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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.
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
Fendler EJ, et al., The impact of alcohol hand sanitizer use
on infection rates ... Am J Infect Control 2002 Jun;30(4):226-33.
Hilburn J, et al., Use of alcohol hand sanitizer as an infection
control ... acute care facility. Am J Infect Control 2003
Apr;31(2):109-16.
Guinan M, et al., ...comprehensive handwashing...absenteeism
in elementary schools. Am J Infect Control 2002 Jun;30(4):217-20.
Culprit in Food-Borne Illnesses Is Often the Consumer Himself,
Curt Thacker, Wall Street Journal, April 16, 2003.
Van Straten M, Josling P, Preventing the common cold with
a vitamin C supplement: ... Adv Ther 2002 May-Jun;19(3):151-9.
Kohut ML, et al., Exercise and psychosocial factors modulate
immunity to influenza vaccine in elderly individuals. J Gerontol
A Biol Sci Med Sci 2002 Sep;57(9):M557-62.
Gruzelier JH, A review of the impact of hypnosis, relaxation,
guided imagery and...immunity and health. Stress 2002 Jun;5(2):147-63.
Cardinali DP, et al., ...melatonin to accelerate resynchronization
of sleep-wake cycle... J Pineal Res 2002 Jan;32(1):41-6.
Guerrero JM, Reiter RJ, Melatonin-immune system relationships.
Curr Top Med Chem 2002 Feb;2(2):167-79.
Ringsdorf WM Jr, et al., Sucrose, neutrophilic phagocytosis
and resistance to disease. Dent Surv 1976 Dec;52(12):46-8.
Weber ND, et al., In vitro virucidal effects of Allium sativum
(garlic) extract and compounds. Planta Med 1992 Oct;58(5):417-23.
Cheshier JE, et al., Immunomodulation by [proanthocyanidins]
in retrovirus-infected or ethanol-fed mice. Life Sci 1996;58(5):PL
87-96.
Nattel S , et al., Actions of intravenous
magnesium on ventricular arrhythmias... J Pharmacol Exp Ther
1991 Nov;259(2):939-46.
Platt R, Current concepts in optimum nutrition for cardiovascular
disease. Prev Cardiol 2000 Spring;3(2):83-87.
Garjani A, et al., ...Crataegus [hawthorn]...ischaemic arrhythmias
in anaesthetized rats. Phytother Res 2000 Sep;14(6):428-31.
drjanson@drjanson.com
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