Monday, November 10, 2008

Protecting Yourself from Germs and Bacteria

In the US, peak flu season occurs from late November through March. With cold and flu season coming up soon, everyone is typically concerned about germs and bacteria. Here's a transcript of an interview between our medical director, Dr. Patricia David, and a local reporter regarding germs, bacteria, and viruses in our homes.

Q. What is the difference between germs, bacteria, and viruses?

Dr. Patricia David: “Germs” is a general term. There are actually 4 categories of “germs”: Bacteria, viruses, fungi, and protozoa.

Bacteria are one-celled living animals with a complete genetic code. They are able to self-reproduce. Viruses are not much more than a section of RNA or DNA covered by a protein shell. A virus can’t reproduce without a living host – so it must first find a suitable host, penetrate the cell wall and, once inside, replace the cells’ original genetic commands with its own (usually to make as many copies of the virus as possible). Once the cell has outlived its usefulness, it explodes and sends out thousands of copies of the original virus to other cells.


Q: Which germs are most common in the home?

Dr. Patricia David: Germs are continually introduced in the home via people, food/water, insects, and air. Most are really of little consequence, but you can encounter several dangerous organisms in your home. As far as bacteria, the most commonly found are E. coli from undercooked beef, raw milk, Salmonella from raw/undercooked eggs, undercooked poultry, fruits/veggies, Staphylococcus from cooked high-protein or dairy-containing foods that are kept at room temp for a long time (such as chicken salad), and Listeria from deli meats and soft cheeses. The viruses we can encounter in our home are rotavirus, hepatitis A, the "common cold" viruses rhinovirus and coronavirus, influenza virus, and adenovirus.


Q: Where are they commonly found in the home?

Dr. Patricia David: Everyone’s first thought is obviously the bathroom, but that's actually not true. The kitchen is the dirtiest place in the home, with the sink being dirtier than the bathroom toilet. You can find the most dangerous sources of virulent bacteria (E. coli, Salmonella, Staphylococcus and others) in a typical kitchen sponge and dish cloth. They provide a source of moisture, a ready food supply in the form of food particles, and little pockets where bacteria can cling. A sponge that’s been in use for no more than 2 or 3 days in a kitchen harbors MILLIONS of bacteria.

The sink itself, as well as refrigerator door handles, are also breeding grounds for bacteria. Another source is plastic cutting boards; wood cutting boards have received some bad press – even the FDA says that plastic is less likely to harbor bacteria than wood – however, experimenters at UC-Davis showed that the wood absorbs bacteria but won’t release it. Bamboo may actually be the best choice, since its properties are presumably similar to wood but is more environmentally friendly.

Poorly cooked food is another source. Microbes multiply in rare or even medium steaks, raw or lightly steamed shellfish, poached eggs and unwashed fruit. An estimated 76 million cases of food-borne illnesses in the United States each year are contracted in the home – and many of these can be prevented.


Q: So the bathroom isn't the dirtiest place?

Dr. Patricia David: That's correct. The kitchen sink is the dirtiest place in the house. The bathroom is still obviously a dirty area – but it’s not the toilet, where you'd think it would be. In the bathroom, it's the sink drain that harbors the most germs.


Q: What are some tips to combat germs/bacteria in the kitchen, bathroom, bedroom, carpeting/flooring?

Dr. Patricia David: First, always wash your hands thoroughly. The biggest obstacle seems to be simply getting people to wash their hands. Washing hands in hot soapy water for at least 20 seconds rinses off surface bacteria and makes it difficult for bacteria to cling to skin. In an experiment by Utah State University, a raw chicken was covered with “GloGerm,” which is invisible in daylight but visible when exposed to ultraviolet light. This chicken was given to a home cook, who was asked to prepare it. By the time the chicken was done, the ultraviolet light revealed chicken juice everywhere - on the counter, in the sink, on cabinet handles, and even on the sippy cup of the cook's 2-year-old child.

If you use cellulose sponges, make sure you wash them well and then microwave them for a minute. Experimenters at UC-Davis Dept of Food Safety soaked sponges in bacteria-laden concoctions, and a one minute nuke eliminated them.

If you use dishcloths, change them often. By the way, it's interesting to note that studies of bacteria in home kitchens have found that people who had the cleanest-looking kitchens were often the dirtiest – and it’s because these "clean" people wipe up frequently using the same cloth, so they often end up spreading bacteria all over the place. The cleanest kitchens were in the homes of those who never wiped up, and just put their dirty dishes in the sink.

