- The artificial sweetener industry has defended the safety of sucralose (Splenda), stating that it rapidly passes unmetabolized through your body and therefore has no biological effects
- Recent research reveals sucralose is in fact metabolized and that it accumulates in your fat cells. The study found two new metabolites that have not previously been identified
- As these findings were not part of the original regulatory decision process for sucralose, the researchers are calling for a review of its safety and regulatory status
- Other recent research found sucralose causes definite changes in the liver of treated rats, suggesting toxic effects. According to the researchers, sucralose should be used with caution to avoid liver damage
- Previous research found sucralose reduces gut bacteria by 50 percent, preferentially targeting bacteria known to have important human health benefits
By Dr. Mercola
Sucralose (sold under the brand name Splenda) was approved by the U.S. Food and Drug Administration (FDA) in 1998 as a tabletop sweetener and for use in products such as baked goods, nonalcoholic beverages, chewing gum, frozen dairy desserts, fruit juices and gelatins.
It’s also permitted as a general-purpose sweetener for processed foods. (In the European Union, sucralose is known under the additive code E955.) The approval was given after the FDA supposedly reviewed more than 110 animal and human safety studies, but of these 110 studies, only two were done on humans, and the longest one lasted just four days.
I knew the approval of sucralose was a nearly identical mistake that the FDA made with aspartame, which is why I wrote my book, “Sweet Deception,” in 2006, despite the fact Johnson & Johnson threatened to sue me if I published it. It is certainly vindicating to see the studies confirm what I wrote about in my book over 12 years ago. And the video I made above was shot over seven years ago.
Artificial sweeteners like aspartame and sucralose may have zero calories, but your body isn’t fooled. When hit with a “sweet” taste, your body expects calories to follow, and when this doesn’t happen, it causes biochemical distortions that can result in weight gain, metabolic dysfunction and other health problems.
Sucralose Decimates Your Gut Microbiome
Different artificial sweeteners have been found to wreak havoc in a number of different ways. Aspartame, for example, has a long list of studies detailing harmful effects ranging from brain damage to preterm delivery. Sucralose, meanwhile, has been found to be particularly damaging to your gut. Research1 published in 2008 found sucralose:
- Reduces gut bacteria by 50 percent, preferentially targeting bacteria known to have important human health benefits (consuming as few as seven little Splenda packages is enough to have a detrimental effect on your microbiome)
- Increases the pH level in your intestines
- Is absorbed into and accumulates in fat tissue
In response to this study, James Turner, chairman of the national consumer education group Citizens for Health issued the following statement:2
“The report makes it clear that the artificial sweetener Splenda and its key component sucralose pose a threat to the people who consume the product. Hundreds of consumers have complained to us about side effects from using Splenda and this study … confirms that the chemicals in the little yellow package should carry a big red warning label.”
New Study Finds Sucralose Is Metabolized and Stored in Your Body
Needless to say, the industry has vehemently defended sucralose (and all other chemical sweeteners), stating that it rapidly passes unmetabolized through your body and therefore has no biological effects. Alas, recent research has punched yet another giant hole in the argument that sucralose is a biologically inert chemical, showing it is in fact metabolized and that it accumulates in fat cells.
Ten rats were given an average dose of 80.4 milligrams (mg) of sucralose per kilo per day (k/day) for 40 days. According to the researchers, this dosage is “within the range utilized in historical toxicology studies submitted for regulatory approval in North America, Europe and Asia.”
Urine and feces were collected daily from each rat, and were analyzed using ultrahigh performance liquid chromatography tandem mass spectrometry (UHPLC–MS/MS), which “revealed two new biotransformation products that have not previously been reported.”
Research Calls for New Safety Review of Sucralose
The two metabolites are acetylated forms of sucralose that are lipophilic, meaning they dissolve in and combine with fats. Sucralose itself is far less lipophilic, which has been part of the safety argument. According to the authors:
“These metabolites were present in urine and feces throughout the sucralose dosing period and still detected at low levels in the urine 11 days after discontinuation of sucralose administration and six days after sucralose was no longer detected in the urine or feces.
The finding of acetylated sucralose metabolites in urine and feces do not support early metabolism studies, on which regulatory approval was based, that claimed ingested sucralose is excreted unchanged (i.e., not metabolized).
The historical metabolic studies apparently failed to detect these metabolites in part because investigators used a methanol fraction from feces for analysis along with thin layer chromatography and a low-resolution linear radioactivity analyzer.
