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Woman cured of Type 1 diabetes in life-changing clinical trial

Marlaina Goedel was diagnosed with Type 1 diabetes when she was just five-years-old, and not only was the disease controlling her, but it almost cost her life. "I've crashed my car into a brick building before having a diabetic attack while driving," Goedel recalled. Her condition was so extreme that she felt robbed of a normal childhood, telling the Daily Mail that she was in and out of hospital with life-threatening diabetic ketoacidosis, which causes toxic chemicals to build up in the blood due to a lack of insulin. Now 30-years-old, the Illinois woman no longer needs daily insulin shots and can finally enjoy sugar again thanks to a pioneering stem cell therapy that has cured her of type 1 diabetes. Goedel was one of three Americans who have been cured of their type 1 diabetes thanks to the clinical trial involving an islet cell transplant. It is a one-off infusion that involved transplanting islet cells into her liver to help her body produce insulin on its own. After four weeks, she no longer needed to take insulin. "[My doctor] said, ‘Mark it on your calendar. Today is the day. Stop all insulin,'" Goedel said of the life-changing moment. "I just went quiet and finally said, ‘I’m here. I’m in shock. I’m going to need you to repeat that.’" The trial was being run at the University of Chicago Medicine Transplant Institute. While Islet cell transplants isn't a new procedure, the current anti-rejection medication used can be toxic to the transplanted cells, potentially making it less effective over time. The clinical trial that ran at the university tested out a new antibody called tegoprubart, which was given to Goedel and the two other patients. Tegoprubart is made from lab-made antibodies that trick the immune system into thinking the body made the cells on its own, preventing them from being rejected. The patients were then given islet cells from a deceased donor's pancreas, which were then infused into the patient's small blood vessels in their liver. Those cells then lodged into the blood vessels and started producing insulin. For Goedel the only side effect of the procedure was "feeling like I got punched in the ribs," with the procedure lasting just an hour. "The cure is out there," Goedel told the Daily Mail. With her new lease on life, Goedel plans to go back to school and go horse riding without worrying about suffering an attack and causing an accident. "It took a while to get used to saying, 'I am cured. I am diabetes free.' It's been very freeing," she said. "No one should have to live with this disease. I know that now more than ever." Images: Good Morning America/ UChicago Medicine

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

<a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Type 2 diabetes affects <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-common-is-diabetes/type-2-diabetes">1.2 million Australians</a> and accounts for <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">85-90%</a> of all diabetes cases. This chronic condition is characterised by high blood glucose (sugar) levels, which carry serious <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30058-2/abstract">health</a> risks. <a href="https://www.nature.com/articles/nrendo.2017.151">Complications</a> include heart disease, kidney failure and vision problems. Diet is an important way people living with type 2 diabetes manage blood glucose, alongside exercise and medication. But while we know individualised, professional dietary advice improves blood glucose, it can be <a href="https://linkinghub.elsevier.com/retrieve/pii/S0168822717317588">complex</a> and is not always <a href="https://www.publish.csiro.au/py/PY13021">accessible</a>. <a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">Our new study</a> looked at the impact of time-restricted eating – focusing on when you eat, rather than what or how much – on blood glucose levels. We found it had similar results to individualised advice from an accredited practising dietitian. But there were added benefits, because it was simple, achievable, easy to stick to – and motivated people to make other positive changes. <h2>What is time-restricted eating?</h2> Time-restricted eating, also known as <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-082018-124320">the 16:8 diet</a>, became popular for weight loss around 2015. Studies have since shown it is also an <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">effective way</a> for people with type 2 diabetes to manage blood glucose. Time-restricted eating involves limiting when you eat each day, rather than focusing on what you eat. You restrict eating to a window during daylight hours, for example between 11am and 7pm, and then fast for the remaining hours. This can sometimes naturally lead to also eating less. Giving your body a break from constantly digesting food in this way helps align eating with natural <a href="https://doi.org/10.1111/jne.12886">circadian rhythms</a>. This <a href="https://doi.org/10.1111/jnc.15246">can help</a> regulate metabolism and improve overall health. For people with type 2 diabetes, there may be specific benefits. They often have their <a href="https://doi.org/10.2337/dc12-2127">highest blood glucose</a> reading in the morning. Delaying breakfast to mid-morning means there is time for physical activity to occur to help reduce glucose levels and prepare the body for the first meal. <h2>How we got here</h2> We ran an <a href="https://www.mdpi.com/2072-6643/12/11/3228">initial study</a> in 2018 to see whether following time-restricted eating was achievable for people with type 2 diabetes. We found participants could easily stick to this eating pattern over four weeks, for an average of five days a week. Importantly, they also had improvements in blood glucose, spending less time with high levels. <a href="https://www.mdpi.com/2072-6643/12/2/505">Our previous research</a> suggests the reduced time between meals may play a role in how the hormone insulin is able to reduce glucose concentrations. <a href="https://doi.org/10.1001/jamanetworkopen.2023.39337">Other studies</a> have confirmed these findings, which have <a href="https://doi.org/10.1186/s12986-021-00613-9">also shown</a> notable improvements in HbA1c. This is a <a href="https://www.ncbi.nlm.nih.gov/books/NBK304271/">marker</a> in the blood that represents concentrations of blood glucose over an average of three months. It is the <a href="https://journals.sagepub.com/doi/10.4137/BMI.S38440">primary clinical tool</a> used for diabetes. However, these studies provided intensive support to participants through weekly or fortnightly meetings with researchers. While we know this level of support <a href="https://www.nature.com/articles/0802295">increases</a> how likely people are to stick to the plan and improves outcomes, it is not readily available to everyday Australians living with type 2 diabetes. <h2>What we did</h2> In our <a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">new study</a>, we compared time-restricted eating directly with advice from an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a>, to test whether results were similar across six months. We recruited 52 people with type 2 diabetes who were currently managing their diabetes with up to two oral medications. There were 22 women and 30 men, aged between 35 and 65. Participants were randomly divided into two groups: diet and time-restricted eating. In both groups, participants received four consultations across the first four months. During the next two months they managed diet alone, without consultation, and we continued to measure the impact on blood glucose. In the diet group, consultations focused on changing their diet to control blood glucose, including improving diet quality (for example, eating more vegetables and limiting alcohol). In the time-restricted eating group, advice focused on how to limit eating to a nine-hour window between 10am and 7pm. Over six months, we measured each participant’s blood glucose levels every two months using the HbA1c test. Each fortnight, we also asked participants about their experience of making dietary changes (to what or when they ate). <h2>What we found</h2> We found time-restricted eating was as effective as the diet intervention. Both groups had reduced blood glucose levels, with the greatest improvements occurring after the first two months. Although it wasn’t an objective of the study, some participants in each group also lost weight (5-10kg). When surveyed, participants in the time-restricted eating group said they had adjusted well and were able to follow the restricted eating window. Many told us they had family support and enjoyed earlier mealtimes together. Some also found they slept better. After two months, people in the time-restricted group were looking for more dietary advice to further improve their health. Those in the diet group were less likely to stick to their plan. Despite similar health outcomes, time-restricted eating seems to be a simpler initial approach than making complex dietary changes. <h2>Is time-restricted eating achievable?</h2> The main barriers to following time-restricted eating are social occasions, caring for others and work schedules. These factors may prevent people eating within the window. However, there are many benefits. The message is simple, focusing on when to eat as the main diet change. This may make time-restricted eating more translatable to people from a wider variety of socio-cultural backgrounds, as the types of foods they eat don’t need to change, just the timing. Many people don’t have access to more individualised support from a dietitian, and receive nutrition advice from their GP. This makes time-restricted eating an alternative – and equally effective – strategy for people with type 2 diabetes. People should still try to stick to <a href="https://www.eatforhealth.gov.au/guidelines/guidelines">dietary guidelines</a> and prioritise vegetables, fruit, wholegrains, lean meat and healthy fats. But our study showed time-restricted eating may also serve as stepping stone for people with type 2 diabetes to take control of their health, as people became more interested in making diet and other positive changes. Time-restricted eating might not be appropriate for everyone, especially people on medications which don’t recommend fasting. Before trying this dietary change, it’s best speak to the healthcare professional who helps you manage diabetes.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241472/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, Research Fellow in Exercise Metabolism and Nutrition, Mary MacKillop Institute for Health Research, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, Lecturer in Nutrition and Dietetics, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/for-type-2-diabetes-focusing-on-when-you-eat-not-what-can-help-control-blood-sugar-241472">original article</a>.

