Melanoma is a type of skin cancer. It is not the most common, but it is the most serious, as it often spreads. When this happens, it can be difficult to treat, and the outlook may be poor. Risk factors for melanoma include overexposure to the sun, having fair skin, and a family history of melanoma, among others.

Receiving an early diagnosis and getting prompt treatment can improve the outlook for people with melanoma.

For this reason, people should keep track of any changing or growing moles. Using adequate protection against sun exposure can help a person prevent melanoma altogether.

What is melanoma?

Melanoma is a type of skin cancer that occurs when pigment producing cells called melanocytes mutate and begin to divide uncontrollably.

Most pigment cells develop in the skin. Melanomas can develop anywhere on the skin, but certain areas are more at risk than others. In men, it is most likely to affect the chest and back. In women, the legs are the most common site. Other common sites of melanoma include the face.

However, melanoma can also occur in the eyes and other parts of the body, including — on very rare occasions — the intestines.

Melanoma is relatively rare in people with darker skin.

Stages

The stage of a cancer at diagnosis will indicate how far it has already spread and what kind of treatment will be suitable.

One method of assigning a stage to melanoma describes the cancer in five stages, from 0 to 4:

• Stage 0: The cancer is only present in the outermost layer of skin. Doctors refer to this stage as “melanoma in situ.”
• Stage 1: The cancer is up to 2 millimeters (mm) thick. It has not yet spread to lymph nodes or other sites, and it may or may not be ulcerated.
• Stage 2: The cancer is at least 1 mm thick but may be thicker than 4 mm. It may or may not be ulcerated, and it has not yet spread to lymph nodes or other sites.
• Stage 3: The cancer has spread to one or more lymph nodes or nearby lymphatic channels but not distant sites. The original cancer may no longer be visible. If it is visible, it may be thicker than 4 mm and also ulcerated.
• Stage 4: The cancer has spread to distant lymph nodes or organs, such as the brain, lungs, or liver.

The more advanced a cancer is, the harder it is to treat and the worse the outlook becomes.

Types

There are four types of melanoma. Learn more about each type in the sections below.

Superficial spreading melanoma

This is the most common type of melanoma, and it often appears on the trunk or limbs. The cells tend to grow slowly at first before spreading across the surface of the skin.

Nodular melanoma

This is the second most common type of melanoma, appearing on the trunk, head, or neck. It tends to grow quicker than other types, and it may appear as a reddish or blue-black color.

Lentigo maligna melanoma

This is less common and tends to develop in older adults, especially in parts of the body that have had excessive sun exposure over several years, such as the face.

It starts as a Hutchinson’s freckle, or lentigo maligna, which looks like a stain on the skin. It usually grows slowly and is less dangerous than other types of melanoma.

Acral lentiginous melanoma

This is the rarest kind of melanoma. It appears on the palms of the hands, soles of the feet, or under the nails.

Since people with darker skin do not typically get other types of melanoma, these tend to be the most common type of melanoma in those with darker skin types.

Risk factors

Research into the exact causes of melanoma is ongoing.

However, scientists do know that people with certain skin types are more prone to developing melanoma.

The following factors may also contribute to an increased risk of skin cancer:

• a high density of freckles or a tendency to develop freckles following exposure to the sun
• a high number of moles
• five or more atypical moles
• the presence of actinic lentigines, also known as liver spots or age spots
• giant congenital melanocytic nevi, a type of brown birthmark
• pale skin that does not tan easily and tends to burn
• light eyes
• red or light hair
• high sun exposure, particularly if it produces blistering sunburn, and if sun exposure is intermittent rather than regular
• older age
• a family or personal history of melanoma
• a previous organ transplant

Of these risk factors, only sun exposure and sunburn are avoidable. Avoiding overexposure to the sun and preventing sunburn can significantly lower the risk of skin cancer. Tanning beds are also a source of damaging ultraviolet (UV) rays.

Being able to tell the difference between normal moles or freckles and those that indicate skin cancer can support an early diagnosis.

