Placeholder Content Image

Christina Applegate details bout of Covid and Sapovirus amid MS battle

<p>Christina Applegate has detailed her latest health battle amid her multiple sclerosis (MS).</p> <p>Speaking on her <em>MesSy</em> podcast with co-host Jamie-Lynn Sigler, the actress revealed her rough experience after contracting Covid for the first time, which then turned into long Covid, and to make matters worse, she then contracted Sapovirus from contaminated food. </p> <p>Sapoviruses can cause acute gastroenteritis, and the actress candidly shared that she had been wearing diapers in recent weeks because of how often she has had to go to the bathroom. </p> <p>"I finally got the Covies.. someone real close to me dropped the ball and came home with the stuff and it spread all over the house," she began.</p> <p>"I had one day when I had a headache and chills and I thought I was making it through this."</p> <p>"It turned into long covid and it turned into a chest infection and then my heart was doing weird stuff, where it just speeds up... so I was like mother f--ker!"</p> <p>She then continued, saying that after contracting the virus she was "p---ing out of her a** for a few days".</p> <p>"I was so dizzy. I was so sick. I couldn't eat... Someone else's poop went into my mouth and I ate it."</p> <p>The actress recently revealed that she has 30 lesions on her brain from her MS,  a condition where the body's own immune system mistakenly attacks and damages the fatty material around the nerves, which can cause a range of symptoms. </p> <p>It is the most common acquired chronic neurological disease affecting young adults, according to MS Australia. </p> <p><em>Image: Getty</em></p>

Caring

Placeholder Content Image

6 little known facts about The Sound of Music

<p>The Sound of Music, released in 1965, continues to be one of the most beloved family films of all time. In honour of the iconic film, we look behind the scenes to reveal some little known facts about one of our favourite movies.</p> <p><strong>1. Julie Andrews kept falling over during the famous opening mountain scene</strong></p> <p>While Julie Andrews may look graceful twirling atop the mountain in the opening scenes, in reality she kept being knocked over by the draft of the helicopter trying to capture the iconic aerial scene. Andrews said: “the down draft from those jets was so strong that every time… the helicopter circled around me and the down draft just flattened me into the grass. And I mean flattened. It was fine for a couple of takes, but after that you begin to get just a little bit angry… And I really tried. I mean, I braced myself, I thought, ‘It’s not going to get me this time.’ And every single time, I bit the dust.”</p> <p><strong>2. Christopher Plummer hates the movies</strong></p> <p>Fans of Christopher Plummer’s Captain von Trapp will be disappointed to learn that he hated the film so much he called it “The Sound of Mucus”. “Because it was so awful and sentimental and gooey,” he said. “You had to work terribly hard to try and infuse some minuscule bit of humour into it.” To ease his pain, Plummer drank, even on set. He admitted on the DVD commentary that he was drunk when filming the Austrian music festival scene.</p> <p><strong>3. Charmian Carr injured herself during “Sixteen going on seventeen”</strong></p> <p>Charmian Carr, who played Liesl Von Trapp, slipped while leaping from a bench in the gazebo scene. She fell through the glass and injured her ankle. In the scene, she is wearing a bandage on her leg, which is covered by make up.</p> <p><strong>4. Friedrich grew 15 centimetres during the six months of filming  </strong> </p> <p>Nicholas Hammond, who played Friedrich Von Trapp, grew from 1.60 metres to 1.75 metres in the six months of filming. It caused many continuity problems in the movie as Friedrich had to be shorter than Liesl but taller than Louisa. As the beginning of the film, Hammond had lifts in his films but by the end, Carr who played Liesl had to stand on a box.</p> <p><strong>5. Mia Farrow auditioned for the role of Liesl.</strong> </p> <p><span style="text-decoration: underline;"><strong><a href="https://youtu.be/66v7gtwRGdM" target="_blank" rel="noopener">Watch her audition tape here.</a></strong></span></p> <p><strong>6. The film is historically inaccurate</strong></p> <p>The movie is loosely based on the autobiography of Maria von Trapp, The Story of the Trapp Family Singers, but the film took many liberties. For instance, there were 10 von Trapp children, not seven. Maria left the convent to tutor one of the children, not to governess all them. Georg was a kind man, not the stern disciplinarian as depicted the film. Maria and him were married 11 years before the Nazis invaded Austria. And the Von Trapp family didn’t escape from the mountains by crossing over the mountains – that would have led straight to Hitler’s Germany.</p> <p><em>Image credits: Getty Images</em></p>

Movies

Placeholder Content Image

Good news: midlife health is about more than a waist measurement. Here’s why

<p><em><a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>You’re not in your 20s or 30s anymore and you know regular health checks are important. So you go to your GP. During the appointment they measure your waist. They might also check your weight. Looking concerned, they recommend some lifestyle changes.</p> <p>GPs and health professionals commonly <a href="https://theconversation.com/the-body-mass-index-cant-tell-us-if-were-healthy-heres-what-we-should-use-instead-211190">measure waist circumference</a> as a vital sign for health. This is a better indicator than body mass index (BMI) of the amount of intra-abdominal fat. This is the really risky fat around and within the organs that can drive heart disease and metabolic disorders such as type 2 diabetes.</p> <p>Men are at greatly increased risk of health issues if their waist circumference is <a href="https://www.bmj.com/content/311/7017/1401">greater than 102 centimetres</a>. Women are considered to be at greater risk with a waist circumference of <a href="https://www.bmj.com/content/311/7017/1401">88 centimetres or more</a>. More than <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/waist-circumference-and-bmi/latest-release">two-thirds of Australian adults</a> have waist measurements that put them at an increased risk of disease. An even better indicator is waist circumference divided by height or <a href="https://www.baker.edu.au/news/in-the-media/waist-height-ratio#:%7E:text=According%20to%20research%2C%20a%20healthy,the%20highest%20risk%20of%20disease.">waist-to-height ratio</a>.</p> <p>But we know people (especially women) have a propensity to <a href="https://www.ajog.org/article/S0002-9378(19)30588-5/abstract">gain weight around their middle during midlife</a>, which can be very hard to control. Are they doomed to ill health? It turns out that, although such measurements are important, they are not the whole story when it comes to your risk of disease and death.</p> <h2>How much is too much?</h2> <p>Having a waist circumference to height ratio larger than 0.5 is associated with greater risk of chronic disease as well as premature death and this applies in adults of any age. A healthy waist-to-height ratio is between 0.4 to 0.49. A ratio of 0.6 or more <a href="https://www.baker.edu.au/news/in-the-media/waist-height-ratio#:%7E:text=According%20to%20research%2C%20a%20healthy,the%20highest%20risk%20of%20disease">places a person at the highest risk of disease</a>.</p> <p>Some experts recommend <a href="https://www.nature.com/articles/s41574-019-0310-7">waist circumference be routinely measured in patients during health appointments</a>. This can kick off a discussion about their risk of chronic diseases and how they might address this.</p> <p>Excessive body fat and the associated health problems manifest more strongly during midlife. A range of social, personal and physiological factors come together to make it more difficult to control waist circumference as we age. Metabolism tends to slow down mainly due to decreasing muscle mass because people do <a href="https://onlinelibrary.wiley.com/doi/10.1002/jcb.25077">less vigorous physical activity, in particular resistance exercise</a>.</p> <p>For women, hormone levels begin changing in mid-life and this also <a href="https://www.tandfonline.com/doi/full/10.3109/13697137.2012.707385">stimulates increased fat levels particularly around the abdomen</a>. At the same time, this life phase (often involving job responsibilities, parenting and caring for ageing parents) is when elevated stress can lead to <a href="https://journals.lww.com/psychosomaticmedicine/abstract/2000/09000/stress_and_body_shape__stress_induced_cortisol.5.aspx">increased cortisol which causes fat gain in the abdominal region</a>.</p> <p>Midlife can also bring poorer sleep patterns. These contribute to fat gain with <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0010062">disruption to the hormones that control appetite</a>.</p> <p>Finally, your family history and genetics can <a href="https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1002695">make you predisposed to gaining more abdominal fat</a>.</p> <h2>Why the waist?</h2> <p>This intra-abdominal or visceral fat is much more metabolically active (it has a greater impact on body organs and systems) than the fat under the skin (subcutaneous fat).</p> <p>Visceral fat surrounds and infiltrates major organs such as the liver, pancreas and intestines, releasing a variety of chemicals (hormones, inflammatory signals, and fatty acids). These affect inflammation, lipid metabolism, cholesterol levels and insulin resistance, <a href="https://academic.oup.com/eurheartjsupp/article/8/suppl_B/B4/461962">contributing to the development of chronic illnesses</a>.</p> <p>The issue is particularly evident <a href="https://www.ajog.org/article/S0002-9378(19)30588-5/abstract">during menopause</a>. In addition to the direct effects of hormone changes, <a href="https://www.sciencedirect.com/science/article/pii/S0960076013001118?via%3Dihub">declining levels of oestrogen change brain function, mood and motivation</a>. These psychological alterations can result in reduced physical activity and increased eating – often of comfort foods high in sugar and fat.</p> <p>But these outcomes are not inevitable. Diet, exercise and managing mental health can limit visceral fat gains in mid-life. And importantly, the waist circumference (and ratio to height) is just one measure of human health. There are so many other aspects of body composition, exercise and diet. These can have much larger influence on a person’s health.</p> <h2>Muscle matters</h2> <p>The quantity and quality of skeletal muscle (attached to bones to produce movement) a person has makes a <a href="https://www.nature.com/articles/nrendo.2012.49">big difference</a> to their heart, lung, metabolic, immune, neurological and mental health as well as their physical function.</p> <p>On current evidence, it is equally or more important for health and longevity to <a href="https://www.bmj.com/content/345/bmj.e7279">have</a> higher muscle mass and better cardiorespiratory (aerobic) fitness than waist circumference within the healthy range.</p> <p>So, if a person does have an excessive waist circumference, but they are also sedentary and have less muscle mass and aerobic fitness, then the recommendation would be to focus on an appropriate exercise program. The fitness deficits should be addressed as priority rather than worry about fat loss.</p> <p>Conversely, a person with low visceral fat levels is not necessarily fit and healthy and may have quite poor aerobic fitness, muscle mass, and strength. <a href="https://bjsm.bmj.com/content/45/6/504">The research evidence</a> is that these vital signs of health – how strong a person is, the quality of their diet and how well their heart, circulation and lungs are working – are more predictive of risk of disease and death than how thin or fat a person is.</p> <p>For example, a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510687/">2017 Dutch study</a> followed overweight and obese people for 15 years and found people who were very physically active had no increased heart disease risk than “normal weight” participants.</p> <h2>Getting moving is important advice</h2> <p>Physical activity has many benefits. Exercise can counter a lot of the negative behavioural and physiological changes that are occurring during midlife including for people going through menopause.</p> <p>And regular exercise reduces the tendency to use food and drink to help manage what can be a <a href="https://journals.lww.com/acsm-msse/fulltext/2008/05000/physical_activity,_sedentary_index,_and_mental.7.aspx">quite difficult time in life</a>.</p> <p>Measuring your waist circumference and monitoring your weight remains important. If the measures exceed the values listed above, then it is certainly a good idea to make some changes. Exercise is effective for fat loss and in particular <a href="https://bjsm.bmj.com/content/57/16/1035">decreasing visceral fat</a> with greater effectiveness when <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-019-0864-5">combined with dietary restriction of energy intake</a>. Importantly, any fat loss program – whether through drugs, diet or surgery – is also a muscle loss program unless resistance exercise is part of the program. Talking about your overall health with a doctor is a great place to start.</p> <p><a href="https://www.essa.org.au/Public/Public/Searches/find-aep-withdistance.aspx">Accredited exercise physiologists</a> and <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitians</a> are the most appropriate allied health professionals to assess your physical structure, fitness and diet and work with you to get a plan in place to improve your health, fitness and reduce your current and future health risks.<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/226019/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/rob-newton-12124"><em>Rob Newton</em></a><em>, Professor of Exercise Medicine, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/good-news-midlife-health-is-about-more-than-a-waist-measurement-heres-why-226019">original article</a>.</em></p>

