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What is methanol? How does it get into drinks and cause harm?

<p><em><a href="https://theconversation.com/profiles/ian-musgrave-1808">Ian Musgrave</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Melbourne teenager Bianca Jones <a href="https://www.abc.net.au/news/2024-11-21/bianca-jones-dead-laos-methanol-poisoning/104630384">has died</a> and her friend Holly Bowles remains severely ill in hospital in Thailand, after experiencing suspected methanol poisoning while they were travelling in Laos.</p> <p>The pair are reportedly among <a href="https://x.com/Smartraveller/status/1858850858227954118">several foreign nationals</a> who became ill after unknowingly consuming alcoholic drinks containing methanol in the south-east Asian country.</p> <p>So what is methanol, and how does it make people sick?</p> <h2>Methanol versus ethanol</h2> <p><a href="https://en.wikipedia.org/wiki/Methanol">Methanol</a> is an <a href="https://en.wikipedia.org/wiki/Alcohol_(chemistry)">alcohol</a>, like the familiar <a href="https://en.wikipedia.org/wiki/Ethanol">ethanol</a> we consume in alcoholic beverages.</p> <p>Like ethanol, methanol is a colourless, flammable liquid. It has a smell similar to ethanol as well.</p> <p>But the two have different chemical structures. Methanol is composed of only one carbon atom, while ethanol has two.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=300&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=300&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=300&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=377&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=377&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/633188/original/file-20241120-15-i7wr12.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=377&amp;fit=crop&amp;dpr=3 2262w" alt="Models of methanol and ethanol depicted with balls and sticks." /><figcaption><span class="caption">Methanol (left) and ethanol (right) have differing chemical structures.</span> <span class="attribution"><span class="source">Wikimedia Commons</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure> <p>That one carbon atom makes all the difference. It means methanol is processed differently in our bodies and is much more toxic than ethanol.</p> <p>Methanol is used in a <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Methanol">variety of industrial and household products</a>, such as windshield cleaning fluids, antifreeze and fuel. It’s not safe for human consumption.</p> <h2>What makes methanol toxic?</h2> <p>The difference is in how methanol is metabolised, or broken down in our bodies.</p> <p>Ethanol is metabolised into a chemical compound called acetaldehyde. Acetaldehyde is toxic, but is rapidly converted to acetate (also known as acetic acid, found in vinegar). Generating an acid may sound bad, but acetate actually <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6699882/">produces energy and makes important molecules</a> in the body.</p> <p>By contrast, methanol is metabolised into <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/formaldehyde">formaldehyde</a> (a chemical used in <a href="https://www.safework.nsw.gov.au/hazards-a-z/hazardous-chemical/priority-chemicals/formaldehyde">industrial glues</a> and for embalming corpses, for example) and then to <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Formic-Acid">formic acid</a> (the chemical in some ant bites that makes them hurt so much).</p> <p>Unlike acetate, which the body uses, formic acid <a href="https://pubmed.ncbi.nlm.nih.gov/1665561/">poisons the mitochondria</a>, the powerhouses of the cells.</p> <p>As a result, a person exposed to methanol can go into severe <a href="https://www.ncbi.nlm.nih.gov/books/NBK482121/">metabolic acidosis</a>, which is when too much acid builds up in the body.</p> <p>Methanol poisoning can cause nausea, vomiting, and abdominal pain. The acidosis then causes depression of the central nervous system which can cause people with methanol poisoning to fall unconscious and go into a coma, as well as retinal damage leading to vision loss. This is because the retinas are full of active mitochondria and sensitive to them being damaged.</p> <p>Death is not inevitable if only a small amount of methanol has been consumed, and rapid treatment will greatly reduce damage.</p> <p>However, permanent vision damage can occur even at <a href="https://www.ncbi.nlm.nih.gov/books/NBK482121/">non-lethal doses</a> if treatment is not administered quickly.</p> <h2>What does treatment involve?</h2> <p><a href="https://www.ncbi.nlm.nih.gov/books/NBK482121/">Treatment</a> is mainly supportive care, such as intubation and mechanical ventilation to help the patient to breathe.</p> <p>But it can also involve drugs such as <a href="https://go.drugbank.com/drugs/DB01213">fomepizole</a> (which inhibits the generation of toxic formic acid) and dialysis to remove methanol and its metabolites from the body.</p> <h2>How does methanol get into alcoholic drinks?</h2> <p>Methanol can turn up in any alcoholic beverage, but it’s most likely in beverages with higher alcohol content, such as spirits, and traditionally brewed drinks, such as fruit wines.</p> <p>Methanol can get into alcoholic beverages in a number of ways. Sometimes it’s added <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8303512/">deliberately and illegally</a> during or after manufacturing as a cheaper way to increase the alcohol content in a drink.</p> <p><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5028366/">Traditional brewing methods</a> can also inadvertently generate methanol as well as ethanol and produce toxic levels of methanol depending on the microbes and the types of plant materials used in the fermentation process.</p> <p>We don’t yet know how the Australian teenagers came to be poisoned in this tragedy. But it is a good idea when travelling (particularly in areas with traditionally fremented drinks, such as south-east Asia, the Indian subcontinent and parts of Africa) to always be careful.</p> <p>The Australian government’s <a href="https://www.smartraveller.gov.au/before-you-go/safety/partying#methanol">Smartraveller website</a> advises that to avoid methanol poisoning you should be careful drinking cocktails and drinks made with spirits, drink only at reputable licensed premises and avoid home-made alcoholic drinks.</p> <p>Drinking only mass-produced commercial brews can be safer, though understandably people often want to try locally made drinks as part of their adventure.<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/244151/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/ian-musgrave-1808">Ian Musgrave</a>, Senior lecturer in Pharmacology, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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-methanol-how-does-it-get-into-drinks-and-cause-harm-244151">original article</a>.</em></p>

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What does Donald Trump’s win mean for his brand of populist authoritarianism?

<h1 class="theconversation-article-title">What does Donald Trump’s win mean for his brand of populist authoritarianism?</h1> <div class="theconversation-article-body"><a href="https://theconversation.com/profiles/daniel-drache-1409730">Daniel Drache</a>, <em><a href="https://theconversation.com/institutions/york-university-canada-1610">York University, Canada</a></em> and <a href="https://theconversation.com/profiles/marc-d-froese-1411858">Marc D. Froese</a>, <em><a href="https://theconversation.com/institutions/burman-university-5814">Burman University</a></em></p> <p><a href="https://www.opensecrets.org/news/2024/10/total-2024-election-spending-projected-to-exceed-previous-record/">In the most expensive election in American history</a>, Republicans flipped the Senate, likely tightened their grip on the House of Representatives and <a href="https://www.washingtonpost.com/politics/2024/11/06/donald-trump-wins-presidential-election/">returned Donald Trump to the White House</a>.</p> <p>The so-called <a href="https://www.politico.com/news/2022/11/09/abortion-votes-2022-election-results-00065983">“red wave” predicted for the 2022 mid-term elections</a> rolled in two years later, and the MAGA movement is now the dominant force in American politics.</p> <p>Trump has an unprecedented mandate to reshape American life and politics, and is the first Republican to win the <a href="https://thehill.com/homenews/nexstar_media_wire/4976301-when-was-the-last-time-the-republican-party-won-the-popular-vote/">popular vote</a> since 2004. He intends to be an activist and transformative president. Now Americans and the rest of the world must brace for the global fallout in Ukraine, Russia, China, Israel and Iran.</p> <p>According to the <a href="https://www.bbc.com/news/topics/cj3ergr8209t">latest tabulations</a>, more than 71 million of Trump’s followers stayed loyal to the MAGA movement despite <a href="https://theconversation.com/trump-found-guilty-5-key-aspects-of-the-trial-explained-by-a-law-professor-231236">his criminal convictions and indictments</a>, <a href="https://www.motherjones.com/politics/2024/09/trump-hate-speech-migrants-campaign-rallies-incitement/">hate speech</a> and <a href="https://www.washingtonpost.com/politics/how-fact-checker-tracked-trump-claims/2021/01/23/ad04b69a-5c1d-11eb-a976-bad6431e03e2_story.html">fire hose of lies</a>.</p> <p>Trump won the presidency with the help of blue-collar, middle-class voters in the vital centre of the political spectrum, and in open defiance of the political establishment and most political power brokers.</p> <h2>Weak centre</h2> <p>What does Trump’s comeback mean for his unique brand of nationalist authoritarianism?</p> <p>Trump’s victory shows just how weak and lacklustre the centre has become in comparison to surging extremism. The silent majority that once rallied to support Ronald Reagan’s popular agenda, for example, is now a seemingly amoral majority indifferent to Trump’s felonies and his apocalyptic vision for the country.</p> <p>It’s now clear that the <a href="https://www.nytimes.com/2024/10/23/opinion/election-polls-results-trump-harris.html">undecided centre</a> is smaller than ever. Voters on the left were dismayed about Kamala Harris’s support for Benjamin Netanyahu’s government in Israel. Some planned not to vote or <a href="https://www.forbes.com/sites/stephenpastis/2024/11/04/will-third-party-candidates-be-2024-spoilers-heres-the-latest-data-as-trump-harris-race-nearly-tied/">to vote for third-party</a> candidates.</p> <p>What’s more, Republicans have been courting working class and racialized voters for years, and their messaging is paying off. Chipping away small numbers of <a href="https://www.pewresearch.org/short-reads/2024/01/10/key-facts-about-black-eligible-voters-in-2024/">Black</a> and <a href="https://www.pewresearch.org/short-reads/2024/07/19/how-latino-voters-view-the-2024-presidential-election/">Latino</a> voters is adding up to <a href="https://thehill.com/homenews/campaign/4975849-trump-harris-2024-presidential-run/?ipid=promo-link-block1">real gains</a>.</p> <h2>‘Make extremism great again’</h2> <p>The Republican machine has grasped an essential truth: parties must redefine their centre of gravity with the shifting of the <a href="https://www.mackinac.org/OvertonWindow">Overton window</a> of political acceptability, which holds that the centre is not fixed forever; it is simply a gauge of the new extremes.</p> <p>After a decade of the upheaval Trump has fuelled, mainstreaming extremism has become a proven formula for winning elections. The most basic question emphasized by the Trump-Harris showdown was: Can <a href="https://www.thenation.com/article/politics/myth-cheney-democrats-harris-walz-campaign/">cautious centrism</a> defeat <a href="https://www.iiss.org/online-analysis/survival-online/2021/01/trump-politics-of-paranoia/">paranoid populism</a>?</p> <p>In America in 2024, it could not.</p> <p>After 1945, the centre referred to the vast number of voters who rejected <a href="https://www.latimes.com/opinion/story/2024-09-13/on-freedom-timothy-snyder-erasing-history-jason-stanley-book-review">communism and fascism</a> while embracing the welfare state and full-employment capitalism.</p> <figure class="align-left zoomable"></figure> <p>This middle “<a href="https://www.theguardian.com/politics/2003/feb/10/labour.uk1">or third way</a>” — sought by politicians from Tony Blair to Barack Obama — won repeated elections. But today, the centre has been eclipsed by loyalty to a charismatic leader.</p> <p>When the extremes cease to be red lines, reasonable parties can only intermittently eke out a win. That means extremist movements grow ever stronger. What will happen in four years is anyone’s guess. But even after Trump is gone, he will live on atop the conservative pantheon, having risen to even greater esteem among his supporters than Reagan or <a href="https://www.politico.com/magazine/story/2014/10/barry-goldwater-lasting-legacy-112210/">Barry Goldwater</a>, the Republican senator who became a conservative standard-bearer for a generation.</p> <h2>Negative voting</h2> <p>The American election turned on negative voting. The only real question was whose fear would carry the day?</p> <p>Democrats feared the loss of <a href="https://www.brookings.edu/articles/freedom-harriss-message-to-america/">reproductive freedoms</a> for women. Republicans feared immigration conspiracy theories such as “<a href="https://www.npr.org/2022/05/17/1099223012/how-the-replacement-theory-went-mainstream-on-the-political-right">the great replacement</a>” theory.</p> <p>Republicans made border security a successful culture war issue, and it will unquestionably loom even larger in future elections. Gallup has shown that 55 per cent of Americans now want immigration levels <a href="https://news.gallup.com/poll/647123/sharply-americans-curb-immigration.aspx">drastically reduced</a>, a significant rise from 41 per cent just last year.</p> <p>The United States is not alone. What began as anger over Syrian refugees in Germany has metastasized into an enormous <a href="https://www.fosterglobal.com/blog/its-not-just-the-u-s-europes-growing-anti-immigration-backlash/">anti-immigrant backlash across Europe</a>. Anti-immigration sentiment is on the rise <a href="https://immigration.ca/canada-rated-best-country-in-world-for-welcoming-immigrants/">in Canada too despite it being one of the most welcoming nations in terms of immigration</a>.</p> <h2>The rise of anti-immigration sentiment</h2> <p>Future Republican contenders will almost certainly be avowed opponents of immigration given Trump’s stunning comeback. He leveraged the issue at a time when immigrants and border security have become powerful symbols of the enormous changes brought about by globalization.</p> <p>Zygmunt Bauman, the late eminent Polish sociologist, has described the technological advancement that defines global capitalism as “<a href="https://www.theoryculturesociety.org/blog/review-ali-rattansi-bauman-and-contemporary-sociology">liquid modernity</a>.”</p> <p>He argues that constant change <a href="https://openknowledge.worldbank.org/handle/10986/40672">rewards the wealthy and the hyper-mobile</a>. The blue-collar middle class is not worse off in absolute terms, but they’re <a href="https://reviewcanada.ca/magazine/2023/01/the-shill-of-the-people/">falling behind</a> as the billionaire class surges ahead and governments fail to protect the traditional institutions of the welfare state.</p> <p>For Trump voters, the “<a href="https://www.nbcnews.com/meet-the-press/video/trump-doubles-down-on-enemy-within-rhetoric-in-final-campaign-push-222300229921">enemy within</a>” was the most potent narrative for the MAGA coalition. Xenophobia was on <a href="https://www.nytimes.com/2024/10/28/opinion/trump-rally-msg-racism.html">full display</a> during the closing days of the campaign when a comedian at Trump’s Madison Square Garden rally referred to Puerto Rico as an “<a href="https://www.bbc.com/news/articles/cy9jj2g75q4o">island of garbage</a>.”</p> <p>The full force of liquid modernity continues to degrade the institutions of advanced societies and to reward rule-breakers. It’s not hyperbole to suggest this election could transform both America and the post-war <a href="https://www.foreignaffairs.com/united-states/how-trump-will-change-world">liberal international order</a>.</p> <h2>A dark MAGA future</h2> <p>One primary takeaway from this election is that an even darker, more apocalyptic form of the MAGA movement has taken hold. At a recent rally, Elon Musk, the world’s richest man, <a href="https://www.vanityfair.com/news/story/elon-musk-donald-trump-dark-maga-twitter">joined Trump on stage in a black MAGA cap, declaring</a>: “I’m not just MAGA, I’m dark MAGA.”</p> <p>In Trump’s warped view, an electoral loss would have been proof of cheating, but a win is a triumph of the will. In America today, conspiracy theories seemingly attract votes.</p> <p>It’s hard to underestimate the impact of Trump’s toxicity on American civic life. With his new mandate, Trump has a green light to implement most, if not all, of his most extreme policies, from tariffs to cementing an absolutist approach to presidential power.</p> <p>Trump has already promised to prosecute “<a href="https://www.cnn.com/2024/09/08/politics/trump-threatens-prosecution-2024-election-officials/index.html">to the fullest extent of the law</a>” his political enemies. He has threatened to use American troops to round up 15 million undocumented immigrants. It is his stated intent to exercise enormous presidential privilege by pardoning the “patriots” who stormed the capital in January 2021 “<a href="https://www.msnbc.com/deadline-white-house/deadline-legal-blog/trump-jan-6-pardons-day-one-2024-election-rcna170194">on Day One</a>.”</p> <p>It is far from certain that the American constitutional order will survive intact.<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/242867/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/daniel-drache-1409730"><em>Daniel Drache</em></a><em>, Professor Emeritus, Department of Politics, <a href="https://theconversation.com/institutions/york-university-canada-1610">York University, Canada</a> and <a href="https://theconversation.com/profiles/marc-d-froese-1411858">Marc D. Froese</a>, Professor of Political Science and Founding Director, International Studies Program, <a href="https://theconversation.com/institutions/burman-university-5814">Burman 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-does-donald-trumps-win-mean-for-his-brand-of-populist-authoritarianism-242867">original article</a>.</em></p> </div>

