Whole grains or no grains? Food labels can be misleading

Food labels contain a wealth of information: calories, serving size, and the amounts of fat, sugar, vitamins, and fiber contained in a food, among other things. But do consumers know how to effectively use this information? A recent study showed that some consumers are struggling, especially when it comes to understanding whole grains.

Recent study highlights consumer confusion

For the study, published in Public Health Nutrition, researchers conducted two experiments to examine consumer understanding of whole grains on food labels. The research, which focused on food labels on bread, cereal, and crackers, was done online and involved more than 1,000 adults.

In the first experiment, researchers displayed pairs of products with different amounts of whole grains (based on the ingredients list and fiber content), sugar, and salt on mocked-up Nutrition Facts panels. One of the products contained a good amount of whole grains but made no claims on the front of the package. The other product had less overall whole grains, but sold itself with terms like “multigrain” or “wheat” on the front of the package. Results showed that 29% to 47% of study participants incorrectly identified the less healthy product as the better option.

The second experiment used actual food labels and asked the study participants to identify which products had 100% whole grain, mostly whole grain, or little to no whole grain. About half of the study participants (43% to 51%) overstated the amount of whole grains in the products that were mostly refined grains. For another product, composed mainly of whole grains, 17% of the consumers understated the whole grain content.

The study concluded that consumers have difficulty identifying the healthfulness and the whole-grain content of some packaged foods, and that they rely on whole-grain labeling on the front of the package rather than considering information from the Nutrition Facts label and the ingredients list.

Why should we eat whole grains?

Whole grains refer to the entire grain kernel, including the bran, germ, and endosperm. The process of refining grains removes most of the bran and germ, leaving the endosperm (white flour). Each component of the whole grain contributes different nutrients, including vitamins, minerals, fiber, and other health-promoting compounds.

Whole grains offer a complete package of health benefits, unlike refined grains, which are stripped of valuable nutrients in the refining process. Studies show that they decrease our risk for several chronic diseases including type 2 diabetes, heart disease, stroke, and death from any cause.

Whole grains are also a rich source of vitamins and minerals. Compared to enriched white flour, 100% whole wheat flour contains: 96% more vitamin E, 82% more vitamin B₆, 80% more selenium, 78% more magnesium, 72% more chromium, 58% more copper, 52% more zinc, and 37% more folate.

Hulled barley, bulgur, whole-grain couscous, oats, rye, spelt, triticale, and whole wheat are all whole grains. Gluten-free whole grains include amaranth, brown rice, buckwheat, corn, millet, quinoa, teff, and wild rice.

Tips for selecting whole grain products

Don’t rely on front-of-the-package marketing. Just because the package shows a photo of a beautiful wheat field does not necessarily mean its contents are made with a whole grain. Even packages that say “multigrain,” “wheat,” “double fiber,” “cracked wheat,” “7 grain,” “stone ground,” “enriched,” “fortified,” or “made with whole grains” may be mostly enriched white flour.

Do not assume that darker is better. Products that are darker in color are not necessarily whole grains. Ingredients such as molasses or caramel coloring may have been used to impart color.

Check the ingredients list. The relative amount of whole grain in the food can be gauged by the placement of the grain in the ingredients list. The whole grain should be the first ingredient — or the second ingredient, after water. For foods with multiple whole-grain ingredients, they should appear near the beginning of the ingredients list. Choose foods that list “whole” or “whole grain” before the grain’s name, such as whole rye flour, whole wheat flour, or whole buckwheat.

Know what the labels really mean

If the label says…	The product contains…
100% whole grain	No refined flour
Made with whole grains	May contain a little or a lot of whole grains
Whole grain	As little as 51% whole grain flour
Good source of whole grain	15% to 25% whole grain
Multigrain	A mixture of grains, possibly all or mostly refined grains

Look at the Nutrition Facts label

The amount of fiber listed on the food label can provide a helpful clue to a food’s whole grain content. When selecting a product, choose breads that contain at least 3 grams of fiber per serving, cereals that have at least 5 grams of fiber per serving, and crackers that contain at least 3 grams of fiber per serving.

But don’t focus solely on whole grains. When trying to improve your diet, use food labels to guide you toward products with less sodium, saturated fat, and added sugar as well.

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Sick child this school year? Planning for the inevitable during a pandemic

Children get sick; it’s part of life. They catch colds, they get fevers, they throw up and get diarrhea. Most of the time, it’s nothing at all. But this year, as we struggle through the COVID-19 pandemic, every sniffle will be complicated.

The problem is, the symptoms of COVID-19 can be not just mild, but similar to the symptoms of all the common illnesses kids get all the time. Symptoms can include

• fever, even a mild one
• cough (that you don’t have another clear reason for)
• breathing difficulty
• sore throat or runny nose (that you don’t have another clear reason for)
• loss of taste or smell
• headache (if with other symptoms)
• muscle or body aches
• nausea, vomiting, or diarrhea.

