Placeholder Content Image

Anti-cellulite products are big business – but here’s what the science says

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/rebecca-shepherd-423135">Rebecca Shepherd</a>, <em><a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p>Although <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.14815">90% of women have cellulite</a>, we’re yet to see it represented as a normal anatomical characteristic in popular culture. In Greta Gerwig’s 2023 Hollywood blockbuster, for instance, Stereotypical Barbie, played by Margot Robbie, develops dimples on her upper thigh as part of her existential crisis – along with other human faults such as halitosis, flat feet and irrepressible thoughts of death.</p> <p>When Stereotypical Barbie asks doll sage Weird Barbie what the dimples are, she explains: “That’s cellulite. That’s going to spread everywhere. Then you’re going to start getting sad and mushy and complicated.” Barbie’s perfect smooth plastic perfection is marred.</p> <p>Despite its prevalence, then, cellulite has been constructed as a flaw in need of correction. Consumers, it seems, agree, especially when fed a diet of the <a href="https://www.tandfonline.com/doi/full/10.1080/21604851.2021.1913827">photoshop smoothed skin</a> of models, social media influencers – and Hollywood stars.</p> <figure><iframe src="https://www.youtube.com/embed/rmThigh1i8s?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">“NO!” Barbie shouts when Weird Barbie tells her she has cellulite.</span></figcaption></figure> <p>Cellulite’s usually found in areas that have greater amounts of subcutaneous fat, when fat deposits push through the connective tissue beneath the skin, leading to a lumpy appearance. It is common, <a href="https://www.sciencedirect.com/science/article/pii/S0738081X1300076X?via%3Dihub">usually painless</a> and harmless.</p> <p>The human skin is the <a href="https://theconversation.com/the-skin-is-a-very-important-and-our-largest-organ-what-does-it-do-91515">body’s largest organ</a>, made up of three layers. At the surface, the epidermis acts as our first line of defence against the environment. This outermost, impermeable layer is made up of cells that are constantly renewed and shed, protecting our body from external elements.</p> <p>Beneath the epidermis lies the dermis, a robust layer containing fibroblasts, the cells responsible for producing essential proteins such as collagen and elastin. These proteins provide structure and elasticity, contributing to the skin’s strength and flexibility.</p> <p>Deeper still is the hypodermis, also known as the subcutaneous layer. This layer is rich in adipose tissue – mostly made up of fat, which plays a crucial role in cushioning and insulating the body, as well as storing fat that can be used when needed. Beneath these three layers of skin, there is muscle. Running from the muscle to the dermis are <a href="https://journals.lww.com/amjdermatopathology/fulltext/2000/02000/cellulite__from_standing_fat_herniation_to.7.aspx">bands of connective tissue</a>, that holds the adipose tissue in “pockets”.</p> <p>Cellulite does not affect health, although some people report that it affects their <a href="https://www.tandfonline.com/doi/abs/10.1080/07853890.2018.1561731">self-esteem and body image</a> but that’s more to do with the social pressure on women to be physically perfect – or spend money, time and energy trying to be as close to perfect as possible.</p> <p>Cellulite, then, has become big business for the beauty industry. In the lead up to summer especially, companies will promote <a href="https://www.asa.org.uk/advice-online/weight-control-cellulite.html">all manner of products</a> from creams and serums to gadgets and pills, all aimed at creating perfectly smooth limbs. The most popular question seems to be, “Do these treatments work?” but as an anatomist I think the more pressing question is, “Why are healthy women’s bodies considered something to treat, cure or correct?”</p> <p>The beauty and wellness industry has long capitalised on societal standards of beauty. The idea that cellulite is undesirable and <a href="https://journals.lww.com/dermatologicsurgery/abstract/1978/03000/So_Called_Cellulite.9.aspx">should be corrected</a> has been perpetuated since Vogue magazine was the <a href="https://archive.vogue.com/article/1968/4/cellulite-the-new-word-for-fat-you-couldnt-lose-before">first English language magazine</a> to use the term “cellulite”, introducing the concept to thousands of women. This marketing strategy taps into the insecurities of consumers, particularly women, and promotes an endless pursuit of “perfection” for bodies that have normal anatomical variation.</p> <p>By framing cellulite as a condition that needs treatment, companies can sell a wide range of products and services, bolstered by celebrity endorsements, which lend credibility and aspirational value to pseudo-medical “smoothing” products. However, there is limited scientific evidence supporting the effectiveness of these supplements in treating cellulite. In fact, the <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.1978.tb00416.x">first scientific paper</a> on cellulite, published in 1978, referred to it as “so called cellulite: the invented disease”.</p> <p>Recent product launches include, <a href="https://lemmelive.com/en-gb/products/lemme-smooth-capsules?variant=45597048111318">Lemme Smooth</a>, Kourtney Kardashian-Barker’s latest addition to her vitamin and supplement range. The product’s promotional materials claim that the capsule “visibly reduces cellulite in 28 days”. But what does the science tell us?</p> <p>Supplements like Lemme Smooth claim to improve skin texture and reduce cellulite from within. Kardashian-Barker’s supplement contains a mixture of <a href="https://link.springer.com/article/10.1007/s10298-015-0977-4">french cantaloupe melon</a>, hyaluronic acid, chromium and vitamin C among other ingredients. The body’s ability to absorb and utilise these ingredients in a way that would impact cellulite is still a subject of debate.</p> <p>There is evidence that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110621/#:%7E:text=In%20a%20randomized%2C%20double%2Dblind,in%20part%2C%20to%20the%20skin.">ingested hyaluronic acid</a> can migrate into the skin, stimulating the production of collagens within the dermis – and vitamin C has been shown to <a href="https://www.nature.com/articles/s41598-020-72704-1">thicken the surface layer</a> of the skin. However, the lack of standardisation in testing for the use of these ingredients in the treatment of cellulite means it’s still not clear if they will have a <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1467-2494.2006.00318.x">significant effect</a>.</p> <p>Other products marketed to reduce the appearance of cellulite include topical creams and lotions, containing ingredients like <a href="https://karger.com/books/book/763/chapter-abstract/5600478/Specific-Use-Cosmeceuticals-for-Body-Skin-Texture?redirectedFrom=fulltext">caffeine, retinol, and herbal extracts</a>. Cosmetic products are not able to penetrate the epidermis enough to significantly affect the underlying fat deposits and connective tissue.</p> <p>Some invasive treatments, such as <a href="https://www.aad.org/public/cosmetic/fat-removal/cellulite-treatments-what-really-works">laser therapy, subcision, and acoustic wave therapy</a> can offer more promising results. These procedures work by breaking down the connective tissue bands that cause dimpling and stimulating collagen production in the dermis to improve skin elasticity. While these methods <a href="https://www.aad.org/public/cosmetic/fat-removal/cellulite-treatments-what-really-works">may be more effective</a>, they are often expensive, require multiple sessions to achieve results – and aren’t without risk.</p> <p>Maintaining a healthy diet, drinking lots of water, and regular physical activity can help improve the overall appearance of the skin and reduce the visibility of cellulite. Losing weight and strengthening the muscles in the legs, buttocks and abdomen may make cellulite less noticeable, but it won’t make it <a href="https://jndc-chemistryarticles.info/ijn/article/318">disappear altogether</a>.</p> <p>The bottom line, though, is that cellulite does not need to be treated. It’s a normal anatomical variation that’s been transformed into a condition driving a lucrative market for cures <a href="https://link.springer.com/article/10.1007/s40257-015-0129-5">that don’t exist</a>.</p> <p>My top expert advice in the run up to summer? Be wary of claims from cosmetic companies and save your money.</p> <hr /> <p><em>The Conversation has approached the Lemme Live brand for comment.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232318/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/rebecca-shepherd-423135">Rebecca Shepherd</a>, Senior Lecturer in Human Anatomy, School of Anatomy, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/anti-cellulite-products-are-big-business-but-heres-what-the-science-says-232318">original article</a>.</em></p> </div>

Body

Placeholder Content Image

What is ‘breathwork’? And do I need to do it?

<div class="theconversation-article-body"> <p><em><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/judy-pickard-831093">Judy Pickard</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>From “breathwork recipes” to breathing techniques, many <a href="https://www.instagram.com/p/C5WpkWxNrDI/">social media</a> and <a href="https://www.healthline.com/health/breathing-exercise">health websites</a> are recommending breathwork to reduce stress.</p> <p>But breathwork is not new. Rather it is the latest in a long history of breathing techniques such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336946/">Pranayama</a> from India and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312231/#:%7E:text=Qigong%2C%20on%20the%20other%20hand,one%20or%20two%20balancing%20poses.">qigong</a> from China. Such practices have been used for thousands of years to promote a healthy mind and body.</p> <p>The benefits can be immediate and obvious. Try taking a deep breath in through your nose and exhaling slowly. Do you feel a little calmer?</p> <p>So, what’s the difference between the breathing we do to keep us alive and breathwork?</p> <h2>Breathwork is about control</h2> <p>Breathwork is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9873947/#bib3">not the same</a> as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">other mindfulness practices</a>. While the latter focus on observing the breath, breathwork is about <a href="https://www.nature.com/articles/s41598-022-27247-y">controlling inhalation and exhalation</a>.</p> <p>Normally, breathing happens automatically via messages from the brain, outside our conscious control. But we can control our breath, by directing the movement of our diaphragm and mouth.</p> <p><a href="https://www.medicalnewstoday.com/articles/diaphragmatic-breathing">The diaphragm</a> is a large muscle that separates our thoracic (chest) and abdominal (belly) cavities. When the diaphragm contracts, it expands the thoracic cavity and pulls air into the lungs.</p> <p>Controlling how deep, how often, how fast and through what (nose or mouth) we inhale is the crux of breathwork, from <a href="https://www.healthline.com/health/breath-of-fire-yoga">fire breathing</a> to the <a href="https://www.headspace.com/content/meditation/humming-bee-breath/9422">humming bee breath</a>.</p> <h2>Breathwork can calm or excite</h2> <p>Even small bits of breathwork can have physical and mental health benefits and <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">complete the stress cycle</a> to avoid burnout.</p> <p>Calming breathwork includes diaphragmatic (belly) breathing, slow breathing, pausing between breaths, and specifically slowing down the exhale.</p> <p>In diaphragmatic breathing, you consciously contract your diaphragm down into your abdomen to inhale. This pushes your belly outwards and makes your breathing deeper and slower.</p> <p>You can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681046/">slow the breath</a> by doing:</p> <ul> <li> <p><a href="https://www.medicalnewstoday.com/articles/321805">box breathing</a> (count to four for each of four steps: breathe in, hold, breathe out, hold), or</p> </li> <li> <p><a href="https://pubmed.ncbi.nlm.nih.gov/38092805/">coherent breathing</a> (controlled slow breathing of five or six breaths per minute), or</p> </li> <li> <p><a href="https://www.healthline.com/health/alternate-nostril-breathing#benefits">alternate nostril breathing</a> (close the left nostril and breathe in slowly through the right nostril, then close the right nostril and breathe out slowly through the left nostril, then repeat the opposite way).</p> </li> </ul> <p>You can slow down the exhalation specifically by counting, humming or pursing your lips as you breathe out.</p> <p>In contrast to these calming breathing practices, energising fast-paced breathwork increases arousal. For example, <a href="https://www.webmd.com/balance/what-is-breath-of-fire-yoga">fire breathing</a> (breathe in and out quickly, but not deeply, through your nose in a consistent rhythm) and <a href="https://www.healthline.com/health/breathing-exercise#breath-focus">Lion’s breath</a> (breathe out through your mouth, stick your tongue out and make a strong “haa” sound).</p> <h2>What is happening in the body?</h2> <p>Deep and slow breathing, especially with a long exhale, is the best way to <a href="https://theconversation.com/our-vagus-nerves-help-us-rest-digest-and-restore-can-you-really-reset-them-to-feel-better-210469">stimulate the vagus nerves</a>. The vagus nerves pass through the diaphragm and are the main nerves of the parasympathetic nervous system.</p> <p>Simulating the vagus nerves calms our sympathetic nervous system (fight or flight) stress response. This improves mood, lowers the stress hormone <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/">cortisol</a> and helps to regulate emotions and responses. It also promotes more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137615/">coordinated brain activity</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">improves immune function and reduces inflammation</a>.</p> <p>Taking deep, diaphragmatic breaths also has <a href="https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing">physical benefits</a>. This improves blood flow, lung function and exercise performance, increases oxygen in the body, and strengthens the diaphragm.</p> <p><a href="https://link.springer.com/article/10.1007/s12671-023-02294-2#:%7E:text=Accumulating%20evidence%20supports%20the%20efficacy,et%20al.%2C%202001">Slow breathing</a> reduces heart rate and blood pressure and increases heart rate variability (normal variation in <a href="https://www.health.harvard.edu/blog/heart-rate-variability-new-way-track-well-2017112212789">time between heart beats</a>). These are linked to better heart health.</p> <p>Taking shallow, quick, rhythmic breaths in and out through your nose stimulates the sympathetic nervous system. Short-term, controlled activation of the stress response is healthy and <a href="https://pubmed.ncbi.nlm.nih.gov/36624160/">develops resilience to stress</a>.</p> <h2>Breathing in through the nose</h2> <p>We are designed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986941/">inhale through our nose</a>, not our mouth. Inside our nose are lots of <a href="https://www.ncbi.nlm.nih.gov/books/NBK544232/">blood vessels, mucous glands and tiny hairs called cilia</a>. These warm and humidify the air we breathe and filter out germs and toxins.</p> <p>We want the air that reaches our airways and lungs to be clean and moist. Cold and dry air is irritating to our nose and throat, and we don’t want germs to get into the body.</p> <p><a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00148.2023?utm_source=AJPRegu&amp;utm_medium=PressRelease&amp;utm_campaign=1.17.2024">Nasal breathing</a> increases parasympathetic activity and releases nitric oxide, which improves airway dilation and lowers blood pressure.</p> <p>Consistently breathing through our mouth <a href="https://www.sciencefocus.com/the-human-body/mouth-breathing">is not healthy</a>. It can lead to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455204/">pollutants</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967998/#:%7E:text=Hence%2C%20we%20sought%20to%20synthesize,barriers%20to%20long%2Dterm%20enjoyment.">infections</a> reaching the lungs, snoring, sleep apnoea, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986941/">dental issues</a> including cavities and jaw joint problems.</p> <h2>A free workout</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/">Slow breathing</a> – even short sessions at home – can reduce stress, anxiety and depression in the general population and among those with clinical depression or anxiety. Research on breathwork in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309518/">helping post-traumatic stress disorder</a> (PTSD) is also promising.</p> <p>Diaphragmatic breathing to improve lung function and strengthen the diaphragm can improve breathing and exercise intolerance in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9690833/">chronic heart failure</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/33076360/">chronic obstructive pulmonary disease</a> and <a href="https://www.medicalnewstoday.com/articles/diaphragmatic-breathing#conditions-it-can-help-with">asthma</a>. It can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967998/#:%7E:text=Hence%2C%20we%20sought%20to%20synthesize,barriers%20to%20long%2Dterm%20enjoyment.">improve exercise performance</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/19875429/">reduce oxidative stress</a> (an imbalance of more free radicals and/or less antioxidants, which can damage cells) after exercise.</p> <h2>A mind-body connection you can access any time</h2> <p>If you feel stressed or anxious, you might subconsciously <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/breathing-to-reduce-stress">take shallow, quick breaths</a>, but this can make you feel more anxious. Deep diaphragmatic breaths through your nose and focusing on strong exhalations can help break this cycle and bring calm and mental clarity.</p> <p>Just <a href="https://www.nature.com/articles/s41598-022-27247-y">a few minutes a day</a> of breathwork can improve your physical and mental health and wellbeing. Daily deep breathing exercises <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1040091/full">in the workplace</a> reduce blood pressure and stress, which is important since <a href="https://theconversation.com/what-is-burnout-and-how-to-prevent-it-in-the-workplace-insights-from-a-clinical-psychologist-196578">burnout rates are high</a>.</p> <p>Bottom line: any conscious control of your breath throughout the day is positive.</p> <p>So, next time you are waiting in a line, at traffic lights or for the kettle to boil, take a moment to focus on your breath. Breathe deeply into your belly through your nose, exhale slowly, and enjoy the benefits.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231192/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/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/judy-pickard-831093">Judy Pickard</a>, Senior Lecturer, Clinical Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-breathwork-and-do-i-need-to-do-it-231192">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Meet the 65-year-old bodybuilder committed to defying stereotypes