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What does a good death look like when you’re really old and ready to go?

<p><em><a href="https://theconversation.com/profiles/naomi-richards-182120">Naomi Richards</a>, <a href="https://theconversation.com/institutions/university-of-glasgow-1269">University of Glasgow</a></em></p> <p><a href="https://www.huffingtonpost.co.uk/entry/hawaii-legalizes-assisted-suicide_us_5ac6c6f5e4b0337ad1e621fb">Hawaii</a> recently joined the growing number of states and countries where doctor-assisted dying is legal. In these jurisdictions, help to die is rarely extended to those who don’t have a terminal illness. Yet, increasingly, very old people, without a terminal illness, who feel that they have lived too long, are arguing that they also have a right to such assistance.</p> <p>Media coverage of <a href="https://www.washingtonpost.com/news/to-your-health/wp/2018/05/09/this-104-year-old-plans-to-die-tomorrow-and-hopes-to-change-views-on-assisted-suicide/?utm_term=.b00a9036f9bc">David Goodall</a>, the 104-year-old Australian scientist who travelled to Switzerland for assisted dying, demonstrates the level of public interest in ethical dilemmas at the <a href="https://www.bmj.com/content/361/bmj.k1891.full">extremities of life</a>. Goodall wanted to die because he no longer enjoyed life. Shortly before his death, he told reporters that he spends most of his day just sitting. “What’s the use of that?” he asked.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0277953615002889?via%3Dihub">Research</a> shows that life can be a constant struggle for the very old, with social connections hard to sustain and health increasingly fragile. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25982088">Studies</a> looking specifically at the motivation for assisted dying among the very old show that many feel a deep sense of loneliness, tiredness, an inability to express their individuality by taking part in activities that are important to them, and a hatred of dependency.</p> <p>Of the jurisdictions where assisted dying is legal, some make suffering the determinant (Canada, for example). Others require a prognosis of six months (California, for example). Mainly, though, the focus is on people who have a terminal illness because it is seen as less of an ethical problem to hasten the death of someone who is already dying than someone who is simply tired of life.</p> <h2>Why give precedence to physical suffering?</h2> <p>Assisted dying for people with psychological or existential reasons for wanting to end their life is unlikely to be supported by doctors because it is not objectively verifiable and also potentially remediable. In the Netherlands, despite the legal power to offer assistance where there is no life-limiting illness, doctors are <a href="https://www.ncbi.nlm.nih.gov/pubmed/25693947">seldom convinced</a> of the unbearable nature of non-physical suffering, and so will rarely administer a lethal dose in such cases.</p> <p>Although doctors may look to a physical diagnosis to give them confidence in their decision to hasten a patient’s death, physical symptoms are often not mentioned by the people they are assisting. Instead, the most common reason given by those who have received help to die is <a href="https://www.nejm.org/doi/full/10.1056/NEJMms1700606">loss of autonomy</a>. Other common reasons are to avoid burdening others and not being able to enjoy one’s life – the exact same reason given by Goodall. This suggests that requests from people with terminal illness, and from those who are just very old and ready to go, are not as different as both the law – and doctors’ interpretation of the law – claim them to be.</p> <h2>Sympathetic coverage</h2> <p>It seems that the general public does not draw a clear distinction either. Most of the media coverage of Goodall’s journey to Switzerland was sympathetic, to the dismay of <a href="http://www.carenotkilling.org.uk/press-releases/centenarians-assisted-suicide/">opponents</a> of assisted dying.</p> <p>Media reports about <a href="https://www.theguardian.com/tv-and-radio/2014/sep/02/mary-berry-great-british-bake-off-centenarian-assisted-dying">ageing celebrities</a> endorsing assisted dying in cases of both terminal illness and very old age, blur the distinction still further.</p> <p>One of the reasons for this categorical confusion is that, at root, this debate is about what a good death looks like, and this doesn’t rely on prognosis; it relies on <a href="https://www.tandfonline.com/doi/full/10.1080/01459740.2016.1255610">personality</a>. And, it’s worth remembering, the personalities of the very old are as diverse as those of the very young.</p> <p>Discussion of assisted suicide often focuses on concerns that some older people may be exposed to coercion by carers or family members. But older people also play another role in this debate. They make up the rank and file <a href="http://www.ep.liu.se/ej/ijal/2012/v7/i1/a01/ijal12v7i1a01.pdf">activists</a> of the global right-to-die movement. In this conflict of rights, protectionist impulses conflict with these older activists’ demands to die on their own terms and at a time of their own choosing.</p> <p>In light of the <a href="https://www.nih.gov/news-events/news-releases/worlds-older-population-grows-dramatically">unprecedented ageing</a> of the world’s population and increasing longevity, it is important to think about what a good death looks like in deep old age. In an era when more jurisdictions are passing laws to permit doctor-assisted dying, the choreographed death of a 104-year-old, who died listening to Ode to Joy after enjoying a last fish supper, starts to look like a socially approved good death.<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/96589/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/naomi-richards-182120">Naomi Richards</a>, Lecturer in Social Science (End of Life Studies), <a href="https://theconversation.com/institutions/university-of-glasgow-1269">University of Glasgow</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-does-a-good-death-look-like-when-youre-really-old-and-ready-to-go-96589">original article</a>.</em></p>

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What is ‘health at every size’ lifestyle counselling? How does it compare with weight-focused treatments?

<p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p>Health at every size (or HAES) is a lifestyle counselling approach that promotes mindful eating and lifestyle behaviours to pursue health and wellness, without focusing on weight loss. Weight loss is seen as a <a href="https://www1.racgp.org.au/newsgp/clinical/understanding-the-%E2%80%98health-at-every-size%E2%80%99-paradigm">beneficial side effect</a>, rather than a goal.</p> <p>The <a href="https://www.sizeinclusivehealth.org.au/What-is-HAES">Association for Size Diversity and Health</a> first developed the approach in 2003 and revised it in 2013 and 2024. Its current <a href="https://asdah.org/haes/">core principles</a> promote:</p> <ul> <li>minimising weight discrimination</li> <li>encouraging body acceptance</li> <li>intuitive eating</li> <li>enjoyable physical activities.</li> </ul> <p>It also aims to address <a href="https://theobesitycollective.org.au/our-work/#weight-stigma-awareness">stigma and discrimination</a> that people in larger bodies may experience when seeking medical care.</p> <p>Internationally, a <a href="https://asdah.org/listing/">range of health professionals</a> have incorporated the HAES approach into their treatment and services. Some organisations, such as <a href="https://obesitycanada.ca/guidelines/nutrition/">Obesity Canada</a>, have included HAES in their <a href="https://pubmed.ncbi.nlm.nih.gov/32753461/">guidelines for obesity treatment</a>.</p> <h2>How does it compare with weight-focused treatments?</h2> <p>We conducted a <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">systematic review and meta-analysis</a> of all the research studies published until November 2022 that had used HAES-based programs.</p> <p>Across 19 scientific papers, we compared the outcomes of people living in larger bodies who used HAES-based programs <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">with</a>:</p> <ul> <li>conventional weight loss programs (six studies)</li> <li>people on waiting lists receiving no treatment at all (six studies)</li> <li>groups where people received weekly social support in groups (four studies).</li> </ul> <p>We evaluated the program’s impact on appetite, weight, physical health measurements including cholesterol and blood pressure, and also wellbeing and mental health.</p> <p>Our analysis found HAES interventions were beneficial in reducing susceptibility to hunger more than other approaches, meaning people had less subjective perceptions of hunger or eating in response to emotions.</p> <p>However, compared to control interventions, HAES did not show superior results for improving any other physical health outcome – weight loss, blood cholesterol levels, blood pressure – or wellbeing or mental health outcomes.</p> <p>Given the results to date, the choice about whether to use a HAES-based approach (or not) will depend on each person’s preference, needs and goals.</p> <h2>Don’t get your health advice from influencers</h2> <p>While HAES has been used in clinical practice for many years, some United States and Canadian anti-diet practitioner’s motives have been scrutinised because of their links <a href="https://www.washingtonpost.com/wellness/2024/04/03/diet-culture-nutrition-influencers-general-mills-processed-food/">with processed food companies</a>.</p> <p>The spotlight was put on the <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">very small number</a> of dietitian “influencers” (roughly 20 from a membership of more than 80,000 dietitians in the US and Canada) promoting “eat what you feel like” and discouraging people from making weight loss attempts, under the banner of HAES. They failed to mention they were being paid to promote products sold by food, beverage or supplement companies.</p> <p>US <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">author and dietitian Carrie Dennet</a> urges people to not look to influencers for health advice. Instead, seek non-judgemental health care from your GP.</p> <h2>What might treatment look like?</h2> <p>When improving your health is a treatment goal, a good place to start your journey is to have a health check-up with your doctor, as well as to assess your relationship with food.</p> <p>A healthy relationship with food means being able to eat appropriate amounts and variety of foods to meet your nutritional, health and wellbeing goals. This might include strategies such as:</p> <ul> <li>keeping a <a href="https://theconversation.com/what-does-having-a-good-relationship-with-food-mean-4-ways-to-know-if-youve-got-one-202622">food mood diary</a></li> <li>reflecting on factors that influence your eating</li> <li>practising <a href="https://theconversation.com/thinking-youre-on-a-diet-is-half-the-problem-heres-how-to-be-a-mindful-eater-99207">mindful eating</a></li> <li>learning about nutrient needs</li> <li>focusing on food enjoyment and the pleasure that comes from preparing, sharing and eating with others.</li> </ul> <p>If you need more help to develop this, ask your doctor to refer you to a health practitioner who can assist.</p> <h2>What if your goal is weight loss?</h2> <p>When it comes to medical nutrition therapy to treat weight-related health conditions, such as high blood pressure and type 2 diabetes, the approach will depend on individual needs and expectations.</p> <p>Broadly, there are three graded energy intake target levels:</p> <ol> <li> <p>a reduced-energy diet where the goal is to lower energy intake by 2,000 to 4,000 kilojoules (kJ) per day by identifying food substitutions, like swapping soft drinks and other sugar-sweetened drinks for zero or diet versions or water.</p> </li> <li> <p>a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">low-energy diet</a>, which uses an energy intake goal in the range of 4,200-5,000 kJ, up to 7,000 kJ per day depending on an individual’s energy expenditure.</p> </li> <li> <p>the most restricted regime is a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a>, has an energy intake target less than 2,500 kJ/day, achieved using formulated meal replacement products.</p> </li> </ol> <p>The aim of a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a> is to facilitate rapid weight loss when this is essential to improve health acutely such as poorly controlled type 2 diabetes. Such a diet should be used under supervision by your doctor and dietitian.</p> <p>When selecting an initial <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">strategy</a>, seek a balance between energy intake goals and your ability to stick to it. Your approach may change over time as your health needs change.</p> <p>If you need personalised nutrition advice, ask for a referral to an accredited practising dietitian. The <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">register of service providers though Dietitians Australia</a> allows you to view their expertise and location.</p> <p>Regardless of whether your practitioner uses a HAES approach or not, your health providers should always treat you with respect and address your personal health and wellbeing.<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/234376/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, Postdoctoral Researcher, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, Post Doctorate Fellow, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, Dietitian and early career researcher, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>Image </em><em>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-health-at-every-size-lifestyle-counselling-how-does-it-compare-with-weight-focused-treatments-234376">original article</a>.</em></p>

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The Princess of Wales wants to stay cancer-free. What does this mean?