And even if there is another explanation for that sore throat or cough, it doesn’t mean that your child couldn’t also have COVID-19. People can get two germs at once.

Set the bar low for keeping sick children home

This is not a year when you can send your child to school or daycare with that cough, or that one vomit, or that low-grade temp, and hope for the best. This is a year when we need to do our best to keep every sick person home, whether they have COVID-19 or something else. This is also not a year to skip the flu shot. We need there to be as little influenza as possible this year for everyone’s safety and well-being.

Here’s what you should do if your child gets any of the symptoms above:

• Keep them home from school or daycare. I understand that this may mean missing work, but there is simply no choice.
• To the extent that it is possible, keep them away from other family members.
• Call your doctor. If they have any trouble breathing, a high fever, severe pain or irritability, or unusual sleepiness, you should go to an emergency room. Otherwise, your doctor will advise you about next steps, including testing for COVID-19.

Theoretically, everybody with any of the above symptoms should be tested. But that may not be possible. And for some children — those with mild symptoms who aren’t in daycare or school, whose parents are working remotely and who don’t have contact with high-risk individuals — a test may not be crucial as long as everyone can stay home. Make sure you talk with your doctor and understand exactly what you and other family members need to do if your child is not tested.

The difference between quarantine and isolation

Quarantine and isolation are two terms that are used a lot these days, and while they are often used interchangeably, they aren’t the same thing.

• Quarantine means staying home: no trips to stores, or anywhere outside of the house or yard.
• Isolating means staying away from other people in the home — in a separate room, preferably with a separate bathroom (or wiping down in between), wearing a mask when they must leave their room, and not sharing utensils, towels, or anything else with anyone.

What to do if a test for COVID-19 is positive or you cannot get a test

The American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recommend these steps:

If your child tests positive for COVID-19:

• Make sure you are in touch with your doctor, follow all recommendations, and call for help if you have any concerns about how your child is acting or feeling.
• Isolate your child at home, to the extent that this is possible.
• Don’t send them back to school or daycare until at least 10 days from the start of their symptoms (longer if they are still sick), and until they have not had a fever for at least 24 hours without any fever-reducing medications.

Children who test positive are considered infectious until that 10 day/no fever point. So family members living with the child need to quarantine until 14 days after the 10-day point (if anybody gets sick, call your doctor). They also should wear masks and do their best to isolate from others at home, as you never know which person might get sick.

Getting family members tested doesn’t change the quarantine requirement — because the incubation period can be as long as 14 days. Theoretically you could be infected at day nine of your child’s infection — and not show symptoms for 14 days after that. It’s best to wait four to five days after the 10-day day point to be sure the test will be accurate (although any family member with symptoms should schedule a test right away). Testing family members can pick up asymptomatic cases — and may reset the quarantine clock for everyone else. Your doctor can guide you through.

This is going to be hard, and very disruptive, but it’s the only way to contain the virus.

If you can’t or don’t test your child, all the same instructions apply — because you don’t know if they have COVID-19. So you need to act as if they do, to be safe.

What to do if a test for COVID-19 is negative

If your child tests negative for COVID-19, talk to your doctor about what to do and when your child can return to school or daycare. It will depend on your child’s symptoms and whether another diagnosis was made.

What to do if your child is exposed to COVID-19 away from home

If your child is exposed to someone with COVID-19 outside of the home (being within six feet of them for 10 to 15 minutes), call your doctor for advice. Most likely, you will be told that your child needs to quarantine for 14 days after their last exposure to that person. As above, if you decide to test you should wait a few days — unless your child develops symptoms, in which case testing right away is a good idea. A negative test won’t get your child out of quarantine, but if they test positive then you will know to start isolating them — and start the clock for everyone else’s quarantine.

This is complicated, I know. Call your doctor’s office if you have questions — and check out the website of the American Academy of Pediatrics.

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Philly Cheesesteak Stuffed Peppers

I absolutely love the flavors of a Philly cheesesteak. Soft, toasty bread, tender beef, and melty cheese. Mmmm… I first had Philly cheesesteak when we visited my aunt and her family in Philadelphia. Let’s just say it wasn’t a grain-free or sugar-free trip. When we got back home I wanted to find a way to enjoy the flavors …

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The White House Reportedly Pressured the CDC to Downplay COVID Risk in Schools

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Treating mild hypothyroidism: Benefits still uncertain

Your thyroid, a tiny, butterfly-shaped gland located in front of your windpipe (trachea) and below your voice box (larynx) can have a profound impact on your health and well-being. Throughout life, your thyroid is constantly producing hormones that influence your metabolism. These hormones affect your mood, energy, body temperature, weight, heart, and more.

