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Living Without Fear
Reasonable Infection
Protection
Personal Hygiene
Enhance Your Immunity
Ask Dr. J: Rapid Heart Rate
In the Health News
Diet and Disease
Recipe of the Month: Polenta
Spinach Lasagna
References
Many thanks for all of the supportive cards
and Emails that you sent after my successful
aortic valve surgery in March. I am happy to
report that I have more energy every day, my
chest pain and discomfort are almost gone, and
my physical stamina is coming back rapidly.
I feel great, am walking longer distances,
and will soon get back to more vigorous exercise,
such as bicycling, rollerblading, and running,
and I am gradually regaining the weight that
I lost while in the hospital. In a few weeks,
I’ll be presenting my usual lectures (about
six hours in two days) at the meeting of the
American College for Advancement in Medicine.
I have addressed this issue before, but with
current world conditions, it is worth considering
again. Although in some ways we live in a dangerous
world, for most people the external dangers
are remote. Yes, we have wars, terrorism, infectious
diseases such as SARS, potential nuclear holocaust,
and chemical and biological weapons, but have
our risks increased much?
When I was growing up, the fear instilled in
us was of a takeover by the Russians, and nuclear
war. I remember the recurrent warnings about
air raids, drills, signs indicating fallout
protection areas in buildings, and the obsession
with building personal protection chambers underground
in case of nuclear war.
With the fall of the Berlin wall and the USSR,
those fears were apparently eliminated or greatly
reduced, but in some ways governments thrive
on perpetuating fear among the governed. In
a timely fashion, new fears have emerged to
take the place of those that have diminished.
I have made a personal decision not to live
in the shadow of these fears, without being
foolhardy in my activities or life decisions.
I do not want to live my life as a captive to
possible but remote threats. This is not because
the threats are not real, but because they are
mostly out of my control, and much less likely
to affect me than those threats from which I
can protect myself through my own decisions.
It is reasonable to take certain precautions,
which I will discuss in the next pages, but
I am still traveling to conferences and for
vacation. I still get together with friends
and meet new people, and I will continue to
explore new places and learn new skills. I will
also protect my physiology and support my immune
system through diet, exercise, stress management,
and dietary supplements, and a positive attitude,
emphasizing activities and relationships that
contribute to personal growth.
You can take good care of yourself, and not
give in to the fears on which newspapers thrive.
These are positive steps that will help protect
you from disasters while enhancing your life.
I have to admit that I am not traveling to Hong
Kong in the near future. Because of the appearance
of SARS, I honestly don’t know what I
would have done if I had had a scheduled conference
in Southeast Asia, but I think I probably would
have postponed it (particularly in light of
my recent surgery!).
As of April 26th, the cumulative cases worldwide
since reporting began in November is about 4800.
Of these, 4500 have been in China, Hong Kong,
Singapore, and Viet Nam. Although there may
be more cases in China that have not been reported,
the risk of SARS in China and surrounding countries
is still quite low (lower than deaths from food
poisoning in the United States alone). The reasons
that SARS instills such fear are that it is
new, apparently untreatable, and unclear as
to how it is transmitted.
The number of reported cases in Japan is only
two, although Japan is surrounded by and does
business with all of the countries with higher
incidences of the disease. Personal hygiene
is particularly important to the Japanese, and
it is one of the best ways to protect yourself
from all infectious diseases. Handwashing and
plumbing in modern society have probably been
more critical to the control of infectious epidemics
than medical treatment and immunizations.
The recent development of alcohol-based, instant
hand sanitizers with skin softening ingredients
has been a great help in hospitals and for individuals
in reducing the transmission of bacteria and
viruses. In one study at an extended care facility,
infections were reduced by 30 percent when hand
sanitizers were introduced in two units, compared
to the other units.
In another study in an acute-care hospital
they taught the patients to use hand cleaners
and also had the staff use them. They found
that urinary tract and wound infections were
reduced by 36 percent in the units using the
hand cleaners compared to baseline levels in
the same units before the introduction of the
sanitizers.
