Thursday Aug 27, 2020

The Gary Null Show - 08.27.20

Desperate Times for Pandemic Lead to... Ozone?

Case study in three patients with severe COVID-19 pneumonia

MedPage Today August 24, 2020

Three patients present to a hospital emergency department in Ibiza, Spain, with severe COVID-19 pneumonia and respiratory failure and are given an unproven -- and possibly dangerous -- treatment: oxygen-ozone (O2-O3) therapy -- also called ozonated autohemotherapy, which has been used to treat gout and involves intravenous infusion of ozonated autologous whole blood.

The FDA has called ozone "a toxic gas with no known useful medical application."Furthermore, in April 2020a federal court entered a permanent injunction halting a purported "ozone therapy" center in Dallas from offering unproven treatments for COVID-19, after the company claimed that the treatments were able to "eradicate" the virus and were 95% effective in preventing the illness even for individuals who had tested positive.

As described in this case report, published on Aug. 17, 2020, of three patients in Spain, the clinicians drew 200 mL of autologous whole blood from the antecubital vein into a standard plastic disposable blood collection bag (certified SANO3 bag) with 35 mL of anticoagulant citrate dextrose solution. The team enriched the blood with 200 mL of gas mixture O2-Owith an ozone concentration of 40 μg/mL obtained using an ozone generator with CE0120 certificate type IIb. This was followed by reinfusion of the ozonized blood using the same vein over approximately 10 minutes.

Patient 1

Patient 1, a 49-year-old man, body mass index (BMI) of 31, reported having 1 week of ongoing abdominal pain, and that over the course of the previous day he had increasing shortness of breath. Examination finds a soft abdomen with no distension.

Upon auscultation of his chest, clinicians noted bilateral crackles with reduced air entry and ordered a computed tomography (CT) scan of the chest and abdomen, which identified lung infiltrates in both lungs, compatible with COVID-19 pneumonia. Laboratory tests show elevated levels of:

  • Ferritin (1,609 ng/mL)
  • D-dimer (1,900 ng/dL)
  • C-reactive protein (CRP, 17.3 mg/dL)
  • Lactate dehydrogenase (LDH, 536 IU/L)
Clinicians took a nasopharyngeal swab; real-time polymerase chain reaction (RT-PCR) analysis identified the sample as positive for viral RNA, and the man is admitted to the intensive care unit (ICU). Over the following 24 hours, his condition improves and he is transferred to the general ward.

However, during the following day, the patient's oxygen levels declined, followed by respiratory distress, with a PaO2/FiO2 [partial pressure of arterial oxygen/percentage of inspired oxygen] ratio of 235. Clinicians put the patient on a non-rebreather face mask with oxygen on FiO2 of 0.8, and noninvasive ventilation (NIV) is not required. An x-ray revealed diffuse bilateral infiltrates.

For the next 3 days, the patient received two sessions of ozone autohemotherapy daily q 12 hours. He had a rapid clinical response, as evidenced by a marked improvement in respiratory rate and an increased PaO2/FiO2 ratio, with decreased FiO2 to 0.31% (3 L) after 1 day. After 2 sessions of ozone therapy, the patient's ferritin levels dropped from over 2,000 to 246 ng/mL, and his D-dimer levels dropped from 1,900 to 323 ng/mL.

On day 4, the patient was discharged home.

 

 

Patient 2 

The second patient, a 61-year-old man, BMI of 29, presented a week after developing a persistent fever of over 39°C. He reported having long-standing hypertension and becoming progressively short of breath over the previous 2 days. Chest auscultation showed crackles with reduced air entry over the right hemithorax. CT of the chest–abdomen revealed right upper infiltrates suggestive of COVID-19 pneumonia. Baseline PaO2/FiO2 was 253.

Laboratory tests showed high levels of:

  • Ferritin (2,200 ng/mL)
  • D-dimer (3,660 ng/mL)
  • CRP (10 mg/dL)
  • LDH (816 IU/L)

The patient remained in the general ward, where he received oxygen at an FiO2 of 0.6 via face mask, and he did not require NIV.

