Which gut drugs might end up in a lawsuit? Are there really links with cancer and kidney disease? Should I stop taking them?
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.
Common medicines used to treat conditions including heartburn, reflux, indigestion and stomach ulcers may be the subject of a class action lawsuit in Australia.
Lawyers are exploring whether long-term use of these over-the-counter and prescription drugs are linked to stomach cancer or kidney disease.
The potential class action follows the settlement of a related multi-million dollar lawsuit in the United States. Last year, international pharmaceutical company AstraZeneca settled for US$425 million (A$637 million) after patients made the case that two of its drugs caused significant and potentially life-threatening side effects.
Specifically, patients claimed the company’s drugs Nexium (esomeprazole) and Prilosec (omeprazole) increased the risk of kidney damage.
Which drugs are involved in Australia?
The class of drugs we’re talking about are “proton pump inhibitors” (sometimes called PPIs). In the case of the Australian potential class action, lawyers are investigating:
- Nexium (esomeprazole)
- Losec, Asimax (omeprazole)
- Somac (pantoprazole)
- Pariet (rabeprazole)
- Zoton (lansoprazole).
Depending on their strength and quantity, these medicines are available over-the-counter in pharmacies or by prescription.
They have been available in Australia for more than 20 years and are in the top ten medicines dispensed through the Pharmaceutical Benefits Scheme.
They are used to treat conditions exacerbated by stomach acid. These include heartburn, gastric reflux and indigestion. They work by blocking the protein responsible for pumping acid into the stomach.
These drugs are also prescribed with antibiotics to treat the bacterium Helicobacter pylori, which causes stomach ulcers and stomach cancer.
What do we know about the risks?
Appropriate use of proton pump inhibitors plays an important role in treating several serious digestive problems. Like all medicines, there are risks associated with their use depending on how much and how long they are used.
When proton pump inhibitors are used appropriately for the short-term treatment of stomach problems, they are generally well tolerated, safe and effective.
Their risks are mostly associated with long-term use (using them for more than a year) due to the negative effects from having reduced levels of stomach acid. In elderly people, these include an increased risk of gut and respiratory tract infections, nutrient deficiencies and fractures. Long-term use of these drugs in elderly people has also been associated with an increased risk of dementia.
In children, there is an increased risk of serious infection associated with using these drugs, regardless of how long they are used.
How about the cancer and kidney risk?
Currently, the Australian consumer medicine information sheets that come with the medicines, like this one for esomeprazole, do not list stomach cancer or kidney injury as a risk associated with using proton pump inhibitors.
So what does the evidence say about the risk?
Over the past few years, there have been large studies based on observing people in the general population who have used proton pump inhibitors. These studies have found people who take them are almost two times more likely to develop stomach cancer and 1.7 times more likely to develop chronic kidney disease when compared with people who are not taking them.
In particular, these studies report that users of the drugs lansoprazole and pantoprazole have about a three to four times higher risk than non-users of developing chronic kidney disease.
While these observational studies show a link between using the drugs and these outcomes, we cannot say from this evidence that one causes the other.
What can I do if I’m worried?
Several digestive conditions, especially reflux and heartburn, may benefit from simple dietary and lifestyle changes. But the overall evidence for these is not strong and how well they work varies between individuals.
But it may help to avoid large meals within two to three hours before bed, and reduce your intake of fatty food, alcohol and coffee. Eating slowly and getting your weight down if you are overweight may also help your symptoms.
There are also medications other than proton pump inhibitors that can be used for heartburn, reflux and stomach ulcers.
These include over-the-counter antacids (such as Gaviscon and Mylanta), which work by neutralising the acidic environment of the stomach.
Alternatives for prescription drugs include nizatidine and famotidine. These work by blocking histamine receptors in the stomach, which decreases stomach acid production.
If you are concerned about your use of proton pump inhibitors it is important to speak with your doctor or pharmacist before you stop using them. That’s because when you have been using them for a while, stopping them may result in increased or “rebound” acid production.
Nial Wheate, Professor and Director – Academic Excellence, Macquarie University; Joanna Harnett, Senior Lecturer – Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, and Wai-Jo Jocelin Chan, Pharmacist and Associate Lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
When Carbs, Proteins, & Fats Switch Metabolic Roles
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.
