handshaking

Is Handshaking Gone for Good?

One thing our primary care doctors in Jupiter were not sad to lose during the pandemic was the ancient tradition of handshaking. It’s not because we’re anti-social. Quite the opposite, in fact. We love meeting new people, as well as seeing people we haven’t seen in awhile.

When people avoided each other, wore masks, and bumped elbows instead of shaking hands when they did meet, the incidence of other communicable diseases plunged. Science says the reduction in handshaking played a big role in that.

Statistics tell the story

Last fall, the Centers for Disease Control and Prevention (CDC) reported, “Following widespread adoption of community mitigation measures to reduce transmission of SARS-CoV-2, the virus that causes COVID-19, the percentage of U.S. respiratory specimens submitted for influenza testing that tested positive decreased from greater than 20 percent to 2.3 percent and has remained at historically low levels (.2 percent versus 1-2 percent).”

During the 2020-21 flu season, the CDC estimated that about 600 Americans died from the virus. That’s opposed to about 22,000 deaths in the 2019-20 flu season, and 34,000 in the season before that.

In April of this year, Scientific American reported that the influenza virus had virtually disappeared worldwide.

“There’s just no flu circulating,” Greg Poland, who has studied the disease at the Mayo Clinic for decades, told the magazine.

Other infectious illnesses, including colds, influenza-like illnesses (ILIs), gastrointestinal illnesses (like infectious diarrhea), hepatitis A, meningitis, and respiratory syncytial virus (RSV), saw similar declines.

Handshaking spreads germs

One study from the University of Colorado, Boulder, found a typical person’s hand had about 150 different species of bacteria living on it. Others have revealed that the most common bacteria found on hands is fecal coliform. That’s because studies show that up to 95 percent of people don’t wash their hands well enough after using the toilet.

“I don’t think we should ever shake hands again,” Dr. Anthony Fauci, White House health advisor, said last year at the height of the pandemic. He later clarified that he was “somewhat serious.”

But he’s not the only medical professional who wishes humans had never begun the tradition. And not just because of the risk of passing on the coronavirus.

“It’s never been safe,” Gregory Poland, a Mayo clinic physician and professor specializing in infectious diseases, told the Minneapolis Star recently.

The practice carries the risk of transmitting a host of germs, including norovirus, food poisoning, and “hand-borne transmission of fecal bacteria,” he said. “We’re not talking about a minor issue,” he added. “Would you lick someone’s hand?”

It’s not so much the handshaking as what we do with our hands afterward: touching our eyes, noses, and mouths, experts say. This is what can lead to infection with all these other illnesses.

Fighting tradition

Unfortunately for our communal health, handshaking is a tradition that goes back millennia. It crosses many cultures, from Babylonia to Rome to present-day Europeans and Americans.  National Geographic noted that ancient artifacts show people shaking hands.

Some other cultures have never used the handshake when meeting others. Many in the Arab world simply touch their palms to their hearts. The Japanese bow. Hindus place their palms together in the Namaste greeting.

Nevertheless, handshaking in our culture is a practice that may never go away, pandemic or no pandemic.

“It’s very deeply ingrained in the social fabric,” Juliana Schroeder, a management professor at the University of California, Berkeley, who has studied handshakes, told USA Today. “It feels like something will be lost.”

Keeping it clean

If you want to go back to shaking hands when greeting someone, at least remember the lessons learned as a result of the pandemic.

According to the Florida Department of Health, one of the most effective ways to stay healthy is also the simplest: effective hand washing. So here’s a refresher from them on how to do it right.

When to Wash:
  • before, during, and after preparing food
  • before eating food
  • before and after caring for someone who is sick
  • before and after treating a cut or wound
  • after using the toilet
  • after changing diapers or cleaning up a child who has used the toilet
  • after blowing your nose, coughing or sneezing
  • after touching an animal, animal feed, or animal waste
  • after handling pet food or pet treats
  • after touching garbage
  • when they are visibly dirty
How to Wash:
  • Wet your hands with clean, running water, either warm or cold, turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between our fingers, and especially under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel, or air-dry them.
Anti Inflammatory Diet

What Is An Anti-Inflammatory Diet?

Our primary care concierge doctors in Jupiter have told you many times about the dangers inflammation poses to your health. Often, the best way to reverse these dangers is by participating in an anti-inflammatory diet.