• Superficial spreading melanoma
• Nodular melanoma
• Lentigo maligna melanoma
• Acral lentiginous melanoma
• Skin changes due to cancer
• Normal mole

Symptoms

In its early stages, melanoma can be difficult to detect. It is important to check the skin for any signs of change.

Alterations in the appearance of the skin are vital indicators of melanoma. Doctors use them in the diagnostic process.

The Melanoma Research Foundation offer pictures of melanomas and normal moles to help a person learn how to tell the difference.

They also list some symptoms that should prompt a person to visit the doctor, including:

• any skin changes, such as a new spot or mole or a change in the color, shape, or size of an existing spot or mole
• a skin sore that fails to heal
• a spot or sore that becomes painful, itchy, or tender
• a spot or sore that starts to bleed
• a spot or lump that looks shiny, waxy, smooth, or pale
• a firm, red lump that bleeds or looks ulcerated or crusty
• a flat, red spot that is rough, dry, or scaly

ABCDE examination

The ABCDE examination of moles is an important method for revealing potentially cancerous lesions. It describes five simple characteristics to check for in a mole that can help a person either confirm or rule out melanoma:

• Asymmetric: Noncancerous moles tend to be round and symmetrical, whereas one side of a cancerous mole is likely to look different to the other side.
• Border: This is likely to be irregular rather than smooth and may appear ragged, notched, or blurred.
• Color: Melanomas tend to contain uneven shades and colors, including black, brown, and tan. They may even contain white or blue pigmentation.
• Diameter: Melanoma can cause a change in the size of a mole. For example, if a mole becomes larger than one-quarter of an inch in diameter, it might be cancerous.
• Evolving: A change in a mole’s appearance over weeks or months can be a sign of skin cancer.

Treatment

The treatment of skin cancer is similar to that of other cancers. However, unlike many cancers inside the body, it is easier to access the cancerous tissue and remove it completely. For this reason, surgery is the standard treatment option for melanoma.

Surgery involves removing the lesion and some of the noncancerous tissue around it. When the surgeon removes the lesion, they send it to pathology to determine the extent of the involvement of the cancer, and to make sure that they have removed all of it.

If melanoma covers a large area of skin, a skin graft may be necessary.

If there is a risk that the cancer has spread to the lymph nodes, a doctor may request a lymph node biopsy.

They may also recommend radiation therapy for treating melanoma, especially in the later stages.

Melanoma may metastasize to other organs. If this happens, a doctor will request treatments depending on where the melanoma has spread, including:

• chemotherapy, in which a doctor uses medications that target the cancer cells
• immunotherapy, in which a doctor administers drugs that work with the immune system to help fight the cancer
• targeted therapy, which uses medications that identify and target particular genes or proteins specific to melanoma

Prevention

Avoiding excessive exposure to UV radiation can reduce the risk of skin cancer. People can achieve this by:

• avoiding sunburn
• wearing clothes that protect the body from the sun
• using broad spectrum sunscreen with a minimum sun protection factor (SPF) of 30, preferably a physical blocker such as zinc oxide or titanium dioxide
• liberally applying sunscreen about half an hour before going outside in the sun
• reapplying sunscreen every 2 hours and after swimming or sweating to maintain adequate protection
• avoiding the highest sun intensity by finding shade between the hours of 10 a.m. and 4 p.m.
• keeping children in the shade as much as possible, having them wear protective clothing, and applying SPF 50+ sunscreen
• ]keeping infants out of direct sunlight

Wearing sunscreen is not a reason to spend longer in the sun. People should still take steps to limit sun exposure where possible.

Those who work outdoors should also take precautions to minimize exposure.

Doctors recommend avoiding tanning booths, lamps, and sunbeds.

What about vitamin D?

The American Academy of Dermatology (AAD) do not currently recommend sun exposure (or tanning) for the purpose of obtaining vitamin D.

Instead, they suggest “getting vitamin D from a [healthful] diet that includes foods naturally rich in vitamin D, foods and beverages fortified with vitamin D, and/or vitamin D supplements”

Diagnosis

Most cases of melanoma affect the skin. They usually produce changes in existing moles.

