Search

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

<a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes. So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex. <h2>The study</h2> Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade. The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk. As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets. Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category. The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours. One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less. Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations. <h2>Why might short sleep increase diabetes risk?</h2> In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body. We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes. Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>. This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses. These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours. While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes. Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase. The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>. <h2>Good sleep, healthy diet</h2> Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes. Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle. While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health. The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk. In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>.

Body

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

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

Body

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

<a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> An article published this week in the prestigious journal <a href="https://www.nature.com/articles/s41591-023-02729-2">Nature Medicine</a> documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person. The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors. Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s. The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop <a href="https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/creutzfeldt-jakob-disease-cjd/">Creuztfeldt-Jakob disease</a> (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million. <h2>What’s CJD got to do with Alzehimer’s?</h2> CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell. Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised <a href="https://en.wikipedia.org/wiki/United_Kingdom_BSE_outbreak">public health concerns</a> over the eating of beef products in the United Kingdom in the 1980s. <h2>Human growth hormone used to come from donated organs</h2> Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue. But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00000563.htm">16,000 donated glands</a>. An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people. hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk. <h2>What are the latest findings about Alzheimer’s disease?</h2> The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission. The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease. They considered other explanations for the findings but concluded donated hGH was the likely cause. Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease. Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-017-0488-7">increasing evidence</a> these proteins spread in the brain in a <a href="https://pubmed.ncbi.nlm.nih.gov/8086126/">similar way to prion diseases</a>. So the mode of transmission the authors propose is certainly plausible. However, given the amyloid protein deposits in the brain <a href="https://www.nia.nih.gov/news/estimates-amyloid-onset-may-predict-alzheimers-progression">at least 20 years</a> before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident. <h2>When was this process used in Australia?</h2> In Australia, donated pituitary material <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">was used</a> from 1967 to 1985 to treat people with short stature and infertility. <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">More than 2,000 people</a> received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch. The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are <a href="https://www.mja.com.au/journal/2010/193/6/iatrogenic-creutzfeldt-jakob-disease-australia-time-amend-infection-control">considered to be</a> incredibly small. Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356853/">around 5%</a> of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution. <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide. Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk. The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images 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/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.

Mind

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

<a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> People in developed countries spend an average of <a href="https://doi.org/10.1136/bjsports-2022-106568">nine to ten hours</a> a day sitting. Whether it’s spending time in front of a computer, stuck in traffic, or unwinding in front of the TV, our lives have become increasingly sedentary. This is concerning because prolonged time spent sitting is <a href="https://bjsm.bmj.com/content/54/24/1451?s=09&int_source=trendmd&int_medium=cpc&int_campaign=usage-042019">linked to a number of health issues</a> including obesity, heart disease, and certain types of cancers. These health issues can contribute to earlier death. But a <a href="https://doi.org/10.1136/bjsports-2022-106568">new study</a> suggests that for people over 50, getting just 22 minutes of exercise a day can lower the increased risk of premature death from a highly sedentary lifestyle. <h2>What the researchers did</h2> The team combined data from two studies from Norway, one from Sweden and one from the United States. The studies included about 12,000 people aged 50 or older who wore wearable devices to track how active and sedentary they were during their daily routines. Participants were followed up for at least two years (the median was 5.2 years) during the study period, which spanned 2003-2020. Analyses took several lifestyle and health factors into account, such as education, alcohol intake, smoking status, and previous history of heart disease, cancer and diabetes. All this data was linked to national death registries. <h2>A 22 minute threshold</h2> A total of 805 participants died during follow up. The researchers found people who were sedentary for more than 12 hours a day had the highest risk of death (a 38% higher risk than people who were sedentary for eight hours). However, this was only observed in those who did less than 22 minutes of moderate to vigorous physical activity daily. So for people who did more than 22 minutes of exercise, there was no longer a significantly heightened risk – that is, the risk became generally similar to those who were sedentary for eight hours. Higher daily duration of physical activity was consistently associated with lower risk of death, regardless of total sedentary time. For example, the team reported an additional ten minutes of moderate to vigorous physical activity each day could lower mortality risk by up to 15% for people who were sedentary less than 10.5 hours a day. For those considered highly sedentary (10.5 hours a day or more), an additional ten minutes lowered mortality risk by up to 35%. <h2>The study had some limitations</h2> The team couldn’t assess how changes in physical activity or sedentary time over several months or years may affect risk of death. And the study included only participants aged 50 and above, making results less applicable to younger age groups. Further, cultural and lifestyle differences between countries may have influenced how data between studies was measured and analysed. Ultimately, because this study was observational, we can’t draw conclusions on cause and effect with certainty. But the results of this research align with a growing body of evidence exploring the relationship between physical activity, sedentary time, and death. <h2>It’s positive news</h2> Research has previously suggested <a href="https://bjsm.bmj.com/content/54/24/1499">physical activity may offset</a> health risks associated with <a href="https://www.jacc.org/doi/abs/10.1016/j.jacc.2019.02.031">high sedentary time</a>. The good news is, even short bouts of exercise can have these positive effects. In this study, the 22 minutes wasn’t necessarily done all at once. It was a total of the physical activity someone did in a day, and would have included incidental exercise (activity that’s part of a daily routine, such as climbing the stairs). Several studies using wearable devices have found short bursts of high-intensity everyday activities such as stair climbing or energetic outdoor home maintenance activities such as mowing the lawn or cleaning the windows can lower <a href="https://www.nature.com/articles/s41591-022-02100-x">mortality</a>, <a href="https://academic.oup.com/eurheartj/article/43/46/4801/6771381">heart disease</a> and <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">cancer</a> risk. A recent study using wearable devices found moderate to vigorous bouts of activity <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00183-4/fulltext">lasting three to five minutes</a> provide similar benefits to bouts longer than ten minutes when it comes to stroke and heart attack risk. Several other studies have found <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2596007">being active just on the weekend</a> provides similar health benefits as <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2794038">being active throughout the week</a>. Research has also shown the benefits of <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2795819">physical activity</a> and <a href="https://jamanetwork.com/journals/jama/article-abstract/2809418">reducing sedentary time</a> extend to cognitive health. Routines such as desk jobs can foster a sedentary lifestyle that may be difficult to shift. But mixing short bursts of activity into our day can make a significant difference towards improving our health and longevity. Whether it’s a brisk walk during lunch, taking the stairs, or even a short at-home workout, this study is yet another to suggest that every minute counts.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216259/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, Postdoctoral Research Fellow, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-22-minutes-of-exercise-a-day-could-reduce-the-health-risks-from-sitting-too-long-216259">original article</a>.

Body

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>. Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease. Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link? <h2>What the study did and found</h2> This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period. Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia. During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. <h2>Important considerations</h2> In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk. Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively. These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable. Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves. This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association. <h2>What does other evidence say?</h2> <a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both. High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too. For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life. <h2>Why the link?</h2> There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia. Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline. Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>. We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<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/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.

Mind

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

<a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with <a href="https://animalmedicinesaustralia.org.au/media-release/more-than-two-thirds-of-australian-households-now-own-a-pet/">a recent survey</a> finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies. While owning a pet is linked to numerous <a href="https://www.onehealth.org/blog/10-mental-physical-health-benefits-of-having-pets">mental and physical health benefits</a>, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low. But some, such as pregnant people and those with weakened immune systems, are at <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/index.html">greater risk</a> of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections. <h2>What diseases can pets carry?</h2> Infectious diseases that move from animals to humans are called zoonotic diseases or <a href="https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html">zoonoses</a>. More than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668296/#B18">70 pathogens</a> of companion animals are known to be transmissible to people. Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs. Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water. Studies suggest <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500695/">the prevalence of pet-associated zoonoses is low</a>. However, the true number of infections is likely <a href="https://www.mdpi.com/1660-4601/17/11/3789">underestimated</a> since many zoonoses are not “<a href="https://www.healthdirect.gov.au/notification-of-illness-and-disease">notifiable</a>”, or may have multiple exposure pathways or generic symptoms. Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. <a href="https://www.who.int/data/gho/data/themes/topics/rabies">In endemic regions in Africa and Asia</a>, dogs are the main source of rabies which is transmitted through saliva. Dogs also commonly carry Capnocytophaga bacteria <a href="https://www.cdc.gov/capnocytophaga/index.html">in their mouths and saliva</a>, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, <a href="https://www.cdc.gov/capnocytophaga/signs-symptoms/index.html">resulting</a> in severe illness and sometimes death. Just last week, such a death <a href="https://thewest.com.au/news/wa/tracy-ridout-perth-mum-dies-11-days-after-rare-bacterial-infection-from-minor-dog-bite-c-11748887">was reported in Western Australia</a>. Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray. Cats can also sometimes transmit infections through bites and scratches, including the aptly named <a href="https://www.cdc.gov/healthypets/diseases/cat-scratch.html#:%7E:text=Cat%20scratch%20disease%20(CSD)%20is,the%20surface%20of%20the%20skin.">cat scratch disease</a>, which is caused by the bacterium Bartonella henselae. Both dogs and cats are also reservoirs for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122942/">methicillin-resistant bacterium Staphylococcus aureus</a> (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission. <h2>Birds, turtles and fish can also transmit disease</h2> But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit <a href="https://www.cdc.gov/pneumonia/atypical/psittacosis/">psittacosis</a>, a bacterial infection which causes pneumonia. Contact with <a href="https://www.fda.gov/animal-veterinary/animal-health-literacy/pet-turtles-source-germs">pet turtles</a> has been linked to Salmonella infections in humans, particularly in young children. Even pet fish have been linked to a <a href="https://www.cdc.gov/healthypets/pets/fish.html">range of bacterial infections</a> in humans, including vibriosis, mycobacteriosis and salmonellosis. Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. <a href="https://pubmed.ncbi.nlm.nih.gov/19398275/">A study from the Netherlands</a> found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink. Kissing pets has also been linked to occasional zoonotic infections in pet owners. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298380/">In one case</a>, a woman in Japan developed meningitis due to Pasteurella multicoda infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats. Young children are also more likely to engage in behaviours which increase their risk of <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthypets%2Fspecific-groups%2Fchildren.html">getting sick</a> from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets. Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed. For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or <a href="https://www.nhs.uk/common-health-questions/pregnancy/what-are-the-risks-of-toxoplasmosis-during-pregnancy/">cause birth defects in foetuses</a>. <h2>What should I do if I’m worried about catching a disease from my pet?</h2> There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include: <ul> <li>washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces</li> <li>not allowing your pets to lick your face or open wounds</li> <li>supervising young children when they are playing with pets and when washing their hands after playing with pets</li> <li>wearing gloves when changing litter trays or cleaning aquariums</li> <li>wetting bird cage surfaces when cleaning to minimise aerosols</li> <li>keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces)</li> <li>keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments</li> <li>seeking veterinary care if you think your pet is unwell.</li> </ul> It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.<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/210898/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-mclean-1351935">Sarah McLean</a>, Lecturer in environmental health, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Getty Images 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/is-it-okay-to-kiss-your-pet-the-risk-of-animal-borne-diseases-is-small-but-real-210898">original article</a>.

