Ask Bonnie

If you were like me as a kid, you probably resented having to wait after eating — seemingly an eternity — before you could go back in the pool. Some parents said to wait an hour; others recommended less time. And what would happen if you disobeyed? Would you really develop a cramp and drown?

If you are now a parent, do you still promote this poolside wisdom? Do you follow it yourself? If so, you might wonder:

What is the ideal time to wait after eating before returning to the pool?

Does it matter how much or what you eat?

Should you wait at all?

The medical literature does not provide ready answers for any of these questions. Specifically, research provides no compelling support for a prolonged waiting period before swimming after eating. On the other hand, no studies clearly refute the recommendation either. Perhaps this lack of published information is because documentation of the specifics of recent meals in cases of drowning or near-drowning is simply unavailable and unrecorded. Alternatively, it may reflect the rarity of the problem, especially in waters that are easy to leave (such as a hotel pool) if problems do develop.

Considering how food is digested, waiting for complete absorption of a meal is clearly unnecessary. After you consume food, enzymes in saliva and the stomach begin the digestive process right away. About half of the consumed food remains in the stomach for two hours; it takes about four hours for the stomach to completely empty. Food spends another two hours in the small intestine and 14 hours in the large intestine. Moreover, what you eat makes a difference in terms of digestion. Simple carbohydrates (such as the sugar in an apple or a carbonated beverage) may be digested more quickly than a fatty meal (for example, a cheeseburger).

After a meal, there is an increased flow of blood to the stomach and intestines to absorb nutrients. This increased blood flow leaves less blood available to deliver oxygen and to remove waste products from exercising muscles, including those muscles involved with breathing. Trying to exercise after eating thus sets up competition for blood flow between the digestive organs and the muscles. It is thought that some abdominal or muscle cramps (including what is often called a “stitch”) might be caused by an inability to meet the increased demands of both areas.

Is this situation dangerous? If cramping occurs, will it paralyze or otherwise incapacitate a person so suddenly that he or she could drown if in the water? It is possible. However, if drownings or near-drownings have ever occurred because a person did not wait long enough after eating, these events are rare. More important risk factors for drowning include alcohol use, a lack of safety gear on boats and a lack of protective fencing and covers for pools.

The notion that swimming soon after eating is dangerous may be a medical myth based on commonsense, intuition and the oral tradition that passes “wisdom” down from generation to generation. Strenuous exercise after a large meal is often uncomfortable, so taking some time to digest (more time for larger meals) makes sense, but failing to do so is probably not the enormous danger about which we are often warned.

Age-old wisdom may not always be based on sound scientific reasoning, but listening to signals from your body does makes sense — if you experience pain, cramping or severe fatigue when swimming, perhaps you did go back in the pool too soon.

One of the world’s most prestigious health journals has lashed a fast-growing trend in the United States and Britain for “designer vaginas,” the tabloid term for cosmetic surgery to the female genitalia.
The fashion is being driven by commercial and media pressures that exploit women’s insecurities and is fraught with unknowns, including a risk to sexual arousal, the British Medical Journal (BMJ) says.

Known as elective genitoplasty, the surgery usually entails shortening or changing the shape of the outer lips, or labia, but may also include reduction in the hood of skin covering the clitoris or shortening the vagina itself.

Anecdotal evidence suggests that the practice is spreading fast in the United States as well as in Britain, but the picture is unclear, the BMJ says.

Not only is there a disturbing lack of data about the phenomenon, there has been negligible assessment about surgical after-effects — and almost zero reflexion as to whether a labial “problem” exists in the first place, the BMJ says angrily.

In 2004-5, 800 “labial reductions” were conducted by Britain’s state-run National Health Service (NHS), more than a doubling of the figure of six years earlier. Other operations were carried out by the private sector, although the full figures are unknown.

The authors of the article, London gynaecologist Sarah Creighton and clinical psychologist Lih Mei Liao, conducted their own small-scale probe into why women sought this surgery.

