Young girl pouring pills image via Shutterstock

“Up and Away and Out of Sight” encourages parents to follow some basic principles for keeping medications out of the hands of children:

• Keep prescription medications, over-the-counter medications, and vitamins out of reach of children, and in a place where the children can’t see the medications.

• Put medications away in an out-of-sight, out-of-reach place every time they’re used, even if another dose will be necessary in a few hours’ time.

• Listen for the “click” of a properly locked safety cap when closing medication.

• Teach children what medication is, and that they must not take it on their own. It’s important to avoid referring to medication as “candy” or a “treat.”

• Make sure visitors put their bags, purses, and anything else that contains medication out of reach of children.

• Call Poison Control in the case of a suspected or known medication overdose.

While many parents recognize that prescription medication can be dangerous in the case of an accidental ingestion or overdose, fewer realize that over-the-counter medication overdoses can have harmful or fatal consequences. For instance, acetaminophen — the ingredient in Tylenol — can lead to irreversible and catastrophic liver damage if too much is taken. Acetaminophen overdoses are particularly common in children, because the ingredient is present in many different over-the-counter medications, and parents or caregivers may not think to cross check all the medications they’re giving for a child’s symptoms. Further, parents or caregivers can unintentionally overdose a child in the event that they don’t communicate with one another about when a dose of medication was last given.

Until recently, acetaminophen was available in two different pediatric formulations: one for babies, and one for toddlers and older children. The infant formulation was administered by dropper, and was much more concentrated than the older child formulation, which was consequently administered in larger doses. A parent used to using the weaker formulation could inadvertently overdose a child by giving the same volume of the much stronger infant formulation. The FDA was originally planning to discuss the safety of Infant Tylenol, but several drugmakers — including Johnson & Johnson — preempted any formal action by announcing a decision to discontinue over-the-counter infant drops of medications that contain acetaminophen in May of 2011 [2]. This came amid a number of product recalls in 2011 as J&J was looking to restore brand confidence.

Because the FDA did not take formal action on the acetaminophen formulation issue, manufacturers are still free to make infant-strength acetaminophen formulations. Parents should therefore double-check the strength and dosage of acetaminophen — or any other medication — before administering it to children.

References

1. Many young children overdosing from medicines at home. U.S. Centers for Disease Control and Prevention press release. 2011 Dec 13.
2. OTC Industry Announces Voluntary Transition to One Concentration of Single-Ingredient Pediatric Liquid Acetaminophen Medicines. Consumer Healthcare Products Association. 2011 May 4

Research has shown that, following a large meal, less tryptophan will reach the brain than on an empty stomach. The real culprit is the types and quantity of food you’ve eaten. Blame your sleepiness instead on high-calorie, high glycemic index foods.

Here are a few easy science-based tips to ensure not only a delicious turkey but a healthy Thanksgiving.

Defrost safely

If your Thanksgiving turkey is frozen, when you defrost it keep the outside of the bird below 41 degrees Fahrenheit (5 degrees Celsius). Pathogens such as Salmonella or Campylobacter don’t grow below that temperature. You can do this by putting the bird in cool water or the refrigerator.

If you go the route of the refrigerator — likely the easier of the two options — note that it can take additional time to thaw. According to the U.S. Department of Agriculture (USDA), it takes about 1 day for every 4-5 pounds [1]. If you thaw your turkey this way, be sure to catch any drippings under the turkey so you don’t contaminate ready-to-eat foods like apples or lettuce.

Don’t wash that bird

Running a raw turkey under the faucet doesn’t remove bacteria. In fact, doing so can spread pathogens around the kitchen. Splashing water can aerosolize bacteria and carry them around the room. Instead, wipe the turkey with a paper towel to remove foreign debris.

With all that cooking going on in the kitchen, make sure you keep track of your knives and cutting boards. Anything that’s touched raw meat needs to be washed with soap and water to prevent cross-contamination — that includes your hands and the countertop. If you’ve thawed your turkey in water, be sure to clean the sink with soap and water to remove any bacteria.

Cook your stuffing separately

The USDA advises against stuffing the turkey [1]. Instead, cook your stuffing outside the bird. Stuffing can easily become contaminated with Salmonella from inside the turkey. In addition, thick breading can interfere with moisture migration and cause the turkey to cook more slowly. This makes it even more difficult to get the breading hot enough to kill bacteria without overcooking the turkey.

If you decide to stuff the bird anyway, be sure to use a food thermometer. The center of the stuffing needs to reach a safe minimum internal temperature of 165 degrees Fahrenheit (74 degrees Celsius). Let the bird stand 20 minutes before removing the stuffing and carving.

The perfect turkey

Why does meat get dry when it’s overdone? As meat is cooked, heat flows in and denatures (meaning unfolds) proteins. Once unfolded, the proteins no longer wrap around water molecules in the cells and stick together, making the meat tougher.

The challenge with cooking a turkey is that it has two different kinds of meat. White breast meat is very different from dark leg, thigh and wing meat.

Muscular dark meat is reinforced with connective tissue, tendons and ligaments, all of which are abundant with a protein called collagen. Softening dark meat takes hours of roasting to turn the collagen into gelatin that moistens the meat. In contrast, white meat doesn’t have much collagen and is abundant in myosin and actin proteins. White meat becomes tender after myosin breaks down, occurring at a lower temperature than what is required to break down the collagen in dark meat. This is the reason why it’s common to have a turkey with moist dark meat but dry white meat; the white meat has been overcooked.

