Self Care Pharmacy Blog

Archive for December, 2015


The Not –So- Sweet Truth about What You’re Drinking

Friday, December 4th, 2015

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By Liz Aziz, PharmD Student Cedarville University School of Pharmacy

Many Americans have grasped the warning on excessive sugar intake. The problem is, these sugary calories often creep into the average American’s diet through drink, not food. Sugary drinks have already been tied to an increased risk of Type 2 diabetes as well as weight gain.­1 But just this month, a study published by the British Medical Journal has now found that sweetened beverages can also be associated with increase heart failure.2  Life with heart failure is nothing to take lightly, that’s why this gives the nation all the more reason to twist the cap shut on sweetened beverages and to choose healthier habits.

Increased prevalence of heart failure and other heart complications.chf As mentioned above, the recent study found a correlation between frequent consumption of sugary drinks and heart failure.2 These drinks include any beverage sweetened by sugar including soda, fruit juice/punch, lemonade, powdered drinks, or energy drinks.2 The study was a 12-year long population based study on 42,000 men ages 45-79. Researchers tracked incidents of heart failure between 1998 through 2010. Using food-frequency questionnaires, they found that men who drink two or more drinks a day were 23% more likely to develop heart failure. 2 Men who did not consume such beverages did not experience as many incidents of heart failure.2 Though the study has its limitations, such as survey bias and outside variables affecting study subjects, there are other literature that support the declining heart health of sugary-drink consumers.

In a similar study published by Circulation, researchers discovered a 20% increase in coronary heart disease in those who drink sweetened beverages.3  This study took into account age and family history when considering the correlation.3 They also concluded that the association had to do with sugar-sweetened drinks, not artificially-sweetened drinks (no-calorie sugary drinks).3  The study found sugar to be the underlying problem. Women are not excluded from this risk. The Nurses’ Health Study tracked the health of over 90,000 women during a time period of twenty years.4 They found similar results as the studies done on men, however the results were even more severe. Women who drank more than two servings of sugary drinks each day had a 40 % higher risk of heart attacks or death from heart disease in comparison to women who were rare consumers.4

So what is heart failure and heart disease? Heart failure is essentially when the heart is too exhausted or damaged to pump blood and oxygen to the rest of the body.5 Those that suffer from heart failure live a very difficult and limited life.5 Daily tasks become a struggle due to shortness of breath.5 This can further result in a sedentary lifestyle which is associated with its own health problems.5 Illnesses that can lead to heart failure are coronary heart disease as well as diabetes.5 The issue with excess sugar is that the build-up of the glucose metabolite in the body and frequent insulin spikes can cause significant damage and stress to the heart, leading to heart failure and heart disease.5 According to the Center of Disease Control, there are already 5 million Americans suffering from heart failure and more and more each year are adopting habits that put them at risk. soda

Sugary drinks overload your diet with sugar. A statement made by the American Heart Association recommended that the average adult should not consume more than 5 to 9 teaspoons of sugar. 7 However, the average 20-ounce bottle of a sugary drink contains 16 teaspoons of sugar.8 That almost TRIPLES the amount of sugar a person should consume in one day. With individuals having two or more of these drinks a day, it’s no wonder it is having a detrimental impact on Americans’ health.

What is the take home message? Those that regularly consume sugary drinks should set goals and limit their consumption.9 Though this is not the answer to all heart-related problems; it is definitely a start. There is plenty of research that supports this recommendation not only when it comes to heart failure but also diabetes and obesity. However, the question remains: Is this enough to get Americans to put down that can?



  1. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006;84:274–288.
  2. Rahman I, Wolk A, Larsson SC. The relationship between sweetened beverage consumption and risk of heart failure in men. Heart. 2015;
  3. De koning L, Malik VS, Kellogg MD, Rimm EB, Willett WC, Hu FB. Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men. Circulation. 2012;125(14):1735-41, S1.
  4. Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89:1037-42.
  5. What Is Heart Failure? – NHLBI, NIH. 2015. Available at: Accessed November 11, 2015.
  6. en S, Kundu B, Wu H et al. Glucose Regulation of Load-Induced mTOR Signaling and ER Stress in Mammalian Heart. Journal of the American Heart Association. 2013;2(3):e004796-e004796. doi:10.1161/jaha.113.004796.
  7. Johnson RK, Appel LJ, Brands M, et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association.Circulation. 2009;120(11):1011-1020.
  8. Wang YC, Coxson P, Shen YM, Goldman L, Bibbins-Domingo K. A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes.Health Aff (Millwood). 2012;31(1):199-207.
  9. Sandee LaMotte C. Study links sweetened soda and heart failure – CNN. 2015. Available at: Accessed November 11, 2015.
  10. Sugary Drinks.; 2014. Available at: Accessed November 11, 2015.
  11. CHF.; 2015. Available at: Accessed November 11, 2015.
  12. Creative Commons. Vending Machine.; 2015. Available at: Accessed November 11, 2015.


