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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Dates vs Banana – Which is Healthier?
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Our Verdict
When comparing dates to banana, we picked the dates.
Why?
It was close, and bananas do have some strengths too! We pitted these two against each other as they’re both sweet fruits often used as a sweetening and consistency-altering ingredient in desserts and sweet snacks, so if you’re making a choice between them, here are the things to consider:
In terms of macros, dates have more than 3x the fiber, more than 2x the protein, and a little over 3x the carbs. You may be wondering how this adds up in terms of glycemic index: dates have the lower GI. So, we pick dates, here, for that reason and overall nutritional density too.
When it comes to vitamins, bananas have their moment, albeit barely: dates have more of vitamins B1, B3, B5, and K, while bananas have more of vitamins A, B6, C, E, and choline, making for a marginal victory for bananas in this category.
Looking at minerals next, however, it’s quite a different story: dates have more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while bananas are not higher in any mineral. No, not even potassium, for which they are famous—dates have nearly 2x more potassium than bananas.
Adding up these sections makes for a clear win for dates in general!
Enjoy either/both, but dates are the more nutritious snack/ingredient.
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Is it OK if my child eats lots of fruit but no vegetables?
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Does it seem like most vegetables you serve your children end up left on the plate, or worse, strewn across the floor? But mention dessert, and your fruit skewers are polished off in an instant.
Or maybe the carrot and cucumber sticks keep coming home in your child’s lunchbox untouched, yet the orange slices are nowhere to be seen.
If you’re facing these struggles with your child, you’re not alone. Many children prefer fruit to vegetables.
So if your child eats lots of fruit but minimal or no vegetables, is that OK? And how can you get them to eat more veggies?
Children have an innate preference for fruit
The Australian Dietary Guidelines’ recommended daily intakes for vegetables and fruit depend on a child’s age.
Fruit and vegetable serving sizes by age. The Conversation.
National Health and Medical Research Council, CC BY-SAConsumption among Australian children falls well below recommendations. Around 62.6% of children aged over two meet the recommended daily fruit intake, but only 9% meet the recommended vegetable intake.
This is not surprising given children have a natural preference for fruit. At least in part, this is due to its sweetness and texture, whether crispy, crunchy or juicy. The texture of fruit has been linked to a positive sensory experience among children.
Vegetables, on the other hand, are more of an acquired taste, and certain types, such as cruciferous vegetables, can be perceived by children as bitter.
The reason children often prefer fruit over vegetables could also be related to the parents’ preferences. Some research has even suggested we develop food preferences before birth based on what our mother consumes during pregnancy.
Balance is key
So, a preference for fruit is common. But is it OK if your child eats lots of fruit but little to no vegetables? This is a question we, as dietitians, get asked regularly.
You might be thinking, at least my child is eating fruit. They could be eating no veggies and no fruit. This is true. But while it’s great your child loves fruit, vegetables are just as important as part of a balanced eating pattern.
Vegetables provide us with energy, essential vitamins and minerals, as well as water and fibre, which help keep our bowels regular. They also support a strong immune system.
If your child is only eating fruit, they are missing some essential nutrients. But the same is true if they are eating only veggies.
Fruit likewise provides the body with a variety of essential vitamins and minerals, as well as phytochemicals, which can help reduce inflammation.
Evidence shows healthy consumption of fruit and vegetables protects against chronic diseases including high blood pressure, heart disease and stroke.
Consumed together, fruit and vegetables in a variety of colours provide different nutrients we need, some of which we can’t get from other foods. We should encourage kids to eat a “rainbow” of fruit and vegetables each day to support their growth and development.
What if my child eats too much fruit?
If your child is eating slightly more fruit than what’s recommended each day, it’s not usually a problem.
Fruit contains natural sugar which is good for you. But too much of a good thing, even if it’s natural, can create problems. Fruit also contains virtually no fat and very little to no protein, both essential for a growing child.
