Fall is a busy time. Kids are back in school and schedules suddenly seem a lot more crowded. Work, too, kicks back into high gear after a summer lull. So, how can you stay calm and not stress out? How can parents keep kids healthy as they are exposed to germs at school? And why am I still sneezing? Isn’t allergy season over?

We put all of these questions and more to physician Kevin M. Fosnocht, an assistant professor of clinical medicine at Penn Presbyterian Medical Center. Here’s what he had to say:

Q. Summer is over—so why am I still suffering from allergies?
A. Allergy season is not over—and for many it has just begun. Hayfever symptoms (sneezing, itchy nose and eyes, nasal congestion) can be caused by a variety of environmental allergens. In the fall, beginning about mid-August, these allergens tend to be ragweed pollen and molds. Ragweed pollen concentration is highest in the early to mid-morning hours so exposure can be reduced by staying indoors until late morning. Ragweed season ends with the first frost. Molds—created by fallen leaves and other dying plant matter—have peak air concentrations in the late afternoon. Exposure to both allergens can be limited by in-home air filters, washing all clothing and bathing (including hair washing) after working outside.

Q. What can parents do to keep kids from catching colds or other illnesses as they go back to school?
A. No surprise here—the single most important thing parents, teachers and children of all ages can do is wash their hands regularly. Hand washing will not only reduce the risk of becoming infected oneself, but perhaps more importantly, will reduce the risk of spreading viruses and bacteria to others. Soap and water are good—but it does appear that the instant hand sanitizers, like Purell, are better. Hand washing is typically fun for small children, so the time should be taken by adults to both model good hand washing technique and make sure that children are doing a thorough job.

Q. A lot of people seem to be sneezing and getting colds. Is this because we’re inside more now than we were a month ago?
A. The rise in upper respiratory infections is linked to spending more time indoors, and therefore more exposure, both in number and in duration, to more people. Other factors may also play a role: cold viruses typically thrive in less humid environments; the drier air can also lead to a more fragile nasal mucosa, so cold viruses may be more likely to cause an infection with that part of the immune system compromised.

Q. Who needs to take vitamins or other supplements? Assuming you eat a pretty balanced diet, should you take a multivitamin?
A. Many nutrition experts and authorities recommend taking a daily multivitamin or other dietary supplements. A study published this year systematically reviewed the literature on dietary supplements and concluded the following. First, the quality of the numerous studies examining the benefits and risks of dietary supplements is very mixed. Second, there was very little data to support recommending a daily multivitamin for anyone who eats a balanced diet and is otherwise healthy. Finally, there is no conclusive evidence that a dietary supplement can be harmful, when taken in recommended doses—though beta-carotene and high-dose vitamin E may be exceptions and could be harmful. This review has, however, not led to changes in the recommendation for prenatal vitamins; calcium and vitamin-D supplementation in post-menopausal women; and multivitamin supplementation in patients known to have inadequate nutrition. Patients should therefore consult with their physicians regarding recommendations for vitamins and other dietary supplements.

Q. Fall is a busy time for many people and stress levels can run high. What are some simple ways people can “de-stress?”
A. Most of us are not going to be able to “de-stress” during this busy season. Instead, we are going to have to manage our stress. The most effective ways of managing stress tend to be the two behaviors that are put aside most quickly when we get busy: exercising regularly and getting adequate sleep. These are both simple, but not easy to achieve, I realize, but a commitment to both is necessary for managing the stressors of life. Regular exercise need not be a two-hour workout at the local gym, but can be a 20 to 30 minute period on most days of vigorous exercise. Regular exercise tends to improve the quality of sleep, so that the sleep one does get is more restorative. Avoid the two most prevalent behaviors of stress management: over-eating (especially in the evenings), and hours of TV watching (again—especially late at night). The two often go together and give an immediate sense of “de-stressing,” but can actually leave you feeling more unsettled and lead to a poor night’s sleep.

Originally published on October 5, 2006.