Further, sucralose was found in adipose tissue in rats two weeks after cessation of the 40-day feeding period even though this compound had disappeared from the urine and feces.”
So, not only is sucralose metabolized, these metabolites accumulate in your fat tissues, where they remain for “an extended period of time” after you stop consuming sucralose. In all, these findings led the authors to conclude:
“These new findings of metabolism of sucralose in the gastrointestinal tract and its accumulation in adipose tissue were not part of the original regulatory decision process for this agent and indicate that it now may be time to revisit the safety and regulatory status of this organochlorine artificial sweetener.”
Sucralose Is Not an Inert Compound
Previous research has also noted that sucralose is not a biologically inert compound, as claimed. In the 2013 paper,6 “Sucralose, a Synthetic Organochloride Sweetener: Overview of Biological Issues,” the authors state, in part:
“Sucralose and one of its hydrolysis products were found to be mutagenic at elevated concentrations in several testing methods … Both human and rodent studies demonstrated that sucralose may alter glucose, insulin and glucagon-like peptide 1 levels. Taken together, these findings indicate that sucralose is not a biologically inert compound.”
Importantly, the study also notes that “Cooking with sucralose at high temperatures … generates chloropropanols, a potentially toxic class of compounds.” Yet, Splenda is frequently recommended for cooking and baking,7 and is often used in processed foods in which high heat was involved.
Chloropropanols, which are still poorly understood, are thought to have adverse effects on your kidneys and may have carcinogenic effects.8 However, it’s worth noting that chloropropanols are part of a class of toxins known as dioxins, and dioxins are known to cause cancer and endocrine disruption.
Sucralose May Cause Liver Damage With Regular Use, and More
Another study9 published online August 2, 2018, in the journal Morphologie, found sucralose caused “definite changes” in the liver of treated rats, “indicating toxic effects on regular ingestion.” According to these researchers, their findings suggest “sucralose would be taken with caution to avoid hepatic damage.”
In other words, regularly using Splenda could damage your liver. Here, adult rats were given a much higher (yet nonlethal) oral dose of sucralose — 3 grams (3,000 milligrams) per kilo body mass per day for 30 days, after which the animals’ livers were dissected and compared to the livers of unexposed controls. According to the authors:
“Experimental rats showed features of patchy degeneration of hepatocytes along with Kupffer cells hyperplasia, lymphocytic infiltration, sinusoidal dilatation and fibrosis indicating a definite hepatic damage on regular ingestion of sucralose. Sinusoidal width was also found to be increased in experimental animals as compared to controls.”
Studies have also linked sucralose consumption to:
|Genotoxicity (DNA damage) and potentially adverse epigenetic effects.10 According to this paper, the acceptable daily intake set for sucralose may in fact be hundreds of times too high to ensure safety|
|Shrinkage of the thymus, up to 40 percent11,12|
|Enlargement of the liver and kidneys13,14|
|Calcification of the kidneys15,16|
|Increased leukocyte populations (immune system cells) in the thymus and lymph nodes17|
|Altered glucose, insulin and glucagon-like peptide-1 levels and responses,19 which raises your risk for Type 2 diabetes.
A study20 published in the journal Diabetes Care confirmed that, compared to controls, obese patients using sucralose experienced a greater incremental increase in peak plasma concentrations of glucose, a greater incremental increase in insulin and peak insulin secretion rate, along with a decrease in insulin clearance.
According to the authors, “These data demonstrate that sucralose affects the glycemic and insulin responses to an oral glucose load in obese people who do not normally consume non-nutritive sweeteners”
|Alterations in P-glycoprotein (P-gp) levels, which could result in medications used in chemotherapy, AIDS treatment and treatments for heart conditions being shunted back into the intestines, rather than being absorbed by your body21|
Commonly Reported Side Effects of Splenda
If you start searching for adverse events reports, you’ll find scores of people reporting a variety of side effects from using Splenda. The following are common symptoms, usually noticed within a 24-hour period following consumption of a Splenda product:
|Skin — Redness, itching, swelling, blistering, weeping, crusting, rash, eruptions or hives (itchy bumps or welts)|
|Lungs — Wheezing, tightness, cough or shortness of breath|
|Head — Swelling of the face, eyelids, lips, tongue, or throat; headaches and migraines (severe headaches)|
|Nose — Stuffy nose, runny nose (clear, thin discharge), sneezing|
|Eyes — Red (bloodshot), itchy, swollen or watery|
|Stomach — Bloating, gas, pain, nausea, vomiting, diarrhea or bloody diarrhea|
|Heart — Palpitations or fluttering|
|Joints — Joint pains or aches|
|Neurological — Anxiety, dizziness, spaced-out sensation, depression|
Are You Having a Reaction to Splenda?
