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Balance declines with age, but exercise can help stave off some of the risk of falling

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a></em></p> <p>My wife and I were in the grocery store recently when we noticed an older woman reaching above her head for some produce. As she stretched out her hand, she lost her balance and began falling forward. Fortunately, she leaned into her grocery cart, which prevented her from falling to the ground.</p> <p>Each year, about <a href="https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm">1 in every 4 older adults experience a fall</a>. In fact, falls are the leading cause of injuries in adults ages 65 and older. Falls are the <a href="https://doi.org/10.1007/bf00298717">most common cause of hip fractures</a> and <a href="https://doi.org/10.1111/j.1553-2712.2000.tb00515.x">traumatic brain injuries</a>.</p> <p>Injuries like those are also <a href="https://doi.org/10.1056/NEJM199710303371806">risk factors for placement in a nursing home</a>, where the fall risk is <a href="https://doi.org/10.7326/0003-4819-121-6-199409150-00009">nearly three times higher than for people living in the community</a>.</p> <p>A number of physical changes with aging often go unseen preceding falls, including muscle weakness, decreased balance and changes in vision.</p> <p>I am a <a href="https://facultyprofiles.tufts.edu/evan-papa">physical therapist</a> and <a href="https://scholar.google.com/citations?user=T9B_dHQAAAAJ&amp;hl=en">clinical scientist focused on fall prevention</a> in older adults, commonly ages 65 and older. I’ve spent most of my career investigating why older adults fall and working with patients and their families to prevent falls.</p> <h2>Why aging leads to increased risk of falls</h2> <p>Aging is a process that affects the systems and tissues of every person. The rate and magnitude of aging may be different for each person, but overall physical decline is an inevitable part of life. Most people think aging starts in their 60s, but in fact we spend most of our life span <a href="https://doi.org/10.1093%2Fgeront%2Fgnv130">undergoing the process of decline</a>, typically beginning in our 30s.</p> <p>Older adults are more prone to falling for various reasons, including age-related changes in their bodies and vision changes that leave them vulnerable to environmental factors such as curbs, stairs and carpet folds.</p> <figure><iframe src="https://www.youtube.com/embed/ztPbKP68P2Q?wmode=transparent&amp;start=24" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Some straightforward measures to improve the safety of the home environment for older adults can significantly lower the risk of falls.</span></figcaption></figure> <p>Based on my experience, here are some common reasons older adults may experience falls:</p> <p>First, <a href="https://my.clevelandclinic.org/health/diseases/23167-sarcopenia">aging leads to a natural loss of muscle strength</a> and flexibility, making it more challenging to maintain balance and stability. The loss of strength and poor balance are two of the most common causes of falls.</p> <p>Second, older adults often have chronic conditions such as arthritis, Parkinson’s disease or diabetes that can affect their mobility, coordination and overall stability.</p> <p>In addition, certain medications commonly taken by older adults, <a href="https://doi.org/10.4088/jcp.18f12340">such as sedatives</a> or <a href="https://doi.org/10.1001/jamainternmed.2013.14764">blood pressure drugs</a>, can cause dizziness, drowsiness or a drop in blood pressure, leading to an increased risk of falls.</p> <p>Age-related vision changes, such as reduced depth perception and peripheral vision and difficulty in differentiating colors or contrasts, can make it harder to navigate and identify potential hazards. Hazards in the environment, such as uneven surfaces, slippery floors, inadequate lighting, loose rugs or carpets or cluttered pathways, can <a href="https://doi.org/10.1186/s12877-021-02499-x">significantly contribute to falls among older adults</a>.</p> <p>Older adults who lead a sedentary lifestyle or have limited physical activity may also experience reduced strength, flexibility and balance.</p> <p>And finally, such conditions as dementia or Alzheimer’s disease can affect judgment, attention and spatial awareness, leading to increased fall risk.</p> <h2>Theories of aging</h2> <p>There are numerous theories about why we age but there is no one unifying notion that explains all the changes in our bodies. A large portion of aging-related decline is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295054/">caused by our genes</a>, which determine the structure and function of bones, muscle growth and repair and visual depth perception, among other things. But there are also numerous lifestyle-related factors that influence our rate of aging including diet, exercise, stress and exposure to environmental toxins.</p> <p>A recent advance in scientific understanding of aging is that there is a difference between your <a href="https://theconversation.com/are-you-a-rapid-ager-biological-age-is-a-better-health-indicator-than-the-number-of-years-youve-lived-but-its-tricky-to-measure-198849">chronological age and your biological age</a>. Chronological age is simply the number of years you’ve been on the Earth. Biological age, however, refers to how old your cells and tissues are. It is based on physiological evidence from a blood test and is related to your physical and functional ability. Thus, if you’re healthy and fit, your biological age may be lower than your chronological age. However, the reverse can also be true.</p> <p>I encourage patients to focus on their biological age because it empowers them to take control over the aging process. We obviously have no control over when we are born. By focusing on the age of our cells, we can avoid long-held beliefs that our bodies are destined to develop cancer, diabetes or other conditions that <a href="https://doi.org/10.1016/j.cub.2012.07.024">have historically been tied to how long we live</a>.</p> <p>And by taking control of diet, exercise, sleep and other lifestyle factors you can actually <a href="https://doi.org/10.1111%2Facel.13538">decrease your biological age</a> and improve your quality of life. As one example, our team’s research has shown that moderate amounts of aerobic exercise <a href="https://doi.org/10.1371/journal.pone.0188538">can slow down motor decline</a> even when a person begins exercise in the latter half of the life span.</p> <h2>Fall prevention</h2> <p>Adopting lifestyle changes such as regular, long-term exercise can <a href="https://doi.org/10.1001/jamainternmed.2018.5406">reduce the consequences of aging</a>, including falls and injuries. Following a healthy diet, managing chronic conditions, reviewing medications with health care professionals, maintaining a safe home environment and getting regular vision checkups can also help reduce the risk of falls in older adults.</p> <p>There are several exercises that physical therapists use to improve balance for patients. It is important to note however, that before starting any exercise program, everyone should consult with a health care professional or a qualified physical therapist to determine the most appropriate exercises for their specific needs. Here are five forms of exercise I commonly recommend to my patients to improve balance:</p> <ol> <li> <p>Balance training can help improve coordination and <a href="https://www.sciencedirect.com/topics/neuroscience/proprioception">proprioception</a>, which is the body’s ability to sense where it is in space. By practicing movements that challenge the body’s balance, such as standing on one leg or walking heel-to-toe, the nervous system becomes better at coordinating movement and maintaining balance. A large research study analyzing nearly 8,000 older adults found that balance and functional exercises <a href="https://doi.org/10.1002/14651858.cd012424.pub2">reduce the rate of falls by 24%</a>.</p> </li> <li> <p>Strength training exercises involve lifting weights or using resistance bands to increase muscle strength and power. By strengthening the muscles in the legs, hips and core, older adults can improve their ability to maintain balance and stability. Our research has shown that strength training can also lead to <a href="https://doi.org/10.2147/cia.s104674">improvements in walking speed and a reduction in fall risk</a>.</p> </li> <li> <p>Tai chi is a gentle martial art that focuses on slow, controlled movements and shifting body weight. Research shows that it can improve balance, strength and flexibility in older adults. Several combined studies in tai chi have demonstrated a 20% reduction in the <a href="https://doi.org/10.1002/14651858.cd012424.pub2">number of people who experience falls</a>.</p> </li> <li> <p>Certain yoga poses can enhance balance and stability. Tree pose, warrior pose and mountain pose are examples of poses that can help improve balance. It’s best to <a href="https://theconversation.com/yoga-modern-research-shows-a-variety-of-benefits-to-both-body-and-mind-from-the-ancient-practice-197662">practice yoga</a> under the guidance of a qualified instructor who can adapt the poses to individual abilities.</p> </li> <li> <p>Flexibility training involves stretching the muscles and joints, which can improve range of motion and reduce stiffness. By improving range of motion, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990889/">older adults can improve their ability to move safely</a> and avoid falls caused by limitations in mobility.</p> </li> <li> <p>Use of assistive devices can be helpful when strength or balance impairments are present. Research studies involving the evaluation of canes and walkers used by older adults confirm that <a href="https://doi.org/10.1016/j.apmr.2004.04.023">these devices can improve balance and mobility</a>. Training from a physical or occupational therapist in the proper use of assistive devices is an important part of improving safety.</p> </li> </ol> <p>When I think back about the woman who nearly fell in the grocery store, I wish I could share everything we have learned about healthy aging with her. There’s no way to know if she was already putting these tips into practice, but I’m comforted by the thought that she may have avoided the fall by being in the right place at the right time. After all, she was standing in the produce aisle.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/204174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, Associate Professor of Physical Therapy and Rehabilitation Science, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/balance-declines-with-age-but-exercise-can-help-stave-off-some-of-the-risk-of-falling-204174">original article</a>.</em></p> </div>

Body

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How to rewire your brain to feel good on Monday