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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

<a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes. Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">both type 1 and type 2 diabetes</a>. More people became aware of this condition after <a href="https://www.imdb.com/name/nm0004726/">Lance Bass</a>, best known for his role in the iconic American pop band NSYNC, <a href="https://www.foxnews.com/health/pop-singer-lance-bass-type-1-5-diabetes-know-disease">recently revealed</a> he has it. So, what is type 1.5 diabetes? And how is it diagnosed and treated? <h2>There are several types of diabetes</h2> Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually <a href="https://diabetesjournals.org/care/article/37/Supplement_1/S81/37753/Diagnosis-and-Classification-of-Diabetes-Mellitus">more than ten types</a> of diabetes, but the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext">most common</a> are type 1 and type 2. Type 1 diabetes is an <a href="https://diabetesjournals.org/care/article/44/11/2589/138492/The-Management-of-Type-1-Diabetes-in-Adults-A">autoimmune condition</a> where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production. Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995794/">insulin medication daily</a>. Type 1 diabetes usually <a href="https://www.nature.com/articles/s41390-024-03107-5">appears</a> in children or young adults. Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to <a href="https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954/2-Diagnosis-and-Classification-of-Diabetes">overcome this resistance</a>. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin. Type 2 is more common in adults but is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1871402121002733">increasingly</a> seen in children and young people. Management <a href="https://www.racgp.org.au/getattachment/41fee8dc-7f97-4f87-9d90-b7af337af778/Management-of-type-2-diabetes-A-handbook-for-general-practice.aspx">can include</a> behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy. <h2>How does type 1.5 diabetes differ from types 1 and 2?</h2> Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">immediately</a> because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/">five years</a> of diagnosis, while those with type 1 typically require it from diagnosis. Type 1.5 diabetes is usually diagnosed in people <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">over 30</a>, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2. Type 1.5 diabetes shares <a href="https://www.nature.com/articles/nrendo.2017.99">genetic and autoimmune risk factors</a> with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as <a href="https://pubmed.ncbi.nlm.nih.gov/29589073/">obesity</a> and <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00320/full">physical inactivity</a> which are more commonly associated with type 2 diabetes. <h2>What are the symptoms, and how is it treated?</h2> The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a>: <ul> <li>increased thirst</li> <li>frequent urination</li> <li>fatigue</li> <li>blurred vision</li> <li>unintentional weight loss.</li> </ul> Typically, type 1.5 diabetes is <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">initially treated</a> with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day. When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.959011/full">no universally accepted</a> management or treatment strategies for type 1.5 diabetes. <h2>Type 1.5 diabetes is often misdiagnosed</h2> Lance Bass said he was initially diagnosed with <a href="https://www.healthline.com/health-news/lance-bass-misdiagnosed-diabetes">type 2 diabetes</a>, but later learned he actually has type 1.5 diabetes. This is <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">not entirely uncommon</a>. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">5–10% of the time</a>. There are a few possible reasons for this. First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">antibody tests</a> (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them. Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults). Third, people with <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">type 1.5 diabetes</a> often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin. Finally, because type 1.5 diabetes has <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a> that are similar to type 2 diabetes, it may initially be treated as type 2. <h2>We’re still learning about type 1.5</h2> Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">non-European populations</a>. In 2023, it was estimated type 1.5 diabetes represented <a href="https://pubmed.ncbi.nlm.nih.gov/37428296/">8.9%</a> of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers. Overall, there has been a limited awareness of type 1.5 diabetes and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/">unclear diagnostic criteria</a> which have slowed down our understanding of this condition. A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road. Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce <a href="https://diabetesjournals.org/diabetes/article/73/Supplement_1/55-OR/155112/55-OR-Diabetes-Distress-among-Persons-Living-with">diabetes distress</a>. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.<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/237041/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-type-1-5-diabetes-its-a-bit-like-type-1-and-a-bit-like-type-2-but-its-often-misdiagnosed-237041">original article</a>.

