Monthly Archives: November 2020

Thyroid function and osteoporosis in menopause

Nov 29

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Evaluation of thyroid function status among postmenopausal women with and without osteoporosis

Berrin Acar

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Berrin Acar

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Affiliations

  • Department of Obstetrics and Gynecology, School of Medicine, Dokuz Eylul University, Izmir, Turkey

Abstract

Objective

To investigate the relationship between thyroid function status and bone mineral density (BMD) among women with postmenopausal osteoporosis.

Methods

A retrospective study was performed among 1217 women aged 45–80 years who attended the Department of Obstetrics and Gynecology at Dokuz Eylul University, Izmir, Turkey, between August 1, 2009, and June 1, 2013. Eligible participants were grouped according to the presence or absence of osteoporosis as defined by BMD measurements at the lumbar vertebrae (L1–L4), femoral neck, or trochanter of the femur. Serum levels of free tri-iodothyronine, free tetraiodothyronine, and thyroid-stimulating hormone (TSH) were assessed.

Results

The 303 women with osteoporosis had a lower mean TSH level (1.8 mIU/L) than did the 914 women without osteoporosis (1.9 mIU/L; P = 0.01). A positive correlation between TSH level and measures of BMD was observed (P = 0.01). The TSH level was associated with a protective effect in a regression model for development of osteoporosis; the odds ratio was 0.68 (95% confidence interval 0.53–0.86).

Conclusion

Osteoporosis appeared to be independently associated with serum TSH level. Maintaining TSH levels within the upper limit of the reference range during treatment of hypothyroidism could be important to prevent osteoporosis among postmenopausal women.

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How do you know if you’re obsessed with your health?

Nov 25

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­

Health Check: how do you know if you’re obsessed with your health?

January 23, 2017 12.53pm AEDT
Jill Newby

Author

  1. Lecturer and NHMRC Early Career Research Fellow, UNSW Australia

Disclosure statement

Jill Newby receives funding from the Australian National Health and Medical Research Council (NHMRC) in the form of an Early Career Fellowship (1037787).

Partners

UNSW Australia provides funding as a member of The Conversation AU.

View current jobs from UNSW Australia

Most of us worry about our health at some point. You may notice a new symptom or change in your body and become convinced it’s a sign of a horrible illness; a loved one might become ill and you might worry it may also happen to you.

In fact, it can be helpful to be concerned about your health. This is the type of concern that might motivate you to visit your doctor to check a sore back, apply sunscreen to prevent skin cancer, eat well, exercise or drink enough water.

Usually, worries about your health are short-lived and disappear after symptoms go away or after you receive the all clear from your doctor.

But for some people, what starts as a normal health concern can tip over into a serious mental health problem you might know as hypochondria, health anxiety or to give it its official title, illness anxiety disorder.

So how can you tell if your health concerns are helpful or harmful? And where can you go for help?

What is illness anxiety disorder?

Illness anxiety disorder involves an overwhelming, disabling and crippling fear of illness and is a new psychiatric disorder listed in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5.

Illness anxiety disorder replaced the contentious diagnosis of hypochondriasis in previous versions of the DSM. The new label, which is also sometimes referred to as severe health anxiety or health anxiety for short, is less stigmatising, and better reflects the fact anxiety about illness is at the heart of this condition.

How do you know if you have it?

Like any mental health condition, answer the following questions to see if your anxiety has become a problem:

  1. Is it lasting too long, occurring too often and difficult to control?
  2. Is it out of proportion to the actual danger or seriousness of the physical symptoms?
  3. Is it distressing or affecting your quality of life, well-being and relationships?

Do you ever Google your symptoms or check your body a lot for illness signs and symptoms? Are you very careful about what and where you eat because you are afraid you might get sick? Do you seek a lot of reassurance from friends, loved ones or health professionals about your health, or go straight to the doctor as soon as you notice a change in your body? Or do you simply spend a lot of time thinking about your health, dreading the idea you may become sick?

These things aren’t necessarily a sign of anything unusual, but if they happen too often or start affecting your quality of life, they might be a signal you need to seek help and support.

Illness anxiety is common

We published data from an Australian population survey that found illness anxiety affects 5.7% of Australians at some point in their lives. That’s over one million people.

