Concussion: movies vs. reality

Our hero sinks back into the shadows, waiting for the night watchman to make his regular rounds. He doesn’t have to wait long. He swings with the butt of his pistol and renders the guard unconscious with a blow to the head. “Sweet dreams,” he says. “You’re gonna wake up with a wicked headache.”

Stop the video. For decades, good guys and bad guys (and girls, too) have been knocked out with a bop on the head, a sock to the chin or a quick karate chop. The movies’ all time knockout champ has to be super spy James Bond, who usually comes into consciousness bound and gagged for the next cliffhanger. The hapless detective on The Rockford Files was knocked out pretty much every episode of the TV show’s six-season run.   

We asked Dr. Kenneth Podell, a neuropsychologist and co-director of the Houston Methodist Concussion Center: Is it really possible to smack someone in the head and render them unconscious?

The short answer is yes, it is indeed possible, but the complications come after. “If you hit somebody hard enough with an object to cause unconsciousness, you could also be hitting them hard enough to break the skull,” Podell says. “It depends on the weapon … one with a large surface area (like a frying pan) dissipates the shock over a larger area, while a smaller weapon focuses the force and can easily fracture a skull.”

It doesn't take a big blow to result in a concussion that carries many long-term health effects Click To Tweet

Podell has seen many cases of people suffering long-term effects from concussion after receiving a blow much less violent than those usually depicted in movies. A person coming out of an unconscious episode, waking up as if from a nap, does not happen most of the time. “There’s a kernel of truth there but a blow substantial enough to cause unconsciousness is also very, very dangerous,” he says.

Let’s speed up the video a bit and check out this part: two combatants grapple fiercely in hand-to-hand combat, and the battle is at a deadlock. Suddenly, one uses an explosive head butt to stun his opponent and gain the upper hand.

“Again, this has a bit of truth to it as well … the front, top part of the skull is the thickest part and can theoretically be used as a weapon,” Podell explains. “But remember that’s also the other guy’s thick skull, so the butt-er needs to select a weak point on the butt-ee, like the bridge of the nose or the side of the head.”

Podell cautions that any kind of head injury has the potential to be very serious and have long-term complications. Concussion can cause dizziness, shaky balance, confusion, headaches and memory loss that can linger for weeks or even months. If you suspect you or someone you know may have had a concussion, please immediately seek medical care. 

Like many other physicians, Podell regularly sees things in movies that don’t really line up with real life. He tries to check his expertise at the door, he says, and suspends disbelief to enjoy the fantasy on screen.

The lowdown on caffeine: fact or fiction

When we wake up in the morning, many of us think of one thing: coffee. You drag your body out of bed just to stumble to the coffee maker. That morning dose of caffeine provides the boost that gets you going. It wakes you up, gives you energy and helps your morning productivity.

Caffeine has been hailed for its health benefits and studied relentlessly, but how much do you really know about caffeine? What is fact and fiction?

Caffeine is a drug.

Fact: Caffeine is a pharmacologically-active substance; it can work as a mild stimulant, and therefore is a drug. Some caffeine drinkers report difficulty in reducing or stopping caffeine. Caffeine is addictive and withdrawal can cause symptoms such as headache, loss of energy, fatigue, drowsiness, irritability, anxiety, nausea and depression.

Caffeine is good for kids (ages 8-17).

Myth: Since the U.S. Food and Drug Administration (FDA) doesn’t require manufacturers to list caffeine content on nutrition labels, it’s often hard to tell whether a product contains the stimulant, and how much. Even low doses of caffeine—such as a small soda—have an effect on kids’ blood pressure and heart rates. New research suggests that boys are impacted by the effects of caffeine more than girls.

Over 2.25 billion cups of coffee are consumed in the world every day, making it the most popular caffeine drink.
Over 2.25 billion cups of coffee are consumed in the world every day, making it the most popular caffeinated drink.

Two grande coffees from Starbucks is a good amount to drink per day.

Myth: The recommended daily intake of caffeine is 400mg. One grande coffee from Starbucks contains 330mg of caffeine. Experts suggest staying closer to 200mg in order to reap the benefits and avoid problems. Each person is different; weight, age, and tolerance should be considered.

Coffee makes a drunk person sober and fit to drive.

Myth: Studies reveal this widely perceived claim is false. Caffeine is known for making people more alert, which presumably led to the idea, but it can’t remove the cognitive deficits that alcohol causes.

Cigarette smokers metabolize caffeine faster than nonsmokers.

Fact: Caffeine metabolism is slower among infants, pregnant women, women taking oral contraceptives and individuals with liver disease. Cigarette smokers can actually metabolize caffeine twice as fast as non-smokers.

Cigarette smokers can actually metabolize caffeine twice as fast as non-smokers Click To Tweet

4 cups of coffee = 10 cans of soda = 2 energy shots.

Fact: Click here for more information on caffeine content in foods.

You can’t overdose of caffeine.

Myth: Although it is uncommon, there have been deaths reported due to an overdose of caffeine.

