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Balance declines with age, but exercise can help stave off some of the risk of falling

<a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a> My wife and I were in the grocery store recently when we noticed an older woman reaching above her head for some produce. As she stretched out her hand, she lost her balance and began falling forward. Fortunately, she leaned into her grocery cart, which prevented her from falling to the ground. Each year, about <a href="https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm">1 in every 4 older adults experience a fall</a>. In fact, falls are the leading cause of injuries in adults ages 65 and older. Falls are the <a href="https://doi.org/10.1007/bf00298717">most common cause of hip fractures</a> and <a href="https://doi.org/10.1111/j.1553-2712.2000.tb00515.x">traumatic brain injuries</a>. Injuries like those are also <a href="https://doi.org/10.1056/NEJM199710303371806">risk factors for placement in a nursing home</a>, where the fall risk is <a href="https://doi.org/10.7326/0003-4819-121-6-199409150-00009">nearly three times higher than for people living in the community</a>. A number of physical changes with aging often go unseen preceding falls, including muscle weakness, decreased balance and changes in vision. I am a <a href="https://facultyprofiles.tufts.edu/evan-papa">physical therapist</a> and <a href="https://scholar.google.com/citations?user=T9B_dHQAAAAJ&hl=en">clinical scientist focused on fall prevention</a> in older adults, commonly ages 65 and older. I’ve spent most of my career investigating why older adults fall and working with patients and their families to prevent falls. <h2>Why aging leads to increased risk of falls</h2> Aging is a process that affects the systems and tissues of every person. The rate and magnitude of aging may be different for each person, but overall physical decline is an inevitable part of life. Most people think aging starts in their 60s, but in fact we spend most of our life span <a href="https://doi.org/10.1093%2Fgeront%2Fgnv130">undergoing the process of decline</a>, typically beginning in our 30s. Older adults are more prone to falling for various reasons, including age-related changes in their bodies and vision changes that leave them vulnerable to environmental factors such as curbs, stairs and carpet folds. <figure><iframe src="https://www.youtube.com/embed/ztPbKP68P2Q?wmode=transparent&start=24" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Some straightforward measures to improve the safety of the home environment for older adults can significantly lower the risk of falls.</figcaption></figure> Based on my experience, here are some common reasons older adults may experience falls: First, <a href="https://my.clevelandclinic.org/health/diseases/23167-sarcopenia">aging leads to a natural loss of muscle strength</a> and flexibility, making it more challenging to maintain balance and stability. The loss of strength and poor balance are two of the most common causes of falls. Second, older adults often have chronic conditions such as arthritis, Parkinson’s disease or diabetes that can affect their mobility, coordination and overall stability. In addition, certain medications commonly taken by older adults, <a href="https://doi.org/10.4088/jcp.18f12340">such as sedatives</a> or <a href="https://doi.org/10.1001/jamainternmed.2013.14764">blood pressure drugs</a>, can cause dizziness, drowsiness or a drop in blood pressure, leading to an increased risk of falls. Age-related vision changes, such as reduced depth perception and peripheral vision and difficulty in differentiating colors or contrasts, can make it harder to navigate and identify potential hazards. Hazards in the environment, such as uneven surfaces, slippery floors, inadequate lighting, loose rugs or carpets or cluttered pathways, can <a href="https://doi.org/10.1186/s12877-021-02499-x">significantly contribute to falls among older adults</a>. Older adults who lead a sedentary lifestyle or have limited physical activity may also experience reduced strength, flexibility and balance. And finally, such conditions as dementia or Alzheimer’s disease can affect judgment, attention and spatial awareness, leading to increased fall risk. <h2>Theories of aging</h2> There are numerous theories about why we age but there is no one unifying notion that explains all the changes in our bodies. A large portion of aging-related decline is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295054/">caused by our genes</a>, which determine the structure and function of bones, muscle growth and repair and visual depth perception, among other things. But there are also numerous lifestyle-related factors that influence our rate of aging including diet, exercise, stress and exposure to environmental toxins. A recent advance in scientific understanding of aging is that there is a difference between your <a href="https://theconversation.com/are-you-a-rapid-ager-biological-age-is-a-better-health-indicator-than-the-number-of-years-youve-lived-but-its-tricky-to-measure-198849">chronological age and your biological age</a>. Chronological age is simply the number of years you’ve been on the Earth. Biological age, however, refers to how old your cells and tissues are. It is based on physiological evidence from a blood test and is related to your physical and functional ability. Thus, if you’re healthy and fit, your biological age may be lower than your chronological age. However, the reverse can also be true. I encourage patients to focus on their biological age because it empowers them to take control over the aging process. We obviously have no control over when we are born. By focusing on the age of our cells, we can avoid long-held beliefs that our bodies are destined to develop cancer, diabetes or other conditions that <a href="https://doi.org/10.1016/j.cub.2012.07.024">have historically been tied to how long we live</a>. And by taking control of diet, exercise, sleep and other lifestyle factors you can actually <a href="https://doi.org/10.1111%2Facel.13538">decrease your biological age</a> and improve your quality of life. As one example, our team’s research has shown that moderate amounts of aerobic exercise <a href="https://doi.org/10.1371/journal.pone.0188538">can slow down motor decline</a> even when a person begins exercise in the latter half of the life span. <h2>Fall prevention</h2> Adopting lifestyle changes such as regular, long-term exercise can <a href="https://doi.org/10.1001/jamainternmed.2018.5406">reduce the consequences of aging</a>, including falls and injuries. Following a healthy diet, managing chronic conditions, reviewing medications with health care professionals, maintaining a safe home environment and getting regular vision checkups can also help reduce the risk of falls in older adults. There are several exercises that physical therapists use to improve balance for patients. It is important to note however, that before starting any exercise program, everyone should consult with a health care professional or a qualified physical therapist to determine the most appropriate exercises for their specific needs. Here are five forms of exercise I commonly recommend to my patients to improve balance: <ol> <li> Balance training can help improve coordination and <a href="https://www.sciencedirect.com/topics/neuroscience/proprioception">proprioception</a>, which is the body’s ability to sense where it is in space. By practicing movements that challenge the body’s balance, such as standing on one leg or walking heel-to-toe, the nervous system becomes better at coordinating movement and maintaining balance. A large research study analyzing nearly 8,000 older adults found that balance and functional exercises <a href="https://doi.org/10.1002/14651858.cd012424.pub2">reduce the rate of falls by 24%</a>. </li> <li> Strength training exercises involve lifting weights or using resistance bands to increase muscle strength and power. By strengthening the muscles in the legs, hips and core, older adults can improve their ability to maintain balance and stability. Our research has shown that strength training can also lead to <a href="https://doi.org/10.2147/cia.s104674">improvements in walking speed and a reduction in fall risk</a>. </li> <li> Tai chi is a gentle martial art that focuses on slow, controlled movements and shifting body weight. Research shows that it can improve balance, strength and flexibility in older adults. Several combined studies in tai chi have demonstrated a 20% reduction in the <a href="https://doi.org/10.1002/14651858.cd012424.pub2">number of people who experience falls</a>. </li> <li> Certain yoga poses can enhance balance and stability. Tree pose, warrior pose and mountain pose are examples of poses that can help improve balance. It’s best to <a href="https://theconversation.com/yoga-modern-research-shows-a-variety-of-benefits-to-both-body-and-mind-from-the-ancient-practice-197662">practice yoga</a> under the guidance of a qualified instructor who can adapt the poses to individual abilities. </li> <li> Flexibility training involves stretching the muscles and joints, which can improve range of motion and reduce stiffness. By improving range of motion, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990889/">older adults can improve their ability to move safely</a> and avoid falls caused by limitations in mobility. </li> <li> Use of assistive devices can be helpful when strength or balance impairments are present. Research studies involving the evaluation of canes and walkers used by older adults confirm that <a href="https://doi.org/10.1016/j.apmr.2004.04.023">these devices can improve balance and mobility</a>. Training from a physical or occupational therapist in the proper use of assistive devices is an important part of improving safety. </li> </ol> When I think back about the woman who nearly fell in the grocery store, I wish I could share everything we have learned about healthy aging with her. There’s no way to know if she was already putting these tips into practice, but I’m comforted by the thought that she may have avoided the fall by being in the right place at the right time. After all, she was standing in the produce aisle.<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/204174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, Associate Professor of Physical Therapy and Rehabilitation Science, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts 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/balance-declines-with-age-but-exercise-can-help-stave-off-some-of-the-risk-of-falling-204174">original article</a>.