Family & Pets

Not all mental health apps are helpful. Experts explain the risks, and how to choose one wisely

<a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> There are thousands of mental health apps available on the app market, offering services including meditation, mood tracking and counselling, among others. You would think such “health” and “wellbeing” apps – which often present as solutions for conditions such as <a href="https://www.headspace.com/">anxiety</a> and <a href="https://www.calm.com">sleeplessness</a> – would have been rigorously tested and verified. But this isn’t necessarily the case. In fact, many may be taking your money and data in return for a service that does nothing for your mental health – at least, not in a way that’s backed by scientific evidence. <h2>Bringing AI to mental health apps</h2> Although some mental health apps connect users with a <a href="https://www.betterhelp.com/get-started/?go=true&utm_source=AdWords&utm_medium=Search_PPC_c&utm_term=betterhelp+australia_e&utm_content=133525856790&network=g&placement=&target=&matchtype=e&utm_campaign=15228709182&ad_type=text&adposition=&kwd_id=kwd-401317619253&gclid=Cj0KCQjwoeemBhCfARIsADR2QCtfZHNw8mqpBe7cLfLtZBD-JZ5xvAmDCfol8npbAAH3ALJGYvpngtoaAtFlEALw_wcB¬_found=1&gor=start">registered therapist</a>, most provide a fully automated service that bypasses the human element. This means they’re not subject to the same standards of care and confidentiality as a registered mental health professional. Some aren’t even designed by mental health professionals. These apps also increasingly claim to be incorporating artificial intelligence into their design to make personalised recommendations (such as for meditation or mindfulness) to users. However, they give little detail about this process. It’s possible the recommendations are based on a user’s previous activities, similar to Netflix’s <a href="https://help.netflix.com/en/node/100639">recommendation algorithm</a>. Some apps such as <a href="https://legal.wysa.io/privacy-policy#aiChatbot">Wysa</a>, <a href="https://www.youper.ai/">Youper</a> and <a href="https://woebothealth.com/">Woebot</a> use AI-driven chatbots to deliver support, or even established therapeutic interventions such as cognitive behavioural therapy. But these apps usually don’t reveal what kinds of algorithms they use. It’s likely most of these AI chatbots use <a href="https://www.techtarget.com/searchenterpriseai/feature/How-to-choose-between-a-rules-based-vs-machine-learning-system">rules-based systems</a> that respond to users in accordance with predetermined rules (rather than learning on the go as adaptive models do). These rules would ideally prevent the unexpected (and often <a href="https://www.vice.com/en/article/pkadgm/man-dies-by-suicide-after-talking-with-ai-chatbot-widow-says">harmful and inappropriate</a>) outputs AI chatbots have become known for – but there’s no guarantee. The use of AI in this context comes with risks of biased, discriminatory or completely inapplicable information being provided to users. And these risks haven’t been adequately investigated. <h2>Misleading marketing and a lack of supporting evidence</h2> Mental health apps might be able to provide certain benefits to users if they are well designed and properly vetted and deployed. But even then they can’t be considered a substitute for professional therapy targeted towards conditions such as anxiety or depression. The <a href="https://theconversation.com/pixels-are-not-people-mental-health-apps-are-increasingly-popular-but-human-connection-is-still-key-192247">clinical value</a> of automated mental health and mindfulness apps is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1077722918300233?casa_token=lwm1E6FhcG0AAAAA:saV7szbZl4DqbvmZiomLG9yMWi_4-zbmy3QCtQzVEQr957QX1E7Aiqkm5BcEntR0mVFgfDVo">still being assessed</a>. Evidence of their efficacy is generally <a href="https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000002">lacking</a>. Some apps make ambitious claims regarding their effectiveness and refer to studies that supposedly support their benefits. In many cases these claims are based on less-than-robust findings. For instance, they may be based on: <ul> <li><a href="https://sensa.health/">user testimonials</a></li> <li>short-term studies with narrow <a href="https://www.wired.co.uk/article/mental-health-chatbots">or homogeneous cohorts</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9533203/">studies involving</a> researchers or funding from the very group <a href="https://www.theguardian.com/us-news/2022/apr/13/chatbots-robot-therapists-youth-mental-health-crisis">promoting the app</a></li> <li>or evidence of the benefits of a <a href="https://www.headspace.com/meditation/anxiety">practice delivered face to face</a> (rather than via an app).</li> </ul> Moreover, any claims about reducing symptoms of poor mental health aren’t carried through in contract terms. The fine print will typically state the app does not claim to provide any physical, therapeutic or medical benefit (along with a host of other disclaimers). In other words, it isn’t obliged to successfully provide the service it promotes. For some users, mental health apps may even cause harm, and lead to increases in the very <a href="https://pubmed.ncbi.nlm.nih.gov/34074221/">symptoms</a> people so often use them to address. The may happen, in part, as a result of creating more awareness of problems, without providing the tools needed to address them. In the case of most mental health apps, research on their effectiveness won’t have considered <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505389/">individual differences</a> such as socioeconomic status, age and other factors that can influence engagement. Most apps also will not indicate whether they’re an inclusive space for marginalised people, such as those from culturally and linguistically diverse, LGBTQ+ or neurodiverse communities. <h2>Inadequate privacy protections</h2> Mental health apps are subject to standard consumer protection and privacy laws. While data protection and <a href="https://cybersecuritycrc.org.au/sites/default/files/2021-07/2915_cscrc_casestudies_mentalhealthapps_1.pdf">cybersecurity</a> practices vary between apps, an investigation by research foundation Mozilla <a href="https://foundation.mozilla.org/en/privacynotincluded/articles/are-mental-health-apps-better-or-worse-at-privacy-in-2023">concluded that</a> most rank poorly. For example, the mindfulness app <a href="https://www.headspace.com/privacy-policy">Headspace</a> collects data about users from a <a href="https://foundation.mozilla.org/en/privacynotincluded/headspace/">range of sources</a>, and uses those data to advertise to users. Chatbot-based apps also commonly repurpose conversations to predict <a href="https://legal.wysa.io/privacy-policy">users’ moods</a>, and use anonymised user data to train the language models <a href="https://www.youper.ai/policy/privacy-policy">underpinning the bots</a>. Many apps share so-called <a href="https://theconversation.com/popular-fertility-apps-are-engaging-in-widespread-misuse-of-data-including-on-sex-periods-and-pregnancy-202127">anonymised</a> data with <a href="https://www.wysa.com/">third parties</a>, such as <a href="https://www.headspace.com/privacy-policy">employers</a>, that sponsor their use. Re-identification of <a href="https://www.unimelb.edu.au/newsroom/news/2017/december/research-reveals-de-identified-patient-data-can-be-re-identified">these data</a> can be relatively easy in some cases. Australia’s Therapeutic Goods Administration (TGA) doesn’t require most mental health and wellbeing apps to go through the same testing and monitoring as other medical products. In most cases, they are lightly regulated as <a href="https://www.tga.gov.au/how-we-regulate/manufacturing/medical-devices/manufacturer-guidance-specific-types-medical-devices/regulation-software-based-medical-devices">health and lifestyle</a> products or tools for <a href="https://www.tga.gov.au/sites/default/files/digital-mental-health-software-based-medical-devices.pdf">managing mental health</a> that are excluded from TGA regulations (provided they meet certain criteria). <h2>How can you choose an app?</h2> Although consumers can access third-party rankings for various mental health apps, these often focus on just a few elements, such as <a href="https://onemindpsyberguide.org/apps/">usability</a> or <a href="https://foundation.mozilla.org/en/privacynotincluded/categories/mental-health-apps/">privacy</a>. Different guides may also be inconsistent with each other. Nonetheless, there are some steps you can take to figure out whether a particular mental health or mindfulness app might be useful for you. <ol> <li> consult your doctor, as they may have a better understanding of the efficacy of particular apps and/or how they might benefit you as an individual </li> <li> check whether a mental health professional or trusted institution was involved in developing the app </li> <li> check if the app has been rated by a third party, and compare different ratings </li> <li> make use of free trials, but be careful of them shifting to paid subscriptions, and be wary about trials that require payment information upfront </li> <li> stop using the app if you experience any adverse effects. </li> </ol> Overall, and most importantly, remember that an app is never a substitute for real help from a human professional.<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/211513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, Professor of Law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, Associate Professor, School of Psychological Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, Postdoctoral Research Fellow, Disability Research Initiative, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-mental-health-apps-are-helpful-experts-explain-the-risks-and-how-to-choose-one-wisely-211513">original article</a>.

Mind

Climb the stairs, lug the shopping, chase the kids. Incidental vigorous activity linked to lower cancer risks

<a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Many people know exercise reduces the risk of <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2521826">cancers</a>, including liver, lung, breast and kidney. But structured exercise is time-consuming, requires significant commitment and often financial outlay or travel to a gym. These practicalities can make it infeasible for <a href="https://bjsm.bmj.com/content/42/11/901">most adults</a>. There is <a href="https://www.nature.com/articles/s41591-022-02100-x">very little research</a> on the potential of incidental physical activity for reducing the risk of cancer. Incidental activities can include doing errands on foot, work-related activity or housework as part of daily routines. As such they do not require an extra time commitment, special equipment or any particular practical arrangements. In our <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">study</a> out today, we explored the health potential of brief bursts of vigorous physical activities embedded into daily life. These could be short power walks to get to the bus or tram stop, stair climbing, carrying heavy shopping, active housework or energetic play with children. <h2>How was the study done?</h2> Our <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">new study</a> included 22,398 <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a> participants who had never been diagnosed with cancer before and did not do any structured exercise in their leisure time. Around 55% of participants were female, with an average age of 62. Participants wore wrist activity trackers for a week. Such trackers monitor activity levels continuously and with a high level of detail throughout the day, allowing us to calculate how hard and exactly for how long people in the study were moving. Participants’ activity and other information was then linked to future cancer registrations and other cancer-related health records for the next 6.7 years. This meant we could estimate the overall risk of cancer by different levels of what we call “<a href="https://pubmed.ncbi.nlm.nih.gov/33108651/">vigorous intermittent lifestyle physical activity</a>”, the incidental bursts of activity in everyday life. We also analysed separately a group of <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2521826">13 cancer sites in the body</a> with more established links to exercise, such such as breast, lung, liver, and bowel cancers. Our analyses took into account other factors that influence cancer risk, such as age, smoking, diet, and alcohol habits. <h2>What we found out</h2> Even though study participants were not doing any structured exercise, about 94% recorded short bursts of <a href="https://pubmed.ncbi.nlm.nih.gov/33108651/">vigorous activity</a>. Some 92% of all bouts were done in very short bursts lasting up to one minute. A minimum of around 3.5 minutes each day was associated with a 17–18% reduction in total cancer risk compared with not doing any such activity. Half the participants did at least 4.5 minutes a day, associated with a 20–21% reduction in total cancer risk. For cancers such as breast, lung and bowel cancers, which we know are impacted by the amount of exercise people do, the results were stronger and the risk reduction sharper. For example, a minimum of 3.5 minutes per a day of vigorous incidental activity reduced the risk of these cancers by 28–29%. At 4.5 minutes a day, these risks were reduced by 31–32%. For both total cancer and those known to be linked to exercise, the results clearly show the benefits of doing day-to-day activities with gusto that makes you huff and puff. <h2>Our study had its limits</h2> The study is observational, meaning we looked at a group of people and their outcomes retrospectively and did not test new interventions. That means it cannot directly explore cause and effect with certainty. However, we took several statistical measures to minimise the possibility those with the lowest levels of activity were not the unhealthiest, and hence the most likely to get cancer – a phenomenon called “<a href="https://www.sciencedirect.com/topics/computer-science/reverse-causation">reverse causation</a>”. Our study can’t explain the biological mechanisms of how vigorous intensity activity may reduce cancer risk. Previous <a href="https://journals.lww.com/acsm-msse/Fulltext/2017/02000/Brief_Intense_Stair_Climbing_Improves.10.aspx">early-stage trials</a> show this type of activity leads to rapid improvements in heart and lung fitness. And higher fitness is linked to lower <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002934320300097">insulin resistance</a> and lower <a href="https://www.sciencedirect.com/science/article/pii/S0735109704017036">chronic inflammation</a>. High levels of these are risk <a href="https://www.sciencedirect.com/science/article/pii/S0735109704017036">factors for cancer</a>. There is very little research on incidental physical activity and cancer in general, because most of the scientific evidence on lifestyle health behaviours and cancer is based on questionnaires. This method doesn’t capture short bursts of activity and is very inaccurate for measuring the incidental activities of daily life. So the field of vigorous intensity activity and cancer risk is at its infancy, despite some <a href="https://academic.oup.com/eurheartj/article/43/46/4801/6771381">very promising</a> recent findings that vigorous activity in short bouts across the week could cut health risks. In another recent study of ours, we found benefits from daily <a href="https://www.nature.com/articles/s41591-022-02100-x%22%22">vigorous intermittent lifestyle activity</a> on the risk of death overall and death from cancer or cardiovascular causes. <h2>In a nutshell: get moving in your daily routine</h2> Our study found 3 to 4 minutes of vigorous incidental activity each day is linked with decreased cancer risk. This is a very small amount of activity compared to <a href="https://bjsm.bmj.com/content/54/24/1451">current recommendations</a> of 150–300 minutes of moderate intensity or 75–150 minutes of vigorous intensity activity a week. Vigorous incidental physical activity is a promising avenue for cancer prevention among people unable or unmotivated to exercise in their leisure time. Our study also highlights the potential of technology. These results are just a glimpse how wearables combined with machine learning – which our study used to identify brief bursts of vigorous activity – can reveal health benefits of unexplored aspects of our lives. The future potential impact of such technologies to prevent cancer and possibly a <a href="https://www.nature.com/articles/s41591-022-02100-x">host of other</a> conditions could be very large.<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/210288/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, Postdoctoral Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/climb-the-stairs-lug-the-shopping-chase-the-kids-incidental-vigorous-activity-linked-to-lower-cancer-risks-210288">original article</a>.

