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Commissioner speaks out after son's killer avoids jail

Police Commissioner Grant Stevens has shared an emotional statement outside of court after the young man accused of killing his son had his sentence suspended. Dhirren Randhawa, 19, was sentenced at Adelaide District Court to 13 months in prison for driving without due care and leaving the scene of an accident after crashing into 18-year-old Charlie Stevens in 2023. Charlie was celebrating schoolies with his friends, before being struck and suffering irreversible brain damage, as he died in hospital just days later. Judge Joanne Tracey suspended the sentence with a two-year good behaviour bond and a 10-year suspension of his license, citing many reasons why he should not be placed behind bars. Justice Tracey said Randhawa’s youth, lack of prior offending, the circumstances of the offending, his genuine remorse and his guilty pleas were all factors in her decision. “You have accepted there was more you could have done to avoid this tragic outcome,” she said on Tuesday. “It is, of course, the case you had no intention to harm anyone that night." “It is an offence any one of us as road users may commit if we do not take proper care or drive without proper attention.” Speaking after the sentence, Commissioner Stevens he and his family were “grateful” the court process had finished. “The judge said in summing up today … no matter what happens in the courtroom today, it’s not going to change anything for our family, and I think that’s a very true statement,” he said alongside his wife Emma. “We’re grateful this part of the entire process is over. Each court date that has come up has been difficult, stressful and emotional for our family." “We’re grateful Dhirren chose to plead guilty to his offence because that brought this part of it to a conclusion much more quickly." “It is one of those things, we are continuing to learn how to live with every single day without Charlie. It’s not getting any easier, as I’m sure people who have lost a child would appreciate." “We’re very grateful for the support and the sympathy we’ve received from the South Australian community … there’s no way we can acknowledge or repay that in any other format other than thanking people for their support.” Image credits: SA Police / Facebook

Caring

Avoid missing prostate warning signs with this handy quiz

A leading Australian Urologist is sounding a warning to men who unknowingly ignore symptoms of an enlarged prostate, wrongly assuming it’s just a part of growing older. Symptoms the Urologist highlighted include, increased frequency going to the toilet at night or a change in urine flow. Dr Gordon O’Neill, who has been treating diseases of the prostate for over 25 years said almost half of all men over 50 have an enlarged prostate, or benign prostatic hypertrophy (BPH), where the prostate gland enlarges and obstructs the urethra - the tube which expels urine from the bladder, and this may cause bothersome urinary symptoms. “While BPH is not cancerous or life threatening, the symptoms such as leaking or frequent urination can negatively impact a man’s quality of life,” Dr O’Neill said. “The prostate starts to compress the urine channel and this in turn may interfere with bladder function. In some severe cases, some men have trouble urinating at all. “If left undiagnosed this condition could lead to bladder damage, urinary tract infections and bleeding,” he said. Dr O’Neill is encouraging men to complete <a title="https://www.getmosh.com.au/start/prostate-enlargement-health-check" href="https://www.getmosh.com.au/start/prostate-enlargement-health-check" data-outlook-id="dea5c553-2489-4009-ae90-d09c24226c83">Mosh’s BPH quiz</a> which can help flag any irregularities that might cause need for concern. Mosh Medical Director Joanna Sharp said the quiz makes it easy for men to raise an issue they often deem embarrassing to discuss. “It’s a simple survey that can be done anywhere, at any time, allowing men who may be worried about their prostate function to find out whether medical intervention is needed,” said Dr Sharp. “There’s a lot of unnecessary fear and old school thinking among men when it comes to the prostate and there’s no need. Women are very good at being more in tune with their bodies, men are not so great. We need men to do better to notice changes in their body, especially ones that could be hiding something more sinister.” “Are they having to get up to urinate more frequently at night and is that impacting their quality of sleep? Does it dribble at the end? We don’t want men suffering in silence, thinking it’s secret men’s business. Troublesome symptoms of enlarged prostate can be fixed very easily,” Dr Sharp said. About one in seven men aged 40 to 49 years are diagnosed with a prostate problem, which increases to about one in every four men aged 70 years and older. GPs then assess the survey results referring those that need further examination to a urologist, like Dr O’Neill. “Some men live with an enlarged prostate and have no idea and that’s okay. But for those men where the symptoms have become an issue there are minimally invasive options such as an implant procedure,” Dr O’Neill said. “It’s a minimally invasive treatment that opens the prostatic urethra, relieving obstruction for men who suffer urinary symptoms related to BPH." “The implant holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue with no impact on sexual function which can be a big fear and deterrent for some men,” he said. Dr O’Neill believes men should also be screened for prostate cancer by getting a PSA test from the age of 40. As they age the prostate gland grows and the PSA is likely to rise slightly. “The prostate grows on average about four percent a year, so changes can start as early as 30 but they won’t become apparent for another 20 years,” he said. “While having BPH or an enlarged prostate doesn’t increase your risk of prostate cancer, symptoms left unchecked could be masking a much more sinister problem such as prostate cancer so it’s better to have your symptoms assessed,” Dr O’Neill said. You can find Mosh's BPH quiz <a href="https://www.getmosh.com.au/start/prostate-enlargement-health-check" target="_blank" rel="noopener">here</a>. Image credits: Shutterstock

Body

How to help your grandkids avoid the same food mistakes you made

For parents and grandparents, often the biggest challenge is knowing what foods you should provide for your children, particularly if you have a picky eater. I am a father, so I know firsthand how fussy children can be, even more so at the end of the day when they are feeling shattered. Many parents see mealtimes as an opportunity to fill ’em up and get ’em out, which teaches your child that food is all about being ‘fast’ and unintentionally promotes a set of food-related behaviours that research tells us leads to negative health outcomes. I realise that with the endless demands of modern life, mealtimes can feel like yet another repetitive chore to get through, but I’m going give it to you straight: you wouldn’t light up a cigarette in your child’s mouth, and you wouldn’t let your child drink a can of beer, because you know the damage that this does to them. Over time, processed Western food can be just as detrimental to a person’s health as a cigarette or beer. Saving time or placating children by giving them processed food will simply lead to a new generation that struggles with obesity, diabetes, heart disease and other underlying health concerns. Breaking out of these lifelong food habits and ways of thinking is hard to do, which is why so many people don’t. Dealing with fussy eating is one of the most significant – and stressful – challenges many parents face, leaving them frustrated and worried about their child's nutrition, development and health. But fussy eating is normal – in fact, all parents should expect their child to go through a fussy eating phase. The science of why children are fussy eaters The reason why children predominantly go through a period of fussy eating is basic biology – the roots of this behaviour can be traced back to our hunter-gatherer ancestors and their development of a range of physiological responses for survival. This included developing ‘food fussiness’ – a natural aversion to unfamiliar foods and bitter flavours – like vegetables – to avoid ingesting potential toxins. Additionally, as our hunter-gatherer ancestors often experienced extended periods of food scarcity, they learned to seek out and store high-energy, palatable foods found in nature that were also high in natural sugars, fat and protein, such as fruits, honey, meat and nuts, to avoid starvation. As well as offering the best ‘bang for buck’ calorie-wise, these foods also provided a natural high and sense of satisfaction, triggering the release of feel-good chemicals called endorphins and learning chemicals called dopamine, which enabled our ancestors to remember the pleasure associated with eating that food and trigger a response the next time they saw it. So, when your child pushes back on the vegetables, there’s an evolutionary reason why! Seven things you can do to overcome fussy eating Fortunately, there are some simple – but effective – things you can do to support introducing healthy foods to your child or grandchild and overcome fussy eating: 1. Never bribe or force them to eat everything on the plate. You may have been brought up to do this, but it is wrong advice. Forcing them to eat is only disrupting their appetite regulation; let them dictate how much they eat. 2. Involve your child in meal preparation and cooking. Getting your child’s assistance with food shopping and preparation tasks is guaranteed to make them curious about the meal they’ve helped create and more willing to taste it. 3. Eliminate mealtime distractions. Turning off the television and putting the devices away will make sure your child can focus on the important task of tasting and fully experiencing new foods. 4. Wind back the clock and gather everyone around the dinner table. We all know that kids closely observe and mimic their parents so the best way to overcome fussy eating is by showing enthusiasm for trying new foods and a positive attitude toward healthy eating. 5. Offer small portions. Serving new foods in smaller servings will ensure you don’t overwhelm your child with new tastes and allow them to let you know if they’d like more of what they’ve tasted. 6. Resist the urge to make another meal. While it’s tempting to offer an alternative when your child refuses a meal, it creates more problems than it solves, teaching fussy eaters they can get the foods they like by refusing to eat what’s been served. 7. Don’t use food as a reward or punishment. Every parent has been there – trading the promise of a yummy dessert for two more bites of beans – but this practice only creates unhealthy associations with healthy foods. Your children will learn from what you do and eat; this goes for all facets of life, but none more so than what is placed in front of them at the dining table. You hold the keys to your child’s food future. <img src="https://oversixtydev.blob.core.windows.net/media/2024/08/dr-nick-fuller.jpg" alt="" width="1280" height="720" /> Dr Nick Fuller, The University of Sydney and Royal Prince Alfred Hospital, and author of the new book <a href="https://www.penguin.com.au/books/healthy-parents-healthy-kids-9780143791119" target="_blank" rel="noopener">Healthy Parents, Healthy Kids</a>, published by Penguin Books. Image credits: Shutterstock

Body

Planning a country escape these school holidays? 4 ways to avoid clogging up the emergency department