Body

Wimbledon champion calls out commentator's "disappointing" remarks

Wimbledon tennis champion Barbora Krejcikova has called out a commentator for making "unprofessional" remarks about her live on-air. The Czech player was taking part in the WTA Finals in Saudi Arabia, which was broadcast on the Tennis Channel, when the comments were made by commentator Jon Wertheim. The 28-year-old player took to X to express her disappointment over the comments, writing, “As an athlete who has dedicated herself to this sport, it was disappointing to see this type of unprofessional commentary." "This isn’t the first time something like this is happening in sports world. I’ve often chosen not to speak up, but I believe it’s time to address the need for respect and professionalism in sports media." “These moments distract from the true essence of sport and the dedication all athletes bring to the field." "I love tennis deeply, and I want to see it represented in a way that honours the commitment we make to compete at this level.” Wertheim responded to Krejcikova's posts, apologising for his comments and also explaining what happened. "During a Tennis Channel studio show on Friday, I made some deeply regrettable comments off-air," he said. "I acknowledge them. I apologise for them. I reached out immediately and apologised to the player. "What happened? I joined the show by Zoom. In rehearsal we were shown a graphic of a player who had just competed. It showed her at an angle that exaggerated her forehead." "A few moments later, I was told to frame up my Zoom. I looked at the low camera angle and joked that it made my forehead resemble the photo of the player in question." "Someone in the control room chimed in and I bantered back. Though this was a private rehearsal, this exchange inadvertently and without context made it to live air." "I realise I am not the victim here. It was neither professional nor charitable nor reflective of the person I strive to be. I am accountable. I own this. I am sorry." Image credits: Artur Widak/NurPhoto/Shutterstock Editorial

Legal

Baggage handler calls out crucial mistake at bag-drop

A ramp agent for a major airline has revealed one crucial mistake that many people make when checking their luggage before they fly. Sharing all the details of the little-known trick on a lengthy Reddit thread, the baggage handler, who has years of experience working with American Airlines, noted an extra step that many people miss to ensure the safe arrival of their bags. "Your bag tag has three 'bingo' stickers with your itinerary on them. Take one off and stick it on your suitcase," the airline worker shared. "This way, even if the bag tag gets torn off at some point, we can still get it to its destination." The stickers look like small barcodes at the very end of the long luggage tag and can simply be pulled off and placed anywhere else on the suitcase. It can also be a good idea to keep one of these small tickets with you, whether on your boarding pass (in an area that doesn’t restrict important information), or simply on an old receipt. That way if your luggage unfortunately goes missing, you have the right barcode and number for your bags to be easily located, wherever they may be. Another thing the baggage handler mentions is the location of the luggage tag. While many signs indicate it should be placed around the side handle (if your case has one), the staff member suggests the top handle is better. "Having the tag on the top handle, which is the one that faces outward on the cart, makes it more likely for mistakes to be caught," he points out. Image credits: Shutterstock

Travel Tips

Coldplay bring out Hollywood cameo for Aussie show

Coldplay have shocked the crowd at their Melbourne concert by bringing out a 1980s movie legend to the stage for a surprise cameo. Karate Kid Actor Ralph Macchio took to the stage during the show to help the band perform their song The Karate Kid, from their new album Moon Music. Macchio, 62, lip-synched to frontman Chris Martin’s vocals, before the pair embraced warmly in front of the crowd at the sold-out gig. <blockquote class="twitter-tweet" data-media-max-width="560"> NEWS • Karate Kid Actor Ralph Macchio took to the stage during today’s show in Melbourne to shoot the music video for "The Karate Kid". | <a href="https://twitter.com/hashtag/ColdplayMelbourne?src=hash&ref_src=twsrc%5Etfw">#ColdplayMelbourne</a> 🇦🇺 He lip synced to Chris's voice 🥋🎤 🎥<a href="https://twitter.com/coldplaybrasil?ref_src=twsrc%5Etfw">@coldplaybrasil</a> <a href="https://t.co/bWP1YN79G3">pic.twitter.com/bWP1YN79G3</a> — Coldplay United Kingdom (@ColdplayUK_) <a href="https://twitter.com/ColdplayUK_/status/1851967580363255983?ref_src=twsrc%5Etfw">October 31, 2024</a></blockquote> Macchio became a household name in the 1980s for playing Daniel LaRusso in three Karate Kid films, and more recently has reprised the iconic role in the Netflix series Cobra Kai. According to a Coldplay fan account on social media, the footage of the actor’s on-stage cameo will be used as a music video when The Karate Kid is released as a single. The famous actor had earlier been spotted in the audience at Coldplay’s Wednesday show at Melbourne’s Marvel Stadium, having flown from New York to attend the gig. Image credits: X/Sonia Moskowitz Gordon/ZUMA/Shutterstock Editorial

Music

Young woman dies after horror cruise fall

A woman in her 20s has died after plunging from the MSC Virtuosa cruise ship in the middle of the night. The cruise ship was travelling from Lisbon to Southampton when disaster struck at around 2am on October 12. While air ambulance successfully winched her out of the English Channel, she was pronounced dead at the hospital despite the best efforts of medics. British and French police are now probing the unidentified woman's death, The Sun reported. The ship originally sounded a Man Overboard alert and spotlights were then used to light up the sea, as aircraft from France and the Channel Islands attended the sea. Infra-red cameras were used to locate the woman, who would've struggled to survive in the cold water. At around 3am French time, an emergency alert was issued saying that a person was missing, a coast guard told The Sun. A helicopter was sent to a search area just north Les Casquets rocks, near the Channel Island of Alderney, while a plane from Channel Islands Air Search was sent to the scene from Guernsey, along with lifeboat crews. The £650 million ($A1.2 billion) vessel, which has a crew of more than 1500 and can carry up to 6300 passengers, remained in the area before making its way to Southampton. “A guest on board MSC Virtuosa went overboard on 12 October, while the ship was sailing to Southampton,” a Virtuosa spokesperson said. “The body was later recovered with the involvement of the authorities. “We are deeply saddened by this tragic event, and our thoughts are with the family during this difficult time. “Out of respect for their privacy, we will not be providing further details.” A Hampshire Police spokesperson added: “The investigation is not being managed by UK authorities.” Images: P.Cartwright / Shutterstock.com/ Channel Islands Air Search

Travel Trouble

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

<a href="https://theconversation.com/profiles/peggy-liu-818769">Peggy Liu</a>, <a href="https://theconversation.com/institutions/university-of-pittsburgh-854">University of Pittsburgh</a> and <a href="https://theconversation.com/profiles/lauren-min-1354136">Lauren Min</a>, <a href="https://theconversation.com/institutions/university-of-kansas-1588">University of Kansas</a> <h2>The big idea</h2> The next time you wonder whether to reach out to a friend, family member, classmate or other person who’s been out of touch for a long time, go ahead and do it. According to <a href="https://doi.org/10.1037/pspi0000402">our just-published research</a>, it’s likely they’ll appreciate it more than you think. In a series of 13 experiments involving over 5,900 participants, we – along with colleagues <a href="https://scholar.google.com/citations?user=0Stzf1cAAAAJ&hl=en">SoYon Rim</a> and <a href="https://scholar.google.com/citations?user=TZQefJAAAAAJ&hl=en">Kate Min</a> – wanted to investigate whether people accurately predict <a href="https://doi.org/10.1037/pspi0000402">how much their social contacts appreciate being reached out to</a>. In one experiment we conducted, college students wrote a note “to check in and say hello” to a classmate they hadn’t interacted with in a while. Then we asked them how much they thought their classmate would appreciate receiving this note. Next, we delivered these notes to their classmates and asked the recipients how much they appreciated receiving them. We found that the students who received the notes were much more appreciative of the gesture than the students who wrote them had anticipated. Other experiments varied the scenario by involving older adults as participants rather than college students, switching the written message to a small gift – such as cookies or coffee – and comparing how much the sender underestimated the appreciation that an emotionally distant contact would feel compared with a close contact. Overall they yielded the same basic finding: People tended to underestimate how much others appreciated hearing from them. What drives this underestimation? Our results suggest that it’s related to how little the people reaching out factor in the surprise felt by those being contacted. When we asked recipients what they focused on when indicating how appreciative they felt, they reported paying a lot of attention to their positive feelings of surprise, which were linked to how appreciative they felt. Comparatively, potential senders did not report focusing much on recipients’ positive feelings of surprise. It also mattered whether the two parties were already in a close relationship. People’s underestimations were even greater when their contact was a distant acquaintance because these recipients were especially surprised at being contacted. <h2>Why it matters</h2> Many people can name at least one person with whom they would like to reconnect. Taking a new job, moving to a different city, becoming a parent, or the busyness of everyday life – these are just some of the life events and circumstances that can cause people to lose touch. Then, if the desire to reconnect arises on one side, doubts may arise about whether the other person may appreciate being contacted out of the blue. When people consider taking the initiative to reach out, especially after a prolonged period of no contact, they may worry about being rejected. This worry might keep them from reaching out in the first place. Our research lessens this challenge by showing that often, these gestures will be much more appreciated than one might expect. <h2>What other research is being done</h2> Our findings fit within a growing stream of research examining the tendency to underestimate others’ appreciation of various social exchanges. For example, other researchers have found that people underestimate how much <a href="https://doi.org/10.1037/pspa0000277">others appreciate receiving compliments</a> or <a href="https://doi.org/10.1177/0956797618772506">expressions of gratitude</a>. Our work adds to this area by broadening the scope of the contexts in which people underestimate how much social exchanges are appreciated. Reaching out could but need not require giving compliments or expressing gratitude – the gesture can be as simple as checking in with someone to show that one is thinking about them.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/185001/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peggy-liu-818769">Peggy Liu</a>, Ben L. Fryrear Chair in Marketing and Associate Professor of Business Administration, <a href="https://theconversation.com/institutions/university-of-pittsburgh-854">University of Pittsburgh</a> and <a href="https://theconversation.com/profiles/lauren-min-1354136">Lauren Min</a>, Assistant Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-kansas-1588">University of Kansas</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/lost-touch-with-someone-reach-out-your-friend-will-likely-appreciate-it-more-than-you-think-185001">original article</a>.

