Pregnancy + Acetaminophen = WHAT?

This is really interesting! -- Dr. Dale

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Acetaminophen in pregnancy linked to 'ADHD-like behaviors'

Post by: 

Arianna Yanes -- CNN Medical Intern

http://thechart.blogs.cnn.com/2014/02/24/acetaminophen-in-pregnancy-linked-to-adhd-like-behaviors/

Doctors frequently recommend acetaminophen, commonly found in over-the-counter pain relievers including Tylenol, to pregnant women for treating mild pain.

But a new study out of Denmark suggests the use of acetaminophen during pregnancy could be associated with ADHD-like behavioral problems in children.

“(Pregnant women) shouldn’t worry at this point,” says study author Dr. Beate Ritz, professor and chair of the epidemiology department at the University of California, Los Angeles Fielding School of Public Health. “But if I were a woman who was pregnant ... I would try to avoid taking painkillers as much as I can until we know more about this.”

The study, published Monday in the medical journal JAMA Pediatrics, analyzed data from more than 64,000 children enrolled in the Danish National Birth Cohort study between 1996 and 2002. Mothers in the cohort study reported on their children’s behavior, and the researchers looked at databases to determine how many prescriptions for ADHD drugs were written and how many children received a diagnosis of a severe form of ADHD called hyperkinetic disorder, or HKD.

The study authors concluded that prenatal exposure to acetaminophen may increase the risk of a child being diagnosed with HKD or being prescribed ADHD medications and “exhibiting ADHD-like behaviors." It's important to note that ADHD-like behaviors are not the same as having ADHD.

An accompanying editorial published in JAMA Pediatrics emphasizes that the study has found “an interesting observed association,” but that the researchers did not find that acetaminophen causes ADHD. The study authors agree that their results do not show a cause-and-effect relationship.

The data suggests that taking acetaminophen for longer periods and later in pregnancy is associated with higher risks, Ritz says. When women reported use for 20 weeks or more, their children had a 50% increased risk for receiving ADHD medication, according to the study.

Ritz says more than half of all mothers in the study reported some acetaminophen use while pregnant. The study measured how many weeks the mother reported taking any amount of acetaminophen but did not take the dosage into account.

“When used as directed, Tylenol has one of the most favorable safety profiles among over-the-counter pain relievers,” said McNeil Consumer Healthcare, the maker of Tylenol. “We are aware of the recent JAMA Pediatrics study; however, there are no prospective, randomized controlled studies demonstrating a causal link between acetaminophen use during pregnancy and adverse effects on child development."

The study’s authors suggest that acetaminophen may increase the risk of ADHD by interfering with maternal hormones that are critical for fetal brain development, citing a previous study done using acetaminophen in rats and a study of acetaminophen and autism done with humans.

“The cited literature is not relevant to the human condition,” says Dr. Max Wiznitzer, pediatric neurologist and associate professor at Case Western Reserve University School of Medicine. “I’m afraid that (women) will think, somehow, that they caused their child’s problem when the study does not tell us that. It tells us that they are linked but does not tell us how.”

“There are a lot of variables that still need to be considered, such as the fact that ADHD runs in families,” Wiznitzer says. Seventy to 80% of ADHD cases are hereditary, he says.

The study highlights the importance of not taking a drug’s safety during pregnancy for granted, the accompanying editorial points out.

“There are nonpharmacological ways to deal with pain,” says Dr. Jeffrey Chapa, head of maternal-fetal medicine at Cleveland Clinic Children’s Hospital. Massages, baths and acupuncture are some alternatives he suggests to help relieve pain. “I think we have to focus a little bit more on that as opposed to just medications.”

Do NOT read this!

Hi family, there are many misconceptions about sugar.  Just because it's sugar-free doesn't mean it's "healthier" for you.  Just because it's fruit, doesn't mean the sugar is "healthy for you." Thanks for checking out the below.  It's really good.

http://www.huffingtonpost.com/2014/05/19/healthy-sugar-sugars_n_5315969.html?utm_hp_ref=healthy-living

Sorry, But There's No Such Thing As A 'Healthy' Sugar

The Huffington Post  | by  

Rebecca Adams

Posted: 

05/19/2014 8:16 am EDT 

Infographic designed by Noelle Campbell

We hate to be the bearers of bad news, but we feel the need to clarify a common misconception: There's no such thing as a "healthy" sugar. Or even a "less bad" sugar. Your body doesn't care if it's "organic" or "unrefined" or "all-natural," and it certainly doesn't care if Gwyneth Paltrow deems it suitable for her children's consumption.

Done hyperventilating? Now let's delve into the nutritional science behind this.

First things first: All sugar is sugar.

It's no secret that consuming sugar in large quantities has deleterious effects on your health -- studies have linked it to obesity, diabetes and increased risk of heart disease, to name a few. Sure, you need carbohydrates, which include both complex and simple sugars, for your body to break down and convert to energy. But it's the added sugars that sweeten some of your favorite foods and beverages that you need to watch out for.

