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Why do I need to take some medicines with food?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to? There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food. To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food. Different brands of the same medicine may also have different recommendations when it comes to taking it with food. <h2>Food impacts drug absorption</h2> Food can affect how fast and how much a drug is absorbed into the body in up to <a href="https://academic.oup.com/jpp/article-abstract/71/4/510/6122024?login=false">40% of medicines</a> taken orally. When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption. Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505616/">gastric emptying</a>. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption. Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly. But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach. <h2>Food can make medicines more tolerable</h2> Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets. Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452716/">one in four users affected</a>. To combat these side effects, it is generally recommended to be taken with food. The same <a href="https://amhonline.amh.net.au/auth">advice</a> is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline). Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed. <h2>Can food make medicines safer?</h2> Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/medications/latest-release">within a two-week period</a>. While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of <a href="https://www.tandfonline.com/doi/full/10.1586/14737175.6.11.1643#d1e212">bleeding, ulceration and perforation</a> with long-term use. But there <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">isn’t enough research</a> to show taking ibuprofen with food reduces this risk. Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration. The <a href="https://amhonline.amh.net.au/auth">Australian Medicines Handbook</a>, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">A systematic review published in 2015</a> found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses. To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs">non-steroidal anti-inflammatory medicines</a> at the same time. For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a <a href="https://australianprescriber.tg.org.au/articles/peptic-ulcer-disease-and-non-steroidal-anti-inflammatory-drugs.html">proton pump inhibitor</a>, a medicine that reduces stomach acid and protects the stomach lining. <h2>How much food do you need?</h2> When you need to take a medicine with food, how much is enough? Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone. However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised. Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.<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/235782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Associate Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Shutterstock 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-take-some-medicines-with-food-235782">original article</a>. </div>

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What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a <a href="https://apnews.com/article/bronny-james-cardiac-arrest-3953eee8789e83f3cccfb6dd798bc54e">cardiac arrest</a>. Many media outlets incorrectly referred to the event as a “<a href="https://en.as.com/nba/lebron-james-son-bronny-plays-for-the-usc-trojans-for-the-first-time-since-suffering-a-heart-attack-n/">heart attack</a>” or used the terms interchangeably. A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart. With some background in <a href="https://www.youtube.com/watch?v=uKrgEv7-rVM&t=16s">how the heart works</a>, we can see how they differ and how they’re related. <h2>Understanding the heart</h2> The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body. For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs. This can cause the heart muscle to become injured or die, and results in the heart not pumping properly. <h2>Heart attack or cardiac arrest?</h2> Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle. A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump. In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other. <h2>Why do they happen? Who’s at risk?</h2> Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease. The underlying cause in about <a href="https://www.ncbi.nlm.nih.gov/books/NBK507799/#:%7E:text=It%20has%20been%20reported%20that,increases%20beyond%20age%2050%20years.">75% of people</a> is a process called <a href="https://youtu.be/jwL4lkSlvSA?si=H2as7dQkhbIqWWkU">atherosclerosis</a>. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot. Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process. Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle. Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="Heart attack vs cardiac arrest" /></a><figcaption>Here’s a simple way to remember the difference. Author provided</figcaption></figure> But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to <a href="https://www.youtube.com/watch?v=M_soKG-Tzh0&t=903s">electrical malfunctions</a> in the heart. There are four distinct types: <ul> <li> ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541285/">100 beats per minute</a> (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately </li> <li> ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute </li> <li> pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse </li> <li> asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart. </li> </ul> Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a <a href="https://www.espn.com.au/mens-college-basketball/story/_/id/38260006/bronny-james-cardiac-arrest-caused-congenital-heart-defect">congenital heart defect</a>, a heart condition he was born with. But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting <a href="https://pubmed.ncbi.nlm.nih.gov/11898927/">for 70%</a> of all cases. So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest. So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack. <h2>What do they look like?</h2> Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin. But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating. <h2>What’s the take-home message?</h2> While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes. A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring. Despite their different nature both conditions can have severe consequences and require immediate medical attention.<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/229633/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, Associate Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, Senior lecturer, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock 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/whats-the-difference-between-a-heart-attack-and-cardiac-arrest-ones-about-plumbing-the-other-wiring-229633">original article</a>. </div>

Body

You’re probably brushing your teeth wrong – here are four tips for better dental health

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> We all know the advice for healthy teeth – brush twice daily and don’t eat too much sugar. So why do those of us following these instructions find we sometimes need a filling when we visit the dentist? The truth is, there’s a little more to preventing tooth decay than these guidelines suggest. Here’s what you need to know. <h2>Brush up on your skills</h2> How you brush makes a big difference. The mechanical act of brushing removes the very sticky dental plaque – a mixture of bacteria, their acids and sticky byproducts and food remnants. It forms naturally on teeth immediately after you’ve eaten but doesn’t get nasty and start to cause damage to the teeth until it reaches a certain stage of maturity. The exact amount of time this takes isn’t known but is at least more than 12 hours. Bacteria consume sugar and, as a byproduct, produce acids which dissolve mineral out of the teeth, leaving microscopic holes we can’t see. If the process isn’t stopped and they aren’t repaired, these can become big, visible cavities. Taking two minutes to brush your teeth is a good target for removing plaque and you should brush at night and one other time daily. Brushing frequently stops the bacteria developing to a stage where the species which produce the most acid can become established. Electric toothbrushes can be <a href="https://www.cochrane.org/CD002281/ORAL_poweredelectric-toothbrushes-compared-to-manual-toothbrushes-for-maintaining-oral-health">more effective than manual brushing</a> and a small toothbrush head helps to reach awkward areas in the mouth, while medium-textured bristles help you clean effectively without causing harm to gums and teeth. The main thing, however, is to get brushing! <h2>Use fluoride toothpaste and disclosing tablets</h2> Most of the benefit from brushing comes from toothpaste. The key ingredient is fluoride, which evidence shows <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002278/full#CD002278-abs-0003">prevents tooth decay</a>. Fluoride replaces lost minerals in teeth and also makes them stronger. For maximum benefit, <a href="https://www.cochrane.org/CD007868/ORAL_comparison-between-different-concentrations-of-fluoride-toothpaste-for-preventing-tooth-decay-in-children-and-adolescents">use toothpaste with 1350-1500 ppmF</a> – that’s concentration of fluoride in parts per million – to prevent tooth decay. Check your toothpaste’s concentration by reading the ingredients on the back of the tube. <a href="https://theconversation.com/childrens-toothpaste-the-facts-80508">Not all children’s toothpastes are strong enough</a> for them to gain maximum benefit. Your dentist may prescribe higher strength fluoride toothpaste based on their assessment of your or your child’s risk of tooth decay. Plaque is difficult to see because it is whitish, like your teeth. Disclosing tablets are available in supermarkets and chemists and they make plaque more visible, showing areas you may have missed when brushing. <h2>Spit, don’t rinse</h2> At night, you produce less saliva than during the day. Because of this, your teeth have less protection from saliva and are more vulnerable to acid attacks. That’s why it’s important to remove food from your teeth before bed so plaque bacteria can’t feast overnight. Don’t eat or drink anything except water <a href="https://www.sign.ac.uk/assets/sign138.pdf">after brushing at night</a>. This also gives fluoride the longest opportunity to work. Once you’ve brushed, don’t rinse your mouth with water or mouthwash – you’re washing away the fluoride! This can be a difficult habit to break, but can <a href="https://www.sign.ac.uk/assets/sign138.pdf">reduce tooth decay by up to 25%</a>. <h2>No more than four ‘sugar hits’</h2> Intrinsic sugars are found naturally in foods like fruit and they are far less likely to cause tooth decay than added or <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/sugar-salt-and-fat/free-sugars">free sugars</a>. Free sugars are generally those added to foods by manufacturers but also include honey, syrup and fruit juices. These are all easy for bacteria to consume, metabolise and produce acids from. However, it can be difficult to tell which are the worst sugars for teeth. For example, although normal amounts of fruit are fine, fruit juices have sugar liberated from the plant cells and heavy consumption can cause decay. <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">The World Health Organization</a> and <a href="https://www.nhs.uk/common-health-questions/food-and-diet/how-much-sugar-is-good-for-me/">NHS</a> recommend free sugars should ideally make up less than 5% of your daily calorie intake. So what does this look like? For adults and children over about 11 years old, this is around 30g – about eight teaspoons – of sugar daily. A 330ml can of Coke has <a href="https://www.coca-cola.co.uk/drinks/coca-cola/coca-cola">35g of sugar</a>. The <a href="https://play.google.com/store/apps/details?id=com.phe.c4lfoodsmart&hl=en_GB">change4life app</a> is helpful to track how much sugar you consume in your diet. Although not as important as how much, how often you eat sugar also matters. Simple carbohydrates like sugar are easier for bacteria to digest than proteins or complex carbohydrates. Bacteria produce acids after they metabolise sugar which causes demineralisation. Fortunately, through the actions of fluoride toothpaste and the remineralising effects of saliva, your teeth can recover from the early stages of these attacks. It’s like having a set of scales – trying to keep the balance between sugars on one side, fluoride toothpaste and cleaning on the other. Typically, your teeth can be exposed to four “sugar hits” – episodes of sugar intake – daily without irreversible damage to the teeth. Why not try counting how many sugary hits you have a day? This includes biscuits, cups of sugary tea or coffee and other snacks with refined carbohydrates like crisps. A simple way of cutting down would be to stop putting sugar in hot drinks and limiting snacking. Brush twice daily with fluoride toothpaste, spit don’t rinse, eat and drink nothing after brushing, and don’t have sugar more than four times daily. Easy!<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/103959/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, Clinical Lecturer in Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, Professor of Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> Image credits: Shutterstock 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/youre-probably-brushing-your-teeth-wrong-here-are-four-tips-for-better-dental-health-103959">original article</a>. </div>

