Posted in Employment, food, Health

Employers: How to Help Improve Your Employees’ Health

Image above from


While the future of employer based health insurance remains uncertain, one certainty that remains is employers need healthy employees.

Your staff is the backbone of the organization, hence nurturing and facilitating good health practices not only ensures their stability and health but also that of your company/business.

Here are a few ways to accomplish this:

Offer the Flu Shot

According to the CDC, 20% of Americans get the flu each year, costing businesses $87 billion dollars a year.  The cost of supplying the flu shot pales in comparison to 1/5 of your workforce calling out sick during your busy season.  Supplying a one day flu shot clinic is not only economical but life saving as the flu can be deadly.



Provide Adequate Sick Leave

Sick leave varies per company and critics of extended sick leave are concerned with abuse of the paid days given.  Some employees may use up their sick leave for personal time and then when cough and cold season comes around, they are forced to go to work sick or face unpaid leave.  This exposes other workers to illness leaving more posts vacant when those employees need to take leave.  Understandably, it’s a controversial subject as a small employer would have to staff double to ensure adequate coverage of a position if one calls out sick. The more sick leave, the potentially higher the cost.

However a few modifications may help both employer and employee.

a.  Begin the Sick-Leave Cycle during Flu Season.  Rather than Leave Periods renewing every July 1, start the new Leave Cycle November 1.  This helps increase the chance that the employee would have their sick days untouched during a very common time of year when it needs to be used.

b.  Make sure adequate hours are offered for both sick leave and personal leave.  A cold, respiratory infection, stomach ailment, etc. can easily burn through 5 sick days.  An employee taking off one or two days could still be contagious days 3-5 or more.  Adequate sick leave prevents one from returning to work too soon.

c.  Offer a means to earn extra days of leave.  If an employee wants to re-earn sick leave/personal hours for later in the year, offer incentives or work projects that allow employees to gain extra days.

d.  Institute an “hours bank”.  If an employee has used all of his/her personal, vacation and sick leave, they can borrow from an “hours bank”.  The “hours bank” could include hours donated by other employees, hours won during office contests, or simply a bank that exists that will award an employee additional time with the understanding that they will have to replenish the hours in the bank at a later date.  This will allow an immediate need for sick time to be gratified but prevent abuse as it is understood to be a “loan” of hours.

Promote Prevention/Offer Screening Services

Encouraging employees to get preventative screens may help prevent serious illness. These screens can be done at their primary care provider’s office or the employer can bring the screening in-house.

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

life line

Encourage Getting Up and Moving Around

Before the end of each hour, a “stand up and move around” alarm should go off and allow 5-10 minutes of physical activity. Not only is this beneficial for health but helps prevent burnout in the work place.

Offer Heathy Snacks

Swap the sugary carbs in the snack machine with healthy juices, snacks, and bottled water.  Encourage potlucks or contests where employees bring in their most creative healthy snacks.


Image above from HealthyFamily


Have Plenty of Sinks and Hand Sanitizing Stations

An individual’s workplace can get very dirty as studies have shown computer keyboards to hold more pathogens than a toilet seat.  Offering cleansing wipes, wall sinks and sanitizing stations will improve employee hygiene.


Offer Workstation Modifications

Many employees may suffer from low back pain, arthritis, hemorrhoids, and a variety of conditions that may worsen when one sits all day at a computer.  Offering chair modifications, for example, could decrease their need to call out and help improve their comfort and therefore efficiency.



A well implemented program for workplace and employee health is a necessity for all organizations, and as you will come to see, cost saving in the long run.




                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Childhood Obesity is Exploding – Why and How to Stop It

Image above from the Huffington Post


The World Health Organization (WHO) finds the number of obese children in the world to be 10 times greater than what it was 4 decades ago.

They estimate currently 50 million girls and 74 million boys are obese worldwide.

Back in 1975 only 11 million children world-wide were obese. Now the number sits at 124 million.

True, population has grown since then, but the percentage of children obese is exploding.  19% of girls and 22.4% of boys in the US are considered obese.

Adult obesity is skyrocketing as well.  In 1975 there were 100 million obese adults worldwide. This jumped to 671 million in 2016 and doesn’t include the 1.3 billion “overweight” adults.

The Center for Disease Control and Prevention (CDC) states the following:

Obesity is defined as having excess body fat. Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Body mass index, or BMI, is a widely used screening tool for measuring both overweight and obesity. BMI percentile is preferred for measuring children and young adults (ages 2–20) because it takes into account that they are still growing, and growing at different rates depending on their age and sex. Health professionals use growth charts to see whether a child’s weight falls into a healthy range for the child’s height, age, and sex.

  • Children with a BMI at or above the 85th percentile and less than the 95th percentile are considered overweight.
  • Children at or above the 95th percentile have obesity.


Why such a rise in obesity?