To determine if you’re having a reaction to artificial sweeteners — be it Splenda, aspartame or any of the others — take the following steps:
- Eliminate all artificial sweeteners from your diet for two weeks
- After two weeks, reintroduce your artificial sweetener of choice in a significant quantity (about three servings daily)
- Avoid other artificial sweeteners during this period
- Do this for one to three days and take notice of how you feel, especially as compared to when you were abstaining from artificial sweeteners
- If you don’t notice a difference in how you feel after reintroducing your primary artificial sweetener for a few days, it’s a safe bet you’re able to tolerate it acutely, meaning your body doesn’t have an immediate, adverse response. Just know that this doesn’t mean your health won’t be damaged in the long run
- If you’ve been consuming more than one type of artificial sweetener, repeat steps 2 through 4 with the next sweetener on your list
If you do experience side effects from an artificial sweetener (or any other food additive for that matter), please report it to the FDA (if you live in the U.S.). It’s easy to make a report — just go to the FDA Consumer Complaint Coordinator page, find the phone number for your state, and make a call to report your reaction.
Keep in mind that some medications may contain sucralose as well, even if it’s not listed on the label. If you continue to experience any of the symptoms above even though you’re avoiding Splenda and other artificial sweeteners, then it may be worth investigating whether any of the medications you’re taking contain artificial sweeteners.
Splenda Has Never Been Proven Safe for Human Consumption
The FDA claims they reviewed over 100 studies conducted on Splenda. What they don’t tell you is that a) only six of these studies were human trials — and only two of them were published before the FDA approved sucralose for human consumption — and b) the remaining animal studies actually revealed potential health problems, including:22
- Decreased red blood cells (a sign of anemia) at levels above 1,500 mg/kg/day
- Increased male infertility by interfering with sperm production and vitality, as well as brain lesions at higher doses
- Spontaneous abortions in nearly half the rabbit population given sucralose, compared to zero aborted pregnancies in the control group
- A 23 percent death rate in rabbits, compared to a 6 percent death rate in the control group
What’s more, the two human trials had a grand total of 36 subjects, only 23 of whom were actually given sucralose, and the longest of these trials lasted just four days and looked at sucralose in relation to tooth decay, not human tolerance.23
Even more shocking, the absorption of Splenda into the human body was studied on a grand total of six men. Based on that study,24 the FDA allowed the findings to be generalized as being representative of the entire human population, including women, children, the elderly and those with any chronic illness — none of whom were ever examined.
Healthier Sugar Substitutes
Two of the best sugar substitutes are from the plant kingdom: Stevia and Lo Han Kuo (also spelled Luo Han Guo). Stevia, a highly sweet herb derived from the leaf of the South American stevia plant, is sold as a supplement. It’s completely safe in its natural form and can be used to sweeten most dishes and drinks.
Lo Han Kuo is similar to Stevia, but it’s a bit more expensive and harder to find. In China, the Lo Han fruit has been used as a sweetener for centuries, and it’s about 200 times sweeter than sugar. A third alternative is to use pure glucose, also known as dextrose.
Dextrose is only 70 percent as sweet as sucrose, so you’ll end up using a bit more of it for the same amount of sweetness, making it slightly more expensive than regular sugar. Still, it’s well worth it for your health as it does not contain any fructose whatsoever. Contrary to fructose, glucose can be used directly by every cell in your body and as such is a far safer sugar alternative.
Nadia Murad survived the worst cruelties ever inflicted on her people, the Yazidis of Iraq, before becoming a global champion of their cause and winning the Nobel Peace Prize.
On Friday, Murad and Congolese doctor Denis Mukwege were jointly awarded the prize for their “efforts to end the use of sexual violence as a weapon of war,” Nobel committee chairwoman Berit Reiss-Andersen said in unveiling the winners in Oslo.
The 25-year-old Murad, her thin, pale face framed by her long brown hair, once lived a quiet life in her village near the mountainous Yazidi stronghold of Sinjar in northern Iraq, close to the border with Syria.