As well as placing a burden on the individual, it places a burden on society due to excessive health care use.

There is also little community awareness it exists. And it is often misdiagnosed as a “personality trait” rather than a treatable condition.

Illness anxiety comes in many shapes and sizes

The illnesses people fear are vast and varied. While the creative ways the mind interprets what is going on the body can be fascinating, it’s also troubling how debilitating this condition can be.

Some people are terrified of having cancer, heart defects, HIV or other STIs, despite repeated reassurance and negative test results. Others are anxious they have neurological conditions and dementia despite all evidence pointing to the contrary. Some are convinced they have parasites, mental illnesses and even Ebola.

Most people with illness anxiety frequently seek health care, with higher overall rates of health service use in people with illness anxiety compared to the general population. But people may also avoid health care because they are terrified of finding out they are sick.

Where you can find help?

Illness anxiety can be successfully treated using cognitive behavioural therapy or CBT, a kind of therapy that teaches new ways of thinking and behaving. In CBT, we teach people how to recognise the symptoms of illness anxiety, and practical strategies to overcome the thoughts, worries and unhelpful behaviours (like excessive counterproductive body checking) that make illness anxiety worse in the long term.

The aim of CBT is not to take away all anxiety but to help people live a normal, healthy life without the dread of illness hanging over them.

If you are considering CBT, the first step is to see a doctor you trust for a general health check, and to rule out serious illnesses.

You can receive CBT in face-to-face sessions at specialist anxiety clinics or with experienced psychologists. Recent research shows self-help and online treatment also have excellent results. Self-help resources and comprehensive online CBT programs are now available in Australia.

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Impact of consuming a milk drink containing a probiotic on mood and cognition

Nov 23

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I take a probiotic daily (Table of Plenty, Probiotic Kefir, Grassfed Gippsland cows, 10 live cultures, 90 billion friendly bacteria per serve, available Coles and Woollies) and have for many years. I do feel it has helped me in many ways.

Original Article

European Journal of Clinical Nutrition (2007) 61, 355–361. doi:10.1038/sj.ejcn.1602546; published online 6 December 2006

Impact of consuming a milk drink containing a probiotic on mood and cognition

Guarantor: D Benton.

Contributors: DB was responsible for the design and analysis while CW and AB ran the study and collected the data.

D Benton1, C Williams1 and A Brown1

1Department of Psychology, University of Wales Swansea, Wales, UK

Correspondence: D Benton, Department of Psychology, University of Wales Swansea, Singleton Park, Swansea SA2 8PP, Wales, UK. E-mail: d.benton@swansea.ac.uk

Received 29 November 2005; Revised 19 June 2006; Accepted 17 September 2006; Published online 6 December 2006.

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Abstract

Objective:

The impact on mood and memory of consuming a probiotic containing milk drink, or a placebo, was examined as, previously, a poor mood has been found to correlate with the frequency of constipation.

Design:

A double-blind placebo-controlled trial with random allocation of subjects.

Setting:

Subjects went about their normal life in the community apart from three visits to the laboratory.

Subjects:

One hundred and thirty-two healthy members of general population, mean age 61.8 years, volunteered in response to local media coverage. One hundred and twenty-four finished the trial.

Intervention:

For a 3-week period, either a probiotic containing milk drink, or a placebo, were consumed daily. Mood and cognition were measured at baseline, and after 10 and 20 days of consumption.

Results:

At baseline those who reported themselves to be less frequently constipated were more clearheaded, confident and elated. Although the taking of the probiotic did not generally change the mood, this appeared to be a reflection of the generally good mood in this sample. When those in the bottom third of the depressed/elated dimension at baseline were considered, they selectively responded by reporting themselves as happy rather than depressed after taking the probiotic. The intervention did not, however, influence the reported frequency of defaecation, probably a reflection of the initially low incidence of constipation. An unexpected and possibly chance finding was that the consumption of probiotics resulted in a slightly-poorer performance on two measures of memory.

Conclusions:

The consumption of a probiotic-containing yoghurt improved the mood of those whose mood was initially poor. This improvement in mood was not, however, associated with an increased frequency of defaecation.

