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CNN Sunday Morning
Weekend House Call
Aired November 30, 2003 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning and welcome to WEEKEND HOUSE CALL.
Well, whoever coined the phrase "winter wonderland" must have sold cough syrup or ear muffs or something. The shorter days and colder, nastier weather makes millions of us feel less than our best even when we're being besieged by viruses.
Holly Firfer has some tips to combat the wintertime blues.
(BEGIN VIDEOTAPE)
HOLLY FIRFER, CNN CORRESPONDENT (voice-over): 'Tis the season to:
UNIDENTIFIED MALE: Just stay in the house and want to eat more.
FIRFER: Wait. That's not it.
Or is it? For some, this time of year is anything but jolly. According to some health experts one out of every six people suffers from some form of winter depression. The average adult will gain a couple of pounds and suffer from one to two respiratory illnesses each year.
UNIDENTIFIED MALE: Just doesn't seem to be as happy -- you know, just kind of blah.
UNIDENTIFIED MALE: I think part of it is definitely the fact that some minority of people are affected negatively by cold, gray weather. It makes them feel slow, a little bit less interested in things, they sleep a little bit more.
FIRFER: And, there are some who suffer from a more serious form of winter depression called Seasonal Affective Disorder or SAD.
UNIDENTIFIED MALE: It describes people who on a regular basis every year, just as a response to the seasons, begin to feel blue.
FIRFER: Depression, lethargy, anxiety, and mood changes are common symptoms of this often disabling condition. Doctors say there are some things you can do to fight the winter blues. Spend more time in the sunshine even if you have to bundle up, head outdoors and get some fresh air. Even if you crave fattening foods try to eat more fruits and vegetables. Exercise, and if you're feeling really depresses, see your doctor, you might be a candidate for anti- depressants or light therapy.
UNIDENTIFIED MALE: Almost everybody benefits from getting a light box and just sitting under it for an hour or two in the morning.
FIRFER: Weight gain can also lead to depression.
It's a terrible psychological stresser. People feel bad about themselves, they beat up on themselves.
FIRFER: Doctors say if you're less active in the cold weather, then eat less, drink more water. And if you're at a holiday buffet, for instance, try this.
Eat the dessert first. It turns out that eating dessert first, the food is so rich and sweet it satisfies your appetite, and so you don't tend to eat as much afterwards.
FIRFER: Does this sound familiar?
(sneezing and coughing)
UNIDENTIFIED FEMALE: Sneezing, coughing, running nose.
UNIDENTIFIED MALE: Can't go out and do anything, just sitting at home, be sick.
UNIDENTIFIED MALE: There are several studies now showing that on average people undergo a cold or a -- especially something worse, like a flu, will actually feel more depressed for a few months afterwards compared to those that haven't.
FIRFER: So, take your doctor's advice, get a flu shot, and if you feel like you're coming down with something, listen to your body -- slow down and take care of yourself. We can't change the weather, but we can make this season a jolly one.
Holly Firfer, CNN, Atlanta.
(END VIDEOTAPE)
GUPTA: That looks like fun. And eating your dessert first, that sounds like fun, as well. But, between now and the springtime, allergy season, as many as half of us will pick up a respiratory illness, a third of those illnesses, give or take, will be the flu. So, what's the difference? A lot of people asked about this. Fever, muscle aches, and exhaustion are rare in colds, but common in the flu.
Runny nose, sneezing, and soar throat are hallmarks of colds, but show up occasionally -- only occasionally with the flu.
So, how does a person stay in that 50 percent or more of the population that gets through the winter germ free? Well, our guest today can help shed some light on that topic. She's Dr. Sharon Horesh. She's a general practitioner at Emory University, works with me at Emory, as well, help you right her in Atlanta. The flu, we know that that can be a deadly problem. Very serious problem, no question. New vaccines coming out every year, as well. Speaking to that, we have an e-mail question about this first topic -- about the cold and flu.
Kimberly from Georgia asking: "Is it tempting fate to get a flu shot even if you've never received one before and not had the flu since childhood?"
You know, one of the things we get asked all the time is -- can the flu shot actually give you the flu? I think a lot of people are quite leery about it because of that.
DR. SHARON HORESH, EMORY UNIVERSITY: That's a great question and we get asked that a lot because there are a lot of myths circulating about the flu shot. First of all, you cannot get the flu from the flu shot. The flu shot...
GUPTA: Why is that?
HORESH: That's because the flu shot is actually made of an inactivated, killed form of the flu virus. And in any given year, particles made of the strains that are going to be circulating that year are included in the flu shot, however the true influenza virus is not in the shot. So, you're actually trying to get your immune system to respond to these virus particles, but not actually to the flu shot.
