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Will watching the Olympic Games make you eat more?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/birau-mia-1238429">Birau Mia</a>, <a href="https://theconversation.com/institutions/em-lyon-business-school-2363">EM Lyon Business School</a> and <a href="https://theconversation.com/profiles/carolina-o-c-werle-1434243">Carolina O.C. Werle</a>, <a href="https://theconversation.com/institutions/grenoble-ecole-de-management-gem-2181">Grenoble École de Management (GEM)</a></em></p> <p>Ever wondered why you reach for a snack after hitting the gym? <a href="https://joe.bioscientifica.com/downloadpdf/view/journals/joe/193/2/1930251.pdf">Research shows</a> that physical exercise often leads to increased food consumption, whether it is treating yourself for a job well done or replenishing the energy you have burned. With countless sports events airing and our screens constantly filled with sports’ competitions, a new question arises: Can watching sports on a screen also influence how much we eat?</p> <p>The answer is yes. <a href="https://www.sciencedirect.com/science/article/pii/S0950329317300915">Our research</a> co-authored with <a href="https://www.linkedin.com/in/jannine-lasaleta-94504987">Jannine Lasaleta</a> reveals that watching sports’ videos can increase candy consumption. But there is more to the story: the difficulty of the sports you are watching plays a crucial role in these effects.</p> <h2>From screens to junk food</h2> <p>We first invited 112 students to the <a href="https://www.grenoble-em.com/campus-gem-labs-grenoble">Grenoble Ecole de Management experimental lab</a> to watch a video and test some candies. Half of the students watched a video with men and women <a href="https://fr.adforum.com/creative-work/ad/player/51706/train-barefoot/nike">playing sports</a>, while the other half watched one <a href="https://www.youtube.com/watch?v=xyqR5yI6boo">without any physical activity</a>. We then gave each student a 70g cup of candy and asked them to judge its quality for three minutes. The students who saw the sports’ video ate more candy than those who saw the one without physical activity.</p> <p>Our initial test thus revealed that watching sports’ videos can boost candy consumption, but here’s the twist: male students indulged in far more candy than female students, so maybe the results were triggered by males’ consumption. Plus, we were still unsure if the type of sport watched affects the candy intake.</p> <p>To learn more, we invited just the female students to watch videos portraying either easy (light running) or difficult-to-perform sports (athletics long jump, gymnastics, baseball, rugby or rock climbing). After, the students were invited to test the same candies as before. Students who watched the <a href="https://www.youtube.com/watch?v=2SMXKGE_u-Y">easy sports video</a> (showing a woman and a man running through different landscapes) ate much more candy (30.1 grams) than those who watched the <a href="https://fr.adforum.com/creative-work/ad/player/51706/train-barefoot/nike">difficult sports video</a> (18 grams).</p> <p>We can thus conclude that the ease or difficulty of the exercise shown significantly impacts candy consumption – watching easy-to-perform sports leads to considerably higher candy intake than watching difficult ones.</p> <h2>Why is this happening?</h2> <p>To explain our findings, we looked at research on <a href="https://academic.oup.com/jcr/article-abstract/32/3/370/1867208">goal motivation</a>. When people feel they are not meeting a goal, they push harder; but once they see progress, they tend to slack off. For example, after a workout, those aiming to stay fit might feel they have made good progress and then ease up on their efforts. This can lead to a drop in motivation to pursue related goals, like healthy eating. <a href="https://psycnet.apa.org/record/2006-09808-003">Research</a> shows that achieving smaller goals (like exercising) can make people feel they have earned a break, which can result in indulging more in food. So completing a workout might make you more likely to reward yourself with extra food than if you had not finished your session. And why are women more susceptible to the phenomenon of eating more candy after watching an easy-to-perform sports video? Simply because it has been long <a href="https://phys.org/news/2005-04-women-weight-men.html">shown</a> that women are more concerned with their weight than men and therefore their dieting goals are more salient.</p> <p>Our research suggests that merely watching sports can lead to a sense of vicarious fulfilment of fitness goals. When people can picture themselves doing the activity they are watching, they feel as though they have already exercised, which can lead to more-indulgent food choices. If they perceive the exercise shown as easy rather than difficult, they can more easily imagine themselves doing it, leading to greater feelings of progress toward their fitness goals. This perceived achievement can make them feel they have earned the right to indulge and influence their search for a reward, often resulting in increased food intake.</p> <h2>So what?</h2> <p>This knowledge can be used by policymakers or marketers who aim to encourage healthful lifestyles. When promoting healthy activities by picturing physical activity that seems too easy, people may feel a greater sense of achievement that could backfire and lead to increased consumption. We suggest showing an easy exercise (like walking or jogging) followed by a tougher one (like sprinting or marathon running) as an alternative solution. This approach can motivate people to start with basic exercises while reminding that there is still a long way to go to reach their fitness goals. This strategy could offer an alternative to promote physical activity without giving a false sense of accomplishment.</p> <p>So what is the takeaway for us? Be mindful of how watching sports can affect our eating habits. If you are aiming to stay on track with your diet, watch more challenging sports – it might just help you resist that extra chocolate bar. Moreover, when setting dieting goals, remind yourself that real progress comes from consistent effort, not just imagining yourself doing a workout. Engage in activities that genuinely challenge you, and pair them with mindful eating habits. This way, you can avoid the trap of feeling the fitness goal to be prematurely accomplished and then overindulging.</p> <p>In conclusion, should you watch the Olympic games if you want to keep up with your diet? Of course, but it might be better to choose the physical activities you find the most difficult to perform – and watch them without moderation.<!-- 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/231199/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/birau-mia-1238429">Birau Mia</a>, Associate Professor of Marketing, <a href="https://theconversation.com/institutions/em-lyon-business-school-2363">EM Lyon Business School</a> and <a href="https://theconversation.com/profiles/carolina-o-c-werle-1434243">Carolina O.C. Werle</a>, Professor of marketing, <a href="https://theconversation.com/institutions/grenoble-ecole-de-management-gem-2181">Grenoble École de Management (GEM)</a></em></p> <p><em>Image </em><em>credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/will-watching-the-olympic-games-make-you-eat-more-231199">original article</a>.</em></p> </div>

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Breast cancer screening in Australia may change. Here’s what we know so far