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a> 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. But what’s the science behind these headlines? 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. 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. 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. So, can processed and red meat really increase your risk of developing type 2 diabetes? 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. <figure><iframe src="https://www.youtube.com/embed/EsOBcx2bJqU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> 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. 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. 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. 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. <h2>What’s the link?</h2> 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. 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. 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. 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. Another potential link regarding red meat could be the way it is cooked. <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>. <h2>Bye-bye barbecues and bacon butties?</h2> 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&text=If%20you%20currently%20eat%20more,%2C%20veal%2C%20venison%20and%20goat.">an average of 70g per day</a>. 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. 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. 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. 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>. 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.<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" /> <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> 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>. </div>

Body

Shelley Duvall passes away at 75

Shelley Duvall who starred in Stanley Kubrick's iconic horror film The Shining has passed away aged 75. Duvall died in her sleep on Thursday at her home in Bianco, Texas, after diabetes complications according to her friend and publicist Gary Springer. Her longtime partner, Dan Gilroy shared a heartbreaking statement. "My dear, sweet, wonderful life, partner, and friend left us last night," he said. "Too much suffering lately, now she's free. Fly away beautiful Shelley." Known for her thin physique, large expressive eyes and powerful performances, Duvall was remembered for her standout roles alongside Jack Nicholson in The Shining and Robin Williams in the comedy Popeye. She became Robert Altman's protégé after she was spotted by his staff members at a party in Houston, Texas in 1970, where she attended junior college, and Altman was preparing to film Brewster McCloud at the time. She also played memorable roles in some of his other films, including Nashville in 1975 and 3 Women in 1977, which won her the Cannes Best Actress Award. "He offers me damn good roles," Duvall said about Altman for The New York Times in 1977. "None of them have been alike. He has a great confidence in me, and a trust and respect for me, and he doesn't put any restrictions on me or intimidate me, and I love him. I remember the first advice he ever gave me: 'Don't take yourself seriously.'" Despite The Shining being one of her greatest roles, filming it took an emotional toll on her, after having to be in hysterics during long days of filming, with one scene reportedly requiring 127 takes, By the 1990s she began retiring from acting and retreated from public life. "How would you feel if people were really nice, and then, suddenly, on a dime, they turn on you?" Duvall told the Times earlier this year. "You would never believe it unless it happens to you. That's why you get hurt, because you can't really believe it's true." Images: Soshellyduvall Instagram

Caring

Why do dogs have different coats? Experts explain – and give grooming tips for different types

