Q&A: The facts and fiction about swine flu


WASHINGTON — Here are some questions and answers about the science of swine flu — the H1N1 virus that's sweeping the world:

Q. What exactly is a virus?

A. It's a tiny packet of only eight genes wrapped in a cloak of proteins, much smaller than a bacterium. Unlike bacteria, a virus is only half alive. It can't eat or reproduce on its own, but must take over the genetic machinery of a living cell. Most viruses are harmless; some are useful, but others, such as the flu virus, can be deadly.

Q. What makes this swine flu virus special?

A. It's a novel combination of bird, pig and human viral genes never before found in the U.S. or elsewhere, so people have no immunity to it. It's a descendant of the H1N1 virus that killed tens of millions of people worldwide in the pandemic of 1918-1919, mixed in with recent strains of swine and bird flu viruses. The 1918 virus originated in birds and then jumped to humans. This year's virus apparently jumped from a pig to a 5-year-old boy in Veracruz, Mexico, who passed it on to other humans.

Q. What does H1N1 stand for?

A. It's the initials of two sugar proteins (their scientific names are hemagglutinin and neuramidinase) that sit on the surface of the virus and do its dirty work. There are 16 types of the H protein, numbered H1 through H16, and 9 types of the N protein, numbered N1 through N9. That makes 144 possible combinations of the virus, a constantly changing challenge for prevention or treatment. A new combination, H2N2, cause a brief swine flu epidemic in 1957. An H3N2 strain was the source of another epidemic in 1968. The bird flu virus that is began in Southeast Asia a decade ago and has spread throughout the Old World is an H5N1 combination.

Q. How does the H protein work?

A. The H protein looks like a little spike that fits into a notch, called a receptor, on the outside of an animal or human cell and lets the virus enter. Once inside, the virus hijacks the DNA in the cell's nucleus and uses it to make copies of itself.

Q. What does the N protein do?

A. After infection, it opens a passage in the cell wall and releases the new baby viruses, which can now invade other cells. Without the N protein, infection would be limited to the first cell, rarely enough to cause disease.

Q. How do medicines such as Tamiflu and Relenza work?

A. They block the action of the N protein so the virus can't spread. They're not vaccines to prevent an infection, but drugs to limit its impact. They should be taken as soon as possible since the virus reproduces most rapidly between 24 and 72 hours after illness begins.

Q. How does a new virus develop?

A. When the genes that govern the H and N proteins reproduce, random changes — mutations — can occur in their DNA. The changes gradually accumulate, ultimately producing a virus that may be more lethal or may penetrate a target cell more easily. Another possibility is gene-swapping. This can happen when a cell is infected by viruses from different creatures, say a chicken and a pig. The cell becomes a "mixing bowl,'' whipping up a new virus containing some chicken genes and some pig genes. In the new strain of H1N1 virus, pieces of human, bird and pig genes are all scrambled up.

Q. How does this H1N1 virus differ from the H1N1 that caused the Spanish flu pandemic in 1918-1919?

A. That virus developed various changes over the years, so it's similar but not identical to its ancestor — like a grandson who resembles but also differs from his grandfather. So far, H1N1 is not as virulent as the previous strain, but that could change. The earlier pandemic began mildly in 1918, but returned in a devastating second wave six months later. Experts fear that could happen again. Hence they are rushing to develop a vaccine by this fall.

Q. How does H1N1 virus jump from animals to humans?

A. Usually the H protein on a pig or bird virus doesn't fit easily into the receptor of a human cell. So a person exposed to such a virus is unlikely to get infected. However, random changes may occur in the genes that control the shape of the H protein and allow the virus to pass through the cell wall. This gives rise to a new strain of H1N1 that's adapted to humans. Now the virus can pass from person to person, as is happening now. Contact with infected pigs or birds no longer is necessary.

Q. How does one person catch H1N1 from others?

A. The virus can be transmitted through the air — by a cough or a sneeze — or by a handshake or by touching an infected surface, such as a doorknob. The virus can live for up to two hours outside a cell. It can't be passed by eating pork.

Q. Why is this disease seem to be more deadly in Mexico than in the U.S. or other countries?

A. That may be an illusion. The first U.S. death has now occurred in Texas and more fatalities are expected. It's possible that many cases of mild disease in Mexico went undetected, making the mortality rate appear to be higher there than it does here. It's also possible that the virus strain in the U.S. differs slightly from the one in Mexico , making it less virulent.

