UV Safety Awareness Month

July is Ultraviolet Safety Awareness Month. The sun is closer to us in the summer, and we all tend to spend more time in the sun this time of year. Exposure to UV radiation is a major risk factor for skin cancer, and it causes other skin damage as well. The good news is that you can enjoy outdoor activities and limit the damage to your skin by taking some simple protective measures.

What is UV radiation?

UV radiation is part of the energy that the sun produces. You can't see UV light because it has shorter wavelengths than visible light, but your skin can feel it. UV radiation is also emitted by tanning beds.

There are two types of UV radiation that reach the earth, UVA and UVB. Both are proven to increase the risk of skin cancer. Here are some things you should know about each:

Facts about UVA:

• Slightly less intense than UVB but penetrates your skin more deeply.
• Can cause tanning or sometimes burning. There is no such thing as a "healthy tan".
• UVA is everywhere, accounting for up to 95% of the UV radiation reaching the earth.
• These rays maintain the same level of strength during daylight hours throughout the year.
• UVA can penetrate windows and cloud cover.

Facts about UVB:

• More intense than UVA but only penetrates the outermost layer of the skin.
• Causes tanning, sunburn, and blistering of the skin.
• UVB intensity fluctuates. It poses the highest risk late-morning to midafternoon from spring to fall in temperate climates (greater timespans in tropical climates).
• It can damage your skin year-round, especially at higher altitudes or on reflective surfaces, such as snow or ice.
• UVB rays can be filtered and do not penetrate glass.

How does UV radiation change your skin?

Many people think that tanned skin makes you look healthy. In reality, it is a sign of skin damage from the sun, and it is not healthy at all. UV radiation damages the DNA in the outermost and deeper layers of your skin. Your body can repair some of the DNA damage in skin cells, but it can't repair all of it. This damage builds up over time and causes mutations in the cells that can lead to malignant tumors.

UV radiation also damages skin fibers called elastin. When elastin fibers break down, your skin begins to sag and loses the ability to go back into place after stretching. Over time, this can lead to premature aging of the skin, which can include the following changes:

• Thinning of the skin, easy bruising and tearing of the skin
• Skin discoloration and skin spots sometimes called liver spots
• Wrinkles
• Dilated small blood vessels called telangectasias

Is there anything good about UV radiation?

Your body does need some UV light exposure and here's why:

Vitamin D - When UV light hits the skin, processes inside the tissues start making vitamin D. Vitamin D is vital for your body to function normally. The good news is that you don't need to get a tan to get vitamin D from the sun. Your body will make all the vitamin D it needs for a day in half the time it takes to get a sunburn. For a person with light skin, 15 minutes a day of sun exposure can provide a day's worth of vitamin D. For a person with dark skin, it could take a couple of hours. Frequent but short exposures to the sun's rays are the best way to get your vitamin D without damaging your skin.

Next week, we will talk more about the cancers associated with sun exposure as well as how you can protect your skin from UV damage.

If you have any questions about UV safety, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

The Dangers of Mixing Caffeine with Other Substances

Last week, we talked about some of the side effects of too much caffeine intake, especially for our kids. Caffeine does have its perks when consumed in moderation. Unfortunately, many kids and adults drink far too much of it. Caffeine can also cause more serious problems when mixed with other substances. We will finish our discussion today by talking about caffeine's interaction with other substances and how to cut back on caffeine intake.

Dangers of mixing alcohol and caffeine

Mixing caffeine with alcohol or other drugs, including many prescription drugs as well as illicit drugs is very dangerous. Emergency room visits related to energy drink consumption have increased dramatically over the last 15 years. Often these visits are due to the combination of caffeine with alcohol or drugs. This combination increases the risk of cardiac arrest and death.

A common myth is that caffeine will "sober you up" if you have had too much alcohol. That is absolutely not true. Caffeine has no effect on the metabolism of alcohol by the liver. It does not reduce breath or blood alcohol levels. And it does not reduce the impairment that is a result of alcohol consumption.

When alcohol is mixed with caffeine, the caffeine can mask the depressant effect of alcohol. Because it makes a drinker feel more awake, it gives the false impression of being less drunk, so drinkers often drive while impaired due to the false impression that they get from the caffeine. In addition, drinkers will often drink much more alcohol than they normally would, which can lead to alcohol poisoning and even death.

Mixing alcohol with energy drinks is quite popular, especially among young people in the US. Premixed caffeinated beverages became popular in the early 2000s. The FDA was going to remove them from the market in 2010 due to safety concerns, so the manufacturers removed the caffeine from their products. But you can still buy them separately and mix them, which many kids are doing!

Studies have shown that:

• Drinkers aged 15-23 who mix alcohol with energy drinks are 4 times more likely to binge drink at high intensity (6 or more drinks per episode).
• Drinkers who mix alcohol with energy drinks are more likely than those who do not mix alcohol with energy drinks to report unwanted or unprotected sex, driving drunk, or riding with a driver who was intoxicated, or to sustain alcohol-related injuries.

