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I’ve been given opioids after surgery to take at home. What do I need to know?

<p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p>Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.</p> <p>These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.</p> <p>However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.</p> <h2>Which types of opioids are most common?</h2> <p>The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).</p> <p>In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit.</p> <p><a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.</p> <p>Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.</p> <p>Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.</p> <p>Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.</p> <p>Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.</p> <p>Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.</p> <h2>But there are also risks</h2> <p>As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.</p> <p>Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.</p> <p>But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids.</p> <p>Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.</p> <p>Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer.</p> <p>Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed.</p> <p>This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.</p> <h2>How to mimimise the risks</h2> <p>Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).</p> <p>These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.</p> <p>Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.</p> <p>However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>:</p> <ul> <li> <p>ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects</p> </li> <li> <p>do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing</p> </li> <li> <p>as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen</p> </li> <li> <p>before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.</p> </li> </ul> <h2>If you’re concerned about side effects</h2> <p>If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:</p> <ul> <li> <p><a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives</p> </li> <li> <p>drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor</p> </li> <li> <p>weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.</p> </li> </ul> <h2>If you’re having trouble stopping opioids</h2> <p>Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.</p> <p>You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.</p> <h2>How about leftover opioids?</h2> <p>After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge.</p> <p>Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.</p> <hr /> <p><em>For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.</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/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>.</em></p>

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Walking can prevent low back pain, a new study shows

<p><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year.</p> <p>The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system.</p> <p>In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.</p> <h2>The WalkBack trial</h2> <p>We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).</p> <p>Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.</p> <p>The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.</p> <p>The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.</p> <p>Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.</p> <p>People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care.</p> <h2>What the results showed</h2> <p>We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.</p> <p>The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.</p> <p>Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.</p> <p>Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.</p> <p>This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.</p> <p>Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.</p> <h2>Walking has multiple benefits</h2> <p>We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain.</p> <p>A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.</p> <p>On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.</p> <p>Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.</p> <p>While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.</p> <h2>Why is walking helpful for low back pain?</h2> <p>We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain.</p> <p>It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this.</p> <p>Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<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/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>.</em></p>

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Why do I poo in the morning? A gut expert explains

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.</p> <p>But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?</p> <p>To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.</p> <p>Here’s what the science says.</p> <h2>So morning poos are real?</h2> <p>In a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379343/">UK study</a> from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.</p> <p>The most common time to poo was in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379343/pdf/gut00573-0122.pdf">early morning</a>. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.</p> <p>About a decade later, <a href="https://pubmed.ncbi.nlm.nih.gov/16200717/">a Chinese study</a> found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.</p> <h2>But why the morning?</h2> <p>There are a few reasons. The first involves our <a href="https://theconversation.com/circadian-rhythm-nobel-what-they-discovered-and-why-it-matters-85072">circadian rhythm</a> – our 24-hour internal clock that helps regulate bodily processes, such as digestion.</p> <p>For healthy people, our internal clock means the muscular contractions in our colon follow <a href="https://pubmed.ncbi.nlm.nih.gov/19926812/">a distinct rhythm</a>.</p> <p>There’s minimal activity in the night. The deeper and more restful our sleep, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677652">fewer</a> of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=565&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=565&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=565&amp;fit=crop&amp;dpr=3 2262w" alt="Diagram of digestive system including colon and rectum" /></a><figcaption><span class="caption">Your lower gut is a muscular tube that contracts more strongly at certain times of day.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/illustration-healthcare-medical-education-drawing-chart-1984316789">Vectomart/Shutterstock</a></span></figcaption></figure> <p>But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.</p> <p>One particular type of colon contraction partly controlled by our internal clock are known as “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1411356/">mass movements</a>”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.</p> <p>Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “<a href="https://www.ncbi.nlm.nih.gov/books/NBK549888/">gastrocolic reflex</a>”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.</p> <p>Then there’s our morning coffee. This is a very <a href="https://pubmed.ncbi.nlm.nih.gov/2338272/">powerful stimulant</a> of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.</p> <h2>How important are morning poos?</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1846921/pdf/brmedj02601-0041.pdf">Large international</a> <a href="https://pubmed.ncbi.nlm.nih.gov/20205503/">surveys</a> show the vast majority of people will poo between three times a day and three times a week.</p> <p>This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.</p> <p>So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions <em>do not</em> have to occur once a day in the morning.</p> <p>Morning poos are also not a good thing for everyone. <a href="https://gut.bmj.com/content/61/Suppl_2/A318.1">Some people</a> with <a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">irritable bowel syndrome</a> feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.</p> <h2>Can you train yourself to be regular?</h2> <p>Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast <a href="https://www.ncbi.nlm.nih.gov/books/NBK549888/">to relieve symptoms</a>. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.</p> <p>A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147411/">evenings</a>. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.</p> <p>Regular physical activity and avoiding <a href="https://pubmed.ncbi.nlm.nih.gov/2787735/">sitting down a lot</a> are also important in <a href="https://pubmed.ncbi.nlm.nih.gov/16028436/">stimulating bowel movements</a>, particularly in people with constipation.</p> <p>We know <a href="https://theconversation.com/nervous-tummy-why-you-might-get-the-runs-before-a-first-date-106925">stress</a> can contribute to irregular bowel habits. So minimising stress and focusing on relaxation <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193306/">can help</a> bowel habits become more regular.</p> <p>Fibre from fruits and vegetables also <a href="https://pubmed.ncbi.nlm.nih.gov/665565/">helps</a> make bowel motions more regular.</p> <p>Finally, ensuring <a href="https://theconversation.com/health-check-what-causes-constipation-114290">adequate hydration</a> helps minimise the chance of developing constipation, and helps make bowel motions more regular.</p> <h2>Monitoring your bowel habits</h2> <p>Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.</p> <p>If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.</p> <p>But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.<!-- 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/229624/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/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></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-poo-in-the-morning-a-gut-expert-explains-229624">original article</a>.</em></p> </div>

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

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

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COVID vaccines saved millions of lives – linking them to excess deaths is a mistake

<p><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, <em><a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p>A recent <a href="https://bmjpublichealth.bmj.com/content/2/1/e000282">study</a> has sparked another <a href="https://nypost.com/2024/06/06/us-news/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths-since-pandemic-study/">round of</a> <a href="https://www.telegraph.co.uk/news/2024/06/04/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths/">headlines</a> <a href="https://www.gbnews.com/health/covid-vaccine-side-effects-deaths">claiming</a> that COVID vaccines caused excess deaths. This was accompanied by a predictable outpouring of <a href="https://x.com/DrAseemMalhotra/status/1797922073798717524">I-told-you-sos</a> on social media.</p> <p>Excess deaths are a measure of how many more deaths are being recorded in a country over what would have been expected based on historical trends. In the UK, and in many other countries, death rates have been higher during the years 2020 to 2023 than would have been expected based on historic trends from before the pandemic. But that has been known for some time. A couple of years ago I wrote an article for <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">The Conversation</a> pointing this out and suggesting some reasons. But has anything changed?</p> <p>The authors of the new study, published in BMJ Public Health, used publicly available data from <a href="https://ourworldindata.org/COVID-vaccinations">Our World in Data</a> to determine which countries had “statistically significant” excess deaths – in other words, excess deaths that couldn’t be explained by mere random variation.</p> <p>They studied the years 2020 to 2022 and found that many, but not all, countries did indeed report excess deaths. The authors did not try to explain why these excess deaths occurred, but the suggestion that COVID vaccines could have played a role is clear from their text – and indeed widely interpreted as such by certain newspapers.</p> <p>There is no doubt that a few deaths were associated with <a href="https://journals.sagepub.com/doi/full/10.1177/25166026211053485">the COVID vaccines</a>, but could the vaccination programme explain the large number of excess deaths – 3 million in 47 countries – that have been reported?</p> <p>Based on <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">death certificates</a>, during 2020 and 2021 there were more deaths from COVID than estimated excess deaths in the UK. So during the year 2021 when most vaccine doses were administered, there were actually fewer non-COVID deaths than would have been expected. It was only in 2022 that excess deaths <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathregistrationsummarystatisticsenglandandwales/2022">exceeded COVID deaths</a>.</p> <p>If the vaccination campaign was contributing to the excess deaths that we have seen in recent years, then we should expect to see more deaths in people who have been vaccinated than in those who have not. The most reliable analysis in this regard was done by the UK’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">Office for National Statistics (ONS)</a>. In this analysis, the ONS matched death registrations with the vaccine histories of each death recorded. They then calculated “age-standardised death rates” to account for age differences between those vaccinated and those not.</p> <p>What the ONS found was that in all months from April 2021 to May 2023, the death rate <a href="https://www.ons.gov.uk/redir/eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJpbmRleCI6MSwicGFnZVNpemUiOjEwLCJwYWdlIjoxLCJ1cmkiOiIvcGVvcGxlcG9wdWxhdGlvbmFuZGNvbW11bml0eS9iaXJ0aHNkZWF0aHNhbmRtYXJyaWFnZXMvZGVhdGhzL2RhdGFzZXRzL2V4Y2Vzc2RlYXRoc2luZW5nbGFuZGFuZHdhbGVzIiwibGlzdFR5cGUiOiJyZWxhdGVkZGF0YSJ9.Cot-XDe8Rr07paGllBNnVVz1nTqnXfVafn2woA3tk0c">from all causes was higher</a> in the unvaccinated than in people who had been vaccinated at least once.</p> <p>That deaths from all causes were lower in the vaccinated than the unvaccinated should come as no surprise given that COVID was a major cause of death in 2021 and 2022. And there is ample evidence of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492612/">protective effect of vaccines</a> against severe COVID and death. But what is even more convincing is that, even when known COVID deaths were excluded in the ONS report, the death rate in the unvaccinated was still higher, albeit not by very much in more recent months.</p> <p>Some COVID deaths would certainly not have been recognised as such. But, on the other hand, people with chronic conditions, such as diabetes, were a high priority for vaccination. And these people would have been at increased risk of death even before the pandemic.</p> <h2>Possible causes</h2> <p>If the vaccine is not the cause of the excess deaths, what was?</p> <p>The major cause of the excess deaths reported in the first two years of the BMJ Public Health study was deaths from COVID. But by 2022, excess deaths exceeded COVID deaths in many countries.</p> <p>Possible <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">explanations</a> for these excess deaths include longer-term effects of earlier COVID infections, the return of infections such as influenza that had been suppressed during the COVID control measures, adverse effects of lockdowns on physical and mental health, and delays in the diagnosis of life-threatening infections as health services struggled to cope with the pandemic and its aftermath.</p> <p>We do need to look very carefully at how the pandemic was managed. There is still considerable debate about the effectiveness of different behavioural control measures, such as self-isolation and lockdowns. Even when such interventions were effective at reducing transmission of COVID, what were the harms and were the gains worth the harms? Nevertheless, we can be confident that the excess deaths seen in recent years were not a consequence of the vaccination campaign.<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/231776/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</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/covid-vaccines-saved-millions-of-lives-linking-them-to-excess-deaths-is-a-mistake-231776">original article</a>.</em></p>

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Millions of older people don’t get enough nutrients – how to spot it and what to do about it