<a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Dog hair comes in many varieties, from shaggy to short, curly to straight. If you live with a dog, you live with their hair – on your couch, in your clothes, it’s everywhere! Beyond colour, have you ever wondered what’s behind the differences in coat type? We actually know quite a lot about why dogs have different coats, and it comes down to their genes. <h2>What are the main coat types in dogs?</h2> The three main features of dog coats are how long the hairs are, whether they are curly or straight, and whether they have extra flourishes. The flourishes are called “furnishings”, and can include a hairy moustache and shaggy eyebrows. Combinations of these three features result in seven different coat types in dogs: short, wire, wire and curly, long, long with furnishings, curly, and curly with furnishings. We know from a <a href="https://www.science.org/doi/abs/10.1126/science.1177808">study of more than 1,000 dogs with varying coats</a> that differences in only three genes are responsible for this variety. The gene responsible for long hair (called FGF5) is <a href="https://learn.genetics.utah.edu/content/basics/patterns">recessive</a>, meaning dogs must have two copies of the mutated gene to have long hair. <a href="https://doi.org/10.1073/pnas.1402862111">In humans</a>, the same gene has been identified in families with excessively long eyelashes. Curly coats in dogs are related to a gene called <a href="https://www.pawprintgenetics.com/products/tests/details/173/">KRT71</a>, which affects keratin, a protein involved in hair formation. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974189/">Mutations in this gene</a> in cats result in hairless (Sphynx) or curly-haired (Devon Rex) breeds. The gene responsible for furnishings (<a href="https://medlineplus.gov/genetics/gene/rspo2/">RSPO2</a>) is involved in establishing hair follicles. <a href="https://www.healthline.com/health/hair-follicle">Hair follicles</a> are small pockets in the skin that grow hair. Variations in these three genes could explain the coat type in most (but not all!) of the dogs tested. For example, the long coat of the Afghan hound is not explained by these three genes. Further study is needed to identify less common mutations and genes controlling the coat in these dogs. The earliest dog breeds would have been short-haired, as a result of the “wild-type” genes. Later changes would have arisen through mutation and deliberate selection <a href="https://theconversation.com/managing-mutations-of-a-species-the-evolution-of-dog-breeding-96635">through modern breeding practices</a>. If all three mutations are present, the dog has a long, curly coat with furnishings. An example is the Bichon Frisé. <h2>What else varies in dog coats?</h2> Dog coat types can also be single or double. In a double-coated breed such as a Labrador, there is a longer coarse layer of hairs and a softer and shorter undercoat. Wolves and ancestral dogs are single-coated, and the double coat is a result of a <a href="https://www.mdpi.com/2073-4425/10/5/323">mutation in chromosome 28</a>. In the Labrador, the mutation was probably selected for as they were bred to <a href="https://www.gov.nl.ca/releases/2023/exec/0525n07/">retrieve fishing nets in Canada</a>. The double coat is a great insulator and helps them to stay warm, even in icy water. <h2>Why does it matter what kind of coat a dog has?</h2> We know with climate change our world is going to get hotter. Dogs with a double coat are less able to tolerate heat stress, as their hair prevents heat loss. In a study of dogs <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/avj.13296">suffering heat-related illness</a>, most of the 15 breeds at higher risk had double coats. The death rate in these dogs was 23%. We can only imagine how it must feel going out on a 40 degree day wearing a thick fur coat. Dogs with a double coat shed more hair than dogs with a single coat. This means even short-haired breeds, like the Labrador retriever, can shed an astonishing amount of hair. If you can’t tolerate dog hair, then a dog with a double-coat may not suit you. When we think of wool we think of sheep, but in the past <a href="https://www.si.edu/stories/woolly-dog-mystery-unlocked">woolly dogs were kept for their wool</a> that was <a href="https://www.science.org/doi/10.1126/science.adi6549">woven by Indigenous groups</a> and used to make blankets. A dog’s coat also affects how much time and effort is needed for grooming. Dogs with long or curly hair with furnishings are likely to need more time invested in their care, or visits to a professional groomer. Designer dogs (cross-bred dogs often crossed with a poodle, such as groodles), are likely to be curly with furnishings. In a US study, people with designer dogs reported meeting their dogs’ maintenance and grooming requirements was <a href="https://www.mdpi.com/2076-2615/12/23/3247">much harder than they expected</a>. It’s not just bank balances and the time needed that can suffer. If people are unable to cope with the demands of grooming long-haired dogs, lack of grooming can cause welfare problems. A study of animal cruelty cases in New York found <a href="https://www.frontiersin.org/articles/10.3389/fvets.2022.827348/full">13% involved hair matting</a>, with some hair mats causing strangulation wounds and 93% of affected dogs having long hair. <h2>How can you prevent problems?</h2> If you have a curly- or long-haired breed of dog, it will help to train them to like being brushed from an early age. You can do this by counter-conditioning so they have a positive emotional response to being groomed, rather than feeling anxious. First show the brush or lightly brush them, then give them a treat. They learn to associate being brushed with something positive. If you take your dog to the groomer, it’s very important their first experience is positive. A scary or painful incident will make it much more difficult for future grooming. Is your dog difficult to groom or hard to get out of the car at the groomers? It’s likely grooming is scary for them. Consulting a dog trainer or animal behaviourist who focuses on positive training methods can help a lot. Keeping your dog well groomed, no matter their hair type, will keep them comfortable. More important than looking great, feeling good is an essential part of dogs living their best lives with us.<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/232480/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, Associate Professor, School of Animal and Veterinary Science, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, Research Fellow, Animal Welfare Science Centre, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-dogs-have-different-coats-experts-explain-and-give-grooming-tips-for-different-types-232480">original article</a>.

Family & Pets

Revolutionary diabetes detection via smartphone: A game-changer in healthcare

In a groundbreaking advancement, scientists from <a href="https://www.klick.com/" target="_blank" rel="noopener">Klick Labs</a> have discovered a method that could revolutionise diabetes detection – using just a 10-second smartphone voice recording. No more travelling to clinics or waiting anxiously for blood test results. This new approach promises immediate, on-the-spot results, potentially transforming how we diagnose type 2 diabetes. The study, published in <a href="https://www.mcpdigitalhealth.org/article/S2949-7612(23)00073-1/fulltext" target="_blank" rel="noopener">Mayo Clinic Proceedings: Digital Health</a>, involved 267 participants, including 192 non-diabetic and 75 type 2 diabetic individuals. Each participant recorded a specific phrase on their smartphone multiple times a day over two weeks, resulting in 18,465 recordings. These recordings, lasting between six and 10 seconds each, were meticulously analysed for 14 acoustic features, such as pitch and intensity. Remarkably, these features exhibited consistent differences between diabetic and non-diabetic individuals, differences too subtle for the human ear but detectable by sophisticated signal processing software. Building on this discovery, the scientists developed an AI-based program to analyse the voice recordings alongside patient data like age, sex, height and weight. The results were impressive: the program accurately identified type 2 diabetes in women 89% of the time and in men 86% of the time. These figures are competitive with traditional methods, where fasting blood glucose tests show 85% accuracy and other methods, like glycated haemoglobin and oral glucose tolerance tests, range between 91% and 92%. "This technology has the potential to remove barriers entirely," said Jaycee Kaufman, a research scientist at Klick Labs and the study's lead author. Traditional diabetes detection methods can be time-consuming, costly and inconvenient, but voice technology could change all that, providing a faster, more accessible solution. Looking ahead, the team plans to conduct further tests on a larger, more diverse population to refine and validate this innovative approach. If successful, this could mark a significant leap forward in diabetes management and overall healthcare, making early detection simpler and more accessible than ever before. Stay tuned as this exciting development unfolds, potentially bringing us closer to a future where managing and detecting diabetes is as simple as speaking into your smartphone. Image: Shutterstock