A person can detect the early signs of melanoma themselves by regularly examining existing moles and other colored blemishes and freckles. People should have their backs checked regularly, as it may be harder to see moles in this area.

A partner, family member, friend, or doctor can help check the back and other areas that are hard to see without assistance.

Any changes in the skin’s appearance require further examination by a doctor.

Some apps claim to help a person identify and track changing moles. However, many are not reliable.

Clinical tests

Doctors may use microscopic or photographic tools to examine a lesion in more detail.

If they suspect skin cancer, they will have a dermatologist biopsy the lesion to determine whether or not it is cancerous. A biopsy is a procedure wherein a medical professional takes a sample of a lesion and sends it for examination in the laboratory.

Outlook

Melanoma is an aggressive type of cancer that can be dangerous when it spreads. However, people who identify a lesion early can have a very good outlook.

The ACS have calculated the 5 year relative survival rates for melanoma. These compare the likelihood that a person with melanoma will survive for 5 years with that of a person without cancer.

If a doctor diagnoses and treats melanoma before it spreads, the 5 year relative survival rate is 98%. If it spreads to deeper tissues or nearby lymph nodes, however, the rate drops to 64%.

If it reaches distant organs or tissues, the likelihood of surviving for 5 years reduces to 23%.

For this reason, it is important to monitor any changing moles and seek medical attention for any that are changing, irregular, or growing. Taking preventive steps is also vital when spending long periods of time in the sun.

Music therapy involves using a person’s responses and connections to music to encourage positive changes in mood and overall well-being. Music therapy can include creating music with instruments of all types, singing, moving to music, or just listening to it.

Music has powerful effects on the mind. Different styles of music can have a significant effect on a person’s mood very quickly, and it can help them experience and process a wide range of emotions, from happiness to excitement, as well as sadness, calmness, and thoughtfulness.

Making music can also be as beneficial as listening to music, and music therapy encourages people to actively create the music they find helpful to them.

This article explains what music therapy is, how it can help improve mental health, and its effects on different mental health conditions.

What is music therapy?

Music therapy uses the powerful abilities of music to improve a person’s well-being. It is an alternative to other types of therapy, such as counseling or cognitive behavioral therapy (CBT).

Music therapists use a person’s responses and connections to music to encourage positive changes in mood and overall mental mindset. Music therapy can include listening to music or creating music with instruments of all types. It may also involve singing or moving to music.

It can help improve confidence, communication skills, independence, self-awareness and awareness of others, and concentration and attention skills.

Live musical interaction between a person and their therapist is important during music therapy.

Improvisation can also be a key part of music therapy. This involves making music up on the spot in response to a mood or a theme, such as making the sound of a storm using drums and a rainstick.

How does music therapy work?

The way that music affects the brain is very complex. All aspects of music — including pitch, tempo, and melody — are processed by different areas of the brain.

For instance, the cerebellum processes rhythm, the frontal lobes decode the emotional signals created by the music, and a small portion of the right temporal lobe helps understand pitch.

The reward center of the brain, called the nucleus accumbens, can even produce strong physical signs of pleasure, such as goosebumps, when it hears powerful music.

Music therapy can use these deep physical reactions the body has to music to help people with mental health conditions.

History and origins

Music has been a part of human life for thousands of years. Specifically, experts have found instruments dating back to over 40,000 years ago, suggesting that humans’ desire to express themselves or communicate through music is deep rooted.

The use of music for therapy and healing dates back to Ancient Greece, but its therapeutic use today began in the 20th century, after World War II had ended. The earliest reference to music therapy comes from a 1789 article called “Music physically considered.”

The 1800s saw medical research into the therapeutic nature of music grow, and by the 1940s, universities were offering music therapy programs. E. Thayer Gaston, one of three men who pioneered the use of music as a therapeutic tool, had organized and promoted the practice so that it would become an accepted type of therapy.

Now, there are many music therapy associations around the world, and music therapists work in private care, education, and social care.

Music therapy vs. other forms of therapy

Music therapy does not rely on verbal communication, so it can be better for people who struggle to communicate verbally. This could be due to a disability, a neurodegenerative condition such as dementia, an acquired brain injury, or a mental health condition.

