Latest / Morning Medical with Dr. Chow / Synthetic nicotine risks, tattoos and lymphoma, and outdoor exercise benefits

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Synthetic nicotine risks, tattoos and lymphoma, and outdoor exercise benefits · Morning Medical with Dr. Chow

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Good morning, and welcome to another episode of Morning Medical with Doctor Chiao.
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I am your host, doctor Chi-Ming Chow, And today, we have some critical health updates
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from around the globe.
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We will be discussing a series of important topics, including new warnings from the food
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and drug administration regarding nicotine like chemicals and vapes, a study linking tattoos,
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higher lymphoma risk and how early life experiences contribute to racial disparities in
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cognitive outcomes.
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We will also a listener's question about hearing their heartbeat in their ears and share
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tips on how to start an outdoor exercise routine.
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So let us dive right in.
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Our first story today comes from the United States Food And Drug Administration, which has
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issued a new warning about synthetic nicotine like chemicals found in vapes.
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According to the FDA, these substances, such as 6 methyl nicotine, may be more potent and
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addictive than traditional nicotine.
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This is particularly concerning because these synthetic substances are not currently
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regulated by US tobacco and vaping laws, which means they can be sold without FDA
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authorization.
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Traditional nicotine is derived from tobacco leaves, but 6 meth nicotine is synthesized in
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laboratories using chemicals.
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This distinction is significant because it means that manufacturers can produce and sell
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vapes containing these synthetic nicotine analogs without going through the costly and
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time consuming FDA authorization process.
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Big Tobacco Companies such as Altria Group And British American Tobacco have already noted a
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substantial loss in US.
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Sales to disposable vapes containing traditional nicotine that are being sold
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illegally without FDA approval.
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In a letter to the FDA dated May 9th 2024, Altria highlighted the emerging use of methyl
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nicotine in vapes and other smoking alternatives.
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The company urged the FDA to evaluate these compounds and determine what regulatory
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authority it has over them, warning that they pose a new threat to the regulation of the
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sector.
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The letter emphasized that the unchecked introduction and growth of chemicals intended
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to imitate the effects of nicotine.
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Could present unknown risks to US and consumers and undermine the FDA's authority.
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One example cited in the letter is the spree bar of vape launched in October by Charlie's
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Holdings, Inc, which uses 6 methyl nicotine.
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The FDA has not commented on its correspondence with individual firms, but it did issue a
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statement in response to questions from Reuters.
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The FDA acknowledged that emerging data suggests these nicotine analogues may be more
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potent than traditional nicotine, which is already highly addictive, and can alter
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adolescent brain development as well as having long term effects on youth's attention,
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learning, and memory.
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The FDA is taking a comprehensive approach to assessing these synthetic compounds and has
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committed to using all available resources to protect youth from harmful products.
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Traditional nicotine found in many vapes and pouches is extracted from tobacco leaves,
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Whereas 6 methyl nicotine is entirely lab made.
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The agency is currently reviewing available data to inform potential regulatory actions.
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Academic researchers have pointed out that current studies on 6 methyl nicotine are too
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limited to draw definitive conclusions about its health impact or its level of
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addictiveness.
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Ahmad Damaj, a professor in the department of pharmacology and toxicology at Virginia
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Commonwealth University, noted that while his research indicates 6 methylnicotine may be more
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potent than traditional nicotine, more extensive tests are needed to understand its
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effects on humans fully.
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Limitations in existing research include the fact that some studies are industry funded,
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while others focus only on the short term impact on animals or cells, making it difficult
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to ascertain the long term effects on human health.
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Despite these limitations, there is a growing concern among health experts about the
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potential risks posed by these synthetic nicotine analogues.
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Charlie's Holdings, the company behind spree Bar, refers to the 6 methyl nicotine solution
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used in their products as meta time.
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According to spree bars website, Metatyne may have a toxicity profile similar to nicotine.
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The product promises users 6000 puffs per device and offers various fruity flavors, such
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as blue razice and creamy melon.
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Notably, the FDA has yet to approve any flavored vape using traditional nicotine for
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sale in the United States.
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Citing that companies have not demonstrated that the health benefits to smokers outweigh
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the known risks to young people who are often attracted by these flavors.
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Ryan Stump, cofounder of Charlie's holdings, told Reuters that the company targets only
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adults and that flavors play a crucial role in team and noted that the company dilutes it in
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its products.
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Charlie's holdings is also working on new varieties of spree bar and plans to launch them
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internationally this year.