Teens, Smartphones, and Poor Sleep

Tuesday, December 1st, 2015

By Dominic Yeboah, Pharmacy Student Cedarville University

Technology has evolved tremendously over the past few years.  The use of cell phones, tablets, and computers among children and adolescents is also on the rise. Schools also use technology in the classroom to help with teaching and learning. Cell phone use, especially texting in middle school through high school is on the rise.1,2 Teenagers are often on their phones using the Internet or texting, especially at bedtime. It was reported in the New York Daily News that 57% of teenagers texted while in bed, and an additional 21% were awoken by text.1  This has led to kids and teenagers, especially those in high school and middle school, getting an inadequate amount of sleep.1

A recent study analyzed the impact of communication technology on teenagers’ mood, cognition and daytime functioning. The study was a cross-sectional study in a Middlesex county school district in New Jersey.  It involved a total population of 3,139 with the ages ranging between 12-17. The study reported that the use of smartphones in this age group has increased by 14% between 2011 and 2013, with texting, use of the Internet, social media activities, and online gaming reporting highest use.2

Image courtesy of David Castillo Dominici at

Image courtesy of David Castillo Dominici at

The results indicated that close to 62% of teens used a smart phone or tablet after bedtime, 56.7% texted or tweeted messages in bed, and 20.8% were awoken by texts messages. Continuous wakening to use and check cell phones led to changes in sleep pattern and in some cases insomnia. Teenagers may not be able to go back to sleep because they end up texting or checking other social media when they are awaken from sleep.3,5  The inadequate night-sleep has led to daytime sleepiness, academic problems, mood swings, aggressive behaviors, increased risk of accidents, as well as an increase risk of substance abuse.4-7 Studies have also shown that reduced sleep time can contribute to obesity in children which may also lead to an increase in type 2 diabetes and other chronic diseases later in life.3,8

Reasonable limitations and appropriate smart phone and tablet use are very important. Maintaining good sleep hygiene can prevent the effects listed above. It is essential for teenagers to practice good and effective sleep hygiene. Therefore, non-pharmacological treatment is the most appropriate and desired form of treatment. This includes making choices at bedtime that will foster a good night sleep such as maintaining a cool and quiet sleeping space, eliminating all use of electronics (especially cell phones, tablets or television), eliminating bright lights, and decreasing caffeine intake before bedtime.9

Parents of teenagers who still have problems with insomnia after trying and implementing proper sleep hygiene  (non-pharmacological treatment) may consult their child’s primary care provider for further evaluation.


  1. Robins B(2015). Late night texting is linked to insomnia and poor grades, study finds. New York Daily News.
  2. Polos P, Bhat S, Gupta D, O’Malley R, Debari V, Upadhyay H, et al (2015). The impact of Sleep Time-Related Information and Communication Technology (STRICT) on sleep patterns and daytime functioning in American adolescents. Journal of Adolescence, 232-244.
  3. Krinsky DL, Berardi RR, Ferreri SP, et al. Handbook of nonprescription Drug: An Interactive Approach to Self-care. 18th Washington, D.C.: American Pharmacists Association; 2015: 853-860.
  4. Institute CM, Gary J. (2014). What happens when teenagers don’t get enough sleep | child mind institute. Available at: (Accessed: 17 November 2015).
  5. Fossum IN, Nordnes LT, Storemark SS, Bjorvatn B, Pallesen S. The association between use of electronic media in bed before going to sleep and insomnia symptoms, daytime sleepiness, morningness, and chronotype. Behave Sleep Med. 2014; 12(5): 343-57.
  6. Chung KF, Cheung MM. Sleep-wake patterns and sleep disturbance among Hong Kong Chinese adolescents. Sleep. 2008; 31(2): 185-94.
  7. Asarnow LD, Mcglinchey E, Harvey AG. The effects of bedtime and sleep duration on academic and emotional outcomes in a nationally representative sample of adolescents. J Adolescent Health. 2014; 54(3): 350-6.
  8. Chaput JP. Is sleep deprivation a contributor to obesity in children?. Eat Weight Disord. 2015;
  9. Lemola S, Perkinson-gloor N, Brand S, Dewald-kaufmann JF, Grob A. Adolescents’ electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age. J Youth Adolesc. 2015;44(2):405-18.