Columnist Tara Parker-Pope answers readers' questions.
April 5, 2005; Page D4
Q: I am using Oroweat Seven Grain bread. From all I have read, this bread isn't a whole-grain bread. Can you suggest another brand?
-- K.B.
A: Most popular breads are made with some type of wheat flour. But a wheat kernel has three layers -- the fiber-rich bran outer layer; the endosperm middle layer; and the wheat germ, the nutrient-dense embryo. The most healthful breads use the whole kernel -- thus the name "whole-grain breads." But bread makers often strip away the bran and the germ, which allows them to make soft, airy breads with a longer shelf life. Although extra vitamins and minerals are added to replace the lost nutrients, this "enriched" flour isn't a replacement for the lost fiber.
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You can e-mail Tara Parker-Pope at healthjournal@wsj.com.
To pick a better loaf, ignore the marketing name listed on the wrapper and go straight to the ingredient list. The most healthful breads will always contain the word "whole" in the first ingredient -- either "whole wheat" or another whole grain. If the first ingredient says "enriched wheat flour" then you aren't getting the benefit of whole grains -- even if the bread is brown or dubbed a "wheat bread" or "multi-grain" bread on the label. Most bread companies make several types of breads, so if you like a particularly brand, chances are they also make a whole-grain variety. Oroweat Seven-Grain bread is made with enriched wheat flour so it isn't considered a whole-grain bread. However, Oroweat does make several whole-grain varieties, which it lists on its Web site www.oroweat.com.
Q: Do you have any new/updated information regarding snoring and its relationship to sleep apnea?
-- P.V.
A: People with untreated sleep apnea stop breathing repeatedly during sleep. It's a potentially serious medical problem that can lead to high blood pressure and other cardiovascular risks, memory problems, weight gain, impotency and headaches, as well as problems associated with lack of sleep -- such as poor job performance, fatigue and car accidents. Snoring is a typical symptom, but snoring alone doesn't mean you have sleep apnea. Apnea sufferers typically are very loud, continuous snorers. To help patients gauge their risk for sleep apnea, the National Sleep Foundation offers a number of quizzes and tools, including the "snore score" test at www.sleepfoundation.org/quiz/index.php. The American Sleep Apnea Association Web site at www.sleepapnea.org, is an excellent resource for information about the problem and seeking treatment.
Q: The little toenail on my right foot has been infected with toenail fungus for about 20 years. It is unsightly, but more important it affects the fit of my shoes. I purchased a dietary supplement called Leucatin, which promises to cure toenail fungus. Is Leucatin effective and safe to use?
-- B.K.
A: Toenail fungus, also known as onychomycosis, is a vexing problem, serious enough to cause distress but not so serious that the sufferer wants to risk the potential liver problems of prescription antifungal agents.
Leucatin capsules contain several herbs, but the main ingredient is Hydrastis Canadensis, which is also known as Goldenseal. An active component of Goldenseal, a compound named berberine, has been studied as a potential antimicrobial agent and even a tumor fighter. Goldenseal has been touted as a treatment for anorexia, cancer, fever, infections and even the common cold. However, there aren't any reputable studies evaluating the efficacy of Goldenseal for any purpose, let alone as a fighter of toenail fungus. And the supplement does carry risks. It can interfere with blood-pressure medicines and blood-thinning drugs, and it can cause gastrointestinal complaints. People with hypertension, cardiovascular disease or women who are pregnant shouldn't take it, and anyone else should consult a doctor before trying it.
Leucatin also comes as a topical solution that contains various oils, including almond oil and tea-tree oil. Tea-tree oil has, in fact, been shown to have antimicrobial properties. And a 1994 study in the Journal of Family Practice found that about half the nail-fungus patients treated with a tea-tree-oil solution reported at least some improvement in the problem after six months of treatment. The main risk is an allergic reaction, although tea-tree oil can be deadly if ingested, so it should be stored safely away from children.
The Memorial Sloan-Kettering Cancer Center Web site, www.mskcc.org/aboutherbs is a great resource for learning more about herbs, botanicals and other products, the scientific research behind them and their potential for risk and interacting with other drugs.
• You can e-mail Tara Parker-Pope at healthjournal@wsj.com.
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