DEAR DR. ROACH: I have had several kidney stones and was advised to avoid oxalate. I was told that green, leafy vegetables and grains are high in oxalate. How can my diet be healthy if I avoid these healthy foods? — D.F.
ANSWER: Calcium oxalate is the most common type of kidney stone, so limiting dietary oxalate makes sense. However, increasing water intake, dietary calcium and potassium can help prevent kidney stones. It is paradoxical, but dietary calcium reduces kidney stone risk while calcium supplements increase kidney stone risk. Also, vitamin C increases kidney stone risk, so it’s not recommended to take supplemental vitamin C.
There are many places to find the oxalate content of food, starting with your dietician, but websites like www.lowoxalate.info and www.ohf.org have nice lists. There you can find many fruits and vegetables that have little or no oxalate, including broccoli, lettuce and cucumber. You do need to avoid spinach, beets and similar vegetables. As far as grains go, corn, rice and wild rice are good choices. * * *
DEAR DR. ROACH: For a young couple wanting a baby, is there any help available for a man with a low sperm count? — N.N.
ANSWER: Identifying the cause of a couple’s infertility is often difficult. In one large study, 20 percent of cases were attributed to male factors, and 38 percent to female. In 27 percent, there were reasons for infertility in both partners, and in 15 percent of cases no cause could be found. Clearly, both partners need to be evaluated.
Low sperm count isn’t a diagnosis; many separate systems can be affected, all leading to reduced sperm count. Abnormalities in hormonal function, mechanical obstruction and testicular disease all are possibilities. Although many causes of low sperm count are untreatable, not all are. For example, elevated prolactin levels from a tumor or medication can be treated, leading to improved fertility. Low sex-hormone levels can be replaced. Many men are advised to wear boxer shorts, as high temperatures affect fertility, but it’s not clear this is effective.
Assistive procedures, such as intrauterine insemination, in-vitro fertilization and intracytoplasmic sperm injection (a single spermatozoa injected into an egg) can be effective, but these procedures are always expensive, rarely covered by insurance, not 100 percent effective and have a small increased risk of birth defects. * * *
DEAR DR. ROACH: Is secondhand vapor (from the electronic cigarettes) harmful? — B.S.B.
ANSWER: While the evidence that secondhand smoke from regular cigarettes is harmful to people around smokers, causing increased risks of lung cancer and heart disease, the data just aren’t clear about the vapor from electronic cigarettes. It is known that the vapor contains nicotine and potentially cancer-causing chemicals, but the amounts are much lower than with regular cigarettes. These chemicals can be inhaled by nonsmokers if close enough and possibly absorbed through the skin.
Electronic cigarettes, also called vaporizers, may help people quit smoking. That’s the only use for them that I would recommend, after which they should be eliminated.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive Orlando, FL 32803.
Foods that are cooked together on the same skewer should heat quickly and take the same amount of time to cook. Foods with different cooking times, like vegetables and meat, should be grilled on separate skewers. Also, be sure to leave a little space between pieces on the skewer so the food cooks evenly. If you like metal skewers, buy twisted or square ones, not round — the food will twirl on the skewers less and cook more evenly. If you’re using wooden or bamboo skewers, shape isn’t a factor. But soak them in water for at least 15 minutes before using so they don’t burn. Just pat dry before putting food on them.
Share Time, Words and Intention to Help Children Learn
Reading and talking to children, even infants and toddlers, is a good way to increase their language skills. Children begin learning very early in their lives. Infants and toddlers are busy analyzing their world. They’re figuring out how they are separate from everything they see. They’re beginning to identify objects and routines and who they can depend on for their everyday care. They also are beginning to understand that movements and sounds are used to communicate with others.
Oral language development begins with social interaction with others. Infants and toddlers learn language as we talk, from nursery rhymes, telling stores and singing songs. We can have two-way conversations with infants by imitating the sounds they make and taking turns ‘speaking’.
Make eye contact with the child, and use gestures and other nonverbal communication. Talk about what you are doing like a play-by-play sportscaster. Describe what you and others are doing, as well as daily routines.
