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

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

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Nearly 200 chemicals linked to cancer found in everyday food packaging

A new study has uncovered the alarming amount of potential carcinogens in food packaging and plastic tableware. Researchers from the Food Packaging Forum found that nearly 200 chemicals linked to breast cancer are being used in food packaging, with dozens of these carcinogens able to find their way into the body. “There is strong evidence that 76 known or potential breast carcinogens from food contact materials recently purchased all over the world can be found in people,” study co-author Jane Muncke said. “Getting rid of these known or suspected carcinogens in our food supply is a huge opportunity for cancer prevention.” Muncke is managing director and chief scientific officer at the Food Packaging Forum, a non-profit foundation based in Zurich, Switzerland focusing on science communication and research. The study, published last month in the journal Frontiers In Toxicology, compared a list of potential breast carcinogens to a list of chemicals that have been found in food contact materials to find out which of the potential carcinogens could be getting into people's diets. Of the 189 potential mammary carcinogens in food contact materials, with 143 of these found in plastics and 89 found in paper or cardboard. Of the recently detected chemicals found in food packaging, 40 have already been classified as hazardous by regulatory agencies around the world. Another research scientist, Jenny Kay, from Silent Spring Institute an organisation focused on the link between chemicals, women's health, and breast cancer said: “So many of these chemicals have already been classified as human health hazards, yet they are still allowed to be used in food contact materials thus allowing them to migrate into the food we eat." Early-onset breast cancer rates in women younger than 50 have been increasing, and experts said the trend cannot be explained by genetics alone. “Many of the mammary carcinogens are hormone disruptors, too, and many of the chemicals on our list can also damage DNA," Kay said. “Consumers should not have to keep track of all of the scientific literature on what chemicals to avoid. It should be on regulators to recognise the danger and take action.” The Consumer Brands Association, which represents the consumer products industry, said its members adhered to the US Food and Drug Administration’s evidence-based safety standards. “Packaging exists to protect and keep food safe for consumption,” the association’s senior vice president of product policy and federal affairs Sarah Gallo told CNN. “The FDA reviews and approves food contact substances through their science and risk-based system before they go to market. “The agency’s post-market review also provides continuous safety analysis and regulation of the approved substances.” Image: Shutterstock

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Breakthrough study finds genetic link to Parkinson's and ADHD

A major scientific study has found a surprising link between the genes that control brain size and the risk of brain-related conditions. A Queensland Institute of Medical Research Associate Professor Miguel Renteria led an international team of experts who scanned DNA data and MRI scans from 76,000 participants. “Genetic variants associated with larger brain volumes in key brain regions also increase the risk of Parkinson’s disease, while variants linked to smaller brain volumes in key regions are associated with an increased risk of ADHD,” Renteria said. “It brings us closer to answering key questions about how genetics influence brain structure, and how we can potentially treat these conditions in future.” Parkinson’s Australia CEO Olivia Nassaris has celebrated the results of the study, saying the surprising results open the door to future treatment options for Parkinson’s, which currently has no cure or cause. “The more answers we have the closer we are to understanding this condition,” she said. Michael Wiseman, who has been living with Parkinson’s for eight years, said he is pleased more research is being done about the neurodegenerative condition. “I know it’s not going to benefit me in any way, as far as a cure or anything … I just hope they keep going, kicking some goals and finding results because it’s an insidious sort of thing, it’s a passenger I’ll have until I go to the grave.” Image credits: Shutterstock

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New study links Ozempic and Wegovy to suicidal thoughts

A new study has found a link between weight reduction drugs and reports of suicidal thoughts. Semaglutide, the drug sold under the brand names Ozempic and Wegovy, has been widely used for weight loss despite only being approved for the treatment of diabetes. An analysis of data on the adverse drug reactions database of the World Health Organisation found a disproportionate number of people reporting suicidal thoughts while using semaglutide. The research published in JAMA Network also found that the effect was "significant" compared to other diabetes medication, and that people with anxiety and depression were more likely to report suicidal thoughts when taking the drug. The researches have called for "urgent clarification" and larger studies around how semaglutide medications impact the brain. "The study raises key questions about whether additional precautions are needed when prescribing semaglutide," Trevor Steward, a neurobiology researcher from the University of Melbourne said. However, there are a few limitations with the study as there were a lack of information about the dosages, and did not adjust for things like alcohol and substance misuse and off-label use. While the study did not find a direct cause between suicidal thoughts and the use of semaglutide, it is important to raise concerns, especially for those who may want to use these drugs based on information they found on social media, and therefore do not fully understand the risks. The use of semaglutide for weight loss in Australia is considered 'off label', meaning that it has been prescribed for purposes outside of its approved use. The Therapeutic Goods Administration (TGA) believes that these prescriptions have been driving shortages, which they are trying to address and believe will last until 2025. Images: Shutterstock

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

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

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New link to Madeleine McCann suspect revealed for the first time

Detectives have uncovered an email account belonging to convicted paedophile Christian Brueckner that ties him to the disappearance of Madeleine McCann, a court has heard. Detective Titus Stampa told a court that the German FBI had identified two email accounts linked to the man, but was unable to discuss one of them because it was “related to the killing” of the child. The second email account was used for trading child pornography images with people online. However, the account had all of the messages deleted from the first half of 2007: the time Maddie vanished. Detective Stampa refused to confirm if the “murder” account contained any “photos”, but he said investigators were also in possession of a hard drive related to the “murder” which he was not allowed to discuss. The detective told the court, “An external hard drive is also belonging to the killing case – and I am not allowed to talk about it.” Asked about the account used for swapping child sex abuse images, Detective Stampa said, “I can remember that things were ‘massively’ deleted in the inbox. “There was nothing in there from January 2007.” The revelation offered the first glimpse into the physical proof that has led German investigators to believe Brueckner kidnapped and killed Maddie. Brueckner has long been the main suspect in the case of Maddie’s disappearance, after a key witness came forward in 2017 to report the man, who claimed that while discussing the McCann case, Brueckner said, “She didn’t scream.” Madeleine was last seen when she was just three years old in 2007 in Praia da Luz on Portugal’s Algarve coast, when she was on holiday with her family. Image credits: MGG/Shutterstock Editorial

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How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a> COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others. So how much stress is too much, and what can you do about it? I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues. I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.” A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging. <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit. Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.” The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface. When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions. For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors. <h2>‘Treating’ stress</h2> Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan. Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure. Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>. Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress. Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses. <h2>Suffering from toxic stress</h2> Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood. Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be. And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all. Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress. <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Exercise, meditation and a healthy diet help fight toxic stress.</figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>. The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate. Adopting these lifestyle changes is not quick or easy, but it works. The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits. There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<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/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.

