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The best exercises to boost your brain health after 60

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a></em></p> <p>Have you ever thought about why we have a <a href="https://theconversation.com/fr/topics/cerveau-21903">brain</a>? The obvious answer might be “to think”. But scientist Daniel Wolpert came up with a completely different explanation at the <a href="https://www.ted.com/talks/daniel_wolpert_the_real_reason_for_brains">2011 meeting of the <em>Society for Neuroscience</em></a>:</p> <blockquote> <p>“We have a brain for one reason and one reason only: to produce adaptable and complex movements”</p> </blockquote> <h2>Use your brain to stay efficient</h2> <p>The brain, in other words, is the orchestra conductor which orders the body’s movements. We call the faculties that allow us to interact with our environment <em>cognitive abilities</em>. These include concentrating, learning, reasoning, adapting and communicating with others. Every one of them is key in enabling us to go about our routine and help us maintain a good lifestyle.</p> <p>So, how can we best take care of our brains so that they can stay as efficient as long as possible? Contrary to popular belief, the brain does not deteriorate continuously with age. Instead, it only sees the number of its brain cells drop and connections deteriorate <a href="https://www.bmj.com/content/344/bmj.d7622">from the age of 45 onwards</a> as part of a normal ageing process. But cerebral plasticity, although reduced, is present until the end of life. Each individual will build up a cognitive reserve throughout their lives.</p> <p>The more positive, rich and stimulating the lifestyle, the more powerful and effective the reserve. In other words, it’s possible to moderate the effects of age on cognition.</p> <h2>The benefits of physical activity on cognitive capacity after 60</h2> <p>In fact, much research shows indeed that physical activity improves cognitive capacity, even after the age of 60. From increased memory, better reactivity to greater planning skills, the <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-072720-014213">benefits are endless</a>.</p> <p>Despite this, few older folks engage in <a href="https://theconversation.com/fr/topics/activite-physique-adaptee-apa-146288">physical education</a> adapted to their bodies on a regular basis. Poor motivation and access to these exercises are some of the factors don’t help.</p> <p>With that in mind, many carers might be tempted to offer older people monotonous, routine activities because of their diminishing physical, cognitive and sensory abilities. And indeed, for a long time, the range of sports on offer and research in this field revolved around the same triptych: gentle gymnastics, walking and yoga. However, you’ll reap more benefits by <a href="https://www-sciencedirect-com.ezproxy.u-paris.fr/science/article/abs/pii/B9780444633279000175">combining different training methods</a>.</p> <h2>Three ingredients to train the brains of senior citizens</h2> <p>Researchers are currently attempting to crack the winning formula that would flex older people’s cognitive, as well as physical muscles. It’ll consist of three main ingredients:</p> <p><em>First ingredient: complex physical and motor stimulation of at least moderate intensity.</em></p> <p>Moderate cardio workouts not only improve cardiorespiratory health but also make the brain more <a href="https://www.nature.com/articles/22682">efficient</a>. Overall improved cardiofitness, in turn, allows the brain to receive more oxygen and even to generate <a href="https://www.pnas.org/doi/full/10.1073/pnas.1015950108">new neurons in the hippocampus</a>, where memory is lodged.</p> <p>It therefore makes sense for programmes designed to boost cognitive function to include cardio. But it is also <a href="https://journals.sagepub.com/doi/abs/10.1111/1467-9280.t01-1-01430">necessary to combine them with muscle-strengthening, flexibility and balance exercises to achieve greater benefits</a>. In addition, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763413001012">researchers</a> emphasise the importance of adding situations requiring complex motor skills and coordination, as these would have a significant impact on cognitive functions (e.g. memory, attention and mental flexibility), particularly in the elderly.</p> <p><em>Second ingredient: fire up those brain cells during exercises</em></p> <p>Incorporating cognitive stimulation, such as remembering information for a period of time and executing it, anticipating actions, or planning a move, is another winning strategy. When cognitive stimulation is combined with physical activity, it can produce <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">synergistic effects</a> and, as a result, be more effective on cognitive functions.</p> <p>_Third ingredient: group activities that lead to social interaction. _</p> <p>Working out as part of a group has been shown to help us <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001756">persevere through it</a>.</p> <p>What this winning formula could look like in practice is still being researched. At present, there are two broad types of exercises that have caught our attention that could help older people stay sharp.</p> <h2>Opting for cooperative and oppositional team sports</h2> <p>Team sports offer much more than just physical exercise sessions. What’s particularly great about them is that they don’t only challenge cardiorespiratory balance, but tap into the whole body’s physical skill-set.</p> <p>Take basketball or handball, for example: to move around the court, dribble or score, balance, coordination and flexibility are essential. Muscular strength is also required for passing, recovering the ball and moving around. These team sports can be suitable even after the age of 60, provided they are properly supervised.</p> <p>From a cognitive point of view, these activities create situations that are always new, rich and stimulating. We call this double combination of stimuli <em><a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">simultaneous training</a></em>. A number of researchers have highlighted the importance of this cognitive involvement in team sports and encourage their practice, particularly among the elderly.</p> <p>Recent studies, such as <a href="https://linkinghub.elsevier.com/retrieve/pii/S162748302100129X">the one carried out in 2022</a> by French researchers, have shown that participation in team sports improves short-term visuospatial memory (which enables people, for example, to remember the location of certain objects for a limited period of time) and planning skills in the elderly.</p> <h2>Get your body moving with exergames</h2> <p>Another promising avenue are <em>exergames</em> – video games that require players to move around to play. Named after the contraction of “exercise” and “games”, they grew popular in the 2000s thanks to Nintendo’s Wii and Switch and Microsoft’s Kinect.</p> <p>Exogames have been thought out to exercise different fitness skills, such as balance, endurance, strength, and coordination, while simultaneously stimulating cognitive functions. Among older people, <a href="https://psycnet.apa.org/record/2011-27707-001">several research studies</a> show that this type of training helps to improve many physical and cognitive abilities.</p> <p>In 2020, a new generation of exergames emerged, making use of interactive walls to create an even more immersive gaming experience, such as Neo Xperiences’ <em>Neo-One</em>, Sphery’s <em>ExerCube</em> and Lü’s <em>Aire interactive</em>. In these games combining real and virtual worlds, physical objects (such as balls) and digital objects coexist and interact in real time.</p> <p>A <a href="https://link.springer.com/article/10.1007/s11357-023-00952-w">recent study</a> compared an exergame programme assisted by an immersive wall with a walking and muscle-strengthening programme. Its results suggest that this new generation of exergames may be more effective on cognitive abilities than traditional training.</p> <p>Combining physical and cognitive exercises offers the best chance to keep one’s brain health while keeping fit. This is essential for an active and fulfilling life, whatever your age.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, Doctorante en sciences du mouvement, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, Maitre de conférences HDR, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, Maître de conférences en STAPS, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-best-exercises-to-boost-your-brain-health-after-60-237162">original article</a>.</em></p> </div>

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I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities.</p> <p>Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>.</p> <p>But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&amp;text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>.</p> <h2>Stress makes it harder to fight off viruses</h2> <p>When the immune system starts to break down, a virus that would normally have been under control starts to flourish.</p> <p>Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>.</p> <p>In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>.</p> <p>These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>.</p> <p>One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>.</p> <h2>Cortisol suppresses immunity</h2> <p>“Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>.</p> <p>When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=472&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=472&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=472&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=593&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=593&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=593&amp;fit=crop&amp;dpr=3 2262w" alt="Human brain illustration" /><figcaption><span class="caption">The hypothalamus sets off an alarm system in response to a real or perceived threat.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></span></figcaption></figure> <p>In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>.</p> <p>But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness.</p> <p>Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>.</p> <h2>Stress causes inflammation</h2> <p><a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>.</p> <p>The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>.</p> <p>Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>.</p> <p>During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>.</p> <h2>What about chronic stress?</h2> <p>Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>.</p> <p>The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins).</p> <p>Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>.</p> <p>Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>.</p> <h2>So how can you manage your stress?</h2> <p>We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by:</p> <p><strong>1) Getting enough sleep</strong></p> <p>Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation.</p> <p><strong>2) Taking regular exercise</strong></p> <p>Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>.</p> <p><strong>3) Eating a healthy diet</strong></p> <p>Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>.</p> <p><strong>4) Socialising and practising meditation or mindfulness</strong></p> <p>These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist &amp; Lecturer in Cancer Sciences &amp; Digital Health| Superstar of STEM| Science Communicator, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>.</em></p> </div>

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Do mobile phones cause brain cancer? Science makes definitive call

<p>The question of whether mobile phones - specifically the electromagnetic radiation or radio waves emitted by these devices - cause cancer has been debated and researched for a long time, and now scientists have made a definitive call. </p> <p>A new comprehensive review commissioned by the World Health Organization has found that mobile phones are NOT linked to brain and head cancers. </p> <p>The systematic review, led by the Australian Radiation Protection and Nuclear Safety Agency (Arpansa), examined over 5,000 studies, which included 63 observational studies on humans published between 1994 and 2022 and is "the most comprehensive review to date" according to review lead author, associate prof Ken Karipidis. </p> <p>“We concluded the evidence does not show a link between mobile phones and brain cancer or other head and neck cancers," he said. </p> <p>The review, which was published on Wednesday, focused on cancers of the nervous system, salivary gland and brain tumours. </p> <p>They found no overall association between mobile phone use and cancer, even if people have used it for a long time (over 10 years) or spend a lot of time on their phones. </p> <p>“I’m quite confident with our conclusion. And what makes us quite confident is … even though mobile phone use has skyrocketed, brain tumour rates have remained stable,” Karipidis continued. </p> <p>Despite emitting electromagnetic radiation, also known as radio waves, the exposure is relatively low. </p> <p>Karipidis said people hear the word radiation and assume it is similar to nuclear radiation, “and because we use a mobile phone close to the head when we’re making calls, there is a lot of concern.”</p> <p>He clarified that “radiation is basically energy that travels from one point to another. There are many different types, for example, ultraviolet radiation from the sun." </p> <p>“We’re always exposed to low-level radio waves in the everyday environment.”</p> <p>While exposure from mobile phones is still low, it is much higher than exposure from any other wireless technology sources since they are used close to the head, Karipidis said. </p> <p>The association between mobile phones and cancers came about from early studies comparing differences between those with and without brain tumours and asking about their exposure history. </p> <p>According to Karipidis, who is also the vice-chair of the International Commission on Non-Ionizing Radiation Protection, the results from these kind of studies tend to be biased, as the group with the tumour tend to overreport their exposure. </p> <p>Based on these early studies WHO’s International Agency for Research on Cancer (IARC) designated radio-frequency fields like those from mobile phones as a possible cancer risk, but Karipidis said "this classification doesn’t mean all that much”.</p> <p>This is because the IARC has different classifications of cancer risk, with some substances classified as  a “definite” carcinogen (such as smoking), and others as “probable” or “possible” carcinogens.</p> <p>Tim Driscoll, a professor at the University of Sydney and chair of the Australian Cancer Council’s occupational and environmental cancers committee, also backed the systematic review. </p> <p>“I think people should feel reassured by this study … but it’s worthwhile just remembering that the studies aren’t perfect, but the weight of evidence certainly is that mobile phones should be considered safe to use in terms of any concerns about increased risk of cancer,” Driscoll said.</p> <p><em>Images: Shutterstock</em></p> <p> </p>

