Regular soft drinks linked to many health hazards

Regular Soft Drinks – a particularly dangerous source of sugar

Sugar is not just a quick source of energy, it is truly hazardous to health. Soft drinks are one of the most common sources of it, and because fluids don’t fill one up and provide a source of fullness, it is easy to take in too many calories. But perhaps the most concerning aspect of soft drinks lies in the other ingredients, including the artificial sweeteners in diet beverages. This latter topic is proving worthy of a separate blog article so that will follow in the near future.

This is an important topic not just because sugar is linked to the start of so many chronic illnesses, but also because soft drink consumption is still so high. In Angela Epstein’s article on fizzy drinks, found in the February 10, 2015 issue of Daily Mail, the average American drinks 25 gallons of soft drinks a year. An older article by Karina Hamalainen in the 2012 issue of Scholastic Choices, close to 25% of high school students drink at least one soft drink a day. Sugar activates the reward system in the brain, contributing to cravings for it. Because of this property, foods high in sugar become hard to resist (from Kelly Brownell’s “In your face – how the food industry drives us to eat,” in the May, 2010 issue of Nutrition Action Healthletter).

The high fructose corn syrup (HFCS) in regular soft drinks has been linked to weight gain that is greater than what would be produced by table sugar (from Killer Colas by N. Appleton and G.N. Jacobs, Square One Publishers, 2011). This sweetener has also been linked to abdominal obesity, insulin resistance and a decrease in the appetite suppressing hormone leptin. Other possible soft drink ingredients that are harmful:

  • phosphoric acid – added to create a tangy flavor and maintain carbonation pulls calcium out of bone contributing to osteoporosis, kidney stones, weakens tooth enamel and can worsen GERD (esophageal reflux, AKA heartburn).
  • carbon dioxide – used for carbonation – contributes to GERD and tooth enamel damage.
  • ascorbic acid – added to preserve flavor and coloring – sounds beneficial but in a beverage that also contains sodium benzoate can lead to the formation of the carcinogen benzene if exposed to heat and light.
  • caffeine – found in colas as well as other beverages – can be too stimulating to the nervous system and contribute to anxiety and insomnia. Consuming it can also contribute to soft drink addiction. In high amounts, it can also further osteoporosis.

The information on these ingredients and their effects are from Killer Colas. The authors also note that it is hard to tell what soda components cause what negative effects. In addition to the above health threats, regular soft drink consumption is linked to an increased risk of metabolic syndrome (including type 2 diabetes and coronary artery disease as well as hypertension). Specific cancers associated with regular soft drink intake include primarily gastrointestinal cancers:  esophageal, colon, gastric and pancreatic.

A link between soft drinks and asthma has been suggested by research including what was reported in S. Park, et al, in “Association of sugar-sweetened beverage intake frequency and asthma among U.S. adults, 2013 (Preventive Medicine, October, 2016, Vol. 91). Of note, this correlation was found for higher intake, that is, those consuming more than one sugar-sweetened beverage a day.

 

Medications used to treat type 2 diabetes

Oral Medications for Diabetes

There are two major types of diabetes, type 1 which was once called juvenile diabetes, and type 2 diabetes – previously referred to as adult-onset diabetes. Type 1 affects about 1 in 100 Americans “Diabetes Medications:  The next Generation of Oral Agents, Insulin and more” by Donna Ellis in MedSurg Nursing, July/August 2013, volume 22, issue #4); it is usually diagnosed in children, thus its original name. It starts with the body’s immune system attacking and destroying the cells in the pancreas that make insulin. Because insulin is needed to allow glucose to move into muscle and fat cells, without it those cells burn fat for energy and the pH level of the blood drops dramatically. This is an emergency. Those with this type of diabetes require insulin replacement and the oral diabetes medication would not help them.

Type 2 diabetes is much more common, affecting about 10% of Americans (Ellis, 2013). It develops much more slowly and there is often a long period before diagnosis when the pancreas makes too much insulin. This occurs because the insulin receptors, molecules on fat and muscle cells that the insulin fits into to have its effect, are not working properly. This abnormality in the receptors is called insulin resistance.  The extra insulin helps get the glucose into cells and prevents the buildup of glucose in the bloodstream where too much glucose can damage arteries and other tissues. The high levels of insulin make it difficult to lose weight since insulin enhances fat storage.