Inflammation is necessary to keeping the body healthy. But when your body is repeatedly assaulted by various harmful stimuli such as pathogens, injuries, or poor lifestyle habits, the inflammation never ends and can eventually cause long-term damage.

What is inflammation?

There are two types of inflammation: acute and chronic. Acute is the healthy kind, in which the body mounts a defense against sudden injury or illness like the flu or COVID-19. Chronic is the dangerous kind, in which the body spends months or years attempting to fight off constant, lower-level threats, such as pollution, poor diet, and the effects of ongoing stress.

Chronic inflammation has been implicated in either causing or exacerbating such conditions and diseases as:

  • allergies
  • Alzheimer’s
  • anemia
  • asthma
  • cancer
  • Crohn’s disease
  • colitis
  • depression
  • diabetes
  • gout
  • kidney disease
  • multiple sclerosis
  • Parkinson’s
  • Polycystic Ovarian Syndrome (PCOS)
  • psoriasis
  • rheumatoid arthritis
  • wrinkles and other signs of aging

Confirmed link

The deadliest illness with a confirmed link to inflammation is cardiovascular disease (CVD).

A landmark study released in 2017 included over 10,000 patients who had previously suffered a heart attack and were then were given a drug meant to reduce inflammation. The drug, which costs about $200,000 per year, is not only prohibitively expensive, but its fatal side effects offset any gains in cardiovascular mortality reduction.

Then why were cardiologists so excited about this research? Because it proved that reducing inflammation in the body will result in fewer heart attacks. (The drug also proved effective against certain forms of cancer, another illness thought to be tied to chronic inflammation.)

The drug had no effect on cholesterol, which is what is reduced with the use of statins, thereby proving that reducing inflammation was solely responsible for the 15 percent reduction in deaths seen in the study.

Prevention is the best cure

While medical science offers various drugs and treatment that can address all these illnesses and diseases, the best approach is to reduce inflammation before it becomes a problem in the body.

Some causes of chronic inflammation are beyond our control. These include environmental pollutants and certain genetic factors.

But many other causes are within our control. The steps we can take to reduce dangerous inflammation include regular exercise, stress reduction, and healthy lifestyle choices like not smoking and avoiding the sun.

Non-diet diet

A prime prevention tool is an anti-inflammatory diet. And we don’t mean that in the traditional sense of counting calories and planning each bite, but in the sense of the types of foods you eat regularly.

“Many experimental studies have shown that components of foods or beverages may have anti-inflammatory effects,” Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health, told Harvard Health Publishing.

“Some of the foods that have been associated with an increased risk for chronic diseases such as type 2 diabetes and heart disease are also associated with excess inflammation,” he said. “It’s not surprising, since inflammation is an important underlying mechanism for the development of these diseases.”

Common food culprits implicated in causing inflammation include:

  • refined carbohydrates, such as white bread and pasta
  • fried foods such as French fries
  • soda and other sugar-sweetened beverages
  • red meat (steaks and hamburgers)
  • processed meat (hot dogs, sausages, and deli meats)
  • margarine, shortening, and lard
  • refined sugars, including cookies, cakes, candy, and ice cream
  • snack foods such as crackers and chips

What’s left?

You may be thinking that the above list doesn’t leave at lot left to eat. Actually, there’s quite a bit of healthy foods to choose from.

The Mediterranean diet—high in seafood, nuts, fresh produce, olive oil, and beans, and low in red meat, dairy, sugar, processed foods, and saturated fat—is a classic anti-inflammatory diet, which is no doubt why it works so well to not only aid weight loss but to improve health overall.

This diet is based on studies during the 1990s that found those in countries bordering the Mediterranean Sea tend to live longer, healthier lives than those in other developed countries, and have lower rates of cardiovascular disease and cancer.

Other anti-inflammatory foods that can help fight inflammation include:

  • tomatoes
  • green leafy vegetables
  • beets and avocados
  • whole grains
  • fatty fish (tuna, sardines, salmon, and mackerel)
  • nuts, especially walnuts, cashews, and almonds
  • berries
  • fruits such as cherries, oranges, and melons
  • water, tea, and red wine if you drink alcohol

Finally, because the anti-inflammatory diet is a way of eating for life (in both meanings of the word), don’t stress over every bite you put into your mouth. Don’t think of the inflammation-triggering foods as “forbidden foods,” but try to minimize them as part of your diet. Simply prefer fresh food over processed as often as possible, and eat lots of fruits and vegetables.

tea good health

Tea Leads to Good Overall Health

To our concierge family practice doctors in Jupiter, Florida, tea is the second-best beverage you can drink for good health. It comes as a close second, of course, to drinking water.

