October 29, 2021 - Podcast

Episode 196—Halloween safety, and black licorice

Pumpkins are carved, candy bowls are filled, and trick-or-treating is just a few days away. But how can we ensure a safe Halloween, especially when kids under 12 are too young to be vaccinated for COVID-19? Dr. Aaron Carroll, pediatrician and Indiana University’s chief health officer, says while there is no absolute safety with any activity, there are definitely things you can do to allow kids to trick-or-treat. Being outside, staying in small groups (or only with those in your household), maintaining distance around others, and picking up candy from a bowl instead of being face-to-face with another person are all ways to make trick-or-treating safer. For those people planning to pass out candy to trick-or-treaters, Carroll says a safer option is to set out pre-packaged goody bags for kids to grab and set up a chair six or so feet from the candy so you can still interact with your friends and neighbors. There is risk involved in the traditional trick-or-treat experience of ringing the doorbell and putting candy into kids’ treat bags, he says. But if that’s something you want to do, wear a mask, even if fully vaccinated, and make interactions as brief as possible. Some parents may wonder whether their child should wear a mask with their costume this year. Carroll says, in general, being outside and mask-free is low risk. However, if you will be in a larger group, with people outside your household or interacting face-to-face with neighbors for trick-or-treating, Carroll says it is safer to mask up – something you should consider for any indoor Halloween activities. And if Halloween parties are a major part of your annual celebrations, Carroll says to consider hosting your event outdoors and sticking to a smaller guest list then a larger group. Masking up will be safer than no masks, he says.

In other news, for some people, eating black licorice is a fundamental part of celebrating Halloween. But while it may look and taste like an innocent treat, the candy has a dark side. In fact, it has even been ruled as a cause of death. Bill Sullivan, a professor of pharmacology and toxicology at the IU School of Medicine, says overdosing on licorice may sound like a twisted tale, but it happens. There are reports in medical journals in which patients experience hypertension crisis, muscle breakdown or even death after eating black licorice. Adverse reactions are most frequently seen in people over the age of 40 who are eating far more black licorice than the average person, and in those consuming the product over prolonged periods of time. How does a flowering plant native to parts of Europe and Asia become deadly? The chemical glycyrrhizin (also called glycyrrhizic acid) gives black licorice its signature flavor, and it can also lead to its toxic effects, Sullivan says. Glycyrrhizin mimics the hormone aldosterone, which is made when the body needs to retain sodium and excrete potassium. Sodium and potassium work together to drive communication between our nerves and the contraction of muscles. Too much glycyrrhizin upsets that communication, which can raise blood pressure and disturb the heart’s rhythm. Examination of a man who died in 2020 from eating too much black licorice revealed that he had dangerously low levels of potassium, consistent with glycyrrhizin toxicity. Sullivan says because glycyrrhizin has the distinct licorice flavor and is 50 times sweeter than sugar, it’s used in other types of candy, soft drinks, tea, Belgian beers, throat lozenges and tobacco. This can make it challenging to keep track of how much glycyrrhizin you may have consumed, and a combination of these products could trigger adverse effects. Sullivan says people with certain preexisting conditions are more susceptible to black licorice overdose. But if you’re a fan of black licorice, there is no need to ban it from your pantry, he says. Eaten in small quantities from time to time, licorice poses no significant threat to otherwise healthy adults and children, as long as you monitor your intake.