Sponsorship:

Funded by Yakult, Japan.

Keywords:

constipation, depression, memory, mood, probiotic

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Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women.

Nov 22

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Vaginal dryness and discomfort is common in the menopause. As is pain on intercourse. Unfortunately, most women do not mention it to their doctors, and just suffer in silence. Treatment is effective – either oestrogen in HRT or oestrogen as a pessary or vaginal cream. This study shows that treatment is best and more effective if started early, rather than when the problem has been there for a while.

Maturitas. 2019 Jun;124:55-61. doi: 10.1016/j.maturitas.2019.03.013. Epub 2019 Mar 18.

Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women.

Panay N1, Palacios S2, Bruyniks N3, Particco M4, Nappi RE5; EVES Study investigators.

Author information

Abstract

OBJECTIVES:

To evaluate the association between treatments for vulvovaginal atrophy (VVA) and symptom frequency and severity, quality of life (QoL) and sexual functioning in postmenopausal women.

STUDY DESIGN:

Cross-sectional survey conducted in postmenopausal women aged 45-75 years. Data on demographic and clinical variables, as well as vaginal, vulvar and urinary symptoms were collected. The EuroQoL questionnaire (EQ5D3L), the Day-to-Day Impact of Vaginal Aging (DIVA), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale – revised (FSDS-R) were filled out.

MAIN OUTCOME MEASURES:

Association between treatments for VVA and symptom frequency.

RESULTS:

Women on VVA treatment presented with more severe symptoms. The sexual function score was higher in the treated women (FSFI: 15.6 vs 16.7; p = 0.010), as was the score for sexual distress (FSDS-R: 9.2 vs 12.3, p < 0.0005). The systemic hormone group presented with fewer VVA symptoms, lower vaginal impact (DIVA), and better sexual function (FSFI and FSDS-R) and vaginal health. The rates of sexual distress and vulvar atrophy were higher in the non-hormonal treatment group. No significant differences were found according to treatment duration.

CONCLUSIONS:

Postmenopausal women with VVA receiving treatment complained of more severe symptoms than those untreated. Women on systemic ( orally or transdermal) treatment had fewer and milder VVA symptoms and presented with better vaginal and vulvar health than women on other treatments.

Many women request effective local treatment too late, when VVA symptoms are already severe. Our data suggest that VVA treatments should ideally be initiated when symptoms commence and cause distress, rather than later, when symptoms may have become more severe and even a cause of intolerable distress for the woman.

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Diabetes drug has unexpected, broad implications for healthy aging

Nov 18

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Top News in Internal Medicine

I have been interested in Metformin for some time for its antiaging and anti-cancer properites. The other advantage is that it comes from natural sources. History. Metformin was originally developed from natural compounds found in the plant Galega officinalis, known as French lilac or goat’s rue. It is well known that diabetics get less cancer than the general population, and it is thought to be due to the metformin they take (AKA Diabex, Diaformin)

Diabetes drug has unexpected, broad implications for healthy aging

MedicalXpress Breaking News-and-Events | December 03, 2019

Metformin is the most commonly prescribed type 2 diabetes drug, yet scientists still do not fully know how it works to control blood sugar levels. In a collaborative effort, researchers from the Salk Institute, The Scripps Research Institute and Weill Cornell Medical College have used a novel technology to investigate why it functions so well. The findings, which identified a surprising number of biochemical “switches” for various cellular processes, could also explain why metformin has been shown to extend health span and life span in recent studies. The work was published in Cell Reports on December 3, 2019.

“These results provide us with new avenues to explore in order to understand how metformin works as a diabetes drug, along with its health-span-extending effects,” says Professor Reuben Shaw, co-corresponding author of the paper and the director of Salk’s NCI-designated Cancer Center. “These are pathways that neither we, nor anyone else, would have imagined.”

Previously, the only biochemical pathway that was known to be activated by metformin was the AMPK pathway, which Shaw discovered stalls cell growth and changes metabolism when nutrients are scarce, as can occur in cancer. But the scientists believed more pathways than AMPK might be involved.

