WHAT TO DO ABOUT A COLD

The common cold is caused by a viral infection in the upper airways, sinuses, throat and nose, although most apparent in the latter area. Uncommonly there may also be a fever. Despite the discomfort from the sneezing, sore throat, cough, and runny nose, happily it gets better on its own without requiring any special treatment, usually within a week—but sometimes a bit longer. At present there is no cure for this common illness. So, while waiting for it to disappear, what can we do to ease the symptoms without making things worse?

First, since they have no effect on the culprit viruses, contrary to the almost universal misconception, antibiotics should not be employed. Using them will neither shorten the cold’s duration nor prevent its spread to others. Moreover, the more we take antibiotics, the greater chance of producing resistant bacteria that could create mischief to others at a later time. Although delayed complications such as pneumonia are occasionally encountered in elderly individuals, an article published in the British Medical Journal counsels that fear of complications is not a good enough reason to prescribe antibiotics for the common cold. A better approach would be to consult a physician if the cold seems to persist for over a week, causes a moist cough, or produces a fever for more than one or two days.

What about echinacea, an herbal product that supposedly treats the common cold. Although there are only a limited number of controlled trials, there is no convincing evidence it is effective. The herb is probably safe, for prior studies show rates of side effects to be similar in echinacea and placebo groups. Thus with or without it, the cold will resolve within 1 to 2 weeks anyway. The same can be said for vitamin C, which has been extensively studied and offers no significant benefit.

Given the absence of any cures, what can we do to relieve symptoms during the illness? First, take plenty of liquids, especially water, to combat dehydration that may result from the cold, especially in children. Although I am a great believer in chicken soup, which can help to combat dehydration and help relieve subjective symptoms, there is little evidence that real benefit will accrue.

Another often overlooked simple method is the use of salt water gargle – if you make a solution consisting of ¼ teaspoon of salt dissolved in 8 ounces of warm water and gargle, your sore throat symptoms may be temporarily relieved, probably resulting from salt water’s ability to draw excess fluid from inflamed tissue. Applying saltwater to the nasal passages, done with nasal drops, may be useful for loosening thick mucus, making it easier to expel, especially for young babies. Nasal saline drops may be a useful alternative to salt solutions for gargling, a futile endeavor for babies and very young children.

Another old trick is the use of steam inhalation, which usually helps alleviate symptoms of congestion. You can half fill a pan with water and bring it to the boil. Place the pan on a sturdy table; make sure there is a towel or heat-resistant mat under it. Then sit with your head over the pan and cover yourself with a towel. Mechanical humidifiers, either with cold are warm steam, are also effective and easier to use.

Getting plenty of rest will not only help alleviate some of the symptoms, and make you feel less miserable, it may also reduce the duration of your cold. One should get plenty of rest for as long as symptoms persist, at least until abatement of the general sense of fatigue and malaise that often accompanies the cold. Remaining at rest is also important to prevent the spread of infection. As a rule of thumb, stay away from work or school while you do not feel well. When you can’t avoid proximity to others, cover your mouth with a tissue when you cough or sneeze, and throw it away into a trash can immediately, and wash your hands with warm water and soap.

What else can we do to relieve the symptoms? First, antihistamines have been a time-honored method to relieve the nasal congestion and promote easier breathing. Sedating (first generation) antihistamines may alleviate some cold symptoms, such as the watery eyes, runny nose, coughs and sneezes, but the newer agents, such as Allegra, Zyrtec and Claritin are less sedating and can be more useful.

Decongestants are medications that shrink the swollen membranes in the nose, allowing for easier breathing. There are oral or nasal decongestants, I prefer the nasal form, oxymetazoline (AfrinR) because each application lasts for several hours and tends to produce less “rebound” nasal congestion upon withdrawal. Nevertheless, persistent use for more than about five days might produce excessive nasal blockage. Patients with high blood pressure should use decongestants with caution, best accomplished under a doctor’s supervision.

Cough medicines, available in numerous forms, are generally not effective and, therefore, their use should be discouraged.

Although a high fever may not be desirable, a slight fever is not such a bad thing – it helps the body fight off infections more rapidly. When your body temperature rises, viruses (and bacteria) find it harder to reproduce, and this also seems to ramp up the body’s defense mechanisms. With the exception of very young patients, physicians no longer recommend trying to bring a slight fever down.

Painkillers (analgesics) may be helpful. The standard analgesics such as aspirin, acetaminophen (TylenolR), or ibuprofen (AdvilR), used for many years, produce relief of general aches. Aspirin should only be taken by adults, not children, especially very young ones.

So, the bottom line is simple: Hang in there; the cold will go away by itself. Just don’t make matters worse by over treating with useless remedies!

