Q: My doctor says my blood pressure is on the borderline of being too high. Is there something I can do to avoid taking blood pressure medicines?
A: If you have borderline or only mild hypertension, you may be able to keep your pressure normal without using medicines. The two most effective ways are controlling your weight and lowering the amount of soduim in your diet.
Overweight people can lower their blood pressure by losing weight, even without changing the amount of sodium they consume.
Sodium is found in many foods and ordinary table salt (sodium chloride). Most foods that taste salty have a lot of sodium in them, but there are many sodium-rich foods that we don't usually think of as being salty. Your doctor can give you a list of foods to avoid on a low-sodium diet.
Sodium restriction seems to lower blood pressure more in some people than others. I recommend giving it a try to see how it works for you.
Other dietary changes that may be helpful are increasing your intake of potassium- and calcium-rich foods and decreasing your intake of saturated fats. However, there are fewer studies that show these changes are effective.
Drinking a lot of alcohol can raise your blood pressure, so you may also want to cut back or stop drinking altogether.
Exercise probably doesn't change blood pressure in most people, but some have lowered their blood pressure slightly through exercise.
Relaxation techniques, such as meditation, yoga, biofeedback and muscle relaxation, have helped some people control their blood pressure.
If you're interested in trying any of these methods, I suggest talking it over with your physician first.
Q: I have a problem digesting milk and dairy products. Is there anything I can do about this?
A: Milk contains a sugar called lactose, which is digested in the intestines by an enzyme called lactase. From childhood on, the amount of lactase in the intestines decreases, and in some cases this leads to difficulty digesting lactose. Also, certain races tend to have less lactase, including American blacks, Africans, Orientals, Native Americans, Mexicans and people of Mediterranean origin.
Symptoms of lactose intolerance include stomach bloating, cramps, gassiness and diarrhea. Symptoms can be mild or severe, but most people with lactose intolerance can still drink some milk. You can learn to adjust the amount to avoid symptoms -- drinking one glass of milk, for example, instead of two.
Another approach is to add lactase to the diet. It is available in drugstores without a prescription. Two brands are Lactaid, a liquid that you add to milk, and Lactrase, a capsule that you take with food.
Four to 10 drops of Lactaid in a quart of milk will partially "digest" the milk sugar before you drink it. You can adjust the number of drops to suit your needs. The milk will taste slightly sweeter.
Lactrase capsules contain lactase crystals that can either be swallowed whole with milk-containing foods or opened and sprinkled on such foods as ice cream.
Yogurt is another way to get the good nutrition of milk while avoiding problems with lactose. The active cultures in yogurt contain the lactose-digesting enzyme.
Some fermented dairy foods, such as buttermilk and cottage cheese, have less milk sugar in them, and you may tolerate these better than regular milk.
If after trying these recommendations you are still troubled by lactose intolerance, you should carefully read food labels for their contents, since many foods are made with milk products. However, it would be unusual if you weren't helped at all by these measures. Since some intestinal diseases can mimic lactose intolerance, check with your doctor if you continue to have problems.
Q: Whenever I drink something cold I sneeze. My doctor says I might have a thermal allergy and should avoid cold foods. My wife makes fun of me and says it's all in my head. Is there such a thing as a thermal allergy and what can I do to get rid of it?
A: Sneezing induced by drinking cold liquids is rare and not an allergy in the true sense of the word. It is a response triggered when nerves in the mouth are stimulated by something cold. Cold and heat can have other effects on bodily response, causing hives in some people, for example.
Sneezing can be triggered by many stimuli, most commonly dust, allergenic particles such as pollen, and irritants such as pepper. In addition to local stimulation in the nose and mouth, other factors such as bright light, sexual excitement, chilling, menstruation and pregnancy may make a person sneeze. Through complex nerve connections, tickling of the ear canal can induce sneezing or coughing. And in rare cases, mental stress also has been associated with nasal swelling and sneezing.
Usually it is the initial, sudden change in temperature on first swallowing cold liquids that triggers the sneeze, which usually abates with continued drinking. To avoid sneezing, sip the first few swallows slowly, or drink beverages that aren't ice cold.