<div title="Page 1"> <div> <div> <div title="Page 1"> <div> <div> <div> <div title="Page 1"> <div> <div> <div title="Page 1"> <div> <div> <p>The adage that "age is just a number" could have been written for Jan Herdman, 65. </p> </div> </div> </div> <p>Jan has well and truly shattered the age stereotypes into smithereens by dominating the bodybuilding champions and winning 'Mrs Supranational Australia'. </p> <p>Jan Herdman is not your average 65-year-old. Jan is in fact: 65 years young, she's breaking barriers, shattering stereotypes, and proving that age is merely a number.</p> <p>In a remarkable display of strength, determination, and sheer grit, Jan has just received 1st place in the ICN Australia Bodybuilding Championship (awarded on May 4th 2024) in the over 60s category, along with securing 2nd place in the over 40s category and 3rd place in the ‘Novice Figures’ category.</p> <p>Jan’s triumphs don't end there; she also seized the prestigious title of ‘Mrs Supranational’ in the ‘Mrs of Australia Pageant’, held in Sydney in April 2024.</p> </div> </div> </div> <p>Jan's journey is not just about winning titles; it's about inspiring others to redefine their perceptions of aging. Embarking on her strength training journey to support others, and herself, in defeating age-related illnesses, Jan exemplifies the essence of ageing gracefully and living a fulfilling life at any age.</p> </div> </div> </div> </div> <p>"I refuse to let age define me," says Jan Herdman. "Every day is an opportunity to challenge myself, push my limits, and inspire others to realise their full potential. Age should never be a barrier to pursuing your dreams."</p> <p>Jan's story is a testament to resilience, perseverance, and the power of the human spirit. Her relentless pursuit of excellence serves as a beacon of inspiration to women and men worldwide, encouraging them to embrace life's challenges with courage and tenacity.</p> <p>Jan actively leans into her credo; Having been through her own chronic health challenges and needing to restart life out on her own, Jan Herdman has become a powerhouse of inspiration and transformation to her fast-growing community.</p> <p>Jan watched her mother become frail and incapable of taking care of herself, and that set Jan off on a mission to change the trajectory of her own future and turn her health and life around. Jan’s story is one of total transformation in all aspects of her life.</p> <p>Jan is now a sought-after commentator on living a life with vitality at any age. Jan is an advocate for strength training as the starting point for a total life transformation to prevent age-related illnesses and mobility issues.</p> <p>Through popular demand Jan has created her own program coined The Ageless MethodTM which captures her proven model of transformation, for all levels at any age.</p> </div> </div> </div> <div class="page" title="Page 2"> <div class="layoutArea"> <div class="column"> <p>The 12 Week ‘Transformer Program’ has just kicked off on 19th June 2024, and will recommence on 11 September 2024.</p> <p>The 6 Week ‘Kickstarter Program’ starts on 2 July 2024, then 10 September 2024, then 29 October 2024.</p> <p>Jan also offers on demand 1:1 coaching, as needed. More info here across all offerings here: <a href="https://www.ageless-transformations.com" target="_blank" rel="noopener">ageless-transformations.com</a></p> <p><em>Image credits: Supplied</em></p> <pre> </pre> </div> </div> </div>

Body

Placeholder Content Image

Why can’t I sleep? It could be your sheets or doona

<div class="theconversation-article-body"> <p><a href="https://theconversation.com/profiles/chin-moi-chow-169404">Chin Moi Chow</a>, <em><a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em>; <a href="https://theconversation.com/profiles/cynthia-xinzhu-li-1532937">Cynthia (Xinzhu) Li</a>, <em><a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em>, and <a href="https://theconversation.com/profiles/mark-halaki-1532934">Mark Halaki</a>, <em><a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>It’s winter, so many of us will be bringing out, or buying, winter bedding.</p> <p>But how much of a difference does your bedding make to your thermal comfort? Can a particular textile help you sleep?</p> <p>Is it wool, or other natural fibres, such as cotton? How about polyester? With so much choice, it’s easy to be confused.</p> <p>Here’s what we <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.14217">found</a> when we reviewed the evidence – not just for winter, but also for the summer ahead.</p> <h2>The importance of bedding</h2> <p>We <a href="https://doi.org/10.1016/j.enbuild.2020.110097">rely on our bedding</a> to maintain a comfortable temperature to help us sleep. And the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0378778817317681">right textiles</a> can help regulate our body temperature and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/9783527342587.ch31">wick away moisture</a> from sweat, promoting better sleep.</p> <p>In the cooler months, we’re mainly concerned about a textile’s insulation properties – keeping body heat in and the cold out. As the temperature climbs, we’re less concerned about insulation and more concerned about wicking away moisture from sweat.</p> <p>Another factor to consider is a textile’s breathability – how well it allows air to pass through it. A breathable textile helps keep you cool, by allowing warmth from your body to escape. It also helps keep you comfortable by preventing build-up of moisture. By releasing excess heat and moisture, a breathable textile makes it feel cooler and more comfortable against the skin.</p> <h2>Different textiles have different properties</h2> <p>Some textiles are better than others when it comes to insulation, wicking away moisture or breathability.</p> <p>For instance, cotton and wool have tiny air pockets that <a href="https://nopr.niscair.res.in/bitstream/123456789/24505/1/IJFTR%2031(1)%20177-186.pdf">act as insulation</a> to provide <a href="https://www.sciencedirect.com/science/article/abs/pii/0379711281900072">warmth</a> in cold weather. Thicker fabrics with more air pockets tend to be warmer, softer and more breathable. But these factors are also affected by the type of fibre, the weave of the fabric and the manufacturing process.</p> <p>Cotton and wool are also breathable fabrics, meaning they help regulate temperature.</p> <hr /> <p><iframe id="CqVe0" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/CqVe0/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>While cotton absorbs moisture (sweat) from your skin, it doesn’t wick it away efficiently. This retained moisture can make cotton feel clingy and uncomfortable, potentially leading to chills in warm weather.</p> <p>But wool is <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.14217">highly absorbent</a> and wicks moisture effectively. In warmer weather, when we sweat, wool fibres allow for airflow and moisture transfer, promoting efficient sweat evaporation and cooling, and preventing overheating. So wool (in different thicknesses) can be a good option in both summer and winter.</p> <p>Linen, although breathable and having moisture-wicking properties, provides less insulation than wool and cotton due to its hollow fibres. This makes linen less effective for keeping warm in winter but is effective for keeping cool in summer.</p> <p>Polyester is a synthetic fibre that can be made to trap air for insulation, but it is not naturally breathable. Usually, it absorbs moisture poorly. So it can trap sweat next to the skin, causing discomfort. However, polyester can be specially treated to help control moisture from sweat.</p> <h2>Which sheets help you sleep?</h2> <p>As part of our review, we couldn’t find any studies that directly compared sheets made from different textiles (for instance, regular cotton and flannelette) and their impact on sleep when it’s cold.</p> <p>However, linen sheets are particularly effective in warmer conditions. In one study, conducted at 29°C and high humidity, linen sheets <a href="https://openurl.ebsco.com/EPDB%3Agcd%3A10%3A26460954/detailv2?sid=ebsco%3Aplink%3Ascholar&amp;id=ebsco%3Agcd%3A87732897&amp;crl=c">promoted</a> less wakefulness and fewer stages of light sleep than cotton sheets.</p> <h2>How about doonas?</h2> <p>If you don’t heat your bedroom at night in winter, a goose down doona (one made from fine, goose feathers) might be an option.</p> <p>These promoted the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0378778818321728">longest, deep-sleep</a>, followed by duck down, then cotton when sleeping at 11°C. This may be because down offers better insulation (by trapping more air) than cotton. Down also has lower thermal conductivity than cotton, meaning it’s better at keeping warmth in.</p> <p>Choosing between a wool or polyester doona? In a wool-industry funded <a href="https://www.tandfonline.com/doi/full/10.2147/NSS.S100271">study</a> two of us (Chow and Halaki) co-authored, there wasn’t much difference. The study in young adults found no significant difference on sleep at 17°C or 22°C.</p> <h2>So how do I choose?</h2> <p>The choice of bedding is highly individual. What feels comfortable to one person is not the same for the next. That’s because of variations in body size and metabolic rate, local climate, bedroom temperature and building insulation. These can also affect sleep.</p> <p>This variability, and a wide range of study designs, also makes it hard to compare different studies about the impact of different textiles on sleep. So you might need to experiment with different textiles to discover what works for you.</p> <hr /> <p><em>Many factors can affect your sleep, not just your bedding. So if you’re having trouble sleeping, you can find more information from the <a href="https://www.sleephealthfoundation.org.au/">Sleep Health Foundation</a>. If symptoms continue, see your GP.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229604/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/chin-moi-chow-169404">Chin Moi Chow</a>, Associate Professor of Sleep and Wellbeing, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/cynthia-xinzhu-li-1532937">Cynthia (Xinzhu) Li</a>, PhD candidate studying menopause and sleep, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/mark-halaki-1532934">Mark Halaki</a>, Professor of Human Movement, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-cant-i-sleep-it-could-be-your-sheets-or-doona-229604">original article</a>.</em></p> </div>