Body

More than a game: Crosswords and puzzles may reduce dementia risk

Playing games, doing crosswords, writing letters or learning something new are all associated with reduced dementia risk in older adults, according to a large, long-term study. A team of Melbourne and US-based researchers study tracked 10,318 older Australians over a period of ten years (2010 to 2020), collecting detailed information on the types of leisure activities they engaged in, along with regular health checks and cognitive assessments. The study is <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807256" target="_blank" rel="noreferrer noopener">published</a> in JAMA Network Open. Paper co-author Dr Joanne Ryan from Monash University says “the findings show that engaging in mentally stimulating activities can help preserve cognitive function and may help delay the onset of dementia.” “We know the importance of physical activity. We need to think about helping to keep our mind stimulated as well.” <iframe title="Why do Women Live Longer than Men? And What About Gender Diverse People?" src="https://omny.fm/shows/huh-science-explained/why-do-women-live-longer-than-men-and-what-about-g/embed?in_playlist=podcast&style=Cover" width="100%" height="180" frameborder="0"></iframe> Adult literacy activities such as writing, using a computer or taking education classes were associated with an 11% lower risk of dementia, the study found. Active mental health activities such as playing games or doing puzzles were associated with a 9% lower risk. Creative activities like craft or woodwork and passive mental activities (reading books, watching television or listening to the radio) also reduced risks but to a lesser extent. Meanwhile, social activities were not associated with dementia risk. Ryan says this was a “little bit unexpected”. But she says it’s possible one of the reasons is those who volunteered to participate in the study were broadly already socially engaged. The median age of those participating in the study was 73.8 years. Around 2% of the cohort participating in the study developed dementia, Ryan says. Dementia risk varies depending on age and health status of individuals, she says. For instance, “we know that the risk of dementia actually increases exponentially as you get then over 80 years and over 90 years,” she says. Image credits: Getty Images <div id="contributors"> <a href="https://cosmosmagazine.com/health/body-and-mind/more-than-a-game-crosswords-and-puzzles-may-reduce-dementia-risk/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock">Petra Stock</a>. </div>

Mind

Does artificial sweetener aspartame really cause cancer? What the WHO listing means for your diet soft drink habit

<a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> The International Agency for Research on Cancer (IARC), which is the specialised cancer agency of the World Health Organization, has declared aspartame may be a <a href="https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released">possible carcinogenic hazard to humans</a>. Another branch of the WHO, the Joint WHO and Food and Agriculture Organization’s Expert Committee on Food Additives has assessed the risk and developed recommendations on how much aspartame is safe to consume. They have recommended the acceptable daily intake be 0 to 40mg per kilo of body weight, as we currently have <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame/Pages/default.aspx">in Australia</a>. A hazard is different to a risk. The hazard rating means it’s an agent that is capable of causing cancer; a risk measures the likelihood it could cause cancer. So what does this hazard assessment mean for you? <h2>Firstly, what is aspartame?</h2> <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame/Pages/default.aspx">Aspartame is an artificial sweetener</a> that is 200 times sweeter than sugar, but without any kilojoules. It’s used in a <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame/Pages/default.aspx">variety of products</a> including carbonated drinks such as Coke Zero, Diet Coke, Pepsi Max and some home brand offerings. You can identify aspartame in drinks and foods by looking for additive number 951. Food products such as yogurt and confectionery may also contain aspartame, but it’s not stable at warm temperatures and thus not used in baked goods. Commercial names of aspartame include Equal, Nutrasweet, Canderel and Sugar Twin. In Australia the acceptable daily intake is 40mg per kilo of body weight per day, which is about 60 sachets. <a href="https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food#:%7E:text=How%20many%20packets%20can%20a,based%20on%20its%20sweetness%20intensity%3F&text=Notes%20About%20the%20Chart%3A,50%20mg%2Fkg%20bw%2Fd">In America</a> the acceptable daily intake has been set at 75 sachets. <h2>What evidence have they used to come to this conclusion?</h2> <a href="https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released">IARC looked closely</a> at the <a href="https://cdn.who.int/media/docs/default-source/nutrition-and-food-safety/july-13-final-summary-of-findings-aspartame.pdf?sfvrsn=a531e2c1_5&download=true">evidence base</a> from around the world – using data from observational studies, experimental studies and animal studies. They found there was some limited evidence in human studies linking aspartame and cancer (specifically liver cancer) and limited evidence from animal studies as well. They also considered the biological mechanism studies which showed how cancer may develop from the consumption of aspartame. Usually these are lab-based studies which show exactly how exposure to the agent may lead to a cancer. In this case they found there was limited evidence for how aspartame might cause cancer. There were only three human studies that looked at cancer and aspartame intake. These large observational studies used the intake of soft drinks as an indicator of aspartame intake. All three found a positive association between artificially sweetened beverages and liver cancer in either all of the population they were studying or sub-groups within them. But these studies could not rule out other factors that may have been responsible for the findings. A study <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284800/">conducted in Europe</a> followed 475,000 people for 11 years and found that each additional serve of diet soft drink consumed per week was linked to a 6% increased risk of liver cancer. However the scientists did conclude that due to the rarity of liver cancer they still had small numbers of people in the study. <a href="https://pubmed.ncbi.nlm.nih.gov/35728406/">In a study from the US</a>, increased risk of liver cancer was seen in people with diabetes who drank more than two or more cans of a diet soda a week. The <a href="https://aacrjournals.org/cebp/article/31/10/1907/709398/Sugar-and-Artificially-Sweetened-Beverages-and">third study</a>, also from the US, found an increase in liver cancer risk in men who never smoked and drank two or more artificially sweetened drinks a day. From this they have decided to declare aspartame as a Group 2b “possible carcinogen”. But they have also said more and better research is needed to further understand the relationship between aspartame and cancer. IARC has four categories (groupings) available for potential substances (or as they are referred to by IARC, “agents”) that may cause cancer. <h2>What does each grouping mean?</h2> Group 1 Carcinogenic to humans: an agent in this group is carcinogenic, which means there is convincing evidence from human studies and we know precisely how it causes cancer. There are 126 agents in this group, including tobacco smoking, alcohol, processed meat, radiation and ionising radiation. Group 2a Probably carcinogenic to humans: there are positive associations between the agent and cancer in humans, but there may still be other explanations for the association which were not fully examined in the studies. There are 95 agents in this group, including red meat, DDT insecticide and night shift work. Group 2b Possibly carcinogenic in humans: this means limited evidence of causing cancer in humans, but sufficient evidence from animal studies, or the mechanism of how the agent may be carcinogenic is well understood. This basically means the current evidence indicates an agent may possibly be carcinogenic, but more scientific evidence from better conducted studies is needed. There are now <a href="https://monographs.iarc.who.int/agents-classified-by-the-iarc/">323</a> agents in this group, including aloe vera (whole leaf extract), ginkgo biloba and lead. Group 3 Not classifiable as a carcinogen: there’s not enough evidence from humans or animals, and there is limited mechanistic evidence of how it may be a carcinogen. There are 500 agents in this group. <h2>So do I have to give up my diet soft drink habit?</h2> For a 70kg person you would need to consume about 14 cans (over 5 litres) of soft drink sweetened with aspartame a day to reach the acceptable daily intake. But we need to remember there may also be aspartame added in other foods consumed. So this is an unrealistic amount to consume, but not impossible. We also need to consider all the evidence on aspartame together. The foods we typically see aspartame in are processed or ultra-processed, which have recently also been <a href="https://theconversation.com/ultra-processed-foods-are-trashing-our-health-and-the-planet-180115">shown to be detrimental to health</a>. And artificial sweeteners (including aspartame) <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892765/#!po=59.3750">can make people crave more sugar</a>, making them want to eat more food, potentially causing them to gain more weight. All together, this indicates we should be more careful about the amount of artificial sweeteners we consume, since they <a href="https://theconversation.com/the-who-says-we-shouldnt-bother-with-artificial-sweeteners-for-weight-loss-or-health-is-sugar-better-205827">do not provide any health benefits</a>, and have possible adverse effects. But overall, from this evidence, drinking the occasional or even daily can of a diet drink is safe and probably not a cancer risk. <hr /> Correction: this article originally stated each serve of soft drink in a study was linked to a 6% increased risk of liver cancer, however it was each additional serve per week. This has been amended.<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/208844/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-artificial-sweetener-aspartame-really-cause-cancer-what-the-who-listing-means-for-your-diet-soft-drink-habit-208844">original article</a>.

Body

Why is extreme ‘frontier travel’ booming despite the risks?