The practice of brewing leaves appears to go back at least 5,000 years, but its actual origins are hazy. The most persistent legend concerns a Chinese emperor who drank a bowl of hot water that was boiled for sanitary purposes. He was in his garden when a few leaves fell into his bowl, surprising him with the resulting pleasant flavor.

But a great deal of recent research has found there’s far more to be found in a cup of tea than a soothing drink.

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poison prevention

Poison Prevention Saves Lives

We tend to think of our homes as our safe place. But according to the American Association of Poison Control Centers (AAPCC), accidental poisoning is the leading cause of injury-type deaths in the U.S., and 92 percent of those occur in the home.

From prescription medications to cleaning supplies, hidden dangers lurk in every corner of our homes.

Which is why our concierge doctors at MD 2.0 in Jupiter, Florida, want to take advantage of National Poison Prevention Week, March 21-27, to highlight ways you can keep yourself and your family safe.

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best diet

The Best Diet for You

The start of a new year is traditionally the time to turn the page on the bad habits and disappointments of the previous year.

Usually near the top of the list of New Year’s resolutions that people make is the decision to lose weight. And from a health perspective, our concierge doctors certainly applaud that one.

Overweight or obesity is responsible for a host of chronic diseases, from type 2 diabetes to backaches to joint pain. So you want to achieve and maintain a healthy body weight, right? But which diet is best?

The problem with keto

What about the popular keto diet? Studies show that 80 percent of those who try it struggle to stick with it. Why, when it often results in huge and rapid amounts of weight loss?

First, it can it cause numerous side effects—body aches, headaches, light-headedness, nausea, fatigue and lethargy, constipation, and brain fog. Plus, all their friends are eating garlic bread and mashed potatoes (not cauliflower) with gravy and pasta. Or because they lost their job and need a regular intake of brownies to help them feel better. Or because they’re stressed about the pandemic—possible job loss, not being able to see friends and family, worried about catching the coronavirus. And that chocolate cream pie dulls the loneliness and anxiety, at least for a little while.

Because, in short, the keto diet restrictive. It has a long list of quite tasty foods that either aren’t allowed, or allowed only in small portions after a certain time.

“When you are on the keto diet, you drastically cut your carbs to only 20 per day. That’s less than one apple!” nutritionist Lisa Drayer, a CNN contributor, told the network.

The common problem

And this is the problem with all diets. Nearly all of them work as promised, but are difficult to adhere to over time. So you “cheat.” Then you cheat some more. Then you figure, why bother? You then start eating normally again and regain all the weight you lost. And you likely gain back even more.

But here’s the thing: It’s not you, it’s them. In other words, it’s the whole concept of dieting to begin with. Someone once pointed out that diet begins with the word “die,” so even if only subconsciously, the concept has a negative connotation.

In addition, our bodies were built to store calories. That’s because our ancient ancestors never knew when they’d be facing lean times, or even starvation if the mastodons they hunted migrated elsewhere. Even in more recent times, before there was such a thing as a food industry, mankind learned to store food over the winter. But it still wasn’t as abundant as during the summer months.

So we’re biologically built to store up calories to last through the lean times.

And speaking of the food industry, their entire reason for being is to get us to buy more of their product. Stores are laid out with enticing displays of sugary, fat-laden foods. Advertising constantly tempts us with photos and videos of delicious, fattening foods.

We succumb, we gain weight, and then it’s up to us to find a way to lose it. And we try a long list of diets, only to be disappointed with the results. So which one do we recommend?

The only real solution

The best diet is one that works for you, that helps you gradually lose weight, but doesn’t leave you feeling deprived or hungry all the time.

“For any given person, it’s really a matter of what they can stick with,” Michael Jensen of the Mayo Clinic told Psychology Today.

Keto might be the right choice for some people. For others, the Paleo diet, moderation, veganism, intermittent fasting, or simply cutting back on sugar and flour.

Above all, research shows the most successful diet is the one that you yourself designed. This gives you a sense of control, rather than being at the mercy of a set of restrictive rules.