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Flu shots play an important role in protecting against bird flu. But not for the reason you might think

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>A current strain of highly pathogenic avian influenza, commonly known as bird flu, has become a global problem. The virus has affected <a href="https://www.cdc.gov/bird-flu/situation-summary/data-map-commercial.html">many millions</a> of birds, some other <a href="https://www.cdc.gov/bird-flu/situation-summary/mammals.html">animal species</a>, and a <a href="https://cdn.who.int/media/docs/default-source/influenza/avian-and-other-zoonotic-influenza/joint-fao-oie-who-preliminary-risk-assessment-associated-with-avian-influenza-a(h5n1)-virus.pdf?sfvrsn=faa6e47e_28&amp;download=true">small number of people</a>.</p> <p>Last week, the Australian government <a href="https://www.sbs.com.au/news/article/australians-issued-new-health-risks-travel-warning-for-europe-asia-and-the-americas/gmh1hk9py">issued a warning</a> to residents travelling to Europe, North America, South America and Asia about the risk of bird flu.</p> <p>The alert, published on the <a href="https://www.smartraveller.gov.au/news-and-updates/highly-pathogenic-avian-influenza-outbreak">Smartraveller website</a>, included advice to ensure your flu vaccine is up to date. If you are about to go travelling, this generally means if you’ve had a flu jab this year, although if it has been 3–6 months since your vaccine you should discuss this with your doctor.</p> <p>But the seasonal flu vaccine we get each year doesn’t actually prevent bird flu in humans. So why is it being recommended in this context?</p> <h2>Some bird flu background</h2> <p>Smartraveller notes <a href="https://www.smartraveller.gov.au/news-and-updates/highly-pathogenic-avian-influenza-outbreak">several strains</a> of bird flu are currently circulating.</p> <p>The most concerning strain, called the <a href="https://www.nature.com/articles/s41467-023-38415-7">2.3.4.4b clade</a>, emerged a few years ago from a type of influenza A (H5, or A/H5) that has been circulating for several decades.</p> <p>Clade 2.3.4.4b primarily affects birds, including wild birds and poultry. It has had <a href="https://theconversation.com/uk-poultry-can-roam-free-outside-again-but-bird-flu-risk-hasnt-gone-away-203361">devastating effects</a> on bird populations, as well as farmers and others involved in the poultry industry.</p> <p>In recent years, clade 2.3.4.4b has adapted to <a href="https://www.nature.com/articles/s44298-024-00039-z">infect some mammals</a>. Unfortunately it seems to cause severe disease in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11083745/">certain animals</a>. Some marine mammals have been hit particularly hard, with mass mortality events <a href="https://www.theguardian.com/environment/2023/dec/08/mass-deaths-elephant-seals-penguins-bird-flu-antarctic-ecological-disaster-aoe">reported</a> in elephant seals and sea lions. In the United States, bird flu has also spread <a href="https://www.cdc.gov/bird-flu/situation-summary/mammals.html">among dairy cows</a>.</p> <p>Compared to the huge number of animal cases, there have been a relatively small number of <a href="https://www.who.int/publications/m/item/joint-fao-who-woah-preliminary-assessment-of-recent-influenza-a(h5n1)-viruses">humans infected with bird flu</a>. Since 2003, <a href="https://www.who.int/publications/m/item/cumulative-number-of-confirmed-human-cases-for-avian-influenza-a(h5n1)-reported-to-who--2003-2023--3-october-2023">878 cases</a> of A/H5N1 influenza have been reported in humans, with a small proportion of these reported since 2020 when <a href="https://www.outbreak.gov.au/emerging-risks/high-pathogenicity-avian-influenza">clade 2.3.4.4b first emerged</a>. The reported cases have been people who have had close contact with infected animals. It does not appear to spread from person to person.</p> <p>As such, the <a href="https://www.ecdc.europa.eu/en/infectious-disease-topics/z-disease-list/avian-influenza/threats-and-outbreaks/risk-assessment-h5">risk to travellers is low</a>. There are some situations where the risk may be greater, such as for people visiting live markets, or those who are travelling specifically to work with wildlife or animals in food production.</p> <p><a href="https://www.who.int/publications/m/item/joint-fao-who-woah-preliminary-assessment-of-recent-influenza-a(h5n1)-viruses">Infections in humans</a> with H5 influenza can vary significantly in severity, from mild conjunctivitis up to fatal pneumonia. H5 influenza strains appear to be <a href="https://asm.org/articles/2024/june/what-you-should-know-about-avian-influenza-a-h5n1">sensitive to antivirals</a> (oseltamivir, also known as Tamiflu) and they are generally <a href="https://www.cdc.gov/bird-flu/hcp/novel-av-treatment-guidance/">recommended</a> as treatment for human infection, but it’s <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01307-2/fulltext">not clear</a> whether they reduce the risk of death in those with severe disease.</p> <p>To date, one case of A/H5 influenza (not 2.3.4.4b) has been <a href="https://www.abc.net.au/news/2024-05-22/bird-flu-avian-influenza-human-detection/103879886">reported in Australia</a>, in a child who had recently returned from overseas.</p> <p>While <a href="https://www.fao.org/animal-health/situation-updates/global-aiv-with-zoonotic-potential/en">clade 2.3.4.4b has been detected</a> in all continents <a href="https://www.outbreak.gov.au/emerging-risks/high-pathogenicity-avian-influenza">except Australia</a>, other avian influenza strains (A/H7) <a href="https://www.outbreak.gov.au/current-outbreaks/avian-influenza">have been reported here</a> earlier this year.</p> <h2>Seasonal flu vaccines are not effective against bird flu</h2> <p>Seasonal influenza refers to the flu strains that circulate each year. Since the COVID pandemic, three different strains have circulated in various proportions – influenza A H1N1 (descended from the <a href="https://www.nature.com/articles/nature08182">2009 swine flu strain</a>), influenza A H3N2 (which has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149781/">circulated since 1968</a>) and an influenza B strain. Interestingly, a second influenza B strain (the Yamagata lineage) <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">appears to have vanished</a> during the COVID pandemic.</p> <p>Seasonal influenza vaccines contain up-to-date variants of these types (A/H1N1, A/H3N2 and B) that are recommended by the World Health Organization each year. They are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912669/">moderately effective</a>, reducing the risk of hospitalisation by about 40–60%.</p> <p>Influenza vaccines are quite specific in the protection that they provide. For seasonal vaccines, even the very small changes that occur in the virus from year to year are enough to allow them to “escape” vaccine-induced immunity. Therefore seasonal flu vaccines <a href="https://www.cdc.gov.au/topics/avian-influenza-bird-flu">do not provide any protection</a> against A/H5 influenza.</p> <h2>Preventing a hybrid bird-human strain</h2> <p>The rationale for recommending travellers have a flu shot in the context of the current bird flu outbreak is that seasonal flu vaccines may help reduce the risk of simultaneous infection with both A/H5 and a seasonal influenza strain.</p> <p>When this occurs, there is potential for a “recombination” of the genetic code from both viral strains. This could have the transmissibility of a seasonal human virus with the severity of an avian influenza virus. The 2009 swine flu strain <a href="https://www.nejm.org/doi/full/10.1056/NEJMra0904322">arose from the recombination</a> of several strains over years to become more transmissible in humans.</p> <p>Obviously a more effective vaccine would include a H5 strain, to generate immune responses specific to the H5 flu strain. Vaccine manufacturers have <a href="https://www.ema.europa.eu/en/medicines/human/EPAR/celldemic">developed H5 vaccines</a> over the years, but to date <a href="https://thl.fi/en/-/avian-influenza-vaccinations-begin-vaccine-to-be-offered-to-persons-at-increased-risk-of-infection">only Finland</a> has deployed a H5 vaccine in a small group of people who work closely with potentially infected animals.</p> <p>Currently the <a href="https://www.ecdc.europa.eu/en/infectious-disease-topics/z-disease-list/avian-influenza/threats-and-outbreaks/risk-assessment-h5">level of risk</a> posed by H5 to humans is not thought to be sufficient to require a specific vaccine program, as the potential benefits are small compared to the costs and the potential risks associated with any new vaccine program.</p> <h2>The value of a flu shot for travellers</h2> <p>Seasonal flu vaccines protect against influenza infection, and may also reduce the risk of simultaneous infection with human and bird flu strains. Bird flu aside, for most travellers who haven’t received a flu shot this year, reducing the risk of illness disrupting travel plans should be enough of a reason to get one.</p> <p>For those who have already received a flu shot this season, similar to COVID jabs, protection after vaccination appears to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499703/">wane over time</a>. So if you’re travelling to the northern hemisphere during the winter months, and it’s been more than 3–6 months since you received a flu vaccine, your doctor may recommend you have another.</p> <p>Bird flu is only a small risk to most travellers, but people may want to take sensible precautions, such as avoiding close contact with birds at markets.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237859/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/flu-shots-play-an-important-role-in-protecting-against-bird-flu-but-not-for-the-reason-you-might-think-237859">original article</a>.</em></p> </div>