<p><em><a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>; <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>, and <a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822"><em>WEHI (Walter and Eliza Hall Institute of Medical Research)</em></a></em></p> <p>Catherine, Princess of Wales, <a href="https://www.theguardian.com/uk-news/article/2024/sep/09/princess-of-wales-cancer-free-after-completing-chemotherapy">has announced</a> she has now completed a course of preventive chemotherapy.</p> <p>The news comes nine months after the princess first <a href="https://www.bbc.com/news/uk-68641441">revealed</a> she was being treated for an unspecified form of cancer.</p> <p>In the new <a href="https://www.youtube.com/watch?v=QSrDEq8QFkc">video message</a> released by Kensington Palace, Princess Catherine says she’s focused on doing what she can to stay “cancer-free”. She acknowledges her cancer journey is not over and the “path to recovery and healing is long”.</p> <p>While we don’t know the details of the princess’s cancer or treatment, it raises some questions about how we declare someone fully clear of the disease. So what does being – and staying – “cancer-free” mean?</p> <h2>What’s the difference between being cancer-free and in remission?</h2> <p>Medically, “cancer-free” <a href="https://www.mdanderson.org/cancerwise/remission--cancer-free--no-evidence-of-disease--what-is-the-difference-when-talking-about-cancer-treatment-effectiveness-and-results.h00-159460845.html">means</a> two things. First, it means no cancer cells are able to be detected in a patient’s body using the available testing methods. Second, there is no cancer left in the patient.</p> <p>These might sound basically the same. But this second aspect of “cancer-free” can be complicated, as it’s essentially impossible to be sure no cancer cells have survived a treatment.</p> <p>It only takes a few surviving cells for the cancer to <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">grow back</a>. But these cells may not be detectable via testing, and can lie dormant for some time. The possibility of some cells still surviving means it is more accurate to say a patient is “in remission”, rather than “cancer-free”.</p> <p>Remission means there is no detectable cancer left. Once a patient has been in remission for a certain period of time, they are often considered to be fully “cancer-free”.</p> <p>Princess Catherine was not necessarily speaking in the strict medical sense. Nonetheless, she is clearly signalling a promising step in her recovery.</p> <h2>What happens during remission?</h2> <p>During remission, patients will usually undergo surveillance testing to make sure their cancer hasn’t returned. Detection tests can vary greatly depending on both the patient and their cancer type.</p> <p>Many <a href="https://www.cancer.gov/about-cancer/screening/screening-tests">tests</a> involve simply looking at different organs to see if there are cancer cells present, but at varying levels of complexity.</p> <p>Some cancers can be detected with the naked eye, such as skin cancers. In other cases, technology is needed: colonoscopies for colorectal cancers, X-ray mammograms for breast cancers, or CT scans for lung cancers. There are also molecular tests, which test for the presence of cancer cells using protein or DNA from blood or tissue samples.</p> <p>For most patients, testing will continue for years at regular intervals. Surveillance testing ensures any returning cancer is caught early, giving patients the best chance of successful treatment.</p> <p>Remaining in remission for five years can be a huge milestone in a patient’s cancer journey. For most types of cancer, the <a href="https://pubmed.ncbi.nlm.nih.gov/31231898/">chances of cancer returning</a> drop significantly after five years of remission. After this point, surveillance testing may be performed less frequently, as the patients might be deemed to be at a lower risk of their cancer returning.</p> <h2>Measuring survival rates</h2> <p>Because it is very difficult to tell when a cancer is “cured”, clinicians may instead refer to a “five-year survival rate”. This measures how likely a cancer patient is to be alive five years after their diagnosis.</p> <p>For example, data shows the <a href="https://ncci.canceraustralia.gov.au/outcomes/relative-survival-rate/5-year-relative-survival-diagnosis">five-year survival rate</a> for <a href="https://cancer.org.au/cancer-information/types-of-cancer/bowel-cancer">bowel cancer</a> among Australian women (of all ages) is around 70%. That means if you had 100 patients with bowel cancer, after five years you would expect 70 to still be alive and 30 to have succumbed to the disease.</p> <p>These statistics can’t tell us much about individual cases. But comparing five-year survival rates between large groups of patients after different cancer treatments can help clinicians make the often complex decisions about how best to treat their patients.</p> <p>The likelihood of cancer coming back, or recurring, is influenced by many factors which can vary over time. For instance, approximately 30% of people with lung cancer <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061059/">develop a recurrent disease</a>, even after treatment. On the other hand, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933127/">breast cancer recurrence</a> within two years of the initial diagnosis is approximately 15%. Within five years it drops to 10%. After ten, it falls below 2%.</p> <p>These are generalisations though – recurrence rates can vary greatly depending on things such as what kind of cancer the patient has, how advanced it is, and whether it has spread.</p> <h2>Staying cancer-free</h2> <p>Princess Catherine <a href="https://www.theguardian.com/uk-news/article/2024/sep/09/princess-of-wales-cancer-free-after-completing-chemotherapy">says</a> her focus now is to “stay cancer-free”. What might this involve?</p> <p>How a cancer develops and whether it recurs can be <a href="https://nature.com/articles/s41467-018-05467-z">influenced</a> by things we can’t control, such as age, ethnicity, gender, genetics and hormones.</p> <p>However, there are sometimes <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/substances">environmental factors</a> we can control. That includes things like exposure to UV radiation from the sun, or inhaling carcinogens like tobacco.</p> <p>Lifestyle factors also play a role. Poor diet and nutrition, a lack of exercise and excessive alcohol consumption can all <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925935">contribute to cancer development</a>.</p> <p>Research estimates more than half of all cancers could <a href="https://www.canceraustralia.gov.au/resources/position-statements/lifestyle-risk-factors-and-primary-prevention-cancer/recommendations">potentially be prevented</a> through <a href="https://www.health.gov.au/topics/cancer/screening-for-cancer">regular screening</a> and maintaining a healthy lifestyle (not to mention preventing other chronic conditions such as heart disease and diabetes).</p> <p>Recommendations to reduce cancer risk are the same for everyone, not just those who’ve had treatment like Princess Catherine. They include not smoking, eating a nutritious and balanced diet, exercising regularly, cutting down on alcohol and staying sun smart.<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/238681/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, PhD Candidate in Genetic Engineering and Cancer, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>; <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, Senior Research Officer, Blood Cells and Blood Cancer, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>, and <a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research)</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/the-princess-of-wales-wants-to-stay-cancer-free-what-does-this-mean-238681">original article</a>.</em></p>

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Does intermittent fasting increase or decrease our risk of cancer?

<p><em><a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822"><em>WEHI (Walter and Eliza Hall Institute of Medical Research)</em></a></em></p> <p>Research over the years has suggested intermittent fasting has the potential to improve our health and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/">reduce the likelihood</a> of developing cancer.</p> <p>So what should we make of a <a href="https://www.nature.com/articles/s41586-024-07840-z">new study</a> in mice suggesting fasting increases the risk of cancer?</p> <h2>What is intermittent fasting?</h2> <p>Intermittent fasting means switching between times of eating and not eating. Unlike traditional diets that focus on <em>what</em> to eat, this approach focuses on <em>when</em> to eat.</p> <p>There are lots of commonly used <a href="https://dietitiansaustralia.org.au/health-advice/intermittent-fasting">intermittent fasting schedules</a>. The 16/8 plan means you only eat within an eight-hour window, then fast for the remaining 16 hours. Another popular option is the 5:2 diet, where you eat normally for five days then restrict calories for two days.</p> <p>In Australia, poor diet contributes to <a href="https://www.health.gov.au/topics/food-and-nutrition/what-were-doing">7% of all cases of disease</a>, including coronary heart disease, stroke, type 2 diabetes, and cancers of the bowel and lung. Globally, poor diet is linked to <a href="https://www.thelancet.com/article/S0140-6736(19)30041-8/fulltext">22% of deaths</a> in adults over the age of 25.</p> <p>Intermittent fasting has gained a lot of attention in recent years for its potential health benefits. Fasting <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/metabolism">influences metabolism</a>, which is how your body processes food and energy. It can affect how the body absorbs nutrients from food and burns energy from sugar and fat.</p> <h2>What did the new study find?</h2> <p>The <a href="https://www.nature.com/articles/s41586-024-07840-z">new study</a>, published in Nature, found when mice ate again after fasting, their <a href="https://www.nature.com/articles/s12276-024-01179-1">gut stem cells</a>, which help repair the intestine, became more active. The stem cells were better at regenerating compared with those of mice who were either totally fasting or eating normally.</p> <p>This suggests the body might be better at healing itself when eating after fasting.</p> <p>However, this could also have a downside. If there are <a href="https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-changes-infographic">genetic mutations</a> present, the burst of stem cell-driven regeneration after eating again might make it easier for cancer to develop.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027058/">Polyamines</a> – small molecules important for cell growth – drive this regeneration after refeeding. These polyamines can be produced by the body, influenced by diet, or come from gut bacteria.</p> <p>The findings suggest that while fasting and refeeding can improve stem cell function and regeneration, there might be a tradeoff with an increased risk of cancer, especially if fasting and refeeding cycles are repeated over time.</p> <p>While this has been shown in mice, the link between intermittent fasting and cancer risk in humans is more complicated and not yet fully understood.</p> <h2>What has other research found?</h2> <p><a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-071816-064634">Studies in animals</a> have found intermittent fasting can help with weight loss, improve blood pressure and blood sugar levels, and subsequently <a href="https://pubmed.ncbi.nlm.nih.gov/27810402/">reduce the risks</a> of diabetes and heart disease.</p> <p>Research in humans <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">suggests</a> intermittent fasting can reduce body weight, improve <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361187/">metabolic health</a>, reduce inflammation, and enhance <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/">cellular repair processes</a>, which remove damaged cells that could potentially turn cancerous.</p> <p>However, other studies warn that the benefits of intermittent fasting are the same as what can be achieved through <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2623528">calorie restriction</a>, and that there <a href="https://www.sciencedirect.com/science/article/pii/S2161831322007542">isn’t enough evidence</a> to confirm it reduces cancer risk in humans.</p> <h2>What about in people with cancer?</h2> <p>In studies of people who have cancer, fasting has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815756/">reported to</a> protect against the side effects of chemotherapy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311547/">improve the effectiveness</a> of cancer treatments, while decreasing damage to healthy cells.</p> <p>Prolonged fasting in some patients who have cancer has been shown to be safe and <a href="https://pubmed.ncbi.nlm.nih.gov/34383300/">may potentially</a> be able to decrease tumour growth.</p> <p>On the other hand, some experts advise caution. Studies in mice show intermittent fasting could <a href="https://www.nature.com/articles/s41423-023-01033-w">weaken the immune system</a> and make the body less able to fight infection, potentially leading to worse health outcomes in people who are unwell. However, there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757987/">currently no evidence</a> that fasting increases the risk of bacterial infections in humans.</p> <h2>So is it OK to try intermittent fasting?</h2> <p>The current view on intermittent fasting is that it can be beneficial, but experts agree more research is needed. Short-term benefits such as weight loss and better overall health are well supported. But we don’t fully understand the long-term effects, especially when it comes to cancer risk and other immune-related issues.</p> <p>Since there are many different methods of intermittent fasting and people react to them differently, it’s hard to <a href="https://www.nature.com/articles/s41423-023-01033-w">give advice that works for everyone</a>. And because most people who participated in the studies were overweight, or had diabetes or other health problems, we don’t know how the results apply to the broader population.</p> <p>For healthy people, intermittent fasting is generally considered safe. But it’s <a href="https://dietitiansaustralia.org.au/health-advice/intermittent-fasting">not suitable for everyone</a>, particularly those with certain medical conditions, pregnant or breastfeeding women, and people with a history of eating disorders. So consult your health-care provider before starting any fasting program.<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/238071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, PhD Candidate in Genetic Engineering and Cancer, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research)</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/does-intermittent-fasting-increase-or-decrease-our-risk-of-cancer-238071">original article</a>.</em></p>

