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How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christian-brakenridge-1295221">Christian Brakenridge</a>, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</a> People have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">good sleep is imperative</a>. However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health? <a href="https://link.springer.com/article/10.1007/s00125-024-06145-0">Our research</a> attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each. <iframe id="dw4bx" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/dw4bx/" width="100%" height="400px" frameborder="0"></iframe> <h2>Finding the right balance</h2> Current health guidelines recommend you stick to a <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">sensible regime</a> of moderate-to vigorous-intensity physical activity 2.5–5 hours per week. However <a href="https://doi.org/10.1016/j.jacc.2019.02.031">mounting evidence</a> now <a href="https://doi.org/10.2337/dc14-2073">suggests</a> how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping. Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours. At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model. Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity. When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk. <h2>You’re doing more physical activity than you think</h2> We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise. Our experimental evidence shows that <a href="https://diabetesjournals.org/care/article/39/6/964/29532/Benefits-for-Type-2-Diabetes-of-Interrupting">interrupting our sitting</a> regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch. While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk. It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies. The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time. <h2>Australia’s adult physical activity guidelines need updating</h2> Australia’s <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">physical activity guidelines</a> currently only recommend exercise intensity and time. A <a href="https://www.uow.edu.au/media/2023/why-adults-need-to-move-more-stop-sitting-and-sleep-better-.php">new set of guidelines</a> are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements. While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night. Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening. It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.<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/228894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christian-brakenridge-1295221">Christian Brakenridge</a>, Postdoctoral research fellow at Swinburne University, Centre for Urban Transitions, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</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-much-time-should-you-spend-sitting-versus-standing-new-research-reveals-the-perfect-mix-for-optimal-health-228894">original article</a>. </div>

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What are heart rate zones, and how can you incorporate them into your exercise routine?

<a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537749/">Heart rate zones</a> reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute. But what are the different heart rate zones, and how can you use these zones to optimise your workout? <h2>The three-zone model</h2> While there are several models used to describe heart rate zones, the most common model in the scientific literature is the <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">three-zone model</a>, where the zones may be categorised as follows: <ul> <li> zone 1: 55%–82% of maximum heart rate </li> <li> zone 2: 82%–87% of maximum heart rate </li> <li> zone 3: 87%–97% of maximum heart rate. </li> </ul> If you’re not sure what your maximum heart rate is, it can be calculated using <a href="https://www.jacc.org/doi/full/10.1016/S0735-1097%2800%2901054-8">this equation</a>: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute. There are also other models used to describe heart rate zones, such as the <a href="https://journals.humankinetics.com/view/journals/ijspp/14/8/article-p1151.xml">five-zone model</a> (as its name implies, this one has five distinct zones). These <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">models</a> largely describe the same thing and can mostly be used interchangeably. <h2>What do the different zones involve?</h2> The three zones are based around a person’s <a href="https://link.springer.com/article/10.2165/00007256-200939060-00003">lactate threshold</a>, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic. Aerobic exercise <a href="https://www.healthline.com/health/fitness-exercise/difference-between-aerobic-and-anaerobic">uses oxygen</a> to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time. On average your lactate threshold tends to sit around <a href="https://www.tandfonline.com/doi/full/10.2147/OAJSM.S141657">85% of your maximum heart rate</a>, although this varies from person to person, and can be <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00043.2013">higher in athletes</a>. In the three-zone model, each zone loosely describes <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2015.00295/full">one of three types of training</a>. Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace. Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences. Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3. <h2>Striking a balance</h2> To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout. While zone 3 is thought to produce the largest improvements in <a href="https://www.sciencedirect.com/science/article/pii/S1440244018309198">maximal oxygen uptake</a> – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much. Training in different heart rate zones improves <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=38c07018c0636422d9d5a77316216efb3c10164f">slightly different physiological qualities</a>, and so by spending time in each zone, you ensure a <a href="https://link.springer.com/article/10.1007/bf00426304">variety of benefits</a> for performance and health. <h2>So how much time should you spend in each zone?</h2> Most <a href="https://www.frontiersin.org/articles/10.3389/fspor.2023.1258585/full">elite endurance athletes</a>, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3. Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate <a href="https://journals.humankinetics.com/view/journals/ijsnem/22/5/article-p392.xml?content=pdf">more than 250 kilometres per week</a>, which would be impossible to recover from if it was all performed in zone 2 or 3. Of course, most people are not professional athletes. The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization</a> recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week. If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines. <h2>What if I don’t have a heart rate monitor?</h2> If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training. The three heart rate zones discussed in this article can also be prescribed based on feel using a simple <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2004.00418.x">10-point scale</a>, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce. With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10. Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.<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/228520/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, Lecturer in Exercise Science, <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/what-are-heart-rate-zones-and-how-can-you-incorporate-them-into-your-exercise-routine-228520">original article</a>.

Body

How extreme dieting can affect bone health

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a> In a recent Instagram post, the actor Jameela Jamil revealed she has poor bone density, despite only being in her 30s. Jamil blamed this finding on 20 years of dieting – urging her followers to be aware of the harms diet culture can do to your health. Bone density is important for many reasons, primarily because it acts as a reservoir for many of the important minerals our bones need to function well. Many factors can affect your bone density – and as Jamil has pointed out, diet is one component that has a significant effect on bone health. Bone is a living tissue. This means our skeleton <a href="https://www.sciencedirect.com/science/article/abs/pii/S1521690X08000869">grows and remodels itself</a> according to the stresses and strains it’s put under. Everything from fractures to exercise require our bones to change their shape or density. This is why a weightlifter’s skeleton is <a href="https://link.springer.com/article/10.1007/BF00298721">much denser</a> than a marathon runner’s. The biggest skeletal changes we experience happen in our younger years. But bones keep changing throughout our lives depending on how active we are, what our diet consists of, and if we’ve suffered an injury or disease. Bones are <a href="https://www.niams.nih.gov/health-topics/what-bone">made of proteins</a>, such as collagen, as well as minerals – largely calcium. This is a <a href="https://www.ncbi.nlm.nih.gov/books/NBK430714/">key mineral</a> for us, as it keeps our bones and teeth strong and helps repair and rebuild any injured bones. But other minerals and vitamins are also important. For example, vitamin D supports calcium, playing a key role in <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2761808">bone mineralisation</a>. This is where calcium <a href="https://www.ncbi.nlm.nih.gov/books/NBK279023/">combines with phosphate</a> in our bones to create the mineral crystal <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264100/">hydroxyapatite</a>. This crystal is crucial to our bone mineral density (also known as “bone mass”), as it helps bones remodel and maintain their structural strength. <a href="https://www.nhs.uk/conditions/dexa-scan/">Dexa scans</a> – the type of scan Jamil referred to in her post – can measure the density of these crystals in bones. The <a href="https://theros.org.uk/information-and-support/osteoporosis/scans-tests-and-results/bone-density-scan-dxa/">more hydroxyapatite crystals</a> detected, the healthier the bones are. <figure class="align-center "><img src="https://images.theconversation.com/files/591182/original/file-20240430-18-u30byz.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/591182/original/file-20240430-18-u30byz.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/591182/original/file-20240430-18-u30byz.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/591182/original/file-20240430-18-u30byz.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/591182/original/file-20240430-18-u30byz.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/591182/original/file-20240430-18-u30byz.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/591182/original/file-20240430-18-u30byz.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="The interior of bones, showing four depictions of bone density – from healthy to severe osteoporosis." /><figcaption>The more crystals detected, the better your bone density. <a class="source" href="https://www.shutterstock.com/image-illustration/osteoporosis-4-stages-one-picture-3d-524364046">Crevis/ Shutterstock</a></figcaption></figure> We hit peak bone mineral density in our <a href="https://pubmed.ncbi.nlm.nih.gov/35869910/">late teens and early 20s</a>, when our body has grown to full size and our metabolism is working its best. From here, it’s possible to maintain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684300/">stable bone mass</a> into your late 30s for women and early 40s for men, with the right diet and activity. But after this point, it begins to decline. <h2>Bone density</h2> We accrue calcium over many years. It initially comes from our mother, then later from our diet. Our body accrues calcium so it can adapt to times when calcium demand is greater than what we can get from our diet – such as during pregnancy, when the foetus needs calcium to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355895/">build its own bones</a>. However, relying solely on this skeletal calcium reserve can’t be sustained for lengthy or repeated periods, because of how long it takes to be replenished. This is why diet is so important for bone density – and why a poor diet can cause extreme damage, especially when certain food groups or minerals are consistently left out. For instance, studies have shown consuming soft drinks, (<a href="https://pubmed.ncbi.nlm.nih.gov/17023723/">particularly cola</a>), more than four times a week is linked with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071508/">lower bone density</a> and increased fracture risk. This is true even after adjusting for many other variables that affect bone density. These carbonated and energy drinks contain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966367/">varying levels of vitamins</a> – often with none of the minerals, including calcium, that the body needs to function optimally. This causes the body to draw on its reserves if calcium isn’t being delivered elsewhere in the diet. Diets high in added sugar can also have a detrimental affect on the skeleton. Excess sugar causes inflammation and other physiological changes, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471313/">obesity</a>. Consuming high amounts of sugar is linked with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748414/">reduced calcium intake</a>, especially in children who substitute milk for sugary drinks. Excess sugar consumption also causes the body to <a href="https://jps.biomedcentral.com/articles/10.1007/s12576-016-0487-7">excrete excess calcium</a>, instead of reabsorbing it in the kidney as the body normally would. <a href="https://pubmed.ncbi.nlm.nih.gov/25491765/">Low- and high-fat diets</a> have also been associated with increased risk of <a href="https://www.nhs.uk/conditions/osteoporosis/">osteoporosis</a> (a condition that weakens bones) in women – though larger studies are needed to better understand the effects of removing whole food groups on bone health. <a href="https://www.nhs.uk/mental-health/conditions/anorexia/overview/">Anorexia nervosa</a> also has a significant affect on <a href="https://pubmed.ncbi.nlm.nih.gov/30817009">bone density</a> – affecting a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959847/">majority of people</a> with the condition. Low bone mineral density – especially in the spine – puts people with anorexia at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959847/">increased risk of fractures</a> because their bone thickness is reduced, increasing the likelihood of developing osteoporosis, which is associated with increased fractures. Anorexia in young adulthood is particularly challenging. This is the stage where the skeleton is building itself to reach peak <a href="https://pubmed.ncbi.nlm.nih.gov/15574617/">bone mass</a>, so it’s depositing calcium at a record pace. When diet is insufficient and the body already starts drawing on its mineral reserves, there’s a potential that the bone density or calcium reserves in the body will never be optimal – increasing fracture risk for the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746661/">rest of that person’s life</a>. <h2>Can bone health be fixed?</h2> Optimal bone health starts in utero, but our prepubescent years are key to <a href="https://pubmed.ncbi.nlm.nih.gov/26884506/">setting our skeleton up</a> for later life. People who are behind the curve in early life may have difficulty achieving their peak, as poor bone mineral density can affect everything from our appetite to how efficient our gastrointestinal tract is at absorbing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971894/">important nutrients</a> (including calcium). Supplements have a limited effect because our body can only absorb a set amount of any <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746734/">vitamin or mineral at a time</a>. While it’s possible to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684300/">limit some of the decline</a> in bone density that naturally happens as we age, some of the choices we make – such as not consuming enough calcium – can accelerate the decline. Biological sex also has a significant impact on our bone health in old age – with post-menopausal women at greater risk of osteoporosis because they <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643776/">produce less oestrogen</a>, which helps keep the cells that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424385">degrade bone</a> in check.<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/228321/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a> 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-extreme-dieting-can-affect-bone-health-228321">original article</a>. </div>

Body

What is childhood dementia? And how could new research help?