As CBT and counseling are both talking therapies, they may not be suitable for people who find verbal communication difficult. This is where music therapy can be beneficial.

Additionally, mental health practitioners can bring music therapy directly to a person, such as if they cannot get out of bed or are unable to get to a therapist’s office. Enjoying music therapy at home can also benefit children who want to be in a familiar environment during their sessions.

This is not specific to music therapy, though, as many other types of psychotherapy can take place in the home.

The skills a person learns in music therapy can be useful in their everyday life, too. They may even take up learning an instrument as a new hobby, which they can use as a tool for improving their mental health and coping with difficult situations throughout their life.

Benefits

There are extra benefits to listening or creating music that talking therapies may not be able to offer.

For instance, learning and practicing a piece of music can improve memory skills, coordination, reading, comprehension, and math skills, and it can also give lessons in responsibility and perseverance.

People can also enjoy a great sense of achievement from creating a piece of music, which can help improve their mood and self-esteem.

Music therapy can also introduce people to many different cultures, as clients can explore any type and genre of music during therapy. Understanding the history behind a piece of music can help people connect with the music they are hearing or playing.

Although self-expression is a part of talking therapy, music therapy allows people to express themselves in a creative way, which can be a more enjoyable way of exploring difficult emotions.

Lyric analysis is another accessible way for people to explore and process difficult emotions, experiences, or memories through music.

For example, a person can find themes and meanings within lyrics and offer alternative lyrics that apply to their life and experiences, which can help them find the words that represent how they are feeling if they are finding it hard to express this themselves.

Some of the documented benefits of music therapy include:

• improved self-esteem
• decreased anxiety
• increased motivation
• successful and safe emotional release
• increased verbalization
• stronger connections with other people

How it helps with anxiety

Many studies suggest that music therapy can reduce feelings of anxiety, including in people with cancer, those undergoing surgery, and individuals going into intensive care units. Some studies also suggest that music can reduce blood pressure and the heartbeat, which can have a direct impact on how stressed a person feels.

There is also evidence to suggest that those undergoing music therapy experience reduced anxiety immediately after the session, which indicates that music therapy could be a convenient way to reduce symptoms quickly.

Music affects the amount of stress hormones, such as adrenaline and cortisol, that the body releases, and reducing these hormones can help relieve symptoms of anxiety.

• According to the results of a recent systematic review, quitting smoking may produce positive health effects in a matter of weeks.
• The review found that people who quit smoking had a greater reduction in anxiety, depression, and symptoms of stress than people who did not.
• If accurate, these findings could help motivate millions of people looking for more reasons to quit smoking or avoid stopping for fears of negative mental health or social effects.

Each year, smoking cigarettes claims the lives of more than 480,000 people in the United States and more than 8 million people around the world. And, according to the World Health Organization (WHO), smoking is the leading cause of preventable illness, impoverishment, and death worldwide.

Smoking rates have been falling substantially over the last 50 years, particularly in high income countries, with the rate of tobacco use now at 19.7% in the U.S in 2018. In contrast, this rate remains stubbornly high (36.7%) in people with mental health issues.

Some people believe smoking offers mental health benefits, such as reducing stress and anxiety. In one study, it was not just smokers who thought this but also mental health practitioners. Around 40–45% of mental health professionals assumed that smoking cessation would not be helpful to their patients.

Some also believe that mental health symptoms would worsen if they quit smoking. Many smokers worry that they will lose social relationships, either from the irritability that can occur early on during smoking cessation or because they view smoking as a central part of their social life.

According to the Centers for Disease Control and Prevention (CDC), nearly 40 million people in the U.S. continue to smoke cigarettes.

This is why a group of researchers set out to explore how smoking impacts mental health precisely. Their review appears in the Cochrane Library.

The mental benefits of quitting

“Smokers often believe that cigarettes are the crutch they need when they feel low, but there is good reason to think that smoking is actually making them feel worse,” said Dr. Gemma Taylor, the review’s lead author.

“The daily cycle of waking up with cravings, satisfying the cravings through smoking, only to be back wanting another cigarette within hours has an understandable impact on how people feel.

