Peak season for sore throats lingers on, here are the causes

by Tim Ditman
OSF Healthcare

---

Temperatures may be warming, but Awad Alyami, MD, an OSF HealthCare pediatrician, says we’re still in the peak season for sore throats. Many cases have time-tested treatments, but some can have serious complications.

Dr. Awad Alyami

---

Dr. Alyami says a sore throat is an infection that causes inflammation in your throat. They’re annoying and painful, bringing symptoms like difficulty swallowing or talking and swelling of glands and tonsils. Causes can include tonsil stones, heartburn and allergies. But most commonly, causes break down into two groups: viral and bacterial.

Viral infections

Dr. Alyami says many viruses can cause sore throats – the common cold, influenza, coronavirus and others. Dr. Alyami says if your sore throat comes with coughing or a runny nose, that’s a sign it’s a viral infection. You can start treatment at home with over-the-counter medicine like Tylenol and ibuprofen. You can also gargle salt water and, generally, stay hydrated. Water is good for all ages, and Pedialyte can help hydrate kids.

If your symptoms include fever and neck swelling, it’s a more serious situation. You should see a health care provider.

Bacterial infections

The main bacterial infection that causes sore throats is group A streptococcus (commonly known as strep or strep throat). Strep throat may bring the hallmark sore throat symptoms, but you should also watch for fever and white patches toward the back of your mouth.

“This is a bacterial infection that’s common in kids,” Dr. Alyami says of strep throat. “About 30% of sore throats are strep, and about 70% are viral. It’s a big deal. We need to treat to prevent complications.”

The most common complication is dehydration, Dr. Alyami says.

“The sore throat is so bad, the child doesn’t want to eat or drink,” he explains.

Other times, untreated strep throat can lead to abscesses, or pus pockets.

“If that abscess gets big enough, it can go toward other structures in the body that are very important. That infection can spread and progress very quickly,” Dr. Alyami says. Life-threatening conditions like difficulty breathing can result.

Dr. Alyami says providers can diagnose strep throat with a throat swab. They treat strep throat with 10 days of antibiotic medication, either injected or taken orally. He says most kids will take the medicine orally unless that’s troublesome. For example, some kids have a tough time swallowing pills due to throat pain.

Prevention

It’s advice you’ve heard before, but it’s worth repeating. Dr. Alyami says good hand hygiene goes a long way to preventing sore throats. Wash your hands thoroughly, and keep them away from your face.

Early detection is also key.

“If the child is sick, especially with symptoms that could be strep, it’s better to get them to a health care professional early,” Dr. Alyami implores. “They can get checked and isolated for 12 to 24 hours before they start antibiotics.

“If you’re sure about what they have, it’s better to just bring them in and get them checked,” he adds.

---

Show host Wendy Williams diagnosed with FTD, aphasia

by Tim Ditman
OSF Healthcare

---

PEORIA - Roughly in one year's time, two major names in Hollywood received a similar diagnosis of frontotemporal dementia (FTD) and aphasia.

In February 2024, actor Bruce Willis’ family announced his aphasia diagnosis had progressed into FTD. In February 2024, former talk show host Wendy Williams' care team announced the same.

“In 2023, after undergoing a battery of medical tests, Wendy was officially diagnosed with primary progressive aphasia and frontotemporal dementia (FTD). Aphasia, a condition affecting language and communication abilities, and frontotemporal dementia, a progressive disorder impacting behavior and cognitive functions, have already presented significant hurdles in Wendy's life,” her care team released in a statement.

Williams is most well-known for “The Wendy Williams Show." Before that, she was a radio host in Philadelphia and New York City.

FTD affects between 50,000-60,000 Americans. Most patients are between 45-65 years old, according to the Alzheimer’s Association.

Dr. Deepak Nair

---

The disease is progressive, meaning symptoms get worse over time. Dr. Deepak Nair, a neurologist with OSF HealthCare Illinois Neurological Institute, says while someone might not die as a result of FTD, it can lead to other health problems that do cause death. He calls the brain and nervous system the “master control” over every other organ system.

"It's sort of like what happened in the COVID era. People are talking about 'are the people dying from COVID or with COVID?' Same problem. When people die with dementia, there's a lot of other things that can lead to their death. But the processes of dementia, over time, will start to affect other organ systems. In that sense, any of the known dementias will ultimately lead to death from another reason, though,” Dr. Nair says.

