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5 reasons art therapy is great for your mental health as you age

We know how important it is to look after our <a style="color: blue;" href="https://www.betterhealth.vic.gov.au/health/servicesandsupport/healthy-and-active-ageing">physical health</a> as we age, but our mental health is equally important. <a style="color: blue;" href="https://aifs.gov.au/resources/short-articles/normalising-mental-illness-older-adults-barrier-care">Studies have shown</a> that besides the immediate impact on wellbeing, older people with untreated mental ill health are at risk of poorer overall health, increased hospital admissions, and an earlier transition into aged care. Art therapy is an excellent way to boost our mental wellbeing. In a nutshell, this type of therapy is when visual art, such as drawing, sculpting, or collage, is used in a <a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/">therapeutic context</a>. And don’t be put off if you haven’t picked up a paintbrush since you were a kid. Art therapy is not about creating works of beauty but about the process. It’s a completely <a style="color: blue;" href="https://cata.org.au/faqs-myth-busters/#:~:text=The%20focus%20of%20Creative%20Art,%2C%20growth%20and%20self%2Dawareness.&text=Reality%3A%20Creative%20Art%20Therapy%20does,to%20affect%20change%20and%20growth.">judgement free zone</a>! Emotional release: Growing up, many of us were never taught that it was okay to express how we’re feeling, especially emotions like anger and sadness. In that way, art therapy can be ideal us older folks who often feel stuck when it comes to expressing ourselves. Art therapy provides the opportunity to express our <a style="color: blue;" href="https://creativityintherapy.com/2017/06/expressing-emotions-creativity-6-step-art-process/">inner experiences</a> in a visual way. Through the act of creation, we can release pent-up feelings, reduce stress, and experience emotional release. Another challenging emotion that art therapy can help with is grief. As we age, we are more likely to experience the <a style="color: blue;" href="https://www.nari.net.au/the-impact-of-prolonged-grief-in-older-people">loss of a loved one</a> and we don’t get ‘used to it’. The hole it leaves in our hearts is just as dark. Through <a style="color: blue;" href="https://www.vivianpaans.com.au/blog/healing-through-art-how-art-therapy-can-help-with-grief-and-wellbeing">creating art</a> we can explore the feelings of grief and sadness in a safe, judgement-free space. It can also foster a sense of self-compassion and when we have more compassion for ourselves, it becomes easier to accept our emotions. Stress relief: <a style="color: blue;" href="https://www.sane.org/information-and-resources/facts-and-guides/facts-mental-health-issues">Anxiety, depression, and past traumas</a> can heavily impact on our daily lives. Risk factors over our lifespans may change but they don’t magically disappear once we hit a certain age. Illness, grief, financial stress, social isolation, and life transitions such as menopause can all be <a style="color: blue;" href="https://www.healthdirect.gov.au/older-people-and-mental-health">contributing factors</a> of poor mental health for older adults. Creating art can ease symptoms as we refocus on what we’re creating and move thoughts away from overthinking and worry. Creating art releases <a style="color: blue;" href="https://www.rtor.org/2018/07/10/benefits-of-art-therapy/">dopamine,</a> the chemical responsible for allowing us to feel pleasure and satisfaction. This further reduces bothersome symptoms of anxiety and depression. Also, participating in art therapy leads to a more creative brain. A creative brain is better equipped to create stress-relieving techniques for other areas of our lives. Through creating art, we draw the fears that are inside our minds. This takes them out of our heads and places them away from us, helping us feel more in control. Recovering from <a style="color: blue;" href="https://www.interrelate.org.au/news-media/blogs/november-2021/how-art-can-heal-trauma">trauma</a> can be a lifelong process for many, and it’s important for someone dealing with it to find tools that will help this process. Art therapy can be one of those as it can give a sense of agency and self-understanding through the ability to express feelings symbolically. This can give <a style="color: blue;" href="https://anzacata.org/About-CAT">new perspectives</a> of ourselves and our worldview which is essential in the recovery process. It can also help connect with deeply stored emotions and help process them. Self-discovery: When we are younger we are often so busy working, socialising, and raising a family many of us never get a chance to take the time out for <a style="color: blue;" href="https://www.visionpsychology.com/starting-the-process-of-self-discovery/">self-discovery</a>. Self-discovery is important in our lives as it gives us a clearer sense of purpose and direction in life. In turn, this leads to making better decisions that lead to our overall happiness. Some of us see our kids leave home and suddenly we’re left wondering, who am I when I don’t have a family to care for? Creating art can help us acknowledge and recognise feelings that have been suppressed in our subconscious. Through learning to use different techniques of art our minds open up to thinking more freely. Self-discovery comes from both the finished product we create as well as the process of making it. Self-esteem: As we age, it’s easy to look in the mirror and struggle to recognise the person we see. Our bodies are changing, and it can often feel like society doesn’t value us as much as when we were young. It can be a major shift in the way we view ourselves and lead to poor self-esteem. Art therapy teaches us how to use a variety of media to create something new. We can develop talents and see strengths as we master new materials and see the completion of projects. This sense of accomplishment can be a big leg up to our <a style="color: blue;" href="https://artbusinessnews.com/2022/01/benefits-of-art-therapy/">self-esteem.</a> A sense of community: <a style="color: blue;" href="https://likefamily.com.au/blog/what-is-loneliness-and-how-does-it-affect-someone/">Loneliness</a> is a big contributor to poor mental health. <a style="color: blue;" href="https://www.psychiatrist.com/news/study-why-older-people-feel-so-lonely/">Studies</a> show two groups of people are most at risk: young adults and older people. With factors at our age such as children leaving home, not working as much or at all, living alone, and chronic illness, it’s easy to see how loneliness can creep into our lives. Group art therapy is a wonderful way to connect with others. We share a space with those who have similar interests, and it gives us a sense of belonging. For those who can't make a session in person due to distance or illness, some therapists offer <a style="color: blue;" href="https://www.artandplaytherapytraining.com.au/art_therapy">online group art therapy</a>. You don’t need to see an art therapist to get the mental health benefits of creating art. But the advantage of that is they have the skills to work out what best suits your needs. They’ll also work with you through any tough emotions that may arise from your art therapy. So maybe it’s time to hide those new coloured pencils from the little ones, crack them open, and enjoy them yourself! If you’d like to find out more about art therapy sessions, the links below are helpful. They offer online, in person and group sessions. <a style="color: blue;" href="https://www.zevaarttherapy.com/" target="_blank" rel="noopener">https://www.zevaarttherapy.com/</a> <a style="color: blue;" href="https://www.alliedarttherapy.com.au/" target="_blank" rel="noopener">https://www.alliedarttherapy.com.au/</a> <a style="color: blue;" href="https://www.solacecreativetherapies.com.au/" target="_blank" rel="noopener">https://www.solacecreativetherapies.com.au/</a> <a style="color: blue;" href="https://cata.org.au/programs-ndis/online-creative-art-therapy/" target="_blank" rel="noopener">https://cata.org.au/programs-ndis/online-creative-art-therapy/</a> And for some more ideas on dabbling in art therapy on your own (or with a friend), check out Shelley Klammer’s amazing resources. She is US-based but has some online workshops that are also amazing: <a style="color: blue;" href="https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/" target="_blank" rel="noopener">https://www.expressiveartworkshops.com/expressive-art-resources/100-art-therapy-exercises/</a> Article written by Kylie Carberry Image: Shutterstock

Mind

“These are people’s lives”: Calls for gambling reform after fatal cruise ship plunge

The shocking death of a 50-year-old father who went overboard on a P&O Cruise has caused widespread outrage, with many questioning who is to blame for his untimely passing. Shane Dixon had racked up $5,000 of gambling debt while onboard the Elvis-themed voyage, which his mother, who was also travelling with him, helped him to repay. The next day, Dixon went back to the cruise ship's casino where he racked up another $4,000 in debt, before he plunged to his death while the vessel was on its way into Sydney Harbour. While questions have arisen about the circumstances surrounding his death, the CEO of the Alliance for Gambling Reform Carol Bennett said the cruise ship operator had failed to provide Shane with an adequate duty of care, and encouraged him to keep gambling. "It's really concerning that when a ship sails 12 nautical miles off the coast it can then allow anything and everything to happen," she told <a href="https://www.dailymail.co.uk/news/article-13414919/Anti-gambling-Shane-Dixon-cruise-ship-casino.html" target="_blank" rel="noopener">Daily Mail Australia</a>. "The rules that might apply on land no longer seem to apply and yet you would expect this cruise line would have some kind of duty of care to ensure that people are not plied with inducements, promotions and advertisements that are pushing them to gamble to extremely harmful levels." "It is just beyond belief that there is not an expectation that when a cruise ship leaves a dock that the rules of that jurisdiction apply." "But clearly that's not the case and we leave it all in the hands of the cruise line operator who may or may not apply the responsible service of gambling." Ms Bennett said it was "fundamental" that gamblers were able to set spend limits, self-exclude themselves and be in an environment free of inducements: all of which are required by law when it comes to casinos on Australian soil. "This is just basic harm reduction that any provider or organisation that is providing gambling services should be complying with," she said. "And if they're not, we need to really seriously think about what governments need to do to address this problem because you do wonder how widespread this is. This could be just the tip of the iceberg." Ms Bennett said Australia loses an estimated $25billion on legal forms of gambling each year, with the consequences spreading far beyond the impact on the economy. "It leads to everything from domestic and family violence to health and mental health issues, anxiety, depression, financial distress, right through to suicide," she said. "It is a huge and to some degree hidden problem in Australia, which is why we need stronger enforcement of safeguards and guardrails around gambling that don't see people led into a situation where they see no other way out but suicide." "These are peoples lives. For every person who gambles, there are six people around them who are going to be directly impacted." Labor backbencher Graham Perrett said the British cruise line most likely operated under the UK's gambling laws. "My understanding is that the UK gambling laws are not dissimilar to ours in terms of marketing and advertising," he said. "It's not just a gambling free-for-all, even if they are outside our territorial seas they still have to follow the laws of the UK." Image credits: Facebook / Shutterstock