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SNAKE OIL ENTERS POLITICS: AN UNSAVORY DUO

                 

     Pro golfer Fred Couples states he takes the dietary supplement Anatabloc “to help me stay on top of my game.” Such athletes’ paid endorsements are typical of the food supplement industry. In this instance, Star Scientific Co., the maker of Anatabloc, touts this product through the use of this and other similar testimonials by a marathon runner, an NFL tight end, and a professional tennis player. In its marketing of the product, the company vaguely states Anatabloc helps users “reduce inflammation and support a healthy metabolism.”

     While Star Scientific has not made any explicit claims that Anatabloc can cure diseases, it has put out at least 15 news releases since April 2010 announcing or detailing various “scientific” studies backed by the company and indicating that anatabine, the claimed active ingredient of Anatabloc, in addition to relieving muscle aches and pains, could mitigate the underlying causes of conditions such as Alzheimer’s disease, multiple sclerosis, thyroiditis and traumatic brain injuries. The reason for all that, the company says, is attributable to anatabine’s anti-inflammatory properties. But Anatabloc, like other dietary supplements, is not directly regulated by the U.S. Food and Drug Administration in the same way that medical drugs are regulated. In my review of the world’s actual scientific literature, I could find only one reference to a study performed in humans, and it concluded as follows: “Anatabine supplementation had no effect on the recovery of muscle strength, hanging joint angle, arm swelling, or subjective pain ratings after a bout of maximal eccentric exercise in the forearm flexors. Therefore, it may not be beneficial for those seeking to improve recovery from heavy eccentric exercise.” Interestingly, this study was funded by a research grant from Rock Creek Pharmaceuticals, Inc, a subsidiary of Star Scientific Co. I’m surprised that they allowed the manuscript to be published!

     So, while the acceptance of payment by athletes and other high-profile luminaries constitutes shameful behavior, it is not illegal. Moreover, after being filmed beside a bottle of said nostrum, those shills have probably never gone near this product, and likely never will, for why should they? After all, its efficacy is supported by no credible evidence and, as usual for these and other similar products, long-term safety is seldom well monitored and always in question.

   But what does this have to do with politics? Plenty! This brings us to the story of. Robert McDonnell(R) former Governor of Virginia and his wife Maureen, whose repeated misconduct was exposed by The Washington Post’s Rosalind Helderman. The sordid story began with relatively trivial, if astonishingly morally obtuse, bits of graft and back-scratching. I won’t bore you with the convoluted details, but will provide a brief overview:

    Jonnie R. Williams Sr., CEO of Star Scientific, maker of Anatabloc, provided $15,000 to help cover the catering bill at the at the McDonnells’ daughter’s wedding — an event that took place three days after Virginia first lady Maureen McDonnell flew to Florida, where she touted Anatabloc. These monies were later supplemented to purchase a $6,500 Rolex, complete with engraved inscription, “71st Governor of Virginia,” that Williams bought for the governor at Maureen McDonnell’s behest, and a $15,000 spree at Bergdorf Goodman, again on Williams’ tab. Even more outrageously, Williams gave $70,000 — supposedly a loan — to a corporation owned by McDonnell and his sister; plus $50,000 to Maureen McDonnell in 2011, and $10,000 as a wedding present to another McDonnell daughter.

   The Governor defended his actions by stating that he was complying with the letter of Virginia disclosure rules, which do not require reporting of gifts to family members. “To, after the fact, impose some new requirements on an official,” McDonnell told a Norfolk radio show, “obviously wouldn’t be fair.” Doesn’t that sound at least a bit fishy?

     But all these gratuities were provided apparently in exchange for the first family’s ongoing touting of Anatabloc, a.k.a. “snake oil”—also known as a useless product! That would represent—in anyone’s book—a classic example of a conflict of interest. So, it seems obvious that us taxpayers are being ripped off in two ways: 1) encouraged to waste money on a useless product and 2) not being able to partake in the ill-begotten funds raised by their public official.

    So, as the old saying goes, Gov. McDonnell got his hand caught in the cookie jar, but in this case it was the “snake oil jar”!

    Or perhaps to state it more pointedly, shouldn’t McDonnell be subjected to the same transparency that he had previously tried to impose on all those women on whom he attempted to force trans-vaginal ultrasound examinations during unwanted pregnancies?  Although backing off after public protests, he finally persuaded the legislators to pass instead a slightly watered-down version of the bill requiring less invasive abdominal ultrasound exams before abortions and exempting women who were pregnant as a result of rape or incest. Although still subjected to considerable opposition, McDonnell signed the redrafted bill into law on March 7, 2012.

    At this time this unsavory character is no longer governor, and we find that, after all, justice may be catching up with him. After being indicted in January 2014 for corruption, U.S. District Judge James Spencer has decided that both McDonnell and his wife are to be tried together for corruption.  Trial will take place during the Summer, 2014. We wish them both the worst of luck!

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NUTS AND PLANT SEEDS: HEALTH EFFECTS AS GOOD AS MEDICINE?



                                       NUTS

     This category includes nuts from trees, including almonds, hazelnuts, walnuts, pistachios, pine nuts, cashews, pecans, macadamias, and Brazil nuts. Although not technically a “tree nut”, peanuts possess similar traits and are, therefore, including in this category.

