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For type 2 diabetes, focusing on when you eat – not what – can help control blood sugar

<p><em><a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Type 2 diabetes affects <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-common-is-diabetes/type-2-diabetes">1.2 million Australians</a> and accounts for <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">85-90%</a> of all diabetes cases. This chronic condition is characterised by high blood glucose (sugar) levels, which carry serious <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30058-2/abstract">health</a> risks. <a href="https://www.nature.com/articles/nrendo.2017.151">Complications</a> include heart disease, kidney failure and vision problems.</p> <p>Diet is an important way people living with type 2 diabetes manage blood glucose, alongside exercise and medication. But while we know individualised, professional dietary advice improves blood glucose, it can be <a href="https://linkinghub.elsevier.com/retrieve/pii/S0168822717317588">complex</a> and is not always <a href="https://www.publish.csiro.au/py/PY13021">accessible</a>.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">Our new study</a> looked at the impact of time-restricted eating – focusing on when you eat, rather than what or how much – on blood glucose levels.</p> <p>We found it had similar results to individualised advice from an accredited practising dietitian. But there were added benefits, because it was simple, achievable, easy to stick to – and motivated people to make other positive changes.</p> <h2>What is time-restricted eating?</h2> <p>Time-restricted eating, also known as <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-082018-124320">the 16:8 diet</a>, became popular for weight loss around 2015. Studies have since shown it is also an <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">effective way</a> for people with type 2 diabetes to manage blood glucose.</p> <p>Time-restricted eating involves limiting when you eat each day, rather than focusing on what you eat. You restrict eating to a window during daylight hours, for example between 11am and 7pm, and then fast for the remaining hours. This can sometimes naturally lead to also eating less.</p> <p>Giving your body a break from constantly digesting food in this way helps align eating with natural <a href="https://doi.org/10.1111/jne.12886">circadian rhythms</a>. This <a href="https://doi.org/10.1111/jnc.15246">can help</a> regulate metabolism and improve overall health.</p> <p>For people with type 2 diabetes, there may be specific benefits. They often have their <a href="https://doi.org/10.2337/dc12-2127">highest blood glucose</a> reading in the morning. Delaying breakfast to mid-morning means there is time for physical activity to occur to help reduce glucose levels and prepare the body for the first meal.</p> <h2>How we got here</h2> <p>We ran an <a href="https://www.mdpi.com/2072-6643/12/11/3228">initial study</a> in 2018 to see whether following time-restricted eating was achievable for people with type 2 diabetes. We found participants could easily stick to this eating pattern over four weeks, for an average of five days a week.</p> <p>Importantly, they also had improvements in blood glucose, spending less time with high levels. <a href="https://www.mdpi.com/2072-6643/12/2/505">Our previous research</a> suggests the reduced time between meals may play a role in how the hormone insulin is able to reduce glucose concentrations.</p> <p><a href="https://doi.org/10.1001/jamanetworkopen.2023.39337">Other studies</a> have confirmed these findings, which have <a href="https://doi.org/10.1186/s12986-021-00613-9">also shown</a> notable improvements in HbA1c. This is a <a href="https://www.ncbi.nlm.nih.gov/books/NBK304271/">marker</a> in the blood that represents concentrations of blood glucose over an average of three months. It is the <a href="https://journals.sagepub.com/doi/10.4137/BMI.S38440">primary clinical tool</a> used for diabetes.</p> <p>However, these studies provided intensive support to participants through weekly or fortnightly meetings with researchers.</p> <p>While we know this level of support <a href="https://www.nature.com/articles/0802295">increases</a> how likely people are to stick to the plan and improves outcomes, it is not readily available to everyday Australians living with type 2 diabetes.</p> <h2>What we did</h2> <p>In our <a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">new study</a>, we compared time-restricted eating directly with advice from an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a>, to test whether results were similar across six months.</p> <p>We recruited 52 people with type 2 diabetes who were currently managing their diabetes with up to two oral medications. There were 22 women and 30 men, aged between 35 and 65.</p> <p>Participants were randomly divided into two groups: diet and time-restricted eating. In both groups, participants received four consultations across the first four months. During the next two months they managed diet alone, without consultation, and we continued to measure the impact on blood glucose.</p> <p>In the diet group, consultations focused on changing their diet to control blood glucose, including improving diet quality (for example, eating more vegetables and limiting alcohol).</p> <p>In the time-restricted eating group, advice focused on how to limit eating to a nine-hour window between 10am and 7pm.</p> <p>Over six months, we measured each participant’s blood glucose levels every two months using the HbA1c test. Each fortnight, we also asked participants about their experience of making dietary changes (to what or when they ate).</p> <h2>What we found</h2> <p>We found time-restricted eating was as effective as the diet intervention.</p> <p>Both groups had reduced blood glucose levels, with the greatest improvements occurring after the first two months. Although it wasn’t an objective of the study, some participants in each group also lost weight (5-10kg).</p> <p>When surveyed, participants in the time-restricted eating group said they had adjusted well and were able to follow the restricted eating window. Many told us they had family support and enjoyed earlier mealtimes together. Some also found they slept better.</p> <p>After two months, people in the time-restricted group were looking for more dietary advice to further improve their health.</p> <p>Those in the diet group were less likely to stick to their plan. Despite similar health outcomes, time-restricted eating seems to be a simpler initial approach than making complex dietary changes.</p> <h2>Is time-restricted eating achievable?</h2> <p>The main barriers to following time-restricted eating are social occasions, caring for others and work schedules. These factors may prevent people eating within the window.</p> <p>However, there are many benefits. The message is simple, focusing on when to eat as the main diet change. This may make time-restricted eating more translatable to people from a wider variety of socio-cultural backgrounds, as the types of foods they eat don’t need to change, just the timing.</p> <p>Many people don’t have access to more individualised support from a dietitian, and receive nutrition advice from their GP. This makes time-restricted eating an alternative – and equally effective – strategy for people with type 2 diabetes.</p> <p>People should still try to stick to <a href="https://www.eatforhealth.gov.au/guidelines/guidelines">dietary guidelines</a> and prioritise vegetables, fruit, wholegrains, lean meat and healthy fats.</p> <p>But our study showed time-restricted eating may also serve as stepping stone for people with type 2 diabetes to take control of their health, as people became more interested in making diet and other positive changes.</p> <p>Time-restricted eating might not be appropriate for everyone, especially people on medications which don’t recommend fasting. Before trying this dietary change, it’s best speak to the healthcare professional who helps you manage diabetes.<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/241472/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, Research Fellow in Exercise Metabolism and Nutrition, Mary MacKillop Institute for Health Research, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, Lecturer in Nutrition and Dietetics, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/for-type-2-diabetes-focusing-on-when-you-eat-not-what-can-help-control-blood-sugar-241472">original article</a>.</em></p>

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Walking can prevent low back pain, a new study shows

<p><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year.</p> <p>The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system.</p> <p>In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.</p> <h2>The WalkBack trial</h2> <p>We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).</p> <p>Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.</p> <p>The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.</p> <p>The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.</p> <p>Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.</p> <p>People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care.</p> <h2>What the results showed</h2> <p>We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.</p> <p>The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.</p> <p>Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.</p> <p>Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.</p> <p>This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.</p> <p>Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.</p> <h2>Walking has multiple benefits</h2> <p>We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain.</p> <p>A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.</p> <p>On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.</p> <p>Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.</p> <p>While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.</p> <h2>Why is walking helpful for low back pain?</h2> <p>We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain.</p> <p>It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this.</p> <p>Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<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/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>.</em></p>

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I want to eat healthily. So why do I crave sugar, salt and carbs?