Body

$2 billion lotto win tears family apart

A man who won one of the biggest lottery jackpots in American history has been accused of cutting his family out of their promised share after winning $2 billion (AUD) in the Mega Millions jackpot. The unidentified man has been in a legal battle with his daughter’s mum since November, after he accused her of violating a nondisclosure agreement by telling the rest of the family about his fortune before their daughter's 18th birthday in 2032, according to the Independent. He bought the winning ticket in Lebanon, Maine on January 13 2023. The mum – identified by a pseudonym, Sara Smith – claimed that he was the one who told his family about his lotto winnings, not her. The man's father supported Smith's claim and said that his son told him about the win and all the things he planned to do with his new-found fortune, which he collected through an LLC in a lump sum of over $750 million. “February or March of 2023, my son came to my house … and informed me and my wife that he won a large amount of money in the Maine State Lottery,” his father wrote in new court documents. “I understand that my son has stated that he told me nothing about his money ‘other than the simple fact that I had won’,” the dad wrote. “That is not true.” He also claimed that he didn't ask his son for any money, but the lotto-winner allegedly made a bunch of promises, including building his dad a garage to fix up old cars, buying his childhood home, setting up a million-dollar trust fund and funding future medical expenses for his dad and stepmum. The lotto-winner also allegedly demanded his father to not talk to Smith. "I told him … ‘You are not the son I knew’,” his dad wrote in the filing. “He got angry, calling me a ‘dictator’ and an ‘a**ehole’. I have not heard from my son since, and he has not done any of [the] things he promised.” The half-billionaire refuted his dad and Smith's claims. “I made the mistake of telling my father that I had won the lottery without having him sign a confidentiality agreement,” he wrote. “Our relationship deteriorated quickly thereafter,” he continued. “I did not tell him what I was doing with my money, how I was going to benefit my daughter, or any facts other than the simple fact that I had won.” He also accused his ex-partner of trying to reveal his identity to the world and that she wrongly accused him of trying to kidnap their daughter after he refused to pay for her and her new boyfriend's vacation. Image: Shutterstock

Legal

Yes, adults can develop food allergies. Here are 4 types you need to know about

<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> If you didn’t have food allergies as a child, is it possible to develop them as an adult? The short answer is yes. But the reasons why are much more complicated. Preschoolers are about <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">four times more likely to have a food allergy</a> than adults and are more likely to grow out of it as they get older. It’s hard to get accurate figures on adult food allergy prevalence. The Australian National Allergy Council reports <a href="https://nationalallergycouncil.org.au/about-us/our-strategy">one in 50 adults</a> have food allergies. But a US survey suggested as many as <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">one in ten adults</a> were allergic to at least one food, with some developing allergies in adulthood. <h2>What is a food allergy</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">Food allergies</a> are immune reactions involving <a href="https://www.aaaai.org/tools-for-the-public/allergy,-asthma-immunology-glossary/immunoglobulin-e-(ige)-defined">immunoglobulin E (IgE)</a> – an antibody that’s central to triggering allergic responses. These are known as “IgE-mediated food allergies”. Food allergy symptoms that are not mediated by IgE are usually delayed reactions and called <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">food intolerances or hypersensitivity</a>. Food allergy symptoms can include hives, swelling, difficulty swallowing, vomiting, throat or chest tightening, trouble breathing, chest pain, rapid heart rate, dizziness, low blood pressure or <a href="https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines?highlight=WyJhbmFwaHlsYXhpcyJd">anaphylaxis</a>. IgE-mediated food allergies can be life threatening, so all adults need an <a href="https://allergyfacts.org.au/allergy-management/newly-diagnosed/action-plan-essentials">action management plan</a> developed in consultation with their medical team. Here are four IgE-mediated food allergies that can occur in adults – from relatively common ones to rare allergies you’ve probably never heard of. <h2>1. Single food allergies</h2> The most <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">common IgE-mediated food allergies</a> in adults in a US survey were to: <ul> <li>shellfish (2.9%)</li> <li>cow’s milk (1.9%)</li> <li>peanut (1.8%)</li> <li>tree nuts (1.2%)</li> <li>fin fish (0.9%) like barramundi, snapper, salmon, cod and perch.</li> </ul> In these adults, about 45% reported reacting to multiple foods. This compares to <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">most common childhood food allergies</a>: cow’s milk, egg, peanut and soy. Overall, adult food allergy prevalence appears to be increasing. Compared to <a href="https://pubmed.ncbi.nlm.nih.gov/14657884/">older surveys published in 2003</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/15241360/">2004</a>, peanut allergy prevalence has increased about three-fold (from 0.6%), while tree nuts and fin fish roughly doubled (from 0.5% each), with shellfish similar (2.5%). While new <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">adult-onset food allergies are increasing</a>, childhood-onset food allergies are also more likely to be retained into adulthood. Possible reasons for both <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">include</a> low vitamin D status, lack of immune system challenges due to being overly “clean”, heightened sensitisation due to allergen avoidance, and more frequent antibiotic use. <h2>2. Tick-meat allergy</h2> Tick-meat allergy, also