Wash, Cook and enjoy a Tomato a Day

The tomatoes are just starting to ripen so what better time to analyze their health benefits. In the last blog article antioxidants were examined and how they act as a shield from free radical injury. Controlling such oxygen free radical damage is vital to preventing many chronic illnesses (Tweed, V., 2016). Tomatoes are one of many types of whole foods with many antioxidants and nutrients.

Tomatoes contain beta-carotene, vitamin E, potassium, lutein/zeaxanthin, phytoene/phytofluene, polyphenols, magnesium, zinc, manganese, and alpha-carotene. They are also low in calories and high in fiber. Raw tomatoes are high in vitamin C (Pratt, S and Matthews, K, 2004).

But the real gold in tomatoes is the lycopene. This compound is a carotenoid – one of a group of nutrients that provide pigmentation for plants and act as antioxidants. It may be as powerful an antioxidant as beta-carotene. Lycopene gives many red foods their color, so yellow or orange tomatoes don’t have this antioxidant. Cooking makes more lycopene available for absorption so aim for canned or otherwise cooked tomatoes. Adding some fat to the cooked tomatoes also increases lycopene absorption. Lycopene can be found in a capsule form but, as with many nutrients, it is best to eat it in the whole food form where other nutrients support or even enhance its benefits (Harvard Health Letter, 2013). Numerous studies have linked tomato consumption with decreased cancer risk, especially lung, prostate and stomach cancer. It may also lower the chances of getting breast, bladder and GI cancers.

Lycopene also decreases inflammation so it causes less damage. In addition, it strengthens the immune system, and decreases blood clotting.

Some scientists recommend getting 10 mg. of lycopene a day.  Sources:

  • 1 cup canned tomato sauce has 37 mg.
  • 1 cup of tomato juice has 21 mg.
  • A slice of watermelon 12 mg.
  • 1 Tbsp. tomato paste 3 mg.
  • 1 Tbsp. Salsa 1.7 mg.
  • Half a pink or red grapefruit 1.7 mg. (Harvard Health Letter, 2013).

Recent research has lead some to suggest lycopene-rich foods for prevention of chronic diseases, including those caused by obesity. For a long time, it was believed that fat cells are inert. But obesity is linked to many chronic diseases, in part because fat cells secrete substances that increase the blood pressure and promote systemic inflammation. The latter process increases oxygen free radical production that damages cell components – the start of many chronic illnesses. Lycopene is readily taken up by fat cells and leads to a decrease in such inflammatory chemicals being released.

Because the body doesn’t easily store lycopene, it is essential to get it regularly. Since the skin contains the highest levels of lycopene don’t pass up cherry and grape tomatoes. Even so, pesticides and germs are found in the greatest amount in the skin of produce so it is essential to wash them well. So, wash, cook and enjoy these red wunderfruit.




Tomatoes and stroke prevention, Harvard Health Letter, February, 2013


Khan, J. Effect of Tomato Derived Lycopene on Obesity Induced Inflammation. International Medical Journal, Vol. 21, No. 5, pages 477-479.


Pratt, Dr. S, and Matthews, K. Fourteen Foods that will change your life SuperFoods Rx, (HarperCollins, 2004).

Tweed, V. Red Revolution, Better Nutrition, May 2016.



Diuretics – Good drugs but Precautions needed

It would be wonderful if medications were never needed but not taking pills if your blood pressure isn’t well controlled can be deadly. With hypertension, blood hits the inner walls of the arteries with great force and injures them. The body attempts to repair the resulting damage with the inflammatory process and in arteries that takes the form of arteriosclerosis. This is a major cause of illness and death worldwide. But high blood pressure can be easily treated and cardiovascular diseases like heart attack, stroke, kidney injury prevented.

Blood pressure can be lowered with lifestyle changes like exercise and weight loss, but that may not be enough. The many types of antihypertensive drugs work in different ways. Diuretics decrease blood pressure by forcing the kidneys to get rid of more salt and that leads to less water being reabsorbed back into the blood. This increases the amount of urine produced but decreases the amount of water in the blood so that there is less force hitting the inner arteries. Diuretics are effective in treating hypertension. They are also inexpensive.

