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Seed Oils, Benadryl Risks, and Hypertension in Young Americans · Morning Medical with Dr. Chow

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Welcome to another episode of Morning Medical with Doctor Chow.
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I'm your host, Doctor Chi-Ming Chow, bringing you the latest updates in medical and health
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news from around the world.
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Today, we have a fascinating topic to discuss about the oils you might be using your kitchen.
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So, let's dive right in!
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Recently, there's been a lot of buzz about seed oils, particularly those that have been dubbed
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the "hateful eight." These are seed oils that some experts claim could be harmful to your
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health.
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According to board-certified family physician Doctor Cate Shanahan, who specializes in using
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traditional food to promote health and reverse disease, these oils include corn, canola,
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cottonseed, soy, sunflower, safflower, rice bran, and grapeseed oils.
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Doctor Shanahan explains that these oils are often extracted using high heat and pressure, a
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process that can introduce a neurotoxin called hexane.
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This method of extraction, combined with the oils' polyunsaturated fatty acid content, can
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lead to the formation of toxins when the oils are heated during cooking.
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This is particularly concerning because these oils are prevalent in processed foods, often
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referred to as 'junk' foods, and are also commonly used in restaurants and even
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hospitals.
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The refining process that makes these oils edible unfortunately strips them of important
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nutrients, such as choline and lecithin, which are crucial for brain health, nervous system
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function, and cellular division.
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Without these nutrients, the oils are left almost devoid of any beneficial components,
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according to Doctor Shanahan.
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However, it's important to note that not everyone agrees with this perspective.
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The American Heart Association, for instance, has stated that there is no reason to avoid
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seed oils and plenty of reasons to include them in your diet.
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They argue that the idea that these oils break down into toxins during cooking is misleading.
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Instead, they emphasize the importance of focusing on the overall consumption of
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ultraprocessed foods, which often contain other harmful ingredients like high-fructose corn
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syrup, added sugars, and sodium.
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Doctor Christopher Gardner, a professor of medicine at Stanford University, also weighs
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in, stating that these oils are not something to be feared.
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He highlights the importance of looking at the bigger picture of our dietary habits rather
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than singling out specific ingredients.
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This topic certainly gives us something to ponder about the choices we make in our
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kitchens and the broader implications they have on our health.
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As always, it's crucial to stay informed and make dietary decisions based on a balanced
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understanding of the available evidence.
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Doctor Cate Shanahan, a board-certified family physician based in Florida, is sparking a
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conversation about the seed oils many of us use in our kitchens.
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She has coined the term "hateful eight" to describe certain seed oils that she believes
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could be harmful to our health.
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These oils are corn, canola, cottonseed, soy, sunflower, safflower, rice bran, and grapeseed
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oils.
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According to Doctor Shanahan, these seed oils are often extracted using high heat and
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pressure, a process that can introduce a neurotoxin called hexane.
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Doctor Shanahan explains that the oils contain polyunsaturated fatty acids which can break
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down into toxins during the cooking process.
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This breakdown is particularly concerning because it can continue even after the oils
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have been refined, especially when they are heated.
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The refining process, while necessary to make these oils edible, unfortunately strips away
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important nutrients like choline and lecithin, which are crucial for brain health, nervous
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system function, and cellular division.
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These seed oils are commonly found in processed foods, often labeled as 'junk food,' and they
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are also used in many restaurants and even hospitals.
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Doctor Shanahan emphasizes that the ingredients in our food, especially these oils, play a
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significant role in determining whether a food is considered 'junk.' She points out that
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paying attention to these ingredients is vital for our health.
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However, not everyone agrees with Doctor Shanahan's perspective.
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The American Heart Association published a piece stating that there is no reason to avoid
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these seed oils and plenty of reasons to include them in our diets.
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They argue that the idea that these oils break down into toxins during cooking is misleading.
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Instead, they suggest that the real concern should be the consumption of ultraprocessed
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foods, which often contain other harmful ingredients like high-fructose corn syrup,
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added sugars, and sodium.
