November 2009

Beef Up Your Immune System for the Winter

There are many ways that you can improve your immune system and ward off colds and viruses. It can be as simple as eating the right foods and exercising!

Foods that Boost your Immunity

Omega 3 fatty acids that are found in fish, flaxseed, and walnuts reduce inflammation and help strengthen the immune system. You might want to shoot for at least two servings a week.


Zinc is important for white blood cells to function properly. The white blood cells are the cells that fight infection. Zinc is found in protein such as lean meats, chicken, eggs, and tofu. It is also found in fortified foods. It is important to eat adequate amounts of these zinc containing proteins.

Fruits and Vegetables

Brightly colored fruits and vegetables are loaded with phytonutrients. Phytonutrients improve the immune system and can help to fight cancers as well. Not to mention, they are just plain good for you!


Citrus fruits contain vitamin C. This vitamin can help ward off colds. Although you can find it in supplements, it is probably more effective if you can get it in food such as oranges and grapefruit.


Nuts contain vitamin E. Vitamin E is an antioxidant vitamin that helps to fight colds and upper respiratory infections. The best nuts for vitamin E are sunflower seeds (1/4 cup), almonds (1/4 cup) and 2-3 brazil nuts (they also contain selenium).


Garlic has immune boosting properties that fights bacteria and viruses. If you have a cold, the best way to use garlic is to chop it up and swallow it. You can use it as a paste on bread or mixed in applesauce. Don’t chew it if you don’t want your breath to smell!

Chicken Soup

The hot liquid of chicken soup clears the nasal passages. However, something about most chicken soup helps boost the immune system and helps to fight colds. Whether it is the soup or the love with which it is cooked, chicken soup works!


Mitake, shitake, and reishi mushrooms are among the mushrooms that help boost the immune system. You can stir fry them or get them in capsules ( Better yet, put them in your chicken soup!


Regular, moderate exercise allows the cells that fight viruses and bacteria to circulate more quickly throughout the body. While they are getting an energy boost, they give your immunity a big boost. The more you exercise, the longer lasting the immune effect. That is another reason why exercise is so important.

In Summary

By eating well and exercising, you can increase your odds of having a healthy cold-free winter!

The “Best of” Our Blogs: Food Safety

Now that Thanksgiving is right upon us, and the rest of the Holidays are around the corner – all of which have a feeding frenzy associated with them – a warning about food-borne illnesses is timely. My husband could quickly give you an example of a food-borne illness because he’s been upset with me ever since I told him to be careful about eating hamburger meat due to the recent outbreaks of E. Coli infection associated with that particular food.

So, why should you worry if you don’t eat hamburger? Because the Centers for Disease Control and Prevention (CDC) estimates that 76 million Americans get sick from food-borne illnesses each year. And that’s just the tip of the iceberg because not all food-borne illnesses are even reported to public authorities.

A recent study done by the Center for Science in the Public Interest (CSPI), reported on October 9, 2009, found that even some of the healthiest foods can carry food-borne infections. The CSPI group analyzed information on food-borne illnesses from the most recent all the way back to 1990; the information was based on the CDC’s data.  The authors found that the most common organisms causing the illnesses included norovirus, and E. Coli and Salmonella bacteria.

What specific foods were most likely to carry an organism that caused a food-borne infection and illness? The authors found that leafy green vegetables were the food type that was responsible for the highest number of outbreaks, causing approximately 13,600 illnesses during the time period studied.

Here is a listing of the rest of the top ten foods responsible for food-borne illnesses during this period.

  • Eggs, involved in 352 outbreaks and 11,163 reported cases of illness.
  • Tuna, involved in 268 outbreaks and 2,341 reported cases of illness.
  • Oysters, involved in 132 outbreaks and 3,409 reported cases of illness.
  • Potatoes, involved in 108 outbreaks and 3,659 reported cases of illness.
  • Cheese, involved in 83 outbreaks and 2,761 reported cases of illness.
  • Ice cream, involved in 74 outbreaks and 2,594 reported cases of illness.
  • Tomatoes, involved in 31 outbreaks and 3,292 reported cases of illness.
  • Sprouts, involved in 31 outbreaks and 2,022 reported cases of illness.
  • Berries, involved in 25 outbreaks and 3,397 reported cases of illness.

An important issue about the above listing of specific foods is that the CDC’s database cannot discriminate whether the specific food caused the illness, or whether it was other foods mixed with that food; for instance whether tomatoes alone caused an illness, or if tomatoes were in a salad, whether it was the other ingredients of the salad. The authors of the study also caution that since potatoes are almost always eaten cooked, it was probably a food eaten along with the potato that caused the illness.