  1.  We’re successfully fighting the war on tobacco.  Adults especially can’t turn to a stick of nicotine as easily as they once could to curb their appetite.  Teen smoking is down as well, so their appetites may be up.
  2. We like fast food.  Its cheap, yummy and convenient.  For 99 cents you can get a small burger that is served to you in a matter of minutes and can be eaten before your next meeting or class.  Fast food contains excess calories, fat and preservatives that our body doesn’t need.
  3. We eat too quickly.  The speed at which we eat may affect our metabolism.  Eating too quickly prevents a satiety signal from reaching the brain, hence we will gulp down more food than is needed.  For more on this read here.
  4. We don’t move around as much.  We can all agree that children and adults these days don’t play outside as much as we did in previous generations.  And even if we did get some exercise in each day during PE or at the gym, we lose much of the ground gained when we sit on our computers at night for hours on end.
  5. More hormones are in our food.  Hormones such as steroids and recombinant bovine growth hormone (rBGH) that enhance food production in our food-producing animals may affect our metabolism.
  6. Sugar isn’t a treat anymore, it’s considered a food group.  In the 70’s if you got dessert one night at dinner it would be a rare treat.  Today kids have dessert at lunch and even breakfast has sugar levels overflowething the cereal bowl.  Excess sugar leads to fat storage.
  7. Our portions have gotten bigger.  Remember when the Quarter Pounder came out in the early 70’s and we thought it was the biggest burger ever?  Now people will eat two in one sitting.

Below is a table showing the difference in portion sizes today vs. the 1950’s.

portion sizes.jpg
Image from Daily Mail


What can we do to combat the obesity epidemic?


  1.  Make exercise not a choice but a daily necessity.  Schools should have English class conducted on walks around the school rather than sitting in desks.  A 30 minute workout should be a given every morning without excuses.  We brush our teeth, we wash our hair, we gas up our truck, we exercise.
  2. Eat fresh, avoid fast food.  The more junk food the more junk in your trunk.  Avoid preservatives and processed foods. Your body was designed to eat the basics.  Give it what it needs.
  3. Eat slowly.  No need to chow down on the run.  If you’re in a hurry then eat half the sandwich as save the rest for later.  Which brings us to…
  4. Eat smaller portions. Get rid of the platters you call plates these days and eat your dinner off of a saucer dish.  You’ll still fill up your tummy.
  5. Swap vegetables for carbs.  Its healthier, filling, and helps you poop.
  6. Just say NO to sugar.  This will be a hard one for me but if you do it, I will.


Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

life line


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Acid-Reflux Drugs Found to Increase Liver Disease Risk

A study out of the University of San Diego, California found Proton Pump Inhibitors such as Prilosec, Prevacid and Nexium change the gut microbiome.  The overgrowth of the new bacteria can lead to liver inflammation.

As opposed to being forms of calcium carbonate, such as acid neutralizers such as Tums, or H2 (Histamine H2 Antagonist) blockers such as Pepcid and Zantac, the PPI’s reduce stomach acid production from the start.  They’re popularity has been skyrocketing over the last two decades and have become a mainstay treatment for multiple gastrointestinal issues including ulcers.

Stomach acid pH averages around 2-2.5.  Any minor change to this could allow downstream bacteria in the intestine to change its growth patterns.  If the liver is not accustomed to the new growth, it may “stress”.  Stress leads to inflammation and cell death.  Moreover, if the bacteria travel to the liver, it could cause inflammation as well.

In this study mouse models were used to see what would happen to their livers if they were given alcohol, a proton pump inhibitor, or genetically engineered to not produce enough stomach acid.  Researchers found Enterococcus faecalis bacteria to grow, exacerbating alcoholic liver disease.

When they colonized new mice subjects with E. faecalis, the rodents developed steatosis, or fat deposits within the liver consistent with liver disease.

They then reviewed medical records of 4,400 chronic alcohol drinkers and evaluated their liver disease risk based on their past PPI use. Those who used PPIs actively raised their risk of liver disease by 20%. Those who didn’t only raised their risk by 12.4%.

In 2015 McDonald et al found PPI use to increase risk of recurrent Clostridium difficile infection.

In 2011, Fohl et all found an increased risk of community acquired pneumonia in those taking PPIs.

PPI’s liked to stroke

In a Danish study, researchers reviewed the records of 245,000 patients who were suffering from abdominal pain and reflux, and found 9,500 to later suffer from stroke. After adjusting out for other causes of heart disease and stroke they concluded that the Proton Pump Inhibitors increased these patients’ risk of ischemic stroke by 21%.   It varied depending on the brand with Prevacid and Prilosec increasing stroke risk by 33%, Nexium by 50% and Protonix, 79%. They note that these were high doses of PPIs as low doses appeared NOT to increase risk of stroke.