But when the so-called Islamic State jihadist group stormed across swathes of the two countries in 2014, her fate changed forever and her nightmare began.
One day in August that year, pick-up trucks bearing the black flag of the jihadists swept into her village, Kocho.
IS fighters set about killing the men, taking children captive to train them as fighters and condemning thousands of women to a life of forced labour and sexual slavery.
Today, Murad and her friend Lamia Haji Bashar, joint recipients of the EU’s 2016 Sakharov human rights prize, continue the fight for the 3,000 Yazidis who remain missing, presumed still in captivity.
IS fighters wanted “to take our honour, but they lost their honour,” said Murad, now a United Nations goodwill ambassador for survivors of human trafficking.
It is an evil she personally experienced during a harrowing three months.
After being captured by IS fighters, Murad was taken by force to Mosul, the de facto “capital” of the IS’s self-declared caliphate.
During her ordeal she was held captive and repeatedly gang-raped, tortured and beaten.
The jihadists organised slave markets for selling off the women and girls, and Yazidi women were forced to renounce their religion.
– Seen as heretics –
For the jihadists, with their ultra-strict interpretation of Islam, the Yazidis are seen as heretics.
The Kurdish-speaking community follows an ancient religion, revering a single God and the “leader of the angels”, represented by a peacock.
Like thousands of Yazidis, Murad was forcibly married to a jihadist, beaten and forced to wear makeup and tight clothes — an experience she later related in front of the United Nations Security Council.
“The first thing they did was they forced us to covert to Islam”, Murad told AFP in 2016.
Shocked by the violence, Murad set about trying to escape, and managed to flee with the help of a Muslim family from Mosul.
Armed with false identity papers, she managed to cross the few dozen kilometres (miles) to Iraqi Kurdistan, joining crowds of other displaced Yazidis in camps.
There, she learnt that six of her brothers and her mother had been killed.
With the help of an organisation that assists Yazidis, she joined her sister in Germany, where she lives today.
She has since dedicated herself to what she calls “our peoples’ fight”, before a well-known spokeswoman even before the #MeToo movement swept the world.
The Yezidis numbered around 550,000 in Iraq before 2014, but some 100,000 have since left the country.
Many others have fled and remain in Iraqi Kurdistan, reluctant to return to their traditional lands.
Slight, and softly-spoken Murad has now become a global voice, campaigning for justice for her people and for the acts committed by the jihadists to be recognised internationally as genocide.
And she and the Yazidis have won a high-profile supporter — Lebanese-British lawyer and rights activist Amal Clooney, who also penned the foreword to Murad’s book, “The Last Girl”, published in 2017.
The same year, the UN Security Council committed to helping Iraq gather evidence of IS crimes.
Yet in contrast to all the tragedies that have befallen her, recent pictures on Murad’s Twitter feed show happier times.
In August, she announced her engagement to fellow Yazidi activist Abid Shamdeen.
“The struggle of our people brought us together & we will continue this path together,” she wrote.
Underneath, a photo showed her next to a young man in a bow tie, her face still framed by her long brown hair, but this time, bearing a broad smile.
Critics fear it could become a bio-weapon.
The Pentagon is studying whether insects can be enlisted to combat crop loss during agricultural emergencies.
The bugs would carry genetically engineered viruses that could be deployed rapidly if critical crops such as corn or wheat became vulnerable to a drought, a natural blight or a sudden attack by a biological weapon.
The concept envisions the viruses making genetic modifications that protect the plants immediately, during a single growing season.
The program, funded by the Defense Advanced Research Projects Agency (DARPA), has a warm and fuzzy name: ‘Insect Allies’. But some critics find the whole thing creepy.
A team of skeptical scientists and legal scholars published an article in the journal Science on Thursday arguing that the Insect Allies program opens a “Pandora’s box” and involves technology that “may be widely perceived as an effort to develop biological agents for hostile purposes and their means of delivery”.
A website created by the critics puts their objection more bluntly: “The DARPA program is easily weaponized”.
DARPA’s program manager for Insect Allies, Blake Bextine, pushed back on the Science article, saying the program is solely for peaceful purposes, has been reviewed by government agencies responsible for agricultural safety and has multiple layers of safeguards built into the research protocols, including total containment of the insects.
