Early Hormone Therapy Has Benefits

It was surprising news in the Canadian Medical Association Journal. There’s another about-turn among scientists studying hormone therapy (HT) as a treatment for symptoms of menopause. This time, researchers have produced findings that suggest benefits to healthy women who start HT early in the transition to menopause.

Women have long been perplexed by conflicting advice on hormone replacement, and this new study doesn’t offer universal guidance. The bottom line remains, HT is a complicated business, requiring patients and doctors to weigh many factors in deciding for or against.

Dr. Iliana Lega of the Women’s College Hospital and the University of Toronto has this to say, “Menopausal hormone therapy is the first line treatment of symptoms in the absence of contraindications.” That clarity may be overly simplified, and she adds that patients and doctors need to consider symptoms before and during menopause and to discuss treatments based on personal preferences and potential risk factors.

Those risk factors have been well publicized. Many studies have suggested leaning away from HT due to associated increased risk of breast cancer, stroke, and cardiovascular disease. But new findings offer important insights for younger women.

Previous studies have shown an increased risk of breast cancer in women taking HT. However, this new study reports the risk is much lower in people aged 50-59 years and in those who start HRT in the first 10 years of menopause.

Increased risk of ischemic stroke (blood clot) has been a concern for women older than 60 years who start HT 10 years after the start of menopause. But new findings suggest the risk is reduced for those younger than sixty.

Furthermore, data from the Women’s Health Initiative trial show a possible reduction in coronary artery disease with HT among younger menopausal patients, specifically those who start HT before 60 years of age or within 10 years of the start of menopause.

Be sure to discuss the issues with your surgeon if you are scheduled for a hysterectomy. Leaving ovaries in place can preserve natural estrogen function for a time. But removal of ovaries and use of HT eliminates any future risk of ovarian cancer. Of course, most saved ovaries do not develop a malignancy. So, sparing one or both ovaries in younger patients should be a matter for discussion.

There are other benefits of hormone therapy in the treatment of menopausal symptoms. Reducing the severity of hot flashes is the main one. Another is reduced fragility, with one large study involving over 25,000 women aged 50-79 showing that HT reduced the risk of any fracture by 28 percent, a major osteoporotic fracture by 40 percent, and a hip fracture by 34 percent. HT can also offer relief from mood swings, vaginal dryness, and joint pain.

The cognitive effects of HT are debated. Past research questioned the impact on risk for dementia. Other research found benefits including reduced “brain fog” and reduced risk of Alzheimer’s.

Dr. Pauline Maki is a specialist in menopause and cognition in the department of Psychiatry and Psychology at the University of Illinois at Chicago.  She notes, “Women who initiate hormone therapy before their final menstrual period show increased blood flow to the hippocampus and better verbal memory compared to nonusers.”

The message is that “timing is everything” in decisions around hormone therapy.

That’s not easy to action given menopause may begin up to 10 years before the last menstrual period and can last more than 10 years. For some women, the symptoms are intense. Others never know the menopause has come and gone.

So get informed guidance from your doctor and start the discussion early.

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Total Family Doctor Prevents Needless Surgery

How important is what I like to call the “Total Family Doctor” (TFD)? For years, I’ve praised the hardworking family doctor for the role he or she plays in medical care. Now, many North Americans say it’s impossible to find a family doctor.  What has happened to them?

Prior to becoming a surgeon, I had the good fortune to spend time as a family doctor. And I nearly decided to follow this path. Why? Because I also watched Specialists performing the same task every day. It could become boring, I thought. So, surgery finally won. But I’ve never forgotten the challenges of being a family physician. I even experienced the roles of hotel doctor and ship’s surgeon during medical training.

I believe that people who are fortunate enough to have a family doctor have a better chance of living longer. Why? Because seeing a doctor regularly for checkups means they’re not playing Russian Roulette with their health. We all hope that nothing is going to go wrong with the only body we will have in this life. But when your family doctor finds you have hypertension, you can start to cut down on salt. Or when the doctor recommends you should avoid obesity, you can improve the diet and decrease health risks.

Getting a head start on problems cannot be overemphasized. Consider the woman whose breast malignancy is diagnosed early. Or the man who believes rectal bleeding is due to hemorrhoids. The “total family doctor” thinks otherwise and orders a colonoscopy which detects early cancer of the bowel. Or someone who believes a chronic cough is due to allergy. But an x-ray ordered by the family doctor finds early cancer of the lungs.