Strange Things Happening In The Islets Of Langerhans
It is generally known and widely accepted that carbs have the biggest effect on blood sugar levels (and thus insulin response), fats less so, and protein least of all.
And yet, there was a groundbreaking study published yesterday which found:
❝Glucose is the well-known driver of insulin, but we were surprised to see such high variability, with some individuals showing a strong response to proteins, and others to fats, which had never been characterized before.
Insulin plays a major role in human health, in everything from diabetes, where it is too low*, to obesity, weight gain and even some forms of cancer, where it is too high.
These findings lay the groundwork for personalized nutrition that could transform how we treat and manage a range of conditions.❞
*saying ”too low” here is potentially misleading without clarification; yes, Type 1 Diabetics will have too little [endogenous] insulin (because the pancreas is at war with itself and thus isn’t producing useful quantities of insulin, if any). Type 2, however, is more a case of acquired insulin insensitivity, because of having too much at once too often, thus the body stops listening to it, “boy who cried wolf”-style, and the pancreas also starts to get fatigued from producing so much insulin that’s often getting ignored, and does eventually produce less and less while needing more and more insulin to get the same response, so it can be legitimately said “there’s not enough”, but that’s more of a subjective outcome than an objective cause.
Back to the study itself, though…
What they found, and how they found it
Researchers took pancreatic islets from 140 heterogenous donors (varied in age and sex; ostensibly mostly non-diabetic donors, but they acknowledge type 2 diabetes could potentially have gone undiagnosed in some donors*) and tested cell cultures from each with various carbs, proteins, and fats.
They found the expected results in most of the cases, but around 9% responded more strongly to the fats than the carbs (even more strongly than to glucose specifically), and even more surprisingly 8% responded more strongly to the proteins.
*there were also some known type 2 diabetics amongst the donors; as expected, those had a poor insulin response to glucose, but their insulin response to proteins and fats were largely unaffected.
What this means
While this is, in essence, a pilot study (the researchers called for larger and more varied studies, as well as in vivo human studies), the implications so far are important:
It appears that, for a minority of people, a lot of (generally considered very good) antidiabetic advice may not be working in the way previously understood. They’re going to (for example) put fat on their carbs to reduce the blood sugar spike, which will technically still work, but the insulin response is going to be briefly spiked anyway, because of the fats, which very insulin response is what will lower the blood sugars.
In practical terms, there’s not a lot we can do about this at home just yet—even continuous glucose monitors won’t tell us precisely, because they’re monitoring glucose, not the insulin response. We could probably measure everything and do some math and work out what our insulin response has been like based on the pace of change in blood sugar levels (which won’t decrease without insulin to allow such), but even that is at best grounds for a hypothesis for now.
Hopefully, more publicly-available tests will be developed soon, enabling us all to know our “insulin response type” per the proteome predictors discovered in this study, rather than having to just blindly bet on it being “normal”.
Ironically, this very response may have hidden itself for a while—if taking fats raised insulin response without raising blood sugar levels, then if blood sugar levels are the only thing being measured, all we’ll see is “took fats at dinner; blood sugars returned to normal more quickly than when taking carbs without fats”.
You can read the study in full here:
Proteomic predictors of individualized nutrient-specific insulin secretion in health and disease
Want to know more about blood sugar management?
You might like to catch up on:
- 10 Ways To Balance Your Blood Sugars
- Track Your Blood Sugars For Better Personalized Health
- How To Turn Back The Clock On Insulin Resistance
Take care!
Share This Post
-
Potatoes & Anxiety
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.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝My other half considers potatoes a wonder food, except when fried. I don’t. I find, when I am eating potatoes I put on weight; and, when I’m not eating them, I lose it. Also, although I can’t swear to it, potatoes also make me feel a little anxious (someone once told me it could have something to do with where they are on the “glycemic index”). What does the science say?❞
The glycemic index of potatoes depends on the kind of potato (obviously) and also, less obviously, how it’s prepared. For a given white potato, boiling (which removes a lot of starch) might produce a GI of around 60, while instant mash (basically: potato starch) can be more like 80. For reference, pure glucose is 100. And you probably wouldn’t take that in the same quantity you’d take potato, and expect to feel good!
So: as for anxiety, it could be, since spiked blood sugars can cause mood swings, including anxiety.