Mind

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>. Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease. Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link? <h2>What the study did and found</h2> This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period. Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia. During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. <h2>Important considerations</h2> In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk. Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively. These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable. Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves. This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association. <h2>What does other evidence say?</h2> <a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both. High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too. For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life. <h2>Why the link?</h2> There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia. Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline. Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>. We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<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/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.

Mind

Climb the stairs, lug the shopping, chase the kids. Incidental vigorous activity linked to lower cancer risks

<a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Many people know exercise reduces the risk of <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2521826">cancers</a>, including liver, lung, breast and kidney. But structured exercise is time-consuming, requires significant commitment and often financial outlay or travel to a gym. These practicalities can make it infeasible for <a href="https://bjsm.bmj.com/content/42/11/901">most adults</a>. There is <a href="https://www.nature.com/articles/s41591-022-02100-x">very little research</a> on the potential of incidental physical activity for reducing the risk of cancer. Incidental activities can include doing errands on foot, work-related activity or housework as part of daily routines. As such they do not require an extra time commitment, special equipment or any particular practical arrangements. In our <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">study</a> out today, we explored the health potential of brief bursts of vigorous physical activities embedded into daily life. These could be short power walks to get to the bus or tram stop, stair climbing, carrying heavy shopping, active housework or energetic play with children. <h2>How was the study done?</h2> Our <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">new study</a> included 22,398 <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a> participants who had never been diagnosed with cancer before and did not do any structured exercise in their leisure time. Around 55% of participants were female, with an average age of 62. Participants wore wrist activity trackers for a week. Such trackers monitor activity levels continuously and with a high level of detail throughout the day, allowing us to calculate how hard and exactly for how long people in the study were moving. Participants’ activity and other information was then linked to future cancer registrations and other cancer-related health records for the next 6.7 years. This meant we could estimate the overall risk of cancer by different levels of what we call “<a href="https://pubmed.ncbi.nlm.nih.gov/33108651/">vigorous intermittent lifestyle physical activity</a>”, the incidental bursts of activity in everyday life. We also analysed separately a group of <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2521826">13 cancer sites in the body</a> with more established links to exercise, such such as breast, lung, liver, and bowel cancers. Our analyses took into account other factors that influence cancer risk, such as age, smoking, diet, and alcohol habits. <h2>What we found out</h2> Even though study participants were not doing any structured exercise, about 94% recorded short bursts of <a href="https://pubmed.ncbi.nlm.nih.gov/33108651/">vigorous activity</a>. Some 92% of all bouts were done in very short bursts lasting up to one minute. A minimum of around 3.5 minutes each day was associated with a 17–18% reduction in total cancer risk compared with not doing any such activity. Half the participants did at least 4.5 minutes a day, associated with a 20–21% reduction in total cancer risk. For cancers such as breast, lung and bowel cancers, which we know are impacted by the amount of exercise people do, the results were stronger and the risk reduction sharper. For example, a minimum of 3.5 minutes per a day of vigorous incidental activity reduced the risk of these cancers by 28–29%. At 4.5 minutes a day, these risks were reduced by 31–32%. For both total cancer and those known to be linked to exercise, the results clearly show the benefits of doing day-to-day activities with gusto that makes you huff and puff. <h2>Our study had its limits</h2> The study is observational, meaning we looked at a group of people and their outcomes retrospectively and did not test new interventions. That means it cannot directly explore cause and effect with certainty. However, we took several statistical measures to minimise the possibility those with the lowest levels of activity were not the unhealthiest, and hence the most likely to get cancer – a phenomenon called “<a href="https://www.sciencedirect.com/topics/computer-science/reverse-causation">reverse causation</a>”. Our study can’t explain the biological mechanisms of how vigorous intensity activity may reduce cancer risk. Previous <a href="https://journals.lww.com/acsm-msse/Fulltext/2017/02000/Brief_Intense_Stair_Climbing_Improves.10.aspx">early-stage trials</a> show this type of activity leads to rapid improvements in heart and lung fitness. And higher fitness is linked to lower <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002934320300097">insulin resistance</a> and lower <a href="https://www.sciencedirect.com/science/article/pii/S0735109704017036">chronic inflammation</a>. High levels of these are risk <a href="https://www.sciencedirect.com/science/article/pii/S0735109704017036">factors for cancer</a>. There is very little research on incidental physical activity and cancer in general, because most of the scientific evidence on lifestyle health behaviours and cancer is based on questionnaires. This method doesn’t capture short bursts of activity and is very inaccurate for measuring the incidental activities of daily life. So the field of vigorous intensity activity and cancer risk is at its infancy, despite some <a href="https://academic.oup.com/eurheartj/article/43/46/4801/6771381">very promising</a> recent findings that vigorous activity in short bouts across the week could cut health risks. In another recent study of ours, we found benefits from daily <a href="https://www.nature.com/articles/s41591-022-02100-x%22%22">vigorous intermittent lifestyle activity</a> on the risk of death overall and death from cancer or cardiovascular causes. <h2>In a nutshell: get moving in your daily routine</h2> Our study found 3 to 4 minutes of vigorous incidental activity each day is linked with decreased cancer risk. This is a very small amount of activity compared to <a href="https://bjsm.bmj.com/content/54/24/1451">current recommendations</a> of 150–300 minutes of moderate intensity or 75–150 minutes of vigorous intensity activity a week. Vigorous incidental physical activity is a promising avenue for cancer prevention among people unable or unmotivated to exercise in their leisure time. Our study also highlights the potential of technology. These results are just a glimpse how wearables combined with machine learning – which our study used to identify brief bursts of vigorous activity – can reveal health benefits of unexplored aspects of our lives. The future potential impact of such technologies to prevent cancer and possibly a <a href="https://www.nature.com/articles/s41591-022-02100-x">host of other</a> conditions could be very large.<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/210288/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, Postdoctoral Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/climb-the-stairs-lug-the-shopping-chase-the-kids-incidental-vigorous-activity-linked-to-lower-cancer-risks-210288">original article</a>.