Cruising

"I am so lost without you": Sam Rubin's son speaks out

Sam Rubin’s son has delivered an emotional on-air tribute to his late dad just days after his <a href="https://oversixty.com.au/health/caring/legendary-today-show-reporter-dies-unexpectedly" target="_blank" rel="noopener">passing</a>. The entertainment reporter died unexpectedly at the age of 64, after reportedly suffering a heart attack in his Los Angeles home last Friday. He worked for LA TV station KTLA as their entertainment reporter, and was a regular guest on Aussie programs like Today and Today Extra. Colby Rubin, the youngest of the reporter's four children, joined KTLA 5 Morning News on Monday to reflect on his father's death. “Hi dad. I wrote this under the desk in your cubicle – only you weren’t there to wake me up this time. Dad, I can’t believe you’re gone,” the 16-year-old began. “I love you so much. On the day you died, I hope you heard me say that. You were the kindest soul, the light in every room. I can’t imagine my life without you... You were always there.” He said he idolised his father calling him his hero, and said: “I never got to tell you that, and I’m so sorry dad.” Colby then shared some of their private texts showing how encouraging his father was when he was unsure of himself, telling him: "You can do this,” and "you have every gift. Respect your own talent." At this point, Colby was overwhelmed with emotion, with the hosts telling him he could take a break but the teen powered on. “I can’t believe I’ve lost you. I had more of a father in 16 years than some people get in their entire lives, and I’m so grateful. "You are a beautiful human and you will never be forgotten. Dad I love you. I am so lost without you, I’ll miss you every day. I hope you know how loved you are.” Colby's tribute left his father's colleagues in tears with one co-host telling him simply: “He knew.” “He would be so proud of you. All of us are parents, we all can say – that is the most beautiful thing I’ve ever heard,” another said as she fought back tears. Viewers praised Colby for his “strength and composure” in delivering such an emotional tribute just days after losing his father. “Amazing how Colby was able to do this with such grace, strength, and composure. You can tell Sam was an amazing father through Colby’s tribute,” TV anchor Stephanie Myers wrote on X. Sam is survived by his wife Leslie and four children: Perry, 28, Rory, 23, Darcy, 18, and Colby. Image: KTLA/ X

Family & Pets

15,000 squares, 500 hours, 19 months: how I used embroidery to make sense of Australia’s catastrophic fires

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/tracey-clement-1518268">Tracey Clement</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> I slip the needle through a small loop of black thread, pull it tight and snip. Done. I have just tied off the very last stitch on an embroidered scroll that has taken me more than 500 hours across 19 months to complete. All of my artwork is extremely labour-intensive. But I have to admit, this is a bit excessive, even for me. It’s not surprising that I have been asked more than once “why not just outsource the labour?” and even “what is the point?” I always sigh and think enviously of plumbers. I am 100% sure hardworking tradies are never asked to justify the point of their work. Why do I work so hard? There is no one easy answer, it’s different every time. The labour intensity of my processes adds time into the equation and this both carries meaning and can change the meaning of the work as it goes on (and on and on). I always learn something unexpected. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/590597/original/file-20240426-17-sg7esy.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" alt="A finger points to a knot on the back of a messy abstract embroidery done in black, red, orange and yellow" /></a><figcaption>The last stitch! Tracey Clement</figcaption></figure> I put my little scissors down and, before busting out the bubbles, I snap a picture for Instagram because #selfpromotion, but also because this is news, albeit of a very slow-breaking kind. This is what I’ve learned after stitching for seemingly endless hours: while no news may be good news, “slow news” is even better. My embroidered scroll is titled Impossible Numbers. It started as my attempt to memorialise <a href="https://wwf.org.au/what-we-do/australian-bushfires/in-depth-australian-bushfires">the estimated 3,000,000,000 non-human lives lost</a> in the devastating bushfires of 2019–20, a number impossible to actually comprehend. <h2>Doomscrolling an emergency</h2> During that long and awful summer Sydney was often shrouded in an eerie orange haze. You could smell smoke. Ash fell. But, like many Australians, I experienced the worst of it by <a href="https://dictionary.cambridge.org/dictionary/english/doomscrolling">doomscrolling</a> fast news. I was both horrified and fascinated by images of fires so huge and hot they generated their own weather, by pictures of houses reduced to smoking skeletal outlines that somehow remained standing, by headlines comparing the fires to <a href="https://www.theguardian.com/australia-news/2019/dec/31/mallacoota-fire-mayhem-armageddon-bushfires-rage-victoria-east-gippsland">armageddon</a> and <a href="https://www.theguardian.com/australia-news/2020/oct/30/australia-must-prepare-for-future-shaped-by-extreme-climate-bushfire-royal-commission-report-warns">the apocalypse</a>. This hyperbolic language implies we are locked in a war of good versus evil. Even headlines in the vein of “Firefighters battle blazes” pit us (people) against them (the forces of nature). And in the heat of the moment the language of war feels right. <a href="https://traceyclement.com/2020/04/21/apocalypse-now">I’ve succumbed to it myself</a>. But it is dangerous. This language reinforces the idea we can dominate nature; it frames the fires as a conflict that we can end by winning. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=1432&fit=crop&dpr=1 600w, https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=1432&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=1432&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=1800&fit=crop&dpr=1 754w, https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=1800&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/590572/original/file-20240426-21-7mbf5w.JPG?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=1800&fit=crop&dpr=3 2262w" alt="A hand holds a phone taking a picture of a long abstract embroidery in black, red, orange and yellow." /></a><figcaption>Viewing the world through the phone. Tracey Clement</figcaption></figure> I will admit watching a goat-toting woman <a href="https://www.abc.net.au/news/2020-01-03/scott-morrison-got-bushfire-welcome-he-deserved-says-liberal-mp/11838476">berate a sitting prime minister</a> left me with a short-lived, but mildly satisfying, feeling of shared righteous indignation. But mostly doomscrolling just fuelled my sorrow and left me feeling impotent as, inevitably, the fast news cycled on to the next crisis (and the next, and the next). <h2>Slowing it down</h2> In October 2022, I finally stopped trying to process the bushfires, and all their terrifying implications, through the fast-news language of war. I picked up a needle instead. Of course 3,000,000,000 stitches would be too many, even for me, so I decided to stitch a grid of some 15,000 squares, which I filled with innumerable stitches – a nod to the endless stream of pixels that usually deliver our news. I started wanting to honour the 3 billion dead, that impossible number, but after months of stitching I realised I was “writing” a kind of slow-news story. It may sound ridiculous, but this tactic has been used before. The <a href="https://www.bayeuxmuseum.com/en/the-bayeux-tapestry">Bayeux Tapestry</a> is a slow-news story that documents the Norman conquest of England through embroidery. It took years to stitch, and some 950 years later it is still in circulation. As an alternative to doomscrolling easily digestible fast-news stories of good triumphing (or not) over evil, I have created an actual fabric scroll which depicts a stylised firestorm building in intensity until it becomes all-consuming. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=799&fit=crop&dpr=1 600w, https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=799&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=799&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=1004&fit=crop&dpr=1 754w, https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=1004&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/590574/original/file-20240426-16-lk14qm.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=1004&fit=crop&dpr=3 2262w" alt="A middle-aged white woman peeks out from behind a very long abstract embroidery in black, red, orange and yellow." /></a><figcaption>The artist with Impossible Numbers. Tracey Clement</figcaption></figure> Despite mimicking pixels, Impossible Numbers is resolutely handmade. It is too messy, too crude, to be anything else. It is bleedingly obvious (and there was blood) the will of a person is inextricably stitched into this image of devastating fire. Human labour is literally entangled in this artwork; it shows us as part of the picture, part of nature. And this is good news Impossible Numbers doesn’t have a victorious ending, or any ending at all. The scroll is not fully unrolled. There is no end in sight: the story isn’t over, it’s ongoing. In this way it points to the future; a future in which we are not fighting nature. And this is good news too. If you don’t have a spare 500 hours to process the news into slow news, don’t worry. By the time I finally tied my last knot, I found I had transformed my fear and rage into something tangible, something both magnificent and beautiful (if I do say so myself), no longer about me. It is now a slow-news story that is no longer about a particular event; something everyone can share. This is why I do the work. Impossible Numbers is on display as part of <a href="https://www.casulapowerhouse.com/prizes/the-blake-art-prize">The Blake Prize</a> at the Casula Powerhouse, Sydney, until July 7. <hr /> This article is part of <a href="https://theconversation.com/au/topics/making-art-work-126611">Making Art Work</a>, our series on what inspires artists and the process of their work.<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/227907/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tracey-clement-1518268">Tracey Clement</a>, Lecturer in Visual Art and McGlade Gallery Director, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Image credits: Instagram 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/15-000-squares-500-hours-19-months-how-i-used-embroidery-to-make-sense-of-australias-catastrophic-fires-227907">original article</a>. </div>