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"Someone is going to die": Kerri-Anne slams "irresponsible" Elle Macpherson interview

Kerri-Anne Kennerley has slammed Elle Macpherson for announcing that she allegedly "cured" her breast cancer after shunning the advice of doctors and opting for "holistic" treatment paths instead, while also taking aim at 60 Minutes for airing an interview with the supermodel where she doubled down on her beliefs. In her new memoir, Elle: Life, Lessons, and Learning to Trust Yourself, Macpherson revealed that at the age of 53, she was <a href="https://oversixty.com.au/health/caring/elle-macpherson-reveals-secret-battle-with-cancer" target="_blank" rel="noopener">diagnosed</a> with breast cancer and decided to go against doctors orders for her treatment. The 60-year-old recalled how her doctors recommended a mastectomy with radiation, chemotherapy, hormone therapy, plus reconstruction of her breast to fight the illness, and how she instead decide to forge her own path of "holistic wellness" to beat the disease without the use on conventional medicines, which she claims "cured" her cancer. “It really gave me an opportunity to dig deep in my inner sense to find a solution that worked for me," she told Australian's Women's Weekly. “It was a wonderful exercise in being true to myself, trusting myself and trusting the nature of my body and the course of action that I had chosen.” Macpherson then doubled down on her decision in an exclusive interview with 60 Minutes on Sunday, in which she claimed that there is “no possibility” of her breast cancer recurring given “the body has the infinite capacity to heal”, and making the bizarre remark that it’s “fear” that actually makes people ill. Kerri-Anne Kennerley, who is also a survivor of breast cancer, was one of <a href="https://oversixty.com.au/health/caring/shockingly-irresponsible-elle-macpherson-slammed-for-holistic-cancer-treatment" target="_blank" rel="noopener">many</a> who found problems with the interview, as she said it was dangerous for the news program to broadcast such information. “Think of the poor oncologists, surgeons and doctors today … inundated with phone calls from people (saying) ‘I’m rethinking my treatment because Elle Macpherson said this and that’,” she told <a href="https://www.theaustralian.com.au/business/media/someone-is-going-to-die-kerrianne-kennerleys-warning-on-elle-macphersons-breast-cancer-message/news-story/39ddfd8c848375d1690faeb50b391e18" data-tgev="event119" data-tgev-container="bodylink" data-tgev-order="39ddfd8c848375d1690faeb50b391e18" data-tgev-label="business" data-tgev-metric="ev">The Australian.</a> “I understand Elle … did what she thought was good for her personally, but the very fact she has resisted any other medical treatment … absolutely terrifies me.” “Without question, it will result in the future that somebody will take that line and feel confident enough to try and do it themselves naturally, and someone is going to die.” Kennerley, who was diagnosed with breast cancer in 2012, said the 60 Minutes report should've been more "balanced" by having expert testimony from doctors as a counterargument to Elle's claims. “(60 Minutes reporter) Tracy (Grimshaw) did a piece to camera about it. But to be seriously responsible, you have to have an oncologist who could actually balance Elle’s remarks,” Kennerley said. “I believe 60 Minutes was irresponsible by not having an oncologist who would give an alternative point of view. Elle’s given her natural point of view, and she’s followed through with it. They should have absolutely gotten an oncologist that said ‘as an oncologist, I’ve seen this type of cancer and many other types of cancers in my 30-year career. People who have not followed the advice have died.'” Image credits: 60 Minutes / Instagram

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Does intermittent fasting increase or decrease our risk of cancer?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a> Research over the years has suggested intermittent fasting has the potential to improve our health and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/">reduce the likelihood</a> of developing cancer. So what should we make of a <a href="https://www.nature.com/articles/s41586-024-07840-z">new study</a> in mice suggesting fasting increases the risk of cancer? <h2>What is intermittent fasting?</h2> Intermittent fasting means switching between times of eating and not eating. Unlike traditional diets that focus on what to eat, this approach focuses on when to eat. There are lots of commonly used <a href="https://dietitiansaustralia.org.au/health-advice/intermittent-fasting">intermittent fasting schedules</a>. The 16/8 plan means you only eat within an eight-hour window, then fast for the remaining 16 hours. Another popular option is the 5:2 diet, where you eat normally for five days then restrict calories for two days. In Australia, poor diet contributes to <a href="https://www.health.gov.au/topics/food-and-nutrition/what-were-doing">7% of all cases of disease</a>, including coronary heart disease, stroke, type 2 diabetes, and cancers of the bowel and lung. Globally, poor diet is linked to <a href="https://www.thelancet.com/article/S0140-6736(19)30041-8/fulltext">22% of deaths</a> in adults over the age of 25. Intermittent fasting has gained a lot of attention in recent years for its potential health benefits. Fasting <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/metabolism">influences metabolism</a>, which is how your body processes food and energy. It can affect how the body absorbs nutrients from food and burns energy from sugar and fat. <h2>What did the new study find?</h2> The <a href="https://www.nature.com/articles/s41586-024-07840-z">new study</a>, published in Nature, found when mice ate again after fasting, their <a href="https://www.nature.com/articles/s12276-024-01179-1">gut stem cells</a>, which help repair the intestine, became more active. The stem cells were better at regenerating compared with those of mice who were either totally fasting or eating normally. This suggests the body might be better at healing itself when eating after fasting. However, this could also have a downside. If there are <a href="https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-changes-infographic">genetic mutations</a> present, the burst of stem cell-driven regeneration after eating again might make it easier for cancer to develop. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027058/">Polyamines</a> – small molecules important for cell growth – drive this regeneration after refeeding. These polyamines can be produced by the body, influenced by diet, or come from gut bacteria. The findings suggest that while fasting and refeeding can improve stem cell function and regeneration, there might be a tradeoff with an increased risk of cancer, especially if fasting and refeeding cycles are repeated over time. While this has been shown in mice, the link between intermittent fasting and cancer risk in humans is more complicated and not yet fully understood. <h2>What has other research found?</h2> <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-071816-064634">Studies in animals</a> have found intermittent fasting can help with weight loss, improve blood pressure and blood sugar levels, and subsequently <a href="https://pubmed.ncbi.nlm.nih.gov/27810402/">reduce the risks</a> of diabetes and heart disease. Research in humans <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">suggests</a> intermittent fasting can reduce body weight, improve <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361187/">metabolic health</a>, reduce inflammation, and enhance <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/">cellular repair processes</a>, which remove damaged cells that could potentially turn cancerous. However, other studies warn that the benefits of intermittent fasting are the same as what can be achieved through <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2623528">calorie restriction</a>, and that there <a href="https://www.sciencedirect.com/science/article/pii/S2161831322007542">isn’t enough evidence</a> to confirm it reduces cancer risk in humans. <h2>What about in people with cancer?</h2> In studies of people who have cancer, fasting has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815756/">reported to</a> protect against the side effects of chemotherapy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311547/">improve the effectiveness</a> of cancer treatments, while decreasing damage to healthy cells. Prolonged fasting in some patients who have cancer has been shown to be safe and <a href="https://pubmed.ncbi.nlm.nih.gov/34383300/">may potentially</a> be able to decrease tumour growth. On the other hand, some experts advise caution. Studies in mice show intermittent fasting could <a href="https://www.nature.com/articles/s41423-023-01033-w">weaken the immune system</a> and make the body less able to fight infection, potentially leading to worse health outcomes in people who are unwell. However, there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757987/">currently no evidence</a> that fasting increases the risk of bacterial infections in humans. <h2>So is it OK to try intermittent fasting?</h2> The current view on intermittent fasting is that it can be beneficial, but experts agree more research is needed. Short-term benefits such as weight loss and better overall health are well supported. But we don’t fully understand the long-term effects, especially when it comes to cancer risk and other immune-related issues. Since there are many different methods of intermittent fasting and people react to them differently, it’s hard to <a href="https://www.nature.com/articles/s41423-023-01033-w">give advice that works for everyone</a>. And because most people who participated in the studies were overweight, or had diabetes or other health problems, we don’t know how the results apply to the broader population. For healthy people, intermittent fasting is generally considered safe. But it’s <a href="https://dietitiansaustralia.org.au/health-advice/intermittent-fasting">not suitable for everyone</a>, particularly those with certain medical conditions, pregnant or breastfeeding women, and people with a history of eating disorders. So consult your health-care provider before starting any fasting program.<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/238071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, PhD Candidate in Genetic Engineering and Cancer, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research)</a> Image credits: Shutterstock 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-increase-or-decrease-our-risk-of-cancer-238071">original article</a>. </div>

