A vegetarian diet is healthy but...                                

            There is no doubt that a strictly vegetarian diet is healthier than the all-too-prevalent sugary, fat-laden, high-starch eating pattern that characterizes the average American. It takes some careful planning to take advantage of the benefits of the vegetarian menu and avoid its potential shortcomings.

            Persons who avoid foods derived from animals boast of the longer lifespan and the freedom from several chronic diseases that they enjoy and medical science backs up nearly all of those claims. It’s clear that vegetarians, especially the vegans, who don’t give in even for eggs and dairy products, have less heart disease, stroke and high blood pressure. They are less likely to be obese or to have type 2 diabetes or gallbladder disease, all of which are closely linked. Claims of lower incidence of cancer, dementia or chronic kidney disease are controversial although there is no doubt that they are complications of obesity. Lifestyle factors such as exercise do matter and they tend to complicate any side-by-side comparison between vegetarians and meat eaters.

            Vegetarians eat foods that fill them up, not fill them out. Vegetables and fruits have lots of appetite-satisfying fiber and are calorie-sparse. Of course, a vegetarian diet may also include pastries, candy and soft drinks, a nutritionist’s nightmare.

            When vegetarians develop health problems on that diet it’s usually because they fail to include some key nutrients. Iodine is perhaps the most common deficiency because they avoid fish and may not include enough iodized salt in meal preparation. Anemia might occur because although there is a moderate amount of iron in many plant foods it is not as bioavailable as it is in meat products. Except for the occasional insect that inhabits fruits and vegetables, there is no vitamin B₁₂, another cause of anemia. There is less calcium in plant foods but it is absorbed more readily than from dairy products although some plants have antinutrients that keep calcium from being utilized by the body. Zinc deficiency may occur for the same reason.

            Omega-3 fats are not abundant in plant foods. Strict vegans should take a supplement that is derived from plant sources such as algae.

            Parents should be aware that vegetarianism may be an eating disorder in disguise. They should always help a child to plan his or her menu and to monitor them carefully. Anorexia nervosa and bulemia have severe long-term consequences.

            A vegetarian diet is healthy. Just do it right.

             

              

Is there an upside to vaccine side effects?    

            American children receive more than 40 immunizations by the time they reach first grade. Boosters are due during teen years and physicians recommend vaccines against pneumonia and shingles when we reach Medicare age. The value of vaccines is accepted by all but a few who feel that the dangers of vaccines justify their avoidance. It’s true that some vaccines have severe, sometimes fatal side effects. For the families in which such tragedies occur there is small consolation in knowing that the benefits of widespread immunization far outweigh the hazards. A half-century ago a pediatrician might see dozens of children every month with measles, mumps or rubella (German measles). Today’s pediatricians may practice for years without seeing a single child with one of these diseases.

            In countries such as the United Kingdom when the fear of whooping cough (pertussis) vaccine sharply reduced immunization levels there were hundreds of deaths due to the natural disease, far more than suffered vaccine complications. In every country in which polio immunization levels are high the incidence of paralytic polio is zero. Today in Pakistan the Taliban have forced a halt in polio vaccination and more than 40 children there contracted the disease in 2013. That number is probably an underestimate.

            The most common side effects of most vaccines are pain at the injection site and low-grade fever. Seizures (convulsions) were fairly common in children who received older versions of pertussis vaccine but the newer versions rarely cause this complication.

            A child will sometimes develop a mild rash following measles vaccination but the dreaded complications of natural measles are nonexistent in children who have received the vaccine.

            If a child has a high fever or some other complication, even a seizure, following immunization it could indicate an unusual susceptibility to the natural disease. If that child were to be exposed to the wild virus he or she might have been the one child in a thousand who developed encephalitis during a pre-vaccine-era measles outbreak or who died of other measles complications. In other words, a greater than normal reaction to the vaccine virus might indicate that the natural virus would have caused a serious, perhaps fatal, infection.

            When a vaccine causes a mild illness it’s not be something to worry about. Instead it may indicate greater susceptibility to the real thing and parents should be relieved that their child is now protected.

           

Toasted thighs and other laptop hazards   

            Toasted skin syndrome is a modern malady blamed on laptop computers but it’s something that our grandparents were aware of. Hot water bottles, those ugly, unwieldy red rubber bags that were applied to sore muscles and painful backs sometimes caused superficial burns when the water that was poured into them was too hot. A generation later the careless use of heating pads caused the same problem, pain and redness that took a couple of days to go away. The heating pad is obviously a technological improvement but because it can produce heat for a much longer time than a hot water bottle it can lead to more severe burns, especially in patients with diabetes, who often have poor sensation in the legs.

            Laptop computers are the latest reason for toasted skin syndrome and the area affected – no surprise – is the front of the upper thigh. On airplanes, in student lounges and coffee shops I have watched young persons casually typing away on a laptop perched – where else – on the lap. The designers of those convenient computers are aware of the heat that they generate and some of them warn users about the hazards. Most do not.

            The first sign of toasted skin syndrome is sunburn-like reddening of the skin but a mottled appearance occurs with longer exposure. If the condition is ignored there may be long-term discoloration and degeneration of the skin. Some dermatologists warn that skin cancer is a potential hazard. That has not yet been seen in laptop users but there are numerous reports of skin cancer from other sources of heat injury. Time will tell.

            The cure is simple: use the laptop on a desk or table. For the dedicated laptopper there are plenty of gadgets available to use as heat shields but something as simple as a magazine placed under the unit will solve the problem.

            The propensity for young people to assume uncomfortable-looking positions while using laptop and notebook computers is a more likely cause of problems. Neck, shoulder and back pain are common complaints, sometimes as a result of carrying a three- or four-pound computer on a shoulder strap.

            There is a glimmer of hope in the recent trend toward smaller notebook-type and tablet computers. They aren’t well suited to the lap, they generate less heat and they are so light that carrying one all day isn’t likely to cause much discomfort.