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Make Every Bite Count

picture of fruits, vegetables, and meat and poultry foods.

The 2020-2025 Dietary Guidelines for Americans were just released! While much of the information they contain has been carried over from previous guidelines, the Department of Agriculture (USDA) and Health and Human Services (HHS) continue to review research and present evidence-based recommendations for a healthy life. Below are the main themes and takeaways from the 2020 guidelines.

“Follow a healthy dietary pattern at every life stage.”  This guideline emphasizes the importance of healthy eating at every stage of life to promote health and reduce the risk of chronic disease. For infants to 6 months of life, the guidelines recommend the exclusive consumption of human milk. If human milk is not an option, it is important to choose an iron-fortified infant formula. Regardless of human milk or formula, infants should also be given a vitamin D supplement. At 6 months, infants can begin to eat nutrient-dense foods. When introducing new foods, do so one at a time in case there is an allergic reaction. From 12 months on, the guidelines recommend eating a variety of nutrient-dense foods and establishing a healthy dietary pattern that can span one’s lifetime. This will help meet nutrient needs, maintain a healthy weight, and ultimately reduce the risk of chronic diseases such as cardiovascular disease, type II diabetes, and obesity.

“Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.” The current American population is vastly diverse and culture extends to the plate. The current document welcomes this diversity and looks to customize the guidelines to fit an individual’s cultural background.

“Focus on meeting food group needs with nutrient-dense foods and beverages and stay within calorie limits.” Throughout the document, the phrase nutrient-dense comes up quite a few times. What is the difference between nutrient-dense and calorie-dense? Simply put, nutrient-dense food contains many nutrients with minimal added sugars, saturated fat, or sodium. Calorie-dense foods, on the other hand, tend to be high in added sugar, fat and sodium with limited vitamins and minerals. Filling your plate with nutrient-dense foods to meet your caloric needs will result in a healthier life.

“Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages.” The guidelines recommend individuals age two and older limit added sugars and saturated fat to less than 10% of calories per day. Sodium intake should be less than 2,300mg per day. Men should limit their alcohol intake to two beverages a day and women to one drink per day.

two hands holding a beverage in glass

Modifying one’s diet can be daunting, but there are tools to make it easier to eat better. MyPlate can help you visualize your plate, and the new MyPlate planning tool can help you customize it! Eating better for one’s health does not have to be a difficult endeavor, or one you embark upon alone.

Written by: Emily Beasecker, BGSU Graduate Student interning with Ohio State University Extension, Wood County Extension, and Susan Zies, Extension Educator , Family and Consumer Sciences, Ohio State University Extension, Wood County, Zies.1@osu.edu

Reviewed by Jenny Lobb, Extension Educator, Family and Consumer Sciences, Ohio State University Extension Franklin County, Lobb.3@osu.edu

Sources:

Home | Dietary Guidelines for Americans [Internet]. Dietaryguidelines.gov. 2021 Available from: https://www.dietaryguidelines.gov/

MyPlate | U.S. Department of Agriculture [Internet]. Myplate.gov. 2021 Available from: https://www.myplate.gov/

American Heart Association (2018). How can I eat more nutrient-dense foods? https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/how-can-i-eat-more-nutrient-dense-foods

Husband and wife family picture

My brother-in-law was born with neurofibromatosis type 1 (NF1). One of the possible indications of NF1 is heart deformations. Specifically, for him, it resulted in his ascending aorta and left ventricle being deformed at birth. Originally his family was told this should not be an issue until his 50’s. Like many young men in their 20’s who are in great health (non-smoker, no alcohol or drug use, and an avid bodybuilder) he felt fine, so he did not schedule his routine cardiovascular checkups.

At the age of 26 he began to experience chest pains because of inflammation of the chest cavity. His deformed valve had weakened, and he would need a heart transplant in 5 years if he did not address it immediately. His first open heart surgery took a team of surgeons 8 hours to rebuild his ascending aorta, left ventricle and to implant a St. Jude mechanical valve.