Reading shows children that written words have meaning. It also promotes listening and speaking, which are part of oral language development. Reading to children introduces new words and helps them develop a larger, more complex vocabulary.
This is important because by the age of three, children should be learning at least 2,500 new words each year. Reading and talking about a variety of topics will help children understand more about their world.
Here are some tips for sharing books with infants and toddlers:
Read as long as the child is interested.
Talk or sing about the pictures.
Let the child turn the pages if he or she can.
Skipping pages is acceptable until the child knows the book better than you do.
Run your finger along the words as you read.
Use your voice to create interest in the characters.
Relate your own family or community to what is happening the story.
Let the child tell the story and have fun.
The gifts of presence, time, words, print and intention are important as we share language and literacy with infants and toddlers. Intention turns a routine activity into a pleasant play time that also is educational.
Resources Understanding children – Learning to read and write, PM 1529E Ages and Stages – PM 1530A–E Early Learning – Preschool & Kindergarten Ahead – PM 2081A Understanding Children Language Development – PM 1529F
• “If you are going on vacation, leave a plastic baggie filled with ice cubes in your freezer. When you return, if the baggie is filled with a single chunk of ice, you’ll know your power was interrupted long enough to spoil your food while you were away.” -- G.L. in Missouri
• Here’s another moving tip: Bundle clothing on hangers with a rubber band. Slip the whole lot into a trash bag. The items will be ready to hang in the new closet with hardly any fuss.
• Ants in your pet’s food bowl? Set cat or dog food bowls in a pie plate or other shallow dish filled with water. Ants and bugs can’t cross the water to get to the food, so it’s safe from pests.
• “Use charcoal in the bathroom to prevent humidity from turning into mildew. Put a few charcoal bricks into a small open container, like a bowl. Then just tuck it behind the toilet. It traps excess moisture. Use only plain charcoal, not the kind that has lighter fluid in it!” — W.K. in Ohio
• “If you have a magnetic closure on a kitchen cabinet that is too strong (you have to really pull the door to get it open), try this simple fix: Put a small piece of clear tape over the magnet. It reduces the magnet’s pull just enough that it doesn’t take as much effort. We did this at my grandma’s house when she got new kitchen cabinets, and she’s much happier now!” -- Y.L.S. in Alabama
• Have a terrific-smelling candle that’s burned down to bits? Scrape them out, and place in a small mason jar. Poke holes in the lid, and cap the jar. Then keep the jar in your car’s cup holder. When the car warms in the sun, it’ll smell wonderful, and there’s no need for a flame.
Send your tips to Now Here’s a Tip, 628 Virginia Drive, Orlando, FL 32803.
Summer activities are winding down for school children everywhere and they will soon return to the classroom. That means an increase in two and four-wheel traffic, increased pedestrians and of course school buses. The afternoon hours are particularly dangerous for pedestrians. Over the last decade nearly one in four pedestrian fatalities occurred between 3pm and 7pm.
When operating outside your normal area of travel pay particular attention to traffic signs. The pentagon shape with the point to the top warns us to watch for school areas and school crossings. These signs may be yellow in color or fluorescent yellow-green which makes them easier to see in low light or foggy or rainy weather. These signs may include a warning that a crossing area is ahead. Respond to these signs by reducing speed and watching for children.
School crossing signs are located at school crosswalks. Remember to obey crossing guard signals and watch for youngsters who may be distracted.
Here are several suggestions to help keep kids safe:
• Slow down. There is a reason speed limits in school zones are reduced.
• Stop completely at stop signs. Easier than it sounds, but one third of drivers roll through stop signs. Stopping completely allows you time to check carefully for children on sidewalks and in crosswalks before proceeding.
• Avoid distractions. Taking your eyes off the road increases your chance of crashing. Children can be quick, crossing the road unexpectedly or emerging suddenly between two parked cars.
• Avoid backing up if possible. All cars have blind spots. If you do need to back up check, recheck and back slowly.
• Watch for bicycles. Kids on bikes are often inexperienced, unsteady and unpredictable. Give plenty of room if you are passing a bicyclist.
If possible, plan your trips to avoid peak school traffic or areas where youngsters congregate. Remember to stay alert so we all reach our destinations safely.