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Squats and lunges might help you avoid knee surgery

<p>Whether it’s another round of squats and lunges, or a longer wall sit, researchers say working those quads could help lower your risk of a knee replacement.</p> <div> <p>In Australia, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/arthritis" target="_blank" rel="noopener">about 9% of the population</a> has osteoarthritis, a condition known to lead to hip and knee surgery in severe cases. About 14 million Americans suffer from knee osteoarthritis, about half are expected to face knee replacement surgery. </p> <p>But new research offers hope, finding stronger quadricep muscles could play a role in avoiding knee replacement surgery.</p> <p>A study presented to <a href="https://press.rsna.org/timssnet/media/rsna/newsroom2023.cfm" target="_blank" rel="noopener">annual meeting</a> of the Radiological Society of North America, offers hope to people with arthritis, finding stronger quadriceps could help in avoiding a knee replacement.</p> <p>The two most important muscles in the knee are the extensors or quadriceps, and the hamstrings. Quads are the strong muscles located at the front of the thigh, which play a key role in gait. Hammies at the back of the thigh, are essential for hip and knee flexibility.</p> <p>The two muscles act as opposing forces, allowing physical activity while also protecting the knee. An imbalance can change the body’s biomechanics, and may progress to osteoarthritis.</p> <p>Using MRI scans – from the time of surgery as well as 2 and 4 years prior – researchers analysed thigh muscle volume in 134 participants from a national study called the Osteoarthritis Initiative. </p> <p>Using artificial intelligence to compute muscle volume from the MRI scans, the researchers compared 67 of the cohort who had a total, single knee replacement with 67 control participants who had not undergone knee replacement surgery.</p> <p>They found patients who had a higher ratio of quadricep to hamstring volume had significantly lower odds of a total knee replacement. Higher volume hamstrings were also associated with lower odds of surgery.</p> <p>The results suggest strength training – focusing on the quadriceps – may be beneficial, both in people with arthritis as well as the general population.</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <em><img id="cosmos-post-tracker" src="https://syndication.cosmosmagazine.com/?id=289325&amp;title=Squats+and+lunges+might+help+you+avoid+knee+surgery" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" />Image credits: Getty Images</em></div> <div> </div> <div><em><a href="https://cosmosmagazine.com/health/body-and-mind/squats-and-lunges-might-help-you-avoid-knee-surgery/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </em></div>

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Drug resistance may make common infections like thrush untreatable

<p><em><a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p>We’ve all heard about antibiotic resistance. This happens when bacteria develop strategies to avoid being destroyed by an antibiotic.</p> <p>The consequences of antibiotic resistance mean an antibiotic previously used to cure bacterial infections no longer works effectively because the bacteria have become resistant to the drug. This means it’s getting harder to cure the infections some bacteria cause.</p> <p>But unfortunately, it’s only one part of the problem. The same phenomenon is also happening with other causes of infections in humans: fungi, viruses and parasites.</p> <p>“Antimicrobial resistance” means the drugs used to treat diseases caused by microbes (bugs that cause infection) no longer work. This occurs with antibacterial agents used against bacteria, antifungal agents used against fungi, anti-parasitic agents used against parasites and antiviral agents used against viruses.</p> <p>This means a wide range of previously controllable infections are becoming difficult to treat – and may become untreatable.</p> <h2>Fighting fungi</h2> <p>Fungi are responsible for a range of infections in humans. Tinea, ringworm and vulvovaginal candidiasis (thrush) are some of the more familiar and common superficial fungal infections.</p> <p>There are also life-threatening fungal infections such as aspergillosis, cryptococcosis and invasive fungal bloodstream infections including those caused by <em>Candida albicans</em> and <em>Candida auris</em>.</p> <p>Fungal resistance to antifungal agents is a problem for several reasons.</p> <p>First, the range of antifungal agents available to treat fungal infections is limited, especially compared to the range of antibiotics available to treat bacterial infections. There are only four broad families of antifungal agents, with a small number of drugs in each category. Antifungal resistance further restricts already limited options.</p> <p>Life-threatening fungal infections happen less frequently than life-threatening bacterial infections. But they’re rising in frequency, especially among people whose immune systems are compromised, including by <a href="https://7news.com.au/news/qld/first-heart-transplant-patient-to-die-from-fungal-infection-at-brisbanes-prince-charles-hospital-identified-as-mango-hill-gp-muhammad-hussain-c-12551559">organ transplants</a> and chemotherapy or immunotherapy for cancer. The threat of getting a drug-resistant fungal infection makes all of these health interventions riskier.</p> <p>The greatest <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2017.00735/full">burden of serious fungal disease</a> occurs in places with limited health-care resources available for diagnosing and treating the infections. Even if infections are diagnosed and antifungal treatment is available, antifungal resistance reduces the treatment options that will work.</p> <p>But even in Australia, common fungal infections are impacted by resistance to antifungal agents. Vulvovaginal candidiasis, known as thrush and caused by <em>Candida</em> species and some closely related fungi, is usually reliably treated by a topical antifungal cream, sometimes supplemented with an oral tablet. However, instances of <a href="https://www.theage.com.au/national/victoria/they-can-t-sit-properly-doctors-treat-growing-number-of-women-with-chronic-thrush-20230913-p5e499.html">drug-resistant thrush</a> are increasing, and new treatments are needed.</p> <h2>Targeting viruses</h2> <p>Even <a href="https://theconversation.com/why-are-there-so-many-drugs-to-kill-bacteria-but-so-few-to-tackle-viruses-137480">fewer antivirals</a> are available than antibacterial and antifungal agents.</p> <p>Most antimicrobial treatments work by exploiting differences between the microbe causing the infection and the host (us) experiencing the infection. Since viruses use our cells to replicate and cause their infection, it’s difficult to find antiviral treatments that selectively target the virus without damaging us.</p> <p>With so few antiviral drugs available, any resistance that develops to one of them significantly reduces the treatment options available.</p> <p>Take COVID, for example. Two antiviral medicines are in widespread use to treat this viral infection: Paxlovid (containing nirmatrelvir and ritonavir) and Lagevrio (molnupiravir). So far, SARS-CoV-2, the virus that causes COVID, has not developed significant resistance to either of these <a href="https://www.cidrap.umn.edu/covid-19/low-levels-resistance-paxlovid-seen-sars-cov-2-isolates">treatments</a>.</p> <p>But if SARS-CoV-2 develops resistance to either one of them, it halves the treatment options. Subsequently relying on one would likely lead to its increased use, which may heighten the risk that resistance to the second agent will develop, leaving us with no antiviral agents to treat COVID.</p> <p>The threat of antimicrobial resistance makes our ability to treat serious COVID infections rather precarious.</p> <h2>Stopping parasites</h2> <p>Another group of microbes that cause infections in humans are single-celled microbes such as <em>Plasmodium</em>, <em>Giardia</em>, <em>Leishmania</em>, and <em>Trypanosoma</em>. These microbes are sometimes referred to as parasites, and they are becoming increasingly resistant to the very limited range of anti-parasitic agents used to treat the infections they cause.</p> <p>Several <em>Plasmodium</em> species cause malaria and anti-parasitic drugs have been the cornerstone of malaria treatment for decades. But their usefulness has been significantly reduced by the <a href="https://www.mmv.org/our-work/mmvs-pipeline-antimalarial-drugs/antimalarial-drug-resistance">development of resistance</a>.</p> <p><em>Giardia</em> parasites cause an infection called giardiasis. This can resolve on its own, but it can also cause severe gastrointestinal symptoms such as diarrhea, nausea, and bloating. These microbes have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207226/">developed resistance</a> to the main treatments and patients infected with drug-resistant parasites can have protracted, unpleasant infections.</p> <h2>Resistance is a natural consequence</h2> <p>Treating infections influences microbes’ evolutionary processes. Exposure to drugs that stop or kill them pushes microbes to either evolve or die. The exposure to antimicrobial agents provokes the evolutionary process, selecting for microbes that are resistant and can survive the exposure.</p> <p>The pressure to evolve, provoked by the antimicrobial treatment, is called “selection pressure”. While most microbes will die, a few will evolve in time to overcome the antimicrobial drugs used against them.</p> <p>The evolutionary process that leads to the emergence of resistance is inevitable. But some things can be done to minimise this and the problems it brings.</p> <p>Limiting the use of antimicrobial agents is one approach. This means reserving antimicrobial agents for when their use is known to be necessary, rather than using them “just in case”.</p> <p>Antimicrobial agents are precious resources, holding at bay many infectious diseases that would otherwise sicken and kill millions. It is imperative we do all we can to preserve the effectiveness of those that remain, and give ourselves more options by working to discover and develop new ones.<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/213460/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, Senior Research Fellow, School of Medicine, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western 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/drug-resistance-may-make-common-infections-like-thrush-untreatable-213460">original article</a>.</em></p>

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Thinking of trying a detox? Here’s what you need to know first

<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>What is a “detox”? It’s a process that involves using particular products, diets or other detoxification methods to try and rid the body of so-called “toxins”.</p> <p>Detoxes are <a href="https://www.sciencedirect.com/science/article/abs/pii/S1499404619308127">prevalent on social media</a> and spruiked by brands offering detox products, celebrities and influencers.</p> <p>A documentary airing on Channel 10 this week – Todd Sampson’s <a href="https://tvblackbox.com.au/page/2023/11/06/todd-sampson-returns-with-new-mirror-mirror-testing-wellness-industry/">Mirror Mirror: Are You Well?</a> – explores our fascination with detoxing, and the science (or lack thereof) behind it.</p> <p>So if you’re thinking of trying a detox, here’s what you need to know.</p> <h2>Detoxing is not new</h2> <p>Detoxing has held an attraction since the time of <a href="https://bcmj.org/premise/history-bloodletting">Hippocrates</a>, who believed four bodily fluids or “humors” – blood, phlegm, black bile and yellow bile – had to remain in balance to maintain good health. Being unwell meant the body’s organs and fluids were somehow imbalanced and in need of correction.</p> <p>Throughout the centuries these “imbalances” have been treated with everything from <a href="https://www.smh.com.au/national/nsw/leeches-bloodletting-enemas-and-emetics-the-uncomfortable-history-of-medicine-20220726-p5b4u2.html">enemas and emetics</a> to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757849/">leech therapy</a> and <a href="https://en.wikipedia.org/wiki/Bloodletting">bloodletting</a>. An enema sees a tube <a href="https://www.healthline.com/health/enema-administration#administration">inserted into the anus</a> to deliver medication or fluids to the rectum or colon. An <a href="https://www.britannica.com/science/emetic">emetic</a> is a compound designed to make you vomit. <a href="https://bcmj.org/premise/history-bloodletting">Bloodletting</a> involved using certain techniques – not for the faint of heart – to remove blood from a patient and supposedly cure disease.</p> <p>Meanwhile, throughout history, the <a href="https://pubmed.ncbi.nlm.nih.gov/26133274/">ritual of fasting</a> as a display of self-discipline, purity and holiness was common, particularly among women.</p> <h2>What are the different types of detox?</h2> <p>Fast forward to today, and detoxes look a bit different. Detox products sold over the counter or online are typically teas or drinks to be consumed instead of food.</p> <p>These approaches sometimes start with a fasting phase or use intermittent fasting throughout the program.</p> <p>The “detox” tag is appearing on a growing range of teas, coffee, infused waters, drinks with added fruit, vegetables, herbal mixes, nutrients or added blends of “natural” ingredients. These products often claim to flush toxins from the body, or to boost immunity.</p> <p><a href="https://www.fortunebusinessinsights.com/detox-drinks-market-107122">Global predictions</a> indicate the detox drink market, estimated at more than US$5 billion in 2022, will grow in value by another 50% before 2030.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/22103982/">survey of detoxification therapies</a> used by naturopaths in the United States reported that more than three-quarters recommended dietary measures, including “cleansing foods” (such as beetroot), vitamin, mineral or antioxidant supplements, organic foods, elimination diets and probiotics.</p> <p>While drinks and dietary measures represent typical approaches to a detox, there are also some more unusual detox practices.</p> <p>One-third of patients in that same US study had undergone colonic irrigation, which involves <a href="https://www.healthline.com/health/digestive-health/pros-cons-colon-cleanse#what-is-it?">infusing fluids into the colon</a> to remove digestive waste.</p> <p>More than one-quarter had used <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/homeopathy">homeopathic remedies</a> or laxative herbs.</p> <p>While we don’t have equivalent data for Australia, a survey of <a href="https://pubmed.ncbi.nlm.nih.gov/30470778/">more than 2,000 Australian adults</a> found 63% had either used or consulted someone about complementary therapies in the previous year. A portion of these were likely detox therapies.</p> <h2>Do detoxes work?</h2> <p>The short answer is no. A <a href="https://pubmed.ncbi.nlm.nih.gov/35866077/">review published in 2022</a> found detox diets failed to identify plausible pathways by which toxins could be eliminated, or the specific toxins supposedly removed by a particular diet.</p> <p>This review also pointed out that detoxes defy the general principles of human physiology, in that the liver and kidneys are quite efficient at removing toxins from our bodies.</p> <p>A previous <a href="https://pubmed.ncbi.nlm.nih.gov/25522674/">review from 2015</a> similarly found studies did not provide convincing evidence to support the use of detox diets.</p> <p>Detox products don’t have to prove they’re effective to be on the market. In Australia, complementary medicines sold over the counter are regulated by the <a href="https://www.tga.gov.au/what-tga-regulates">Therapeutic Goods Administration</a>, with ingredients assessed for quality and safety, but not whether the products actually work.</p> <p>You should check any product and marketing claims before purchasing to see what the manufacturers say. Big promises to be sceptical about include eliminating toxins, rapid weight loss, stronger willpower, improved self-esteem, an energy or immunity boost, feeling happier, inner peace, or better skin, hair and nails.</p> <h2>Potential dangers of detoxing</h2> <p>Consuming detox products in place of a regular diet leads to a very low total kilojoule intake, and therefore may lead to <a href="https://pubmed.ncbi.nlm.nih.gov/29124370/">weight loss</a> in the short term. But they’re not a sustainable way to lose weight.</p> <p>Detox diets that severely restrict kilojoules or food groups increase the risk of nutrient deficiencies. Adverse effects <a href="https://www.healthline.com/nutrition/detox-diets-101#safety-and-side-effects">include</a> fatigue, irritability and <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/halitosis-or-bad-breath">bad breath</a>.</p> <p>There’s also a risk detox product ingredient labels <a href="https://pubmed.ncbi.nlm.nih.gov/35866077/">might not be accurate</a>, increasing the risk of side effects, potential overdoses or other adverse events. In Spain, a <a href="https://pubmed.ncbi.nlm.nih.gov/22884574/">50-year-old man</a> died after an incorrect ingredient was added to a liver cleanse detox product he used, leading to manganese poisoning.</p> <p>A 2018-19 <a href="https://www.phrp.com.au/issues/july-2023-volume-33-issue-2/compliance-audit-of-colonic-lavage-businesses/">audit of premises in New South Wales</a> performing colonic irrigation found failures to meet infection control standards.</p> <p>Some people should definitely not try detoxing. This includes people with chronic medical conditions, eating disorders, older adults, children and women who are pregnant or breastfeeding.</p> <p>One positive aspect of detox programs is that they may help raise awareness of your current food, alcohol or lifestyle habits that could be improved. Reflecting on these can potentially provide the motivation to try and eat more healthily.<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/212776/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></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: 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/thinking-of-trying-a-detox-heres-what-you-need-to-know-first-212776">original article</a>.</em></p>

