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Does intermittent fasting have benefits for our brain?

<p><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <em><a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Intermittent fasting has become a popular dietary approach to help people lose or manage their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8683964/">weight</a>. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and <a href="https://pubmed.ncbi.nlm.nih.gov/27810402">improve overall health</a>.</p> <p>Meanwhile, some research suggests intermittent fasting may offer a different way for the brain to access energy and provide protection against neurodegenerative diseases like <a href="https://link.springer.com/article/10.1007/s11011-023-01288-2">Alzheimer’s disease</a>.</p> <p>This is not a new idea – the ancient Greeks believed fasting <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839325/">enhanced thinking</a>. But what does the modern-day evidence say?</p> <h2>First, what is intermittent fasting?</h2> <p>Our <a href="https://pubmed.ncbi.nlm.nih.gov/35487190/">diets</a> – including calories consumed, macronutrient composition (the ratios of fats, protein and carbohydrates we eat) and when meals are consumed – are factors in our lifestyle we can change. People do this for cultural reasons, desired weight loss or potential health gains.</p> <p>Intermittent fasting consists of short periods of calorie (energy) restriction where food intake is limited for 12 to 48 hours (usually 12 to 16 hours per day), followed by periods of normal food intake. The intermittent component means a re-occurrence of the pattern rather than a “one off” fast.</p> <p>Food deprivation beyond 24 hours typically constitutes starvation. This is distinct from fasting due to its specific and potentially harmful biochemical alterations and nutrient deficiencies if continued for long periods.</p> <h2>4 ways fasting works and how it might affect the brain</h2> <p>The brain accounts for about <a href="https://theconversation.com/how-much-energy-do-we-expend-thinking-and-using-our-brain-197990">20% of the body’s energy consumption</a>.</p> <p>Here are four ways intermittent fasting can act on the body which could help explain its potential effects on the brain.</p> <p><strong>1. Ketosis</strong></p> <p>The goal of many intermittent fasting routines is to flip a “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">metabolic switch</a>” to go from burning predominately carbohydrates to burning fat. This is called ketosis and typically occurs after 12–16 hours of fasting, when liver and glycogen stores are depleted. <a href="https://www.ncbi.nlm.nih.gov/books/NBK493179/">Ketones</a> – chemicals produced by this metabolic process – become the preferred energy source for the brain.</p> <p>Due to this being a slower metabolic process to produce energy and potential for lowering blood sugar levels, ketosis can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844723/">cause symptoms</a> of hunger, fatigue, nausea, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754590/">low mood</a>, irritability, constipation, headaches, and brain “fog”.</p> <p>At the same time, as glucose metabolism in the brain declines with ageing, studies have shown ketones could provide an alternative energy source to <a href="https://www.science.org/doi/10.1126/science.aau2095">preserve brain function</a> and prevent <a href="https://pubmed.ncbi.nlm.nih.gov/32709961/">age-related neurodegeneration disorders and cognitive decline</a>.</p> <p>Consistent with this, increasing ketones through <a href="https://pubmed.ncbi.nlm.nih.gov/31027873/">supplementation</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/31757576/">diet</a> has been shown to improve cognition in adults with mild cognitive decline and those at risk of Alzheimer’s disease respectively.</p> <p><strong>2. Circadian syncing</strong></p> <p>Eating at times that <a href="https://pubmed.ncbi.nlm.nih.gov/32480126/">don’t match our body’s natural daily rhythms</a> can disrupt how our organs work. Studies in shift workers have suggested this might also make us more prone to <a href="https://pubmed.ncbi.nlm.nih.gov/22010477/">chronic disease</a>.</p> <p>Time-restricted eating is when you eat your meals within a six to ten-hour window during the day when you’re most active. Time-restricted eating causes changes in <a href="https://pubmed.ncbi.nlm.nih.gov/36599299/">expression of genes in tissue</a> and helps the body during rest and activity.</p> <p>A 2021 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827225/">study of 883 adults</a> in Italy indicated those who restricted their food intake to ten hours a day were less likely to have cognitive impairment compared to those eating without time restrictions.</p> <p><strong>3. Mitochondria</strong></p> <p>Intermittent fasting may provide <a href="https://pubmed.ncbi.nlm.nih.gov/35218914/">brain protection</a> through improving mitochondrial function, metabolism and reducing oxidants.</p> <p>Mitochondria’s <a href="https://www.genome.gov/genetics-glossary/Mitochondria">main role is to produce energy</a> and they are crucial to brain health. Many age-related diseases are closely related to an energy supply and demand imbalance, likely attributed to <a href="https://www.nature.com/articles/s41574-021-00626-7">mitochondrial dysfunction during ageing</a>.</p> <p>Rodent studies suggest alternate day fasting or reducing calories <a href="https://journals.sagepub.com/doi/10.1038/jcbfm.2014.114">by up to 40%</a> might protect or improve <a href="http://www.ncbi.nlm.nih.gov/pubmed/21861096">brain mitochondrial function</a>. But not all studies support this theory.</p> <p><strong>4. The gut-brain axis</strong></p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/">gut and the brain communicate with each other</a> via the body’s nervous systems. The brain can influence how the gut feels (think about how you get “butterflies” in your tummy when nervous) and the gut can affect mood, cognition and mental health.</p> <p>In mice, intermittent fasting has shown promise for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">improving brain health</a> by increasing survival and <a href="https://pubmed.ncbi.nlm.nih.gov/12354284/">formation of neurons</a> (nerve cells) in the hippocampus brain region, which is involved in memory, learning and emotion.</p> <p>There’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470960/">no clear evidence</a> on the effects of intermittent fasting on cognition in healthy adults. However one 2022 study interviewed 411 older adults and found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646955/">lower meal frequency</a> (less than three meals a day) was associated with reduced evidence of Alzheimer’s disease on brain imaging.</p> <p>Some research has suggested calorie restriction may have a protective effect against <a href="https://academic.oup.com/nutritionreviews/article/81/9/1225/7116310">Alzheimer’s disease</a> by reducing oxidative stress and inflammation and promoting vascular health.</p> <p>When we look at the effects of overall energy restriction (rather than intermittent fasting specifically) the evidence is mixed. Among people with mild cognitive impairment, one study showed <a href="https://pubmed.ncbi.nlm.nih.gov/26713821/">cognitive improvement</a> when participants followed a calorie restricted diet for 12 months.</p> <p>Another study found a 25% calorie restriction was associated with <a href="https://pubmed.ncbi.nlm.nih.gov/30968820">slightly improved working memory</a> in healthy adults. But a <a href="https://www.sciencedirect.com/science/article/pii/S0022316623025221?via%3Dihub">recent study</a>, which looked at the impact of calorie restriction on spatial working memory, found no significant effect.</p> <h2>Bottom line</h2> <p>Studies in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740746/">mice</a> support a role for intermittent fasting in improving brain health and ageing, but few studies in humans exist, and the evidence we have is mixed.</p> <p>Rapid weight loss associated with calorie restriction and intermittent fasting can lead to nutrient deficiencies, muscle loss, and decreased immune function, particularly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749464/">older adults</a> whose nutritional needs may be higher.</p> <p>Further, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314618/">prolonged fasting</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9042193/">severe calorie restriction</a> may pose risks such as fatigue, dizziness, and electrolyte imbalances, which could exacerbate existing health conditions.</p> <p>If you’re considering <a href="https://www.nejm.org/doi/10.1056/NEJMra1905136?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">intermittent fasting</a>, it’s best to seek advice from a health professional such as a dietitian who can provide guidance on structuring fasting periods, meal timing, and nutrient intake. This ensures intermittent fasting is approached in a safe, sustainable way, tailored to individual needs and goals.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223181/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <em><a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-intermittent-fasting-have-benefits-for-our-brain-223181">original article</a>.</em></p> <p><em>Image: Getty </em></p>

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How long does menopause last? 5 tips for navigating uncertain times

<p><em><a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>Around half of the world’s population are women or people who menstruate – yet the way their body works can be a mystery, even to them.</p> <p>Most women will experience periods roughly every month, many will go through childbirth and those who live into midlife will experience menopause.</p> <p>While menopause is a significant time of change, it isn’t talked about much, other than as a punchline. This may contribute to keeping it a <a href="https://www.theguardian.com/membership/2019/sep/21/breaking-the-menopause-taboo-there-are-vital-stories-we-should-continue-to-pursue">taboo topic</a>.</p> <p>So, what happens during menopause? How do you know when it is happening to you? And – the thing most women want to know – how long will it last?</p> <h2>What is menopause?</h2> <p>Menopause is <a href="https://www.nia.nih.gov/health/what-menopause">defined</a> as the permanent cessation of menstruation, which is medically determined to be one year after the final menstrual period. After this time women are considered to be postmenopausal.</p> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/26598775/">average age</a> of “natural menopause” (that is not caused by a medical condition, treatment or surgery) is considered to be around 51 years.</p> <p>However, natural menopause does not occur suddenly. <a href="https://www.researchgate.net/profile/Riitta-Luoto/publication/46425690_Prevalence_of_menopause_symptoms_and_their_association_with_lifestyle_among_Finnish_middle-aged_women/links/5c5704ac458515a4c7553c7b/Prevalence-of-menopause-symptoms-and-their-association-with-lifestyle-among-Finnish-middle-aged-women.pdf">Changes can begin</a> a number of years before periods stop and most often occur in a woman’s 40s but they can be earlier. Changes <a href="https://pubmed.ncbi.nlm.nih.gov/25686030/">can continue</a> for 10 years or more after periods have stopped.</p> <p>Using hormones such as the oral contraceptive pill or hormone intrauterine devices may make it more <a href="https://pubmed.ncbi.nlm.nih.gov/31934948/">difficult to determine</a> when changes start.</p> <p>Menopause that occurs <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">before 45</a> is called “early menopause”, while menopause before 40 is called “premature menopause”.</p> <h2>What about perimenopause?</h2> <p>Various <a href="https://www.menopause.org.au/hp/information-sheets/glossary-of-terms">terms</a> are used to describe this period of change, including “menopause” or “the menopause”, “menopausal transition”, “perimenopause” or “<a href="https://pubmed.ncbi.nlm.nih.gov/12188398/">climacteric</a>”.</p> <p>These terms tend to refer to the period before and after the final menstrual period, when changes are considered to be related to menopause.</p> <p>The difficulty with the definition of menopause is it can only be decided retrospectively. Yet women can experience changes many years before their periods stop (a lead up usually called “perimenopause”). Also, any <a href="https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0889854518300627/first-page-pdf">changes noticed</a> may not be associated with menopause (because people might not be aware of what to expect) or changes may be associated with a combination of factors such as stress, being busy or other health issues.</p> <h2>So, what is going on?</h2> <p>Through a feminist lens, menopause can be seen as a <a href="https://www.researchgate.net/publication/354652248_The_volcano_within_a_study_of_women's_lived_experience_of_the_journey_through_natural_menopause">complex and diverse experience</a>, influenced by biological, psychological, social and cultural aspects of women’s lives.</p> <p>However, it is usually viewed from the biomedical perspective. This sees it as a biological event, marked by the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">decline</a> in ovarian hormone levels leading to a reduction in reproductive function.</p> <p>The female reproductive system operates because of a finely tuned balance of hormones managed by the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466056/#:%7E:text=The%20hypothalamic%2Dpituitary%2Dovarian%20(HPO)%20axis%20must%20be,priming%20the%20endometrium%20for%20implantation.">hypothalamic-pituitary-ovarian axis</a>. International <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/">experts</a> have developed a staging system for female reproductive ageing, with seven stages from “early reproductive” years to “late postmenopause”.</p> <p>However, female reproductive hormones do not just affect the reproductive system but <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">other aspects</a> of the body’s function. These include the <a href="https://pubmed.ncbi.nlm.nih.gov/26007613/">neurological system</a>, which is linked to hot flushes and night sweats and disrupted sleep. Hormones may also affect the <a href="https://www.nature.com/articles/nrdp20154">heart and body’s blood circulation</a>, bone health and potentially the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">immune system</a>.</p> <p>Menopausal hormone changes may <a href="https://www.thewomens.org.au/health-information/menopause-information/menopause-symptoms/">cause</a> hot flushes, night/cold sweats, mood swings, sleep disruption and tiredness, vaginal dryness.</p> <p>Medical confirmation of menopausal changes in women over 45 years is based on two biological indicators: vasomotor symptoms (those hot flushes and night sweats again) and an <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">irregular menstrual cycle</a>.</p> <p>In early perimenopause the changes to the menstrual cycle may be subtle. Women may not recognise early indicators, unless they keep a record and know what to watch for.</p> <h2>How long does it last?</h2> <p>The body demonstrates an amazing ability to change over a lifetime. In a similar way to adolescence where long-lasting changes occur, the outcome of menopause is also change.</p> <p>Research suggests it is difficult to give an exact time frame for how long menopausal changes occur – the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">average</a> is between four and eight years.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">Penn Ovarian Ageing Study</a> found 79% of the 259 participants experienced hot flushes starting before the age of 50, most commonly between 45 and 49 years of age.</p> <p>A later report on the same study found one third of women studied experienced <a href="https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-016-0014-2">moderate to severe hot flushes</a> more than ten years after their periods had stopped. A <a href="https://journals.lww.com/menopausejournal/Abstract/2017/03000/Cultural_issues_in_menopause__an_exploratory.11.aspx">2017 study</a> found a small number of women continued to experience hot flushes and other symptoms into their 70s.</p> <p>So overall, the research cannot offer a specific window for perimenopause, and menopause does not appear to mark the end of changes for everyone.</p> <h2>5 tips for uncertain times</h2> <p>Shifts and changes can be recognised early by developing knowledge, paying attention to changes to our bodies and talking about menopause and perimenopause more openly.</p> <p>Here are five tips for moving from uncertainty to certainty:</p> <p><strong>1.</strong> talk to people and find out as much information as you can. The experiences of mothers and sisters may help, for some women there are familial similarities</p> <p><strong>2.</strong> notice any changes to your body and make a note of them, this will help you recognise changes earlier. There are <a href="https://www.redonline.co.uk/wellbeing/a36980118/menopause-apps/">menopause tracking apps</a> available</p> <p><strong>3.</strong> keep a note of your menstrual cycle: start date, duration, flow and note any changes. Again, an app might help</p> <p><strong>4.</strong> if you are worried, seek advice from a GP or nurse that specialises in women’s health. They may suggest ways to help with symptoms or refer to a specialist</p> <p><strong>5.</strong> remember changes are the indicator to pay attention to, not time or your age.</p> <p>Menopause is a natural process and although we have focused here on the time frame and “symptoms”, it can also be a time of freedom (particularly from periods!), reflection and a time to focus on yourself.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/195211/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <figure><iframe src="https://www.youtube.com/embed/lhosPUwWhfI?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Women speak about their experiences of menopause.</span></figcaption></figure> <p><em><a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, Nurse &amp; Lecturer, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-menopause-last-5-tips-for-navigating-uncertain-times-195211">original article</a>.</em></p>