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Although specific markets have not been disclosed.
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The 6 methyl nicotine solution used in spree bar is supplied by novel compounds, a US firm
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that imports the chemical from overseas and modifies it for use in products like spreeBot.
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Samuel Beneaim, founder of novel compounds, stated that tests commissioned by his company
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found 6 methyl nicotine to be no more harmful than traditional nicotine.
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But he also agreed that further research is necessary.
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He added that novel compounds is committed to legal compliance and has received legal advice
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that its product is not classified as a tobacco product or drug in the United States.
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Experts like Sven Yort, a professor at Duke University, have raised concerns that 6 methyl
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nicotine could be more addictive and toxic than traditional nicotine.
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He questioned whether such a chemical should be available as a recreational product.
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Novel compounds sells its 6 methyl nicotine solution, not only in the United States, but
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also in international markets.
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Including the United Kingdom, Indonesia, India, and Japan.
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In the United Kingdom, another company, Aroma King, sells 6 methyl nicotine and pouches that
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users insert under their lip to get a buzz.
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These pouches are marketed with eye catching graphics, and are self classified by the
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supplier as less toxic under the European Union's classification, labeling, and packaging
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of substances and mixtures regulation.
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However, the supplier has not disclosed its identity.
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In conclusion, the emergence of synthetic nicotine like chemicals such as 6 methyl
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nicotine in vaping products poses a new challenge for public health and regulatory
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authorities.
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While some companies claim these substances are less harmful than traditional nicotine, the
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current scientific evidence is insufficient to support these claims.
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The FDA and independent researchers are calling for more extensive studies to understand the
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long term health impacts of these synthetic compounds.
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As always, it is crucial for consumers to stay informed and exercise caution when using such
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products.
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Our next story delves into a study from Sweden that has uncovered a potential link between
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tattoos and an increased risk of lymphoma.
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Researchers from Lund University published their findings in the Lancet's eclinical
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medicine on May 21 2024.
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The study found that individuals with tattoos have a 21% higher risk of developing lymphoma
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compared to those without tattoos.
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This alarming statistic has raised concerns about the long term health implications of
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tattooing, a practice that has grown increasingly popular over the years.
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The researchers embarked on this study to fill a gap in existing knowledge about the health
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effects of tattoos.
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Tattoo Ink often contains carcinogenic chemicals, including primary aromatic amines,
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polycyclic aromatic hydrocarbons, and various metals.
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Many of these chemicals are classified as carcinogenic by the international agency for
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research on cancer.
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Making their presence in tattoo ink, particularly worrisome.
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Lead author Crystal Nielsen, an epidemiology researcher at Lund University, explained that
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when tattoo ink is injected into the skin, the body perceives it as a foreign substance,
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prompting an immune response.
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A significant portion of the ink is then transported from the skin to the lymph nodes
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where it is deposited.
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This process may contribute to the increased lymphoma risk observed in the study.
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Lymphoma is a type of cancer that originates from immune system cells and includes both
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Hodgkin lymphoma and non Hodgkin lymphoma.
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According to the leukemia and lymphoma society of Canada, There are many sub types of
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lymphoma, each varying in severity, prognosis, and treatment options.
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The latest data from the society shows that in 2020, there were approximately 11,400 new cases
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of lymphoma in Canada.
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Nadine Pravos The business unit director of research and community support with the
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leukemia and lymphoma society of Canada highlighted that the causes of lymphoma are
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largely unknown.
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While there may be a genetic predisposition, environmental factors such as pollution could
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also play a role.
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Pivost emphasized that lymphoma is a complex disease with multiple risk factors.
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None of which are very well defined.
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Pravast also stressed the importance of studies like the one published in the Lancet for
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advancing our understanding of lymphoma.
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However, she urged caution in interpreting the findings, noting that more targeted research is
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needed to fully comprehend the complexities of the disease.
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We need to be careful not to present it in a way that people are starting to go back and get
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their tattoos removed or anything like that, provost said.
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The Swedish study examined data from 11,000 Tundra 5 individuals identifying 3000 people
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diagnosed with lymphoma between 20072017and9000 people who did not develop the cancer.
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After accounting for other factors such as smoking and age, researchers found that the
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risk of developing lymphoma was 21% higher among those with tattoos.
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Interestingly, the study found that the risk of lymphoma was highest in individuals who had
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less than 2 years between their first tattoo and diagnosis.