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Does eating ham, bacon and beef really increase your risk of developing type 2 diabetes?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p>That lunchtime staple, the humble ham sandwich, has come in for a bashing in the press recently. According to <a href="https://www.theguardian.com/society/article/2024/aug/20/two-slices-of-ham-a-day-can-raise-type-2-diabetes-risk-by-15-research-suggests">many</a> <a href="https://www.dailymail.co.uk/health/article-13761253/Eating-ham-daily-linked-increase-risk-diabetes.html">reports</a>, eating two slices of ham a day can increase your risk of developing type 2 diabetes.</p> <p>But what’s the science behind these headlines?</p> <p>The research offers a more complex picture. <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00179-7/fulltext">A new study</a> from the University of Cambridge highlighted an association between developing type 2 diabetes and eating processed meat like ham and bacon, and red meat such as beef and lamb.</p> <p>This led to headlines suggesting the risk was mainly linked to <a href="https://www.telegraph.co.uk/news/2024/08/21/ham-sandwich-processed-meat-fresh-risk-link-type-2-diabetes/">ham sandwiches</a>. This seems to have come from the <a href="https://www.cam.ac.uk/research/news/red-and-processed-meat-consumption-associated-with-higher-type-2-diabetes-risk">press release</a>, which used ham as the example to quantify the amount of processed meat associated with a 15% increased risk of developing type 2 diabetes over ten years.</p> <p>The research found that this risk was linked to eating an extra 50g of processed meat every day, which happens to equate to two slices of ham. A useful example thus appears to have been taken up by the media as the main cause, perhaps ignoring some of the key messages coming from the study.</p> <p>So, can processed and red meat really increase your risk of developing type 2 diabetes?</p> <p>The <a href="https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/diabetes-risk-factors">biggest risk factors</a> linked to developing type 2 diabetes are being over 40, having family members with type 2 diabetes, being of South Asian or African descent, or having a higher body weight – and especially a larger waist.</p> <figure><iframe src="https://www.youtube.com/embed/EsOBcx2bJqU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The Cambridge study used data from nearly 2 million people from 31 studies. Participants were followed for an average of ten years. During this time, around one in 20 people developed type 2 diabetes.</p> <p>The research suggested that a 10% increase in the probability of developing type 2 diabetes was associated with every 100g of additional red meat eaten daily. Eating half as much extra processed meat every day was linked to an even greater increased risk of developing the disease.</p> <p>This is not the <a href="https://ajcn.nutrition.org/article/S0002-9165(23)66119-2/abstract">first time</a> that both processed and red meats have been linked with an increased risk of developing type 2 diabetes. However, the key strength of the Cambridge study was that it tried to control for many of the other factors linked to the disease, including smoking, having a higher body weight, dietary intake and exercise.</p> <p>However, the size of the increased risk is modest, considering few people included in the study ate 50g or more processed meat per day – meaning moderate ham consumption is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908545/">no meaningful effect</a> on your risk.</p> <h2>What’s the link?</h2> <p>Processed meat has been linked to increased risk of type 2 diabetes because of its nitrate and salt content – additives that are used to cure many processed meats.</p> <p>Nitrates and salt in processed meats have also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893523/">been linked to</a> an increased risk of developing colon cancer. In fact, the World Health Organization classifies the additives as <a href="https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat">group 1 carcinogens</a>, which means they can cause a range of cancers.</p> <p>The mechanism linking processed meat to cancer seems to be similar to how it might be linked to type 2 diabetes. During digestion, processed meat produces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294997/">N-nitroso chemicals</a>, which can damage cells. This can lead to inflammation and affects how insulin, the hormone that controls blood glucose (sugar), works. This in turn can lead to <a href="https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance">insulin resistance</a>, when cells in your muscles, fat and liver don’t respond well to insulin and can’t easily take up glucose from your blood.</p> <p>Red meat, meanwhile, is <a href="https://www.healthline.com/nutrition/healthy-iron-rich-foods">rich in iron</a>. Research suggests that people with <a href="https://www.diabetes.org.uk/diabetes-the-basics/related-conditions/haemochromatosis-diabetes#:%7E:text=So%20a%20rise%20of%20iron,GP%20as%20soon%20as%20possible.">high levels of iron</a> are more likely to develop type 2 diabetes. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744124/#:%7E:text=The%20WHO%20has%20recognised%20iron,being%20affected%20with%20this%20condition.">low levels of iron</a> are more of a health concern for the general population.</p> <p>Another potential link regarding red meat could be the way it is cooked.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521980/">Previous studies</a> have suggested that charred meat, cooked over an open flame or at high temperature, is also linked to an increased risk of developing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911789/">type 2 diabetes</a>. Charring meat leads to formation of toxic chemicals such as <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/heterocyclic-amine#:%7E:text=Heterocyclic%20amines%20are%20aromatic%20compounds,of%20reactions%20called%20Maillard%20reactions.">heterocyclic aromatic amines</a> and harmful compounds like <a href="https://www.healthline.com/nutrition/advanced-glycation-end-products">advanced glycation end products</a>, both of which have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/21709297/">insulin resistance and type 2 diabetes</a>.</p> <h2>Bye-bye barbecues and bacon butties?</h2> <p>The key message is reduction, rather than avoidance. The UK government nutritional recommendations offer sound advice: limit your combined intake of red and processed meat to no more than <a href="https://www.nhs.uk/live-well/eat-well/food-types/meat-nutrition/#:%7E:text=Red%20meat%20and%20processed%20meat&amp;text=If%20you%20currently%20eat%20more,%2C%20veal%2C%20venison%20and%20goat.">an average of 70g per day</a>.</p> <p>But these guidelines also suggest that red meat can be a valuable source of iron. So, if you decide to stop eating red meat, you should eat alternative sources of iron such as beans, lentils, dark green vegetables and fortified cereals.</p> <p>This needs to be done as part of a carefully planned diet. Non-meat sources of iron are more difficult for our bodies to absorb so should be eaten with a source of vitamin C, found in green vegetables and citrus fruit.</p> <p>The best advice to reduce your risk of developing type 2 diabetes is to maintain a healthy weight – consider losing weight if you have a higher body weight – and be as physically active as possible.</p> <p>A healthy diet should be based on plenty of vegetables, fruit, beans, peas, lentils, nuts and seeds, along with some wholegrain foods, some dairy products, fish and white meat (or vegetarian alternatives) – plus moderate amounts of red meat and minimal processed meat. This will help reduce your risk of type 2 diabetes, <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating">heart disease</a>, and <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/does-having-a-healthy-diet-reduce-my-risk-of-cancer">many cancers</a> – as well being more <a href="https://www.bda.uk.com/static/539e2268-7991-4d24-b9ee867c1b2808fc/a1283104-a0dd-476b-bda723452ae93870/one%20blue%20dot%20reference%20guide.pdf">environmentally sustainable</a>.</p> <p>But if you have a penchant for ham sandwiches, rest assured you can continue to indulge as an occasional treat. It’s your overall lifestyle and diet that really matter for your health and risk of developing type 2 diabetes.<!-- 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/237346/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/duane-mellor-136502">Duane Mellor</a>, Visiting Academic, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></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/does-eating-ham-bacon-and-beef-really-increase-your-risk-of-developing-type-2-diabetes-237346">original article</a>.</em></p> </div>

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How long does back pain last? And how can learning about pain increase the chance of recovery?

<p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>.</p> <p>Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>.</p> <p>If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups:</p> <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> <p>We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.</p> <p>Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.</p> <h2>More pain doesn’t mean a more serious injury</h2> <p>Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease.</p> <p>There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.</p> <p>Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.</p> <p>The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.</p> <p>The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.</p> <h2>Reduce your chance of lasting pain</h2> <p>Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:</p> <ul> <li> <p>understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain</p> </li> <li> <p>reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.</p> </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> <p>Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.</p> <p>These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover.</p> <p>But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.</p> <p>When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>.</p> <p>Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community.</p> <p>But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<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/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</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/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.</em></p>

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Readers response: Who’s the most interesting person you’ve met while travelling?

<p>One of the best parts of travelling is the people you met along the way. </p> <p>Whether it's as part of a tour group or an interesting character you meet by chance, interacting with interesting people in interesting places can bring a lot to your travel experience. </p> <p>We asked our readers to tell us about the most interesting person they've encountered on their travels and the response was overwhelming. Here's what they said. </p> <p><strong>Diana Jason</strong> - Cargo Holly Harrison. He walked 15000 miles from the bottom of South America to the top of Alaska. A truly fascinating man.</p> <p><strong>Margie Buckingham</strong> - While caravanning around Oz, every night we would meet interesting ppl enjoying pre-dinner drinks &amp; nibbles around the campfire. We all had personal stories to tell or the best places to camp.</p> <p><strong>Ann Smith</strong> - Myself. Travelled to the UK and found my independence and confidence, two and a bit years after I lost love of my life to cancer.</p> <p><strong>Pamela Cari</strong> - We met the lady who played the mother of Apollonia Vitelli in The Godfather when we were in Savoca.</p> <p><strong>Rosalie Busch</strong> - A couple who grew up behind the wall in East Berlin. </p> <p><strong>Sue Velvin</strong> - Shaquille O'Neal when my daughter and I had a holiday in the states a few years ago! Awesome man.</p> <p><strong>Wendy Farnham</strong> - A Buddhist Nun in Cambodia who lost her husband and 6 of her 7 children to starvation under Pol Pot’s regime.</p> <p><strong>Lyn Schuemaker</strong> - Everybody. They all have stories to tell.</p> <p><em>Image credits: Shutterstock </em></p>

International Travel

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Woman “bullied” on plane over budget seating trick

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

Travel Trouble

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Does screen use really impact our thinking skills? Our analysis suggests it could

<p><em><a href="https://theconversation.com/profiles/michoel-moshel-1433565">Michoel Moshel</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/jennifer-batchelor-1485101">Jennifer Batchelor</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/joanne-bennett-1485102">Joanne Bennett</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>, and <a href="https://theconversation.com/profiles/wayne-warburton-402810">Wayne Warburton</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Screens have become seamlessly integrated into our daily lives, serving as indispensable tools for work, education and leisure. But while they enrich our lives in countless ways, we often fail to consider the potential impact of screen time on our cognitive abilities.</p> <p>In a <a href="https://link.springer.com/article/10.1007/s11065-023-09612-4">new meta-analysis</a> of dozens of earlier studies, we’ve found a clear link between disordered screen use and lower cognitive functioning.</p> <p>The findings suggest we should exercise caution before advocating for more screen time, and before introducing screens into even more aspects of daily life.</p> <h2>Young people’s screen time is increasing</h2> <p>In 2020, a UNSW Gonski Institute for Education report <a href="https://www.gie.unsw.edu.au/sites/default/files/documents/UNSW%20GIE%20GUD%20Phase%201%20Technical%20Report%20MAR20%20v2.pdf">noted a concerning statistic</a>: about 84% of Australian educators believe digital technologies are distracting in a learning environment.</p> <p>And according to the ABC, a recent Beyond Blue <a href="https://www.abc.net.au/news/2023-09-18/mental-health-depression-anxiety-support-coming-for-schools/102831464">survey</a> of Australian teachers identified excessive screen time as the second-most significant challenge for young people, just behind mental health issues.</p> <p>Despite mounting concerns, more than half of Australian schools have embraced a “<a href="https://www.linewize.io/anz/blog/the-rise-of-byod-in-australian-schools">bring your own device</a>” policy. Students are spending more time online than <a href="https://read.oecd-ilibrary.org/education/students-computers-and-learning_9789264239555-en#page46">ever before</a> and starting at increasingly younger ages. A 2021 report by <a href="https://www.commonsensemedia.org/sites/default/files/research/report/8-18-census-integrated-report-final-web_0.pdf">Common Sense Media</a> estimated tweens spend an average of 5 hours and 33 minutes using screen-based entertainment each day, while teenagers devote a whopping 8 hours and 39 minutes.</p> <p>A surge in screen use has led to some individuals, including children, adolescents and adults, developing screen-related addictions. One example is gaming disorder, for which <a href="https://journals.sagepub.com/doi/full/10.1177/0004867420962851">2–3% of people</a> meet the criteria.</p> <h2>What is ‘disordered screen use’?</h2> <p>The impact of screens on our cognitive abilities – that is, our thinking skills such as attention, memory, language and problem-solving – has sparked much debate.</p> <p>On one hand, some researchers and reporters claim screen use can have negative effects, such as <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12701-3">health problems</a>, shortened attention <a href="https://time.com/3858309/attention-spans-goldfish/">spans</a> and hindered <a href="https://www.researchgate.net/publication/312489265_The_relationship_between_television_exposure_and_children's_cognition_and_behaviour_A_systematic_review">development</a>.</p> <p>On the other, schools are <a href="https://www.smh.com.au/education/tech-takeover-classrooms-crowded-with-digital-devices-20200125-p53ul1.html">increasingly adopting</a> technology to boost student engagement. Tech companies are also marketing their products as tools to help you enhance your problem-solving and memory skills.</p> <p>Our <a href="https://link.springer.com/article/10.1007/s11065-023-09612-4">recent study</a> sought to understand the potential cognitive consequences of “disordered screen-related behaviours”. This is a broad category of problematic behaviours that may include screen dependency, and persisting with screen use even when it’s harmful.</p> <p>We conducted a meta-analysis of 34 studies that explored various forms of screen use (including gaming, internet browsing, smartphone use and social media use) and compared the cognitive performance of individuals with disordered screen use to those without it.</p> <p>Our findings paint a concerning picture.</p> <h2>Differences in cognitive function</h2> <p>Across these rigorously peer-reviewed studies, individuals with disordered screen use consistently demonstrated significantly poorer cognitive performance compared to others.</p> <p>The most affected cognitive domain was attention, and specifically sustained attention, which is the ability to maintain focus on an unchanging stimulus for an extended period.</p> <p>The second-most notable difference was in their “executive functioning” – particularly in impulse control, which is the ability to control one’s automatic responses.</p> <p>Interestingly, the type of screen activity didn’t make a difference in the results. The trend also wasn’t confined to children, but was observed across all age groups.</p> <h2>Two ways to interpret the results</h2> <p>Why do people with disordered screen-related behaviours have poorer cognitive functioning?</p> <p>The first explanation is that disordered screen use actually leads to poorer cognitive function, including poorer attention skills (but we’ll need more experimental and longitudinal studies to establish causality).</p> <p>If this is the case, it may be the result of being constantly bombarded by algorithms and features designed to capture our attention. By diverting our focus outward, screen use may weaken one’s intrinsic ability to concentrate over time.</p> <p>Crucially, impaired attention also <a href="https://akjournals.com/view/journals/2006/10/1/article-p77.xml">makes it harder to disengage</a> from addictive behaviours, and would therefore make it harder to recognise when screen use has become a problem.</p> <p>The second explanation is that people who already have poorer cognitive functioning (such as less inhibitory control) are more likely to engage in disordered screen use.</p> <p>This could be a result of the plethora of addictive cues designed to keep us glued to our screens. Being bombarded by these could make it harder to <a href="https://akjournals.com/view/journals/2006/9/4/article-p990.xml">pull the brakes</a> on screen use.</p> <p>Although the literature doesn’t seem to favour this explanation – and does seem to suggest that cognitive functioning is impaired as a result of disordered screen use – it’s still a possibility we can’t rule out.</p> <p>Attention is the bedrock of everyday tasks. People with weakened attention may struggle to keep up in less stimulating environments, such as a static workplace or classroom. They may find themselves turning to a screen as a result.</p> <p>Similarly, people with less inhibitory control would also find it more challenging to moderate their screen use. This could be what drives them towards problematic screen-related behaviours in the first place.</p> <h2>Who should shoulder the responsibility?</h2> <p>Research indicates people with impaired cognitive functioning usually aren’t as well equipped to moderate their own screen time.</p> <p>Many users with disordered screen use are <a href="https://www.sciencedirect.com/science/article/pii/S0747563220302326?casa_token=BQv_N_MFffYAAAAA:AsGkAfdwXjCZHJB463G40Mx-ckS2Q1c8jSOn2SWR_9iW64eWaQsru1IJAZBDCgSPXwhZ3Qwl">young</a>, with mainly males engaging in internet gaming and mainly females engaging in social media use. Neurodiverse people are <a href="https://www.mdpi.com/1660-4601/19/9/5587">also at greater risk</a>.</p> <p>Tech companies are driven by the goal of <a href="https://www.theguardian.com/technology/2017/apr/18/netflix-competitor-sleep-uber-facebook">capturing our attention</a>. For instance, Netflix chief executive Reed Hastings acknowledged the company’s <a href="https://www.theguardian.com/technology/2017/apr/18/netflix-competitor-sleep-uber-facebook">most formidable competitor was sleep</a>.</p> <p>At the same time, researchers find themselves struggling to keep up with the pace of technological innovation. A potential path forward is to encourage open-access data policies from tech companies, so researchers can delve deeper into the study of screen use and its effect on individuals. <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/216828/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/michoel-moshel-1433565">Michoel Moshel</a>, PhD/Masters Clinical Neuropsychology Candidate, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/jennifer-batchelor-1485101">Jennifer Batchelor</a>, Associate Professor, School of Psychological Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/joanne-bennett-1485102">Joanne Bennett</a>, Lecturer, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>, and <a href="https://theconversation.com/profiles/wayne-warburton-402810">Wayne Warburton</a>, Associate Professor, <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/does-screen-use-really-impact-our-thinking-skills-our-analysis-suggests-it-could-216828">original article</a>.</em></p>