When the pancreas can no longer keep up with the excess insulin production, the blood glucose (also called blood sugar) level rises. It is at this point that diabetes can be diagnosed. Treatment may include diet changes, weight loss, and exercise. Medications can be started to help lower the blood sugar level.

One group of medications used is the sulfonylureas. These medications increase production of insulin by the pancreas. They have been used for years but the newer, second generation sulfonylureas are most often used. Because they increase insulin secretion, they can cause hypoglycemia, an abnormally low blood sugar. This is a dangerous situation because the brain relies on the glucose in the blood. Not surprising, many of the symptoms of hypoglycemia are caused by the lack of glucose in in the brain such as headache, irritability, shakiness, and even confusion if it gets severe, confusion. It has to be treated quickly with something high in sugar such as orange juice or regular soda. Per an article in Diabetic Medicine (C. L. Edridge et al, March 2015) about hypoglycemia caused by diabetes medications, in a one month period more than 50% of those with type 2 diabetes had an episode of hypoglycemia in the month before the study was conducted.

Sulfonylureas can also contribute to weight gain. Because of these side effects and the way these drugs can advance pancreatic beta cell burnout, some recommend the use of sulfonylureas (“A dynamic duo for T2DM” by C. Winter, in Nurse Practitioner Perspective, July/August 2015).

Biguinides in another class of oral medications for diabetes. This has become first-line treatment. It lowers the blood glucose level by decreasing the breakdown of the storage form of glucose in the liver. Because it doesn’t increase insulin production, it doesn’t cause hypoglycemia. It can cause diarrhea, especially when treatment is started at a high dose.

Glitazones are medications that make the insulin receptors more sensitive to insulin. They can cause the body to retain fluids and this can potentially worsen heart failure.

Alpha glucosidase inhibitors decrease the breakdown of complex carbohydrates like bread into simple sugars like glucose. These drugs are particularly helpful in decreasing the after meal rise in blood sugar. Side effects they can cause include flatus and diarrhea. They don’t lower the average blood sugar as much as the other oral diabetes medications. This is measured by a test called a hemoglobin A1C. It measures how much glucose is attached to red blood cells and the level goes up the more glucose the cells are exposed to so it is much better at gauging diabetes management.

Adherence is a common issue for the treatment of many chronic illness. In “Failure to Reach Target Glycosylated A1C Levels Among Patients with Diabetes Who Are Adherent to Their Antidiabetic Medication” by D. Juarez, et al (Population Health Management, Volume 17, number 4, for 2014) the compliance rate for diabetes medication use ranges from 67 to 85%. This article studied the records of thousands of patients that were deemed adherent to their medication regime. Adherence was assessed based on patients getting their medications refilled. 56.1% of such compliant patients were deemed to have poor control of their diabetes. This was quantified as having a hemoglobin A1C of >7%. One of the responses to this low rate of success was that diet, weight management and/or exercise were not being fully attended to. There are certainly other possibilities, some of which they suggested. But, as was noted in C. Winter’s article, diet and exercise can lower the glycosylated hemoglobin (hgb A1C) by 1 to 2%. This is a significant decrease and perhaps an area that needs to be emphasized.

This article is not intended to replace your health care provider. The intent is to make important information about medications available.

Over-the-counter medication labeling dangers

Over-the-counter medication label dangers

The words medication and drugs usually are assumed to refer to prescription medications. But here are some statistics from Lehne’s Pharmacology for Nursing Care, 9th edition (2016) that could change that.

60% of medications taken every day are over-the-counter

On average, there are 24 such non-prescription medications per home medicine cabinet

40% of Americans take an OTC medication every other day

Since 1970, one hundred drugs have been changed from prescription to over-the-counter status. The Food and Drug Administration (FDA) decides which medications can be sold without a prescription. About fifty prescription drugs are being evaluated for OTC sale.

