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Ozempic, Wegovy, Rybelsus: Are we losing sight of overall health? Here’s what the science says

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> The craze for new drugs in the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analogue class, better known under the trade names Ozempic and Wegovy, is remarkable, but it’s not totally unprecedented in the history of pharmaceutical blockbusters. The volume of prescriptions and the budget allocated to them by public health insurance schemes are exploding, as are the <a href="https://www.forbes.com/sites/roberthart/2024/05/02/ozempic-maker-novo-nordisk-beats-profit-forecasts-amid-weight-loss-drug-frenzy/">profits of the companies that manufacture them</a>. Part of the popularity of these drugs owes to social networks, but these are not always the best source for health information. When it comes to the subject of weight loss, both fantasy and prejudice come into play. This works to the detriment of everyone’s well-being, but particularly those who are already stigmatized. As specialists in the philosophy of medicine (Université de Montréal), nutrition and food science (Université Laval), the sociology of medication (Université de Montréal) and endocrinology (Institut de recherches cliniques de Montréal), we feel it’s necessary to step back and take stock of both the promises and the limitations of these new treatments. <h2>The best of both worlds</h2> GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in people with Type 2 diabetes, thereby preventing the complications associated with this disease. When studies were carried out to assess their safety and efficacy, it was discovered that these drugs also led to weight loss. This prompted new research which showed that at higher doses, the drugs could lead to <a href="https://pubmed.ncbi.nlm.nih.gov/38078870/">very significant weight loss</a>, from 15 to 25 per cent of the starting weight. The mode of action of these drugs on blood sugar regulation is clear: they simulate incretin hormones which, in turn, increase insulin secretion. Weight loss, on the other hand, was only explained after the fact: in addition to the pancreas, these molecules also act on the brain by regulating the sensation of satiety and, indirectly, on the stomach by slowing gastric emptying. These two combined effects reduce appetite and lead to weight reduction. This is how a new use for the drug appeared, at which point the company Novo Nordisk began marketing the same drug under two different names: Ozempic to treat Type 2 diabetes, and <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">Wegovy to manage obesity</a>. <h2>A new era</h2> GLP-1/GIP analogues are a welcome therapeutic breakthrough at a time when the <a href="https://www.diabetes.ca/advocacy---policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada">prevalence of Type 2 diabetes</a> and <a href="https://www.statcan.gc.ca/o1/en/plus/5742-overview-weight-and-height-measurements-world-obesity-day">obesity</a> is exploding and affecting people younger and younger. These diseases particularly affect women, members of racialized groups and socio-economically disadvantaged populations. The physical and mental suffering these cause and the costs associated with treating them are both considerable. So the arrival of new weapons in the therapeutic arsenal is a source of hope. Draconian changes in lifestyle are certainly effective. But they are very difficult to implement and maintain over time for reasons that go beyond the individual sphere; on the one hand, genetic predisposition plays a major role in the development of Type 2 diabetes and obesity; on the other, because these conditions are <a href="https://obesitycanada.ca/managing-obesity/">multifactorial</a>, management of them must be comprehensive to be effective and long lasting: it must combine medical interventions but also nutritional, functional, psycho-social, environmental and even institutional interventions. Support services of this kind do exist, but only in large university hospital centres to which many people do not have access. Nor do many people have easy access to <a href="https://health-infobase.canada.ca/health-inequalities/index">healthy and varied food options</a>, sports facilities or social and psychological support. <h2>Treating the effects but not the causes</h2> To be effective over the long term, GLP-1/GIP analogues must be taken continuously: without drastic lifestyle changes, the <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">weight that was lost is regained within a year of stopping</a>, and glycemic control is compromised once again. In other words, the drugs treat the effects of Type 2 diabetes and obesity but not their causes. And yet some of these causes are modifiable: for example, according to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">Statistics Canada</a>, less than half the Canadian population (49.2 per cent for adults; 43.9 per cent for young people and children) achieves the recommended amount of weekly physical activity. According to the same source, <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">food insecurity</a> affects around 14 per cent of the Québec population (22 per cent in Alberta). Pharmacological treatment, even if it allows an individual to eat less, does not necessarily mean that person will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837702/">eat better</a>. Similarly, losing weight does not mean one will become more active or healthier. So these new drugs do not cure Type 2 diabetes or obesity. Nor do they prevent these diseases from developing, although they do help to limit the many complications to which they give rise. <h2>Prescribe and treat</h2> A drug such as Mounjaro is as effective at weight loss as bariatric surgery. Much easier to administer and much less risky, it could be a real game changer in the treatment of obesity. Prescribed directly by family doctors and dispensed in pharmacies, it would also be much more accessible and easier to administer for those who need it. This raises the question of costs and reimbursement, but not only that: prescribing is not the same as treating. Here, the manufacturers are following the recommendations of the health authorities: this treatment must be preceded by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748770/">careful assessment</a>, then management, and above all a close and regular monitoring of diet, physical activity, mental health, and if necessary, socio-economic assistance. This requires not only time that GPs do not have, but also co-ordination with other players in the health-care network. The problem is not whether the treatment will be effective, but what can happen if it is. Losing 25 per cent of your body weight in just a few months has serious consequences, which are not always beneficial: it involves a loss of body fat, but also of muscle mass, which is associated with intense fatigue. Nor should we underestimate the <a href="https://pubmed.ncbi.nlm.nih.gov/37990685/">challenge of adapting physically and psychologically</a> to a body transformation of this scale. Losing weight doesn’t solve everything, and expectations must remain realistic. <h2>What lessons can we learn?</h2> The clinical effectiveness of GLP-1/GIP analogues in reducing the complications associated with Type 2 diabetes and obesity is indisputable. However, these drugs are not suitable for everyone, and they are certainly not miracle cures that will make it possible for one to regain health without making any changes to lifestyle or environment. We must bear in mind that their success, both commercial and medical, is also the result of a failure: that of our societies to prevent these diseases, to promote healthy lifestyles and to develop environments conducive to the health of all.<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/238484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, Professeure agrégée, Philosophie (épistémologie et philosophie de la médecine), <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, Professeur agrégé, Faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, Professeur adjoint à la faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, Professeur de médecine et de nutrition, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ozempic-wegovy-rybelsus-are-we-losing-sight-of-overall-health-heres-what-the-science-says-238484">original article</a>. </div>

Body

MSG is back. Is the idea it’s bad for us just a myth or food science?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> MSG is making a comeback. The internet’s favourite cucumber salad recipe includes fish sauce, cucumber, garlic and – as the video’s creator Logan tells us with a generous sprinkle from the bag – “MSG, obviously”. But for many of us, it’s not obvious. Do you have a vague sense MSG is unhealthy but you’re not sure why? Here is the science behind monosodium glutamate, how it got a bad rap, and whether you should add it to your cooking. <h2>What is MSG?</h2> Monosodium glutamate (MSG) is a sodium salt of glutamic acid, one of the amino acids that make up proteins. It occurs naturally in <a href="https://www.tandfonline.com/doi/full/10.1080/10942912.2017.1295260#d1e167">foods</a> such as mature cheeses, fish, beef, mushrooms, tomatoes, onion and garlic. It provides their savoury and “meaty” flavour, known as <a href="https://www.sciencedirect.com/science/article/pii/S0022316622140186">umami</a>. MSG has been used to season food for <a href="https://wjpsonline.com/index.php/wjps/article/view/effects-monosodium-glutamate-human-health-review">more than 100 years</a>. Traditionally it <a href="https://pubs.acs.org/doi/epdf/10.1021/ed081p347?ref=article_openPDF">was extracted</a> from seaweed broth, but now it’s made by fermenting starch in sugar beets, sugar cane and molasses. Today it’s widely used as a flavour enhancer in many dishes and pre-packaged goods, including soups, condiments and processed meats. There is no chemical difference between the MSG found in food and the additive. <h2>Is it safe?</h2> For most people, yes. MSG is a safe and authorised additive, according to the Australian agency that regulates food. This corresponds with food standards in the <a href="https://www.fda.gov/food/food-additives-petitions/questions-and-answers-monosodium-glutamate-msg">United States</a>, <a href="https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A02008R1333-20201223#tocId3">European Union and United Kingdom</a>. Two major <a href="https://www.foodstandards.gov.au/sites/default/files/consumer/additives/msg/Documents/MSG%20Technical%20Report.pdf">safety reviews</a> have been conducted: one in 1987 by a United Nations expert committee and another 1995 by the Federation of American Societies for Experimental Biology. Both concluded MSG was safe for the general population. In 2017 the <a href="https://www.efsa.europa.eu/en/efsajournal/pub/4910">European Food Safety Authority</a> updated its stance and set a recommended limit based on body weight, aimed to prevent headaches and increased blood pressure. That limit is still higher than most people consume. The authority says an 80kg person should not have more than 2.4g of added MSG per day. <a href="https://www.nature.com/articles/1602526">For reference</a>, Europeans average less than a gram per day (0.3-1 gram), while in Asia intake is somewhere between 1.2-1.7 grams a day. Food Standards Australia New Zealand says the European update does not raise any new safety concerns not already assessed. <h2>Isn’t it bad for me?</h2> Despite the evidence, the idea MSG is dangerous persists. Its notorious reputation can be traced back to a <a href="https://news.colgate.edu/magazine/2019/02/06/the-strange-case-of-dr-ho-man-kwok/">hoax letter</a> published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJM196805162782014">New England Journal of Medicine</a> in 1968. A doctor claiming to have experienced palpitations, numbness and fatigue after eating at a Chinese restaurant suggested MSG could be to blame. With a follow-up article in the <a href="https://www.nytimes.com/1968/05/19/archives/-chinese-restaurant-syndrome-puzzles-doctors.html">New York Times</a>, the idea of “Chinese Restaurant Syndrome” took off. Eating MSG was associated with a range of symptoms, including headache, hives, throat swelling, itching and belly pain. However an <a href="https://www.sciencedirect.com/science/article/pii/027869159390012N?via%3Dihub">early randomised control trial</a> showed no difference in these symptoms between people who were given MSG versus a placebo. This has since been confirmed in a <a href="https://ift.onlinelibrary.wiley.com/doi/full/10.1111/1541-4337.12448">review of many studies</a>. <h2>Can MSG cause reactions?</h2> A very small percentage of people may have hypersensitivities to MSG. The reported reaction is now known as MSG symptom complex, rather than so-called Chinese restaurant syndrome, with its <a href="https://www.jandonline.org/article/S2212-2672(21)00068-X/abstract#:%7E:text=A%20New%20York%20Times%20piece,connecting%20MSG%20to%20health%20outcomes.">problematic</a> racial connotations. Symptoms are usually mild, short-term and don’t need treatment. <a href="https://www.sciencedirect.com/science/article/pii/S0091674999703714">One study</a> looked at 100 people with asthma, 30 of whom believed they had hypersensitivities to MSG. However when participants were blinded to whether they were consuming MSG, not one reported a reaction. If you believe you do react to added MSG, it’s relatively easy to avoid. In Australia, it is <a href="https://www.foodstandards.gov.au/consumer/additives/msg">listed</a> in ingredients as either monosodium glutamate or flavour enhancer 621. <h2>Is it better than table salt?</h2> Using MSG instead of regular salt may help <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893472/">reduce</a> your overall sodium intake, as MSG <a href="https://www.medicalnewstoday.com/articles/msg-what-the-science-says-about-its-safety#Uses-of-MSG">contains</a> about one third the amount of sodium. <a href="https://pubmed.ncbi.nlm.nih.gov/21372742/">One study</a> found people who ate soup seasoned with MSG rather than salt actually liked it more. They still found it salty to taste, but their sodium intake was reduced by 18%. MSG still contains sodium, so high use is associated with increased <a href="https://pubmed.ncbi.nlm.nih.gov/21372742/">blood pressure</a>. If you’re using MSG as a substitute and you have high blood pressure, you should closely monitor it (just as you would with other salt products). <h2>Should I use MSG in my cooking?</h2> If you want to – yes. Unless you are one of the rare people with hypersensitivities, enhancing the flavour of your dish with a sprinkle of MSG will not cause any health problems. It could even help reduce how much salt you use. If you’re <a href="https://www.tandfonline.com/doi/full/10.1080/25765299.2020.1807084#d1e199">vegetarian or vegan</a>, cooking with MSG could help add the umami flavour you may miss from animal products such as meat, fish sauce and cheese. But buying foods with added MSG? Be aware, many of them will also be <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/un-decade-of-nutrition-the-nova-food-classification-and-the-trouble-with-ultraprocessing/2A9776922A28F8F757BDA32C3266AC2A">ultra-processed</a> and it’s that – not the MSG – that’s associated with poor physical and mental <a href="https://www.mdpi.com/2072-6643/14/1/174">health outcomes</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237871/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/msg-is-back-is-the-idea-its-bad-for-us-just-a-myth-or-food-science-237871">original article</a>. </div>

