The hospital opened its pediatric care center in 2017, and now joins more than 220 children's hospitals nationwide.Read More
Recently I saw one of my centenarian patients, and I was impressed at how well she was doing, both physically and mentally. She is one of some 75,000 Americans living today over the age of 100. Just who lives long and healthy lives, and why?Read More
Everybody sneezes. Some sneezes are barely perceptible, others are loud and distinct, and still others come in multiples. Why do we sneeze? What’s happening when we sneeze?
Some liken a sneeze to a reboot of the system; a reset of the nasal environment. Sensory receptors in the nose are activated by mucous, germs, dust, pollen, animal dander, or pollutants. The activated receptors then send signals to the brain stem. The resulting sneeze expels mucous along with the irritants, and this reflex protects us from the particles that might otherwise enter our lungs. It clears our nasal passages so that we can keep on breathing. It happens when we’re sick, allergic, or even anxious. The bottom line is that sneezing is a part of our immune system, and helps to keep our body safe by clearing away bacteria, viruses, and more.
Are sneezes controllable? Certainly there is some degree of conscious control; just compare your public sneeze to your private sneeze. At the beginning of the sneeze, when the nose’s sensory receptors first become irritated, it is often possible to stifle it by pinching the nose and shutting the mouth. The next part of the sneeze involves inhaling deeply, and an involuntary blink (perhaps in order to protect our eyes?) and exhaling explosively. At that point, it’s too late to stop, but not too late to shield others. Saliva and whatever accompanies it is shot out at a speed of 30 to 40 mph or more. Due to the force involved, and the very small size of the particles, they can be hurled 5-20 feet away, or even farther. It’s no surprise that a sneeze is an effective way to send germs into a large area, and to spread infectious disease. That is why we are taught to sneeze into a tissue or into an elbow, and why we are reminded to wash our hands with soap and water (or an alcohol-based hand sanitizer) after sneezing and throughout the day.
Sneezing styles vary. The strength, sound, and volume of a sneeze depend on the strength of the abdominal muscles, the lung volume, and the size of the windpipe or trachea. The contents of the sneeze might be mostly expelled through the mouth, or might mostly come through the nose.
Injuries from sneezing do occur. The most common is muscle strain. Rarely, a violent sneeze has lead to stroke, miscarriage, car accident, broken blood vessels in the eyes, retinal detachment, and fainting. There are rare reports of hearing loss and vertigo as a result of a ruptured eardrum – likely caused by stifling the sneeze.
Some people sneeze multiple times. Perhaps those with chronic sinus disease or allergies require more sneezes to completely clear the nasal passages. In a few extreme cases, a teenage boy sneezed three to six times a minute for more than a month, and Guinness World Records lists a 12-year-old girl who sneezed about a million times over a year and finally stopped after more than two years.
One unusual sneezing trigger, affecting up to 35% of us, is looking at a bright light. This trigger seems to run in families. Perhaps it’s a result of a crossover of nerve signals, such that the nerve stimulated when the eyes see a bright light also stimulates the nerve responsible for the sneeze reflex. Similarly, plucking eyebrows may trigger that nerve and lead to a sneeze.
Working out may lead to sneezing; it certainly does for me. During a long hard run, I breathe large volumes of air (including allergens) and dry out my nasal passages. This leads to the creation of mucous, which leads to sneezes.
In some cultures, sneezing is a sign of good luck - which becomes bad luck if two people sneeze at the same time. Other cultures hold that a sneeze means that someone is talking about you behind your back. Saying “God bless you” may stem from the belief that with a sneeze, the soul (which presumably resides in the head) exits the body, and that by saying this, you are protecting the person who sneezes.
Your next sneeze is inevitable, so God bless you all!
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.
Growth in humans and other animals is stimulated by naturally produced growth hormones. In the 1950s, the FDA approved the use of *artificial*growth hormones to enhance the growth rate of cattle and poultry, as well as to increase egg, dairy, and meat production.
Artificial growth hormones are quite effective at expanding our food supply and increasing profits for the food industry, but just how safe is it when we end up consuming them in the foods we eat? Concerns include cancer, early puberty in girls, and other issues. Consumer advocates have fought for years to support a ban similar to one in Europe, where regulations are generally more stringent.
One of the earliest artificial growth hormones to be approved was *recombinant bovine growth hormone *(RBGH), which increases milk production by dairy cows. Although RBGH has been shown to have no discernible direct effect in humans, is it possible that using growth hormone may increase the presence of another hormone, *insulin-like growth factor*(IGF)?
One study found that milk from cows that had been given RBGH contains up to 10 times more IGF. Higher levels of IGF have been associated with an increased risk of breast, prostate and colon cancers in humans, and there may be a higher risk for diabetes as well.
However, even if consuming milk, other dairy, and some fish does indeed raise human blood levels of IGF, the amount appears to be negligible compared to the much higher amount that is naturally found in our body. To match the amount of IGF found in our saliva and digestive tract, we would need to drink about 95 quarts of milk, or eat 170 three-ounce servings of genetically modified salmon in a single day.
It is possible, however, that even negligible increases might be enough to cause harm. Unfortunately, this question has not been conclusively answered yet.
Also dating from the 1950s, ranchers began to fatten up cattle with sex hormones, including estrogen. Today, most beef cows in the United States have an implant in an ear that delivers these hormones. One major concern is that once this beef enters the human food supply, it may lead to earlier puberty (note that today’s children, on average, enter puberty at a younger age than did those of a generation ago).
However, once again, the amount of estrogen found in beef is tiny compared to the levels that are naturally in our bodies. Could even miniscule amounts of estrogen affect prepubescent girls and boys? One study showed that children who consumed the most protein from animal sources entered puberty about seven months earlier than those who consumed the least.
However, it is still not clear whether this is purely a result of hormones added to the food supply, and not due to a number of other factors.
Note that organic meat, poultry, eggs and dairy products arecertified by the U.S. Department of Agriculture to have nohormones or antibiotics added. These foods also come with a much higher price tag. While some experts recommend staying away from all hormone-treated beef and milk, others suggest simply limiting consumption of meat to twice per week and dairy to three servings per day.