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/cristina-r-reschke-1413051">Cristina R. Reschke</a>, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> and <a href="https://theconversation.com/profiles/jolanta-burke-315263">Jolanta Burke</a>, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a></em></p> <p>If you hate Mondays, you’re most certainly in good company. After a couple of days off, many of us have difficulty settling back into our routines and work duties. You may even have dread and anxiety that seeps into the weekend in the form of “<a href="https://theconversation.com/three-ways-to-tackle-the-sunday-scaries-the-anxiety-and-dread-many-people-feel-at-the-end-of-the-weekend-187313">Sunday scaries</a>”.</p> <p>You can’t always change your schedule or obligations to make Mondays more appealing, but you may be able to “reprogram” your brain to think about the week differently.</p> <p>Our brains love predictability and routine. Research has shown that lack of routine is associated with <a href="https://journals.sagepub.com/doi/full/10.1177/0003122418823184">decline in wellbeing and psychological distress</a>. Even though the weekend heralds a leisurely and pleasant time, our brain works hard to adjust to this sudden change to a routine.</p> <p>The good news is that the brain does not need to make too much effort when adjusting to the weekend’s freedom and lack of routine. However, it’s a different story when coming back to the less pleasant activities, such as a to-do list on Monday morning.</p> <p>One way to adjust to post-weekend change is introducing routines that last the whole week and have the power to make our lives <a href="https://journals.sagepub.com/doi/full/10.1177/0146167218795133">more meaningful</a>. These may include <a href="https://portal.research.lu.se/en/publications/routines-made-and-unmade">watching your favourite TV programme, gardening</a> or going <a href="https://pubmed.ncbi.nlm.nih.gov/22976286/">to the gym</a>. It is helpful to do these things at the same time every day.</p> <p>Routines improve our <a href="https://pubmed.ncbi.nlm.nih.gov/16448317/">sense of coherence</a>, a process that allows us to make sense of the jigsaw of life events. When we have an established routine, be it the routine of working five days and taking two days off or engaging in a set of actions every day, our lives become <a href="https://journals.sagepub.com/doi/full/10.1177/0146167218795133">more meaningful</a>.</p> <p>Another important routine to establish is your sleep routine. <a href="https://www.nature.com/articles/s41746-021-00400-z">Research shows</a> that keeping consistent sleep time may be as important for enjoying Mondays as how long your sleep lasts or its quality.</p> <p>Changes in sleep patterns during weekends trigger <a href="https://www.mdpi.com/2072-6643/13/12/4543">social jetlag</a>. For instance, sleeping in later than usual and for longer on free days may trigger a discrepancy between your body clock and socially-imposed responsibilities. This is linked to higher stress levels on Monday morning.</p> <p>Try to keep a set time for going to bed and waking up, avoid naps. You might also want to create a 30 minute “wind-down” routine before sleep, by turning off or putting away your digital devices and practising relaxation techniques.</p> <h2>Hacking your hormones</h2> <p>Hormones can also play a role in how we feel about Mondays. For instance, cortisol is a very important multifunction hormone. It helps our bodies to control our metabolism, regulate our sleep-wake cycle and our response to stress, among other things. It is usually released about an hour before we wake up (it helps us feel awake) and then its levels lower until the next morning, unless we’re under stress.</p> <p>Under acute stress, our bodies release not only cortisol, but also adrenaline in preparation for fight or flight. This is when the heart beats fast, we get sweaty palms and may react impulsively. This is our amygdala (a small almond-shaped area in the base of our brains) hijacking our brains. It creates a super fast emotional response to stress even before our brains can process and think whether it was needed.</p> <p>But as soon we can think – activating the brain’s prefrontal cortex, the area for our reason and executive thinking – this response will be mitigated, if there is no real threat. It is a constant battle between our emotions and reason. This might wake us up in the middle of the night when we’re too stressed or anxious.</p> <p>It shouldn’t be surprising then that cortisol levels, measured in saliva samples of full-time working individuals, tend to be higher on Mondays and Tuesdays, with the lowest levels reported on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824866/">Sundays</a>.</p> <p>As a stress hormone, cortisol fluctuates daily, but not consistently. On weekdays, as soon as we wake up, <a href="https://psycnet.apa.org/record/2007-18151-008">cortisol levels soar</a> and variations tend to be higher than on <a href="https://pubmed.ncbi.nlm.nih.gov/11324714/">weekends</a>.</p> <p>To combat this, we need to trick the amygdala by training the brain to only recognise actual threats. In other words, we need to activate our prefrontal cortex as fast as possible.</p> <p>One of the best ways to achieve this and lower overall stress is through relaxation activities, especially on Mondays. One possibility is mindfulness, which is associated with a <a href="https://pubmed.ncbi.nlm.nih.gov/23724462/">reduction in cortisol</a>. <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full">Spending time in nature</a> is another method – going outside first thing on Monday or even during your lunch hour can make a significant difference to how you perceive the beginning of the week.</p> <p>Give yourself time before checking your phone, social media and the news. It’s good to wait for cortisol peak to decrease naturally, which happens approximately one hour after waking up, before you expose yourself to external stressors.</p> <p>By following these simple tips, you can train your brain to believe that the weekdays can be (nearly) as good as the weekend.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/199236/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/cristina-r-reschke-1413051"><em>Cristina R. Reschke</em></a><em>, Lecturer in the School of Pharmacy and Biomolecular Sciences &amp; Funded Investigator in the FutureNeuro Research Centre, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> and <a href="https://theconversation.com/profiles/jolanta-burke-315263">Jolanta Burke</a>, Senior Lecturer, Centre for Positive Health Sciences, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-rewire-your-brain-to-feel-good-on-mondays-199236">original article</a>.</em></p> </div>

Mind

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Breakthrough study finds genetic link to Parkinson's and ADHD

<p>A major scientific study has found a surprising link between the genes that control brain size and the risk of brain-related conditions. </p> <p>A Queensland Institute of Medical Research Associate Professor Miguel Renteria led an international team of experts who scanned DNA data and MRI scans from 76,000 participants.</p> <p>“Genetic variants associated with larger brain volumes in key brain regions also increase the risk of Parkinson’s disease, while variants linked to smaller brain volumes in key regions are associated with an increased risk of ADHD,” Renteria said. </p> <p>“It brings us closer to answering key questions about how genetics influence brain structure, and how we can potentially treat these conditions in future.”</p> <p>Parkinson’s Australia CEO Olivia Nassaris has celebrated the results of the study, saying the surprising results open the door to future treatment options for Parkinson’s, which currently has no cure or cause.</p> <p>“The more answers we have the closer we are to understanding this condition,” she said.</p> <p>Michael Wiseman, who has been living with Parkinson’s for eight years, said he is pleased more research is being done about the neurodegenerative condition.</p> <p>“I know it’s not going to benefit me in any way, as far as a cure or anything … I just hope they keep going, kicking some goals and finding results because it’s an insidious sort of thing, it’s a passenger I’ll have until I go to the grave.”</p> <p><em>Image credits: Shutterstock </em></p>

Caring

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Retiring early can be bad for the brain

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/plamen-v-nikolov-1112610">Plamen V Nikolov</a>, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</a></em></p> <p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p> <h2>The big idea</h2> <p>People who retire early suffer from accelerated cognitive decline and may even encounter early onset of dementia, according to a I conducted with my doctoral student <a href="https://sites.google.com/binghamton.edu/alan-adelman/home">Alan Adelman</a>.</p> <p>To establish that finding, we examined the effects of a rural pension program China introduced in 2009 that provided people who participated with a stable income if they stopped working after the official retirement age of 60. We found that people who participated in the program and retired within one or two years experienced a cognitive decline equivalent to a drop in general intelligence of 1.7% relative to the general population. This drop is equivalent to about three IQ points and could make it harder for someone to <a href="https://doi.org/10.1017/S0033291700008412">adhere to a medication schedule</a> or <a href="https://doi.org/10.1111/j.1475-%205890.2007.00052.x">conduct financial planning</a>. The largest negative effect was in what is called “delayed recall,” which measures a person’s ability to remember something mentioned several minutes ago. Neurological research <a href="https://doi.org/10.1001/archneur.1991.00530150046016">links problems in this area to an early onset of dementia</a>.</p> <h2>Why it matters</h2> <p>Cognitive decline refers to when a person has trouble remembering, learning new things, concentrating or making decisions that affect their everyday life. Although some cognitive decline appears to be an inevitable byproduct of aging, faster decline can have profound adverse consequences on one’s life.</p> <p>Better understanding of the causes of this has powerful financial consequences. Cognitive skills – the mental processes of gathering and processing information to solve problems, adapt to situations and learn from experiences – are crucial for decision-making. They influence an individual’s ability to process information and <a href="https://www.jstor.org/stable/1818642">are connected to higher earnings</a> and a <a href="https://www.doi.org/10.1257/jep.25.1.159">better quality of life</a>.</p> <p>Retiring early and working less or not at all can generate large benefits, such as reduced stress, better diets and more sleep. But as we found, it also has unintended adverse effects, like fewer social activities and less time spent challenging the mind, that far outweighed the positives.</p> <p>While retirement schemes like the 401(k) and similar programs in other countries <a href="https://www.doi.org/10.1023/B:PUCH.0000035859.20258.e0">are typically introduced to ensure the welfare of aging adults</a>, our research suggests they need to be designed carefully to avoid unintended and significant adverse consequences. When people consider retirement, they should weigh the benefits with the significant downsides of a sudden lack of mental activity. A good way to ameliorate these effects is to stay engaged in social activities and continue to use your brains in the same way you did when you were working.</p> <p>In short, we show that if you rest, you rust.</p> <h2>What still isn’t known</h2> <p>Because we are using data and a program in China, the mechanisms of how retirement induces cognitive decline could be context-specific and may not necessarily apply to people in other countries. For example, cultural differences or other policies that can provide support to individuals in old age can buffer some of the negative effects that we see in rural China due to the increase in social isolation and reduced mental activities.</p> <p>Therefore, we can not definitively say that the findings will extrapolate to other countries. We are looking for data from other countries’ retirement programs, such as India’s, to see if the effects are similar or how they are different.</p> <h2>How I do my research</h2> <p>A big focus of the <a href="https://scholar.harvard.edu/pnikolov/my-research-group-1">economics research lab</a> I run is to <a href="http://www.nber.org/%7Enikolovp/research.html">better understand</a> the causes and consequences of changes in what economists call <a href="https://www.britannica.com/topic/human-capital">“human capital”</a> – especially cognitive skills – in the context of developing countries.</p> <p>Our lab’s mission is to generate research to inform economic policies and empower individuals in low-income countries to rise out of poverty. One of the main ways we do this is through the use of randomized controlled trials to measure the impact of a particular intervention, such as retiring early or access to microcredit, on education outcomes, productivity and health decisions.<!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/plamen-v-nikolov-1112610"><em>Plamen V Nikolov</em></a><em>, Assistant Professor of Economics, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/retiring-early-can-be-bad-for-the-brain-145603">original article</a>.</em></p> </div>

Mind

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Trying to lose weight? Here’s why your genetics could be just as important as your exercise regime