Another common site for infection transmission
is in schools, where large numbers of children
are in close proximity for most of the day.
In one study, instruction of elementary school
children in the use of the hand sanitizers reduced
the rate of absenteeism due to infectious illness
by 50 percent. Other studies show the importance
of handwashing in preventing disease transmission
in food service industries. This is a practical
and effective means of preventing infections.
Carry a small bottle of instant hand cleaner
with you and use it regularly. After touching
surfaces, such as doorknobs and telephones,
be careful not to touch your mouth or eyes before
cleaning.
Food-borne illnesses are other risks worth
considering when you buy your food and prepare
it at home, although with proper care, illness
is unlikely. Having said that, in the U.S. over
5000 people die each year from the millions
of cases of infections. Salmonella and E. coli
are the common food pathogens, mainly on meats,
dairy products, poultry, and fish. These grow
rapidly at room temperature, or worse, in a
hot car.
Be sure to keep your foods refrigerated and
take them home quickly from the grocery. I sometimes
carry a cooler in the car for shopping (I use
insulated “Cool-Tote” bags). If
you eat meats, which I do not recommend, make
sure to prepare them separately from other foods,
and do not put cooked foods back on cutting
boards used for rawfood preparation without
a good washing.
It is good that airlines are disinfecting planes
that have been to SARS-affected countries, but
I would not travel unnecessarily to those areas.
However, it is still only a remote possibility
that you will even contact someone who has SARS,
let alone be affected by it. Nevertheless, even
with a low risk, I would do everything to enhance
immune function with good health practices.
Both aerobic exercise and relaxation practices
enhance immune function. Adequate sleep also
helps, but if you are traveling, sleep is often
disrupted. Melatonin (3 mg) at bedtime reduces
jet lag, and it promotes both sleep and immunity.
Eat whole, natural foods, emphasizing fresh
vegetables, fruits, whole grains, and beans,
plus some seeds and nuts. Eliminate refined
sugar from your diet, as it reduces the effectiveness
of your white blood cells. Excessive alcohol
can disrupt immune function, and caffeine alters
sleep patterns, especially with jet lag.
Common dietary supplements that enhance immunity
include vitamins C (2000 to 10,000 mg) and E
(400 to 800 IU), coenzyme Q10 (100 to 200 mg),
proanthocyanidins (50 to 150 mg), gammalinolenic
acid (GLA, 240 mg), and zinc (30 mg).
Standardized herbs that help include astragalus
(1000 mg), echinacea (500 mg), and mushroom
extracts such as maitake (1000 to 2000 mg),
or beta 1,3 glucan (100 to 200 mg).
Deodorized garlic (1000 mg) not only promotes
healthy immunity, it also has antiviral activity.
Elderberry extract (1000 mg) has antiviral effects,
particularly against influenza, so it might
be valuable against the coronavirus associated
with SARS (a relative of cold viruses).
I would treat any serious viral illness with
high dose intravenous vitamin C, oxidative therapies,
as well as the above health practices and supplements.
No specific treatment exists for SARS, and you
should always consult a physician if you have
any serious disease, but you can only gain by
adding these complementary and alternative treatments
to any other therapy.
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Q. My doctor says I have a rapid heart rate,
called sinus tachycardia, at 114 beats per minute.
He said it was related to anxiety or flu, and
not to worry. What should I do? GV, via Email
A. A rapid heart rate, not related to exercise,
is common with fevers, stress or adrenaline
excess, or pain. If it is temporary, it is probably
nothing to worry about. However, it may be a
sign of some health problems, such as low oxygen
in the blood, anemia, drug side effects, toxicity,
or abnormal mineral levels (such as potassium
or magnesium). If the condition persists, you
might experience palpitations, fatigue, or shortness
of breath, or have no immediate symptoms.
