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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels. However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>. Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes. Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked? <h2>Osteoarthritis and obesity</h2> Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis. Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation. For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>. Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help. But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten. Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness. <h2>Semaglutide for osteoarthritis?</h2> The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight. They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight. As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group. The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group. This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale. The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>. Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test. <h2>How could semaglutide reduce knee pain?</h2> It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain. But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>. While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not. The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity. It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue. There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this. Further, it can be difficult to access. <h2>I have knee osteoarthritis, what should I do?</h2> Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<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/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstocl 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-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>.

Body

What’s the difference between liquid and powder laundry detergent? It’s not just the obvious

<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> When shopping for a laundry detergent, the array of choices is baffling. All of the products will likely get your laundry somewhat cleaner. But what gets the best outcome for your clothes and your budget? Do you want whiter whites? Do you need enzymes? And what’s the difference between a powder and liquid detergent? As is often the case, knowing more about the chemistry involved will help you answer those questions. <h2>What is a detergent?</h2> The active ingredients in both laundry powders and liquids are “surfactants”, also known as detergents (hence the product name). These are typically charged or “ionic” molecules that have two distinct parts to their structure. One part interacts well with water and the other interacts with oils. This useful property allows surfactants to lift grease and grime from fabrics and suspend it in the water. Surfactants can also form bubbles. Metal salts dissolved in your water can limit the performance of the surfactants. So-called hard water contains lots of dissolved calcium and magnesium salts which can readily form soap scum. Modern laundry detergents therefore contain phosphates, water softeners and other metal “sequestrants” to stop the formation of soap scum. Phosphates can cause algal blooms in fresh water environments. This is why modern detergent formulations <a href="https://accord.asn.au/sustainability/phosphorus-standard/">contain smaller amounts of phosphates</a>. Many products also contain optical brighteners. These chemicals absorb ultraviolet light and release blue light, which provides the “whiter white” or “brighter colour” phenomenon. Laundry detergents typically contain fragrances. These aren’t essential to the chemistry of cleaning, but give the impression the clothes are fresh. Lastly, some laundry detergents contain enzymes – more on those later. <h2>What’s in laundry powder?</h2> While detergents and ingredients to avoid soap scum are the most important components, they aren’t the most abundant. The main ingredients in powders are salts (like sodium sulfate) that add bulk and stop the powder from clumping. Another common salt added to laundry powders is sodium carbonate, also known as washing soda. Washing soda (a chemical cousin of <a href="https://theconversation.com/vinegar-and-baking-soda-a-cleaning-hack-or-just-a-bunch-of-fizz-225177">baking soda</a>) helps to chemically modify grease and grime so they dissolve in water. Laundry powders also frequently contain oxidising agents like sodium percarbonate. This is a stable combination of washing soda and hydrogen peroxide. An additive known as tetraacetylethylenediamine activates the percarbonate to give a mild bleaching effect. Chemically, powders have an advantage – their components can be formulated and mixed but kept separate in a solid form. (You can usually see different types of granules in your laundry powder.) <h2>What’s in laundry liquid?</h2> The main ingredient of laundry liquid is water. The remaining ingredients have to be carefully considered. They must be stable in the bottle and then work together in the wash. These include similar ingredients to the powders, such as alkaline salts, metal sequestrants, water softeners and surfactants. The surfactants in liquid products are often listed as “ionic” (charged) and “non-ionic” (non-charged). Non-ionic surfactants can be liquid by default, which makes them inappropriate for powdered formulations. Non-ionic surfactants are good at suspending oils in water and don’t form soap scum. Liquid detergents also contain preservatives to prevent the growth of microbes spoiling the mixture. There are also microbial implications for inside the washing machine. Liquid products can’t contain the peroxides (mild bleaching agents) found in powdered products. Peroxides kill microbes. The absence of peroxides in liquid detergents makes it more likely for <a href="https://www.mdpi.com/1420-3049/27/1/195#B15-molecules-27-00195">mould biofilms to form</a> in the machine and for bacteria to be transferred between items of clothing. As an alternative to peroxides, liquids will typically contain only optical brighteners. Liquids do have one advantage over powders – they can be added directly to stains prior to placing the item in the wash. A recent “convenience” version of liquid formulas are highly concentrated detergent pods. Colourful and bearing a resemblance to sweet treats, these products have been found to be <a href="https://poisoncenters.org/track/laundry-detergent-packets">dangerous to young children and people with cognitive impairment</a>. Pods also remove the option to add less detergent if you’re running a smaller load or just want to use less detergent in general. <h2>So, what about enzymes?</h2> Enzymes are naturally evolved proteins included in laundry products to remove specific stains. Chemically, they are catalysts – things that speed up chemical reactions. Enzymes are named for the molecules they work on, followed by the ending “-ase”. For example, lipase breaks down fats (lipids), protease breaks down protein, while amylase and mannanase break down starches and sugars. These enzymes are derived from organisms found in cool climate regions, which helps them function at the low temperature of washing water. Running an excessively hot wash cycle can damage or denature the enzyme structure, stopping them from assisting in your wash. Think of an egg white <a href="https://theconversation.com/how-to-make-the-perfect-pavlova-according-to-chemistry-experts-196485">changing from translucent to white while cooked</a> – that’s protein denaturing. If your detergent contains enzymes, the washing temperature should be neither too hot nor too cold. As a guide, temperatures of 15–20°C are used in <a href="https://environment.ec.europa.eu/document/download/557d8ab5-4e75-41a4-a901-1548be7f685d_en">standard laundry tests</a>. <h2>Is powder or liquid better?</h2> We make consumer choices guided by performance, psychology, cost, scent, environmental considerations and convenience. It’s worth experimenting with different products to find what works best for you and fits your needs, household budget and environmental considerations, such as having <a href="https://theconversation.com/curious-kids-why-can-some-plastics-be-recycled-but-others-cant-229270">recyclable packaging</a>. Personally, I wash at 20°C with half the recommended dose of a pleasant-smelling laundry powder, packaged in recyclable cardboard, and containing a wide range of enzymes and an activated peroxide source. Knowing a little chemistry can go a long way to getting your clothes clean. However, laundry detergent manufacturers don’t always disclose the full list of ingredients on their product packaging. If you want more information on what’s in your product, you have to look at the product website. You can also dig a little deeper by reading documents called <a href="https://theconversation.com/a-new-tiktok-trend-has-people-drinking-toxic-borax-an-expert-explains-the-risks-and-how-to-read-product-labels-210278">safety data sheets</a> (SDS). Every product containing potentially hazardous chemicals must have an SDS.<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/239850/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> 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/whats-the-difference-between-liquid-and-powder-laundry-detergent-its-not-just-the-obvious-239850">original article</a>.

Home & Garden

Don’t like drinking plain water? 10 healthy ideas for staying hydrated this summer