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Should we still be using RATs to test for COVID? 4 key questions answered

<p><em><a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>We’re currently navigating <a href="https://www.thenewdaily.com.au/life/health/2023/11/15/covid-australia-eighth-wave">an eighth wave</a> of <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">COVID infections</a> in Australia. However the threat COVID poses to us is significantly less than it has ever been, thanks to immunity we’ve acquired through <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00801-5/fulltext">a combination</a> of prior infection and vaccination.</p> <p>That said, COVID is by no means behind us. The threat of severe illness remains higher for many people, and we’re all potentially at risk of developing <a href="https://www.health.gov.au/topics/covid-19/long-covid">long COVID</a>.</p> <p>While many people appear to be doing fewer rapid antigen tests (RATs) than they used to – if any at all – with rising cases, and as we head towards the festive season, testing continues to be important.</p> <p>So what do you need to know about testing in this wave? Here are four key questions answered.</p> <h2>1. When should I do a RAT?</h2> <p>There are a few situations where determining your COVID status is important to inform your actions, particularly during an uptick in infections. With more circulating virus, your index of suspicion that you have COVID if you’re experiencing cold-like symptoms should be higher.</p> <p>RATs work best when they’re used to confirm whether you have COVID when you <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/how-testing-works-covid-19">have respiratory symptoms</a> and are infectious. So the primary use of RATs should be to determine your COVID status when you’re sick. A positive test should prompt you to isolate, and if you’re eligible, to seek antivirals.</p> <p>Testing might also be worthwhile if you’ve come into contact with someone with COVID but you haven’t developed symptoms. If you find you have in fact contracted the virus, you can take steps to avoid spreading it to other people (you can infect others even <a href="https://www.healthline.com/health/what-is-asymptomatic-covid#prevalence">when you’re asymptomatic</a>). This is especially important if you’re going to be socialising in large groups or in contact with people who are vulnerable.</p> <p>Another situation in which to consider testing, particularly at this time of year, is before attending large social gatherings. While the reliability of a RAT is never perfect, do the test as close to the event as possible, because your disease status <a href="https://www.businessinsider.com/omicron-rapid-test-hour-before-party-not-day-before-expert-2021-12">can change quickly</a>.</p> <h2>2. Should I test multiple times?</h2> <p>Yes. RATs are not as sensitive as PCR tests, which is the trade-off we make for being able to do this test at home and <a href="https://www.wsj.com/articles/public-health-officials-pursue-covid-19-tests-that-trade-precision-for-speed-11599562800">getting a rapid result</a>.</p> <p>This means that while if you test positive with a RAT you can be very confident you have COVID, if you test negative, you cannot be as confident that you don’t have COVID. That is, the test may give you a false negative result.</p> <p>Although RATs from different manufacturers have different accuracies, all RATs approved by Australia’s Therapeutic Goods Administration must have a sensitivity of <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/covid-19-rapid-antigen-self-tests-home-use/covid-19-rapid-antigen-self-tests-are-approved-australia#:%7E:text=For%20rapid%20antigen%20tests%2C%20this,specificity%20of%20at%20least%2098%25.">at least 80%</a>.</p> <p>The way to increase your confidence in a negative result is to do multiple RATs serially – each negative test increases the confidence you can have that you don’t have COVID. If you have symptoms and have tested negative after your first RAT, <a href="https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-results-fda-safety">the advice</a> is to repeat the test after 48 hours, and potentially a third time after another 48 hours if the second test is also negative.</p> <h2>3. Do RATs detect the latest variants?</h2> <p>Since RATs <a href="https://www.healthdirect.gov.au/covid-19/testing#:%7E:text=Rapid%20antigen%20tests%2C%20or%20RATs,of%20proteins%20of%20the%20virus.">detect particular surface proteins</a> on SARS-CoV-2 (the virus that causes COVID), it’s theoretically possible that as the virus evolves, the reliability of these tests may be affected.</p> <p>However, RATs were designed to detect a part of the virus that is not as likely to mutate, so the hope is these tests <a href="https://www.health.com/do-covid-tests-work-new-variants-7967102">will continue to hold up</a> as SARS-CoV-2 evolves.</p> <p>The performance of RATs is continually being assessed by manufacturers. So far, there’s been no change reported in the ability of these tests to <a href="https://www.ama.com.au/articles/tga-updated-advice-rats-nearing-expiry-and-rats-efficacy-current-strains#:%7E:text=The%20TGA%20has%20received%20evidence,19%20RAT%20post%2Dmarket%20review.">detect the latest variants</a>.</p> <h2>4. Can I rely on expired RATs?</h2> <p>At this point in the pandemic, you might have a few expired tests at the back of your cupboard.</p> <p>Technically the most appropriate advice is to say you should never use a diagnostic test <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/covid-19-rapid-antigen-self-tests-home-use/covid-19-rapid-antigen-self-tests-are-approved-australia">past its expiry date</a>. As a general principle the performance of a test cannot be guaranteed beyond this date. The risk is that over time the components of the RAT degrade and if you use a test that’s not working optimally, it’s more likely to indicate <a href="https://www.health.com/can-you-use-expired-covid-test-6827970">you don’t have COVID</a> when you actually do, which may have consequences.</p> <p>However, as for all things COVID, the answer is not so black and white. Since these tests were new when they were introduced earlier in the pandemic, manufacturers didn’t have specific data on their performance over time, and so the expiry dates given were necessarily conservative.</p> <p>It’s likely these tests will work beyond the expiry dates on the packet, but just how long and how well they work is a bit of an unknown, so we need to be cautious.</p> <p>The other thing to consider is ensuring you store RATs correctly. Storage instructions should be found on the packet, but the key issue is making sure they’re not exposed to extreme temperatures. In particular, <a href="https://7news.com.au/lifestyle/health-wellbeing/how-to-properly-store-your-at-home-covid-19-rapid-antigen-tests-c-5465412">high temperatures</a> may damage the chemicals in the test which may reduce its sensitivity.</p> <h2>The path from here</h2> <p>Regular upticks in COVID cases are something we’re going to have to get used to. At these times, we should all be a bit more cautious about looking after ourselves and others as we go about our lives. What this looks like will vary for different people depending on their personal circumstances.</p> <p>However, being up to date with <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">booster vaccinations</a>, having a plan for <a href="https://www.health.gov.au/topics/covid-19/oral-treatments">accessing antivirals</a> if you’re eligible, <a href="https://theconversation.com/with-covid-surging-should-i-wear-a-mask-217902">wearing masks</a> in high-risk settings and testing all continue to play an important role in responding to COVID.<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/218016/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/hassan-vally-202904"><em>Hassan Vally</em></a><em>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin 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/should-we-still-be-using-rats-to-test-for-covid-4-key-questions-answered-218016">original article</a>.</em></p>

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What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

<p><em><a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection.</p> <p>These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID.</p> <p>Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older.</p> <p>Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe?</p> <h2>Who’s eligible for the new boosters?</h2> <p>The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September.</p> <p>ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose.</p> <p>People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">For people without risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>Adults aged 18 to 64 <em>with</em> underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">Advice for people with risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>For adults aged 18 to 64 <em>without</em> underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose.</p> <p>Additional doses aren’t recommended for children <em>without</em> underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years <em>without</em> additional risk factors.</p> <h2>Monovalent, bivalent? What’s the difference?</h2> <p><strong>From monovalent</strong></p> <p>The initial COVID vaccines were “monovalent”. They had one target – the original viral strain.</p> <p>But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity.</p> <p><strong>To bivalent</strong></p> <p>So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>.</p> <p>Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission.</p> <p>The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5.</p> <p><strong>Back to monovalent</strong></p> <p>Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement.</p> <p>This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>).</p> <p>This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed.</p> <p>According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is.</p> <p>The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore.</p> <p>In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>.</p> <h2>Do these newer vaccines work?</h2> <p>Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA.</p> <p>Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control.</p> <p>Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster.</p> <p>The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>.</p> <p>It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored.</p> <h2>Are they safe?</h2> <p>The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported.</p> <p>Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines.</p> <h2>What happens next?</h2> <p>The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated.</p> <p>We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<!-- 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/217804/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/paul-griffin-1129798"><em>Paul Griffin</em></a><em>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.</em></p>

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How to get rid of sciatica pain: solutions from back experts

