Recently, Aaron Carroll suggested in his New York Times article titled “No, You Do Not have to Drink 8 Glasses of Water a Day” that many people are following outdated and unsubstantiated guidelines for hydration.  While I agree that one standard does not fit all people, I think many more people would be harmed by putting less emphasis on the importance of drinking adequate amounts of water.  Though it is true that food contains a lot of water (think foods like celery or watermelon which are primarily composed of water), we also consume a lot of salt on average in our diets which require us to ingest more water to eliminate them from our bodies.  Excess salt stored in our bodies usually leads to higher blood pressure.

Being even slightly dehydrated has many serious health consequences, including increased risk for kidney stones, fainting/dizziness, overheating “heatstroke”, and fatigue.  If you do any amount of physical activity, drink any caffeinated or alcoholic beverages, are taking medications for high blood pressure, sweat more than average, or work outdoors in warm weather, are over 60 years old, you ABSOLUTELY need to maintain adequate hydration (about 8 glasses).  Can you overdue hydration?  Of course, but your body has a great way of eliminating excess water through the kidneys.  In fact, this often prevents the kidneys from shutting down, as excess buildup of wastes in your kidneys can cause kidney stones.  If your urine appears clear/colorless then perhaps you could cut back on water intake. Conversely, if your urine is a dark amber color, you absolutely need to drink more water.  As I mentioned in a previous blog, elderly people are more vulnerable to dehydration and should be encouraged to drink adequate fluids at all times.

As I always instruct my patients, you need to listen to your body and adjust your water intake accordingly.  Do you feel thirsty, tired, overheated?  Are your lips/mouth dry?  Is your urine dark?  It may be time to take a drink of water.

I remember as a child my parents telling me not to waste food.  You may be familiar with the phrase, “Finish your plate, there are starving people in (fill in with name of impoverished country).”  Over the years, I think this has a profound effect on how we eat and our relationship with food.  We think in terms of needing to finish what is served to us rather than stopping when we are full.  A similar phenomenon occurs when people go to buffet restaurants and feel the need to “eat back” the equivalent value of food that they had paid.  As a result, we override our own body’s sensation of stomach distention telling us to stop eating and we take in much more calories than we needed, much of which will be stored as fat.  I’m not suggesting that we throw away food, but we should be mindful about what we buy and try to avoid taking more than we need.

Here are some tips about incorporating this into your life

• Buy smaller sized plates- Your perception of how much food you are eating depends greatly on what sized plates the food is served on.
• Take only the food that you are comfortably able to consume.  For most people that would roughly be a piece of protein (meat, chicken, fish, tofu) the size of a deck of cards, carbs (potatoes, pasta, bread) about the size of your closed fist), with the rest of the meal consisting of vegetables.
• Allow your body time to digest during the meal.  Eat slower and savor each bite.  I recommend putting the fork or spoon down and taking a sip of water in between each bite of food.  When we eat too quickly, the message sent by your stomach to your brain indicating it is full may not get processed in time before you have overeaten.  This is a typical situation during Thanksgiving dinners when we may feel “overstuffed”
• When you are given gifts of food that are too large for you to finish yourself, don’t be afraid to freeze some of it so you can enjoy at a later time or throw some of it out.  You can also share your bounty with those less fortunate.  During the holidays, when I receive baskets of fruits, cookies and chocolates, I will often bring them to a local homeless shelter for others to enjoy.
• Avoid buying in bulk.  Sure, you may save some money but having excess food sitting around in your pantry creates temptation that can lead to many chronic illnesses which can be far more expensive to treat down the road.  You will also have excess guilt resulting around eating more than you should.
• Take food home when you eat out.  Restaurant portions are enormous and it’s difficult to not finish your plate.  One tip is to divide your meal in half, and put half on a separate plate, which you can ask the waiter to wrap up immediately.  Keeping the food on the table during the meal can sometimes be too tempting.
• Consider getting two appetizers instead of an appetizer and an entree.  Have the waiter bring out the second appetizer when your other dinner companions are getting their entrees.  Again, given larger portion sizes these days I’m sure you’ll be just as satisfied.
• Avoid pressuring others to eat.  In some cultures, food is equated with hospitality and family harmony.  Eating together at a table is a way of establishing a bond.  However, we should not encourage overindulging with phrases like, “You look too thin, you need to eat more”.  Every person has his/her own set point for how much food is enough.  Be considerate about gifts of food that you give others.  I always recommend fruit baskets in lieu of chocolates and cookies.
• Don’t feel guilty that you do not finish your portion of food!  Food is meant to nourish and for us to enjoy.  You shouldn’t have feelings of guilt.  Maintaining good health is more important!