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a></em></p> <p>Weight loss is a complicated process. There are so many factors involved including your diet, how much sleep you get each night and the kind of exercise you do. Our recent study shows that your <a href="https://www.tandfonline.com/doi/full/10.1080/02701367.2024.2404981">specific genetic profile</a> may also have a dominant effect on how well you lose weight through exercise. This might explain why two people who do an identical workout will see very different results.</p> <p>We identified 14 genes that appeared to significantly contribute to how much weight a person lost through running. This suggests that some of us have a natural talent when it comes to burning fat and losing weight through exercise.</p> <p>To conduct our study, we recruited 38 men and women born in the UK aged between 20 and 40. None of the participants regularly exercised at the start of the study. The group was randomly divided, with one half following a strict eight-week endurance programme that consisted of three weekly runs of 20-30 minutes.</p> <p>The other group acted as a <a href="https://www.britannica.com/science/control-group">control</a>. They were instructed to refrain from exercise and continue their daily routines as normal over this study period, including diet and lifestyle habits.</p> <p>All participants conducted a running test to see how far they could run in 12 minutes, and were weighed before and after the study period. This was to gauge their initial fitness level and see how much they changed over the duration of the study. <a href="https://www.nhs.uk/conditions/obesity/">Body mass index</a> (BMI) was also calculated.</p> <p>Additionally, a saliva sample was collected from each person with a <a href="https://muhdo.com/?gclid=Cj0KCQjwiIOmBhDjARIsAP6YhSUB3WI81JP4Q_snYLhh-SBVNeCJNy2m63C8bKJFvO-nJ5UsHuCCdqMaAhTeEALw_wcB">DNA test kit</a> at the end of the study to assess their unique genetic profile.</p> <p>It’s important to note that everyone who participated in the study had a similar body weight, BMI and aerobic fitness level at the start of the study. This is beneficial for <a href="https://casp-uk.net/news/homogeneity-in-research/">multiple reasons</a>. It meant everyone was at the same starting point, and some <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/confounding-variable">confounding variables</a> were already controlled for such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128125/">fitness level</a>. This ultimately improves accuracy in interpreting the results.</p> <h2>Exercise genes</h2> <p>Everyone in the exercise group managed to lose weight – around 2kg on average. The control group, on the other hand, put on a little bit of weight.</p> <p>While a 2kg weight loss may not sound like a lot, it’s significant considering the exercise regime only lasted eight weeks and participants made no <a href="https://www.intechopen.com/chapters/87186">changes to their diet</a>.</p> <p>More significant, however, was the large variation in results among those that exercised – with an up to 10kg difference in weight loss between some of the participants. In fact, everyone within the exercise group improved at different rates.</p> <p>Since we controlled for factors such as the <a href="https://pubmed.ncbi.nlm.nih.gov/3529283/">intensity, duration and frequency</a> of the exercises and used participants who’d had a similar body weight and fitness level at the start of the study, this suggests that some people naturally benefited more than others from endurance training.</p> <p>When we looked at the genetic profiles of our participants, we found that differences in each person’s response to the exercise was strongly associated with their specific genetics.</p> <p>We showed there was a strong linear correlation between the amount of weight participants lost and 14 genes that have previously been shown to be associated with body weight, metabolism or <a href="https://www.nature.com/articles/s41380-018-0017-5">psychological conditions</a> that affect BMI. The greater number of these genes a participant had, the more weight they lost. Our results also revealed that around 63% of the variance in weight lost among participants were explained by the genes identified.</p> <p>For example, research has shown the <a href="https://www.ncbi.nlm.nih.gov/gene/10891">PPARGC1A gene</a> plays a role in metabolism and the <a href="https://link.springer.com/article/10.1007/S11033-020-05801-Z">use of fats for energy</a> while exercising. Our study found that all participants who lost more than 1.5kg from exercise had this gene. Those who lost less than this did not have this gene.</p> <p>Our findings align with what <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249501&amp;s2=P875440273_1683331208925004155">previous studies</a> have shown. But while previous papers have only looked at the link between individual genes and weight loss, ours is the first to show that 14 different genes appear to work in combination to affect whether a person loses weight from endurance exercise.</p> <h2>Piece of the puzzle</h2> <p>Our study also suggests that while some people possess genes that make it easier for them to get fit and lose weight, people with these favourable genetics can only flourish if they actually exercise. In fact, our control group also had a number of these listed genes, but without exercise these genes could not activate, and so the participants did not lose any weight.</p> <p>While our study provides compelling findings, it’s not without limitations. Since we only looked at endurance-based exercise, it will be important for future studies to investigate whether there are similar links between weight loss, genetics and combinations of different types of training (such as a mixture of endurance and strength sessions into a training plan).</p> <p>It’s also worth mentioning that exercise is only <a href="https://www.who.int/activities/controlling-the-global-obesity-epidemic">one piece of the puzzle</a> when it comes to weight loss. So even if you have all 14 of these genes, you won’t lose any weight or get fit if you don’t exercise and maintain a healthy diet and sleep pattern.</p> <p>On the flip side, someone that only has a few of these favourable genes can still benefit if they exercise and are mindful of other aspects of their lifestyle.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/240506/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, Lecturer in Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/trying-to-lose-weight-heres-why-your-genetics-could-be-just-as-important-as-your-exercise-regime-240506">original article</a>.</em></p> </div>

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The best exercises to boost your brain health after 60

<div class="theconversation-article-body"><em><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></em></p> <p>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 <em>Society for Neuroscience</em></a>:</p> <blockquote> <p>“We have a brain for one reason and one reason only: to produce adaptable and complex movements”</p> </blockquote> <h2>Use your brain to stay efficient</h2> <p>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 <em>cognitive abilities</em>. 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.</p> <p>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.</p> <p>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.</p> <h2>The benefits of physical activity on cognitive capacity after 60</h2> <p>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>.</p> <p>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.</p> <p>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>.</p> <h2>Three ingredients to train the brains of senior citizens</h2> <p>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:</p> <p><em>First ingredient: complex physical and motor stimulation of at least moderate intensity.</em></p> <p>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.</p> <p>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.</p> <p><em>Second ingredient: fire up those brain cells during exercises</em></p> <p>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.</p> <p>_Third ingredient: group activities that lead to social interaction. _</p> <p>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>.</p> <p>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.</p> <h2>Opting for cooperative and oppositional team sports</h2> <p>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.</p> <p>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.</p> <p>From a cognitive point of view, these activities create situations that are always new, rich and stimulating. We call this double combination of stimuli <em><a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">simultaneous training</a></em>. A number of researchers have highlighted the importance of this cognitive involvement in team sports and encourage their practice, particularly among the elderly.</p> <p>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.</p> <h2>Get your body moving with exergames</h2> <p>Another promising avenue are <em>exergames</em> – 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.</p> <p>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.</p> <p>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’ <em>Neo-One</em>, Sphery’s <em>ExerCube</em> and Lü’s <em>Aire interactive</em>. In these games combining real and virtual worlds, physical objects (such as balls) and digital objects coexist and interact in real time.</p> <p>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.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/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></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-best-exercises-to-boost-your-brain-health-after-60-237162">original article</a>.</em></p> </div>

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Do mobile phones cause brain cancer? Science makes definitive call

<p>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. </p> <p>A new comprehensive review commissioned by the World Health Organization has found that mobile phones are NOT linked to brain and head cancers. </p> <p>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. </p> <p>“We concluded the evidence does not show a link between mobile phones and brain cancer or other head and neck cancers," he said. </p> <p>The review, which was published on Wednesday, focused on cancers of the nervous system, salivary gland and brain tumours. </p> <p>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. </p> <p>“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. </p> <p>Despite emitting electromagnetic radiation, also known as radio waves, the exposure is relatively low. </p> <p>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.”</p> <p>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." </p> <p>“We’re always exposed to low-level radio waves in the everyday environment.”</p> <p>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. </p> <p>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. </p> <p>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. </p> <p>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”.</p> <p>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.</p> <p>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. </p> <p>“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.</p> <p><em>Images: Shutterstock</em></p> <p> </p>

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Can a 10-year-old be responsible for a crime? Here’s what brain science tells us

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, <a href="https://theconversation.com/institutions/deakin-university-757"><em>Deakin University</em></a></em></p> <p>The age a child can be arrested, charged and jailed in Australia is back in the spotlight.</p> <p>Last year, the Northern Territory became the first jurisdiction to raise the age of criminal responsibility from ten to 12. Now its new, tough-on-crime government has pledged to <a href="https://www.sbs.com.au/nitv/article/incoming-chief-minister-says-age-of-criminal-responsibility-to-be-lowered-to-10-years-old/a1xm9jy9c">return it to ten</a>. It comes after Victoria <a href="https://www.abc.net.au/news/2024-08-13/victoria-youth-justice-reform-criminal-age/104217160">walked back</a> its earlier commitment to raise the age to 14, settling instead on 12.</p> <p>But the United Nations Committee on the Rights of the Child says 14 should be the absolute <a href="https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-24-2019-childrens-rights-child">minimum</a>. It raised this age from its earlier recommendation (in 2007) of 12, citing a decade of new research into child and adolescent development.</p> <p>So what does the science say? What happens to the brain between ten and 14? And how much can those under 14 understand the consequences of their actions?</p> <h2>Who is an adolescent?</h2> <p>Our research shows adolescence is a <a href="https://pubmed.ncbi.nlm.nih.gov/30169257/">critical period</a> for development. It’s the time children’s experiences and explorations shape how they develop cognitive skills (including critical thinking and decision making), as well as social and emotional skills (including moral reasoning).</p> <p>Adolescence also lasts longer than we tend to think. Important brain development begins during late childhood, around eight to nine years. Intense changes then follow during early adolescence (ages ten to 14). But these changes continue well into the twenties, and full cognitive and emotional maturity is not usually reached until around age 24.</p> <p>However, everyone’s brain matures at a different rate. That means there is no definitive age we can say humans reach “adult” levels of cognitive maturity. What we do know is the period of early adolescence is critical.</p> <h2>What does puberty do to the brain?</h2> <p>Puberty is a defining feature of early adolescence. Most of us are familiar with the changes that occur to the body and reproductive systems. But the increase in puberty hormones, such as testosterone and oestrogen, also trigger changes to the brain. These hormones <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453017313252?via%3Dihub">increase most sharply</a> between ten and 15 years of age, although gradual changes continue into the early twenties.</p> <p>Puberty hormones change the structures in the brain which process emotions, including the amygdala (which encodes fear and stress) and ventral striatum (involved in reward and motivation).</p> <p>This makes adolescents particularly reactive to emotional rewards and threats. <a href="https://doi.org/10.1016/j.cortex.2019.04.024">Our research</a> has shown the brain’s sensitivity to emotions increases throughout early adolescence until around 14 or 15 years old.</p> <p>At the same time, changes in puberty have <a href="http://dx.doi.org/10.1037/pspp0000172">been linked</a> to increased sensation seeking and impulsive behaviours during early adolescence.</p> <p>This context is crucial when we discuss the behaviour of children in the ten to 14 age range. The way their brains change during this period makes them more sensitive and responsive to emotions, and more likely to be seeking experiences that are new and intense.</p> <h2>How do adolescents make decisions?</h2> <p>The emotional context of puberty influences how younger adolescents make decisions and understand their consequences.</p> <p>Decision making relies on several basic cognitive functions, including the brain’s flexibility, memory and ability to control impulses.</p> <p>These cognitive abilities – which together help us consider the consequences of our actions – undergo some of the <a href="https://doi.org/10.1523/JNEUROSCI.1741-13.2013">steepest development</a> between ages ten and 14. By age 15, the ability to make complex decisions has usually <a href="https://doi.org/10.1037/lhb0000315">reached adult maturity</a>.</p> <p>But adolescents at this age remain highly susceptible to emotions. So while their brain may be equipped to make a complex decision, their ability to think through the consequences, weighing up costs and benefits, can be clouded by emotional situations.</p> <p>For example, <a href="https://doi.org/10.1111/cdev.12085">research has shown</a> 13-14 year-olds were more distracted from completing a task and less able to control their behaviour when they viewed images that made them feel negative emotions.</p> <p>The social world of teenagers also has a significant impact on how they make decisions – especially in early adolescence. One study found that while older adolescents (aged 15-18) are more influenced by what adults think when weighing up risk, adolescents aged 12-14 <a href="https://journals.sagepub.com/doi/full/10.1177/0956797615569578">look to other teenagers</a>.</p> <p>Experiments <a href="https://doi.org/10.1177/0272431616648453">have also shown</a> adolescents aged 12-15 make riskier decisions when they are with peers than by themselves. Their brain responses also suggest they experience a greater sense of reward in taking those risks <a href="https://doi.org/10.1093/scan/nsy071">with peers</a>.</p> <h2>How do teens understand the consequences of their actions?</h2> <p>The concept of <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp2122/Quick_Guides/MinimumAgeCriminalResponsibility">criminal responsibility</a> is based on whether a person is able to understand their action and know whether it is wrong.</p> <p>Moral reasoning – how people think about right and wrong – depends on the ability to understand another person’s mental state and adopt their perspective. These skills are in development <a href="https://doi.org/10.1016/j.biopsych.2020.09.012">across adolescence</a>.</p> <p>Research suggests it may take more effort for adolescent brains to process <a href="https://doi.org/10.1162/jocn.2009.21121">“social” emotions</a> such as guilt and embarrassment, compared to adults. This is similar when they make <a href="https://doi.org/10.1080/17470919.2014.933714">moral judgements</a>. This evidence suggests teenage brains may have to work harder when considering other people’s intentions and desires.</p> <p>Young adolescents have the cognitive ability to appreciate they made a bad decision, but it is more mentally demanding. And social rewards, emotions and the chance to experience something new all have a strong bearing on their decisions and actions in the moment — possibly more than whether it is right or wrong.</p> <h2>Early adolescence is critical for the brain</h2> <p>There are also a number of reasons adolescent brains may develop differently. This includes various forms of neurodisability such as acquired brain injury, fetal alcohol spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and intellectual disability, as well as exposure to trauma.</p> <p>Teenagers with neurodevelopmental disorders will likely cope differently with decision making, social pressure, impulse control and risk assessment, and face <a href="https://www.mcri.edu.au/images/research/strategic-collaborations/Flagships/Neurodevelopment/Neurodevelopment_Flagship_Brochure.pdf">extra difficulties</a>. Across the world, they are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30217-8/fulltext">disproportionately incarcerated</a>.</p> <p>In Australia, Indigenous children and adolescents are incarcerated <a href="https://www.indigenoushpf.gov.au/measures/2-11-contact-with-the-criminal-justice-system#:%7E:text=On%20an%20average%20day%20in%202021%E2%80%9322%2C%20there%20were%3A,AIHW%202023d%3A%20Table%20S76a">in greater numbers</a> than their non-Indigenous peers.</p> <p>Each child matures differently, and some face extra challenges. But for every person, the period between ten and 14 is critical for developing the cognitive, social and emotional skills they’ll carry through the rest of their life.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237552/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, Professor of Adolescent Health The University of Melbourne; Director, Royal Children's Hospital Centre for Adolescent Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, Research Fellow, School of Psychology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-a-10-year-old-be-responsible-for-a-crime-heres-what-brain-science-tells-us-237552">original article</a>.</em></p> </div>