<p><strong>The scoop on sciatica pain</strong></p> <p>Fun fact: The sciatic nerve is the largest nerve in the human body. It runs from the lower back down each side of your body, along the back of the hips, butt cheeks, and knees, down the back of the calf, and into the foot. It provides both sensory and motor nerve function to the legs and feet.</p> <p>Not-so-fun fact: Sometimes this nerve can get compressed in the spine at one of the roots – where it branches off the spinal cord – and cause pain that radiates down the length of the nerve. This is a dreaded condition known as sciatica. It is estimated that between 10 and 40 percent of people will experience sciatica in their lifetime.</p> <p>“Sciatica is the body telling you the sciatic nerve is unhappy,” says E. Quinn Regan, MD, an orthopaedic surgeon. “When the nerve is compressed at the root, it becomes inflamed, causing symptoms,” Dr Regan says. These symptoms can range from mild to debilitating.</p> <p>While sciatica can often resolve on its own, easing symptoms and feeling better usually requires some attention and careful behaviour modifications. Rarely, you may need more medical intervention to recover fully.</p> <p>Here’s everything you need to know about sciatica, including symptoms, how it’s diagnosed, how it’s treated, and what you can do to prevent it from recurring.</p> <p><strong>Symptoms of sciatica</strong></p> <p>Sciatica is quite literally a pain in the butt. The telltale symptom of sciatica is pain that radiates along the nerve, usually on the outside of the butt cheek and down the back of the leg. It usually only happens on one side of the body at a time. Sciatica doesn’t necessarily cause lower back pain, though it can.</p> <p>Dr Regan says that people with sciatica describe the pain as electric, burning, or stabbing, and in more severe cases, it can also be associated with numbness or weakness in the leg. If sciatica causes significant muscle weakness, to the point of losing function, and/or the pain is so bad you can’t function, it’s time to get immediate help, Dr Regan says.</p> <p>Another symptom that warrants a trip to the ER and immediate medical intervention: bowel or bladder incontinence. “That means there’s a massive compression, and the pressure is so severe it’s harming the nerves that go to the bowel and bladder,” says orthopaedic surgeon Dr Brian A. Cole. This is rare, but when it happens, it’s imperative to decompress the nerve immediately, he says.</p> <p><strong>The main causes of sciatica</strong></p> <p>The most common cause of sciatica is a herniated or slipped disc. A herniated or slipped disc happens when pressure forces one of the discs that cushion each vertebra in the spine to move out of place or rupture. Usually it’s caused when you lift something heavy and hurt your back, or after repetitive bending or twisting of the lower back from a sport or a physically demanding job.</p> <p>Sciatica also can be caused by:</p> <ul> <li>a bone spur (osteophyte), which can form as a result of osteoarthritis</li> <li>narrowing of the spinal canal (spinal stenosis), which happens with normal wear-and-tear of the spine and is more common in people over 60</li> <li>spondylolisthesis, a condition where one of your vertebrae slips out of place</li> <li>a lower back or pelvic muscle spasm or any sort of inflammation that presses on the nerve root</li> </ul> <p>Some people are born with back problems that lead to spinal stenosis at an earlier age. Other potential, yet rare, causes of sciatic nerve compression include tumours and abscesses.</p> <p><strong>Could it be piriformis syndrome?</strong></p> <p>Something known as piriformis syndrome can also cause sciatica-like symptoms, though it is not considered true sciatica. The piriformis is a muscle that runs along the outside of the hip and butt and plays an important role in hip extension and leg rotation.</p> <p>Piriformis syndrome is an overuse injury that’s common in runners, who repetitively strain this muscle, leading to inflammation and irritation. Because the muscle is so close to the sciatic nerve, piriformis syndrome can compress the nerve and cause a similar tingling, radiating pain as sciatica. The difference is that this pain is not caused by compression at the nerve root, but rather, irritation or pressure at some point along the length of the nerve.</p> <p><strong>Sciatica risk factors </strong></p> <p>Anyone can end up with a herniated disc and ultimately sciatica, but some people are more at risk than others. The biggest risk factor is age. “The discs begin to age at about age 30, and when this happens they can develop defects,” Dr Regan says. These defects slowly increase the risk of a disc slipping or rupturing.</p> <p>Men are three times more likely than women to have a herniated disc, Dr Regan says. Being overweight or obese also increases your chance of injuring a disc. A physically demanding job, regular strenuous exercise, osteoarthritis in the spine, and a history of back injury can also increase your risk. Sitting all day doesn’t help either, Dr Cole says. “You put more stress on your back biomechanically sitting than anything else you do.”</p> <p>Certain muscle weaknesses and imbalances can also make you more prone to disc injury and, consequently, sciatica. “People with weak core muscles and instability around the spine might be more prone to this since the muscles need to stabilise the joints of the vertebrae in which the nerves exit,” says Theresa Marko, an orthopaedic physical therapist.</p> <p><strong>How sciatica is diagnosed</strong></p> <p>If your symptoms suggest sciatica, your doctor will do a physical exam to check your strength, reflexes and sensation. A test called a straight leg raise can also test for sciatica, Dr Regan says. How it’s done: Patients lie face up on the floor, legs extended, and the clinician slowly lifts one leg up. At a certain point, it may trigger sciatica symptoms. (The test can also be done sitting down.)</p> <p>Depending on how severe the pain is and how long you’ve had symptoms, doctors may also do some scans (MRI or CT) on your spine to figure out what’s causing the sciatica and how many nerve roots are impacted.</p> <p>Scans can also confirm there isn’t something else mimicking the symptoms of sciatica. Muscle spasms, abscesses, hematomas (a collection of blood outside a blood vessel), tumours and Potts disease (spinal tuberculosis) can all cause similar symptoms.</p> <p><strong>Managing mild to moderate sciatica </strong></p> <p>Resting, avoiding anything that strains your back, icing the area that hurts, and taking nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, are the first-line treatment options for sciatica, Dr Regan says. If you have a physically demanding job that requires you to lift heavy things, taking some time off, if at all possible, will help.</p> <p>While it’s important to avoid activities that might make things worse, you do want to keep moving, says Marko. “Research now advises against bed rest. You want to move without overdoing it.”</p> <p>A physical therapist can help you figure out what movements are safe and beneficial to do. For example, certain motions – squatting, performing a deadlift, or doing anything that involves bending forward at the waist – can be really aggravating. Light spine and hamstring stretching, low-impact activities like biking and swimming, and core work can help. “In general, we need the nerve to calm down a bit and to strengthen the muscles of your spine, pelvis and hips,” Marko says.</p> <p>“Within a week to 10 days, about 80 percent of patients with mild to moderate sciatica are going to be doing much better,” Dr Regan says. Within four to six weeks, you should be able to return to your regular activities – with the caveat that you’ll need to be careful about straining your back to avoid triggering sciatica again.</p> <p><strong>Treating severe sciatica</strong></p> <p>If you’re trying the treatment options for mild to moderate sciatica and your symptoms worsen or just don’t get better, you may need a higher level of treatment.</p> <p>If OTC pain relievers aren’t cutting it, your doctor may prescribe a muscle relaxant like cyclobenzaprine (Flexeril).</p> <p>An epidural steroid injection near the nerve root can reduce inflammation and provide a huge relief for some people with sciatica. The results are varied, and some people may need more than one injection to really feel relief.</p> <p>Surgery is usually a last resort, only considered once all of the conservative and minimally invasive options have been exhausted. Dr Regan notes that a small percentage of people with sciatica end up needing surgery – these are usually patients who have severe enough sciatica that their primary care doctors have referred them to spinal specialists. And only about a third of patients who see spinal specialists may end up having surgery, he says.</p> <p>Surgeries to relieve disc compression are typically quick and done on an outpatient basis, according to Dr Cole.</p> <p><strong>Preventing sciatica in the future</strong></p> <p>“Once you have a back issue, you have a higher chance of having a back issue in the future,” Dr Regan says. Which means that your first bout of sciatica isn’t likely to be your last. It’s important to adopt a healthy lifestyle to reduce the risk of sciatica striking again.</p> <p>Building core strength is key. “Think of your midsection as a box, and you need to target all sides,” Marko says. “By this, I mean abdominals, obliques, diaphragm, pelvic floor, glutes and lateral hip muscles.” These muscles all support the spine, so the stronger they are, the better the spine can handle whatever is thrown its way.</p> <p>If there’s an activity you enjoy that aggravates your back, ditch it for an alternative. For example, running can trigger back pain and sciatica in some people, Dr Regan says. If you’re prone to it, try a new form of cardio that’s gentler on your back, like swimming, biking, or using the elliptical. Even just logging fewer kilometres per week can help reduce your risk.</p> <p>Dr Regan also recommends making sure you learn how to weight train properly. Lifting with the best form possible, learning your limits, and reducing weight when you need to will help keep your back safe from disc injuries.</p> <p>Making small changes to your daily life and workouts can help keep your back healthy and minimise the time you have to waste dealing with sciatica in the future.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/backtips-advice/how-to-get-rid-of-sciatica-pain-solutions-from-back-experts" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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When it comes to weight, your ‘diet’ is much more than what you eat

<p>Atkins, keto, palaeo, gluten-free, low-carb, low-fat, high-fat, raw, vegan, vego, pescatarian – phew, that’s a lot of different diets!</p> <div class="copy"> <p>And it’s by no means an exhaustive list.</p> <p>The old adage ‘you are what you eat’ has come to be a mantra for good diet and health. It was originally coined by 19th-century German philosopher Ludwig Feuerbach, himself drawing on commentary by an earlier French gourmand Anthelme Brillat-Savarin.</p> <p>Increasingly, science is finding new connections between diet and our overall picture of health. You may have heard how our gut microbiome acts as a second brain, or that avoiding unprocessed foods can lead to all-cause mortality.</p> <p>But when it comes to many fad diets that promise quick weight loss or improved health, the science can sometimes be skimp. This can change over time as researchers test the influence of diet on general health, weight management and as a medical treatment.</p> <p>The <a href="https://cosmosmagazine.com/health/mediterranean-diet-heart-dementia/">Mediterranean diet</a> is probably closest to the mark as a lifestyle of choice, in terms of overall health, nutrition, and diet science. It emphasises <a href="https://cosmosmagazine.com/health/nutrition/plant-based-diets-could-prevent-type-2-diabetes/">fruit and vegetable</a> consumption, with some wholegrain breads and cereals, legumes, nuts, seeds and fish, with olive oil as a primary fat source.</p> <p>This diet is either explicitly endorsed by many health authorities around the world such as the <a href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet" target="_blank" rel="noreferrer noopener">American Heart Association</a>, the <a href="https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/nutrition/mediterranean-diet-for-reducing-cardiovascular-dis" target="_blank" rel="noreferrer noopener">Royal Australian College of General Practitioners</a> as a diet for lowering cardiovascular disease risk, or used as a basis for other recommendations. The World Health Organization also <a href="https://www.who.int/europe/news/item/07-05-2018-fostering-healthier-and-more-sustainable-diets-learning-from-the-mediterranean-and-new-nordic-experience" target="_blank" rel="noreferrer noopener">advises</a> on ways for the Mediterranean and similar New Nordic diets to be implemented as <a href="https://iris.who.int/bitstream/handle/10665/326264/9789289053013-eng.pdf?sequence=3" target="_blank" rel="noreferrer noopener">health policy</a>.</p> <p>But diet might be better considered about more than what goes in one’s mouth.</p> <p>Dr Evangeline Mantzioris, Program Director of the Nutrition and Food Sciences Degree at the University of South Australia, says a truer interpretation of the world extends beyond merely food and drink.</p> <p>“The word diet actually derives from the Greek word <em>diaita</em>, which means the way you choose to live your life,” Mantzioris told the <a href="https://cosmosmagazine.com/tag/debunks/" target="_blank" rel="noreferrer noopener"><em>Debunks</em> podcast.</a></p> <p>“So it’s not just about the food, it’s about the exercise, it’s about the social interaction, it’s about the rest. It’s about the sleep. It’s all of that.”</p> <p>The WHO’s 2019 Health Evidence Network Synthesis Report also acknowledges both social and sleep components of the lifestyle, noting shared eating practices, post-meal siestas and lengthy meal times all contribute to positive health effects.</p> <p>In terms of the nutritional component, Mantzioris notes that adherence to the diet requires not just an uptake of olive oil, but cutting down on less beneficial foods and an active lifestyle.</p> <p>“It’s not just the olive oil, it’s dropping down the meat, it’s mainly a plant food diet, it’s purposeful exercise,” she says.</p> <p>“I’m always a little bit nervous when people just talk about the diet and the food without considering the rest of it.</p> <p>“In the 60s, when the health benefits of the Mediterranean diet were seen […] they were out there harvesting, growing their food, preparing their food, doing all that sort of purposeful exercise in the outdoor environment, often in quite steep terrain. So that is just as important.</p> <p>“The Mediterranean diet continues to be shown to be quite healthy and beneficial in terms of improving chronic disease risk, even without weight loss.”</p> <p>Mantzioris says that the diet has also been shown to improve cognitive and mental health outcomes.</p> <p>Diet is the focus of the latest episode of <em>Debunks</em> from Cosmos and 9Podcasts, where we dive not simply into what makes a good diet, but the principles that dieticians and nutritionists look for when recommending one for a patient to consider.</p> <p><iframe title="Weight: Do diets actually work?" src="https://omny.fm/shows/debunks/weight-do-diets-actually-work/embed?style=Artwork" width="100%" height="180" frameborder="0"></iframe> <!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=287991&amp;title=When+it+comes+to+weight%2C+your+%E2%80%98diet%E2%80%99+is+much+more+than+what+you+eat" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></div> <div class="copy"> </div> <div><em>Image credits: Shutterstock</em></div> <div> </div> <div><em><a href="https://cosmosmagazine.com/health/body-and-mind/diet-is-much-more-than-what-you-eat/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/matthew-agius/">Matthew Ward Agius</a>. </em></div>

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The BMI isn’t all its cracked up to be

<p>The obsession people have with weight is nothing new. But as the relationship between science and weight evolves, health professionals are increasingly advocating for a shift away from one of the most often used tools as an individual measure of health.</p> <div class="copy"> <p>The Body Mass Index – or BMI – has been used for the past half century as a standard measurement tool for weight and obesity. It’s calculated by dividing a person’s weight in kilograms by the square of their height in metres.</p> <p>This produces a figure which is indexed on a spectrum of weight ranges. A BMI below 18.5 is considered underweight, above 25 is overweight, and above 30 is obese.</p> <p>The latest episode of <em>Debunks</em>, a new podcast from Cosmos, investigates how useful the BMI actually is for assessing health.</p> <p>Health advocacy bodies, health insurers and government departments all make reference to the BMI as being a globally recognised standard for weight classification.</p> <p>Most – but not all – <a href="https://cosmosmagazine.com/health/bmi-overweight-obese-healthy-deaths/">acknowledge that the tool is imperfect</a>. Its <a href="https://cosmosmagazine.com/health/body-and-mind/body-mass-index-miscalculation/">simple arithmetic</a> is based on a system devised by 19th-century Belgian mathematician Adolphe Quetelet, who was an early pioneer of the social sciences and the use of data to understand human trends.</p> <p>The so-called ‘Quetelet Index’ was first described in 1832 as a means of trying to identify a calculation for the average man, first by conducting cross-sectional studies of infants and then adults.</p> <p>The need to consider weight as an indicator for health, mortality and morbidity, saw scientists trial several measurements before settling on Quetelet’s formula and rebranding it as the BMI in 1972.</p> <p>The problem? The BMI was largely based on studies of Anglo-Saxon populations. This is one of the biggest limitations often recognised by health groups. The Australian Department of Health, for instance, notes that a healthy BMI range is generally lower for people of Asian backgrounds, and higher for those of Polynesian backgrounds.</p> <p>But ethnicity isn’t the only limiting factor. Age and pregnancy status also play a part. Even athletes with more lean muscle (which weighs more than fat) might also find the standard BMI doesn’t capture their health status accurately.</p> <p>Diets and lifestyles have also shifted from the 19th century Belgian standard, and even from those of 50 years ago. Health professionals have long supported a shift away from the BMI being used as a rolled gold indicator of individual health, and medical professionals are beginning to take a wider view of patient health.</p> <p>“There has been a recent change in the position from the [US] National Academies of Nutrition and Dietetics surrounding BMI and there are shifts in the guidelines around BMI for medical diagnosis,” Dr Emma Beckett, a molecular nutritionist at the University of Newcastle, tells <em>Debunks</em>.</p> <p>The same goes for other measurements like waist-to-hip ratios and waist circumference. These metrics are often used by researchers conducting large population studies, but they don’t necessarily explain a person’s ‘health picture’.</p> <p>“Because we measure them in so many of our research studies, people mistakenly believe they are the most important markers of health and it’s just not true. Health is so much more complicated,” Beckett says.</p> <p>“The ‘normal’ [BMI] category is the one with the lowest health risks, but it doesn’t mean being in that category means you have no health risks and it doesn’t mean if you just get yourself into that category and change nothing else, there are no health risks.”</p> <p>On the latest series of Debunks, a podcast from Cosmos and 9Podcasts, find out how weight – and measurements like the BMI – are much more complicated than they might seem.</p> <p><iframe title="Weight: Should you care about your BMI?" src="https://omny.fm/shows/debunks/weight-should-you-care-about-your-bmi/embed" width="100%" height="180" frameborder="0"></iframe></p> <div><em>Image credits: Shutterstock</em></div> <div style="background-color: #f4f4f4; padding-top: 20px; padding-right: 20px; padding-bottom: 20px;"><em><a href="https://cosmosmagazine.com/health/body-and-mind/the-bmi-isnt-all-its-cracked-up-to-be/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="null">Cosmos</a>. </em></div> </div>