Art

Everything you need to know about tipping in the US

There are few social customs in the US more confusing to travellers than tipping. To most Americans, gratuities are normal, like adding sales tax at the register. To foreign visitors, though, the very idea can induce anxiety or panic. We're notoriously poor tippers. Partly this is accidental ignorance, but partly it is self-righteous rejection of an institution many of us see as unfair. I once had a meal in New York with a woman from Brisbane who refused to tip "on principle." I nodded in agreement ... and then tipped for both of us. The truth is, federal minimum wage for adults in the US is just US$7.25 an hour. In industries where tipping is routine, employers are legally allowed to pay wages as low as US$2.13 an hour. So while travellers may stage a quiet rebellion, refusing to tip, the bereaved party is never going to be the restaurant owners (who earns their profit through the itemised bill), but the poor waiters. Until the US government raises minimum wages to Australian levels (something that will probably never happen), tipping is here to stay. Which means travellers need to accept it, then learn the rules. First rule: After clearing immigration get your hands on a stack of "singles" (US$1 bills). You're going to need them. Getting around In theory, tips should only go to people who are helpful; the more helpful, the more bountiful their reward. In reality, tips are par for the course, and to "stiff" somebody is tantamount to slapping them in the face. If a airport porter helps you with your bags, give them US$1-2 per bag. If they meet you at the gate with a wheelchair, give them US$3-5. For most travellers, the first real test comes with transports away from the airport. If you're lucky enough to have a hotel worker collect you from Arrivals, give them US$10-15 for the effort. If you take a taxi, a little more thought will be required. Many taxis now have seat-back displays that offer "default tipping" amounts at the end of a journey: in New York, 20, 25, and 30 per cent. You should only really tip 30 per cent if the taxi turns out to be the Batmobile, getting you to your destination in record time. Even 20 per cent can sometimes feels a little high. Tipping is subjective: I often manually override the default, leaving 15-20 per cent, or a few extra dollars if I'm paying in cash. If you hire a car and take advantage of valet (all but mandatory in Los Angeles), be prepared to tip the worker US$3-5 upon pick-up, depending on how ritzy the establishment is. A quick rule of thumb: more ritz equals more tip. Hotels If you arrive at the hotel and somebody opens the door for you, that's on the house. If they carry your bags, that is not on the house. Give them US$2-3 a bag. If the hotel has a concierge, their friendliness isn't contingent on your generosity. But if they perform a service for you - book a trip, hire a car, charter a private jet to the Bahamas - acknowledge this effort with US$10-20 at the end of your stay, presented with a handshake. One case where tipping can have a direct impact on the quality of service you receive is housekeeping. Each morning, leave US$2-5 on your pillow with a thank you note. This ensures different cleaners get their due, and it also means cleaners will be extra diligent for the rest of your stay. If you think this is a little rich, keep in mind that these people are picking up your dirty towels, so spare change for a cup of coffee is the least you can do. One point of confusion with hotel tipping is the in-room dining. Some hotels include a default tip on their dining bills; some include a "service charge," which goes to the hotel, and should not be treated as a tip. If there's no obvious tip included on the bill, slip the server 15-20 per cent when they knock on your door. Dining and drinking Nobody can force you to tip in a restaurant, though they can try to counteract your miserliness by stating on the menu that tips are automatically added to the final charge. This is increasingly common in areas catering to large numbers of foreign travellers; it's also pretty standard when your table has more than six people. If tips have been added by the time you come to hand over your card, no further gratuity is needed. If no tip has been included, you might need to leave some money on the table. How much exactly depends on what kind of table it is. If it is a fast food table, no tip. If it is a table at a restaurant ranging from modest diner to upmarket eatery, 15-20 per cent for the waiter is standard (err on the high side in major cities like New York and San Francisco). If you leave less than 15 per cent, staff will assume you weren't happy with their service. If you leave two pennies on top of the bill - a code - they will know you were very unhappy, and feel bad even as they silently loathe you for being a Scrooge. It is almost never okay to withhold a tip; if you're considering doing that, you should also be considering complaining to the manager. If it is a very fancy restaurant, perhaps one with Michelin stars, prepare to hand over 25 per cent of the bill (before tax) to the waiter, who will divide it up among his or her support staff. You should also tip the sommelier if they suggest wine, and perhaps the maitre'd, if they gave you a fabulous table. Always, without exception, tip a bartender a dollar for every drink; bigger tips can mean stronger second cocktails in my experience. As for coffee shops, despite the increasing prevalence of tip jars, and "suggested tips" when paying with a card, this is cheekiness and should only be taken seriously if the barista goes out of their way, like the man who once drew Darth Vader in my cappuccino crema. Everything else This guide covers the most common situations a traveller will have to contend when in the US, though the list is not exhaustive. For example, do you tip a massage therapist? Yes, 10-20 per cent. A hairdresser? Same. Tour guide or hiking leader? 15-20 per cent of the total charge, depending on their performance. That Elvis impersonator who officiated your wedding in a Las Vegas chapel? Same. Tip anyone, in fact, that provides you with a service: 15 per cent is a good default to keep in mind. Just remember, nobody is affronted by the offer of a gratuity, so you shouldn't feel bashful about giving one. Written by Lance Richardson. First appeared on <a href="http://Stuff.co.nz" target="_blank" rel="noopener">Stuff.co.nz</a>. Image credits: Shutterstock

International Travel

4 ways to avoid foot pain when travelling

Whether it’s caused by a hectic day of sightseeing or a mad rush through the airports, there’s nothing quite as annoying as foot pain when you’re on holidays. And when you consider how easy it is to avoid (so long as you take the correct preventative measures) you’ll feeling like kicking yourself for putting up with it for all these years. Here are four ways to avoid foot pain when travelling. 1. Choosing the right pair of shoes Out of all the fashion statements, shoes are probably responsible for more chronic foot pain than anything else. So make sure you choose the right pair of shoes for your trip. For example, if you’re going to be walking around all day sightseeing it might be an idea to ditch the stiletto heels for a pair of joggers (even if they’re not quite so aesthetically pleasing). Dr Robert Mathews from Cremorne Medical in NSW says, “I recommend wearing supportive shoe such as running shoes. If you want to wear something more stylish then consider buying some gel insoles to slip in your shoes, you can get a wide variety of these from your local chemist.“ 2. Manage your feet on flights Foot swelling can become quite a big problem on long haul flight, so managing your feet becomes crucial. Simple, preventative measures anyone can take, like wearing support stocks, standing up every so often to move around or even just flexing your feet and wriggling your toes, can make a big difference and greatly reduce the chance of swelling. 3. Slip, slop and slap So many island holidays have been soured by the blistering pain of sunburnt feet. If you’re staying at a resort or near a beach and your feet are exposed, don’t forget to apply sunscreen everywhere. Otherwise you’re going to want to have some aloe vera gel handy! 4. Take time to rest While you’re probably in a mad rush to see everything, fear of missing out can put significant strain on your feet. So make sure you set aside plenty of time every day to put your feet up and rest. It also might be worth considering some extra pampering, like a foot bath or even a half hour massage. You are on holidays after all, so why not treat yourself! Dr Matthews adds, “It may also be worth taking with you some thick band aids in case you develop any blisters from long walks.” Image credits: Shutterstock

Travel Tips

10 questions you must ask before booking a tour

A tour can be a memorable experience, for the right and wrong reasons. Here are 10 questions you must ask yourself before booking one on your next holiday. 1. Are there minimum or maximum group sizes? This applies for two reasons. Firstly, you need to decide how many people you’d like to travel with. Small group tours will have no more than a dozen or so while larger tours could be up to 50. The size will drastically impact your tour experience, affecting everything from the mode of transport to the type of meals. Secondly, you need to know if there’s a minimum group size needed for the tour to run. If you’re the only one who books you may find it cancelled. 2. What is your cancellation/refund policy? As a rule of thumb, you should ask this question about any kind of travel you book before you hand over your cash. With a tour, make sure you find out their policies around inclement weather, too few passengers or if you need to cancel. And as always, travel insurance is your best friend. 3. Are you available for support throughout? One of the good things about travelling with a tour is that you’ll have the services of at least one guide. It’s also good to know if the tour office itself is available for assistance when you’re on the road. This comes in handy if you have to make changes, get sick or are unhappy with the experience. 4. Do you have any reviews I can read? If you can’t find the tour company on TripAdvisor or a similar review site, ask the company if they have any testimonials from previous customers. Before you make your final decision, it’s nice to know what other people have said about the tour and its style. 5. What experience/qualifications do the guides have? Many tour companies now pride themselves on using locals or people who have lived in a country for many years to guide tours. You don’t want to be stuck with someone who just reads from a guidebook – you can do that yourself for half the price. Find out what they know before you go. 6. How active is it? There is a huge spectrum when it comes to tours, ranging from coach journeys with very little walking to active treks where you cover hard ground every day. Make sure you find out exactly what will be involved and if that suits your abilities and fitness level. And be realistic – you and the tour group will suffer otherwise. 7. What is the demographic? You don’t want to get stuck on a tour with a bunch of 25 year olds who are just looking for the pub. Most people prefer to travel with people around their own age and in similar demographics (such as solo travellers, seniors, families etc), so make sure you find out who is likely to be in your group before you book. 8. Is everything included or will I have to pay for extras? You should be able to get a detailed break down of exactly what is – and what isn’t – included in the price. What looked like a good deal can quickly become very expensive if you have to pay for day excursions, admission fees, alcohol or other surprises. 9. How much time do you spend in each place? Are you looking to tick many famous sites off your list or do you want to have the time to immerse yourself in a destination? When you’re looking at an itinerary, ask questions about how long you will actually be spending at each place to ensure that you get enough time to really enjoy it. 10. Will I get any free time on my own? After many days as part of a group, it’s nice to have some time on your own. You can explore sites that aren’t on your itinerary, try a new restaurant or just have a well deserved nap. Find out how rigid the schedules are and if there will be some time to do your own thing. Image credits: Shutterstock