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The way women are screened for breast cancer in Australia may <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/early-detection/breast-cancer/rosa/key-findings">change</a>.</p> <p>There’s international debate on the <a href="https://www.bmj.com/content/385/bmj.q1353">age</a> women should be invited for screening. But an even larger change being considered worldwide is whether to screen women at <a href="https://www.nature.com/articles/s41416-021-01550-3">high and low risk</a> of breast cancer differently.</p> <p>But what such a “risk-based” approach to screening might look like in Australia is not yet clear.</p> <p>Here’s why researchers and public health officials are floating a change to breast cancer screening in Australia, and what any changes might mean.</p> <h2>Why breast cancer screening may need to change</h2> <p>Mass screening (known as population-based screening) for breast cancer was introduced in Australia and many other developed countries in the 1980s and 90s.</p> <p>This was based on <a href="https://pubmed.ncbi.nlm.nih.gov/26756588/">robust research</a> that found early detection and treatment of cancers before there were symptoms prevented some women from dying from breast cancer.</p> <p>These programs offer regular breast cancer screening to women within a specific age group. For example, <a href="https://www.aihw.gov.au/reports/cancer-screening/national-cancer-screening-programs-participation/contents/breastscreen-australia">in Australia</a>, women aged 40-74 years can have free mammograms (x-rays of the breasts) every two years. The BreastScreen program sends invitations for screening to those aged 50-74.</p> <p>However, evidence has been mounting that mammography screening could be inadvertently causing <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61611-0/abstract">harm</a> for some women.</p> <p>For some, screening causes a false alarm that may cause anxiety, and unnecessary tests and procedures. Even though these tests rule out cancer, these women may remain anxious and perceive something is wrong <a href="https://bmjopen.bmj.com/content/13/4/e072188">for many years</a>.</p> <p>A more insidious harm is <a href="https://theconversation.com/five-warning-signs-of-overdiagnosis-110895">overdiagnosis</a>, where screening detects a non-growing or slow-growing lesion that looks like “cancer” under the microscope, but would not have progressed or caused harm if it had been left alone. This means some women are having unnecessary surgery, radiotherapy and hormone therapy that will not benefit them, but may harm.</p> <p>Although trials have shown screening reduces the risk of dying from breast cancer, questions are being raised about how much it <a href="https://www.bmj.com/content/352/bmj.h6080.abstract">saves lives overall</a>. That is, it’s uncertain how much the reduced risk of dying from breast cancer translates into improvements in a woman’s overall survival.</p> <h2>How about better targeting women?</h2> <p>One idea is to target screening to those most likely to benefit. Under such a “<a href="https://www.nature.com/articles/s41416-021-01550-3">risk-based</a>” approach, a women’s personal risk of breast cancer is estimated. This may be based on her age and many other factors that may include breast density, family history of breast cancer, body-mass index, genetics, age she started and stopped her periods, and the number of children she’s had.</p> <p>Women who are at higher risk would be recommended to start screening at a younger age and to screen more frequently or to use different, more sensitive, imaging tests. Women at lower risk would be recommended to start later and to screen less often.</p> <p>The idea of this more “precise” approach to screening is to direct efforts and resources towards the smaller number of women most likely to benefit from screening via the early detection of cancer.</p> <p>At the same time, this approach would reduce the risk of harm from false positives (detection of an anomaly but no cancer is present) and overdiagnosis (detection of a non-growing or slow-growing cancer) for the larger number of women who are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230256/">unlikely to benefit</a>.</p> <p>On face value this sounds like a good idea, and could be a favourable change for breast cancer screening.</p> <h2>But there’s much we don’t know</h2> <p>However, it’s uncertain how this would play out in practice. For one thing, someone’s future risk of a cancer diagnosis includes the risk of detecting both <a href="https://www.acpjournals.org/doi/10.7326/m17-2792">overdiagnosed cancers</a> as well as potentially lethal ones. This is proving to be a problem in risk-based screening for <a href="https://www.nature.com/articles/s41698-022-00266-8">prostate cancer</a>, another cancer prone to overdiagnosis.</p> <p>Ideally, we’d want to predict someone’s risk of <a href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00113-9/fulltext">potentially lethal cancers</a> as these are the ones we want to catch early.</p> <p>It is also still uncertain how many women found to be at <a href="https://pubmed.ncbi.nlm.nih.gov/31701797/">low risk</a> will accept a recommendation for <a href="https://pubmed.ncbi.nlm.nih.gov/23092125/">less screening</a>.</p> <p>These uncertainties mean we need robust evidence the benefits outweigh the harms for Australian women before we make changes to the breast cancer screening program.</p> <p>There are several international <a href="https://www.nature.com/articles/s41416-021-01550-3">randomised controlled trials</a> (the gold standard for research) under way to evaluate the effectiveness of risk-based screening compared to current practice. So it may be prudent to wait for their findings before making changes to policy or practice.</p> <p>Even if such trials did give us robust evidence, there are still a number of issues to address before implementing a risk-based approach.</p> <p>One key issue is having enough staff to run the program, including people with the skills and time to discuss with women any concerns they have about their calculated risk.</p> <h2>How about breast density?</h2> <p>Women with dense breasts are at <a href="https://www.sciencedirect.com/science/article/pii/S0960977622001618#:%7E:text=Mammographic%20density%20is%20a%20well,increased%20risk%20of%20breast%20cancer.">higher risk of breast cancer</a>. So notifying women about their breast density has been proposed as a “first step” on the pathway to risk-based screening. However, this ignores the many other factors that determine a woman’s risk of breast cancer.</p> <p>Legislation in the <a href="https://www.fda.gov/radiation-emitting-products/mammography-quality-standards-act-and-program">United States</a> and changes in some <a href="https://australianbreastcancer.org.au/news-stories/latest-news/breast-density-reporting-at-all-sa-clinics/">Australian states</a> mean some women are already being notified about their breast density. The idea is to enhance their knowledge about their breast cancer risk so they can make informed decisions about future screening.</p> <p>But this has happened before we know what the best options are for such women. An <a href="https://www.mja.com.au/journal/2023/219/9/psychosocial-outcomes-and-health-service-use-after-notifying-women-participating">ongoing Australian trial</a> is investigating the effects that breast density notification has on individual women and the health system.</p> <h2>What next?</h2> <p>Robust evidence and careful planning are needed before risk-based screening or other changes are made to Australia’s breast cancer screening program.</p> <p>Where changes are made, there needs to be early evaluation of both the <a href="https://www.bmj.com/content/350/bmj.h1566.abstract">benefits and harms</a>. Programs also need <a href="https://www.bmj.com/content/374/bmj.n2049.long">independent, regular re-evaluation</a> in the longer term.<!-- 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/231917/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/brooke-nickel-200747">Brooke Nickel</a>, NHMRC Emerging Leader Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, Professor in Clinical Epidemiology, Sydney School of Public Health, <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/breast-cancer-screening-in-australia-may-change-heres-what-we-know-so-far-231917">original article</a>.</em></p> </div>

