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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"><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a> 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. 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>. 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>. A number of physical changes with aging often go unseen preceding falls, including muscle weakness, decreased balance and changes in vision. 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&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. <h2>Why aging leads to increased risk of falls</h2> 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. 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. <figure><iframe src="https://www.youtube.com/embed/ztPbKP68P2Q?wmode=transparent&start=24" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Some straightforward measures to improve the safety of the home environment for older adults can significantly lower the risk of falls.</figcaption></figure> Based on my experience, here are some common reasons older adults may experience falls: 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. Second, older adults often have chronic conditions such as arthritis, Parkinson’s disease or diabetes that can affect their mobility, coordination and overall stability. 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. 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>. Older adults who lead a sedentary lifestyle or have limited physical activity may also experience reduced strength, flexibility and balance. And finally, such conditions as dementia or Alzheimer’s disease can affect judgment, attention and spatial awareness, leading to increased fall risk. <h2>Theories of aging</h2> 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. 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. 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>. 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. <h2>Fall prevention</h2> 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. 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: <ol> <li> 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>. </li> <li> 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>. </li> <li> 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>. </li> <li> 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. </li> <li> 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. </li> <li> 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. </li> </ol> 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.<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" /> <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> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/balance-declines-with-age-but-exercise-can-help-stave-off-some-of-the-risk-of-falling-204174">original article</a>. </div>

Body

These 12 things can reduce your dementia risk – but many Australians don’t know them all

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/joyce-siette-1377445">Joyce Siette</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/laura-dodds-1378067">Laura Dodds</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Dementia is a <a href="https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/jan-may-2022">leading</a> cause of death in Australia. Although dementia mainly affects older people, it is an avoidable part of ageing. In fact, we all have the power to reduce our risk of developing dementia, no matter your age. Research shows your risk of developing dementia could be <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduced by up to 40%</a> (and even higher if you live in a <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30074-9/fulltext">low or middle-income country</a>) by addressing lifestyle factors such as healthy diet, exercise and alcohol consumption. But the first step to reducing population-wide dementia risk is to understand how well people understand the risk factors and the barriers they may face to making lifestyle changes. Our new <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">paper</a>, published this week in the <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">Journal of Ageing and Longevity</a>, found most older people are aware that dementia is a modifiable condition and that they have the power to change their dementia risk. We also found the key barrier to making brain healthy lifestyle choices was a lack of knowledge, which suggests a public awareness campaign is urgently needed. <h2>What we did</h2> We began by <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">reviewing</a> the published research to identify 12 factors shown to reduce dementia risk. We surveyed 834 older Australians about their awareness of the 12 factors, which were: <ol> <li>having a mentally active lifestyle</li> <li>doing physical activity</li> <li>having a healthy diet</li> <li>having strong mental health</li> <li>not smoking</li> <li>not consuming alcohol</li> <li>controlling high blood pressure</li> <li>maintaining a healthy weight</li> <li>managing high cholesterol</li> <li>preventing heart disease</li> <li>not having kidney disease</li> <li>not having diabetes</li> </ol> <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">The Lancet</a> subsequently published its own list of factors that help reduce dementia risk, which covered much the same territory (but included a few others, such as reducing air pollution, treating hearing impairment and being socially engaged). Of course, there is no way to cut your dementia risk to zero. Some people do all the “right” things and still get dementia. But there is <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">good evidence</a> managing lifestyle factors help make it less likely you will get dementia over your lifetime. Our study shows many older Australians are quite aware, with over 75% able to correctly identify more than four of the factors in our list of 12. However, few were able to name the less well-known risk factors, such as preventing heart disease and health conditions like kidney disease. The good news is that close to half of the sample correctly identified more than six of the 12 protective factors, with mentally active lifestyle, physical activity and healthy diet in the top three spots. <h2>Two key issues</h2> Two things stood out as strongly linked with the ability to identify factors influencing dementia risk. Education was key. People who received more than 12 years of formal schooling were more likely to agree that dementia was a modifiable condition. We are first exposed to health management in our school years and thus more likely to form healthier habits. Age was the other key factor. Younger respondents (less than 75 years old) were able to accurately identify more protective factors compared to older respondents. This is why health promotion initiatives and public education efforts about dementia are vital (such as Dementia Awareness Month and <a href="https://www.memorywalk.com.au/">Memory, Walk and Jog initiatives</a>). <h2>How can these findings be used in practice?</h2> Our findings suggest we need to target education across the different age groups, from children to older Australians. This could involve a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/ajag.13049">whole system approach</a>, from programs targeted at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858574/#:%7E:text=Family%20Coaching%20has%20specific%20goals,to%20problem%20solve%20challenging%20situations.">families</a>, to educational sessions for school-aged children, to involving GPs in awareness promotion. We also need to tackle barriers that hinder dementia risk reduction. This means doing activities that motivate you, finding programs that suit your needs and schedule, and are accessible. <h2>What does this mean for you?</h2> Reducing your dementia risk means recognising change starts with you. We are all familiar with the everyday challenges that stop us from starting an exercise program or sticking to a meal plan. There are simple and easy changes we can begin with. Our team has developed a program that can help. We are offering limited <a href="https://www.brainbootcamp.com.au/">free brain health boxes</a>, which include information resources and physical items such as a pedometer. These boxes aim to help rural Australians aged 55 years and over to adopt lifestyle changes that support healthy brain ageing. If you’re interested in signing up, visit our <a href="https://www.brainbootcamp.com.au">website</a>. Now is the time to think about your brain health. Let’s start now.<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/191504/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joyce-siette-1377445">Joyce Siette</a>, Research Theme Fellow, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/laura-dodds-1378067">Laura Dodds</a>, PhD Candidate, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/these-12-things-can-reduce-your-dementia-risk-but-many-australians-dont-know-them-all-191504">original article</a>. </div>

Mind

Bunnings' unexpected visitor sparks sad discussion

A kangaroo has been spotted hopping around a Bunnings Warehouse, with many locals thinking the lost mammal could highlight a much bigger problem. Shoppers in Western Australia's Albany Bunnings were greeted by the "unusual customer", who was filmed roaming the outdoor furniture section before stopping to take in its surroundings. A woman captured the scenes and shared the video online, captioning the post, "Looking for a new outdoor setting. Pouch was checked on the way out." While many couldn't help but be amused at the hoppy shopper, others noted the "sad" issue likely contributing to its "bizarre" appearance. <div> <div id="sda-INARTICLE"></div> </div> "So sad, poor baby, where's his habitat gone? "one questioned. "Poor guy," another expressed. "Aww it must be frightened," another pointed out. Bunnings confirmed the recent incident to <a href="https://au.news.yahoo.com/unexpected-bunnings-visitor-highlights-sad-trend-poor-guy-053209942.html" target="_blank" rel="noopener">Yahoo News</a>, as Bunnings Regional Manager Danielle Walker said, "Our Albany store had an unexpected visitor early Monday morning when a kangaroo hopped in via our drive-through area." "We thank our team for their assistance in quickly ushering the kangaroo out safely and helping to keep customers shopping with us at a distance". It's not clear how long the animal was inside the store. The Bunnings incident is not the first time in the last few months that kangaroos have been spotted in unusual places, as the animals are increasingly being squeezed out as developers build housing that’s needed for the human population. The habitat loss is thought to be contributing to animals ending up in seemingly random places with nowhere to go. Image credits: Facebook

Travel Trouble

Readers response: Have you picked up any new skills or learned something unexpected since retiring?