<a href="https://theconversation.com/profiles/anne-hardy-151480">Anne Hardy</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/can-seng-ooi-399312">Can Seng Ooi</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/hanne-e-f-nielsen-139245">Hanne E.F. Nielsen</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/joseph-m-cheer-104606">Joseph M. Cheer</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> The world has watched in shock as rescue crews feverishly search for the <a href="https://oceangate.com/our-subs/titan-submersible.html">Titan</a> submersible vehicle, which <a href="https://www.theguardian.com/uk-news/2023/jun/19/titanic-tourist-submarine-missing-north-atlantic">disappeared</a> while attempting to take tourists to view the wreckage of the Titanic in the North Atlantic. The horror of the incident raises questions as to why people engage in risky tourism activities in remote locations and whether there should be more restrictions to what adrenaline-seeking tourists can do. <h2>What is frontier tourism?</h2> This type of travel, known as “<a href="https://research.monash.edu/en/publications/frontier-tourism-retracing-mythic-journeys">frontier tourism</a>”, is becoming big business. The wider adventure tourism industry is already worth <a href="https://www.futuremarketinsights.com/reports/adventure-tourism-market">billions of dollars</a> – and is growing quickly. Frontier tourism is an exclusive and extreme form of adventure travel. The trips are very expensive, aim to overstimulate the senses and go to the outer limits of our planet – the deep oceans, high mountains, polar areas – and even space. Frontier tourism is not new; humans have explored remote locations for millennia. Pasifika people used the stars to navigate the oceans for migration and trade. Europeans sailed to the edges of what they believed to be a flat Earth. In recent years, however, frontier tourism has attracted widespread attention thanks to the common occurrence of long queues on <a href="https://theconversation.com/70-years-after-the-first-ascent-of-everest-the-impact-of-mass-mountaineering-must-be-confronted-204270">Mount Everest</a>, the trending <a href="https://www.tiktok.com/discover/Drake-Shake">TikTok phenomenon</a> of crossing the #DrakePassage in <a href="https://theconversation.com/more-than-100-000-tourists-will-head-to-antarctica-this-summer-should-we-worry-about-damage-to-the-ice-and-its-ecosystems-192843">Antarctica</a> and the rapid development of <a href="https://theconversation.com/virgin-galactics-use-of-the-overview-effect-to-promote-space-tourism-is-a-terrible-irony-206868">space tourism</a> for the wealthy. The rise of travel content sharing on social media and <a href="https://www.tandfonline.com/doi/abs/10.1080/10548408.2021.2006858?journalCode=wttm20">revenge travel following COVID-19</a> have contributed to the surge in its popularity. <blockquote class="twitter-tweet"> When you’re happily having dinner and the ocean decides to scare the shit out of you! Cue debate around just how strong those windows are… <a href="https://twitter.com/hashtag/DrakePassage?src=hash&ref_src=twsrc%5Etfw">#DrakePassage</a> <a href="https://twitter.com/hashtag/SouthernOcean?src=hash&ref_src=twsrc%5Etfw">#SouthernOcean</a> <a href="https://twitter.com/hashtag/BigSwell?src=hash&ref_src=twsrc%5Etfw">#BigSwell</a> <a href="https://t.co/OLDq5W2Wkm">pic.twitter.com/OLDq5W2Wkm</a> — Dan Brown (@DanBrownNature) <a href="https://twitter.com/DanBrownNature/status/1598669901350293509?ref_src=twsrc%5Etfw">December 2, 2022</a></blockquote> <h2>Why are we so obsessed with extreme forms of tourism?</h2> Risky activities release chemicals in the brain that can be addictive. Research <a href="https://doi.org/10.1177/0013916594261001">suggests</a> engaging in risky tourism activities, such as scaling a high mountain, can bring about feelings of accomplishment and euphoria. Travellers report feeling alive and experiencing a sense of transformation. Some are also <a href="https://doi.org/10.1080/09669582.2021.1897131">attracted</a> to the pristine, untouched and remote aspects of the locations that they visit. Furthermore, the <a href="https://www.nytimes.com/2023/06/20/movies/james-cameron-titanic.html">element of fantasy</a> associated with imagining certain places or stories, like the movie Titanic, can be alluring. Besides physical frontiers, there is also the <a href="https://www.cabidigitallibrary.org/doi/10.1079/9781780642093.0111">thrill people get</a> at pushing the human body to its limits and facing one’s fears. Base-jumping, skydiving, bungee jumping and polar plunges are common examples of this. In a slightly more mundane way, even tasting “<a href="https://journals.sagepub.com/doi/10.1177/1356766709104271">scary food</a>” pushes tourists outside of their comfort zone and helps them <a href="https://www.insider.com/harvard-psychologist-why-wealthy-seek-high-risk-trips-titanic-space-2023-6">feel alive</a>. Still others make extreme tourist journeys to follow in the <a href="https://www.nebraskapress.unl.edu/nebraska/9781496221216/">footsteps of their heroes</a>, such as those who travel to Antarctica to pay homage to explorer Ernest Shackleton. Extreme and risky activities not only make participants feel euphoric, but they also convey status. When bucket lists are ticked off and experiences shared on social media, this brings bragging rights. <a href="https://www.cambridge.org/core/journals/polar-record/article/from-awe-to-satisfaction-immediate-affective-responses-to-the-antarctic-tourism-experience/2B65FEDCEF9D7DEBB689C39C93549702">Research</a> suggests many travellers seek recognition for undertaking the first, longest or most extreme experiences possible. But frontier tourism is clearly not for all. It is usually only accessible to a privileged few, as the tragic circumstances of the Titan highlight. Passengers onboard the vessel reportedly paid <a href="https://www.bbc.com/news/world-us-canada-65953872">US$250,000</a> for the voyage. <h2>What are the impacts of frontier tourism?</h2> Beyond the unspeakable angst that friends and family must endure when things go wrong, there are many other impacts of this form of tourism. This type of travel can create <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003219866-11/tourist-experiences-attention-products-seng-ooi">environmental harm and negatively impact local communities</a>. For example, after decades of mass mountaineering, the environmental <a href="https://theconversation.com/70-years-after-the-first-ascent-of-everest-the-impact-of-mass-mountaineering-must-be-confronted-204270">impact</a> on Mount Everest must be addressed. And when mishaps do occur, the cost of search and rescue efforts can be massive and put rescue teams at great risk. The plight of frontier tourists are usually the focus of media reports, while emergency responders are often overlooked. Recent efforts by sherpas such as <a href="https://www.netflix.com/au/title/81464765">Nimsdai Purja</a> are trying to overcome this issue. Through the Netflix documentary, 14 Peaks, he publicises the behind-the-scene preparations and heavy lifting work done by sherpas who guide and rescue tourists up Everest and other mountains. <blockquote class="twitter-tweet"> Climbers have been filmed crushed together in a “human traffic jam” as they battle the elements in an attempt to reach the summit of Mount Everest. Terrifying. <a href="https://t.co/pehNmJCPdP">https://t.co/pehNmJCPdP</a> <a href="https://t.co/nxVhADM0L8">pic.twitter.com/nxVhADM0L8</a> — news.com.au (@newscomauHQ) <a href="https://twitter.com/newscomauHQ/status/1133978847387430912?ref_src=twsrc%5Etfw">May 30, 2019</a></blockquote> <h2>Frontier tourism is not going away</h2> Despite tragedies like the Titan disappearance, tourists remain attracted to the quest for the most unique experiences in the most remote, uncharted places. Tourists also increasingly feel able to embark on trips once perceived as too dangerous because technology and other innovations have ostensibly made them safer and more accessible. In many instances that danger remains, but the commercial transaction <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1835-9310.2002.tb00213.x">strips away the perceived risks</a> involved. Marketing materials aim to sell “safe” adventures, with the risks are often listed in the fineprint. A <a href="https://www.tandfonline.com/doi/full/10.1080/11745398.2017.1286512">polar plunge</a> in Antarctica, for instance, is often marketed as safe because participants are attached to a tether and the swim time is limited to prevent hypothermia. Two decades ago, in forecasting the growth of space tourism, anthropologist Valene Smith <a href="https://www.tandfonline.com/doi/pdf/10.1080/02508281.2000.11014920">said</a> what tourists want, the industry will provide. This has become a truism, as the Titan voyages demonstrate. The massive growth of frontier tourism could lead to even greater problems if the industry doesn’t respond in the right way. If travellers are going to expose themselves to extreme risks, whose responsibility is it, then, to ensure their safety and recovery should accidents occur? Many tourism businesses and travel insurance companies make risks known to their guests. But regulations on disclosing risks differ between countries. These means travellers may have to evaluate the risks themselves, and this is fraught with danger if company standards are low. One solution is frontier tourism might be best experienced in controlled and safe environments through <a href="https://www.tandfonline.com/doi/full/10.1080/14616688.2023.2224043">digital storytelling</a> or <a href="https://www.mdpi.com/2071-1050/15/4/3348">augmented and mixed reality</a>. However, this may not be enough to satisfy the adrenaline junkies out there. As the Titan incident illustrates, the unpredictable nature and unintended consequences of frontier tourism are very real things. While money can allow us to travel almost anywhere, it’s worth considering whether some places should just remain untouched, sacred and off limits completely.<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/208201/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/anne-hardy-151480">Anne Hardy</a>, Associate Professor, Tourism and Society, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/can-seng-ooi-399312">Can Seng Ooi</a>, Professor, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/hanne-e-f-nielsen-139245">Hanne E.F. Nielsen</a>, Senior lecturer, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/joseph-m-cheer-104606">Joseph M. Cheer</a>, Professor of Sustainable Tourism and Heritage | Co Chair - World Economic Forum Global Future Council on the Future of Sustainable Tourism, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: OceanGate 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-is-extreme-frontier-travel-booming-despite-the-risks-208201">original article</a>.

Travel Tips

Disaster, opulence, and the merciless ocean: why the Titanic disaster continues to enthral

<a href="https://theconversation.com/profiles/kristie-patricia-flannery-1220337">Kristie Patricia Flannery</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> The question on many minds this week is why did some of the world’s richest men risk death to venture to the bottom of the sea in a cold and cramped <a href="https://www.nytimes.com/2023/06/20/us/oceangate-titanic-missing-submersible.html">“experimental” submersible</a> for a chance to glimpse the wreck of the Titanic? The “unsinkable” ship that sunk on its maiden voyage across the Atlantic in 1912 after colliding with an iceberg is arguably the world’s most well-known boat. The Titanic is recognisable to more of the world’s population than, say, the Niña, the Pinta, and the Santa Maria (Christopher Colombus’s fleet that launched the Spanish conquest of the Americas), or Captain Cook’s HMS Endeavour (the tall ship that set in motion the British conquest of Australia). The Endeavour’s long-forgotten wreck was found scuttled off the coast of Rhode Island <a href="https://theconversation.com/has-captain-cooks-ship-endeavour-been-found-debate-rages-but-heres-whats-usually-involved-in-identifying-a-shipwreck-176363">just last year</a>. The Titanic’s maiden voyage and calamitous end was one of the biggest news stories of 1912, and has continued to fascinate us ever since. The disaster inspired songs and multiple films in the twentieth century, including James Cameron’s 1997 epic romance, which long reigned as the <a href="https://en.wikipedia.org/wiki/List_of_highest-grossing_films#Timeline_of_highest-grossing_films">highest-grossing film of all time</a>. More recently, Titanic exhibitions that invite visitors to examine relics and <a href="https://titanicexhibition.com/nyc/#sec_instafeed">explore the ship’s recreated rooms have attracted huge crowds in New York, Seville and Hong Kong</a>. <h2>Opulence and immigrants</h2> There are two reasons why we are so drawn to the Titanic, and why the super-rich are apparently willing to part with their money and even risk their lives to catch a glimpse of its broken hull. The first is its opulence. The White Start Line that built the Titanic advertised the ship as the most luxurious ever to set sail. Wealthy passengers paid up to £870 for the privilege of occupying the Titanic’s most expensive and spacious first-class cabins. To put this 110-year-old money in perspective, when the first world war broke out in 1914, infantry soldiers in the British army were paid a basic salary of around £20 per year. Titanic movies and exhibitions are popular because audiences enjoy the voyeurism of gazing on the ship’s beautiful furnishings, the stunning clothes worn by its rich and beautiful passengers, and their elaborate meals in fancy restaurants. First-class passengers feasted on <a href="https://online.ucpress.edu/gastronomica/article-abstract/9/4/32/93511/The-Night-the-Good-Ship-Went-Down-Three-Fateful">multi-course dinners</a> with salmon, steak, and pâté de foie gras. Chefs in Australia and around the globe occasionally <a href="https://www.timeout.com/melbourne/things-to-do/titanic-dining-experience">recreate Titanic meals</a> for curious clients. Hundreds of poor immigrant passengers, represented by Jack (played by Leonardo DiCaprio) in Cameron’s movie, were also aboard the Titanic. They lived in crowded quarters and enjoyed less thrilling meals such as boiled beef and potatoes. If their ilk were the only people on board the Titanic, the ship would arguably have faded quickly from memory. <figure><iframe src="https://www.youtube.com/embed/erAQ9LkftwA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>The power of the sea</h2> The fact the Titanic was touted as unsinkable also adds to its allure. The ship, whose name evoked its massive size, was engineered to cheat the ocean. When it departed England it symbolised man’s domination over nature. At the bottom of the Atlantic, it serves as a visceral reminder of the indomitable sea’s awesome power. The same two factors - the excess of the voyage, and its defeat by the sea – are now driving the current global interest in the Titan submersible disaster. Few world events garner so much attention, including statements from Downing Street and the White House, and live news blogs from The New York Times and the Guardian. The Titan, like the Titanic, commands our attention because of its obscenely rich passengers, who each reportedly paid US$250,000 (or between four and five times the average US salary) to visit the wreck of the famous ship that battled the sea and lost. And then there is the intriguing mystery and power of the sea. News outlets are publishing helpful graphics that try to teach our terrestrial brains to comprehend just how deep the ocean is, and how far below the sea’s surface the Titanic and possibly the Titan lie. <h2>The limits of human knowledge</h2> Last night I spied <a href="https://neal.fun/deep-sea/">Neal Argawal’s Deep Sea</a> website circulating on social media. The site allows viewers to scroll from the sea surface to the sea floor, diving down past images of various marine animals that inhabit different oceanic depths. At 114 metres is an orca, and 332m marks the the deepest depth a human has ever reached using SCUBA gear. It takes a lot of scrolling to descend to the Titanic almost 4,000m below the waves. Besides gross income inequality, reflecting on the Titan and the Titanic invite us to confront just how little we can “see” of the sea in this age of mass surveillance. Not even the powerful US navy, assisted by the Canadian, UK and French governments, can muster the resources and technology required to locate, let alone rescue, the missing submersible. As the sea seems to have swallowed yet another ship, we are reminded of limits of human knowledge and mastery over the ocean.<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/208200/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kristie-patricia-flannery-1220337">Kristie Patricia Flannery</a>, Research Fellow, Institute for Humanities and Social Sciences, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Image credits: Getty Images 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/disaster-opulence-and-the-merciless-ocean-why-the-titanic-disaster-continues-to-enthral-208200">original article</a>.