Like all medications, diuretics have side effects. In fact, they are the most common cause of drug-related side effects and interactions in the elderly. That is not a reason to abandon these drugs. The side effects can be managed or even prevented.

There are three major classes of diuretics:  thiazide, loop, and potassium-sparing diuretics. All of them can cause the blood pressure to fall too much, causing hypotension. That is why it is important to check your blood pressure before you take each dose. If it is too low, call the person who prescribed it before taking it. Diuretics can also cause orthostatic hypotension, a significant drop in the blood pressure with sitting up after lying down or with standing. This big drop in the blood pressure can cause dizziness or even fainting. That effect can be managed by changing position slowly.

All three classes of diuretics can cause or worsen dehydration because they’ll cause salt and water loss even if you are dehydrated. They essentially block the body’s normal management of dehydration. This is another reason to check your BP before taking an antihypertensive.

Loop diuretics and thiazide diuretics can lead to a low potassium level. Most providers recommend eating plenty of potassium-rich foods while taking these drugs, such as oranges, yogurt, and bananas. Potassium-sparing diuretics cause the body to retain potassium, so usually people taking them need to avoid foods high in potassium to prevent a high potassium level. A potassium level that is too high or too low can affect heart function. Usually diet changes are sufficient to prevent a potassium imbalance.

Loop diuretics are the most powerful diuretics, usually reserved for treating heart failure. They can cause trouble with balance and hearing. They can also worsen gout, as can thiazide diuretics. If those problems develop, see your health care professional so your medications can be adjusted without risking control of your blood pressure. Diuretics can also worsen incontinence, especially if taken in the morning when kidney function is at its peak. If this is a problem, ask your doctor about taking it at noon instead.

Also see your health care provider if you develop headaches or become confused. This can be from your blood salt level falling too much and has to be quickly checked and corrected. All diuretics can worsen kidney function, so it is important that a blood test be done to check that periodically.

Managing hypertension is still the best way to prevent heart and blood vessel disease, a major killer. With a little extra effort, diuretics can still be a lifesaver. As with all articles, this is not intended to replace the medical care provided by your health care provider, but instead to make you more aware of important information and prompt you to discuss it with your health care provider.



Kaufman, G. (2014). Diuretics:  how they work, cautions and contraindications. Clinical Reviews, Feb. 2014, vol. 16, #2, pages 83-87.

Rosenthal, L., and Burchum, J. (2016). Lehne’s Pharmacology for nursing care, 9th edition. St. Louis, MO:  Elsevier.

Antioxidants: Biochemical Life Savers

Antioxidant – Biochemical Life Savers

For many years, the field of nutrition focused on illnesses caused by a lack of macronutrients like protein, or micronutrients such as iron. More recent research has made it clear that antioxidants are just as critical to preventing the diseases that weaken or kill most people. Numerous chemicals act as antioxidants, including vitamins A, C and E. But there are many others compounds that are found in a variety of foods.

Why are antioxidants such key components of disease prevention? Because our bodies are constantly producing unstable compounds in the course of normal functioning. One such essential processes is cellular energy production. That creates oxygen free radicals, a form of oxygen that can cause a lot of damage. Antioxidants deactivate these harmful compounds and that is why they are life savers.

The body usually makes sufficient antioxidants but there are situations where oxygen free radical production is increased and overwhelms the body. One such circumstance is chronic inflammation. Inflammation is a protective response of the body to anything deemed to be a threat. It can be caused by germs that have gotten into the tissues, a chemical like carbon tetrachloride, or even unhealthy foods such as sugar, or cigarette smoke. This inflammatory response can help eliminate the foreign substance but in the process oxygen free radical production increases. If inflammation is quickly resolved, no permanent harm is likely. But if the cause of the inflammation isn’t removed or avoided, as with years smoking, the inflammatory process continues and the long-term increase in oxygen free radicals injures tissues and cause diseases.