Some people love spicy foods and others do not.  Here’s a study that suggest you may want to challenge your taste buds and learn to appreciate the burning sensation on your tongue.  Last week, the British Medical Journal reported study findings from China that may show a correlation between people who eat spicier foods and reduced risk of death.  The researchers followed adults over 7 years and found that people consumed spicy foods had lower risk of dying from all causes particularly heart disease, cancer, and respiratory diseases.  While the exact reason for this statistically significant finding is unknown, there is a thought that the main chemical ingredient of hot chiles called capsaicin may have something to do with it.  Capsaicin creates that fiery hot sensation on your tongue followed by a numbing feeling.  Arthritis sufferers and athletes may also recognize capsaicin as the main ingredient in topical creams used to soothe aching joints and muscles.  Just like the capsaicin can reduce pain, perhaps it can also reduce inflammation in your organs and bloodstream.  Inflammation has long been implicated in diseases such as coronary artery disease, autoimmune diseases, and diabetes.  Some scientists theorize that the appetite suppression of eating spicy foods could also be at play.  When you eat spicy foods, you can only eat so much until your stomach gets irritated.  Other people say they feel more full when they eat spicy food compared to bland food.  Chiles also contain plentiful vitamin C, A, K, B6, and potassium, all of which are vital antioxidants and nutrients that are essential for normal body metabolism.

Want to live longer?  Try adding some spice to your life!

Sometimes, we must travel on planes when we have a cold or sinus infection.  This can be problematic as the pressure changes during flight can cause ear problems and pain.  We have a tube called the “Eustachian Tube” which connects the ear to the airway (sinuses/throat).  When this tube gets clogged, pressure builds up behind the eardrum (tympanic membrane).  When the pressure changes on the outside, the pressure difference can be so great that the eardrum can burst.  People describe severe pain crescendo-ing (building up of pressure), then a severe pain (eardrum bursting), a sense of relief (pressure is equalized), then a realization that they cannot hear as well out of that ear. I always recommend that you see a health care provider before you fly when you are sick.  If your symptoms are severe, you may want to postpone your flight.  Here are some tips that can reduce your risk.

• Take decongestants at least 1 day before your flight.  These are pills such as psuedephedrine or phenylephrine or nasal decongestant spray called oxymetazoline (Afrin).  (If you have high blood pressure or heart problems, you should not take these.)
• Use a medication called Mucinex to thin out the mucus.  Thick mucus is difficult to clear out of your nose and can block the Eustachian tube.
• Drink plenty of fluids before the flight.  Sip on fluids continuously while the plane is taking off and landing.  I recommend buying a large bottle of water so that you have it at your seat rather than depend on the flight attendants.
• Do NOT fall asleep just before landing.  This is the most dangerous part of the flight.  Instead, make sure you sip fluids.  If you are tired, a cup of coffee can help you stay awake.
• Do a “clearing technique” when you feel pressure start to build.  Cover your nostrils with one hand and keep your mouth closed.  Then gently blow your nose.  You should feel the pressure suddenly release in both ears.  If not, repeat.   If you feel pressure start to build up again, repeat this process.
• Yawn and swallow frequently.  Candies that stimulate salivation are helpful.  Sour candies work the best (lemon flavored or “Sour Patch Kids” are my favorite)
• Blow your nose if you feel mucus starting to accumulate in your nose.
• If you feel like your eardrum has burst, make sure you visit a medical provider immediately for further evaluation.  A burst eardrum makes you more susceptible to inner ear infections.  Avoid getting water in the ear.