Body

Thinking of trying a new diet? 4 questions to ask yourself before you do

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/melissa-eaton-1522868">Melissa Eaton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>; <a href="https://theconversation.com/profiles/verena-vaiciurgis-1647095">Verena Vaiciurgis</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>, and <a href="https://theconversation.com/profiles/yasmine-probst-235268">Yasmine Probst</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> We live in a society that glorifies dieting, with around <a href="https://doi.org/10.1111%2Fobr.12466">42% of adults globally</a> having tried to lose weight. Messages about <a href="https://doi.org/10.2196/38245">dieting and weight loss</a> are amplified on social media, with a never-ending cycle of weight loss fads and diet trends. Amid often conflicting messages and misinformation, if you’re looking for diet advice online, it’s easy to become confused and overwhelmed. So before diving into the latest weight loss trend or extreme diet, consider these four questions to help you make a more informed decision. <h2>1. Is the diet realistic?</h2> Have you considered the financial cost of maintaining the diet or lifestyle, and the time and resources that would be required? For example, do you need to purchase specific products, supplements, or follow a rigid meal plan? If the diet is coming from someone who is trying to sell you something – such as a particular weight-loss product you need in order to follow the diet – this could be a particular red flag. Many extreme diet recommendations come from a place of privilege and overlook food access, affordability, cooking skills, where you live, or even your culture and ethics. If the diet has these sorts of issues it can lead to <a href="https://doi.org/10.1017/S1368980024000132">frustration, stress, stigmatisation</a> and feelings of failure for the person trying to adhere to the diet. But the problem may be with the diet itself – not with you. <h2>2. Is there evidence to support this diet?</h2> Self-proclaimed “experts” online will often make claims focused on specific groups, known as <a href="https://doi.org/10.4103%2F0972-6748.77642">target populations</a>. This might be 30- to 50-year-old men with diabetes, for example. In some cases, evidence for claims made may come from animal studies, which might not be applicable to humans at all. So be aware that if research findings are for a group that doesn’t match your profile, then the results might not be relevant to you. It takes time and a lot of high-quality studies to tell us a “diet” is safe and effective, not just one study. Ask yourself, is it supported by multiple studies in humans? Be critical and question the claims before you accept them. For accurate information look for government websites, or ask your GP or dietitian. <h2>3. How will this diet affect my life?</h2> Food is much more than calories and nutrients. It plays many roles in our lives, and likewise diets can influence our lives in ways we often overlook. Socially and culturally, food can be a point of <a href="https://doi.org/10.1017/S1368980024000132">connection and celebration</a>. It can be a source of enjoyment, a <a href="https://doi.org/10.1016/j.jbusres.2018.12.024">source of</a> comfort, or even a way to explore new parts of the world. So when you’re considering a new diet, think about how it might affect meaningful moments for you. For example, if you’re going travelling, will your diet influence the food choices you make? Will you feel that you can’t sample the local cuisine? Or would you be deterred from going out for dinner with friends because of their choice of restaurant? <h2>4. Will this diet make me feel guilty or affect my mental health?</h2> What is your favourite meal? Does this diet “allow” you to eat it? Imagine visiting your mum who has prepared your favourite childhood meal. How will the diet affect your feelings about these special foods? Will it cause you to feel stressed or guilty about enjoying a birthday cake or a meal cooked by a loved one? Studies have shown that dieting can negatively impact our <a href="https://doi.org/10.1007%2FBF03405201">mental health</a>, and skipping meals can increase symptoms of <a href="https://doi.org/10.1016/j.jagp.2020.01.160">depression and anxiety</a>. Many diets fail to consider the psychological aspects of eating, even though our mental health is just as important as physical health. Eating should not make you feel stressed, anxious, or guilty. So before starting another diet, consider how it might affect your mental health. <h2>Moving away from a dieting mindset</h2> We’re frequently told that weight loss is the path to better health. Whereas, we can prioritise our health without focusing on our weight. Constant messages about the need to lose weight can also be harmful to mental health, and not necessarily helpful for <a href="https://doi.org/10.1152/ajpregu.00755.2010">physical health</a>. Our research has found eating in a way that prioritises health over weight loss is linked to a range of <a href="https://doi.org/10.1016/j.appet.2024.107361">positive outcomes</a> for our health and wellbeing. These include a more <a href="https://books.google.com.au/books?hl=en&lr=&id=IuZzDgAAQBAJ&oi=fnd&pg=PT9&dq=%22relationship+with+food%22&ots=e-NxLzUIFF&sig=s7p6_SijfgZE6Odx7ztV4xXPGp8&redir_esc=y#v=onepage&q=%22relationship%20with%20food%22&f=false">positive relationship</a> with food, and less guilt and stress. Our research also indicates <a href="https://doi.org/10.1016/j.appet.2024.107361">mindful and intuitive eating</a> practices – which focus on internal cues, body trust, and being present and mindful when eating – are related to lower levels of depression and stress, and greater body image and self-compassion. But like anything, it takes practice and time to build a positive relationship with food. Be kind to yourself, seek out <a href="https://www.sizeinclusivehealth.org.au/find-a-provider">weight-inclusive</a> health-care professionals, and the changes will come. Finally, remember you’re allowed to find joy in food.<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/237766/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/melissa-eaton-1522868">Melissa Eaton</a>, Accredited Practising Dietitian; PhD Candidate, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>; <a href="https://theconversation.com/profiles/verena-vaiciurgis-1647095">Verena Vaiciurgis</a>, Accredited Practising Dietitian; PhD Candidate, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a>, and <a href="https://theconversation.com/profiles/yasmine-probst-235268">Yasmine Probst</a>, Associate Professor, School of Medical, Indigenous and Health Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Shutterstock 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/thinking-of-trying-a-new-diet-4-questions-to-ask-yourself-before-you-do-237766">original article</a>. </div>

Body

Body found in search for wife of former rugby star

A body has been found in the search for Jenny Hastings, the wife of the former Scotland rugby star Scott Hastings. Jenny, 60, went missing at Wardie Bay, a wild swimming spot near Edinburgh, on Tuesday. A massive search involving police, ambulance and coastguard crews was launched in the Firth of Forth, according to The Sun. Despite their efforts, the search was stood down on Tuesday night. On Saturday afternoon, police said a woman's body was found in the Hound Point area of South Queensferry, near Edinburgh. Formal identification has yet to take place, but police said that: “The family of missing woman Jenny Hastings has been informed.” They also said "there did not appear to be any suspicious circumstances and a report will be submitted to the Procurator Fiscal". Police were treating her disappearance as a “high-risk missing persons case,” as Jenny struggles with her mental health. Her family previously issued a statement amid fears she was dead. “It appears that she wished to end her suffering in what was a regular and healing place for her," they said. “She loved the water but unfortunately her mind was not in a place of safety. “The Hastings family are absolutely heartbroken. We miss our Jenny. “She leaves a gaping hole in all our hearts and hope that she is returned to us safely so that we can celebrate her remarkable life.” Scottish Rugby also shared a statement on social media yesterday, sending their love and support to the Hastings family. “Scottish Rugby sends its love and support to Scott Hastings, Scotland cap 848, after his wife Jenny was reported missing whilst swimming earlier this week. “Our thoughts are with their children, and the wider Hastings family, at this heartbreaking time.” Jenny had been open about her struggles with mental health. In March 2017, she disappeared from the couple's Edinburgh home for 36 hours and walked to the Pentland Hills while she was suffering from depression. The couple both became ambassadors for charity Support in Mind Scotland and devoted work to helping others with their own mental health by staying active. They helped launch the 100 Streets challenge, encouraging people to get out and exercise with friends. Images: news.com.au

