A swirling controversy is amongst us – specifically the taxation of soft drinks and sugared beverages. Its supporters argue that soda and the like are paving the way towards obesity and heart disease. Taxation of these goods may, therefore, improve general health while at the same time dramatically increase state and federal revenue. Detractors maintain the obesity crisis will not be solved through increased taxation and only serves to punish those who consume small amounts of sugared beverages.
Statistically, our consumption of sugared beverages has sky-rocketed in the last quarter century. Since 1977, the per capita intake of caloric drinks has doubled in the United States. The average daily caloric intake is estimated at approximately 172-175 calories per adult and child. Unfortunately, patients recognition that sugared beverages constitute “empty calories” and contributes to weight gain has been less than impressive.
Multiple studies have evaluated the effect of soft drink consumption on obesity and cardiovascular health. In particular, a two year study involving middle school students showed a 60% increased risk of obesity for every additional serving of sugared beverages per day. Another eight year study involving women showed that by increasing consumption of sugared beverages over the study’s final four years, a woman could expect a 17.6 pound weight gain versus 6.2 pounds in the groups that did not increase their consumption.
The massive Nurses Health Study evaluated 91,249 women over eight years and revealed a two fold increase in diabetes mellitus among women who consumed one or more sugared beverage per day. Half the risk appeared to be attributable to greater body weight. Heart disease was increased 23% and jumped to 35% with consumption of two or more servings per day.
Health risks are felt to be secondary to a variety of causes, from elevated triglyceride levels and blood pressures, to decreased HDL (good cholesterol) and an increase in insulin resistance. Medical costs for obese patients are estimated at 147 billion dollars per year – nearly 10% of all U.S health care costs!
Suggested taxation is one cent per ounce of beverage. This would increase the cost of a 20 ounce bottle by about 20% or so. In turn, it is estimated that this would raise 14.9 billion dollars in federal revenue with 928 million dollars raised in Florida alone. Taxes would be levied on the companies themselves, which would then be passed on to the retailer. Consumers would then become aware of the cost increase at the point of sale which may discourage them from their purchase. If a typical consumer changed to a no-calorie substitute, he would shave nearly 175 calories from his diet per day (as noted above). This could decrease total caloric intake by 63,875 per year, or 18.25 pounds!
The backlash from corporate America has been strong. Pepsi threatened to move their headquarters from New York after an 18% tax on sugared beverages was proposed. The beverage industry has created an American Against Food Taxes group to fight the potential governmental taxations. It would appear that their efforts confirm their belief that taxation of sugared beverages will dramatically reduce consumption. Of course, reduced consumption equals reduced profits.
It is clear that a simple reduction in calories may have a huge impact on general health in this country. The question is whether or not taxation of these goods is the best way of achieving these gains.
Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.
Increasing Hair Loss
Dear Dr. Spence,
I am a 52 year old female who has been having increasing hair loss. I’m afraid if I don’t do something at once, I’ll soon be completely bald. Help! What do you suggest I do?
Signed,
Imma Shining
-- Dear Imma,
There are many causes of hair loss. It is important to understand the principles of hair growth before one can understand the principles of hair loss. Hair grows in cycles of two to six years with an average growth of one centimeter per month during each cycle. It is normal to lose approximately 100 hairs per day which can be disconcerting for some people that are not aware of this. This, in part, may explain why hair growth can recuperate after a period of apparent loss.
As noted, there are numerous causes of hair loss, or alopecia. The most common is known as telogen effluvium (doctors always need fancy words to explain common conditions!). In telogen effluvium, an increased number of hairs enter the telogen, or resting phase and these hairs eventually fall out approximately three months later. The normal hair loss of 100 per day dramatically increases and may cause a loss of up to 30-50% of total body hair. Telogen effluvium is typically precipitated by some form of stressful event three months prior to the complaint. Stressful events may include surgery, childbirth, illness, injury or even severe psychologic stress. Other possible causes include thryoid disease (overactive or underactive) and iron deficiency. Medications may be the culprit and can include antiepileptics, hormones, blood thinners and some blood pressure medications.
Alopecia areata causes hair loss in circular patches and is typically a result of chronic illness like diabetes mellitus, thyroid disease or lupus. It can happen at any age and treatment usually consists of treating the underlying disease process. Other causes of hair loss include nutritional deficiencies, syphilis, medications and repeated trauma to the hair though braids, perms, use of hair curlers or twisting.
For physicians, the general evaluation revolves around a thorough history and physical. In some cases, bloodwork may be of some value and often includes thyroid testing as well as evaluation of iron stores and hormone levels (testosterone etc.). As noted, most cases are secondary to telogen effluvium and will resolve over time once the stressor has passed.
Finally, once all is said and done, many women are simply suffering from female pattern hair loss which is characterized by thinning over the central area of the scalp with widening of the midline part. Nearly 50% of women will experience female pattern hair loss in their lifetime. Treatment consists of over the counter minoxidil. It may take three to six months to see results. The higher concentration solutions (5%) do not offer any clear benefit and may be more likely to cause dryness, itching and possible skin irritation. I recommend the 2% solution.
Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.
I am a 52 year old female who has been having increasing hair loss. I’m afraid if I don’t do something at once, I’ll soon be completely bald. Help! What do you suggest I do?
Signed,
Imma Shining
-- Dear Imma,
There are many causes of hair loss. It is important to understand the principles of hair growth before one can understand the principles of hair loss. Hair grows in cycles of two to six years with an average growth of one centimeter per month during each cycle. It is normal to lose approximately 100 hairs per day which can be disconcerting for some people that are not aware of this. This, in part, may explain why hair growth can recuperate after a period of apparent loss.
As noted, there are numerous causes of hair loss, or alopecia. The most common is known as telogen effluvium (doctors always need fancy words to explain common conditions!). In telogen effluvium, an increased number of hairs enter the telogen, or resting phase and these hairs eventually fall out approximately three months later. The normal hair loss of 100 per day dramatically increases and may cause a loss of up to 30-50% of total body hair. Telogen effluvium is typically precipitated by some form of stressful event three months prior to the complaint. Stressful events may include surgery, childbirth, illness, injury or even severe psychologic stress. Other possible causes include thryoid disease (overactive or underactive) and iron deficiency. Medications may be the culprit and can include antiepileptics, hormones, blood thinners and some blood pressure medications.
Alopecia areata causes hair loss in circular patches and is typically a result of chronic illness like diabetes mellitus, thyroid disease or lupus. It can happen at any age and treatment usually consists of treating the underlying disease process. Other causes of hair loss include nutritional deficiencies, syphilis, medications and repeated trauma to the hair though braids, perms, use of hair curlers or twisting.
For physicians, the general evaluation revolves around a thorough history and physical. In some cases, bloodwork may be of some value and often includes thyroid testing as well as evaluation of iron stores and hormone levels (testosterone etc.). As noted, most cases are secondary to telogen effluvium and will resolve over time once the stressor has passed.
Finally, once all is said and done, many women are simply suffering from female pattern hair loss which is characterized by thinning over the central area of the scalp with widening of the midline part. Nearly 50% of women will experience female pattern hair loss in their lifetime. Treatment consists of over the counter minoxidil. It may take three to six months to see results. The higher concentration solutions (5%) do not offer any clear benefit and may be more likely to cause dryness, itching and possible skin irritation. I recommend the 2% solution.
Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.
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