A brief overview of hypothyroidism

Your thyroid produces two kinds of thyroid hormones: T4, or thyroxine, and T3, or triiodothyronine. These hormones influence every cell, tissue, and organ in your body, from your muscles, bones, and skin to your digestive tract, brain, and heart, by controlling how fast and efficiently cells convert nutrients into energy — a chemical activity known as metabolism.

The thyroid gland is under the influence of the pituitary gland. No larger than a pea and located at the base of the brain, the pituitary gland controls your thyroid’s production of thyroid hormone by releasing thyroid stimulating hormone (TSH).

TSH levels in your bloodstream rise or fall depending on whether there is enough thyroid hormone made to meet your body’s needs. Higher levels of TSH prompt the thyroid to produce more thyroid hormone, while lower levels signal the thyroid to produce less.

Hypothyroidism occurs when the thyroid fails to produce enough thyroid hormone to meet the body’s needs, thereby slowing metabolism. In someone with overt hypothyroidism, thyroid hormone levels are below normal and TSH levels are well above the normal range.

What is mild hypothyroidism?

Subclinical, or mild, hypothyroidism doesn’t meet the standard definition of hypothyroidism. In mild hypothyroidism, you may or may not have symptoms and your levels of T4 and T3 are normal, but your TSH levels are slightly elevated. Mild hypothyroidism is diagnosed by a blood test.

More than 10 million adults in the US have hypothyroidism, the vast majority of which is subclinical.

What are the risks of leaving mild hypothyroidism untreated?

Whether or not to treat mild hypothyroidism is a subject that has been studied and debated for years. What worries doctors most about mild hypothyroidism is the potential link between untreated mild hypothyroidism and coronary artery disease. Results of research on whether subclinical thyroid disease causes heart problems have been conflicting. The condition has been associated with heart and blood vessel abnormalities, and studies indicate that treating mild hypothyroidism can improve various markers of heart structure and function.

However, a recent study published in the Journal of the American Medical Association may give doctors pause. The researchers studied people with mild hypothyroidism who had also had a heart attack. They treated one group of these patients for their mild hypothyroidism, and left the condition untreated in the other group. The study showed that those treated for mild hypothyroidism did not have better heart function than those who were not treated.

What are the downsides of treating mild hypothyroidism?

When mild hypothyroidism is treated, levothyroxine (T4) is the treatment of choice.

A 2017 trial published in The New England Journal of Medicine found that treating people ages 65 and older for mild hypothyroidism doesn’t have much of a benefit. The authors found no real differences in symptoms between participants who received levothyroxine and those who got a placebo. The authors say many older adults revert to normal thyroid function on their own, without treatment. A follow-up study recently published in the Annals of Internal Medicine analyzed data from patients enrolled in the 2017 NEJM study, and determined that even those with the greatest number of symptoms did not benefit.

In addition to the possibility that the treatment may not offer any benefit, there are other reasons for caution. Overtreatment — prescribing thyroid medication to someone with subclinical disease who may not need treatment, or giving excessive thyroid medication — comes with serious risks, particularly thyrotoxicosis, the presence of too much thyroid hormone in the body. This happens frequently; estimates suggest 20% or more of those treated with thyroid hormone experience thyrotoxicosis. Long-term complications of even mild thyrotoxicosis can include heart problems and bone loss.

Considering the risks and benefits of treatment

If you are weighing the pros and cons of treatment for hypothyroidism, discuss the following questions with your doctor:

• How might I benefit from treatment? Could it treat my symptoms? Prevent heart disease? Help me conceive?
• What are the risks of treatment?
• How will we know if treatment is working, and how long will it take to determine this?
• For how long will I need to continue treatment?

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Hey health redditators i I feel coughing pain after three seconds of good inhalation with cut off breathing . What does that means

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National Poll: 1 in 3 Parents Plan to Skip Flu Shots for Their Kids During COVID-19 Pandemic

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378: Q&A: Health on a Budget, Virtual Schooling, Screen Time, Self Care, Eczema & Giving Blood

Today we’re going to switch things up and have a Q&A episode to cover some of the great questions I get from all of you. We’ll cover some timely topics like virtual schooling and homeschooling on a budget, as well as health-related topics I have been talking about for a while, like why I make …

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Why You Should Never Eat Vegetable Oil or Margarine

Aside from whole grains, vegetable oils and margarine are some of the most misunderstood and over-recommended foods in the health community. You’ve probably heard these referred to as “heart-healthy oils,” a good alternative to those “artery-clogging saturated fats.” Only one problem…. science doesn’t back these claims up! Vegetable oils are found in practically every processed …

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Managing the new normal: Actively help your family weather the pandemic

When the pandemic first began earlier this year, it seemed like if we could just hunker down until perhaps summer, things would get better and we’d be able to get back to life as usual (or at least something similar to life as usual). We were in survival mode: we cut corners and made do, broke some parenting rules, and otherwise made choices we would never usually make. Because that’s what you do when you are in survival mode.