The data gathered does not yet show conclusive serious harmful effects from the use of these hormones, but in my opinion, concerns are valid. More research is needed, and in the meantime, we each must come to our own conclusions as to whether changing our diets, or our shopping habits, is worth it.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.
The new facility is part of Rancho’s $418 million campus overhaul.Read More
Roughly 32 million pounds of antibiotics are given to animals that we then consume each year.
It started back in the 1940s, when it became clear that animals given low-dose antibiotics gained weight more quickly. But it’s been in the last 20 years that antibiotic use has really skyrocketed, and recently, some 70% of all antibiotics sold in this country have been for use in food-producing animals. For these animals, low dose antibiotics promote faster growth, treat infections, reduce death rates and improve reproduction.
However, the FDA has several concerns. Does this antibiotic use contribute to the rise of resistant “superbugs?” Just as antibiotics are used to promote weight gain in food animals, might they also be contributing to obesity in humans? Do antibiotics in our food animals affect our intestinal microbiomes? Are antibiotics being overused?
The animals given the highest levels of antibiotics are pigs, then chickens, and then cattle. Notable levels are also found in farmed shrimp and fish. Surprisingly, even organic vegetables may contain antibiotics, because some 75% of antibiotics fed to livestock are excreted into manure that ends up fertilizing our fields.
Do antibiotics given to animals affect our weight? Many types of bacteria in our gut help our body to absorb calories from food. If these bacteria are not in balance, and too many of them break our food down into energy, we may be absorbing more calories from the same amount of food. Interestingly, obese people do indeed have a different mix of gut bacteria than do lean people. In fact, research has shown that transplanting fecal matter of obese mice into thin mice actually does lead to weight gain among the thin mice. However, any data correlating the use of antibiotics to human obesity is very limited.
The science is clear (and it’s more than obvious!) that diet and lifestyle is a factor in obesity, but this does not fully explain our country’s obesity epidemic. We do in fact consume more calories today than in the past. Today’s average daily consumption of 3,900 calories can be compared to 3,400 calories in the early 1900s. Yet while obesity increased very slowly until the middle of the 1970s, it exploded after that.
One large change has been the ever-increasing levels of antibiotics in our food and water. Our obesity epidemic may in fact be partly due to “super size me” trends, partly due to consuming antibiotics that affect calorie absorption, and partly due to other factors. Clearly, more research is needed.
What is the solution? Right now in the United States, the FDA has asked the food industry to voluntarily phase out antibiotic use. If you’re concerned about this, look for organic meat from animals that have been raised without the use of antibiotics. The demand for these food products has increased drastically over the past few years. The food labels will read: “No Antibiotics”, or “Raised Without Antibiotics”.
Choose restaurants that have pledged not to use meat or seafood with antibiotics. Shop at markets (like Whole Foods) that are committed to selling meat with no antibiotics. Costco has tightened its standards for the use of antibiotics in the meat and poultry it sells. You may choose to look for other sources of protein and adopt a plant-based diet.
Until more studies are conducted, we simply cannot be certain whether eating antibiotic-treated foods are bad for us.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.
“Doctor, I feel tired all of the time.” I can’t tell you how frequently I hear those words.Read More
DOWNEY – Another year has gone by. Have you accomplished what you set out to do during 2018? Did things go as you intended? Does life ever go as we intend?
If your year was anything like mine, many things happened that were not exactly on your radar. It can feel as though we are passengers on our journey, and not the captain.
Plenty of adjustments to our path are required as we travel through life. (I recommend reading “We Plan, God Laughs: 10 Steps to Finding Your Divine Path When Life Is Not Turning Out Like You Wanted.”)
Nevertheless, I would argue that we are indeed each ultimately the captains of our own life. How we react to these unplanned life events is what determines our ultimate path. I like to keep in mind the following words. My understanding is that the name of the original writer is lost, but the message is clear:
►Carefully watch your thoughts for they become your words.
►Manage and watch your words for they will become your actions.
►Consider and judge your actions for they will become your habits.
►Acknowledge and watch your habits for they shall become your character.
►Understand and embrace your character for it becomes your destiny and your dreams.
No matter what befalls us – and let’s be clear, some of them are real doozies – let’s remain in in the pilot’s seat.
I urge you to continue to make choices that are good for you, your family, your community, and your health. I wish you all joyous holidays!
2019 is right around the corner. Many of us make New Year’s resolutions, and in my practice, the ones I hear the most concern eating better and losing weight.
Every year, U.S. News and World Report assembles a panel of experts to rank leading diets in a variety of categories. Ranked #1 for Best Weight-Loss diet was once again the Weight Watcher diet. What was the very last (worst!) one on the Best Overall diet list? I recently dedicated an entire column to it: the very popular low carb, high fat Ketodiet.
These results don’t surprise me. Also unsurprising is that once again, the DASH diet ranked the best overall diet, sharing the lead with the Mediterranean diet. The DASH diet also ranked best for healthy eating, and best for heart-healthy eating.
DASH stands for Dietary Approaches to Stop Hypertension. It was developed to lower blood pressure without medication, and emphasizes portion size, eating a variety of foods, and proper nutrients. It encourages us to reduce the sodium in our diet and to consume foods rich in potassium, calcium, and magnesium. It is also in line with recommendations to prevent osteoporosis, heart disease, stroke, diabetes, and some cancers. This diet is intended to be a lifelong approach to healthy eating.
Some of the DASH highlights:
Grains are OK. Look for labels that specify 100% whole grain.
Vegetables fill the diet with fiber, vitamins and minerals. Variety and quantity are great. Try stir-fry, soups, salads, and juicing.
·Fruit is important, as it is packed with fiber, potassium, magnesium, vitamins and minerals. Use fruit as a snack, dessert, or in juicing along with vegetables.
Dairy is a major source of calcium, vitamin D, and protein. Make it low- to no-fat. Try substituting frozen yogurt for ice cream.
Lean meat, poultry and fish are good sources of protein, B vitamins, iron and zinc. Keep the portion sizes small, and trim away fat and skin. Bake, broil, roast or grill instead of frying in fat. When selecting fish, focus on those that are rich in omega-3 fatty acids, which help to lower cholesterol.