<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/the-university-of-queensland-805">The University of Queensland</a> Have you heard the saying “water is life?” Well, it’s true. Water is an <a href="https://www.hsph.harvard.edu/nutritionsource/water/">essential nutrient</a>. Our body cannot produce sufficient water to live, so we need to consume water through food and fluids to survive. Maintaining hydration is one of the most fundamental components of good health. But lots of people don’t like drinking plain water much. The good news is there are many other healthy ways to help you stay hydrated. <h2>Why hydration is important</h2> Water is vital for many aspects of body functioning. About half our blood is “blood plasma”, which is over 90% water. Blood plasma is essential for carrying energy, nutrients and oxygen to the cells in the body that need it most. Water helps to remove waste products via the kidneys. It also helps keep joints lubricated, the digestive system functioning, the body’s temperature controlled and skin plump and strong. If you don’t consume enough water, you may experience symptoms of dehydration such as headaches, dizziness, tiredness, low concentration, constipation and a dry mouth. Being severely dehydrated increases the risk of <a href="https://www.kidney.org/atoz/content/kidneystones">kidney stones</a> and <a href="https://www.healthdirect.gov.au/urinary-tract-infection-uti">urinary tract infections</a>. If you feel thirsty, it means your body is already <a href="https://my.clevelandclinic.org/health/treatments/9013-dehydration#:%7E:text=If%20you're%20thirsty%2C%20you,life%2Dthreatening%20illnesses%20like%20heatstroke.">mildly dehydrated</a>, so make sure you pay attention to what your body is telling you. <h2>How much fluid do you need?</h2> The amount of fluid we need changes as we age. Relative to our body weight, our needs decrease. So, a newborn baby has higher fluid needs (per kilogram body weight) than their parent, and older adults have lower fluid needs than younger adults. Fluid requirements are related to metabolic needs and vary from person-to-person. The normal turnover of water in adults is approximately 4% of total body weight per day. So, for example, if you weigh 70 kilograms, you’ll lose about 2.5 to 3 litres of water a day (not including sweating). This means you will need to consume that amount of water from food and drinks to maintain your hydration. Eight cups (or two litres) a day is often <a href="https://www.npr.org/2022/09/21/1124371309/busting-common-hydration-water-myths?utm_source=npr_newsletter&utm_medium=email&utm_content=20221016&utm_term=7386723&utm_campaign=health&utm_id=31926817&orgid=&utm_att1=">mentioned</a> as the amount of water we should aim for and a nice way to track your intake. But it doesn’t account for individual variation based on age, gender, body size and activity levels. Alcohol is a diuretic, which means it dehydrates the body by promoting water loss through urine. This fluid loss is a key factor that contributes to the severity of a hangover. Always have a glass of water in between alcoholic drinks to help stay hydrated. Caffeinated drinks (like tea and coffee) only have a mild diuretic effect. For most healthy adults, it’s okay to consume up to 400 mg of caffeine a day – that’s about four cups of coffee or eight cups of tea. If you drink more than this, it may impact your hydration levels. To check your specific requirements, check out the Australian <a href="https://www.nrv.gov.au/nutrients/water">guidelines</a> for fluid intake. <h2>People who should take extra care</h2> Some people are at greater risk of the harmful health effects from dehydration and need to pay special attention to their fluid intake. The highest priority groups are babies, young kids, pregnant women, and older adults. These groups are at greater risk for many reasons, including relatively higher water needs per kilo of body weight, reduced ability to detect and respond to symptoms of dehydration, and barriers to consuming fluids regularly. Family and friends can play an important role in <a href="https://www.agedcareguide.com.au/information/hydration-for-elderly-people-and-the-dangers-of-dehydration">supporting loved ones</a> to maintain hydration, especially during warm weather. <h2>Ten ideas for keeping fluids up this summer</h2> <ol> <li> Download a water reminder app on your phone This will help keep you on track during the day and give you digital “high fives” when you hit your water goals. </li> <li> Add sugar-free flavouring Try a sugar-free fruit infusion in your water to make it more appealing. Prepare a jug in the refrigerator and infuse it overnight so it’s chilled for you the next day. Fill it up and take it everywhere with you! </li> <li> Add some fresh fruit Add some slices of lime, lemon, berries, pineapple or orange to your water bottle for some natural flavouring. If the bottle is kept in a fridge, the fruit will stay fresh for about three days. </li> <li> Make a jug of iced tea (not the bottled stuff) There are many great sugar-free recipes online. Tea contributes to fluid intake too. For green and black teas, brew in boiling water then cool overnight on the bench before refrigerating. Fruit teas can be made using cold water immediately. </li> <li> Add a dash of cordial to your water A small amount of cordial in your water is a healthier alternative to drinking a sugar-sweetened soft drink or fruit juice. Diet cordials have less added sugar again. </li> <li> Make a fruit ‘slushie’ Combine fresh fruit, ice and water at home in the morning and sip to increase your fluid intake for the day. </li> <li> Buy a soda maker for your home Some people find plain water tastes better with bubbles. Sparkling mineral water is great too, as long as there is no added sugar or sweeteners. </li> <li> Before you eat anything, have a glass of water Make it a rule with yourself to have a glass of water before every snack or meal. </li> <li> Eat water-rich fruits and vegetables Many fruits and vegetables have a high water content. Some of the best include berries, oranges, grapes, carrots, lettuce, cabbage, spinach and melons. Keep a container full of cut-up fruit to snack on in your fridge. </li> <li> Use a water bottle Take it with you during the day and keep it by your bed overnight. </li> </ol> <h2>A tip on water bottles</h2> Water bottles are everywhere and sometimes seem to offer <a href="https://www.refinery29.com/en-au/emotional-support-water-bottle-girlies-tiktok-trend">emotional support</a> as well as hydration. Having a water bottle you enjoy using can go a long way in helping you keep up your fluids during the day. Pay attention to the material of the water bottle and use one that helps you form good habits. Some people prefer metal water bottles as they can keep water cooler for longer (others feel like they are camping). Some prefer glass bottles because the water isn’t affected by any flavours from the container (others fear breaking the glass). Consider the practical aspects, too: Will it fit in your bag? Will it be light enough to carry with you? Can you “chug” on it when you’re exceptionally thirsty? Does the lid require screwing? How durable is it in preventing leaks? Do some <a href="https://www.marthastewart.com/7842071/best-water-bottles-hydration">homework</a> on your water bottle, an essential accessory! <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 and Researcher, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/dont-like-drinking-plain-water-10-healthy-ideas-for-staying-hydrated-this-summer-191859">original article</a>.

Body

Filling the silences in family stories − how to think like a historian to uncover your family’s narrative

<a href="https://theconversation.com/profiles/andrea-kaston-tange-1417052">Andrea Kaston Tange</a>, <a href="https://theconversation.com/institutions/macalester-college-2632">Macalester College</a> Great-grandmothers. We all have them. But most of us will never know them except through glimpses of fading bits of paper: sepia photographs, recipe cards, letters in handwriting traced by a fountain pen dispensing cocoa-colored ink. What does it take to build coherent stories out of such tantalizing fragments of lives? I face this question routinely in my career as a <a href="https://www.macalester.edu/english/facultystaff/andreakastontange/">professor of 19th-century literature and culture</a>. Recently, I’ve turned that experience to writing a book about my own family. When I inherited my great-grandmother’s diary, a repurposed teacher’s planner in which she chronicled the family’s 1926 move from Michigan to Miami, I found a wedding portrait tucked inside. The angled profile showcases her youthful skin and a dress too elaborate for a Midwestern schoolteacher’s daily wear. It is easy to imagine that she took pleasure in inscribing her new name on the picture’s reverse: Faith Avery. I stared at her beautiful image for years, as if details of her satin gown could explain why a woman widowed in 1918 would, for the rest of her life, refuse to admit to having had that first husband and yet carefully preserve this portrait. And then, because archives have been at the center of my scholarly work, I turned to research. I located marriage records and draft cards, pored over maps, found family members in censuses and obituaries. Within those documents lay answers both surprising and poignant. What did I look for? How might anyone with a half-told family story begin to uncover more truths? And what does it take to make sense of them? <h2>The digging</h2> Questions that begin with “why” can rarely be answered easily. Researchers thus often prefer to start with “who” and “when” and “how,” locating a person in one spot and then tracing them through time. This adventure down a rabbit hole follows a method. Make a list of unknowns. These may be facts or enticing tidbits of incomplete family lore. My mother, trying to be helpful, told me things like, “Faith always said there was a horse thief in the family, but she was too mortified to reveal his name” and “I think Aunt Harriette (Faith’s sister) was married once briefly.” Do precise, not general, searches. Typing “horse thief Avery” into Google yields nothing useful, but many other sources contain rich information about old-fashioned exploits. The New York Public Library’s <a href="https://www.nypl.org/blog/2019/03/25/genealogy-guide-books">guide for family research</a> introduces some options. The <a href="https://www.loc.gov/pictures/">Library of Congress print and photograph collection</a> can also help you envision your ancestors’ world. Physical libraries contain historic photographs, maps, local records and digitized newspapers not available online. Historical societies and state universities typically allow free, in-person use of their collections. Know that sometimes you will fail and need to change course. I spent several days looking for the horse thief to no avail, much to my mother’s disappointment. But when I turned to Aunt Harriette’s marriage, I found a character no less fascinating, one I now think of as “Four Wives Frank.” Read old documents knowing they were produced by a patchwork of individuals who took information on trust. The handwritten birth, death, marriage and <a href="https://www.archives.gov/research/census/about">census records</a> of past centuries relied on self-reported data that required no verification. They can be plagued by carelessness in the name of efficiency. One hurried census-taker recorded Faith’s mother Cara as “Cora,” another renamed her brother Horace “Harris.” Frank offered up a variety of birth years, countries of origin and maiden names for his mother as he worked his way west. He must have been charming. Who but a charming man could have convinced woman after woman to marry him, each thinking she was, at most, his second wife? Marriage register officers and census-takers, not to mention his trail of brides, were none the wiser. Which leads me to this: Cross-check information. I knew I had the right Frank because he had the same three sons in multiple records. Inconsistencies across those records, in conjunction with the trajectory of his life, made this conclusion inevitable: The man purposefully reinvented himself. <h2>The assembly</h2> My academic work has taught me that most <a href="https://doi.org/10.2979/victorianstudies.63.2.02">archival answers lead to more questions</a>. As a result, I expect multiple phases of collecting. I gathered everything I could find about Faith’s early life, in hopes something might explain her reticence about her first marriage. As her story emerged, I periodically hit holes in the narrative that sent me back for more digging. Understanding people is easier if you are familiar with their world. For background, I read histories of Miami in the 1920s and researched details in Faith’s diary that might reveal her personality or motivations. Exploring her reading lists showed me a woman who enjoyed popular entertainment, such as 1926’s blockbuster “<a href="https://www.imdb.com/title/tt0016598/">Aloma of the South Seas</a>.” Primers of <a href="https://libraryguides.missouri.edu/pricesandwages/1920-1929">1920s wages and prices</a> explained the family’s economic worries. As I got to know Faith, I revisited documents with new questions. To figure out whether Harriette’s husband Frank had anything to do with Faith, I made timelines for both sisters. To ponder the emotional underpinnings of those events, I reread Faith’s diary, paying particular attention to entries about Harriette and about Faith’s second husband. Because every pile of documents contains multiple stories, the key to a coherent narrative is locating a through line that addresses the biggest conundrums while identifying the tangents. I let go of the horse thief. <h2>The results</h2> The detective-style plots of what I call “<a href="https://www.writersdigest.com/be-inspired/lilly-dancyger-memoir-as-detective-novel">investigative memoir</a>” may inspire you to do your own family research. Genealogy sites such as <a href="https://www.ancestry.com/">Ancestry.com</a> and <a href="https://www.familysearch.org/en/united-states/">FamilySearch.org</a> can help. But it’s worth remembering that secondary reading will add richness to any family story. And local librarians are extraordinary at helping patrons navigate the search process. Improbable as it might seem, Four Wives Frank helped me understand the extent of Faith’s secrets and that she harbored them in hopes that her children’s lives would be easier. Such self-sacrifices are common for mothers. And yet, their particulars are as individual as the faintly silvered portrait of the soft young woman who married Harold Avery in 1911, and whose story requires an entire book to tell properly.<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/234341/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrea-kaston-tange-1417052">Andrea Kaston Tange</a>, Professor of English, <a href="https://theconversation.com/institutions/macalester-college-2632">Macalester College</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/filling-the-silences-in-family-stories-how-to-think-like-a-historian-to-uncover-your-familys-narrative-234341">original article</a>.