It’s now very clear that the pandemic is here for at least this school year, and survival mode is taking on a whole new meaning. It’s time to make new habits and routines specifically for the pandemic. It’s time to make better and more durable choices that can help keep us healthier — and happier.

Some things obviously aren’t about choices. If you have lost loved ones, are struggling financially, are living in a dangerous situation, or if you or anyone in your family is having thoughts of self-harm, please reach out for help. Your doctor may be able to direct you to resources in your community.

What I am talking about is practical, daily life choices that we can make in a different way that may help us feel and live better. Be proactive — and do it as a group activity with your partner and family, so that everyone feels heard and invested.

Identify the pain points and tackle those first

Think about the past few months, and literally make a list of everything that was particularly hard. Lack of structure? Too much screen time for everyone? Problems getting kids to do their remote work? Problems getting your own remote work done? Feeling isolated from friends and family?

Work together to come up with ideas to tackle these pain points. They might include:

• Clear daily routines (use something like a white board so that all are on the same page). Along with those routines, have rules about screen time limits.
• For those doing remote work or remote school, create spaces they can use that approximate school or work spaces (no school from bed, for example).
• Come up with some non-screen activities for all of you. Books with pages, for example. Blocks for kids, arts and crafts, dollhouses, and other things that spur imagination.
• Set up regular remote contact with friends and family that you haven’t seen. Consider widening your “bubble” to include some select friends and family that you trust to be safe and take precautions.
• If you have a partner, work out the division of labor in a way that feels fair to both of you.

Identify activities that make you happy, and build them in too

We really need this now; it is crucial, not optional. We need to be deliberate in this. Identify both things that people can do alone, and things that you can do together, and make them part of your routines. Maybe it’s some alone time for each of the adults, a date night (light some candles at a table after the kids go to sleep and put your phones aside), a family game night, some daily silliness… whatever makes you smile, build it in.

Identify ways to become healthier, both physically and mentally

This too is crucial; it’s not something we can put aside anymore. For example:

• Be sure everyone is getting enough sleep (at night, not during the day, unless someone works a night shift).
• Eat healthy foods. I know, pandemics seem to justify comfort food. But too much cookies, ice cream, and chips catch up with you eventually, and start to make you feel bad instead of good.
• Get exercise. Every day is best, but do it at least five times a week — and make sure everyone in the family does it. It could literally be dancing in the kitchen, or a YouTube exercise video. If you can get outside, even for a short walk, all the better — we need to be places that don’t have ceilings sometimes.
• Be mindful of your alcohol and other substance use. That little bit to “take the edge off” can be a slippery slope.
• Build in time for communication with each other. It could be as simple as device-free family dinner and at least one device-free check-in with your partner.
• Reach out to your doctor if you or anyone in your family is feeling particularly sad or anxious. There are many resources available. Lots of counselors offer virtual sessions. Don’t wait, hoping things will get better. They may only get worse, and at the very least will get better with help.

We will make it through this. The choices we make today will make all the difference in who and how we are when we emerge — so let’s make them proactively, wisely, and with kindness.

Follow me on Twitter @drClaire

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Vaping while pregnant found to have potential impact on prenatal brain development in zebrafish

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Homemade Finger Paint Recipe

Rainy days, long afternoons…  sometimes we mamas need a trusty list of fun kids’ activities! A homemade finger paint recipe deserves to make the list. This version can be as simple as two ingredients. Even better, it’s totally edible and non-toxic if they just happen to eat some! Why Homemade Finger Paint? I usually opt for …

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Nice infographic about tha SARS-Cov2 measurement over time in the Netherlands

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Lifestyle medicine for all: Healthy food comes first

“Lifestyle medicine is only for rich people, right?” a colleague asked me several years ago, questioning my involvement in this relatively new field of medicine that guides people toward healthy habits. This has been a common misperception, for sure.

But across the US, a revitalized brand of health activism is intent on bringing lifestyle medicine to a broader range of people. This is backed by a new effort from the American College of Lifestyle Medicine to engage communities most affected by chronic disease.

The first pillar of healthy lifestyle: Food is medicine

Lifestyle medicine is an evidence-based practice of helping people adopt and sustain healthy behaviors like improving diet, increasing activity, managing stress, sleeping well, moderating alcohol consumption, and quitting tobacco. Large studies show such habits can extend our lives by well over a decade. What’s more, these habits can even keep these extra years free of diseases like diabetes, heart disease, strokes, and cancer.

Eating a plant-based diet — meaning a diet rich in vegetables, fruits, beans and legumes, nuts and seeds, and whole grains — can lower inflammation, as well as the risk of many chronic diseases such as diabetes, heart disease, strokes, and cancer. Simply put, food is medicine. Some doctors are providing this information to patients as part of their regular medical care.