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Why our voices change as we get older

<p><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>Sir Elton John set a record at this year’s Glastonbury, becoming the <a href="https://www.independent.co.uk/arts-entertainment/music/news/elton-john-glastonbury-viewing-record-b2364260.html">most-watched headliner</a> in the festival’s history, with more than 7 million people tuning in live to the BBC to watch his last ever UK performance.</p> <p>The 76-year-old singer certainly delivered all his characteristic showmanship. But many who have followed his music over the decades will have noticed how much his voice has changed during his career – and not only because of the <a href="https://www.billboard.com/music/music-news/a-qa-with-elton-john-65620/">surgery he had</a> in the 1980s to <a href="https://ultimateclassicrock.com/elton-john-throat-surgery/">remove polyps</a> from his vocal cords.</p> <p>Equally, it’s not all down to the process of ageing. While it’s no mystery that this affects every part of our body, it isn’t the only reason that a person’s voice – even a professional singer like Sir Elton – can sound quite different over the years.</p> <h2>The sound of your voice</h2> <p>The vocal cords are what produce the sound of your voice. They are located in the <a href="https://www.ncbi.nlm.nih.gov/books/NBK538202/">larynx</a>, a part of the respiratory system that allows air to pass from your throat to your lungs. When air passes out of the lungs and through the larynx, it causes the vocal cords to vibrate – <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412481/">producing sound</a>.</p> <p>The vocal cords are composed of <a href="https://www.kenhub.com/en/library/anatomy/vocal-cords">three main parts</a>: the vocalis muscle, vocal ligament, and a mucous membrane (containing glands) to cover them. This keeps the surface moist and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810851/">protects them from damage</a>.</p> <p>There are also approximately <a href="https://radiopaedia.org/articles/intrinsic-muscles-of-the-larynx?lang=gb">17 other muscles</a> in the larynx that can alter vocal cord position and tension – thus changing the sound produced.</p> <p>Pre-puberty, there’s very little difference in the sound the vocal cords produce. But during puberty, hormones begin exerting their effects. This changes the structure of the larynx – making the “Adam’s apple” more prominent in men – and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0018506X16301271?via%3Dihub">length of the vocal cords</a>. After puberty, they’re around 16mm in length in men, and 10mm in women.</p> <p>Women’s vocal cords are also <a href="https://pubs.aip.org/asa/jasa/article/82/S1/S90/719336/Physiology-of-the-female-larynx">20-30%</a> thinner after puberty. These shorter, thinner vocal cords are the reason why women typically have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3306615">higher voices</a> than men.</p> <p>Even after puberty, hormones can affect the voice. For instance, a woman’s voice may sound different depending on the stage of her menstrual cycle – with the <a href="https://www.jvoice.org/article/S0892-1997(08)00169-0/fulltext">best voice quality</a> being in the ovulatory phase. This is because the glands produce most mucous during this phase, giving the vocal cords their best functional ability.</p> <p>Research also shows that women taking the contraceptive pill show <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199717304940">less variation in voice quality</a> because the pill halts ovulation.</p> <p>On the other hand, hormonal changes during the premenstrual phase impede the vocal cords, making them stiffer. This may explain why opera singers would be offered “<a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199717301133">grace days</a>” in the 1960s to ensure they didn’t damage their vocal cords. And, because <a href="https://www.asha.org/practice-portal/clinical-topics/voice-disorders/#collapse_1">women’s vocal cords</a> are thinner, they may also be more likely to <a href="https://pubmed.ncbi.nlm.nih.gov/15157130/">suffer damage</a> from overuse.</p> <h2>Everything ages</h2> <p>As with almost every other part of the body, vocal cords age. But these changes might not be as <a href="https://www.sciencedirect.com/science/article/pii/S0892199721000011">noticeable for everyone</a>.</p> <p>As we get older, the larynx begins increasing its <a href="https://www.sciencedirect.com/science/article/abs/pii/S1752928X21001840">mineral content</a>, making it stiffer and more like bone than cartilage. This change can begin happening as early as <a href="https://meridian.allenpress.com/angle-orthodontist/article/75/2/196/57743/Ossification-of-Laryngeal-Cartilages-on-Lateral">your thirties</a> – especially in men. This makes the vocal cords less flexible.</p> <p>The muscles that allow the vocal cords to move also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166195/">begin wasting</a> (as do our other muscles) as we age. The ligaments and tissues that support the vocal cords also <a href="https://pubmed.ncbi.nlm.nih.gov/11800365/">lose elasticity</a>, becoming <a href="https://pubmed.ncbi.nlm.nih.gov/25645525/">less flexible</a>.</p> <p>There’s also a decrease in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695176/">pulmonary muscle function</a>, reducing the power of the air expelled from the lungs to create the sound. The number of glands that produce the protective mucus also decrease, alongside a reduction in the ability to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156980/">control the larynx</a>.</p> <h2>Lifestyle is a factor</h2> <p>While vocal cords age at largely the same rate in most people, many lifestyle factors can increase the risk of damage to them – and so can change the way your voice sounds.</p> <p>Smoking, for example, causes <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918293/">localised inflammation</a>, increased <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824943/">mucous production</a>, but can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557797/">dry out</a> the mucosal surfaces. Alcohol has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166195/">similar effect</a>. Over time, these factors can damage the vocal cords and alter the voice’s sound.</p> <p>Some over-the-counter and prescription drugs can also alter the voice – such as <a href="https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/482932">steroid inhalers used for laryngitis</a>. Blood thinners may also <a href="https://pubmed.ncbi.nlm.nih.gov/10875579/">damage the vocal cords</a> and can cause polyps to form, making the voice sound raspy or hoarse. <a href="https://pubmed.ncbi.nlm.nih.gov/7395839/">Muscle relaxants</a>, too, can lead to irritation and vocal cord damage due to the drug allowing stomach acid to wash back into the larynx. Thankfully, the irritation and changes caused by these medications typically disappears after stopping use.</p> <p>One other lifestyle factor can be overuse, which is typically seen in singers and other people who use their voice a lot <a href="https://pubmed.ncbi.nlm.nih.gov/15157130/">during work</a>, such as teachers and fitness instructors. This can lead to an uncommon condition called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392404/">Reinke’s oedema</a>, which can also be caused by smoking. Reinke’s oedema causes fluid to swell in the vocal cords, changing the pitch of the voice – often <a href="https://www.cuh.nhs.uk/patient-information/reinkes-oedema/">making it deeper</a>.</p> <p>In extreme cases of Reinke’s oedema, <a href="https://link.springer.com/article/10.1007/s00405-022-07377-9">surgery is needed</a> to drain the fluid. But in most cases, rest and avoiding irritants (smoking and alcohol) is beneficial, while speech and language therapy can also address the <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1460-6984.1995.tb01660.x">change in sound</a>.</p> <h2>Maintaining our vocal quality</h2> <p>While we can’t help some of the age-related changes that happen to our vocal cords, we can maintain some of our vocal quality and ability through continued use. This may explain why, in many cases, singers show <a href="https://pubmed.ncbi.nlm.nih.gov/27049451/">significantly less vocal change</a> with age than their non-singing counterparts.</p> <p>Singing or <a href="https://www.aarp.org/health/healthy-living/info-2014/improve-aging-voice.html">reading out</a> loud daily can give the vocal cords sufficient exercise to slow their decline.</p> <p><a href="https://www.nidcd.nih.gov/health/taking-care-your-voice">Looking after</a> your vocal cords is also important. Staying hydrated and limiting intake of <a href="https://www.cuh.nhs.uk/patient-information/presbyphonia/">alcohol</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069957/">tobacco</a> can help prevent high rates of decline and damage.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208640/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/adam-taylor-283950"><em>Adam Taylor</em></a><em>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-our-voices-change-as-we-get-older-208640">original article</a>.</em></p>

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Why do I need to get up during the night to wee? Is this normal?

<p><em><a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>It can be normal to wake up once or even twice during the night to wee, especially as we get older.</p> <p>One in three adults over 30 makes <a href="https://pubmed.ncbi.nlm.nih.gov/30085529">at least two</a> trips to the bathroom every night.</p> <p>Waking up from sleep to urinate on a regular basis is called <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">nocturia</a>. It’s one of the most commonly reported <a href="https://pubmed.ncbi.nlm.nih.gov/32249998/">bothersome urinary symptoms</a> (others include urgency and poor stream).</p> <p>So what causes nocturia, and how can it affect wellbeing?</p> <h2>A range of causes</h2> <p>Nocturia can be caused by a variety of <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">medical conditions</a>, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an <a href="https://www.nature.com/articles/s41598-023-44916-8">overactive bladder</a>, or gastrointestinal issues. Other causes include pregnancy, <a href="https://onlinelibrary.wiley.com/doi/10.1002/nau.24839">medications</a> and consumption of alcohol or caffeine before bed.</p> <p>While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055528/">insomnia</a>, can also cause nocturia.</p> <p>When we sleep, an antidiuretic hormone is released that slows down the rate at which our <a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">kidneys produce urine</a>. If we lie awake at night, less of this hormone <a href="https://journals.physiology.org/doi/full/10.1152/ajprenal.00025.2023">is released</a>, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night.</p> <p>Stress, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153377/">anxiety</a> and watching television <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987">late into the night</a> are common causes of insomnia.</p> <h2>Effects of nocturia on daily functioning</h2> <p>The recommended amount of sleep for adults is between <a href="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep">seven and nine hours</a> per night. The more times you have to get up in the night to go to the bathroom, the more this impacts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602727/#:%7E:text=Nocturia%20is%2C%20however%2C%20an%20important,(QoL)%20and%20general%20health.">sleep quantity and quality</a>.</p> <p>Decreased sleep can result in increased <a href="https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1251-5">tiredness</a> during the day, poor concentration, forgetfulness, changes in mood and impaired <a href="https://pubmed.ncbi.nlm.nih.gov/28425062/">work performance</a>.</p> <p>If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life.</p> <p>In more severe cases, nocturia has been compared to having a similar impact on <a href="https://www.racgp.org.au/getattachment/b43c05ba-e29e-47c3-b816-ec47ceeafe97/Nocturia-a-guide-to-assessment-and-management.aspx">quality of life</a> as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts.</p> <p>Nocturia not only upsets sleep, but also increases the risk of <a href="https://www.auajournals.org/doi/10.1097/JU.0000000000000459">falls</a> from moving around in the dark to go to the bathroom.</p> <p>Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed.</p> <h2>Can you have a ‘small bladder’?</h2> <p>It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is <a href="https://youtu.be/blVmyrBPves">smaller</a> relative to your other organs.</p> <p>If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often.</p> <figure><iframe src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Can you have a small bladder?</span></figcaption></figure> <p>If you find you are going to the bathroom quite a lot during the day and evening (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903463/">more than eight times</a> in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate.</p> <p>If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP.</p> <p>There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night.</p> <h2>A happy and healthy bladder</h2> <p>Here are some tips to maintain a happy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206217/">healthy</a> bladder, and reduce the risk you’ll be up at night:</p> <ul> <li> <p>make your <a href="https://theconversation.com/what-position-should-i-sleep-in-and-is-there-a-right-way-to-sleep-189873">sleep environment comfortable</a>, with a suitable mattress and sheets to suit the temperature</p> </li> <li> <p>get to bed early, and limit <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">screens</a>, or activites before bed</p> </li> <li> <p>limit foods and drinks that irritate the bladder, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811496/">coffee or alcohol</a>, especially before bedtime</p> </li> <li> <p>sit in a <a href="https://theconversation.com/does-it-matter-if-you-sit-or-stand-to-pee-and-what-about-peeing-in-the-shower-206869">relaxed position</a> when urinating, and allow time for the bladder to completely empty</p> </li> <li> <p>practice <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor muscle exercises</a></p> </li> <li> <p>drink an adequate amount of fluids during the day, and avoid becoming <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">dehydrated</a></p> </li> <li> <p>maintain a healthy lifestyle, eat <a href="https://journals.physiology.org/doi/full/10.1152/advan.00052.2023">nutritious foods</a> and do not do anything harmful to the body such as smoking or using illicit drugs</p> </li> <li> <p>review your medications, as the time you take some <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">pharmaceuticals</a> may affect urine production or sleep</p> </li> <li> <p>if you have <a href="https://pubmed.ncbi.nlm.nih.gov/28675633/">swollen legs</a>, raise them a few hours before bedtime to let the <a href="https://www.racgp.org.au/afp/2012/june/nocturia-a-guide-to-assessment-and-management">fluid drain</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224160/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, Associate Professor of Science &amp; Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, Senior Teaching Fellow, Medical Program, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-get-up-during-the-night-to-wee-is-this-normal-224160">original article</a>.</em></p>

