Why do I need to take some medicines with food?
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Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to?
There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.
To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.
Different brands of the same medicine may also have different recommendations when it comes to taking it with food.
Food impacts drug absorption
Food can affect how fast and how much a drug is absorbed into the body in up to 40% of medicines taken orally.
When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.
Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as gastric emptying. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption.
Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.
But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach.
Food can make medicines more tolerable
Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.
Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with one in four users affected. To combat these side effects, it is generally recommended to be taken with food.
The same advice is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).
Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed.
Can food make medicines safer?
Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use within a two-week period.
While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of bleeding, ulceration and perforation with long-term use.
But there isn’t enough research to show taking ibuprofen with food reduces this risk.
Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.
The Australian Medicines Handbook, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach.
A systematic review published in 2015 found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.
To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other non-steroidal anti-inflammatory medicines at the same time.
For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a proton pump inhibitor, a medicine that reduces stomach acid and protects the stomach lining.
How much food do you need?
When you need to take a medicine with food, how much is enough?
Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.
However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.
Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.
Mary Bushell, Clinical Associate Professor in Pharmacy, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Breast Milk’s Benefits That Are (So Far) Not Replicable
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Simply The Breast 🎶
In Wednesday’s newsletter, we asked you for your opinion on breast vs formula milk (for babies!), and got the above-depicted, below-described, set of responses:
- 80% said “Breast is best, as the slogan goes, and should be first choice”
- 20% said “They both have their strengths and weaknesses; use whatever”
- 0% said “Formula is formulated to be best, and should be first choice”
That’s the first time we’ve ever had a possible poll option come back with zero votes whatsoever! It seems this topic is relatively uncontentious amongst our readership, so we’ll keep things brief today, but there is still a little mythbusting to be done.
So, what does the science say?
[Breast milk should be the first choice] at least for the few few weeks and months for the benefit of baby’s health as breast milk has protective factors formula does not: True or False?
True! The wording here was taken from one of our readers’ responses, by the way (thank you, Robin). There are a good number of those protective factors, the most well-known of which is passing on immune cells and cell-like things; in other words, immune-related information being passed from parent* to child.
*usually the mother, though in principle it could be someone else and in practice sometimes it is; the only real requirements are that the other person be healthy, lactating, and willing.
As for immune benefits, see for example:
Perspectives on Immunoglobulins in Colostrum and Milk
And for that matter, also:
(Colostrum is simply the milk that is produced for a short period after giving birth; the composition of milk will tend to change later)
In any case, immunoglobulin A is a very important component in breast milk (colostrum and later), as well as lactoferrin (has an important antimicrobial effect and is good for the newborn’s gut), and a plethora of cytokines:
As for that about the gut, lactoferrin isn’t the only breast milk component that benefits this, by far, and there’s a lot that can’t be replicated yet:
Human Breast Milk and the Gastrointestinal Innate Immune System
As long as your infant/child is nutritiously fed, it shouldn’t matter if it comes from breast or formula: True or False?
False! Formula milk will not convey those immune benefits.
This doesn’t mean that formula-feeding is neglectful; as several people who commented mentioned*, there are many reasons a person may not be able to breastfeed, and they certainly should not be shamed for that.
*(including the reader whose words we borrowed for this True/False item; the words we quoted above were prefaced with: “Not everyone is able to breastfeed for many different reasons”)
But, while formula milk is a very good second choice, and absolutely a respectable choice if breast milk isn’t an option (or an acceptable option) for whatever reason, it still does not convey all the health benefits of breast milk—yet! The day may come when they’ll find a way to replicate the immune benefits, but today is not that day.
They both have their strengths and weaknesses: True or False?
True! But formula’s strengths are only in the category of convenience and sometimes necessity—formula conveys no health benefits that breast milk could not do better, if available.
For many babies, formula means they get to eat, when without it they would starve due to non-availability of breast milk. That’s a pretty important role!