Having said all that, the above list is pretty scary, right? Especially when you remember that this is an underestimate of the actual number of illnesses caused by food borne infections.

Is there anything you can do to prevent a food-borne infection from ruining your happy and healthy holidays? Absolutely. 

·        Always keep fresh (and frozen) food products cold.

·        Always be sure to thoroughly cook your food.

·        Always keep your food preparation area clean and sanitary.

·        Avoid eating raw eggs or using them in recipes, including ice cream.

·        Keep foods, like oysters, chilled. Avoid eating them raw.

·        If you do eat raw oysters or sushi, be aware that they can carry organisms that can cause illness.

·        Wash your hands frequently!  Janet Horn


Watch Out for Food-Borne Illnesses During the Holidays (and all the time)!

The New Recommendations for Breast Cancer Screening: What Should You Do?

We felt that this needed to be posted again!

You may have heard that the U.S. Preventive Services Task Force (USPSTF) issued new recommendations for breast cancer screening this week, which include many changes from prior recommendations. There has been an outpouring of responses and media attention since the announcement was made. The American College of Radiology released a statement saying that these changed recommendations will result in “countless unnecessary breast cancer deaths each year.”  The American Cancer Society as well as the American College of Obstetrics and Gynecology also disagree with the recommendations, and believe that women should continue to follow the  prior recommendations. In fact, the Secretary of Health and Human Services issued a statement telling women to keep getting mammograms as they’ve been doing in spite of the USPSTF recommendations.

What are these new recommendations that have created such confusion among patients and controversy among physicians? The two major changes include:

·        not routinely screening (with mammograms) women ages 40-49, biennially screening women ages 50-74, and screening ages 75 and beyond based on general health;

·        discouraging teaching breast self-exams

What is the controversy? Previously, it was recommended that all women begin getting routine mammograms at age 40, and yearly thereafter. No age group  has been considered too old to get mammograms.  In addition, the teaching of breast self exam (BSE) has been for years a major part of the campaign for early detection of breast cancer.

This is confusing, but here’s what you need to know.

The recommendations were based on two reports, commissioned for this Task Force, that combined and synthesized research data from the past seven years, which was when the USPSTF made its last recommendations.  Several important results, which affected their recommendations. were found in these reports:

1) the largest number of mammograms that were false positive (ie, showed an abnormality that was not cancer when biopsied) occurred in women ages 40-49 – thus, mammograms in this age group led to many unnecessary biopsies;

 2) mammograms done every year do not significantly reduce the death rate from breast cancer, whereas mammograms done every two years do reduce the death rate significantly – this says that mammograms done every two years minimizes the risks while maximizing the benefits of mammography in the largest number of women;

3)teaching breast self-exam does not reduce the number of deaths from breast cancer, and can cause harm in that more unnecessary imaging and biopsies done in women who find abnormalities by BSE;

4) there was not enough information about the number of deaths from breast cancer in women ages 75 and older because the data showed that more deaths are due to heart disease and strokes in this group – therefore no recommendations could be made about mammograms for women of this age.

You can probably see from the above findings that the USPSTF based its recommendations on large groups of women in the general population, and not those with risk factors for breast cancer. In addition, their recommendations were made based on death rates caused by breast cancer; in studies that looked to see if mammograms affect the chance of living longer in a significant number of women, the answer was yes – early detection of breast cancer improves survival and saves lives. It almost seems that the recommendations were also based on what was cost-effective for the general population.

The most important point I want to make here is the same one we make in our book. Each woman has a unique medical history and lifestyle; because of this, decisions on your healthcare should be made based on your individual genetic make-up, medical history and lifestyle, not on generic recommendations made to all women. If you’re concerned about the frequency of your routine mammograms,  talk to your clinician about the best screening schedule for you, especially if you have a family history of breast cancer. If you don’t know your risk for breast cancer, ask your clinician to discuss this with you.  If you’re comfortable with BSE and wish to continue, then go ahead and do so. And DEFINITELY, if you find a lump in your breast, don’t ignore it.  See your clinician immediately about it.

The worst thing would be to become so confused or upset by these recommendations that you don’t do any preventive health maintenance. Remember, these are only recommendations and could (and probably will) change again at any time. Even the experts don’t agree on them. You should do what’s best for you and your health.  


Going on a Cruise? Better Read This Now!

