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Annual Healthy Georgia Report looks at public health in the Peach State
The fourth edition of the “Healthy Georgia: Our State of Public Health” report has been released by the Institute of Public and Preventive Health in Augusta University’s School of Public Health. Within the 64 pages of the report is a snapshot of how healthy Georgians are compared to citizens across the 12 states that make up the Southeastern Region (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia) and the entire United States. The 2025 edition addresses 31 health topics and has been expanded this year to include multimorbidity; long COVID-19; HIV, chlamydia, gonorrhea and syphilis infection rates; opioid and methamphetamine drug use; suicides; and vaping. Biplab Datta, PhD, assistant professor in the Department of Health Management, Economics, and Policy in SPH, heads up the team of IPPH faculty and staff who create the report each year. Datta credits Jen Jaremski, research associate, and Kit Wooten, public health analyst, with handling much of the work of bringing the report to life. Together, Jaremski and Wooten collected and organized all of the needed assets and organized the 64-page document, preparing it for print and the web. “Every year we strive to present data in a way that policymakers may find helpful in making policy choices,” Datta said. “There are several new topics that were added to this year’s report and some of those are concerning for the state of Georgia, particularly the communicable diseases like HIV, chlamydia, gonorrhea and syphilis. High prevalence rates of these conditions in Georgia, compared to the rest of the U.S. and the Southeastern Region, warrant attention of the public health community.” Georgia has the second-highest rate of HIV infections in the U.S., fourth-highest rates of gonorrhea, sixth-highest for chlamydia and 13th for syphilis. Something that is also new in this year’s report is a comparison of numbers from 2019, or before the COVID-19 pandemic began, compared to after the pandemic for certain conditions. Also coming out of the pandemic, the report looks at how long COVID has affected Georgians, with the state ranking 24th in the nation for rates of long COVID. According to the U.S. Centers for Disease Control and Prevention, long COVID is defined as a chronic condition that occurs after COVID-19 infection and is present for at least three months. On top of looking at comparisons between Georgia and the Southeast and the nation, Datta noted a clearer picture is starting to emerge concerning the difference in urban and rural areas within the state. “For several chronic conditions, like hypertension, diabetes and multimorbidity, we clearly see a striking difference between rural and urban residents of Georgia,” Datta said. Hypertension affects 44.1% of adults in rural Georgia compared to 35% in urban areas, while diabetes affects 17.5% of adults in rural Georgia compared to 12.3% of those in urban areas. Hypertension and diabetes are major risk factors for cardiovascular disease, which affects 12.2% of adults in rural areas compared to 8.3% of adults in urban areas of Georgia. “Hypertension and diabetes are the major risk factors for heart disease, which is the leading cause of death in the U.S. and worldwide, so these are some concerning numbers to see,” Datta said. Multimorbidity, which is when a person has multiple chronic conditions, including obesity, asthma, chronic obstructive pulmonary disease, depression, kidney disease, diabetes, hypertension, high cholesterol, cardiovascular disease, cancer, skin cancer and arthritis, affects 57.4% of adults in rural Georgia compared to 49% of adults in urban areas of the state. These rates are significantly lower than the rest of the Southeast but on par with the rest of the country. When comparing Georgia to the U.S. national average, adults in Georgia have lower rates of cancer and methamphetamine use but higher rates of childhood asthma and adult obesity. At the same time, rates of adult asthma and adult obesity among Georgians were comparable to the averages seen in the Southeast. Interestingly, while adult health insurance coverage was significantly lower than the U.S. national and Southeast Regional averages, the child health insurance coverage in Georgia was comparable to both national and regional averages. The Healthy Georgia Report is the only report of its kind in the state Looking to know more or connect with Biplab Datta, PhD? Then let us help. Dr. Datta is available to speak with media regarding this important topic. Simply click on his icon now to arrange an interview today.