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The risk decreased for those who had their first tattoo 3 to 10 years before diagnosis,
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but seem to increase again in individuals who got their first tattoo 11 or more years before
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diagnosis contrary to initial expectation the researchers did not find that the size of the
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tattoo affected lymphoma risk.
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They had speculated that larger tattoos might carry a greater cancer risk compared to smaller
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ones.
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Surprisingly, the study found the highest lymphoma risk in individuals with tattoos
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smaller than one hand palm.
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We do not yet know why this was the case.
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1 can only speculate that a tattoo, regardless of size, triggers a low grade inflammation in
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the body, which in turn can trigger cancer.
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The picture is thus more complex than we initially thought.
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Nielsen commented.
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The researchers noted that the study does not pinpoint which specific aspects of tattoo ink
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might be driving the association with lymphoma.
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However, existing literature indicates that ink injected into the skin can migrate within the
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body and end up in the lymphatic system.
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For instance, a 2017 study published in the journal Nature found that nanoparticles from
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tattoos can travel to the lymph nodes carrying potentially toxic elements such as aluminum,
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chromium, iron, nickel, and copper.
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Given these findings, the Swedish researchers emphasized the need for further studies to
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investigate the link between tattoos and other forms of cancer, as well as inflammatory
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diseases.
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People will likely want to continue to express their identity through tattoos, and therefore,
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it is very important that we, as a society, can make sure that it is safe.
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Nelson concluded.
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For the individual, it is good to know that tattoos can affect your health and that you
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should turn to your health care provider if you experience symptoms that you believe could be
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related to your tattoo.
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Nadine Pravost added that while any research on lymphoma is valuable, It is crucial to avoid
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presenting the link between tattoo ink and cancer as definitive.
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I do not want people thinking that avoiding getting tattoo can prevent malignant lymphoma
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because I really do not think that is the case, she said.
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A recent cross sectional study has highlighted the significant impact of early life
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experiences on cognitive outcomes for black and white individuals over the age of fifty.
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According to the research, cognitive scores were notably lower among black participants
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compared to their white counterparts.
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Specifically, black participants scored an average of 13.5 points on a 27 point scale,
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while white participants averaged 15.8 points.
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The study led by doctor Xi Chen from the Yale School of Public Health found that the
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prevalence of cognitive impairment defined as a score below 12 was significantly higher among
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black participants.
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About 33.6% of black individuals were found to have cognitive impairment compared to 16.4
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percent of white participants.
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This disparity in cognitive outcomes can be largely attributed to differences in early life
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circumstances, including educational experiences.
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The researchers reported that early life factors accounted for 61.5 percent of the
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racial disparities in cognitive scores and 82.3 percent of the disparities in cognitive
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impairment.
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Educational experiences alone were associated with 35 point 2% of the disparities in
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cognitive scores and 48.6 percent of the disparities in cognitive impairment.
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School racial segregation, which included all segregated schooling before college, was linked
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to 28.8 percent of the disparities in cognitive scores, and 39.7 percent of the disparities in
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cognitive impairment.
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Doctor Chow emphasized that among the early life experiences, school segregation stood out
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as the most significant factor affecting later life cognition.
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He noted that the impact of school segregation was even more pronounced than the total number
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of years of education.
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Previous studies have indicated that dementia is nearly twice as prevalent among black adults
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compared to their white peers, even when accounting for age, sex, and certain aspects of
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education.
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While mid to late life factors have been linked to cognitive outcomes in older Americans, early
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life education has received less attention and research.
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Reagan Durant, a medical doctor in Master Public Health from the University of Alabama at
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Birmingham, commented on the study in an accompanying editorial.
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Doctor Adurant pointed out that black students who attended desegregated schools likely face
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the stress of both interpersonal and institutional racism more directly than those
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who attended segregated schools.
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Conversely, Some black students and segregated schools thrived educationally despite the
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challenges.
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Doctor Durant highlighted the need for more detailed assessments of the qualitative aspects
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of early life education, such as segregation, to better understand the mechanisms driving the
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racial differences in cognitive and health outcomes.
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He suggested that identifying and exploring the resilience mechanisms in black individuals who
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achieved academically despite adverse conditions could provide valuable insights.
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The study utilized data from the health and retirement study, a large nationally
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representative survey of adults over age fifty.
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Participants self reported their early life circumstances through various components of the
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survey, including the life history mail survey and the enhanced face to face interview.