The Holidays and upcoming winter are a popular time to go on a cruise. Especially since there’s nothing to worry about when you’re on a cruise. There are NO: meals to fix; house to clean; repairs to make; work to obsess over. The only concerns may be an outbreak of stomach flu (viral gastroenteritis) or a Titanic-like occurrence – both very low risk, right? Yes, for the Titanic-like happening; but for the outbreak – think again.

A recent study was published in Clinical Infectious Diseases (2009 Nov 1; 49:1312) in which a team of 46 medical professionals evaluated the cleanliness of  the public restrooms in 52 cruise ships over a three year period. Obviously, this was a covert operation.  The clever way that they were able to check for cleanliness included the application of a gel to objects in several restrooms at the start of each cruise by a team member; the gel was colorless and fluorescent (visible under ultraviolet light) and was easily removable by the light application of water. The restrooms were examined daily by the team member, and the gel was reapplied if it had been washed away.

Cleanliness varied widely from ship to ship, with scores from 100% to less than 5%! Although toilet seats were the best-cleaned objects overall, they were cleaned only 50% of the time. The handholding rails next to the toilets were often overlooked.  Baby-changing tables were the least cleaned objects, being cleaned less than 30% of the time.

In the event of an outbreak of gastroenteritis on a ship, the team member present on that ship was able to compare the cleanliness in the bathrooms before and after the outbreak.  Not surprisingly, those ships that had an outbreak had significantly lower cleanliness scores (measured before the outbreak) than did the ships with no outbreaks. However, the ships with the outbreaks had better cleanliness scores after the outbreak than they did before.

Moral of the story: don’t be complacent in thinking that your cruise ship is very clean as a matter of course. Better yet, consider booking a cruise on a ship that has just had an outbreak as the staff will be much more attuned to the importance of regular cleaning and sanitation! And – always wash your hands frequently.

Why Do We Stuff Ourselves? Unexpected Traps That Can Expand Your Waistline

Nutritionists and scientists have long tried to unlock the secrets of overeating. But some of the best information is coming from an unexpected source: marketing experts! It turns out that even the most self-aware individuals are subject to mindless eating.

Most of the research comes from a marketing professor, Dr Brian Wansink, from Stanford University. He wrote a book called Mindless Eating: Why We Eat More Than We Think.

Interesting things to know

* Package size counts
In one study, two groups of people were given free, but stale (five-days old) popcorn while watching a movie. Half of the group got a medium-sized tub; the other got a large tub. The people with the larger tubs ate 53 percent more than those with the medium tubs. They ate the popcorn regardless of taste (five-day-old movie popcorn? YUK!) because it was there and they were distracted by the movie.

* People use visual clues to stop eating
In another study, Dr. Wansink rigged a soup bowl to continuously fill with tomato soup essentially making it bottomless. The eaters with the rigged soup bowls ate on average six ounces more soup than those with a regular bowl. This means that most people ignore how full they feel and eat until they clean their plates.

• Our eating is influenced by color
People will eat more M&M’s when they are multicolored than when they are all one color. People also eat more in a yellow or red room (think about the colors at McDonald’s), and eat less in a blue room.

• We are influenced by those who eat around us
People are more likely to eat faster (and larger amounts) if those around them are shoveling food into their mouths.

• Sound and distraction matters
Playing fast music while eating will cause you to eat more. And every parent knows that kids (and adults) eat more when in front of a TV.

Some tips to help you avoid overeating:

* Eat slowly (or pick a slow eater to sit next to at the next dinner party). It takes ten to 20 minutes for your brain to register that your gut is full.

* Use smaller bowls and plates. Since we all have a tendency to clean our plates and bowls, start small and use smaller utensils as well.

* Never eat directly from the box or bag (think cookies and chips). You can’t see how much you’re eating, which means you won’t remember how many calories you’re consuming.

* Beware of buffets. Use a small plate and only put two items on the plate at a time.

* Be aware of your surroundings. Always sit down to eat and try not to eat in front of the TV. When you choose restaurants, gravitate toward the quiet ones that are painted blue!

Mindless eating contributes to the gradual weight gain that many of us experience as we age. By being aware of some of the cues that trigger overeating, you can turn gradual weight gain into weight loss!

A Cure for Diabetes

I once had a professor in medical school who, during a basic lecture on diabetes, said that the discovery of insulin by Banting and Best in 1920 actually prevented scientific progress on the disease. His rationale was that there was no immediate need then to do research to find a cure since there was treatment to keep people alive.

Sound odd? Not really, when you remember that untreated diabetes can be, in fact, a fatal disease. And back then, most of the patients who were being diagnosed with it, were also either quite ill or dying from it. So, even though the daily injection(s) of insulin – the only way it could be made available to the body then – was uncomfortable and sometimes life-changing, it did indeed keep people with diabetes alive.