Body

Placeholder Content Image

Spice Girls reunite for Victoria Beckham's 50th birthday

<p>The Spice Girls have reunited and performed one of their most iconic songs at Victoria Beckham's lavish 50th birthday party. </p> <p>The birthday bash – which cost an estimated $480,000 – was hosted at Oswald’s, a private members’ restaurant in London, with all five Spice Girls, plus host of star guests, including Tom Cruise and Eva Longoria in attendance. </p> <p>David Beckham took to Instagram to share what Spice Girls fans have been dying to see - a video of the girl group singing and dancing to "Stop". </p> <p>“I mean come on x," he captioned the post. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C6AWKeaoENX/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C6AWKeaoENX/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by David Beckham (@davidbeckham)</a></p> </div> </blockquote> <p>Fans were over the moon and even British supermodel Adwoa Aboah commented: “What dreams are made of!”</p> <p>“David you are the best social media manager out there, thank you for giving the people CONTENT,” one fan wrote. </p> <p>“I am crying happy tears! OMG! I love Spice Girls so freaking much! Happy birthday, Victoria!” another commented. </p> <p>“The moment the entire planet has been waiting for,” a third added. </p> <p>"The way a whole generation is SHAKING," commented a fourth. </p> <p>Just last month, during an appearance on UK talk show <em>Loose Women</em>, Mel B hinted at a Spice Girls reunion of some kind, which she said would "definitely" be happening this year. </p> <p>“We are definitely doing something,” she told co-host Christine Lampard.</p> <p>“I’m probably going to get told off (for revealing that), but I’ve said it. There you go. I’m in trouble now.”</p> <p><em>Images: Instagram</em></p> <p> </p> <p> </p>

TV

Placeholder Content Image

Could not getting enough sleep increase your risk of type 2 diabetes?

<p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936"><em>University of Technology Sydney</em></a></em></p> <p>Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.</p> <p>So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.</p> <h2>The study</h2> <p>Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.</p> <p>The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.</p> <p>As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.</p> <p>Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.</p> <p>The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.</p> <p>One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.</p> <p>Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.</p> <h2>Why might short sleep increase diabetes risk?</h2> <p>In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.</p> <p>We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.</p> <p>Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>.</p> <p>This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.</p> <p>These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.</p> <p>While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.</p> <p>Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.</p> <p>The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>.</p> <h2>Good sleep, healthy diet</h2> <p>Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.</p> <p>Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.</p> <p>While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health.</p> <p>The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk.</p> <p>In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<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/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>.</em></p>

Body

Placeholder Content Image

Elephant tourism often involves cruelty – here are steps toward more humane, animal-friendly excursions

<p><em><a href="https://theconversation.com/profiles/michelle-szydlowski-1495781">Michelle Szydlowski</a>, <a href="https://theconversation.com/institutions/miami-university-1934">Miami University</a></em></p> <p>Suju Kali is a 50-year-old elephant in Nepal who has been carrying tourists for over 30 years. Like many elephants I encounter through my <a href="https://doi.org/10.1080/10888705.2022.2028628">research</a>, Suju Kali exhibits anxiety and can be aggressive toward strangers. She suffers from emotional trauma as a result of prolonged, commercial human contact.</p> <p>Like Suju Kali, many animals are trapped within the tourism industry. Some venues have no oversight and little concern for animal or tourist safety. Between 120,000 and 340,000 animals are used globally in a variety of wildlife tourism attractions, including <a href="https://doi.org/10.1371/journal.pone.0138939">endangered species</a> like elephants. Over a quarter of the world’s <a href="https://www.iucnredlist.org/species/7140/45818198">endangered elephants</a> reside in captivity with little oversight.</p> <p>Wildlife tourism – which involves viewing wildlife such as primates or birds in conservation areas, feeding or touching captive or “rehabilitated” wildlife in facilities, and bathing or riding animals like elephants – is <a href="https://doi.org/10.1080/14724049.2022.2156523">tricky business</a>. I know this because I am <a href="https://scholar.google.com/citations?user=YbweA2MAAAAJ&amp;hl=en">a researcher studying human relationships with elephants</a> in both tourism and conservation settings within Southeast Asia.</p> <p>These types of experiences have long been an <a href="https://kathmandupost.com/money/2021/06/17/tourism-is-nepal-s-fourth-largest-industry-by-employment-study">extremely popular and profitable</a> part of the <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002074">tourism market</a>. But now, many travel-related organizations are urging people not to participate in, or <a href="https://www.usatoday.com/story/travel/destinations/2018/04/27/animal-welfare-travelers-how-enjoy-wildlife-without-harming/544938002/">calling for an outright ban on, interactive wildlife experiences</a>.</p> <p>Tourism vendors have started marketing more “ethical options” for consumers. Some are attempting to truly improve the health and welfare of wildlife, and some are transitioning captive wildlife into touch-free, non-riding or lower-stress environments. In other places, organizations are attempting to <a href="https://www.fao.org/documents/card/es/c/b2c5dad0-b9b9-5a3d-a720-20bf3b9f0dc2/">implement standards of care</a> or create manuals that outline good practices for animal husbandry.</p> <p>This marketing, academics argue, is often simply “<a href="https://doi.org/10.1016/j.gecco.2017.11.007">greenwashing</a>,” <a href="http://dx.doi.org/10.1080/13683500.2023.2280704">applying marketing labels to make consumers feel better</a> about their choices without making any real changes. Worse, research shows that some programs marketing themselves as ethical tourism may instead be widening economic gaps and harming both humans and other species that they are meant to protect.</p> <h2>No quick fix</h2> <p>For example, rather than tourist dollars trickling down to local struggling families as intended by local governments, many tourism venues are owned by nonresidents, <a href="http://dx.doi.org/10.3126/japfcsc.v2i1.26746">meaning the profits do not stay in the area</a>. Likewise, only a small number of residents can afford to own tourism venues, and venues do not provide employment for locals from lower income groups.</p> <p>This economic gap is especially obvious in Nepalese elephant stables: Venue owners continue to make money off elephants, while elephant caregivers continue to work 17 hours a day for about US$21 a month; tourists are led to believe they are “<a href="https://www.cabidigitallibrary.org/doi/book/10.1079/9781800624498.0000">promoting sustainability</a>.”</p> <p>Yet, there are no easy answers, especially for elephants working in tourism. Moving them to sanctuaries is difficult because with no governmental or global welfare oversight, elephants may end up in worse conditions.</p> <p>Many kindhearted souls who want to “help” elephants know little about their biology and mental health needs, or what it takes to keep them healthy. Also, feeding large animals like Suju Kali is pricey, <a href="https://doi.org/10.3390/ani14010171">costing around $19,000 yearly</a>. So without profits from riding or other income, owners – or would-be rescuers – can’t maintain elephants. Releasing captive elephants to the jungle is not a choice – many have never learned to live in the wild, so they cannot survive on their own.</p> <h2>Hurting local people</h2> <p>Part of the problem lies with governments, as many have marketed tourism as a way to fund conservation projects. For example in Nepal, a percentage of ticket sales from elephant rides are given to community groups to use for forest preservation and support for local families.</p> <p>Increasing demand for <a href="https://www.routledge.com/Tourism-and-Animal-Ethics/Fennell/p/book/9781032431826">wildlife-based tourism</a> may increase traffic in the area and thus put pressure on local governments to further limit local people’s access to forest resources.</p> <p>This may also lead to <a href="https://www.worldanimalprotection.org/latest/news/un-world-tourism-organisation-urged-create-better-future-animals/">increased demands on local communities</a>, as was the case in Nepal. In the 1970s, the Nepalese government removed local people from their lands in what is now Chitwan National Park as part of increasing “conservation efforts” and changed the protected area’s boundaries. Indigenous “Tharu,” or people of the forest, were forced to abandon their villages and land. While some were offered access to “buffer zones” in the 1990s, many remain poor and landless today.</p> <p>In addition, more and more desirable land surrounding conservation areas in Nepal is being developed for tourist-based businesses such as hotels, restaurants and shops, <a href="http://dx.doi.org/10.3126/japfcsc.v2i1.26746">pushing local poor people farther away</a> from central village areas and the associated tourism income.</p> <p>Some activists would like humans to simply release all wildlife back into the wild, but <a href="https://www.cabidigitallibrary.org/doi/book/10.1079/9781800624498.0000">there are multiple issues</a> with that. Elephant habitats throughout Southeast Asia have been transformed into croplands, cities or train tracks for human use. Other problems arise from the fact that tourism elephants have <a href="https://doi.org/10.4324/9781315457413">never learned</a> how to be elephants in their natural elements, as they were <a href="https://www.pugetsound.edu/sites/default/files/file/8342_Journal%20of%20Tourism%20%282009%29_0.pdf">separated from their herds</a> at an early age.</p> <p>So tourism may be vital to providing food, care and shelter to captive elephants for the rest of their lives and providing jobs for those who really need them. Because elephants can live beyond 60 years, this can be a large commitment.</p> <h2>How to be an ethical tourist</h2> <p>To protect elephants, tourists should check out reviews and photos from any venue they want to visit, and look for clues that animal welfare might be impacted, such as tourists allowed to feed, hold or ride captive wildlife animals. Look for healthy animals, which means doing research on what “healthy” animals of that species should look like.</p> <p>If a venue lists no-touch demonstrations – “unnatural” behaviors that don’t mimic what an elephant might do of their own accord, such as sitting on a ball or riding a bike, or other performances – remember that the behind-the-scenes training used to achieve these behaviors can be <a href="https://doi.org/10.21832/9781845415051-014">violent, traumatic or coercive</a>.</p> <p>Another way to help people and elephant is to to use small, local companies to book your adventures in your area of interest, rather than paying large, international tourism agencies. Look for locally owned hotels, and wait to book excursions until you arrive so you can use local service providers. Book homestay programs and attend cultural events led by community members; talk to tourists and locals you meet in the target town to get their opinions, and use local guides who provide wildlife viewing opportunities <a href="https://nepaldynamicecotours.com/">while maintaining distance from animals</a>.</p> <p>Or tourists can ask to visit <a href="https://www.americanhumane.org/press-release/global-humane-launches-humane-tourism-certification-program/">venues that are certified</a> by international humane animal organizations and that <a href="https://www.su4e.org/">do not allow contact</a> with wildlife. Or they can opt for guided hikes, canoe or kayak experiences, and other environmentally friendly options.</p> <p>While these suggestions will not guarantee that your excursion is animal-friendly, they will help decrease your impact on wildlife, support local families and encourage venues to stop using elephants as entertainment. Those are good first steps.<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/219792/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/michelle-szydlowski-1495781">Michelle Szydlowski</a>, Visiting Assistant Professor, Department of Biology, Project Dragonfly, <a href="https://theconversation.com/institutions/miami-university-1934">Miami University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/elephant-tourism-often-involves-cruelty-here-are-steps-toward-more-humane-animal-friendly-excursions-219792">original article</a>.</em></p>