Caring

The best exercises to boost your brain health after 60

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a> Have you ever thought about why we have a <a href="https://theconversation.com/fr/topics/cerveau-21903">brain</a>? The obvious answer might be “to think”. But scientist Daniel Wolpert came up with a completely different explanation at the <a href="https://www.ted.com/talks/daniel_wolpert_the_real_reason_for_brains">2011 meeting of the Society for Neuroscience</a>: <blockquote> “We have a brain for one reason and one reason only: to produce adaptable and complex movements” </blockquote> <h2>Use your brain to stay efficient</h2> The brain, in other words, is the orchestra conductor which orders the body’s movements. We call the faculties that allow us to interact with our environment cognitive abilities. These include concentrating, learning, reasoning, adapting and communicating with others. Every one of them is key in enabling us to go about our routine and help us maintain a good lifestyle. So, how can we best take care of our brains so that they can stay as efficient as long as possible? Contrary to popular belief, the brain does not deteriorate continuously with age. Instead, it only sees the number of its brain cells drop and connections deteriorate <a href="https://www.bmj.com/content/344/bmj.d7622">from the age of 45 onwards</a> as part of a normal ageing process. But cerebral plasticity, although reduced, is present until the end of life. Each individual will build up a cognitive reserve throughout their lives. The more positive, rich and stimulating the lifestyle, the more powerful and effective the reserve. In other words, it’s possible to moderate the effects of age on cognition. <h2>The benefits of physical activity on cognitive capacity after 60</h2> In fact, much research shows indeed that physical activity improves cognitive capacity, even after the age of 60. From increased memory, better reactivity to greater planning skills, the <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-072720-014213">benefits are endless</a>. Despite this, few older folks engage in <a href="https://theconversation.com/fr/topics/activite-physique-adaptee-apa-146288">physical education</a> adapted to their bodies on a regular basis. Poor motivation and access to these exercises are some of the factors don’t help. With that in mind, many carers might be tempted to offer older people monotonous, routine activities because of their diminishing physical, cognitive and sensory abilities. And indeed, for a long time, the range of sports on offer and research in this field revolved around the same triptych: gentle gymnastics, walking and yoga. However, you’ll reap more benefits by <a href="https://www-sciencedirect-com.ezproxy.u-paris.fr/science/article/abs/pii/B9780444633279000175">combining different training methods</a>. <h2>Three ingredients to train the brains of senior citizens</h2> Researchers are currently attempting to crack the winning formula that would flex older people’s cognitive, as well as physical muscles. It’ll consist of three main ingredients: First ingredient: complex physical and motor stimulation of at least moderate intensity. Moderate cardio workouts not only improve cardiorespiratory health but also make the brain more <a href="https://www.nature.com/articles/22682">efficient</a>. Overall improved cardiofitness, in turn, allows the brain to receive more oxygen and even to generate <a href="https://www.pnas.org/doi/full/10.1073/pnas.1015950108">new neurons in the hippocampus</a>, where memory is lodged. It therefore makes sense for programmes designed to boost cognitive function to include cardio. But it is also <a href="https://journals.sagepub.com/doi/abs/10.1111/1467-9280.t01-1-01430">necessary to combine them with muscle-strengthening, flexibility and balance exercises to achieve greater benefits</a>. In addition, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763413001012">researchers</a> emphasise the importance of adding situations requiring complex motor skills and coordination, as these would have a significant impact on cognitive functions (e.g. memory, attention and mental flexibility), particularly in the elderly. Second ingredient: fire up those brain cells during exercises Incorporating cognitive stimulation, such as remembering information for a period of time and executing it, anticipating actions, or planning a move, is another winning strategy. When cognitive stimulation is combined with physical activity, it can produce <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">synergistic effects</a> and, as a result, be more effective on cognitive functions. _Third ingredient: group activities that lead to social interaction. _ Working out as part of a group has been shown to help us <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001756">persevere through it</a>. What this winning formula could look like in practice is still being researched. At present, there are two broad types of exercises that have caught our attention that could help older people stay sharp. <h2>Opting for cooperative and oppositional team sports</h2> Team sports offer much more than just physical exercise sessions. What’s particularly great about them is that they don’t only challenge cardiorespiratory balance, but tap into the whole body’s physical skill-set. Take basketball or handball, for example: to move around the court, dribble or score, balance, coordination and flexibility are essential. Muscular strength is also required for passing, recovering the ball and moving around. These team sports can be suitable even after the age of 60, provided they are properly supervised. From a cognitive point of view, these activities create situations that are always new, rich and stimulating. We call this double combination of stimuli <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">simultaneous training</a>. A number of researchers have highlighted the importance of this cognitive involvement in team sports and encourage their practice, particularly among the elderly. Recent studies, such as <a href="https://linkinghub.elsevier.com/retrieve/pii/S162748302100129X">the one carried out in 2022</a> by French researchers, have shown that participation in team sports improves short-term visuospatial memory (which enables people, for example, to remember the location of certain objects for a limited period of time) and planning skills in the elderly. <h2>Get your body moving with exergames</h2> Another promising avenue are exergames – video games that require players to move around to play. Named after the contraction of “exercise” and “games”, they grew popular in the 2000s thanks to Nintendo’s Wii and Switch and Microsoft’s Kinect. Exogames have been thought out to exercise different fitness skills, such as balance, endurance, strength, and coordination, while simultaneously stimulating cognitive functions. Among older people, <a href="https://psycnet.apa.org/record/2011-27707-001">several research studies</a> show that this type of training helps to improve many physical and cognitive abilities. In 2020, a new generation of exergames emerged, making use of interactive walls to create an even more immersive gaming experience, such as Neo Xperiences’ Neo-One, Sphery’s ExerCube and Lü’s Aire interactive. In these games combining real and virtual worlds, physical objects (such as balls) and digital objects coexist and interact in real time. A <a href="https://link.springer.com/article/10.1007/s11357-023-00952-w">recent study</a> compared an exergame programme assisted by an immersive wall with a walking and muscle-strengthening programme. Its results suggest that this new generation of exergames may be more effective on cognitive abilities than traditional training. Combining physical and cognitive exercises offers the best chance to keep one’s brain health while keeping fit. This is essential for an active and fulfilling life, whatever your age.<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/237162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, Doctorante en sciences du mouvement, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, Maitre de conférences HDR, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, Maître de conférences en STAPS, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a> Image credits: Shutterstock 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/the-best-exercises-to-boost-your-brain-health-after-60-237162">original article</a>. </div>

Body

I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities. Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>. But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>. <h2>Stress makes it harder to fight off viruses</h2> When the immune system starts to break down, a virus that would normally have been under control starts to flourish. Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>. In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>. These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>. One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>. <h2>Cortisol suppresses immunity</h2> “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>. When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=593&fit=crop&dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=593&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=593&fit=crop&dpr=3 2262w" alt="Human brain illustration" /><figcaption>The hypothalamus sets off an alarm system in response to a real or perceived threat. <a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></figcaption></figure> In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>. But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness. Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>. <h2>Stress causes inflammation</h2> <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>. The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>. Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>. During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>. <h2>What about chronic stress?</h2> Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>. The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins). Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>. Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>. <h2>So how can you manage your stress?</h2> We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by: 1) Getting enough sleep Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation. 2) Taking regular exercise Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>. 3) Eating a healthy diet Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>. 4) Socialising and practising meditation or mindfulness These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</a>.<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/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock 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/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>. </div>

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Do mobile phones cause brain cancer? Science makes definitive call

The question of whether mobile phones - specifically the electromagnetic radiation or radio waves emitted by these devices - cause cancer has been debated and researched for a long time, and now scientists have made a definitive call. A new comprehensive review commissioned by the World Health Organization has found that mobile phones are NOT linked to brain and head cancers. The systematic review, led by the Australian Radiation Protection and Nuclear Safety Agency (Arpansa), examined over 5,000 studies, which included 63 observational studies on humans published between 1994 and 2022 and is "the most comprehensive review to date" according to review lead author, associate prof Ken Karipidis. “We concluded the evidence does not show a link between mobile phones and brain cancer or other head and neck cancers," he said. The review, which was published on Wednesday, focused on cancers of the nervous system, salivary gland and brain tumours. They found no overall association between mobile phone use and cancer, even if people have used it for a long time (over 10 years) or spend a lot of time on their phones. “I’m quite confident with our conclusion. And what makes us quite confident is … even though mobile phone use has skyrocketed, brain tumour rates have remained stable,” Karipidis continued. Despite emitting electromagnetic radiation, also known as radio waves, the exposure is relatively low. Karipidis said people hear the word radiation and assume it is similar to nuclear radiation, “and because we use a mobile phone close to the head when we’re making calls, there is a lot of concern.” He clarified that “radiation is basically energy that travels from one point to another. There are many different types, for example, ultraviolet radiation from the sun." “We’re always exposed to low-level radio waves in the everyday environment.” While exposure from mobile phones is still low, it is much higher than exposure from any other wireless technology sources since they are used close to the head, Karipidis said. The association between mobile phones and cancers came about from early studies comparing differences between those with and without brain tumours and asking about their exposure history. According to Karipidis, who is also the vice-chair of the International Commission on Non-Ionizing Radiation Protection, the results from these kind of studies tend to be biased, as the group with the tumour tend to overreport their exposure. Based on these early studies WHO’s International Agency for Research on Cancer (IARC) designated radio-frequency fields like those from mobile phones as a possible cancer risk, but Karipidis said "this classification doesn’t mean all that much”. This is because the IARC has different classifications of cancer risk, with some substances classified as a “definite” carcinogen (such as smoking), and others as “probable” or “possible” carcinogens. Tim Driscoll, a professor at the University of Sydney and chair of the Australian Cancer Council’s occupational and environmental cancers committee, also backed the systematic review. “I think people should feel reassured by this study … but it’s worthwhile just remembering that the studies aren’t perfect, but the weight of evidence certainly is that mobile phones should be considered safe to use in terms of any concerns about increased risk of cancer,” Driscoll said. Images: Shutterstock

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Flu shots play an important role in protecting against bird flu. But not for the reason you might think