<p><em><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>We all want to eat healthily, especially as we reset our health goals at the start of a new year. But sometimes these plans are sabotaged by powerful cravings for sweet, salty or carb-heavy foods.</p> <p>So why do you crave these foods when you’re trying to improve your diet or lose weight? And what can you do about it?</p> <p>There are many reasons for craving specific foods, but let’s focus on four common ones:</p> <h2>1. Blood sugar crashes</h2> <p>Sugar is a key energy source for all animals, and its taste is one of the most basic sensory experiences. Even without specific sweet taste receptors on the tongue, a strong preference for sugar can develop, indicating a mechanism beyond taste alone.</p> <p>Neurons <a href="https://www.nature.com/articles/s41593-021-00982-7">responding to sugar</a> are activated when sugar is delivered to the gut. This can increase appetite and make you want to consume more. Giving into cravings also drives an appetite for more sugar.</p> <p>In the long term, research suggests a high-sugar diet can affect <a href="https://www.bmj.com/content/369/bmj.m2382">mood</a>, digestion and <a href="https://pubmed.ncbi.nlm.nih.gov/33339337/">inflammation</a> in the <a href="https://www.science.org/doi/10.1126/scitranslmed.aay6218?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">gut</a>.</p> <p>While there’s a lot of <a href="https://www.sciencedirect.com/science/article/pii/S0149763402000040?via%3Dihub#aep-section-id23">variation between individuals</a>, regularly eating sugary and high-carb foods can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/30951762/">rapid spikes and crashes</a> in blood sugar levels. When your blood sugar drops, your body can respond by craving quick sources of energy, often in the form of sugar and carbs because these deliver the fastest, most easily accessible form of energy.</p> <h2>2. Drops in dopamine and serotonin</h2> <p>Certain neurotransmitters, such as <a href="https://pubmed.ncbi.nlm.nih.gov/30595479/">dopamine</a>, are involved in the reward and pleasure centres of the brain. Eating sugary and carb-rich foods can trigger the release of dopamine, creating a pleasurable experience and reinforcing the craving.</p> <p>Serotonin, the feel-good hormone, suppresses <a href="https://www.sciencedirect.com/science/article/pii/S1569733910700886">appetite</a>. Natural changes in serotonin can influence daily fluctuations in mood, energy levels and attention. It’s also associated with eating more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829131/">carb-rich snacks in the afternoon</a>.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/21985780/">Low carb diets</a> may reduce serotonin and lower mood. However, a recent systematic review suggests little association between these diets and risk for <a href="https://www.sciencedirect.com/science/article/pii/S0165032722013933?via%3Dihub">anxiety and depression</a>.</p> <p>Compared to men, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189179/">women tend to crave more carb rich foods</a>. Feeling irritable, tired, depressed or experiencing carb cravings are part of premenstrual <a href="https://pubmed.ncbi.nlm.nih.gov/29218451/">symptoms</a> and could be <a href="https://www.ncbi.nlm.nih.gov/books/NBK560698/">linked to</a> reduced <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9928757/">serotonin levels</a>.</p> <h2>3. Loss of fluids and drops in blood sugar and salt</h2> <p>Sometimes our bodies crave the things they’re missing, such as hydration or even salt. A low-carb diet, for example, <a href="https://www.ncbi.nlm.nih.gov/books/NBK537084/">depletes</a> insulin levels, decreasing sodium and water retention.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S1933287419302673">Very low-carb diets</a>, like ketogenic diets, induce “ketosis”, a metabolic state where the body switches to using fat as its primary energy source, moving away from the usual dependence on carbohydrates.</p> <p>Ketosis is often associated with increased urine production, further contributing to potential fluid loss, electrolyte imbalances and salt cravings.</p> <h2>4. High levels of stress or emotional turmoil</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214609/">Stress</a>, boredom and emotional turmoil can lead to cravings for comfort foods. This is because stress-related hormones can impact our appetite, satiety (feeling full) and food preferences.</p> <p>The stress hormone <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425607/">cortisol</a>, in particular, can drive cravings for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">sweet comfort foods</a>.</p> <p>A <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">2001 study</a> of 59 premenopausal women subjected to stress revealed that the stress led to higher calorie consumption.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/37295418/">A more recent study</a> found chronic stress, when paired with high-calorie diet, increases food intake and a preference for sweet foods. This shows the importance of a healthy diet during stress to prevent weight gain.</p> <h2>What can you do about cravings?</h2> <p>Here are four tips to curb cravings:</p> <p><strong>1) don’t cut out whole food groups.</strong> Aim for a well-balanced diet and make sure you include:</p> <ul> <li> <p><em>sufficient protein</em> in your meals to help you feel full and reduce the urge to snack on sugary and carb-rich foods. Older adults should aim for 20–40g protein per meal with a particular focus on <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.12838">breakfast and lunch</a> and an overall daily protein intake of at least <a href="https://apps.who.int/iris/handle/10665/43411">0.8g</a> per kg of body weight for <a href="https://pubmed.ncbi.nlm.nih.gov/35187864/">muscle health</a></p> </li> <li> <p><em>fibre-rich foods</em>, such as vegetables and whole grains. These make you feel full and <a href="https://pubmed.ncbi.nlm.nih.gov/32142510/">stabilise your blood sugar</a> levels. Examples include broccoli, quinoa, brown rice, oats, beans, lentils and bran cereals. Substitute refined carbs high in sugar like processed snack bars, soft drink or baked goods for more complex ones like whole grain bread or wholewheat muffins, or nut and seed bars or energy bites made with chia seeds and oats</p> </li> </ul> <p><strong>2) manage your stress levels.</strong> Practise stress-reduction techniques like meditation, deep breathing, or yoga to manage emotional triggers for cravings. Practising <a href="https://pubmed.ncbi.nlm.nih.gov/30570305/">mindful eating</a>, by eating slowly and tuning into bodily sensations, can also reduce daily calorie intake and curb cravings and stress-driven eating</p> <p><strong>3) get enough sleep.</strong> Aim for <a href="https://pubmed.ncbi.nlm.nih.gov/33054337/">seven to eight</a> hours of quality sleep per night, with a minimum of seven hours. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031614/">Lack of sleep</a> can disrupt hormones that regulate hunger and cravings</p> <p><strong>4) control your portions.</strong> If you decide to indulge in a treat, control your portion size to avoid overindulging.</p> <p>Overcoming cravings for sugar, salt and carbs when trying to eat healthily or lose weight is undoubtedly a formidable challenge. Remember, it’s a journey, and setbacks may occur. Be patient with yourself – your success is not defined by occasional cravings but by your ability to manage and overcome them.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/212114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-want-to-eat-healthily-so-why-do-i-crave-sugar-salt-and-carbs-212114">original article</a>.</em></p>

Food & Wine

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Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

<p><em><a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>An article published this week in the prestigious journal <a href="https://www.nature.com/articles/s41591-023-02729-2">Nature Medicine</a> documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person.</p> <p>The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors.</p> <p>Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s.</p> <p>The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop <a href="https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/creutzfeldt-jakob-disease-cjd/">Creuztfeldt-Jakob disease</a> (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million.</p> <h2>What’s CJD got to do with Alzehimer’s?</h2> <p>CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell.</p> <p>Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised <a href="https://en.wikipedia.org/wiki/United_Kingdom_BSE_outbreak">public health concerns</a> over the eating of beef products in the United Kingdom in the 1980s.</p> <h2>Human growth hormone used to come from donated organs</h2> <p>Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue.</p> <p>But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00000563.htm">16,000 donated glands</a>.</p> <p>An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people.</p> <p>hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk.</p> <h2>What are the latest findings about Alzheimer’s disease?</h2> <p>The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission.</p> <p>The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease.</p> <p>They considered other explanations for the findings but concluded donated hGH was the likely cause.</p> <p>Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease.</p> <p>Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-017-0488-7">increasing evidence</a> these proteins spread in the brain in a <a href="https://pubmed.ncbi.nlm.nih.gov/8086126/">similar way to prion diseases</a>. So the mode of transmission the authors propose is certainly plausible.</p> <p>However, given the amyloid protein deposits in the brain <a href="https://www.nia.nih.gov/news/estimates-amyloid-onset-may-predict-alzheimers-progression">at least 20 years</a> before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident.</p> <h2>When was this process used in Australia?</h2> <p>In Australia, donated pituitary material <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">was used</a> from 1967 to 1985 to treat people with short stature and infertility.</p> <p><a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">More than 2,000 people</a> received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch.</p> <p>The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are <a href="https://www.mja.com.au/journal/2010/193/6/iatrogenic-creutzfeldt-jakob-disease-australia-time-amend-infection-control">considered to be</a> incredibly small.</p> <p>Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356853/">around 5%</a> of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution.</p> <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> <p>The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide.</p> <p>Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk.</p> <p>The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/steve-macfarlane-4722"><em>Steve Macfarlane</em></a><em>, Head of Clinical Services, Dementia Support Australia, &amp; Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.</em></p>

Mind

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6 signs you’re low in iron

<p>Feeling constantly tired, looking pale and having heart palpitations? Well you could be one of the two billion people thought to suffer from some degree of iron deficiency.</p> <p>Low iron is the most common and widespread nutritional disorder in the world, and is the only nutrient deficiency that is significantly prevalent in the western world, according to the World Health Organization.  </p> <p>Here's how to know, and what to do if you tick all the low iron boxes</p> <p><strong>1. You suffer from fatigue (aka feel tired ALL of the time)</strong></p> <p>The body uses iron to make haemoglobin, the substance in red blood cells that transports oxygen around the body. When you don't have enough healthy red blood cells, you start to feel pretty exhausted. </p> <p><strong>2. You seem to get out of breath easily – even if you’re fit</strong></p> <p>When the body is not efficiently transporting oxygen to the lungs, you can feel breathlessness after minimal exertion. Low iron levels can also cause your endurance to suffer too.</p> <p><strong>3. You look pale and washed out</strong></p> <p>In addition to looking pale, if the inside of your lips, your gums, and the inside of your bottom eyelids are less red than usual, low iron may be the reason behind this. </p> <p><strong>4. You get sick often</strong></p> <p>Ever felt like you’re fighting an endless cold? Research has shown iron deficiency can affect the immune system, making you more likely to pick up infections and viruses.</p> <p><strong>5. You experience heart palpitations</strong></p> <p>Your heart may feel like it's pounding, fluttering or beating irregularly, often for just a few seconds or minutes. </p> <p><strong>6. You get unusual cravings for non-food substances such as dirt, ice, paint, or clay</strong></p> <p>Yes, this does sound very strange, but it's a real symptom that can occur when your body is low in iron – it's called pica. </p> <p><em>Image credits: Getty Images</em></p>

Body

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What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p>If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months).</p> <p>There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles.</p> <p>We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>.</p> <p>But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again.</p> <h2>People are often given the wrong advice</h2> <p>People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis.</p> <p>But these findings are very common in people <em>without</em> low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain.</p> <p>Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain.</p> <p>In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress.</p> <p>It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves.</p> <h2>So how should low back pain be treated?</h2> <p>A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety.</p> <p>Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language.</p> <p>They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities.</p> <p>An example of this type of care is cognitive functional therapy.</p> <h2>What is cognitive functional therapy?</h2> <p><a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out.</p> <p>The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it.</p> <p>It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>.</p> <p>Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required.</p> <h2>What’s the evidence for this type of therapy?</h2> <p>Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments.</p> <p>We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”.</p> <p>We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care.</p> <p>The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>.</p> <p>People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group.</p> <p>The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work.</p> <h2>What does this mean for you?</h2> <p>This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success.</p> <p><a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up.</p> <p>The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <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/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.</em></p>

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Why do I crave sugar and carbs when I’m sick?