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Worried about getting a blood test? 5 tips to make them easier (and still accurate)

<p><em><a href="https://theconversation.com/profiles/sapha-shibeeb-1481231">Sapha Shibeeb</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p>Blood tests are a common medical procedure, offering valuable insights into a person’s health. Whether you’re getting a routine check-up, diagnosing a medical condition or monitoring treatment progress, understanding the process can make the experience more comfortable and effective.</p> <p>For the majority of patients, blood collections are a minor inconvenience. Others may feel <a href="https://www.sciencedirect.com/science/article/abs/pii/S0887618506000041">uneasy and anxious</a>.</p> <p>Preparation strategies can help get you through the procedure.</p> <h2>How blood is collected</h2> <p>During venipuncture (blood draw), the phlebotomist (blood collector) inserts a needle through the skin into a vein and a small amount of blood is collected and transferred into a test tube.</p> <p>Tubes are sent to a laboratory, where the blood is analysed. A laboratory technician may count or examine cells and measure the levels of minerals/salts, enzymes, proteins or other substances in the sample. For some tests, blood plasma is separated out by spinning (centrifuging) the sample. Others pass a light beam through the sample to determine the amount of a chemical present.</p> <p>For collection, the phlebotomist usually selects a vein in the crook of your elbow, where veins are readily accessible. Blood can also be drawn from veins in the wrists, fingers or heels. A tourniquet may be applied to restrict blood flow and make the chosen vein puff out.</p> <h2>Different tests require different preparation</h2> <p>Before a blood test, the GP or health-care provider will give you specific instructions.</p> <p>These may include fasting for up to 12 hours or temporarily discontinuing certain medications.</p> <p>It is crucial to follow these guidelines meticulously as they can significantly impact the accuracy of your test results. For example, fasting is required before glucose (blood sugar) and lipids (blood fats) testing because blood sugar and cholesterol levels typically increase after a meal.</p> <p>If the blood test requires fasting, you will be asked not to eat or drink (no tea, coffee, juice or alcohol) for about eight to 12 hours. Water is allowed but smoking should be avoided because it can increase <a href="https://diabetesjournals.org/care/article/19/2/112/19825/Acute-Effect-of-Cigarette-Smoking-on-Glucose">blood sugar, cholesterol and triglyceride levels</a>.</p> <p>Generally, you will be asked to fast overnight and have the blood collection done in the morning. Fasting for longer than 15 hours could impact your results, too, by causing dehydration or the release of certain chemicals in the blood.</p> <p>If you have diabetes, you must consult your doctor prior to fasting because it can increase the risk of hypoglycemia (low blood sugar) in people with type 1 diabetes. Most type 2 diabetics can safely fast before a blood test but there are some exceptions, such as people who are taking certain medications including insulin.</p> <h2>5 tips for a better blood test</h2> <p>To improve your blood collection experience, consider these tips:</p> <p><strong>1. Hydrate</strong></p> <p>Drink plenty of water right up to 30 minutes before your appointment. Adequate hydration improves blood flow, making your veins more accessible. Avoid <a href="https://academic.oup.com/labmed/article/34/10/736/2657269">strenuous exercise</a> before your blood test, which can increase some blood parameters (such as liver function) while decreasing others (such as sodium).</p> <p><strong>2. Loose clothing</strong></p> <p>Wear clothing that allows easy access to your arms to ensure a less stressful procedure.</p> <p><strong>3. Manage anxiety</strong></p> <p>If the sight of blood or the procedure makes you anxious, look away while the needle is inserted and try to keep breathing normally. Distraction can help – virtual reality has been <a href="https://pubmed.ncbi.nlm.nih.gov/31889358/">trialled</a> to reduce needle anxiety in children. You could try bringing something to read or music to listen to.</p> <p><strong>4. Know your risk of fainting</strong></p> <p>If you’re prone to fainting, make sure to inform the phlebotomist when you arrive. You can have your blood drawn while lying down to minimise the risk of passing out and injury. Hydration helps maintain blood pressure and can also <a href="https://www.ahajournals.org/doi/10.1161/01.CIR.0000101966.24899.CB">reduce the risk</a> of fainting.</p> <p><strong>5. Discuss difficult veins</strong></p> <p>Some people have smaller or scarred veins, often due to repeated punctures, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989034/">chemotherapy</a> or blood thinner use. In such cases, venipuncture may require multiple attempts. It is important to talk to the phlebotomist if you feel discomfort or significant pain. A finger prick can be performed as an alternative for some tests, such as blood glucose levels. But other comprehensive tests require larger blood volume.</p> <h2>Blood draws after lymph node removal</h2> <p>Historically, there were concerns about drawing blood from an arm that had undergone lymph node removal. This was due to the risk of <a href="https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-pdq#:%7E:text=Lymphedema%20is%20the%20build%2Dup,the%20way%20that%20it%20should.">lymphedema</a>, a condition marked by fluid build-up in the affected arm. Lymph nodes may have been removed (<a href="https://www.ncbi.nlm.nih.gov/books/NBK564397/#:%7E:text=Lymph%20node%20dissection%2C%20also%20known,surgical%20management%20of%20malignant%20tumors.">lymphadenectomy</a>) for cancer diagnosis or treatment.</p> <p>However, a <a href="https://ascopubs.org/doi/10.1200/JCO.2015.61.5948">2016 study</a> showed people who’ve had lymph nodes removed are not at a higher risk of developing lymphedema following blood draws, even when drawing blood from the affected arm.</p> <h2>After your blood test</h2> <p>The whole blood test procedure usually lasts no more than a few minutes. Afterwards, you may be asked to apply gentle pressure over a clean dressing to aid clotting and reduce swelling.</p> <p>If you do experience swelling, bruising or pain after a test, follow general first aid procedures to alleviate discomfort. These include applying ice to the site, resting the affected arm and, if needed, taking a pain killer.</p> <p>It is usually recommended you do not do heavy lifting for a few hours after a blood draw. This is to prevent surges in blood flow that could prevent clotting where the blood was taken.<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/216073/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sapha-shibeeb-1481231">Sapha Shibeeb</a>, Senior lecturer in Laboratory Medicine , <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT 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/worried-about-getting-a-blood-test-5-tips-to-make-them-easier-and-still-accurate-216073">original article</a>.</em></p>

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Is cracking your knuckles bad for you?

<p><strong>Snap. Crackle. Pop. </strong></p> <p>No, it’s not the cereal, it’s tribonucleation, the technical term for cracking your knuckles. Whether done out of habit, stress or just because it feels good, you’ve likely been warned by someone who means well (or has just had enough of the sound) that it will give you arthritis.</p> <p>But their warning doesn’t have much merit, according to most medical professionals.</p> <p>One doctor was so eager to prove his nagging family wrong that he cracked the knuckles in his left hand at least 36,500 times (by his count) for over 50 years while leaving his right hand untouched. Dr Donald Unger, an allergist, did this in the name of science, though he seems to have been at least as motivated by an eventual “I told you so”. Publishing his findings in a letter to the scientific journal Arthritis &amp; Rheumatology in 2004, he said that “There was no arthritis in either hand, and no apparent differences between the two hands.”</p> <p>His findings are, of course, anecdotal, although often cited by professionals in the field. But do they mean that there are no side effects to cracking your knuckles (or other parts of your body for that matter)?</p> <p><strong>Is cracking your knuckles bad for you?</strong></p> <p>“As best we understand, it seems to be neutral,” says Dr Erin Brown, a clinical professor at the University of British Columbia. “There’s not a lot of research about this,” he adds, but “other studies have not found that it’s associated with arthritis.”</p> <p>Despite this, the popping noise can be disconcerting/annoying for some. What is the sound we hear when someone cracks a knuckle or other joint? It has to do with gas bubbles that form in the synovial fluid, which lubricates your joints, when two solid surfaces (i.e. your bones) move apart temporarily, creating a sort of suction.</p> <p>There’s been some debate over the years over whether the sound happens when that gas bubble bursts or when it’s formed. Recent studies using MRIs show that these little gas bubbles persist even after the ‘pop’ has been heard, suggesting that it’s the creation of the bubbles that makes the noise.</p> <p><strong>Listen up!</strong></p> <p>And if you’re one of the people irritated by the sound, that could be because mathematicians have found that the sound produced by cracking your knuckles can reach up to 83 decibels, which is louder than the average radio and similar to city traffic from inside a car.</p> <p>Whether you love it or hate it, up to 45 percent of you do it, and many describe a feeling of relief from doing so. Some of that could be because after a joint is cracked, there’s a slightly increased range of motion, so you feel more flexible.</p> <p>Of course, there are some things to watch—er, listen—out for.</p> <p><strong>Should I be worried about hearing other bones crack?</strong></p> <p>“As you get older, a lot of us have knees or something else that creaks. You sit down and you get up and you can hear them snapping and cracking. That’s a different thing,” says Dr Brown. “That is the bones actually rubbing against each other, and that can be a sign of wear and tear.”</p> <p>He also mentions that while he’s never seen it, there have been odd cases where someone can dislocate a joint when it pops out of place. But when it comes to basic knuckle cracking, however, Dr Brown assures us that if it feels okay, we’re free to keep doing it.</p> <p>Still, if you’re cracking any part of your body, heed the doctor’s orders – if it “doesn’t feel right, then it’s probably worth having assessed because it could be something else.”</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/is-cracking-your-knuckles-bad-for-you" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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How much protein do I need as I get older? And do I need supplements to get enough?