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/katherine-riley-1499452">Katherine Riley</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/rebekkah-middleton-314433">Rebekkah Middleton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Winter school holidays are either here or coming up, depending on where in Australia you live. Maybe you’re planning a <a href="https://www.tra.gov.au/en/domestic/domestic-tourism-results">rural escape</a>. Rural tourism is crucial for job growth and sustainability of small rural towns. However, for rural emergency departments, <a href="https://www.abc.net.au/listen/programs/am/holiday-medico-shortages-in-rural-and-remote-australia/103266540">school holidays</a> are often the busiest times. No-one plans a trip to the emergency department on holidays. But if you need health care, there are often other ways of accessing it than turning up at a rural hospital. Here’s why it’s so important to leave rural emergency departments for life-threatening illness or injuries, and some other options for seeking care. <h2>We’re short of doctors and nurses</h2> The Australian Institute of Health and Welfare <a href="https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health">reports</a> a significant shortfall of nurses and specialist doctors in rural towns compared with staffing levels in big cities. This means many small rural emergency departments only have nurses on staff, with doctors on call or consulted remotely from a larger hospital. In a <a href="https://www.sciencedirect.com/science/article/pii/S1755599X2300143X">study</a> published earlier this year, my colleagues and I discovered this dynamic was especially challenging for rural emergency nurses when critically ill patients presented. One nurse told us: "We need more staff. I mean, I look at these emergency TV shows, and you see them in Kings Cross at the big hospitals there or overseas, they get a phone call […] there’s a resus coming in. Everyone’s standing around the bed with all their signs on, the airway/circulation/team leader […] and here, we have two people. It’s just so different. It’s just a false sense of reality. It’s ridiculous." So emergency departments should be used for <a href="https://www.health.nsw.gov.au/Hospitals/Going_To_hospital/Publications/keep-ed-emergencies.pdf">emergencies only</a>. These include: <ul> <li>sudden collapse</li> <li>chest pain or pressure lasting more than ten minutes</li> <li>breathing difficulty</li> <li>serious mental health condition</li> <li>uncontrollable bleeding.</li> </ul> When emergency departments are used responsibly, this can reduce the pressure on staff. It ensures the most seriously ill receive the care they need promptly. <h2>What are my alternatives?</h2> Here are four ways you and your family can be better prepared for your rural holiday and avoid an unnecessary visit to the emergency department. 1. Pack your scripts and medical history summary Bring essential scripts and medications with you. This reduces the need to visit the local emergency department and ensures you have what you need during your stay. Do you have a chronic condition or have had a recent illness or surgery? Make sure you speak to your GP before you go. They can provide a medical health summary that includes your recent treatments and medications. Alternatively, if you have access to <a href="https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record">My Health Record</a>, ask your GP to prepare a shared health summary and upload it to your record. If you need medical care, this summary will assist in a timely assessment. 2. Call Healthdirect, NURSE-ON-CALL or 13HEALTH depending on where you are <a href="https://www.healthdirect.gov.au/how-healthdirect-can-help-you">Healthdirect</a> is a 24-hour telephone health advice line (known as NURSE-ON-CALL in Victoria or 13HEALTH in Queensland). By calling the relevant number, you will be connected to a registered nurse who will ask a series of questions and provide evidence-based advice and guidance. The Healthdirect website also offers an interactive <a href="https://www.healthdirect.gov.au/symptom-checker">symptom checker</a> to advise whether you should see a GP, go to an emergency department, or manage your symptoms at home (or in this case, on holidays): <ul> <li> <a href="https://www.healthdirect.gov.au">Healthdirect</a> - 1800 022 222 </li> <li> <a href="https://www.healthdirect.gov.au/nurse-on-call">NURSE-ON-CALL</a> (Vic) - 1300 60 60 24 </li> <li> <a href="https://www.qld.gov.au/health/contacts/advice/13health">13HEALTH</a> (Qld) - 13 43 25 84. </li> </ul> 3. Need a GP? How about GP telehealth services? For minor health concerns or non-urgent issues, <a href="https://www.smh.com.au/national/nsw/how-emily-took-advantage-of-one-of-the-few-good-things-to-come-out-of-covid-20240507-p5fpg3.html">GP telehealth services</a> are a remote-access option that can be used when away from home. Before you go away, check with your GP to see if they offer a <a href="https://www.health.gov.au/topics/health-technologies-and-digital-health/about/telehealth">telehealth service</a>. 4. Go to an Urgent Care Clinic The Australian government has funded the opening of <a href="https://www.health.gov.au/find-a-medicare-ucc/about">Urgent Care Clinics</a> across the country. These clinics provide medical assessment and care for urgent illnesses or injuries. They have been created as a solution to divert people away from busy emergency departments. But these Urgent Care Clinics are not suitable for people experiencing emergency or life-threatening conditions. Urgent Care Clinics are ideal for illnesses and injuries that would require urgent treatment such as gastroenteritis, minor infections, lacerations and back pain. Check <a href="https://www.health.gov.au/find-a-medicare-ucc">here</a> to find your closest clinic. <hr /> Please keep the emergency department for life-threatening illnesses or injuries, and if needed, call 000 for an ambulance immediately.<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/232262/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katherine-riley-1499452">Katherine Riley</a>, Lecturer, School of Nursing, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/rebekkah-middleton-314433">Rebekkah Middleton</a>, Associate Professor, School of Nursing, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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/planning-a-country-escape-these-school-holidays-4-ways-to-avoid-clogging-up-the-emergency-department-232262">original article</a>. </div>

Domestic Travel

Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact? The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines). I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65. <h2>Polypharmacy among older adults</h2> Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics. Is it a good idea to take so many drugs? According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability. In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic. <h2>The risks of polypharmacy: 5 points to consider</h2> When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken. <ol> <li> Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments. </li> <li> A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses? </li> <li> The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences. </li> <li> The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death. </li> <li> Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks. </li> </ol> Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements. Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health. <h2>3 tips to avoid the risks associated with polypharmacy</h2> What can we do as a patient, or as a caregiver? <ol> <li> Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ? </li> <li> Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced? </li> <li> Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter. </li> </ol> <h2>Benefits should outweigh the risks</h2> Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion. Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<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/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</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/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>. </div>

Body

Costly mistakes to avoid when travelling

While travelling the world is an exciting and joyous way to spend your time, getting caught up in devious scams can sour even the best holiday. Whenever you hit the road, there are a few measures you can take to avoid being hit by hackers and sneaky scammers, and enjoy your holiday to the fullest. When it comes to online scams, some countries are more vulnerable than others, as NAB Executive, Group Investigations Chris Sheehan says. "Just like you'd plan visas and check the weather at your destination, it's also vital to be aware of common scams in the countries you're visiting so you can recognise the red flags and protect yourself," he said. When travelling in a new country, it’s important to be wary of accommodation or booking website impersonation scams, ticket scams for major events, as well as overcharging or wrong charge scams. "The pressure to act now is a red flag in ticket and accommodation scams, while overcharging or wrong charging scams play on distraction and a lack of detail," Chris says. "Letting your bank know where and when you're travelling can help with more accurately monitoring your transactions for suspicious activity while you're away." Another thing to be wary of when on holiday is to avoid posting your real-time location on social media, or inadvertently sharing sensitive travel documents can expose you to serious risks. Broadcasting your whereabouts can make you vulnerable to various risks, including burglary, stalking, and other personal safety threats, while criminals can take advantage of the information you share to target you or your unoccupied home. Travel expert Trevor Cooke from <a href="https://earthweb.com/">EarthWeb</a> says its best to wait until you’ve moved on until you share your location online. "If you really want to share the location of where you travelled to, wait until you're already at the next location or back home," he says. "By delaying your posts, you can still share your experiences without compromising your safety." Another thing to keep in mind when you’re next hitting the road is to be wary about unknowingly posting personal information online, such as your boarding pass. "Many people don't realise how much personal information is on your boarding pass and other temporary travel documents," says security expert Trevor. "Boarding passes, for instance, contain sensitive data such as your full name, frequent flyer number, and a barcode that can be scanned to reveal even more information. This data can be used by criminals for identity theft, unauthorised access to your accounts, and other malicious activities." "To protect yourself, always double-check that any picture you upload does not include your boarding pass, travel itinerary, hotel receipts, or any other sensitive information," Trevor adds. Image credits: Shutterstock

Travel Tips

The one in-flight activity to avoid to conquer jet lag

While many people love to travel and explore new destinations, there’s no doubt that the worst part of a holiday is often the long-haul flight. With many holidays, especially ones overseas, a drastic change of timezones can mean jet lag is unavoidable, but there are a few things you can do to make life easy when you land. According to one travel expert, how you feel when you disembark often boils down to your in-flight activities. Sarah Built, who has worked up a lifetime of long-haul travel as the Etihad Airways Vice President of Sales for Australasia, told <a href="https://travel.nine.com.au/latest/flight-tips-how-to-avoid-jet-lag/db8fbda1-2318-44c0-b9fe-e14d11dec70c">9Travel</a> that there is one thing she always avoids onboard in order to land at her destination feeling fresh: alcohol. "Whilst the allure of coffee, cocktails and snacks is real (particularly if you're travelling with kids), they can actually contribute to dehydration and worsen jet lag," she says. Instead of that in-flight beer glass of wine, Sarah says to drink water (with lime added for a twist) or herbal tea to boost your hydration and lessen that groggy mid-flight feeling. Drinking water is obviously also the key to staying hydrated, as Sarah says it's important to start drinking extra water the day before your flight, so you're going in prepared. "I carry a reusable water bottle to keep fluids up during the journey (most airports will have water stations for you to refill easily)," she says, which means you won't need to pay for an overpriced bottle at the airport. "Dehydration can cause headaches and fatigue, and you want to be able to hit the ground running on arrival, so always remember to drink plenty of water," she advises. Image credits: Shutterstock

Travel Tips

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

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

5 ways to avoid going overboard on a cruise

Falling overboard is the stuff of cruising nightmares (and it happens surprisingly more frequently than you might think. Just this year we’ve brought you two stories about passengers falling overboard, but this fishy fate is by no means unavoidable. Here are five ways to ensure you keep your feet dry. 1. Limit your alcohol intake If the prices weren’t enough of a reason to go easy on the sauce on your cruise, perhaps the risk of tipping over the balcony will persuade you. Think of it this way – the effect of alcohol on a cruise is the same as the effect of alcohol on dry land, but when you’re on a cruise you’re travelling through sometimes heavy seas at about 20 knots. 2. Stay in your room during inclement weather If your ship is sailing into dicey conditions, you’re better off keeping to your quarters. You never know how a cruise liner is going to stand up to the ocean’s wrath, and even if you want a good view of Mother Nature’s nasty side, you’re safer below deck. 3. Keep clear of dark corners It’s not a very pleasant thing to think about, but when there are 4,000 passengers on a cruise they’re not all going to be good eggs. Be aware of your surroundings, just as you would be on land, and be sure to report any suspicious activity to a crew member. 4. Pay attention during the practice drills Even if you’ve been on 20 cruises it’s a good idea to pay attention during the practice drills. This will reinforce what you need to do in an event of an emergency, and might just save your life (or someone else’s by knowing where to find the safety gear). 5. Don’t re-enact the Titanic scene Because going overboard will make you look like anything but, “The king of the world.” Have you ever been on a cruise? Did you ever feel unsafe at any point? Let us know in the comments below, we’d love to hear from you. Image credits: Getty Images