Wilmington Campus Receives $1 Million Donation From the Rocco A. and Mary Abessinio Foundation
ChristianaCare has received a $1 million gift from The Rocco A. and Mary Abessinio Foundation Inc. in support of ChristianaCare’s Wilmington Campus. “All families and communities deserve the excellent care that Wilmington Hospital and ChristianaCare provide,” said Rocco and Mary Abessinio. “It is an honor for our family to support the health and wellbeing of the Wilmington community.” The funds will support areas of greatest need, including the expansion of patient care initiatives aimed at reducing disparities in screening and treatment for cancer and cardiovascular disease in the city of Wilmington. “We are tremendously grateful to the Rocco A. and Mary Abessinio Foundation for their continued, generous support of the Wilmington Campus – a vital resource serving the greater Wilmington community,” said Janice Nevin, M.D., MPH, ChristianaCare president and CEO. “With their help, we are closing gaps in health disparities and improving health for everyone, including some of Delaware’s most vulnerable populations.” The Rocco A. and Mary Abessinio Foundation provided a $1 million gift in 2014 for the redesign and renovation of the health center, which was then named the Rocco A. Abessinio Family Health Center at Wilmington Hospital. The health center is home to three primary care practices and other programs and services that offer high-quality health care, wellness and preventive health visits for people of all ages, regardless of their income or ability to pay. “As a result of the Abessinio family’s longstanding partnership and investment in our mission of service, we are making significant progress in addressing disparities and building strong and healthy communities,” said LeRoi S. Hicks, M.D., MPH, FACP, campus executive director of ChristianaCare’s Wilmington Hospital. A Wilmington landmark in the heart of the city, the ChristianaCare Wilmington Hospital has been serving the diverse medical needs of the city and surrounding region for over 125 years. “Philanthropy is essential to ChristianaCare’s mission of service to our community, and we extend our heartfelt thanks and appreciation to Rocco and Mary Abessinio for their inspiring and visionary philanthropic leadership in support of the Wilmington Campus,” said Dia Williams Adams, MPA, vice president of philanthropy at ChristianaCare. “Their gift is a legacy that not only allows us to increase our ability to make a positive impact on patients and community, but honors the incredible work that our caregivers do every day.” For more information about ways to support ChristianaCare’s mission of service to the community, visit: https://christianacare.org/us/en/make-a-gift.
Healthy Environment, Healthy People: The Intersection Between Climate and Health
How is climate change influencing our health? Why does climate change have a greater impact on vulnerable populations and low-income people? How does the U.S. health care system affect the climate? How can health care systems improve their impact on the climate and the environment? ChristianaCare’s inaugural Climate and Health Conference addressed these topics and raised possible solutions at the John H. Ammon Medical Education Center on the Newark, Delaware, campus on April 12. At the conference, the common denominator was this: An unhealthy environment can lead to illnesses and deaths from air pollution, high heat, contaminated water and extreme weather events. Health systems, government entities, community organizations and individuals all have a role to play in decreasing these effects. “Climate, the environment and health care systems are intertwined,” said Greg O’Neill, MSN, APRN, AGCNS-BC. “We need to pay close attention to this relationship so we can improve health for everyone.” O’Neill is director of Patient & Family Health Education and co-chair of the Environmental Sustainability Caregiver Committee at ChristianaCare. Climate change and intensifying health conditions Negative health effects are so closely tied to the environments where people live, work and play that The Lancet called climate change “the greatest global health threat facing the world in the 21st century [and] the greatest opportunity to redefine the social and environmental determinants of health.” At the conference, speakers addressed specific areas of concern. Asthma. Air pollutants, while largely invisible, are associated with asthma. What’s more, people who live in urban areas with little green space are more likely to have uncontrolled asthma, said speaker Robert Ries, M.D., an emergency medicine resident at ChristianaCare. And there’s the rub, he said: When people with asthma spend time in green spaces, it may improve their health. “In Canada,” he said, “some doctors prescribe nature – two hours a week for better overall health outcomes. Could we do that here?” Heat-related illness. Temperatures worldwide have been rising, increasing the likelihood of heat-related health incidents. Heat waves may be harmful to children and older adults, particularly those who don’t have access to air conditioning, swimming pools or transportation to the beach, said speaker Alan Greenglass, M.D., a retired primary care physician. Children visit the emergency room 20% more frequently during heat waves. Weather-related illness. Climate change is causing more floods, which may result in respiratory problems