Father and Daughter family picture

Just two years later he would undergo a second open heart surgery, after he developed dull chest pains, severe back pains, and a lack of energy. Scar tissue had created a 98% blockage in his left anterior descending artery – commonly known as the widow maker

It has been 14 years since his last surgery. With the use of medications, he is feeling great. He must be diligent with his diet to make sure he is not eating foods high in vitamin K (when taking a blood thinner such as Warfarin, Vitamin K should be limited) and that he is watching his LDL cholesterol level.

Exercise is also an important part of his heart healthy lifestyle. He can no longer complete body builder style workouts, but he does make sure to do aerobic exercise to improve his circulation which helps to lower his blood pressure and heart rate, this along with strength training helps increase his HDL (good) cholesterol and lower his LDL (bad) cholesterol. His motivation is his wife and daughters. He must take care of his heart so that he will be there to walk his daughters down the aisle and to be by his wife’s side as they grow older together.

His advice:

  • See your doctor regularly. Your routine appointments are important to maintain your heart health.
  • Take your medications as prescribed.
  • Inform your doctor of any changes, including your diet. Certain foods can impact the effectiveness of some medications, so they may not be working as prescribed.
  • Exercise. Aerobic exercise is a great way to work out your heart muscle.

Just as my brother-in-law is Strong @ Heart, I invite you join me as we introduce you to others who are Strong @ Heart during American Heart Month! We will explore what Strong @ Heart means in a fun, interactive, and lighthearted ways.

Sign up for the Ohio State University Extension’s award winning, Live Healthy Live Well 6-week email wellness challenge. I will send you two weekly emails from February 1 – March 15, 2021.

What is the cost? It is FREE!!

Who can participate? Any adult with an email account.

How do I sign up? You can register with this link: go.osu.edu/LHLWWest

Be Healthy, Be Well, and Be Strong @ Heart!

Written by: Roseanne Scammahorn, Ph.D., Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Darke County, scammahorn.5@osu.edu

Reviewed by: Michelle Treber, Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Pickaway County, treber.1@osu.edu

Reviewed by: Misty Harmon, Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Perry County, harmon.416@osu.edu

The beginning of a new year is an opportunity to consider those things you have been putting off. I heard last week that two of the greatest gifts you can give the next generation are organized, digitized photos and your advance care directives. If you are like 70 percent of Americans, then you are without an advance care plan. Advance directives provide you with the opportunity to express your end-of-life wishes in writing.

Every adult, no matter how young or how old, should consider advance care planning. This includes what you want to happen if you are not able to make your own medical decisions. There are some key parts to advance care planning including designating a Health Care Power of Attorney and completing advance directives like a Living Will, donor registry, and declaration for funeral arrangements.  

The Conversation Project from the Institute for Healthcare Improvement has a helpful resource available called “How to Choose a Health Care Proxy.” A health care proxy is also known as a health care agent or power of attorney for health care. This person is the one who will speak for you when you are unable to speak for yourself. This resource walks you through several things to consider in choosing a person and how to have the conversation with them.

Another excellent resource is from The Ohio Hospital Association called “Choices: Living Well at the End of Life.” Because this is an Ohio specific publication, it contains forms that can be completed here in Ohio. It also clearly explains the differences between a Health Care Power of Attorney and a Living Will. A Health Care Power of Attorney provides an agent with the authority to make health care decisions on your behalf, access your records, set up appointments, choose which doctors see you, and more. This is different from a Financial Power of Attorney, which allows a person of your choosing to make financial decisions on your behalf when you are unable to make them.  

A Living Will is only used in situations when you are unable to tell your physician what kind of health care services you want to receive. For it to go into effect, you must be terminally ill and unable to tell your physician your wishes or permanently unconscious. A Living Will may include a Do-Not-Resuscitate (DNR) Order for a person who does not wish to have cardiopulmonary resuscitation (CPR). It may also include wishes about comfort care and nutrition and hydration. A Living Will takes precedence over a Health Care Power of Attorney.

It is a good idea to have both documents, as they each address different aspects of your care. Any document you sign must be in accordance with the specific language spelled out in the Ohio Revised Code. You can obtain standard forms online that you can complete and have notarized. You may also consult with an attorney for assistance.