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a></em></p> <p>By 2050, approximately a quarter of the UK population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/january2021">expected to be over the age of 65</a>. With this in mind, the World Health Organization (WHO) has put “<a href="https://cdn.who.int/media/docs/default-source/decade-of-healthy-ageing/decade-proposal-final-apr2020-en.pdf?sfvrsn=b4b75ebc_28">healthy ageing</a>” on its agenda. This means finding ways to maintain health, wellbeing and functional ability in order to have a good quality of life and enjoy the later years.</p> <p>Everyone ages at a different rate – but there are some things that can influence how well we age, such as by making changes to the types of activity we do and the foods we eat.</p> <p>Older adults are <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/research-report-2019--one-step-at-a-time.pdf">generally less physically active</a> than they were when they were younger and because of this, their energy intake requirement may decrease. However, there is a difference between energy requirements and nutrient requirements, and nutrient requirements actually remain the same, if not increase, as we get older.</p> <p>This means we need to get more nutrients into less energy which can be tricky as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/#:%7E:text=The%20physiological%20changes%20that%20occur,can%20contribute%20to%20declining%20appetite.">older adults often have lower appetites</a>. This is why <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971894/">scientists suggest</a> that it may be necessary to enrich the food of older people to maintain the nutrient intake.</p> <h2>How to spot when someone isn’t eating enough?</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399049/">Several studies have shown</a> that undernutrition affects one in ten older people living independently at home. However, it affects five in ten older people living in nursing homes, and seven in ten older people in hospital.</p> <p>Being overweight, even obese, <a href="https://link.springer.com/article/10.1007/s40520-023-02650-1">does not protect</a> against undernutrition. And when older adults lose weight, they lose muscle, meaning that they are more likely to lose their <a href="https://www.frontiersin.org/articles/10.3389/fnut.2022.892675/full?&amp;utm_source=Email_to_authors_&amp;utm_medium=Email&amp;utm_content=T1_11.5e1_author&amp;utm_campaign=Email_publication&amp;field=&amp;journalName=Frontiers_in_Nutrition&amp;id=892675">abilities to do daily tasks</a>.</p> <p>Weight loss in older adults is a key sign of malnutrition that needs to be addressed – but it can be easily missed, especially when many older adults associate the idea of thinness <a href="https://www.sciencedirect.com/science/article/pii/S0195666319307603?casa_token=iU5UIdNwGDgAAAAA:I81EKDJ2T0oBsOsZunpPBk6uI-TcgiCr-5gPJE1tz4-Tq3w8pK4Yi_mv22AhVHHpRpiv1Bvz0RI">with good health</a>. But clothing that’s too loose or a watchstrap that floats on the wrist are all warning signs of undernourishment.</p> <p>Similarly, if someone you care for has started to say things like, “Oh, I don’t want much food today, I’m not hungry”, “I’m not hungry, it’s natural, I’m getting older”, or “I’d rather just have a biscuit to be honest,” then these could be warning signs. An effective way to keep on top of this is regular weighing at least once per month which enables a quick response to potential indicators of malnutrition.</p> <h2>Getting more nutrients into less food</h2> <p>If people are eating small amounts of food, it is important to think about how to add more nutrients into it. A very effective technique, “fortification” is commonly done with pre-made products such as breakfast cereals, plant-based milk and bread in the UK.</p> <p>Fortification (adding foods, ingredients or nutrients into to existing foods or meals) is easy to do at home as well and can provide a flexible approach for older adults as it allows them to continue eating the foods that they most enjoy.</p> <figure><iframe src="https://www.youtube.com/embed/kNu8auu3fuU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>For older adults in particular, protein is a very important nutrient, because of muscle loss (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/#:%7E:text=Sarcopenia%20has%20been%20defined%20as,decade%20of%20life%20%5B1%5D.">sarcopenia)</a> which is a natural part of ageing. This could be slowed down or even reversed by <a href="https://www.medicalnewstoday.com/articles/could-a-higher-protein-intake-lead-to-healthier-eating">eating enough protein</a> at regular intervals throughout the day. A few ways to increase protein include:</p> <p>• Adding dairy ingredients such as milk, high-protein yoghurt, Quark (soft cheese), milk powders, eggs and cheese into meals – even into simple foods like mashed potato.</p> <p>• Nuts are a great source of protein, try adding ground almonds to savoury or sweet meals (beware of nut allergies).</p> <p>• Soy protein can be a convenient and cost-effective option, either for vegetarians or to further fortify minced-meat meals.</p> <p>• Look in the sports section of supermarkets to find <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/whey-powder#:%7E:text=Whey%20powders%20are%20characterized%20as,of%20products%20obtained%20from%20milk.">whey protein</a> powders. These are marketed to gym enthusiasts, but actually whey is one of the <a href="https://www.mdpi.com/2072-6643/15/15/3424">best proteins to stimulate muscle growth</a>. This versatile ingredient can be mixed into porridge before cooking or used it as a substitute for other powdered ingredients in baking.</p> <h2>Importance of physical activity and strength exercises</h2> <p>Physical activity and nutrition go hand-in-hand – both are equally important. As we age, being physically active becomes <a href="https://link.springer.com/article/10.1007/s12603-021-1665-8?fbclid=IwAR3dJkeHjgcSrR9Xq5kBfN-HLrbpli8WcAnz7AeY5Nu9XcGCHEB07Sd2z1w">even more essential</a> as it helps to prevent disease, maintains independence, decreases risk of falls, improves cognitive function, mental health and sleep.</p> <p>Exercise can also <a href="https://academic.oup.com/ageing/article/48/4/476/5423796?login=false">combat isolation and loneliness</a> which has also been <a href="https://www.bda.uk.com/resource/loneliness-and-malnutrition.html">linked to decreased appetite</a> in older adults. Often strength training gets ignored when we think of being active but to keep independence and prevent falls, older adults should do varied physical activity that emphasises balance and strength training at moderate or greater intensity on three or more days a week.</p> <p>Ultimately, it’s essential to contact a doctor or dietician with any worries or concerns about malnutrition or unintentional weight loss. There are, however, <a href="https://www.futurelearn.com/courses/ageing-well-nutrition-and-exercise-for-older-adults">some excellent resources</a> to learn more about ageing healthily and maintaining a good quality of life in later years.<!-- 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/221380/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/miriam-clegg-997096">Miriam Clegg</a>, Senior Lecturer in Human Nutrition, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, Sensory and Consumer Scientist, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</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/millions-of-older-people-dont-get-enough-nutrients-how-to-spot-it-and-what-to-do-about-it-221380">original article</a>.</em></p> </div>

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"I'm a prisoner in my own body": Rob Burrow's heartbreaking last message

<p>An emotional final message from rugby legend Rob Burrow has been released in the days after his death. </p> <p>The former footballer <a href="https://oversixty.com.au/health/caring/rugby-league-hero-dies-at-just-41" target="_blank" rel="noopener">died</a> at the age of 41 on Sunday after a lengthy battle with motor neurone disease, with his former club, the Leeds Rhinos, sharing the news of his passing. </p> <p>Before he died, Burrow was involved in the making of a documentary about his life by the BBC, titled <em>There's Only One Burrow</em>, only agreeing to appear in the program on the condition it only be used after his death.</p> <p>In the documentary, Burrow spoke of how the cruel disease impacted his life and how he hoped to raise awareness for MND research.</p> <p>"I want to live in a world free of MND. By the time you watch this I will no longer be here," he said in the video.</p> <p>"In a world full of adversity, we must still dare to dream. I'm just a lad from Yorkshire who got to live out his dream of playing rugby league."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by BBC SPORT (@bbcsport)</a></p> </div> </blockquote> <p>His pre-recorded final words were shown to his friends and family on screen, reacting to his words.</p> <p>"I'm a fighter, to be honest. I might not be able to tackle MND but I'll certainly be swinging, I'm not going to give in, not until my last breath," he said.</p> <p>"I'm a prisoner in my own body, that's the way MND gets you. The lights are on but no one is home."</p> <p>Recalling his diagnosis, he said, "My family told me I was slurring my speech a bit but I didn't take notice or believe them."</p> <p>In an emotional segment of the widow, Burrow's wife Lindsey spoke of how she learnt of her husband's devastating disease.</p> <p>"I remember that moment being told it's not good news. Asking how long and them saying two years. Rob said 'thank god it's me and not the kids'. That's all he was bothered about," she recalled.</p> <p>When asked about his children, Burrow became emotional, saying, "I had no idea how my family would cope. They've become a beacon of hope for families in the same situation as ours." </p> <p>"I have had such a great life. I have been gifted with the most incredible wife and three children. I hope they know how much I love them."</p> <p>Burrows finishes the piece, saying. "As a father of three young children, I would never want someone to go through this."</p> <p>"I hope I have left a mark on this disease. I hope you choose to live in the moment. I hope you find inspiration."</p> <p>"My final message to you is whatever your personal battle to be brave and face it."</p> <p>"Every single day is precious. Don't waste a moment. In a world full of adversity we must still dare to dream. Rob Burrow over and out."</p> <p><em>Image credits: BBC</em></p>

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Weight loss: drinking a gallon of water a day probably won’t help you lose weight

