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Healthnotes Newswire (July 17, 2008)—Everyone knows that fish is good for you, but it turns out that some is better than others for certain health needs and goals.

A new study, published in the Journal of the American Dietetic Association, analyzed 30 species of wild and farmed fish and found that while wild fish is generally more healthful than farm-grown, fish such as salmon and trout still maintain a beneficial fatty acid profile. Other farmed fish, such as talapia, do not, so while these may be incorporated into a regular diet as an occasional inexpensive, low-fat protein source, people wanting to maximize disease-fighting health benefits from fish will opt in favor of those with a better balance of fatty acids.

The ratio is the real measure of risk

A wealth of research shows that eating fish rich in omega-3 fatty acids may help prevent and treat diseases such as heart disease, diabetes, inflammatory and autoimmune diseases, and some cancers. However evidence increasingly points to the ratio of omega-3 to the less discussed omega-6 fatty acids in the diet as the indicator of disease risk.

• Fish with an omega-3 to omega-6 ratio of greater than one are considered beneficial because of their effect on the fatty acid profile of the entire diet.

• Fish with a ratio of 0.5 or lower are considered not protective against disease.

As a polyunsaturated fat, omega-6 also plays a role in supporting health, as long as it is consumed in moderation.

The best fish for fending off disease

The authors of the study collected samples of commonly eaten fish—including tuna, snapper, mahi-mahi, cod, sole, halibut, haddock, talapia, swordfish, catfish, salmon, and trout—from distributors in the US and Chile, from fish farms in the US, Chile, Canada, Ecuador, Honduras, Norway, and New Zealand, and from supermarkets in the US. Some highlights of their findings include:

• Sockeye salmon, Coho salmon, Copper River salmon, and farmed rainbow trout had a beneficial fatty acid pattern—in other words, a high ratio of omega-3 to omega-6 fatty acids.

• Farm-raised Atlantic salmon had high levels of omega-3 fatty acids but their levels of omega-6 fatty acids were higher than those of the wild salmon, making their ratio slightly less favorable, though still healthy.

• Tuna, one of the most commonly eaten fish in the US, had a low level of omega-3 fatty acids, but it also had a low omega-6 level, so its ratio remained favorable.

• On the other end of the spectrum, farmed talapia and catfish had low levels of omega-3 and poor ratios of omega-3 to omega-6 fatty acids.

Balancing factors besides fatty acids also important

Of all the fish reviewed in this study, tilapia has received the most attention for its unfavorable fatty acid content. “All other nutritional content aside, the inflammatory potential of hamburger and pork bacon is lower than the average serving of farmed tilapia,” the article cautions. However, keep in mind that a fish not being highly protective against heart disease does not mean it needs to be avoided entirely. Other health factors, such as heavy metal contamination—which are high in otherwise healthful fatty fish like tuna, but low in less heart-healthy fish like tilapia—should also be taken into account.

To give the pros and cons of fish consumption some real world perpective, consider that eating moderate amounts of farmed tilapia is roughly equivalent to other staples of the average diet, and may be a reasonable option for some people. For those at risk for inflammatory diseases such as heart disease, fish with a good omega-3 to -6 ratio such as salmon or trout are the best choice.

(J Am Diet Assoc 2008;108:1178–85)

Healthnotes Newswire (July 17, 2008)—A new study has shown that education, combined with healthy behaviors such as eating fruits and vegetables each day, exercising, and keeping a food diary, are key ingredients for maintaining weight loss. While it is well known that such behaviors can help a heavy person lose weight, few large studies have looked at behavioral interventions for keeping weight off, which is critical for overweight people with high blood pressure or high cholesterol.

Healthy habits are key

The study, known as the Weight Loss Maintenance Trial, compared various strategies for maintaining weight loss over a 30-month period. All 1,684 participants were 25 years or older and were overweight or obese and taking medication for high blood pressure and/or high cholesterol. Each participant was encouraged to attend 20 weekly group educational sessions, restrict calories, use a daily food diary, exercise daily at a moderate to intense level, and follow the Dietary Approaches to Stop Hypertension (DASH) diet, which is rich in fruits, vegetables, and low-fat dairy foods, and limits saturated fat, total fat, and cholesterol.

After two and a half years, people who lost the most weight (18.7 pounds [8.5 kg] or more) had, on average, attended more weekly educational sessions (15), exercised more (159 minutes per week), kept more food diary records (4.2 records per week), and eaten more fruits and vegetables (3.6 servings per day).

