H 1 N 1 , seasonal flu, and upper respiratory infection over- the - counter
( OTC) prevention recommendations seem daunting, but in reality, only several diverse lifestyle changes , supplements , and prescriptions have adequate evidence that should be discussed with patients. In addition ,numerous other recommendations contain little to no evidence. For example, most heart healthy behavioral changes , such as reducing visceral adipose tissue, simultaneously improve immune health, and this needs to be emphasized . Ethyl alcohol hand gel and plain soap and water should be encouraged , and antimicrobial soaps should be discouraged . Gargling with water and using nasal saline spray are also cost effective and supported with clinical evidence .Vitamins C and D
have the largest benefit-to-risk ratio for patients and may reduce the risk
of pneumonia from a recent meta-analysis . Other supplements, such
has echinacea , vitamin E, and zinc, have some clinical data, but also
have potential long-term safety issues. High-calorie antioxidant bever -
ages only encourage weight and waist gain, but a teaspoon or two of
honey has antimicrobial activity and may suppress cough. Finally, vac -
cine compliance as early as possible should be promoted as a selfless
act that reduces viral transmission that could cause morbidity and mor -
tality in the most immune vulnerable individuals, and simply promotes
herd immunit y, rather than a self-centered act whose individual result
and response (n = 1) currently and unfortunately seems to mirror the
perceived personal effectiveness orlack of effectiveness of the vaccine