For the following 2 days, he received two sessions of ozone autohemotherapy over a period of 24 hours. On day 3, clinicians noted a decline in the FiO2 of 0.31% (3 L) with improved PaO2 to 90 mmHg, and decreased levels of laboratory markers.

The patient was discharged home on day 3 after a total of four sessions of O2-O3therapy. Post-discharge, clinicians reported that the patient's LDH levels dropped from 816 U/L at baseline to 469 U/L by day 6 after the start of ozone therapy. Likewise, his CRP levels began falling progressively after initiation of ozone therapy, from 10 mg/dL at the time of presentation to approximately 4 mg/dL on day 3 and about 0 mg/dL on day 21.

 

Eat local foods to regulate blood pressure and reduce diabetes risk

University of Turin (Italy), August 26, 2020

 

In a recent pilot trial, researchers from the University of Turin in Italy and the Graduate Institute of International and Development Studies (IHEID) in Geneva found that the increased consumption of foods purchased from local producers led to reductions in major risk factors linked to non-communicable diseases (NCD) after just six months.

Their findings had been published in the journal Diabetes & Metabolism.

Neither fat nor sugar

In their article, the researchers noted that the consumption of ultra-processed foods (UPFs) has been studied for its influence on the risk of NCDs like diabetes and heart disease.

UPFs include food products like packaged bread, biscuits and pre-prepared pasta dishes. Compared to their fresh or homemade counterparts, these foods tend to contain higher amounts of fat, sugar and sodium.

But as the researchers pointed out, scientists often fail to look into the additives that are added to these food products as part of industrial food production norms. Plus, studies on nutrition and disease risk often focus on the impact of single nutrients like fats or sugars on health, not on additives in UPFs.

The researchers speculated that these additives may be influencing disease risk, not just nutrients like fat and sugar. 

Local producers are safer sources of food

To test their hypothesis, the researchers gathered 159 healthy participants in Italy. Rather than asking them to cut back on processed foods, such as cheese, sausage, pasta, pastries, biscuits and chocolate, the researchers asked half of the participants to source these foods from local producers. The other half were asked to purchase them from supermarkets.

The team brought in a food production expert to ensure that those in the local food group ate foods that had no additives at all and that the production of the foods themselves had been local. The team also asked both groups to adopt a Mediterranean diet and to log their food intake.

Prior to and after the trial, the team collected anthropometric data, including blood pressure and abdominal fat. The team also used a questionnaire to assess for depression, a mood disorder that is often linked to NCDs.

Furthermore, the researchers collected the participants’ blood samples to assess markers of diabetes, like fasting blood glucose, insulin and C-peptide and calculated their homeostasis model assessment (HOMA) scores. Getting a high score on this index indicates that cells are resistant to insulin, the hormone that controls blood glucose.

Six months later, the team found that participants in the local food group had more significant reductions in their HOMA scores and fasting blood glucose than those in the supermarket food group.

Those in the local food group also had greater reductions in their abdominal fat and systolic blood pressure than participants in the supermarket food group. The same could be said for the depression scores of both groups.

On the other hand, those in the supermarket food group exhibited significant increases in their fasting blood glucose, diastolic blood pressure and C-peptide levels. Taken together, these factors indicate insulin resistance and a greater risk of both diabetes and heart disease.

These findings support the idea that artificial ingredients in UPFs influence their impact on health and disease risk. Based on these findings, the researchers concluded that the short-term consumption of foods sourced from local producers can lead to significant improvements in major risk factors for NCDs.

The researchers recommend that the trial be conducted again in the future to involve a larger cohort and a double-blind trial to validate the results.

 

 

 

Zinc therapy in early Alzheimer disease: safety and potential efficacy

Molecular Markers Laboratory (Italy), August 20, 2020

 

According to news originating from Brescia, Italy, by NewsRx correspondents, research stated, “Zinc therapy is normally utilized for treatment of Wilson disease (WD), an inherited condition that is characterized by increased levels of non-ceruloplasmin bound (‘free’) copper in serum and urine.”