When many of us retire and our time is now fully our own, some people use this time to pick up a new skill or hobby they've always wanted to try. We asked our readers if they have picked up any new skills since retiring, and the response was overwhelming. Here's what they said. Marion Thompson - Cycling, travelling and watercolour art. Dee Douglas - How to take a walk and look at everything with new eyes rather than a head filled with work issues. Margaret Mason - Line dancing and croquet since moving in the last 18 months. I have actually been retired for 18 years and in that time also learnt some New Testament Greek. Yvonne Cooper - Spoon carving and wood work. Loving it! Glenn Azlin - Competed Certificate III Applied Languages (Mandarin). Anne O'Donohue - How to take all week to do the chores I could do in a day. Helen Morgan - It turns out I am very good at doing nothing, a real expert! Sheila Ball - Taking time to read a book. Image credits: Shutterstock

Retirement Life

Readers response: What’s the most unexpected thing you’ve learned about yourself through travel?

When it comes to travelling, it's not uncommon to have revelations about yourself while self-reflecting in a new place. We asked our readers what the most unexpected thing they've learned about themselves is through travel, and the response was overwhelming. Here's what they said. Penny Corbin - I don't need the cathedrals, monuments, the tours, I just love walking in the space and finding my own beauty wherever it leads me. Dom Cimino - That I really love meeting people of all backgrounds. Jenny Halkett - To treat it as an adventure, and don’t be afraid to ask a qualified person for advice. Kristeen Collison - That I’m more adventurous than I thought. Angie Jansen - That I love it. Just new places, culture, food, history, the wonderful people, the adventures you have and the memories, it’s the experiencing new things and learning, exploring, being amazed. Just so grateful I can still do it. Palma Hemer - To have a sense of humour, rain hail or shine. Anne Jenkin - That I can enjoy the travel by myself but I do like meeting new people on these trips. Kath Sheppard - To try to learn basic phrases when travelling. It's definitely appreciated. Kerry Fischer - Soak up the vibe wherever you are! Every place has beauty! Jacqueline Buchanan - That a smile speaks many languages. Martin Drake - That there is just too much to see and not enough time. Image credits: Shutterstock

Travel Tips

Are common heartburn products putting your health at risk?

Proton Pump Inhibitors (PPIs) such as products like Nexium and Somac have long been the go-to treatment for reflux, indigestion, and other gastric acid-related conditions. However, the long-term use of PPIs has sparked growing concern over their safety, leading to class action lawsuits in the U.S. and now most recently, in Australia. A prominent legal firm in Australia is exploring a potential class action against makers of common heartburn drugs, for failing to disclose the long-term health risks associated with Proton Pump Inhibitors (PPIs). The lawsuit brings to light the potential side effects linked to prolonged PPI use including kidney disease, bone fractures, further gastric issues and cancer. Channel 9 news reported “Pharmaceutical giant AstraZeneca settled a US lawsuit late last year, paying $630 million to almost 19,000 patients who claimed two proton pump inhibitors – Nexium and Prilosec (marketed as Losec in Australia) – caused their chronic kidney disease.” (<a href="https://www.9news.com.au/national/legal-firm-eyes-potential-class-action-over-common-heartburn-drugs-used-by-millions-of-aussies/95cbe77b-22f9-402d-ae46-132a52e53dd1" target="_blank" rel="noopener">see the full article here</a>) With millions of Australians relying on these medications for relief, growing awareness of these risks is prompting patients to explore safer alternatives to managing gastric health. Safer Alternatives Available Amid this shift, attention has turned to <a href="https://www.raydel.com.au/shop" target="_blank" rel="noopener">Raydel Abexol</a> 50mg, a gentler and safer alternative to supporting digestive and gastric health. Raydel Abexol contains the active ingredient of beeswax alcohols; clinically supported long chain alcohols that have been extracted and purified from bees wax. As a crucial distinction from PPIs, which suppress the body’s natural acid production and disrupt gastric processes, beeswax alcohols work through anti-inflammatory and antioxidant pathways, promoting the protection and repair of the stomach lining without interfering with gastric acid production. <img src="https://oversixtydev.blob.core.windows.net/media/2024/07/RAYDEL-Abexol2_1280.jpg" alt="" width="1280" height="716" /> Registered with the Therapeutic Goods Administration of Australia (TGA), Abexol is indicated to relieve symptoms of indigestion, heartburn and abdominal discomfort while also supporting overall improved gastrointestinal health. Additionally, Abexol also reinforces the gastric mucosa, helping to fortify the stomach lining against triggers such as stress and nonsteroidal anti-inflammatory drugs (NSAIDs). This protective effect supports the stomach’s resilience in the face of these irritants. As the conversation around PPI safety continues to grow, Raydel Abexol represents a promising solution for those seeking to support their gastric health without the risks associated with prolonged use of proton pump inhibitors. Beeswax alcohols present a solution that supports the stomach’s natural healing and protective processes without the risks tied to acid suppression. If you would like to experience the benefits of Abexol, Beeswax Alcohols, Raydel is offering 15% off to first time customers. To find out more, <a href="https://www.raydel.com.au/shop" target="_blank" rel="noopener">click here</a> and use the code: OSABEXOL to redeem offer. Also available at select pharmacies <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;">Images: Supplied <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 0px; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;">This is a sponsored article produced in partnership with Raydel.

Caring

More Australians are using their superannuation for medical procedures. But that might put their financial health at risk