If you stick to plastic cutting boards, you can wash them in the dishwasher but make sure the water gets hotter than 140 degrees or it will only spread the bacteria around, and the bacteria in the cracks will remain.

An environmentally-safe cleaner to use in your kitchen and bathrooms is 5% vinegar (such as that found in the supermarket). This kills 99 percent of bacteria, 82 percent of mold, and 80 percent of viruses. You can also try 1 cup water + 1 tsp pure essential oil of lavender – lavender is more antiseptic than phenol (the industry standard for disinfectants) – and it smells much better! To clean floors and carpet, the very best way is steam cleaning – the high heat kills bacteria.


Q: Do homes with pets have an increased risk for higher germ levels? What germs to pets tend to carry?

Dr. Patricia David: Yes, homes with pets have this additional source for bringing in germs. Cats tend to carry Bartonellosis (cat scratch disease) and Toxoplasma (toxoplasmosis). Dogs harbor roundworms, Campylobacter, and Pasterella multocida (a bacteria found in dogs’ mouths). Both of these pets also can carry rabies, Giardia, Cryptosporidium, and ringworm.

Even the more unusual pets still carry some germs that can be harmful to their owners. For example, reptiles can have Salmonella, birds carry Psittacosis, and deer mice can carry Hantavirus.


Q: Is it true thousands of droplets from a sneeze may contain millions of virus particles that can be infectious for hours or even several days and that a sneeze sends 10,000 virus-filled droplets into the air at 200mph? What should people do when they're in close proximity to a cougher/sneezer? Does holding your breath work?

Dr. Patricia David: Yes - when you sneeze, 40,000 droplets containing several thousand particles fly out of your mouth and nose (mostly the mouth). They’ve been clocked at 103.6 miles per hour, and can potentially land up to 12 feet away. If the person sneezing has the flu and doesn’t cover up, everything in the room is covered with the droplets.

The germs in those droplets can thrive for a few hours on hard dry surfaces (faucet handles, doorknobs, credit cards, telephones, etc.). They can thrive for a day (perhaps longer) in skin folds, under fingernails, in creases in your palms.

The most likely way for those germs to make you ill is for you to touch an infected surface, then touch your eyes, mouth, etc. If you’re in close proximity to a sneezer, holding your breath and leaving the area of the sneeze may help keep you from breathing in the particles – but you still have to remember to wash your hands, since the sneeze particles can be sitting on your skin or clothing. And, when you go back in the room, make sure you wash up again if you touch anything.


Q: So what's your best advice for us?

Dr. Patricia David: Our best protection is to wash your hands well, and wash them often. Each washing should involve vigorous scrubbing with soap – all surfaces, including between the fingers and underneath the fingernails – for at least 20 seconds. Antibacterial soap isn't necessary -- just plain old soap is fine, as long as you follow the instructions for vigorous scrubbing of all surfaces for at least 20 seconds. Wearers of fake fingernails should be aware that germs are embedded in those false fingernails -- and can still be there even after you wash your hands.

Monday, September 22, 2008

Fighting Off Colds and Flu: Foods to Boost Your Immune System

Welcome to the first day of Autumn! Along with the cooler weather and gorgeous explosion of colors comes cold and flu season. To boost the natural fighting power of your immune system, when planning your meals you may want to incorporate a variety of functional foods -- foods that provide health benefits beyond just basic nutrition.