<a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> “Childhood” and “dementia” are two words we wish we didn’t have to use together. But sadly, around <a href="https://doi.org/10.1093/brain/awad242">1,400 Australian children and young people</a> live with currently untreatable childhood dementia. Broadly speaking, childhood dementia is caused by any one of <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">more than 100</a> rare genetic disorders. Although the causes differ from dementia acquired later in life, the progressive nature of the illness is the same. <a href="https://doi.org/10.1093/brain/awad242">Half</a> of infants and children diagnosed with childhood dementia will not reach their tenth birthday, and most will die <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">before turning 18</a>. Yet this devastating condition has lacked awareness, and importantly, the research attention needed to work towards treatments and a cure. <h2>More about the causes</h2> Most types of childhood dementia are <a href="https://academic.oup.com/brain/article/146/11/4446/7226999">caused</a> by <a href="https://www.genome.gov/genetics-glossary/Mutation">mutations</a> (or mistakes) in our <a href="https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid">DNA</a>. These mistakes lead to a range of rare genetic disorders, which in turn cause childhood dementia. <a href="https://doi.org/10.1093/brain/awad242">Two-thirds</a> of childhood dementia disorders are caused by “<a href="https://www.ncbi.nlm.nih.gov/books/NBK459183/">inborn errors of metabolism</a>”. This means the metabolic pathways involved in the breakdown of carbohydrates, lipids, fatty acids and proteins in the body fail. As a result, nerve pathways fail to function, neurons (nerve cells that send messages around the body) die, and progressive cognitive decline occurs. <h2>What happens to children with childhood dementia?</h2> Most children initially appear unaffected. But after a period of apparently normal development, children with childhood dementia <a href="https://doi.org/10.1016/j.pediatrneurol.2023.09.006">progressively lose</a> all previously acquired skills and abilities, such as talking, walking, learning, remembering and reasoning. Childhood dementia also leads to significant changes in behaviour, such as aggression and hyperactivity. Severe sleep disturbance is common and vision and hearing can also be affected. Many children have seizures. The age when symptoms start can vary, depending partly on the particular genetic disorder causing the dementia, but the average is around <a href="https://doi.org/10.1093%2Fbrain%2Fawad242">two years old</a>. The symptoms are caused by significant, progressive brain damage. <h2>Are there any treatments available?</h2> Childhood dementia treatments currently <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">under evaluation</a> or approved are for a very limited number of disorders, and are only available in some parts of the world. These include gene replacement, <a href="https://doi.org/10.1002/jmd2.12378">gene-modified cell therapy</a> and protein or <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1712649">enzyme replacement therapy</a>. Enzyme replacement therapy is available in Australia for <a href="https://australianprescriber.tg.org.au/articles/cerliponase-alfa-for-neuronal-ceroid-lipofuscinosis-type-2-disease.html">one form of childhood dementia</a>. These therapies attempt to “fix” the problems causing the disease, and have shown promising results. Other experimental therapies include ones that <a href="https://doi.org/10.3390/life12050608">target</a> faulty protein production or <a href="https://doi.org/10.1056/nejmoa2310151">reduce inflammation</a> in the brain. <h2>Research attention is lacking</h2> Death rates for Australian children with cancer <a href="http://www.childhooddementia.org/getasset/2WX39O">nearly halved</a> between <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">1997 and 2017</a> thanks to research that has enabled the development of multiple treatments. But over recent decades, <a href="http://www.childhooddementia.org/getasset/2WX39O">nothing has changed</a> for children with dementia. In 2017–2023, research for childhood cancer received over four times more funding per patient compared to funding for <a href="https://www.childhooddementia.org/getasset/2WX39O">childhood dementia</a>. This is despite childhood dementia causing a <a href="https://doi.org/10.1093/brain/awad242">similar number of deaths</a> each year as childhood cancer. The success <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">for childhood cancer sufferers</a> in recent decades demonstrates how adequately funding medical research can lead to improvements in patient outcomes. Another bottleneck for childhood dementia patients in Australia is the lack of access to clinical trials. An <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">analysis</a> published in March this year showed that in December 2023, only two clinical trials were recruiting patients with childhood dementia in Australia. Worldwide however, 54 trials were recruiting, meaning Australian patients and their families are left watching patients in other parts of the world receive potentially lifesaving treatments, with no recourse themselves. That said, we’ve seen a slowing in the establishment of <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">clinical trials</a> for childhood dementia across the world in recent years. In addition, we know from <a href="https://www.childhooddementia.org/join-us/professionals/impacts">consultation with families</a> that current care and support systems <a href="https://www.childhooddementia.org/getasset/44MLP8">are not meeting the needs</a> of children with dementia and their families. <h2>New research</h2> Recently, we were awarded <a href="https://www.premier.sa.gov.au/media-releases/news-items/major-funding-boost-for-research-into-childhood-dementia">new funding</a> for <a href="https://www.flinders.edu.au/giving/our-donors/impact-of-giving/improving-the-lives-of-children-with-dementia">our research</a> on childhood dementia. This will help us continue and expand studies that seek to develop lifesaving treatments. More broadly, we need to see increased funding in Australia and around the world for research to develop and translate treatments for the broad spectrum of childhood dementia conditions. Dr Kristina Elvidge, head of research at the <a href="https://www.childhooddementia.org/our-people">Childhood Dementia Initiative</a>, and Megan Maack, director and CEO, contributed to this article.<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/228508/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, Head, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, Head, Paediatric Neurodegenerative Diseases Research Group, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, Research Associate, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders 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/what-is-childhood-dementia-and-how-could-new-research-help-228508">original article</a>.

Mind

Battling to make ends meet? Financial planning expert offers 5 tips on how to build your budget

<a href="https://theconversation.com/profiles/bomikazi-zeka-680577">Bomikazi Zeka</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Every day seems to bring new headlines about rising costs. <a href="https://www.news24.com/news24/africa/news/nigerias-big-unions-call-indefinite-strike-over-fuel-prices-and-the-cost-of-living-20230926">In Nigeria</a>, unions are threatening to strike amid soaring fuel prices; the country’s inflation rate <a href="https://www.cbn.gov.ng/rates/inflrates.asp">hit 25%</a> in August. The amount it costs to fill a food basket in South Africa <a href="https://pmbejd.org.za/wp-content/uploads/2023/09/PMBEJD_Key-Data_September-2023_27092023.pdf">keeps climbing</a>. Ghanaians <a href="https://www.reuters.com/world/africa/multi-day-protests-over-economic-crisis-grip-ghanas-capital-2023-09-23/">took to the streets</a> of Accra in late September to protest about the cost of living. A <a href="https://www2.deloitte.com/us/en/insights/industry/retail-distribution/consumer-behavior-trends-state-of-the-consumer-tracker.html">recent study by the audit and consulting firm Deloitte</a> found that 75% of South Africans were concerned that the prices for everyday purchases would continue to increase, while 80% of consumers across all income groups expected the prices of groceries, household utilities and fuel to rise. This stark reality means budgeting may be more necessary than ever. If you don’t know how to create a budget, then you shouldn’t feel bad – most adults aren’t taught how to create one. And most people don’t budget, because they see it as restrictive or unsustainable. But it need not be: once you appreciate that a budget can work for you, it can be a financially empowering exercise. It’s a cornerstone of financial planning because it ensures you are living within your means and helps you remain in financial control. As a financial planning academic, I focus in <a href="https://researchprofiles.canberra.edu.au/en/persons/bomikazi-zeka/publications/">my research</a> on improving financial wellbeing and promoting savings behaviours through interventions such as budgeting. Here are five guidelines for creating a budget. <h2>1. Apps vs spreadsheet</h2> A good place to start is to choose the format of how you’re going to budget. There are several <a href="https://www.sanlamreality.co.za/wealth-sense/setting-up-a-family-budget-that-works/">online templates</a> and apps you can use for budgeting. For instance, <a href="https://www.22seven.com/">22Seven</a> has gained popularity in South Africa due to its compatibility with several financial institutions, including the country’s big five banks. Similarly, <a href="https://www.the-star.co.ke/business/kenya/2021-01-25-budgeting-using-mint-app/">Mint</a> is a popular budgeting tool that is used in Kenya and Nigeria. If you prefer to put pen to paper, some online templates come with <a href="https://www.wonga.co.za/blog/free-budget-template">free printable budgets</a>. Creating your own <a href="https://create.microsoft.com/en-us/learn/articles/how-to-make-excel-budget">Excel spreadsheet</a> is an equally good approach. What matters most is using a tool that you can commit to. <h2>2. Itemising your income and expenses</h2> A budget essentially shows how much you’re spending in relation to how much you’re earning. So once you have selected your budgeting tool, you need to fill in your income and itemise how much you’re spending on each expense in a month. A budget can be considered a cashflow statement because it allows you to track money coming in (income) and money going out (expenses). If you are living within your means, your budget should indicate a surplus – more cash inflows than cash outflows. So budgeting provides an accurate account of your short-term financial position. <h2>3. A realistic account of expenses</h2> When you look at your financial statements, fill your expenses into your budget honestly and accurately. Don’t cheat! Since everyone’s financial situation is different, your budget will also be unique. Even though there is no one-size-fits-all approach to budgeting, it should still consider all of your expenses (both regular and intermittent). A general rule of thumb is that if it’s deducted from your account then you should treat it as an expense. This includes payments for housing, medical insurance, fuel, dining out, credit card repayments and even bank fees. <h2>4. Save first, spend later</h2> Now you’ve seen how much you’re spending. Either it’s too much – and you can plan where to cut back – or you have savings at the end of the month. When compiling your budget it’s important to demarcate how much will be in the form of savings. What’s more important is getting into the habit of saving before you spend instead of saving after spending. If you spend first then you’ve deprived yourself of the opportunity to save for a rainy day. Furthermore, <a href="https://eprints.hud.ac.uk/id/eprint/10231/1/Microsoft_Word_-_submitted_version_3rd_June_201.pdf">research</a> has shown that getting into the habit of saving has a transgenerational effect: it can be considered a cultural value that is passed on from one generation to another. So think of saving as paying yourself first. Once you have done so, you won’t feel guilty for treating yourself because you’ve already done the financially responsible thing by putting your savings aside. <h2>5. Considering assets and liabilities</h2> Once you’ve become comfortable with consistently budgeting, you can take it up a notch by including your assets (everything you own with an economic value) and liabilities (everything you owe) to determine your overall financial position. You can get a clearer picture of your overall financial wellbeing by compiling a list of all your assets, for example your savings and <a href="https://www.investopedia.com/terms/h/home_equity.asp">home equity</a>, in relation to liabilities (such as bank loans). Knowing your long-term financial position can indicate how financially resilient or vulnerable you are. In the event of a financial emergency, you will know which resources you can draw upon to meet an unexpected expense. By creating a budget (and sticking to it), you can protect yourself and your household from financial shocks. Consider the alternative. Imagine you haven’t budgeted and set savings aside. If a financial emergency were to arise, your next best bet would be to borrow the funds you need. You’d have to come up with a plan to repay what you’d borrowed while also building your savings. <h2>A healthy habit</h2> Getting into the habit of budgeting isn’t easy, especially if you haven’t done it before or you’re intimidated by the process. But, as the expression goes, “a journey of a thousand miles begins with a single step”. Think of budgeting as taking a small but important step towards reclaiming control over your finances and improving your financial well-being.<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/214861/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bomikazi-zeka-680577">Bomikazi Zeka</a>, Assistant Professor in Finance and Financial Planning, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/battling-to-make-ends-meet-financial-planning-expert-offers-5-tips-on-how-to-build-your-budget-214861">original article</a>.