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> A record number of Australians are accessing their superannuation early on compassionate grounds, mainly to fund their own medical procedures – or those of a family member. Some 150,000 Australians have used the scheme in the last five years. Nearly 40,000 people <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/early-release/compassionate-release-of-super">had applications approved</a> in 2022-23, compared to just under 30,000 in 2018-19 – an increase of 47%. Some people think this flexible use of funds is a good way to ensure people can fund their own medical needs. But more transparency and better oversight is needed. <h2>What are compassionate grounds?</h2> Since July 2018, the Australian Tax Office has administered the early release of superannuation – meaning before <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/super-withdrawal-options#Preservationage">retirement</a> – under certain circumstances, including compassionate grounds. <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/early-access-to-super/access-on-compassionate-grounds/expenses-eligible-for-release-on-compassionate-grounds">Compassionate grounds</a> for you or your dependant (such as child or spouse) are: <ul> <li>medical treatment or transport</li> <li>modifying your home or vehicle to accommodate special needs for a severe disability</li> <li>palliative care for a terminal illness</li> <li>death, funeral or burial expenses</li> <li>preventing foreclosure or forced sale of your home.</li> </ul> The medical treatment must be for a life-threatening illness or injury, or to alleviate acute or chronic pain, or acute or chronic mental illness. The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded. You also have to prove you cannot afford to pay part or all of the expenses without accessing your super, for example, by spending your savings, selling assets or getting a loan. People who can access other funding for the expense, such as via the <a href="https://theconversation.com/lists-of-eligible-supports-could-be-a-backwards-step-for-the-ndis-and-people-with-disability-236578">National Disability Insurance Scheme</a>, are ineligible. <h2>Why are people using this scheme more?</h2> The ATO has not explained what is driving the surge. General cost-of-living pressures may play a role. People may have fewer savings to draw on for medical procedures. But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues. There have long been issues with IVF and <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086#:%7E:text=The%20real%20reason%20dental%20hasn,has%20a%20structural%20budget%20problem.">dental care</a> not being readily available or funded in the public health system. Weight loss surgeries (including <a href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258">bariatric surgery</a>) can help combat potentially life-threatening conditions such as heart disease. Recent <a href="https://www.monash.edu/news/articles/fewer-australians-having-bariatric-surgery-monash-university-led-report">research</a> suggests there has been an overall drop in the number of Australians having bariatric surgeries since 2016. But of those, 95% are performed through the private system. While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated. <h2>Lack of clarity</h2> As my co-author and I <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2021/06/Issue-442-PDF-3-Bhatia-and-Porceddu.pdf">have shown</a>, the vague wording of the <a href="https://www.legislation.gov.au/F1996B00580/2022-09-28/text">Superannuation Industry regulations</a> leaves them worryingly open to interpretation. For example, the meaning of “mental disturbance” is not defined. You may not meet the criteria of having an acute or life-threatening illness, or acute or chronic pain. But if you can show a certain condition causes you acute mental disturbance, you may qualify to release your superannuation early. People accessing their superannuation for IVF use this criterion, for example, by arguing they need to access funds to continue treatment and alleviate the acute mental distress caused by ongoing infertility issues. Two registered medical practitioners are each required to submit a report demonstrating the treatment is needed, and one must be a specialist in the field in which the treatment is required. However, the regulations do not specify clearly that the specialist should have relevant qualifications. In the IVF example, this means the specialist opinion can be provided by a fertility doctor rather than a mental health expert – and that person may stand to profit if they later also provide treatment. <h2>A closed-loop system</h2> Conflict of interest is another major issue. There is nothing in the regulations to stop a medical practitioner – such as a dentist – being involved in all steps and then financially benefiting. They could encourage a patient to access superannuation for a treatment, write the specialist report and then also receive payment for the treatment. Some clinics <a href="https://www.theguardian.com/australia-news/2024/apr/06/online-ads-promote-simple-access-to-super-to-pay-for-healthcare-despite-strict-rules">promote</a> accessing superannuation as an option to pay for expensive treatments. This raises important questions about the independence of the process, as well as professional ethics. Medical practitioners making recommendations for early release of superannuation should be doing so on genuinely compassionate grounds. But the potential for exploitation remains an ethical concern, when a practitioner can financially benefit from recommending early access to nest egg funds. Transparency around potential <a href="https://theconversation.com/people-are-using-their-super-to-pay-for-ivf-with-their-fertility-clinics-blessing-thats-a-conflict-of-interest-161278">conflicts of interest</a> are impossible to ensure without proper oversight. <h2>What is needed?</h2> 1. Mandatory financial counselling The ATO <a href="https://www.theage.com.au/healthcare/worrying-trend-record-number-of-australians-raid-super-to-fund-medical-treatments-20240920-p5kc44.html">has warned</a> accessing super early is not “free money”, with a spokesperson urging people to get financial advice. But the law should go a step further and make this compulsory. That way people making decisions during an emotionally charged moment can understand any future implications. 2. Tightening of the criteria Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited. 3. Better oversight Less health-care industry involvement would promote greater transparency and independence. An independent body of medical practitioners could assess applications rather than practitioners who could financially benefit if applications are approved. This would help alleviate perceived and actual conflicts of interest. Accessing superannuation early may be the only option for some people to start a family or access other life-changing medical care. But they should be able to make this decision in a fully informed way, safeguarded from exploitation and aware of the implications for their future.<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/239588/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/more-australians-are-using-their-superannuation-for-medical-procedures-but-that-might-put-their-financial-health-at-risk-239588">original article</a>. </div>

Money & Banking

Does intermittent fasting increase or decrease our risk of cancer?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a> Research over the years has suggested intermittent fasting has the potential to improve our health and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/">reduce the likelihood</a> of developing cancer. So what should we make of a <a href="https://www.nature.com/articles/s41586-024-07840-z">new study</a> in mice suggesting fasting increases the risk of cancer? <h2>What is intermittent fasting?</h2> Intermittent fasting means switching between times of eating and not eating. Unlike traditional diets that focus on what to eat, this approach focuses on when to eat. There are lots of commonly used <a href="https://dietitiansaustralia.org.au/health-advice/intermittent-fasting">intermittent fasting schedules</a>. The 16/8 plan means you only eat within an eight-hour window, then fast for the remaining 16 hours. Another popular option is the 5:2 diet, where you eat normally for five days then restrict calories for two days. In Australia, poor diet contributes to <a href="https://www.health.gov.au/topics/food-and-nutrition/what-were-doing">7% of all cases of disease</a>, including coronary heart disease, stroke, type 2 diabetes, and cancers of the bowel and lung. Globally, poor diet is linked to <a href="https://www.thelancet.com/article/S0140-6736(19)30041-8/fulltext">22% of deaths</a> in adults over the age of 25. Intermittent fasting has gained a lot of attention in recent years for its potential health benefits. Fasting <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/metabolism">influences metabolism</a>, which is how your body processes food and energy. It can affect how the body absorbs nutrients from food and burns energy from sugar and fat. <h2>What did the new study find?</h2> The <a href="https://www.nature.com/articles/s41586-024-07840-z">new study</a>, published in Nature, found when mice ate again after fasting, their <a href="https://www.nature.com/articles/s12276-024-01179-1">gut stem cells</a>, which help repair the intestine, became more active. The stem cells were better at regenerating compared with those of mice who were either totally fasting or eating normally. This suggests the body might be better at healing itself when eating after fasting. However, this could also have a downside. If there are <a href="https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-changes-infographic">genetic mutations</a> present, the burst of stem cell-driven regeneration after eating again might make it easier for cancer to develop. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027058/">Polyamines</a> – small molecules important for cell growth – drive this regeneration after refeeding. These polyamines can be produced by the body, influenced by diet, or come from gut bacteria. The findings suggest that while fasting and refeeding can improve stem cell function and regeneration, there might be a tradeoff with an increased risk of cancer, especially if fasting and refeeding cycles are repeated over time. While this has been shown in mice, the link between intermittent fasting and cancer risk in humans is more complicated and not yet fully understood. <h2>What has other research found?</h2> <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-071816-064634">Studies in animals</a> have found intermittent fasting can help with weight loss, improve blood pressure and blood sugar levels, and subsequently <a href="https://pubmed.ncbi.nlm.nih.gov/27810402/">reduce the risks</a> of diabetes and heart disease. Research in humans <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">suggests</a> intermittent fasting can reduce body weight, improve <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361187/">metabolic health</a>, reduce inflammation, and enhance <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/">cellular repair processes</a>, which remove damaged cells that could potentially turn cancerous. However, other studies warn that the benefits of intermittent fasting are the same as what can be achieved through <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2623528">calorie restriction</a>, and that there <a href="https://www.sciencedirect.com/science/article/pii/S2161831322007542">isn’t enough evidence</a> to confirm it reduces cancer risk in humans. <h2>What about in people with cancer?</h2> In studies of people who have cancer, fasting has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815756/">reported to</a> protect against the side effects of chemotherapy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311547/">improve the effectiveness</a> of cancer treatments, while decreasing damage to healthy cells. Prolonged fasting in some patients who have cancer has been shown to be safe and <a href="https://pubmed.ncbi.nlm.nih.gov/34383300/">may potentially</a> be able to decrease tumour growth. On the other hand, some experts advise caution. Studies in mice show intermittent fasting could <a href="https://www.nature.com/articles/s41423-023-01033-w">weaken the immune system</a> and make the body less able to fight infection, potentially leading to worse health outcomes in people who are unwell. However, there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757987/">currently no evidence</a> that fasting increases the risk of bacterial infections in humans. <h2>So is it OK to try intermittent fasting?</h2> The current view on intermittent fasting is that it can be beneficial, but experts agree more research is needed. Short-term benefits such as weight loss and better overall health are well supported. But we don’t fully understand the long-term effects, especially when it comes to cancer risk and other immune-related issues. Since there are many different methods of intermittent fasting and people react to them differently, it’s hard to <a href="https://www.nature.com/articles/s41423-023-01033-w">give advice that works for everyone</a>. And because most people who participated in the studies were overweight, or had diabetes or other health problems, we don’t know how the results apply to the broader population. For healthy people, intermittent fasting is generally considered safe. But it’s <a href="https://dietitiansaustralia.org.au/health-advice/intermittent-fasting">not suitable for everyone</a>, particularly those with certain medical conditions, pregnant or breastfeeding women, and people with a history of eating disorders. So consult your health-care provider before starting any fasting program.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, PhD Candidate in Genetic Engineering and Cancer, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research)</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-intermittent-fasting-increase-or-decrease-our-risk-of-cancer-238071">original article</a>. </div>