Food & Wine

Do mobile phones cause brain cancer? Science makes definitive call

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

Body

Can a 10-year-old be responsible for a crime? Here’s what brain science tells us

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> The age a child can be arrested, charged and jailed in Australia is back in the spotlight. Last year, the Northern Territory became the first jurisdiction to raise the age of criminal responsibility from ten to 12. Now its new, tough-on-crime government has pledged to <a href="https://www.sbs.com.au/nitv/article/incoming-chief-minister-says-age-of-criminal-responsibility-to-be-lowered-to-10-years-old/a1xm9jy9c">return it to ten</a>. It comes after Victoria <a href="https://www.abc.net.au/news/2024-08-13/victoria-youth-justice-reform-criminal-age/104217160">walked back</a> its earlier commitment to raise the age to 14, settling instead on 12. But the United Nations Committee on the Rights of the Child says 14 should be the absolute <a href="https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-24-2019-childrens-rights-child">minimum</a>. It raised this age from its earlier recommendation (in 2007) of 12, citing a decade of new research into child and adolescent development. So what does the science say? What happens to the brain between ten and 14? And how much can those under 14 understand the consequences of their actions? <h2>Who is an adolescent?</h2> Our research shows adolescence is a <a href="https://pubmed.ncbi.nlm.nih.gov/30169257/">critical period</a> for development. It’s the time children’s experiences and explorations shape how they develop cognitive skills (including critical thinking and decision making), as well as social and emotional skills (including moral reasoning). Adolescence also lasts longer than we tend to think. Important brain development begins during late childhood, around eight to nine years. Intense changes then follow during early adolescence (ages ten to 14). But these changes continue well into the twenties, and full cognitive and emotional maturity is not usually reached until around age 24. However, everyone’s brain matures at a different rate. That means there is no definitive age we can say humans reach “adult” levels of cognitive maturity. What we do know is the period of early adolescence is critical. <h2>What does puberty do to the brain?</h2> Puberty is a defining feature of early adolescence. Most of us are familiar with the changes that occur to the body and reproductive systems. But the increase in puberty hormones, such as testosterone and oestrogen, also trigger changes to the brain. These hormones <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453017313252?via%3Dihub">increase most sharply</a> between ten and 15 years of age, although gradual changes continue into the early twenties. Puberty hormones change the structures in the brain which process emotions, including the amygdala (which encodes fear and stress) and ventral striatum (involved in reward and motivation). This makes adolescents particularly reactive to emotional rewards and threats. <a href="https://doi.org/10.1016/j.cortex.2019.04.024">Our research</a> has shown the brain’s sensitivity to emotions increases throughout early adolescence until around 14 or 15 years old. At the same time, changes in puberty have <a href="http://dx.doi.org/10.1037/pspp0000172">been linked</a> to increased sensation seeking and impulsive behaviours during early adolescence. This context is crucial when we discuss the behaviour of children in the ten to 14 age range. The way their brains change during this period makes them more sensitive and responsive to emotions, and more likely to be seeking experiences that are new and intense. <h2>How do adolescents make decisions?</h2> The emotional context of puberty influences how younger adolescents make decisions and understand their consequences. Decision making relies on several basic cognitive functions, including the brain’s flexibility, memory and ability to control impulses. These cognitive abilities – which together help us consider the consequences of our actions – undergo some of the <a href="https://doi.org/10.1523/JNEUROSCI.1741-13.2013">steepest development</a> between ages ten and 14. By age 15, the ability to make complex decisions has usually <a href="https://doi.org/10.1037/lhb0000315">reached adult maturity</a>. But adolescents at this age remain highly susceptible to emotions. So while their brain may be equipped to make a complex decision, their ability to think through the consequences, weighing up costs and benefits, can be clouded by emotional situations. For example, <a href="https://doi.org/10.1111/cdev.12085">research has shown</a> 13-14 year-olds were more distracted from completing a task and less able to control their behaviour when they viewed images that made them feel negative emotions. The social world of teenagers also has a significant impact on how they make decisions – especially in early adolescence. One study found that while older adolescents (aged 15-18) are more influenced by what adults think when weighing up risk, adolescents aged 12-14 <a href="https://journals.sagepub.com/doi/full/10.1177/0956797615569578">look to other teenagers</a>. Experiments <a href="https://doi.org/10.1177/0272431616648453">have also shown</a> adolescents aged 12-15 make riskier decisions when they are with peers than by themselves. Their brain responses also suggest they experience a greater sense of reward in taking those risks <a href="https://doi.org/10.1093/scan/nsy071">with peers</a>. <h2>How do teens understand the consequences of their actions?</h2> The concept of <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp2122/Quick_Guides/MinimumAgeCriminalResponsibility">criminal responsibility</a> is based on whether a person is able to understand their action and know whether it is wrong. Moral reasoning – how people think about right and wrong – depends on the ability to understand another person’s mental state and adopt their perspective. These skills are in development <a href="https://doi.org/10.1016/j.biopsych.2020.09.012">across adolescence</a>. Research suggests it may take more effort for adolescent brains to process <a href="https://doi.org/10.1162/jocn.2009.21121">“social” emotions</a> such as guilt and embarrassment, compared to adults. This is similar when they make <a href="https://doi.org/10.1080/17470919.2014.933714">moral judgements</a>. This evidence suggests teenage brains may have to work harder when considering other people’s intentions and desires. Young adolescents have the cognitive ability to appreciate they made a bad decision, but it is more mentally demanding. And social rewards, emotions and the chance to experience something new all have a strong bearing on their decisions and actions in the moment — possibly more than whether it is right or wrong. <h2>Early adolescence is critical for the brain</h2> There are also a number of reasons adolescent brains may develop differently. This includes various forms of neurodisability such as acquired brain injury, fetal alcohol spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and intellectual disability, as well as exposure to trauma. Teenagers with neurodevelopmental disorders will likely cope differently with decision making, social pressure, impulse control and risk assessment, and face <a href="https://www.mcri.edu.au/images/research/strategic-collaborations/Flagships/Neurodevelopment/Neurodevelopment_Flagship_Brochure.pdf">extra difficulties</a>. Across the world, they are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30217-8/fulltext">disproportionately incarcerated</a>. In Australia, Indigenous children and adolescents are incarcerated <a href="https://www.indigenoushpf.gov.au/measures/2-11-contact-with-the-criminal-justice-system#:%7E:text=On%20an%20average%20day%20in%202021%E2%80%9322%2C%20there%20were%3A,AIHW%202023d%3A%20Table%20S76a">in greater numbers</a> than their non-Indigenous peers. Each child matures differently, and some face extra challenges. But for every person, the period between ten and 14 is critical for developing the cognitive, social and emotional skills they’ll carry through the rest of their life.<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/237552/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, Professor of Adolescent Health The University of Melbourne; Director, Royal Children's Hospital Centre for Adolescent Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, Research Fellow, School of Psychology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-a-10-year-old-be-responsible-for-a-crime-heres-what-brain-science-tells-us-237552">original article</a>. </div>

Mind

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>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a> 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. 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. 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. <figure><iframe src="https://www.youtube.com/embed/rmThigh1i8s?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>“NO!” Barbie shouts when Weird Barbie tells her she has cellulite.</figcaption></figure> 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. 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. 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. 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”. 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. 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?” 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. 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”. 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? 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. 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>. 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. 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. 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>. 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>. My top expert advice in the run up to summer? Be wary of claims from cosmetic companies and save your money. <hr /> The Conversation has approached the Lemme Live brand for comment.<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" /> <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> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/anti-cellulite-products-are-big-business-but-heres-what-the-science-says-232318">original article</a>. </div>

Body

Michael Mosley used science communication to advance health and wellbeing. We can learn a lot from his approach