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> A current strain of highly pathogenic avian influenza, commonly known as bird flu, has become a global problem. The virus has affected <a href="https://www.cdc.gov/bird-flu/situation-summary/data-map-commercial.html">many millions</a> of birds, some other <a href="https://www.cdc.gov/bird-flu/situation-summary/mammals.html">animal species</a>, and a <a href="https://cdn.who.int/media/docs/default-source/influenza/avian-and-other-zoonotic-influenza/joint-fao-oie-who-preliminary-risk-assessment-associated-with-avian-influenza-a(h5n1)-virus.pdf?sfvrsn=faa6e47e_28&download=true">small number of people</a>. Last week, the Australian government <a href="https://www.sbs.com.au/news/article/australians-issued-new-health-risks-travel-warning-for-europe-asia-and-the-americas/gmh1hk9py">issued a warning</a> to residents travelling to Europe, North America, South America and Asia about the risk of bird flu. The alert, published on the <a href="https://www.smartraveller.gov.au/news-and-updates/highly-pathogenic-avian-influenza-outbreak">Smartraveller website</a>, included advice to ensure your flu vaccine is up to date. If you are about to go travelling, this generally means if you’ve had a flu jab this year, although if it has been 3–6 months since your vaccine you should discuss this with your doctor. But the seasonal flu vaccine we get each year doesn’t actually prevent bird flu in humans. So why is it being recommended in this context? <h2>Some bird flu background</h2> Smartraveller notes <a href="https://www.smartraveller.gov.au/news-and-updates/highly-pathogenic-avian-influenza-outbreak">several strains</a> of bird flu are currently circulating. The most concerning strain, called the <a href="https://www.nature.com/articles/s41467-023-38415-7">2.3.4.4b clade</a>, emerged a few years ago from a type of influenza A (H5, or A/H5) that has been circulating for several decades. Clade 2.3.4.4b primarily affects birds, including wild birds and poultry. It has had <a href="https://theconversation.com/uk-poultry-can-roam-free-outside-again-but-bird-flu-risk-hasnt-gone-away-203361">devastating effects</a> on bird populations, as well as farmers and others involved in the poultry industry. In recent years, clade 2.3.4.4b has adapted to <a href="https://www.nature.com/articles/s44298-024-00039-z">infect some mammals</a>. Unfortunately it seems to cause severe disease in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11083745/">certain animals</a>. Some marine mammals have been hit particularly hard, with mass mortality events <a href="https://www.theguardian.com/environment/2023/dec/08/mass-deaths-elephant-seals-penguins-bird-flu-antarctic-ecological-disaster-aoe">reported</a> in elephant seals and sea lions. In the United States, bird flu has also spread <a href="https://www.cdc.gov/bird-flu/situation-summary/mammals.html">among dairy cows</a>. Compared to the huge number of animal cases, there have been a relatively small number of <a href="https://www.who.int/publications/m/item/joint-fao-who-woah-preliminary-assessment-of-recent-influenza-a(h5n1)-viruses">humans infected with bird flu</a>. Since 2003, <a href="https://www.who.int/publications/m/item/cumulative-number-of-confirmed-human-cases-for-avian-influenza-a(h5n1)-reported-to-who--2003-2023--3-october-2023">878 cases</a> of A/H5N1 influenza have been reported in humans, with a small proportion of these reported since 2020 when <a href="https://www.outbreak.gov.au/emerging-risks/high-pathogenicity-avian-influenza">clade 2.3.4.4b first emerged</a>. The reported cases have been people who have had close contact with infected animals. It does not appear to spread from person to person. As such, the <a href="https://www.ecdc.europa.eu/en/infectious-disease-topics/z-disease-list/avian-influenza/threats-and-outbreaks/risk-assessment-h5">risk to travellers is low</a>. There are some situations where the risk may be greater, such as for people visiting live markets, or those who are travelling specifically to work with wildlife or animals in food production. <a href="https://www.who.int/publications/m/item/joint-fao-who-woah-preliminary-assessment-of-recent-influenza-a(h5n1)-viruses">Infections in humans</a> with H5 influenza can vary significantly in severity, from mild conjunctivitis up to fatal pneumonia. H5 influenza strains appear to be <a href="https://asm.org/articles/2024/june/what-you-should-know-about-avian-influenza-a-h5n1">sensitive to antivirals</a> (oseltamivir, also known as Tamiflu) and they are generally <a href="https://www.cdc.gov/bird-flu/hcp/novel-av-treatment-guidance/">recommended</a> as treatment for human infection, but it’s <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01307-2/fulltext">not clear</a> whether they reduce the risk of death in those with severe disease. To date, one case of A/H5 influenza (not 2.3.4.4b) has been <a href="https://www.abc.net.au/news/2024-05-22/bird-flu-avian-influenza-human-detection/103879886">reported in Australia</a>, in a child who had recently returned from overseas. While <a href="https://www.fao.org/animal-health/situation-updates/global-aiv-with-zoonotic-potential/en">clade 2.3.4.4b has been detected</a> in all continents <a href="https://www.outbreak.gov.au/emerging-risks/high-pathogenicity-avian-influenza">except Australia</a>, other avian influenza strains (A/H7) <a href="https://www.outbreak.gov.au/current-outbreaks/avian-influenza">have been reported here</a> earlier this year. <h2>Seasonal flu vaccines are not effective against bird flu</h2> Seasonal influenza refers to the flu strains that circulate each year. Since the COVID pandemic, three different strains have circulated in various proportions – influenza A H1N1 (descended from the <a href="https://www.nature.com/articles/nature08182">2009 swine flu strain</a>), influenza A H3N2 (which has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149781/">circulated since 1968</a>) and an influenza B strain. Interestingly, a second influenza B strain (the Yamagata lineage) <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">appears to have vanished</a> during the COVID pandemic. Seasonal influenza vaccines contain up-to-date variants of these types (A/H1N1, A/H3N2 and B) that are recommended by the World Health Organization each year. They are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912669/">moderately effective</a>, reducing the risk of hospitalisation by about 40–60%. Influenza vaccines are quite specific in the protection that they provide. For seasonal vaccines, even the very small changes that occur in the virus from year to year are enough to allow them to “escape” vaccine-induced immunity. Therefore seasonal flu vaccines <a href="https://www.cdc.gov.au/topics/avian-influenza-bird-flu">do not provide any protection</a> against A/H5 influenza. <h2>Preventing a hybrid bird-human strain</h2> The rationale for recommending travellers have a flu shot in the context of the current bird flu outbreak is that seasonal flu vaccines may help reduce the risk of simultaneous infection with both A/H5 and a seasonal influenza strain. When this occurs, there is potential for a “recombination” of the genetic code from both viral strains. This could have the transmissibility of a seasonal human virus with the severity of an avian influenza virus. The 2009 swine flu strain <a href="https://www.nejm.org/doi/full/10.1056/NEJMra0904322">arose from the recombination</a> of several strains over years to become more transmissible in humans. Obviously a more effective vaccine would include a H5 strain, to generate immune responses specific to the H5 flu strain. Vaccine manufacturers have <a href="https://www.ema.europa.eu/en/medicines/human/EPAR/celldemic">developed H5 vaccines</a> over the years, but to date <a href="https://thl.fi/en/-/avian-influenza-vaccinations-begin-vaccine-to-be-offered-to-persons-at-increased-risk-of-infection">only Finland</a> has deployed a H5 vaccine in a small group of people who work closely with potentially infected animals. Currently the <a href="https://www.ecdc.europa.eu/en/infectious-disease-topics/z-disease-list/avian-influenza/threats-and-outbreaks/risk-assessment-h5">level of risk</a> posed by H5 to humans is not thought to be sufficient to require a specific vaccine program, as the potential benefits are small compared to the costs and the potential risks associated with any new vaccine program. <h2>The value of a flu shot for travellers</h2> Seasonal flu vaccines protect against influenza infection, and may also reduce the risk of simultaneous infection with human and bird flu strains. Bird flu aside, for most travellers who haven’t received a flu shot this year, reducing the risk of illness disrupting travel plans should be enough of a reason to get one. For those who have already received a flu shot this season, similar to COVID jabs, protection after vaccination appears to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499703/">wane over time</a>. So if you’re travelling to the northern hemisphere during the winter months, and it’s been more than 3–6 months since you received a flu vaccine, your doctor may recommend you have another. Bird flu is only a small risk to most travellers, but people may want to take sensible precautions, such as avoiding close contact with birds at markets.<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/237859/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock 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/flu-shots-play-an-important-role-in-protecting-against-bird-flu-but-not-for-the-reason-you-might-think-237859">original article</a>. </div>