The scientists developed a novel screening platform to examine kinases, the proteins that transfer phosphate groups, which are critical on/off switches in cells and can be rapidly flipped by metformin. Using this technology, the researchers were able to decode hundreds of regulatory “switch-flipping” events that could affect healthy aging.

“Being mentored by John Yates, one of the top mass spectrometry investigators in the world, and Reuben Shaw, an expert in the field of metabolism, enabled me to both develop and apply a novel technology to a critical biological question: What pathways are regulated by metformin in the liver?” says Ben Stein, first author and postdoctoral associate at Weill Cornell Medical College.

The results revealed that metformin turns on unexpected kinases and pathways, many independent of AMPK. Two of the activated kinases are called Protein Kinase D and MAPKAPK2. These kinases are poorly understood, but are known to have some relation to cellular stress, which could connect them to the health-span- and life-span-extending effects observed in other studies. In fact, metformin is currently being tested in multiple large-scale clinical trials as a health-span- and life-span-extending drug, but the mechanism for how metformin could affect health and aging has not been clear. The current study indicates that Protein Kinase D and MAPKAPK2 may be two players in providing these therapeutic effects, and identifies new targets and cellular processes regulated by AMPK that may also be critical to metformin’s beneficial effects.

“We never imagined these two kinases would have anything to do with metformin,” says Shaw, holder of the William R. Brody Chair. “The results broaden our understanding of how metformin induces a mild stress that triggers sensors to restore metabolic balance, explaining some of the benefits previously reported such as extended healthy aging in model organisms taking metformin. The big questions now are what targets of metformin can benefit the health of all individuals, not just type 2 diabetics.”

Next, the researchers plan to examine the new signaling pathways they discovered in more detail to better understand the beneficial effects of metformin.

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Should I test my gut microbes to improve my health?

Nov 16

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Shutterstock

Should I test my gut microbes to improve my health?

March 16, 2020 5.50am AEDT

Authors

  1. Amy Loughman Research Fellow, Deakin University
  2. Heidi Staudacher Postdoctoral Research Fellow, Food & Mood Centre, Deakin University

Disclosure statement

Amy Loughman receives funding from Deakin University and The Jack Brockhoff Foundation.

Heidi Staudacher is funded by an Alfred Deakin Postdoctoral Research Fellowship from Deakin University.

Partners

Deakin University

Deakin University provides funding as a member of The Conversation AU.

CC BY NDWe believe in the free flow of information
Republish our articles for free, online or in print, under Creative Commons licence.

People are paying hundreds of dollars to have their gut microbes analysed, hoping the insights will allow them to adjust their diet and improve their health.

But these testing services are based on science that’s still in its infancy, as we explain in our recent paper.

So while there may be great promise for analysing our gut microbiome to help diagnose and treat people in the future, for the moment knowing what’s in your gut is mostly a curiosity.

Read more: Essays on health: microbes aren’t the enemy, they’re a big part of who we are

But aren’t these tests based on science?

The idea of your gut microbiome – the whole community of gut microbes and their products – influencing your health is gaining momentum.

Over about the past two decades, the gut microbiome has been linked to everything from inflammatory bowel disease to depression. Remind me again, what’s a microbiome?

So it’s been appealing to think if you just knew what was in your gut microbiome, you could tweak your diet and create a “designer microbiome” to improve your health.

There’s preliminary evidence analysing the gut microbiome in a stool sample can help predict who will do well on a certain diet.

There’s also some evidence it can help predict which people with inflammatory bowel disease respond to medical treatments.

Read more: Explainer: what is inflammatory bowel disease?

But these findings are far from being applied more generally and for routine health care.

One day, we may understand how combining information about your microbiome with other test results, such as genomic tests (sequencing your human genes) might help.

The idea is that this would help people prevent disease and medication side-effects, predict their future risk of disease, and help choose a personalised diet for optimal health.

Combining the results from blood tests with analysing your gut microbiome may one day give us more insight. But it’s too early to tell. Shutterstock

For instance, information about someone’s microbiome, when combined with blood tests and their diet, can predict how someone’s blood glucose levels respond to specific meals.

This 2015 study also showed that by analysing someone’s gut microbes you could tailor their diet to keep their blood glucose under control.

Again, while the prospect might sound appealing – and the potential impact huge – we don’t yet have the evidence to implement this more widely.