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/kirsten-adlard-684475">Kirsten Adlard</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Overnight, we learned of the <a href="https://www.abc.net.au/news/2024-06-09/michael-mosley-body-found-greek-island-clare-bailey-mosley/103957382">tragic passing</a> of Michael Mosley, who went missing last week while on holiday on the Greek island of Symi. The British celebrity doctor was a household name in many countries, including Australia. Mosley was well known for his television shows, documentaries, books and columns on healthy eating, weight management, physical activity and sleep. During the days he was missing and once his death was confirmed, media outlets have acknowledged Mosley’s <a href="https://www.independent.co.uk/arts-entertainment/tv/features/michael-mosley-tv-doctor-death-b2558717.html">career achievements</a>. He is being celebrated for his connection to diverse public audiences and his unrelenting focus on science as the best guide to our daily habits. <h2>From medicine to the media</h2> Mosley was born in India <a href="https://www.bbc.com/news/articles/c8770jyz6vvo">in 1957</a> and was sent to England at age seven to attend boarding school. He later studied philosophy, politics and economics at the <a href="https://michaelmosley.co.uk/biog/">University of Oxford</a>. After a short stint in investment banking, Mosley opted to train in medicine at the Royal Free Hospital in London. Rather than forging a career in clinical practice, <a href="https://michaelmosley.co.uk/biog/">Mosley</a> started working at the BBC in 1985 as a trainee assistant producer. In the decades that followed, Mosley continued to work with the BBC as a producer and presenter. Mosley became a popular public figure by applying his medical training to journalism to examine a breadth of health and wellbeing topics. In 1995, following his documentary on <a href="https://genome.ch.bbc.co.uk/baf970949e3a46a992ae52420395a7c2">Helicobacter pylori</a>, a bacterium that causes ulcers in the stomach, the British Medical Association named him <a href="https://www.bbc.co.uk/programmes/profiles/2kczjZKp8sGSDxSxKYzxsyr/michael-mosley">medical journalist of the year</a>. His other television work on diet, weight management, exercise and sleep earned him <a href="https://www.emmys.com/bios/michael-mosley">Emmy</a>, <a href="https://www.imdb.com/name/nm0608839/awards/">BAFTA</a> (the British Academy of Film and Television Arts), and <a href="https://rts.org.uk/tags/michael-mosley">Royal Television Society</a> <a href="https://www.bbc.co.uk/programmes/profiles/2kczjZKp8sGSDxSxKYzxsyr/michael-mosley">award nominations</a>. Over the past decade, Mosley published <a href="https://www.amazon.com.au/Fast-Diet-Original-Revised-Research/dp/1780722370/ref=sr_1_6?dib=eyJ2IjoiMSJ9.75_akcxo8tanyLrD4CVMwd1lCTliHyckSLPU2W7K4HmdPqRlVqvMbKWKkJ6CPCsrFsAw4Vfw5SWOYkl_Y8ah4yNCSjQksdT3ByCSHhiycNB9AB5h6vVUqB99okxDDWPaXUCwD-CZMzHZDvAjuAotTN">several books</a> on <a href="https://www.fishpond.com.au/Books/Fastexercise-Michael-Mosley-Peta-Bee-With/9781476759982?utm_source=googleps&utm_medium=ps&utm_campaign=AU&gad_source=1&gclid=CjwKCAjw34qzBhBmEiwAOUQcF3wd7d1bj8KMFeEtKS6ZU7py5rRzjiycZhcsMbSEQ9lXhjEBcY4GRxoCwgIQAvD_BwE">exercise</a>, <a href="https://www.amazon.com.au/8-Week-Blood-Sugar-Diet-Recipe/dp/1925456595/ref=sr_1_7?dib=eyJ2IjoiMSJ9.75_akcxo8tanyLrD4CVMwd1lCTliHyckSLPU2W7K4HmdPqRlVqvMbKWKkJ6CPCsrFsAw4Vfw5SWOYkl_Y8ah4yNCSjQksdT3ByCSHhiycNB9AB5h6vVUqB99okxDDWPaXUCwD-CZMzHZDvAjuAotTNxxkW3">healthy eating</a>, <a href="https://www.amazon.com.au/Fast-800-Australian-New-Zealand/dp/B07MPRQWJP/ref=sr_1_8?dib=eyJ2IjoiMSJ9.75_akcxo8tanyLrD4CVMwd1lCTliHyckSLPU2W7K4HmdPqRlVqvMbKWKkJ6CPCsrFsAw4Vfw5SWOYkl_Y8ah4yNCSjQksdT3ByCSHhiycNB9AB5h6vVUqB99okxDDWPaXUCwD-CZMzHZDvAjuAotTNxxkW">intermittent fasting</a>, <a href="https://www.amazon.com.au/Weeks-Better-Sleep-life-changing-improved/dp/1761425927/ref=sr_1_1?dib=eyJ2IjoiMSJ9.75_akcxo8tanyLrD4CVMwd1lCTliHyckSLPU2W7K4HmdPqRlVqvMbKWKkJ6CPCsrFsAw4Vfw5SWOYkl_Y8ah4yNCSjQksdT3ByCSHhiycNB9AB5h6vVUqB99okxDDWPaXUCwD-CZMzHZDvAj">sleep</a> and <a href="https://www.amazon.com.au/Just-One-Thing-Changes-Transform/dp/B0BJVRP94X/ref=sr_1_9?dib=eyJ2IjoiMSJ9.75_akcxo8tanyLrD4CVMwd1lCTliHyckSLPU2W7K4HmdPqRlVqvMbKWKkJ6CPCsrFsAw4Vfw5SWOYkl_Y8ah4yNCSjQksdT3ByCSHhiycNB9AB5h6vVUqB99okxDDWPaXUCwD-CZMzHZDvAjuAotTNxxk">behaviour change</a>. He sold millions of copies of his books around the world, including at least <a href="https://www.simonandschuster.com.au/p/mosley-1mil-sales">one million</a> in Australia and New Zealand. Alongside his wife, Dr Clare Bailey Mosley, he recently embarked on a <a href="https://michaelmosley.co.uk/live/">live theatre show tour</a>, yet another vehicle to bring his key messages to audiences. <h2>A trusted voice</h2> Mosley became a trusted voice for health and wellbeing throughout his journalistic career. His television program <a href="https://www.bbc.co.uk/programmes/b04j9gny">Trust Me, I’m a Doctor</a> drew on his medical qualifications to discuss health and wellbeing credibly on a public platform. His medical training also inferred credibility in examining the scientific literature that underpins the topics he was communicating. At the same time, Mosley used simple terminology that captured the attention of diverse audiences. For many of Mosley’s outputs, he used himself as an example. For instance, in his <a href="https://www.bbc.co.uk/programmes/p09by3yy/episodes/downloads">podcast series</a> Just One Thing and <a href="https://www.amazon.com.au/Just-One-Thing-Changes-Transform/dp/B0BJVRP94X/ref=sr_1_9?dib=eyJ2IjoiMSJ9.75_akcxo8tanyLrD4CVMwd1lCTliHyckSLPU2W7K4HmdPqRlVqvMbKWKkJ6CPCsrFsAw4Vfw5SWOYkl_Y8ah4yNCSjQksdT3ByCSHhiycNB9AB5h6vVUqB99okxDDWPaXUCwD-CZMzHZDvAjuAotTNxxk">companion book</a>, Mosley self-tested a range of evidence-based behavioural habits (while also interviewing subject-matter experts), covering topics such as eating slowly, yoga, listening to music, cooking, gardening and drinking green tea. His focus on intermittent fasting and high-intensity training was fuelled by his <a href="https://www.abc.net.au/news/2024-06-08/how-dr-michael-mosley-popularised-intermittent-fasting/103952408">diagnosis of type 2 diabetes</a>, and his work on sleep health was based on his experience <a href="https://www.sbs.com.au/food/article/sleep-revolution-michael-mosley/okmv5o7qe">with chronic insomnia</a>. At the most extreme end of the spectrum, Mosley <a href="https://www.bbc.com/news/science-environment-25968755">infested himself with tapeworms</a> in the pursuit of exploring their effects on the human body. By using himself as a <a href="https://www.theguardian.com/media/article/2024/jun/09/michael-mosley-favourite-health-tip-slow-deep-breathing">human guinea pig</a>, he fostered a connection with his audience, showing the <a href="https://www.chronicle.com/article/the-personal-touch-using-anecdotes-to-hook-a-reader">power</a> of personal anecdotes. <h2>Some controversies along the way</h2> Despite his notable career achievements, Mosley received ongoing criticisms about his work due to differing opinions within the medical and scientific communities. One key concern was around his promotion of potentially risky diets such as intermittent fasting and other restrictive diets, including the 5:2 diet and low-carb diets. While <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946909/">some evidence</a> supports intermittent fasting as a way to improve metabolic health and enable weight management, Mosley was criticised for not fully acknowledging the potential risks of these diets, such as a potential to lead to <a href="https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-023-00152-7">disordered eating</a> habits. His promotion of low-carb diets also raised concerns that his work added to a diet-focused <a href="https://www.independent.co.uk/life-style/health-and-families/lose-a-stone-in-21-days-channel-4-criticism-eating-disorder-food-relationship-beat-a9656531.html">culture war</a>, ultimately to the detriment of many people’s relationship with food and their bodies. More broadly, in his efforts to make scientific concepts simple and accessible to the general public, Mosley was sometimes criticised for overgeneralising science. The concern was that he didn’t properly discuss the nuance and tension inherent in scientific evidence, thereby providing an incomplete synthesis of the evidence. For example, Mosley conceptualised the <a href="https://thebloodsugardiet.com">blood sugar diet</a> (a low-carbohydrate Mediterranean-style diet), which was <a href="https://www.bbc.com/news/health-68452019">criticised</a> for lacking a strong grounding in scientific evidence. Similarly, <a href="https://www.thetimes.com/life-style/health-fitness/article/smoke-and-mirrors-the-truth-about-vaping-nmpf3przr">associating his name with e-cigarettes</a> may have drawn unhelpful attention to the topic, irrespective of the underlying details. <h2>What can we learn from Mosley?</h2> Overall, Mosley has been objectively successful in communicating scientific concepts to large, engaged audiences. Mosley showed us that people want to consume scientific information, whether through the news media, social media, podcasts or books. His passion and persistence in using science to promote health and wellbeing have likely supported public health efforts across the globe.<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/231934/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/kirsten-adlard-684475">Kirsten Adlard</a>, Supervisor of Engagement, Communication, and Outreach, Centre for Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Ken McKay/ITV/Shutterstock Editorial 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/michael-mosley-used-science-communication-to-advance-health-and-wellbeing-we-can-learn-a-lot-from-his-approach-231934">original article</a>. </div>

Caring

Are young people smarter than older adults? My research shows cognitive differences between generations are diminishing

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> We often assume young people are smarter, or at least quicker, than older people. For example, we’ve all heard that scientists, and even more so mathematicians, <a href="https://www.forbes.com/sites/nextavenue/2014/08/07/who-says-scientists-peak-by-age-50/">carry out their most important work</a> when they’re comparatively young. But my new research, <a href="https://www.sciencedirect.com/science/article/pii/S027322972400008X#:%7E:text=Highlights&text=Three%20review%20studies%20measure%20secular,%2C%20education%2C%20and%20overall%20health.">published in Developmental Review</a>, suggests that cognitive differences between the old and young are tapering off over time. This is hugely important as stereotypes about the intelligence of people in their sixties or older may be holding them back – in the workplace and beyond. Cognitive ageing is often measured by comparing young adults, aged 18-30, to older adults, aged 65 and over. There are a variety of tasks that older adults do not perform well on compared to young adults, such as memory, spatial ability and speed of processing, which often form the basis of <a href="https://theconversation.com/the-iq-test-wars-why-screening-for-intelligence-is-still-so-controversial-81428">IQ tests</a>. That said, there are a few tasks that older people do better at than younger people, such as reading comprehension and vocabulary. Declines in cognition are driven by a process called <a href="https://www.nature.com/collections/cbjacdabdf">cognitive ageing</a>, which happens to everyone. Surprisingly, age-related cognitive deficits start very early in adulthood, and declines in cognition have been measured as dropping in adults as young as just 25. Often, it is only when people reach older age that these effects add up to a noticeable amount. Common complaints consist of walking into a room and forgetting why you entered, as well as difficulty remembering names and struggling to drive in the dark. <h2>The trouble with comparison</h2> Sometimes, comparing young adults to older adults can be misleading though. The two generations were brought up in different times, with different levels of education, healthcare and nutrition. They also lead different daily lives, with some older people having lived though a world war while the youngest generation is growing up with the internet. Most of these factors favour the younger generation, and this can explain a proportion of their advantage in cognitive tasks. Indeed, much existing research shows that <a href="https://theconversation.com/iq-tests-are-humans-getting-smarter-158837">IQ has been improving</a> globally throughout the 20th century. This means that later-born generations are more cognitively able than those born earlier. This is even found when both generations are tested in the same way at the same age. Currently, there is growing evidence that <a href="https://www.pnas.org/doi/10.1073/pnas.1718793115">increases in IQ are levelling off,</a> such that, in the most recent couple of decades, young adults are no more cognitively able than young adults born shortly beforehand. Together, these factors may underlie the current result, namely that cognitive differences between young and older adults are diminishing over time. <h2>New results</h2> My research began when my team started getting strange results in our lab. We found that often the age differences we were getting between young and older adults was smaller or absent, compared to prior research from early 2000s. This prompted me to start looking at trends in age differences across the psychological literature in this area. I uncovered a variety of data that compared young and older adults from the 1960s up to the current day. I plotted this data against year of publication, and found that age deficits have been getting smaller over the last six decades. Next, I assessed if the average increases in cognitive ability over time seen across all individuals was a result that also applied to older adults specifically. Many large databases exist where groups of individuals are recruited every few years to take part in the same tests. I analysed studies using these data sets to look at older adults. I found that, just like younger people, older adults were indeed becoming more cognitively able with each cohort. But if differences are disappearing, does that mean younger people’s improvements in cognitive ability have slowed down or that older people’s have increased? I analysed data from my own laboratory that I had gathered over a seven-year period to find out. Here, I was able to dissociate the performance of the young from the performance of the older. I found that each cohort of young adults was performing to a similar extent across this seven-year period, but that older adults were showing improvements in both processing speed and vocabulary scores. <figure class="align-center "><img src="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=333&fit=crop&dpr=1 600w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=333&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=333&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=418&fit=crop&dpr=1 754w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=418&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=418&fit=crop&dpr=3 2262w" alt="The figure shows data for a speed-based task where higher scores represent better performance." /><figcaption>The figure shows data for a speed-based task where higher scores represent better performance. <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></figcaption></figure> I believe the older adults of today are benefiting from many of the factors previously most applicable to young adults. For example, the number of children who went to school <a href="https://education-uk.org/history/chapter12.html">increased significantly</a> in the 1960s – with the system being more similar to what it is today than what it was at the start of the 20th century. This is being reflected in that cohort’s increased scores today, now they are older adults. At the same time, young adults have hit a ceiling and are no longer improving as much with each cohort. It is not entirely clear why the young generations have stopped improving so much. Some research has <a href="https://doi.org/10.1016/j.intell.2016.10.002">explored maternal age, mental health and even evolutionary trends</a>. I favour the opinion that there is just a natural ceiling – a limit to how much factors such as education, nutrition and health can improve cognitive performance. These data have important implications for research into dementia. For example, it is possible that a modern older adult in the early stages of dementia might pass a dementia test that was designed 20 or 30 years ago for the general population at that time. Therefore, as older adults are performing better in general than previous generations, it may be necessary to revise definitions of dementia that depend on an individuals’ expected level of ability. Ultimately, we need to rethink what it means to become older. And there’s finally some good news. Ultimately, we can expect to be more cognitively able than our grandparents were when we reach their age.<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/229132/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-young-people-smarter-than-older-adults-my-research-shows-cognitive-differences-between-generations-are-diminishing-229132">original article</a>. </div>