Mind

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Can you drink your fruit and vegetables? How does juice compare to the whole food?

<p><em><a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>Do you struggle to eat your fruits and vegetables? You are not alone. Less than 5% of Australians eat the recommended serves of fresh produce <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/dietary-behaviour/latest-release">each day</a> (with 44% eating enough fruit but only 6% eating the recommended vegetables).</p> <p>Adults <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups">should aim to eat</a> at least five serves of vegetables (or roughly 375 grams) and two serves of fruit (about 300 grams) each day. Fruits and vegetables help keep us healthy because they have lots of nutrients (vitamins, minerals and fibre) and health-promoting bioactive compounds (substances not technically essential but which have health benefits) without having many calories.</p> <p>So, if you are having trouble <a href="https://theconversation.com/want-your-child-to-eat-more-veggies-talk-to-them-about-eating-the-rainbow-195563">eating the rainbow</a>, you might be wondering – is it OK to drink your fruits and vegetables instead in a juice or smoothie? Like everything in nutrition, the answer is all about context.</p> <h2>It might help overcome barriers</h2> <p>Common reasons for not eating enough fruits and vegetables are <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1747-0080.12735">preferences, habits, perishability, cost, availability, time and poor cooking skills</a>. Drinking your fruits and vegetables in juices or smoothies can help overcome some of these barriers.</p> <p><a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-3010.2009.01760.x">Juicing or blending</a> can help disguise tastes you don’t like, like bitterness in vegetables. And it can blitz imperfections such as bruises or soft spots. Preparation doesn’t take much skill or time, particularly if you just have to pour store-bought juice from the bottle. Treating for food safety and shipping time does change the make up of juices slightly, but unsweetened juices still remain significant sources of <a href="https://pubmed.ncbi.nlm.nih.gov/12403253/">nutrients</a> and <a href="https://www.emerald.com/insight/content/doi/10.1108/00070701111140089/full/html?fullSc=1">beneficial bioactives</a>.</p> <p>Juicing can <a href="https://academic.oup.com/nutritionreviews/advance-article-pdf/doi/10.1093/nutrit/nuz031/30096176/nuz031.pdf">extend shelf life</a> and reduce the cost of nutrients. In fact, when researchers looked at the density of nutrients relative to the costs of common foods, <a href="https://www.mdpi.com/1660-4601/18/11/5771">fruit juice was the top performer</a>.</p> <h2>So, drinking my fruits and veggies counts as a serve, right?</h2> <p>How juice is positioned in healthy eating recommendations is a bit confusing. The <a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/fruit">Australian Dietary Guidelines</a> include 100% fruit juice with fruit but vegetable juice isn’t mentioned. This is likely because vegetable juices weren’t as common in 2013 when the guidelines were last revised.</p> <p><a href="https://www.eatforhealth.gov.au/food-essentials/five-food-groups/fruit">The guidelines</a> also warn against having juice too often or in too high amounts. This appears to be based on the logic that juice is similar, but not quite as good as, whole fruit. Juice has lower levels of fibre compared to fruits, with fibre important for gut health, heart health and promoting feelings of fullness. Juice and smoothies also release the sugar from the fruit’s other structures, making them “free”. The <a href="https://www.who.int/publications-detail-redirect/9789241549028">World Health Organization recommends</a> we limit free sugars for good health.</p> <p>But fruit and vegetables are more than just the sum of their parts. When we take a “<a href="https://hal.science/hal-01630639/">reductionist</a>” approach to nutrition, foods and drinks are judged based on assumptions made about limited features such as sugar content or specific vitamins.</p> <p>But these features might not have the impact we logically assume because of the complexity of foods and people. When humans eat varied and complex diets, we don’t necessarily need to be concerned that some foods are lower in fibre than others. Juice can retain the nutrients and bioactive compounds of fruit and vegetables and even add more because parts of the fruit we don’t normally eat, like the skin, can be included.</p> <h2>So, it is healthy then?</h2> <p>A recent <a href="https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuae036/7659479?login=false">umbrella review of meta-analyses</a> (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977198/">a type of research</a> that combines data from multiple studies of multiple outcomes into one paper looked at the relationship between 100% juice and a range of health outcomes.</p> <p>Most of the evidence showed juice had a neutral impact on health (meaning no impact) or a positive one. Pure 100% juice was linked to improved heart health and inflammatory markers and wasn’t clearly linked to weight gain, multiple cancer types or metabolic markers (such as blood sugar levels).</p> <p>Some health risks linked to drinking juice were <a href="https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuae036/7659479?login=false">reported</a>: death from heart disease, prostate cancer and diabetes risk. But the risks were all reported in <a href="https://www.cancer.gov/research/participate/what-are-observational-studies#:%7E:text=Observational%20studies%20are%20research%20studies,over%20a%20period%20of%20time.">observational studies</a>, where researchers look at data from groups of people collected over time. These are not controlled and do not record consumption in the moment. So other drinks people think of as 100% fruit juice (such as sugar-sweetened juices or cordials) might accidentally be counted as 100% fruit juice. These types of studies are not good at showing the direct causes of illness or death.</p> <h2>What about my teeth?</h2> <p>The common belief juice damages teeth might not stack up. Studies that show juice damages teeth often <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2019.00190/full">lump 100% juice in with sweetened drinks</a>. Or they use model systems like fake mouths that <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2019.00190/full">don’t match</a> how people drinks juice in real life. Some <a href="https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2019.00190/full">use extreme scenarios</a> like sipping on large volumes of drink frequently over long periods of time.</p> <p>Juice is acidic and does contain sugars, but it is possible proper oral hygiene, including <a href="https://www.sciencedirect.com/science/article/abs/pii/S0300571207000152?via%3Dihub">rinsing, cleaning</a> and using straws can mitigate these risks.</p> <p>Again, reducing juice to its acid level misses the rest of the story, including the nutrients and bioactives contained in juice that are <a href="https://www.sciencedirect.com/science/article/pii/S2352385919300210#:%7E:text=Research%20has%20also%20confirmed%20that,prevention%20of%20oral%20inflammatory%20disorders.">beneficial to oral health</a>.</p> <h2>So, what should I do?</h2> <p>Comparing whole fruit (a food) to juice (a drink) can be problematic. They serve different culinary purposes, so aren’t really interchangeable.</p> <p>The Australian Guide to Healthy Eating recommends <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">water as the preferred beverage</a> but this assumes you are getting all your essential nutrients from eating.</p> <p>Where juice fits in your diet depends on what you are eating and what other drinks it is replacing. Juice might replace water in the context of a “perfect” diet. Or juice might replace <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/substitution-of-pure-fruit-juice-for-fruit-and-sugarsweetened-beverages-and-cardiometabolic-risk-in-epicnl-a-prospective-cohort-study/B7314F1198109712DE0F2E44D919A6A7">alcohol or sugary soft drinks</a> and make the relative benefits look very different.</p> <h2>On balance</h2> <p>Whether you want to eat your fruits and vegetables or drink them comes down to what works for you, how it fits into the context of your diet and your life.</p> <p>Smoothies and juices aren’t a silver bullet, and there is no evidence they work as a “cleanse” or <a href="https://theconversation.com/lemon-water-wont-detox-or-energise-you-but-it-may-affect-your-body-in-other-ways-180035">detox</a>. But, with society’s low levels of fruit and vegetable eating, having the option to access nutrients and bioactives in a cheap, easy and tasty way shouldn’t be discouraged either.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, Adjunct Senior Lecturer, Nutrition, Dietetics &amp; Food Innovation - School of Health Sciences, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/can-you-drink-your-fruit-and-vegetables-how-does-juice-compare-to-the-whole-food-205222">original article</a>.</em></p>

Food & Wine

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Julian Assange was isolated for more than a decade. Here’s what that does to the body and mind