<p><em><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Your nose is running, your head hurts and you feel like you’re coming down with a cold. You’re settling in on the couch for a sick day. Then you reach for the snacks.</p> <p>When you’re sick, your appetite often decreases. So why, at other times, do you crave sugary treats and carbohydrate-loaded comfort foods?</p> <p>A food <a href="https://pubmed.ncbi.nlm.nih.gov/28375878/">craving</a> goes beyond a mere desire to eat, it encompasses a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399671/#CR1">complex mix</a> of emotional, behavioural, cognitive and physiological processes. Whether it’s the need for a quick energy source or a temporary relief from discomfort, our bodies and minds work in tandem to drive our food preferences.</p> <p>Here we’ll explore the science behind why our bodies crave sugar and carbs – especially when we’re sick.</p> <h2>Fuelling the immune system</h2> <p>When sickness strikes, our immune system springs into action, requiring additional energy to combat invaders.</p> <p>This heightened activity often leads to an increase in our <a href="https://pubmed.ncbi.nlm.nih.gov/36505552/">metabolic rate</a>, energy demands and nutritional requirements.</p> <p>Sugary treats and carbs are quick sources of energy, satisfying this increased demand.</p> <p>But while a high sugar diet during times of illness may help meet increased metabolic demands, it could also exacerbate the immune and inflammatory response, potentially impeding recovery.</p> <p>In the longer term, high-sugar diets promote chronic <a href="https://pubmed.ncbi.nlm.nih.gov/33339337/">inflammation</a>, <a href="https://www.science.org/doi/10.1126/scitranslmed.aay6218?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">alter gut microbiota</a> composition, and are associated with chronic disease. For a <a href="https://www.mdpi.com/2072-6643/12/4/1181">well-functioning immune system</a>, aim for a <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">balanced intake</a> of <a href="https://pubmed.ncbi.nlm.nih.gov/31267783/">fruits, vegetables</a>, fibre, protein, and low-glycaemic carbohydrates.</p> <h2>The stress response</h2> <p>Being sick is stressful for the body. Acute mild or intense stress, like we’d see if we’re sick, boosts the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5921333/">flight or fight</a>” hormones adrenaline and cortisol. This mobilises stored energy to meet increased demands, but it can also curb appetite.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/31125634/">Prolonged stress</a> can disrupt energy balance, and cause nutritional deficiencies and alterations in gut and brain functions. This can reduce a person’s threshold for craving sugar and salt, increasing their preferences towards energy-dense foods.</p> <p>The stress hormone cortisol can also increase your <a href="https://pubmed.ncbi.nlm.nih.gov/24123563/">preference</a> for high-calorie, comfort foods, which can <a href="https://pubmed.ncbi.nlm.nih.gov/36615866/">temporarily alleviate stress</a>.</p> <h2>The brain’s reward system</h2> <p>Comfort foods trigger your brain’s reward system, releasing feel-good neurotransmitters like <a href="https://pubmed.ncbi.nlm.nih.gov/30595479/">dopamine</a> and serotonin.</p> <p>But “<a href="https://pubmed.ncbi.nlm.nih.gov/30951762/">sugar rushes</a>” are often short-lived and can lead to decreased alertness and heightened fatigue within an hour of consumption.</p> <p>The link between carbohydrates (which the body converts to sugar) and serotonin can be traced back to 1971 when <a href="https://www.science.org/doi/10.1126/science.174.4013.1023?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">researchers</a> found elevated tryptophan levels (serotonin’s precursor) in rats’ plasma and brains after a carbohydrate-rich diet.</p> <p>Subsequent studies in humans established connections between carbohydrates and mood, especially in relation to <a href="https://pubmed.ncbi.nlm.nih.gov/2903717/">obesity, depression and seasonal affective disorder</a>. Therapies enhancing serotonin have since been shown to <a href="https://pubmed.ncbi.nlm.nih.gov/2903717/">reduce carbohydrate intake</a>.</p> <p>Remarkably, around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911970/pdf/molecules-27-01680.pdf">90% of serotonin</a> production occurs in the gut. The vast microbial population in our gut exerts a potent influence on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106557/">immunity, metabolism</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293578/pdf/40168_2021_Article_1093.pdf">appetite</a>.</p> <p>Recent mouse studies have even identified specific microbes linked to <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(22)01750-X">sugar binges after antibiotic treatment</a>.</p> <h2>Some people eat less when they’re sick</h2> <p>Not everyone craves sugar and carbs when they are sick. Some people eat less for a few reasons:</p> <ul> <li> <p>they have less of an appetite. While <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610818/pdf/JDR2017-4527980.pdf">ghrelin</a> (the “hunger” hormone) levels might initially rise, prolonged illness can suppress appetite due to nausea, fatigue and discomfort. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5921333/">Critically ill</a> patients have reduced food intake and are at risk of malnutrition</p> </li> <li> <p><a href="https://pubmed.ncbi.nlm.nih.gov/30777142/">metabolic adaptation</a>. The body might slow specific metabolic processes to conserve energy, reducing overall calorie requirements</p> </li> <li> <p>altered taste perception. <a href="https://pubmed.ncbi.nlm.nih.gov/32195512/#:%7E:text=The%20ability%20of%20an%20individual%20to%20perceive%20tastes,intake%2C%20playing%20an%20important%20role%20in%20promoting%20satiation%2Fsatiety.">Taste</a> is an important component that affects both appetite and energy intake. Alterations in taste and smell is a common symptom when we are sick and was common with <a href="https://doi.org/10.1101/2020.04.05.20048421">COVID</a></p> </li> <li> <p>consuming fluids like water, tea or broths might be more appealing and manageable than solid foods. These fluids provide hydration but contribute minimally to calorie intake.<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/210565/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-crave-sugar-and-carbs-when-im-sick-210565">original article</a>.</em></p>

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Rob Lowe's West Wing confession

<p>Rob Lowe has spoken candidly about leaving one of his most acclaimed TV shows. </p> <p>The 59-year-old actor has opened up about leaving <em>The West Wing</em>, which first aired in 1999 with Lowe playing  the character of Sam Seaborn, the Bartlet administration's deputy communications director, on the very first episode of the show. </p> <p>The show ran for seven seasons and went off the air in 2006, although Lowe left the show during season four. </p> <p>Despite the show's popularity, Lowe said that leaving the show when he did was the best decision to make for him and his future career. </p> <p>Speaking candidly on the Stitcher Studios' podcast <em>Podcrushed</em>, Lowe was asked about why he left the show, and he summed up his departure with an analogy.</p> <p>He said, "I walked away from the most popular girl at school, but I also knew that it was a super unhealthy relationship, and it was the best thing I ever did."</p> <p>The unofficial story when Lowe left the show, as reported by <em><a href="https://www.cnn.com/2002/SHOWBIZ/TV/07/24/west.wing.lowe/index.html" target="_blank" rel="nofollow noopener" data-i13n="cpos:3;pos:1" data-ylk="slk:Daily Variety;cpos:3;pos:1;elm:context_link;itc:0" data-rapid_p="33" data-v9y="1">Daily Variety</a></em>, was that he was doing so because he couldn't get the salary that he wanted. </p> <p>As Lowe explained to <em>Podcrushed</em> hosts Penn Badgley, Nava Kavelin and Sophie Ansari, his decision had boiled down to one thing.</p> <p>"I felt very undervalued," said Lowe, the author of 2012's <em>Stories I Only Tell My Friends</em>. "Whenever I talk to actors who complain about, you know, their relationships on their shows, it happens. It happens in any workplace. You could be in an environment where people sandbag you, want to see you fail, don't appreciate you, whatever it is and whenever I share my stories, people are like, 'I will never share my own stories again.'"</p> <p>"They would make your hair stand up and there's some of them I wrote. I shared some of them in my book, but I purposely didn't share half of the other ones because it would make the people involved look so bad that I didn't want to do it to them."</p> <p>"So, I did not have a good experience. Tried to make it work and tried to make it work and tried to make it work and then what happened was my kids were getting to a certain age where I could see them having first girlfriends or friends and being in a relationship that was abusive and taking it," said Lowe, the father of sons John Owen, a 27-year-old actor, and venture capitalist Matthew, 29. </p> <p>"She's the popular girl, everybody likes her, she's beautiful, it must be great. All the things that people would say about making <em>The West Wing</em> to me. It's so popular, it's so amazing, it must be amazing, but I know what it's like and if I couldn't walk away from it, then how could I empower my kids to walk away from it?"</p> <p>When Lowe did leave the show, he issued a statement on why his character would be written out.</p> <p>"As much as it hurts to admit it, it has been increasingly clear, for quite a while, that there was no longer a place for Sam Seaborn on<em> The West Wing</em>," he said, <a href="https://www.cnn.com/2002/SHOWBIZ/TV/07/24/west.wing.lowe/index.html" target="_blank" rel="nofollow noopener" data-i13n="cpos:5;pos:1" data-ylk="slk:per CNN;cpos:5;pos:1;elm:context_link;itc:0" data-rapid_p="36" data-v9y="1">per CNN</a>. "However, Warner Bros. has allowed me an opportunity to leave the show as I arrived ... grateful for it, happy to have been on it and proud of it. We were a part of television history and I will never forget it."</p> <p><em>Image credits: Getty Images</em></p>

TV

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Harrison Ford is back as an 80-year-old Indiana Jones – and a 40-something Indy. The highs (and lows) of returning to iconic roles