Money & Banking

Dog care below freezing − how to keep your pet warm and safe from cold weather, road salt and more this winter

<a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a> Time outside with your dog in the spring, summer and fall can be lovely. Visiting your favorite downtown café on a cool spring morning, going to a favorite dog park on a clear summer evening or going on walks along a river when the leaves are changing color are all wonderful when the weather is favorable. But in much of the country, when winter rolls around, previously hospitable conditions can <a href="https://theconversation.com/is-winter-miserable-for-wildlife-108734">quickly turn chilly and dangerous</a> for people and pups alike. Winter brings some unique challenges for dog owners, since dogs still need activity and socialization during colder seasons. Studies have shown that dog owners are almost 50% less likely to walk their dogs <a href="https://doi.org/10.3390/ani11113302">when the weather gets cold</a>. Knowing the basics of winter safety is critical to maintaining a healthy lifestyle for your dog. I am an <a href="https://www.vetmed.ucdavis.edu/faculty/erik-olstad">assistant professor</a> at the University of California Davis School of Veterinary Medicine who weathered polar vortexes with my dog while living in Michigan early in my career. While I’ve since moved to sunny California, I’ve seen how quickly frigid temperatures can turn dangerous for pets. <h2>Breed and age differences</h2> Not all dogs have the same abilities to deal with cold weather. A short-coated dog like a Chihuahua is much more susceptible to the dangers of cold weather than a thick-coated husky. When the weather dips below 40 degrees Fahrenheit (4 degrees Celsius), the well-acclimated husky may be comfortable, whereas the Chihuahua would shiver and be at risk of hypothermia. Additionally, if your dog is used to warm weather, but you decide to move to a colder region, the dog will need time to acclimate to that colder weather, even if they have a thick coat. Age also affects cold-weather resilience. Puppies and elderly dogs can’t withstand the chill as well as other dogs, but every dog is unique – each may have individual health conditions or physical attributes that make them more or less resilient to cold weather. <h2>When is my dog too cold?</h2> Pet owners should be able to recognize the symptoms of a dog that is getting too cold. Dogs will shiver, and some may vocalize or whine. Dogs may resist putting their feet down on the cold ground, or burrow, or try to find warmth in their environment when they are uncomfortable. Just like people, <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">dogs can get frostbite</a>. And just like people, the signs can take days to appear, making it hard to assess them in the moment. The most common sites for frostbite in dogs are their ears and the tips of their tails. Some of the initial signs of frostbite are skin discoloring, turning paler than normal, or purple, gray or even black; red, blistered skin; swelling; pain at the site; <a href="https://www.britannica.com/science/ulcer">or ulceration</a>. Other <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">serious signs of hypothermia</a> include sluggishness or lethargy, and if you observe them, please visit your veterinarian immediately. A good rule to live by is if it is too cold for you, it is too cold for your dog. Getting your dog a <a href="https://www.cnn.com/cnn-underscored/pets/best-winter-dog-coats-jackets">sweater or jacket</a> and <a href="https://www.akc.org/expert-advice/vets-corner/protect-dogs-paws-snow-ice-salt/">paw covers</a> can provide them with protection from the elements and keep them comfortable. Veterinarians also recommend closely monitoring your dog and limiting their time outside when the temperature nears the freezing point or drops below it. <h2>Road salt dangers</h2> Road salt that treats ice on streets and sidewalks <a href="https://www.cbc.ca/news/canada/kitchener-waterloo/ice-salt-toxic-for-pets-1.5020088">can also harm dogs</a>. When dogs walk on the salt, the sharp, rough edges of the salt crystals can irritate the sensitive skin on their paws. Dogs will often lick their feet when they’re dirty, wet or irritated, and if they ingest any salt doing that, they may face GI upset, dehydration, kidney failure, seizures or even death. Even small amounts of pure salt can <a href="https://www.petpoisonhelpline.com/pet-tips/my-dog-ate-road-salt-will-they-be-okay/">disrupt critical body functions</a> in dogs. Some companies make pet-safe salt, but in public it can be hard to tell what type of salt is on the ground. After walking your dog, wash off their feet or boots. You can also keep their paw fur trimmed to prevent snow from balling up or salt collecting in the fur. Applying a thin layer of petroleum jelly or <a href="https://www.akc.org/expert-advice/lifestyle/how-to-make-your-own-paw-balm-for-winter/">paw pad balm</a> to the skin of the paw pads can also help protect your pet’s paws from irritation. <h2>Antifreeze risks</h2> <a href="https://www.britannica.com/science/antifreeze-chemical-substance">Antifreeze, or ethylene glycol</a>, is in most vehicles to prevent the fluids from freezing when it gets cold out. Some people pour antifreeze into their toilets when away from their home to prevent the water in the toilet from freezing. Antifreeze is an exceptionally dangerous chemical to dogs and cats, as it tastes sweet but can be deadly when ingested. If a pet ingests even a small amount of antifreeze, the substance causes a chemical cascade in their body that results in severe kidney damage. If left untreated, the pet may have <a href="https://www.petpoisonhelpline.com/pet-owner-blog/antifreeze-poisoning/">permanent kidney damage or die</a>. There are safer antifreeze options on the market that use ingredients other than ethylene glycol. If your dog ingests antifreeze, please see your veterinarian immediately for treatment. When temperatures dip below freezing, the best thing pet owners can do is keep the time spent outside as minimal as possible. Try some <a href="https://www.akc.org/expert-advice/lifestyle/great-indoor-games-to-play-with-your-dog/">indoor activities</a>, like hide-and-seek with low-calorie treats, fetch or even an interactive obstacle course. Food puzzles can also keep your dog mentally engaged during indoor time. Although winter presents some unique challenges, it can still be an enjoyable and healthy time for you and your canine companion.<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/221709/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, Health Sciences Assistant Professor of Clinical Veterinary Medicine, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</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/dog-care-below-freezing-how-to-keep-your-pet-warm-and-safe-from-cold-weather-road-salt-and-more-this-winter-221709">original article</a>.

Family & Pets

How tracking menopause symptoms can give women more control over their health

<a href="https://theconversation.com/profiles/deborah-lancastle-1452267">Deborah Lancastle</a>, <a href="https://theconversation.com/institutions/university-of-south-wales-1586">University of South Wales</a> Menopause can cause more symptoms than hot flushes alone. And some of your symptoms and reactions might be due to the menopause, even if you are still having periods. Research shows that keeping track of those symptoms can help to alleviate them. People sometimes talk about the menopause as though it were a single event that happens when you are in your early 50s, which is <a href="https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397#:%7E:text=Menopause%20is%20the%20time%20that,is%20a%20natural%20biological%20process.">the average time</a> to have your last period. But the menopause generally stretches between the ages of 45 and 55. And some women will experience an earlier “medical” menopause because of surgery to remove the womb or ovaries. The menopause often happens at one of the busiest times of life. You might have teenagers at home or be supporting grown-up children, have elderly parents, be employed and have a great social life. If you feel exhausted, hot and bothered, irritable and can’t sleep well, you might be tempted to think that it is because you never get a minute’s peace. But that is why monitoring symptoms is important. <a href="https://journals.lww.com/menopausejournal/Abstract/2023/03000/Symptom_monitoring_improves_physical_and_emotional.7.aspx">My team recently tested</a> the effects of tracking symptoms and emotions during the menopause. We asked women to rate 30 physical and 20 emotional symptoms of the menopause. The physical and psychological symptoms included poor concentration, problems with digesting food, stress and itchy skin, as well as the obvious symptoms like hot flushes and night sweats. Women tracked positive emotions like happiness and contentment, and negative emotions like feeling sad, isolated and angry. There were two groups of women in this study. One group recorded their symptoms and emotions every day for two weeks. The other group recorded their symptoms and emotions once at the beginning of the fortnight and once at the end. The results showed that the women who monitored their symptoms and emotions every day reported much lower negative emotions, physical symptoms and loneliness at the end of two weeks than at the beginning, compared to the other group. As well as this, although the loneliness scores of the group who monitored every day were lower than the other group, women in both groups said that being in the study and thinking about symptoms helped them feel less lonely. Simply knowing that other women were having similar experiences seemed to help. One participant said: “I feel more normal that other women are doing the same survey and are probably experiencing similar issues, especially the emotional and mental ones.” <h2>Why does monitoring symptoms help?</h2> One reason why tracking might help is that rating symptoms can help you notice changes and patterns in how you feel. This could encourage you to seek help. Another reason is that noticing changes in symptoms might help you link the change to what you have been doing. For example, looking at whether symptoms spike after eating certain foods or are better after exercise. This could mean that you change your behaviour in ways that improve your symptoms. Many menopause symptoms are known as “non-specific” symptoms. This is because they can also be symptoms of mental health, thyroid or heart problems. It is important not to think your symptoms are “just” the menopause. You should always speak to your doctor if you are worried about your health. Another good thing about monitoring symptoms is that you can take information about how often you experience symptoms and how bad they are to your GP appointment. This can help the doctor decide what might be the problem. Websites such as <a href="https://healthandher.com">Health and Her</a> and <a href="https://www.balance-menopause.com">Balance</a> offer symptom monitoring tools that can help you track what is happening to your physical and emotional health. There are several apps you can use on your phone, too. Or you might prefer to note symptoms and how bad they are in a notebook every day.<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/209004/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/deborah-lancastle-1452267">Deborah Lancastle</a>, Associate Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-south-wales-1586">University of South Wales</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-tracking-menopause-symptoms-can-give-women-more-control-over-their-health-209004">original article</a>.