“But get past the withdrawal that many smokers feel when they stop, and better mental health is on the other side,” she continued. “From our evidence, we see that the link between smoking cessation and mood seem to be similar in a range of people. And most crucially, there is no evidence that people with mental health conditions will experience a worsening of their health if they stop smoking.”

If these findings are confirmed, they could offer hope to millions of people afraid to quit smoking for fears of experiencing worsened mental health symptoms.

Knowing that quitting smoking can improve mental and social well-being within weeks could also help keep individuals motivated during withdrawal.

Nicotine and dopamine

Nicotine, the primary active ingredient in tobacco cigarettes, can briefly improve mood.

When someone inhales smoke, it takes around 10–20 seconds for nicotine to reach the brain. Once there, it stimulates the release of dopamine.

Dopamine is a neurotransmitter associated with positive feelings. It tends to improve concentration and mood, relax muscles, and reduce stress. These properties give most people an almost immediate feeling of relaxation.

But the positive effects of nicotine wear off quickly.

Smoking and mental health

When someone smokes, it temporarily reduces withdrawal symptoms. This means they must keep smoking at the same rate to avoid withdrawal. This cycle of positive and negative symptoms helps drive nicotine addiction.

But smoking can not provide any long-term or meaningful positive benefits.

Scientists have identified links between mental health and smoking. For instance, one report found that people with mental health disorders smoke at two to four times the average rate of the general population.

Other studies have shown associations between depression and smoking, but the relationship between the two is likely to be complex, and scientists need to carry out more research to understand the details. Depression is a persistent risk factor for nicotine dependency across age groups.

Quitting improves mental well-being

In the recent review, researchers examined the findings of 102 studies. For inclusion in the review, each study had to last for at least 6 weeks and track whether participants quit smoking or not, plus any mental health changes. The studies either had to have a control group or be a long-term follow-up study of smokers, some of whom quit and some who did not.

In total, the review included data from more than 169,500 participants.

Most of the studies surveyed the general population, while several included people with mental health conditions. Some of the studies gathered information from participants with physical or chronic health conditions, pregnant people, or those who had recently undergone surgery.

Based on their analysis, the team concluded that, contrary to smokers and some practitioners’ fears, quitting smoking compared with not quitting did not worsen depression, anxiety, and symptoms of stress.

The review also found some evidence that quitting smoking promoted positive feelings and mental well-being. The team concluded that stopping may even have a small positive effect on social well-being.

A sub-analysis of three studies showed a pooled reduced likelihood of 24% in developing mixed anxiety and depression in the future and, based on two studies, a 44% reduced chance of developing anxiety alone. The studies on future diagnoses of depression were too dissimilar to calculate a summary result.

Limitations

It is worth noting that the team had high confidence in the overall finding that quitting tobacco does not worsen mental health symptoms.

However, they were less confident in their results regarding the mental health benefits of stopping smoking — the calculated likelihood of these findings was very low to moderate.

Their confidence in the link between quitting smoking and improvement in mental health symptoms was very low for depression and low for anxiety.

This is because the studies included in the review used different methods and ways of assessing mental health symptoms, making it harder to combine the results. The authors also note that certain studies had limitations and design flaws.

The research duration also varied drastically between studies, ranging from 6 weeks to 6 years.

More robust, uniform research is needed to understand the true relationship between mental health, mental health symptoms, and smoking.

During a pandemic may not seem like the time to quit smoking. But now may just be the right time, according to Deborah Arnott, Chief Executive of Action on Smoking and Health.

“After the year we’ve all had, some smokers might feel now is not the time to stop. The opposite is true — put smoking behind you, and a brighter future beckons. Using nicotine replacement, whether patches, gum, or vapes, can help deal with any withdrawal symptoms, which last at most a matter of weeks,” says Arnott.

“Be confident that once you’ve put smoking behind you, not only will you be healthier and wealthier, but you will feel happier too.”

The American Lung Association offer tips for cutting down and quitting smoking successfully. They say that every smoker can quit, and they will help find the technique that works for every individual smoker.

