Vol. 194 June 1, 2018 Some DOs and DON’Ts

June 1, 2018

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Avoid fried meats which anger up the blood.
-Satchel Paige’s Guide to Good Living

 


DON’T drink alcohol
 Really?? I thought red wine prolonged your life by preventing certain types of heart disease. That IS the current wisdom. It is thought to be the compound reservatrol that provides that benefit. If you believe that then eat lots of grape skins, peanuts, and blueberries for their reservatrol.

A Lancet Journal study of 600,000 current  high-income European drinkers suggests that the threshold for an increased risk of cardiovascular disease is LESS than previously thought. The U.S. Dietary Guidelines, based on previous studies, state that one glass of wine daily for women and two glasses daily men is carries no risk and might even be beneficial. This Lancet study suggests that the threshold of increased risk of death from cardiovascular disease is just one glass a day, regardless of gender. Reviewers of the study remark that such guidelines are not very helpful for individuals. Remembering that obesity kills more people than alcohol is helpful for the context. But, alcohol deaths are still more common than opioid deaths. About one-third of driving fatalities involve alcohol-impaired drivers. In one study 40% of convicted killers said they were under the influence of alcohol when they committed homicide. About 25% of suicides are alcohol related. So, again, as they say on Fox radio news, “We report. You decide.”

DO measure your PAS (Prostate-Specific-Antigen) if your 55-69 years old.
DON’T measure it if you’re 70 or older.
This is a more neutral update of the 2012 U.S. Preventative Services Task Force recommendation against PAS testing because of studies showing overly aggressive diagnostic testing and treatment of low risk patients based on the PAS level. Nowadays “active surveillance” rather than “aggressive treatment” has become the norm as has “shared decision-making” ( the fancy label for discussing the results and management options with your primary physician).

DON’T smoke marijuana if breast-feeding.
A very small study (8 women from Denver, … from where else but?) had their breast milk analyzed for THC at different times after smoking a standard joint. Calculations showed that about 2.5% of the inhaled dose was ingested by the infants. The THC levels in the breast milk were highest in the 1 and 2-hour post-joint breast milk samples . The 20 minute and 4 hour post-joint samples were one-half that. Those breast milk levels are very low, would not cause any apparent change in the infant’s behavior, but the effect of any exposure of cannabis to the developing brain is unknown. No THC metabolites were found in the breast milk.

DO consider liquid nicotine for e-cigarettes as dangerous for toddlers.
One quarter of the nearly 9000 children under 6 years old that got into liquid nicotine meant for e-cigarettes during 2012-2017 had significant clinical effects from the ingestion. Many states, but not all, have legislated child-proof packaging of the liquid nicotine as a result.

DO use the right words for childhood obesity.
Apparently Latino children are more apt to be obese than non-Latino children. A study has shown that those children and parents prefer the words,”unhealthy weight” and “too much weight for the child’s health”. DON’T use “chubby”, “fat”, gordo”, or “muy gordo”. The words “high BMI” and “overweight” were judged to be not motivating in BOTH languages. I guess words DO matter.

DO ignore baby formula marketing pitches.
If you don’t breast feed your infant, then DO use any cow’s milk formula. All the cow’s milk formula’s with added iron are the same nutritionally. DON’T be led astray by marketing ploys like “added amino acids”, “probiotics added”, ” more digestible protein”, etc. The global baby milk formula market is close to $62.5 billion. The only beneficial added ingredient to formula is iron.  Most babies do very well on whatever cow’s milk formula you give them.  Some special infants may need special formulas, but it is a small number. Vegetarians and babies with galactosemia can use soy-milk formula. Otherwise, all infants are “of course, above average” and can thrive on what ever cow’s milk with iron formula you buy for them.

DO reconsider your child’s allergy to penicillin.
Formal allergy testing of 100 children making an ER visit and labeled as “allergic to penicillin” revealed that 0% (nada) of those children with previous low-risk symptoms of penicillin allergy were actually allergic to penicillin. In a follow-up of those children one year later, 60% of them had been given penicillin treatment without incident or allergic reaction symptoms. The estimated savings from using penicillin instead of the higher priced non-penicillin antibiotics for all of the 6700 patients who visit that ER annually with a diagnosis of penicillin allergy was $192,000.

DON’T spend your money for SPF over 30 in sunscreens.
An SPF of 15 blocks 94% of UVB rays. SPF 30 blocks 96%. SPF 40 blocks 97%. None of the usual sunscreens available in the U.S. block the UVA rays which penetrate deeper in the skin and cause aging of the skin. The FDA continues its years-long study of UVA blocking sunscreens already available in Europe. DO put on the sunscreen 30 minutes before going out in the sun to allow its ingredients to activate the skin, and re-apply 20 minutes after exposure to the sun.

and finally . . .

 Avoid running at all times.
DON’T look back. Something might be gaining on you.
– Satchel Paige’s Guide To Good Living

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