaucoma can progress with few symptoms until there has been some loss of vision.

Glaucoma is usually – but not always – due to an increase of pressure within the eyeball. It causes a loss of peripheral vision and it may be so gradual that we hardly notice. Persons with diabetes, high blood pressure, overweight and low thyroid function are especially at risk.

In the next Carvings blogs we’ll discuss some other conditions that sneak up on us, and some eye symptoms that actually are signs of serious disease.


Are we and our kids getting too many vaccines?

Most American children get nearly fifty shots – vaccines – by the time they start first grade. Doctors are pushing seniors to get several vaccines as well. The question often comes up: do all those vaccines interfere with each other? Can they actually weaken our immune system? Are they harmful?

It’s true that vaccines sometimes have nasty, even fatal, side effects but deaths are extremely rare and most are due to two reasons. First, some children are born with severely deficient immune systems and when they receive a live vaccine virus their body may be overwhelmed by even such a weakened virus. When most of us were kids we got the smallpox vaccine and did just fine but it was fatal in kids with severe immunodeficiency.

The second reason is now very rare: defective or contaminated vaccines. Some of us remember “the Cutter incident” in which polio vaccine virus was not killed but survived to infect several thousand children. Fifty-six developed paralysis and five died.

Diseases that I saw regularly early in my days as a pediatrician have simply vanished. Today’s pediatricians will probably never see meningitis due to a bacterium known as Hemophilus, encephalitis (inflammation of the brain) due to mumps or chickenpox, congenital rubella syndrome that caused infants to be blind, deaf and severely brain-damaged. They will never see polio, which affected some of my classmates.

Some vaccines have barely a tenth of the chemicals that occur in the natural germs. Some vaccines are prepared in yeast cells; some are made from small portions of benign bacteria. The natural germs that have been eliminated by these vaccines contained orders of magnitude more ingredients than the vaccines.

Do you know of a child who had a severe reaction to something like the measles vaccine? Consider this: that reaction may indicate that the child might have been the one child out of a thousand in the pre-vaccine era who died or suffered severe brain damage from natural measles. That reaction may indicate increased susceptibility.

In the next Carvings blog I’ll discuss vaccines for adults. You’re going to be surprised!