Relationships

Olympian's life "a living nightmare" after simple self-check out mistake

A former Olympian has spoken about how her life was ruined after she accidentally failed to scan to items at a self-checkout machine in Walmart. Canadian athlete Meaggan Pettipiece, 48, was arrested on March 28 in Indiana for theft, possession of marijuana and possession of a controlled substance. The charges have since been dropped, but Pettipiece lost her prestigious job as the head coach of the Valparaiso University softball team as a result and says her career and reputation have been ruined. The ordeal began when the self-checkout machine at Walmart reportedly failed to scan the asparagus and ham that Pettipiece intended to purchase. Walmart security saw that she failed to scan the items — worth a total of $67 — prompting them to call the police despite her having paid $167 for her other groceries. Pettipiece was arrested and when police searched her they found three disposable vapes in her purse, along with two unopened blister packs containing anti-nausea medication Zofran. The former athlete said the vapes did not contain any nicotine or THC, and the anti-nausea pills belonged to an assistant coach who had asked her to keep them in her purse during a softball game, days before her arrest. “We both forgot about them,” Pettipiece told the National Post. The outlet reported that earlier this month, her lawyer submitted an application for dismissal that included her account of the incident, proof of her assistant’s prescription, and character reference letters. After reading the application, her charges were dropped by justice officials on September 19, but the damage caused by the incident "changed everything". “It is bittersweet,” she told National Post. “I’m happy, obviously, the charges were dismissed. The sad part is the damage it did to my career. It has changed everything in my life.” Pettipiece resigned as head coach of the softball team shortly after the Walmart incident. "It's been five months, a living nightmare. I lost my career, I lost my job, the life I was building and it's been really difficult." Along with the damage to her career, Pettipiece said the effect on her reputation has been equally heartbreaking. “The softball community is a tight-knit group and it (the news) went through like wildfire,” she said. “You really do learn who the people are that really believe in you and trust you and are truly a friend for you." The former athlete is now living in Ohio with her family, and though the charges against her have been dismissed she is worried the damage "can't be reversed". “The tough thing is, how do you get out to people that you are innocent? And this damage was done for something so ridiculous,” Pettipiece told the outlet. “I’m not sure of the future. For now, I’m going to stay at home and focus on my kids. I’d like to figure out which direction I’m going to go in.” Image: Valparaiso University Athletics/ ZikG / Shutterstock.com

Legal

"This is horrific": Queen icon calls out convincing scam

Brian May has spoken out after becoming the target of a dangerous scam, urging people to be careful online. The guitarist of iconic rock band Queen was made aware of the scam by a fan, who sent him the TikTok of what seems to be May himself offering concert tickets at a discount. The video, which is actually AI-generated and has nothing to do with May or with Queen, shows the rockstar offering music fans the chance to see a concert from backstage. “I hope you’re all well out there,” says the fake Brian May in the video. “Some good news. Backstage tickets for my next show in your cities are now going for only $800, which were previously $2000. I’m only selecting 10 people in the comments, so if you’re ready to make payment, comment, ‘ready’.” May responded to the post publicly, sharing his horror and anger with fans over the “creepy” video, saying, “My God. This is horrific.” “I suppose this is now so easy to do – and there are always people who will sink to any depths to try to make a quick buck. Disgusting.” He continued, “Thanks for the alert dear (TikTok username) stereojazz. I’ve alerted our team and hopefully we can squash this.” Fans were quick to comment that they had almost been fooled by the convincing video. “That they abuse your beautiful personality for this scam hurts even more and is really scary. I hate it,” commented one. “It is insanely terrifying what AI can do these days,” wrote another. Image credits: TikTok

Legal

Twelve-year-old boy falls to his death on cruise

A 12-year-old boy has fallen to his death onboard the Royal Caribbean Harmony of the Seas, as guests watched on in horror. The cruise was nearing the end of its itinerary on Sunday and was heading back to Texas after its seven-day cruise around the Western Caribbean when the incident occurred. Witnesses recalled that the boy was playing with a group of friends he had made on the ship before he tumbled over a 13-storey balcony, falling into the internal Central Park area of the ship, a plaza filled with bars, pubs and restaurants. Royal Caribbean staff attempted to resuscitate the youngster, but he died before the ship docked in Texas. The cruise company shared a statement that a death had occurred onboard but refused to share any more information as investigations into the incident began. Witnesses took to a Facebook page for passengers to share their condolences to the boy's grieving family, and share their version of event. "My daughter was friends with him and said he was upset today," posted passenger Sara Tullas. "She is so upset. I wish I would have known he was struggling today." The boy had taken part in the cruise's teen-club, and many passengers said their children had got to know the boy before his death. "The conversations I have had to have with my son really tripped me up," wrote Shannon Elizabeth on the Facebook page. "My son and him actually got really close on the cruise, and he saw too much of what happened." "My family and I saw the incident unfold right before us as we were looking down into Central Park from the pool deck," wrote Christa Schoolfield. "We did not see whether he jumped or was playing around." Another passenger wrote, "I looked over the railing after the emergency alert and wish I didn’t." "All I ask is to please hug your children tight and tell your family members you love them. Life can change in an instant. Today I was hiding ducks in Central Park and one second later a child's life was gone in front of me." Friends said the boy was on board with his family, including two sisters, for a birthday celebration. Image credits: Shutterstock

Travel Trouble

You’re probably brushing your teeth wrong – here are four tips for better dental health

