The Unproductive Office Visit

/in /by

I recently got an email from a long-time listener to my local radio show Dr. Chet’s Straight Talk on Health. The gist of what she wrote went something like this. “You always tell me to work with my physician for my better health, that they should be my partner for good health. What if I can’t get their attention to listen to what I have to say? I had to get a new primary care physician (PCP). They didn’t really listen to me and just wanted to order a bunch of tests for no specific reason.” I’ve heard that before.

When we lived in Buffalo, Paula got an appointment with a new PCP. Paula goes to the doctor prepared; she always takes a list of her medications and because this was a new PCP and she knew she might forget something critical, she had printed a list of symptoms she wanted to discuss in hope of arriving at a diagnosis. The physician threw the list on the desk without looking at it and proceeded with his agenda. That’s not the way to get along with Paula; it went downhill from there.

Is this a common problem? Physicians who don’t take the time to listen to what ails us? Researchers wanted to find out. They examined video and audio tapes of office visits that were recorded for training purposes. This is a complex task because in some cases, a nurse may inquire about the nature of the visit while getting baseline information. In others, residents working with the physician may interview the patient to determine the purpose of their visit. In many cases, it was the first contact between patient and physician. What they found was interesting and disturbing; more in Thursday’s Memo.

Tomorrow night is the July Conference Call for Insiders. If you want to take part, simply go to DrChet.com and join as an Insider. I’m going to be discussing several topics including the effectiveness of complementary medicine in cancer treatment. As always, I’ll be answering Insiders’ questions as well.

What are you prepared to do today?

Dr. Chet

 

References: J Gen Intern Med (2018). https://doi.org/10.1007/s11606-018-4540-5

 

Travel Bugs: Everywhere but Planes

/in /by

Given the results of this study, where would a person most likely pick up a bug while traveling? Remember, the results of the air and physical locations of the plane that were tested and sent for analysis showed no measurable respiratory viruses of any kind, so the authors speculated about the most likely locations for picking up a virus. They believe you’re more likely to find a bug in transportation to the airport and then to the hotel. Or in the airport at a restaurant or store. In the gate area where people are less confined. In bathrooms where people are more likely to spread the virus to surfaces.

In other words, you can pick up a virus just about everywhere you can imagine but the plane. It’s a good idea to pay the closest attention outside the plane—keep your hand sanitizer handy and wash your hands often—and then don’t worry so much about the inside. Kids are a germ magnet at any time, so be extra vigilant when traveling.

You can also do what I do beginning the day before I leave for a trip: start taking echinacea, garlic, and extra vitamin C to boost your immune system. That’s my way of avoiding respiratory infections or any other form of illness when I travel. After 20 years on the road, it still serves me well. Get the details in the Health Info section of DrChet.com: Immune Boost 1-2-3. In it you’ll learn all about how to tune up your immune system to get ready to meet new germs and viruses, along with the latest info on echinacea, and one more step you can take to get your insides ready to hit the road.

What are you prepared to do today?

Dr. Chet

 

Reference: www.pnas.org/cgi/doi/10.1073/pnas.1711611115

 

The Safest Seat on a Plane

/in /by

If you want to boost your odds of remaining healthy after a flight, let’s begin with the location of your seating assignment. Researchers determined that the people in the center of coach had the most contacts with other passengers and flight crew. That makes sense. Everyone with the need is going forward or backward to use the bathrooms. But the contacts increase if the passengers leave their seats. In addition, there’s more contact with the crew in the center of the plane.

As to seat location, the aisle seats get the most contact with crew and passengers, the middle seats a little less. The seat with the least contact with passengers or crew is definitely the window seat; in fact, there are zero contacts about 10% of the time. The crew has the most direct contact with passengers; that’s to be expected as they distribute food and drinks, answer questions, and conduct safety checks.

Here’s the surprise: the results of the air and physical locations that were tested and sent for analysis showed no measurable respiratory viruses of any kind. That seems unusual because eight of the flights were during cold and flu season. But finding no viruses means they found no viruses using standard virus-detection tests. It should be noted they did not test for bacteria that could have been present, just respiratory viruses.

