The Sucralose News: Scaremongering Or Serious?
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What’s the news on sucralose?
These past days the press has been abuzz with frightening tales:
- This Common Artificial Sweetener Can Break Down DNA, Scientists Warn
- Sucralose Damages DNA, Linked to Leaky Gut
- Chemical found in common sweetener damages DNA
- Chemical found in widely used sweetener breaks up DNA
- Chemical from Splenda breaks up DNA
How true and/or serious is this?
Firstly, let’s manage expectations. Pineapple juice also breaks down DNA, but is not generally considered a health risk. So let’s keep that in mind, while we look into the science.
Is sucralose as scary as pineapple juice, or is it something actually dangerous?
The new study (that sparked off these headlines)
The much-referenced study is publicly available to read in full—here it is:
You may notice that this doesn’t have quite the snappy punchiness of some of the headlines, but let’s break this down, if you’ll pardon the turn of phrase:
- Toxicological: pertaining to whether or not it has toxic qualities
- Pharmacokinetic: the science of asking, of chemicals in bodies, “where did it come from; where did it go; what could it do there; what can we know?”
- Sucralose-6-acetate: an impurity that can be found in sucralose. For perspective, the study found that the sucralose in Splenda contained “up to” 0.67% sucralose-6-acetate.
- Sucralose: a modified form of sucrose, that makes it hundreds of times sweeter, and non-caloric because the body cannot break it down so it’s treated as a dietary fiber and just passes through
- In vitro: things are happening in petri dishes, not in animals (human or otherwise), which would be called “in vivo”
- Screening assays: “we set up a very closed-parameters chemical test, to see what happens when we add this to this” ⇽ oversimplification, but this is the basic format of a screening assay
Great, now we understand the title, but what about the study?
Researchers looked primarily at the effects of sucralose-6-acetate and sucralose (together and separately) on epithelial cells (these are very simple cells that are easy to study; conveniently, they are also most of what makes up our intestinal walls). For this, they used a fancy way of replicating human intestinal walls, that’s actually quite fascinating but beyond the scope of today’s newsletter. Suffice it to say: it’s quite good, and/but has its limitations too. They also looked at some in vivo rat studies.
What they found was…
Based on samples from the rat feces (somehow this didn’t make it into the headlines), it appears that sucralose may be acetylated in the intestines. What that means is that we, if we are like the rats (definitely not a given, but a reasonable hypothesis), might convert up to 10% of sucralose into sucralose-6-acetate inside us. Iff we do, the next part of the findings become more serious.
Based on the in vitro simulations, both sucralose and sucralose-6-acetate reduced intestinal barrier integrity at least a little, but sucralose-6-acetate was the kicker when it came to most of the effects—at least, so we (reasonably!) suppose.
Basically, there’s a lot of supposition going on here but the suppositions are reasonable. That’s how science works; there’s usually little we can know for sure from a single study; it’s when more studies roll in that we start to get a more complete picture.
What was sucralose-6-acetate found to do? It increased the expression of genes associated with inflammation, oxidative stress, and cancer (granted those three things generally go together). So that’s a “this probably has this end result” supposition.
More concretely, and which most of the headlines latched onto, it was found (in vitro) to induce cytogenic damage, specifically, of the clastogenic variety (produces DNA strand breaks—so this is different than pineapple’s bromelain and DNA-helicase’s relatively harmless unzipping of genes).
The dose makes the poison
So, how much is too much and is that 0.67% something to worry about?
- Remembering the rat study, it may be more like 10% once our intestines have done their thing. Iff we’re like rats.
- But, even if it’s only 0.67%, this will still be above the “threshold of toxicological concern for genotoxicity”, of 0.15µg/person/day.
- On the other hand, the fact that these were in vitro studies is a serious limitation.
- Sometimes something is very dangerous in vitro, because it’s being put directly onto cells, whereas in vivo we may have mechanisms for dealing with that.
We won’t know for sure until we get in vivo studies in human subjects, and that may not happen any time soon, if ever, depending on the technical limitations and ethical considerations that sometimes preclude doing certain studies in humans.