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Doctor Christopher Gardner, a professor of medicine at Stanford University, also weighs in
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on the topic.
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He highlights that these oils are not something to be feared and stresses the importance of
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looking at the bigger picture of our dietary habits rather than focusing on specific
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ingredients.
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He finds it peculiar how the internet has latched onto demonizing these oils, despite
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there being little evidence to support such fears.
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This debate over seed oils certainly gives us something to ponder about the choices we make
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in our kitchens.
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As always, it's crucial to stay informed and make dietary decisions based on a balanced
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understanding of the available evidence.
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Whether you choose to avoid these oils or include them in your diet, the key is to focus
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on overall dietary patterns and the quality of the foods we consume.
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Today, we're diving into a discussion that has been gaining traction among medical
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professionals on social media: the call to say a "final goodbye" to diphenhydramine, more
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commonly known as Benadryl.
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This conversation is fueled by a paper published in the World Allergy Organization
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Journal, which highlights several reasons why it's time to move away from Benadryl.
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The authors point to the availability of safer and more effective second-generation
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antihistamines, the frequent and sometimes severe adverse reactions to first-generation
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agents like Benadryl, and its potential for abuse.
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Doctor James Clark from Johns Hopkins University School of Medicine, the lead author
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of the paper, has noted the continued prevalence of diphenhydramine use in both
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prescription and over-the-counter forms in the United States.
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He mentions that many patients, including children, are already using Benadryl when they
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visit his clinic.
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He often finds himself educating parents about the different options available and the
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potential downsides of using Benadryl.
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Other experts in allergy and immunology are sharing the paper on social media to raise
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awareness.
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Doctor David Stukus from Nationwide Children's Hospital in Columbus, Ohio, emphasizes that
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anything Benadryl is used for can be replaced with safer alternatives like cetirizine,
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loratadine, fexofenadine, or levocetirizine.
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He asserts that these alternatives are not only safer but also effective for a range of
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allergic reactions, including acute reactions, hives, and seasonal allergies.
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Doctor Stukus elaborates that diphenhydramine is a non-selective binder, meaning it does not
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only target histamine receptors but can affect various organ systems, leading to significant
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side effects.
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The paper by Clark and his colleagues also highlights that diphenhydramine can interfere
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with sleep quality and cause sedation, drowsiness, and psychomotor impairment.
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They point to the "Benadryl challenge" on TikTok during the pandemic, which led to
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dangerous outcomes, as an example of its abuse potential.
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Moreover, diphenhydramine is not recommended for individuals with specific health issues
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like closed-angle glaucoma, dry eyes, peptic ulcers, constipation, and urinary retention.
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It also poses risks for pregnant or breastfeeding women and for those over age
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sixty-five, due to its anticholinergic properties, which are linked to Alzheimer's
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disease and other forms of dementia.
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In contrast, second-generation antihistamines primarily target histamine receptors and have
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fewer side effects.
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They offer equivalent onset and longer-lasting effects, making them a better therapeutic
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choice, according to Clark and colleagues.
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These medications are similarly priced and widely available, making them accessible
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alternatives.
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Doctor Zachary Rubin, a pediatrician specializing in allergy and immunology, points
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out that while Benadryl is one of the oldest antihistamines available, it is not necessarily
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the most effective or safe.
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Some countries have already taken steps to limit its availability.
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For instance, Germany, the Netherlands, and Sweden require a prescription for
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diphenhydramine, and in Canada, it is recommended that first-generation
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antihistamines be considered behind-the-counter medications.
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Despite these moves, it is unlikely that diphenhydramine will disappear from the U.S.
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market altogether.
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Doctor Rubin notes that Benadryl still has its place, particularly as the only readily
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available intravenous antihistamine in many places.
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However, he emphasizes the importance of consulting with a doctor before making any
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changes to medication usage, as individual cases vary.
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Doctor Stukus concludes that medicine is about lifelong learning and evolving with evidence.