To avoid this, you could prepare the turkey parts individually and cook them to the optimal texture and temperature. Another option is to start out with the breast section cooler than the rest of the bird. This can be accomplished by placing an ice pack on the breasts while the bird is thawing or for about a half-hour prior to cooking. This will allow the different meats of the turkey to cook more evenly. You’ll have to add 15-30 minutes to the cooking time to ensure the white meat is fully cooked. Remember that a whole turkey is safe cooked to a minimum internal temperature of 165 degrees Fahrenheit (74 degrees Celsius) throughout the bird.

One last thing to consider is basting. Many people baste their turkey with hot juices right from the roasting or drip pan. However, pouring very hot liquid over white breast meat causes it to cook faster. You can baste legs and wings with the hot liquid right from the pan, but let the juices cool down before you baste the breast. This will help maintain some moisture in the meat, add flavor and keep the turkey cooking properly.

Give thanks

People typically give thanks during the holiday for family, food and home. But did you know that research has found that expressing gratitude is also good for your health?

Scientists have shown that being grateful affects an individual’s health in a positive way. Grateful people report having a heightened sense of well-being, greater optimism and improved life satisfaction [2-4]. Not surprisingly, writing letters of gratitude also has positive psychological and physical benefits.

Have a safe and healthy Thanksgiving!

References

1. Food Safety of Turkey … from Farm to Table. U.S. Department of Agriculture. Accessed 2011 Nov 22
2. Froh et al. Counting blessings in early adolescents: an experimental study of gratitude and subjective well-being. J Sch Psychol. 2008 Apr;46(2):213-33. Epub 2007 May 4.
   View abstract
3. Froh et al. Measuring gratitude in youth: assessing the psychometric properties of adult gratitude scales in children and adolescents. Psychol Assess. 2011 Jun;23(2):311-24.
   View abstract
4. Emmons and McCullough. Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003 Feb;84(2):377-89.
   View abstract

Too much body fat, however, is associated with a number of negative health effects, including increased risk of heart disease, type 2 diabetes, arthritis, and apnea.

Fat in the diet can contribute to excess fat on the body, as dietary fat is a dense source of calories. This means that even small quantities of fatty food are very calorie-rich. However, too much body fat comes from too much food in general — regardless of whether it’s made up of fat, carbohydrate or protein — since the body converts excess protein and carbohydrate into stored fat. Further, appropriate quantities of fat are important in the diet; dietary fat serves as a satiety signal, increases the absorption of fat-soluble vitamins, and (depending upon the kind of fat) plays other roles as well.

There are three basic categories of fat in the diet: saturated fats, trans fats and unsaturated fats. For a healthy diet, a growing body of research suggests that you should avoid saturated fats and trans fats, and focus on eating unsaturated fats.

What to avoid: saturated fats

Saturated fats come mainly from animal sources, though there are some plants (avocados and coconut, for instance) that contain saturated fat. Because of their chemical makeup, these fats have high melting points, and are solid at room temperature. Saturated fats contribute to heart disease by increasing low-density lipoprotein, also known as LDL (sometimes called “bad cholesterol”) and should be limited in the diet. According to the American Heart Association, an individual on a 2,000 calorie-per-day diet should limit saturated fat intake to no more than about 16 grams [2].

What to avoid: trans fats

Trans fats are common in the American diet, but they’re not found in nature to any significant extent. Instead, they come about by processing unsaturated oils (including corn and soybean oil). The processes used, called “partial hydrogenation” and “interesterification,” result in the production of plant-based fat that behaves in food like saturated fat. Shortening is an example of trans fat; it’s plant based, but it’s solid at room temperature. Trans fats act strangely in the body: they not only increase LDL, as saturated fat does, they also decrease high-density lipoprotein or HDL. This makes them particularly deleterious components of diet.

In addition to impacting cholesterol, trans fats appear to increase risk of type 2 diabetes. The American Heart Association recommends limiting the amount of trans fat in the diet as much as possible, and sets an upper recommended limit of 2 grams per day [4]. Nutrition labels on foods report how much trans fat is in a serving of the food; whole foods (which don’t have nutrition labels) don’t contain trans fat. One important point to remember is that manufacturers can report that a food contains zero grams of trans fat per serving as long as it contains no more than 0.49 grams per serving. Avoiding trans fat in the diet therefore requires reading ingredient lists as well as nutrition facts; if the words “partially-hydrogenated” or “interesterified” appear in the ingredients, there’s trans fat in the food. The most common sources of trans fat in the diet are processed foods and fast food.

Unsaturated fats are healthy fats

Unsaturated fats, which include both monounsaturated and polyunsaturated fats, come mainly from plant sources, though they’re also found in cold-water fish. Their chemical makeup is such that they have low melting points, and are liquid at room temperature. Some of them are even liquid in the refrigerator or freezer. They confer all the benefits of dietary fat (immune system support, increased fat-soluble vitamin absorption, and so forth) without increasing LDL concentration in the blood. The American Heart Association recommends that 25-35% of daily calories come from fat, the vast majority of which should be unsaturated [3].

Omega-3 fats and omega-6 fats are subcategories of unsaturated fat. They’re both essential in the human diet, but the typical Western diet is much too high in omega-6 fat relative to the amount of omega-3 fat. Generally speaking, omega-6 fat is pro-inflammatory, and increases risk of arthritis, asthma and heart disease when consumed out-of-proportion with omega-3 fat, which is generally anti-inflammatory. Omega-6 fat comes from plant sources, most notably from grains and grain-based oils like corn oil. Omega-3 fat is found in some plant sources (flax is a commonly-cited example), and in fish. Unfortunately, the majority of omega-3 fat in plant sources isn’t a type that humans can use, and has to be converted in the cells into usable omega-3 fats such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Human cells are quite inefficient at this conversion, meaning most of the omega-3 fat from the majority of plant sources isn’t bioavailable. Fatty, cold-water fish are the best source of bioavailable omega-3 fat.

