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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

Readers response: What have you had to cut out of your life to cope with cost of living pressures?

As the cost of living continues to rise, many people have had to cut things out of their day to day spending to cope with the financial struggles. We asked our readers what they have had to cut out of their budgets to cope with cost of living pressures, and the response was overwhelming. Here's what they said. Wendy Oliver - We don’t eat out often at all… I spend too much in the supermarket. Christine Brooks - I've cut out steak, good nutritional foods, TV streaming, entertainment, haircuts, new clothes, pets, pool cleaning, and more. Kerrie Dare - I limit steak meals. I've stopped my haircuts to every 4 months. Internet is getting chopped. I can only afford exercise classes twice a week. I don't eat as much fruit as I used too. I only buy groceries when on special. One bottle of wine per fortnight. One slice of sourdough in the morning, which means the loaf lasts a week. I turn on my washing machine around every 10 days & I have quick showers. No eating out or take away. Maybe one cup of coffee per week with a friend. Movies once every 6 weeks as a social group. No concerts or clubs. I drive only locally, so a tank of petrol lasts 1 month. No weekends away. Jane Dawes - No coffees, beauty treatments, hairdresser, eating out, takeouts etc. The trouble is not affording to spend on certain items has a flow on effect for businesses. Everyone is suffering. Lois E. Fisk - Going out to eat or see movies in the cinema or live plays or new clothes. I shop at the least expensive grocery stores as much as possible, and good cuts of meat rarely happen. Janice Stenning - Don't go to the hairdressers as often and don't buy as many clothes. Debra Dugar - Thinking about dropping my extras cover of my insurance. By the time I pay for it, I can't afford the gap you have to pay. Robyn Lee - Living in my own house. I now live with my family. Rhondda Hughes - Well, petrol is expensive so I have to really think if I can afford to visit anyone. I can’t eat meat much and even vegetables can be expensive. We have three chickens so they give us eggs but good quality eggs and healthy chickens require money too. Fortunately I live in Perth so, in comparison to other states, it isn’t as cold however the cost of heating is a significant consideration and therefore I just tend to go to bed. <div style="font-family: inherit;">Felicity Jill Murphy - Stopped going out to shopping centres. That's where I spend money unnecessarily.</div> <div style="font-family: inherit;">Image credits: Shutterstock </div>

Money & Banking

Doting dad sells everything he owns to develop cure for son's "incurable" condition

A dedicated father has drained his life savings to help find a cure for his son's "incurable" disorder. Terry Pirovolakis, a 44-year-old IT director, was hellbent on finding a cure for his six-year-old son Michael after he was diagnosed with Spastic paraplegia 50 (SPG50): a degenerative neurological condition that affects less than 100 people worldwide. SPG50 affects children's development, leading to cognitive impairment, muscle weakness, and paralysis over the course several years, often ending in death usually before a patient reaches the age of 30. "They said he'd never walk or talk, and would need support for the rest of his life," he recalled of the 2018 diagnosis. "They told us to just go home and love him - and said he would be paralysed from the waist down by age 10, and quadriplegic by age 20," he continued. Determined to save his son, Terry drained his life savings to start researching potential cures rooted in gene therapy, after reading countless journals on the subject and meeting with experts around the world. Terry said, "We then liquidated our life savings, refinanced our home and paid a team at the University of Texas Southwestern Medical Center to create a proof of concept to start Michael's gene therapy." The father soon signed a contract to start a gene therapy program, consisting of injecting cerebral spinal fluid into the patient's back, and after years of lab work, the treatment started to take, and on December 30th 2021, the government <a id="mol-70453400-6948-11ef-9b54-1d20db350cbd" href="https://www.dailymail.co.uk/news/canada/index.html" target="_self"></a>moved it forward. "On March 24, 2022, my son was the first person to ever get treated with gene therapy at SickKids in Toronto," Pirovolakis, a father of three, told Fox News in detailing his medical odyssey. Michael was the first to receive his father's one-time treatment, after Pirovolakis quit his job and started a nonprofit in California to devote himself to the cause. The company, named Elpida Therapeutics, after the Greek word for 'hope', now has five employees and 20 consultants, with Michael now on the mend. Since being treated, the youngster's condition seems to have stabilised, and he is now able to use a device to communicate with his family and caregivers. Another three children who were able to receive the remaining doses from Pirovolakis' first batch, as the drug still costs about $1million to make for each child, are also seeing positive results. "When I heard that no one was going to do anything about it, I had to - I couldn't let them die," Pirovolakis said. "We decided that we had to help other kids." Despite it being approved, big pharmaceutical companies have been slow to manufacture the drug, with several firms rejecting the prospect when proposed, Pirovolakis said "No investor is going to give you money to treat a disease that is not going to make money," he said. "That's the dilemma we're in." Pirovolakis said that when his son was diagnosed, he was told the boy would be paralysed from the waist down by the age of ten and quadriplegic by the age of 20, forcing the father to do everything he can. "We were told he would never speak or walk, and that he will have severe developmental delays. I just couldn't accept that fate for my child," he said. "The technology to cure our children is already here. I hope that someone with immense wealth - and more importantly, the vision and influence - will step in." Image credits: Facebook

Money & Banking

"My heart is broken": Mariah Carey reveals sad double tragedy

Mariah Carey has revealed a devastating double tragedy, as both her mother and sister passed away on the same day. In a heartbreaking statement to <a href="https://people.com/mariah-carey-mom-patricia-sister-alison-both-died-same-day-exclusive-8701561" target="_blank" rel="noopener">People</a>, the singer announced the deaths of her mum Patricia, 87, and sister Alison, 63, who died over the weekend. Carey's statement read, "My heart is broken that I've lost my mother this past weekend. Sadly, in a tragic turn of events, my sister lost her life on the same day." "I feel blessed that I was able to spend the last week with my mom before she passed." "I appreciate everyone's love and support and respect for my privacy during this impossible time." No cause of death has been revealed for either member of the family. Carey famously had a turbulent relationship with her mother and sister over the years, and was estranged from Alison for three decades before her untimely death. In 2016, Alison, who was a recovering drug addict, made a plea to her famous sister through the Daily Mail to ask for support, saying, "Mariah I love you, I desperately need your help." As well as substance abuse, Alison endured homelessness throughout her life and tested positive for the HIV virus. Mariah opened up about complicated relationships with her mom and sister in her 2020 memoir, The Meaning Of Mariah Carey. "Like many aspects of my life, my journey with my mother has been full of contradictions and competing realities. It's never been only black-and-white — it's been a whole rainbow of emotions," she explained. She said their relationship was a "prickly rope of pride, pain, shame, gratitude, jealousy, admiration, and disappointment", however the book was still dedicated to Patricia. "And to Pat, my mother, who, through it all, I do believe actually did the best she could," the singer penned in the dedication. "I will love you the best I can, always." Image credits: Paul Archuleta/Shutterstock Editorial