Travel Tips

Placeholder Content Image

Do optimists really live longer? Here’s what the research says

<p><em><a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, <a href="https://theconversation.com/institutions/durham-university-867">Durham University</a></em></p> <p>Do you tend to see the glass as half full, rather than half empty? Are you always looking on the bright side of life? If so, you may be surprised to learn that this tendency could actually be good for your health.</p> <p>A <a href="https://content.apa.org/record/2020-71981-001">number of studies</a> have shown that optimists enjoy higher levels of wellbeing, better sleep, lower stress and even better cardiovascular health and immune function. And now, <a href="https://pubmed.ncbi.nlm.nih.gov/35674052/">a recent study</a> has shown that being an optimist is linked to longer life.</p> <p>To conduct their study, researchers tracked the lifespan of nearly 160,000 women aged between 50 to 79 for a period of 26 years. At the beginning of the study, the women completed a <a href="https://local.psy.miami.edu/people/faculty/ccarver/availbale-self-report-instruments/lot-r/">self-report measure of optimism</a>. Women with the highest scores on the measure were categorised as optimists. Those with the lowest scores were considered pessimists.</p> <p>Then, in 2019, the researchers followed up with the participants who were still living. They also looked at the lifespan of participants who had died. What they found was that those who had the highest levels of optimism were more likely to live longer. More importantly, the optimists were also more likely than those who were pessimists to live into their nineties. Researchers refer to this as “exceptional longevity”, considering the average lifespan for women is about 83 years in developed countries.</p> <p>What makes these findings especially impressive is that the results remained even after accounting for other factors known to predict a long life – including education level and economic status, ethnicity, and whether a person suffered from depression or other chronic health conditions.</p> <p>But given this study only looked at women, it’s uncertain whether the same would be true for men. However, <a href="https://www.pnas.org/doi/abs/10.1073/pnas.1900712116">another study</a> which looked at both men and women also found that people with the highest levels of optimism enjoyed a lifespan that was between 11% and 15% longer than those who were the least optimistic.</p> <h2>The fountain of youth?</h2> <p>So why is it that optimists live longer? At first glance it would seem that it may have to do with their healthier lifestyle.</p> <p>For example, <a href="https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.117.310828">research from several studies</a> has found that optimism is linked to eating a healthy diet, staying physically active, and being less likely to smoke cigarettes. These healthy behaviours are well known to improve heart health and <a href="https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases">reduce the risk</a> for cardiovascular disease, which is a <a href="https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)">leading cause of death</a> globally. Adopting a healthy lifestyle is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857242/">important for reducing the risk</a> of other potentially deadly diseases, such as diabetes and cancer.</p> <p>But having a healthy lifestyle may only be part of the reason optimists live a longer than average life. This latest study found that lifestyle only accounted for 24% of the link between optimism and longevity. This suggests a number of other factors affect longevity for optimists.</p> <p>Another possible reason could be due to the way optimists manage stress. When faced with a stressful situation, optimists tend to deal with it head-on. They <a href="https://pubmed.ncbi.nlm.nih.gov/16859439/">use adaptive coping strategies</a> that help them resolve the source of the stress, or view the situation in a less stressful way. For example, optimists will problem-solve and plan ways to deal with the stressor, call on others for support, or try to find a “silver lining” in the stressful situation.</p> <p>All of these approaches are well-known to reduce feelings of stress, as well as the biological reactions that occur when we feel stressed. It’s these <a href="https://www.apa.org/topics/stress/body">biological reactions to stress</a> –- such as elevated cortisol (sometimes called the “stress hormone”), increased heart rate and blood pressure, and impaired immune system functioning –- that can take a toll on health over time and increase the risk for developing <a href="https://www.sciencedirect.com/science/article/pii/S0889159115004316?via%3Dihub">life-threatening diseases</a>, such as cardiovascular disease. In short, the way optimists cope with stress may help protect them somewhat against its harmful effects.</p> <h2>Looking on the bright side</h2> <p>Optimism is typically viewed by researchers as a relatively stable personality trait that is determined by both <a href="https://www.cambridge.org/core/journals/twin-research-and-human-genetics/article/sex-differences-in-the-genetic-architecture-of-optimism-and-health-and-their-interrelation-a-study-of-australian-and-swedish-twins/58F21AA11943D44B4BA4C63A966E6AC7">genetic</a> and early childhood influences (such as having a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541423/">secure and warm relationship</a> with your parents or caregivers). But if you’re not naturally prone to seeing the glass as half full, there are some ways you can increase your <a href="https://www.tandfonline.com/doi/abs/10.1080/17439760.2016.1221122?journalCode=rpos20">capacity to be optimistic</a>.</p> <p>Research shows optimism can change over time, and can be cultivated by engaging in simple exercises. For example, visualising and then writing about your “<a href="https://www.psychologytoday.com/us/blog/what-matters-most/201303/what-is-your-best-possible-self">best possible self</a>” (a future version of yourself who has accomplished your goals) is a technique that studies have found can <a href="https://www.tandfonline.com/doi/full/10.1080/17439760.2016.1221122">significantly increase optimism</a>, at least temporarily. But for best results, the goals need to be both positive and reasonable, rather than just wishful thinking. Similarly, simply <a href="https://www.tandfonline.com/doi/abs/10.3200/SOCP.149.3.349-364">thinking about positive future events</a> can also be effective for boosting optimism.</p> <p>It’s also crucial to temper any expectations for success with an accurate view of what you can and can’t control. Optimism is reinforced when we experience the positive outcomes that we expect, and <a href="https://psycnet.apa.org/record/1970-20680-001">can decrease</a> when these outcomes aren’t as we want them to be. Although more research is needed, it’s possible that regularly envisioning yourself as having the best possible outcomes, and taking realistic steps towards achieving them, can help develop an optimistic mindset.</p> <p>Of course, this might be easier said than done for some. If you’re someone who isn’t naturally optimistic, the best chances to improve your longevity is by <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003332">living a healthy lifestyle</a> by staying physically active, eating a healthy diet, managing stress, and getting a good night’s sleep. Add to this cultivating a more optimistic mindset and you might further increase your chances for a long life.<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/184785/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, Professor in Social &amp; Health Psychology, <a href="https://theconversation.com/institutions/durham-university-867">Durham University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-optimists-really-live-longer-heres-what-the-research-says-184785">original article</a>.</em></p>

Caring

Placeholder Content Image

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

<p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p>Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">lowering the risk</a> of a having a heart attack or stroke, while also silencing “<a href="https://theconversation.com/some-ozempic-users-say-it-silences-food-noise-but-there-are-drug-free-ways-to-stop-thinking-about-food-so-much-208467">food noise</a>”.</p> <p>As demand for semaglutide increases, so are <a href="https://www.smh.com.au/lifestyle/health-and-wellness/in-a-fat-phobic-world-ozempic-is-hardly-the-easy-way-out-20240401-p5fgjd.html">claims</a> that taking it is “cheating” at weight loss or the “easy way out”.</p> <p>We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.</p> <p>Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.</p> <h2>How does it work?</h2> <p>Semaglutide is a <a href="https://en.wikipedia.org/wiki/GLP-1_receptor_agonist">glucagon-like peptide-1</a> receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called <a href="https://en.wikipedia.org/wiki/Glucagon-like_peptide-1">GLP-1</a> for short, work better.</p> <p>GLP-1 gets secreted by cells in your gut when it <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">detects increased nutrient levels</a> after eating. This stimulates insulin production, which lowers blood sugars.</p> <p>GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.</p> <p><iframe id="tc-infographic-1031" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1031/c11b606581d4bc58a71f066492d7f740b52c04e1/site/index.html" width="100%" height="400px" frameborder="0"></iframe></p> <p>GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.</p> <p>Some studies have found less GLP-1 gets released after meals in <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">adults with obesity or type 2 diabetes mellitus</a> compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.</p> <p>GLP-1 has a very short half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/28443255/">two minutes</a>. So GLP-1RA medications were designed to have a very long half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">seven days</a>. That’s why semaglutide is given as a weekly injection.</p> <h2>What can users expect? What does the research say?</h2> <p>Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).</p> <p>A large group of <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">randomised controlled trials</a>, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.</p> <p>Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">led to 6–12% greater weight loss</a> compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.</p> <p>Weight reduction due to semaglutide also leads to a <a href="https://pubmed.ncbi.nlm.nih.gov/36769420/">reduction in systolic and diastolic blood pressure</a> of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">triglyceride levels</a> (a type of blood fat) and <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">improved physical function</a>.</p> <p>Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">20% lower risk</a> of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.</p> <h2>Who is eligible for semaglutide?</h2> <p>Australia’s regulator, the Therapeutic Goods Administration (TGA), has <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">approved</a> semaglutide, sold as Ozempic, for treating type 2 diabetes.</p> <p>However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.</p> <p>The TGA has <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy to treat obesity</a> but it’s not currently available in Australia.</p> <p>When it’s available, doctors will be able to prescribe <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">semaglutide to treat obesity</a> in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.</p> <h2>What else do you need to do during Ozempic treatment?</h2> <p>Checking details of the <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">STEP trial intervention components</a>, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.</p> <p>Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of <a href="https://www.healthdirect.gov.au/tips-for-getting-active">moderate-to-vigorous physical activity</a>, like brisk walking, dancing and gardening each week.</p> <p>STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">review of obesity medication trials</a> found people reported they needed less <a href="https://pubmed.ncbi.nlm.nih.gov/28652832/">cognitive behaviour training</a> to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and <a href="https://theconversation.com/9-ways-wont-power-is-better-than-willpower-for-resisting-temptation-and-helping-you-eat-better-71267">avoiding things that trigger eating</a>.</p> <h2>But what are the side effects?</h2> <p>Semaglutide’s side-effects <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">include</a> nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.</p> <p>In one study these <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">led to</a> discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.</p> <p>More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.</p> <p>To reduce risk or severity of side-effects, <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">medication doses are increased very slowly</a> over months. Once the full dose and response are achieved, research indicates you need to take it long term.</p> <p>Given this long-term commitment, and associated <a href="https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers/out-of-pocket-costs#:%7E:text=An%20out%20of%20pocket%20cost,called%20gap%20or%20patient%20payments">high out-of-pocket cost of medication</a>, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219116/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/clare-collins-7316"><em>Clare Collins</em></a><em>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>Image credits: </em><em>Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-taking-drugs-like-ozempic-isnt-cheating-at-weight-loss-or-the-easy-way-out-219116">original article</a>.</em></p>

