Category Archives: Health and Wellness

Common Myths

Are Melatonin Supplements Effective Sleep Aids?

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Platform bed and nightstand with lamp.

IMG via University of Michigan School of Public Health 

With all the distractions in our lives, falling asleep can be difficult. Especially with our phones and other devices stimulating us at all hours, it is easy to derail our natural sleep cycles. While sleeping pills are prescribed carefully in select circumstances, over-the-counter sleep aids like sedating antihistamines (Benadryl) and melatonin are also available (1,2). In particular, melatonin, a hormone that controls the sleep-wake cycle, has grown in popularity. Now, children and adults alike have started to include melatonin gummies in their nighttime routines (3). But should we think twice about the effectiveness of melatonin supplements as sleep aids? Are there any downsides to regular or long-term use? Should we prioritize healthy sleep habits and attention to our mental health?  

Melatonin is produced in the pineal gland of the brain and regulates circadian rhythm, or the cycle of alertness and sleepiness resulting from light changes in the environment (4,5). Melatonin production is highest when the environment is dark and decreases as the environment becomes lighter. This means that melatonin production can be hindered if light exposure is too high at night, leading to difficulty falling asleep (6). Melatonin supplements function by regulating patterns of sleepiness, although the exact role of melatonin is not known.  

Three systematic reviews with meta-analysis found that melatonin supplements lowered sleep latency (the time it takes to fall asleep) and improved sleep quality better than placebos (7). Additionally, these reviews found that melatonin supplements increased total sleep time (8), and improved sleep quality based on a sleep quality assessment, except in subjects with mental health disorders or neurodegenerative diseases (9).  

There are some concerns about potential downsides of long-term melatonin use in children (10). One study of 69 young adults with chronic sleep-onset insomnia during childhood found no differences in sleep quality between people that used melatonin for a mean of 11 years and people that did not use melatonin (11). While this finding may alleviate concerns about the safety of long-term melatonin use, it also questions the efficacy of melatonin since young adults did not experience significantly improved sleep quality in later life related to melatonin use.  

While the use of melatonin is associated with some sleep benefits more information is needed regarding the degree of benefit and potential harms. If you’re considering melatonin, it may be wise to attend to healthy sleep habits, such as limiting caffeine intake and avoiding use of electronic devices and blue light prior to sleep, and also prioritize alleviation of any feelings of despair or anxiety.   

References:

1. Mayo Clinic Staff. Prescription Sleeping Pills: What’s Right for You? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/art-20043959

2. Mayo Clinic Staff. Sleep Aids: Understand Options Sold Without a Prescription. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep-aids/art-20047860

3. Fliesler, Nancy. Melatonin for kids: Is it safe? Is it effective? Boston Children’s Hospital. 13 June 2022. https://answers.childrenshospital.org/melatonin-for-children/

4. Zisapel N. New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation. Br J Pharmacol. 2018;175(16):3190-3199. doi:10.1111/bph.14116

5. Reddy S, Reddy V, Sharma S. Physiology, Circadian Rhythm. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519507/

6. Melatonin: What You Need to Know. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know

7. Li T, Jiang S, Han M, et al. Exogenous melatonin as a treatment for secondary sleep disorders: A systematic review and meta-analysis. Front Neuroendocrinol. 2019;52:22-28. doi:10.1016/j.yfrne.2018.06.004

8. Chan V, Lo K. Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis. Postgrad Med J. 2022;98(1158):285-293. doi:10.1136/postgradmedj-2020-139319

9. Fatemeh G, Sajjad M, Niloufar R, Neda S, Leila S, Khadijeh M. Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. J Neurol. 2022;269(1):205-216. doi:10.1007/s00415-020-10381-w

10. Van de Walle, Gavin. “What does melatonin do, and how does it work?” Healthline. January 13, 2023. https://www.healthline.com/nutrition/melatonin-and-sleep#other-benefits

11. Zwart TC, Smits MG, Egberts TCG, Rademaker CMA, van Geijlswijk IM. Long-Term Melatonin Therapy for Adolescents and Young Adults with Chronic Sleep Onset Insomnia and Late Melatonin Onset: Evaluation of Sleep Quality, Chronotype, and Lifestyle Factors Compared to Age-Related Randomly Selected Population Cohorts. Healthcare (Basel). 2018;6(1):23. Published 2018 Mar 2. doi:10.3390/healthcare6010023

12. https://sph.umich.edu/pursuit/2020posts/why-sleep-is-so-important-to-your-health.html

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Is carbonated water as healthy as regular water?