At the campaign website of MyPlate, which replaced the Food Pyramid to help consumers eat better, there are a number of nutrition education tips in an easy-to-follow, convenient format. One of the ten tips to making food choices for a healthy lifestyle in Choose MyPlate: 10 tips to a great plate focuses on “foods to eat less often”: these include foods high in solid fats, such as ice cream, pizza, ribs, sausages, bacon and hot dogs. Instead, choose lean, protein-rich foods such as soy, fish, skinless chicken and fat-free or 1% dairy products. Eat foods that are naturally low in fat such as whole grains, fruits and vegetables.

References

1. Obesity and Overweight for Professionals: Data and Statistics: U.S. Obesity Trends. Centers for Disease Control and Prevention. Accessed 2011 Nov 15.
2. Saturated Fats. American Heart Association. Accessed 2011 Nov 15.
3. Know Your Fats. American Heart Association. Accessed 2011 Nov 15.
4. Trans Fats American Heart Association. Accessed 2011 Nov 15.

Yes, you read that right: zombie apocalypse.

As it turns out, preparing for the zombie apocalypse is similar to preparing for any other disaster: stock up on food, water and medications; have tools and supplies on hand; have items for sanitation and hygiene; etc. The CDC outlines emergency preparedness elsewhere on their website, but apparently no one really wants to read about preparing for a tornado, flood or winter weather. What people do want to read about is the zombie apocalypse. Thus, running with the idea that how you prepare is more important that what you prepare for, CDC went with a tongue-in-cheek, partially no-nonsense discussion of the undead and what happens when they attack.

If zombie preparedness made the CDC the government’s equivalent of a cool kid, the Food and Drug Administration (FDA) is the class nerd: both an object of contempt and a scapegoat. I have to admit I feel sorry for the FDA because they have quite a balancing act to perform: they’re given less credit for their actions and more credit for autonomy than they deserve (the FDA’s actions and powers are determined by congress, so where they “fail” to provide for public safety, it’s often because they truly can’t take action.)

In a recent article published in the Journal of the American Medical Association, Dr. Joshua Sharfstein from the Maryland, Baltimore Department of Health and Mental Hygiene, addresses the dilemma the FDA faces [2]. The FDA is an organization responsible for overseeing the safety and regulating the approval of both prescription drugs and over-the-counter medications, not to mention a large part of the U.S. food supply. The agency is under tremendous pressure to approve drugs, both from consumers who want to see treatments for diseases become available and from pharmaceutical companies who want to make money. We live in a society that isn’t willing to accept risk, and we find it completely unacceptable when an approved drug causes harm. The FDA thus has to balance quick drug approval with appropriate safety precautions.

Long ago, pharmaceutical manufacturers weren’t required to prove that a drug was safe or effective before bringing it to market. The proverbial “snake-oil salesman” could sell anything — even something ineffective and/or dangerous — and make any claim he wished. In 1906, prior to the creation of the FDA, the Pure Food and Drug Act only required that certain specified drugs be accurately labeled with contents and dosage. In 1937, a pharmaceutical manufacturer created a preparation of sulfanilamide, a sulfonamide antibacterial (sulfonamides are often called “sulfa drugs” or “sulpha drugs”), using diethylene glycol as a solvent. Diethylene glycol is sweet and did a good job of dissolving the antibiotic, which made the sulfanilamide elixir popular with parents, since it was easy to give to children. Unfortunately, diethylene glycol is chemically similar to antifreeze and just as toxic.

Although animal testing should have been routine, the pharmaceutical manufacturer didn’t perform any and there were no regulations requiring safety testing of new drugs before going to market. Of 353 children who took the medication, 100 died of kidney failure. The public outcry was tremendous; as a result, congress passed the 1938 Food, Drug and Cosmetic Act, which gave authority to the FDA to oversee the safety of food, drugs and cosmetics. Further acts and amendments followed, shaping the legislation that outlines the responsibilities of the FDA today.

Obviously, these laws have improved the safety of drugs brought to market. Even “failed” drugs that are pulled off the market for poor safety records do nowhere near the damage sulfanilamide elixir did. Consider Baycol (a cholesterol drug), for example, which was pulled off the market in 2001. While Baycol appeared safe during extensive drug trials, post-marketing surveillance revealed that it increased the risk of potentially fatal muscle weakness; 52 people died in all. How many people actually took the drug? It’s hard to know for sure; tens of thousands, maybe more. Regardless, compare Baycol’s “unacceptable” safety record to that of sulfanilamide elixir and you get an idea of how successful the FDA is in helping to prevent large-scale pharmaceutical disasters. The FDA did everything right. They required Bayer (the pharmaceutical company) to provide evidence of safety and efficacy in animals before the drug was even approved for human trials. They required years and years of human trials before the drug was brought to market. Everything looked good. All this to the background noise of consumers complaining that the FDA takes too long to approve new drugs, but the agency took its time and released Baycol only when it appeared truly safe and effective. And then the FDA continued to do its job; they monitored the safety of the drug post-marketing, because some side effects are so rare they don’t show up in human safety trials (even large ones), and others take years to show up. When adverse reactions to Baycol started cropping up in the public, it was removed from the market. Let me say it again: the FDA did its job. But Baycol is often cited as an example of an FDA “failure.”