Cruising

Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression

<div class="theconversation-article-body"> Can you remember a time when you felt stressed leading up to a big life event and then afterwards felt like a weight had been lifted? This process – the ramping up of the stress response and then feeling this settle back down – shows completion of the “stress cycle”. Some stress in daily life is unavoidable. But remaining stressed is unhealthy. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/">Chronic stress</a> increases <a href="https://pubmed.ncbi.nlm.nih.gov/32886587/">chronic health conditions</a>, including heart disease and stroke and diabetes. It can also lead to <a href="https://theconversation.com/were-all-exhausted-but-are-you-experiencing-burnout-heres-what-to-look-out-for-164393">burnout</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137920/">depression</a>. Exercise, cognitive, creative, social and self-soothing activities help us process stress in healthier ways and complete the stress cycle. <h2>What does the stress cycle look like?</h2> Scientists and researchers refer to the “stress response”, often with a focus on the fight-or-flight reactions. The phrase the “stress cycle” has been made popular by <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">self-help experts</a> but it does have a scientific basis. The <a href="https://www.ncbi.nlm.nih.gov/books/NBK541120/">stress cycle</a> is our body’s response to a stressful event, whether real or perceived, physical or psychological. It could be being chased by a vicious dog, an upcoming exam or a difficult conversation. The stress cycle has three stages: <ul> <li> stage 1 is perceiving the threat </li> <li> stage 2 is the fight-or-flight response, driven by our stress hormones: adrenaline and cortisol </li> <li> stage 3 is relief, including physiological and psychological relief. This completes the stress cycle. </li> </ul> Different people will respond to stress differently based on their life experiences and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181835/#:%7E:text=The%20major%20findings%20regarding%20the,renin%2Dangiotensin%2Daldosterone%20system%20or">genetics</a>. Unfortunately, many people experience <a href="https://www.weforum.org/agenda/2023/01/polycrisis-global-risks-report-cost-of-living/">multiple and ongoing stressors</a> out of their control, including the cost-of-living crisis, extreme weather events and <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/types-of-violence/family-domestic-violence">domestic violence</a>. Remaining in stage 2 (the flight-or-flight response), can lead to chronic stress. <a href="https://theconversation.com/how-chronic-stress-changes-the-brain-and-what-you-can-do-to-reverse-the-damage-133194">Chronic stress</a> and high cortisol can increase <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476783/">inflammation</a>, which damages our brain and other organs. When you are stuck in chronic fight-or-flight mode, you don’t think clearly and are more easily distracted. Activities that provide temporary pleasure, such as eating junk food or drinking alcohol are <a href="https://onlinelibrary.wiley.com/doi/10.1111/acer.14518">unhelpful strategies</a> that do not reduce the stress effects on our brain and body. Scrolling through social media is also not an effective way to complete the stress cycle. In fact, this is associated with an <a href="https://www.apa.org/monitor/2022/11/strain-media-overload">increased stress response</a>. <h2>Stress and the brain</h2> In the brain, chronic high cortisol can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561403/">shrink the hippocampus</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557684/#:%7E:text=The%20hippocampal%20formation%20plays%20a,%2C%20memory%2C%20motivation%20and%20emotion.&text=Therefore%2C%20reduced%20hippocampal%20volumes%20should,in%20patients%20with%20major%20depression">impair a person’s memory</a> and their capacity to think and concentrate. Chronic high cortisol also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907136/#:%7E:text=The%20prefrontal%20cortex%20(PFC)%20intelligently,brain%20regions%20(BOX%201).">reduces activity</a> in the prefrontal cortex but <a href="https://www.sciencedirect.com/science/article/pii/S2352289514000101">increases activity</a> in the amygdala. The prefrontal cortex is responsible for higher-order control of our thoughts, behaviours and emotions, and is <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">goal-directed</a> and rational. The amygdala is involved in reflexive and emotional responses. Higher amygdala activity and lower prefrontal cortex activity explains why we are less rational and more emotional and reactive when we are stressed. There are five <a href="https://www.penguin.co.uk/articles/2019/03/complete-stress-cycle-emotional-exhaustion-burnout">types of activities</a> that can help our brains complete the stress cycle. <figure><iframe src="https://www.youtube.com/embed/eD1wliuHxHI?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>It can help to understand how the brain encounters stress.</figcaption></figure> <h2>1. Exercise – its own complete stress cycle</h2> When we exercise we get a short-term spike in cortisol, followed by a <a href="https://www.health.harvard.edu/staying-healthy/exercising-to-relax">healthy reduction</a> in cortisol and adrenaline. Exercise also <a href="https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469#:%7E:text=Exercise%20in%20almost%20any%20form,distract%20you%20from%20daily%20worries.&text=You%20know%20that%20exercise%20does,fit%20it%20into%20your%20routine.">increases endorphins and serotonin</a>, which improve mood. Endorphins cause an elated feeling often called “runner’s high” and have <a href="https://pubmed.ncbi.nlm.nih.gov/33396962/">anti-inflammatory effects</a>. When you exercise, there is more blood flow to the brain and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721405/">higher activity</a> in the prefrontal cortex. This is why you can often think more clearly after a walk or run. Exercise can be a helpful way to <a href="https://www.healthline.com/health/heart-disease/exercise-stress-relief">relieve feelings of stress</a>. Exercise can also increase the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041121/">volume</a> of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915811/">hippocampus</a>. This is linked to better short-term and long-term memory processing, as well as reduced stress, depression and anxiety. <h2>2. Cognitive activities – reduce negative thinking</h2> Overly negative thinking can trigger or extend the stress response. In our 2019 research, we found the relationship between stress and cortisol was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987429/">stronger in people with more negative thinking</a>. Higher amygdala activity and less rational thinking when you are stressed can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/18628348/">distorted thinking</a> such as focusing on negatives and rigid “black-and-white” thinking. Activities to reduce negative thinking and promote a more realistic view can reduce the stress response. In clinical settings this is usually called <a href="https://www.healthdirect.gov.au/cognitive-behaviour-therapy-cbt">cognitive behaviour therapy</a>. At home, this could be journalling or writing down worries. This engages the logical and rational parts of our brain and helps us think more realistically. Finding evidence to challenge negative thoughts (“I’ve prepared well for the exam, so I can do my best”) can help to complete the stress cycle. <h2>3. Getting creative – a pathway out of ‘flight or fight’</h2> Creative activities can be art, craft, gardening, cooking or <a href="https://heartmindonline.org/resources/10-exercises-for-your-prefrontal-cortex">other activities</a> such as doing a puzzle, juggling, music, theatre, dancing or simply being absorbed in enjoyable work. Such pursuits increase <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2014.00761/full">prefrontal cortex activity</a> and promote flow and focus. Flow is a <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.645498/full">state of full engagement</a> in an activity you enjoy. It lowers high-stress levels of noradrenaline, the brain’s adrenaline. When you are focussed like this, the brain only processes information relevant to the task and ignores non-relevant information, including stresses. <h2>4. Getting social and releasing feel-good hormones</h2> Talking with someone else, physical affection with a person or pet and laughing can all <a href="https://theconversation.com/what-happens-in-our-brain-and-body-when-were-in-love-198885">increase oxytocin</a>. This is a chemical messenger in the brain that increases social bonding and makes us feel connected and safe. Laughing is also a social activity that <a href="https://neurosciencenews.com/laughter-physical-mental-psychology-17339/">activates parts</a> of the limbic system – the part of the brain involved in emotional and behavioural responses. This increases <a href="https://www.jneurosci.org/content/37/36/8581">endorphins</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/27439375/">serotonin</a> and improves our mood. <h2>5. Self-soothing</h2> Breathing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">exercises</a> and meditation stimulate the parasympathetic nervous system (which calms down our stress responses so we can “reset”) via the <a href="https://theconversation.com/our-vagus-nerves-help-us-rest-digest-and-restore-can-you-really-reset-them-to-feel-better-210469">vagus nerves</a>, and <a href="https://www.tandfonline.com/doi/full/10.1080/17437199.2020.1760727">reduce cortisol</a>. A good <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035568/#:%7E:text=We%20conclude%20that%2C%20in%20addition,self%2Dsoothing%20effects%20of%20crying.">cry can help too</a> by releasing stress energy and increasing oxytocin and endorphins. <a href="https://www.medicalnewstoday.com/articles/319631#:%7E:text=Possible%20benefits%20of%20crying%20include,of%201.9%20times%20a%20month.">Emotional tears</a> also remove cortisol and the hormone prolactin from the body. Our prior research showed <a href="https://pubmed.ncbi.nlm.nih.gov/29096223/">cortisol</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216608/">prolactin</a> were associated with depression, anxiety and hostility.<a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> <h2>Action beats distraction</h2> Whether it’s watching a funny or sad movie, exercising, journalling, gardening or doing a puzzle, there is science behind why you should complete the stress cycle. Doing at least one positive activity every day can also reduce our baseline stress level and is beneficial for good mental health and wellbeing. Importantly, chronic stress and <a href="https://theconversation.com/are-you-burnt-out-at-work-ask-yourself-these-4-questions-118128">burnout</a> can also indicate the need for change, <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20311">such as in our workplaces</a>. However, not all stressful circumstances can be easily changed. Remember help is always available. If you have concerns about your stress or health, please talk to a doctor. If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14 or <a href="https://kidshelpline.com.au/">Kids Helpline</a> on 1800 55 1800.<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/218599/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/susan-j-thomas-1293985">Susan J. Thomas</a>, Associate professor in Mental Health and Behavioural Science, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">original article</a>. </div>

