Could You Be Allergic to Your Holiday Tree?

What is Christmas Tree Syndrome?

Christmas tree syndrome refers to an allergic reaction that some people experience after bringing a Christmas tree into their home. This syndrome can cause a variety of symptoms, including wheezing, sneezing, coughs, sore eyes, and potentially serious asthma attacks. Interestingly, both real and artificial Christmas trees can trigger these allergic reactions​​.

Causes of Christmas Tree Syndrome

  • Real Trees: Trees like cypress and pine can accumulate high amounts of pollen from other plants before they are cut down. Additionally, Christmas trees can carry about 50 different types of mold, which can increase the mold spore count in a home by more than six times​​.
  • Artificial Trees: These can also be problematic if they gather dust, dust mites, or mold while in storage​​​​.

Who is Affected?

Christmas tree syndrome is more common in people prone to allergies and asthma but can affect anyone. The symptoms are particularly noticeable for those who regularly bring real trees into their homes during the holiday season​​.

Managing Christmas Tree Syndrome

  1. For Real Trees:
    • Hose down the tree before bringing it indoors to wash off allergens​​.
    • Shake the tree to remove loose debris and rinse it with a hose or veggie wash, drying it thoroughly afterward​​.
    • Consider less allergenic trees like fir, spruce, or cypress, especially the Leyland Cypress, which does not produce pollen​​.
  2. For Artificial Trees:
    • Unpack and clean the tree outdoors to remove dust and mold spores. Vacuum or wipe it down before bringing it inside​​.
    • Store the tree in an airtight container or sealed box in a dry place to prevent mold growth​​.
  3. General Tips:
    • Use air purifiers in the room with the tree to trap allergens​​.
    • Clean and unpack Christmas ornaments and decorations outside to reduce dust and mold exposure​​.
    • If allergies persist with both live and artificial trees, consider setting up a decorated tree outside a patio door or large window to enjoy it from indoors​​.
  4. Health Precautions:
    • Be aware of your asthma triggers and manage them if possible.
    • Follow your written asthma action plan and ensure you have your medication, especially during the festive season​​.

Christmas tree syndrome, while not widely known, can significantly impact the quality of life during the holiday season for those susceptible. By understanding its causes and implementing these management strategies, you can enjoy your festive decorations without compromising your health. Remember, if symptoms persist, consult a healthcare professional for personalized advice and treatment.

Understanding Different Heat Illnesses

As the temperatures rise during the warmer months, many of us enjoy spending more time outdoors. However, with the increase in temperatures comes the potential risk of heat-related illnesses. Our primary care doctors in Jupiter want you to be informed about the different types of heat illnesses to prevent them and to provide proper care if someone is affected.

1. Heat Stroke

What it is: Heat stroke is the most severe form of heat illness and is a medical emergency. It happens when the body’s temperature rises rapidly, and it can’t cool down.

Symptoms:

  • High body temperature (above 103°F)
  • Hot, red, dry, or damp skin
  • Fast, strong pulse
  • Headache
  • Dizziness
  • Nausea
  • Confusion
  • Losing consciousness (passing out)

What to do: Call 911 immediately. While waiting for medical professionals, move the person to a cooler place and try to reduce their body temperature with cool cloths or a cool bath. Do not give the person anything to drink.

2. Heat Exhaustion

What it is: Heat exhaustion is a warning that your body can no longer keep itself cool. If left untreated, it can escalate to heat stroke.

Symptoms:

  • Heavy sweating
  • Cold, pale, and clammy skin
  • Fast, weak pulse
  • Nausea or vomiting
  • Muscle cramps
  • Tiredness or weakness
  • Dizziness
  • Headache
  • Fainting

What to do: Move to a cool place, loosen your clothes, put cool, wet clothes on your body or take a cool bath. If the person is fully conscious, they can sip water. If the symptoms worsen or last longer than an hour, seek medical attention.

3. Heat Cramps

What it is: Muscle spasms or pains that occur due to intense exercise in hot weather.

Symptoms:

  • Muscle cramps, usually in the legs or abdomen
  • Heavy sweating

What to do: Stop the activity and move to a cool place. Drink water or a sports drink. Wait for the cramps to go away before you do any more physical activity.

4. Heat Rash

What it is: Skin irritation from excessive sweating.

Symptoms:

  • Red clusters of small blisters that look like pimples on the skin
  • Usually appears on the neck, chest, groin, or elbow creases

What to do: Stay in a cool, dry place. Keep the rash dry and avoid using ointments or creams as they can keep the skin warm and moist, worsening the condition.

5. Dehydration

What it is: A lack of enough water in the body, often caused by too much sweating.

Symptoms:

  • Dry mouth and throat
  • Dark yellow urine
  • Not urinating much
  • Feeling dizzy or lightheaded
  • Feeling tired
  • Dry skin

What to do: Drink plenty of fluids, preferably water. If dehydration is severe and accompanied by symptoms like confusion, rapid heartbeat, or rapid breathing, seek medical attention immediately.