There’s also much we don’t know about the microbiome itself. For instance, scientists don’t agree what a healthy microbiome looks like, we haven’t sequenced all of the bacterial genes, and we don’t know what they do or how they interact.

So while we are starting to understand the ideal microbiome for health, it is still more of a rough sketch than a blueprint.

But I’m curious anyway

Most companies ask you to send in a stool sample, which you take yourself and post in a secure package to a laboratory to analyse the results.

Each company is different

Different companies analyse your stool sample in different ways.

For instance, some tell you the relative abundance of bacteria down to the genus level (but not the species level). Some tell you which strains of microbe are present (not just bacteria, but viruses and fungi too) and their function. Some tell you which of the microbe genes are expressed and active.

All of these are legitimate approaches to analysing your gut microbiome, and you could expect a reasonable degree of accuracy.

How do you interpret the results?

The companies also differ in how they supply and interpret the results. The company may compare your results with others they’ve analysed. But they can’t compare them with an “average” or “healthy” microbiome because an individual company doesn’t sample the whole population, and scientists haven’t yet defined a “healthy” microbiome.

Some companies advise the types of foods you could eat to boost levels of particular bacteria. You might also be told that a certain bacteria can be associated with some health condition, like obesity or constipation.

Ideally, alongside your results would be an explanation about the types of research the insights are based on, limitations of the evidence, and a caution the results cannot be considered medical advice.

Unfortunately, consumers don’t always receive this information, and it can be hard to know what to do with the test results.

What about privacy?

Another important issue to consider is who has access to your test results and under what circumstances. This has been a concern with take-home genetic tests in the United States.

Although data about your microbial genes may not seem sensitive and private as your own genes, ensuring you know who might have access to your stool testing data is an important consideration.

There’s research to see whether the microbiome could may one day be used in forensics, demonstrating the very personal nature of these data.

In a nutshell

Given the complexity of the gut microbiome and its interaction with us, its host, we still need large research trials replicated across different centres to make sense of the data.

So-called microbiome diagnostics could become central to optimising health and improving care of people with chronic disease in the future.

But, for the moment, knowing the specific community of your gut microbes will only serve to satisfy your curiosity, not improve your health.

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Boost your memory with these simple tricks

Nov 11

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Boost your memory with these simple tricks

John Murphy|November 6, 2020

How many times have you put down your car keys and almost instantly forgot where you laid them? Everyone has a lapse in memory now and again. The good news is that you can actually do something about this. Your brain’s “memory banks” aren’t restricted by size or function—you can expand and improve your recall. memory tips

Memory isn’t hard-wired in the brain. These tips and tricks can help you improve your memory and recall.

To that end, here are some simple tips and tricks you can use to help boost your brain’s memory banks. 

Say it out loud

Want to remember something? Say it out loud. In a study published in Memory, researchers showed that people remember information best when they hear themselves reading it aloud. The action of speaking, called the “production effect,” is the secret sauce to this improvement in memory. “When we add an active measure or a production element to a word, that word becomes more distinct in long-term memory, and hence more memorable,” said one of the co-authors of the study. 

Check the instant replay

To lodge a memory, replay the event in your mind. Researchers at the University of Sussex reported in the Journal of Neuroscience that people create a more lasting memory if they replay (or “rehearse”) in their minds a scene they just witnessed. “The findings have implications for any situation where accurate recall of an event is critical, such as witnessing an accident or crime,” said the study’s lead researcher. “Memory for the event will be significantly improved if the witness rehearses the sequence of events as soon as possible afterwards.”

Don’t multitask for important things

Multitasking is a misnomer. It implies that a person can perform several tasks at the same time. In reality, multitaskers are really just switching quickly between tasks because our brains only allow us to do one thing at a time. As such, Stanford researchers showed in a study in Proceedings of the National Academy of Sciences that people who multitask on several media at the same time—eg, smartphones, TV, laptops, etc—perform significantly worse on simple cognitive memory tasks. Plus, multitasking is more of a time-waster than a time-saver. “If you’re multitasking while doing something significant, like an academic paper or work project, you’ll be slower to complete it and you might be less successful,” said a co-author of the study. 