Our news editors obtained a quote from the research from Molecular Markers Laboratory: “A subset of patients with Alzheimer’s disease (AD) or its prodromal form, known as Mild Cognitive Impairment (MCI), fail to maintain a normal copper metabolic balance and exhibit higher than normal values of non-ceruloplasmin copper. Zinc’s action mechanism involves the induction of intestinal cell metallothionein, which blocks copper absorption from the intestinal tract, thus restoring physiological levels of non-ceruloplasmin copper in the body. On this basis, it is employed in WD. Zinc therapy has shown potential beneficial effects in preliminary AD clinical trials, even though the studies have missed their primary endpoints, since they have study design and other important weaknesses. Nevertheless, in the studied AD patients, zinc effectively decreased non-ceruloplasmin copper levels and showed potential for improved cognitive performances with no major side effects.”

According to the news editors, the research concluded: “This review discusses zinc therapy safety and the potential therapeutic effects that might be expected on a subset of individuals showing both cognitive complaints and signs of copper imbalance.”

 

 

Magnetic stimulation dramatically improves fecal incontinence

Medical College of Georgia at Augusta University, August 26, 2020

 

Painless magnetic stimulation of nerves that regulate muscles in the anus and rectum appears to improve their function and dramatically reduce episodes of fecal incontinence, a debilitating problem affecting about 10% of the population, investigators report. 

They have early evidence that TNT, or translumbosacral neuromodulation therapy, is a promising, novel, safe, low-cost treatment for strengthening key nerves and reducing or even eliminating episodes of stool leakage, Medical College of Georgia investigators report in the American Journal of Gastroenterology.

"We have identified that nerve damage is an important mechanism in the pathogenesis of stool leakage, and we have identified a noninvasive and targeted treatment to correct the nerve damage and address this pervasive problem," says Dr. Satish S.C. Rao, director of neurogastroenterology/motility and the Digestive Health Clinical Research Center at the Medical College of Georgia at Augusta University. 

"We found there was significant improvement in fecal incontinence across the board," says Rao, after six sessions of weekly TNT treatment to key nerves, "which told us something is happening with this treatment. There is an effect on nerve function which, in turn, is leading to improvement of symptoms." 

The rectum is the connector between the colon and the anus, where stool exits, and the muscles directly involved in moving feces along then holding it in place until we are ready to go to the bathroom, have been a focal point for treating fecal incontinence. However current strategies are largely unsatisfactory for at least half of patients because they do not directly address the causes, including nerve dysfunction in the anus and rectum, the investigators say. 

Rao and his team decided to take a step back and look at the function of the nerves controlling those muscles. He developed a relatively benign test, called TAMS, or translumbosacral anorectal magnetic stimulation, to look at nerve activity by placing a probe in the rectum and a coil on the back to deliver magnetic stimulation to nerves in the anus and rectum and watch the response. When they found that nerve function was an issue in 80-90% of patients they assessed, they began exploring a similar approach using external, repetitive magnetic stimulation to help heal those nerves.

This first study was in 33 participants, including 23 women, who tend to have more problems with fecal incontinence, and, who were an average of about 60 years old. Age also is a risk factor. They used the same four sites on the upper and lower back they used to test the function of the relevant lumbar and sacral nerves, which are about two inches below the skin, after some surface mapping to find an exact location in each individual. 

Patients lie comfortably face down and the machine makes a steady 'tock, tock' sound. Treatment lasts 15 minutes to an hour depending on the frequency. The 15-minute version meant, for example, 15 stimulations per second, or 15 hertz, clearly the quickest but, surprisingly, not the most effective frequency for this purpose.

Rather, while all participants derived some benefit, it was those receiving the lowest frequency, one hertz, over an hour who benefited most. 