Prevention Tips

  • Stay Hydrated: Drink plenty of water throughout the day. Avoid drinks with caffeine or alcohol as they can dehydrate you.
  • Dress Appropriately: Wear lightweight, light-colored, loose-fitting clothing. Use a wide-brimmed hat or an umbrella for shade.
  • Stay Cool: Avoid direct sunlight whenever possible, especially during the hottest parts of the day. Use fans or air conditioning to cool down.
  • Limit Outdoor Activities: Do strenuous activities during the cooler parts of the day, such as early morning or late evening.

By understanding the signs and symptoms of heat-related illnesses and taking preventive measures, you can safely enjoy the warm weather without the health risks. Always listen to your body, and if you or someone around you is showing signs of a heat illness, take it seriously and seek medical attention if needed.

Improve Your Nutrition with these Simple Steps 

Nutrition plays a crucial role in providing the necessary nutrients for our bodies to function properly. These essential nutrients include carbohydrates, proteins, fats, vitamins, and minerals. Carbohydrates provide energy, proteins are vital for tissue growth and repair, fats contribute to insulation and organ protection, while vitamins and minerals are required for various bodily functions, such as building strong bones, maintaining a healthy immune system, and supporting heart and brain health.

A balanced and healthy diet, consisting of a variety of foods from different food groups, ensures that our bodies receive all the necessary nutrients. Proper nutrition not only helps to maintain healthy body weight but also reduces the risk of chronic diseases like diabetes, heart disease, and cancer. On the other hand, a poor diet lacking essential nutrients can lead to malnutrition and various health problems. Therefore, good nutrition is essential for overall health and well-being.

There are several ways to improve your nutrition, including:

  • Encouraging a balanced diet: Consume a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. A balanced diet provides the necessary nutrients for the body to function properly.
  • Ensuring adequate hydration: Stay hydrated by drinking plenty of water and other fluids. This helps prevent dehydration, which can lead to health problems.
  • Providing smaller, more frequent meals: Instead of large meals, consider offering smaller, more frequent meals throughout the day, especially for adults. This ensures they receive the necessary nutrients without feeling overwhelmed.
  • Offering nutrient-dense snacks: Opt for nutrient-dense snacks such as fresh fruits, vegetables, nuts, and seeds. These snacks boost energy levels and provide essential nutrients.

In conclusion, in addition to prioritizing good nutrition, it is beneficial to seek guidance and support from primary care concierge doctors in Jupiter. These healthcare professionals specialize in personalized care and can offer valuable insights and recommendations tailored to individual needs. Collaborating with primary care doctors can further enhance one’s journey toward optimal nutrition and overall health. By combining their expertise with the principles of a balanced diet, hydration, and nutrient-dense snacks, individuals can receive comprehensive care that addresses their unique requirements and fosters long-term well-being. Together, the commitment to sound nutrition and the assistance of primary care concierge doctors empower patients to lead fulfilling and healthy lives.

Staying Safe In Flooding Events

In light of last month’s flood disaster in Fort Lauderdale, and the fact that such events are happening more often, our primary care concierge doctors in Jupiter want to review what you should know to stay safe in similar situations.

Not only are extreme flooding events more likely these days, but here on the east coast of Florida we also regularly deal with the threat of hurricanes. And with hurricane season arriving in just a few weeks, it pays to be prepared.

More to Come

In the aftermath of the Fort Lauderdale flooding, Kevin Guthrie, director of the Florida Division of Emergency Management, said, “This is the second most-catastrophic flooding event that I’ve seen in my tenure as emergency manager . . . over the last 33 years,” with Hurricane Ian being the worst.

Unfortunately, with the changing climate, such events are becoming more common, both in Florida and across the country. Warmer air holds more water vapor than cooler air, thus intensifying rainfall amounts.

The National Weather Service (NWS) reports that flooding kills more people than almost any other weather-related hazard. That’s why it’s important to know what to do in storm emergencies.

Before the Storm

  • Be sure you have a 30-day supply of your medications—both prescription and non-prescription—on hand before the storm hits. See us if you need refills of any drugs you may be taking.
  • If your medications need to be refrigerated, talk to us about how to keep them properly stored if your power goes out.
  • If you are on dialysis, talk to the doctors or staff at the dialysis center about where to go after the storm.
  • If you use medical devices such as ventilators or oxygen concentrators, be sure the batteries are fully charged, and know where to go if the battery doesn’t work.
  • If you are on a special diet, be sure to have enough food available to last at least a week. And have enough bottled water available for everyone in the household to prevent dehydration. The rule of thumb is one gallon per person per day.
  • If you have service animals or pets, ensure they have enough water, food, and any medications to last at least 10 days after the storm.
  • Be sure to have plenty of hand sanitizers and hand wipes available.
  • Make sure to take all your medical paperwork with you if you evacuate: a list of current medications, a list of drug allergies, insurance cards, and contact numbers for your physicians.
  • If you haven’t had a tetanus vaccine in the past 10 years, see us now to be inoculated. During after-storm cleanup, tetanus bacteria can infect you from even a minor cut or scratch.