Family & Pets

"My daughter was right": Gracious grandma praised for humble act

Watching your parents become grandparents is a beautiful experience, but it often comes with disagreements or differences in opinion in terms of how you are raising your kids. One grandma has gone viral for her wise words when it comes to navigating these differences. "If I don't agree with every little decision that my daughter makes for the baby, I usually don't say anything," TikTok user @mommom.maria, who frequently posts about being a grandma, shared recalled her most recent babysitting experience. "Sometimes I can't help myself, and when it came to this I couldn't help myself, I had to say something." She explained that her 13-month-old granddaughter has two bottles a day, one in the morning and one at night. "My husband and I were babysitting the other night and my daughter said to put her milk before bed in this," she said, holding up a sippy cup with a straw. The grandmother didn't think it was okay that her granddaughter was drinking out of a sippy cup that young, but admitted that it's not her decision to make. "I'm not the decision maker. I'm not the mum: I'm the Mum-Mum, the privileged Mum-Mum that gets to babysit her," she explained. She decided to respect her daughter's choices, and said that her granddaughter drank her milk with no issues. "So I guess my daughter was right, and that's really what I wanted to say to the other grandmothers: You don't have to agree, but you have to do it," she finished. Many have praised the grandmother for respecting her daughter's wishes, with the video gaining over 100k views. "Protect this sweet woman at all costs," commented one person. "Oh how I wish my MIL (mother in law) was like you," another added. "You are so emotionally mature about it. I'm so proud of you showing what respecting your children's right to parent looks like!" wrote a third. One woman also shared the way she approached parenting differences and replied, "I told my Mom and MIL this 'I'm not saying you're wrong with how you chose to do things with your kids. I just do things differently.' Helped a lot!" Images: TikTok

Family & Pets

My Kitchen Rules star dies at just 46

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

Caring

Woman “bullied” on plane over budget seating trick

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

Travel Trouble

Cancer diagnosis can be devastating, but for some it gives permission to live more radically

<a href="https://theconversation.com/profiles/kevin-dew-577291">Kevin Dew</a>, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/chris-cunningham-1534054">Chris Cunningham</a>, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>; <a href="https://theconversation.com/profiles/elizabeth-dennett-1532423">Elizabeth Dennett</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>; <a href="https://theconversation.com/profiles/kerry-chamberlain-103714">Kerry Chamberlain</a>, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>, and <a href="https://theconversation.com/profiles/richard-egan-400188">Richard Egan</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a> A diagnosis of life-limiting cancer can be overwhelming and cause feelings of panic and anxiety. But for some people, it provides a license to live life differently, including quitting toxic jobs and becoming more adventurous. In our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13797">recently published research</a>, we sought to understand the impact of a cancer diagnosis and subsequent experiences for cancer survivors. We talked with 81 New Zealanders (23 Māori and 58 non-Māori) who had lived longer than expected with a life-limiting or terminal diagnosis of cancer (four to 32 years since first diagnosis), and 25 people who were identified as their supporters. We found there are vastly different ways in which people experience and respond to a cancer diagnosis, but for some it’s a prompt to make significant changes. Of the 81 participants, 26 expressed the view, unsolicited, that cancer had some positive impact on their lives – without downplaying the negative impacts it could have as well. <h2>A licence to change</h2> Being told you only have limited time left to live can undoubtedly be a shock. But it can lead to profound change. It’s not uncommon for people who receive a serious diagnosis to draw up a “<a href="https://theconversation.com/paris-in-spring-bali-in-winter-how-bucket-lists-help-cancer-patients-handle-life-and-death-225682">bucket list</a>”. Some people in our study took the opportunity to travel or move to a new home. For others, the diagnosis provided a chance to rethink their lives and make more significant changes to the way they lived. They decided to be culturally more adventurous and to take up new skills. Many of these people quit their jobs or changed to jobs that suited them better. Many changed their relationships with the people around them. One talked about showing more affection for his children, another was kinder and stopped fretting over small things. Some decided to be more selective and no longer be around people who were negative. Others took up new hobbies or crafts which they felt were healing. For one person, the cancer diagnosis provided the impetus to look at things and people differently, which they thought would not have happened otherwise. Individuals could also undergo a transformation to become what they felt they were meant to be in life. One person, given two months to live, embraced rongoā (Māori traditional healing), including its spiritual side. They now love their “journey” and feel this was what they were “supposed to do”. For many, a diagnosis of cancer gave them license to be different people and to resist conforming to social norms, including having a job, being thrifty or not taking risks. <h2>Disrupting diagnoses</h2> One person, given only months to live, moved out of her flat, gave away her possessions, quit her job that she described was toxic, and returned home to say goodbye to her family. Most importantly for her, she worked on experiencing “joy” – after receiving the diagnosis, she realised she had lost it. But she continues to live many years later. After a while, she had to find a new flat, get a new job and the recovery of her joy was challenged: <blockquote> I had to start working again. And, of course, with working again, joy goes down, time goes down, rest goes down, spirituality goes down. </blockquote> But not everyone has the opportunity to change. Some peoples’ lives were limited because of the physical effects of the cancer, its treatment, or because of their personal, social or financial resources. Some go to great lengths to ensure their lives change as little as possible after diagnosis to maintain a sense of normality. <h2>Why we need to know</h2> Given the fear a cancer diagnosis can elicit, it is important to see there are different ways of responding. It is also worth knowing there are people who live longer than expected. Many people in our study were given just months to live, but one woman was still alive 12 years after being told she had a year left. Beyond that, this research documents how the disruption produced by a cancer diagnosis can prompt people to breach social norms. Where people have the capacity and resources to change, those around them and their health professionals can support them in taking opportunities to live life differently. We heard people say they think of their cancer as a friend or an amazing opportunity. Some even felt thankful. The possibility of cancer providing opportunities for some in no way diminishes the grief or a sense of loss, fear and anxiety that can accompany such diagnoses. Our research supports a reframing of cancer narratives, to consider ways of tempering the negative impacts of a diagnosis – while remaining cognisant of the struggle that can follow such news, and the variability in people’s capacity to engage with that struggle.<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/233782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kevin-dew-577291">Kevin Dew</a>, Professor of Sociology, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology & Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/chris-cunningham-1534054">Chris Cunningham</a>, Professor of Maori & Public Health, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>; <a href="https://theconversation.com/profiles/elizabeth-dennett-1532423">Elizabeth Dennett</a>, Associate Professor in Surgery, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>; <a href="https://theconversation.com/profiles/kerry-chamberlain-103714">Kerry Chamberlain</a>, Professor of Social and Health Psychology, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>, and <a href="https://theconversation.com/profiles/richard-egan-400188">Richard Egan</a>, Associate Professor in Health Promotion, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</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/cancer-diagnosis-can-be-devastating-but-for-some-it-gives-permission-to-live-more-radically-233782">original article</a>.