Guest Author:  Keith Bracy, DDS

Dr. Bracy practices the full scope of general, cosmetic and implant dentistry in Manhattan. He focuses on minimally invasive techniques and patient education.  Dr. Bracy has extensive experience treating those fearful of dentistry, and believes excellent care begins with careful co-diagnosis and communication.

More information is available at his website drbracy.com

If you are like many patients, chances are you have been postponing a visit to the dentist. In fact, a recent article in the Journal of the American Dental Association, titled “Where have all the dental care visits gone?” by Dr. Marko Vujicic highlights a 7% decrease in dental care visits, with “no need” and “cost” being the top reasons given to skip out on routine dental visits. Everyday, patients describe to me how dental care terrifies them, their fear of judgment by a dentist, and a multitude of reasons why they have delayed dental care. Let’s explore when and why you should see your dentist.

So when should you see a dentist? For the vast majority of patients routine dental visits every six months is the answer. If you are having any symptoms such as pain, swelling, bleeding gums, or toothaches you should seek dental care immediately. You should discuss your risk factors for dental conditions with your dentist, and come up with care schedule to best suit your risks and needs.If you need some motivation to make that dreaded dental appointment, here are 5 reasons why you should not delay.

1. Dental Care is Part of Overall Systematic Health     Oftentimes, patients dissociate the connection between oral health and general health. Your mouth is indeed connected to the rest of your body and what happens there can affect your overall health. There is overwhelming evidence to show that inflammation from common gum disease is correlated with increased risk for cardiovascular disease, diabetes, and pregnancy complications. Although dental cavities are commonplace, left untreated can cause serious infections that travel to other parts of your body.
2. Your Oral Cancer Risk Might Be Higher Than You Think    Your general dentist is your first line of defense against oral and pharyngeal (throat) cancers, through early detection and screening. Your routine dental examination should include an oral cancer screening during which your mouth, throat, neck and head are examined for signs of the disease. Tobacco and alcohol usage are major risk factors for oral cancers, but even if you do not smoke or drink, you can still be at high risk. According to the American Cancer Society Facts & Figures 2015, there has been a recent and rapid rise in oral cancers linked to infection with human papilloma virus in white men and women.2 Early detection and screening can save your life.
3. Dental Disease is Often “Silent”     Most people are unaware of common dental conditions such as cavities and gum disease as they may not show any symptoms or cause pain until it is too late. For example, the gum disease, periodontitis, is a condition in which the gums and bone that hold teeth in your mouth, gradually retreats and deteriorates. You might not be in any pain if you have this condition, and not aware of the problem until the teeth become loose from the retreating tissues. Routine, preventative visits help detect these common problems, and facilitate early treatment that betters the prognosis.
4. Routine, Preventative Care Can Save Money     The fear of the bill, following a dental visit might be scarier to some patients, than the visit itself! However, routine preventative visits can save you money and time. Many dental insurance plans provide for coverage of routine care like exams, x-rays and cleanings at very high rates, if not at 100% coverage. While the same plans often cover basic work like fillings at lesser rates like 80% and major work like crowns at 50% or not at all. If you do not have dental insurance, the fee for a routine exam, where conditions can be detected when small and easily treatable, will be much less than an emergency visit, when a major procedure is needed.
5. Changing Your Smile Can Change Everything     Like it or not, your teeth and smile are the first thing people may notice about you. Furthermore, the way your teeth look and function greatly affects the quality of your life. There have been many advances in dental technologies such as clear aligners to straighten misaligned teeth, dental implants to replace missing teeth, and lasers to change the appearance of your gums . These technologies and procedures can allow you to have the healthy, beautiful smile you always wanted. What your dentist told you was not possible 10 or 15 years ago, might be possible today due to these advances.

Prevention is the best medicine. Don’t delay, see your dentist today!