Driving Safely

Flash floods are caused by slow-moving thunderstorms, or storms that move over the same area one right after the other, known as “training,” because they follow each other like train cars. The NWS says that most deaths associated with floods occur at night or when people become trapped in cars that stall while driving in flooded areas. 

In April’s flooding, CNN reported that a month’s worth of rain fell on Fort Lauderdale in just one hour. Many of the city’s streets turned into lakes as two feet of rain left over 1,000 people calling for help.

If you encounter flooding, remember: Turn around, don’t drown. It takes just a foot of water to float a car; two feet will float most vehicles, including pick-up trucks.

One final tip from the man who helped create the “turn around, don’t drown” slogan: Hector Guerrero, formerly with the NWS, tells NPR that floodwaters can make it challenging to open car doors or windows. That’s why he keeps a safety hammer in his car in case he gets stuck in rising waters.

“You hit the corner of that windshield,” he says. “You can break it out if it has to come to that.”

Then head to higher ground: a nearby hill, a building, or even a tree.

After the Storm

Many deaths and injuries occur after a disaster. So here’s what you need to know to stay safe.

  • Avoid floodwaters if at all possible. They are filled with such contaminants as oil and gas, infectious diseases, household chemicals, and sewage, not to mention displaced animals. Water may also cover potholes and sinkholes.
  • If you’re using a generator to maintain power, be sure it’s far enough away from the house to prevent carbon monoxide from seeping into the home.
  • Do not eat any food or water that may have come into contact with floodwater. If in doubt, throw it out.
  • If lifesaving drugs have been exposed to floodwaters, the U.S. Food and Drug Administration (FDA) says that if the container is contaminated but the contents appear unaffected (i.e., the pills are dry), they may be used until replacements are available. Other types of drugs or drug products such as inhalers, oral liquids, drugs for injections, and so forth, should be discarded if they have come in contact with contaminated water.
  • Insulin loses its potency according to the temperature it is exposed to and the length of the exposure. Under emergency conditions, you might still need to use insulin that has been stored above 86 degrees Fahrenheit. When a fresh supply becomes available, discard any questionable insulin remaining.
  • Take care during cleanup. Be aware of downed power lines, the hazards of power tools like chainsaws, and the dangers of overexertion and heat.

Celebrate Earth Day With a Climate-Friendly Diet

As we prepare to celebrate the 51st Earth Day this week, our primary care concierge doctors in Jupiter know that many people are looking for ways to be kinder to the Earth without radically altering their entire lifestyle.

One way is to be more mindful of the carbon impact of the foods we eat. As an added bonus, eating more sustainably provides great health benefits, as well.

But you don’t have to make drastic changes to make a difference.

First, Some Facts

The World Economic Forum reports that, in a business-as-usual scenario, emissions from food production alone could use up all of the earth’s 1.5°C to 2°C carbon budget.

The World Health Organization (WHO) says that food production accounts for 20-30 percent of global greenhouse gas (GHG) emissions and as much as 66 percent of water usage.

According to Scientific American (SA), the Environmental Working Group (EWG) found that red meat such as beef and lamb is responsible for 10 to 40 times as many GHG emissions as grains and vegetables.

Livestock farming from cattle alone is estimated to generate about 20 percent of the GHG methane produced in the U.S.

In addition, a 2009 study found that cattle ranching is responsible for 80 percent of the deforestation of the Amazon rainforest.

Finally, SA reports that concentrated animal feeding operations (CAFOs or “factory farms”) can produce as much sewage waste as a small city.

The Wellness Advantage

In addition to the benefits for the planet, this way of eating provides another bonus: From a health perspective, plant-based diets are unquestionably better for the body than a diet high in meat, especially red meat.

According to Harvard Health, “an accumulated body of evidence shows a clear link between high intake of red and processed meats and a higher risk for heart disease, cancer, diabetes, and premature death.”

“The evidence is consistent across different studies,” says Dr. Frank Hu, chair of Harvard’s Department of Nutrition.

On the flip side, plant-forward diets have been shown to support the immune system, reduce inflammation in the body, reduce the plaques associated with Alzheimer’s disease, and improve the gut microbiome.

And, of course, incorporating more plants into your diet reduces the number of antibiotics you’re exposed to.

As SA reports, the widespread use of antibiotics to keep livestock healthy in the unnatural confines of those overcrowded CAFOs has led to the development of dangerous antibiotic-resistant strains of bacteria that can make some common infections impossible to treat.

Different Approaches

As we said, you don’t have to go totally vegan to help the planet or your health. There is an array of climate-friendly (or at least friendlier) diets to choose from.

Vegans, of course, don’t consume any animal products at all.

Vegetarians don’t eat meat but may eat some animal products such as eggs and dairy.

