Dr Leila Masson's Blog

Keeping Healthy in the Winter

Keeping Healthy in the Winter

The beginning of autumn is a good time to start thinking about winter-proofing your family’s health. Soon it will be the season of colds, viral infections, asthma exacerbations and the flu, but there are some practical steps you can take to reduce the risk of getting sick. Start by making sure that you and your children have optimal levels of vitamins and minerals needed for a strong immune system to fight all those winter nasties.

Here are 4 steps you can take to protect yourselves this winter.

1.  Eat a healthy diet, especially lots of vegetables and fruit – to get your vitamin C, antioxidants, and other immune-boosting nutrients. Try to eat all the colours of the rainbow every day, or at least most: some red beets, tomatoes or berries; orange kumara, carrots or pumpkin; yellow squash, lemon, corn or peppers; green spinach, kale, peas, beans or avocado; and blueberries, blue corn, eggplant or cabbage (HERE is a useful extensive list of vegetables by colour). 
Include immune enhancing vegetables, such as reishi and shitake mushrooms, which contain beta-glucans that help fight infections; also serve some berries every day, which are high in antioxidants and great for your health. I always keep a bag of organic berries in my freezer. And don’t forget to add your daily dose of spices and herbs, such as garlic, turmeric, ginger, oregano and cinnamon (which actually kill bad bacteria!).
Avoid sugar, as this suppresses the immune system (this, of course, applies to the summer as well, when we generally consume even more sugar from ice cream, lollies and fizzy drinks). If you have not taken your family to see “That Sugar Movie” yet, reserve seats right now or pre-order the DVD and prepare your own (colourful) popcorn at home. The first step in reducing sugar is to cut out all fizzy drinks (apart from mineral water) and lollies. These do not add anything positive to your diet and you can achieve the same “sweet happiness moments” from fruit, fruit smoothies, or a yummy mixture of nuts and dried fruits. It may take some getting used to, but you will do yourself and your family a favour by cutting down on sugar in your diet.
If you want to sweeten herbal tea use Manuka honey, which is well known for its immune boosting effects due to its “NPA” or non-peroxide activity. The higher the activity indicator (10+ for example), the stronger the honey is at killing bacteria and viruses.

2. Get your sunshine vitamin D level to optimal: 
The optimal level is around 120nmol/L. A level below 80 nmol/L is considered insufficient and below 50nmol/L is deficient. Given that most children in Australia and New Zealand are vitamin D deficient in the winter (below 50nmol/L), it is likely that your child’s vitamin D will be insufficient and that he or she will benefit from a vitamin D supplement (or a trip to Fiji). In the winter the sun is at an angle at which it is just too weak to produce vitamin D in our skin.
Vitamin D up-regulates cathelicidin, an antimicrobial protein, which is powerful at killing bacteria, fungi, and viruses. The lower the vitamin D level, the higher the risk of an asthma exacerbation, a viral infection, eczema, allergic reactions, as well as low moods, and of course – everyone knows that – vitamin D deficiency can cause soft bones or rickets. In Northern European countries children receive a daily dose of vitamin D from the government to boost their immune system and strengthen their bones. The recommended dose varies from country to country – about 400-1000 IU per day. You can get liquid vitamin D that contains the daily dose of 400IU or 1000 IU in just one drop. Vitamin D can also help to fight off the winter blues or SAD – seasonal affective disorder. Even if the sun is not strong enough to produce vitamin D in the winter, it is still very healthy to spend time playing outdoors every day - the longer the better. I am often asked how people used to cope before there were vitamin D supplements. Think about how we evolved: humans lived near the equator where there is equally strong sunshine year-round; where it is warmer, people wore fewer clothes and spent most of the time outdoors in the sunshine. Modern humans have a very different lifestyle: we have spread out to all corners of the globe, to countries far away from the equator, where we only get sufficient sun to produce vitamin D in the summer; we cover ourselves with clothes, and we spend most of our time indoors. This is why we are not getting enough vitamin D and why many countries have adopted public health policies recommending vitamin D supplements. Talk to your health professional about the appropriate dose for yourself and your children. Most studies show that a daily dose is better than intermittent high doses. There are some studies that show no benefit from vitamin D but the problem is usually an insufficient dose. Giving a person who is vitamin D deficient a tiny dose of vitamin D is not going to fix the problem. You need a dose that gets your blood level into that optimal range of 100-150nmol/L.

