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May 2003

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

Dear Friends,

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.

Living Without Fear
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.

Reasonable Infection Protection
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.

Personal Hygiene
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.

Enhance Your Immunity
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.

Ask Dr. J: Rapid Heart Rate
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.

In the Health News
• 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 and Disease
• 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.)

Recipe of the Month: Polenta Spinach Mushroom Lasagna
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.

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References

Reasonable Protection
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.

Ask Dr. J
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.

 

 


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CONSULTATIONS:

From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.


Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.

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