“A combined emphasis on dietary intake and physical activity is important to both short- and long-term weight loss goals,” said the study’s author, Jack Hollis, PhD, from the Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon. “Behavioral strategies to modify these health behaviors are important components of weight-loss interventions because they emphasize the individual’s ability to monitor and regulate behavior, and target the barriers to both initial weight loss and long-term maintenance.”

Smart slimming strategies

People with high blood pressure, high cholesterol, and diabetes are at high risk for cardiovascular diseases such as stroke or heart attack, but weight control can help prevent and treat these conditions. There is no quick fix for losing weight or maintaining weight loss. If you are overweight, start by eating right, exercising, keeping stress in check and seeing your doctor.

Here are some tips for losing weight and keeping it off:

• Eat an abundance of fruits and vegetables based on recommendations from your healthcare provider. Limit saturated fat and sugar and avoid “empty” calories that provide little or no nutrition such as some processed foods, snacks, and beverages.

• Get enough exercise. A report from the Institute of Medicine suggests that adults need 60 minutes of moderate physical activity every day in order to optimize health and prevent disease; children need a minimum of 90 minutes.

• Keep a diary to track your daily food and calorie intake and help you learn how to identify eating patterns and make healthy choices throughout the day.

• Join a support group for health lifestyle behaviors or share the experience with friends and family, which can help improve your chances for success.

(Am J Prev Med 2008;35:118–26)

Healthnotes Newswire (July 17, 2008)—If you are chronically tired, getting moving might be just the thing to put some pep in your step. A new study has found that exercise can improve energy and lessen feelings of tiredness in people who suffer from persistent fatigue.

The effects of exercise on people with certain chronic medical conditions (heart disease and cancer, for example) are well documented, but less is known about its role in improving stamina in people suffering from fatigue without an underlying disease. The new study aimed to determine how exercise affects feelings of fatigue and energy in young people with fatigue unrelated to a medical condition.

In the study, published in Psychotherapy and Psychosomatics, 36 sedentary people with persistent fatigue ranging in age from 18 to 35 were assigned to a low- or moderate-intensity exercise group, or to a no-treatment control group. The low-intensity group worked out on a stationary bicycle at 40% of their peak oxygen consumption (roughly equivalent to walking at a leisurely pace) and the moderate intensity group at 75% of their peak oxygen consumption (about the same as walking at a fast pace), for 30 minutes three times per week for six weeks.

Slow and steady the best bet for persistent fatigue

People in the low- and moderate-intensity exercise groups had a 20% improvement in energy levels after six weeks compared with levels at the beginning of the study. Low-intensity exercise decreased feelings of fatigue by 65%, compared with 49% in the moderate-intensity group. The changes in fatigue and energy levels were unrelated to changes in aerobic fitness. The authors suggested that energy and fatigue improvements are due to the direct effects of exercise on the central nervous system.

Exercise professionals agree

“I have found that maintaining a consistent exercise routine keeps me feeling well balanced and energized,” says Rachel Weisz-Nesshoever, Aerobic and Fitness Association of America certified group exercise instructor in Narragansett, Rhode Island. “Exercise has a way of lifting the spirits and combating fatigue. Sometimes people who are chronically tired tend to avoid exercising. What they don’t realize is that—if it’s done right—exercise can actually give you more stamina and energy to do the things you want to do.”

(Psychother Psychosom 2008;77:167–74)

Healthnotes Newswire (July 10, 2008)—Good news for your little juice lovers: Although several studies have suggested that drinking fruit juice might contribute to overweight in children, a review of 21 studies found that the link was not strong. “There is no systematic association between consumption of 100% fruit juice and overweight in children and adolescents,” said the study’s authors in the American Journal of Lifestyle Medicine.

The origins of overweight

While genetics play a role, diet and exercise patterns are also intimately involved in maintaining healthy weight. In a previous study, one researcher found that children who drank more than 12 ounces of fruit juice per day were more likely to be overweight than children who drank less juice. Since juice is the drink of choice for many youngsters, the new study compiled evidence from studies concerning juice consumption and overweight in children to try to answer the question: Does drinking juice make kids fatter?

Only 6 of the 21 studies reviewed found a relationship between drinking 100% fruit juice and overweight in children, none of which were based on a nationally representative sample. Those that found a relationship did so only in adolescent girls and children who were overweight to begin with. The other 15 studies—5 of which were based on nationally representative samples—found no relationship between drinking juice and becoming overweight.