due to mold growth; and droughts, which may threaten water safety and contribute to global food insecurity, said speaker Anat Feingold, M.D., MPH, an infectious disease specialist at Cooper Health. Stress and anxiety. Climate change can affect mental health, even leading to “solastalgia,” which is distress about environmental change and its effect on one’s home, said speaker Zachary Radcliff, Ph.D., an adolescent psychologist at Nemours. He encouraged clinicians in the audience to keep this mental health concern in mind when seeing patients as it may become more prevalent. Cardiovascular disease risk. Frequent consumption of red meat increases the risk of cardiovascular disease, the top cause of death in the U.S. It’s also unhealthy for the environment, said speaker Shirley Kalwaney, M.D., an internal medicine specialist at Inova. Livestock uses 80% of available farmland to produce only 17% of calories consumed, creating a high level of greenhouse gas emissions. By comparison, plant-based whole foods decrease the risk of cardiovascular disease and diabetes. They use only 16% of available farmland, producing 82% of calories consumed. This makes reducing red meat in our diets one of the most powerful ways to lower the impact on our environment. Health equity and the environment People in low-income communities are more likely to live in urban areas that experience the greatest impacts of climate change, including exposure to air pollutants and little access to green space, said speaker Abby Nerlinger, M.D., a pediatrician for Nemours. A Harvard study in 2020 demonstrated that air pollution was linked with higher death rates from COVID-19 — likely one of the many reasons the pandemic has disproportionally harmed Black and Latino communities. Similarly, access to safe, affordable housing is essential to a healthy environment, said Sarah Stowens, Ed.D., manager of State Policy and Advocacy for ChristianaCare, who advocated for legislation including the Climate Solutions Act, another bill that increased oversight regarding testing and reporting of lead poisoning and a policy to reduce waste from topical medications. Opportunities for change in health care Reduce emissions from pharmaceuticals and chemicals. These emissions are responsible for 18% of a health system’s greenhouse gas emissions. One way to reduce this number is for clinicians to prescribe a dry-powder inhaler (DPI) instead of a metered-dose inhaler (MDI) when applicable and safe for the patient and to give patients any inhalers that were used in the hospital at discharge if they are going home on the same prescription. Hospitals have opportunities to reduce greenhouse gases while caring for patients, said Deanna Benner, MSN, APRN, WHNP, women’s health nurse practitioner and co-chair of ChristianaCare’s Environmental Sustainability Caregiver Committee. The health care sector is responsible for 8.5% of U.S. greenhouse gas emissions, the highest per person in the world. U.S. greenhouse gas emissions account for 27% of the global health care footprint. One way to significantly reduce the carbon footprint is to use fewer anesthetic gases associated with greater greenhouse gas emissions, Benner said. Limit single-use medical devices. Did you know that one surgical procedure may produce more waste than a family of four produces in a week? Elizabeth Cerceo, M.D., director of climate health at Cooper Health, posed this question during her talk. Sterilizing and reusing medical devices, instead of using single-use medical devices, she said, may meaningfully reduce hospital waste. ChristianaCare’s commitment to healthy environments and healthy people As one of the nation’s leading health systems, ChristianaCare is taking a bold, comprehensive approach to environmental stewardship. ChristianaCare reduced its carbon footprint by 37% in 2023 by purchasing emission-free electricity. ChristianaCare joined the White House Climate Pledge to use 100% renewable energy by 2025, reduce greenhouse gas emissions by 50% by 2030 and achieve zero net emissions by 2050. ChristianaCare has created an Environmental, Social and Governance structure to help advance a five-year strategic plan that delivers health equity and environmental stewardship. Nearly 150 staff members have become Eco-Champions, an opportunity to be environmental change-leaders in the workplace. In 2023, ChristianaCare’s successful environmental stewardship included: Reducing our carbon footprint by 37% by purchasing emission-free electricity. Recycling 96,663 pounds of paper, which preserved 11,485 trees. Reducing air pollution by releasing an estimated 33,000 fewer pounds of nitrogen oxides and sulfur oxides through the use of a cogeneration energy plant on the Newark campus. Donating 34,095 pounds of unused food to the Sunday Breakfast Mission in Wilmington, Delaware. Donating 1,575 pounds of unused medical equipment to Project C.U.R.E., ChristianaCare’s Virtual Education and Simulation Training Center and Delaware Technical Community College. “In quality improvement, they say you improve the things that you measure,” O’Neill said in expressing goals for continued success. In looking ahead, said Benner, “I really hope that this conference is the catalyst for positive change with more people understanding how climate is connected to health, so that we can protect health from environmental harms and promote a healthy environment for all people to thrive.”
