health

What Are Viruses, and How Do They Work?

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | April 6th, 2020

Dear Doctor: Everybody is talking about the coronavirus right now, but I still don’t really know what a virus is. How do they work? Why don’t antibiotics kill them?

Dear Reader: You’re far from alone in your struggle to understand viruses. They are simultaneously simple and quite complex, and so small that it wasn’t until the invention of the electron microscope almost 90 years ago that we were even able to see them.

A virus is neither plant nor animal; it isn’t a bacterium, fungus or one-celled organism; and it can’t live or reproduce outside of a living host cell. Considering all that, it’s not surprising that the scientific community continues to debate whether or not viruses are even alive. In fact, it’s almost easier to talk about what a virus isn’t than to explain what it is. But we’ll do our best.

A single virus particle is known as a virion. It’s a packet of genetic material -- either DNA or RNA -- wrapped in a layer of proteins, known as a capsid. In many kinds of viruses, the protein shell is topped by a layer of lipids, a type of organic compound that’s roughly comparable to fat and is not soluble in water. Taken together, the protein and lipid structure is known as an envelope.

Viruses are mind-bendingly small. They range from about 20 nanometers to upward of 300 nanometers in size, with many tending toward the lower end of the scale. As a point of reference, there are 25.4 million nanometers in one inch. Viruses come in a wide range of shapes, including circular, cylindrical and stringlike. Some, like the coronavirus, are studded with spikes. These act as docking devices to attach to host cells and then use their unique chemical composition to penetrate the cell membranes.

The sole purpose of a virus is to infect another organism -- either an animal, plant or bacterium -- make billions of copies of itself and then move on to infect a new host. Small wonder the name for these infectious agents derives from a Latin word that roughly translates to “poisonous slime.”

To achieve its aim, the virion injects its genetic material into the host cell and hijacks that cell’s internal machinery. Instead of doing its designated job, the cell now goes to work replicating the virus. Each virion is so ruthlessly efficient, it can force a cell to make a million copies. The infected cells send out a chemical distress signal in the form of proteins known as cytokines. They set off the inflammatory reaction that causes our immune systems to attack, which results in the symptoms we feel when we’re sick, such as fever, congestion, coughing and sneezing, headache, body aches and gastric distress.

You are correct that antibiotics have no effect on viral illnesses. Antibiotics work by breaching a bacterium’s cell walls, which viruses don’t have, or disrupting its reproduction, which viruses do differently. Due to antibiotic resistance, which is now a serious problem, it’s important not to use these drugs to fight a viral infection. Instead, for viruses such as the flu, your doctor will prescribe an antiviral, which works by interfering when the virus tries to force the cell to make copies of it.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

COVID-19
health

Quitting Sugar Is a Challenge That Requires Awareness

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | April 3rd, 2020

Dear Doctor: I’m stalled on my resolution to quit eating sugar. Why is it so hard? I just can’t seem to stop saying yes to sweets, especially my favorites -- cookies and candy bars. Do you have any suggestions?

Dear Reader: First of all, please don’t feel bad. In your quest to control your sugar intake, you’re battling two powerful forces -- biology and modern food science.

Sugars provide the body with an efficient source of energy, and the pursuit of them is hardwired into our brains. This, along with the fact that sugar wakes up the reward centers of the brain, has been weaponized by food scientists. The result is a vast array of sweet treats, many of them amped up with fats and salt, and each carefully designed to be irresistible. Adding to these challenges is the fact that quitting sugar cold turkey can leave you with genuine symptoms of withdrawal, including headache, fatigue, irritability and low mood. But don’t despair. Armed with a bit of self-knowledge and a few deliberate strategies -- and, yes, some willpower and discipline -- you can successfully get your sweet tooth under control.