The investigators defined responders as those with at least a 50% reduction in the number of episodes of stool leakage per week. The one-hertz group experienced about a 90% reduction in weekly episodes as well as significantly improved ability to sense a need to defecate and in their ability to hold more stool. Those in the one hertz and midrange five-hertz group also reported the most improvement in quality of life issues.

"We measured several parameters including their leakage events, we measured their nerve and muscle function, quality of life, all of those were measured," Rao says. Participants also kept stool diaries, with some reporting zero incontinence episodes following TNT. 

"It's still in the early stage, but it's quite remarkable what we are seeing," he says. 

Like the patients he sees in his practice, study participants had a variety of issues that likely contributed to their lack of fecal control including diabetes, back injuries, hysterectomies and bladder and hemorrhoid surgeries. Childbirth is a common cause of both fecal and urinary incontinence. One of the females in the study had never had a baby, 18 others had vaginal deliveries and three of those also had a C-section, and four others only had a C-section. Eleven of the women with a vaginal delivery had vaginal tears and six had a forceps-assisted delivery.

While they didn't selectively pick people with nerve damage for the study, the investigators again found that whatever the cause, those with significant stool leakage had problems with delayed and weakened nerve conduction compared to healthy controls. 

TNT dramatically shortened the time it takes those nerves to activate the muscle by several important milliseconds, particularly in the one-hertz group, where the response time consistently returned to normal. 

"We have always tended to blame the anal muscle as the problem," Rao says of key controls needed to keep stool contained until we are in the bathroom. But they also know from women who experience muscle tears during childbirth, which is common, that repairing the muscle does not guarantee the woman will not have problems with leakage, he says. Sometimes muscle repair works temporarily, but when you follow up five years later, about half are incontinent, and nearly 90% are incontinent in 10 years, he says. "Ideally you want to treat all the mechanisms that are not working. We have not really approached it like that," Rao says. 

His team suspected their repeated stimulation of the nerves would induce their innate ability to adapt in response to a variety of stimulations, called neuroplasticity, a skill that exists in nerves throughout the brain and body that enables both learning as well as recovery from injury or disease. They had preliminary evidence of this including studies indicating that magnetic stimulation improves neuropathy and pain in a condition called levator ani syndrome, in which patients experience burning pain in the rectal or perianal region. 

They suspected high frequency stimulation, like 15 hertz, already used in the brain to treat problems like depression and stroke recovery, would work best, which is why they were surprised to find that the relevant nerves in this case were most responsive to longer periods of low frequency 1 hertz. Rao surmises one reason may be that the nerves that help control defecation are not as active as typical brain cells, although laboratory studies are needed to confirm that theory, he says. He also wants to learn more about underlying mechanisms for how the nerve changes occur with magnetic stimulation and, along with colleague Dr. Amol Sharma, MCG gastroenterologist and a study coauthor, look at its potential in other gastrointestinal motility problems caused by conditions like Parkinson's disease and the stomach-paralyzing problem gastroparesis. 

How long benefits of TNT hold, and how often follow-up sessions may be needed are already being pursued in a larger study of 132 participants now underway at MCG and AU Health System and Harvard University's Massachusetts General Hospital in Boston, on which Rao is also the project director and principal investigator. 

Participants for the published study were recruited from MCG's adult teaching hospital, AU Medical Center, and from the University of Manchester's Manchester Academic Health Sciences Centre in the United Kingdom, under the supervision of Dr. Shaheen Hamdy, professor of neurogastroenterology, although all participants were ultimately enrolled at the Augusta facility. 

They went through extensive screening to ensure there weren't other medical problems, like severe diarrhea or inflammatory bowel disease, that could contribute to their incontinence, as well as a host of other serious medical conditions. To qualify, individuals had to have a history of recurrent fecal incontinence for six months that did not respond to approaches like diet modifications and diarrhea medication, and a two-week diary that reported at least one episode of fecal incontinence per week. As part of the study, investigators performed several tests to assess nerve and muscle function, including Rao's TAMS test, at the start and finish of the trial. They also used TAMS to ensure the participant's nerves were responding to the stimulation. 