Managing Menopause: Mind-Body Solutions for Hot Flashes, Sleep and Well-Being
In recognition of World Menopause Day, Baylor psychologist shares research on hypnotherapy's beneficial effects in relieving hot flashes (Image credit: Rana Hamid via Getty Images) The natural aging process of perimenopause and menopause can create a wide range of symptoms for women, with hot flashes and poor sleep being the most frequently reported – and most disruptive – symptoms. World Menopause Day is recognized on Oct. 18, and one Baylor University researcher has been on a 20-year mission to identify safe and effective options to hormone replacement therapy (HRT) to help women find relief from hot flashes and improve sleep and well-being during the menopause transition. Gary Elkins, Ph.D., professor of psychology and neuroscience and director of the Mind-Body Medicine Research Laboratory at Baylor University, is among the nation’s leading researchers on hypnotherapy and mind-body approaches, including continued funding by the National Institutes of Health (NIH) to evaluate the efficacy of a self-hypnosis intervention to reduce hot flashes and improve sleep, as well as other outcomes. “It is important to recognize that hot flashes are a natural part of menopause,” Elkins said. “They are not caused by stress or personality but are due to the decline in estrogen that occurs naturally with aging.” Perimenopause (the hormonal transition leading up to menopause) and menopause (the cessation of menstrual cycles) is the natural aging process marked by the decline in the reproductive hormone estrogen and progesterone in women and can last anywhere from seven to 20 years. Menopause usually begins around age 52 or can result from breast cancer treatment or hysterectomies. Although HRT remains the most effective treatment for hot flashes, it is not appropriate for everyone. A major NIH study found that HRT led to an increased risk of breast cancer and cardiovascular disease in some post-menopausal women and breast cancer survivors. Elkins’ research is aimed at giving women choices for their own healthcare, including alternatives such as hypnotherapy. “While hypnotherapy is not widely understood by many people, it can regulate hot flashes and improve sleep by managing how temperatures are perceived and regulated in the brain,” Elkins said. “Hypnotherapy is a mind-body therapy, similar to mindfulness and guided imagery, that involves the focus of attention, a relaxed state and therapeutic suggestions.” Elkins’ research on hot flashes and sleep and hypnotherapy has been clinically shown to reduce hot flashes by up to 80%, more effective than any other hot flash management tool available, with the exception of HRT. He also has found that hypnotherapy, as a mind-body intervention, can reduce hot flashes to a degree comparable to HRT, improve sleep quality by over 50% and reduce anxiety while increasing well-being. “Hypnotherapy involves daily practice of 15-minute hypnotic relaxation sessions that teach your brain to adapt to your body’s changing hormone level. Mental images for coolness and control are used to empower women to take control of the two most troublesome menopause symptoms – hot flashes and sleep,” Elkins said. Elkins offers the following suggestions for women to empower them and help them find relief from hot flashes, anxiety and interrupted sleep. Remember that hot flashes are a normal part of the perimenopausal/menopausal transition, and the effects a woman experiences are real. Talk to your doctor about options that may work for you. Everyone is an individual, and it is important to find what works best for you. A combined approach of mind-body hypnosis therapy along with low-dose medications can be helpful for some women. It can be helpful to keep a daily diary of your hot flashes to monitor them. Get good sleep. Poor sleep and night sweats can make hot flashes worse. Be knowledgeable about things that have not been shown to work, such as fans, cold packs and certain herbs. Seek support from family and friends. Elkins has developed the Evia from Mindset Health App to give women easy access to hypnotherapy for hot flashes. The app comes with a free trial that delivers evidence-based hypnotherapy intervention for women during the menopause transition and beyond.
Are butter boards bad for you? An expert view on the latest food trend
In an unexpected twist, butter seems to be back on the menu. After years of being a maligned ingredient that many people shied away from, butter has now become the latest food trend on social media, thanks to the recent popularity of “butter boards”. These are sort of the meat-free equivalent of a charcuterie board. Butter is whipped then spread onto a chopping board, sprinkled with a variety of toppings – from sweet to savoury – and served with an accompaniment of choice (such as bread or a toasted baguette). But although they may be delicious, butter is still full of saturated fat – which many of us know can be harmful to our health. Here’s what you may want to consider before whipping up a butter board of your own. Is butter really that bad? Butter is made from cream, the fat-rich part of milk. While it’s usually made from cow’s milk, it can also be made from other milks such as goat milk. The reason that butter has been seen as a no-go for so many years is because it’s one of the ultimate sources of saturated fat. Butter contains around 80% fat, of which about two-thirds is saturated fat. It contains little else nutrient-wise. Saturated fats should be avoided in large amounts as they’re linked with many health problems, including heart disease and shorter life expectancy. Clinical trials have also shown that saturated fats can have an negative effects on blood cholesterol levels. When it comes to butter on its own, it appears that eating it has a relatively small or neutral effect on the risk of heart disease. But research that compared butter to olive oil (another source of saturated fat) found that butter can increase levels of LDL cholesterol, which is sometimes called “bad” cholesterol as it’s linked to greater risk of heart disease. But the majority of the butter many of us consume in our diets comes from other foods such as biscuits, cakes and pastries. Alongside butter, these foods tend also to contain high amounts of sugar, while being low in other nutrients. High intakes of these types of foods is also linked with greater risk of heart disease. Overall, sharing a butter board with friends every now and then is unlikely to cause much harm to your health. But doing it often, or eating very large quantities, could raise cholesterol levels and increase your risk of cardiovascular disease somewhat. It’s also worth bearing in mind what