A recent study of those consuming artificially sweetened drinks confirmed a link to increased risk of stroke and dementia. This study shows once again that sugary sweeteners aren't the only ones that are likely to be bad for your health.

Not so sweet?

With the risks of sugary drinks recognized more and more, consumers have been increasing their consumption of "healthier" diet drinks as an alternative. However, there is no solid research that has shown artificial sweeteners are any healthier than processed sugars. In fact, research has indicated artificial sweeteners may cause weight gain, increase the risk of diabetes, heart attack, and vascular death.

A closer look at artificial sweeteners, stroke and dementia

The authors of this recent study found that during a follow-up of 10 years, "higher recent and cumulative intake of artificially sweetened soft drinks was associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer’s dementia." This link persisted when the data was adjusted for other factors other than cardiovascular risk and diabetes.

With no evidence of clear benefit from artificial sweeteners used in diet drinks, and potentially significant risk, we recommend avoiding these beverages or foods whenever possible. There are plenty of other unsweetened beverages to choose from these days and don't forget the best drink ever made - water. Drop the artificial sweeteners and save yourself from the risk of stroke and dementia.

NSAIDs like Ibuprofen, Tylenol, and opioid medications have commonly been used to relieve back pain for years, but recent studies on effectiveness have surprised doctors by finding little benefit to these medications.

You know what they say about assuming...

Ibuprofen and Tylenol have been assumed to be first-line treatments for back pain, but few doctors or patients knew there has been little research to support their effectiveness. Opioids have similarly been assumed and promoted as a good option for severe back pain, but had not been well researched. Now the studies are out on all three forms of medication, and the results are not good. 

Tylenol no help for back pain recovery

Researchers performed a controlled trial for Tylenol and back pain with over 1500 patients across 235 primary care centers from 2009 to 2013. The use of Tylenol daily and as needed for back pain was compared to placebo pill. The placebo group on average actually recovered slightly quicker than the Tylenol groups. The researchers concluded: "Our findings suggest that regular or as-needed dosing with [Tylenol] does not affect recovery time compared with placebo in low-back pain, and question the universal endorsement of [Tylenol] in this patient group."

Ibuprofen no better than sugar pill

After Tylenol failed to show effectiveness for back pain, researchers reviewed 35 randomised placebo-controlled trials (RCTs) looking for evidence of NSAID (Ibuprofen and others) effectiveness for back pain.  They struck out again. NSAIDs only reduced pain and disability as much as placebo, but provided clinically unimportant effects over placebo. Researchers concluded: "The magnitude of the difference in outcomes between the [NSAIDs] and placebo groups is not clinically important. At present, there are no simple analgesics that provide clinically important effects for spinal pain over placebo."

Opioids = strike three. Little benefit. High Risk.

It's hard to believe the death toll opioids have caused when there hasn't been thorough study of their effectiveness for back pain, but that is the case. Once again, researchers reviewed 20 RCTs of opioid analgesics (with a total of 7925 participants) and 13 trials (3419 participants) evaluating short-term effects on chronic low back pain. There were no RCTs for acute back pain. In half of the 13 trials, at least 50% of participants left the study due to side effects or lack of efficacy, and relief was so little it was "not clinically important." The researchers concluded that those who can tolerate opioids may see a little short-term pain relief, but it is not significant. "Evidence on long-term efficacy is lacking. The efficacy of opioid analgesics in acute low back pain is unknown."

What treatment is best for back pain?

The American College of Physicians (ACP) back pain guidelines recommend first using non-invasive, non-drug treatment like chiropractic spinal manipulation before resorting to drug therapies for pain. Other non-drug treatments like acupuncture, exercise therapy, heat, and massage can also be helpful. These non-drug treatments can be just as effective, and in some cases more effective than medications like Tylenol, Ibuprofen, and opioids without the risks and  dependency. Never start with opioids, and think twice before reaching for Tylenol or Ibuprofen first for pain.

The American College of Physicians (ACP) released the latest guidelines recommending non-drug treatment like chiropractic over opioids and other medications. These guidelines emphasized non-drug treatments to be used first for back pain or injury rather than more commonly used medications, and especially before opioids.

One Ohio Injured Worker dies each week from drugs

With the opioid epidemic raging in Ohio and around the country, the Institute of Medicine (IOM), Federal Drug Administration (FDA), and Center for Disease Control (CDC) have all recommended non-drug treatments to be used to treat pain instead of opioids to end the drug abuse and addiction. More recent studies have even found opioids to be less effective for pain that once believed. This combination of limited benefit and high risk of addiction has lead to an epidemic of overdose deaths around the country, with Ohio as "ground zero."

Try non-drug treatment like chiropractic first for pain

Based on current research, ACP Guidelines note that chiropractic manipulation, exercise therapy, acupuncture, massage, and heat therapy are all preferred treatments that should be tried first before medications. Most back pain will improve well with these measures. The few cases that don't respond may try medications, but injections and surgery is not recommended by the guidelines due to limited benefit for most patients and high risks. Opioids are noted as a last resort that should only be used in addition to non-drug treatment; never used alone.

It won't be easy to change decades of physician and patient habits, reaching for medication first for pain, but this is a step in the right direction. More and more medical guidelines recommend a trial of conservative non-drug treatment like chiropractic first for back pain. This trial should last at least 6 weeks and only emergency cases (severe pain is not an emergency) should consider more invasive treatment or advanced imaging. Next time you're hurting, start with chiropractic or other non-drug treatment first.

An analysis of New York Counties that restricted trans fats in foods (2007-2011) before national restrictions start (in 2018) found a significant reduction in heart problems with less trans fat use.

What are trans fats?

Trans fats largely result from processing that makes liquid oils more solid or shelf stable to keep them from going rancid. Think of margarine, which is manufactured from liquid oils (soy, corn, canola), but made to be solid like butter. The trend away from natural animal fats decades ago resulted in a trend toward highly processed plant oils and increased trans fat consumption. And heart problems have skyrocketed.

Unlike naturally saturated fats, years of evidence has clearly shown increased risk of heart disease and other health problems with consumption of trans fats. No level of trans fats have been found to be safe. Lobbyists have long delayed restrictions on trans fats, but finally the evidence is too great to ignore and national restrictions will start in 2018 (unless there is an effort to delay). This study now shows confirms that restrictions should lower the rate of stroke and heart attacks.

Eat the real stuff: butter, olive oil, coconut oil

Food manufacturers don't give up cheap ingredients easily. They have found other ways to artificially solidify oils through a process called interesterification. Sound yummy? We would recommend you play it safe and eat real fats that humans have enjoyed for thousands of years: butter, olive oil, coconut oil...