The authors concluded, “The data do support consumption of 100% fruit juice in moderate amounts and suggest that consumption of fruit juice may be an important strategy to help children meet the current recommendations for fruit.”

“As the mother of one child who wants nothing to do with juice, and another who would drink it all day long, it is a relief to read this new study. I feel like it’s one less thing for me to stress about as a mom,” said Erin Goodman, founder of the Rhode Island Birth Network.

The importance of addressing obesity

According to the 2003-2004 National Health and Nutrition Examination Survey (NHANES), 17% of all children and adolescents are overweight. Among 2 to 5 year olds, the prevalence increased from 7 to 14% between 1988 and 2004; similar increases were seen among 6- to 19-year-olds in this time span, with an increase in the percentage of overweight children from 11 to 19%.

Says Dr. Matthew Baral, medical director of Hamilton Elementary School Clinic in Phoenix, “Eating the whole fruit is preferable to the juice, since the release of sugar in the bloodstream is somewhat blunted by the fiber in whole fruit. When consuming juice, dilute it with water to lessen the amount of sugar the child is getting.”

Help your child maintain a healthy weight

Here are some simple things that parents can do to help keep kids’ weight in a healthy range:

• Snack on fruits and veggies—Make a big fruit salad on the weekend; store in the fridge and eat all week. Keep ready-to-eat cut-up vegetables on hand for quick snacks. Baby carrots, snap peas, broccoli, and cauliflower are easy to eat on the go.

• Get moving in your free time—Set a positive example by making exercise a priority for the whole family.

• Limit TV time—Kids who watch more TV or eat while watching TV are more likely to become overweight.

• Avoid processed foods—Packaged snacks can contain hidden fats and sugar. Opt for home-baked goods to satisfy the urge to snack.

(AJLM 2008;doi:10.1177/1559827608317277)

Healthnotes Newswire (July 10, 2008)—For children with hyperactivity, eliminating food additives should be part of a standard treatment program, according to Andrew Kemp, MD, author of an editorial in the British Medical Journal and professor of pediatric allergies and immunology in Sydney, Australia. Despite the lack of agreement on the effect of dietary modifications on hyperactivity in children, increasing evidence suggests that eliminating food preservatives and artificial colorings from a child’s diet may help.

The roots of hyperactive behavior

When a child is hyperactive, parents and health professionals often look at a variety of factors that may be contributing to the child’s behavior, such as stress in the home or school environment, divorce, death of a loved one, and certain medical or psychiatric conditions. But something as simple as a child’s diet may also play a role. In fact, increasing scientific evidence suggests that food additives may increase hyperactivity in some children.

A study published in the Lancet found that artificial colors and/or sodium benzoate preservative in the diet led to increased hyperactivity in three-, eight-, and nine-year-old children who did not have attention deficit–hyperactivity disorder (ADHD). The study noted that food additives may increase hyperactivity in some children but not in others.

Various experts have weighed in about the impact of such additives on childhood hyperactivity. Dr. Kemp notes that a panel from the European Food Safety Authority acknowledged, after reviewing 22 studies and two meta-analyses from 1975 to 1994, that research provides evidence that food additives and colorings may affect activity and attention in children. However, a recent review of treatment for ADHD by the American Academy of Pediatrics Subcommittee did not review dietary modification as a treatment but supported stimulant medications.

Treatment options: drugs, behavioral therapy, diet—and ditching food additives

Currently, specific treatments for hyperactivity may include drugs, behavioral therapy, and dietary changes. Eliminating food additives is often regarded as an “alternative” rather than standard treatment for ADHD even though research has supported both drug therapy and dietary modifications, according to Dr. Kemp.

In advocating for diet modification as standard treatment, Kemp says, “In view of the relatively harmless intervention of eliminating colorings and preservatives, and the large numbers of children taking drugs for hyperactivity… an appropriately supervised and evaluated trial of eliminating colorings and preservatives should be part of standard treatment for individual children.”

Tips for parents

Parents with a hyperactive child may discuss these types of questions with their healthcare provider:

• Is increased stress causing the behavior? A divorce, loss, a move to another neighborhood, increased school workload, competitive activities, and many other factors can contribute to a change in your child’s behavior.

• Is your child getting enough exercise? A child may be labeled as “hyperactive” when in fact he or she is merely in need of more physical activity.

• Does your child have a supportive and nurturing environment at school that encourages individual learning styles? Again, a child may be labeled “hyperactive” if he or she does not conform to typical classroom standards.