 So give thanks to the Almighty if you have a “total family doctor” looking after you. Kudos if yours steers you away from the disease I call “Pillitis”, causing people to rush for painkillers at the first sign of a headache, ignoring the serious side effects of these drugs. Why not a cold towel on the brow? Or a quiet room to relax? And why the need to rush to the pharmacy after overindulgence in food? The family doctor may suggest just a change in eating habits as the right prescription.

It is also a plus to have a total family doctor who warns about the possible excess of radiation. He or she knows X-rays saves lives, but many patients are heedless of the damage of overuse. Patients should be hesitant to demand X-rays of the reluctant doctor.

Herewith relevant stories. Family doctors, because they know their patients well, are astute diagnosticians.  I’ve known many direct, decisive and empathetic TFDs. Patients appreciate these traits.

I witnessed a telling incident. Three specialists gathered around a patient were worried about his laboured breathing following gallbladder removal. They had decided the obstructed breathing was so serious it required an immediate tracheotomy to put a tube in his throat.

As they were about to wheel the patient into surgery, the family doctor arrived and listened to his long-time patient’s breathing. Promptly he said, “I’ve known Tom for 40 years and he always breathes that way!”  The operation was immediately cancelled. Three embarrassed specialists departed.  This illustrates why continuity of care is so vital.

There’s another way family doctors can be of tremendous help, when the problem is beyond the TFD’s range of expertise. A fast referral to the right specialist is something people without a family doctor rarely achieve.

Let’s train more TFD’s, the backbone of medical practice! In another life, I’d be one of them without hesitation.

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Make a stink for better public washrooms

When asked how to become a famous comedian, Steve Martin replied, “Be so good they can’t ignore you.” It’s true, bad performers can usually be ignored. But there’s no ignoring bad public washrooms.

Public washrooms have a reputation for abysmal filth, as evidenced by dirty toilets, overflowing trash, empty or broken soap dispensers, sloppy countertops, and door handles not to be touched.

An American survey found that 21 percent of respondents used a public washroom at least six times a week, sometimes over 15 times! The reason was not always obvious.

Youth tend to visit washrooms to use their phones, change their clothes, or “get away”.  In fact, 21 percent of youth acknowledge the use of public washrooms to take a mental health break, to avoid someone, and on occasion to cry.

Older people, in addition to using the facilities, also visit public washrooms to check their appearance.

Whatever the reason to visit, how important is it to take precautions? The good news is that some of the germs found in public washrooms are no different than the germs found in many other places, including the bathroom at home.

Take Staphylococcus aureus for example. It will be found in dirty public washrooms. But it is also commonly carried around by 20-30 percent of people on their skin or in the respiratory system. It is an opportunistic pathogen, meaning it starts to cause trouble not when commonly encountered in the washroom but when the immune system is weakened or when the natural balance of bacteria in the gut is altered.

Authorities disagree on how long certain other nasty germs survive or how readily they cause infection. But many bathroom studies have shown remarkable staying power – up to 8 days for E. coli. According to the Centers for Disease Control and Prevention, the flu can survive on some surfaces for 48 hours.

Washing hands after using public facilities is a no brainer. Yet a study published in Antimicrobial Resistance & Infection Control found that handwashing and hand-drying equipment in public washrooms are facilitating infections due to contaminated sink handles and paper towel dispensers. Plus people don’t wash their hands with soapy water for 20 seconds or more.

Even with the best of efforts, some researchers have noted that “adequate hand hygiene may not always be achievable when using public washrooms.” That’s because the door handle used to leave the washroom is covered in germs.

Opting out of using a public bathroom and resorting to “holding behaviour” is not advisable. “Always go to the bathroom when you have a chance,” goes the sage advice of King George V. Royalty have their own reasons. But among common folk, holding urine in the bladder can invite bacteria in the urine to multiply and cause the development of urinary track infections.

When you’ve got to go, you’ve got to go.

But there’s worse news to report. A study published in 2020 in Physics of Fluids described a phenomenon known as “toilet turbulence.” It’s an alarming and repulsive discovery to learn that flushing a toilet can send small droplets of water and aerosols containing fecal germs three feet into the air above the seat!

