Director, Emergency Services, Bikur Cholim Hospital
Last week I discussed the Israeli law determining that the
statement, "all natural ingredients" can appear on a food
label even if sugar is added. Food laws in Israel are not so
strict, although there have been improvements. Most fresh
produce is now pre-washed; this was a big problem in the
past. We are still waiting for childproof bottles and
complete ingredient lists.
As of this writing, there is a problem with E coli 057
infestation of spinach in America. This bacterium was first
found in undercooked hamburgers in the Jack in the Box chain;
this episode caused them to go bankruptcy. The bacterium can
cause bloody diarrhea and kidney failure. It is one of the
examples where antibiotics actually make a disease worse. In
the case in the USA, the problem was traced to an organic
grower, another example where "organic" doesn't necessarily
mean "healthier." The bacterium does not survive high
temperatures, so cooked spinach is safe. Until more details
are available, avoid fresh USA spinach. Because of bug
infestation problems you probably avoid it anyhow.
The Yated often prints articles on health. I want to
make it clear that I am not affiliated with any articles not
printed under my name. I do not review them and cannot vouch
for their accuracy.
I would also like to point out that no other newspaper in
English printed in Israel employs a physician for their
medical columns: instead, they rely on health writers.
Readers are advised to exercise caution.
The March edition of the Infectious Disease Society of
America's journal Clinical Infectious Diseases reports
that a bacterium has been found in formula that could be
harmful to infants. They, of course, recommend nursing for
the first six months, a concept we have often mentioned here.
I am not saying that formula is dangerous, but all efforts
should be made to give mother's milk.
Hyponatremia is a state of low sodium in the blood. How does
one get this condition if sodium is in most foods? You affect
sodium balance by three ways — there is a center for
this in the brain and one in the kidney. Lung disease can
also cause lowering of sodium. If it is gradual it is well
tolerated, but acute drops in sodium can cause weakness and
confusion. This is most commonly caused by medications,
especially hydrochlorothiazide, a diuretic, but there are a
slew of medications that can cause this condition. Second on
the list are antidepressants.
A reader asks if someone could drink his sodium down to
dangerous levels. You sure can. Sweating removes sodium and
these fluids should be replaced by solutions that have
balanced salts. Plain water or mineral water does not replace
these salts. One would have to sweat a lot and drink a lot of
water to bring down one's sodium to a dangerous level, but it
is best to try to drink balanced solutions like fruit juices,
provided you can afford the calories and sugar. Fruit juices
can be high in fiber and potassium. They are definitely
better than soda.
Hypernatremia occurs when there is too much sodium in the
body, but you need a real disease to cause this. Eating a lot
of salt will cause you to get thirsty and you will put more
out in the urine. True hypernatremia occurs in very sick
people with diabetes insidious — a hormonal problem,
unrelated to diabetes mellitus. In the elderly, it is a grave
sign of bad infection. Although I do not recommended that you
eat as much salt as you wish, it won't affect your blood
level. It will affect your fluid balance and your blood
pressure. Write me in care of the Yated.