3. Think zinc and selenium: the soils in Australia and NZ are very low in zinc and selenium, which means that even if you eat an exemplary diet, you will not be getting enough zinc or selenium. This is especially true during growth spurts when your child needs extra amounts. If your child has white spots on his fingernails, this may be a sign of low zinc or selenium stores. Zinc is essential for the immune system, fighting infections, skin healing, brain function and mood. Children with a zinc deficiency can get more frequent infections, may be irritable and can struggle with learning and attention.  The RDI (recommended daily intake) for zinc varies by age from 3-14mg. You may need to take a bit more during times of high need, such as an infection or if you are deficient (for a few weeks until you have corrected the deficiency and have normal levels).  You can get zinc supplements as drops, capsules, tablets or even a transdermal gel for the very young. Selenium, a potent anti-oxidant, is vital for the immune system and the thyroid gland; it may also help to prevent certain cancers. You only need a tiny dose every day – which you can get from eating 3 Brazil nuts (or one Brazil nut for a child – of course, do not give nuts to children with nut allergies!) or a liquid supplement such as Clinicians Selenium drops. You can overdose on zinc and selenium, so keep these supplements away from children and stick to the dose recommended by your health professional.
4. Feed your gut flora: Probiotics. There has been an explosion of interest in the microbiome, the bacteria that live in and on us. It is clear that gut bacteria play an essential part in human health and even mood. Children who take a daily probiotic get sick less often compared to children who don’t take one.  You can get probiotics as powders or capsules or, even better, eat fermented foods that naturally contain probiotics: kefir, sauerkraut, kimchi, kombucha, tempeh, olives and pickles (yoghurt is not the best source, as it does not contains large amounts of probiotics and often contains sugar and additives).
If you take these 4 steps, you may all enjoy a healthier winter this year, free from nasty infections. If you still manage to contract something, you should get over the illness faster. If you or your child gets sick with a virus there is no need to artificially lower the fever. A high temperature is the body’s way of fighting an infection, of killing the virus or bacteria, which are making you sick. If you lower this artificially by giving medicines such as Pamol, you just end up being sick for longer. If your child has a very high-temperature*, take him or her to your doctor to rule out any serious infections.  If you are dealing with a cold or viral illness, supportive measures, including the 4 points above and extra vitamin C plus immune boosting herbs, such as elderberry, olive leaf extract, goldenseal or echinacea can get you back to optimal health quickly.
Feeling ready for winter? fill your fridge with healthy food and stock up on zinc, vitamin D and probiotics.
Caution: You can overdose on zinc, selenium and vitamin D, so talk to your health professional about what dose would be appropriate for you or your child and remember to take your child to a doctor if he or she gets very sick, has a high fever or you are concerned about their health.  
*Infants under 3 months should be assessed for a temperature of 38 Celsius or higher. Infants between 3-6 months should be taken to the doctor or hospital for a temperature of 38.3 or higher. Babies 6-12 months should be assessed by a doctor for a temperature of 39.4C. For older children, the American Academy of Pediatrics recommends seeing a doctor if the temperature is above 40C. In older children, the height of the fever does not matter as much as how sick your child looks and acts: If your child is playful, eating and not overly bothered by the fever, then he or she is probably not gravely ill.  If your child is lethargic, refuses to eat, struggles to breathe, is in pain, or has a rash you should see a doctor.

Dr Leila Masson

Sydney based paediatrician specialised in nutritional and environmental medicine. Author of the handy 'Children's Health A to Z' guide for parents. Dr Masson lectures internationally on children's health.

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