Body

Flight attendant reveals how to score a free upgrade

A flight attendant has shared her number one trick for securing an upgrade on your next plane journey. American flight attendant Cierra Mistt revealed the one question you should ask at check-in to score an upgrade to first class, with the hack working almost every time. Mistt started her now-viral video by saying her hack to get a free upgrade was top secret. “Let’s look at the big picture. Everyone is flying right now, and no one is more excited about that than commercial airlines,” she said. “The majority of airlines are overbooking every single flight they have.” “It comes from the last month of me trying to get home and not even being able to get on standby because every single flight has been oversold,” she said. “I am not talking about one or two seats. I am talking about 10-30 seats that have been oversold.” Mistt said this overselling of flights presents an opportunity to travellers. “If everyone does show up, including the extra passengers that were oversold their tickets, the airlines have no choice but to financially compensate,” she said. The flight attendant shared that airlines “normally start off with vouchers for $500 or something”. “Normally they say a voucher but you can ask for it in cash,” she said. “Depending on the flight and how desperate they are, they will go up to, like three, four, five thousand dollars.” “This is where the free upgrades come in.” Mistt said not only could you ask for a free upgrade in such circumstances, but you could “also ask for other incentives”. “For example, drinks, dinners, breakfast, even a hotel if you have to stay overnight until the next flight,” she said. “And, yes, you can also ask to be upgraded to first class.” Her video received more than a million views, with people praising the hack and sharing how it has worked for them. “I got upgraded to first class by doing this,” said one person. Image credits: TikTok / Getty Images

Travel Tips

How music is changing the way dementia patients think

New research has proven that music truly is the universal language, with experts discovering how the power of music is helping those suffering with dementia. Music therapists have shown that music brings dementia patients back to the present, with some even finding their voice thanks to the nostalgic memories of the past. According to Registered Music Therapist and Managing Director of music therapy company Music Beat, Dr Vicky Abad, the power of music is not to be overlooked when it comes to degenerative diseases. “Music is a window into people’s pasts,” she said. “It builds on strengths and abilities against a disease that can strip a person of their dignity, abilities and quality of life.” The team at <a href="https://www.tricare.com.au/">TriCare Aged Care and Retirement</a>, who see the devastating impact of dementia each and every day, also experience first-hand the impact music has on residents, with many noticing “unrecognisable” changes in personality when a nostalgic tune is played. Louis Rose, an 80-year-old dementia patient and TriCare resident, was diagnosed with dementia six years ago, and requires assistance with many aspects of day to day life. However, listening to music is one thing he can enjoy on his own. “I grew up in Mauritius and while we didn’t have a lot, we certainly had music. Listening to music has always been an escape for me and a way to relax,” Mr Rose said. “When your brain starts to slow down and you find yourself forgetting things, it can be quite frustrating and confusing. Listening to music has been a way to distract myself from what’s going on in my head, it has helped me so much.” Tamsin Sutherland is a regular live music performer at TriCare facilities across Queensland, and has been able to witness incredible moments with the residents as they come alive as soon as she starts to play. “Watching residents who are often non-verbal sing along to the words is incredible,” she said “It really is like they are coming back to life and reconnecting with who they once were. To be part of that is quite emotional for me.” According to Dr Abad, music can help prevent the restless behaviour that often leads to pacing and wandering, especially in the evenings, which are often difficult times for those battling the disease. “Sundowning usually occurs in the late afternoon as dusk approaches, a time that is also associated with what used to be a busy time period in people’s lives,” she noted. “Personalised music is a simple and effective tool to help residents feel validated in their emotions during this time and provides them an opportunity to experience a calmer state of mind”. Image credits: Getty Images

Mind

Selfies and social media: how tourists indulge their influencer fantasies

<a href="https://theconversation.com/profiles/brendan-canavan-228682">Brendan Canavan</a>, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</a> A town in the US state of Vermont <a href="https://www.nbcnews.com/news/vermont-town-banning-influencers-tourists-visiting-fall-foliage-rcna117413">closed its roads to tourists</a> in September 2023 after a social media tag sparked a swarm of visitors that overwhelmed the rural destination. Videos on TikTok were seen by thousands and the hashtag #sleepyhollowfarm went viral, prompting a tourist rush to the pretty New England town of Pomfret, where visitors tried to take photos of themselves against the countryside backdrop. The town, famous for its fall foliage, criticised this as problematic and “influencer tourism”, part of <a href="https://www.sciencedirect.com/science/article/pii/S0160738320300426">a travel trend</a> where a social media phenomenon can spark an overwhelming and unexpected rise in visitor numbers. <a href="https://journals.sagepub.com/doi/pdf/10.1177/0002764292036002005?casa_token=gQo4-8jeYdIAAAAA:Oq3Nf5gTtAFK7N00D1NgPO7_zl9ONlOEnzFZnojX6fX1nKXQWJZ4ERn52MlV3abn4fDN4_C4hJjq">Traditionally</a>, we think of tourists as travelling to gain new experiences. They look at sites, take photographs and collect souvenirs. However, this relationship between the tourist and touring is changing. Driven by <a href="https://www.dw.com/en/how-instagram-changed-the-tourism-industry/a-65348690">24-hour access to social media</a>, some tourists now travel primarily to have an experience that <a href="https://www.americanexpress.com/en-us/travel/discover/get-inspired/Global-Travel-Trends">looks good online</a>. Around 75% of people in a recent American Express survey said they had been inspired to visit somewhere by social media. Some tourists may be prompted to choose a destination by seeing a <a href="https://www.elle.com/culture/travel-food/a27561982/best-instagram-spots/">backdrop that is popular on social media or on television</a>, in order to create a high-status photo. The expansion of social media and ubiquity of smartphone cameras has had a <a href="https://www.mdpi.com/2071-1050/13/13/7312">major impact on tourists’ behaviour</a>. This has also led to what’s been called a <a href="https://www.traveldailynews.com/column/articles/who-are-the-selfie-gaze-tourists/">selfie “tourist gaze”</a>, creating photos where the traveller is at the forefront of images rather than the destination. Indeed, according to my research, increasingly, some tourists go somewhere <a href="https://www.sciencedirect.com/science/article/pii/S0160738320300426">to be spotted</a> – to be observed by others both online and in person at these destinations. <h2>Looking for drama</h2> Studies have highlighted how tourists <a href="https://www.sciencedirect.com/science/article/pii/S0261517715300388?casa_token=W51WkDKJSK8AAAAA:DG99dEWkyYKWIe6hNcLXR4KRApXV24QksHIzrRNcjVY3FngukDgIv9HLHG4o3NV4rqNJtdet">head for</a> particularly dramatic or luxurious destinations because of their social media links. Dubai, for example, with its bling culture and high-end shopping, has become a <a href="https://www.theguardian.com/world/2021/apr/17/in-this-world-social-media-is-everything-how-dubai-became-the-planets-influencer-capital">playground for influencers</a> looking for a luxury backdrop to add to their celebrity-style image. Some tourists aim to photograph themselves in prestigious locations, rather than taking shots of their <a href="https://journals.sagepub.com/doi/pdf/10.1177/13567667221113079?casa_token=xbdUjWECQvMAAAAA:mc4rqleOqgjazW9DAYduW7LaPTu4KEw1DIfbPbWF0vl0efwNPC_GQ0U-HjltguwsIsCoO4ycXgyW7Q">travel surroundings</a>. Others choose to <a href="https://www.sciencedirect.com/science/article/pii/S0160738320300426">act like mini-celebrities</a> and perform for the camera, expecting and wanting to be looked at by those they encounter – or even narrating their participation in extreme events. One of these is the <a href="https://www.theadventurists.com/rickshaw-run/">Rickshaw Run</a>, a 2,000km race across India. This adventure tourism event encourages participants to dress up, act eccentrically and get noticed. Driving tuk-tuks around India, from Kerala to Darjeeling, vehicles are personalised with eye-catching designs. Many participants film themselves and <a href="https://www.youtube.com/watch?v=2p3wd0ii2oQ">upload the results</a> to social media, and the events tend to create a significant following. For instance, this YouTube video series created by Rickshaw Run participants drew 3.6m subscribers: <figure><iframe src="https://www.youtube.com/embed/2p3wd0ii2oQ?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Taking part in the Rickshaw Run.</figcaption></figure> However, some of these tourist “performances” can cause controversy. For instance, <a href="https://www.nzherald.co.nz/travel/mexico-tourist-beaten-with-stick-for-climbing-chichen-itza-pyramid/EL5KGLB4CNC5ZONNZCKAMX3LLE/">climbing over</a> fragile archaeological sites in search of social media content might damage them. <a href="https://www.unilad.com/news/russian-tourist-deported-nude-photo-bali-064402-20230330">Posing for laughs</a> in areas considered sacred can offend. The reducing of cultures to <a href="https://www.thetimes.co.uk/article/selfie-tourists-get-up-easter-islanders-noses-sgfxdtkj7">backdrops for social media content</a> can suggest a lack of interest in or respect for hosts by tourists. My research points to a growth in <a href="https://www.tandfonline.com/doi/pdf/10.1080/09669582.2016.1263309">narcissism in society</a>, and connects this with what tourists desire from travel and how they act when travelling. This may be reflected in increased sense of entitlement and exhibitionism by tourists who aim to take photos in more difficult to reach locations or off-limit areas, for instance. Selfie culture arguably promotes <a href="https://www.tandfonline.com/doi/pdf/10.1080/09528822.2015.1082339?casa_token=tbsXw1drBAEAAAAA:qfSfJBbHWi3x8MSVeoyHBIceP7W_8C55rVctylf-2zRBzx-aG_EeFwvTmHHsOdjQpMd8LVaUrjSo">self-involvement rather than social responsibility</a>. It is well established that tourists <a href="https://www.tandfonline.com/doi/pdf/10.1080/1368350050408668198?casa_token=K4p5aZCN8t4AAAAA:96p7f3qNu2WndpE-C-D0rs5mJaOlnJ5F6P4iXQlWQopseMGWuJ_5TiaFmRggxFsEjrMCoAr14Kn4">can be selfish</a>, putting their own comfort and entertainment ahead of concerns about local issues. This is especially true of the super-rich. Private jet users <a href="https://www.transportenvironment.org/discover/private-jets-can-the-super-rich-supercharge-zero-emission-aviation/">are responsible for</a> half of global aviation emissions. However, the desire to promote the individual and their values could be <a href="https://www.tandfonline.com/doi/pdf/10.1080/09669582.2016.1263309">harnessed to promote</a> more sustainable tourism. Those volunteering abroad might be motivated by the image enhancement opportunities of doing good, but they often offer something back to the social and natural environments of <a href="https://www.tandfonline.com/doi/pdf/10.1080/09669580903395030?casa_token=NvJorz8d1F4AAAAA:AXXTdW7ePimqFkWNg1W5w8umGCBwXIjus0WICRIoNZH_gsdr1hHomvMAQV21PYA2HkLwBGsO_Qus8g">their host destinations</a> in the process. There are signs that there’s another tourism trend, with travellers looking for deep and meaningful experiences, and ecotourism could help provide those. The act of travelling in a <a href="https://www.tandfonline.com/doi/abs/10.1080/09669582.2020.1825458">more environmentally friendly way</a> could also be seen as a way to show off, and still provide selfie material. The environmental pros and cons of tourist self-obsession might be <a href="https://www.tandfonline.com/doi/pdf/10.1080/09669582.2016.1263309">debatable</a>. However, self-fixation is arguably not good for tourists themselves. For example, the desire to “perform” on camera could affect people’s mental health, according to one <a href="https://www.tandfonline.com/doi/pdf/10.1080/10253866.2018.1467318?casa_token=wI7sETKEKJAAAAAA:ebds6fykbyHAGSXIk9iv6-tyziFSIvganp32S65hiX8KeWlaQDwhPxF_2tWEgkNqssqd-SCE-w_3Eg">study</a>. Research has shown that <a href="https://www.tandfonline.com/doi/full/10.1080/14616688.2012.762691?casa_token=Jb9SzAGXBD0AAAAA:L5Q-HhPs9jWtfm0Zq4nB0uFHrZ3W8N7o1Liq0KAIRqC4ivEhKyEexEZN-ACoz1qzm7CMqD96zXOm">unexpected encounters help tourists to gain self-insight</a>. In addition, getting out of your comfort zone can lead to <a href="https://www.sciencedirect.com/science/article/pii/S2213078020300074?casa_token=MkMbkdyr_cMAAAAA:LLu44kUbbsP5e-iW-kDdI7iSEo3WkLgH5IvKqb2txZA504q74J4OAhTuXIx8m90oDMSvuiq4Mg">rewarding personal growth</a>. <h2>A disconnect between self and place</h2> Taking yet more selfies could cut people off from their surroundings. In doing so, they could be <a href="https://www.sciencedirect.com/science/article/pii/S016073831730097X?casa_token=tOaqrhfVQ-wAAAAA:uxb7djQMWjifvjjgPMZzbq2IQqlgoaGHzWoJkkGbQYQqkbZoeuOqLD91zqwBuWs1SfY7dcK4">less present in the travel experience itself</a>. Indeed, the <a href="https://english.elpais.com/usa/2021-10-29/rise-of-selfie-deaths-leads-experts-to-talk-about-a-public-health-problem.html">growing number</a> of <a href="https://edition.cnn.com/2019/11/15/asia/french-man-selfie-death-intl-scli/index.html">selfie-related tourist deaths</a> might attest to a disconnect between self and place. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131996/#:%7E:text=selfie-related%20deaths.-,From%20October%202011%20to%20November%202017%2C%20there%20have%20been%20259,respectively%2C%20in%202016%20and%202017">2018 report</a> estimated 259 deaths to have occurred while taking selfies between 2011-2017. Other research suggests that individuals who are motivated by the desire to present a particular online image may be <a href="https://www.sciencedirect.com/science/article/pii/S2211973620301458?casa_token=-HkTUB7WC7cAAAAA:455BE0L2jP-CL1nD18__Ey3fj5GsLmYfKL_EB_P7IWa7lDddpJYIW3UIo5fUjg68e7Nvm7PUlTA#s0050">more likely to take risks</a> with their travel selfies, with potentially fatal consequences. Tourists have always been somewhat self-obsessed. The 18th-century <a href="https://www.sciencedirect.com/science/article/pii/0160738385900027">Grand Tour</a>, a leisurely trip around Europe, allowed the wealthy to <a href="https://www.historyhit.com/what-was-the-grand-tour/">indulge themselves</a> in <a href="https://www.salon.com/2002/05/31/sultry/">ways</a> that might not have been socially acceptable back home. And at the beginning of the 21st century, <a href="https://www.sciencedirect.com/science/article/pii/S0160738301000305?casa_token=C5eb2NJQvGsAAAAA:YrdY-xjJwBrUE9RjwyOJ3kRBS4-o7e5Jni5sluTCuZOrgnCULybO8EgJtQqsuSL7B5nZJwiH3Q#BIB37">academics worried about</a> self-involved backpacker communities in southeast Asia having little interest in mixing with local people. What is different about smartphones and social media is that these allow some tourists to present such self-indulgent, and sometimes insensitive, tourism traits immediately. Wifi and mobile data mean that these tourists can travel with one eye on finding the perfect selfie backdrop – filtering and sharing their travel as it happens, responding to likes and comments. For better or worse, living this influencer fantasy may have become an integral part of tourism for some time.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214681/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brendan-canavan-228682">Brendan Canavan</a>, Senior Lecturer in Marketing, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</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/selfies-and-social-media-how-tourists-indulge-their-influencer-fantasies-214681">original article</a>.