• Any child with a significant change in behavior or persistent disruptive behavior should be evaluated by a physician to determine whether or not there is a medical cause. Evaluation by a physician or psychologist who is specifically trained in the area of hyperactivity may be helpful.

• Ask a physician or nutritionist who is aware of the effects of dietary factors on hyperactivity for suggestions in treating the behavior. Consider the role that food additives may be playing, and look for more fresh, unprocessed foods to enjoy with your family.

(BMJ 2008;336:1144; Lancet 2007;370:1560–67)

Healthnotes Newswire (July 10, 2008)—When applied to the skin, honey may help prevent and treat skin diseases caused by bacteria, according to a new study published in Clinical Infectious Diseases. As the number of antibiotic-resistant infections increases, alternative solutions are needed for infections.

Some research has already demonstrated that honey may help with wound healing. In the new study, Revamil, a medical-grade honey, was effective in killing or reducing many types of bacteria on the skin of healthy volunteers, including bacteria that are susceptible to or resistant to antibiotics.

Compared with the control group, bacteria on the forearm were reduced 100-fold after honey was applied for two days, and more than 80% of the honey-treated skin patches showed no evidence of bacteria compared with only 21% of the control patches. Test tube studies also showed that within 24 hours honey killed all antibiotic-resistant and -susceptible strains of Staphylococcus aureus, Staphylococcus epidermis, Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca.

The study’s authors commented that since very few new antibiotics are being developed, alternative solutions are needed. Honey, they said, could be helpful in treating wound infections and in preventing infection at skin sites where bacteria are likely to thrive, such as catheter sites in ill patients. Further research is needed to understand the potential role of medical-grade honey in preventing and treating skin infections.

Honey may kill or suppress bacteria growth because of its high sugar content, high acid content, natural production of hydrogen peroxide, or because of other actions related to flower or bee components. Though the authors warn that pulling a jar of honey off of the shelf to treat skin infections may not get the job done (Revamil is produced in a greenhouse under standardized conditions), evidence from other studies suggests that raw, unprocessed honey may be effective.

(Clin Infect Dis 2008;46:1677–82)

Healthnotes Newswire (July 3, 2008)—It’s well known that vitamin D is needed for proper bone growth in children and general bone health in children and adults, but it appears that adolescents worldwide are vitamin D deficient, and that current recommendations for daily D may not be enough for health and disease prevention. The good news: a recent study finds that giving teens higher amounts of vitamin D can raise them to healthy levels after one year of treatment.

The value of the “sunshine vitamin”

Vitamin D deficiency may lead to abnormal bone growth and development and to the development of chronic diseases in adulthood such as osteoporosis, cancer, and multiple sclerosis, and research suggests that the recommended daily intake of 200 IU of vitamin D may not be enough to prevent deficiency. The authors of this new long-term study suggest that a vitamin D blood level of 30 ng/ml (measured as 25-hydroxyvitamin D) is desirable based on expert recommendations, but many people have much lower levels. They tested a higher dose of vitamin D to see if it was safe for teens and effective in raising vitamin D levels.

In the study, 340 students, ages 10 to 17, were randomly assigned to take low-dose vitamin D3 (1,400 IU per week), high-dose vitamin D3 (14,000 IU per week), or placebo. After one year of treatment, adolescents who received the high-dose vitamin D had significantly higher blood levels (average, 38 ng/ml of 25-hydroxyvitamin D) compared with the levels in the low-dose vitamin D (17 ng/ml) and placebo groups (16 ng/ml).

The authors claim that vitamin D deficiency “is prevalent in children and adolescents worldwide.” They add that the high worldwide prevalence of vitamin D deficiency, the fact that many adult diseases begin in childhood because of vitamin deficiencies, and increasing evidence for the safety of higher doses of vitamin D should prompt a change in the current recommendations for an adequate daily amount. More research is needed to determine the safety of taking higher daily doses of vitamin D and to determine optimal levels for health and disease prevention.

