FDA warning: Do not give kids codeine or tramadol for pain
Joanna Hayden, PhD, CHES

In a safety alert last week, the FDA announced a new warning against giving the opioid pain relievers codeine and tramadol to kids younger than 12 or those 12-18 who are obese or have sleep apnea because they can cause life-threatening breathing problems. Further, because these drugs cross into breastmilk, nursing mothers should also avoid taking them.

For the full FDA safety alert: https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm554029.htm

Use this news

In addition to codeine being prescribed alone, it is commonly found in combination with acetaminophen in a prescription for Tylenol # 3 and in prescription cough medications. Tramadol is in combination with acetaminophen in Ultracet and ConZip and alone as Ultram.

Parents should:

·         Reads the label on all medications to make sure they do not contain these opioids.

·         Ask the health care practitioner writing out the prescription or the pharmacist filling the prescription if the medication contains codeine or tramadol.

·         Discuss with the child’s health care practitioner alternative pain relief and cold and cough medication options that do not contain opioids.

 The FDA’s list of things to watch for in children taking these drugs includes:

·         slow or shallow breathing

·         difficulty or noisy breathing

·          confusion

·          more than usual sleepiness

For breastfeeding infants - trouble breastfeeding or limpness.

If any of these signs occur, stop the medication and take the child immediately to the emergency room or call 911.

For more information on:

Codiene - https://www.drugs.com/codeine.html

Tramadol - https://www.drugs.com/tramadol.html

Need a reason to stop drinking diet soda?
New research finds an association between artificial sweeteners, stroke and dementia.

Joanna Hayden, PhD, CHES

Results of research published this week in the American Heart Association journal Stroke found that over a seven year period, people who drank one artificially sweetened beverage a day were almost 3 times (2.96 times to be exact) more likely to have a stroke caused by a blood clot than were people who didn’t drink artificially sweetened beverages. The same held true for dementia and Alzheimer ’s disease risk. Those who drank one artificially sweetened beverage a day had an almost 3 time greater risk of Alzheimer ’s disease and a two and a half times greater risk of dementia from all causes.

Article summary: www.medscape.com/viewarticle/878894

Article Abstract is at: http://stroke.ahajournals.org/content/early/2017/04/20/STROKEAHA.116.016027

Complete article is available at:


Use this News

Although there have been many studies done over the years on the health effects of artificial sweeteners, the results have been inconsistent with some finding no health risks, and others finding there are health risks including: higher blood glucose levels, diabetes, obesity, fatty liver, changes in gut biome (bacteria) associated with diabetes and obesity, and now - increased risk of stroke and dementia.

Since there is on-going debate, it’s best to act prudently and try to eliminate artificial sweeteners if you can or at the very least, reduce the amount you use.

Possible substitutes for diet beverages and artificial sweeteners–

            Flavored seltzer
            Sparkling water
            Teas – iced or hot
                            Organic Rooibos
                             Wild Sweet Orange
                             Sweet and Spicy
                             Spiced orange
                             Raspberry Zinger
                             Ginger (from ginger root)

            To enhance your coffee try -
                             Almond milk
                             Coconut milk

  For more information see:

Harvard Health Publications
Artificial Sweeteners: Sugar free but at what cost?

National Institutes of Health
Taking a look at artificial sweeteners

American Heart Association
Artificial Sweeteners may increase blood sugar

Vacation time is near...
Don’t make bed bugs your souvenir!

Joanna Hayden, PhD, CHES

Research conducted at Purdue University and published in the Journal of Economic Entomology found that bed bugs are developing resistance to two insecticides commonly used today by pest control companies. Using bed bug samples from 10 states including New Jersey, they found that 25% of the bugs were still alive seven days after exposure to the chemicals.  This is in addition to the significant resistance bed bugs have to previously used chemicals.

Use this news

While bed bugs don’t cause or carry disease causing bacteria like ticks do, they are still parasites that feed on blood – your blood!  Bed bug bites do cause redness, itching and in some people, serious allergic reactions.

A little bed bug history for those ‘itching’ to know – around the middle of the 1940’s, bed bugs were pretty much eliminated with the use of DDT and Malathion. But, in the late 1990’s they started to reappear, in hotels world-wide. Increased traveling, bug resistance to the chemicals used to control them and changes in hotel pest control practices, allowed bed bugs to make a roaring come back.  

Here’s the thing about these little critters – they are stealth hitchhikers!  We pick them up in hotel rooms and bring them home without knowing it. That’s because they hide during the day and come out at night to feed – on us- while we’re asleep.

According to the University of Kentucky Entomology Extension, here’s where they hide during the day:

Seams, folds and crevices of mattresses, box springs

Box springs give them many places to hide, especially along the upper seams and underneath, where the bottom edge of the box rests on the frame.

Bed frames and headboards
Cracks and crevices of wooden bed frames. Bed bugs like wood and fabric more than metal or plastic.

Wooden support slats, screw holes, knots and other places they can crawl into are also common hiding places.

Headboards attached to walls, as common in hotels, provide hiding areas behind them and are often the first place bed bugs become established.

Items stored under beds provide great hiding places.

Upholstered furniture.
 Chairs, recliners and sofas especially if used for sleeping, are typically the next most   likely area for bed bugs to hide. They hide in the seams, skirts or in fabric folds.


Nightstands and dressers
          Bugs will hide in cracks, corners, and recesses.