We want our drugs and we want them NOW; we aren’t willing to wait years and years for testing. We also want our drugs completely safe, so FDA had better ensure that companies test for safety carefully (but quickly!). Moreover, we don’t want our drugs tested on animals (because that’s cruel), but neither do we want them tested on people (because they could be dangerous, and no one should be exposed to that. Or they could be effective, in which case it’s not fair that some people in drug trials get randomly assigned to the placebo). We’re unhappy with the FDA no matter what they do. And to boot, we’re unhappy that all the safety testing costs pharmaceutical companies millions and millions of dollars per drug, which increases drug prices. So we want our drugs SAFE, FAST and CHEAP, and we resent the FDA for “standing in the way” of our safe, fast, cheap drugs with a checklist that they insist on filling out before they allow all those (undoubtedly perfect, life-saving) drugs that they’re “withholding” to come to market. Yes, I feel sorry for the FDA. As Sharfstein astutely notes, “Some claim the FDA is captive to manufacturers … others assert the agency [moves too slowly]. Sometimes stories outlining conflicting perspectives appear on facing pages of the same newspaper” [2].

Maybe what the FDA needs is to spiff up their image a bit. They should take a lesson from the CDC and incorporate zombies into their policy statements. Or … maybe not, since ultimately, the CDC’s cool image proved tenuous at best. Now that the buzz about zombie apocalypse preparedness has died down, the CDC is right back where it was beforehand: a geeky institution that we’re convinced is on the take from big pharma (why else would they push all those vaccinations!?), and that overstates the danger of “routine” childhood illnesses. Apparently you can’t win. Unless you write about zombies.

References

1. Preparedness 101: Zombie Apocalypse. Centers for Disease Control and Prevention. Accessed 14 Oct 2011.
2. Sharfstein JM. The FDA–a misunderstood agency. JAMA. 2011 Sep 21;306(11):1250-1.
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Go4Life was presented Oct. 19, 2011, at a briefing on exercise and aging on Capitol Hill, hosted by Herb Kohl, D-Wis., Chair of the Senate Special Committee on Aging and by Mark Udall, D-Colo., Senate Special Committee on Aging.

The briefing highlighted the public-private partnership central to the campaign — a Go4Life team that will work to bring the campaign into communities across the United States. The team includes NIH, other agencies in the U.S. Department of Health and Human Services, and national organizations, corporations, insurers, health care providers, and nonprofit organizations.

Go4Life’s participating organizations will incorporate campaign resources into their own health and wellness activities, disseminating Go4Life web links and materials to their members, employees, and customers. Many partners will directly sponsor events or community activities aimed at engaging older adults in exercise and physical activity as the campaign moves forward.

The campaign was conceived, and is being led, by the National Institute on Aging (NIA), the component of NIH devoted to research on aging. The NIA will work with the Go4Life community on events and will highlight participating organizations and their activities on the campaign website.

U.S. Surgeon General, Regina Benjamin, M.D., M.B.A., said:

If we want to become a healthy and fit nation, we need to increase the number of Americans who are healthy at every stage of life. Go4Life provides older adults with the tools and resources to get moving and keep moving. With the release of the National Prevention Strategy, we are moving our health care system from a focus on sickness and disease to a focus on wellness and prevention.

The campaign developed from concerns that, despite proven health benefits, exercise and physical activity rates among older people are low. About 30 percent of people aged 45–64 say they engage in regular leisure-time physical activity. Only a quarter of those ages 65–74 say they do. And while experts say people age 85 and older, can benefit from exercise, only 11 percent of that age group report being active. At the same time, NIA noted, some older adults were contacting the Institute for guidance on kinds of exercises to do, indicating interest in becoming more active.

According to Richard J. Hodes, M.D., director of the NIA:

You’re never too old to increase your level of physical activity and exercise. Go4Life is based on studies demonstrating the benefits of exercise and physical activity for older people, including those with chronic health conditions. This new campaign reaches out to older people who traditionally have not embraced exercise and shows them ways that even those with physical limitations may be able to exercise safely as well.

The research-based resources of Go4Life center on a colorful, interactive website providing information and motivation for exercise for individuals, families and friends, organizations, and health care professionals. The site features specific exercises, success stories, and free materials to motivate growing numbers of older people to start exercising and keep going. It even offers online virtual coaches to help motivate Go4Life participants. Many Go4Life materials are also available in Spanish.

To develop Go4Life, NIA brought together some of the nation’s leading experts on aging, exercise, and motivation. Over two years, the task force reviewed the research and worked with the institute to develop a book, Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging. The campaign is based on the book.

Some specific benefits of exercise for health and aging include:

• Fitness and cardiorespiratory health: In one study, moderately fit women and men had a 50 percent lower risk of type 2 diabetes, hypertension, coronary heart disease, obesity, and some cancers when compared with their low fit peers. High fit people obtained additional benefit, typically another 10-15 percent lower risk.
• Reduced pain, better function with osteoarthritis: In a clinical trial of people age 60 and older with knee osteoarthritis, those who participated in an aerobic exercise or resistance exercise program reported less pain and better function than those in the group assigned to a health education program.
• Preventing diabetes: Results from the NIH-sponsored Diabetes Prevention Program, which examines ways to prevent or delay the development of non-insulin-dependent diabetes, found that people over age 60 at high risk for diabetes reduced their risk by 71 percent by adopting a moderate exercise routine and a low-fat diet.

Assistant Secretary for Aging Kathy Greenlee, who heads the Administration on Aging at HHS, said:

An important part of active aging is being healthy and staying fit. I look forward to working with NIH and the growing number of campaign partners in the aging network to distribute to seniors around the country these tips on how to get active and stay active.