Start by becoming aware of how much sugar you eat, and when. Do you add it to your morning coffee or tea? Is it part of your breakfast? Do you drink sugared beverages? All of these, along with any candy, baked goods, ice cream or other sweet snacks that you grab throughout the day, contribute to the estimated 17 teaspoons of sugar that we Americans ingest daily. That’s double the recommended limit of 9 teaspoons per day for men and triple the 6 teaspoons for women, and it adds up to almost 57(!) pounds of sugar per person per year. Since 75% of all processed foods -- even those that come across as savory -- contain added sugars, you’ll need to check food labels for an accurate picture of your intake.

Once you’ve identified the sources of sugar in your diet, you can begin the process of weaning yourself off of it. If you’re stirring it in to coffee, cut back a little each day until it’s gone. If you’re a soda drinker, switch to one of the many varieties of sparkling water that have become available. It is helpful to understand that sugar makes blood glucose levels spike, which triggers the pancreas to release insulin. That’s the hormone that allows cells to absorb and use glucose for energy. A healthy blood sugar balance depends on limiting surges of insulin, so think in terms of meals and snacks full of protein, fiber and healthy fats. They will fill you up and lessen your cravings without making your blood sugar levels go crazy.

Artificial sweeteners may be tempting, but studies have linked them to a boomerang effect of craving more sugar, as well as to adverse effects on the gut microbiome. Plus, after just a few days of sugar abstinence, you’ll find that your taste buds are waking up to the natural sugars in foods, which will become satisfying. There’s no question that quitting sugar can be a challenge, so be kind to yourself and take things gradually.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Physical HealthNutrition
health

Study Links Overtime to Masked Hypertension

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | April 1st, 2020

Dear Doctor: I heard about a study that says working overtime gives you high blood pressure. My husband just joined a competitive company, and he’s expected to work a lot of extra hours. He’s already a Type A kind of guy, and I’m worried.

Dear Reader: You’re referring to the results of research published last December that found a connection between putting in long hours at work each week and an increased risk of developing high blood pressure. More specifically, the study uncovered a link to a condition known as “masked hypertension.” This is when blood pressure readings in the doctor’s office are normal but then rise to elevated -- and even dangerous -- levels outside of the clinical setting. That makes diagnosis and treatment difficult and may put someone at higher risk of heart problems and stroke.

In the study, published in the journal Hypertension, researchers in Canada followed 3,500 office workers for five years. Participants in the study wore a device that measured their blood pressure every 15 minutes. The researchers also obtained daily blood pressure readings while the workers were at rest. The goal was to identify periods of normal blood pressure, sustained high blood pressure and masked hypertension. After adjusting the resulting data for lifestyle factors such as weight and smoking, existing medical conditions such as diabetes, family medical history and job strain, the researchers found a correlation between how much overtime someone worked and their blood pressure.

Overall, the study found a 70% higher risk of masked hypertension among workers who put in 49 or more hours per week as compared to those with a workweek of 35 hours or fewer. They also found that the overtime group had a 66% higher risk of sustained high blood pressure. These are blood pressure readings that remain high and can be measured in a clinical setting. As little as one to nine hours of overtime was linked to a significant increase in risk of both types of hypertension. The results held true for both women and men.

Analysis of previous research, which also finds a connection between a long workweek and developing high blood pressure, suggests stress and loss of sleep as potential causes. But because the number-crunching in the Canadian study takes those factors into consideration, the authors suspect some other mechanism is at work. Considering that the study looked at white-collar workers, who spend the lion’s share of their time behind a desk, recent revelations about the adverse health effects of prolonged sitting may hold a clue. These include weight gain, increased risk of developing metabolic diseases like Type 2 diabetes, and, yes, hypertension. It will be interesting to see if these parallel avenues of research converge.

Meanwhile, considering the demands of your husband’s new job, as well as your description of him as a driven Type A personality, we think it would be wise for him to check in with his health care provider. He may be advised to monitor his blood pressure with a wearable monitor, which would allow a diagnosis, and, if needed, appropriate treatment.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Physical Health

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