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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.</p> <p>Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">both type 1 and type 2 diabetes</a>.</p> <p>More people became aware of this condition after <a href="https://www.imdb.com/name/nm0004726/">Lance Bass</a>, best known for his role in the iconic American pop band NSYNC, <a href="https://www.foxnews.com/health/pop-singer-lance-bass-type-1-5-diabetes-know-disease">recently revealed</a> he has it.</p> <p>So, what is type 1.5 diabetes? And how is it diagnosed and treated?</p> <h2>There are several types of diabetes</h2> <p>Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually <a href="https://diabetesjournals.org/care/article/37/Supplement_1/S81/37753/Diagnosis-and-Classification-of-Diabetes-Mellitus">more than ten types</a> of diabetes, but the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext">most common</a> are type 1 and type 2.</p> <p>Type 1 diabetes is an <a href="https://diabetesjournals.org/care/article/44/11/2589/138492/The-Management-of-Type-1-Diabetes-in-Adults-A">autoimmune condition</a> where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.</p> <p>Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995794/">insulin medication daily</a>. Type 1 diabetes usually <a href="https://www.nature.com/articles/s41390-024-03107-5">appears</a> in children or young adults.</p> <p>Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to <a href="https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954/2-Diagnosis-and-Classification-of-Diabetes">overcome this resistance</a>. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.</p> <p>Type 2 is more common in adults but is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1871402121002733">increasingly</a> seen in children and young people. Management <a href="https://www.racgp.org.au/getattachment/41fee8dc-7f97-4f87-9d90-b7af337af778/Management-of-type-2-diabetes-A-handbook-for-general-practice.aspx">can include</a> behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.</p> <h2>How does type 1.5 diabetes differ from types 1 and 2?</h2> <p>Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">immediately</a> because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/">five years</a> of diagnosis, while those with type 1 typically require it from diagnosis.</p> <p>Type 1.5 diabetes is usually diagnosed in people <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">over 30</a>, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.</p> <p>Type 1.5 diabetes shares <a href="https://www.nature.com/articles/nrendo.2017.99">genetic and autoimmune risk factors</a> with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as <a href="https://pubmed.ncbi.nlm.nih.gov/29589073/">obesity</a> and <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00320/full">physical inactivity</a> which are more commonly associated with type 2 diabetes.</p> <h2>What are the symptoms, and how is it treated?</h2> <p>The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a>:</p> <ul> <li>increased thirst</li> <li>frequent urination</li> <li>fatigue</li> <li>blurred vision</li> <li>unintentional weight loss.</li> </ul> <p>Typically, type 1.5 diabetes is <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">initially treated</a> with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.</p> <p>When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.959011/full">no universally accepted</a> management or treatment strategies for type 1.5 diabetes.</p> <h2>Type 1.5 diabetes is often misdiagnosed</h2> <p>Lance Bass said he was initially diagnosed with <a href="https://www.healthline.com/health-news/lance-bass-misdiagnosed-diabetes">type 2 diabetes</a>, but later learned he actually has type 1.5 diabetes. This is <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">not entirely uncommon</a>. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">5–10% of the time</a>.</p> <p>There are a few possible reasons for this.</p> <p>First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">antibody tests</a> (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.</p> <p>Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).</p> <p>Third, people with <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">type 1.5 diabetes</a> often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.</p> <p>Finally, because type 1.5 diabetes has <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a> that are similar to type 2 diabetes, it may initially be treated as type 2.</p> <h2>We’re still learning about type 1.5</h2> <p>Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">non-European populations</a>. In 2023, it was estimated type 1.5 diabetes represented <a href="https://pubmed.ncbi.nlm.nih.gov/37428296/">8.9%</a> of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.</p> <p>Overall, there has been a limited awareness of type 1.5 diabetes and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/">unclear diagnostic criteria</a> which have slowed down our understanding of this condition.</p> <p>A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.</p> <p>Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce <a href="https://diabetesjournals.org/diabetes/article/73/Supplement_1/55-OR/155112/55-OR-Diabetes-Distress-among-Persons-Living-with">diabetes distress</a>. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237041/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-type-1-5-diabetes-its-a-bit-like-type-1-and-a-bit-like-type-2-but-its-often-misdiagnosed-237041">original article</a>.</em></p> </div>

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I’m iron deficient. Which supplements will work best for me and how should I take them?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a></em></p> <p>Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women <a href="https://static1.squarespace.com/static/57bfc0498419c24a01318ae2/t/607fc2e06ace2f22d5ca9a43/1618985699483/20210421+-+IDC+-+economic+impact+of+iron+deficiency+-+FINAL.pdf">are low in iron</a> compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant.</p> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/11160590/">body needs iron</a> to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration.</p> <p>If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day?</p> <p>Here are some tips to help you work out how, when and what iron supplement to take.</p> <h2>How do I pick the right iron supplement?</h2> <p>The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need.</p> <p>The sweet spot is between <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364?via%3Dihub">60-120 mg of elemental iron</a>. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain.</p> <p>In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). <a href="https://www.ncbi.nlm.nih.gov/books/NBK557376/">The iron salts</a> you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%).</p> <p>These formulations <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">all work similarly</a>, so your choice should come down to dose and cost.</p> <p>Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency.</p> <h2>Should I take tablets or liquid formulas?</h2> <p>Iron contained within a tablet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">just as well absorbed</a> as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference.</p> <p>The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term.</p> <h2>What should I eat with my iron supplement?</h2> <p>Research <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">has shown</a> you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone.</p> <p>If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it.</p> <p>Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other <a href="https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/">vitamin C-rich foods</a>.</p> <p>On the other hand, tea, coffee and calcium all <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">decrease the body’s ability to absorb iron</a>. So you should try to limit these close to the time you take your supplement.</p> <h2>Should I take my supplement in the morning or evening?</h2> <p>The best time of day to take your supplement is in the morning. The body can <a href="https://journals.lww.com/acsm-msse/fulltext/2019/10000/the_impact_of_morning_versus_afternoon_exercise_on.20.aspx">absorb significantly more</a> iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest.</p> <p>Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can <a href="https://journals.humankinetics.com/view/journals/ijsnem/32/5/article-p359.xml">limit your ability to absorb it</a>. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop.</p> <p><a href="https://journals.lww.com/acsm-msse/fulltext/2024/01000/iron_absorption_in_highly_trained_male_runners_.14.aspx">Our research</a> has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes).</p> <h2>My supplements are upsetting my stomach. What should I do?</h2> <p>If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily.</p> <p>Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltext#%20">has shown</a> taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects.</p> <p>Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success.</p> <p>It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430862/">iron can be toxic</a>, so you don’t want to be consuming additional iron if your body doesn’t need it.</p> <p>If you think you may be low on iron, talk to your GP to find out your best options.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235315/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, Postdoctoral Research Fellow, Sports Nutrition, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-iron-deficient-which-supplements-will-work-best-for-me-and-how-should-i-take-them-235315">original article</a>.</em></p> </div>

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Constipation increases your risk of a heart attack, new study finds – and not just on the toilet

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and <a href="https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death">it’s believed</a> he was straining very hard to poo, which then led to a fatal heart attack.</p> <p>We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many.</p> <p>But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack.</p> <p>This includes a recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">study</a> led by Australian researchers involving data from thousands of people.</p> <h2>Are constipation and heart attacks linked?</h2> <p>Large <a href="https://www.nature.com/articles/s41598-023-38068-y">population</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">studies</a> show constipation is linked to an increased risk of heart attacks.</p> <p>For example, an <a href="https://www.nature.com/articles/s41598-023-38068-y">Australian study</a> involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">Danish study</a> of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes.</p> <p>It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital.</p> <p>These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated.</p> <h2>How about this new study?</h2> <p>The recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">international study</a> led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population.</p> <p>The researchers analysed data from the <a href="https://www.ukbiobank.ac.uk">UK Biobank</a>, a database of health-related information from about half a million people in the United Kingdom.</p> <p>The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation.</p> <p>People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation.</p> <p>The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension.</p> <p>The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/26812003/">Japanese study</a> looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day.</p> <h2>How might constipation cause a heart attack?</h2> <p>Chronic constipation can lead to straining when passing a stool. This can result in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">laboured breathing</a> and can lead to a rise in blood pressure.</p> <p>In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">one Japanese study</a> including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">One theory</a> is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels.</p> <p>As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">doubles</a> when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure).</p> <p>The systolic blood pressure rise with straining in passing a stool has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">reported to be</a> as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/22256893/">Some people</a> with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing.</p> <p>This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure.</p> <p>Another intriguing avenue of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399019/">research</a> examines the imbalance in gut bacteria in people with <a href="https://pubmed.ncbi.nlm.nih.gov/3596341/">constipation</a>.</p> <p>This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack.</p> <p>This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease.</p> <h2>What can we do about this?</h2> <p>Constipation affects around <a href="https://pubmed.ncbi.nlm.nih.gov/36826591/">19% of the global population</a> aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health.</p> <p>Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/vincent-ho-141549"><em>Vincent Ho</em></a><em>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/constipation-increases-your-risk-of-a-heart-attack-new-study-finds-and-not-just-on-the-toilet-237209">original article</a>.</em></p> </div>

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Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2022-PI-01930-1&amp;d=20240731172310101&amp;d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia.</p> <p>Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2022-PI-01930-1&amp;d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity.</p> <p>So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it?</p> <p>Let’s look at what the science says.</p> <h2>What is Wegovy?</h2> <p>Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.</p> <p>Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten.</p> <p>Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes.</p> <h2>How does Wegovy differ from Ozempic?</h2> <p>Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk.</p> <p>But there are two differences:</p> <p><strong>1) They are approved for two different (but related) reasons.</strong></p> <p>In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease.</p> <p>Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2022-PI-01930-1&amp;d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure.</p> <p>Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease.</p> <p><strong>2) They are both injected but come in different strengths.</strong></p> <p>Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed.</p> <p>Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly.</p> <p>While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024.</p> <h2>Is Wegovy effective for weight loss?</h2> <p>Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss.</p> <p>A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm.</p> <p>For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>.</p> <h2>What are the side effects of Wegovy?</h2> <p>The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting.</p> <p>However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>.</p> <p>In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient).</p> <p>Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo.</p> <p>Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo.</p> <p>Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000.</p> <p>There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play.</p> <p>Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones.</p> <h2>How can people access Wegovy?</h2> <p>Wegovy is available for purchase at pharmacists with a prescription from a doctor.</p> <p>But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose.</p> <p>If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>.</em></p> </div>