Based on the results, the researchers estimated that the major points of contact would be one meter in front and behind a sick passenger sitting in any row. If you were outside of that zone, you could be reasonably confident you didn’t catch a respiratory infection while on a flight, even if some of the passengers were infected with a respiratory virus. In this day and age, the fear of catching some form of respiratory superbug on a flight is extremely low.

Yet we know travel often results in illness. Where could people pick up a bug? I’ll let you know on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: www.pnas.org/cgi/doi/10.1073/pnas.1711611115

Can Airline Travel Make You Sick?

/in /by

Have you ever flown for a vacation and found you were beginning to get a cold or other respiratory infection? How about when you fly for business? Just when you want to be at your peak, you’re feeling congested and beginning to cough. You immediately want to blame the flight for making you sick; after all, being in an enclosed area and breathing all that recycled air in a confined space, you obviously picked up a bug from another passenger. Is that a reasonable conclusion?

The risk of respiratory infection is on the minds of those of us who travel for business and pleasure—okay, maybe not the first thing we think about, but it’s on the list. With the possibility of infections being easy to transmit on flights, it’s a global concern as well. The airline manufacturers are concerned because they provide the delivery systems for billions of passengers. It’s also on the minds of researchers who want to know how infections are spread on planes.

Researchers from Emory University, Georgia Institute of Technology, and the Boeing Corporation sought to find out. Using prior research as a guide, they created a methodology of how to assess the course of respiratory infections. This is the kind of study research assistants dream about: they got to take 10 intercontinental flights from Atlanta to several West Coast locations. However, they were not just sitting quietly. They had to track the movement of every passenger and flight crewmember for the entire flight to monitor contacts between passengers and crew. And since they were on Boeing 757s, that’s quite a few passengers. Then they had to sample 22 different surfaces per flight.

I’ll let you know what they found on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: www.pnas.org/cgi/doi/10.1073/pnas.1711611115

 

Rising CO2 and Nutrition: The Bottom Line

/in /by

All of nature is a delicate balance; when any component changes, there will be some sort of effect—maybe good, maybe not. The mineral nutrient and trace element content composition of a plant, technically called the ionome, reflects a balance between carbon, obtained through CO2 in the air, and the remaining nutrients, obtained from the soil. If the CO2 increases in a disproportionate way to the nutrients available from the soil, it could create an ionomic imbalance. In other words, the balance of nutrients is disrupted. This imbalance in CO2 and soil nutrients could affect the nutrient content of the plant including the protein and micronutrients.

That’s exactly what scientists found in their research. Remember, they used a CO2 level in the FACE-field testing to mimic CO2 levels at the end of the 21st century. Most species of rice declined in protein, iron, and zinc, but that was expected based on prior research. But there were also consistent reductions in vitamins B1, B2, B5, and B9. On the upside, they did find an increase in vitamin E in some varieties of the rice.

Here’s the concern: rice is a staple for two billion people. In fact, it’s their primary source of nutrients because food is not plentiful in many of those countries. A 10% decline in protein could have a major impact on the growth and development of the people dependent on rice for their primary food source. The same is true for any of the other nutrients; they’re critical for the immune system and many other biochemical functions.

The Bottom Line—For Now

While this research is real, it’s most definitely not complete yet. The CO2 projections for the turn of the century may not be accurate; they could be lower or they could be even higher. What if they were higher? Let’s take it one step farther and consider the food supply in the U.S. and Canada right now. What if the current CO2 levels are having an impact on our food supply now, not just on rice, but in all the food that’s grown? What if our food is becoming less nutritious?

This raises two points. If there were ever a reason to complement your diet with dietary supplements, this would be it.

Take it a step further. I get more queries on what people can and cannot eat because they have issues with specific foods such as wheat. What if it’s not the gluten in wheat that’s the problem? What if it’s the changes in nutrient content that upsets the balance of amino acids? Or the B vitamins? That imbalance may be the actual culprit. Only more research will tell.