The only reported side effect of TNT was some temporary tingling in the treatment area, probably prompted by rejuvenating nerves, Rao says. He notes penetrability of the magnetic stimulations can be problematic with obesity or in patients with significant scarring from problems like back injury and/or surgeries. He also notes poor nerve conduction likely is a factor in some patients with constipation.

 

 

Rosmarinic acid interferes with interaction between amyloid beta and copper, suggesting its use against Alzheimer disease

University of Siena (Italy), August 22, 2020

 

According to news originating from Siena, Italy, by NewsRx correspondents, research stated, “Alzheimer’s disease is a severe disorder that affects millions of people worldwide. It is a very debilitating disease with no cure at the moment.”

Our news journalists obtained a quote from the research from the University of Siena, “The necessity of finding an effective treatment is very demanding, and the entire scientific community is putting in a lot of effort to address this issue. The major hallmark of Alzheimer’s disease is the presence of toxic aggregated species in the brain, impaired metal homeostasis, and high levels of oxidative stress. Rosmarinic acid is a well-known potent antioxidant molecule, the efficacy of which has been proved both in vitro and in vivo. In this study, we investigated the possible role played by rosmarinic acid as a mediator of the copper(II)-induced neurotoxicity. Several spectroscopic techniques and biological assays were applied to characterize the metal complexes and to evaluate the cytotoxicity and the mutagenicity of rosmarinic acid and its Cu(II) complex.”

According to the news editors, the research concluded: “Our data indicate that rosmarinic acid is able to interfere with the interaction between amyloid beta and Cu(II) by forming an original ternary association.”

 

 

Seven Reasons Why Skipping Rope Is So Good For You

 

University of Hertfordshire (UK), August 25, 2020

 

While many of us may remember skipping as something we did as children, the pastime has regained popularity during the pandemic as a way of keeping fit.

Not only is jumping rope a fun, affordable and portable form of exercise, it also has many benefits for our health and fitness. Here are just a few reasons why jumping rope is such a good form of exercise:

1. It improves cardiovascular fitness

Jumping rope has long been used by boxers as a form of training to help improve their footwork and general conditioning.

Jumping rope will cause an increase in heart rate and breathing similar to if you went jogging. If you were to do ten minutes of jump rope everyday, you would create adaptations to your body that are beneficial to cardiovascular health, such as lowering blood pressure and reducing resting heart rate.

Jumping rope will also increase your cardiorespiratory fitness which essentially means your body becomes more efficient at taking up and using oxygen.

Research has shown that cardiorespiratory fitness is linked to improved health and longevity. Improved cardiorespriatory fitness has been shown to reduce blood pressure, improve insulin sensitivity, reduce inflammation in the body and lower chances of developing diabetes and many other chronic disease.

2. It’s a full body workout

Skipping is a full body workout which uses your abdominal muscles to stabilise the body, your legs for jumping, and your shoulders and arms for turning the rope. It therefore provides an all over workout rather than just isolating one portion of the body.

Full body workouts increase muscle tone, which will help with all daily activities, and increase our resting metabolism, which helps us burn calories even while resting.

3. It improves coordination and motor skills

Skipping involves coordination to time your jump with the rope. Research has shown that it improves coordination, balance and basic movement skills in children. These are important fitness components for later in life as they reduce our chances of trips and falls.

There are so many different exercises you can do with the rope and each one requires different coordination to complete the exercise. This may help exercise your brain as well.

4. It increases bone mineral density

Jumping rope involves making impact with the ground with every jump. These impacts cause our bones to remodel themselves to become stronger, thus increasing bone density. Bone density can be a benefit later on in life, when it naturally begins to decrease.

Research has shown that jumping rope increases bone mineral density. Higher bone mineral density makes you less likely to break a bone or develop osteoporosis as you get older. Hip fractures are a major cause of morbidity and mortality in older people, leading to loss of independence and a huge economic burden. Improving bone density and balance throughout your life reduces the chances of trips and falls later on.