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and <a href="https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death">it’s believed</a> he was straining very hard to poo, which then led to a fatal heart attack. We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many. But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack. This includes a recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">study</a> led by Australian researchers involving data from thousands of people. <h2>Are constipation and heart attacks linked?</h2> Large <a href="https://www.nature.com/articles/s41598-023-38068-y">population</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">studies</a> show constipation is linked to an increased risk of heart attacks. For example, an <a href="https://www.nature.com/articles/s41598-023-38068-y">Australian study</a> involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age. A <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">Danish study</a> of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes. It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital. These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated. <h2>How about this new study?</h2> The recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">international study</a> led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population. The researchers analysed data from the <a href="https://www.ukbiobank.ac.uk">UK Biobank</a>, a database of health-related information from about half a million people in the United Kingdom. The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation. People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation. The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension. The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations. A <a href="https://pubmed.ncbi.nlm.nih.gov/26812003/">Japanese study</a> looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day. <h2>How might constipation cause a heart attack?</h2> Chronic constipation can lead to straining when passing a stool. This can result in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">laboured breathing</a> and can lead to a rise in blood pressure. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">one Japanese study</a> including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">One theory</a> is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels. As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">doubles</a> when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure). The systolic blood pressure rise with straining in passing a stool has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">reported to be</a> as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks. <a href="https://pubmed.ncbi.nlm.nih.gov/22256893/">Some people</a> with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing. This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure. Another intriguing avenue of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399019/">research</a> examines the imbalance in gut bacteria in people with <a href="https://pubmed.ncbi.nlm.nih.gov/3596341/">constipation</a>. This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack. This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease. <h2>What can we do about this?</h2> Constipation affects around <a href="https://pubmed.ncbi.nlm.nih.gov/36826591/">19% of the global population</a> aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health. Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/constipation-increases-your-risk-of-a-heart-attack-new-study-finds-and-not-just-on-the-toilet-237209">original article</a>. </div>

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>. </div>

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a> That lunchtime staple, the humble ham sandwich, has come in for a bashing in the press recently. According to <a href="https://www.theguardian.com/society/article/2024/aug/20/two-slices-of-ham-a-day-can-raise-type-2-diabetes-risk-by-15-research-suggests">many</a> <a href="https://www.dailymail.co.uk/health/article-13761253/Eating-ham-daily-linked-increase-risk-diabetes.html">reports</a>, eating two slices of ham a day can increase your risk of developing type 2 diabetes. But what’s the science behind these headlines? The research offers a more complex picture. <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00179-7/fulltext">A new study</a> from the University of Cambridge highlighted an association between developing type 2 diabetes and eating processed meat like ham and bacon, and red meat such as beef and lamb. This led to headlines suggesting the risk was mainly linked to <a href="https://www.telegraph.co.uk/news/2024/08/21/ham-sandwich-processed-meat-fresh-risk-link-type-2-diabetes/">ham sandwiches</a>. This seems to have come from the <a href="https://www.cam.ac.uk/research/news/red-and-processed-meat-consumption-associated-with-higher-type-2-diabetes-risk">press release</a>, which used ham as the example to quantify the amount of processed meat associated with a 15% increased risk of developing type 2 diabetes over ten years. The research found that this risk was linked to eating an extra 50g of processed meat every day, which happens to equate to two slices of ham. A useful example thus appears to have been taken up by the media as the main cause, perhaps ignoring some of the key messages coming from the study. So, can processed and red meat really increase your risk of developing type 2 diabetes? The <a href="https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/diabetes-risk-factors">biggest risk factors</a> linked to developing type 2 diabetes are being over 40, having family members with type 2 diabetes, being of South Asian or African descent, or having a higher body weight – and especially a larger waist. <figure><iframe src="https://www.youtube.com/embed/EsOBcx2bJqU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The Cambridge study used data from nearly 2 million people from 31 studies. Participants were followed for an average of ten years. During this time, around one in 20 people developed type 2 diabetes. The research suggested that a 10% increase in the probability of developing type 2 diabetes was associated with every 100g of additional red meat eaten daily. Eating half as much extra processed meat every day was linked to an even greater increased risk of developing the disease. This is not the <a href="https://ajcn.nutrition.org/article/S0002-9165(23)66119-2/abstract">first time</a> that both processed and red meats have been linked with an increased risk of developing type 2 diabetes. However, the key strength of the Cambridge study was that it tried to control for many of the other factors linked to the disease, including smoking, having a higher body weight, dietary intake and exercise. However, the size of the increased risk is modest, considering few people included in the study ate 50g or more processed meat per day – meaning moderate ham consumption is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908545/">no meaningful effect</a> on your risk. <h2>What’s the link?</h2> Processed meat has been linked to increased risk of type 2 diabetes because of its nitrate and salt content – additives that are used to cure many processed meats. Nitrates and salt in processed meats have also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893523/">been linked to</a> an increased risk of developing colon cancer. In fact, the World Health Organization classifies the additives as <a href="https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat">group 1 carcinogens</a>, which means they can cause a range of cancers. The mechanism linking processed meat to cancer seems to be similar to how it might be linked to type 2 diabetes. During digestion, processed meat produces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294997/">N-nitroso chemicals</a>, which can damage cells. This can lead to inflammation and affects how insulin, the hormone that controls blood glucose (sugar), works. This in turn can lead to <a href="https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance">insulin resistance</a>, when cells in your muscles, fat and liver don’t respond well to insulin and can’t easily take up glucose from your blood. Red meat, meanwhile, is <a href="https://www.healthline.com/nutrition/healthy-iron-rich-foods">rich in iron</a>. Research suggests that people with <a href="https://www.diabetes.org.uk/diabetes-the-basics/related-conditions/haemochromatosis-diabetes#:%7E:text=So%20a%20rise%20of%20iron,GP%20as%20soon%20as%20possible.">high levels of iron</a> are more likely to develop type 2 diabetes. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744124/#:%7E:text=The%20WHO%20has%20recognised%20iron,being%20affected%20with%20this%20condition.">low levels of iron</a> are more of a health concern for the general population. Another potential link regarding red meat could be the way it is cooked. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521980/">Previous studies</a> have suggested that charred meat, cooked over an open flame or at high temperature, is also linked to an increased risk of developing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911789/">type 2 diabetes</a>. Charring meat leads to formation of toxic chemicals such as <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/heterocyclic-amine#:%7E:text=Heterocyclic%20amines%20are%20aromatic%20compounds,of%20reactions%20called%20Maillard%20reactions.">heterocyclic aromatic amines</a> and harmful compounds like <a href="https://www.healthline.com/nutrition/advanced-glycation-end-products">advanced glycation end products</a>, both of which have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/21709297/">insulin resistance and type 2 diabetes</a>. <h2>Bye-bye barbecues and bacon butties?</h2> The key message is reduction, rather than avoidance. The UK government nutritional recommendations offer sound advice: limit your combined intake of red and processed meat to no more than <a href="https://www.nhs.uk/live-well/eat-well/food-types/meat-nutrition/#:%7E:text=Red%20meat%20and%20processed%20meat&text=If%20you%20currently%20eat%20more,%2C%20veal%2C%20venison%20and%20goat.">an average of 70g per day</a>. But these guidelines also suggest that red meat can be a valuable source of iron. So, if you decide to stop eating red meat, you should eat alternative sources of iron such as beans, lentils, dark green vegetables and fortified cereals. This needs to be done as part of a carefully planned diet. Non-meat sources of iron are more difficult for our bodies to absorb so should be eaten with a source of vitamin C, found in green vegetables and citrus fruit. The best advice to reduce your risk of developing type 2 diabetes is to maintain a healthy weight – consider losing weight if you have a higher body weight – and be as physically active as possible. A healthy diet should be based on plenty of vegetables, fruit, beans, peas, lentils, nuts and seeds, along with some wholegrain foods, some dairy products, fish and white meat (or vegetarian alternatives) – plus moderate amounts of red meat and minimal processed meat. This will help reduce your risk of type 2 diabetes, <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating">heart disease</a>, and <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/does-having-a-healthy-diet-reduce-my-risk-of-cancer">many cancers</a> – as well being more <a href="https://www.bda.uk.com/static/539e2268-7991-4d24-b9ee867c1b2808fc/a1283104-a0dd-476b-bda723452ae93870/one%20blue%20dot%20reference%20guide.pdf">environmentally sustainable</a>. But if you have a penchant for ham sandwiches, rest assured you can continue to indulge as an occasional treat. It’s your overall lifestyle and diet that really matter for your health and risk of developing type 2 diabetes.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237346/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Visiting Academic, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-eating-ham-bacon-and-beef-really-increase-your-risk-of-developing-type-2-diabetes-237346">original article</a>. </div>