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I’ve been sick. When can I start exercising again?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>You’ve had a cold or the flu and your symptoms have begun to subside. Your nose has stopped dripping, your cough is clearing and your head and muscles no longer ache.</p> <p>You’re ready to get off the couch. But is it too early to go for a run? Here’s what to consider when getting back to exercising after illness.</p> <h2>Exercise can boost your immune system – but not always</h2> <p>Exercise <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523821/">reduces the chance</a> of getting respiratory infections by increasing your immune function and the ability to fight off viruses.</p> <p>However, an acute bout of endurance exercise may temporarily increase your susceptibility to upper respiratory infections, such as colds and the flu, via the short-term suppression of your immune system. This is known as the “open window” theory.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/20839496/">study</a> from 2010 examined changes in trained cyclists’ immune systems up to eight hours after two-hour high-intensity cycling. It found important immune functions were suppressed, resulting in an increased rate of upper respiratory infections after the intense endurance exercise.</p> <p>So, we have to be more careful after performing harder exercises than normal.</p> <h2>Can you exercise when you’re sick?</h2> <p>This depends on the severity of your symptoms and the intensity of exercise.</p> <p>Mild to moderate exercise (reducing the intensity and length of workout) may be OK if your symptoms are a runny nose, nasal congestion, sneezing and minor sore throat, without a fever.</p> <p>Exercise may help you feel better by opening your nasal passages and temporarily relieving nasal congestion.</p> <p>However, if you try to exercise at your normal intensity when you are sick, you risk injury or more serious illness. So it’s important to listen to your body.</p> <p>If your symptoms include chest congestion, a cough, upset stomach, fever, fatigue or widespread muscle aches, avoid exercising. Exercising when you have these symptoms may worsen the symptoms and prolong the recovery time.</p> <p>If you’ve had the flu or another respiratory illness that caused a high fever, make sure your temperature is back to normal before getting back to exercise. Exercising raises your body temperature, so if you already have a fever, your temperature will become high quicker, which makes you sicker.</p> <p>If you have COVID or other contagious illnesses, stay at home, rest and isolate yourself from others.</p> <p>When you’re sick and feel weak, don’t force yourself to exercise. Focus instead on getting plenty of rest. This may actually shorten the time it takes to recover and resume your normal workout routine.</p> <h2>I’ve been sick for a few weeks. What has happened to my strength and fitness?</h2> <p>You may think taking two weeks off from training is disastrous, and worry you’ll lose the gains you’ve made in your previous workouts. But it could be just what the body needs.</p> <p>It’s true that almost all training benefits are <a href="https://journals.lww.com/acsm-csmr/fulltext/2019/04000/sports_training_principles.2.aspx">reversible</a> to some degree. This means the physical fitness that you have built up over time can be lost without regular exercise.</p> <p>To study the effects of de-training on our body functions, researchers have undertaken “bed rest” studies, where healthy volunteers spend up to 70 days in bed. They <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00415.2017">found</a> that V̇O₂max (the maximum amount of oxygen a person can use during maximal exercise, which is a measure of <a href="https://my.clevelandclinic.org/health/articles/7050-aerobic-exercise">aerobic</a> fitness) declines 0.3–0.4% a day. And the higher pre-bed-rest V̇O₂max levels, the <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00415.2017">larger</a> the declines.</p> <p>In terms of skeletal muscles, upper thigh muscles <a href="https://doi.org/10.1152/japplphysiol.00363.2020">become smaller by</a> 2% after five days of bed rest, 5% at 14 days, and 12% at 35 days of bed rest.</p> <p><a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00363.2020">Muscle strength declines more</a> than muscle mass: knee extensor muscle strength gets weaker by 8% at five days, 12% at 14 days and more than 20% after around 35 days of bed rest.</p> <p>This is why it feels harder to do the same exercises after resting for even five days.</p> <p>But in <a href="https://iaaspace.org/product/guidelines-for-standardization-of-bed-rest-studies-in-the-spaceflight-context/">bed rest studies</a>, physical activities are strictly limited, and even standing up from a bed is prohibited during the whole length of a study. When we’re sick in bed, we have some physical activities such as sitting on a bed, standing up and walking to the toilet. These activities could reduce the rate of decreases in our physical functions compared with study participants.</p> <h2>How to ease back into exercise</h2> <p>Start with a lower-intensity workout initially, such as going for a walk instead of a run. Your first workout back should be light so you don’t get out of breath. Go low (intensity) and go slow.</p> <p>Gradually increase the volume and intensity to the previous level. It may take the same number of days or weeks you rested to get back to where you were. If you were absent from an exercise routine for two weeks, for example, it may require two weeks for your fitness to return to the same level.</p> <p>If you feel exhausted after exercising, take an extra day off before working out again. A day or two off from exercising shouldn’t affect your performance very much.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233130/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, Professor of Exercise and Sports Science, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-sick-when-can-i-start-exercising-again-233130">original article</a>.</em></p> </div>

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Food and exercise can treat depression as well as a psychologist, our study found. And it’s cheaper

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>Around <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">3.2 million</a> Australians live with depression.</p> <p>At the same time, <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">few</a> Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other?</p> <p>Our world-first trial, <a href="https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065%2824%2900136-6/fulltext">published this week</a>, shows improving diet and doing more physical activity can be as effective as therapy with a psychologist for treating low-grade depression.</p> <p>Previous studies (including <a href="https://link.springer.com/article/10.1186/s12916-017-0791-y">our own</a>) have found “lifestyle” therapies are effective for depression. But they have never been directly compared with psychological therapies – until now.</p> <p>Amid a nation-wide <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">shortage</a> of mental health professionals, our research points to a potential solution. As we found lifestyle counselling was as effective as psychological therapy, our findings suggest dietitians and exercise physiologists may one day play a role in managing depression.</p> <h2>What did our study measure?</h2> <p>During the prolonged COVID lockdowns, Victorians’ distress levels were <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50831">high and widespread</a>. Face-to-face mental health services were limited.</p> <p>Our trial targeted people living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder. Typical symptoms included feeling down, hopeless, irritable or tearful.</p> <p>We partnered with our <a href="https://www.barwonhealth.org.au/mhdas/">local mental health service</a> to recruit 182 adults and provided group-based sessions on Zoom. All participants took part in up to six sessions over eight weeks, facilitated by health professionals.</p> <p>Half were randomly assigned to participate in a program co-facilitated by an accredited practising dietitian and an exercise physiologist. That group – called the lifestyle program – developed nutrition and movement goals:</p> <ul> <li>eating a wide variety of foods</li> <li>choosing high-fibre plant foods</li> <li>including high quality fats</li> <li>limiting discretionary foods, such as those high in saturated fats and added sugars</li> <li>doing enjoyable physical activity.</li> </ul> <p>The second group took part in psychotherapy sessions convened by two psychologists. The psychotherapy program used cognitive behavioural therapy (CBT), the gold standard for treating depression in <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2730724">groups and when delivered remotely</a>.</p> <p>In both groups, participants could continue existing treatments (such as taking antidepressant medication). We gave both groups <a href="https://link.springer.com/article/10.1186/s12888-022-03840-3">workbooks and hampers</a>. The lifestyle group received a food hamper, while the psychotherapy group received items such as a colouring book, stress ball and head massager.</p> <h2>Lifestyle therapies just as effective</h2> <p>We found similar results in each program.</p> <p>At the trial’s beginning we gave each participant a score based on their self-reported mental health. We measured them again at the end of the program.</p> <p>Over eight weeks, those scores showed symptoms of depression reduced for participants in the lifestyle program (42%) and the psychotherapy program (37%). That difference was not statistically or clinically meaningful so we could conclude both treatments were as good as each other.</p> <p>There were some differences between groups. People in the lifestyle program improved their diet, while those in the psychotherapy program felt they had increased their social support – meaning how connected they felt to other people – compared to at the start of the treatment.</p> <p>Participants in both programs increased their physical activity. While this was expected for those in the lifestyle program, it was less expected for those in the psychotherapy program. It may be because they knew they were enrolled in a research study about lifestyle and subconsciously changed their activity patterns, or it could be a positive by-product of doing psychotherapy.</p> <p>There was also not much difference in cost. The lifestyle program was slightly cheaper to deliver: A$482 per participant, versus $503 for psychotherapy. That’s because hourly rates differ between dietitians and exercise physiologists, and psychologists.</p> <h2>What does this mean for mental health workforce shortages?</h2> <p>Demand for mental health services is increasing in Australia, while at the same time the workforce <a href="https://www.health.gov.au/sites/default/files/2023-10/national-mental-health-workforce-strategy-2022-2032.pdf">faces worsening nation-wide shortages</a>.</p> <p>Psychologists, who provide <a href="https://www.aihw.gov.au/getmedia/6b19e493-0ebe-420f-a9a3-e48b26aace9f/aihw-aus-249-ib.pdf?v=20240628145747&amp;inline=true">about half</a> of all mental health services, can have long wait times. Our results suggest that, with the appropriate training and guidelines, allied health professionals who specialise in diet and exercise could help address this gap.</p> <p>Lifestyle therapies can be combined with psychology sessions for multi-disciplinary care. But diet and exercise therapies could prove particularly effective for those on waitlists to see a psychologists, who may be receiving no other professional support while they wait.</p> <p>Many dietitians and exercise physiologists already have advanced skills and expertise in motivating behaviour change. Most accredited practising dietitians are trained in managing <a href="https://link.springer.com/content/pdf/10.1007/978-3-030-67929-3_38-1.pdf">eating disorders</a> or <a href="https://www.nature.com/articles/s41572-020-0200-2">gastrointestinal conditions</a>, which commonly overlap with depression.</p> <p>There is also a cost argument. It is <a href="https://journals.sagepub.com/doi/full/10.1177/1355819616668202">overall cheaper</a> to train a dietitian ($153,039) than a psychologist ($189,063) – and it takes less time.</p> <h2>Potential barriers</h2> <p>Australians with chronic conditions (such as diabetes) can access subsidised dietitian and exercise physiologist appointments under various Medicare treatment plans. Those with eating disorders can also access subsidised dietitian appointments. But mental health care plans for people with depression do not support subsidised sessions with dietitians or exercise physiologists, despite <a href="https://dietitiansaustralia.org.au/sites/default/files/2024-04/Dietitians%20Australia%20Mental%20Health%20Evidence%20Brief%202024.pdf">peak bodies</a> urging them to do so.</p> <p>Increased training, upskilling and Medicare subsidies would be needed to support dietitians and exercise physiologists to be involved in treating mental health issues.</p> <p><a href="https://foodandmoodcentre.com.au/academy">Our training</a> and clinical <a href="https://www.tandfonline.com/doi/full/10.1080/15622975.2022.2112074">guidelines</a> are intended to help clinicians practising lifestyle-based mental health care within their scope of practice (activities a health care provider can undertake).</p> <h2>Future directions</h2> <p>Our trial took place during COVID lockdowns and examined people with at least mild symptoms of depression who did not necessarily have a mental disorder. We are seeking to replicate these findings and are now running <a href="https://foodandmoodcentre.com.au/projects/the-harmone-trial/">a study</a> open to Australians with mental health conditions such as major depression or bipolar disorder.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235952/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/adrienne-oneil-268324">Adrienne O'Neil</a>, Professor, Food &amp; Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/sophie-mahoney-1557294">Sophie Mahoney</a>, Associate Research Fellow, Food and Mood Centre, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image </em><em>credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/food-and-exercise-can-treat-depression-as-well-as-a-psychologist-our-study-found-and-its-cheaper-235952">original article</a>.</em></p> </div>