Get your daily D

A person gets vitamin D several ways:

• Modest sun exposure (approximately 20 minutes per day)—people who get very little sun exposure, such as those who live in cloudy climates and at northern latitudes, may need to rely on diet and supplements to achieve adequate vitamin D levels

• Supplements such as vitamin D3 and cod liver oil—1 teaspoon of some brands provides 400 IU of natural vitamin D

• Some foods and beverages—fortified milk and cereal, fatty fish such as salmon and mackerel, and, to a lesser extent, eggs, beef, some cheeses, and other foods

According to the American Academy of Dermatology, most people get the current recommended amounts of vitamin D through incidental sun exposure. They recommend using sunscreen when outdoors in the sun and obtaining needed amounts of vitamin D through foods and supplementation. However, for those not likely to take supplements or deliberately get enough D in the diet, it is important to weigh the risks and benefits of sun exposure against your risks for bone disease and other health issues. Talk to your doctor about your vitamin D needs and what combination of sources might be best for you.

(J Clin Endocrin Metab 2008:doi:10.1210/jc.2007-2530)

Healthnotes Newswire (July 3, 2008)—Reishi, shitake, and maitake are among the mushrooms long known to contain medicinal properties that help with health and healing, but the Journal of the Science of Food and Agriculture reports that a mushroom doesn’t need to be exotic to pack a healthy punch. It turns out that common white button mushrooms are rich in antioxidants, making them a wise choice for healthy eating.

Whitecoats study white button mushrooms

In the study, extracts from two wild strains and one cultivated strain of button mushrooms (Agaricus bisporus) were tested for their antioxidant activity. The cultivated strain had the highest, quenching more free radicals than either of the wild strains. In all of the mushrooms, the gills had stronger antioxidant effects than the stems and caps.

Some extracts were tested in the lab for their effects on replenishing glutathione, a molecule sometimes referred to as the body’s “master antioxidant.” All of the mushrooms were strong promoters of restoring glutathione to its beneficial active form. Other tests demonstrated their ability to preserve other important antioxidant enzymes.

Eating your favorite fungus may have health benefits

Button mushrooms are the most commonly eaten mushrooms in the United States. Preliminary studies have found that these mushrooms can stimulate the immune system and block cancer growth in test tubes. Several recent studies have linked eating high amounts of button mushrooms with lower risk of breast and stomach cancers.

The degree of antioxidant activity measured in the white button mushroom extracts was similar to that seen in extracts of other Asian mushrooms that have historically been used as food and medicine, such as himematsutake, basket stinkhorn, maitake, lion’s mane, white matsutake, and poplar fieldcap. Studies of these mushrooms and two other well-known medicinal mushrooms, reishi and shitake, suggest that they have immune-enhancing and anticancer properties.

Research shows that dietary antioxidants are important nutrients for preventing chronic diseases including heart disease and cancer. Eating lots of colorful fruits and vegetables is the best way to support a healthy immune system and prevent cancer, and adding more white button mushrooms to your meals may be one easy way to do so.

“The results presented here indicate that the premier cultivated mushroom, the white button mushroom, might be an important source of dietary antioxidants that could have protective effects in the body,” said Dr. Jean–Michel Savoie of the French National Institute for Agricultural Research, Laboratory Mycology and Food Safety in Bordeaux, France. “This common mushroom could be included in the growing group of mushrooms that have demonstrated excellent antioxidant activity.”

(J Sci Food Agric 2008;88:970–5)

Healthnotes Newswire (July 3, 2008)—Eating less and exercising more leads to weight loss. But does it matter which diet you follow? A new study suggests that it does: researchers found that a low-fat diet might be more effective than a low-carbohydrate diet at preventing cardiovascular disease in the long term, as it has better effects on the blood vessels.

Atkins vs. the American Heart Association

The study, published in Hypertension, included 20 obese but otherwise healthy adults who were assigned to eat either a low-fat diet or a low-carb diet for six weeks. The low-fat diet was based on the American Heart Association’s diet, which limits calories from fat to 30% of total calories. The low-carb diet was based on the Atkins diet in which only 20 grams of carbs (approximately the amount in one medium apple or two slices of whole-wheat bread) are allowed each day. The diets were designed to provide the same number of calories.

At the end of the study, people in both groups had lost about ten pounds, and blood pressures had decreased, though they were normal throughout the study. Vascular ultrasound showed that blood vessels dilated more readily in response to increases in blood flow after six weeks on the low-fat diet, indicating improved vascular health. In the low-carb group, this measure of blood vessel health had worsened.

Low-Fat Best for Heart Health, but Low-Carb Can Still Help

The low-carb diet was not without benefits, however. Fasting insulin levels decreased in this group, indicating that their insulin sensitivity and ability to control blood sugar had improved. This suggests that the relative benefits of the two diets might be different in people with diabetes. In addition, triglyceride levels, which are associated with heart disease risk, fell in the people consuming the low-carb diet.