GUPTA: Can you get sick at all from it then?
HORESH: You can. One of the side effects of the flu shot, and this occurs in maybe less than 10 percent of people, is a 24-hour achy, feverish, headachey syndrome, but it won't turn out into a full blown flu infection.
GUPTA: I think it takes about two weeks for the flu shot to start working, right?
HORESH: Absolutely.
GUPTA: All right. Let's go to another e-mail question, as well.
Now Tim from New York wants to know: "Are there any new cold and flu drugs for the flu season? What's this flu mist?"
So, a couple questions about that. You don't have to get a shot for that, that's sort of like a flu shot in a nasal spray, right?
HORESH: Exactly. The flu mist is new this year, and it offers the convenience of being delivered as a nasal spray. However, it has certain -- kind of disadvantages, if you will, over the traditional flu shot in that it's only, right now, approved for people who are age 5 to 49 years old, and only for healthy people. The FDC has not yet approved it for people who have serious medical problems or any weakness in their immune system.
GUPTA: Does that have inactivated virus, as well, or is that an active virus?
HORESH: That is actually a live virus. And that is why, right now, there are precautions in people who have a weakened immune system.
GUPTA: Interesting. OK, we went to the streets of New York to get some more questions. Some -- this is question, actually, from the street of New York City.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: What can I do to keep myself from getting a cold? Because a lot of times nothing really works -- you know, what kind of vitamins can I take? What can I eat to help keep my immune system up?
(END VIDEO CLIP)
GUPTA: So, you know, not the flu here, but now just talking about colds. Are there things that we can do now to try and ward those off this holiday season?
HORESH: That's a very good question. There are certainly things you can add in your diet, in particular foods that are rich in vitamin C. So, citrus fruits, broccoli, tomatoes, those all have a good amount of vitamin C. You may also want to include some zinc in your diet. And some people are proponents of Echinacea. There are no studies proving that any of these prevent colds, but there are a lot of anecdotal cases and people who are strong believers in all of the vitamins and minerals.
GUPTA: You have to start drinking that Echinacea pretty early, though right?
HORESH: Yes.
GUPTA: You can't just take a pill and think that you're going to ward off a cold?
HORESH: Exactly. You've to get it into your system and use it primarily for prevention. Once you start getting symptoms, it's usually a little too late to start the Echinacea.
GUPTA: Doctor, telling us to eat our broccoli, no big surprise there, right?
Our next question comes from e-mail from Sharon who writes: "I am seven months pregnant and have been feeling a little under the weather. I'm afraid of catching the flu. If I do get it, will it have any negative effect on my unborn baby?"
So, Dr. Horesh, a pregnancy a potential complication, is that something to worry about if you get a flu?
HORESH: Those are really good questions. For someone who's seven months old it is unlikely that catching influenza at that stage I going to affect the unborn child. However, if a woman who's pregnant with in the first four weeks of pregnancy develops a fever from the flu up to 102, there is a slightly increased risk of a birth defect called spina bifida. However, for all women who are pregnant, if you catch the flu, pregnancy is a state where the immune system is suppressed. So, women who get the flu or any cold during pregnancy tend to have a longer course and have a higher a rate of complications and certain hospitalizations.
GUPTA: So, any special advice for pregnant women who are watching?
HORESH: Absolutely. Pregnant women need to be extra careful, to drink lots of water, get plenty of rest, get some light exercise, and try and reduce stress, because that also wears the immune system.
GUPTA: All right. Stay there. When we come back, we're going to talk about a age-old question. Is there a connection between cold weather and colds? Our mothers seem to think so. Far be it from us to try to contradict them, but when WEEKEND HOUSE CALL we're going to look at some of the science behind the common sense advice to bundle up. But first, our "Daily Dose Health Quiz."
Which of these isn't likely to help you boost your immune system?
A positive attitude, plenty of sleep, plenty of fruits and veggies, or plenty of milk.
We'll have that answer after a break.
(COMMERCIAL BREAK)
GUPTA: Before the break, we tested your knowledge in immunity boosters. Of attitude, sleep, fruits and vegetables, or milk, the one that probably won't make you any more resistant to winter germs is milk. Drink it anyways, though.
That brings us back to our discussion of colds and the flu and cold weather. Our guest is Dr. Sharon Horesh of Emory University.
Dr. Horesh, let's get back to this question, first of all, we're going to head outside to the streets of Atlanta.
(BEGIN VIDEO CLIP)
How can you stay outside for longer and not run the risk of getting sick?