toppings you serve your butter board with. Certain foods (such as processed or cured meats) also contain saturated fats, and should only be enjoyed occasionally. Butter alternatives Since butter is very calorific and fat-rich, some people may want to look at using butter alternatives for the base of their butter board. The first substitute many people might look to is margarine. Margarine is chemically very similar to butter. Depending on the product though, it only contains around 40%-70% fat, making it a lighter alternative with a possibly similar taste. In the past, the processes needed to make margarine solid resulted in the production of trans fats, which have been linked to increased risk of heart disease. But these processes have since been improved so margarine no longer contain trans fat. So it may be a good option for people wary of the amount of fat they consume. Another alternative people may look at using is ghee, also sometimes known as clarified butter. A staple of Indian cooking, this is still made from milk, but the fat is much more concentrated as most of the water has been simmered away. This means it won’t have the same creamy texture as butter. Grass-fed ghee is as rich in saturated fats as butter. It also contains naturally produced trans fats. However, these trans fats are different to the industrially produced types which are bad for our health. But since ghee contains more calories than butter, it may not be the best choice for a butter board, especially if you’re looking for the best flavour. Cultured butter may also be a choice for your butter board. This is made from cream which has been fermented like yoghurt. However, no research to date has looked at whether the probiotics in cultured butter provide the same health benefits as those in yoghurt and other fermented foods. Nutrition-wise, it contains the same amount of fat and calories as regular butter. All in all, butter is not bad. But since it’s very high in calories and cholesterol, you may want to try not to have too much. Sharing a butter board with some friends or loved ones every now and again is unlikely to have any long-term negative impact on your health.
Researchers in Georgia Southern University’s Tactical Athlete Readiness and Preparedness Program (TARP) have teamed up with the Georgia Public Safety Training Center (GPSTC) to ensure the readiness and resilience of Georgia’s public safety officials. Members of the TARP in the Waters College of Health Professions have worked to revise the fitness training standards for Georgia’s police cadets with a focus on functional fitness, mental resilience and injury prevention. In addition, the program has formed a partnership with the GPSTC, Georgia’s premier training facility for all state and local public safety related units to include police, fire and communication. Bridget Melton, Ed.D., professor of exercise science and lead faculty member of TARP, said that due to high stress and health concerns, some police and public safety officials are at high risk for cardiovascular disease or other fatal illnesses. “Our program provides state academies with fitness exercises that increase overall cadet fitness and focuses on injury prevention,” said Melton. “Our program focuses on occupational focused fitness to hopefully encourage a more positive view of exercise that will stick with cadets even after their academy training is done.” Richard Cleveland, Ed.D., associate professor of leadership, technology and human development, heads resilience and mental health for the TARP team, and has created a Mindfulness-Based Tactical Instruction curriculum for the state of Georgia. “Tactical athletes need training and support for resilience and mental health, but too often it’s only presented as a one-time workshop or seminar,” said Cleveland. “Our program dovetails into the state’s resilience curriculum for officers, but provides ‘bite-sized’ mindfulness practices within the fitness program. This gives cadets repeated practice at using mindfulness and embeds it within their context using police language, actions and behaviors.” The partnership was made possible due to a subgrant GPSTC was awarded from the Criminal Justice Coordinating Council to fund TARP at their facilities due to the program’s comprehensive view of officer wellness, which is aimed at improving de-escalation skills among recruits through mental and physical training. “We are pleased to form a partnership with the GPSTC and the Tactical Athlete Readiness and Preparedness Program,” stated Chris Wigginton, director of GPSTC. “This partnership will allow public safety professionals to be better prepared in their personal and professional lives. Some of the many benefits will be a reduction in injuries, being better prepared to use needed skills in rapidly evolving situations, and the resiliency and mental health component. As word has gotten out of the possibility of the GPSTC implementing this program we have already been contacted by several states regarding the initiative.” Additionally, graduate students in the Department of Health Sciences and Kinesiology participate in the program and gain firsthand and practical experience by performing training and assessment for state instructors. TARP is part of Georgia Southern’s Tactical Athlete Initiative, which aims to reduce the number of injuries and increase readiness and preparedness of tactical athletes. The interdisciplinary team consists of the following Georgia Southern faculty members: • Bridget Melton, Ed.D., Professor • Richard Cleveland, Ed.D., Associate Professor • Greg Grosicki, Ph.D., Assistant Professor • Haresh Rochani, DrPH, Associate Professor • Mary Beth Yarbrough, Lecturer • Sarah Davis, Lecturer TARP is just one example of the work coming from Georgia Southern University’s Tactical Athlete Initiative. The Tactical Athlete Initiative is a multi-discipline collaboration providing research, training and support for military, police, fire and EMS workers. The Tactical Athlete Initiative has partnered with multiple agencies including the Statesboro Police Department, Statesboro Fire Department, Bulloch County Sheriff’s Office, Forsyth County Sheriff’s Office, Waycross Fire Department, Georgia Public Safety Training Centers, Federal Law Enforcement Training Centers and the United States Army. If you're a reporter looking to know more about this partnership at Georgia Southern University - the let us help. Richard Cleveland, Ph.D., is an assistant professor in the Department of Leadership, Technology & Human Development at Georgia Southern - simply click on his icon to get in touch or contact Georgia Southern Director of Communications Jennifer Wise at jwise@georgiasouthern.edu to arrange an interview today.