Bottom line:
- The headlines are written to be scary, but aren’t wrong; their claims are fundamentally true
- What that means for us as actual humans may not be the same, however; we don’t know yet
- For now, it is probably reasonable to avoid sucralose just in case
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Four Habits That Drastically Improve Mobility
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Mobility is critical for health living, but stretching isn’t the entire story:
Beyond just stretching
Liv Townsend, of LivInLeggings fames, recommends these four habits:
- Sit less: prolonged sitting affects hip and shoulder mobility. Specifically, it affects it negatively. It is also a bringer of woe in many other ways beyond the scope of what we’re doing here today, but the important thing for mobility is to sit less. So, if you spent a lot of time at a desk, invest in a standing desk (writer’s note: I dearly love mine, which is technically a sit-stand converter like this one on Amazon but I just keep it in the up position all the time, so it’s easy to forget it has multiple settings. Anyway, it’s sooooooo much better for my back than sitting for hours at a time.). For how to deal with other (i.e. not desk-related) reasons you might be sitting a lot, check out: Stand Up For Your Health (Or Don’t*)
- Take creatine: more than just for strength and muscle-building (and even aside from its brain-benefits that it bestows to older people, but not young ones), creatine also supports mobility and flexibility. Any brand is fine, so long as creatine monohydrate is the sole ingredient. Also, micronized or not is also fine—that’s just to do with whether it’s been pre-compacted into super-tiny beads (so small that it will still effectively be a powder), which helps it to avoid clumping when mixed in a liquid, that’s all. It shouldn’t have any additives either way (so, check labels to ensure it doesn’t).
- Spend more time under tension: no, we’re not talking about texting your spouse “we need to talk”, but rather, this means that when we do stretch, we should spend longer in the stretched position. While dynamic stretching has its place, passive stretching (holding stretches for longer periods) is essential and shouldn’t be overlooked.
- Incorporate “movement snacks”: this is about when we are going about our daily life, we should move more while doing everyday tasks. Get in some shoulder stretches while waiting for the kettle to boil, deep squat while petting the dog, etc. These are very important, because mobility is very much a “use it or lose it” thing, and so moving in many different ways, frequently, is the only way to ensure full coverage (no stretching regimen is going to be able to cover the many compound movements that we do in everyday life).
*That article also covers how to avoid the damage of sitting even if you cannot physically stand!
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Mobility As Though A Sporting Pursuit: Train For The Event Of Your Life!
Take care!
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Machine-Dispensed Coffee & Heart Health
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We have written before about the health benefits (and risks) of coffee; for most people, the benefits far outweigh the risks, but individual cases may vary:
The Bitter Truth About Coffee (or is it?) ← this is a mythbusting edition
Speaking of bitterness; coffee has abundant polyphenols, which means…
- Coffee is the world’s biggest source of antioxidants
- 65% reduced risk of Alzheimer’s for coffee-drinkers
- 67% reduced risk of type 2 diabetes for coffee-drinkers
- 43% reduced risk of liver cancer for coffee-drinkers
- 53% reduced suicide risk for coffee-drinkers
See also: Why Bitter Is Better: Enjoy Bitter Foods For Your Heart & Brain ← while it says foods in the title, this does cover coffee too.
For mythbusting on caffeine specifically, enjoy: Caffeine: Cognitive Enhancer Or Brain-Wrecker?
There are also gut health benefits from drinking coffee, and what’s good for our gut is invariably good for our heart and brain:
Coffee & Your Gut ← gut bacteria do not, by the way, have a preference about how you make your coffee or whether it is caffeinated or not
The latest science on coffee and heart health
Specifically, on coffee and cholesterol levels, so for a quick primer on cholesterol, check out: Demystifying Cholesterol
High total cholesterol, and especially high LDL (“bad” cholesterol) is generally associated with cardiovascular disease, for the reasons outlined in the link above.
Recently, researchers at Uppsala University in Sweden examined the levels of cafestol and kahweol, which are both diterpenes, substances known to increase cholesterol levels, in coffee made by various methods, including those dispensed from coffee machines in workplaces.
Two samples were taken from each machine every 2–3 weeks, and the most common kinds of machines produced the highest concentrations of diterpenes. These machines are the ones that push hot water through a small amount of ground coffee, through a wide-gauge filter, dispensing coffee into a cup in about 30 seconds.
Actual espresso machines, which work on the same principle but usually with a finer filter, higher pressure, and slower dispensing of the drink, had widely varying results, quite possibly because there is (in most machines) a human element in how tightly the ground coffee is packed into the metal filter basket.
Simple filter coffee, whether made in a coffee percolator machine or made using the pour-over method, had the lowest concentrations of diterpenes.
You can read about this study here:
However!