Family & Pets

What does a good death look like when you’re really old and ready to go?

<a href="https://theconversation.com/profiles/naomi-richards-182120">Naomi Richards</a>, <a href="https://theconversation.com/institutions/university-of-glasgow-1269">University of Glasgow</a> <a href="https://www.huffingtonpost.co.uk/entry/hawaii-legalizes-assisted-suicide_us_5ac6c6f5e4b0337ad1e621fb">Hawaii</a> recently joined the growing number of states and countries where doctor-assisted dying is legal. In these jurisdictions, help to die is rarely extended to those who don’t have a terminal illness. Yet, increasingly, very old people, without a terminal illness, who feel that they have lived too long, are arguing that they also have a right to such assistance. Media coverage of <a href="https://www.washingtonpost.com/news/to-your-health/wp/2018/05/09/this-104-year-old-plans-to-die-tomorrow-and-hopes-to-change-views-on-assisted-suicide/?utm_term=.b00a9036f9bc">David Goodall</a>, the 104-year-old Australian scientist who travelled to Switzerland for assisted dying, demonstrates the level of public interest in ethical dilemmas at the <a href="https://www.bmj.com/content/361/bmj.k1891.full">extremities of life</a>. Goodall wanted to die because he no longer enjoyed life. Shortly before his death, he told reporters that he spends most of his day just sitting. “What’s the use of that?” he asked. <a href="https://www.sciencedirect.com/science/article/pii/S0277953615002889?via%3Dihub">Research</a> shows that life can be a constant struggle for the very old, with social connections hard to sustain and health increasingly fragile. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25982088">Studies</a> looking specifically at the motivation for assisted dying among the very old show that many feel a deep sense of loneliness, tiredness, an inability to express their individuality by taking part in activities that are important to them, and a hatred of dependency. Of the jurisdictions where assisted dying is legal, some make suffering the determinant (Canada, for example). Others require a prognosis of six months (California, for example). Mainly, though, the focus is on people who have a terminal illness because it is seen as less of an ethical problem to hasten the death of someone who is already dying than someone who is simply tired of life. <h2>Why give precedence to physical suffering?</h2> Assisted dying for people with psychological or existential reasons for wanting to end their life is unlikely to be supported by doctors because it is not objectively verifiable and also potentially remediable. In the Netherlands, despite the legal power to offer assistance where there is no life-limiting illness, doctors are <a href="https://www.ncbi.nlm.nih.gov/pubmed/25693947">seldom convinced</a> of the unbearable nature of non-physical suffering, and so will rarely administer a lethal dose in such cases. Although doctors may look to a physical diagnosis to give them confidence in their decision to hasten a patient’s death, physical symptoms are often not mentioned by the people they are assisting. Instead, the most common reason given by those who have received help to die is <a href="https://www.nejm.org/doi/full/10.1056/NEJMms1700606">loss of autonomy</a>. Other common reasons are to avoid burdening others and not being able to enjoy one’s life – the exact same reason given by Goodall. This suggests that requests from people with terminal illness, and from those who are just very old and ready to go, are not as different as both the law – and doctors’ interpretation of the law – claim them to be. <h2>Sympathetic coverage</h2> It seems that the general public does not draw a clear distinction either. Most of the media coverage of Goodall’s journey to Switzerland was sympathetic, to the dismay of <a href="http://www.carenotkilling.org.uk/press-releases/centenarians-assisted-suicide/">opponents</a> of assisted dying. Media reports about <a href="https://www.theguardian.com/tv-and-radio/2014/sep/02/mary-berry-great-british-bake-off-centenarian-assisted-dying">ageing celebrities</a> endorsing assisted dying in cases of both terminal illness and very old age, blur the distinction still further. One of the reasons for this categorical confusion is that, at root, this debate is about what a good death looks like, and this doesn’t rely on prognosis; it relies on <a href="https://www.tandfonline.com/doi/full/10.1080/01459740.2016.1255610">personality</a>. And, it’s worth remembering, the personalities of the very old are as diverse as those of the very young. Discussion of assisted suicide often focuses on concerns that some older people may be exposed to coercion by carers or family members. But older people also play another role in this debate. They make up the rank and file <a href="http://www.ep.liu.se/ej/ijal/2012/v7/i1/a01/ijal12v7i1a01.pdf">activists</a> of the global right-to-die movement. In this conflict of rights, protectionist impulses conflict with these older activists’ demands to die on their own terms and at a time of their own choosing. In light of the <a href="https://www.nih.gov/news-events/news-releases/worlds-older-population-grows-dramatically">unprecedented ageing</a> of the world’s population and increasing longevity, it is important to think about what a good death looks like in deep old age. In an era when more jurisdictions are passing laws to permit doctor-assisted dying, the choreographed death of a 104-year-old, who died listening to Ode to Joy after enjoying a last fish supper, starts to look like a socially approved good death.<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/96589/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/naomi-richards-182120">Naomi Richards</a>, Lecturer in Social Science (End of Life Studies), <a href="https://theconversation.com/institutions/university-of-glasgow-1269">University of Glasgow</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-does-a-good-death-look-like-when-youre-really-old-and-ready-to-go-96589">original article</a>.