<a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> We all know the advice for healthy teeth – brush twice daily and don’t eat too much sugar. So why do those of us following these instructions find we sometimes need a filling when we visit the dentist? The truth is, there’s a little more to preventing tooth decay than these guidelines suggest. Here’s what you need to know. <h2>Brush up on your skills</h2> How you brush makes a big difference. The mechanical act of brushing removes the very sticky dental plaque – a mixture of bacteria, their acids and sticky byproducts and food remnants. It forms naturally on teeth immediately after you’ve eaten but doesn’t get nasty and start to cause damage to the teeth until it reaches a certain stage of maturity. The exact amount of time this takes isn’t known but is at least more than 12 hours. Bacteria consume sugar and, as a byproduct, produce acids which dissolve mineral out of the teeth, leaving microscopic holes we can’t see. If the process isn’t stopped and they aren’t repaired, these can become big, visible cavities. Taking two minutes to brush your teeth is a good target for removing plaque and you should brush at night and one other time daily. Brushing frequently stops the bacteria developing to a stage where the species which produce the most acid can become established. Electric toothbrushes can be <a href="https://www.cochrane.org/CD002281/ORAL_poweredelectric-toothbrushes-compared-to-manual-toothbrushes-for-maintaining-oral-health">more effective than manual brushing</a> and a small toothbrush head helps to reach awkward areas in the mouth, while medium-textured bristles help you clean effectively without causing harm to gums and teeth. The main thing, however, is to get brushing! <h2>Use fluoride toothpaste and disclosing tablets</h2> Most of the benefit from brushing comes from toothpaste. The key ingredient is fluoride, which evidence shows <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002278/full#CD002278-abs-0003">prevents tooth decay</a>. Fluoride replaces lost minerals in teeth and also makes them stronger. For maximum benefit, <a href="https://www.cochrane.org/CD007868/ORAL_comparison-between-different-concentrations-of-fluoride-toothpaste-for-preventing-tooth-decay-in-children-and-adolescents">use toothpaste with 1350-1500 ppmF</a> – that’s concentration of fluoride in parts per million – to prevent tooth decay. Check your toothpaste’s concentration by reading the ingredients on the back of the tube. <a href="https://theconversation.com/childrens-toothpaste-the-facts-80508">Not all children’s toothpastes are strong enough</a> for them to gain maximum benefit. Your dentist may prescribe higher strength fluoride toothpaste based on their assessment of your or your child’s risk of tooth decay. Plaque is difficult to see because it is whitish, like your teeth. Disclosing tablets are available in supermarkets and chemists and they make plaque more visible, showing areas you may have missed when brushing. <h2>Spit, don’t rinse</h2> At night, you produce less saliva than during the day. Because of this, your teeth have less protection from saliva and are more vulnerable to acid attacks. That’s why it’s important to remove food from your teeth before bed so plaque bacteria can’t feast overnight. Don’t eat or drink anything except water <a href="https://www.sign.ac.uk/assets/sign138.pdf">after brushing at night</a>. This also gives fluoride the longest opportunity to work. Once you’ve brushed, don’t rinse your mouth with water or mouthwash – you’re washing away the fluoride! This can be a difficult habit to break, but can <a href="https://www.sign.ac.uk/assets/sign138.pdf">reduce tooth decay by up to 25%</a>. <h2>No more than four ‘sugar hits’</h2> Intrinsic sugars are found naturally in foods like fruit and they are far less likely to cause tooth decay than added or <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/sugar-salt-and-fat/free-sugars">free sugars</a>. Free sugars are generally those added to foods by manufacturers but also include honey, syrup and fruit juices. These are all easy for bacteria to consume, metabolise and produce acids from. However, it can be difficult to tell which are the worst sugars for teeth. For example, although normal amounts of fruit are fine, fruit juices have sugar liberated from the plant cells and heavy consumption can cause decay. <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">The World Health Organization</a> and <a href="https://www.nhs.uk/common-health-questions/food-and-diet/how-much-sugar-is-good-for-me/">NHS</a> recommend free sugars should ideally make up less than 5% of your daily calorie intake. So what does this look like? For adults and children over about 11 years old, this is around 30g – about eight teaspoons – of sugar daily. A 330ml can of Coke has <a href="https://www.coca-cola.co.uk/drinks/coca-cola/coca-cola">35g of sugar</a>. The <a href="https://play.google.com/store/apps/details?id=com.phe.c4lfoodsmart&hl=en_GB">change4life app</a> is helpful to track how much sugar you consume in your diet. Although not as important as how much, how often you eat sugar also matters. Simple carbohydrates like sugar are easier for bacteria to digest than proteins or complex carbohydrates. Bacteria produce acids after they metabolise sugar which causes demineralisation. Fortunately, through the actions of fluoride toothpaste and the remineralising effects of saliva, your teeth can recover from the early stages of these attacks. It’s like having a set of scales – trying to keep the balance between sugars on one side, fluoride toothpaste and cleaning on the other. Typically, your teeth can be exposed to four “sugar hits” – episodes of sugar intake – daily without irreversible damage to the teeth. Why not try counting how many sugary hits you have a day? This includes biscuits, cups of sugary tea or coffee and other snacks with refined carbohydrates like crisps. A simple way of cutting down would be to stop putting sugar in hot drinks and limiting snacking. Brush twice daily with fluoride toothpaste, spit don’t rinse, eat and drink nothing after brushing, and don’t have sugar more than four times daily. Easy!<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/103959/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, Clinical Lecturer in Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, Professor of Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</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/youre-probably-brushing-your-teeth-wrong-here-are-four-tips-for-better-dental-health-103959">original article</a>.

Body

Sir Ian McKellen shares health update after fall

Sir Ian McKellen has admitted his health is deteriorating, after he <a href="https://www.oversixty.com.au/health/caring/sir-ian-mckellen-rushed-to-hospital" target="_blank" rel="noopener">fell off stage</a> during a performance in a London theatre a few months ago. The Lord of the Rings actor was starring in a production of Player Kings at the Noel Coward Theatre when he fell off stage and snapped his wrist. He also chipped a vertebrae, but has now revealed that he has other issues too. “I forget names … When you’re older you’ve got more to remember than people who are young," he said. “Nevertheless, it’s a nuisance when you can’t remember your best friend’s name or forget your telephone number.” Despite being 85, the actor is determined to keep working, but said that he will take time off until 2025. “What else would I be doing if I wasn’t working? I shall take the rest of the year off and then get back to work in January," he shared. “Just keep at it as long as the legs and the lungs and the mind keep working.” He is also eager to reprise his role as Gandalf in the 2026 film The Lord of the Rings: The Hunt for Gollum, which would be his first appearance as the wizard in 12 years. In an interview for the BBC, he said: “Well, I’ve had some indication from the powers that be, Gandalf will make an appearance, and I’m not letting anybody else put on the pointy hat and beard if I can help it.” Images: Jeff Moore/ Shutterstock Editorial

Caring

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

How fear of missing out can lead to you paying more when buying a home

<a href="https://theconversation.com/profiles/park-thaichon-175182">Park Thaichon</a>, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a> The property market is a competitive space where finding a nice home, in the area you want, at a price you can afford is a hard ask. With buyers outnumbering available properties, the pressure is even greater causing some would-be buyers to develop <a href="https://health.clevelandclinic.org/understanding-fomo">a fear of missing out</a> (FOMO) and to make irrational decisions. FOMO might make you worry others are finding nicer homes and getting better deals, or that prices will rise to the point where you are priced out of the market altogether. This could cause you to pay too much or to buy a property in an area unsuitable for your needs. Then there is <a href="https://www.psychologytoday.com/au/blog/counseling-keys/202103/overcoming-fear-of-making-mistakes">fear of making a mistake</a> (FOMM), which can also cause problems if you’re a home hunter. You might be reluctant to bid or to negotiate because you are afraid of choosing the wrong property or paying more than it’s worth. <h2>Problems caused by FOMO and FOMM</h2> The principles of contagion theory, crowd psychology and the scarcity principle we identified in <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijcs.12649?casa_token=271MN72XdP8AAAAA%3AfhYF_2yUJtM7KGv5jvFdXn5UsXQLkMcIM_F6hffYa30QaSdRivjf2mhFX-cr5C7ttCuLl1-e2OFYXBA">our research</a> on panic-buying during the pandemic, can be applied to any purchasing decisions. In this instance we applied them to buying properties in a competitive housing market. <a href="https://www.communicationtheory.org/contagion-theory/">Contagion theory</a> applies when people act irrationally under the influence of a crowd. <a href="https://www.bestvalueschools.com/faq/what-is-crowd-psychology/">Crowd psychology</a> is similar but relates to how a crowd behaves in certain circumstances, while <a href="https://www.indeed.com/career-advice/career-development/scarcity-principle">scarcity principle</a> is the idea if there are fewer items available, their value increases. Each of these can increase the likelihood of several behaviours when purchasing a property. These include: <ul> <li>Underbidding and overbidding</li> </ul> Fearing other buyers might get the house, house hunters might get caught up in a bidding war and end up paying more than planned. Conversely, buyers with FOMM might fear spending too much so bid too low to start with and risk losing the house. <ul> <li>Following the crowd and peer pressure influence</li> </ul> Buyers might feel <a href="https://link.springer.com/article/10.1007/s11403-021-00324-7">pressured to buy</a> in a certain area because it’s popular, even if it is not best fit for them. This can lead to paying more for a house just because others are doing the same. <ul> <li>Delaying decisions</li> </ul> FOMM can lead to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ijcs.12990?casa_token=ZhJnLBOwVxUAAAAA%3AW5haHZKSA1rFQsRNdvw0liOoyvdxl0OrFR2phkhGfYC6TnWRv9EsnV-N8w52CmcnAVb8X2yU1obpIjKx">taking too long to decide</a>. This delay can mean missing out on good deals or being forced to rush into a decision and end up overpaying. <ul> <li>Avoiding negotiation</li> </ul> Some buyers might avoid negotiating the price or special conditions such as building and pest inspections and finance approval because they fear the seller will reject their offer. This can result in paying more than they need to if there are problems later. <ul> <li>Excessive inspections and appraisals</li> </ul> While inspections and appraisals are important, too many can suggest indecisiveness driven by fear, resulting in wasted money on unnecessary assessments, and more importantly, wasted time and delayed decisions. <h2>Removing fear from the buying process</h2> Start with thorough research and preparation by learning about different neighbourhoods and house prices. The history of properties and suburbs can be found for free on property websites and is a good place to start. Seek professional guidance from real estate agents or financial advisers to help you through the process. Get insights on market trends from an agent from a selling company or bank to help find homes that meet your criteria. Keep in mind these agents will get some form of incentive from your purchase. All the big banks or loan officers can provide free property reports on specific properties or suburbs. Don’t forget to check council mapping and water authority documents to check for potential future road projects and other developments and for an area’s flood rating. Perform due diligence by thoroughly inspecting properties and reviewing contracts to ensure they meet your needs and are a good investment. For example, it is a good idea to hire a home inspector to check for any hidden issues before making an offer. Another common mistake made by most buyers is not asking their <a href="https://www.qld.gov.au/law/housing-and-neighbours/buying-and-selling-a-property/buying-a-home/before-you-start-looking/appointing-a-solicitor">solicitor</a> to check and give suggestions before signing a contract or offer. A solicitor can check the sale contract before you sign, review the disclosure documents, give advice on your mortgage contract, carry out title searches and explain the results and explain how the purchase may affect your liability for land tax. Do some contingency planning by preparing for unexpected price increases and for the presence of other strong bidders to reduce anxiety about making the wrong decision. Setting aside extra funds could help deal with higher than expected prices or unexpected repairs that need doing. In the end, plan well and make decisions without letting emotions take over. Taking your time to find the right home that fits your budget and goals, rather than rushing into a purchase due to fear of missing out or making a mistake.<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/233197/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/park-thaichon-175182">Park Thaichon</a>, Associate Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-fear-of-missing-out-can-lead-to-you-paying-more-when-buying-a-home-233197">original article</a>.

