HEALTH RISKS OF ENERGY DRINKS

Energy Drinks FREE ONLINE FIRST

Janet M. Torpy, MD; Edward H. Livingston, MD

JAMA. 2012;():1. doi:10.1001/jama.2012.170614.

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Published online December 19, 2012

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Beverages called energy drinks are popular, especially with teenagers and young adults. These energy drinks are advertised to give individuals a higher energy level, to make a person feel more awake, and to boost attention span.

Energy drinks are marketed in different serving sizes and have varying amounts of caffeine. Sodas (also known as pop, colas, or soft drinks) may contain sugar and caffeine, although most sodas contain less caffeine than energy drinks on an ounce-by-ounce basis. As a comparison, an 8-oz cup of coffee has about 100 mg of caffeine (see table at right, and expanded table online at www.jama.com). The January 16, 2013, issue of JAMA contains 2 articles discussing the harms associated with energy drinks.

COMMON INGREDIENTS IN ENERGY DRINKS

• Caffeine
• Sugar
• Guarana (a plant with seeds that contain caffeine)
• Cocoa
• B vitamins
• Herbs, including ginseng, licorice, and kola nut

HEALTH RISKS ASSOCIATED WITH ENERGY DRINKS

• Increased heart rate
• Irregular heart rate and palpitations
• Increased blood pressure
• Sleep disturbances, including insomnia
• Diuresis (increased urine production)
• Hyperglycemia (increased blood sugar) is related to all beverages with high sugar content. This can be harmful for individuals with diabetes or other metabolic health problems.

The American Academy of Pediatrics recommends that young children should not consume energy drinks. Caffeine may be especially harmful for children. Adolescents should not have more than 100 mg of caffeine each day. Parents should monitor how much soda or coffee (or other beverages containing caffeine, including energy drinks of any kind) their teenagers drink and help them understand the risks associated with taking in large amounts of caffeine.

Adults should limit their caffeine intake to 500 mg per day. Individuals who have heart problems, high blood pressure, or trouble sleeping or who are taking medications should be careful to limit the amount of caffeine they drink. Older persons may be more sensitive to the effects of caffeine.

Energy drinks are not regulated by the US Food and Drug Administration. However, the ingredients in energy drinks may be harmful to some individuals. It is important to read labels for any food or drink product that you consume. If you choose to use energy drinks, make sure you understand the ingredients and serving sizes listed on the label.

DIABETES SELF MANAGEMENT: MEN VS WOMEN

Self-management experiences among men and women with type 2 diabetes mellitus: a qualitative analysis

Rebecca Mathew, Enza Gucciardi, Margaret De Melo and Paula Barata

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BMC Family Practice 2012, 13:122 doi:10.1186/1471-2296-13-122

Published: 19 December 2012

Abstract (provisional)

Background

The purpose of this study is to better understand differences in diabetes self-management, specifically needs, barriers and challenges among men and women living with type 2 diabetes mellitus (T2DM).

Methods

35 participants were recruited from a diabetes education center (DEC) in Toronto, Canada. Five focus groups and nine individual interviews were conducted to explore men and women's diabetes self-management experiences.

Results

The average age of participants was 57 years and just over half (51.4%) were female. Analyses revealed five themes: disclosure and identity as a person living with diabetes; self-monitoring of blood glucose (SMBG); diet struggles across varying contexts; utilization of diabetes resources; and social support. Women disclosed their diabetes more readily and integrated management into their daily lives, whereas men were more reluctant to tell friends and family about their diabetes and were less observant of self-management practices in social settings. Men focused on practical aspects of SMBG and experimented with various aspects of management to reduce reliance on medications whereas women focused on affective components of SMBG. Women restricted foods from their diets perceived as prohibited whereas many men moderated their intake of perceived unhealthy foods, except in social situations. Women used socially interactive resources, like education classes and support groups whereas men relied more on self-directed learning but also described wanting more guidance to help navigate the healthcare system. Finally, men and women reported wanting physician support for both affective and practical aspects of self-management.

Conclusions

Our findings highlight the differences in needs and challenges of diabetes self-management among men and women, which may inform gender-sensitive diabetes, care, counseling and support.