But many people do not have easy access to healthy plant foods. Especially now, they may be suffering from significant financial limitations, unemployment, and unstable housing. Or they may live in a “food desert,” where grocery options are severely limited, or worse, a “food swamp,” an area where fast food and junk food are more available than anything else. Living in a food swamp puts people at a higher risk of becoming overweight or obese.

Ways to help change the equation

Helping patients access healthy plant foods is critically important. And some doctors and academic medical centers are taking action to bring healthy foods to underserved communities.

Food pantries. Dr. Jacob Mirsky is a physician at Massachusetts General Hospital and co-director of the department of medicine’s Healthy Lifestyle Program. He works in an underserved community north of Boston, where he directs his clinic’s new plant-based food pantry. When he prescribes a plant-predominant diet to his patients, he also is able to provide the plants. He views this work as activism and a potent way to address inequalities while also taking care of his patients.

Plant-based food pantries and food prescription programs have been positively received by communities. One such program in a rural, low-income area of Texas provided 30 pounds of fresh produce to households identified as food-insecure — meaning they did not have enough food to eat — every two weeks for six months. Participants described the program as critical for helping them feed their families, and 99% reported that they consumed all or almost all of the food they received.

Education and support. Dr. Michelle McMacken is an assistant professor of medicine at New York University’s Grossman School of Medicine, and director of the Plant-Based Lifestyle Medicine Program at NYC Health and Bellevue Hospital. She is working to make lifestyle medicine services available to as many patients as possible, regardless of socioeconomic status.

“I believe everyone deserves access to lifestyle medicine, especially the highest-risk, most vulnerable patients who potentially stand to benefit the most,” she says. “The majority of my patients — including those facing significant socioeconomic challenges — want to learn what they can do to become healthier. We collaborate to figure out how they can leverage lifestyle medicine within their own situation.”

Despite challenging circumstances, she has seen patients achieve health transformations, including weight loss and improved cholesterol and blood sugar levels.

Programs that educate people about the power of plant foods can have a big impact. A study of 32 Latinx people with type 2 diabetes living in a medically underserved area of California offered a five-week program introducing participants to the power of plant foods. Declines in blood sugar continued even six months after that program had ended.

Connecting people and food. The Family Van is a longtime mobile health program supported by Harvard Medical School that provides free education, resources, and some clinical services to anyone, regardless of insured status. A large part of what they do is help people access nutritional support through SNAP (Supplemental Nutrition Assistance Program) and locate low-cost produce sources like The Fresh Truck and The Daily Table. They also will provide grocery gift cards along with their healthy diet counseling. The Family Van has been collecting data such as body mass index, blood pressure, blood sugars, and ore for over a decade, and has published several papers showing that such interventions work.

Programs like these are essential and wonderful, but there is a lot more work to be done. In our Healthy Lifestyle Program at Massachusetts General Hospital, we hope to establish the practice of healthy lifestyle as the standard of care for preventing and treating chronic disease for all of our patients. To do this, we are developing practical, accurate methods to assess clinically important diet and lifestyle factors at every patient’s physical exam. At the same time, we’re studying evidence-based approaches to help people eat and live healthier, including our plant-based food pantry, health coaching, and web-based group education classes. We hope that in the future, every one of our patients will have access to the quality information, resources, and support that they need to live their healthiest life.

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'Brain-boosting' supplements may contain unapproved drugs, study says: some that contain not only the unapproved drugs included on the label, but also unapproved pharmaceuticals that aren’t even listed

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377: How to Overcome Stress, Cravings & Weight Gain With The Watkins Method

During quarantine, I’ve heard from many of you asking for help with cravings and weight gain caused by stress and the emotional toll all of this is taking. To that end I brought in Brittany Watkins, one of my favorite people for advice on natural ways to stop emotional eating, control food cravings, and end …

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Study finds Gut Microbiome Plays Important Role in Sleep Regulation: Researchers discovered how sleep disturbances due to obstructive sleep apnea (OSA) affect the gut microbiome in mice and how transplanting those gut bacteria into other mice can cause changes to sleep patterns in the recipient mice

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Berkeley, California passes ordinance requiring healthy snacks at grocery checkout aisles

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SARS-CoV-2 during pregnancy was not associated with complications in neonates: Almost two out of three pregnant women who tested positive for SARS-CoV-2 were asymptomatic and the researchers found no higher prevalence of complications during delivery or of ill-health in the neonates

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Cannabis use during pregnancy may increase a child's risk of psychotic behavior, a study found

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Sport and memory go hand in hand: By evaluating memory performance following a sport session, neuroscientists demonstrate that an intensive physical exercise session as short as 15 minutes improves memory, including the acquisition of new motor skills

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CBD for chronic pain: The science doesn’t match the marketing

If you ask health care providers about the most challenging condition to treat, chronic pain is mentioned frequently. By its nature, chronic pain is a complex and multidimensional experience. Pain perception is affected by our unique biology, our mood, our social environment, and past experiences. If you or a loved one is suffering from chronic pain, you already know the heavy burden.