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Foods to avoid if you have acid reflux or digestion issues

<p><strong>What common foods are good and bad for your belly?</strong></p> <p>Foods containing rapidly fermentable carbohydrates called FODMAPs can feed bacteria in the gut and may be responsible for gut inflammation, gas, bloating and other uncomfortable tummy troubles in some people. Cutting back on foods that contain FODMAPs may help improve your digestion and eliminate GI problems.</p> <p>“An anti-inflammatory diet is high in fibre-rich foods, which promote the growth of healthy bacteria in the gut (one way the diet assists to control inflammation),” says registered dietitian Maxine Smith. A FODMAP diet, which is low in fermentable carbohydrates, is low in fibre and may be beneficial for some people with gastrointestinal problems.</p> <p>In general, a low FODMAPs diet isn’t recommended for people unless they have a condition like irritable bowel syndrome that hasn’t responded to other treatments or dietary changes.</p> <p><strong>Watermelon: Avoid</strong></p> <p>This lovely summer treat isn’t as harmless as all the water it contains. Watermelon is high in fructose, fructans and polyols, which are FODMAPs. Remember, the more the FODMAPs, the more potential for tummy trouble in people who are sensitive to them.</p> <p><strong>Fermented foods: Enjoy some, avoid some</strong></p> <p>Some fermented foods are good for your tummy; others can create problems for certain people, according to an article published by Harvard Medical School. Fermented foods include wine, cheese, vinegar, miso, yoghurt, sauerkraut and pickles.</p> <p>In yoghurt, milk is combined with bacteria that break down some of the lactose, so what remains may be easier for your stomach to process. So fermented foods such as yoghurt are often considered “probiotic foods” that are good for your gut. Look for dairy products that are low in lactose and your digestion should be A-OK.</p> <p><strong>Pistachios, cashews, hazelnuts and almonds: Avoid</strong></p> <p>Most nuts are good for your tummy, but pistachios and cashews are high in fructans and GOS (galacto-oligosaccharides), both FODMAPs. Hazelnuts and almonds are a little higher in FODMAPs than some other nuts so eat them in limited quantities (10 nuts or 1 tablespoon of nut butter per serving). Steer clear of almond milk, which is made with large amounts of almonds.</p> <p><strong>Acidic foods: Enjoy with caution</strong></p> <p>In almost every list of “the worst foods for digestion,” you’ll find acidic foods like oranges and tomatoes. These are commonly thought to cause heartburn, but studies have shown that acidic foods don’t have any effect on LES pressure (or pressure on the lower oesophageal sphincter, a valve that acts as the doorway between the oesophagus and the stomach) and don’t cause heartburn symptoms.</p> <p>However, if you have severe acid reflux that hasn’t been treated and has irritated the oesophagus, acidic foods can be like “salt in the wound.” So if you find that oranges or tomatoes do make your heartburn feel worse, replace them with other fruits.</p> <p><strong>Dairy foods: Enjoy some, avoid some</strong></p> <p>Not all dairy foods have equal amounts of lactose, which can cause digestion issues, and even those with lactose intolerance are usually okay with small amounts of lactose. That means that not all milk, cheeses and dairy products are tummy twisters.</p> <p>Hard cheeses, like cheddar, Swiss or Parmesan, generally have less than a gram of lactose per serving. According to the Cleveland Clinic, you may want to avoid dairy such as “chocolate shakes or drinks, milkshakes, whole milk fat yoghurt, whole milk fat (4%) cottage cheese, and full-fat cheese.”</p> <p><strong>Soy foods: Enjoy some, avoid some</strong></p> <p>Whole soybeans (often sold as edamame), like other beans, are a source of GOS, which are hard-to-digest chains of sugars. Tofu and tempeh are made using processes that eliminate some of the GOS, making them easier on your digestion. What about soy milk? It depends.</p> <p>If soy milk is made with only soybean isolates or soy protein, then it should be low in FODMAPs. Soy milk made with whole soybeans is likely a source of GOS, making it a gassy beverage for some, so read the ingredients.</p> <p><strong>Blackberries: Avoid</strong></p> <p>Strawberries, blueberries, blackberries – which is the odd one out here? Blackberries are also rich in antioxidants, but they have sugar alcohols called polyols, which are difficult to digest and can cause some real problems if your stomach is sensitive. (Check out these foods that GI doctors always avoid.)</p> <p><strong>Tomato and tomato products: Enjoy some, avoid some</strong></p> <p>Fresh and canned tomatoes are fine for your tummy. But tomato paste is a concentrated form of tomato that has excess fructose, a FODMAP that makes it a no-no except in small quantities. And tomato sauces? If they’re homemade, they’re fine to eat (just don’t cook it to the point where all the juices are lost).</p> <p>Most commercial sauces have onions and garlic (FODMAPs), added sugar (which may make it carb-dense), and salt (which bloats you), so steer clear of the store-bought variety.</p> <p><strong>Grapefruit: Enjoy with caution</strong></p> <p>Grapefruit does have hard-to-digest fructans, so you should try to limit how much you eat. A few sections should be okay, but don’t eat a half a grapefruit. If you’re looking for citrus, lemon, lime and oranges are your best bets.</p> <p><strong>Milk: Enjoy some, avoid some</strong></p> <p>Most types of animal milk are high in tummy twisting lactose – that means goat’s or sheep’s milk can be just as problematic as cow’s milk. Plant-based milks, such as coconut milk, soy milk or almond milk, are technically not milk at all and generally do not have any lactose.</p> <p>Some, however, including almond milk and soy milk, may contain other FODMAPs that harm your digestion.</p> <p><strong>Corn: Avoid</strong></p> <p>Corn comes in many varieties, such as popcorn, on the cob and in polenta. Fresh sweet corn contains two types of FODMAPs, making corn challenging for some people to digest. Popcorn feels like a light and healthy snack, but it’s actually carb-dense (it has about 64 grams of carbs per 100 grams), which can upset digestion.</p> <p>Whole cornmeal and corn tortillas seem to be better tolerated by most people. Whole grain polenta is also low in FODMAPs. You may need to experiment a little to figure out which corn products work for you. And stick with only limited quantities (up to 1 cup cooked per serving).</p> <p><strong>Common cabbage: Enjoy</strong></p> <p>Cabbage usually makes it on all the lists of foods that make you gassy, but common green cabbage doesn’t deserve that reputation. It’s actually low in FODMAPs and most of us break it down very well.</p> <p>Red cabbage also seems to be well-tolerated, but savoy and napa cabbage is much higher in FODMAPs and should be limited if you tend to suffer from gas and bloating.</p> <p><strong>Hot sauce: Enjoy with caution</strong></p> <p>Tolerance to hot sauce is very individual. It’s more problematic for those with heartburn. If you would like to try some, pick a brand without onion and garlic.</p> <p><em>Image credits: Getty Images </em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/foods-to-avoid-if-you-have-acid-reflux-or-digestion-issues?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.</em></p>

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Why Barnaby Joyce’s TV diagnosis of insomnia plus sleep apnoea is such a big deal

<p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>The <a href="https://theconversation.com/view-from-the-hill-how-does-david-littleproud-handle-the-latest-barnaby-joyce-embarrassment-223289">health</a> of Nationals MP Barnaby Joyce is in the news again, this time with a diagnosis of a sleep disorder made <a href="https://www.afr.com/companies/media-and-marketing/barnaby-joyce-to-be-diagnosed-with-a-sleep-disorder-on-live-tv-20240223-p5f79q">while filming</a> a TV documentary.</p> <p>Joyce’s diagnosis of insomnia plus sleep apnoea arose while filming <a href="https://www.sbs.com.au/whats-on/article/australias-sleep-revolution-with-dr-michael-mosley/nuyko305b">Australia’s Sleep Revolution with Dr Michael Mosley</a> in 2023. SBS has confirmed episode three, in which my Flinders University colleagues reveal his sleep disorder, is set to air on March 20.</p> <p>I was not involved in the program and have no knowledge of Joyce’s <a href="https://www.theaustralian.com.au/weekend-australian-magazine/australias-sleep-crisis-has-flinders-university-cracked-the-code-to-a-better-nights-sleep/news-story/d3b82617af33fff82487da2534722733">ongoing health care</a>. But I was part of the research team that in 2017 <a href="https://doi.org/10.1016/j.smrv.2016.04.004">coined the term COMISA</a> (co-morbid insomnia and sleep apnoea), the official name of Joyce’s on-screen diagnosis. Since then, I’ve led research into this <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> sleep disorder.</p> <p>Here’s why it’s so important to diagnose and treat it.</p> <h2>What was Joyce’s diagnosis?</h2> <p>People can be diagnosed separately with <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">insomnia</a> or <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/obstructive-sleep-apnoea">sleep apnoea</a>.</p> <p>Insomnia includes frequent difficulties falling asleep at the start of the night or difficulties staying asleep during the night. These can result in daytime fatigue, reduced energy, concentration difficulties and poor mood. Over time, insomnia can start to impact your <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and quality of life.</p> <p>Sleep apnoea (specifically, obstructive sleep apnoea) is when people experience repeated interruptions or pauses in breathing while they sleep. This reduces oxygen levels during sleep, and you can wake up multiple times at night. People with sleep apnoea may be aware of loud snoring, gasping for air when they wake up, or feeling exhausted the next morning. However, not all people have these symptoms, and sleep apnoea can go undiagnosed for years.</p> <p>But in Joyce’s case, both insomnia and sleep apnoea occur at the same time.</p> <p>We’ve known this could happen since <a href="https://doi.org/10.1126/science.181.4102.856">the 1970s</a>, with <a href="https://psycnet.apa.org/doi/10.1037/0022-006X.67.3.405">evidence growing</a> over <a href="https://doi.org/10.1378/chest.120.6.1923">subsequent decades</a>. Since then, sleep researchers and clinicians around the world have learned more about how <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> this is, its <a href="https://doi.org/10.1183/13993003.01958-2021">consequences</a> and how best to <a href="https://doi.org/10.1111/jsr.13847">treat it</a>.</p> <h2>How do you know if you have it?</h2> <p>Many people <a href="https://doi.org/10.1016/j.sleep.2005.08.008">seek help</a> for their sleep problems because of fatigue, exhaustion, physical symptoms, or poor mood during the day.</p> <p>If you think you have insomnia, a GP or sleep specialist can talk to you about your sleep pattern, and might ask you to complete <a href="https://www.sleepprimarycareresources.org.au/insomnia/assessment-questionnaires">brief questionnaires</a> about your sleep and daytime symptoms. You might also be asked to fill in a “sleep diary” for one to two weeks. These will allow a trained clinician to see if you have insomnia.</p> <p>If you or your GP think you may have (or are at risk of having) sleep apnoea, you may be referred for a sleep study. This normally involves sleeping overnight in a sleep clinic where your sleep patterns and breathing are monitored. Alternatively, you might be set up with a recording device to monitor your sleep at home. A trained medical professional, such as a sleep and respiratory physician, will often make the diagnosis.</p> <p><a href="https://doi.org/10.1016/j.smrv.2021.101519">Up to 50%</a> of people with sleep apnoea report symptoms of insomnia. About <a href="https://doi.org/10.1016/j.smrv.2021.101519">30–40%</a> of people with insomnia also have sleep apnoea.</p> <h2>What are the consequences?</h2> <p>Insomnia and sleep apnoea (individually) are associated with reduced <a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">sleep quality</a>, <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and <a href="https://theconversation.com/health-check-heres-what-you-need-to-know-about-sleep-apnoea-26402">physical health</a>.</p> <p>Importantly, people with both at the same also tend to <a href="https://doi.org/10.3390/brainsci9120371">experience</a> worse sleep, daytime function, mental health, physical health and quality of life, compared with people with no sleep disorder.</p> <p>For instance, we know having both conditions comes with an <a href="https://doi.org/10.1111/jsr.13563">increased risk</a> of diseases of the heart.</p> <p><a href="https://doi.org/10.2147/NSS.S379252">In</a> <a href="https://doi.org/10.1183/13993003.01958-2021">three</a> <a href="https://doi.org/10.1016/j.sleepe.2022.100043">studies</a>, we found people with both insomnia and sleep apnoea have about a 50–70% higher risk of dying early from any cause, compared with people with neither sleep condition. People with insomnia alone and sleep apnoea alone did not have an increased risk of dying early.</p> <p>However, there are effective treatments to reduce these health consequences.</p> <h2>How is it treated?</h2> <p>In general, it is best for people to access evidence-based treatments for both disorders. These treatments vary according to the patient and the severity of their condition.</p> <p>For instance, wearing a <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/cpap-continuous-positive-airway-pressure">CPAP mask</a> while sleeping improves breathing during sleep and reduces many of the daytime consequences of obstructive sleep apnoea. However, other effective treatments may be recommended based on each person’s symptoms, such as weight management, avoiding sleeping on your back, <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/oral-appliances-to-treat-snoring-and-obstructive-sleep-apnoea-osa">oral devices</a> (which look a bit like a mouthguard), or surgery.</p> <p>The <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">most effective</a> treatment for insomnia is cognitive behavioural therapy for insomnia, also known as <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a>. About four to eight sessions often lead to improvements in sleep, daytime function and mental health that are maintained for many <a href="https://doi.org/10.1080/16506073.2021.2009019">years</a>. This can be delivered by trained therapists such as psychologists, nurses or GPs, as well as via <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online</a> programs.</p> <p>Last year, we drew together evidence from more than 1,000 people with both conditions. We found CBTi is an <a href="https://doi.org/10.1111/jsr.13847">effective treatment</a> for insomnia in people with treated and untreated sleep apnoea.</p> <h2>New treatments and approaches</h2> <p><a href="https://www.frontiersin.org/articles/10.3389/frsle.2024.1355468/abstract">We</a> and <a href="https://doi.org/10.1186/s13063-022-06753-4">other teams</a> internationally are developing and testing new ways of delivering CBTi.</p> <p>Several groups are testing devices, which <a href="https://doi.org/10.1002%2Flio2.761">stimulate</a> the tongue muscles during sleep, to treat sleep apnoea in people with both disorders.</p> <p>And we’re still working out the best order for patients to access treatments, and the best combination of treatments.</p> <h2>The power of TV</h2> <p>Joyce’s public diagnosis of both insomnia and sleep apnoea will no doubt raise awareness of what we suspect is an underdiagnosed condition.</p> <p>Based on how common insomnia and sleep apnoea are in Australia, we estimate Joyce is one of about <a href="https://doi.org/10.1016/j.sleep.2021.03.023">5–10%</a> of Australian adults to have both at the same time.</p> <p>The Conversation contacted Joyce’s spokesperson for comment but did not hear back before deadline.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224616/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-barnaby-joyces-tv-diagnosis-of-insomnia-plus-sleep-apnoea-is-such-a-big-deal-224616">original article</a>.</em></p>