5. It increases speed

Because jumping rope requires fast movement of the feet and arms, it’s considered a plyometric exercise. This is where the muscles exert maximum force in short intervals of time, with the goal of increasing power.

Plyometric exercise is used in the sporting world to increase an athlete’s speed. A lot of exercises, such as jogging, only improve cardiovascular health – whereas jumping rope has the added benefit of improving speed as well. Daily jump rope practice may help you run quicker than before.

6. Time efficient

Jumping rope offers many health benefits that may be achieved in a short period of time. Because it’s a full body exercise that requires speed and coordination, you could argue that it’s a form of high intensity interval training (HIIT).

HIIT exercise is where you have short bouts of high intensity efforts followed by a short rest intervals. This is repeated several times. HIIT has been shown to produce higher levels of cardiorespiratory fitness in comparison to traditional endurance training.

It’s also more time efficient, as you can perform exercise over a shorter period. This is why HIIT training has become the most popular workout worldwide.

Jumping rope is easily adaptable, and can be a high-intensity workout depending on the effort and power a person puts into their training.

7. Enjoyable

One of the most important points we need to consider to help us change our exercise habits is that what we do needs to be enjoyable to us. One of the biggest barriers for people when it comes to sticking with exercise is enjoyment. And research shows enjoying exercise is critical for helping us change our exercise habitsand continue exercising.

The great thing about skipping is that there are so many different ways you can jump, and hop over the rope. You can create a varied workout which helps maintain your enjoyment.

However, it’s worth noting that skipping can put a lot of force on our lower limbs when we land. Though this improves our bone mineral density, it can lead to lower-body injury, especially if we’re not used to this force. But different jumping styles can be used to help ease force and reduce chance of injury. As with all types of exercise, it’s good to build up duration gradually. This will help minimise injury.

Overall, jumping rope could be a very beneficial form of exercise. Not only does it improve many important aspects of our health – including cardiovascular health, and improving bone density – but it’s also affordable, portable and doesn’t require much space.The Conversation

 

Depressed or anxious teens risk heart attacks in middle age

Orebro University (Sweden), August 26, 2020

 

: Depression or anxiety in adolescence is linked with a 20% greater likelihood of having a heart attack mid-life, according to research released today at ESC Congress 2020.1 

In a warning to parents, study author Dr. Cecilia Bergh of Örebro University in Sweden, said: "Be vigilant and look for signs of stress, depression or anxiety that is beyond the normal teenage angst: seek help if there seems to be a persistent problem (telephone helplines may be particularly helpful during the COVID-19 pandemic). If a healthy lifestyle is encouraged as early as possible in childhood and adolescence it is more likely to persist into adulthood and improve long-term health." 

There are indications that mental well-being is declining in young people. This study investigated whether conditions like depression in adolescence (age 18 or 19) are associated with a higher risk of cardiovascular disease in adulthood. The researchers also examined the possible role of stress resilience (ability to cope with stress in everyday life) in helping to explain any associations. 

The study included 238,013 men born between 1952 and 1956 who underwent extensive examinations in late adolescence (as part of their assessment for compulsory military service) and were then followed into middle age (up to the age of 58 years). The assessments at the age of 18 or 19 years included medical, psychiatric, and physical examinations by physicians and psychologists.

Stress resilience was measured by an interview with a psychologist and a questionnaire, and based on familial, medical, social, behavioural and personality characteristics.

A total of 34,503 men were diagnosed with a non-psychotic mental disorder (such as depression or anxiety) at conscription. Follow-up for cardiovascular disease was through hospital medical records.

The study found that a mental disorder in adolescence was associated with the risk of having a myocardial infarction (heart attack) by middle age. Compared to men without a mental illness in adolescence, the risk of myocardial infarction was 20% higher among men with a diagnosis - even after taking into account other characteristics in adolescence such as blood pressure, body mass index, general health, and parental socioeconomic status.

