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Bottled Water

Over one billion people around the world have no access to clean water and 2.4 billion have inadequate sanitation. Two million people world wide die every year from water related diarrheal illnesses. . The latest tsunami disaster has magnified the problem immensely.

In developed countries there is so much clean water running through our taps that we can afford to use our drinking water to flush toilets, wash ourselves, our clothes and our cars. On top of that we can afford to spend millions of dollars on bottled water.

Like cell phones, bottled water is everywhere.

Bottled water is the world’s fastest selling drink. In the last 10 to 20 years there has been 70-fold increase in the sale of bottled water in North America and Europe. We are talking in terms of billions of gallons of bottled water.

Why has bottled water become so popular in developed countries?

“Bottled water exploits our worries about what affects health in the modern world,” says an editorial in the British Medical Journal. Bottled water is seen as a natural antidote to what the consumer sees wrong with modernity.

Health Canada website says that drinking bottled water is a matter of personal taste and preference over municipal tap water. Some people think bottled water is safer than municipal tap water, but Health Canada says that there is no evidence to support this.

Bottled water is not sterile. Bacteria are found in most bottled waters sold for drinking purposes. Bottled water is usually disinfected to remove harmful organisms, but is not intended to sterilize the water. Usually, sterile water is reserved for pharmaceuticals.
In Canada, bottled water is considered to be a food and is regulated under the Food and Drug Regulations. Health Canada website has excellent information on bottled water. Here are some points of interest:
-Bottled water labeled mineral or spring water is fit for human consumption that comes from an underground source. It cannot come from a public water supply.

-Mineral and spring waters must not have their composition modified through the use of chemicals, but carbon dioxide and ozone can be added during the bottling process to protect the freshness.

-Bottled water not represented as mineral or spring water, is water from any source (municipal water, well water, etc) that can be treated to make it fit for human consumption or to modify its composition.

-Do not buy bottles that have a broken seal.

-Do not refill old bottles. It is preferable to buy newly manufactured bottled water.

-While traveling, avoid bottled water unless it is carbonated or disinfected. Buy only sealed products. Wipe off the bottle or can top before drinking or pouring from them.

-Water coolers should be cleaned regularly.

Less than one percent of earth’s total water is fresh water. There isn’t unlimited supply available to waste water. Our municipalities should do a better job of informing and educating the public that tap water is clean, pure, fat-free and about thousand times cheaper than bottled water. And water should be used carefully. There is no need to spend millions of dollars on bottled water.

Joke for the week:

Doctor: How’s that little boy?…The one who swallowed all those quarters.
Nurse: No change yet!
-Edgar Argo cartoon

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Polypill and Polymeal

How much do you know about Polypill and Polymeal?

If you are like me, then not much. So I did some research. Allow me to share this with you. It may give a new meaning to the word prevention and may stimulate your taste buds as well!

It is no secret that cardiovascular disease (CVD) is a leading cause of death and disability in the affluent societies. There are several risk factors which cause heart disease and stroke. Four of these risk factors (LDL cholesterol, blood pressure, homocysteine, and platelet function) account for most CVD and can be reduced by drugs or vitamins.

So, in 2003, two Professors from the University of London, England published an article in the British Medical Journal (BMJ) titled, “A strategy to reduce cardiovascular disease by more than 80 percent.” And they introduced the concept of the Polypill.

The Polypill will be one pill containing six pharmacological components of commonly used drugs to prevent CVD. These are the drugs used by people at high risk for heart problems and stroke – a statin (to lower cholesterol level), aspirin (as a blood thinner), folic acid (to lower homocysteine), and three anti-hypertensives (a thiazide, a ß blocker, and an angiotensin converting enzyme inhibitor), all at half dose.

The authors proposed that the Polypill should be taken by everyone aged 55 and older and everyone with existing CVD. And they felt that it would be acceptably safe and with widespread use would have a greater impact on the prevention of disease in the Western world than any other single intervention.

Recently, BMJ reported that at a meeting of experts organized just before Christmas by the US Centers for Disease Control in Atlanta generally supported the idea of a Polypill but would like to see a series of trials to test its safety and efficacy before it is given to the whole population without screening. Sounds like a good idea!

What about the Polymeal? Sounds tastier than Polypill? May be!

From Netherlands comes a paper (BMJ DEC 18, 2004) titled “The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75 percent.”
The authors of the article say that pharmacological interventions are not the only option for preventing heart disease. A healthy diet and an active lifestyle reduce CVD as well. Certainly, they have a point. Many experts feel that the side-effects and cost of Polypill may be prohibitive. Polymeal may be a safer and tastier alternative.

They looked at the scientific literature and felt that the evidence based recipe should included wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds. This variety of food has been enjoyed by humankind for centuries.

They calculated that a daily consumption of 150 ml of wine, 114 grams fish four times a week, 100 grams of dark chocolate daily, 400 grams of fruit and vegetables daily, 2.7 grams of fresh garlic daily, and 68 grams of almonds daily could reduce CVD by more than 75 percent.

The authors feel that the Polymeal and active lifestyle will bring us happiness and spare us a future of pills and hypochondria. That may be so. Only time will tell. In the meantime, I better learn to pronounce those names on the wine bottles! I don’t want to be left out.

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MSG

Dear Dr. B: I was wondering if you could write on allergies to MSG.