Mind

Foods to avoid if you have acid reflux or digestion issues

What common foods are good and bad for your belly? Foods containing rapidly fermentable carbohydrates called FODMAPs can feed bacteria in the gut and may be responsible for gut inflammation, gas, bloating and other uncomfortable tummy troubles in some people. Cutting back on foods that contain FODMAPs may help improve your digestion and eliminate GI problems. “An anti-inflammatory diet is high in fibre-rich foods, which promote the growth of healthy bacteria in the gut (one way the diet assists to control inflammation),” says registered dietitian Maxine Smith. A FODMAP diet, which is low in fermentable carbohydrates, is low in fibre and may be beneficial for some people with gastrointestinal problems. In general, a low FODMAPs diet isn’t recommended for people unless they have a condition like irritable bowel syndrome that hasn’t responded to other treatments or dietary changes. Watermelon: Avoid This lovely summer treat isn’t as harmless as all the water it contains. Watermelon is high in fructose, fructans and polyols, which are FODMAPs. Remember, the more the FODMAPs, the more potential for tummy trouble in people who are sensitive to them. Fermented foods: Enjoy some, avoid some Some fermented foods are good for your tummy; others can create problems for certain people, according to an article published by Harvard Medical School. Fermented foods include wine, cheese, vinegar, miso, yoghurt, sauerkraut and pickles. In yoghurt, milk is combined with bacteria that break down some of the lactose, so what remains may be easier for your stomach to process. So fermented foods such as yoghurt are often considered “probiotic foods” that are good for your gut. Look for dairy products that are low in lactose and your digestion should be A-OK. Pistachios, cashews, hazelnuts and almonds: Avoid Most nuts are good for your tummy, but pistachios and cashews are high in fructans and GOS (galacto-oligosaccharides), both FODMAPs. Hazelnuts and almonds are a little higher in FODMAPs than some other nuts so eat them in limited quantities (10 nuts or 1 tablespoon of nut butter per serving). Steer clear of almond milk, which is made with large amounts of almonds. Acidic foods: Enjoy with caution In almost every list of “the worst foods for digestion,” you’ll find acidic foods like oranges and tomatoes. These are commonly thought to cause heartburn, but studies have shown that acidic foods don’t have any effect on LES pressure (or pressure on the lower oesophageal sphincter, a valve that acts as the doorway between the oesophagus and the stomach) and don’t cause heartburn symptoms. However, if you have severe acid reflux that hasn’t been treated and has irritated the oesophagus, acidic foods can be like “salt in the wound.” So if you find that oranges or tomatoes do make your heartburn feel worse, replace them with other fruits. Dairy foods: Enjoy some, avoid some Not all dairy foods have equal amounts of lactose, which can cause digestion issues, and even those with lactose intolerance are usually okay with small amounts of lactose. That means that not all milk, cheeses and dairy products are tummy twisters. Hard cheeses, like cheddar, Swiss or Parmesan, generally have less than a gram of lactose per serving. According to the Cleveland Clinic, you may want to avoid dairy such as “chocolate shakes or drinks, milkshakes, whole milk fat yoghurt, whole milk fat (4%) cottage cheese, and full-fat cheese.” Soy foods: Enjoy some, avoid some Whole soybeans (often sold as edamame), like other beans, are a source of GOS, which are hard-to-digest chains of sugars. Tofu and tempeh are made using processes that eliminate some of the GOS, making them easier on your digestion. What about soy milk? It depends. If soy milk is made with only soybean isolates or soy protein, then it should be low in FODMAPs. Soy milk made with whole soybeans is likely a source of GOS, making it a gassy beverage for some, so read the ingredients. Blackberries: Avoid Strawberries, blueberries, blackberries – which is the odd one out here? Blackberries are also rich in antioxidants, but they have sugar alcohols called polyols, which are difficult to digest and can cause some real problems if your stomach is sensitive. (Check out these foods that GI doctors always avoid.) Tomato and tomato products: Enjoy some, avoid some Fresh and canned tomatoes are fine for your tummy. But tomato paste is a concentrated form of tomato that has excess fructose, a FODMAP that makes it a no-no except in small quantities. And tomato sauces? If they’re homemade, they’re fine to eat (just don’t cook it to the point where all the juices are lost). Most commercial sauces have onions and garlic (FODMAPs), added sugar (which may make it carb-dense), and salt (which bloats you), so steer clear of the store-bought variety. Grapefruit: Enjoy with caution Grapefruit does have hard-to-digest fructans, so you should try to limit how much you eat. A few sections should be okay, but don’t eat a half a grapefruit. If you’re looking for citrus, lemon, lime and oranges are your best bets. Milk: Enjoy some, avoid some Most types of animal milk are high in tummy twisting lactose – that means goat’s or sheep’s milk can be just as problematic as cow’s milk. Plant-based milks, such as coconut milk, soy milk or almond milk, are technically not milk at all and generally do not have any lactose. Some, however, including almond milk and soy milk, may contain other FODMAPs that harm your digestion. Corn: Avoid Corn comes in many varieties, such as popcorn, on the cob and in polenta. Fresh sweet corn contains two types of FODMAPs, making corn challenging for some people to digest. Popcorn feels like a light and healthy snack, but it’s actually carb-dense (it has about 64 grams of carbs per 100 grams), which can upset digestion. Whole cornmeal and corn tortillas seem to be better tolerated by most people. Whole grain polenta is also low in FODMAPs. You may need to experiment a little to figure out which corn products work for you. And stick with only limited quantities (up to 1 cup cooked per serving). Common cabbage: Enjoy Cabbage usually makes it on all the lists of foods that make you gassy, but common green cabbage doesn’t deserve that reputation. It’s actually low in FODMAPs and most of us break it down very well. Red cabbage also seems to be well-tolerated, but savoy and napa cabbage is much higher in FODMAPs and should be limited if you tend to suffer from gas and bloating. Hot sauce: Enjoy with caution Tolerance to hot sauce is very individual. It’s more problematic for those with heartburn. If you would like to try some, pick a brand without onion and garlic. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/foods-to-avoid-if-you-have-acid-reflux-or-digestion-issues?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