<p><em><a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>If you are a woman around 50, you might have seen advice on social media or <a href="https://www.instagram.com/p/CyVwOSzucnh">from influencers</a> telling you protein requirements increase dramatically in midlife. Such recommendations suggest a 70 kilogram woman needs around 150 grams of protein each day. That’s the equivalent of 25 boiled eggs at 6 grams of protein each.</p> <p>Can that be right? Firstly let’s have a look at what protein is and where you get it.</p> <p><a href="https://www.betterhealth.vic.gov.au/health/healthyliving/protein">Protein</a> is an essential macro-nutrient in our diet. It provides us with energy and is used to repair and make muscle, bones, soft tissues and hormones and enzymes. Mostly we associate animal foods (dairy, meat and eggs) as being rich in protein. Plant foods such as bread, grains and legumes provide valuable sources of protein too.</p> <p>But what happens to our requirements as we get older?</p> <h2>Ages and stages</h2> <p>Protein requirements change <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/protein">through different life stages</a>. This reflects changes in growth, especially from babies through to young adulthood. The estimated average requirements by age are:</p> <ul> <li> <p>1.43g protein per kg of body weight at birth</p> </li> <li> <p>1.6g per kg of body weight at 6–12 months (when protein requirements are at their highest point)</p> </li> <li> <p>protein needs decline from 0.92g down to 0.62g per kg of body weight from 6–18 years.</p> </li> </ul> <p>When we reach adulthood, protein requirements differ for men and women, which reflects the higher muscle mass in men compared to women:</p> <ul> <li> <p>0.68g per kg of body weight for men</p> </li> <li> <p>0.6g per kg of body weight for women.</p> </li> </ul> <p>Australian recommendations for people over 70 reflect the increased need for tissue repair and muscle maintenance:</p> <ul> <li> <p>0.86g per kg of bodyweight for men</p> </li> <li> <p>0.75g per kg of bodyweight for women.</p> </li> </ul> <p>For a 70kg man this is a difference of 12.6g/protein per day. For a 70kg woman this is an increase of 10.5g per day. You can add 10g of protein by consuming an extra 300ml milk, 60g cheese, 35g chicken, 140g lentils, or 3–4 slices of bread.</p> <p>There is emerging evidence <a href="https://www.scopus.com/record/display.uri?eid=2-s2.0-85124835199&amp;origin=resultslist&amp;sort=plf-f&amp;cite=2-s2.0-84881254292&amp;src=s&amp;nlo=&amp;nlr=&amp;nls=&amp;imp=t&amp;sid=c07c9e014577c86ab8cf85c62d9764cd&amp;sot=cite&amp;sdt=a&amp;sl=0&amp;relpos=39&amp;citeCnt=6&amp;searchTerm=">higher intakes</a> for people over 70 (up to 0.94–1.3g per kg of bodyweight per day) might reduce age-related decline in muscle mass (known as sarcopenia). But this must be accompanied with increased resistance-based exercise, such as using weights or stretchy bands. As yet these have not been included in any national nutrient guidelines.</p> <h2>But what about in midlife?</h2> <p>So, part of a push for higher protein in midlife might be due to wanting to prevent age-related muscle loss. And it might also be part of a common desire to prevent weight gain that may come with <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17290?af=R">hormonal changes</a>.</p> <p>There have been relatively few studies specifically looking at protein intake in middle-aged women. One large 2017 observational study (where researchers look for patterns in a population sample) of over 85,000 middle-aged nurses found higher intake of vegetable protein – but not animal protein or total protein – was linked to a <a href="https://academic.oup.com/aje/article/187/2/270/3886033">lower incidence of early menopause</a>.</p> <p>In the same group of women another study found higher intake of vegetable protein was linked to a <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jcsm.12972">lower risk of frailty</a> (meaning a lower risk of falls, disability, hospitalisation and death). Higher intake of animal protein was linked to higher risk of frailty, but total intake of protein had no impact.</p> <p>Another <a href="https://journals.lww.com/menopausejournal/abstract/2017/05000/skeletal_muscle_mass_is_associated_with_higher.9.aspx">smaller observational study</a> of 103 postmenopausal women found higher lean muscle mass in middle-aged women with higher protein intake. Yet an <a href="https://journals.lww.com/menopausejournal/abstract/2021/03000/effects_of_high_protein,_low_glycemic_index_diet.11.aspx">intervention study</a> (where researchers test out a specific change) showed no effect of higher protein intake on lean body mass in late post-menopasual women.</p> <p><a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17290?af=R">Some researchers</a> are theorising that higher dietary protein intake, along with a reduction in kilojoules, could reduce weight gain in menopause. But this has not been tested in clinical trials.</p> <p>Increasing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539343/">protein intake</a>, improves satiety (feeling full), which may be responsible for reducing body weight and maintaining muscle mass. The protein intake to improve satiety in studies has been about 1.0–1.6g per kg of bodyweight per day. However such studies have not been specific to middle-aged women, but across all ages and in both men and women.</p> <h2>What are we actually eating?</h2> <p>If we look at what the <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-usual-nutrient-intakes/latest-release">average daily intake of protein is</a>, we can see 99% of Australians under the age of 70 meet their protein requirements from food. So most adults won’t need supplements.</p> <p>Only 14% of men over 70 and 4% of women over 70 do not meet their estimated average protein requirements. This could be for many reasons, including a decline in overall health or an illness or injury which leads to reduced appetite, reduced ability to prepare foods for themselves and also the cost of animal sources of protein.</p> <p>While they may benefit from increased protein from supplements, opting for a food-first approach is preferable. As well as being more familiar and delicious, it comes with other essential nutrients. For example, red meat also has iron and zinc in it, fish has omega-3 fats, and eggs have vitamin A and D, some iron and omega-3 fats and dairy has calcium.</p> <h2>So what should I do?</h2> <p>Symptoms of <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/protein#getting-too-little-protein-protein-deficiency">protein deficiency</a> include muscle wasting, poor wound healing, oedema (fluid build-up) and anaemia (when blood doesn’t provide enough oxygen to cells). But the amount of protein in the average Australian diet means deficiency is rare. The <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">Australian dietary guidelines</a> provide information on the number of serves you need from each food group to achieve a balanced diet that will meet your nutrient requirements.</p> <p>If you are concerned about your protein intake due to poor health, increased demand because of the sports you’re doing or because you are a vegan or vegetarian, talk to your GP or an accredited practising dietitian.<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/215695/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/evangeline-mantzioris-153250"><em>Evangeline Mantzioris</em></a><em>, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-protein-do-i-need-as-i-get-older-and-do-i-need-supplements-to-get-enough-215695">original article</a>.</em></p>

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Name that rash: 6 common skin conditions (and how to treat them)

<p><strong>Psoriasis</strong></p> <p><span style="text-decoration: underline;"><em>What psoriasis is like:</em></span> Psoriasis is made of red, scaly plaques that can be itchy and painful. It can show up anywhere but is most commonly found on the scalp, as well as the outside of the elbows and knees. It usually starts between age 10 and 30 and tends to be a chronic condition. “It’s a stubborn disease that waxes and wanes, so people have it for their whole lives,” says dermatologist Paul Cohen.</p> <p><span style="text-decoration: underline;"><em>What causes psoriasis:</em></span> This skin rash is the result of your immune system attacking the skin’s cells, and creating new ones too quickly, which then build up into the plaques. There’s no one single cause, but the condition runs in families. Stress, obesity, smoking and having many infections (particularly strep throat) increase your risk.</p> <p><span style="text-decoration: underline;"><em>How to treat psoriasis:</em></span> The first step is generally topical steroids, which can be used for a week or two at a time to clear up the plaques. For ongoing treatment, people use a synthetic form of vitamin D (which slows skin growth), medicated shampoos and retinoids (a topical version of vitamin A). Daily exposure to sunlight also seems to help, as does moisturising well. For more serious cases, options include oral medications that suppress the immune system and phototherapy done in a doctor’s office with a special light. (Discover more applications of light therapy.)</p> <p><span style="text-decoration: underline;"><em>Possible red flag:</em></span> Serious cases can involve the joints, a condition called psoriatic arthritis. Also, psoriasis increases your chances of having some other diseases, including type 2 diabetes, cardiovascular disease and autoimmune conditions such as Crohn’s – all of which are, like psoriasis, linked to inflammation.</p> <p><strong>Hives</strong></p> <p><span style="text-decoration: underline;"><em>What hives are like:</em></span> Hives are itchy, raised welts that often have a red ring around them. Their most salient characteristic is that they disappear after about a day, only to show up later in a different location. They come in two forms: acute, which lasts six weeks or less, and chronic.</p> <p><span style="text-decoration: underline;"><em>What causes hives:</em></span> Hives are often the result of the body releasing histamine as part of an allergic reaction to drugs, food or some other irritant. They also commonly appear after a viral illness, as a side effect of your immune system revving up to battle the disease. “There are a number of potential triggers,” says dermatologist Katie Beleznay. In most cases, she adds, the specific origin is never determined.</p> <p><span style="text-decoration: underline;"><em>How to treat hives:</em></span> Since hives are a histamine reaction, over-the-counter antihistamines are the first line of defence. If that doesn’t clear them up, ask a doctor if you should use a stronger antihistamine or oral prednisone, an anti-inflammatory medication.</p> <p><span style="text-decoration: underline;"><em>Possible red flag:</em></span> Rarely, people suffer from ongoing outbreaks of hives almost daily for six weeks or more, a condition called chronic idiopathic urticaria (CIU). The treatment for CIU is the same as for regular hives, but in some cases, it can also be a sign of an underlying thyroid disease or cancer.</p> <p><strong>Eczema</strong></p> <p><span style="text-decoration: underline;"><em>What eczema is like:</em></span> Eczema presents as patches of red, scaly skin that are extremely itchy, especially at night. These rashes often appear on the inside of your elbows and knees. If it’s more serious, the skin might blister or look thickened and white in those areas.</p> <p><span style="text-decoration: underline;"><em>What causes eczema:</em></span> Eczema is the result of having a weakened skin barrier, which can lead to inflammation and an overreaction from your immune system. Most people are born with it, and your genes are partly to blame. “You’re more predisposed to eczema if you have a family history of asthma, hay fever or the condition itself,” says Lisa Kellett, a dermatologist in Toronto. Some research also suggests that it might be a reaction to pollution, or to not being exposed to enough germs in childhood. (Kids who have dogs, for example, are less likely to have eczema.)</p> <p><span style="text-decoration: underline;"><em>How to treat eczema:</em></span> For general maintenance, apply a thick, hypoallergenic moisturizer to affected areas immediately after a bath or shower and at night. More serious flares will need topical prescription steroid creams or non-steroid immunosuppressant creams. People with stubborn eczema might also try phototherapy, which uses UVB light to help calm your immune system and reduce itchiness.</p> <p><span style="text-decoration: underline;"><em>Possible red flag:</em></span> Rarely, what looks like eczema is actually skin cancer, as both can appear red and scaly. “The difference with skin cancer is that it doesn’t go away if you use a steroid,” says Kellett.</p> <p><strong>Contact Dermatitis</strong></p> <p><span style="text-decoration: underline;"><em>What contact dermatitis is like:</em></span> Contact dermatitis is a variation of eczema, and it looks similar – red, itchy patches on your skin. But unlike that chronic condition, this skin rash is a reaction to something specific and appears only where the offending object has made contact. “Poison ivy, for instance, will show up as a streak where the branch touched the skin,” says Beleznay.</p> <p><span style="text-decoration: underline;"><em>What causes contact dermatitis:</em></span> Besides poison ivy, other common culprits that can cause the immune system to go into overdrive are face cream, jewellery or fragrances. You can also develop a new intolerance to something you’ve used for a long time, such as Polysporin. If it’s not clear what caused it, your dermatologist can do a patch test, putting small amounts of suspected substances on your skin to see if you react.</p> <p><span style="text-decoration: underline;"><em>How to treat contact dermatitis:</em></span> Contact dermatitis is treated with topical steroids, or a stronger oral one, to calm down your immune system and stop the reaction.</p> <p><span style="text-decoration: underline;"><em>Possible red flag:</em></span> Like eczema, the red and scaly presentation of contact dermatitis could be confused for skin cancer, which is another reason to visit your doctor if you’re not sure what caused it.</p> <p><strong>Rosacea</strong></p> <p><span style="text-decoration: underline;"><em>What rosacea is like:</em></span> As rosacea is a dilation of the blood vessels in your cheeks and nose, it often presents as red, sensitive skin in those places. Another form of the condition also includes bumps that resemble acne. For some people, the skin on their nose thickens, making it appear larger.</p> <p><span style="text-decoration: underline;"><em>What causes rosacea:</em></span> We don’t know what brings rosacea on, but, as with eczema, you’re more likely to have it if others in your family do, too. You’re also prone to acquire the condition if you have sun-damaged skin. “Rosacea usually begins around the age of 35 and gets worse with time,” says Kellett. People often find their flare-ups come after eating or drinking specific things.</p> <p><span style="text-decoration: underline;"><em>How to treat rosacea:</em></span> For many, preventing activation of their rosacea is as simple as avoiding triggers – but that’s easier than it sounds and can be a serious test of a sufferer’s willpower. “Those are often the good things in life,” says Beleznay, citing coffee, spicy foods and alcohol as common aggravators. Some women find that everyday makeup is enough to cover up the cosmetic impact of the condition, while others use prescription creams or laser or light therapy to constrict the blood vessels in the cheeks and reduce redness. For those whose rosacea includes bumps, topical creams or oral antibiotics often get rid of them.</p> <p><span style="text-decoration: underline;"><em>Possible red flag:</em></span> Rarely, what looks like rosacea can be confused for the butterfly rash that’s a symptom of lupus, a serious autoimmune disease. The butterfly rash is named as such because of the shape it makes on the nose and both cheeks.</p> <p><strong>Shingles</strong></p> <p><span style="text-decoration: underline;"><em>What shingles is like:</em></span> Shingles normally starts out as a tingly, numb or bruised feeling in a small area, most commonly a patch on the abdomen. A few days later, a painful skin rash with blisters appears over those places. As the condition follows the path of a nerve, the rash eventually presents as a stripe that lasts from two to six weeks.</p> <p><span style="text-decoration: underline;"><em>What causes shingles:</em></span> This one’s easy: chicken pox. Even once you have fully recovered from that virus, your body never totally beats it; it simply retreats and lies dormant in your nerve cells, where, decades later, it can re-erupt as shingles. You’re more likely to get them if you’re immunocompromised or over 50, the age at which most public health agencies recommend you get the vaccine.</p> <p><span style="text-decoration: underline;"><em>How to treat shingles:</em></span> If you suspect you have shingles, see your doctor immediately. “You have to go right away because studies show that people do much better if the antiviral pills are started within 72 hours of the rash onset,” says Cohen. Additionally, sufferers are often given medication, like a local anaesthetic or codeine, to help control the pain.</p> <p><span style="text-decoration: underline;"><em>Possible red flag:</em></span> The real worry with shingles is that for some people, if it is not contained quickly, the virus can lead to longer-term pain lasting over three months and in some cases over a year. If the skin rash appears on the face, it can even cause blindness.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/name-that-rash-6-common-skin-conditions-and-how-to-treat-them" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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What is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?