<p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p>It’s often claimed that if you’re trying to lose weight, one of the things you should do each day is drink plenty of water – with some internet advice even suggesting this should be as much as a gallon (about 4.5 litres). The claim is that water helps burn calories and reduce appetite, which in turn leads to weight loss.</p> <p>But while we all might wish it was this easy to lose weight, unfortunately there’s little evidence to back up these claims.</p> <h2>Myth 1: water helps burn calories</h2> <p>One <a href="https://pubmed.ncbi.nlm.nih.gov/14671205/">small study</a>, of 14 young adults, found drinking 500ml of water increased resting energy expenditure (the amount of calories our body burns before exercise) by about 24%.</p> <p>While this may sound great, this effect only lasted an hour. And this wouldn’t translate to a big difference at all. For an average 70kg adult, they would only use an additional 20 calories – a quarter of a biscuit – for every 500ml of water they drank.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/16822824/">Another study</a> of eight young adults only saw an increase in energy expenditure when the water was fridge cold – reporting a very modest 4% increase in calories burned. This may be because the body needs to use more energy in order to bring the water up to body temperature, or because it requires more energy for the body to filter the increased volume of fluid through the kidneys. And again, this effect was only seen for about an hour.</p> <p>So although scientifically it might be possible, the actual net increase in calories burned is tiny. For example, even if you drank an extra 1.5l of water per day, it would save fewer calories than you’d get in a slice of bread.</p> <p>It’s also worth noting that all this research was in young healthy adults. More research is needed to see whether this effect is also seen in other groups (such as middle-aged and older adults).</p> <h2>Myth 2: water with meals reduces appetite</h2> <p>This claim again seems sensible, in that if your stomach is at least partly full of water there’s less room for food – so you end up eating less.</p> <p>A number of studies actually support this, particularly those conducted in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859815/#:%7E:text=Thus%2C%20when%20combined%20with%20a,meal%20EI%20following%20water%20ingestion.">middle-aged and older adults</a>. It’s also a reason people who are unwell or have a poor appetite are advised <a href="https://www.ageuk.org.uk/bp-assets/globalassets/salford/forms/improve-your-food-and-drink-intake.pdf">not to drink before eating</a> as it may lead to under-eating.</p> <p>But for people looking to lose weight, the science is a little less straightforward.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/17228036/">One study</a> showed middle-aged and older adults lost 2kg over a 12-week period when they drank water before meals compared with people who didn’t drink any water with their meal. Younger participants (aged 21-35) on the other hand did not lose any weight, regardless of whether they drank water before their meal or not.</p> <p>But since the study didn’t use blinding (where information which may influence participants is withheld until after the experiment is finished), it means that participants may have become aware of why they were drinking water before their meal. This may have led some participants to purposefully change how much they ate in the hopes it might increase their changes of losing weight. However, this doesn’t explain why the effect wasn’t seen in young adults, so it will be important for future studies to investigate why this is.</p> <p>The other challenge with a lot of this kind of research is that it only focuses on whether participants eat less during just one of their day’s meals after drinking water. Although this might suggest the potential to lose weight, there’s <a href="https://pubmed.ncbi.nlm.nih.gov/20736036/">very little good-quality evidence</a> showing that reducing appetite in general leads to weight loss over time.</p> <p>Perhaps this is due to our body’s biological drive to <a href="https://pubmed.ncbi.nlm.nih.gov/28193517/">maintain its size</a>. It’s for this reason that no claims can be legally made in Europe about foods which help make you <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/satietyenhancing-products-for-appetite-control-science-and-regulation-of-functional-foods-for-weight-management/E4CCAE4C90A220994FD29C27FAE7F666">feel fuller for longer</a> with <a href="https://www.gov.uk/government/publications/nutrition-and-health-claims-guidance-to-compliance-with-regulation-ec-1924-2006-on-nutrition-and-health-claims-made-on-foods/nutrition-and-health-claims-guidance-to-compliance-with-regulation-ec-19242006#section-6">reference to weight loss</a>.</p> <p>So, although there might be some appetite-dulling effects of water, it seems that it might not result in long-term weight change – and may possibly be due to making conscious changes to your diet.</p> <h2>Just water isn’t enough</h2> <p>There’s a pretty good reason why water on its own is not terribly effective at <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/eating-habits-and-appetite-control-a-psychobiological-perspective/0D0605739F5150D1A7C49420D75F3CDF">regulating appetite</a>. If it did, prehistoric humans might have starved.</p> <p>But while appetite and satiation – feeling full and not wanting to eat again – aren’t perfectly aligned with being able to <a href="https://pubmed.ncbi.nlm.nih.gov/20736036/">lose weight</a>, it might be a helpful starting point.</p> <p>Part of what helps us to feel full is our stomach. When food enters the stomach, it triggers stretch receptors that in turn lead to the release of hormones which tell us we’re full.</p> <p>But since water is a liquid, it’s rapidly emptied from our stomach – meaning it doesn’t actually fill us up. Even more interestingly, due to the <a href="https://pubmed.ncbi.nlm.nih.gov/16934271/">stomach’s shape</a>, fluids can bypass any semi-solid food content that’s being digested in the lower part of the stomach. This means that water can still be quickly emptied from the stomach. So even if it’s consumed at the end of a meal it might not necessarily extend your feelings of fullness.</p> <p>If you’re trying to eat less and lose weight, drinking excessive amounts of water may not be a great solution. But there is evidence showing when water is mixed with other substances (such as <a href="https://pubmed.ncbi.nlm.nih.gov/30166637/">fibre</a>, <a href="https://www.sciencedirect.com/science/article/pii/0031938494903034">soups</a> or vegetable sauces) this can delay how fast the stomach empties its contents – meaning you feel fuller longer.</p> <p>But while water may not help you lose weight directly, it may still aid in weight loss given it’s the healthiest drink we can choose. Swapping high-calorie drinks such as soda and alcohol for water may be an easy way of reducing the calories you consume daily, which may help with weight loss.<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/211311/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Lead for Evidence-Based Medicine and Nutrition, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston 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/weight-loss-drinking-a-gallon-of-water-a-day-probably-wont-help-you-lose-weight-211311">original article</a>.</em></p>

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The growing promise of cancer vaccines

<div class="copy"> <p>A cure for cancer — which is <a href="https://ourworldindata.org/grapher/burden-of-disease-by-cause" target="_blank" rel="noopener">second only to cardiovascular diseases</a> in its contribution to the global burden of disease — has long been a dream.</p> <p>While no magic bullet is yet in sight, three vaccines for particular skin and lung cancer types have advanced to the last stage of clinical trials in recent months.</p> <p>If successful, these vaccines should be available to patients in the next three to 11 years. Unlike vaccines which prevent diseases, these aim to cure them or prevent relapses.</p> <p>Cancer in every person is different because the cells in every cancerous tumour have different sets of genetic mutations. Recognising this, two of the vaccines are personalised and tailor-made for each patient. Oncologists working with pharmaceutical companies have developed these individualised neoantigen therapies.</p> <p>A vaccine typically works by training the immune cells of our body to recognise antigens – proteins from pathogens, such as viruses – against future attacks by the pathogen.</p> <p>In cancer, however, there is no external pathogen. The cells of a cancerous tumour undergo continuous mutations, some of which help them to grow much faster than normal cells while some others help them evade the body’s natural immune system. The mutated proteins in cancerous cells are called ‘neoantigens’.</p> <p>In individualised neoantigen therapy, the gene sequence of the tumour and normal blood cells are compared to identify neoantigens from each patient, and then a subset of neoantigens are chosen that are most likely to induce an immune response. The vaccine for an individual patient targets this chosen subset of neoantigens.</p> <p>These vaccines, jointly developed by pharma giants Moderna and Merck, have been shown in trials conducted so far to be significantly more effective in combination with immunotherapy than immunotherapy alone in preventing both the relapse of melanoma — a type of skin cancer — and non-small cell lung cancer after the tumours had been surgically removed.</p> <p>Following these promising results in phase II clinical trials, the vaccines are now being tested on a larger group of patients in phase III trials. The studies are expected to be complete by 2030 for <a href="https://clinicaltrials.gov/study/NCT05933577" target="_blank" rel="noopener">melanoma</a> and 2035 for <a href="https://www.clinicaltrials.gov/study/NCT06077760?intr=mRNA-4157&amp;rank=3" target="_blank" rel="noopener">lung cancer</a>.</p> <p>The Moderna-Merck cancer vaccine may not be the first to reach the market. The French company OSE Immunotherapeutics <a href="https://www.clinicaltrialsarena.com/news/ose-shares-pipeline-updates-with-plans-phase-iii-trial-for-tedopi/" target="_blank" rel="noopener">published positive results</a> last September from phase III clinical trials of a vaccine using a different approach for advanced non-small cell lung cancer. Its vaccine, Tedopi, is scheduled to start <a href="https://finance.yahoo.com/news/ose-immunotherapeutics-receives-8-4-160000694.html?guccounter=1&amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&amp;guce_referrer_sig=AQAAADAX7Kqu7RTAEowvwOw2f-2cJ7SJ4uLpvjH-3tXzGtifqidaZfPs4eHLz23UqqjHDPjbVE1Vwel5qIKzKbmWvPLfLQzzH_PvKJAMsqTHuz8p5nPoR39RbIToLShEUG53eOeDFg6pWlRc2JPqrX7sGnc3ByO9FFfqXQYpZ4FZ-jgr" target="_blank" rel="noopener">confirmatory trials</a> – which are the last step before regulatory approval – later this year and may be available by 2027.</p> <p>Vaccines for pancreatic cancer being developed by BioNTech and Genentech, and for colon cancer by Gritstone, are also showing promising results in the early phases of clinical trials. Like the vaccines being developed by Moderna and Merck, these too are individualised neoantigen therapies based on messenger RNA (mRNA).</p> <p>There is another kind of RNA therapy also under development that uses small interfering RNA (siRNA) and microRNA (miRNA). Since 2018, six siRNA-based therapies have been approved by the US Food and Drug Administration for the treatment of neural, skin, heart and renal diseases. Several more siRNA drugs are at various clinical trial stages for different types of cancer and a diverse range of other diseases.</p> <p>Within cells, there are two kinds of nucleic acid molecules that contain coded information vital to life: DNA and RNA. While DNA contains genetic information, mRNA — one among the different types of RNA — carries the codes for the proteins. In addition, there are also non-coding RNA, some of which are functionally important. siRNA and miRNA are examples of such non-coding RNA.</p> <p>The RNA vaccine for an individualised neoantigen therapy is a cocktail of mRNA carrying the codes for neoantigens — the mutated fingerprint proteins in cancerous cells. For the <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">Moderna-Merck study</a>, scientists identified 34 neoantigens per patient. They delivered the corresponding mRNA vaccine cocktail packed in lipid nanoparticles, just like the mRNA vaccines for COVID-19 developed by Moderna and Pfizer-BioNTech.</p> <p>When the vaccine is delivered after removing the tumour, it trains the immune system to recognise neoantigens and fight back against the cancer returning. Usually, the body’s natural immune system corrects mutations and prevents us from having cancers. However, in some cases this natural immune response is insufficient, leading to tumour growth. In individualised neoantigen therapy, these mutations in the tumour cells are used for vaccine development and for training the immune system to fight back against relapse after removal of the tumour.</p> <p>Recent advances in artificial intelligence are helping identify potential neoantigens and manage personalised therapies. Firstly, gene sequencing of tumours and normal blood cells of a patient and their comparison produces a huge amount of data. AI is used to find the genetic mutations of the patient’s cancer in such ‘big data’. Moreover, individualised therapy requires timely production and delivery of vaccines that are different for each patient. AI is also useful in the management of such data.</p> <p>The individualised nature of the treatment is probably why it has been <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">more effective in trials</a> than previous, unsuccessful RNA vaccine candidates. However, this personalisation is also likely to raise challenges for the timely and cost-effective delivery of treatment to populations around the world.</p> <p>The siRNA and miRNA treatments work in a way opposite to mRNA. While each mRNA in a vaccine carries the code for producing a protein from a pathogen (antigen) or tumour (neoantigen) to train our immune systems against future attacks by the pathogen or tumour, siRNA directly targets the mRNA of the antigen or neoantigen and terminates the production of the protein it codes. Thus, the effect of a siRNA is more direct and immediate (like a drug), rather than a protection against future attacks (like a vaccine).</p> <p>Discovered at the turn of this millennium, siRNA-based therapeutics attracted immediate attention, but their initial success was limited due to their inherent low stability, difficulties in delivering them to desired locations, and rapid clearance from the bloodstream. However, in recent years, siRNA therapies have been boosted through chemical modifications that have increased their stability and ability to be delivered to specific locations such as tumours, and improved delivery systems such as lipid nanoparticle encasings.</p> <p>These improvements led to recent successes in FDA approvals of siRNA-based therapies and further <a href="https://www.rockefeller.edu/news/35461-a-new-way-to-target-the-culprit-behind-a-deadly-liver-cancer/" target="_blank" rel="noopener">promising reports of advances</a> in the treatment of diseases including a type of liver cancer.</p> <p><em>Research scientist </em><em><strong>Dr Bidyut Sarkar</strong></em><em> is the DBT-Wellcome Trust India Alliance Intermediate Fellow in the Department of Chemistry at Shiv Nadar Institute of Eminence, Delhi NCR, India.</em></p> <p><em>Originally published under <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">Creative Commons</a> by <a href="https://360info.org/" target="_blank" rel="noopener">360info</a>™.</em></p> <p><em>Image credits: Shutterstock </em></p> <div> <p align="center"> </p> </div> <p><em><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=304875&amp;title=The+growing+promise+of+cancer+vaccines" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em></div> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/the-body/the-growing-promise-of-cancer-vaccines/">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/360info-2/">360info</a>. Originally published under Creative Commons by 360info™.</em></p> </div>