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Is carbonated water as good for you as regular water? - National | Globalnews.ca

IMG via Global News 

Some say that carbonation in water may limit hydration, reduce gastrointestinal symptoms, and increase satiety. But let’s think twice about those claims.   

Regarding hydration, a randomized trial found no difference in urine volume after consumption of still water compared to sparkling water (1).  

Regarding gastrointestinal health, a small (21 subjects) double-blind randomized trial found fewer symptoms of indigestion with carbonated water compared to tap water (2). Another double-blind study of 40 elderly people found fewer symptoms of constipation among people who consumed carbonated water compared to those who drank still water (3). One question about both of these studies is how blinding was accomplished, since subjects can sense carbonation. The small number of study subjects decreases confidence in each experiment.  

It is also speculated that carbonated water can improve satiety, or sense of fullness. Two very small uncontrolled studies reported that people felt satiated after drinking carbonated water (4,5). But that might be the case for still water as well. There is also no good evidence that sparkling water can cause gas and bloating (6) and no evidence that it erodes tooth enamel, even though these symptoms have been reported anecdotally (7).  

While experimental evidence from randomized controlled trials is required to determine the relative health benefits of still and sparkling water, it is a good option for hydration, particularly compared to sugary drinks.  

References:

  1. Maughan RJ, Watson P, Cordery PA, et al. A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. Am J Clin Nutr. 2016;103(3):717-723. doi:10.3945/ajcn.115.114769 
  2. Cuomo R, Grasso R, Sarnelli G, et al. Effects of carbonated water on functional dyspepsia and constipation. Eur J Gastroenterol Hepatol. 2002;14(9):991-999. doi:10.1097/00042737-200209000-00010 
  3. Mun JH, Jun SS. J Korean Acad Nurs. 2011;41(2):269-275. doi:10.4040/jkan.2011.41.2.269 
  4. Suzuki M, Mura E, Taniguchi A, Moritani T, Nagai N. Oral Carbonation Attenuates Feeling of Hunger and Gastric Myoelectrical Activity in Young Women. J Nutr Sci Vitaminol (Tokyo). 2017;63(3):186-192. doi:10.3177/jnsv.63.186 
  5. Wakisaka S, Nagai H, Mura E, Matsumoto T, Moritani T, Nagai N. The effects of carbonated water upon gastric and cardiac activities and fullness in healthy young women. J Nutr Sci Vitaminol (Tokyo). 2012;58(5):333-338. doi:10.3177/jnsv.58.333 
  6. Welstead L, Schuchmann C. Is sparkling water good for you? What about hard water? University of Chicago Medicine. 10 May 2023. 
  7. Parry J, Shaw L, Arnaud MJ, Smith AJ. Investigation of mineral waters and soft drinks in relation to dental erosion. J Oral Rehabil. 2001;28(8):766-772. doi:10.1046/j.1365-2842.2001.00795.x 
  8. https://globalnews.ca/news/4286475/is-carbonated-water-good-for-you/

 

Uncategorized

Is Dark Chocolate Good for You?

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bigstock-Delicious-dark-chocolate-bar-i-15054239

IMG via Moorings Park Communities 

Sweets are tasty, but refined sugar shouldn’t comprise a large part of our diet. Dark chocolate is promoted as a sweet with relative health benefits. Let’s think twice: what’s the evidence that dark chocolate is good for you? 

