It’s bitterly cold right now in most parts of the US with some areas covered in many feet of snow.  Here are some tips on how to stay warm and healthy.

• Cover up.  Make sure when you go outdoors, you cover up exposed skin as much as possible.  Make sure your head and neck are covered as these areas lose the most heat.
• Drink warm liquids such as tea.  In traditional Chinese medicine, ginger has properties that can add heat or “yang” energy to the body. Make yourself a cup of ginger tea when you come in from the cold.  Fluids are also necessary to replace the water lost to the dry cold air.
• Avoid alcoholic drinks.  Many cultures believe that alcohol can warm you up.  People often notice that when you drink alcohol, your face turns warm and hot.  However, this is caused by blood vessel expansion called vasodilation.  When this occurs, blood rises to the surface of the skin causing a more rapid loss of heat.  Drinking excessive alcohol can contribute to hypothermia (lowering of body temperature to life threatening range) by making you less aware of the need to stay warm.
• Exercise.  When you exercise, your metabolism increases and your body temperature rises.  Start the day off with some cardio to keep you warm throughout the day.  Do a few jumping jacks before you head out into the cold (not to the point of sweating, but just enough to feel warm)
• Moisturize regularly.  Cold air is dry air.  Your skin can dry out easily.  Use a moisturizer on your skin often, especially after you’ve just gotten out of the shower and your skin is damp.  Don’t forget lip balm to prevent chapped lips.
• Get your flu shot.  When you are exposed to extreme cold, your immune system may become weak making you vulnerable to getting the flu.  Also, when the weather gets cold, we tend to congregate with other people indoors, leading to more potential for viruses such as the flu to spread rapidly.
• Keep an emergency supply of food.  When the weather is bitterly cold or snow makes driving difficult, you’re best off staying indoors and off the roads.
• Dress up before you go outdoors.  About 10 minutes before you head out into the bitter cold, put on your cold weather gear (coat, hat, scarf) and walk around indoors.  While this may look silly, this allows you to accumulate heat within your clothing.  Once you head outdoors and wind starts to blow against your body, heat starts to leave your body immediately.  By warming up the clothing first, you will stay warmer much longer.
• Take a warm bath.  Nothing compares to a steamy bath at the end of a cold day.  Pamper yourself and your body when the mercury drops!

Many foods are advertised as being “healthy” but in reality they offer little nutritional benefit and may be filled with calories or fat.  I often have patients say they picked a certain brand of cereal because it was advertised as being “heart healthy”, yet they can’t seem to lose weight.  Most cereals are composed of refined grains, some of which are GMO (genetically modified organism) and a large proportion of corn products.  The next time you are walking in the grocery aisle, try to find a cereal that does not have any corn products (e.g. corn syrup).  It’s a difficult challenge!   I recommend picking a cereal where you can recognize the individual grains (barley, flax seeds, oats) and not overly processed flakes, donut shapes, or multicolored cartoon shapes with marshmallows.

Don’t depend on the government to police the food manufacturers on their incorrect labelling.  The FDA currently has, in my opinion, very loose definitions of what can be considered “healthy” or “organic” or “low fat”.  They also are slow to enforce any violators.  In fact, a popular chocolate-hazelnut spread was reprimanded after over 6 months of a successful TV commercial campaign that said it could be a healthy addition to breakfast.  (BTW, 2 tablespoons of the said chocolate-hazelnut spread has 200 calories, 21 grams of sugar, and 11 grams of fat!)  I can only imagine how much weight was gained by people following this misinformation!

What can you trust?  Make sure you read all nutrition information on all foods that you eat.  Pay close attention to calories per serving, and the number of servings per package.  Some food manufacturers like to use extremely small, unrealistic serving sizes to show that they are “low in calories”.  When was the last time you split a granola bar into 4 pieces and just ate one of them?