Nuts, seeds and legumes (including almonds, seeds, beans, peas, and lentils) are good sources of potassium, magnesium, fiber and protein.
Fat is essential to a good diet, but too much fat increases the risk of diabetes, heart disease, arthritis, hypertension, and obesity. Minimize saturated fats (found in meat, butter, cheese, whole milk, cream and egg yolks) and trans fats (found in processed foods such as crackers, solid shortenings, palm and coconut oils, and lard).
The diet permits sweets, but in moderation.
Alcohol raises blood pressure. Limit consumption to no more than two drinks per day for men and one drink per day for women.
Caffeine can raise blood pressure in the short term, so if you already have hypertension, you should limit caffeine.
I encourage you to make changes in your diet gradually, to reward yourself for successes, to include physical activity, and to build support around you. Approach this together with your family. Eating healthy food is not an all-or-nothing goal. The more positive changes you make, the more successful you will be.
In 2019, let’s feel better, live well and eat healthfully!
Here we go again: We are entering the flu season. What will it be like this year, and why is getting vaccinated so important?
Influenza (flu) is a contagious respiratory illness caused by a virus. It infects the nose, throat, and sometimes lungs, and can be mild, severe, or even deadly. Symptoms include fever, cough, sore throat, runny nose, body aches, headaches, chills, fatigue, and sometimes diarrhea and vomiting. It is communicated through tiny droplets that spread when we cough, sneeze or even just talk. They may land in the mouth or nose of people nearby, or we can infect ourselves when we touch an object that has the flu virus on it, and then touch our own nose, mouth or eyes.
It’s important to note that we are at our most contagious during the first three to four days of the illness, but flu symptoms don’t even appear until about two days after exposure. So, it’s very easy to spread the virus to friends, loved ones, and strangers before we even know that we have it!
Which flu viruses will we see this season? There are many different ones and they are constantly changing. About a year ago, scientists used worldwide patterns to forecast which strains we are most likely to see now. Usually, they choose the three most likely strains, but this year the vaccine is quadrivalent – it protects against the four most likely viruses. This increases the odds of hitting the correct strains.
The current flu vaccine is an injection made up of killed viruses from those four lines. There is also a lesser-used nasal spray flu vaccine made of live attenuated flu viruses. This means that the actual viruses are living but weakened, so less likely to cause disease. Your doctor can advise you as to which vaccine is best for you.
The time to get a flu vaccine is before the flu begins to spread. It takes about two weeks after receiving the vaccine for our bodies to develop protective antibodies. So, NOW is the time.
How severe will this season be? It’s too soon to predict. Flu season runs from about October to May nationwide, but here in California we tend to lag behind the rest of the country. But we can expect that it will affect between 9 and 49 million people across the nation this year.
How can we each avoid coming down with the flu? Getting vaccinated every year is a great way, and it’s quite safe for almost everyone. (Don’t skip a year, because the viruses that come around each year are usually different from the previous year’s. Also note that the immunity you may have from either getting the flu or from getting a vaccine declines over time.) Avoid public places where you might come into contact with a lot of sick people – including those whose symptoms aren’t yet showing. Wash your hands frequently, and keep them away from your face. Maintain a healthy lifestyle including proper sleep, exercise and nutrition. If you are sick, stay home to prevent spreading your germs to others.
And yes, there are those who get the flu despite having been vaccinated. How can this happen?
· You might be exposed to the flu virus shortly before or after getting the flu vaccine. Because it takes two weeks for the antibodies to fully develop, it may simply be a matter of timing.
· You might be exposed to a flu virus that is not included in the vaccine, as there are many different strains that circulate each year. Scientists are quite good at choosing the most likely strains, but it’s really a best guess.
·While the vaccine works for the vast majority of us, its effectiveness may be reduced by age, chronic disease, or other factors.
Are flu vaccines safe? Hundreds of millions of Americans have safely received flu vaccines over the past 50 years, and extensive research is done to support our safety. You cannot get the flu from the vaccine injection. There are, however, potential side effects from the vaccine that occur roughly one or two percent of the time.
These rare and mild side effects may last a day or two and include soreness or redness at the injection site, headache, fever, nausea and muscle aches. Interestingly, these potential side effects may resemble the flu itself – but are not the flu.
As is the case with all vaccines, there is an approximately one per million – let me repeat that: one per million - chance of developing Guillain-Barre syndrome.
What if you do come down with the flu? Medicines like Tamiflu can help reduce the symptoms and length of infection, if started during the first few days. But overall, the flu vaccine works. Most insurers cover the vaccine because they are convinced of this, and as a result, that it benefits their own bottom-line.
The vaccine protects us each from illness, but it’s also for the greater good: when we choose to become vaccinated it reduces the spread of the disease in the community.
Last weekend while making a sandwich, I pulled out the cheese and found a lovely kaleidoscope of colors. Colorful cheese is usually a bad sign, but it’s actually a bit more complex - and how can we tell when other foods have gone bad?
No, please don’t trust expiration dates; they’re only a suggestion. An expiration date may encourage us to waste perfectly good food, or mislead us into eating food that has already spoiled. Trust me, I’m a doctor: food poisoning is no fun at all. Here are a few guidelines to follow.
We all know that it’s easy to tell whether milk has spoiled – it just takes a sniff. Milk spoils due to microbes that pasteurization misses. Pasteurization is not perfect, so some bacteria are left behind. These bacteria dine on the lactose and excrete lactic acid, which starts a chain reaction.
Let me share my wife’s trick: sometimes, the only milk that has gone bad is well above the level of the liquid, at the very top of the container. Give that top part inside a wipe with a clean cloth or paper towel and then sniff again. Another sign of spoilage is when the milk at the surface separates.
Non-dairy milk, such as soy and almond milk, is completely different. It’s so stable that an unopened container has a shelf life of about a year, and once opened, will last up to 10 days. Separation in non-dairy milk is not a sign it has gone bad - shaking will restore the consistency. Sniff and look at the milk: if it has a sour smell, or is starting to clump, toss it.
Butter is perishable, and will eventually smell and taste bad. Its base of cream causes it to turn rancid. It’s fine to keep butter out on the counter, but there it will be exposed to both heat and light, which will make it go rancid faster. Note that unsalted butter doesn’t last as long as salted butter.