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12 signs that you’re borderline diabetic

<p><strong>Do you have diabetes?</strong></p> <p>If you are a borderline diabetic, it means you have prediabetes. Your blood sugar levels are higher than normal, but not enough to be diagnosed with full-blown type 2 diabetes. Maybe you’ve noticed that you’re losing weight or more tired than normal. Or perhaps you’re thirsty or have vision issues. Here’s a look at some of the more common signs that you could be a borderline diabetic.</p> <p><strong>You’re really thirsty and are peeing a lot</strong></p> <p>“Prediabetes is caused when the body is unable to efficiently process blood sugars,” says endocrinologist Dr Jason Ng. “This happens over time as the body builds up resistance to insulin, the hormone that helps the body control blood sugars.” As you become insulin resistant, the body has to produce more insulin to keep blood sugars at a good level.</p> <p>Eventually it can’t keep up, so blood sugars rise. Prediabetes may take you by surprise, as there often aren’t symptoms – though there are a few subtle cues you can look out for. “A patient may feel slightly more thirsty and have to urinate more over time as well as the sugars increase in their body,” Dr Ng says.</p> <p><strong>You're exhausted </strong></p> <p>Borderline diabetes could be one of the medical reasons you’re tired all the time. If you’re one of the 2 million Australians who have prediabetes, according to Diabetes Australia you may notice you’re not feeling up to your normal activity level. “Patients may feel more tired or sluggish,” Dr Ng says. Blood sugar fluctuations can cause fatigue; plus, other factors that often appear with blood sugar problems could be the culprit, such as depression or obesity, according to a study published in 2012 in Diabetes Educator.</p> <p>Physical activity is recommended by the American Diabetes Association to help with prediabetes symptoms, but ironically people with the condition may be too tired to exercise. If that’s the case, see your doctor. “Most of prediabetes is diagnosed by lab work at a doctor’s office,” Dr Ng says. With prediabetes, “fasting sugar is between 100 to 125 mg/dl or a random blood sugar between 140 to 200 mg/dl.”</p> <p><strong>You’re losing weight</strong></p> <p>Among the silent diabetes signs you might be missing is weight loss. Although we associate blood sugar problems with being overweight, once you start becoming borderline diabetic you may actually drop kilos. If you’re going to the bathroom more frequently, you’re excreting extra sugar and losing more kilojoules. Diabetes may also keep sugar in your food from reaching your cells.</p> <p>This might leave you “feeling hungry all the time,” says Dr Deena Adimoolam, assistant professor of medicine, endocrinology, diabetes and bone disease. So if you’re eating more than usual and still losing weight, talk to your doctor.</p> <p><strong>You have blurred vision </strong></p> <p>One of the clear signs you have high blood sugar is actually not seeing clearly. Dr Adimoolam says that blurred vision is a sign that you’re borderline prediabetic. Why? Diabetic eye disease occurs when high blood sugar causes damage to the blood vessels in the eye, which can leak and swell, leading to vision changes. According to the National Eye Institute, one type of eye damage, diabetic retinopathy, is the leading cause of vision loss among people with diabetes and the leading cause of blindness among adults.</p> <p>A study by The Diabetes Prevention Program (DPP) found that 8 per cent of prediabetic participants had diabetic retinopathy. It can be addressed if caught early, so bring up blurry vision to your doctor as soon as you notice it.</p> <p><strong>You have dark areas on your skin</strong></p> <p>One body changes that could signal a bigger problem that you are borderline prediabetic are dark patches on your skin called acanthosis nigricans (AN). The condition usually appears in elbows, armpits, knees, or on the neck, has a velvety texture, and likely occurs because excess insulin causes a rapid growth of cells. It’s also more common in people with obesity – another risk factor for prediabetes.</p> <p>But a study published in the Annals of Family Medicine showed that although patients with AN tend to have multiple risk factors for diabetes, AN itself may also be an independent risk factor for the disease. Because of this, AN’s presence may help doctors detect prediabetes sooner.</p> <p><strong>You have PCOS</strong></p> <p>Polycystic ovary syndrome (PCOS) is a disorder where a woman’s hormones are unbalanced. Studies like one published in the Journal of Clinical Endocrinology and Metabolism in 2017, have shown that PCOS is a risk factor for diabetes.</p> <p>It’s not known exactly how they are linked, but researchers are looking into the connection between PCOS and insulin. High levels of insulin may contribute to increased production of male hormones called androgens, which is a symptom of PCOS. PCOS is also associated with being overweight, as is prediabetes – but studies have shown that even average-weight women with PCOS are at increased risk of high blood sugar.</p> <p>Also, women with PCOS may be more likely to have gestational diabetes (diabetes while pregnant; more on that later), which also can lead to an increased risk of type 2 diabetes. If you are diagnosed with PCOS, your reproductive endocrinologist may test your glucose level to make sure you’re not borderline prediabetic.</p> <p><strong>You don't get good sleep </strong></p> <p>“When you don’t get enough sleep, less insulin is released in the body,” says Dr Richard Shane, behavioural sleep therapist. “Sleep deprivation can cause insulin-producing cells to fail to use the insulin efficiently or to stop functioning. Your body also secretes more stress hormones, which interfere with insulin’s ability to be effective.”</p> <p>In one study, duration and quality of sleep was shown to be associated with prediabetes. Another factor could be that we tend to crave kilojoules and junk food for energy when we’re tired – plus, we don’t feel like exercising. This can lead to inactivity and weight gain, other risk factors for prediabetes.</p> <p><strong>You have a family history of diabetes</strong></p> <p>Among the medical facts you should know is your family’s health history. “There can be a genetic cause for the development of type 2 diabetes due to certain gene mutations,” Dr Adimoolam says. “Some people may have a genetic predisposition to developing type 2 diabetes due to presence of certain genes than have been passed down from one generation to the next.” One study in Diabetologia found that a family history of diabetes increased the risk for prediabetes by 26 per cent.</p> <p>The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that you’re more likely to develop diabetes if you have a family history of the disease. In addition, “Some data suggests that the risk of type 2 diabetes is five times higher in those with diabetes on both the maternal and paternal sides of the family,” Dr Adimoolam says.</p> <p><strong>You're of a certain age </strong></p> <p>There are many reasons why you’ll age better than your parents, including that you know age itself is a risk factor for certain conditions – so you’ll take measures to prevent them. Unfortunately, prediabetes is more likely in older people. “The higher your age, the greater risk for development of diabetes,” Dr Adimoolam says. “This might be related to increased body fat with age, which increases one’s risk for type 2 diabetes.”</p> <p>In addition, Dr Ng says that high blood pressure and high cholesterol are also risk factors for prediabetes. These are all common conditions as we age, and are also associated with metabolic syndrome, a cluster of disorders that can lead to heart disease and stroke.</p> <p><strong>You had gestational diabetes</strong></p> <p>Having had gestational diabetes in the past also puts you at risk for prediabetes now, according to research, including a study in BMC Pregnancy and Childbirth. “Once you have been diagnosed with any form of diabetes, like gestational diabetes, you are at an increased risk for developing this again over time, especially with weight gain,” Dr Adimoolam says.</p> <p>According to the American Diabetes Association, doctors don’t know exactly why gestational diabetes develops, but it could be that pregnancy hormones affect how the body uses insulin. The NIDDK suggests women who’ve had gestational diabetes have their blood glucose tested every three years.</p> <p><strong>You're overweight </strong></p> <p>You can potentially reverse type 2 diabetes if you lose weight – and the same goes for if you are borderline diabetic. “By and large, obesity is the main cause of insulin resistance, as certain fat cells are known to cause and intensify insulin resistance over time,” Dr Ng says. And it’s not just how much you weigh, but where your weight is located on your body. “Waist size is typically proportional to centralised, or abdominal, obesity,” Dr Adimoolam says.</p> <p>“The more centralised abdominal fat, the higher one’s insulin resistance, and the greater the increased risk for the development of type 2 diabetes.” Genetics may also play a role here, as certain body types with more abdominal fat (“apple-shaped”) can run in families and certain ethnic groups, she says.</p> <p><strong>You have an unhealthy lifestyle </strong></p> <p>Whether you are borderline prediabetic or not, there are many science-based reasons to start working out. “Lack of exercise may promote weight gain, which is a risk factor for type 2 diabetes,” Dr Adimoolam says. A study from Johns Hopkins published in the Journal of General Internal Medicineshowed that people with prediabetes who dropped 10 per cent of their body weight dramatically reduced their risk of diabetes – but every little bit helps.</p> <p>Dr Ng suggests losing even 5 to 7 per cent of your body weight, quitting smoking, and adopting a borderline diabetic diet. “Interventions that typically reduce weight include increased exercise, especially aerobic exercise, 150 minutes or more per week, and eating a balanced, low-fat diet that is not heavy on carbs,” he says. “Prediabetes is often thought of as a ‘warning sign,’ which is why lifestyle intervention is so important.”</p> <p>Ultimately, the message is that prediabetes is not irreversible. “Prediabetes is the stage before one develops type 2 diabetes, and in most cases is preventable,” Dr Adimoolam says. “You may not need medications to treat prediabetes if you are able to change your lifestyle, with the goal for treatment focusing on diet changes and exercise.”</p> <p><em>Image credits: Getty Images </em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/diabetes/12-signs-that-youre-borderline-diabetic?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

