By Dr. Elizabeth Bird

I am a Chester mom of 3, a longtime e-list subscriber and a pediatrician. After 16 years caring for children and adolescents in a large academic setting, I recently opened my own pediatric micro-practice in a cozy space in downtown Chester.

What is a micro-practice? Picture an old-fashioned, Norman Rockwell-style doctor’s office powered by technology. Unlike a production-based practice where physicians are expected to see patients every 10-15 minutes, I limit my staffing and overhead so that I can see less patients and spend more time with each one. I use online booking, texting and a secure portal to communicate with my patients. I check vital signs myself (and have found I can learn a great deal about my patients in the process). I take most insurance, including Medicaid. And Yes– this doctor makes house calls.

Winterizing your Family: Integrative, Evidence-Based Tips to Stay Healthy During Cold and Flu Season

Why do some people never get sick, while others seem to spend all winter sniffling and sneezing? The answer probably lies somewhere in our immune systems, diets, stress levels and dumb luck—the sort of thing that is hard to study scientifically. So while the scientific evidence to back my recommendations is somewhat limited, the following are some tried and true strategies that I’ve developed over the years to help my patients and their families stay healthy. The following are suggestions for how to not get sick in the first place. The topic of how to quickly get better if do you get a winter virus will be the subject of another article.

First and foremost, it is important to know how to avoid viral exposures

• Don’t touch your face. Viruses love to cling to the surfaces you touch and then enter your body through your mouth, nose, and eyes. One study demonstrated that the average person in a public place touches their face and common, germy objects an average of 3-4 times per hour.
• Clean your supermarket cart handle before you go touching all of your food with the same hands that touch the handle.
• Wash your hands frequently.
• Balance all of this cleanliness by eating a little dirt now and again. Don’t be overzealous about washing organic fruits and veggies. Let your kids play in the mud and then hug you. Go play in the mud yourself: do some yard work. There is evidence that if the immune system does not have some germs to react to, especially early in life, that it can turn on itself with allergies and autoimmune conditions.

Since we can’t live in a bubble, the following are some healthy practices to make your immune system more capable of disarming viruses if you do get exposed to them, before they get you sick.

• Exercise moderately and regularly. Those who do, are less likely to get sick and when they do get sick are more likely to recover quickly.
• Squirt some saline up your nose. During the winter months, I routinely use a nasal spray called xlear, which contains xylitol, grapefruit seed extract and saline. The saline will, at the very least, dilute the microbes I to which am exposed and make them less likely to latch on to my nasal passages. There is some evidence that xylitol and grapefruit seed extract have antimicrobial and anti-inflammatory effects and its use has been linked to decreased ear infections in children.
• Make sure you are getting enough zinc. Poultry, red meats and legumes are good dietary sources. While zinc appears to be most effective at shortening the duration of a cold, it may have some benefit in also preventing colds. Be judicious with zinc lozenges—if you are adult sized, you don’t want to take more than 40mg of zinc daily. The number is less for children.
• Make sure you are getting enough vitamin D3. There is decent evidence that vitamin D3 supplementation can help reduce the frequency and severity of viral illnesses. It can be hard to get enough D3 through diet alone, so this is one that I recommend talking to your doctor about supplementing. There is good evidence that vitamin D3 supplementation can help reduce the frequency and severity of viral illnesses.

Make the supermarket your pharmacy and eat a balanced, nutrient-rich, low inflammation diet. Your immune system seems to do best without big dips or spikes in your blood sugar. A good general rule of thumb is to limit/eliminate processed foods and stick with whole foods whose ingredients you can pronounce. These are a couple of websites I like to turn to for healthy recipes: https://www.creativehealthyfamily.com
https://minimalistbaker.com/
https://www.loveandlemons.com

• Elderberry syrup has been shown in some studies to help shorten the duration of viruses, and its regular use may help prevent viral illnesses. I sometimes recommend it daily during the winter in kids who seem to get back-to-back viral illnesses. Be sure to use a honey-free version if using it in children under a year and talk to your pediatrician about age and weight-based dosages
• Incorporate garlic into your diet. In addition to helping to ward off viral and bacterial infections, it also has beneficial effects on cardiovascular health.
• Make sure you are getting enough sleep. A study that actually put drops containing rhinovirus (the common cold) into the noses of healthy volunteers found that those who were sleeping less than 7 hrs a night had a greater likelihood of coming down with cold symptoms.
• Manage your stress. Cortisol hampers your immune system. While you may not be able to change your stressful lifestyle/situation, you can manage your stress response. I like the mindfulness app that you can download onto your smartphone https://itunes.apple.com/us/app/the-mindfulness-app/id417071430, and there are countless, simple breathing exercises you can practice throughout the day. I particularly like Andrew Weil’s 4-7-8 technique: https://www.cordem.org/globalassets/files/academic-assembly/2017-aa/handouts/day-three/biofeedback-exercises-for-stress-2—fernances-j.pdf
• Get a preservative-free flu vaccine. It helps your immune system fight the flu more effectively, even in years that it is not a perfect match for the virus. If you ever come down with the flu, you’ll appreciate any little bit of help getting rid of it. Is it without any risk? No, and neither is exercising. But I believe that the potential benefits outweigh the risks and it is not just you that you are protecting. You are also protecting those around you, such as newborns who not only cannot get immunized but are disproportionately vulnerable to poor outcomes from the flu.

I don’t believe there is just one magic bullet to staying healthy during cold and flu season. Much of what I have outlined is really is a concerted effort at adopting and maintaining healthy habits, many of which will benefit other aspects of your life and health.