Caring

Olympic legend given just two years to live

British Olympic legend Sir Chris Hoy has announced that his cancer is terminal. In an interview with The Sunday Times, the six-time Olympic cycling champion revealed that doctors have told him he has between two and four years to live. He told the publication that he had initially been diagnosed with cancer in his prostate, which had spread to his bones. Despite the terminal cancer diagnosis, the athlete remained positive and expressed his gratitude for the messages of support he has been receiving since the article's publication on Sunday. "You may see in the news this weekend some articles about my health, so I just wanted to reassure you all that I'm feeling fit, strong and positive," he wrote on Instagram. "Overwhelmed by all the love and support shown to my family and me. Onwards." Fellow Olympic cyclist Sir Mark Cavendish was among the many British sporting stars to send their support. "Hero of a human being," Cavendish wrote on Instagram. Three-time Olympic track medallist, Dame Kelly Holmes, added: "Sending love to you Chris." "Legend," commented Team GB Paralympic cycling medallist Archie Atkinson. Scottish Cycling added: "Sending our love and best wishes to Sir Chris and his family from everyone in the Scottish Cycling community. "As ever, he continues to be an inspiration on and off the track." <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/DBJEVKhO00z/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/DBJEVKhO00z/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Skarper (@skarperofficial)</a> </div> </blockquote> UK Health Secretary Wes Streeting expressed his support and admiration for Hoy's openness during such a difficult moment. "I'm in awe that Chris Hoy is meeting his cancer with the same positivity and resilience that has defined his life and career," Streeting wrote on X. "The whole country will be cheering him on as we have done so many times before and sending him and his family so much love." <blockquote class="twitter-tweet"> Sir Chris Hoy has been an inspiration to us all as a world class sportsman, decorated Olympian & a proud Scot. He’s provided so much joy to millions. He is also incredibly brave. I send my very best wishes to Chris and his family at this difficult time.<a href="https://t.co/aoP5OTKmDb">https://t.co/aoP5OTKmDb</a> — Ian Murray MP (@IanMurrayMP) <a href="https://twitter.com/IanMurrayMP/status/1847910282254758044?ref_src=twsrc%5Etfw">October 20, 2024</a></blockquote> Streeting, a cancer survivor himself, also told the BBC that he was "in awe" of Sir Chris's courage and positivity. "I'm in awe of his courage and positivity in face of a death sentence, which is what his cancer diagnosis is. The whole nation will be cheering him on now as we have done in the past," he said. "He is not the only person in this country today dealing with a terminal diagnosis... what a wonderful message of hope he has sent." Images: Instagram

Caring

Trying to lose weight? Here’s why your genetics could be just as important as your exercise regime

<a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a> Weight loss is a complicated process. There are so many factors involved including your diet, how much sleep you get each night and the kind of exercise you do. Our recent study shows that your <a href="https://www.tandfonline.com/doi/full/10.1080/02701367.2024.2404981">specific genetic profile</a> may also have a dominant effect on how well you lose weight through exercise. This might explain why two people who do an identical workout will see very different results. We identified 14 genes that appeared to significantly contribute to how much weight a person lost through running. This suggests that some of us have a natural talent when it comes to burning fat and losing weight through exercise. To conduct our study, we recruited 38 men and women born in the UK aged between 20 and 40. None of the participants regularly exercised at the start of the study. The group was randomly divided, with one half following a strict eight-week endurance programme that consisted of three weekly runs of 20-30 minutes. The other group acted as a <a href="https://www.britannica.com/science/control-group">control</a>. They were instructed to refrain from exercise and continue their daily routines as normal over this study period, including diet and lifestyle habits. All participants conducted a running test to see how far they could run in 12 minutes, and were weighed before and after the study period. This was to gauge their initial fitness level and see how much they changed over the duration of the study. <a href="https://www.nhs.uk/conditions/obesity/">Body mass index</a> (BMI) was also calculated. Additionally, a saliva sample was collected from each person with a <a href="https://muhdo.com/?gclid=Cj0KCQjwiIOmBhDjARIsAP6YhSUB3WI81JP4Q_snYLhh-SBVNeCJNy2m63C8bKJFvO-nJ5UsHuCCdqMaAhTeEALw_wcB">DNA test kit</a> at the end of the study to assess their unique genetic profile. It’s important to note that everyone who participated in the study had a similar body weight, BMI and aerobic fitness level at the start of the study. This is beneficial for <a href="https://casp-uk.net/news/homogeneity-in-research/">multiple reasons</a>. It meant everyone was at the same starting point, and some <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/confounding-variable">confounding variables</a> were already controlled for such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128125/">fitness level</a>. This ultimately improves accuracy in interpreting the results. <h2>Exercise genes</h2> Everyone in the exercise group managed to lose weight – around 2kg on average. The control group, on the other hand, put on a little bit of weight. While a 2kg weight loss may not sound like a lot, it’s significant considering the exercise regime only lasted eight weeks and participants made no <a href="https://www.intechopen.com/chapters/87186">changes to their diet</a>. More significant, however, was the large variation in results among those that exercised – with an up to 10kg difference in weight loss between some of the participants. In fact, everyone within the exercise group improved at different rates. Since we controlled for factors such as the <a href="https://pubmed.ncbi.nlm.nih.gov/3529283/">intensity, duration and frequency</a> of the exercises and used participants who’d had a similar body weight and fitness level at the start of the study, this suggests that some people naturally benefited more than others from endurance training. When we looked at the genetic profiles of our participants, we found that differences in each person’s response to the exercise was strongly associated with their specific genetics. We showed there was a strong linear correlation between the amount of weight participants lost and 14 genes that have previously been shown to be associated with body weight, metabolism or <a href="https://www.nature.com/articles/s41380-018-0017-5">psychological conditions</a> that affect BMI. The greater number of these genes a participant had, the more weight they lost. Our results also revealed that around 63% of the variance in weight lost among participants were explained by the genes identified. For example, research has shown the <a href="https://www.ncbi.nlm.nih.gov/gene/10891">PPARGC1A gene</a> plays a role in metabolism and the <a href="https://link.springer.com/article/10.1007/S11033-020-05801-Z">use of fats for energy</a> while exercising. Our study found that all participants who lost more than 1.5kg from exercise had this gene. Those who lost less than this did not have this gene. Our findings align with what <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249501&s2=P875440273_1683331208925004155">previous studies</a> have shown. But while previous papers have only looked at the link between individual genes and weight loss, ours is the first to show that 14 different genes appear to work in combination to affect whether a person loses weight from endurance exercise. <h2>Piece of the puzzle</h2> Our study also suggests that while some people possess genes that make it easier for them to get fit and lose weight, people with these favourable genetics can only flourish if they actually exercise. In fact, our control group also had a number of these listed genes, but without exercise these genes could not activate, and so the participants did not lose any weight. While our study provides compelling findings, it’s not without limitations. Since we only looked at endurance-based exercise, it will be important for future studies to investigate whether there are similar links between weight loss, genetics and combinations of different types of training (such as a mixture of endurance and strength sessions into a training plan). It’s also worth mentioning that exercise is only <a href="https://www.who.int/activities/controlling-the-global-obesity-epidemic">one piece of the puzzle</a> when it comes to weight loss. So even if you have all 14 of these genes, you won’t lose any weight or get fit if you don’t exercise and maintain a healthy diet and sleep pattern. On the flip side, someone that only has a few of these favourable genes can still benefit if they exercise and are mindful of other aspects of their lifestyle.<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/240506/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, Lecturer in Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</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/trying-to-lose-weight-heres-why-your-genetics-could-be-just-as-important-as-your-exercise-regime-240506">original article</a>.