For efficient immune system function, the body requires certain nutrients which you can easily find from food sources:
  • Beta-carotene (Vitamin A): Found in Chinese cabbage, carrots, sweet potatoes, pumpkin, and kale
  • Copper: Found in Brazil nuts, dried apricots, olives, avocado
  • Folic acid: Found in beans, lentils, other legumes; green leafy vegetables; asparagus; oranges and other citrus fruit
  • Iron: Found in pumpkin seeds, blackstrap molasses, soybeans, spinach, kidney beans, lima beans, prunes, raisins
  • Vitamin B6: Found in potatoes, bananas, beans, sunflower seeds, spinach
  • Vitamin B12: Found in meat, eggs, dairy
  • Vitamin C: Found in guava, papaya, strawberries, kiwi, tomatoes, broccoli, spinach, oranges, grapefruit
  • Vitamin E: Found in nuts, green leafy vegetables, avocados, wheat germ, whole grains
  • Selenium: Found in brown rice, wheat germ, beef, Brazil nuts, turkey breast
  • Zinc: Found in seafood (oysters, crab), beans, eggs, pumpkin seeds
  • Bioflavenoids: Found in apples, onions, green tea, cacao, red wine, various vegetables
  • Allicin: Found in garlic
  • Essential Fatty Acids: Found in flax oil and fatty fish (salmon, tuna, and mackerel)
While supplements are widely available, keep in mind that excess vitamins can be toxic to the body, can actually impair immune function, or can simply be excreted in the urine. Also, remember that in nature, nutrients do not occur in isolation – fruits and vegetables contain a variety of nutrients which may in fact interact with each other to give you maximum health benefit. Therefore, whenever possible, we encourage you to get your vitamins from natural food sources – and it tastes better that way!



Thursday, August 28, 2008

Lose Weight Without Counting Calories

Although we all know it's important to have a handle on our daily caloric intake, from a practical standpoint it's really hard to count calories. That's the reason why many of the big diet giants force you to purchase their packaged meal plans -- the convenience of those packaged meals is appealing, if you don't have the time or desire to pre-plan your daily meals.

But you can't live on those expensive packaged meal plans forever. Even if your pocketbook can sustain the costs, at some point you'll realize that you really do need to learn how to eat better in order to stay healthy and maintain your goal weight for the long term.

Our Nourish medical nutrition programs can help give you a roadmap of what to eat, and how to eat. A BMR test can give you your precise caloric requirements. But if you're still the type of person who doesn't like counting calories or following a menu, here are just three easy tips to help you maintain good health and an appropriate weight.

Re-learn portion sizes. It's easy to stick to single-serving portions if you associate a portion with a common household object. For example, a 3-oz serving of meat should be roughly the size of a deck of cards; your serving of rice should be the size of a tennis ball; and a 1-oz serving of cheese should be equal to a 1-inch cube.

Eat lean protein at every meal or snack. Aim for one or two bites of lean protein for every bite of carbohydrate -- it's an easy way to keep a healthy protein-to-carbohydrate ratio at mealtime.

Snack smart. Eat 3 meals and 2 or 3 snacks per day -- always eat a small snack at mid-morning and mid-afternoon, and consider a small low-carb snack at bedtime as well. Choose high-quality snacks such as low-fat string cheese, a handful of walnuts, or a few slices of low-sodium organic deli ham / chicken / turkey.

So even if you hate counting calories, that doesn't mean you have to settle for being overweight and unhealthy! Memorizing these three simple tips will help you achieve your goals for good health and a healthy body weight.

Wednesday, August 27, 2008

Recommended shakes and meal replacements

At our wellness center, we're often asked to give recommendations on the best tasting shakes. Here are the top five shakes that our health coaches and physicians use and recommend -- and a few that, sadly, get the thumbs-down vote due to taste.


Our top 5 recommended shakes:

Low-Carb Ultramet:
Deliciously creamy, and very satisfying. Blends well too. Great protein-to-carbohydrate ratio. This comes in two flavors -- Vanilla Cream and Chocolate Fudge -- and is what the medical director at Healthy U drinks every day for her afternoon snack After a few minutes in the freezer, it tastes just like an ice cream shake.

Body Fortress Whey Protein:
This is a favorite of the head trainer at Masaya Healing & Wellness Center. It is available in Vanilla and Chocolate, and tastes good mixed with skim milk or fruit and yogurt.

JUVO:
Another of Healthy U's medical director's favorites, this is a raw food meal replacement. Tastes really chalky when mixed with water, but when blended with vanilla soymilk it has a creamy taste that's not too sweet. Throw in a few frozen raspberries or a tablespoon of nut butter, and it makes for a very filling breakfast drink that takes you through the morning.

Vegan Complete Mint Chocolate Chip:
An all-natural protein shake that tastes good and has a lot of nutrients. If you mix it up with water it isn't very thick, but it still gives you enough nutrition to last till your next meal or snack. A minor drawback: The little flakes of "stuff" that settle out at the bottom of the cup; it doesn't dissolve completely. Still, it's a terrific and easily digestible, pea protein based meal replacement.