Mind

New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Mild cognitive impairment – an early stage of dementia – is widely underdiagnosed in people 65 and older. That is the key takeaway of two recent studies from our team. In the first study, we used Medicare data for about 40 million beneficiaries age 65 and older from 2015 to 2019 to estimate the prevalence of mild cognitive impairment in that population and to identify what proportion of them had actually been diagnosed. Our <a href="https://doi.org/10.1186/s13195-023-01272-z">finding was sobering</a>: A mere 8% of the number of cases with mild cognitive impairment that we expected based on a statistical model had actually been diagnosed. Scaled up to the general population 65 and older, this means that approximately 7.4 million cases across the country remain undiagnosed. In the second study, we analyzed data for 226,756 primary care clinicians and found that <a href="https://doi.org/10.14283/jpad.2023.131">over 99% of them underdiagnosed mild cognitive impairment</a> in this population. <h2>Why it matters</h2> Mild cognitive impairment is an early symptom of Alzheimer’s disease in <a href="https://doi.org/10.1001/jama.2019.2000">about half of cases</a> and progresses to dementia <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment">at a rate of 10% to 15% per year</a>. It includes symptoms such as losing the ability to remember recent events and appointments, make sound decisions and master complex tasks. Failure to detect it might deprive patients of an opportunity to get treated and to slow down disease progression. Mild cognitive impairment can sometimes be caused by easily addressable factors, such as medication side effects, thyroid dysfunction or <a href="https://theconversation.com/vitamin-b12-deficiency-is-a-common-health-problem-that-can-have-serious-consequences-but-doctors-often-overlook-it-192714">vitamin B12 deficiency</a>. Since mild cognitive impairment has <a href="https://doi.org/10.1016/j.amjopharm.2008.06.004">the same risk factors as cardiovascular disease</a>, such as high blood pressure and cholesterol, medication management of these risks combined with diet and exercise <a href="https://doi.org/10.1016/S0140-6736(15)60461-5">can reduce the risk of progression</a>. In 2023, the Food and Drug Administration <a href="https://www.fda.gov/news-events/press-announcements/fda-converts-novel-alzheimers-disease-treatment-traditional-approval">approved the drug lecanemab</a> as the <a href="https://theconversation.com/what-the-fdas-accelerated-approval-of-a-new-alzheimers-drug-could-mean-for-those-with-the-disease-5-questions-answered-about-lecanemab-197460">first disease-modifying treatment</a> <a href="https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease">for Alzheimer’s disease</a>, the most common cause of mild cognitive impairment. In contrast to previous drugs, which can temporarily improve symptoms of the disease, such as memory loss and agitation, this new treatment addresses the underlying cause of the disease. Lecanemab, a monoclonal antibody, <a href="https://www.news-medical.net/health/What-are-Amyloid-Plaques.aspx">reduces amyloid plaques</a> in the brain, which are toxic protein clumps that are believed to contribute to the progression of the disease. In a large clinical trial, lecanemab was able to <a href="https://doi.org/10.1056/NEJMoa2212948">reduce the progression</a> of early-stage Alzheimer’s disease. A similar drug, donanemab, also <a href="https://doi.org/10.1001/jama.2023.13239">succeeded in a clinical trial</a> and is expected to be <a href="https://www.medicalnewstoday.com/articles/fda-delays-approval-of-alzheimers-drug-donanemab-what-experts-think">approved sometime in 2024</a>. However, these drugs must be used in the early stages of Alzheimer’s disease, ideally when a patient has only mild cognitive impairment, as there is <a href="https://www.alz.org/alzheimers-dementia/treatments/lecanemab-leqembi">no evidence that they are effective in advanced stages</a>. <figure><iframe src="https://www.youtube.com/embed/w3IbAscNjsQ?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>An earlier diagnosis leads to early treatment and better outcomes.</figcaption></figure> <h2>What still isn’t known</h2> Many factors contribute to the <a href="https://doi.org/10.1002/alz.13051">lack of timely detection</a>. But researchers don’t have a good understanding of the relative importance of those individual factors or how to reduce the high rate of underdiagnosis. While distinct, symptoms are subtle and their slow progression means that they can be overlooked or misinterpreted as normal aging. A neurologist in China told our research team that diagnosis rates spike in China after the New Year’s holiday, when children who haven’t seen their parents for a year notice changes that are harder to pick up when interacting with someone daily. Doctors also commonly discount memory concerns as normal aging and doubt that much can be done about it. While cognitive tests to distinguish mild cognitive impairment from pathologic decline do exist, they take about 15 minutes, which can be hard to come by during the limited time of a doctor’s visit and may require a follow-up appointment. <h2>What’s next</h2> People, particularly those in their 60s and beyond, as well as their families and friends need to be vigilant about cognitive decline, bring it up during doctor’s appointments and insist on a formal assessment. The <a href="https://www.medicare.gov/coverage/yearly-wellness-visits">Medicare yearly “wellness” visit</a> is an opportunity to explore such concerns, but only about half of beneficiaries <a href="https://doi.org/10.1377/hlthaff.2019.01795">take advantage of it</a>. Just as physicians ask patients about unexplained weight loss and take those concerns seriously, we believe questions that explore a patient’s cognitive state need to become the norm. The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, Director of the USC Dornsife Brain Health Observatory, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, Research Scientist, Center for Economic and Social Research, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-studies-suggest-millions-with-mild-cognitive-impairment-go-undiagnosed-often-until-its-too-late-216892">original article</a>. </div>

Mind

What is minoxidil, the anti-balding hair growth treatment? Here’s what the science says

<a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Hair loss (also known as alopecia) often affects the scalp but can occur anywhere on the body. It’s very common and usually nothing to worry about; about <a href="https://www.sciencedirect.com/science/article/pii/S0022202X15525840">half of Australian men</a> show signs of visible baldness at age 50 and <a href="https://www.sciencedirect.com/science/article/pii/S0022202X15525840">over a quarter of Australian women</a> report hair thinning by the same age. It’s often genetic. But if you’ve noticed hair loss and are worried by it, see a GP or dermatologist for a diagnosis before trying any treatments. Products claiming to reverse hair loss are everywhere, but few have been scientifically tested for how well they work. One group of products that have actually been scientifically tested, however, are known as topical minoxidil products. These include products such as Regaine®. So, do they work? Here’s what the research evidence says, what you can realistically expect and what you need to know if you’re considering this treatment. <h2>What is minoxidil – and does it work?</h2> Topical minoxidil usually comes as a kind of foam or serum you apply to your scalp. It’s been approved by the <a href="https://www.tga.gov.au/">Therapeutic Goods Administration</a>, Australia’s regulatory authority for therapeutic goods, for the treatment of hereditary hair loss in males and females. Minoxidil is also available in tablet form, but this isn’t currently approved for hair loss (more on that later). So, is topical minoxidil effective? In short – yes, but the results vary widely from person to person, and it needs to be used consistently over several months to see results. Scientists don’t know exactly how minoxidil works. It may affect the different phases of the hair life cycle, thereby encouraging growth. It also <a href="https://www.tandfonline.com/doi/full/10.1080/09546634.2021.1945527?casa_token=KhIM_u0u8nwAAAAA:5njp_XE5cHhip454ycvU1p9p_t0VVzpjRu0ozDZ9YqNb04fmhmngWzYeiowZcG5UugLQkTVIzCcj7A">opens up blood vessels</a> near hair follicles. This increases blood flow, which in turn delivers more oxygen and nutrients to the hair. While minoxidil is unlikely to restore a full head of thick, lush, hair, it can slow down hair loss and can <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007628.pub4/full?highlightAbstract=minoxidil">stimulate regrowth</a>. It is the over-the-counter option with the most evidence. Two strengths are available: 5% and 2%. An analysis of randomised controlled trials found minoxidil applied to the scalp twice a day increased the number of hairs per square centimetre by <a href="https://pubmed.ncbi.nlm.nih.gov/28396101/">eight to 15 hairs</a>, with the higher strength treatment having a slightly greater effect. <h2>Can I use it for non-genetic balding?</h2> There are many causes of hair loss. The main cause in both males and females is a hereditary condition called androgenic alopecia. Although topical minoxidil is only approved for use in Australia for androgenic alopecia, there is some evidence it can also help in other conditions that cause hair loss. For example, it may hasten hair regrowth in patients who have lost hair due to <a href="https://www.jaad.org/article/S0190-9622(96)90500-9/abstract">chemotherapy</a>. Unfortunately, minoxidil is not effective when the hair follicle is gone, like after a burn injury. Although small studies have found promising results using minoxidil to promote hair growth on the face (for <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.13312">beard</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/24471459/">eyebrow</a> enhancement), topical minoxidil products are not currently approved for this use. More research is required. <h2>What else do I need to know?</h2> Minoxidil won’t work well for everyone. Early in treatment you might notice a temporary increase in <a href="https://pubmed.ncbi.nlm.nih.gov/22409453/">hair shedding</a>, as it alters the hair cycle to make way for new growth. Minoxidil needs to be trialled for three to six months to determine if it’s effective. And as it doesn’t cure hair loss, you must <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.14624?casa_token=P-zW7kDNRs8AAAAA%3AaUgUzxU7lbwBpg1BYPajOfXFhpb_mU5g_ounZ6GtjsLLkHO_AdVQ2Kf-8zZkW80ykBj3N_sOsyn392uc">continue</a> to use it each day to maintain the effect. If you stop, you will start losing the new hair growth <a href="https://www.nps.org.au/assets/medicines/1f8127a5-2a98-4013-a7c3-a53300feb0e5-reduced.pdf">within three to four months</a>. Minoxidil products may not be suitable for everyone. If you have any medical conditions or take any medications, you should speak with your doctor or pharmacist before using minoxidil products. It has not been tested for safety in <a href="https://www.nps.org.au/assets/medicines/1f8127a5-2a98-4013-a7c3-a53300feb0e5-reduced.pdf">people under 18, over 65, or those who are pregnant</a>. You can read the <a href="https://www.nps.org.au/medicine-finder/regaine-for-men-regular-strength-application">consumer medicines information sheet</a> for more information about using over-the-counter minoxidil products. Many people do not like to use minoxidil solution or foams long-term because they need to be applied everyday day, which can be inconvenient. Or they may notice side effects, such as scalp irritation and changes to hair texture. Some people <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.14624?casa_token=P-zW7kDNRs8AAAAA%3AaUgUzxU7lbwBpg1BYPajOfXFhpb_mU5g_ounZ6GtjsLLkHO_AdVQ2Kf-8zZkW80ykBj3N_sOsyn392uc">tolerate the foam products better</a> than the solution, as the solution contains more of a compound called propylene glycol (which can irritate the skin). <h2>What about the oral tablet form of minoxidil?</h2> Minoxidil is also available on prescription as an oral tablet. While traditionally used for high blood pressure, it has also been used as a treatment for hair loss. In 2020, a <a href="https://www.jaad.org/article/S0190-9622(20)32109-5/abstract">systematic review</a> identified 17 studies involving 634 patients using oral minoxidil for various hair loss conditions. The authors found oral minoxidil was effective and generally well tolerated in healthy people who were having trouble using the topical products. The review noted oral minoxidil may increase hair growth over the whole body and may cause heart-related side effects in some patients. More research is required. In Australia, oral minoxidil is available under the trade name <a href="https://www.nps.org.au/assets/medicines/df29e16f-6464-4652-ba1f-a53300fed275.pdf">Loniten</a>®. However, it is currently only approved for use in high blood pressure. When people seek a prescription treatment for a non-approved purpose, this is called “off-label” prescribing. Off-label prescribing of oral minoxidil, potentially for use in alopecia, may have contributed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170338/">shortages</a> of Loniten® tablets in recent years. This can reduce availability of this medicine for people who need it for high blood pressure.<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/223736/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, Senior Lecturer in Pharmacy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> 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-minoxidil-the-anti-balding-hair-growth-treatment-heres-what-the-science-says-223736">original article</a>. Image: Getty