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Does eating ham, bacon and beef really increase your risk of developing type 2 diabetes?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p>That lunchtime staple, the humble ham sandwich, has come in for a bashing in the press recently. According to <a href="https://www.theguardian.com/society/article/2024/aug/20/two-slices-of-ham-a-day-can-raise-type-2-diabetes-risk-by-15-research-suggests">many</a> <a href="https://www.dailymail.co.uk/health/article-13761253/Eating-ham-daily-linked-increase-risk-diabetes.html">reports</a>, eating two slices of ham a day can increase your risk of developing type 2 diabetes.</p> <p>But what’s the science behind these headlines?</p> <p>The research offers a more complex picture. <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00179-7/fulltext">A new study</a> from the University of Cambridge highlighted an association between developing type 2 diabetes and eating processed meat like ham and bacon, and red meat such as beef and lamb.</p> <p>This led to headlines suggesting the risk was mainly linked to <a href="https://www.telegraph.co.uk/news/2024/08/21/ham-sandwich-processed-meat-fresh-risk-link-type-2-diabetes/">ham sandwiches</a>. This seems to have come from the <a href="https://www.cam.ac.uk/research/news/red-and-processed-meat-consumption-associated-with-higher-type-2-diabetes-risk">press release</a>, which used ham as the example to quantify the amount of processed meat associated with a 15% increased risk of developing type 2 diabetes over ten years.</p> <p>The research found that this risk was linked to eating an extra 50g of processed meat every day, which happens to equate to two slices of ham. A useful example thus appears to have been taken up by the media as the main cause, perhaps ignoring some of the key messages coming from the study.</p> <p>So, can processed and red meat really increase your risk of developing type 2 diabetes?</p> <p>The <a href="https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/diabetes-risk-factors">biggest risk factors</a> linked to developing type 2 diabetes are being over 40, having family members with type 2 diabetes, being of South Asian or African descent, or having a higher body weight – and especially a larger waist.</p> <figure><iframe src="https://www.youtube.com/embed/EsOBcx2bJqU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The Cambridge study used data from nearly 2 million people from 31 studies. Participants were followed for an average of ten years. During this time, around one in 20 people developed type 2 diabetes.</p> <p>The research suggested that a 10% increase in the probability of developing type 2 diabetes was associated with every 100g of additional red meat eaten daily. Eating half as much extra processed meat every day was linked to an even greater increased risk of developing the disease.</p> <p>This is not the <a href="https://ajcn.nutrition.org/article/S0002-9165(23)66119-2/abstract">first time</a> that both processed and red meats have been linked with an increased risk of developing type 2 diabetes. However, the key strength of the Cambridge study was that it tried to control for many of the other factors linked to the disease, including smoking, having a higher body weight, dietary intake and exercise.</p> <p>However, the size of the increased risk is modest, considering few people included in the study ate 50g or more processed meat per day – meaning moderate ham consumption is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908545/">no meaningful effect</a> on your risk.</p> <h2>What’s the link?</h2> <p>Processed meat has been linked to increased risk of type 2 diabetes because of its nitrate and salt content – additives that are used to cure many processed meats.</p> <p>Nitrates and salt in processed meats have also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893523/">been linked to</a> an increased risk of developing colon cancer. In fact, the World Health Organization classifies the additives as <a href="https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat">group 1 carcinogens</a>, which means they can cause a range of cancers.</p> <p>The mechanism linking processed meat to cancer seems to be similar to how it might be linked to type 2 diabetes. During digestion, processed meat produces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294997/">N-nitroso chemicals</a>, which can damage cells. This can lead to inflammation and affects how insulin, the hormone that controls blood glucose (sugar), works. This in turn can lead to <a href="https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance">insulin resistance</a>, when cells in your muscles, fat and liver don’t respond well to insulin and can’t easily take up glucose from your blood.</p> <p>Red meat, meanwhile, is <a href="https://www.healthline.com/nutrition/healthy-iron-rich-foods">rich in iron</a>. Research suggests that people with <a href="https://www.diabetes.org.uk/diabetes-the-basics/related-conditions/haemochromatosis-diabetes#:%7E:text=So%20a%20rise%20of%20iron,GP%20as%20soon%20as%20possible.">high levels of iron</a> are more likely to develop type 2 diabetes. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744124/#:%7E:text=The%20WHO%20has%20recognised%20iron,being%20affected%20with%20this%20condition.">low levels of iron</a> are more of a health concern for the general population.</p> <p>Another potential link regarding red meat could be the way it is cooked.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521980/">Previous studies</a> have suggested that charred meat, cooked over an open flame or at high temperature, is also linked to an increased risk of developing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911789/">type 2 diabetes</a>. Charring meat leads to formation of toxic chemicals such as <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/heterocyclic-amine#:%7E:text=Heterocyclic%20amines%20are%20aromatic%20compounds,of%20reactions%20called%20Maillard%20reactions.">heterocyclic aromatic amines</a> and harmful compounds like <a href="https://www.healthline.com/nutrition/advanced-glycation-end-products">advanced glycation end products</a>, both of which have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/21709297/">insulin resistance and type 2 diabetes</a>.</p> <h2>Bye-bye barbecues and bacon butties?</h2> <p>The key message is reduction, rather than avoidance. The UK government nutritional recommendations offer sound advice: limit your combined intake of red and processed meat to no more than <a href="https://www.nhs.uk/live-well/eat-well/food-types/meat-nutrition/#:%7E:text=Red%20meat%20and%20processed%20meat&amp;text=If%20you%20currently%20eat%20more,%2C%20veal%2C%20venison%20and%20goat.">an average of 70g per day</a>.</p> <p>But these guidelines also suggest that red meat can be a valuable source of iron. So, if you decide to stop eating red meat, you should eat alternative sources of iron such as beans, lentils, dark green vegetables and fortified cereals.</p> <p>This needs to be done as part of a carefully planned diet. Non-meat sources of iron are more difficult for our bodies to absorb so should be eaten with a source of vitamin C, found in green vegetables and citrus fruit.</p> <p>The best advice to reduce your risk of developing type 2 diabetes is to maintain a healthy weight – consider losing weight if you have a higher body weight – and be as physically active as possible.</p> <p>A healthy diet should be based on plenty of vegetables, fruit, beans, peas, lentils, nuts and seeds, along with some wholegrain foods, some dairy products, fish and white meat (or vegetarian alternatives) – plus moderate amounts of red meat and minimal processed meat. This will help reduce your risk of type 2 diabetes, <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating">heart disease</a>, and <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/does-having-a-healthy-diet-reduce-my-risk-of-cancer">many cancers</a> – as well being more <a href="https://www.bda.uk.com/static/539e2268-7991-4d24-b9ee867c1b2808fc/a1283104-a0dd-476b-bda723452ae93870/one%20blue%20dot%20reference%20guide.pdf">environmentally sustainable</a>.</p> <p>But if you have a penchant for ham sandwiches, rest assured you can continue to indulge as an occasional treat. It’s your overall lifestyle and diet that really matter for your health and risk of developing type 2 diabetes.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237346/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Visiting Academic, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-eating-ham-bacon-and-beef-really-increase-your-risk-of-developing-type-2-diabetes-237346">original article</a>.</em></p> </div>

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I’m due for a cervical cancer screening. What can I expect? Can I do it myself? And what happened to Pap smears?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/karen-canfell-22668">Karen Canfell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/deborah-bateson-16105">Deborah Bateson</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/megan-smith-131901">Megan Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Cervical screening in Australia has <a href="https://pubmed.ncbi.nlm.nih.gov/34499374/">changed</a> over the past seven years. The test has changed, and women (and people with a cervix) now have much more choice and control. Here’s why – and what you can expect if you’re aged 25 to 74 and are <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">due for a test</a>.</p> <h2>When and why did the test change?</h2> <p>In 2017, Australia became one of the first two countries to transition from Pap smears to tests for the presence of the human papillomavirus (HPV).</p> <p>HPV causes virtually all cervical cancers, so testing for the presence of this virus is a very good indicator of a person’s current and future risk of the disease.</p> <p>This contrasts with the older Pap smear technology, which involved inspection of cells every two years for the changes resulting from HPV infection.</p> <p>The change to screening was supported by a very large body of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62218-7/abstract">international</a> and <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002388">Australian</a> data showing primary testing for HPV is more accurate than Pap smears.</p> <p>Women and people with a cervix who do not have HPV detected on their test are at a very low risk of developing cervical cancer over the next five years, or even longer. This was the basis for lengthening the screening interval when HPV screening was introduced.</p> <p>Australia now <a href="https://www.health.gov.au/our-work/national-cervical-screening-program">recommends</a> five-yearly HPV screening, starting at age 25 up to the age of 74 for eligible people, whether or not they have been vaccinated against HPV. Many other countries are following suit to transition to HPV screening.</p> <p>All established screening tests – which are conducted in people without any symptoms – are associated with health benefits but also with some harms. These can include the psychological and clinical consequences of receiving a “positive” screening result, which needs to be investigated further.</p> <p>However, recent World Health Organization (WHO) <a href="https://www.nejm.org/doi/full/10.1056/NEJMsr2030640">reviews of the evidence</a> have found:</p> <ul> <li>HPV is a more effective screening test than Pap smears or any other method</li> <li>it substantially reduces incidence and death rates from cervical cancer</li> <li>it is the method of cervical screening that has the <a href="https://www.nature.com/articles/s41591-023-02600-4">best balance</a> of benefits to harms.</li> </ul> <p>As a consequence, the WHO now unequivocally <a href="https://www.who.int/publications/i/item/9789240030824">recommends</a> HPV screening as the best-practice method.</p> <h2>Now you can collect your own sample</h2> <p>One of the major benefits of switching to HPV screening is it opened the door for a person being able to <a href="https://www.health.gov.au/self-collection-for-the-cervical-screening-test">collect their own sample</a> (which was impossible with the Pap smear). If HPV is present, it can be detected in the vagina rather than having to directly sample the cervix.</p> <p>In 2022, Australia became one of the <a href="https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/landmark-changes-improving-access-to-life-saving-cervical-screenings">first countries</a> in the world to introduce a universal option to choose self-collection within a major national-level screening program. This means people eligible for screening, under the guidance of a primary care practitioner, can now choose to collect their own vaginal sample, in privacy, using a simple swab.</p> <p>By the end of 2023, <a href="https://www.ncsr.gov.au/about-us/news-and-media/self-collection-for-cervical-screening--at-an-all-time-high.html">27% of people</a> were choosing to take the test this way, but this is on an upward trajectory and is likely to increase further, with an <a href="https://acpcc.org.au/self-collection-campaign/">awareness campaign</a> due to start next month.</p> <h2>So what happens when I have a test?</h2> <p>You’ll receive an invitation from the <a href="https://www.ncsr.gov.au/information-for-participants/participant-forms-and-guides.html#cervical-forms">National Cancer Screening Register</a> to attend your first screen when you turn 25. If you’re older, you’ll receive reminders when you are due for your next test. You will be invited to visit your GP or community health service for the test.</p> <p>You should be asked whether you would prefer to have a clinician collect the test or whether you would prefer to take the sample yourself.</p> <p>There’s no right or wrong way. The accuracy of testing has been <a href="https://www.bmj.com/content/363/bmj.k4823">shown</a> to be equivalent for clinician or self-collected sampling. This is a matter of choice.</p> <p>If the clinician does the test, they will undertake a pelvic examination with a speculum inserted into the vagina. This enables the doctor or nurse to view the cervix and take a sample.</p> <p>If you are interested in the self-collection option, check whether the practice is offering it when making an appointment.</p> <p>If you opt for self-collection, you’ll be able to do so in private. You’ll be given a swab (which looks like a COVID test swab with a longer stem), and you’ll be given instructions about how to insert and rotate the swab in the vagina to take the sample. It takes only a few minutes.</p> <h2>What does it mean if my test detects HPV?</h2> <p>If your test detects HPV, this means you have an HPV infection. These are very common and by itself doesn’t mean you have cancer, or even pre-cancer (which involves changes to cervical cells that make them more likely to develop into cancer over time).</p> <p>It does mean, however, that you are at higher risk of having a pre-cancer, or developing one in future, and that you will benefit from further follow-up or diagnostic testing. Your doctor or nurse will <a href="https://www.cancer.org.au/clinical-guidelines/cervical-cancer/cervical-cancer-screening">guide you</a> on the next steps in line with national guidelines.</p> <p>If you require a diagnostic examination, this will involve a procedure called colposcopy, where the cervix is closely examined by a gynaecologist or other specially trained healthcare practitioner, and a small sample may be taken for detailed examination of the cells.</p> <p>If you have a pre-cancer, you can be treated simply and quickly, usually without needing to be admitted to hospital. Treatment involves ablating or removing a small area of the cervix. This treatment will drastically reduce your risk of ever developing cervical cancer.</p> <h2>What does this mean for cervical cancer rates?</h2> <p>Cervical screening for HPV is a very effective method of preventing cervical cancer. Because of Australia’s HPV screening, combined with HPV vaccination in younger people, Australia is <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30183-X/fulltext">expected</a> to achieve such low rates of cervical cancer by 2035 that it will be considered eliminated.</p> <p>Last year, the government launched a <a href="https://www.health.gov.au/sites/default/files/2023-11/national-strategy-for-the-elimination-of-cervical-cancer-in-australia.pdf">national strategy for cervical cancer elimination</a> which provides key recommendations for eliminating cervical cancer, and for doing so equitably in all groups of women and people with a cervix.</p> <p>One of the best things you can do to protect yourself is to have your cervical screening test when you become eligible, whether or not you have been vaccinated against HPV.</p> <p><em>Marion Saville, a pathologist and Executive Director at the Australian Centre for the Prevention of Cervical Cancer, co-authored this article.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229495/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/karen-canfell-22668"><em>Karen Canfell</em></a><em>, Professor &amp; Director, Daffodil Centre, A Joint Venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/deborah-bateson-16105">Deborah Bateson</a>, Professor of Practice, The Daffodil Centre, a joint venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/megan-smith-131901">Megan Smith</a>, Principal Research Fellow, The Daffodil Centre, a joint venture with Cancer Council NSW, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-due-for-a-cervical-cancer-screening-what-can-i-expect-can-i-do-it-myself-and-what-happened-to-pap-smears-229495">original article</a>.</em></p> </div>