<p><a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Saddle up, don the fedora and crack that whip: Harrison Ford is back as the intrepid archaeologist in <em>Indiana Jones and the Dial of Destiny</em>. The film premiered at Cannes, where Ford was <a href="https://www.hollywoodreporter.com/movies/movie-news/harrison-ford-honorary-palme-dor-cannes-1235495463/">awarded</a> an Honorary Palme d’Or in recognition of his life’s work.</p> <p>Reviews for the fifth film in the franchise <a href="https://www.hollywoodreporter.com/movies/movie-news/indiana-jones-5-review-roundup-1235495961/">have been mixed</a>, and it is the first Indy film not to be directed by Steven Spielberg (this time, it’s James Mangold, best known for his motor-racing drama Ford v Ferrari).</p> <p>But this is “event” cinema that combines nostalgia, old-school special effects and John Williams’ <a href="https://theconversation.com/from-jaws-to-star-wars-to-harry-potter-john-williams-90-today-is-our-greatest-living-composer-176245">iconic score</a>.</p> <p>So, Ford is back, aged 80. What draws actors back after all this time?</p> <figure><iframe src="https://www.youtube.com/embed/eQfMbSe7F2g?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Role returns</h2> <p>Ford first played Indy in 1981 and last played him in 2008. That is a full 15 years since the most recent film in the series, and 42 years since his first outing in <em>Raiders of the Lost Ark</em>.</p> <p>Ford has form in returning to celebrated characters. One of the great pleasures of watching <em>The Force Awakens</em> back in 2015 was seeing Ford play Han Solo again for the <a href="https://www.dailymotion.com/video/x3j2j09">first time in over 30 years</a>.</p> <figure><iframe src="https://www.youtube.com/embed/0xQSIdSRlAk?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Actors return to roles for numerous reasons:</p> <ul> <li>financial (Ford was reportedly paid <a href="https://okmagazine.com/exclusives/harrison-ford-paid-indiana-jones-5-plagued-with-problems/">US$25 million</a> for <em>Dial of Destiny</em>)</li> <li>protection of their brand, image and star persona (Michael Keaton <a href="https://www.fortressofsolitude.co.za/the-flash-movies-biggest-hero-how-michael-keaton-saved-the-film/">returning to play Batman</a> after three decades and three other actors who have embodied the role)</li> <li>professional (Tom Cruise admitted over the 36 years between <em>Top Gun</em> films he wanted to make sure the sequel <a href="https://screenrant.com/top-gun-maverick-tom-cruise-return-how-explained/">could live up to the original</a>)</li> <li>personal (once-huge stars are working less and less, and only feel the need to return to a built-in fan base every few years – Bill Murray in the 2021 <em>Ghostbusters</em> sequel springs to mind).</li> </ul> <p>It’s not always a successful endeavour.</p> <p>Arnold Schwarzenegger and Sylvester Stallone – two of the biggest action stars of the 1980s off the back of iconic roles as <em>The Terminator</em>, Rocky Balboa and John Rambo – have repeatedly returned to those roles, and critics have been <a href="https://screenrant.com/terminator-dark-fate-undermined-john-connor-storyline-franchise-bad/">particularly harsh</a>.</p> <p>It did not work for Sigourney Weaver in <em><a href="https://www.rogerebert.com/reviews/alien-resurrection-1997">Alien: Resurrection</a></em> in 1997, 18 years after her first time as Ripley; nor for Keanu Reeves in <em><a href="https://www.theguardian.com/film/2021/dec/21/the-matrix-resurrections-review-keanu-reeves">The Matrix Resurrections</a></em> in 2021, 23 years after the original.</p> <p>And still, I’m intrigued to see what Michael Mann could do with his long-rumoured sequel to <em>Heat</em>, his definitive 1995 crime film. Ever since Mann published his novel Heat 2 last year – a kind of origin story for <em>Heat’s</em> key protagonists – fans have been hoping a de-aged Al Pacino (now aged 83) <a href="https://deadline.com/2023/04/michael-mann-heat-2-warner-bros-adam-driver-young-neil-mccauley-1235316777/">might return</a> as LA cop Vincent Hanna.</p> <h2>Undoing time</h2> <p>“Digital de-ageing” first entered the Hollywood mainstream in 2019 with <em>The Irishman</em> and <em>Captain Marvel</em>.</p> <p><a href="https://www.indiewire.com/features/craft/de-aging-actors-history-benjamin-button-dial-of-destiny-harrison-ford-1234863938/">Via this process</a>, older actors (Robert De Niro, Al Pacino and Samuel L. Jackson have all been subject to the technology) move back and forwards in time without younger actors having to play them.</p> <figure><iframe src="https://www.youtube.com/embed/OF-lElIlZM0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Films still tend to cast two actors to play older and younger versions of the same character, a choice that dates back at least to 1974’s <em>The Godfather Part II</em>, in which a young Robert de Niro plays Vito Corleone, portrayed by the much older Marlon Brando in the first film.</p> <p>In 1989, <em>Indiana Jones and the Last Crusade</em> features a delightful opening scene where River Phoenix plays the young version of Indiana Jones, before Ford takes over for the rest of the film.</p> <figure><iframe src="https://www.youtube.com/embed/AwH6-Yh7_SM?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Actors used to just play characters of their own age when reprising earlier roles. Paul Newman finally won a Best Actor Oscar for his role as “Fast Eddie” Felson in <em>The Color of Money</em> (1986), a quarter of a century after first playing him in The Hustler.</p> <p>The sequel plays on Newman’s age, and his role as a mentor to an upcoming Tom Cruise, and bathes viewers in nostalgia and memories of <a href="https://faroutmagazine.co.uk/paul-newman-schooled-tom-cruise-the-color-of-money/">a younger Newman</a>.</p> <figure><iframe src="https://www.youtube.com/embed/k7gmrKAFshE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>But actors no longer have to exclusively play their age.</p> <p>The first part of <em>Dial of Destiny</em> is an extended flashback, set in 1944, in which Ford has been digitally de-aged to appear in his 40s. This process used an AI system that scanned used and unused reels of footage of Ford from <a href="https://www.cbr.com/harrison-ford-de-aging-indiana-jones-dial-of-destiny/">the first three Indy films</a> to match his present-day performance.</p> <p>Here, it is as if we are getting two Fords for the price of one: the “younger”, fitter Indy and the older, more world-weary version. It makes for a powerfully emotional connection on screen.</p> <p>Yet there are some <a href="https://variety.com/2023/film/awards/indiana-jones-5-harrison-ford-de-aging-not-working-1235618698/">pitfalls to de-ageing</a>. Some viewers complain that the whole process is distracting and that the hyper-real visual look of de-aged scenes resembles a video game.</p> <p>Even so, de-ageing in Hollywood cinema is here to stay. Tom Hanks’s <a href="https://variety.com/2023/film/news/tom-hanks-robin-wright-digitally-deaged-robert-zemeckis-movie-1235507766/">next film</a> is using AI-based generative technology to digitally de-age him.</p> <p>Given its reduced cost, speed and reduced human input, AI-driven innovation might have <a href="https://filmstories.co.uk/news/new-ai-driven-de-ageing-tools-to-be-used-in-tom-hanks-project/">industry-changing ramifications</a>.</p> <h2>The star of Ford</h2> <p>Harrison Ford remains a bona fide “movie star” in an industry profoundly buffeted by COVID, the rise of streaming platforms, the demise of the monoculture, and the changing nature of who constitutes a star.</p> <p>In the midst of all this industry uncertainty, it seems there is no longer a statute of limitations on actors returning to much-loved characters.</p> <p>The next big ethical issue for the film industry as it further embraces AI is whether to <a href="https://collider.com/james-dean-digital-cgi-performance-in-new-movie/">resurrect deceased actors</a> and cast them in new movies.</p> <p>Still, I’m looking forward to seeing more actors de-aged as the technology improves and audiences acclimatise to watching older actors “playing” younger versions of themselves. We are only at the start of Hollywood’s next big adventure.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/202357/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ben-mccann-398197">Ben McCann</a>, Associate Professor of French Studies, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/harrison-ford-is-back-as-an-80-year-old-indiana-jones-and-a-40-something-indy-the-highs-and-lows-of-returning-to-iconic-roles-202357">original article</a>.</em></p>

Movies

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Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds

<p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Opioids are the one of the most prescribed pain-relief for people with low back and neck pain. In Australia, around <a href="https://link.springer.com/article/10.1007/s00586-017-5178-4">40% of people</a> with low back and neck pain who present to their GP and <a href="https://qualitysafety.bmj.com/content/28/10/826">70% of people</a> with low back pain who visit a hospital emergency department are prescribed opioids such as oxycodone.</p> <p>But our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/fulltext">new study</a>, published today in the Lancet medical journal, found opioids do not relieve “acute” low back or neck pain (lasting up to 12 weeks) and can result in worse pain.</p> <p>Prescribing opioids for low back and neck pain can also cause <a href="https://www.healthdirect.gov.au/taking-opioid-medicines-safely">harms</a> ranging from common side effects – such as nausea, constipation and dizziness – to <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/opioid-harm-in-australia/summary">misuse, dependency, poisoning and death</a>.</p> <p>Our findings show opioids should <em>not</em> be recommended for acute low back pain or neck pain. A change in prescribing for low back pain and neck pain is urgently needed in <a href="https://www.tga.gov.au/resources/publication/publications/addressing-prescription-opioid-use-and-misuse-australia">Australia</a> and <a href="https://www.thelancet.com/commissions/opioid-crisis">globally</a> to reduce opioid-related harms.</p> <h2>Comparing opioids to a placebo</h2> <p>In our trial, we randomly allocated 347 people with acute low back pain and neck pain to take either an opioid (oxycodone plus naloxone) or <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo</a> (a tablet that looked the same but had no active ingredients).</p> <p>Oxycodone is an opioid pain medicine which can be given orally. <a href="https://www.nps.org.au/radar/articles/oxycodone-with-naloxone-controlled-release-tablets-targin-for-chronic-severe-pain">Naloxone</a>, an opioid-reversal drug, reduces the severity of constipation while not disrupting the pain relieving effects of oxycodone.</p> <p>Participants took the opioid or placebo for a maximum of six weeks.</p> <p>People in the both groups also received <a href="https://www.sciencedirect.com/science/article/pii/S1836955321000941">education and advice</a> from their treating doctor. This could be, for example, advice on returning to their normal activities and avoiding bed rest.</p> <p>We assessed their outcomes over a one-year period.</p> <h2>What did we find?</h2> <p>After six weeks of treatment, taking opioids did not result in better pain relief compared to the placebo.</p> <p>Nor were there benefits to other outcomes such as physical function, quality of life, recovery time or work absenteeism.</p> <p>More people in the group treated with opioids experienced nausea, constipation and dizziness than in the placebo group.</p> <p>Results at one year highlight the potential long-term harm of opioids even with short-term use. Compared to the placebo group, people in the opioid group experienced slightly worse pain, and reported a higher risk of <a href="https://academic.oup.com/painmedicine/article/20/1/113/4728236#129780622">opioid misuse</a> (problems with their thinking, mood or behaviour, or using opioids differently from how the medicines were prescribed).</p> <p>More people in the opioid group reported pain at one year: 66 people compared to 50 in the placebo group.</p> <h2>What will this mean for opioid prescribing?</h2> <p>In recent years, international low back pain guidelines have shifted the focus of treatment from drug to non-drug treatment due to <a href="https://www.thelancet.com/article/S0140-6736(18)30489-6/fulltext">evidence</a> of limited treatment benefits and concern of medication-related harm.</p> <p>For acute low back pain, <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">guidelines</a> recommend patient education and advice, and if required, anti-inflammatory pain medicines such as ibuprofen. Opioids are <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">recommended only</a> when other treatments haven’t worked or aren’t appropriate.</p> <p>Guidelines for <a href="https://pubmed.ncbi.nlm.nih.gov/33064878/">neck</a> pain similarly discourage the use of opioids.</p> <p>Our latest research clearly demonstrates the benefits of opioids do not outweigh possible harms in people with acute low back pain and neck pain.</p> <p>Instead of advising opioid use for these conditions in selected circumstances, opioids should be discouraged without qualification.</p> <h2>Change is possible</h2> <p>Complex problems such as opioid use need smart solutions, and another study we recently conducted provides convincing data opioid prescribing can be successfully reduced.</p> <p>The <a href="https://qualitysafety.bmj.com/content/30/10/825">study</a> involved four hospital emergency departments, 269 clinicians and 4,625 patients with low back pain. The intervention comprised of:</p> <ul> <li>clinician education about <a href="https://aci.health.nsw.gov.au/networks/musculoskeletal/resources/low-back-pain">evidence-based management</a> of low back pain</li> <li>patient education using posters and handouts to highlight the benefits and harms of opioids</li> <li>providing heat packs and anti-inflammatory pain medicines as alternative pain-management treatments</li> <li>fast-tracking referrals to outpatient clinics to avoid long waiting lists</li> <li>audits and feedback to clinicians on information about opioid prescribing rates.</li> </ul> <p>This intervention reduced opioid prescribing from <a href="https://qualitysafety.bmj.com/content/30/10/825">63% to 51% of low back pain presentations</a>. The <a href="https://emj.bmj.com/content/early/2023/04/02/emermed-2022-212874">reduction was sustained for 30 months</a>.</p> <p>Key to this successful approach is that we worked with clinicians to develop suitable pain-management treatments without opioids that were feasible in their setting.</p> <p>More work is needed to evaluate this and other interventions aimed at reducing opioid prescribing in other settings including GP clinics.</p> <p>A nuanced approach is often necessary to avoid causing <a href="https://theconversation.com/opioid-script-changes-mean-well-but-have-left-some-people-in-chronic-pain-156753">unintended consequences</a> in reducing opioid use.</p> <p>If people with low back pain or neck pain are using opioids, especially at higher doses over an extended period of time, it’s important they seek advice from their doctor or pharmacist before stopping these medicines to avoid <a href="https://www.healthdirect.gov.au/opioid-withdrawal-symptoms">unwanted effects when the medicines are abruptly stopped</a>.</p> <p>Our research provides compelling evidence opioids have a limited role in the management of acute low back and neck pain. The challenge is getting this new information to clinicians and the general public, and to implement this evidence into practice.<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/203244/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, Postdoctoral Research Associate in Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/opioids-dont-relieve-acute-low-back-or-neck-pain-and-can-result-in-worse-pain-new-study-finds-203244">original article</a>.</em></p>