“I don’t think that the public needs to be worried. I don’t think that the international community needs to be worried,” Bextine told The Washington Post.
He acknowledged that Insect Allies involves new technologies that potentially could be “dual use” – deployed, in theory, for either defensive or offensive purposes. But that’s true for almost any advanced technology, he said.
“I think anytime you’re developing a new and revolutionary technology, there is that potential for dual-use capability. But that is not what we are doing. We are delivering positive traits to plants. We’re focused on that positive goal. We want to make sure we ensure food security, because food security is national security in our eyes,” Bextine said.
The program currently envisions three types of pestiferous insects as allies: aphids, leafhoppers and whiteflies. In nature these bugs routinely spread viruses among plants.
Recent advances in gene editing, including the relatively cheap and simple system known as CRISPR (for clustered regularly interspaced palindromic repeats), could potentially allow researchers to customize viruses to achieve a specific goal in the infected plant.
The engineered virus could switch on or off certain genes that, for example, control a plant’s growth rate, which could be useful during an unexpected, severe drought.
Bextine said there are multiple layers of protection to ensure that this technology does not have unintended ecological effects. He also said that the program is not targeting the germline cells of plants and thus would not lead to heritable traits.
The DARPA goal is to find a way to make a temporary, beneficial modification to plants in a single growing season.
This research may never bear fruit. That’s the norm for most DARPA projects.
The agency, famous for its key role in laying the foundation for the Internet half a century ago, typically funds research with a low probability of success but a potentially huge pay-off.
Food security is a major issue not likely to vanish anytime in the coming decades, as a more crowded planet experiences climate change, pollution, loss of biodiversity and the surging demand for food and water. Crop warfare is another concern.
In ancient times, armies burned fields as a strategic element of conquest. In today’s world the threats could include the distribution of natural pathogens or something engineered in a laboratory.
DARPA’s description of Insect Allies touts the rapid-response feature of the concept.
“National security can be quickly jeopardized by naturally occurring threats to the crop system, including pathogens, drought, flooding, and frost, but especially by threats introduced by state or non-state actors,” the DARPA website states.
“Insect Allies seeks to mitigate the impact of these incursions by applying targeted therapies to mature plants with effects that are expressed at relevant timescales – namely, within a single growing season. ”
The authors of the Science paper contend that Insect Allies could potentially be interpreted as a violation of an international treaty called the Biological Weapons Convention. They do not go so far as to claim that DARPA has nefarious motives.
They have said that if observers see the program as having an offensive military applications that could undermine adherence to the biological weapons treaty.
“We argue that there is the risk that the program is seen as not justified by peaceful purposes,” co-author Silja Voeneky, a professor of international law at the University of Freiburg, told The Washington Post.
She said the use of insects as a key feature of the program is particularly alarming, because insects could be deployed cheaply and surreptitiously by malevolent actors.
“In our opinion the justifications are not clear enough. For example, why do they use insects? They could use spraying systems,” Voeneky said.
“To use insects as a vector to spread diseases is a classical bioweapon.”
The biological weapons treaty does permit research that has a clearly stated peaceful purpose, said Andy Weber, a former Pentagon official overseeing nuclear, chemical and biological defense programs and now a senior fellow at the Council on Strategic Risks.
Weber noted that the biodefense community has been concerned about the potential use of new gene-editing technologies by hostile actors.
“Over time, terrorist groups and individuals could also exploit these new capabilities, but I don’t see that as something that is going to happen this year or next year. But it’s certainly something that we want to get ahead of,” he said.
James Stack, a plant pathologist at Kansas State University who is serving on the advisory panel of the Insect Allies project, said the alarm sounded by the Science article is unfounded.
“It’s nowhere near the application stage. This is to determine if this approach is viable or not. I don’t understand the level of concern raised in this paper, and to jump ahead and accuse DARPA of using this as a screen to develop biological weapons is outrageous,” Stack said.
He went on: “There’s risk inherent in life and you just have to manage it well. And I think as we move into a more crowded planet it’s going to put increasing demands on our food systems, our water systems. We’re going to need all the tools in the tool box that we possibly have.”
One of those tools is genetic modification of organisms through laboratory techniques. Insect Allies might be so effective as an gene-editing technology that it could become a standard procedure for farmers, said Guy Reeves, a co-author of the Science paper and an evolutionary biologist at Max Planck Institute for Evolutionary Biology.