Body

"Really unexpected": Lisa McCune opens up on Dancing With The Stars win

Lisa McCune has opened up about her journey on Dancing With The Stars following her "unexpected" <a href="https://oversixty.com.au/entertainment/tv/dancing-with-the-stars-champion-crowned" target="_blank" rel="noopener">win</a>. Monday night's finale of the show saw Lisa McCune and her dancing partner Ian Waite took home the mirrorball trophy against finalists Ant Middleton, James Stewart, Nikki Osborne, and Samantha Jade. After the win, McCune told <a href="https://7news.com.au/entertainment/celebrity/lisa-mccune-spills-on-unexpected-dancing-with-the-stars-win-c-15683539" target="_blank" rel="noopener">7News</a> that she was as shocked by the win as viewers were. “It really was unexpected,” McCune said. The actress added that she was extra thrilled for her dancing partner Ian Waite who has now taken out the Mirrorball Trophy for the first time. The win comes weeks after the gruelling DWTS process, which she admitted was more involved than she originally thought. “My agent said to me that somebody else had told them how difficult it was. And I thought, ‘Well, I probably needed a bit of a kick up the bum to do a bit more exercise’,” she says. “So I thought, ‘Well, it’d be good for me’. I started and I pretty quickly realised that the techniques involved and the different disciplines is pretty intense." “I think you underestimate how aerobically fit you actually need to be. But I gave it a red-hot go, and we had a really good time.” While McCune knew she did well through the competition, she said "Watching it back, I couldn’t recall any of the scores that we got because when you’re in the moment your adrenaline is kind of heightened, and (it’s like) watching it fresh.” As part of being crowned the Dancing With The Stars champion, Lisa was awarded $20,000 for her chosen charities: the RCD Foundation and the Harrison Riedel Foundation. <div> </div> “Both the charities I have a personal connection to in my local area, based on Victoria, both of them headed up by two amazing mums. These initiatives are spectacular.” Image credits: Instagram / Seven

Could the shingles vaccine lower your risk of dementia?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ibrahim-javed-1552271">Ibrahim Javed</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> A <a href="https://www.nature.com/articles/s41591-024-03201-5">recent study</a> has suggested Shingrix, a relatively new vaccine given to protect older adults against shingles, may delay the onset of dementia. This might seem like a bizarre link, but actually, <a href="https://pubmed.ncbi.nlm.nih.gov/34697158/">research</a> has previously shown an older version of the shingles vaccine, Zostavax, reduced the risk of dementia. In this new study, published last week in the journal Nature Medicine, researchers from the United Kingdom found Shingrix delayed dementia onset by 17% compared with Zostavax. So how did the researchers work this out, and how could a shingles vaccine affect dementia risk? <h2>From Zostavax to Shingrix</h2> Shingles is a viral infection caused by the varicella-zoster virus. It causes <a href="https://www.healthdirect.gov.au/shingles">painful rashes</a>, and affects older people in particular. Previously, Zostavax was used to vaccinate against shingles. It was administered as a single shot and provided good protection for about <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster">five years</a>. Shingrix has been developed based on a newer vaccine technology, and is thought to offer stronger and longer-lasting protection. Given in two doses, it’s now the preferred option for shingles vaccination in Australia and elsewhere. In November 2023, Shingrix replaced Zostavax on the <a href="https://www.health.gov.au/news/national-immunisation-program-changes-to-shingles-vaccination-from-1-november-2023">National Immunisation Program</a>, making it available for free to those at highest risk of complications from shingles. This includes all adults aged 65 and over, First Nations people aged 50 and older, and younger adults with certain medical conditions that affect their immune systems. <h2>What the study found</h2> Shingrix was approved by the US Food and Drugs Administration in <a href="https://www.drugs.com/history/shingrix.html">October 2017</a>. The researchers in the new study used the transition from Zostavax to Shingrix in the United States as an opportunity for research. They selected 103,837 people who received Zostavax (between October 2014 and September 2017) and compared them with 103,837 people who received Shingrix (between November 2017 and October 2020). By analysing data from electronic health records, they found people who received Shingrix had a 17% increase in “diagnosis-free time” during the follow-up period (up to six years after vaccination) compared with those who received Zostavax. This was equivalent to an average of 164 extra days without a dementia diagnosis. The researchers also compared the shingles vaccines to other vaccines: influenza, and a combined vaccine for tetanus, diphtheria and pertussis. Shingrix and Zostavax performed around 14–27% better in lowering the risk of a dementia diagnosis, with Shingrix associated with a greater improvement. The benefits of Shingrix in terms of dementia risk were significant for both sexes, but more pronounced for women. This is not entirely surprising, because we know women have <a href="https://www.alzheimers.org.uk/blog/why-dementia-different-women">a higher risk</a> of developing dementia due to interplay of biological factors. These include being more sensitive to certain genetic mutations associated with dementia and hormonal differences. <h2>Why the link?</h2> The idea that vaccination against viral infection can lower the risk of dementia has been around for more than two decades. Associations have been <a href="https://pubmed.ncbi.nlm.nih.gov/11762573/">observed</a> between vaccines, such as those for diphtheria, tetanus, polio and influenza, and subsequent dementia risk. Research has shown Zostavax vaccination can <a href="https://bmjopen.bmj.com/content/11/10/e045871">reduce the risk</a> of developing dementia by 20% compared with people who are unvaccinated. But it may not be that the vaccines themselves protect against dementia. Rather, it may be the resulting lack of viral infection creating this effect. Research indicates bacterial infections in the gut, as well as viral infections, are associated with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169152/">higher risk of dementia</a>. Notably, untreated infections with herpes simplex (herpes) virus – closely related to the varicella-zoster virus that causes shingles – can <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/trc2.12119">significantly increase</a> the risk of developing dementia. Research has also shown shingles increases the risk of a later dementia diagnosis. The mechanism is not entirely clear. But there are two potential pathways which may help us understand why infections could increase the risk of dementia. First, certain molecules are produced when a baby is developing in the womb to help with the body’s development. These molecules have the potential to cause inflammation and accelerate ageing, so the production of these molecules is silenced around birth. However, viral infections such as shingles can <a href="https://doi.org/10.1016/j.virol.2018.07.011">reactivate</a> the production of these molecules in adult life which could <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717685/#:%7E:text=The%20disease%20mechanisms%20of%20AD,may%20lead%20to%20new%20therapies.">hypothetically lead to dementia</a>. Second, in Alzheimer’s disease, a specific protein called Amyloid-β go rogue and kill brain cells. Certain proteins produced by viruses <a href="https://www.biorxiv.org/content/10.1101/2024.05.16.594465v1">such as COVID</a> and <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.202001299">bad gut bacteria</a> have the potential to support Amyloid-β in its toxic form. In laboratory conditions, these proteins have been shown to <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1003537">accelerate the onset</a> of dementia. <h2>What does this all mean?</h2> With an ageing population, the burden of dementia is only likely to become greater in the years to come. There’s a lot more we have to learn about the causes of the disease and what we can potentially do to prevent and treat it. This new study has some limitations. For example, time without a diagnosis doesn’t necessarily mean time without disease. Some people may have underlying disease with delayed diagnosis. This research indicates Shingrix could have a silent benefit, but it’s too early to suggest we can use antiviral vaccines to prevent dementia. Overall, we need more research exploring in greater detail how infections are linked with dementia. This will help us understand the root causes of dementia and design potential therapies.<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/235597/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ibrahim-javed-1552271">Ibrahim Javed</a>, Enterprise and NHMRC Emerging Leadership Fellow, UniSA Clinical & Health Sciences, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-the-shingles-vaccine-lower-your-risk-of-dementia-235597">original article</a>. </div>