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/carol-maher-217811">Carol Maher</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/johanna-badcock-995697">Johanna Badcock</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p>Anyone who lived through the COVID pandemic would likely understand that even a small period of isolation can cause <a href="https://pubmed.ncbi.nlm.nih.gov/35787541/">physical and mental stress</a>.</p> <p>WikiLeaks founder Julian Assange – <a href="https://theconversation.com/julian-assange-will-be-freed-after-striking-plea-deal-with-us-authorities-233210">who will return to Australia</a> after reaching a plea deal with the US Department of Justice – is <a href="https://www.afr.com/policy/foreign-affairs/his-health-is-very-risky-assange-s-brother-fears-for-his-life-20240327-p5ffjw">reported to have suffered</a> various mental and physical challenges during his almost 15 years in some form of isolation.</p> <p>Assange was first arrested in Britain in 2010 after Swedish authorities said they wanted to <a href="https://www.theguardian.com/media/2010/dec/17/julian-assange-sweden">question him over sex crime allegations</a>.</p> <p>After exhausting legal avenues to stop an extradition to Sweden, in June 2012 he entered <a href="https://www.theguardian.com/world/2018/may/15/julian-assange-ecuador-london-embassy-how-he-became-unwelcome-guest">Ecuador’s embassy in London</a>, where he remained for seven years.</p> <p>In early 2019, he was <a href="https://www.reuters.com/article/idUSKCN1S73H5/">jailed for skipping bail</a> and held at London’s Belmarsh prison where he spent most of the following five years fighting extradition to the US. Now, he’s coming home.</p> <p>While we have no idea how Assange is coping from being cooped up inside for so long with few visitors, we do know that isolation can have <a href="https://theconversation.com/my-own-prison-ordeal-gave-me-a-taste-of-what-assange-may-be-feeling-hes-out-but-the-chilling-effect-on-press-freedom-remains-233215">a severe negative impact</a> on many people.</p> <p><iframe id="qxq2l" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/qxq2l/" width="100%" height="400px" frameborder="0"></iframe></p> <h2>How physical inactivity impacts your body</h2> <p>Physical activity is vital for <a href="https://jamanetwork.com/journals/jama/articlepdf/2712935/jama_piercy_2018_sc_180005.pdf">overall health</a>. It keeps your heart strong, helps manage weight, and builds muscle and bone strength.</p> <p>Regular exercise also lifts your mood, reducing symptoms of depression and anxiety, and sharpens your mind. Plus, it boosts your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195025/">immune system</a>, making you more resistant to infections and diseases.</p> <p>When you don’t move enough, especially in isolation, your health can take a hit. Muscles weaken and joints stiffen, making you less strong and flexible.</p> <p>Your <a href="https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.102.9.975">heart health</a> suffers, too, raising the risk of high blood pressure, heart attacks and strokes because your heart isn’t getting the workout it needs.</p> <p>Metabolic issues such as obesity and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908414/">type 2 diabetes</a> become more common with inactivity, especially if you don’t have access to healthy food.</p> <p>Isolation often means less fresh air and sunlight, both crucial for good health. Poor ventilation can lead to <a href="https://www.mdpi.com/1660-4601/17/8/2927/pdf">respiratory problems</a>. Lack of sunlight can cause <a href="https://academic.oup.com/jcem/article-pdf/95/6/2630/9067013/jcem2630.pdf">vitamin D deficiency</a>, weakening bones and the immune system, and increasing the risk of fractures.</p> <p>These effects fit with the reports that Assange suffered a <a href="https://www.theguardian.com/media/2022/mar/23/today-i-will-marry-the-love-of-my-life-julian-assanges-fiancee">mini-stroke</a> in 2021 and a <a href="https://www.theguardian.com/commentisfree/2024/feb/18/julian-assange-press-freedom-wikileaks-uk-high-court">broken rib</a> from persistent coughing fits while in isolation.</p> <h2>What about mental health?</h2> <p>Social disconnection comes in two main forms, both of which have serious consequences for our mental health.</p> <p>The first is social isolation. The reasons for being isolated are many and varied, including geographical distance, lack of access to transport, or incarceration.</p> <p>The end result is the same: you have few relationships, social roles or group memberships, and limited social interaction.</p> <p>The second form of social disconnection is more invisible but just as harmful.</p> <p><a href="https://psychology.org.au/for-the-public/psychology-topics/loneliness">Loneliness</a> is that subjective, unpleasant feeling of wanting but lacking satisfying relationships with others.</p> <p>You can be isolated and not feel lonely, but the two are often unwelcome bedfellows.</p> <p>Social connection is not a luxury. It’s a fundamental need, as essential to our health as food and water.</p> <p>Just as hunger reminds us to eat, <a href="https://healthymale.org.au/health-article/what-is-loneliness-and-social-isolation">loneliness acts as a signal</a> alerting us that our social relationships are weak and need to be improved if we are to remain healthy.</p> <p>The science around the health impacts of social disconnection is clear, especially when it is prolonged. So much so, the World Health Organization recently launched a <a href="https://www.who.int/groups/commission-on-social-connection">Commission on Social Connection</a> to increase awareness of the impact of social isolation and loneliness on health and have it recognised as a global health priority.</p> <p>Substantial evidence shows social isolation and loneliness are linked to poorer cognitive functioning and an increased risk of dementia, though possibly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995915/">different ways</a>.</p> <p>Among adults aged 50 years and over, chronic (meaning persistent and severe) loneliness and social isolation may increase the risk of dementia by <a href="https://www.tandfonline.com/doi/full/10.1080/13651501.2021.1959616">around 50%</a>.</p> <p>A lack of cognitive stimulation that naturally occurs when interacting with others, whether it’s old friends or strangers, might explain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995915/">the link</a> between social isolation and cognitive difficulties (think “use it or lose it”).</p> <p>On the other hand, loneliness <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995915/">may impact cognitive health</a> through its effects on emotional wellbeing. It’s <a href="https://www.nature.com/articles/s41598-022-13049-9">a well-known risk factor</a> for developing depression, anxiety and suicidality.</p> <p>For instance, <a href="https://pubmed.ncbi.nlm.nih.gov/35583561/">studies show</a> the chances of developing depression in adults is more than double in people who often feel lonely, compared with those who rarely or never feel lonely.</p> <p>Other research examining 500,000 middle-aged adults over nine years showed living alone doubled the risk of dying by suicide for men, while loneliness <a href="https://pubmed.ncbi.nlm.nih.gov/33096330">increased the risk of hospitalisation</a> for self-harm in both men and women.</p> <p>In a <a href="https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf">2023 report</a>, the US Surgeon General’s advisory concluded:</p> <blockquote> <p>Given the totality of the evidence, social connection may be one of the strongest protective factors against self-harm and suicide among people with and without serious underlying mental health challenges.</p> </blockquote> <h2>What about after release?</h2> <p>When a person leaves long-term isolation, they’ll face many challenges as they re-enter society.</p> <p>The world will have changed. There’s a lot to catch up on, from technological advancements to shifts in social norms.</p> <p>In addition to these broader changes, there’s a need to focus on rebuilding physical and mental health. Health issues that developed during isolation can <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext?cid=in%3Adisplay%3Alfhtn0&amp;dclid=CNKCgb7nle0CFVUkjwodG0YCkg">persist or worsen</a>. A weakened immune system might struggle with new infections in a post-COVID world.</p> <p>To navigate this transition, it’s important to establish a routine that includes regular exercise, nutritious meals and comprehensive medical and psychological care.</p> <p>Gradually increasing social interactions can also help in rebuilding relationships and social connections. These steps are supportive in restoring overall health and wellbeing in a changed world.<!-- 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/233214/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/carol-maher-217811">Carol Maher</a>, Professor, Medical Research Future Fund Emerging Leader, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/johanna-badcock-995697">Johanna Badcock</a>, Adjunct Professor, School of Psychological Science | Freelance Research Consultant, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p><em>Image credits: Ray Tang/Shutterstock Editorial </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/julian-assange-was-isolated-for-more-than-a-decade-heres-what-that-does-to-the-body-and-mind-233214">original article</a>.</em></p> </div>

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Princess Diana's brother shares "immensely sad" personal news

<p>Princess Diana's younger brother Charles Spencer has shared that he and his wife are divorcing after 13 years of marriage. </p> <p>The Earl's relationship with his wife, Karen Gordon, reportedly broke down while Spencer was writing his harrowing memoir which detailed the physical and sexual abuse he suffered at boarding school. </p> <p>Revealing the split to the <em><a href="https://www.dailymail.co.uk/news/article-13509355/charles-spencer-sad-divorce-wife-memoir.html" target="_blank" rel="noopener">Mail on Sunday</a></em>, the 60-year-old said, "It is immensely sad."</p> <p>"I just want to devote myself to all my children, and to my grandchildren, and I wish Karen every happiness in the future."</p> <p>Spencer and Gordon, a Canadian philanthropist, first met on a blind date at a restaurant in Los Angeles in 2010, and got married just one year later in June 2011 on the Althorp estate, where Princess Diana is buried. </p> <p>The couple share a 12-year-old daughter named Charlotte Diana, while Spencer also has four children from his previous marriage to his first wife, Victoria Lockwood, and two children with his second wife, Caroline Freud.</p> <p>Karen was notably absent at events held at Althorp and Spencer House in London in mid-March to launch the Earl's tell-all book, <em>A Very Private School</em>.</p> <p>Charles Spencer told the <em>Mail on Sunday</em> that the five years of work on his memoir has deeply affected him and led to him undergoing residential treatment for trauma late last year.</p> <p>In a March interview with <em><a href="https://people.com/charles-spencer-reveals-he-was-sexually-abused-by-a-woman-as-a-child-at-boarding-school-8606246" target="_blank" rel="noopener">People</a></em>, Spencer opened up about how “supportive” Karen had been throughout his healing journey as he recalled the traumatic details of his childhood.</p> <p>“I think it was very challenging for her to have a husband going through what was essentially four and a half years of the most profound therapy with very difficult undertones to it. And she supported the idea of me doing it,” he said.</p> <p>“I think she always hoped I would come out happier and healthier and that seems to be the case very much. So, I’m grateful to have her standing by me while I went through this, what I now realise was an essential process.”</p> <p><em>Image credits: Splashnews.com/Shutterstock Editorial </em></p>

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‘Sleeping on it’ really does help and four other recent sleep research breakthroughs

<p><em><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</a></em></p> <p>Twenty-six years. That is roughly <a href="https://www.nature.com/articles/s41467-022-34624-8">how much of our lives</a> are spent asleep. Scientists have been trying to explain why we spend so much time sleeping since at least the <a href="https://plato.stanford.edu/entries/alcmaeon/">ancient Greeks</a>, but pinning down the exact functions of sleep has proven to be difficult.</p> <p>During the past decade, there has been a surge of interest from researchers in the nature and function of sleep. New experimental models coupled with advances in technology and analytical techniques are giving us a deeper look inside the sleeping brain. Here are some of the biggest recent breakthroughs in the science of sleep.</p> <h2>1. We know more about lucid dreaming</h2> <p>No longer on the fringes, the neuroscientific study of dreaming has now become mainstream.</p> <p>US researchers in a 2017 study woke their participants up at regular intervals during the night and asked them what was going through their minds prior to the alarm call. Sometimes participants couldn’t recall any dreaming. The study team then looked at what was <a href="https://www.nature.com/articles/nn.4545">happening in the participant’s brain</a> moments before waking.</p> <p>Participants’ recall of dream content was associated with increased activity in the posterior hot zone, an area of the brain closely <a href="https://www.nature.com/articles/d41586-018-05097-x">linked to conscious awareness</a>. Researchers could predict the presence or absence of dream experiences by monitoring this zone in real time.</p> <p>Another exciting development in the study of dreams is research into lucid dreams, in which <a href="https://theconversation.com/the-ability-to-control-dreams-may-help-us-unravel-the-mystery-of-consciousness-52394">you are aware that</a> you are dreaming. A 2021 study established <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00059-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982221000592%3Fshowall%3Dtrue">two-way communication</a> between a dreamer and a researcher. In this experiment, participants signalled to the researcher that they were dreaming by moving their eyes in a pre-agreed pattern.</p> <p>The researcher read out maths problems (what is eight minus six?). The dreamer could respond to this question with eye movements. The dreamers were accurate, indicating they had access to high level cognitive functions. The researchers used <a href="https://www.mayoclinic.org/tests-procedures/polysomnography/about/pac-20394877">polysomnography</a>, which monitors bodily functions such as breathing and brain activity during sleep, to confirm that participants were asleep.</p> <p>These discoveries have dream researchers excited about the future of “interactive dreaming”, such as practising a skill or solving a problem in our dreams.</p> <h2>2. Our brain replays memories while we sleep</h2> <p>This year marks the centenary of the first demonstration that <a href="https://www.jstor.org/stable/1414040?origin=crossref">sleep improves our memory</a>. However, a 2023 review of recent research has shown that memories formed during the day <a href="https://portlandpress.com/emergtoplifesci/article/7/5/487/233796/Neural-reactivation-during-human-sleep">get reactivated</a> while we are sleeping. Researchers discovered this using machine learning techniques to “decode” the contents of the sleeping brain.</p> <p><a href="https://www.nature.com/articles/s41467-021-24357-5">A 2021 study</a> found that training algorithms to distinguish between different memories while awake makes it possible to see the same neural patterns re-emerge in the sleeping brain. A different study, also in 2021, found that the more times these patterns re-emerge during sleep, <a href="https://www.nature.com/articles/s41467-021-23520-2">the bigger the benefit</a> to memory.</p> <p>In other approaches, scientists have been able to reactivate certain memories by <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)31035-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219310358%3Fshowall%3Dtrue">replaying sounds</a> associated with the memory in question while the participant was asleep. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144680/">2020 meta-analysis of 91 experiments</a> found that when participants’ memory was tested after sleep they remembered more of the stimuli whose sounds were played back during sleep, compared with control stimuli whose sounds were not replayed.</p> <p>Research has also shown that sleep strengthens memory for the <a href="https://www.pnas.org/doi/10.1073/pnas.2202657119">most important aspects</a> of an experience, restructures our memories to form <a href="https://www.jneurosci.org/content/40/9/1909">more cohesive narratives</a> and helps us come up with <a href="https://journals.sagepub.com/doi/10.1177/0956797619873344">solutions to problems</a> we are stuck on. Science is showing that sleeping on it really does help.</p> <h2>3. Sleep keeps our minds healthy</h2> <p>We all know that a lack of sleep makes us feel bad. Laboratory sleep deprivation studies, where researchers keep willing participants awake throughout the night, have been combined with <a href="https://www.open.edu/openlearn/body-mind/health/health-sciences/how-fmri-works">functional MRI brain scans</a> to paint a detailed picture of the sleep-deprived brain. These studies have shown that a lack of sleep severely disrupts the <a href="https://www.nature.com/articles/nrn.2017.55">connectivity between</a> different brain networks. These changes include a breakdown of connectivity between brain regions <a href="https://link.springer.com/article/10.1007/s11682-018-9868-2">responsible for cognitive control</a>, and an amplification of those involved in <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)30761-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219307614%3Fshowall%3Dtrue">threat and emotional processing</a>.</p> <p>The consequence of this is that the sleep-deprived brain is worse at <a href="https://academic.oup.com/cercor/article/33/5/1610/6573958">learning new information</a>, <a href="https://academic.oup.com/sleep/article/44/6/zsaa289/6053003">poorer at regulating emotions</a>, and unable to <a href="https://journals.sagepub.com/doi/10.1177/2167702620951511">suppress intrusive thoughts</a>. Sleep loss may even make you less likely to <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3001733">help other people</a>. These findings may explain why poor sleep quality is so <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13930">ubiquitous in poor mental health</a>.</p> <h2>4. Sleep protects us against neurodegenerative diseases</h2> <p>Although we naturally <a href="https://www.nature.com/articles/s41467-022-34624-8">sleep less as we age</a>, mounting evidence suggests that sleep problems earlier in life <a href="https://jnnp.bmj.com/content/91/3/236">increase the risk</a> of dementia.</p> <p>The build-up of β-amyloid, a <a href="https://www.nhs.uk/conditions/alzheimers-disease/causes/">metabolic waste product</a>, is one of the mechanisms underlying Alzheimer’s disease. Recently, it has become apparent that deep, undisturbed sleep is good for <a href="https://www.science.org/doi/10.1126/sciadv.aav5447">flushing these toxins</a> out of the brain. Sleep deprivation increases the the rate of build-up of β-amyloid in parts of the brain involved in memory, <a href="https://www.pnas.org/doi/full/10.1073/pnas.1721694115">such as the hippocampus</a>. A longitudinal study published in 2020 found that sleep problems were associated with a higher rate of β-amyloid accumulation at a follow-up <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(20)31171-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982220311714%3Fshowall%3Dtrue">four years later</a>. In a different study, published in 2022, sleep parameters <a href="https://elifesciences.org/articles/78191">forecasted the rate</a> of cognitive decline in participants over the following two years.</p> <h2>5. We can engineer sleep</h2> <p>The good news is that research is developing treatments to get a better night’s sleep and boost its benefits.</p> <p>For example, the <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.14035">European Sleep Research Society</a> and the <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8986">American Academy of Sleep Medicine</a> recommend cognitive behavioural therapy for insomnia (CBT-I). <a href="https://www.cntw.nhs.uk/services/nctalkingtherapies/what-do-nc-talking-therapies-offer/cbt-i-cbt-for-insomnia/">CBT-I works by</a> identifying thoughts, feelings and behaviour that contribute to insomnia, which can then be modified to help promote sleep.</p> <p>In 2022, a CBT-I app became the <a href="https://www.nice.org.uk/news/article/nice-recommends-offering-app-based-treatment-for-people-with-insomnia-instead-of-sleeping-pills">first digital therapy</a> recommended by England’s National Institute for Health and Care Excellence for treatment on the NHS.</p> <p>These interventions can improve other aspects of our lives as well. A <a href="https://www.sciencedirect.com/science/article/pii/S1087079221001416?via%3Dihub">2021 meta-analysis</a> of 65 clinical trials found that improving sleep via CBT-I reduced symptoms of depression, anxiety, rumination and stress.<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/230484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, Marie Skłodowska-Curie Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</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/sleeping-on-it-really-does-help-and-four-other-recent-sleep-research-breakthroughs-230484">original article</a>.</em></p>