The very good news is that antioxidants can also be consumed and boost the level of antioxidants in the body. This is why you’ve probably read a lot about eating fruits, nuts, vegetables, whole grains and other healthy foods. Different foods contain different types of antioxidants and the greater the variety of foods consumed, the more likely you are to be protected from a wider array of diseases. Eating an assortment of various colored fruits and vegetables is just one way to help ensure this. For example, yellow and orange vegetables and fruits are rich in carotenoids. And carotenoids like beta-carotene act as antioxidants.

Many research studies have supported the disease-preventing power of antioxidants. One large, long study found that the research subjects who consumed more than 27 servings of vegetables, berries and fruit per month, when compared with an otherwise similar group that ate less than that amount, had an 8 to 10% decrease in all cause mortality, as well as a 20% lower stroke death rate. Higher fruit consumption was linked most strongly with lower cancer rates, and regular produce intake was associated in particular with less gastrointestinal cancer.

It should be noted that cooked vegetables seem to offer fewer benefits than raw. Also, fruit juices aren’t as protective as whole fruit, in part because the fiber in the fruit slows the release of sugar into the bloodstream. The pesticides on many types of produce can make them less healthy. If cost is a concern, stick to organic for the “dirty dozen” such as apples and strawberries, but not for the “clean fifteen,” produce like oranges with a thick skin that can be removed.

Damage from oxygen free radicals is a major threat to health. It has been linked to the start of diseases ranging from cardiovascular disease to neurological disorders like Alzheimer’s disease, certain dermatological disorders, endocrine disorders like type 2 diabetes, and immune disorders, to cancers. But antioxidants are plentiful in a wide variety of healthy foods. This certainly makes them a lifesaver in my book!


  1. Hjartaker, et al, (2015) “Consumption of berries, fruits and vegetables and mortality among 10,000 Norwegian men followed for four decades.” European Journal of Nutrition (2015) 54: 599-608
  2. Pratt, M.D. and K. Matthews (2004). SuperFoods Rx. NY, NY: Harper Collins.
  3. Yang, et al (2018). “Proanthocyanidins against Oxidative Stress: From Molecular Mechanisms to Clinical Applications.” Biomedical Research International.

Made to Move

Made to Move

It would be impossible to overstate the benefits from exercise. And there are benefits for people of all ages and situations, although the more time a person exercises and the higher the intensity, generally the greater the benefits will be. Different types of exercise have different effects but that is beyond the scope of this article.

Only 20% of adults, per the Centers for Disease Control (CDC), get the recommended 150 minutes a week (21 minutes a day) of moderate-intensity physical activity (Mahon, S., 2017).

Even children benefit tremendously from regular exercise, including better musculoskeletal and cardiopulmonary function, better blood pressure, depression prevention and treatment. Sedentary children are more likely to become sedentary adults, and that’s a setup for future cardiovascular disease and type 2 diabetes (Downs, A., 2005).

Those over age 60 are particularly apt to be inactive and that contributes to coronary artery disease development, some cancers, obesity, decreased muscle mass, strokes, circulatory problems and frailty. Some of these problems make falls more likely and threaten independent living. But regular physical activity can help lessen depression, anxiety, heart failure, stroke risk. It also supports good sleep, and improves the ability to think. Multiple studies have revealed that older adults that regularly dance at least 45 minutes once a week have greater flexibility, posture stability, muscle strength, endurance, reaction time and cognitive performance than those who are inactive (Hwang, P., and Braun, K., 2015).

Regular physical activity can decrease the risk of breast, colon, and endometrial cancer. It is empowering to be able to do anything to prevent cancer and exercise is perhaps one of the easiest (Mahon, S., 2017).

In Dr. Robert Lustig’s excellent book on healthy eating and living, he writes “Exercise is the single best thing you can do for yourself.” He adds to the list of exercise benefits increased muscle mass. Even at rest, one pound of muscle burns 35 calories a day, but one pound of fat only 2 calories. So even though it may not help with weight loss, or decrease the BMI, exercise does promote fat loss.  Dr. Lustig adds that regular physical activity improves insulin sensitivity, that is, aids the muscle, fat and liver cells’ response to insulin which lets glucose into cells and gets it out of the blood vessels (Lustig, 2013). This is significant because type 2 diabetes is insulin resistance.

