Dr. Kevin Most: Winter Already

Dr. Kevin Most

Well we have one week under our belts with the time change. The impact of the time change has probably been felt by all this year as it has been coupled with some unusually cold weather. The days of going to work in the dark and coming home in the dark will be with us for a while as we are still a month away from the shortest day of sunlight. As we approach the holidays with darkness around us I thought it might be a good idea to get us prepped for the upcoming winter from a health view.

The time changed coupled with cold weather has impacted our time we spend outside. Normally at this time we are in the low 60’s and have weather that is still fine to be outside to exercise or stress relief that is not the case this year. That loss of outdoor time came abruptly and it came along with the time change so in a matter of days we were greatly impacted. This impact would have normally been a little more gradual and we would have enjoyed more time outside. The health impacts of this change cannot be minimized as this impacts us mentally as well as physically.

Let’s take a few minutes to discuss the impacts and what we can do to have a healthy winter.

HEART

First let’s consider our heart, blood pressure and cholesterol. These three are tied together with exercise and diet. As we start to get in to the dark cold weather, our body has a craving for heavy meals as well as carbohydrate loaded foods. When you combine a diet like that with a decrease in activity we see our weight go up, which often results in our blood pressure rising as well as our cholesterol. Control of one’s diet is key thru the winter. This is when you should do a couple of things, one is to actually calorie count each day. Although this sounds like a hassle, technology has made it much easier. There are many apps that allow you to put in the ingredients of your meal in and an estimate of calories is projected. Many restaurants now provide calorie counts on their menus. Tracking is easy on many of these apps as well. Do you know how many calories you should take in each day? A rough estimate is 2,000 calories to 2,500 calories a day. For perspective a Whopper with Cheese is 750 calories and footlong Italian sub at Subway is 960 calories, you can see how these add up quickly. In the summer these may be part of your diet as you exercise more and have more outdoor activity, during winter this is not the case.

So consider what you eat, eat in moderation, and beware of the calories. Doing it now will set a tone for the upcoming months. Preventing weight gain is much easier than attempting weight loss, so get on a healthy track early.

Exercise is difficult in the winter. The walk before or after dinner is difficult in the dark and with a wind chill, both factors are not motivating and often replaced with sedentary activities. Many of you have exercise equipment that has been sitting quiet for months as your activity has been outside. Time to get back on that treadmill or bike to get some exercise and burn some calories. My suggestion for success here is to make a schedule each week for what activities and for which days and then track your success. It may be as simple as a 45 minute brisk walk in the mall, or it may be to go up and down stairs in the home 10 additional times in a day. Regardless of the activity schedule it and track it. There are many videos of exercise, yoga or Pilates that are easily accessible on line and led by experts, these often take minimal or no equipment and can be done in an open area of your home. If you are using exercise equipment at home, make sure you place it in front of a TV. Watching the news or Netflix will make the exercise time go by very quickly. Exercise is good to help control any weight change as well as helping with blood pressure.

MENTAL HEALTH

Mental health is stressed at this time of the year. The lack of sunlight impacts us mentally and in some cases much more than others. We all expect to feel a bit down with the winter blues, however if those winter blues seem to be around every day or for most of the day most days, it is worth a discussion with your doctor. Approximately 20 percent of population suffer from SAD in some fashion. SAD or Seasonal Affective Disorder also commonly called Winter Depression. This condition appears after the time change and with the shorter days of sunlight, it stays with individuals often until the early summer. This condition is more common in women but is seen in men as well. The further north you live the higher the chance that you will suffer from this.

Symptoms for SAD include
• A change in appetite, especially a craving for sweet or starchy foods
• Weight gain
• A heavy feeling in the arms or legs
• A drop in energy level
• Fatigue
• A tendency to oversleep
• Difficulty concentrating
• Irritability
• Increased sensitivity to social rejection
• Avoidance of social situations—not wanting to go out
Now many of us may feel that we have some of these symptoms thru the winter but having them occasionally is different than having them daily. If you feel like you have these symptoms consistently speak to your doctor as they have options for treatment. Treatment may include light therapy, this is therapy where the patient is exposed to a light box each day for a few hours and that light mimics the light we see naturally. It allows for the brain receptors to function at a summer level and elevates mood in many cases. Other treatment options include medications and in many cases adding Vitamin D to one’s diet.
We know that social isolation also impacts our mental health and the inability to get out because of cold or inclement weather only makes this worse. Social media has certainly helped with this as well the ability to facetime with others. Spending time with the most natural light is also a key to improving mental health thru the winter, you may need to rearrange furniture and function of the rooms but getting any sunlight is helpful.

VITAMINS
We have discussed the importance of Vitamin D to our body. This is a unique Vitamin as we make it in the body but we need sunlight to activate it. In the summer when we are exposed to a lot of sunlight we have ample Vitamin D, however in the winter that is not the case. Vitamin D is important as It helps us maintain good bone strength by helping us absorb calcium, but it has other very important benefits. In seniors it has been shown to improve cognition, decrease our chances with Diabetes and help us decrease our chance of depression. I recommend individuals take 2,000 IU of Vitamin D each day after the time change as we are not producing enough with the limited day light we see.

INFECTIONS
If you have not received your flu shot, right now is the time. Remember it takes 2 weeks for it to work. With Thanksgiving just a few weeks away we would like to see as many people protected by then. The reason being is the amount of travelers that move across the country that weekend. This increases the opportunity for a local outbreak to be spread quickly. The CDC expects this to be a bad flu year with H3N2 Type A strain causing the most havoc as it did last season in the Southern Hemisphere. So if you have not gotten the flu shot, please do so this week. Many pharmacies and grocery stores are offering it for free.
We do need to realize that we are coming into Cold and Flu season. Protecting ourselves from viral illnesses is important. Not only are they aggravating they can also impact the health of our families and coworkers. Viruses actually do very well in the winter. Many of them have a hard shell covering that allows them to live on surfaces for hours, couple that with people staying indoors and in closer contact allows for viruses to spread. The message here is wash your hands frequently, clean surfaces where many hands touch, (think light switches, door handles, faucets are often over looked) cough into your elbow. The vast majority of winter illnesses are caused by viruses and do not require antibiotics. Do not be mad or disappointed if your doctor tells you that your cold is due to a virus, that you may have it for a week and that supportive measures like fluids, Advil and Mucinex is what they recommend. Antibiotics do nothing against viruses and just increase the chance of bacterial resistance in the community. Those of you who think the Z Pak is the reason your “cold” was cured are incorrect, in fact Z Pak have been so over used that there is a lot of resistant bacteria that are no longer impacted by this antibiotic.

ASTHMA
Those of you with asthma know that this can often be a lot worse in the winter. Not only will viruses and other infections trigger the symptoms but also the bitter cold dry air causes inflammation and triggers the asthma. Individuals with asthma should make sure they don’t miss any of their maintenance medications but equally as important is to check and make sure their rescue inhaler is available and up to date. A well-controlled asthma patient may only need their rescue inhaler 1-2 a month, however in the winter that number can rise based on irritation and inflammation of the airways, so make sure you have your rescue inhaler with you and that it is not expired or empty. Patients with asthma and COPD need to make sure they have their flu vaccine soon if they have not already received it.

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