Body

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Don’t blame women for low libido. Sexual sparks fly when partners do their share of chores – including calling the plumber

<p>When a comic about “mental load” <a href="https://english.emmaclit.com/2017/05/20/you-shouldve-asked/">went viral in 2017</a>, it sparked conversations about the invisible workload women carry. Even when women are in paid employment, they remember their mother-in-law’s birthday, know what’s in the pantry and organise the plumber. This mental load often goes unnoticed.</p> <p>Women also <a href="https://theconversation.com/yet-again-the-census-shows-women-are-doing-more-housework-now-is-the-time-to-invest-in-interventions-185488">continue to do more housework</a> and childcare than their male partners.</p> <p>This burden has been exacerbated over the recent pandemic (homeschooling anyone?), <a href="https://theconversation.com/planning-stress-and-worry-put-the-mental-load-on-mothers-will-2022-be-the-year-they-share-the-burden-172599">leaving women</a> feeling exhausted, anxious and resentful.</p> <p>As sexuality researchers, we wondered, with all this extra work, do women have any energy left for sex?</p> <p>We decided to explore how mental load affects intimate relationships. We focused on female sexual desire, as “low desire” affects <a href="https://www.sciencedirect.com/science/article/abs/pii/S1743609520307566">more than 50% of women</a> and is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0091302217300079">difficult to treat</a>.</p> <p>Our study, published in the <a href="https://www.tandfonline.com/doi/full/10.1080/00224499.2022.2079111">Journal of Sex Research</a>, shows women in equal relationships (in terms of housework and the mental load) are more satisfied with their relationships and, in turn, feel more sexual desire than those in unequal relationships.</p> <p> </p> <h2>How do we define low desire?</h2> <p>Low desire is tricky to explore. More than simply the motivation to have sex, women describe sexual desire as a state-of-being and a need for closeness.</p> <p>Adding to this complexity is the fluctuating nature of female desire that changes in response to life experiences and the <a href="https://www.bbc.com/future/article/20160630-the-enduring-enigma-of-female-desire">quality of relationships</a>.</p> <p>Relationships are especially important to female desire: relationship dissatisfaction is a <a href="https://pubmed.ncbi.nlm.nih.gov/18410300/">top risk factor</a> for low desire in women, even more than the physiological impacts of age and menopause. Clearly, relationship factors are critical to understanding female sexual desire.</p> <p>As a way of addressing the complexity of female desire, a <a href="https://link.springer.com/article/10.1007/s10508-018-1212-9">recent theory</a> proposed two different types of desire: dyadic desire is the sexual desire one feels for another, whereas solo desire is about individual feelings.</p> <p>Not surprisingly, dyadic desire is intertwined with the dynamics of the relationship, while solo desire is more amorphous and involves feeling good about yourself as a sexual being (feeling sexy), without needing validation from another.</p> <h2>Assessing the link</h2> <p>Our research acknowledged the nuances of women’s desire and its strong connection to relationship quality by exploring how fairness in relationships might affect desire.</p> <p>The research involved asking 299 Australian women aged 18 to 39 questions about desire and relationships.</p> <p>These questions included assessments of housework, mental load – such as who organised social activities and made financial arrangements – and who had more leisure time.</p> <p>We compared three groups:</p> <ul> <li>relationships where women perceived the work as equally shared equal (the “equal work” group)</li> <li>when the woman felt she did more work (the “women’s work” group)</li> <li>when women thought that their partner contributed more (the “partner’s work” group).</li> </ul> <p>We then explored how these differences in relationship equity impacted female sexual desire.</p> <h2>What we found</h2> <p>The findings were stark. Women who rated their relationships as equal also reported greater relationship satisfaction and higher dyadic desire (intertwined with the dynamics of the relationship) than other women in the study.</p> <p>Unfortunately (and perhaps, tellingly), the partner’s work group was too small to draw any substantial conclusions.</p> <p>However, for the women’s work group it was clear their dyadic desire was diminished. This group was also less satisfied in their relationships overall.</p> <p>We found something interesting when turning our attention to women’s solo desire. While it seems logical that relationship inequities might affect all aspects of women’s sexuality, our results showed that fairness did not significantly impact solo desire.</p> <p>This suggests women’s low desire isn’t an internal sexual problem to be treated with <a href="https://www.insider.com/guides/health/yoni-eggs#:%7E:text=Yoni%20eggs%20are%20egg%2Dshaped,bacterial%20infections%20and%20intense%20pain.">mindfulness apps and jade eggs</a>, but rather one that needs effort from both partners.</p> <p>Other relationship factors are involved. We found children increased the workload for women, leading to lower relationship equity and consequently, lower sexual desire.</p> <p> </p> <p>Relationship length also played a role. Research shows long-term relationships are <a href="https://link.springer.com/article/10.1007/s10508-018-1175-x">associated with</a> decreasing desire for women, and this is often attributed to the tedium of over-familiarity (think of the bored, sexless <a href="https://www.youtube.com/watch?v=kBq-Nyo0lQg">wives in 90s sitcoms</a>).</p> <p>However our research indicates relationship boredom is not the reason, with the increasing inequity over the course of a relationship often the cause of women’s disinterest in sex.</p> <p>The longer some relationships continue, the more unfair they become, lowering women’s desire. This may be because women take on managing their partner’s relationships, as well as their own (“It’s time we had your best friend over for dinner”).</p> <p>And while domestic housework may start as equally shared, over time, women <a href="https://www.abs.gov.au/media-centre/media-releases/women-spent-more-time-men-unpaid-work-may">tend to do more</a> household tasks.</p> <h2>What about same-sex couples?</h2> <p>Same-sex couples have <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/fare.12293">more equitable relationships</a>.</p> <p>However, we found the same link between equity and desire for women in same-sex relationships, although it was much stronger for heteronormative couples.</p> <p>A sense of fairness within a relationship is fundamental to all women’s satisfaction and sexual desire.</p> <h2>What happens next?</h2> <p>Our findings suggest one response to low desire in women could be to address the amount of work women have to take on in relationships.</p> <p>The link between relationship satisfaction and female sexual desire has been firmly established in <a href="https://link.springer.com/article/10.1007/s10508-018-1175-x">previous research</a> but our findings explain how this dynamic works: women’s sense of fairness within a relationship forecasts their contentment, which has repercussions on their desire for their partner.</p> <p>To translate our results into clinical practice, we could run trials to confirm if lowering women’s mental load results in greater sexual desire.</p> <p>We could have a “housework and mental load ban” for a sample of women reporting low sexual desire and record if there are changes in their reported levels of desire.</p> <p>Or perhaps women’s sexual partners could do the dishes tonight and see what happens.</p> <p><em>Image credit: Shutterstock</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/dont-blame-women-for-low-libido-sexual-sparks-fly-when-partners-do-their-share-of-chores-including-calling-the-plumber-185401" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Relationships

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5 hidden sugar bombs you should be aware of

<p>It seems like a pretty easy rule to follow – when you’re doing your weekly shop, if an item is packaged, it's likely laden with sugar. We all know that the sweet stuff is absolutely everywhere and that food companies use clever little tricks to disguise this from us when it comes to food labels. So, if you're not careful, sneaky foods packed with sugar will make their way into your home. Here we bring you some tips on how to arm yourself with the knowledge to avoid an accidental sugar binge.</p> <p><strong>Fruit yoghurt</strong></p> <p>It seems innocent enough, but fruit yogurt can be one of the biggest sugar bombs at the supermarket. Have you ever noticed how this popular morning snack feels like it would be more appropriately placed as a dessert option, well that’s because they are loaded with sugar. Opt for natural yoghurt and add cinnamon or berries to naturally sweeten.</p> <p><strong>Pasta sauce</strong></p> <p>Never mind the shortcomings of refined white pasta, it's the sauce that should be of concern. Pasta sauce alone can carry up to 12 grams of sugar for every half cup.</p> <p><strong>Agave</strong></p> <p>Despite it being sold in health food stores and renowned as a healthy alternative to sugar, it doesn’t change the fact that agave is pretty much just sugar dressed up in a healthier looking outfit. As it's 85 per cent fructose, it may be worse for you than cane sugar, which is all sucrose. What does this mean? Well, fructose is metabolised almost exclusively by your liver, which is hard work, and we’re still learning about the way different forms of sugar affect our health.</p> <p><strong>Dried fruit</strong></p> <p>Given it’s fruit it’s not surprising that most people count dried fruits amongst healthy food options, however, in some cases it might as well be like eating lollies. Just one-third of a cup can have 24 grams of sugar.</p> <p><strong>Granola bars</strong></p> <p>A convenient snack that is easy to carry in your bag to enjoy on the run? Yes. But the health factor of these bars depends on the ingredients. Most varieties aren't only made of wholegrain oats. In fact, one bar can pack as much as 12 grams (or much more) of sugar, so be sure to read the label before adding these to your shopping trolly.</p> <p><em>Image credits: Getty Images </em></p>

Food & Wine

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The verdict: Full fat versus low fat milk