Weight loss can help lower the risk of high blood pressure and hardened arteries (atherosclerosis) and their associated conditions: stroke and heart attack. People with obesity will benefit from losing weight, and a low-fat diet might be healthiest for their blood vessels. In addition, quitting smoking, exercising, and reducing stress can all contribute to a lower risk of cardiovascular disease and a healthier life.

Obesity is a major risk factor for cardiovascular disease, the number one cause of disability and death in the developed world. In response to rising obesity rates, weight-loss diets and fads continue to rotate through awareness and popularity. An estimated 45% of women and 30% of men in the United States diet to lose weight, but their choice of diets—and their results—vary widely.

“The composition of diet may be as important as the degree of weight loss in determining the effect of dietary interventions on dietary health,” said the study’s authors in their conclusion. “Low-fat diets may confer greater cardiovascular protection than low-carbohydrate diets.”

More information about the American Heart Association’s low-fat diet recommendations can be found at www.americanheart.org.

(Hypertension 2008;51:376–82)

Healthnotes Newswire (June 26, 2008)—As most people know, a recent salmonella food poisoning scare was traced to raw tomatoes, leading to national attention on tomato sources and causing many people and food purveyors to temporarily abandon all fresh tomato products. Fortunately, the scope of the outbreak has been identified, and now tomatoes from regions other than some parts of Florida and Mexico have been ruled safe, as have cherry tomatoes, grape tomatoes, tomatoes still attached to the vine from any area, and processed tomato products.

Attack of the tomatoes

The US Food and Drug Administration tracked the source of the 550-plus cases of food poisoning that have been reported since April to contaminated raw red plum, red Roma, round red tomatoes, and certain products containing these tomatoes. Though the FDA has narrowed the source of the outbreak to locations in Florida or Mexico, they are not certain of the exact source and point out that tomatoes grown in some regions in Florida and Mexico are also safe to eat.

It should give consumers confidence that all types of tomatoes grown in most states have not been associated with the outbreak (for the FDA’s list, visit www.fda.gov/oc/opacom/hottopics/tomatoes.html). If you are not sure about the source of your tomatoes or fresh tomato products such as salsa, check with the retailer or product manufacturer. The FDA warns that tomatoes from unknown sources should not be eaten.

What you should know about salmonella

Salmonella can thrive in raw food that is not kept to minimum cold storage and cooking temperatures (see FDA’s recommendations at www.fsis.usda.gov/FactSheets/Salmonella_Questions_&_Answers). Cooking to proper heat (145°F) will kill most salmonella, so concerns are primarily about raw or undercooked foods. Small amounts of bacteria are known to cause many cases of salmonella poisoning, most of which go unreported because the cases are mild and resolve without medical intervention.

A person can develop salmonella food poisoning from eating or drinking something contaminated with the bacteria or being in close contact with a contaminated human or animal. Salmonella may pass from an animal’s intestinal tract to its feces, ultimately ending up in soil where it may contaminate food. Infected humans may also spread salmonella to each other and contaminate food through improper hygiene. Raw meat, poultry, eggs, milk, and vegetables are food sources that have been known to become contaminated with salmonella.

Infection with salmonella may occur within hours or a couple of days after being exposed to the bacteria. Symptoms may include diarrhea, abdominal cramping, nausea, fever, muscle aches, headache, and others. If these symptoms develop, see a doctor. Most people improve without antibiotic treatment but if the condition spreads outside of the intestinal tract and becomes systemic they may need antibiotic treatment.

To help prevent the salmonella poisoning, remember the following:

• Wash hands before and after preparing food, and before eating.

• If you suspect you are infected with salmonella, do not prepare and serve food.

• Fully cook meat, poultry, and eggs.

• Buy food, including milk and vegetables, from reputable and high-quality sources where safe food-handling and hygiene are practiced.

• If you hear about new outbreaks, check with sources such as the FDA so you can make health decisions based on the best available information rather than hearsay.

“Tomatoes are an important part of the diet and are rich in antioxidants such as vitamins A and C, and lycopene, which have been linked to cancer prevention and other important health effects,” James Gerber, MS, DC, who teaches nutrition in several institutions of higher learning. So, take this opportunity to check your family’s food-handling practices and follow the FDA’s recommendations, but don’t stop eating tomatoes.

(Salmonellosis Outbreak in Certain Types of Tomatoes US Food and Drug Administration www.fda.gov/oc/opacom/hottopics/tomatoes.html)