While too much caffeine can be determinantal, moderate amounts in beverages like coffee can have health benefits.
While too much caffeine can be determinantal, moderate amounts in beverages like coffee can have health benefits.

Caffeine can be found in drinks, food and medicines.

Fact: Caffeine is found in more than 60 plants including coffee beans, tea leaves, kola nuts (used to flavor soft drinks) and cacao pods. It can also be found in foods like chocolate, ice cream and energy water, and medicines such as weight-loss pills, pain relievers and migraine medications. You can even spray caffeine directly on your skin.

Caffeine may help protect against some diseases.

Fact: Studies have shown a healthy dose of caffeine could help protect against type 2 diabetes, Parkinson’s disease, cardiovascular disease, stroke and help boost long-term memory. It has also been reported that it reduces suicide risk in adults, risk of liver cancer and the risk of mouth and throat cancer.

Caffeine could help protect against diabetes, heart disease and stroke Click To Tweet

Caffeine is good before a workout.

Myth: Caffeine is a diuretic, meaning it makes your body lose more water, which could lead to dehydration. Avoid drinking caffeinated beverages like coffee, soda, or energy drinks before a workout. If you drink caffeine before, make sure to drink enough water throughout and after your workout in order to stay hydrated.

Is high fructose corn syrup worse than sugar?

Not a week goes by in the media without stories about potential health problems associated with high fructose corn syrup (HFCS). From brands like Yoplait to Heinz and Hunt’s, consumers are asking for the removal of the ingredient from products and companies are responding.

However, what do you really know about HFCS? Is it the main culprit when it comes to weight gain and metabolic problems or is there more to the story? In order to tackle this subject, let’s first look at HFCS and sugar at the molecular level.

Up close and personal: HFCS and sugar

Time for a little biochemistry: The kind of HFCS used in packaged foods and soda goes by the names HFCS 55 and HFCS 42. In the 55 variant, 55% of molecules are fructose and 42% are glucose. For HFCS 42, the breakdown is 42% fructose and 53% glucose. Both fructose and glucose are basic, simple forms of carbohydrates.

At the molecular level, high fructose corn syrup and sugar are nearly identical Click To Tweet

Why did I provide that molecular breakdown? Sucrose or sugar often replaces HFCS when brands swap ingredients and guess what? It has a 1:1 ratio of glucose to fructose, meaning that 50% of the molecules are fructose and 50% are glucose. At the molecular level, HFCS and sugar are nearly identical.

sucrose
This image shows the molecular layout of sucrose or sugar. 50% of it is fructose and 50% is glucose, making it a near mirror molecular image of high fructose corn syrup.

Research roundup: HFCS vs. sugar

Given that HFCS and sugar have a very similar glucose-to-fructose ratio, what does the nutritional literature have to say about the health effects of HFCS?

According to a 2008 study, “Sucrose and HFCS do not have substantially different short-term endocrine/metabolic effects.” Even when looking at other critical factors like appetite- and fat-related hormones, no difference has been found between sugar and HFCS.

A 2012 study that put subjects on a reduced-calorie diet noted that both the HFCS and sugar group lost similar amounts of weight and body fat, leading researchers to conclude the type of sugar in the diet was of no significance.

All these results are similar to a 2007 critical review in Food Science and Nutrition, which summed up its research saying, “The currently available evidence is insufficient to implicate HFCS per se as a causal factor in the overweight and obesity problem in the United States.”

The real nutritional culprit: excess carbohydrates

It may seem like I’m letting HFCS and sugar off the hook, but I’m not. What’s important to realize is that they’re both carbohydrates and because of their connection to “sweetness,” they shift the conversation away from something people need to be more aware of when it comes to their diet: too many carbohydrates elevates blood sugar.

Note how sugar consumption ramped up  in the early '70s. While sweetener choice has changed with time, one aspect has remained constant: Americans are eating more simple carbohydrates.
Note how sugar consumption ramped up in the early ’70s. While sweetener choice has changed with time, one aspect has remained constant: Americans are eating more simple carbohydrates. Image source: Austin G. Davis-Richardson (Wikipedia)

A diet composed of too many insulin-spiking carbohydrates has been implicated in the following health problems:

Too many insulin-spiking carbohydrates may lead to heart disease, diabetes and macular degeneration Click To Tweet

Making healthier choices

Elimination of foods containing HFCS is a great start to revamping one’s diet as HFCS is typically found in processed foods that contain artificial ingredients, little nutrient density, low fiber counts and hydrogenated vegetable oils.

But don’t be misled: eating the same amount of a food that uses sugar or a similar sweetener in the place of HFCS won’t lead to significant improvements in your health.

Instead, shop the perimeter of the grocery store, stocking up on fibrous fruits and vegetables like berries, avocados and broccoli, and protein sources like wild-caught salmon and grass-fed beef. It’s all about increasing the nutrient density of your food choices and being a more aware consumer.

Reviewed by Kristen Kizer, R.D.