One public health message advises users to turn away from the toilet when flushing. Good lord! There’s a reason for a toilet seat lid. Put it down before you flush.

Making a stink about public washrooms that are poorly designed and infrequently cleaned is probably the best course of action. Afterall, what restaurant or community venue wants to be associated with disgusting washrooms?

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Are Canadians Better at Preventing Lyme Disease?

It’s tick season and the little pests are out with a vengeance. Tiny as they are, ticks are a huge nuisance and a hazardous vector of disease. Their ability to latch onto unsuspecting hosts has made them one of the most successful blood-sucking parasites on the planet.

Ticks are the primary carriers of Lyme disease, infecting people with their bite. But do ticks or people account for the sizable difference in the number of reported cases in the US and Canada? Every year, in the United States, about half a million people are diagnosed with Lyme disease. Based on population, all other things equal, one would expect about 50,000 cases annually in Canada. Other things, however, must not be equal. Because according to the Public Health Agency of Canada, only 3,147 cases were reported in Canada in 2021, up from 144 in 2009.

Is geography behind this huge difference? Ticks that transmit Lyme are found in most parts of the US and have expanded into the areas of Canada where most people live over the past two decades.

Challenges with diagnosis of Lyme disease might help explain the gap. When diagnosed early, a course of antibiotics is an effective treatment. If untreated, the bacteria causing infection can linger in the body for months or years before presenting symptoms ranging, for example, from short-term fevers, rashes, and fatigue to more devastating conditions.

An attack on the central nervous system could be one manifestation. This can cause numbness, pain, stiff neck, headache, and many other symptoms, including psychiatric problems.

Another concern is the cardiovascular system, where Lyme disease can disrupt electrical signals that coordinate heart beats.

Painful swelling of joints is a common feature.

Celebrities have shared their experience with long lists of problems. Among them are musicians Avril Lavigne, Shania Twain, and Darryl Hall, actors Alec Baldwin and Ben Stiller, writer Amy Tan, and even President George W. Bush.

How can these stars, and even a president, fall victim? Ticks are stealthy. They can bite people and feed for a day or more before dropping off undetected.

Tick saliva is amazing stuff, containing antimicrobials, analgesics, blood thinners, and immune suppressors in cocktails that change according to the situation. It’s this saliva that enables ticks to bite and feast without notice. What’s more, unlike female ticks which become engorged, male ticks don’t eat such a big meal, making them very hard to notice.

Take a walk outdoors when good weather beckons but know how to avoid trouble. Ticks can’t jump to catch a ride. They “quest” by perching on the tips of grasses, leaves, and branches, then use their forward legs to grab hold when a host brushes up. So stay out of long grasses in areas home to deer, rabbits and field mice. Be wary of other places where ticks might catch a human host. For instance, ticks are commonly found in grasses, bushes and treed areas of golf courses. Any pet dog stepping into long grass or jumping in and out of ditches could pick up ticks, then bring them in the home where close contact with owners can easily occur.

Why do Canadians record so few cases of Lyme disease as compared to Americans? Lack of awareness of the disease among healthcare providers and low sensitivity of diagnostic tests are part of the answer. Additionally, one study found that Canadians tend to seek medical care less frequently for tick bites and are less likely to be tested for Lyme disease, leading to a 40% lower detection rate.

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Fish Oil: Superhero of Supplements

You may be forgiven if you are unfamiliar with Aquaman, a superhero who breathes underwater, communicates with sea creatures, and possesses superhuman strength and agility. But revisit past columns if you haven’t learned that fish are the real superheroes. Why? Because when mere mortals consume fish, their bodies gain extraordinary powers to fight the arch-nemesis of illness.

Studies have repeatedly shown that the omega-3 fatty acids found in fish oil have remarkable health benefits, including reducing the risk of heart disease, improving cognitive function, and reducing inflammation throughout the body.

To gain these benefits, eating enough fatty fish, like salmon and mackerel, isn’t easy, especially with high food prices. For a fraction of the cost, fish oil supplements are a no-brainer.

What’s preventing some people from taking this superhero of supplements?

Some people suffer from “fish burps”. It’s what happens when your digestive system lets out a little aquatic airfare, and a pungent reminder of your fish oil supplement.