What about peanut butter? It’s pretty amazing - even at room temperature, and even after opening, it can last for months. Due to its high fat content and dry nature, most bacteria don’t survive. Separation is not a sign that it has gone bad; just stir it again. It goes bad by becoming rancid, which changes the flavor and smell. The sniff test should work, and apparently, eating rancid peanut butter will not harm us.
If mold is visible on one slice of a loaf of bread, even with no visible mold on the rest, none of the loaf is safe to eat. This is because bread is porous, and mold spores can spread easily throughout the loaf. If bread has become hard and dry but has no mold, it’s OK.
Many of us keep rice in the cupboard. Most rice, including white, wild, jasmine, basmati, and Arborio, can last a very long time if stored properly, keeping moisture and pests out. Brown rice, however, has a higher oil content, and can go bad in three to six months at room temperature (longer if stored in the refrigerator or frozen). If old rice has become contaminated with bacteria, cooking will not make it safe to eat. If your rice has started to smell a little off, or seems crunchier or drier than usual, throw it away.
If the color of red meat has changed, it hasn’t necessarily gone bad. Meat may become brownish-red due to a reaction with air. However, fading or turning very dark is a sign of aging. Other very bad signs include developing an odor or turning tacky, sticky, or slimy.
How about poultry? Color alone is not the best indicator for whether it has gone bad, as color can normally range from a bluish-white to yellow, depending on living conditions. Seeing darkening around the bones and different shades of pink and red are all normal. However, bad poultry will smell, and develop a slimy or sticky texture.
Bad fish can make us quite ill. Choose fish that is cold to the touch and doesn’t have a strong fishy smell. Fresh fish is extremely perishable: it must go straight into the refrigerator, and don’t keep it around for more than a day or two.
Eggs are pretty easy. Spoiled eggs will give off the distinct odor of sulfur, even after cooking. Contrary to popular opinion, if an egg floats, it’s not necessarily bad. It has, however, aged. When an egg is laid, there is no air inside. As it cools, the contents inside the shell contract. The porous shell allows air to enter, and the egg becomes buoyant. It must be cracked open in order to tell whether it is still good to eat.
What about canned foods? Beware of dented, corroded, or broken cans, as any damage to the can could compromise what is inside. If you see anything suspicious, throw it out. Non-acidic canned goods like soups and puddings last much longer than acidic foods like fruits and tomatoes.
It’s fairly easy to tell when vegetables go bad. Keep an eye out for changes in color, or becoming soft or slimy. Wilted lettuce, celery, and other leafy greens are fine if you remove the bad parts. For cucumbers, zucchini, and squash, cut away the outer layer as necessary. Sprouted onions and potatoes are fine after removing the sprouted parts.
Fruit is more complicated. Take bananas - even when they turn black, they are perfectly fine to eat, and even sweeter when used in banana bread. Citrus fruit is only bad when it is rotten all the way through - just discard the bad parts. The same applies to bruised fruits. If there is mold on berries, cherries, or grapes, throw away the bad ones and thoroughly rinse the rest before eating.
Personally, I think that mushrooms are bad from the start, but I’m told that’s just my childhood bias! To me, they smell strange even when fresh, and always have an odd texture. They have a shelf life of about two weeks. Signs that they are turning bad include wrinkling, turning darker, having a changed smell, and slime.
Let’s get back to cheese. Cheese is tough because there are so many different odors and types. For lifespan purposes, cheese falls into three categories. Dry, hard cheeses like cheddar and Parmesan can last up to six months in the refrigerator. Blue, green or white mold that may show up can simply be cut away. If the mold is any other color, throw away the cheese. Soft cheeses including cream cheese, mozzarella, feta, and Brie go bad quickly due to their high moisture content. When they start to turn, throw the entire cheese away. Other cheeses fall somewhere in the middle.
Freezing is generally the best preservative for our foods. If a freezer keeps a proper and consistent temperature, the food won’t become dangerous – however, the quality will decline. In the event of a power outage, keep the door shut, and there should be a day or two before food spoils. If any frozen food has partly thawed, or rises above 40 degrees, or smells or looks bad, throw it away!
Bad food, or even potentially bad food, is NEVER worth the risk.
While enjoying a bowl of cereal I noticed something suspicious floating in the bowl. Of course, that was the end of that bowl of cereal; I tossed it down the drain. It was probably nothing, but it got me wondering: what in the world was in there?
Nobody wants to find insect parts, rat hairs, mouse poop or maggots in their food. However, the Food and Drug Administration allows low levels of those unsavory items to be present in our food. In fact, the FDA considers this to be natural and unavoidable.
Most of us have never heard of the FDA Defect Levels Handbook. This is (I hope!) the most disgusting government publication in existence. For more than 100 food items, from allspice to wheat flour, this booklet spells out the maximum allowable levels of “defects” that are permissible before the agency considers the food to be unacceptable. It actually spells out just how much mold, rot, parasites, bugs, and other contaminants are allowed in our food.
The handbook puts it this way: “The FDA set these action levels because it is economically impractical to grow, harvest or process raw products that are totally free of nonhazardous, naturally occurring, unavoidable defects.”
Given the large amount of food that is produced daily in the United States, it is unrealistic to think that some outside materials won’t make their way into the finished product. When grain is harvested, it is inevitable that there will be a bug in there somewhere. After harvest, when it is being processed at a factory, or being stored, or in transit, there might be a mouse, and therefore…mouse poop. These “defects” exist in the environment where foods come from, and it is just impractical and too expensive to remove every little bit if it does not actually pose a threat to our health.
If it’s at all reassuring, do note that food-processing systems are far cleaner, more effective and more efficient than ever before.
The motivation for setting limits is to utilize this inevitable contamination as an indicator of whether there is something dangerously wrong. One mouse hair in food will not harm us, but many hairs may be evidence of an infestation at the factory. Along with an infestation may be bacteria, viruses, or other harmful microorganisms.
Consider these examples of FDA limits:
· A 16-ounce box of pasta may contain no more than nine rodent hairs.