(END VIDEO CLIP)
GUPTA: What about it? Is -- can you get a cold from being in the cold?
HORESH: Now, that is something most of our mothers would have you believe. However, you cannot catch the cold from cold weather. However, in cold weather, there are a lot more viruses that circulate, so our chances of getting sick are greater. And also, when we're out in cold weather, our immune system has to work harder so we're more susceptible to catching colds. So, the best thing we can do when we're out, especially for a prolonged amounts of time is to dress appropriately for the cold weather. By that I mean lots of layers, you want layers of material such as silk or wool, materials that don't absorb moisture such as cotton. And you want to wear layers so when you go indoors you can peel off the appropriate layers and not let sweat trap and give you a chill.
GUPTA: I love the cold weather myself. I love bundling up and getting outside, a nice little chill in the air. Feels kind of nice.
Let's approach this from a little bit of a different angle.
Kedar from Masochists asking: "Does the large difference between temperature outside and inside the home during winter cause any health problems? If so, what are they and what is the remedy?"
A lot of people think that, as well -- you know, you sort of get a chill when you walk inside after being outside in the cold. What do you tell Kedar?
HORESH: There are a couple illnesses that can get triggered by abrupt temperature changes. In particular, people who have arthritis will be the first to tell you when they suddenly go out in the cold they get very achy and stiff. And also people who have migraine headaches, wind changes cold temperature changes can trigger migraines. And people with asthma. Sudden changes in temperature, either from hot to cold or vice versa can trigger an asthma flare.
GUTPA: Does a migraine headache come on right away when you go from outside to inside?
HORESH: There's a short delay. The theory behind that is that changes in temperature can affect vessels in the brain whether they dilate or constrict. So there's a short delay, and then people get migraine.
GUPTA: Interesting for headache sufferers out there.
Another e-mail question, now. Peggy from Mississippi writing: "How can one tell the difference between a common cold, which is contagious, and sinus/allergy problems, which are not?"
Good question, right? Because if you think you got a cold, you may want to stay home from work, things like that.
HORESH: Exactly. There are a lot of similarities, so it is a very good question. First of all, its similarities would include: nasal congestion, some sneezing, coughing. But some of the key differences to look for are only colds cause a fever, only colds give you just a generalized achy feeling. And colds, in particular, will make you feel really just tired and run down where you know you can't go for exercise and you just want to crawl back into bed.
GUPTA: So, the good question for you then I guess, follow-up is, when should someone come and see you? You know, a common cold, when they get the flu, sinus infections? When should they be seeing you?
HORESH: The point where people should go see their doctor is if the symptoms have gone on for a week or they're getting progressively worse, that would be a good time to go see your doctor. Also, if a person has a fever that just doesn't go away after a couple days or develops thick secretions, be it just cough and phlegm or nasal discharge that's just thick and discolored, those would be good times to see a doctor.
GUPTA: Not very appetizing, is it?
HORESH: No.
GUPTA: All right. For millions of people, the down side of winter is just that? A down time that has nothing to do with viruses or fevers. When we come back, we're going to get to the bottom of SAD, Seasonal Affective Disorder. It's not just the winter blahs. We're going to tell you all about it. Stay with us.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: I like a lot of sunlight, and it's hard to simulate the natural sunlight. So, yeah, holiday blues comes about -- right about daylight savings time.
(END VIDEO CLIP)
GUPTA: When the skies turn gray and the nights get long, many -- millions of us find our moods turned dark, as well. It's often just a passing funk, tied to some particular disappointment, then a good night's sleep or a talk with a friend will help. An estimated 30 percent of us though, suffer from, to some degree, from something called SAD, Seasonal Affective Disorder. It's a form of depression arising from a spurt in body's production of a sleep related hormone called melatonin. And that spurt arises, at least in part, from reduced expose to sunlight.
We're exploring all manners of winter woes this morning with Dr. Sharon Horesh. She's a general practitioner at Emory University in Atlanta.
Doctor, as you know, the majority of SAD sufferers are people in the northern climates. Let's go to an e-mail, sort of, talking about that. This is actually from New Brunswick; it falls into both those categories.
"Most of the time, I'm upbeat and happy. When autumn comes, however, I become a totally different person. I experience feeling of such sadness and hopelessness that I am overwhelmed by them. As winter gets closer, I know what I am going to encounter, and the prospect just makes me wonder how I am going to make it through."