Travel Trouble

How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast. Give meditation a try As a mindfulness coach, I’m very aware of the day-to-day anxieties and worries that can interfere with a good night’s sleep. One of the most effective natural sleep aids is a quick meditation session to ease yourself out of those stresses. If you’ve never meditated before, you’ll likely find the meditation interrupted by thoughts flashing through your mind. It’s important for you to know that this isn’t a failure on your part, and that you aren’t doing anything wrong. Thinking is just what the brain does, as naturally as lungs take in air. The point is to be non-judgmental yet aware of your thoughts, bodily experiences and breath, moment by moment. Stop wanting to fall asleep It’s counterintuitive, isn’t it? Sometimes trying too hard to do something is the very thing that prevents us from achieving it – and that’s never more true than when it comes to falling asleep. Desperately wanting to sleep will only stoke anxieties that will further stress your brain, essentially feeding it the message that it’s not safe to sleep. Throw in those worries about your to-do list at work the following day, and the whole thing can snowball into a panic attack. Try letting go of that feeling that you absolutely must sleep now, and observe your own anxieties for what they are without judgment. When you stop looking at sleep as a goal, you’ll find it easier to fall asleep. Start a journal If you find yourself struggling to fall asleep, pick up a pen and paper (not your phone!), and start writing: simply scribble down an account of what’s going on inside your head. Although there’s no “right” way to journal, you might start by listing the events of your day, and from there, how those events and encounters made you feel. Building this structured picture of your thoughts may help you see that the problem that’s keeping you up at night, and is likely less overwhelming than you thought. Why my insistence on a pen and paper? First off, studies show the simple motor action that’s involved in the act of handwriting has a calming effect. Secondly, the light emitted by laptops and phones isn’t conducive to falling asleep. Find yourself a "3am friend" Some of us are lucky to have a ‘3am friend’, that close confidant you can call up in the wee hours knowing that they won’t hold it against you in the morning. Although it’s great to have someone to talk to when you want to fall asleep, it’s important that the conversation doesn’t just rehash the anxieties that are preventing you from catching shut-eye in the first place. Rather than using the call to seek solutions for those issues, talk about things that calm your nerves, or even have them assist you in deep breathing. It may sound silly, but doing a series of deep, relaxing breaths can help you let go of the troubles that are keeping you wide awake. Take a warm shower Taking a warm shower not only relaxes your muscles and soothes minor aches and pains, but it also raises your core body temperature. As soon as you step out of the shower, your body starts working at lowering that temperature, which is something that normally happens when you’re falling asleep naturally. (That’s why we always feel the need for a blanket when we sleep, no matter how warm it is!) By kick-starting that temperature-lowering process, you’re tricking your body into falling asleep fast. Stretch yourself to sleep Anxiety keeping you up? Research suggests mild stretching can help take the edge off and relax muscles that have become stiff and sore after a long day. We’re not talking intricate yoga poses or acrobatics here, either: Simple stretches like an overhead arm stretch and bending over to touch your toes should do the trick. Ramp up the relaxation potential with a soundtrack of ambient noise at a volume that’s just barely audible. There are plenty of white noise apps that are free to download, but soft music can work as well (so long as there are no lyrics). Just remember, if you’re using an electronic device to play these sleep-promoting sounds, make sure it’s placed screen-down so you’re not distracted by the light it emits. Read (or listen!) to something new When you’re struggling with insomnia, it might be tempting to pull an old favourite off the bookshelf. In reality, it’s better to read or listen to an audio book that covers a topic on which you know absolutely nothing. New information, while taking attention away from the stressors that are keeping you up at night, gives your brain enough of a workout to make it tire more quickly than when it’s engaged with familiar subjects and concepts. Again, if it’s an audio book or podcast you’re listening to, make sure the light-emitting side of the device is face down to keep the room as dark as possible. Darkness and warmth play an essential part in the production and maintenance of melatonin, the hormone that plays the central role falling asleep. Image credits: Getty Images This article by Deepak Kashyap originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/conditions/sleep/how-to-fall-asleep-without-sleeping-pills-7-natural-sleep-aids-that-actually-work" target="_blank" rel="noopener">Reader's Digest</a>.

Body

How to look after your mental health while packing up Mum or Dad’s home

<a href="https://theconversation.com/profiles/erika-penney-1416241">Erika Penney</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a>; <a href="https://theconversation.com/profiles/alice-norton-1516505">Alice Norton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/avalon-tissue-1515840">Avalon Tissue</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> So Mum or Dad has died, or moved to aged care, and now you’ve got to pack up their house. It’s a huge job and you’re dreading it. It’s normal to feel grief, loss, guilt, exhaustion or even resentment at being left with this job. So how can you look after your mental health while tackling the task? <h2>It’s OK to feel a lot of feelings</h2> Research has documented how this task can exert an intense <a href="https://www.tandfonline.com/doi/full/10.1080/15267431.2021.1943399">physical and emotional toll</a>. This can be more intense for those who had strained – or even <a href="https://journals.sagepub.com/doi/epub/10.1177/0030222819868107">traumatic</a> – relationships with the person whose house they’re packing up. Decisions around distributing or discarding items can, in some families, bring up painful reminders of the past or end up <a href="https://journals.sagepub.com/doi/10.1177/1074840711428451">replaying strained dynamics</a>. Family members who were carers for the deceased may feel exhaustion, overwhelm, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.1512?sid=vendor%3Adatabase">burnout</a> or a sense of injustice they must now continue to be responsible for their loved one’s affairs. Grief can be compounded by the practical challenges of deciding how to <a href="https://doi.org/10.1016/0148-2963(94)00054-I">store or discard belongings</a>, <a href="https://www.jstor.org/stable/30000385">arrange the funeral</a>, execute the will, deal with the aged care place or, in some cases, navigate legal disputes. But packing up the house may also be cathartic or helpful. <a href="https://www.tandfonline.com/doi/full/10.1080/15267431.2021.1943399">Research</a> has shown how the task of cleaning out a loved one’s belongings can provide an opportunity for family and friends to talk, share memories, and make sense of what has just happened. It’s also normal to grieve before someone dies. What psychologists call “<a href="https://pubmed.ncbi.nlm.nih.gov/29206700/">anticipatory</a> grief” can happen to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1615888/">relatives packing up the house</a> of a parent who has moved to aged care or palliative care. <h2>What to do with all this stuff?</h2> <a href="https://doi.org/10.1016/0148-2963(94)00054-I">Some</a> treat their loved one’s items with sanctity, holding onto as many of their belongings as possible and creating “shrines” in their honour. Others alleviate the weight of grief by clearing out a loved one’s house as soon as possible, giving away, selling or discarding as much as they can. But if you experience a mix of these – enthusiastically getting rid of some stuff, while desperately wanting to hold onto other things – that’s OK too. One <a href="https://www.tandfonline.com/doi/abs/10.1080/10253866.2017.1367677">study</a> identified a process punctuated by four key periods: <ol> <li> numbness and overwhelm at the task of packing the house </li> <li> yearning to maintain a link to the loved through their belongings </li> <li> working through grief, anger and guilt regarding the loved one and the task of managing their belongings, and </li> <li> healing and making sense of the relationship with the deceased and their belongings. </li> </ol> However, it is important to note everyone’s approach is different and there is no “right” way to do the clean out, or “right” way to feel. <h2>Caring for your mental health during the clean out</h2> To care for your mental health during these difficult times, you might try to: <ul> <li> make space for your feelings, whether it’s sadness, loss, resentment, anger, relief or all the above. There is no right or wrong way to feel. <a href="https://guilfordjournals.com/doi/abs/10.1521/jscp.2011.30.2.163">Accepting</a> your emotions is healthier than suppressing them </li> <li> share the load. <a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.1999.01220.x">Research</a> has shown practical support from close friends and family can help a lot with grief. Accept help with packing, planning, dealing with removalists, selling or donating items and cleaning. Don’t be afraid to reduce your mental load by delegating tasks to friends, who are likely wondering how they can help </li> <li> take a systematic approach. Break tasks into their smallest component. For example, aim to clean out a drawer instead of an entire bedroom. This can help the mental and physical task feel more manageable </li> <li> reflect on what’s meaningful to you. Some belongings will have <a href="https://doi.org/10.1016/0148-2963(94)00054-I">meaning</a>, while others will not. What was valuable to the deceased may not be valuable to you. Things they probably saw as pretty worthless (a handwritten shopping list, an old sewing kit) may be very meaningful to you. Ask yourself whether retaining a small number of meaningful possessions would allow you to maintain a connection with your loved one, or if clearing out the space and discarding the items is what you need </li> <li> share your story. When you feel ready, share your “<a href="https://www.tandfonline.com/doi/full/10.1080/15267431.2021.1943399">cleaning out the closet</a>” story with trusted friends and family. Storytelling allows the deceased to live on in memory. <a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.1999.01220.x">Research</a> also suggests we cope better with bereavement when friends and relatives make time to hear our feelings </li> <li> remember that professional help is available. Just as a solicitor can help with legal disputes, a mental health professional can help you process your feelings. </li> </ul> The home of your loved one is not merely a place where they lived, but a space filled with meaning and stories. Packing up the house of a loved one can be incredibly daunting and challenging, but it can also be an important part of your grieving process. If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<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/223956/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erika-penney-1416241">Erika Penney</a>, Lecturer in Clinical Psychology, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a>; <a href="https://theconversation.com/profiles/alice-norton-1516505">Alice Norton</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/avalon-tissue-1515840">Avalon Tissue</a>, Associate Lecturer in Clinical Psychology, <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-to-look-after-your-mental-health-while-packing-up-mum-or-dads-home-223956">original article</a>.