Try a little mindfulness

Mindfulness can prevent your mind from wandering, which improves focus and memory, according to researchers at the University of California–Santa Barbara. In a study published in Psychological Science, the researchers showed that a 2-week mindfulness course significantly improved participants’ working memory capacity, reading comprehension, and ability to focus. “Improvements in performance following mindfulness training were mediated by reduced mind wandering among participants who were prone to distraction at pretesting,” the authors concluded. “Our results suggest that cultivating mindfulness is an effective and efficient technique for improving cognitive function, with wide-reaching consequences.”

Use pen and paper

Writing notes by hand is better for retaining conceptual information than taking notes on a laptop, according to research published in Psychological Science. Although laptop users took more notes and took them verbatim, pen-and-paper users scored significantly better at answering conceptual questions on the material. “It may be that longhand note takers engage in more processing than laptop note takers, thus selecting more important information to include in their notes, which enables them to study this content more efficiently,” the researchers wrote.

Take a hike

Getting out for a nature walk can help you forget your troubles. But it can also help you remember better—and feel better—according to researchers. In one study, people who took a 50-minute walk in a “nature environment” had less anxiety, rumination, and negative affect than people who walked in an “urban environment.” Nature walkers also showed improvements in positive affect and working memory. “These findings support an account of a pathway by which nature exposure may provide a ‘restorative’ affective experience, perhaps through some process of ‘negative affect repair,’” the authors wrote. 

Retrace your steps

Retracing your steps—literally—can help you remember. In a study published in the journal Cognition, researchers showed that people who walked backward during a memory experiment had better short-term memory recall than those who walked forward or sat still. This held true even if participants imagined walking in reverse or watched a video that simulated backward motion. “The results demonstrated for the first time that motion-induced past-directed mental time travel improved mnemonic performance for different types of information. We briefly discuss theoretical and practical implications of this ‘mnemonic time-travel effect,’” the study authors wrote. 

Take a nap

A 1-hour “power nap” can significantly improve memory performance, according to the results of a study in Neurobiology of Learning and Memory. “Even a short sleep lasting 45 to 60 minutes produces a five-fold improvement in information retrieval from memory,” said one of the study co-authors. These results could be put into practice just about anywhere, the researchers noted. “A short nap at the office or in school is enough to significantly improve learning success. Wherever people are in a learning environment, we should think seriously about the positive effects of sleep,” the co-author said.

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Dangers of Panadol

Nov 9

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The world’s most popular OTC painkiller is increasingly causing poisonings

ScienceAlert Latest|October 30, 2020

Acetaminophen is one of the most popular painkillers in the world. Better known by brand names like Tylenol, Panadol or Excedrin, this drug can be used very safely to treat minor aches, pains, and fevers in the short-term.

That said, over the past few decades, unintentional overdoses from acetaminophen have been on the rise in many nations, and some scientists think it has to do with the dosages available.

Even when prescribed by physicians, new research from Switzerland suggests a higher dose of acetaminophen makes it easier for people to accidentally poison themselves, and while this doesn’t often lead to death (we have an effective antidote), it can cause severe liver damage.ADVERTISEMENT – SCROLL TO KEEP READING

In Switzerland, most over-the-counter (OTC) tablets contain roughly 500 milligrams of acetaminophen. But in 2003, the nation introduced a prescription-only tablet containing 1,000 mg of the drug.

Within two years, national sales for this larger tablet had outrun the smaller one, and today, the higher dose is sold ten times more.

Analysing calls to the Swiss National Poison Centre before and after 2003, researchers were alarmed to find a significant increase in unintentional overdoses from acetaminophen, and most of these cases were tied to the 1,000-mg tablet.

Intentional poisonings, on the other hand, did not appear to increase, which suggests the vast majority of these emergency situations are entirely avoidable.

“One problem with [acetaminophen] is that it is not effective for all patients or against all forms of pain,” explains Andrea Burden, a pharmacoepidemiologist at ETH Zurich.

“If the drug doesn’t help to ease someone’s symptoms, they may be tempted to increase the dosage without consulting a medical professional. That’s the real problem.”