Body

An unbroken night’s sleep is a myth. Here’s what good sleep looks like

<a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> What do you imagine a good night’s sleep to be? Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep. Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">the same belief</a>. In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like. <h2>Sleep cycles are a roller-coaster</h2> As an adult, our sleep moves through <a href="https://www.sleepfoundation.org/stages-of-sleep">different cycles</a> and brief awakenings during the night. Sleep cycles last roughly 90 minutes each. We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming. If sleeping well, we get most of our deep sleep in the first half of the night, with <a href="https://www.nhlbi.nih.gov/health/sleep/stages-of-sleep#:%7E:text=During%20REM%20sleep%2C%20your%20eyes,from%20acting%20out%20your%20dreams">REM sleep</a> more common in the second half of the night. Adults usually move through five or six sleep cycles in a night, and it is entirely <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">normal</a> to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief. <h2>What does getting a ‘good’ sleep actually mean?</h2> You’ll often hear that adults <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need#:%7E:text=Sleep%20requirements%20stabilise%20in%20early,their%20best%20the%20next%20day">need between seven and nine hours</a> of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality. For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day. You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb). But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons. <h2>Common issues</h2> Sleep disorders are common. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/35478719/">25% of adults</a> have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like. Rates of common sleep disorders such as insomnia and <a href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631">sleep apnoea</a> – where your breathing can partially or completely stop many times during the night – also increase with age, affecting <a href="https://pubmed.ncbi.nlm.nih.gov/32280974/">20% of early adults</a> and 40% of people in <a href="https://pubmed.ncbi.nlm.nih.gov/35082023/">middle age</a>. There are effective treatments, so asking for help is important. Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0012369218311139">pain</a> – and by <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13075">certain medications</a>. There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “<a href="https://www.tandfonline.com/doi/full/10.1080/07420528.2021.2003375">forced awakenings</a>” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause. A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help. We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own <a href="https://www.sleephealthfoundation.org.au/sleep-categories/circadian-rhythm-disorders#:%7E:text=The%20circadian%20rhythms%20throughout%20the,regulation%20of%20our%20sleeping%20patterns">internal clock</a>, which can influence the time your body prefers to sleep. If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern. <h2>Can my smart watch help?</h2> It is important to remember sleep-tracking devices can <a href="https://www.nature.com/articles/s41746-024-01016-9">vary in accuracy</a> for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure. In-laboratory <a href="https://pubmed.ncbi.nlm.nih.gov/31277862/">polysomnography</a>, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep. Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time. <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8356">Understanding your sleep patterns</a> may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment. And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.<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/238069/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, Associate Professor in Clinical Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, Research Associate, Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, Postdoctoral Research Fellow, Clinical Psychologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, Research Fellow in Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, Associate Professor, Adelaide Institute for Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders 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/an-unbroken-nights-sleep-is-a-myth-heres-what-good-sleep-looks-like-238069">original article</a>.

Body

Lost touch with someone? Reach out – your friend will likely appreciate it more than you think

<a href="https://theconversation.com/profiles/peggy-liu-818769">Peggy Liu</a>, <a href="https://theconversation.com/institutions/university-of-pittsburgh-854">University of Pittsburgh</a> and <a href="https://theconversation.com/profiles/lauren-min-1354136">Lauren Min</a>, <a href="https://theconversation.com/institutions/university-of-kansas-1588">University of Kansas</a> <h2>The big idea</h2> The next time you wonder whether to reach out to a friend, family member, classmate or other person who’s been out of touch for a long time, go ahead and do it. According to <a href="https://doi.org/10.1037/pspi0000402">our just-published research</a>, it’s likely they’ll appreciate it more than you think. In a series of 13 experiments involving over 5,900 participants, we – along with colleagues <a href="https://scholar.google.com/citations?user=0Stzf1cAAAAJ&hl=en">SoYon Rim</a> and <a href="https://scholar.google.com/citations?user=TZQefJAAAAAJ&hl=en">Kate Min</a> – wanted to investigate whether people accurately predict <a href="https://doi.org/10.1037/pspi0000402">how much their social contacts appreciate being reached out to</a>. In one experiment we conducted, college students wrote a note “to check in and say hello” to a classmate they hadn’t interacted with in a while. Then we asked them how much they thought their classmate would appreciate receiving this note. Next, we delivered these notes to their classmates and asked the recipients how much they appreciated receiving them. We found that the students who received the notes were much more appreciative of the gesture than the students who wrote them had anticipated. Other experiments varied the scenario by involving older adults as participants rather than college students, switching the written message to a small gift – such as cookies or coffee – and comparing how much the sender underestimated the appreciation that an emotionally distant contact would feel compared with a close contact. Overall they yielded the same basic finding: People tended to underestimate how much others appreciated hearing from them. What drives this underestimation? Our results suggest that it’s related to how little the people reaching out factor in the surprise felt by those being contacted. When we asked recipients what they focused on when indicating how appreciative they felt, they reported paying a lot of attention to their positive feelings of surprise, which were linked to how appreciative they felt. Comparatively, potential senders did not report focusing much on recipients’ positive feelings of surprise. It also mattered whether the two parties were already in a close relationship. People’s underestimations were even greater when their contact was a distant acquaintance because these recipients were especially surprised at being contacted. <h2>Why it matters</h2> Many people can name at least one person with whom they would like to reconnect. Taking a new job, moving to a different city, becoming a parent, or the busyness of everyday life – these are just some of the life events and circumstances that can cause people to lose touch. Then, if the desire to reconnect arises on one side, doubts may arise about whether the other person may appreciate being contacted out of the blue. When people consider taking the initiative to reach out, especially after a prolonged period of no contact, they may worry about being rejected. This worry might keep them from reaching out in the first place. Our research lessens this challenge by showing that often, these gestures will be much more appreciated than one might expect. <h2>What other research is being done</h2> Our findings fit within a growing stream of research examining the tendency to underestimate others’ appreciation of various social exchanges. For example, other researchers have found that people underestimate how much <a href="https://doi.org/10.1037/pspa0000277">others appreciate receiving compliments</a> or <a href="https://doi.org/10.1177/0956797618772506">expressions of gratitude</a>. Our work adds to this area by broadening the scope of the contexts in which people underestimate how much social exchanges are appreciated. Reaching out could but need not require giving compliments or expressing gratitude – the gesture can be as simple as checking in with someone to show that one is thinking about them.<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/185001/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peggy-liu-818769">Peggy Liu</a>, Ben L. Fryrear Chair in Marketing and Associate Professor of Business Administration, <a href="https://theconversation.com/institutions/university-of-pittsburgh-854">University of Pittsburgh</a> and <a href="https://theconversation.com/profiles/lauren-min-1354136">Lauren Min</a>, Assistant Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-kansas-1588">University of Kansas</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/lost-touch-with-someone-reach-out-your-friend-will-likely-appreciate-it-more-than-you-think-185001">original article</a>.

Relationships

TikTok couple slammed for leaving toddlers unattended in cruise cabin

TikTok Influencers Matt and Abby Howard have been slammed online for their controversial parenting choice while on a family vacation. In a now deleted video, the couple explained that they had brought their sons Griffin, 2, and August, 1 on a family cruise, and they went to dinner without the boys, but monitored the room through FaceTime. "So we ended up taking them for 5 nights and it became apparent that they weren't enjoying it and therefore we weren't either," they said in the caption. "So THEN we switched our dinner time to AFTER their bedtime and FaceTimed the monitors while we ate." Abby noted that baby monitors "don't work on board unless you're only like 10 feet away", adding that their dinnertime solution worked out "much better for everyone" Social media users were quick to respond to their decision, with many highlighting the safety concerns. "They literally could not have gotten to them fast enough if anything had happened and I cannot stop thinking about that. It’s sickening," one wrote on Reddit. "It's literally common sense that you do not leave a baby alone unsupervised," another added. "The fact that they would so willingly leave their children in an unfamiliar environment completely alone is shocking," another added. "Are they seriously that f****** dumb? Do they not watch the news, have they not seen what happened to Madeline McCann?" a fourth wrote. Following the controversy, the couple released a video claiming that a family member was always with the children while they were at dinner, although they didn't clarify who. "We take our roles as parents extremely seriously and we love our children more than anything in the entire world, and we're very protective of our kids," Matt said in the video. "We had someone with our children at all times on this boat," he continued adding that the speculation surrounding them is "completely untrue". "I do want to clarify that we have not, would not, will not ever leave our children unattended. We would would never, ever want to put them in harms way in anyway," Abby added. She explained that her family would "tag team" to help the couple out with watching their children. Viewers were quick to speculate whether they were telling the truth, while others were glad they clarified. "Thanks for the clarification because it did come off like the boys were alone- context is everything," one wrote. "I hope this is the truth," another added. "For them to post about it like it's some genius parenting hack is just wild," a third wrote. Image: Instagram

Family & Pets

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

<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>.