Body

To avoid the worst of climate change we have to change how we travel

In September last year I embarked on a 5 week trip throughout Italy and France. We swam in the waters of Cinque Terre, ate the best pizza we’d ever had in Naples, and walked blisters into our feet through the streets of Paris. The marvels of modern aviation meant I completed my 32,000 km round trip in roughly 24 hours each way. But while I budgeted for the monetary costs associated with the trip, I neglected to consider another crucial one – the carbon cost. Humans are changing the Earth’s climate. It is estimated our activities have caused about 1°C of additional atmospheric warming since the industrial revolution. The Intergovernmental Panel on Climate Change (IPCC) says <a href="https://www.ipcc.ch/sr15/chapter/spm/" target="_blank" rel="noreferrer noopener">crossing a 1.5°C threshold</a> will unleash devastating climate change impacts on human life and ecosystems. To keep global warming to below 1.5°C, as called for in the <a href="https://unfccc.int/process-and-meetings/the-paris-agreement" target="_blank" rel="noreferrer noopener">Paris Agreement</a>, emissions must peak before 2025 at the latest, halve by 2030, and reach net-zero as soon as possible before 2050. The <a href="https://www.unwto.org/the-glasgow-declaration-on-climate-action-in-tourism" target="_blank" rel="noreferrer noopener">Glasgow Declaration on Climate Action in Tourism</a>, launched at <a href="https://www.un.org/en/climatechange/cop26" target="_blank" rel="noreferrer noopener">COP26</a>, commits the tourism sector to these goals. So, what will global tourism look like as it begins to decarbonise? Will it necessitate changing the way I approach travel in the coming decades? Paul Peeters, a professor of sustainable transport and tourism at Breda University of Applied Sciences in the Netherlands is one of the principal authors of a report released last year that seeks to <a href="https://pure.buas.nl/ws/portalfiles/portal/27136592/Peeters_Papp_EnvisionTourism_report.pdf" target="_blank" rel="noreferrer noopener">envision tourism in 2030 and beyond.</a> <h2 class="wp-block-heading">Tourism and emissions: how big of a contributor is it?</h2> Tourism is a major contributor to climate change. According to Peeters, at least 5% of global CO2 emissions come from tourism and travel, with some estimates as high as 8-11% if you include indirect (supply chain) emissions. These emissions are inequitable, about half of the global tourism footprint is caused by travel between the richest countries. If global tourism continues unchanged, it’s predicted to increase emissions by 73% by 2050, compared to 2019. In this scenario, the sector will use over 66% of the world’s remaining carbon budget between 2023 and 2100. Peeters says this is not a viable way forward. But it doesn’t mean that tourism will cease to exist, or that we must stop flying altogether. Instead, the modelling he presents finds there is a plausible decarbonisation pathway that allows tourism to continue with similar levels of growth in global revenue, trips, and guest nights compared to 2019, while also achieving net-zero emissions, by 2050. This model is called the Tourism Decarbonisation Scenario (TDS) and it requires us to re-think how we travel. <h2 class="wp-block-heading">How do you put tourism emissions into a holding pattern?</h2> “If you look at the division of the [emissions from] different parts of travel, then in general… transport takes about 75-80%, 20% goes to the accommodation sector,” says Peeters. That 20% also includes activities, like visiting museums or amusement parks. “And then within transport, you see that about more than half of the emissions come from aviation, while at the same time aviation serves about a quarter of all trips,” he says. Each country party to the Paris Agreement – a legally binding international treaty on climate change – is required to establish a <a href="https://www.un.org/en/climatechange/all-about-ndcs#:~:text=Simply%20put%2C%20an%20NDC%2C%20or,and%20adapt%20to%20climate%20impacts." target="_blank" rel="noreferrer noopener">Nationally Determined Contribution</a> (NDC). An NDC is an action plan to cut emissions and adapt to climate impacts, updated every 5 years. Most of tourism – like accommodation and on-ground transportation – falls within the Paris Agreement and these NDCs and will decarbonise through changes already happening in the legislation of each country. For instance, the transition to electrified forms of travel and accommodation powered by renewable energy. So, as a tourist, I won’t need to change my behaviour there. “But it’s not true for aviation. And the problem is that aviation, in terms of governance, has got an exemption,” says Peeters. Aviation emissions are much harder to reduce. The International Civil Aviation Organization – ICAO – governs international aviation. It has a long-term aspirational goal for net-zero carbon emissions by 2050, and to achieve these goals is pursuing improvements to <a href="https://cosmosmagazine.com/science/engineering/hydrogen-fuelled-planes/">aircraft technology</a>, <a href="https://cosmosmagazine.com/technology/energy/from-refinery-to-biofuel-reactor/">sustainable aviation fuels</a>, and <a href="https://cosmosmagazine.com/earth/climate/carbon-offsetting-right/">carbon offsets</a>. But Peeters’ modelling says this won’t be enough. “The final technology is low or zero emission aircraft technology,” he says. “But that takes decades to develop and then decades to replace the whole fleet – you are not buying a new aircraft every year like a car. “That technology will come […] much faster actually than 10 years ago, but still it’s at a pace that we will have it by the end of the century fully implemented, not before. “We need an international body that governs the growth of aviation that actually stops it for the next couple of decades, to create a timeframe for the technology we need.” So until sustainable aviation technology can be fully implemented, the key is to slow the rate of growth of aviation. <h2 class="wp-block-heading">Further does not equal better</h2> In 2019, nearly all long-distance travel over 16,000 kms return trip was by air. These trips, equivalent to flying return Shanghai to Sydney or further, made up just 2% of all trips in 2019. But they were the most polluting – accounting for 19% of tourism’s total carbon emissions. My roundtrip from Australia to Europe sits in this bracket. I estimate my seats on those planes probably came with a carbon footprint of about 6.4 tonnes of CO2 altogether. To put that in perspective, the average Australian emits 15 tonnes per year, according to <a href="https://ourworldindata.org/co2/country/australia" target="_blank" rel="noreferrer noopener">ourworldindata.org</a>, and I emitted almost half that in just 48 hours. Failing to curb the growth of these longest-haul trips means they will make up 4% of all trips but account for a massive 41% of tourism’s total emissions by 2050. To prevent this, the TDS says we need to cap them at 2019 levels – about 120 million return trips per year. In this scenario, shorter distance trips up to 900km return – that’s roughly equivalent to flying from Rome to Milan in Italy – and those by car, rail, coach, and ferry, would increase to 81% of all trips by 2050. Longer distance trips (return journeys of more than 7,000km, roughly equivalent to return flying Sydney to Perth and further) would also grow less quickly than current rates and account for 3.5% of all trips by 2050 (down from 6.0% in 2019). This could have flow-on benefits, especially for local tourism. “So, you keep the number of trips, and you keep the number of nights – you could even increase that a little bit as a compensation maybe for not being able to travel so far, then you can travel deeper. And that means the total revenues in the sector can grow as we are used to because the number of trips and the number of nights generate most of the revenues,” explains Peeters. <h2 class="wp-block-heading">What curbing the aviation industry could look like</h2> So, what will this mean for my travel habits in the coming years, if further isn’t better? It will likely involve a switch in mindset to consider whether an alternative, less carbon intensive mode of transport exists to reach the destination I have in mind. According to Peeters, even 1 fewer person sitting in an aircraft’s seats can measurably change its emissions. “Aircraft are quite lightweight, half of the weight of an aircraft taking off is not its structure. But it means that if you remove 100 kilograms, even off an Airbus A320, you can measure the difference in fuel consumption. It will save, I calculated it for flights, just a 1,500 km flight, already up to 10 kilograms of CO2,” says Peeters. Compare that to a different mode – adding an additional person to an already incredibly heavy train will add perhaps half a kilogram in emissions at most, probably less. It’s a little embarrassing to admit that I’ve never considered the idea of an interstate road trip, taking the car across the border or opting for a coach or train instead of flying, as a viable option for domestic travel in Australia. But it has for other people. <a href="https://flightfree.net.au/about/" target="_blank" rel="noreferrer noopener">Flight Free Australia</a> encourages us to stop flying, and people have already taken their pledge to swear off air travel – whether for the next 12 months or until it’s ‘climate safe’ to do so again. As for Europe… Well, Peeter’s report predicts that ticket prices will increase, with the cost of flying increasing to 0.18 $/pkm in 2050, from 0.06 $/pkm in 2019, caused mainly by mandates for sustainable aviation e-fuels. Entire families have event attempted to make it from one end of the world to another without setting foot on a plane – a months-long journey ultimately <a href="https://www.abc.net.au/news/2023-12-22/british-family-travel-australia-without-flying-carbon-footprint/103256280" target="_blank" rel="noreferrer noopener">foiled</a> by cyclones north of Darwin. Whether the changes outlined in the Envisioning Tourism in 2030 and Beyond report are made to the aviation industry, already my perspective on flying is changing. Why would I reduce my carbon footprint in other areas of my life, but turn around and negate those efforts by jumping on a plane? It doesn’t mean that I have to give up travel, just change my perspective on what makes a worthy destination. “You see a growing number of people, particularly young people, that say, ‘I stopped flying, whatever happens, I never go anymore’,” says Peeters. “And it makes your life so much easier. You don’t have to choose every time ‘should I fly?’. No, if you can’t get there by train, car, or whatever, you don’t go. And then you go somewhere else, of course, you’re not sitting at home. And you discover that somewhere else is also beautiful.” <div> <noscript data-spai="1"><img decoding="async" fetchpriority="high" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/11/Cosmos-Catch-Up-embed_728x150-1.jpg" data-spai-egr="1" alt="Sign up to our weekly newsletter" width="600" height="154" title="to avoid the worst of climate change we have to change how we travel 2"></noscript> </div>  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=294884&title=To+avoid+the+worst+of+climate+change+we+have+to+change+how+we+travel" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" />  <div class="share-syndicate-wrapper margin-top-1"> <div class="article-sharing"> Image credits: Getty Images </div> </div> <div id="contributors"> <a href="https://cosmosmagazine.com/synergy/to-avoid-the-worst-of-climate-change-we-have-to-change-how-we-travel/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto/">Imma Perfetto</a>. </div>

Travel Trouble

5 ways to avoid weight gain and save money on food this Christmas

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> As Christmas approaches, so does the challenge of healthy eating and maintaining weight-related goals. The season’s many social gatherings can easily tempt us to indulge in calorie-rich food and celebratory drinks. It’s why we typically <a href="https://www.nejm.org/doi/full/10.1056/NEJMc1602012">gain weight</a> over Christmas and then struggle to take it off for the <a href="https://www.sciencedirect.com/science/article/pii/S0031938414001528">remainder of the year</a>. Christmas 2023 is also exacerbating cost-of-living pressures, prompting some to rethink their food choices. Throughout the year, <a href="https://dvh1deh6tagwk.cloudfront.net/finder-au/wp-uploads/2023/03/Cost-of-Living-Report-2023.pdf">71% of Australians</a> – or 14.2 million people – <a href="https://retailworldmagazine.com.au/rising-cost-of-living-forces-aussies-to-change-diets/">adapted</a> their eating behaviour in response to rising costs. Fortunately, there are some simple, science-backed hacks for the festive season to help you celebrate with the food traditions you love without impacting your healthy eating habits, weight, or hip pocket. <h2>1. Fill up on healthy pre-party snacks before heading out</h2> If your festive season is filled with end-of-year parties likely to tempt you to fill up on finger foods and meals high in fat, salt, and sugar and low in nutritional value, have a healthy pre-event snack before you head out. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015032/#sec-a.g.atitle">Research</a> shows carefully selected snack foods can impact satiety (feelings of fullness after eating), potentially reducing the calories you eat later. High-protein, high-fibre snack foods have the strongest effect: because they take longer to digest, our hunger is satisfied for longer. So enjoy a handful of nuts, a tub of yoghurt, or a serving of hummus with veggie sticks before you head out to help keep your healthy eating plan on track. <h2>2. Skip the low-carb drinks and enjoy your favourites in moderation</h2> Despite the marketing promises, low-carb alcoholic drinks <a href="https://onlinelibrary.wiley.com/doi/10.1002/hpja.531">aren’t better for our health or waistlines</a>. Many low-carb options have a similar amount of carbohydrates as regular options but lull us into thinking they’re better, so we drink more. A <a href="https://www.vichealth.vic.gov.au/sites/default/files/K-013_Low-carb-beer_FactSheet_FINAL.pdf">survey</a> found 15% of low-carb beer drinkers drank more beer than they usually would because they believed it was healthier for them. A typical lager or ale will contain less than 1.5 grams of carbohydrate per 100 ml while the “lower-carb” variety can range anywhere from 0.5 grams to 2.0 grams. The calories in drinks come from the alcohol itself, not the carbohydrate content. Next time you go to order, think about the quantity of alcohol you’re drinking rather than the carbs. Make sure you sip lots of water in between drinks to stay hydrated, too. <h2>3. Don’t skimp on healthy food for Christmas Day – it’s actually cheaper</h2> There’s a perception that healthy eating is more expensive. But studies show this is a misconception. A <a href="https://southwesthealthcare.com.au/swh-study-finds-eating-a-healthier-diet-is-actually-cheaper-at-the-checkout/#:%7E:text=A%20recent%20study%20from%20the,does%20not%20meet%20the%20guidelines">recent analysis</a> in Victoria, for example, found following the Australian Dietary Guidelines cost the average family A$156 less a fortnight than the cost of the average diet, which incorporates packaged processed foods and alcohol. So when you’re planning your Christmas Day meal, give the pre-prepared, processed food a miss and swap in healthier ingredients: <ul> <li> swap the heavy, salted ham for leaner and lighter meats such as fresh seafood. Some seafood, such as prawns, is also tipped to be cheaper this year thanks to <a href="https://www.smh.com.au/goodfood/lobsters-up-prawns-stable-a-buying-guide-to-seafood-this-christmas-20231208-p5eq3m.html">favourable weather conditions</a> boosting local supplies </li> <li> for side dishes, opt for fresh salads incorporating seasonal ingredients such as mango, watermelon, peach, cucumber and tomatoes. This will save you money and ensure you’re eating foods when they’re freshest and most flavoursome </li> </ul> <ul> <li> if you’re roasting veggies, use healthier cooking oils like olive as opposed to vegetable oil, and use flavourful herbs instead of salt </li> <li> if there’s an out-of-season vegetable you want to include, look for frozen and canned substitutes. They’re cheaper, and <a href="https://www.sciencedirect.com/science/article/pii/S0889157517300418">just as nutritious</a> and tasty because the produce is usually frozen or canned at its best. Watch the sodium content of canned foods, though, and give them a quick rinse to remove any salty water </li> <li> give store-bought sauces and dressings a miss, making your own from scratch using fresh ingredients. </li> </ul> <h2>4. Plan your Christmas food shop with military precision</h2> Before heading to the supermarket to shop for your Christmas Day meal, create a detailed meal plan and shopping list, and don’t forget to check your pantry and fridge for things you already have. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586574/">Eating beforehand</a> and shopping with a plan in hand means you’ll only buy what you need and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206473/">avoid impulse purchasing</a>. When you’re shopping, price check everything. Comparing the cost per 100 grams is the most effective way to save money and get the best value. Check prices on products sold in different ways and places, too, such as nuts you scoop yourself versus prepacked options. <h2>5. Don’t skip breakfast on Christmas Day</h2> We’ve all been tempted to skip or have a small breakfast on Christmas morning to “save” the calories for later. But this plan will fail when you sit down at lunch hungry and find yourself eating far more calories than you’d “saved” for. <a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> shows a low-calorie or small breakfast leads to increased feelings of hunger, specifically appetite for sweets, across the course of the day. What you eat for breakfast on Christmas morning is just as important too – choosing the right foods will <a href="https://theconversation.com/im-trying-to-lose-weight-and-eat-healthily-why-do-i-feel-so-hungry-all-the-time-what-can-i-do-about-it-215808">help you manage your appetite</a> and avoid the temptation to overindulge later in the day. <a href="https://pubmed.ncbi.nlm.nih.gov/24703415/">Studies</a> show a breakfast containing protein-rich foods, such as eggs, will leave us feeling fuller for longer. So before you head out to the Christmas lunch, have a large, nutritionally balanced breakfast, such as eggs on wholegrain toast with avocado. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest. <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/219114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <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/5-ways-to-avoid-weight-gain-and-save-money-on-food-this-christmas-219114">original article</a>.