Body

Bees have appeared on coins for millennia, hinting at an age-old link between sweetness and value

<a href="https://theconversation.com/profiles/adrian-dyer-387798">Adrian Dyer</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> In 2022, the Royal Australian Mint issued a $2 coin decorated with honeybees. Around 2,400 years earlier, a mint in the kingdom of Macedon had the same idea, creating a silver obol coin with a bee stamped on one side. Over the centuries between these two events, currency demonstrating a symbolic link between honey and money is surprisingly common. In a recent study in <a href="https://s3.ap-southeast-2.amazonaws.com/assets.mmxgroup.com.au/ACR/Bee+Article.pdf">Australian Coin Review</a>, I trace the bee through numismatic history – and suggest a scientific reason why our brains might naturally draw a connection between the melliferous insects and the abstract idea of value. <figure class="align-center "><img src="https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="" /><figcaption>A Royal Australian Mint 2022 two-dollar coin representing 200 years since the introduction of the honeybee to Australia.</figcaption></figure> <h2>What is currency and why is it important?</h2> Money is a store of value, and can act as a medium of exchange for goods or services. Currency is a physical manifestation of money, so coins are a durable representation of value. Coins have had central role in many communities to enable efficient trade since ancient times. Their durability makes them important time capsules. Ancient Malta was famous for its honey. The modern 3 Mils coin (<a href="https://en.numista.com/catalogue/pieces1775.html">1972-81</a>) celebrates this history with images of a bee and honeycomb. According to the information card issued with the coin set, <blockquote> A bee and honeycomb are shown on the 3 Mils coin, symbolising the fact that honey was used as currency in Ancient Malta. </blockquote> <figure class="align-center "><img src="https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=582&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=582&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=582&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=732&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=732&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=732&fit=crop&dpr=3 2262w" alt="" /><figcaption>A circulating 3 Mils coin from Malta showing a honeybee on honeycomb.</figcaption></figure> In ancient Greece, bees were used on some of the earliest coins made in Europe. A silver Greek obol coin minted in Macedon between 412 BCE and 350 BCE, now housed in the British Museum, shows a bee on one side of the coin. <figure class="align-center "><img src="https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" alt="" /><figcaption>An ancient obol from Macedon, dated between 412 BCE and 350 BCE, shows a bee one side.</figcaption></figure> Bees also feature on coins minted elsewhere in the ancient Greek world, such as a bronze coin minted in Ephesus dated between 202 BCE and 133 BCE. <figure class="align-center "><img src="https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=546&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=546&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=546&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=686&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=686&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=686&fit=crop&dpr=3 2262w" alt="" /><figcaption>A bronze coin minted in Ephesus, dated between 202BCE and 133BCE, featuring a honeybee.</figcaption></figure> The use of bees on ancient coins extended for many centuries including widely circulated bronze coins, and new varieties <a href="https://coinweek.com/bee-all-that-you-can-bee-honeybees-on-ancient-coins/">continue to be discovered</a>. <h2>Why we might like bees on coins</h2> Why have bees appeared so often on coins? One approach to this question comes from the field of neuro-aesthetics, which seeks to understand our tastes by understanding the basic brain processes that underpin aesthetic appreciation. From this perspective, it seems likely the sweet taste of honey – which indicates the large amount of sugar it delivers – promotes positive neural activity <a href="https://brill.com/view/journals/artp/10/1/article-p1_2.xml">associated with bees and honey</a>. Indeed, primatologist Jane Goodall once proposed that obtaining high-calorie nutrition from bee honey may have been <a href="https://www.sciencedirect.com/science/article/abs/pii/S0066185668800032">an important step</a> in the cognitive development of primates. Our brain may thus be pre-adapted to liking bees due to their association with the sweet taste of honey. Early usage of bees on coins may have been a functional illustration of the link between a known value (honey) and a new form of currency: coins as money. <h2>The bee on modern coins</h2> <figure class="align-center "><img src="https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=588&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=588&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=588&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=738&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=738&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=738&fit=crop&dpr=3 2262w" alt="" /><figcaption>A 1920 Italian bronze ten-centesimi coin featuring featuring an Italian honeybee on a flower.</figcaption></figure> The use of bees as a design feature has persisted from ancient to modern times. A honeybee visiting a flower is shown on a series of ten-centesimi bronze coins issued in Italy from <a href="https://en.numista.com/catalogue/pieces1960.html">1919 to 1937</a>. (As an aside, the world’s last stock of pure Italian honeybees is found in Australia, on Kangaroo Island, which was declared a sanctuary for Ligurian bees by an <a href="https://www.legislation.sa.gov.au/home/historical-numbered-as-made-acts/1885/0342-Lingurian-Bees-Act-No-342-of-48-and-49-Vic,-1885.pdf">act of parliament</a> in 1885.) <figure class="align-center "><img src="https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=586&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=586&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=586&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=737&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=737&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=737&fit=crop&dpr=3 2262w" alt="" /><figcaption>A coin from Tonga showing 20 honeybees emerging from a hive.</figcaption></figure> More recently, a 20-seniti coin from the Pacific nation of Tonga shows 20 honeybees flying out of a hive. This coin was part of a series initiated by the Food and Agriculture Organization of the United Nations to promote sustainable agricultural and cultural development around the world. Bees are relevant here because their pollinating efforts contribute to about one-third of the food required to feed the world, with a value in excess of <a href="https://zenodo.org/record/2616458">US$200 billion per year</a>, and they are threatened by climate change and other environmental factors. <h2>Bees on coins, today and tomorrow</h2> Public awareness of bees and environmental sustainability may well be factors in the current interest in bee coins. The diversity of countries using bees as a design feature over the entire history of coins suggests people have valued the relationship with bees as essential to our own prosperity for a long time. In Australia, the 2022 honeybee $2 coin is part of a series developed by the <a href="https://www.ramint.gov.au/about-mint">Royal Australian Mint</a>. In 2019, the Perth Mint in Western Australia also released coins and stamps celebrating native bees. <figure class="align-center "><img src="https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=373&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=373&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=373&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=469&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=469&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=469&fit=crop&dpr=3 2262w" alt="" /><figcaption>Australian native bee coin and stamps released in 2019 by the Perth Mint.</figcaption></figure> Despite the decline of cash, bee coins still appear to be going strong. The buzzing companions of human society are likely to be an important subject for coin design for as long as coins continue to be used.<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/208912/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrian-dyer-387798">Adrian Dyer</a>, Associate Professor, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Australian Royal Mint / NZ Post Collectables 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/bees-have-appeared-on-coins-for-millennia-hinting-at-an-age-old-link-between-sweetness-and-value-208912">original article</a>.