Flexitarians are, as their name suggests, more flexible in what they eat. Closest to vegetarians, they do occasionally consume meat.

Sustainarians eat a mostly plant-based diet but will eat meat if it is locally and humanely raised.

Reducetarians try to eat less meat for a variety of reasons, including their own health, the welfare of animals, and the environmental impact of their food. They’re also concerned with the concepts of biodiversity loss, and their food’s impact on water supplies and food workers.

Climatarians, also known as “climavores,” eat less meat and only a moderate amount of sustainable fish, avoid food waste and “air-flown” food, and choose high-welfare, organic meat.

Regenivores’ diets are similar to those above, especially reducetarians, but focus even more on whether it’s ethically produced. HuffPost reports they take into consideration soil health, workers’ rights, the impact of chemicals on the humans involved in food production, and the treatment of animals throughout the supply chain.

Other Ideas

Kind of confusing, isn’t it? If you don’t want to label your efforts to reduce your carbon footprint but just want to eat more sustainably, Canadian Living offers a simpler approach:

  1. Eat less meat. “A 2016 systematic review shows that following a diet low in animal products has the biggest impact on the environment of any dietary change, reducing GHG emissions and land use up to 70-80 percent, and water uses up to 50 percent,” the magazine reports. Keep in mind that beef has the largest carbon footprint of all animal products.
  2. Eat more plants. For your health and that of the planet, focus on vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils, moderate amounts of seafood and poultry, and little red or processed meat, added sugar, or refined grains.
  3. Reduce food waste. Food waste ends up in landfills, where it generates about 25 percent of Canada’s methane gas. (The U.S. total is approximately 16 percent). Buy only what you need, and make a plan to use up leftovers as much as possible.
  4. Buy local food. This supports local farmers, reduces the need for transporting food long distances, and is more nutritious because fewer nutrients are lost during transit.
  5. Reduce kitchen garbage:
    • Buy/use reusable grocery and produce bags.
    • Carry a reusable water bottle.
    • Use beeswax wraps instead of plastic wrap.
    • Replace washable silicone bags instead of plastic bags.

This Earth Day, you can do your health and the planet a favor just by making a few simple changes to your diet.

For a suggested Earth Day menu, Earthday.org offers a sample here.

Live Longer with Blue Zone Foods

Of all the diet trends available today, one our primary care concierge doctors in Jupiter can highly recommend is the Blue Zone way of eating: fresh, healthy, unprocessed food, from as close to its source as possible, in meals shared with family and friends.

The term “Blue Zone” was coined nearly 20 years ago by journalist and researcher Dan Buettner in a 2005 National Geographic cover story titled, “Secrets of Living Longer.”

His team of anthropologists, demographers, and scientists had traveled the world to find the world’s longest-living people, and to discover the secrets to their longevity.

Buettner’s team found five seemingly disparate places where the people live exceptionally long, healthy lives: on average, around 100. (The term “blue zone” came from the blue circles the researchers drew on a map during their quest.)

The five places are:

Okinawa, Japan
the Nicoyan Peninsula in Costa Rica
the Seventh Day Adventists in Loma Linda, California
Sardinia, Italy
Ikaria, Greece

More than Diet

Of course, healthy eating is key to a healthy body, but the Blue Zone residents had more than good food on their side. Genetics, as always, plays a big role in how long anyone will live no matter where they are.

Other factors the team found the Blue Zones had in common were:

Natural movement: no marathons or gym visits, just long walks, hiking, gardening, etc.
Hara Hachi Bu: an Okinawan term for eating until they’re about 80 percent full
Plant slant: a preference for plant foods over meat
Grapes of Life: one to two servings of red wine daily (except for the Seventh Day Adventists, who eschew alcohol)
Plan de Vida: or “why I wake up in the morning,” i.e., a sense of purpose
Downshift: controlling stress, a sense of serenity
Belong: participation in a spiritual community
Loved ones first: making family a priority
Close tribe: social connectedness

Blue Zone Meals

The Blue Zone diet, which Buettner details in his latest book, “The Blue Zones American Kitchen: 100 Recipes to Live to 100,” is a cornerstone of the Blue Zone program, and closely resembles the Mediterranean diet, but with even less emphasis on fish and meat.

“The five pillars of every longevity diet, including the Blue Zones, are whole grains, vegetables in season, tubers, nuts, and beans. In fact, I argue the cornerstone of a longevity diet is beans,” he told CNN.

Legumes, in fact, are key, he told The Washington Post. They are rich in fiber, which is key to improving cholesterol and blood sugar levels.

“Figure out how to get a cup of beans into your diet every day,” he told the paper. “Just one cup gives you half of all the daily fiber you need.”

What Not to Eat

And even though the Mediterranean diet includes a certain amount of meat and fish, Blue Zone diets contain little, if any.

“People in Blue Zones don’t eat nearly as much fish as the Mediterranean diet prescribes, only three times a week and only three ounces,” he told CNN. “Meat is eaten only five times a month. There’s no cow’s milk in any Blue Zone.”