Can you recommend anything that might help her? HORESH: Yes. SAD is truly a form of depression however, it has a seasonal pattern to it. So, it's not -- it's very common for people to experience symptoms similar to depression, in particular, the decreased concentration, decrease in energy, not wanting to get out of bed, can't concentrate, want to eat more. A lot of times we treat it the same way we treat depression. We do anti-depressant medication pretty commonly. And typically for people who have SAD, we only do it six months out of the year. Another form of treatment is light therapy, and that involves having exposures to a light box and this light box has an intensity of light that's maybe 10 to 20 times typical indoor lighting. And a lot of times within a week people feel that that helps their mood turn around.
GUPTA: How can you tell though, I mean, everyone gets a little depressed from time to time. Maybe the weather does this, maybe not. But, how can you tell if it's that versus true Seasonal Affective Disorder?
HORESH: That's a very good question, because a lot of people, like you just said, have just winter blues. But that is a much milder form of depression than the Seasonal Affective Disorder. People who have the true Seasonal Affective Disorder literally can't complete tasks that were once so easy for them to do, and they just can't accomplish their daily activities.
GUPTA: Anybody particularly vulnerable to this?
HORESH: People who are vulnerable, first of all, women more than men. It affects women four times as often as men. There's a hereditary component, so it probably somehow is linked to some biochemical transmitters, such as serotonin. Also, people who tend to be in climates where the days are shorter, people who live at either poles more susceptible to that.
GUPTA: Like New Brunswick, for example.
HORESH: Exactly.
GUPTA: Let's take it to the streets again. Listen to another issue -- another issue with this winter season.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: It's a lot harder to exercise in the winter. I'm very much of an outdoor person. So I exercise indoors, but I like to run outside and I definitely stay inside a lot more in the winter.
(END VIDEO CLIP)
GUPTA: So, we know that working out can lessen the impact of SAD, but that too, is sort of complicated. Does it really directly -- exercise improve your mood? How does that work?
HORESH: Well, a couple things are -- you know accomplished by being able to exercise. First of all, exercise boosts the immune system, so if there's anytime of year that you really want to be out there exercising, it really is the wintertime. Also, when you're outside exercising, you're getting sunlight. And, that tends to boost the mood.
GUPTA: What about indoors? I mean do people -- it does get pretty cold out there, what if they just want to stay on the treadmill inside?
HORESH: Well, by staying on the treadmill inside, again, that aerobic activity is what really boosts the immune system, so if it's too cold for you to be outside, exercise indoors is far better than not exercising at all.
GUPTA: It boosts your immune system. But it also -- does it release those feel good hormones?
HORESH: Yes, endorphins that you hear about.
GUPTA: Right.
HORESH: The same endorphins that are in chocolate. This is a much healthier way to give your body that boost.
GUPTA: So, instead of eating chocolate, jump on the treadmill. Is that your advice?
HORESH: Exactly.
GUPTA: That's pretty good advice. Not surprising from a doctor.
We're not finished yet, at home there, folks. So, grab a pen. When WEEKEND HOUSE CALL returns, we're going to point to some Web sites that are going to make for some smooth sledding all winter along.
We also want to tell you the surest, cheapest, quickest, easiest, most absolutely painless way to keep from spreading germs year round.
First, this week's edition of "Your Health."
(BEGIN VIDEOTAPE)
ANNOUNCER: Heart disease is the number one killer of women. Women are less likely to survive heart attacks than men. Why? No one knows for sure, but it may be that women don't seek treatment as soon as men. The biggest factors that contribute to heart disease are smoking, high blood pressure, high cholesterol, and family history. Women should consult their doctor and assess their risk and make a plan to avoid potential problems.
(END VIDEOTAPE)
(COMMERCIAL BREAK)
GUPTA: You can read more about the winter woes at the Mayo Clinic's web site, that's at mayoclinic.com. And for those information -- who want information about Seasonal Affective Disorder check out the SAD Association's Web site, that's at sada.org.uk.
Getting a lot of advice today. Lots of motherly advice, lots of advice to try to keep away from the cold and flu this year.
We were just talking on the break, you rarely gets cold and the flu, so why do you think that is, primarily?
HORESH: Well, I pretty much do the thing is tell other people to do, in particular I wash my hands all the time. I get plenty of rest, I exercise, and I'm a big believer in vitamin C.
GUPTA: All right, and the washing the hands thing, a really important point, is the surest, safest, easiest way to try to prevent the flu. No question about that.
36,000 people a year die from the flu every year, and it's a very, very preventable problem.
Dr. Sharon Horesh, thank you for joining us. Very good advice.
Viewers at home, thanks for join us, as well. That's it for today. Thank you for all your questions and be sure and join us every Saturday and Sunday at 8:30 Eastern, 5:30 Pacific, right here on CNN. Thanks for watching, I'm Dr. Sanjay Gupta.