Mind

Ada Nicodemou breaks silence on "unexpected" romance with co-star

Home and Away star Ada Nicodemou has finally broken her silence on her new relationship with James Stewart. The pair's rumoured romance first hit headlines in early May, not long after Nicodemou announced her split from Adam Rigby, who was her partner of eight years. In her latest interview with <a href="https://www.instagram.com/p/C9qRZnvo_Rx/?utm_source=ig_embed&ig_rid=c42ee60a-b9ff-442c-bd2f-38a0c4cd6caf" target="_blank" rel="noopener">Stellar</a> magazine, the actress has finally confirmed their romance. “Jimmy and I are together, yes,” she told the publication. “At 47, you know what you want and what you don’t. It's only early days. It's very recent and very unexpected. I'm super happy. It's really lovely." The pair, who play husband-and-wife Leah Patterson and Justin Morgan on the show, were photographed kissing on Anzac Day, and the photos were made public a few weeks later. A few weeks before the photographs were made public, the couple's on-screen wedding aired on April 9, but Nicodemou shut down the rumours that they were romantically involved during shooting. "There weren't genuine feelings then," she said, adding the episode was shot six months prior to it airing. "It was shot last year. But I think whenever you're watching any TV couple, you're always wondering if they really do have feelings." “We’ve always respected each other. We’ve known each other since Breakers. Jimmy is an amazing actor," she added referring to the 1998 soap opera they were both in. “I’ve loved working with him for five years and I think our scenes are great. I always like going to work – we push ourselves, and push each other, in a really good way.” Home and Away fans were quick to react to the actress' confirmation of her relationship, with one fan writing on Instagram, "Damn right! Set that record straight!" "Your life your love 🥰 I hope you have the privacy you need both of you," another added. "Can't help who you fall in love with. Enjoy new beginnings. You two are gorgeous together, hope it's forever," a third added. Prior to her relationship with Rigby, Nicodemou was married to Chrys Xipolitas and they share one child together, 11-year-old son Johnas. Stewart was previously married to Sarah Roberts and they were together for six years before they split in 2015. They share daughter Scout. Images: Instagram

Relationships

Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact? The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines). I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65. <h2>Polypharmacy among older adults</h2> Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics. Is it a good idea to take so many drugs? According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability. In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic. <h2>The risks of polypharmacy: 5 points to consider</h2> When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken. <ol> <li> Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments. </li> <li> A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses? </li> <li> The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences. </li> <li> The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death. </li> <li> Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks. </li> </ol> Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements. Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health. <h2>3 tips to avoid the risks associated with polypharmacy</h2> What can we do as a patient, or as a caregiver? <ol> <li> Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ? </li> <li> Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced? </li> <li> Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter. </li> </ol> <h2>Benefits should outweigh the risks</h2> Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion. Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<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/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>. </div>

Body

Flight attendant reveals the unexpected reason why it's so cold on planes

When it comes to packing essentials in your carry-on for your next flight, many people add a jumper, extra socks, or even their own blanket to their bags. Because one thing’s for sure: you’ll probably be cold on your flight. But have you ever stopped to think of the reason why the cabin of a plane is so cold? According to a Canadian flight attendant, it's to do with keeping you feeling good. Vanessa Settimi told Reader's Digest that a cooler cabin helps passengers who are prone to fainting or have motion sickness during turbulence. She also clarified that despite what travellers may think, cabin crew don’t have control over the cabin temperature. "Temperature in the cabin is controlled by the pilots. Even though travellers often ask to get the temperature turned up during flights, it is kept on the cooler side." She went on to say that the key to staying warm on your next flight is bringing extra layers. "Now this might just be the flight attendant in me," says Settimi, "but you will never catch me flying as a traveller in sandals and a tank top!" Image credits: Shutterstock

Travel Trouble

Grace Tame reveals unexpected health diagnosis

After years of dismissing her symptoms, including chronic pelvic pain and vomiting, Grace Tame has revealed that she has endometriosis. Tame, an activist for survivors of sexual assault, is among the one in nine Australian women and girls who suffer from the debilitating disease, which mostly affects the reproductive organs. She announced the news in an Instagram post on Tuesday morning and revealed that she underwent surgery to remove the endometriosis from her bowel, pelvic walls and sacral ligaments on May 24. The former Australian of the Year, initially ignored the symptoms thinking it was due to her traumatic experiences of child sex abuse that she endured when she was 15-years-old, but only recently discovered the actual cause of her pain. "It’s easy to fall into the trap of internalising trauma to our detriment," she said. "I always assumed persistent sexual abuse alone caused my chronic pelvic pain, and learned to disassociate from most of it. "The episodes of violent sickness I put down to food poisoning. That is, until the end of 2022, when I began vomiting weekly into early 2023. "After negative screenings for Crohn’s, coeliac and IBD, my cousin Morgan encouraged me to see a gynaecologist for the first time in over a decade." She added that her gynaecologist suspected endo, and later on confirmed the diagnosis in a laparoscopic operation. "Surgery went smoothly, and as I write this, I can’t help but feel extremely grateful to be where I am, even if removal isn’t the panacea for this disease,” she said, hoping to raise more awareness for the disease. “Grateful knowing, in the absence of both prevention and cure, there are still options, and we’re not alone," she said. She also added that she was grateful for the support of her friends and family, and for being able to afford and access treatment. According to the Australian Institute of Health and Welfare (AIHW), there were 40,500 endometriosis-related hospitalisations in 2021–22, with this rate doubling in the past decade. In May's federal budget, the government announced a $49.1m investment into tackling endometriosis. From July 1, 2025, women suffering from endometriosis will have longer specialist consultations of 45 minutes or more covered under Medicare. Images: Instagram