So why can added sugars like agave nectar, raw honey or coconut palm sugar never really be deemed "healthy"? Because, as Dr. Marion Nestle, the Paulette Goddard Professor of Nutrition, Food Studies and Public Health at New York University, put it, "Sugar is sugar, alas." Meaning: No matter what type of sugar you consume -- whether it's table sugar or maple syrup chock full of "vitamins" and "minerals" -- your blood sugar goes up. "Minerals don't counter calories or hormones," Nestle told The Huffington Post.

And it's those pesky calories that link deceptively "healthy" sugars with the regular refined stuff. Dr. Jaimie Davis, an Assistant Professor in the Department of Nutritional Sciences at the University of Texas at Austin, explained to The Huffington Post, "Ultimately, they're all having similar effects on obesity and metabolic disorders. There's no data that suggests that if you consume more calories from honey, you store it differently."

And by "sugar," we mean a combination of fructose and glucose.

To understand why "sugar is sugar," one must know what it is in the first place. What we commonly refer to as table sugar is actually sucrose, a compound composed of 50 percent glucose and 50 percent fructose. Most caloric sweeteners, including the so-called "healthy" ones, contain some ratio of glucose and fructose, which trigger key reactions in your body. Kristin Kirkpatrick, a registered dietitian and manager of wellness nutrition services for the Cleveland Clinic Wellness Institute, told The Huffington Post that when you consume sugar, the metabolic process begins the minute the sugar reaches your mouth. But the majority is ultimately absorbed in the small intestine, where the sugar is metabolized and absorbed into your blood. Enzymes from the stomach then convert the sugar into glucose, your body's preferred energy source. While it can provide your cells with fuel, something your body and brain need for proper functioning, glucose can cause excess weight gain. It spikes your insulin and blood sugar levels, plus it's absorbed and used up quickly.

"Insulin is the chaperone that takes the sugar into your cells where -- after your body immediately takes what it needs -- it's transformed into glycogen, stored and ready to be drawn on by the body for energy," she explained, noting that this is a very basic explanation of the metabolic process.

Fructose, or "fruit sugar," is metabolized differently, since the liver does most of the metabolizing and your insulin levels don't spike quite as much as when you ingest glucose (this is due to the lower glycemic index of fructose). That can make fructose sound like glucose's better half, but it's not true: insulin triggers the hormonal response that tells your brain you're full. Fructose doesn't elicit this reaction, so it's easier to overeat. The effects of sugars higher in fructose is a controversial topic in the nutrition world, since fructose is often blamed for adverse health conditions -- like increased LDL, leptin resistance and uric acid increase -- and fructose is the form most likely to be added to foods, Kirkpatrick explained. Fructose may be tolerable in small amounts but more and more research is being conducted to determine if even small amounts put you at risk for metabolic disorders like insulin resistance. It's worth noting that some so-called "healthy" sugars, like agave nectar, are even higher in fructose than table sugar.

While sugar is never "healthy," you can certainly adopt mindful sugar consumption habits.

The problem with calling sugars "healthy" is the health halo effect, which makes people feel better about eating more of it. But Davis conceded, "I have heard that people who use honey and agave are a little bit more health-conscious, so they might use less, which would have a beneficial effect." And that's the trick when it comes to sugar: just use less of it. Yup, Mary Poppins wasn't so off-base with that whole "spoonfull of sugar" theory, after all.

When incorporating sugar into your diet, keep in mind that the World Health Organization recommends that added sugars make up no more than 10 percent of your calorie intake, while the American Heart Association wants women to consume less than 100 calories and men to consume less than 150 calories of added sugars a day. And it doesn't matter if it's organic molasses or plain old Domino sugar -- it's thequantity that makes all the difference.

So when it comes to trying to decipher between sugars higher in either glucose or fructose, it's very much a "choose your poison" scenario. You don't have to cut out added sugar altogether per se -- the bottom line, according to Nestle, Davis and Kirkpatrick, is to limit your sugar intake no matter what the source. And don't let yourself get too smug for choosing the raw, "all-natural" or "healthy" sugar du jour.

Hate being alone?

Check out this article by Alena Hall via the Huffington Post.  Very interesting! -- Dr. Dale

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Why You Can't Stand To Be Alone -- And How To Learn To Love It

http://www.huffingtonpost.com/2014/09/09/how-to-be-alone-loneliness-coping-strategies-tips_n_5737600.html?utm_hp_ref=healthy-living

For many of us, the idea of being alone conjures up a sense of dread. Maybe it’s the sense of boredom, or the feelings of isolation, or being forced to confront our own thoughts. In fact, a recent study in the journal Science showed that people would rather give themselves electric shocks than be alone with their thoughts for just 15 minutes.

But turns out, there’s a difference between being alone and feeling lonely. Even though we may use the phrases interchangeably in conversation, psychotherapist and HuffPost blogger Ross Rosenberg, who also authored The Human Magnet Syndrome: Why We Love People Who Hurt Us, explains that they’re actually two distinct concepts.

The main distinguisher: Being alone is a physical description (meaning when we are alone, we are just not with people), while loneliness is a feeling that often is experienced as negative and painful. “You can be alone and happy, you can be alone and lonely,” Rosenberg explains. “The idea of being alone is what you make of it."