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4 things you’re likely doing that are damaging your hearing

<p>Your hearing is a precious gift, so it’s important to take good care of your ears. We’ve got some advice on the things to avoid, and what you can do to protect your hearing.</p> <p><strong>Using cotton tips</strong></p> <p>Though they’re commonly used for the job, cotton tips should never be used to clean out your ears. In fact, no solid object should be put inside your ears. Cotton tips account for around four per cent of all ruptured eardrums. </p> <p>These innocuous-looking objects can also cause bleeding, scratch your ear canal, or trigger an infection. So put them down and step away. Instead, use a commercial ear cleaner, or even just a few drops of mineral oil, baby oil, or glycerine to soften the earwax.</p> <p><strong>Don’t wait and see</strong></p> <p>If your hearing in one or both ears suddenly disappears without cause, you need to go and see your doctor as soon as you can. It could be inflammation, infection, or a decrease in blood supply to the area. </p> <p>If you need treatment, you’ll likely need it immediately to have any hope of restoring your hearing.</p> <p><strong>Using eardrops without advice</strong></p> <p>There are many over-the-counter eardrops available to help with things like swimmer’s ear. But in extreme cases, these products can cause deafness. Before you use anything, including a home remedy, get your doctor to check that you don’t have a ruptured eardrum. </p> <p>Some people may be born that way, or have had surgery as a child, or suffered an injury. If the ingredients in these drops make their way inside your eardrum, it can cause a lot of pain, and permanent deafness.</p> <p><strong>Always protect your ears</strong></p> <p>It’s incredibly important to protect your ears from permanent damage. Tiny hairs inside your ears act as hearing receptors, and these can be broken by extremely loud noises. Once they’re gone, they don’t come back. </p> <p>So things like loud music, fireworks, machinery, and artillery are all risky to be around. The best thing you can do is cover up with earmuffs whenever you’re around these things – especially if it’s on a regular basis. For extra safety, use earplugs as well.</p> <p><em>Image credits: Shutterstock </em></p>

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‘Sleeping on it’ really does help and four other recent sleep research breakthroughs

<p><em><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</a></em></p> <p>Twenty-six years. That is roughly <a href="https://www.nature.com/articles/s41467-022-34624-8">how much of our lives</a> are spent asleep. Scientists have been trying to explain why we spend so much time sleeping since at least the <a href="https://plato.stanford.edu/entries/alcmaeon/">ancient Greeks</a>, but pinning down the exact functions of sleep has proven to be difficult.</p> <p>During the past decade, there has been a surge of interest from researchers in the nature and function of sleep. New experimental models coupled with advances in technology and analytical techniques are giving us a deeper look inside the sleeping brain. Here are some of the biggest recent breakthroughs in the science of sleep.</p> <h2>1. We know more about lucid dreaming</h2> <p>No longer on the fringes, the neuroscientific study of dreaming has now become mainstream.</p> <p>US researchers in a 2017 study woke their participants up at regular intervals during the night and asked them what was going through their minds prior to the alarm call. Sometimes participants couldn’t recall any dreaming. The study team then looked at what was <a href="https://www.nature.com/articles/nn.4545">happening in the participant’s brain</a> moments before waking.</p> <p>Participants’ recall of dream content was associated with increased activity in the posterior hot zone, an area of the brain closely <a href="https://www.nature.com/articles/d41586-018-05097-x">linked to conscious awareness</a>. Researchers could predict the presence or absence of dream experiences by monitoring this zone in real time.</p> <p>Another exciting development in the study of dreams is research into lucid dreams, in which <a href="https://theconversation.com/the-ability-to-control-dreams-may-help-us-unravel-the-mystery-of-consciousness-52394">you are aware that</a> you are dreaming. A 2021 study established <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00059-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982221000592%3Fshowall%3Dtrue">two-way communication</a> between a dreamer and a researcher. In this experiment, participants signalled to the researcher that they were dreaming by moving their eyes in a pre-agreed pattern.</p> <p>The researcher read out maths problems (what is eight minus six?). The dreamer could respond to this question with eye movements. The dreamers were accurate, indicating they had access to high level cognitive functions. The researchers used <a href="https://www.mayoclinic.org/tests-procedures/polysomnography/about/pac-20394877">polysomnography</a>, which monitors bodily functions such as breathing and brain activity during sleep, to confirm that participants were asleep.</p> <p>These discoveries have dream researchers excited about the future of “interactive dreaming”, such as practising a skill or solving a problem in our dreams.</p> <h2>2. Our brain replays memories while we sleep</h2> <p>This year marks the centenary of the first demonstration that <a href="https://www.jstor.org/stable/1414040?origin=crossref">sleep improves our memory</a>. However, a 2023 review of recent research has shown that memories formed during the day <a href="https://portlandpress.com/emergtoplifesci/article/7/5/487/233796/Neural-reactivation-during-human-sleep">get reactivated</a> while we are sleeping. Researchers discovered this using machine learning techniques to “decode” the contents of the sleeping brain.</p> <p><a href="https://www.nature.com/articles/s41467-021-24357-5">A 2021 study</a> found that training algorithms to distinguish between different memories while awake makes it possible to see the same neural patterns re-emerge in the sleeping brain. A different study, also in 2021, found that the more times these patterns re-emerge during sleep, <a href="https://www.nature.com/articles/s41467-021-23520-2">the bigger the benefit</a> to memory.</p> <p>In other approaches, scientists have been able to reactivate certain memories by <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)31035-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219310358%3Fshowall%3Dtrue">replaying sounds</a> associated with the memory in question while the participant was asleep. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144680/">2020 meta-analysis of 91 experiments</a> found that when participants’ memory was tested after sleep they remembered more of the stimuli whose sounds were played back during sleep, compared with control stimuli whose sounds were not replayed.</p> <p>Research has also shown that sleep strengthens memory for the <a href="https://www.pnas.org/doi/10.1073/pnas.2202657119">most important aspects</a> of an experience, restructures our memories to form <a href="https://www.jneurosci.org/content/40/9/1909">more cohesive narratives</a> and helps us come up with <a href="https://journals.sagepub.com/doi/10.1177/0956797619873344">solutions to problems</a> we are stuck on. Science is showing that sleeping on it really does help.</p> <h2>3. Sleep keeps our minds healthy</h2> <p>We all know that a lack of sleep makes us feel bad. Laboratory sleep deprivation studies, where researchers keep willing participants awake throughout the night, have been combined with <a href="https://www.open.edu/openlearn/body-mind/health/health-sciences/how-fmri-works">functional MRI brain scans</a> to paint a detailed picture of the sleep-deprived brain. These studies have shown that a lack of sleep severely disrupts the <a href="https://www.nature.com/articles/nrn.2017.55">connectivity between</a> different brain networks. These changes include a breakdown of connectivity between brain regions <a href="https://link.springer.com/article/10.1007/s11682-018-9868-2">responsible for cognitive control</a>, and an amplification of those involved in <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)30761-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219307614%3Fshowall%3Dtrue">threat and emotional processing</a>.</p> <p>The consequence of this is that the sleep-deprived brain is worse at <a href="https://academic.oup.com/cercor/article/33/5/1610/6573958">learning new information</a>, <a href="https://academic.oup.com/sleep/article/44/6/zsaa289/6053003">poorer at regulating emotions</a>, and unable to <a href="https://journals.sagepub.com/doi/10.1177/2167702620951511">suppress intrusive thoughts</a>. Sleep loss may even make you less likely to <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3001733">help other people</a>. These findings may explain why poor sleep quality is so <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13930">ubiquitous in poor mental health</a>.</p> <h2>4. Sleep protects us against neurodegenerative diseases</h2> <p>Although we naturally <a href="https://www.nature.com/articles/s41467-022-34624-8">sleep less as we age</a>, mounting evidence suggests that sleep problems earlier in life <a href="https://jnnp.bmj.com/content/91/3/236">increase the risk</a> of dementia.</p> <p>The build-up of β-amyloid, a <a href="https://www.nhs.uk/conditions/alzheimers-disease/causes/">metabolic waste product</a>, is one of the mechanisms underlying Alzheimer’s disease. Recently, it has become apparent that deep, undisturbed sleep is good for <a href="https://www.science.org/doi/10.1126/sciadv.aav5447">flushing these toxins</a> out of the brain. Sleep deprivation increases the the rate of build-up of β-amyloid in parts of the brain involved in memory, <a href="https://www.pnas.org/doi/full/10.1073/pnas.1721694115">such as the hippocampus</a>. A longitudinal study published in 2020 found that sleep problems were associated with a higher rate of β-amyloid accumulation at a follow-up <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(20)31171-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982220311714%3Fshowall%3Dtrue">four years later</a>. In a different study, published in 2022, sleep parameters <a href="https://elifesciences.org/articles/78191">forecasted the rate</a> of cognitive decline in participants over the following two years.</p> <h2>5. We can engineer sleep</h2> <p>The good news is that research is developing treatments to get a better night’s sleep and boost its benefits.</p> <p>For example, the <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.14035">European Sleep Research Society</a> and the <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8986">American Academy of Sleep Medicine</a> recommend cognitive behavioural therapy for insomnia (CBT-I). <a href="https://www.cntw.nhs.uk/services/nctalkingtherapies/what-do-nc-talking-therapies-offer/cbt-i-cbt-for-insomnia/">CBT-I works by</a> identifying thoughts, feelings and behaviour that contribute to insomnia, which can then be modified to help promote sleep.</p> <p>In 2022, a CBT-I app became the <a href="https://www.nice.org.uk/news/article/nice-recommends-offering-app-based-treatment-for-people-with-insomnia-instead-of-sleeping-pills">first digital therapy</a> recommended by England’s National Institute for Health and Care Excellence for treatment on the NHS.</p> <p>These interventions can improve other aspects of our lives as well. A <a href="https://www.sciencedirect.com/science/article/pii/S1087079221001416?via%3Dihub">2021 meta-analysis</a> of 65 clinical trials found that improving sleep via CBT-I reduced symptoms of depression, anxiety, rumination and stress.<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/230484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, Marie Skłodowska-Curie Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sleeping-on-it-really-does-help-and-four-other-recent-sleep-research-breakthroughs-230484">original article</a>.</em></p>

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Drinking lots of water may seem like a healthy habit – here’s when and why it can prove toxic