Travel Tips

Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a> <h2>The big idea</h2> Social ballroom dancing can improve cognitive functions and reduce brain atrophy in older adults who are at increased risk for Alzheimer’s disease and other forms of dementia. That’s the key finding of my team’s <a href="https://doi.org/10.1123/japa.2022-0176">recently published study</a> in the Journal of Aging and Physical Activity. In our study, we enrolled 25 adults over 65 years of age in either six months of twice-weekly ballroom dancing classes or six months of twice-weekly treadmill walking classes. None of them were engaged in formal dancing or other exercise programs. The overall goal was to see how each experience affected cognitive function and brain health. While none of the study volunteers had a dementia diagnosis, all performed a bit lower than expected on at least one of our dementia screening tests. We found that older adults that completed six months of social dancing and those that completed six months of treadmill walking improved their executive functioning – an umbrella term for planning, reasoning and processing tasks that require attention. Dancing, however, generated significantly greater improvements than treadmill walking on one measure of executive function and on processing speed, which is the time it takes to respond to or process information. Compared with walking, dancing was also associated with reduced brain atrophy in the hippocampus – a brain region that is key to memory functioning and is particularly affected by Alzheimer’s disease. Researchers also know that this part of our brain can undergo neurogenesis – or grow new neurons – <a href="https://doi.org/10.1073/pnas.0611721104">in response to aerobic exercise</a>. <figure><iframe src="https://www.youtube.com/embed/unmbhUvnGow?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Research shows those who regularly dance with a partner have a more positive outlook on life.</figcaption></figure> While several previous studies suggest that dancing has beneficial effects <a href="https://doi.org/10.1093/ageing/afaa270">on cognitive function in older adults</a>, only a few studies have compared it directly with traditional exercises. Our study is the first to observe both better cognitive function and improved brain health following dancing than walking in older adults at risk for dementia. We think that social dancing may be more beneficial than walking because it is physically, socially and cognitively demanding – and therefore strengthens a wide network of brain regions. While dancing, you’re not only using brain regions that are important for physical movement. You’re also relying on brain regions that are important for interacting and adapting to the movements of your dancing partner, as well as those necessary for learning new dance steps or remembering those you’ve learned already. <h2>Why it matters</h2> Nearly 6 million older adults in the U.S. and 55 million worldwide <a href="https://doi.org/10.1016/j.jalz.2019.01.010">have Alzheimer’s disease</a> or a <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">related dementia</a>, yet there is no cure. Sadly, the efficacy and ethics surrounding recently developed drug treatments <a href="https://doi.org/10.1080/21507740.2022.2129858">are still under debate</a>. The good news is that older adults can potentially <a href="https://doi.org/10.1016/S0140-6736(20)30367-6">lower their risk for dementia</a> through lifestyle interventions, even later in life. These include reducing social isolation and physical inactivity. Social ballroom dancing targets both isolation and inactivity. In these later stages of the COVID-19 pandemic, a better understanding of the <a href="https://doi.org/10.1177/23337214211005223">indirect effects of COVID-19</a> – particularly those that increase dementia risk, such as social isolation – is urgently needed. In my view, early intervention is critical to prevent dementia from becoming the next pandemic. Social dancing could be a particularly timely way to overcome the adverse cognitive and brain effects associated with isolation and fewer social interactions during the pandemic. <h2>What still isn’t known</h2> Traditional aerobic exercise interventions such as treadmill-walking or running have been shown to lead to modest but reliable improvements in cognition – <a href="https://doi.org/10.1177/1745691617707316">particularly in executive function</a>. My team’s study builds on that research and provides preliminary evidence that not all exercise is equal when it comes to brain health. Yet our sample size was quite small, and larger studies are needed to confirm these initial findings. Additional studies are also needed to determine the optimal length, frequency and intensity of dancing classes that may result in positive changes. Lifestyle interventions like social ballroom dancing are a promising, noninvasive and cost-effective path toward staving off dementia as we – eventually – leave the COVID-19 pandemic behind.<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/194969/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, Associate Professor of Medicine and Neurology, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/kick-up-your-heels-ballroom-dancing-offers-benefits-to-the-aging-brain-and-could-help-stave-off-dementia-194969">original article</a>. </div>

Mind

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/yousuf-mohammed-858232">Yousuf Mohammed</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/khanh-phan-1489820">Khanh Phan</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/vania-rodrigues-leite-e-silva-1497208">Vania Rodrigues Leite E. Silva</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> You wake up, stagger to the bathroom and gaze into the mirror. No, you’re not imagining it. You’ve developed face wrinkles overnight. They’re sleep wrinkles. Sleep wrinkles are temporary. But as your skin loses its elasticity as you age, they can set in. Here’s what you can do to minimise the chance of them forming in the first place. <h2>How side-sleeping affects your face</h2> Your skin wrinkles for a number of reasons, including ageing, sun damage, smoking, poor hydration, habitual facial expressions (such as grinning, pouting, frowning, squinting) and sleeping positions. When you sleep on your side or stomach, your face skin is <a href="https://academic.oup.com/asj/article/36/8/931/2613967">squeezed and crushed</a> a lot more than if you sleep on your back. When you sleep on your side or stomach, gravity presses your face against the pillow. Your face skin is distorted as your skin is stretched, compressed and pulled in all directions as you move about in your sleep. You can reduce these external forces acting on the face by sleeping on your back or changing positions frequently. <h2>Doctors can tell which side you sleep on by looking at your face</h2> In a young face, sleep wrinkles are transient and disappear after waking. Temporary sleep wrinkles can become persistent with time and repetition. As we <a href="https://pubmed.ncbi.nlm.nih.gov/19624425/">age</a>, our skin <a href="https://pubmed.ncbi.nlm.nih.gov/22233477/">loses elasticity</a> (recoil) and extensibility (stretch), creating <a href="https://pubmed.ncbi.nlm.nih.gov/27329660/">ideal conditions</a> for sleep wrinkles or lines to set in and last longer. The time spent in each sleeping position, the magnitude of external forces applied to each area of the face, as well as the surface area of contact with the pillow surface, also <a href="https://pubmed.ncbi.nlm.nih.gov/27329660/">affects</a> the pattern and rate of sleep wrinkle formation. Skin specialists can often recognise this. People who favour sleeping on one side of their body tend to have a flatter face on their sleeping side and more visible sleep lines. <h2>Can a night skincare routine avoid sleep wrinkles?</h2> Collagen and elastin are two primary components of the dermis (inner layer) of skin. They form the skin structure and maintain the elasticity of skin. <figure class="align-center "><img src="https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=395&fit=crop&dpr=1 600w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=395&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=395&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=496&fit=crop&dpr=1 754w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=496&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/593034/original/file-20240509-16-hz2ha3.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=496&fit=crop&dpr=3 2262w" alt="Skin structure" /><figcaption>The dermis is the inner layer of skin. <a class="source" href="https://www.shutterstock.com/image-vector/skin-structure-old-young-1707589036">mermaid3/Shutterstock</a></figcaption></figure> Supplementing collagen through skincare routines to enhance skin elasticity can <a href="https://pubmed.ncbi.nlm.nih.gov/32799362/">help reduce</a> wrinkle formation. <a href="https://pubmed.ncbi.nlm.nih.gov/30287361/">Hyaluronic</a> acid is a naturally occurring molecule in human bodies. It holds our skin’s collagen and elastin in a proper configuration, stimulates the production of <a href="https://www.mdpi.com/1420-3049/26/15/4429">collagen</a> and adds hydration, which can help slow down wrinkle formation. Hyaluronic acid is one of the most common <a href="https://pubmed.ncbi.nlm.nih.gov/30287361/">active ingredients</a> in skincare creams, gels and lotions. Moisturisers can hydrate the skin in <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1473-2165.2009.00421.x">different ways</a>. “Occlusive” substances produce a thin layer of oil on the skin that prevents water loss due to evaporation. “Humectants” attract and hold water in the skin, and they can differ in their capacity to bind with water, which influences the degree of skin hydration. <h2>Do silk pillowcases actually make a difference?</h2> Silk pillowcases can make a difference in wrinkle formation, if they let your skin glide and move, rather than adding friction and pressure on a single spot. If you can, use silk sheets and silk pillows. Studies have also <a href="https://academic.oup.com/asj/article/36/8/931/2613967">shown</a> pillows designed to reduce mechanical stress during sleep can prevent skin deformations. Such a pillow <a href="https://www.scirp.org/journal/paperinformation?paperid=67035#:%7E:text=Introduction-,The%20duration%20of%20sleep%20and%20the%20position%20of%20the%20face,permanent%20sleep%20lines%20with%20time.">could be useful</a> in slowing down and preventing the formation of certain facial wrinkles. Sleeping on your back can reduce the risk of sleep lines, as can a nighttime routine of moisturising before sleep. Otherwise, lifestyle choices and habits, such quitting smoking, drinking plenty of water, a healthy diet (eating enough vegetables, <a href="https://www.tandfonline.com/doi/full/10.1080/07315724.2001.10719017?casa_token=uD1flbkLyKUAAAAA%3AsMTWPmxzO3fGHAI41o80B_bWrGrOrvQFeJwF2FtIEnkd73Qmjvyhxr1-GO2kU8_Yc2LYgZp56DqHVg">fruits</a>, nuts, seeds, healthy fats, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452251/pdf/nutrients-09-00521.pdf">yogurt and other fermented foods</a>) and regular use of sunscreens can help improve the appearance of the skin on our face.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217380/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yousuf-mohammed-858232">Yousuf Mohammed</a>, Dermatology researcher, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/khanh-phan-1489820">Khanh Phan</a>, Postdoctoral Research Fellow, Frazer Institute, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/vania-rodrigues-leite-e-silva-1497208">Vania Rodrigues Leite E. Silva</a>, Honorary Associate Professor, Frazer Institute, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sleep-wrinkles-are-real-heres-how-they-leave-their-mark-217380">original article</a>. </div>