People are looking for novel, nonaddictive ways to treat pain

Given the ongoing challenges of chronic pain management coupled with the consequences of the opioid epidemic, pain management practitioners and their patients are searching for effective and safer alternatives to opioids to alleviate pain. With the legalization of marijuana in many states and resulting cultural acceptance of this drug for recreational and medical use, there has been an increased interest in using cannabis for a myriad of medical problems, including pain.

Cannabis (most commonly obtained from the Cannabis indica and Cannabis sativa plants) has three major components: cannabinoids, terpenoids, and flavonoids. While there are over a hundred different cannabinoids, the two major components are tetrahydrocannabional (THC) and cannabidiol (CBD). Historically more attention has been paid to the psychoactive (euphoric “getting high”) component of the cannabis plant, THC; there have been fewer scientific studies on the medical use of CBD, a non-psychoactive component of the plant.

What’s the thinking behind using cannabis for chronic pain?

CBD is emerging as a promising pharmaceutical agent to treat pain, inflammation, seizures, and anxiety without the psychoactive effects of THC. Our understanding of the role of CBD in pain management continues to evolve, and evidence from animal studies has shown that CBD exerts its pain-relieving effects through its various interactions and modulation of the endocannabinoid, inflammatory, and nociceptive (pain sensing) systems. The endocannabinoid system consists of cannabinoid receptors that interact with our own naturally occurring cannabinoids. This system is involved in regulating many functions in the body, including metabolism and appetite, mood and anxiety, and pain perception.

What’s the research that CBD works in humans?

Given its promising results in animal models, along with its relative safety, non-psychoactive properties, and low potential for abuse, CBD is an attractive candidate to relieve pain. Unfortunately, there is a lack of human studies about the effectiveness of CBD. However, there is an abundance of commercial advertisements about the magical effects of CBD, and it is frequently presented as a cure-it-all potion that will treat everything including diabetes, depression, cancer, chronic pain, and even your dog’s anxiety!

So far, pharmaceutical CBD is only approved by the FDA as adjunct therapy for the treatment of a special and rare form of epilepsy. Currently, CBD alone is not approved for treatment of pain in the United States. But a combination medication (that contains both THC and CBD in a 1:1 ratio) was approved by Health Canada for prescription for certain types of pain, specifically central neuropathic pain in multiple sclerosis, and the treatment of cancer pain unresponsive to optimized opioid therapy. There is currently no high-quality research study that supports the use of CBD alone for the treatment of pain.

Why is CBD presented to the public this way, when it is not without risks?

Given the rapid change in the legality of cannabis coupled with the increased appetite for something new, and driven by unprecedented profit margins, the advertising for cannabinoids in general and CBD in particular has gone wild. The FDA is very clear that it is illegal to market CBD by adding it to a food or labeling it as a dietary supplement. And it warns the public about its potential side effects, as it’s often advertised in a way that may lead people to mistakenly believe using CBD “can’t hurt.” CBD can cause liver injury, and can affect the male reproductive system (as demonstrated in laboratory animal studies).

Most importantly, CBD can interact with other important medications like blood thinners, heart medications, and immunosuppressants (medications given after organ transplantation), potentially changing the levels of these important medications in the blood and leading to catastrophic results, including death. Also, more information needs to be gathered about its safety in special populations such as the elderly, children, those who are immunocompromised, and pregnant and breastfeeding women.

Many of the CBD products on the market are unregulated

In fact, the FDA has issued several warning letters to companies and individuals that market unapproved new drugs that allegedly contain CBD. The FDA has tested the chemical content of cannabinoid compounds in some of the products, and many were found to not contain the levels of CBD the manufacturers had claimed they contain.

Beware of powerful testimonials

Finally, there is anecdotal wisdom, when experiences by patients and health professionals have positive results. While the experience or medication could be beneficial, that doesn’t mean it is going to work for everyone. That’s because each and every person is unique, and what works perfectly for one patient could have no effect on another patient. This is especially true for pain, where many other factors (our mood and stress level, our environment and other medical conditions, and our previous experiences) can affect the perception of pain. Please be careful, and keep in mind that some of these incredible-sounding testimonials are merely marketing materials meant to lure consumers to buy more products, as the CBD market is expected to hit $20 billion by 2024.

The bottom line: Don’t make CBD your first or only choice for pain relief

If you or someone close to you is considering trying CBD, I would recommend Dr. Robert Shmerling’s advice about the dos and don’ts in choosing an appropriate product. Until there is high-quality scientific evidence in humans, it is difficult to make a recommendation for the regular use of CBD in chronic pain management.