Over the centuries, this crystalline sweetener has invaded everyone’s snacks, drinks, guts, and minds. It has caused its fair share of controversy, too.

Although everyone is familiar with sugar as a concept, we’ll start with a brief explainer.

What is sugar?

Sugar is a soluble carbohydrate — a biological molecule consisting of carbon, hydrogen, and oxygen atoms. Other carbohydrates include starch and cellulose, which is a structural component of plant cell walls.

Simple sugars, or monosaccharides, include glucose and fructose. Granulated sugar is a compound sugar, or disaccharide, known as sucrose, which consists of glucose and fructose. During digestion, the body breaks down disaccharides into monosaccharides.

Still, the chemistry of sugar does not explain its infamy. The substance gained its dastardly reputation because it tastes delicious and, if consumed too freely, is bad for our health.

1. Sugar is addictive

Some experts believe sugar is an addictive substance. For instance, the authors of a controversial narrative review in 2017 write:

“Animal data has shown significant overlap between the consumption of added sugars and drug-like effects, including bingeing, craving, tolerance, withdrawal, cross-sensitization, cross-tolerance, cross-dependence, and reward and opioid effects.”

However, this review focuses on animal studies. As the authors of another review explain, “there is a methodological challenge in translating this work because humans rarely consume sugar in isolation.”

Dr. Dominic M. Dwyer from Cardiff University’s School of Psychology explains, “Although certainly present in some people, addiction-like behaviors toward sugar and other foods are present only in a minority of obese individuals. However, we should remember that sugar can drive the overconsumption of foods alongside its addiction-like potential.”

Along similar lines, Prof. David Nutt, Chair of the Independent Scientific Committee on Drugs and head of the Department of Neuropsychopharmacology and Molecular Imaging at Imperial College London, writes:

“There is not currently scientific evidence that sugar is addictive, although we know that sugar has psychological effects, including producing pleasure, and these are almost certainly mediated via brain reward systems.”

It is worth noting that even though health experts do not class sugar as an addictive substance, that does not make it healthful.

2. Sugar makes kids hyperactive

This is perhaps the most common myth associated with sugar: eating candy causes children to run wild. In fact, there is no scientific evidence that sugar increases hyperactivity in the vast majority of children.

For instance, a 1995 meta-analysis in JAMA combined data from 23 experiments across 16 scientific papers. They concluded:

“This meta-analysis of the reported studies to date found that sugar (mainly sucrose) does not affect the behavior or cognitive performance of children.”

However, people with children may doubt the truth of this conclusion. 

3. Sugar causes diabetes

Another relatively common myth is that sugar directly causes diabetes. However, there is no direct link between the two. The confusion perhaps arises because there is an intrinsic association between blood sugar levels and diabetes.

The story is a little more complicated, though. Overweight and obesity are risk factors for type 2 diabetes, and consuming high levels of sugar does increase the likelihood of developing overweight or obesity. However, sugar is not the direct cause of type 2 diabetes.

As for type 1 diabetes, dietary and lifestyle factors do not play a part.

4. Avoid fruit when dieting

Fruits are delicious, partly because they are sweet, thanks to naturally occurring sugars. Because of their sugar content, some people believe that we should avoid eating fruit when maintaining a moderate weight.

This is a myth. Fruits contain a range of healthful compounds, including a variety of vitamins and minerals, and fiber.

Fruit consumption is associated with health benefits, including a reduced mortality rate.

One study concluded that freeze-dried mango “does not negatively impact body weight but provides a positive effect on fasting blood glucose.” Another study found that consuming blueberries enhanced insulin sensitivity.

However, it is worth noting that the two studies mentioned above received grants from the National Mango Board and the United States Highbush Blueberry Council, respectively.

Make of that what you will, but there is no doubt that consuming fruit benefits health. Removing it from our diet to reduce sugar intake would be a mistake.

5. We must eliminate sugar from our diet

Because we know consuming excess sugar is bad for health, it makes sense to reduce our intake. However, it is not necessary to remove it from our diet entirely.

As we noted above, fruits contain sugar, and they benefit health, so cutting it from our diet would be counter-productive.