Body

Placeholder Content Image

I’ve been given opioids after surgery to take at home. What do I need to know?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p>Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.</p> <p>These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.</p> <p>However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.</p> <h2>Which types of opioids are most common?</h2> <p>The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).</p> <p>In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit.</p> <p><a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.</p> <p>Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.</p> <p>Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.</p> <p>Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.</p> <p>Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.</p> <p>Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.</p> <h2>But there are also risks</h2> <p>As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.</p> <p>Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.</p> <p>But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids.</p> <p>Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.</p> <p>Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer.</p> <p>Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed.</p> <p>This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.</p> <h2>How to mimimise the risks</h2> <p>Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).</p> <p>These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.</p> <p>Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.</p> <p>However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>:</p> <ul> <li> <p>ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects</p> </li> <li> <p>do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing</p> </li> <li> <p>as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen</p> </li> <li> <p>before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.</p> </li> </ul> <h2>If you’re concerned about side effects</h2> <p>If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:</p> <ul> <li> <p><a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives</p> </li> <li> <p>drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor</p> </li> <li> <p>weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.</p> </li> </ul> <h2>If you’re having trouble stopping opioids</h2> <p>Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.</p> <p>You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.</p> <h2>How about leftover opioids?</h2> <p>After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge.</p> <p>Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.</p> <hr /> <p><em>For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Walking can prevent low back pain, a new study shows

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year.</p> <p>The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system.</p> <p>In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.</p> <h2>The WalkBack trial</h2> <p>We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).</p> <p>Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.</p> <p>The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.</p> <p>The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.</p> <p>Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.</p> <p>People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care.</p> <h2>What the results showed</h2> <p>We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.</p> <p>The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.</p> <p>Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.</p> <p>Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.</p> <p>This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.</p> <p>Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.</p> <h2>Walking has multiple benefits</h2> <p>We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain.</p> <p>A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.</p> <p>On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.</p> <p>Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.</p> <p>While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.</p> <h2>Why is walking helpful for low back pain?</h2> <p>We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain.</p> <p>It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this.</p> <p>Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Why do I poo in the morning? A gut expert explains

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.</p> <p>But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?</p> <p>To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.</p> <p>Here’s what the science says.</p> <h2>So morning poos are real?</h2> <p>In a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379343/">UK study</a> from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.</p> <p>The most common time to poo was in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379343/pdf/gut00573-0122.pdf">early morning</a>. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.</p> <p>About a decade later, <a href="https://pubmed.ncbi.nlm.nih.gov/16200717/">a Chinese study</a> found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.</p> <h2>But why the morning?</h2> <p>There are a few reasons. The first involves our <a href="https://theconversation.com/circadian-rhythm-nobel-what-they-discovered-and-why-it-matters-85072">circadian rhythm</a> – our 24-hour internal clock that helps regulate bodily processes, such as digestion.</p> <p>For healthy people, our internal clock means the muscular contractions in our colon follow <a href="https://pubmed.ncbi.nlm.nih.gov/19926812/">a distinct rhythm</a>.</p> <p>There’s minimal activity in the night. The deeper and more restful our sleep, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677652">fewer</a> of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=565&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=565&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/597362/original/file-20240530-21-v2gvrq.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=565&amp;fit=crop&amp;dpr=3 2262w" alt="Diagram of digestive system including colon and rectum" /></a><figcaption><span class="caption">Your lower gut is a muscular tube that contracts more strongly at certain times of day.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/illustration-healthcare-medical-education-drawing-chart-1984316789">Vectomart/Shutterstock</a></span></figcaption></figure> <p>But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.</p> <p>One particular type of colon contraction partly controlled by our internal clock are known as “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1411356/">mass movements</a>”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.</p> <p>Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “<a href="https://www.ncbi.nlm.nih.gov/books/NBK549888/">gastrocolic reflex</a>”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.</p> <p>Then there’s our morning coffee. This is a very <a href="https://pubmed.ncbi.nlm.nih.gov/2338272/">powerful stimulant</a> of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.</p> <h2>How important are morning poos?</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1846921/pdf/brmedj02601-0041.pdf">Large international</a> <a href="https://pubmed.ncbi.nlm.nih.gov/20205503/">surveys</a> show the vast majority of people will poo between three times a day and three times a week.</p> <p>This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.</p> <p>So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions <em>do not</em> have to occur once a day in the morning.</p> <p>Morning poos are also not a good thing for everyone. <a href="https://gut.bmj.com/content/61/Suppl_2/A318.1">Some people</a> with <a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">irritable bowel syndrome</a> feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.</p> <h2>Can you train yourself to be regular?</h2> <p>Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast <a href="https://www.ncbi.nlm.nih.gov/books/NBK549888/">to relieve symptoms</a>. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.</p> <p>A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147411/">evenings</a>. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.</p> <p>Regular physical activity and avoiding <a href="https://pubmed.ncbi.nlm.nih.gov/2787735/">sitting down a lot</a> are also important in <a href="https://pubmed.ncbi.nlm.nih.gov/16028436/">stimulating bowel movements</a>, particularly in people with constipation.</p> <p>We know <a href="https://theconversation.com/nervous-tummy-why-you-might-get-the-runs-before-a-first-date-106925">stress</a> can contribute to irregular bowel habits. So minimising stress and focusing on relaxation <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193306/">can help</a> bowel habits become more regular.</p> <p>Fibre from fruits and vegetables also <a href="https://pubmed.ncbi.nlm.nih.gov/665565/">helps</a> make bowel motions more regular.</p> <p>Finally, ensuring <a href="https://theconversation.com/health-check-what-causes-constipation-114290">adequate hydration</a> helps minimise the chance of developing constipation, and helps make bowel motions more regular.</p> <h2>Monitoring your bowel habits</h2> <p>Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.</p> <p>If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.</p> <p>But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229624/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-poo-in-the-morning-a-gut-expert-explains-229624">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Why your health issues keep flaring up – and how to switch them off

<p><em>Author, </em><em>accredited Clinical Nutritionist, Functional Medicine Practitioner, Coach, Trauma Therapist &amp; PhD Scholar </em><em style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Filipa Bellette shows us how you can tap into your body's ancient wisdom and finally find relief from chronic health issues by learning to deeply listen, connect, and trust yourself.</em></p> <p>Have you been struggling with chronic health issues for years, maybe even decades? Things like fatigue, anxiety, gut issues, food sensitivities, body pain, headaches, menopausal symptoms (if you’re a woman)? You’ve probably tried everything under the sun - GP visits, lab tests, naturopaths, supplements, diets, even yoga and breath-work - but still those annoying symptoms keep coming back. Sound familiar?</p> <p><strong>My Chronic Health Story</strong></p> <p>I was there once too. I have experienced chronic “weird” health issues three times. I struggled with a mix of anxiety, insomnia, gut issues, low immunity, body pain, female hormone issues, low energy, chemical sensitivity and histamine intolerance.</p> <p>The first time was after my first baby and I resolved some of the issues with lifestyle changes - sleep, movement, wholefoods and low-tox living. It was GREAT, until baby number two came along, and all my symptoms flared back up, even though my lifestyle was dialled in. This is when I came across functional medicine, and I <a href="https://www.chrisandfilly.fm/" target="_blank" rel="noopener">became a practitioner</a> and started lab testing my own body systems and therapeutically supporting imbalances in my body with natural medicine supplements.</p> <p>This worked amazing, and I got on top of my symptoms. Until … COVID came along, and I was under a lot of stress, and all the same issues flared up again! I realised I still hadn’t addressed the deepest root-cause of my health issues, and that was the “baggage” stuck in my unconscious mind (dysfunctional unconscious core beliefs, deep-seated perfectionism, people pleasing and addictive-doing patterns, and unprocessed past distressing events), that were dysregulating my nervous system.</p> <p><strong>The Missing Piece In Healthcare</strong></p> <p>What I’ve found in the health industry as a whole, is that we have lost the ability to communicate with our bodies. You go to a GP or medical specialist and they are the expert dictating what tests to do, and what medications you need to be on. I even see this in natural medicine modalities, like <a href="https://www.chrisandfilly.fm/" target="_blank" rel="noopener">functional medicine (which I practice)</a>, where the practitioner runs some labs and creates a protocol for the patient. This is great for therapeutic support, and something I do with clients, however, it is still promoting the message that “others know best.”</p> <p>This is simply not true.</p> <p><strong>You Are The Expert of Your Body</strong></p> <p>I wholeheartedly believe that 95% of what you need to heal is already inside of you. Our bodies hold ancient wisdom, and you know inherently what is good for you, and what isn’t. The thing is, society as a whole has lost the ability to listen to and communicate with our bodies.</p> <p>I’m here to change that! In our practice we work with clients to rebuild trust with self, to learn how THEIR body communicates to THEM, and to act on the messages.</p> <p>When you act, magic happens! I have literally seen symptoms “switch off” in the moment when clients listen to their bodies and act accordingly. For example, I spoke at a business women’s conference on the Gold Coast on the weekend, and took attendees through a process to communicate with their unconscious mind through the symptoms in their bodies. One lady stood up at the end and said her chronic headache that had been hanging around for days completely disappeared (she’d even taken 4 pain-killers that morning, which didn’t budge the headache!).</p> <p>Oh my gosh, how cool! I see this again and again for myself and with our clients, how quickly chronic health issues can be resolved when you deeply listen, connect, trust and love yourself.</p> <p>I’ve seen:</p> <ul> <li>Chronic fatigue disappear over months</li> <li>Heartburn clear up in a moment</li> <li>Anxiety ease</li> <li>Chronic pain in the body switch off within days</li> <li>Brain fog lift</li> <li>Food sensitivities dissolve</li> <li>Plus so much more!</li> </ul> <p><strong>It’s Not Woo-Woo – It’s Science</strong></p> <p>If you’re someone who needs the facts, let me tell you this way of holistic healing isn’t just “woo woo” or “magic”. It’s how we’re wired as human beings.</p> <p>For example, let’s look at pain. Pain is not your enemy. As humans we have evolved for safety and survival. Pain is a primitive way our bodies have warned us of danger. You touch fire, you get burned, your brain creates a neural pathway to never touch the fire again because it hurts!</p> <p>The nervous system, too, is so important at sending you messages of safety or danger. It’s always trying to keep us safe and alive. So if it deems something unsafe - this could be your own beliefs about yourself, self-doubt, uncertainty, shame, guilt, frustration, or fears about eating certain foods, smelling perfumes, being around mould, etc – your system gets very good at creating symptoms to alert you of danger, which then leads to chronic health issues.</p> <p>When you can create the space to ask: what is unsafe? What’s the story behind the symptom? And what do you need from me, body, to feel safe and loved and to heal? Then you can finally end your state of dysregulation and body burnout.</p> <p><em>Filipa Bellette, author of Ending Body Burnout ($29.95), is an accredited Clinical Nutritionist, Functional Medicine Practitioner, Coach, Trauma Therapist &amp; PhD Scholar. She is co-founder of multi award-winning health practice Chris &amp; Filly Functional Medicine, best known for ending body burnout (for good!) in “busy” people with energy, mood &amp; gut issues. Find out more at <a href="http://www.chrisandfilly.fm/" target="_blank" rel="noopener">www.chrisandfilly.fm</a>  </em></p> <p><em>Image: Courtesy of </em><em style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Filipa Bellette</em></p>