We were curious as to how, exactly, cafestol and kahweol increase cholesterol levels.
It turns out that research in this area has been scant, because most mice aren’t affected by it in the way that most humans are, which has limited mouse model studies.
Scant does not mean non-existent, though, and the answer came by virtue of transgenic mice (specifically, apolipoprotein (apo) E*3-Leiden transgenic mice, which do have the same reaction to cafestol as humans), the paper title sums it up nicely:
You may be wondering: what does suppression of bile acid synthesis have to do with cholesterol levels?
To oversimplify it a bit: cafestol messes with cholesterol metabolism by interfering with the enzymes involved in cholesterol metabolism (specifically, regulatory enzymes found in bile acid).
As to what it actually does in that regard: it reduces LDLR (LDL receptor) mRNA levels by 37% (that figure’s an average of the specific enzymes, sterol 27-hydroxylase and oxysterol 7α-hydroxylase, which were reduced by 32% and 48%, respectively).
Why this matters in practical terms: cafestol does not add any cholesterol to our systems, it inhibits our ability to clear LDL cholesterol, thus promoting raised LDL cholesterol levels.
In other words: if you have little or no dietary cholesterol (no dietary cholesterol, for example, if you are vegan), then your body will only have the cholesterol that it made for itself because it needed it, and as such, the body won’t need to do the same kind of clean-up job that it would if you had that coffee with a double cheeseburger with extra bacon.
As such, if you have little or no dietary cholesterol, cafestol is unlikely to have anything like the same effect on cholesterol levels.
Disclaimer: this latter is technically a hypothesis, but based on sound reasoning:
It’s the same logic that says “if you do not drink alcohol, then eating a durian fruit, which inhibits aldehyde dehydrogenase, which the body uses to metabolize alcohol, will not cause alcohol-related problems for you”.
Want to know more?
We wrote previously on coffee and cafestol, along with some suggestions:
Health-Hack Your Coffee To Make Your Coffee Heart-Healthier!
Enjoy!
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ADHD medication – can you take it long term? What are the risks and do benefits continue?
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Attention deficit hyperactivity disorder (ADHD) is a condition that can affect all stages of life. Medication is not the only treatment, but it is often the treatment that can make the most obvious difference to a person who has difficulties focusing attention, sitting still or not acting on impulse.
But what happens once you’ve found the medication that works for you or your child? Do you just keep taking it forever? Here’s what to consider.
What are ADHD medications?
The mainstay of medication for ADHD is stimulants. These include methylphenidate (with brand names Ritalin, Concerta) and dexamfetamine. There is also lisdexamfetamine (branded Vyvanse), a “prodrug” of dexamfetamine (it has a protein molecule attached, which is removed in the body to release dexamfetamine).
There are also non-stimulants, in particular atomoxetine and guanfacine, which are used less often but can also be highly effective. Non-stimulants can be prescribed by GPs but this may not always be covered by the Pharmaceutical Benefits Scheme and could cost more.
How stimulants work
Some stimulants prescribed for ADHD are “short acting”. This means the effect comes on after around 20 minutes and lasts around four hours.
Longer-acting stimulants give a longer-lasting effect, usually by releasing medication more slowly. The choice between the two will be guided by whether the person wants to take medication once a day or prefers to target the medication effect to specific times or tasks.
For the stimulants (with the possible exception of lisdexamfetamine) there is very little carry-over effect to the next day. This means the symptoms of ADHD may be very obvious until the first dose of the morning takes effect.
One of the main aims of treatment is the person with ADHD should live their best life and achieve their goals. In young children it is the parents who have to consider the risks and benefits on behalf of the child. As children mature, their role in decision making increases.
What about side effects?
The most consistent side effects of the stimulants are they suppress appetite, resulting in weight loss. In children this is associated with temporary slowing of the growth rate and perhaps a slight delay in pubertal development. They can also increase the heart rate and may cause a rise in blood pressure. Stimulants often cause insomnia.
These changes are largely reversible on stopping medication. However, there is concern the small rises in blood pressure could accelerate the rate of heart disease, so people who take medication over a number of years might have heart attacks or strokes slightly sooner than would have happened otherwise.
This does not mean older adults should not have their ADHD treated. Rather, they should be aware of the potential risks so they can make an informed decision. They should also make sure high blood pressure and attacks of chest pain are taken seriously.