A large research study uncovered the important finding that regular physical activity is more effective in preventing heart disease than being normal weight. Also, exercise lessens the negative effects of stress. Cortisol rises during exercises but drops after activity stops and stays down for many hours after finishing a workout. It also increases the “feeling good” hormone endorphin. Excess physical activity can cause some health problems but few people exercise more than an hour a day so that won’t be discussed here. But one more key item: the benefits of exercise won’t persist unless the activity continues. That’s why exercise needs to be part of everyone’s daily routine to reap all the positive effects.


Downs, A. (2005). Pediatric Physical Activity and Fitness Benefits for Kids. Cardiopulmonary Physical Therapy Journal.

Hwang, P., and Braun, K. (2015). The Effectiveness of Dance Interventions to Improve Older Adults’ Health:  A Systematic Literature Review. Alternative Therapies.

Lustig, Dr. Robert (2013). Fat Chance:  Beating the Odds Against Sugar, Processed Food, Obesity, and Disease. New York:  Hudson Street Press

Mahon, S., (2017). Physical Activity Benefits Patients and Nurses Throughout Life. ONS.

Cut the Cortisol

Cut the Cortisol

Cortisol is a hormone that is critical to life. It is produced by the adrenal glands, and normally it is secreted in the greatest amount during early morning and tapers off throughout the day. But too much cortisol is a killer and short of that, causes many chronic and acute diseases.

What causes excess cortisol production? In the modern world, primarily psychological stress and too often that source is chronic. Short-term stress is healthy and helpful but a prolonged stress response leads to long periods of exposure to hormones like cortisol and epinephrine that increase the blood sugar and contribute to weight gain and insulin resistance, and if untreated, eventually leads to diabetes. It also raises the blood pressure and if that isn’t treated it can cause coronary artery disease, stroke or kidney failure. It can also damage the immune system, weakening its ability to fight infections as well as cancer. Entire articles books could be written about any of those topics or about the psychological effects of prolonged stress.

But that isn’t the theme of this article. Cutting the cortisol is our goal. But that is easier said than done. It isn’t easy to lessen our response to stress. It would be ridiculous to even try. But there are things that can help a person relax and lower their cortisol level.

There are tests for determining the level of cortisol someone is producing at any given moment. The salivary cortisol test was developed a few decades ago. It correlates well with serum (blood) levels of cortisol and is easier and less painful to collect. It has been dubbed a “proxy measure of human stress,” and is used in experiments that set out to gauge if an intervention or practice really did help lower stress. Follow are some of the things that have been determined to reduce cortisol:

Art projects (Kaimal, 2016)

Talking with someone supportive and caring (S. Webster, 2016)

Making music or listening to music (Kaimal, 2016)


Writing including journaling (Kaimal, 2016)

Massage, hugging, pats on the back, etc. (Field, 2014)

Exercising (Lustig, 2012)

Quite a list and clearly plenty we can do to lower the cortisol level. And, of course, it isn’t just about lowering cortisol but about decreasing it and all the other hormones and other things that come with prolonged stress. I’ll end here with the references so you can learn more about how to rid yourself from the ill effects of stress without taking a single, solitary pill. I’m headed to the gym.



Tiffany Field (2014), Touch, 2nd edition, by, Cambridge, MA:  The Massachusetts Institute of Technology Press

  1. Kaimal, K. Ray, and J. Muniz, 2016. “Reduction of Cortisol Levels and Participants’ Responses Following Art Making.” Art Therapy: Journal of the American Art Therapy Association, 33 (2), pages 74-80

Robert Lustig, M.D., 2012. Fat Chance:  Beating the Odds Against Sugar, Processed Food, Obesity, and Disease. NY, NY:  Hudson Street Press

  1. Webster, et al, 2016. “Impact of Emotional Support on Serum Cortisol in Breast Cancer Patients.” Indian Journal of Palliative Care.



Touch – an essential part of life

Touch is the first sense to develop and often the last to fade with aging. It is not only a crucial part of communication and comfort, but development as well. This can even be observed in animals as mother dogs, rats and cats spend much of their time licking their newborns. Conversely, babies and small children living in understaffed orphanages frequently suffer from failure to thrive or even die when they aren’t held and cuddled enough.