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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes. Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">both type 1 and type 2 diabetes</a>. More people became aware of this condition after <a href="https://www.imdb.com/name/nm0004726/">Lance Bass</a>, best known for his role in the iconic American pop band NSYNC, <a href="https://www.foxnews.com/health/pop-singer-lance-bass-type-1-5-diabetes-know-disease">recently revealed</a> he has it. So, what is type 1.5 diabetes? And how is it diagnosed and treated? <h2>There are several types of diabetes</h2> Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually <a href="https://diabetesjournals.org/care/article/37/Supplement_1/S81/37753/Diagnosis-and-Classification-of-Diabetes-Mellitus">more than ten types</a> of diabetes, but the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext">most common</a> are type 1 and type 2. Type 1 diabetes is an <a href="https://diabetesjournals.org/care/article/44/11/2589/138492/The-Management-of-Type-1-Diabetes-in-Adults-A">autoimmune condition</a> where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production. Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995794/">insulin medication daily</a>. Type 1 diabetes usually <a href="https://www.nature.com/articles/s41390-024-03107-5">appears</a> in children or young adults. Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to <a href="https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954/2-Diagnosis-and-Classification-of-Diabetes">overcome this resistance</a>. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin. Type 2 is more common in adults but is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1871402121002733">increasingly</a> seen in children and young people. Management <a href="https://www.racgp.org.au/getattachment/41fee8dc-7f97-4f87-9d90-b7af337af778/Management-of-type-2-diabetes-A-handbook-for-general-practice.aspx">can include</a> behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy. <h2>How does type 1.5 diabetes differ from types 1 and 2?</h2> Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">immediately</a> because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/">five years</a> of diagnosis, while those with type 1 typically require it from diagnosis. Type 1.5 diabetes is usually diagnosed in people <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">over 30</a>, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2. Type 1.5 diabetes shares <a href="https://www.nature.com/articles/nrendo.2017.99">genetic and autoimmune risk factors</a> with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as <a href="https://pubmed.ncbi.nlm.nih.gov/29589073/">obesity</a> and <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00320/full">physical inactivity</a> which are more commonly associated with type 2 diabetes. <h2>What are the symptoms, and how is it treated?</h2> The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a>: <ul> <li>increased thirst</li> <li>frequent urination</li> <li>fatigue</li> <li>blurred vision</li> <li>unintentional weight loss.</li> </ul> Typically, type 1.5 diabetes is <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">initially treated</a> with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day. When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.959011/full">no universally accepted</a> management or treatment strategies for type 1.5 diabetes. <h2>Type 1.5 diabetes is often misdiagnosed</h2> Lance Bass said he was initially diagnosed with <a href="https://www.healthline.com/health-news/lance-bass-misdiagnosed-diabetes">type 2 diabetes</a>, but later learned he actually has type 1.5 diabetes. This is <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">not entirely uncommon</a>. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">5–10% of the time</a>. There are a few possible reasons for this. First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">antibody tests</a> (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them. Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults). Third, people with <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">type 1.5 diabetes</a> often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin. Finally, because type 1.5 diabetes has <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a> that are similar to type 2 diabetes, it may initially be treated as type 2. <h2>We’re still learning about type 1.5</h2> Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">non-European populations</a>. In 2023, it was estimated type 1.5 diabetes represented <a href="https://pubmed.ncbi.nlm.nih.gov/37428296/">8.9%</a> of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers. Overall, there has been a limited awareness of type 1.5 diabetes and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/">unclear diagnostic criteria</a> which have slowed down our understanding of this condition. A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road. Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce <a href="https://diabetesjournals.org/diabetes/article/73/Supplement_1/55-OR/155112/55-OR-Diabetes-Distress-among-Persons-Living-with">diabetes distress</a>. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.<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/237041/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock 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/what-is-type-1-5-diabetes-its-a-bit-like-type-1-and-a-bit-like-type-2-but-its-often-misdiagnosed-237041">original article</a>. </div>

Body

I’m iron deficient. Which supplements will work best for me and how should I take them?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women <a href="https://static1.squarespace.com/static/57bfc0498419c24a01318ae2/t/607fc2e06ace2f22d5ca9a43/1618985699483/20210421+-+IDC+-+economic+impact+of+iron+deficiency+-+FINAL.pdf">are low in iron</a> compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant. The <a href="https://pubmed.ncbi.nlm.nih.gov/11160590/">body needs iron</a> to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration. If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day? Here are some tips to help you work out how, when and what iron supplement to take. <h2>How do I pick the right iron supplement?</h2> The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need. The sweet spot is between <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364?via%3Dihub">60-120 mg of elemental iron</a>. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain. In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). <a href="https://www.ncbi.nlm.nih.gov/books/NBK557376/">The iron salts</a> you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%). These formulations <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">all work similarly</a>, so your choice should come down to dose and cost. Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency. <h2>Should I take tablets or liquid formulas?</h2> Iron contained within a tablet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">just as well absorbed</a> as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference. The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term. <h2>What should I eat with my iron supplement?</h2> Research <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">has shown</a> you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone. If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it. Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other <a href="https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/">vitamin C-rich foods</a>. On the other hand, tea, coffee and calcium all <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">decrease the body’s ability to absorb iron</a>. So you should try to limit these close to the time you take your supplement. <h2>Should I take my supplement in the morning or evening?</h2> The best time of day to take your supplement is in the morning. The body can <a href="https://journals.lww.com/acsm-msse/fulltext/2019/10000/the_impact_of_morning_versus_afternoon_exercise_on.20.aspx">absorb significantly more</a> iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest. Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can <a href="https://journals.humankinetics.com/view/journals/ijsnem/32/5/article-p359.xml">limit your ability to absorb it</a>. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop. <a href="https://journals.lww.com/acsm-msse/fulltext/2024/01000/iron_absorption_in_highly_trained_male_runners_.14.aspx">Our research</a> has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes). <h2>My supplements are upsetting my stomach. What should I do?</h2> If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily. Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltext#%20">has shown</a> taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects. Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success. It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430862/">iron can be toxic</a>, so you don’t want to be consuming additional iron if your body doesn’t need it. If you think you may be low on iron, talk to your GP to find out your best options.<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/235315/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, Postdoctoral Research Fellow, Sports Nutrition, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Image credits: Shutterstock 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/im-iron-deficient-which-supplements-will-work-best-for-me-and-how-should-i-take-them-235315">original article</a>. </div>

Body

Constipation increases your risk of a heart attack, new study finds – and not just on the toilet

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and <a href="https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death">it’s believed</a> he was straining very hard to poo, which then led to a fatal heart attack. We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many. But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack. This includes a recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">study</a> led by Australian researchers involving data from thousands of people. <h2>Are constipation and heart attacks linked?</h2> Large <a href="https://www.nature.com/articles/s41598-023-38068-y">population</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">studies</a> show constipation is linked to an increased risk of heart attacks. For example, an <a href="https://www.nature.com/articles/s41598-023-38068-y">Australian study</a> involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age. A <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">Danish study</a> of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes. It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital. These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated. <h2>How about this new study?</h2> The recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">international study</a> led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population. The researchers analysed data from the <a href="https://www.ukbiobank.ac.uk">UK Biobank</a>, a database of health-related information from about half a million people in the United Kingdom. The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation. People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation. The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension. The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations. A <a href="https://pubmed.ncbi.nlm.nih.gov/26812003/">Japanese study</a> looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day. <h2>How might constipation cause a heart attack?</h2> Chronic constipation can lead to straining when passing a stool. This can result in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">laboured breathing</a> and can lead to a rise in blood pressure. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">one Japanese study</a> including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">One theory</a> is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels. As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">doubles</a> when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure). The systolic blood pressure rise with straining in passing a stool has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">reported to be</a> as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks. <a href="https://pubmed.ncbi.nlm.nih.gov/22256893/">Some people</a> with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing. This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure. Another intriguing avenue of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399019/">research</a> examines the imbalance in gut bacteria in people with <a href="https://pubmed.ncbi.nlm.nih.gov/3596341/">constipation</a>. This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack. This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease. <h2>What can we do about this?</h2> Constipation affects around <a href="https://pubmed.ncbi.nlm.nih.gov/36826591/">19% of the global population</a> aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health. Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.<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/237209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock 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/constipation-increases-your-risk-of-a-heart-attack-new-study-finds-and-not-just-on-the-toilet-237209">original article</a>. </div>

Body

Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<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/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock 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/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>. </div>