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The study included 915 participants of whom 18.1% were black, and 81.9% were white.
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The mean age of black participants was 69.2 years, and 67.0% were women.
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For white participants, the mean age was 73.2 years with 59.7% being women.
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Cognitiveative scores were measured using a range of tests adapted from the telephone
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interview for cognitive status, which included tasks such as immediate word recall, delayed
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word recall, serial 7 subtraction, and backward counting.
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Scores range from 0 to 27 points with a score below 12 indicating cognitive impairment.
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The researchers evaluated early life circumstances using 2 models.
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The first model included traditional factors such as age cohort, regional, financial,
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health, trauma, and family relationship factors along with years of education.
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The 2nd model incorporated early life educational experiences, including family
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education factors, preschool attendance, and school segregation.
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The findings suggest that less favorable early life circumstances are associated with
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significant racial disparities in late life cognition.
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The authors emphasized that policies aimed at improving educational equity could potentially
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reduce these disparities.
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The researchers acknowledged several limitations, including the possibility that
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individuals with impaired cognition or other health issues may have been less likely to
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participate in the study.
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Additionally, the sample sizes prevented the study of other racial and ethnic groups and the
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prevalence of dementia was too low to evaluate as an outcome.
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Moreover, the study could not account for variations in the quality of segregated schools
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or unknown early life factors that might influence cognitive outcomes.
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Despite these limitations, The research underscores the critical role that early life
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experiences, particularly educational experiences play in shaping cognitive health
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later in life.
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In conclusion, Doctor Chow and his co authors advocate for policies that promote educational
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equity as a means to address and potentially reduce racial disparities in cognitive outcomes
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among older adults.
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The study highlights the long lasting impact of early life education and the importance of
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addressing segregation and other adverse conditions to improve cognitive health for
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future generations.
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Chi-Ming your heartbeat in your ears, also known by the Latin name, pulsatile tinnitus, is
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a sensation that can be both startling and concerning.
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While it is not always a sign of a medical problem, it could warrant a discussion with
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your physician.
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According to Frederick James Meinee MD, an interventional cardiologist with Novant Health
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in Wilmington, North Carolina.
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Many people experience this phenomenon at one time or another, especially when they are lying
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down on their side.
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Doctor Maya, Mimi explains that hearing your heartbeat can be related to various ear issues
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such as wax buildup, fluid in the ear, or other hearing problems.
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The most common cause, however, is eustachian tube dysfunction.
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This condition is usually due to allergies according to Jesus Lazar Zaburo, MD, a family
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physician, with TPMG Grafton Family Medicine in Yorktown, Virginia.
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The Eustachian tube connects the middle ear to the back of your nose.
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When it is blocked or does not open and close properly, it can cause the sound of your
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heartbeat to be heard in your ears.
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Doctor Sit, Lazar Zaboto explains.
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Another potential culprit is earwax buildup, which can create a seal in the ear canal that
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makes the heartbeat easier to hear.
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Elevated blood pressure is another, albeit less common cause.
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On rare occasions, medications such as non steroidal anti inflammatories, antibiotics,
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diuretics, chemotherapy drugs, aspirin, certain antidepressants, quinine, and antivirals can
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cause tinnitus.
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Which is a ringing in the ears that is in rhythm with the heart rate noted, Doctor
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Nizarzaburu.
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Extremely rare causes include an aneurysm, which is a bulging of blood vessel in the
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brain, or a vascular tumor, which is made up of a collection of blood vessels.
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A thorough physical exam, including a blood pressure check, and an examination of the
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carotid arteries in the neck is an important part of gauging overall cardiovascular health,
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doctor Mina advises.
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Additionally, ruling out anemia or hyperthyroidism, both of which could cause
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increased blood flow and possibly contribute to pulsatile tinnitus can be evaluated with simple
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lab tests he adds.
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If someone experiences the condition intermittently, it is likely less worrisome,
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doctor, minor notes, However, if it is persistent or new onset, a complete history and
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physical exam should be performed.
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From a cardiovascular perspective, if you are experiencing pulsatile tinnitus or hearing your
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heartbeat in your ears, it is important to rule out any potential cardiovascular issues.
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The physician would also ensure that the patient does not have a blockage or narrowing
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of the neck arteries which could contribute to louder heart sounds in the ears and head,
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doctor Mina says.
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He stresses that most of us occasionally hear our heartbeats.
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In our heads and ears, especially when our heart rate is increased during exercise.