Dr. Nair says his team works with speech language pathologists to help detect subtle cognitive impairment or to confirm the presence of aphasia.

Are they able to name objects? Can they repeat phrases or sentences? He says Bruce Willis’ family opening up about his diagnosis could help other families.

"Having this discussed publicly is a powerful thing. People are now going to pay attention to this,” Dr. Nair says. “I'm sure there are a lot of Google searches about FTD and aphasia. Some increase in public awareness is a huge benefit to all of us."

Dr. Nair says there hasn’t been any conclusive research showing a direct correlation between prior injuries causing FTD.

In March 2022, Willis announced his retirement from acting due to aphasia, which impacted his ability to speak and understand language. His family says his condition progressed, leading to the recent diagnosis of FTD.

FTD causes progressive nerve cell loss in the frontal and temporal lobes of the brain. This leads to a loss of function in these brain regions, impacting someone’s behavior, personality and language function.

"That timeframe from when they first recognized the aphasia to now, making this diagnosis, is not surprising,” Dr. Nair says. “Because what that probably suggests is they've seen changes over time in Mr. Willis' function. Not just his language function, but other functions. It was enough to show he now meets the criteria for dementia."

Dr. Nair says many times there are underlying health issues before someone is diagnosed with FTD.

“For aphasia to arise suddenly and spontaneously without some acute injury, then you start often thinking about if there is some underlying degenerative process," he adds.

Dr. Nair says early intervention and being attentive to our loved ones is extremely important.

---

Don’t confuse these types of cancer

by Tim Ditman
OSF Healthcare

---

ALTON - Anal and rectal cancer occur in parts of the body near each other, and they both have prevention steps and time-tested treatments. But they are different types of cancer, says Raman Kumar, MD, a colorectal and general surgeon with OSF HealthCare.

Rectal cancer

Dr. Kumar says the rectum is the last part of the colon, where stool is stored.

Signs of rectal cancer include bleeding, irregular bowel movements (such as the shape of the stool changing and the inability to have a complete bowel movement), weight loss, fatigue and pain in the rectal area.

Rectal cancer impacts men and women roughly equally, and it’s seen “at almost any age,” Dr. Kumar says. If you smoke and eat a lot of red meat and processed food, your risk will go up.

Anal cancer

Dr. Kumar says the anus is where stool comes out. He says signs of anal cancer can be like those of rectal cancer. But often, he says an anal cancer diagnosis starts when a person believes they have hemorrhoids, or when the veins or blood vessels around the anus and lower rectum become swollen and irritated due to extra pressure.

“It turns out not to be a hemorrhoid. It could be a mass or a lesion. You could have some bleeding, especially when you’re wiping with toilet paper or wet wipes,” Dr. Kumar says.

Anal cancer’s prevalence in the United States is “very low,” Dr. Kumar says, with around 8,000 cases per year. Around two-thirds of the cases are women, and it’s more common in age 50 and up.

“The number one cause of anal cancer is HPV, the human papillomavirus,” Dr. Kumar says. “So, it is considered a sexually transmitted disease.”

But he says you don’t have to be sexually active to get anal cancer. Regardless, there are vaccines for the most common HPVs that cause cancer.

Prevention and treatment

Symptoms aside, Dr. Kumar says there’s a must-do for anal and rectal cancer prevention: get on a colonoscopy schedule as advised by your health care provider. A colonoscopy is when a provider inspects your colon and surrounding areas using a tiny camera on the end of a tube. Dr. Kumar says generally, colonoscopies start at age 45. But they could start earlier if you have a family history of cancer.

Other tips: Don’t smoke. Exercise regularly. Eat a healthy diet with plenty of fruits, vegetables and fiber. Thirty grams of fiber per day is a good goal, Dr. Kumar says.

If you do have symptoms of anal or rectal cancer, see a provider to get checked out.

Dr. Kumar says treatment for anal cancer is usually chemotherapy and radiation therapy. He says when treated properly, the typical five-year survival rate is around 80%.

“The only times we would operate on anal cancer are to get the original [cancerous] mass out and if the cancer comes back,” Dr. Kumar explains.

For rectal cancer, Dr. Kumar says around 40% of people can also be treated with chemotherapy and radiation. Others will need surgery to remove the cancer. But Dr. Kumar says medicine has progressed to where people can typically avoid a colostomy, or when a part of the colon is diverted outside the skin to bypass a damaged part of the colon. This is temporary and comes with a bag that collects the waste that would normally leave your body via a bowel movement.