Labeling requirements enacted in 2006 have paved the way for easier to understand information on OTC drugs as well as printing large enough for most people to be able to read. We still have a long way to go. In “Readability and comprehensibility of over-the-counter medication labels” by Hariprasad Trivedi, Akshaya Trivedi, and Mary F. Hannan (Renal Failure for 2014), forty nonprescription medication labels were analyzed and found to have “poor readability and comprehensibility characteristics.” Even more concerning, OTC drugs that were considered “high risk” were deemed to be the worst. Nonsteroidal anti-inflammatory medications were included in this group and noted to be among the most difficult for people understand.

The authors of this article included data to support their prediction that the segment of the population that is over 65 is growing rapidly and by 2030 twenty percent of the population will be 65 and older. By then, they’ll be 30% of the nonprescription market. Considering the decreased metabolism and elimination of drugs that usually accompanies aging, combined with the lack of clarity of such OTC information, adverse effects from these medications will continue to rise. Improved labelling can reverse this terrible trend. It is hard to believe the pharmaceutical producers will do this. Learning about OTC medications or not taking them are other options. Remember too that pharmacists are knowledgeable about these medications as well and can answer your questions about them. This is one situation where ignorance is not bliss!

This article is not intended to replace your health care provider. The intent is to make important information about medications available.

Adolescent Drug Abuse Prevention — Does it really help?

Adolescent drug abuse prevention programs – do they really help?

At the risk of “giving away the ending,” the answer to the title of this article is “Yes, but…” The “but” is that not just any intervention will be effective. In the book Dangerous Drugs:  an easy-to-use reference for parents and professionals by Carol Falkowski, drug and alcohol use are a leading cause of preventable death for those 15 to 24 years of age. Focusing on the word preventable, it is vital to appreciate that there are factors that can increase the risk for drug use and addiction plus protective factors that can lower it the chance of drug addiction and alcoholism. Drug abuse is associated with underachievement in school, delinquency, teenage pregnancy and depression so that is further motivation to prevent such abuse.

In “Adolescent drug abuse – Awareness and Prevention” by B. Chakravarthy, et al (The Indian Journal of Medical Research, 6/1/2013 issue) it is noted that children that have experienced more than several adverse childhood experiences (ACEs) have an increased risk of abusing drugs. Such ACEs include neglect, as well as living in a home where adults abuse drugs or are criminals or have mental illness. Those teens who have experienced more than a few ACEs should be selected for interventions such as mentoring and tutoring.

The above article also notes that poverty, unless extreme, isn’t an ACE. It is also important to recognize factors that decrease the risk for drug use and abuse. Included in this list are parental involvement, school success, and clear expectations and consequences for teen behaviors.

Beyond targeting those at high risk for drug abuse and providing appropriate intervention, what else works to prevent this deadly problem? Per the Chakravarthy article, multiple exposures on drug abuse, interactive methods information delivery, social skill training, culturally sensitive materials, and presentations of familiar topics. Also, enhancing protective factors.

Per the United Nations Office of Drugs and Crime (INODC), one in twenty adults aged 15-65 abuses heroin, cocaine or other illegal drugs. Per Carol Falkowski, most adult drug users started their inappropriate drug use as teens.

Information in this article and other sources should lead to optimism since this is a problem we can do something about. The National Institute of Drug Abuse (NIDA) stresses that prevention can decrease the chances an adolescent will try illegal drugs or become addicted. In Dangerous Drugs, the author notes that parents often incorrectly believe their teens don’t care what they think, but that isn’t true. If you’re a parent or other caring individual, make the precious investment in a teen.

Fast Food Fat

Fast Food Fat

Although there are many unhealthy fast foods, this article will focus on some of the problems with fats. Many who have given in to the practice of eating fast foods on a regular basis and become overweight console themselves that it is a temporary situation. In Kelly Brownell’s “In Your Face How the Food Industry Drives us to Eat” (Nutrition Action Healthletter, May, 2010), it is noted that obesity is very hard to correct. After a weight loss, the body requires fewer calories and that efficiency may continue after the weight loss. Hormonal changes after dieting can contribute to more frequent hunger that further sabotages maintenance at a particular weight.