Use your common sense.  If something tastes extremely sweet and is not made of artificial sugar, it is likely high in calories.  I used to buy small Greek yogurt cups with 0% fat and fruit.  However, I noticed the “fruit on the bottom” was almost like jam and sickeningly sweet.  Lo and behold, while the yogurt is fat free, the fruit jam was full of sugars.  I replaced them immediately.  Now, I buy plain 0% fat Greek yogurt in a large tub size.  Then I take fresh fruit or unsweetened frozen berries and I place them at the bottom of small reusable containers about the same size of a yogurt cup and add the yogurt on top.  Every Sunday, I create 7 of these “parfaits” for each day of the week and keep them in the fridge.  I also add a teaspoon each of chia seeds, flax seeds and 2 tablespoons of extra virgin olive oil as part of the Mediterranean Diet.  When you create your own food, you know what is going into your food and what is NOT going into your food.  Yes, it may take more work, but at the end of the day you will feel healthier.

There are many “medical myths” which continue to be perpetuated.  Some of them are harmless, but others can cause severe health problems.  Here is my list of top 6 medical myths, how they can be dangerous and what are the real facts.

1. “Starve a cold, feed a fever”  When you have an infection, whether it be the common cold or a bacterial infection such as pneumonia, your immune system needs energy to fight.  You should definitely eat adequately and stay well hydrated when you have a cold.  I would recommend chicken soup and ginger tea.
2. “Ginger ale for an upset stomach”  Ginger tea is helpful, but not ginger ale.  Most ginger ale does not truly have any ginger extract.  Also, the carbonation in soda is carbonic acid.  This acid is strong enough to cause your stomach lining to become irritated.  The gas produced can also contribute to gas pains, perhaps the last thing you need when you have an upset stomach.  Instead, you should drink plenty of cool water and keep your diet simple (avoid acidic foods, caffeine, and spicy foods)
3. “Vitamin C will prevent me from getting sick”  Many supplements which are purported to protect you from cold and viruses contain vitamin C.  Unfortunately, many studies have disproven this myth and have shown it may even cause you harm.  One study from Sweden published in JAMA found that taking in even as little as an extra 1000mg of vitamin C supplements can double your risk of developing kidney stones.
4. “You can get the flu from the flu shot”  For most flu shots, it is impossible to get the flu as there is no live flu virus in the injectable vaccine.  Whenever you get any immunization, you are stimulating the immune system to produce antibodies.  In a way, you are fooling your immune system into thinking it has an infection.  It is normal and common to have some reaction to a flu shot which lasts 24-48 hours, much less and generally less severe than having the full-blown flu infection.  Having some reaction after a flu vaccine shows your immune system is working well and may indicate you will have good protection against the flu.
5. “Water is the best liquid to drink when you are dehydrated”  Water is very important to our bodies.  In fact our bodies are over 75% water.  However, we are not composed of pure water.  We also have a large concentration of electrolytes.  These are elements such as potassium, sodium, and chloride which help us to hold onto water in our bodies.  Think of the last time you tasted your sweat.  It’s salty, isn’t it?  Whenever you lose fluids from sweating, diarrhea, or bleeding, you are losing water AND  electrolytes.  Replacing them with just water alone does not often fix the problem.  Instead, you should drink water and some fluids containing electrolytes such as Gatorade, Powerade, tomato juice or coconut water.  Be careful if you have a history of high blood pressure as these fluids can raise your blood pressure.
6. “Eating excess amounts of salt will cause me to develop high blood pressure”  High blood pressure also called hypertension is a partly genetic condition.  Risk factors include smoking, family history, obesity, diabetes, older age, and kidney disease.  While high blood pressure can be reduced somewhat by reducing salt (sodium) intake, the reverse is not true.  However, we still should not eat too much salt as this can cause headaches and fluid retention.

If you haven’t gotten your Flu shot yet, now’s the time!  Flu vaccines are plentiful and practically every medical office is giving them out.