When overindulging in fruit starts to displace other food groups such as vegetables, dairy products and meat, that’s when things can get tricky.
6 tips to get your kids to love vegetables
1. Get them involved
Take your child with you when you go shopping. Let them choose new vegetables. See if you can find vegetables even you haven’t tried, so you’re both having a new experience. Then ask them to help you with preparing or cooking the vegetables using a recipe you have chosen together. This will expose your child to veggies in a positive way and encourage them to eat more.
2. Sensory learning
Try to expose your child to vegetables rather than hiding them. Kids are more likely to eat veggies when they see, smell and feel them. This is called sensory learning.
3. Have fun with food
Use colourful vegetables of different sizes and textures. Make them fun by creating scenes or faces on your child’s plate. Add edible flowers or mint for decoration. You can even serve this with a side of veggie-based dip such as hummus or guacamole for some bonus healthy fats.
4. Teach them to grow their own
Teach your child how to grow their own vegetables. Evidence shows kids are more inclined to try the food they have helped and watched grow. You don’t need to have a big backyard to do this. A windowsill with a pot plant is a perfect start.
5. Lead by example
Your child learns from you, and your eating habits will influence theirs. Ensure they see you eating and enjoying veggies, whether in meals or as snacks.
6. Practise persistence
If your child refuses a particular vegetable once, don’t give up. It can take many attempts to encourage children to try a new food.
Yasmine Probst, Associate Professor, School of Medical, Indigenous and Health Sciences, University of Wollongong; Olivia Wills, Accredited Practising Dietitian, PhD candidate, University of Wollongong, and Shoroog Allogmanny, Accredited Practising Dietitian, PhD candidate, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Elderberries vs Gooseberries – Which is Healthier?
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Our Verdict
When comparing elderberries to gooseberries, we picked the elderberries.
Why?
These are both berries more likely found in your garden or local wood than in the supermarket, but if you have convenient access to them, they’re great options for eating!
In terms of macros, elderberry has nearly 2x the carbs and/but also nearly 2x the fiber, which in glycemic index terms, mostly cancels out (although: elderberry has the slightly lower glycemic index of the two)
In the category of vitamins, both are great but elderberries are winning with more of vitamins A, B1, B2, B3, B6, and C, while gooseberries have more vitamin B5.
When it comes to minerals, elderberries again lead with more calcium, iron, phosphorus, and potassium, while gooseberries have more magnesium.
There is an extra category today, which is “extra medicinal properties”, and elderberries have extra immune-boosting qualities, whereas gooseberries—while being as polyphenol-laden as one usually expects berries to be—do not confer the same kind of benefit in this regard.
You can check out the information about elderberry’s extra properties in the links section below; meanwhile, if you’re choosing between these berries, that’s the clear winner in every category today!
Want to learn more?
You might like to read:
- Herbs for Evidence-Based Health & Healing ← including elderberry
- Does It Come In A Pill? ← it does (but it doesn’t have to)
- Beyond Supplements: The Real Immune-Boosters! ← this article focusses on not-supplements, but does also have a supplement section
Take care!
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The Truth About Vaccines
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The Truth About Vaccines
Yesterday we asked your views on vaccines, and we got an interesting spread of answers. Of those who responded to the poll, most were in favour of vaccines. We got quite a lot of comments this time too; we can’t feature them all, but we’ll include extracts from a few in our article today, as they raised interesting points!
Vaccines contain dangerous ingredients that will harm us more than the disease would: True or False?
False, contextually.
Many people are very understandably wary of things they know full well to be toxic, being injected into them.
One subscriber who voted for “Vaccines are poison, and/or are some manner of conspiracy ” wrote:
❝I think vaccines from 50–60 years ago are true vaccines and were safer than vaccines today. I have not had a vaccine for many, many years, and I never plan to have any kind of vaccine/shot again.❞
They didn’t say why they personally felt this way, but the notion that “things were simpler back in the day” is a common (and often correct!) observation regards health, especially when it comes to unwanted additives and ultraprocessing of food.