· Perhaps there are dark specks in your cornmeal. Maybe they’re just cornmeal, but the FDA’s action levels do allow for up to 13 “fragments” of rodent excreta in a 24-ounce container.
· The government permits three maggots in a 28-ounce can of tomatoes.
· A 16-ounce jar of peanut butter may contain up to 136 insect fragments and four rodent hairs.
· Beer drinkers take note: there is a limit of 2,500 aphids for every 10 grams of hops.
· Tiny bugs such as aphids, thrips, or mites may come in from the field with the broccoli. The limit is 60 creatures per 100 grams – or 204 in a 12-ounce bag of frozen broccoli.
· 6% of potato chips may contain rot. However, only 5% of prunes can be moldy, decomposed, or insect-infested.
· 15 ounces of golden raisins may contain no more than 40 milligrams of sand and grit…as well as 65 fly eggs.
· Mushrooms can contain up to 20 maggots per can.
· The cranberry sauce accompanying your Thanksgiving turkey may contain an average of 15% mold filaments.
Honestly, after perusing this FDA handbook, I thought twice about ever eating again. These imperfections sound disgusting.
The good news is that the FDA reassures us that these allowable imperfections present no health hazards. Although the FDA has established these acceptable defect levels, and can take action if a food exceeds those levels, the amounts actually found are much lower. In fact, most food companies set their own quality standards at far stricter levels than these FDA limits.
Note that today’s column does not address intrinsically harmful food contaminants such as pesticides, metals or environmental chemicals, but “merely” defects in food quality. Keep this in mind as you consume your next grasshopper leg.
You are approaching your favorite restaurant and see a letter grade rating in the window. Should you eat at a restaurant rated B? How about C? What does it mean?
Starting in 1998, most (but not all) cities in Los Angeles County have adopted a restaurant grading system. In fact, Downey and Norwalk were among the first. The Los Angeles County Department of Public Health is responsible for conducting twice-yearly inspections.
A perfect rating is 100, and a restaurant is docked a certain number of points for any violation, based on the associated public health risk. A score of 90 to 100 gives the restaurant a letter grade of A, and means “generally superior in food handling practices and overall food facility maintenance.” 80 to 89 results in a B, which means “generally good in food handling practices and overall food facility maintenance.” A score of 70 to 79 yields a C, which means “generally acceptable in food handling practices and overall food facility maintenance.” A rating between 0 and 69 represents “poor in food handling practices and overall food facility maintenance.”
A restaurant that receives a score below 70 twice within a twelve-month period is subject to closure and legal action. Both the letter grade and the actual score must be prominently posted.
Of course, there are major violations that can close down a restaurant immediately, regardless of the score.
It’s important to note that these restaurant inspections are merely a snapshot of daily operations. Inspectors will generally spend a few hours inside the restaurant, and the inspection will be a fair representation, but cannot tell the whole story. So, it’s ultimately up to us to decide for ourselves whether to eat there.
A low score does not mean that dining there will make you ill; nor does a high score guarantee you will not get sick. The inspection is a public service that gives us some information to go on.
More important than the final score or grade are the specific violations that earned the score.
For more detail, it’s easy to look up the inspection report (Google “LA County Food Ratings”) and see what specific deficiencies were found.
A B rating can be a result of having a few cracked floor tiles, a dusty ventilation hood, a fruit fly found at the bar, and perhaps an imprecise thermometer. Or, a live rat could be found, a 10-point deduction, but the overall rating could still be an A.
And that is what can be misleading about the letter grade. Your favorite restaurant may have obtained a letter A, but nonetheless have a serious problem with food handling.
Closures can happen at any restaurant no matter what their grade. A study examined 1,069 food permit suspensions issued to restaurants. A whopping 95% of these suspensions were given to restaurants that were receiving an A or B grade at the time they were closed. (The most common automatic closure is due to finding live insects or rodents in the kitchen.)
In addition to paying attention to the letter grade and the story behind it, I recommend reading public reviews on websites like Yelp and TripAdvisor, taking a look at the bathroom as an indication of overall restaurant cleanliness, and previewing the menu.
If, after all of this, you still have an interest in eating out, I wish you safe and delicious dining!
Ginger has long been one of my mother’s favorite foods. Birthday presents that contain it in one form or another are always a hit. In addition to its unique flavor, however, ginger has some amazing properties.
Ginger is native to warmer parts of Asia, including China, Japan, and India. Its use for health-related purposes comes up in ancient Sanskrit, Chinese, Greek, Roman, and Arabic texts. Dried ginger has been used for thousands of years to treat stomachaches, diarrhea, and nausea.
Scientific analysis shows that ginger contains hundreds of components and metabolites, some of which do appear to contribute to health and healing. Of these, the gingerols and shogaols have been most extensively researched. The most common current medical uses for ginger include:
Digestion - The phenolic compounds in ginger help relieve gastrointestinal (GI) irritation, stimulate the production of saliva and bile, and suppress gastric contractions as food and fluids move through the digestive tract. Ginger also stimulates the pancreatic enzymes.
Nausea - Chewing raw ginger, drinking ginger tea, or consuming it as lozenges or candies is a common remedy for nausea, especially during cancer treatment or after surgery. Taking ginger for motion sickness often reduces feelings of nausea (but does not appear to prevent vomiting). Ginger in low doses is safe to use for nausea during pregnancy.
Cold and flu relief - Drinking ginger tea with lemon and honey helps to treat a cough. It also acts as a diaphoretic (it promotes sweating), which helps the body to rid itself of fevers and toxins.
Pain relief – Some studies have shown that daily ginger supplementation reduces exercise-induced muscle pain. It’s also been found to alleviate menstrual pain.
Osteoarthritis inflammation - Ginger has been found to be modestly effective and reasonably safe when used for this type of inflammation.
There are, of course, many additional claims of ginger’s benefits, and studies are ongoing.
As with any herb or medication, use precaution and moderation. When ginger is used as a spice, it is considered safe. For some, however, ginger can cause abdominal pain, diarrhea, and gas. It is recommended that those with gallbladder disease use caution because it may increase the flow of bile. There is some concern about taking ginger with anticoagulants (such as warfarin).