Travel Tips

Why being married cuts your risk of skin cancer

A new study has found that married couples are less likely to die of skin cancer because they spot warning signs earlier than singles. The study, which observed 50,000 American skin cancer patients, found that 45.7 per cent of those who were married, had stage 1 tumours – which have a 98 per cent survival rate. The chance of catching skin cancer early dropped 32 per cent for singles, 38 per cent for divorcees and 70 per cent for widowers. The researchers from the University of Pennsylvania said they were stunned by the striking difference in diagnoses. The researchers believe these findings should help dermatologists adjust their advice to patients based on their relationship status, suggesting screening at an earlier age for single patients and encouraging home-screen training for those in relationships. Victims of melanoma, the deadliest form of skin cancer, are expected to increase by seven per cent by 2035. For those diagnosed with stage 1 disease, the five-year survival is reportedly 98 per cent. The five-year survival drops to 62 per cent for those diagnosed with stage 3 disease The study, published in the Journal of the American Heart Association, aimed to investigate how lifestyle and relationships could impact patients’ early detection chances. “Spouses likely facilitate early detection of melanomas by assisting in identification of pigmented lesions that may have otherwise gone unnoticed,” said corresponding author Dr Cimarron Sharon, a dermatologist at the Hospital of the University of Pennsylvania. “They may also provide support and encouragement to see a physician for evaluation. “Thus, married patients are likely to receive a better prognosis because of earlier surgical management.” The study also found that married patients were more likely than single, divorced or widowed patients to have a sentinel lymph node biopsy. SLNB is linked to survival as the sentinel lymph node is closest to a tumour and is the first place it would spread. Dr Sharon said this could be “associated with the spouse's role in supporting the patient and engaging in further discussion”. A partner also reduces the difficulty in travelling to and from a hospital and finding a carer post-surgery. This study is the largest of its kind to find the influence of marriage on the detection of melanoma. Dr Sharon said, “These findings support increased consideration of spousal training for partner skin examination and perhaps more frequent screening for unmarried patients. “Marital status should be considered when counselling patients for melanoma procedures and when recommending screening and follow-up to optimize patient care.” Image credit: Shutterstock

Body

COVID-19 infection linked to a higher risk of diabetes

A Canadian study looking at more than 600,000 people has found a higher rate of new diabetes diagnoses in those who’d been infected with <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://cosmosmagazine.com/health/covid/" target="_blank" rel="noreferrer noopener">COVID-19</a>. <div class="copy"> The study, which is <a href="https://doi.org/10.1001/jamanetworkopen.2023.8866" target="_blank" rel="noreferrer noopener">published</a> in JAMA Network Open, suggests that COVID may be responsible for a 3% to 5% excess burden of diabetes at the population level. The Canadian researchers drew on data from the British Columbia COVID-19 Cohort: a study that collected the health records of people tested for SARS-CoV-2 in the province from January 2020 to December 2021. From this cohort, 125,987 people tested positive to COVID-19. The researchers matched each of these people with four unexposed people of the same age, sex, and test date. This gave them a sample of 629,935 people, a fifth of whom had been infected with SARS-CoV-2. They then went looking for incident diabetes – that is, a new diagnosis – more than 30 days after the COVID test. The COVID-positive group had a rate of 672.2 new diabetes diagnoses per 100,000 people, significantly higher than the control group’s rate of 508.7 new diagnoses per 100,000. This translates to roughly 3-5% extra diabetes cases at a population level, according to the researchers’ analysis. “Our overall results were consistent with several other studies finding higher risk of incident diabetes after SARS-CoV-2 infection; however, the increase in risk was lower in our analysis compared with other studies,” they write in their paper. They suggest a few differences in study populations for this discrepancy. It’s not yet clear why there’s a link between COVID infection and diabetes. In their paper, the researchers point out that SARS-CoV-2 has been shown to attack pancreatic cells which are involved with insulin production. Low-grade inflammation from COVID could also play a role. But these processes are still poorly understood. “Our study highlights the importance of health agencies and clinicians being aware of the potential long-term consequences of COVID-19 and monitoring people after COVID-19 infection for new-onset diabetes for timely diagnosis and treatment,” conclude the researchers. </div> <div id="contributors"> This article was originally published on <a href="https://cosmosmagazine.com/health/covid/diabetes-covid-link/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Images: Getty </div>

Body

Mediterranean diet associated with big reduction in the risk of heart disease and dementia

Further scientific evidence of the benefits of a “Mediterranean diet” on health have been published this week, extolling the virtues of fruit, veggies, nuts and even a little wine. <div class="copy"> In one Australian-led <a href="https://doi.org/10.1136/%20heartjnl-2022-321930" target="_blank" rel="noreferrer noopener">review</a> researchers found women who closely followed a Mediterranean diet were associated with up to 24% lower risk of cardiovascular disease and up to 23% lower risk of death from any cause. This is the first study to examine the association between the Mediterranean diet, cardiovascular disease, and mortality in women specifically, and is published in the journal Heart. A <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02772-3" target="_blank" rel="noreferrer noopener">UK study</a> in BMC Medicine has also found that men and women with a strict Mediterranean diet had up to 23% lower risk for developing dementia in comparison with those with the lowest level of adherence to the diet. The Mediterranean diet is rich in fruits, vegetables, legumes, nuts, seeds, wholegrains, and olive oil; moderate in fish and shellfish; low to moderate in wine; and low in red meat and processed meats, dairy products, animal fat, and processed foods. Cardiovascular disease is an umbrella term that includes heart, stroke, and blood vessel diseases, and was the <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/about" target="_blank" rel="noreferrer noopener">underlying cause</a> of one in four deaths in Australia in 2019. “The Mediterranean diet is known for its health benefits, especially for heart health, but most studies and research into diet and heart disease are done primarily in men,” says Anushriya Pant, University of Sydney PhD candidate at the Westmead Applied Research Centre (WARC) and first author of the Heart paper. The study analysed pooled data from 16 studies published between 2006 and 2021, involving over 722,000 female participants aged 18 and above who followed the Mediterranean diet and whose cardiovascular health was monitored for an average of 12.5 years. The researchers found that the reduced risk of cardiovascular disease and death applied to women of all ethnicities.. “Now we have confirmed that similar benefits apply for women’s dietary guidelines, and this reflects the strength of the Mediterranean diet for good heart health,” adds Pant. “In medical research, there are sex disparities in how clinical trials are designed. This creates large gaps in clinical data, which can potentially impact the development of health advice. Our work is a step towards addressing this gap.” The researchers acknowledge some limitations to their findings. All studies analysed were observational – so could only establish an association, not causation, between the Mediterranean diet and lowered risk of cardiovascular disease and death – and relied on self-reported food frequency questionnaires. Adjustments for potentially influencing factors also varied across the studies. The second study into dementia is equally supportive of the diet guidelines. UK scientists analysed data from 60,298 individuals from the <a href="https://www.ukbiobank.ac.uk/" target="_blank" rel="noreferrer noopener">UK Biobank</a> – a large-scale biomedical database containing genetic and health information from half a million UK participants – who completed a dietary assessment. Participants were followed for nine years, during which there were 882 cases of dementia. The researchers scored individuals based on how closely their diet matched the key features of a Mediterranean one, while taking into account their genetic risk for dementia. The authors say the findings indicate that, even for those with a higher genetic risk for dementia, having a better diet could reduce the likelihood of developing the condition. “Dementia impacts the lives of millions of individuals throughout the world, and there are currently limited options for treating this condition,” says Dr Oliver Shannon, a lecturer in Human Nutrition and Ageing at Newcastle University, and first author of the study. “Finding ways to reduce our risk of developing dementia is, therefore, a major priority for researchers and clinicians. “Our study suggests that eating a more Mediterranean-like diet could be one strategy to help individuals lower their risk of dementia.” The authors caution that there are limitations to this study, including that their analysis is limited to individuals who self-reported their ethnic background as white, British, or Irish, as only genetic data based on European ancestry was available. Further research is needed in a range of populations to determine the potential benefit for all people. In 2022, it was estimated that there were 401,300 <a href="https://www.aihw.gov.au/reports/dementia/dementia-in-aus/contents/summary" target="_blank" rel="noreferrer noopener">Australians living with dementia</a>. With an ageing and growing population this number is predicted to more than double to 849,300 people by 2058. <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=239397&title=Mediterranean+diet+associated+with+big+reduction+in+the+risk+of+heart+disease+and+dementia" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></div> <div id="contributors"> <a href="https://cosmosmagazine.com/health/mediterranean-diet-heart-dementia/">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>. Image credit: Shutterstock </div>

Body

Yes, masks reduce the risk of spreading COVID, despite a review saying they don’t