In “Nutritional challenges and health implications of takeaway and fast food” by A. Jaworowska, T. Blackham I. Davies, and L. Stevenson (Nutrition Reviews, Vol 71 (5):  310-318), the correlation between fast food consumption and a higher intake of calories, trans and saturated fats, sugar and salt is noted. Likewise, regular fast food intake is associated with a decreased fiber, macronutrient and vitamin consumption than those that don’t eat fast food.

Research has uncovered the tendency of humans to eat a fairly set weight of food each day. If food is calorically dense it becomes easy to eat too much. Fats in particular are quite a concentrated energy source. Many fast foods are high in fat and that by itself is associated with weight gain. One study discussed in the above article noted that between 1997 and 2010 the average calories across all fast food items didn’t change very much. Other research found that eating fast food more than once a week increases the probability of becoming obese by 129%! Because fat improves the taste and texture of many foods, that factor also can increase intake. Unfortunately, the belief that fat provides a prolonged sense of fullness has been disproved by scientists.

Saturated fats increase the total cholesterol level as well as HDL cholesterol level, but the degree of increase varies with the type of fat. Perhaps more concerning is the association between a diet high in saturated fat and impaired glucose tolerance, insulin resistance and type 2 diabetes. The increase in weight from a high fat diet is one possible reason for this impaired glucose utilization. High saturated fat intake has been found to increase the risk of several cancers.

Trans fat consumption has decreased over the last ten years, but those who eat a lot of foods high in it are at risk for an increase in the level of several different blood lipids and an increased risk for coronary artery disease. French fries and some baked goods are often high in trans fat.

In his excellent book Fast Food Nation, Eric Schlosser noted that cooking oil used to prepare fries gives them their special taste. Until 1990, McDonald’s prepared fries in a mix that was 93% beef tallow. This created fries that had more saturated fat per ounce than their hamburgers. They switched to vegetable oil with “natural flavor” – a lab concoction that shouldn’t give anyone the idea that it is healthy. French fries absorb a lot of fat and thus pack plenty of calories. Sad to say, fries are a top seller in many types of fast food restaurants, and one that many don’t think of as a source of fat.

Some recent articles have given the false idea that saturated fat really isn’t that unhealthy. But the high calorie count from fat should keep us away from it. And trans fats won’t be cleared of their bad reputation in the near future, or maybe ever. Keep away from both, and, while you’re at it, stay away from those fast food joints.

Noise Pollution

 

Noise Pollution damages ears and more

It’s become a noisy world. Before motor vehicles and electronics, the main sources of loud sound were probably thunder storms, barking dogs and crying babies. Thanks to the Industrial Revolution, countless jobs come with high levels of sound that often require hearing protection. But that is only part of our exposure to noise and all the potential harm it can cause.

In Suman Gupta’s article “Noise Pollution,” published in Alive:  Canada’s Natural Health and Wellness Magazine, in April, 2015, various sources of noise for many of us living in the developed world are described. Below is the link to this excellent article.               (http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid,url,uid&custid=s7324964&db=cmh&AN=102370223&site=chc-live). The author lists the following common exposures to noise:  work in or residence near an industrial area, road traffic, airplanes, trains, construction sites, loud parties and household noise. Included in the latter category are televisions, radios, vacuum cleaners and loud conversations. Per the World Health Organization, noise is a threat to public health.

Author Gupta notes that repeated exposure to loud sound can contribute to cognitive impairment in children, sleep disturbances and cardiovascular disease. The impact is worse if it occurs at night. In “Turn Down the Noise, Turn Up the Quiet,” by Dr. Daniel Fink and Bryan Pollard (Hearing Health A Publication of Hearing Health Foundation, Summer, 2015) it is noted that thirty seconds of exposure to a 115 decibel (dB) sound can permanently damage hearing. 100-115 dB of sound volume can be reached with headphones and earbuds, chase and explosion scenes in movies, and at stadiums during sporting events. Background noise at bars, restaurants, stores and celebrations such as weddings, can also reach that painful level.  This article also describes apps to document noise and suggestions for enlisting local government in decreasing noise. Here is the link to this article:  http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid,url,uid&custid=s7324964&db=cmh&AN=108435972&site=chc-live