Despite knowing how important touch is, touching is declining in many societies. Part of this trend is a side effect of increased social media. That isn’t a criticism of social media because it has certainly increased communications. But it can easily replace or lessen verbal and physical communication. In one study, 15% of young people who text sent more than two hundred such messages per day. Fears of misinterpretation of touch is another reason we are touching one another less than even a few decades ago.

Anthropology research has uncovered a correlation between increased touch and decreased adult aggression. This is a particularly important insight since the U.S. and much of northern Europe have been classified as low contact societies, while the Mediterranean countries are high touch. Not surprising, the places where there is more touch have reaped many benefits.

Per touch research, females are much more likely to touch and be touched. Also, older people are often not touched and that can be detrimental for them. One study linked a lack of touch with increased irritability, forgetfulness and bad eating habits in a group of elderly. Older people with pets benefit from that source of tactile stimulation. Another study discovered benefits for seniors that massaged babies. In fact, there were greater benefits from giving a massage than receiving one. All the information in this article is from the book Touch, 2nd edition, by Tiffany Field (2014), Cambridge, MA:  The Massachusetts Institute of Technology Press. A few more articles on touch and massage therapy will follow in the near future.



Between 15% and 25% of the population around the world suffers from periodic allergic rhinitis. It can be occasionally annoying or severe enough to affect the quality of life. Antihistamines are the primary medication used to treat this and other forms of allergy.1

The older types of these medications, the first-generation antihistamines, are sedating. For that reason, they tend to be used more often as sleeping pills. Indeed, some 12% of those over age 65 take such medications for insomnia. This is concerning since over-the-counter sleep medications with the antihistamines diphenhydramine (Benadryl) and doxylamine (Unisom) are on the Beers List – medications to be avoided in those over age 65 because they can cause difficulty with thinking, problems with coordination, can worsen kidney or liver insufficiency, and lead to dizziness and falls. They are a common source of drug interactions including with some antidepressants and cardiac medications.2

Antihistamines are one of the most commonly prescribed drugs for children. Per a Cochrane Review (medical studies that are well-known for their scientific analysis and for thoroughness), the effectiveness of antihistamines for treating nonspecific cough in children is not certain. Also, children are more susceptible to antihistamine adverse effects, including sedation as well as paradoxical agitation and excitability.3   Topical antihistamines should be avoided in children

Some people also take antihistamines for their cold symptoms. While the older, first generation antihistamines may dry secretions, they can thicken the mucus excessively so that it is harder to cough them up.3

     Antihistamines are effective in the treatment of allergic rhinitis and chronic urticaria. For chronic allergy symptoms, regular use of an antihistamine is probably more effective than taking them only as needed. Allergic conjunctivitis is probably better treated with antihistamine eye medications. Antihistamine effects vary from person to person so if one type doesn’t help, another may. 4, 5

First generation antihistamines are not recommended because they can cause sedation as well as difficulty thinking. These medications should be avoided not only in those over 65 years of age, but also those with glaucoma, constipation, dementia, or benign prostate enlargement. Second generation antihistamines are much less likely to cause sleepiness but it can have this effect in some, especially in higher doses.5

Because many types of antihistamines are sold without a prescription, it is essential to discuss any use of them with your pharmacist so that they can determine if there are any interactions with your prescriptions. And remember, it is far superior to try to determine what is causing an allergic reaction and make every effort to eliminate exposure to such.

This article is not intended to replace your health care provider. The intent is to make important information about medications available.


1D. Passali, et al, “The International Study of the Allergic Rhinitis Survey:  outcomes from 4 geographic regions,” Asia Pacific Allergy, January, 2018; 8 (1): e7.

2O. Abraham, et al, “Over-the-Counter medications containing diphenhydramine and doxylamine used by older adults to improve sleep.” International Journal of Clinical Pharmacy 297; 39(4) 808-817.

3J. Van Schoor, Antihistamines:  A brief review, Professional Nursing Today, 2012: 16(5).

4Dr. Koop’s Self-Care Advisor. Time Life Medical Books, 1996.

5The Merck Manual, 19th edition. Whitehouse, New Jersey:  Merck, Sharp and Dohme, 2011.