“You have to have joy and pleasure in food,” Stanford University professor of medicine Christopher Gardner told The Washington Post. He has conducted numerous randomized trials to test the success rate of various diets, and found they are essentially the same.

“They agree more than they disagree,” he said. Instead, he counsels, “Limit added sugars and refined grains, and eat more non-starchy vegetables. [I]f you do those two things, you get 90 percent of the benefits.” 

If you enjoy what you eat, you’ll have a much better chance of sticking with it for the rest of your life, he added.

“[The most successful way of dieting] will be different from one person to the next, and there will never be a randomized trial of it.”

We would add that for the most wholesome way to eat, consider the Mediterranean diet. It rates number one in surveys of diets, not only for long-term weight loss, but also for ease of adherence and the healthiest outcomes.

If you have any questions about weight loss, please talk with us. We can suggest the best approach specifically for you.

running knees

Studies Say Running May Actually Be Good for Your Knees

Of course running is bad for your knees, right? Everybody knows this. After all, it only makes sense. You’re bringing the full weight of your body down on these joints with every step, so you’re wearing out the cartilage from overuse.

But our concierge doctors have often found that what seems like “common sense” is anything but, which is why we look to science for answers.

Studies say otherwise

Rather than the widespread notion that running wears out the cartilage in the knees, it appears the opposite is true. The old adage “use it or lose it” apparently applies here.

Over the last fifty years, researchers have been looking at the question of whether running is bad for the knees.

One of the oldest studies dates to 1971. Here researchers began studying the children and spouses of the Framingham, Massachusetts Heart Study. Called the Framingham Offspring Cohort, 1,279 volunteers participated in a study of exercise and arthritis, which ultimately found no link between jogging and arthritis.

A 2008 study at Stanford University not only confirmed the Framingham findings, but in a 21-year-long follow-up, the runners “experienced significantly less musculoskeletal disability than did their less-active peers,” according to a Harvard University report on the study. They also found that runners experienced less disability and lived 39 percent longer than those who weren’t as physically active.

An Australian study that same year found subjects who engaged in vigorous exercise had knee cartilage that was thicker and healthier than those who didn’t exercise routinely.

In another study, published in the Journal of Orthpaedic and Sports Physical Therapy in 2017, 10 percent of those who weren’t runners developed osteoarthritis in their knees or hips over the course of the study. Only 3.5 percent of runners did so.

Movement is medicine

What about the frequent reports of runners experiencing knee problems? Experts believe that they would have happened whether subjects were runners or not. Researchers attribute the onset of osteoarthritis to obesity or genes, rather than overuse of the joints.

And one recent study published in the European Journal of Applied Physiology seems to bear this out.

Researchers asked six recreational runners, ages 18-35, to spend 30 minutes running, and then extracted the cushioning synovial fluid from their knees. They found that two cytokine markers for inflammation were lower in the runners than in a control group of non-runners.

“What we now know is that for young, healthy individuals, exercise creates an anti-inflammatory environment that may be beneficial in terms of long-term joint health,” the study’s lead author, Robert Hyldahl, BYU assistant professor of exercise science, said in a statement. He further wrote that the study results indicate exercise may help delay the onset of such joint degenerative diseases as osteoarthritis.

“In fact, a normally functioning joint can withstand and actually flourish under a lot of wear,” James Fries told Time magazine. Fries was the lead researcher on the Stanford study, and is professor emeritus of medicine at Stanford.

He explained that cartilage—the soft connective tissue that surrounds the bones in joints—doesn’t contain arteries that deliver blood along with its rejuvenating dose of oxygen and nutrients. Therefore, cartilage depends on movement to obtain needed nourishment.

 “When you bear weight,” he said, “[the joint] squishes out fluid, and when you release weight, it sucks in fluid,” thus delivering the necessary nutrients to build new cartilage.

Protect yourself regardless

Running, however, does carry some element of risk, including the possibility of stress fractures and soft-tissue injuries. But with proper precautions, these can generally be prevented.

Here are some tips to prevent running injuries:

1. Wear the right shoes

You need to be fitted with a proper pair of running shoes, matched to your gait and foot size. Don’t try to run in regular footwear.

2. Strengthen supporting muscles

To ensure good support for your knees as you run, be sure to exercise all your leg muscles, especially the quads and glutes. 