He said the genetic modifications – delivered by what he refers to as “horizontal environmental genetic alteration agents” – would likely spread into fields reserved for organic, non-genetically modified crops.
“If this program is acceptable, and we decide this technology is something we want to move forward with, why would we use any other technology for anything?” he said.
“If this technology works, almost by definition, national governments will not be able to control its spread.”
DARPA said this week that the Insect Allies program includes grants to four research institutions: the Boyce Thompson Institute, Penn State, Ohio State and the University of Texas at Austin.
The research is still in its initial phase, Bextine said. The first major achievement is the demonstration that an aphid can infect a mature corn plant with a modified virus containing a gene that creates fluorescence.
The corn glowed.
Coca-Cola says it is “closely watching” the use of CBD (Cannabidiol) as an ingredient in “wellness beverages” as a growing number of companies develop cannabis-infused drinks.
CBD is a cannabinoid that can be extracted from both marijuana and hemp varieties of cannabis. CBD doesn’t produce the high associated with marijuana, however, it is believed by many to have calming, anti-inflammatory and pain-relieving properties.
While Coca-Cola said it has “no interest in marijuana or cannabis,” they have stated: “Along with many others in the beverage industry, we are closely watching the growth of non-psychoactive CBD as an ingredient in functional wellness beverages around the world,” the company added. “The space is evolving quickly. No decisions have been made at this time.”
Coca-Cola released their statement after a report from Canada’s BNN Bloomberg reported that they were in “serious talks” with Aurora Cannabis, a medical marijuana producer and distributor, to develop drinks infused with CBD.
Following the BNN report, stocks for Aurora Cannabis spiked 17% and Coca-Cola’s shares rose slightly.
Aurora spokeswoman Heather MacGregor said her company “has expressed specific interest in the infused-beverage space and we intend to enter that market”.
CBD oil has boomed in popularity as a number of states and countries legalize the use of CBD, hemp and marijuana products. The CBD market is forecast to grow $2.1 billion by 2020 according to Hemp Business Journal.
Canadians can legally buy and consume cannabis starting October 17th. South Africa’s highest court has recently legalized the use of cannabis by adults in private places, although it remains illegal to sell, supply and use in public. The statement has been seen as a prelude to further legalization in the united states.
Coca-Cola has been diversifying their product portfolio with recent investments in sparkling water and coffee beverages. Demand for sugary sodas has declined each year over the last decade as consumers become more health conscious.
Beer giant Molson Coors announced on August 1st that they were teaming up with The Hydropothecary Corporation, a Canadian medical marijuana grower, to develop cannabis-infused non-alcoholic beverages. Although it likely that these beverages will not only contain CBD, but also THC, the cannabinoid that causes the high or buzz effect of marijuana.
Two weeks later, spirits company Constellation Brands announced a new $4 billion in investment in Canada’s Canopy Growth, a Canadian medical marijuana producer, in exchange for a 38% stake in the company.
Ever since she was diagnosed with a form of aggressive breast cancer six years ago, Tara Shuman has channeled her abundant energy and optimism into getting through and beyond her cancer, and also on doing everything possible to help others facing it.
Shuman, 38, was living a fun, frenetic existence as a healthcare attorney raising 4- and 1-year-old kids when an August 2012 visit with her friend—whose cancer had recently returned—prompted her to do a breast self-exam. The bump she found was diagnosed as triple-positive breast cancer; five weeks later she underwent a bilateral mastectomy, followed by chemotherapy and biotherapy infusions.
Shuman’s treatment now consists solely of oral hormonal therapy, which she takes daily to help slow the growth of cancer and stop new tumors from emerging. Her busy life continues, with much of its focus now in a new area. In addition to co-captaining Team Tara, one of the largest fundraising teams supporting research and clinical care at Dana-Farber in this year’s Boston Marathon® Jimmy Fund Walk presented by Hyundai, Shuman has served on the cancer center’s Adult Patient and Family Advisory Council, authored a book and blog devoted to cancer survivorship, and makes herself available to other people facing cancer.
She is aided in these efforts by her husband, children, and a large network of loved ones, as well as caregivers and colleagues at Dana-Farber who have become a second family.
“I try to do for others what others have done for me,” says Shuman. “The further I get from treatment, the luckier I feel, because I know life can change in an instant.”