The NIA invites public and private organizations whose interests and activities involve health, aging and exercise to join the campaign. Agencies, organizations and companies on board as of today as initial Go4Life team members are:

Federal agencies:

• Administration on Aging
• Agency for Healthcare Research and Quality
• Centers for Disease Control and Prevention
• National Institutes of Health
• National Center for Complementary and Alternative Medicine
• National Heart, Lung and Blood Institute
• National Institute of Arthritis and Musculoskeletal and Skin Diseases
• National Institute of Diabetes and Digestive and Kidney Diseases
• National Institute of Mental Health
• National Institute of Neurological Disorders and Stroke
• Office of Disease Prevention and Health Promotion, HHS
• President’s Council on Fitness, Sports & Nutrition

Private and nonprofit organizations:

• Alliance for Aging Research
• America On the Move Foundation, Inc.
• American College of Sports Medicine
• American Federation for Aging Research
• American Geriatrics Society
• American Library Association
• American Medical Association
• American Occupational Therapy Association
• American Physical Therapy Association
• American Psychological Association
• America’s Health Insurance Plans
• CenturyLink
• Easter Seals
• Erickson Living/Greenspring
• Gerontological Society of America
• Humana Inc.
• International Council on Active Aging
• Jewish Community Centers Association of North America
• National Association of Area Agencies on Aging
• National Association of States United for Aging and Disabilities
• National Council on Aging
• National Recreation and Park Association
• National Senior Health & Fitness Day (Mature Market Resource Center)
• OASIS
• Sunrise Senior Living
• U.S. Chamber of Commerce
• Volunteers of America
• Year of Vitality Cleveland
• YMCA of the USA

For further information on the public and private support of the Go4Life initiative, please visit www.nia.nih.gov/Go4Life.

The NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute’s broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, aging, and health, go to www.nia.nih.gov.

Source: NIH News

Saccharin is the oldest of the artificial sugars that’s still in use today. It was discovered in the late 19th century, completely by chance, when a chemistry student who was working with coal tar derivatives licked his fingers and found they tasted sweet [1]. Saccharin is about 500 times sweeter than sugar, and the human body can’t break it down to provide the cells with energy, which is why it contains no calories. While some research suggests that it can cause bladder cancer in lab rats, no research has linked saccharin to cancer in humans. Saccharin-containing foods once carried warning labels, but scientists have since determined that rats have specific features of their urinary system (which humans lack) that make them susceptible to bladder cancer from saccharine [2]. Warning labels have been removed from foods as of 2000. Sweet’N Low is a brand of artificial sweetener made from granulated saccharin, dextrose and cream of tartar.

Aspartame is another non-nutritive sweetener that was discovered serendipitously by Jim Schlatter in 1965, as he was attempting to synthesize an ulcer drug [3]. Aspartame is a modified dipeptide, whose full name is aspartyl-phenylalanine methyl ester. Equal is an example of an aspartame-based sweetener.

Like saccharin, aspartame is sweeter than table sugar (by a factor of about 200), and it’s not possible for the human body to break aspartame down, which explains its lack of calories. The reason artificial sweeteners are sweeter than table sugar is that they bind more tightly to sweetness receptors on the human tongue, which then sends a signal to the brain. Chemicals that don’t bind very tightly — like table sugar — send signals of mild sweetness. Chemicals like aspartame and saccharine bind much more tightly, meaning they stay in the sweetness receptor (and continue to trigger signals) for a longer period of time.

The sweetness receptor is a complex called a G-protein coupled receptor comprised of proteins encoded by the genes TAS1R2 taste receptor, type 1, member 2 (TAS1R2) and TAS1R3 taste receptor, type 1, member 3 (TAS1R3) [4].

While there’s no evidence linking aspartame to cancer or other major health problems in most people, it’s not safe for individuals with the disease phenylketonuria (PKU). PKU is a genetic, meaning inherited, disorder in which affected individuals can’t break down phenylalanine. Phenylalanine is one of the amino acids, which are components of protein. Because those with PKU can’t break phenylalanine down, it accumulates in the bloodstream, and negatively impacts brain development in babies and children. Babies with PKU (a disease that hospitals routinely test newborns for) must be kept on a phenylalanine-free diet in order to avoid impaired physical and mental function. Adults with PKU don’t have to follow as strict a diet, but generally benefit from diets with low phenylalanine. Because aspartame contains the amino acid phenylalanine, aspartame-containing foods carry a warning label.

Sucralose is yet another non-nutritive sweetener. Its chemical structure is quite similar to that of table sugar, but key differences (e.g. the presence of chlorine atoms, where table sugar has none) prevent the human body from breaking it down for energy. Like the other non-nutritive sweeteners, sucralose is much sweeter than table sugar. No research has yet linked sucralose to cancer or other major health problems, but as the newest of the popular non-nutritive sweeteners, it may be some time before long-term effects of routine consumption — if there are any — reveal themselves. Splenda is an example of a sucralose-based artificial sweetener.

While there isn’t reason to believe that non-nutritive sweeteners cause cancer, there is some research evidence to suggest that they aren’t as benign as manufacturers claim. Many individuals who use these calorie-free sweeteners do so in an attempt to avoid the weight gain associated with excess sugar consumption, since the body can convert sugar — but not non-nutritive sweeteners — into fat. However, research suggests that there are sweetness receptors in the gut as well as in the mouth [5], and that artificial sweeteners can bind to these receptors. Further, research reveals that when calorie-free sweeteners bind to gut sweetness receptors, physiological responses mimic those expected in the case of sugar binding to the same receptors: the cells take up glucose [6], and the gut releases digestive hormones [7]. In short, it appears that the human body has an ability to sense the sugar — and therefore caloric — content of foods based upon the binding of key nutrients in those foods to receptors in the gut, but that these receptors are fooled (just like receptors in the mouth) by substitute chemicals. This can disrupt the body’s ability to determine whether a given quantity of food is sufficient to meet energy needs [8]. Compare, for example, the quantity of salad necessary to stimulate a feeling of fullness to the quantity of cheesecake necessary to do the same; the average individual consumes a much greater quantity of salad than of cheesecake, because the gut senses the caloric density of the cheesecake and sends satiety signals after consumption of a smaller quantity.