The prevalence of burping or other gastrointestinal side effects when taking omega-3 fish oil supplements can vary depending on the individual. Some studies report that 30% of individuals may experience gastrointestinal symptoms such as burping, heartburn, or diarrhea. Most people experience no effects at all.

Why do people burp from fish oil? The main reason is that fish oil is a rich source of omega-3 fatty acids, which can be difficult for the body to digest, leading to the release of gas, which causes burping.

For those who are affected by burping, taking fish oil supplements can be a real problem. Not only is the burping unpleasant and embarrassing, but it can dissuade people from taking fish oil altogether, leaving them without the health benefits.

The likelihood of experiencing burping or other gastrointestinal side effects may also depend on the dose and formulation of the supplement being used.

And that’s where there is a good solution to the burping problem. Look for a fish oil supplement that offers a form more readily accepted by the stomach. One example to be found at health food stores is Certified Naturals Omega3X fish oil containing MaxSimil, which is pre-digested with enzymes, leading to better absorption and making it much less likely to cause burps.

To explain, omega-3 fatty acids are a type of polyunsaturated fat that are often found in the form of triglycerides. Triglycerides are the main form of fat in the human body and in the food we eat. They consist of a glycerol molecule and three fatty acids. In consuming omega-3 fatty acids, the role of the digestive system is to capture them for use as energy.

But our bodies contain a lot of water, and these oily triglycerides therefore can pass right through the body’s digestive system and out the other end, all benefits missed. The purpose of using enzymes is to convert the fats from a triglyceride to a monoglyceride. Monoglycerides are the form of fat that our body must convert fish oils into, so having it pre-digested into a monoglyceride makes it easier for our system to absorb, and thus less burping.  

In another approach to reduce burping, some supplements involve gelcaps that are enteric-coated for delayed release, but these can contain undesirable plasticizers.

For some, no matter how good the supplement, burping can remain a problem. Try refrigerating the capsules and taking them with food. Remember, accepting a little burp is better than forgoing the benefits.

If persistent or severe burping persists, talk to your healthcare provider, as these symptoms may indicate an underlying health condition or allergy.

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What Is the Best Nutritional Advice Ever Given?

How long has this column recommended a high-fiber diet? Since March 1978 when readers were informed that processed foods create a “slow assembly line” in the bowels. Now some of the world’s most highly regarded nutritional scientists at Imperial College London say dietary fiber is “the best health advice of all time”!

What is it about fiber that is so important? Soluble fiber dissolves in the stomach and can help lower blood cholesterol and glucose levels. Insoluble fiber passes through the digestive system, supporting a faster assembly line that moves waste out, reducing the risks for hemorrhoids and colon disease that creep up when hard stools loiter the bowels.

Experts agree that women need about 25-30 grams of fiber daily, and men about 30-35 grams. Children need substantial fiber too. But on average, North Americans are consuming only 15 grams of fiber a day.

Instead, most people are choosing too much processed food – white flour, sugar, low-quality breakfast cereal, chips, pies, processed meat, and ready meals, to name a few. One must shake the head when the benefits of fiber have been known for so long.

Dr. Denis Burkitt, an Irish researcher, reported decades ago that even disadvantaged populations in Africa consumed large amounts of fiber and had healthy bowel movements. Unlike better off Europeans, they did not suffer from constipation, and it was rare to see appendicitis and large bowel problems.

Most people won’t remember the King George V battleship chasing the German battleship Bismarck in World War II. But the British captain was also a medical expert. He brought sacks of bran on board to fight the common ailment at sea of constipation. The bowels of the battleship and the sailors performed very well!

Going back further in history, Hippocrates, who lived from 460-370 BC, told the people of Athens that to keep healthy they should have large bulky bowel movements. He scrutinized the stools of his patients to diagnose problems and recommended bread, fruits and vegetables.

Today we know that whole wheat, fruits and vegetables are high in fiber. Bananas, tomatoes, prunes, celery and roasted almonds are also good choices. Don’t forget the old adage, “An apple a day keeps the doctor away.” The reason? An apple can contain over 3 grams of fiber.

Be sure you’re not fooled by food labels. Look for the words “whole grain” or “whole wheat” on bread. One slice contains about two grams of fiber. Breads that are labelled “multigrain” may contain little or no fiber.