EXERCISE THERAPY FOR MUSCULOSKELETAL DISEASES

Exercise therapy for bone and muscle health: an overview of systematic reviews

Kare B Hagen, Hanne Dagfinrud, Rikke H Moe, Nina Osteras, Ingvild Kjeken, Margreth Grotle and Geir Smedslund

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BMC Medicine 2012, 10:167 doi:10.1186/1741-7015-10-167

Published: 19 December 2012

Abstract (provisional)

Background

Musculoskeletal conditions (MSCs) are widely prevalent in present-day society, with resultant high healthcare costs and substantial negative effects on patient health and quality of life. The main aim of this overview was to synthesize evidence from systematic reviews on the effects of exercise therapy (ET) on pain and physical function for patients with MSCs. In addition, the evidence for the effect of ET on disease pathogenesis, and whether particular components of exercise programs are associated with the size of the treatment effects, was also explored.

Methods

We included four common conditions: fibromyalgia (FM), low back pain (LBP), neck pain (NP), and shoulder pain (SP), and four specific musculoskeletal diseases: osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), and osteoporosis (OP). We first included Cochrane reviews with the most recent update being January 2007 or later, and then searched for non-Cochrane reviews published after this date. Pain and physical functioning were selected as primary outcomes.

Results

We identified 9 reviews, comprising a total of 224 trials and 24,059 patients. In addition, one review addressing the effect of exercise on pathogenesis was included. Overall, we found solid evidence supporting ET in the management of MSCs, but there were substantial differences in the level of research evidence between the included diagnostic groups. The standardized mean differences for knee OA, LBP, FM, and SP varied between 0.30 and 0.65 and were significantly in favor of exercise for both pain and function. For NP, hip OA, RA, and AS, the effect estimates were generally smaller and not always significant. There was little or no evidence that ET can influence disease pathogenesis. The only exception was for osteoporosis, where there was evidence that ET increases bone mineral density in postmenopausal women, but no significant effects were found for clinically relevant outcomes (fractures). For LBP and knee OA, there was evidence suggesting that the treatment effect increases with the number of exercise sessions.

Conclusions

There is empirical evidence that ET has beneficial clinical effects for most MSCs. Except for osteoporosis, there seems to be a gap in the understanding of the ways in which ET influences disease mechanisms.

CYCLING AND BONE HEALTH

cine 2012, 10:168 doi:10.1186/1741-7015-10-168

Published: 20 December 2012

Abstract (provisional)

Background

Cycling is considered to be a highly beneficial sport for significantly enhancing cardiovascular fitness in individuals, yet studies show little or no corresponding improvements in bone mass.

Methods

A scientific literature search on studies discussing bone mass and bone metabolism in cyclists was performed to collect all relevant published material up to April 2012. Descriptive, cross-sectional, longitudinal and interventional studies were all reviewed. Inclusion criteria were met by 31 studies.

Results

Heterogeneous studies in terms of gender, age, data source, group of comparison, cycling level or modality practiced among others factors showed minor but important differences in results. Despite some controversial results, it has been observed that adult road cyclists participating in regular training have low bone mineral density in key regions (for example, lumbar spine). Conversely, other types of cycling (such as mountain biking), or combination with other sports could reduce this unsafe effect. These results cannot yet be explained by differences in dietary patterns or endocrine factors.

Conclusions

From our comprehensive survey of the current available literature it can be concluded that road cycling does not appear to confer any significant osteogenic benefit. The cause of this may be related to spending long hours in a weight-supported position on the bike in combination with the necessary enforced recovery time that involves a large amount of time sitting or lying supine, especially at the competitive level. See related commentary http://www.biomedcentral.com/1741-7015/10/169.

FRAIL HEALTH OF THE ABORIGINAL CANADIANS

BMC Public Health 2012, 12:1098 doi:10.1186/1471-2458-12-1098

Published: 20 December 2012

Abstract (provisional)

The disproportionate effects of the 2009 H1N1 pandemic on many Canadian Aboriginal communities have drawn attention to the vulnerability of these communities in terms of health outcomes in the face of emerging and reemerging infectious diseases. Exploring the particular challenges facing these communities is essential to improving public health planning. In alignment with the objectives of the Pandemic Influenza Outbreak Research Modelling (Pan-InfORM) team, a Canadian public health workshop was held at the Centre for Disease Modelling (CDM) to: (i) evaluate post-pandemic research findings; (ii) identify existing gaps in knowledge that have yet to be addressed through ongoing research and collaborative activities; and (iii) build upon existing partnerships within the research community to forge new collaborative links with Aboriginal health organizations. The workshop achieved its objectives in identifying main research findings and emerging information post pandemic, and highlighting key challenges that pose significant impediments to the health protection and promotion of Canadian Aboriginal populations. The health challenges faced by Canadian indigenous populations are unique and complex, and can only be addressed through active engagement with affected communities. The academic research community will need to develop a new interdisciplinary framework, building upon concepts from 'Communities of Practice', to ensure that the research priorities are identified and targeted, and the outcomes are translated into the context of community health to improve policy and practice.