<p>The idea of full low milk being healthier for us began circulating in the 1950s. It was shown that saturated fat increased blood cholesterol levels, with certain statistical evidence leading to the assumption it resulted in higher rates of heart disease and obesity.  </p> <p>This idea is not totally wrong. Full fat milk does indeed have a high saturated fat content, about 65 percent in fact.</p> <p><span style="text-decoration: underline;"><strong><a href="http://www.simoneaustin.com/" target="_blank" rel="noopener">Simone Austin</a></strong></span>, accredited practising dietitian and spokesperson for the <span style="text-decoration: underline;"><strong><a href="http://daa.asn.au/" target="_blank" rel="noopener">Dietitians Association of Australia</a></strong></span> addresses the claims that saturated fat should be avoided when it comes to weight management.</p> <p> “We are still recommending saturated fat should be kept to a minimum as there is still a link between saturated and plasma cholesterol levels, however full cream milk is only 4% total fat and is therefore not a high fat product, depending on quantity of course.”</p> <p>Health and nutrition coach and whole foods chef, Lee Holmes, believes that low-fat milk is a great option for those trying to lose weight.  Even though the fat is skimmed, the milk itself still contains an abundance of calcium and protein, and these are essential to weight loss.</p> <p>“Low-fat milk is better for overall weight control and maintenance as it only contains 0.15% fat as opposed to full-cream milk which contains 3.8% fat” she explains.</p> <p>The New Zealand Ministry of Health recommends enjoying mostly low and reduced fat milk and milk products, as it can reduce the total daily kilojoule intake to aid with weight management. This is generally believed to lead to weight loss and reduced risk of heart disease.</p> <p>However, Simone explains why it is not quite that straight forward. “Fat can give some feeling of satiety. If you are having less milk overall, and it is more filling to have full cream milk, then this might decrease overall volume of food consumed and therefore not be detrimental”.</p> <p>This approach is supported by recent research conducted by <a href="../%20http:/www.ncbi.nlm.nih.gov/pubmed/26746178"><strong><span style="text-decoration: underline;">Swedish researchers</span></strong></a>, looking at the dairy consumption of a group of middle aged men. If found that those who ate full fat dairy products were less likely to become obese over a period of 12 years, compare with men who rarely ate high- fat diary.  This is because the weight-loss effect of reducing saturated fat depends on what replaces it in the diet, which is usually sugar and carbohydrates. Unfortunately, most of us are susceptible to consciously or unconsciously replacing a larger reduction in calories with something else.</p> <p>So, if you drink low-fat varieties of milk in order to reduce calorie intake, you must ensure you are not making up these calories elsewhere for this approach to be effective.</p> <p>However, in your quest for a slimmer waist line, it is important not to overlook other important health factors.</p> <p>Milk is a primary source of nutrients, and according to both Simone and the <strong><a href="http://ro.uow.edu.au/cgi/viewcontent.cgi?article=2032&amp;context=sspapers" target="_blank" rel="noopener"><span style="text-decoration: underline;">ABS</span></a></strong>, most over-60s simply aren’t getting what they need.</p> <p>“In New Zealand the annual per capita consumption of milk has declined by 30% in the last 20 years, and 20% of the New Zealand population has an inadequate intake of calcium”.</p> <p>Simone stresses that simply aiming to meet serves is the priority. “Milk also provides a valuable source of protein and as we age our efficiency at using protein reduces, so we need to have a little more”.</p> <p>Lee Holmes echoes this, stating that ideally, people over 60 years of age should be having two to three glasses of cow’s milk daily to absorb the necessary amounts of calcium. If you don’t want to consume that much milk, are lactose intolerant or prefer to opt for non-cow’s milk (such as almond) you need to make these nutrients up elsewhere.</p> <p>“You may want to consider a quality, natural supplement to ensure you are giving your body all the nutrients it needs."</p> <p>So whether it be low-fat or full-fat, say cheers to milk and manage your weight loss in accordance with other health factors.</p> <p><em>Image: Getty Images</em></p>

Food & Wine

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Ultra-processed foods: it’s not just their low nutritional value that’s a concern

<p>In countries such as the UK, US and Canada, ultra-processed foods now account for <a href="https://pubmed.ncbi.nlm.nih.gov/30744710/">50% or more</a> of calories consumed. This is concerning, given that these foods have been linked to a number of different health conditions, including a greater risk of <a href="https://pubmed.ncbi.nlm.nih.gov/33167080/">obesity</a> and various chronic diseases such as <a href="https://nutritionj.biomedcentral.com/articles/10.1186/s12937-020-00604-1">cardiovascular disease</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/35896436/">dementia</a>.</p> <p>Ultra-processed foods are <a href="https://pubmed.ncbi.nlm.nih.gov/30744710/">concoctions of various industrial ingredients</a> (such as emulsifiers, thickeners and artificial flavours), amalgamated into food products by a series of manufacturing processes.</p> <p>Sugary drinks and many breakfast cereals are ultra-processed foods, as are more recent innovations, such as so-called <a href="https://www.sciencedirect.com/science/article/pii/S2213453019301144,">“plant-based” burgers</a>, which are typically made of protein isolates and other chemicals to make the products palatable.</p> <p>The intense industrial processes used to produced ultra-processed foods destroy the <a href="https://pubmed.ncbi.nlm.nih.gov/35067754/">natural structure</a> of the food ingredients and strip away many beneficial nutrients such as fibre, vitamins, minerals and phytochemicals.</p> <p>Many of us are well aware that ultra-processed foods are harmful for our health. But it’s been unclear if this is simply because these foods are of poor nutritional value. Now, two new studies have shown that poor nutrition may not be enough to explain their health risks. This suggests that other factors may be needed to fully explain their health risks.</p> <h2>The role of inflammation</h2> <p>The <a href="https://www.bmj.com/content/378/bmj-2022-070688">first study</a>, which looked at over 20,000 health Italian adults, found that participants who consumed the highest number of ultra-processed foods had an increased risk of dying prematurely from any cause. The <a href="https://www.bmj.com/content/378/bmj-2021-068921">second study</a>, which looked at over 50,000 US male health professionals, found high consumption of ultra-processed foods was associated with a greater risk of colon cancer.</p> <p>What’s most interesting about these studies is that the health risks from eating a diet high in ultra-processed foods remained even after they had accounted for the poor nutritional quality of their diets. This suggests that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8747015/">other factors</a> contribute to the harms caused by ultra-processed foods.</p> <p>It also implies that getting the right nutrients elsewhere in the diet may not be enough to cancel out the risk of disease from consuming ultra-processed foods. Similarly, attempts by the food industry to improve the nutritional value of ultra-processed foods by adding a few more vitamins may be side-stepping a more fundamental problem with these foods.</p> <p>So what factors may explain why ultra-processed foods are so harmful to our health?</p> <p>The Italian study found that inflammatory markers – such as a higher white blood cell count – were higher in groups that ate the most ultra-processed foods. Our bodies may trigger an inflammatory response for any number of reasons – for example, if we catch a cold or get cut. The body responds by sending signals to our immune cells (such as white blood cells) to attack any invading pathogens (such as bacteria or viruses).</p> <p>Usually, our inflammatory response resolves quite quickly, but some people may develop chronic inflammation throughout their body. This can cause tissue damage, and is involved in many chronic diseases – such as <a href="https://pubmed.ncbi.nlm.nih.gov/25859884/">cancer</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/28744020/">cardiovascular disease</a>.</p> <p>Many studies have found that poor diets can increase inflammation in the body, and that this is linked to <a href="https://pubmed.ncbi.nlm.nih.gov/28744020/">higher risk</a> of chronic diseases. Given that signs of inflammation were seen in participants of the Italian study who ate the most ultra-processed foods, this could suggest that inflammation may contribute to why ultra-processed foods increase disease risk. Some food additives common in ultra-processed foods (such as emulsifiers and artificial sweeteners) also increase inflammation in the gut by causing <a href="https://pubmed.ncbi.nlm.nih.gov/29899036/">changes to the gut microbiome</a>.</p> <figure class="align-center ">Some researchers have theorised that ultra-processed foods increase inflammation because they are recognised by the body as foreign – much like an invading bacteria. So the body mounts an inflammatory response, which has been dubbed “<a href="https://pubmed.ncbi.nlm.nih.gov/24939238/">fast food fever</a>”. This increases inflammation throughout the body as a result.</figure> <p>Although the US colon cancer study did not establish if inflammation increased in the men consuming the most ultra-processed foods, inflammation is strongly linked with an <a href="https://pubmed.ncbi.nlm.nih.gov/27821485/">increased risk of colon cancer</a>.</p> <p>Research shows that other mechanisms – such as <a href="https://www.bmj.com/content/378/bmj-2022-070688">impaired kidney function</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/19502515/">toxins in packaging</a> – may also explain why ultra-processed foods cause so many dangerous health problems.</p> <p>Since inflammatory responses are hard-wired in our bodies, the best way to prevent this from happening is by not eating ultra-processed foods at all. Some plant-based diets high in natural, unprocessed foods (such as the <a href="https://pubmed.ncbi.nlm.nih.gov/36039924/">Mediterranean diet</a>) have also been shown to be anti-inflammatory. This may also explain why plant-based diets free from ultra-processed foods can help ward off <a href="https://pubmed.ncbi.nlm.nih.gov/26148921/">chronic diseases</a>. It’s currently not known to what extent an anti-inflammatory diet can help counteract the effects of ultra-processed foods.</p> <p>Simply reducing your intake of ultra-processed foods may be a challenge. Ultra-processed foods are designed to be hyper-palatable – and together with persuasive marketing, this can make resisting them an enormous challenge for <a href="https://pubmed.ncbi.nlm.nih.gov/33153827/">some people</a>.</p> <p>These foods are also not labelled as such on food packaging. The best way to identify them is by looking at their ingredients. Typically, things such as emulsifiers, thickeners, protein isolates and other industrial-sounding products are a sign it’s an ultra-processed food. But making meals from scratch using natural foods is the best way to avoid the harms of ultra-processed foods.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/189918/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/richard-hoffman-221275">Richard Hoffman</a>, Associate lecturer, Nutritional Biochemistry, <em><a href="https://theconversation.com/institutions/university-of-hertfordshire-799">University of Hertfordshire</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a>. Read the <a href="https://theconversation.com/ultra-processed-foods-its-not-just-their-low-nutritional-value-thats-a-concern-189918">original article</a>.</p>

Food & Wine

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Low iron is a health risk made worse by COVID