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Is an electric bike right for you? Here’s what to consider before you buy

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/muhammad-rizwan-azhar-1472288">Muhammad Rizwan Azhar</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> and <a href="https://theconversation.com/profiles/waqas-uzair-1486684">Waqas Uzair</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><a href="https://www.theguardian.com/australia-news/2023/oct/08/its-also-just-fun-why-a-growing-number-of-australia-families-are-ditching-cars-for-e-bikes">More Australians than ever</a> are riding electric bikes – a fact you may have noticed on the streets of our cities and towns.</p> <p>Electric bikes, or e-bikes, are typically equipped with an electric motor and a battery, providing power to help you pedal. Some allow you to boost and lower the amount of pedalling assistance you get.</p> <p>Globally, the transport sector produces <a href="https://www.un.org/sites/un2.un.org/files/media_gstc/FACT_SHEET_Climate_Change.pdf">about one-quarter</a> of greenhouse gas emissions. Finding cleaner ways to get around is vital to combating the climate crisis. E-bikes also offer solutions to the problems of traffic congestion, fuel costs and sedentary lifestyles.</p> <p>But is an electric bike right for you? Below, we discuss the pros and cons, to help you decide.</p> <h2>The pros</h2> <p><strong>– Reduce carbon emissions</strong></p> <p>In developed countries, transport can be one of the largest proportions of an individual’s carbon footprint. But you can <a href="https://sustainability.anu.edu.au/options-for-owning-an-e-bike">reduce your travel emissions</a> by 75% if you replace car use with an e-bike for short trips such as the work commute.</p> <p><a href="https://www.creds.ac.uk/publications/e-bike-carbon-savings-how-much-and-where/">Research has found</a> e-bikes, if used to replace cars, could cut carbon dioxide (CO₂) emissions by up to 50% in England – or about 30 million tonnes a year. Other analysis showed the potential was <a href="https://www.sciencedirect.com/science/article/pii/S0967070X21003401">greatest</a> in rural areas.</p> <p><strong>– Connect with your community</strong></p> <p>The “car-rification” of our cities changed community dynamics. Retail became concentrated in <a href="https://www.sciencedirect.com/science/article/abs/pii/S0264837716312479">out-of-town shopping centres</a>, leading to a decline in smaller town centres. This provided fewer opportunities to meet our neighbours and has contributed to high rates of <a href="https://www.vox.com/features/23191527/urban-planning-friendship-houston-cars-loneliness">loneliness and social isolation</a>.</p> <p>Similar to <a href="https://www.researchgate.net/publication/308794595_From_Pedal_to_People_The_Social_Effects_of_Biking">regular cycling</a>, riding e-bikes helps create community bonds. It makes us more likely to engage with our surroundings and interact with people around us. You can even join an <a href="https://www.meetup.com/topics/electric-bicycles/au/">e-bike group</a> or community ride.</p> <p><strong>– Save money</strong></p> <p>E-bikes offer substantial long-term financial benefits to owners.</p> <p>In Australia, an e-bike costs from about A$1,000 to more than $5,000. An annual e-bike service will set you back <a href="https://www.choice.com.au/transport/bikes/electric/articles/how-to-maintain-your-electric-bike#:%7E:text=How%20much%20does%20an%20e,%24300%2C%20depending%20on%20what's%20included.">between $100 and $300</a>. And retailers <a href="https://crooze.com.au/blogs/news/the-costs-of-owning-an-ebike#:%7E:text=This%20means%20it%20costs%20roughly,electricity%20charges%20per%2030kms%20ridden.">currently</a> <a href="https://www.glowwormbicycles.com.au/blogs/electric-bikes/how-much-should-i-spend-on-an-e-bike">put the cost</a> of a full battery charge at 10–15 cents, translating to roughly $20 per year for an average commuter.</p> <p>Cars, of course, cost far more to run. For example, Victorian motoring body RACV <a href="https://www.racv.com.au/about-racv/newsroom/victorias-cheapest-cars-2023.html">last year found</a> the state’s cheapest car to own and operate was the MG3 Core light Hatch, with monthly costs of $734.84. Even taking into account charging costs and maintenance, you can see how quickly an e-bike would pay for itself.</p> <p><strong>– Get active</strong></p> <p>E-bikes are clearly better for your health than riding in a car.</p> <p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790588/">2019 study investigated</a> e‐bike commuting for inactive, overweight people living in regional Australia. It found e-bike users increased their physical activity by an average 90 minutes a week.</p> <p>A <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/sms.14155">literature review in 2022</a> found e-biking was a moderately intense physical activity on measures such as energy expenditure, heart rate and oxygen consumption. The benefits were lower than conventional cycling, but generally greater than walking.</p> <p>Women, in particular, have reported benefits from e-bike use. A <a href="https://activetravelstudies.org/article/id/991/">New Zealand study</a> showed e-bikes provided less fit women with “more empowering physical activity experiences” and increased their cycling confidence.</p> <h2>The cons</h2> <p><strong>– Safety challenges</strong></p> <p>Like any form of mobility, e-bikes must be used safely. Concerns around e-bikes include <a href="https://www.abc.net.au/news/2023-09-13/fat-bike-boom-in-sydney-sparks-safety-fears/102823330">speeding</a>, <a href="https://www.nbcnews.com/nightly-news/video/concerns-grow-over-safety-of-e-bikes-amid-reports-of-accidents-192619077845">accidents</a> and people riding <a href="https://www.nbnnews.com.au/2024/03/20/e-bike-safety-concerns-spark-in-lennox-head/">without helmets</a>.