Many people don’t realise that each pill of acetaminophen you swallow adds up in the body. This means taking just a few extra 1,000 milligram tablets can put you at risk of an overdose, easily exceeding the 4,000 recommended milligrams a day for adults.

For that very reason, in 2008, the United States Food and Drug Administration (FDA) recommended limiting an adult dose to two tablets containing 325 mg of acetaminophen, with a boxed warning about how toxic byproducts form the drug can build up in your liver, causing damage or even failure.ADVERTISEMENT – SCROLL TO KEEP READING

In Switzerland during these years, however, larger doses were only growing in popularity. Within a year of 1,000-mg tablet being introduced, the new study found a significant increase in acetaminophen-related calls to the Swiss National Poison Centre.

Between 2005 and 2008, there was actually a 40 percent increase in poisoning cases, especially among older adults and kids.

“On that basis, we can conclude that the increased number of poisoning cases is associated with the availability of the 1,000 milligram tablets,” says pharmacologist Stefan Weiler, scientific director of the Swiss National Poison Centre.

Interestingly, the results suggest these 1,000-mg tablets are not necessarily replacing 500-mg ones. Instead, it appears an entirely new group of people are being prescribed these larger doses, possibly because they are considered safer pain meds to opioids and other narcotics.

This is worrisome given the limited effectiveness of acetaminophen for acute pain and particularly for chronic pain. If people are expecting these meds to work and they’re not, they might take another pill too early, putting themselves at risk of overdose.

“We recognize that pain management is challenging, and other medications may have severe adverse effects,” says Burden.

“But, if [acetaminophen] doesn’t have the desired effect, it’s important not to simply take more tablets. Instead, people should seek professional medical advice in order to find the best therapeutic option.”

Luckily, 90 percent of people in the study who overdosed on acetaminophen received the antidote within 8-10 hours, reducing their risk of liver damage and death.ADVERTISEMENT – SCROLL TO KEEP READING

Yet most of these situations could have been avoided entirely. If acetaminophen is not suitable for chronic pain, Burden says, then pack sizes should represent that. They shouldn’t contain 40 tablets or more.

“At the very least, packs of the 1,000 milligram tablets should contain a smaller number of tablets,” says Burden. Even if a patient needs a higher dose, it might be safer to prescribe two tablets of 500 mg.

While it’s too early to determine the exact cause of the poisonings, public health experts have a few ideas. Patients might be mistaking stronger tablets for weaker ones, unknowingly doubling their dose. If this happens in young children, one pill is sometimes enough to put them well above the daily minimum and at risk of poisoning.

Another part of the problem comes from a lack of communication. Many doctors and pharmacists don’t take the time to explain to their patients how acetaminophen can build up in the body, how it can impact the liver and how the drug is limited when it comes to chronic pain.

These sorts of mistakes are easy to mitigate, we just need to draw attention to the problem.

The study was published in JAMA Network Open.

To read more, click here

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Foods you didn’t know could cause obesity and cancer

Nov 8

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Foods you didn’t know could cause obesity and cancer

Alistair Gardiner|November 5, 2020

How careful are you about how you fuel your body? Maybe you count calories. Maybe you’ve found a diet with the right balance of carbohydrates, proteins, and fats. Maybe you’ve even seen some positive results. There’s still a good chance that you’re consuming too much of one insidious ingredient—sugar.sugar obesity cancer

These foods may seem healthy, but their hidden sugar content means they can lead to obesity and cancer.

Sugar is hiding in many foods that we commonly assume are healthy, and there are several reasons you should monitor how much of it you’re eating.

For years, researchers have been studying the links between sugar intake and cancer. While research hasn’t established a causal link in humans, some studies in mice have found a correlation between the consumption of sugar and the likelihood of developing cancer.

Also, excess dietary sugar frequently leads to obesity. Numerous studies and research involving millions of people over decades has established a clear link between being overweight and increased risks of developing cancer. In 2012 in the United States, an estimated 3.5% of all new cases of cancer in men and 9.5% of new cancer cases in women were due to overweight or obesity, according to a large worldwide population-based study. Obesity can be a factor in various types of cancer, including but not limited to breast, colon, uterine, gallbladder, thyroid, and kidney cancer

The research is slowly but consistently suggesting that sugar could be carcinogenic, whatever your body size. One study published last year established a link between the consumption of sugary drinks and an increased risk of developing cancer, regardless of body weight.