called α-Gal syndrome or mammalian meat allergy, is an allergic reaction to galactose-alpha-1,3-galactose, or α-Gal for short. <a href="https://pubmed.ncbi.nlm.nih.gov/33529984/">Australian immunologists first reported</a> links between α-Gal syndrome and tick bites in 2009, with cases also reported in the United States, Japan, Europe and South Africa. The <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">US Centers for Disease Control estimates</a> about 450,000 Americans <a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm">could be affected</a>. The α-Gal contains a carbohydrate molecule that is bound to a <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">protein</a> molecule in <a href="https://alphagalinformation.org/what-is-a-mammal/">mammals</a>. The IgE-mediated allergy is triggered after repeated bites from ticks or <a href="https://www.insectshield.com/pages/chiggers">chigger mites</a> that have bitten those mammals. When tick saliva crosses into your body through the bite, antibodies to α-Gal are produced. When you subsequently eat foods that contain α-Gal, the allergy is triggered. These triggering foods include meat (lamb, beef, pork, rabbit, kangaroo), dairy products (yoghurt, cheese, ice-cream, cream), <a href="https://en.wikipedia.org/wiki/Gelatin">animal-origin gelatin</a> added to gummy foods (jelly, lollies, marshmallow), prescription medications and over-the counter supplements containing gelatin (<a href="https://www.drugs.com/inactive/gelatin-57.html">some antibiotics, vitamins and other supplements</a>). Tick-meat allergy reactions can be hard to recognise because they’re usually delayed, and they can be severe and include anaphylaxis. Allergy <a href="https://www.allergy.org.au/patients/food-allergy/mammalian-meat-tick-faq">organisations produce management guidelines</a>, so always discuss management with your doctor. <h2>3. Fruit-pollen allergy</h2> Fruit-pollen allergy, called pollen food allergy syndrome, is an <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">IgE-mediated allergic reaction</a>. In susceptible adults, pollen in the air provokes the production of IgE antibodies to antigens in the pollen, but these antigens are similar to ones found in some fruits, vegetables and herbs. The problem is that <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">eating those plants</a> triggers an allergic reaction. The <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">most allergenic tree pollens</a> are from birch, cypress, Japanese cedar, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/latex-allergy">latex</a>, grass, and ragweed. Their pollen can cross-react with <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">fruit and vegetables</a>, including kiwi, banana, mango, avocado, grapes, celery, carrot and potato, and some herbs such as caraway, coriander, fennel, pepper and paprika. Fruit-pollen allergy is not common. Prevalence <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">estimates are between 0.03% and 8%</a> depending on the country, but it can be life-threatening. Reactions range from itching or tingling of lips, mouth, tongue and throat, called <a href="https://pubmed.ncbi.nlm.nih.gov/20306812/">oral allergy syndrome</a>, to mild <a href="https://www.allergy.org.au/patients/skin-allergy/urticaria-hives">hives</a>, to anaphylaxis. <h2>4. Food-dependent, exercise-induced food allergy</h2> During heavy exercise, the stomach produces less acid than usual and gut permeability increases, meaning that small molecules in your gut are more likely to escape across the membrane into your blood. These include food molecules that trigger an IgE reaction. If the person already has IgE antibodies to the foods eaten before exercise, then the risk of triggering food allergy reactions is increased. This allergy is called <a href="https://pubmed.ncbi.nlm.nih.gov/37893663/">food-dependent exercise-induced allergy</a>, with symptoms ranging from hives and swelling, to difficulty breathing and anaphylaxis. <a href="https://pubmed.ncbi.nlm.nih.gov/30601082/">Common trigger foods include</a> wheat, seafood, meat, poultry, egg, milk, nuts, grapes, celery and other foods, which could have been eaten many hours before exercising. To complicate things even further, allergic <a href="https://pubmed.ncbi.nlm.nih.gov/33181008/">reactions can</a> occur at lower levels of trigger-food exposure, and be more severe if the person is simultaneously taking non-steroidal inflammatory medications like aspirin, drinking alcohol or is sleep-deprived. Food-dependent exercise-induced allergy is extremely rare. Surveys have estimated prevalence as between <a href="https://www.sciencedirect.com/science/article/pii/S1555415517300259">one to 17 cases per 1,000 people worldwide</a> with the highest prevalence between the teenage years to age 35. Those affected often have other allergic conditions such as hay fever, asthma, allergic conjunctivitis and dermatitis. <h2>Allergies are a growing burden</h2> The <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">burden on physical health, psychological health</a> and health costs due to food allergy is increasing. In the US, this <a href="https://pubmed.ncbi.nlm.nih.gov/38393624/">financial burden was estimated as $24 billion per year</a>. Adult food allergy needs to be taken seriously and those with severe symptoms should wear a medical information bracelet or chain and carry an <a href="https://www.healthdirect.gov.au/how-to-use-an-adrenaline-autoinjector-epipen-anapen">adrenaline auto-injector pen</a>. Concerningly, surveys suggest only <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">about one in four adults</a> with food allergy have an adrenaline pen. If you have an IgE-mediated food allergy, discuss your management plan with your doctor. You can also find more information at <a href="https://allergyfacts.org.au/">Allergy and Anaphylaxis Australia</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <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> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/yes-adults-can-develop-food-allergies-here-are-4-types-you-need-to-know-about-223342">original article</a>.