“Have a conversation with your family about your end-of-life wishes while you are healthy. No one wants to have that discussion… but if you do, you’ll be giving your loved ones a tremendous gift, since they won’t have to guess what your wishes would have been, and it takes the onus of responsibility off of them.”

Jodi Picoult

Written by: Emily Marrison, Family and Consumer Sciences Educator, OSU Extension Coshocton County

Reviewed by: Kathy Tutt, Family and Consumer Sciences Educator, OSU Extension Clark County

Sources:

The Conversation Project https://theconversationproject.org/

Ohio Hospital Association: Advance Directives https://ohiohospitals.org/News-Publications/Publications/Advance-Directives

Heart Health Updates

Heart disease is the most common cause of death in the United States (about 1 in 4 deaths). In this blog we have shared how dietary choices, including adding more plant foods reduces the risk of heart disease. Increasing physical activity is another important way to strengthen our hearts and bodies. Researchers are always learning more about heart health and ways to reduce the risk of disease. Here are some recent updates and recommendations.

Add some steps.  A 2020 study supports the evidence that increasing your daily step count reduces the risk of mortality of all causes. That’s right, all causes. The intensity of these steps did not have a significant difference on the overall reduction of risk. The takeaway? Make it a goal to take 8,000 steps each day, for your heart and your overall health. Movement does not have to make you sweat buckets to have a positive, long-term impact on health.

Schedule your flu shot. Did you know getting a flu shot can help to protect your heart? It is true! The flu can cause stress or damage to our heart and other organs. In a study of over 80,000 U.S. patients hospitalized with the flu, more than 1 in 10 had an acute cardiac event before discharge. An acute cardiac event could be acute heart failure, a heart attack, or a hypertensive crisis. Almost a third of those patients then required intensive care.

Image of a blooming tea flower in a clear mug on a wooden table.

Make time for tea. Studies have shown that adding tea to a heart-healthy diet can have many benefits. Some benefits may include:

  • improved brain function
  • protection against some cancers
  • better weight maintenance
  • increased HDL or “good” cholesterol
  • decreased LDL or “bad” cholesterol
  • better smelling breath

Adding sweeteners like sugar and honey can counteract the benefits that come from drinking tea. Tea contains tannins and drinking too much can lead to poor iron absorption. Tea also contains caffeine, which can cause anxiety or trouble sleeping. Most healthy individuals can safely consume 3-4 cups of tea each day. Check with a healthcare professional before starting a new diet or exercise routine.

When taking care of our heart, small changes can make a big difference. Check back to this blog often for new research findings. If you are interested in learning more about heart health join our Strong @ Heart email challenge that starts February 1! Sign up here: go.osu.edu/LHLWopen


Written by: Courtney Woelfl, Family and Consumer Sciences Educator, Cuyahoga County, woelfl.1@osu.edu

Reviewed by: Shannon Carter, Family and Consumer Sciences Educator, Fairfield County, carter.413@osu.edu

References: https://www.heart.org/en/around-the-aha/aha-names-top-heart-disease-and-stroke-research-advances-of-2020

a snow-covered landscape with trees

Winter is my least favorite season. The cold weather and shorter days make me want to hibernate, and I know I am not alone in feeling this way! Sluggishness and sleepiness, decreased energy, feeling less social, and changes in appetite are all symptoms of the “winter blues”. These symptoms can usually be managed through activities such as exercise, time outdoors, socialization and self-care. If you find that the winter blues are interfering with your ability to carry out daily activities, however, you may have a more serious form of the blues called Seasonal Affective Disorder or SAD. SAD is a form of depression that follows a seasonal pattern. It usually begins in the fall, continues through the winter, and resolves in the spring. If you suspect that you have SAD, please be proactive and seek professional help.

