I am sure that most of you know that the medical research institution of the US government (the National Institutes of Health) over the last decade has begun investigating "complementary and alternative" medical (CAM) practices. Some of you know that I occasionally work for the NIH in this effort. One of the most substantial elements in this process is the funding of research intended to establish the merits and mechanisms of action for various forms of CAM. I will be out of the office until Thursday June 10 because I will in Washington as a member of the panel deciding which current research proposals will receive funding. 

Anticipating another imminent absence, I should also tell you that I will be away from the office June 16-20 to attend the first meeting of the International Society of Sports Nutrition. To assuage my guilt over having too much fun I will also tell you that meeting will include some work consulting with that organization about physician interest in the topic. The group is unfortunately to date almost (?) entirely absent physician members.

Best, Michael Carlston, M.D.
www.carlstonmd.com 
707-545-1554

Studies show that we continue to do a very bad job of using sunscreen. While it is best to carefully limit your sun exposure, sunscreen also has an important part to play. Due to recent changes the SPF numbers are becoming more meaningful (the higher the better). The number is irrelevant though if you don't use it properly. That means, you must apply sunscreen liberally (2 tablespoons is about right for an average adult) and often (a minimum of every 2 hours -45 minutes would be better). Although children are most vulnerable to ill effects with every childhood sunburn doubling the lifetime risk of skin cancer, our adult skin needs as much protection as we can give it.

Remember also that there are new sunscreen formulas, most notably miconized zinc oxide, that protect without the ill effects of the old ones. Also, stabilized topical vitamin C can repair at least some of the cancerous changes caused by sun exposure.

Some raw almonds from a very large central California farm are contaminated with Salmonella and should be returned to the point of purchase. Trader Joes and Costco are among the retailers who sold these almonds, however the Santa Rosa Costco says they did not sell any almonds from that farm.  The advisory states that "all raw almonds with a best by August 21 or later" should be returned.

English data collected from adolescents who were born prematurely show that those who were breastfed appear to have significantly lower risk for developing heart disease. Their lipid panels (cholesterol) and C-reative protein levels were much better than adolescents who were premature and formula fed.

A very interesting study looked at an intriguing question in a few ways, one of which is a harbinger of future research. The question is the effect of "indoor" air pollution inside cars. The interesting measurement is heart rate variability.

Heart rate normally varies. When it does not it is a sign of physiologic stress. Some top level bicycle racers use it as an indication of maximal heart training/fitness level. I am part of a medical study expanding or knowledge of heart rate variability and health/disease states. 

This study of highway patrolmen found that airborne particulates (which have been strongly associated with asthma and cardiovascular disease risk in recent years) were very high inside the cars and associated with decreased heart rate variability. The level of particulates was not as high as outside the cars however hydrocarbon pollutants, carbon monoxide, metals and nitrogen dioxide were all higher inside the patrol cars than outside.