Instead, people eat goat and sheep’s milk cheeses such as feta and pecorino, he said.

In addition, “no more than three eggs are consumed per week,” he told NBC’s Today show.

“The Blue Zone eating pattern is 98 percent plant-based foods—whole food-based and high carbohydrate,” Buettner told CNN.

“But only complex carbs, not the simple carbs like salty snacks and candy bars and soda pop. You say carbohydrates and people are horrified, but the healthiest foods in our food system are complex carbohydrates,” he added.

Time and Place Count, too

In keeping with the other factors that affect longevity, sharing meals—especially with family—is another component. While our busy schedules might not often permit this, Buettner says it’s worth doing as often as possible.

“Families that eat together tend to each much more nutritiously, they eat slower, and there’s good research that children have fewer issues with disordered eating if they’re eating socially,” he told The Post.

And it turns out the recent trend toward intermittent fasting appears to have some validity. Buettner reports that people in Blue Zones tend to eat earlier in the day.

Okinawans, for instance, traditionally eat a big breakfast and a moderate lunch.

“They don’t even have dinner,” he told the paper.

And the Seventh Day Adventists in Loma Linda would eat a big breakfast at 10 a.m. and a moderate lunch at 4 p.m. “And then they’re done for the day,” he said.

Small Moves

Of course, there’s more to the Blue Zone lifestyle than just food, as we mentioned earlier. Three of the five Blue Zones are isolated, which forces tight social connections and a lot of walking.

“Walking is one of the best forms of exercise and you can do it without thinking about it,” Buettner told Today, suggesting that people think about adopting a dog as a strategy to encourage regular walks.

“We’re all looking for magic dietary pills or serums or supplements, but you see none of that in the Blue Zones,” he said. “It’s mostly small things driven by the right environment,” he said.

That includes social connections.

“We’re genetically hardwired to crave social interaction, and when you don’t have it, there’s a level of subconscious stress that grates away at you,” he added.

Nature Can Heal in More Ways Than One

Humans evolved in the natural world. We may have retreated to caves or huts to protect ourselves from the elements, but we spent much of our time outdoors, hunting, gathering, cooking, telling stories, and so on. Our lives these days, though, are largely spent cut off from nature.

This way of life has sparked a wealth of studies showing that our loss of contact with nature—dubbed “nature deficit disorder”—has a real impact on our physical and mental health.

So our primary care concierge doctors in Jupiter weren’t too surprised to learn of a new study published this month in the journal Occupational & Environmental Medicine, which found that enjoying nature up to four times a week reduced the odds of needing mental health medications by 33 percent.

It also reduced the odds of using blood pressure pills by 36 percent and asthma medications by 26 percent.

The Study

Researchers interviewed about 6,000 people who live in large cities in Finland, asking about their access to and use of green and blue spaces, including parks, zoos, rivers, lakes, or the sea. 

They also asked subjects whether they could see views of nature from their homes, how often they spent time outdoors as well as how much they exercised while outdoors.

The study also accounted for other possible factors such as traffic-related outdoor air pollution and noise, which have been proven to have an adverse effect on health.

Respondents were then asked about their use of medications for depression, anxiety, high blood pressure, asthma, or insomnia, and correlated these with time spent in nature.

As noted above, the results were markedly better for those who were regularly exposed to green or blue spaces. Notably, those who lived in areas with a lot of green spaces or who simply looked at nature from their windows showed no improvement in any of these categories.

“Frequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive, and asthma medication in urban environments,” the study authors wrote.

Confirming Prior Research

Numerous earlier studies have found significant benefits from spending time in nature.

One meta-review of 143 other studies published in the journal Environmental Research, for example, found that people with access to green space generally had a slower heart rate, lower blood pressure, and fewer blood levels of the stress hormone cortisol. Researchers also found significantly fewer cases of diabetes and lower rates of mortality from heart disease in the group regularly exposed to nature.

An American Institutes for Research (AIR) study in 2005 found that sixth-grade students who attended three outdoor education programs showed marked improvement in conflict resolution skills.

Another study in China in 2013 involved 60,000 children between the ages of two and 17. It showed that regular exposure to nature, or “greenness” around their schools, reduced the incidence of attention deficit/hyperactivity disorder (ADHD). A more recent study at the University of Illinois produced similar results.

And a 2016 study of nearly 100,000 women conducted over eight years found that having access to the greenest space not only improved the subjects’ mental health but also reduced their death rate by 12 percent.

Nature Deprivation Hurts

Author Richard Louv coined the phrase Nature Deficit Disorder (NDD) in his 2005 book “Last Child in the Woods: Saving Our Children from Nature Deficit Disorder.” In it, he argued that elements of our urbanized lifestyle, including few natural spaces, a car-focused culture, more screen time, changes in the perception of risk (e.g., fear of “stranger danger”), less leisure time, and increased time pressure from work or school, combine to decrease or even eliminate contact with nature for both adults and children, according to the National Institutes for Health (NIH).