As with everything in life, moderation is key. With that said, sweetened beverages, such as soda, have associations with several negative health consequences, including kidney damage, cellular aging, hip fractures, obesity, type 2 diabetes, and more.

Cutting soda from our diets would certainly  be a fantastic idea.

6. Sugar causes cancer

Despite the rumors, most experts do not believe sugar directly causes cancer or fuels its spread.

Cancer cells divide rapidly, meaning they require a great deal of energy, which sugar can provide. This, perhaps, is the root of this myth.

However, all cells need sugar, and cancer cells also require other nutrients to survive, such as amino acids and fats, so it’s not all about sugar. According to Cancer Research UK:

“There’s no evidence that following a sugar-free diet lowers the risk of getting cancer, or boosts the chances of surviving if you are diagnosed.”

As with diabetes, there is a twist — increased sugar intake has links with weight gain, while overweight and obesity are linked with increased cancer risk.

So, although sugar does not directly cause cancer and does not help it thrive, if someone consumes high levels of sugar and develops obesity, their risk increases.

Scientists are continuing to investigate the relationship between cancer and sugar intake. If there are links between the two, they are likely to be convoluted. For instance, the American Cancer Society write:

“There is evidence that a dietary pattern high in added sugars affects levels of insulin and related hormones in ways that may increase the risk of certain cancers.”

One study, which included data from 101,279 participants, concluded that “total sugar intake was associated with higher overall cancer risk,” even after controlling for multiple factors, including weight.

Other researchers have found links between sugar intake and specific cancers, such as endometrial cancer and colon cancer. However, for now, the link is not as solid as the rumor mill claims.

The take home

Sugar is a much-researched topic. Typing “sugar health” into Google Scholar brings up more than 78,000 results from 2020 alone. Navigating this amount of content is unwieldy, and, as with any scientific topic, there are disagreements.

Something to bear in mind is that many studies investigating the health impacts of sugar receive funding from the food industry. One review of research into soft drink consumption, nutrition, and health examined the results of 88 relevant studies.

They found “clear associations” between soft drink intake, body weight, and medical issues.” Tellingly, they also report that “studies funded by the food industry reported significantly smaller effects than did non-industry-funded studies.”

Although there are a number of misunderstandings surrounding sugar, some things are certain: although it might not directly cause diabetes or cancer, eating high levels of sugar is not healthful. Moderation, I am afraid, is the solution.

• Growing evidence is showing that COVID-19 affects kids differently than adults.
• Children experience lower infection rates, accounting for less than 10 percent of cases in the United States.
• Infectious disease specialists say there are several factors that seem to protect children: immunity to seasonal coronaviruses, underdeveloped sinuses, and fewer chronic health conditions.

A new model from researchers in Israel found that kids are half as susceptible to COVID-19 compared to adults.

The report published Thursday, Feb. 11, in PLOS Computational Biology also found that people under 20 are less likely to transmit the virus to other people.

Growing evidence has showed that COVID-19 affects kids and younger people differently.

Children experience lower infection rates, accounting for less than 10 percent of cases in the United States.

When kids do get the disease, the symptoms are typically milder.

They also appear to transmit the virus less and are not primary drivers of community transmission.

Dr. Sharon Nachman, the chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, said the lower rates of infection in kids are likely due to many factors.

“These could include a different immune response to virus as compared to adults, the frequent lack of comorbid conditions in many children, and ongoing/frequent exposures to other coronaviruses, and possibly some cross-variant nonspecific immunity,” Nachman said.

What the modeling found

The researchers evaluated transmission data of 637 households in Bnei Brak, Israel.

All individuals underwent PCR testing, and some of the participants were given serological antibody tests.

The researchers then took those findings and adjusted them to reflect the coronavirus’s overall infection and transmission rates.

They found that kids are 43 percent as susceptible to COVID-19 compared to adults.

The findings suggest kids transmit COVID-19 far less than adults. That is, the ability of children to pass the virus is about 63 percent compared to adults.

Children are also less likely to produce positive PCR tests, which looks for genetic material of the virus, even when they have the virus.