Caring

Placeholder Content Image

Karl Stefanovic reveals real meaning behind "controversial" tattoo

<p>Karl Stefanovic has revealed the real meaning behind his own tattoo fail. </p> <p>The <em>Today</em> show host opened up about his youthful mistake during an appearance on Nova's <em>Jase & Lauren show</em>, as they were discussing unfortunate tattoos. </p> <p>Stefanovic showed off the Japanese phrase inked on his shoulder to hosts Jason Hawkins, Lauren Phillips and Clint Stanaway, and explained that he found out it was mistranslated 20 years after he got it. </p> <p>"I got this when I was at uni. Look at that bad boy!" Stefanovic said on the show.</p> <p>When asked what the tattoo was supposed to mean he answered: "Well, it's controversial, because when I got it done, I wanted to say to be real and to love, right?" </p> <p>"And then, like, 20 years later, I'm in this pool with this Japanese lady and I said 'what does this mean?' She goes, 'it doesn't mean that'," he continued. </p> <p>"And I said, well what does it mean? She goes, it means you really love yourself!"</p> <p>A clearly amused Lauren replied: "Perfect!"</p> <p>Stefanovic isn't the only star who has a tattoo with an error. Ariana Grande,  Christina Aguilera and Hayden Panettiere are some of the other famous names who have made the same mistake. </p> <p>Back in the 2000s Britney Spears also got a tattoo with the wrong translation. </p> <p>According to the New York Times, the pop star wanted the word "mysterios" written in Chinese characters on her hip, but ended up with a word that translated to "strange" instead. </p> <p><em>Images: Instagram/ Nine</em></p> <div style="box-sizing: border-box; margin: 0px; padding: 0px; border: 0px; font: inherit; vertical-align: baseline;"> <div class="ob-smartfeed-wrapper feedIdx-0" style="box-sizing: border-box; margin: 0px; padding: 0px; border: 0px; font: inherit; vertical-align: baseline;"> <div id="outbrain_widget_0" class="OUTBRAIN" style="box-sizing: border-box; margin: 0px; padding: 0px; border: 0px; font: inherit; vertical-align: baseline;" data-src="//celebrity.nine.com.au/latest/karl-stefanovic-discovered-tattoo-meaning-20-years-later/184996a1-6709-4aef-8f8e-d61ad95da58b" data-widget-id="AR_8" data-external-id="70508f2b6f72d5ccede0a8c344e8e8b2" data-ob-mark="true" data-browser="chrome" data-os="macintel" data-dynload="" data-idx="0"> <div class="ob-widget ob-feed-layout AR_8" style="box-sizing: content-box; margin: 0px; padding: 0px 3px; border: 0px; font: inherit; vertical-align: baseline; position: relative; width: auto; min-width: 0px; clear: both;"> <div class="ob-widget-header" style="box-sizing: content-box; margin: 24px 0px 14px; padding: 0px; border: 0px; font-style: inherit; font-variant: inherit; font-weight: bold; font-stretch: inherit; font-size: 18px; line-height: inherit; font-family: inherit; font-optical-sizing: inherit; font-kerning: inherit; font-feature-settings: inherit; font-variation-settings: inherit; vertical-align: baseline; color: #303030; direction: ltr; display: flex; justify-content: space-between; align-items: center;"> </div> </div> </div> </div> </div>

Body

Placeholder Content Image

Jelena Dokic hits back at body shaming trolls

<p>Jelena Dokic has hit back at body shaming trolls after revealing her dramatic weight loss. </p> <p>The former tennis player revealed that she has lost 20kgs after becoming concerned about her family's health history, and she had a message for online bullies. </p> <p>“It’s not good if you gain weight and it’s not good if you lose weight. It’s not good if you are a size zero, 10 or 18 it seems,” she wrote in the raw Instagram post on Monday. </p> <p>“So you all know I am very open and honest.</p> <p>“Whether I gain weight, lose weight, depressed, feel great, go through the good or the bad, I am always honest about both sides.</p> <p>“So I thought I would just quickly address my recent weight loss because a few people have written to me and also commented.</p> <p>“So, I have lost 20 kilos from my heaviest weight last year.</p> <p>“I had some health issues but also I just wanted to get healthier and fitter and when I turned 40 last year, I really started to think about my family history of diabetes, high blood pressure and heart problems.</p> <p>“Also, my work has increased dramatically and I needed to be fitter both physically and mentally and have more energy.</p> <p>“I didn’t have enough energy especially mentally to keep up. I needed to eat healthier to achieve that.</p> <p>“So, I didn’t focus on weight so much but just making better choices to feel my best.</p> <p>“With that the weight started coming off.”</p> <p>While she has previously faced people bullying her over her weight gain, she revealed that she's also been copping flak for losing weight, with some shaming her saying that: "I have succumbed to the ‘diet culture’ and don’t represent the plus size people anymore."</p> <p>"Please don’t even go there,” she said. </p> <p>She added that she will always stand up for people no matter their size, especially women. </p> <p>“It was always about not judging, shaming and bullying people no matter what their weight and size is and instead highlighting that kindness is what matters, not our size.</p> <p>“So, while I have lost 20 kilos it changes nothing.</p> <p>“I still want people to value me and others based on whether we are kind and good people.</p> <p>“I will always be proud of myself and not hide or be embarrassed no matter what size I am. And I will always be against body shaming and against valuing people based on their size and weight no matter if I gain or lose some kilos and dress sizes.</p> <p>“Always against body shaming no matter what.”</p> <p>Her post has already received over 45,000 likes and 3,000 comments, with many praising her for speaking up. </p> <p>“Keep well Jelena, don’t listen to the noise, you will never please everyone. Just keep doing the amazing work you do, love your commentary,” wrote one follower. </p> <p><em>Images: Instagram</em></p>

Body

Placeholder Content Image

What are compound exercises and why are they good for you?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mandy-hagstrom-1180806">Mandy Hagstrom</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/anurag-pandit-1534963">Anurag Pandit</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>So you’ve got yourself a gym membership or bought a set of home weights. Now what? With the sheer amount of confusing exercise advice out there, it can be hard to decide what to include in a weights routine.</p> <p>It can help to know there are broadly two types of movements in resistance training (lifting weights): compound exercises and isolation exercises.</p> <p>So what’s the difference? And what’s all this got to do with strength, speed and healthy ageing?</p> <h2>What’s the difference?</h2> <p>Compound exercises involve multiple joints and muscle groups working together.</p> <p>In a push up, for example, your shoulder and elbow joints are moving together. This targets the muscles in the chest, shoulder and triceps.</p> <p>When you do a squat, you’re using your thigh and butt muscles, your back, and even the muscles in your core.</p> <p>It can help to think about compound movements by grouping them by primary movement patterns.</p> <p>For example, some lower body compound exercises follow a “squat pattern”. Examples include bodyweight squats, weighted squats, lunges and split squats.</p> <p>We also have “hinge patterns”, where you hinge from a point on your body (such as the hips). Examples include deadlifts, hip thrusts and kettle bell swings.</p> <p>Upper body compounded exercises can be grouped into “push patterns” (such as vertical barbell lifts) or “pull patterns” (such as weighted rows, chin ups or lat pull downs, which is where you use a pulley system machine to lift weights by pulling a bar downwards).</p> <p>In contrast, isolation exercises are movements that occur at a single joint.</p> <p>For instance, bicep curls only require movement at the elbow joint and work your bicep muscles. Tricep extensions and lateral raises are other examples of isolation exercises.</p> <h2>Compound exercises can make daily life easier</h2> <p>Many compound exercises mimic movements we do every day.</p> <p>Hinge patterns mimic picking something off the floor. A vertical press mimics putting a heavy box on a high shelf. A squat mimics standing up from the couch or getting on and off the toilet.</p> <p>That might sound ridiculous to a young, fit person (“why would I need to practise getting on and off a toilet?”).</p> <p>Unfortunately, we lose strength and muscle mass as we age. Men lose about <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2012.00260/full">5%</a> of their muscle mass per decade, while for women the figure is about <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2012.00260/full">4%</a> per decade.</p> <p>When this decline begins can vary widely. However, approximately 30% of an adult’s peak muscle mass is lost by the time they are 80.</p> <p>The good news is resistance training can counteract these <a href="https://journals.lww.com/nsca-jscr/fulltext/2019/08000/resistance_training_for_older_adults__position.1.aspx">age-related changes</a> in muscle size and strength.</p> <p>So building strength through compound exercise movements may help make daily life feel a bit easier. In fact, our ability to perform compound movements are a good indicator how well we can function <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1442-2018.2007.00317.x">as we age</a>.</p> <h2>What about strength and athletic ability?</h2> <p>Compound exercises use multiple joints, so you can generally lift heavier weights than you could with isolation exercises. Lifting a heavier weight means you can build muscle strength more efficiently.</p> <p>One <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2017.01105/full">study</a> divided a group of 36 people into two. Three times a week, one group performed isolation exercises, while the other group did compound exercises.</p> <p>After eight weeks, both groups had lost fat. But the compound exercises group saw much better results on measures of cardiovascular fitness, bench press strength, knee extension strength, and squat strength.</p> <p>If you play a sport, compound movements can also help boost athletic ability.</p> <p>Squat patterns require your hip, knee, and ankle to extend at the same time (also known as triple extension).</p> <p>Our bodies use this triple extension trick when we run, sprint, jump or change direction quickly. In fact, research has found squat strength is strongly linked to being able to <a href="https://bjsm.bmj.com/content/38/3/285.short?casa_token=hQDvLoU1GWYAAAAA:bx5DqM5HevN8AJpVLOWN5KlNKgqYubTysTvl5dqYr8855acTxNgf4QEmPELWU1hzL6HG9ZezysFQ">sprint faster and jump higher</a>.</p> <h2>Isolation exercises are still good</h2> <p>What if you’re unable to do compound movements, or you just don’t want to?</p> <p>Don’t worry, you’ll still build strength and muscle with isolation exercises.</p> <p>Isolation exercises are also typically <a href="https://www.sciencedirect.com/science/article/pii/S0079612303430033">easier to learn</a> as there is no skill required. They are an easy and low risk way to add extra exercise at the end of the workout, where you might otherwise be too tired to do more compound exercises safely and with correct form.</p> <p>In fact, both isolation and compound exercises seem to be equally effective in helping us <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2017.01105/full">lose body fat and increase fat-free muscle mass</a> when total intensity and volume of exercises are otherwise equal.</p> <p>Some people also do isolation exercises when they want to build up a particular muscle group for a certain sport or for a bodybuilding competition, for example.</p> <h2>I just want a time efficient workout</h2> <p>Considering the above factors, you could consider prioritising compound exercises if you’re:</p> <ul> <li> <p>time poor</p> </li> <li> <p>keen to lift heavier weights</p> </li> <li> <p>looking for an efficient way to train many muscles in the one workout</p> </li> <li> <p>interested in healthy ageing.</p> </li> </ul> <p>That said, most well designed workout programs will include both compound and isolation movements.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228385/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mandy-hagstrom-1180806">Mandy Hagstrom</a>, Senior Lecturer, Exercise Physiology. School of Health Sciences, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/anurag-pandit-1534963">Anurag Pandit</a>, PhD Candidate in Exercise Physiology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">original article</a>.</em></p> </div>

Body

Placeholder Content Image

COVID vaccines saved millions of lives – linking them to excess deaths is a mistake