Food & Wine

Retirement doesn’t just raise financial concerns – it can also mean feeling unmoored and irrelevant

<a href="https://theconversation.com/profiles/marianne-janack-681018">Marianne Janack</a>, <a href="https://theconversation.com/institutions/hamilton-college-2966">Hamilton College</a> Most discussions of retirement focus on the financial aspects of leaving the workforce: “<a href="https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/publications/top-10-ways-to-prepare-for-retirement.pdf">How to save enough for retirement</a>” or “<a href="https://www.businessinsider.com/personal-finance/investing/when-can-i-retire">How do you know if you have enough money for retirement</a>?” But this might not be the biggest problem that potential retirees face. The deeper issues of meaning, relevance and identity that retirement can bring to the fore are more significant to some workers. Work has <a href="https://www.theatlantic.com/ideas/archive/2023/03/work-revolution-ai-wfh-new-book/673572/">become central to the modern American identity</a>, as <a href="https://www.theatlantic.com/atlantic-editions/">journalist Derek Thompson bemoans</a> in The Atlantic. And some theorists have argued that work shapes what we are. For most people, as business ethicist <a href="https://www.luc.edu/quinlan/faculty/algini.shtml#:%7E:text=About,the%20Society%20for%20Business%20Ethics.">Al Gini</a> argues, one’s work – which is usually also one’s job – <a href="https://doi.org/10.4324/9780203950555">means more than a paycheck</a>. Work can structure our friendships, our understandings of ourselves and others, our ideas about free time, our forms of entertainment – indeed our lives. I <a href="https://www.hamilton.edu/academics/our-faculty/directory/faculty-detail/marianne-janack">teach a philosophy course about the self</a>, and I find that most of my students think of the problems of identity without thinking about how a job will make them into a particular kind of person. They think mostly about the prestige and pay that come with certain jobs, or about where jobs are located. But when we get to <a href="https://plato.stanford.edu/entries/existentialism/">existentialist philosophers</a> such as <a href="https://plato.stanford.edu/entries/sartre/">Jean-Paul Sartre</a> and <a href="https://plato.stanford.edu/entries/beauvoir/">Simone de Beauvoir</a>, I often urge them to think about what it means to say, as the existentialists do, <a href="https://philosophynow.org/issues/115/On_Being_An_Existentialist">that “you are what you do</a>.” How you spend 40 years of your life, I tell them, for at least 40 hours each week – the time many people spend at their jobs – is not just a financial decision. And I have come to see that retirement isn’t just a financial decision, either, as I consider that next phase of my life. <h2>Usefulness, tools and freedom</h2> For Greek and Roman philosophers, <a href="https://search.worldcat.org/title/Work-what-it-has-meant-to-men-through-the-ages/oclc/780872063">leisure was more noble than work</a>. The life of the craftsperson, artisan – or even that of the university professor or the lawyer – was to be avoided if wealth made that possible. The good life was a life not driven by the necessity of producing goods or making money. Work, Aristotle thought, was an obstacle to the achievement of the particular forms of excellence characteristic of human life, like thought, contemplation and study – <a href="https://classics.mit.edu/Aristotle/nicomachaen.7.vii.html">activities that express</a> the <a href="https://classics.mit.edu/Aristotle/nicomachaen.8.viii.html">particular character of human beings</a> and are done for their own sake. And so, one might surmise, retirement would be something that would allow people the kind of leisure that is essential to human excellence. But contemporary retirement does not seem to encourage leisure devoted to developing human excellence, partly because it follows a long period of making oneself into an object – something that is not free. German philosopher Immanuel Kant distinguished between the value of objects and of subjects by the idea of “use.” Objects are not free: They are meant to be used, like tools – their value is tied to their usefulness. But rational beings like humans, who are subjects, are more than their use value – <a href="https://search.worldcat.org/title/5796114">they are valuable in their own right</a>, unlike tools. And yet, much of contemporary work culture encourages workers to think of themselves and their value <a href="https://www.simonandschuster.com/books/Bullshit-Jobs/David-Graeber/9781501143335">in terms of their use value</a>, a change that would have made both Kant and the ancient Greek and Roman philosophers wonder why people didn’t retire as soon as they could. <h2>‘What we do is what we are’</h2> But as one of my colleagues said when I asked him about retirement: “If I’m not a college professor, then what am I?” Another friend, who retired at 59, told me that she does not like to describe herself as retired, even though she is. “Retired implies useless,” she said. So retiring is not just giving up a way of making money; it is a deeply existential issue, one that challenges one’s idea of oneself, one’s place in the world, and one’s usefulness. One might want to say, with Kant and the ancients, that those of us who have tangled up our identities with our jobs have made ourselves into tools, and we should throw off our shackles by retiring as soon as possible. And perhaps from the outside perspective, that’s true. But from the participant perspective, it’s harder to resist the ways in which what we have done has made us what we are. Rather than worry about our finances, we should worry, as we think about retirement, more about what the good life for creatures like us – those who are now free from our jobs – should be.<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/233963/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marianne-janack-681018">Marianne Janack</a>, John Stewart Kennedy Professor of Philosophy, <a href="https://theconversation.com/institutions/hamilton-college-2966">Hamilton College</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/retirement-doesnt-just-raise-financial-concerns-it-can-also-mean-feeling-unmoored-and-irrelevant-233963">original article</a>.

Retirement Income

Olympian killed at just 33 years of age

Ugandan Olympic athlete Rebecca Cheptegei, 33, has tragically passed away at Moi Teaching and Referral Hospital in Eldoret, Kenya, where she had been receiving treatment for severe burns sustained in an attack by her former boyfriend. A hospital spokesperson, Owen Menach, confirmed that Cheptegei succumbed to her injuries after suffering multiple organ failures. Cheptegei, who competed in the women’s marathon at the Paris Olympics just weeks ago, sustained burns to 80% of her body after her ex-partner, Dickson Ndiema, allegedly doused her in petrol and set her on fire during a domestic dispute. Trans Nzoia County Police Commander Jeremiah ole Kosiom revealed that Ndiema also suffered burns in the incident to 30% of his body, and that he remains in intensive care but is in a stable condition. Cheptegei's parents stated that she had recently bought land in Kenya’s Trans Nzoia County to be near athletic training centres in the region. A report from the local chief indicated that Cheptegei and her former boyfriend were involved in a heated argument over the property before the attack occurred. The Uganda Athletics Federation and the Uganda Olympic Committee have expressed their grief over the loss of Cheptegei. In a statement shared on the social media platform X, the Athletics Federation wrote, "We are deeply saddened to announce the passing of our athlete, Rebecca Cheptegei early this morning who tragically fell victim to domestic violence." They further condemned the attack, calling for justice. Uganda Olympic Committee president Donald Rukare added, “May her gentle soul rest in peace and we strongly condemn violence against women. This was a cowardly and senseless act that has led to the loss of a great athlete. Her legacy will continue to endure.” Image: Narnabi / Wikimedia Commons

Caring

I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities. Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>. But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>. <h2>Stress makes it harder to fight off viruses</h2> When the immune system starts to break down, a virus that would normally have been under control starts to flourish. Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>. In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>. These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>. One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>. <h2>Cortisol suppresses immunity</h2> “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>. When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.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/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=593&fit=crop&dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=593&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=593&fit=crop&dpr=3 2262w" alt="Human brain illustration" /><figcaption>The hypothalamus sets off an alarm system in response to a real or perceived threat. <a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></figcaption></figure> In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>. But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness. Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>. <h2>Stress causes inflammation</h2> <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>. The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>. Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>. During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>. <h2>What about chronic stress?</h2> Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>. The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins). Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>. Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>. <h2>So how can you manage your stress?</h2> We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by: 1) Getting enough sleep Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation. 2) Taking regular exercise Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>. 3) Eating a healthy diet Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>. 4) Socialising and practising meditation or mindfulness These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</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/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</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/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>. </div>