Money & Banking

Who let the wrong dog out? Dad's hilarious doggy daycare blunder

Leigh Terrell entrusted her dad to pick her dog up from daycare. Little did she know that the pup he had with him was not hers, and now the moment she realised her dog had been left behind at the daycare has gone viral. "This is what happens when you let a man pick up your dog from daycare," she captioned the post shared on <a href="https://www.tiktok.com/@leigh.terrell/photo/7403459903190289695" target="_blank" rel="noopener">TikTok</a>. She shared a series of text messages between her and her dad, after he sent her a picture of the dog he collected, to which she replied: "Let me see his face haha that doesn't look like him." She then jokingly sent a follow up text saying: "make sure you got the right dog," with no idea that he actually collected the wrong dog. Her dad then sent another photo of the dog, now facing him, and wrote: "His collar [is] on," and that was the moment it clicked for Terrell. "That's not my dog dad. That is not Archie, you need to go back and switch him out," she replied. It appeared that both dad and the daycare had mixed up the two dogs who looked pretty similar. The father then replied with a photo of Archie, to which Terrell replied: "Alright that's my dog thanks." The video has racked up over 4 million views, and many were amused at the dad's blunder. "The way the first dog is looking out the window for his real dad, too," one user wrote. Another joked: "I'm imagining the first dog thinking 'my name is NOT Archie' as your dad tries to get his attention for a pic lmao." "The way your dad didn't reply, I bet he was panicking and thinking he did not just dognap someone's baby," another wrote. "That dog knew he wasn't supposed to be there" another joked. Images: TikTok

Family & Pets

4 ways to cut down on meat when dining out – and still make healthy choices

.<a href="https://theconversation.com/profiles/laura-marchese-1271636">Laura Marchese</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Many of us are looking for ways to eat a healthier and more <a href="https://theconversation.com/how-sustainable-is-your-weekly-grocery-shop-these-small-changes-can-have-big-benefits-234367">sustainable diet</a>. And one way to do this is by reducing the amount of meat we eat. That doesn’t mean you need to become a <a href="https://theconversation.com/why-you-should-eat-a-plant-based-diet-but-that-doesnt-mean-being-a-vegetarian-78470">vegan or vegetarian</a>. Our <a href="https://jn.nutrition.org/article/S0022-3166(24)00333-X/fulltext">recent research</a> shows even small changes to cut down on meat consumption could help improve health and wellbeing. But not all plant-based options are created equal and some are <a href="https://pubmed.ncbi.nlm.nih.gov/30744710/">ultra-processed</a>. Navigating what’s available when eating out – including options like tofu and fake meats – can be a challenge. So what are your best options at a cafe or restaurant? Here are some guiding principles to keep in mind when cutting down on meat. <h2>Health benefits to cutting down</h2> Small amounts of lean meat can be part of a healthy, balanced diet. But the majority of Australians <a href="https://cancer.org.au/about-us/policy-and-advocacy/prevention/obesity/related-resources/meat-and-cancer#consumption">still eat more meat</a> than recommended. Only a small percentage of Australians (10%) are vegetarian or vegan. But an <a href="https://www.foodfrontier.org/wp-content/uploads/2019/10/Food-Frontier-Hungry-For-Plant-Based-Australian-Consumer-Insights.pdf">increasing</a> number opt for a <a href="https://theconversation.com/love-meat-too-much-to-be-vegetarian-go-flexitarian-73741">flexitarian</a> diet. <a href="https://theconversation.com/whats-the-difference-between-vegan-and-vegetarian-225275">Flexitarians</a> eat a diet rich in fruits and vegetables, while still enjoying small amounts of meat, dairy, eggs and fish. Our <a href="https://jn.nutrition.org/article/S0022-3166(24)00333-X/fulltext">recent research</a> looked at whether the average Australian diet would improve if we swapped meat and dairy for plant-based alternatives, and the results were promising. The study found health benefits when people halved the amount of meat and dairy they ate and replaced them with healthy plant-based foods, like tofu or <a href="https://www.heartfoundation.org.au/blog/why-you-need-legumes-in-your-life">legumes</a>. On average, their dietary fibre intake – which helps with feeling fuller for longer and digestive health – went up. Saturated fats – which increase our blood cholesterol levels, a risk factor for heart disease – went down. Including more fibre and less saturated fat helps reduce the risk of <a href="https://www.heartfoundation.org.au/healthy-living/healthy-eating/healthy-eating-to-protect-your-heart">heart disease</a>. Achieving these health benefits may be as simple as swapping ham for baked beans in a toastie for lunch, or substituting half of the mince in your bolognese for lentils at dinner. <h2>How it’s made matters</h2> For a long time we’ve known processed meats – such as ham, bacon and sausages – are bad for your health. Eating high amounts of these foods is associated with poor <a href="https://www.heartfoundation.org.au/healthy-living/healthy-eating/protein-and-heart-health">heart health</a> and some forms of <a href="https://cancer.org.au/cancer-information/causes-and-prevention/diet-and-exercise/meat-and-cancer-risk">cancer</a>. But the same can be true of many processed meat alternatives. Plant-based alternatives designed to mimic meat, such as sausages and burgers, have become readily available in supermarkets, cafes and restaurants. These products are ultra-processed and can be <a href="https://theconversation.com/we-looked-at-700-plant-based-foods-to-see-how-healthy-they-really-are-heres-what-we-found-222991">high in salt and saturated fat</a>. Our study found when people replaced meat and dairy with ultra-processed meat alternatives – such as plant-based burgers or sausages – they ate more salt and less calcium, compared to eating meat or healthy plant-based options. So if you’re cutting down on meat for health reasons, it’s important to think about what you’re replacing it with. The <a href="https://www.eatforhealth.gov.au/sites/default/files/2022-09/n55g_adult_brochure.pdf">Australian Dietary Guidelines</a> recommend eggs, legumes/beans, tofu, nuts and seeds. Tofu can be a great option. But we recommend flavouring plain tofu with herbs and spices yourself, as pre-marinated products are often ultra-processed and can be high in salt. <h2>What about when dining out?</h2> When you’re making your own food, it’s easier to adapt recipes or reduce the amount of meat. But when faced with a menu, it can be difficult to work out what is the best option. Here are our four ways to make healthy choices when you eat out: 1. Fill half your plate with vegetables When cutting down on meat, aim for half your plate to be vegetables. Try to also eat <a href="https://theconversation.com/were-told-to-eat-a-rainbow-of-fruit-and-vegetables-heres-what-each-colour-does-in-our-body-191337">a variety of colours</a>, such as leafy green spinach, red capsicum and pumpkin. When you’re out, this might look like choosing a vegetable-based entree, a stir-fry or ordering a side salad to have with your meal. 2. Avoid the deep fryer The Australian Dietary Guidelines <a href="https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55a_australian_dietary_guidelines_summary_130530.pdf">recommend limiting</a> deep fried foods to once a week or less. When dining out, choose plant-based options that are sautéed, grilled, baked, steamed, boiled or poached – instead of those that are crumbed or battered before deep frying. This could mean choosing vegetarian dumplings that are steamed not fried, or poached eggs at brunch instead of fried. Ordering a side of roast vegetables instead of hot chips is also a great option. 3. Pick wholegrains Scan the menu for wholegrain options such as brown rice, wholemeal pizza or pasta, barley, quinoa or wholemeal burger buns. Not only are they good sources of protein, but they also provide more <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/grain-cereal-foods-mostly-wholegrain-and-or-high-cereal-fibre">dietary fibre</a> than refined grains, which help keep you fuller for longer. 4. If you do pick meat – choose less processed kinds You may not always want, or be able, to make a vegetarian choice when eating out and with other people. If you do opt for meat, it’s better to steer clear of processed options like bacon or sausages. If sharing dishes with other people, you could try adding unprocessed plant-based options into the mix. For example, a curry with lentils or chickpeas, or a vegetable-based pizza instead of one with ham or salami. If that’s not an option, try choose meat that’s a lean cut, such as chicken breast, or options which are grilled rather than fried.<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/236505/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-marchese-1271636">Laura Marchese</a>, PhD candidate at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/4-ways-to-cut-down-on-meat-when-dining-out-and-still-make-healthy-choices-236505">original article</a>.