<p><em><a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial.</p> <p>UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom.</p> <p>Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557479/">Chronic UTIs</a> are typically diagnosed when a person experiences two or more infections within six months or three or more within a year.</p> <p>They can happen to anyone, but some are more prone due to their <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults">body’s makeup or habits</a>. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area.</p> <p>Up to <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults#Related%20Resources">60% of women</a> will have at least one UTI in their lifetime. While effective treatments exist, <a href="https://www.health.harvard.edu/bladder-and-bowel/when-urinary-tract-infections-keep-coming-back#:%7E:text=Your%20urine%20might%20be%20cloudy,they%20take%20on%20your%20life.">about 25%</a> of women face recurrent infections within six months. Around <a href="https://sciendo.com/article/10.33073/pjm-2019-048?tab=article">20–30%</a> of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments.</p> <h2>Why are chronic UTIs so hard to treat?</h2> <p>Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach.</p> <p>The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments.</p> <p>This ability to evade treatment has led to a troubling <a href="https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543">increase in antibiotic resistance</a>, a global health concern that renders some of the conventional treatments ineffective.</p> <p>Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted.</p> <p>But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead.</p> <p>Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria.</p> <p>Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions.</p> <p>The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence.</p> <p>For post-menopausal women, <a href="https://link.springer.com/article/10.1007/s00192-020-04397-z">estrogen therapy</a> has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur.</p> <p>Lifestyle changes, such as <a href="https://journals.lww.com/co-nephrolhypertens/FullText/2013/05001/Impact_of_fluid_intake_in_the_prevention_of.1.aspx">drinking more water</a> and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role.</p> <p>Some swear by cranberry juice or supplements, though researchers are still figuring out <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001322.pub2/full">how effective these remedies truly are</a>.</p> <h2>What treatments might we see in the future?</h2> <p>Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052183/pdf/pathogens-12-00359.pdf">vaccines</a> aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu.</p> <p>Another new method being looked at is called <a href="https://link.springer.com/article/10.1007/s12223-019-00750-y">phage therapy</a>. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus.</p> <p>Researchers are also exploring the potential of <a href="https://www.mdpi.com/2079-6382/12/1/167">probiotics</a>. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves.</p> <p>Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response.</p> <p>Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223008/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/iris-lim-1204657">I<em>ris Lim</em></a><em>, Assistant Professor, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-keep-getting-urinary-tract-infections-and-why-are-chronic-utis-so-hard-to-treat-223008">original article</a>.</em></p>

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3 cholesterol myths debunked

<p>For years, cholesterol has been seen as the villain in your diet – responsible for many of the health woes people experience daily. But many of the “facts” about cholesterol are actually just misconceptions. So let’s clear up some of these myths now.</p> <p>As with everything to do with your diet, any major changes should be made in consultation with your healthcare professional or a nutritionist to make sure it’s right for you.</p> <p><strong>Cholesterol is bad for you</strong></p> <p>Just like cake, cholesterol should be enjoyed in moderation. Interestingly, it actually performs many important functions. It helps produce cell membranes, vitamin D, hormones, and helps with digestion. It also plays a role in helping to form memories.</p> <p>And, believe it or not, cholesterol is naturally created by your body. So most of the cholesterol in your bloodstream is not there because of your diet.</p> <p><strong>Eggs are the enemy</strong></p> <p>People with high cholesterol levels used to be advised to avoid eating too many eggs, but they’ve recently been put back on the “safe list.” Research at Yale University actually showed that even people with coronary heart disease could eat two eggs each day for six weeks without any effect on their cholesterol levels.</p> <p><strong>Low-fat diets are the best</strong></p> <p>While saturated fats do increase the “bad” cholesterol (LDL), it also increases the levels of “good” cholesterol (HDL). A study published in Annals of Internal Medicine showed no link between the consumption of saturated fats and an increased risk of heart attacks.</p> <p>Foods that are high or low in saturated fat can have a positive, negative, or neutral effect on your body – it all depends on the type of food. A diet that is low in carbohydrates is more effective at raising the levels of “good” cholesterol in your system.</p> <p><em>Image credits: Getty Images </em></p>

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How long does back pain last? And how can learning about pain increase the chance of recovery?

<p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>.</p> <p>Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>.</p> <p>If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups:</p> <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> <p>We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.</p> <p>Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.</p> <h2>More pain doesn’t mean a more serious injury</h2> <p>Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease.</p> <p>There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.</p> <p>Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.</p> <p>The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.</p> <p>The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.</p> <h2>Reduce your chance of lasting pain</h2> <p>Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:</p> <ul> <li> <p>understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain</p> </li> <li> <p>reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.</p> </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> <p>Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.</p> <p>These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover.</p> <p>But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.</p> <p>When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>.</p> <p>Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community.</p> <p>But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.</em></p>

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Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

<p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>.</p> <p><a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment.</p> <p>Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it.</p> <h2>Walk, run, lift, or dance away depression</h2> <p>We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together.</p> <p>We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them.</p> <p>Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants.</p> <p>But of these exercises, people were most likely to stick with strength training and yoga.</p> <p><iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing.</p> <p>Still, our evidence shows that if you have depression, you should get a psychologist <em>and</em> an exercise plan, whether or not you’re taking antidepressants.</p> <h2>Join a program and go hard (with support)</h2> <p>Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.”</p> <p>But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression.</p> <p>We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results.</p> <h2>Yes, it’s hard to keep motivated</h2> <p>We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results.</p> <p>Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free.</p> <p>We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression.</p> <p>Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result.</p> <p>Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult.</p> <p>A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted.</p> <p>Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it.</p> <p>So, when starting out, it seems wise to avoid going it alone. Instead:</p> <ul> <li> <p>join a fitness group or yoga studio</p> </li> <li> <p>get a trainer or an exercise physiologist</p> </li> <li> <p>ask a friend or family member to go for a walk with you.</p> </li> </ul> <p>Taking a few steps towards getting that support makes it more likely you’ll keep exercising.</p> <h2>Let’s make this official</h2> <p>Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”.</p> <p>Based on our research, this recommendation is withholding a potent treatment from many people who need it.</p> <p>In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression.</p> <p>Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression.</p> <p><em>I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based.</em></p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223441/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/running-or-yoga-can-help-beat-depression-research-shows-even-if-exercise-is-the-last-thing-you-feel-like-223441">original article</a>.</em></p>

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Your unique smell can provide clues about how healthy you are

<p><em><a href="https://theconversation.com/profiles/aoife-morrin-1478132">Aoife Morrin</a>, <a href="https://theconversation.com/institutions/dublin-city-university-1528">Dublin City University</a></em></p> <p>Hundreds of chemicals stream from our bodies into the air every second. These chemicals release into the air easily as they have high vapour pressures, meaning they boil and turn into gases at room temperature. They give clues about who we are, and how healthy we are.</p> <p>Since ancient Greek times, we’ve known that we smell differently when we are unwell. While we rely on blood analysis today, ancient Greek physicians used smell to diagnose maladies. If they took a whiff of your breath and described it as <em>fetor hepaticus</em> (meaning bad liver), it meant you could be headed for liver failure.</p> <p>If a person’s whiff was sweet or fruity, physicians thought this meant that sugars in the digestive system were not being broken down, and that person had probably diabetes. Science has since shown the ancient Greeks were right – liver failure and <a href="https://tisserandinstitute.org/human-volatilome/">diabetes</a> and many <a href="https://link.springer.com/article/10.1007/s00216-023-04986-z">other diseases</a> including infectious diseases give your breath a distinctive smell.</p> <p>In 1971, <a href="https://www.nobelprize.org/prizes/peace/1962/pauling/facts/">Nobel Laureate chemist Linus Pauling</a> <a href="https://edu.rsc.org/feature/breath-analysis/2020106.article#:%7E:text=The%20'modern%20era'%20of%20breath,in%20an%20average%20breath%20sample.">counted 250 different</a> gaseous chemicals in breath. These gaseous chemicals are called volatile organic compounds or VOCs.</p> <figure><iframe src="https://www.youtube.com/embed/RzozmYPfCmM?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Since Pauling’s discovery, other scientists have <a href="https://link.springer.com/article/10.1007/s40291-023-00640-7">discovered hundreds more VOCs</a> in our breath. We have learned that many of these VOCs have distinctive odours, but some have no odour that our noses can perceive.</p> <p>Scientists believe that whether a VOC <a href="https://tisserandinstitute.org/human-volatilome/">has an odour</a> that our noses can detect or not, they can reveal information about how healthy someone is.</p> <p>A Scottish man’s Parkinson’s disease onset was <a href="https://www.bbc.co.uk/news/uk-scotland-47627179">identified by his wife</a>, retired nurse Joy Milner, after she was convinced the way he smelled had changed, years before he was diagnosed in 2005. This discovery has <a href="https://www.manchester.ac.uk/discover/news/smell-of-skin-could-lead-to-early-diagnosis-for-parkinsons/">led to research programmes</a> involving Joy Milner to identify <a href="https://www.scientificamerican.com/article/a-supersmeller-can-detect-the-scent-of-parkinsons-leading-to-an-experimental-test-for-the-illness/">the precise smell</a> of this disease.</p> <p>Dogs can <a href="https://www.nature.com/articles/d41586-022-01629-8">sniff out more diseases</a> than humans because of their more <a href="https://www.understandinganimalresearch.org.uk/news/the-science-of-sniffs-disease-smelling-dogs%20-%20I%20think%20the%20previous%20nature%20link%20has%20more%20credibility%20for%20here%20also">sophisticated olfactory talents</a>. But technological techniques, like <a href="https://www.britannica.com/science/mass-spectrometry">analytical tool mass spectrometry</a>, picks up even more subtle changes in VOC profiles that are being linked to <a href="https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(20)30100-6/fulltext">gut</a>, <a href="https://www-sciencedirect-com.dcu.idm.oclc.org/science/article/pii/S0165993618305168">skin</a> and <a href="https://err.ersjournals.com/content/28/152/190011">respiratory</a> diseases as well as neurological diseases like Parkinson’s. Researchers believe that one day some diseases will be diagnosed simply by breathing into a device.</p> <figure><iframe src="https://www.youtube.com/embed/Xjo2M-XMYfs?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Where do VOCs come from?</h2> <p>Breath is not the only source of VOCs in the body. They are also emitted from skin, urine and faeces.</p> <p>VOCs from skin are the result of millions of skin glands removing metabolic waste from the body, as well as waste generated by bacteria and other microbes that live on our skin. Sweating produces extra nutrients for these bacteria to metabolise which can result in particularly odorous VOCs. Odour from sweat only makes up a fraction of the scents from VOCs though.</p> <p><a href="https://www.nature.com/articles/nrmicro.2017.157">Our skin</a> and also our gut microbiomes are made up from a delicate balance of these microbes. Scientists think <a href="https://journals.lww.com/co-gastroenterology/abstract/2015/01000/the_gut_microbiome_in_health_and_in_disease.12.aspx">they influence our health</a>, but we don’t yet understand a lot about how this relationship works.</p> <p>Unlike the gut, the skin is relatively easy to study – you can collect skin samples from living humans without having to go deep into the body. <a href="https://www-sciencedirect-com.dcu.idm.oclc.org/science/article/pii/S1471492221002087">Scientists think</a> skin VOCs can offer insights into how the microbiome’s bacteria and the human body work together to maintain our health and protect us from disease.</p> <p>In my team’s laboratory, <a href="https://iopscience.iop.org/article/10.1088/1752-7163/abf20a">we are investigating</a> whether the skin VOC signature can reveal different attributes of the person it belongs to. These signals in skin VOC signatures are probably how dogs distinguish between people by smell.</p> <p>We are at a relatively early stage in this research area but we have shown that you can tell males from females based on how acidic the VOCs from skin are. We use mass spectrometry to see this as the average human nose is not sophisticated enough to detect these VOCs.</p> <p>We can also predict a person’s age with reasonable accuracy to within a few years from their skin VOC profile. This is not surprising considering that oxidative stress in our bodies increases as we age.</p> <p><a href="https://www.metabolismjournal.com/article/S0026-0495(00)80077-3/pdf">Oxidative stress</a> happens when your antioxidant levels are low and causes irreversible damage to our cells and organs. <a href="https://pubs.acs.org/doi/10.1021/jasms.3c00315">Our recent research</a> found by-products of this oxidative damage in skin VOC profiles.</p> <p>Not only are these VOCs responsible for personal scent – they are used by plants, insects and animals as a communication channel. Plants are in a <a href="https://www.nature.com/articles/s41598-017-10975-x">constant VOC dialogue</a> with other organisms including pollinators, herbivores, other plants and their natural enemies such as harmful bacteria and insects. VOCs used for this back and forth dialogue are known as pheromones.</p> <h2>What has science shown about love pheromones?</h2> <p>In the animal kingdom, there is good evidence VOCs can act as aphrodisiacs. Mice for example have microbes which contribute to a particularly <a href="https://www.sciencedirect.com/science/article/pii/S0960982212012687">smelly compound called trimethylamine</a>, which allows mice to verify the species of a potential mate. <a href="https://www.sciencedirect.com/science/article/abs/pii/S0093691X21003083">Pigs</a> and <a href="https://www.nature.com/articles/4381097a">elephants</a> have sex pheromones too.</p> <p>It is possible that humans also produce VOCs for attracting the perfect mate. Scientists have yet to fully decode skin – or other VOCs that are released from our bodies. But evidence for human love pheromones so far is <a href="https://www.science.org/content/article/do-human-pheromones-actually-exist">controversial at best</a>. <a href="https://www.newscientist.com/article/dn3835-colour-vision-ended-human-pheromone-use/">One theory suggests</a> that they were lost about 23 million years ago when primates developed full colour vision and started relying on their enhanced vision to choose a mate.</p> <p>However, we believe that whether human pheromones exist or not, skin VOCs can reveal who and how we are, in terms of things like ageing, nutrition and fitness, fertility and even stress levels. This signature probably contains markers we can use to monitor our health and diagnose disease.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215311/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/aoife-morrin-1478132"><em>Aoife Morrin</em></a><em>, Associate Professor of Analytical Chemistry, <a href="https://theconversation.com/institutions/dublin-city-university-1528">Dublin City University</a></em></p> <p><em>Image credits: </em><em>Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-unique-smell-can-provide-clues-about-how-healthy-you-are-215311">original article</a>.</em></p>

