Tag Archives: health

Carvings December 1, 2024

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In the news

            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 July 15, 2024

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In the news

Increasing rates of colon cancer in young persons

          In less than a generation – from the year 2000 to 2023 – the incidence of colon cancer in persons below the age of 40 has doubled or tripled in some parts of the world. Colon cancer is one of the most common forms of cancer, not far behind number one, lung cancer. Three main causes of this increase have been emerging in the past few years: increased sugar consumption, low intake of fiber, and taurine, an ingredient in energy drinks. All three are associated with disruption of the good germs that inhabit the large intestine, the site of colon cancer.

            A diet that is high in sugar and low in fiber tends to promote the growth of organisms that are linked to increased inflammation, a factor that increases the formation of cancer cells, and in addition increases the risk of heart disease, stroke, diabetes and osteoporosis. Younger persons have a high intake of energy drinks that contain taurine, an ingredient that further promotes the growth of bacteria that promote inflammation. Young persons also have an abysmally low intake of fiber. Instead of the recommended 10 servings a day of fiber-rich plant foods, the average teenager gets less than ONE serving a day, most likely to be iceberg lettuce, a nearly worthless “vegetable.”

            About half of the adolescent population consumes one or more energy drinks every day. This does not bode well for the health of our population by mid-century.

Lifestyle

Are you a food label reader? Two reasons why you should be.

            Some food manufacturers deliberately mislead buyers and they have government’s permission to do so. Perhaps the most egregious example is the deceptive listing of “sugar” to make it look like there’s not as much of it in that product as you might think.

            Food manufacturers are required to list ingredients in order of weight and if they listed the amount of sugar in many foods you might put them back on the shelf. So if they are allowed to list every different type of sugar in pastry, for example, each ingredient would be farther down the list and thus appear to be less detrimental to your health. For example, the nutrient label on a popular supermarket’s almond bear claw coffee cake contains the following TEN different kinds of sugar, each listed separately: sugar, almond paste (which contains sugar), corn syrup, fructose, dextrose (also known as glucose), sucrose, invert sugar (a mixture of glucose and fructose), cornstarch (which breaks down into sugar), maltodextrin and high-fructose corn syrup. Some manufacturers even list glucose and dextrose as separate entities, even though they are one and the same. Except for the relatively small amounts of fructose and glucose found in fruit, none of the other forms were part of the human diet until a couple of hundred years ago. Today the average American takes in approximately one pound of sugar a week – 57 pounds a year. Is it any wonder that more than 80 percent of Americans are either overweight or obese?

            When you pick up a loaf of bread you might think that anything with a brown color is more healthy than white bread. Not necessarily, unless whole wheat or whole grain flour is the only ingredient. The term enriched flour means white flour and some breads have both, suggesting a healthy choice, and there might be much more white flour than brown. On the other hand, the brown color might be due to the addition of molasses, caramel, coffee or cocoa.

            Learn to read labels. It’s not rocket science!

Carvings July 1, 2024

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Too old? Not!

            My fitness center is a busy place. That’s good. I’m delighted to see scores of people working out regularly, most of whom appear to be in their twenties or thirties. The bad news: most of them appear to be in their twenties or thirties. It shouldn’t be that way. Considering that a) the chronic non-infectious diseases that lead to roughly 90 percent of deaths in the U.S. mostly affect persons of retirement age, b) regular exercise can postpone, modify or even eliminate the ten leading causes of death and c) that retired folks by definition have lots of time on their hands, they should vastly outnumber the kids.

            Since moving to an old folks’ home, euphemistically called a senior facility, I am dismayed that the fitness center here, literally across the hall from my apartment, stands empty almost all the time. I do not exaggerate when I note that in the past eight months since my arrival, I have not seen it in use more than ten times. (Disclosure: I never use it either because I prefer the fitness center about a mile away, where the equipment and the scenery are much better.)

            The average American gains about one pound a year between graduation from college and enrolling in Medicare. A pound isn’t much but that comes to about 30 pounds by age 65, and that’s where most Americans are; more than 80 percent of us are either overweight or obese.

            Exercise, of course, is only half the story. Most of us just eat more than we need to. But regular exercise offers more benefits than simply keeping our weight in the normal range. The immune system gets a boost not only from exercise itself, but as body weight increases, immune function decreases. Nowhere was this more clearly shown than in the recent pandemic, where the vast majority of deaths occurred in persons who were obese, diabetic, hypertensive and afflicted with coronary artery disease. Age is clearly not the problem. More than a score of centenarians survived COVID-19.

            Age is no excuse to avoid exercise and being physically active, and the Senior Olympics offer us wonderful examples. For instance, in recent years, an 85-year-old took first place in the pole vault. An 86-year-old won the triple jump and the long jump and took third in the 100- and 200-meter dash. A 97-year-old with osteoporosis won the 1500-meter run. My hero is Ruth Frith, whose shot put went 13 feet, 4 inches when she was 100 years old!

            One of my personal heroes is a friend who celebrated his 81st  birthday by doing 81 push-ups!

            The bottom line: no one is too old to exercise.

Carvings June 1, 2024

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In the news

More confusing research

          The last thirty years or so have seen a surge in publications touting the benefits of omega-3 fats in preventing heart disease and stroke. There have been a few studies that claim no benefit, but almost none have stated that these nutrients can be detrimental to heart health. A recent study from the UK reported that persons with poor heart health did receive benefits from omega-3s but previously healthy persons had a small (6 percent) risk of developing atrial fibrillation, a heart attack, heart failure or stroke.