Food & Wine

It’s hard to reach out to old friends, but doing so may help alleviate loneliness

<a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a> Millions of <a href="https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=4510004801">Canadians are lonely</a>. This is worrisome because loneliness, defined by the World Health Organization as “<a href="https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connection">the social pain of not feeling connected</a>,” predicts both lower mental and physical health. Research shows that lacking a sense of social connection can pose an <a href="https://doi.org/10.1177/1745691614568352">equivalent health risk to smoking 15 cigarettes per day</a>. To combat loneliness, people are commonly advised to seek out social connection. For many, this guidance brings to mind spending time with loved ones, such as close friends, family and romantic partners. But are there other people we can reach out to? In our research, recently published in Communications Psychology, we examined whether people have “old friends” — individuals that they care about but with whom they have lost touch — and <a href="https://doi.org/10.1038/s44271-024-00075-8">how easily these relationships can be rekindled</a>. We found that certain strategies can help people reconnect — and, in new research, we are getting a sense that certain values and personality traits may make it easier for people to stay in touch far into the future. <h2>Reconnecting with old friends</h2> Across a series of seven studies, we found the majority of people reported having an old friend. Yet, when we asked over 400 participants how willing they would be to reach out to an old friend right now, most said they were neutral or unwilling. In fact, in one study, people reported being no more willing to reach out to an old friend than they were to talk to a stranger or pick up trash. This reluctance was observable in behaviour too. We conducted two experiments in which more than 1,000 people were given several minutes to draft and send a message to an old friend. Only 30 per cent sent the message to their old friend. Given that reaching out to an old friend could boost <a href="https://www.forbes.com/sites/nextavenue/2018/08/19/the-power-and-joy-of-reconnecting-with-old-friends/">feelings of social connection and happiness</a>, we tried designing interventions to encourage reaching out. For instance, we reminded participants that reaching out to an old friend was an act of kindness and that the recipient would appreciate it more than they realize. We also tried telling participants not to overthink it — to just send their message. Unfortunately, neither prompt was effective at encouraging more people to reach out. <h2>Reluctance to reconnect</h2> Why are people reluctant to reach out to old friends? There may be a number of reasons, including the possibility that old friends feel like strangers after time has passed. In one study with over 500 participants we asked people to list between three to five old friends, and tell us how close each one felt to them right now. The more unfamiliar an old friend felt, the less willing people were to reach out. Research has found that when people <a href="https://doi.org/10.1016/j.jesp.2022.104356">practise talking to strangers for a week</a>, they become less anxious about it. If old friends can feel like strangers, might a similar strategy encourage people to reach out to old friends? To find out, we conducted an experiment in which we randomly assigned some people to complete a three-minute warm-up activity in which they messaged current family or friends. Other participants were randomly assigned to a control condition in which they simply browsed social media for three minutes instead. Afterward, all participants were given an opportunity to write and send a message to an old friend. While only 30 per cent of participants sent their message in the control condition, over 50 per cent did so after warming-up, suggesting that practising the behaviour that underlies reaching out may make this act easier. <h2>Personality traits</h2> We are extending this research in a number of new directions. For instance, in some newly conducted and unpublished research, we are examining whether people with certain personality traits or beliefs are more likely to send a message to an old friend. Responses from over 300 people suggest that people who are open to new experiences — <a href="https://www.psychologytoday.com/ca/basics/big-5-personality-traits">one of the five key personality traits studied by psychologists</a> — say they are willing to reach out to an old friend. Despite this inclination, our research found that highly open people do not necessarily communicate with old friends when given the chance. On the other hand, people’s values and beliefs may be important determinants of whether they stay in touch. Our preliminary work shows that people who see friendship as a bond that does not easily break may be more likely to reach out than others. We hope this work helps normalize the fact that friendships can fade and be hard to rekindle. That said, with some practice, people can overcome this reluctance and hit “send” to potentially open a path to connection and less loneliness.<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/234895/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, Distinguished Professor of Social Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, Senior Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, Master's Student, Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser 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/its-hard-to-reach-out-to-old-friends-but-doing-so-may-help-alleviate-loneliness-234895">original article</a>.