Body

Placeholder Content Image

Days are getting shorter and colder. 6 tips for sticking to your fitness goal

<p><em><a href="https://theconversation.com/profiles/juliana-s-oliveira-709434">Juliana S. Oliveira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/anne-tiedemann-409380">Anne Tiedemann</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/cathie-sherrington-561141">Cathie Sherrington</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/leanne-hassett-1497197">Leanne Hassett</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Daylight saving ends this weekend. The days are shorter and getting colder. It’s less appealing to cycle to work, walk after dinner, or wake up early to hit the gym. But we all know daily physical activity is essential for our health and wellbeing.</p> <p>Physical activity releases feel-good neurotransmitters in our brains, which help to alleviate <a href="https://bjsm.bmj.com/content/57/18/1203">stress, anxiety, and depression</a>. It also helps <a href="https://www.cdc.gov/chronicdisease/resources/infographic/physical-activity.htm#:%7E:text=Regular%20physical%20activity%20helps%20improve,depression%20and%20anxiety%2C%20and%20dementia.">prevent diseases</a> such as diabetes, heart disease and some cancers. Regular physical activity can prolong life and improve overall quality of life.</p> <p>However, many of us find it difficult to achieve the <a href="https://bjsm.bmj.com/content/54/24/1451">recommended 150 minutes of moderate intensity physical activity</a> each week. In fact, three out of ten Australians and half of Australians aged 65 and over are <a href="https://www.aihw.gov.au/reports/physical-activity/physical-activity">inactive</a>.</p> <p>So, what can you do to stay motivated and keep moving regularly through the darker months? Here are some tips.</p> <h2>1. Nail those goals</h2> <p>Goals can provide us with a sense of purpose, meaning and direction. But just aiming to “get fit” is less likely to cut it than goals that are SMART: specific, measurable, achievable, realistic and time-bound.</p> <p><strong>Specific</strong> goals are based on an observable behaviour or activity, such as step count, yoga, or competing in an event.</p> <p><strong>Measurable</strong> goals can be tracked, so you can easily tell whether you have ticked them off.</p> <p><strong>Achievable</strong> goals are realistic and based on your current fitness and abilities. But they can and should still be challenging. If you’ve only ever run 5 kilometres, it won’t be realistic to aim for a half marathon in the next month. But you could aim for 10 kilometres.</p> <p><strong>Relevant</strong> goals hold personal meaning for you. Articulating why it’s important will help motivate you to do it.</p> <p><strong>Time-bound</strong> goals include a target date for achieving them. You can always revisit your deadline if you’re ahead of schedule or if it’s too unrealistic.</p> <p>An example of a SMART goal could be: “I will walk 10,000 steps every weekday within a month.” Then you can break it down into short-term goals to make it more achievable. If you currently walk 6,000 steps each day, you can increase steps by 1,000 every week to reach 10,000 by the end of the month.</p> <h2>2. Keep track</h2> <p>More than <a href="https://www.deloitte.com/au/en/Industries/tmt/blogs/digital-consumer-trends-who-is-purchasing-what-now.html">90% of Australians own a smartphone</a> and more than <a href="https://www.deloitte.com/au/en/Industries/telecom-media-entertainment/blogs/digital-consumer-trends-touch-less-healthier-wiser.html">two in ten own a fitness tracker or a smartwatch</a>. These devices can help you track your goals and activity, keep you accountable and increase your motivation.</p> <p>A 2021 systematic review suggests fitness trackers and smartphone apps <a href="https://bjsm.bmj.com/content/55/8/422">can assist people</a> to increase their step count by up to 2,000 steps per day. <a href="https://bjsm.bmj.com/content/54/20/1188">Our research</a> demonstrated fitness trackers can also be helpful in increasing physical activity among older people. If you don’t have a fitness tracker, you can buy low-cost pedometers or track your activity times using paper and pen.</p> <h2>3. Plan for success but prepare for barriers</h2> <p>Take some time to think about the potential barriers that could prevent you from being active and plan solutions to overcome them.</p> <p>For example, if the cost of physical activity is too high for you, try to find options that are free, such as walking or running. You can also consider free online programs or streaming videos.</p> <p>If you find it difficult to fit exercise into your busy schedule, try exercising early in the morning before you start your day and laying out your workout clothes the night before. You could consider joining a gym with flexible timetables. A good strategy is to try to fit physical activity into your daily routine, such as walking or cycling to work.</p> <p>If you are living with a chronic health condition or disability, consider seeking guidance from a health professional such as an <a href="https://www.essa.org.au/Public/SearchAEP.aspx?WebsiteKey=44cfee74-3fc3-444e-bb5f-77729c390872">exercise physiologist</a> or <a href="https://choose.physio/find-a-physio">physiotherapist</a>. Start slow and gradually increase your activity and find something you enjoy so you are more likely to keep doing it.</p> <h2>4. Team up with a workout friend</h2> <p>Physical activity can be more fun when you do it with someone else. Studies show <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167494322002953?via%253Dihub&amp;sa=D&amp;source=docs&amp;ust=1712015093947627&amp;usg=AOvVaw1XGQBMDMFspL5YrQtKo3h">working out with friends can be more motivating and enjoyable</a>. It can also help with accountability, as some people are more likely to show up when they have a workout partner. So, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60407-9/fulltext">find a friend</a> who supports your goal of being more active or maintaining your current activity levels.</p> <h2>5. Plan yourself a little treat</h2> <p>Make an appointment with yourself in your diary to exercise. Approach it as just as important as meeting a friend or colleague. One idea is to delay something you’d rather do and make it a reward for sticking to your activity appointment. If you really want to go out for coffee, do a hobby, or watch something, go for a walk first.</p> <p>Research shows <a href="https://www.nature.com/articles/s41746-019-0164-3">incentives can dramatically increase physical activity levels</a>.</p> <h2>6. Find a coach</h2> <p>If you want more support, <a href="https://bjsm.bmj.com/content/51/19/1425">health coaching</a> might be an option.</p> <p>Trained professionals work one-on-one with people, sometimes via telehealth, to find out what’s reducing their motivation to make healthier choices, such as exercise. Then they employ behaviour change techniques to help them meet their health goals.</p> <p>Our recent research suggests health coaching can improve physical activity in <a href="https://bjsm.bmj.com/content/58/7/382">older people</a> and those with <a href="https://www.sciencedirect.com/science/article/pii/S183695532400002X">chronic pain</a>. In <a href="https://www.gethealthynsw.com.au/#:%7E:text=About%20the%20Get%20Healthy%20Service&amp;text=Delivered%20by%20NSW%20Health%2C%20the,and%20achieve%20your%20health%20goals">New South Wales</a>, <a href="https://lifeprogram.org.au/">Victoria</a> and <a href="https://www.myhealthforlife.com.au/">Queensland</a>, these sessions are government-subsidised or free.<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/226619/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/juliana-s-oliveira-709434">Juliana S. Oliveira</a>, Postdoctoral Research Fellow, Physical Activity, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/anne-tiedemann-409380">Anne Tiedemann</a>, Professor of Physical Activity and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/cathie-sherrington-561141">Cathie Sherrington</a>, Professor, Institute for Musculoskeletal Health, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/leanne-hassett-1497197">Leanne Hassett</a>, Associate Professor in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/days-are-getting-shorter-and-colder-6-tips-for-sticking-to-your-fitness-goals-226619">original article</a>.</em></p>

Body

Placeholder Content Image

Silent cancers: here’s what you need to know when there are no obvious symptoms

<p><em><a href="https://theconversation.com/profiles/justin-stebbing-1405462">Justin Stebbing</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p>The recent revelations about the Princess of Wales’s <a href="https://www.bbc.com/news/uk-68640917">cancer diagnosis</a> highlight a crucial aspect of cancer detection – the disease’s sometimes silent nature.</p> <p>Silent cancers are those without noticeable symptoms. They pose a unique challenge in early detection and treatment.</p> <p>Contrary to common perception, cancer does not always announce its presence through overt symptoms or obvious signs. Many people receive a <a href="https://academic.oup.com/clinchem/article-abstract/70/1/179/7283928">cancer diagnosis incidentally</a>, when it’s found during routine medical examinations or investigations for unrelated health concerns – as seems to be the case for both <a href="https://www.wsj.com/health/kate-middleton-catherine-cancer-what-is-preventative-chemotherapy-9625370d">the princess</a> and <a href="https://www.bbc.co.uk/news/health-68171163">King Charles III</a>.</p> <p>While even silent cancers can sometimes be <a href="https://pubmed.ncbi.nlm.nih.gov/22584215/">aggressive and advance rapidly</a>, they can also remain <a href="https://pubmed.ncbi.nlm.nih.gov/20363069/">dormant</a> for years or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819710/">even decades</a>. Some <a href="https://ascopubs.org/doi/10.14694/EdBook_AM.2012.32.98">prostate</a>, <a href="https://ascopubs.org/doi/10.14694/EdBook_AM.2012.32.301">breast</a> and <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.571421/full">thyroid</a> cancers, for example, <a href="https://www.tmlep.com/clinical-learning/2023-01-23-when-did-this-tumour-start-the-need-for-a-gompertzian-understanding-of-tumour-growth-kinetics">often evolve slowly</a> without obvious symptoms or spreading beyond the original area.</p> <p>Research suggests that some of these cancers are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.571421/full">overtreated</a>. Sometimes patients are best left alone or treated much more gently, perhaps even without medical intervention, using a <a href="https://www.nejm.org/doi/full/10.1056/nejmoa1311593">“watch and wait”</a> strategy. This approach may be taken with prostate cancer in the elderly, for example.</p> <h2>The importance of early diagnosis</h2> <p>Whatever the cancer, it’s always important to get an early diagnosis though – and for silent cancers, this is obviously a challenge.</p> <p>Some cancer symptoms <a href="https://pubmed.ncbi.nlm.nih.gov/36702593/">can be vague</a> and easily mistaken for benign ailments. Fatigue, unexplained weight loss and persistent pain are among the nonspecific symptoms that may signal an underlying malignancy. But such symptoms can be misinterpreted or easily dismissed, which contributes to delayed diagnosis and treatment.</p> <figure><iframe src="https://www.youtube.com/embed/MGMy6BzBvp0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Fortunately, in many countries including the UK, we have <a href="https://www.england.nhs.uk/cancer/early-diagnosis/screening-and-earlier-diagnosis/">screening</a> tests for diseases like breast or colon cancer, to increase early diagnoses.</p> <p>Early diagnosis is a <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.32887">key factor</a> for successful cancer treatment. Detecting cancer in its silent phase offers a window of opportunity for early intervention and improved outcomes. The discovery of asymptomatic cancers through diagnostic imaging or screening tests underscores the importance of these proactive healthcare measures.</p> <p>Identifying cancer at an early stage means the disease is confined to its site of origin, smaller and potentially easier to cure. Diagnosing a smaller cancer often means that if an operation is needed, it may be a less invasive surgery. There may also be a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825992/">lower chance</a> of needing post-operative preventative chemotherapy, to mop up any residual cells.</p> <p>Colorectal cancer (CRC) is a good example to show the critical importance of screening. Studies show that patients who participate in CRC <a href="https://www.nice.org.uk/guidance/dg56/chapter/1-Recommendations">screening</a>, such as colonoscopies or tests that look for blood in the stool, are more likely to be diagnosed while asymptomatic and have more positive prognoses after treatment. Those diagnosed with CRC after showing symptoms, such as rectal bleeding or changes in bowel habits, tend to have more <a href="https://bmjopengastro.bmj.com/content/4/1/e000146%20">advanced tumors and poorer outcomes</a>.</p> <figure><iframe src="https://www.youtube.com/embed/nA9_Io3LDpA?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Public health initiatives aimed at raising awareness about the importance of both cancer screening and symptom recognition play a pivotal role in reducing diagnostic delays. Empowering people to engage in <a href="https://healthcaredelivery.cancer.gov/prevention/#:%7E:text=Cancer%20can%20be%20prevented%20through,they%20are%20more%20easily%20treated.">preventive healthcare measures</a> such as HPV vaccinations and lifestyle changes that decrease risk can facilitate early detection and intervention, potentially altering the trajectory of the disease.</p> <h2>Biomarker discovery</h2> <p>The latest advances in diagnostic technologies, often known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012218/#:%7E:text=During%20biomarker%20discovery%2C%20evaluation%20of,design%20of%20future%20validation%20studies.">“biomarker discovery”</a>, hold promise for improving early detection rates and refining treatment strategies for silent cancers. From <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/molecular-profiling">molecular profiling</a> to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922467/">liquid biopsy techniques</a> (blood tests to diagnose cancer), innovative approaches are reshaping the landscape of cancer diagnosis, offering new avenues for personalised and precision medicine.</p> <p>For example, I worked with a team using blood tests to identify cancers in more than <a href="https://www.nature.com/articles/s41388-023-02591-z">1,000 women recalled after screening for mammography</a>. We looked at the DNA that tumour cells release – so-called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496721/">cell-free DNA</a> – and also metabolomics (rare markers related to metabolism in the blood). From this information, we found healthy patients, benign disease, pre-cancer and breast cancer. Although there’s increasing awareness and use of this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1769721218307110">approach in Europe</a>, it isn’t standard in the UK.</p> <p>Asymptomatic cancers represent a formidable challenge for patient care. But, by encouraging patients to adopt preventive lifestyles and engage with screenings and tests, asymptomatic cancers don’t have to be a hidden threat to health.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226536/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/justin-stebbing-1405462">Justin Stebbing</a>, Professor of Biomedical Sciences, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/silent-cancers-heres-what-you-need-to-know-when-there-are-no-obvious-symptoms-226536">original article</a>.</em></p>