“The average young American now spends practically every minute—except for the time in school—using a smartphone, computer, television, or electronic device,” Tamar Lewin reported in a Kaiser Family Foundation study on the subject.

According to the Children and Nature Network (C-NN), which was co-founded by Louv, an expanding body of scientific evidence suggests that nature-deficit disorder contributes to:

  • diminished use of the senses
  • attention difficulties
  • conditions of obesity, and
  • higher rates of emotional and physical illnesses

Make the Connection

Unfortunately, to get back to nature, you may need to make a specific effort, because in our harried lives trapped indoors, focused on our screens, we have very little time for real relaxation.

Therefore, it’s often necessary to add nature breaks to our schedules the same way we schedule everything else.

One way is to undertake the Japanese practice known as “forest bathing,” or shinrin-yoku. As Kaiser Permanente’s’ online Thrive explains, “Heading out to a heavily wooded area isn’t required. You could take a trip to a nearby park, your favorite local trail, the beach, or any natural setting. Just be sure to turn off or silence your phone or other devices.”

Psychology Today explains, “Forest bathing is an antidote to pinging distractions, impending deadlines, and never-ending obligations . . . . The idea is to immerse yourself in a natural environment and soak up the many health benefits of being in the green woods.”

However, you manage it, for the sake of your overall health we recommend you take the time to reconnect with the natural world as often as possible.

There’s a Reason Why You’re Feeling SAD

If you’ve been feeling down, sleepy, or hopeless, even with all the holiday merriment going on around you, our primary care concierge doctors in Jupiter want you to know you’re not alone. Health experts estimate that seasonal affective disorder (SAD), or the “winter blues,” affects about five percent of the U.S. population.

SAD is more than just the “winter blues,” according to the American Psychiatric Association (APA). The symptoms can be distressing and overwhelming, and can interfere with daily functioning, the APA reports. 

Affecting more than 10 million Americans, symptoms of the condition usually begin in October or November and begin to subside in March or April. However, some patients don’t feel fully back to normal until early May.

SAD may begin at any age, but it typically starts when a person is between the ages of 18 and 30 and seems to affect women more than men.

Symptoms

The APA lists the following symptoms associated with SAD:

  • fatigue, even with excessive amounts of sleep
  • weight gain associated with overeating and carbohydrate cravings
  • feelings of sadness or depressed mood
  • marked loss of interest or pleasure in activities once enjoyed
  • loss of energy
  • an increase in restless activity (e.g., hand-wringing or pacing)
  • slowed movements and speech
  • feeling worthless or guilty
  • trouble concentrating or making decisions
  • thoughts of death or suicide or attempts at suicide.

The severity of such symptoms can vary from person to person, and not everyone will experience all these symptoms.

Likely Causes

While no one is certain what causes SAD, the lower amounts of sunlight in fall and winter are believed to lead to a biochemical imbalance in the brain, impacting the body’s circadian clock, which triggers sleep and wake cycles.

This process affects the output of serotonin, the so-called “mood” hormone. Studies have shown that the circadian-related output of serotonin drops markedly with the decrease in light during the winter. It also increases the level of melatonin, a hormone secreted by the pineal gland that regulates the sleep cycle.

The cause of SAD may have an ancient survival connection, as humans learned to restrict activity when food sources were scarce. The tendency may still be hardwired into our biology, and people can experience symptoms on a sliding scale from barely noticeable to full-blown clinical depression.

Risk factors include a family history of SAD or another form of depression, having major depression or bipolar disorder, and having lower levels of vitamin D. Vitamin D is believed to promote serotonin production.

Treatment

SAD can be effectively treated in a number of ways, including through the use of light-box therapy, which employs specially built full-spectrum lamps to alleviate symptoms. The NIMH reports that this type of therapy has been a mainstay for treating SAD since the 1980s.

In this treatment, a person sits in front of a very bright lightbox (10,000 lux) every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring. The light boxes, which are about 20 times brighter than ordinary indoor light, filter out the potentially damaging UV light, making this treatment safe for most people.

However, those with certain eye diseases or people taking certain medications that increase their sensitivity to sunlight might need other treatment types.

Other approaches include the use of antidepressants such as Paxil and Prozac, or cognitive behavioral therapy (CBT), a type of talk therapy aimed at helping individuals learn how to cope with difficult situations. In addition, the U.S. Food and Drug Administration (FDA) has also approved another type of antidepressant specifically for SAD: bupropion. In extended-release form, it is taken daily from fall to spring to prevent major depressive episodes.

Self-care

Meanwhile, there are steps you can take to help mitigate milder cases.

1. Stay active outdoors

Exposure to early morning light has been shown to be the most effective at reducing symptoms, as has regular exercise. An early morning walk or run might be all you need to help alleviate your symptoms.

2. Let in the light

If you can’t get outside, at least let the sunshine in as much as possible. Open blinds and drapes first thing in the morning, and keep them open all day. If you can, arrange your home or office so you’re exposed to as much sunlight as possible during the day (but remember that the sun’s harmful UV rays can penetrate glass, so use sunscreen if you’re actually sitting in the sun all day).