Things like aluminum or mercury in vaccines are much like sodium and chlorine in table salt. Sodium and chlorine are indeed both toxic to us. But in the form of sodium chloride, it’s a normal part of our diet, provided we don’t overdo it.
Additionally, the amount of unwanted metals (e.g. aluminum, mercury) in vaccines is orders of magnitude smaller than the amount in dietary sources—even if you’re a baby and your “dietary sources” are breast milk and/or formula milk.
In the case of formaldehyde (an inactivating agent), it’s also the dose that makes the poison (and the quantity in vaccines is truly miniscule).
This academic paper alone cites more sources than we could here without making today’s newsletter longer than it already is:
Vaccine Safety: Myths and Misinformation
I have a perfectly good immune system, it can handle the disease: True or False?
True! Contingently.
In fact, our immune system is so good at defending against disease, that the best thing we can do to protect ourselves is show our immune system a dead or deactivated version of a pathogen, so that when the real pathogen comes along, our immune system knows exactly what it is and what to do about it.
In other words, a vaccine.
One subscriber who voted for “Vaccines are important but in some cases the side effects can be worse ” wrote:
❝In some ways I’m vacd out. I got COVid a few months ago and had no symptoms except a cough. I have asthma and it didn’t trigger a lot of congestion. No issues. I am fully vaccinated but not sure I’ll get one in fall.❞
We’re glad this subscriber didn’t get too ill! A testimony to their robust immune system doing what it’s supposed to, after being shown a recent-ish edition of the pathogen, in deactivated form.
It’s very reasonable to start wondering: “surely I’m vaccinated enough by now”
And, hopefully, you are! But, as any given pathogen mutates over time, we eventually need to show our immune system what the new version looks like, or else it won’t recognize it.
See also: Why Experts Think You’ll Need a COVID-19 Booster Shot in the Future
So why don’t we need booster shots for everything? Often, it’s because a pathogen has stopped mutating at any meaningful rate. Polio is an example of this—no booster is needed for most people in most places.
Others, like flu, require annual boosters to keep up with the pathogens.
Herd immunity will keep us safe: True or False?
True! Ish.
But it doesn’t mean what a lot of people think it means. For example, in the UK, “herd immunity” was the strategy promoted by Prime Minister of the hour, Boris Johnson. But he misunderstood what it meant:
- What he thought it meant: everyone gets the disease, then everyone who doesn’t die is now immune
- What it actually means: if most people are immune to the disease (for example: due to having been vaccinated), it can’t easily get to the people who aren’t immune
One subscriber who voted for “Vaccines are critical for our health; vax to the max! ” wrote:
❝I had a chiropractor a few years ago, who explained to me that if the general public took vaccines, then she would not have to vaccinate her children and take a risk of having side effects❞
Obviously, we can’t speak for this subscriber’s chiropractor’s children, but this raises a good example: some people can’t safely have a given vaccine, due to underlying medical conditions—or perhaps it is not available to them, for example if they are under a certain age.
In such cases, herd immunity—other people around having been vaccinated and thus not passing on the disease—is what will keep them safe.
Here’s a useful guide from the US Dept of Health and Human Services:
How does community immunity (a.k.a. herd immunity) work?
And, for those who are more visually inclined, here’s a graphical representation of a mathematical model of how herd immunity works (you can run a simulation)!
Stay safe!
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Chorus or Cacophony? Cicada Song Hits Some Ears Harder Than Others
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ST. LOUIS — Shhhooo. Wee-uuu. Chick, chick, chick. That’s the sound of three different cicada species. For some people, those sounds are the song of the summer. Others wish the insects would turn it down. The cacophony can be especially irritating for people on the autism spectrum who have hearing sensitivity.
Warren Rickly, 14, lives in suburban south St. Louis County, Missouri. Warren, who has autism, was at the bus stop recently waiting for his younger brother when the sound of cicadas became too much to bear.