Q. Why does H1N1 seem to attack healthy young adults more than sick and elderly people, who are most affected by the ordinary seasonal flu?

A. Young adults have a healthy immune system that launches a massive counterattack of antibodies against the flu virus. Unfortunately, the counterattack can cause an overwhelming inflammation that damages other organs, such as the lungs. Elderly people with weaker immune systems are less likely to suffer from such harmful inflammation. Older people who were exposed to earlier flu epidemics might also have some residual immunity in their systems.


9 Foods That Reduce Stress


Reach for these items next time you're feeling under pressure, under the weather, or just too close to that breaking point. Munching on these stress-free foods will help pull you back into the game.

A German study in Psychopharmacology found that vitamin C helps reduce stress and return blood pressure and cortisol to normal levels after a stressful situation. Vitamin C is also well known for boosting your immune system.

Sweet Potatoes

Sweet potatoes can be particularly stress-reducing because they can satisfy the urge you get for carbohydrates and sweets when you are under a great deal of stress. They are packed full of beta-carotene and other vitamins, and the fiber helps your body to process the carbohydrates in a slow and steady manner.

Dried Apricots
Apricots are rich in magnesium, which is a stress-buster and a natural muscle relaxant as well.

Almonds, Pistachios, and Walnuts

Almonds are packed with B and E vitamins, which help boost your immune system, and walnuts and pistachios help lower blood pressure.


Turkey contains an amino acid called L-tryptophan. This amino acid triggers the release of serotonin, which is a feel-good brain chemical. This is the reason why many people who eat turkey feel relaxed, or even tired, after eating it. L-tryptophan has a documented calming effect.

A deficiency in magnesium can cause migraine headaches and a feeling of fatigue. One cup of spinach provides 40 percent of your daily needs for magnesium.

Diets high in omega-3 fatty acids protect against heart disease. A study from Diabetes & Metabolism found that omega-3s keep the stress hormones cortisol and adrenaline from peaking.

The monounsaturated fats and potassium in avocados help lower blood pressure. The National Heart, Lung, and Blood Institute says that one of the best ways to lower blood pressure is to consume enough potassium (avocados have more than bananas).

Green Vegetables
Broccoli, kale, and other dark green vegetables are powerhouses of vitamins that help replenish our bodies in times of stress.

More Stress-Busting Tips:

  • Exercise regularly.
  • Drink an energy shake for breakfast.
  • Eat small meals throughout the day, which will keep your blood sugar stable (when blood sugar is low, mental, physical, and emotional energy decreases, and stress increases).




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10 Flat Belly Tips


Stomach feeling fat? Here's how you can de-bloat to look and feel better.

You'd love to have a flat belly for the party tonight, but thanks to one too many sodas or that basket of tortilla chips, zipping your pants is a real struggle. Abdominal bloating not only looks bad, but can cause physical discomfort. The good news? Experts say stomach bloating is a condition you can avoid pretty easily.

We're not talking about extra pounds of stomach fat here, but the temporary abdominal distention that plagues most everyone from time to time. Unless your stomach bloating is because of a medical condition, such as liver or heart disease, the only real cause is intestinal gas – not "water weight," says Michael Jensen, MD, an endocrinologist and obesity researcher at Mayo Clinic.

“It is a myth that bloating in the stomach is from fluid accumulation in healthy adults, because the abdomen is not a place where fluids accumulate first," Jensen says. "Instead, you would see it in your feet or ankles as long as you are upright."

So what causes gas to accumulate and wreak havoc on how you feel and look? Experts say there are several causes, from food intolerances to constipation.

Flat Belly Tip No. 1: Avoid Constipation.

Too little fiber, fluids, and physical activity can lead to constipation, which can result in bloating, Jensen says.

To avoid this, eat a diet high in fiber (25 daily grams for women and 38 for men) from whole grains, fruits, vegetables, legumes, nuts, and seeds. Also, drink plenty of fluids (aim for 6-8 glasses a day) and aim for physical activity for at least 30 minutes, five times a week.

If you're eating a low-fiber diet, gradually bump up the fiber level, making sure you also drink plenty of fluids for better tolerance.

Flat Belly Tip No. 2: Rule Out Wheat Allergies or Lactose Intolerance.