Body

"My days are numbered": Rod Stewart reveals candid thoughts on death

Sir Rod Stewart is one of the best-selling music artists of all time, and he's well aware he can't live forever. As he nears 80-years-old, the music legend shared his views on death, and how he knows his "days are numbered", but that won't stop him from toning down his rock 'n' roll lifestyle as he kicks off his last run of Las Vegas shows after 13 years of residency. "I'm aware my days are numbered but I've got no fear," he told The Sun. "We have all got to pass on at some point, so we are all in the same basket. "I am going to be enjoying myself for these last few years as much as I can. I say few — probably another 15. I can do that easy mate, easy," he added. He then admitted: "I'm not like I was in the '70s and '80s and I can't stay up all night, get drunk and go mad and still have a voice just like that. Nowadays I have to protect my voice before and after every show." The singer said he counts on staying hydrated to keep up with his performance demands as he got older, but he definitely has not vowed off the booze. "You're talking to Rod Stewart here, mate. We go mad after every show. There are 13 of us, six women, really great musicians and I make them drink. We absolutely love it," he said. Despite keeping up his party ways, the rock star is also very conscious of his health, after he revealed that he had experienced a private three-year battle with prostate cancer in 2019. "I am more aware of my health now than before. You should be when you start getting on a bit. It's very important," he said. The rock star said he works out three or four times a day with his personal trainer of three years who has been keeping him in check for over three decades. Images: Kiko Huesca/EPA-EFE/ Shutterstock Editorial

Family & Pets

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Migraine is many things, but one thing it’s not is “just a headache”. “Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided. Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function. Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.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/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands. In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect. <iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Aspirin For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication. Triptans For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”. Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack. However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers. <h2>What about preventing migraines?</h2> The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol. Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives. Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached. It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more. <hr /> <iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>‘Nothing works for me!’</h2> In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP. The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections. These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist. Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away. Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives. Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<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/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>. </div>

Body

"My little Spice Girl": Victoria Beckham's sweet tribute as daughter turns 13

David and Victoria Beckham's daughter has turned 13. On Wednesday July 10, the couple marked Harper's milestone birthday with a cute throwback video shared on Instagram. The sweet video — set to Bruno Mars’ Just The Way You Are — featured a compilation of footage of Harper through the years, from her taking her first steps to playing soccer with her dad. "Happy 13th Birthday to my beautiful little girl," David began in the caption. "Daddy is so proud of you, you have grown up to be a kind, generous & a beautiful young lady with the most amazing heart & the most amazing smile that we all love so so much," he continued. "Always be the beautiful person that you are. Harper Seven you're my world." <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C9Prtgjo_IN/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C9Prtgjo_IN/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by David Beckham (@davidbeckham)</a> </div> </blockquote> Victoria also shared a special tribute to her daughter, with the caption: “Happy Birthday to my best friend. You are sweet and kind and your smile warms our hearts every day 😊" "You really are our everything Harper Seven and we are so proud of the happy, beautiful, talented young lady you are becoming. We love you so so much ❤️❤️❤️❤️❤️❤️❤️❤️ " Victoria's celebrity friends took to the comments to share their birthday wishes. “Happy birthday beautiful Harper! We love you so much! ❤️,” wrote Victoria’s best friend Eva Longoria. “Happy birthday Harper, we love you to bits. Xx,” added Spice Girl bandmate Emma Bunton. Images: Instagram