Caring

The hidden risks of buy now, pay later: What shoppers need to know

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/vivek-astvansh-1318943">Vivek Astvansh</a>, <a href="https://theconversation.com/institutions/mcgill-university-827">McGill University</a> and <a href="https://theconversation.com/profiles/chandan-kumar-behera-1479139">Chandan Kumar Behera</a>, <a href="https://theconversation.com/institutions/indian-institute-of-management-lucknow-6023">Indian Institute of Management Lucknow</a> <iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" src="https://narrations.ad-auris.com/widget/the-conversation-canada/the-hidden-risks-of-buy-now-pay-later-what-shoppers-need-to-know" width="100%" height="400"></iframe> <a href="https://www.canada.ca/en/financial-consumer-agency/services/loans/buy-now-pay-later.html">Buy now, pay later</a> is a relatively new form of financial technology that allows consumers to purchase an item immediately and repay the balance at a later time in instalments. Unlike applying for a credit card, buy now, pay later <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4591446">doesn’t require a credit check</a>. Instead, <a href="https://doi.org/10.1108/EJM-11-2021-0923">these programs use algorithms</a> to perform <a href="https://www.investopedia.com/terms/s/soft-inquiry.asp">“soft” credit checks</a> to determine <a href="https://theconversation.com/if-it-looks-like-debt-lets-treat-it-like-debt-buy-now-pay-later-schemes-need-firmer-regulation-in-nz-211820">a shopper’s eligibility</a>. This means buy now, pay later loans target <a href="https://www.theguardian.com/money/2022/jan/27/buy-now-pay-later-schemes-entice-consumers-spend-more">low-income, tech-savvy</a> <a href="https://www.cnbc.com/2022/10/27/gen-z-and-millennials-prefer-buy-now-pay-later-services.html">millennials and Gen Z shoppers</a> in an effort to <a href="https://libertystreeteconomics.newyorkfed.org/2023/09/who-uses-buy-now-pay-later/">supposedly improve financial inclusion</a> for these groups. However, the newness of buy now, pay later programs means existing <a href="https://doi.org/10.1111/acfi.13100">consumer credit laws don’t cover it</a>. This lack of regulation puts shoppers at financial risk of accumulating higher levels of debt. <h2>Credit cards versus buy now, pay later</h2> There are three key differences between credit cards and buy now, pay later loans. First, while buy now, pay later loans are a line of credit like credit cards are, <a href="https://www.cnbc.com/2022/05/04/klarna-to-report-buy-now-pay-later-data-to-uk-credit-bureaus.html">they don’t impact credit reports</a>. Because of this, shoppers might be less cautious when using buy now, pay later services. Credit cards typically have annual interest rates ranging from <a href="https://www.bankrate.com/finance/credit-cards/what-is-credit-card-apr/#credit-card-apr-vs-credit-card-interest">15 to 26 per cent</a>. While most buy now, pay later loans have no interest, longer term loans have <a href="https://www.cbsnews.com/news/buy-now-pay-later-loans-interest-rate-fees-tips-what-to-know/">annual interest rates of about 37 per cent</a>. Shoppers are <a href="https://hbswk.hbs.edu/item/buy-now-pay-later-how-retails-hot-feature-hurts-lower-income-shoppers">at risk of overusing buy now, pay later programs</a> and accumulating more debt than they can manage. In addition, formal lenders, such as banks, currently have no way of knowing what buy now, pay later debt a person is carrying. The lender, therefore, likely incurs more risk than they are aware of. Second, credit cards typically provide <a href="https://doi.org/10.1080/1369118X.2022.2161830">an interest-free period</a>, after which <a href="https://doi.org/10.1177/03128962211032448">borrowers must pay interest</a>. In contrast, buy now, pay later users typically don’t have interest fees, but can incur <a href="https://doi.org/10.1108/IJBM-07-2022-0324">late fees for missed or late payments</a>. Falling behind on payment terms <a href="https://www.forbes.com/sites/andriacheng/2020/12/16/why-retailers-are-embracing-buy-now-pay-later-service-this-holiday-season/">can result in charges</a> that exceed <a href="https://stateline.org/2022/02/02/regulators-scrutinize-buy-now-pay-later-plans/">typical credit card interest rates</a>, causing more harm than interest payments. Low-income buy now, pay later users are <a href="https://hbswk.hbs.edu/item/buy-now-pay-later-how-retails-hot-feature-hurts-lower-income-shoppers">particularly vulnerable</a> to <a href="https://www.consumerfinance.gov/data-research/research-reports/consumer-use-of-buy-now-pay-later-insights-from-the-cfpb-making-ends-meet-survey/">using overdrafts to cover their buy now, pay later payments</a>. Third, people typically have just a few credit cards, making it easier to keep track of payments. Buy now, pay later users, on the other hand, usually engage with multiple buy now, pay later lenders through retailers. As a result, it’s difficult for them to keep track of all the buy now, pay later lenders and retailers they made purchases from. <h2>What are the Canadian governments doing?</h2> Canada classifies buy now, pay later as an unsecured instalment loan, which means lenders are subject to laws at the federal and provincial levels. Under federal law, there is an <a href="https://www.sec.gov/Archives/edgar/data/1711291/000171129122000011/curo-20211231.htm">annual interest rate cap of 60 per cent</a>. Provincial laws require buy now, pay later lenders to disclose the cost of credit and extend consumer protection rights to buy now, pay later shoppers. At the provincial level, <a href="https://www.canada.ca/en/financial-consumer-agency/services/loans/buy-now-pay-later.html">specific laws come into play</a>. Manitoba, Alberta, Québec, and Ontario have passed laws that require lenders to be licensed before they offer these products and be subject to regulatory oversight. These laws regulate high-cost credit products that have annual rates of 32 per cent or higher. This means buy now, pay later services should fall under this category. However, I found no evidence of buy now, pay later lenders being licensed in Canada. This means either lenders are not aware they fall under these laws, or no one is enforcing them. This ambiguity over whether or not buy now, pay later lenders are subject to regulatory oversight could be a hindrance for banks like the <a href="https://financialpost.com/fp-finance/fintech/why-higher-interest-rates-threaten-the-buy-now-pay-later-bubble">Bank of Nova Scotia and the Canadian Imperial Bank of Commerce</a>, as it deters them from entering the buy now, pay later market despite its profitability. <h2>Questions to ask before using buy now, pay later</h2> Before signing up for a buy now, pay later loan, shoppers should consider the following six questions. 1. Payment structure. How much of the invoice amount needs to be paid upfront? The norm is typically 25 per cent. What is the number of remaining instalments? The answer to this is usually four. Lastly, what is the frequency of instalments? The norm is biweekly. 2. Sensitive information. Does the lender require you to provide information about your chequing account? This is sensitive information to give away and puts you at risk of data breaches. Most buy now, pay later lenders withdraw instalment amounts from chequing accounts or debit cards, potentially exposing shoppers to greater risks than credit cards. 3. Interest charges Does the buy now, pay later lender charge interest on instalment payments? The norm is no. 4. Late fees How much is the late fee, when does it apply and what is the maximum amount of the late fee? Typically, late fees don’t exceed $8 or one-quarter of the invoice amount. Late fees usually kick in if your scheduled payment remains unpaid after 10 days. 5. Data responsibility. Who is responsible for your data? Whether it’s the retailer, the buy now, pay later lender or a company whose cloud storage the provider may be using, you should know. In general, the buy now, pay later lender holds this responsibility. 6. Licensing. Is the buy now, pay later lender licensed to sell the loan? Usually, the <a href="https://dfpi.ca.gov/wp-content/uploads/sites/337/2020/03/afterpay-settlement.pdf">answer to this question is no</a>. <h2>Buy now, pay later regulation</h2> Two sets of laws and regulations should be implemented to address some of these issues. The first set of regulations focuses on how buy now, pay later lenders interact with consumers. These lenders should clearly communicate <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4359956">all terms and conditions of their loans</a>, including late charges, interest charges and payment schedules, on their platforms to ensure shoppers are fully informed of their financial obligations. The Financial Conduct Authority in the United Kingdom recently issued guidelines allowing buy now, pay later lenders to <a href="https://www.ft.com/content/ca428bc8-65c3-49ed-8ba6-0d6f206098aa">terminate, suspend or restrict access to shopper accounts</a> for any reason without notice. Effective September 2024, New Zealand will require buy now, pay later lenders to <a href="https://theconversation.com/if-it-looks-like-debt-lets-treat-it-like-debt-buy-now-pay-later-schemes-need-firmer-regulation-in-nz-211820">check a shopper’s credit</a> before providing them a buy now, pay later loan. The second set of regulations defines the scope and boundaries of buy now, pay later lenders. On Dec. 9, 2022, California became the first American state to <a href="https://dfpi.ca.gov/2022/12/09/buy-now-pay-later-protect-yourself-before-you-check-out/">classify buy now, pay later as a loan</a>. Such classifications allowed California regulators to <a href="https://stateline.org/2022/02/02/regulators-scrutinize-buy-now-pay-later-plans/">question lenders about their transparency in disclosing the terms of their offerings</a>. The hope is that these laws and regulations will facilitate microlending and not impede the existence of buy now, pay later services, but rather make it safer and more secure for both lenders and users.<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/215421/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vivek-astvansh-1318943">Vivek Astvansh</a>, Associate Professor of Quantitative Marketing and Analytics, <a href="https://theconversation.com/institutions/mcgill-university-827">McGill University</a> and <a href="https://theconversation.com/profiles/chandan-kumar-behera-1479139">Chandan Kumar Behera</a>, PhD Student in Marketing, <a href="https://theconversation.com/institutions/indian-institute-of-management-lucknow-6023">Indian Institute of Management Lucknow</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-hidden-risks-of-buy-now-pay-later-what-shoppers-need-to-know-215421">original article</a>. </div>

