Pneumonia Shot

The pneumonia shot is recommended for all adults older than age 65. More than ninety different types of pneumococcus bacteria have been identified and it is impossible to immunize against all of them. Vaccines have been developed against the most common types.

The traditional pneumonia shot given to older adults protects against the twenty-three strains that cause 80-90% of disease. This is the vaccine that has been used for decades. Recently, guidelines recommend adding a second shot that protects against thirteen additional strains. This second shot had previously been given to children and adults who had underlying medical conditions that reduced their immunity.

The latest recommendation from United States Advisory Committee on Immunization Practices (ACIP) is that at age 65 every adult have the PCV 13 shot followed by the PCV 23 six to twelve months later. Adults older than 65 who already had the PCV 23 should have the PCV 13 one or more years later. 

Either form of the pneumonia shot can be given at the same time as another vaccine. It takes the body about two weeks to start producing antibodies (which is how the vaccine works). The most common side-effects are pain, swelling and redness at the injection site – these typically last fewer than 48 hours.

More information about PCV 23 and PCV 13.

Medicare and many insurance companies will pay for these shots - but be sure to check with your carrier. 

Brown or White?

Egg farmers produce a wide variety of eggs to meet consumer demand. Brown eggs are preferred primarily in the Northeast United States, while white eggs are preferred across the rest of the country. Shell color has no effect on nutrient content as nutrient content is determined by the hen’s feed. The only difference is white-feathered hens lay white eggs and red-feathered hens lay brown eggs. Brown and white eggs have virtually identical nutrient profiles, but studies show consumers perceive brown eggs to be more nutritious, have greater flavor and fat content, and believe they come from less conventional farm practices. Hens that lay brown eggs are larger and require more feed; as a result, brown eggs may be more expensive.

America’s egg farmers produce eggs using a variety of production methods. Consumers may recognize USDA-defined terms such as “cage-free” or “free-roaming” eggs laid by hens in indoor floor operations; and “free-range” eggs that are laid by hens with access to the outdoors in accordance with weather, environmental or state laws. Studies have been conducted to determine if housing and production methods affect nutrient quality. The findings indicate that housing type had no effect on cholesterol, vitamin A or vitamin E content. Fatty acid composition, however, did vary between housing types: eggs from the free range production system had slightly higher total fat, monounsaturated fat, and polyunsaturated fat than eggs produced by caged hens. The research suggests that these differences in fatty acid composition reflect the free range hens’ access to wild seeds and insects. There is little nutritional difference between certified organic and conventional eggs.

While people will always have their own egg preferences, the preponderance of current research suggests that all types of hen-laid eggs offer high-quality protein with varying amounts of 13 essential vitamins and minerals. Let your conscience (and pocketbook) be your guide.

More information (sponsored by the egg industry - keep that in mind).

Kidney Stones

There is universal agreement: kidney stones are the most painful experiences known. Once someone has a kidney stone he will make all efforts to prevent it from happening again. There are some current recommendations lending scientific credence to widely held beliefs.

Drinking more fluid to increase urination may decrease the risk of recurrence of kidney stones. Patients who have had kidney stones should drink enough to produce at least two liters of urine daily.

Researchers reviewed published literature from 1948 to March 2014 to create the evidence-based guideline, which appeared in the Nov. 4 Annals of Internal Medicine. 

Stone recurrence may also be prevented by reducing dietary oxalate, such as that found in chocolate, beets, nuts, rhubarb, spinach, strawberries, tea, and wheat bran; reducing dietary animal protein and purines; and maintaining normal dietary calcium, according to the guideline.

The evidence also showed that patients who decreased intake of soda that was acidified by phosphoric acid had reduced kidney stone recurrence. The benefit was limited to patients who drank soda that was acidified by phosphoric acid (typically colas) rather than those acidified by citric acid (typically fruit-flavored sodas).  Even though colas are the bad actors in these studies, there doesn’t appear to be any role for any type of soda in the diet.

Too Much, Too Fast

Binge drinking is a dangerous pattern of drinking that can put your health and safety at serious risk. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as drinking that raises your blood alcohol concentration (BAC) to 0.08 percent or higher. A rough way to estimate this is 5 or more standard drinks in two hours for men or 4 or more standard drinks in 2 hours for women or anyone over the age of 65. A standard “drink” is usually equal to a bottle of beer, a glass of wine, a shot of distilled liquor, or a cocktail or mixed drink. This definition is based on the percentage of alcohol usually found in these different drink categories.

Binge drinkers are more likely to experience alcohol-related incidences of physical and verbal abuse, property damage or loss and fear-related situations. Binge drinking is associated with risky sexual behavior, including multiple partners and sex without barrier protection (condoms). These effects are in addition to injury due to motor vehicle accidents.

Despite the dangers, too much and too fast has its attractions. An Australian study found men who engaged in frequent heavy episodic drinking and women who drank more frequently were given a higher status among their peers than those drinking less. The higher social status was also linked to drinking more on an occasion. The author of the study stated, "We don't really know why a higher social status is associated with more drinking but, for young men especially, it may be related to the perception the ability to tolerate large amounts of alcohol is associated with 'coolness', power and masculinity. For young women, tolerance of alcohol is evaluated positively by female peers, often as a sign they can 'keep up with the boys'."

The legal limit to drive is a BAC less than 0.08 percent.

Rethinking Drinking

Reducing Your Risk 

Apps

There are more than 800,000 medical apps in the iTunes store – how to know which ones are good?

Here a few recommendations:

Pill Reminder is a medication and refill reminder. It allows tracking of multiple medications for multiple users. 

My Fitness Pal helps count calories and suggests exercise programs.

Lose It! is one of the most popular weight loss apps; it includes a barcode scanner and recipe planner.

GoMeals is especially useful for diabetics. 

And just for fun: SongPop.  Keeping the brain challenged may head off dementia.

The links are for the Apple products - these programs all available of the Android platform as well. 

Harvest Season

The frost is not yet on the pumpkin, but harvest season is at hand. For many it’s a time of plenty, but many of our friends and neighbors are food insecure: not confident that they will have enough to feed their families.  It is a challenge to pay for housing, utilities, healthcare and food. Natural and financial disasters are equal opportunity actors.

I have my favorite national charities and will “set the table for another” by making regular contributions. I also participate in local drives to replenish the shelves in our local pantry. It’s no effort (and not very expensive) to pick up case of canned corn or canned fruit at the warehouse club. The store brand is fine – it’s what I feed my own family.

I was a little disheartened when I made room for my canned corn for the food drive yesterday and surveyed the other contributions.  We need to better educate those who choose to contribute. A food drive is not the opportunity to clean the pantry of old food. Food that is out of date must be discarded – a waste of a volunteer’s time and the charity will need to pay for the disposal. If your kids won’t eat that weird canned stuff, someone else’s kids won’t eat it either. If you won’t feed your children breakfast cereal that is little more then sugar and chemicals don’t feed it to someone else’s child.

If you are fortunate enough, please share. Please give mindfully and with love.

Some resources:

Mazon 

Connecticut Food Bank

No Kid Hungry