"CNN Sunday Morning" continues, now.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired November 30, 2003 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning and welcome to WEEKEND HOUSE CALL.
Well, whoever coined the phrase "winter wonderland" must have sold cough syrup or ear muffs or something. The shorter days and colder, nastier weather makes millions of us feel less than our best even when we're being besieged by viruses.
Holly Firfer has some tips to combat the wintertime blues.
(BEGIN VIDEOTAPE)
HOLLY FIRFER, CNN CORRESPONDENT (voice-over): 'Tis the season to:
UNIDENTIFIED MALE: Just stay in the house and want to eat more.
FIRFER: Wait. That's not it.
Or is it? For some, this time of year is anything but jolly. According to some health experts one out of every six people suffers from some form of winter depression. The average adult will gain a couple of pounds and suffer from one to two respiratory illnesses each year.
UNIDENTIFIED MALE: Just doesn't seem to be as happy -- you know, just kind of blah.
UNIDENTIFIED MALE: I think part of it is definitely the fact that some minority of people are affected negatively by cold, gray weather. It makes them feel slow, a little bit less interested in things, they sleep a little bit more.
FIRFER: And, there are some who suffer from a more serious form of winter depression called Seasonal Affective Disorder or SAD.
UNIDENTIFIED MALE: It describes people who on a regular basis every year, just as a response to the seasons, begin to feel blue.
FIRFER: Depression, lethargy, anxiety, and mood changes are common symptoms of this often disabling condition. Doctors say there are some things you can do to fight the winter blues. Spend more time in the sunshine even if you have to bundle up, head outdoors and get some fresh air. Even if you crave fattening foods try to eat more fruits and vegetables. Exercise, and if you're feeling really depresses, see your doctor, you might be a candidate for anti- depressants or light therapy.
UNIDENTIFIED MALE: Almost everybody benefits from getting a light box and just sitting under it for an hour or two in the morning.
FIRFER: Weight gain can also lead to depression.
It's a terrible psychological stresser. People feel bad about themselves, they beat up on themselves.
FIRFER: Doctors say if you're less active in the cold weather, then eat less, drink more water. And if you're at a holiday buffet, for instance, try this.
Eat the dessert first. It turns out that eating dessert first, the food is so rich and sweet it satisfies your appetite, and so you don't tend to eat as much afterwards.
FIRFER: Does this sound familiar?
(sneezing and coughing)
UNIDENTIFIED FEMALE: Sneezing, coughing, running nose.
UNIDENTIFIED MALE: Can't go out and do anything, just sitting at home, be sick.
UNIDENTIFIED MALE: There are several studies now showing that on average people undergo a cold or a -- especially something worse, like a flu, will actually feel more depressed for a few months afterwards compared to those that haven't.
FIRFER: So, take your doctor's advice, get a flu shot, and if you feel like you're coming down with something, listen to your body -- slow down and take care of yourself. We can't change the weather, but we can make this season a jolly one.
Holly Firfer, CNN, Atlanta.
(END VIDEOTAPE)
GUPTA: That looks like fun. And eating your dessert first, that sounds like fun, as well. But, between now and the springtime, allergy season, as many as half of us will pick up a respiratory illness, a third of those illnesses, give or take, will be the flu. So, what's the difference? A lot of people asked about this. Fever, muscle aches, and exhaustion are rare in colds, but common in the flu.
Runny nose, sneezing, and soar throat are hallmarks of colds, but show up occasionally -- only occasionally with the flu.
So, how does a person stay in that 50 percent or more of the population that gets through the winter germ free? Well, our guest today can help shed some light on that topic. She's Dr. Sharon Horesh. She's a general practitioner at Emory University, works with me at Emory, as well, help you right her in Atlanta. The flu, we know that that can be a deadly problem. Very serious problem, no question. New vaccines coming out every year, as well. Speaking to that, we have an e-mail question about this first topic -- about the cold and flu.
Kimberly from Georgia asking: "Is it tempting fate to get a flu shot even if you've never received one before and not had the flu since childhood?"
You know, one of the things we get asked all the time is -- can the flu shot actually give you the flu? I think a lot of people are quite leery about it because of that.
DR. SHARON HORESH, EMORY UNIVERSITY: That's a great question and we get asked that a lot because there are a lot of myths circulating about the flu shot. First of all, you cannot get the flu from the flu shot. The flu shot...
GUPTA: Why is that?