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>In late 2023, actor <a href="https://www.glamour.com/story/brooke-shields-recently-experienced-a-full-blown-seizure-and-bradley-cooper-came-running?utm_source=instagram&amp;utm_medium=social&amp;utm_content=instagram-bio-link&amp;client_service_id=31196&amp;client_service_name=glamour&amp;service_user_id=1.78e+16&amp;supported_service_name=instagram_publishing&amp;utm_brand=glm&amp;utm_social_type=owned">Brooke Shields</a> suffered a seizure after “flooding” her body with water. Shields became dangerously low on sodium while preparing for her show by drinking loads of water. “I flooded my system and I drowned myself,” she would later explain. “And if you don’t have enough sodium in your blood or urine or your body, you can have a seizure.”</p> <p>Shields said she found herself walking around outside for “no reason at all”, wondering: “Why am I out here?”</p> <blockquote> <p>Then I walk into the restaurant and go to the sommelier who had just taken an hour to watch my run through. That’s when everything went black. Then my hands drop to my side and I go headfirst into the wall.</p> </blockquote> <p>Shields added that she was “frothing at the mouth, totally blue, trying to swallow my tongue”.</p> <p>Like Shields, many people may be unaware of the dangers of drinking excessive amounts of water – especially because hydration is so often associated with health benefits. Models and celebrities <a href="https://www.teenvogue.com/story/drinking-water-flawless-skin#:%7E:text=If%20you're%20reading%20a,long%20hours%20at%20a%20time.">often advocate</a> drinking lots of water to help maintain clear, smooth skin. Some <a href="https://www.independent.co.uk/life-style/75-hard-challenge-before-and-after-tiktok-b2382706.html">social media influencers</a> have promoted drinking a gallon of water daily for weight loss.</p> <p>But excessive water consumption can cause <a href="https://patient.info/treatment-medication/hyponatraemia-leaflet">hyponatraemia</a> – a potentially fatal condition of low sodium in the blood.</p> <h2>Worried about hydration levels? Check your urine</h2> <p>The body strictly regulates its water content to maintain the optimum level of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323003/">total body water</a> and “osmolality” – the concentration of dissolved particles in your blood. Osmolality increases when you are dehydrated and decreases when you have too much fluid in your blood.</p> <p>Osmolality is monitored by <a href="https://pubmed.ncbi.nlm.nih.gov/9074779/">osmoreceptors</a> that regulate sodium and water balance in the hypothalamus – the part of the brain that controls numerous hormones. These osmoreceptors signal the release of antidiuretic hormone (ADH), which acts on blood vessels and the kidneys to control the amount of water and salt in the body.</p> <figure><iframe src="https://www.youtube.com/embed/Qghf7Y9ILAs?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>In healthy people, the body releases ADH when osmolality becomes high. ADH tells the kidneys to reabsorb water, which makes urine more concentrated. The reabsorbed water dilutes the blood, bringing osmolality back to normal levels.</p> <p>Low blood osmolality suppresses the release of ADH, reducing how much water the kidneys reabsorb. This dilutes your urine, which the body then passes to rid itself of the excess water.</p> <p>Healthy urine should be clear and odourless. Darker, yellower urine with a noticeable odour can indicate dehydration – although medications and certain foods, including <a href="https://pubmed.ncbi.nlm.nih.gov/3433805/">asparagus</a>, can affect urine colour and odour, too.</p> <h2>How much is too much?</h2> <p>Adults should consume <a href="https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/water-drinks-nutrition/">two-to-three litres per day</a>, of which around 20% comes from food. However, we can lose <a href="https://www.ncbi.nlm.nih.gov/books/NBK236237/">up to ten litres</a> of water through perspiration – so sweating during exercise or in hot weather increases the amount of water we need to replace through drinking.</p> <p>Some medical conditions can cause overhydration. Approximately <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616165/">one in five</a> schizophrenia patients drink water compulsively, a dangerous condition known as <a href="https://www.theguardian.com/uk-news/2024/apr/15/woman-died-mental-hospital-excessive-water-drinking-inquest#:%7E:text=Woman%20died%20at%20mental%20hospital%20after%20excessive%20water%20drinking%2C%20inquest%20told,-Parents%20of%20Lillian&amp;text=A%20woman%20collapsed%20and%20died,water%2C%20an%20inquest%20has%20heard.">psychogenic polydipsia</a>. One long-term study found that patients with psychogenic polydipsia have a <a href="https://pubmed.ncbi.nlm.nih.gov/18984069/">“74% greater chance</a> of dying before a non-polydipsic patient”.</p> <p>In <a href="https://pubmed.ncbi.nlm.nih.gov/22306188/">some cases</a>, people with <a href="https://psychiatry-psychopharmacology.com/en/childhood-and-adolescence-disorders-psychogenic-polydipsia-in-an-adolescent-with-eating-disorder-a-case-report-132438">anorexia nervosa</a> can also suffer from compulsive water drinking.</p> <figure><iframe src="https://www.youtube.com/embed/ReQew2zcN7c?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>For those suffering from polydipsia, treatment is focused on medication to reduce the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675986/">urge to drink</a>, as well as <a href="https://www.uptodate.com/contents/overview-of-the-treatment-of-hyponatremia-in-adults/print">increasing sodium levels</a>. This should be done gradually to avoid causing <a href="https://www.ncbi.nlm.nih.gov/books/NBK562251/">myelinolysis</a> – <a href="https://www.ncbi.nlm.nih.gov/books/NBK551697/">neurological damage</a> caused by rapid changes in sodium levels in nerve cells.</p> <p>In rare but often highly publicised cases such as that of <a href="http://news.bbc.co.uk/onthisday/hi/dates/stories/november/13/newsid_2516000/2516593.stm">Leah Betts</a> in 1995, some users of the illegal drug MDMA (also known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119400/">ecstasy)</a> have <a href="https://pubmed.ncbi.nlm.nih.gov/11265566/">died</a> after drinking copious amounts of water to rehydrate after dancing and sweating.</p> <p>The drug <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/">increases body temperature</a>, so users drink water to avoid overheating. Unfortunately, MDMA also triggers the <a href="https://pubmed.ncbi.nlm.nih.gov/12105115/">unnecessary release of ADH</a>, causing water retention. The body becomes unable to rid itself of excess water, which affects its electrolyte levels – causing cells to swell with water.</p> <p>Symptoms of water intoxication start with nausea, vomiting, blurred vision and dizziness. As the condition progresses, sufferers can often display symptoms of <a href="https://www.nhs.uk/mental-health/conditions/psychosis/symptoms/">psychosis</a>, such as inappropriate behaviour, confusion, delusions, disorientation and hallucinations.</p> <p>These symptoms are caused by <a href="https://www.ncbi.nlm.nih.gov/books/NBK470386/">hyponatraemia</a>, where sodium levels are diluted or depleted in blood and the subsequent imbalance of electrolytes affects the nervous system. Water begins to move into the brain causing <a href="https://www.sciencedirect.com/science/article/pii/S1572349604000149">a cerebral oedema</a> – brain swelling because of excessive fluid buildup, which is usually fatal if not treated.</p> <p>A healthy body will tell you when it needs water. If you’re thirsty and your urine is dark with a noticeable odour, then you need to drink more. If you aren’t thirsty and your urine is clear or the colour of light straw, then you’re already doing a good job of hydrating yourself.<!-- 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/228715/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/adam-taylor-283950"><em>Adam Taylor</em></a><em>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster 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/drinking-lots-of-water-may-seem-like-a-healthy-habit-heres-when-and-why-it-can-prove-toxic-228715">original article</a>.</em></p> </div>

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Here’s what happens to your body during plane turbulence – and how to reduce the discomfort it causes

<p><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>This week has seen another barrage of <a href="https://www.theguardian.com/uk-news/2024/jan/22/uk-weather-storm-jocelyn-to-follow-isha-with-more-strong-winds-and-heavy-rain">unsettled weather</a> sweep across the UK, with many flights delayed or cancelled. Some of those who were fortunate enough to take off found themselves arriving at destinations that weren’t on their boarding passes – such as passengers travelling from Stansted to Newquay who eventually diverted to <a href="https://uk.news.yahoo.com/storm-isha-creates-flight-diversion-142821278.html">Malaga</a>.</p> <p>One thing that was consistently described by passengers was that parts of the flights and the attempted landings were some of the most unnerving they’d ever experienced, due to turbulence.</p> <p>Turbulence results from uneven air movement, which is <a href="https://agupubs.onlinelibrary.wiley.com/doi/10.1029/2023GL103814">increasing</a> in frequency. If you turn your hair dryer on at home and hold it still, the air moves at a constant rate, but once you begin drying your hair and moving the hairdryer around, the air movement becomes uneven, that is to say, turbulent.</p> <p>Although turbulence may be unnerving and make you feel unwell, it is important to recognise that it is very common and typically <a href="https://pubmed.ncbi.nlm.nih.gov/18018437/">nothing to worry about</a> if you’re in your seat with your seatbelt fastened.</p> <h2>How the body detects and responds to turbulence</h2> <p>The body recognises itself within any environment. Its relationship with objects in terms of distance and direction is called <a href="https://www.sciencedirect.com/science/article/abs/pii/B9780123750006003414">spatial orientation</a>.</p> <p>When flying, this is typically moving forwards, ascending, some turns and a descent. However, turbulence disrupts this relationship and confuses the sensory information being received by the brain – it makes the body want to respond or recalibrate.</p> <p>Our inner ears play a pivotal role in all this. It consists of complex apparatuses that undertake more than hearing. These include the cochlea, <a href="https://www.ncbi.nlm.nih.gov/books/NBK279394/">three semi-circular canals</a>, <a href="https://radiopaedia.org/articles/utricle-ear?lang=gb">the utricle</a> and <a href="https://radiopaedia.org/articles/saccule-ear-1?lang=gb">the saccule</a>.</p> <p>The cochlea is responsible for hearing. It converts <a href="https://www.ncbi.nlm.nih.gov/books/NBK531483/">sound energy into electrical energy</a> that is then “heard” by the brain. The remaining structures are responsible for the balance and position of the head and body. The semi-circular canals are positioned in a vertical (side to side), horizontal and front-to-back plane, detecting movement in a nodding, shaking and touching ear-to-shoulder direction.</p> <p>Attached to these canals are <a href="https://www.ncbi.nlm.nih.gov/books/NBK532978/">the utricle and saccule</a>, which can detect <a href="https://www.ncbi.nlm.nih.gov/books/NBK10792/">movement</a> and <a href="https://www.cell.com/current-biology/pdf/S0960-9822(05)00837-7.pdf">acceleration</a>.</p> <p>All of these apparatuses use microscopic hair cells in a specialised fluid called <a href="https://www.ncbi.nlm.nih.gov/books/NBK531505/">endolymph</a> that flows with the head to create a sense of movement. When the plane encounters turbulence, this fluid moves around, but unpredictably. It takes <a href="https://www.ncbi.nlm.nih.gov/books/NBK518976/">about ten to 20 seconds</a> for the fluid to recalibrate its position, while the brain struggles to understand what is going on.</p> <p>When the aircraft hits turbulence, the balance apparatus <a href="https://www.frontiersin.org/articles/10.3389/fneur.2023.949227/full">cannot distinguish</a> the movement of the plane from that of the head, so the brain interprets the aircraft movement as that of the head or body. But this doesn’t match the visual information being received, which causes sensory confusion.</p> <p>The reason the inner ear causes so much confusion is because during flights you are devoid of your primary sensory tool relative to the external environment – your sight and the horizon.</p> <p>Eighty per cent of <a href="https://www.ncbi.nlm.nih.gov/books/NBK518976/">spatial information</a> comes from your eyes during flight. However, you only have the seat in front of you or the cabin as a reference point, which means your inner ear becomes the dominant sensory message to the brain during turbulence and disrupts the <a href="https://www.ncbi.nlm.nih.gov/books/NBK545297/">“vestibulo-ocular reflex”</a>. This reflex keeps your vision <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4130651/">aligned</a> with your balance or expected position.</p> <p>Vision is the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6777262/">most valued</a> of the senses and one-third of the brain is attributed to its function, reinforcing its importance in spatial orientation.</p> <p>This sensory mixed messaging often results in things like dizziness and sweating as well as gastrointestinal symptoms, such as <a href="https://www.airmedicaljournal.com/article/S1067-991X(02)70038-2/fulltext">nausea and vomiting</a>.</p> <p>Motion sickness can be triggered by turbulence and although research into specific airsickness is limited, other modes that induce motion sickness suggest that <a href="https://pubmed.ncbi.nlm.nih.gov/16018346/">women</a> are <a href="https://pubmed.ncbi.nlm.nih.gov/26466829/">more susceptible</a> than men, particularly in the <a href="https://pubmed.ncbi.nlm.nih.gov/16235881/">early stages</a> of the menstrual cycle.</p> <p>The turbulence also causes an increase in your heart rate, which is already higher than normal when flying because of a <a href="https://pubmed.ncbi.nlm.nih.gov/15819766/">decrease in oxygen saturation</a>.</p> <h2>What about the pilots?</h2> <p>Commercial pilots accrue thousands of hours at the controls, they are subject to the same forces as the passengers.</p> <p>Over time, they can <a href="https://academic.oup.com/milmed/article/180/11/1135/4160573">adapt to these forces</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/15828634/">experiences</a>, but they also have a couple of additional resources that most passengers don’t.</p> <p>They have the view out of the cockpit windows, so have a horizon to use as a reference point and can see what lies immediately ahead.</p> <p>If it is cloudy or visibility is low, their instruments provide additional visual <a href="https://www.faa.gov/sites/faa.gov/files/regulations_policies/handbooks_manuals/aviation/phak/19_phak_ch17.pdf">reference</a> to the position of the aircraft. This doesn’t mean they are immune to the effects of turbulence, with some studies reporting up to <a href="https://pubmed.ncbi.nlm.nih.gov/26540704/">71% of trainee pilots</a> reporting episodes of airsickness.</p> <h2>How to reduce the discomfort</h2> <p>A window seat can help, or even looking out the window. This gives the brain some sensory information through visual pathways, helping calm the brain in response to the vestibular information it is receiving.</p> <p>If you can get one, a seat towards the front or over the wing reduces the effects of turbulence.</p> <p>Deep or rhythmical breathing can help reduce motion sickness induced by turbulence. Focusing on your breathing <a href="https://pubmed.ncbi.nlm.nih.gov/25945662/">calms the nervous system</a>.</p> <p>Don’t reach for the alcohol. While you may feel it calms your nerves, if you hit turbulence it’s going to interfere with your <a href="https://pubmed.ncbi.nlm.nih.gov/7610847/">visual and auditory processing</a> and increase the likelihood of vomiting.</p> <p>If you suffer from motion sickness and are worried about turbulence while flying, then there are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241144/">drugs that can help</a>, including certain <a href="https://www.nhs.uk/medicines/cinnarizine/about-cinnarizine/">antihistamines</a>.</p> <p>Finally, it’s important to remember that although turbulence can be unpleasant, aircraft are designed to withstand the forces it generates and many passengers, even frequent fliers, will rarely encounter the most severe categories of turbulence because pilots actively plan routes to avoid it.<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/221780/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster 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/heres-what-happens-to-your-body-during-plane-turbulence-and-how-to-reduce-the-discomfort-it-causes-221780">original article</a>.</em></p>