Body

Run out of butter or eggs? Here’s the science behind substitute ingredients

<a href="https://theconversation.com/profiles/paulomi-polly-burey-404695">Paulomi (Polly) Burey</a>, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a> It’s an all too common situation – you’re busy cooking or baking to a recipe when you open the cupboard and suddenly realise you are missing an ingredient. Unless you can immediately run to the shops, this can leave you scrambling for a substitute that can perform a similar function. Thankfully, such substitutes can be more successful than you’d expect. There are a few reasons why certain ingredient substitutions work so well. This is usually to do with the chemistry and the physical features having enough similarity to the original ingredient to still do the job appropriately. Let’s delve into some common ingredient substitutions and why they work – or need to be tweaked. <iframe id="IitfH" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/IitfH/1/" width="100%" height="400px" frameborder="0"></iframe> <h2>Oils versus butter</h2> Both butter and oils belong to a chemical class called <a href="https://chem.libretexts.org/Bookshelves/Introductory_Chemistry/Map%3A_Fundamentals_of_General_Organic_and_Biological_Chemistry_(McMurry_et_al.)/23%3A_Lipids/23.01%3A_Structure_and_Classification_of_Lipids">lipids</a>. It encompasses solid, semi-solid and liquid fats. In a baked product the “job” of these ingredients is to provide flavour and influence the structure and texture of the finished item. In cake batters, lipids contribute to creating an emulsion structure – this means combining two liquids that wouldn’t usually mix. In the baking process, this helps to create a light, fluffy crumb. One of the primary differences between butter and oil is that butter is only about 80% lipid (the rest being water), while <a href="https://www.nutritionadvance.com/types-of-cooking-fats-and-oils/">oil is almost 100% lipid</a>. Oil creates a softer crumb but is still a great fat to bake with. You can use a wide range of oils from different sources, such as olive oil, rice bran, avocado, peanut, coconut, macadamia and many more. Each of these may impart different flavours. Other “butters”, such as peanut and cashew butter, aren’t strictly butters but pastes. They impart different characteristics and can’t easily replace dairy butter, unless you also add extra oil. <h2>Aquafaba or flaxseed versus eggs</h2> Aquafaba is the liquid you drain from a can of legumes – such as chickpeas or lentils. It contains proteins, kind of how egg white also contains proteins. The proteins in egg white include albumins, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912395/">aquafaba also contains albumins</a>. This is why it is possible to make meringue from egg whites, or from aquafaba if you’re after a vegan version. The proteins act as a foam stabiliser – they hold the light, airy texture in the product. The concentration of protein in egg white is a bit higher, so it doesn’t take long to create a stable foam. Aquafaba requires more whipping to create a meringue-like foam, but it will bake in a similar way. Another albumin-containing alternative for eggs is <a href="https://foodstruct.com/compare/seeds-flaxseed-vs-egg">flaxseed</a>. These seeds form a thick gel texture when mixed with a little water. The texture is similar to raw egg and can provide structure and emulsification in baked recipes that call for a small amount of egg white. <h2>Lemon plus dairy versus buttermilk</h2> Buttermilk is the liquid left over after churning butter – it can be made from sweet cream, cultured/sour cream or whey-based cream. Buttermilk mostly <a href="https://www.journalofdairyscience.org/article/S0022-0302(06)72115-4/fulltext">contains proteins and fats</a>. Cultured buttermilk has a somewhat tangy flavour. Slightly soured milk can be a good substitute as it contains similar components and isn’t too different from “real” buttermilk, chemically speaking. One way to achieve slightly soured milk is by adding some lemon juice or cream of tartar to milk. Buttermilk is used in pancakes and baked goods to give extra height or volume. This is because the acidic (sour) components of buttermilk interact with baking soda, producing a light and airy texture. Buttermilk can also influence flavour, imparting a slightly tangy taste to pancakes and baked goods. It can also be used in sauces and dressings if you’re looking for a lightly acidic touch. <h2>Honey versus sugar</h2> Honey is a <a href="https://resources.perkinelmer.com/lab-solutions/resources/docs/APP_Analysis-of-Sugars-in-Honey-012101_01.pdf">complex sugar-based syrup</a> that includes floral or botanical flavours and aromas. Honey can be used in cooking and baking, adding both flavour and texture (viscosity, softness) to a wide range of products. If you add honey instead of regular sugar in baked goods, keep in mind that honey imparts a softer, moister texture. This is because it contains more moisture and is a humectant (that is, it likes to hold on to water). It is also less crystalline than sugar, unless you leave it to crystallise. The intensity of sweetness can also be different – some people find honey is sweeter than its granular counterpart, so you will want to adjust your recipes accordingly. <h2>Gluten-free versus regular flour</h2> Sometimes you need to make substitutions to avoid allergens, such as gluten – the protein found in cereal grains such as wheat, rye, barley and others. Unfortunately, gluten is also the component that gives a nice, stretchy, squishy quality to bread. To build this characteristic in a gluten-free product, it’s necessary to have a mixture of ingredients that work together to mimic this texture. Common ingredients used are corn or rice flour, xanthan gum, which acts as a binder and moisture holder, and tapioca starch, which is a good water absorbent and can aid with binding the dough. <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/202036/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paulomi-polly-burey-404695">Paulomi (Polly) Burey</a>, Associate Professor (Food Science), <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/run-out-of-butter-or-eggs-heres-the-science-behind-substitute-ingredients-202036">original article</a>.

Food & Wine

Science finally proves "Money doesn't buy happiness"

A new study has proven that the old adage "money can't buy you happiness" is true. Historically, economic wealth and higher income households are often seen to have an increased level of wellbeing and happiness, with the extra money making way for less stress and more general comfortability. However, researchers from Canada and Spain have concluded this may not be true, with such surveys often including responses from people in industrialised areas only. People in small-scale societies where money does not play a central role in every day life are often excluded from these studies, as the livelihood of residents in these small communities usually depend more on nature. Now, 2,966 people from Indigenous and local communities in 19 locations across the globe have been included in a study, with researchers now finding that societies of Indigenous people and those in small, local communities report living very satisfying lives despite not having a lot of money. The researchers wrote, "The striking aspect of our findings... is that reported life satisfaction in very low-income communities can meet and even exceed that reported at the highest average levels of material wealth provided by industrial ways of life." Researchers concluded the findings are strong evidence that economic growth is not needed to be happy, with only 64 percent of households included in the survey reported having any cash income. Eric Galbraith, lead author of the study, said, "Surprisingly, many populations with very low monetary incomes report very high average levels of life satisfaction, with scores similar to those in wealthy countries." Researchers added that high life satisfaction is shown in these communities "despite many of these societies having suffered histories of marginalisation and oppression." Galbraith added, "I would hope that, by learning more about what makes life satisfying in these diverse communities, it might help many others to lead more satisfying lives while addressing the sustainability crisis." Image credits: Shutterstock

Money & Banking

How to make the perfect pavlova, according to chemistry experts

<a href="https://theconversation.com/profiles/nathan-kilah-599082">Nathan Kilah</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> and <a href="https://theconversation.com/profiles/chloe-taylor-1400788">Chloe Taylor</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> The pavlova is a summer icon; just a few simple ingredients can be transformed into a beautifully flavoured and textured dessert. But despite its simplicity, there’s a surprising amount of chemistry involved in making a pavlova. Knowing what’s happening in each step is a sure-fire way to make yours a success. So exactly what does it take to make the perfect pavlova? Let us break it down for you. <h2>Egg whites</h2> <a href="https://theconversation.com/eight-cracking-facts-about-eggs-150797">Egg white</a> is basically a mixture of proteins in water. Two of these proteins, ovalbumin and ovomucin, are the key to forming a perfect foamy meringue mixture. Whipping the egg whites agitates the proteins and disrupts their structure, causing them to unfold so the protein’s interior surface is exposed, in a process <a href="https://theconversation.com/sunny-side-up-can-you-really-fry-an-egg-on-the-footpath-on-a-hot-day-172616">known as denaturing</a>. These surfaces then join with one another to trap air bubbles and turn into a stable foam. Egg yolk must be completely removed for this process to work. Yolk is mostly made of fat molecules, which would destabilise the protein network and pop the air bubbles. It only takes a trace amount of fat, or even just a greasy bowl, to disrupt foam formation. You should always whip your egg whites in a clean glass or metal bowl. Plastic bowls are more likely to hold leftover grease. <h2>Sugar</h2> A traditional pavlova uses sugar – a lot of it – to provide texture and flavour. The ratio of sugar to egg white will differ between recipes. The first thing to remember is that adding more sugar will give you a drier and crispier texture, whereas less sugar will lead to a softer and chewier pavlova that won’t keep as long. The second thing is the size of the sugar crystals. The larger they are, the longer they’ll need to be whipped to dissolve, and the greater the chance you will overwork the proteins in your meringue. Powdered icing sugar (not icing mixture) is preferable to caster or granulated sugar. If you do happen to overbeat your meringue (which may end up looking clumpy and watery) you can try to save it by adding another egg white. <h2>Acid</h2> Many pavlova recipes call for adding cream of tartar or vinegar. Cream of tartar is also known as potassium hydrogen tartrate, which you may have seen in the form of crystals at the <a href="https://theconversation.com/louis-pasteurs-scientific-discoveries-in-the-19th-century-revolutionized-medicine-and-continue-to-save-the-lives-of-millions-today-191395">bottom of a wine glass</a>. These acids act as a stabilising agent for the meringue by aiding in the unfolding of the egg white proteins. More isn’t always better, though. Using too much stabiliser can affect the taste and texture, so use it sparingly. <h2>Heat</h2> Cooking a pavlova requires a very slow oven for specific chemical reasons. Namely, egg white proteins gel at temperatures above 60°C, setting the meringue. At higher temperatures a chemical reaction known as the <a href="https://theconversation.com/kitchen-science-from-sizzling-brisket-to-fresh-baked-bread-the-chemical-reaction-that-makes-our-favourite-foods-taste-so-good-58577">Maillard reaction</a> takes place in which proteins and sugars react to form new flavourful compounds. We can thank the Maillard reaction for many delicious foods including <a href="https://theconversation.com/brewing-a-great-cup-of-coffee-depends-on-chemistry-and-physics-84473">roasted coffee</a>, toast and <a href="https://theconversation.com/what-makes-smoky-charred-barbecue-taste-so-good-the-chemistry-of-cooking-over-an-open-flame-184206">seared steak</a>. However, excessive Maillard reactions are undesirable for a pavlova. An oven that’s too hot will turn your meringue brown and give it a “caramelised” flavour. Recipes calling for pavlova to be left in the oven overnight may actually overcook it. At the same time, you don’t want to accidentally undercook your pavlova – especially since uncooked eggs are often responsible for <a href="https://theconversation.com/how-to-avoid-food-borne-illness-a-nutritionist-explains-153185">food poisoning</a>. To kill dangerous bacteria, including salmonella, the pavlova’s spongy centre must reach <a href="https://foodsafety.asn.au/eggs/">temperatures above 72°C</a>. An alternative is to use pasteurised egg whites, which are briefly heated to a very high temperature to kill any pathogens. But this processing may also affect the egg white’s whippability. <h2>Substitute ingredients</h2> People love pavlova, and nobody should have to miss out. Luckily they don’t have to. If you want to <a href="https://theconversation.com/a-taste-for-sweet-an-anthropologist-explains-the-evolutionary-origins-of-why-youre-programmed-to-love-sugar-173197">limit your sugar intake</a>, you can make your meringue using sweeteners such as <a href="https://theconversation.com/whats-the-difference-between-sugar-other-natural-sweeteners-and-artificial-sweeteners-a-food-chemist-explains-sweet-science-172571">powdered erythritol or monk fruit</a>. But, if you do, you may want to add some extra stabiliser such as cornflour, arrowroot starch, or a pinch of xanthan gum to maintain the classic texture. Also, if you want a vegan pavlova, you can turn to the chickpea instead of the chicken! <a href="https://review.jove.com/t/56305/composition-properties-aquafaba-water-recovered-from-commercially">Aquafaba</a> – the water collected from tinned or soaked beans – contains proteins and carbohydrates that give it emulsifying, foaming and even thickening properties. Egg-free pavlova recipes typically replace one egg white with about two tablespoons of aquafaba. And for those of you who don’t do gluten, pavlova can easily be made <a href="https://theconversation.com/gluten-free-diet-is-expensive-socially-challenging-for-those-with-celiac-disease-and-wheat-allergy-155861">gluten-free</a> by using certain stabilising agents. All that’s left is to get creative with your toppings and decide what to do with those leftover yolks!<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/196485/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nathan-kilah-599082">Nathan Kilah</a>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> and <a href="https://theconversation.com/profiles/chloe-taylor-1400788">Chloe Taylor</a>, Research Fellow - PhD candidate, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-make-the-perfect-pavlova-according-to-chemistry-experts-196485">original article</a>.

Food & Wine

Worrying news – ozone layer not recovering after all

Alarming news from New Zealand scientists suggests the ozone layer might not be recovering after all, with the problem exacerbated by bushfires, volcanic eruptions and greenhouse gas emissions. <div class="copy"> The research <a href="https://doi.org/10.1038/s41467-023-42637-0" target="_blank" rel="noopener">published</a> in Nature Communications suggests the Antarctic ozone layer has reduced by 26% since 2004, contrary to previous reports of recovery by actions taken under an agreement called the Montreal Protocol. The authors say wildfire and volcanic aerosols together with greenhouse gas emissions probably explain recent setbacks with record large, long-lived ozone holes re-emerging over Antarctica during Spring since 2020. Climate change is influencing the <a href="http://www.bom.gov.au/weather-services/fire-weather-centre/bushfire-weather/index.shtml" target="_blank" rel="noopener">severity and frequency</a> of bushfires. The ozone hole was previously thought to be under repair thanks to a global agreement signed in Montreal, Canada to limit ozone depleting substances. But the paper finds insignificant long-term change in the total ozone column since the early 2000s, “even where significant recovery has previously been reported”. The analysis of daily and monthly ozone changes between 2001 – 2022, show delays in the formation of the ozone hole. While early springtime shows signs of recovery in the ozone layer, this is followed by declines during late September. Researcher and author Hannah Kessenich from the University of Otago says: “by looking at detailed, daily ozone observations from the last 19 years, we find evidence of much less ozone in the centre of the Antarctic ozone hole compared to 19 years ago. This means that the hole has not only remained large in area, but it has also become deeper (i.e. has less ozone) throughout most of Antarctic spring.” But Atmospheric scientist, Dr Martin Jucker from the University of NSW is not convinced by the results of the study. He says: “Their results rely heavily on the large ozone holes we have seen in 2020-2022. However, existing literature has already found reasons for these large ozone holes: Smoke from the 2019 bushfires and a volcanic eruption (La Soufriere), as well as a general relationship between the polar stratosphere and El Niño Southern Oscillation […] The years 2020-22 have seen a rare triple La Niña, but this relationship is never mentioned in the study.” <a href="https://cosmosmagazine.com/earth/earth-sciences/ozone-hole-among-largest-on-record/">This Spring</a>, the European Space Agency reported yet another large ozone hole had formed, among the biggest on record. The layer of ozone high in the atmosphere protects the Earth from ultraviolet (UV) radiation from the Sun. Ozone depletion exposes people, particularly in the Southern Hemisphere, to a higher risk of skin cancer. Image credits: Getty Images <div> <noscript data-spai="1">&lt;img decoding="async" fetchpriority="high" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/11/Cosmos-Catch-Up-embed_728x150-1.jpg" data-spai-egr="1" alt="Sign up to our weekly newsletter" width="600" height="154" title="worrying news - ozone layer not recovering after all 2"&gt;</noscript> </div>  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=288486&title=Worrying+news+%26%238211%3B+ozone+layer+not+recovering+after+all" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /><a href="https://cosmosmagazine.com/earth/climate/ozone-layer-not-recovering/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </div>