Body

AFL player found dead at just 29

AFL player Cameron McCarthy has died at the age of 29. McCarthy, a former Fremantle Dockers and GWS Giants player, was confirmed dead by The Age and WA media after WA police confirmed on Friday that a body had been found. "About 6:15pm yesterday, Thursday 9 May 2024, emergency services were called to an address in Lake Coogee," police said. "Upon arrival, it was confirmed a 29-year-old male was deceased. The death is being treated as non-suspicious. A report will be prepared for the coroner." McCarthy was drafted with pick 14 in 2013 and played 21 games for the Giants in Sydney, but requested a trade home to Perth due to homesickness, and later joined Fremantle at the end of 2016. After being the club's leading goal kicker in 2017 and playing 49 games for the Dockers, he was cut at the end of 2020. Midway through the 2020 season McCarthy collapsed at training, and was later diagnosed with epilepsy. "Cam is remembered as not just a prodigious football talent but as a popular, compassionate and caring person who had time for everyone at our club," South Fremantle said in a statement. "He will be dearly missed." In honour of McCarthy, the Dockers will reportedly wear black armbands during Friday night's game against the Swans. Image credits: Instagram

Caring

"I love you all": Social media star announces her own death

Social media star Kimberley Nix has passed away at the age of 31 after a gruelling battle with cancer, and has announced the news of her own death to her dedicated followers. The TikTok star, who has amassed a following of 143,000 people as she documented her cancer journey, spoke candidly in a pre-filmed video that was posted to her page, letting her followers know that her "journey here is over". Kimberley, who was also a doctor in training, told her fans that if they were seeing the heartbreaking clip, that she had "passed", before sharing that they had made her "so happy". She captioned the viral video, which has so far amassed more than 5.1 million views, "My journey here is over and I can't thank each and every one of you enough. You have all made me so happy and your comments and support are more than enough to have gotten anyone through anything!" "If you wish, please donate through my link in bio to sarcoma cancer research and follow my husband [Michael MacIsaac] in his updates." At the beginning of the clip, Kimberley said, "Hello followers, if you're seeing this clip, I have passed away peacefully. " Holding back tears, she said that she had a "very beautiful life" that she was "so proud" of. "Those who know me, know I love my pets, my husband, and makeup. And though being a doctor is a big part of my identity, those are the things that matter," she said during the heartbreaking clip. Kim went on to note that in 2021 she got the "opportunity to start making TikTok videos", admitting that she "never thought anything would come of it". "I shared about love, joy, and gratitude because in this journey, I was grateful for the people and the little moments." "Those little parts of your day, like that warm first sip of tea in the morning or how it feels when snow is fresh on your face, those are the most beautiful [moments]." At the end of the clip, she thanked her followers for helping her and said that they meant the world to her. "I can't thank you enough, I will miss you TikTok. I love you all. Thank you for this amazing opportunity, I am in happy tears because I have found so much purpose in the end of my life," she said. "Thank you from the bottom of my heart, goodbye." Kimberley was diagnosed with metastatic sarcoma, which is known as cell cancer, at just 28 years old, and she was finishing up her final year of her internal medicine core residency when she got the diagnosis. She is survived by her husband Michael, who she married in February. Image credits: TikTok

Caring

Not all ultra-processed foods are bad for your health, whatever you might have heard

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/gary-sacks-3957">Gary Sacks</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-backholer-10739">Kathryn Backholer</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-bradbury-1532662">Kathryn Bradbury</a>, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a>, and <a href="https://theconversation.com/profiles/sally-mackay-1532685">Sally Mackay</a>, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a> In recent years, there’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11036430/">increasing</a> <a href="https://theconversation.com/ultra-processed-foods-heres-what-the-evidence-actually-says-about-them-220255#:%7E:text=Hype%20around%20ultra%2Dprocessed%20food,or%20worry%20about%20their%20health.">hype</a> about the potential health risks associated with so-called “ultra-processed” foods. But new evidence published <a href="https://www.bmj.com/content/385/bmj-2023-078476">this week</a> found not all “ultra-processed” foods are linked to poor health. That includes the mass-produced wholegrain bread you buy from the supermarket. While this newly published research and associated <a href="https://www.bmj.com/content/385/bmj.q793">editorial</a> are unlikely to end the wrangling about how best to define unhealthy foods and diets, it’s critical those debates don’t delay the implementation of policies that are likely to actually improve our diets. <h2>What are ultra-processed foods?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/30744710/">Ultra-processed foods</a> are industrially produced using a variety of processing techniques. They typically include ingredients that can’t be found in a home kitchen, such as preservatives, emulsifiers, sweeteners and/or artificial colours. Common examples of ultra-processed foods include packaged chips, flavoured yoghurts, soft drinks, sausages and mass-produced packaged wholegrain bread. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719194/#CR13">many other countries</a>, ultra-processed foods make up a large proportion of what people eat. A <a href="https://pubmed.ncbi.nlm.nih.gov/31676952/">recent study</a> estimated they make up an average of 42% of total energy intake in Australia. <h2>How do ultra-processed foods affect our health?</h2> Previous <a href="https://pubmed.ncbi.nlm.nih.gov/33167080/">studies</a> have linked increased consumption of ultra-processed food with poorer health. High consumption of ultra-processed food, for example, has been associated with a <a href="https://pubmed.ncbi.nlm.nih.gov/38418082/">higher risk</a> of type 2 diabetes, and death from heart disease and stroke. Ultra-processed foods are typically high in energy, added sugars, salt and/or unhealthy fats. These have long been <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">recognised</a> as risk factors for a range of diseases. It has also been suggested that structural changes that happen to ultra-processed foods as part of the manufacturing process <a href="https://pubmed.ncbi.nlm.nih.gov/31105044/">may</a> lead you to eat more than you should. Potential explanations are that, due to the way they’re made, the foods are quicker to eat and more palatable. It’s also <a href="https://pubmed.ncbi.nlm.nih.gov/35952706/">possible</a> certain food additives may impair normal body functions, such as the way our cells reproduce. <h2>Is it harmful? It depends on the food’s nutrients</h2> The <a href="https://www.bmj.com/content/385/bmj-2023-078476">new paper</a> just published used 30 years of data from two large US cohort studies to evaluate the relationship between ultra-processed food consumption and long-term health. The study tried to disentangle the effects of the manufacturing process itself from the nutrient profile of foods. The study found a small increase in the risk of early death with higher ultra-processed food consumption. But importantly, the authors also looked at diet quality. They found that for people who had high quality diets (high in fruit, vegetables, wholegrains, as well as healthy fats, and low in sugary drinks, salt, and red and processed meat), there was no clear association between the amount of ultra-processed food they ate and risk of premature death. This suggests overall diet quality has a stronger influence on long-term health than ultra-processed food consumption. When the researchers analysed ultra-processed foods by sub-category, mass-produced wholegrain products, such as supermarket wholegrain breads and wholegrain breakfast cereals, were not associated with poorer health. This finding matches another recent <a href="https://pubmed.ncbi.nlm.nih.gov/38417577/">study</a> that suggests ultra-processed wholegrain foods are not a driver of poor health. The authors concluded, while there was some support for limiting consumption of certain types of ultra-processed food for long-term health, not all ultra-processed food products should be universally restricted. <h2>Should dietary guidelines advise against ultra-processed foods?</h2> Existing national <a href="https://www.eatforhealth.gov.au/sites/default/files/2022-09/n55_australian_dietary_guidelines.pdf">dietary</a> <a href="https://www.health.govt.nz/system/files/documents/publications/eating-activity-guidelines-new-zealand-adults-updated-2020-oct22.pdf">guidelines</a> have been developed and refined based on decades of nutrition evidence. Much of the recent evidence related to ultra-processed foods tells us what we already knew: that products like soft drinks, alcohol and processed meats are bad for health. Dietary guidelines <a href="https://pubmed.ncbi.nlm.nih.gov/35184508/">generally</a> already advise to eat mostly whole foods and to limit consumption of highly processed foods that are high in refined grains, saturated fat, sugar and salt. But some nutrition researchers have <a href="https://www.bmj.com/content/384/bmj.q439">called</a> for dietary guidelines to be amended to recommend avoiding ultra-processed foods. Based on the available evidence, it would be difficult to justify adding a sweeping statement about avoiding all ultra-processed foods. Advice to avoid all ultra-processed foods would likely unfairly impact people on low-incomes, as many ultra-processed foods, such as supermarket breads, are relatively affordable and convenient. Wholegrain breads also provide important nutrients, such as fibre. In many countries, bread is the <a href="https://www.health.govt.nz/system/files/documents/publications/a-focus-on-nutrition-ch3_0.pdf">biggest contributor</a> to fibre intake. So it would be problematic to recommend avoiding supermarket wholegrain bread just because it’s ultra-processed. <h2>So how can we improve our diets?</h2> There is strong <a href="https://www.foodpolicyindex.org.au/_files/ugd/7ee332_a2fa1694e42f423195caf581044fccf1.pdf">consensus</a> on the need to implement evidence-based policies to improve population diets. This includes legislation to restrict children’s exposure to the marketing of unhealthy foods and brands, mandatory Health Star Rating nutrition labelling and taxes on sugary drinks. These policies are underpinned by <a href="https://pubmed.ncbi.nlm.nih.gov/37659696/">well-established systems</a> for classifying the healthiness of foods. If new evidence unfolds about mechanisms by which ultra-processed foods drive health harms, these classification systems can be updated to reflect such evidence. If specific additives are found to be harmful to health, for example, this evidence can be incorporated into existing nutrient profiling systems, such as the <a href="http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/content/home">Health Star Rating</a> food labelling scheme. Accordingly, policymakers can confidently progress food policy implementation using the tools for classifying the healthiness of foods that we already have. Unhealthy diets and obesity are among the <a href="https://www.aihw.gov.au/reports/burden-of-disease/burden-of-disease-study-2018-key-findings/contents/key-findings">largest contributors</a> to poor health. We can’t let the hype and academic debate around “ultra-processed” foods delay implementation of globally recommended policies for improving population diets.<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/229493/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gary-sacks-3957">Gary Sacks</a>, Professor of Public Health Policy, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-backholer-10739">Kathryn Backholer</a>, Co-Director, Global Centre for Preventive Health and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kathryn-bradbury-1532662">Kathryn Bradbury</a>, Senior Research Fellow in the School of Population Health, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a>, and <a href="https://theconversation.com/profiles/sally-mackay-1532685">Sally Mackay</a>, Senior Lecturer Epidemiology and Biostatistics, <a href="https://theconversation.com/institutions/university-of-auckland-waipapa-taumata-rau-1305">University of Auckland, Waipapa Taumata Rau</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-ultra-processed-foods-are-bad-for-your-health-whatever-you-might-have-heard-229493">original article</a>. </div>