<p><em><a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>What do British Prime Minister <a href="https://www.sciencefocus.com/the-human-body/one-meal-a-day-diet-omad">Rishi Sunak</a> and singer <a href="https://theconversation.com/one-meal-a-day-diet-popular-with-celebrities-could-do-more-harm-than-good-heres-why-203086">Bruce Springsteen</a> have in common?</p> <p>They’re among an ever-growing group of public figures touting the benefits of eating just one meal a day.</p> <p>As a result, the one meal a day (OMAD) diet is the latest attention-grabbing weight loss trend. Advocates claim it leads to fast, long-term weight loss success and better health, including delaying the ageing process.</p> <p>Like most weight-loss programs, the OMAD diet makes big and bold promises. Here’s what you need to know about eating one meal a day and what it means for weight loss.</p> <h2>The OMAD diet explained</h2> <p>Essentially, the OMAD diet is a type of intermittent fasting, where you fast for 23 hours and consume all your daily calories in one meal eaten within one hour.</p> <p>The OMAD diet rules are presented as simple and easy to follow:</p> <ol> <li> <p>You can eat whatever you want, provided it fits on a standard dinner plate, with no calorie restrictions or nutritional guidelines to follow.</p> </li> <li> <p>You can drink calorie-free drinks throughout the day (water, black tea and coffee).</p> </li> <li> <p>You must follow a consistent meal schedule, eating your one meal around the same time each day.</p> </li> </ol> <p>Along with creating a calorie deficit, resulting in weight loss, advocates believe the OMAD diet’s extended fasting period <a href="https://www.frontiersin.org/articles/10.3389/fphys.2021.771944/full">leads to physiological changes</a> in the body that promote better health, including boosting your metabolism by triggering a process called ketosis, where your body burns stored fat for energy instead of glucose.</p> <h2>What does the evidence say?</h2> <p>Unfortunately, research into the OMAD diet is limited. Most studies have examined its impact on <a href="https://www.cell.com/cell-metabolism/pdf/S1550-4131(18)30512-6.pdf">animals</a>, and the <a href="https://pubmed.ncbi.nlm.nih.gov/35087416/">primary study</a> with humans involved 11 lean, young people following the OMAD diet for a mere 11 days.</p> <p>Claims about the OMAD diet typically rely on research into intermittent fasting, rather than on the OMAD diet itself. There is <a href="https://www.cfp.ca/content/66/2/117.short">evidence</a> backing the efficacy of intermittent fasting to achieve weight loss. However, <a href="https://www.nature.com/articles/s41574-022-00638-x">most studies</a> have focused on short-term results only, typically considering the results achieved across 12 weeks or less.</p> <p>One <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2114833">longer-term study from 2022</a> randomly assigned 139 patients with obesity to either a calorie-restricted diet with time-restricted eating between 8am and 4pm daily, or to a diet with daily calorie restriction alone for 12 months.</p> <p>After 12 months, both groups had lost around the same weight and experienced similar changes in body fat, blood sugar, cholesterol and blood pressure. This indicates long-term weight loss achieved with intermittent fasting is not superior and on a par with that achieved by traditional dieting approaches (daily calorie restriction).</p> <h2>So what are the problems with the OMAD diet?</h2> <p><strong>1. It can cause nutritional deficiencies and health issues.</strong></p> <p>The OMAD diet’s lack of nutritional guidance on what to eat for that one meal a day raises many red flags.</p> <p>The meals we eat every day should include a source of protein balanced with wholegrain carbs, vegetables, fruits, protein and good fats to support <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071223/">optimum health, disease prevention and weight management</a>.</p> <p>Not eating a balanced diet will result in nutritional deficiencies that can result in poor immune function, fatigue and a decrease in bone density, leading to osteoporosis.</p> <p>Fasting for 23 hours a day is also likely to lead to extreme feelings of hunger and uncontrollable cravings, which may mean you consistently eat foods that are not good for you when it’s time to eat.</p> <p><strong>2. It’s unlikely to be sustainable.</strong></p> <p>You might be able to stick with the OMAD diet initially, but it will wear thin over time.</p> <p>Extreme diets – especially ones prescribing extended periods of fasting – aren’t enjoyable, leading to feelings of deprivation and social isolation during meal times. It’s hard enough to refuse a piece of office birthday cake at the best of times, imagine how this would feel when you haven’t eaten for 23 hours!</p> <p>Restrictive eating can also lead to an unhealthy relationship with food, making it even harder to achieve and maintain a healthy weight.</p> <p><strong>3. Quick fixes don’t work.</strong></p> <p>Like other popular intermittent fasting methods, the OMAD diet appeals because it’s easy to digest, and the results appear fast.</p> <p>But the OMAD diet is just another fancy way of cutting calories to achieve a quick drop on the scales.</p> <p>As your weight falls, things will quickly go downhill when your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">body activates its defence mechanisms</a> to defend your weight loss. In fact, it will regain weight – a response that stems from our hunter-gatherer ancestors’ need to survive periods of deprivation when food was scarce.</p> <h2>The bottom line</h2> <p>Despite the hype, the OMAD diet is unsustainable, and it doesn’t result in better weight-loss outcomes than its predecessors. Our old habits creep back in and we find ourselves fighting a cascade of physiological changes to ensure we regain the weight we lost.</p> <p>Successfully losing weight long-term comes down to:</p> <ul> <li> <p>losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight</p> </li> <li> <p>making gradual changes to your lifestyle to ensure you form habits that last a lifetime.</p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-the-omad-diet-is-one-meal-a-day-actually-good-for-weight-loss-and-is-it-safe-207723">original article</a>.</em></p>

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Demi Moore flaunts stunning bikini body at 60

<p>Fans have been wowed by Demi Moore's latest Instagram post, after the 60-year-old actress flaunted her bikini body in a series of photos documenting her recent “nature immersion” trip.</p> <p>“Sharing a few precious moments from my recent adventure with @tilliewaltonofficial and @nash2o on #TilliesRiverTrip,”  she captioned the post. </p> <p>"Back in September, I had the opportunity to journey through the Grand Canyon on the Colorado River alongside so many beautiful souls. </p> <p>"We laughed, cried and formed lifelong bonds that I will hold close to my heart forever. I will never truly be able to describe the many ways that this recent nature immersion has impacted me," she added. </p> <p>The star shared a photo of her in a black bikini standing under a waterfall, with her arms in the air. </p> <p>"Standing on the banks of the Colorado River as we all took in its magnificence and beauty, I was reminded of the urgent need to preserve and protect this vital lifeline," she wrote before urging her followers to “be the change we want to see.”</p> <p>She added a few other photos and a video of her with some fellow travellers while on their nature immersion trip. </p> <p>Fans praised the  <em>G.I. Jane</em> star for raising awareness and her timeless beauty. </p> <p>“And this Ladies and Gentlemen’s is what 60 year old looks like. Insane," wrote one fan. </p> <p>“You get better with age,” agreed another. </p> <p>“Demi looks amazing! If I look that good at her age I’ll be happy," commented a third. </p> <p>“Yes … had the honour to join @tilliewaltonofficial on a Grand Canyon trip and it’s LIFE CHANGING,” journalist Frank Elaridi wrote, adding, “Thank you for raising awareness to protect rivers ️.”</p> <p>"So much gratitude for dropping deep into nature with you. Your radiant wisdom and effervescence rocks my world!" added one of the travellers she went with. </p> <p>"Incredible Demi what's your secret to staying so young and beautiful 😍" commented another. </p> <p><em>Images: Instagram</em></p>

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Can I actually target areas to lose fat, like my belly?

<p><em><a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Spend some time scrolling social media and you’re all-but-guaranteed to see an ad promising to help you with targeted fat loss. These ads promote a concept known as “spot reduction”, claiming you can burn fat in a specific body area, usually the belly, with specially designed exercises or workouts.</p> <p>It’s also common to see ads touting special diets, pills and supplements that will blast fat in targeted areas. These ads – which often feature impressive before and after photos taken weeks apart – can seem believable.</p> <p>Unfortunately, spot reduction is another weight-loss myth. It’s simply not possible to target the location of fat loss. Here’s why.</p> <h2>1. Our bodies are hardwired to access and burn all our fat stores for energy</h2> <p>To understand why spot reduction is a myth, it’s important to understand how body fat is stored and used.</p> <p>The fat stored in our bodies takes the form of triglycerides, which are a type of lipid or fat molecule we can use for energy. Around 95% of the dietary fats <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">we consume are triglycerides</a>, and when we eat, our bodies also convert any unused energy consumed into triglycerides.</p> <p>Triglycerides are stored in special fat cells called adipocytes, and they’re released into our bloodstream and transported to adipose tissue – tissue we more commonly refer to as body fat.</p> <p>This body fat is found all over our bodies, but it’s primarily stored as subcutaneous fat under our skin and as visceral fat around our internal organs.</p> <p>These fat stores serve as a vital energy reserve, with our bodies mobilising to access stored triglycerides to provide energy during periods of prolonged exercise. We also draw on these reserves when we’re dieting and fasting.</p> <p>However, contrary to what many spot-reduction ads would have us think, our muscles can’t directly access and burn specific fat stores when we exercise.</p> <p>Instead, they use a process called lipolysis to convert triglycerides into free fatty acids and a compound called glycerol, which then travels to our muscles via our bloodstream.</p> <p>As a result, the fat stores we’re using for energy when we exercise come from everywhere in our bodies – not just the areas we’re targeting for fat loss.</p> <p>Research reinforces how our bodies burn fat when we exercise, confirming spot reduction is a weight-loss myth. This includes a randomised <a href="https://pubmed.ncbi.nlm.nih.gov/25766455/">12-week clinical trial</a> which found no greater improvement in reducing belly fat between people who undertook an abdominal resistance program in addition to changes in diet compared to those in the diet-only group.</p> <p>Further, <a href="https://www.termedia.pl/A-proposed-model-to-test-the-hypothesis-of-exerciseinduced-localized-fat-reduction-spot-reduction-including-a-systematic-review-with-meta-analysis,129,45538,0,1.html">a 2021 meta-analysis</a> of 13 studies involving more than 1,100 participants found that localised muscle training had no effect on localised fat deposits. That is, exercising a specific part of the body did not reduce fat in that part of the body.</p> <p><a href="https://www.mdpi.com/1660-4601/18/7/3845">Studies</a> purporting to show spot-reduction benefits have small numbers of participants with results that aren’t clinically meaningful.</p> <h2>2. Our bodies decide where we store fat and where we lose it from first</h2> <p>Factors outside of our control influence the areas and order in which our bodies store and lose fat, namely:</p> <ul> <li> <p>our genes. Just as DNA prescribes whether we’re short or tall, genetics plays a significant role in how our fat stores are managed. Research shows our genes can account for <a href="https://pubmed.ncbi.nlm.nih.gov/24632736/">60% of where fat is distributed</a>. So, if your mum tends to store and lose weight from her face first, there’s a good chance you will, too</p> </li> <li> <p>our gender. Our bodies, by nature, have distinct fat storage characteristics <a href="https://pubmed.ncbi.nlm.nih.gov/11706283/">driven by our gender</a>, including females having more fat mass than males. This is primarily because the female body is designed to hold fat reserves to support pregnancy and nursing, with women tending to lose weight from their face, calves and arms first because they impact childbearing the least, while holding onto fat stored around the hips, thighs and buttocks</p> </li> <li> <p>our age. The ageing process triggers changes in muscle mass, metabolism, and hormone levels, which can impact where and how quickly fat is lost. Post-menopausal <a href="https://theconversation.com/is-menopause-making-me-put-on-weight-no-but-its-complicated-198308">women</a> and middle-aged <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/sex-differences-in-fat-storage-fat-metabolism-and-the-health-risks-from-obesity-possible-evolutionary-origins/00950AD6710FB3D0414B13EAA67D4327">men</a> tend to store visceral fat around the midsection and find it a stubborn place to shift fat from.</p> </li> </ul> <h2>3. Over-the-counter pills and supplements cannot effectively target fat loss</h2> <p>Most advertising for these pills and dietary supplements – including products claiming to be “the best way to lose belly fat” – will also proudly claim their product’s results are backed by “clinical trials” and “scientific evidence”.</p> <p>But the reality is a host of independent studies don’t support these claims.</p> <p>This includes two recent studies by the University of Sydney that examined data from more than 120 placebo-controlled trials of <a href="https://pubmed.ncbi.nlm.nih.gov/31984610/">herbal</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33976376/">dietary</a> supplements. None of the supplements examined provided a clinically meaningful reduction in body weight among overweight or obese people.</p> <h2>The bottom line</h2> <p>Spot reduction is a myth – we can’t control where our bodies lose fat. But we can achieve the results we’re seeking in specific areas by targeting overall fat loss.</p> <p>While you may not lose the weight in a specific spot when exercising, all physical activity helps to burn body fat and preserve muscle mass. This will lead to a change in your body shape over time and it will also help you with long-term weight management.</p> <p>This is because your metabolic rate – how much energy you burn at rest – is determined by how much muscle and fat you carry. As muscle is more metabolically active than fat (meaning it burns more energy than fat), a person with a higher muscle mass will have a faster metabolic rate than someone of the same body weight with a higher fat mass.</p> <p>Successfully losing fat long term comes down to losing weight in small, manageable chunks you can sustain – periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight.</p> <p>It also requires gradual changes to your lifestyle (diet, exercise and sleep) to ensure you form habits that last a lifetime.</p> <p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</em><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/205203/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/nick-fuller-219993"><em>Nick Fuller</em></a><em>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-i-actually-target-areas-to-lose-fat-like-my-belly-205203">original article</a>.</em></p>

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Slashing salt can save lives – and it won’t hurt your hip pocket or tastebuds