Body

Placeholder Content Image

There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

<p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people.</p> <p>Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020.</p> <p>It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year.</p> <p>Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>.</p> <h2>What goes into a flu vaccine?</h2> <p>Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus.</p> <p>Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains.</p> <p>All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future.</p> <h2>What’s different about new flu vaccines?</h2> <p>There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad).</p> <p>Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely.</p> <p>However, there have been several enhancements to influenza vaccines in recent years.</p> <p>Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people.</p> <p>An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people.</p> <p>Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future.</p> <h2>What should I do this year?</h2> <p>Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life.</p> <p>Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>.</p> <p>In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need.</p> <h2>Are there side effects?</h2> <p>All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines.</p> <p>As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines.</p> <p>Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<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/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.</em></p>

Body

Placeholder Content Image

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<p><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <em><a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <em><a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs.</p> <p>As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns.</p> <p>But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug.</p> <h2>Potential benefits</h2> <p><strong>1) It’s likely to help you lose weight</strong></p> <p>The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity.</p> <p>The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight).</p> <p>In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg.</p> <p>Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication.</p> <p><strong>2) It may reduce your chronic disease risk factors</strong></p> <p>When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases.</p> <p>In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels.</p> <p>In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels.</p> <p><strong>3) It might improve your quality of life, emotional wellbeing or sense of achievement</strong></p> <p>The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health.</p> <p>Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image.</p> <h2>What about the risks?</h2> <p><strong>1) You may experience gastrointestinal symptoms</strong></p> <p>In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%).</p> <p>In the UK study, nausea and diarrhoea were also commonly reported.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living.</p> <p>Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study.</p> <p><strong>2) You might feel fatigued</strong></p> <p>Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants.</p> <p><strong>3) You might be among the minority who don’t tolerate the drug</strong></p> <p>Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia.</p> <p>In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing.</p> <p>More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period.</p> <p>A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period.</p> <p>Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions.</p> <p><strong>4) It might be difficult to access</strong></p> <p>Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024.</p> <p>To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication.</p> <p><strong>5) You might not always get clear information from vested interests</strong></p> <p>Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>.</p> <p>Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications.</p> <h2>Bottom line</h2> <p>Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/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>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.</em></p>

Body

Placeholder Content Image

Eating some chocolate really might be good for you – here’s what the research says

<p><em><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p>Although it always makes me scoff slightly to see Easter eggs making their first appearance in supermarkets at the end of December, there are few people who aren’t delighted to receive a bit of chocolate every year.</p> <p>It makes sense that too much chocolate would be bad for you because of the high fat and sugar content in most products. But what should we make of common claims that eating some chocolate is actually good for you?</p> <p>Happily, there is a fair amount of evidence that shows, in the right circumstances, chocolate may be both beneficial for your heart and good for your mental state.</p> <p>In fact, chocolate – or more specifically cacao, the raw, unrefined bean – is a medicinal wonder. It contains many different active compounds which can evoke pharmacological effects within the body, like medicines or drugs.</p> <p>Compounds that lead to neurological effects in the brain have to be able to cross the <a href="https://link.springer.com/chapter/10.1007/978-3-642-13443-2_7">blood-brain barrier</a>, the protective shield which prevents harmful substances – like toxins and bacteria – entering the delicate nervous tissue.</p> <p>One of these is the compound <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672386/">theobromine</a>, which is also found in tea and contributes towards its bitter taste. Tea and chocolate also contain caffeine, which theobromine is related to as part of the purine family of chemicals.</p> <p>These chemicals, among others, contribute to chocolate’s addictive nature. They have the ability to cross the blood-brain barrier, where they can influence the nervous system. They are therefore known as <a href="https://pubmed.ncbi.nlm.nih.gov/15549276/">psychoactive</a> chemicals.</p> <figure><iframe src="https://www.youtube.com/embed/HloqayQdR6M?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>What effects can chocolate have on mood? Well, <a href="https://academic.oup.com/nutritionreviews/article/71/10/665/1931144?login=false">a systematic review</a> looked at a group of studies which examined the feelings and emotions associated with consuming chocolate. Most demonstrated improvements in mood, anxiety, energy and states of arousal.</p> <p>Some noted the feeling of guilt, which is perhaps something we’ve all felt after one too many Dairy Milks.</p> <h2>Health benefits of cocoa</h2> <p>There are other organs, aside from the brain, that might benefit from the medicinal effects of cocoa. For centuries, chocolate has been used as a medicine to treat a <a href="https://pubmed.ncbi.nlm.nih.gov/10917925/">long list of diseases</a> including anaemia, tuberculosis, gout and even low libido.</p> <p>These might be spurious claims but there is evidence to suggest that eating cacao has a positive effect on the cardiovascular system. First, it can prevent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068178/">endothelial dysfunction</a>. This is the process through which arteries harden and get laden down with fatty plaques, which can in turn lead to heart attacks and strokes.</p> <p>Eating dark chocolate may also reduce <a href="https://www.sciencedirect.com/science/article/pii/S1537189115001135?via%3Dihub">blood pressure</a>, which is another risk factor for developing arterial disease, and prevent formation of clots which block up blood vessels.</p> <figure><iframe src="https://www.youtube.com/embed/8VUcPCbSSCY?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Some studies have suggested that dark chocolate might be useful in adjusting ratios of <a href="https://pubmed.ncbi.nlm.nih.gov/20968113/">high-density lipoprotein cholesterol</a>, which can help protect the heart.</p> <p>Others have examined insulin resistance, the phenomenon associated with Type 2 diabetes and weight gain. They suggest that the <a href="https://www.sciencedirect.com/science/article/pii/S0963996900000697#:%7E:text=Cocoa%20is%20rich%20in%20polyphenols%20particularly%20in%20catechins,and%20cocoa%20powder%20have%20been%20published%20only%20recently.">polyphenols</a> – chemical compounds present in plants – found in foodstuffs like chocolate may also lead to <a href="https://pubmed.ncbi.nlm.nih.gov/29993262/">improved control of blood sugars</a>.</p> <h2>Chocolate toxicity</h2> <p>As much as chocolate might be considered a medicine for some, it can be a poison for others.</p> <p>It’s well documented that the ingestion of caffeine and theobromine is highly toxic for domestic animals. Dogs are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801869/">particularly affected</a> because of their often voracious appetites and generally unfussy natures.</p> <p>The culprit is often dark chocolate, which can provoke symptoms of agitation, rigid muscles and even seizures. In certain cases, if ingested in high enough quantities, it can lead to comas and abnormal, even fatal heart rhythms.</p> <p>Some of the compounds found in chocolate have also been found to have potentially negative effects in humans. Chocolate is a source of oxalate which, along with calcium, is one of the main components of <a href="https://pubmed.ncbi.nlm.nih.gov/20301742/">kidney stones</a>.</p> <p>Some clinical groups have advised against consuming oxalate rich foods, such as spinach and rhubarb – and chocolate, for those who suffer from recurrent kidney stones.</p> <p>So, what should all this mean for our chocolate consumption habits? Science points in the direction of chocolate that has as high a cocoa solid content as possible, and the minimum of extras. The potentially harmful effects of chocolate are more related to fat and sugar, and may counteract any possible benefits.</p> <p>A daily dose of 20g-30g of plain or dark chocolate with cocoa solids above 70% – rather than milk chocolate, which contains fewer solids and white chocolate, which contains none – could lead to a greater health benefit, as well as a greater high.</p> <p>But whatever chocolate you go for, please don’t share it with the dog.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226759/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/dan-baumgardt-1451396"><em>Dan Baumgardt</em></a><em>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/eating-some-chocolate-really-might-be-good-for-you-heres-what-the-research-says-226759">original article</a>.</em></p>

