By Ask Dr. Ramo BARRY RAMO For the Journal
Q: I have been drinking energy drinks and have an energy bar before I exercise. What do you think of them? I think they make me stronger when I work out.
A: If they make you feel stronger, then they work for you even if they are a placebo. The idea that you can drink an energy drink or eat a bar right before you exercise and it is going to boost your exercise tolerance isn’t supported by science unless you are engaged in prolonged exercise.
They do pack a lot of calories in a small package so if you’re hiking or biking and can’t eat, they are fine. If you are on a diet and you are exercising for less than 90 minutes, they are empty and sugary calories that will keep you from losing weight.
The first of such concoctions were Power Bars and Gatorade, which were developed to give athletes easily digestible calories to reduce fatigue during prolonged exercise. Gatorade also has some potassium, sodium and magnesium. Some do contain caffeine and that is a bonus if you tend to fall asleep during a boring exercise. Caffeine makes those drinks unsuitable for kids, so read the labels and you will discover that there are ingredients in there you don’t really want in your body.
The allure of both the drinks and the bars has been too seductive for the average American to resist. Instead of eating breakfast, it’s a power bar. The sugary “power boosters” are useful for marathoners to soften the blow when they “hit the wall” and run out of glucose. That occurs at about 20 miles. Most power drinkers or snackers aren’t going to hit any walls.
You can build your sugar stores with a bagel and cream cheese before the race. Of course you need hydration but water works just fine. Some drinks contain vitamins and electrolytes and they won’t hurt you.
So my view, unless you’re out there for more than an hour or so, you won’t get much more than a lot of empty calories.
The additional downside is that when you drink sugary energy drinks your brain doesn’t process the information the same way it does if you have a bagel or a steak. So despite the fact that some energy drinks have fewer calories per ounce, you tend to drink a lot more and end up with the same or greater number of calories.
My advice is that the energy bar or drink won’t hurt the average weekend athlete but they won’t offer you a boost of energy. You just can’t pack all those vitamins, minerals and antioxidants into a bar to replace what you get from food.
Q: My 16-year-old daughter wants to start taking birth control pills. I am confused about the health benefits and the dangers because every study seems to show something different. What is the current thinking about the safety of birth control pills?
A: Medical research supports the idea that some cancers depend on naturally occurring sex hormones for their development, that there is a possible link between those hormones and the development of certain cancers.
An analysis of studies looking at what factors contribute to the development of breast cancer concluded that oral contraceptives produce a small increase in the risk for breast cancer. The younger a woman started taking them, the greater the risk. Ten or more years after women stopped taking birth control pills, their risk returns to the level of someone who had never taken them. Also, cancers that the women taking birth control pills developed were less aggressive than in women who had never taken the pill.
For a number of years researchers have known that the risk for ovarian and endometrial cancer is reduced when women take oral contraceptives. A recent study evaluating more than 50 reports asked the question, “Does longterm birth control pill use prevent ovarian cancer?”
The carefully performed study reported in the English journal Lancet in January 2008 found that compared to women who didn’t take birth control pills, those on birth control pills had a significantly lower risk for developing ovarian cancer. At five years, the risk was 20 percent less and by 15 years the risk of developing ovarian cancer was cut in half.
The study extended over the period during which birth control pills have been used and therefore the type of birth control pills changed significantly with the newer ones having far less estrogen than the original pills. Their conclusions were that the estrogen concentration didn’t seem to make any difference, but they couldn’t definitely prove that.
As for now, as always, your daughter needs to discuss the pros and cons with her physician and, based on what we know, take the birth control pill with the least amount of estrogen.
Dr. Barry Ramo is a cardiologist with the New Mexico Heart Institute and medical editor for KOAT-TV. Send questions for him to Albuquerque Journal Boomer, P.O. Drawer J, Albuquerque, NM 87103, or e-mail to [email protected] abqjournal.com.
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