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, <em><a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p>A recent <a href="https://bmjpublichealth.bmj.com/content/2/1/e000282">study</a> has sparked another <a href="https://nypost.com/2024/06/06/us-news/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths-since-pandemic-study/">round of</a> <a href="https://www.telegraph.co.uk/news/2024/06/04/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths/">headlines</a> <a href="https://www.gbnews.com/health/covid-vaccine-side-effects-deaths">claiming</a> that COVID vaccines caused excess deaths. This was accompanied by a predictable outpouring of <a href="https://x.com/DrAseemMalhotra/status/1797922073798717524">I-told-you-sos</a> on social media.</p> <p>Excess deaths are a measure of how many more deaths are being recorded in a country over what would have been expected based on historical trends. In the UK, and in many other countries, death rates have been higher during the years 2020 to 2023 than would have been expected based on historic trends from before the pandemic. But that has been known for some time. A couple of years ago I wrote an article for <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">The Conversation</a> pointing this out and suggesting some reasons. But has anything changed?</p> <p>The authors of the new study, published in BMJ Public Health, used publicly available data from <a href="https://ourworldindata.org/COVID-vaccinations">Our World in Data</a> to determine which countries had “statistically significant” excess deaths – in other words, excess deaths that couldn’t be explained by mere random variation.</p> <p>They studied the years 2020 to 2022 and found that many, but not all, countries did indeed report excess deaths. The authors did not try to explain why these excess deaths occurred, but the suggestion that COVID vaccines could have played a role is clear from their text – and indeed widely interpreted as such by certain newspapers.</p> <p>There is no doubt that a few deaths were associated with <a href="https://journals.sagepub.com/doi/full/10.1177/25166026211053485">the COVID vaccines</a>, but could the vaccination programme explain the large number of excess deaths – 3 million in 47 countries – that have been reported?</p> <p>Based on <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">death certificates</a>, during 2020 and 2021 there were more deaths from COVID than estimated excess deaths in the UK. So during the year 2021 when most vaccine doses were administered, there were actually fewer non-COVID deaths than would have been expected. It was only in 2022 that excess deaths <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathregistrationsummarystatisticsenglandandwales/2022">exceeded COVID deaths</a>.</p> <p>If the vaccination campaign was contributing to the excess deaths that we have seen in recent years, then we should expect to see more deaths in people who have been vaccinated than in those who have not. The most reliable analysis in this regard was done by the UK’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">Office for National Statistics (ONS)</a>. In this analysis, the ONS matched death registrations with the vaccine histories of each death recorded. They then calculated “age-standardised death rates” to account for age differences between those vaccinated and those not.</p> <p>What the ONS found was that in all months from April 2021 to May 2023, the death rate <a href="https://www.ons.gov.uk/redir/eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJpbmRleCI6MSwicGFnZVNpemUiOjEwLCJwYWdlIjoxLCJ1cmkiOiIvcGVvcGxlcG9wdWxhdGlvbmFuZGNvbW11bml0eS9iaXJ0aHNkZWF0aHNhbmRtYXJyaWFnZXMvZGVhdGhzL2RhdGFzZXRzL2V4Y2Vzc2RlYXRoc2luZW5nbGFuZGFuZHdhbGVzIiwibGlzdFR5cGUiOiJyZWxhdGVkZGF0YSJ9.Cot-XDe8Rr07paGllBNnVVz1nTqnXfVafn2woA3tk0c">from all causes was higher</a> in the unvaccinated than in people who had been vaccinated at least once.</p> <p>That deaths from all causes were lower in the vaccinated than the unvaccinated should come as no surprise given that COVID was a major cause of death in 2021 and 2022. And there is ample evidence of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492612/">protective effect of vaccines</a> against severe COVID and death. But what is even more convincing is that, even when known COVID deaths were excluded in the ONS report, the death rate in the unvaccinated was still higher, albeit not by very much in more recent months.</p> <p>Some COVID deaths would certainly not have been recognised as such. But, on the other hand, people with chronic conditions, such as diabetes, were a high priority for vaccination. And these people would have been at increased risk of death even before the pandemic.</p> <h2>Possible causes</h2> <p>If the vaccine is not the cause of the excess deaths, what was?</p> <p>The major cause of the excess deaths reported in the first two years of the BMJ Public Health study was deaths from COVID. But by 2022, excess deaths exceeded COVID deaths in many countries.</p> <p>Possible <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">explanations</a> for these excess deaths include longer-term effects of earlier COVID infections, the return of infections such as influenza that had been suppressed during the COVID control measures, adverse effects of lockdowns on physical and mental health, and delays in the diagnosis of life-threatening infections as health services struggled to cope with the pandemic and its aftermath.</p> <p>We do need to look very carefully at how the pandemic was managed. There is still considerable debate about the effectiveness of different behavioural control measures, such as self-isolation and lockdowns. Even when such interventions were effective at reducing transmission of COVID, what were the harms and were the gains worth the harms? Nevertheless, we can be confident that the excess deaths seen in recent years were not a consequence of the vaccination campaign.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231776/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/covid-vaccines-saved-millions-of-lives-linking-them-to-excess-deaths-is-a-mistake-231776">original article</a>.</em></p> </div>

Body

Placeholder Content Image

1 in 5 deaths are caused by heart disease, but what else are Australians dying from?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/garry-jennings-5307">Garry Jennings</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Nobody dies in good health, at least in their final moments. But to think the causes of death are easy to count or that there is generally a single reason somebody passes is an oversimplification.</p> <p>In fact, in 2022, four out of five Australians had multiple conditions at the time of death listed on their death certificate, and almost one-quarter had five or more recorded. This is one of many key findings from a <a href="https://pp.aihw.gov.au/reports/life-expectancy-deaths/what-do-australians-die-from/contents/about">new report</a> from the Australian Institute of Health and Welfare (AIHW).</p> <p>The report distinguishes between three types of causes of death – underlying, direct, and contributory. An underlying cause is the condition that initiates the chain of events leading to death, such as having coronary heart disease. The direct cause of death is what the person died from (rather than with), like a heart attack. Contributory causes are things that significantly contributed to the chain of events leading to death but are not directly involved, like having high blood pressure. The report also tracks how these three types of causes can overlap in deaths involving multiple causes.</p> <p>In 2022 the top five conditions involved in deaths in Australia were coronary heart disease (20% of deaths), dementia (18%), hypertension, or high blood pressure (12%), cerebrovascular disease such as stroke (11.5%), and diabetes (11.4%).</p> <hr /> <p><iframe id="MzQHA" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/MzQHA/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>When the underlying cause of death was examined, the list was similar (coronary heart disease 10%, dementia 9%, cerebrovascular disease 5%, followed by COVID and lung cancer, each 5%). This means coronary heart disease was not just lurking at the time of death but also the major underlying cause.</p> <p>The direct cause of death however was most often a lower respiratory condition (8%), cardiac or respiratory arrest (6.5%), sepsis (6%), pneumonitis, or lung inflammation (4%) or hypertension (4%).</p> <h2>Why is this important?</h2> <p>Without looking at all the contributing causes of death, the role of important factors such as coronary heart disease, sepsis, depression, high blood pressure and alcohol use can be underestimated.</p> <p>Even more importantly, the various causes draw attention to the areas where we should be focusing public health prevention. The report also helps us understand which groups to focus on for prevention and health care. For example, the number one cause of death in women was dementia, whereas in men it was coronary heart disease.</p> <hr /> <p><iframe id="NosVz" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/NosVz/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>People aged under 55 tended to die from external events such as accidents and violence, whereas older people died against a background of chronic disease.</p> <hr /> <p><iframe id="1l3OS" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/1l3OS/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>We cannot prevent death, but we can prevent many diseases and injuries. And this report highlights that many of these causes of death, both for younger Australians and older, are preventable. The top five conditions involved in death (coronary heart disease, dementia, hypertension, cerebrovascular disease and diabetes) all share common risk factors such as tobacco use, high cholesterol, poor nutrition, physical inactivity, or are risk factors themselves, like hypertension or diabetes.</p> <hr /> <p><iframe id="7Eb8O" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/7Eb8O/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>Tobacco use, high blood pressure, being overweight or obese and poor diet were attributable to a combined 44% of all deaths in this report. This suggests a comprehensive approach to health promotion, disease prevention and management is needed.</p> <hr /> <p><iframe id="2MmGg" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/2MmGg/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>This should include strategies and programs encouraging eating a healthy diet, participating in regular physical activity, limiting or eliminating alcohol consumption, quitting smoking, and seeing a doctor for regular health screenings, such as the Medicare-funded <a href="https://www.heartfoundation.org.au/your-heart/heart-health-checks">Heart Health Checks</a>. Programs directed at accident prevention, mental health and violence, especially gender-related violence, will address untimely deaths in the young.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231598/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/garry-jennings-5307"><em>Garry Jennings</em></a><em>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/1-in-5-deaths-are-caused-by-heart-disease-but-what-else-are-australians-dying-from-231598">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Millions of older people don’t get enough nutrients – how to spot it and what to do about it

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a></em></p> <p>By 2050, approximately a quarter of the UK population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/january2021">expected to be over the age of 65</a>. With this in mind, the World Health Organization (WHO) has put “<a href="https://cdn.who.int/media/docs/default-source/decade-of-healthy-ageing/decade-proposal-final-apr2020-en.pdf?sfvrsn=b4b75ebc_28">healthy ageing</a>” on its agenda. This means finding ways to maintain health, wellbeing and functional ability in order to have a good quality of life and enjoy the later years.</p> <p>Everyone ages at a different rate – but there are some things that can influence how well we age, such as by making changes to the types of activity we do and the foods we eat.</p> <p>Older adults are <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/research-report-2019--one-step-at-a-time.pdf">generally less physically active</a> than they were when they were younger and because of this, their energy intake requirement may decrease. However, there is a difference between energy requirements and nutrient requirements, and nutrient requirements actually remain the same, if not increase, as we get older.</p> <p>This means we need to get more nutrients into less energy which can be tricky as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/#:%7E:text=The%20physiological%20changes%20that%20occur,can%20contribute%20to%20declining%20appetite.">older adults often have lower appetites</a>. This is why <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971894/">scientists suggest</a> that it may be necessary to enrich the food of older people to maintain the nutrient intake.</p> <h2>How to spot when someone isn’t eating enough?</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399049/">Several studies have shown</a> that undernutrition affects one in ten older people living independently at home. However, it affects five in ten older people living in nursing homes, and seven in ten older people in hospital.</p> <p>Being overweight, even obese, <a href="https://link.springer.com/article/10.1007/s40520-023-02650-1">does not protect</a> against undernutrition. And when older adults lose weight, they lose muscle, meaning that they are more likely to lose their <a href="https://www.frontiersin.org/articles/10.3389/fnut.2022.892675/full?&amp;utm_source=Email_to_authors_&amp;utm_medium=Email&amp;utm_content=T1_11.5e1_author&amp;utm_campaign=Email_publication&amp;field=&amp;journalName=Frontiers_in_Nutrition&amp;id=892675">abilities to do daily tasks</a>.</p> <p>Weight loss in older adults is a key sign of malnutrition that needs to be addressed – but it can be easily missed, especially when many older adults associate the idea of thinness <a href="https://www.sciencedirect.com/science/article/pii/S0195666319307603?casa_token=iU5UIdNwGDgAAAAA:I81EKDJ2T0oBsOsZunpPBk6uI-TcgiCr-5gPJE1tz4-Tq3w8pK4Yi_mv22AhVHHpRpiv1Bvz0RI">with good health</a>. But clothing that’s too loose or a watchstrap that floats on the wrist are all warning signs of undernourishment.</p> <p>Similarly, if someone you care for has started to say things like, “Oh, I don’t want much food today, I’m not hungry”, “I’m not hungry, it’s natural, I’m getting older”, or “I’d rather just have a biscuit to be honest,” then these could be warning signs. An effective way to keep on top of this is regular weighing at least once per month which enables a quick response to potential indicators of malnutrition.</p> <h2>Getting more nutrients into less food</h2> <p>If people are eating small amounts of food, it is important to think about how to add more nutrients into it. A very effective technique, “fortification” is commonly done with pre-made products such as breakfast cereals, plant-based milk and bread in the UK.</p> <p>Fortification (adding foods, ingredients or nutrients into to existing foods or meals) is easy to do at home as well and can provide a flexible approach for older adults as it allows them to continue eating the foods that they most enjoy.</p> <figure><iframe src="https://www.youtube.com/embed/kNu8auu3fuU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>For older adults in particular, protein is a very important nutrient, because of muscle loss (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/#:%7E:text=Sarcopenia%20has%20been%20defined%20as,decade%20of%20life%20%5B1%5D.">sarcopenia)</a> which is a natural part of ageing. This could be slowed down or even reversed by <a href="https://www.medicalnewstoday.com/articles/could-a-higher-protein-intake-lead-to-healthier-eating">eating enough protein</a> at regular intervals throughout the day. A few ways to increase protein include:</p> <p>• Adding dairy ingredients such as milk, high-protein yoghurt, Quark (soft cheese), milk powders, eggs and cheese into meals – even into simple foods like mashed potato.</p> <p>• Nuts are a great source of protein, try adding ground almonds to savoury or sweet meals (beware of nut allergies).</p> <p>• Soy protein can be a convenient and cost-effective option, either for vegetarians or to further fortify minced-meat meals.</p> <p>• Look in the sports section of supermarkets to find <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/whey-powder#:%7E:text=Whey%20powders%20are%20characterized%20as,of%20products%20obtained%20from%20milk.">whey protein</a> powders. These are marketed to gym enthusiasts, but actually whey is one of the <a href="https://www.mdpi.com/2072-6643/15/15/3424">best proteins to stimulate muscle growth</a>. This versatile ingredient can be mixed into porridge before cooking or used it as a substitute for other powdered ingredients in baking.</p> <h2>Importance of physical activity and strength exercises</h2> <p>Physical activity and nutrition go hand-in-hand – both are equally important. As we age, being physically active becomes <a href="https://link.springer.com/article/10.1007/s12603-021-1665-8?fbclid=IwAR3dJkeHjgcSrR9Xq5kBfN-HLrbpli8WcAnz7AeY5Nu9XcGCHEB07Sd2z1w">even more essential</a> as it helps to prevent disease, maintains independence, decreases risk of falls, improves cognitive function, mental health and sleep.</p> <p>Exercise can also <a href="https://academic.oup.com/ageing/article/48/4/476/5423796?login=false">combat isolation and loneliness</a> which has also been <a href="https://www.bda.uk.com/resource/loneliness-and-malnutrition.html">linked to decreased appetite</a> in older adults. Often strength training gets ignored when we think of being active but to keep independence and prevent falls, older adults should do varied physical activity that emphasises balance and strength training at moderate or greater intensity on three or more days a week.</p> <p>Ultimately, it’s essential to contact a doctor or dietician with any worries or concerns about malnutrition or unintentional weight loss. There are, however, <a href="https://www.futurelearn.com/courses/ageing-well-nutrition-and-exercise-for-older-adults">some excellent resources</a> to learn more about ageing healthily and maintaining a good quality of life in later years.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221380/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, Senior Lecturer in Human Nutrition, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, Sensory and Consumer Scientist, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/millions-of-older-people-dont-get-enough-nutrients-how-to-spot-it-and-what-to-do-about-it-221380">original article</a>.</em></p> </div>