---

Commentary |No way having a baby should cause a financial catastrophe

by Lindsay K. Saunders

---

---

... my first and only experience with motherhood was marred by stress and trauma.

I had a baby in 2021 and quickly learned how parenting and child care expenses add up.

My husband and I had saved up for months to afford my unpaid maternity leave — I kept working even after my water broke because we needed every penny. It was a dream come true to have a career that I was proud of and finally be welcoming a child into our lives.

But I had no idea how hard it would really be.

Bringing a bundles of joy like this cute little one into the world shouldn't be a financial burden.

Photo: Kaushal Mishra/Unsplash

While I was on unpaid maternity leave that cost us our health benefits, my husband was let go from his job. Already reliant on WIC — the federal food aid program for women, infants, and children — we were forced to go to food pantries, apply for Medicaid, and referred to a diaper bank. We were in survival mode: exhausted, stressed out, and worried.

Despite a litany of postpartum complications that continue to plague me more than two years later, I ended up only taking seven weeks of leave before I returned to work out of desperation.

I wondered: Why doesn’t the U.S. have a paid parental leave policy?

Instead, my first and only experience with motherhood was marred by stress and trauma. Again and again, I had to choose between my health and a paycheck, which can feel like a punishment. I’d proudly served my country on a one-year assignment overseas working on foreign aid, and it didn’t matter.

We found child care at a loving, quality child care center, but the tuition kept increasing. Now the monthly cost is almost twice our mortgage. In fact, child care costs exceed college tuition where we live in North Carolina, as well as in at least 27 other states. My stomach gets in a knot every six months when I know the tuition will increase again.

I wondered: Why don’t we invest more in early care and education?

Meanwhile, the crises causing outsized harm to families throughout the pandemic compounded: a diaper shortage, a formula shortage, inflation, and wages that wouldn’t keep up. So many people are struggling to get back on their feet and desperately need balance and some peace of mind. The stress took its toll, and my husband and I separated in spring 2023.

I wondered: If only we’d had more support, would we have made it?

I have an advanced degree and work as a communications director at a nonprofit while also freelancing. After paying for necessities, we have nothing left, so I get food and supplies from neighbors and friends. I work so hard as a single mom to try to achieve the dreams I have for myself and my baby boy — the dreams that all mothers have. I don’t want my child to deal with the stress and constant refrain of “we don’t have the money for that,” like I did growing up.

Families desperately need, want, and deserve better. Welcoming a child should never be the reason a family plunges into poverty, especially in one of the wealthiest countries in the world. We shouldn’t be sacrificing health, quality early learning, or stability in exchange for a roof over our heads and food. Instead, we should be building strong foundations and generational wealth for our kids.

We need federally mandated paid parental and medical leave. We need additional dedicated funding for programs like WIC that support over 6 million families.

And we need to continue expanding the Child Tax Credit. In North Carolina alone, the monthly Child Tax Credits received in 2021 helped the families of 140,000 children lift themselves out of poverty. Nationally, the credit cut child poverty by over 40 percent before Congress let the pandemic expansion expire at the end of 2021.

Congress must put our tax dollars and policies toward strong support for families. Let’s ensure no parent experiences welcoming a child a child as a financial catastrophe and make this country a place where families prosper.

---

About the author:
Lindsay K. Saunders is a North Carolina mother and dedicated advocate for RESULTS Educational Fund, a national anti-poverty organization. This op-ed was distributed by OtherWords.org.

---

Study finds two common types of antidepressants were safe for most stroke survivors

by American Heart Association

Researchers looked at the frequency of serious bleeding among hundreds of thousands of stroke survivors who took different types of SSRI and/or SNRI antidepressants.

DALLAS — Most stroke survivors were able to safely take two types of common antidepressants, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2024. The meeting will be held in Phoenix, Feb. 7-9, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

Among people with ischemic (clot-caused) stroke, those who began taking an antidepressant known as an SSRI (selective serotonin reuptake inhibitor) and/or an SNRI (serotonin and norepinephrine reuptake inhibitor) for the common conditions of post-stroke depression and anxiety, did not have an increased risk of hemorrhagic (bleeds) stroke or other serious bleeding. This included people taking anticoagulation medications. There was, however, an increased risk of hemorrhagic stroke among stroke patients taking two anti-platelet medications, also called dual anti-platelet therapy or DAPT.