Money & Banking

Eerie link between OceanGate pilot and Titanic disaster

A chilling link has been discovered between pilot Stockton Rush, who was onboard the OceanGate submersible, and the Titanic disaster in 1912. Mr Rush, who was at the helm of the vehicle bound for the Titanic wreckage, has a personal connection to two of the victims who were onboard the Titanic when it sank over 100 years ago. His wife, Wendy Rush, is the great-great-granddaughter of Isador Straus, who co-founded Macy’s department store, and Ida Straus, who were among the wealthiest people aboard the Titanic’s ill-fated transatlantic voyage, according to archived records obtained by the New York Times. The Strauses have long been remembered for their display of love and affection when the ocean liner hit the iceberg before infamously sinking in the North Atlantic, claiming the lives of more than 1500 people. Survivors of the disaster reported seeing Ida refuse a place on the lifeboats, which were reserved largely for women and children, and decided to stay onboard the sinking vessel with her husband of more than 40 years. Their tragic love story was depicted in James Cameron’s fictionalised version of the tragedy, his 1997 blockbuster Titanic, which features a scene showing an elderly couple holding on to each other in bed as waters rise around them. Wendy Rush is descended from one of the couple’s daughters, Minnie Strauss, who married Dr. Richard Weil in 1905, and their son, Richard Weil Jr., served as president of Macy’s New York, His son, Dr. Richard Weil III, is Wendy Rush’s father, Joan Adler, the executive director of the Straus Historical Society. Isador’s body was found at sea weeks after the Titanic sank, but his wife’s body was never recovered. Wendy also worked for OceanGate as their communications director, with her LinkedIn indicating she had been on several trips to the wreckage of the Titanic herself. The OceanGate submersible <a href="https://oversixty.co.nz/news/news/surprising-cause-of-death-revealed-for-missing-titan-sub-crew" target="_blank" rel="noopener">reportedly imploded</a> hours after it went missing, with all five people on board believed to be dead. Image credits: OceanGate / Wikimedia

Family & Pets

COVID-19 infection linked to a higher risk of diabetes

A Canadian study looking at more than 600,000 people has found a higher rate of new diabetes diagnoses in those who’d been infected with <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://cosmosmagazine.com/health/covid/" target="_blank" rel="noreferrer noopener">COVID-19</a>. <div class="copy"> The study, which is <a href="https://doi.org/10.1001/jamanetworkopen.2023.8866" target="_blank" rel="noreferrer noopener">published</a> in JAMA Network Open, suggests that COVID may be responsible for a 3% to 5% excess burden of diabetes at the population level. The Canadian researchers drew on data from the British Columbia COVID-19 Cohort: a study that collected the health records of people tested for SARS-CoV-2 in the province from January 2020 to December 2021. From this cohort, 125,987 people tested positive to COVID-19. The researchers matched each of these people with four unexposed people of the same age, sex, and test date. This gave them a sample of 629,935 people, a fifth of whom had been infected with SARS-CoV-2. They then went looking for incident diabetes – that is, a new diagnosis – more than 30 days after the COVID test. The COVID-positive group had a rate of 672.2 new diabetes diagnoses per 100,000 people, significantly higher than the control group’s rate of 508.7 new diagnoses per 100,000. This translates to roughly 3-5% extra diabetes cases at a population level, according to the researchers’ analysis. “Our overall results were consistent with several other studies finding higher risk of incident diabetes after SARS-CoV-2 infection; however, the increase in risk was lower in our analysis compared with other studies,” they write in their paper. They suggest a few differences in study populations for this discrepancy. It’s not yet clear why there’s a link between COVID infection and diabetes. In their paper, the researchers point out that SARS-CoV-2 has been shown to attack pancreatic cells which are involved with insulin production. Low-grade inflammation from COVID could also play a role. But these processes are still poorly understood. “Our study highlights the importance of health agencies and clinicians being aware of the potential long-term consequences of COVID-19 and monitoring people after COVID-19 infection for new-onset diabetes for timely diagnosis and treatment,” conclude the researchers. </div> <div id="contributors"> This article was originally published on <a href="https://cosmosmagazine.com/health/covid/diabetes-covid-link/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Images: Getty </div>

Body

Global review shows link between social media use, body image and eating disorders

Body image has remains a <a href="https://www.missionaustralia.com.au/what-we-do/research-impact-policy-advocacy/youth-survey" target="_blank" rel="noopener">top personal concern</a> for young people in Australia, with 76% concerned about the issue. Social media use by teens is rising at the same time – with <a href="https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Social-Media-and-Teens-100.aspx" target="_blank" rel="noopener">more than 90% on platforms</a> like Facebook, YouTube, Instagram, Snapchat, WeChat and TikTok. While there have long been concerns about the association between social media, body image and eating disorders the connection remains relatively unexplored as a public health issue. Now, researchers from University College London in the UK have undertaken a systematic review of 50 scientific studies across 17 countries showing clear links between social media use and body image concerns. The paper, <a href="https://doi.org/10.1371/journal.pgph.0001091" target="_blank" rel="noopener">published</a> in PLOS Global Public Health, analyses the relationship between body image or eating disorders in young people and social media use. The researchers identify specific aspects of social media – platforms with an emphasis on photos, and engaging with “fitspiration” and “thinspiration” trends – as the factors most closely linked to body image concerns, disordered eating and poor mental health. Other key risk factors included female gender, high body-mass-index and pre-existing body image concerns. The researchers note further studies are needed into the direction of causality. “For example, do body image dissatisfaction and disordered eating occur because of social media usage, or do these pre-exist, encourage engagement in certain online activities, and result in unfavourable clinically significant outcomes?” they ask. Eating disorders involve disturbed attitudes to body image, pre-occupation with weight and body shape and are associated with significant negative outcomes such as cardiovascular disease, reduced bone density, and psychiatric conditions. In Australia, the <a href="https://butterfly.org.au/" target="_blank" rel="noopener">Butterfly Foundation</a> reports eating disorders affect around one million people, with the conditions causing more people die each year than the road toll. Image credits: Getty Images This article was originally published on <a href="https://cosmosmagazine.com/health/social-media-use-body-image/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Petra Stock.