“He said it sounds like there’s always a train running next to him,” his mother, Jamie Reed, said.
Warren told her the noise hurt.
Starting this spring, trillions of the red-eyed insects crawled their way out of the ground across the Midwest and Southeast. It’s part of a rare simultaneous emergence of two broods — one that appears every 13 years, the other every 17.
The noisy insects can be stressful. People with autism can have a sensitivity to texture, brightness, and sound.
“I think the difference for individuals with autism is the level of intensity or how upsetting some of these sensory differences are,” said Rachel Follmer, a developmental and behavioral pediatrician at Lurie Children’s Hospital in Chicago.
“It can get to the extreme where it can cause physical discomfort,” she said.
When a large group of cicadas starts to sing, the chorus can be as loud as a motorcycle. Researchers at the University of Missouri-St. Louis this year crowdsourced cicada noise levels as high as 86 decibels, about as loud as a food blender.
That can be stressful, not melodic, Follmer said.
To help children cope, she suggests giving them a primer before they encounter a noisy situation. For cicadas, that could mean explaining what they are, that they don’t bite or sting, and that they’ll be here for just a short time.
“When something is uncomfortable, not having power in that situation can be very scary for a lot of individuals, whether you’re on the spectrum or not,” Follmer said.
Jamie Reed’s family has been using this and other strategies to help her son. Warren wears noise-canceling headphones, listens to music, and has been teaching himself about cicadas.
“For him, researching it and looking into it I think grounds him a little bit,” Reed said.
Fatima Husain is a professor and neuroscientist at the University of Illinois Urbana-Champaign and studies how the brain processes sound. She said people with tinnitus may also struggle with cicada song.
Tinnitus, a ringing or other noise in the ears, is a person’s perception of sound without an external source.
“Some people say it sounds like buzzing, like wind blowing through trees, and ironically, quite a few people say it sounds like cicadas,” Husain said.
For most people with tinnitus the cicada’s song is harmless background noise, according to Husain, but for others the ringing can prevent easy conversation or sleep. Those with tinnitus are also more likely to have anxiety or depression. A loud persistent sound, like singing cicadas, can make someone’s tinnitus worse, Husain said.
It’s not always bad, though. The cicada’s song can also be a relief.
For some, tinnitus gets worse in a quiet environment. Husain said she’s seen reports this year of patients saying the cicadas’ song has been like soothing white noise.
“The sound is loud enough that in some ways it’s drowning their internal tinnitus,” Husain said.
As loud as the cicadas can be, they won’t necessarily damage anyone’s hearing, according to the Centers for Disease Control and Prevention. Hearing loss builds up over time from repeated exposure to loud sounds. Cicadas aren’t loud enough for long enough to do lasting damage, Husain said.
Everyday sources of noise come with a higher risk. Husain said constant exposure to loud highways, an airport, industrial sites, or household appliances like blenders and hair dryers can be a concern. And they can take a toll on someone’s emotional well-being.
“If you are being exposed to very loud sounds for a part of your school day or your working day, it may make you more stressed out; it may make you more angry about things,” she said.
Unlike the highway or an airport, cicadas won’t be around long. Most of the current brood will be gone in the next few weeks. Just in time for another noisy summer event: the Fourth of July.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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STI rates are increasing among midlife and older adults. We need to talk about it
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Globally, the rates of common sexually transmissible infections (STIs) are increasing among people aged over 50. In some cases, rates are rising faster than among younger people.
Recent data from the United States Centers for Disease Control and Prevention shows that, among people aged 55 and older, rates of gonorrhoea and chlamydia, two of the most common STIs, more than doubled between 2012 and 2022.
Australian STI surveillance data has reflected similar trends. Between 2013 and 2022, there was a steady increase in diagnoses of chlamydia, gonorrhoea and syphilis among people aged 40 and older. For example, there were 5,883 notifications of chlamydia in Australians 40 plus in 2013, compared with 10,263 in 2022.