Food & Wine

Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/leah-williams-veazey-1223970">Leah Williams Veazey</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> In the 2007 film <a href="https://www.imdb.com/title/tt0825232/">The Bucket List</a> Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades. Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common. You can read articles listing <a href="https://www.cnbc.com/2023/01/11/cities-to-visit-before-you-die-according-to-50-travel-experts-and-only-one-is-in-the-us.html">the seven cities</a> you must visit before you die or <a href="https://www.qantas.com/travelinsider/en/trending/top-100-guide/best-things-to-do-and-see-in-australia-travel-bucket-list.html">the 100</a> Australian bucket-list travel experiences. <figure><iframe src="https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life <a href="https://onlinelibrary.wiley.com/doi/10.1002/pon.4821">is regret</a> for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret. The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness. In a <a href="https://journals.sagepub.com/doi/10.1177/14407833241251496">study</a> published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel. <h2>Why is travel so important?</h2> There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important <a href="https://doi.org/10.1016/j.annals.2003.10.005">life transitions</a>: the youthful gap year, the journey to self-discovery in the 2010 film <a href="https://www.imdb.com/title/tt0879870/">Eat Pray Love</a>, or the popular figure of the “<a href="https://theconversation.com/grey-nomad-lifestyle-provides-a-model-for-living-remotely-106074">grey nomad</a>”. The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams. Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans: "We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed." For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse: "So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend." People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland. Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement: "In the last three years, I think I’ve lived more than a lot of 80-year-olds." <h2>But travel is expensive</h2> Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire. Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true. But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us: "We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind." Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet. Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said: "This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel." <h2>Something we ‘ought’ to do?</h2> Bucket lists are also a symptom of a broader culture that emphasises conspicuous <a href="https://www.youtube.com/watch?v=JH_Pa1hOEVc">consumption</a> and <a href="https://productiveageinginstitute.org.au/">productivity</a>, even into the end of life. Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “<a href="https://doi.org/10.1080/14461242.2021.1918016">ought</a>” to do. Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey. <hr /> Names of study participants mentioned in this article are pseudonyms.<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/225682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leah-williams-veazey-1223970">Leah Williams Veazey</a>, ARC DECRA Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology & Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/paris-in-spring-bali-in-winter-how-bucket-lists-help-cancer-patients-handle-life-and-death-225682">original article</a>. </div>

Caring

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> If you didn’t have food allergies as a child, is it possible to develop them as an adult? The short answer is yes. But the reasons why are much more complicated. Preschoolers are about <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">four times more likely to have a food allergy</a> than adults and are more likely to grow out of it as they get older. It’s hard to get accurate figures on adult food allergy prevalence. The Australian National Allergy Council reports <a href="https://nationalallergycouncil.org.au/about-us/our-strategy">one in 50 adults</a> have food allergies. But a US survey suggested as many as <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">one in ten adults</a> were allergic to at least one food, with some developing allergies in adulthood. <h2>What is a food allergy</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">Food allergies</a> are immune reactions involving <a href="https://www.aaaai.org/tools-for-the-public/allergy,-asthma-immunology-glossary/immunoglobulin-e-(ige)-defined">immunoglobulin E (IgE)</a> – an antibody that’s central to triggering allergic responses. These are known as “IgE-mediated food allergies”. Food allergy symptoms that are not mediated by IgE are usually delayed reactions and called <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">food intolerances or hypersensitivity</a>. Food allergy symptoms can include hives, swelling, difficulty swallowing, vomiting, throat or chest tightening, trouble breathing, chest pain, rapid heart rate, dizziness, low blood pressure or <a href="https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines?highlight=WyJhbmFwaHlsYXhpcyJd">anaphylaxis</a>. IgE-mediated food allergies can be life threatening, so all adults need an <a href="https://allergyfacts.org.au/allergy-management/newly-diagnosed/action-plan-essentials">action management plan</a> developed in consultation with their medical team. Here are four IgE-mediated food allergies that can occur in adults – from relatively common ones to rare allergies you’ve probably never heard of. <h2>1. Single food allergies</h2> The most <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">common IgE-mediated food allergies</a> in adults in a US survey were to: <ul> <li>shellfish (2.9%)</li> <li>cow’s milk (1.9%)</li> <li>peanut (1.8%)</li> <li>tree nuts (1.2%)</li> <li>fin fish (0.9%) like barramundi, snapper, salmon, cod and perch.</li> </ul> In these adults, about 45% reported reacting to multiple foods. This compares to <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">most common childhood food allergies</a>: cow’s milk, egg, peanut and soy. Overall, adult food allergy prevalence appears to be increasing. Compared to <a href="https://pubmed.ncbi.nlm.nih.gov/14657884/">older surveys published in 2003</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/15241360/">2004</a>, peanut allergy prevalence has increased about three-fold (from 0.6%), while tree nuts and fin fish roughly doubled (from 0.5% each), with shellfish similar (2.5%). While new <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">adult-onset food allergies are increasing</a>, childhood-onset food allergies are also more likely to be retained into adulthood. Possible reasons for both <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">include</a> low vitamin D status, lack of immune system challenges due to being overly “clean”, heightened sensitisation due to allergen avoidance, and more frequent antibiotic use. <h2>2. Tick-meat allergy</h2> Tick-meat allergy, also called α-Gal syndrome or mammalian meat allergy, is an allergic reaction to galactose-alpha-1,3-galactose, or α-Gal for short. <a href="https://pubmed.ncbi.nlm.nih.gov/33529984/">Australian immunologists first reported</a> links between α-Gal syndrome and tick bites in 2009, with cases also reported in the United States, Japan, Europe and South Africa. The <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">US Centers for Disease Control estimates</a> about 450,000 Americans <a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm">could be affected</a>. The α-Gal contains a carbohydrate molecule that is bound to a <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">protein</a> molecule in <a href="https://alphagalinformation.org/what-is-a-mammal/">mammals</a>. The IgE-mediated allergy is triggered after repeated bites from ticks or <a href="https://www.insectshield.com/pages/chiggers">chigger mites</a> that have bitten those mammals. When tick saliva crosses into your body through the bite, antibodies to α-Gal are produced. When you subsequently eat foods that contain α-Gal, the allergy is triggered. These triggering foods include meat (lamb, beef, pork, rabbit, kangaroo), dairy products (yoghurt, cheese, ice-cream, cream), <a href="https://en.wikipedia.org/wiki/Gelatin">animal-origin gelatin</a> added to gummy foods (jelly, lollies, marshmallow), prescription medications and over-the counter supplements containing gelatin (<a href="https://www.drugs.com/inactive/gelatin-57.html">some antibiotics, vitamins and other supplements</a>). Tick-meat allergy reactions can be hard to recognise because they’re usually delayed, and they can be severe and include anaphylaxis. Allergy <a href="https://www.allergy.org.au/patients/food-allergy/mammalian-meat-tick-faq">organisations produce management guidelines</a>, so always discuss management with your doctor. <h2>3. Fruit-pollen allergy</h2> Fruit-pollen allergy, called pollen food allergy syndrome, is an <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">IgE-mediated allergic reaction</a>. In susceptible adults, pollen in the air provokes the production of IgE antibodies to antigens in the pollen, but these antigens are similar to ones found in some fruits, vegetables and herbs. The problem is that <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">eating those plants</a> triggers an allergic reaction. The <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">most allergenic tree pollens</a> are from birch, cypress, Japanese cedar, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/latex-allergy">latex</a>, grass, and ragweed. Their pollen can cross-react with <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">fruit and vegetables</a>, including kiwi, banana, mango, avocado, grapes, celery, carrot and potato, and some herbs such as caraway, coriander, fennel, pepper and paprika. Fruit-pollen allergy is not common. Prevalence <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">estimates are between 0.03% and 8%</a> depending on the country, but it can be life-threatening. Reactions range from itching or tingling of lips, mouth, tongue and throat, called <a href="https://pubmed.ncbi.nlm.nih.gov/20306812/">oral allergy syndrome</a>, to mild <a href="https://www.allergy.org.au/patients/skin-allergy/urticaria-hives">hives</a>, to anaphylaxis. <h2>4. Food-dependent, exercise-induced food allergy</h2> During heavy exercise, the stomach produces less acid than usual and gut permeability increases, meaning that small molecules in your gut are more likely to escape across the membrane into your blood. These include food molecules that trigger an IgE reaction. If the person already has IgE antibodies to the foods eaten before exercise, then the risk of triggering food allergy reactions is increased. This allergy is called <a href="https://pubmed.ncbi.nlm.nih.gov/37893663/">food-dependent exercise-induced allergy</a>, with symptoms ranging from hives and swelling, to difficulty breathing and anaphylaxis. <a href="https://pubmed.ncbi.nlm.nih.gov/30601082/">Common trigger foods include</a> wheat, seafood, meat, poultry, egg, milk, nuts, grapes, celery and other foods, which could have been eaten many hours before exercising. To complicate things even further, allergic <a href="https://pubmed.ncbi.nlm.nih.gov/33181008/">reactions can</a> occur at lower levels of trigger-food exposure, and be more severe if the person is simultaneously taking non-steroidal inflammatory medications like aspirin, drinking alcohol or is sleep-deprived. Food-dependent exercise-induced allergy is extremely rare. Surveys have estimated prevalence as between <a href="https://www.sciencedirect.com/science/article/pii/S1555415517300259">one to 17 cases per 1,000 people worldwide</a> with the highest prevalence between the teenage years to age 35. Those affected often have other allergic conditions such as hay fever, asthma, allergic conjunctivitis and dermatitis. <h2>Allergies are a growing burden</h2> The <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">burden on physical health, psychological health</a> and health costs due to food allergy is increasing. In the US, this <a href="https://pubmed.ncbi.nlm.nih.gov/38393624/">financial burden was estimated as $24 billion per year</a>. Adult food allergy needs to be taken seriously and those with severe symptoms should wear a medical information bracelet or chain and carry an <a href="https://www.healthdirect.gov.au/how-to-use-an-adrenaline-autoinjector-epipen-anapen">adrenaline auto-injector pen</a>. Concerningly, surveys suggest only <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">about one in four adults</a> with food allergy have an adrenaline pen. If you have an IgE-mediated food allergy, discuss your management plan with your doctor. You can also find more information at <a href="https://allergyfacts.org.au/">Allergy and Anaphylaxis Australia</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/yes-adults-can-develop-food-allergies-here-are-4-types-you-need-to-know-about-223342">original article</a>. </div>