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How long does back pain last? And how can learning about pain increase the chance of recovery?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>.</p> <p>Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>.</p> <p>If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups:</p> <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> <p>We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.</p> <p>Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.</p> <h2>More pain doesn’t mean a more serious injury</h2> <p>Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease.</p> <p>There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.</p> <p>Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.</p> <p>The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.</p> <p>The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.</p> <h2>Reduce your chance of lasting pain</h2> <p>Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:</p> <ul> <li> <p>understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain</p> </li> <li> <p>reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.</p> </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> <p>Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.</p> <p>These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover.</p> <p>But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.</p> <p>When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>.</p> <p>Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community.</p> <p>But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.</em></p> </div>

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What your nose can tell you about your health

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p>Thanks to a quirk known as <a href="https://www.psychologytoday.com/us/blog/brain-babble/201502/is-how-the-brain-filters-out-unimportant-details">unconscious selective attention</a>, your brain has learned to ignore your nose. A prominent feature that’s positioned closely to the eyes, the schnoz could get in the way of our vision – but the nervous system cleverly filters it out.</p> <p>You can choose to look for your nose though. Either close one eye or look left, right or downwards and it’ll pop into view.</p> <p>But, although your brain works hard to stop your nose from interfering with your line of vision, your snout is not something to ignore. Like <a href="https://theconversation.com/navel-gazing-checking-your-belly-button-can-tell-you-a-lot-about-your-health-228759">many other</a> parts of your body, examining the nose can help diagnose external skin conditions – and internal diseases.</p> <h2>Acne</h2> <p>While there are a <a href="https://www.nhs.uk/conditions/acne/">number of forms</a> of <a href="https://patient.info/skin-conditions/acne-leaflet">acne</a>, <a href="https://dermnetnz.org/topics/acne-vulgaris">acne vulgaris</a> is the most common – and it often affects the nose.</p> <p>This skin condition develops from the clogging of tiny glands in the skin that secrete protective oils, which leads to <a href="https://www.medicalnewstoday.com/articles/comedonal-acne#outlook">open and closed comedones</a>. Open comedones – better known as blackheads – develop a dark coloured plug, whereas closed comedones are whiteheads that form when the pore is blocked completely. Clogged pores can also develop into larger lumps and bumps which can become infected, inflamed and and pus-filled and can even scar the skin.</p> <p><a href="https://dermnetnz.org/topics/rosacea">Acne rosacea</a> has a different appearance. It is an inflammatory skin condition that causes erythema – or reddening of the skin – most often across the nose and cheeks. Rosacea <a href="https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/rosacea/#:%7E:text=Although%20rosacea%20can't%20be,you%20can%20stop%20treatment%20temporarily.">is currently incurable</a> but it can be managed, often with long-term treatment. Patients with rosacea may often develop a rash papules and pustules that resembles acne – and also have visible blood vessels that appear as thin red or purplish lines across the nose and cheeks.</p> <p>In some cases, rosacea can cause the skin of the nose to grow and thicken. This condition is referred to as <a href="https://patient.info/doctor/rosacea-and-rhinophyma">rhinophyma</a>, and, like other visible skin conditions, can result in profound changes to appearance and seriously affect self-esteem in sufferers.</p> <figure><iframe src="https://www.youtube.com/embed/cO9pa0aGBTY?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Both acne vulgaris and rosacea have been connected with <a href="https://pubmed.ncbi.nlm.nih.gov/32238884/">various risk factors</a> and health conditions, though some links are stronger than others. In the case of rosacea, the list includes <a href="https://pubmed.ncbi.nlm.nih.gov/32621366/">high blood pressure and cholesterol</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29107339/">diabetes and rheumatoid arthritis</a>.</p> <h2>Wolf’s nose</h2> <p><a href="https://www.sarcoidosisuk.org/information-hub/what-is-sarcoidosis/">Sarcoidosis</a>, is an inflammatory disease that can affect any of the body’s tissues – though mainly the lungs and lymph nodes. The condition can generate patches of bluish or purplish rashes, particularly on the body’s extremities where the skin is typically cooler. This includes the ears, the fingers and toes, and of course, the nose. When sarcoidosis affects the nose, it’s known as <a href="https://dermnetnz.org/topics/lupus-pernio">lupus pernio</a>, although the name is a misnomer because this condition is not the same as the <a href="https://lupusuk.org.uk/the-symptoms/">autoimmune disease known as lupus</a>.</p> <p>Regular lupus is a completely different condition where the body attacks its own tissues. It takes its name from the Latin word for “wolf” and the name dates back to <a href="https://pubmed.ncbi.nlm.nih.gov/32380218/">medieval times</a> when the associated skin rash was said to resemble the bite of a wolf.</p> <p>When lupus, rather than sarcoidosis, affects the skin it generates a <a href="https://www.medicalnewstoday.com/articles/321594">butterfly rash</a> – or <a href="https://www.ncbi.nlm.nih.gov/books/NBK555981/">malar rash</a>, which fans across the cheeks and nasal bridge. This rash can look very similar to rosacea.</p> <p>In fact, lupus is known as <a href="https://www.nature.com/articles/nm1103-1337a">“the great imitator”</a> because it shares similar symptoms to many different diseases.</p> <h2>Trigeminal trophic syndrome</h2> <p><a href="https://dermnetnz.org/topics/trigeminal-trophic-syndrome">Trigeminal trophic syndrome</a> is a rare condition triggered by damage to the <a href="https://teachmeanatomy.info/head/cranial-nerves/trigeminal-nerve/">trigeminal nerve</a>, which controls chewing but also gives sensation to the face. When the smaller nerve branches supplying the area of skin around the nostrils are damaged, sensation is affected. The patient notices either the skin becoming desensitised, or numb – or that it prickles, like pins and needles, creating an urge to pick or scratch. Repeated damage to the skin can <a href="https://rarediseases.org/rare-diseases/trigeminal-trophic-syndrome/">cause ulcers</a> to develop around the nostrils.</p> <p>This condition differs from <a href="https://theconversation.com/skin-picking-is-often-trivialised-as-a-bad-habit-but-dermatillomania-can-be-dangerous-224659">skin picking disorder</a> – or dermatillomania – when a psychological compulsion drives the desire to pick at the skin.</p> <p>So, close one eye every now and then in order to admire your hooter, or, even better have a good look at it in the mirror. It deserves more recognition than the blind spot your brain allows.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228760/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-your-nose-can-tell-you-about-your-health-228760">original article</a>.</em></p> </div>

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All the reasons a cup of coffee really can be good for you

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/justin-stebbing-1405462">Justin Stebbing</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p>Consuming too much caffeine is definitely bad for your health, and there may be good reasons why some people want to <a href="https://theconversation.com/caffeine-heres-how-quitting-can-benefit-your-health-220746">quit it altogether</a>. But if you despair at the idea of giving up your morning coffee, fear not.</p> <p>There’s lots of research out there to show that moderate coffee intake is linked with all sorts of benefits. As well as well-known pluses improving heart health, a daily cup of coffee even seems to be good for your brain and may help prevent mental illness.</p> <p>For a start, coffee contains several essential nutrients beneficial to <a href="https://pubmed.ncbi.nlm.nih.gov/37764216/">overall health</a>. A typical eight-ounce cup of coffee provides small amounts of B <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073624/">vitamins</a> – riboflavin, pantothenic acid, thiamine and niacin – as well as minerals <a href="https://pubmed.ncbi.nlm.nih.gov/25415479/">potassium, manganese, and magnesium</a>. The nutrients in coffee can contribute significantly to daily intake when multiple cups are consumed.</p> <p>It’s also rich in <a href="https://pubmed.ncbi.nlm.nih.gov/36361861/">antioxidants</a>. In fact, many people – especially in the west – will probably get more antioxidants from coffee than from fruit and vegetables.</p> <p>So what does drinking coffee actually mean for the body? One of the most <a href="https://www.ncbi.nlm.nih.gov/books/NBK209050/">well-known</a> potential benefits of coffee is its ability to <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">boost energy levels</a> and improve mental <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608989/">alertness</a>, especially first thing in the morning or during an afternoon slump.</p> <p>This is primarily due to caffeine, a natural stimulant found in coffee, which blocks the brain’s <a href="https://www.news-medical.net/health/What-is-Adenosine.aspx#:%7E:text=In%20the%20brain%20adenosine%20is,the%20brain%20rise%20each%20hour.">inhibitory neurotransmitter adenosine</a>, which promotes sleep and suppresses arousal. This leads to increased neuronal firing and the <a href="https://pubmed.ncbi.nlm.nih.gov/1356551/">release</a> of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462609/">neurotransmitters</a> like <a href="https://www.ncbi.nlm.nih.gov/books/NBK223808/">dopamine</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK537259/">norepinephrine</a>, which enhance mood, reaction time and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202818/">cognitive function</a>.</p> <p>However, sometimes it’s difficult to work out cause and effect here. People drink coffee at work, for example, and in social settings with friends so research has to tease out the effects of the coffee and those of the social aspect of sharing time with friends and colleagues.</p> <figure><iframe src="https://www.youtube.com/embed/I9xzgV7z1Bg?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Chronic diseases</h2> <p>In the long term, moderate coffee consumption can help reduce your risk of developing a host of chronic diseases.</p> <p><strong>1. Cardiovascular diseases</strong></p> <p>Moderate coffee consumption is associated with a reduced risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262944/">heart disease and stroke</a>. Studies indicate that drinking one to two cups of coffee daily may lower the risk of heart failure. Additionally, <a href="https://www.acc.org/About-ACC/Press-Releases/2022/03/23/17/55/Good-News-for-Coffee-Lovers-Daily-Coffee-May-Benefit-the-Heart">coffee consumption</a> has been linked to a lower risk of cardiovascular mortality and disease. Interestingly, even when someone has abnormal heart rhythms, <a href="https://www.heart.org/en/news/2024/03/01/can-people-with-an-irregular-heartbeat-drink-coffee">coffee is not harmful</a> according to <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204737">recent</a> data.</p> <p><strong>2. Type 2 diabetes</strong></p> <p>Coffee may enhance the body’s ability to process glucose, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0939475321002374">reducing the risk</a> of developing type 2 diabetes. Research has shown that people who consume more coffee have a <a href="https://www.healthline.com/health/coffee-s-effect-diabetes">lower likelihood</a> of developing this condition.</p> <p><strong>3. Liver diseases</strong></p> <p>Coffee seems to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440772/">help protect</a> the liver appears to have protective. Both regular and decaffeinated coffee have been associated with healthier liver enzyme levels, and coffee drinkers have a <a href="https://britishlivertrust.org.uk/coffee-report/">significantly lower risk</a> of liver cirrhosis and liver cancer.</p> <p><strong>4. Cancer</strong></p> <p>Coffee consumption has been linked to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9916720/">reduced risk</a> of several other types of cancer, including colorectal and womb cancers. A systematic review found that high coffee consumption is associated with an 18% lower risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">cancer</a>.</p> <p><strong>5. Neurodegenerative diseases</strong></p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7773776/">Caffeine</a> is associated with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353179/">lower risk</a> of developing Parkinson’s disease and may help those with the condition manage their movements better. Additionally, coffee consumption may reduce the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690364/">Alzheimer’s disease</a> and other forms of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478584/">dementia</a>.</p> <h2>Mental health</h2> <p>As if the physical benefits aren’t enough, coffee has also been shown to have <a href="https://www.webmd.com/mental-health/news/20230915/moderate-coffee-intake-lowers-risk-of-anxiety--depression">positive</a> effects on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467199/">mental health</a>. Studies suggest that coffee drinkers have a lower risk of depression, with some findings indicating a 20% reduced risk of becoming depressed.</p> <p>What’s more, coffee consumption has been associated with a decreased risk of suicide. Research has found that people who drink four or more cups a day are 53% less likely to commit <a href="https://pubmed.ncbi.nlm.nih.gov/23819683/">suicide</a>.</p> <figure><iframe src="https://www.youtube.com/embed/62wEk02YKs0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Lifespan</h2> <p>With all these benefits, it’s not surprising that <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2686145">research suggests</a> that coffee drinkers tend to live longer than non-drinkers. A large study involving over 400,000 people found that coffee consumption over a period of 12 to 13 years was linked to a lower risk of death – with the strongest effect observed at four to five cups per day.</p> <p>This longevity <a href="https://www.nejm.org/doi/pdf/10.1056/NEJMoa1112010">benefit</a> could be due to the cumulative effects of coffee’s protective properties against various diseases.</p> <h2>Moderation required</h2> <p>While coffee offers numerous <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">health benefits</a>, it is essential to consume it in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">moderation</a>. It’s also advisable to limit added sugars and creams to avoid unnecessary calorie intake.</p> <p><a href="https://www.healthline.com/nutrition/caffeine-side-effects">Excessive caffeine</a> intake can lead to negative side effects such as jitteriness, anxiety and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292246/">sleep disturbances</a>. Some people who are especially sensitive to caffeine may need to limit their coffee intake or avoid it altogether, as even decaffeinated coffee <a href="https://www.healthline.com/nutrition/caffeine-in-decaf">contains caffeine</a>.</p> <p>As with any dietary component, balance is key. By understanding the potential benefits and limitations of coffee, people can make informed decisions about incorporating it into their daily routine.</p> <p>I, for one, will be sticking to my morning cup.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236852/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/justin-stebbing-1405462">Justin Stebbing</a>, Professor of Biomedical Sciences, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p><em>Image </em><em>credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/all-the-reasons-a-cup-of-coffee-really-can-be-good-for-you-236852">original article</a>.</em></p> </div>