This one is far from over. I’ll keep watching to keep you informed.

What are you prepared to do today?

Dr. Chet

 

Reference: Science Advances: DOI: 10.1126/sciadv.aaq1012.

 

How Researchers Determined the Effect of CO2 on Nutrition

/in /by

An international group of researchers wanted to know how higher CO2 levels would impact the nutrient content of a staple in the diet of over two billion people: rice. If the nutrient levels change substantially, that could have an impact on the nutritional status of many people who might already be undernourished.

Over several years the researchers grew 18 strains of rice that are raised throughout the world. They used an interesting technique called FACE, which stands for free-air CO2 enrichment. The technique uses tubing to emit CO2 near the plants. The amount emitted is dependent on the CO2 levels on the plot of land and controlled by sensors. That allows them to keep the CO2 levels constant just as they would be when grown in fields while the plants grow in a natural outdoors setting.

The researchers used the CO2 levels that are estimated to occur by the end of this century. True, none of us will likely be alive by then, but most of us know people who will be. The knowledge gives agricultural scientists time to develop plants that can grow with adequate nutrient content in those CO2 levels. CO2 may not increase as expected, but future generations can be prepared if they do.

What did they find? I’ll let you know on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: Science Advances: DOI: 10.1126/sciadv.aaq1012.

 

Does Carbon Dioxide Affect Nutrition?

/in /by

Carbon dioxide is a waste product of energy metabolism. When we burn the food we eat, the protein, carbohydrates, and fat will be eliminated as carbon dioxide and water. When we use the gasoline in our cars or lawnmowers, CO2 and water are also released during that form of metabolism (called combustion) as well. The benefit for us and our cars is that we get energy. The problem is that we’re producing too much CO2 from gasoline and other fossil fuels.

CO2 levels have risen and fallen over the millennia in response to global trends, but since the invention of the internal combustion engine, the atmospheric CO2 levels continue to rise. As the number of uses for engines has increased, so have CO2 levels; they’re now 100 ppm higher than the previous highest level.

What does this have to do with nutrition? After all, don’t plants need CO2 for photosynthesis? They combine CO2 and H2O together to make sugar, right? Correct. But what researchers wanted to know is whether the excess CO2 would affect the nutrient content of specific crops. Are we growing supercrops? That could have immense implications for global nutrition. I’ll talk about what they discovered on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: https://go.nasa.gov/2zkpdjL.

 

Celebrate Your Independence

/in /by

Tomorrow we celebrate Independence Day in the U. S. with parades, picnics, and fireworks. We will eat our favorite grilled foods—burgers and dogs or smoked slow-cooked ribs and corn on the cob and on and on.

The problem is that while we celebrate our nation’s Independence, we are giving up our own independence. Based on a just-released report from the Centers for Disease Control, just 22.9% of all adults meet the exercise guidelines set 10 years ago (1).

It’s this simple: if you’re not working at moving, you’ll eventually lose your independence to move. You’ll need canes and walkers just to be able to prevent falls. You may graduate to a wheelchair and then the ultimate: the motorized cart. The more sedentary you are, the more independence you lose. Ever sink your behind into a chair you couldn’t get out of without help? Imagine if that’s your life all day, every day.

The guidelines aren’t that complicated. Two days a week, do some muscle-strengthening activities: lifting weights, calisthenics, yoga, whatever strengthens and stretches your muscles. Then either moderate-intensity aerobic exercise for at least 150 minutes per week or 75 minutes of vigorous-intensity aerobic exercise or some combination of the two. That’s it. Just about 30 minutes per day.

Yet less then 23% of all adults meet those guidelines. Some states are better than others. The best? Colorado at 32.5%. The worst? Mississippi at 13.5%. Just for comparison, I checked a similar map of the diagnosed type 2 diabetes rate of the U.S. If you super-imposed the type 2 diabetes diagnosis rate over the exercise levels, they would be close to identical. The lower the rate of exercise, the higher the rate of diabetes. Diabetic neuropathy, diabetic retinopathy, and a whole host of other health issues wait for those who stay sedentary.