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For those who do not enjoy working out in a gym, choosing to exercise outdoors can make a
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great alternative.
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To get started, build on what you enjoy.
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If that is hiking or biking, take longer walks and rides until you're comfortable being active
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for about 45 minutes.
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To stay motivated and consistent It can be helpful to recruit an exercise buddy and get
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appropriate clothing that will keep you warm and dry in inclement weather.
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Between the sweat smell, fluorescent lights, and omnipresent television screens, April
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Herring has never connected with going to the gym.
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Instead, she runs bikes, hikes, plays tennis, pickleball, and football.
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Chi-Ming to get her exercise outside as often as possible.
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Fresh air, sunshine, the variety of the trees as the seasons change, said Herring, an
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administrator at Carroll Community College in North Maryland.
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There's something about the energetic healing quality of nature.
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The health benefits of spending time in nature have long been established and exercise in
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general, of course, improves physical and mental well-being.
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Combine the 2 and you double down on what adults need to stay healthy.
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Said Debbie Ria, professor in kinesiology at Texas Christian University.
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We've gotta get outside.
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We've got to be active Ria said.
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If we're going to live long lives, this is what it's about.
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Getting started on an outdoor routine, however, might not be as easy as signing up for another
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gym membership.
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Here's how to get going.
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If you haven't been active for a while, Think back to the activities you enjoyed years ago,
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suggested Connie Shalino, founder of the Alpine Training Center in Boulder, Colorado a gym that
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trains athletes for outdoor mountain sports.
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People who like occasionally hiking or biking should start building an aerobic base by taking
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progressively longer walks or rides.
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Once you're comfortably in the 35 to 45 minute range, start adding some intensity to build
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strength, she said.
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If jogging is their main activity, I would send them to the bleaches or do some up down on
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stairs either in sprint format or put a pack on their back, she said.
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Ria cautioned again jumping back into a sport you used to play without preparing your body
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for the proper movement.
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Let's say they're in their thirties, forties, fifties, and they haven't sprinted, and now
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they try to run around those bases.
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She said, they're probably going to hurt an Achilles or a hamstring or something by doing
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something too fast.
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A side benefit of exercising outside is that there's no need to buy expensive equipment.
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Trainers say After warming up with your preferred aerobic activity, add strength
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training by using your body weight and what is available in the built environment.
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That could be finding a picnic table or low wall and placing your hand's shoulder width
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apart to do leaning push ups, then turn around put your hands on the same surface and lower
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your body for dips that work your triceps.
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For working your legs, add squats with your feet shoulder width apart.
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Looking straight ahead with your back straight.
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Add lunges by taking giant steps and bending down into the space between your feet.
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For the corps, find a patch of grass to do sit ups, start with 8 to 10 repetitions, or no more
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than you are comfortable with, and add sets with short breaks in between as you get
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stronger.
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For a more complete workout, find a park or trail with outdoor exercise equipment, which is
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installed in 1 third of park agencies according to the National Recreation And Park
27:05
Association.
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The equipment can range from basic pull up bars to gym style bench presses and rowing machines.
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In many cities, including Chicago, San Antonio, and Atlanta, offer free group classes outdoors.
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When it inevitably rains or the weather turns colder, it helps to keep in mind an old Acxiom.
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There's no such thing as bad weather, only bad clothing.
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If we have the clothing for whatever the temperatures are that we may be in, Then we're
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more likely to go outside to be active when we need to, Ria said.
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She suggested investing in a jacket that breeds in a light hat with a brim you can use on sunny
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or rainy days.
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Trainer, Katie Higgins, recommended having a contingency plan for inclement weather.
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Pick an area with surfaces that won't get slippery when wet or somewhere with some tree
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shelter so as not to be bombarded by rain.
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On those days, having a regular exercise buddy really helps, said Higgins Botham, who oversees
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quality control for train fitness a united kingdom based private training provider.
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If you know someone is there waiting for you, it's difficult to say no at the last minute,
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she said.
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Finally, it helps to set a goal, whether that is training for a 5 k charity walk or a
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triathlon.
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If you're working towards something, it keeps you motivated to keep going.
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Sheilino said, when you have that day marked on your calendar, You have to perform these things
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or die out there, she said.
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She that wraps up today's episode of morning medical with doctor Chow.
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Thank you for joining me as we navigated through these important health updates and
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tips.
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If you found today's episode helpful, be sure to tune in tomorrow for more medical news and
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insights.
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Until then, take care and stay healthy.