If you enjoy the taste of ginger, by all means consume it and enjoy. If you also get therapeutic benefits from it, please indulge. My mother would certainly approve.
I’m writing this on Sept. 24. It’s my 26th birthday, and after a weekend spent celebrating with family and loved ones you’d think I’d be bursting at the seams.
But I’m not. In fact, I feel pretty much the same way I’ve felt for the last several months. Trust me, that’s not a good thing.
Speaking about anxiety and depression can be taboo; for many it’s a giant elephant in the room.
The Anxiety and Depression Association of America says anxiety disorders are the most common mental illness in the United States, affecting 40 million adults in the United States age 18 and older, or 18.1 percent of the population every year. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.
These illnesses are not black and white; I’d caution to say they’re even gray.
When these disorders develop, they do so seemingly indiscriminately. They don’t necessarily form due to any one thing. You can suffer because of your physiology, your personality, your experiences.
As a journalist, it is my daily goal to bring information forward for the public knowledge and use. Because everyone’s experiences with depression and anxiety are different, the only way I know how to do my job here is to do so by sharing my own battle.
I’ve only recently started to open up about my struggle with anxiety within the last year or so. While I’ve frequented a psychologist off and on since I was a kid, he never truly got the full story.
For me, as I’m sure it is for many other people who struggle, I didn’t want to admit that there was something so totally wrong going on in my head. I didn’t want to seem weak. For years, I’d brush off anything I was feeling so that I could help someone else with whatever their struggle was.
“I’d rather I worry about you than you worry about me,” I’d say.
The problem with that mentality is none of your feelings resolve. They sit. They marinate. They fester. They boil.
Dealing with these illnesses is more than just feeling sad or nervous. For me, depression and anxiety are this:
It’s walking down a hall, but feeling like you’re walking through water and being held back.
It’s the air feeling heavy. It’s a simultaneous fluttering and heavy feeling in your chest.
It’s sleeping on the couch for a month instead of your own bed. You don’t know why, but you just do.
It’s still being embarrassed about little mistakes, errors, and bloopers that you made days, months, or years ago that others have long forgotten.
It’s feeling like you’re annoying your best friend because they didn’t text you back right away.
It’s feeling like you’re going to walk into losing your job every time you put the key in the door at work.
It’s seeing your name on a byline week after week, but seriously doubting anyone ever reads your articles.
It’s cleaning off your desk little by little of the bits of your personality that make your workspace feel homey because you’re ashamed that your personality includes a love of pro wrestling, Spider-Man and Power Rangers.
It’s not playing your saxophone as much anymore because you’re sure that the neighbors hate it.
It’s staying up until 3 a.m. agonizing because the girl who gave you her number and seemed interested in going out with you didn’t respond.
It’s not going to church for over a month because you don’t feel worthy of being there.
It’s not necessarily thinking about hurting yourself, but feeling like if something catastrophic did happen to you it wouldn’t be the worst thing in the world.
It’s being angry at your brain for the chemicals firing in it that make you feel this way.
For anyone dealing with anxiety and depression who reads this, I pray that you take something from it. Reach out to someone. Get help. Don’t let what you’re feeling consume you.
The hardest thing to do, above all else, is to try and remember that you’re not alone.
For more information on dealing with a mental illness, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP (4357).
For more serious situations, the U.S. National Suicide Prevention Hotline can be reached at 1-800-273-TALK (8255).
How can a diet that pushes butter, red meat and bacon, and eliminates complex carbohydrates like fruits, vegetables, and whole grains, be a good thing? I’m frequently asked about the ketogenic (keto) diet. Admittedly, I began my investigation with a distinctly negative bias.
Back in the 1920s, researchers observed that children with epilepsy improved on this type of diet, and it has remained in the medical textbooks ever since. There is now speculation that other groups of people might benefit from it, including those with neurodegenerative disorders such as multiple sclerosis, Parkinson’s and Alzheimer’s disease, and even those with traumatic brain injuries.
The keto diet allows very few or no carbohydrates, which are the body’s main source of energy. The body is then forced into a state of ketosis, where fat is burned for energy instead of carbohydrates. The keto diet includes large amounts of high-fat foods, including red meat, avocado, coconut milk, oils, nuts and nut butter, bacon, egg yolks, butter and cheese. It also includes fish and seafood, low-carb vegetables, meat, poultry, and plain yogurt. A very small quantity of leafy greens, broccoli, asparagus, cucumber, celery, tomatoes, peppers, mushrooms and zucchini are allowed.
Excluded foods include fruit, bread, pasta, legumes, beans, starchy vegetables like sweet potatoes, vegetables like winter squash, beets, or carrots, most processed foods, and anything with added sugar. Calories break down to about 75% fat, 20% protein, and 5% carbohydrate. This is dramatically different from the standard American diet, where the proportions are closer to 50% carbohydrates, 30% fats, and 20% protein.
Surprisingly, both research and anecdotal evidence have shown that this high fat diet can indeed be effective for weight loss. The body is forced to burn fat for energy. In addition, eating high fat foods can help minimize cravings and increase the feeling of being full.
The keto diet is also recognized for helping to control insulin sensitivity and release, which plays a vital role in controlling diabetes. When carbohydrates are eliminated, an overload of insulin is avoided, and more balanced blood sugar levels result.
By now, my readers should be expecting to see the word “however.”
· HOWEVER, our brains use sugar to perform. Without carbohydrates, glucose doesn’t enter the blood stream, resulting in a decline in brain function.
· HOWEVER, starvation due to a prolonged lack of carbohydrates can lead to the body losing muscle and energy. Note that once the body enters starvation mode, it can actually be more difficult to shed weight.
· HOWEVER, athletes avoid the keto diet. Low carbohydrate and high fat diets have been shown to do a poor job at feeding the muscles, reducing muscle mass and peak sports performance.
· HOWEVER, while studies do show that consumption of large amounts of saturated fats can actually level out cholesterol levels (temporarily), this diet can ultimately result in much higher blood cholesterol, which can cause far more harm than good, particularly to the heart.
