#Melatonin in Gummies for Children

Research reported in JAMA April 25, 2023 showed that the amount of melatonin listed on the label of some samples of melatonin gummies was different than the actual amount.

Researchers studied various brands and tested 25 gummy products for the actual amount of melatonin in each one. Of the 25 tested, 22 had different amounts than listed on the label.

At the extremes, one had 347% more, another had 26% less, and yet another one had no melatonin.

The researchers noted that melatonin use in children is not unusual but is controversial. Parents who give melatonin to their kids do so mainly for sleep, stress, and relaxation.

However, the article pointed out that there is a “lack of high-quality evidence to support melatonin’s efficacy for these indications in healthy children …”

Also, melatonin is not without risks. As reported in The New York Times, from 2012 to 2021 calls about melatonin to the U.S. Poison Control Center increased by 530%. There were 27,795 visits to an ED or clinic, 4,097 hospital admissions, 287 ICU admissions, and 2 deaths.

It seems reasonable to be cautious in the use of melatonin in gummies for children. Speak to your child’s doctor or a pharmacist.

Peter M. Hartmann, MD

Family Medicine & Psychiatry

#Sugar and Health

An article in the April 5, 2023 edition of The British Medical Journal by Huang and colleagues addressed concerns about excessive sugar intake. The authors reviewed summaries of 8,601 research articles on this topic.

They found evidence that excessive dietary sugar can contribute to multiple health problems including endocrine, cardiac, psychiatric, dental, bone, and allergy disorders.

People who consume large amounts of sugar have a greater body weight (especially from sugar sweetened beverages) and distribution of fat around internal organs (mainly from added sugars) when compared to people with low sugar intake.

The authors conclude that people should limit sugar intake to less than 25 grams per day (about 6 teaspoons of sugar per day) and limit sugar sweetened beverages to less than one serving of sugar sweetened beverages no more than once per week.

The paper reports that “generally, sugar sweetened beverages are the largest source of added sugars, including carbonated and noncarbonated soft drinks, fruit drinks, and sports and energy drinks.”

Peter M. Hartmann, MD

Family Medicine & Psychiatry

#Coffee: Good or Bad?

Is drinking daily coffee OK? Sara Berg, MS (staff writer for the AMA) reviewed information provided on this topic by an expert on preventive cardiology. Her article appeared in the AMA publishing in March of 2023.

The expert is Stephen Devries, MD who is an Adjunct Associate Professor of Nutrition at the Harvard School of Public Health. He also is the Executive Director of the nonprofit education center, the Gaples Institute.

Dr. Devries was quoted in Sarah Berg’s article as stating that adults who drink no more than 4 cups of coffee per day have a 29% decrease in all-causes of death and a 15% decrease in heart disease over a 7 year timeframe when compared to adults who don’t drink coffee.

Adults who drink the most coffee daily have a 29% decrease in the incidence of Type 2 Diabetes. Again, this is in comparison to non coffee drinkers.

Drinking coffee daily is not all good, however. Dr. Devries notes that the caffeine in coffee can cause jitteriness, anxiety, and insomnia. People differ in their sensitivity to these potential effects from. caffeine.

Another problem may arise from getting “fancy” coffee from coffee shops, which may contain large amounts of sugar. A third concern that Dr. Devries describes is the risk that unfiltered coffee may contain substances that can raise the level of “bad” cholesterol. Thus, he recommends using a standard paper filter when making coffee at home.

Caffeine is naturally found in coffee, and it plays a role in the benefits listed above. However, the FDA recommends that non-pregnant adults consume no more than 400 mg per day from all sources. Pregnant women should consume less than 200 mg daily. Drinking decaf coffee is one way to keep the levels down.

In addition to caffeine, coffee has large amounts of natural plant chemicals called polyphenols. These chemicals protect cells and tissues from damage by inflammation and from unstable molecules (free radicals). Polyphenols are also found in many other foods such as berries, dark chocolate, nuts, red wine, olive oil, peaches, eggplant, and many others.

The bottom line is that coffee consumption can play a role in disease prevention. However, adults should be careful not to take in excessive caffeine. Also, limit the amount of coffee with large amounts of added sugar. When making coffee at home, you reduce the risk of elevated levels of LDL cholesterol (bad cholesterol) if you filter it with a standard paper filter.

The majority of this blog was based on an excellent article by Sara Berg, MS, as noted above.

Peter M. Hartmann, MD

Family Medicine & Psychiatry.

High #Salt Intake and Risk of #Cardiovascular Disease

A Swedish study published in the European Heart Journal Open on 23 March 2023 showed that HIGH LEVELS OF SALT INTAKE resulted in elevated blood pressure and increased risk of developing “hardening of the arteries” to the heart and the large arteries in the neck leading to the brain.

The research showed increased blood pressure, cardiovascular disease, and death. Hardening of the arteries in the neck likely will lead to more strokes.

The increase in hardening of the arteries begins years before it is apparent. Thus, the earlier a person reduces their salt intake, the better. At minimum, do not add extra salt to your food and avoid processed foods with high sodium levels.

Peter M. Hartmann, MD

Family Medicine & Psychiatry