Travel Trouble

Sweet secrets – the science of keeping good news hush hush

Most people keep secrets, and staying hush about good news – like pregnancy, presents, proposals and promotions – tends to be freely chosen, enjoyable and energising according to new research. <div class="copy"> Conventional wisdom holds that secrecy is a burden, and good news is <a href="https://cosmosmagazine.com/health/body-and-mind/seeing-emotions/">meant to be shared</a>. But Australian and United States researchers <a href="https://dx.doi.org/10.1037/pspa0000352" target="_blank" rel="noopener">publishing</a> in the Journal of Personality and Social Psychology investigated the effects of keeping positive news to one’s self, finding the motivations and effects are quite different to other types of secrets. Associate Professor Katharine Greenaway researches <a href="https://cosmosmagazine.com/people/society/are-sciences-equal/">social psychology</a> at the University of Melbourne and is an author of the paper. She tells Cosmos: “secrecy is extremely common – on average, 97% of people are keeping a secret right now.” “It’s obviously fascinating to know, people’s secrets, and why they keep them,” she says. Greenaway adds studying secrecy is “really interesting theoretically because we’re social creatures. From our evolutionary past, we’ve always had to be social, we’ve had to communicate in order to co-operate. So, from that perspective it’s really interesting, why would we ever want to keep information from other people? […] It’s particularly interesting why we would keep positive information from others.” Across 5 different experiments involving 2,500 participants the researchers tested different elements of positive secrecy: the effect of secret and non-secret good news; deliberately keeping news secret for personal reasons compared to external reasons ; and the effects of positive secrets compared to other kinds of secrets. “Positive secrets, we’ve found, tend to be the types of secrets people choose freely, and they actually quite enjoy keeping,” Greenaway says. In one study, involving 194 people, participants were provided with a list of 38 common categories of good news, such as: pregnancy; won something; new possession; financial windfall; family news; and self-development. They were asked to indicate which items were relevant, and any they were keeping secret. On average, participants held 14 to 15 pieces of good news, keeping 5 to 6 positive items to themselves. A second study tested motivation. A new group of 600 participants in committed relationships were asked to imagine a plausible piece of good news (from the list of common good news). They were randomly assigned to imagine either: deciding to keep the news secret until they chose share it with their partner, or the information remaining unknown due to external factors like being in meetings all day. For a further group, no reason was specified for not sharing the news. Participants were then asked about how “tired, depleted, weak, passive, active, invigorated, strong, energized, awake and alert, and alive they felt” on a scale from not at all ‘1’ to very much ‘7’. When people elected to keep a piece of good news private, they felt energised. But when external factors got in the way of sharing information, they felt fatigued. <iframe title="People are Seriously becoming Friends with their Robotic Vacuums" src="https://omny.fm/shows/huh-science-explained/people-are-seriously-becoming-friends-with-their-r/embed?in_playlist=podcast&style=Cover" width="100%" height="180" frameborder="0"></iframe> Three further experiments tested the effect of positive or negative secrets. Finding positive secrets were more likely to be kept for personal reasons, freely chosen, generating greater feelings of energy. “When people keep a positive secret as opposed to a different type of secret, they tend to have relatively more intrinsic motivation for doing so. Intrinsic motivation is associated with feeling like something is really important, personally valuable to you. And also enjoyable,” says Greenaway. “If you’ve kept a negative secret, often you’re worried about what would happen if that secret got out […] you feel as though that’s something that’s being imposed on you, as opposed to something that you’re freely choosing to keep secret from others.” Prior research has mostly focused on negative secrets, suggesting secrecy can be harmful. In contrast, this new research suggests holding on to positive news is more likely to be freely chosen, for personal reasons, and can be more energising than sharing the information. Image credits: Getty Images <div> <noscript data-spai="1">&lt;img decoding="async" fetchpriority="high" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/11/Cosmos-Catch-Up-embed_728x150-1.jpg" data-spai-egr="1" alt="Sign up to our weekly newsletter" width="600" height="154" title="sweet secrets - the science of keeping good news hush hush 2"&gt;</noscript> </div>  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=288402&title=Sweet+secrets+%26%238211%3B+the+science+of+keeping+good+news+hush+hush" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /><a href="https://cosmosmagazine.com/people/social-sciences/sweet-secrets-science/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </div>

Mind

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

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Coffee is well recognised as having a positive impact on long-term health. Drinking the equivalent of three to four cups of instant coffee a day <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">reduces the risk</a> of many health conditions including heart disease, type 2 diabetes and some cancers. Most people gain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984841/">small amounts of weight</a> each year as they age. But can coffee help prevent this gradual weight gain? A group of researchers examined whether drinking an extra cup of coffee a day – or adding sugar, cream or a non-dairy alternative – resulted in more or less weight gain than those who didn’t adjust their intake. Their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002916523661702">research</a> (currently a pre-proof, which means it has been peer reviewed but is yet to undergo the final formatting and copyediting) found a modest link between coffee and gaining less weight than expected. People who drank an extra cup of coffee a day gained 0.12 kg less weight than expected over four years. Adding sugar resulted in a fraction more (0.09 kg) weight gain than expected over four years. <h2>How was the study conducted? What did it find?</h2> Researchers combined data from three large studies from the United States: two <a href="https://nurseshealthstudy.org">Nurses’ Health Studies</a> from 1986 to 2010, and from 1991 to 2015, and a <a href="https://www.hsph.harvard.edu/hpfs/about-the-study/">Health Professional Follow-up study</a> from 1991 to 2014. The Nurses’ Health Studies are two of the largest cohort studies, with more 230,000 participants, and investigates chronic disease risks for women. The Health Professional Follow-up study involves more than 50,000 male health professionals and investigates the relationship between diet and health outcomes. Participants in all three studies completed a baseline questionnaire, and another questionnaire every four years to assess their food and drink intake. Using the combined datasets, researchers analysed changes in coffee intake and changes in the participants’ self-reported weight at four-year intervals. The average four year weight-gains for the nurses’ studies were 1.2kg and 1.7kg, while participants in the health professionals study gained an average of 0.8kg. The researchers found that increasing unsweetened caffeinated or decaffeinated coffee intake by one cup a day was associated with a weight gain that was 0.12 kg less than expected over four years. Adding creamer (milk) or a non-dairy alternative did not significantly affect this weight change. However, adding sugar (one teaspoon) to coffee was associated with a weight gain that was 0.09 kg more than expected over four years. These associations were stronger in participants who were younger and had a higher body mass index at the beginning of the studies. <h2>What are the pros and cons of the study?</h2> This study is unique in two ways. It had a very large sample size and followed participants for many years. This adds confidence that the associations were real and can likely be applied to other populations. However, there are three reasons to be cautious. First, the findings represent an association, not causation. This means the study does not prove that coffee intake is the true reason for the weight change. Rather, it shows the two changes were observed together over time. Second, the findings around weight were very modest. The average four-year weight gain averted, based on one cup of coffee, was 0.12 kilograms, which is about 30 grams per year. This amount may not be a meaningful change for most people looking to manage weight. Finally, this analysis did not consider the variability in the amount of caffeine in coffee (which we <a href="https://pubmed.ncbi.nlm.nih.gov/17412475/">know can be high</a>), it just assumed a standard amount of caffeine per cup. <h2>How could coffee help with weight management?</h2> Caffeine is a natural stimulant which has been <a href="https://www.sciencedirect.com/science/article/pii/S0149763416300690">shown to</a> temporarily reduce appetite and increase alertness. This may help to feel less hungry for a short period, potentially leading to reduced energy intake. Some people consume coffee before exercise as a stimulant to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777221/">improve their workout performance</a> – if a workout is more effective, more energy may be expended. However, the benefit is largely thought to be short-lived, rather than long-term. Caffeine has also been <a href="https://www.sciencedirect.com/science/article/pii/S0271531720304449">shown to</a> speed up our metabolism, causing more energy to be burned while resting. However, this effect is relatively small and is not a suitable substitute for regular physical activity and a healthy diet. Finally, coffee has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725310/">mild diuretic effect</a>, which can lead to temporary water weight loss. This is water loss, not fat loss, and the weight is quickly regained when you re-hydrate. <h2>Is it worth trying coffee for weight loss?</h2> Losing weight can be influenced by various factors, so don’t get too enthusiastic about the coffee-weight link highlighted in this new study, or increase your coffee intake to unreasonable levels. Most adults can safely consume around <a href="https://www.healthdirect.gov.au/caffeine">400mg</a> of caffeine a day. That’s the equivalent of two espressos or four cups of instant coffee or eight cups of tea. If you are pregnant or breastfeeding, it is important to talk to your doctor before increasing your caffeine intake, because caffeine can be passed through to your growing baby. If you need individualised weight guidance, talk to your GP or visit an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitian</a>. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214954/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher & Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-coffee-help-you-avoid-weight-gain-heres-what-the-science-says-214954">original article</a>.

Body

Can a daily multivitamin improve your memory?