Studies have not yet examined the long-term possible negative impacts on the heart, kidneys, nutritional deficiencies, hydration, cholesterol, etc. The keto diet is recommended only for short-term use, generally for a maximum of 12 weeks. It is not a good idea for the long run, is very difficult to maintain, and doesn’t offer a good option for a full lifestyle change.
I do find the ketogenic diet fascinating because it forces the body to digest fat, thereby targeting body fat stores, resulting in weight loss. The data on treating certain neurodegenerative diseases is promising, and is undergoing further study. The data on diabetes control is also noteworthy. But remember that we need carbohydrates to fuel our brains and our bodies.
The best diet in the long-term is one that builds healthy and sustainable habits. If you are considering the keto diet, I urge you to evaluate with your doctor whether it is appropriate for your own unique health profile.
Coffee – admit it; you love it. But it seems that every day there is a new study telling us that caffeine is good…or bad for us. Which is it? The best answer is both.
Caffeine is a stimulant that occurs naturally in the leaves, seeds, or fruit of more than 60 plant species, including coffee beans, tea leaves and buds, cacao beans, dola nuts, guarana seeds, and yerba mate leaf. It’s known as a central nervous system stimulant, and in some prescription and over-the-counter medicines, it’s used to lessen drowsiness and to improve the effect of pain relievers.
In recent years, caffeine has been added to protein and energy bars, workout drinks, powders, gels, and evengum, jellybeans, waffles, oatmeal, water, syrup, sunflower seeds…and marshmallows! In the United States, more than 90% of adults consume caffeine regularly, at over 200 milligrams per day on average.
Caffeine raises our heart rate and blood pressure, increases energy levels, and improves mood. It acts within minutes, and has a half-life of about five hours, meaning that half of it will still be in our body five hours later. We can build up a tolerance as the body becomes resistant to the drug, and some barely even notice its effects.
On the other hand, those who are very sensitive to caffeine may feel it for hours, and even into the next day. It depends upon the amount consumed and on individual factors, including age and body weight.
Many studies have demonstrated caffeine’s benefits. Here are just a few:
· Just 75mg can increase attention and alertness, and higher doses may improve mental alertness, speed of reasoning, and memory.
· Caffeine can increase endurance and reduce perceived exertion.
·Drinking coffee may slow the mental decline that is often associated with age.
· Some studies suggest that long-term caffeine consumption may reduce the risk of developing Alzheimer’s dementia, and higher levels of coffee consumption have been associated with a lower risk of developing Parkinson’s disease.
· Caffeine may help with weight loss by suppressing appetite. It also may stimulate thermogenesis, so that the body generates more heat and energy from digesting food.
· Caffeine may help protect people from blepharospasm, an eye disorder, and may help protect the lens of the eye against cataracts.
· Caffeine may guard against some skin cancers. One study showed that the consumption of three cups of coffee a day led to a 21% lower risk of developing basal cell cancer for women, and a 10% lower risk for men.
· A higher caffeine intake was associated with a lower risk of kidney stones.
· Men and women who consumed four cups of coffee per day showed a 49% lower risk of death from oral cancers.
· A study of Swedish women indicated that drinking more than one cup of coffee per day may lead to a 25% lower risk of stroke, and a recent German study found a lower risk of mortality from heart disease.
The negative side effects of caffeine are well known, including nervousness, restlessness, irritability, stomach ache, diarrhea, rapid or irregular heart beat, increased rate of breathing, insomnia, sweating, gout attacks, incontinence, exacerbation of hot flashes during menopause, migraines, heartburn, and even anxiety and panic attacks.
Caffeine increases urinary volume and frequency, causing the body to lose water and electrolytes. High doses are associated with a small decrease in bone density, because caffeine affects the way in which our bodies absorb calcium.
The American Psychiatric Association does not label caffeine as an addictive drug. Still, caffeine withdrawal is a real syndrome. Symptoms, including fatigue, irritability, muscle pain, nausea, lack of focus, and headache typically subside within a few days. A gradual taper usually works best for those trying to quit their caffeine habit.
An important note about alcohol and caffeine: drinking coffee does not make us sober, or fit to drive. It does make us more alert, but does not reverse the poor judgment and other effects associated with alcohol.
My bottom line? The data coming at us is both positive and negative, and oftentimes directly conflicts. Consume caffeine if you enjoy it. Be attuned to undesirable side effects, and reduce your consumption as necessary. If your goal is to increase your energy level, consider other methods such as exercise, improved nutrition, better sleep, and stress reduction.
Are you familiar with moringa, a popular new supplement? The sheer number of sources claiming a very wide range of unbelievable benefits is astounding. I must admit that after my recent research into health scams, this makes warning lights go off in my head.
Moringa oleifera is known as the drumstick tree, the miracle tree, the ben oil tree, and the horseradish tree. It has long been used to treat a variety of conditions. Native to India, it also grows in Asia, Africa, and South America. The supplement can be made from the leaves, bark, flowers, fruit, seeds, and root.
In some parts of the world, moringa is an important food source. It contains a variety of vitamins and minerals, including Vitamin A, thiamine, riboflavin, niacin, B6, folate, ascorbic acid, calcium, potassium, iron, magnesium, phosphorus, and zinc.
Because it can be grown cheaply and easily, and because the dried leaves retain their vitamins and minerals, moringa is used in India and Africa in programs to fight malnutrition.
The immature green pods (drumsticks) are prepared like green beans, and the seeds are removed from mature pods and cooked like peas or roasted like nuts. The leaves are cooked and used like spinach, and they are also dried and powdered for use as a condiment.
Some of the benefits claimed by manufacturers of moringa supplements appear reasonable; its antioxidants may well fight free radicals, for example, which might lead to other significant benefits. But the list of benefits is rather staggering and speculative, including curing ailments from head to toe - from reducing inflammation to fighting cancer. Almost none have yet been backed up by scientific studies.
Naturally, moringa can have unintended side effects; consult your doctor before taking any kind of supplement. As with all supplements, the United States Food and Drug Administration doesn’t monitor or certify any health claims. It doesn’t evaluate the purity or quality. It doesn’t stand behind the validity of the claims made by the manufacturers, or whether it is safe or beneficial to consume.
The fact is that every chemical has some effect. For example, cinnamon lowers blood sugar, but diabetics don’t replace their insulin with cinnamon. Moringa may indeed lower blood pressure and raise thyroid levels in the body.
