The most common ‘condition’ in the world is upper respiratory tract infections, so coughs and colds to you and me. And, how do we deal with these, well, for decades over the counter (OTC) medications have been developed and sold for the relief of the associated symptoms.

Now, because these medications are OTC there has been less than rigorous control of them, though in 2007 the FDA did recommend that they not be used for children under six.

But how good are they? The evidence gives a consistent message relative to the effectiveness of these OTC medications both for adults and children. The message is that they are not effective and could potentially cause harm. There are, however, other more natural approaches that appear to be effective in relieving the associated symptoms of upper respiratory infections.

A Cochrane Review of the effectiveness of OTC also concluded that

“There is no good evidence for or against the effectiveness of OTC medicines in acute cough”.

In yet another study comparing two common medications, Diphenhydramine and dextromethorphan (DM), with no treatment found:

“Diphenhydramine and dextromethorphan are not superior to placebo in providing nocturnal symptom relief for children with cough and sleep difficulty as a result of an upper respiratory infection. Furthermore, the medications given to children do not result in improved quality of sleep for their parents when compared with placebo. Each clinician should consider these findings, the potential for adverse effects, and the individual and cumulative costs of the drugs before recommending them to families.”

Which is just crazy. Why do we do it, well it’s “the economy stupid”. Millions of pounds and dollars are spent promoting cough suppressants and other medications for relief of coughs and colds and the profits are staggering. Dr Richard Russell, of the British Thoracic Society, said:

“Over-the-counter sales for acute cough medicines currently reach approximately £100m a year in the UK – money that is being spent on remedies, where there is no evidence that they work.”

So now, I’d suggest, the use of these products is engrained in our culture and it will take years of patient education and perhaps more action by the authorities to reduce the risk to society they pose.

At the other end of the scale look at this gem: A clinical trial comparing honey, dextromethorphan and no treatment found that:

“…parents rated honey most favourably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection.”

oh, sorry, I meant:

In a comparison of honey, DM, and no treatment, parents rated honey most favourably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection. So, simple honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection than the drugs.

And, in a more recent trial (November 2010) a simple vapour rub, petrolatum and no treatment were compared and the authors concluded that:

“Despite mild irritant adverse effects, VR provided symptomatic relief for children and allowed them and their parents to have a more restful night than those in the other study groups.”

How do you calculate your daily energy requirements in calories?
Basic energy requirements (BER) includes your basal metabolic rate (BMR) + extra energy requirements (EER).
To calculate BMR:
For every Kg of body weight 1.3 Calories is required every hour.
1.3 x 24 x bodyweight KG = BMR
(e.g A person weighing 50Kg would require 1.3 × 24hrs × 50Kg = 1560 Calories/day to maintain their current weight.)

To calculate EER:
For each hours training you require an additional 8.5 Calories for each Kg of body weight.
8.5 x training hours x bodyweight KG = EER
(e.g. For a two hour training session our 50Kg person would require 8.5 × 2hrs × 50Kg = 850 calories extra.)

BMR + EER = BER
Basic energy requirements MAINTAIN your current weight.
Calculate Daily Calorie Deficit For Fat Loss
The following are guidelines and tips to get your nutrition plan assembled for effective fat reduction to improve your PWR (power to weight ratio).

Determine your total caloric intake for (fat) mass reduction

Method one: multiply your weight in pounds by 11 and 12 and subtract 300 to 500 calories to obtain goal daily calorie intake range to promote healthy weight loss.

Example: 200 lbs times 11 (= 2200) minus 500 = 1700 200 lbs times 12 (= 2400) minus 500 = 1900 Calorie range = 1700 to 1900 calories

Method two: Reduce your BER figure by 10 – 20%

Both of these methods introduce a calorie deficit of up to 3000-4000 calories per week to lose between 1-2 lbs of weight. Should your activity level increase, you create a larger calories deficit. Adjust energy intake accordingly to avoid fatigue or excessive hunger.

Calories = Energy/Fuel
Like fuel for a car, the energy we need has to be blended. The blend that most people require is as follows:
40 – 70% Carbohydrates (sugar, sweets, bread, cakes)
15 – 25% Fats (dairy products, oil)
15 – 40% Protein (eggs, milk, meat, poultry, fish)

The energy yield per gram is as follows: Carbohydrate – 4 Calories, Fats – 9 Calories and Protein – 4 Calories.
What does a 50 kg athlete require in terms of carbohydrates, fats and protein?
Carbohydrates – 57% of 2410 = 1374 Calories – at 4 Calories/gram = 1374 ÷ 4 = 343 grams

Fats – 30% of 2410 = 723 Calories – at 9 Calories/gram = 723 ÷ 9 = 80 grams

Protein – 13% of 2410 = 313 Calories – at 4 Calories/gram = 313 ÷ 4 = 78 grams

Our 50kg athlete requires 343 grams of Carbohydrates, 80 grams of Fat and 78 grams of Protein

Consider these easy ways to cut calories

Keep a food record (for at least 3 days) to evaluate and monitor your current eating habits. Calculate your average daily calorie intake. It is a very effective self-monitoring tool. It will identify hidden calorie sources; it is a remedy for “food amnesia”!

Limit animal protein (beef, pork, poultry and seafood) to 8 ounces or less daily. Reduce or use very small amounts of added fats like cooking oils spreads and dressings. Drink zero calorie or low calorie beverages (water, diet drinks)
Eat three meals with one or two snacks daily. Spread your calories throughout the day. Your body operates best when it has a steady supply of fuel. Let fruits and vegetables dominate your plate. Choose mainly whole grain starches; avoid processed grains (sugar, white flour).

Consider taking a standard multivitamin
Meeting vitamin and mineral needs while following a calorie-controlled eating plan coupled with exercise should be easy if you are eating responsibly. A standard multivitamin will help you meet your daily vitamin and mineral needs if you feel unable to do this.

Maintain good hydration
Aim for 2-3 liters water daily. Carry a water bottle and drink from it throughout the day. Avoid alcohol and caffeine.

Stay focused during the holidays
Limit or avoid alcoholic beverages (they’re high in calories!) Avoid being too restrictive yet regulate your food portions.

Monitor your weight and body composition
Take measurements and trend these parameters over time.

Get most of your fats from EFA’s. Flax powder or cold pressed oil is an excellent source of EFA’s. Walnuts also have high levels of omega 6 & 9. These essential fatty acids are not manufactured by our own body’s therefore we must make sure we intake adequate amounts. EFA’s have been shown to improve muscle repair, aid anti-inflammatory response and also fats help aid satiety by slowing down gastric emptying. Limiting fats to lower than 20% will only leave you depleted, hungry and grumpy so don’t avoid them completly, just get them from intelligent sources.