Family & Pets

Take my (bad) breath away – causes of halitosis and how to check whether you have it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a> In Greek mythology, the many-headed beast <a href="https://mythopedia.com/topics/hydra">Hydra</a> had such severe <a href="https://patient.info/oral-dental-care/bad-breath-halitosis">halitosis</a> that the stench of its breath was deadly to anyone who smelled it. Thankfully, our morning breath might not be that pungent – although eating <a href="https://www.healthline.com/health/get-rid-of-garlic-onion-breath">onions or garlic</a> can put some people in competition with the Hydra. Halitosis has many causes (aside from poor oral hygiene) and can indicate problems with the gut, the sinuses and even the bloodstream. In fact, breath samples can even be tested to make formal diagnoses of health conditions. One condition that can affect the smell of breath is <a href="https://www.diabetes.org.uk/">diabetes mellitus</a>. This is a metabolic disorder where sugar (glucose) is unable to access the body’s cells where it is needed to provide energy, and so rises in the bloodstream. In some instances, such as insufficient insulin dosing, or infection, the body’s response is to break down fats into compounds called ketones to act as a rapid form of fuel. This serious condition is called <a href="https://www.nhs.uk/conditions/diabetic-ketoacidosis/">diabetic ketoacidosis</a>. Ketones have a distinctive scent. <a href="https://www.gov.uk/government/publications/acetone-properties-and-incident-management/acetone-general-information">Acetone</a>, which is also an ingredient in some nail varnish removers, is one of these ketones and has the smell of pear drops. When ketones build up in the bloodstream they easily <a href="https://iopscience.iop.org/article/10.1088/0967-3334/32/8/N01/pdf">diffuse into the breath</a>, giving it a <a href="https://www.medicalnewstoday.com/articles/319683">fruity odour</a>. It’s not just diabetes that can trigger ketone production. <a href="https://pubmed.ncbi.nlm.nih.gov/36033148/">Some diets</a> are based on generating ketones from the breakdown of fats to promote weight loss. These methods, such as the <a href="https://www.healthline.com/nutrition/atkins-diet-101">Atkins diet</a>, force the body to convert fat into energy by restricting carbohydrates. <figure><iframe src="https://www.youtube.com/embed/5U8IDO1fHlU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Other diets based on the same principles include the <a href="https://patient.info/healthy-living/weight-loss-weight-reduction/52-diet">5:2</a> intermittent fasting diet. On this diet, followers restrict food intake on two days of the week to significantly reduce calorie consumption – and make the body produce ketones. These diets may help weight loss, but the side-effects can be grim. One of the most notorious side-effects is foul breath, although there are also anecdotal reports of <a href="https://www.forbes.com/sites/brucelee/2019/03/03/is-keto-crotch-really-a-side-effect-of-the-keto-diet/">“keto crotch”</a> where some followers of keto diets complain of strong genital odour. <h2>Bacteria and breath</h2> Another cause of bad breath is an <a href="https://iopscience.iop.org/article/10.1088/1752-7155/4/1/017003/pdf">overgrowth of bacteria</a> that produce foul smells. There are plenty of nooks and crannies in the mouth for bacteria to hide, grow and fester, especially the hard-to-clean areas – in between the teeth, and in and around the gums and tongue – or out-of-reach places, such as right at the back of the mouth and the throat. The throat acts as a passage for food, fluids and air. Some patients can develop a condition called <a href="https://www.entuk.org/patients/conditions/49/pharyngeal_pouch_surgery_new">pharyngeal pouch</a>. This is where a pocket forms at the back of the pharynx (the medical name for the throat) in which food and fluids can accumulate, ferment and give breath a pungent odour. Bacteria can also trigger infections in the mouth, like tonsillitis and tooth abscesses where tissues become inflamed, or develop purulence (production of pus). Pus is a collection of different dead cells, including bacteria, and it too can give off a putrid smell. Also, <a href="https://pubmed.ncbi.nlm.nih.gov/25234037/">sinusitis</a> – which is an infection of the air-filled cavities in the skull – can drip foul-smelling infected secretions into the throat, causing bad breath. <h2>Breath tests</h2> Doctors can test breath for bacteria to diagnose some health conditions. For example, <a href="https://pubmed.ncbi.nlm.nih.gov/28891138/">Helicobacter pylori</a>, bacteria that can irritate the gut and lead to the development of potentially dangerous ulcers, turns the compound urea into carbon dioxide. To test for H pylori, a <a href="https://www.nhs.uk/conditions/stomach-ulcer/diagnosis/">diagnostic breath test</a> is performed before and after dosing a patient with urea. If the patient exhales increased levels of carbon dioxide after being dosed with urea, then the test is positive. Breath can also be tested for an overgrowth of bacteria in the <a href="https://www.healthline.com/health/sibo">small intestine</a> (Sibo), which can lead to symptoms like abdominal pain and bloating. Sibo produces gases like hydrogen and methane that can also be detected with a breath test. If you’re worried about pongy breath and don’t have any medical issues, then you can <a href="https://www.healthline.com/health/dental-and-oral-health/how-to-smell-your-own-breath">test your own breath</a>. The age-old method is to lick the back of your wrist, let it dry and then have a sniff. You can also do the same with a tongue scraper, dental floss or a sample of breath exhaled into a cupped hand. <figure><iframe src="https://www.youtube.com/embed/ak5UEM8FK2s?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Often, we can become used to the smell of our own breath. We might only notice when it becomes really bad, or when there are other symptoms, like a foul taste in the mouth. Or when someone plucks up the courage to finally tell you that you have a case of the breath pongs. Suppose someone has broken the news – what do you do now? <a href="https://www.nhs.uk/conditions/bad-breath/">Simple measures can work well</a>, including regular fluid intake – <a href="https://www.dentalhealth.org/bad-breath">dry mouth</a> can lead to bad breath so make sure you’re drinking enough water – and good oral hygiene. This involves brushing the teeth, tongue and flossing between your teeth to eliminate any bacterial hot spots, as well as regular checkups at the dentist. Mouthwash can be an effective temporary solution but there’s evidence that a <a href="https://theconversation.com/eating-leafy-greens-could-be-better-for-oral-health-than-using-mouthwash-221181#:%7E:text=But%20research%20has%20indicated%20that,alternative%20for%20treating%20oral%20disease.">diet rich in leafy greens</a> might be even better at countering bad breath. Smoking is another potential underlying <a href="https://www.healthline.com/health/how-to-get-rid-of-cigarette-breath#1-brush-teeth">cause of halitosis</a>. So if you want sweeter breath, pack in the cigarettes – yet another good reason to give up.<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/231858/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/take-my-bad-breath-away-causes-of-halitosis-and-how-to-check-whether-you-have-it-231858">original article</a>. </div>

Body

Pioneering TV presenter reveals terminal diagnosis live on air

Popular New Zealand TV presenter Joanna Paul-Robie has revealed she is dying of cancer. The pioneering presenter, known for her work on TV3, shared the heartbreaking news during an interview with Radio New Zealand on Friday morning. Paul-Robie, who has been a beloved figure in the broadcasting world, made the announcement while accepting the Icon Award for her contributions to the creative industries. “I was so touched because this award means so much to me, coming from Tauranga Moana,” she said. “But more importantly, because I am, unfortunately, dying – I have terminal cancer – and really to have this award before one posthumously gets it is an even better break. I can’t tell you the lightness, the brightness, the feeling of aroha inside me last night.” Reflecting on her career, Paul-Robie recounted her experiences as one of the few Māori individuals on New Zealand's television screens. “The newsroom was really … it was being run by mostly a pair of middle-class, middle-aged white men who had the audacity and the balls to say ‘If it bleeds, it leads’ but these guys you know they had never been in a Māori world,” she remarked. Starting her career at Radio New Zealand, Paul-Robie later became a newsreader for TV3 and played a significant role in establishing Māori Television in 2004, serving as a program and production manager. During a 2011 interview with NZOnScreen, she spoke about the challenges and triumphs of setting up the network. “There’s been a handful of people in the world who have built a television station and taken it to air,” she said. “There are only a handful of people in the world who can do that and even though it nearly broke me in half on the day that we launched, I thought ‘hell we did that’. I think it is difficult for someone like me with an A-type personality to think now you have done your big thing maybe you should take it easy now.” Paul-Robie's courage and dedication have left an indelible mark on New Zealand's broadcasting landscape. Her announcement has been met with an outpouring of support and love from colleagues, fans and the wider community, who admire her strength and resilience in the face of such a personal battle. Images: NZOnScreen

Caring

I’ve been diagnosed with cancer. How do I tell my children?