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He urges both practitioners and patients to regularly re-evaluate the necessity and
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effectiveness of medications, considering newer, safer options when available.
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This ongoing assessment ensures that medical practices remain aligned with the best
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available evidence.
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Today, we're turning our attention to a pressing issue in the realm of cardiology: the
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increasing number of young Americans unaware of their hypertension.
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A recent national study, published in JAMA Cardiology, highlights a worrying trend where
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awareness of high blood pressure among young adults has significantly declined over the past
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decade.
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While awareness of diabetes and high cholesterol levels remained relatively stable,
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the proportion of Americans who are unaware they have hypertension has grown notably.
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The study utilized data from the National Health and Nutrition Examination Survey
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(NHANES), examining cycles from 2013 to 2023.
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It showed that adults aged 20 to 44 who were unaware of having hypertension have surpassed
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one in three as recently as 2023.
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This is a concerning increase from 21.9% in 2013-2014 to 37.1% in 2023-2024.
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This trend has been attributed to various factors, including the indirect health effects
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of the COVID-19 pandemic, such as disrupted medical care and increased sedentary behavior.
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The study's authors, including Doctor Rishi Wadhera from Beth Israel Deaconess Medical
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Center and Harvard T.H.
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Chan School of Public Health, emphasize the need for policy efforts to bridge these
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awareness gaps to prevent future cardiovascular events.
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They highlight that declining cardiometabolic health in young adults is a significant
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concern, with approximately one in three unaware of their hypertension, two in five with
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diabetes, and one in four with high cholesterol levels.
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Interestingly, the study also pointed out that this lack of awareness was more pronounced in
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adults under 45, with no discernible increase in hypertension awareness among those aged 45
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or older.
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Moreover, women have been disproportionately affected, with a notable increase in the
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proportion unaware of their high blood pressure—from 11.3% to 16.5%.
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NHANES, a well-known cross-sectional survey of the noninstitutionalized general population in
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the United States, was used as the foundation for this study.
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Participants underwent household interviews, physical assessments, and lab tests.
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The researchers used survey weights from NHANES to generate nationally representative
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estimates, providing a comprehensive overview of the situation.
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While the study sheds light on some alarming trends, it also acknowledges certain
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limitations, primarily the reliance on self-reported awareness and medication data.
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Despite this, the findings underscore the critical need for increased awareness and
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education efforts to address the growing number of young people unaware of their blood pressure
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status.
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Today, we're exploring a significant development in the healthcare industry as CVS
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Health announces a massive investment in health technology.
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The company is committing twenty billion dollars over the next ten years to enhance the
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consumer health experience through a tech-driven, interoperable healthcare system.
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This initiative aims to streamline communication across its various brands,
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including health providers, Aetna health insurance, and retail pharmacies, while also
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allowing competitors and stakeholders to integrate into CVS's new system.
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The core objective of this investment is to improve interoperability, which means creating
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a seamless and unified patient record system.
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This system will provide healthcare professionals, regardless of their company
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affiliation, with a comprehensive view of a patient's health status.
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CVS Health wants to empower patients by proactively communicating important
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information, such as claim denials, through texts, calls, or app notifications.
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Instead of patients having to chase down information, they'll receive updates directly,
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making the process more efficient and less stressful.
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CVS Health anticipates that this bold plan will significantly transform the consumer health
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experience in as little as five years.
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A spokesperson for CVS highlighted the company's commitment to simplifying the United
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States health system for consumers by advancing interoperability among members, patients,
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caregivers, providers, and community resources.
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The goal is to foster collaboration, improve health outcomes, increase satisfaction, and
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enhance efficiencies by ensuring that the right information is available at the right time to
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support healthcare decision-making.
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This investment is part of a larger trend in the healthcare industry where companies are
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looking to leverage technology to enhance patient care and streamline operations.
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Recently, CVS has been restructuring its operations, including closing some of its
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stores and acquiring prescription files from Rite Aid pharmacies.