</p> <p>In May this year, Sydney’s Northern Beaches Council <a href="https://www.northernbeaches.nsw.gov.au/e-bike-and-e-scooter-safety">launched a public awareness</a> campaign on e-bike safety. <a href="https://www.northernbeaches.nsw.gov.au/council/news/media-releases/northern-beaches-council-leads-pack-e-bike-safety-campaign">The advice includes</a>:</p> <ul> <li>slow to walking pace when others are on the path</li> <li>ring your bell to signal your approach</li> <li>be ready for sudden changes.</li> </ul> <p>Government regulation on e-bikes is also important for public safety. For example <a href="https://fit-ebike.com/en-en/about-us/blog/s-pedelecs/">in Germany</a>, high-speed e-bikes are classed as mopeds and cannot be ridden on bike paths.</p> <p>Separately, e-bikes usually contain lithium-ion batteries which can explode and start fires – particularly in e-bikes bought from overseas retailers that don’t meet Australian standards. Before buying, <a href="https://www.fire.nsw.gov.au/page.php?id=9406">check advice from fire authorities</a>.</p> <figure><iframe src="https://www.youtube.com/embed/U58Pv7-7fnE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p><strong>– Lack of cycling and charging infrastructure</strong></p> <p>Well-designed <a href="https://www.sciencedirect.com/science/article/pii/S2214140519301033">cycling infrastructure</a> encourages e-bike use. In Australia, governments are <a href="https://www.infrastructureaustralia.gov.au/sites/default/files/2019-06/Cycling_Infrastructure_Background_Paper_16Mar09_WEB.pdf">slowly accepting</a> the need for infrastructure such as dedicated bike lanes and <a href="https://www.transport.nsw.gov.au/get-nsw-active/emicro-smart-micro-mobility-infrastructure">charging stations</a>, but <a href="https://theconversation.com/why-do-so-few-people-cycle-for-transport-in-australia-6-ideas-on-how-to-reap-all-the-benefits-of-bikes-229811">more money</a> is needed.</p> <p>In the Netherlands, a surge in e-bike sales has <a href="https://www.government.nl/topics/bicycles">driven</a> investments in cycling paths, improvements in bicycle parking at train stations, and other efforts to promote cycling and e-bike use.</p> <p><strong>– Higher upfront cost than a regular bike</strong></p> <p>The cost of buying an e-bike can be a barrier for some. For example, <a href="https://activetravelstudies.org/article/id/991/">NZ-based research</a> found the purchase cost meant the benefits were less likely to be available to lower-income women.</p> <p>So how can the cost barrier be overcome? In Australia, some companies offer e-bike rentals, via a weekly <a href="https://lug-carrie.com">subscription service</a>. And overseas, <a href="https://www.pbsc.com/blog/2021/09/pbsc-e-bike-sharing-schemes-in-15-cities-around-the-world">share schemes</a> mean people can access e-bikes without having to buy one.</p> <p>In 2023, <a href="https://www.service.tas.gov.au/services/government-help-and-support/concessions-and-discounts/apply-for-an-electric-vehicle-or-e-mobility-rebate">Tasmania became the first Australian state</a> to offer a subsidy for e-bike purchases, and the uptake was rapid. However, the scheme has now closed.</p> <p><strong>– Environmental impacts</strong></p> <p>Almost everything we buy has an environmental impact, and electric bikes are no exception. However, they are obviously a better alternative to conventional cars – and also have less impact than electric vehicles.</p> <p>Over the total lifecycle of the product, including manufacturing, an e-bike emits <a href="https://ecf.com/resources/cycling-facts-and-figures/environmental">about 10%</a> of the CO₂ emissions associated with producing an electric car, according to the European Cyclists Federation. And e-bikes <a href="https://electrek.co/2023/05/04/you-cant-trust-electric-bike-companies-battery-range/">consume</a> about <a href="https://ebikes.ca/learn/solar.html#:%7E:text=6%20wh%2Fkm%20would%20be,heavy%20loads%20and%20riding%20fast.">15 watt-hours per kilometre</a>, compared to electric cars which <a href="https://www.drive.com.au/caradvice/what-is-a-good-energy-consumption-figure-for-electric-vehicles/">consume around</a> 150 to 200 watt-hours per kilometre.</p> <p>E-bike battery systems also typically require fewer raw materials and simpler design than an electric vehicle, which <a href="https://www.sciencedirect.com/science/article/pii/S0892687524000293">simplifies</a> the battery recycling process.</p> <h2>Cleaner, cheaper, better</h2> <p>Electric cars are crucial for replacing traditional vehicles on longer routes and for family travel. However, e-bikes offer a more affordable and lower-impact solution for commuting and short-distance travel – and if you buy a cargo e-bike, you can even take your family.</p> <p>Mass adoption of e-bikes in Australia requires better cycling infrastructure, new government regulation and price incentives. But in the meantime, thousands of Australians are already enjoying the benefits of e-bikes. Perhaps you could too?</p> <p><em><a href="https://theconversation.com/profiles/muhammad-rizwan-azhar-1472288">Muhammad Rizwan Azhar</a>, Lecturer of Chemical Engineering, Sustainable Energy and Resources, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> and <a href="https://theconversation.com/profiles/waqas-uzair-1486684">Waqas Uzair</a>, Research Associate, Advanced Battery Systems and Safety, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan 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/is-an-electric-bike-right-for-you-heres-what-to-consider-before-you-buy-230024">original article</a>.</em></p> </div>