Contrast that scenario with other diseases, like the many types of cancer or AIDS, and you can understand what that professor meant. When people are dying from a disease that has no known treatment or cure, the medical and scientific establishment places a lot of emphasis -quickly – on research in that area.

Back to diabetes – we’ve not really advanced all that much since the discovery of insulin, have we? In 2007, it was found that 7.8% of the American population – or 23.6 million children and adults – had diabetes, 5.7 million of those people being undiagnosed. In addition, it was found that 57 million people had pre-diabetes, the form of the disease in which the body cannot use the glucose (sugar) in any food to create energy as it should, but in which the blood glucose level is not high enough to be considered frank diabetes. Although we do have more types of treatment available than we did in 1920 when insulin was discovered, having the disease and caring for oneself properly can still be lifechanging as it was then. And more distressing is the fact that having the disease puts one at high risk for heart disease and stroke, among other complications.

And yet, in many people with diabetes (I’m referring here to Type II Diabetes, the most common form), it is curable. Think you may have missed the media blitz about the cure? You didn’t, as it’s so deceptively simple that it’s not sexy enough to be mentioned in the media. I’m talking here about weight loss in those people with Type II diabetes who are obese or overweight. Because in many people, diabetes develops only because of their excess weight, or because of a weight gain. 

With excess weight, the cells of the body become insulin-resistant and can’t use insulin properly to metabolize glucose and turn it into life-giving energy. Therefore, the glucose stays outside of the cells and circulates in the bloodstream, causing the sugar level in the blood to be high and allowing all the bad consequences of that to follow.And in many people, if that excess weight is lost, the cells of the body then are again able to use glucose properly. It’s that simple. I’ve seen many patients be able to stop their diabetes medications and be healthy after weight loss.

So, why are there still so many overweight people with, and getting newly diagnosed with, Type II diabetes when a cure is available? Because it’s easier to take a pill, or even an injection of insulin (or an insulin pump or nasal spray) than to lose weight.  Exercising, and eating a nutritious low calorie, enough to lose weight is difficult. No one is denying that. But look at the rewards if you do have diabetes – getting off your medications, feeling better, not having the ups and downs of a high or low blood sugar, and possibly decreasing your risk of stroke and heart attack.

November is National Diabetes Awareness Month. If you, or someone you know or love, has diabetes, you owe it to yourself to find out all the facts. This is one disease that you can control yourself, and perhaps even cure, by changing your lifestyle.

Stay tuned. We will be chatting here about other topics related to diabetes this month.

For more information, go to:


An Ancient Treatment That Still Works: Pessaries for Stress Urinary Incontinence

Stress urinary incontinence (SUI) is so common in women at midlife and beyond that it is one of the first symptoms of aging that women mention. Stress incontinence is the leakage of urine only during certain activities that place stress on the bladder, such as coughing, sneezing, and running.  Recommendations by the NIH have emphasized that nonsurgical methods can be quite effective in treating SUI, and thus should be tried before surgery.

One of the oldest treatments for SUI is the pessary.  This is a device placed in the vagina that lifts and supports the urethra so that urine does not leak. It is also used for prolapse of the uterus. Another type of treatment for SUI is known as behavioral therapy in which the patient trains the bladder in progressive steps. Although we know that both of these work to treat SUI in some patients, there have been no studies comparing how effective each is over the long term and  as short term treatment. Until now.

Such a study was recently reported at the American Urogynecologic Society 30th Annual

Scientific Meeting by the principal investigator, Dr. Holly Richter. In this study, 446 women from ten medical centers in the US were randomized to receive either a pessary, or behavioral therapy, or both. Outcomes were based on the patient’s assessment as to how much her symptoms had improved; these assessments were made at three months and twelve months after the start of therapy.

In the short term (after three months), behavioral therapy was found to result in greater patient satisfaction than the pessary. However, at twelve months, there was no difference between the two therapies in terms of patient satisfaction. In addition, combined therapy was not superior to either of the therapies individually in the short term or the long term.

Therefore, based on this study, it is safe to say that both therapies work in certain patients. Some women prefer behavioral therapy to wearing a pessary, while others are comfortable with the pessary.  Not mentioned in this study is the fact that weight loss often greatly relieves the symptoms of SUI.

If you are experiencing SUI, be sure to talk to your clinician about the various nonsurgical methods that are effective in treating it before you consider surgery. And, when discussing these nonsurgical methods, try to assess which type of therapy you would be more comfortable with based on your own preferences.




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