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Step up: take the stairs to help your heart

<p>Climbing stairs is associated with a longer life, according to research presented this week at an annual meeting of Europe’s leading cardiologists.</p> <div class="copy"> <p>The systematic review of 9 previous studies covering nearly 500,000 participants investigated whether climbing stairs as a form of physical activity could play a role in reducing the risks of <a href="https://cosmosmagazine.com/science/biology/how-organ-on-a-chip-technology-is-revolutionising-the-way-we-study-cardiovascular-disease/">cardiovascular diseases</a> and premature death.</p> <p>Study author Dr Sophie Paddock, of the Norfolk and Norwich University Hospital Foundation Trust, UK, says: “if you have the choice of taking the stairs or the lift, go for the stairs as it will help your heart”.</p> <p>“Even brief bursts of physical activity have beneficial health impacts, and short bouts of stair climbing should be an achievable target to integrate into daily routines.”</p> <p>Cardiovascular diseases (CVDs) are a group of disorders of the hearth and blood vessels. They are the leading cause of non-communicable disease death globally, with 17.9m people estimated to have died of one in 2019 alone. Physical inactivity is one of the most important behavioural risk factors for developing CVDs. More than 1 in 4 adults do not meet the global <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity" target="_blank" rel="noreferrer noopener">recommended levels</a> of physical activity.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049418/" target="_blank" rel="noreferrer noopener">meta-analysis</a> on the best available science  covered 480,479 individuals aged 35-84 years old. 53% of participants were women.</p> <p>Stair climbing was significantly associated with a 24% reduced risk of dying from any cause and a 39% lower likelihood of dying from cardiovascular disease, compared to not climbing stairs.</p> <p>It was also linked to a reduced <a href="https://cosmosmagazine.com/health/covid-19-impacts-on-cardiac-health/">risk of CVDs</a> including heart attack, heart failure and stroke.</p> <p>“Based on these results, we would encourage people to incorporate stair climbing into their day-to-day lives,” says Paddock.</p> <p>“Our study suggested that the more stairs climbed, the greater the benefits – but this needs to be confirmed. So, whether at work, home, or elsewhere, take the stairs.”</p> <p>The research was presented to <a href="https://www.escardio.org/Congresses-Events/Preventive-Cardiology" target="_blank" rel="noreferrer noopener">ESC Preventive Cardiology 2024</a>, an annual congress of the European Association of Preventive Cardiology in Greece this week.</p> <p><em>Image credits: Shutterstock </em></p> <div> <p align="center"> </p> </div> <p><em><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=302751&amp;title=Step+up%3A+take+the+stairs+to+help+your+heart" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em></div> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/body-and-mind/step-up-take-the-stairs-to-help-your-heart/">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/imma-perfetto/">Imma Perfetto</a>. </em></p> </div>

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New study reveals people who do this daily make more money over their lifetimes

<p>You’ve heard that regular exercise can help you live richly. Frequent movement, even in short bursts throughout the day, has been linked to lower all-cause mortality rates and reduced risk of heart disease, type-2 diabetes and other age-related conditions, helping you age healthfully and stay independent.</p> <p>Now, new research suggests frequent exercise might help you live well in another meaningful way; in terms of income. In a recent study published in the journal Clinical Orthopaedics and Related Research, doctors from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), which is part of the National Institute of Health (NIH), investigated whether individuals who stayed active would earn more money as a result of their active lifestyle.</p> <p>The researchers’ findings revealed that staying active not only resulted in higher present earnings, but also predicted increased future income throughout one’s life. In essence, the science was clear: Getting more exercise could make you wealthier.</p> <h2>How exercise predicted future earnings</h2> <p>The researchers set out to explore three key correlations: How mobility affected income, how mobility influenced income over time, and whether exercise could help people maintain their mobility as they aged.</p> <p>The team analysed data from the US-federally-supported Health and Retirement Study (HRS), the largest study tracking changes over time in Americans aged 50 and above. This comprehensive study takes into account various life aspects, including work, socio-economic status, health, psychology and family matters, as individuals age.</p> <p>To assess the impact of current mobility on income, the researchers examined data from over 19,000 respondents to determine how well they could perform simple tasks, such as walking several blocks, climbing multiple flights of stairs, or moving around a room. Each person received a numerical score, with 5 indicating full mobility and 0 indicating difficulties with these tasks.</p> <h2>What earnings over time revealed</h2> <p>The researchers found that for each decrease in the mobility category, individuals lost out on an average of US$3000 in annual income compared to their peers. Those who were active were also significantly more likely to remain working for longer than the other group. It appeared that engaging in exercise enabled individuals to maintain mobility and engage in professional life for a longer period of time than those who were less active.</p> <p>Looking at earnings over time revealed even more substantial benefits for those who remained active throughout their lives. Active individuals showed an overall income level that was US$6500 higher, along with higher rates of employment.</p> <p>For the third part of the study, it’s not surprising that those who engaged in exercise continued to maintain their mobility after the age of 55 and had higher employment rates. Even exercising just one day a week showed improvements in mobility outcomes.</p> <h2>Moving more benefits more than just health</h2> <p>While this study doesn’t definitively prove that leading a healthy lifestyle directly leads to higher earnings, it strongly suggests that staying healthy and mobile brings benefits beyond just lower levels of disease (which is a type of wealth in and of itself). NIAMS Director Lindsey A. Criswell, M.D., M.P.H., underscores this point: “We have long understood that greater mobility is an important indicator of good health … The notion that mobility can have economic rewards further extends the evidence for the benefits of exercise and maintaining an active lifestyle.”</p> <p>If this science inspires you to make a healthy lifestyle change, speak with a licensed healthcare provider to determine the right exercise programme for you.</p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/food-home-garden/money/new-study-reveals-people-who-do-this-daily-make-more-money-over-their-lifetimes" target="_blank" rel="noopener">Reader's Digest</a>.</em> </p>

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If I’m diagnosed with one cancer, am I likely to get another?

<p><em><a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health.</p> <p>Fear of cancer returning is one of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321869/">top health concerns</a>. And <a href="https://www.cancercouncil.com.au/cancer-information/living-well/after-cancer-treatment/fear-of-the-cancer-returning/managing-fear-of-recurrence/">managing this fear</a> is an important part of cancer treatment.</p> <p>But how likely is it to get cancer for a second time?</p> <h2>Why can cancer return?</h2> <p>While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms.</p> <p>This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">metastasis</a>.</p> <p>Actor Hugh Jackman has gone public about his <a href="https://www.skincancer.org/blog/is-basal-cell-carcinoma-serious/">multiple diagnoses</a> of basal cell carcinoma (a type of skin cancer) over the <a href="https://www.bbc.com/news/world-australia-65158945">past decade</a>.</p> <p>The exact reason why cancer returns differs depending on the cancer type and the treatment received. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486871/">Research</a> is <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.3408">ongoing</a> to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people.</p> <h2>What are the chances of cancer returning?</h2> <p>The risk of cancer returning differs between cancers, and between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019423/">sub-types</a> of the same cancer.</p> <p>New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2812113">31-68%</a>. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning.</p> <p>For most types of cancer, the highest risk of cancer returning is within the <a href="https://pubmed.ncbi.nlm.nih.gov/31231898/">first three years</a> after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning.</p> <p>Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed.</p> <h2>What about second, unrelated cancers?</h2> <p>Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) <a href="https://www.bbc.com/news/uk-68047608">shortly after</a> being treated for breast cancer.</p> <p>Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one.</p> <p>Australian research from <a href="https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-83">Queensland</a> and <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.31247">Tasmania</a> shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population.</p> <h2>Who’s at risk of another, unrelated cancer?</h2> <p>With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer.</p> <p>Reasons for such cancers <a href="https://www.cancer.net/survivorship/what-second-cancer">include</a> different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors.</p> <p>The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435077/">relatively small</a> when compared with the (sometimes lifesaving) benefits of these treatment and procedures.</p> <p>While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years.</p> <p>Similarly, in a <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.30164">large US study</a> only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years).</p> <p>The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer.</p> <p>People diagnosed with cancer as a <a href="https://www.mja.com.au/journal/2020/212/3/second-primary-cancers-people-who-had-cancer-children-australian-childhood">child</a>, <a href="https://www.liebertpub.com/doi/10.1089/jayao.2022.0074">adolescent or young adult</a> also have a greater risk of a second, unrelated cancer.</p> <h2>What can I do to lower my risk?</h2> <p>Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment.</p> <p><a href="https://www.lymphoma.org.au/lymphoma/treatments/maintenance-therapy/">Maintenance therapy</a> may be used to reduce the risk of some types of cancer returning. However, despite ongoing <a href="https://febs.onlinelibrary.wiley.com/doi/10.1111/febs.15626">research</a>, there are no <em>specific</em> treatments against cancer recurrence or developing a second, unrelated cancer.</p> <p>But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21719">cancer returning</a> and <a href="https://www.cancer.net/survivorship/what-second-cancer">getting a second cancer</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226386/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, Senior Lecturer in Cancer Epidemiology, <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/if-im-diagnosed-with-one-cancer-am-i-likely-to-get-another-226386">original article</a>.</em></p>