Myoplex Light:
Another favorite of the head trainer at Masaya. Comes in Chocolate, Strawberry, or Vanilla.


Ones that were voted down:

Raw Power:
It's a great idea for a raw food, high protein, non-whey-based shake, and is very healthy for you. But the problem is the hemp protein. It's gritty and doesn't mix well. It also has a very bitter taste that's difficult to mask.

Nutiva Organic Hemp:
Again, it's the hemp protein. Bitter and gritty, our health coaches said it tasted like drinking dirt. Although the components are healthy for you, it's hard to give it a good recommendation based on the taste.

Vega Complete:
We really, really wanted to like this one. The ingredients were right on target as far as being healthy, all natural, and unprocessed. The problem is that it was hard to get past the taste.

Accelerade:
This is another one that loses because of taste. The head trainer at Masaya says it tastes like an unpleasant mixture of milk and juice.

Tuesday, August 26, 2008

The Benefits of Omega-3 Fatty Acids

Omega-3 fatty acids are polyunsaturated fatty acids that are essential nutrients for health. They are responsible for numerous normal body functions, such as controlling blood clotting and building cell membranes in the brain.

There are two major types of omega-3 fatty acids that we should obtain from dietary sources. One is alpha-linolenic acid (ALA), which is found in walnuts, flaxseed, and some oils such as soybean and canola; other sources include green vegetables such as Brussels sprouts and spinach. The second category of omega-3 includes eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are found in fatty fish such as salmon, sardines, herring, and lake trout. The body partially converts ALA to EPA and DHA.

There is scientific evidence for the multiple health benefits from omega-3 fatty acids. Studies have shown a reduction in blood pressure, decreased blood triglyceride levels, and a lower risk of heart attack and death in those with coronary heart disease. However, experts still recommend omega-3 fatty acids even for those who do not have coronary heart disease risks. Omega-3 fatty acids reduce inflammation, decrease formation and growth rate of atherosclerotic plaques, improve blood vessel function, and a significantly lower rate of death from heart disease.

The current recommendation is to consume one serving of fatty fish at least twice weekly. If you don’t like the taste of fish, you can use an omega-3 fatty acid supplement; just make sure that the supplement you choose is pharmaceutical-grade and look for molecularly-distilled products that are free of heavy metals and other contaminants. The appropriate dose is 1 to 4 grams of EPA + DHA per day; check with your doctor to see what dose is best for you.

Monday, August 25, 2008

How to Read a Nutrition Label

One of the first steps to implementing a healthier lifestyle is to get in the habit of reading nutrition labels.

Nutrition labels were first developed when nutrient deficiencies were common. However, in 1993 the label information changed to reflect increasing public health concern over dietary fats, fiber, and sugar.

The nutritional information that is required on a label include:

Serving size, in both a typical household measuring unit and its metric equivalent;
Number of servings in the container;
Calories per serving, and the total number of fat calories;
Fat (including saturated fat and trans fat);
Cholesterol;
Sodium;
Carbohydrates (including dietary fiber and sugar);
Protein; and
Vitamins A and C, Calcium, and Iron.

Although some nutrition labels may include additional nutritional information, this list is what is required by the Food and Drug Administration and the Food Safety and Inspection Service of the US Department of Agriculture. Other requirements include a list of ingredients (beginning with the ingredient that has the most weight), the address or phone number of the manufacturer, and % Daily Values based on a 2000-calorie reference diet. Additionally, any health claims must be supported by scientific evidence and approved by the FDA.

When reviewing a nutrition label, start with the serving size, and number of servings per container. This lets you know exactly how much is considered a single-serving portion of that particular food. The size of single serving is important, since the quantity you eat will obviously influence the number of calories and nutrients you will be consuming.

Then, take a look at the calories per serving. The calories reflect the amount of energy you will get from a single serving. If you are restricting your total caloric intake for the day, you'll be able to tell how many calories you will have left after eating one serving of that particular food.

Check the amount of trans fat. Fat, in and of itself, is not bad for you in moderation; however, trans fat should be avoided.

Carbohydrate grams and fiber are important, especially if you have insulin resistance, diabetes, or high triglycerides and need to watch your total carbohydrate intake.

Sodium and cholesterol are also of importance. From a general health standpoint, you should limit your sodium to 2000mg/day and cholesterol to 200mg/day. Being a little above those numbers is okay if you don't have high blood pressure or high cholesterol, but if you do have those health conditions you should monitor your total sodium and/or cholesterol intake and strive to be well below those numbers.