“Mental health conditions, such as depression and anxiety, are very common yet treatable conditions that may develop after a stroke. Our results should reassure clinicians that for most stroke survivors, it is safe to prescribe SSRI and/or SNRI antidepressants early after stroke to treat post-stroke depression and anxiety, which may help optimize their patients’ recovery,” said study lead author Kent P. Simmonds, D.O., Ph.D., a third-year physical medicine and rehabilitation resident at the University of Texas Southwestern Medical Center in Dallas. “However, caution is needed when considering the risk-benefit profile for stroke patients receiving dual anti-platelet therapy because we did find an increased risk of bleeding among this group.”

According to the American Heart Association’s Heart Disease and Stroke Statistics 2024 Update, when considered separately from other cardiovascular diseases, stroke ranks fifth among all causes of death, behind diseases of the heart, cancer, COVID-19 and unintentional injuries/accidents. Approximately one-third of stroke survivors develop poststroke depression. If left untreated, depression may affect quality of life and reduce the chances for optimal poststroke recovery such as returning to their usual daily living activities without assistance.

The most common classes of antidepressants are SSRIs or SNRIs, and they are widely used and effective for treating anxiety and depression. However, they may not be prescribed at all or early enough after a stroke, when the risk of depression or anxiety is particularly high, due to concerns that they may increase the risk of a hemorrhagic stroke or other serious types of bleeding.

Researchers looked at the frequency of serious bleeding among hundreds of thousands of stroke survivors who took different types of SSRI and/or SNRI antidepressants (such as sertraline, fluoxetine, citalopram, venlalfaxine). Serious bleeding was defined as bleeding in the brain, digestive tract; and shock, which occurs when bleeding prevents blood from reaching the body’s tissues.

Researchers also investigated serious bleeding among stroke survivors who took antidepressants combined with different types of blood-thinning medications that are used to prevent future blood clots. These blood-thinning medications may include either anticoagulants or antiplatelet medications. Anticoagulants are prescribed as a single medication and include medications such as warfarin, apixaban and rivaroxaban. Antiplatelet medications may be prescribed as either a single medication (commonly aspirin) or two types of antiplatelet medications can be used in dual antiplatelet therapy. DAPT includes aspirin plus another antiplatelet medication called a P2Y12 inhibitor (such as clopidogrel, prasugrel or ticagrelor).

The study found:

SSRI and SNRIs were generally safe to start during the important early stages of recovery as patients taking these medications were not more likely to develop serious bleeding compared to stroke survivors who did not take an antidepressant. This included ischemic stroke patients who are also taking anti-coagulation therapy.

An increased risk of serious bleeding occurred when SSRIs or SNRIs were taken in combination with DAPT treatments (aspirin and blood thinners). However, the overall risk remained low as serious bleeding events were rare.

Among ischemic stroke patients on antidepressant medications, there was a 15% increase in the risk of serious bleeding when taking medications from classes such as mirtazapine, bupropion and tricyclics compared to SSRI/SNRIs.

“Maximizing rehabilitation early after a stroke is essential because recovery is somewhat time-dependent, and most functional gains occur during the first few months after a stroke,” Simmonds said. “Fortunately, dual antiplatelet therapy is often administered for 14, 30 or 90 days, so, when indicated, clinicians may not need to withhold antidepressant medications for prolonged periods of time. Future research should investigate the risk of bleeding associated with the use of anti-depressant and anxiety medications among patients with hemorrhagic or bleeding stroke.”

According to a 2022 American Heart Association scientific statement, social isolation and loneliness are associated with about a 30% increased risk of heart attack or stroke, or death from either. “Depression may lead to social isolation, and social isolation may increase the likelihood of experiencing depression. The current study helps answer safety issues around the use of antidepressants for treatment of mental health issues that may develop after a stroke,” said Crystal Wiley Cené, M.D., M.P.H., FAHA, chair of the writing group for the Association’s scientific statement, and a professor of clinical medicine and chief administrative officer for health equity, diversity and inclusion at the University of California San Diego Health. Dr. Cené was not involved in this study.