Body

Could not getting enough sleep increase your risk of type 2 diabetes?

<a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes. So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex. <h2>The study</h2> Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade. The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk. As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets. Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category. The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours. One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less. Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations. <h2>Why might short sleep increase diabetes risk?</h2> In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body. We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes. Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>. This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses. These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours. While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes. Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase. The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>. <h2>Good sleep, healthy diet</h2> Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes. Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle. While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health. The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk. In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<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/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>.

Body

12 signs that you’re borderline diabetic

Do you have diabetes? If you are a borderline diabetic, it means you have prediabetes. Your blood sugar levels are higher than normal, but not enough to be diagnosed with full-blown type 2 diabetes. Maybe you’ve noticed that you’re losing weight or more tired than normal. Or perhaps you’re thirsty or have vision issues. Here’s a look at some of the more common signs that you could be a borderline diabetic. You’re really thirsty and are peeing a lot “Prediabetes is caused when the body is unable to efficiently process blood sugars,” says endocrinologist Dr Jason Ng. “This happens over time as the body builds up resistance to insulin, the hormone that helps the body control blood sugars.” As you become insulin resistant, the body has to produce more insulin to keep blood sugars at a good level. Eventually it can’t keep up, so blood sugars rise. Prediabetes may take you by surprise, as there often aren’t symptoms – though there are a few subtle cues you can look out for. “A patient may feel slightly more thirsty and have to urinate more over time as well as the sugars increase in their body,” Dr Ng says. You're exhausted Borderline diabetes could be one of the medical reasons you’re tired all the time. If you’re one of the 2 million Australians who have prediabetes, according to Diabetes Australia you may notice you’re not feeling up to your normal activity level. “Patients may feel more tired or sluggish,” Dr Ng says. Blood sugar fluctuations can cause fatigue; plus, other factors that often appear with blood sugar problems could be the culprit, such as depression or obesity, according to a study published in 2012 in Diabetes Educator. Physical activity is recommended by the American Diabetes Association to help with prediabetes symptoms, but ironically people with the condition may be too tired to exercise. If that’s the case, see your doctor. “Most of prediabetes is diagnosed by lab work at a doctor’s office,” Dr Ng says. With prediabetes, “fasting sugar is between 100 to 125 mg/dl or a random blood sugar between 140 to 200 mg/dl.” You’re losing weight Among the silent diabetes signs you might be missing is weight loss. Although we associate blood sugar problems with being overweight, once you start becoming borderline diabetic you may actually drop kilos. If you’re going to the bathroom more frequently, you’re excreting extra sugar and losing more kilojoules. Diabetes may also keep sugar in your food from reaching your cells. This might leave you “feeling hungry all the time,” says Dr Deena Adimoolam, assistant professor of medicine, endocrinology, diabetes and bone disease. So if you’re eating more than usual and still losing weight, talk to your doctor. You have blurred vision One of the clear signs you have high blood sugar is actually not seeing clearly. Dr Adimoolam says that blurred vision is a sign that you’re borderline prediabetic. Why? Diabetic eye disease occurs when high blood sugar causes damage to the blood vessels in the eye, which can leak and swell, leading to vision changes. According to the National Eye Institute, one type of eye damage, diabetic retinopathy, is the leading cause of vision loss among people with diabetes and the leading cause of blindness among adults. A study by The Diabetes Prevention Program (DPP) found that 8 per cent of prediabetic participants had diabetic retinopathy. It can be addressed if caught early, so bring up blurry vision to your doctor as soon as you notice it. You have dark areas on your skin One body changes that could signal a bigger problem that you are borderline prediabetic are dark patches on your skin called acanthosis nigricans (AN). The condition usually appears in elbows, armpits, knees, or on the neck, has a velvety texture, and likely occurs because excess insulin causes a rapid growth of cells. It’s also more common in people with obesity – another risk factor for prediabetes. But a study published in the Annals of Family Medicine showed that although patients with AN tend to have multiple risk factors for diabetes, AN itself may also be an independent risk factor for the disease. Because of this, AN’s presence may help doctors detect prediabetes sooner. You have PCOS Polycystic ovary syndrome (PCOS) is a disorder where a woman’s hormones are unbalanced. Studies like one published in the Journal of Clinical Endocrinology and Metabolism in 2017, have shown that PCOS is a risk factor for diabetes. It’s not known exactly how they are linked, but researchers are looking into the connection between PCOS and insulin. High levels of insulin may contribute to increased production of male hormones called androgens, which is a symptom of PCOS. PCOS is also associated with being overweight, as is prediabetes – but studies have shown that even average-weight women with PCOS are at increased risk of high blood sugar. Also, women with PCOS may be more likely to have gestational diabetes (diabetes while pregnant; more on that later), which also can lead to an increased risk of type 2 diabetes. If you are diagnosed with PCOS, your reproductive endocrinologist may test your glucose level to make sure you’re not borderline prediabetic. You don't get good sleep “When you don’t get enough sleep, less insulin is released in the body,” says Dr Richard Shane, behavioural sleep therapist. “Sleep deprivation can cause insulin-producing cells to fail to use the insulin efficiently or to stop functioning. Your body also secretes more stress hormones, which interfere with insulin’s ability to be effective.” In one study, duration and quality of sleep was shown to be associated with prediabetes. Another factor could be that we tend to crave kilojoules and junk food for energy when we’re tired – plus, we don’t feel like exercising. This can lead to inactivity and weight gain, other risk factors for prediabetes. You have a family history of diabetes Among the medical facts you should know is your family’s health history. “There can be a genetic cause for the development of type 2 diabetes due to certain gene mutations,” Dr Adimoolam says. “Some people may have a genetic predisposition to developing type 2 diabetes due to presence of certain genes than have been passed down from one generation to the next.” One study in Diabetologia found that a family history of diabetes increased the risk for prediabetes by 26 per cent. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that you’re more likely to develop diabetes if you have a family history of the disease. In addition, “Some data suggests that the risk of type 2 diabetes is five times higher in those with diabetes on both the maternal and paternal sides of the family,” Dr Adimoolam says. You're of a certain age There are many reasons why you’ll age better than your parents, including that you know age itself is a risk factor for certain conditions – so you’ll take measures to prevent them. Unfortunately, prediabetes is more likely in older people. “The higher your age, the greater risk for development of diabetes,” Dr Adimoolam says. “This might be related to increased body fat with age, which increases one’s risk for type 2 diabetes.” In addition, Dr Ng says that high blood pressure and high cholesterol are also risk factors for prediabetes. These are all common conditions as we age, and are also associated with metabolic syndrome, a cluster of disorders that can lead to heart disease and stroke. You had gestational diabetes Having had gestational diabetes in the past also puts you at risk for prediabetes now, according to research, including a study in BMC Pregnancy and Childbirth. “Once you have been diagnosed with any form of diabetes, like gestational diabetes, you are at an increased risk for developing this again over time, especially with weight gain,” Dr Adimoolam says. According to the American Diabetes Association, doctors don’t know exactly why gestational diabetes develops, but it could be that pregnancy hormones affect how the body uses insulin. The NIDDK suggests women who’ve had gestational diabetes have their blood glucose tested every three years. You're overweight You can potentially reverse type 2 diabetes if you lose weight – and the same goes for if you are borderline diabetic. “By and large, obesity is the main cause of insulin resistance, as certain fat cells are known to cause and intensify insulin resistance over time,” Dr Ng says. And it’s not just how much you weigh, but where your weight is located on your body. “Waist size is typically proportional to centralised, or abdominal, obesity,” Dr Adimoolam says. “The more centralised abdominal fat, the higher one’s insulin resistance, and the greater the increased risk for the development of type 2 diabetes.” Genetics may also play a role here, as certain body types with more abdominal fat (“apple-shaped”) can run in families and certain ethnic groups, she says. You have an unhealthy lifestyle Whether you are borderline prediabetic or not, there are many science-based reasons to start working out. “Lack of exercise may promote weight gain, which is a risk factor for type 2 diabetes,” Dr Adimoolam says. A study from Johns Hopkins published in the Journal of General Internal Medicineshowed that people with prediabetes who dropped 10 per cent of their body weight dramatically reduced their risk of diabetes – but every little bit helps. Dr Ng suggests losing even 5 to 7 per cent of your body weight, quitting smoking, and adopting a borderline diabetic diet. “Interventions that typically reduce weight include increased exercise, especially aerobic exercise, 150 minutes or more per week, and eating a balanced, low-fat diet that is not heavy on carbs,” he says. “Prediabetes is often thought of as a ‘warning sign,’ which is why lifestyle intervention is so important.” Ultimately, the message is that prediabetes is not irreversible. “Prediabetes is the stage before one develops type 2 diabetes, and in most cases is preventable,” Dr Adimoolam says. “You may not need medications to treat prediabetes if you are able to change your lifestyle, with the goal for treatment focusing on diet changes and exercise.” Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/diabetes/12-signs-that-youre-borderline-diabetic?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Mothers’ dieting habits and self-talk have profound impact on daughters − 2 psychologists explain how to cultivate healthy behaviors and body image