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

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

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Revolutionary diabetes detection via smartphone: A game-changer in healthcare

<p>In a groundbreaking advancement, scientists from <a href="https://www.klick.com/" target="_blank" rel="noopener">Klick Labs</a> have discovered a method that could revolutionise diabetes detection – using just a 10-second smartphone voice recording.</p> <p>No more travelling to clinics or waiting anxiously for blood test results. This new approach promises immediate, on-the-spot results, potentially transforming how we diagnose type 2 diabetes.</p> <p>The study, published in <a href="https://www.mcpdigitalhealth.org/article/S2949-7612(23)00073-1/fulltext" target="_blank" rel="noopener">Mayo Clinic Proceedings: Digital Health</a>, involved 267 participants, including 192 non-diabetic and 75 type 2 diabetic individuals. Each participant recorded a specific phrase on their smartphone multiple times a day over two weeks, resulting in 18,465 recordings.</p> <p>These recordings, lasting between six and 10 seconds each, were meticulously analysed for 14 acoustic features, such as pitch and intensity. Remarkably, these features exhibited consistent differences between diabetic and non-diabetic individuals, differences too subtle for the human ear but detectable by sophisticated signal processing software.</p> <p>Building on this discovery, the scientists developed an AI-based program to analyse the voice recordings alongside patient data like age, sex, height and weight. The results were impressive: the program accurately identified type 2 diabetes in women 89% of the time and in men 86% of the time.</p> <p>These figures are competitive with traditional methods, where fasting blood glucose tests show 85% accuracy and other methods, like glycated haemoglobin and oral glucose tolerance tests, range between 91% and 92%.</p> <p>"This technology has the potential to remove barriers entirely," said Jaycee Kaufman, a research scientist at Klick Labs and the study's lead author. Traditional diabetes detection methods can be time-consuming, costly and inconvenient, but voice technology could change all that, providing a faster, more accessible solution.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Looking ahead, the team plans to conduct further tests on a larger, more diverse population to refine and validate this innovative approach. If successful, this could mark a significant leap forward in diabetes management and overall healthcare, making early detection simpler and more accessible than ever before.</span></p> <p>Stay tuned as this exciting development unfolds, potentially bringing us closer to a future where managing and detecting diabetes is as simple as speaking into your smartphone.</p> <p><em>Image: Shutterstock</em></p>

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How often should you really weigh yourself?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Few topics are more debated in health than the value of the humble bathroom scale. Some experts advocate daily self-weigh-ins to promote accountability for weight management, particularly when we’re following a diet and exercise program to lose weight.</p> <p>Others suggest ditching self-weigh-ins altogether, arguing they can trigger negative <a href="https://link.springer.com/article/10.1007/s13679-015-0142-2">psychological responses and unhealthy behaviours</a> when we don’t like, or understand, the number we see on the scale.</p> <p>Many, like me, recommend using scales to weigh yourself weekly, even when we’re not trying to lose weight. Here’s why.</p> <h2>1. Weighing weekly helps you manage your weight</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588640/?tool=pmcentrez&amp;report=abstract">Research</a> confirms regular self-weighing is an effective weight loss and management strategy, primarily because it helps increase awareness of our current weight and any changes.</p> <p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588640/?tool=pmcentrez&amp;report=abstract">systematic review of 12 studies</a> found participants who weighed themselves weekly or daily over several months lost 1–3 BMI (body mass index) units more and regained less weight than participants who didn’t weight themselves frequently. The weight-loss benefit was evident with weekly weighing; there was no added benefit with daily weighing.</p> <p>Self-weigh-ins are an essential tool for weight management as we age. Adults <a href="https://pubmed.ncbi.nlm.nih.gov/23638485/">tend to gain weight</a> progressively <a href="https://pubmed.ncbi.nlm.nih.gov/8363190/">through middle age</a>. While the average weight gain is typically between <a href="https://www.sciencedirect.com/science/article/abs/pii/S0031938414001528">0.5–1kg per year</a>, this modest accumulation of weight can lead to obesity over time. Weekly weighing and keeping track of the results helps avoid unnecessary weight gain.</p> <p>Tracking our weight can also help identify medical issues early. Dramatic changes in weight can be an early sign of some conditions, including problems with our thyroid, digestion and diabetes.</p> <h2>2. Weekly weighing accounts for normal fluctuations</h2> <p>Our body weight can fluctuate within a single day and across the days of the week. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192384/">Studies</a> show body weight fluctuates by 0.35% within the week and it’s typically higher after the weekend.</p> <p>Daily and day-to-day body weight fluctuations have several causes, many linked to our body’s water content. The more common causes include:</p> <p><strong>The type of food we’ve consumed</strong></p> <p>When we’ve eaten a dinner higher in carbohydrates, we’ll weigh more the next day. This change is a result of our bodies temporarily carrying more water. We <a href="https://pubmed.ncbi.nlm.nih.gov/25911631/">retain 3–4 grams of water</a> per gram of carbohydrate consumed to store the energy we take from carbs.</p> <p>Our water content also increases when we consume <a href="https://www.ncbi.nlm.nih.gov/books/NBK50952/">foods higher in salt</a>. Our bodies try to maintain a balance of sodium and water. When the concentration of salt in our bloodstream increases, a mechanism is triggered to restore balance by retaining water to dilute the excess salt.</p> <p><strong>Our food intake</strong></p> <p>Whether it’s 30 grams of nuts or 65 grams of lean meat, everything we eat and drink has weight, which increases our body weight temporarily while we digest and metabolise what we’ve consumed.</p> <p>Our weight also tends to be lower first thing in the morning after our food intake has been restricted overnight and higher in the evening after our daily intake of food and drinks.</p> <p><strong>Exercise</strong></p> <p>If we weigh ourselves at the gym after a workout, there’s a good chance we’ll weigh less due to sweat-induced fluid loss. The amount of water lost varies depending on things like our workout intensity and duration, the temperature and humidity, along with our sweat rate and hydration level. On average, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993146/">we lose 1 litre of sweat</a> during an hour of <a href="https://link.springer.com/article/10.1007/BF00421168">moderate-intensity exercise</a>.</p> <p><strong>Hormonal changes</strong></p> <p><a href="https://theconversation.com/from-energy-levels-to-metabolism-understanding-your-menstrual-cycle-can-be-key-to-achieving-exercise-goals-131561">Fluctuations in hormones</a> within your menstrual cycle can also affect fluid balance. Women may experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154522/">fluid retention</a> and temporarily gain 0.5–2kg of weight at this time. Specifically, the luteal phase, which represents the second half of a woman’s cycle, results in a shift of fluid from your blood plasma to your cells, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154522/">bloating</a>.</p> <p><strong>Bowel movements</strong></p> <p>Going to the bathroom can lead to small but immediate weight loss as waste is eliminated from the body. While the amount lost will vary, we generally eliminate <a href="https://pubmed.ncbi.nlm.nih.gov/1333426/">around 100 grams of weight</a> through our daily bowel movements.</p> <p>All of these fluctuations are normal, and they’re not indicative of significant changes in our body fat or muscle mass. However, seeing these fluctuations can lead to unnecessary stress and a fixation with our weight.</p> <h2>3. Weekly weighing avoids scale obsession and weight-loss sabotage</h2> <p>Weighing too frequently can create an obsession with the number on the scales and do more harm than good.</p> <p>Often, our reaction when we see this number not moving in the direction we want or expect is to further restrict our food intake or embark on fad dieting. Along with not being enjoyable or sustainable, fad diets also ultimately increase our weight gain rather than reversing it.</p> <p>This was confirmed in a <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">long-term study</a> comparing intentional weight loss among more than 4,000 twins. The researchers found the likelihood of becoming overweight by the age of 25 was significantly greater for a twin who dieted to lose 5kg or more. This suggests frequent dieting makes us more susceptible to weight gain and prone to future weight gain.</p> <h2>So what should you do?</h2> <p>Weighing ourselves weekly gives a more accurate measure of our weight trends over time.</p> <p>Aim to weigh yourself on the same day, at the same time and in the same environment each week – for example, first thing every Friday morning when you’re getting ready to take a shower, after you’ve gone to the bathroom, but before you’ve drunk or eaten anything.</p> <p>Use the best quality scales you can afford. Change the batteries regularly and check their accuracy by using a “known” weight – for example, a 10kg weight plate. Place the “known” weight on the scale and check the measurement aligns with the “known” weight.</p> <p>Remember, the number on the scale is just one part of health and weight management. Focusing solely on it can overshadow other indicators, such as <a href="https://theconversation.com/can-you-be-overweight-and-healthy-182219">how your clothes fit</a>. It’s also essential to pay equal attention to how we’re feeling, physically and emotionally.</p> <p>Stop weighing yourself – at any time interval – if it’s triggering anxiety or stress, and get in touch with a health-care professional to discuss this.</p> <hr /> <p><em>At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.</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/223864/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/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-often-should-you-really-weigh-yourself-223864">original article</a>.</em></p> </div>