Food allergies and intolerances can cause gas and bloating, but these need to be confirmed by your doctor. Many people self-diagnose these conditions and unnecessarily eliminate healthy dairy and whole grains from their diets. If you suspect you have an allergy or intolerance, see your doctor for tests.

You may benefit from reducing the amount of the suspected food and/or eating it with other foods. In the case of dairy, it can help to choose aged cheeses and yogurts, which are lower in lactose.

Flat Belly Tip No. 3: Don't Eat Too Fast.

Eating quickly and not chewing your food well can cause air swallowing that leads to bloating, says Dawn Jackson Blatner, RD, a spokesperson for the American Dietetic Association.

So slow down and enjoy your food. Your meals should last at least 30 minutes. Also, keep in mind that digestion begins in the mouth, and you can decrease bloating just by chewing your food more, Blatner says.

There's another benefit to slowing things down: When you take your time to thoroughly chew and taste your food, your snack or meal becomes more satisfying. And studies have shown that if you eat more slowly, you may end up eating less.

lat Belly Tip No. 4: Don't Overdo Carbonated Drinks.

The fizz in carbonated drinks (even diet ones) can cause gas to get trapped in your belly, Blatner says.

Instead, drink water flavored with lemon, lime, or cucumber. Or just reduce the number of fizzy drinks you consume each day. Try some peppermint tea for a soothing beverage that may help reduce bloat.

Flat Belly Tip No. 5: Don't Overdo Chewing Gum.

Chewing gum can also lead to swallowing air, which can cause bloating.

If you've got a gum habit, alternate chewing gum with sucking on a piece of hard candy or eating a healthy, high-fiber snack like fruit, vegetables, or lower-fat popcorn.

Flat Belly Tip No. 6: Watch Out for Sugar-Free Foods.

"Many of my patients suffer from bloating because they consume too much sugar alcohol in artificially sweetened foods and drinks," which can lead to bloating, Blatner says.

Experts recommend consuming no more than 2-3 servings per day of artificially sweetened foods and drinks.

Flat Belly Tip No. 7: Limit Sodium.

Highly processed foods tend to be high in sodium and low in fiber, both of which can contribute to that bloated feeling, Jensen says.

Get in the habit of reading food labels, Blatner advises. When buying processed, canned, or frozen foods, shoot for no more than 500 mg of sodium per serving in any product -- or a total of 2,300 mg of sodium per day.

Flat Belly Tip No. 8: Go Slow with Beans and Gassy Vegetables.

If you're not used to eating beans, they can cause that gassy feeling. So can the cruciferous family of vegetables, such as broccoli, Brussels sprouts, and cauliflower.

That doesn't mean you should give up on these super-nutritious, high-fiber vegetables.

"Don’t be nervous about beans," Blatner says. "Just work them into your diet slowly until your body adjusts to the compounds that can initially cause gas."

Or, you can take an enzyme product like "Beano," which can help reduce gas from beans or vegetables.

Flat Belly Tip No. 9: Eat Smaller Meals More Often

Instead of three big meals per day, try eating smaller meals more often. This can keep you free of the bloated feeling that often follows large meals (think Thanksgiving). Eating more frequently can also help control blood sugar and manage hunger.

So go for five to six small meals each day, but make sure the quantity of food and calories are proportionate to your needs. To create a daily meal plan that includes the recommended amounts of all major nutrients, visit the U.S. Department of Agriculture's "mypyramid" web site.

Flat Belly Tip No. 10: Try Anti-Bloating Foods and Drinks.

A few studies suggest that peppermint tea, ginger, pineapple, parsley, and yogurts containing probiotics ("good" bacteria) may help reduce bloating.

"These are safe foods that are good for you when used appropriately, so why not try them and see if they help you de-bloat?" says Blatner, author of The Flexitarian Diet.

A Final Word About Stomach Fat

Experts agree that laxatives, water pills, fasting, and skipping meals are not recommended, either to help you de-bloat or lose weight.

If you're looking to flatten your belly for the long term, there's no substitute for losing a few pounds, Jensen says.

"For most everyone, when you lose total body fat, your body reduces belly fat preferentially," he says. "Even though people lose weight differently, there is a little more lost in the abdominal region than elsewhere.”

Experts also say that doing ab exercises all day long won’t get rid of the excess belly. Although you can’t necessarily spot reduce, you can strengthen abdominal muscles with routines like Pilates and exercise ball workouts. And, stronger muscles can help your belly appear flatter.

