Welcome to Straight Talk on Health. I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the practical application of health information. Nutrition. Exercise. Diet. Supplementation. I look at the science behind them and let you know whether it’s something to consider or not. You can check out other things that I do on my website Drchet.com and sign up for my free emails.
In the US, we have access to some of the freshest and healthiest foods grown or produced here and from anywhere in the world. At the same time, we have access to some of the most highly processed foods that are designed to appeal to the flavors we love like sweet, salty, sour, and umami. The other flavor, bitter, I haven’t heard much about at all. I myself love salty and crunchy.
My question is why don’t we make better choices? It has always mystified me especially because I fall into that group that makes poorer choices more days than I don’t. Looking back on when I chose to make changes in my lifestyle, there was always a reason that was probably only significant to me. When I quit smoking years ago,, I couldn’t face a classroom of students to talk about the hazards of smoking while smoking myself. So I quit. Before that, even though I understood the health ramifications, it wasn’t enough why to quit.
I used to drink beer, and back when I ran almost every day, I was in the 4-6 bottles of beer a day. The attitude among a lot of runners was “I earned this!” with all the time spent on running. I only drank one brand and one style and it took me years of trying to get exactly what I wanted in flavor. I didn’t drink to get drunk but just to take the edge off a little. But there were consequences—not drastic—but interfering with my life. I decided that I didn’t want to spend another second of my life where anything interfered with my ability to think clearly from the second I woke up until the second I fell asleep. Any type of alcohol requires the body to recover from it and that requires time. Close to 18 hours. So I quit.
Now, I’m at the point where eating has reached that level of interference. When food tastes good, mostly something I prepare for Paula and I, I like to get my share and then some because it will never taste as good reheated as it does right then. But it takes time to digest big meals. I can’t quit eating but I can control snacking and the volume I eat. That’s my goal for 2026. Eat less.
With the new year approaching,it’s time to examine what aspect of health you want to improve. Maybe it’s eating better with more veggies and fruits. Maybe it’s getting some regular exercise. Whatever it is, make a decision to make the change and stick to it. You may have to try different tactics to ultimately be successful. But you can do it as long as you don’t quit trying. You just have to find your why even if it’s only meaningful to you. It’s that important. On to melatonin.
Medical conferences are always a great source for controversy. Why? Studies are presented that haven’t been peer reviewed but may have a great press release to advertise them. A major cardiac medical organization met recently and the scientific sessions didn’t disappoint. The abstract review that caught my attention was based on an analysis of a large database of subjects from a variety of countries that demonstrated that melatonin use to treat insomnia could lead to an increased risk of CVD and hospitalizations.
Researchers chose subjects who were diagnosed with insomnia and took melatonin for at least a year based on their medical charts. They were matched with control subjects on a variety of characteristics including age, height, weight, and many more variables, who were also diagnosed insomniacs but did not report melatonin use. The subjects were added over a period of 5 years before the data were analyzed.
The abstract stated that there was a 90% greater risk of CVD diagnosis in the melatonin group. Further, there was a 350% increased risk of being hospitalized in the melatonin group and a 100% increased risk of dying from all causes as well. Woah! Is it time to throw out melatonin? Keep in mind something I’ve said repeatedly over the years: when results are presented in percentages, find out what the numbers are that make up those percentages.
Before we toss the melatonin, let’s put the unreviewed abstract in perspective. The simplest way to is to convert the percentage of risk into real percentages. The study reported that the risk of developing heart failure was over 90%. That’s true but is based on the percentage of insomniacs that didn’t use melatonin at 2.7% versus 4.6% in those that did use melatonin. The same logic was used for hospitalizations (6.6% vs.19.0%), and mortality (4.3% vs.7.8%). It still seems like a significant risk but there is one more number that’s important: the total number of subjects in the study.
In the United States, the average number of adults that are diagnosed with insomnia is 12%. With 268 million adults in the US, that means that about 32.2 million people have chronic insomnia. The percent diagnosed insomniacs is about the same in all Westernized countries around the world. The researchers used a database that claims to have 150 million de-identified electronic medical records in its database. My question is how did the number of subjects get to only 120,000? It should have been at least 15 million.
Yes, the subjects were matched for a variety of criteria including age, gender, medications, and other factors but still, that’s an awful lot of lost subjects. Even without the diagnosis of insomnia, other diagnoses such as depression and other mental health diagnoses result in insomnia. They can also predispose people to heart failure as well. Those subjects might also have been included which can affect the results.
The most significant information that was not collected was any data on over the counter melatonin use. To their credit, the researchers did cite that as an issue but there are no data as to how much melatonin was actually used by the subjects who took melatonin. There is no record of melatonin use by persons in the non-melatonin group if they didn’t report it as a supplement they use to their physician. There are more questions but that’s enough to call the results into question.
Perhaps after the peer-review process, the data collection will be more clear as well as the data analyses. But as for right now, the best thing that could be said is that they distributed a great press release that caused a lot of concern. As for actual research evidence? There is no reason to modify melatonin use at this point. However, it is always a good idea for you to report what supplements you’re taking to your healthcare provider. If and when the actual study is published, I’ll let you know the rest of the storyon this study.
That’s all the time I have for this episode. If you like this podcast, please hit the share button and tell your friends and colleagues about it. Until next time, this is Dr. Chet Zelasko saying health is a choice. Choose wisely today and every day.
Reference: American Heart Association Scientific Sessions 2025, Abstract MP2306