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Study shows weighted blankets can decrease insomnia severity. Randomized, controlled trial finds that weighted blankets are safe and effective .

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Where the highest rates of Chlamydia are diagnosed in the United States

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Is Aging a Disease You Can Reverse? A Look at the Science Behind the Longevity Movement

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Researchers Present How Couples’ Lifestyle Influences Diabetes Risk

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Attention-Deficit Hyperactivity Disorder (ADHD) Study Reveals Unique Genetic Differences between African American Patients with the Condition and Those of European Ancestry: Findings may play an important part in how patients of different ethnic backgrounds respond to treatments for this condition

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Study predicts increase in mosquito-borne diseases as planet warms

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Researchers pinpoint brain circuitry underlying dissociative experiences: The findings implicate a particular protein in particular set of cells as crucial to feeling of dissociation; could lead to better-targeted therapies for conditions such as PTSD, borderline personality disorder and epilepsy

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Cough and cold season is arriving: Choose medicines safely

With the summer winding down and fall moving in, colder weather will arrive soon — along with cold and flu season. Millions of Americans get the common cold each year, often more than once. To counter coughs and runny noses, many will turn to over-the-counter (OTC) medications available for relief without a prescription.

Heading to the pharmacy for some relief? Read this first

While OTC medicines do not cure or shorten the common cold or flu, they can ease some symptoms. Finding a product that fits your needs, however, may not be so straightforward. A recent study evaluated brand-name OTC medications marketed as cold, allergy, sinus, and nasal remedies. It found that 14 common brand names, such as Mucinex, Tylenol, Robitussin, Benadryl, and Theraflu, accounted for 211 unique products, yet all of these products contained only eight active ingredients, alone or in combination.

Half of those ingredients turned up in more than 100 different products, very often combined with up to three other active ingredients. In total, 688 combination products were found. Many appear under the same brand name, and all aim to remedy colds, allergies, or sinus and nasal ailments. No wonder a trip to a pharmacy aisle can be confusing (and the study did not even include store-branded and generic products).

How to safely choose cough and cold medicines

So, how to choose from a myriad of similar products? First, understand that many products contain more active ingredients than you need. And yes, those extra active ingredients have side effects and may interact with other medicines you take. The simplest advice is to check the list of active ingredients on the package, and pick a product that targets your particular symptoms.

• For sore throats, headaches, and muscle aches a pain reliever such as acetaminophen or a nonsteroidal anti-inflammatory drug such as ibuprofen will do the trick. These will also break a fever.
• Runny nose, watery eyes, and sneezing may be relieved by an antihistamine, such as chlorpheniramine. Antihistamines can cause drowsiness, so caution is advised when taking an antihistamine during the day.
• Nasal congestion responds temporarily to decongestants, such as phenylephrine and pseudoephedrine. However, decongestants can cause insomnia and agitation. These medications can also increase blood pressure and heart rate, so check with your doctor or a pharmacist if you have diabetes, glaucoma, heart disease, high blood pressure, prostate problems, or thyroid problems. Some decongestants are available as a nasal spray. These should not be used for more than three days, as longer use can lead to rebound congestion.
• Common cough medicine ingredients are guaifenesin, which can help clear mucus, and dextromethorphan, a cough suppressant. The relief they provide is minor, if any. Guaifenesin is relatively safe; on the other hand, excessive use of dextromethorphan may increase blood pressure, cause irregular heartbeat, and make you feel dizzy.

What to be careful about

Despite glamourous claims and an ever-growing arsenal of products, over-the-counter cough, cold, and flu medications provide only minor relief for some symptoms, which will go away on their own without any treatment.

• Be aware that the American Academy of Pediatrics does not recommend any over-the-counter cough and cold preparations for children under the age of 6.
• If you’re taking more than one product, make sure you don’t double up on ingredients. Acetaminophen, in particular, is present in many cough and cold medications, as well as in some prescription pain medications. While safe in low doses, it can be toxic to the liver in high doses (above 4 grams daily), so check the labels.
• Most of these products contain multiple ingredients, many of which have potentially serious side effects. Do not assume they are safe for you, and do read labels carefully. Talk to a pharmacist or your doctor when in doubt.
• Always let your doctor know about all the medicines and supplements you’re taking. A brand name may not offer enough information, so bring products or packages to your visit.

These precautions are especially important if you have underlying medical conditions, such as high blood pressure or heart problems.

The best treatment for common colds is plenty of rest and liquids. Prevention is better still. So wash your hands and stay away from sick people, if possible. And get a flu shot — it won’t prevent a cold, but it’s the best way to prevent flu, and you don’t want to be worrying about flu this year.