“Our patients sometimes cited restrictions on lifestyle as reasons for their decision,” they say.

“These restrictions included inability to wear tight clothing, go to the beach, take communal showers or ride a bicycle comfortably, or avoidance of some sexual practices.

“Men, however, do not usually want the size of their genitals reduced for such reasons. Furthermore, they find alternative solutions for any discomfort arising from rubbing or chaffing of the genitals.”

Patients who sought genitoplasty “uniformly” wanted their vulvas to be flat and with no protrusion, similar to the prepubescent look of girls in Western fashion ads, they found.

“Not unlike presenting for a haircut at a salon, women often brought along images to illustrate the desired appearance,” say Creighton and Liao. “The illustrations, usually from advertisements or pornography, are always selective and possibly digitally altered.”

Plastic surgery to the labia carries risks, for this zone carries nerve fibres that are highly sensitive and are a key pathway of sexual arousal, the article warns sternly.

“Incision to any part of the genitalia could compromise sensitivity,” it says.

The BMJ piece suggests genitoplasty is a classic example of where commercial, media and social pressures artificially create a problem, fuel concern over it and then put forward a solution for it.

“There is nothing unusual about protrusion of the labia,” it says.

“It is the negative meaning that makes it into a problem — meanings that can give rise to physical, emotional and behavioural reactions, such as discomfort, self-disgust, perhaps avoidance

Fergie Fuels Up

What: Fuel Belt Endurance 4-Bottle Belt

Why: Fergie keeps the boys on “lock lock” with her very serious exercise routine. She’s been spotted sweating all over town, and it looks like she’s got a new addition to her regular routine. This FuelBelt consists of four, seven-ounce flasks that can carry water or gels, so you can’t use extreme thirst as an excuse to bail on your workout. Generally used by marathon runners, or people in training, the belt can also be used to add some weight, and increase the intensity of your workout. It’s also available in two- and six-flask models, all of which feature a little pouch for storing your keys, MP3 player and ID.

With all the water she’ll be drinking, let’s just hope Fergie remembers to hit the ladies after working out, lest she have another “accident” like she did at the San Diego Street Scene concert.

Price: $36

Find it on www.Amazon.com

Antioxidants may help limit damage from UV radiation.

People who unwind with a cup of tea every night may have a lower risk of two common forms of skin cancer, new research suggests.

In a study of nearly 2,200 adults, researchers found that tea drinkers had a lower risk of developing squamous cell or basal cell carcinoma, the two most common forms of skin cancer.

Men and women who had ever been regular tea drinkers — having one or more cups a day — were 20 percent to 30 percent less likely to develop the cancers than those who didn’t drink tea.

The effect was even stronger among study participants who’d been tea fans for decades, as well as those who regularly had at least two cups a day, according to findings published in the Journal of the American Academy of Dermatology.

However, the findings do not mean it’s OK to bake in the sun as long as you have a cup of tea afterward. The researchers found no evidence that tea drinking lowered skin cancer risk in people who’d accumulated painful sunburns in the past.

Nor did the study look at the relationship between tea drinking and malignant melanoma, the least common but most deadly form of skin cancer.

Still, the findings support the theory that tea antioxidants may limit the damage UV radiation inflicts on the skin, according to the study authors, led by Dr. Judy R. Rees of Dartmouth Medical School in Lebanon, N.H.

In particular, a tea antioxidant known as EGCG has been shown to reduce burning on UV-exposed skin.

The current findings are based on interviews with 770 New Hampshire residents with basal cell carcinoma, 696 with squamous cell carcinoma, and 715 cancer-free men and women the same age.

Tea consumption was linked to a lower skin cancer risk, even with factors such as age, skin type and history of severe burns considered. However, tea drinkers who’d suffered multiple painful burns in the past did not have a lower risk of skin cancer.

It’s possible, the researchers explain, that the antioxidants in tea are enough to limit skin damage caused by moderate sun exposure, but not the “more extreme” effects of sun exposure, such as cancer-promoting damage to the DNA in skin cells.