<a href="https://theconversation.com/profiles/jacques-raubenheimer-1144463">Jacques Raubenheimer</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> <a href="https://theconversation.com/au/topics/research-check-25155">Research Checks</a> interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate. <hr /> Don’t we all want to do what we can to reduce the impact of age-related decline on our memory? A new study suggests a daily multivitamin and mineral supplement is a simple and inexpensive way to help older adults slow the decline in some aspects of memory function. The <a href="https://ajcn.nutrition.org/article/S0002-9165(23)48904-6/fulltext">new study</a>, which comes from a <a href="https://www.clinicaltrials.gov/ct2/show/NCT02422745?term=NCT02422745&draw=2&rank=1">long-running clinical trial</a>, shows there may be a small benefit of taking a daily multivitamin and mineral supplement for one type of cognitive task (immediate word recall) among well-functioning elderly white people. At least in the short term. But that doesn’t mean we should all rush out and buy multivitamins. The results of the study don’t apply to the whole population, or to all types of memory function. Nor does the study show long-term benefits. <h2>How was the study conducted?</h2> The overarching COSMOS study is a well-designed double-blind randomised control trial. This means participants were randomly allocated to receive the intervention (a daily multivitamin and mineral supplement) or a placebo (dummy tablet), but neither the participants nor the researchers knew which one they were taking. This type of study is considered the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654877/">gold standard</a> and allows researchers to compare various outcomes. Participants (3,562) were older than 64 for women, and 59 for men, with no history of heart attack, invasive cancer, stroke or serious illness. They couldn’t use multivitamins or minerals (or <a href="https://www.pnas.org/doi/10.1073/pnas.2216932120">cocoa extract</a> which they also tested) during the trial. Participants completed a <a href="https://www.clinicaltrials.gov/ct2/show/NCT04582617?term=NCT04582617&draw=2&rank=1">battery of online cognitive tests</a> at the start of the study (known as baseline), then yearly for three years, of which only three were reported in this paper: <ul> <li> ModRey, measuring immediate recall. Participants were shown “a list of 20 words, one at a time, for three seconds each,” and then had to type the list from memory </li> <li> ModBent, measuring object recognition. Participants were given 20 prompts with a shape and then had to select the correct match from a pair of similar prompts. After this, they were prompted with 40 shapes in turn, and had to indicate whether each was included in the original 20 or not </li> <li> Flanker, measuring “executive control”. Participants had to select a coloured block that corresponded to an arrow in a matrix of arrows, which could have the same (or different) colour to the surrounding arrows, and the same (or different) direction as the prompt block. </li> </ul> <h2>What did the researchers find?</h2> Of all the tests the researchers performed, only immediate recall (ModRey) at one year showed a significant effect, meaning the result is unlikely to just be a result of chance. At two and three years, the effect was no longer significant (meaning it could be down to chance). However they added an “overall estimate” by averaging the results from all three years to arrive at another significant effect. All the effect sizes reported are very small. The largest effect is for the participants’ immediate recall at one year, which was 0.07 – a value that is <a href="https://academic.oup.com/jpepsy/article/34/9/917/939415">generally considered very small without justification</a>. Also of note is that both the multivitamin and placebo groups had higher immediate word recall scores at one year (compared to baseline), although the multivitamin group’s increase was significantly larger. <a href="https://www.pnas.org/doi/epdf/10.1073/pnas.2216932120">In the researchers’ prior study</a>, the increase in word recall scores was described as a “typical learning (practice) effect”. This means they attributed the higher scores at one year to familiarisation with the test. For some reason, this “learning effect” was not discussed in the current paper, where the treatment group showed a significantly larger increase compared to those who were given the placebo. <h2>What are the limitations of the study?</h2> The team used a suitable statistical analysis. However, it did not adjust for demographic characteristics such as age, gender, race, and level of education. The authors detail their study’s major limitation well: it is not very generalisable, as it used “mostly white participants” who had to be very computer literate, and, one could argue, would be quite well-functioning cognitively. <figure class="align-center "><figcaption></figcaption>Another unmentioned limitation is the advanced age of their sample, meaning long-term results for younger people can’t be assessed.</figure> Additionally, the baseline diet score for their sample was abysmal. The researchers say participants’ diet scores “were consistent with <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1899558">averages from the US population</a>” but the cited study noted “the overall dietary quality… [was] poor.” And they didn’t measure changes in diet over the three years, which could impact the results. <h2>How should we interpret the results?</h2> The poor dietary quality of the sample raises the question: can a better diet be the simple fix, rather than multivitamin and mineral supplements? Even for the effect they observed, which micronutrient from the supplement was the contributing factor? The researchers speculate about vitamins B12 and D. But you can find research on cognitive function for any arbitrarily chosen <a href="https://www.centrum.com/content/dam/cf-consumer-healthcare/bp-wellness-centrum/en_US/pdf/lbl-00000775-web-ready-centrum-silver-adults-tablets-(versio.pdf">ingredient</a>, including <a href="https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=selenium+cognitive+function">selenium</a>, which can be <a href="https://www.sciencedirect.com/science/article/pii/S0048969720378608">toxic at high levels</a>. <h2>So should I take a multivitamin?</h2> <a href="https://newsinhealth.nih.gov/2013/08/should-you-take-dietary-supplements">Health authorities advise</a> daily multivitamin use isn’t necessary, as you can get all the nutrients you need by eating a wide variety of healthy foods. However, supplementation may be appropriate to meet any specific nutrient gaps an individual has. Using a good quality multivitamin at the recommended dose shouldn’t do any harm, but at best, this study shows well-functioning elderly white people might show some additional benefit in one type of cognitive task from using a multivitamin supplement. The case for most of the rest of the population, and the long-term benefit for younger people, can’t be made. <hr /> <h2>Blind peer review</h2> Clare Collins writes: I agree with the reviewer’s assessment, which is a comprehensive critique of the study. The key result was a small effect size from taking a daily multivitamin and mineral (or “multinutrient”) supplement on memory recall at one year (but not later time points) and is equivalent to a training effect where you get better at taking a test the more times you do it. It’s also worth noting the study authors received support and funding from commercial companies to undertake the study. While the study authors state they don’t believe background diet quality impacted the results, they didn’t comprehensively assess this. They used a brief <a href="https://pubmed.ncbi.nlm.nih.gov/22513989/">diet quality assessment score</a> only at baseline. Participants may have changed their eating habits during the study, which could then impact the results. Given all participants reported low diet quality scores, an important question is whether giving participants the knowledge, skills and resources to eat more healthily would have a bigger impact on cognition than taking supplements. <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/208114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Image credit: Shutterstock <a href="https://theconversation.com/profiles/jacques-raubenheimer-1144463">Jacques Raubenheimer</a>, Senior Research Fellow, Biostatistics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-a-daily-multivitamin-improve-your-memory-208114">original article</a>.

Body

The science of dreams and nightmares – what is going on in our brains while we’re sleeping?

<a href="https://theconversation.com/profiles/drew-dawson-13517">Drew Dawson</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Last night you probably slept for <a href="https://www.sciencedirect.com/science/article/pii/S2352721816301292">seven to eight hours</a>. About one or two of these was likely in deep sleep, especially if you’re young or physically active. That’s because <a href="http://apsychoserver.psych.arizona.edu/jjbareprints/psyc501a/readings/Carskadon%20Dement%202011.pdf">sleep changes with age</a> and <a href="https://www.hindawi.com/journals/apm/2017/1364387/">exercise</a> affects brain activity. About three or four hours will have been spent in light sleep. For the remaining time, you were likely in rapid eye movement (REM) sleep. While this is not the only time your brain is potentially dreaming – we also dream during other sleep stages – it is the time your brain activity is most likely to be recalled and reported when you’re awake. That’s usually because either really weird thoughts or feelings wake you up or because the last hour of sleep is nearly all <a href="https://www.researchgate.net/profile/Elizaveta-Solomonova/publication/320356182_Dream_Recall_and_Content_in_Different_Stages_of_Sleep_and_Time-of-Night_Effect/links/5a707bdb0f7e9ba2e1cade56/Dream-Recall-and-Content-in-Different-Stages-of-Sleep-and-Time-of-Night-Effect.pdf">REM sleep</a>. When dreams or your alarm wake you, you’re likely coming out of dream sleep and your dream often lingers into the first few minutes of being awake. In this case you remember it. If they’re strange or interesting dreams, you might tell someone else about them, which may further <a href="https://link.springer.com/article/10.1007/s00426-022-01722-7">encode</a> the dream memory. Dreams and nightmares are mysterious and we’re still learning about them. They keep our brains ticking over. They wash the thoughts from the day’s events at a molecular level. They might even help us imagine what’s possible during our waking hours. <h2>What do scientists know about REM sleep and dreaming?</h2> It’s really hard to study dreaming because people are asleep and we can’t observe what’s going on. Brain imaging has indicated certain <a href="https://www.sciencedirect.com/science/article/pii/S1087079216300673#sec3">patterns of brain activity</a> are associated with dreaming (and with certain sleep stages where dreams are more likely to occur). But such studies ultimately rely on self-reports of the dream experience. Anything we spend so much time doing probably serves multiple ends. At the basic physiological level (indicated by <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409">brain activity, sleep behaviour and studies of conciousness</a>), all mammals dream – even the platypus and echidna probably experience something similar to dreaming (provided they are at the <a href="https://www.wired.com/2014/07/the-creature-feature-10-fun-facts-about-the-echidna/#:%7E:text=It%20was%20long%20thought%20that,re%20at%20the%20right%20temperature.">right temperature</a>). Their brain activity and sleep stages align to some degree with human <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409#b0630">REM sleep</a>. Less evolved species do not. Some <a href="https://www.sciencedirect.com/science/article/pii/S2468867319301993#sec0030">jellyfish</a> – who do not have a brain – do experience what could physiologically be characterised as sleep (shown by their posture, quietness, lack of responsiveness and rapid “waking” when prompted). But they do not experience the same physiological and behavioural elements that resemble REM dream sleep. In humans, REM sleep is thought to occur cyclically every 90 to 120 minutes across the night. It prevents us from sleeping too deeply and being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972941/">vulnerable to attack</a>. Some scientists think we dream in order to stop our brains and bodies from getting too cold. Our core body temperature is typically <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00210-1/fulltext">higher while dreaming</a>. It is typically easier to <a href="https://www.tandfonline.com/doi/pdf/10.2147/NSS.S188911">wake from dreaming</a> if we need to respond to external cues or dangers. The brain activity in REM sleep kicks our brain into gear for a bit. It’s like a periscope into a more conscious state, observing what’s going on at the surface, then going back down if all is well. Some evidence suggests “fever dreams” are far less common than we might expect. We actually experience <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00053/full">far less REM sleep</a> when we have a fever – though the dreams we do have tend to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830719/">darker in tone and more unusual</a>. Spending less time in REM sleep when we’re feverish might happen because we are far less capable of regulating our body temperature in this stage of sleep. To protect us, our brain tries to regulate our temperature by “skipping” this sleep stage. We tend to have fewer dreams when the weather is hot <a href="https://www.tandfonline.com/doi/abs/10.1080/23744731.2020.1756664">for the same reason</a>. <h2>A deep-cleaning system for the brain</h2> REM sleep is important for ensuring our brain is working as it should, as indicated by studies using <a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">electoencephalography</a>, which measures brain activity. In the same way deep sleep helps the body restore its physical capacity, dream sleep “<a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">back-flushes</a>” our neural circuits. At the molecular level, the chemicals that underpin our thinking are bent out of shape by the day’s cognitive activity. Deep sleep is when those chemicals are returned to their unused shape. The brain is “<a href="https://www.science.org/doi/abs/10.1126/science.1241224">washed</a>” with cerebrospinal fluid, controlled by the <a href="https://theconversation.com/on-your-back-side-face-down-mice-show-how-we-sleep-may-trigger-or-protect-our-brain-from-diseases-like-als-181954">glymphatic system</a>. At the next level, dream sleep “tidies up” our recent memories and feelings. During <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">REM sleep</a>, our brains consolidate procedural memories (of how to do tasks) and emotions. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">Non-REM sleep</a>, where we typically expect fewer dreams, is important for the consolidation of episodic memories (events from your life). As our night’s sleep progresses, we produce more cortisol - the <a href="https://psycnet.apa.org/record/2005-01907-021">stress hormone</a>. It is thought the amount of cortisol present can impact the type of memories we are consolidating and potentially the types of dreams we have. This means the dreams we have later in the night may be <a href="https://learnmem.cshlp.org/content/11/6/671.full.pdf">more fragmented or bizarre</a>. Both kinds of sleep help <a href="https://www.researchgate.net/profile/Jb-Eichenlaub/publication/313545620_Daily_Life_Experiences_in_Dreams_and_Sleep-Dependent_Memory_Consolidation/links/5c532b0ba6fdccd6b5d76270/Daily-Life-Experiences-in-Dreams-and-Sleep-Dependent-Memory-Consolidation.pdf?ref=nepopularna.org">consolidate</a> the useful brain activity of the day. The brain also discards less important information. <h2>Random thoughts, rearranged feelings</h2> This filing and discarding of the day’s activities is going on while we are sleeping. That’s why we often dream about things that happen <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264574">during the day</a>. Sometimes when we’re rearranging the thoughts and feelings to go in the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921176/">bin</a>” during sleep, our level of consciousness allows us to experience awareness. Random thoughts and feelings end up all jumbled together in weird and wonderful ways. Our awareness of this process may explain the bizarre nature of some of our dreams. Our daytime experiences can also fuel nightmares or anxiety-filled dreams after a <a href="https://www.sleepfoundation.org/dreams/how-trauma-can-affect-dreams">traumatic event</a>. Some dreams appear to <a href="https://rai.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1467-9655.2010.01668.x">foretell the future or carry potent symbolism</a>. In many societies dreams are believed to be a window into an <a href="https://digitalcommons.ciis.edu/cgi/viewcontent.cgi?article=1050&context=ijts-transpersonalstudies">alternate reality</a> where we can envisage what is possible. <h2>What does it all mean?</h2> Our scientific understanding of the thermoregulatory, molecular and basic neural aspects of dreaming sleep is <a href="https://www.nature.com/articles/nrn2716">good</a>. But the psychological and spiritual aspects of dreaming remain largely hidden. Perhaps our brains are wired to try and make sense of things. Human societies have always interpreted the random – birds wheeling, tea leaves and the planets – and looked for <a href="https://brill.com/display/book/edcoll/9789047407966/B9789047407966-s003.xml">meaning</a>. Nearly every human society has regarded dreams as more than just random neural firing. And the history of science tells us some things once thought to be magic can later be understood and harnessed – for better or worse.<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/210901/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/drew-dawson-13517">Drew Dawson</a>, Director, Appleton Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-science-of-dreams-and-nightmares-what-is-going-on-in-our-brains-while-were-sleeping-210901">original article</a>.

Mind

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</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>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months). There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles. We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>. But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again. <h2>People are often given the wrong advice</h2> People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis. But these findings are very common in people without low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain. Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain. In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress. It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves. <h2>So how should low back pain be treated?</h2> A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety. Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice. <a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language. They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities. An example of this type of care is cognitive functional therapy. <h2>What is cognitive functional therapy?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out. The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it. It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>. Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required. <h2>What’s the evidence for this type of therapy?</h2> Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments. We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”. We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care. The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>. People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group. The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work. <h2>What does this mean for you?</h2> This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success. <a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up. The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <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/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</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>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.