How do you know if you’re getting sufficient fiber? Be like Hippocrates and have a look in the toilet bowl. Small, hard, stools are a problem. A high fiber diet will result in regular soft stools having the texture of bananas.

Fiber also fights obesity. One apple loaded with fiber has a filling effect. Wait a few minutes after eating one to note how it eliminates the hunger reflex.

Get “fiber smart” and begin the day with a bowl of high fiber cereal along with a banana, blueberries, or other fruits and nuts. Then select meals at lunch and dinner that provide more fiber. Pass on the processed options. Desserts don’t need to be loaded with unhealthy calories. Apple crumble is an example of a high fiber dessert.

No one can claim that fiber is bad for your health. But keep in mind that adding too much fiber too quickly could cause a commotion in the bowels in the form of intestinal gas and bloating. Increase fiber in the diet gradually.

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Ecosystem Biodiversity Important to Human Health and Nutrition

The routine of modern-day life for most of us involves regular trips to the grocery store and three meals a day. The regular patterns of our diet can be a source of comfort or a rushed necessity. But is eating the same familiar foods – often the same recipes, products, brands, over and over, day by day – good for us?

As nutritious as a “well-balanced” diet may be, there are good reasons to strive for a more diverse diet.

Chimamanda Ngozi Adichie, the acclaimed Nigerian writer, was not referring to plant and animal ecosystems when she wrote, “Diversity is not about feeling included, it’s about feeling valued.” Yet, she’d surely agree. Unless biodiversity is valued, it will lose ground, quite literally.

Now, new research is showing that valuing diversity in the natural world has important implications for human health.

A study in the journal PNAS examines the relationship between aquatic biodiversity and human health. Researchers found that aquatic ecosystems, such as rivers, lakes, and oceans, provide a wide range of nutritional benefits to human populations.

According to the study, consuming a diet that includes a variety of fish, seaweed, and other aquatic foods can help prevent chronic diseases such as heart disease and diabetes. Additionally, these foods are rich in important nutrients such as omega-3 fatty acids, iodine, and iron, which are essential for human health.

The researchers also found that consuming a diverse range of aquatic foods can have positive impacts on the environment. By promoting the consumption of a wider range of fish and other aquatic foods, fisheries and aquaculture can diversify their operations and reduce pressure on overfished species.

Protecting the biodiversity of aquatic ecosystems is essential for continued access to nutritional benefits. Yet, climate change and human activities have already impacted the health of the world’s water. Conservation and sustainable use simply haven’t been the priority.

Land surfaces, where humans live, haven’t fared any better. Scientists are concerned about the health of the soil, grasses, and forbs that many animal species depend on for their dietary nutrition. 

Dr. Forest Isbell, professor of ecology at the University of Minnesota, notes, “Land use changes and overexploitation are driving changes in biodiversity and ecosystems in many parts of the world.”

Isbell has closely read the research published in PNAS and thinks the findings are likely to be replicated in other ecosystems. He’s involved in studies that test the effects of biodiversity in grasslands that provide essential forage for grazing livestock. “It’s an important question,” he says. “Due to widespread farming and overgrazing by livestock, we have seen significant biodiversity loss in many grasslands.  Just as people benefit from a diverse diet, so too do our livestock. By studying how biodiversity of grasses affects nutritional content of forage for herd animals, for example, we will be better able to inform policies and practices designed to protect land-based ecosystems.”

Human health depends on a diverse diet that delivers vitamins, minerals, protein, fats, water, and carbohydrates. It’s essential to place high value on the availability and quality of these components, as demonstrated by growing evidence of a vital relationship ecosystem biodiversity and human health.

Sadly, a study by the Food and Agriculture Organization of the United Nations reports that 95 percent of the calories consumed worldwide come from a mere 30 species. Farmers cultivate only about 150 of the 30,000 edible plant species. And 90 percent of the food from domesticated livestock comes from only 14 animals.

What can health-conscious consumers do? In the next trip to the grocery store, think about the choices and try pick out a diverse range of foods, including from aquatic sources.

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What to do when things fall down

The law of gravity means our bodies are pulled down to Earth. This fact inevitably spells trouble over time. But for some women, it causes inconvenient and annoying issues, and sometimes surgery, to address what’s called vaginal prolapse.