The question of whether and to what extent face masks work to prevent respiratory infections such as COVID and influenza has split the scientific community for <a href="https://www.baltimoresun.com/news/bs-xpm-2007-03-06-0703060040-story.html">decades</a>. Although there is strong evidence face masks <a href="https://www.sciencedirect.com/science/article/pii/S0020748920301139?via%3Dihub">significantly reduce transmission of such infections</a> both in health-care settings and in the community, some experts do not agree. An updated <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full">Cochrane Review</a> published last week is the latest to suggest face masks don’t work in the community. <blockquote class="twitter-tweet"> "Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks"<a href="https://twitter.com/CochraneLibrary?ref_src=twsrc%5Etfw">@CochraneLibrary</a> Review. Published: 30 January 2023 <a href="https://t.co/zODu6QEF1M">https://t.co/zODu6QEF1M</a> <a href="https://t.co/c26yHPaSCD">pic.twitter.com/c26yHPaSCD</a> — Robin Monotti (@robinmonotti) <a href="https://twitter.com/robinmonotti/status/1620311528523304960?ref_src=twsrc%5Etfw">January 31, 2023</a></blockquote> However there are problems with the review’s methodology and its underpinning assumptions about transmission. The Cochrane Review combined randomised controlled trials (RCTs) using <a href="https://ebn.bmj.com/content/16/1/3">meta-analysis</a>. RTCs test an intervention in one group and compare it with a “control” group that doesn’t receive the intervention or receives a different intervention. A meta-analysis pools the results of multiple studies. This approach assumes (a) RCTs are the “best” evidence and (b) combining results from multiple RCTs will give you an average “effect size”. But RCTs are only the undisputed gold standard for certain kinds of questions. For other questions, a mix of study designs is better. And RCTs should be combined in a meta-analysis only if they are all addressing the same research question in the same way. Here are some reasons why the conclusions of this Cochrane Review are misleading. <h2>It didn’t consider how COVID spreads and how masks work</h2> COVID, along with influenza and many other respiratory diseases, is transmitted primarily <a href="https://theconversation.com/covid-how-the-disease-moves-through-the-air-173490">through the air</a>. Respirators (such as N95s) are designed and regulated to prevent airborne infections by fitting <a href="https://theconversation.com/high-filtration-masks-only-work-when-they-fit-so-we-created-a-new-way-to-test-if-they-do-155987">closely to the face</a> to prevent air leakage and by filtering out 95% or more of potential infectious particles. In contrast, surgical masks are designed to prevent splatter of fluid on the face and are loose-fitting, causing unfiltered air to leak in through the gaps around the mask. The filtration of a surgical mask is not regulated. In other words, respirators are designed for respiratory protection and cloth and surgical masks are not. The review starts with an assumption that masks provide respiratory protection, which is flawed. An understanding of these differences should inform both studies and reviews of those studies. <h2>The studies addressed quite different questions</h2> A common mistake in meta-analysis is to combine apples and oranges. If apples work but oranges don’t, combining all studies in a single average figure may lead to the conclusion that apples do not work. This Cochrane Review combined RCTs where face masks or respirators were worn part of the time (for example, when caring for patients with known COVID or influenza: “occasional” or “targeted” use) with RCTs where they were worn at all times (“continuous use”). Because both SARS-CoV-2 and influenza viruses are airborne, an unmasked person could be infected anywhere in the building and even after an infectious patient has left the room, especially since some people have <a href="https://www.pnas.org/doi/10.1073/pnas.2109229118">no symptoms</a> while contagious. Most RCTs of masks and N95s included in the review have not had a <a href="https://jamanetwork.com/journals/jama/fullarticle/184819">control arm</a> – therefore finding no difference could indicate equal efficacy or equal inefficacy. <a href="https://jamanetwork.com/journals/jama/fullarticle/2749214">Studies</a> examining wearing a surgical mask or respirator (such as an N95) only when in contact with sick people or when doing a high-risk procedure (occasional use) have generally shown that, when worn in this way, there is no difference. An RCT comparing occasional versus continuous use of respirators in health care workers <a href="https://www.atsjournals.org/doi/10.1164/rccm.201207-1164OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubme">showed</a> N95 respirators and surgical masks were equally ineffective when only worn occasionally by hospital workers. They had to wear them all the time at work to be protected. We also combined only apples and apples in a <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">meta-analysis</a> of two RCTs conducted in exactly the same way and measuring the same interventions and outcomes. We found N95 respirators provide significant protection against respiratory infections when surgical masks did not, even against infections assumed to be “droplet spread”. <h2>Most trials addressed only half the question</h2> Face masks and respirators work in two ways: they protect the wearer from becoming infected and they prevent an infected wearer from spreading their germs to other people. Most RCTs in this Cochrane Review looked only at the former scenario, not the latter. In other words, the researchers had asked people to wear masks and then tested to see if those people became infected. A previous <a href="https://pubmed.ncbi.nlm.nih.gov/20092668/">systematic review</a> found face masks worn by sick people during an influenza epidemic reduced the risk of them transmitting the infection to family members or other carers. Preventing an infection in one person also prevents onward transmission to others within a closed setting, which means such RCTs should use a special method called “cluster randomisation” to account for this. Data from a RCT of N95 respirator use by <a href="https://journals.sagepub.com/doi/full/10.1177/0300060516665491?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org">health workers</a> showed even their unmasked colleagues were protected. Yet some of the trials included in the review did not use cluster randomisation. <h2>The new paper combined health and community settings</h2> This is another apples-plus-oranges issue. Different settings have widely differing risks of transmission, since airborne particles build up when sick patients are exhaling the virus in <a href="https://theconversation.com/heres-where-and-how-you-are-most-likely-to-catch-covid-new-study-174473">underventilated, crowded settings</a> especially if many infected people are present (such as in a hospital). <blockquote class="twitter-tweet"> Here’s where (and how) you are most likely to catch COVID – new study <a href="https://t.co/Ro88Shc897">https://t.co/Ro88Shc897</a> <a href="https://t.co/TlFA9EQskF">pic.twitter.com/TlFA9EQskF</a> — Jeffrey J Davis (@JeffreyJDavis) <a href="https://twitter.com/JeffreyJDavis/status/1484210379093954564?ref_src=twsrc%5Etfw">January 20, 2022</a></blockquote> A genuine protective effect of masks or respirators shown in a RCT in a high-risk setting will be obscured if that trial is combined in a meta-analysis with several other RCTs that were conducted in low-risk settings. A large <a href="https://www.science.org/doi/10.1126/science.abi9069">RCT in the community in Bangladesh</a> found face masks reduced the risk of infection by 11% overall and 35% in people over 60 years. In contrast, in <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">hospitals</a>, N95 reduce risk by 67% against bacterial infections and 54% against viral infections. Viruses like influenza also vary substantially from year to year – some years there is very little influenza, and if a RCT is conducted during such a year, it will not find enough infections to show a difference. The review failed to account for such seasonal effects. <h2>But did they actually wear the mask?</h2> The authors of the Cochrane Review acknowledged compliance with masking advice was poor in most studies. In the real world, we can’t force people to follow medical advice, so RCTs should be analysed on an “intention to treat” basis. For example, people who are prescribed the active drug but who choose not to take it should not be shifted to the placebo group for the analysis. But if in a study of masking, most people don’t actually wear them, you can’t conclude that masks don’t work when the study shows no difference between the groups. You can only conclude that the mask advice didn’t work in this study. There is a great deal of <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246317">psychological evidence</a> on why people do or don’t choose to comply with advice to mask and how to improve uptake. The science of masking needs to separate the impact of the mask itself from the impact of the advice to mask. Mask-wearing <a href="https://www.ijidonline.com/article/S1201-9712(21)00274-5/fulltext">goes up</a> substantially to over 70% if there is an actual mandate in place. <h2>It didn’t include other types of research</h2> A comprehensive review of the evidence would also include other types of study besides RCTs. For example, a <a href="https://www.sciencedirect.com/science/article/pii/S0140673620311429">large systematic review</a> of 172 various study designs, which included 25,697 patients with SARS-CoV-2, SARS, or MERS, concluded masks were effective in preventing transmission of respiratory viruses. Well-designed <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm?s_cid=mm7106e1_w">real-world studies</a> during the pandemic showed any mask reduces the risk of COVID transmission by 50–80%, with the highest protection offered by N95 respirators. <a href="https://pubmed.ncbi.nlm.nih.gov/20095070/">Many lab-based studies</a> have shown respirators are superior to masks at preventing airborne respiratory infections and the <a href="https://thorax.bmj.com/content/75/11/1024.long">incremental superiority</a> from a single to two layered cloth mask to a three-layered surgical mask in blocking respiratory aerosols. <h2>Yes, masks reduce the spread of COVID</h2> There is strong and consistent evidence for the effectiveness of masks and (even more so) respirators in protecting against respiratory infections. Masks are an important protection against serious infections. Current COVID vaccines protect against death and hospitalisation, but do <a href="https://fortune.com/well/2023/01/06/kraken-xbb15-omicron-covid-variant-most-transmissible-yet-could-spawn-more-immune-evasive-variants-study-china-vaccine-monoclonal-antibodies-breakthrough-infection/">not prevent infection</a> well due to waning vaccine immunity and substantial immune escape from new variants. A systematic review is only as good as the rigour it employs in combining similar studies of similar interventions, with similar measurement of outcomes. When very different studies of different interventions are combined, the results are not informative. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992" target="_blank" rel="noopener">The Conversation</a>.

Body

Toxic pollutants can build up inside our homes. Here are 8 ways to reduce the risks

We know everything in our homes gathers dust. What you probably don’t know is whether there are toxic contaminants in your house dust, and where these might come from. Our <a href="https://doi.org/10.1016/j.envres.2022.115173">newly published research</a> found most of the dust inside homes came from outside and contains potentially toxic trace metals such as lead, arsenic and chromium. Worryingly, we found some contaminants can accumulate at higher concentrations inside homes than outside. This happened in homes with certain characteristics: older properties, metal construction materials enriched in zinc, recent renovations and deteriorating paint. Fortunately, you can take some simple steps to reduce your exposure, which we explain later. <h2>What’s in house dust?</h2> Our study explored the connected sources, pathways and potentially harmful exposures to trace metals at homes across Sydney. We collected and analysed 383 samples from nearby road dust (51 samples) and garden soil (166), as well as indoor dust (166). We found the dust in homes comes from a range of sources including outdoor environments and soil, skin, cleaning products, pet hair and cooking particles. Nearly 60% of dust particles inside the homes originated from their immediate outdoor environment – it was <a href="https://theconversation.com/wearing-shoes-in-the-house-is-just-plain-gross-the-verdict-from-scientists-who-study-indoor-contaminants-177542">dirt from outside</a>! Wind, your shoes or your pets can carry in <a href="https://www.sciencedirect.com/science/article/pii/S0160412021002075?via%3Dihub">soil</a> and <a href="https://pubs.acs.org/doi/10.1021/acs.est.1c04494">dust</a>-related contaminants. The remaining 40% of home dust came from indoor sources. These included <a href="https://theconversation.com/microplastics-are-common-in-homes-across-29-countries-new-research-shows-whos-most-at-risk-189051">fibres from clothes, carpets and furnishings</a>, cleaning products, skin and hair. Some dust sources can carry a cocktail of potentially harmful contaminants including: <ul> <li> <a href="https://doi.org/10.1016/j.envpol.2021.117064">microplastics</a> </li> <li> <a href="https://doi.org/10.1016/j.envres.2014.10.009">persistent organic pollutants</a> </li> <li> <a href="https://doi.org/10.1016/j.scitotenv.2019.05.463">perfluorinated chemicals</a> (PFAS) </li> <li> <a href="https://doi.org/10.1016/j.envpol.2021.117593">trace metals</a> </li> <li> <a href="https://doi.org/10.3389/fenvs.2021.754657">bacterial communities</a> </li> <li> <a href="https://doi.org/10.1016/j.envint.2021.106501">antimicrobial resistance genes</a>. </li> </ul> The nature of the risk is related to how much of the contaminant you’re exposed to and for how long. The risks are greatest in children under the age of five. This is because they are small, closer to the floor and have frequent hand-mouth contact, which increases ingestion of contaminants. <h2>How do contaminants build up in homes?</h2> Industrial activity has left a marked legacy of contaminants in many city neighbourhoods. We analysed road dust, garden soil and vacuum dust samples from 166 homes in Sydney to see how this risk translated to inside homes. We used high-magnification microscopy and <a href="https://www.climate-policy-watcher.org/earth-sciences/lead-isotopes-as-tools-for-source-identification.html">lead isotopic ratios</a> to understand trace metal composition in the samples. On average, concentrations of trace metals arsenic, chromium, copper, manganese, lead and zinc were all higher inside homes than outside. This means homes are not only “accumulators” of trace metal contaminants but also important sources of a significant proportion of harmful contaminants that we can be exposed to. The lead isotopic ratios, or the lead “fingerprints”, of each home and its garden soil matched. This confirms the soil is the main source of lead inside homes. Most of this lead is the result of the pre-1970s use of high concentrations of lead in <a href="https://www.dcceew.gov.au/environment/protection/chemicals-management/lead/lead-in-house-paint">paints</a> and <a href="http://dx.doi.org/10.1016/j.apgeochem.2017.02.007">petrol</a>, which contaminated many garden soils. Even <a href="https://theconversation.com/why-lead-is-dangerous-and-the-damage-it-does-116506">low levels of lead exposure</a> can be harmful. Lead levels in some <a href="https://theconversation.com/elevated-lead-levels-in-sydney-back-yards-heres-what-you-can-do-68499">Sydney backyards</a> pose a risk for <a href="https://doi.org/10.1016/j.dib.2021.107151">urban veggie growers</a> and <a href="https://theconversation.com/backyard-hens-eggs-contain-40-times-more-lead-on-averagethan-shop-eggs-research-finds-187442">backyard chickens and their eggs</a>. High-magnification images of house dust showed mineral particles that have been blown in or tracked in on shoes. The rest of the dust was elongated fibres and hair from indoor sources. <h2>Which homes are most at risk?</h2> We also collected information about each house, relevant activities and renovations at the property. We found house age, proximity to the city centre and renovations had the greatest influence on levels of lead and other trace metals in the home. All homes more than 50 years old had higher concentrations of arsenic, copper, lead and zinc in their garden soil and house dust. They are typically <a href="https://iupui-earth-science.shinyapps.io/MME_Sydney/">located closer to city centres</a>, where early industrial activity has contaminated soils. As older homes in former industrial areas are renovated, trace metal loads in these homes and gardens can increase. Walls and ceilings contain decades of dust. Old paint buried under more recent layers can also be released, causing <a href="https://www.abc.net.au/radionational/programs/backgroundbriefing/3983094">lead exposure risks</a>. It is critical that home renovators take appropriate remediation steps or <a href="https://painters.edu.au/Training-Courses/CPCCPD3031-Work-safely-with-lead-painted-surfaces-in-the-painting-industry.htm">employ a qualified paint professional</a> so lead dust isn’t spread across the area. <h2>8 ways to reduce your risk</h2> We spend about <a href="https://escholarship.org/uc/item/1zg3q68x#main">70% of our time at home</a>, which the pandemic has increased. Understanding the environmental <a href="https://www.cdc.gov/niosh/topics/exposome/default.html">conditions and contaminants we encounter</a>and their effects on our health is more important than ever. Armed with this knowledge, though, you can take some simple steps to reduce your exposure to contaminants in your home and garden: <ol> <li> regularly vacuum carpeted areas with a good vacuum cleaner fitted with a <a href="https://www2.education.vic.gov.au/pal/ventilation-air-purification/print-all">HEPA filter</a> </li> <li> wet mop and wet dust hard surfaces </li> <li> mulch areas of exposed soil in your garden </li> <li> use a quality doormat and wash it regularly, which can roughly <a href="https://nrl.northumbria.ac.uk/id/eprint/51148/1/Manuscript_File_Global_Pb_Modeling_Final_clean_1%20%281%29.pdf">halve the amount of lead</a> in your home within three months </li> <li> leave your shoes at the door as they can <a href="https://theconversation.com/wearing-shoes-in-the-house-is-just-plain-gross-the-verdict-from-scientists-who-study-indoor-contaminants-177542">bring all sorts of nasties into the home</a> </li> <li> wash your hands and your veggies thoroughly </li> <li> close windows on windy days </li> <li> when renovating, use dust-mitigation strategies and personal protective equipment (PPE). </li> </ol> You can dig a little deeper into what’s in your own home environment by sending your soil to <a href="https://www.360dustanalysis.com/">VegeSafe Australia</a> or <a href="https://www.epa.vic.gov.au/for-community/get-involved/citizen-science-program/gardensafe">EPA Victoria’s GardenSafe</a> for analysis. If you live in the United States, Canada, United Kingdom or Australia you can also send your vacuum dust to <a href="https://www.360dustanalysis.com/">DustSafe</a> for testing. You will receive a report outlining what was in your sample, with links and advice on what to do next where necessary. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/toxic-pollutants-can-build-up-inside-our-homes-here-are-8-ways-to-reduce-the-risks-197908" target="_blank" rel="noopener">The Conversation</a>.