Body

Does it matter what time of day I eat? And can intermittent fasting improve my health? Here’s what the science says

<a href="https://theconversation.com/profiles/frederic-gachon-1379094">Frederic Gachon</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/meltem-weger-1408599">Meltem Weger</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Early hunter-gatherers faced long periods of fasting. Their <a href="https://pubmed.ncbi.nlm.nih.gov/35834774/">access to food</a> relied on successful hunting, fishing, and the availability of wild plants. Over time, the development of modern agriculture and the transition to industrialised societies <a href="https://pubmed.ncbi.nlm.nih.gov/35834774/">changed our regular eating patterns</a>, shifting our dinner time to later in the day to accommodate work schedules. Today, with access to an abundance of food, we rarely experience prolonged periods of fasting, except for weight loss or religious practices. It’s <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">now common</a> to have four or more meals a day, with the most calories consumed later in the day. Frequent snacking is also common, over a window of around 15 hours. However, research increasingly shows our health is not only affected by what and how much we eat, but also when we eat. So what does this mean for meal scheduling? And can intermittent fasting help? <h2>Our body clock controls more than our sleep</h2> Our internal biological timekeeper, or circadian clock, regulates many aspects of our physiology and behaviour. It tells us to be awake and active during the day, and <a href="https://theconversation.com/does-it-matter-what-time-i-go-to-bed-198146">rest and sleep</a> during the night. It can also tell us the best time to eat. Our body is biologically prepared to have food during the day. Food digestion, nutrient uptake and energy metabolism is optimised to occur when we’re supposed to be active and eating. Working against this default stage, by regularly eating when we’re supposed to sleep and fast, can compromise these processes and impact our health. <a href="https://pubmed.ncbi.nlm.nih.gov/31813351/">Erratic eating patterns</a>, including late-night meals, have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/36198293/">weight gain</a> and a greater risk of metabolic disease. Shift-workers, for example, and people who work evening, night or rotating shifts, have a <a href="https://theconversation.com/why-does-night-shift-increase-the-risk-of-cancer-diabetes-and-heart-disease-heres-what-we-know-so-far-190652">higher risk</a> of obesity, heart disease and diabetes. But adopting an eating pattern that aligns with our circadian rhythm can reduce these risks. <h2>So can intermittent fasting help?</h2> Nutritional interventions are increasingly focused not only on “what” we eat but also “when”. Intermittent fasting is one way to restrict the timing, rather than the content, of what we eat. There are <a href="https://pubmed.ncbi.nlm.nih.gov/35834774/">several types</a> of intermittent fasting, one of which is time-restricted eating. This means eating all our calories in a consistent 8-12 hour, or even shorter, interval each day. But is it backed by evidence? Most of what we know today about intermittent fasting and time-restricted eating is from <a href="https://pubmed.ncbi.nlm.nih.gov/35834774/">mouse studies</a>, which demonstrate remarkable weight loss and overall health benefits associated with these types of dietary interventions. However, some aspects of mouse physiology can be different to humans. Mice need to eat more frequently than humans and even a short period of fasting has a more significant physiological impact on mice. One day of fasting in mice leads to a 10% <a href="https://www.sciencedirect.com/science/article/pii/S2212877820301320">loss of body weight</a>, whereas humans would need to fast for 14 days to achieve <a href="https://pubmed.ncbi.nlm.nih.gov/30881957/">similar results</a>. This makes a direct translation from mice to humans more complicated. While health benefits of <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2623528">intermittent fasting</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2114833">time-restricted eating</a> have also been observed in humans, the findings in respect of weight loss are less clear. Current data suggest only modest, if any, weight loss in human participants who undergo these diet regimens when compared to calorie-restricted diets. Drawing <a href="https://pubmed.ncbi.nlm.nih.gov/35834774/">definitive conclusions</a> in humans may be more <a href="https://pubmed.ncbi.nlm.nih.gov/32480126/">difficult</a> because of the small sample sizes and individual differences in metabolism, variations in study design (such as the use of different protocols with varying times and duration of food restriction), and participants not complying with their instructions. <h2>Health benefits could be due to eating fewer calories</h2> Most studies describing the health benefits of <a href="https://pubmed.ncbi.nlm.nih.gov/33466692/#:%7E:text=and%20Future%20Perspectives-,Time%2DRestricted%20Eating%20and%20Metabolic%20Syndrome%3A%20Current%20Status%20and%20Future,doi%3A%2010.3390%2Fnu13010221.">time restricted eating</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/27569118/">intermittent fasting</a> also found these diets were accompanied by calorie restriction: reducing the time of food access implicitly leads people to eat less. Studies that controlled calorie intake did not detect any more benefits of intermittent fasting than <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2623528">calorie restriction</a> alone. The weight loss and health benefits observed with intermittent fasting is likely attributed due to the resultant reduction in <a href="https://pubmed.ncbi.nlm.nih.gov/34135111/">calorie intake</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/32986097/">Similar findings</a> have been reported for time-restricted eating. <h2>Benefit of following our body clock</h2> Nevertheless, time-restricted eating offers additional health benefits in humans, such as improved glucose metabolism and blood pressure, even without differences in calorie intake, in particular when restricted to the <a href="https://pubmed.ncbi.nlm.nih.gov/29754952/">earlier part of the day</a> (that is, when having a six-hour eating window with dinner before 3pm). Restricting food intake to the daytime for shift-workers <a href="https://pubmed.ncbi.nlm.nih.gov/28635334/">can alleviate</a> metabolic differences caused by shift-work, whereas this effect is not observed when food intake is restricted to <a href="https://www.science.org/doi/10.1126/sciadv.abg9910">nighttime</a>. One idea is that consuming food early, in alignment with our circadian rhythm, helps to <a href="https://pubmed.ncbi.nlm.nih.gov/28578930/">synchronise our circadian clock</a>. This restores the rhythm of our autonomous nervous system, which regulates essential functions such as breathing and heart rate, to keep our physiology “tuned”, as it was shown <a href="https://www.pnas.org/doi/10.1073/pnas.2015873118">in mice</a>. While there’s much still to learn from research in this field, the evidence suggests that to maintain a healthy weight and overall wellbeing, aim for regular, nutritious meals during the day, while avoiding late-night eating and frequent snacking.<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/203762/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/frederic-gachon-1379094">Frederic Gachon</a>, Associate Professor, Physiology of Circadian Rhythms, Institute for Molecular Bioscience, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/meltem-weger-1408599">Meltem Weger</a>, Postdoctoral Research Fellow, Institute for Molecular Bioscience, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-it-matter-what-time-of-day-i-eat-and-can-intermittent-fasting-improve-my-health-heres-what-the-science-says-203762">original article</a>.

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Does a woman’s menstrual cycle affect her athletic performance? Here’s what the science says

<a href="https://theconversation.com/profiles/sara-chica-latorre-1443479">Sara Chica-Latorre</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> and <a href="https://theconversation.com/profiles/michael-pengelly-1443674">Michael Pengelly</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> During the Women’s FIFA World Cup, it has been wonderful to see the spotlight turn to female athletes. There’s always been <a href="https://pubmed.ncbi.nlm.nih.gov/24766579/">more research on male athletes</a> compared to female athletes, but the gap is narrowing. One thing we still don’t know enough about is the effect of the menstrual cycle on athletic performance. <h2>What does the menstrual cycle do to a woman’s body?</h2> The menstrual cycle is a complex cascade of events typically lasting 28 days. The primary female sex hormones oestrogen and progesterone rise and fall as the body cycles through four phases, beginning at menstruation, maturation and releasing of an egg (ovulation), preparation for pregnancy, and restarting the cycle if the egg is not fertilised. Fluctuations in female sex hormones have been associated with changes in inflammation, metabolism, muscle activation and body composition, which <a href="https://pubmed.ncbi.nlm.nih.gov/33572406/">can influence athletic performance</a>. For instance, <a href="https://pubmed.ncbi.nlm.nih.gov/22306563/">inflammation decreases</a> when the body is preparing to ovulate, reaching its lowest point around ovulation. It then increases following ovulation and peaks during menstruation. This peak coincides with lower perceived performance among many female athletes. The menstrual cycle can also give rise to symptoms including pain, cramps, weakness, and poor sleep and focus, <a href="https://pubmed.ncbi.nlm.nih.gov/35911030/">challenging performance</a> during training and competition. For example, <a href="https://doi.org/10.1080/24733938.2021.2020330">research</a> conducted in elite female soccer players found over 87% of players perceived reduced power and increased fatigue during menstruation, while over 66% perceived their reaction time and recovery to be affected. Considering the approximate maximum career length of soccer players (21 years) and a woman’s fertile life, that adds up to about 250 times throughout a woman’s soccer career that performance may be compromised. Trends observed among female soccer players closely mirror the experiences of other female athletes, with over <a href="https://pubmed.ncbi.nlm.nih.gov/37389782/#:%7E:text=Results%3A%20Sixty%20studies%20involving%206380,the%20most%20prevalent%20MC%20disorder">74% reporting</a> negative effects mainly during the first days of menstruation. For some, this may lead to reduced training participation, potentially compromising skill development, fitness levels, and even their chances of being selected for competition. But the menstrual cycle is complex, and its effects can vary between athletes and sports. Consequently there is disagreement regarding whether the menstrual cycle universally affects athletic performance, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076834/#:%7E:text=Findings%20suggest%20that%20strength%2Drelated,cause%20variations%20in%20strength%20performance">some research</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32661839/">indicating</a> no influence of the menstrual cycle on certain performance measures. But these studies are few and had various logistical limitations, including a small number of participants. Also important to note is that most studies to-date have excluded women using hormonal contraceptives, which is about <a href="https://pubmed.ncbi.nlm.nih.gov/29283683/">50% of female athletes</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/35475746/#:%7E:text=Conclusion%3A%20Most%20WSL%20players%20do,minimise%20discomfort%20and%20maximise%20performance.">28% of female soccer players</a>. The use of hormonal contraceptives suppresses natural hormonal fluctuations and replaces them with external synthetic versions of female sex hormones, affecting the athlete differently. Clearly the extent and severity to which the menstrual cycle impacts athletic performance is highly variable and complex, with more research needed. So for now it’s sensible to consider the effects of the menstrual cycle on an individual basis. <h2>How to support athletic performance at all cycle stages</h2> It’s essential for players to familiarise themselves with their own cycles to understand how they’re affected throughout, as well as communicate any menstrual cycle-related issues to support staff (physicians and coaches). This awareness can guide adjustments in training and nutrition when required. For example, oestrogen has an important influence on iron levels in females, such as chronic oestrogen deficiency is <a href="https://pubmed.ncbi.nlm.nih.gov/23041085/">linked to iron deficiency</a>. Iron status can also be compromised by blood loss during menstruation, depending on the heaviness and duration of bleeding. Iron is essential for human function, facilitating energy production and the transportation of oxygen around the body. In soccer, about <a href="https://pubmed.ncbi.nlm.nih.gov/16521852/#:%7E:text=Of%20the%20investigated%20female%20soccer,at%20the%20top%20international%20level">60% of elite female players</a> present as iron deficient, compared to <a href="https://pubmed.ncbi.nlm.nih.gov/18384395/">less than 12% of their male counterparts</a>. For an iron deficient midfielder, this might translate into covering less distance at lower speeds. It’s therefore important female athletes have their iron levels regularly checked by qualified practitioners. Addressing deficiencies through diet, supplementation, or iron transfusions, will ensure athletic performance during training and competition is not compromised. Individual athletes’ training loads can also be strategically managed to accommodate severe menstrual symptoms. Football clubs around the world have been <a href="https://www.tandfonline.com/doi/full/10.1080/24733938.2020.1828615">experimenting with this strategy</a> since it gained popularity during the 2019 Women’s FIFA World Cup. But how does it look in practice? For team sport athletes, such as soccer players, this can be a demanding logistical task. It’s not easy to track the menstrual cycles of more than 25 players concurrently, and hold training sessions at convenient times for all of them. The complexities are heightened when training and game days cannot be avoided. But performance coaches must consider athletes’ needs and ensure they’re prepared for competition, while minimising the risk of injury and menstrual discomfort. Coaches should also ensure athletes maintain adequate nutrition for both competition and to support their menstrual cycle. For an athlete who reports severe menstrual symptoms during the first days of menstruation (such as increased pain and weakness), this might translate into reduced training intensity, additional recovery days, and an anti-inflammatory diet that also supports the restoration of iron levels (increased intake of nuts, seeds, berries, lean red meats, and fibre and Omega-3 rich foods). And it’s important to keep in mind some athletes might experience menstrual cycle issues in phases other than menstruation. So, training and nutrition should be flexible and individualised across the cycle. Using this approach, athletes can mitigate the influence of the menstrual cycle on their performance, giving them the best opportunity to achieve their athletic potential and success during competition.<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/206700/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sara-chica-latorre-1443479">Sara Chica-Latorre</a>, Phd Candidate and Research Assistant, Research Institute for Sport and Exercise, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> and <a href="https://theconversation.com/profiles/michael-pengelly-1443674">Michael Pengelly</a>, PhD Candidate, Research Institute for Sport and Exercise, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-a-womans-menstrual-cycle-affect-her-athletic-performance-heres-what-the-science-says-206700">original article</a>.

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Does a woman’s menstrual cycle affect her athletic performance? Here’s what the science says

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