Stimulants can be associated with stomach ache or headache. These effects may lessen over time or with a reduction in dose. While there have been reports about stimulants being misused by students, research on the risks of long-term prescription stimulant dependence is lacking.
Will medication be needed long term?
Although ADHD can affect a person’s functioning at all stages of their life, most people stop medication within the first two years.
People may stop taking it because they don’t like the way it makes them feel, or don’t like taking medication at all. Their short period on medication may have helped them develop a better understanding of themselves and how best to manage their ADHD.
In teenagers the medication may lose its effectiveness as they outgrow their dose and so they stop taking it. But this should be differentiated from tolerance, when the dose becomes less effective and there are only temporary improvements with dose increases.
Tolerance may be managed by taking short breaks from medication, switching from one stimulant to another or using a non-stimulant.
Medication is usually prescribed by a specialist but rules differ around Australia.
Ground Picture/ShutterstockToo many prescriptions?
ADHD is becoming increasingly recognised, with more people – 2–5% of adults and 5–10% of children – being diagnosed. In Australia stimulants are highly regulated and mainly prescribed by specialists (paediatricians or psychiatrists), though this differs from state to state. As case loads grow for this lifelong diagnosis, there just aren’t enough specialists to fit everyone in.
In November, a Senate inquiry report into ADHD assessment and support services highlighted the desperation experienced by people seeking treatment.
There have already been changes to the legislation in New South Wales that may lead to more GPs being able to treat ADHD. Further training could help GPs feel more confident to manage ADHD. This could be in a shared-care arrangement or independent management of ADHD by GPs like a model being piloted at Nepean Blue Mountains Local Health District, with GPs training within an ADHD clinic (where I am a specialist clinician).
Not every person with ADHD will need or want to take medication. However, it should be more easily available for those who could find it helpful.
Alison Poulton, Senior Lecturer, Brain Mind Centre Nepean, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Cancer is increasingly survivable – but it shouldn’t depend on your ability to ‘wrangle’ the health system
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One in three of us will develop cancer at some point in our lives. But survival rates have improved to the point that two-thirds of those diagnosed live more than five years.
This extraordinary shift over the past few decades introduces new challenges. A large and growing proportion of people diagnosed with cancer are living with it, rather than dying of it.
In our recently published research we examined the cancer experiences of 81 New Zealanders (23 Māori and 58 non-Māori).
We found survivorship not only entailed managing the disease, but also “wrangling” a complex health system.
Surviving disease or surviving the system
Our research focused on those who had lived longer than expected (four to 32 years since first diagnosis) with a life-limiting or terminal diagnosis of cancer.
Common to many survivors’ stories was the effort it took to wrangle the system or find others to advocate on their behalf, even to get a formal diagnosis and treatment.
By wrangling we refer to the practices required to traverse complex and sometimes unwelcoming systems. This is an often unnoticed but very real struggle that comes on top of managing the disease itself.
The common focus of the healthcare system is on symptoms, side effects of treatment and other biological aspects of cancer. But formal and informal care often falls by the wayside, despite being key to people’s everyday experiences.
Survival is often linked to someone’s social connections and capacity to access funds. Getty Images The inequities of cancer survivorship are well known. Analyses show postcodes and socioeconomic status play a strong role in the prevalence of cancer and survival.
Less well known, but illustrated in our research, is that survival is also linked to people’s capacity to manage the entire healthcare system. That includes accessing a diagnosis or treatment, or identifying and accessing alternative treatments.
Survivorship is strongly related to material resources, social connections, and understandings of how the health system works and what is available. For instance, one participant who was contemplating travelling overseas to get surgery not available in New Zealand said:
We don’t trust the public system. So thankfully we had private health insurance […] But if we went overseas, health insurance only paid out to $30,000 and I think the surgery was going to be a couple of hundred thousand. I remember Dad saying and crying and just being like, I’ll sell my business […] we’ll all put in money. It was really amazing.
Assets of survivorship
In New Zealand, the government agency Pharmac determines which medications are subsidised. Yet many participants were advised by oncologists or others to “find ways” of taking costly, unsubsidised medicines.
This often meant finding tens of thousands of dollars with no guarantees. Some had the means, but for others it meant drawing on family savings, retirement funds or extending mortgages. This disproportionately favours those with access to assets and influences who survives.
But access to economic capital is only one advantage. People also have cultural resources – often described as cultural capital.
