diet soda canRecent studies have shown that intake of artificial sweeteners may contribute to glucose intolerance. Those of us who enjoy diet drinks and cut calories by selecting foods with sugar substitutes may decide that the trade-off is not the healthy choice. We may want to think twice before satisfying cravings for Diet Coke and go for an unsweetened iced tea instead.

Glucose intolerance is a serious health risk because it can lead to diabetes as well as metabolic syndrome. Diabetes is characterized by the body’s inability to produce insulin to process sugar intake. Insulin is a hormone produced in the pancreas that is needed by the body to regulate glucose levels. Metabolic syndrome is a set of biochemical changes that increases one’s risk for heart disease and diabetes. The physiologic changes in metabolic syndrome include glucose intolerance, abnormal lipid levels, insulin resistance and obesity.

The human intestines are filled with microscopic living organisms, the so-called “gut flora.” A normal intestinal environment is home to these organisms, most of which are bacteria. A study published in the 9/18/2014 issue of Nature described findings that intake of artificial sweeteners changes the composition and function of this flora. The researchers fed mice three of the most commonly-used sugar alternatives: aspartame (Equal), saccharin (Sweet’N Low) and sucralose (Splenda). The mice drinking the artificially-sweetened water had altered intestinal bacteria and marked glucose intolerance. Antibiotics administered to kill this bacteria resulted in resolution of the glucose intolerance.

Additional research was carried out on a limited number of human subjects. Nondiabetic subjects who reported artificial sweetener use were more likely to develop glucose intolerance over time than were those who stated they did not use artificial sweeteners. These participants also were more likely to show changes in gut flora. The researchers gave seven human subjects high levels of saccharin over six days, and four of thee subjects then had abnormal sugar levels. The scientists theorize that the altered combination of bacteria causes a change in glucose metabolism, blocking the sugar levels from declining as quickly as they should.

Although the study’s authors point out that the percentages supporting their findings are statistically significant, they note that more studies are needed. Over the past several years, evidence has accumulated that intake of artificial sweeteners increases sugar cravings. Some studies have even shown that those who use artificial sweeteners are more likely to be overweight. Now with the possibility that these additives can have serious health effects such as diabetes, the support for decreased ingestion of artificial sweeteners grows. The research findings indicate that it might be time to cut back on total intake, perhaps drinking one fewer can of diet soda per day and selecting a snack of nuts or blueberries rather than sugar-free cookies. Limited consumption of products with artificial sweeteners could be important to limiting the associated health risks. Similar to other medical recommendations regarding nutrition and fitness, the guidance at this point is moderation.

Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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grapefruit & pills


You are diligent about taking your medication each day. But did you ever think that the bologna sandwich, grapefruit or glass of milk you have with it could be making your medicine less effective, or even dangerous? Read on for five facts you need to know about food and drug interactions.

      1.  Beware of grapefruit. This popular breakfast fruit interacts with a variety of medications, including blood pressure meds, statins, and HIV and organ transplant medications, says Charlie Twilley, Pharm.D., a pharmacist at Johns Hopkins Bayview Medical Center. The culprits are furanocoumarins, compounds found in grapefruit that block the enzymes in the intestines responsible for breaking down these drugs. This can make the drugs more potent, and raise the level of drug in your bloodstream. If you are a big grapefruit fan, talk to your doctor or pharmacist to find out whether it is safe to eat with the medications you take.
      2. Dairy diminishes an antibiotic’s infection-fighting powers. Twilley warns that the calcium in milk, yogurt, cheese, ice cream and antacids can interact with tetracycline and the tetracycline group of antibiotics used to treat a number of bacterial infections. To make sure you are getting the full benefit of your antibiotic, take it one hour before, or two hours after, you eat anything containing calcium.
      3. Leafy greens cancel warfarin effects. The vitamin K in spinach, collards, kale and broccoli can lessen the effectiveness of warfarin, a blood thinner used to prevent blood clots and stroke. The darker green the vegetable is, the more vitamin K it has. “You don’t want to eliminate leafy greens from your diet, because they do have many health benefits,” says Twilley. The key is to be consistent with the amount you eat. If you plan to drastically change the amount of these veggies in your diet, talk to your doctor or pharmacist first.
      4. Beer, red wine and chocolate are dangerous to mix with some antidepressants. These popular indulgences may be a nice way to relax in the evening, but they contain tyramine, a naturally occurring amino acid that can cause an unsafe spike in blood pressure when mixed with MAO inhibitors. Tyramine also is found in processed meat, avocados and some cheeses. “This is a significant, dangerous interaction,” says Twilley. If you take MAO inhibitors for depression, talk to your doctor or pharmacist before eating anything with tyramine. Alternative therapy may be considered.
      5. Think before you crush medication in applesauce. Many people who have trouble swallowing pills like to crush them and mix them with applesauce or pudding. Always ask your doctor or pharmacist before you crush or take apart medication. “This method can dump too much of the drug into your system at once, or change the way the drug works,” says Twilley.