Outside of the matter of blood sugars, the only reference we could find for potatoes causing anxiety was fried potatoes specifically:
❝frequent fried food consumption, especially fried potato consumption, is strongly associated with 12% and 7% higher risk of anxiety and depression, respectively❞
…which heavily puts the blame not on the potatoes themselves, but on acrylamide (the orange/brown stuff that is made by the Maillard reaction of cooking starches in the absence of water, e.g. by frying, roasting, etc).
Here’s a very good overview of that, by the way:
A Review on Acrylamide in Food: Occurrence, Toxicity, and Mitigation Strategies
Back on the core topic of potatoes and GI and blood sugar spikes and anxiety, you might benefit from a few tweaks that will allow you to enjoy potatoes without spiking blood sugars:
10 Ways To Balance Blood Sugars
Enjoy!
Share This Post
-
Vital Aspects of Holistic Wellness
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.
It’s Q&A Day!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
Q: I am interested in the following: Aging, Exercise, Diet, Relationships, Purpose, Lowering Stress
You’re going to love our Psychology Sunday editions of 10almonds! You might like some of these…
- Relationships: Seriously Useful Communication Skills!
- Purpose: Are You Flourishing? (There’s a Scale)
- Managing stress: Lower Your Cortisol! (Here’s Why & How)
- Also about managing stress: Sunday Stress-Buster
- Also applicable to stress: How To Set Your Anxiety Aside
Share This Post
-
Peanuts vs Macadamias – Which is Healthier?
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.
Our Verdict
When comparing peanuts to macadamias, we picked the peanuts.
Why?
In terms of macros, peanuts have more than 3x the protein while macadamias have a lot more fat. It’s mostly healthy monounsaturated fat, but all the same, we’ll prioritize the protein over the fat, which becomes the deciding factor since they are approximately equal on carbs and fiber. So, a subjective win for peanuts in this category.
In the category of vitamins, peanuts have a lot more of vitamins B3, B5, B6, B9, E, and choline, while macadamias have slightly more of vitamins B1, B2, and C. A clear and convincing win for peanuts.
When it comes to minerals, peanuts have more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while macadamias have more manganese. An overwhelming win for peanuts.
Adding up the sections with their various degrees of win for peanuts, makes for an overall absolute win for peanuts, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Almonds vs Peanuts – Which is Healthier?
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.
Our Verdict
When comparing almonds to peanuts, we picked the almonds.
Why?
No, it’s not just our pro-almonds bias… But it’s also not as one-sided, nutritionally speaking, as you might think!
In terms of macros, almonds have a lot more fiber, and moderately more carbs, the ratio of which give almonds the lower glycemic index. On the other hand, peanuts have a little more protein. Both of these nuts are equally fatty, but peanuts have the higher saturated fat content. All in all, we say the biggest deciding factor is the fiber, and hand this one to the almonds.
In the category of vitamins, almonds have more of vitamins B2 and E, while peanuts have more of vitamins B1, B3, B5, B6, B7, and B9. An easy win for peanuts this time.
When it comes to minerals, almonds have more calcium, magnesium, manganese, phosphorus, and potassium, while peanuts have more copper, iron, selenium, and zinc. Thus, a 5:4 marginal win for almonds.
Adding up the sections makes for an overall win for almonds, but as you can see, it was close and peanuts certainly have their merits too, so by all means enjoy either or both; diversity is good!
Unless you are allergic, in which case, obviously please don’t do that.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts!
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Hazelnuts vs Pecans – Which is Healthier?
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.
Our Verdict
When comparing hazelnuts to pecans, we picked the hazelnuts.
Why?
In terms of macros, hazelnuts have more protein, carbs, and fiber, though the difference is not big in the latter two cases, and the glycemic indices are resultantly about the same. Meanwhile, pecans have a little more fat, but the fat is healthy in both cases. Everything taken into account, we’re calling it a tie on macros.
When it comes to vitamins, hazelnuts have more of vitamins B3, B5, B6, B7, B9, C, E, K, and choline, while pecans have more of vitamins A, B1, and B2. An easy win for hazelnuts here.
In the category of minerals, hazelnuts have more calcium, copper, iron, magnesium, manganese, phosphorus, and potassium, while pecans have more selenium and zinc. Another clear win for hazelnuts.
In short, enjoy either or both (unless you’re allergic, in which case, don’t), but hazelnuts are ultimately the more nutritionally dense of the two.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