Technology

Gaming 'loot boxes' linked to problem gambling

Gamers who purchase 'loot boxes' - digital treasure chests filled with random items that you buy in games using real-world currency - are more likely to have a problem with gambling, according to new research. A study published in <a href="https://doi.org/10.1080/16066359.2022.2141717" target="_blank" rel="noopener">Addiction Research & Theory</a> has found that 57 percent of adults surveyed who had bought loot boxes had gambled in the same year, compared to 37 percent of a control group who hadn't bought the virtual items. While previous studies have found a link between loot box purchasing, gambling and problem gambling, this study explored whether this link was due to psychological risk factors for gambling, such as childhood neglect, emotional distress, and the tendency to act rashly when upset. After analysing the purchase history and questionnaires of 1,189 Canadian university students, along with 499 adults recruited from the community, they found that a similar proportion of the students and adults had bought loot boxes, with an average spend between $90.63 and $240.94 respectively. Among the students, 28 percent of loot box-purchasers also gambled, in comparison to 19 percent of those who hadn't bought any loot boxes. Students who reported buying more loot boxes and other 'riskier' habits were also more likely to have a gambling habit. While this wasn't seen in the adult group, the authors argue this may be due to the small sample size. "Findings indicate that loot box purchasing represents an important marker of risk for gambling and problem gambling among people who play video games," Sophie Coelho, a PhD student at Toronto’s York University, said. "The persistent associations we observed between loot box purchasing and gambling may provide preliminary support for the role of loot boxes as a 'gateway' to gambling and eventually problem gambling. "Loot boxes may prime people to gamble and increase susceptibility to problem gambling." As for the role of gambling risk factors, the authors found that adverse childhood experiences, like abuse and neglect, were "most consistently associated with an increased likelihood of past-year gambling and greater problem gambling". They concluded that those with troubled upbringings have a "heightened vulnerability" to develop a gambling problem. “This may be compounded by engaging with gambling-like features embedded in video games, such as loot boxes," they added. Loot boxes, also called loot or prize crates, have become the subject of controversy recently, with concerns that their use of random chance to give players randomised weapons, armour, and items they can use to customise their character could be a form of gambling. In some games, loot boxes became a way to “pay to win”, with items that can affect gameplay and offer a competitive advantage, driving players to pay for more loot boxes to get items that allow them to compete with other players. Some countries have begun to introduce laws to regulate loot boxes, with Belgium and the Netherlands banning loot boxes altogether. In Australia, a law to restrict the use of loot boxes in games aimed at children has been proposed which could see games with loot boxes given a rating of R18+ or RC (“Refused Classification”, so they can't be sold in Australia) and carry warning labels. Image: Sameboat, CC BY-SA 4.0 (Wikimedia Commons)

Money & Banking

Severe COVID-19 linked to signs of ageing in the brain

COVID-19 infection has been associated with the same molecular changes seen in ageing brains, including higher levels of activity from genes associated with the ageing process. As we age, our brains shrink - with a five percent decline in weight per decade after the age of 40 - while our memory and levels of neurotransmitters like serotonin and dopamine decline. With previous research finding that people who are infected with Covid can experience neurological conditions after they recover, as well as declines in cognitive performance that mimic accelerated ageing, a team of researchers from Harvard Medical School examined the brain tissue of 54 deceased people, including 21 who had severe Covid infections. They found that changes in how genes were expressed in the brains of Covid-infected people were similar to what is seen in older brains. Using a particular kind of analysis called whole-transcriptome sequencing, the team were able to investigate which genes were being switched on and off in a person at the time of their death, comparing brain samples from people infected with Covid and those who hadn’t been infected (from before the pandemic). In comparison to the uninfected group, the Covid group showed higher levels of activity for genes associated with immunity. Meanwhile, genes linked to cognition, memory and the activity of synapses, which are essential for helping impulses travel through the nervous system, had lower levels of expression. "We also observed significant associations of cellular response to DNA damage, mitochondrial function, regulation of response to stress and oxidative stress, vesicular transport, calcium homeostasis, and insulin signalling/secretion pathways previously associated with ageing processes and brain ageing," they wrote. "Altogether, our analyses suggest that many biological pathways that change with natural ageing in the brain also change in severe COVID-19." Also investigating the trigger of these changes, they found increased levels of activity in several inflammatory pathways associated with ageing in the brain, and that specific immune cells influence the expression of several of these genes. This supports the hypothesis that the neurological symptoms that can accompany Covid are caused by inflammation triggered by the virus. But they also explored the other hypothesis, that the neurological symptoms are caused by the virus infiltrating and infecting the brain - specifically the frontal cortex - by looking to see whether there was evidence of Covid RNA (which contains the virus’ genetic material it needs to replicate). “In agreement with previous studies, SARS-CoV-2 viral RNA was not detected in samples from individuals with COVID-19, suggesting that the observed gene expression changes are unlikely due to the effects of the viral RNA in the frontal cortex,” they wrote. With these findings, the researchers concluded that managing Covid-induced inflammation could protect against the development of the neurological symptoms associated with Covid. They also argue that following up with patients recovering from Covid could be beneficial in reducing the risk or delaying the neurological symptoms and cognitive decline. Speaking to Nature, neuropathologist Marianna Bugiani, who wasn’t involved in the study, said that it’s still difficult to know whether these changes to gene expression are permanent or whether they are also seen in people experiencing mild bouts of Covid. “It opens a plethora of questions that are important, not only for understanding the disease, but to prepare society for what the consequences of the pandemic might be,” she said. “And these consequences might not be clear for years.” The researchers published their findings in the journal <a href="https://doi.org/10.1038/s43587-022-00321-w" target="_blank" rel="noopener">Nature Aging</a>. Image: Getty Images