Body

Placeholder Content Image

"I'm a prisoner in my own body": Rob Burrow's heartbreaking last message

<p>An emotional final message from rugby legend Rob Burrow has been released in the days after his death. </p> <p>The former footballer <a href="https://oversixty.com.au/health/caring/rugby-league-hero-dies-at-just-41" target="_blank" rel="noopener">died</a> at the age of 41 on Sunday after a lengthy battle with motor neurone disease, with his former club, the Leeds Rhinos, sharing the news of his passing. </p> <p>Before he died, Burrow was involved in the making of a documentary about his life by the BBC, titled <em>There's Only One Burrow</em>, only agreeing to appear in the program on the condition it only be used after his death.</p> <p>In the documentary, Burrow spoke of how the cruel disease impacted his life and how he hoped to raise awareness for MND research.</p> <p>"I want to live in a world free of MND. By the time you watch this I will no longer be here," he said in the video.</p> <p>"In a world full of adversity, we must still dare to dream. I'm just a lad from Yorkshire who got to live out his dream of playing rugby league."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by BBC SPORT (@bbcsport)</a></p> </div> </blockquote> <p>His pre-recorded final words were shown to his friends and family on screen, reacting to his words.</p> <p>"I'm a fighter, to be honest. I might not be able to tackle MND but I'll certainly be swinging, I'm not going to give in, not until my last breath," he said.</p> <p>"I'm a prisoner in my own body, that's the way MND gets you. The lights are on but no one is home."</p> <p>Recalling his diagnosis, he said, "My family told me I was slurring my speech a bit but I didn't take notice or believe them."</p> <p>In an emotional segment of the widow, Burrow's wife Lindsey spoke of how she learnt of her husband's devastating disease.</p> <p>"I remember that moment being told it's not good news. Asking how long and them saying two years. Rob said 'thank god it's me and not the kids'. That's all he was bothered about," she recalled.</p> <p>When asked about his children, Burrow became emotional, saying, "I had no idea how my family would cope. They've become a beacon of hope for families in the same situation as ours." </p> <p>"I have had such a great life. I have been gifted with the most incredible wife and three children. I hope they know how much I love them."</p> <p>Burrows finishes the piece, saying. "As a father of three young children, I would never want someone to go through this."</p> <p>"I hope I have left a mark on this disease. I hope you choose to live in the moment. I hope you find inspiration."</p> <p>"My final message to you is whatever your personal battle to be brave and face it."</p> <p>"Every single day is precious. Don't waste a moment. In a world full of adversity we must still dare to dream. Rob Burrow over and out."</p> <p><em>Image credits: BBC</em></p>

Caring

Placeholder Content Image

Weight loss: drinking a gallon of water a day probably won’t help you lose weight

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p>It’s often claimed that if you’re trying to lose weight, one of the things you should do each day is drink plenty of water – with some internet advice even suggesting this should be as much as a gallon (about 4.5 litres). The claim is that water helps burn calories and reduce appetite, which in turn leads to weight loss.</p> <p>But while we all might wish it was this easy to lose weight, unfortunately there’s little evidence to back up these claims.</p> <h2>Myth 1: water helps burn calories</h2> <p>One <a href="https://pubmed.ncbi.nlm.nih.gov/14671205/">small study</a>, of 14 young adults, found drinking 500ml of water increased resting energy expenditure (the amount of calories our body burns before exercise) by about 24%.</p> <p>While this may sound great, this effect only lasted an hour. And this wouldn’t translate to a big difference at all. For an average 70kg adult, they would only use an additional 20 calories – a quarter of a biscuit – for every 500ml of water they drank.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/16822824/">Another study</a> of eight young adults only saw an increase in energy expenditure when the water was fridge cold – reporting a very modest 4% increase in calories burned. This may be because the body needs to use more energy in order to bring the water up to body temperature, or because it requires more energy for the body to filter the increased volume of fluid through the kidneys. And again, this effect was only seen for about an hour.</p> <p>So although scientifically it might be possible, the actual net increase in calories burned is tiny. For example, even if you drank an extra 1.5l of water per day, it would save fewer calories than you’d get in a slice of bread.</p> <p>It’s also worth noting that all this research was in young healthy adults. More research is needed to see whether this effect is also seen in other groups (such as middle-aged and older adults).</p> <h2>Myth 2: water with meals reduces appetite</h2> <p>This claim again seems sensible, in that if your stomach is at least partly full of water there’s less room for food – so you end up eating less.</p> <p>A number of studies actually support this, particularly those conducted in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859815/#:%7E:text=Thus%2C%20when%20combined%20with%20a,meal%20EI%20following%20water%20ingestion.">middle-aged and older adults</a>. It’s also a reason people who are unwell or have a poor appetite are advised <a href="https://www.ageuk.org.uk/bp-assets/globalassets/salford/forms/improve-your-food-and-drink-intake.pdf">not to drink before eating</a> as it may lead to under-eating.</p> <p>But for people looking to lose weight, the science is a little less straightforward.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/17228036/">One study</a> showed middle-aged and older adults lost 2kg over a 12-week period when they drank water before meals compared with people who didn’t drink any water with their meal. Younger participants (aged 21-35) on the other hand did not lose any weight, regardless of whether they drank water before their meal or not.</p> <p>But since the study didn’t use blinding (where information which may influence participants is withheld until after the experiment is finished), it means that participants may have become aware of why they were drinking water before their meal. This may have led some participants to purposefully change how much they ate in the hopes it might increase their changes of losing weight. However, this doesn’t explain why the effect wasn’t seen in young adults, so it will be important for future studies to investigate why this is.</p> <p>The other challenge with a lot of this kind of research is that it only focuses on whether participants eat less during just one of their day’s meals after drinking water. Although this might suggest the potential to lose weight, there’s <a href="https://pubmed.ncbi.nlm.nih.gov/20736036/">very little good-quality evidence</a> showing that reducing appetite in general leads to weight loss over time.</p> <p>Perhaps this is due to our body’s biological drive to <a href="https://pubmed.ncbi.nlm.nih.gov/28193517/">maintain its size</a>. It’s for this reason that no claims can be legally made in Europe about foods which help make you <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/satietyenhancing-products-for-appetite-control-science-and-regulation-of-functional-foods-for-weight-management/E4CCAE4C90A220994FD29C27FAE7F666">feel fuller for longer</a> with <a href="https://www.gov.uk/government/publications/nutrition-and-health-claims-guidance-to-compliance-with-regulation-ec-1924-2006-on-nutrition-and-health-claims-made-on-foods/nutrition-and-health-claims-guidance-to-compliance-with-regulation-ec-19242006#section-6">reference to weight loss</a>.</p> <p>So, although there might be some appetite-dulling effects of water, it seems that it might not result in long-term weight change – and may possibly be due to making conscious changes to your diet.</p> <h2>Just water isn’t enough</h2> <p>There’s a pretty good reason why water on its own is not terribly effective at <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/eating-habits-and-appetite-control-a-psychobiological-perspective/0D0605739F5150D1A7C49420D75F3CDF">regulating appetite</a>. If it did, prehistoric humans might have starved.</p> <p>But while appetite and satiation – feeling full and not wanting to eat again – aren’t perfectly aligned with being able to <a href="https://pubmed.ncbi.nlm.nih.gov/20736036/">lose weight</a>, it might be a helpful starting point.</p> <p>Part of what helps us to feel full is our stomach. When food enters the stomach, it triggers stretch receptors that in turn lead to the release of hormones which tell us we’re full.</p> <p>But since water is a liquid, it’s rapidly emptied from our stomach – meaning it doesn’t actually fill us up. Even more interestingly, due to the <a href="https://pubmed.ncbi.nlm.nih.gov/16934271/">stomach’s shape</a>, fluids can bypass any semi-solid food content that’s being digested in the lower part of the stomach. This means that water can still be quickly emptied from the stomach. So even if it’s consumed at the end of a meal it might not necessarily extend your feelings of fullness.</p> <p>If you’re trying to eat less and lose weight, drinking excessive amounts of water may not be a great solution. But there is evidence showing when water is mixed with other substances (such as <a href="https://pubmed.ncbi.nlm.nih.gov/30166637/">fibre</a>, <a href="https://www.sciencedirect.com/science/article/pii/0031938494903034">soups</a> or vegetable sauces) this can delay how fast the stomach empties its contents – meaning you feel fuller longer.</p> <p>But while water may not help you lose weight directly, it may still aid in weight loss given it’s the healthiest drink we can choose. Swapping high-calorie drinks such as soda and alcohol for water may be an easy way of reducing the calories you consume daily, which may help with weight loss.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211311/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Lead for Evidence-Based Medicine and Nutrition, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/weight-loss-drinking-a-gallon-of-water-a-day-probably-wont-help-you-lose-weight-211311">original article</a>.</em></p> </div>