Body

Placeholder Content Image

How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">La<em>wson R. Wulsin</em></a><em>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a></em></p> <p>COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others.</p> <p>So how much stress is too much, and what can you do about it?</p> <p>I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues.</p> <p>I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.”</p> <p>A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging.</p> <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</span></figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> <p>Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit.</p> <p>Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.”</p> <p>The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface.</p> <p>When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions.</p> <p>For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors.</p> <h2>‘Treating’ stress</h2> <p>Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan.</p> <p>Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure.</p> <p>Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>.</p> <p>Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress.</p> <p>Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses.</p> <h2>Suffering from toxic stress</h2> <p>Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood.</p> <p>Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be.</p> <p>And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all.</p> <p>Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress.</p> <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Exercise, meditation and a healthy diet help fight toxic stress.</span></figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> <p>The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>.</p> <p>The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate.</p> <p>Adopting these lifestyle changes is not quick or easy, but it works.</p> <p>The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits.</p> <p>There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655"><em>Lawson R. Wulsin</em></a><em>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.</em></p>

Mind

Placeholder Content Image

Announcing Kate Middleton’s cancer diagnosis should have been simple. But the palace let it get out of hand

<p><em><a href="https://theconversation.com/profiles/victoria-fielding-236389">Victoria Fielding</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/saira-ali-1522239">Saira Ali</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>The British royal family is famous for its carefully curated media image. That’s why it was a surprise to see them lose control of the narrative in the wake of what we now know is a serious health crisis befalling Catherine, Princess of Wales (or Kate Middleton as she’s popularly known).</p> <p>It is clear the nearly 1,000-year-old institution of the monarchy and its tradition of “<a href="https://news.northeastern.edu/2024/03/14/kate-middleton-photo-pr-crisis/">never complain, never explain</a>” is being tested by social media and its power to spread rumours and misinformation. The palace’s public relations team has underestimated how difficult it is to manage relationships with social media audiences. Their reactive attempts to rein in speculation has turned Catherine’s health challenge into a PR disaster.</p> <p>Social media, with its lax regulations and freer environment, offers a more open forum for users to say whatever they like about the royals. It’s served as a hotbed for Catherine conspiracies, particularly on TikTok. These theories are as wild as they are ridiculous, from Catherine being a prisoner in the palace to her hiding in <a href="https://www.prdaily.com/kate-middleton-stanley-alabama-retail/">Taylor Swift’s London home</a>.</p> <p>What should have been a simple announcement to a sympathetic public about a popular royal having cancer turned into a spider’s web of competing conspiracy theories across social media. How did it all go so terribly wrong?</p> <h2>I’ve lost track, what happened?</h2> <p>All was well with the Prince and Princess of Wales when they were filmed attending church on Christmas Day. As usual when royals are out in public, the scene was picture perfect with everyone dutifully smiling for the cameras in “<a href="https://www.harpersbazaar.com/celebrity/latest/a46227698/kate-middleton-royal-blue-christmas-day-church-service-prince-william-kids/">co-ordinated</a>” outfits.</p> <p>Two weeks later, Kensington Palace announced Catherine had undergone planned abdominal surgery, with <a href="https://abcnews.go.com/GMA/Culture/princess-kate-hospitalized-after-planned-abdominal-surgery-palace/story?id=106441561">palace sources</a> telling media the surgery had been “successful” and she would need two weeks to recover.</p> <p>On January 29, the palace announced Catherine had returned home to recuperate. <a href="https://www.townandcountrymag.com/society/tradition/a46569739/king-charles-discharged-from-hospital/">Unlike King Charles</a> when he released news of his cancer diagnosis on February 5, Catherine was not photographed leaving hospital. This was the first PR misstep. She had appeared outside hospital soon after giving birth to her three children, but this time she remained uncharacteristically out of the public eye.</p> <p>Almost a month later, when Prince William <a href="https://au.lifestyle.yahoo.com/prince-william-pulls-memorial-godfather-211406977.html?amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&amp;guce_referrer_sig=AQAAAG6tOzuXsqZXP6G2nLLd-lnWzZhYKHVJ5TJ-w5XCCfgMjerRrR8v1R8unjtcoQTbvPDsVt3mtTcZ_g0os6zwOuEFfMKCh0kfEExvz-dB2FG0uqcy6-GoryjvG99TEhMli66hNZLjLENmMhq1mwoV7GmM0AYezMDsZtZVtONH9C1b&amp;guccounter=2">unexpectedly withdrew</a> from his godfather’s memorial citing “personal reasons”, social media users started asking “Where is Princess Kate?”.</p> <p>Used to a steady stream of content about the royal family, the public were unsurprisingly questioning if there was more to Catherine’s abdominal surgery than they were being told.</p> <p>In a rare reactive move, the palace tried to quell questions about Catherine’s whereabouts by releasing a <a href="https://people.com/palace-responds-kate-middleton-conspiracy-theories-online-surgery-recovery-rare-statement-8602191">statement</a> reiterating that she would not be returning to public duties until Easter.</p> <p>On March 4, US outlet <a href="https://www.tmz.com/2024/03/04/kate-middleton-seen-spotted-public-first-time-mystery-hospitalization/">TMZ published</a> a paparazzi photo of Catherine driving with her mother. Social media audiences asked if it really was Catherine.</p> <p>Over the next week, conspiracy theories about Catherine’s absence reached frenzied levels. To show everything was fine, Kensington Palace released a <a href="https://twitter.com/KensingtonRoyal/status/1766750995445387393?s=20">Mother’s Day photo</a> of Catherine and her children on their social media accounts. Social media users spotted apparently edited flaws and global news agencies announced “<a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">kill orders</a>”, saying the image had been manipulated. The next day, Catherine <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised</a> on social media for editing the photo.</p> <p>Although royals have been <a href="https://www.townandcountrymag.com/society/tradition/a60191061/royal-photoshop-history/">editing their pictures</a> for centuries, it seems particularly digitally naive of the palace’s PR team to release such an obviously edited image into an already cynical social media environment, creating fodder for more conspiracy theories.</p> <p>Mainstream news outlets then joined social media users in asking questions about Catherine’s absence. Although this media attention did not legitimise wild conspiracies, in some ways it fuelled them.</p> <p>Days later, TMZ <a href="https://www.youtube.com/watch?v=erWJNmbrECs">published footage</a> of Catherine and William shopping. At this point in the media chaos, many social media users claimed it was fake.</p> <p>This intense public speculation finally ended on March 23, when Catherine <a href="https://twitter.com/KensingtonRoyal/status/1771235267837321694?s=20">released a video</a> explaining her extended absence after abdominal surgery was caused by the surgeons discovering cancer.</p> <p>During a crisis, the public crave transparency, authenticity, honesty and reassurance. These elements were missing in the royal PR team’s carefully worded statements made directly to mainstream media along with reactive, overly curated social media posts.</p> <p>By providing scant details, the palace seemed to believe they could control public perception. But public image is increasingly difficult to control.</p> <h2>The double-edged sword of social media</h2> <p>After Princess Diana’s death in a paparazzi-chase car accident, privacy laws and <a href="https://time.com/4914324/princess-diana-anniversary-paparazzi-tabloid-media/">media regulations</a> forbade the most invasive breaches of the royal family’s privacy, particularly for her children, princes William and Harry. However, tabloid appetite for uncontrolled access soon returned once the princes became adults.</p> <p>Recently, Harry and his wife Meghan have been involved in <a href="https://www.reuters.com/world/uk/prince-harry-his-many-lawsuits-against-press-2023-12-15/">several lawsuits</a> against media companies over breaches of privacy, including phone hacking.</p> <p>The rise of social media has typically been viewed as a tool that gives royals more control over their image through the curation of their own personal content. Previously, the fact Catherine was the one <a href="https://www.businessinsider.com/kate-middleton-cutest-family-photos-2018-5">taking photos</a> of her children was seen as a sign of authenticity and being down to earth (as much as a princess could be).</p> <p>Yet, social media is both a blessing and a curse for the management of public reputations.</p> <p>The perpetuation of contested facts and theories on social media in the wake of Princess Catherine’s unexplained absence shows how difficult it is to curate a controlled image using social media. Lack of verified information in mainstream media helps fuel speculative flames.</p> <p>While <a href="https://www.thedrum.com/news/2024/03/22/where-the-palace-lost-the-plot-and-what-we-can-learn-about-pr-and-empathy-kategate">PR experts</a> believe it is understandable and appropriate for Catherine and her family to have privacy during this time, more timely, direct and honest communication would have gone a long way to prevent relentless gossip.</p> <p>Once rumours and conspiracies gained momentum, the palace perhaps thought the less information provided, the better. However, silence during a crisis just fuels more speculation because the lack of information makes it look like there is something to hide.</p> <p>Catherine’s personal video announcing her cancer diagnosis helped end the social media frenzy. This shows a simple, clear statement posted by Kensington Palace to social media weeks ago would likely have avoided the PR disaster and provided Catherine the privacy she so clearly needs.</p> <p>The palace is now <a href="https://www.sheknows.com/entertainment/articles/2986509/kate-middleton-cancer-pr-disaster/">being criticised</a> for complicating a situation that was relatively simple in retrospect. Many social media users are also upset Catherine took public blame for the photoshopping incident.</p> <p>Any organisation that deals with the media to maintain positive reputations, including the British monarchy, has no choice but to adapt to all kinds of media, including social media. The long-time practice of keeping calm and carrying on amid controversy and the 24-hour gossip cycle doesn’t work in the era of TikTok, X and YouTube.</p> <p>In the absence of trusted information, social media will do what it does best: take mostly innocuous online chatter and amplify it until it goes viral.<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/226490/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/victoria-fielding-236389">Victoria Fielding</a>, Lecturer, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/saira-ali-1522239">Saira Ali</a>, Senior Lecturer in Media, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/announcing-kate-middletons-cancer-diagnosis-should-have-been-simple-but-the-palace-let-it-get-out-of-hand-226490">original article</a>.</em></p>

Caring

Placeholder Content Image

Here’s why having chocolate can make you feel great or a bit sick – plus 4 tips for better eating