HORESH: That's because the flu shot is actually made of an inactivated, killed form of the flu virus. And in any given year, particles made of the strains that are going to be circulating that year are included in the flu shot, however the true influenza virus is not in the shot. So, you're actually trying to get your immune system to respond to these virus particles, but not actually to the flu shot.
GUPTA: Can you get sick at all from it then?
HORESH: You can. One of the side effects of the flu shot, and this occurs in maybe less than 10 percent of people, is a 24-hour achy, feverish, headachey syndrome, but it won't turn out into a full blown flu infection.
GUPTA: I think it takes about two weeks for the flu shot to start working, right?
HORESH: Absolutely.
GUPTA: All right. Let's go to another e-mail question, as well.
Now Tim from New York wants to know: "Are there any new cold and flu drugs for the flu season? What's this flu mist?"
So, a couple questions about that. You don't have to get a shot for that, that's sort of like a flu shot in a nasal spray, right?
HORESH: Exactly. The flu mist is new this year, and it offers the convenience of being delivered as a nasal spray. However, it has certain -- kind of disadvantages, if you will, over the traditional flu shot in that it's only, right now, approved for people who are age 5 to 49 years old, and only for healthy people. The FDC has not yet approved it for people who have serious medical problems or any weakness in their immune system.
GUPTA: Does that have inactivated virus, as well, or is that an active virus?
HORESH: That is actually a live virus. And that is why, right now, there are precautions in people who have a weakened immune system.
GUPTA: Interesting. OK, we went to the streets of New York to get some more questions. Some -- this is question, actually, from the street of New York City.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: What can I do to keep myself from getting a cold? Because a lot of times nothing really works -- you know, what kind of vitamins can I take? What can I eat to help keep my immune system up?
(END VIDEO CLIP)
GUPTA: So, you know, not the flu here, but now just talking about colds. Are there things that we can do now to try and ward those off this holiday season?
HORESH: That's a very good question. There are certainly things you can add in your diet, in particular foods that are rich in vitamin C. So, citrus fruits, broccoli, tomatoes, those all have a good amount of vitamin C. You may also want to include some zinc in your diet. And some people are proponents of Echinacea. There are no studies proving that any of these prevent colds, but there are a lot of anecdotal cases and people who are strong believers in all of the vitamins and minerals.
GUPTA: You have to start drinking that Echinacea pretty early, though right?
HORESH: Yes.
GUPTA: You can't just take a pill and think that you're going to ward off a cold?
HORESH: Exactly. You've to get it into your system and use it primarily for prevention. Once you start getting symptoms, it's usually a little too late to start the Echinacea.
GUPTA: Doctor, telling us to eat our broccoli, no big surprise there, right?
Our next question comes from e-mail from Sharon who writes: "I am seven months pregnant and have been feeling a little under the weather. I'm afraid of catching the flu. If I do get it, will it have any negative effect on my unborn baby?"
So, Dr. Horesh, a pregnancy a potential complication, is that something to worry about if you get a flu?
HORESH: Those are really good questions. For someone who's seven months old it is unlikely that catching influenza at that stage I going to affect the unborn child. However, if a woman who's pregnant with in the first four weeks of pregnancy develops a fever from the flu up to 102, there is a slightly increased risk of a birth defect called spina bifida. However, for all women who are pregnant, if you catch the flu, pregnancy is a state where the immune system is suppressed. So, women who get the flu or any cold during pregnancy tend to have a longer course and have a higher a rate of complications and certain hospitalizations.
GUPTA: So, any special advice for pregnant women who are watching?
HORESH: Absolutely. Pregnant women need to be extra careful, to drink lots of water, get plenty of rest, get some light exercise, and try and reduce stress, because that also wears the immune system.
GUPTA: All right. Stay there. When we come back, we're going to talk about a age-old question. Is there a connection between cold weather and colds? Our mothers seem to think so. Far be it from us to try to contradict them, but when WEEKEND HOUSE CALL we're going to look at some of the science behind the common sense advice to bundle up. But first, our "Daily Dose Health Quiz."
Which of these isn't likely to help you boost your immune system?
A positive attitude, plenty of sleep, plenty of fruits and veggies, or plenty of milk.
We'll have that answer after a break.
(COMMERCIAL BREAK)
GUPTA: Before the break, we tested your knowledge in immunity boosters. Of attitude, sleep, fruits and vegetables, or milk, the one that probably won't make you any more resistant to winter germs is milk. Drink it anyways, though.
That brings us back to our discussion of colds and the flu and cold weather. Our guest is Dr. Sharon Horesh of Emory University.
Dr. Horesh, let's get back to this question, first of all, we're going to head outside to the streets of Atlanta.
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How can you stay outside for longer and not run the risk of getting sick?