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Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it

<p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically between 45 and 55. As women approach or experience menopause, common “change of life” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244939/">concerns</a> include hot flushes, sweats and mood swings, brain fog and fatigue.</p> <p>But many women may not be aware of the <a href="https://pubmed.ncbi.nlm.nih.gov/32705886/">long-term effects</a> of menopause on the heart and blood vessels that make up the cardiovascular system. Heart disease accounts for <a href="http://world-heart-federation.org/what-we-do/women-cvd/">35% of deaths</a> in women each year – more than all cancers combined.</p> <p>What should women – and their doctors – know about these risks?</p> <h2>Hormones protect hearts – until they don’t</h2> <p>As early as 1976, the <a href="https://pubmed.ncbi.nlm.nih.gov/970770/">Framingham Heart Study</a> reported more than twice the rates of cardiovascular events in postmenopausal than pre-menopausal women of the same age. Early menopause (younger than age 40) also <a href="https://pubmed.ncbi.nlm.nih.gov/25331207/">increases heart risk</a>.</p> <p>Before menopause, women tend to be protected by their circulating hormones: oestrogen, to a lesser extent progesterone and low levels of testosterone.</p> <p>These sex hormones help to relax and dilate blood vessels, reduce inflammation and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503403/">improve lipid (cholesterol) levels</a>. From the mid-40s, a decline in these hormone levels can <a href="https://pubmed.ncbi.nlm.nih.gov/10362825/">contribute to unfavourable changes</a> in cholesterol levels, blood pressure and weight gain – all risk factors for heart disease.</p> <h2>4 ways hormone changes impact heart risk</h2> <p><strong>1. Dyslipidaemia</strong>– Menopause often involves <a href="https://pubmed.ncbi.nlm.nih.gov/38002671/">atherogenic changes</a> – an unhealthy imbalance of lipids in the blood, with higher levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL-C), dubbed the “bad” cholesterol. There are also reduced levels of high-density lipoprotein (HDL-C) – the “good” cholesterol that helps remove LDL-C from blood. These changes are a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503403/">major risk factor for heart attack or stroke</a>.</p> <p><strong>2. Hypertension</strong> – Declines in oestrogen and progesterone levels during menopause contribute to narrowing of the large blood vessels on the heart’s surface, arterial stiffness and <a href="https://pubmed.ncbi.nlm.nih.gov/35722103/">raise blood pressure</a>.</p> <p><strong>3. Weight gain</strong> – Females are born with one to two million eggs, which develop in follicles. By the time they <a href="https://www.thewomens.org.au/health-information/fertility-information/getting-pregnant/ovulation-and-conception">stop ovulating</a> in midlife, fewer than 1,000 remain. This depletion progressively changes fat distribution and storage, from the hips to the waist and abdomen. Increased waist circumference (greater than 80–88 cm) has been <a href="https://pubmed.ncbi.nlm.nih.gov/18359190/">reported to contribute to heart risk</a> – though it is <a href="https://theconversation.com/good-news-midlife-health-is-about-more-than-a-waist-measurement-heres-why-226019">not the only factor to consider</a>.</p> <p><strong>4. Comorbidities</strong> – Changes in body composition, sex hormone decline, increased food consumption, weight gain and sedentary lifestyles impair the body’s ability to effectively use insulin. This <a href="https://pubmed.ncbi.nlm.nih.gov/11133069/">increases the risk</a> of developing metabolic syndromes such as type 2 diabetes.</p> <p>While risk factors apply to both genders, hypertension, smoking, obesity and type 2 diabetes confer a greater relative risk for heart disease in women.</p> <h2>So, what can women do?</h2> <p>Every woman has a different level of baseline cardiovascular and metabolic risk pre-menopause. This is based on their genetics and family history, diet, and lifestyle. But all women can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351755/">reduce their post-menopause heart risk with</a>:</p> <ul> <li>regular moderate intensity exercise such as brisk walking, pushing a lawn mower, riding a bike or water aerobics for 30 minutes, four or five times every week</li> <li>a healthy heart diet with smaller portion sizes (try using a smaller plate or bowl) and more low-calorie, nutrient-rich foods such as vegetables, fruit and whole grains</li> <li>plant sterols (unrefined vegetable oil spreads, nuts, seeds and grains) each day. A review of 14 clinical trials found plant sterols, at doses of at least 2 grams a day, produced an average reduction in serum LDL-C (bad cholesterol) of about 9–14%. This could reduce the risk of heart disease by <a href="https://pubmed.ncbi.nlm.nih.gov/10731187/">25% in two years</a></li> <li>less unhealthy (saturated or trans) fats and more low-fat protein sources (lean meat, poultry, fish – especially oily fish high in omega-3 fatty acids), legumes and low-fat dairy</li> <li>less high-calorie, high-sodium foods such as processed or fast foods</li> <li>a reduction or cessation of smoking (nicotine or cannabis) and alcohol</li> <li>weight-gain management or prevention.</li> </ul> <h2>What about hormone therapy medications?</h2> <p>Hormone therapy remains the most effective means of <a href="https://pubmed.ncbi.nlm.nih.gov/15495039/">managing hot flushes and night sweats</a> and is beneficial for <a href="https://pubmed.ncbi.nlm.nih.gov/18418063/">slowing the loss of bone mineral density</a>.</p> <p>The decision to recommend oestrogen alone or a combination of oestrogen plus progesterone hormone therapy depends on whether a woman has had a hysterectomy or not. The choice also depends on whether the hormone therapy benefit outweighs the woman’s disease risks. Where symptoms are bothersome, hormone therapy has <a href="https://pubmed.ncbi.nlm.nih.gov/33841322/">favourable or neutral effects on coronary heart disease risk</a> and medication risks are low for healthy women younger than 60 or within ten years of menopause.</p> <p>Depending on the level of stroke or heart risk and the response to lifestyle strategies, some women may also require medication management to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351755/">control high blood pressure or elevated cholesterol levels</a>. Up until the early 2000s, women were underrepresented in most outcome trials with lipid-lowering medicines.</p> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/25579834/">Cholesterol Treatment Trialists’ Collaboration</a> analysed 27 clinical trials of statins (medications commonly prescribed to lower cholesterol) with a total of 174,000 participants, of whom 27% were women. Statins were about as effective in women and men who had similar risk of heart disease in preventing events such as stroke and heart attack.</p> <p>Every woman approaching menopause should ask their GP for a 20-minute <a href="https://www.health.gov.au/news/heart-health">Heart Health Check</a> to help better understand their risk of a heart attack or stroke and get tailored strategies to reduce it.</p> <p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/menopause-can-bring-increased-cholesterol-levels-and-other-heart-risks-heres-why-and-what-to-do-about-it-228010">original article</a>.</em></p>

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

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

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Sleep wrinkles are real. Here’s how they leave their mark

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/yousuf-mohammed-858232">Yousuf Mohammed</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/khanh-phan-1489820">Khanh Phan</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/vania-rodrigues-leite-e-silva-1497208">Vania Rodrigues Leite E. Silva</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>You wake up, stagger to the bathroom and gaze into the mirror. No, you’re not imagining it. You’ve developed face wrinkles overnight. They’re sleep wrinkles.</p> <p>Sleep wrinkles are temporary. But as your skin loses its elasticity as you age, they can set in.</p> <p>Here’s what you can do to minimise the chance of them forming in the first place.</p> <h2>How side-sleeping affects your face</h2> <p>Your skin wrinkles for a number of reasons, including ageing, sun damage, smoking, poor hydration, habitual facial expressions (such as grinning, pouting, frowning, squinting) and sleeping positions.</p> <p>When you sleep on your side or stomach, your face skin is <a href="https://academic.oup.com/asj/article/36/8/931/2613967">squeezed and crushed</a> a lot more than if you sleep on your back. When you sleep on your side or stomach, gravity presses your face against the pillow. Your face skin is distorted as your skin is stretched, compressed and pulled in all directions as you move about in your sleep.</p> <p>You can reduce these external forces acting on the face by sleeping on your back or changing positions frequently.</p> <h2>Doctors can tell which side you sleep on by looking at your face</h2> <p>In a young face, sleep wrinkles are transient and disappear after waking.</p> <p>Temporary sleep wrinkles can become persistent with time and repetition. As we <a href="https://pubmed.ncbi.nlm.nih.gov/19624425/">age</a>, our skin <a href="https://pubmed.ncbi.nlm.nih.gov/22233477/">loses elasticity</a> (recoil) and extensibility (stretch), creating <a href="https://pubmed.ncbi.nlm.nih.gov/27329660/">ideal conditions</a> for sleep wrinkles or lines to set in and last longer.</p> <p>The time spent in each sleeping position, the magnitude of external forces applied to each area of the face, as well as the surface area of contact with the pillow surface, also <a href="https://pubmed.ncbi.nlm.nih.gov/27329660/">affects</a> the pattern and rate of sleep wrinkle formation.</p> <p>Skin specialists can often recognise this. People who favour sleeping on one side of their body tend to have a flatter face on their sleeping side and more visible sleep lines.</p> <h2>Can a night skincare routine avoid sleep wrinkles?</h2> <p>Collagen and elastin are two primary components of the dermis (inner layer) of skin. They form the skin structure and maintain the elasticity of skin.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=395&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=395&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=395&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=496&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=496&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=496&amp;fit=crop&amp;dpr=3 2262w" alt="Skin structure" /><figcaption><span class="caption">The dermis is the inner layer of skin.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/skin-structure-old-young-1707589036">mermaid3/Shutterstock</a></span></figcaption></figure> <p>Supplementing collagen through skincare routines to enhance skin elasticity can <a href="https://pubmed.ncbi.nlm.nih.gov/32799362/">help reduce</a> wrinkle formation.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/30287361/">Hyaluronic</a> acid is a naturally occurring molecule in human bodies. It holds our skin’s collagen and elastin in a proper configuration, stimulates the production of <a href="https://www.mdpi.com/1420-3049/26/15/4429">collagen</a> and adds hydration, which can help slow down wrinkle formation. Hyaluronic acid is one of the most common <a href="https://pubmed.ncbi.nlm.nih.gov/30287361/">active ingredients</a> in skincare creams, gels and lotions.</p> <p>Moisturisers can hydrate the skin in <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1473-2165.2009.00421.x">different ways</a>. “Occlusive” substances produce a thin layer of oil on the skin that prevents water loss due to evaporation. “Humectants” attract and hold water in the skin, and they can differ in their capacity to bind with water, which influences the degree of skin hydration.</p> <h2>Do silk pillowcases actually make a difference?</h2> <p>Silk pillowcases can make a difference in wrinkle formation, if they let your skin glide and move, rather than adding friction and pressure on a single spot. If you can, use silk sheets and silk pillows.</p> <p>Studies have also <a href="https://academic.oup.com/asj/article/36/8/931/2613967">shown</a> pillows designed to reduce mechanical stress during sleep can prevent skin deformations. Such a pillow <a href="https://www.scirp.org/journal/paperinformation?paperid=67035#:%7E:text=Introduction-,The%20duration%20of%20sleep%20and%20the%20position%20of%20the%20face,permanent%20sleep%20lines%20with%20time.">could be useful</a> in slowing down and preventing the formation of certain facial wrinkles.</p> <p>Sleeping on your back can reduce the risk of sleep lines, as can a nighttime routine of moisturising before sleep.</p> <p>Otherwise, lifestyle choices and habits, such quitting smoking, drinking plenty of water, a healthy diet (eating enough vegetables, <a href="https://www.tandfonline.com/doi/full/10.1080/07315724.2001.10719017?casa_token=uD1flbkLyKUAAAAA%3AsMTWPmxzO3fGHAI41o80B_bWrGrOrvQFeJwF2FtIEnkd73Qmjvyhxr1-GO2kU8_Yc2LYgZp56DqHVg">fruits</a>, nuts, seeds, healthy fats, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452251/pdf/nutrients-09-00521.pdf">yogurt and other fermented foods</a>) and regular use of sunscreens can help improve the appearance of the skin on our face.<!-- 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/217380/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/yousuf-mohammed-858232">Yousuf Mohammed</a>, Dermatology researcher, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/khanh-phan-1489820">Khanh Phan</a>, Postdoctoral Research Fellow, Frazer Institute, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/vania-rodrigues-leite-e-silva-1497208">Vania Rodrigues Leite E. Silva</a>, Honorary Associate Professor, Frazer Institute, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/sleep-wrinkles-are-real-heres-how-they-leave-their-mark-217380">original article</a>.</em></p> </div>