By disrupting the body’s ability to equate sweetness with calories, it appears that non-nutritive sweeteners can “teach” the body that sugar contains no calories. This can result in consumption of more total calories, which can lead to increased weight gain. In the end, consumption of sugar in moderate quantities may be more compatible with weight-loss or weight maintenance goals than consumption of artificial sweeteners.

References

1. Wotiz. The discovery of saccharin. J. Chem. Educ. 1978 55(3): 161.
2. Whysner et al. Saccharin mechanistic data and risk assessment: urine composition, enhanced cell proliferation, and tumor promotion. Pharmacol Ther. 1996;71(1-2):225-52.
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3. Mazur, R.H. (1984). Discovery of aspartame. In Aspartame: Physiology and Biochemistry (L. D. Stegink and L. J. Filer Jr., Eds.). Marcel Dekker, New York, pp. 3–9.
4. Li et al. Human receptors for sweet and umami taste. Proc Natl Acad Sci U S A. 2002 Apr 2;99(7):4692-6. Epub 2002 Mar 26.
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5. Jang et al. Gut-expressed gustducin and taste receptors regulate secretion of glucagon-like peptide-1. Proc Natl Acad Sci U S A. 2007 Sep 18;104(38):15069-74. Epub 2007 Aug 27.
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6. Mace et al. Sweet taste receptors in rat small intestine stimulate glucose absorption through apical GLUT2. J Physiol. 2007 Jul 1;582(Pt 1):379-92. Epub 2007 May 10.
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7. Kokrashvili et al. Taste signaling elements expressed in gut enteroendocrine cells regulate nutrient-responsive secretion of gut hormones. Am J Clin Nutr. 2009 Sep;90(3):822S-825S. Epub 2009 Jul 1.
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8. Egan et al. Taste cells of the gut and gastrointestinal chemosensation. Mol Interv. 2008 Apr;8(2):78-81.
   View abstract

Poland points out that the current anti-vaccination movement, which is by no means unique in history, looks particularly unfavorably upon the measles, mumps, and rubella (MMR) vaccine. This is largely due to a since-retracted study published in the Lancet journal by Andrew Wakefield [2], which suggested a causal link between the MMR vaccine and autism. In his commentary, Poland emphasizes that there are more than 20 well-conducted studies that show no link between MMR and autism, and that scientific societies unilaterally agree that there is no reason to suspect such a link. Nevertheless, fear of autism and other serious adverse reactions to vaccines is having a significant impact upon public health in the United States. Indeed, just this week, inaccurate statements about the HPV vaccine causing mental retardation made the headlines.

As more and more children are withheld from vaccination, the risk of contracting the disease for which they were to be immunized increases. Last year, researchers determined that children whose parents refused the chickenpox vaccine have an 8-fold increased risk of catching the virus compared to fully immunized children.

One of the arguments used by opponents of vaccination is that the diseases for which children are routinely vaccinated aren’t serious, but the adverse reactions associated with vaccines are. U.S. Centers for Disease Control and Prevention (CDC) data, however, demonstrate otherwise. Measles is incredibly communicable — prior to the advent of vaccination, almost 100% of the U.S. population got the disease — and isn’t as innocuous as opponents of vaccination claim. As many as 20% of measles cases in the U.S. result in hospitalization, and six percent of total cases result in pneumonia, which is the major cause of measles-related death. Approximately three of every 1000 individuals infected with measles die.

Reactions to the MMR vaccine, on the other hand, are largely innocuous by comparison. While as many as one in six people vaccinated will experience a fever, these vaccine-related fevers are mild, short-lived, and have no lasting effects. Other mild reactions to the vaccine include a rash (about 5% of those vaccinated) and swelling of lymph nodes. Seizures as a result of the vaccine are considered a more serious consequence, but are very rare, at one in 3000 doses (or one ninth the risk of death from measles infection). Serious reactions include allergy, which happens in less than one in 1,000,000 vaccinations, and debilitating seizures or brain damage, which happen too rarely to quantify and, in fact, are so rare that there’s no way to be sure these events are the result of the vaccination at all. By the numbers, a given individual is many times more likely to die of the measles than to have even a moderate reaction to the vaccine.

The importance of the MMR vaccine, however, doesn’t end with self-interest and personal safety. Vaccines work in two ways: they help to protect the vaccinated individual from infection, and they reduce the likelihood that the disease in question can spread through a population by helping to produce herd immunity.

Because measles is so contagious, 96% of the population must be vaccinated to secure herd immunity, explains Poland. As anti-vaccination sentiment continues to spread, the United States is losing herd immunity, as evidenced by the measles cases reported in the early part of 2011 [3]. In the first six months of this year alone, there have been three times as many measles cases reported as normally seen in an entire year in the U.S. Particularly at risk are babies too young to be vaccinated, as the first dose of MMR isn’t given until an infant is 12 months of age. To leave a vaccine-eligible individual unvaccinated doesn’t just threaten that individual; it threatens the entire community — especially the community’s most vulnerable individuals.

Interestingly enough, anti-vaccine sentiment isn’t new in a historical context. Anti-vaccination movements have gained popularity periodically since the very first laws requiring vaccination, including the Vaccination Act of 1853 that required inoculation of children in the United Kingdom. Public health officials and researchers have noticed that anti-vaccination movements often follow a pattern in which a researcher attempts to explain an otherwise poorly-understood medical phenomenon by tying it to vaccination. While these anti-vaccination studies are generally poorly conducted and irreproducible, they nevertheless ignite fear in the public when they’re reported, and lead to a reduction in vaccination rates. The disease for which vaccination rates have decreased then experiences a resurgence, which results in many avoidable deaths, until such time as the public regains confidence in the vaccine. Examples of epidemics produced as a result of this repeating pattern include the smallpox epidemic in Stockholm in 1873 [4], the pertussis epidemic in the 1970s in the U.K. [5], and the Netherlands measles epidemic of 1999 [6].