Food & Wine

Squats and lunges might help you avoid knee surgery

Whether it’s another round of squats and lunges, or a longer wall sit, researchers say working those quads could help lower your risk of a knee replacement. <div> In Australia, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/arthritis" target="_blank" rel="noopener">about 9% of the population</a> has osteoarthritis, a condition known to lead to hip and knee surgery in severe cases. About 14 million Americans suffer from knee osteoarthritis, about half are expected to face knee replacement surgery. But new research offers hope, finding stronger quadricep muscles could play a role in avoiding knee replacement surgery. A study presented to <a href="https://press.rsna.org/timssnet/media/rsna/newsroom2023.cfm" target="_blank" rel="noopener">annual meeting</a> of the Radiological Society of North America, offers hope to people with arthritis, finding stronger quadriceps could help in avoiding a knee replacement. The two most important muscles in the knee are the extensors or quadriceps, and the hamstrings. Quads are the strong muscles located at the front of the thigh, which play a key role in gait. Hammies at the back of the thigh, are essential for hip and knee flexibility. The two muscles act as opposing forces, allowing physical activity while also protecting the knee. An imbalance can change the body’s biomechanics, and may progress to osteoarthritis. Using MRI scans – from the time of surgery as well as 2 and 4 years prior – researchers analysed thigh muscle volume in 134 participants from a national study called the Osteoarthritis Initiative. Using artificial intelligence to compute muscle volume from the MRI scans, the researchers compared 67 of the cohort who had a total, single knee replacement with 67 control participants who had not undergone knee replacement surgery. They found patients who had a higher ratio of quadricep to hamstring volume had significantly lower odds of a total knee replacement. Higher volume hamstrings were also associated with lower odds of surgery. The results suggest strength training – focusing on the quadriceps – may be beneficial, both in people with arthritis as well as the general population.  <img id="cosmos-post-tracker" src="https://syndication.cosmosmagazine.com/?id=289325&title=Squats+and+lunges+might+help+you+avoid+knee+surgery" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" />Image credits: Getty Images</div> <div> </div> <div><a href="https://cosmosmagazine.com/health/body-and-mind/squats-and-lunges-might-help-you-avoid-knee-surgery/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </div>

Body

No, antibiotics aren’t always needed. Here’s how GPs can avoid overprescribing

<a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> The growth in antibiotic resistance threatens to return the world to the pre-antibiotic era – with deaths from now-treatable infections, and some elective surgery being restricted because of the risks of infection. Antibiotic resistance is a major problem worldwide and should be the concern of everyone, including you. We need to develop new antibiotics that can fight the resistant bacteria or antibiotics that bacteria would not be quickly resistant to. This is like finding new weapons to help the immune system fight the bacteria. More importantly, we need to use our current antibiotics – our existing weapons against the bacteria – more wisely. <h2>Giving GPs the tools to say no</h2> In 2022, more than <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health">one-third of Australians</a> had least one antibiotic prescription, with <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/analysis-2015-2022-pbs-and-rpbs-antimicrobial-dispensing-data">88%</a> of antibiotics prescribed by GPs. Many people <a href="https://pubmed.ncbi.nlm.nih.gov/28289114/">mistakenly think</a> antibiotics are necessary for treating any infection and that infections won’t improve unless treated with antibiotics. This misconception is found in studies involving patients with various conditions, including respiratory infections and conjunctivitis. In reality, not all infections require antibiotics, and this belief drives patients requesting antibiotics from GPs. Other times, GPs give antibiotics because they think patients want them, even when they might not be necessary. Although, in reality they are <a href="https://pubmed.ncbi.nlm.nih.gov/17148626/">after symptom relief</a>. For GPs, there are ways to target antibiotics for only when they are clearly needed, even with short appointments with patients perceived to want antibiotics. This includes: <ul> <li> using <a href="https://pubmed.ncbi.nlm.nih.gov/32357226/">decision guides</a> or tests to decide if antibiotics are really necessary </li> <li> giving <a href="https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making/decision-support-tools-specific-conditions">patients information sheets</a> when antibiotics aren’t needed </li> <li> giving a “<a href="https://pubmed.ncbi.nlm.nih.gov/33910882/">delayed prescription</a>” – only to be used after the patient waits to see if they get better on their own. </li> </ul> All these strategies need some <a href="https://www.nps.org.au/assets/NPS/pdf/NPS-MedicineWise-Economic-evaluation-report-Reducing-Antibiotic-Resistance-2012-17.pdf">training</a> and practice, but they can help GPs prescribe antibiotics more responsibly. GPs can also learn from each other and use tools like <a href="https://pubmed.ncbi.nlm.nih.gov/24474434/">posters</a> as reminders. To help with patients’ expectations, public campaigns have been run periodically to educate people about antibiotics. These campaigns <a href="https://pubmed.ncbi.nlm.nih.gov/35098267/">explain why</a> using antibiotics too much can be harmful and when it’s essential to take them. <h2>Giving doctors feedback on their prescribing</h2> National programs and interventions can help GPs use antibiotics more wisely One successful way they do this is by <a href="https://pubmed.ncbi.nlm.nih.gov/34356788/">giving GPs feedback</a> about how they prescribe antibiotics. This works better when it’s provided by organisations that GPs trust, it happens more than once and clear goals are set for improvement. The NPS (formerly National Prescribing Service) MedicineWise program, for example, had been giving feedback to GPs on how their antibiotic prescriptions compared to others. This reduced the number of antibiotics prescribed. However, <a href="https://australianprescriber.tg.org.au/articles/the-end-of-nps-medicinewise.html">NPS no longer exists</a>. In 2017, the Australian health department did something similar by sending <a href="https://behaviouraleconomics.pmc.gov.au/projects/nudge-vs-superbugs-behavioural-economics-trial-reduce-overprescribing-antibiotics">feedback letters</a>, randomly using different formats, to the GPs who prescribed the most antibiotics, showing them how they were prescribing compared to others. The most effective letter, which used pictures to show this comparison, reduced the number of antibiotics GPs prescribed by <a href="https://behaviouraleconomics.pmc.gov.au/sites/default/files/projects/nudge-vs-superbugs-12-months-on-report.pdf">9% in a year</a>. <h2>Clearer rules and regulations</h2> Rules and regulations are crucial in the fight against antibiotic resistance. Before April 2020, many GPs’ computer systems made it easy to get multiple repeat prescriptions for the same condition, which could encourage their overuse. However, in April 2020, the Pharmaceutical Benefits Scheme (PBS) <a href="https://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/psd/2019-08/antibiotic-repeats-on-the-pharmaceutical-benefits-scheme">changed the rules</a> to ensure GPs had to think more carefully about whether patients actually needed repeat antibiotics. This meant the amount of medicine prescribed better matched the days it was needed for. Other regulations or policy targets could include: <ul> <li> ensuring all GPs have access to antibiotic prescribing guidelines, such as <a href="https://www.tg.org.au/">Therapeutic Guidelines</a>, which is well accepted and widely available in Australia </li> <li> ensuring GPs are only prescribing antibiotics when needed. Many of the conditions antibiotics are currently prescribed for (such as sore throat, cough and middle ear infections) are self-limiting, meaning they will get better without antibiotics </li> <li> encouraging GP working with antibiotics manufacturers to align pack sizes to the recommended treatment duration. The recommended first-line treatments for uncomplicated urinary tract infections in non-pregnant women, for example, are either three days of trimethoprim 300 mg per night or five days of nitrofurantoin 100 mg every six hours. However, the packs contain enough for seven days. This can mean patients take it for longer or use leftovers later. </li> </ul> <h2>Australia lags behind Sweden</h2> Australia has some good strategies for antibiotic prescribing, but we have not had a sustained long-term plan to ensure wise use. Although Australian GPs have been doing well in <a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/aura-2021">reducing antibiotic prescribing</a> since 2015, <a href="https://pubmed.ncbi.nlm.nih.gov/35098269/">more</a> could be done. In the 1990s, Sweden’s antibiotic use was similar to Australia’s, but is now less than half. For more than two decades, Sweden has had a national strategy that reduces antibiotic use by about <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677604/">7% annually</a>. It is vital Australia invests in a similar long-term national strategy – to have a centrally funded program, but with regional groups working on the implementation. This could be funded directly by the Commonwealth Department of Health and Ageing, or with earmarked funds via another body such as the Australian Centre for Disease Control. In the meantime, individual GPs can do their part to prescribe antibiotics better, and patients can join the national effort to combat antibiotic resistance by asking their GP: “what would happen if I don’t take an antibiotic?”. <a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, Assistant Professor of Public Health, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-antibiotics-arent-always-needed-heres-how-gps-can-avoid-overprescribing-213981">original article</a>.