3. Start slowly

Before you begin each run, always warm up with long, slow stretches to get the blood flowing. As with any form of exercise, you need to build up to full speed gradually. Pace yourself as you start out or if you’re returning to running after a long time away from it.

4. Run correctly

If your strides are too long, you’ll land on your heels, a prime cause of shin splints and joint pain. Shorter strides will allow you to land on mid-foot, minimizing the chances of injury. In addition, a 2018 study found that leaning forward slightly while running can help reduce the stress on your knees. Ensuring proper form will optimize your run.

5. Cross-train

Alternate days of running and days of other forms of exercise to allow muscles and tendons time to heal.

If you have any questions about your body’s ability to withstand any type of exercise, be sure and talk with us.

effects of sitting

Sitting Is the New Smoking

If you’ve been one of those fortunate enough to be able to work at home during the pandemic, you’ve probably been glued to your chair for eight or more hours a day. At least at the office you might have been able to walk around from desk to desk, or take the stairs, or take a walk at lunch.

Whereas at home, our concierge doctors are guessing that you get very little chance to move at all. And that could be detrimental to your health.

Scientists have been researching the effects of sitting…

Researchers have known for several years that sitting for long periods is hazardous to your health. But newer studies have revealed that lack of frequent movement is even more dangerous than previously known.

Some of the results that attributed to prolonged periods of sitting include:

  • organ damage, including heart disease
  • an over-productive pancreas
  • a greater risk for colon, breast, and endometrial cancers
  • muscle degeneration
  • leg disorders, including osteoporosis
  • slower brain function

One 2011 study examined more than 800,000 people’s sitting habits. Those who sat the most during the day found they had:

  • a 112 percent increased risk of diabetes
  • a 147 percent increased risk of heart attacks and strokes
  • a 90 percent increased risk of death from CVD
  • a 49 percent risk of death from any cause

… And they continue to see similar results

Newer studies have confirmed those who spend more time sitting than moving have higher rates of cardiovascular disease (CVD) and certain cancers than people who don’t sit as long. They are also more likely to die early than their less sedentary counterparts.

One study, for example, found that adults who sat for 11 hours or more a day had a 40 percent higher risk of dying in the next three years than those who sat for less than four hours daily.

Another study published in the Annals of Internal Medicine, tracked the daily movements of 7,985 adults. Participants used hip-mounted accelerometers to actually record their activity, rather than rely on self-reported data. As the total time spent sitting increased, so did the risk of death from any cause, regardless of age, sex, race, body-mass index (BMI), or exercise habits.

Those who sat for less than 30 minutes at a time had a 55 percent lower risk of death compared with those who sat longer than that.

So, yes, sitting really is as bad for your health as smoking.

Some good news

But it is possible to counteract the effects of sitting just by getting out of your chair from time to time.

The World Health Organization (WHO) released new guidelines last month to help counteract the effects of prolonged sitting, based on a new study published in a special issue of the British Journal of Sports Medicine (BJSM).

The WHO now says that all physical activity counts toward better long-term health. This could include anything from climbing stairs instead of taking the elevator, gardening or doing housework, taking a walk around the block, participating in a team sport, going for a run or a bike ride, or participating in a high-intensity interval training workout.

The BJSM researchers followed more than 44,000 people from four countries. They fitted each participant with activity trackers. They found that moderate to vigorous physical activity for 30-40 minutes daily brought the risk from prolonged periods of sitting down to levels associated with very low amounts of sedentary time.

What to do for your health

So, while the higher intensity workouts were better, it appears that any movement is better than nothing.

“These guidelines are very timely, given that we are in the middle of a global pandemic, which has confined people indoors for long periods and encouraged an increase in sedentary behavior,” Emmanuel Stamatakis, BJSM co-editor and professor at the University of Sydney, wrote in the journal.

“But people can still protect their health and offset the harmful effects of physical inactivity,” he said. “As these guidelines emphasize, all physical activity counts and any amount of it is better than none. There are plenty of indoor options that don’t need a lot of space or equipment, such as climbing the stairs, active play with children or pets, dancing, or online yoga or Pilates classes.”

There’s one more benefit from any type of exercise that we’d like to point out: stress relief. The pandemic has put us all on edge, and a brisk walk outdoors or a brief period of play with the kids or the dog can go a long way to helping alleviate tension.

So, for better health all around, set a kitchen timer, your watch, or your phone to remind you to get up and move every few minutes throughout the day.

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