After her initial treatment through Dana-Farber’s Susan F. Smith Center for Women’s Cancers, led by breast oncologist Craig Bunnell, MD, MPH, Shuman quickly achieved an early post-treatment goal: walking the 5K (3.1-mile) route of the 2013 Jimmy Fund Walk with her 5-year-old son, Teddy.
The next year Shuman felt so good that she set out to walk the entire 26.2-mile, Hopkinton-to-Copley Square Jimmy Fund Walk route with members of her newly-formed Team Tara. Near the end she started feeling faint and was forced to drop out at Mile 25, within sight of the famous Citgo sign. Undeterred, she returned a week later with her husband, Brian, to walk the last mile. A crowd of team members and Dana-Farber staff welcomed them at the finish line.
It took a few more years of training, but last year she finally did the whole route in one day for the first time—as one of 273 members of the latest Team Tara crew. This year’s team goal is 300 walkers, and Shuman and her co-captain Amy Killeen are determined to make it.
“Talk about making lemonade from lemons; Tara has grown an entire grove of lemon trees from her experience,” says Bunnell, who is also Dana-Farber’s chief medical officer. “She is an inspiration to all of us, patients and care team alike.”
In addition to organizing the Jimmy Fund Walk team every year and guiding others along their cancer journeys, Shuman is enjoying life with Brian and her kids—son Teddy, 10, and daughter Annabel, 7, who fill the weekends with practices, meets, and games, and the students at the Boston high school where she teaches English.
“I don’t feel any sense of celebration at doing well, and I don’t consider myself brave. I am lucky and thankful to have found Dana-Farber and to be able to reach out and connect with so many people going through cancer.”
A patient’s treatment plan for fighting cancer doesn’t stop at the hospital door. Adopting a healthy lifestyle, in terms of diet and exercise, is especially important for cancer patients in reducing stress, minimizing side effects, and boosting energy levels to power through treatment and recovery.
More than 93 million American adults could be counted as obese in 2016, according to the most recently available data from the Centers for Disease Control and Prevention. “Obesity not only increases the risks of developing cancer; it also increases the risks of complications in diagnosed patients,” says Jennifer Ligibel, MD, director of Dana-Farber’s Leonard P. Zakim Center for Integrative Therapies and Healthy Living.
Plus, in some common cancers, such as breast cancer and prostate cancer, many patients now tend to gain—rather than lose—weight during treatment.
“That contradicts a common misperception that people have had for many years,” Ligibel continues. “Some patients think, ‘I have cancer. I have to make sure I don’t lose weight,’ so they bulk up. But we have much better medications to help patients avoid nausea and weight loss during treatment now than we did even a few years ago.
“Many people become less active during their cancer treatment, and even afterward,” says Ligibel. “Some cancer treatments can also contribute to weight gain.”
How Patients Can Evaluate and Manage Their Diet
Ligibel recommends following the American Cancer Society’s guidelines on nutrition and weight management. They emphasize a plant-based diet with most nutrients coming from fruits, vegetables, whole grains, lean meats and fish.
“When you look across a population of people who have healthy behaviors—they eat a plant-based diet, their weight is in the normal range—we know that those people are less likely to get cancer in the first place,” Ligibel says. “In some cases, they are also less likely to have it comes back after it develops.”
Why Exercise is Important
Exercise is crucial in helping patients lose and manage weight and also provides other critical health benefits.
“If you exercise during your cancer treatment, and afterward, that can help prevent some of the long-term side effects that patients can develop from cancer treatment,” Ligibel says. “Exercise has been shown to reduce side effects like fatigue and joint pains from cancer treatments. Patients also feel better when they exercise and experience less anxiety and depression.”
Exercise also helps to preserve muscle; muscle loss often happens during cancer treatment, and can make recovery difficult, Ligibel says.
Those very side effects—especially fatigue—can make it difficult for patients to feel motivated to exercise in the first place. What’s important is to start now, wherever you are in your treatment, and to start slowly.
“I tell patients that 10 percent of something is better than 100 percent of nothing,” says Nancy Campbell, a clinical exercise physiologist at the Zakim Center. “Patients don’t have to go to a gym, start training for a marathon or buy expensive equipment. All it takes is a walk out your door or around your house to get started.”
Campbell suggests using a fitness tracking device, be it a basic pedometer, a smart phone app or Fitbit. After wearing it for a few weeks, you should have a baseline of your activity during treatment weeks, non-treatment weeks and weekends.