Lecturer Carol Jordan, left, and student Anna Bryan assist with a vitamin D assay as part of a study on racial disparities and cardiovascular health. Researchers in the Waters College of Health Professions (WCHP) at Georgia Southern University are studying why Black adults in America are 30% more likely to die from cardiovascular disease (CVD) than white adults through a study on racial disparities and cardiovascular health. Faculty and graduate students in the University’s Biodynamics and Human Performance Center and Medical Laboratory Sciences program have teamed up to examine the biological basis for these racial differences to aid in the development of effective prevention and treatment strategies. “More than half of this racial disparity may be attributed to substantially greater rates of high blood pressure and vascular dysfunction in Black adults,” said Greg Grosicki, Ph.D., principal investigator on the study and assistant professor in WCHP). The team is examining the difference in skin pigmentation, which can influence cardio preventive vitamin D levels. Through the use of an enzyme-linked immunosorbent assay (ELISA), a biochemical test to measure antibodies, antigens, proteins and glycoproteins in biological samples, the team is able to measure vitamin D levels in plasma samples. By pairing vitamin D values with measures of skin pigmentation and the team’s comprehensive assessments of cardiovascular health, they are able to determine whether low vitamin D levels may be contributing to higher blood pressure and vascular dysfunction in Black adults, which will help inform future interventions and therapeutic strategies seeking to alleviate racial disparities in CVD. The ELISAs were purchased using a Graduate Student Organization grant awarded to Josiah Frederic, a graduate student studying sports medicine. The research team consists of both faculty and students from the Department of Health Sciences and Kinesiology as well as the Department of Diagnostic and Therapeutic Sciences. Team members include the following: Brett Cross, graduate sports medicine student Joe Vondrasek, graduate sports medicine student Josiah Frederic, graduate sports medicine student Zoe Lincoln, undergraduate health science student Peter Gaither, graduate sports medicine student Wesley Blumenburg, graduate sports medicine student Andrew Flatt, Ph.D., assistant professor Greg Grosicki, Ph.D., principal investigator and assistant professor Amy Frazier, lecturer Carol Jordan, clinical coordinator and senior lecturer Anna Bryan, undergraduate medical laboratory sciences student If you're a reporter looking to know more about this important research - then let us help. Greg Grosicki, Ph.D., is available to speak with media - simply reach out to Georgia Southern Director of Communications Jennifer Wise at jwise@georgiasouthern.edu to arrange an interview today.