Dangers of mixing caffeine with other substances

There are many substances that interact with caffeine, including over-the-counter and prescription medications, herbal supplements, and illicit drugs. Mixing caffeine with the wrong substance could cause:

• High blood pressure
• Stroke
• Seizures
• Nausea and vomiting
• Abnormal heart rhythms
• Anxiety, nervousness, irritability
• Death

What can you do to avoid these dangerous consequences?

• WARN your children, at all ages, of the dangers of mixing caffeine with other substances.
• Talk to your doctor or pharmacist about whether caffeine may interact with medications or supplements that you are taking.
• Know what your kids are drinking. Ask them about energy drinks and other caffeine consumption.
• Cut back on caffeine intake and help your kids do the same.

What can you do to decrease caffeine intake?

Try these measures to help you cut back on caffeine:

• Pay attention to how much caffeine you and your kids are getting. You may not realize how much you are actually consuming unless you read labels, keep track, and educate yourself. Remember that some foods or drinks that contain caffeine may not have it listed on the label.
• Cut back gradually. Stopping high caffeine intake abruptly can lead to side effects such as headaches, which may prompt you to abandon the goal. Cut back in small increments, by cutting out one half to one drink a day for instance.
• Avoid caffeine later in the day. I like to limit my caffeine to less than 30 mg after 1 pm.
• Choose decaffeinated drinks. They often taste the same as their caffeinated version. Just remember that decaffeinated drinks (coffee, tea, soft drinks) can contain 10-20 mg of caffeine per 8 ounces. Herbal teas that are naturally caffeine-free contain no caffeine.
• Shorten brew time for tea or go herbal. If you're a tea drinker like me, you can cut down the brew time, which will decrease the caffeine content.
• Check the label on over-the-counter medications. Some contain caffeine, which will be on the list of ingredients. Chose alternative medications that do not contain caffeine.

If you have any questions about caffeine and its interaction with other substances, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Are Your Kids Drinking Too Much Caffeine?

Energy drinks are now very popular with teenagers and even some younger kids, in part due to social media bad influencers. Recently, the FDA has been asked to investigate one energy drink called "Prime" because of its extremely high caffeine levels, based on concerns that they contain more caffeine than is safe for child consumption. Today we will talk about the recommended caffeine intake for different age groups and the risks associated with too much caffeine intake, particularly for children and teenagers.

How much caffeine is too much?

• Children younger than 12 should have no caffeine. There is no proven safe dose of caffeine for children.
• Adolescents aged 12-18 should limit their intake to 100 mg per day.
• Adults should limit caffeine to 400 mg per day at most. Adults should drink less caffeine if they have side effects or any adverse reaction to caffeine.
• Women who are pregnant, trying to get pregnant, or breastfeeding should limit their caffeine intake to less than 200 mg per day.

How much caffeine is in typical drinks?

The actual caffeine content in beverages varies widely, especially among energy drinks. Here are some examples of approximate caffeine content:

• Coffee – about 100 mg of caffeine per 8-ounce cup of brewed coffee
• Cola – about 40 mg per 12 ounces
• Tea – Black tea contains about 40-75 mg per 8 ounces, often depending on how long it is steeped. Green tea contains only about 15-30 mg per cup.
• Energy drinks – Prime Energy contains the most caffeine (200 mg in a 12 ounce can), Red Bull (80 mg per 8.4 ounce can), Monster (160 mg per 16 ounce can)
• Caffeine in powder or liquid form can provide toxic levels of caffeine. Just one teaspoon of powdered caffeine is equivalent to 28 cups of coffee.
• Decaffeinated drinks can contain 10-20 mg of caffeine per 8-ounces.

What are the side effects or adverse reactions to caffeine?

At any age, overconsumption of caffeine can cause:

• Insomnia and sleep deprivation
• Anxiety or nervousness
• Irritability
• Nausea and lack of appetite
• Headaches
• Heart racing and/or palpitations
• Muscle tremors or twitches
• Dizziness
• Frequent urination and/or loss of bladder control
• Very high levels of caffeine intake can cause more serious health problems, including cardiac arrest and death.

How does caffeine affect sleep? Why is that important?

Caffeine is a stimulant and can interfere with your sleep, particularly if you drink it in the afternoon or evening. Even small amounts of sleep loss can add up and impact your alertness and ability to concentrate, focus, or perform tasks during the day.

Many adolescents and adults use caffeine to mask sleep deprivation. This can create a viscous cycle. If you drink caffeinated beverages because you are sleepy during the day, that same caffeine keeps you from falling asleep at night, shortening the length of time you sleep, thus making you sleepier the next day, so you drink more caffeine to stay awake!

Sleep is critical during the teenage years when adolescents undergo significant physical, social, emotional, and cognitive development. The optimal amount of sleep for teens between the ages of 13-18 is around 8-10 hours a night. Most of them are not getting enough sleep.

The consequences of losing sleep are potentially serious and can impact a teen's mood, physical health, and school performance. Loss of sleep can cause symptoms that mimic Attention Deficit and Hyperactivity Disorder (ADHD). Memory, attention, and focus are highly impacted by loss of sleep.

Next week, we will talk more about the effects of caffeine, including interactions with other substances, and how to cut back or help your teen cut back on caffeine intake.

If you have any questions about caffiene, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor