Sugar

Sugar tastes wonderful and enhances the taste of other foods.  However, it provides only “empty calories” and is of no nutritional value in that it contains no vitamins or minerals.  It is easy for 4 to 8 year olds to eat 60 or so grams of added sugar a day, which over the period of a year adds up to 50 pounds of sugar.  The USDA Dietary Guidelines recommends that children and adults limit added sugar to 10 percent or fewer of daily calories.  This is about half as much as children ages 4 to 8 are consuming now.  Children are biologically programmed to prefer a higher level of sweetness than adults do.  Sugar is full of calories, and we crave sweet food at an early age.

Young children who consume too much added sugar are at higher risk of heart disease, diabetes, or both.  Children aged 3 to 11 who drink about 12 ounces of sugar-sweetened beverages daily have higher levels of C-reactive protein, an indicator of harmful inflammation in their bodies, than do children who do not consume sugary drinks.  Eating too much added sugar may also trigger metabolic syndrome, which can increase the possibility of having heart disease, diabetes, and strokes.

Naturally occurring sugars in dairy products and whole, fresh fruit are not considered added-sugar because the body does not process them in the same way that it does sugar added to food.  Learn to read labels to help identify added sugar, and try to find nonsweetened products.  Encourage drinking water and limit juices.  Limit soda and lemonade to special occasions.  If your child drinks milk, use plain milk rather than flavored milk.  Be sure your food does not contain added sweeteners like sugar alcohols, stevia or sucralose.  Added sugar may be listed as high fructose corn syrup, corn syrup solids, dextrose, fructose, maltose, or grain syrups.  Words ending in “ose” usually indicate the presence of a sugar.

Irritable Bowel Syndrome

Affecting about 12% of Americans, more often women and people younger than 45, irritable bowel syndrome (IBS) involves chronic diarrhea, constipation, or both, along with abdominal cramping.  It does not alter bowel tissue or put patients at increased risk for colorectal cancer as more serious gut conditions do.  It does cause pain, embarrassment, and anxiety in sufferers who must plan their activities only in places close to a restroom.

Although the FDA has approved two new drugs for treatment of IBS, severe side effects are possible.  A diet developed in Australia eliminates or reduces foods that have been found to trigger symptoms. It is called “Low Fodmap,” an acronym for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols,” which are a group of sugars and other food ingredients poorly absorbed in the gut.  Eating foods with low amounts of these substances helps minimize the diarrhea, gas, and bloating.  Compared with a traditional American diet it also reduces the frequency of abdominal pain.  More research is needed to show that this diet does not have a negative effect on gut microbes.  

The Dangers of Over–the–Counter Drugs

Many people assume that over-the-counter (OTC) drugs are safe, maybe even safer than drugs that require a prescription.  Just because they are available over the counter does not mean they are risk free.  It is important to be aware of the active ingredients and potential side effect before taking the drug.  Most people do not read all of the information on OTC drug labels.

Acetaminophen is the active ingredient in Tylenol, the most commonly used OTC medication. It is deadly if not used within the dosage limits, and it can cause liver damage if too much is taken as a daily dose.  Alcohol consumption while taking acetaminophen increases the risk of kidney damage.  Serious skin reactions are also possible.  NAC, N-acetyl cysteine, is an antidote for acetaminophen toxicity.

Laxatives are the most misused OTC drug.  Many laxatives include sodium phosphate, which if taken in excess can lead to dehydration and abnormal electrolyte levels in the blood.  Because it is possible for the body to become dependent on laxatives, they should be avoided and used only as a last resort.  It can be tempting to take sleeping pills to help with sleep problems.  However, many of them are addictive and some types lose their effectiveness over time.  This tempts people to increase their dose. 

Many people also feel the need to take something to relieve their heartburn. OTC heartburn drugs do not address the problem.  They only temporarily treat the problem, and they can have potentially serious side effects.  Heavily medicated people who take multiple prescription drugs also tend to take OTC drugs.  Combining OTC drugs with prescription drugs can be dangerous.  