Sweeteners may be linked to increased cancer risk – new research
Sweeteners have long been suggested to be bad for our health. Studies have linked consuming too many sweeteners with conditions such as obesity, type 2 diabetes and cardiovascular disease. But links with cancer have been less certain. An artificial sweetener, called cyclamate, that was sold in the US in the 1970s was shown to increase bladder cancer in rats. However, human physiology is very different from rats, and observational studies failed to find a link between the sweetener and cancer risk in humans. Despite this, the media continued to report a link between sweeteners and cancer. But now, a study published in PLOS Medicine which looked at over 100,000 people, has shown that those who consume high levels of some sweeteners have a small increase in their risk of developing certain types of cancer. To assess their intake of artificial sweeteners, the researchers asked the participants to keep a food diary. Around half of the participants were followed for more than eight years. The study reported that aspartame and acesulfame K, in particular, were associated with increased cancer risk – especially breast and obesity-related cancers, such as colorectal, stomach and prostate cancers. This suggests that removing some types of sweeteners from your diet may reduce the risk of cancer. Cancer risk Many common foods contain sweeteners. These food additives mimic the effect of sugar on our taste receptors, providing intense sweetness with no or very few calories. Some sweeteners occur naturally (such as stevia or yacon syrup). Others, such as aspartame, are artificial. Although they have few or no calories, sweeteners still have an effect on our health. For example, aspartame turns into formaldehyde (a known carcinogen) when the body digests it. This could potentially see it accumulate in cells and cause them to become cancerous. Our cells are hard-wired to self-destruct when they become cancerous. But aspartame has been shown to “switch off” the genes that tell cancer cells to do this. Other sweeteners, including sucralose and saccharin, have also been shown to damage DNA, which can lead to cancer. But this has only been shown in cells in a dish rather than in a living organism. Sweeteners can also have a profound effect on the bacteria that live in our gut. Changing the bacteria in the gut can impair the immune system, which could mean they no longer identify and remove cancerous cells. But it’s still unclear from these animal and cell-based experiments precisely how sweeteners initiate or support cancerous changes to cells. Many of these experiments would also be difficult to apply to humans because the amount of sweetener was given at much higher doses than a human would ever consume. The results from previous research studies are limited, largely because most studies on this subject have only observed the effect of consuming sweeteners without comparing against a group that hasn’t consumed any sweeteners. A recent systematic review of almost 600,000 participants even concluded there was limited evidence to suggest heavy consumption of artificial sweeteners may increase the risk of certain cancers. A review in the BMJ came to a similar conclusion. Although the findings of this recent study certainly warrant further research, it’s important to acknowledge the study’s limitations. First, food diaries can be unreliable because people aren’t always honest about what they eat or they may forget what they have consumed. Although this study collected food diaries every six months, there’s still a risk people weren’t always accurately recording what they were eating and drinking. Though the researchers partially mitigated this risk by having participants take photos of the food they ate, people still might not have included all the foods they ate. Based on current evidence, it’s generally agreed that using artificial sweeteners is associated with increased body weight – though researchers aren’t quite certain whether sweeteners directly cause this to happen. Although this recent study took people’s body mass index into account, it’s possible that changes in body fat may have contributed to the development of many of these types of cancers – not necessarily the sweeteners themselves. Finally, the risk of developing cancer in those who consumed the highest levels of artificial sweeteners compared with those who consumed the lowest amounts was modest – with only at 13% higher relative risk of developing cancer in the study period. So although people who consumed the highest amounts of sweetener had an increased risk of developing cancer, this was still only slightly higher than those with the lowest intake. While the link between sweetener use and diseases, including cancer, is still controversial, it’s important to note that not all sweeteners are equal. While sweeteners such as aspartame and saccharin may be associated with ill health, not all sweeteners are. Stevia, produced from the Stevia rebaudiana plant, has been reported to be useful in controlling diabetes and body weight, and may also lower blood pressure. The naturally occurring sugar alcohol, xylitol, may also support the immune system and digestion. Both stevia and xylitol have also been shown to protect from tooth decay, possibly because they kill bad oral bacteria. So the important choice may be not the amount of sweetener you eat but the type you use.
Melatonin’s role in protecting the heart – the evidence so far
Many people know of melatonin as the sleep hormone – and, indeed, that’s what most of the research on melatonin has focused on. However, melatonin is also an antioxidant, protecting cells from harmful “free radicals” that can damage DNA – and this includes protecting cells in the heart and blood vessels. Given that heart disease is the leading cause of death in the world, killing around 17.9 million people each year, this action is of particular interest to researchers. Research shows that people with cardiovascular disease have lower levels of melatonin in their blood compared with healthy people. And there is a strong inverse relationship between melatonin levels and cardiovascular disease. In other words, the lower a person’s melatonin level, the higher their risk of cardiovascular disease. Melatonin supplements (2.5mg taken one hour before sleep) have been shown to reduce blood pressure. And, of course, high blood pressure (hypertension) is a known risk factor for cardiovascular disease. Also, so-called cardiovascular events, including heart attacks and sudden cardiac death (unexpected death caused by a change in heart rhythm), occur at a higher rate in the early morning when melatonin is at its lowest. These studies strongly suggest that melatonin protects the heart and blood vessels. Importantly, patients who have had a heart attack have reduced nighttime melatonin levels. This observation has led to the theory that melatonin may be able to improve recovery from a heart attack and form part of the standard treatment given immediately after a heart attack occurs. Laboratory studies of heart attack (using rats’ hearts kept alive outside of their bodies) have shown that melatonin does indeed protect the heart from damage after a heart attack. Similar studies have shown that when rats’ hearts are deprived of oxygen, as occurs in a heart attack, providing the heart with melatonin had a protective effect. Evidence less certain in people In humans, the evidence is less clear. A large trial where melatonin was injected into patients’ hearts after a heart attack showed no beneficial effects. A later analysis of the same data suggested that melatonin reduced the size of damage caused to the heart by being starved of oxygen during a heart attack. And a similar clinical trial suggested no beneficial effects of giving melatonin to people who had suffered a heart attack. So the evidence is contradictory and no clear picture of melatonin’s role in helping to prevent damage to the heart during a heart attack has emerged so far. It has been suggested that giving melatonin orally after a heart attack, rather than directly to the heart, could explain the contradictory findings in clinical trials. Trials looking at the effect of melatonin on heart attack are still in the relatively early stages, and it is clear further studies are needed to look at how and when melatonin could be administered after a heart attack. However, it is clear that melatonin levels decline as we get older, and this may lead to an increased risk of heart disease. As melatonin pills are only available on prescription in the UK, EU and Australia, melatonin levels can’t be topped up with a supplement – as can be done with other hormones, such as vitamin D. Ultimately, eating a diet that contains foods rich in melatonin, such as milk, eggs, grapes, walnuts and grains, may help protect you from cardiovascular disease. Melatonin is also found in wine, and some suggest that this may explain red wine’s heart-protective effects.