Here are some reasons why you should get the flu shot this year:

• The most common (Trivalent) vaccine is covered under most insurances, so it won’t cost you much money.  Many pharmacies can now administer flu shots.
• You don’t want to get the flu this year.  The early symptoms of the flu (fever, sore throat, and body ache) are similar to other scary diseases such as Ebola and Enterovirus (EV-D68).  Get the flu shot so you don’t have to have that extra worry.
• You don’t want to get sick while you’re on vacation.  All travelers should get the flu shot at least 2 weeks before traveling.  Planes are like petri dishes for all sorts of viruses and bacteria, especially with crowding of people and minimal cleaning in between flights.  Protect yourself with the flu shot!
• You never want to be the one who infects your family members during the holidays.  Flu spreads rapidly during family gatherings around the holidays.  Hugging, kissing, and sharing food allow for easy transmission.  If you have children, the flu shot is a MUST for you.  Imagine if you got the flu and your kid got it from you.  Young kids and elderly adults can develop life-threatening consequences such as pneumonia from the flu.  The best way to prevent the flu from spreading during the holiday season is by getting the flu shot.  Don’t be THAT guy/gal who ruins the holidays for everyone else!
• Think of all that time you will have not being sick!  Remember the last time you had a flu or bad cold.  You were probably out 3-5 days from work or worse, on your vacation, sick as a dog, laying in bed.  Now think about if you were given those days back.  Get your flu shot and you will prevent this from happening.
• It’s doesn’t hurt…  much.  Needles used for flu shots are much smaller than needles used for drawing blood.  Yes, you may feel a pinch, but it’s worth the discomfort.  If you want it to hurt less, take a pain reliever such as naproxen about 30 minutes before the shot.  You can also apply a cool pack for 1-2 minutes to numb your arm just before the shot.
• It’s never too early to get the flu shot!  I hear many people saying it’s too early to get the flu shot.  This is false.  You want to get it NOW before the supply runs out.  In the 2012-2013 season, there were severe shortages in January which caused a lot of chaos.  Don’t wait until this happens again!
• You may forget when the holidays season begins.  During the holidays, we are all busy with parties, shopping, and family gatherings.  It’s easy to forget about getting the flu shot.
• You believe in being healthy.  The flu is an infection with a virus that can cause inflammation in the body.  When your body experiences inflammation, you will produce hormones such as cortisol which lead to weight gain.  When you are sick, you will likely be lying in bed and eating fattier foods (e.g. chicken soup).  Studies have shown that excess inflammation can also lead to increased risk of heart disease.  Get your flu shot and you will be keeping yourself healthy and feeling better!

Ebola is constantly in the news these days, and we all should be concerned but there is a more grim side to the story.  While the death rate from Ebola is estimated at over 50%, death from other infectious causes will far surpass the direct casualties of the virus.  Areas of Western Africa including Liberia, Sierra Leone, and Guinea, are the home to diseases more devastating in terms of number of victims and death rate.  These include Malaria, Lassa fever, Dengue Fever, Tuberculosis and a whole host of diarrheal diseases including typhoid fever and hepatitis.  For many decades, money has gone to fight these diseases with great success but we will likely see a reversal of these gains.

With the focus now on Ebola and strained medical resources, there is no doubt we will see a resurgence of deaths from these infections.  Unlike Ebola, these other diseases are much easier to transmit and more difficult to control.  Malaria and Dengue fever are transmitted by a simple mosquito bite. Lassa fever is transmitted by food or water polluted with rodent urine.  Tuberculosis is far easier to acquire than Ebola as breathing the air in the same room as someone coughing can transmit the bacteria!

Diversion of health care focus will negatively impact vaccination efforts against childhood diseases such as polio, measles, and pertussis (whooping cough).  This may also be fueled by the people’s fear to seek healthcare in settings where it could mean exposure to Ebola patients.  If you were a mother with a newborn, why would you bring your child to a hospital with infected Ebola patients for a polio vaccine?  A resurgence of these diseases would mean disaster.  Large migrations of people such as refugees will carry these diseases to other areas. We have seen a precedence for this in war-torn Syria, where there have been polio outbreaks among unvaccinated children.

The emergence of Ebola is like the opening of Pandora’s box.  Many infectious diseases will certainly take advantage of the poor access to healthcare, poor sanitation, and overcrowding resulting from Ebola.  There is no easy answer to quell the epidemic except that a more aggressive approach needs to be taken to improve these and be implemented as soon as possible.