Mind

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What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Migraine is many things, but one thing it’s not is “just a headache”.</p> <p>“Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.</p> <p>Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.</p> <p>Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.</p> <h2>What’s happening in my brain?</h2> <p>The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:</p> <p>The earliest phase is called the <strong>prodrome</strong>. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">The hypothalamus is shown here in red.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></span></figcaption></figure> <p>Next is the <strong>aura phase</strong>, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.</p> <p>In the <strong>headache phase</strong>, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.</p> <p>Finally, the <strong>postdromal phase</strong> occurs after the headache resolves and commonly involves changes in mood and energy.</p> <h2>What can you do about the acute attack?</h2> <p>A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.</p> <p><iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <p><strong>Aspirin</strong></p> <p>For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.</p> <p><strong>Triptans</strong></p> <p>For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.</p> <p>Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.</p> <p>The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).</p> <p>As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.</p> <p><strong>Gepants</strong></p> <p>Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.</p> <p>Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.</p> <p>They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.</p> <p><strong>Ditans</strong></p> <p>Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.</p> <p>However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers.</p> <h2>What about preventing migraines?</h2> <p>The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.</p> <p>Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives.</p> <p>Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:</p> <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> <p>Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.</p> <p>For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.</p> <p>It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more.</p> <hr /> <p><iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <hr /> <h2>‘Nothing works for me!’</h2> <p>In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP.</p> <p>The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.</p> <p>These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist.</p> <p>Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.</p> <p>Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.</p> <p>Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>.</em></p> </div>

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Poor sleep is really bad for your health. But we found exercise can offset some of these harms

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Despite the well-known links between poor sleep and poorer health, getting enough good quality sleep has become a luxury in modern society.</p> <p>Many of us struggle to improve our sleep, while amid the COVID pandemic and recurring lock-downs, <a href="https://theconversation.com/were-sleeping-more-in-lockdown-but-the-quality-is-worse-155797">our sleep has deteriorated</a>.</p> <p>But <a href="https://doi.org/10.1136/bjsports-2021-104046">our new study</a>, published today in the British Journal of Sports Medicine, bears some encouraging news.</p> <p>We found doing enough physical activity (including exercise such as running or going to the gym) may counter some of the adverse health effects of unhealthy sleep patterns.</p> <p>Let us explain.</p> <h2>Does poor sleep really harm our health?</h2> <p>Unhealthy sleep patterns include:</p> <ul> <li> <p>not sleeping for long enough (less than seven hours per night for adults)</p> </li> <li> <p>sleeping for too long (more than nine hours per night for adults)</p> </li> <li> <p>snoring</p> </li> <li> <p>insomnia</p> </li> <li> <p>being a night owl, also known as “late chronotype”. This is people who naturally feel most awake and motivated in the evening, and are sluggish in the morning.</p> </li> </ul> <p>They are <a href="https://doi.org/10/ggjqrt">all associated</a> with poorer health.</p> <p>Recent research shows poor sleep may:</p> <ul> <li> <p>cause <a href="https://doi.org/10.1038/s41577-019-0190-z">inflammation</a></p> </li> <li> <p>impair the metabolism of glucose (also known as blood sugar) and reduce the number of calories burned, thereby increasing the risk of <a href="https://theconversation.com/why-sleep-is-so-important-for-losing-weight-145058">obesity</a></p> </li> <li> <p>increase the risk of <a href="https://doi.org/10/gg6x87">heart disease</a> and <a href="https://doi.org/10/ggnw5h">premature death</a>.</p> </li> </ul> <p>However, very few studies have examined how sleep and physical activity interact and impact our health.</p> <p>We set out to answer the question: if I have poor sleep but I do quite a lot of physical activity, can that offset some of the harms of my poor sleep in the long-term? Or would this not make any difference?</p> <h2>What did we do?</h2> <p>We analysed the information provided by 380,055 middle-aged adults in the UK Biobank study, recruited between 2006 and 2010. Participants reported their level of physical activity and five aspects of their sleep.</p> <p>We grouped people based on their sleep behaviour into healthy, intermediate or poor.</p> <p>We categorised people’s level of physical activity based on <a href="https://bjsm.bmj.com/content/54/24/1451">the World Health Organization (WHO) guidelines</a>. People who met the upper bounds of the guidelines did 300 minutes of moderate intensity physical activity a week, or 150 minutes of vigorous exercise, or a combination of both. Those who met the lower bound did 150 minutes of moderate intensity exercise a week, or 75 minutes of vigorous exercise, or a combination.</p> <p>Moderate intensity physical activity usually makes you slightly out of breath if sustained for a few minutes and includes brisk walking or cycling at a leisurely pace.</p> <p>Vigorous exercise usually makes you breath hard and can include running, swimming, and playing sports like tennis, netball, soccer or footy.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=409&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=409&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=409&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=515&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=515&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=515&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">Doing at least 150 minutes of moderate intensity physical activity a week, or 75 minutes of vigorous exercise, can offset some of the health harms of poor sleep.</span> <span class="attribution"><a class="source" href="https://apps.who.int/iris/bitstream/handle/10665/336656/9789240015128-eng.pdf?sequence=1&amp;isAllowed=y">World Health Organization, CC BY-NC-SA 3.0 IGO</a></span></figcaption></figure> <h2>What did we find?</h2> <p>We followed up with the participants after 11 years. By May 2020, 15,503 participants had died, of which 4,095 died from heart disease and 9,064 died from cancer.</p> <p><a href="https://doi.org/10.1136/bjsports-2021-104046">We found</a> that, compared to healthy sleepers, people with poor sleep had a 23% higher risk of premature death, a 39% higher risk of dying from heart disease, and a 13% higher risk of dying from cancer.</p> <p>We then compared the data of people who slept well with those who slept poorly, and how much they exercised. We found people who had the highest risk of dying from heart disease and cancer were those who had poor sleep and didn’t meet the WHO physical activity guidelines. On the other hand, those who had poor sleep but did enough physical activity to meet the WHO guidelines didn’t have as high a risk of dying from heart disease or cancer, compared to those who slept poorly and didn’t meet the physical activity guidelines.</p> <p>For example, let’s look at the risk of dying from cancer. Those who had poor sleep and did no physical activity had a 45% higher risk of dying from cancer compared to those who had healthy sleep and exercised a lot. But among those who met the physical activity guidelines, despite poor sleep, they didn’t really have a higher risk of dying from cancer any more.</p> <p>We found physical activity levels which met at least the bottom threshold of the WHO guidelines could reduce or eliminate some of the health harms of poor sleep. So people who did at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week were to some extent protected against the detrimental health effects of poor sleep.</p> <p>Those who had both poor sleep and did no moderate-to-vigorous intensity physical activity had the highest risks of premature death.</p> <p>Our study wasn’t designed to find out how and why physical activity may counteract some of the bad physiological impacts of poor sleep. But other research provides theories. For example, adequate physical activity may <a href="https://doi.org/10.1249/MSS.0000000000001179">reduce inflammation, help maintain a healthy glucose metabolism</a>, and <a href="https://doi.org/10.1016/j.pcad.2018.07.014">increase the number of calories burned</a>.</p> <p>It’s important to note our study was what’s called an “observational study”. It shows an association between adequate physical activity and reduced harms from poor sleep, but we must be careful in interpreting causation. It can’t conclusively say adequate physical activity <em>causes</em> the reduction of harms from poor sleep, though there’s strong evidence for an association in the right direction.</p> <p>Our study offers a hopeful message, that even if you haven’t been able to improve your sleep, you can still offset some of the health harms by doing enough exercise. <a href="https://www.sciencedirect.com/science/article/abs/pii/S009174352030339X">Our previous research</a> has also shown physical activity may help improve poor sleep patterns, which are a serious health problem across the world.</p> <p>In addition to combating some of the negative outcomes of poor sleep, physical activity can also provide many other health benefits and extend our lives. For example, a 2019 study found people who met WHO’s physical activity target above <a href="https://doi.org/10.1186/s12916-019-1339-0">lived three years longer on average</a> than those who didn’t.</p> <p>During lockdowns, access to parks, gyms, and swimming pools might be limited in many places. But there are still many ways to <a href="https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/stay-physically-active-during-self-quarantine">to stay fit and active at home during the coronavirus</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/163270/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, PhD candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/poor-sleep-is-really-bad-for-your-health-but-we-found-exercise-can-offset-some-of-these-harms-163270">original article</a>.</em></p> </div>

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Want to sleep longer? Adding mini-bursts of exercise to your evening routine can help

