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Readers offer advice on teething devices and portion control

Dr. Ko and Dr. Glazier.jpg

Dr. Elizabeth Ko, left, and Dr. Eve Glazier

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Dr. Eve Glazier and Dr. Elizabeth Ko
Medical Columnists

Tuesday, February 20, 2018

Hello again, dear readers! How is 2018 treating you so far? Thank you, as ever, for your emails and letters. Your kind comments warm our hearts; your criticisms make us want to do better; and your questions, comments and opinions widen our worldview. And on that note, onward!

-- After our column about teething remedies was published, we received quite a few questions regarding the purported benefits of amber teething necklaces. These necklaces have become popular teething aids in some parts of the country. Amber, which is fossilized tree resin, has long had a role in folk medicine. When it comes to teething, the idea is that the succinic acid contained in Baltic amber will be absorbed via the skin and confer therapeutic effects.

While it's true that Baltic amber does contain small amounts of succinic acid, we were unable to find any research that shows it acts as an analgesic, that body heat will cause it to be released or that it can be absorbed through the skin. Even if the above were possible, the dose of succinic acid available in an amber necklace would be miniscule. Add in the choking hazard presented by the size of the amber beads and a recent study that found these necklaces to be associated with bacterial colonization, and our position is that the very real risks outweigh the unproven benefits.

-- A recent column about portion control showed us how creative you readers are. The range and variety of visual guidelines you use for portion control has been fascinating to see. We particularly liked this whole-plate approach to making sure a meal doesn't stray into overeating:

"Make it simple," writes Noreen, who uses a small salad plate as her template. She fills two-thirds of the plate with vegetables, then fills the remaining space with meat or a meat substitute, and a serving of fruit. Noreen reverses the typical American approach and eats her largest meals at breakfast and lunch and goes light on dinner.

-- And, finally, thank you to a reader for adding to our discussion of urinary incontinence.

"You have mentioned stress incontinence in your column a couple of times recently, but I don't recall that there was any mention of obesity as a contributing factor," our reader points out. "If weight loss can be part of treatment for UI, it would be helpful to know for people who have both of those conditions."

You're right -- a number of studies have shown a clear link between obesity and urinary incontinence. Individuals who are overweight experience an increase in intra-abdominal pressure. This has the effect of increasing pressure on the pelvic floor, including the bladder and the bowel, and plays a role in developing urinary incontinence, or UI.

The good news is that several studies have shown that weight loss can significantly reduce the number of stress incontinence episodes experienced by participants. In fact, weight loss, along with exercise, is recommended as a first-line treatment for urinary incontinence among individuals who are significantly overweight.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.

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