One of the potential benefits of dark chocolate is its relatively high content of antioxidants. Antioxidants can neutralize the free radicals (molecules that can damage cells) produced during natural metabolic processes, or when we are exposed to smoke, radiation, or other carcinogens (1). It is proposed that ingesting antioxidants can help protect against cardiovascular disease and cognitive decline (2,3).  

The idea that flavanols, the antioxidant agents in dark chocolate, reduce rates of cognitive decline has no support from adequately controlled and randomized experiments (4). The quality of the evidence used to support the claim that flavanols delay cognitive decline is low, such as uncontrolled cohort studies. For example, a study of just 17 participants claimed flavanols increase blood flow to the brain (an indirect outcome) (5).  

A large randomized trial with no placebo arm studied antioxidant supplementation beginning in 1998 and found that cognitive function was perhaps marginally improved over an 18-year period (6). But a placebo-controlled trial found that antioxidant-containing supplements did not protect against dementia (7). As is often the case, better quality evidence often contradicts the findings of less rigorous studies.   

Another claim for antioxidants is that they protect against cardiovascular disease. However, several large studies have shown no difference in cardiovascular outcomes between people taking antioxidant supplements and those taking placebos (8,9). After a careful look, it is questionable whether dark chocolate provides protection against cognitive decline or cardiovascular disease. However, that’s not to say it isn’t still a satisfying sweet! 

References:

  1. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4(8):118-126. doi:10.4103/0973-7847.70902 
  2. A flavanol-rich diet may increase brain function. Harvard Health Publishing and Harvard Medical School. March 1, 2021. Accessed July 15, 2023. https://www.health.harvard.edu/mind-and-mood/a-flavanol-rich-diet-may-increase-brain-function 
  3. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4(8):118-126. doi:10.4103/0973-7847.70902 
  4. A flavanol-rich diet may increase brain function. Harvard Health Publishing and Harvard Medical School. March 1, 2021. Accessed July 15, 2023. https://www.health.harvard.edu/mind-and-mood/a-flavanol-rich-diet-may-increase-brain-function 
  5. Ullah A, Munir S, Badshah SL, et al. Important Flavonoids and Their Role as a Therapeutic Agent. Molecules. 2020;25(22):5243. Published 2020 Nov 11. doi:10.3390/molecules25225243 
  6. Panche AN, Diwan AD, Chandra SR. Flavonoids: an overview. J Nutr Sci. 2016;5:e47. Published 2016 Dec 29. doi:10.1017/jns.2016.41 
  7. Gratton, G., Weaver, S.R., Burley, C.V. et al. Dietary flavanols improve cerebral cortical oxygenation and cognition in healthy adults. Sci Rep 10, 19409 (2020). https://doi.org/10.1038/s41598-020-76160-9 
  8. Grodstein F, Kang JH, Glynn RJ, Cook NR, Gaziano JM. A Randomized Trial of Beta Carotene Supplementation and Cognitive Function in Men: The Physicians’ Health Study II. Arch Intern Med. 2007;167(20):2184–2190. doi:10.1001/archinte.167.20.2184 
  9. Kryscio RJ, Abner EL, Caban-Holt A, et al. Association of Antioxidant Supplement Use and Dementia in the Prevention of Alzheimer’s Disease by Vitamin E and Selenium Trial (PREADViSE). JAMA Neurol. 2017;74(5):567–573. doi:10.1001/jamaneurol.2016.5778 
  10. Hennekens C., et al. Lack of Effect of Long-Term Supplementation with Beta Carotene on the Incidence of Malignant Neoplasms and Cardiovascular Disease. New England Journal of Medicine. 1996; 334:1145-1149. DOI: 10.1056/NEJM199605023341801 
  11. Lee I, Cook NR, Gaziano JM, et al. Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer: The Women’s Health Study: A Randomized Controlled Trial. JAMA. 2005;294(1):56–65. doi:10.1001/jama.294.1.56 
  12. https://www.mooringspark.org/news/the-health-benefits-of-dark-chocolate