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Homemade Coconut Milk Recipe

I’ve been using coconut products for years and now you can find everything from coconut cream to coconut flour in your grocery store baking aisle. Coconut milk is a wonderful alternative to pasteurized cow’s milk or to rice, almond, soy, or other plant-based milk, and you can find this at most stores as well. Unfortunately, …

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Coronavirus vaccine won't bring about 'fairytale' ending to pandemic, expert warns

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Mosquito-borne viruses linked to stroke: A deadly combination of two mosquito-borne viruses may be a trigger for stroke, new research published in the The Lancet Neurology has found

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Genetic and emotional links to migraines and the best ways of treating problem

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CDC Issues, Reverses Guidance About Airborne Coronavirus Transmission

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A link between sensory neurons activation and the immune system: Scientists have developed an implantable technology that enabled the discovery of an interaction between sensory neurons and immune cells

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Discrimination, high blood pressure, and health disparities in African Americans

Over the past few months, we have all seen the results of significant disruption to daily life due to the COVID-19 pandemic, high levels of unemployment, and civil unrest driven by chronic racial injustice. These overlapping waves of societal insult have begun to bring necessary attention to the importance of health care disparities in the United States.

Direct links between stress, discrimination, racial injustice, and health outcomes occurring over one’s lifespan have not been well studied. But a recently published article in the journal Hypertension has looked at the connection between discrimination and increased risk of hypertension (high blood pressure) in African Americans.

Study links discrimination and hypertension in African Americans

It has been well established that African Americans have a higher risk of hypertension compared with other racial or ethnic groups in the United States. The authors of the Hypertension study hypothesized that a possible explanation for this disparity is discrimination.

The researchers reviewed data on 1,845 African Americans, ages 21 to 85, enrolled in the Jackson Heart Study, an ongoing longitudinal study of cardiovascular disease risk factors among African Americans in Jackson, Mississippi. Participants in the Hypertension analysis did not have hypertension during their first study visits in 2000 through 2004. Their blood pressure was checked, and they were asked about blood pressure medications, during two follow-up study visits from 2005 to 2008 and from 2009 to 2013. They also self-reported their discrimination experiences through in-home interviews, questionnaires, and in-clinic examinations.

The study found that higher stress from lifetime discrimination was associated with higher risk of hypertension, but the association was weaker when hypertension risk factors such as body mass index, smoking, alcohol, diet, and physical activity were taken into consideration. The study authors concluded that lifetime discrimination may increase the risk of hypertension in African Americans.

Discrimination may impact hypertension directly and indirectly

Discrimination is a chronic stressor that has been proposed to contribute to adverse health outcomes, including hypertension. Discriminatory acts may directly impact hypertension via the stress pathway, triggering a rise in hormones that cause blood vessels to narrow, the heart to beat faster, and blood pressure to rise. Discrimination may also contribute to the development of hypertension through unhealthy behaviors, such as unhealthy eating or sedentary lifestyles. People may even avoid seeking medical care due to concern that they will experience discrimination in a medical setting.

Two other longitudinal studies (a type of study that follows participants over time) have examined discrimination and hypertension. A 2019 study published in Annals of Behavioral Medicine found that everyday discrimination may be associated with elevated hypertension risk among a sample of white, African American, Latino, and Asian middle-aged women. Another 2019 study in the International Journal of Environmental Research and Public Health found association between chronic discrimination and hypertension in a large sample of African American women.

Disparities are evident across health indicators

Racial and ethnic health disparities are reflected in a number of national health indicators. For example, in 2002, non-Hispanic Blacks trailed non-Hispanic whites in the following areas:

• people younger than 65 with health insurance (81% of non-Hispanic blacks versus 87% of non-Hispanic whites)
• adults 65 or older vaccinated against influenza (50% versus 69%) and pneumococcal disease (37% versus 60%)
• women receiving prenatal care in the first trimester of pregnancy (75% versus 89%)
• adults 18 and older who participated in regular moderate physical activity (25% versus 35%).

In addition, non-Hispanic Blacks had substantially higher proportions of deaths from homicide, and children and adults who were overweight or obese, compared to non-Hispanic whites.

Many factors contribute to health inequities

For African Americans in the United States, health disparities can mean earlier deaths related to development of chronic disease such as diabetes, hypertension, stroke, heart disease, decreased quality of life, loss of economic opportunities, and perceptions of injustice. In our society, these disparities translate into less than optimal productivity, higher health care costs, and social inequity.

It is clear that multiple factors contribute to racial and ethnic health disparities. These include socioeconomic factors such as education, employment, and income; lifestyle factors like physical activity and alcohol intake; social and environment factors, including educational and economic opportunities, racial/ethnic discrimination, and neighborhood and work conditions; and access to preventive health care services such as cancer screening and vaccination.

The solution to health disparities for African Americans is certainly within our societal grasp. It requires leadership at a state and national level, appropriate resource allocation, and larger and more focused clinical investigation.

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