Researchers do not know why this class of drugs increases stroke risk. They theorize it may have something to do with altering gut bacteria, or prevention of vital nutrients being broken down to become absorbed since stomach acid levels are decreased.

Foods that cause reflux

Gastroesophageal reflux disease can be caused by foods difficult to digest like processed foods, sugars, and those with refined carbohydrates.



Foods that help relieve acid reflux

They following may help relieve acid reflux symptoms:




Aloe vera





Lean turkey and chicken


Here’s another chart that shows foods that may help or trigger reflux:

reflux foods

Elevating the bed 45 degrees at night helps reduce reflux symptoms.

Avoiding drinking lots of water before sleep helps as well.

Eating smaller meals and avoiding a large dinner at bedtime will decrease acid reflux.

So why take medication at all?

Those suffering from GERD can be prone to esophageal cancer if the stomach acid bombarding the lower esophagus fails to be subdued.  Acid reflux can also cause chronic sore throat and chronic cough.  For these reasons, PPIs will still be recommended for severe reflux cases, but maybe lower doses and combinations with other drugs and lifestyle changes should be started first.


Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

life line


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

Posted in food, Health, news

Can Coffee Cause Cancer?

For years we’ve been told drinking coffee wards off cancer but this week the topic of cancer-causing chemicals in a cup of joe is giving people the jitters.

A legal battle in Los Angeles may result in coffee donning cancer-warning labels due to its acrylamide content.

The Council for Education and Research on Toxics wants coffee manufacturers, distributors and retailers to post warnings regarding the acrylamide content.

The Safe Drinking Water and Toxic Enforcement Act, passed in 1986, requires businesses that expose individuals to toxic chemicals in the course of doing business to first give warnings to such individuals.

If they do not, they can be open to liability.

What is acrylamide?

Acrylamide is a chemical used in many industrial products that produce plastics, adhesives, food packaging and the treatment of drinking water.  It can also be produced when foods are heated, fried, baked, or roasted to above 120 degrees Celsius (248 degrees Fahrenheit).  In 2002 reports came out regarding acrylamide in french fries, and in 2013 the FDA issued guidance to the food industry on how to minimize producing the chemical.

Roasting coffee requires the beans to be heated to close to 450 degrees Fahrenheit.  This heat produces a chemical reaction between the amino acid asparagine and sugars resulting in the formation of acrylamide.

The amounts however are miniscule.  Much smaller than other modes of acrylamide exposure such as cigarette smoking and exposure at work when working in industries that use acrylamide such as plastics, food processing, mining, paper, agriculture and construction.

What can acrylamide do?

In rodents, acrylamide was found to increase several types of cancer. But the doses were 1,000-10,000 times greater than what the average human is exposed to.

According to the American Cancer Society, most of the studies done so far have not found an increased risk of cancer in humans. For some types of cancer, such as kidney, ovarian and endometrial cancer, the results have been mixed, but there are currently no cancer types for which there is clearly an increased risk related to acrylamide intake.

How do I decrease exposure?

As noted earlier, acrylamide can be in a variety of products we use throughout the day.  Large quantities, however, can be consumed through cigarette smoke, hence avoiding smoking is key.  Moreover, avoiding frying foods, especially starches, greater than 120 degrees Celsius/248 degrees Fahrenheit if possible.  Frying and or toasting to a light gold, rather than crispy dark brown color, may limit your exposure as well.



But keep in mind, numerous studies have found coffee drinkers to lower their risk of cancer, especially liver, uterine, prostate and mouth cancer.  However 4-6 cups had to be consumed in order for researchers to notice a benefit.

More research still needs to be done.  So while we wait for the verdict lets kick back with a cup of … chocolate?



Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician


Posted in food, Health, news

Can Cough and Cold Medicine Make you a Killer?

A North Carolina man killed his wife in her sleep, claiming his cough medicine induced his psychosis.  28 year old Matthew Phelps found his newlywed wife, Lauren Ashley-Nicole Phelps, dead with multiple stab wounds Friday evening. He called 911 and has been held at Wake County Jail without bail.

He stated, “I took more medicine than I should have. I took Coricidin Cough and Cold because I know it can make you feel good and sometimes I can’t sleep at night,” Daily Mail reports.

Can Cough and Cold Medicine Induce Psychosis?

Yes, but if taken in large quantities.  A case in 2005 reported by Sharma et al in Annals of pharmacotherapy reported a case in which a 35 year old woman began hearing auditory hallucinations after ingesting large quantities of Nyquil days prior to admission.

In 2013, Aytha et al reported another case of a 40 year old male thrust into an acute psychosis after ingesting CoricidinHBP, however, he ingested 30 tablets and had a history of prior drug use.

Other cases have been described with the cold medications dextromethorphan, pseudoephedrine and phenylpropanolamine.