<a href="https://theconversation.com/profiles/cassy-dittman-1380541">Cassy Dittman</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/govind-krishnamoorthy-1467986">Govind Krishnamoorthy</a>, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a>, and <a href="https://theconversation.com/profiles/marg-rogers-867368">Marg Rogers</a>, <a href="https://theconversation.com/institutions/university-of-new-england-919">University of New England</a> With around <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/cancer/2022">one in 50 adults</a> diagnosed with cancer each year, many people are faced with the difficult task of sharing the news of their diagnosis with their loved ones. Parents with cancer may be most <a href="https://www.sciencedirect.com/science/article/pii/S1462388914000994">worried about</a> telling their children. It’s best to give children factual and age-appropriate information, so children don’t create their own explanations or <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33202-1/fulltext">blame themselves</a>. Over time, supportive family relationships and open communication <a href="https://link.springer.com/article/10.1007/s00520-016-3214-2">help children adjust</a> to their parent’s diagnosis and treatment. It’s natural to feel you don’t have the <a href="https://onlinelibrary.wiley.com/doi/10.1111/ecc.12018">skills or knowledge</a> to talk with your children about cancer. But preparing for the conversation can improve your confidence. <h2>Preparing for the conversation</h2> Choose a suitable time and location in a place where your children feel comfortable. Turn off distractions such as screens and phones. For teenagers, who can find face-to-face conversations confronting, think about talking while you are going for a walk. Consider if you will tell all children at once or separately. Will you be the only adult present, or will having another adult close to your child be helpful? Another adult might give your children a person they can talk to later, especially to answer questions they might be worried about asking you. Finally, plan what to do after the conversation, like doing an activity with them that they enjoy. Older children and teenagers might want some time alone to digest the news, but you can suggest things you know they like to do to relax. Also consider what you might need to support yourself. <h2>Preparing the words</h2> Parents might be worried about the <a href="https://www.bmj.com/content/321/7259/479.full.pdf+html">best words or language</a> to use to make sure the explanations are at a level their child understands. Make a plan for what you will say and take notes to stay on track. The toughest part is likely to be saying to your children that you have cancer. It can help to practise saying those words out aloud. Ask family and friends for their feedback on what you want to say. <a href="https://www.cancer.org.au/cancer-information/types-of-cancer/childhood-cancers/talking-to-kids-about-cancer">Make use of guides</a> by the Cancer Council, which provide age-appropriate wording for explaining medical terms like “cancer”, “chemotherapy” and “tumour”. <h2>Having the conversation</h2> Being open, honest and factual is important. Consider the balance between being too vague, and providing too much information. The <a href="https://www.sciencedirect.com/science/article/pii/S1462388914000994">amount and type</a> of information you give will be based on their age and previous experiences with illness. Remember, if things don’t go as planned, you can always try again later. Start by telling your children the news in a few short sentences, describing what you know about the diagnosis in language suitable for their age. Generally, this information will include the name of the cancer, the area of the body affected and what will be involved in treatment. Let them know what to expect in the coming weeks and months. Balance hope with reality. For example: <blockquote> The doctors will do everything they can to help me get well. But, it is going to be a long road and the treatments will make me quite sick. </blockquote> Check what your child knows about cancer. Young children may not know much about cancer, while primary school-aged children are starting to understand that it is a <a href="https://journals.sagepub.com/doi/epdf/10.1177/0165025408093663">serious illness</a>. Young children may worry about becoming unwell themselves, or other loved ones becoming sick. Older children and teenagers may have experiences with cancer through other family members, friends at school or social media. This process allows you to correct any misconceptions and provides opportunities for them to ask questions. Regardless of their level of knowledge, it is important to reassure them that the cancer is not their fault. Ask them if there is anything they want to know or say. Talk to them about what will stay the same as well as what may change. For example: <blockquote> You can still do gymnastics, but sometimes Kate’s mum will have to pick you up if I am having treatment. </blockquote> If you can’t answer their questions, be OK with saying “I’m not sure”, or “I will try to find out”. Finally, tell children you love them and offer them comfort. <h2>How might they respond?</h2> Be prepared for a range of <a href="https://link.springer.com/article/10.1007/s00520-016-3214-2">different responses</a>. Some might be distressed and cry, others might be angry, and some might not seem upset at all. This might be due to shock, or a sign they need time to process the news. It also might mean they are trying to be brave because they don’t want to upset you. Children’s reactions will change over time as they come to terms with the news and process the information. They might seem like they are happy and coping well, then be teary and clingy, or angry and irritable. Older children and teenagers may ask if they can tell their friends and family about what is happening. It may be useful to come together as a family to discuss how to inform friends and family. <h2>What’s next?</h2> Consider the conversation the first of many ongoing discussions. Let children know they can talk to you and ask questions. Resources might also help; for example, The Cancer Council’s <a href="https://www.campquality.org.au/kids-guide-to-cancer/">app for children and teenagers</a> and Redkite’s <a href="https://www.redkite.org.au/service/book-club/">library of free books</a> for families affected by cancer. If you or other adults involved in the children’s lives are concerned about how they are coping, speak to your GP or treating specialist about options for psychological support.<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/228012/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cassy-dittman-1380541">Cassy Dittman</a>, Senior Lecturer/Head of Course (Undergraduate Psychology), Research Fellow, Manna Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/govind-krishnamoorthy-1467986">Govind Krishnamoorthy</a>, Senior Lecturer, School of Psychology and Wellbeing, Post Doctoral Fellow, Manna Institute, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a>, and <a href="https://theconversation.com/profiles/marg-rogers-867368">Marg Rogers</a>, Senior Lecturer, Early Childhood Education; Post Doctoral Fellow, Manna Institute, <a href="https://theconversation.com/institutions/university-of-new-england-919">University of New England</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-diagnosed-with-cancer-how-do-i-tell-my-children-228012">original article</a>.

Family & Pets

"Do not cry for me": Teacher announces own death

A teacher and mum-of-two who chronicled her breast cancer journey online has announced her own death, through a social media post written before her passing. "If you're reading this, it means I have died," Kate Rackham, 45, shared on her Teacher With Cancer X account. "But do not cry for me. I have lived my life on my own terms, the way I have wanted to." The mum told her followers that she joined X, formerly Twitter, as she "needed an outlet", but "what I got was so much more". "You made me feel validated in my feelings and much less alone. Thank you." <blockquote class="twitter-tweet"> If you’re reading this, it means I have died. But do not cry for me. I have lived my life on my own terms, the way I have wanted to. I joined X because I needed an outlet, what I got was so much more. You made me feel validated in my feelings and much less alone. Thank you ❤️ — Teacher with Cancer (@kate_rackham) <a href="https://twitter.com/kate_rackham/status/1801137648146243756?ref_src=twsrc%5Etfw">June 13, 2024</a></blockquote> The British mum was only 39 when she was diagnosed with incurable oestrogen-receptive breast cancer and spent the past six years fighting the disease. She began documenting her journey online, and explained that she had no obvious risk factors leading to the disease. Just before her passing, she was admitted into hospital and was told by doctors that "there is nothing more we can do" and that she "needed a bit of time" to process the news. "I'm now home, where I want to be. With Mark and the girls. Surrounded by love, family and friends," she shared at the time. "Everyone is rallying around and I have so much support. Despite everything I feel blessed." Many have shared their condolences, including friends and those who are also battling breast cancer. "When my time comes, I can but hope I display the dignity and strength of character you did. Much love and condolences to your family and friends," one wrote. "I hope you are free from the pain. You still live in your children your husband. Your legacy," another said. "Thank you for sharing your journey with grace and dignity," a third added. "I hope wherever you are you are no longer in pain. Sending love and thoughts to your family." Rackham is survived by her husband Mark and their two daughters Ruby and Nancy. Images: X/ Nine

Caring

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

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

Body

Why it’s still a scientific mystery how some can live past 100 – and how to crack it