For those of us who experience SAD or the winter blues, this season will be especially challenging as most of us have experienced or are currently experiencing the pandemic blues as well. In addition, some of the coping strategies we might normally use to beat the blues need to be modified due to the pandemic. For example, one of the strategies that experts recommend for beating the winter blues is interacting with friends and family regularly. If socializing with others is your primary coping strategy, it is important to understand potential risks of going out and what you can do to reduce the spread of COVID-19. According to the Centers for Disease Control and Prevention, the risk of COVID-19 spread is directly related to how closely we interact with others and the length of those interactions. If you choose to socialize with others in person, you can reduce your risk by wearing a mask, maintaining a distance of at least six feet, and choosing to meet outdoors rather than indoors.

Gathering outdoors in the winter may seem like an unrealistic or unpleasant option, but that is not always the case! This year is the perfect opportunity to shift your mindset and try something new. In a New York Times parenting column on outdoor winter playdates, author Elisabeth Kwak-Heffran quotes British guidebook writer Alfred Wainwright: “There’s no such thing as bad weather, only unsuitable clothing.” This column provides numerous tips from winter athletes and professionals for bundling up and enjoying the outdoors in cold weather. While this column makes the case for getting outside in the winter to break cabin fever, an added benefit is that outdoor time is another recommend strategy for beating the winter blues.

Do you want additional strategies for beating the winter blues? Sign up for our free, four session webinar series that will be held on Friday mornings in January at go.osu.edu/beatingthewinterblues.

Written by Jenny Lobb, Family and Consumer Sciences Educator, Ohio State University Extension Franklin County

Reviewed by Lorrissa Dunfee, Family and Consumer Sciences Educator, Ohio State University Extension Belmont County

Sources:

Carter, S. (2014). Beating the Winter Blues. Live Healthy, Live Well blog. https://livehealthyosu.com/2014/02/19/beating-the-winter-blues/

Carter, S. (2020). Beating the Pandemic Blues. Live Healthy, Live Well blog. https://livehealthyosu.com/2020/08/31/beating-the-pandemic-blues/

Centers for Disease Control and Prevention (2020). Coronavirus Disease 2019 (COVID-19): Deciding to go out. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/deciding-to-go-out.html

Harmon, M. (2019). Fall: A SAD Time of Year. Live Healthy, Live Well blog. https://livehealthyosu.com/2019/10/21/fall-a-sad-time-of-year/

Kwak-Heffran, E. (2020). Yes, your kids can play outside all winter. The New York Times. https://www.nytimes.com/2020/11/04/parenting/kids-winter-play-outside.html

Mayo Clinic (2017). Seasonal Affective Disorder (SAD). https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

Now what is written on blank piece of paper with black marker.

After all the fun family activities and festivities surrounding the holidays, many people find themselves experiencing a big let-down or what some might call the “winter blues”.   Typically, there is such anticipation and jubilation heading into the holidays that once it is all over, we find ourselves asking the question “Now what?”

According to the American Addiction Centers, post-holiday let-down symptoms include:

  • Fatigue from overextending ourselves, hectic holiday schedules, etc.
  • Loneliness from the sudden dip in social contact and fewer get-togethers
  • Sadness and feelings of loss or emptiness upon the return to “regular” life
  • Reduced motivation when the excitement and energy of the holidays that buoyed you disappears

If you recognize these symptoms in yourself, you are not alone.  Studies show as many as 25 percent of Americans suffer from low-grade to full-blown depression after the holidays.  If you notice depressive symptoms try implementing these strategies:

  • Take care of yourself.  Make sure you are getting quality sleep, regular exercise and eating a balanced diet. 
  • Schedule time for fun.  Even though the holiday parties are over, you can still make plans to interact with others.  Go for lunch, FaceTime a friend, or plan an activity you enjoy.  Stay involved and reach out to others.
  • Be patient and go easy on yourself.  Getting back into your routine can be challenging.  Be kind to yourself.  Meditate, read, enjoy a hot bath and just take time to relax.

Taking a proactive approach can help you beat the winter blues!  In addition to the strategies above, try planning at least one thing in your week that you look forward to and that gives you pleasure.  If you find yourself still struggling despite your best attempts to move forward, I encourage you to reach out to the Crisis Hotline by texting “4hope” to 741741 or calling 1-800-273-8255.  The Crisis Hotline provides free 24/7 support and is anonymous. 