Mind

How a sense of purpose can link creativity to happiness

There are plenty of famous artists who have produced highly creative work while they were deeply unhappy or suffering from poor mental health. In 1931, the poet T.S. Eliot <a href="https://muse.jhu.edu/article/615958">wrote a letter</a> to a friend describing his “considerable mental agony” and how he felt “on the verge of insanity”. Vincent Van Gogh eventually took his own lifet, <a href="https://ajp.psychiatryonline.org/doi/pdfplus/10.1176/appi.ajp.159.4.519">having written</a> of “horrible fits of anxiety” and “feelings of emptiness and fatigue”. So how are creativity and happiness linked? Does happiness make us more creative or does creativity make us happy? Most of the research so far seems to indicate that a <a href="https://www.sciencedirect.com/science/article/pii/S074959780800054X">positive mood enhances creativity</a>. But others have <a href="https://www.tandfonline.com/doi/abs/10.1080/10400419.2003.9651405">challenged this argument</a>, suggesting a more complex relationship. For example, a <a href="https://www.ncbi.nlm.nih.gov/pubmed/23063328">large study</a> in Sweden found that authors were more likely to suffer from psychiatric disorders compared to people from non-creative professions. Even in the corporate world, it has been suggested that negative emotions can <a href="https://www.london.edu/lbsr/why-negative-emotions-can-spark-creativity">spark creativity</a> and that “anxiety can focus the mind”, resulting in improved creative output. Meanwhile, the psychologist Mihaly Csikszentmihalyi conducted <a href="https://www.amazon.co.uk/Creativity-Psychology-Discovery-Mihaly-Csikszentmihaly/dp/0062283251/ref=asc_df_0062283251/?tag=googshopuk-21&linkCode=df0&hvadid=310973726618&hvpos=1o1&hvnetw=g&hvrand=8230695318472149356&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=1006567&hvtargid=pla-435435502203&psc=1&th=1&psc=1">extensive research</a> on creative individuals across many disciplines, which found a common sense among all the people he interviewed: that they loved what they did, and that “designing or discovering something new” was one of their most enjoyable experiences. It seems, then, that research to date supports a variety of different views, and I believe one of the reasons for this relates to time scale. A key factor that affects creativity is attention. In the short term, you can get people to pay attention using external rewards (such as money) or by creating pressure to meet urgent deadlines. But it is much harder to sustain creativity over longer periods using these approaches – so the role of happiness becomes increasingly important. My <a href="https://20twentybusinessgrowth.com/">experience of working</a> with a large number of commercial organisations in Wales (and my own career in the public and private sectors) is that creativity is often not sustained within an organisation, even when it is encouraged (or demanded) by senior management. Typical reasons for this lack of sustained creativity are pressures and stresses at work, the fear of judgement, the fear of failure, or employee apathy. One way to tackle this might be to aspire to psychologist Paul Dolan’s <a href="https://www.amazon.co.uk/Happiness-Design-Finding-Pleasure-Everyday/dp/0141977531/ref=asc_df_0141977531/?tag=googshopuk-21&linkCode=df0&hvadid=310805565966&hvpos=1o2&hvnetw=g&hvrand=3028055397477065849&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=1006567&hvtargid=pla-453838269765&psc=1&th=1&psc=1">definition of happiness</a>as the “experiences of pleasure and purpose over time”. He describes purpose as relating to “fulfilment, meaning and worthwhileness” and believes we are at our happiest with a “balance between pleasure and purpose”. Therefore, if your work is meaningful, fulfilling and worthwhile it helps in supporting your happiness. It also has the added advantage of making you want to engage and pay attention (rather than having to). Bringing <a href="https://www.youtube.com/watch?v=xegfNVFgxBs">purpose and creativity together</a> helps provide the intrinsic motivation for undertaking creativity, what has been called the “<a href="https://www.researchgate.net/publication/11946306_Self-Determination_Theory_and_the_Facilitation_of_Intrinsic_Motivation_Social_Development_and_Well-Being">energy for action</a>”, and enables creativity to be sustained. So, if you want to be creative in the long term, the key questions to ask yourself are whether you are doing work that is interesting and enjoyable for you, and is that work of value to you? Or, as the American academic Teresa Amabile <a href="https://www.amazon.co.uk/Progress-Principle-Ignite-Engagement-Creativity/dp/142219857X/ref=sr_1_1?adgrpid=52852474973&gclid=CjwKCAjw7anqBRALEiwAgvGgm7iZtdMahFJqhgxsC2Vr0P4aDxPC5aF1N6xhibIux1kR4TIfVxrnbRoCIE0QAvD_BwE&hvadid=259142341871&hvdev=c&hvlocphy=9045373&hvnetw=g&hvpos=1t1&hvqmt=e&hvrand=4572506516620655268&hvtargid=aud-613328383159%3Akwd-300577486763&hydadcr=11464_1788015&keywords=the+progress+principle&qid=1565170905&s=gateway&sr=8-1">puts it</a>, do you “perceive your work as contributing value to something or someone who matters”. <h2>Performance anxiety</h2> Another question to ask yourself is: are you helping others gain that “energy for action”, whether you are a manager in a company or a teacher in a school. In situations where creative work has not been associated with happiness, such as the example of some prominent artists and authors, it might well be that their creative work was still driven by a sense of purpose and that other factors made them unhappy. Another common element affecting the happiness of many creative people is the pressure they put on themselves to be creative, something I have often <a href="https://repository.cardiffmet.ac.uk/handle/10369/10281?locale-attribute=cy">seen with my own students</a>. This kind of pressure and stress can result in creative blocks and consequently perpetuate the problem. So maybe the solution in these situations is to seek pleasure rather than purpose, as a positive mood does seem to enhance creativity, or to encourage people to be more playful. For those creative people who suffer from mental health problems, it is a much more complicated picture. But perhaps the act of undertaking creative activity can at least help in the healing process. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/how-a-sense-of-purpose-can-link-creativity-to-happiness-115335" target="_blank" rel="noopener">The Conversation</a>.