Not all women are born equal. Some inherit tougher pelvic tissues and do not experience prolapse, even after bearing several children. But the more pregnancies, the greater the risk in older age of weakened all pelvic structures leading to the sagging of the vagina, urinary bladder and often the rectum.

The most common complaint is the loss of urine on coughing and sneezing. A large survey of women in North America revealed that four percent suffer from this annoying problem.

Apart from pregnancy, what else can contribute to prolapse? Obesity is a factor, causing so many other medical complications too. It is staggering that some women still smoke. If cancer and respiratory diseases aren’t incentives enough to quit, then maybe vaginal prolapse should be more prominently added to the list. Why? A smoker’s cough pushes on the urinary bladder. Prolapse can also be worsened by heavily lifting.

Here’s another concern. Many women continue to suffer needlessly from chronic constipation. Why do they strain their innards and try to solve the problem with laxatives? This harms the bowel over the course of years.

One of the best kept secrets is that vitamin C is a safe, inexpensive, effective, and natural remedy for constipation. But it must be in higher doses than found in most supplements. Start with taking 2,000 milligrams before bed. If no results, increase to 4,000 mg the following night. It invariably works.

Remember, simply because prolapse has developed does not mean it always be treated. This is an important point to stress because many women with prolapse will never know they have the condition. Awareness usually becomes evident when they start to experience troublesome urinary incontinence.

What can be done depends on the severity of prolapse and if it’s causing annoyance. The most frequent treatment is the use of a vaginal pessary which is easy to insert and can be easily removed to be cleaned.

The use of a pessary will help to elevate the urinary prolapse and may stop the loss of urine. But sometimes in elderly women another easy and effective treatment is acceptable. Inserting a large vaginal tampon to push up the bladder can help ease the loss of urine.

Prevention is advantage of those not yet dealing with serious prolapse. So in addition to maintaining a healthy weight, not smoking, eating a nutritious diet, and sleeping well, don’t forget moderate exercise for the entire body, including those easy-to-miss pelvic muscles. Develop a habit of doing Kegel exercises several times a day. This is done by concentrating on pulling up the pelvic and rectal muscles. It’s possible to do this seated, standing, or lying down. So identify a consistent place and time each day, and do it. The more you exercise these muscles, the stronger they will become.

If all this fails, doctors will suggest surgery. There are several methods. One is to stitch up the position of the bladder. Your surgeon may also advise an artificial support for extra strength. Or the prolapse can be repaired during a hysterectomy.

Do men develop prolapse? Yes, but much less often and it’s usually a prolapse of the rectal area.

Marilyn Monroe famously said, “I defy gravity.” But such fortunes elude most people. Talk with your doctor and see if treatment can get the annoyance resolved.

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Don’t Let Food Safety in the Kitchen Lapse

It’s an age-old problem, but not one that should come with age. Yet, compared to younger culinary novices, elderly people may be more prone to making mistakes in food preparation that can lead to food poisoning.

Kitchens can be a dangerous place. So no harm in having a refresher to make sure food safety in the kitchen doesn’t lapse. You know why. Recall that occasion when it seemed like a good meal – until later, when cramps, nausea and diarrhea had you vowing never to eat again.  Unless you’ve been visiting uncared for places or you are victim to an outbreak of foodborne illness, there’s no excuse for food poisoning other than an unfortunate mistake.

Unfortunately, mistakes happen, and with some frequency in the kitchens of seniors. For example, a study published in the Journal of Food Protection found that older adults were less likely to use food thermometers when cooking meat, increasing the risk of undercooked meat.

Another study found that elderly people were more likely to store food at unsafe temperatures, such as leaving perishable foods out at room temperature for too long or storing them in the refrigerator at temperatures above 40°F (4°C). This could increase the risk of bacterial growth.

The Centers for Disease Control and Prevention (CDC) reports that older adults are more likely to develop severe complications from foodborne illnesses, such as kidney failure or sepsis, due to age-related changes in the immune system and underlying health conditions.

The World Health Organization (WHO) claims that contaminated food is one of the most serious health problems in the world. It’s usually due to an organism called E. coli. And for infants, pregnant women and the elderly the consequences of consuming it can be fatal.

The good news is that food safety in the kitchen is straightforward and largely unchanging.

One – Wash your hands repeatedly. Your fingers are excellent at transmitting infection.