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Men have a biological clock too. Here’s what’s more likely when dads are over 50

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/karin-hammarberg-113096">Karin Hammarberg</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>We hear a lot about women’s biological clock and how age affects the chance of pregnancy.</p> <p><a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">New research shows</a> men’s fertility is also affected by age. When dads are over 50, the risk of pregnancy complications increases.</p> <p>Data from more than 46 million births in the <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">United States</a> between 2011 and 2022 compared fathers in their 30s with fathers in their 50s.</p> <p>While taking into account the age of the mother and other factors known to affect pregnancy outcomes, the researchers found every ten-year increase in paternal age was linked to more complications.</p> <p>The researchers found that compared to couples where the father was aged 30–39, for couples where the dad was in his 50s, there was a:</p> <ul> <li>16% increased risk of preterm birth</li> <li>14% increased risk of low birth weight</li> <li>13% increase in gestational diabetes.</li> </ul> <p>The older fathers were also twice as likely to have used assisted reproductive technology, including IVF, to conceive than their younger counterparts.</p> <h2>Dads are getting older</h2> <p>In this <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">US study</a>, the mean age of all fathers increased from 30.8 years in 2011 to 32.1 years in 2022.</p> <p>In that same period, the proportion of men aged 50 years or older fathering a child increased from 1.1% to 1.3%.</p> <p>We don’t know the proportion of men over 50 years who father children in Australia, but data shows the average age of fathers has increased.</p> <p>In 1975 the <a href="https://www.abs.gov.au/statistics/people/population/births-australia/latest-release">median age of Australian dads</a> was 28.6 years. This jumped to 33.7 years in 2022.</p> <h2>How male age affects getting pregnant</h2> <p>As we know from <a href="https://www.businessinsider.com/celebrities-dads-first-time-over-age-50#when-he-was-54-simon-cowell-and-girlfriend-lauren-silverman-became-parents-to-their-son-eric-7">media reports</a> of celebrity dads, men produce sperm from puberty throughout life and can father children well into old age.</p> <p>However, there is a noticeable decline in <a href="https://www.fertstert.org/article/S0015-0282(18)30269-3/fulltext">sperm quality</a> from about age 40.</p> <p>Female partners of older men take longer to achieve pregnancy than those with younger partners.</p> <p>A study of the effect of male age on <a href="https://www.fertstert.org/article/S0015-0282(03)00366-2/fulltext">time to pregnancy</a> showed women with male partners aged 45 or older were almost five times more likely to take more than a year to conceive compared to those with partners aged 25 or under. More than three quarters (76.8%) of men under the age of 25 years impregnated their female partners within six months, compared with just over half (52.9%) of men over the age of 45.</p> <p>Pooled data from ten studies showed that partners of older men are also more likely to experience miscarriage. Compared to couples where the male was aged 25 to 29 years, <a href="https://pubmed.ncbi.nlm.nih.gov/32358607/">paternal age over 45 years</a> increased the risk of miscarriage by 43%.</p> <h2>Older men are more likely to need IVF</h2> <p>Outcomes of assisted reproductive technology, such as IVF, are also influenced by the age of the male partner.</p> <p>A <a href="https://doi.org/10.1016/j.rbmo.2022.03.031">review of studies</a> in couples using assisted reproductive technologies found paternal age under 40 years reduced the risk of miscarriage by about 25% compared to couples with men aged over 40.</p> <p>Having a male under 40 years also almost doubled the chance of a live birth per treatment cycle. With a man over 40, 17.6% of treatment rounds resulted in a live birth, compared to 28.4% when the male was under 40.</p> <h2>How does male age affect the health outcomes of children?</h2> <p>As a result of age-related changes in sperm DNA, the children of older fathers have increased risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9957550/">a number of conditions</a>. Autism, schizophrenia, bipolar disorders and leukaemia have been linked to the father’s advanced years.</p> <p>A <a href="https://www.fertstert.org/article/S0015-0282(22)01979-3/fulltext">review of studies</a> assessing the impact of advanced paternal age reported that children of older fathers have increased rates of psychiatric disease and behavioural impairments.</p> <p>But while the increased risk of adverse health outcomes linked to older paternal age is real, the magnitude of <a href="https://pubmed.ncbi.nlm.nih.gov/29471389/">the effect is modest</a>. It’s important to remember that an increase in a very small risk is still a small risk and most children of older fathers are born healthy and develop well.</p> <h2>Improving your health can improve your fertility</h2> <p>In addition to the effects of older age, some chronic conditions that affect fertility and reproductive outcomes become more common as men get older. They include <a href="https://www.fertstert.org/article/S0015-0282(23)01935-0/fulltext">obesity and diabetes</a> which affect sperm quality by lowering testosterone levels.</p> <p>While we can’t change our age, some lifestyle factors that increase the risk of pregnancy complications and reduce fertility, can be tackled. They include:</p> <ul> <li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639396/">smoking</a></li> <li>recreational <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/tre.414">drug taking</a></li> <li><a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/tre.414">anabolic steroid</a> use</li> <li>heavy <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504800/">alcohol consumption</a>.</li> </ul> <h2>Get the facts about the male biological clock</h2> <p>Research shows <a href="https://academic.oup.com/humupd/article/23/4/458/3065332?login=false">men want children</a> as much as women do. And most men want at least two children.</p> <p>Yet most men <a href="https://academic.oup.com/humupd/article/23/4/458/3065332?login=false">lack knowledge</a> about the limitations of female and male fertility and overestimate the chance of getting pregnant, with and without assisted reproductive technologies.</p> <p>We need better public education, starting at school, to improve awareness of the impact of male and female age on reproductive outcomes and help people have healthy babies.</p> <p>For men wanting to improve their chance of conceiving, the government-funded sites <a href="https://healthymale.org.au/">Healthy Male</a> and <a href="https://www.yourfertility.org.au/">Your Fertility</a> are a good place to start. These offer evidence-based and accessible information about reproductive health, and <a href="https://www.yourfertility.org.au/fertility-week-2022">tips</a> to improve your reproductive health and give your children the best start in life.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/karin-hammarberg-113096">Karin Hammarberg</a>, Senior Research Fellow, Global and Women's Health, School of Public Health &amp; Preventive Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/men-have-a-biological-clock-too-heres-whats-more-likely-when-dads-are-over-50-236892">original article</a>.</em></p> </div>