In one case, a participant realised a drug company was likely to apply to have a medicine approved. They asked their private oncologist to lobby on their behalf to obtain the drug through a compassionate access scheme, without having to pay for it.
Others gained community support through fundraising from clubs they belonged to. But some worried about where they would find the money, or did not want to burden their community.
I had my doctor friend and some others that wanted to do some public fundraising. But at the time I said, “Look, most of the people that will be contributing are people from my community who are poor already, so I’m not going to do that option”.
Accessing alternative therapies, almost exclusively self-funded, was another layer of inequity. Some felt forced to negotiate the black market to access substances such as marijuana to treat their cancer or alleviate the side effects of orthodox cancer treatment.
Cultural capital is not a replacement for access to assets, however. Māori survivorship was greatly assisted by accessing cultural resources, but often limited by lack of material assets.
Persistence pays
The last thing we need when faced with the possibility of cancer is to have to push for formal diagnosis and care. Yet this was a common experience.
One participant was told nothing could be found to explain their abdominal pain – only to find later they had pancreatic cancer. Another was told their concerns about breathing problems were a result of anxiety related to a prior mental health history, only to learn later their earlier breast cancer had spread to their lungs.
Persistence is another layer of wrangling and it often causes distress.
Once a diagnosis was given, for many people the public health system kicked in and delivered appropriate treatment. However, experiences were patchy and variable across New Zealand.
Issues included proximity to hospitals, varying degrees of specialisation available, and the requirement of extensive periods away from home and whānau. This reflects an ongoing unevenness and lack of fairness in the current system.
When facing a terminal or life-limiting diagnosis, the capacity to wrangle the system makes a difference. We shouldn’t have to wrangle, but facing this reality is an important first step.
We must ensure it doesn’t become a continuing form of inequity, whereby people with access to material resources and social and cultural connections can survive longer.
Kevin Dew, Professor of Sociology, Te Herenga Waka — Victoria University of Wellington; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney; Chris Cunningham, Professor of Maori & Public Health, Massey University; Elizabeth Dennett, Associate Professor in Surgery, University of Otago; Kerry Chamberlain, Professor of Social and Health Psychology, Massey University, and Richard Egan, Associate Professor in Health Promotion, University of Otago
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How to Prevent Dementia – by Dr. Richard Restak
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We’ve written about this topic here, we know. But there’s a lot more we can do to be on guard against, and pre-emptively strengthen ourselves against, dementia.
The author, a neurologist, takes us on a detailed exploration of dementia in general, with a strong focus on Alzheimer’s in particular, as that accounts for more than half of all dementia cases.
But what if you can’t avoid it? It could be that with the wrong genes and some other factor(s) outside of your control, it will get you if something else doesn’t get you first.
Rather than scaremongering, Dr. Restak tackles this head-on too, and discusses how symptoms can be managed, to make the illness less anxiety-inducing, and look to maintain quality of life as much as possible.
The style of the book is… it reads a lot like an essay compilation. Good essays, then organized and arranged in a sensible order for reading, but distinct self-contained pieces. There are ten or eleven chapters (depending on how we count them), each divided into few or many sections. All this makes for:
- A very “read a bit now and a bit later and a bit the next day” book, if you like
- A feeling of a very quick pace, if you prefer to sit down and read it in one go
Either way, it’s a very informative read.
Bottom line: if you’d like to better understand the many-headed beast that is dementia, this book gives a far more comprehensive overview than we could here, and also explains the prophylactic interventions available.
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The Body Is Not an Apology – by Sonya Renee Taylor
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First, a couple of things that this book is not about:
- Self-confidence (it’s about more than merely thinking highly of oneself)
- Self-acceptance (it’s about more than merely settling for “good enough”)
In contrast, it’s about loving and celebrating what is, while striving for better, for oneself and for others.
You may be wondering: whence this “radical” in the title?
The author argues that often, the problem with our bodies is not actually our bodies. If we have cancer, or diabetes, then sure, that’s a problem with the body. But most of the time, the “problem with our bodies” is simply society’s rejection of our “imperfect” bodies as somehow “less than”, and something we must invest time and money to correct. Hence, the need for a radical uprooting of ideas, to fix the real problem.
Bottom line: if, like most of us, you have a body that would not entirely pass for that of a Marvel Comics superhero, this is a book for you. And if you do have a MCU body? This is also a book for you, because we have bad news for you about what happens with age.
Click here to check out The Body Is Not An Apology, and appreciate more about yours!
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