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We finally know why some people got COVID while others didn’t

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p>Throughout the pandemic, one of the key questions on everyone’s mind was why some people avoided getting COVID, while others caught the virus multiple times.</p> <p>Through a collaboration between University College London, the Wellcome Sanger Institute and Imperial College London in the UK, we set out to answer this question using the world’s first controlled <a href="https://www.nature.com/articles/s41591-022-01780-9">“challenge trial” for COVID</a> – where volunteers were deliberately exposed to SARS-CoV-2, the virus that causes COVID, so that it could be studied in great detail.</p> <p>Unvaccinated healthy volunteers with no prior history of COVID were exposed – via a nasal spray – to an extremely low dose of the original strain of SARS-CoV-2. The volunteers were then closely monitored in a quarantine unit, with regular tests and samples taken to study their response to the virus in a highly controlled and safe environment.</p> <p>For our <a href="https://www.nature.com/articles/s41586-024-07575-x">recent study</a>, published in Nature, we collected samples from tissue located midway between the nose and the throat as well as blood samples from 16 volunteers. These samples were taken before the participants were exposed to the virus, to give us a baseline measurement, and afterwards at regular intervals.</p> <p>The samples were then processed and analysed using single-cell sequencing technology, which allowed us to extract and sequence the genetic material of individual cells. Using this cutting-edge technology, we could track the evolution of the disease in unprecedented detail, from pre-infection to recovery.</p> <p>To our surprise, we found that, despite all the volunteers being carefully exposed to the exact same dose of the virus in the same manner, not everyone ended up testing positive for COVID.</p> <p>In fact, we were able to divide the volunteers into three distinct infection groups (see illustration). Six out of the 16 volunteers developed typical mild COVID, testing positive for several days with cold-like symptoms. We referred to this group as the “sustained infection group”.</p> <p>Out of the ten volunteers who did not develop a sustained infection, suggesting that they were able to fight off the virus early on, three went on to develop an “intermediate” infection with intermittent single positive viral tests and limited symptoms. We called them the “transient infection group”.</p> <p>The final seven volunteers remained negative on testing and did not develop any symptoms. This was the “abortive infection group”. This is the first confirmation of abortive infections, which were previously <a href="https://www.nature.com/articles/s41586-021-04186-8">unproven</a>. Despite differences in infection outcomes, participants in all groups shared some specific novel immune responses, including in those whose immune systems prevented the infection.</p> <p>When we compared the timings of the cellular response between the three infection groups, we saw distinct patterns. For example, in the transiently infected volunteers where the virus was only briefly detected, we saw a strong and immediate accumulation of immune cells in the nose one day after infection.</p> <p>This contrasted with the sustained infection group, where a more delayed response was seen, starting five days after infection and potentially enabling the virus to take hold in these volunteers.</p> <p>In these people, we were able to identify cells stimulated by a key antiviral defence response in both the nose and the blood. This response, called the “interferon” response, is one of the ways our bodies signal to our immune system to help fight off viruses and other infections. We were surprised to find that this response was detected in the blood before it was detected in the nose, suggesting that the immune response spreads from the nose very quickly.</p> <h2>Protective gene</h2> <p>Lastly, we identified a specific gene called HLA-DQA2, which was expressed (activated to produce a protein) at a much higher level in the volunteers who did not go on to develop a sustained infection and could hence be used as a marker of protection. Therefore, we might be able to use this information and identify those who are probably going to be protected from severe COVID.</p> <p>These findings help us fill in some gaps in our knowledge, painting a much more detailed picture regarding how our bodies react to a new virus, particularly in the first couple of days of an infection, which is crucial.</p> <p>We can use this information to compare our data to other data we are currently generating, specifically where we are “challenging” volunteers to other viruses and more recent strains of COVID. In contrast to our current study, these will mostly include volunteers who have been vaccinated or naturally infected – that is, people who already have immunity.</p> <p>Our study has significant implications for future treatments and vaccine development. By comparing our data to volunteers who have never been exposed to the virus with those who already have immunity, we may be able to identify new ways of inducing protection, while also helping the development of more effective vaccines for future pandemics. In essence, our research is a step towards better preparedness for the next pandemic.<!-- 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/233063/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/marko-nikolic-1543289">Marko Nikolic</a>, Principal Research Fellow/Honorary consultant Respiratory Medicine, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, Postdoc Research Fellow, Molecular and Cellular Biology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</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/we-finally-know-why-some-people-got-covid-while-others-didnt-233063">original article</a>.</em></p> </div>