Body

Does eating ham, bacon and beef really increase your risk of developing type 2 diabetes?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a> That lunchtime staple, the humble ham sandwich, has come in for a bashing in the press recently. According to <a href="https://www.theguardian.com/society/article/2024/aug/20/two-slices-of-ham-a-day-can-raise-type-2-diabetes-risk-by-15-research-suggests">many</a> <a href="https://www.dailymail.co.uk/health/article-13761253/Eating-ham-daily-linked-increase-risk-diabetes.html">reports</a>, eating two slices of ham a day can increase your risk of developing type 2 diabetes. But what’s the science behind these headlines? The research offers a more complex picture. <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00179-7/fulltext">A new study</a> from the University of Cambridge highlighted an association between developing type 2 diabetes and eating processed meat like ham and bacon, and red meat such as beef and lamb. This led to headlines suggesting the risk was mainly linked to <a href="https://www.telegraph.co.uk/news/2024/08/21/ham-sandwich-processed-meat-fresh-risk-link-type-2-diabetes/">ham sandwiches</a>. This seems to have come from the <a href="https://www.cam.ac.uk/research/news/red-and-processed-meat-consumption-associated-with-higher-type-2-diabetes-risk">press release</a>, which used ham as the example to quantify the amount of processed meat associated with a 15% increased risk of developing type 2 diabetes over ten years. The research found that this risk was linked to eating an extra 50g of processed meat every day, which happens to equate to two slices of ham. A useful example thus appears to have been taken up by the media as the main cause, perhaps ignoring some of the key messages coming from the study. So, can processed and red meat really increase your risk of developing type 2 diabetes? The <a href="https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/diabetes-risk-factors">biggest risk factors</a> linked to developing type 2 diabetes are being over 40, having family members with type 2 diabetes, being of South Asian or African descent, or having a higher body weight – and especially a larger waist. <figure><iframe src="https://www.youtube.com/embed/EsOBcx2bJqU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The Cambridge study used data from nearly 2 million people from 31 studies. Participants were followed for an average of ten years. During this time, around one in 20 people developed type 2 diabetes. The research suggested that a 10% increase in the probability of developing type 2 diabetes was associated with every 100g of additional red meat eaten daily. Eating half as much extra processed meat every day was linked to an even greater increased risk of developing the disease. This is not the <a href="https://ajcn.nutrition.org/article/S0002-9165(23)66119-2/abstract">first time</a> that both processed and red meats have been linked with an increased risk of developing type 2 diabetes. However, the key strength of the Cambridge study was that it tried to control for many of the other factors linked to the disease, including smoking, having a higher body weight, dietary intake and exercise. However, the size of the increased risk is modest, considering few people included in the study ate 50g or more processed meat per day – meaning moderate ham consumption is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908545/">no meaningful effect</a> on your risk. <h2>What’s the link?</h2> Processed meat has been linked to increased risk of type 2 diabetes because of its nitrate and salt content – additives that are used to cure many processed meats. Nitrates and salt in processed meats have also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893523/">been linked to</a> an increased risk of developing colon cancer. In fact, the World Health Organization classifies the additives as <a href="https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat">group 1 carcinogens</a>, which means they can cause a range of cancers. The mechanism linking processed meat to cancer seems to be similar to how it might be linked to type 2 diabetes. During digestion, processed meat produces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294997/">N-nitroso chemicals</a>, which can damage cells. This can lead to inflammation and affects how insulin, the hormone that controls blood glucose (sugar), works. This in turn can lead to <a href="https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance">insulin resistance</a>, when cells in your muscles, fat and liver don’t respond well to insulin and can’t easily take up glucose from your blood. Red meat, meanwhile, is <a href="https://www.healthline.com/nutrition/healthy-iron-rich-foods">rich in iron</a>. Research suggests that people with <a href="https://www.diabetes.org.uk/diabetes-the-basics/related-conditions/haemochromatosis-diabetes#:%7E:text=So%20a%20rise%20of%20iron,GP%20as%20soon%20as%20possible.">high levels of iron</a> are more likely to develop type 2 diabetes. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744124/#:%7E:text=The%20WHO%20has%20recognised%20iron,being%20affected%20with%20this%20condition.">low levels of iron</a> are more of a health concern for the general population. Another potential link regarding red meat could be the way it is cooked. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521980/">Previous studies</a> have suggested that charred meat, cooked over an open flame or at high temperature, is also linked to an increased risk of developing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911789/">type 2 diabetes</a>. Charring meat leads to formation of toxic chemicals such as <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/heterocyclic-amine#:%7E:text=Heterocyclic%20amines%20are%20aromatic%20compounds,of%20reactions%20called%20Maillard%20reactions.">heterocyclic aromatic amines</a> and harmful compounds like <a href="https://www.healthline.com/nutrition/advanced-glycation-end-products">advanced glycation end products</a>, both of which have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/21709297/">insulin resistance and type 2 diabetes</a>. <h2>Bye-bye barbecues and bacon butties?</h2> The key message is reduction, rather than avoidance. The UK government nutritional recommendations offer sound advice: limit your combined intake of red and processed meat to no more than <a href="https://www.nhs.uk/live-well/eat-well/food-types/meat-nutrition/#:%7E:text=Red%20meat%20and%20processed%20meat&text=If%20you%20currently%20eat%20more,%2C%20veal%2C%20venison%20and%20goat.">an average of 70g per day</a>. But these guidelines also suggest that red meat can be a valuable source of iron. So, if you decide to stop eating red meat, you should eat alternative sources of iron such as beans, lentils, dark green vegetables and fortified cereals. This needs to be done as part of a carefully planned diet. Non-meat sources of iron are more difficult for our bodies to absorb so should be eaten with a source of vitamin C, found in green vegetables and citrus fruit. The best advice to reduce your risk of developing type 2 diabetes is to maintain a healthy weight – consider losing weight if you have a higher body weight – and be as physically active as possible. A healthy diet should be based on plenty of vegetables, fruit, beans, peas, lentils, nuts and seeds, along with some wholegrain foods, some dairy products, fish and white meat (or vegetarian alternatives) – plus moderate amounts of red meat and minimal processed meat. This will help reduce your risk of type 2 diabetes, <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating">heart disease</a>, and <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/does-having-a-healthy-diet-reduce-my-risk-of-cancer">many cancers</a> – as well being more <a href="https://www.bda.uk.com/static/539e2268-7991-4d24-b9ee867c1b2808fc/a1283104-a0dd-476b-bda723452ae93870/one%20blue%20dot%20reference%20guide.pdf">environmentally sustainable</a>. But if you have a penchant for ham sandwiches, rest assured you can continue to indulge as an occasional treat. It’s your overall lifestyle and diet that really matter for your health and risk of developing type 2 diabetes.<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/237346/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Visiting Academic, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a> 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-eating-ham-bacon-and-beef-really-increase-your-risk-of-developing-type-2-diabetes-237346">original article</a>. </div>

Body

I’m due for a cervical cancer screening. What can I expect? Can I do it myself? And what happened to Pap smears?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/karen-canfell-22668">Karen Canfell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/deborah-bateson-16105">Deborah Bateson</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/megan-smith-131901">Megan Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Cervical screening in Australia has <a href="https://pubmed.ncbi.nlm.nih.gov/34499374/">changed</a> over the past seven years. The test has changed, and women (and people with a cervix) now have much more choice and control. Here’s why – and what you can expect if you’re aged 25 to 74 and are <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">due for a test</a>. <h2>When and why did the test change?</h2> In 2017, Australia became one of the first two countries to transition from Pap smears to tests for the presence of the human papillomavirus (HPV). HPV causes virtually all cervical cancers, so testing for the presence of this virus is a very good indicator of a person’s current and future risk of the disease. This contrasts with the older Pap smear technology, which involved inspection of cells every two years for the changes resulting from HPV infection. The change to screening was supported by a very large body of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62218-7/abstract">international</a> and <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002388">Australian</a> data showing primary testing for HPV is more accurate than Pap smears. Women and people with a cervix who do not have HPV detected on their test are at a very low risk of developing cervical cancer over the next five years, or even longer. This was the basis for lengthening the screening interval when HPV screening was introduced. Australia now <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">recommends</a> five-yearly HPV screening, starting at age 25 up to the age of 74 for eligible people, whether or not they have been vaccinated against HPV. Many other countries are following suit to transition to HPV screening. All established screening tests – which are conducted in people without any symptoms – are associated with health benefits but also with some harms. These can include the psychological and clinical consequences of receiving a “positive” screening result, which needs to be investigated further. However, recent World Health Organization (WHO) <a href="https://www.nejm.org/doi/full/10.1056/NEJMsr2030640">reviews of the evidence</a> have found: <ul> <li>HPV is a more effective screening test than Pap smears or any other method</li> <li>it substantially reduces incidence and death rates from cervical cancer</li> <li>it is the method of cervical screening that has the <a href="https://www.nature.com/articles/s41591-023-02600-4">best balance</a> of benefits to harms.</li> </ul> As a consequence, the WHO now unequivocally <a href="https://www.who.int/publications/i/item/9789240030824">recommends</a> HPV screening as the best-practice method. <h2>Now you can collect your own sample</h2> One of the major benefits of switching to HPV screening is it opened the door for a person being able to <a href="https://www.health.gov.au/self-collection-for-the-cervical-screening-test">collect their own sample</a> (which was impossible with the Pap smear). If HPV is present, it can be detected in the vagina rather than having to directly sample the cervix. In 2022, Australia became one of the <a href="https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/landmark-changes-improving-access-to-life-saving-cervical-screenings">first countries</a> in the world to introduce a universal option to choose self-collection within a major national-level screening program. This means people eligible for screening, under the guidance of a primary care practitioner, can now choose to collect their own vaginal sample, in privacy, using a simple swab. By the end of 2023, <a href="https://www.ncsr.gov.au/about-us/news-and-media/self-collection-for-cervical-screening--at-an-all-time-high.html">27% of people</a> were choosing to take the test this way, but this is on an upward trajectory and is likely to increase further, with an <a href="https://acpcc.org.au/self-collection-campaign/">awareness campaign</a> due to start next month. <h2>So what happens when I have a test?</h2> You’ll receive an invitation from the <a href="https://www.ncsr.gov.au/information-for-participants/participant-forms-and-guides.html#cervical-forms">National Cancer Screening Register</a> to attend your first screen when you turn 25. If you’re older, you’ll receive reminders when you are due for your next test. You will be invited to visit your GP or community health service for the test. You should be asked whether you would prefer to have a clinician collect the test or whether you would prefer to take the sample yourself. There’s no right or wrong way. The accuracy of testing has been <a href="https://www.bmj.com/content/363/bmj.k4823">shown</a> to be equivalent for clinician or self-collected sampling. This is a matter of choice. If the clinician does the test, they will undertake a pelvic examination with a speculum inserted into the vagina. This enables the doctor or nurse to view the cervix and take a sample. If you are interested in the self-collection option, check whether the practice is offering it when making an appointment. If you opt for self-collection, you’ll be able to do so in private. You’ll be given a swab (which looks like a COVID test swab with a longer stem), and you’ll be given instructions about how to insert and rotate the swab in the vagina to take the sample. It takes only a few minutes. <h2>What does it mean if my test detects HPV?</h2> If your test detects HPV, this means you have an HPV infection. These are very common and by itself doesn’t mean you have cancer, or even pre-cancer (which involves changes to cervical cells that make them more likely to develop into cancer over time). It does mean, however, that you are at higher risk of having a pre-cancer, or developing one in future, and that you will benefit from further follow-up or diagnostic testing. Your doctor or nurse will <a href="https://www.cancer.org.au/clinical-guidelines/cervical-cancer/cervical-cancer-screening">guide you</a> on the next steps in line with national guidelines. If you require a diagnostic examination, this will involve a procedure called colposcopy, where the cervix is closely examined by a gynaecologist or other specially trained healthcare practitioner, and a small sample may be taken for detailed examination of the cells. If you have a pre-cancer, you can be treated simply and quickly, usually without needing to be admitted to hospital. Treatment involves ablating or removing a small area of the cervix. This treatment will drastically reduce your risk of ever developing cervical cancer. <h2>What does this mean for cervical cancer rates?</h2> Cervical screening for HPV is a very effective method of preventing cervical cancer. Because of Australia’s HPV screening, combined with HPV vaccination in younger people, Australia is <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30183-X/fulltext">expected</a> to achieve such low rates of cervical cancer by 2035 that it will be considered eliminated. Last year, the government launched a <a href="https://www.health.gov.au/sites/default/files/2023-11/national-strategy-for-the-elimination-of-cervical-cancer-in-australia.pdf">national strategy for cervical cancer elimination</a> which provides key recommendations for eliminating cervical cancer, and for doing so equitably in all groups of women and people with a cervix. One of the best things you can do to protect yourself is to have your cervical screening test when you become eligible, whether or not you have been vaccinated against HPV. Marion Saville, a pathologist and Executive Director at the Australian Centre for the Prevention of Cervical Cancer, co-authored this article.<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/229495/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/karen-canfell-22668">Karen Canfell</a>, Professor & Director, Daffodil Centre, A Joint Venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/deborah-bateson-16105">Deborah Bateson</a>, Professor of Practice, The Daffodil Centre, a joint venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/megan-smith-131901">Megan Smith</a>, Principal Research Fellow, The Daffodil Centre, a joint venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock 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/im-due-for-a-cervical-cancer-screening-what-can-i-expect-can-i-do-it-myself-and-what-happened-to-pap-smears-229495">original article</a>. </div>