<p><em><a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/lachlan-fox-1283428">Lachlan Fox</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p>Each year, more than <a href="https://www.aihw.gov.au/getmedia/eb5fee21-7f05-4be1-8414-8b2bba7b4070/ABDS-2018-Risk-factor-supp-data-tables.xlsx.aspx">2,500 Australians</a> die from diseases linked to eating too much salt.</p> <p>We shouldn’t be putting up with so much unnecessary illness, mainly from heart disease and strokes, and so many deaths.</p> <p>As a new <a href="https://grattan.edu.au/report/sneaky-salt/">Grattan Institute report</a> shows, there are practical steps the federal government can take to save lives, reduce health spending and help the economy.</p> <h2>We eat too much salt, with deadly consequences</h2> <p>Eating too much salt is bad for your health. It <a href="https://www.nature.com/articles/s41569-018-0004-1">raises blood pressure</a>, which increases the risk of <a href="https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.119.14240">heart disease and stroke</a>.</p> <p>About <a href="https://www.aihw.gov.au/reports/risk-factors/high-blood-pressure/contents/summary">one in three</a> Australians has high blood pressure, and eating too much salt is the biggest individual contributor.</p> <p>Unfortunately, the average Australian eats far too much salt – <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja17.00394">almost double</a> the recommended daily maximum of 5 grams, equivalent to <a href="https://www.heartfoundation.org.au/sodium-and-salt-converter#:%7E:text=We%20recommend%20adults%20eat%20less,about%201%20teaspoon%20a%20day">a teaspoon</a>.</p> <p>Australian governments know excessive salt intake is a big problem. That’s why in <a href="https://www.health.gov.au/resources/publications/national-preventive-health-strategy-2021-2030?language=en">2021 they set a target</a> to reduce salt intake by at least 30% by 2030.</p> <p>It’s an ambitious and worthy goal. But we’re still eating too much salt and we don’t have the policies to change that.</p> <h2>Most of the salt we eat is added to food during manufacturing</h2> <p>Most of the salt Australians eat doesn’t come from the shaker on the table. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231587/">About three-quarters</a> of it is added to food during manufacturing.</p> <p>This salt is hidden in everyday staples such as bread, cheese and processed meats. Common foods such as ready-to-eat pasta meals or a ham sandwich can have up to half our total recommended salt intake.</p> <h2>Salt limits are the best way to cut salt intake</h2> <p>Reducing the amount of salt added to food during manufacturing is the most effective way to reduce intake.</p> <p>Salt limits can help us do that. They work by setting limits on how much salt can be added to different kinds of food, such as bread or biscuits. To meet these limits, companies need to change the recipes of their products, reducing the amount of salt.</p> <p>Under salt limits, the United Kingdom reduced salt intake <a href="https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16649">by 20% in about a decade</a>. <a href="https://www.nature.com/articles/s41371-021-00653-x">South Africa</a> is making even faster gains. Salt limits are cheap and easy to implement, and can get results quickly.</p> <p>Most consumers won’t notice a change at the checkout. Companies will need to update their recipes, but even if all the costs of updating recipes were passed on to shoppers, we calculate that at most it would cost about 10 cents each week for the average household.</p> <p>Nor will consumers notice much of a change at the dinner table. <a href="https://www.mdpi.com/2072-6643/6/10/4354">Most people don’t notice</a> when some salt is removed <a href="https://www.sciencedirect.com/science/article/pii/S0022316622031224">from common foods</a>. There are many ways companies can make foods taste just as salty without adding as much salt. For example, they can make <a href="https://www.wsj.com/articles/SB10001424052748704534904575131602283791566">salt crystals finer</a>, or use <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520464/">potassium-enriched salt</a>, which swaps some of the harmful sodium in salt for potassium. And because the change will be gradual, our tastebuds will <a href="https://doi.org/10.1093/eurjcn/zvac060.077">adapt to less salty foods</a> over time.</p> <h2>Australia’s salt limits are failing</h2> <p>Australia has had voluntary salt limits since 2009, but they are badly designed, poorly implemented, and have reduced population salt intake by just <a href="https://www.abs.gov.au/articles/healthy-food-partnership-reformulation-program-two-year-progress">0.3%</a>.</p> <p>Because Australia’s limits are voluntary, many food companies have chosen not to participate in the scheme. Our analysis shows that 73% of eligible food products are not participating, and only 4% have reduced their salt content.</p> <h2>Action could save lives</h2> <p>Modelling from the University of Melbourne <a href="https://mspgh.unimelb.edu.au/__data/assets/pdf_file/0004/4783405/The-Health-and-Cost-Impacts-of-Sodium-Reduction-Interventions-in-Australia.pdf">shows</a> that fixing our failed salt limits could add 36,000 extra healthy years of life, across the population, over the next 20 years.</p> <p>This would delay more than 300 deaths each year and reduce health-care spending by A$35 million annually, the equivalent of 6,000 hospital visits.</p> <p><a href="https://www.nature.com/articles/jhh2013105">International experience</a> <a href="https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16649">shows</a> the costs of implementing such salt limits would be very low and far outweighed by the benefits.</p> <h2>How to fix our failed salt limits</h2> <p>To achieve these gains, the federal government should start by enforcing the limits we already have, by making compliance mandatory. <a href="https://www.sciencedirect.com/science/article/abs/pii/S216183132300042X">Fifteen countries</a> have mandatory salt limits, and 14 are planning to introduce them.</p> <p>The number of foods covered by salt limits in Australia should more than double, to be as broad as those the <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/604338/Salt_reduction_targets_for_2017.pdf">UK set in 2014</a>. Broader targets would include common foods for which Australia does not currently set targets, such as baked beans, butter, margarine and canned vegetables.</p> <p>A loophole in the current scheme that lets companies leave out a fifth of their products should be closed. The federal government should design the policy, rather than doing it jointly with industry representatives.</p> <p>Over the coming decades, Australia will need many new and improved policies to reduce diet-related disease. Reducing salt intake must be part of this agenda. For too long, Australia has let the food industry set the standard, with almost no progress against a major threat to our health.</p> <p>Getting serious about salt would save lives, and it would more than pay for itself through reduced health-care costs and increased economic activity.<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/213980/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/peter-breadon-1348098"><em>Peter Breadon</em></a><em>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/lachlan-fox-1283428">Lachlan Fox</a>, Associate, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</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/slashing-salt-can-save-lives-and-it-wont-hurt-your-hip-pocket-or-tastebuds-213980">original article</a>.</em></p>

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Hello hay fever – why pressing under your nose could stop a sneeze but why you shouldn’t

<p><em><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/jessica-nealon-1481995">Jessica Nealon</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>If you have <a href="https://theconversation.com/sniffles-sneezing-and-cough-how-to-tell-if-its-a-simple-allergy-rather-than-the-virus-139657">hay fever</a>, you’ve probably been sneezing a lot lately.</p> <p>Sneezing is universal but also quite unique to each of us. It is a protective reflex action outside our conscious control, to remove irritants from inside our nose.</p> <p>The <a href="https://www.healthline.com/health/holding-in-a-sneeze">pressure in the airways</a> during a sneeze is more than 30 times greater than heavy breathing during exercise. Estimates of how fast a sneeze travels range from <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0059970">5 metres a second</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/19617285/">more than 150 kilometres per hour</a>.</p> <p>You can sometimes stop a sneeze by holding your nose or pressing underneath it. This is related to the <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/gate-control-theory">gate control theory of pain</a> and the idea you can change neural responses with external stimulation. But given the velocity of a sneeze, it might not be a good idea to stop it after it has started.</p> <h2>An involuntary reflex</h2> <p>A sneeze is initiated when sensory nerves in our nose are <a href="https://journals.sagepub.com/doi/10.1177/1753465809340571?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">stimulated by an irritant</a> such as allergens, viruses, bacteria or even fluid.</p> <p>The sensory nerves then carry this irritant information to the brain.</p> <p>When a threshold amount of irritant signals reach the brain, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077498/">sneeze reflex is triggered</a>. A sneeze first involves a deep intake of breath and a <a href="https://www.scientificamerican.com/article/why-do-we-sneeze/">build-up of pressure inside the airways</a>. This is then followed by <a href="https://www.healthline.com/health/back-pain/back-pain-when-sneezing#sneezing-as-a-cause">contraction of the diaphragm</a> and rib muscles, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077498/">reflex closing of the eyes</a> and a strong exhalation.</p> <p>These are the “ah” and the “tchoo” phases of a sneeze.</p> <p>On the exhalation of a sneeze, your tongue is lifted to the roof of your mouth. This <a href="https://www.atsjournals.org/doi/10.1164/rccm.202004-1263PP">closes off the back of the mouth</a> so the air is forced mostly through your nose. The air expelled through the nose flushes out the irritants that caused the sneeze. The “tch” sound of a sneeze is the reflexive touching of the tongue to the roof of your mouth.</p> <h2>The trigeminal nerves</h2> <p>The trigeminal nerves are the <a href="https://my.clevelandclinic.org/health/body/21998-cranial-nerves">largest of our 12 pairs of cranial nerves</a> and the largest sensory nerves in the body.</p> <p>The left and right trigeminal nerves carry sensory information from the face to the brain. This includes touch, pain and irritation sensory information from the facial skin and from inside the nose and mouth. Within each trigeminal nerve are thousands of individual nerve branches that each carry a <a href="https://journals.sagepub.com/doi/full/10.1177/1744806920901890">specific type of sensory information</a>.</p> <h2>Sensory nerves communicate in the spinal cord</h2> <figure class="align-right zoomable"><a href="https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=631&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=631&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=631&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=792&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=792&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=792&amp;fit=crop&amp;dpr=3 2262w" alt="drawing of face with nerves labelled" /></a><figcaption><span class="caption">Henry Gray’s anatomical illustration of the trigeminal nerve.</span> <span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/8/83/Gray778.png">Gray's Anatomy/Wikimedia Commons</a></span></figcaption></figure> <p>Sensory nerves travel to the brain via the spinal cord. The sensory nerves that carry pain and irritant signals are narrow, whereas those that carry touch information are wider and faster.</p> <p>In the spinal cord, these nerves communicate with each other via interneurons before sending their message to the brain. The interneurons are the “gates” of the <a href="https://www.physio-pedia.com/Gate_Control_Theory_of_Pain#:%7E:text=and%20trigger%20%E2%80%A2-,Introduction,be%20let%20through%20or%20restricted.">gate control theory of pain</a>.</p> <p>A nerve carrying a pain signal tells the interneuron to “open the gate” for the pain signal to reach the brain. But the larger nerves that carry touch information can “close the gate” and block the pain messages getting to the brain.</p> <p>This is why rubbing an injured area can reduce the sensation of pain.</p> <p><a href="https://www.frontiersin.org/articles/10.3389/fphys.2018.01037/full">One study</a> showed stimulating the trigeminal nerves by moving the jaw reduced tooth pain. We can observe this in action when babies instinctively <a href="https://chaimommas.com/2013/11/05/what-to-expect-with-teething-and-tooth-development-chart/">bite on things or pull their ear</a> when they are teething. These actions can stimulate the trigeminal touch nerves and reduce pain signals via the gate control mechanism.</p> <h2>So does putting your finger under your nose stop a sneeze?</h2> <p>There are <a href="https://www.healthline.com/health/how-to-stop-sneezing">many suggestions</a> of how to stop a sneeze. These include pulling your ear, putting your tongue to the roof of your mouth or the back of your teeth, touching your nose, or even sticking your finger in your nose.</p> <p>All of these stimulate the trigeminal touch nerves with the goal of telling the interneurons to “close the gate”. This can block the irritant signals from reaching the brain and triggering a sneeze.</p> <h2>But should you stop a sneeze?</h2> <p>What if an irritant in your nose has triggered a sneeze response, but you’re somewhere it might be considered inappropriate to sneeze. Should you stop it?</p> <p>Closing your mouth or nose during a sneeze increases the pressure in the airways <a href="https://pubmed.ncbi.nlm.nih.gov/26914240/">five to 20 times more than a normal sneeze</a>. With no escape, this <a href="https://journals.sagepub.com/doi/10.1177/1945892418823147#:%7E:text=The%20high%20Valsalva%20pressure%20generated,to%20all%20people%20who%20sneeze.">pressure has to be transmitted elsewhere</a> and that can damage your eyes, ears or blood vessels. Though the risk is low, brain aneurysm, ruptured throat and collapsed lung have been <a href="https://www.healthline.com/health/holding-in-a-sneeze#can-holding-a-sneeze-kill-you">reported</a>.</p> <p>So it’s probably best to try and prevent the sneeze reflex by treating allergies or addressing irritants. Failing that, embrace your personal sneeze style and <a href="https://theconversation.com/handkerchief-or-tissue-which-ones-better-for-our-health-and-the-planet-213065">sneeze into a tissue</a>. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215265/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/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/jessica-nealon-1481995">Jessica Nealon</a>, Lecturer in Medical Sciences (Neuroscience), <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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/hello-hay-fever-why-pressing-under-your-nose-could-stop-a-sneeze-but-why-you-shouldnt-215265">original article</a>.</em></p>

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How 22 minutes of exercise a day could reduce the health risks from sitting too long