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Coles shopper humiliated after being accused of shoplifting

<p dir="ltr">A Coles shopper has been left feeling humiliated after they were forced to lift up their shirt to prove they weren’t shoplifting. </p> <p dir="ltr">Tony Jones, 39, was about to pay for his groceries at self-checkout on Saturday morning when he was confronted by the employee of the Brisbane Coles who made the accusation.</p> <p dir="ltr">“And what about what’s under your shirt?” Mr Jones said the staff member loudly asked him, causing the other customers to look around.</p> <p dir="ltr">Mr Jones has a stoma as a result of having his entire bowel removed from bowel cancer a few years ago, and later developed an “extremely obvious” hernia at the site which “sticks out about 15 centimetres from my stomach”.</p> <p dir="ltr">“My initial reaction was flat-out shock, because she didn’t say it in a way of asking me, she flat-out accused me,” he told <em><a href="https://www.news.com.au/finance/business/retail/customer-with-obvious-hernia-humiliated-at-selfservice-checkout/news-story/56980cdcada75ba9ae0cca9cb90c75f0" target="_blank" rel="noopener">news.com.au</a></em>.</p> <p dir="ltr">“She seemed quite proud. Everybody in the self-checkout bay heard what she accused me of, and she walked over to me. I was just stunned, I guess I kind of shut down — I’ve never been accused of being a thief before — so I just lifted my shirt.”</p> <p dir="ltr">After revealing his condition, Jones was left feeling “violated” as the supermarket worker simply said, “Yeah, sorry, we’ve had a few of those lately,” apparently referring to shoplifting incidents.</p> <p dir="ltr">Coles has since apologised to Mr Jones, but that hasn’t made up for the trauma he endured in the supermarket. </p> <p dir="ltr">“I’ve lived here for 12 or 13 years, I’ve been at that Coles plenty,” he said.</p> <p dir="ltr">“Obviously I don’t expect retail staff to recognise everybody … I assume they’ve had some thefts lately, I’m not sure whether they’ve been given instructions to pull up more people because they don’t have a [security] gate yet.”</p> <p dir="ltr">Mr Jones took to Reddit to share the story of his encounter, asking those on the social media site, “Is Coles allowed to ask what’s under my shirt? When it’s just my hernia.”</p> <p dir="ltr">The post quickly went viral, attracting hundreds of comments.</p> <p dir="ltr">“Former loss prevention officer here — they cannot detain you in any way unless they have witnessed you select the goods and witnessed you not take advantage of a reasonable opportunity to pay,” one person wrote.</p> <p dir="ltr">Another woman said, “I have a permanent ileostomy and have had retail workers accuse me of stealing too. It’s annoying because most of the time I wear clothes where the top of it pokes out the top and it’s happened when I’ve worn clothes that completely covered it.”</p> <p dir="ltr">A third person commented, “Gentle reminder Coles turned a record profit in the midst of the Covid recession, then decided to install hard arse security detectors to catch thieves.”</p> <p dir="ltr">Mr Jones said the whole experience left him feeling rattled and upset, especially as he continues to undergo treatment for his condition and prepare for another surgery. </p> <p dir="ltr">“I’m not dealing with it great, if I’m truthful,” he said. </p> <p dir="ltr">“I’m seeing doctors weekly at the moment. Things add up, and getting called out on Saturday, it basically shut me down for the entire day, [left me] for lack of a better word feeling like s**t. I had all eyes on me. I’m not a social person so I just wanted to get out of there to be honest. I don’t think I’ll ever be going back to Coles.”</p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

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Why it’s a bad idea to mix alcohol with some medications

<p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.</p> <p>But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.</p> <p>When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.</p> <h2>How alcohol and medicines interact</h2> <p>The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to <a href="https://www.medicalnewstoday.com/articles/324330">convulsions</a>. Too much inhibition and you will experience effects like sedation and depression.</p> <p><iframe id="JCh01" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/JCh01/1/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.</p> <p>With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.</p> <p>Medications can interact with alcohol to <a href="https://awspntest.apa.org/record/2022-33281-033">produce different or increased effects</a>. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those <a href="https://www.drugs.com/article/medications-and-alcohol.html#:%7E:text=Additive%20effects%20of%20alcohol%20and,of%20drug%20in%20the%20bloodstream.">effects can be compounded</a>.</p> <p>Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can <a href="https://www.healthline.com/health/adhd/ritalin-and-alcohol#side-effects">increase the drug’s effect on the heart</a>, increasing your heart rate and the risk of a heart attack.</p> <p>Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.</p> <p>Alcohol can increase the break-down of certain medicines, such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763421005121?via%3Dihub">opioids, cannabis, seizures, and even ritalin</a>. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with <a href="https://australianprescriber.tg.org.au/articles/alcohol-and-paracetamol.html">paracetamol</a>.</p> <p>At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.</p> <h2>Who is at most risk?</h2> <p>The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.</p> <p>Older people do not break down medicines as quickly as younger people, and are often on <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over#:%7E:text=is%20this%20important%3F-,Polypharmacy%20is%20when%20people%20are%20using%20five%20or%20more%20medicines,take%20five%20or%20more%20medicines.">more than one medication</a>.</p> <p>Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.</p> <p>Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.</p> <h2>What drugs can’t you mix with alcohol?</h2> <p>You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.</p> <p>The most common <a href="https://adf.org.au/insights/prescription-meds-alcohol/">alcohol-interacting prescription medicines</a> are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.</p> <p>It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.</p> <p>Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.</p> <p>If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223293/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/nial-wheate-96839"><em>Nial Wheate</em></a><em>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, Pharmacist and PhD Candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, Associate Professor in Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-its-a-bad-idea-to-mix-alcohol-with-some-medications-223293">original article</a>.</em></p>

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Should you be worried about the amount of coffee or tea you drink?

<p>Before you reach for that cup of coffee or tea, have you ever thought about whether that caffeinated beverage is <a href="https://cosmosmagazine.com/health/body-and-mind/debunks-vices-coffee-caffeine/">good or bad for you</a>?</p> <p><iframe title="Vices: Is coffee good or bad for you?" src="https://omny.fm/shows/debunks/vices-is-coffee-good-or-bad-for-you/embed?style=Cover" width="100%" height="180" frameborder="0"></iframe></p> <p>Most of us will drink coffee or tea each day.</p> <p>It helps keep us alert, especially in a world of the nine-to-five grind. Some workers rely on caffeine to get them through shift work and night shifts.</p> <p>Many, like me, would just collapse in a heap if it weren’t for that liquid black gold to keep us peppy in the morning.</p> <h2 class="wp-block-heading">What is caffeine?</h2> <p>To get a better picture of how coffee or tea affects us, let’s examine the active ingredient: <a href="https://cosmosmagazine.com/podcast/huh-science-explained-stirring-the-science-of-caffeine/">caffeine</a>.</p> <p>Caffeine is a <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/caffeine" target="_blank" rel="noopener">drug</a>. It’s a white, odourless substance known to chemists as 1,3,7-trimethylxanthine and is made up of 8 carbon, 10 hydrogen, 4 nitrogen and 2 oxygen atoms.</p> <p>Caffeine occurs naturally in coffee beans, cocoa beans, kola nuts, and tea leaves.</p> <p>It is an adenosine antagonist, blocking the A1, A2A, and A2B receptors in the brain and body to promote wakefulness. Normally, adenosine (a chemical compound with a similar 3D structure to caffeine) binds to its receptors, slowing neural activity and making you sleepy.</p> <p>When caffeine, instead, binds to the receptors, adenosine is blocked and brain activity speeds up, making you feel more alert.</p> <h2 class="wp-block-heading">History lesson</h2> <p>Tea and coffee are the most common way for humans to get their caffeine fix.</p> <p>Drinks made using coffee beans date back more than a thousand years to the coffee forests of the horn of Africa.</p> <p>Legend says that, around 800 CE, an Ethiopian goat herder named Kaldi noticed his goats were energetic and didn’t sleep when they ate the coffee beans. Coffee then spread eastward to the Arabian Peninsula, reaching Yemen in the 15th century, and Egypt, Syria, Persia and Turkey in the 1500s. From their it made it to Europe and eventually the whole world.</p> <p>But caffeine is also present in other beverages like tea, cola and even some foods like chocolate.</p> <h2 class="wp-block-heading">Is it bad for you?</h2> <p>Given how prevalent the drug is, are there negative side effects we should be worried about?</p> <p>For one thing, it is an addictive substance. And the more you drink, the more you need.</p> <p>“Our body tends to adjust to a new level of consumption,” Kitty Pham, a PhD candidate at the University of South Australia and expert in nutritional and genetic epidemiology, tells <em>Cosmos</em>. “Your body does develop a tolerance to the caffeine. So, you start to need to drink more and more to feel the same effect as before.”</p> <p>Caffeine can also act as an anxiogenic – a substance that can trigger heightened levels of anxiety.</p> <p>Pham notes some risks associated with too much caffeine consumption over a long period of time.</p> <p>“Greater than 6 cups per day, we did see an increase in dementia risk,” she notes. “There’s also some research on how it might increase your cholesterol. There’s a substance in coffee called cafestol that can regulate your blood cholesterol. If you’re drinking too much coffee, it might be increasing your cholesterol. So, there are risks, but often they are at really high consumption.”</p> <h2 class="wp-block-heading">What’s the limit?</h2> <p>So, how much caffeine is too much according to science?</p> <p>“That’s, the million-dollar question, isn’t it?” Pham laughs. “There’s a lot of varying research on it. It’s hard to tell a definite limit. But generally, most studies really agree that one to two cups of coffee, or an equivalent of 100 to 200 milligrams of caffeine is safe and okay.”</p> <p>The average cup of coffee has about 100 mg of caffeine. On average, instant coffee with one teaspoon of powder contains about 70 mg of caffeine, while a coffee pod has 60–90 mg.</p> <p>Other drinks containing might have even more caffeine, making it important to monitor your consumption more carefully.</p> <p>A 355 mL can of Red Bull energy drink has more than 110 mg of caffeine. Meanwhile, an average bar of dark chocolate has about 70 mg of caffeine.</p> <p>Many people are moving away from coffee to drinks like tea and matcha which may have <a href="https://cosmosmagazine.com/health/flavonoids-black-tea/">additional</a> <a href="https://cosmosmagazine.com/health/tea-drinkers-may-well-live-longer/">health</a> <a href="https://cosmosmagazine.com/health/black-tea-mortality-risk/">benefits</a>. A 100-gram cup of black tea has only about 20 mg of caffeine, while matcha can have 140–170 mg of caffeine!</p> <p>“Looking at the US, they usually recommend less than 400 milligrams. So overall, moderation and keeping your consumption to one to two cups – that’s what I’d recommend.”</p> <p>Now that I’ve written about caffeine, I think I need another cuppa. It’s only my second of the day, I swear. </p> <p><em>Image credits: Getty Images </em></p> <div> <h3><em><a href="https://link.cosmosmagazine.com/JQ4R"><noscript data-spai="1"><img decoding="async" class="alignleft size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/ret_img/cosmosmagazine.com/wp-content/uploads/2023/04/Apple-Podcasts.svg" data-spai-egr="1" alt="Subscribe to our podcasts" width="300" height="54" title="should you be worried about the amount of coffee or tea you drink? 2"></noscript></a><a href="https://link.cosmosmagazine.com/JQ4U"><noscript data-spai="1"><img decoding="async" class="alignleft size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/ret_img/cosmosmagazine.com/wp-content/uploads/2023/04/Spotify.svg" data-spai-egr="1" alt="Subscribe to our podcasts" width="300" height="54" title="should you be worried about the amount of coffee or tea you drink? 3"></noscript></a></em></h3> </div> <p><em><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --></em></p> <p><em><a href="https://cosmosmagazine.com/health/body-and-mind/coffee-tea-caffeine-debunks/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/evrim-yazgin/">Evrim Yazgin</a>.</em></p>

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Your skin is a mirror of your health – here’s what yours might be saying