Body

Grandmother's body found 800km from home

Police have revealed the body of a Queensland grandmother has been found 800km from home in bushland near a main tourist area. Wendy Hansen, 63, was last seen at an ATM in her hometown Monto - about 170km west of Bundaberg, Queensland - on February 29 this year. She was reported missing when she didn't return home, with police finding CCTV footage of her driving 400km south on Queensland's main highway on February 29. Queensland Police continued their public push for information in the months that followed, but on Thursday, NSW police revealed that they found her body half buried in bushland near Jordan Esplanade in Coffs Harbour on June 18. NSW homicide detectives are now looking for her vehicle, a silver 2007 two-door Mitsubishi Pajero with Queensland registration plates 645TCZ. In a statement on Thursday, NSW detectives appealed to the public for help with finding her car. "As investigations continue detectives are appealing to the public for any information, CCTV or dashcam footage that may assist the investigation to contact NSW Police or Crime Stoppers on 1800 333 000," they said. "Detectives are specifically interested in the location of Wendy’s car which has not yet been located and are urging anyone with dashcam vision of the car to contact police immediately." Images: NSW Police

Caring

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

<div class="theconversation-article-body"> <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> 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>. 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>. 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: <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> 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. 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. <h2>More pain doesn’t mean a more serious injury</h2> 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. 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. 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. 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. 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. <h2>Reduce your chance of lasting pain</h2> 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: <ul> <li> 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 </li> <li> reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal. </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> 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. 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. 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. 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>. 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. 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.<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" /> <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> Image credits: Shutterstock 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>. </div>

Body

What your nose can tell you about your health

<div class="theconversation-article-body"><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> Thanks to a quirk known as <a href="https://www.psychologytoday.com/us/blog/brain-babble/201502/is-how-the-brain-filters-out-unimportant-details">unconscious selective attention</a>, your brain has learned to ignore your nose. A prominent feature that’s positioned closely to the eyes, the schnoz could get in the way of our vision – but the nervous system cleverly filters it out. You can choose to look for your nose though. Either close one eye or look left, right or downwards and it’ll pop into view. But, although your brain works hard to stop your nose from interfering with your line of vision, your snout is not something to ignore. Like <a href="https://theconversation.com/navel-gazing-checking-your-belly-button-can-tell-you-a-lot-about-your-health-228759">many other</a> parts of your body, examining the nose can help diagnose external skin conditions – and internal diseases. <h2>Acne</h2> While there are a <a href="https://www.nhs.uk/conditions/acne/">number of forms</a> of <a href="https://patient.info/skin-conditions/acne-leaflet">acne</a>, <a href="https://dermnetnz.org/topics/acne-vulgaris">acne vulgaris</a> is the most common – and it often affects the nose. This skin condition develops from the clogging of tiny glands in the skin that secrete protective oils, which leads to <a href="https://www.medicalnewstoday.com/articles/comedonal-acne#outlook">open and closed comedones</a>. Open comedones – better known as blackheads – develop a dark coloured plug, whereas closed comedones are whiteheads that form when the pore is blocked completely. Clogged pores can also develop into larger lumps and bumps which can become infected, inflamed and and pus-filled and can even scar the skin. <a href="https://dermnetnz.org/topics/rosacea">Acne rosacea</a> has a different appearance. It is an inflammatory skin condition that causes erythema – or reddening of the skin – most often across the nose and cheeks. Rosacea <a href="https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/rosacea/#:%7E:text=Although%20rosacea%20can't%20be,you%20can%20stop%20treatment%20temporarily.">is currently incurable</a> but it can be managed, often with long-term treatment. Patients with rosacea may often develop a rash papules and pustules that resembles acne – and also have visible blood vessels that appear as thin red or purplish lines across the nose and cheeks. In some cases, rosacea can cause the skin of the nose to grow and thicken. This condition is referred to as <a href="https://patient.info/doctor/rosacea-and-rhinophyma">rhinophyma</a>, and, like other visible skin conditions, can result in profound changes to appearance and seriously affect self-esteem in sufferers. <figure><iframe src="https://www.youtube.com/embed/cO9pa0aGBTY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Both acne vulgaris and rosacea have been connected with <a href="https://pubmed.ncbi.nlm.nih.gov/32238884/">various risk factors</a> and health conditions, though some links are stronger than others. In the case of rosacea, the list includes <a href="https://pubmed.ncbi.nlm.nih.gov/32621366/">high blood pressure and cholesterol</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29107339/">diabetes and rheumatoid arthritis</a>. <h2>Wolf’s nose</h2> <a href="https://www.sarcoidosisuk.org/information-hub/what-is-sarcoidosis/">Sarcoidosis</a>, is an inflammatory disease that can affect any of the body’s tissues – though mainly the lungs and lymph nodes. The condition can generate patches of bluish or purplish rashes, particularly on the body’s extremities where the skin is typically cooler. This includes the ears, the fingers and toes, and of course, the nose. When sarcoidosis affects the nose, it’s known as <a href="https://dermnetnz.org/topics/lupus-pernio">lupus pernio</a>, although the name is a misnomer because this condition is not the same as the <a href="https://lupusuk.org.uk/the-symptoms/">autoimmune disease known as lupus</a>. Regular lupus is a completely different condition where the body attacks its own tissues. It takes its name from the Latin word for “wolf” and the name dates back to <a href="https://pubmed.ncbi.nlm.nih.gov/32380218/">medieval times</a> when the associated skin rash was said to resemble the bite of a wolf. When lupus, rather than sarcoidosis, affects the skin it generates a <a href="https://www.medicalnewstoday.com/articles/321594">butterfly rash</a> – or <a href="https://www.ncbi.nlm.nih.gov/books/NBK555981/">malar rash</a>, which fans across the cheeks and nasal bridge. This rash can look very similar to rosacea. In fact, lupus is known as <a href="https://www.nature.com/articles/nm1103-1337a">“the great imitator”</a> because it shares similar symptoms to many different diseases. <h2>Trigeminal trophic syndrome</h2> <a href="https://dermnetnz.org/topics/trigeminal-trophic-syndrome">Trigeminal trophic syndrome</a> is a rare condition triggered by damage to the <a href="https://teachmeanatomy.info/head/cranial-nerves/trigeminal-nerve/">trigeminal nerve</a>, which controls chewing but also gives sensation to the face. When the smaller nerve branches supplying the area of skin around the nostrils are damaged, sensation is affected. The patient notices either the skin becoming desensitised, or numb – or that it prickles, like pins and needles, creating an urge to pick or scratch. Repeated damage to the skin can <a href="https://rarediseases.org/rare-diseases/trigeminal-trophic-syndrome/">cause ulcers</a> to develop around the nostrils. This condition differs from <a href="https://theconversation.com/skin-picking-is-often-trivialised-as-a-bad-habit-but-dermatillomania-can-be-dangerous-224659">skin picking disorder</a> – or dermatillomania – when a psychological compulsion drives the desire to pick at the skin. So, close one eye every now and then in order to admire your hooter, or, even better have a good look at it in the mirror. It deserves more recognition than the blind spot your brain allows.<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/228760/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <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> Image credits: Shutterstock 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/what-your-nose-can-tell-you-about-your-health-228760">original article</a>. </div>

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Why do I need to take some medicines with food?

What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring

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

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