If you would like additional strategies and tips for beating the winter blues, please register for our free four session webinar series beginning January 8 at go.osu.edu/beatingthewinterblues

Written by Lorrissa Dunfee, Family and Consumer Sciences Educator, Ohio State University Extension Belmont County

Reviewed by Jenny Lobb, Family and Consumer Sciences Educator, Ohio State University Extension Franklin County

Sources:

Article by: MacCarthy Libby MacCarthy, Libby. “What’s Behind The Post-Holiday Funk & How To Snap Out Of It Post Holiday Depression.” Psycom.net – Mental Health Treatment Resource Since 1996, 17 Aug. 2020, www.psycom.net/post-holiday-depression.

“Winter Blues Definition and Meaning: Collins English Dictionary.” Winter Blues Definition and Meaning | Collins English Dictionary, HarperCollins Publishers Ltd, 2007, www.collinsdictionary.com/us/dictionary/english/winter-blues.

Milios, Rita. “Avoid Holiday Blues and Post-Holiday Letdown.” Recovery.org, 16 Dec. 2016, www.recovery.org/pro/articles/avoid-holiday-blues-and-post-holiday-letdown/.

Marie Hartwell-Walker, EdD. “How to Manage Post-Holiday Depression.” Psych Central, Psych Central, 17 May 2016, https://psychcentral.com/lib/how-to-manage-post-holiday-depression#1

Do you like to watch “Chopped”, “MasterChef”, “Top Chef”, or “The Great British Baking Show”? Most of us enjoy seeing the creative creations they come up with over the course of 30 – 60 minutes, that look oh so tasty too. Have you thought about trying your own cooking challenge at home?? Having your own cooking challenge can provide a few benefits:

  • Gives you/your family something to do when so many things are closed
  • Cleans out the cupboard/freezer/refrigerator
  • Saves money, because you are not purchasing new food – you are using things you already have
  • Prevents waste, encouraging you to use things before they are past the best-buy date.

Did you know there is research supporting the benefit of family meals too? Numerous studies support that families who eat or cook together: have healthier diets, eat on a budget, spend time talking about their days, have lower rates of obesity and eating disorders, and the children have lower rates of substance use and depression. Children also benefit from learning basic meal preparations skills: washing vegetables or fruits, setting the table, measuring or mixing ingredients, or reading the recipe. Sounds like a lot of reasons to eat and prepare meals together.

challenge pork roast

So why not try your own cooking challenge? You can come up with your own rules – do they get to purchase 1 new ingredient, or must they use all foods on hand? Do you draw names, and each person prepares a different part of the meal – main dish, vegetable, fruit, or dessert? Or do you work in teams? Or does one person or group prepare the meal this week and then in a week or two the next challenger cooks and you write down scores? Is there a secret ingredient that must be in every dish? My own family decided to try the cooking challenge – our daughter took the first week and used all foods on hand to come up with a couple meals from a small pork roast. First, we had pork and rice bowls with a side of fresh fruit, and the left-over pork (mixed with a can of black beans) made nachos 2 days later. I am going to have a hard time beating that! I cannot wait to hear the Cupboard Clean-Out creations you come up with.

Writer: Lisa Barlage, Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Ross County.

Reviewer: Misty Harmon, Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Perry County.

Photo credit: Rachel Barlage

What’s for dinner?

an empty cutting board with a fork and knife

After months of living in a pandemic, does the thought of finding an answer to this ordinary question evoke feelings of panic, stress, or dread? If you answered with an emphatic “yes”, you’re not alone!

While we know there are many positive, lifelong health and social benefits associated with family meals, most families have found themselves eating at home together much more often this year than in pre-pandemic times, and the continuous effort required to plan, prepare and clean up meals can be exhausting. In a survey of over 2,000 Americans conducted earlier this year, 55% said that cooking at home has made them feel fatigued. Of those surveyed, the average respondent was cooking nine meals a week and had cooked the same meal 28 times since the start of the pandemic. Even those who reportedly enjoy cooking wish they could make a healthy meal more quickly!