With sinus tachycardia, the beat is regular
and it follows the normal electrical pathway,
but it is just too fast. Relaxation techniques
can be helpful, such as deep breathing, meditation,
visualization, or yoga. Acupuncture can also
control heart rhythms. Regular exercise can
reduce stress, and in the long term it can reduce
the heart rate, as it strengthens the heart
muscle.
A number of dietary supplements help to restore
normal heart rates and rhythm. Magnesium and
potassium are the most important minerals, but
with a healthy whole, natural-food diet, you
should get plenty of potassium. I usually recommend
supplements of magnesium aspartate (500 to 1000
mg). Taurine is an amino acid that can stabilize
heart rate and rhythm. I often recommend 3000
mg daily. In acute heart rate abnormalities,
I administer intravenous magnesium and taurine
with some other nutrients.
Rapid rates are stressful on the heart, so
you want to be sure to protect your heart muscle
while you are controlling your rate. Coenzyme
Q10 (200 to 400 mg) and L-carnitine (3000 mg)
are valuable additions to any heart health program.
Vitamins E (400 IU) and C (2000 to 4000 mg)
reduce the risks of heart disease, as do a variety
of other antioxidants. Ribose (5 to 60 gms),
a 5-carbon sugar essential for cardiac energy,
may also help to protect the heart.
Standardized hawthorn berry extract (500 to
1000 mg) helps with heart arrhythmias as well
as maintaining normal blood pressure.
• Exercise is beneficial for the heart.
However, recent evidence shows that you need
to do vigorous exercise at least part of the
time in order to reduce mortality from heart
disease. A large study of nearly 2000 men in
England (Yu S, et al., What level of physical
activity protects against premature cardiovascular
death?...Heart 2003 May;89(5):502-6.) suggests
that benefits from walking for an hour or more
are inadequate to consistently protect the heart,
while even 10 minutes a day of tennis, jogging,
stair climbing, squash, or heavy digging can
reduce premature death by 47 percent and heart
deaths by 62 percent. While lighter exercise
may be beneficial in a number of ways, including
weight control, you may need to add some vigorous
exercise to achieve maximal protection.
• A new study (Calle EE, et al., Overweight,
obesity, and mortality from cancer... N Engl
J Med 2003 Apr 24;348(17):1625-38.) shows that
obese people are more likely to die of cancer,
specifically, prostate and stomach in men, and
breast, uterus, cervix, and ovary in women,
as well as colon, liver, and pancreas, and others
in both sexes. Another study showed that obese
children have a health-related quality of life
similar to children with cancer. These data
speak for themselves. (Schwimmer JB, et al.,
Health-related quality of life of severely obese
children and adolescents. JAMA 2003 Apr 9;289(14):1813-9.)
• Diet, not genes, are apparently what
protect Japanese men from prostate cancer. American
men have ten times more prostate cancer, but
men born in the USA of Japanese parents have
the Western rate of disease. Japanese eat more
soy and less meat, fat, and processed foods,
and this may be what protects them. (Reuters
Health, Study Suggests Western Diet Tied to
Prostate Cancer, April 28, 2003.)
I use ground corn instead of pasta in this dish.
I grind my corn in a VitaMix, or buy whole corn
grits. Cook it (3 parts water to 1 part corn)
in a crock pot so it needs almost no stirring.
Stir-fry onions, garlic, and some oregano, add
some fresh spinach and some sliced mushrooms,
and cook lightly. Add grilled tomatoes or tomato
sauce and some crumbled tofu. Put a layer of
polenta in a baking dish over a thin layer of
tomato sauce, cover it with the vegetable mix
and some chopped fresh basil, then another layer
of the polenta, and another layer of the veggie
mix. Sprinke a small amount of parmesan or romano
cheese on top as a garnish, if you like, with
some more oregano, and then bake the dish in
the oven until it is slightly brown on top.
SARS, World Health Organization,
Communicable Disease Surveillance and Response.
www.who.int/csr/sarscountry
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