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I’ve recovered from a cold but I still have a hoarse voice. What should I do?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Cold, flu, COVID and <a href="https://theconversation.com/rsv-is-everywhere-right-now-what-parents-need-to-know-about-respiratory-syncytial-virus-208855">RSV</a> have been <a href="https://www.abc.net.au/news/2024-06-21/flu-whooping-cough-rsv-cases-up-as-covid-cases-unkown/104002964">circulating across Australia this winter</a>. Many of us have caught and recovered from <a href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">one of these</a> common upper respiratory tract infections.</p> <p>But for some people their impact is ongoing. Even if your throat isn’t <a href="https://theconversation.com/sore-throats-suck-do-throat-lozenges-help-at-all-184454">sore</a> anymore, your voice may still be hoarse or croaky.</p> <p>So what happens to the voice when we get a virus? And what happens after?</p> <p>Here’s what you should know if your voice is still hoarse for days – or even weeks – after your other symptoms have resolved.</p> <h2>Why does my voice get croaky during a cold?</h2> <p>A healthy voice is normally clear and strong. It’s powered by the lungs, which push air past the vocal cords to make them vibrate. These vibrations are amplified in the throat and mouth, creating the voice we hear.</p> <p>The vocal cords are two elastic muscles situated in your throat, around the level of your laryngeal prominence, or Adam’s apple. (Although everyone has one, it tends to be more pronounced in males.) The vocal cords are small and delicate – around the size of your fingernail. Any small change in their structure will affect how the voice sounds.</p> <p>When the vocal cords become inflamed – known as laryngitis – your voice will sound different. Laryngitis is a common part of upper respiratory tract infections, but can also be caused through misuse.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=366&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=366&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=366&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=460&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=460&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=460&amp;fit=crop&amp;dpr=3 2262w" alt="Two drawn circles comparing normal vocal cords with inflamed, red vocal cords." /><figcaption><span class="caption">Viruses such as the common cold can inflame the vocal cords.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458117">Pepermpron/Shutterstock</a></span></figcaption></figure> <p>Catching a virus triggers the body’s defence mechanisms. White blood cells are recruited to kill the virus and heal the tissues in the vocal cords. They become inflamed, but also stiffer. It’s harder for them to vibrate, so the voice comes out hoarse and croaky.</p> <p>In some instances, you may find it hard to speak in a loud voice or have a reduced pitch range, meaning you can’t go as high or loud as normal. You may even “lose” your voice altogether.</p> <p>Coughing can also make things worse. It is the body’s way of trying to clear the airways of irritation, including your own mucus dripping onto your throat (<a href="https://www.health.harvard.edu/staying-healthy/treatments-for-post-nasal-drip">post-nasal drip</a>). But coughing slams the vocal cords together with force.</p> <p>Chronic coughing can lead to persistent inflammation and even thicken the vocal cords. This thickening is the body trying to protect itself, similar to developing a callus when a pair of new shoes rubs.</p> <p>Thickening on your vocal cords can lead to physical changes in the vocal cords – such as developing a growth or “nodule” – and further deterioration of your voice quality.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=376&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=376&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=376&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=473&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=473&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=473&amp;fit=crop&amp;dpr=3 2262w" alt="Diagram compares healthy vocal cords with cords that have nodules, two small bumps." /><figcaption><span class="caption">Coughing and exertion can cause inflamed vocal cords to thicken and develop nodules.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458126">Pepermpron/Shutterstock</a></span></figcaption></figure> <h2>How can you care for your voice during infection?</h2> <p>People who use their voices a lot professionally – such as teachers, call centre workers and singers – are often desperate to resume their vocal activities. They are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478078/">more at risk</a> of forcing their voice before it’s ready.</p> <p>The good news is most viral infections resolve themselves. Your voice is usually restored within five to ten days of recovering from a cold.</p> <p>Occasionally, your pharmacist or doctor may prescribe cough suppressants to limit additional damage to the vocal cords (among other reasons) or mucolytics, which break down mucus. But the most effective treatments for viral upper respiratory tract infections are hydration and rest.</p> <p>Drink plenty of water, avoid alcohol and exposure to cigarette smoke. <a href="https://www.healthdirect.gov.au/laryngitis#:%7E:text=You%20can%20help%20your%20voice%20recover%20by%3A%201,avoid%20nasal%20decongestants%20%28these%20make%20your%20throat%20drier%29">Inhaling steam</a> by making yourself a cup of hot water will also help clear blocked noses and hydrate your vocal cords.</p> <p>Rest your voice by talking as little as possible. If you do need to talk, don’t whisper – this <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199704001730">strains the muscles</a>.</p> <p>Instead, consider using “<a href="https://www.instagram.com/reel/C0d-oNIMM1y/">confidential voice</a>”. This is a soft voice – not a whisper – that gently vibrates your vocal cords but puts less strain on your voice than normal speech. Think of the voice you use when communicating with someone close by.</p> <p>During the first five to ten days of your infection, it is important not to push through. Exerting the voice by talking a lot or loudly will only exacerbate the situation. Once you’ve recovered from your cold, you can speak as you would normally.</p> <h2>What should you do if your voice is still hoarse after recovery?</h2> <p>If your voice hasn’t returned to normal after <a href="https://www.healthdirect.gov.au/laryngitis">two to three weeks</a>, you should seek medical attention from your doctor, who may refer you to an ear nose and throat specialist.</p> <p>If you’ve developed a nodule, the specialist would likely refer you to a speech pathologist who will show you how to take care of your voice. Many nodules can be <a href="https://britishvoiceassociation.org.uk/voicecare_vocal-nodules.htm">treated</a> with voice therapy and don’t require surgery.</p> <p>You may have also developed a habit of straining your vocal cords, if you forced yourself to speak or sing while they were inflamed. This can be a reason why some people continue to have a hoarse voice even when they’ve recovered from the cold.</p> <p>In those cases, a speech pathologist may play a valuable role. They may teach you to exercises that make voicing more efficient. For example, <a href="https://www.youtube.com/watch?v=fwNPp-RS4IY">lip trills</a> (blowing raspberries) are a fun and easy way you can learn to relax the voice. This can help break the habit of straining your voice you may have developed during infection.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, Postdoctoral Research and Lecturer of Speech Pathology, School of Health Sciences, <em><a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-recovered-from-a-cold-but-i-still-have-a-hoarse-voice-what-should-i-do-236398">original article</a>.</p> </div>

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Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care.</p> <p>So what is knee osteoarthritis and what are the best ways to manage it?</p> <h2>More than 2 million Australians have osteoarthritis</h2> <p>Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year.</p> <p>Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.</p> <p>Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.</p> <h2>Is it caused by ‘wear and tear’?</h2> <p>Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions.</p> <p>Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain.</p> <p>This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis.</p> <h2>What’s the best way to manage osteoarthritis?</h2> <p>Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.</p> <p>Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.</p> <p>Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management.</p> <p>Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future.</p> <p>Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.</p> <p>Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.</p> <p>Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>.</p> <p>Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs.</p> <p>Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits.</p> <h2>What about surgery?</h2> <p>People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.</p> <p>Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.</p> <p>However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.</p> <p>Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis.</p> <p>Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.</p> <p>The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.</p> <h2>I have knee osteoarthritis. What should I do?</h2> <p>The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include:</p> <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> <p>If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/belinda-lawford-1294188"><em>Belinda Lawford</em></a><em>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>.</em></p> </div>

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Strength training has a range of benefits for women. Here are 4 ways to get into weights

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment.</p> <p>This is more than just anecdotal. According to data from the <a href="https://app.powerbi.com/view?r=eyJrIjoiZGU1YWFhZDgtMmRhZi00YTgyLThhMzItYjc2ODk5NTg0MTg1IiwidCI6IjhkMmUwZjRjLTU1ZjItNGNiMS04ZWU3LWRhNWRkM2ZmMzYwMCJ9">Australian Sports Commission</a>, the number of women <a href="https://www.clearinghouseforsport.gov.au/research/ausplay/results#portal">participating in weightlifting</a> (either competitively or not) grew nearly five-fold between 2016 and 2022.</p> <p>Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles.</p> <h2>Health benefits</h2> <p><a href="https://www.womenshealth.gov/a-z-topics/osteoporosis">Osteoporosis</a>, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670">bone density</a>, a crucial factor for <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-47">preventing osteoporosis</a>, especially for women negotiating menopause.</p> <p>Strength training also improves <a href="http://link.springer.com/10.1007/s40279-015-0379-7">insulin sensitivity</a>, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better <a href="https://doi.org/10.1139/apnm-2020-0245">heart health</a> too.</p> <p>There’s a mental health boost as well. Strength training has been linked to reduced symptoms of <a href="https://doi.org/10.1001/jamapsychiatry.2018.0572">depression</a> and <a href="http://link.springer.com/10.1007/s40279-017-0769-0">anxiety</a>.</p> <h2>Improved confidence and body image</h2> <p>Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2019.1634127">conquer challenges</a>.</p> <p>This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A <a href="https://linkinghub.elsevier.com/retrieve/pii/S1755296623000194">recent study</a> found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym.</p> <p>Strength training also has the potential to positively impact <a href="https://journals.lww.com/nsca-jscr/abstract/2002/11000/Relations_of_Strength_Training_to_Body_Image_Among.25.aspx">body image</a>. In a world where women are often judged on appearance, lifting weights can shift the focus <a href="http://journals.sagepub.com/doi/10.1177/0193732502238256">to function</a>.</p> <p>Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success.</p> <p>Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative <a href="https://journals.humankinetics.com/view/journals/wspaj/aop/article-10.1123-wspaj.2022-0088/article-10.1123-wspaj.2022-0088.xml">research</a> I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us:</p> <blockquote> <p>I wanted something that would allow me to train that just didn’t have anything to do with how I looked.</p> </blockquote> <p>Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said:</p> <blockquote> <p>We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we?</p> </blockquote> <p>This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained:</p> <blockquote> <p>Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life.</p> </blockquote> <p>This newfound confidence often spills over into other areas of life. As one woman said:</p> <blockquote> <p>I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter.</p> </blockquote> <h2>Feeling inspired? Here’s how to get started</h2> <p><strong>1. Take things slow</strong></p> <p>Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">compound movements</a>, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient.</p> <p><strong>2. Prioritise proper form</strong></p> <p>Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially.</p> <p><strong>3. Consistency is key</strong></p> <p>Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else.</p> <p><strong>4. Find a community</strong></p> <p>Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum.</p> <h2>Are there any downsides?</h2> <p>Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag.</p> <p>Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging.</p> <p>If you’re concerned about getting too “bulky”, it’s very difficult for <a href="https://journals.sagepub.com/doi/epub/10.1177/0031512520967610">women</a> to bulk up like male bodybuilders without pharmaceutical assistance.</p> <p>The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/erin-kelly-1497598"><em>Erin Kelly</em></a><em>, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/strength-training-has-a-range-of-benefits-for-women-here-are-4-ways-to-get-into-weights-221307">original article</a>.</em></p> </div>

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Australia’s IV fluids shortage will likely last all year. Here’s what that means for surgeries