Body

How to avoid 6 common tourist scams

Often when people are on holidays their focus is on relaxing or seeing the sights of the area. But if you don’t keep your wits about you, it’s possible you might end up losing everything to scammers who will do anything to get their hands on your belongings. Here we have six common scams to look out for while you are travelling abroad. Scam 1: You are in a busy bar in a tourist friendly area when some locals ask where you’re from and offer to buy you a drink. Without thinking, you accept the drink and then find yourself waking up hours later without any of your belongings as you’ve had your drink spiked. Solution: If people seem too friendly, be aware that they may be scammers. Don’t accept drinks from people you don’t know, and don’t leave your drink unattended to use the bathroom. Scam 2: You are about to put your handbag and computer on the conveyer belt to go through the scanner. The people in front of you walk through the metal detector and while one goes through, the other sets off the alarms. They step back into where you are standing and take their time removing wallets and coins from their pockets. While you are waiting for your turn to walk through the metal detector, the other person has taken your belongings and is long gone. Solution: Don’t place your items on the conveyer belt until there is no one else waiting in front of you to go through the metal detector. Scam 3: In a busy area such as after a concert or a busy night like New Year’s Eve it can be impossible to get public transport or a taxi back to your hotel. A friendly looking guy comes by and offers you a lift for a reasonable fee using his private car. The scam itself can then range from being charged an exorbitant amount when you arrive at your hotel – or you could even find yourself robbed and dropped by the side of the road with no way home. Solution: However tempting it is, never get in the car with an unlicensed taxi driver. This is even more important to note if you are travelling alone. Scam 4: While you are waiting with your luggage for a train or bus, a passer-by appears to drop their wallet and walk off without noticing. You might try to do the right thing by grabbing the wallet and running after the person to return it. By the time you get back, your luggage is missing. Solution: When travelling alone, never leave your items unattended even if it means you don’t help someone when you normally would. This is especially true in airports where baggage will quickly be confiscated if left alone. Scam 5: You’re taking in the sights when a couple of men dressed as policemen approach you. They demand to see your wallet and let you know that counterfeit money has been given to tourists in the area. When your wallet is returned it has had much of the contents removed. Solution: Police would never demand to see your wallet. If something doesn’t feel right, suggest that you continue the discussion at the nearest police station as you don’t feel comfortable. Most likely they will not push their luck. Scam 6: You receive a phone call in your hotel room late at night from someone claiming to be from the front desk. They apologise for the late call but request that you just confirm your credit card details as their system is playing up. You read out the numbers and hang up. Before too long your credit card has rung up a huge bill as this was a scammer calling you, not a staff member. Solution: Organise payment in person by letting the caller know that you will come down to the front desk to discuss it. Image credits: Getty Images

Travel Tips

3 common travel illnesses (and how to avoid them)

Nobody wants to fall sick when they’re on holidays but it happens and is actually quite common. Not every travel illness is foreseeable, but the most prevalent ones usually can be managed if you’re prepared and know what to look out for. Here are three of the most common illnesses travellers experience and what you can do to avoid them. Traveller’s diarrhoea It may be an unpleasant topic of conversation, but as diarrhoeais the most common travel sickness, it’s important to be prepared. It is estimated diarrhoeais experienced by almost half of travellers at some point on their holiday, but mainly by those visiting developing countries. It’s contracted by eating or drinking contaminated food and water and in severe cases can last for days. How to avoid it: Stick to bottled or purified water, freshly cooked meals and fruits and vegetables you can peel yourself. Talk to your doctor for antibiotics you can take in case you are struck with traveller’s diarrhoea. Motion sickness Whether it’s by boat, plane, or car, many travellers experience motion sickness. This occurs when your eyes see motion but your body doesn’t register it, leading to a conflict of the senses. It often results in nausea, vomiting, headaches, and sweating. How to avoid it: If flying, try to sit near the wings of plane. If cruising, get an outside cabin in the middle of ship, and if in a car, sit up front. Don’t play with your devices, as looking at a small screens often exacerbates the problem; instead try to look far to the horizon. Have a light meal before travelling and avoid spicy, greasy or rich foods. You can talk to your doctor about over-the-counter medication that can help motion sickness as well. Bug bites There are all sorts of infectious diseases like malaria, dengue, chikungunya and yellow fever you can pick up from bug bites, especially in developing nations. While you should always talk to your doctor about the types of vaccines you need to take for your travel destination, it is always advisable to protect against insect bites. How to avoid it: Apply insect repellent, wear long sleeves and pants where possible and try to avoid outside activity around dust and dawn when mosquitos are active. If sleeping outdoors, it is advisable to use curtain nettings. Image credits: Getty Images