Note also: this is a health science publication, not a philosophical publication, but we’d be remiss not to mention one thing; let’s bring it in under the umbrella of sociology:
The right to bodily autonomy continues to be the right to bodily autonomy even if somebody else wants/needs something from your body.
Therefore, while there are indeed many good reasons for not being able to breastfeed, or even just not being safely* able to breastfeed, it is at the very least this writer’s opinion that nobody should be pressed to give their reason for not breastfeeding; “no” is already a sufficient answer.
*Writer’s example re safety: when I was born, my mother was on such drugs that it would have been a very bad idea for her to breastfeed me. There are plenty of other possible reasons why it might be unsafe for someone one way or another, but “on drugs that have a clear ‘do not take while pregnant or nursing’ warning” is a relatively common one.
All that said, for those who are willing and safely able, the science is clear: breast is best.
Want to read more?
The World Health Organization has a wealth of information (including explanations of its recommendations of, where possible, exclusive breastfeeding for the first 6 months, ideally continuing some breastfeeding for the first 2 years), here:
World Health Organization | Breastfeeding
Take care!
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Asparagus vs Edamame – Which is Healthier?
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Our Verdict
When comparing asparagus to edamame, we picked the edamame.
Why?
Perhaps it’s a little unfair comparing a legume to a vegetable that’s not leguminous (given legumes’ high protein content), but these two vegetables often serve a similar culinary role, and there is more to nutrition than protein. That said…
In terms of macros, edamame has a lot more protein and fiber; it also has more carbs, but the ratio is such that edamame still has the lower glycemic index. Thus, the macros category is a win for edamame in all relevant aspects.
When it comes to vitamins, things are a little closer; asparagus has more of vitamins A, B3, and C, while edamame has more of vitamins B1, B2, B5, B6, and B9. All in all, a moderate win for edamame, unless we want to consider the much higher vitamin C content of asparagus as particularly more relevant.
In the category of minerals, asparagus boasts only more selenium (and more sodium, not that that’s a good thing for most people in industrialized countries), while edamame has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. An easy win for edamame.
In short, enjoy both (unless you have a soy allergy, because edamame is young soy beans), but edamame is the more nutritionally dense by far.
Want to learn more?
You might like to read:
Take care!
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Hardcore Self Help: F**k Anxiety – by Dr. Robert Duff
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We’ve reviewed other anxiety books before, so what makes this one different? Mostly, it’s the style.
Aside from swearing approximately once every two lines (so you might want to skip this one if that would bother you), Dr. Duff’s writing is very down-to-earth in other ways too, making it unpretentiously comfortable and accessible without failing to draw upon the wealth of good-practice, evidence-based advice he has to offer.
To that end, he talks about what anxiety is and isn’t, and goes over various approaches, explaining them in a “about” fashion, and also a “how to” fashion, covering areas such as CBT, somatic therapies, social support, when talk therapy is most likely to help.
The book is a quick read (a modest 74 pages), and it’s refreshing that it hasn’t been padded unnecessarily, unlike a lot of books that could have been a fraction of the size without losing value.
Bottom line: if you (or perhaps someone you care about) would benefit from a straight-to-the-point, no-BS approach to dealing with anxiety (that’s actually evidence-based, not just a “get over it” dismissal), then this is the book for you.
Click here to check out Hardcore Self Help: F**k Anxiety, and indeed do just that!
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Shoulders Range – by Elia Bartolini
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Shoulder flexibility and mobility can be a big deal, especially when it starts to decline—more so than other kinds of flexibility. Most seniors can get through the day without doing the splits against a wall, for example, but shoulder tightness can be more of a problem if you can’t easily get into or out of your clothes.
If you think it couldn’t happen to you: the great Jane Fonda has a now-famous photoset of her looking glamorous in a dress at a red carpet event, and then looking frazzled making breakfast in the same dress in her kitchen the next morning, because, as she wrote, “I couldn’t get my dress unzipped so I slept in it”.