Some authors suggest it could be the high quantities ingested and the behavior of abuse that puts one at risk of psychosis.

Another theory is some may have undiagnosed mental illness that becomes very apparent once stimulants are taken, such as those in cough and cold medications.

These medications can constrict blood vessels and raise blood pressure as well.

This is a developing story.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Harvey Flooding Brings Major Health Risks

After the initial flooding and torrential downpour subside, Hurricane Harvey will put thousands of residents at risk for major health issues.

In addition to drowning, falls and other deadly injuries, victims of Harvey may endure the following:


Many of those who did prepare for the storm may not have stored plenty of food, especially healthy fresh food.  Those trapped in their homes may find the food they did store contaminated by flood water.

Greater Baton Rouge Food Bank 2016


Infectious disease

The World Health Organization states that floods bring water borne diseases such as cholera, typhoid fever, leptospirosis and Hepatitis A.  Vector borne diseases include Zika, malaria, dengue hemorrhagic fever, yellow fever, and West Nile.


Mosquitos initially get washed away during the storm, but the resulting puddles of water take weeks to dry and make ideal breeding grounds for insects.

The water gets dirty pretty quickly.  People touching the flood water need to wash their hands thoroughly before eating or preparing food.

Moreover due to the moisture that seeped into walls and floors of houses, mold can grow and cause a variety of respiratory issues among other physical ailments.  Massive disinfecting needs to take place before coming home to flood water contaminated residencies.


Chemical exposure

Chemicals from garages and fuel seeping into flood water expose victims to many compounds such as benzene, toluene and xylene that can cause a multitude of health effects including those that affect breathing, skin, the gut, balance, thought, and memory.


A Cajun Navy rescuer told CNN that looters fired shots at him and his comrades, trying to take their rescue boat, which had actually broken down.  Panic fuels dangerous behavior and those without resources may try to take from those who prepared.

Sexual assault crimes can rise as predators find the chaos and lack of video surveillance ideal conditions to find victims who can’t yell for help.


When one loses their home, neighborhood, income, treasured belongings and more, its devastating.  Post traumatic stress disorder may ensue.

To combat these risks, medical personnel and the CDC are preparing.  Among food, shelter and clothes, paper products, sanitizer, cleaning supplies, tetanus vaccinations and counselors will be needed is mass quantities.

How can we help?

Blood supplies will be needed as residents who routinely donate have evacuated the area. Donating blood at your local blood bank may be shipped to the area in need.

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

The American Red Cross is accepting donations. On their website, they ask to visit, call 1-800-RED CROSS or text the word REDCROSS to 90999 to make a $10 donation.

The Salvation Army is also accepting donations online and by calling 1-800-SAL-ARMY (725-2769).

The Red Cross and Salvation Army may also need local volunteers to help set up shelters.  Contact the above numbers.

Local volunteers are asked to donate supplies to nearby recreation centers housing evacuees.

Supply drives in out-of-state locations may not be accepted directly but could help local charities who need to ship supplies to the affected area.


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician


Posted in food, Health, news

Hepatitis A Kills 14 in San Diego

A southern California city is reporting the “deadliest outbreak” of Hepatitis A that the US has seen in decades.

264 people have been hospitalized and 14 dead since the outbreak of the virus began in November of 2016.

70% of the cases were homeless individuals, lacking good sanitation and immunocompromised due to their lack of nutrition and possible drug/alcohol use.  9 people have died within the last 6 weeks.

What is Hepatitis A?

Hepatitis A is a disease that affects the liver.  Its caused by a virus (Hepatitis A virus) that is most commonly ingested. Poor hand washing and/or contaminated food are likely culprits.  Its transmitted by the fecal-oral route, where food or drink contaminated by fecal matter enters another person’s GI tract.  Sexual transmission of Hepatitis A has been reported during activities involving oral-anal sex.

Hepatitis A can live outside the body for months, so unclean dining areas can be contaminated and transfer to food.

Those who are immunosuppressed run the risk of dying from the infection.


What are the symptoms of Hepatitis A?

Symptoms of Hepatitis A include:

Jaundice – yellowing of the skin and eyes


Abdominal Pain


Dark Urine

Joint Pain

Clay – looking stools




Loss of appetite



What is the treatment for Hepatitis A?

There is no specific treatment for hepatitis A.  Most hepatitis A infections resolve on their own.

We usually recommend rest, fluids, and offer medications to help with nausea and vomiting.

For liver injury we avoid medications and alcohol that can worsen liver damage. The liver will usually recover within months after hepatitis A infection.


There are vaccines for Hepatitis A included in the childhood vaccination schedule.  Those older who weren’t vaccinated as a child can get the vaccine from their local provider or health department.  Many states require all health care and food workers to be vaccinated.

The best form of prevention however is good hand washing, dining area hygiene, and cooking food thoroughly.


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician