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Why do I get so anxious after drinking? Here’s the science behind ‘hangxiety’

<a href="https://theconversation.com/profiles/blair-aitken-1510537">Blair Aitken</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rebecca-rothman-2231560">Rebecca Rothman</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> You had a great night out, but the next morning, anxiety hits: your heart races, and you replay every conversation from the night before in your head. This feeling, known as hangover anxiety or “<a href="https://adf.org.au/insights/what-is-hangxiety/">hangxiety</a>”, <a href="https://onlinelibrary.wiley.com/doi/10.1002/hup.2623">affects around 22%</a> of social drinkers. While for some people, it’s mild nerves, for others, it’s a wave of anxiety that feels impossible to ride out. The “Sunday scaries” may make you feel panicked, filled with dread and unable to relax. Hangover anxiety can make even simple tasks feel overwhelming. Here’s why it happens, and what you can do about it. <h2>What does alcohol do to our brains?</h2> A hangover is the body’s way of recovering after drinking alcohol, bringing with it a range of symptoms. <a href="https://www.mdpi.com/2077-0383/10/23/5691">Dehydration and disrupted sleep</a> play a large part in the pounding headaches and nausea many of us know too well after a big night out. But hangovers aren’t just physical – there’s a strong mental side too. Alcohol is a nervous system depressant, meaning it alters how certain chemical messengers (or neurotransmitters) behave in the brain. Alcohol relaxes you by increasing <a href="https://my.clevelandclinic.org/health/articles/22857-gamma-aminobutyric-acid-gaba">gamma-aminobutyric acid</a> (GABA), the neurotransmitter that makes you feel calm and lowers inhibitions. It decreases <a href="https://my.clevelandclinic.org/health/articles/22839-glutamate">glutamate</a> and this also slows down your thoughts and helps ease you into a more relaxed state. Together, this interaction affects your mood, emotions and alertness. This is why when we drink, we often feel more sociable, carefree and willing to let our guard down. As the effects of the alcohol wear off, your brain works to rebalance these chemicals by <a href="https://www.sciencedirect.com/science/article/pii/S0191886918305762">reducing GABA and increasing glutamate</a>. This shift has the opposite effect of the night before, causing your brain to become more excitable and overstimulated, which can lead to feelings of anxiety. So why do some people get hangxiety, while others don’t? There isn’t one clear answer to this question, as several factors can play a role in whether someone experiences hangover-related anxiety. <h2>Genes play a role</h2> For some, a hangover is simply a matter of how much they drank or how hydrated they are. But genetics may also play a significant role. <a href="https://onlinelibrary.wiley.com/doi/10.1111/add.12699">Research</a> shows your genes can explain almost half the reason why you wake up feeling hungover, while your friend might not. Because genes influence how your body processes alcohol, some people may experience more intense hangover symptoms, such as headaches or dehydration. These stronger physical effects can, in turn, <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/hup.2623">trigger anxiety during a hangover</a>, making you more susceptible to “hangxiety.” <h2>Do you remember what you said last night?</h2> But one of the most common culprits for feeling anxious the next day is often <a href="https://journals.sagepub.com/doi/pdf/10.1177/0091450915604988">what you do while drinking</a>. Let’s say you’ve had a big night out and you can’t quite recall a conversation you had or something you did. Maybe you acted in ways that you now regret or feel embarrassed about. You might fixate on these thoughts and get trapped in a cycle of worrying and rumination. This cycle can be hard to break and can make you feel more anxious. <a href="https://doi.org/10.1016/j.addbeh.2023.107619">Research</a> suggests people who already struggle with feelings of anxiety in their day-to-day lives are especially vulnerable to hangxiety. Some people drink alcohol to unwind after a stressful day or to make themselves feel more comfortable at social events. This often leads to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9756407">heavier consumption</a>, which can make hangover symptoms more severe. It can also begin a cycle of drinking to feel better, making hangxiety even harder to escape. <h2>Preventing hangover anxiety</h2> The best way to prevent hangxiety is to limit your alcohol consumption. The <a href="https://adf.org.au/reducing-risk/alcohol/alcohol-guidelines">Australian guidelines</a> recommend having no more than ten standard drinks per week and no more than four standard drinks on any one day. Generally, the more you drink, the more intense your hangover symptoms might be, and the worse you are likely to feel. Mixing other drugs with alcohol can also increase the risk of hangxiety. This is especially true for party drugs, such as ecstasy or MDMA, that give you a temporary high but can lead to anxiety as they wear off and you are <a href="https://adf.org.au/insights/drug-comedowns">coming down</a>. If you do wake up feeling anxious: <ul> <li> focus on the physical recovery to help ease the mental strain </li> <li> drink plenty of water, eat a light meal and allow yourself time to rest </li> <li> try <a href="https://www.headspace.com/mindfulness/mindfulness-101">mindfulness meditation</a> or deep breathing exercises, especially if anxiety keeps you awake or your mind races </li> <li> consider journalling. This can help re-frame anxious thoughts, put your feelings into perspective and encourage self-compassion </li> <li> talk to a close friend. This can provide a safe space to express concerns and feel less isolated. </li> </ul> Hangxiety is an unwelcome guest after a night out. Understanding why hangxiety happens – and how you can manage it – can make the morning after a little less daunting, and help keep those anxious thoughts at bay.<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/240991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/blair-aitken-1510537">Blair Aitken</a>, Postdoctoral Research Fellow in Psychopharmacology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rebecca-rothman-2231560">Rebecca Rothman</a>, PhD Candidate in Clinical Psychology, School of Health Sciences, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</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/why-do-i-get-so-anxious-after-drinking-heres-the-science-behind-hangxiety-240991">original article</a>.

Mind

I spoke to 100 Japanese seniors, and learnt the secret to a good retirement is a good working life

<a href="https://theconversation.com/profiles/shiori-shakuto-1537774">Shiori Shakuto</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> What makes a good retirement? I’ve <a href="https://www.pennpress.org/9781512827088/after-work/">been researching</a> the lives of “silver backpackers”: Japanese seniors who embark on a later-life journey of self-discovery. Many experienced Japan’s high-growth economy, characterised by rigid gender roles. For many men who worked as iconic cultural figures of <a href="https://en.wikipedia.org/wiki/Salaryman">sarariiman</a> (white collar workers), excessive working hours were normalised and expected. Their absence from home was compensated by their female partners, many full-time stay-at-home mothers. Entering their 60s meant either retirement from work, or children leaving home. For men and women, retirement is understood as an opportunity to live a life for themselves, leading to a journey of self-discovery. <h2>Dedicating life to work</h2> I interviewed more than 100 older Japanese women and men and found a significant disparity in the quality of life between them. Japanese retired men who led a work-oriented life struggled to find meaning at the initial stages of retirement. One man I spoke to retired at the age of 60 from a large trading company. He was a successful businessman, having travelled the world and held various managerial positions in the company. His wife looked after the children most of the time. They bought a house with a yard in a suburb so the children could attend a good school. It significantly increased his commute, and further reduced his time with children. He also worked on weekends. He barely had time to develop his hobbies or get to know his neighbours. He idealised his retirement as a time to finally spend with his family and develop his own hobbies. When he retired, however, he realised that he and his family didn’t have any common topics of conversation. Through decades of excessive hours spent at work away from home, the rest of the family established a routine that did not include him. Taking up new hobbies at the age of 60 was not as easy as he thought, nor was making new friends at this age. “I became a nureochiba,” he lamented. Nureochiba refers to the wet fallen leaves that linger and are difficult to get rid of. The term is commonly used to describe retired men with no friends or hobbies who constantly accompany their wives. The retirement for many former sarariiman was characterised by boredom – having nowhere to go to or having nothing to do. The sense of boredom led to a sense of isolation and low confidence in old age. Many older Japanese men I spoke to lament not having built a connection with their children or communities at a younger age. <h2>Dedicating life to family and community</h2> Older Japanese women I spoke with were more well-connected with their children and local communities in later life. Many were in regular contact with their children through visits, phone calls and messages. Some continued to care for them by providing food or by looking after grandchildren. Children very much appreciated them. Many older women who had been full-time stay-at-home mothers had already taken up hobbies or volunteering activities at community organisations, and they could accelerate these involvements in their old age. Even women who worked full-time seemed to maintain better connections with their family members because working excessively away from home was simply not possible for them. Older men relied on these women’s networks and activities conducted at the scales of home and communities – from caring for others to pursuing hobbies – to enact a meaningful retirement. The sense of connection with family and communities, not to mention their husbands’ reliance on them, led to a high confidence and wellbeing among older women. I saw many instances where older women preferred spending time with their female friends than their retired husbands and embarked on adventurous trips alone. One woman went on a three-month cruise alone. Feeling liberated, she sent a fax message to her husband from the ship: “When I get off this ship, I will devote the rest of my life to myself. You will have to take care of your own mother.” Upon disembarking, she moved to Malaysia to start her second life. <h2>The silver backpackers</h2> Malaysia has become a popular destination for silver backpackers looking to embark on a journey of self-discovery. Some travel as couples, while others go alone, regardless of their marital status. For many male silver backpackers I spoke to, moving to Malaysia offers a second chance at life to make new friends, find hobbies and, most importantly, start anew with their partners. For many female silver backpackers, visiting Malaysia means being able to enjoy an independent lifestyle while having the security of friends and family in Malaysia and Japan. The experiences of older Japanese men and women can be translated into the experiences of anyone who spent excessive hours at work and those who spent more time cultivating relationships outside of work. The activities of the latter group are not as valued in a society that narrowly defines productivity. However, my research shows that it is their activities that carry more value in old age. Are you under pressure to work long hours? If you can, turn off your phone and computer. Instead of organising events for work, organise a dinner with your family and friends. Take up a new hobby in your local community centres. You can change how you work and live now for a better old age.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238571/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/shiori-shakuto-1537774">Shiori Shakuto</a>, Lecturer in Anthropology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</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/i-spoke-to-100-japanese-seniors-and-learnt-the-secret-to-a-good-retirement-is-a-good-working-life-238571">original article</a>.

Retirement Life

"I’m coming home from a party, and I don’t want to end up getting arrested": do driving apps help people break road rules?

<a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft University of Technology</a> Apps such as Google Maps, Apple Maps and Waze can tell drivers when they are approaching speed cameras or random breath testing stations. Countries such as Germany, France and Switzerland have banned apps from displaying these enforcement locations. But what effect are these apps having in Australia – are they helping drivers break road rules? Our new <a href="https://www.sciencedirect.com/science/article/pii/S0925753524002972">paper</a>, published in the journal Safety Science, examined this question. We found this technology can, in some cases, contribute to people thinking they are invincible on the roads. However, we also found they can sometimes help people drive more safely. <h2>Being made aware of enforcement can help road safety</h2> We conducted focus groups and interviews with a total of 58 drivers from Queensland, to understand how the use of this technology influences perceptions of being caught for breaking road rules. One driver told us: "If I know it’s coming up, I’ll put my phone down. If I was, say, texting or checking something, but then like once a good few 100 metres away, I sort of pick it up again, depending though." Another said: "It sort of depends where I am driving, I guess. Like, if I am driving on a country road and there is a speed camera there I would probably slow down for the speed camera and then sort of speed up again once I am sort of past that; it sort of depends on the circumstances." We also found that, for some people, being made aware of enforcement locations can help drivers better regulate their speed. This helped them comply with road rules more consistently. Waze also shows the speed limit in the area, which further assisted some drivers to stick to the speed limit. One driver told us: "I’m a bit careful if I just look at the speedo and just double check that I’m on the right amount of speed." Another said: "It just gives you a warning like, ‘OK, you need to check your speed.’ Just to double-check you’re going on the right speed perhaps or when it’s a camera coming up." <h2>Concerning behaviours</h2> Concerningly, we also found some drivers who use these apps are looking at and touching their screens more than they otherwise would. This can distract drivers and increase their <a href="https://www.sciencedirect.com/science/article/pii/S0925753524001097">risk of crashing</a>. One driver told us they post traffic updates on the app they use while driving, “which I know is wrong.” Another said: "Just hit the button on the phone. Just two steps after I go past the camera." Another driver told us: "It’s so helpful […] Especially if it’s, say, late night and I’m coming home from a party, and I don’t want to end up getting arrested." One driver said: "I probably feel slightly more invincible, which is probably not a good thing." When asked why these apps are used, one driver said: "I guess the drug and the drink-driving." <h2>Apps can help and hinder road safety</h2> We know breaking road rules significantly contributes to <a href="https://www.who.int/teams/social-determinants-of-health/safety-and-mobility/global-status-report-on-road-safety-2023">crashes and road fatalities</a>, with deaths on Australian roads continuing to <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">increase</a> over time. On the one hand, when drivers are aware of enforcement measures like cameras and police, they are more likely to stop breaking the rules in those areas. That’s particularly true for behaviours such as speeding and using a phone while driving, we found. Using apps that flag where cameras and police are located also means drivers would be more exposed to enforcement activities than they otherwise would be on a normal drive. On the other hand, our results suggest some drivers are using these applications to break road rules more often in places where they think they won’t be caught. These apps are also not always completely accurate. For instance, even though Waze can display some police operation locations such as roadside breath testing, it can’t capture all on-road police activities. Further, camera locations are not always up to date or accurate. <h2>Weighing benefits against risks</h2> While these apps do have some benefits, it’s important to weigh these against the risks. It’s also important to recognise traffic enforcement isn’t just there to make you comply with road rules at a specific point; it is meant to remind you of the constant risk of being caught and to encourage consistent rule compliance. The goal is to ensure that drivers are following the traffic rules across the entire network, not just in isolated spots. With road fatalities at some of the <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">highest rates we’ve seen in recent years</a>, we need everyone to work together to stop more preventable deaths and injuries.<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/237664/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, Senior Research Fellow in Road Safety Research, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, A/Professor Responsible Risk Management, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft University of Technology</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-coming-home-from-a-party-and-i-dont-want-to-end-up-getting-arrested-do-driving-apps-help-people-break-road-rules-237664">original article</a>.

Legal

What are house dust mites and how do I know if I’m allergic to them?

<a href="https://theconversation.com/profiles/deryn-lee-thompson-1449312">Deryn Lee Thompson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> People often believe they are allergic to <a href="https://ahd.csiro.au/everything-in-our-homes-gathers-dust-but-what-exactly-is-it-where-does-it-come-from-and-why-does-it-keep-coming-back-is-it-from-outside-is-it-fibres-from-our-clothes-and-cells-from-our-skin/">house dust</a>. But of the <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">20% of Australians</a> suffereing with allergies, a number are are actually allergic to microscopic <a href="https://www.healthdirect.gov.au/dust-mites">house dust mites</a>. House dust mites belong to the same family as spiders and ticks. They measure just 0.2-0.3 mm, with 50 fitting on a single pinhead. They <a href="https://www.intechopen.com/chapters/71977">live</a> for 65–100 days, and females lay 60–100 eggs in their life. House dust mites love temperate climates and humidity. They feed off the skin cells we and animals shed, as well as mould, which they digest using special enzymes. These enzymes are excreted in their poo about <a href="https://www.intechopen.com/chapters/71977">20 times a day</a>. They also shed fragments of their exoskeletons. All these fragments trigger allergies in people with this type of allergic rhinitis (which is also known as hay fever) <h2>What are the symptoms?</h2> When people with house dust mite allergy inhale the allergens, they penetrate the mucous membranes of the airways and eyes. Their body recognises the allergens as a threat, releasing chemicals including one called histamine. This causes symptoms including a runny nose, an itchy nose, eyes and throat, sneezing, coughing and a feeling of mucus at the back of your throat (known as a post-nasal drip). People with this type of allergy usually mouth breath, snore, rub their nose constantly (creating a nasal crease called the “dust mite salute”) and have dark shadows under their eyes. House dust mite allergy <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328274/">can also cause</a> poor sleep, constant tiredness, reduced concentration at work or school and lower quality of life. For people with eczema, their damaged skin barrier can allow house dust mite proteins in. This prompts immune cells in the skin to <a href="https://academic.oup.com/bjd/article/190/1/e5/7485663">release chemicals</a> which make already flared skin become redder, sorer and itchier, especially in children. Symptoms of house dust mite allergy occur year round, and are often worse after going to bed and when waking in the morning. But people with house dust mite allergy and pollen allergies find their year-round symptoms worsen in spring. <h2>How is it diagnosed?</h2> House dust mite allergy symptoms often build up over months, or even years before people seek help. But an accurate diagnosis means you can not only access the right treatment – it’s also vital for minimising exposure. Doctor and nurse practitioners can order a <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">blood test</a> to check for house dust mite allergy. Alternatively, health care providers with <a href="https://www.allergy.org.au/hp/a-career-in-clinical-immunology-and-allergy">specialised allergy training</a> can perform skin prick tests. This involves placing drops of the allergens on the arm, along with a positive and negative “control”. After 15 minutes, those who test positive will have developed a mosquito bite-like mark. <h2>How is it treated?</h2> Medication options include one or a combination of: <ul> <li>daily non-sedating antihistamines</li> <li>a steroid nasal spray</li> <li>allergy eye drops.</li> </ul> Your health care professional will work with you to develop a <a href="https://www.allergy.org.au/images/stories/pospapers/ar/ASCIA_HP_Allergic_Rhinitis_2022.pdf">rhinitis (hay fever) medical management plan</a> to reduce your symptoms. If you’re using a nasal spray, your health provider will <a href="https://www.youtube.com/watch?v=_ytYj1TLojM">show you how to use it</a>, as people often use it incorrectly. If you also have <a href="https://www.nationalasthma.org.au/understanding-asthma/how-is-asthma-managed">asthma</a> or eczema which is worsened by dust mites, your health provider will adapt your <a href="https://www.nationalasthma.org.au/health-professionals/asthma-action-plans">asthma action plan</a> or <a href="https://medcast.com.au/qhub/eczema/resources">eczema care plan</a> accordingly. If you experience severe symptoms, a longer-term option is <a href="https://www.allergy.org.au/images/pc/ASCIA_PC_Allergen_Immunotherapy_FAQ_2024.pdf">immunotherapy</a>. This aims to gradually turn off your immune system’s ability to recognise house dust mites as a harmful allergen. Immunotherapy involves taking either a daily sublingual tablet, under the tongue, or a series of injections. Injections require monthly attendances over three years, after the initial weekly build-up phase. These are <a href="https://theconversation.com/im-considering-allergen-immunotherapy-for-my-hay-fever-what-do-i-need-to-know-190408">effective</a>, but are costly (as well as time-consuming). So it’s important to weigh up the potential benefits and downsides with your health-care provider. <h2>How can you minimise house dust mites?</h2> There are also important allergy minimisation measures you can take to reduce allergens in your home. Each week, <a href="https://www.allergy.org.au/component/finder/search?q=minimisation&Itemid=100001">wash</a> your bedding and pyjamas in hot water (over 60°C). This <a href="https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/dust-mites-trigger-my-asthma">removes</a> house dust mite eggs and debris. Opt for doonas, covers or quilts that can be washed in hot water above 60°C. Alternatively, low-cost waterproof or leak proof covers can keep house dust mites out. If you can, favour blinds and wood floors over curtains and carpet. Dust blinds and surfaces with a damp cloth each week and vacuum while wearing a mask, or have someone else do it, as house dust mites can become airborne during cleaning. But beware of costly products with big marketing budgets and little evidence to support their use. A new mattress, for example, will always be house dust mite-free. But once slept on, the house dust mite life cycle can start. Mattress protectors and toppers commonly claim to be “hypoallergenic”, “anti-allergy” or “allergy free”. But their pore sizes are not small enough to keep house dust mites and their poo out, or shed skin going through. Sprays claiming to kill mites require so much spray to penetrate the product that it’s likely to become wet, may smell like the spray and, unless dried properly, may grow mould. Finally, claims that expensive vacuum cleaners can extract all the house dust mites are unsubstantiated. For more information, visit <a href="https://www.healthdirect.gov.au/dust-mites">healthdirect.gov.au</a> or the <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">Australian Society of Clinical Immunology and Allergy</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/240918/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/deryn-lee-thompson-1449312">Deryn Lee Thompson</a>, Eczema and Allergy Nurse; Lecturer, <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/what-are-house-dust-mites-and-how-do-i-know-if-im-allergic-to-them-240918">original article</a>.

Body

What washing machine settings can I use to make my clothes last longer?

<a href="https://theconversation.com/profiles/alessandra-sutti-1513345">Alessandra Sutti</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/amol-patil-1513347">Amol Patil</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/maryam-naebe-1513346">Maryam Naebe</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Orbiting 400 kilometres above Earth’s surface, the astronauts on the International Space Station live a pretty normal social life, if not for one thing: they happily wear their unwashed clothes <a href="https://www.nasa.gov/centers-and-facilities/glenn/nasa-glenn-interns-take-space-washing-machine-designs-for-a-spin/">for days and weeks at a time</a>. They can’t do their laundry <a href="https://www.esa.int/Enabling_Support/Space_Engineering_Technology/Keeping_your_underwear_clean_on_the_Moon">just yet</a> because water is scarce up there. But down here on Earth, washing clothes is a large part of our lives. <a href="https://bigee.net/media/filer_public/2013/03/28/bigee_domestic_washing_machines_worldwide_potential_20130328.pdf">It’s estimated</a> that a volume of water equivalent to 21,000 Olympic swimming pools is used every day for domestic laundry worldwide. Fibres from our clothes make their way into the environment via the air (during use or in the dryer), water (washing) and soil (lint rubbish in landfill). Most of this fibre loss is invisible – we often only notice our favourite clothing is “disappearing” when it’s too late. How can you ensure your favourite outfit will outlast your wish to wear it? Simple question, complex answer. <h2>Washing machines are not gentle</h2> When you clean the filters in your washing machine and dryer, how often do you stop to think that the lint you’re holding <a href="https://theconversation.com/uk-laundry-releases-microfibres-weighing-the-equivalent-of-1-500-buses-each-year-199712">was, in fact, your clothes</a>? Laundering is harsh on our clothes, and <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250346">research confirms this</a>. Several factors play a role: the type of washing machine, the washing cycle, detergents, temperature, time, and the type of fabric and yarn construction. There are two types of domestic washing machines: top-loader and front-loader. Mechanical agitation (the way the machine moves the clothes around) is one of the things that helps ease dirt off the fabric. Top-loaders have a vertical, bucket-like basket with a paddle, which sloshes clothes around in a large volume of water. Front-loaders have a horizontal bucket which rotates, exposing the clothes to a smaller volume of water – it takes advantage of gravity, not paddles. Top-loading machines <a href="https://link.springer.com/article/10.1007/s12541-010-0047-7">tend to be more aggressive</a> towards fabrics than front-loaders due to the different mechanical action and larger volumes of water. Washing machine panels also present many choices. Shorter, low-temperature programs <a href="https://clevercare.info/more-eco-temperature-tips">are usually sufficient for everyday stains</a>. Choose longer or <a href="https://iprefer30.eu/animations/UK/wash-brochure-uk.pdf">high-temperature programs</a> only for clothing you have concerns about (healthcare uniforms, washable nappies, etc.). Generally, washing machine programs are carefully selected combinations of water volume, agitation intensity and temperature recommended by the manufacturer. They take into consideration the type of fabric and its level of cleanliness. Select the wrong program and you can say goodbye to your favourite top. For example, high temperatures or harsh agitation may cause some fibres to weaken and break, causing holes in the garment. <h2>Some fabrics lose fibres more easily than others</h2> At a microscopic level, the fabric in our clothes is made of yarns – individual fibres twisted together. The nature and length of the fibres, the way they are twisted and the way the yarns form the fabric can determine how many fibres will be lost during a wash. In general, if you want to lose fewer fibres, you should wash less frequently, but some fabrics are affected more than others. Open fabric structures (knits) with loose yarns <a href="https://www.nature.com/articles/s41598-021-98836-6">can lose more fibres</a> than tighter ones. Some sports clothing, like running shirts, are made of continuous filament yarn. These fibres are less likely to come loose in the wash. Cotton fibres are only a few centimetres long. Twisted tightly together into a yarn, they can still escape. Wool fibres are also short, but have an additional feature: scales, which make wool clothes much more delicate. Wool fibres can come loose like cotton ones, but also tangle with each other during the wash due to their scales. This last aspect is what causes wool garments to shrink when <a href="https://journals.sagepub.com/doi/abs/10.1177/004051756403400303">exposed to heat</a> and agitation. <h2>Go easy on the chemicals</h2> The type of detergent and other products you use also makes a difference. Detergents contain a soap component, enzymes to make stains easier to remove at low temperature, and fragrances. Some contain harsher compounds, such as bleaching or whitening agents. Modern detergents are very effective at <a href="https://www.choice.com.au/home-and-living/laundry-and-cleaning/laundry-detergents/review-and-compare/laundry-detergents">removing stains such as food</a>, and you don’t need to use much. An incorrect choice of wash cycles, laundry detergent and bleaching additives could cause disaster. Certain products, like bleach, can <a href="https://site.extension.uga.edu/textiles/textile-basics/understand-your-fibers/">damage some fibres like wool and silk</a>. Meanwhile, research on <a href="https://www.sciencedirect.com/science/article/pii/S0269749120366872?via%3Dihub">fabric softeners and other treatments</a> <a href="https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0233332&type=printable">continues</a> – there’s no one-size-fits-all answer about their potential impact on our clothes. <h2>Just skip laundry day</h2> So, how to ensure your clothes last longer? The main tip is to wash them less often. When it’s time for a wash, carefully read and follow the care labels. In the future, our washing machines will <a href="https://www.teknoscienze.com/tks_article/trends-in-laundry-by-2030/">recognise fabrics and select the wash cycle</a>. For now, that’s our responsibility. And the next time you throw your shirt into the dirty laundry basket, stop. Think of the astronauts orbiting above Earth and ask yourself: if they can go without clean laundry for a few days, maybe I can too? (Although we don’t recommend just burning your dirty undies, either.)<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/224064/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <figure><iframe src="https://www.youtube.com/embed/C1j6KLP492E?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <a href="https://theconversation.com/profiles/alessandra-sutti-1513345">Alessandra Sutti</a>, Associate Professor, Institute for Frontier Materials, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/amol-patil-1513347">Amol Patil</a>, Research Engineer, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/maryam-naebe-1513346">Maryam Naebe</a>, Associate professor, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-washing-machine-settings-can-i-use-to-make-my-clothes-last-longer-224064">original article</a>.

Home & Garden

I have hay fever. How can I tell what I’m allergic to?

<a href="https://theconversation.com/profiles/ryan-mead-hunter-1480189">Ryan Mead-Hunter</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> When we think of spring we think of warming weather, birdsong and flowers. But for many people, this also means the return of their seasonal hay fever symptoms. Around <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/latest-release">24% of Australians</a> get hay fever, with sneezing, a runny or blocked nose, and itchy or watery eyes the most common symptoms. In <a href="https://www.healthdirect.gov.au/hay-fever#:%7E:text=Key%20facts,dust%20mites%2C%20and%20animal%20fur">severe cases</a>, this may impact sleep and concentration, or be linked to increased frequency of sinus infections. The exact timing of the symptoms depends on your exposure to an allergen – the thing you’re allergic to. Those impacted by tree pollen (from plane trees or cypress pine, for example) may experience symptoms at different times of the year than those impacted by grass pollen (such as rye grass). This will also vary around the country. In Perth, for example, tree pollen (cypress pine) is generally present in August to October, while grass pollen counts tend to be highest in October to November. Other cities and regions may have longer pollen seasons, which may extend further into summer. <h2>Remind me, how does hay fever impact the body?</h2> What we know colloquially as hay fever is called allergic rhinitis. Exposure to a specific allergen (or allergens) triggers an immune response in the body. This leads to inflammation and swelling of the tissue lining the nasal passages in the nose. A range of <a href="https://www.healthdirect.gov.au/hay-fever#:%7E:text=Key%20facts,dust%20mites%2C%20and%20animal%20fur.">allergens</a> may trigger such a response: pollen (from trees, grass or weeds), dust mites, pet fur, dander, mould and some air pollutants. Those with allergies that are only present for part of the year, such as pollen, experience what we call seasonal hay fever, while those with allergies that may be present at any time, such as dust mites and pet dander, experience perennial hay fever. <h2>Getting a diagnosis</h2> Many people with hay fever self-manage their symptoms by limiting exposure to allergens and using over-the-counter <a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">antihistamines and steroid nasal sprays</a>. But this may require assistance from your GP and confirmation that what you’re experiencing is hay fever. Your GP can assess your symptoms and medical history, provide a diagnosis, and help with treating and managing your symptoms. Your GP may also be able help you identify potential allergens, based on when you experience symptoms and the environments to which you’re exposed. If symptoms persist, your GP may suggest allergy testing. They may refer you to a specialist called an immunologist, to determine what particular allergen is causing your symptoms, using <a href="https://www.allergy.org.au/patients/allergy-testing/allergy-testing">skin prick tests or blood tests</a>. Tests typically involve controlled exposure to small quantities of suspected allergens. But note, there are a number of tests marketed online that are unproven and not recommended by reputable bodies. <h2>How else can I work out what I’m allergic to?</h2> For those with seasonal hay fever, resources are available to help manage exposures, based on the flowering seasons for common allergy-related species or through pollen forecasting services. The Australian Society of Clinical Immunology and Allergy provides a <a href="https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/guide-to-common-allergenic-pollen">useful pollen guide</a> for each species and when they’re most likely to cause symptoms, broken down for each state and territory. Pollen monitoring and forecasting services – such as <a href="https://www.perthpollen.com.au/">Perth Pollen</a>, <a href="https://www.melbournepollen.com.au/">Melbourne Pollen</a> and <a href="https://www.sydneypollen.com.au/">Sydney Pollen</a>, as well as for other cities – can help you plan outdoor activities. There are also associated phone apps for these services, which can give notifications when the pollen count is high. You can down load these apps (such as <a href="https://airrater.org/">AirRater</a>, Perth Pollen, Melbourne Pollen and Sydney Pollen) from your preferred app store. Apps such as <a href="https://airrater.org/">AirRater</a> also allow you to enter information about your symptoms, which can then be matched to the environmental conditions at the time (pollen count, temperature, smoke, and so on). Using statistical modelling, the app may be able to establish a link between symptoms and exposure. If a sufficiently high correlation is established, the app can send you notifications when the <a href="https://airrater.org/how-does-it-work/">exposure risk</a> is high. This may prompt you to limit outdoor activities and have any medication readily available. <hr /> Further information about managing allergic rhinitis is available from <a href="https://www.healthdirect.gov.au/hay-fever">healthdirect</a> and <a href="https://allergyfacts.org.au/__interest/allergic-rhinitis/">Allergy and Anaphylaxis Australia</a> <a href="https://theconversation.com/profiles/ryan-mead-hunter-1480189">Ryan Mead-Hunter</a>, Senior lecturer, School of Population Health, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-hay-fever-how-can-i-tell-what-im-allergic-to-240450">original article</a>.

Body

Why do I have hay fever? I didn’t have it as a child

<a href="https://theconversation.com/profiles/janet-davies-103598">Janet Davies</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/joy-lee-1480523">Joy Lee</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Hay fever (or allergic rhinitis) is a long-term inflammatory condition that’s incredibly common. It affects about <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-state-and-territory-findings/latest-release">one-quarter</a> of Australians. Symptoms vary but <a href="https://www.allergy.org.au/patients/fast-facts/hay-fever-allergic-rhinitis">can include</a> sneezing, itchy eyes and a runny or blocked nose. Hay fever can also contribute to sinus and ear infections, snoring, poor sleep and asthma, as well as lower performance at school or work. But many people didn’t have hay fever as a child, and only develop symptoms as a teenager or adult. Here’s how a combination of genetics, hormones and the environment can lead to people developing hay fever later in life. <h2>Remind me, what is hay fever?</h2> Hay fever is caused by the nose, eyes and throat coming into contact with a substance to which a person is allergic, known as an allergen. Common sources of outside allergens include airborne grass, weed or tree pollen, and mould spores. Pollen allergens can be carried indoors on clothes, and through open windows and doors. Depending on where you live, you may be exposed to a range of pollen types across the pollen season, but grass pollen is the most common trigger of hay fever. In <a href="https://www.sciencedirect.com/science/article/abs/pii/S0013935122010891?via%3Dihub">some regions</a> the grass pollen season can extend from spring well into summer and autumn. <h2>How does hay fever start?</h2> Hay fever symptoms most commonly start in adolescence or young adulthood. <a href="http://dx.doi.org/10.2147/JAA.S170285">One study</a> found 7% of children aged six had hay fever, but that grew to 44% of adults aged 24. Before anyone has hay fever symptoms, their immune system has already been “sensitised” to specific allergens, often allergens of grass pollen. Exposure to these allergens means their immune system has made a particular type of antibody (known as IgE) against them. During repeated or prolonged exposure to an allergen source such as pollen, a person’s immune system may start to respond to another part of the same allergen, or another allergen within the pollen. Over time, these new allergic sensitisations can lead to development of <a href="https://www.jacionline.org/article/S0091-6749(12)00959-1/fulltext">hay fever</a> and possibly other conditions, such as allergic asthma. <h2>Why do some people only develop hay fever as an adult?</h2> 1. Environmental factors Some people develop hay fever as an adult simply because they’ve had more time to become sensitised to specific allergens. Migration or moving to a new location can also change someone’s risk of developing hay fever. This may be due to exposure to different <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969722076884">pollens</a>, <a href="https://www.sciencedirect.com/science/article/pii/S0048969724060194?via%3Dihub">climate and weather</a>, green space <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.14177">and/or</a> air quality factors. A number of studies <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0105347">show</a> people who have migrated from low- and middle-income countries to higher-income countries may be at a higher risk of developing hay fever. This may due to local environmental conditions influencing expression of genes that regulate the immune system. 2. Hormonal factors <a href="http://dx.doi.org/10.1016/j.anai.2015.04.019">Hormonal changes</a> at puberty may also help drive the onset of hay fever. This may relate to sex hormones, such as oestrogen and progesterone, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392967/#R55">affecting</a> histamine levels, immune regulation, and the response of cells in the lining of the nose and lower airways. 3. Genetic factors <a href="https://www.nature.com/articles/ng.3985">Our genes</a> underpin <a href="https://www.ncbi.nlm.nih.gov/books/NBK542187/">our risk</a> of hay fever, and whether this and other related allergic disease persists. For instance, babies with the skin condition eczema (known as atopic dermatitis) have a <a href="https://www.annallergy.org/article/S1081-1206(21)00172-1/abstract">three times greater risk</a> of developing hay fever (and asthma) later in life. Having a food allergy in childhood is also a risk factor for developing hay fever later in life. In the case of a peanut allergy, that risk is more than <a href="https://pubmed.ncbi.nlm.nih.gov/27542726/">2.5 times greater</a>. <h2>What are the best options for treatment?</h2> Depending on where you live, avoiding allergen exposures can be difficult. But <a href="https://auspollen.edu.au/auspollensitesmap/">pollen count forecasts</a>, if available, can be useful. These can help you decide whether it’s best to stay inside to reduce your pollen exposure, or to take preventative medications. You may also find <a href="https://www.health.vic.gov.au/environmental-health/epidemic-thunderstorm-asthma-risk-forecast">alerts on thunderstorm asthma</a>, where pollens combine with specific weather conditions to trigger <a href="https://theconversation.com/we-could-see-thunderstorm-asthma-in-south-eastern-australia-this-season-heres-how-to-prepare-215793">breathing difficulties</a>. If you have mild, occasional hay fever symptoms, you can take non-drowsy antihistamines, which you can buy at the pharmacy. However, for more severe or persistent symptoms, intranasal steroid sprays, or an intranasal spray containing a steroid with antihistamine, are the <a href="https://theconversation.com/can-i-take-antihistamines-everyday-more-than-the-recommended-dose-what-if-im-pregnant-heres-what-the-research-says-228390">most effective treatments</a>. However, it is important to use these <a href="https://allergyfacts.org.au/allergic-rhinitis-treatment/">regularly and correctly</a>. Allergen immunotherapy, also known as desensitisation, is an <a href="https://onlinelibrary.wiley.com/doi/10.1111/all.13201">effective treatment</a> for people with severe hay fever symptoms that can reduce the need for medication and avoiding allergens. However, it involves a longer treatment course (about three years), usually with the supervision of an allergy or immunology specialist. <h2>When should people see their doctor?</h2> It is important to treat hay fever, because symptoms can significantly affect a <a href="https://bmjopen.bmj.com/content/10/11/e038870.long">person’s quality of life</a>. A GP can: <ul> <li> recommend treatments for hay fever and can guide you to use them correctly </li> <li> organise blood tests to confirm which allergen sensitisations (if any) are present, and whether these correlate with your symptoms </li> <li> screen for asthma, which commonly exists with hay fever, and may require other treatments </li> <li> arrange referrals to allergy or immunology specialists, if needed, for other tests, such as allergen skin prick testing, or to consider <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy">allergen immunotherapy</a> if symptoms are severe. </li> </ul> <hr /> More information about hay fever is available from the <a href="https://www.allergy.org.au/patients/fast-facts/hay-fever-allergic-rhinitis">Australasian Society of Clinical Immunology and Allergy</a> and <a href="https://allergyfacts.org.au/">Allergy & Anaphylaxis Australia</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/239409/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/janet-davies-103598">Janet Davies</a>, Respiratory Allergy Stream Co-chair, National Allergy Centre of Excellence; Professor and Head, Allergy Research Group, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/joy-lee-1480523">Joy Lee</a>, Respiratory Allergy Stream member, National Allergy Centre of Excellence; Associate Professor, School of Translational 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/why-do-i-have-hay-fever-i-didnt-have-it-as-a-child-239409">original article</a>.

Body

I have a stuffy nose, how can I tell if it’s hay fever, COVID or something else?

<a href="https://theconversation.com/profiles/deryn-thompson-1449312">Deryn Thompson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Hay fever (also called allergic rhinitis) affects <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-state-and-territory-findings/latest-release">24%</a> of Australians. <a href="https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-rhinitis-or-hay-fever">Symptoms</a> include sneezing, a runny nose (which may feel blocked or stuffy) and itchy eyes. People can also experience an itchy nose, throat or ears. But COVID is still <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">spreading</a>, and <a href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">other viruses</a> can cause cold-like symptoms. So how do you know which one you’ve got? <h2>Remind me, how does hay fever cause symptoms?</h2> <a href="https://www.allergy.org.au/hp/papers/allergic-rhinitis-clinical-update">Hay fever</a> happens when a person has become “sensitised” to an allergen trigger. This means a person’s body is always primed to react to this trigger. Triggers can include allergens in the air (such as pollen from trees, grasses and flowers), mould spores, animals or house dust mites which mostly live in people’s mattresses and bedding, and feed on shed skin. When the body is exposed to the trigger, it produces IgE (immunoglobulin E) antibodies. These cause the release of many of the body’s own chemicals, including histamine, which result in hay fever symptoms. People who have asthma may find their asthma symptoms (cough, wheeze, tight chest or trouble breathing) worsen when exposed to airborne allergens. Spring and sometimes into summer can be the worst time for people with grass, tree or flower allergies. However, animal and house dust mite symptoms usually happen year-round. <h2>What else might be causing my symptoms?</h2> Hay fever does not cause a fever, sore throat, muscle aches and pains, weakness, loss of taste or smell, nor does it cause you to cough up mucus. These symptoms are likely to be caused by a virus, such as COVID, influenza, respiratory syncytial virus (RSV) or a “cold” (often caused by rhinoviruses). These conditions can occur all year round, with some overlap of symptoms: <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.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/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=582&fit=crop&dpr=1 600w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=582&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=582&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=731&fit=crop&dpr=1 754w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=731&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=731&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><a class="source" href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">Natasha Yates/The Conversation</a></figcaption></figure> COVID still <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">surrounds</a> us. <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/health+statistics/surveillance+of+notifiable+conditions/respiratory+infections+dashboard">RSV and influenza</a> rates appear higher than before the COVID pandemic, but it may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10888990/#:%7E:text=Increases%20in%20RSV%20patient%20volume,with%20an%20RSV%20diagnosis%20occurred">due to more testing</a>. So if you have a fever, sore throat, muscle aches/pains, weakness, fatigue, or are coughing up mucus, stay home and avoid mixing with others to limit transmission. People with COVID symptoms can take a rapid antigen test (<a href="https://www.health.gov.au/sites/default/files/2024-04/coronavirus-covid-19-rapid-antigen-tests.pdf">RAT</a>), ideally when <a href="https://www.cochrane.org/CD013705/INFECTN_how-accurate-are-rapid-antigen-tests-diagnosing-covid-19">symptoms start</a>, then isolate until symptoms disappear. <a href="https://www.mja.com.au/journal/2023/219/11/covid-19-rapid-antigen-tests-approved-self-testing-australia-published">One negative RAT alone</a> can’t rule out COVID if symptoms are still present, so test again 24–48 hours after your initial test if symptoms persist. You can now test yourself for COVID, RSV and influenza in a <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">combined RAT</a>. But again, a negative test doesn’t rule out the virus. If your symptoms continue, <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">test again</a> 24–48 hours after the previous test. <h2>If it’s hay fever, how do I treat it?</h2> Treatment involves blocking the body’s histamine release, by taking antihistamine medication which helps reduce the symptoms. Doctors, nurse practitioners and pharmacists can develop a <a href="https://www.allergy.org.au/images/pc/ASCIA_Allergic_Rhinitis_Treatment_Plan_2024.pdf">hay fever care plan</a>. This may include using a nasal spray containing a topical corticosteroid to help reduce the swelling inside the nose, which causes stuffiness or blockage. Nasal sprays need to delivered <a href="https://allergyfacts.org.au/are-you-using-your-nasal-spray-correctly/">using correct technique</a> and used over several weeks to work properly. Often these sprays can also help lessen the itchy eyes of hay fever. Drying bed linen and pyjamas inside during spring can <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">lessen symptoms</a>, as can putting a <a href="https://www.nps.org.au/consumers/managing-hay-fever">smear of Vaseline</a> in the nostrils when going outside. Pollen sticks to the Vaseline, and gently blowing your nose later removes it. People with asthma should also have an <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma plan</a>, created by their doctor or nurse practitioner, explaining how to adjust their asthma reliever and preventer medications in hay fever seasons or on allergen exposure. People with asthma also need to be <a href="https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/thunderstorm-asthma">alert for thunderstorms</a>, where pollens can burst into tinier particles, be inhaled deeper in the lungs and cause a severe asthma attack, and even death. <h2>What if it’s COVID, RSV or the flu?</h2> Australians aged 70 and over and others with underlying health conditions who test positive for COVID are <a href="https://www.healthdirect.gov.au/covid-19/medications#at-home">eligible for antivirals</a> to reduce their chance of severe illness. Most other people with COVID, RSV and influenza will recover at home with rest, fluids and paracetamol to relieve symptoms. However some groups are at greater risk of serious illness and may require additional treatment or hospitalisation. For <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/respiratory-syncytial-virus.aspx">RSV</a>, this includes premature infants, babies 12 months and younger, children under two who have other medical conditions, adults over 75, people with heart and lung conditions, or health conditions that lessens the immune system response. For influenza, people at <a href="https://www.health.nsw.gov.au/Infectious/Influenza/Pages/at-risk.aspx">higher risk</a> of severe illness are pregnant women, Aboriginal people, people under five or over 65 years, or people with long-term medical conditions, such as kidney, heart, lung or liver disease, diabetes and decreased immunity. If you’re concerned about severe symptoms of COVID, RSV or influenza, consult your doctor or call 000 in an emergency. If your symptoms are mild but persist, and you’re not sure what’s causing them, book an appointment with your doctor or nurse practitioner. Although hay fever season is here, we need to avoid spreading other serious infectious. For more information, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria); use the <a href="https://www.healthdirect.gov.au/symptom-checker">online Symptom Checker</a>; or visit <a href="http://healthdirect.gov.au/">healthdirect.gov.au</a> or the <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">Australian Society of Clinical Immunology and Allergy</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/240453/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/deryn-thompson-1449312">Deryn Thompson</a>, Eczema and Allergy Nurse; Lecturer, <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/i-have-a-stuffy-nose-how-can-i-tell-if-its-hay-fever-covid-or-something-else-240453">original article</a>.

Body

How do I know when it’s time to replace my running shoes?

<a href="https://theconversation.com/profiles/john-arnold-178470">John Arnold</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joel-fuller-2210202">Joel Fuller</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Any runner will tell you there’s nothing better than slipping on a brand new pair of shoes. But how regularly should runners fork out hundreds of dollars on their next pair? Conventional wisdom tells us the average lifespan of a running shoe is around 500 to 800 kilometres. But where did this advice come from, and is it based on science? Some evidence comes from <a href="https://doi.org/10.1177/0363546585013004">impact testing</a> with machines designed to simulate the shoe repeatedly contacting the ground during running. Other evidence comes from <a href="https://doi.org/10.1080/19424280.2010.519348">monitoring runners who have used shoes in the real world</a> for long periods. This research is often focused on shoe materials and structure. But we think more compelling markers for the runner are shoe comfort, performance benefit and injury risk. Rather than seeking a “one-size-fits-all” answer to how many kilometres your shoes should be limited to, it’s also better to consider individual signs based on your shoe type and its purpose. <h2>The three signs to watch for</h2> Runners tend to replace their shoes for three main reasons: <ol> <li>they believe their performance is being negatively impacted</li> <li>their shoes are leading to some bodily discomfort which may cause (or has already caused) an injury</li> <li>the shoes are no longer comfortable or “feel” as good as they used to.</li> </ol> So what does the evidence say about these factors? <h2>Performance</h2> Some shoe material properties do contribute to enhanced running efficiency. Degrading these materials by racking up the kilometres may hinder peak performance on race day. This is most clearly seen in carbon fibre plate shoes used by modern elite runners to achieve <a href="https://doi.org/10.1007/s40279-020-01420-7">rapid road race times</a>. The design features <a href="https://doi.org/10.1007/s40279-018-1024-z">thought to drive this</a> are the combination of highly compliant and resilient midsole foam and a stiff embedded carbon fibre plate, which support energy storage and return. Runners will typically “save” these shoes for race day and replace them after fewer kilometres, compared to conventional running shoes. The available research does support the <a href="https://doi.org/10.1007/s40279-017-0811-2">performance benefits of these shoes</a>. However, it’s not known how long the benefits last relative to kilometres of wear. To our best knowledge, there’s only one study on running performance and shoe wear, but unfortunately it did not involve carbon fibre plate shoes. A University of Connecticut 2020 <a href="http://hdl.handle.net/11134/20002:860659513">master’s thesis</a> investigated eight college-level runners over 400 miles (643km) of Nike Pegasus shoe use. Large reductions in running economy were reported at 240km, and this was statistically significant at 320km. No reduction was observed at 160km. So, if you’re chasing personal best times, the evidence above suggests that for peak performance, shoes should be replaced somewhere between 160 and 240km (although this is not directly based on carbon fibre plate shoe research). It appears that minimising training kilometres for your favourite racing shoes – keeping them “fresh” – could contribute to peak performance on race day, compared to racing in a pair of old shoes. <h2>Injury or discomfort</h2> The link between shoe wear and injury is unclear, and based on <a href="https://bjsm.bmj.com/content/37/3/239">minimal and often conflicting evidence</a>. One study did find that <a href="https://doi.org/10.1111/sms.12154">runners who alternate their running shoes</a> have a lower risk of injury than runners who run only in the same pair of shoes over a 22-week period. Runners who alternated shoes throughout the study period would have accumulated less wear in each shoe. This provides some support for the notion that accumulating too many kilometres in your shoes may increase risk of injury. Unfortunately, the exact age of running shoes was not reported in this study. However, based on the running characteristics reported, the single-shoe pair users completed an average of 320km in their shoes (after adjusting for a small fraction who had to replace shoes during the study). This was compared to the multi-shoe pair users who used an average of 3.6 pairs of shoes, ran more total kilometres, but accumulated an average of only 200km per shoe pair. <h2>Comfort</h2> Comfort and fit are the <a href="https://www.tandfonline.com/doi/full/10.1080/19424280.2024.2353597#abstract">two most important factors</a> to runners when selecting running shoes. Evidence linking improved shoe comfort to <a href="https://journals.lww.com/acsm-msse/fulltext/2001/11000/relationship_between_footwear_comfort_of_shoe.21.aspx">reduced injury rates</a> or <a href="https://www.tandfonline.com/doi/full/10.1080/17461391.2019.1640288">improved running economy</a> is mixed, but reducing harms from poorly fitting and uncomfortable shoes is clearly a priority for runners. Most <a href="https://commons.nmu.edu/isbs/vol35/iss1/293/">runners land on their heel</a>. The repeated compression of the midsole causes the material to harden, possibly after as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534152/pdf/ijspt-12-616.pdf">little as 160km</a>, according to one study from 2017. However, there was virtually no change in the amount of cushioning runners perceived under their heel after 160km. Even after using the shoes for 640km, they felt little difference – about 3%. While at first this might seem like runners are not very good at judging when shoes lose their cushioning, it also tells us changes in perceived shoe cushioning are very gradual and may not be important for runners until they reach a certain threshold. This amount will differ from person to person, and from shoe to shoe, but research suggests it’s not until perceived cushioning reaches about a <a href="https://www.tandfonline.com/doi/full/10.1080/02640414.2020.1773613?casa_token=P87vatZhOlgAAAAA%3ACu11TZmGjKc1xYsaUlEVfWvZDvcSnx3qgKL1E2DsRYwf6hMvBiyVAm-M_-4Iauq4lwHna0QMu1IRmw">10% change</a> that runners consider it meaningful. We must be careful when applying these findings to the latest running shoes which use newer materials. But you can use it as a rule of thumb – once you notice a drop in comfort, it’s time to get a new pair. <h2>When to choose new shoes</h2> Ultimately, there’s no one simple answer for when you should get new running shoes. You may also not keep close track of how many kilometres your favourite pair has racked up. Overall, we believe the most practical advice is to keep your racing shoes “fresh” (under 240km), alternate a couple of other pairs during regular training, and replace them when you detect a notable drop in comfort.<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/238997/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/john-arnold-178470">John Arnold</a>, Senior lecturer, Sport & Exercise Biomechanics, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joel-fuller-2210202">Joel Fuller</a>, Senior Lecturer, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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/how-do-i-know-when-its-time-to-replace-my-running-shoes-238997">original article</a>.

Beauty & Style

How can I stop using food to cope with negative emotions?

<a href="https://theconversation.com/profiles/inge-gnatt-1425767">Inge Gnatt</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Have you ever noticed changes in your eating habits when you are sad, bored or anxious? Many people report eating either more, or less, as a way of helping them to cope when they experience difficult emotions. Although this is a very normal response, it can take the pleasure out of eating, and can become distressing and bring about other feelings of <a href="https://doi.org/10.1016/j.eatbeh.2018.02.008">shame and self-criticism</a>. Adding to the complexity of it all, we live in a world where <a href="https://butterfly.org.au/diet-culture-101/">diet culture</a> is unavoidable, and our relationship to eating, food and body image can become complicated and confusing. <h2>Emotional eating is common</h2> “Emotional eating” refers to the eating behaviours (typically eating more) that occur in response to difficult emotions. <a href="https://doi.org/10.3390/ijerph18041744">Research shows</a> around 20% of people regularly engage in emotional eating, with a higher prevalence <a href="https://doi.org/10.1371/journal.pone.0285446">among adolescents</a> and women. In a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285446#sec012">study</a> of more than 1,500 adolescents, 34% engaged in emotional eating while sad and 40% did so while anxious. Foods consumed are often fast-foods and other energy-dense, nutrient-poor convenience foods. <h2>Stress, strong emotions and depression</h2> For some people, emotional eating was simply a <a href="https://doi.org/10.1038/s41598-017-09519-0">habit formed earlier in life</a> that has persisted over time. But other factors might also contribute to the likelihood of emotional eating. The physiological effects of stress and strong emotions, for example, can influence hormones such as <a href="https://doi.org/10.1016/S0306-4530(00)00035-4">cortisol, insulin and glucose</a>, which can also increase appetite. Increased impulsivity (<a href="https://doi.org/10.1176/appi.ajp.158.11.1783">behaving</a> before thinking things through), vulnerability to depression, a tendency to ruminate and <a href="https://doi.org/10.1080/1047840X.2014.940781">difficulties regulating emotions</a> also <a href="https://doi.org/10.1097/FBP.0b013e328357bd4e">increase the likelihood</a> of emotional eating. <h2>So what do you do?</h2> First, know that fluctuations in eating are normal. However, if you find that the way you eat in response to difficult emotions is not working for you, there are a few things you can do. Starting with small things that are achievable but can have a huge impact, such as prioritising <a href="https://theconversation.com/no-sleep-challenge-the-dangers-of-sleep-deprivation-236608">getting enough sleep</a> and <a href="https://insideoutinstitute.org.au/podcasts/episode-3-the-mindful-dietitian-fiona-sutherland">eating regularly</a>. Then, you can start to think about how you handle your emotions and hunger cues. <h2>Expand your emotional awareness</h2> Often we label emotions as good or bad, and this can result in fear, avoidance, and <a href="https://youtu.be/NDQ1Mi5I4rg?si=lv9d8qjUThSsemXG">unhelpful coping strategies</a> such as emotional eating. But it’s also important to <a href="https://www.pspnet.ca/assets/the-gottman-institute-the-feeling-wheel-v2.pdf">differentiate</a> the exact emotion. This might be feeling isolated, powerless or victimised, rather than something as broad as sad. By <a href="https://headspace.org.au/online-and-phone-support/interactive-tools/activities/understanding-emotions/">noticing</a> what the emotion is, we can bring curiosity to what it means, how we feel in our minds and bodies, and how we think and behave in response. <h2>Tap into your feelings of hunger and fullness</h2> Developing an intuitive way of eating is another helpful strategy to promote <a href="https://insideoutinstitute.org.au/blog/what-is-normal-eating">healthy eating behaviours</a>. Intuitive eating means recognising, understanding and responding to internal signals of hunger and fullness. This might mean tuning in to and acknowledging physical hunger cues, responding by eating food that is nourishing and enjoyable, and identifying sensations of fullness. Intuitive eating <a href="https://doi.org/10.1002/eat.23509">encourages flexibility</a> and thinking about the pleasure we get from food and eating. This style of eating also allows us to enjoy eating out with friends, and sample local delicacies when travelling. It can also reduce the psychological distress from feeling out of control with your <a href="https://doi.org/10.1016/j.jand.2013.12.024">eating</a> habits and the associated negative <a href="https://doi.org/10.1016/j.appet.2015.10.012">body image</a>. <h2>When is it time to seek help?</h2> For some people, the thoughts and behaviours relating to food, eating and body image can negatively impact their life. Having the support of friends and family, accessing <a href="https://nedc.com.au/eating-disorder-resources/interactive-digital-resource-for-eating-disorders">online resources</a> and, in some instances, seeing a trained professional, can be very helpful. There are many <a href="https://doi.org/10.1007/s00787-020-01498-4">therapeutic interventions</a> that work to <a href="https://doi.org/10.1016/j.copsyc.2015.02.010">improve aspects</a> associated with emotional eating. These will depend on your situation, needs, stage of life and other factors, such as whether you are <a href="https://nedc.com.au/eating-disorders/types/neurodivergence">neurodivergent</a>. The best approach is to engage with someone who can bring compassion and understanding to your personal situation, and work with you collaboratively. This work might include: <ul> <li>unpacking some of the patterns that could be underlying these emotions, thoughts and behaviours</li> <li>helping you to discover your emotions</li> <li>supporting you to process other experiences, such as trauma exposure</li> <li>developing a more flexible and intuitive way of eating.</li> </ul> One of the dangers that can occur in response to emotional eating is the temptation to diet, which can lead to disordered eating, and eating disorder behaviours. Indicators of a potential <a href="https://nedc.com.au/eating-disorders/eating-disorders-explained/whats-an-eating-disorder">eating disorder</a> can include: <ul> <li>recent rapid weight loss</li> <li>preoccupation with weight and shape (which is usually in contrast to other people’s perceptions)</li> <li>eating large amounts of food within a short space of time (two hours or less) and feeling a sense of loss of control</li> <li>eating in secret</li> <li>compensating for food eaten (with vomiting, exercise or laxatives).</li> </ul> <a href="https://nedc.com.au/eating-disorders/treatment-and-recovery/treatment-options">Evidence-based approaches</a> can support people experiencing eating disorders. To find a health professional who is informed and specialises in this area, search the <a href="https://butterfly.org.au/get-support/butterflys-referral-database/">Butterfly Foundation’s expert database</a>. <hr /> If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14, or the <a href="https://butterfly.org.au/get-support/helpline/">Butterfly Foundation</a> on 1800 ED HOPE (1800 33 4673).<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/238218/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/inge-gnatt-1425767">Inge Gnatt</a>, PhD Candidate, Lecturer in Psychology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</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/how-can-i-stop-using-food-to-cope-with-negative-emotions-238218">original article</a>.

Body

Why do I need to take some medicines with food?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to? There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food. To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food. Different brands of the same medicine may also have different recommendations when it comes to taking it with food. <h2>Food impacts drug absorption</h2> Food can affect how fast and how much a drug is absorbed into the body in up to <a href="https://academic.oup.com/jpp/article-abstract/71/4/510/6122024?login=false">40% of medicines</a> taken orally. When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption. Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505616/">gastric emptying</a>. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption. Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly. But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach. <h2>Food can make medicines more tolerable</h2> Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets. Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452716/">one in four users affected</a>. To combat these side effects, it is generally recommended to be taken with food. The same <a href="https://amhonline.amh.net.au/auth">advice</a> is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline). Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed. <h2>Can food make medicines safer?</h2> Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/medications/latest-release">within a two-week period</a>. While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of <a href="https://www.tandfonline.com/doi/full/10.1586/14737175.6.11.1643#d1e212">bleeding, ulceration and perforation</a> with long-term use. But there <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">isn’t enough research</a> to show taking ibuprofen with food reduces this risk. Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration. The <a href="https://amhonline.amh.net.au/auth">Australian Medicines Handbook</a>, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">A systematic review published in 2015</a> found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses. To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs">non-steroidal anti-inflammatory medicines</a> at the same time. For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a <a href="https://australianprescriber.tg.org.au/articles/peptic-ulcer-disease-and-non-steroidal-anti-inflammatory-drugs.html">proton pump inhibitor</a>, a medicine that reduces stomach acid and protects the stomach lining. <h2>How much food do you need?</h2> When you need to take a medicine with food, how much is enough? Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone. However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised. Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.<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/235782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Associate Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/why-do-i-need-to-take-some-medicines-with-food-235782">original article</a>.

Body

"I don't call that a life": Couple sign up to die in double suicide pod

Warning: This article contains sensitive content that some readers may find distressing. A couple from the UK has signed up to be the first to die in a double suicide pod, invented by an Australian doctor, after 46 years of marriage. Peter and Christine Scott, from Suffolk in England’s east, have shared their plans to travel to Switzerland to die together after Ms Scott, a former nurse, was diagnosed with early-stage vascular dementia. After meeting at a jazz club, the pair married 46 years ago, and shared that they have opted out of potentially years of hospital treatment and the crippling costs of care which could eat into their life savings. “We have had long, happy, healthy, fulfilled lives but here we are in old age and it does not do nice things to you,” Mr Scott, 86, told<a title="www.dailymail.co.uk" href="https://www.dailymail.co.uk/news/article-13825105/Former-RAF-engineer-nurse-wife-sign-British-couple-use-double-suicide-pod-Switzerland-dementia.html"> The Daily Mail</a>. “The idea of watching the slow degradation of Chris’s mental abilities in parallel to my own physical decline is horrific to me,” the former Royal Air Force pilot added. “Obviously I would care for her to the point I could not, but she has nursed enough people with dementia during her career to be adamant she wants to remain in control of herself and her life”. “I would not want to go on living without her,” he said of his 80-year-old wife. “I don’t want to go into care, to be lying in bed dribbling and incontinent – I don’t call that a life”. As English law does not allow for euthanasia, the couple have planned their trip to Switzerland for the procedure, where Ms Scott has planned out her final days with her husband. “I’d like to go walking with Peter in the Swiss Alps, by a river. I’d have a beautiful plate of fish for my last supper, and enjoy a great bottle of Merlot,” she said. “I’d make a playlist including Wild Cat Blues and The Young Ones by Cliff Richard and I’ve found a poem called Miss Me But Let Me Go, which sums up exactly how I feel”. The suicide pod, known as Sarco, can be turned on with a simple flick of a switch from inside the futuristic capsule that resembles a modern car. The machine was invented by Australian Dr Philip Nitschke, who has long been behind a number of initiatives to allow legal euthanasia in Australia. The 3D printed Sarco capsule ends the lives of those inside by pumping the pod with nitrogen which replaces the oxygen in the pod, which renders the occupants unconscious within about a minute without, its claimed, any panic or distress. With falling oxygen, the person eventually suffocates. Dr Nitschke said the machine is activated by a button from inside the pod. “The capsule for two people works exactly the same as the single Sarco but there is only one button so they will decide between them who will push it,” he told <a title="www.dailymail.co.uk" href="https://www.dailymail.co.uk/news/article-13825105/Former-RAF-engineer-nurse-wife-sign-British-couple-use-double-suicide-pod-Switzerland-dementia.html">The Daily Mail</a>. “Then they’ll be able to hold each other”. Image credits: Courtesy of Exit International

Legal

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

I’m iron deficient. Which supplements will work best for me and how should I take them?

<a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women <a href="https://static1.squarespace.com/static/57bfc0498419c24a01318ae2/t/607fc2e06ace2f22d5ca9a43/1618985699483/20210421+-+IDC+-+economic+impact+of+iron+deficiency+-+FINAL.pdf">are low in iron</a> compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant. The <a href="https://pubmed.ncbi.nlm.nih.gov/11160590/">body needs iron</a> to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration. If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day? Here are some tips to help you work out how, when and what iron supplement to take. <h2>How do I pick the right iron supplement?</h2> The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need. The sweet spot is between <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364?via%3Dihub">60-120 mg of elemental iron</a>. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain. In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). <a href="https://www.ncbi.nlm.nih.gov/books/NBK557376/">The iron salts</a> you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%). These formulations <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">all work similarly</a>, so your choice should come down to dose and cost. Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency. <h2>Should I take tablets or liquid formulas?</h2> Iron contained within a tablet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">just as well absorbed</a> as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference. The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term. <h2>What should I eat with my iron supplement?</h2> Research <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">has shown</a> you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone. If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it. Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other <a href="https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/">vitamin C-rich foods</a>. On the other hand, tea, coffee and calcium all <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">decrease the body’s ability to absorb iron</a>. So you should try to limit these close to the time you take your supplement. <h2>Should I take my supplement in the morning or evening?</h2> The best time of day to take your supplement is in the morning. The body can <a href="https://journals.lww.com/acsm-msse/fulltext/2019/10000/the_impact_of_morning_versus_afternoon_exercise_on.20.aspx">absorb significantly more</a> iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest. Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can <a href="https://journals.humankinetics.com/view/journals/ijsnem/32/5/article-p359.xml">limit your ability to absorb it</a>. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop. <a href="https://journals.lww.com/acsm-msse/fulltext/2024/01000/iron_absorption_in_highly_trained_male_runners_.14.aspx">Our research</a> has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes). <h2>My supplements are upsetting my stomach. What should I do?</h2> If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily. Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltext#%20">has shown</a> taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects. Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success. It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430862/">iron can be toxic</a>, so you don’t want to be consuming additional iron if your body doesn’t need it. If you think you may be low on iron, talk to your GP to find out your best options.<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/235315/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, Postdoctoral Research Fellow, Sports Nutrition, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic 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/im-iron-deficient-which-supplements-will-work-best-for-me-and-how-should-i-take-them-235315">original article</a>.

Body

Is white rice bad for me? Can I make it lower GI or healthier?

<a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Rice is a <a href="http://www.ipni.net/publication/bci.nsf/0/42A2EA40E95CBD1385257BBA006531E9/$FILE/Better%20Crops%20International%202002-3%20p03.pdf">culinary staple</a> in Australia and around the world. It might seem like a given that brown rice is healthier than white and official <a href="https://www.eatforhealth.gov.au/eating-well/healthy-recipes/recipe-modification-tips">public health resources</a> often recommend brown rice instead of white as a “healthy swap”. But <a href="https://pubmed.ncbi.nlm.nih.gov/34441728/">Australians definitely prefer white rice</a> over brown. So, what’s the difference, and what do we need to know when choosing rice? <h2>What makes rice white or brown?</h2> Rice “grains” are technically seeds. A complete, whole rice seed is called a “paddy”, which has <a href="https://www.fao.org/4/t0567e/t0567e07.htm">multiple parts</a>: <ol> <li>the “hull” is the hard outer layer which protects the seed</li> <li>the “bran”, which is a softer protective layer containing the seed coat</li> <li>the “germ” or the embryo, which is the part of the seed that would develop into a new plant if was germinated</li> <li>the “endosperm”, which makes up most of the seed and is essentially the store of nutrients that feeds the developing plant as a seed grows into a plant.</li> </ol> Rice needs to be <a href="https://www.tandfonline.com/doi/pdf/10.1080/87559128509540778">processed</a> for humans to eat it. Along with cleaning and drying, the hard hulls are removed since we can’t digest them. This is how <a href="https://ift.onlinelibrary.wiley.com/doi/abs/10.1111/1541-4337.12449">brown rice is made</a>, with the other three parts of the rice remaining intact. This means brown rice is regarded as a “wholegrain”. White rice, however, is a “refined” grain, as it is <a href="https://ift.onlinelibrary.wiley.com/doi/abs/10.1111/1541-4337.12449">further polished</a> to remove the bran and germ, leaving just the endosperm. This is a mechanical and not a chemical process. <h2>What’s the difference, nutritionally?</h2> Keeping the bran and the germ means <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/cche.10322">brown rice has more</a> magnesium, phosphorus, potassium B vitamins (niacin, folate, riboflavin and pyridoxine), iron, zinc and fibre. The germ and the bran also contain more bioactives (compounds in foods that aren’t essential nutrients but have health benefits), like <a href="https://www.mdpi.com/1420-3049/28/2/532#:%7E:text=Brown%20rice%20(BR)%20is%20obtained,and%20phenolic%20compounds%20%5B3%5D.">oryzanols and phenolic compounds</a> which have antioxidant effects. But that doesn’t mean white rice is just empty calories. It <a href="https://www.glnc.org.au/wp-content/uploads/2011/04/GLNC_Rice-factsheet_WEB.pdf">still contains</a> vitamins, minerals and some fibre, and is low in fat and salt, and is naturally gluten-free. White and brown rice actually have <a href="https://ift.onlinelibrary.wiley.com/doi/abs/10.1111/1541-4337.12449">similar</a> amounts of calories (or kilojoules) and total carbohydrates. There are studies that show eating more white rice is linked to <a href="https://diabetesjournals.org/care/article/43/11/2625/35820/A-Global-Perspective-on-White-Rice-Consumption-and">a higher risk</a> of type 2 diabetes. But it is difficult to know if this is down to the rice itself, or other related factors such as socioeconomic variables or other dietary patterns. <h2>What about the glycaemic index?</h2> The higher fibre means brown rice has a <a href="https://www.sciencedirect.com/science/article/pii/S0002916523314862">lower glycaemic index</a> (GI), meaning it raises blood sugar levels more slowly. But this is highly variable between different rices within the white and brown categories. The <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index#:%7E:text=The%20glycaemic%20index%20(GI)%20is,simple'%20or%20'complex'.">GI system</a> uses low (less than 55), medium (55–70) and high (above 70) categories. <a href="https://glycemicindex.com/gi-search/?food_name=rice&product_category=&country=&gi=&gi_filter=&serving_size_(g)=&serving_size_(g)_filter=&carbs_per_serve_(g)=&carbs_per_serve_(g)_filter=&gl=&gl_filter=">Brown rices</a> fall into the low and medium categories. <a href="https://glycemicindex.com/gi-search/?food_name=rice&product_category=&country=&gi=&gi_filter=&serving_size_(g)=&serving_size_(g)_filter=&carbs_per_serve_(g)=&carbs_per_serve_(g)_filter=&gl=&gl_filter=">White rices</a> fall in the medium and high. There are specific <a href="https://www.gisymbol.com/low-gi-products/sunrice-doongara-low-gi-white-clever-rice-1kg/">low-GI types available</a> for both white and brown types. You can also lower the GI of rice by <a href="https://pubs.acs.org/doi/abs/10.1021/jf503203r">heating and then cooling it</a>. This process converts some of the “available carbohydrates” into “resistant starch”, which then functions like dietary fibre. <h2>Are there any benefits to white rice?</h2> The <a href="https://www.realsimple.com/brown-rice-vs-white-rice-8417468#:%7E:text=The%20eating%20experience%20between%20these,chewier%20texture%20and%20nuttier%20flavor.">taste and textural qualities</a> of white and brown rices differ. White rice tends to have a softer texture and more mild or neutral flavour. Brown rice has a chewier texture and nuttier flavour. So, while you can technically substitute brown rice into most recipes, the experience will be different. Or other ingredients may need to be added or changed to create the desired texture. Removing more of the outer layers may also reduce the levels of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375490/">contaminants</a> such as pesticides. <h2>We don’t just eat rice</h2> Comparing white and brown rice seems like an easy way to boost nutritional value. But just because one food (brown rice) is more nutrient-dense doesn’t make the other food (white rice) “bad”. Ultimately, it’s not often that we eat just rice, so we don’t need the rice we choose to be the perfect one. Rice is typically the staple base of a more complex dish. So, it’s probably more important to think about what we eat with rice. Adding vegetables and lean proteins to rice-based dishes can easily add the micronutrients, bioactives and fibre that white rice is comparatively lacking, and this can likely do more to contribute to diet quality than eating brown rice instead.<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/236767/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation - School of Health Sciences, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</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/is-white-rice-bad-for-me-can-i-make-it-lower-gi-or-healthier-236767">original article</a>.

Food & Wine

I’ve recovered from a cold but I still have a hoarse voice. What should I do?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Cold, flu, COVID and <a href="https://theconversation.com/rsv-is-everywhere-right-now-what-parents-need-to-know-about-respiratory-syncytial-virus-208855">RSV</a> have been <a href="https://www.abc.net.au/news/2024-06-21/flu-whooping-cough-rsv-cases-up-as-covid-cases-unkown/104002964">circulating across Australia this winter</a>. Many of us have caught and recovered from <a href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">one of these</a> common upper respiratory tract infections. But for some people their impact is ongoing. Even if your throat isn’t <a href="https://theconversation.com/sore-throats-suck-do-throat-lozenges-help-at-all-184454">sore</a> anymore, your voice may still be hoarse or croaky. So what happens to the voice when we get a virus? And what happens after? Here’s what you should know if your voice is still hoarse for days – or even weeks – after your other symptoms have resolved. <h2>Why does my voice get croaky during a cold?</h2> A healthy voice is normally clear and strong. It’s powered by the lungs, which push air past the vocal cords to make them vibrate. These vibrations are amplified in the throat and mouth, creating the voice we hear. The vocal cords are two elastic muscles situated in your throat, around the level of your laryngeal prominence, or Adam’s apple. (Although everyone has one, it tends to be more pronounced in males.) The vocal cords are small and delicate – around the size of your fingernail. Any small change in their structure will affect how the voice sounds. When the vocal cords become inflamed – known as laryngitis – your voice will sound different. Laryngitis is a common part of upper respiratory tract infections, but can also be caused through misuse. <figure class="align-center "><img src="https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?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/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=366&fit=crop&dpr=1 600w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=366&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=366&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=460&fit=crop&dpr=1 754w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=460&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/614706/original/file-20240821-17-nzg1mc.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=460&fit=crop&dpr=3 2262w" alt="Two drawn circles comparing normal vocal cords with inflamed, red vocal cords." /><figcaption>Viruses such as the common cold can inflame the vocal cords. <a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458117">Pepermpron/Shutterstock</a></figcaption></figure> Catching a virus triggers the body’s defence mechanisms. White blood cells are recruited to kill the virus and heal the tissues in the vocal cords. They become inflamed, but also stiffer. It’s harder for them to vibrate, so the voice comes out hoarse and croaky. In some instances, you may find it hard to speak in a loud voice or have a reduced pitch range, meaning you can’t go as high or loud as normal. You may even “lose” your voice altogether. Coughing can also make things worse. It is the body’s way of trying to clear the airways of irritation, including your own mucus dripping onto your throat (<a href="https://www.health.harvard.edu/staying-healthy/treatments-for-post-nasal-drip">post-nasal drip</a>). But coughing slams the vocal cords together with force. Chronic coughing can lead to persistent inflammation and even thicken the vocal cords. This thickening is the body trying to protect itself, similar to developing a callus when a pair of new shoes rubs. Thickening on your vocal cords can lead to physical changes in the vocal cords – such as developing a growth or “nodule” – and further deterioration of your voice quality. <figure class="align-center "><img src="https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?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/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=376&fit=crop&dpr=1 600w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=376&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=376&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=473&fit=crop&dpr=1 754w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=473&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/614707/original/file-20240821-21-vizs73.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=473&fit=crop&dpr=3 2262w" alt="Diagram compares healthy vocal cords with cords that have nodules, two small bumps." /><figcaption>Coughing and exertion can cause inflamed vocal cords to thicken and develop nodules. <a class="source" href="https://www.shutterstock.com/image-vector/dry-sore-loss-cough-virus-viral-1821458126">Pepermpron/Shutterstock</a></figcaption></figure> <h2>How can you care for your voice during infection?</h2> People who use their voices a lot professionally – such as teachers, call centre workers and singers – are often desperate to resume their vocal activities. They are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478078/">more at risk</a> of forcing their voice before it’s ready. The good news is most viral infections resolve themselves. Your voice is usually restored within five to ten days of recovering from a cold. Occasionally, your pharmacist or doctor may prescribe cough suppressants to limit additional damage to the vocal cords (among other reasons) or mucolytics, which break down mucus. But the most effective treatments for viral upper respiratory tract infections are hydration and rest. Drink plenty of water, avoid alcohol and exposure to cigarette smoke. <a href="https://www.healthdirect.gov.au/laryngitis#:%7E:text=You%20can%20help%20your%20voice%20recover%20by%3A%201,avoid%20nasal%20decongestants%20%28these%20make%20your%20throat%20drier%29">Inhaling steam</a> by making yourself a cup of hot water will also help clear blocked noses and hydrate your vocal cords. Rest your voice by talking as little as possible. If you do need to talk, don’t whisper – this <a href="https://www.sciencedirect.com/science/article/abs/pii/S0892199704001730">strains the muscles</a>. Instead, consider using “<a href="https://www.instagram.com/reel/C0d-oNIMM1y/">confidential voice</a>”. This is a soft voice – not a whisper – that gently vibrates your vocal cords but puts less strain on your voice than normal speech. Think of the voice you use when communicating with someone close by. During the first five to ten days of your infection, it is important not to push through. Exerting the voice by talking a lot or loudly will only exacerbate the situation. Once you’ve recovered from your cold, you can speak as you would normally. <h2>What should you do if your voice is still hoarse after recovery?</h2> If your voice hasn’t returned to normal after <a href="https://www.healthdirect.gov.au/laryngitis">two to three weeks</a>, you should seek medical attention from your doctor, who may refer you to an ear nose and throat specialist. If you’ve developed a nodule, the specialist would likely refer you to a speech pathologist who will show you how to take care of your voice. Many nodules can be <a href="https://britishvoiceassociation.org.uk/voicecare_vocal-nodules.htm">treated</a> with voice therapy and don’t require surgery. You may have also developed a habit of straining your vocal cords, if you forced yourself to speak or sing while they were inflamed. This can be a reason why some people continue to have a hoarse voice even when they’ve recovered from the cold. In those cases, a speech pathologist may play a valuable role. They may teach you to exercises that make voicing more efficient. For example, <a href="https://www.youtube.com/watch?v=fwNPp-RS4IY">lip trills</a> (blowing raspberries) are a fun and easy way you can learn to relax the voice. This can help break the habit of straining your voice you may have developed during infection.<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/236398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yeptain-leung-1563747">Yeptain Leung</a>, Postdoctoral Research and Lecturer of Speech Pathology, School of Health Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-recovered-from-a-cold-but-i-still-have-a-hoarse-voice-what-should-i-do-236398">original article</a>. </div>

Body

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

Travel Trouble

"I am a woman": Boxer launches legal action after gold medal win

Imane Khelif has filed an official complaint over online bullying and harassment she has been subject to throughout the course of the Paris Olympics. The Algerian boxer, who took home the gold medal in the women's competition, has been at the centre of a wave of abuse over her gender, with misinformation circulating over her gender. According to Khelif's lawyer Nabil Boudi, the gold medallist has filed a legal complaint in France for online harassment. “The boxer Imane Khelif has decided to begin a new fight, a fight for justice, dignity and honour,” Boudi said in a statement, saying Khelif had filed the complaint for “aggravated online harassment … to Paris prosecutors”. He added, “The investigation will determine who was behind this misogynist, racist and sexist campaign, but will also have to concern itself with those who fed the online lynching.” The “iniquitous harassment” the boxing champion had been subjected to would remain “the biggest stain on these Olympic Games”, said Boudi. On Saturday, Khelif emerged victorious in the women’s 66kg final against China’s Yang Liu in a unanimous points decision, having been the focus of intense scrutiny in the French capital for the duration of the Games. After her victory, Khelif said the gold medal she had won was the best response to her critics. Asked by reporters about the row over her eligibility, she said, “I am fully qualified to take part, I am a woman like any other. I was born a woman, lived a woman and competed as a woman.” Image credits: Ulrik Pedersen/CSM/Shutterstock Editorial

Legal

I’ve been sick. When can I start exercising again?