Now, “to avoid ending up like Jane Fonda” is not a series of words that usually precedes advice, but in this case: this book delves into the science of one of the most quirky joints of the human body, and how to leverage this to maximize shoulder mobility, while maintaining adequate strength (because flexibility without strength is just asking for a dislocation) without doing anything that would actually bulk up our shoulders, because it’s just about progressing through passive, active, and tensed stretching, static, dynamic, and loaded stretching, as well as PNF stretching and antagonist stretching.
If that seems like a lot of stretching, don’t worry; the author presents a series of workouts that will take us through these stretches in a very small amount of time each day.
The style is instructional like a textbook, with clear diagrams where appropriate, and lots of callout boxes, bullet points, emboldening for key points, etc. It all makes for every easy learning.
Bottom line: if you’d like to improve and maintain your shoulder mobility, this is an excellent book for that.
Click here to check out Shoulders Range, and perfect your shoulders and upper body flexibility!
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How community health screenings get more people of color vaccinated
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U.S. preventive health screening rates dropped drastically at the height of the COVID-19 pandemic. They have yet to go back to pre-pandemic levels, especially for Black and Latine communities.
Screenings, or routine medical checkups, are important ways to avoid and treat disease. They’re key to finding problems early on and can even help save people’s lives.
Community health workers say screenings are also a key to getting more people vaccinated. Screening fairs provide health workers the chance to build rapport and trust with the communities they serve, while giving their clients the chance to ask questions and get personalized recommendations according to their age, gender, and family history.
But systemic barriers to health care can often keep people from marginalized communities from accessing recommended screenings, exacerbating racial health disparities.
Public Good News spoke with Dr. Marie-Jose Francois, president and chief executive officer, and April Johnson, outreach coordinator, at the Center for Multicultural Wellness and Prevention (CMWP), in Central Florida, to learn how they promote the benefits of screening and leverage screenings for vaccination outreach among their diverse communities.
Here’s what they said.
[Editor’s note: This content has been edited for clarity and length.]
PGN: What is CMWP’s mission? How does vaccine outreach fit into the work you do in the communities you serve?
Dr. Marie-Jose Francois: Since 1995, our mission has been to enhance the health, wellness, and quality of life for diverse populations in Central Florida. At the beginning, our main focus was education, wellness, and screening for HIV/AIDS, and we continue to do case management for HIV screening and testing.
When the issue of COVID-19 came into the picture, we included COVID-19 information and education and stressed the importance of screening and receiving vaccinations during all of our outreach activities.
We try to meet the community where they are. Because there is so much misconception—and taboo—in regard to immunization.
April Johnson: So our job is to disperse accurate information. And how we do that is we go into rural communities. We build partnerships with local apartment complexes, hair salons, nail salons, laundromats, and provide a little community engagement, where people just hang out in different areas.
We build gatekeepers in those communities because you first have to get in there. You have to know that they trust you. Being in this field for about 30 years, I’ve [learned that] flexibility is key. Because sometimes you can’t get them from 9 to 5, or [from] Monday through Friday. So, you have to be very flexible in doing the outreach portion in order to get what you need.
I’ve built collaborations with senior citizen centers, community centers, schools, clinics, churches in Orlando and [in] different areas in Orange, Osceola, Seminole, and Lake counties. And we also partner with other community-based organizations to try to make it like a one-stop shop. So, partnership is a big thing.
PGN: How do you promote the importance of preventive screenings in the communities you serve?
M.F.: We try to make them view their health in a more comprehensive way, for them to understand the importance of screening. [That] self care is key, and for them to not be afraid.
We empower them to know what to ask when they go to the doctor. We ask them, ‘Do you know your status? Do you know your numbers?’
For example, if you go to the doctor, do you know your blood pressure? If you’re diabetic? Do you know your hemoglobin (A1C)? Do you know your cholesterol levels?