Body

Placeholder Content Image

The growing promise of cancer vaccines

<div class="copy"> <p>A cure for cancer — which is <a href="https://ourworldindata.org/grapher/burden-of-disease-by-cause" target="_blank" rel="noopener">second only to cardiovascular diseases</a> in its contribution to the global burden of disease — has long been a dream.</p> <p>While no magic bullet is yet in sight, three vaccines for particular skin and lung cancer types have advanced to the last stage of clinical trials in recent months.</p> <p>If successful, these vaccines should be available to patients in the next three to 11 years. Unlike vaccines which prevent diseases, these aim to cure them or prevent relapses.</p> <p>Cancer in every person is different because the cells in every cancerous tumour have different sets of genetic mutations. Recognising this, two of the vaccines are personalised and tailor-made for each patient. Oncologists working with pharmaceutical companies have developed these individualised neoantigen therapies.</p> <p>A vaccine typically works by training the immune cells of our body to recognise antigens – proteins from pathogens, such as viruses – against future attacks by the pathogen.</p> <p>In cancer, however, there is no external pathogen. The cells of a cancerous tumour undergo continuous mutations, some of which help them to grow much faster than normal cells while some others help them evade the body’s natural immune system. The mutated proteins in cancerous cells are called ‘neoantigens’.</p> <p>In individualised neoantigen therapy, the gene sequence of the tumour and normal blood cells are compared to identify neoantigens from each patient, and then a subset of neoantigens are chosen that are most likely to induce an immune response. The vaccine for an individual patient targets this chosen subset of neoantigens.</p> <p>These vaccines, jointly developed by pharma giants Moderna and Merck, have been shown in trials conducted so far to be significantly more effective in combination with immunotherapy than immunotherapy alone in preventing both the relapse of melanoma — a type of skin cancer — and non-small cell lung cancer after the tumours had been surgically removed.</p> <p>Following these promising results in phase II clinical trials, the vaccines are now being tested on a larger group of patients in phase III trials. The studies are expected to be complete by 2030 for <a href="https://clinicaltrials.gov/study/NCT05933577" target="_blank" rel="noopener">melanoma</a> and 2035 for <a href="https://www.clinicaltrials.gov/study/NCT06077760?intr=mRNA-4157&amp;rank=3" target="_blank" rel="noopener">lung cancer</a>.</p> <p>The Moderna-Merck cancer vaccine may not be the first to reach the market. The French company OSE Immunotherapeutics <a href="https://www.clinicaltrialsarena.com/news/ose-shares-pipeline-updates-with-plans-phase-iii-trial-for-tedopi/" target="_blank" rel="noopener">published positive results</a> last September from phase III clinical trials of a vaccine using a different approach for advanced non-small cell lung cancer. Its vaccine, Tedopi, is scheduled to start <a href="https://finance.yahoo.com/news/ose-immunotherapeutics-receives-8-4-160000694.html?guccounter=1&amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&amp;guce_referrer_sig=AQAAADAX7Kqu7RTAEowvwOw2f-2cJ7SJ4uLpvjH-3tXzGtifqidaZfPs4eHLz23UqqjHDPjbVE1Vwel5qIKzKbmWvPLfLQzzH_PvKJAMsqTHuz8p5nPoR39RbIToLShEUG53eOeDFg6pWlRc2JPqrX7sGnc3ByO9FFfqXQYpZ4FZ-jgr" target="_blank" rel="noopener">confirmatory trials</a> – which are the last step before regulatory approval – later this year and may be available by 2027.</p> <p>Vaccines for pancreatic cancer being developed by BioNTech and Genentech, and for colon cancer by Gritstone, are also showing promising results in the early phases of clinical trials. Like the vaccines being developed by Moderna and Merck, these too are individualised neoantigen therapies based on messenger RNA (mRNA).</p> <p>There is another kind of RNA therapy also under development that uses small interfering RNA (siRNA) and microRNA (miRNA). Since 2018, six siRNA-based therapies have been approved by the US Food and Drug Administration for the treatment of neural, skin, heart and renal diseases. Several more siRNA drugs are at various clinical trial stages for different types of cancer and a diverse range of other diseases.</p> <p>Within cells, there are two kinds of nucleic acid molecules that contain coded information vital to life: DNA and RNA. While DNA contains genetic information, mRNA — one among the different types of RNA — carries the codes for the proteins. In addition, there are also non-coding RNA, some of which are functionally important. siRNA and miRNA are examples of such non-coding RNA.</p> <p>The RNA vaccine for an individualised neoantigen therapy is a cocktail of mRNA carrying the codes for neoantigens — the mutated fingerprint proteins in cancerous cells. For the <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">Moderna-Merck study</a>, scientists identified 34 neoantigens per patient. They delivered the corresponding mRNA vaccine cocktail packed in lipid nanoparticles, just like the mRNA vaccines for COVID-19 developed by Moderna and Pfizer-BioNTech.</p> <p>When the vaccine is delivered after removing the tumour, it trains the immune system to recognise neoantigens and fight back against the cancer returning. Usually, the body’s natural immune system corrects mutations and prevents us from having cancers. However, in some cases this natural immune response is insufficient, leading to tumour growth. In individualised neoantigen therapy, these mutations in the tumour cells are used for vaccine development and for training the immune system to fight back against relapse after removal of the tumour.</p> <p>Recent advances in artificial intelligence are helping identify potential neoantigens and manage personalised therapies. Firstly, gene sequencing of tumours and normal blood cells of a patient and their comparison produces a huge amount of data. AI is used to find the genetic mutations of the patient’s cancer in such ‘big data’. Moreover, individualised therapy requires timely production and delivery of vaccines that are different for each patient. AI is also useful in the management of such data.</p> <p>The individualised nature of the treatment is probably why it has been <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">more effective in trials</a> than previous, unsuccessful RNA vaccine candidates. However, this personalisation is also likely to raise challenges for the timely and cost-effective delivery of treatment to populations around the world.</p> <p>The siRNA and miRNA treatments work in a way opposite to mRNA. While each mRNA in a vaccine carries the code for producing a protein from a pathogen (antigen) or tumour (neoantigen) to train our immune systems against future attacks by the pathogen or tumour, siRNA directly targets the mRNA of the antigen or neoantigen and terminates the production of the protein it codes. Thus, the effect of a siRNA is more direct and immediate (like a drug), rather than a protection against future attacks (like a vaccine).</p> <p>Discovered at the turn of this millennium, siRNA-based therapeutics attracted immediate attention, but their initial success was limited due to their inherent low stability, difficulties in delivering them to desired locations, and rapid clearance from the bloodstream. However, in recent years, siRNA therapies have been boosted through chemical modifications that have increased their stability and ability to be delivered to specific locations such as tumours, and improved delivery systems such as lipid nanoparticle encasings.</p> <p>These improvements led to recent successes in FDA approvals of siRNA-based therapies and further <a href="https://www.rockefeller.edu/news/35461-a-new-way-to-target-the-culprit-behind-a-deadly-liver-cancer/" target="_blank" rel="noopener">promising reports of advances</a> in the treatment of diseases including a type of liver cancer.</p> <p><em>Research scientist </em><em><strong>Dr Bidyut Sarkar</strong></em><em> is the DBT-Wellcome Trust India Alliance Intermediate Fellow in the Department of Chemistry at Shiv Nadar Institute of Eminence, Delhi NCR, India.</em></p> <p><em>Originally published under <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">Creative Commons</a> by <a href="https://360info.org/" target="_blank" rel="noopener">360info</a>™.</em></p> <p><em>Image credits: Shutterstock </em></p> <div> <p align="center"><noscript data-spai="1"><em><img decoding="async" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/12/MICROSCOPIC-TO-TELESCOPIC__Embed-graphic-720x360-1.jpg" data-spai-egr="1" width="600" alt="Buy cosmos print magazine" title="the growing promise of cancer vaccines 2"></em></noscript></p> </div> <p><em><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <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=304875&amp;title=The+growing+promise+of+cancer+vaccines" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /> <!-- End of tracking content syndication --></em></div> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/the-body/the-growing-promise-of-cancer-vaccines/">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/360info-2/">360info</a>. Originally published under Creative Commons by 360info™.</em></p> </div>

Body

Placeholder Content Image

‘Sleeping on it’ really does help and four other recent sleep research breakthroughs

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</a></em></p> <p>Twenty-six years. That is roughly <a href="https://www.nature.com/articles/s41467-022-34624-8">how much of our lives</a> are spent asleep. Scientists have been trying to explain why we spend so much time sleeping since at least the <a href="https://plato.stanford.edu/entries/alcmaeon/">ancient Greeks</a>, but pinning down the exact functions of sleep has proven to be difficult.</p> <p>During the past decade, there has been a surge of interest from researchers in the nature and function of sleep. New experimental models coupled with advances in technology and analytical techniques are giving us a deeper look inside the sleeping brain. Here are some of the biggest recent breakthroughs in the science of sleep.</p> <h2>1. We know more about lucid dreaming</h2> <p>No longer on the fringes, the neuroscientific study of dreaming has now become mainstream.</p> <p>US researchers in a 2017 study woke their participants up at regular intervals during the night and asked them what was going through their minds prior to the alarm call. Sometimes participants couldn’t recall any dreaming. The study team then looked at what was <a href="https://www.nature.com/articles/nn.4545">happening in the participant’s brain</a> moments before waking.</p> <p>Participants’ recall of dream content was associated with increased activity in the posterior hot zone, an area of the brain closely <a href="https://www.nature.com/articles/d41586-018-05097-x">linked to conscious awareness</a>. Researchers could predict the presence or absence of dream experiences by monitoring this zone in real time.</p> <p>Another exciting development in the study of dreams is research into lucid dreams, in which <a href="https://theconversation.com/the-ability-to-control-dreams-may-help-us-unravel-the-mystery-of-consciousness-52394">you are aware that</a> you are dreaming. A 2021 study established <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00059-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982221000592%3Fshowall%3Dtrue">two-way communication</a> between a dreamer and a researcher. In this experiment, participants signalled to the researcher that they were dreaming by moving their eyes in a pre-agreed pattern.</p> <p>The researcher read out maths problems (what is eight minus six?). The dreamer could respond to this question with eye movements. The dreamers were accurate, indicating they had access to high level cognitive functions. The researchers used <a href="https://www.mayoclinic.org/tests-procedures/polysomnography/about/pac-20394877">polysomnography</a>, which monitors bodily functions such as breathing and brain activity during sleep, to confirm that participants were asleep.</p> <p>These discoveries have dream researchers excited about the future of “interactive dreaming”, such as practising a skill or solving a problem in our dreams.</p> <h2>2. Our brain replays memories while we sleep</h2> <p>This year marks the centenary of the first demonstration that <a href="https://www.jstor.org/stable/1414040?origin=crossref">sleep improves our memory</a>. However, a 2023 review of recent research has shown that memories formed during the day <a href="https://portlandpress.com/emergtoplifesci/article/7/5/487/233796/Neural-reactivation-during-human-sleep">get reactivated</a> while we are sleeping. Researchers discovered this using machine learning techniques to “decode” the contents of the sleeping brain.</p> <p><a href="https://www.nature.com/articles/s41467-021-24357-5">A 2021 study</a> found that training algorithms to distinguish between different memories while awake makes it possible to see the same neural patterns re-emerge in the sleeping brain. A different study, also in 2021, found that the more times these patterns re-emerge during sleep, <a href="https://www.nature.com/articles/s41467-021-23520-2">the bigger the benefit</a> to memory.</p> <p>In other approaches, scientists have been able to reactivate certain memories by <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)31035-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219310358%3Fshowall%3Dtrue">replaying sounds</a> associated with the memory in question while the participant was asleep. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144680/">2020 meta-analysis of 91 experiments</a> found that when participants’ memory was tested after sleep they remembered more of the stimuli whose sounds were played back during sleep, compared with control stimuli whose sounds were not replayed.</p> <p>Research has also shown that sleep strengthens memory for the <a href="https://www.pnas.org/doi/10.1073/pnas.2202657119">most important aspects</a> of an experience, restructures our memories to form <a href="https://www.jneurosci.org/content/40/9/1909">more cohesive narratives</a> and helps us come up with <a href="https://journals.sagepub.com/doi/10.1177/0956797619873344">solutions to problems</a> we are stuck on. Science is showing that sleeping on it really does help.</p> <h2>3. Sleep keeps our minds healthy</h2> <p>We all know that a lack of sleep makes us feel bad. Laboratory sleep deprivation studies, where researchers keep willing participants awake throughout the night, have been combined with <a href="https://www.open.edu/openlearn/body-mind/health/health-sciences/how-fmri-works">functional MRI brain scans</a> to paint a detailed picture of the sleep-deprived brain. These studies have shown that a lack of sleep severely disrupts the <a href="https://www.nature.com/articles/nrn.2017.55">connectivity between</a> different brain networks. These changes include a breakdown of connectivity between brain regions <a href="https://link.springer.com/article/10.1007/s11682-018-9868-2">responsible for cognitive control</a>, and an amplification of those involved in <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)30761-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219307614%3Fshowall%3Dtrue">threat and emotional processing</a>.</p> <p>The consequence of this is that the sleep-deprived brain is worse at <a href="https://academic.oup.com/cercor/article/33/5/1610/6573958">learning new information</a>, <a href="https://academic.oup.com/sleep/article/44/6/zsaa289/6053003">poorer at regulating emotions</a>, and unable to <a href="https://journals.sagepub.com/doi/10.1177/2167702620951511">suppress intrusive thoughts</a>. Sleep loss may even make you less likely to <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3001733">help other people</a>. These findings may explain why poor sleep quality is so <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13930">ubiquitous in poor mental health</a>.</p> <h2>4. Sleep protects us against neurodegenerative diseases</h2> <p>Although we naturally <a href="https://www.nature.com/articles/s41467-022-34624-8">sleep less as we age</a>, mounting evidence suggests that sleep problems earlier in life <a href="https://jnnp.bmj.com/content/91/3/236">increase the risk</a> of dementia.</p> <p>The build-up of β-amyloid, a <a href="https://www.nhs.uk/conditions/alzheimers-disease/causes/">metabolic waste product</a>, is one of the mechanisms underlying Alzheimer’s disease. Recently, it has become apparent that deep, undisturbed sleep is good for <a href="https://www.science.org/doi/10.1126/sciadv.aav5447">flushing these toxins</a> out of the brain. Sleep deprivation increases the the rate of build-up of β-amyloid in parts of the brain involved in memory, <a href="https://www.pnas.org/doi/full/10.1073/pnas.1721694115">such as the hippocampus</a>. A longitudinal study published in 2020 found that sleep problems were associated with a higher rate of β-amyloid accumulation at a follow-up <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(20)31171-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982220311714%3Fshowall%3Dtrue">four years later</a>. In a different study, published in 2022, sleep parameters <a href="https://elifesciences.org/articles/78191">forecasted the rate</a> of cognitive decline in participants over the following two years.</p> <h2>5. We can engineer sleep</h2> <p>The good news is that research is developing treatments to get a better night’s sleep and boost its benefits.</p> <p>For example, the <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.14035">European Sleep Research Society</a> and the <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8986">American Academy of Sleep Medicine</a> recommend cognitive behavioural therapy for insomnia (CBT-I). <a href="https://www.cntw.nhs.uk/services/nctalkingtherapies/what-do-nc-talking-therapies-offer/cbt-i-cbt-for-insomnia/">CBT-I works by</a> identifying thoughts, feelings and behaviour that contribute to insomnia, which can then be modified to help promote sleep.</p> <p>In 2022, a CBT-I app became the <a href="https://www.nice.org.uk/news/article/nice-recommends-offering-app-based-treatment-for-people-with-insomnia-instead-of-sleeping-pills">first digital therapy</a> recommended by England’s National Institute for Health and Care Excellence for treatment on the NHS.</p> <p>These interventions can improve other aspects of our lives as well. A <a href="https://www.sciencedirect.com/science/article/pii/S1087079221001416?via%3Dihub">2021 meta-analysis</a> of 65 clinical trials found that improving sleep via CBT-I reduced symptoms of depression, anxiety, rumination and stress.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, Marie Skłodowska-Curie Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sleeping-on-it-really-does-help-and-four-other-recent-sleep-research-breakthroughs-230484">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Drinking lots of water may seem like a healthy habit – here’s when and why it can prove toxic