However, supplements like moringa are not measured or mixed precisely or consistently, and we simply cannot count on them to treat important health issues like low thyroid or high blood pressure.
My bottom line will sound familiar. The world is filled with fascinating products that have the potential to help or to harm. While Western medical science cannot claim to have all of the answers, it does provide a framework with which to proceed as safely as possible. Some as yet unproven supplements might very well prove beneficial.
If you are interested in moringa, please speak with your physician. He or she may not yet be familiar with it, but can at least evaluate your particular health situation and offer some educated advice.
I recently saw a patient who suffered from chronic back pain from a herniated disc. He asked me what I thought about O3, or ozone therapy. The best that I could do was to tell him that I would look into it. Allow me to share what I learned.
We’re all aware that there is an ozone layer found in the Earth’s stratosphere, which absorbs most of the sun’s ultraviolet radiation. Ozone is a colorless, water-soluble gas made up of three oxygen atoms (O3). It is a close cousin to ordinary oxygen, which has two oxygen atoms (O2). Ozone has been used clinically since the 1800s. During the First World War, it was used to disinfect wounds, improve blood flow, and serve as an anti-inflammatory.
The theory behind O3 therapy is that increasing the amount of oxygen in the body may help to reduce the clogging of blood cells, detoxify the liver, decrease uric acid in the body, improve circulation and oxygen supply, kill viruses, bacteria and fungus, and improve the activity of white blood cells. Its effectiveness is still unproven for these claims, but ozone therapy is, nonetheless, being used on infected wounds, circulatory disorders, geriatric disorders, macular degeneration, viral diseases, arthritis, SARS (severe acute respiratory syndrome), AIDS, and cancer.
Using a gas as a medical treatment is quite unusual. This gas is available in several forms, including ozonated olive oil, ozonated water, injections, administered directly into the blood stream, blown into the rectum, and as a gas bath or sauna.
Ozone therapy has been considered safe since at least 1980, when a study looked at over 5 ½ million ozone treatments. Side effects are quite minimal. However, when inhaled, ozone is extremely toxic. Those of us who were raised in Southern California will recall the years of smog alerts. Small amounts of ozone and nitrogen dioxide in smog can irritate the lungs and throat, resulting in coughing, shortness of breath, and damage to lung tissue. Ozone therapy carefully avoids ozone inhalation.
But let’s return to my patient, whose question about his herniated disc pain jump-started my education in ozone: Among its many possible applications, ozone therapy is emerging as a potential alternative to steroid injections and surgery for treatment of herniated discs. Both steroid injections and surgery pose potentially significant safety concerns.
Using ozone gas for herniated disc therapy has been practiced in Europe and Asia, and the research to date shows that 65% to 80% of patients have reduced symptoms after treatment. 75% of patients had benefits that lasted through 10 years.
Given that the European evidence suggests low-risk and high reward, why isn’t ozone therapy used more as an option here in the United States? More research is needed to determine the long-term effectiveness and safety of oxygen-ozone injections. Some of the skepticism is based on the fact that a large percentage of herniated-disc patients actually heal, with time, on their own.
Still, ozone therapy is a promising treatment that appears to be safe and may well be effective for a number of health conditions. Research is ongoing.
Most of us have at least one irrational food dislike, right? Mine is mushrooms.
My wife told me to not write about this topic because I am incapable of being objective. In fact, when my daughters were young, I would visit their classrooms to give the doctor/dad health talk. Somehow my anti-mushroom bias would sneak in, and I hereby apologize to any impressionable young minds I may have impacted. Hopefully my other, more scientifically based, messages got through.
I am now older and hopefully more mature, so here is a far more balanced evaluation of the literature on the health impact of mushrooms.
Mushrooms have been consumed for thousands of years. Early Greek, Egyptian, Roman, Chinese, and Mexican civilizations valued the mushroom as both a culinary delicacy and as a medicine. They are normally classified as a vegetable or an herb, but mushrooms are actually fungi. They are found in a variety of shapes, sizes, and colors. Poisonous mushrooms can be difficult to identify in the wild, so unless you are skilled in picking them, always buy from a reliable source.
Claims abound that certain mushroom species, consumed as either food or extracts, may reduce the risk of disease. Some interesting research includes the following:
· One study substituted mushrooms for meat, thereby reducing calories over a six-month period. Those on the mushroom diet experienced a significant loss in body weight, BMI, and inches around the waist. However, the meat group did as well, and the difference between the two groups was not statistically significant. One guess is that when we cut out one source of fat, we tend to substitute another.
· A shitake mushroom extract was tested to see if it could improve oral health by slowing tooth demineralization and alter the microbes in our mouth. The study looked at a placebo, the shitake extract oral mouth rinse, and a leading gingivitis mouthwash. The mushroom rinse performed best, followed by the gingivitis mouthwash, and last was the placebo.
·An association was demonstrated between mushroom intake and a lower breast cancer risk for women with certain types of tumors.
·Various mice studies have demonstrated improvements in the gut microbiota, mental cognition, and immune function. However, human studies haven’t yet confirmed such findings.
Research would still be useful to identify potential benefits of various species of mushrooms.
Be careful, however, as there are numerous unproven claims out there that sound way too good to be true – and probably are.
But this much is clear: mushrooms are fat-free and quite low in calories and sodium, and are therefore a good food for people trying to control calories and blood pressure. They are also an excellent source of potassium (a portabella mushroom has more potassium than a banana), which helps to further lower blood pressure.
They are loaded with antioxidants, including selenium, which help to protect the body from damaging free radicals that can lead to heart disease and cancer. They are a significant source of beta glucan, which is a form of soluble dietary fiber that helps to lower cholesterol and regulate blood sugar. Mushrooms are rich in the B-vitamins riboflavin, niacin, and pantothenic acid. They are rich in copper, which helps the body make red blood cells and vitamin D.
With enormous reluctance, I must conclude that mushrooms are a nutritionally sound food, filled with substances that may very well boost our health. While I still have absolutely no intention to add them to my own menu, I will admit that they certainly can be a part of a sound and balanced diet.