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These moves are part of CVS's broader strategy to position itself as a leader in the
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health-tech space.
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While some of these changes may cause disruptions, they reflect a shift towards more
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integrated and patient-centered healthcare services.
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CVS Health's commitment to a tech-driven approach signals a move towards a future where
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healthcare is more accessible, efficient, and responsive to the needs of patients and
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providers alike.
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In a fascinating development, wastewater is now playing a crucial role in tracking the spread
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of measles across the United States.
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Wastewater surveillance gained prominence during the COVID-19 pandemic, as testing sewage
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for virus particles provided early warning signs of increased transmission.
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Now, this innovative approach is being used to monitor measles, with the potential to detect
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cases days before individuals show symptoms or seek medical care.
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This new tool, developed by WastewaterSCAN, is the first national wastewater monitoring
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program for measles.
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It's currently being used in nearly 150 wastewater treatment facilities across 40
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states.
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The program offers a vital advantage in identifying possible measles cases early and
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providing a more comprehensive understanding of how the virus is spreading, especially in areas
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where traditional case reporting might be lacking.
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According to a CNN tally using data from state health departments, at least 1,157 measles
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cases have been reported in the United States this year.
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A significant portion of these cases stems from a large multistate outbreak centered in West
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Texas.
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Texas alone has reported 742 outbreak-associated cases, with additional
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cases in New Mexico, Oklahoma, Kansas, and several other states.
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Experts caution that these numbers likely underrepresent the true scale of the outbreak,
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as many cases go unreported.
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The nation is now fewer than 120 cases away from the total reported for 2019, the year with
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the highest number of measles cases since it was declared eliminated in the United States in
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the year 2000.
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This resurgence is particularly concerning, with South Dakota recently reporting its first
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measles case of the year in an adult who had traveled internationally.
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The United States Centers for Disease Control and Prevention has updated its measles guidance
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for travelers, emphasizing the importance of vaccination.
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The advisory warns that travelers can catch measles in many settings, including airports,
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public transportation, and crowded events.
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Infected travelers may then bring the disease back to their communities, where it can spread
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rapidly among those who are not immune.
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The Centers for Disease Control and Prevention strongly recommends that all travelers be fully
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vaccinated against measles before going to any international destination.
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The Centers for Disease Control and Prevention has reported at least 14 measles outbreaks in
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the United States this year, accounting for ninety percent of the cases.
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A vast majority of these cases occur in unvaccinated individuals, with only about five
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percent in those who had received one or two doses of the measles-mumps-rubella vaccine.
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Two doses of the vaccine are ninety-seven percent effective against measles, making it
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the best protection against the disease.
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Unfortunately, childhood vaccination rates have been declining across the United States for
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years.
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The measles-mumps-rubella vaccination coverage among kindergartners has fallen below the
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recommended ninety-five percent threshold for at least four years.
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A study from Johns Hopkins University highlights this trend, showing that vaccination
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rates have dropped in more than three-quarters of U.S.
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counties, with an average decline of 2.7 percent between 2017 and 2024.
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However, there is a silver lining.
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Vaccination rates have surged in some areas experiencing outbreaks.
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In New Mexico, the number of measles-mumps-rubella vaccines administered
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this year has nearly doubled compared to the same time last year.
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In Texas, early vaccination rates among infants have jumped significantly, with some children
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receiving their first measles shot before their first birthday.
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The Centers for Disease Control and Prevention reports that at least 133 people with measles
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have been hospitalized this year, and there have been three deaths, all in unvaccinated
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individuals.
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This underscores the critical importance of vaccination in protecting public health.
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As we wrap up today's episode, it's clear that the integration of technology like wastewater
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surveillance offers promising new ways to combat infectious diseases like measles.
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This innovation, combined with increased vaccination efforts, could be key in curbing
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the spread of such preventable diseases.
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Thank you for joining us on Morning Medical with Doctor Chow.
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Stay informed, stay healthy, and I'll see you next time.