Poland suggests that vaccine denialist propaganda does a public disservice, and recommends that it may be time to consider legislating vaccinations for the public good, and to protect vulnerable members of the population. He notes that while anti-vaccination movements call for more research, continued investigation into vaccine safety — particularly with regard to the well-established MMR vaccine — represents a misallocation of limited research dollars, because of the incredible scientific consensus regarding vaccine safety.

References

1. Poland. MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science. Mayo Clin Proc. 2011 Sep;86(9):869-71.
   View abstract
2. Wakefield et al. Ileal-lymphoid-nodular hy- perplasia, non-specific colitis, and pervasive developmental disorder in children [retracted in: Lancet. 2010;375(9713):445]. Lancet. 1998;351(1903):637-641.
3. Centers for Disease Control and Prevention (CDC). Measles: United States, January–May 20, 2011. MMWR Morb Mortal Wkly Rep. 2011 May 27;60(20):666-8.
   View abstract
4. Nelson et al. The right to die? Anti-vaccination activity and the 1874 smallpox epidemic in Stockholm. Soc Hist Med. 1992 Dec;5(3):369-88.
   View abstract
5. Gangarosa et al. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet. 1998 Jan 31;351(9099):356-61.
   View abstract
6. Centers for Disease Control and Prevention. Measles outbreak–Netherlands, April 1999-January 2000. MMWR Morb Mortal Wkly Rep. 2000 Apr 14;49(14):299-303.
   View abstract

How much do you know about the medicines you’re taking?
What is your prescription drug IQ?

Facts vs. myths about prescription drugs

MYTH: You don’t need to keep a list of the medications you take because your doctor has that information.
FACT: Don’t assume that doctors and hospitals have up-to-date information about the medications you take. Although healthcare professionals do their best to be accurate, errors can creep into medical records. Each time you visit a doctor or hospital, bring along an up-to-date list that includes:

• The names and phone numbers of all the doctors you’re seeing.
• Your current and past conditions.
• The names and dosages of everything you take, including over-the-counter drugs, herbal remedies and vitamins.
• Dates and descriptions of key hospitalizations, surgeries, medical procedures, etc.

MYTH: You don’t need to tell your doctor about herbal or dietary supplements you’re taking.
FACT: Herbs and dietary supplements may interact with prescription drugs. Natural treatments may actually worsen specific health conditions. It is critically important to tell your doctor about any herbal or dietary supplements you’re taking. You also should tell your doctor about any over-the-counter or prescription drugs you are taking.

MYTH: Prescription drug side effects show up immediately.
FACT: Although some side effects from prescription drugs, such as rashes or nausea, may show up immediately, other side effects, such as anemia, show up over time. Be sure to read the information about potential side effects on the information sheet or box your prescriptions come in.

MYTH: You don’t need to double-check prescription information with both your doctor and pharmacist
FACT: A 2003 study of dispensing accuracy rates found that, on average, approximately four errors are made per day in a pharmacy filling 250 prescriptions daily. When you get a prescription from your doctor, follow our tips on how to avoid prescription dispensing mistakes.

MYTH: It doesn’t matter how you store prescription drugs.
FACT: Medications are sensitive to heat, light, humidity or moisture. To preserve their effectiveness, medications should be stored in a cool, dry place. That rules out the bathroom medicine cabinet. Instead, try a kitchen cabinet.

MYTH: Brand-name medications are more expensive than generic because they are more effective.
FACT: The U.S. Food and Drug Administration guarantees that the fate, biochemical and physiological effects of generic drugs are identical or within an acceptable bioequivalent range to the brand name counterpart [2]. The only real difference is price. Generics cost an average of 20% to 40% less than their brand-name counterparts.

MYTH: Drug companies control the cost of prescription drugs.
FACT: There are a number of prescription programs for which you may qualify. PatientAssistance.com is a 501(c)(3) non-profit resource designed to help connect patients who can’t afford their prescription medications with patient assistance programs. In addition, a number of retailers offer special drug discount cards:

• CVS Health Savings Pass
• Walgreens Prescription Savings Club
• Walmart $4 Prescription Program

MYTH: Prescription medications can only be purchased at a pharmacy with a physician’s prescription.
FACT: Not anymore. In 2007, the number of websites advertising and selling prescription drugs increased by 70%. More that two-thirds of the sites selling medications didn’t require a physician’s prescription. Drugs sold by an unlicensed pharmacy may be outdated, expired, improperly manufactured, or contain dangerous ingredients. According to the National Center on Addiction and Substance Abuse (CASA), children are especially at risk in this growing trend.

MYTH: Savvy consumers dispose of old or outdated medications by flushing them down the toilet.
FACT: Wastewater treatment facilities aren’t designed to remove pharmaceuticals. Medications flushed down the toilet end up in our lakes and streams, and ultimately in our drinking water. Follow these guidelines to properly dispose of medicine.

References

1. Health, United States, 2010. National Center for Health Statistics. 2010.
2. Facts About Generic Drugs. U.S. Food and Drug Administration. Accessed 2011 Aug 2.

On July 4th, 2001, Andrew Lumsden of the MRC Centre for Developmental Neurobiology, King’s College London, and F1000 Section Head for Neurodevelopment, became the author of the first F1000 evaluation. Lumsden’s review of “Genetic control of dorsal-ventral identity in the telencephalon: opposing roles for Pax6 and Gsh2″ was the first evaluation collected by Vitek Tracz, founder of F1000.

Throughout 2001, many more evaluations were submitted by F1000 faculty members. In 2002, F1000 launched the F1000 Biology. This was followed by F1000 Medicine in 2006, and in October 2010 the two sites were merged to form F1000.com.