Art

Natural spaces linked to better health – especially for poorer areas

We know wealth is a huge decider of public health, with people in wealthier neighbourhoods enjoying longer life expectancy. Now a new study has suggested that natural spaces can reduce this inequality. Published in the Journal of Epidemiology of Community Health, the research suggests that the amount of green and blue space in an area lengthens the lifespans of people under 65: and, critically, narrows the lifespan gap between richer and poorer areas. Fighting for green space is nothing new to many people, like those in places like Adelaide, Perth and Canberra, but this new understanding will add weight to their arguments that it needs to be retained. The researchers took data from the 2016 Scottish Burden of Disease study, which tracks health in the Scottish population at a local level. Examining data from people aged under 65, the researchers tracked “years of life lost”, or YLL, to get an idea of the chance of premature death. The researchers then used the Ordnance Survey Mastermap to examine area of natural space or private garden. This included woodland, marshes, open water, natural and semi natural grassland (such as grass on sports pitches, roadside verges, and farmland), agriculture, and bare rocky ground or sand and soil. Comparing these two showed that areas with the highest income deprivation had smallest amount of natural space and gardens, as well as the worst health. But, even when wealth was controlled for, natural spaces were still linked with improved health. Every 10% increase in natural space was associated with a 7% fall in premature deaths. Because the study is observational, the researchers can’t show that natural spaces are causing better health: even though income has been taken into account, there may be other factors at play. But, since this result is similar to other studies which have found a beneficial effect of nature, the researchers are hopeful that natural spaces have an “equigenic” effect: they can help to equalise the effects of wealth inequality. “An increased amount of natural/green spaces within local areas has the potential to reduce the disparity in YLL between the most and least income deprived areas,” write the researchers in their paper. An accompanying editorial points out that we still don’t fully understand why natural spaces are good for our health. “Why is green space beneficial? An obvious explanation is that interaction with the natural environment drove our evolution; thus, we prefer biologically diverse environments and derive mental benefits from them,” write the editorial authors, who weren’t involved with the research. “Physical activity, facilitated by green space, is an established contributor to better health,” they add. They also suggest that more time in green space improves the diversity of our microbiome and immunity, but advocate for more research in the area. This article originally appeared on <a href="https://cosmosmagazine.com/health/natural-space-health-inequality/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Image: Shutterstock

Body

High score: Video game play linked to better cognitive performance

Children playing video games for more than three hours a day score better on cognitive performance compared to non-gamers. A study involving more than 1,800 children aged nine and ten by researchers at the University of Vermont in the United States, is believed to be the largest investigation looking at the association between <a href="https://cosmosmagazine.com/people/good-games/" target="_blank" rel="noreferrer noopener">video games</a>, cognition and brain function. The researchers found children who played more than 21 hours of video games per week recorded better scores for <a href="https://cosmosmagazine.com/technology/can-games-tell-if-you-are-impulsive/" target="_blank" rel="noreferrer noopener">response inhibition</a> and working memory than those who never played. The article is <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797596?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=102422" target="_blank" rel="noreferrer noopener">published</a> in JAMA Network Open. Lead author Dr Bader Chaarani told Cosmos, “it makes sense that if you consider the brain is like a muscle, the more you train it, the better it performs.” Impulse control is considered important as it is linked to substance use in adolescence, while working memory is connected to IQ and language processing, Chaarani says. In the study, the children performed two tasks inside an MRI scanner. The first was a ‘stop signal task’ measuring impulse control. The task required children to press a button when arrows pointed left or right, but not press anything when the arrows point up. The second, a working memory task showed children pictures of faces and tested their recall. Children were also tested outside the scanner using oral and verbal tasks. In contrast to the findings of other research, the study did not find any significant difference between gamers and non-gamers in terms of mental health or behaviour. <div class="newsletter-box"> <div id="wpcf7-f6-p220302-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> </div> </div> Chaarani says, “many parents today are concerned about the effects of video games on their children’s health and development, and as these games continue to proliferate among young people, it is crucial that we better understand both the positive and negative impact that such games may have.” In Australia, 78% of children and teenagers play video games, averaging 106 minutes per day, according to <a href="https://igea.net/wp-content/uploads/2021/10/DA22-Report-FINAL-19-10-21.pdf" target="_blank" rel="noreferrer noopener">research commissioned</a> by the Interactive Games and Entertainment Association. In the University of Vermont study, non-video gamers (who spent zero hours a week playing games) and gamers (who played more than 21 hours a week) were recruited from a mix of 21 public, private and charter schools across the United States. The two groups did not differ in terms of characteristics such as age, BMI or IQ. However, the gamers group had a higher share of boys, and lower parental income on average. The research forms part of the <a href="https://abcdstudy.org" target="_blank" rel="noreferrer noopener">Adolescent Brain Cognitive Development Study</a>, the largest long-term study of brain development and child health in the United States. This allows children to be tracked over time into early adulthood to see if changes in video gaming behaviour are linked to changes in cognitive skills, brain activity, behaviour, and mental health. While the results showed an association between playing video games and higher cognitive performance, the paper notes it does not evidence for causality. This will be the focus of further research, given the Adolescent Brain Cognitive Development Study follows children every two years. Chaarani says they also plan to look at the effect of video game genre in future work. The current study did not differentiate by the type of video games children played, whether puzzle games, action adventure, sports, simulation or shooters; or single versus multi-player games. “There are some smaller studies reporting that different types of games may engage different areas in the brain, different functions of the brain… but because of the sample size we cannot trust them enough,” he says. “For the nine and ten years old, we’ve been looking at surveys done internationally. So, these kids tend to play more fast-paced games like action, adventure and shooters that give you immediate reward rather than slow paced games.” <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=220302&title=High+score%3A+Video+game+play+linked+to+better+cognitive+performance" width="1" height="1" /> <div id="contributors"> <a href="https://cosmosmagazine.com/technology/high-score-video-game-play-linked-to-better-cognitive-performance/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Petra Stock. Image: Getty Images </div>