<a href="https://theconversation.com/profiles/richard-faragher-224976">Richard Faragher</a>, <a href="https://theconversation.com/institutions/university-of-brighton-942">University of Brighton</a> and <a href="https://theconversation.com/profiles/nir-barzilai-1293752">Nir Barzilai</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a> A 35-year-old man <a href="https://pubmed.ncbi.nlm.nih.gov/18544745/">only has a 1.5% chance of dying in the next ten years</a>. But the same man at 75 has a 45% chance of dying before he reaches 85. Clearly, ageing is bad for our health. On the bright side, we have made unprecedented progress in understanding the fundamental mechanisms that control ageing and late-life disease. A few tightly linked biological processes, sometimes called the <a href="https://pubmed.ncbi.nlm.nih.gov/23746838/">“hallmarks of ageing”</a>, including our supply of stem cells and communication between cells, act to keep us healthy in the early part of our lives – with <a href="https://theconversation.com/the-secret-to-staying-young-scientists-boost-lifespan-of-mice-by-deleting-defective-cells-54068">problems arising as these start to fail</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/34699859/">Clinical trials are ongoing</a> to see if targeting some of these hallmarks can improve <a href="https://pubmed.ncbi.nlm.nih.gov/31542391/">diabetic kidney disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29997249/">aspects of</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33977284/">immune function</a> and age-related <a href="https://pubmed.ncbi.nlm.nih.gov/30616998/">scarring of the lungs</a> among others. So far, so good. Unfortunately, big, unanswered questions remain in the biology of ageing. To evaluate what these are and how to address them, the <a href="https://www.afar.org/">American Federation For Aging Research</a>, a charity, recently convened a series of <a href="https://www.afar.org/imported/AFAR_GeroFuturesThinkTankReport_November2021.pdf">meetings for leading scientists and doctors</a>. The experts agreed that understanding what is special about the biology of humans who survive more than a century is now a key challenge. These centenarians <a href="https://www.statista.com/chart/18826/number-of-hundred-year-olds-centenarians-worldwide/">comprise less than 0.02% of the UK population</a> but have exceeded the life expectancy of their peers by almost 50 years (babies born in the 1920s typically had a life expectancy of less than 55). How are they doing it? We know that centenarians live so long because they are unusually healthy. They remain in good health for about 30 years longer than most normal people and when they finally fall ill, they are only sick for a very short time. This <a href="https://pubmed.ncbi.nlm.nih.gov/27377170/">“compression of morbidity”</a> is clearly good for them, but also benefits society as a whole. In the US, the medical care costs for a centenarian in their last two years of life <a href="https://www.cdc.gov/nchs/data/series/sr_10/sr10_198.pdf">are about a third of those of someone who dies in their seventies</a> (a time when most centenarians don’t even need to see a doctor). The children of centenarians are also much healthier than average, indicating they are inheriting something beneficial from their parents. But is this genetic or environmental? <h2>Centenarians aren’t always health conscious</h2> Are centenarians the poster children for a healthy lifestyle? For the general population, watching your weight, not smoking, drinking moderately and eating at least five servings of fruit and vegetables a day can <a href="https://pubmed.ncbi.nlm.nih.gov/27296932/">increase life expectancy by up to 14 years</a> compared with someone who does none of these things. This difference <a href="https://publications.parliament.uk/pa/ld5801/ldselect/ldsctech/183/18305.htm#_idTextAnchor012">exceeds that seen</a> between the least and most deprived areas in the UK, so intuitively it would be expected to play a role in surviving for a century. But astonishingly, this needn’t be the case. <a href="https://pubmed.ncbi.nlm.nih.gov/21812767/">One study</a> found that up to 60% of Ashkenazi Jewish centenarians have smoked heavily most of their lives, half have been obese for the same period of time, less than half do even moderate exercise and under 3% are vegetarians. The children of centenarians appear no more health conscious than the general population either. Compared to peers with the same food consumption, wealth and body weight, however, <a href="https://pubmed.ncbi.nlm.nih.gov/29050682/">they have half the prevalence of cardiovascular disease</a>. There is something innately exceptional about these people. <h2>The big secret</h2> Could it be down to rare genetics? If so, then there are two ways in which this could work. Centenarians might carry unusual genetic variants that extend lifespan, or instead they might lack common ones that cause late-life disease and impairment. Several studies, including our own work, <a href="https://pubmed.ncbi.nlm.nih.gov/32860726/">have shown</a> that centenarians have just as many bad genetic variants as the general population. Some even carry two copies of the largest known common risk gene for Alzheimer’s disease (APOE4), but still don’t get the illness. So a plausible working hypothesis is that centenarians carry rare, beneficial genetic variations rather than a lack of disadvantageous ones. And the best available data is consistent with this. Over 60% of centenarians have genetic changes that alter the genes which regulate growth in early life. This implies that these remarkable people are human examples of a type of lifespan extension observed in other species. Most people know that <a href="https://pubmed.ncbi.nlm.nih.gov/28803893/">small dogs tend to live longer than big ones</a> but fewer are aware that this is a general phenomenon across the animal kingdom. <a href="https://pubmed.ncbi.nlm.nih.gov/26857482/">Ponies can live longer than horses</a> and many strains of laboratory mice with dwarfing mutations <a href="https://pubmed.ncbi.nlm.nih.gov/29653683/">live longer than their full-sized counterparts</a>. One potential cause of this is reduced levels of a growth hormone called IGF-1 – although human centenarians <a href="https://pubmed.ncbi.nlm.nih.gov/28630896/">are not necessarily shorter than the rest of us</a>. Obviously, growth hormone is necessary early on in life, but there is increasing evidence that high levels of IGF-1 in mid to late life <a href="https://pubmed.ncbi.nlm.nih.gov/18316725/">are associated with increased late-life illness</a>. The detailed mechanisms underlying this remain an open question, but even among centenarians, women with the lowest levels of growth hormone <a href="https://pubmed.ncbi.nlm.nih.gov/24618355/">live longer than those with the highest</a>. They also have better cognitive and muscle function. That doesn’t solve the problem, though. Centenarians are also different from the rest of us in other ways. For example, they tend to have good cholesterol levels – hinting there may several reasons for their longevity. Ultimately, centenarians are “natural experiments” who show us that it is possible to live in excellent health even if you have been dealt a risky genetic hand and chose to pay no attention to health messages – but only if you carry rare, poorly understood mutations. Understanding exactly how these work should allow scientists to develop new drugs or other interventions that target biological processes in the right tissues at the right time. If these become a reality perhaps more of us than we think will see the next century in. But, until then, don’t take healthy lifestyle tips from centenarians.<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/172020/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/richard-faragher-224976">Richard Faragher</a>, Professor of Biogerontology, <a href="https://theconversation.com/institutions/university-of-brighton-942">University of Brighton</a> and <a href="https://theconversation.com/profiles/nir-barzilai-1293752">Nir Barzilai</a>, Professor of Medicine and Genetics, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</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-its-still-a-scientific-mystery-how-some-can-live-past-100-and-how-to-crack-it-172020">original article</a>.