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Does hosting the Olympics, the World Cup or other major sports events really pay off?

<p><em><a href="https://theconversation.com/profiles/ivan-savin-678930">Ivan Savin</a>, <a href="https://theconversation.com/institutions/escp-business-school-813">ESCP Business School</a></em></p> <p>After a long battle, <a href="https://www.france24.com/en/europe/20240213-paris-booksellers-stay-olympics-macron-bouquiniste-france">Paris’s beloved <em>bouquinistes</em> will be staying put</a> this summer. The decision, announced on 13 February by the French government, came after considerable public backlash to the police prefecture’s original plan to move part of the iconic Seine booksellers elsewhere for the inauguration of the Olympics Games on 26 July.</p> <p>Meanwhile, less than six months away from the event, Parisians continue to grumble over a <a href="https://www.ouest-france.fr/jeux-olympiques/cest-aberrant-ce-maire-vient-dapprendre-que-sa-ville-accueillera-les-jeux-de-paris-ab1fa968-cfd1-11ee-89c0-6cefac77e04a">lack of consultations</a> with locals, warnings of <a href="https://www.rfi.fr/en/france/20231130-paris-vehicle-traffic-to-be-heavily-restricted-during-2024-olympic-games">gridlocked traffic</a>, closed metro stations, extensive video surveillance and other grievances. So for host countries, what was the point of the Olympics, again?</p> <p>In academia, the debate about the potential positive and negative effects of large-scale sporting events is ongoing. Although these events are often associated with substantial economic losses, the long-term benefits are the main argument in favour of hosting them. These include the development of material and soft infrastructure such as hotels, restaurants or parks. Big games can also help put the host region on the map as an attractive place for sports and cultural events, and inspire a better entrepreneurial climate.</p> <h2>The pros and the cons of big sporting events?</h2> <p>The cost of these benefits, as the Parisians have realised, is steep. Host countries appear to suffer from increased tax burdens, low returns on public investments, high construction costs, and onerous running cost of facilities after the event. Communities can also be blighted by noise, pollution, and damage to the environment, while increased criminal activity and potential conflicts between locals and visitors can take a toll on their quality of life. As a result, in the recent past several major cities, including Rome and Hamburg, <a href="https://www.dw.com/en/6-cities-that-rejected-the-olympics/a-46289852">withdrew their bids to host the games</a>.</p> <p>A common feature of the economics of large-scale sporting events is that our expectations of them are more optimistic than what we make of them once they have taken place. Typically, expenditure tends to tip over the original budget, while the revenue-side indicators (such as the number of visitors) are rarely achieved.</p> <p>When analysing the effect of hosting large-scale sporting events on tourist visits, it is important to take into consideration both the positive and negative components of the overall effect. While positive effects may be associated with visitors, negative effects may arise when “regular” tourists refuse to visit the location due to the event. This might be because of overloaded infrastructure, sharp increases in accommodation costs, and inconveniences associated with overcrowding or raucous or/and violent visitors. On top of that, reports of poverty or crime in the global media can actually undermine the location’s attractiveness.</p> <h2>When big sporting events crowd out regular tourists</h2> <p>In an <a href="https://doi.org/10.1177/1527002523120639">article published in the <em>Journal of Sports Economics</em></a> with Igor Drapkin and Ilya Zverev, I assess the effects of hosting large-scale sporting events, such as Winter and Summer Olympics plus FIFA World Cups, on international tourist visits. We utilise a comprehensive dataset on flow of tourists covering the world’s largest destination and origin countries between 1995 and 2019. As a first step, we built an econometric model that effectively predicts the flow of tourists between any pair of countries in our data. Subsequently we compared the predicted tourist inflow in a hypothetical scenario where no large-scale sporting event would have taken place with the actual figures. If the actual figures exceed the predicted ones, we consider the event to have a net positive impact. Otherwise, we consider that it had a “crowding out” effect on “regular” tourists. While conducting this analysis, we distinguished between short-term (i.e., focusing just on the year of the event) and mid-term (year of the event plus three subsequent years).</p> <p>Our results show that the effects of large-scale sporting events vary a lot across host countries: The World Cup in Japan and South Korea 2002 and South Africa 2010 were associated with a distinct increase in tourist arrivals, whereas all other World Cups were either neutral or negative. Among the Summer Olympics, China in 2008 is the only case with a significant positive effect on tourist inflows. The effects of the other four events (Australia 2000, Greece 2004, Great Britain 2012, and Brazil 2016) were found to be negative in the short- and medium-term. As for the Winter Olympics, the only positive case is Russia in 2014. The remaining five events had a negative impact except the one-year neutral effect for Japan 1998.</p> <p>Following large-scale sporting events, host countries are therefore typically less visited by tourists. Out of the 18 hosting countries studied, 11 saw tourist numbers decline over four years, and three did not experience a significant change.</p> <h2>The case for cautious optimism</h2> <p>Our research indicates that the positive effect of hosting large-scale sporting events on tourist inflows is, at best, moderate. While many tourists are attracted by FIFA World Cups and Olympic games, the crowding-out effect of “regular” tourists is strong and often underestimated. This implies that tourists visiting for an event like the Olympics typically dissuade those who would have come for other reasons. Thus, efforts to attract new visitors should be accompanied by efforts to retain the already existing ones.</p> <p>Large-scale sporting events should be considered as part of a long-term policy for promoting a territory to tourists rather than a standalone solution. Revealingly, our results indicate that it is easier to get a net increase in tourist inflows in countries that are less frequent destinations for tourists – for example, those in Asia or Africa. By contrast, the United States and Europe, both of which are traditionally popular with tourists, have no single case of a net positive effect. Put differently, the large-scale sporting events in Asia and Africa helped promote their host countries as tourist destinations, making the case for the initial investment. In the US and Europe, however, those in the last few decades brought little return, at least in terms of tourist inflow.<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/222118/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/ivan-savin-678930">Ivan Savin</a>, Associate professor of quantitative analytics, research fellow at ICTA-UAB, <a href="https://theconversation.com/institutions/escp-business-school-813">ESCP Business School</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/does-hosting-the-olympics-the-world-cup-or-other-major-sports-events-really-pay-off-222118">original article</a>.</em></p>

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Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

<p><a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, <em><a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.”</p> <p>“My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video.</p> <p>No further details have been released about the Princess of Wales’ treatment.</p> <p>But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment.</p> <h2>It’s not the same as preventing cancer</h2> <p>To <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">prevent cancer developing</a>, lifestyle changes such as diet, exercise and sun protection are <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">recommended</a>.</p> <p>Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at <a href="https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-cancer/art-20045353">high risk of breast cancer</a>.</p> <p>Aspirin <a href="https://www.cancer.gov/about-cancer/causes-prevention/research/aspirin-cancer-risk">can also be used</a> for those at high risk of bowel and other cancers.</p> <h2>How can chemotherapy be used as preventive therapy?</h2> <p>In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning.</p> <p>If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer.</p> <p>If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate <a href="https://www.healthline.com/health/cancer/metastatic-cancer">around the body</a> .</p> <p>The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer <a href="https://www.verywellhealth.com/adjuvant-therapy-5198903">coming back</a>. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later.</p> <p>With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back.</p> <p>If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer.</p> <h2>How effective is preventive therapy?</h2> <p>The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy.</p> <p>Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564362/">first chemotherapy tested</a> improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%.</p> <p>Preventive chemotherapy is usually given for three to six months.</p> <h2>How does chemotherapy work?</h2> <p>Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations.</p> <p>Chemotherapy is not selective for cancer cells. It kills any dividing cells.</p> <p>But cancers consist of a higher proportion of dividing cells than the normal body cells. A <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment/chemotherapy/how-does-chemotherapy-work#:%7E:text=Chemotherapy%20works%20by%20killing%20cells%20that%20are%20rapidly,cells%20can%20repair%20the%20damage%20and%20can%20recover.">greater proportion of the cancer is killed</a> with each course of chemotherapy.</p> <p>Normal cells can recover between courses, which are usually given three to four weeks apart.</p> <h2>What are the side effects?</h2> <p>The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells.</p> <p>The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection.</p> <p>Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance.</p> <p>Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet.</p> <p>There are also generalised symptoms such as <a href="https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html">fatigue</a>.</p> <p>Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.<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/226461/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, <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/kate-middleton-is-having-preventive-chemotherapy-for-cancer-what-does-this-mean-226461">original article</a>.</em></p>

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Celine Dion shares rare health update

<p>Celine Dion has shared a rare health update, and revealed that she is determined to get back onstage despite her battle with stiff person syndrome. </p> <p>The singer took to Instagram to share a photo of herself with son René-Charles Angélil, 23, and 13-year-old twins Eddy and Nelson. </p> <p>“Trying to overcome this auto-immune disorder has been one of the hardest experiences of my life, but I remain determined to one day get back onto the stage and to live as normal of a life as possible,” she shared on Friday. </p> <p>“I am deeply grateful for the love and support from my kids, family, team and all of you!”</p> <p>She shared the post in honour of stiff person syndrome awareness day, which falls on the 15th of March. </p> <p>“I want to send my encouragement and support to all those around the world that have been affected by SPS,” she continued in her post. </p> <p>“I want you to know you can do it! We can do it!” she concluded, signing off, “Love Celine xx.”</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/C4j2U_6OI-9/?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/C4j2U_6OI-9/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Céline Dion (@celinedion)</a></p> </div> </blockquote> <p>Stiff Person Syndrome is an an extremely rare neurological disorder that affects the nervous system, mainly the brain and spinal cord. </p> <p>According to the US National Institutes of Health, this disorder can cause stiff muscles in the torso, arms and legs, significantly impeding mobility. </p> <p>The <em>My Heart Will Go On</em> singer first went <a href="https://www.oversixty.com.au/health/caring/celine-dion-reveals-shock-diagnosis" target="_blank" rel="noopener">public</a> with her diagnosis on the 8th of December in 2022, after she was forced to postpone some of her tour dates. </p> <p><em>Image: Instagram</em></p>

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Does intermittent fasting have benefits for our brain?