Home Hints & Tips

Coastal property prices and climate risks are both soaring. We must pull our heads out of the sand

Australians’ <a href="https://www.nfsa.gov.au/collection/curated/australians-beach">well-documented</a> affinity with the sun, surf and sand continues to fuel <a href="https://www.smh.com.au/property/news/stunning-holiday-hotspots-where-house-prices-have-doubled-in-five-years-20221109-p5bwuk.html">coastal property market growth</a>. This growth defies rising interest rates and growing evidence of the <a href="https://www.theguardian.com/australia-news/2020/jul/23/against-the-tide-storm-battered-wamberal-residents-cling-to-beachfront-homes">impacts of climate change</a> on people living in vulnerable coastal locations. People in these areas are finding it harder to insure their properties against these risks. Insurers view the Australian market as sensitive to climate risks, as climate change impacts can trigger large insurance payouts. They are <a href="https://www.theguardian.com/australia-news/2022/nov/12/australians-facing-prohibitive-insurance-premiums-after-climate-related-disasters">pricing their products accordingly</a>. Clearly, there is a vast disconnect between the coastal property market and climate change impacts such as increasingly severe storms, tidal surges, coastal erosion and flooding. There is no shortage of <a href="https://www.smh.com.au/business/banking-and-finance/32-billion-of-cba-mortgages-exposed-to-extreme-weather-risks-climate-analysis-finds-20220819-p5bb5p.html">reports</a>, <a href="https://www.climatecouncil.org.au/resources/australian-homes-uninsurable-2030-climate-risk-map/">studies</a> and <a href="https://www.abc.net.au/news/2022-11-18/gold-coast-council-additional-88-000-properties-at-flood-risk/101664596">analyses</a> confirming the climate risks we are already living with. Yet another alarming <a href="https://www.csiro.au/en/research/environmental-impacts/climate-change/State-of-the-Climate">State of the Climate</a> report was released last week. We keep talking about reaching global net-zero emissions. But this “<a href="https://www.youtube.com/watch?v=ZwD1kG4PI0w">blah blah blah</a>” masks the fact that climate impacts are already with us. Even if we make deeper, faster cuts to emissions, as we must, our world is now warmer. Australians will <a href="https://www.science.org.au/supporting-science/science-policy-and-analysis/reports-and-publications/risks-australia-three-degrees-c-warmer-world">feel the effects of that warming</a>. We ultimately cannot afford the price of business as usual, as embodied by so many coastal developments. <figure><iframe src="https://www.youtube.com/embed/ZwD1kG4PI0w?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Greta Thunberg denounces the ‘blah, blah, blah’ from world leaders in response to the climate emergency.</figcaption></figure> Risks are worrying banks and insurers In Australia, the disasters and the environmental collapse we are experiencing will get worse. While a range of businesses see this as opening up <a href="https://www.accc.gov.au/media-release/accc-internet-sweeps-target-greenwashing-fake-online-reviews">new market and product frontiers</a>, the fact is climate change is creating a fundamentally uncertain, unstable and difficult world. Banks have a <a href="https://law-store.wolterskluwer.com/s/product/banking-on-climate-change-how-finance-actors-regulatory-regimes/01t0f00000J3aMk">central role</a> in addressing climate risks. They are <a href="https://theconversation.com/how-can-your-bank-help-reduce-climate-change-risks-to-your-home-60049">exposed to climate risk</a> through residential lending on properties that are vulnerable to climate impacts and now <a href="https://www.theguardian.com/australia-news/2022/nov/26/australias-unraveling-climate-risk-leaving-more-homes-uninsurable-against-flooding-expert-warns">face insurance pressures</a>. One in 25 Australian homes are <a href="https://www.climatecouncil.org.au/resources/australian-homes-uninsurable-2030-climate-risk-map/">projected to be uninsurable by 2030</a>. The Australian government risks bearing the large costs of supporting the underinsured or uninsured – otherwise known as <a href="https://www.pc.gov.au/inquiries/completed/disaster-funding/report">being “the insurer of last resort”</a>. This costly legacy shows why planning decisions made now must take account of climate change impacts, and <a href="https://link.springer.com/article/10.1007/s40641-020-00161-z">not just in the wake of disasters</a>. The rapidly escalating impacts and risks across sectors demand that we undertake mitigation and adaptation at the same time, urgently and on a large scale. This means reducing emissions to negative levels – not just reaching net zero and transitioning our energy sector, but also actively removing greenhouse gases from the atmosphere. We must also respond to climate change risks already locked into the system. We have to make substantial changes in how we think about, treat, price and act on these risks. <blockquote class="twitter-tweet"> Australia’s ‘unraveling’ climate risk leaving more homes uninsurable against flooding, expert warns <a href="https://t.co/cLj1SKei72">https://t.co/cLj1SKei72</a> — Guardian Australia (@GuardianAus) <a href="https://twitter.com/GuardianAus/status/1596294943529893888?ref_src=twsrc%5Etfw">November 26, 2022</a></blockquote> As the climate shifts, so must our coastal dream The consequences of a warming climate, including reaching and crossing tipping points in the Earth’s weather systems, are <a href="https://www.science.org/doi/10.1126/science.abn7950#core-collateral-purchase-access">occurring sooner than anticipated</a>. The required behavioural, institutional and structural changes are vast and challenging. People are often attached to places based on <a href="https://rgs-ibg.onlinelibrary.wiley.com/doi/abs/10.1111/tran.12368">historical knowledge</a> of them. These lived experiences, while important, inform a worldview based on an understanding of our environment before the <a href="https://link.springer.com/chapter/10.1007/978-981-19-2428-6_2">rapid onset</a> of climate change. This can skew our climate risk responses, but compounding climate impacts are outpacing our ability to adapt as we might have in the past. Institutional signalling, such as <a href="https://www.smh.com.au/business/the-economy/property-values-are-at-risk-in-climate-change-hot-spots-rba-warns-20210917-p58skt.html">warnings by the Reserve Bank</a>, support greater public awareness of climate impacts and risks. When buying a property, people need to consider these factors more seriously than, say, having an extra bathroom. Obligatory disclosure of regional climate change impacts could inform buyers’ decision-making. The data and models used would have to be clear on the validity and limitations of their scenarios. <blockquote class="twitter-tweet"> A great presentation from <a href="https://twitter.com/Tayanah?ref_src=twsrc%5Etfw">@Tayanah</a> at the <a href="https://twitter.com/hashtag/C2C2021?src=hash&ref_src=twsrc%5Etfw">#C2C2021</a> about the legal status of property rights in Australia enabling (or otherwise...) managed retreat as a <a href="https://twitter.com/hashtag/climateadaptation?src=hash&ref_src=twsrc%5Etfw">#climateadaptation</a> solution. Once again we find the climate projections are ahead of our legal preced…<a href="https://t.co/XgDVV5O0Gj">https://t.co/XgDVV5O0Gj</a> — Anthony Boxshall (@ScienceN2Action) <a href="https://twitter.com/ScienceN2Action/status/1420173588217303044?ref_src=twsrc%5Etfw">July 28, 2021</a></blockquote> Nature-based and equitable solutions In recent years there has been an increasing focus on nature-based solutions. This approach uses natural systems and tools for tackling societal issues such as the enormous and complex risks posed by climate change. Indeed, many Indigenous peoples, communities and ways of knowing <a href="https://www.facetsjournal.com/doi/full/10.1139/facets-2019-0058">have long recognised</a> the fundamental role of nature in making good and safe lives possible for people. Nature-based solutions provide a suite of valuable tools for remedying issues we’re already facing on coasts. <a href="https://www.sciencedirect.com/science/article/abs/pii/S0964569121000399">For example</a>, in many contexts, building hard seawalls is often a temporary solution, which instils a false sense of security. Planting soft barriers such as mangroves and dense, deep-rooting vegetation can provide a more enduring solution. It also restores fish habitat, purifies water and eases floods. Acknowledging the well-being of people and nature as interconnected has important implications for decisions about relocating people from high-risk areas. Effective planned retreat strategies must not only get people out of harm’s way, but account for where they will move and how precious ecosystems will be protected as demand for land supply shifts. Nature-based solutions must be built into retreat policies too. As the Australian Academy of Science’s <a href="https://www.science.org.au/news-and-events/events/launch-national-strategy-just-adaptation">Strategy for Just Adaptation</a> explains, effective adaptation also embeds equity and justice in the process. <a href="https://link.springer.com/article/10.1007/s10584-019-02535-1">Research</a> on historic retreat strategies has shown that a failure to properly consider and respect people’s choices, resources and histories can further entrench inequities. Giving people moving to a new home as much choice as possible helps them work through an emotional and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0964569116301119">highly political process</a>. We all need to find the courage to have difficult conversations, to seek information to make prudent choices, and to do all we can to respond to the growing climate risks that confront us. As climate activist Greta Thunburg <a href="https://www.youtube.com/watch?v=ZwD1kG4PI0w">says</a>: <blockquote> “Hope is not passive. Hope is not blah blah blah. Hope is telling the truth. Hope is taking action. And hope always comes from the people.” </blockquote> Acting on this kind of hope can put us on an altogether different and more positive path.<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/195357/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by Tayanah O'Donnell and Eleanor Robson. Republished with permission from <a href="https://theconversation.com/coastal-property-prices-and-climate-risks-are-both-soaring-we-must-pull-our-heads-out-of-the-sand-195357" target="_blank" rel="noopener">The Conversation</a>. Image: Getty Images

Real Estate

Why do I sprain my ankle so often and how can I cut the risk of it happening again?