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GUPTA: What about it? Is -- can you get a cold from being in the cold?
HORESH: Now, that is something most of our mothers would have you believe. However, you cannot catch the cold from cold weather. However, in cold weather, there are a lot more viruses that circulate, so our chances of getting sick are greater. And also, when we're out in cold weather, our immune system has to work harder so we're more susceptible to catching colds. So, the best thing we can do when we're out, especially for a prolonged amounts of time is to dress appropriately for the cold weather. By that I mean lots of layers, you want layers of material such as silk or wool, materials that don't absorb moisture such as cotton. And you want to wear layers so when you go indoors you can peel off the appropriate layers and not let sweat trap and give you a chill.
GUPTA: I love the cold weather myself. I love bundling up and getting outside, a nice little chill in the air. Feels kind of nice.
Let's approach this from a little bit of a different angle.
Kedar from Masochists asking: "Does the large difference between temperature outside and inside the home during winter cause any health problems? If so, what are they and what is the remedy?"
A lot of people think that, as well -- you know, you sort of get a chill when you walk inside after being outside in the cold. What do you tell Kedar?
HORESH: There are a couple illnesses that can get triggered by abrupt temperature changes. In particular, people who have arthritis will be the first to tell you when they suddenly go out in the cold they get very achy and stiff. And also people who have migraine headaches, wind changes cold temperature changes can trigger migraines. And people with asthma. Sudden changes in temperature, either from hot to cold or vice versa can trigger an asthma flare.
GUTPA: Does a migraine headache come on right away when you go from outside to inside?
HORESH: There's a short delay. The theory behind that is that changes in temperature can affect vessels in the brain whether they dilate or constrict. So there's a short delay, and then people get migraine.
GUPTA: Interesting for headache sufferers out there.
Another e-mail question, now. Peggy from Mississippi writing: "How can one tell the difference between a common cold, which is contagious, and sinus/allergy problems, which are not?"
Good question, right? Because if you think you got a cold, you may want to stay home from work, things like that.
HORESH: Exactly. There are a lot of similarities, so it is a very good question. First of all, its similarities would include: nasal congestion, some sneezing, coughing. But some of the key differences to look for are only colds cause a fever, only colds give you just a generalized achy feeling. And colds, in particular, will make you feel really just tired and run down where you know you can't go for exercise and you just want to crawl back into bed.
GUPTA: So, the good question for you then I guess, follow-up is, when should someone come and see you? You know, a common cold, when they get the flu, sinus infections? When should they be seeing you?
HORESH: The point where people should go see their doctor is if the symptoms have gone on for a week or they're getting progressively worse, that would be a good time to go see your doctor. Also, if a person has a fever that just doesn't go away after a couple days or develops thick secretions, be it just cough and phlegm or nasal discharge that's just thick and discolored, those would be good times to see a doctor.
GUPTA: Not very appetizing, is it?
HORESH: No.
GUPTA: All right. For millions of people, the down side of winter is just that? A down time that has nothing to do with viruses or fevers. When we come back, we're going to get to the bottom of SAD, Seasonal Affective Disorder. It's not just the winter blahs. We're going to tell you all about it. Stay with us.
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UNIDENTIFIED FEMALE: I like a lot of sunlight, and it's hard to simulate the natural sunlight. So, yeah, holiday blues comes about -- right about daylight savings time.
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GUPTA: When the skies turn gray and the nights get long, many -- millions of us find our moods turned dark, as well. It's often just a passing funk, tied to some particular disappointment, then a good night's sleep or a talk with a friend will help. An estimated 30 percent of us though, suffer from, to some degree, from something called SAD, Seasonal Affective Disorder. It's a form of depression arising from a spurt in body's production of a sleep related hormone called melatonin. And that spurt arises, at least in part, from reduced expose to sunlight.
We're exploring all manners of winter woes this morning with Dr. Sharon Horesh. She's a general practitioner at Emory University in Atlanta.
Doctor, as you know, the majority of SAD sufferers are people in the northern climates. Let's go to an e-mail, sort of, talking about that. This is actually from New Brunswick; it falls into both those categories.
"Most of the time, I'm upbeat and happy. When autumn comes, however, I become a totally different person. I experience feeling of such sadness and hopelessness that I am overwhelmed by them. As winter gets closer, I know what I am going to encounter, and the prospect just makes me wonder how I am going to make it through."