FORMULA TO LIVE LONGER..ride bicycle to work

The longevity Olympians enjoy is within the reach of everyone, experts say.

Research published on the British Medical Journal (BMJ) website suggests athletes live 2.8 years longer on average than the average lifespan.

The research indicated those who took part in non-contact sports such as cycling, rowing and tennis enjoyed the longest life of all.

But the general population could have a similar "survival advantage" by doing a little more exercise, experts said.

The conclusion by two public health professors came after they reviewed two studies of Olympic athletes published by the BMJ website.

The studies looked at the lifespan and health of 25,000 athletes who competed in Games dating back to 1896.

Those taking part in contact sports such as boxing had the least advantage, while cyclists and rowers enjoyed the best health.

But the researchers also found those who played lower intensity sports such as golf enjoyed a boost.

'Public health failure'

Possible explanations put forward for the finding included genetic and lifestyle factors and the wealth and status that comes with sporting success.

However, the findings prompted public health experts Prof Adrian Bauman, from Australia's Sydney University, and Prof Steven Blair, from South Carolina University in the US, to suggest others could live as long as Olympic athletes.

The recommended level of physical activity for adults is 150 minutes of moderate to vigorous exercise each week.

Studies suggest people who manage that amount or more live for up to several years longer than those that do not.

Writing for the BMJ website, the professors said: "Although the evidence points to a small survival effect of being an Olympian, careful reflection suggests that similar health benefits and longevity could be achieved by all of us through regular physical activity.

"We could and should all award ourselves that personal gold medal."

But they said governments were still not doing enough to promote the benefits of physical activity, calling it a "public health failure".

Sharing a drink with friends.. more than the alcohol

KNOW YOUR BRAND..

Yellow Tail is without doubt the most popular Australian brand of wine known in the USA and UK.. But it was virtually unknown before 2000.

The top 10 popular brands in the Liquor industry are all spirits and they all have wonderful histories. Branding rather than country or region of origin.

 ( with my brother Eliyahu at Resto La Bodeguita in Buenos Aires, tasting a wonderful bottle of Malbec from Mendoza, Argentina)

The best-known brand is Smirnoff, which has nothing to do with Russia; it is owned and produced by a British Company.

Captain Morgan Rum Company has nothing to do with Jamaica except historically for being a pirate in that turbulent region. Bronfman, a Canadian Jew bought the recipe for spiced rum from two Jewish pharmacists in Jamaica, the Levy Brothers and began manufacturing and selling it. It is the most recognized brand of rum around the world.

Bacardi Rum is not made in Cuba but in Bahamas, Puerto Rico or elsewhere. But the association is always with Cuba. The original factory in Santiago de Cuba still stands and produces Havana Club, which is a far superior product than the weak Bacardi rum sold abroad.

Coming back to Yellow Tail, most of its wine and their grapes come not from their vineyard but is gathered from all around Australia, not from Riverina where the owner is located!

This is a trend which began in 1940s and now well entrenched. If you want a good sauvignon Blanc, buy a bottle of Kim Crawford at a reputable store. If you fall for Marlborough Valley label on the wine, you may be falling for origin of the grapes from various parts of the valley and is not even bottled in a winery in the region. I have seen this over and over again on wine bottles from South Africa with strange sounding African names or from Chile with imitated mapuche Indian names. So I have learned that if the name sounds a little strange, the wine origins are also a bit strange.

I am off to Cuba where the drinking culture is purely rum locally produced to satisfy the population. Havana Club White, which is sold for about 4 dollars a bottle, is excellent to make a Cuba Libre, and Anejo 7 year old is good to sip…

While I am there, drinking a good glass of wine is just a hope and a dream… but there is a difference. In Cuba, drinking Rum, you do it with friends and incessant conversations. So it is very social and very satisfying from a personal point of view.

So, with a sauvignon Blanc from 360 degrees from Santa Ana in hand, I salute you… LChaim. To life…

Drinking wine, a glass or two with your meals, is certainly good for your health; I recommend it as an Endocrinologist and specialist in Nutrition…