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How you experience the menopause may have a lot to do with your family

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/megan-arnot-416253">Megan Arnot</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pubmed/30346539">menopause</a> happens around the age of 50, and for many women, the end of their fertile life is accompanied by uncomfortable symptoms, such as hot flashes, night sweats and anxiety. In the West, it is generally taken as read that these symptoms are a normal part of the menopause. But <a href="https://www.ncbi.nlm.nih.gov/pubmed/11330770">cross-cultural research</a> suggests that menopause symptoms are not necessarily inevitable.</p> <p>For example, <a href="https://www.ncbi.nlm.nih.gov/pubmed/18521049">Japanese women</a> rarely report hot flashes, whereas for European women they are a common complaint. As a result, scientists have begun to focus on what causes this difference in experience and the potential impact that behavioural and lifestyle factors, such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/16735636">smoking</a>, might have.</p> <p>Our latest <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ece3.5705">study</a> adds to this knowledge. We found that living away from your genetic family may worsen the menopause.</p> <h2>Family matters?</h2> <p>Where people live once they’re married varies across cultures. To investigate whether these different living arrangements affect menopause symptoms, we travelled to south-west China to collect data.</p> <p>In this region, there are groups with distinct living arrangements. First, the Han and the Yi, in which women typically leave their family after they’ve got married and live with their husband’s family. Second, the Mosuo and Zhaba, who engage in the practice of <em>zou hun</em> (“<a href="https://www.ncbi.nlm.nih.gov/pubmed/23486437">walking marriage</a>”), where the husband and wife live separately with their own related families, and only visit each other at night.</p> <p>We found that women who remained living with their own family following marriage had significantly less severe menopause symptoms than those who went to live with their husband’s family.</p> <h2>In-law conflict</h2> <p>Many anthropologists are interested in how different levels of relatedness within households can have behavioural and physiological implications. For the menopause, we think the difference in symptom severity between the groups may be the result of the different levels of conflict that result from being more or less related to other members of your household.</p> <p>If a woman lives with her husband’s family, then until she has children, she is unrelated to anyone in the household. This lack of relatedness can cause <a href="https://link.springer.com/article/10.1007/s40806-017-0114-8">tension</a> between the new wife and her husband’s relatives as they have little direct genetic interest in her.</p> <p>As well as conflict with non-related household members, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/evan.20226">earlier research</a> has shown that women who live with their husband’s family tend to argue with their partners more and are also more likely to get divorced. Additionally, rates of domestic violence are <a href="https://www.ncbi.nlm.nih.gov/pubmed/27279077">higher</a> when women live away from their genetic family.</p> <p>But how does this relate to the severity of menopause symptoms? We think that increased levels of household conflict would result in the woman being more stressed. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795524/">Stress</a> is known to worsen pain perception and so could aggravate menopause symptoms.</p> <p>In contrast to women who leave their kin group, women who live with their own family once they’re married also tend to have higher levels of <a href="https://scholar.harvard.edu/slowes/publications/matrilineal-spousal-cooperation">social support</a>. There are more people to help with childcare and more shoulders to cry on. This can help to lower stress and thus soften the mental and physical burden of the menopause.</p> <h2>Global perspectives</h2> <p>While our research was conducted in China, globally, we see a wide range of living arrangements, which themselves can bring different levels of conflict and social support. In the West, many women live away from their families, which may mean that they lack social support, perhaps contributing to more turbulent menopause symptoms. Distance from one’s own family can also be seen to increase <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1741-3737.2005.00155.x">conflict</a> within the household – be it between a husband and wife, or wife and in-laws.</p> <p>These results aren’t an excuse to visit your in-laws less, but they show that menopause symptoms are not only about hormonal irregularities. They may also be a product of your social environment, which should be worth bearing in mind when approaching and going through the menopause.<!-- 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/123621/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/megan-arnot-416253">Megan Arnot</a>, PhD Candidate, Evolutionary Anthropology and Behavioural Ecology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-you-experience-the-menopause-may-have-a-lot-to-do-with-your-family-123621">original article</a>.</em></p> </div>

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Julian Assange was isolated for more than a decade. Here’s what that does to the body and mind