Money & Banking

Want to reduce your dementia risk? Eat these 4 foods, says new study

If you are what you eat, this might make you hungrier for foods that are bright in every sense. Research has shown that living, vibrant foods can slow down aging at a cellular level; while fruit and vegetables in particular have been associated with lower incidence of cognitive decline as individuals age. However, research has been relatively lacking on just how much of these brain-healthy foods you really need and which fruit and vegetables are best for the job. In collaboration with public health experts at Harvard University, medical researchers at China’s Zhejiang University School of Medicine conducted a meta-analysis that’s slated to be published in the June 2024 issue of The Journal of Nutrition, Health, and Aging. They combined data from two large-scale population-representative studies that analysed the diets and cognitive function of more than 10,000 participants ages 55 and older from China and the US. <h2>What daily diets revealed</h2> The data included diet questionnaires that honed in on the average of participants’ total daily intake of several different types of foods, including fruit and vegetables, and also broke them down into sub-types like green leafy vegetables and berries. Over a period of five years, the participants also took part in activities designed to assess their cognitive function and the average rate of cognitive decline. Overall, participants who included the most fruit and vegetables in their daily diets performed best on the brain tests and maintained those results over time. This suggested that both fruit and vegetables had protective elements that slowed cognitive decline. <h2>Vegetables that help protect cognition</h2> Interestingly, certain types of vegetables appeared to be more beneficial than others—say the researchers: “Our findings support the potential beneficial roles of VF, especially cruciferous vegetables, green leafy vegetables, and red and yellow vegetables, in maintaining cognitive function and slowing cognitive decline in middle-aged and older adults.” The researchers pointed to several reasons these particular vegetables might have shown a substantial impact, including anti-inflammatory and antioxidation nutrients like flavonoids and various vitamins or even gut improvements that have been shown to help improve or protect cognition. While beans didn’t figure prominently in both studies, they showed a protective element in the US study, so they are also worth keeping on your plate. (Beans are also thought to be one of the top foods for longevity.) <h2>Fruit that pack a punch</h2> As for fruit, while some didn’t show as much of a protective effect across the board, berries and apples are two examples of fruit that experts have previously said provide major polyphenol and antioxidant effect. Participants whose brains maintained performance were shown to have eaten three or more servings of vegetables and two or more servings of fruit per day. This is on par with the five servings of vegetables and two servings of fruit recommended we eat every day. Image credits: Shutterstock This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/want-to-reduce-your-dementia-risk-eat-these-4-foods-says-new-study" target="_blank" rel="noopener">Reader's Digest</a>.

Mind

Study finds new link for increased risk of Alzheimer’s

A new study has found that people suffering from anxiety disorders could be more likely to develop Alzheimer's disease. The study, which was published by brain researchers The Florey, analysed data from 2443 older Australians from Melbourne and Perth, who are part of a cohort for dementia research. Study leads Dr Yijun Pan and Dr Liang Jin found that anxiety and other neurological disorders are linked to an increased likelihood of developing Alzheimer's disease. "People with anxiety and neurological disorders are 1.5 and 2.5 times more likely to have Alzheimer's disease," Dr Pan said. "For people with anxiety, males have higher odds than females of developing Alzheimer's disease." They also found a few other medical conditions which were linked to a decreased risk of Alzheimer's, including arthritis, cancer, gastric complaints, and high cholesterol. The study leads said that the p53 protein - which causes neuron dysfunction and cell death in Alzheimer's patients - loses its function when someone has cancer, which could possibly explain the link between the two conditions. "We need further research to understand whether these diseases interfere with the evolution of Alzheimer's or whether there might be other reasons," Dr Pan said. "The medications or treatments used for these diseases may possibly contribute to this observation." The study however, did not find a link between Alzheimer's and depression, falls or strokes. "This is the first study to assess 20 comorbidity associations with cognitive impairment using a single Australian dataset, which allowed us to fully consider how these conditions affect the likelihood of developing Alzheimer's disease," Dr Pan said. "We also studied whether age, gender, smoking, education, alcohol consumption, and the APOE gene – believed to be connected to Alzheimer's - affects these associations. "Our study indicates a new opportunity for biologists to study the links between these 20 conditions with Alzheimer's disease. "This work also provides valuable epidemiological evidence to clinicians, which may help them to evaluate one's risk of developing Alzheimer's disease." Image: Nine

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