Travel Tips

Vitamins and supplements: what you need to know before taking them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/neelaveni-padayachee-1018709">Neelaveni Padayachee</a>, <a href="https://theconversation.com/institutions/university-of-the-witwatersrand-894">University of the Witwatersrand</a> and <a href="https://theconversation.com/profiles/varsha-bangalee-1253468">Varsha Bangalee</a>, <a href="https://theconversation.com/institutions/university-of-kwazulu-natal-1941">University of KwaZulu-Natal</a> If you were to open your medicine cabinet right now, there’s a fair chance that you’d find at least one bottle of vitamins alongside the painkillers, plasters and cough syrup. After all, people are definitely buying vitamins: in 2020, the global market for complementary and alternative medicines, which includes multivitamin supplements, had an estimated value of <a href="https://www.grandviewresearch.com/industry-analysis/complementary-alternative-medicine-market">US$82.27 billion</a>. The use of natural health products such as minerals and amino acids has <a href="https://journals.lww.com/nutritiontodayonline/Abstract/2007/03000/Why_People_Use_Vitamin_and_Mineral_Supplements.4.aspx">increased</a> – and continues to rise, partly driven by consumers’ buying habits during the COVID-19 pandemic. People <a href="https://www.businesslive.co.za/bd/companies/healthcare/2021-02-08-native-sales-of-sas-vitamins-and-nutritional-supplements-boom/">sought out</a> vitamins C and D, as well as zinc supplements, as potential preventive measures against the virus – even though the <a href="https://www.health.harvard.edu/blog/do-vitamin-d-zinc-and-other-supplements-help-prevent-covid-19-or-hasten-healing-2021040522310">evidence</a> for their efficacy was, and <a href="https://pubmed.ncbi.nlm.nih.gov/35888660/#:%7E:text=Concluding%2C%20available%20data%20on%20the,trials%20(RCTs)%20are%20inconsistent">remains</a>, inconclusive. Multivitamins and mineral supplements are easily accessible to consumers. They are often marketed for their health claims and benefits – sometimes unsubstantiated. But their potential adverse effects are not always stated on the packaging. Collectively, vitamins and minerals are known as micronutrients. They are essential elements needed for our bodies to function properly. Our bodies can only produce micronutrients in small amounts or not at all. We get the bulk of these nutrients <a href="https://www.iprjb.org/journals/index.php/IJF/article/view/1024">from our diets</a>. People usually buy micronutrients to protect against disease or as dietary “insurance”, in case they are not getting sufficient quantities from their diets. There’s a common perception that these supplements are harmless. But they can be dangerous at incorrect dosages. They provide a false sense of hope, pose a risk of drug interactions – and can delay more effective treatment. <h2>Benefits</h2> Vitamins are beneficial if taken for the correct reasons and as prescribed by your doctor. For example, folic acid supplementation in pregnant women has been shown to prevent neural tube defects. And individuals who reduce their intake of red meat without increasing legume consumption require a vitamin B6 supplement. But a worrying trend is increasing among consumers: intravenous vitamin therapy, which is often punted by celebrities and social media marketing. Intravenous vitamins, nutrients and fluids are administered at pharmacies as well as beauty spas, and more recently “<a href="https://www.health.harvard.edu/blog/drip-bar-should-you-get-an-iv-on-demand-2018092814899">IV bars</a>”. Users believe these treatments can quell a cold, slow the effects of ageing, brighten skin, fix a hangover or just make them feel well. Intravenous vitamin therapy was previously only used in medical settings to help patients who could not swallow, needed fluid replacements or had an electrolyte imbalance. However, the evidence to support other benefits of intravenous vitamin therapy is limited. No matter how you choose to get additional vitamins, there are risks. <h2>Warning bells</h2> Most consumers use multivitamins. But others take large doses of single nutrients, especially vitamin C, iron and calcium. As lecturers in pharmacy practice, we think it’s important to highlight the potential adverse effects of commonly used vitamins and minerals: <ul> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-a/">Vitamin A/retinol</a> is beneficial in maintaining good eye health. But it can cause toxicity if more than 300,000IU (units) is ingested. Chronic toxicity (hypervitaminosis) has been <a href="https://www.ncbi.nlm.nih.gov/books/NBK532916/">associated</a> with doses higher than 10,000IU a day. Symptoms include liver impairment, loss of vision and intracranial hypertension. It can cause birth defects in pregnant women. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/niacin-vitamin-b3/">Vitamin B3</a> is beneficial for nervous and digestive system health. At moderate to high doses it can cause peripheral vasodilation (widening or dilating of the blood vessels at the extremities, such as the legs and arms), resulting in skin flushing, burning sensation, pruritis (itchiness of the skin) and hypotension (low blood pressure). </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-b6/">Vitamin B6</a> is essential for brain development and in ensuring that the immune system remains healthy. But it can result in damage to the peripheral nerves, such as those in the hands and feet (causing a sensation of numbness and often referred to as pins and needles) at doses over 200mg/daily. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-c/">Vitamin C</a> is an antioxidant and assists in the repair of body tissue. Taken in high doses it can cause kidney stones and interactions with drugs, such as the oncology drugs doxorubicin, methotrexate, cisplatin and vincristine. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-d/">Vitamin D</a> is essential for bone and teeth development. At high doses it can cause hypercalcaemia (calcium level in the blood is above normal) that results in thirst, excessive urination, seizures, coma and death. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/calcium/#:%7E:text=Calcium%20is%20a%20mineral%20most,heart%20rhythms%20and%20nerve%20functions">Calcium</a> is essential for bone health, but can cause constipation and gastric reflux. High doses can cause hypercalciuria (increased calcium in the urine), kidney stones and secondary hypoparathyroidism (underactive parathyroid gland). It can have drug interactions with zinc, magnesium and iron. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/magnesium/">Magnesium</a> is important for muscle and nerve functioning. At high doses it can cause diarrhoea, nausea and abdominal cramping, and can interact with tetracyclines (antibiotics). </li> <li> Zinc <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781367/">can impair</a> taste and smell, and doses over 80mg daily have been <a href="https://link.springer.com/article/10.1007/s10654-022-00922-0#:%7E:text=Zinc%20supplementation%20of%20more%20than,zinc%20supplements%20among%20adult%20men.">shown</a> to have adverse prostate effects. </li> <li> <a href="https://www.hsph.harvard.edu/nutritionsource/selenium/">Selenium</a> can cause hair and nail loss or brittleness, lesions of the skin and nervous system, skin rashes, fatigue and mood irritability at high doses. </li> <li> <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364#:%7E:text=Expert%20guidelines%20for%20oral%20iron%20supplementation&text=Traditionally%2C%20the%20recommended%20daily%20dose,iron%20(Brittenham%2C%202018).">Iron</a> at 100-200mg/day can cause constipation, black faeces, black discoloration of teeth and abdominal pain. </li> </ul> <h2>Recommendations</h2> People need to make <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8377299/">informed decisions</a> based on evidence before consuming health products. Regular exercise and a well-balanced diet are more likely to do us good, as well as being lighter on the pocket. Seeking advice from a healthcare professional before consuming supplements can reduce the risk of adverse effects. Be aware of the potential adverse effects of vitamins and seek a healthcare professional’s guidance if you have symptoms.<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/198345/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neelaveni-padayachee-1018709">Neelaveni Padayachee</a>, Senior Lecturer, Department of Pharmacy and Pharmacology, <a href="https://theconversation.com/institutions/university-of-the-witwatersrand-894">University of the Witwatersrand</a> and <a href="https://theconversation.com/profiles/varsha-bangalee-1253468">Varsha Bangalee</a>, Associate Professor, Pharmaceutical Sciences, <a href="https://theconversation.com/institutions/university-of-kwazulu-natal-1941">University of KwaZulu-Natal</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/vitamins-and-supplements-what-you-need-to-know-before-taking-them-198345">original article</a>. </div>

Body

7 things you need to know about fear

Fear is an emotion that can be debilitating and unsettling. But it is a natural part of life and we are hardwired to experience it. 1. Fear can protect you Experiencing fear elicits responses from your brain to your limbs. It is the body’s natural way of protecting itself. For our ancestors the fear was often more physical – such as being chased by a lion. Modern fear can range from physical danger (such as a spider or an intruder) or even from perceived danger (such as the worry that something will happen to our partner or child). Feeling fear doesn’t make you a weak person. In fact, not feeling any fear could mean that there are neurological issues present. 2. There are many levels of fear Not everything that we fear is intense and paralysing. It can range from low levels of fear (such as worry about being robbed), to medium levels of fear (say if a loved one is in hospital) to high levels of fear (you are being chased by an attacker). Fear can also become stronger when we hear about events such as a terrorist attack or a natural disaster. It all relates back to how much the scary event will impact our lives. 3. Fear is not just instinctive We become fearful due to three main factors: instinct, learning, and teaching. An example of instinctual fear is pain – we learn to be fearful of things that hurt us. Learned fear comes from being exposed to unpleasant or uncomfortable things and wanting to avoid them in the future. For instance, having a relative die in a car crash could make you fearful of driving in the future. Other fears are taught to us by our family, friends and even society. For example, some religions teach us to be fearful of other religions or customs. 4. Fear can arise without a real threat of danger Fear can also be imagined, so it can be felt even when there is no danger present. If we feel this all the time it can lead to anxiety and depression. It’s important to think about whether the thing you are fearful of is real or likely to happen before you give it too much airtime. 5. Fear produces fear If you are already in a state of fear, your response to more fear is heightened. For instance if you are watching a scary movie, a small noise from the next room could make you jump and scream. Your senses are on red alert, primed to act if the need arises. 6. Fear leads to action Depending on the individual and the level of fear they are experiencing, there tend to be four main types of action as a result of fear: freeze, fight, flight, or fright. When you freeze it means you don’t move while you decide what to do (for instance you see a snake in your garden). From there you choose either fight (grab a shovel) or flight mode (walk away). If the fear is too much you might experience fright, where you do nothing and take no action (stand there screaming or worrying). 7. Real threats can lead to heroic actions Imagined threats can cause us to live in a permanent state of fear and stress. But often we will do nothing about it (for instance being worried about sharks attacking us in the ocean). Compare this to the threat from a real and identifiable source, which will make you spring into action almost immediately. Often we don’t even make the decision to act, it just happens automatically (such as moving a child out of the way of an approaching car). Image credits: Getty Images

Mind

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

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

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537749/">Heart rate zones</a> reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute. But what are the different heart rate zones, and how can you use these zones to optimise your workout? <h2>The three-zone model</h2> While there are several models used to describe heart rate zones, the most common model in the scientific literature is the <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">three-zone model</a>, where the zones may be categorised as follows: <ul> <li> zone 1: 55%–82% of maximum heart rate </li> <li> zone 2: 82%–87% of maximum heart rate </li> <li> zone 3: 87%–97% of maximum heart rate. </li> </ul> If you’re not sure what your maximum heart rate is, it can be calculated using <a href="https://www.jacc.org/doi/full/10.1016/S0735-1097%2800%2901054-8">this equation</a>: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute. There are also other models used to describe heart rate zones, such as the <a href="https://journals.humankinetics.com/view/journals/ijspp/14/8/article-p1151.xml">five-zone model</a> (as its name implies, this one has five distinct zones). These <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">models</a> largely describe the same thing and can mostly be used interchangeably. <h2>What do the different zones involve?</h2> The three zones are based around a person’s <a href="https://link.springer.com/article/10.2165/00007256-200939060-00003">lactate threshold</a>, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic. Aerobic exercise <a href="https://www.healthline.com/health/fitness-exercise/difference-between-aerobic-and-anaerobic">uses oxygen</a> to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time. On average your lactate threshold tends to sit around <a href="https://www.tandfonline.com/doi/full/10.2147/OAJSM.S141657">85% of your maximum heart rate</a>, although this varies from person to person, and can be <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00043.2013">higher in athletes</a>. In the three-zone model, each zone loosely describes <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2015.00295/full">one of three types of training</a>. Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace. Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences. Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3. <h2>Striking a balance</h2> To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout. While zone 3 is thought to produce the largest improvements in <a href="https://www.sciencedirect.com/science/article/pii/S1440244018309198">maximal oxygen uptake</a> – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much. Training in different heart rate zones improves <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=38c07018c0636422d9d5a77316216efb3c10164f">slightly different physiological qualities</a>, and so by spending time in each zone, you ensure a <a href="https://link.springer.com/article/10.1007/bf00426304">variety of benefits</a> for performance and health. <h2>So how much time should you spend in each zone?</h2> Most <a href="https://www.frontiersin.org/articles/10.3389/fspor.2023.1258585/full">elite endurance athletes</a>, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3. Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate <a href="https://journals.humankinetics.com/view/journals/ijsnem/22/5/article-p392.xml?content=pdf">more than 250 kilometres per week</a>, which would be impossible to recover from if it was all performed in zone 2 or 3. Of course, most people are not professional athletes. The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization</a> recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week. If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines. <h2>What if I don’t have a heart rate monitor?</h2> If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training. The three heart rate zones discussed in this article can also be prescribed based on feel using a simple <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2004.00418.x">10-point scale</a>, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce. With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10. Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228520/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, Lecturer in Exercise Science, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-heart-rate-zones-and-how-can-you-incorporate-them-into-your-exercise-routine-228520">original article</a>. </div>

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