A 2020 study of Australian women also showed that, between 2000 and 2018, there was a sharper increase in STI diagnoses among women aged 55–74 than among younger women.
While the overall rate of common STIs is highest among young adults, the significant increase in STI diagnoses among midlife and older adults suggests we need to pay more attention to sexual health across the life course.
Fit Ztudio/Shutterstock Why are STI rates rising among older adults?
STI rates are increasing globally for all age groups, and an increase among midlife and older people is in line with this trend.
However, increases of STIs among older people are likely due to a combination of changing sex and relationship practices and hidden sexual health needs among this group.
The “boomer” generation came of age in the 60s and 70s. They are the generation of free love and their attitude to sex, even as they age, is quite different to that of generations before them.
Given the median age of divorce in Australia is now over 43, and the internet has ushered in new opportunities for post-separation dating, it’s not surprising that midlife and older adults are exploring new sexual practices or finding multiple sexual partners.
People may start new relationships later in life. Tint Media/Shutterstock It’s also possible midlife and older people have not had exposure to sexual health education in school or do not relate to current safe sex messages, which tend to be directed toward young people. Condoms may therefore seem unnecessary for people who aren’t trying to avoid pregnancy. Older people may also lack confidence negotiating safe sex or accessing STI screening.
Hidden sexual health needs
In contemporary life, the sex lives of older adults are largely invisible. Ageing and older bodies are often associated with loss of power and desirability, reflected in the stereotype of older people as asexual and in derogatory jokes about older people having sex.
With some exceptions, we see few positive representations of older sexual bodies in film or television.
Older people’s sexuality is also largely invisible in public policy. In a review of Australian policy relating to sexual and reproductive health, researchers found midlife and older adults were rarely mentioned.
Sexual health policy generally targets groups with the highest STI rates, which excludes most older people. As midlife and older adults are beyond childbearing years, they also do not feature in reproductive health policy. This means there is a general absence of any policy related to sex or sexual health among midlife or older adults.
Added to this, sexual health policy tends to be focused on risk rather than sexual wellbeing. Sexual wellbeing, including freedom and capacity to pursue pleasurable sexual experiences, is strongly associated with overall health and quality of life for adults of all ages. Including sexual wellbeing as a policy priority would enable a focus on safe and respectful sex and relationships across the adult life course.
Without this priority, we have limited knowledge about what supports sexual wellbeing as people age and limited funding for initiatives to engage with midlife or older adults on these issues.
Midlife and older adults may have limited knowledge about STIs. Southworks/Shutterstock How can we support sexual health and wellbeing for older adults?
Most STIs are easily treatable. Serious complications can occur, however, when STIs are undiagnosed and untreated over a long period. Untreated STIs can also be passed on to others.
Late diagnosis is not uncommon as some STIs can have no symptoms and many people don’t routinely screen for STIs. Older, heterosexual adults are, in general, less likely than other groups to seek regular STI screening.
For midlife or older adults, STIs may also be diagnosed late because some doctors do not initiate testing due to concerns they will cause offence or because they assume STI risk among older people is negligible.
Many doctors are reluctant to discuss sexual health with their older patients unless the patient explicitly raises the topic. However, older people can be embarrassed or feel awkward raising matters of sex.
Resources for health-care providers and patients to facilitate conversations about sexual health and STI screening with older patients would be a good first step.
To address rising rates of STIs among midlife and older adults, we also need to ensure sexual health promotion is targeted toward these age groups and improve accessibility of clinical services.
More broadly, it’s important to consider ways to ensure sexual wellbeing is prioritised in policy and practice related to midlife and older adulthood.
A comprehensive approach to older people’s sexual health, that explicitly places value on the significance of sex and intimacy in people’s lives, will enhance our ability to more effectively respond to sexual health and STI prevention across the life course.
Jennifer Power, Associate Professor and Principal Research Fellow, Australian Research Centre in Sex, Health and Society, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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