---

Commentary | Bridging Gaps in Healthcare: An Urgent Call for Avoiding Medication Errors and Improved Medication Reconciliation

by Angela Buxton

---

Why can I speak about this issue? I worked as a pharmacy technician before working as a Registered Nurse (RN) and ultimately becoming a Nurse Practitioner (NP) in 2000. I have been employed in health care for 33 years, including over 20 of those years as a NP. At present, I work in a specialized emergency service, and am attending the University of Washington for a Doctor of Nursing Practice (DNP) degree. I am writing in hopes to affect change on this ubiquitous delivery of health care problem.

A personal story exemplifies this issue. My 90-year-old grandfather was discharged from an ER and resumed taking a long discontinued antihypertensive (blood pressure) medication from an old pill bottle. He took this in addition to his newly prescribed antihypertensive medication, both medications listed as active in his discharge instructions.

Fortunately, my grandfather was okay, and my mother caught this error and understandably had something to say about it. She drove back to the hospital to give them a piece of her mind, before recommending they come up with a better system. They agreed.

One recurring and nationwide theme are health care providers, and patients, becoming confused with the list of medications in their medical records in all phases of care, including at hospital admission and discharge. This medication list often includes medications that are listed as active and those they haven't taken at times since many years ago.

Sadly, this is not an exaggeration, and often leads to harmful medication errors which are a big problem during all phases of health care. Affected phases include outpatient ambulatory care clinics, during hospital admissions, during hospital stays and hospital discharge. Because of these gaps, medication errors are not surprisingly a leading cause of injury or death.

This is a serious issue that I believe can be solved with a concerted effort by an interdisciplinary team approach along with a streamlined electronic health record system. This is in addition to an emphasis on patient education throughout all stages of treatment which includes outpatient care, an urgent hospital visit or inpatient stay. Providers and ancillary services should always be involved in this process.

Better practice solutions:

1. For health care providers, at all phases of treatment, if it remains unclear if a patient is taking a medication, ask questions, and if medication reconciliation is not possible then list it as such. Increasing awareness of this problem in the advent of increasing use of Electronic Health Records (EHR) is key.

2. Incorporation of admission and discharge medication reconciliation as a continuous process by admitting and discharging RNs, the pharmacist and nurse practitioner and physicians.

As noted by J AM Med inform Association (2016) working towards a solution would include incorporating reconciliation modules that are interoperable with other Electronic Health Record components. This includes medication history, the computerized order set and discharge documentation. Some EHRs have some interoperability with external sources (hospitals, clinics, pharmacy) to import medication history and share updated medication list at discharge, although this is not fail safe and should not be relied on itself alone.

3. As health care consumers, don't be afraid to ask questions or clarification. Most health care providers want you to be involved in your own care. You reserve this right 100 percent and it is okay to ask questions and include your loved ones to advocate for you in your treatment plan.

In summary, medication confusion and errors are fear reaching. It is up to us as health care providers to be conscientious and provide essential emphasis on patient education and collaboration. Encouraging patients and their loved ones to actively participate in their care is vital. This includes asking questions and seeking clarification about medications along with interdisciplinary providers to help prevent confusion and potential medication errors. Involving patient's loved ones can contribute to healthy outcomes. Refining EHR is of the utmost importance.

I thank all health care providers for dedication to this important cause, and I wish success in your continued efforts to make a positive impact on health care practices while encouraging health consumers to be proactive in their care.

---

Angela Buxton, FNP-BC is a national Board-Certified (BC) Family Nurse Practitioner (FNP) since 2000 and who is originally from Massachusetts, obtaining her undergraduate and graduate degrees at UMASS, Amherst, and worked as both a Registered Nurse (RN) and FNP throughout her career. She is currently attending the University of Washington to expand her skills as a Doctor of Nursing Practice in Psychiatric Mental Health. She has now been working as a NP at Harborview Medical Center in Seattle, Washington for the last 20 years. She enjoys her role in assessing, diagnosing and developing client centered treatment plans, not limited to prescribing medications. Population includes those who are underserved and across the lifespan. She has membership in Snohomish County, WA Search and Rescue (SSAR), has participated in team endurance events with lessons learned that crossover into daily life. Other outside interests include photography, painting, skiing and hiking the Pacific Northwest.

---

Hospital recommends virtual visits due current Covid spike and rise of RSV

by Matt Sheehan
OSF Healthcare

---

As many viruses continue to make the rounds in our communities, it is paramount to monitor your symptoms and know when the right time is to seek medical care in person.