The key to a healthy lifestyle is making smart choices. Avoid trans fats; emphasize low glycemic index fruits, vegetables, whole grains, and lower-fat milk or milk products; include lean meats, poultry, fish, beans, eggs, and nuts; and choose foods low in sodium and added sugar. Make it a habit to read nutrition labels so that you can easily make smart choices from every food group, and get the most nutrition from your calories.

Sunday, August 24, 2008

Triglyceride Troubles? Tips on Reducing Your Levels

Triglycerides are the chemical form of fat found in food. Together with cholesterol, triglycerides form the plasma lipids. Like cholesterol, triglycerides serve an important purpose in the body, but when found in excess it can be harmful to your health.

Triglycerides are not only found in the foods you eat. The body also makes triglyceride from other food energy sources such as carbohydrates. When you eat, your body transforms carbohydrates into glucose for energy. Once your cells have what they need, the excess glucose is sent to your liver to be converted to glycogen and stored in the muscles. However, once your glycogen stores are full, the excess glycogen is again sent back to your liver where it is converted to triglycerides which can be stored in fat cells, which are later released for energy between meals. Hence, if you regularly eat more calories than you need – regardless of the calorie source – you may have high triglycerides, or hypertriglyceridemia.

Because of the relationship between carbohydrates and triglycerides, hypertriglyceridemia can be a sign of poorly controlled diabetes. Obesity and the metabolic syndrome, hypothyroidism, and liver or kidney disease are other conditions which often accompany high triglycerides. Hypertriglyceridemia can contribute to atherosclerosis (hardening of the arteries), which increases your risk of cardiovascular events such as stroke or heart attack. Another health concern associated with high triglycerides is pancreatitis – a severely painful inflammation of the pancreas which can result in damage to this body organ, along with other life-threatening complications.

A level of triglycerides less than 150 milligrams per deciliter (mg/dL) is considered normal. According to the National Cholesterol Education Program guidelines for triglycerides, abnormal categories of triglycerides include:

Borderline high — 150 to 199 mg/dL
High — 200 to 499 mg/dL
Very high — 500 mg/dL or above

Several studies suggest that your level of triglycerides may help predict your heart attack risk as accurately as other well-known blood fats. A report published in a 1997 issue of "Circulation" revealed that high triglycerides alone increased your risk of heart attack by almost 300%. In this particular study, those with the highest ratio of triglycerides to HDL cholesterol had a risk of heart attack that was sixteen times greater than their counterparts who had the lowest ratio of triglycerides to HDL.

Although there are several drugs on the market used to treat hypertriglyceridemia, there are also several non-pharmaceutical ways to reduce your triglyceride level:


Achieve a Healthy Weight.

Losing the excess weight can help lower triglycerides. Reduce your overall caloric intake to be more consistent with what your body needs – remember that the excess calories that your body doesn’t use is converted to triglycerides.


Exercise.

Regular exercise for at least 30 minutes a day will help improve your triglyceride levels, while also improving your cholesterol levels and blood pressure.

Improve Your Diet.

Reduce your intake of the unhealthy saturated fats, and eliminate trans fat; when you consume these, you’re essentially eating triglycerides. Also watch your cholesterol – set a goal of no more than 200 milligrams of cholesterol a day, and do your best to avoid concentrated sources of cholesterol such as organ meats, egg yolks, and whole milk. Decrease your intake of simple carbohydrates as well, since excess calories are converted to triglycerides.

Go Fish.

Instead of red meat, opt for fish such as mackerel, lake trout, sardines, albacore tuna, and salmon that are high in omega-3 fatty acids. Omega-3 fatty acids lower plasma triglyceride levels by inhibiting the synthesis of very-low-density lipoprotein (VLDL) cholesterol and triglycerides in the liver; research has shown that approximately 4 grams per day of omega-3 fatty acids reduced serum triglyceride concentrations by 25 to 30 percent. The American Heart Association recommends consumption of two servings of fish per week for those with no history of coronary heart disease, and at least one serving of fish daily for those with known coronary heart disease.

Reduce Alcohol Intake.

Alcohol is high in calories and sugar, and therefore has a particularly potent effect on triglycerides. In some people, even small amounts of alcohol can adversely affect their triglyceride levels.