Technology

Aggressive prostate cancer might be linked to ancestral heritage

Globally prostate cancer was the second most frequent cancer, and the fifth leading cause of cancer death, among men in 2020. It was the most commonly diagnosed cancer in Australia in 2018 (and is estimated to remain so in 2022); a man has a 1 in 6 (or 17%) risk of being diagnosed with prostate cancer by the age of 85. But not everyone on Earth is similarly affected by the disease, in fact there are significant differences in the severity of prostate cancer across different ethnicities – particularly across sub-Saharan Africa, where mortality rates are 2.7 times higher than global averages. But is it ancestry, geography, or a combination of the two, that’s causing this variation? To address this question, researchers sequenced the genetics of prostate cancer tumours from South African, Brazilian, and Australian donors. The results, which have been published in two new studies in Nature and Genome Medicine, identified new prostate cancer subtypes and cancer drivers that can distinguish a patient’s ancestry and predict whether the cancer might become life-threatening. “Our understanding of prostate cancer has been severely limited by a research focus on Western populations,” says senior author, Professor Vanessa Hayes, genomicist and Petre Chair of Prostate Cancer Research at the University of Sydney’s Charles Perkins Centre and Faculty of Medicine and Health in Australia. “We found Africans to be impacted by a greater number and spectrum of acquired (including cancer driver) genetic alterations, with significant implications for ancestral consideration when managing and treating prostate cancer,” Hayes says. <h2>Africans’ prostate cancer tumours have more mutations</h2> The researchers sequenced the genomes of untreated prostate cancer samples collected from 183 patients – including 123 South African, 53 Australian, and 7 Brazilian individuals – and were able to identify around 2 million genetic variants (mutations) involved in the cancer. “What was unique about this study is that we sequenced – it means we read the entire DNA sequence of the tumour and blood – from the Africans and Australians in the exact same batch, everything was done in Australia,” explains Hayes. “And that was really important, because that meant the samples went through one technical pipeline and one analysis pipeline.” This was necessary so that the genomic data of all the patients in the study, whether from Australia, Brazil, or South Africa, could be compared – like apples to apples. “Most Australian men, nine out of ten actually, will die with prostate cancer rather than from prostate cancer. We have no idea what distinguishes that one of the ten Australians on the line-up, so we actually have to look away from Australia to try and understand the context,” says Hayes. And they found significant differences between the tumours of people with African ancestry compared to those from Europe. In Africans, the tumours were more mutated – they had a higher tumour mutational burden. According to Hayes, this is important because small mutational events are usually not as common in prostate cancer, like they are in melanoma or lung cancer. And, unlike UV exposure with melanoma or smoking with lung cancer, there is no known carcinogenic driver for prostate cancer. “What we saw in Africans is that the burden of these small changes was higher than in Australians, which raises the idea: is there some carcinogen, some environmental exposure within Africa, which is contributing to aggressive prostate cancer in the region? “So, if we can identify it, then maybe that is what that one of the ten Australian men were also exposed to in their lifetime.” <h2>New ways to classify prostate cancer subtypes</h2> Using computational data science, the team was able to classify the prostate cancers into four different subtypes called global mutational subtypes (GMS). “Combining our unique dataset with the largest public data source of European and Chinese cancer genomes allowed us, for the first time, to place the African prostate cancer genomic landscape into a global context,” says Dr Weerachai Jaratlerdsiri, a computational biologist from the University of Sydney and first author on the Nature paper. Because the patients’ genomes had been sequenced from samples of their blood as well as the tumours, the researchers were able to define their genetic ancestries. Hayes says it’s like doing Ancestry.com but on steroids, because while “Ancestry.com only looks at 600,000 letters across the DNA, we looked at 7 million.” They identified two cancer subtypes – GMS-B and GMS-D – that were only found in the populations with African ancestry. They also identified the universal GMS-A subtype (which occurred in all ethnicities) and the GMS-C subtype – seen in people with African ancestry and people with European ancestry. Those with the GMS-C subtype were significantly more likely to die from prostate cancer than the other subtypes, and clinicians will now be able to use this finding as a prognostic marker to determine whether someone might experience poor clinical outcomes. Five of the South Africans included in the study had European ancestry, but their families had lived in South Africa for multiple generations. Interestingly, one of them had a tumour categorised as a GMS-D subtype, despite this otherwise only having been seen in patients with African ancestry. The team have now received funding to look at a further 100 Africans with European ancestry, but whose ancestors had lived in Africa for generations, to see whether there is a geographical, environmental aspect that might be contributing to the accumulation of these types of mutations. <h2>Opening up new avenues for treatment</h2> The second paper, published in Genome Medicine, focused on the large and dramatic changes to the genome, called “structural variations”, that prostate cancer is prone to. For instance, parts of the chromosome break off, delete, or insert themselves somewhere else, or the chromosomes shatter and come back together again causing rearrangements. These are difficult to locate in the genome because scientists have to use computational methods to infer whether these mutations are there or not. But by using multiple different computational tools the researchers were able to identify brand new mutational drivers of prostate cancer – genes not previously known to be involved in prostate cancer. This opens up new opportunities for treatment, because knowing these drivers allows scientists to design new therapeutic targets or repurpose existing drugs that may already be used to target these genes in other diseases. This article originally appeared on <a href="https://cosmosmagazine.com/health/prostate-cancer-ancestral-heritage/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Imma Perfetto. Image: Shutterstock

Body

Mortali-tea! Black tea drinking linked to lower risk of dying

The health benefits of green tea are well-established, but black tea might be a good idea too, according to a new analysis. The study, published in Annals of Internal Medicine, draws on data from nearly half a million people to find a link between black tea drinking and lower mortality risk. The researchers, who are based at the US National Institute of Health, examined data from the long-term UK Biobank study, which tracked a cohort of 502,488 UK residents aged between 40 and 69. Between 2006 and 2010, participants in this study regularly logged a range of lifestyle, and health-related information via touchscreens at assessment centres. This information included tea drinking, by number of cups per day. Among the 498,043 participants who logged tea-drinking information, 85% reported regularly drinking tea. Nearly a fifth of participants (19%) reported drinking more than six cups of tea per day. A separate survey of a smaller cohort of participants suggested that 89% of the tea drinkers drank black tea, while 7% drank green tea. According to the UN, the UK consumes around 100,000 tonnes of tea each year – or about 1.5 kilograms per person. The American researchers combined the tea-drinking information in the UK with mortality data. Once they’d adjusted for age and demographics, they found that participants who drank at least two cups of tea per day had a 9-13% lower risk of dying. Drinking 2-3 cups per day was associated with the lowest mortality risk, but even drinking 10 or more cups was linked to a lower mortality risk than drinking no tea at all. In their paper, the researchers say that their findings reflect similar studies based in China and Japan, where green tea is much more common than black. “Fewer studies have assessed tea intake and mortality in populations where black tea is predominantly consumed, such as in the United States and Europe, and results have varied across studies,” write the researchers. They point out, however, that they didn’t track some “potentially important aspects” like tea strength or cup size, making it harder to draw precise conclusions. While the study is observational and thus can’t establish a cause, the researchers point out that the polyphenols and flavonoids in black tea have been linked to a variety of health benefits in small randomized-control trials – including lower cholesterol, and a lower risk of carcinogenesis and type 2 diabetes. “These findings provide reassurance to tea drinkers and suggest that black tea can be part of a healthy diet,” write the researchers. This article originally appeared in <a href="https://cosmosmagazine.com/health/black-tea-mortality-risk/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Image: Shutterstock

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High score: Video game play linked to better cognitive performance

Aggressive prostate cancer might be linked to ancestral heritage

Mortali-tea! Black tea drinking linked to lower risk of dying