Other common bed bug hiding places include:
  •  along and under the edge of wall-to-wall carpeting,  especially behind beds and sofas          
  • cracks in wood molding; ceiling-wall junctures behind wall-mounted pictures, mirrors, outlets and switch plates
  • under loose wallpaper
  • in closet clutter
  • inside clocks, phones, televisions and smoke detectors.

What to look for when traveling:
Rusty or reddish stains on bed sheets or mattresses

Dark spots (about this size: •), which are bed bug excrement  and bleed stains on the fabric like a marker would make.

                                                  Tiny, pale yellow eggs  and nymph shells. 

Live bed bugs.
(For more pictures of the above go to: https://www.epa.gov/bedbugs/how-find-bed-bugs)

Itchy yet?

Here are some tips to reduce the chances of bringing them home with you from your vacation:  

1.       When you first enter your hotel room - Put your luggage in the bathroom.

2.       Unmake the bed. Check the mattress and lift the box spring for signs of bugs.

3.      Leave your luggage on the luggage rack (after checking the straps) or a hard surface, not on the carpeted floor.

Bring large plastic bags and put your luggage in them for extra safety.

4.      When you get home, make sure you wash and then dry all of your travel clothes in a hot dryer for 30 minutes to kill any bugs that came home with you.

5.      Store your luggage in the garage or a hot attic (120o) to kill bugs that may be hiding. (Consumer Reports, http://www.consumerreports.org/hotels-inns/check-for-bed-bugs-hotel/)

The Environmental Protection Agency offers these other tips to prevent infestation:

  • Check secondhand furniture, beds, and couches for any signs of bed bug infestation before bringing them home.
  • Use a protective cover that encases mattresses and box springs and eliminates many hiding spots. The light color of the encasement makes bed bugs easier to see. Be sure to purchase a high quality encasement that will resist tearing and check the encasement regularly for holes.
  • Reduce clutter in your home to reduce hiding places for bed bugs.
  • Vacuum frequently to remove any successful hitchhikers and empty the canister or change the bag afterwards.
  • Be vigilant when using shared laundry facilities. Transport items to be washed in plastic bags (if you have an active infestation, use a new bag for the journey home). Remove from dryer directly into bag and fold at home. (A dryer on high heat can kill bed bugs.)
  • If you live in a multi-family home, try to isolate your unit by:
    • Installing door sweeps on the bottom of doors to discourage movement into hallways.
    • Sealing cracks and crevices around baseboards, light sockets, etc., to discourage movement through wall voids.
If you find bed bugs in your home, call a pest control company. They are extremely difficult to eradicate yourself.

For more information:

University of Kentucky – Entomology Extension

 Centers for Disease Control and Prevention
 Bedbug FAQs

Environmental Protection Agency
Protecting your home from bedbugs

Joanna Hayden, PhD, CHES

Researchers at NYU investigating the effects of weight loss/gain cycles (yoyo dieting) in people with coronary artery disease found that those with the largest weight gain/loss cycles had 136% more strokes, 117% more heart attacks, and 124% more deaths than those with the smallest weight gain/loss cycles. The research results were published in the April 6, 2017 issue of the
                                  New England Journal of Medicine.  

Summary of the research: http://www.newswise.com/articles/body-weight-fluctuations-

Journal article abstract: http://www.nejm.org/doi/full/10.1056/NEJMoa1606148

Use this News

This is yet another study showing the association between yoyo dieting and poor health. In this case, it’s the increased risk of stroke, heart attack and death in people who already have heart disease.  

If you want to lose weight, dieting is not the way to go because by their very nature, diets are temporary.  You go “on” a diet, then you go “off” the diet. Going on and off a diet, losing and gaining weight is detrimental to health, as this research found.

So, to use this news if you have heart disease and want to lose weight, don’t diet. Instead, remember that weight management at its most basic level is a balancing act between the amount of energy you take in (calories) and the amount of energy you use.  

Here are some magic numbers to keep in mind – if you eat 3500 calories more than your body needs/uses, you will gain one pound. Consequently, if you eat 3500 calories less than your body needs, you will lose one pound. By reducing 500 calories a day through a combination of eating a little less and using a little more (moving more), you will lose about a pound a week. This does not mean ‘going on a diet.’ This means making small lifestyle changes that over time, will help you manage your weight.

The American Heart Association offers the following guidelines:

1.       Set realistic weight loss goals (1-2 pounds a week)

2.       Keep a food diary or log to record (Use paper and pencil,
           an online site or an app)

                The times you eat
                What you eat
                 How much you eat

3.      Manage portion size

        Know the difference between your portion size and a serving         size. A serving size is the amount used to calculate the                     calories and nutrients of a food. The portion size is the                  amount you eat. It is usually much more than the serving              size. For example, a serving size of pasta is ½ -3/4 cups of
         uncooked dried pasta or about 1 – 1 ½ cups cooked.

4.      Make smart choices

        Choose whole grains over refined flours because cause they         keep you fuller longer, choose fruits and vegetables over        
        processed high calorie snacks, choose unsweetened    
        beverages over those with sugar or artificial sweeteners.

5.      Get moving!
            Increase your activity level. Walk more, even 10 minutes             counts.

For More Information:

American Heart Association
No-Fad Diet Tips

Master the Scale

Choose My Plate
Healthy Eating Style

Centers for Disease Control and Prevention
 Losing Weight