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/carol-maher-217811">Carol Maher</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/johanna-badcock-995697">Johanna Badcock</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p>Anyone who lived through the COVID pandemic would likely understand that even a small period of isolation can cause <a href="https://pubmed.ncbi.nlm.nih.gov/35787541/">physical and mental stress</a>.</p> <p>WikiLeaks founder Julian Assange – <a href="https://theconversation.com/julian-assange-will-be-freed-after-striking-plea-deal-with-us-authorities-233210">who will return to Australia</a> after reaching a plea deal with the US Department of Justice – is <a href="https://www.afr.com/policy/foreign-affairs/his-health-is-very-risky-assange-s-brother-fears-for-his-life-20240327-p5ffjw">reported to have suffered</a> various mental and physical challenges during his almost 15 years in some form of isolation.</p> <p>Assange was first arrested in Britain in 2010 after Swedish authorities said they wanted to <a href="https://www.theguardian.com/media/2010/dec/17/julian-assange-sweden">question him over sex crime allegations</a>.</p> <p>After exhausting legal avenues to stop an extradition to Sweden, in June 2012 he entered <a href="https://www.theguardian.com/world/2018/may/15/julian-assange-ecuador-london-embassy-how-he-became-unwelcome-guest">Ecuador’s embassy in London</a>, where he remained for seven years.</p> <p>In early 2019, he was <a href="https://www.reuters.com/article/idUSKCN1S73H5/">jailed for skipping bail</a> and held at London’s Belmarsh prison where he spent most of the following five years fighting extradition to the US. Now, he’s coming home.</p> <p>While we have no idea how Assange is coping from being cooped up inside for so long with few visitors, we do know that isolation can have <a href="https://theconversation.com/my-own-prison-ordeal-gave-me-a-taste-of-what-assange-may-be-feeling-hes-out-but-the-chilling-effect-on-press-freedom-remains-233215">a severe negative impact</a> on many people.</p> <p><iframe id="qxq2l" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/qxq2l/" width="100%" height="400px" frameborder="0"></iframe></p> <h2>How physical inactivity impacts your body</h2> <p>Physical activity is vital for <a href="https://jamanetwork.com/journals/jama/articlepdf/2712935/jama_piercy_2018_sc_180005.pdf">overall health</a>. It keeps your heart strong, helps manage weight, and builds muscle and bone strength.</p> <p>Regular exercise also lifts your mood, reducing symptoms of depression and anxiety, and sharpens your mind. Plus, it boosts your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195025/">immune system</a>, making you more resistant to infections and diseases.</p> <p>When you don’t move enough, especially in isolation, your health can take a hit. Muscles weaken and joints stiffen, making you less strong and flexible.</p> <p>Your <a href="https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.102.9.975">heart health</a> suffers, too, raising the risk of high blood pressure, heart attacks and strokes because your heart isn’t getting the workout it needs.</p> <p>Metabolic issues such as obesity and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908414/">type 2 diabetes</a> become more common with inactivity, especially if you don’t have access to healthy food.</p> <p>Isolation often means less fresh air and sunlight, both crucial for good health. Poor ventilation can lead to <a href="https://www.mdpi.com/1660-4601/17/8/2927/pdf">respiratory problems</a>. Lack of sunlight can cause <a href="https://academic.oup.com/jcem/article-pdf/95/6/2630/9067013/jcem2630.pdf">vitamin D deficiency</a>, weakening bones and the immune system, and increasing the risk of fractures.</p> <p>These effects fit with the reports that Assange suffered a <a href="https://www.theguardian.com/media/2022/mar/23/today-i-will-marry-the-love-of-my-life-julian-assanges-fiancee">mini-stroke</a> in 2021 and a <a href="https://www.theguardian.com/commentisfree/2024/feb/18/julian-assange-press-freedom-wikileaks-uk-high-court">broken rib</a> from persistent coughing fits while in isolation.</p> <h2>What about mental health?</h2> <p>Social disconnection comes in two main forms, both of which have serious consequences for our mental health.</p> <p>The first is social isolation. The reasons for being isolated are many and varied, including geographical distance, lack of access to transport, or incarceration.</p> <p>The end result is the same: you have few relationships, social roles or group memberships, and limited social interaction.</p> <p>The second form of social disconnection is more invisible but just as harmful.</p> <p><a href="https://psychology.org.au/for-the-public/psychology-topics/loneliness">Loneliness</a> is that subjective, unpleasant feeling of wanting but lacking satisfying relationships with others.</p> <p>You can be isolated and not feel lonely, but the two are often unwelcome bedfellows.</p> <p>Social connection is not a luxury. It’s a fundamental need, as essential to our health as food and water.</p> <p>Just as hunger reminds us to eat, <a href="https://healthymale.org.au/health-article/what-is-loneliness-and-social-isolation">loneliness acts as a signal</a> alerting us that our social relationships are weak and need to be improved if we are to remain healthy.</p> <p>The science around the health impacts of social disconnection is clear, especially when it is prolonged. So much so, the World Health Organization recently launched a <a href="https://www.who.int/groups/commission-on-social-connection">Commission on Social Connection</a> to increase awareness of the impact of social isolation and loneliness on health and have it recognised as a global health priority.</p> <p>Substantial evidence shows social isolation and loneliness are linked to poorer cognitive functioning and an increased risk of dementia, though possibly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995915/">different ways</a>.</p> <p>Among adults aged 50 years and over, chronic (meaning persistent and severe) loneliness and social isolation may increase the risk of dementia by <a href="https://www.tandfonline.com/doi/full/10.1080/13651501.2021.1959616">around 50%</a>.</p> <p>A lack of cognitive stimulation that naturally occurs when interacting with others, whether it’s old friends or strangers, might explain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995915/">the link</a> between social isolation and cognitive difficulties (think “use it or lose it”).</p> <p>On the other hand, loneliness <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995915/">may impact cognitive health</a> through its effects on emotional wellbeing. It’s <a href="https://www.nature.com/articles/s41598-022-13049-9">a well-known risk factor</a> for developing depression, anxiety and suicidality.</p> <p>For instance, <a href="https://pubmed.ncbi.nlm.nih.gov/35583561/">studies show</a> the chances of developing depression in adults is more than double in people who often feel lonely, compared with those who rarely or never feel lonely.</p> <p>Other research examining 500,000 middle-aged adults over nine years showed living alone doubled the risk of dying by suicide for men, while loneliness <a href="https://pubmed.ncbi.nlm.nih.gov/33096330">increased the risk of hospitalisation</a> for self-harm in both men and women.</p> <p>In a <a href="https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf">2023 report</a>, the US Surgeon General’s advisory concluded:</p> <blockquote> <p>Given the totality of the evidence, social connection may be one of the strongest protective factors against self-harm and suicide among people with and without serious underlying mental health challenges.</p> </blockquote> <h2>What about after release?</h2> <p>When a person leaves long-term isolation, they’ll face many challenges as they re-enter society.</p> <p>The world will have changed. There’s a lot to catch up on, from technological advancements to shifts in social norms.</p> <p>In addition to these broader changes, there’s a need to focus on rebuilding physical and mental health. Health issues that developed during isolation can <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext?cid=in%3Adisplay%3Alfhtn0&amp;dclid=CNKCgb7nle0CFVUkjwodG0YCkg">persist or worsen</a>. A weakened immune system might struggle with new infections in a post-COVID world.</p> <p>To navigate this transition, it’s important to establish a routine that includes regular exercise, nutritious meals and comprehensive medical and psychological care.</p> <p>Gradually increasing social interactions can also help in rebuilding relationships and social connections. These steps are supportive in restoring overall health and wellbeing in a changed world.<!-- 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/233214/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/carol-maher-217811">Carol Maher</a>, Professor, Medical Research Future Fund Emerging Leader, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/johanna-badcock-995697">Johanna Badcock</a>, Adjunct Professor, School of Psychological Science | Freelance Research Consultant, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p><em>Image credits: Ray Tang/Shutterstock Editorial </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/julian-assange-was-isolated-for-more-than-a-decade-heres-what-that-does-to-the-body-and-mind-233214">original article</a>.</em></p> </div>

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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>

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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>

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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>

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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>

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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>

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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>

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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

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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>

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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>

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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>

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