<p>“Beauty is an iron mine,” once remarked the Australian mining magnate, Gina Reinhart. She was talking about a precious resource, but iron is also profoundly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464783/" target="_blank" rel="noopener">important to living organisms</a>: from bacteria and fungi, to mammals like us.</p> <p>Iron acts as a key to numerous metabolic functions within our bodies. But iron deficiency remains as <a href="https://cdn.who.int/media/docs/default-source/nutritionlibrary/focusing-on-anaemia_970a28fe-a055-4e63-b3ba-11be7b940b16.pdf?sfvrsn=9ab36bdb_6&amp;download=true" target="_blank" rel="noopener">one of the top global health risks</a> recognised by the World Health Organization (WHO).</p> <p>Iron deficiency has become the most prevalent micronutrient disorder worldwide, and COVID may be worsening the problem.</p> <h2>Iron is hard to get</h2> <p>The type of iron we mine is different from the “free-form” iron that can be used biologically. Free-form iron has a propensity to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842161/" target="_blank" rel="noopener">jump between two chemical states</a>, allowing it to bind to various molecules, and participate in all sorts of essential reactions within our bodies.</p> <p>But we see a different story again during food digestion. Inside our upper small intestine where iron is most effectively absorbed, free-form iron tends to bind to oxygen, other minerals and food components. This often results in rock-like, insoluble clumps (which are like the ones we mine!). These are too big to pass through or between our cells.</p> <p>This means that even when we consume enough iron, <a href="https://www.ncbi.nlm.nih.gov/books/NBK448204/#:%7E:text=Heme%20iron%2C%20derived%20from%20hemoglobin,and%20is%20less%20well%20absorbed." target="_blank" rel="noopener">typically only ~15–35% of it is absorbed</a>. It also means iron availability can be <a href="https://ift.onlinelibrary.wiley.com/doi/10.1111/1541-4337.12669" target="_blank" rel="noopener">improved, or inhibited</a> depending on how we eat it or what we eat it with.</p> <p>For example, heme iron from animal flesh has a <a href="https://omlc.org/spectra/hemoglobin/hemestruct/heme-struct.gif" target="_blank" rel="noopener">cage-like structure</a>, which carries the iron in a soluble form that prevents it from clumping during absorption. In many Western countries, heme iron only accounts for <a href="https://academic.oup.com/metallomics/article/3/2/103/6016197?login=true#219037456" target="_blank" rel="noopener">10% of the iron eaten, but two thirds</a> of the total iron absorbed.</p> <h2>More of us are at risk of deficiency</h2> <p>Getting sufficient iron sounds like simple maths: we want to add enough to our dietary intake to make up for the iron being lost from the body, such as through faeces, skin shedding, menstruation (for women) and sweat. But the two sides of the equation can change depending on who and where we are throughout our lifetime.</p> <p>Generally, iron deficiency occurs when our body’s stores of iron are depleted from not having consumed or absorbed enough iron to meet our needs.</p> <p>This can happen when people restrict their diets, such as for religious, social or medical reasons. Some people also have a tough time keeping up when their iron needs increase, such as <a href="https://www.nature.com/articles/s41430-019-0400-6" target="_blank" rel="noopener">pregnant women</a> and <a href="https://academic.oup.com/ajcn/article/106/suppl_6/1681S/4823199" target="_blank" rel="noopener">growing children</a>.</p> <p>But iron deficiency can also happen when the body has enough iron, <a href="https://onlinelibrary.wiley.com/doi/10.1111/bjh.12311" target="_blank" rel="noopener">but can’t effectively transport it into cells</a>. This is common in those with both acute and chronic infections, heart and autoimmune conditions, and cancers. In these cases, the underlying disease needs to be treated first, rather than improving iron intake.</p> <p>The table below summarises some common causes of iron deficiency. Sometimes multiple causes may occur simultaneously – for example, for many elite athletes (<a href="https://link.springer.com/article/10.1007/s00421-019-04157-y" target="_blank" rel="noopener">35% of women and 11% of men</a>), iron deficiency results from reduced absorption due to inflammation, on top of increased loss through sweat and breakdown of blood cells.</p> <h2>COVID hasn’t helped</h2> <p>The ongoing COVID epidemic has also introduced multiple risk factors for iron deficiency.</p> <p>We know severe infection with SARS-CoV-2 (the virus that causes COVID) may change the way some people <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305218/" target="_blank" rel="noopener">metabolise iron</a>, leading to lower iron levels up to two months after infection. This <a href="https://onlinelibrary.wiley.com/doi/10.1002/jmv.26774" target="_blank" rel="noopener">contributes to symptoms</a> commonly reported after infection, such as fatigue and lethargy.</p> <p>Recovery from the pandemic itself has also exacerbated <a href="https://www.oecd.org/coronavirus/policy-responses/food-supply-chains-and-covid-19-impacts-and-policy-lessons-71b57aea/" target="_blank" rel="noopener">food supply issues</a>, as well as the <a href="https://blogs.worldbank.org/developmenttalk/global-income-inequality-and-covid-19-pandemic-three-charts" target="_blank" rel="noopener">rising global income inequality</a>.</p> <p>This means more people face barriers to food security – and the nutrient-dense foods that help boost our iron intake like red meat or leafy greens may be unavailable or unaffordable for them.</p> <h2>Before you pick up a pill</h2> <p>It may be tempting to pick up one of the many widely available iron supplements to attempt to boost your intake. However, we have to keep in mind that conventional iron supplementation is <a href="https://www.tandfonline.com/doi/full/10.1185/03007995.2012.761599" target="_blank" rel="noopener">associated with some negative side effects</a>.</p> <p>These include damage to our gut lining, nausea, diarrhoea and constipation. Iron supplementation has also been linked to changes in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400826/" target="_blank" rel="noopener">gut microbiome</a>, a critical determinant of health.</p> <p>The WHO has recommended <a href="https://cdn.who.int/media/docs/default-source/micronutrients/gff-part-1-en.pdf?sfvrsn=afc1c426_2" target="_blank" rel="noopener">two other approaches</a>: diet diversification and food fortification.</p> <p><a href="https://cdn.who.int/media/docs/default-source/anaemia/areacop-webinar---24-september-2020/areacop-webinar-nancyaburto-presentation.pdf?sfvrsn=7abd1427_4" target="_blank" rel="noopener">Diet diversification</a> is exactly as it sounds: having a diet with a variety of wholefoods such as fruits and vegetables, grains and legumes, meat, dairy, and nuts and seeds.</p> <p>This approach not only ensures sufficient levels of iron are found in the foods we eat, but also that they come with different forms or “vehicles” to improve absorption. This approach works <a href="https://apps.who.int/iris/bitstream/handle/10665/349086/WHO-EURO-2021-4007-43766-61591-eng.pdf?sequence=1&amp;isAllowed=y" target="_blank" rel="noopener">even with plant-based foods</a>.</p> <p>Food fortification, where iron is added to processed foods, is also a fairly safe yet accessible option due to its lower dose. In Australia, iron is commonly fortified in products such as bread, cereals and ready-to-drink mixes.</p> <p>It can be challenging to get the iron into our body and where it’s needed. But before turning to supplements, we must remind ourselves that food sources should always be first-in-line. In cases of diagnosed deficiencies, your healthcare professional will provide you with further information where supplements are necessary.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/low-iron-is-a-health-risk-made-worse-by-covid-how-to-get-more-without-reaching-for-supplements-185020" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

Body

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“What a low act!": Daniel Morcombe's parents outraged at upcoming film

<p dir="ltr">The devastated parents of murdered Queensland boy Daniel Morcombe have blasted an upcoming film about their son’s death. </p> <p dir="ltr">Daniel Morcombe was only 13 years old when he was abducted and murdered on Queensland’s Sunshine Coast in December, 2003.</p> <p dir="ltr">In August 2011, Brett Peter Cowan was arrested and later found guilty of Daniel’s murder.</p> <p dir="ltr">Now parents Denise and Bruce Morcombe have come out attacking the film <em>The Stranger</em>, which tells the story of an undercover detective trying to catch a killer in Australia.</p> <p dir="ltr"><em>The Stranger</em> premiered at Cannes earlier this year and will play at the Melbourne International Film Festival in August.</p> <p dir="ltr">A statement from the Morcombe’s was shared on the Daniel Morcombe Foundation Facebook page calling the film a “low act” and have asked people not to watch it. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">The movie “The Stranger” is not supported by the Morcombe family. Individuals who make money on a heinous crime are parasites. They are callously disrespectful to Daniel, the DMF &amp; the Morcombe family. We find the making of the movie morally corrupt and cruel. Shame on you. <a href="https://t.co/9FEFAp5g0G">pic.twitter.com/9FEFAp5g0G</a></p> <p>— Denise Morcombe OAM (@DeniseMorcombe) <a href="https://twitter.com/DeniseMorcombe/status/1547358728286261248?ref_src=twsrc%5Etfw">July 13, 2022</a></p></blockquote> <p dir="ltr">“What a low act! I won’t be going to watch this movie. I won’t be recommending anyone go. The movie is not supported or sanctioned in any way by the Morcombe family,” the statement read.</p> <p dir="ltr">“It’s appalling storyline ignores our family‘s pain and chooses to profit from 13-year-old Daniel Morcombe.</p> <p dir="ltr">“Next year will mark 20 years since we lost Daniel. The passage of time does not make it any easier. Personally, I find the making of this movie morally corrupt and a cruel, callous, selfish cash grab by all involved. Shame on you.</p> <p dir="ltr">“I recommend the public stay away from it and either save their money or consider donating it to the Daniel Morcombe Foundation.”</p> <p dir="ltr">Mrs Morcombe took it further and called the movie makers “parasites” for disrespecting her son. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">We are not amused! How can anyone give oxygen to a crime that is so, so evil? Connections of the movie have blood on their hands.</p> <p>— Bruce Morcombe (@BruceMorcombe) <a href="https://twitter.com/BruceMorcombe/status/1547361223804481536?ref_src=twsrc%5Etfw">July 13, 2022</a></p></blockquote> <p dir="ltr">“The movie ‘The Stranger’ is not supported by the Morcombe family. Individuals who make money on a heinous crime are parasites,” she wrote. </p> <p dir="ltr">“They are callously disrespectful to Daniel, the DMF &amp; the Morcombe family. We find the making of the movie morally corrupt and cruel. Shame on you.”</p> <p dir="ltr">Mr Morcombe responded to his wife’s tweet saying: “We are not amused! How can anyone give oxygen to a crime that is so, so evil? Connections of the movie have blood on their hands.” </p> <p dir="ltr">Director Thomas M Wright said he made the film to share a different perspective of the story because he could not “presume” what the family was going through. </p> <p dir="ltr">“One reason I chose not to show the child or family (in The Stranger) was to make a film with a clear moral perspective,” he previously said.</p> <p dir="ltr">“I couldn’t presume to know anything of the experience of that family. But I could see that there was a story about empathy and making meaning in the wake of violence, not violence itself.”</p> <p dir="ltr">According to Hollywood reporter, “the film offers a fictionalised portrait of the massive undercover operation that cracked the infamous cold case of 13-year-old Daniel Morcombe, who went missing in 2003.”</p> <p dir="ltr"><em>Images: Daniel Morcombe Foundation</em></p>

Movies

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Low-cost gel film pulls clean drinking water from desert air, raising hopes of quenching the world’s driest communities