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722"><em>The University of Melbourne</em></a></em></p> <p>The current <a href="https://www.tga.gov.au/about-IV-fluids-shortages">shortage of sterile intravenous (IV) fluids</a> is a serious ongoing concern for doctors across Australia. During surgery, these sterile fluids are essential to administer drugs and hydrate patients intravenously (via the veins).</p> <p>But supplies of two of the most common solutions are critically low.</p> <p>The Australian government has recently moved to <a href="https://www.theguardian.com/australia-news/article/2024/aug/16/australia-iv-fluid-shortage-government-distribution">coordinate supplies</a> of IV fluids to increase manufacturing and ensure distribution. Despite this, supplies are not expected to return to normal levels <a href="https://www.health.gov.au/sites/default/files/2024-08/joint-statement-on-iv-fluids-health-ministers-meeting-16-august-2024.pdf">until the end of the year</a>.</p> <p>So, what will this mean for surgery in Australia? And are there any alternatives?</p> <h2>Why do we need IV fluids for surgery?</h2> <p>IV fluids are used before, during and after surgery to maintain blood volume and the body’s normal functions. They also combat dehydration, which can happen in a number of ways.</p> <p>Before surgery, patients may become dehydrated from illnesses that cause vomiting or diarrhoea. They are also asked to stop eating and drinking for several hours before surgery. This is to minimise the risk of stomach contents being regurgitated and inhaled into the lungs – a <a href="https://my.clevelandclinic.org/health/diseases/21954-aspiration-pneumonia">complication that can cause injury or death</a>. But it can also make them more dehydrated.</p> <p>During surgery, the body continues to lose fluid through normal processes such as sweating and making urine. But some aspects of surgery also exacerbate dehydration, for example, through blood loss or when internal organs are exposed and lose more fluid through evaporation.</p> <p>After the operation, IV fluids may be required for some days. Many patients may still be unable to eat and drink until the function of the gut returns to normal.</p> <p>Multiple research studies, including <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1801601">a trial </a>of 3,000 patients who underwent major abdominal surgery, have demonstrated the importance of adequate fluid therapy throughout all stages of surgery to avoid kidney damage.</p> <p>Apart from hydration, these sterile fluids – prepared under strict conditions so they contain no bacteria or viruses – are used in surgery for other reasons.</p> <p>Anaesthetists commonly use fluid infusions to slowly deliver medications into the bloodstream. There is some evidence this method of maintaining anaesthesia, compared to inhalation, can improve patients’ experience of “waking up” after the procedure, <a href="https://medcast.com.au/blog/total-intravenous-anaesthesia-tiva">such as being clearer headed and having less nausea and vomiting</a>.</p> <p>Surgeons also use sterile fluids to flush out wounds and surgical sites to prevent infection.</p> <h2>Are there workarounds?</h2> <p>Fluid given intravenously needs to closely resemble the salts in the blood to prevent additional problems. The safest and cheapest options are:</p> <ul> <li>isotonic saline, a solution of water with 0.9% table salt</li> <li>Hartmann’s solution (compound sodium lactate), which combines a range of salts such as potassium and calcium.</li> </ul> <p>Both are <a href="https://www.tga.gov.au/about-IV-fluids-shortages">in short supply</a>.</p> <p>One way to work around the shortage is to minimise how much IV fluid is used during the procedure. This can be achieved by ensuring those admitted to surgery are as well hydrated as possible.</p> <p>Many people presenting for minor surgery can safely drink water up until an hour or so before their operation. A recent initiative termed “<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15855">sip ‘til send</a>” has shown it is safe for patients to drink small amounts of fluid until the operating theatre team “sends” for them from the waiting room or hospital ward.</p> <p>However, this may not be appropriate for those at higher risk of inhaling stomach contents, or patients who take medications including <a href="https://www.journal.acorn.org.au/cgi/viewcontent.cgi?article=1291&amp;context=jpn">Ozempic</a>, which delay the stomach emptying. Patients should follow their anaesthetist’s advice about how to prepare for surgery and when to stop eating and drinking.</p> <p>Large research trials have also helped establish protocols called “<a href="https://www.bjanaesthesia.org/article/S0007-0912(17)53976-8/fulltext">enhanced recovery after surgery</a>”. They show that using special hydrating, carbohydrate-rich drinks before surgery can improve patients’ comfort and speed up healing.</p> <p>These protocols are common in <a href="https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/736617/ERAS-Key-principles-for-colorectal-surgery.pdf">major bowel surgery</a> in Australia but not used universally. Widespread adoption of these processes may reduce the amount of IV fluids needed during and after large operations, and help patients return to normal eating and drinking earlier. Medications reducing nausea and vomiting are now also routinely administered after surgery to help with this.</p> <h2>What will the shortage mean for surgeries?</h2> <p>The Australian and New Zealand College of Anaesthetists <a href="https://www.anzca.edu.au/news/guidance-on-sparing-of-intravenous-fluid-use">has advised anaesthetists</a> to reduce the consumption of fluid during operations where there might be limited or minimal benefit. This means that the fluid will only be used for people who need it, without a change to the quality and safety of anaesthetic care for any patient.</p> <p>Even with these actions, there is still a chance that some planned surgeries may <a href="https://www.abc.net.au/news/2024-08-15/iv-fluid-shortage-elective-urgery-delays/104225280">need to be postponed</a> in the coming months.</p> <p>If needed, these cancelled operations will likely be ones requiring large volumes of fluid and ones that would not cause unacceptable risks if delayed. Similar to cancellations during the height of the COVID pandemic, emergency operations and surgery for cancers are unlikely to be affected.</p> <p>Monitoring of the supplies and ongoing honest and open dialogue between senior health managers and clinicians will be crucial in minimising the disruption to surgical services.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/stuart-marshall-1115779">Stuart Marshall</a>, Associate Professor, Department of Critical Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australias-iv-fluids-shortage-will-likely-last-all-year-heres-what-that-means-for-surgeries-237009">original article</a>.</em></p> </div>

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Ovarian cancer is hard to detect. Focusing on these 4 symptoms can help with diagnosis

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Ovarian cancers are often found when they are already advanced and hard to treat.</p> <p>Researchers <a href="https://ascopubs.org/doi/10.1200/JCO.2010.32.2164">have long believed</a> this was because women first experienced symptoms when ovarian cancer was already well-established. Symptoms can also be <a href="https://cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/early-detection-of-ovarian-cancer">hard to identify</a> as they’re vague and similar to other conditions.</p> <p>But <a href="https://ijgc.bmj.com/content/early/2024/07/24/ijgc-2024-005371">a new study</a> shows promising signs ovarian cancer can be detected in its early stages. The study targeted women with four specific symptoms – bloating, abdominal pain, needing to pee frequently, and feeling full quickly – and put them on a fast track to see a specialist.</p> <p>As a result, even the most aggressive forms of ovarian cancer could be detected in their early stages.</p> <p>So what did the study find? And what could it mean for detecting – and treating – ovarian cancer more quickly?</p> <h2>Why is ovarian cancer hard to detect early?</h2> <p>Ovarian cancer <a href="https://pubmed.ncbi.nlm.nih.gov/24979449/">cannot be detected</a> via cervical cancer screening (which used to be called a pap smear) and pelvic exams <a href="https://pubmed.ncbi.nlm.nih.gov/24979449/">aren’t useful</a> as a screening test.</p> <p>Current <a href="https://www.canceraustralia.gov.au/cancer-types/gynaecological-cancers/clinicians-hub/ovarian-cancer-guidelines">Australian guidelines</a> recommend women get tested for ovarian cancer if they have symptoms for <a href="https://www.canceraustralia.gov.au/sites/default/files/publications/assessment-symptoms-may-be-ovarian-cancer-guide-gps/pdf/ocg_assessment_of_symptoms_gp_card_0.pdf">more than a month</a>. But many of the <a href="https://cancer.org.au/cancer-information/types-of-cancer/ovarian-cancer">symptoms</a> – such as tiredness, constipation and changes in menstruation – are vague and overlap with other common illnesses.</p> <p>This makes early detection a challenge. But it is crucial – a woman’s <a href="https://seer.cancer.gov/statfacts/html/ovary.html">chances of surviving ovarian cancer</a> are associated with how advanced the cancer is when she is diagnosed.</p> <p>If the cancer is still confined to the original site with no spread, the five-year survival rate is 92%. But over half of women diagnosed with ovarian cancer first present when the cancer has <a href="https://seer.cancer.gov/statfacts/html/ovary.html">already metastatised</a>, meaning it has spread to other parts of the body.</p> <p>If the cancer has spread to nearby lymph nodes, the survival rate is reduced to 72%. If the cancer has already metastasised and spread to distant sites at the time of diagnosis, the rate is only 31%.</p> <p>There are mixed findings on whether detecting ovarian cancer earlier leads to better survival rates. For example, a trial in the UK that screened more than 200,000 women <a href="https://pubmed.ncbi.nlm.nih.gov/37183782/">failed to reduce deaths</a>.</p> <p>That study screened the general public, rather than relying on self-reported symptoms. The new study suggests asking women to look for specific symptoms can lead to earlier diagnosis, meaning treatment can start more quickly.</p> <h2>What did the new study look at?</h2> <p>Between June 2015 and July 2022, the researchers recruited 2,596 women aged between 16 and 90 from 24 hospitals across the UK.</p> <p>They were asked to monitor for these four symptoms:</p> <ul> <li>persistent abdominal distension (women often refer to this as bloating)</li> <li>feeling full shortly after starting to eat and/or loss of appetite</li> <li>pelvic or abdominal pain (which can feel like indigestion)</li> <li>needing to urinate urgently or more often.</li> </ul> <p>Women who reported at least one of four symptoms persistently or frequently were put on a <a href="https://pubmed.ncbi.nlm.nih.gov/22479719/">fast-track pathway</a>. That means they were sent to see a gynaecologist within two weeks. The fast track pathway has been used in the UK since 2011, but is not specifically part of Australia’s guidelines.</p> <p>Some 1,741 participants were put on this fast track. First, they did a blood test that measured the cancer antigen 125 (CA125). If a woman’s CA125 level was abnormal, she was sent to do a internal vaginal ultrasound.</p> <h2>What did they find?</h2> <p>The study indicates this process is better at detecting ovarian cancer than general screening of people who don’t have symptoms. Some 12% of women on the fast-track pathway were diagnosed with some kind of ovarian cancer.</p> <p>A total of 6.8% of fast-tracked patients were diagnosed with high-grade serous ovarian cancer. It is the most aggressive form of cancer and responsible for 90% of ovarian cancer deaths.</p> <p>Out of those women with the most aggressive form, one in four were diagnosed when the cancer was still in its early stages. That is important because it allowed treatment of the most lethal cancer before it had spread significantly through the body.</p> <p>There were some promising signs in treating those with this aggressive form. The majority (95%) had surgery and three quarters (77%) had chemotherapy. Complete cytoreduction – meaning all of the cancer appears to have been removed – was achieved in six women out of ten (61%).</p> <p>It’s a promising sign that there may be ways to “catch” and target ovarian cancer before it is well-established in the body.</p> <h2>What does this mean for detection?</h2> <p>The study’s findings suggest this method of early testing and referral for the symptoms leads to earlier detection of ovarian cancer. This may also improve outcomes, although the study did not track survival rates.</p> <p>It also points to the importance of public awareness about symptoms.</p> <p>Clinicians should be able to recognise all of the ways ovarian cancer can present, including vague symptoms like general fatigue.</p> <p>But empowering members of the general public to recognise a narrower set of four symptoms can help trigger testing, detection and treatment of ovarian cancer earlier than we thought.</p> <p>This could also save GPs advising every woman who has general tiredness or constipation to undergo an ovarian cancer test, making testing and treatment more targeted and efficient.</p> <p>Many women remain <a href="https://www.google.com/url?q=https://pubmed.ncbi.nlm.nih.gov/24612526/&amp;sa=D&amp;source=docs&amp;ust=1723610085733806&amp;usg=AOvVaw3J5o5DwRFiDzFaQcD7VTQn">unaware of the symptoms</a> of ovarian cancer. This study shows recognising them may help early detection and treatment.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236775/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, Australian Women and Girls' Health Research Centre, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ovarian-cancer-is-hard-to-detect-focusing-on-these-4-symptoms-can-help-with-diagnosis-236775">original article</a>.</em></p> </div>

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