Body

What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

<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> and <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> While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes. Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">both type 1 and type 2 diabetes</a>. More people became aware of this condition after <a href="https://www.imdb.com/name/nm0004726/">Lance Bass</a>, best known for his role in the iconic American pop band NSYNC, <a href="https://www.foxnews.com/health/pop-singer-lance-bass-type-1-5-diabetes-know-disease">recently revealed</a> he has it. So, what is type 1.5 diabetes? And how is it diagnosed and treated? <h2>There are several types of diabetes</h2> Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually <a href="https://diabetesjournals.org/care/article/37/Supplement_1/S81/37753/Diagnosis-and-Classification-of-Diabetes-Mellitus">more than ten types</a> of diabetes, but the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext">most common</a> are type 1 and type 2. Type 1 diabetes is an <a href="https://diabetesjournals.org/care/article/44/11/2589/138492/The-Management-of-Type-1-Diabetes-in-Adults-A">autoimmune condition</a> where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production. Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995794/">insulin medication daily</a>. Type 1 diabetes usually <a href="https://www.nature.com/articles/s41390-024-03107-5">appears</a> in children or young adults. Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to <a href="https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954/2-Diagnosis-and-Classification-of-Diabetes">overcome this resistance</a>. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin. Type 2 is more common in adults but is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1871402121002733">increasingly</a> seen in children and young people. Management <a href="https://www.racgp.org.au/getattachment/41fee8dc-7f97-4f87-9d90-b7af337af778/Management-of-type-2-diabetes-A-handbook-for-general-practice.aspx">can include</a> behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy. <h2>How does type 1.5 diabetes differ from types 1 and 2?</h2> Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">immediately</a> because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/">five years</a> of diagnosis, while those with type 1 typically require it from diagnosis. Type 1.5 diabetes is usually diagnosed in people <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">over 30</a>, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2. Type 1.5 diabetes shares <a href="https://www.nature.com/articles/nrendo.2017.99">genetic and autoimmune risk factors</a> with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as <a href="https://pubmed.ncbi.nlm.nih.gov/29589073/">obesity</a> and <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00320/full">physical inactivity</a> which are more commonly associated with type 2 diabetes. <h2>What are the symptoms, and how is it treated?</h2> The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a>: <ul> <li>increased thirst</li> <li>frequent urination</li> <li>fatigue</li> <li>blurred vision</li> <li>unintentional weight loss.</li> </ul> Typically, type 1.5 diabetes is <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">initially treated</a> with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day. When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.959011/full">no universally accepted</a> management or treatment strategies for type 1.5 diabetes. <h2>Type 1.5 diabetes is often misdiagnosed</h2> Lance Bass said he was initially diagnosed with <a href="https://www.healthline.com/health-news/lance-bass-misdiagnosed-diabetes">type 2 diabetes</a>, but later learned he actually has type 1.5 diabetes. This is <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">not entirely uncommon</a>. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">5–10% of the time</a>. There are a few possible reasons for this. First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">antibody tests</a> (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them. Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults). Third, people with <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">type 1.5 diabetes</a> often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin. Finally, because type 1.5 diabetes has <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a> that are similar to type 2 diabetes, it may initially be treated as type 2. <h2>We’re still learning about type 1.5</h2> Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">non-European populations</a>. In 2023, it was estimated type 1.5 diabetes represented <a href="https://pubmed.ncbi.nlm.nih.gov/37428296/">8.9%</a> of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers. Overall, there has been a limited awareness of type 1.5 diabetes and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/">unclear diagnostic criteria</a> which have slowed down our understanding of this condition. A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road. Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce <a href="https://diabetesjournals.org/diabetes/article/73/Supplement_1/55-OR/155112/55-OR-Diabetes-Distress-among-Persons-Living-with">diabetes distress</a>. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.<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/237041/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <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> 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-type-1-5-diabetes-its-a-bit-like-type-1-and-a-bit-like-type-2-but-its-often-misdiagnosed-237041">original article</a>.

Body

Constipation increases your risk of a heart attack, new study finds – and not just on the toilet

<a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and <a href="https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death">it’s believed</a> he was straining very hard to poo, which then led to a fatal heart attack. We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many. But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack. This includes a recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">study</a> led by Australian researchers involving data from thousands of people. <h2>Are constipation and heart attacks linked?</h2> Large <a href="https://www.nature.com/articles/s41598-023-38068-y">population</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">studies</a> show constipation is linked to an increased risk of heart attacks. For example, an <a href="https://www.nature.com/articles/s41598-023-38068-y">Australian study</a> involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age. A <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">Danish study</a> of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes. It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital. These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated. <h2>How about this new study?</h2> The recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">international study</a> led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population. The researchers analysed data from the <a href="https://www.ukbiobank.ac.uk">UK Biobank</a>, a database of health-related information from about half a million people in the United Kingdom. The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation. People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation. The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension. The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations. A <a href="https://pubmed.ncbi.nlm.nih.gov/26812003/">Japanese study</a> looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day. <h2>How might constipation cause a heart attack?</h2> Chronic constipation can lead to straining when passing a stool. This can result in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">laboured breathing</a> and can lead to a rise in blood pressure. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">one Japanese study</a> including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">One theory</a> is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels. As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">doubles</a> when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure). The systolic blood pressure rise with straining in passing a stool has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">reported to be</a> as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks. <a href="https://pubmed.ncbi.nlm.nih.gov/22256893/">Some people</a> with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing. This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure. Another intriguing avenue of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399019/">research</a> examines the imbalance in gut bacteria in people with <a href="https://pubmed.ncbi.nlm.nih.gov/3596341/">constipation</a>. This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack. This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease. <h2>What can we do about this?</h2> Constipation affects around <a href="https://pubmed.ncbi.nlm.nih.gov/36826591/">19% of the global population</a> aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health. Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.<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/237209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> 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/constipation-increases-your-risk-of-a-heart-attack-new-study-finds-and-not-just-on-the-toilet-237209">original article</a>.

Body

Men have a biological clock too. Here’s what’s more likely when dads are over 50

<a href="https://theconversation.com/profiles/karin-hammarberg-113096">Karin Hammarberg</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> We hear a lot about women’s biological clock and how age affects the chance of pregnancy. <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">New research shows</a> men’s fertility is also affected by age. When dads are over 50, the risk of pregnancy complications increases. Data from more than 46 million births in the <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">United States</a> between 2011 and 2022 compared fathers in their 30s with fathers in their 50s. While taking into account the age of the mother and other factors known to affect pregnancy outcomes, the researchers found every ten-year increase in paternal age was linked to more complications. The researchers found that compared to couples where the father was aged 30–39, for couples where the dad was in his 50s, there was a: <ul> <li>16% increased risk of preterm birth</li> <li>14% increased risk of low birth weight</li> <li>13% increase in gestational diabetes.</li> </ul> The older fathers were also twice as likely to have used assisted reproductive technology, including IVF, to conceive than their younger counterparts. <h2>Dads are getting older</h2> In this <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821811#google_vignette">US study</a>, the mean age of all fathers increased from 30.8 years in 2011 to 32.1 years in 2022. In that same period, the proportion of men aged 50 years or older fathering a child increased from 1.1% to 1.3%. We don’t know the proportion of men over 50 years who father children in Australia, but data shows the average age of fathers has increased. In 1975 the <a href="https://www.abs.gov.au/statistics/people/population/births-australia/latest-release">median age of Australian dads</a> was 28.6 years. This jumped to 33.7 years in 2022. <h2>How male age affects getting pregnant</h2> As we know from <a href="https://www.businessinsider.com/celebrities-dads-first-time-over-age-50#when-he-was-54-simon-cowell-and-girlfriend-lauren-silverman-became-parents-to-their-son-eric-7">media reports</a> of celebrity dads, men produce sperm from puberty throughout life and can father children well into old age. However, there is a noticeable decline in <a href="https://www.fertstert.org/article/S0015-0282(18)30269-3/fulltext">sperm quality</a> from about age 40. Female partners of older men take longer to achieve pregnancy than those with younger partners. A study of the effect of male age on <a href="https://www.fertstert.org/article/S0015-0282(03)00366-2/fulltext">time to pregnancy</a> showed women with male partners aged 45 or older were almost five times more likely to take more than a year to conceive compared to those with partners aged 25 or under. More than three quarters (76.8%) of men under the age of 25 years impregnated their female partners within six months, compared with just over half (52.9%) of men over the age of 45. Pooled data from ten studies showed that partners of older men are also more likely to experience miscarriage. Compared to couples where the male was aged 25 to 29 years, <a href="https://pubmed.ncbi.nlm.nih.gov/32358607/">paternal age over 45 years</a> increased the risk of miscarriage by 43%. <h2>Older men are more likely to need IVF</h2> Outcomes of assisted reproductive technology, such as IVF, are also influenced by the age of the male partner. A <a href="https://doi.org/10.1016/j.rbmo.2022.03.031">review of studies</a> in couples using assisted reproductive technologies found paternal age under 40 years reduced the risk of miscarriage by about 25% compared to couples with men aged over 40. Having a male under 40 years also almost doubled the chance of a live birth per treatment cycle. With a man over 40, 17.6% of treatment rounds resulted in a live birth, compared to 28.4% when the male was under 40. <h2>How does male age affect the health outcomes of children?</h2> As a result of age-related changes in sperm DNA, the children of older fathers have increased risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9957550/">a number of conditions</a>. Autism, schizophrenia, bipolar disorders and leukaemia have been linked to the father’s advanced years. A <a href="https://www.fertstert.org/article/S0015-0282(22)01979-3/fulltext">review of studies</a> assessing the impact of advanced paternal age reported that children of older fathers have increased rates of psychiatric disease and behavioural impairments. But while the increased risk of adverse health outcomes linked to older paternal age is real, the magnitude of <a href="https://pubmed.ncbi.nlm.nih.gov/29471389/">the effect is modest</a>. It’s important to remember that an increase in a very small risk is still a small risk and most children of older fathers are born healthy and develop well. <h2>Improving your health can improve your fertility</h2> In addition to the effects of older age, some chronic conditions that affect fertility and reproductive outcomes become more common as men get older. They include <a href="https://www.fertstert.org/article/S0015-0282(23)01935-0/fulltext">obesity and diabetes</a> which affect sperm quality by lowering testosterone levels. While we can’t change our age, some lifestyle factors that increase the risk of pregnancy complications and reduce fertility, can be tackled. They include: <ul> <li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639396/">smoking</a></li> <li>recreational <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/tre.414">drug taking</a></li> <li><a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/tre.414">anabolic steroid</a> use</li> <li>heavy <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504800/">alcohol consumption</a>.</li> </ul> <h2>Get the facts about the male biological clock</h2> Research shows <a href="https://academic.oup.com/humupd/article/23/4/458/3065332?login=false">men want children</a> as much as women do. And most men want at least two children. Yet most men <a href="https://academic.oup.com/humupd/article/23/4/458/3065332?login=false">lack knowledge</a> about the limitations of female and male fertility and overestimate the chance of getting pregnant, with and without assisted reproductive technologies. We need better public education, starting at school, to improve awareness of the impact of male and female age on reproductive outcomes and help people have healthy babies. For men wanting to improve their chance of conceiving, the government-funded sites <a href="https://healthymale.org.au/">Healthy Male</a> and <a href="https://www.yourfertility.org.au/">Your Fertility</a> are a good place to start. These offer evidence-based and accessible information about reproductive health, and <a href="https://www.yourfertility.org.au/fertility-week-2022">tips</a> to improve your reproductive health and give your children the best start in 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/236892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/karin-hammarberg-113096">Karin Hammarberg</a>, Senior Research Fellow, Global and Women's Health, School of Public Health & Preventive Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash 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/men-have-a-biological-clock-too-heres-whats-more-likely-when-dads-are-over-50-236892">original article</a>.