This could explain why kids have lower diagnosis rates across the globe.

“After monitoring the [COVID-19] pandemic for over a year, the data are clear,” said Dr. Robert Hamilton, a pediatrician at Providence Saint John’s Health Center, “children have been spared the ravages of this illness.”

“Around the world, study after study has shown that children and adolescents account for only 1 to 3 percent of all cases, and that even fewer ultimately required hospitalization,” Hamilton said.

Why are kids less susceptible to COVID-19?

Dr. Amy Baxter, a clinical associate professor at the Medical College of Georgia at Augusta University, and CEO of PainCareLabs, suspects children are less affected by COVID-19 because of their underdeveloped sinuses.

“SARS-CoV-2 replicates in the nasopharynx, and children have extremely underdeveloped sinuses until about age 12,” Baxter told Healthline.

Baxter pointed out that even when children test positive for COVID-19, they may be less likely to transmit SARS-CoV-2.

“Even if the swab seems to show the same viral load, the tank size is so much different that kids’ immune systems aren’t triggered in the same way because they likely don’t absorb nearly as many copies of [the] virus,” Baxter said.

SARS-CoV-2 is usually nasally inhaled before it develops into COVID-19. From there, it travels past the nose and into the nasal cavities where the virus latches onto certain receptors called ACE2 and makes copies of itself to create an infection.

Dr. Kathleen Jordan, an infectious disease specialist and senior vice president of medical affairs at the women’s health provider Tia, suspects the lower attack rate in kids has to do with the fact that children generally don’t have as many health conditions or comorbidities as adults.

The Centers for Disease Control and Prevention (CDC)

lists obesity and type 2 diabetes as health conditions that can increase the risk of severe COVID-19.

Jordan thinks it’s a “combination of higher comorbidities in adults that increase their risk while some characteristics unique to children also protect them, such as immune characteristics and decreased propensity to clotting and inflammatory disorders in general.”

But there are many other theories scientists are looking into.

Kids may have higher immunity from other seasonal coronaviruses

that cause the common cold.

“Immunity to these coronavirus cousins of [SARS-CoV-2] viruses seems to confer some protection against [COVID-19] as well,” Hamilton said.

This crossover immunity may keep their immune systems sharp and ready to attack the novel coronavirus.

“It may be that age is the best protection for COVID,” Nachman noted.

There may be differences in microbiota, vitamin D levels, and melatonin that provide some degree of protection.

“These tempered pathways may play a role in why the disease is so much milder in children and less likely to cause symptoms or end organ damage as seen by these pathways in adults,” Jordan said.

What this means for community transmission

More research is needed to better understand kids’ role in transmitting the virus that causes COVID-19, specifically if and how schools and childcare centers fuel transmission.

However, children are not thought to be key drivers of transmission in schools or their communities.

A study from Ireland evaluating 40,000 people found that kids under 15 were half as likely to get and pass the coronavirus.

Still, kids can contract SARS-CoV-2, and COVID-19 spreads wherever humans interact, schools and childcare facilities included.

But given the growing evidence, Hamilton said many researchers and physicians feel the risks of keeping kids out of school — like depression and anxiety — are greater than the risk of contracting the new coronavirus in a school setting.

Podding, physical distancing, and mask wearing are effective measures for mitigating transmission in schools, Jordan noted.

“We have seen that school is the safest place for our children,” Nachman said. “In pretty much each school that is open to in-person learning, and with masking and some part of social distancing, there is almost no transmission of virus.”

The bottom line

A new model from researchers in Israel found that kids are half as susceptible to COVID-19 compared to adults.

They’re also less likely to transmit the illness and tend to produce negative PCR tests even when they have the virus.

Infectious disease specialists say there’s multiple factors that seem to protect children, such as immunity to seasonal coronaviruses, underdeveloped sinuses, and less comorbidities.

Given the evidence, many health experts believe the benefits of in-school learning outweigh the risks of contracting the coronavirus in a school setting.

Still, COVID-19 spreads wherever humans are, so mitigation measures such as face masking, physical distancing, and pod learning can help offset disease transmissions in childcare and learning facilities.