<a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> You’ve had a cold or the flu and your symptoms have begun to subside. Your nose has stopped dripping, your cough is clearing and your head and muscles no longer ache. You’re ready to get off the couch. But is it too early to go for a run? Here’s what to consider when getting back to exercising after illness. <h2>Exercise can boost your immune system – but not always</h2> Exercise <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523821/">reduces the chance</a> of getting respiratory infections by increasing your immune function and the ability to fight off viruses. However, an acute bout of endurance exercise may temporarily increase your susceptibility to upper respiratory infections, such as colds and the flu, via the short-term suppression of your immune system. This is known as the “open window” theory. A <a href="https://pubmed.ncbi.nlm.nih.gov/20839496/">study</a> from 2010 examined changes in trained cyclists’ immune systems up to eight hours after two-hour high-intensity cycling. It found important immune functions were suppressed, resulting in an increased rate of upper respiratory infections after the intense endurance exercise. So, we have to be more careful after performing harder exercises than normal. <h2>Can you exercise when you’re sick?</h2> This depends on the severity of your symptoms and the intensity of exercise. Mild to moderate exercise (reducing the intensity and length of workout) may be OK if your symptoms are a runny nose, nasal congestion, sneezing and minor sore throat, without a fever. Exercise may help you feel better by opening your nasal passages and temporarily relieving nasal congestion. However, if you try to exercise at your normal intensity when you are sick, you risk injury or more serious illness. So it’s important to listen to your body. If your symptoms include chest congestion, a cough, upset stomach, fever, fatigue or widespread muscle aches, avoid exercising. Exercising when you have these symptoms may worsen the symptoms and prolong the recovery time. If you’ve had the flu or another respiratory illness that caused a high fever, make sure your temperature is back to normal before getting back to exercise. Exercising raises your body temperature, so if you already have a fever, your temperature will become high quicker, which makes you sicker. If you have COVID or other contagious illnesses, stay at home, rest and isolate yourself from others. When you’re sick and feel weak, don’t force yourself to exercise. Focus instead on getting plenty of rest. This may actually shorten the time it takes to recover and resume your normal workout routine. <h2>I’ve been sick for a few weeks. What has happened to my strength and fitness?</h2> You may think taking two weeks off from training is disastrous, and worry you’ll lose the gains you’ve made in your previous workouts. But it could be just what the body needs. It’s true that almost all training benefits are <a href="https://journals.lww.com/acsm-csmr/fulltext/2019/04000/sports_training_principles.2.aspx">reversible</a> to some degree. This means the physical fitness that you have built up over time can be lost without regular exercise. To study the effects of de-training on our body functions, researchers have undertaken “bed rest” studies, where healthy volunteers spend up to 70 days in bed. They <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00415.2017">found</a> that V̇O₂max (the maximum amount of oxygen a person can use during maximal exercise, which is a measure of <a href="https://my.clevelandclinic.org/health/articles/7050-aerobic-exercise">aerobic</a> fitness) declines 0.3–0.4% a day. And the higher pre-bed-rest V̇O₂max levels, the <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00415.2017">larger</a> the declines. In terms of skeletal muscles, upper thigh muscles <a href="https://doi.org/10.1152/japplphysiol.00363.2020">become smaller by</a> 2% after five days of bed rest, 5% at 14 days, and 12% at 35 days of bed rest. <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00363.2020">Muscle strength declines more</a> than muscle mass: knee extensor muscle strength gets weaker by 8% at five days, 12% at 14 days and more than 20% after around 35 days of bed rest. This is why it feels harder to do the same exercises after resting for even five days. But in <a href="https://iaaspace.org/product/guidelines-for-standardization-of-bed-rest-studies-in-the-spaceflight-context/">bed rest studies</a>, physical activities are strictly limited, and even standing up from a bed is prohibited during the whole length of a study. When we’re sick in bed, we have some physical activities such as sitting on a bed, standing up and walking to the toilet. These activities could reduce the rate of decreases in our physical functions compared with study participants. <h2>How to ease back into exercise</h2> Start with a lower-intensity workout initially, such as going for a walk instead of a run. Your first workout back should be light so you don’t get out of breath. Go low (intensity) and go slow. Gradually increase the volume and intensity to the previous level. It may take the same number of days or weeks you rested to get back to where you were. If you were absent from an exercise routine for two weeks, for example, it may require two weeks for your fitness to return to the same level. If you feel exhausted after exercising, take an extra day off before working out again. A day or two off from exercising shouldn’t affect your performance very much.<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/233130/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ken-nosaka-169021">Ken Nosaka</a>, Professor of Exercise and Sports Science, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan 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/ive-been-sick-when-can-i-start-exercising-again-233130">original article</a>.

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I feel sick. How do I know if I have the flu, COVID, RSV or something else?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> You wake with a sore throat and realise you are sick. Is this going to be a two-day or a two-week illness? Should you go to a doctor or just go to bed? Most respiratory illnesses have very similar symptoms at the start: sore throat, congested or runny nose, headache, fatigue and fever. This may progress to a dry cough. Best case scenario is that you have “<a href="https://lungfoundation.com.au/wp-content/uploads/2018/09/Factsheet-Common-Cold-Mar2016.pdf">a cold</a>” (which can be any one of hundreds of viruses, most commonly rhinovirus), which is short-lived and self-limiting. But some respiratory illnesses can be much more serious. Here is a brief guide to some important bugs to know about that are circulating this winter, and how to work out which one you have. <h2>Respiratory syncytial virus (RSV)</h2> For most people an RSV infection will feel like “a cold” – annoying, but only lasting a few days. However, for babies, older adults and people with immune issues, it can lead to <a href="https://www.rch.org.au/kidsinfo/fact_sheets/bronchiolitis/">bronchiolitis</a> or pneumonia, and even become life-threatening. RSV isn’t seasonal, which means you are just as likely to get it in summer as in winter. However, it is highly contagious so we noticed it <a href="https://pubmed.ncbi.nlm.nih.gov/32986804">disappearing almost completely</a> during COVID lockdowns. There is now a <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">rapid-antigen test (RAT) for RSV</a> which also checks for influenza and COVID, and is the best way of finding out if RSV is what is causing symptoms. Recently, a preventative immune therapy has become available for high risk babies (<a href="https://www.schn.health.nsw.gov.au/respiratory-syncytial-virus-rsv-monoclonal-antibody-factsheet">nirsevimab</a>) and there are also <a href="https://ncirs.org.au/ncirs-fact-sheets-faqs-and-other-resources/respiratory-syncytial-virus-rsv-frequently-asked">vaccines for higher risk adults</a>. Nirsevimab is also available to all babies for free in <a href="https://www.health.wa.gov.au/Articles/N_R/Respiratory-syncytial-virus-RSV-immunisation">Western Australia</a> and <a href="https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/immunisation/paediatric-rsv-prevention-program">Queensland</a>. But there are no specific treatments. Adults who get it simply have to ride it out (using whatever you need to <a href="https://www.mayoclinic.org/diseases-conditions/common-cold/diagnosis-treatment/drc-20351611">manage symptoms</a>). Babies and higher risk patients need to present to an emergency department if they test positive for RSV and are also looking or feeling very unwell (this might mean rapid shallow breathing, fevers not coming down with paracetamol or ibuprofen, a baby not feeding, mottled-looking skin, or going blue around the mouth). If a patient has developed a bronchiolitis or pneumonia, they may need to be hospitalised. <h2>Influenza</h2> Once you have had the “true flu” (influenza), you will find it frustrating when people call their sniffly cold-like symptoms a “flu”. Influenza infections generally start with a sore throat and headache which quickly turns into high fevers, generalised aches and excessive fatigue. You feel like you have been hit by a truck and may struggle to get out of bed. This can last a week or more, even in people who are generally fit and healthy. Influenza is a major public health issue internationally, with 3–5 million cases of severe illness and <a href="https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)">290,000 to 650,000 respiratory deaths annually</a>. People who are at <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu">greater risk of complications</a> from influenza include pregnant women, children under five, adults aged 65 and over, First Nations peoples, and people with chronic or immunosuppressive medical conditions. For this reason, annual vaccination is <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">recommended and funded</a> for vulnerable people. Vaccination is also readily available for <a href="https://www.health.gov.au/topics/immunisation/immunisation-contacts">all Australians who want it</a>, through pharmacies as well as medical clinics, usually at a cost of less than A$30. In <a href="https://www.vaccinate.initiatives.qld.gov.au/what-to-vaccinate-against/influenza#:%7E:text=The%20flu%20vaccine%20is%20free,.qld.gov.au">some states</a>, it’s free for all residents. Influenza is seasonal, with definite peaks in the winter months. This is why vaccines are offered from early autumn. If you think you may have influenza, there are now home-testing RATs: all current influenza RATs are in combination with COVID RATs, as the symptoms overlap. Treatment for most people is to manage symptoms and try to avoid spreading it around. Doctors can also <a href="https://theconversation.com/i-think-i-have-the-flu-should-i-ask-my-gp-for-antivirals-210457">prescribe antivirals</a> to vulnerable patients; these work best if started within 48 hours of symptoms. <h2>COVID</h2> It has been less than five years since COVID-19, caused by SARS-CoV-2, started to spread around the world in pandemic proportions. Although COVID is no longer a <a href="https://www.health.gov.au/news/ahppc-statement-end-of-covid-19-emergency-response">public health emergency</a>, it still causes <a href="https://www.abs.gov.au/articles/deaths-due-covid-19-influenza-and-rsv-australia-2022-may-2024">more deaths than influenza and RSV combined</a>. Unlike RSV and influenza, only those <a href="https://www.health.gov.au/topics/covid-19/protect-yourself-and-others/high-risk-groups">aged over 70</a> are in a high-risk age group for COVID. Other <a href="https://www.cdc.gov/covid/risk-factors/?CDC_AAref_Val=https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html">factors besides age</a> may put you at higher risk of becoming very unwell when infected by this virus. This includes having other respiratory diseases (such as asthma or chronic obstructive pulmonary disease, also known as COPD), diabetes, cancer, kidney disease, obesity or heart disease. Unlike most respiratory viruses, SARS-CoV-2 tends to set off inflammation beyond the respiratory system. This can involve a range of other organs including the heart, kidneys and blood vessels. Although most people are back to their usual work or study after a week or two, a significant proportion go on to experience extended symptoms such as fatigue, breathlessness, brain fog and mood changes. When these last <a href="https://aci.health.nsw.gov.au/statewide-programs/critical-intelligence-unit/post-acute-sequelae">more than 12 weeks</a>, without any other explanation for symptoms, it’s called <a href="https://www.healthdirect.gov.au/covid-19/post-covid-symptoms-long-covid">long COVID</a>. COVID vaccines can prevent serious illness and have been <a href="https://pubmed.ncbi.nlm.nih.gov/38282394/">monitored</a> for several years now for their safety and effectiveness. Current vaccination recommendations are <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024?language=en">based on age and immune status</a>. It’s worth discussing them with your doctor if you are unsure whether you would benefit or not. <a href="https://www.health.gov.au/topics/covid-19/oral-treatments">Antivirals</a> can treat COVID in higher-risk people who contract it, whether vaccinated or not. Specific advice about what to do if you test positive on a RAT will vary according to your current state guidelines and workplace, however the <a href="https://www.health.gov.au/topics/covid-19/testing-positive">general principles</a> are always: avoid spreading the virus to others, and give yourself time to rest and recover. <hr /> <iframe id="ConNR" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/ConNR/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>What if it’s not one of those?</h2> So you’ve done your combined RSV/flu/COVID RAT and the result is negative. But you still have symptoms. What else could it be? More than 200 different viruses can cause cold and flu symptoms, including rhinovirus (mentioned above), adenovirus and sometimes even <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130424/">undefined pathogens</a>. If an illness progresses to a cough which will not go away, and/or you start coughing up sputum, this could be a bacterial infection, such as pertussis (whooping cough), streptococcus pneumoniae, haemophilus influenzae or moraxella catarrhalis. So it’s worth <a href="https://www.racgp.org.au/getattachment/0a637812-c8f0-45a2-af9c-fa215b64f8e4/attachment.aspx">getting assessed by a GP</a> who may do a chest Xray and/or <a href="https://www.rcpa.edu.au/Manuals/RCPA-Manual/Pathology-Tests/M/MCS-sputum">test your sputum</a>, particularly if they suspect pneumonia. You also may also start out with what is clearly a viral infection but then get a secondary bacterial infection later. So if you are getting more unwell over time, it’s worth getting tested, in case antibiotics will help. However, taking antibiotics for a purely viral illness will not only be useless, it can contribute to harmful <a href="https://www.nps.org.au/consumers/antibiotic-resistance-the-facts">antibiotic resistance</a> and give you unwanted side effects.<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/234266/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond 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/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">original article</a>. </div>

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