Caring

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

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

Mind

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

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

Body

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

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

Body

How long does menopause last? 5 tips for navigating uncertain times

<a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Around half of the world’s population are women or people who menstruate – yet the way their body works can be a mystery, even to them. Most women will experience periods roughly every month, many will go through childbirth and those who live into midlife will experience menopause. While menopause is a significant time of change, it isn’t talked about much, other than as a punchline. This may contribute to keeping it a <a href="https://www.theguardian.com/membership/2019/sep/21/breaking-the-menopause-taboo-there-are-vital-stories-we-should-continue-to-pursue">taboo topic</a>. So, what happens during menopause? How do you know when it is happening to you? And – the thing most women want to know – how long will it last? <h2>What is menopause?</h2> Menopause is <a href="https://www.nia.nih.gov/health/what-menopause">defined</a> as the permanent cessation of menstruation, which is medically determined to be one year after the final menstrual period. After this time women are considered to be postmenopausal. The <a href="https://pubmed.ncbi.nlm.nih.gov/26598775/">average age</a> of “natural menopause” (that is not caused by a medical condition, treatment or surgery) is considered to be around 51 years. However, natural menopause does not occur suddenly. <a href="https://www.researchgate.net/profile/Riitta-Luoto/publication/46425690_Prevalence_of_menopause_symptoms_and_their_association_with_lifestyle_among_Finnish_middle-aged_women/links/5c5704ac458515a4c7553c7b/Prevalence-of-menopause-symptoms-and-their-association-with-lifestyle-among-Finnish-middle-aged-women.pdf">Changes can begin</a> a number of years before periods stop and most often occur in a woman’s 40s but they can be earlier. Changes <a href="https://pubmed.ncbi.nlm.nih.gov/25686030/">can continue</a> for 10 years or more after periods have stopped. Using hormones such as the oral contraceptive pill or hormone intrauterine devices may make it more <a href="https://pubmed.ncbi.nlm.nih.gov/31934948/">difficult to determine</a> when changes start. Menopause that occurs <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">before 45</a> is called “early menopause”, while menopause before 40 is called “premature menopause”. <h2>What about perimenopause?</h2> Various <a href="https://www.menopause.org.au/hp/information-sheets/glossary-of-terms">terms</a> are used to describe this period of change, including “menopause” or “the menopause”, “menopausal transition”, “perimenopause” or “<a href="https://pubmed.ncbi.nlm.nih.gov/12188398/">climacteric</a>”. These terms tend to refer to the period before and after the final menstrual period, when changes are considered to be related to menopause. The difficulty with the definition of menopause is it can only be decided retrospectively. Yet women can experience changes many years before their periods stop (a lead up usually called “perimenopause”). Also, any <a href="https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0889854518300627/first-page-pdf">changes noticed</a> may not be associated with menopause (because people might not be aware of what to expect) or changes may be associated with a combination of factors such as stress, being busy or other health issues. <h2>So, what is going on?</h2> Through a feminist lens, menopause can be seen as a <a href="https://www.researchgate.net/publication/354652248_The_volcano_within_a_study_of_women's_lived_experience_of_the_journey_through_natural_menopause">complex and diverse experience</a>, influenced by biological, psychological, social and cultural aspects of women’s lives. However, it is usually viewed from the biomedical perspective. This sees it as a biological event, marked by the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">decline</a> in ovarian hormone levels leading to a reduction in reproductive function. The female reproductive system operates because of a finely tuned balance of hormones managed by the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466056/#:%7E:text=The%20hypothalamic%2Dpituitary%2Dovarian%20(HPO)%20axis%20must%20be,priming%20the%20endometrium%20for%20implantation.">hypothalamic-pituitary-ovarian axis</a>. International <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/">experts</a> have developed a staging system for female reproductive ageing, with seven stages from “early reproductive” years to “late postmenopause”. However, female reproductive hormones do not just affect the reproductive system but <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">other aspects</a> of the body’s function. These include the <a href="https://pubmed.ncbi.nlm.nih.gov/26007613/">neurological system</a>, which is linked to hot flushes and night sweats and disrupted sleep. Hormones may also affect the <a href="https://www.nature.com/articles/nrdp20154">heart and body’s blood circulation</a>, bone health and potentially the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">immune system</a>. Menopausal hormone changes may <a href="https://www.thewomens.org.au/health-information/menopause-information/menopause-symptoms/">cause</a> hot flushes, night/cold sweats, mood swings, sleep disruption and tiredness, vaginal dryness. Medical confirmation of menopausal changes in women over 45 years is based on two biological indicators: vasomotor symptoms (those hot flushes and night sweats again) and an <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">irregular menstrual cycle</a>. In early perimenopause the changes to the menstrual cycle may be subtle. Women may not recognise early indicators, unless they keep a record and know what to watch for. <h2>How long does it last?</h2> The body demonstrates an amazing ability to change over a lifetime. In a similar way to adolescence where long-lasting changes occur, the outcome of menopause is also change. Research suggests it is difficult to give an exact time frame for how long menopausal changes occur – the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">average</a> is between four and eight years. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">Penn Ovarian Ageing Study</a> found 79% of the 259 participants experienced hot flushes starting before the age of 50, most commonly between 45 and 49 years of age. A later report on the same study found one third of women studied experienced <a href="https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-016-0014-2">moderate to severe hot flushes</a> more than ten years after their periods had stopped. A <a href="https://journals.lww.com/menopausejournal/Abstract/2017/03000/Cultural_issues_in_menopause__an_exploratory.11.aspx">2017 study</a> found a small number of women continued to experience hot flushes and other symptoms into their 70s. So overall, the research cannot offer a specific window for perimenopause, and menopause does not appear to mark the end of changes for everyone. <h2>5 tips for uncertain times</h2> Shifts and changes can be recognised early by developing knowledge, paying attention to changes to our bodies and talking about menopause and perimenopause more openly. Here are five tips for moving from uncertainty to certainty: 1. talk to people and find out as much information as you can. The experiences of mothers and sisters may help, for some women there are familial similarities 2. notice any changes to your body and make a note of them, this will help you recognise changes earlier. There are <a href="https://www.redonline.co.uk/wellbeing/a36980118/menopause-apps/">menopause tracking apps</a> available 3. keep a note of your menstrual cycle: start date, duration, flow and note any changes. Again, an app might help 4. if you are worried, seek advice from a GP or nurse that specialises in women’s health. They may suggest ways to help with symptoms or refer to a specialist 5. remember changes are the indicator to pay attention to, not time or your age. Menopause is a natural process and although we have focused here on the time frame and “symptoms”, it can also be a time of freedom (particularly from periods!), reflection and a time to focus on yourself.<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/195211/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <figure><iframe src="https://www.youtube.com/embed/lhosPUwWhfI?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Women speak about their experiences of menopause.</figcaption></figure> <a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, Nurse & Lecturer, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan 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/how-long-does-menopause-last-5-tips-for-navigating-uncertain-times-195211">original article</a>.