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jennifer-gale-1548741">Jennifer Gale</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a> and <a href="https://theconversation.com/profiles/meredith-peddie-1548807">Meredith Peddie</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a></em></p> <p>Exercising before bed has <a href="https://www.sciencedirect.com/science/article/pii/S2352721815000157">long been discouraged</a> as the body doesn’t have time to wind down before the lights go out.</p> <p>But <a href="https://bmjopensem.bmj.com/content/10/3/e001774">new research</a> has found breaking up a quiet, sedentary evening of watching television with short bursts of resistance exercise can lead to longer periods of sleep.</p> <p>Adults spend almost one third of the 24-hour day sleeping. But the quality and length of sleep can affect long-term health. Sleeping too little or waking often in the night is associated with an <a href="https://academic.oup.com/sleep/article-lookup/doi/10.5665/sleep.1382">increased risk of heart disease</a> and <a href="https://diabetesjournals.org/care/article/33/2/414/27149/Quantity-and-Quality-of-Sleep-and-Incidence-of">diabetes</a>.</p> <p>Physical activity during the day can help improve sleep. However, <a href="https://www.sciencedirect.com/science/article/pii/S2352721815000157">current recommendations</a> discourage intense exercise before going to bed as it can increase a person’s heart rate and core temperature, which can ultimately disrupt sleep.</p> <h2>Nighttime habits</h2> <p>For many, the longest period of uninterrupted sitting happens at home in the evening. People also usually consume their largest meal during this time (or snack throughout the evening).</p> <p>Insulin (the hormone that helps to remove sugar from the blood stream) tends to be at a lower level in the evening than in the morning.</p> <p>Together these factors promote elevated blood sugar levels, which over the long term can be bad for a person’s health.</p> <p>Our <a href="https://journals.lww.com/acsm-msse/fulltext/2023/08000/breaking_up_evening_sitting_with_resistance.14.aspx">previous research</a> found interrupting evening sitting every 30 minutes with three minutes of resistance exercise reduces the amount of sugar in the bloodstream after eating a meal.</p> <p>But because sleep guidelines currently discourage exercising in the hours before going to sleep, we wanted to know if frequently performing these short bursts of light activity in the evening would affect sleep.</p> <h2>Activity breaks for better sleep</h2> <p>In our latest research, we asked 30 adults to complete two sessions based in a laboratory.</p> <p>During one session the adults sat continuously for a four-hour period while watching streaming services. During the other session, they interrupted sitting by performing three minutes of body-weight resistance exercises (squats, calf raises and hip extensions) every 30 minutes.</p> <p>After these sessions, participants went home to their normal life routines. Their sleep that evening was measured using a wrist monitor.</p> <p>Our research found the quality of sleep (measured by how many times they woke in the night and the length of these awakenings) was the same after the two sessions. But the night after the participants did the exercise “activity breaks” they slept for almost 30 minutes longer.</p> <p>Identifying the biological reasons for the extended sleep in our study requires further research.</p> <p>But regardless of the reason, if activity breaks can extend sleep duration, then getting up and moving at regular intervals in the evening is likely to have clear health benefits.</p> <h2>Time to revisit guidelines</h2> <p>These results add to <a href="https://linkinghub.elsevier.com/retrieve/pii/S1087079221001209">earlier work</a> suggesting current sleep guidelines, which discourage evening exercise before bed, may need to be reviewed.</p> <p>As the activity breaks were performed in a highly controlled laboratory environment, future research should explore how activity breaks performed in real life affect peoples sleep.</p> <p>We selected simple, body-weight exercises to use in this study as they don’t require people to interrupt the show they may be watching, and don’t require a large space or equipment.</p> <p>If people wanted to incorporate activity breaks in their own evening routines, they could probably get the same benefit from other types of exercise. For example, marching on the spot, walking up and down stairs, or even dancing in the living room.</p> <p>The key is to frequently interrupt evening sitting time, with a little bit of whole-body movement at regular intervals.</p> <p>In the long run, performing activity breaks may improve health by improving sleep and post-meal blood sugar levels. The most important thing is to get up frequently and move the body, in a way the works best for a person’s individual household.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234896/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jennifer-gale-1548741">Jennifer Gale</a>, PhD candidate, Department of Human Nutrition, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a> and <a href="https://theconversation.com/profiles/meredith-peddie-1548807">Meredith Peddie</a>, Senior Lecturer, Department of Human Nutrition, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a></em></p> <p><em>Image </em><em>credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/want-to-sleep-longer-adding-mini-bursts-of-exercise-to-your-evening-routine-can-help-new-study-234896">original article</a>.</em></p> </div>

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Want the health benefits of strength training but not keen on the gym? Try ‘exercise snacking’

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/justin-keogh-129041">Justin Keogh</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jackson-fyfe-134774">Jackson Fyfe</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>The science is clear: <a href="https://cdnsciencepub.com/doi/full/10.1139/apnm-2020-0245">resistance training</a> is crucial to ageing well. Lifting weights (or doing bodyweight exercises like lunges, squats or push-ups) can help you live independently for longer, make your bones stronger, reduce your risk of diseases such as diabetes, and may even improve your <a href="https://pubmed.ncbi.nlm.nih.gov/28919335/">sleep and mental health</a>.</p> <p>But not everyone loves the gym. Perhaps you feel you’re not a “gym person” and never will be, or you’re too old to start. Being a gym-goer can be expensive and time-consuming, and some people report feeling <a href="https://www.reddit.com/r/StartingStrength/comments/j3hq32/unwelcome_feeling_at_the_gym/">unwelcome</a> or <a href="https://www.quora.com/I-feel-awkward-and-I-want-to-start-a-gym-but-could-not-What-should-I-do">awkward</a> at the gym.</p> <p>The good news is you don’t need the gym, or lots of free time, to get the health benefits resistance training can offer.</p> <p>You can try “exercise snacking” instead.</p> <h2>What is exercise snacking?</h2> <p>Exercise snacking involves doing multiple shorter bouts (as little as 20 seconds) of exercise throughout the day – often with minimal or no equipment. It’s OK to have <a href="https://doi.org/10.1007/s40279-021-01605-8">several hours of rest</a> between.</p> <p>You could do simple bodyweight exercises such as:</p> <ul> <li> <p>chair sit-to-stand (squats)</p> </li> <li> <p>lunges</p> </li> <li> <p>box step-ups</p> </li> <li> <p>calf raises</p> </li> <li> <p>push-ups.</p> </li> </ul> <p>Exercise snacking like this can help improve muscle mass, strength and physical function.</p> <p>It’s OK to hold onto a nearby object for balance, if you need. And doing these exercises regularly will also improve your balance. That, in turn, reduces your risk of falls and fractures.</p> <h2>OK I have done all those, now what?</h2> <p>Great! You can also try using resistance bands or dumbbells to do the previously mentioned five exercises as well as some of the following exercises:</p> <ul> <li> <p><a href="https://youtu.be/IP4wM2JpDdQ?si=1B1GyV_FY5rcArW8&amp;t=6">seated rows</a></p> </li> <li> <p><a href="https://youtu.be/G6GIffCaJCQ?si=RxXZtzMqQ0DGxF3k&amp;t=48">chest</a> and <a href="https://www.youtube.com/watch?v=TUnnz5i4Mnw&amp;t=5s">shoulder presses</a></p> </li> <li> <p><a href="https://youtu.be/z0omicIkYu4?si=8WffT3ij12SNTqEs">bicep curls</a></p> </li> <li> <p><a href="https://www.youtube.com/watch?v=5wXVnxBgLHo">knee extensions</a></p> </li> <li> <p><a href="https://www.youtube.com/watch?v=LtTcXXgeRYo">leg curls</a>.</p> </li> </ul> <p>When using resistance bands, make sure you hold them tightly and that they’re securely attached to an immovable object.</p> <p>Exercise snacking works well when you pair it with an activity you do often throughout the day. Perhaps you could:</p> <ul> <li> <p>do a few extra squats every time you get up from a bed or chair</p> </li> <li> <p>do some lunges during a TV ad break</p> </li> <li> <p>chuck in a few half squats while you’re waiting for your kettle to boil</p> </li> <li> <p>do a couple of elevated push-ups (where you support your body with your hands on a chair or a bench while doing the push-up) before tucking into lunch</p> </li> <li> <p>sneak in a couple of calf raises while you’re brushing your teeth.</p> </li> </ul> <h2>What does the evidence say about exercise snacking?</h2> <p>One <a href="https://pubmed.ncbi.nlm.nih.gov/31687210/">study</a> had older adults without a history of resistance training do exercise snacks at home twice per day for four weeks.</p> <p>Each session involved five simple bodyweight exercises (chair sit-to-stand, seated knee extension, standing knee bends, marching on the spot, and standing calf raises). The participants did each exercise continuously for one minute, with a one-minute break between exercises.</p> <p>These short and simple exercise sessions, which lasted just nine minutes, were enough to improve a person’s ability to stand up from a chair by 31% after four weeks (compared to a control group who didn’t exercise). Leg power and thigh muscle size improved, too.</p> <p>Research involving one of us (Jackson Fyfe) has also <a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-03207-z">shown</a> older adults found “exercise snacking” feasible and enjoyable when done at home either once, twice, or three times per day for four weeks.</p> <p>Exercise snacking may be a more sustainable approach to improve muscle health in those who don’t want to – or can’t – lift heavier weights in a gym.</p> <h2>A little can yield a lot</h2> <p>We know from other research that the more you exercise, the more likely it is you will <a href="https://www.sciencedirect.com/science/article/pii/S0167268119302586">keep exercising in future</a>.</p> <p>Very brief resistance training, albeit with heavier weights, may be more <a href="https://pubmed.ncbi.nlm.nih.gov/29975122/">enjoyable</a> than traditional approaches where people aim to do many, many sets.</p> <p>We also know brief-and-frequent exercise sessions can break up <a href="https://pubmed.ncbi.nlm.nih.gov/26378942/">periods</a> of sedentary behaviour (which usually means sitting too much). Too much sitting increases your risk of chronic diseases such as diabetes, whereas exercise snacking can help keep your <a href="https://pubmed.ncbi.nlm.nih.gov/36921112/">blood sugar levels steady</a>.</p> <p>Of course, longer-term studies are needed. But the evidence we do have suggests exercise snacking really helps.</p> <h2>Why does any of this matter?</h2> <p>As you age, you lose strength and mass in the muscles you use to walk, or stand up. Everyday tasks can become a struggle.</p> <p>All this <a href="https://pubmed.ncbi.nlm.nih.gov/36907247/">contributes</a> to disability, hospitalisation, chronic disease, and reliance on community and residential aged care support.</p> <p>By preserving your muscle mass and strength, you can:</p> <ul> <li> <p>reduce joint pain</p> </li> <li> <p>get on with activities you enjoy</p> </li> <li> <p>live independently in your own home</p> </li> <li> <p>delay or even eliminate the need for expensive health care or residential aged care.</p> </li> </ul> <h2>What if I walk a lot – is that enough?</h2> <p>Walking may maintain some level of lower body muscle mass, but it won’t preserve your <a href="https://pubmed.ncbi.nlm.nih.gov/38190393/">upper body muscles</a>.</p> <p>If you find it difficult to get out of a chair, or can only walk short distances without getting out of breath, resistance training is the best way to regain some of the independence and function you’ve lost.</p> <p>It’s even more important for women, as muscle mass and strength are typically lower in older women than men. And if you’ve been diagnosed with osteoporosis, which is more common in older women than men, resistance exercise snacking at home can improve your balance, strength, and bone mineral density. All of this reduces the risk of falls and fractures.</p> <p>You don’t need <a href="https://pubmed.ncbi.nlm.nih.gov/37171517/">heavy weights</a> or fancy equipment to benefit from resistance training.</p> <p>So, will you start exercise snacking today?<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/justin-keogh-129041">Justin Keogh</a>, Associate Dean of Research, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jackson-fyfe-134774">Jackson Fyfe</a>, Senior Lecturer, Strength and Conditioning Sciences, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/want-the-health-benefits-of-strength-training-but-not-keen-on-the-gym-try-exercise-snacking-232374">original article</a>.</em></p> </div>