<p><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <em><a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Intermittent fasting has become a popular dietary approach to help people lose or manage their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8683964/">weight</a>. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and <a href="https://pubmed.ncbi.nlm.nih.gov/27810402">improve overall health</a>.</p> <p>Meanwhile, some research suggests intermittent fasting may offer a different way for the brain to access energy and provide protection against neurodegenerative diseases like <a href="https://link.springer.com/article/10.1007/s11011-023-01288-2">Alzheimer’s disease</a>.</p> <p>This is not a new idea – the ancient Greeks believed fasting <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839325/">enhanced thinking</a>. But what does the modern-day evidence say?</p> <h2>First, what is intermittent fasting?</h2> <p>Our <a href="https://pubmed.ncbi.nlm.nih.gov/35487190/">diets</a> – including calories consumed, macronutrient composition (the ratios of fats, protein and carbohydrates we eat) and when meals are consumed – are factors in our lifestyle we can change. People do this for cultural reasons, desired weight loss or potential health gains.</p> <p>Intermittent fasting consists of short periods of calorie (energy) restriction where food intake is limited for 12 to 48 hours (usually 12 to 16 hours per day), followed by periods of normal food intake. The intermittent component means a re-occurrence of the pattern rather than a “one off” fast.</p> <p>Food deprivation beyond 24 hours typically constitutes starvation. This is distinct from fasting due to its specific and potentially harmful biochemical alterations and nutrient deficiencies if continued for long periods.</p> <h2>4 ways fasting works and how it might affect the brain</h2> <p>The brain accounts for about <a href="https://theconversation.com/how-much-energy-do-we-expend-thinking-and-using-our-brain-197990">20% of the body’s energy consumption</a>.</p> <p>Here are four ways intermittent fasting can act on the body which could help explain its potential effects on the brain.</p> <p><strong>1. Ketosis</strong></p> <p>The goal of many intermittent fasting routines is to flip a “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">metabolic switch</a>” to go from burning predominately carbohydrates to burning fat. This is called ketosis and typically occurs after 12–16 hours of fasting, when liver and glycogen stores are depleted. <a href="https://www.ncbi.nlm.nih.gov/books/NBK493179/">Ketones</a> – chemicals produced by this metabolic process – become the preferred energy source for the brain.</p> <p>Due to this being a slower metabolic process to produce energy and potential for lowering blood sugar levels, ketosis can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844723/">cause symptoms</a> of hunger, fatigue, nausea, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754590/">low mood</a>, irritability, constipation, headaches, and brain “fog”.</p> <p>At the same time, as glucose metabolism in the brain declines with ageing, studies have shown ketones could provide an alternative energy source to <a href="https://www.science.org/doi/10.1126/science.aau2095">preserve brain function</a> and prevent <a href="https://pubmed.ncbi.nlm.nih.gov/32709961/">age-related neurodegeneration disorders and cognitive decline</a>.</p> <p>Consistent with this, increasing ketones through <a href="https://pubmed.ncbi.nlm.nih.gov/31027873/">supplementation</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/31757576/">diet</a> has been shown to improve cognition in adults with mild cognitive decline and those at risk of Alzheimer’s disease respectively.</p> <p><strong>2. Circadian syncing</strong></p> <p>Eating at times that <a href="https://pubmed.ncbi.nlm.nih.gov/32480126/">don’t match our body’s natural daily rhythms</a> can disrupt how our organs work. Studies in shift workers have suggested this might also make us more prone to <a href="https://pubmed.ncbi.nlm.nih.gov/22010477/">chronic disease</a>.</p> <p>Time-restricted eating is when you eat your meals within a six to ten-hour window during the day when you’re most active. Time-restricted eating causes changes in <a href="https://pubmed.ncbi.nlm.nih.gov/36599299/">expression of genes in tissue</a> and helps the body during rest and activity.</p> <p>A 2021 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827225/">study of 883 adults</a> in Italy indicated those who restricted their food intake to ten hours a day were less likely to have cognitive impairment compared to those eating without time restrictions.</p> <p><strong>3. Mitochondria</strong></p> <p>Intermittent fasting may provide <a href="https://pubmed.ncbi.nlm.nih.gov/35218914/">brain protection</a> through improving mitochondrial function, metabolism and reducing oxidants.</p> <p>Mitochondria’s <a href="https://www.genome.gov/genetics-glossary/Mitochondria">main role is to produce energy</a> and they are crucial to brain health. Many age-related diseases are closely related to an energy supply and demand imbalance, likely attributed to <a href="https://www.nature.com/articles/s41574-021-00626-7">mitochondrial dysfunction during ageing</a>.</p> <p>Rodent studies suggest alternate day fasting or reducing calories <a href="https://journals.sagepub.com/doi/10.1038/jcbfm.2014.114">by up to 40%</a> might protect or improve <a href="http://www.ncbi.nlm.nih.gov/pubmed/21861096">brain mitochondrial function</a>. But not all studies support this theory.</p> <p><strong>4. The gut-brain axis</strong></p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/">gut and the brain communicate with each other</a> via the body’s nervous systems. The brain can influence how the gut feels (think about how you get “butterflies” in your tummy when nervous) and the gut can affect mood, cognition and mental health.</p> <p>In mice, intermittent fasting has shown promise for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">improving brain health</a> by increasing survival and <a href="https://pubmed.ncbi.nlm.nih.gov/12354284/">formation of neurons</a> (nerve cells) in the hippocampus brain region, which is involved in memory, learning and emotion.</p> <p>There’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470960/">no clear evidence</a> on the effects of intermittent fasting on cognition in healthy adults. However one 2022 study interviewed 411 older adults and found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646955/">lower meal frequency</a> (less than three meals a day) was associated with reduced evidence of Alzheimer’s disease on brain imaging.</p> <p>Some research has suggested calorie restriction may have a protective effect against <a href="https://academic.oup.com/nutritionreviews/article/81/9/1225/7116310">Alzheimer’s disease</a> by reducing oxidative stress and inflammation and promoting vascular health.</p> <p>When we look at the effects of overall energy restriction (rather than intermittent fasting specifically) the evidence is mixed. Among people with mild cognitive impairment, one study showed <a href="https://pubmed.ncbi.nlm.nih.gov/26713821/">cognitive improvement</a> when participants followed a calorie restricted diet for 12 months.</p> <p>Another study found a 25% calorie restriction was associated with <a href="https://pubmed.ncbi.nlm.nih.gov/30968820">slightly improved working memory</a> in healthy adults. But a <a href="https://www.sciencedirect.com/science/article/pii/S0022316623025221?via%3Dihub">recent study</a>, which looked at the impact of calorie restriction on spatial working memory, found no significant effect.</p> <h2>Bottom line</h2> <p>Studies in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740746/">mice</a> support a role for intermittent fasting in improving brain health and ageing, but few studies in humans exist, and the evidence we have is mixed.</p> <p>Rapid weight loss associated with calorie restriction and intermittent fasting can lead to nutrient deficiencies, muscle loss, and decreased immune function, particularly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749464/">older adults</a> whose nutritional needs may be higher.</p> <p>Further, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314618/">prolonged fasting</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9042193/">severe calorie restriction</a> may pose risks such as fatigue, dizziness, and electrolyte imbalances, which could exacerbate existing health conditions.</p> <p>If you’re considering <a href="https://www.nejm.org/doi/10.1056/NEJMra1905136?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">intermittent fasting</a>, it’s best to seek advice from a health professional such as a dietitian who can provide guidance on structuring fasting periods, meal timing, and nutrient intake. This ensures intermittent fasting is approached in a safe, sustainable way, tailored to individual needs and goals.<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/223181/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <em><a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></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/does-intermittent-fasting-have-benefits-for-our-brain-223181">original article</a>.</em></p> <p><em>Image: Getty </em></p>

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Does British tourism really need the royal family?

<p><em><a href="https://theconversation.com/profiles/ross-bennett-cook-1301368">Ross Bennett-Cook</a>, <a href="https://theconversation.com/institutions/university-of-westminster-916">University of Westminster</a></em></p> <p>Love them or loathe them, the royal family are up there with red telephone boxes and scones when it comes to images of Britishness. Souvenir shops are full of their faces, newspapers across the world discuss them, and <a href="https://www.euronews.com/culture/2022/09/13/netflixs-the-crown-skyrockets-in-popularity-following-the-queens-death">television dramas</a> based on their lives have never been more popular.</p> <p>Whenever people are critical of the royal family, the oft-repeated retort is “but think of the tourism!”. This has been particularly common rhetoric recently, as <a href="https://www.independent.co.uk/life-style/royal-family/who-paid-for-coronation-b2334669.html">many people question</a> how a country facing mass strikes and a crippling cost of living crisis can afford the estimated <a href="https://www.lbc.co.uk/news/explained/how-much-king-charles-iii-coronation-cost-who-pays-for-it/">£100 million</a> cost of King Charles III’s coronation.</p> <p>In a recent <a href="https://yougov.co.uk/topics/arts/survey-results/daily/2023/04/18/25178/3">YouGov poll</a>, 51% did not believe the coronation should be paid for by taxpayers. For young people, this figure was even higher, at 62%. But supporters will often use <a href="https://www.independent.co.uk/news/charles-iii-ap-coronation-buckingham-palace-elizabeth-ii-b2326220.html">tourism</a> as justification for lavish expenses.</p> <p>The royal family does bring tourism to the UK. The economic consultancy Centre for Economics and Business Research <a href="https://cebr.com/reports/uk-economy-raises-a-glass-to-337-million-coronation-boost-from-tourism-and-pub-activity/">estimated</a> that the coronation weekend would lead to a £337 million boost from tourism and pub spending.</p> <p>But if the royal family were to disappear, would the UK’s tourism industry suddenly implode?</p> <p>2011 research by <a href="https://webarchive.nationalarchives.gov.uk/ukgwa/20140722183820/http://www.visitbritain.org/mediaroom/archive/2011/vbrwwedding.aspx">Visit Britain</a> found that around 60% of tourists to the UK are likely to visit places associated with the royal family. While there is no more recent specifically royal data, in 2022 Visit Britain found that history and heritage was the biggest <a href="https://www.visitbritain.org/MIDAS-research-project">pull factor to tourists</a>.</p> <p>And while the <a href="https://journals.sagepub.com/doi/10.1177/1468797606071477">international perception</a> of Britain is certainly intertwined with the royal family, this does not tell us whether a reigning royal family is necessary for tourism. After all, the history surrounding the monarchy and places associated with them would still be here even if the royal family was not. Ottoman palaces of Istanbul remain <a href="https://edition.cnn.com/travel/article/most-visited-castles-palaces/index.html">wildly popular</a> attractions 100 years since the collapse of the caliphate, as are the royal châteaus of France or imperial palaces of China.</p> <p>Lack of royalty does not seem to have affected these countries’ appeal, each of which attract <a href="https://www.e-unwto.org/doi/epdf/10.18111/wtobarometereng.2020.18.1.7">more tourists</a> annually than the UK.</p> <h2>A special relationship</h2> <p>The USA is the UK’s <a href="https://www.visitbritain.org/inbound-tourism-trends-old">largest tourist market</a>, and <a href="https://www.telegraph.co.uk/royal-family/2023/05/05/coronation-american-tourists-britain-boom-royal-family-usa/">American tourists</a> do seem to be very fond of things associated with British royalty.</p> <p>But this may change with the new monarch. In a <a href="https://today.yougov.com/topics/entertainment/articles-reports/2021/02/17/british-royals-popular-america-poll">poll taken in February 2021</a>, before the death of Queen Elizabeth II, a whopping 68% of Americans viewed her favourably. The same poll found only 34% had a favourable opinion of Charles – but this has changed in his favour following his accession to the throne, according to a <a href="https://today.yougov.com/topics/international/articles-reports/2023/05/05/americans-think-british-royal-family-charles">poll taken before the coronation</a> which gave him a 50% approval rating in the US. That said, 62% of people in the US said they did not care about the coronation very much or at all.</p> <p>Outside America, the UK’s next largest tourist groups have significantly less interest in the royal family. The holiday firm <a href="https://www.traveldailymedia.com/study-reveals-importance-of-royal-family-to-uk-tourism-industry/">Travelzoo</a> found in 2016 that just 19% of German, 15% of French and only 10% of Spanish travellers want to come to the UK because of the British monarchy.</p> <h2>Where do tourists go?</h2> <p>Typically, when commentators discuss the royal contributions to tourism, they talk about significant events such as weddings, jubilees, coronations and funerals. Even though these events attract huge crowds, they happen rarely and are unrepresentative of the tourism industry as a whole. Research <a href="https://journals.sagepub.com/doi/10.1177/13548166211004361">has found</a> that royal weddings massively improve a country’s image and brand awareness, but are not comparable to major mega events such as the Fifa World Cup, the Super Bowl or the Olympics.</p> <p>Even though royal places are popular, they are far from our most popular attractions. Of Britain’s <a href="https://www.visitbritain.org/annual-survey-visits-visitor-attractions-latest-results">ten most visited</a> free and paid-for attractions in 2021, none were royal attractions. The <a href="https://www.visitbritain.org/sites/default/files/vb-corporate/top_20_listings.pdf">highest ranking</a> royal attraction was the Tower of London, making only 17th on the list.</p> <p>Typically, Chester Zoo attracts more visitors than Windsor Castle or Buckingham Palace, although these statistics do not differentiate between domestic and international tourists. In the most recent <a href="https://www.windsor.gov.uk/dbimgs/Windsor%202017%20Visitor%20Survey%20final%20report%2028_11_17.pdf">Windsor visitor survey</a>, the majority of its tourists came from overseas.</p> <p>Anti-monarchy group <a href="https://www.republic.org.uk/tourism">Republic</a> has disputed the widely cited figure that the monarchy generates £500 million in tourism income for the UK annually – which itself would be only a small fraction of Britain’s £127 billion tourism economy.</p> <p>The group also questions why royalty <a href="https://www.youtube.com/watch?v=9hL9yDOK48A">barely feature</a> on British tourism campaigns or advertisements, if they are so vital to the tourism economy.</p> <p>It is impossible to deny that royalty adds to the UK’s appeal as a tourist destination – the history and associated heritage is famous worldwide. However, what is questionable is whether a reigning monarchy is necessary for this attractiveness to continue.<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/205158/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/ross-bennett-cook-1301368"><em>Ross Bennett-Cook</em></a><em>, Visiting Lecturer, School of Architecture + Cities, <a href="https://theconversation.com/institutions/university-of-westminster-916">University of Westminster</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/does-british-tourism-really-need-the-royal-family-205158">original article</a>.</em></p>

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