Dear reader: MSG stands for monosodium glutamate also called monosodium L-glutamate, or sodium glutamate. It is white crystalline substance, a sodium salt of the amino acid glutamic acid.

MSG is used to intensify the natural flavor of certain foods. According to Encyclopedia Britannica, MSG was first identified as a flavor enhancer 97 years ago by Kikunae Ikeda of Japan, who found that soup stocks made from seaweed contained high levels of MSG. His discovery led to the commercial production of this substance.

National Institute of Nutrition’s website says MSG is produced on a massive scale by fermentation of beets. North Americans consume more than 25,000 tons of MSG every year, mostly as a food additive. It is present in wide variety of canned, packaged and prepared food.

About 36 years ago, reports appeared to suggest that some people who ate at Chinese restaurants developed symptoms such as headache, flushing, sweating, sense of facial pressure or swelling, numbness or burning in or around the mouth and chest pain. This is called Chinese Restaurant Syndrome. It was believed to be caused by MSG.

It is estimated that 15 to 25 percent of diners suffer from some of the these symptoms after eating food that contains MSG.

Subsequent investigation has shown that MSG is not solely responsible for these symptoms. In the United States, the Food and Drug Administration has classified MSG as generally safe. MSG continues to be used in some meals as a food additive.

There have been reports where MSG is supposed to have triggered asthma attacks, headaches and it may cause retinal damage and blindnes. Some reports have suggested that MSG may cause brain damage.

A study published in the Journal of Nutrition in April, 2000 says, “The present study led to the conclusion that Chinese Restaurant Syndrome is an anecdote applied to a variety of postprandial illnesses; rigorous and realistic scientific evidence linking the syndrome to MSG could not be found.”

How do we know what food contains MSG?

This is difficult to know. Food labels generally use the terms “natural flavor,” “flavoring,” or “hydrolyzed vegetable protein (HVP)” which may mean presence of MSG. HVP typically contains 10-30 percent of MSG.

It may be easy to remember that MSG is generally found in oriental and processed foods. And if you think your symptoms are triggered by MSG then try and avoid these types of foods. For most people, MSG in small amount does not seem to be harmful. But we haven’t heard the last word on it yet. If you have food allergies then you have to be careful what you eat and where you eat.

Thought for the week:

“A new year is not really new if we just live the same old life”.

-Unknown Author.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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New Year’s Resolution

Ring out the old, ring in the new,
Ring, happy bells, across the snow:
The year is going, let him go;
Ring out the false, ring in the true.

-Lord Alfred Tennyson (1809-1892)

Somebody asked me the other day, “Eh, doc, what is going to be your new year’s resolution?”

“Good question, I haven’t given it a thought yet!” I replied.

Then came an e-mail from a gentleman who wants to meet with me. He liked my column titled “Walking and my Grandma”. He wants me to take this subject one step further.

So, I met him last week. His name is Rob Gardner. He is a soft spoken, persuasive, enthusiastic, Community Education Coordinator for Canadian Diabetic Association (CDA). Currently, he is enrolling Medicine Hatters into CDA’s diabetes prevention program called “Keep Your Body in Check.”

“Rob”, I asked, “why do I need to enroll in this program? I don’t have diabetes.”

Gently, he put a small colorful flyer on my hands. He said, “Doc, this was mailed to everybody in Medicine Hat. Did you get one?” I could not recollect getting one. Have you looked at all the flyers which have come to your mail box this month? I haven’t!

Rob asked me to look at the question on the other side of the flyer. The question is: Are you at risk for type 2 diabetes?

The pamphlet says yes, I am at risk for type 2 diabetes if I am over 40, overweight (especially around my middle), or am of aboriginal, Hispanic, Asian, south Asian or African descent.

Yes, I am at risk if I have a parent or sibling with diabetes, if I have high cholesterol level, or I have high blood pressure or heart disease.

Yes, I am at high risk if I have given birth to a baby over four kilograms or had gestational diabetes.

I realized immediately that I had more than one risk factor for type 2 diabetes. I didn’t have to be a rocket scientist to know that. So, I enrolled in the diabetes prevention program.

Just like a good Santa, Rob gave me a box full of goodies – all free. Like an excited little boy, I opened the box. I was pleasantly surprised to see a pedometer (step counter), with a log book, a nice t-shirt, and a measuring tape to measure my waist. All free!

So, I knew what my New Year’s resolution was going to be – to keep my body in check and prevent type 2 diabetes. You can do the same, whether or not you have any risk factors. It is a good program to stay healthy. It is very easy to enroll and the gift box will arrive by mail. Use one of the following options to enroll:

-toll free number 1-866-533-7462 or
-the website www.keepincheck.ca or
-phone Rob Gardner at 403-529-4729 or
-e-mail him at rob.gardner@diabetes.ca

Mention that you read about this program in “What’s up doc?” column then Rob will give you an extra gift! Unfortunately, this program is only for people with Medicine Hat postal code. So, hurry up!

In case you missed my column, “Walking and my Grandma” then you can find it on my website: www.nbharwani.com and search under “Articles” or phone my office 527-0099 for a copy. In 2005, this column will run on Tuesdays.

Have a happy and wonderful 2005. And don’t forget Rob Gardner and keep your body in check!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!