Retirement Life

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

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

Caring

How do I keep my fruit, veggies and herbs fresh longer? Are there any ‘hacks’?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/senaka-ranadheera-199225">Senaka Ranadheera</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> We all know <a href="https://theconversation.com/frozen-canned-or-fermented-when-you-cant-shop-often-for-fresh-vegetables-what-are-the-best-alternatives-131678">fresh produce is good for us</a>, but fruit, vegetables and herbs have a tendency to perish quickly if left uneaten. This is because <a href="https://www.sciencedirect.com/science/article/abs/pii/S2212429219305188">even after harvesting</a>, produce from living plants tends to continue its biological processes. This includes respiration: producing energy from stored carbohydrates, proteins and fats while releasing carbon dioxide and water vapour. (Ever found a sprouting potato in your pantry?) On top of that, fresh produce also <a href="https://www.mdpi.com/journal/agriculture/special_issues/quality_safety_fresh_produce">spoils easily thanks to various microbes</a> – both harmless and ones that can cause disease, called pathogens. Simply chucking things in the fridge won’t solve the problem, as different types of plants will react differently to how they’re stored. So, how can you combat food waste and keep produce fresh for longer? Fortunately, there are some helpful tips. <h2>Freshness and quality begin at the farm</h2> Farmers always aim to harvest produce when it’s at an optimal condition, but both pre-harvest and post-harvest factors will affect freshness and quality even before you buy it. Pre-harvest factors are agricultural, such as climatic conditions, soil type and water availability. <a href="https://www.sciencedirect.com/science/article/abs/pii/S2212429219305188">Post-harvest factors</a> include washing and cleaning after harvesting, transportation and distribution, processing and packaging, and storage. As consumers we can’t directly control these factors – sometimes the veggies we buy just won’t be as good. But we can look out for things that will affect the produce once we bring it home. One major thing to look out for is bruised, wounded or damaged produce. This can happen at any stage of post-harvest handling, and can really speed up the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0308814609001411">decay of your veggies and fruit</a>. Moisture loss through damaged skin speeds up deterioration and nutrient loss. The damage also makes it easier for <a href="https://www.sciencedirect.com/science/article/pii/S2468014119301943">spoilage microbes</a> to get in. <h2>To wash or not to wash?</h2> You don’t need to wash your produce before storing it. A lot of what we buy has already been washed commercially. In fact, if you wash your produce and can’t get it completely dry, the added moisture could speed up decay in the fridge. But washing produce <a href="https://theconversation.com/do-we-really-have-to-wash-fruit-and-vegetables-53039">just before you use it</a> is important to remove dirt and pathogenic bugs. Don’t use vinegar in your washing water despite what you see on social media. Studies indicate <a href="https://pubmed.ncbi.nlm.nih.gov/16496573/">vinegar has no effect</a> on lowering microbial loads on fresh produce. Similarly, don’t use baking soda. Even though there’s some evidence baking soda <a href="https://pubs.acs.org/doi/10.1021/acs.jafc.7b03118">can remove pesticide residues</a> from the surface of some produce, it’s not advisable at home. Just use plain tap water. <h2>Location, location, location</h2> The main thing you need is the correct type of packaging and the correct location – you want to manage moisture loss, decay and ripening. The three main storage options are on the counter, in the fridge, or in a “cool, dry and dark place”, such as the pantry. Here are some common examples of produce and where best to put them. Bananas, onion, garlic, potatoes, sweet potato and whole pumpkin will do better in a dark pantry or cupboard. Don’t store potatoes and onions together: onions produce a gas called ethylene that makes potatoes spoil quicker, while the high moisture in potatoes spoils onions. In fact, don’t store fruits such as apples, pears, avocado and bananas together, because these fruits <a href="https://www.tandfonline.com/doi/full/10.1080/15538362.2013.748378#:%7E:text=%27Malindi%27%20had%20higher%20respiration%20rates,retention%20in%20fruit%20during%20ripening">release ethylene gas</a> as they ripen, making nearby fruits ripen (and potentially spoil) much faster. That is, unless you do want to ripen your fruits fast. All leafy greens, carrots, cucumbers, cauliflower and broccoli will do best in the low-humidity drawer (crisper) in the fridge. You can put them in perforated plastic bags to retain moisture but maintain air flow. But don’t put them in completely sealed bags because this can slow down ripening while <a href="https://ucanr.edu/sites/hdnmastergardeners/files/338860.pdf">trapping carbon dioxide</a>, leading to decay and bad smells. Some fruits will also do best in the fridge. For example, apples and citrus fruits such as oranges can keep fresh longer in the fridge (crisper drawer), although they can stay at room temperature for short periods. However, don’t store watermelon in the fridge for too long, as it will lose its flavour and deep red colour if kept refrigerated <a href="https://ucanr.edu/sites/hdnmastergardeners/files/338860.pdf">for longer than three days</a>. Most herbs and some leafy vegetables – like celery, spring onions and asparagus – can be kept with stems in water to keep them crisp. Keep them in a well-ventilated area and away from direct sunlight, so they don’t get too warm and wilt. <figure><iframe src="https://www.youtube.com/embed/cHu10C1DAds?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Experimenting at home is a good way to find the best ways to store your produce.</figcaption></figure> <h2>Fight food waste and experiment</h2> Don’t buy too much. Whenever possible, buy only small amounts so that you don’t need to worry about keeping them fresh. Never buy bruised, wounded or damaged produce if you plan to keep it around for more than a day. “Process” your veggies for storage. If you do buy a large quantity – maybe a bulk option was on sale – consider turning the produce into something you can keep for longer. For example, banana puree made from really ripe bananas can be <a href="https://www.sciencedirect.com/science/article/abs/pii/S0023643817300853">stored for up to 14 days at 4°C</a>. You can use <a href="https://theconversation.com/frozen-canned-or-fermented-when-you-cant-shop-often-for-fresh-vegetables-what-are-the-best-alternatives-131678">freezing, blanching, fermentation and canning</a> for most vegetables. Consider vacuum sealing. Vacuum packaging of vegetables and berries can keep them fresh longer, as well. For example, vacuum-sealed beans can keep up to 16 months in the fridge, but will last only about <a href="https://www.vacpac.com.au/vacuum-sealed-life-expectancy-how-long-will-my-vacuum-sealed-products-last">four weeks in the fridge unsealed</a>. Keep track. Arrange your fridge so you can see the produce easily and use it all before it loses freshness. Experiment with storage hacks. Social media is full of tips and hacks on how best to store produce. Turn your kitchen into a lab and try out any tips you’re curious about – they might just work. You can even use these experiments as a way to teach your kids about the importance of reducing food waste. Grow some of your own. This isn’t <a href="https://theconversation.com/growing-your-own-food-and-foraging-can-help-tackle-your-ballooning-grocery-bill-heres-how-216264">feasible for all of us</a>, but you can always try having some herbs in pots so you don’t need to worry about keeping them fresh or using up a giant bunch of mint all at once. <a href="https://theconversation.com/health-check-are-microgreens-better-for-you-than-regular-greens-73950">Growing your own microgreens</a> could be handy, too.<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/226763/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/senaka-ranadheera-199225">Senaka Ranadheera</a>, Associate Professor, <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/how-do-i-keep-my-fruit-veggies-and-herbs-fresh-longer-are-there-any-hacks-226763">original article</a>. </div>

Food & Wine

Cost of living: if you can’t afford as much fresh produce, are canned veggies or frozen fruit just as good?