"Toning and strengthening the abdominal muscles can help you look less fat [and] improve your appearance, muscle tone, and posture, which is also very good for your back," Jensen says.


Affordable Ways to Make Your Home Safer and Healthier (9) &(10)

9. Use non-toxic cleaning products.

The conventional cleaning supplies under your sink -- with their "warning" and "poison" labels -- contain a potent mix of chemicals.

"If you've ever mopped with ammonia, you know how your lungs constrict," says Lunder. "These chemicals have a very powerful effect on kids with asthma. You're polluting the indoor air when you don't need to." When washed down the drain, they also pollute rivers and lakes.

Look for "green" cleaners that don't contain chlorine or ammonia. Choose ones that say "petroleum-free," "biodegradable," or "phosphate-free."

Or make a cleaner yourself.

Home-brew suggestions:

  • Use vinegar instead of bleach, baking soda to scrub your tiles, and hydrogen peroxide to remove stains.
  • Vinegar also removes grease and soap buildup.
  • Need a window cleaner? Try diluted lemon juice or vinegar. Use borax to inhibit mold growth, boost the cleaning power of soap or detergent, remove stains -- even kill cockroaches, when sugar is mixed in.

10. Eat organic, eat healthy.

When you eat organic food, you ingest fewer pesticides. You’re also helping protect the environment.

More pluses: Research shows that some organic food is more nutritious – organic fruits and vegetables have 25% higher levels of many nutrients than conventional produce.

However, organic produce can be 20% more expensive than conventional. Organic meats and dairy products might be three times the cost of conventional items.

Cut the cost of eating organic foods by:

  • Buying in-season produce, which is plentiful and often cheaper at your local farmer's market.
  • Selectively buy the produce that absorbs the most pesticide if not organic -- like berries, which soak up more pesticides than other fruit. You don't really need organic bananas, since they're protected by a peel.
  • Buy organic for the foods you eat most often.
  • If you’re pregnant or breastfeeding, aim for good health in the kitchen:
  • Getting plenty of omega-3 fats – like those from fatty fish and walnuts -- when breastfeeding seems to protect the fetus' brain development from toxins, Lunder says. (Note: Some fish are high in contaminants like mercury or PCBs that can harm child development. Select safer seafoods, such as shrimp, canned light tuna, and salmon.)
  • Iodine also helps offset negative effects from fire retardants, she adds. That's easy with a prenatal vitamin with iodine.
You could even try the taste of edible flowers -- like those that grow in your lawn, when you quit using pesticides. "Dandelions are salad in France," Landrigan says


Affordable Ways to Make Your Home Safer and Healthier (6), (7) & (8)

6. Filter your tap water.

Filtered tap water may be a better choice of drinking water than bottled water. In a recent study, the Environmental Working Group tested 10 best-selling brands of bottled water. Researchers found mixtures of 38 contaminants, including bacteria, fertilizer, and industrial chemicals -- all at levels similar to those found in tap water.

Here's the catch: Tap water is regulated by the EPA, which requires yearly public reports identifying the contaminants found in local water sources. But bottled water is regulated by the FDA, which has no such requirement.

"But even if you live in a place where drinking water is considered good, there can still be trace amounts of chemicals that may be toxic," says Baker. Although your local water company filters tap water, it still comes through with contaminants -- including lead, chlorine, E. coli, pesticides. Simply filtering your tap water can remove lots of these pollutants.

A simple pitcher-type water filter may be all you need for very drinkable water, Baker advises. There are also filters that attach to a faucet or to the plumbing system. Consumer Reports has published a review of 27 water filters.

Filtering your tap water "is an easy thing to do -- you don't have to invest a lot of money in it," she says. "You just change the filters regularly. It's a 'better safe than sorry' approach." You’ll also cut down on waste in landfills by not buying – and then tossing – plastic bottles.

7. Temper the Teflon.

If you've got pots and pans with Teflon coating -- or other nonstick cookware – make sure you use them wisely. Perfluorinated (PFCs) chemicals are used to make these nonstick coatings, and the chemicals can accumulate in the body. The EPA lists PFOA (one type of PFCs used in Teflon) as a "likely human carcinogen," although there’s no evidence that Teflon-coated pans cause cancer.

DuPont and other companies have agreed, in response to government pressure, to eliminate use of PFOA by 2015. In the meantime, you can switch to other cookware now: stainless steel, anodized aluminum, copper-coated pans, cast iron, or enamel-coated iron. Silicone baking molds are also safe to use.