<p><em><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/12095893/">Skin accounts for around 15% of our body mass</a>. It is the largest and most visible organ in the human body.</p> <p>Yet many of the skin’s functions are often overlooked. It’s a sunscreen, a shield from germs, a reservoir of <a href="https://pubmed.ncbi.nlm.nih.gov/28994020/">vitamin D</a> and a means of tightly regulating our body temperature.</p> <p>Being the most visible of our organs, the skin also offers us a view into the body tissues that it protects. So don’t think of your skin merely aesthetically – think of it as a reflection of your health. Disorders of the gut, blood, hormones and even the heart might first be seen on the skin in the form of a rash.</p> <p>Here are a few to look out for.</p> <h2>Bullseye</h2> <p>Ticks are pesky creatures that no one will want to return home from a country walk with.</p> <p>But while the vast majority of tick bites <a href="https://pubmed.ncbi.nlm.nih.gov/36116831/">won’t make you ill</a>, there is one rash that should prompt a visit to your doctor if you spot it.</p> <p>Erythema migrans, a rash named for its ability to rapidly expand across the skin, is a hallmark of <a href="https://www.bmj.com/content/369/bmj.m1041.long">Lyme disease</a>, a potentially severe bacterial illness. This rash forms a classic target pattern, like a bullseye on a dartboard.</p> <p>Be vigilant for a few weeks after being bitten to check this rash doesn’t make an appearance – especially if you noticed a red lump that wasn’t there before or if you had to remove a tick from your skin. You should also keep an eye out for other associated symptoms of Lyme disease – such as swinging temperatures, muscle and joint pains and headache.</p> <p>The condition is treated with antibiotics, which can prevent long-term complications, including chronic fatigue symptoms.</p> <h2>Purpura</h2> <p>Some rashes are given a <a href="https://linkinghub.elsevier.com/retrieve/pii/S1538-7836(22)01880-3">colourful namesake</a> – purpura is one such example. This rash’s name is derived from a mollusc which was used to make purple dye.</p> <p>Purpura refers to a rash of small purple or red dots. The cause is pooling of blood into a deeper layer of the skin (dermis). When pressed with a finger – or even better, the side of a glass – it refuses to blanch away.</p> <p>Purpura signals an issue with either the walls of the tiny blood vessels that feed the skin or the blood within them. This might be from a deficiency in platelets, the tiny cell fragments that allow blood to clot – perhaps from bone marrow failure, or an autoimmune condition where the body turns on itself and attacks its own cells.</p> <p>At worst, purpura may signal the life-threatening condition <a href="https://www.magonlinelibrary.com/doi/full/10.12968/hmed.2017.78.8.468">septicaemia</a>, where an infection has spread into the bloodstream – perhaps from the lungs, kidneys or even from the skin itself.</p> <h2>Skin spiders</h2> <p>Skin rashes can also take on <a href="https://pubmed.ncbi.nlm.nih.gov/32513406/">recognisable shapes</a>.</p> <p>Spider naevi represent an issue within skin arterioles (small arteries which supply the skin with blood). Arterioles open and close to control the loss of heat from the body’s surface. But sometimes they can get stuck open – and a spider-like pattern will appear.</p> <p>The open arteriole is the spider’s body, and the even tinier capillaries fanning out in all directions are the thready legs. Crush the body under a fingertip and the whole thing disappears, as your touch temporarily stops the blood flow.</p> <p>Often, these are benign and not associated with any specific condition – especially if you only have one or two. However, more than three suggest higher circulating levels of the <a href="https://dermnetnz.org/topics/spider-telangiectasis">hormone oestrogen</a>, often due to liver disease or from the hormonal changes seen in pregnancy. Treat the underlying cause, and the spiders often vanish with time – though they may persist or reappear later.</p> <h2>Black velvet</h2> <p>Changes to the folds of your skin (usually around the armpits or neck) – especially if it becomes thickened and velveteen to the touch – may suggest a condition known as <a href="https://onlinelibrary.wiley.com/doi/10.1111/jocd.13544">acanthosis nigricans</a>. This “black velvet” skin appearance is more commonly seen in darker skins.</p> <p>Usually, the condition is associated with <a href="https://pubmed.ncbi.nlm.nih.gov/29241752/">disorders of the metabolism</a> – namely type 2 diabetes and polycystic ovary syndrome. If either of these conditions are successfully treated, the rash may fade. In rare cases, it can also be a sign of <a href="https://www.hkmj.org/abstracts/v29n4/355.htm">stomach cancer</a>, which should be considered in patients with few or none of the key signs of metabolic disease (obesity and high blood pressure).</p> <h2>Butterfly rashes</h2> <p>Even disorders of the heart can be visible on the skin.</p> <p>Cardiac valves have the important role of correctly directing the journey of blood through the heart and preventing backflow. The valve between the chambers on the left side of the heart (the mitral valve – so called because of its resemblance to a bishop’s hat, or mitre) can sometimes become narrowed, causing the heart’s function to deteriorate. The body’s natural response is to preserve core blood volume, shutting off flow towards the skin.</p> <p>The net effect can produce a purple-red rash, high across the cheeks and the bridge of the nose, like the outstretched wings of a butterfly. We call this <a href="https://journals.sagepub.com/doi/10.1177/2050313X231200965?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">mitral facies</a> which, depending on the extent of damage to the heart and great vessels, may persist despite treatment.</p> <p>It’s important to pay heed to your skin. It’s constantly talking to you, and any changes in its texture, colour or if new marks or patterns appear, may indicate something is going on beneath the surface.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221937/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-skin-is-a-mirror-of-your-health-heres-what-yours-might-be-saying-221937">original article</a>.</em></p>

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Eating leafy greens could be better for oral health than using mouthwash

<p><em><a href="https://theconversation.com/profiles/mia-cousins-burleigh-1201153">Mia Cousins Burleigh</a>, <a href="https://theconversation.com/institutions/university-of-the-west-of-scotland-1385">University of the West of Scotland</a> and <a href="https://theconversation.com/profiles/siobhan-paula-moran-1506183">Siobhan Paula Moran</a>, <a href="https://theconversation.com/institutions/university-of-the-west-of-scotland-1385">University of the West of Scotland</a></em></p> <p>Over half the adult population in the <a href="https://pubmed.ncbi.nlm.nih.gov/26052472">UK and US</a> have gum disease. Typical treatments include <a href="https://www.nature.com/articles/s41598-020-61912-4">mouthwash</a> and in severe cases, <a href="https://www.magonlinelibrary.com/doi/abs/10.12968/vetn.2017.8.10.542">antibiotics</a>. These treatments have side effects, such as dry mouth, the development of <a href="https://pubmed.ncbi.nlm.nih.gov/30967854/">antimicrobial resistance</a> and increased <a href="https://www.nature.com/articles/s41598-020-61912-4">blood pressure</a>.</p> <p>But research has indicated that a molecule called <a href="https://www.nature.com/articles/s41598-020-69931-x">nitrate</a>, which is found in leafy green vegetables, has fewer side effects and offers greater benefits for oral health. And it could be used as a natural alternative for treating oral disease.</p> <p>Inadequate brushing and flossing leads to the build up of <a href="https://www.nature.com/articles/s41598-020-69931-x">dental plaque</a>, a sticky layer of bacteria, on the surface of teeth and gums. Plaque causes tooth decay and gum disease. Sugary and acidic foods, dry mouth, and smoking can also contribute to bad breath, tooth decay, and gum infections.</p> <p>The two main types of gum disease are gingivitis and periodontitis. <a href="https://www.spandidos-publications.com/10.3892/etm.2019.8381">Gingivitis</a> causes redness, swelling and bleeding of the gums. <a href="https://www.spandidos-publications.com/10.3892/etm.2019.8381">Periodontitis</a> is a more advanced form of gum disease, causing damage to the soft tissues and bones supporting the teeth.</p> <p>Periodontal disease can therefore, lead to tooth loss and, when bacteria from the mouth enter the bloodstream, can also contribute to the development of <a href="https://www.nature.com/articles/bdjteam2015163">systemic disorders</a> such as cardiovascular disease, dementia, diabetes and rheumatoid arthritis.</p> <h2>Leafy greens may be the secret</h2> <p>Leafy greens and root vegetables are bursting with <a href="https://www.sciencedirect.com/science/article/pii/S2666149723000312">vitamins, minerals, and antioxidants</a> – and it’s no secret that a diet consisting of these vegetables is crucial for maintaining a healthy weight, boosting the immune system, and preventing <a href="https://journals.sagepub.com/doi/10.1177/2048004016661435">heart disease, cancer and diabetes.</a> The multiple health benefits of leafy greens are partly because spinach, lettuce and beetroots are brimming with <a href="https://www.nature.com/articles/s41598-020-69931-x">nitrate</a>, which can be reduced to nitric oxide by nitrate-reducing bacteria inside the mouth.</p> <figure><iframe src="https://www.youtube.com/embed/7zrRlMGeBes?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Popeye knew a thing or two about the health benefits of eating leafy greens. Boomerang Official, 2017.</span></figcaption></figure> <p>Nitric oxide is known to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0006295222004191">lower blood pressure</a> and improve <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243755#:%7E:text=Nitrate%2Drich%20beetroot%20juice%20offsets,healthy%20male%20runners%20%7C%20PLOS%20ONE">exercise performance</a>. However, in the mouth, it helps to prevent the overgrowth of bad bacteria and reduces <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243755#:%7E:text=Nitrate%2Drich%20beetroot%20juice%20offsets,healthy%20male%20runners%20%7C%20PLOS%20ONE">oral acidity</a>, both of which can cause gum disease and tooth decay.</p> <p>As part of our research on nitrate and oral health, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243755#:%7E:text=Nitrate%2Drich%20beetroot%20juice%20offsets,healthy%20male%20runners%20%7C%20PLOS%20ONE">we studied competitive athletes</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839431/">Athletes are prone to gum disease</a> due to high intake of carbohydrates – which can cause inflammation of the gum tissues – stress, and dry mouth from breathing hard during training.</p> <p>Our study showed that beetroot juice (containing approximately 12 <a href="https://www.nursingtimes.net/students/an-easy-guide-to-mmols-09-02-2012/">millimole</a> of nitrate) protected their teeth from acidic sports drinks and carbohydrate gels during exercise – suggesting that nitrate could be used as a prebiotic by athletes to reduce the risk of tooth decay.</p> <p>Nitrate offers a lot of promise as an oral health <a href="https://www.nature.com/articles/s41598-020-69931-x">prebiotic</a>. Good oral hygiene and a nitrate rich diet could be the key to a healthier body, a vibrant smile and disease-free gums. This is good news for those most at risk of oral health deterioration such as <a href="https://www.news-medical.net/health/Periodontitis-and-Pregnancy.aspx">pregnant women</a>, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771712/">the elderly</a>.</p> <p>In the UK, antiseptic mouthwashes containing <a href="https://www.nature.com/articles/s41598-020-61912-4">chlorhexidine</a> are commonly used to treat dental plaque and gum disease. Unfortunately, these mouthwashes are a blunderbuss approach to oral health, as they indiscriminately remove both good and bad bacteria and increase oral acidity, which can cause disease.</p> <p>Worryingly, early research also indicates that chlorhexidine may contribute to <a href="https://pubmed.ncbi.nlm.nih.gov/30967854/">antimicrobial resistance</a>. Resistance occurs when bacteria and fungi survive the effects of one or more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768623/">antimicrobial drugs</a> due to repeated exposure to these treatments. Antimicrobial resistance is a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext">global health concern</a>, predicted to cause 10 million deaths yearly by the year 2050.</p> <p>In contrast, dietary nitrate is more targeted. Nitrate eliminates disease-associated bacteria, reduces oral acidity and creates a balanced <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944498/">oral microbiome</a>. The oral microbiome refers to all the microorganisms in the mouth. Nitrate offers exciting potential as an <a href="https://www.nature.com/articles/s41598-020-69931-x">oral health prebiotic</a>, which can be used to prevent disease onset or limit disease progression.</p> <h2>How many leafy greens for pearly whites?</h2> <p>So how much should we consume daily? As a rule of thumb, a generous helping of spinach, kale or beetroot at mealtimes contains about 6-10 mmol of nitrate and offers immediate health benefits.</p> <p>Work we have done with our collaborators has shown that treating <a href="https://www.nature.com/articles/s41598-020-69931-x">plaque samples</a> from periodontal disease patients with 6.5 mmol of nitrate increased healthy bacteria levels and reduced acidity.</p> <p>For example, consuming <a href="https://aap.onlinelibrary.wiley.com/doi/full/10.1002/JPER.20-0778">lettuce juice</a> for two weeks reduced gum inflammation and increased healthy bacteria levels in patients with gum disease.</p> <p>Growing evidence suggests that nitrate is a cornerstone of oral health. Crunching on a portion of vegetables at mealtimes can help to prevent or treat oral disease and keeps the mouth fresh and healthy.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221181/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/mia-cousins-burleigh-1201153"><em>Mia Cousins Burleigh</em></a><em>, Lecturer, School of Health and Life Sciences, <a href="https://theconversation.com/institutions/university-of-the-west-of-scotland-1385">University of the West of Scotland</a> and <a href="https://theconversation.com/profiles/siobhan-paula-moran-1506183">Siobhan Paula Moran</a>, PhD candidate, School of Health and Life Sciences, <a href="https://theconversation.com/institutions/university-of-the-west-of-scotland-1385">University of the West of Scotland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/eating-leafy-greens-could-be-better-for-oral-health-than-using-mouthwash-221181">original article</a>.</em></p>

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How much weight do you actually need to lose? It might be a lot less than you think