Many people who struggle with feelings of loneliness can link their struggles to deeper roots. According to Rosenberg, loneliness is a feeling fueled by trauma, loss and grief, a lack of self-esteem, and insecurity. Those who lead healthy, balanced lives are better equipped to face these negative experiences because they have both internal and external resources that help guide them through the process -- from a sense of community to a strong and positive self-concept.

"Loneliness is a normal part of the human existence," Rosenberg says. “We all feel lonely, but chronic, pathological loneliness is a deeply embedded pattern that is self-reinforcing. It’s a self-fulfilling prophecy. Healthy, resilient people respond to normal loneliness by resolving it. Unhealthy people become overwhelmed by it."

Personality type is also a big factor when it comes to who experiences discomfort from being alone. Introverts -- who lose energy from being around others -- may find alone time more desirable than extroverts, who instead gain energy from the company of others.

“If you’re an extrovert, you are comfortable and feel compelled to be around other people. It is just the way you are genetically set up. If you’re an extrovert and you’re not around people, you feel uncomfortable and if you’re psychologically healthy, you use internal and external resources to be around people,” Rosenberg explains. “If you’re an introvert and you like being alone, that’s also completely psychologically healthy. You can be very secure and self-confident and still be very nervous around crowds of people, but you have friends and loved ones, and those are the resources that make an introvert feel just fine when they’re alone."

At the end of the day, whether you're an introvert or an extrovert, all humans experience feelings of loneliness. And many do so during the times they are physically alone. But it doesn't have to be that way. Here are seven ways people who struggle with "me" time can learn to like it, and maybe even love it.

Consider the root causes.

Take the time to ask yourself where the discomfort of solitude comes from. Is it true feelings of loneliness or something else? If it's the former, explore what that means for you and come to the realization that loneliness usually can be traced back to an unpleasant experience or past memory. To truly understand what makes being alone so painful, you must recognize that it comes from a deeper situation -- no matter how uncomfortable it may be to do so, Rosenberg says.

Just do it.

With any uncomfortable situation, sometimes you have to push past the negative thoughts and hesitations and just take the plunge. The same goes for being alone. More often than not, the result will be far more positive than you anticipated.

"It’s like jumping in the pool when you know it’s cold," Rosenberg says. "Everyone knows that once you jump in the pool and get past the coldness, you’re going to have a blast and not even notice it’s cold anymore. You have to tell yourself that that shock to the system is only fleeting and that you're going to enjoy yourself."

It's all about addressing what are called "cognitive distortions," or things that tell us that the pain is not going to be worth it. "We have to actually tell ourselves the opposite," Rosenberg says. "We have to do reverse self-talk."

Explore new hobbies.

Some people who find that they don't like spending time alone are simply bored when they do so. By spending the majority of their time entertaining others, they haven't learned how to entertain themselves. To remedy this, you must retrain the mind by developing habits and hobbies that can consume your attention, inspire your creativity and spark your imagination, Rosenberg says. It may not come naturally at first, and it will likely require experimentation with different activities, but you get that much closer by taking the first step.

Deepen your relationships.

It might sound counterintuitive, but the strength of your relationships can speak bounds to how secure you feel when spending time alone. A lack of depth and connection can make you feel less heard, understood, appreciated or secure in the fact that you do have someone to call should you need to.

"To solve that problem, deepen your relationships, take risks," Rosenberg advises. "Knowing that there are people out there that love you whom you can call will solve your feelings in one of two ways: You’ll actually call them, or you'll just know that you can call them and that will make you feel better. It makes you feel less lonely in your world, and paradoxically, you don’t need to call them because you know they’re out there."

Opt for a change of scenery.

If you hate being alone because you feel stir crazy at home, a change in location could do the trick. Rosenberg suggests doing something new like visiting a museum.

"Do something you’ve never done," he advises. "Step out of your comfort zone physically. At the very least, it will make time pass quicker, and you might find that you actually enjoy yourself."

Think back to your childhood.

A critical component of feeling comfortable spending time alone is the ability to self-soothe, a coping technique learned at a very young age. According to Rosenberg, people with the ability to self-soothe mostly likely had a healthy early childhood, where their parents met their needs unconditionally and in a timely way. And unfortunately, people without this kind of upbringing may struggle more with self-soothing because it isn't something that can often be learned after adolescence.

"If the world around you feels trustworthy, you experience the world as safe. But if you have an early childhood experience when your parent could not or did not meet your nurturing and safety needs, you don’t feel secure in your world -- and as an adult you have to keep trying to bring people into your world to soothe that feeling," he explains.

Ask for help.

Through this self-exploration process, if you find you experience less the physical discomfort of of being alone and more the consistent feelings of loneliness, don't hesitate to reach out for help. According to Rosenberg, psychotherapy is one of the best ways to address chronic loneliness that is debilitating and self-perpetuating. Talking through the parts of life that engender those feelings is critical to discovering the many mindful benefits that solitude can offer.