<a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> The cost of living crisis is affecting how we spend our money. For many people, this means tightening the budget on the weekly supermarket shop. One victim may be fresh fruit and vegetables. Data from the <a href="https://www.abs.gov.au/media-centre/media-releases/australians-consuming-fewer-vegetables-fruit-and-less-milk#:%7E:text=Paul%20Atyeo%2C%20ABS%20health%20statistics,278%20to%20267%20to%20grams.%E2%80%9D">Australian Bureau of Statistics</a> (ABS) suggests Australians were consuming fewer fruit and vegetables in 2022–23 than the year before. The cost of living is likely compounding a problem that exists already – on the whole, Australians don’t eat enough fruit and vegetables. <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">Australian dietary guidelines</a> recommend people aged nine and older should consume <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/fruit">two</a> serves of fruit and <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/vegetables-and-legumes-beans">five</a> serves of vegetables each day for optimal health. But in 2022 the <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/dietary-behaviour/latest-release">ABS reported</a> only 4% of Australians met the recommendations for both fruit and vegetable consumption. Fruit and vegetables are crucial for a healthy, balanced diet, providing a range of <a href="https://theconversation.com/were-told-to-eat-a-rainbow-of-fruit-and-vegetables-heres-what-each-colour-does-in-our-body-191337">vitamins</a> and minerals as well as fibre. If you can’t afford as much fresh produce at the moment, there are other ways to ensure you still get the benefits of these food groups. You might even be able to increase your intake of fruit and vegetables. <h2>Frozen</h2> Fresh produce is often touted as being the most nutritious (think of the old adage “fresh is best”). But this is not necessarily true. Nutrients can decline in transit from the paddock to your kitchen, and while the produce is stored in your fridge. Frozen vegetables may actually be higher in some nutrients such as <a href="https://pubmed.ncbi.nlm.nih.gov/25526594/">vitamin C and E</a> as they are snap frozen very close to the time of harvest. Variations in transport and storage can affect this slightly. <a href="https://pubs.acs.org/doi/10.1021/jf504890k">Minerals</a> such as calcium, iron and magnesium stay at similar levels in frozen produce compared to fresh. Another advantage to frozen vegetables and fruit is the potential to reduce food waste, as you can use only what you need at the time. As well as buying frozen fruit and vegetables from the supermarket, you can freeze produce yourself at home if you have an oversupply from the garden, or when produce may be cheaper. A <a href="https://www.growveg.com.au/guides/freezing-vegetables-and-herbs-the-garden-foodie-version/">quick blanching</a> prior to freezing can improve the safety and quality of the produce. This is when food is briefly submerged in boiling water or steamed for a short time. Frozen vegetables won’t be suitable for salads but can be eaten roasted or steamed and used for soups, stews, casseroles, curries, pies and quiches. Frozen fruits can be added to breakfast dishes (with cereal or youghurt) or used in cooking for fruit pies and cakes, for example. <h2>Canned</h2> Canned vegetables and fruit similarly often offer a cheaper alternative to fresh produce. They’re also very convenient to have on hand. The <a href="https://nchfp.uga.edu/how/can#gsc.tab=0">canning process</a> is the preservation technique, so there’s no need to add any additional preservatives, including salt. Due to the cooking process, levels of heat-sensitive nutrients <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jsfa.2825">such as vitamin C</a> will decline a little compared to fresh produce. When you’re using canned vegetables in a hot dish, you can add them later in the cooking process to reduce the amount of nutrient loss. To minimise waste, you can freeze the portion you don’t need. <h2>Fermented</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723656/">Fermentation</a> has recently come into fashion, but it’s actually one of the oldest food processing and preservation techniques. Fermentation largely retains the vitamins and minerals in fresh vegetables. But fermentation may also enhance the food’s nutritional profile by creating new nutrients and allowing existing ones to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9352655/">absorbed more easily</a>. Further, fermented foods contain probiotics, which are beneficial for our <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051273/">gut microbiome</a>. <h2>5 other tips to get your fresh fix</h2> Although alternatives to fresh such as canned or frozen fruit and vegetables are good substitutes, if you’re looking to get more fresh produce into your diet on a tight budget, here are some things you can do. 1. Buy in season Based on supply and demand principles, buying local seasonal vegetables and fruit will always be cheaper than those that are imported out of season from other countries. 2. Don’t shun the ugly fruit and vegetables Most supermarkets now sell “ugly” fruit and vegetables, that are not physically perfect in some way. This does not affect the levels of nutrients in them at all, or their taste. 3. Reduce waste On average, an Australian household throws out <a href="https://www.ozharvest.org/food-waste-facts/">A$2,000–$2,500</a> worth of food every year. Fruit, vegetables and bagged salad are the <a href="https://www.ozharvest.org/food-waste-facts/">three of the top five foods</a> thrown out in our homes. So properly managing fresh produce could help you save money (and benefit <a href="https://endfoodwaste.com.au/why-end-food-waste/">the environment</a>). To minimise waste, plan your meals and shopping ahead of time. And if you don’t think you’re going to get to eat the fruit and vegetables you have before they go off, freeze them. 4. Swap and share There are many websites and apps which offer the opportunity to swap or even pick up free fresh produce if people have more than they need. Some <a href="https://www.charlessturt.sa.gov.au/environment/sustainable-lifestyles/community-fruit-and-vege-swaps">local councils are also encouraging</a> swaps on their websites, so dig around and see what you can find in your local area. 5. Gardening Regardless of how small your garden is you can always <a href="https://www.gardeningaustraliamag.com.au/best-vegies-grow-pots/">plant produce in pots</a>. Herbs, rocket, cherry tomatoes, chillies and strawberries all grow well. In the long run, these will offset some of your cost on fresh produce. Plus, when you have put the effort in to grow your own produce, <a href="https://mdpi-res.com/sustainability/sustainability-07-02695/article_deploy/sustainability-07-02695.pdf?version=1425549154">you are less likely to waste it</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/229724/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/cost-of-living-if-you-cant-afford-as-much-fresh-produce-are-canned-veggies-or-frozen-fruit-just-as-good-229724">original article</a>.

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