The Bottom Line

Over this holiday and the succeeding weekend, try doing some type of aerobic activity every day for 30 minutes. Continuous or broken up into two 15s or even three 10s. If you can, try to do some stretching for 10 minutes one of those days. Find out for yourself that it’s not that big a deal. Then make it a habit to meet those guidelines. Years from now, you can celebrate your independence from canes and walkers, and so on.

Today, I record the 700th edition of my Grand Rapids radio show Straight Talk on Health. See the Health Info page for info on how to listen online; if you’re a Member or Insider, this new edition will be posted after it plays this weekend.

Happy Fourth of July, a belated Happy Canada Day, and a simple thank you to all my readers all around the world—I continue to be amazed at how many countries this Memo reaches. I’ll be back with new Memos next Tuesday. Until then:

What are you prepared to do today?

Dr. Chet

 

References:
1. https://www.cdc.gov/nchs/data/nhsr/nhsr112.pdf
2. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf.

 

Toddler Health Tip: No More

/in /by

“No more!” Those are the words Riley says when he doesn’t want any more milk, food, or anything else we feed him. When he says “no more,” that’s really it—he’s done. At dinner last week, Paula said, “That pasta was great and I could eat more, but I think I’ll be like Riley: no more.”

Wouldn’t it be great if we would just use those words when our brains tell us we’ve had enough and our eyes tell us it still looks really good? No more. Say it out loud and really make a commitment. It doesn’t mean that seconds aren’t available. It doesn’t mean that a sweet dessert isn’t there. It just means you’re not having any more. You can say that any time during the meal or after you’ve cleaned your plate, but that lets you and everyone else know that you’re done eating. Period.

“Just one more bite.” I’ll bet you’ve done that a time or two or a thousand. I have. But you’ll take no more even when you’re putting away leftovers or getting the take-home box from the restaurant. And you don’t clean up the bite or two the kids left on their plates. No more means no more.

You can follow the ketogenic diet, the Mediterranean diet, a vegan diet, or any of the many ways to eat, but unless you learn to say “no more” on a regular basis, you won’t get to the body weight you desire.

Be like Riley. Say “no more” and see how it affects your weight.

The Bottom Line

The Memos this week have focused on a common-sense approach to health. We absolutely need to get ourselves checked out by healthcare professionals to make sure there’s no underlying disease going on. Once that’s done, remember that many times, the simplest solution is the correct one. That’s a common-sense approach to health.

What are you prepared to do today?

Dr. Chet

 

Common-Sense Health: Pillow Talk

/in /by

Sometimes the smallest mechanical changes can make a big difference. Here’s an example. When I lived in Indiana, a member of my running club had developed chronic hip pain. He spent over a year trying one thing after another with no real relief: new shoes, different types of shoes, orthotics, stretching the iliotibial band that runs the outside of the hip down to the knee, chiropractic. He tried everything. Finally, one day, he went into his closet to find a specific type of shoe and he happened upon his old pillow. About a year before, his wife had purchased new pillows; he always liked the old one, so he put it back on the bed. Within three days, his hip pain was gone.

I could try to explain the changes in forces on the body due to the pillow, but it’s complicated. Suffice it to say that small changes in mechanical forces can create changes in the way the body is aligned. Most of the time we probably just adapt with no issues. Once in a while, people don’t adapt and they have problems that in no way seem related to those changes. It can and does happen.

Common-sense lesson? When you have pain, you should always get it checked out. Once the possible has been eliminated, check for the changes you’ve made—even something as innocuous as getting a new pair of jeans. If they’re just a few millimeters tighter than the last pair, you could change the forces that result in lower back pain. New desk chair, new sofa, any change in your environment can have detrimental effects.

The final common-sense health tip comes from our grandson Riley on Saturday.

What are you prepared to do today?

Dr. Chet