Caring

Unlocking Japan: Insider tips and mistakes to avoid for first-time travellers

Traveling to a new country for the first time can be both exciting and a little overwhelming. With so much information online, it can be tough to keep track of what to do and what to avoid. While it is important to consider the rules of <a href="https://www.klook.com/en-AU/blog/do-and-donts-japan-guide/" target="_blank" rel="noopener">etiquette</a> in Japan, there are a few uncommon things that you might miss if you're a first-time traveller. Here are a few of our do's and don'ts: <h5>DO use a luggage transfer service to travel "hands-free"</h5> Japan is all about efficiency, and one of the things you can do to make sure you can travel more freely is to use a luggage transfer service. We recommend <a href="https://www.kuronekoyamato.co.jp/en/" target="_blank" rel="noopener">Yamato Transport </a> a luggage transfer service that delivers all of your bags from the airport to your hotel and from hotel to hotel. Prices depend on the weight and size of your bags, but for same-day delivery, it was around $40-50 AUD for two 30kg bags. Depending on where you are staying, your hotel may or may not provide the Yamato services directly, but if they don't, you can always check with the nearest Family Mart as some convenience stores will do it for you. Alternatively, you can search for the nearest Yamato on Google maps. It is important to note that there may be delivery delays depending on road and traffic conditions, and in some cases they don't do same-day delivery to the airport, so it's good to double check. <h5>DON'T listen to the influencers </h5> With the rise of influencer culture, a lot more restaurants and tourists spots have become even more popular. Avoid queuing in line for over an hour for the hottest restaurant that's always "so good" and pull out Google or Apple maps, as you can find more hidden gems that the locals visit and are actually worth your time. <h5>DO bring cash </h5> Although most places accept card, places like Kyoto - the ancient capital - still mostly take cash. A lot of tourist spots like Kiyomizudera, some markets, and buses in Kyoto only take cash. On another note, if you have an <a href="https://www.japan-guide.com/e/e2359_003.html" target="_blank" rel="noopener">IC card</a> like the Suica or Icoca, you can also use these as a form of payment at certain vending machines, shops and restaurants. (It's kind of like using your Opal card to pay for things). <h5>DON'T lose or damage your JR Pass </h5> Most travel blogs recommend that you get the <a href="https://www.japan-guide.com/e/e2361.html" target="_blank" rel="noopener">JR pass</a> ,which is a rail pass that offers unlimited rides on the JR trains for one, two or three weeks, and allow you to travel nation-wide. What they don't tell you is that they only hand out physical passes that you cannot lose or damage, as they will not re-issue another card until your current one expires. With the cost of the JR passes increasing in October, it might also be worth booking one-way travel tickets instead, as they might be cheaper depending on which region you're travelling to. <h5>DO bring good socks and wear your comfiest shoes</h5> There is a lot of walking involved, and sometimes lifts can be hard to find – especially at certain stations – so make sure you wear shoes with a lot of padding (or whatever's best for you). You will have to take off your shoes more often than you think, especially in changing rooms and certain traditional accommodation. So leave your hole-y socks at home or wear slippers wherever you go! <h5>DON'T book that morning flight </h5> Check-in for a lot of places is usually at 3pm and you want to avoid the morning rush, especially if you're catching public transportation. These are a few of our tips, are there any we've missed? Images: Getty/ Supplied

International Travel

These are the top mistakes first-time cruise travellers should avoid, according to a cruise ship veteran

Cruise tips for the perfect trip For more than a decade, I have worked on some of the best cruise lines, and for the last six years, I’ve been a cruise director. It’s a dream job: I am the face and voice of a 3,600-person-capacity ship, organising entertainment around the clock for guests, creating the master schedules, coordinating excursions, hosting special events and so much more. I’ve been on hundreds of cruises and live on a ship for most of the year, so it’s safe to say that I know a few cruise tips you’ll find useful. I also know a thing or two about the mistakes people make when it comes to cruises, whether they’re first-time cruisers or regulars. From creating a smart cruise packing list to finding the best deals at sea, these insider cruise tips will ensure that you have the best trip possible. Booking too late It is true that if you’re very flexible with your travel plans and/or you live near a popular port-of-call, you can get some great bargains on cruises by booking at the last minute. But those opportunities are harder to come by these days, thanks to sophisticated computer algorithms that do a great job of adjusting prices to fill bookings earlier. What to do instead: If you’re sure you want to book a particular cruise or your travel plans aren’t flexible, book as early as possible – as in, the date bookings open. Prices will be at their lowest then, but if for some reason they do drop, you can ask customer service to match the new lower price. Just be aware that price adjustments need to be made before the “final booking window,” when all rates are locked in, usually one to three months before departure. Not asking for an upgrade Post-pandemic, a lot of ships are sailing at low capacity, so there are often plenty of open rooms. People are often nervous to ask for an upgrade, but those rooms will just be left empty if they’re not filled by departure time. We love making guests happy, and as long as you’re polite and phrase it as a question, not a demand, we’ll do our best! What to do instead: When you arrive, talk to any of the employees greeting guests about rooms available for upgrades. Different cruise lines have different policies, and the employees will know how to help you. And in case you were wondering, you can ask for an upgrade regardless of how you purchased your tickets. If you’re there for a special event, like a milestone anniversary or a honeymoon, definitely mention it – even if you can’t get an upgrade, they will find other ways to make your cruise special. Some cruises also allow you to “bid” for an upgrade, meaning that you can offer an extra amount of money for that nicer cabin. This is still a good deal, since even with the extra fee, it’s still cheaper than if you had paid the original rate for that room. Not packing a carry-on bag This is one of those cruise tips you’ll really be glad you know before your next trip. Many people overpack their main luggage and don’t give enough thought to what they’re toting in their carry-ons. Remember: It takes several hours minimum to get your luggage to you. Luggage times can range from a couple of hours to half a day, depending on staffing levels and your cabin location. This is why it’s essential to have a day pack with anything you’ll need right away – and don’t forget the fun stuff! What to do instead: Pack a roomy carry-on with medication, contact solution, a change of clothing, a swimsuit, sunscreen, sunglasses, sandals or other items you’ll want to have immediate access to. Being rude or cold to the crew We’re here to help you, but we’re not slaves. I’ve seen passengers have full meltdowns over everything from not being able to get prescription medication from the first-aid station, to the buffet not having a dish they ate on a different cruise line, to their towels being folded instead of shaped, like they saw on Instagram. Regardless of your demeanour with us, we’ll always do our best to help you, but we won’t be motivated to go above and beyond for you. Keep in mind that some events, such as dinner with the captain, are by invitation only or are not advertised, and having a crew member to help you get your name on the golden ticket could make your cruise experience something out of this world. What to do instead: Be polite and kind to the crew. To be clear: You’re allowed to complain, and we definitely want to know if something isn’t right or if it could be better, but just remember that we’re people too – often operating on very little sleep. Not taking advantage of flash deals During booking or before boarding, many cruises offer limited amounts of “flash deals” for things like entertainment shows or drink packages. Many people wait, thinking they can just decide once they’re on board, but you won’t find those same deals on the ship. And these deals are worth it: Purchasing a flash deal ahead of time could get you half-off discounts for food and alcoholic beverages, a VIP excursion or priority seating at shows. Talk about an easy way to get perks and save some serious money! What to do instead: If they’re offering something you know you’ll use, it’s almost always cheaper to purchase it through a flash deal. Flash deals are publicised through a cruise’s site and via email, but the fastest way to be alerted is by installing the app for your cruise line and registering your trip. And be sure to purchase quickly, since many deals are available only for a short time and/or in limited quantities. Using the internet a lot Internet on cruise ships can be overpriced and unreliable. This is because ocean-going ships have to use satellite systems for internet, and they are slower and tend to lose service more easily. And expect to pay for the privilege of slower service – older ships still sell internet by the minute (50 to 75 cents), while state-of-the-art ships offer day passes. Day passes average about $US25 per device, per day. This can add up faster than you realise. So while it’s technologically possible to stream a Netflix movie to your cabin, it may not be the best use of your time or money. What to do instead: See it as a gift! My advice would be to switch off completely while at sea and save your money. Cruise ships are equipped for maximum entertainment, and you should take advantage of all the fun we have on board. (Plus, in a cruise tip that doubles as a life tip, it’s good for you to do a mini digital detox and take a break from social media every once in a while.) If you do need to use the internet – say, to check your work emails or contact family – it will be cheapest and fastest to wait until you’re at port and find a Wi-Fi hot spot. Otherwise, just plan to use the ship’s internet strategically; have a plan before logging on rather than just surfing. Not signing up for the free loyalty program All major cruise lines have loyalty programs that offer real perks, including discounts on tickets, free meals, free internet, priority embarkation and disembarkation, and even free cruises. If you don’t sign up, you’re missing out. While the perks will depend on what “tier” of the loyalty program you sign up for, top-tier loyalty programs are the best deal for serious cruisers. That’s where you’ll be treated like royalty, with upgrades, special events, free or heavily discounted tickets, priority booking and lots of other extras. What to do instead: The base programs are free to sign up, and you’ll want to register for them as soon as possible because you can start earning points immediately. Higher-tier programs are fee-based, but they can be a great deal depending on what amenities you want and how often you plan to cruise. You will be offered the chance to sign up or upgrade during the booking process, but if you miss it, you can sign up at check-in or at any point during the cruise – even when disembarking. Depending on the package and loyalty tier, some of your points will be available immediately for use on your current cruise. Some major cruise lines, like Royal Caribbean, have partnerships with major credit cards that allow you to use your card to rack up loyalty points throughout the year. Sticking to the buffets Yes, buffets are fantastic because they offer a wide variety of popular foods, and it’s all-you-can-eat around the clock. But if you’re only eating at the buffets, you’re missing some of the best food on the cruise! The restaurants are designed to give you a full dining experience and offer regional or specialty cuisines that can’t be found on the buffet. Plus, you can order according to your taste and special-order dishes if you have particular dietary concerns. Many restaurants offer extras like dining with the chef, watching the food be prepared or special entertainment events. What to do instead: Ask your host about special dining events, like the chef’s table, or to help you get reservations for a specialty meal – for instance, a Brazilian steakhouse meal or a five-course tasting with wine pairings. These dining experiences usually cost extra, but they’re totally worth it. Try to book two or three if you can. Not using room service enough When you’re staying at a hotel, you might forgo room service because it can get pricey – or because you can’t order whatever you want, whenever you want it. That’s not necessarily the case on a cruise. Post-pandemic, you can order anything off the menu through room service, 24/7… But not all the food is free. You may have to pay extra for that cheeseburger at 3am. What to do instead: While what’s included in room service varies from cruise line to cruise line, as well as what package you’ve booked, breakfast will likely be free – no matter what. Make the most of this cruise ship secret, and you never have to leave your room for breakfast again if you don’t want to! One etiquette-based cruise tip, though: While tipping isn’t necessary, if you do order room service in the middle of the night, consider tipping the staff a few dollars when they bring it. Not reading the ship's insurance policy If you enjoy doing adventurous activities like ziplining and surfing, make sure you know the risks and what you are covered for in case of an emergency. The ship’s insurance policy covers only the very basic things – those that are directly the cruise line’s responsibility, like cancelled cruises or lost luggage. But anything related to your health or other travel issues won’t be covered, so you’ll need to rely on personal policies. What to do instead: Make sure to read through the insurance policy and ask your cruise host or travel agent if you have questions. Check with your personal insurance provider to see exactly what they cover for cruises and/or out-of-country trips. And it’s never a bad idea to purchase separate travel insurance. Going to Medical for seasickness Cruises are required to have a certified doctor on the ship, but it costs money to get medical care onboard. Doctors bill an hourly rate – often around $US100 per hour – plus fees for any services or extra supplies. Cruise-ship medical bills can range from $US50 to thousands of dollars if you end up needing to be helicoptered out. However, many medical items are available for free through the customer concierge, so save those medical trips for illnesses or injuries that really require a doctor’s attention. What to do instead: Seasickness pills and other over-the-counter meds, such as ibuprofen and Tylenol, are free through guest services, as well as things like adhesive bandages, heating pads and wraps. Stop by the host station, ask any staff member or call directly from your cabin. Pro tip: If you’re prone to seasickness, ask for a cabin on a low deck and mid-ship, since they pitch the least in relation to the rest of the ship. Taking sketchy DIY excursions This really depends on the location, but in lesser-known areas, it is generally wise to stick to the ship-sponsored excursions as opposed to relying on sales pitches from locals, taking internet advice or just winging it. After all, you want to make sure you don’t get taken advantage of, you’re safe and the ship doesn’t leave without you if the excursion runs late! What to do instead: Stick to reputable excursions. Your cruise director will have a list of ship-sponsored excursions and will also be able to advise you on local companies that the cruise line has worked with. It also never hurts to do research before setting sail, looking up your particular ports-of-call and seeing what excursions you might want to ask about. Going too far from the ship It’s fine to go ashore independently and find your own adventures, but I’ve seen too many guests end up losing track of time or distance, and then end up waving the ship goodbye from shore. If this happens, you’ll have to find your own travel to the cruise ship’s next port of call. What to do instead: Instead of driving yourself, find a local taxi driver who knows the area well. Just be sure to negotiate the price and time before hopping in. If you do decide to go it alone, stay fairly close to port, watch the clock and build in extra time for things like traffic jams. Make sure to get back to the boat at least 30 minutes before boarding time. Underestimating how windy it gets at sea Anytime you’re outside on the ship, make sure to secure all your belongings. Hold on tightly if you’re walking around, and if you’re putting your items down, place them in a zippered bag attached to a chair or table, or tether larger items (like blankets) to furniture. It doesn’t take much wind to launch your mobile phone, hat or glasses into the ocean. This happens far more often than you might think! What to do instead: I recommend that guests always bring towel clips for securing towels, clothing, thongs and other flighty items. Your ship may come equipped with some anti-wind protections like special shelters by the pool, lockers or wind breaks. Not honouring cruise traditions Ships, cruise lines and even cruising culture in general have their own traditions. The most popular one on all cruise lines is the “Cruising Duck.” Never heard of it? Guests bring a rubber duck and hide it around the ship to be discovered by others. But there are many more traditions based on individual cruise lines, travel routes or themes (say, a Disney cruise), and part of the fun is getting to discover them. You can read up about them on online forums or just wait to be surprised. What to do instead: Participating in these little traditions will make it more fun for you on your trip, and it’s a great way to integrate yourself into the cruising community. It’s especially fun if you’re doing a themed cruise. Not following current health protocols Health protocols change often, especially post-pandemic. For instance, most cruise ships now require proof of COVID-19 vaccination. Some are still doing rapid tests before boarding. Most prefer (but don’t require) you to wear a mask if you develop any symptoms of illness while aboard. If you test positive for an infectious illness, you’ll be quarantined. And remember, it’s not just COVID they’re concerned about: Outbreaks of norovirus and influenza are common in the close quarters of cruise ships. What to do instead: Stay up to date on the current rules, and do your best to follow them. This information should be given to you the week before your cruise, via email or your online portal. You can also check the website, call customer service or talk to a host during the boarding process. But please don’t argue with us – we don’t make the rules. If you need clarification or an exception, speak to the ship’s doctor. Not booking your next cruise while you're still on the ship This may sound crazy, but it’s one of the smartest cruise tips. Booking your next cruise while on your current cruise is a terrific way to make the most of free onboard credit and loyalty points. Once you leave the ship, the deals they’re offering will be gone. What to do instead: Ask your host about what deals they are offering before you disembark. This is the best time to get a great deal on your favourite cruises – and ones that won’t be available at a later date. Cruise lines really want you to book your next cruise while you’re still there and excited, so they may offer you a cheaper upgrade to a higher tier of the loyalty program and/or nicer perks on your next cruise. If you can book at this time, you definitely should. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/travel/cruising/ive-worked-on-cruise-ships-for-10-years-these-are-the-mistakes-every-traveller-should-avoid?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