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Yes, adults can develop food allergies. Here are 4 types you need to know about

<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>If you didn’t have food allergies as a child, is it possible to develop them as an adult? The short answer is yes. But the reasons why are much more complicated.</p> <p>Preschoolers are about <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">four times more likely to have a food allergy</a> than adults and are more likely to grow out of it as they get older.</p> <p>It’s hard to get accurate figures on adult food allergy prevalence. The Australian National Allergy Council reports <a href="https://nationalallergycouncil.org.au/about-us/our-strategy">one in 50 adults</a> have food allergies. But a US survey suggested as many as <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">one in ten adults</a> were allergic to at least one food, with some developing allergies in adulthood.</p> <h2>What is a food allergy</h2> <p><a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">Food allergies</a> are immune reactions involving <a href="https://www.aaaai.org/tools-for-the-public/allergy,-asthma-immunology-glossary/immunoglobulin-e-(ige)-defined">immunoglobulin E (IgE)</a> – an antibody that’s central to triggering allergic responses. These are known as “IgE-mediated food allergies”.</p> <p>Food allergy symptoms that are <em>not</em> mediated by IgE are usually delayed reactions and called <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">food intolerances or hypersensitivity</a>.</p> <p>Food allergy symptoms can include hives, swelling, difficulty swallowing, vomiting, throat or chest tightening, trouble breathing, chest pain, rapid heart rate, dizziness, low blood pressure or <a href="https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines?highlight=WyJhbmFwaHlsYXhpcyJd">anaphylaxis</a>.</p> <p>IgE-mediated food allergies can be life threatening, so all adults need an <a href="https://allergyfacts.org.au/allergy-management/newly-diagnosed/action-plan-essentials">action management plan</a> developed in consultation with their medical team.</p> <p>Here are four IgE-mediated food allergies that can occur in adults – from relatively common ones to rare allergies you’ve probably never heard of.</p> <h2>1. Single food allergies</h2> <p>The most <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">common IgE-mediated food allergies</a> in adults in a US survey were to:</p> <ul> <li>shellfish (2.9%)</li> <li>cow’s milk (1.9%)</li> <li>peanut (1.8%)</li> <li>tree nuts (1.2%)</li> <li>fin fish (0.9%) like barramundi, snapper, salmon, cod and perch.</li> </ul> <p>In these adults, about 45% reported reacting to multiple foods.</p> <p>This compares to <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">most common childhood food allergies</a>: cow’s milk, egg, peanut and soy.</p> <p>Overall, adult food allergy prevalence appears to be increasing. Compared to <a href="https://pubmed.ncbi.nlm.nih.gov/14657884/">older surveys published in 2003</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/15241360/">2004</a>, peanut allergy prevalence has increased about three-fold (from 0.6%), while tree nuts and fin fish roughly doubled (from 0.5% each), with shellfish similar (2.5%).</p> <p>While new <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">adult-onset food allergies are increasing</a>, childhood-onset food allergies are also more likely to be retained into adulthood. Possible reasons for both <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">include</a> low vitamin D status, lack of immune system challenges due to being overly “clean”, heightened sensitisation due to allergen avoidance, and more frequent antibiotic use.</p> <h2>2. Tick-meat allergy</h2> <p>Tick-meat allergy, also called α-Gal syndrome or mammalian meat allergy, is an allergic reaction to galactose-alpha-1,3-galactose, or α-Gal for short.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/33529984/">Australian immunologists first reported</a> links between α-Gal syndrome and tick bites in 2009, with cases also reported in the United States, Japan, Europe and South Africa. The <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">US Centers for Disease Control estimates</a> about 450,000 Americans <a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm">could be affected</a>.</p> <p>The α-Gal contains a carbohydrate molecule that is bound to a <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">protein</a> molecule in <a href="https://alphagalinformation.org/what-is-a-mammal/">mammals</a>.</p> <p>The IgE-mediated allergy is triggered after repeated bites from ticks or <a href="https://www.insectshield.com/pages/chiggers">chigger mites</a> that have bitten those mammals. When tick saliva crosses into your body through the bite, antibodies to α-Gal are produced.</p> <p>When you subsequently eat foods that contain α-Gal, the allergy is triggered. These triggering foods include meat (lamb, beef, pork, rabbit, kangaroo), dairy products (yoghurt, cheese, ice-cream, cream), <a href="https://en.wikipedia.org/wiki/Gelatin">animal-origin gelatin</a> added to gummy foods (jelly, lollies, marshmallow), prescription medications and over-the counter supplements containing gelatin (<a href="https://www.drugs.com/inactive/gelatin-57.html">some antibiotics, vitamins and other supplements</a>).</p> <p>Tick-meat allergy reactions can be hard to recognise because they’re usually delayed, and they can be severe and include anaphylaxis. Allergy <a href="https://www.allergy.org.au/patients/food-allergy/mammalian-meat-tick-faq">organisations produce management guidelines</a>, so always discuss management with your doctor.</p> <h2>3. Fruit-pollen allergy</h2> <p>Fruit-pollen allergy, called pollen food allergy syndrome, is an <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">IgE-mediated allergic reaction</a>.</p> <p>In susceptible adults, pollen in the air provokes the production of IgE antibodies to antigens in the pollen, but these antigens are similar to ones found in some fruits, vegetables and herbs. The problem is that <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">eating those plants</a> triggers an allergic reaction.</p> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">most allergenic tree pollens</a> are from birch, cypress, Japanese cedar, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/latex-allergy">latex</a>, grass, and ragweed. Their pollen can cross-react with <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">fruit and vegetables</a>, including kiwi, banana, mango, avocado, grapes, celery, carrot and potato, and some herbs such as caraway, coriander, fennel, pepper and paprika.</p> <p>Fruit-pollen allergy is not common. Prevalence <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">estimates are between 0.03% and 8%</a> depending on the country, but it can be life-threatening. Reactions range from itching or tingling of lips, mouth, tongue and throat, called <a href="https://pubmed.ncbi.nlm.nih.gov/20306812/">oral allergy syndrome</a>, to mild <a href="https://www.allergy.org.au/patients/skin-allergy/urticaria-hives">hives</a>, to anaphylaxis.</p> <h2>4. Food-dependent, exercise-induced food allergy</h2> <p>During heavy exercise, the stomach produces less acid than usual and gut permeability increases, meaning that small molecules in your gut are more likely to escape across the membrane into your blood. These include food molecules that trigger an IgE reaction.</p> <p>If the person already has IgE antibodies to the foods eaten before exercise, then the risk of triggering food allergy reactions is increased. This allergy is called <a href="https://pubmed.ncbi.nlm.nih.gov/37893663/">food-dependent exercise-induced allergy</a>, with symptoms ranging from hives and swelling, to difficulty breathing and anaphylaxis.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/30601082/">Common trigger foods include</a> wheat, seafood, meat, poultry, egg, milk, nuts, grapes, celery and other foods, which could have been eaten many hours before exercising.</p> <p>To complicate things even further, allergic <a href="https://pubmed.ncbi.nlm.nih.gov/33181008/">reactions can</a> occur at lower levels of trigger-food exposure, and be more severe if the person is simultaneously taking non-steroidal inflammatory medications like aspirin, drinking alcohol or is sleep-deprived.</p> <p>Food-dependent exercise-induced allergy is extremely rare. Surveys have estimated prevalence as between <a href="https://www.sciencedirect.com/science/article/pii/S1555415517300259">one to 17 cases per 1,000 people worldwide</a> with the highest prevalence between the teenage years to age 35. Those affected often have other allergic conditions such as hay fever, asthma, allergic conjunctivitis and dermatitis.</p> <h2>Allergies are a growing burden</h2> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">burden on physical health, psychological health</a> and health costs due to food allergy is increasing. In the US, this <a href="https://pubmed.ncbi.nlm.nih.gov/38393624/">financial burden was estimated as $24 billion per year</a>.</p> <p>Adult food allergy needs to be taken seriously and those with severe symptoms should wear a medical information bracelet or chain and carry an <a href="https://www.healthdirect.gov.au/how-to-use-an-adrenaline-autoinjector-epipen-anapen">adrenaline auto-injector pen</a>. Concerningly, surveys suggest only <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">about one in four adults</a> with food allergy have an adrenaline pen.</p> <p>If you have an IgE-mediated food allergy, discuss your management plan with your doctor. You can also find more information at <a href="https://allergyfacts.org.au/">Allergy and Anaphylaxis Australia</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223342/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/yes-adults-can-develop-food-allergies-here-are-4-types-you-need-to-know-about-223342">original article</a>.</em></p>

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