<p><em><a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>If you’re one of the <a href="https://www.finder.com.au/new-years-resolutions-statistics">one in three</a> Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards.</p> <p>But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers.</p> <p>Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range.</p> <p>Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight.</p> <p>Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits.</p> <h2>Using BMI to define our target weight is flawed</h2> <p>We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio.</p> <p>BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening.</p> <p>But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is <a href="https://theconversation.com/using-bmi-to-measure-your-health-is-nonsense-heres-why-180412">because</a> it:</p> <ul> <li> <p>fails to consider two critical factors related to body weight and health – body fat percentage and distribution</p> </li> <li> <p>does not account for significant differences in body composition based on gender, ethnicity and age.</p> </li> </ul> <h2>How does losing weight benefit our health?</h2> <p>Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways.</p> <p><strong>1. Reducing cholesterol</strong></p> <p>Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy.</p> <p>Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke.</p> <p>But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987606/">research</a> shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss.</p> <p><strong>2. Lowering blood pressure</strong></p> <p>Our blood pressure is considered high if it reads more than 140/90 on at least two occasions.</p> <p>Excess weight is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">linked to</a> high blood pressure in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">several ways</a>, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure.</p> <p>Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke.</p> <p>Like the improvements in cholesterol, a 5% weight loss <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.21358">improves</a> both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number).</p> <p>A <a href="https://www.ahajournals.org/doi/10.1161/01.hyp.0000094221.86888.ae">meta-analysis of 25 trials</a> on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point.</p> <p><strong>3. Reducing risk for type 2 diabetes</strong></p> <p>Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat).</p> <p>Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels.</p> <p>Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system.</p> <p><a href="https://www.nejm.org/doi/full/10.1056/nejmoa012512">Research</a> shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%.</p> <p><strong>4. Reducing joint pain and the risk of osteoarthritis</strong></p> <p>Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/21425246/">Observational studies</a> show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold.</p> <p>Small amounts of weight loss alleviate this stress on our joints. <a href="https://pubmed.ncbi.nlm.nih.gov/15986358/">In one study</a> each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities.</p> <h2>Focus on long-term habits</h2> <p>If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone.</p> <p>An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/">analysis</a> of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%.</p> <p>When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several <a href="https://pubmed.ncbi.nlm.nih.gov/25896063/">physiological responses</a> to defend our body weight and “survive” starvation.</p> <p>Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to:</p> <ul> <li> <p>losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight</p> </li> <li> <p>making gradual changes to your lifestyle to ensure you form habits that last a lifetime.</p> </li> </ul> <p>Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits.</p> <p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217287/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-weight-do-you-actually-need-to-lose-it-might-be-a-lot-less-than-you-think-217287">original article</a>.</em></p>

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The best diet for 2024

<p>Over years of research and diet rankings, there is one regimen that scientists have crowned the "Best Diet Overall" for seven years in a row. </p> <p>The Mediterranean diet has topped the list in <a href="https://health.usnews.com/best-diet/best-diets-overall" target="_blank" rel="noopener"><em>US News and World Reports’</em></a> annual ranking for 2024, followed by the DASH diet, and the MIND diet coming in third.  </p> <p>The ranking is based off the findings of a panel of leading medical and nutrition experts, who analyse the nutritional completeness, health risks and benefits, long-term sustainability and  effectiveness of the diet in addressing its goals. </p> <p><strong>What sets it apart from other diets? </strong></p> <p>The Mediterranean diet emphasises multiple servings of fruits and vegetables daily, alongside whole grains, legumes, nuts, olive oil and seafood. </p> <p>Red meats, dairy and poultry are consumed occasionally and in moderation, and highly processed foods and added sugars are generally avoided. </p> <h4><strong>What are its benefits?</strong></h4> <p>The experts found that following the diet long term can increase the odds of living a longer, healthier life, with a few other studies suggesting it lowers the risk of heart disease and Type 2 diabetes, while potentially slowing cognitive decline.</p> <p>“It’s a way of life, it’s a cuisine, it dates back thousands of years, and in the last five to six decades, it is the most highly researched cuisine in the world,” said Dr Catherine Itsiopoulos, a professor of nutrition and dietetics at RMIT University in Melbourne.</p> <p><strong>Lowers risk of heart disease</strong></p> <p>A 2021 research review found that the diet has been shown to reduce the risk of coronary heart disease in women by 29 per cent and stroke by 13 per cent. </p> <p>A 2017 analysis found that on average it lowers the risk of coronary heart disease, heart attacks and strokes by 40 per cent. </p> <p>Experts suggest that this may be because  the fats in olive oil, seeds, fish and nuts are monounsaturated or polyunsaturated fats aka healthy fats. </p> <p>Additionally, because of its emphasis on fruits, vegetables and legumes, which contain antioxidants and other beneficial compounds, it is believed to combat chronic inflammation. </p> <p><strong>Lowers chances of developing type 2 diabetes </strong></p> <p>Because this diet relies heavily on honey and cinnamon as sweeteners, and fruits as a primary source of sugar, it reduces the risk of developing this disease. </p> <p>One study conducted on 300,000 participants found that those who were on the Mediterranean diet had a nearly 30 per cent lower risk of Type 2 diabetes. </p> <p><strong>Good for your gut</strong></p> <p>The diet contains a lot of fibre which are associated with more regular bowel movements, lower blood pressure, cholesterol and blood sugar levels, according to the Food and Drug Administration.</p> <p>This is because good bacteria in our stomachs feed off fibre, which creates a stronger lining in the intestines. </p> <p>There are a few other potential health benefits including reducing risk of dementia among seniors by almost 25 per cent, and lowering the risk of death from cancer including breast, colorectal, head and neck and lung cancers. </p> <p>See the full list <a href="https://health.usnews.com/best-diet/best-diets-overall" target="_blank" rel="noopener">here</a>. </p> <p><em>Image: Getty</em></p> <p> </p>

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How dieting, weight suppression and even misuse of drugs like Ozempic can contribute to eating disorders

<p><em><a href="https://theconversation.com/profiles/samantha-withnell-1504436">Samantha Withnell</a>, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> and <a href="https://theconversation.com/profiles/lindsay-bodell-1504260">Lindsay Bodell</a>, <a href="https://theconversation.com/institutions/western-university-882">Western University</a></em></p> <p>Up to 72 per cent of women and 61 per cent of men are dissatisfied with their weight or <a href="https://doi.org/10.1016/j.eatbeh.2014.04.010">body image</a>, according to a U.S. study. Globally, millions of people <a href="https://doi.org/10.1111%2Fobr.12466">attempt to lose weight</a> every year with the hope that weight loss will have positive effects on their body image, health and quality of life.</p> <p>However, these motivated individuals often struggle to maintain new diets or exercise regimens. The rise of medications such as semaglutides, like <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101298">Ozempic</a> or <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101765">Wegovy</a>, <a href="https://www.cbc.ca/news/health/ozempic-weight-loss-1.6772021">might be viewed as an appealing “quick fix”</a> alternative to meet weight loss goals.</p> <p>Research led by our team and others suggests that such attempts to lose weight often do more harm than good, and even increase the risk of <a href="https://osf.io/9stq2">developing an eating disorder</a>.</p> <h2>Weight loss and eating disorders</h2> <p>Eating disorders are <a href="https://doi.org/10.1002/eat.20589">serious mental health conditions</a> primarily characterized by extreme patterns of under- or over-eating, concerns about one’s shape or body weight or other behaviours intended to influence body shape or weight such as exercising excessively or self-inducing vomiting.</p> <p>Although once thought to only affect young, white adolescent girls, eating disorders do not discriminate; eating disorders can develop in people of <a href="https://doi.org/10.1002/erv.2553">any age, sex, gender or racial/ethnic background</a>, with an estimated <a href="https://nedic.ca/general-information/">one million Canadians</a> suffering from an eating disorder at any given time. Feb. 1 to 7 is <a href="https://nedic.ca/edaw/">National Eating Disorders Awareness Week</a>.</p> <p>As a clinical psychologist and clinical psychology graduate student, our research has focused on how eating disorders develop and what keeps them going. Pertinent to society’s focus on weight-related goals, our research has examined associations between weight loss and eating disorder symptoms.</p> <h2>Eating disorders and ‘weight suppression’</h2> <p>In eating disorders research, the state of maintaining weight loss is referred to as “weight suppression.” Weight suppression is typically defined as the difference between a person’s current weight and their highest lifetime weight (excluding pregnancy).</p> <p>Despite the belief that weight loss will improve body satisfaction, we found that in a sample of over 600 men and women, weight loss had no impact on women’s negative body image and was associated with increased body dissatisfaction in <a href="https://doi.org/10.1016/j.bodyim.2023.01.011">men</a>. Importantly, being more weight suppressed has been associated with the <a href="https://doi.org/10.1093/ajcn/nqaa146">onset of eating disorders</a>, including anorexia nervosa and bulimia nervosa.</p> <p><a href="https://doi.org/10.1007/s11920-018-0955-2">One proposed explanation</a> for the relationship between weight suppression and eating disorders is that maintaining weight loss becomes increasingly difficult as body systems that <a href="https://doi.org/10.3945/ajcn.110.010025">reduce metabolic rate and energy expenditure, and increase appetite</a>, are activated to promote weight gain.</p> <p>There is growing awareness that <a href="https://doi.org/10.1136/bmj.g2646">weight regain is highly likely following conventional diet programs</a>. This might lead people to engage in more and more extreme behaviours to control their weight, or they might shift between extreme restriction of food intake and episodes of overeating or binge eating, the characteristic symptoms of bulimia nervosa.</p> <h2>Ozempic and other semaglutide drugs</h2> <p>Semaglutide drugs like Ozempic and Wegovy are part of a class of drug called <a href="https://pdf.hres.ca/dpd_pm/00067924.PDF">glucagon-like peptide-1 agonists (GLP-1As)</a>. These drugs work by mimicking the hormone GLP-1 to interact with neural pathways that signal satiety (fullness) and slow stomach emptying, leading to reduced food intake.</p> <p>Although GLP-1As are indicated to treat Type 2 diabetes, <a href="https://www.cbc.ca/news/canada/london/ozempic-off-label-1.6884141">they are increasingly prescribed off-label</a> or being <a href="https://www.bbc.com/news/health-67414203">illegally purchased</a> without a prescription because of their observed effectiveness at inducing weight loss. Although medications like Ozempic do often lead to weight loss, the rate of weight loss may <a href="https://doi.org/10.1001/jama.2021.3224">slow down or stop over time</a>.</p> <p>Research by Lindsay Bodell, one of the authors of this story, and her colleagues on weight suppression may help explain why effects of semaglutides diminish over time, as <a href="https://doi.org/10.1016/j.physbeh.2019.112565">weight suppression is associated with reduced GLP-1 response</a>. This means those suppressing their weight could become less responsive to the satiety signals activated by GLP-1As.</p> <p>Additionally, weight loss effects are only seen for as long as the medication is taken, meaning those who take these drugs to achieve some weight loss goal are <a href="https://doi.org/10.1111/dom.14725">likely to regain most, if not all, weight lost</a> when they stop taking the medication.</p> <h2>Risks of dieting and weight-loss drugs</h2> <p>The growing market for off-label weight loss drugs is concerning, because of the exacerbation of <a href="https://theconversation.com/ozempic-the-miracle-drug-and-the-harmful-idea-of-a-future-without-fat-211661">weight stigma</a> and the serious <a href="https://doi.org/10.1016/j.jand.2022.01.004">health risks</a> associated with unsupervised weight loss, including developing eating disorders.</p> <p>Researchers and health professionals are already raising the alarm about the use of GLP-1As in children and adolescents, due to concerns about their possible <a href="https://doi.org/10.1017/cts.2023.612">impact on growth and development</a>.</p> <p>Moreover, popular weight-loss methods, whether they involve pills or “crash diets,” often mimic symptoms of eating disorders. For example, intermittent fasting diets that involve long periods of fasting followed by short periods of food consumption may mimic and <a href="https://doi.org/10.1016/j.eatbeh.2022.101681">increase the risk of developing binge eating problems</a>.</p> <p>The use of diet pills or laxatives to lose weight has been found to increase the risk of <a href="https://doi.org/10.2105/AJPH.2019.305390">being diagnosed with an eating disorder in the next one to three years</a>. Drugs like Ozempic may also be <a href="https://doi.org/10.1002/eat.24109">misused by individuals already struggling with an eating disorder</a> to suppress their appetite, compensate for binge eating episodes or manage fear of weight gain.</p> <p>Individuals who are already showing signs of an eating disorder, such as limiting their food intake and intense concerns about their weight, may be most at risk of spiralling from a weight loss diet or medication into an eating disorder, <a href="https://doi.org/10.1002/eat.24116">even if they only lose a moderate amount of weight</a>.</p> <p>People who are dissatisfied with their weight or have made multiple attempts to lose weight often feel pressured to try increasingly drastic methods. However, any diet, exercise program or weight-loss medication promising a quick fix for weight loss should be treated with extreme caution. At best, you may gain the weight back; at worst, you put yourself at risk for much more serious eating disorders and other health problems.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221514/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/samantha-withnell-1504436"><em>Samantha Withnell</em></a><em>, PhD Candidate, Clinical Psychology, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> and <a href="https://theconversation.com/profiles/lindsay-bodell-1504260">Lindsay Bodell</a>, Assistant Professor of Psychology, <a href="https://theconversation.com/institutions/western-university-882">Western University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-dieting-weight-suppression-and-even-misuse-of-drugs-like-ozempic-can-contribute-to-eating-disorders-221514">original article</a>.</em></p>

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