“It gives patients a good gauge of how much activity they are doing and how to gradually increase it,” she explains. “As people start to feel better, they get excited and do more and sometimes may do too much too soon. The device gives you feedback to let you know if you need to add more activity. If patients are sedentary, some of the apps buzz to remind you to move around every hour.”
To rebuild your muscle tone, Campbell suggests signing up for the free Live Strong program offered by YMCA locations across the country. This 12-week physical fitness program is designed specifically for cancer patients.
“There are also plenty of things you can do on your own at home,” she says. “You can get creative with light weights, such as soup cans, at home. But get some professional guidance before you start.”
Yoga, too, has been shown to have significant benefits for cancer patients in terms of reducing fatigue, improving sleep and improving quality of life.
“The data shows us that staying active during treatment definitely helps,” Campbell says. “Just doing a little something can take the edge off the nausea and fatigue, improve your mood and help take your mind off of it all.”
The Norwegian Nobel Committee has decided to award the Nobel Peace Prize for 2018 to Denis Mukwege and Nadia Murad for their efforts to end the use of sexual violence as a weapon of war and armed conflict. Both laureates have made a crucial contribution to focusing attention on, and combating, such war crimes. Denis Mukwege is the helper who has devoted his life to defending these victims. Nadia Murad is the witness who tells of the abuses perpetrated against herself and others. Each of them in their own way has helped to give greater visibility to war-time sexual violence, so that the perpetrators can be held accountable for their actions.
The physician Denis Mukwege has spent large parts of his adult life helping the victims of sexual violence in the Democratic Republic of Congo. Since the Panzi Hospital was established in Bukavu in 1999, Dr. Mukwege and his staff have treated thousands of patients who have fallen victim to such assaults. Most of the abuses have been committed in the context of a long-lasting civil war that has cost the lives of more than six million Congolese.
Denis Mukwege is the foremost, most unifying symbol, both nationally and internationally, of the struggle to end sexual violence in war and armed conflicts. His basic principle is that “justice is everyone’s business”. Men and women, officers and soldiers, and local, national and international authorities alike all have a shared responsibility for reporting, and combating, this type of war crime. The importance of Dr. Mukwege’s enduring, dedicated and selfless efforts in this field cannot be overstated. He has repeatedly condemned impunity for mass rape and criticised the Congolese government and other countries for not doing enough to stop the use of sexual violence against women as a strategy and weapon of war.
Nadia Murad is herself a victim of war crimes. She refused to accept the social codes that require women to remain silent and ashamed of the abuses to which they have been subjected. She has shown uncommon courage in recounting her own sufferings and speaking up on behalf of other victims.
Nadia Murad is a member of the Yazidi minority in northern Iraq, where she lived with her family in the remote village of Kocho. In August 2014 the Islamic State (IS) launched a brutal, systematic attack on the villages of the Sinjar district, aimed at exterminating the Yazidi population. In Nadia Murad’s village, several hundred people were massacred. The younger women, including underage children, were abducted and held as sex slaves. While a captive of the IS, Nadia Murad was repeatedly subjected to rape and other abuses. Her assaulters threatened to execute her if she did not convert to their hateful, inhuman version of Islam.
Nadia Murad is just one of an estimated 3 000 Yazidi girls and women who were victims of rape and other abuses by the IS army. The abuses were systematic, and part of a military strategy. Thus they served as a weapon in the fight against Yazidis and other religious minorities.
After a three-month nightmare Nadia Murad managed to flee. Following her escape, she chose to speak openly about what she had suffered. In 2016, at the age of just 23, she was named the UN’s first Goodwill Ambassador for the Dignity of Survivors of Human Trafficking.
This year marks a decade since the UN Security Council adopted Resolution 1820 (2008), which determined that the use of sexual violence as a weapon of war and armed conflict constitutes both a war crime and a threat to international peace and security. This is also set out in the Rome Statute of 1998, which governs the work of the International Criminal Court. The Statute establishes that sexual violence in war and armed conflict is a grave violation of international law. A more peaceful world can only be achieved if women and their fundamental rights and security are recognised and protected in war.
This year’s Nobel Peace Prize is firmly embedded in the criteria spelled out in Alfred Nobel’s will. Denis Mukwege and Nadia Murad have both put their personal security at risk by courageously combating war crimes and seeking justice for the victims. They have thereby promoted the fraternity of nations through the application of principles of international law.
Oslo, 5 October 2018