The association between mental illness and heart attack was partly - but not completely - explained by poorer stress resilience and lower physical ?tness in teenagers with a mental illness. "We already knew that men who were physically fit in adolescence seem less likely to maintain fitness in later years if they have low stress resilience," said Dr. Bergh. "Our previous research has also shown that low stress resilience is also coupled with a greater tendency towards addictive behaviour, signalled by higher risks of smoking, alcohol consumption and other drug use." 

Dr. Bergh said: "Better fitness in adolescence is likely to help protect against later heart disease, particularly if people stay fit as they age. Physical activity may also alleviate some of the negative consequences of stress. This is relevant to all adolescents, but those with poorer wellbeing could benefit from additional support to encourage exercise and to develop strategies to deal with stress."

 

 

Frequent soft drink consumption may make adolescents more aggressive

University of Alabama, August 26, 2020

A study from the University of Alabama at Birmingham has shown that frequent soft drink consumption by adolescents may contribute to aggressive behavior over time.

Previous studies have shown associations between soft drink consumption and mental health problems in adolescents. The UAB study, led by Sylvie Mrug, Ph.D., professor and chair of the College of Arts and Sciences' Department of Psychology, identified soft drink consumption as a likely predictor of aggressive behavior. It was published in the Journal of Adolescent Health.

"Despite public health policies designed to reduce children's consumption of sugar-sweetened beverages, such as soda taxes and school soda bans, the consumption of sugar-sweetened beverages by youth in the United States remains a significant public health problem," Mrug said. 

Reciprocal relationships were analyzed showing soft drink consumption predicted an increase in aggressive behavior over time.

Soft drink consumption at ages 11 and 13 predicted more aggressive behavior at the next time point, the study showed. Aggressive behavior at age 13 also predicted more soft drink consumption at age 16. Soft drink consumption at age 13 predicted fewer depressive symptoms, but depressive symptoms did not predict soft drink consumption. Findings from this study suggest that reducing adolescents' intake of soft drinks may reduce aggressive behavior, but not depressive symptoms.

Interviews with 5,147 children and their caregivers were conducted from three sites, at child ages 11, 13 and 16. At each time, the children reported on their frequency of consuming soft drinks, aggressive behavior and depressive symptoms.

Soft drinks comprise more than 10 percent of adolescents' total caloric intake and are consumed daily by more than 20 percent of high school students, according to recent reports. High rates of soda consumption among U.S. youth have led to concerns about its impact on pediatric obesity and related health conditions. Besides obesity, concerns have been raised about the potential impact of soft drink consumption on pediatric mental health, particularly for adolescents who consume more soft drinks and experience more emotional and behavioral problems than younger children.

"Paralleling the historical trends of increasing soft drink consumption, emotional problems in adolescents have risen between 1980s and early 2000s," Mrug said. "For example, several studies reported 70 percent to 350 percent increases in emotional problems among adolescent boys and girls in developed countries during this time period."

A number of studies have linked the consumption of soft drinks to adolescents' mental health problems. Specifically, more frequent consumption of soft drinks has been associated with more aggression, other behavior problems such as hyperactivity and oppositional behavior, and depression and suicidal behavior in adolescents from the United States, Norway, Slovakia, Iran and China. Another recent cross-national study found a consistent association between adolescents' high sugar consumption (from soft drinks and sweets) and fighting, bullying and substance use in 24 of the studied 26 countries.

All of these studies have included statistical adjustments for a variety of potential confounders such as child age, gender, BMI, physical activity, diet, substance use and family factors; but the key limitation remains the cross-sectional design. 

Although the results are typically interpreted in terms of soft drinks' contributing to emotional and behavioral problems, it is equally likely that mental health problemsmay be driving the consumption of sugar-sweetened soft drinks, Mrug says. Experimental studies show that some individuals consume more sugary foods in response to stress and negative emotions.

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