Two – Keep kitchen surfaces meticulously clean. Bacteria always win if you become careless.

Three – Protect food from insects and rodents in cupboards and drawers. Animals often carry pathogenic organisms that cause foodborne disease. Store food in closed containers.

Four – Many foods such as fruits and vegetables are better in their natural state. But others are not safe unless they’re processed. For instance, lettuce needs thorough washing and pasteurized milk is safer than raw milk.

Five – Cook food thoroughly. Many raw foods such as poultry, meats and eggs may be contaminated with disease causing organisms. Thorough cooking will kill the pathogens. So if cooked chicken is raw near the bone put it back in the oven until it’s done.

Six – Eat cooked foods immediately. When cooked foods cool to room temperature, bacteria begin to multiply. The longer the wait the greater the risk.

Seven – Store cooked foods carefully. A common error is putting too large a quantity of warm food in the refrigerator. In an overburdened refrigerator, food remains warm too long allowing bacteria to proliferate.

Eight – Reheat cooked foods thoroughly. This is your best protection against bacteria that may have developed during storage.

Nine – Avoid contact between raw foods and cooked foods. For instance, safely cooked foods can become contaminated by even the slightest contact with raw food. So don’t prepare a raw chicken and then use the same unwashed cutting board and knife to carve a cooked bird.

Ten – Add a pinch of common sense. If something seems “off”, then don’t eat it. If food is past it’s expiry date, throw it out.

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Fire the Canons! It’s Daylight Savings Time!

In a letter to the editor of the Journal of Paris in 1784, Benjamin Franklin wrote, “Early to bed, and early to rise, makes a man healthy, wealthy and wise.” In his advocacy for people to wake up and leverage the day, Franklin joked there should be a tax on window shutters, candles should be rationed, and canons should be fired at sunrise!But it was the small town of Port Arthur in northern Ontario that first changed the clocks by enactment on July 1, 1908.In recent times, one of the main arguments for shifting the time to align with the sun focuses on energy savings during evening hours. But dozens of studies have shown the effect to be negligible.

Now, the health implications of Daylight Savings Time (DST) are becoming the hot topic, with researchers investigating its impact on everything from sleep patterns to heart health.

The effect of DST on sleep is significant. Numerous studies have found the time change can disrupt our sleep patterns, leading to sleep deprivation and increased fatigue. This is particularly true in Spring, when we lose an hour of sleep and our bodies struggle to adjust to the new schedule.

The time change and associated disruption to sleep patterns can have more serious health consequences. One study published in the New England Journal of Medicine found that the risk of heart attacks increased by 25% on the Monday following the springtime change. This is powerful evidence that disturbed sleep patterns can be highly stressful on the cardiovascular system.

Mental health can be another victim. One study published in Sleep Medicine found the springtime change was associated with increased symptoms of depression, particularly in people who already had a history of depression. The study’s findings further suggested that the disruption to sleep patterns might even trigger the onset of depressive symptoms.

One strategy to mitigate these problems is to adjust sleep patterns leading up to the time change. For those observing a regular nighttime routine, this means going to bed and waking up 15 minutes earlier each day in the week leading up to the change. Even for those without a firm pattern, making the effort to shift forward in advance – both physically and mentally – should help.

Another strategy is to prioritize good sleep. Create a comfortable sleep environment, establish a regular sleep schedule, and avoid caffeine and alcohol in the hours leading up to bedtime.

Are you tired of the debate about DST? Worse, are you “tired all the time”? You may need to take a closer look at the benefits of getting a good sleep. Sleep scientists can present compelling evidence showing how being tired leads to increased risk of traffic accidents, for example. Studies also link poor sleep with obesity, diabetes, cancer and dementia. Abnormal sleep and psychiatric conditions go hand in glove.

Don’t forget the function of sleep as a sort of garbage collection system. During sleep, the body rejuvenates the brain by sorting “keeper” information from “trash”. Sleep also helps the body clear out and clean up waste in the cardiovascular system while refueling immune function.

If there is a good argument in favour of DST, it might be Franklin’s suggestion to fire a canon each morning at sunrise. That would surely get people on their feet and outside to take a look. An early morning experience in the outdoors – whether it be a walk or even just a few moments of quiet contemplate about the new day – is an excellent step to good health.

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