Relationships

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

From maxing out to slowing down, how much do heart rates vary across sports?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/gregory-peoples-1556509">Gregory Peoples</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> A classic image of the Olympics and Paralympics is an athlete at the end of a race struggling for breath, their heart obviously racing. But at the other end of the scale are athletes such as archers and shooters, who need to slow their heart rates down as much as possible. Athletes in speed and endurance events regularly push their heart rate to the maximum. But these athletes usually have low heart rates at rest. What causes our heart rates and respiratory (breathing) rates to change so much, and is this healthy? <h2>When heart rates and respiratory rates rise</h2> If you are still and calm as you read this, your heart is probably beating 60–100 times per minute and you are likely breathing 12–20 times per minute. These are the <a href="https://theconversation.com/what-should-my-heart-rate-be-and-what-affects-it-98945">normal ranges for a resting adult</a>. During physical activity when muscles are contracting, the muscles need more oxygen to provide them with energy to work. To deliver this extra oxygen (<a href="https://theconversation.com/curious-kids-why-is-blood-red-229121#:%7E:text=Haemoglobin%20is%20like%20a%20red,oxygen%2C%20our%20blood%20is%20red.">carried in our blood</a>), our heart pumps blood faster. In other words, our heart rate increases. We also breathe faster to get more oxygen into our lungs to be delivered to the exercising muscles. <figure><iframe src="https://www.youtube.com/embed/3YOap5k0R_8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Your resting heart rate can tell you plenty about your health and fitness.</figcaption></figure> <h2>How fast can our heart rate get during exercise?</h2> Aerobic means “with oxygen”. In <a href="https://my.clevelandclinic.org/health/articles/7050-aerobic-exercise">aerobic exercise</a> (“cardio”) you use large muscles repetitively and rhythmically. For example, walking, running, cycling, swimming and rowing. Muscles that are contracting during aerobic exercise use a lot of energy and need ten times <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551211/">more oxygen than at rest</a>. High intensity aerobic events that involve large muscles or the entire body cause the highest heart rates. An <a href="https://www.heartonline.org.au/resources/calculators/target-heart-rate-calculator">estimate</a> of maximum heart rate (beats per minute) is 220 minus your age. This equates to 195 beats per minute for a 25-year-old – close to the average age of the Australian Olympic team of 26.5 years. Athletes competing in Olympic events of endurance or speed will reach their maximum heart rate. You can usually only maintain maximum heart rate for a few minutes. But in a 2000-metre rowing race, the rowers maintain intense effort at close to maximum heart rate for 6–8 minutes. This is one of the toughest events for the heart. It’s no wonder rowers often collapse in the boat <a href="https://www.bbc.com/news/uk-england-cambridgeshire-68731840">as they cross the finish line</a>. Highly trained endurance athletes can have a maximum heart rate higher than expected for their age. <a href="https://olympics.com/en/athletes/eliud-kipchoge">Eliud Kipchoge</a> from Kenya is considered the greatest marathon runner of all time. During his <a href="https://au.coros.com/stories?world-record">world record run</a> in the 2022 Berlin marathon, he ran with a heart rate of around 180 beats per minute for almost the entire race. <h2>How does breathing change with exercise?</h2> Our breathing changes with exercise to increase oxygen uptake from the air. At low-to-moderate intensity exercise, you start to take deeper breaths. This brings in more air and oxygen with each breath. However, there is a limit to how much the chest can expand. With higher intensity exercise, respiratory rate increases to increase oxygen intake. Elite athletes can breathe <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818249/">more than 50 times</a> per minute. This is driven by <a href="https://theconversation.com/what-is-breathwork-and-do-i-need-to-do-it-231192">our diaphragm</a>, the most important muscle of breathing. <a href="https://www.abc.net.au/news/2024-07-28/paris-olympics-grace-brown-cycling-gold-medal-australia/104151466">Grace Brown</a>, Olympic gold medal cyclist in Paris, <a href="https://inscyd.com/article/grace-brown-olympic-gold-physiology/">breathes close to a maximal oxygen uptake</a> when she is cycling at high intensity. <h2>Some athletes need to slow things down</h2> Archery and shooting athletes perform better with a lower heart rate. They time their shots to be <a href="https://pubmed.ncbi.nlm.nih.gov/3580727/#:%7E:text=Results%20showed%20that%20the%20champion,both%20during%20diastole%20and%20systole">between heart beats</a> when the body is the most still. This is easier with a slower heart rate, with more time between beats. Archers consciously lower their heart rate <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441821/">prior to shooting</a> by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721071/">slowing their breathing</a>. Other Olympians use <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224217/#:%7E:text=For%20practicing%20slow%20and%20deep,minutes%20before%20starting%20the%20exercise.">breathing techniques</a> to calm pre-race anticipation and high heart rates. Slowing the breath, <a href="https://theconversation.com/what-is-breathwork-and-do-i-need-to-do-it-231192">especially the exhale</a>, is the best way to lower your heart rate. Beta-blockers also reduce heart rate, by blocking adrenaline. This is why they are on the <a href="https://www.wada-ama.org/en/prohibited-list">prohibited substances list</a> of the World Anti-Doping Agency. <h2>What about resting heart rates?</h2> Athletes often have a <a href="https://www.health.harvard.edu/heart-health/is-a-low-heart-rate-worrisome">low resting heart rate</a>, around 40-50 beats per minute, and slower during sleep. Some are even lower – five time Tour de France winner Miguel Indurain famously had a resting heart rate of <a href="https://www.cyclingweekly.com/fitness/miguel-indurain-vs-your-body-34288">28 beats per minute</a>. Legendary US swimmer Michael Phelps is the <a href="https://olympics.com/en/news/michael-phelps-olympic-medals-record-how-many-gold-swimmer-world-record">most successful Olympian</a> of all time – he had a resting heart rate of <a href="https://www.reanfoundation.org/low-resting-heart-rate-and-lifespan/#:%7E:text=Studies%20on%20Athletes%20and%20Low%20Resting%20Heart%20Rate&text=It%20could%20also%20hint%20at,BPM%20throughout%20his%20professional%20career">less than 40 beats per minute</a>. Regular moderate-to-vigorous intensity aerobic exercise makes the <a href="https://www.medicalnewstoday.com/articles/athletes-heart-rate">heart stronger and more efficient</a>. A stronger heart pumps more blood per beat, which means it doesn’t need to beat as often. Exercise also <a href="https://pubmed.ncbi.nlm.nih.gov/12477376/">increases vagus nerve</a> activity to the heart and <a href="https://www.nature.com/articles/ncomms4775">slows down</a> the heart’s pacemaker cells. These both reduce heart rate. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306777/">A large review</a> found endurance training and yoga were the best exercises to reduce resting heart rate. But training needs to be maintained to keep resting heart rate low. When elite athletes reduced their training volume by half during COVID lockdown, their <a href="https://www.mdpi.com/2071-1050/13/5/2970">resting heart rate increased</a>. <h2>What does this mean for our health?</h2> A slower resting heart rate is linked to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306777/">longer life expectancy and reduced death from cardiovascular disease</a>. Indeed, <a href="https://bjsm.bmj.com/content/55/4/206">a study</a> of more than 8,000 Olympians from the United States found they lived longer than the general population. So it is healthy to do activities that increase your heart rate in the short-term, whether as an Olympian or Paralympian competing, or a fan with your heart racing watching a gold medal event.<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/235594/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/gregory-peoples-1556509">Gregory Peoples</a>, Senior Lecturer - Physiology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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/from-maxing-out-to-slowing-down-how-much-do-heart-rates-vary-across-sports-235594">original article</a>. </div>

Body

Prince Harry finally speaks out on "rift" with royal family

Prince Harry has finally opened up on his "rift" with the royal family for the first time, in an interview for the ITV documentary, Tabloids on Trial. The Duke of Sussex revealed that his decision to launch multiple legal battles against a string of tabloid newspapers was central to his rift with the royal family. He said that his determination to fight the publications ruined his relationship with them. “That’s certainly a central piece to it,” he said. “But, you know, that’s a hard question to answer because anything I say about my family results in a torrent of abuse from the press. “I’ve made it very clear that this is something that needs to be done. It would be nice if we, you know, did it as a family," he continued. “I believe that, again, from a service standpoint and when you are in a public role, that these are the things that we should be doing for the greater good. “But, you know, I’m doing this for my reasons. I think everything that’s played out has shown people what the truth of the matter is. “For me, the mission continues, but it has, it has, yes. It’s caused, yeah, as you say, part of a rift.” In December, London's High court ruled that he had been the victim of phone-hacking and other unlawful acts by journalists, with the knowledge of their editors at Mirror Group Newspapers. Harry said that the publications under MGN had targeted him for 15 years. He was awarded £140,600 ($267,400), and called the judge's ruling in his favour a "monumental victory". Image: ITV