If you can’t do without your nonstick cookware – or if it’s too expensive to replace right away -- then follow safe cooking practices. Don’t preheat pans on high, and use the lowest temperature you can to cook food.

Two other places you'll find PFCs – in grease-resistant food packaging and as a stain-protection treatment. Reducing greasy packaged foods and fast foods in your diet (like microwave popcorn, French fries, and pizza) not only lowers your exposure, it’s also good for your heart.

If it's time to replace a big-ticket item like a sofa, say no to stain-protection treatments, advises Baker. "These add-ons cost money, and the health implications are not really known."

8. Wash your hands.

We hear this during cold and flu season -- frequent hand-washing keeps germs from getting passed around. But for young children, hand-washing is a good habit that can keep them from ingesting toxins like fire retardants in house dust. What your vacuum doesn't pick up, a toddler's hands will.

"Hand-washing may be boring, but it's really key to keeping stuff on a child's hands from getting into their mouths," says Lunder.

Another tip: Skip antibacterial soap, because some researchers believe that the quest for hyper-cleanliness may have led to weakened immune systems, and possibly to more cases of asthma and allergies. It’s also been speculated that these products may contribute to bacteria-resistant "super germs."

In fact, new research has also shown that triclosan -- the main ingredient in antibacterial soap, deodorants, toothpaste, mouthwash, cosmetics, fabrics and plastic kitchenware -- has the potential to affect sex hormones and interfere with the nervous system.

And studies show regular soap and water works just as well for killing germs. It’s about the process, not the product. Moisten hands, rub thoroughly with soap (getting backs of hands, between fingers, and around nail beds), and rinse. Singing the ABC’s while you do it will ensure you do it for an adequate amount of time (20 seconds). Be sure adults in your house wash their hands frequently, especially after coming indoors. Ask visitors to do the same.


Affordable Ways to Make Your Home Safer and Healthier (4) & (5)

4. Ditch pesticides.

Pesticides kill roaches, mice, ants, and lawn pests. But overexposure and chronic small exposures may put children at risk of a range of health problems, including asthma, learning disabilities, and problems with brain development.

These chemicals are expensive, too. "These pesticides are not cheap," says Landrigan. "You can easily spend a hundred bucks on one Saturday morning on them."

The problem is, "people don't see the damage the chemicals are doing to themselves and to their child," he tells. "It's silent, but nevertheless real damage."

Save money and promote health by focusing on prevention. Simple steps can keep roaches away -- like washing dishes very carefully, cleaning up all food residue, keeping food packages and containers tightly closed, and sealing any cracks that are a point of entry into your home. Landrigan has tested these methods in New York City apartment buildings, where roaches can seem firmly entrenched. "It's basic stuff, but it works," he says.

Instead of spraying herbicides on your lawn, "don't be so worried about weeds," says Landrigan. "Get used to a little imperfection. Rather than spraying, your time is better spent burning calories -- pulling weeds," he says.

You can learn about non-chemical, commonsense ways of reducing indoor and lawn/garden pests -- a concept called Integrated Pest Management. Look for the EPA's on-line booklet: "Citizen's Guide to Pest Control and Pesticide Safety."

5. Be careful with plastic bottles and canned foods.

The safety of bisphenol A, a chemical found in polycarbonate plastics, is still being debated. These plastics are used in some water bottles and baby bottles.

Bisphenol A is also used in epoxy resins that line metal products like canned foods.

The FDA and the American Chemistry Council say bisphenol A is safe for use. However, another government report -- the National Toxicology Report -- found concern about effects on the brain, prostate gland, and behavior in fetuses, infants, and children. And one study found that adults with high levels of BPA in their urine were more likely to have a history of heart disease or diabetes, compared to people with low levels of BPA.

What can you do to limit exposure to BPA?

  • Look for safer water or baby bottles -- either tempered glass bottles or plastic bottles made of cloudy plastics like polyethelene or polypropylene (recycling symbols 1, 2 or 5) are generally safe. Avoid those marked with a "7" or "PC."
  • Don't microwave plastic food containers. Heat can break down plastic fibers.
  • Don't microwave with cling wraps. Put food in a glass or ceramic dish and then cover with waxed paper or paper towels.
  • Eat fewer canned foods.
  • Use glass and ceramic containers to store or microwave foods.


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