    Most of these nuts provide good sources of caloric energy, primarily from unsaturated fats (oils), useful also for lowering cholesterol.  Moreover, the essential amino acids contained in nuts are vital for constructing protein, i.e., the building blocks for our muscles and other tissues. Although each type of nut does not supply, in itself, a complete source of these amino acids, consuming a variety of nuts will provide a complete complement of the various necessary (essential) components. Other nutritional elements provided by nuts include folic acid, vitamin E, potassium, magnesium, and calcium. Especially noteworthy is their uniformly low sodium content, a highly desirable feature (provided that no salt is added). They also contain polyphenols, bioactive constituents that seem to be beneficial to heart health that extends beyond one’s other dietary efforts.

     During the past 20 years, mounting evidence indicates that consuming these nuts (including peanuts and peanut butter) at least twice weekly provides substantial protection from cardiovascular disease and overall death rates as compared to those consuming them only rarely or not at all#.  These desirable results seem to be obtained primarily through the lowering of unfavorable cholesterol components, and despite a substantial caloric content, nuts do not seem to promote obesity, probably because of their prominent satiating effect. For unknown reasons, nuts also appear to prevent diabetes, another contributor to cardiovascular disease.  Research studies have also indicated that, if  the” Mediterranean” diet, which, in itself is healthy, if supplemented by extra mixed nuts (one ounce daily) and extra virgin olive oil (one quart total per week), substantial additional reductions of cardiovascular disease and stroke can be accomplished.

                                       SEEDS

    Edible seeds that contribute to human nutrition include grains (e.g. wheat, corn, rice, barley, millet and oats), legumes (e.g. soybeans), cocoa and coffee beans.  Some grains, however, are less beneficial, and these include white rice, white bread, pasta, noodles, and refined grain products with added sugar, fat, and sodium (e.g.  biscuits, pastries and cakes). Cocoa beans are the seeds of the tropical tree Theobroma cacao, from which chocolate is derived.

    Whole grains comprise germ, bran, and endosperm. Refining them reduces their nutritional quality by removing beneficial constituents that include germ and bran along with fiber, vitamins minerals, phenolic compounds and phytochemicals. Large studies have demonstrated a 21% lower risk of cardiovascular disease for those individuals consuming an average of 3-5 servings per day compared with those who rarely or never consumed whole grains. This group also had a 26% lower risk for the development of diabetes. In comparison to germ, bran seemed to be more potent in this regard.

    Cocoa and chocolate require special comment. All research clearly confirms the value of chocolate in the prevention of cardiovascular disease, probably through improved cholesterol and blood pressure levels as well as reduced development of diabetes. Most studies point to the value of dark chocolate (as opposed to white or milk  chocolate) being the most beneficial, but the effect of milk chocolate alone cannot be clearly established since many studies do not separate the two types for individual analysis.

    The effects of coffee on health are less certain. This product contains little of nutritional value. Although some data suggest that coffee consumption is associated with a slightly lower mortality risk, one can safely conclude that at least coffee appears to do no harm.

     Seeds, nuts and chocolate possess high fat content, but of the polyunsaturated varieties that decrease cholesterol levels, metabolism of sugar (reducing diabetic tendency) and cardiovascular risk. Whole grains are rich in insoluble fiber (bran), a beneficial nonabsobable nutrient that, for unclear reasons, is also associated with reduced diabetes and cardiovascular risk   

                                    PULSES

    “Pulses” are the seeds of plants contained within pods, and they include lentils, chickpeas, black-eyed peas, and a variety of beans that include pinto, kidney, navy, and fava beans.

    Scientific studies regularly indicate that consumption of these food sources reduces the incidence of cardiovascular disease. One study demonstrated that their consumption four times weekly was associated with a 22% lower risk of heart disease in comparison with those who consumed them less than once weekly. Similar results are found when beans are substituted for white rice.

     The beneficial effects of pulses seem to result primarily from their favorable effects on cholesterol components and enhancement of sugar metabolism that improves prevention and control of diabetes. 

               CONCLUSIONS AND RECOMMENDATIONS

    In general, one should attempt to substitute whole grains and legumes for refined grains in all diets. Moderate consumption of cocoa products can be incorporated. Coffee can be consumed with possible benefit, or at least with no added risks. Separating the effects of different components of seeds and nuts is not possible, and therefore, dietary recommendations should include a wide array of these foods as a major part of a plant-based diet. These modifications should be included with other components of a healthy diet that are well known, such as avoidance of red meat, reduction of salt intake, limitation of caloric intake, and regular inclusion of breakfast.   



# Ros E. and Hu FB. Consumption of plant seeds and cardiovascular health. Epidemiological and clinical trial evidence. Circulation 2013;128:553-565.

Bao Y. et al. Association of nut consumption with total and cause-specific mortality. N. England J. Med. 2013;369:2001.