In “Caution Noise at Work” (HearingHealthmag.com, Winter, 2014) Kathy Mestayer goes into depth about various work-related exposures to noise. She notes that the National Institute for Occupational Safety and Health (NIOSH) will evaluate workplace noise at the request of employees or companies. They also can suggest ways to lower the volume in a work environment. NIOSH can also determine if a particular hearing protection fits properly. Here’s the link for this article:  http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,cpid,url,uid&custid=s7324964&db=cmh&AN=93447131&site=chc-live

Noise-induced hearing loss, per Kate Greene in “Stop that Noise!” (Natural Life, 2015 Annuale, pages 63-67), is one of the most rapidly rising disabilities. Considering how easy it is to prevent such damage as well as the other health effects, isn’t it time we took action?

Melatonin is needed for more than Sleep

Melatonin – Its needed for more than sleep

Melatonin, a hormone produced in the pineal gland in the center of the brain, has long been known for its ability to cause sleepiness. In “All about Melatonin,” an article in the August, 2015 edition of Better Nutrition, author Dr. Isaac Eliaz notes that the hormone has anti-oxidant and anti-inflammatory properties too. It has been classified as an immune modulator and “master repair hormone.”

Many white blood cells have receptors for melatonin and when there isn’t as much of it available, these white blood cells don’t function as well. Melatonin appears to help induce cancer cells to die, and decreases tumor blood vessel production, interfering with cancer growth if not survival. It may also lessen the side effects of chemotherapy and radiation.

The many forms of caffeine available as well as lighting and electronics can interfere with the normal production of melatonin. Considering the many essential roles of melatonin and sleep, it isn’t hard to understand the connection between a lack of such and acute as well as chronic diseases.

In the article “The Efficacy of Oral Melatonin in Improving Sleep in Cancer Patients with Insomnia:  A randomized, double- blind placebo-controlled study” by M. Kurdi and S. Muthukalai, it is noted that melatonin production starts in the evening with a decrease in light. One and a half to two hours later, the individual starts to feel sleepy. This article, found in Indian Journal of Palliative Care for July – September, 2016 Vol. 22, #3, discussed the effects of giving melatonin to a group of patients with cancer. The results of this research led the authors to conclude that giving melatonin led to improved sleep quality and decreased sleep latency – the amount of time between going to bed and falling asleep.

The authors of the above article also added that melatonin has a half-life of only 12 to 48 minutes. What this means is that it is soon cleared from the body and not going to produce drowsiness during the day if it is taken in the evening. Not every sleep aid can make that claim. Exogenous melatonin (not made in the body, such as oral tablets), is quickly absorbed and peak levels are reached one hour to two and a half hours later.

In “Optimal dosages of Melatonin Supplementation Therapy in Older Adults:  A systematic review of the Current Literature,” by E. Vural, et al, found in Drugs Aging (2014) 31:441-451, it is emphasized that melatonin production is decreased in older individuals. In healthy younger adults, melatonin secretion peaks between 2 and 4 a.m. at an average level of 60 pg/ml, gradually decreasing to less than 10 pg/ml during the day.

The pattern of melatonin secretion also changes with age. Changes in breakdown and elimination of melatonin led the authors to recommend that older individuals start with the low dose of 0.3 mg., and that they use only the immediate release formulations. As with all information in this article, this is not to serve as medical advice but rather information to be discussed with the person’s health care provider. Pregnant women shouldn’t take melatonin.

Enhancing Melatonin Production

In “All About Melatonin,” some recommendations for increasing melatonin production are given. These include keeping a regular schedule of sleep in a dark room, avoiding bright lights (including computers, cell phones, and smart phones) in the later evening, and using blackout curtains if your bedroom is near a source of outdoor nighttime lighting. The following foods can also support melatonin production:

  • Cherries, oranges, pineapple and bananas
  • Tomatoes and corn
  • Oats and barley