<p><em><a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p>Australians are <a href="https://www.retail.org.au/media/sweet-spending-boon-predicted-for-easter-retail">predicted</a> to spend around A$1.7 billion on chocolates, hot cross buns and other special foods this Easter season.</p> <p>Chocolate has a long history of production and consumption. It is made from cacao beans that go through processes including fermentation, drying, roasting and grounding. What is left is a rich and fatty liquor that is pressed to remove the fat (cocoa butter) and the cacao (or “cocoa”) powder which will then be mixed with different ingredients to produce dark, milk, white and other types of chocolates.</p> <p>There are several health benefits and potential problems that come in these sweet chocolatey packages.</p> <h2>The good news</h2> <p>Cacao beans contain <a href="https://foodstruct.com/food/cocoa-bean">minerals</a> like iron, potassium, magnesium, zinc and phosphorus and some vitamins. They are also rich in beneficial chemicals called <a href="https://pubmed.ncbi.nlm.nih.gov/23150750/">polyphenols</a>.</p> <p>These are great antioxidants, with the potential to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465250/">improve heart health</a>, increase <a href="https://pubmed.ncbi.nlm.nih.gov/25164923/">nitric oxide</a> (which dilates blood vessels) and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488419/">reduce blood pressure</a>, provide food for gut microbiota and <a href="https://www.mdpi.com/2072-6643/12/7/1908">promote gut health</a>, boost the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465250/">immune system</a> and reduce inflammation.</p> <p>However, the concentration of polyphenols in the chocolate we eat depends largely on the cocoa solid amounts used in the final product.</p> <p>In general terms, the darker the chocolate, the more cocoa solids, minerals and polyphenols it has. For example, dark chocolates may have around <a href="https://www.tandfonline.com/doi/full/10.1080/10942912.2011.614984">seven times more polyphenols</a> compared to white chocolates and <a href="https://www.tandfonline.com/doi/full/10.1080/10942912.2011.614984">three times more polyphenols</a> compared to milk chocolates.</p> <h2>But also some bad news</h2> <p>Unfortunately, the <a href="https://theconversation.com/treat-or-treatment-chocolate-is-good-but-cocoa-is-better-for-your-heart-3084">health benefits of cocoa solids</a> are easily offset by the high sugar and fat content of modern-day chocolates. For example, milk and white chocolate eggs are on average 50% sugar, 40% fat (mostly saturated fats) – which means a lot of added kilojoules (calories).</p> <p>Also, there may be some side effects that come with ingesting chocolate.</p> <p>Cocoa beans include a compound called theobromine. While it has the anti-inflammatory properties responsible for some of the health benefits of chocolate, it is also a mild brain stimulant that acts in a similar way to caffeine. The mood boost it offers may also be partly responsible for how much we <a href="https://www.frontiersin.org/articles/10.3389/fphar.2015.00030/full?crsi=662496658&amp;cicada_org_src=healthwebmagazine.com&amp;cicada_org_mdm=direct">like chocolate</a>. Dark chocolate has higher theobromine compared to milk and white chocolate.</p> <p>But accordingly, overindulging in chocolate (and therefore theobromine) may lead to feeling restless, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672386/">headaches</a> and nausea.</p> <h2>What else is in your chocolate?</h2> <p>Milk and dairy-based chocolates may also cause stomach upset, abdominal pain and bloating in people with <a href="https://dietitiansaustralia.org.au/health-advice/lactose-intolerance">lactose intolerance</a>. This happens when we don’t produce enough lactase enzymes to digest milk sugar (lactose).</p> <p>People with lactose intolerance can usually tolerate up to 6 grams of lactose without showing symptoms. Milk chocolate can have around <a href="https://www.ncbi.nlm.nih.gov/books/NBK310258/">3 grams of lactose</a> per 40 grams (the size of a standard chocolate bar). So two chocolate bars (or the equivalent in milk chocolate eggs or bunnies) may be enough to cause symptoms.</p> <p>It’s worth noting that lactase enzyme activity dramatically declines as we age, with the highest activity in newborns and children. So lactose sensitivity or intolerance may not be such an issue for your kids and your symptoms may increase over time. Genetics also plays a major role in how sensitive people are to lactose.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815241/">Allergic reactions</a> to chocolate are usually due to the added ingredients or cross-contamination with potential allergens such as nuts, milk, soy, and some sweeteners used in the production of chocolate.</p> <p>Symptoms can be mild (acne, rashes and stomach pain) or more severe (swelling of the throat and tongue and shortness of breath).</p> <p>If you or your family members have known allergic reactions, make sure you read the label before indulging – especially in a whole block or basket of the stuff. And if you or your family members do experience symptoms of an allergic reaction after eating chocolate, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/allergic-reactions-emergency-first-aid">seek medical attention</a> immediately.</p> <h2>4 take home tips</h2> <p>So, if you are like me and have a weakness for chocolate there are a few things you can do to make the experience a good one.<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/202848/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <ol> <li>keep an eye out for the darker chocolate varieties with higher cocoa solids. You may notice a percentage on labelling, which refers to how much of its weight is from cocoa beans. In general, the higher this percentage, the lower the sugar. White chocolate has almost no cocoa solid, and mostly cocoa butter, sugar and other ingredients. Dark chocolate has 50–100% cocoa beans, and less sugar. Aim for at least 70% cocoa</li> <li>read the fine print for additives and possible cross-contamination, especially if allergies might be an issue</li> <li>the ingredients list and nutrition information panel should tell you all about the chocolate you choosing. Go for varieties with lower sugar and less saturated fat. Nuts, seeds and dried fruits are better ingredients to have in your chocolate than sugar, creme, syrup, and caramel</li> <li>finally, treat yourself – but keep the amount you have within sensible limits!</li> </ol> <p><em><a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, Postdoctoral Fellow of the National Heart Foundation &amp; Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/heres-why-having-chocolate-can-make-you-feel-great-or-a-bit-sick-plus-4-tips-for-better-eating-202848">original article</a>.</em></p>

Food & Wine

Placeholder Content Image

Summer’s over, so how much sun can (and should) I get?

<p><em><a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a></em></p> <p>As we slide of out summer, you might be wondering how careful you need to be about sun exposure. Excessive exposure causes <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/prevention-policy/national-cancer-prevention-policy/skin-cancer-statistics-and-issues/uv-radiation">skin cancer</a>, but sun exposure also has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">benefits</a>. How do you balance the two?</p> <p>A new <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">position statement</a> from cancer, bone health and other experts <a href="https://www.assc.org.au/wp-content/uploads/2023/01/Sun-Exposure-Summit-PositionStatement_V1.9.pdf">aims to help</a> Australians balance the good and bad effects of sun exposure by taking into account their skin colour, risk of skin cancer, and where they live.</p> <h2>What are the benefits of sunlight?</h2> <p>Ultraviolet (UV) radiation (the wavelengths in sunlight that cause skin cancer) also leads to vitamin D production. <a href="https://dermnetnz.org/topics/vitamin-d">Vitamin D</a> is very important for maintaining strong bones, and is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">multiple other health benefits</a>.</p> <p>But vitamin D probably isn’t the whole story. Sunshine, including UV radiation, is thought to affect health in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">other ways</a> such as improving our mood and reducing the risk of autoimmune diseases and infections. So for many people, avoiding the sun and taking a vitamin D supplement may not be the best approach.</p> <h2>How much time does it take to make vitamin D?</h2> <p>It’s complicated, but for most people and most of the year across most of Australia, it’s a lot less than you think.</p> <p>The <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">amount of time needed</a> depends on the amount of skin covered by clothing and the intensity of UV radiation (indicated by the UV index). More skin exposed and higher UV index equate to less time needed.</p> <p>Both the UV index and the amount of the year that UV radiation is high increase as you get closer to the equator. In summer, all of Australia is bathed in sunshine. But in winter, opposite ends of the country have <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">very different exposures</a>.</p> <p>In summer, everybody except those with deeply pigmented skin can make enough vitamin D in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">just five minutes</a> between 9am and 3pm, anywhere in Australia, provided they are wearing shorts and a T-shirt.</p> <p>In winter it’s a different story. In <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Darwin and Brisbane</a>, 5–10 minutes between 10am and 3pm will do the trick, but in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Hobart</a>, factoring in winter clothing, it will take nearly an hour in the middle of the day.</p> <p>Hover your mouse over the lines below to see the length of exposure needed at specific times of day.</p> <p><iframe id="X5szQ" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/X5szQ/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Staying out for longer than needed doesn’t necessarily make more vitamin D, but it <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib25">does cause skin damage</a>.</p> <h2>Hang on, what about those with darker skin?</h2> <p>People with deeply pigmented, brown to black skin accumulate both vitamin D and DNA damage at a much slower rate than people with lighter skin tones.</p> <p>When UV radiation hits a DNA strand, it causes the DNA to become distorted. If the distortion isn’t fixed, it will cause a mistake when the DNA is copied for a new cell, causing a permanent mutation that sometimes leads to cancer.</p> <p>Melanin, the brown pigment in the skin, absorbs UV photons before that can happen, and the high melanin content in the darkest skin tones provides <a href="https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.201701472R">60 times</a> as much UV protection as the small amount in very fair skin.</p> <p>The flip side is the risk of vitamin D deficiency is much higher than the risk of skin cancer.</p> <p>The new statement accounts for this by putting people into <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">three groups</a> based on their risk of skin cancer, with specialised advice for each group.</p> <h2>Highest skin cancer risk</h2> <p>This includes people with very pale skin that burns easily and tans minimally, but also people with darker white or olive skin who can tan easily but have extra skin cancer risk factors because they:</p> <ul> <li>have had <strong>skin cancer</strong> before</li> <li>have a <strong>family history</strong> of melanomas</li> <li>have many <strong>moles</strong></li> <li>are taking <strong>immunosuppressant</strong> medications.</li> </ul> <p>For these people, the harms of sun exposure almost certainly <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">outweigh the benefits</a>.</p> <p>These people should wear sunscreen every day the <a href="https://www.arpansa.gov.au/our-services/monitoring/ultraviolet-radiation-monitoring/ultraviolet-radiation-index">UV index</a> is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, and use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">five sunsmart steps</a> whenever the UV index is above three:</p> <ul> <li><strong>slip</strong> on clothing covering as much of the body as possible</li> <li><strong>slop</strong> on SPF30+ sunscreen on areas that can’t be covered up</li> <li><strong>slap</strong> on a hat</li> <li><strong>seek</strong> shade</li> <li><strong>slide</strong> on sunglasses.</li> </ul> <p>They shouldn’t spend time outdoors deliberately to make vitamin D, but should discuss vitamin D supplements with their doctor.</p> <h2>Intermediate skin cancer risk</h2> <p>This means people with dark white/olive skin that sometimes burns but tans easily, and who don’t have other skin cancer risk factors.</p> <p>These people should still apply sunscreen as part of their usual routine on all days when the UV index is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, but they can spend enough time outdoors to get a “dose” of vitamin D on most days of the week.</p> <p>Once the time needed for their vitamin D dose is up, they should also use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> steps to avoid accumulating DNA damage.</p> <p>If they’re unable to do this because of health or lifestyle factors, like being housebound, working night shifts, or always covering up with clothing, they should see their doctor about whether they need vitamin D supplements.</p> <h2>Lowest skin cancer risk</h2> <p>This covers people with deeply pigmented brown to black skin that rarely or never burns.</p> <p>These people can <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib14">safely spend enough time outdoors</a> to make vitamin D and get the other benefits of sunshine. But because more time is needed, it can be difficult, particularly when the weather is cold. Vitamin D supplements might be needed.</p> <p>They don’t need to routinely protect their skin, but might need to <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> if they are outdoors for more than two hours.</p> <h2>How do I get the feel-good effects of sunshine?</h2> <p>Spending time outdoors in the early morning is the best way to get the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">feel-good effects</a> of sunshine. An early morning walk is a great idea for all of us, but it won’t make vitamin D.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224144/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, PhD Candidate, Dermatology Research Centre, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, Principal research fellow, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/summers-over-so-how-much-sun-can-and-should-i-get-224144">original article</a>.</em></p>