<p class="spai-bg-prepared">One in three people lives in <a class="spai-bg-prepared" href="https://www.un.org/en/events/desertification_decade/whynow.shtml" target="_blank" rel="noreferrer noopener">drylands</a>, areas covering more than 40% of the Earth’s surface that experience significant water shortages.</p> <p class="spai-bg-prepared">Scientists and engineers have now developed a new material that could help people living in these areas access <a class="spai-bg-prepared" href="https://cosmosmagazine.com/earth/water/an-answer-to-the-clean-water-crisis/" target="_blank" rel="noreferrer noopener">clean drinking water</a> by capturing it right out of the atmosphere, according to a new study in <em class="spai-bg-prepared">Nature Communications</em>.</p> <p class="spai-bg-prepared">They’ve developed a gel film that costs just $2 per kilogram to produce and can pull water from the air in even the driest climates; 1kg of it can produce more than 6 litres per day in less than 15% relative humidity (RH), and 13 litres in areas with up to 30% RH.</p> <p class="spai-bg-prepared">Relative humidity is the ratio of the current absolute humidity to the highest possible absolute humidity.  So a 100% RH means that the air is completely saturated with water vapour and cannot hold any more. People tend to feel most comfortable between 30% and 50%, and arid climates have less than 30% RH.</p> <p class="spai-bg-prepared">These results are promising, as previous attempts to pull water from the desert air have typically been energy-intensive and not very efficient.</p> <p class="spai-bg-prepared">“This new work is about practical solutions that people can use to get water in the hottest, driest places on Earth,” says senior author Guihua Yu, professor of Materials Science and Mechanical Engineering at the University of Texas in Austin, US. “This could allow millions of people without consistent access to drinking water to have simple, water-generating devices at home that they can easily operate.”</p> <div class="newsletter-box spai-bg-prepared"> <div id="wpcf7-f6-p192317-o1" class="wpcf7 spai-bg-prepared" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.61 spai-bg-prepared resetting" action="/technology/gel-film-desert-drinking-water/#wpcf7-f6-p192317-o1" method="post" novalidate="novalidate" data-status="resetting"> <p class="spai-bg-prepared" style="display: none !important;"><span class="wpcf7-form-control-wrap referer-page spai-bg-prepared"><input class="wpcf7-form-control wpcf7-text referer-page spai-bg-prepared" name="referer-page" type="hidden" value="https://cosmosmagazine.com/technology/" data-value="https://cosmosmagazine.com/technology/" aria-invalid="false" /></span></p> <p><!-- Chimpmail extension by Renzo Johnson --></form> </div> </div> <p class="spai-bg-prepared">The gel is made with <a class="spai-bg-prepared" href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/hydroxypropyl-cellulose" target="_blank" rel="noreferrer noopener">hydroxypropyl cellulose</a> (HPC) which is produced from cellulose, and a common kitchen ingredient called <a class="spai-bg-prepared" href="https://www.sciencedirect.com/science/article/abs/pii/S0141813016310339" target="_blank" rel="noreferrer noopener">konjac glucomannan</a>, as well as lithium chloride salt (LiCl). It forms a hydrophilic (water attracting) porous film with a large surface area that collects the water vapour from air.</p> <p class="spai-bg-prepared">“The gel takes two minutes to set simply. Then, it just needs to be freeze dried, and it can be peeled off the mould and used immediately after that,” explains Weixin Guan, a doctoral student on Yu’s team and a lead researcher of the work.</p> <p class="spai-bg-prepared">And, because the cellulose is thermo-responsive, it becomes hydrophobic (water repelling) when heated which allows the collected water to be released within 10 minutes through mild heating at 60 °C.</p> <p class="spai-bg-prepared">This means that the overall energy needed to produce the water is minimised. The film is also flexible, can be moulded into a variety of shapes and sizes, and producing it requires only the gel precursor – which includes all the relevant ingredients poured into a mould.</p> <p class="spai-bg-prepared">“This is not something you need an advanced degree to use,” says lead author Youhong “Nancy” Guo, a former doctoral student in Yu’s lab and now a postdoctoral researcher at the Massachusetts Institute of Technology. “It’s straightforward enough that anyone can make it at home if they have the materials.”</p> <p class="spai-bg-prepared">And because it’s so simple, the authors say the challenges of scaling the technology up and achieving mass usage are reduced.</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --></p> <p><img id="cosmos-post-tracker" class="spai-bg-prepared" 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=192317&amp;title=Low-cost+gel+film+pulls+clean+drinking+water+from+desert+air%2C+raising+hopes+of+quenching+the+world%E2%80%99s+driest+communities" width="1" height="1" /></p> <p><!-- End of tracking content syndication --></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/technology/gel-film-desert-drinking-water/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto">Imma Perfetto</a>. Imma Perfetto is a science writer at Cosmos. She has a Bachelor of Science with Honours in Science Communication from the University of Adelaide.</em></p> <p><em>Image: The University of Texas at Austin/Cockrell School of Engineering</em></p> </div>

Technology

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The best low maintenance pets

<p dir="ltr">If you’ve always wanted a pet but never really bothered because of how high maintenance it is, fret not.</p> <p dir="ltr">Below is a list of five of the lowest maintenance pets to have. </p> <ol> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation"><strong>Hamster</strong></p> </li> </ol> <p dir="ltr">These cute little furry animals are super easy to take care of once they’re set up.</p> <p dir="ltr">All you need is to make sure they have a water bottle, food bowl and their wheel. </p> <ol start="2"> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation"><strong>Guinea Pig</strong></p> </li> </ol> <p dir="ltr">The adorable guinea pigs are low maintenance and look after themselves. A dream, right?! </p> <p dir="ltr">They require a bath here and there and the usual cage, bedding, food and water. </p> <ol start="3"> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation"><strong>Turtle</strong></p> </li> </ol> <p dir="ltr">The Painted Turtle is possibly one of the best pets to have because it doesn’t even need to be fed everyday. </p> <p dir="ltr">Feed it a couple of times a week, make sure it's comfortable in the new aquatic home where the temperature and cleanliness are looked after. </p> <ol start="4"> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation"><strong>Snake</strong></p> </li> </ol> <p dir="ltr">You’re probably thinking what the hell? But obviously get a reptile that isn’t venomous. </p> <p dir="ltr">They are super easy to care for as long as you keep them in a properly sized tank, maintain the tank at a comfortable temperature and feed them their preferred meals.</p> <ol start="5"> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation"><strong>Sea Monkey (aka Brine Shrimp)</strong></p> </li> </ol> <p dir="ltr">These tiny creatures were only created in the last century and are sold in hatching kits.</p> <p dir="ltr">All you need to do is set up their water tank, feed them every five days and keep their tank well-oxygenated. </p> <p dir="ltr"><em>Image: Shutterstock</em></p>

Family & Pets

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Uber driver slammed for refusing guide dog

<p>An Uber driver in South Australia is being slammed for refusing to let a vision impaired woman bring her guide dog in the car.</p> <p>Born with low vision, Ellen Fraser-Barbour relies on her guide dog Inca for safety and sight.</p> <p>But on Wednesday when she was trying to catch an Uber home, Ms Fraser-Barbour says she was told Inca was an unwelcome passenger.</p> <p>She was able to capture footage of the exchange between herself and the Uber driver.</p> <p>"This is an assistance dog, a guide dog," Ms Fraser-Barbour can be heard telling the driver.</p> <p>"No. No. No. I can't do it. Sorry," he replied.</p> <p>"It's an assistance dog, you can't refuse by law," Ms Fraser-Barbour added.</p> <p>But the driver still refused, claiming he was not obliged to accept the ride, leaving Ms Fraser-Barbour on the curb.</p> <p>She says the experience is one that is common for people with a disability.</p> <p>"I have a lot of blind friends and they all tell me about distressing experiences that they've had of being left on the curb. It's a really rampant issue," Ms Fraser-Barbour said.</p> <p>Since the incident she has made a report to Uber and received an apology. Ms Fraser-Barbour says it should never have happened in the first place and is now calling for stricter penalties.</p> <p>"For example being able to fine drivers if they refuse," Ms Fraser-Barbour said.</p> <p>In a statement Uber said a first offence will see a driver's account temporarily deactivated while they receive further education.</p> <p>A second strike could see them permanently banned from the platform.</p> <p>"Taking someone off the platform temporarily doesn't say zero tolerance approach. That says we'll give you another chance," Ms Fraser-Barbour said.</p> <p><em>Image: Nine News</em></p>

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Scammers target flood victims in new low

<p dir="ltr">In the aftermath of the floods that have devastated much of northern NSW and Queensland, those affected have something else to worry about - scammers.</p> <p dir="ltr">As Aussies begin to rebuild their homes and businesses, many are filing insurance claims.</p> <p><span id="docs-internal-guid-c2c3bdc9-7fff-9886-2c93-8fe7954d3572"></span></p> <p dir="ltr">But, reports have begun to emerge of scammers trying to take advantage of flood victims by posing as insurance providers.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CavpKLzhHqI/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CavpKLzhHqI/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ali King MP (@aliforpumicestone)</a></p> </div> </blockquote> <p dir="ltr">Ali King, the MP of Pumicestone in Queensland, said she received a text from an alleged scammer who claimed they would help with her insurance claim after the floods.</p> <p dir="ltr">The only problem was that she didn’t make a claim.</p> <p dir="ltr">“I got a text today from someone assigned to help me with my insurance claim. I don’t have an insurance claim,” she said on Instagram.</p> <p dir="ltr">Stephen Jones, the MP for Whitlam, also took to social media, using King’s tweet to warn those who may become victims of scammers on top of the floods.</p> <p dir="ltr"><span id="docs-internal-guid-deefd467-7fff-c7da-1b06-0d27bc8f81ff"></span></p> <p dir="ltr">“We’ve seen the best of Australia in the huge outpouring of support for those affected by these devastating floods,” he wrote.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Thanks <a href="https://twitter.com/StephenJonesMP?ref_src=twsrc%5Etfw">@StephenJonesMP</a> - we need better laws to deal with these grubs. <a href="https://twitter.com/hashtag/auspol?src=hash&amp;ref_src=twsrc%5Etfw">#auspol</a> <a href="https://twitter.com/hashtag/QLDFloods2022?src=hash&amp;ref_src=twsrc%5Etfw">#QLDFloods2022</a> <a href="https://t.co/FD2vjI9pxg">https://t.co/FD2vjI9pxg</a></p> <p>— Ali King MP (@AliKingLabor) <a href="https://twitter.com/AliKingLabor/status/1501017186537975813?ref_src=twsrc%5Etfw">March 8, 2022</a></p></blockquote> <p dir="ltr">“But scammers posing as insurance agents are looking to exploit people trying to pick up the pieces of their lives.</p> <p dir="ltr">“Look out for suspicious messages and phone calls. Share information with your communities so they know what to watch out for.</p> <p dir="ltr">“Working together we can stop these scammers from taking advantage of yet another tragedy.”</p> <p dir="ltr">A spokesperson for the ACC told <em><a href="https://7news.com.au/technology/scammers-posing-as-insurance-providers-target-flood-victims--c-5961535" target="_blank" rel="noopener">7News</a></em> that they were yet to see reports of the scams, but still urged Aussies to remain cautious.</p> <p dir="ltr">According to the ACCC, here are several things people can do to protect themselves from scams: </p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Don’t click on hyperlinks in texts, social media messages or emails, even if it appears to come from a trusted source</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Never reply to unsolicited messages asking for personal or financial details</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">To determine if a contact is legitimate, look them up through an independent source such as a phone book or online search</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Never send money or personal information, such as credit card details, to anyone you don’t know or trust</p> </li> </ul> <p dir="ltr">If you believe you have fallen victim to a scam, contact your bank and consider lodging a complaint with the <a href="https://aus01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.afca.org.au%2F&amp;data=04%7C01%7CSuWoolley%40seven.com.au%7Cc6008f2b54f04dd1bfb008d9df928a4c%7Cb359291241554399b790752c894d2935%7C0%7C0%7C637786642752505908%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0&amp;sdata=34rdRdW3WEJ0j6pj0PBqVm4Ixxy91pCjrwwk7LQSoME%3D&amp;reserved=0" target="_blank" rel="noopener">Australian Financial Complaints Authority</a> if you’re not satisfied with the bank’s response.</p> <p dir="ltr"><span id="docs-internal-guid-b6aeeb2b-7fff-ee91-d153-74beb6345dcf"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Technology