F1000 provides rapid post-publication assessment of key articles within days of publication with opinions from peer-nominated experts. The service covers over 3500 journals across 44 different topic areas, including fields such as cardiovascular disorders, neurological disorders, respiratory disorders and genetics and genomics.

The F1000 website is interactive, enabling users to nominate articles for review and add comments. It is also clinically applicable, highlighting articles that change clinical practice, as interpreted by respected leaders in the field. Indexing services cover all the literature in their selected fields. However, none is completely comprehensive, and they give no indication of quality or interest. F1000 is not limited to any one indexing service (although because they specialize in biology and medicine, most articles evaluated by the Faculty can be found in PubMed). On average, 1500 new evaluations are published each month, which corresponds to approximately 2% of all published articles in the biological and medical sciences.

F1000 was conceived as a collaboration of 1000 international Faculty Members, but in the ten years since its inception, the Faculty has grown considerably and now numbers more than 10,000. The fully searchable database contains nearly 110,000 evaluations, which provide insight into the best research in over 300 biology and medical disciplines. The wider F1000 service also features an open access repository of posters and presentations and two F1000 Reports journals — F1000 Reports Biology and F1000 Reports Medicine — that review emerging topics as identified by the Faculty.

Sarah Greene, F1000 Editor-in-Chief commented on the milestone [1]:

We’re delighted that Andrew’s contribution commemorates the occasion. He’s been on board as Section Head of Neurodevelopment for a decade, working with his Faculty to flag and explain the top 3000 papers (and counting) in that field, and showing leadership in countless other ways. We cannot offer enough praise to all the Faculty who have devoted time and brainpower to pioneer this brave new model of transparent peer review. Thanks to their efforts, F1000 has become a hub of discourse around that most sacred entity — the research paper.

F1000 is also the publisher of The Scientist, a magazine for life science professionals with print and digital editions covering a wide range of topics central to the study of cell and molecular biology, genetics, and other life-science fields. The magazine highlights the most important papers, authors, and research trends identified by the F1000 Faculty and keeps readers up-to-date with the latest news, profiles, innovations, culture and career advice.

References

1. It all began here… Faculty of 1000 marks ten years since the first evaluation was written. F1000. 2011 Jul 20.

In the United States and Europe, people take it for granted that when they turn on the faucet, clean water will flow out. Indeed, a single flush of a toilet in the West uses more water than most Africans have to perform an entire day’s washing, cleaning, cooking and drinking [2].

Securing access to safe water worldwide is vitally important. Clean water is essential for agriculture, food and energy production, recreation and reduction of poverty. More than 2 million people, most of them children, die every year from water-borne diseases. And time is of the essence: by 2020, more people could die of water-related diseases than those that have died due to HIV/AIDS [2].

In the 1990s, researchers figured out a simple, free and effective way to clean polluted water and kill disease-causing organisms, including E. coli, Vibrio cholera (which causes cholera, an infection of the small intestine), Salmonella (which causes typhus) and Yersinia enterocolitica (which causes diarrhea) [3]. Solar water disinfection, known as SODIS, is a method of disinfecting water using only sunlight and transparent polyethylene terephthalate (PET) plastic bottles (think: clear 2-liter soda bottles).

The first study to evaluate the effect of the SODIS method on health was investigated by the Royal College of Surgeons of Ireland. Carried out in Kenya, research showed that 16-24% of diarrhea-type illnesses and 86% of cholera occurrences were avoided [4]. Since then, many scientific studies have confirmed the effectiveness and reliability of the SODIS method.

The SODIS procedure is incredibly simple: contaminated water is filled in a transparent PET-bottle and exposed to the sun for 6 hours (or 2 days under very cloudy conditions). During exposure, ultraviolet (UV) radiation from the sun kills disease-causing pathogens. Moreover, infrared radiation heats the water. The combined exposure to UV plus heat in the SODIS process has a synergistic effect on microbial inactivation.

However, scientists don’t yet understand how UV kills germs. Researchers currently think that the bacteria die because cellular respiration — the process in which nutrients are converted into useful energy in a cell — is damaged by UVA radiation so severely that it can’t be repaired.

The SODIS method together with washing hands particularly effective at preventing diarrheal diseases. A systematic study found that while better better sanitation facilities prevented 32% of diarrhea cases, treatment of drinking water in the home (e.g. SODIS method) prevented 39% of diarrhea cases [5]. Incredibly, hand washing was the most effective, preventing almost half (45%) of all diarrhea cases.

The SODIS method is used around the world in places like India, Cameroon, Bolivia, Kenya, Nepal and Nicaragua. So why then are people in developing countries going without clean water? According to a 2008 report by Urs Heierli of msd consulting GmbH, a Swiss company focused on market-based development interventions, it’s difficult to persuade the poor to use SODIS and to ensure that those who have been persuaded continue to use it [6].

The World Health Organization (WHO), UNICEF, and the American Red Cross all recommend the SODIS method as a way to treat drinking water in developing countries. Indeed, it is an ideal way solve one of the world’s most vital issues: making clean water.

References

1. Water Facts. Water.org Accessed 2011 Jul 8.
2. Dying for A Drink of Clean Water. The Washington Post. 2005 Sep 20.
3. SODIS: Microbiology. sodis.ch Accessed 2011 July 8.
4. SODIS: Health. sodis.ch Accessed 2011 July 8.
5. Fewtrell et al. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis. 2005 Jan;5(1):42-52.
   View abstract
6. Heierli, U. Marketing safe water systems: why it is so hard to get safe water to the poor – and so profitable to sell it to the rich. Bern, Switzerland, Swiss Agency for Development and Cooperation (SDC). 2008.