Dr. Roach: Wash hands before or after toilet? Do both

Dear Dr. Roach: I just read your comment about washing hands after using the restroom. I have a question about this that maybe you could comment on. Why wash your hands after using the restroom? After all, your “private parts” have been in your pants (whether male or female) and out of contact with the world. What germs will you eradicate by washing, given this? It seems to me the best procedure would be to wash your hands before going to the bathroom in order to avoid contaminating your privates. What do you think?

J.D.

Dear J.D.: I think you are wise to wash your hands twice: Before using the restroom to protect yourself from what germs you might have collected on your hands, and afterward to wash off the bacteria that we all have on our skin. The “privates” certainly have bacteria (without any contact from the environment necessary) that it would be hygienic not to spread around.

Dear Dr. Roach: The idea that replacing saturated fats with polyunsaturated oils rich in omega-6 linoleic acid to prevent heart disease is controversial. In the Lyon Diet Heart Study, in which omega-6 was reduced to about 4 percent, subjects experienced a 70 percent decline in morbidity and mortality. There are no long-term trials in which omega-6 intake gets reduced to historic levels of 2 percent of total caloric intake. Do you think such a trial would be beneficial?

D.B.

Dear D.B.: Omega-3 fatty acids are well-known, and there is increasing evidence that a diet high in omega-3 fatty acids (one type, ALA, is found in some vegetable oils and green vegetables; the other two, EPA and DHA, are found in fatty fish) reduces heart disease risk.

Omega-6 fatty acids are essential in that they are necessary for health, but there is a theory that too many (relative to omega-3) are harmful. However, the most recent evidence has suggested that this might not be the case, and that omega-6 fatty acids do not increase heart disease risk. One omega-6 acid, GLA, appears to have significant anti-inflammatory effects. The results of the Lyon Diet Heart Study can be interpreted in several ways, since the dietary interventions led to multiple changes, and it may be that the ratio of omega-3 to omega-6 is not as important as once was thought.

I am always in favor of trials that can shed light on disease, especially in preventing heart disease, the biggest killer in industrialized countries.

Dear Dr. Roach: In the treatment of nail fungus, you did not mention newer laser treatments. Are they effective?

J.F.

Dear J.F.: We don’t really know, since well-done studies haven’t yet proven it; however, preliminary evidence is suggestive. This would be a great addition to treatment, since the only currently accepted highly effective treatments are oral medications, which have risk of liver damage.

Email questions to ToYourGoodHealth@med.cornell.edu.