Body

Five-time Olympian found dead at just 50

Five-time Olympic cyclist Daniela Larreal Chirinos has been found dead in a Las Vegas apartment at the age of 50. Chirinos, who represented Venezuela at five Olympic Games, was found after employees raised the alarm when she failed to show up for work. While an official cause of death is yet to be released, Venezuelan media have speculated that she died of asphyxiation on August 11th after a preliminary autopsy found solid food remains in her trachea. Larreal was the only Venezuelan athlete to ever compete in five Olympics, representing her country at Barcelona 1992, Atlanta 1996, Sydney 2000, Athens 2004, and London 2012. Throughout her stellar cycling career, she won several gold medals at local and international events, and earned four Olympic diplomas, given to the top eight finalists in Olympic events. Chairman of the Venezuelan Cycling Federation Eliezer Rojas paid tribute to Larreal, saying she was “not only a champion in cycling but a symbol of perseverance, dedication and passion”. “With a career full of success, she inspired generations of cyclists and left a mark on every competition she participated in. Her legacy will endure in the history of Venezuelan cycling and her memory will live on in every pedal strike we take in her honour.” “Her unexpected departure leaves an irreparable void in the hearts of all of us who had the honour of knowing her and following her career.” Image credits: Martin Alipaz/EPA/Shutterstock Editorial

Caring

My Kitchen Rules star dies at just 46

My Kitchen Rules New Zealand contestant Michael Murray has passed away at just 46. An extended family member, who asked not to be named, has confirmed his death on Monday afternoon. “It’s a shock to all those who know him,” the relative told Daily Mail Australia. No cause of death has yet been released. Murray, of Ngāti Maniapoto heritage, competed in the 2024 season of the popular cooking show with his cousin Piki Knap. According to their biography for the series, the pair grew up together in Te Kūiti, south of Auckland, and developed their love of cooking from entertaining family guests. Murray was a huge Jamie Oliver fan, and was comfortable in front of the camera, after spending 12 years in Mexico where he worked on telenovela soap operas and did small stints on other shows. He returned to New Zealand after the pandemic. “My background is modelling and acting,” he told The New Zealand Herald. “I was Mr New Zealand back in 2005, and that’s what took me overseas and eventually to Mexico. Obviously, I’m not Mexican, but they thought I was Latino! "I did some great work there, then to come home and be a part of this whole journey with MKR is a blessing in disguise. I’ve always put my hand up to opportunity.” Murray's family are now dealing with the devastation of losing another loved one after Murray's aunt passed away from terminal cancer a few months after the duo started filming for MKR. Images: My Kitchen Rules NZ

Caring

Woman “bullied” on plane over budget seating trick

A young woman has recalled a flight from hell when she was “bullied” by a couple who were trying to utilise a seating hack that went viral on TikTok. The solo traveller took to Reddit to recount the story and ask social media users if she was in the wrong for her action. The woman began by saying she usually pays more to select her plane seat ahead of time, but a medical emergency on another plane had her waiting on standby and left with no option other than to sit in a middle seat. When she was finally able to board, she was greeted by a couple who had purchased both the window and aisle seats in a bid to have more space, utilising a travel “trick” that has been popular on TikTok. The method, which has been dubbed the 'poor man's business class', usually leaves travellers with an empty middle seat and more space, and few travellers opt to pick a middle seat. “When I got to my row the man and woman were chatting and sharing a snack... it was obvious they were together. I mentioned to the man that I'm in the middle, and he got up to let me in,” the unsuspecting traveller wrote on Reddit. “I asked them if they would prefer to sit together, I said I was totally okay with that. The woman reacted rudely to this and said ‘you're not supposed to be sitting here anyway’.” After noticing how the plane was full, she offered to show the pair her new ticket with the correct seat number on it. “She flicked her hand at my ticket and made a disgusted sound. I offered again if they wanted to sit together to which she didn't reply, her partner said it's okay and... made some small talk,” she continued. The man’s girlfriend then interrupted their conversation to ask,”'Did you use one of those third party websites to book your flight? It's so frustrating when people cheap out to inconvenience others.” The American woman explained that she had booked her flight directly and she had been placed on standby like everyone else and didn't choose the middle seat - she was assigned it. She then tried to keep the peace by refusing to engage with the furious woman. “I was so done with her attitude, I put my headphones on and attempted to do my own thing,” she explained. But the “entitled” girlfriend wasn't letting it go, as the woman explained, “This woman kept reaching over me and tapping her partner and trying to talk to him in a way that was super intrusive.” “I could tell even her partner was trying to engage her less so that she would hopefully stop, but she didn't.” “I think they tried to pull that tactic where they don't sit together on purpose...hoping no one will sit between them. But on full flights it doesn't work. And even so - it's not the other person's fault.” The traveller's post was met with hundreds of comments slamming the girlfriend’s behaviour, as one person wrote, “It's like a toddler having a tantrum.” “She was disappointed and a total a**hole. Gross entitled people,” another added. Another person applauded the traveller’s level-headed behaviour, writing, “Wow! You are my hero for keeping it classy - I’m afraid I would not have been as kind as you.” Image credits: Shutterstock

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Constipation increases your risk of a heart attack, new study finds – and not just on the toilet

Men have a biological clock too. Here’s what’s more likely when dads are over 50

Five-time Olympian found dead at just 50

My Kitchen Rules star dies at just 46

Woman “bullied” on plane over budget seating trick