Are you one of those people who seems to be forever spraining their ankle? To some extent, ankle sprains are <a href="https://meridian.allenpress.com/jat/article/54/6/603/420863/Epidemiology-of-Ankle-Sprains-and-Chronic-Ankle" target="_blank" rel="noopener">part and parcel</a> of being active. But if it’s happening again and again, here’s what may be going on – and how you can reduce your risk of recurrent ankle sprain. <h2>One sprain can lead to another… and another</h2> A large <a href="https://link.springer.com/article/10.1007/s40279-013-0102-5" target="_blank" rel="noopener">review</a> of ankle sprain studies in the journal <a href="https://link.springer.com/article/10.1007/s40279-013-0102-5" target="_blank" rel="noopener">Sports Medicine</a> found most people who actively play sport or train can expect to have a fairly low incidence of ankle sprain per 1,000 hours of training time. But it also said: <blockquote> Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. </blockquote> The most frequent type of ankle sprain occurs if the ligaments on the outside of the ankle are stretched or torn when the joint moves beyond the normal range of movement. This is known as an inversion or lateral ankle sprain. Strong evidence from <a href="https://meridian.allenpress.com/jat/article/56/6/578/466668/Lateral-Ankle-Sprain-and-Subsequent-Ankle-Sprain" target="_blank" rel="noopener">studies</a> suggests once people sprain their ankle, they are more likely to re-sprain it. As one <a href="https://meridian.allenpress.com/jat/article/56/6/578/466668/Lateral-Ankle-Sprain-and-Subsequent-Ankle-Sprain" target="_blank" rel="noopener">review</a> of the evidence put it: <blockquote> a history of lateral ankle sprain is known to disrupt the structural integrity of the ligaments and sensorimotor function, likely impairing an individual’s ability to avoid injurious situations. </blockquote> Some ankle sprains might seem to be very minor, with almost no swelling or mobility problems. But some people can end up with what’s known as chronic ankle instability, where they tend to re-sprain their ankle again and again. Another <a href="https://link.springer.com/article/10.1007/s40279-017-0781-4" target="_blank" rel="noopener">review</a> looking at factors contributing to chronic ankle instability found <blockquote> feelings of instability and recurrent ankle sprain injuries (termed chronic ankle instability, or CAI) have been reported in up to 70% of patients. The subsequent development of CAI has adverse health consequences including reduced quality of life and early-onset osteoarthritis. </blockquote> Once an ankle fracture is excluded, busy hospital emergency departments often send patients home with instructions to ice the ankle and keep off it for a day or two. There’s often no advice to follow up with a physio for rehabilitation. This is unfortunate, as evidence suggests people with a history of ankle sprains will likely: <ul> <li> become progressively <a href="https://meridian.allenpress.com/jat/article/50/7/742/112426/Physical-Activity-Levels-in-College-Students-With" target="_blank" rel="noopener">less active</a> </li> <li> have <a href="https://bjsm.bmj.com/content/50/24/1496.long" target="_blank" rel="noopener">higher</a> body mass indices </li> <li> report more general body <a href="https://bjsm.bmj.com/content/50/24/1496.long" target="_blank" rel="noopener">pain</a> and </li> <li> generally tend to have a lower <a href="https://bjsm.bmj.com/content/50/24/1496.long" target="_blank" rel="noopener">quality of life</a>. </li> </ul> <h2>Even the other ankle may be at risk</h2> Research suggests people who sprain their ankle may be more likely to have <a href="https://meridian.allenpress.com/jat/article/56/6/578/466668/Lateral-Ankle-Sprain-and-Subsequent-Ankle-Sprain" target="_blank" rel="noopener">injuries</a> to other joints on the same leg, or even the opposite leg. A review in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196323/" target="_blank" rel="noopener">International Journal of Sports Physiotherapy</a> noted “an ankle sprain is linked to both re-injury and subsequent injury to the contralateral side”. Why? It may have something to do with the brain’s tremendous ability to continually adapt. Just as <a href="http://www.ajnr.org/content/36/11/2048" target="_blank" rel="noopener">extended bed rest</a> or prolonged microgravity exposure in <a href="https://doi.org/10.1007/978-3-319-68201-3_3" target="_blank" rel="noopener">astronauts</a> can cause changes in the brain and the way it relates to movement, perhaps our brains subconsciously compensate after an ankle injury. That could be by, for example, via limping or a slight change in the way you walk; perhaps you subconsciously don’t want to challenge the ankle due to fear of re-spraining. This may put other joints or the opposite limb at heightened risk. This neuroplasticity adds new challenges to the assessment or rehabilitation of ankle injury, and to predicting who is likely to be at increased <a href="https://www.tandfonline.com/doi/abs/10.1080/00913847.2020.1780098?journalCode=ipsm20" target="_blank" rel="noopener">risk of subsequent injuries</a>. <h2>What can you do to reduce the risk of re-spraining your ankle?</h2> If you’re getting recurrent ankle sprains, see a physiotherapist. They will be able to teach you how to reduce the risk. Currently the best evidence for reducing the chances of re-spraining your ankle sprain comes down to two main things: 1) Protecting the joint with an ankle brace when active This could mean using a <a href="https://meridian.allenpress.com/jat/article/54/6/650/420871/Prevention-of-Lateral-Ankle-Sprains" target="_blank" rel="noopener">professionally fitted external support brace</a> (not an elastic sleeve). This is a relatively low cost and effective means of risk reduction. 2) Using balancing exercises and ‘proprioceptive training’ Examples of <a href="https://meridian.allenpress.com/jat/article/52/11/1065/112804/Proprioceptive-Training-for-the-Prevention-of" target="_blank" rel="noopener">proprioceptive training</a> include: <ul> <li> balancing on each leg, one at a time, while throwing and catching a ball against a wall </li> <li> balancing on an ankle disc or wobble board for three to five minutes daily. </li> </ul> These exercises can help strengthen the muscles and ligaments in your ankle. As one literature review put it: Proprioceptive training is a cost- and time-effective intervention that can benefit patients who have sustained a previous ankle sprain during physical activity and can subsequently reduce the risk of further complications. This article originally appeared on <a href="https://theconversation.com/why-do-i-sprain-my-ankle-so-often-and-how-can-i-cut-the-risk-of-it-happening-again-190751" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

Pumping loud music is putting more than 1 billion young people at risk of hearing loss

Music is an integral part of human life. It’s all around us, just like sunshine, lifting our mood. We enjoy it so much that many of us take it with us everywhere on our phones or we spend weekends hitting the club scene, live-music venues or concerts. Meanwhile, many of us may have felt annoyed by loud sound from music venues or remarked on sound emanating from someone else’s headphones. We’re probably aware we should prevent hearing loss from loud industrial noise at work or from using power tools at home. A systematic review released today in <a href="https://globalhealth.bmj.com/lookup/doi/10.1136/bmjgh-2022-010501">BMJ Global Health</a> reports unsafe listening practices in adolescents and young adults from using personal listening devices (such as phones or digital music players) and going to loud clubs and gigs are common, and could be a major factor contributing to hearing loss. In fact, the authors estimate the pumping tunes could be placing up to 1.35 billion young people at risk of hearing loss worldwide. <h2>What the study looked at</h2> Systematic analysis involves looking across multiple studies to identify consistent findings. In this study, the authors included 33 peer-reviewed studies published between 2000 and 2021, involving over 19,000 people, aged 12–34. In the study, unsafe listening was identified as listening at levels above 80 decibels for over 40 hours per week. For context, this is the level above which most Australian states <a href="https://www.safeworkaustralia.gov.au/safety-topic/hazards/noise/overview#:%7E:text=Workers%20must%20not%20be%20exposed,on%20decibels%20and%20time%20exposed.">require industry</a> to implement noise protection processes such as use of hearing protectors. The study confirms the rate of unsafe listening practices is high in adolescents and young adults: 23.81% of them were listening to music on personal devices at unsafe levels and 48.2% at loud entertainment venues (though this rate is less certain). Based on global estimates of population, this translates to up to 1.35 billion young people at risk of hearing loss globally. The World Health Organization <a href="https://www.who.int/health-topics/hearing-loss#tab=tab_1">estimates</a> over 430 million people worldwide already have a disabling hearing loss and prevalence could double if hearing loss prevention is not prioritised. The results tally with our previous studies conducted by Australia’s National Acoustic Laboratories and HEARing Cooperative Research Centre. More than a decade ago we <a href="https://acc.hearingservices.gov.au/wps/wcm/connect/hso/f1f6299d-96f3-408e-be4b-0775af6d7f41/Lifetime_profile_exposure_sound_what_safe_HLPP2.pdf?MOD=AJPERES">reported</a> a high potential for hearing loss from attendance at nightclubs, pubs and live concerts in young Australians aged between 18–35 years. Back then, we found 13% of young Australians (aged 18–35) were getting a yearly noise dose from nightclubs, concerts and sporting activities that exceeded the maximum acceptable dose in industry. In 2015, the WHO launched the <a href="https://www.who.int/activities/making-listening-safe">Make listening Safe</a>initiative to encourage young people to protect their hearing. <h2>Why it’s bad for your hearing</h2> So what’s the problem with loud music? Like sunshine, overexposure can lead to harm. Loud noise, including music, can <a href="https://www.cdc.gov/nceh/hearing_loss/how_does_loud_noise_cause_hearing_loss.html">kill off hair cells and membranes</a> in the inner ear (the cochlea). Once hearing is lost, a person mightn’t be able to hear or understand speech or sounds around them. <a href="https://www.nidcd.nih.gov/health/noise-induced-hearing-loss">Research</a> shows hearing loss results from a combination of sound being too loud (and it doesn’t need to be painful to cause hearing damage), listening to loud sound too long (and the louder the sound, the less time you can listen before your hearing is at risk) and how often you are exposed (and hearing damage is cumulative over time). A good “rule of ear” is that if you hear ringing in your ears at or after listening, you are at risk of damaging your hearing. This type of hearing loss is <a href="https://www.cdc.gov/nceh/hearing_loss/how_does_loud_noise_cause_hearing_loss.html">permanent</a> and may require use of hearing aids or cochlear implants. <h2>Wait, so no loud music at all?</h2> So what can we do, short of throwing away our headphones and avoiding clubbing and live music? First, just like with the sun and skin, we need to be aware of the risks to our hearing and take the necessary steps to protect ourselves. We need to be aware of how loud sound is around us and how to keep our exposure within safe levels. We can do this by using personal hearing protection in clubs (such as <a href="https://www.nytimes.com/wirecutter/reviews/best-earplugs-for-concerts/">ear muffs or ear plugs</a> that are fit for purpose), or limiting how often we visit noisy music venues or how long we stay at really loud ones. In Australia, people can access a free <a href="https://knowyournoise.nal.gov.au/">noise risk calculator</a> to calculate their personal risk using an online sound level meter, and to explore how changes in lifestyle could protect their hearing while still allowing them to enjoy music. Most phones now come with software that can <a href="https://www.headphonesty.com/2022/03/iphone-headphone-safety/#:%7E:text=Key%20features%20of%20the%20iPhone%20Headphone%20Safety%20feature&text=According%20to%20the%20WHO%20standard,risk%20of%20sustaining%20hearing%20damage.">monitor safe listening levels</a> and limit exposure. Hearing protection at the venue level is more challenging and may require regulatory and industry-based approaches. Our <a href="https://academic.oup.com/annweh/article/64/4/342/5811673">2020 research</a> identified hazard controls for entertainment venues, such alternating volume between louder and softer levels, rotating staff, providing quiet rooms, and raising speaker locations above head height. We also showed DJs and venues were open to initiatives aimed at reducing the risk of hearing loss for their patrons and <a href="https://www.tandfonline.com/doi/abs/10.1080/19338244.2020.1828241?journalCode=vaeh20">staff</a>. Compromises are possible and they could enable enjoyment of music at live-music venues, while still protecting hearing. That way everyone will be able keep enjoying music for longer. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/pumping-loud-music-is-putting-more-than-1-billion-young-people-at-risk-of-hearing-loss-194537" target="_blank" rel="noopener">The Conversation</a>.

Music

Over 60

News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

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

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

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

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

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

Not all mental health apps are helpful. Experts explain the risks, and how to choose one wisely

Climb the stairs, lug the shopping, chase the kids. Incidental vigorous activity linked to lower cancer risks

More than a game: Crosswords and puzzles may reduce dementia risk

Does artificial sweetener aspartame really cause cancer? What the WHO listing means for your diet soft drink habit

Why is extreme ‘frontier travel’ booming despite the risks?

Disaster, opulence, and the merciless ocean: why the Titanic disaster continues to enthral

Why being married cuts your risk of skin cancer

COVID-19 infection linked to a higher risk of diabetes

Mediterranean diet associated with big reduction in the risk of heart disease and dementia

Yes, masks reduce the risk of spreading COVID, despite a review saying they don’t

Toxic pollutants can build up inside our homes. Here are 8 ways to reduce the risks

Coastal property prices and climate risks are both soaring. We must pull our heads out of the sand

Why do I sprain my ankle so often and how can I cut the risk of it happening again?

Pumping loud music is putting more than 1 billion young people at risk of hearing loss

News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

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

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

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

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

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real

Not all mental health apps are helpful. Experts explain the risks, and how to choose one wisely

Climb the stairs, lug the shopping, chase the kids. Incidental vigorous activity linked to lower cancer risks

More than a game: Crosswords and puzzles may reduce dementia risk

Does artificial sweetener aspartame really cause cancer? What the WHO listing means for your diet soft drink habit

Why is extreme ‘frontier travel’ booming despite the risks?

Disaster, opulence, and the merciless ocean: why the Titanic disaster continues to enthral

Why being married cuts your risk of skin cancer

COVID-19 infection linked to a higher risk of diabetes

Mediterranean diet associated with big reduction in the risk of heart disease and dementia

Yes, masks reduce the risk of spreading COVID, despite a review saying they don’t

Toxic pollutants can build up inside our homes. Here are 8 ways to reduce the risks

Coastal property prices and climate risks are both soaring. We must pull our heads out of the sand

Why do I sprain my ankle so often and how can I cut the risk of it happening again?

Pumping loud music is putting more than 1 billion young people at risk of hearing loss

Join Over60