Body

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Think you’ve decided what to buy? Actually, your brain is still deciding – even as you put it in your basket

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>You are standing in the cereal aisle, weighing up whether to buy a healthy bran or a sugary chocolate-flavoured alternative.</p> <p>Your hand hovers momentarily before you make the final grab.</p> <p>But did you know that during those last few seconds, while you’re reaching out, your brain is still evaluating the pros and cons – influenced by everything from your last meal, the health star rating, the catchy jingle in the ad, and the colours of the letters on the box?</p> <p>Our recently published <a href="https://www.nature.com/articles/s41598-024-62135-7">research</a> shows our brains do not just think first and then act. Even while you are reaching for a product on a supermarket shelf, your brain is still evaluating whether you are making the right choice.</p> <p>Further, we found measuring hand movements offers an accurate window into the brain’s ongoing evaluation of the decision – you don’t have to hook people up to expensive brain scanners.</p> <p>What does this say about our decision-making? And what does it mean for consumers and the people marketing to them?</p> <h2>What hand movements tell us about decision-making</h2> <p>There has been <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-psych-010419-051053">debate within neuroscience</a> on whether a person’s movements to enact a decision can be modified once the brain’s “motor plan” has been made.</p> <p>Our research revealed not only that movements can be changed after a decision – “in flight” – but also the changes matched incoming information from a person’s senses.</p> <p>To study <a href="https://doi.org/10.1038/s41598-024-62135-7">how our decisions unfold over time</a>, we tracked people’s hand movements as they reached for different options shown in pictures – for example, in response to the question “is this picture a face or an object?”</p> <p>When choices were easy, their hands moved straight to the right option. But when choices were harder, new information made the brain change its mind, and this was reflected in the trajectory of their hand movements.</p> <p>When we compared these hand movement trajectories to brain activity recorded using neuroimaging, we found that the timing and amount of evidence of the brain’s evaluation matched the movement pattern.</p> <p>Put simply, reaching movements are shaped by ongoing thinking and decision-making.</p> <p>By showing that brain patterns match movement trajectories, our research also highlights that large, expensive brain scanners may not always be required to study the brain’s decision evaluation processes, as movement tracking is much more cost-effective and much easier to test on a large scale.</p> <h2>What does this mean for consumers and marketers?</h2> <p>For consumers, knowing our brains are always reevaluating decisions we might think of as “final” can help us be more aware of our choices.</p> <p>For simple decisions such as choosing a breakfast cereal, the impact may be small. Even if you have preemptively decided on a healthy option, you might be tempted at the last minute by the flashy packaging of a less healthy choice.</p> <p>But for important long-term decisions such as choosing a mortgage, it can have serious effects.</p> <p>On the other side of the coin, marketers have long known that many purchase decisions are <a href="https://www.sciencedirect.com/science/article/pii/S0969698912000781">made on the spot</a>.</p> <p>They use strategies such as attractive packaging and strategic product placement to influence people’s decisions.</p> <p>New ways of studying how people’s brains process information – right up to the last minute – can help marketers design more effective strategies.</p> <h2>Opportunities for further research</h2> <p>Further research in this area could explore how different types of information, such as environmental cues or memories, affect this continuous decision evaluation process in different groups of people. For example, how do people of different ages process information while making decisions?</p> <p>Our finding – that hand movements reflect the inner workings of the brain’s decision making process – could make future studies cheaper and more efficient.</p> <p>The ability to fine-tune marketing in this way has implications beyond just selling products. It can also make public strategic messaging far more effective.</p> <p>This could include tailoring a public health campaign on vaping specifically for people aged under 30, or targeting messaging about superannuation scams more effectively at those of retirement age.</p> <p>The act of reaching for a product is not a simple consequence of a decision already made; it’s a highly dynamic process. Being aware of what influences our last-minute decision-making can help us make better choices that have better outcomes.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234167/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, Senior Research Fellow in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, Research Fellow, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, Associate Professor in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/think-youve-decided-what-to-buy-actually-your-brain-is-still-deciding-even-as-you-put-it-in-your-basket-234167">original article</a>.</em></p> </div>

Mind

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AFL great's son in induced coma after mystery brain infection

<p>Geelong great Peter Riccardi has revealed his son, Osca, was briefly put on life support after suffering a mystery infection on the brain. </p> <p>Speaking on the podcast Beyond The Boundary, the former AFL player revealed that his son became suddenly ill a fortnight ago. </p> <p>“A couple of Sundays ago (Osca) came home, been out with a few of his mates, he’d been to the beach, went out for dinner, went out to play 10-pin bowling ... and said he was going to bed,” Peter Riccardi said. </p> <p>“Then halfway through the night he was up, he was vomiting, he was feeling a bit crook ... we just thought he was run down.</p> <p>“But come lunchtime, he couldn’t talk, he could hardly walk.”</p> <p>He added that they were extremely lucky his wife Mel worked from home that day and rushed Osca straight to hospital, where they found some "swelling" on his brain following a scan. </p> <p>Doctors also found that he had a sinus and ear infection and glandular fever  all “rolled into one”.</p> <p>“Whether the swim did something with his ears and went into his brain, I’m not 100 per cent sure, yet,” Riccardi said.</p> <p>“They put him an induced coma for three days. He was in ICU (Intensive Care Unit) for four days.</p> <p>“But he’s back home now recovering ... you wouldn’t know that two weeks ago, watching him on life support, and seeing him now, it’s amazing what they do in there.”</p> <p>The podcast hosts then asked how scary the situation was for Riccardi and his wife, and he responded: “It was, yeah ... obviously they have got to prepare you for the worst (outcome)."</p> <p>“That was probably the worst thing to hear, because we didn’t know how he was going to come out of it.</p> <p>“But again, like I said, if Mel had gone to work that day, he wouldn’t be here today.</p> <p>“We’re pretty lucky, we’re pretty lucky.</p> <p>“It must have been a mother’s intuition or mother’s instinct to stay at home that day.”</p> <p><em>Image: Facebook/ Geelong Cats</em></p>

Caring

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What are compound exercises and why are they good for you?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mandy-hagstrom-1180806">Mandy Hagstrom</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/anurag-pandit-1534963">Anurag Pandit</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>So you’ve got yourself a gym membership or bought a set of home weights. Now what? With the sheer amount of confusing exercise advice out there, it can be hard to decide what to include in a weights routine.</p> <p>It can help to know there are broadly two types of movements in resistance training (lifting weights): compound exercises and isolation exercises.</p> <p>So what’s the difference? And what’s all this got to do with strength, speed and healthy ageing?</p> <h2>What’s the difference?</h2> <p>Compound exercises involve multiple joints and muscle groups working together.</p> <p>In a push up, for example, your shoulder and elbow joints are moving together. This targets the muscles in the chest, shoulder and triceps.</p> <p>When you do a squat, you’re using your thigh and butt muscles, your back, and even the muscles in your core.</p> <p>It can help to think about compound movements by grouping them by primary movement patterns.</p> <p>For example, some lower body compound exercises follow a “squat pattern”. Examples include bodyweight squats, weighted squats, lunges and split squats.</p> <p>We also have “hinge patterns”, where you hinge from a point on your body (such as the hips). Examples include deadlifts, hip thrusts and kettle bell swings.</p> <p>Upper body compounded exercises can be grouped into “push patterns” (such as vertical barbell lifts) or “pull patterns” (such as weighted rows, chin ups or lat pull downs, which is where you use a pulley system machine to lift weights by pulling a bar downwards).</p> <p>In contrast, isolation exercises are movements that occur at a single joint.</p> <p>For instance, bicep curls only require movement at the elbow joint and work your bicep muscles. Tricep extensions and lateral raises are other examples of isolation exercises.</p> <h2>Compound exercises can make daily life easier</h2> <p>Many compound exercises mimic movements we do every day.</p> <p>Hinge patterns mimic picking something off the floor. A vertical press mimics putting a heavy box on a high shelf. A squat mimics standing up from the couch or getting on and off the toilet.</p> <p>That might sound ridiculous to a young, fit person (“why would I need to practise getting on and off a toilet?”).</p> <p>Unfortunately, we lose strength and muscle mass as we age. Men lose about <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2012.00260/full">5%</a> of their muscle mass per decade, while for women the figure is about <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2012.00260/full">4%</a> per decade.</p> <p>When this decline begins can vary widely. However, approximately 30% of an adult’s peak muscle mass is lost by the time they are 80.</p> <p>The good news is resistance training can counteract these <a href="https://journals.lww.com/nsca-jscr/fulltext/2019/08000/resistance_training_for_older_adults__position.1.aspx">age-related changes</a> in muscle size and strength.</p> <p>So building strength through compound exercise movements may help make daily life feel a bit easier. In fact, our ability to perform compound movements are a good indicator how well we can function <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1442-2018.2007.00317.x">as we age</a>.</p> <h2>What about strength and athletic ability?</h2> <p>Compound exercises use multiple joints, so you can generally lift heavier weights than you could with isolation exercises. Lifting a heavier weight means you can build muscle strength more efficiently.</p> <p>One <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2017.01105/full">study</a> divided a group of 36 people into two. Three times a week, one group performed isolation exercises, while the other group did compound exercises.</p> <p>After eight weeks, both groups had lost fat. But the compound exercises group saw much better results on measures of cardiovascular fitness, bench press strength, knee extension strength, and squat strength.</p> <p>If you play a sport, compound movements can also help boost athletic ability.</p> <p>Squat patterns require your hip, knee, and ankle to extend at the same time (also known as triple extension).</p> <p>Our bodies use this triple extension trick when we run, sprint, jump or change direction quickly. In fact, research has found squat strength is strongly linked to being able to <a href="https://bjsm.bmj.com/content/38/3/285.short?casa_token=hQDvLoU1GWYAAAAA:bx5DqM5HevN8AJpVLOWN5KlNKgqYubTysTvl5dqYr8855acTxNgf4QEmPELWU1hzL6HG9ZezysFQ">sprint faster and jump higher</a>.</p> <h2>Isolation exercises are still good</h2> <p>What if you’re unable to do compound movements, or you just don’t want to?</p> <p>Don’t worry, you’ll still build strength and muscle with isolation exercises.</p> <p>Isolation exercises are also typically <a href="https://www.sciencedirect.com/science/article/pii/S0079612303430033">easier to learn</a> as there is no skill required. They are an easy and low risk way to add extra exercise at the end of the workout, where you might otherwise be too tired to do more compound exercises safely and with correct form.</p> <p>In fact, both isolation and compound exercises seem to be equally effective in helping us <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2017.01105/full">lose body fat and increase fat-free muscle mass</a> when total intensity and volume of exercises are otherwise equal.</p> <p>Some people also do isolation exercises when they want to build up a particular muscle group for a certain sport or for a bodybuilding competition, for example.</p> <h2>I just want a time efficient workout</h2> <p>Considering the above factors, you could consider prioritising compound exercises if you’re:</p> <ul> <li> <p>time poor</p> </li> <li> <p>keen to lift heavier weights</p> </li> <li> <p>looking for an efficient way to train many muscles in the one workout</p> </li> <li> <p>interested in healthy ageing.</p> </li> </ul> <p>That said, most well designed workout programs will include both compound and isolation movements.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228385/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mandy-hagstrom-1180806">Mandy Hagstrom</a>, Senior Lecturer, Exercise Physiology. School of Health Sciences, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/anurag-pandit-1534963">Anurag Pandit</a>, PhD Candidate in Exercise Physiology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">original article</a>.</em></p> </div>