PEORIA - OSF HealthCare hospitals, clinics, and emergency departments across the state continue to see a big influx of people seeking care. The increase in patients in waiting rooms can lead to elevated exposure of germs and viruses, plus longer wait times.

As many viruses continue to make the rounds in our communities, it is paramount to monitor your symptoms and know when the right time is to seek medical care in person. Sarah Overton, the Chief Nursing Officer for OSF Medical Group, Home Care and Employee Health, stresses the importance of virtual care when your symptoms are mild.

“That way we’re not exposing you to anyone in the public and you’re not exposing the health care worker to illness,” Overton says. “Unfortunately, we are seeing an increase in health care worker illness where our nurses and doctors have to stay home because they are being exposed to illness.”

Photo: Andrea Piacquadio/Pexels

Hospitals across the state and in the OSF Ministry network have been seeing a spike in COVID-19 patients. If you suspect you have COVID-19 but your symptoms are mild, take an at-home COVID-19 test.

The federal government has another stockpile of at-home tests that are free to order on COVID.gov. Every household can receive four free rapid tests. Dr. Brian Curtis, Vice President of Clinical Specialty Services with OSF HealthCare, says taking tests at home will help free up space at medical facilities.

“Coming in just to get tested takes up spots for the people that are really sick or are high-risk,” Dr. Curtis says.

“The Emergency Room is reserved for those true emergencies,” Overton adds. “We have patients that have heart attacks and lung issues with their COPD. Additional patients overflowing the Emergency Room takes away precious time from assessing those patients who shouldn’t be exposed to those viruses while being in our waiting rooms.”

But COVID-19 isn’t the only virus making the rounds in our communities right now. Influenza, Respiratory Syncytial Virus (RSV) and others are being seen often as well. So how can we stop the spread of viruses?

· Stay home when you aren’t feeling well.

· Wash your hands and use hand sanitizer regularly.

· Cough or sneeze into your elbow.

· Wipe down high-touch surfaces with disinfectant wipes.

· Don’t share glasses or silverware with others.

· Receive the flu shot.

For treating mild symptoms at home, Dr. Curtis offers some guidance for using over-the-counter options.

“You can take Tylenol or Motrin for fevers and aches. Make sure to drink plenty of fluids and get plenty of rest,” Dr. Curtis says.

Overton says to make sure you read the labels on any over-the-counter medication you buy. If you have any questions, you can ask a retail pharmacist, or send a message through MyChart to your OSF care team.

When is the right time to be seen?

“If you have a super deep cough that’s hanging on for quite a while or have a fever that lasts for several days,” Overton says. “Or if you have high-risk factors and may benefit from some of our medications for COVID, like Paxlovid, which are readily available in our retail pharmacy locations. We also have COVID-19 boosters able to be administered in our primary care offices.”

“There is a medication for influenza, but if you have a mild case, you’ll have more side effects from the medication than you are having from influenza itself. As far as RSV goes, there’s really no treatment for it except for supportive care.”

If you are sick and plan to visit a medical facility, please cover your face with a mask to decrease exposure to the health care workers.

Colds and viruses tend to last one to two weeks. If your symptoms are more serious or linger on much longer than that, reach out to your primary care team and schedule an appointment. You can also consider an in-person or virtual visit to OSF OnCall Urgent Care. A virtual visit is available 24/7.

Pre-workout supplements not for teen and youth athletes, a healthy diet is safer

by Matt Sheehan
OSF Healthcare

---

The question is should middle- or high school-aged kids use these supplements? The answer: Probably not.

PEORIA - Did you have a childhood hero? If so, you likely aspired to emulate them and their achievements.

Nowadays, your kids may see their favorite athlete or influencer using pre-workout supplements, whether on social media or in stores, to enhance their performance in the gym or on the field.

What are pre-workout supplements?

Photo: Aleksander Saks/Unsplash

Pre-workout supplements come in various names, flavors, and sizes. Some popular options are creatine and branched-chain amino acids (BCAA). While creatine and the main ingredient in most pre-workout supplements is caffeine, most BCAAs don’t contain caffeine.

These supplements are taken before a workout or athletic match with the goals of increasing endurance, muscle mass, and reducing recovery time. But the question is should middle- or high school-aged kids use these supplements? The answer: Probably not.

What are the risks of pre-workout supplements?

