Wednesday, May 20, 2009
Another reason to skip the soda: Potassium depletion
Supporters of the recent Senate Finance Committee proposal to tax sugary drinks may want to arm themselves with the findings of a new study on soda drinking. The study, published online May 13 by the International Journal of Clinical Practice, presents some alarming case studies of cola-induced hypokalaemia brought on by chronic consumption of up to 10 liters per day of sugar-sweetened cola.
The study's findings suggest that "potassium deletion should be added to the long list of soft drink-related health problems," (obesity, type 2 diabetes, dental decay and metabolic syndromes, to name a few), said a related editorial. To illustrate, the editorialist relates a case from his own files in which a 51-year-old man with COPD, hypertension and idiopathic gastroparesis developed persistent hypokalaemia, generalized weakness and loose stools. After running through a number of possible causes, the doctor hit upon the problem when the patient arrived in his office with a two-liter bottle of Pepsi in tow; upon further questioning, the patient estimated his total daily consumption at 4 liters. He agreed to keep his intake to two liters, and saw his potassium gradually rise back into the normal range.
The editorial also cites the intriguing case of a 44-year-old ostrich farmer who returned from a kangaroo-hunting trip in the Australian outback with profound muscle weakness and respiratory distress that required intubation and mechanical ventilation. It turned out that his serum potassium level plummeted when he upped his Coca-Cola intake to 10 liters (from his usual 4 liters daily) to combat his thirst on the hunt (From the study, "Coca Cola and kangaroos," Lancet, 2004; 364: 1190).
The editorial warns against relegating these cases as "outliers," citing some rather unsettling statistics. Worldwide consumption of soft drinks was almost 83 liters per person in 2007, with the U.S. level even higher at an estimated 212 liters per person. While healthy adults often can tolerate low potassium levels, not so for patients with heart problems, the editorial points out, and even moderate chronic cola consumption has been associated with chronic kidney disease.
The statistics should be a wake-up call for internists, especially considering the steady rise of obesity and type 2 diabetes. Most people know that sugary drinks are unhealthy, but public health initiatives have focused largely on children and teens. However, the editorialist urges, internists need to start asking their adult patients about soft drink consumption, along with questions about alcohol, cigarette and drug use.
Labels: chronic diseases, diet, obesity
posted by Janet Colwell at
9:51 AM
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Thursday, May 14, 2009
Readable Rx labels: Clear but not compelling
Confusing prescription labels and poor patient adherence to medication are concurrent yet complementary problems. Fixing the former would seem to lead to improvements in the latter. That's what researchers hypothosized in a recent study that assessed the impact of Target pharmacies' easier-to-read labeling, introduced in 2005, on adherence to chronic medications.
But after analyzing 23,745 Target users (clear labeling) and 162,368 matched non-Target pharmacy users (presumably near-incomprehensible gibberish), researchers found no difference in adherence between the two groups. The new labels seemed popular enough, if the small increase in Target users is any indication, but they had no influence on behavior. The study was published in the Journal of General Internal Medicine.
Undaunted, researchers optimistically concluded that, "while adherence may not be improved with better labeling, evaluation of the effect of labeling on safety and adverse effects is needed."
Will that research reveal that patients are less likely to adhere precisely because they finally understand all the fine print they couldn't be bothered to read before? Stay tuned.
Labels: chronic diseases, medication adherence, prescription labeling
posted by Janet Colwell at
9:00 AM
0 Comments
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