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>In late 2023, actor <a href="https://www.glamour.com/story/brooke-shields-recently-experienced-a-full-blown-seizure-and-bradley-cooper-came-running?utm_source=instagram&amp;utm_medium=social&amp;utm_content=instagram-bio-link&amp;client_service_id=31196&amp;client_service_name=glamour&amp;service_user_id=1.78e+16&amp;supported_service_name=instagram_publishing&amp;utm_brand=glm&amp;utm_social_type=owned">Brooke Shields</a> suffered a seizure after “flooding” her body with water. Shields became dangerously low on sodium while preparing for her show by drinking loads of water. “I flooded my system and I drowned myself,” she would later explain. “And if you don’t have enough sodium in your blood or urine or your body, you can have a seizure.”</p> <p>Shields said she found herself walking around outside for “no reason at all”, wondering: “Why am I out here?”</p> <blockquote> <p>Then I walk into the restaurant and go to the sommelier who had just taken an hour to watch my run through. That’s when everything went black. Then my hands drop to my side and I go headfirst into the wall.</p> </blockquote> <p>Shields added that she was “frothing at the mouth, totally blue, trying to swallow my tongue”.</p> <p>Like Shields, many people may be unaware of the dangers of drinking excessive amounts of water – especially because hydration is so often associated with health benefits. Models and celebrities <a href="https://www.teenvogue.com/story/drinking-water-flawless-skin#:%7E:text=If%20you're%20reading%20a,long%20hours%20at%20a%20time.">often advocate</a> drinking lots of water to help maintain clear, smooth skin. Some <a href="https://www.independent.co.uk/life-style/75-hard-challenge-before-and-after-tiktok-b2382706.html">social media influencers</a> have promoted drinking a gallon of water daily for weight loss.</p> <p>But excessive water consumption can cause <a href="https://patient.info/treatment-medication/hyponatraemia-leaflet">hyponatraemia</a> – a potentially fatal condition of low sodium in the blood.</p> <h2>Worried about hydration levels? Check your urine</h2> <p>The body strictly regulates its water content to maintain the optimum level of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323003/">total body water</a> and “osmolality” – the concentration of dissolved particles in your blood. Osmolality increases when you are dehydrated and decreases when you have too much fluid in your blood.</p> <p>Osmolality is monitored by <a href="https://pubmed.ncbi.nlm.nih.gov/9074779/">osmoreceptors</a> that regulate sodium and water balance in the hypothalamus – the part of the brain that controls numerous hormones. These osmoreceptors signal the release of antidiuretic hormone (ADH), which acts on blood vessels and the kidneys to control the amount of water and salt in the body.</p> <figure><iframe src="https://www.youtube.com/embed/Qghf7Y9ILAs?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>In healthy people, the body releases ADH when osmolality becomes high. ADH tells the kidneys to reabsorb water, which makes urine more concentrated. The reabsorbed water dilutes the blood, bringing osmolality back to normal levels.</p> <p>Low blood osmolality suppresses the release of ADH, reducing how much water the kidneys reabsorb. This dilutes your urine, which the body then passes to rid itself of the excess water.</p> <p>Healthy urine should be clear and odourless. Darker, yellower urine with a noticeable odour can indicate dehydration – although medications and certain foods, including <a href="https://pubmed.ncbi.nlm.nih.gov/3433805/">asparagus</a>, can affect urine colour and odour, too.</p> <h2>How much is too much?</h2> <p>Adults should consume <a href="https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/water-drinks-nutrition/">two-to-three litres per day</a>, of which around 20% comes from food. However, we can lose <a href="https://www.ncbi.nlm.nih.gov/books/NBK236237/">up to ten litres</a> of water through perspiration – so sweating during exercise or in hot weather increases the amount of water we need to replace through drinking.</p> <p>Some medical conditions can cause overhydration. Approximately <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616165/">one in five</a> schizophrenia patients drink water compulsively, a dangerous condition known as <a href="https://www.theguardian.com/uk-news/2024/apr/15/woman-died-mental-hospital-excessive-water-drinking-inquest#:%7E:text=Woman%20died%20at%20mental%20hospital%20after%20excessive%20water%20drinking%2C%20inquest%20told,-Parents%20of%20Lillian&amp;text=A%20woman%20collapsed%20and%20died,water%2C%20an%20inquest%20has%20heard.">psychogenic polydipsia</a>. One long-term study found that patients with psychogenic polydipsia have a <a href="https://pubmed.ncbi.nlm.nih.gov/18984069/">“74% greater chance</a> of dying before a non-polydipsic patient”.</p> <p>In <a href="https://pubmed.ncbi.nlm.nih.gov/22306188/">some cases</a>, people with <a href="https://psychiatry-psychopharmacology.com/en/childhood-and-adolescence-disorders-psychogenic-polydipsia-in-an-adolescent-with-eating-disorder-a-case-report-132438">anorexia nervosa</a> can also suffer from compulsive water drinking.</p> <figure><iframe src="https://www.youtube.com/embed/ReQew2zcN7c?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>For those suffering from polydipsia, treatment is focused on medication to reduce the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675986/">urge to drink</a>, as well as <a href="https://www.uptodate.com/contents/overview-of-the-treatment-of-hyponatremia-in-adults/print">increasing sodium levels</a>. This should be done gradually to avoid causing <a href="https://www.ncbi.nlm.nih.gov/books/NBK562251/">myelinolysis</a> – <a href="https://www.ncbi.nlm.nih.gov/books/NBK551697/">neurological damage</a> caused by rapid changes in sodium levels in nerve cells.</p> <p>In rare but often highly publicised cases such as that of <a href="http://news.bbc.co.uk/onthisday/hi/dates/stories/november/13/newsid_2516000/2516593.stm">Leah Betts</a> in 1995, some users of the illegal drug MDMA (also known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119400/">ecstasy)</a> have <a href="https://pubmed.ncbi.nlm.nih.gov/11265566/">died</a> after drinking copious amounts of water to rehydrate after dancing and sweating.</p> <p>The drug <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/">increases body temperature</a>, so users drink water to avoid overheating. Unfortunately, MDMA also triggers the <a href="https://pubmed.ncbi.nlm.nih.gov/12105115/">unnecessary release of ADH</a>, causing water retention. The body becomes unable to rid itself of excess water, which affects its electrolyte levels – causing cells to swell with water.</p> <p>Symptoms of water intoxication start with nausea, vomiting, blurred vision and dizziness. As the condition progresses, sufferers can often display symptoms of <a href="https://www.nhs.uk/mental-health/conditions/psychosis/symptoms/">psychosis</a>, such as inappropriate behaviour, confusion, delusions, disorientation and hallucinations.</p> <p>These symptoms are caused by <a href="https://www.ncbi.nlm.nih.gov/books/NBK470386/">hyponatraemia</a>, where sodium levels are diluted or depleted in blood and the subsequent imbalance of electrolytes affects the nervous system. Water begins to move into the brain causing <a href="https://www.sciencedirect.com/science/article/pii/S1572349604000149">a cerebral oedema</a> – brain swelling because of excessive fluid buildup, which is usually fatal if not treated.</p> <p>A healthy body will tell you when it needs water. If you’re thirsty and your urine is dark with a noticeable odour, then you need to drink more. If you aren’t thirsty and your urine is clear or the colour of light straw, then you’re already doing a good job of hydrating yourself.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228715/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/adam-taylor-283950"><em>Adam Taylor</em></a><em>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drinking-lots-of-water-may-seem-like-a-healthy-habit-heres-when-and-why-it-can-prove-toxic-228715">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Major update in search for Samantha Murphy's body

<p>IMPORTANT UPDATE: Police have announced a significant breakthrough in the ongoing investigation into the disappearance of Samantha Murphy, who went missing during her morning jog on February 4. In a renewed targeted search, “items of interest” have now been discovered, offering new hope in the case.</p> <p>Victoria Police, in a recent statement, revealed that the search area in Buninyong has been cordoned off as specialist police and detectives, with assistance from the Australian Federal Police (AFP), conducted an intensive search. Among the recovered items, one is reported to be a phone. However, police are withholding further details until testing is complete.</p> <p>“At this stage we are not providing further information about the items until that testing has been completed,” a police spokeswoman said. “The investigation remains ongoing. Further information will be provided once we are in a position to do so.”</p> <p>Samantha was last seen on the morning of February 4, leaving her home on Eureka Street in Ballarat East for a run in the Canadian State Forest. Despite extensive efforts, her body has not been found, and her disappearance remains a mystery.</p> <p>On Wednesday May 29, detectives from the Missing Persons Squad, along with a variety of specialist resources, began conducting a new, targeted search in the Ballarat area. In a statement, police paid special attention to the importance of this search to their ongoing investigation.</p> <p>"Police are undertaking a targeted search in the Ballarat area today as part of the investigation into the disappearance of Samantha Murphy," the statement read. "Police ask that members of the public do not attend the search at this time."</p> <p>The renewed search effort included the deployment of an excavator and other specialist equipment, in an obvious nod to the seriousness and intensity of the operation. </p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/05/Samantha_Murphy02_supplied.jpg" alt="" width="1280" height="720" /></p> <p>Since Samantha's disappearance, police have been conducting regular enquiries and smaller searches. These efforts have included the involvement of mounted officers, dog squads and motorcyclists, particularly in a targeted search of the Buninyong Bushland Reserve in March. This earlier search was based on intelligence from multiple sources, according to a police spokesperson.</p> <p>Samantha's family has been kept informed about the ongoing searches. The emotional toll on them has been immense, with the community also expressing widespread concern and support.</p> <p>The investigation took a significant turn when <a href="https://www.oversixty.com.au/finance/legal/everything-we-know-about-samantha-murphy-s-accused-killer" target="_blank" rel="noopener">Patrick Stephenson</a>, the son of former AFL player Orren Stephenson, was charged with Ms. Murphy’s murder. Police believe he acted alone in what they have described as a deliberate attack. "He has been charged with murder so, by definition, we are saying this was a deliberate attack on Samantha," Chief Commissioner Shane Patton stated in March.</p> <p>The details surrounding Samantha's disappearance have been particularly harrowing. She was reported to have left her home around 7am for a 14-kilometre run through the Woowookarung Regional Park, and police believe she reached the Mount Clear area approximately an hour later. Since then, she has neither been seen nor heard from.</p> <p>As the renewed search progresses, the hope remains that it will yield new information or evidence to bring closure to Samantha family and the Ballarat community. The commitment of the police and specialist teams to this investigation is a true testament to the importance of finding answers and achieving justice for Samantha Murphy.</p> <p><em>Images: Supplied</em></p>

Legal

Our Partners