Body

Placeholder Content Image

Only walking for exercise? Here’s how to get the most out of it

<p><em><a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>We’re living longer than in previous generations, with <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/demographic-profile">one in eight</a> elderly Australians now aged over 85. But the current <a href="https://pubmed.ncbi.nlm.nih.gov/26561272/">gap</a> between life expectancy (“lifespan”) and health-adjusted life expectancy (“healthspan”) is about ten years. This means many of us live with significant health problems in our later years.</p> <p>To increase our healthspan, we need planned, structured and regular physical activity (or exercise). The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization recommends</a> 150–300 minutes of moderate-intensity exercise – such as brisk walking, cycling and swimming – per week and muscle strengthening twice a week.</p> <p>Yet few of us meet these recommendations. <a href="https://doi.org/10.1186/s12966-019-0797-2">Only 10%</a> meet the strength-training recommendations. <a href="https://pubmed.ncbi.nlm.nih.gov/32488898/">Lack of time</a> is one of the most common reasons.</p> <p>Walking is cost-effective, doesn’t require any special equipment or training, and can be done with small pockets of time. <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">Our preliminary research</a>, published this week, shows there are ways to incorporate strength-training components into walking to improve your muscle strength and balance.</p> <h2>Why walking isn’t usually enough</h2> <p>Regular walking <a href="http://theconversation.com/health-check-in-terms-of-exercise-is-walking-enough-78604">does not appear</a> to work as muscle-strengthening exercise.</p> <p>In contrast, exercises consisting of “eccentric” or muscle-lengthening contractions <a href="http://theconversation.com/its-ok-to-aim%20lower-with-your-new-years-exercise-resolutions-a-few-minutes-a-day-can-improve-your-muscle-strength-193713">improve</a> muscle strength, <a href="https://pubmed.ncbi.nlm.nih.gov/31130877/">prevent muscle wasting</a> and improve other functions such as balance and flexibility.</p> <p>Typical eccentric contractions are seen, for example, when we sit on a chair slowly. The front thigh muscles lengthen with force generation.</p> <h2>Our research</h2> <p>Our <a href="https://pubmed.ncbi.nlm.nih.gov/31055678/">previous research</a> found body-weight-based eccentric exercise training, such as sitting down on a chair slowly, improved lower limb muscle strength and balance in healthy older adults.</p> <p>We also <a href="https://pubmed.ncbi.nlm.nih.gov/28291022/">showed</a> walking down stairs, with the front thigh muscles undergoing eccentric contractions, increased leg muscle strength and balance in older women more than walking up stairs. When climbing stairs, the front thigh muscles undergo “concentric” contractions, with the muscles shortening.</p> <p>It can be difficult to find stairs or slopes suitable for eccentric exercises. But if they could be incorporated into daily walking, lower limb muscle strength and balance function could be improved.</p> <p>This is where the idea of “eccentric walking” comes into play. This means inserting lunges in conventional walking, in addition to downstairs and downhill walking.</p> <figure><iframe src="https://www.youtube.com/embed/wAI7z3XdY9o?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Eccentric walking means incorporating deep lunges into your movement.</span></figcaption></figure> <p>In our <a href="https://link.springer.com/epdf/10.1007/s00421-024-05453-y?sharing_token=1vDsDJTN5WzPxi5YmSEkOfe4RwlQNchNByi7wbcMAY5hnPeFvF3FY4v2z1P9M2M0oiR78kXv1Yzj0ODMgckqhKOGHUABEd9UOPOfV5kPAj1jf1IYMIYkdIBv-DUEcKCOiDdNyj6MFypeDhSyeYQrWu_bvlAYtPUmOSaldFpmycA%3D">new research</a>, published in the European Journal of Applied Physiology, we investigated the effects of eccentric walking on lower limb muscle strength and balance in 11 regular walkers aged 54 to 88 years.</p> <p>The intervention period was 12 weeks. It consisted of four weeks of normal walking followed by eight weeks of eccentric walking.</p> <p>The number of eccentric steps in the eccentric walking period gradually increased over eight weeks from 100 to 1,000 steps (including lunges, downhill and downstairs steps). Participants took a total of 3,900 eccentric steps over the eight-week eccentric walking period while the total number of steps was the same as the previous four weeks.</p> <p>We measured the thickness of the participants’ front thigh muscles, muscle strength in their knee, their balance and endurance, including how many times they could go from a sitting position to standing in 30 seconds without using their arms. We took these measurements before the study started, at four weeks, after the conventional walking period, and at four and eight weeks into the eccentric walking period.</p> <p>We also tested their cognitive function using a digit symbol-substitution test at the same time points of other tests. And we asked participants to complete a questionnaire relating to their activities of daily living, such as dressing and moving around at home.</p> <p>Finally, we tested participants’ blood sugar, cholesterol levels and complement component 1q (C1q) concentrations, a potential <a href="https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fj.14-262154">marker of sarcopenia</a> (muscle wasting with ageing).</p> <h2>What did we find?</h2> <p>We found no significant changes in any of the outcomes in the first four weeks when participants walked conventionally.</p> <p>From week four to 12, we found significant improvements in muscle strength (19%), chair-stand ability (24%), balance (45%) and a cognitive function test (21%).</p> <p>Serum C1q concentration decreased by 10% after the eccentric walking intervention, indicating participants’ muscles were effectively stimulated.</p> <p>The sample size of the study was small, so we need larger and more comprehensive studies to verify our findings and investigate whether eccentric walking is effective for sedentary people, older people, how the different types of eccentric exercise compare and the potential cognitive and mental health benefits.</p> <p>But, in the meantime, “eccentric walking” appears to be a beneficial exercise that will extend your healthspan. It may look a bit eccentric if we insert lunges while walking on the street, but the more people do it and benefit from it, the less eccentric it will become. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, Professor of Exercise and Sports Science, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/only-walking-for-exercise-heres-how-to-get-the-most-out-of-it-224159">original article</a>.</em></p>

Body

Placeholder Content Image

Demi Moore shares emotional birthday tribute to Bruce Willis

<p>Demi Moore has shared an emotional tribute to her ex-husband, Bruce Willis, to mark his 69th birthday. </p> <p>The <em>Die Hard </em>actor, who was diagnosed with <a href="https://www.oversixty.com.au/news/news/bruce-willis-forced-to-retire-after-medical-diagnosis" target="_blank" rel="noopener">frontotemporal dementia</a> last year,  was pictured holding on to Moore's arm, as they shared a candid moment on the couch. </p> <p>“Happy birthday, BW! We love you and are so grateful for you ♥️,” Moore captioned the series of photos posted on Instagram. </p> <p>She also shared a photo of the actor, smiling lovingly at his grandchild Louetta, who Willis and Moore’s oldest daughter, Rumer welcomed in April 2023.</p> <p>The final photo Moore shared was a throwback picture of Willis smiling as he posed with their three daughters Rumer, Scout and Tallulah, who are now all in their 30s.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C4tOhkVOmAp/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C4tOhkVOmAp/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Demi Moore (@demimoore)</a></p> </div> </blockquote> <p>Fans were quick to share their birthday messages and admiration for their relationship. </p> <p>“Thank you for providing a loving example of parenting even after divorce. ❤️ You’re helping your children more than you know 🥰,” one wrote. </p> <p>“Their relationship is the sweetest thing ever ❤,” another added. </p> <p>“Absolutely love how, even though Bruce and Demi are divorced, they love and respect each other as parents and grandparents ❤🙌,” a third commented. </p> <p>His daughters have also shared their birthday tributes, with Rumer sharing throwback pictures with the caption: “Oh Daddio, to be loved by you is such a gift."</p> <p>“You are the funniest, most tender, charming, out of this world silly, talented and magical papa.</p> <p>“Looking through these photos ... I am just filled with the deepest gratitude that we chose to spend this life together.</p> <p>“I am your first baby and, man, sometimes I wish I could be tiny enough to just cozy up on your chest again and laugh and cuddle you. I love you so deep in my bones I don’t know how my muscles hold them," she added. </p> <p>“You are the greatest papa I could ever hope for. Thank you for your generosity, your silliness and heart.</p> <p>“Lou loves you so big." </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C4s81d9RTU0/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C4s81d9RTU0/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Rumer Glenn Willis (@rumerwillis)</a></p> </div> </blockquote> <p>Rumer's sister Scout also shared a tribute and said: “dad is one of my best friends, perhaps now on a deeper level than ever honestly. I cherish his affection and the immense freedom with which he’s always loved us.”</p> <p>Willis’ wife Emma Heming Willis, also shared a sweet message to the actor with a photo of him holding their two daughters, Mabel Ray, 11 and Evelyn Penn, 9. </p> <p>“Just like you, we simply adore him. What you might not know, but maybe you could imagine, that being wrapped in his arms is the safest place in this whole wide world,”  she said. </p> <p>“He’s a true gentle man. With so much love to give and share. That’s what I get to see, his true core. I can tell you, it’s so pure and ever so good.</p> <p>“Happy Birthday my love. You are the gift that keeps giving 💞.”</p> <p><em>Images: Instagram</em></p> <p> </p>

Caring

Placeholder Content Image

Bruce Willis' daughter reveals shock new health diagnosis

<p>Tallulah Willis, 30, has revealed that she was diagnosed with autism as an adult. </p> <p>The daughter of Hollywood stars Bruce Willis and Demi Moore took to Instagram to publicly share the news for the first time. </p> <p>"Tell me you're autistic without telling me you're autistic 😂," she wrote underneath a throwback video of her playing with her dad's ears during <em>The Whole Ten Yards</em> premiere in 2004. </p> <p>She continued opening up about her diagnosis in the comments. </p> <p>"Actually this is the first time I've ever publicly shared my diagnosis," she replied to a follower. </p> <p> "Found out this summer and it's changed my life," she added with a sun emoji. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C4jRY7Av5b8/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C4jRY7Av5b8/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by tallulah (@buuski)</a></p> </div> </blockquote> <p>According to <a href="https://www.healthdirect.gov.au/autism" target="_blank" rel="noopener"><em>Health Direct</em></a>, Autism spectrum disorder is a "lifelong developmental disorder" which affects how people behave and interact with the world around them and "is caused by differences in how the brain develops".</p> <p>Many fans were quick to comment on the sweet father-daughter bond that her and Bruce share. </p> <p>"The moment when you look at each other !!! So much was said with just one look ❤" one wrote. </p> <p>"I love this so much and I love how unfazed he is while you’re playing with his ear. So precious!" another added. </p> <p>"This is so powerful. The love you share with your papa. He calmed you here, his very body , and that is beautiful. You are beautiful. ❤" a third wrote. </p> <p>A few others thanked Tallulah for her transparency and sharing her autism diagnosis. </p> <p>"My son is autistic too. And I love the saying, “you know one autistic person, you know…. one autistic person.” Because everyone is so different. My son had stims that look nothing like this. But that certainly doesn’t discount what calms you! Most importantly tho: thank you for this post," wrote one fan. </p> <p>"This made me cry! I'm also autistic and felt this through my soul. Die Hard was a favourite movie of my dad's &amp; knowing that you share the same diagnosis as me &amp; so many others warms my heart," another commented.</p> <p>Tallulah has always been candid about her mental and physical health, as she recently opened up about her experience with anorexia nervosa and told her followers that recovery is not linear and can sometimes be "messy." </p> <p><em>Image: Getty</em></p> <p> </p>

Caring