3. Eat right

Simple carbs and sugars wreak havoc with your blood sugar, thereby affecting your mood. Lean meats, fruits, vegetables, nuts, and complex carbohydrates will help to keep your brain functioning properly.

4. Take it easy

Don’t try to do too much, which can add to feelings of being overwhelmed. Do what you can, and postpone the rest, or ask friends and family for help with your to-do list.

5. Stay connected

Studies have shown that connecting with others helps improve mood: volunteering, getting together with friends and family, and participating in group activities, are some possibilities.

If your symptoms are interfering with your daily life, let us know. We can help evaluate your symptoms and recommend the right therapy.

organic

Some Common Questions About Organic Foods

Our concierge primary care doctors in Jupiter of course want our patients to eat healthy foods as much as possible.

This typically means a diet low in processed foods and high in fresh fruits, vegetables, nuts, and seeds, along with lean meats and fish.

Does it also mean eating organic foods as well? Many people hear the word “organic” and automatically think it equals “healthy,” but that may not always be the case. So let’s try to clear up the confusion around this widely available—and usually much more expensive—food.

What does the term “organic” mean?

The word “organic” refers to the way the food is grown and processed. The U.S. Department of Agriculture (USDA) has created a set of standards that describe the specific requirements that must be verified by a USDA-accredited certifying agent before products can be labeled organic.

The National Organic Program (NOP), an advisory committee that includes members of the public, develops these rules and regulations for the USDA.

They include several restrictions on farming practices and raising livestock and poultry, as well as on handling and labeling.

In general, the regulations restrict the types of pesticides, fertilizers, and seeds that can be used, and ensure healthy farming practices to protect the environment.

To receive the USDA Organic seal, a product must:

Improve soil and water quality.
Enable farm animals’ natural behaviors.
Cut pollution.
Promote a self-sustaining cycle of resources on a farm.

Certified organic products cannot use:

artificial fertilizers or sewage sludge as fertilizer
radiation to preserve food or get rid of pests or diseases
genetically modified or engineered materials to improve crop harvests or improve pest or disease resistance
antibiotics or growth hormones for livestock
most synthetic pesticides (except in special, USDA-approved circumstances)

Is organic food healthier?

You can find all kinds of persuasive arguments and testimonials online about how organic food is so much healthier for you to eat.

It’s certainly healthier for the environment, because of the sustainable practices organic farmers use.

It’s also undeniably better to avoid products from animals that have been fed antibiotics throughout their lifecycle to promote unnatural growth and suppress diseases that occur from overcrowded conditions. This is one of the things that contribute to antibiotic resistance in humans.

Other than that, though, science has so far not been able to prove that organic foods contain more substantial nutrients than conventionally grown foods.

As reported by Harvard Health, one meta-study by Stanford researchers, for example, found little difference in nutritional content, except for slightly higher phosphorus levels and a higher omega-3 fatty acid content in organic milk and chicken. And the bacteria that can cause food poisoning were equally present in both organic and non-organic foods.

And according to the Mayo Clinic, studies have shown much lower cadmium levels in organically grown grains, but not fruits and vegetables. Cadmium is a toxic chemical found naturally in the soil and absorbed by plants as they grow.

Is the label ‘organic’ a guarantee?

If the food contains the USDA Certified Organic label, that means it was grown and processed according to federal guidelines.

According to the USDA, “Produce can be called organic if it’s certified to have grown on soil that had no prohibited substances applied for three years prior to harvest. Prohibited substances include most synthetic fertilizers and pesticides.

“As for organic meat, regulations require that animals are raised in living conditions accommodating their natural behavior (like the ability to graze on pasture), fed 100 percent organic feed and forage, and not administered antibiotics or hormones.”

The agency performs more than 45,000 onsite inspections per year to ensure compliance with regulations. If foods are labeled “100 percent organic,” that means all ingredients are certified organic. Foods labeled “organic” contain at least 95 percent certified organic ingredients.

On the other hand, labels that say “made with organic” or “organic ingredients” can’t carry a USDA seal, because they contain less than 95 percent organic ingredients.

More confusion in labels

In addition, there is a difference between “organic” and “natural” on a product’s label. The term “natural” may simply refer to products or animals that have been minimally processed and contain no artificial ingredients, but that doesn’t mean they’re organic.

Another confusing term is “grass-fed,” which means animals receive a majority of their nutrients from grass throughout their entire life and have continuous access to pasture during the growing season. It does not mean they have been raised without the use of antibiotics, hormones, or pesticides on their feed.

Likewise, “cage-free” birds are able to freely roam a building, room, or enclosed area with unlimited access to food and fresh water during their production cycle. “Free-range” birds are provided shelter in a building, room, or area with unlimited access to food and fresh water, as well as continuous access to the outdoors during their production cycle. But neither of these terms reveals whether they have been raised without antibiotics or hormones.