<p><em><a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>People in developed countries spend an average of <a href="https://doi.org/10.1136/bjsports-2022-106568">nine to ten hours</a> a day sitting. Whether it’s spending time in front of a computer, stuck in traffic, or unwinding in front of the TV, our lives have become increasingly sedentary.</p> <p>This is concerning because prolonged time spent sitting is <a href="https://bjsm.bmj.com/content/54/24/1451?s=09&amp;int_source=trendmd&amp;int_medium=cpc&amp;int_campaign=usage-042019">linked to a number of health issues</a> including obesity, heart disease, and certain types of cancers. These health issues can contribute to earlier death.</p> <p>But a <a href="https://doi.org/10.1136/bjsports-2022-106568">new study</a> suggests that for people over 50, getting just 22 minutes of exercise a day can lower the increased risk of premature death from a highly sedentary lifestyle.</p> <h2>What the researchers did</h2> <p>The team combined data from two studies from Norway, one from Sweden and one from the United States. The studies included about 12,000 people aged 50 or older who wore wearable devices to track how active and sedentary they were during their daily routines.</p> <p>Participants were followed up for at least two years (the median was 5.2 years) during the study period, which spanned 2003-2020.</p> <p>Analyses took several lifestyle and health factors into account, such as education, alcohol intake, smoking status, and previous history of heart disease, cancer and diabetes. All this data was linked to national death registries.</p> <h2>A 22 minute threshold</h2> <p>A total of 805 participants died during follow up. The researchers found people who were sedentary for more than 12 hours a day had the highest risk of death (a 38% higher risk than people who were sedentary for eight hours).</p> <p>However, this was only observed in those who did less than 22 minutes of moderate to vigorous physical activity daily. So for people who did more than 22 minutes of exercise, there was no longer a significantly heightened risk – that is, the risk became generally similar to those who were sedentary for eight hours.</p> <p>Higher daily duration of physical activity was consistently associated with lower risk of death, regardless of total sedentary time. For example, the team reported an additional ten minutes of moderate to vigorous physical activity each day could lower mortality risk by up to 15% for people who were sedentary less than 10.5 hours a day. For those considered highly sedentary (10.5 hours a day or more), an additional ten minutes lowered mortality risk by up to 35%.</p> <h2>The study had some limitations</h2> <p>The team couldn’t assess how changes in physical activity or sedentary time over several months or years may affect risk of death. And the study included only participants aged 50 and above, making results less applicable to younger age groups.</p> <p>Further, cultural and lifestyle differences between countries may have influenced how data between studies was measured and analysed.</p> <p>Ultimately, because this study was observational, we can’t draw conclusions on cause and effect with certainty. But the results of this research align with a growing body of evidence exploring the relationship between physical activity, sedentary time, and death.</p> <h2>It’s positive news</h2> <p>Research has previously suggested <a href="https://bjsm.bmj.com/content/54/24/1499">physical activity may offset</a> health risks associated with <a href="https://www.jacc.org/doi/abs/10.1016/j.jacc.2019.02.031">high sedentary time</a>.</p> <p>The good news is, even short bouts of exercise can have these positive effects. In this study, the 22 minutes wasn’t necessarily done all at once. It was a total of the physical activity someone did in a day, and would have included incidental exercise (activity that’s part of a daily routine, such as climbing the stairs).</p> <p>Several studies using wearable devices have found short bursts of high-intensity everyday activities such as stair climbing or energetic outdoor home maintenance activities such as mowing the lawn or cleaning the windows can lower <a href="https://www.nature.com/articles/s41591-022-02100-x">mortality</a>, <a href="https://academic.oup.com/eurheartj/article/43/46/4801/6771381">heart disease</a> and <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">cancer</a> risk.</p> <p>A recent study using wearable devices found moderate to vigorous bouts of activity <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00183-4/fulltext">lasting three to five minutes</a> provide similar benefits to bouts longer than ten minutes when it comes to stroke and heart attack risk.</p> <p>Several other studies have found <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2596007">being active just on the weekend</a> provides similar health benefits as <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2794038">being active throughout the week</a>.</p> <p>Research has also shown the benefits of <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2795819">physical activity</a> and <a href="https://jamanetwork.com/journals/jama/article-abstract/2809418">reducing sedentary time</a> extend to cognitive health.</p> <p>Routines such as desk jobs can foster a sedentary lifestyle that may be difficult to shift. But mixing short bursts of activity into our day can make a significant difference towards improving our health and longevity.</p> <p>Whether it’s a brisk walk during lunch, taking the stairs, or even a short at-home workout, this study is yet another to suggest that every minute counts.<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/216259/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, Postdoctoral Research Fellow, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: 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-22-minutes-of-exercise-a-day-could-reduce-the-health-risks-from-sitting-too-long-216259">original article</a>.</em></p>

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How can I get some sleep? Which treatments actually work?

<p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months?</p> <p>If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia.</p> <p>You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next?</p> <h2>What not to do</h2> <p>These probably won’t help:</p> <ul> <li> <p><strong>spending more time in bed</strong> often results in more time spent <em>awake</em> in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a></p> </li> <li> <p><strong>drinking coffee and taking naps</strong> might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening</p> </li> <li> <p><strong>drinking alcohol</strong> might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid.</p> </li> </ul> <h2>What to do next?</h2> <p>If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours.</p> <p>So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills.</p> <p>It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia.</p> <p>You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>.</p> <p>Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some.</p> <p><a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>.</p> <h2>What if that doesn’t work?</h2> <p>If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia.</p> <p>It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep.</p> <p>Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor.</p> <h2>What about sleeping pills?</h2> <p>Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful.</p> <p>Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep.</p> <p>However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence.</p> <p>Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits.</p> <h2>Are there new treatments? How about medicinal cannabis?</h2> <p>Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant).</p> <p>These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines.</p> <p>However, we don’t know if they work or are safe over the long term.</p> <p><a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>.</p> <p>In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>.</p> <p>But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment.</p> <p>So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term.</p> <h2>What now?</h2> <p>If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these.</p> <p>Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors.</p> <hr /> <p><em>For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</a>.</em><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/212964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.</em></p>

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Why do I bruise so easily? Could it be something serious?

<p><em><a href="https://theconversation.com/profiles/sant-rayn-pasricha-9134">Sant-Rayn Pasricha</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a></em></p> <p>After a bump, we can expect a bruise. But what if we find ourselves bruising without any noticeable cause? What might be behind it? Should we worry?</p> <p>Around <a href="https://pubmed.ncbi.nlm.nih.gov/20942847/">18%</a> of adults report easy bruising. As haematologists (blood doctors), we are often asked for advice when people are worried they might bruise too easily.</p> <p>Here is how we think about the problem.</p> <h2>What the blood does</h2> <p>Firstly, it helps to understand the complex, carefully balanced systems in our body that protect us from bleeding.</p> <p>Blood flows as a liquid through our blood vessels, carrying red cells with their cargo of oxygen and immune cells to defend us from infections, to our brain, muscles and internal organs. Blood contains ingredients that are carefully balanced to protect us from bleeding if we are injured, while simultaneously minimising the risk of dangerous blood clot formation.</p> <p>If a “puncture” occurs in a blood vessel, blood can rapidly thicken to form a jellylike clot, to minimise blood loss until the vessel repairs itself. To achieve this, tiny cell fragments called <a href="https://www.redcrossblood.org/donate-blood/dlp/platelet-information.html#:%7E:text=Platelets%2C%20or%20thrombocytes%2C%20are%20small,white%20blood%20cells%2C%20and%20platelets.">platelets</a> that circulate in the blood bind to the damaged blood vessel wall.</p> <p>A host of proteins (<a href="https://www.ncbi.nlm.nih.gov/books/NBK507850/">clotting factors</a>), attracted by the platelets and damaged vessel wall, then combine to thicken the blood at the site and form a blood clot. Like all blood cells, platelets are made in the bone marrow, while clotting factors are mostly made in the liver.</p> <p>So what can go wrong? If we have a problem affecting either our clotting factors, our platelets, or our blood vessel walls, we can find ourselves developing easy bruising or even problematic bleeding.</p> <h2>Could it be a problem?</h2> <p>In many patients who report easy bruising, haematologists can’t find any particular cause.</p> <p>Blood doctors are usually more cautious when a person has a constellation of problems related to bleeding. For example, a disorder is more likely if the bruising is widespread with <a href="https://www.webmd.com/first-aid/ss/slideshow-bruise-guide">large bruises</a>, is accompanied by frequent <a href="https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis">nosebleeds</a>, <a href="https://www.cdc.gov/ncbddd/blooddisorders/women/symptoms.html">heavy periods</a>, problems with bleeding after major dental work, surgery or childbirth – or even <a href="https://pubmed.ncbi.nlm.nih.gov/30017659/">spontaneous serious bleeding</a> into joints or into the brain.</p> <p>A few simple tests can help us figure out if there is likely to be a serious problem.</p> <p>The first we would perform for any person reporting easy bruising is a <a href="https://www.healthdirect.gov.au/full-blood-count">full blood count</a>. This will include a measurement of the platelet count and reliably show if the platelet numbers are normal.</p> <p>Our platelets can be reduced for a number of reasons – either because they are not being produced in the bone marrow appropriately or in sufficient quantity, or because they are being removed from the circulation too quickly.</p> <p>The latter scenario happens in a common condition called <a href="https://www.ncbi.nlm.nih.gov/books/NBK537240/#:%7E:text=Immune%20thrombocytopenic%20purpura%20(ITP)%20is%20an%20autoimmune%20disease%20characterized%20by,autoantibodies%20sensitize%20the%20circulating%20platelets.">immune thrombocytopenic purpura</a>. This condition can affect children or adults out of the blue or following a viral infection. Patients can develop severe reductions in their platelet count and come out in a fine rash, which is actually small bruises.</p> <p>In children, it is usually a short-term condition that recovers by itself. In adults, severe cases may need treatment with medicines that suppress the immune system or boost platelet production. Sometimes adults need surgery to remove the spleen.</p> <h2>Problems with clotting proteins and diseases</h2> <p>Clotting factors – the proteins mentioned earlier – can be affected by a range of inherited or acquired causes.</p> <p>Some people are born with low levels of important factors that help the blood clot when it needs to control bleeding.</p> <p><a href="https://www.hemophilia.org/bleeding-disorders-a-z/types/hemophilia-a">Haemophilia A</a> is seen almost exclusively in men and is caused by a genetic reduction in Factor VIII (a key clotting factor). Both men and women can have <a href="https://www.cdc.gov/ncbddd/vwd/facts.html">von Willebrand Disease</a>, which involves reduced production or function of another key clotting factor.</p> <p>Liver disease can also cause clotting problems. That’s why the second test we perform in any person reporting easy bruising is to measure clotting function. If we find an abnormality, we’ll follow up by testing the levels of key clotting factors.</p> <h2>Problems with blood vessels</h2> <p>Though rare today, severe vitamin C deficiency used to more commonly cause easy bruising and gum bleeding (“<a href="https://www.healthdirect.gov.au/scurvy">scurvy</a>”) and <a href="https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-why-bruise-easily">deficiencies</a> can still cause bruising.</p> <p>Several diseases can cause blood vessel thinning or inflammation, including <a href="https://www.rch.org.au/clinicalguide/guideline_index/HenochSchonlein_Purpura/">Henoch-Schonlein purpura</a> – an autoimmune condition that results in leg and thigh bruising.</p> <p><a href="https://www.healthline.com/health/senile-purpura">Older people</a> can have fragile skin and blood vessels, making bruising more likely.</p> <h2>Medicines and supplements</h2> <p>We always ask patients about their medication and alternative medicine use.</p> <p><a href="https://www.nhs.uk/medicines/low-dose-aspirin/side-effects-of-low-dose-aspirin/#:%7E:text=Because%20aspirin%20helps%20to%20stop,an%20injury%20or%20a%20cut.">Aspirin</a> – often prescribed to prevent platelets from worsening the risk of cardiac disease or stroke – can also reduce platelet function.</p> <p>Medications like clopidogrel (to stop problem clotting) and non steroidal anti-inflammatory drugs (like ibuprofen or others taken for pain and inflammation) can <a href="https://www.uptodate.com/contents/nonsteroidal-antiinflammatory-drugs-nsaids-beyond-the-basics">reduce platelet function</a>. <a href="https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.029541">Blood thinners</a> such as warfarin, apixaban and rivaroxaban, prescribed to people with a higher risk of clots leading to stroke, can affect bruising.</p> <p>People using oral or inhaled <a href="https://www.ncbi.nlm.nih.gov/books/NBK531462/#:%7E:text=Oral%20Administration&amp;text=Long%2Dterm%20oral%20corticosteroid%20therapy,sclerosis%2C%20organ%20transplantation%2C%20etc.">corticosteroids</a> for a prolonged period (such as for chronic illnesses) may notice increased bruising because of thinning of the skin and weakened blood vessel walls.</p> <p>Over-the-counter supplements including <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760599/">gingko and vitamin E</a> can also promote easy bruising, as can some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035804/">antidepressant</a> medications.</p> <h2>Questions of abuse and trauma</h2> <p>Finally, blood vessels can be damaged by trauma. Clinicians should carefully ask if the person has experienced any injuries, including a sensitive <a href="https://www.aafp.org/pubs/afp/issues/2016/0215/p279.html">consideration</a> of child abuse or intimate partner violence.</p> <p>While there are many medical conditions that can cause easy bruising, if you don’t have a strong history of other forms of excessive bleeding, and your blood counts and clotting function tests are normal, it shouldn’t be a cause for concern.<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/207736/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sant-rayn-pasricha-9134">Sant-Rayn Pasricha</a>, Division Head, Population Health and Immunity, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</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/why-do-i-bruise-so-easily-could-it-be-something-serious-207736">original article</a>.</em></p>

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