Caffeine Controversy

There has always been controversy regarding how much caffeine is too much.  Caffeine intoxication became official when it was added as an official diagnosis to the Diagnostic and Statistical Manual of Mental Disorders in 2013..  Most caffeine is consumed in coffee although there are energy drinks and some soft drinks in which it is an ingredient. Caffeine affects different people in different ways.  For some people a small amount makes them feel edgy.  Others require two double espressos to get going in the morning.  Nervousness, excitement, insomnia, and rambling thoughts can result from overindulgence.  Most people who consume caffeine do not experience severe consequences.  Overdosing and dying from too much caffeine would require drinking 140 cups  (8-ounce cups) of coffee in one day.  Most people cannot consume more that 5 cups of coffee a day without uncomfortable symptoms resulting.

Some benefits are reported from consuming caffeine.  Among them there may be lessened mortality, reduction of depression, and helping to avoid clogged arteries.  However, in a depressed patient predisposed to panic attacks, caffeine may make the condition worse.  Pregnant women should not drink coffee.  While there may be benefits to their body, it is not beneficial to a fetus.  Caffeine does not provide any benefits to the baby, only potential hazards.  Children should never be given coffee or drinks containing caffeine.  Adults consuming coffee should drink it early in the day and drink only filtered coffee.

Sleep

Sleep is as important to health and life as are food and water.  It is a restorative activity when the body repairs muscles, consolidates memory, restores energy, and releases hormones. If sleep time is cut short, the body does not have time to complete these tasks.  Good sleep is essential for optimal health.  Most people need between 6 to 8 hours of sleep a night.  However, the amount of sleep needed varies from person to person and depends on many factors, including age.  For example, infants require more sleep than adults.

Many things can affect sleep, and sleep problems are common among all ages around the world.  There are as many as 84 sleep disorders, and many of them are not recognized for years, leading to poor quality of life and unnecessary suffering.  The number one sleep disorder is insomnia, followed by sleep apnea.  Sleep hygiene will help nearly all sleep problems.  It may be thought of as a series of habits and rituals that will improve the ability to fall asleep and stay asleep.  Some sleep disorders require the intervention of a physician, and sleep medicine has recently been recognized as a specialty of medicine.  Physicians are now acquiring knowledge necessary for diagnosis and treatment of sleep disorders.

Pediatric Migraines

It was thought at one time that children could not have migraines and that the typical age for migraines to begin was 17.  Children, even young children, can have and do have migraines.  Children who have migraines have usually inherited the tendency from their parents.  These headaches may appear in about one quarter of these children by age five and about half before the age of 20.  Before puberty boys are slightly more likely than girls to get migraines.  After puberty migraines are more common in girls because of hormone changes.

Migraines will cause throbbing pain and are nearly always accompanied by nausea and vomiting.  Pain may be on both sides of the head.  Abdominal migraines, a variant of migraines, often occurs in children.  The “stomachache” and nausea is usually relieved by a nap.  However, migraine in a child may be as short as one hour or can last a day or so.  Children with abdominal migraines usually develop “typical” migraines as adults.

Triggers for migraines must be identified to reduce the frequency and intensity of the headaches.  Regular routines for eating, exercise, and sleeping must remain constant throughout the year.  For some children relaxation and stress management techniques are helpful as is biofeedback.  There are some medications that do help.  Analgesics may help with the pain.  Triptans approved for children may abort migraines.  As with any technique, some methods are helpful for childhood migraines; others are not.

Sexting

Sexting is sending and receiving sexually explicit messages, usually between mobile phones.  Sexting is a term for which the words sex and texting are combined.  Usually a message and images are sent.  A photo can be forwarded in a matter of seconds.  Sexting takes place all over the world.  It is estimated that 88% of self-made explicit images are “stolen” from their original upload location and made available on other websites, in particular porn sites collecting sexual images of children and young people.  Sexting is illegal, and according to laws, it usually does not matter whether the explicit photos were shared voluntarily.  Teenagers who have unlimited text messaging plans are more likely to receive sexually suggestive texts.

Most laws that would apply to texting were written before the advent of smartphones.  At least 20 states have updated their laws since 2009 to account for youth sexting.  While coercion and unauthorized image-sharing should be punished, teenagers willingly exchanging nude images should be handled differently.  Many of the newer laws still prohibit teen sexting, but have reduced penalties.  Teens need to be aware of the dangers of sexting.  Sexting can result in humiliation and ostracism, but most teens are not aware it can have legal consequences.  The majority of them do not realize sexting could be considered as a crime.  Parents and the school sex education classes should explain to teens why someone would not and should not want to share nude photos.  Teen or underage sexting can violate some child pornography laws.  An affirmative defense may not be available if sexting was done without consent.