If you can relate, here are a few ideas for overcoming cooking fatigue:

  • Solicit help. Delegate age-appropriate food preparation and clean-up tasks to other members of the household whenever possible.
  • Use convenience foods such as frozen vegetables and canned beans to cut preparation and clean-up time.
  • Ask friends and family members to share their favorite easy recipes. You could coordinate a holiday recipe exchange or start an email chain for recipe sharing.
  • Try something new and exciting! Take a trip around the world by trying various recipes from different countries, work your way through a new cookbook, or take the opportunity to get comfortable with a new appliance – something like an air fryer or an electric pressure cooker.
  • Build a collection of easy recipes that can be assembled from ingredients you might already have on hand. Food Hero and Celebrate Your Plate are my favorite websites for finding easy, budget-friendly recipes that feature fruits and vegetables. Many of the recipes on these sites are kid-friendly, too.

Do you have additional tips for overcoming cooking fatigue? If so, please comment below with your ideas!

Written by: Jenny Lobb, Family and Consumer Sciences Educator, Ohio State University Extension Franklin County

Reviewed by: Margaret Jenkins, Family and Consumer Sciences Educator, Ohio State University Extension Clermont County

Sources:

Family Meals Movement. Why Family Meals Matter? https://www.fmi.org/family-meals-movement/meals-matter

Sadlier, A. (2020). Americans experiencing cooking fatigue while stuck at home during the pandemic. SWNS Digital. https://www.swnsdigital.com/2020/08/many-americans-are-experiencing-cooking-fatigue-while-stuck-at-home-during-the-pandemic/

Schuster, E. (2020). Cooking Fatigue: How to Overcome It & Resources. Society of Nutrition Education and Behavior. https://www.sneb.org/blog/2020/12/02/general/cooking-fatigue-how-to-overcome-it-resources/

Safe and Happy Holidays

I was surprised to learn a few weeks ago that I was putting my family at risk with a simple decision I was making; leaving my tree lights on.  Holiday decorations can increase the chance of fire in your home if not done safely. According to the National Fire Protection Association, tree fires during the holidays are more likely to be serious. Lighting on trees is involved in more than two of every five home fires Christmas trees. There are a few simple things you can do to keep your home safe and enjoy all your holiday decorations.

Inspect your lights before hanging. Throw away any lights with cracked strands, excessive kicking, or frayed cords. If your lights are warm to the touch throw them out!

Hang your lights with clips, avoid using nails. Never use your electric lights on a metal tree.

Do not overload your electrical sockets. Plan to limit your lights to 50 screw-in bulbs or no more than three strands.

Pay attention to where you place your extension cords. Avoid running them under carpets, heaters, or high traffic areas.  Running cords across doorways may cause a tripping hazard, be mindful to place them in places where they will not be tripped over.

Make sure your decorations are nonflammable and place them away from lights or heater vents. Consider vents and fireplaces when choosing a place for your tree.

When enjoying your holiday candles, place them out of reach of children and pets.  Fifty-seven percent of December home decoration fires were started by candles, compared to 32 percent in January through November.

Ensure your candles burn safely by removing burnable materials from around them and never leave them unattended.

Always keep your live tree watered, using water only! Cutting the bottom two inches off the trunk before setting it up will help improve water absorption.

Unplug your lights before going to bed or leaving your house.

For more holiday safety tips see the resources below. We hope you have a happy and safe holiday!

Writer: Alisha Barton, Extension Educator, Family & Consumer Sciences, Ohio State University Extension, Miami County, barton.345@osu.edu

Reviewer:  Lorrissa Dunfee , Extension Educator, Family & Consumer Sciences, Ohio State University Extension, Belmont County, dunfee.54@osu.edu

Resources:

ESFI Holiday Decorating Safety. (2015).  Electrical Safety Foundation International https://www.esfi.org/resource/holiday-decorating-safety-342

Holiday Decorations Safety Tips. (n.d.). U.S. Consumer Product Safety Commission https://cpsc.gov/s3fs-public/611.pdf