So is organic better for you? In some of the ways we’ve listed above, yes. But only you can decide whether the extra expense is worth the small gains in nutritional value, as well as the larger impact on the environment and the animal’s welfare.

pfas

How to Combat the Lingering Danger of ‘Forever Chemicals’

They’re called “forever chemicals” because they don’t break down fully in the environment, and this summer the Environmental Protection Agency (EPA) warned that they are more dangerous to human health than regulators knew.

Within weeks, the National Academies of Sciences, Engineering, and Medicine (NAS) weighed in with its own 300-page report on these chemicals, known as perfluoroalkyl and poly-fluoroalkyl (PFAS) substances, urging doctors to test high-risk patients for PFAS contamination.

Because of the heightened attention on these chemicals, our primary care concierge doctors in Jupiter want to summarize for you what we’ve learned about them, and offer tips on how to reduce your exposure.

The Problems with PFAS

In 1946, DuPont introduced its revolutionary non-stick product, Teflon. By 1950, studies by DuPont and 3M showed that PFAS could build up in the blood, but chose to keep these results secret, according to the non-profit Environmental Working Group (EWG).

Since 1998, when a class-action lawsuit against a West Virginia DuPont factory revealed the extent of the pollution from the factory, researchers have found probable links to such diseases as:

  • thyroid disease
  • high blood pressure
  • kidney cancer
  • testicular cancer
  • breast cancer
  • higher cholesterol levels
  • ulcerative colitis
  • weakened immune system 
  • vaccine interference
  • weight gain
  • changes in liver enzymes
  • decreased fertility
  • growth and learning delays in infants and children

The NAS report encourages doctors to conduct blood tests for these chemicals on patients who are worried about exposure or who are at high risk for exposure or who are in “vulnerable life stages”: during pregnancy, early childhood, and old age. 

They’re Everywhere

As we’ve seen with microplastics, PFAS can begin innocently enough and end up in unexpected places, including our water.

Recently, for example, Consumer Reports (CR) tested more than 100 food-packaging products from U.S. restaurants and supermarkets. They found dangerous PFAS chemicals in many of the products, including paper bags for french fries, hamburger wrappers, pizza boxes, molded fiber salad bowls, and single-use paper plates.

These chemicals are used in a wide variety of products, including waterproof and sweatproof makeup, nonstick cookware, cellphones, waterproof clothing, carpets, and—especially—fast-food containers, where their ability to make products grease-proof has led to their widespread use.

They are also used to make products water-repellent and resistant to high temperatures, as well as in fire-fighting foams used at military installations, floor wax, upholstery, and clothing. The qualities that make items containing PFAS so desirable, however, also make them long-lasting in the environment.

Lingering Threat

“These chemicals are ubiquitous in the American environment,” Ned Calonge, an associate professor of epidemiology at the Colorado School of Public Health and chair of the NAS committee that wrote the report, told CNN.

“More than 2,800 communities in the U.S., including all 50 states and two territories, have documented PFAS contamination,” he said.

Researchers have even detected them in the snows of Mt. Everest, apparently shed from climbers’ waterproof tents and parkas. 

“You are not just exposed in one place or one source,” toxicologist Linda Birnbaum, former director of the National Institute of Environmental Health Sciences and the National Toxicology Program, told The Washington Post. “They are everywhere.”

The problem is that these chemicals build up (or “bioaccumulate”) in the body over time. 

And according to the Centers for Disease Control and Prevention (CDC), which has been conducting studies of the U.S. population, PFAS has been found in the blood of nearly all people they’ve tested. Since the risk appears to rise with the amount of exposure, it’s important to try to limit the amount we come in contact with.

What You Can Do

Because PFAS chemicals are found in so many consumer products, they’re next to impossible to avoid. But there are ways to reduce the amount you’re exposed to.

“The most dangerous way that people are exposed to PFAS is through drinking water,” says Don Huber, director of product safety at CR.

That’s why the NAS report recommended filtering tap water as a major step consumers could take to protect themselves.

“The water filters that are most effective for PFAS are reverse osmosis filters,” David Andrews, a senior scientist for the EWG, told CNN, adding that some carbon-based filters can also reduce some levels.

“The important part is that you have to keep changing those filters,” he said. “If you don’t change that filter, and it becomes saturated, the levels of PFAS in the filtered water can actually be above levels in the tap water.”

The NAS committee also offered these tips:

  • Stay away from stain-resistant carpets and upholstery, and don’t use waterproofing sprays.
  • Look for the ingredient PTFE or other “floro” ingredients on product labels.
  • Avoid nonstick cookware. Instead, use cast-iron, stainless steel, glass, or enamel products.
  • Boycott takeout containers and other food packaging. Instead, cook at home and eat more fresh foods.
  • Don’t eat microwave popcorn or greasy foods wrapped in paper.
  • Choose uncoated nylon or silk dental floss or one that is coated in natural wax.
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