And now, [we also ask them]: ‘Have you received your flu shot for the year? Have you received all of your vaccine doses for COVID-19?’ We are even adding the mpox vaccine now, based on risk factors.
[We recommend they] ask their provider. For women, [we ask], ‘When do you need to have your mammogram?’ For the men, ‘You need to ask about your PSA and also about when and when to have your colonoscopy based on your age.’
We also try to explain to the community that the more they know their family history, the more they can engage in their own health. Because sometimes you have mom and dad who have a history of cancer. They have a history of diabetes or blood pressure—and they don’t talk to their children. So, we try to [recommend they] talk to their children. Your own family needs to know what’s going on so they can be proactive in their screenings.
PGN: What strategies or methods have you found most effective in getting people screened?
M.F.: Not everybody wants to be screened, not everybody wants to receive vaccines.
But with patience, just give them the facts. It goes right back to education, people have to be assured.
When you talk to them about COVID, or even HIV, you may hear them say, ‘Oh, I don’t see myself at risk for HIV.’ But we have to repeat to them that the more they get screened to make sure they’re OK, the better it is for them. ‘The more you use condoms, [the] safer it is for you.’
In Haitian culture, they listen to the radio. So we use the radio as a tool to educate and deliver information [to] get vaccinated, wash your hands. ‘If you’re coughing, cover your mouth. If you have a fever, wear your masks. Call your doctor.’
In our target population, we have people who have chronic conditions. We have people with HIV. So, we have to motivate them to receive the flu vaccine, to receive the COVID vaccine, to receive that RSV [vaccine], or to get the mpox vaccine. We have people with diabetes, high blood pressure, high cholesterol, depressed immune systems. We have people with lupus, we have people with sickle cell disease.
So, this is a way to [ensure that] whomever you’re talking to one-on-one understands the value of being safe.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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International Women’s Day (and what it can mean for you, really)
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How to not just #EmbraceEquity, but actually grow it, this International Women’s Day!
It’s International Women’s Day, and there’s a lot going on beyond the hashtagging! So, what’s happening, and how could you get involved in more than a “token” way in your workplace, business, or general life?
Well, that depends on your own environment and circumstances, but for example…
A feminist policy for productivity in the food sector?
We tend to think that in this modern world, we all have equal standing when it comes to productivity, food, and health. And yet…
❝If women do 70 per cent of the work in agriculture worldwide, but the land is mainly owned by men, then we don’t have equity yet. If in Germany, only one-tenth of female farmers manage the farm on which they work on, while they also manage the household, then there is no equity yet❞
~ Lea Leimann, Germany
What to do about it, though? It turns out there’s a worldwide organization dedicated to fixing this! It’s called Slow Food.
Their mission is to make food…
- GOOD: quality, flavorsome and healthy food
- CLEAN: production that does not harm the environment
- FAIR: accessible prices for consumers and fair conditions and pay for producers
…and yes, that explicitly includes feminism-attentive food policy:
Read all about it: Slow Food women forge change in the food system
Do you work in the food system?
If so, you can have an impact. Your knee-jerk reaction might be “I don’t”, but there are a LOT of steps from farm-to-table, so, are you sure?
Story time: me, I’m a writer (you’d never have guessed, right?) and wouldn’t immediately think of myself as working “in the food system”.
But! Not long back I (a woman) was contracted by a marketing agent (a woman) to write marketing materials for a small business (owned by a woman) selling pickles and chutneys across the Australian market, based on the recipes she learned from her mother, in India. The result?
I made an impact in the food chain the other side of the planet from me, without leaving my desk.
Furthermore, the way I went about my work empowered—at the very least—myself and the end client (the lady making and selling the pickles and chutneys).
Sometimes we can’t change the world by ourselves… but we don’t have to.
If we all just nudge things in the right direction, we’ll end up with a healthier, better-fed, more productive system for all!
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