Family & Pets

Long COVID puzzle pieces are falling into place – the picture is unsettling

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</a> Since 2020, the condition known as long COVID-19 has become a <a href="https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/guidance-long-covid-disability/index.html">widespread disability</a> affecting the health and quality of life of millions of people across the globe and costing economies billions of dollars in <a href="https://www.oecd.org/en/publications/the-impacts-of-long-covid-across-oecd-countries_8bd08383-en.html">reduced productivity of employees and an overall drop in the work force</a>. The intense scientific effort that long COVID sparked has resulted in <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%22long+covid%22+or+%22pasc%22+or+%22post-acute+sequelae+of+covid-19%22+or+%22postacute+sequelae+of+covid-19%22+or+%22post-acute+sequelae+of+SARS-CoV-2%22+or+%22postacute+sequelae+of+SARS-CoV-2%22+or+%22post+covid+condition%22+or+%22post+covid+conditions%22+or+%E2%80%9Cchronic+covid-19%E2%80%9D+or+%E2%80%9Cpost+covid-19+condition%E2%80%9D+or+%E2%80%9Cpost+covid-19+conditions%E2%80%9D+or+%E2%80%9Cpost-covid+condition%E2%80%9D+or+%E2%80%9Cpost-covid+conditions%E2%80%9D+or+%E2%80%9Clong+covid-19%E2%80%9D+or+%28%22long-term%22+and+%22COVID-19%22%29+or+%28%22longterm%22+and+%22COVID-19%22%29+or+%28%22long-term%22+and+%22SARS-CoV-2%22%29+or+%28%22longterm%22+and+%22SARS-CoV-2%22%29+or+%E2%80%9Cpostcovid+condition%E2%80%9D+or+%E2%80%9Cpostcovid+conditions%E2%80%9D+&sort=date">more than 24,000 scientific publications</a>, making it the most researched health condition in any four years of recorded human history. <a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html">Long COVID</a> is a term that describes the <a href="https://www.yalemedicine.org/conditions/long-covid-post-covid-conditions-pcc">constellation of long-term health effects</a> caused by infection with the SARS-CoV-2 virus. These range from persistent respiratory symptoms, such as shortness of breath, to debilitating fatigue or brain fog that limits people’s ability to work, and conditions such as heart failure and diabetes, which are known to last a lifetime. I am a physician scientist, and I have been deeply immersed in studying long COVID since the early days of the pandemic. I have testified before the U.S. Senate as an <a href="https://www.help.senate.gov/imo/media/doc/baf4e4e7-b423-6bef-7cb4-1b272df66eb8/Al-Aly%20Testimony.pdf">expert witness on long COVID</a>, have <a href="https://scholar.google.com/citations?hl=en&user=DtuRVcUAAAAJ">published extensively on it</a> and was named as one of <a href="https://time.com/6966812/ziyad-al-aly/">Time’s 100 most influential people in health in 2024</a> for my research in this area. Over the first half of 2024, a <a href="https://www.nationalacademies.org/our-work/long-term-health-effects-stemming-from-covid-19-and-implications-for-the-social-security-administration#sl-three-columns-afa91458-20e0-42ab-9bd6-55e3c8262ecc">flurry of reports</a> and <a href="https://doi.org/10.1056/NEJMoa2403211">scientific papers</a> on long COVID added clarity to this complex condition. These include, in particular, insights into how COVID-19 can still wreak havoc in many organs years after the initial viral infection, as well as emerging evidence on viral persistence and immune dysfunction that last for months or years after initial infection. <h2>How long COVID affects the body</h2> A new study that my colleagues and I published in the New England Journal of Medicine on July 17, 2024, shows that the <a href="https://doi.org/10.1056/NEJMoa2403211">risk of long COVID declined</a> over the course of the pandemic. In 2020, when the ancestral strain of SARS-CoV-2 was dominant and vaccines were not available, about 10.4% of adults who got COVID-19 developed long COVID. By early 2022, when the omicron family of variants predominated, that rate declined to 7.7% among unvaccinated adults and 3.5% of vaccinated adults. In other words, unvaccinated people were more than twice as likely to develop long COVID. While researchers like me do not yet have concrete numbers for the current rate in mid-2024 due to the time it takes for long COVID cases to be reflected in the data, the flow of new patients into long COVID clinics has been on par with 2022. We found that the decline was the result of two key drivers: availability of vaccines and changes in the characteristics of the virus – which made the virus less prone to cause severe acute infections and may have reduced its ability to persist in the human body long enough to cause chronic disease. Despite the decline in risk of developing long COVID, even a 3.5% risk is substantial. New and repeat COVID-19 infections translate into millions of new long COVID cases that add to an already staggering number of people suffering from this condition. Estimates for the first year of the pandemic suggests that at <a href="https://doi.org/10.1038/s41579-023-00896-0">least 65 million people</a> globally have had long COVID. Along with a group of other leading scientists, my team will soon publish updated estimates of the global burden of long COVID and its impact on the global economy through 2023. In addition, a major new report by the National Academies of Sciences Engineering and Medicine details all the <a href="https://nap.nationalacademies.org/catalog/27756/long-term-health-effects-of-covid-19-disability-and-function">health effects that constitute long COVID</a>. The report was commissioned by the Social Security Administration to understand the implications of long COVID on its disability benefits. It concludes that long COVID is a complex chronic condition that can result in more than 200 health effects across multiple body systems. These include new onset or worsening: <ul> <li><a href="https://doi.org/10.1038/s41591-022-01689-3">heart disease</a></li> <li><a href="https://doi.org/10.1038/s41591-022-02001-z">neurologic problems</a> such as <a href="https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-with-significant-drops-in-iq-scores-224216">cognitive impairment</a>, strokes and <a href="https://my.clevelandclinic.org/health/diseases/6004-dysautonomia">dysautonomia</a>. This is a category of disorders that affect the body’s <a href="https://my.clevelandclinic.org/health/body/23273-autonomic-nervous-system">autonomic nervous system</a> – nerves that regulate most of the body’s vital mechanisms such as blood pressure, heart rate and temperature.</li> <li><a href="https://www.cdc.gov/me-cfs/hcp/clinical-care/treating-the-most-disruptive-symptoms-first-and-preventing-worsening-of-symptoms.html">post-exertional malaise</a>, a state of severe exhaustion that may happen after even minor activity — often leaving the patient unable to function for hours, days or weeks</li> <li><a href="https://doi.org/10.1038/s41467-023-36223-7">gastrointestinal disorders</a></li> <li><a href="https://doi.org/10.1681/ASN.2021060734">kidney disease</a></li> <li>metabolic disorders such as <a href="https://doi.org/10.1016/S2213-8587(22)00044-4">diabetes</a> and <a href="https://doi.org/10.1016/S2213-8587(22)00355-2">hyperlipidemia</a>, or a rise in bad cholesterol</li> <li><a href="https://doi.org/10.1038/s41590-023-01724-6">immune dysfunction</a></li> </ul> Long COVID can affect people across the lifespan from children to older adults and across race and ethnicity and baseline health status. Importantly, <a href="https://doi.org/10.1126/science.adl0867">more than 90% of people with long COVID</a> had mild COVID-19 infections. The National Academies report also concluded that long COVID can result in the inability to return to work or school; poor quality of life; diminished ability to perform activities of daily living; and decreased physical and cognitive function for months or years after the initial infection. The report points out that many health effects of long COVID, such as post-exertional malaise and chronic fatigue, cognitive impairment and autonomic dysfunction, are not currently captured in the <a href="https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm">Social Security Administration’s Listing of Impairments</a>, yet may significantly affect an individual’s ability to participate in work or school. <figure><iframe src="https://www.youtube.com/embed/9kJ5GWb2wzw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Many people experience long COVID symptoms for years following initial infection.</figcaption></figure> <h2>A long road ahead</h2> What’s more, health problems resulting from COVID-19 can last years after the initial infection. A large study published in early 2024 showed that even people who had a <a href="https://doi.org/10.1038/s41591-024-02987-8">mild SARS-CoV-2 infection still experienced new health problems</a> related to COVID-19 in the third year after the initial infection. Such findings parallel other research showing that the <a href="https://doi.org/10.1016/S1473-3099(24)00171-3">virus persists</a> in various organ systems for months or years after COVID-19 infection. And research is showing that immune responses to the infection are <a href="https://doi.org/10.1126/scitranslmed.adk3295">still evident two to three years</a> after a mild infection. Together, these studies may explain why a SARS-CoV-2 infection years ago could still cause new health problems long after the initial infection. Important progress is also being made in understanding the pathways by which long COVID wreaks havoc on the body. Two preliminary studies <a href="https://doi.org/10.1101/2024.06.18.24309100">from the U.S.</a> and <a href="https://doi.org/10.1101/2024.05.30.596590">the Netherlands</a> show that when researchers transfer auto-antibodies – antibodies generated by a person’s immune system that are directed at their own tissues and organs – from people with long COVID into healthy mice, the animals start to experience long COVID-like symptoms such as muscle weakness and poor balance. These studies suggest that an abnormal immune response thought to be responsible for the generation of these auto-antibodies may underlie long COVID and that <a href="https://doi.org/10.1126/science.zbzipqn">removing these auto-antibodies</a> may hold promise as potential treatments. <h2>An ongoing threat</h2> Despite overwhelming evidence of the wide-ranging risks of COVID-19, a great deal of messaging suggests that it is no longer a threat to the public. Although there is no empirical evidence to back this up, this misinformation has permeated the public narrative. The data, however, tells a different story. <a href="https://covid.cdc.gov/covid-data-tracker/#datatracker-home">COVID-19 infections</a> continue to <a href="https://www.cdc.gov/flu/weekly/index.htm">outnumber flu cases</a> and lead to <a href="https://www.cdc.gov/resp-net/dashboard/index.html">more hospitalization</a> and <a href="https://doi.org/10.1001/jama.2024.7395">death</a> than the flu. COVID-19 also leads to <a href="https://doi.org/10.1016/S1473-3099(23)00684-9">more serious long-term health problems</a>. Trivializing COVID-19 as an inconsequential cold or <a href="https://www.theatlantic.com/health/archive/2024/02/covid-anniversary-flu-isolation-cdc/677588/">equating it with the flu</a> does not align with reality.<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/233759/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, Chief of Research and Development, VA St. Louis Health Care System. Clinical Epidemiologist, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</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/long-covid-puzzle-pieces-are-falling-into-place-the-picture-is-unsettling-233759">original article</a>. </div>

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