Ray A. Blackwell, M.D., MJ, chief of Cardiac Surgery and the W. Samuel Carpenter, III, Distinguished Chair of Cardiovascular Surgery at ChristianaCare, received the 2021 Tilton Award from the Medical Society of Delaware on Oct. 28 at the Tilton Mansion, now the University & Whist Club in Wilmington, Del. The award recognizes Dr. Blackwell as a pre-eminent cardiac surgeon the past 21 years and for his life-long commitment to service for the betterment of patients, the local community and the nation. The award is named for James Tilton, M.D., the first U.S. Army Surgeon General of the United States and the first president of the Medical Society of Delaware. “Dr. Blackwell is an outstanding choice for this prestigious award,” said Kirk Garratt, M.D., medical director of ChristianaCare’s Center for Heart & Vascular Health. “He has given a great deal to his patients, his colleagues and his profession. His strong leadership and clinical expertise have led to optimal health and an exceptional experience for many patients in our community. In addition to being an excellent surgeon, Dr. Blackwell has been dedicated to driving innovations that improve patient outcomes and has been committed to finding ways of keeping patients healthy and preventing cardiovascular disease.” Since joining ChristianaCare in 1996, Dr. Blackwell has been recognized among the top cardiac physicians in our region and has been instrumental to the development of the cardiac surgery program. In 2011, he became the surgical director of the Mechanical Circulatory Support Program and led the initiative to establish Christiana Care’s Ventricular Assist Device Program. In 2017 he was named Chief of Cardiac Surgery and has since led the health system’s team of highly skilled and experienced heart surgeons who perform more than 700 heart surgeries each year. Dr. Blackwell is a clinical assistant professor of Surgery at Sidney Kimmel Medical College of Thomas Jefferson University. He served as the chair of ChristianaCare’s Blood Pressure Ambassador Advisory Committee. Dr. Blackwell has dedicated his life to service of others, especially on behalf of underprivileged and underrepresented people. As a high school student, he participated in A Better Chance Program, which places underprivileged, underrepresented and underfunded students in better academic environments. He is still active with the organization. He also served on the minority admissions subcommittee and later became a regional recruiter for Dartmouth College and Dartmouth Medical School. In 2019, he received a lifetime achievement award as part of a Dartmouth College celebration, “Standing at the Threshold,” honoring Dr. Martin Luther King Jr. Dr. Blackwell also received the Raising Kings award in 2018 from the One Village Alliance, an agency dedicated to elevating positive images and setting high expectations for Wilmington’s Black men and boys, He is a regional alumni council member of National Medical Fellowships, which funds underrepresented and underfunded medical students and is co-founder of the Association of Black Cardiovascular and Thoracic Surgeons, which supports and develops upcoming and practicing cardiothoracic surgeons. He has also held numerous leadership board positions for Delaware organizations, including the Delaware Medical Education Foundation, the Delaware Board of Medical Licensure and Discipline, the New Castle County and Great Rivers Affiliate Boards of Directors for the American Heart Association. He is also a board member of the Friends of Hockessin Colored School 107C and Indoor Track Delaware. Dr. Blackwell is also a recipient of the James H. Gilliam, Jr. Award from the American Heart Association for his contributions to the health, welfare and benefit of the community.