Body

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Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>With so many high-profile people <a href="https://www.theguardian.com/uk-news/2024/mar/23/cancer-charities-princess-of-wales-speaking-about-diagnosis">diagnosed with cancer</a> we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are <a href="https://www.cancer.org/research/acs-research-news/facts-and-figures-2024.html">increasing among younger people</a> in their 30s and 40s.</p> <p>On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are <a href="https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21763">improving greatly</a> and some cancers are now being managed more as <a href="https://www.cancer.org/cancer/survivorship/long-term-health-concerns/cancer-as-a-chronic-illness.html">long-term chronic diseases</a> rather than illnesses that will rapidly claim a patient’s life.</p> <p>The <a href="https://www.cancer.org/cancer/managing-cancer/treatment-types.html">mainstays of cancer treatment</a> remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment.</p> <h2>Keep moving if you can</h2> <p>Physical exercise is now recognised as a <a href="https://www.exerciseismedicine.org/">medicine</a>. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where <a href="https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.884">cancer is less likely to flourish</a>. It does this in a number of ways.</p> <p>Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue <a href="https://jitc.bmj.com/content/9/7/e001872">to identify and kill cancer cells</a>.</p> <p>Our skeletal muscles (those attached to bone for movement) release signalling molecules called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288608/">myokines</a>. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells <a href="https://www.sciencedirect.com/science/article/pii/S2095254623001175">slowing their growth and causing cell death</a>.</p> <p>Exercise can also greatly <a href="https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.884">reduce the side effects of cancer treatment</a> such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of <a href="https://doi.org/10.2337/diacare.27.7.1812">developing other chronic diseases</a> such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health <a href="https://www.hindawi.com/journals/tbj/2022/9921575/">for patients with cancer</a>.</p> <p>Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as <a href="https://aacrjournals.org/cancerres/article/81/19/4889/670308/Effects-of-Exercise-on-Cancer-Treatment-Efficacy-A">chemotherapy</a> and <a href="https://www.nature.com/articles/s41391-020-0245-z">radiation therapy</a>. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then <a href="https://www.jsams.org/article/S1440-2440(18)31270-2/fulltext">rehabilitating them after surgery</a>.</p> <p>These mechanisms explain why cancer patients who are physically active have much <a href="https://journals.lww.com/acsm-msse/fulltext/2019/06000/physical_activity_in_cancer_prevention_and.20.aspx">better survival outcomes</a> with the relative risk of death from cancer <a href="https://journals.lww.com/acsm-msse/fulltext/2019/06000/physical_activity_in_cancer_prevention_and.20.aspx">reduced by as much as 40–50%</a>.</p> <h2>Mental health helps</h2> <p>The second “tool” which has a major role in cancer management is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016045/">psycho-oncology</a>. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships.</p> <p>Supporting quality of life and happiness is important on their own, but these barometers <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1349880/full">can also impact</a> a patient’s physical health, response to exercise medicine, resilience to disease and to treatments.</p> <p>If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression <a href="https://www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet">through hormonal and inflammatory mechanisms</a>. So it’s essential their mental health is supported.</p> <h2>Putting the good things in: diet</h2> <p>A third therapy in the supportive cancer care toolbox is diet. A healthy diet <a href="https://www.cancer.org/cancer/survivorship/coping/nutrition/benefits.html">can support the body</a> to fight cancer and help it tolerate and recover from medical or surgical treatments.</p> <p>Inflammation provides a more fertile environment <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2022/reducing-inflammation-to-treat-cancer">for cancer cells</a>. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This <a href="https://www.frontiersin.org/articles/10.3389/fnut.2021.709435/full">generally means</a> avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based.</p> <p>Muscle loss is <a href="https://onlinelibrary.wiley.com/doi/10.1002/rco2.56">a side effect of all cancer treatments</a>. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so <a href="https://www.sciencedirect.com/science/article/pii/S0261561421005422">supplementation may be indicated</a>.</p> <p>Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233663/">cachexia and needs careful management</a>.</p> <p>Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes).</p> <h2>Working as a team</h2> <p>These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients.</p> <p>If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support.</p> <p>For exercise medicine support it is best to consult with an <a href="https://www.essa.org.au/Public/Public/Consumer_Information/What_is_an_Accredited_Exercise_Physiologist_.aspx">accredited exercise physiologist</a>, for diet therapy an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a> and mental health support with a <a href="https://psychology.org.au/psychology/about-psychology/what-is-psychology">registered psychologist</a>. Some of these services are supported through Medicare on referral from a general practitioner.</p> <hr /> <p><em>For free and confidential cancer support call the <a href="https://www.cancer.org.au/support-and-services/cancer-council-13-11-20">Cancer Council</a> on 13 11 20.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226720/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, Professor of Exercise Medicine, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/exercise-therapy-and-diet-can-all-improve-life-during-cancer-treatment-and-boost-survival-heres-how-226720">original article</a>.</em></p> </div>

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After 180 years, new clues are revealing just how general anaesthesia works in the brain

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773932/pdf/BLT.15.159293.pdf/">Over 350 million surgeries</a> are performed globally each year. For most of us, it’s likely at some point in our lives we’ll have to undergo a procedure that needs general anaesthesia.</p> <p>Even though it is one of the safest medical practices, we still don’t have a complete, thorough understanding of precisely how anaesthetic drugs work in the brain.</p> <p>In fact, it has largely remained a mystery since general anaesthesia was introduced into medicine over <a href="https://www.tandfonline.com/doi/full/10.3109/08941939.2015.1061826">180 years ago</a>.</p> <p>Our study published <a href="https://doi.org/10.1523/JNEUROSCI.0588-23.2024">in The Journal of Neuroscience today</a> provides new clues on the intricacies of the process. General anaesthetic drugs seem to only affect specific parts of the brain responsible for keeping us alert and awake.</p> <h2>Brain cells striking a balance</h2> <p>In a study using fruit flies, we found a potential way that allows anaesthetic drugs to interact with specific types of neurons (brain cells), and it’s all to do with proteins. Your brain has around <a href="https://onlinelibrary.wiley.com/doi/10.1002/cne.21974">86 billion neurons</a> and not all of them are the same – it’s these differences that allow general anaesthesia to be effective.</p> <p>To be clear, we’re not completely in the dark on <a href="https://linkinghub.elsevier.com/retrieve/pii/S0165614719300951">how anaesthetic drugs affect us</a>. We know why general anaesthetics are able to make us lose consciousness so quickly, thanks to a <a href="https://www.nature.com/articles/367607a0">landmark discovery made in 1994</a>.</p> <p>But to better understand the fine details, we first have to look to the minute differences between the cells in our brains.</p> <p>Broadly speaking, there are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591655/">two main categories of neurons in the brain</a>.</p> <p>The first are what we call “excitatory” neurons, generally responsible for keeping us alert and awake. The second are “inhibitory” neurons – their job is to regulate and control the excitatory ones.</p> <p>In our day-to-day lives, excitatory and inhibitory neurons are constantly working and balancing one another.</p> <p><a href="https://www.nature.com/articles/npp2017294">When we fall asleep</a>, there are inhibitory neurons in the brain that “silence” the excitatory ones keeping us awake. This happens <a href="https://askdruniverse.wsu.edu/2018/01/07/why-do-we-get-tired/">gradually over time</a>, which is why you may feel progressively more tired through the day.</p> <p>General anaesthetics speed up this process by directly silencing these excitatory neurons without any action from the inhibitory ones. This is why your anaesthetist will tell you that they’ll “put you to sleep” for the procedure: <a href="https://www.nature.com/articles/nrn2372">it’s essentially the same process</a>.</p> <h2>A special kind of sleep</h2> <p>While we know why anaesthetics put us to sleep, the question then becomes: “why do we <em>stay</em> asleep during surgery?”. If you went to bed tonight, fell asleep and somebody tried to do surgery on you, you’d wake up with quite a shock.</p> <p>To date, there is no strong consensus in the field as to why general anaesthesia causes people to remain unconscious during surgery.</p> <p>Over the last couple of decades, researchers have proposed several potential explanations, but they all seem to point to one root cause. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709148/#:%7E:text=At%20presynaptic%20part%2C%20voltage%2Dgated,anesthetics%20to%20inhibiting%20neurotransmitter%20release.">Neurons stop talking to each other</a> when exposed to general anaesthetics.</p> <p>While the idea of “cells talking to each other” may sound a little strange, it’s a <a href="https://qbi.uq.edu.au/brain-basics/brain/brain-physiology/action-potentials-and-synapses">fundamental concept in neuroscience</a>. Without this communication, our brains wouldn’t be able to function at all. And it allows the brain to know what’s happening throughout the body.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=3 2262w" alt="Two branching structures in orange, green, blue and yellow colours on a black background." /></a><figcaption><span class="caption">Colourised neurons in the brain of a fly.</span> <span class="attribution"><span class="source">Adam Hines</span></span></figcaption></figure> <h2>What did we discover?</h2> <p>Our new study shows that general anaesthetics appear to stop excitatory neurons from communicating, but not inhibitory ones. <a href="https://www.jneurosci.org/content/40/21/4103">This concept isn’t new</a>, but we found some compelling evidence as to <em>why</em> only excitatory neurons are affected.</p> <p>For neurons to communicate, proteins have to get involved. One of the jobs these proteins have is to get neurons to release molecules called <a href="https://my.clevelandclinic.org/health/articles/22513-neurotransmitters">neurotransmitters</a>. These chemical messengers are what gets signals across from one neuron to another: dopamine, adrenaline and serotonin are all neurotransmitters, for example.</p> <p>We found that general anaesthetics impair the ability of these proteins to release neurotransmitters, but only in excitatory neurons. To test this, we used <a href="https://www.eneuro.org/content/8/3/ENEURO.0057-21.2021"><em>Drosophila melanogaster</em> fruit flies</a> and <a href="https://imb.uq.edu.au/research/facilities/microscopy/training-manuals/microscopy-online-resources/image-capture/super-resolution-microscopy">super resolution microscopy</a> to directly see what effects a general anaesthetic was having on these proteins at a molecular scale.</p> <p>Part of what makes excitatory and inhibitory neurons different from each other is that they <a href="https://journals.physiology.org/doi/full/10.1152/physrev.00007.2012">express different types of the same protein</a>. This is kind of like having two cars of the same make and model, but one is green and has a sports package, while the other is just standard and red. They both do the same thing, but one’s just a little bit different.</p> <p>Neurotransmitter release is a complex process involving lots of different proteins. If one piece of the puzzle isn’t exactly right, then general anaesthetics won’t be able to do their job.</p> <p>As a next research step, we will need to figure out which piece of the puzzle is different, to understand why general anaesthetics only stop excitatory communication.</p> <p>Ultimately, our results hint that the drugs used in general anaesthetics cause massive global inhibition in the brain. By silencing excitability in two ways, these drugs put us to sleep and keep it that way.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229713/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, Research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/after-180-years-new-clues-are-revealing-just-how-general-anaesthesia-works-in-the-brain-229713">original article</a>.</em></p> </div>

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