McKelvey, S. (2019, December 13). The Holiday Season Presents Increased Fire Risks Due to Multiple Factors. Retrieved December 14, 2020, from https://www.nfpa.org/News-and-Research/Publications-and-media/Blogs-Landing-Page/NFPA-Today/Blog-Posts/2019/12/13/the-holiday-season-presents-increased-fire-risks-due-to-multiple-factors

Box of Singulair/Montelukast Prescription Medication

Do you or a loved one take Singulair (generic name is Montelukast) for asthma or allergies? Earlier this year, the U.S. Food and Drug Administration (FDA) acknowledged serious mental health side effects related to this popular medicine, prescribed to over 35 million people. The side effects include suicidal thoughts or actions, agitation, hallucinations, and depression. Since March 2020, the medication now requires a Black Box warning, due to the overwhelming evidence of serious mental health side effects.

According to A Guide to Drug Safety Terms at FDA, a black box warning “appears on a prescription drug’s label and is designed to call attention to serious or life-threatening risks.” Medline Plus, a website operated by the U.S. National Library of Medicine, has the following information about Singulair/Montelukast:

Montelukast may cause serious or life-threatening mental health changes while you are taking this medication or after treatment has stopped. You should call your doctor right away and stop taking montelukast if you experience any of the following symptoms: agitation, aggressive behavior, anxiety, irritability, difficulty paying attention, memory loss or forgetfulness, confusion, unusual dreams, hallucinations (seeing things or hearing voices that do not exist), repeating thoughts that you cannot control, depression, difficulty falling asleep or staying asleep, restlessness, sleep walking, suicidal thoughts or actions (thinking about harming or killing yourself or planning or trying to do so), or tremor (uncontrollable shaking of a part of the body). Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

~ National Institutes of Health

If someone you know takes Singulair/Montelukast, encourage them to contact their doctor to discuss whether they should continue taking the medication.

Benefits vs. Risks
Medicine, whether over-the-counter (OTC) or prescription, has side effects. In the best case scenario, the benefits of any drug should outweigh the side effects. However, the FDA found that the benefits of Singulair/Montelukast often did not outweigh the risks.

To educate yourself about the side effects/adverse reactions of any FDA-approved medication, visit DailyMed, a website maintained by the National Institutes of Health (NIH). To help you make the best decisions related to your health, read Think It Through: Managing the Benefits and Risks of Medicines, a guide written by the FDA.

Report Adverse Reactions
If you or a loved one have taken Singulair/Montelukast and have experienced any adverse reactions, you are encouraged to make a report to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program. To do this, visit MedWatch to submit a report online or to download a reporting form.

Written by: Laura Stanton, MA, MS, Family and Consumer Sciences Educator, Ohio State University Extension, Warren County, stanton.60@osu.edu.

Reviewed by: Shari Gallup, MS, CHWC, Family and Consumer Sciences Educator, Ohio State University Extension, Licking County, gallup.1@osu.edu.

Sources:
DailyMed- Singular/Montelukast: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8c166755-7711-4df9-d689-8836a1a70885#S5.1

FDA requires Boxed Warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair); advises restricting use for allergic rhinitis; Risks may include suicidal thoughts or actions: https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-boxed-warning-about-serious-mental-health-side-effects-asthma-and-allergy-drug

Finding and Learning about Side Effects (adverse reactions): https://www.fda.gov/drugs/drug-information-consumers/finding-and-learning-about-side-effects-adverse-reactions

A Guide to Drug Safety Terms at FDA: https://www.fda.gov/media/74382/download

MedlinePlus- Singulair/Montelukast: https://medlineplus.gov/druginfo/meds/a600014.html

National Institutes of Health: https://www.nih.gov

Singulair (montelukast) and All Montelukast Generics: Strengthened Boxed Warning – Due to Restricting Use for Allergic Rhinitis: https://www.fda.gov/safety/medical-product-safety-information/singulair-montelukast-and-all-montelukast-generics-strengthened-boxed-warning-due-restricting-use

Think It Through: Managing the Benefits and Risks of Medicines: https://www.fda.gov/drugs/drug-information-consumers/think-it-through-managing-benefits-and-risks-medicines