Body

Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

<a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a> Equipped with the latest gear and a thirst for adventure, mountaineers embrace the perils that come with conquering the world’s highest peaks. Yet, even those who tread more cautiously at high altitude are not immune from the health hazards waiting in the thin air above. Altitude sickness, which most commonly refers to <a href="https://medlineplus.gov/ency/article/000133.htm">acute mountain sickness</a>, <a href="https://doi.org/10.1016/j.pcad.2010.02.003">presents a significant challenge</a> to those traveling to and adventuring in high-altitude destinations. Its symptoms can range from <a href="https://doi.org/10.1089/ham.2017.0164">mildly annoying to incapacitating</a> and, in some cases, may progress to more <a href="https://doi.org/10.1183/16000617.0096-2016">life-threatening illnesses</a>. While <a href="https://doi.org/10.18111/9789284424023">interest in high-altitude tourism is rapidly growing</a>, general awareness and understanding about the hazards of visiting these locations <a href="https://doi.org/10.1089/ham.2022.0083">remains low</a>. The more travelers know, the better they can prepare for and enjoy their journey. As an <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/36740">emergency physician specializing in high-altitude illnesses</a>, I work to improve health care in remote and mountainous locations around the world. I’m invested in finding ways to allow people from all backgrounds to experience the magic of the mountains in an enjoyable and meaningful way. <h2>The science behind altitude sickness</h2> Altitude sickness is rare in locations lower than 8,200 feet (2,500 meters); however, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">it becomes very common</a> when ascending above this elevation. In fact, it affects about <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">25% of visitors to the mountains of Colorado</a>, where I conduct most of my research. The risk rapidly increases with higher ascents. Above 9,800 feet (3,000 meters), up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">75% of travelers</a> may develop symptoms. Symptoms of altitude sickness are usually mild and consist of <a href="https://doi.org/10.1089/ham.2017.0164">headache, dizziness, nausea, fatigue and insomnia</a>. They usually <a href="https://doi.org/10.1016/j.rceng.2019.12.009">resolve after one to two days</a>, as long as travelers stop their ascent, and the symptoms quickly resolve with descent. When travelers do not properly acclimatize, they can be susceptible to life-threatening altitude illnesses, such as <a href="https://doi.org/10.1016/j.resp.2007.05.002">high-altitude pulmonary edema</a> or <a href="https://doi.org/10.1089/1527029041352054">high-altitude cerebral edema</a>. These conditions are characterized by fluid accumulation within the tissues of the lungs and brain, respectively, and are the <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">most severe forms of altitude sickness</a>. Altitude sickness symptoms are thought to be caused by <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">increased pressure surrounding the brain</a>, which results from the failure of the body to acclimatize to higher elevations. As people enter into an environment with lower air pressure and, therefore, <a href="https://doi.org/10.1001/jamanetworkopen.2023.18036">lower oxygen content</a>, their <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">breathing rate increases</a> in order to compensate. This causes an increase in the amount of <a href="https://doi.org/10.1016/s1357-2725(03)00050-5">oxygen in the blood as well as decreased CO₂ levels</a>, which then increases blood pH. As a result, the <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">kidneys compensate</a> by removing a chemical called bicarbonate from the blood into the urine. This process makes people urinate more and helps correct the acid and alkaline content of the blood to a more normal level. <figure><iframe src="https://www.youtube.com/embed/iv1vQPIdX_k?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Tips for preventing or reducing the risk of altitude sickness.</figcaption></figure> <h2>The importance of gradual ascent</h2> High-altitude medicine experts and other physicians <a href="https://doi.org/10.1016/s0140-6736(76)91677-9">have known for decades</a> that <a href="https://doi.org/10.1089/ham.2010.1006">taking time to slowly ascend is the best way</a> to prevent the development of altitude sickness. This strategy gives the body time to complete its natural physiologic responses to the changes in air pressure and oxygen content. In fact, spending just <a href="https://doi.org/10.1089/ham.2010.1006">one night at a moderate elevation</a>, such as Denver, Colorado, which is at 5,280 feet (1,600 meters), has been shown to <a href="https://doi.org/10.7326/0003-4819-118-8-199304150-00003">significantly reduce the likelihood of developing symptoms</a>. People who skip this step and travel directly to high elevations are <a href="https://doi.org/10.1093/jtm/taad011">up to four times more likely</a> to develop altitude sickness symptoms. When going to elevations greater than 11,000 feet, multiple days of acclimatization are necessary. Experts generally recommend ascending <a href="https://doi.org/10.1089/ham.2010.1006">no more than 1,500 feet per day</a> once the threshold of 8,200 feet of elevation has been crossed. Workers at high altitude, such as <a href="https://doi.org/10.1089/ham.2020.0004">porters in the Nepali Himalaya</a>, are at <a href="https://doi.org/10.1016/j.wem.2018.06.002">particular risk of altitude-related illness</a>. These workers often do not adhere to acclimatization recommendations in order to maximize earnings during tourist seasons; as a result, they are more likely to experience <a href="https://www.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">severe forms of altitude sickness</a>. <h2>Effective medications</h2> For more than 40 years, <a href="https://doi.org/10.1056/nejm196810172791601">a medicine called acetazolamide</a> has been used to <a href="https://medlineplus.gov/druginfo/meds/a682756.html">prevent the development of altitude sickness</a> and to treat its symptoms. Acetazolamide is <a href="https://www.ncbi.nlm.nih.gov/books/NBK557838/">commonly used as a diuretic</a> and for the <a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma">treatment of glaucoma</a>, a condition that causes increased pressure within the eye. If started <a href="https://doi.org/10.1378/chest.09-2445">two days prior</a> to going up to a high elevation, acetazolamide can <a href="https://doi.org/10.1378/chest.09-2445">prevent symptoms of acute illness</a> by speeding up the acclimatization process. Nonetheless, it does not negate the recommendations to ascend slowly, and it is <a href="https://doi.org/10.1016/j.wem.2019.04.006">routinely recommended only</a> when people cannot slowly ascend or for people who have a history of severe altitude sickness symptoms even with slow ascent. Other medications, including ibuprofen, have <a href="https://doi.org/10.1016/j.wem.2012.08.001">shown some effectiveness</a> in treating acute mountain sickness, although <a href="https://doi.org/10.1016/j.amjmed.2018.10.021">not as well as acetazolamide</a>. A <a href="https://pubmed.ncbi.nlm.nih.gov/2028586/">steroid medication called dexamethasone</a> is effective in both treating and preventing symptoms, but it does not improve acclimatization. It is <a href="https://doi.org/10.1016/j.wem.2019.04.006">recommended only when acetazolamide is not effective</a> or cannot be taken. Additionally, it is important to <a href="https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes">avoid alcohol during the first few days at higher altitudes</a>, as it impairs the body’s ability to acclimatize. <h2>Unproven therapies and remedies are common</h2> As high-altitude tourism becomes increasingly popular, multiple commercial products and remedies have emerged. Most of them are not effective or provide no evidence to suggest they work as advertised. Other options have mixed evidence, making them difficult to recommend. Medications such as <a href="https://doi.org/10.1089/ham.2007.1037">aspirin</a>, <a href="https://doi.org/10.1183/13993003.01355-2017">inhaled steroids</a> and <a href="https://doi.org/10.1089/ham.2011.0007">sildenafil</a> have been proposed as possible preventive agents for altitude sickness, but on the whole they have not been found to be effective. <a href="https://doi.org/10.1093/qjmed/hcp026">Supplements and antioxidants have no proven benefit</a> in preventing or treating altitude sickness symptoms. Both normal and high-altitude exercise are popular ways to prepare for high elevations, especially among athletes. However, beyond <a href="https://doi.org/10.1097/jes.0b013e31825eaa33">certain pre-acclimatization strategies</a>, such as brief sojourns to high altitude, <a href="https://doi.org/10.1016/j.tmaid.2013.12.002">physical fitness and training is of little benefit</a>. <a href="https://missouripoisoncenter.org/canned-oxygen-is-it-good-for-you">Canned oxygen</a> has also exploded in popularity with travelers. While <a href="https://doi.org/10.1016/0140-6736(90)93240-p">continuously administered medical oxygen</a> in a health care setting can alleviate altitude sickness symptoms, portable oxygen cans <a href="https://doi.org/10.1016/j.wem.2019.04.006">contain very little oxygen gas</a>, casting doubt on their effectiveness. Some high-altitude adventure travelers sleep in <a href="https://doi.org/10.2165/00007256-200131040-00002">specialized tents</a> that simulate increased elevation by lowering the quantity of available oxygen in ambient air. The lower oxygen levels within the tent are thought to accelerate the acclimatization process, but the tents aren’t able to decrease barometric pressure. This is an important part of the high-altitude environment that induces acclimatization. Without modifying ambient air pressure, these <a href="https://doi.org/10.1016/j.wem.2014.04.004">tents may take multiple weeks</a> to be effective. Natural medicines, such as <a href="https://doi.org/10.1580/08-weme-br-247.1">gingko</a> and <a href="https://doi.org/10.1186/s40794-019-0095-7">coca leaves</a>, are touted as natural altitude sickness treatments, but few studies have been done on them. The modest benefits and significant side effects of these options makes their use <a href="https://doi.org/10.1016/j.wem.2019.04.006">difficult to recommend</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/8469948/">Staying hydrated</a> is very important at high altitudes due to fluid losses from increased urination, dry air and increased physical exertion. <a href="https://doi.org/10.1186%2Fs12889-018-6252-5">Dehydration symptoms</a> can also mimic those of altitude sickness. But there is <a href="https://doi.org/10.1580/1080-6032(2006)17%5B215:AMSIOF%5D2.0.CO;2">little evidence that consuming excessive amounts of water</a> can prevent or treat altitude sickness. The mountains have something for visitors of all interests and expertise and can offer truly life-changing experiences. While there are health risks associated with travel at higher elevations, these can be lessened by making basic preparations and taking time to slowly ascend.<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/222057/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, Senior Instructor in Emergency Medicine, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</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/altitude-sickness-is-typically-mild-but-can-sometimes-turn-very-serious-a-high-altitude-medicine-physician-explains-how-to-safely-prepare-222057">original article</a>.

Travel Trouble

How bad is junk food for you, really?

Consuming more junk foods, such as soft drinks, packaged snacks, and sugary cereals, is associated with a higher risk of more than 30 different health problems – both physical and mental – according to researchers. A study, known as an umbrella review, combined the results of 45 previous meta-analyses published in the last three years, representing about 10 million participants. Thirty-two different poor health outcomes were found to be linked to the consumption of ultra-processed foods (UPFs), with varying levels of evidence supporting the findings. The researchers found the most convincing evidence around higher ultra-processed food intake, which was associated with a 50% increased risk of cardiovascular disease-related death, a 48-53% higher risk of anxiety and common mental disorders, and a 12% greater risk of type 2 diabetes. Evidence marked as ‘highly suggestive’ included a 21% increase in death from any cause, a 40-66% increased risk of a heart disease related death, obesity, type 2 diabetes, and sleep problems, as well as a 22% increased risk of depression. The review also found there may be links between ultra-processed food and asthma; gastrointestinal health; some cancers; and other risk factors such as high blood fats and low levels of ‘good’ cholesterol, but the researchers note this evidence is limited. Dr Daisy Coyle from the George Institute for Global Health in Sydney, who was not involved in the research, says the statistics are “staggering.” “Ultra-processed foods, laden with additives and sometimes lacking in essential nutrients, have become ubiquitous in the Australian diet,” she says. “In fact, they make up almost half of what we buy at the supermarket. While not all ultra-processed foods are linked to poor health outcomes, many are, particularly sugary drinks and processed meats.” <div> </div> While the findings are in line with other research that highlights the health risks associated with UPFs, some experts have pointed out that the study is observational, and therefore can’t prove the ultra-processed foods cause these health issues. It can only show an association. “While these associations are interesting and warrant further high-quality research, they do not and cannot provide evidence of causality,” The University of Sydney’s Dr Alan Barclay told the AusSMC. “By their very nature, observational studies are renowned for being confounded by numerous factors – both known and unknown.” Clare Collins, Laureate Professor at the University of Newcastle agreed, but added that it’s difficult to conduct dietary studies like this in a different way. “The studies are observational, which means cause and effect cannot be proven and that the research evidence gets downgraded, compared to intervention studies,” she says. “The problem is that it is not ethical to do an intervention study lasting for many years where you feed people lots of UPF every day and wait for them to get sick and die.” For now, researchers seem to agree that it can’t be a bad thing to minimise UPF intake. The review suggests a need for policies that pull consumers away from ultra-processed foods, such as advertising restrictions, warning labels, bans in schools and hospitals. It also calls for measures that make healthier foods more accessible and affordable. Dr Charlotte Gupta from Central Queensland University suggests that this is issue of accessibility is particularly relevant for shift workers such as doctors, nurses, firefighters, taxi drivers, miners, and hospitality workers. “There is a lack of availability of fresh foods or time to prepare any food, and so ultra-processed foods have to be relied on (e.g. from the vending machine in the hospital),” she said. “This highlights the need for not only individuals to try reducing ultra-processed foods in our diet, but also for public health actions to improve access to healthier foods.” Image credits: Shutterstock <a href="https://cosmosmagazine.com/health/how-bad-is-junk-food-for-you-really/">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/olivia-henry/">Olivia Henry</a>.