Can you recommend anything that might help her? HORESH: Yes. SAD is truly a form of depression however, it has a seasonal pattern to it. So, it's not -- it's very common for people to experience symptoms similar to depression, in particular, the decreased concentration, decrease in energy, not wanting to get out of bed, can't concentrate, want to eat more. A lot of times we treat it the same way we treat depression. We do anti-depressant medication pretty commonly. And typically for people who have SAD, we only do it six months out of the year. Another form of treatment is light therapy, and that involves having exposures to a light box and this light box has an intensity of light that's maybe 10 to 20 times typical indoor lighting. And a lot of times within a week people feel that that helps their mood turn around.
GUPTA: How can you tell though, I mean, everyone gets a little depressed from time to time. Maybe the weather does this, maybe not. But, how can you tell if it's that versus true Seasonal Affective Disorder?
HORESH: That's a very good question, because a lot of people, like you just said, have just winter blues. But that is a much milder form of depression than the Seasonal Affective Disorder. People who have the true Seasonal Affective Disorder literally can't complete tasks that were once so easy for them to do, and they just can't accomplish their daily activities.
GUPTA: Anybody particularly vulnerable to this?
HORESH: People who are vulnerable, first of all, women more than men. It affects women four times as often as men. There's a hereditary component, so it probably somehow is linked to some biochemical transmitters, such as serotonin. Also, people who tend to be in climates where the days are shorter, people who live at either poles more susceptible to that.
GUPTA: Like New Brunswick, for example.
HORESH: Exactly.
GUPTA: Let's take it to the streets again. Listen to another issue -- another issue with this winter season.
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UNIDENTIFIED MALE: It's a lot harder to exercise in the winter. I'm very much of an outdoor person. So I exercise indoors, but I like to run outside and I definitely stay inside a lot more in the winter.
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GUPTA: So, we know that working out can lessen the impact of SAD, but that too, is sort of complicated. Does it really directly -- exercise improve your mood? How does that work?
HORESH: Well, a couple things are -- you know accomplished by being able to exercise. First of all, exercise boosts the immune system, so if there's anytime of year that you really want to be out there exercising, it really is the wintertime. Also, when you're outside exercising, you're getting sunlight. And, that tends to boost the mood.
GUPTA: What about indoors? I mean do people -- it does get pretty cold out there, what if they just want to stay on the treadmill inside?
HORESH: Well, by staying on the treadmill inside, again, that aerobic activity is what really boosts the immune system, so if it's too cold for you to be outside, exercise indoors is far better than not exercising at all.
GUPTA: It boosts your immune system. But it also -- does it release those feel good hormones?
HORESH: Yes, endorphins that you hear about.
GUPTA: Right.
HORESH: The same endorphins that are in chocolate. This is a much healthier way to give your body that boost.
GUPTA: So, instead of eating chocolate, jump on the treadmill. Is that your advice?
HORESH: Exactly.
GUPTA: That's pretty good advice. Not surprising from a doctor.
We're not finished yet, at home there, folks. So, grab a pen. When WEEKEND HOUSE CALL returns, we're going to point to some Web sites that are going to make for some smooth sledding all winter along.
We also want to tell you the surest, cheapest, quickest, easiest, most absolutely painless way to keep from spreading germs year round.
First, this week's edition of "Your Health."
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ANNOUNCER: Heart disease is the number one killer of women. Women are less likely to survive heart attacks than men. Why? No one knows for sure, but it may be that women don't seek treatment as soon as men. The biggest factors that contribute to heart disease are smoking, high blood pressure, high cholesterol, and family history. Women should consult their doctor and assess their risk and make a plan to avoid potential problems.
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GUPTA: You can read more about the winter woes at the Mayo Clinic's web site, that's at mayoclinic.com. And for those information -- who want information about Seasonal Affective Disorder check out the SAD Association's Web site, that's at sada.org.uk.
Getting a lot of advice today. Lots of motherly advice, lots of advice to try to keep away from the cold and flu this year.
We were just talking on the break, you rarely gets cold and the flu, so why do you think that is, primarily?
HORESH: Well, I pretty much do the thing is tell other people to do, in particular I wash my hands all the time. I get plenty of rest, I exercise, and I'm a big believer in vitamin C.
GUPTA: All right, and the washing the hands thing, a really important point, is the surest, safest, easiest way to try to prevent the flu. No question about that.
36,000 people a year die from the flu every year, and it's a very, very preventable problem.
Dr. Sharon Horesh, thank you for joining us. Very good advice.
Viewers at home, thanks for join us, as well. That's it for today. Thank you for all your questions and be sure and join us every Saturday and Sunday at 8:30 Eastern, 5:30 Pacific, right here on CNN. Thanks for watching, I'm Dr. Sanjay Gupta.
"CNN Sunday Morning" continues, now.
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