Cruising

Can coffee help you avoid weight gain? Here’s what the science says

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Coffee is well recognised as having a positive impact on long-term health. Drinking the equivalent of three to four cups of instant coffee a day <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">reduces the risk</a> of many health conditions including heart disease, type 2 diabetes and some cancers. Most people gain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984841/">small amounts of weight</a> each year as they age. But can coffee help prevent this gradual weight gain? A group of researchers examined whether drinking an extra cup of coffee a day – or adding sugar, cream or a non-dairy alternative – resulted in more or less weight gain than those who didn’t adjust their intake. Their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002916523661702">research</a> (currently a pre-proof, which means it has been peer reviewed but is yet to undergo the final formatting and copyediting) found a modest link between coffee and gaining less weight than expected. People who drank an extra cup of coffee a day gained 0.12 kg less weight than expected over four years. Adding sugar resulted in a fraction more (0.09 kg) weight gain than expected over four years. <h2>How was the study conducted? What did it find?</h2> Researchers combined data from three large studies from the United States: two <a href="https://nurseshealthstudy.org">Nurses’ Health Studies</a> from 1986 to 2010, and from 1991 to 2015, and a <a href="https://www.hsph.harvard.edu/hpfs/about-the-study/">Health Professional Follow-up study</a> from 1991 to 2014. The Nurses’ Health Studies are two of the largest cohort studies, with more 230,000 participants, and investigates chronic disease risks for women. The Health Professional Follow-up study involves more than 50,000 male health professionals and investigates the relationship between diet and health outcomes. Participants in all three studies completed a baseline questionnaire, and another questionnaire every four years to assess their food and drink intake. Using the combined datasets, researchers analysed changes in coffee intake and changes in the participants’ self-reported weight at four-year intervals. The average four year weight-gains for the nurses’ studies were 1.2kg and 1.7kg, while participants in the health professionals study gained an average of 0.8kg. The researchers found that increasing unsweetened caffeinated or decaffeinated coffee intake by one cup a day was associated with a weight gain that was 0.12 kg less than expected over four years. Adding creamer (milk) or a non-dairy alternative did not significantly affect this weight change. However, adding sugar (one teaspoon) to coffee was associated with a weight gain that was 0.09 kg more than expected over four years. These associations were stronger in participants who were younger and had a higher body mass index at the beginning of the studies. <h2>What are the pros and cons of the study?</h2> This study is unique in two ways. It had a very large sample size and followed participants for many years. This adds confidence that the associations were real and can likely be applied to other populations. However, there are three reasons to be cautious. First, the findings represent an association, not causation. This means the study does not prove that coffee intake is the true reason for the weight change. Rather, it shows the two changes were observed together over time. Second, the findings around weight were very modest. The average four-year weight gain averted, based on one cup of coffee, was 0.12 kilograms, which is about 30 grams per year. This amount may not be a meaningful change for most people looking to manage weight. Finally, this analysis did not consider the variability in the amount of caffeine in coffee (which we <a href="https://pubmed.ncbi.nlm.nih.gov/17412475/">know can be high</a>), it just assumed a standard amount of caffeine per cup. <h2>How could coffee help with weight management?</h2> Caffeine is a natural stimulant which has been <a href="https://www.sciencedirect.com/science/article/pii/S0149763416300690">shown to</a> temporarily reduce appetite and increase alertness. This may help to feel less hungry for a short period, potentially leading to reduced energy intake. Some people consume coffee before exercise as a stimulant to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777221/">improve their workout performance</a> – if a workout is more effective, more energy may be expended. However, the benefit is largely thought to be short-lived, rather than long-term. Caffeine has also been <a href="https://www.sciencedirect.com/science/article/pii/S0271531720304449">shown to</a> speed up our metabolism, causing more energy to be burned while resting. However, this effect is relatively small and is not a suitable substitute for regular physical activity and a healthy diet. Finally, coffee has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725310/">mild diuretic effect</a>, which can lead to temporary water weight loss. This is water loss, not fat loss, and the weight is quickly regained when you re-hydrate. <h2>Is it worth trying coffee for weight loss?</h2> Losing weight can be influenced by various factors, so don’t get too enthusiastic about the coffee-weight link highlighted in this new study, or increase your coffee intake to unreasonable levels. Most adults can safely consume around <a href="https://www.healthdirect.gov.au/caffeine">400mg</a> of caffeine a day. That’s the equivalent of two espressos or four cups of instant coffee or eight cups of tea. If you are pregnant or breastfeeding, it is important to talk to your doctor before increasing your caffeine intake, because caffeine can be passed through to your growing baby. If you need individualised weight guidance, talk to your GP or visit an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitian</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/214954/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher & Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-coffee-help-you-avoid-weight-gain-heres-what-the-science-says-214954">original article</a>.

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