Food & Wine

How can I stop overthinking everything? A clinical psychologist offers solutions

<a href="https://theconversation.com/profiles/kirsty-ross-1513078">Kirsty Ross</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> As a clinical psychologist, I often have clients say they are having trouble with thoughts “on a loop” in their head, which they find difficult to manage. While rumination and overthinking are often considered the same thing, they are slightly different (though linked). <a href="https://www.apa.org/monitor/nov05/cycle">Rumination</a> is having thoughts on repeat in our minds. This can lead to overthinking – analysing those thoughts without finding solutions or solving the problem. It’s like a vinyl record playing the same part of the song over and over. With a record, this is usually because of a scratch. Why we overthink is a little more complicated. <h2>We’re on the lookout for threats</h2> Our brains are hardwired to look for threats, to make a plan to address those threats and keep us safe. Those perceived threats may be based on past experiences, or may be the “what ifs” we imagine could happen in the future. Our “what ifs” are usually negative outcomes. These are what we call “<a href="https://ccbhc.org/hot-thoughts-what-are-they-and-how-can-you-handle-them/">hot thoughts</a>” – they bring up a lot of emotion (particularly sadness, worry or anger), which means we can easily get stuck on those thoughts and keep going over them. However, because they are about things that have either already happened or might happen in the future (but are not happening now), we cannot fix the problem, so we keep going over the same thoughts. <h2>Who overthinks?</h2> Most people find themselves in situations at one time or another when they overthink. Some people are <a href="https://www.apa.org/monitor/nov05/cycle">more likely</a> to ruminate. People who have had prior challenges or experienced trauma may have come to expect threats and look for them more than people who have not had adversities. Deep thinkers, people who are prone to anxiety or low mood, and those who are sensitive or feel emotions deeply are also more likely to ruminate and overthink. Also, when we are stressed, our emotions tend to be stronger and last longer, and our thoughts can be less accurate, which means we can get stuck on thoughts more than we would usually. Being run down or physically unwell can also mean our thoughts are <a href="https://healthify.nz/hauora-wellbeing/m/mental-health-and-your-body/">harder to tackle</a> and manage. <h2>Acknowledge your feelings</h2> When thoughts go on repeat, it is helpful to use both emotion-focused and problem-focused <a href="https://link.springer.com/referencework/10.1007/978-1-4419-1005-9">strategies</a>. Being emotion-focused means figuring out how we feel about something and addressing those feelings. For example, we might feel regret, anger or sadness about something that has happened, or worry about something that might happen. Acknowledging those emotions, using self-care techniques and accessing social support to talk about and manage your feelings will be helpful. The second part is being problem-focused. Looking at what you would do differently (if the thoughts are about something from your past) and making a plan for dealing with future possibilities your thoughts are raising. But it is difficult to plan for all eventualities, so this strategy has limited usefulness. What is more helpful is to make a plan for one or two of the more likely possibilities and accept there may be things that happen you haven’t thought of. <h2>Think about why these thoughts are showing up</h2> Our feelings and experiences are information; it is important to ask what this information is telling you and why these thoughts are showing up now. For example, university has just started again. Parents of high school leavers might be lying awake at night (which is when rumination and overthinking is common) worrying about their young person. Knowing how you would respond to some more likely possibilities (such as they will need money, they might be lonely or homesick) might be helpful. But overthinking is also a sign of a new stage in both your lives, and needing to accept less control over your child’s choices and lives, while wanting the best for them. Recognising this means you can also talk about those feelings with others. <h2>Let the thoughts go</h2> A useful way to manage rumination or overthinking is “<a href="https://www.getselfhelp.co.uk/docs/Options.pdf">change, accept, and let go</a>”. Challenge and change aspects of your thoughts where you can. For example, the chance that your young person will run out of money and have no food and starve (overthinking tends to lead to your brain coming up with catastrophic outcomes!) is not likely. You could plan to check in with your child regularly about how they are coping financially and encourage them to access budgeting support from university services. Your thoughts are just ideas. They are not necessarily true or accurate, but when we overthink and have them on repeat, they can start to feel true because they become familiar. Coming up with a more realistic thought can help stop the loop of the unhelpful thought. Accepting your emotions and finding ways to manage those (good self-care, social support, communication with those close to you) will also be helpful. As will accepting that life inevitably involves a lack of complete control over outcomes and possibilities life may throw at us. What we do have control over is our reactions and behaviours. Remember, you have a 100% success rate of getting through challenges up until this point. You might have wanted to do things differently (and can plan to do that) but nevertheless, you coped and got through. So, the last part is letting go of the need to know exactly how things will turn out, and believing in your ability (and sometimes others’) to cope. <h2>What else can you do?</h2> A stressed out and tired brain will be <a href="https://mentalhealth.org.nz/resources/resource/stress-and-how-to-manage-it">more likely</a> to overthink, leading to more stress and creating a cycle that can affect your wellbeing. So it’s important to manage your stress levels by eating and sleeping well, moving your body, doing things you enjoy, seeing people you care about, and doing things that fuel your soul and spirit. Distraction – with pleasurable activities and people who bring you joy – can also get your thoughts off repeat. If you do find overthinking is affecting your life, and your levels of anxiety are rising or your mood is dropping (your sleep, appetite and enjoyment of life and people is being negatively affected), it might be time to talk to someone and get some strategies to manage. When things become too difficult to manage yourself (or with the help of those close to you), a therapist can provide tools that have been proven to be helpful. Some helpful tools to manage worry and your thoughts can also be found <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Anxiety">here</a>. When you find yourself overthinking, think about why you are having “hot thoughts”, acknowledge your feelings and do some future-focused problem solving. But also accept life can be unpredictable and focus on having faith in your ability to cope. <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/223973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kirsty-ross-1513078">Kirsty Ross</a>, Associate Professor and Senior Clinical Psychologist, <a href="https://theconversation.com/institutions/massey-university-806">Massey 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/how-can-i-stop-overthinking-everything-a-clinical-psychologist-offers-solutions-223973">original article</a>.

Mind

Why and how often do I need to wash makeup brushes and sponges?

<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> and <a href="https://theconversation.com/profiles/rosalie-hocking-1428271">Rosalie Hocking</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> From the bristles of brushes to the porous surfaces of sponges, your makeup kit can harbour a host of bacteria and fungi. These potentially hazardous contaminants can originate not only from the cosmetics themselves, but also from the very surface of our skin. So, how can we keep things hygienic and avoid microbial growth on makeup brushes and sponges? Here’s what you need to know. <h2>How do germs and fungi get in my brushes and sponges?</h2> Germs and fungi can make their way into your makeup kit in lots of ways. Ever flushed a toilet with the lid open with your makeup brushes nearby? There’s a good chance <a href="https://theconversation.com/mobile-phones-are-covered-in-germs-disinfecting-them-daily-could-help-stop-diseases-spreading-135318">faecal particles</a> have landed on them. Perhaps a family member or housemate has used your eyeshadow brush when you weren’t looking, and transferred some microbes across in the process. Bacteria that trigger a pimple outbreak can be easily transferred from the surface of your skin to a makeup brush or sponge. And tiny little mites called Demodex mites, which have been linked to certain rashes and acne, live on your skin, as well, and so may end up in your sponge or brushes. Bacterial contamination of <a href="https://pubmed.ncbi.nlm.nih.gov/38020232/">lip cosmetics</a>, in particular, can pose a risk of skin and eye infections (so keep that in mind if you use lip brushes). Lipsticks are frequently contaminated with bacteria such as Staphylococcus aureus, E. coli, and Streptococcus pneumoniae. Low-quality cosmetics are more likely to have higher and more diverse microbial growth compared to <a href="https://www.sciencedirect.com/science/article/pii/S1319562X23002978?pes=vor">high-quality cosmetics</a>. Brushes exposed to sensitive areas like the eyes, mouth and nose are particularly susceptible to being potential sources of infection. The range of conditions caused by these microorganisms includes: <ul> <li> abscesses </li> <li> skin and soft tissue infections </li> <li> skin lesions </li> <li> rashes </li> <li> and dermatitis. </li> </ul> In severe cases, infections can lead to invasion of the bloodstream or deep tissues. Commercially available cosmetics contain varying amounts and types of preservatives aimed at inhibiting the growth of fungi and bacteria. But when you apply makeup, different cosmetics with unique formulations of preservatives can become mixed. When a preservative meant for one product mixes with others, it might not work as well because they have different water amounts or pH levels. So preservatives are not foolproof. We also need to observe good hygiene practices when it comes to brushes and other cosmetics applicators. <h2>Keeping brushes clean</h2> Start with the basics: never <a href="https://www.semanticscholar.org/paper/Isolation-of-Pathogenic-Microbes-from-Beauty-Salons-Hassan-Hamad/0199635290628fe326fcd04a2b8a2422884a8240">share makeup brushes or sponges</a>. Everyone carries different microbes on their skin, so sharing brushes and sponges means you are also sharing germs and fungi. If you need to share makeup, use something disposable to apply it, or make sure any shared brushes are washed and sterilised before the next person uses it. Clean makeup brushes by washing with hot soapy water and rinsing thoroughly. How often? Stick to a cleaning routine you can repeat with consistency (as opposed to a deep clean that is done annually). <a href="https://www.aad.org/public/everyday-care/skin-care-secrets/routine/clean-your-makeup-brushes#:%7E:text=To%20protect%20your%20skin%20and,every%207%20to%2010%20days.">Once a week</a> might be a good goal for some, while others may need to wash more regularly if they are heavy users of makeup. Definitely wash straight away if someone else has used your brushes or sponges. And if you’ve had an eye infection such as conjunctivitis, ensure you clean applicators thoroughly after the infection has resolved. You can use bactericidal soap, 70% ethanol or chlorhexidine solutions to wash. Just make sure you wash very thoroughly with hot water after, as some of these things can irritate your skin. (While some people online say alcohol can degrade brushes and sponges, opinion seems to be mixed; in general, most disinfectants are unlikely to cause significant corrosion.) For some brushes, heating or steaming them and letting them dry may also be an effective sterilisation method once they are washed with detergent. Microwaving sponges isn’t a good idea because while the heat generated by a domestic microwave would kill microbes, it would need temperatures approaching 100°C for a decent period of time (at least several minutes). The heat could melt some parts of the sponge and hot materials could be a scalding hazard. Once clean, ensure brushes and sponges are stored in a dry place away from water sources (and not near an open toilet). If you’re having makeup applied professionally, brushes and applicators should be sterilised or changed from person to person. <h2>Should I wash them with micellar water?</h2> No. Not only is this expensive, it’s unnecessary. The same benefits can be achieved with cheaper detergents or alcohol (just rinse brushes carefully afterwards). Disinfection methods such as using bactericidal soap, 70% ethanol, or chlorhexidine are all very good at reducing the amount of microbes on your brushes and sponges.<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/220280/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <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> and <a href="https://theconversation.com/profiles/rosalie-hocking-1428271">Rosalie Hocking</a>, <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/why-and-how-often-do-i-need-to-wash-makeup-brushes-and-sponges-220280">original article</a>.

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Why and how often do I need to wash makeup brushes and sponges?

News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

What are heart rate zones, and how can you incorporate them into your exercise routine?

How extreme dieting can affect bone health

What is childhood dementia? And how could new research help?

Battling to make ends meet? Financial planning expert offers 5 tips on how to build your budget

Dog care below freezing − how to keep your pet warm and safe from cold weather, road salt and more this winter

How tracking menopause symptoms can give women more control over their health

Flight attendant reveals how to score a free upgrade

How music is changing the way dementia patients think

Selfies and social media: how tourists indulge their influencer fantasies

How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

How to look after your mental health while packing up Mum or Dad’s home

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

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

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

How long does menopause last? 5 tips for navigating uncertain times

Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

How bad is junk food for you, really?

How can I stop overthinking everything? A clinical psychologist offers solutions

Why and how often do I need to wash makeup brushes and sponges?

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