“These can cause increased heart rate or heart burn. You’re also taking a lot of supplements that are going straight to your gut. You can see some nausea, vomiting, diarrhea or constipation. They’re also not well-monitored, the U.S. Food & Drug Administration (FDA) isn’t regulating these very closely,” says Erica Dawkins, a dietetic intern with OSF HealthCare.

Taking it further, kids with heart defects need to steer clear of these supplements.

“A lot of times we see defects or heart irregularities that somebody isn’t even aware of. They don’t know that until they take something like this and have an adverse event,” Dawkins says. “So, if you already know, avoid these because we don’t want to throw that heart into an abnormal rhythm it might not be able to come back from.”

What are the benefits of pre-workout supplements?

“A lot of them will already have beta-alanine or branched-chain amino acids which help improve recovery time and reduce fatigue,” Dawkins says. “We also see some nitrates used that help improve blood flow to the muscles.”

Most pre-workouts are intended for healthy adults in moderation. Pregnant and nursing women are generally advised to avoid them due to the high caffeine content.

“Focus first on making sure you’re having quality workouts, then introduce healthy nutrition,” Dawkins says. “We want to make sure we’re getting that nutrition throughout the day. Especially if we’re working out multiple times throughout the day. If you’re working out within two to four hours, make sure you’re getting a snack. We see a lot of benefits for pre-workout snacks or snacks during half-time. We also want to make sure we’re staying adequately hydrated.”

Dawkins says leafy and root vegetables like spinach, lettuce and beets are a great, natural option.

“Those have the natural nitrate in it. So, we’re getting the same effects we would from a pre-workout supplement, just in our regular diet,” Dawkins adds.

Having a conversation with your child’s pediatrician or sports medicine physician is extremely important if you are wondering what supplements should or should not be added into their routine.

Dietitian says we don't need to fear aspartame

by Tim Ditman
OSF Healthcare

---

URBANA - With the new year starting this week, your mind may wander back to conflicting summer news about aspartame, an artificial sweetener found in things like diet soda, gum, ice cream, yogurt and other sugar-free foods. The World Health Organization (WHO) cited “limited evidence” of aspartame being “possibly carcinogenic to humans.”

Not so fast, responded the United States Food and Drug Administration (FDA).

“Aspartame is one of the most studied food additives in the human food supply,” the agency said. “FDA scientists do not have safety concerns when aspartame is used under the approved conditions.”

Carly Zimmer, a registered dietitian-nutritionist at OSF HealthCare, explains how we got here.

Zimmer says the agency within WHO that researches cancer has four levels of certainty that a substance can cause the disease. Group one is labeled “carcinogenic to humans.” Things like tobacco, alcohol and solar radiation are here. Group 2A is “probably carcinogenic to humans.” Group 2B is “possibly carcinogenic to humans.” And group three is “not classifiable as to its carcinogenicity to humans.” Coffee and mercury are in this group.

WHO put aspartame in group 2B along with aloe vera plant extract and traditional Asian pickled vegetables.

“That group B classification means there is a possible risk for that substance to cause cancer, not that it’s necessarily linked to cancer,” Zimmer says.

The other thing to consider: Zimmer says the FDA sets an acceptable daily intake for the six sweeteners it has approved. For aspartame, the limit is 50 milligrams per kilogram of body weight. For example, someone who is 60 kilograms (or 132 pounds) would have to consume 75 packets of aspartame (think of brand names like Equal, NutraSweet and Sugar Twin) in a day to reach the limit.

“It would be pretty hard to reach those numbers,” Zimmer says.

That’s not a license to add a lot of sweeteners to your drinks or drink soda with every meal. Sugary foods are bad for your heart, among other things, and should be consumed in moderation. But cancer risk from diet soda? It’s not something to lose sleep over.

“Artificial sweeteners definitely have a place [in diets], but we don’t want to consume them in excess,” Zimmer says. For example, sweeteners can add sweetness to foods without raising blood sugar. That’s helpful for people with diabetes or heart disease. Want to cut aspartame out greatly or all together? Try fruit-infused water, which you can make at home or get at the store. But check the label. Zimmer says drink mixes like Crystal Light often have aspartame. Hint Water is a better choice, she says. Also, look for high levels of added sugar on the food label.

And in general, talk to your health care provider or a dietitian if you have questions about what you should eat and drink.

---