Also keep in mind that some medications are affected by whether or not you eat with them. Before you start any new drug, talk to your doctor or pharmacist about whether it is affected by food. “They can help you come up with a schedule that’s good for the drug and convenient for you,” says Twilley. Even over-the-counter medications and supplements can have food interactions.

For additional reliable information about common food and drug interactions, you can search for this topic in the Johns Hopkins online Health Library.

Sara Baker, Public Affairs and Marketing Coordinator, Johns Hopkins Bayview Medical Center

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Childhood headaches or frequent constipation? They can sometimes be symptoms of poor nutrition choices. Here’s five tips to get your child’s diet on track.

Adults in children’s lives play a large role in a child’s nutrition and developing eating habits. “Kids are going to model what their parents do. If their parents are eating a lot of fast food and drinking a lot of soda, their kids are going to develop those habits,” said Michael Lasser, M.D., a pediatrician on staff at Howard County General Hospital. “It is really important families sit down and eat together. Not only to see how the child’s day was, but if parents are eating healthy food, that is what the kids are going to eat.” Check out the below slideshow for more tips to help your children make wise food and drink choices.


  • The Water Connection: Children need to drink more water. "Kids do not drink enough water throughout the day and will come home from school with headaches because they didn't have breakfast or drink enough water and are dehydrated," said Dr. Lasser. [© Yarkovoy |]

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fattening food; nutrition tips

© Sarah2 |

Did you know vitamin-enhanced water can have as much sugar as 7 chocolate sandwich cookies? Think about your drink and other nutrition guidelines for your 2015 diet.

Here we go again! New Year’s Eve is tomorrow night, and after an evening  (and a season) of overindulging in so many ways, most of us will end the night with a farewell toast to Auld Lang Syne and a pledge to give up at least some of our vices in the new year. Many will be food-related – losing weight, giving up sugar and eating a healthier diet.

But what exactly does that mean? With so many choices and so much information about food and nutrition, it can be difficult—even for adults—to make good decisions when it comes to eating the right foods. These choices are important, because a healthy diet and lifestyle are the best weapons to fight diseases such as heart disease, stroke, diabetes and certain types of cancer.

The American Heart Association recommends a diet including lean meats and skinless poultry; fish at least twice a week; selecting fat-free, one percent fat or low-fat dairy products and cutting back on added sugars.

Choosing a healthy lifestyle that includes eating the right foods and getting plenty of exercise goes a long way in keeping the body healthy. Make sure half of your plate is vegetables or salad, and eat your fruit or vegetable first to help fill you up so you will eat less of other things.

Think about your drink
Everything has gotten big. Serving sizes that were once 8 ounces are now 20 ounces and sometimes even larger. When you couple the increasing size with the amount of sugar in many beverages, you have a recipe for weight gain. This is especially true when it comes to energy drinks.

Many beverages that may appear to have health benefits have added sugar that is not healthy. Scientific evidence supports the association between consumption of sugar-sweetened beverages and an increased risk of obesity, which can contribute to the development of diabetes, heart disease and cancer. Drinks that are labeled vitamin-enhanced water can have the same amount of sugar as seven chocolate sandwich cookies! To burn off the calories in a fancy 16 ounce coffee drink, you will need to strength train for 30 minutes. Also, calories consumed in a liquid form don’t tell our body to turn off hunger. So we need to be careful about using beverages to satisfy cravings.

Eat the rainbow
It is important to include colorful fruits and vegetables in your meals. Brightly-colored fruits and vegetables indicate that they are high in antioxidants. The deeper and darker the color of the vegetable or fruit, the better it is for you. When thinking about your daily diet, choose at least four servings of colorful vegetables and three servings of colorful fruits. Though there are supplemental pills available you may think would be easier, they do not supply the same benefits derived from food.

Read the labels for these key words
I understand that most of us are not going to soak our own beans and make our own breads, but if you buy pre-packaged food, you really need to read the labels. If one of the first three ingredients is sugar, salt or partially hydrogenated oil, put it back on the shelf. Processed food contains added salt, sugar and fat, and you lose fiber. On a food ingredients label, there are many words that can indicate added sugar that doesn’t occur naturally, including: high fructose corn syrup, agave, fruit juice concentrate – often added in yogurt, dextrose, honey, molasses and brown rice syrup just to name a few. Excess sugar causes inflammation inside our blood vessels even more so than saturated fats. Research is leading us to really take a look at the role excess sugar has on our cardiovascular system.

Let’s start the new year with a resolution we can actually stick to. Think about what you eat and drink and try to make it healthier!

Howard County General Hospital’s Teresa Love, MS, RD, CDE, has been a registered dietitian for more than 30 years and a certified diabetes educator since 2009. She enjoys helping patients manage their diabetes. In her spare time she is an avid tennis player.

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woman with pretzel

© Arne9001 |

Good nutrition is essential to a healthy lifestyle. For people with diabetes, nutrition has even more critical implications, so keeping track of what you eat to make sure you get a variety of the right foods in the right amounts is an important element of maintaining a healthy lifestyle.