          Even though this was a large study involving more than 400,000 people, it was observational and did not show direct causation. The authors noted that a limitation of the study was the lack of information regarding the dose and type of fish oil consumed. Takers of fish oil were significantly more likely to be elderly, which could be a factor in more of them developing atrial fibrillation.

          Although healthy persons taking fish oil supplements were more likely to develop heart disease, they were less likely to die than non-takers. The authors’ discussion did not take into consideration other benefits of omega-3 fats, including the lowering of inflammation, reduction in blood pressure, improvement in immune function and a lower risk of sudden cardiac arrest. A circuitous benefit of omega-3 fats is their role in preventing osteoporosis. A fall in an elderly person that results in a fracture leads indirectly to death, especially when that fracture involves the hip or the skull, for very different reasons.

          In an associated commentary, a nutritionist stated that she still recommends an intake of 500 milligrams of omega-3 fats per day, from fish, fish oil or a combination of the two.

And so we come to sardines!

          Sardines are one of the most beneficial foods on the planet, but I can already hear you say “Ugh! Not for me!” From my lecture experience I am well aware that Americans are about evenly split between sardine lovers and sardine haters. An Internet search will come up with nearly 100 recipes for sardine dishes, although I will admit that “sardine pie” did not excite me.

          Because sardines are so low on the food chain there is virtually no risk of mercury contamination that is a challenge in large fish such as tuna. A single four-ounce serving provides more than the recommended amount of omega-3s mentioned above, a fourth of your calcium requirements and as much iron as a hamburger. Canned sardines are convenient, can be stored almost forever and are a whole lot cheaper than beef or larger fish.

Carvings May 1, 2024

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In the news

Walk, don’t run!

          “Running is not exercise; running is a sport.” I have repeated that comment over the years and I have taken a bit of flak as a result. No matter. I have thick skin and I can back up my statement. My follow-up: You can get hurt in a sport. You can’t hurt yourself exercising as long as you do it right.

            Runner’s knee is a common medical term. Walker’s knee not so much. Stress fractures and shin splints are much more common among runners.

            Several studies over the years have indicated that walking confers nearly the same health and longevity benefits as running does. Running is more efficient for humans than walking, since evolution has made humans excellent runners, but that’s where an advantage lies for walking as an exercise. Although it seems counterintuitive, walking, being less efficient than running, requires a greater expenditure of calories per mile. (Note: this is a much-argued issue and involves several factors that make comparisons difficult.)

             Not all studies account for the fact that runners usually have a different lifestyle than walkers. The former are more likely to have other good habits such as engaging in resistance exercise, i.e.., lifting weights and eating a better diet. Runners are less likely to be overweight and thus avoid its consequences, such as heart disease and type 2 diabetes.

            Although walking is an excellent exercise for the heart and lungs, it’s not enough. We need resistance exercises, especially for the upper body, in order to maintain strong bones.

            A caveat: do not carry hand weights while walking. That was a common practice in the 70s but it has been shown to lead to problems involving the elbow and shoulder joints, and the spine. Swinging hand weights also can throw you off balance, leading to falls.

            If you enjoy running, by all means do so. The endorphin rush adds a great deal to that enjoyment. But if your goal is to attain overall good health, walking about 2 ½ hours per week, the current recommendation, it means only 30 minutes a day, and it doesn’t have be done all at once.

Lifestyle

The return of the Saturday night bath?

            Stone Agers never bathed, except maybe by accident, just as animals don’t. (Ever try bathing a cat?) As the trend to bathe seldom or never picks up speed, especially among Californians (!) some serious research is being done to determine the advantages and disadvantages of bathing every day.

            I must admit that this question has been of interest to me since I began researching the lifestyles of Stone Agers, who were considerably healthier than those of us who live in the 21st century. (I can already visualize the raised eyebrows among you.) Consider that humans who lived 30,000 years or so ago had no coronary artery disease, hypertension, type 2 diabetes or osteoporosis, nor were their lives shortened by alcohol, tobacco or drugs. We know that from studying modern hunter-gatherers who live as their Stone Age ancestors did, and who are entirely free of these diseases. It seems extremely unlikely that those ancient people bathed any more frequently than the animals that they ate – or who ate them.

            I didn’t take my first shower until I was seven years old when my parents moved to a house that had one. Until then my parents, my sister and I had a bath on Saturday night. (Yes, we did change the water!) I can’t recall that any of us had skin problems, nor do I recall that we smelled bad.

            Bathing every day does have some adverse effects but it isn’t clear that this is significantly detrimental to our health. No-bath proponents point out that nature coats our skin with natural oils and a layer of beneficial bacteria, both of which we remove with soap and hot water. The oils protect our skin from drying out and forming micro-cracks that allow harmful germs to enter. Those “good” bacteria ward off harmful ones and stimulate our immune system. Dermatologists have speculated for decades that harmful chemicals and heavy metals enter our bodies during a bath or shower.

            My personal opinion is that daily bathing is not necessary, that going shower-free two or three days a week might be of some benefit, and that a little deodorant on those days will eliminate the phew factor. Of course, showering is obviously needed after a sweaty workout or a busy day in the garden.

            A caveat: In contrast to a body wash, handwashing should be done several times a day, especially before eating anything and after elimination.