Beverages, Botox and mindfulness

Medical Minutes

Grab some ginger ale

A new study is suggesting that oral perceptions of coldness and carbonation may help to reduce thirst. Because thirst and its cessation contribute to how much fluid a person drinks, the current findings could help guide sensory approaches to increase fluid intake in populations at risk for dehydration, such as older adults. Hopefully, this study will help lead to improved beverage choices for older adults.

Drinking fluids helps protect against dehydration, which occurs when the body loses more fluid than it consumes. Mild to moderate dehydration can lead to thirst and headaches, but severe dehydration requires immediate medical attention.

“We have a decent understanding of what turns thirst on, but need to better understand what turns it off so we can motivate the elderly and other at-risk populations to keep drinking their fluids,” said study author Paul Breslin, PhD, who is a sensory biologist at the Monell Chemical Senses Center in Chicago.

Sensory cues in the mouth appear to play a role in thirst quenching, but the specific signals that the body uses to determine the amount of liquid consumed and when to stop drinking remain largely unknown. In the current study, researchers investigated several oral sensations to identify which have an impact on thirst and influence the amount of liquid people drink.

A total of 98 healthy individuals participated in the experiments. To induce thirst, participants abstained from liquid and food overnight and then ate a small breakfast of toast and jelly. At this point, the participants rated their thirst as ‘strong.’ Each individual then had five minutes to drink 13.5 ounces of water under one of four conditions, varying temperature (room-temperature or cold refrigerator-temperature) and carbonation (plain or carbonated). Then, after a short waiting period the participants were allowed to drink as much plain (non-carbonated, room temperature) water as they wished.

By measuring how much plain water was consumed after the experimental beverage, the researchers could evaluate how well the experimental beverage had quenched participants’ thirst. Using this functional measure, the researchers found that cold liquid reduced thirst more effectively than room temperature. Adding carbonation to a cold beverage further enhanced the beverage’s thirst quenching properties. Experiments testing the thirst-quenching effects of astringency, sweetness and mild acidification showed no effect, supporting the specific effects of cold and carbonation on thirst reduction.

Keeping negative emotions in check

Meditation can help tame your emotions even if you’re not a mindful person, according to researchers at Michigan State University. Reporting in the journal “Frontiers in Human Neuroscience,” psychology researchers recorded the brain activity of people looking at disturbing pictures immediately after meditating for the first time. These participants were able to tame their negative emotions just as well as participants who were naturally mindful.

“Our findings not only demonstrate that meditation improves emotional health, but that people can acquire these benefits regardless of their ‘natural’ ability to be mindful,” said lead study investigator Yanli Lin, a Michigan State University graduate student. “It just takes some practice.”

Mindfulness, a moment-by-moment awareness of one’s thoughts, feelings and sensations, has gained worldwide popularity as a way to promote health and well-being. But what if someone isn’t naturally mindful? Can they become so simply by trying to make mindfulness a “state of mind”? Researchers assessed 68 participants for mindfulness using a scientifically validated survey. The participants were then randomly assigned to engage in an 18-minute audio guided meditation or listen to a presentation of how to learn a new language, before viewing negative pictures (such as a bloody corpse) while their brain activity was recorded.

The participants who meditated had varying levels of natural mindfulness and showed similar levels of “emotion regulatory” brain activity as people with high levels of natural mindfulness. In addition, some of the participants were instructed to look at the gruesome photos “mindfully” (be in a mindful state of mind) while others received no such instruction.

Interestingly, the people who viewed the photos “mindfully” showed no better ability to keep their negative emotions in check. This suggests that for non-meditators, the emotional benefits of mindfulness might be better achieved through meditation, rather than forcing a state of mindfulness, according to the researchers.

Botox for urinary incontinence versus implanted electrodes

A new study by researchers at Duke University in Durham, North Carolina, is suggesting that it is a bit of toss up when comparing Botox to sacral neuromodulation (use of an implanted electrode for bladder control) in controlling episodes of refractory urgency urinary incontinence in women.

Urgency urinary incontinence is a sudden need to void resulting in uncontrollable urine loss. This disruptive condition is common and increases with age. Women with refractory (not responsive to treatment) urgency urinary incontinence are treated with onabotulinumtoxinA (Botox) and sacral neuromodulation. This type of neurostimulation involves the implantation of a small electrode tip near the sacral nerve, which controls voiding function in the lower spine. The implanted device stimulates the nerve to act as a sort of pacemaker for the bladder.

Researchers at nine medical centers randomly assigned 192 women with refractory urgency urinary incontinence to an injection of Botox and 189 women to sacral neuromodulation. The mean age of the women was 63. The researchers found that the Botox group had a statistically significant greater reduction in six-month average number of episodes of urgency incontinence per day compared to the sacral neuromodulation group (-3.9 compared to -3.3 episodes per day).

Women treated in the Botox group showed greater improvement in an overactive bladder questionnaire for symptom bother, treatment satisfaction and treatment endorsement compared to the sacral neuromodulation group. However, there was no significant difference for quality of life or for measures of treatment preference, convenience, or adverse effects. The Botox group had an increase in the risk of urinary tract infections and need for self-catheterizations compared to the sacral neuromodulation group.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at

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John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

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