According to the National Diabetes Education Program, nearly 21 million Americans have diabetes, a serious disease in which blood sugar (glucose) levels are above normal. Most people with diabetes have Type 2, once known as adult-onset diabetes.

Type 1 diabetes is not caused by obesity, and many people with this disease are of normal weight. Type 2 diabetes, on the other hand, is strongly related to being overweight or obese, and losing even a moderate amount of weight can reduce the need for treating the diabetes with medication. In some cases, it can even eliminate the diabetes and lower your blood pressure and cholesterol. Anyone with diabetes needs to watch their carbohydrate consumption to avoid spikes in blood glucose levels.

“You are somewhat in the driver’s seat. Typically, diabetics require more medicine over the years to manage their disease. But, if you can lose weight and make dietary changes, you may be able to reduce the medicine you need.”
—Teresa Love, MS, RD, CDE

Myth: Diabetics can’t eat fruit, bread, potatoes, rice, carrots or anything white.
Truth: They can in moderation.
People with Type 2 diabetes need to be aware of the carbs in their diet, but reducing overall calories and exercising regularly are the biggest keys to weight loss success. It is important to eat three meals a day with a balance of complex carbohydrates (vegetables and whole grains), healthy fats (think nuts and olive oil) and lean proteins (fish, chicken and beans). It’s also a good idea to keep some healthy snacks on hand.

Strict limiting of one particular kind of food over a long period of time is difficult for many people to stick with, so eat a well-balanced diet and get more exercise! The goal is not to eliminate all carbohydrates and sugars, but to practice moderation.

Lifestyle changes that can help you lose weight
The Diabetes Prevention Program, an evidence-based program led by the Centers for Disease Control and Prevention, has shown that you can prevent or delay the onset of Type 2 diabetes by losing weight through a reduced-calorie diet and by increasing physical activity. “Individuals should aim for a seven percent weight loss over three months and 150 minutes of physical activity weekly,” said Teresa Love, MS, RD, CDE, a nutritionist at Howard County General Hospital.

Diabetic diet DOs
Our nutritionist recommends that you:

  • Keep a log of all your food and beverages using a notebook or websites and apps to track calorie intake.
  • Incorporate lima, kidney and black beans into your diet. They are a good source of iron and fiber and a carbohydrate that doesn’t raise blood sugar significantly.
  • Try not to drink calories in the form of sugary beverages or alcohol.
  • Eat breakfast within an hour or two of getting up.
  • Eat consistently – a meal or a snack – every three to five hours.
  • Don’t consume all of your food at the end of the day.
  • Eat more vegetables.
  • Try to have a protein-based food with each meal: lean meat, eggs, cottage cheese, or yogurt to control hunger and blood sugar.
  • Practice strategies that help control portions like using
  • Do not buy all sugar-free and no-sugar-added products. Instead, eat whole foods that are natural and less processed. The fewer ingredients, the better the food is for you.
  • Eat half of your meal when you eat out at a restaurant and take the rest home or share with someone. Restaurant portions are typically too large.
  • Remember that exercise not only helps you lose weight but can help lower blood glucose levels.










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Many thanks to Kelly Mack for her contributions to Well & Wise.

In my farewell reflections, I want to share my thanks for allowing me to tell some of my health stories and lessons learned. I view health as a journey, trying to find a good balance in our daily life. With this approach, taking a look back at the path can be very helpful for planning next steps.

In my case, I made some great steps in physical therapy and gaining strength following knee replacement surgery. While I still have additional goals, I have found regular exercise to be very beneficial in my recovery and overall health. On the more challenging side, my chronic rheumatoid arthritis (RA) provides more adventure than I would like. This year I went on a new medication, but the side effects of weakening my immune system have led to bronchitis, pneumonia, and similar issues.

For me, health is a tricky balance. I don’t often feel I have a handle on it, but try to approach health as a daily practice. When I can string together some healthy days, I feel encouraged. A few weeks and I get ecstatic. I’m never 100 percent, but I’m always working on my health.

For the coming year I have a good foundation to build on. I’m happy with my exercise practice and feel I’ve made great improvements to my eating habits with the help of a nutritionist. I plan on incorporating meditation to help manage stress and pain from my RA. Continuing to gain strength will always be an important goal while also trying to maintain (or even improve) my quality of life with RA.

More elusively, I need to find a better balance with my RA treatment’s side effects and the attack of the disease. Unfortunately, I don’t have a plan for this piece, but need to consult with my doctor and work step-by-step to find a way.

With this in mind, how would you assess your year in health? Made some improvements? Noted some setbacks? Can you pick out one or two new practices you can embrace every day to support your health? It may sound crazy, but I’ve found making a change to daily habits can build gradually over time and give the confidence that long term health goals are possible to achieve.

Best of luck in your assessment and hope you can stake out some wins in the New Year!

Kelly Mack lives in Washington, DC, and works for a marketing communications firm.

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