The 2020 US Dietary Guidelines Advisory Committee lowered the daily recommended intake of sugar from 10% of daily calories to 6%. For men, this means lowering their daily intake from roughly 38 g to 23 g (or from about 9 to 6 tsp). For women, this means going from around 25 g (6 tsp) of sugar per day to roughly 15 g (3.5 tsp). By comparison, the average American eats about 17 tsp of sugar a day, not including the sugars that naturally occur in foods like fruits, vegetables, and milk.

The public is now well aware of some foods that are packed with sugar, like sodas. But here are six foods that you may not have realized contain a lot of added sugars.

Low-fat yogurt

You may think that grabbing a tub of low-fat yogurt is a healthier choice than the full-fat option. However, yogurt is among various low-fat products that often contain added sugar to improve taste.

One study surveyed the sugar content of more than 900 yogurts and found that the average amount of sugar across the categories was more than 10 g for each 100-g serving. More than half of low-fat yogurts included in the study were found to have between 10-20 g of sugar per serving. Interestingly, organic yogurts were found to be some of the sweetest. The median sugar content for all organic yogurts included in the study was more than 13 g per 100-g serving, with some brands featuring almost 17 g of sugar per serving.

If you’re a big fan of yogurt, you should stick to unflavored varieties, particularly natural or Greek yogurts. One of the findings of the study was that sugar accounted for the majority of total calories in all yogurts analyzed with the exception of those labeled natural or Greek.

Ketchup

The most iconic condiment on Americans’ dinner table, ketchup is also unfortunately a Trojan horse for added sugar. According to the USDA database, many brands of ketchup contain as much as 23 g of sugar per 100-g serving.

Of course, when it comes to ketchup, there’s one name on the tip of everyone’s tongue: Heinz. According to the company’s website, 1 tbsp of Heinz ketchup contains 4 g of sugar, which means a full bottle contains roughly two-thirds of a cup of the sweet stuff.

Flavored milk

Flavored milk can be a real treat for kids (and some grownups, too). But watch out: Those beverages that we all remember from childhood and still enjoy as adults can be packed with added sugars.

According to the USDA, 100 ml of plain whole milk typically contains around 4.5 g of sugar. However, various brands of flavored milks often contain more than 10 g of sugar per serving.

Many of us enjoy indulging occasionally, but if you or your kids are craving a flavored milk, look at the nutrition label first and avoid making it a daily habit.

Granola

Granola may seem like a healthy snack, but that’s only the case with certain brands or with the homemade variety. According to the USDA, various granolas have as much as 20 g of sugar per 100-g serving. Some even feature sugar levels as high as almost 30 g per 100-g serving.

That said, not all granolas are created equally. There are various products on the market that feature far lower levels of sugar, some between 1-14 g per serving. Once again, the key is to check the label before you buy, and look for brands that feature more oats, nuts, and seeds. These will feature lower levels of sugar and more protein and fiber, which will fill you up more quickly and keep you satiated longer.

Nutrition bars

While often marketed as healthy snacks, nutrition bars (also known as energy bars or granola bars) can sometimes have the same amount of sugar as a packet of candy—as much as 20 g of sugar per bar. That’s almost the same amount of sugar you’d get from a package of Reese’s Peanut Butter Cups.

Substitute your nutrition bar for an afternoon snack that’s actually nutritional, like some fruit.

Canned beans

If you’re looking to get healthy, beans are your friend. They’re a great low-fat source of protein, fiber, vitamins, and minerals. Unfortunately, canned beans can also be stuffed with added sugar.

According to the USDA, many brands of canned beans contain more than 10 g of sugar per 100-g serving. Some contain as much as 16 g per serving.

So, while adding beans to your diet is definitely a good idea, stick with the rule of thumb: Check the label

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Dr Holloway’s Holidays.

Nov 8

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I am going to be away from the 11th December until the 19th Jan. Anyone who needs to see me before then, will need to make an appointment soon, as I still have some appointments available. Anyone who will need a prescription to tide them over, arrange that before that date. Keep safe and well.

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