<a href="https://theconversation.com/profiles/janet-j-boseovski-451496">Janet J. Boseovski</a>, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a> and <a href="https://theconversation.com/profiles/ashleigh-gallagher-1505989">Ashleigh Gallagher</a>, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a> Weight loss is one of the most common health and appearance-related goals. Women and <a href="https://www.cdc.gov/nchs/products/databriefs/db340.htm">teen girls</a> are <a href="https://www.cdc.gov/nchs/products/databriefs/db313.htm">especially likely to pursue dieting</a> to achieve weight loss goals even though a great deal of research shows that <a href="https://theconversation.com/what-thin-people-dont-understand-about-dieting-86604">dieting doesn’t work over the long term</a>. We are a <a href="https://www.duck-lab.com/people">developmental psychologist</a> and a <a href="https://psy.uncg.edu/directory/ashleigh-gallagher/">social psychologist</a> who together wrote a forthcoming book, “Beyond Body Positive: A Mother’s Evidence-Based Guide for Helping Girls Build a Healthy Body Image.” In the book, we address topics such as the effects of maternal dieting behaviors on daughters’ health and well-being. We provide information on how to build a foundation for healthy body image beginning in girlhood. <h2>Culturally defined body ideals</h2> Given the strong influence of social media and other cultural influences on body ideals, it’s understandable that so many people pursue diets aimed at weight loss. <a href="https://communityhealth.mayoclinic.org/featured-stories/tiktok-diets">TikTok</a>, YouTube, Instagram and celebrity websites feature slim influencers and “how-tos” for achieving those same results in no time. For example, women and teens are engaging in rigid and extreme forms of exercise such as 54D, a program to <a href="https://54d.com/">achieve body transformation in 54 days</a>, or the <a href="https://health.clevelandclinic.org/75-hard-challenge-and-rules">75 Hard Challenge</a>, which is to follow five strict rules for 75 days. For teens, these pursuits are likely fueled by trendy body preoccupations such as the desire for “<a href="https://www.nytimes.com/2024/02/06/well/move/tiktok-legging-legs-eating-disorders.html">legging legs</a>.” Women and teens have also been been inundated with recent messaging around <a href="https://theconversation.com/drugs-that-melt-away-pounds-still-present-more-questions-than-answers-but-ozempic-wegovy-and-mounjaro-could-be-key-tools-in-reducing-the-obesity-epidemic-205549">quick-fix weight loss drugs</a>, which come with a lot of caveats. Dieting and weight loss goals are highly individual, and when people are intensely self-focused, it is <a href="https://doi.org/10.1521/jscp.2000.19.1.70">possible to lose sight of the bigger picture</a>. Although women might wonder what the harm is in trying the latest diet, science shows that dieting behavior doesn’t just affect the dieter. In particular, for women who are mothers or who have other girls in their lives, these behaviors affect girls’ emerging body image and their health and well-being. <h2>The profound effect of maternal role models</h2> Research shows that mothers and maternal figures <a href="https://doi.org/10.1016/j.brat.2017.11.001">have a profound influence on their daughters’ body image</a>. The opportunity to influence girls’ body image comes far earlier than adolescence. In fact, research shows that these influences on body image <a href="https://www.teenvogue.com/story/how-toxic-diet-culture-is-passed-from-moms-to-daughters">begin very early in life</a> – <a href="https://doi.org/10.1016/bs.acdb.2016.10.006">during the preschool years</a>. Mothers may feel that they are being discreet about their dieting behavior, but little girls are watching and listening, and they are far more observant of us than many might think. For example, one study revealed that compared with daughters of nondieting women, 5-year-old girls whose mothers dieted <a href="https://doi.org/10.1016/S0002-8223(00)00339-4">were aware of the connection between dieting and thinness</a>. Mothers’ eating behavior does not just affect girls’ ideas about dieting, but also their daughters’ eating behavior. The amount of food that mothers eat <a href="https://doi.org/10.1016/j.appet.2018.04.018">predicts how much their daughters will eat</a>. In addition, daughters whose mothers are dieters are <a href="https://doi.org/10.1016/j.appet.2018.04.018">more likely to become dieters themselves</a> and are also <a href="https://doi.org/10.1016/j.eatbeh.2007.03.001">more likely to have a negative body image</a>. Negative body image is <a href="https://theconversation.com/mounting-research-documents-the-harmful-effects-of-social-media-use-on-mental-health-including-body-image-and-development-of-eating-disorders-206170">not a trivial matter</a>. It affects girls’ and women’s mental and physical well-being in a <a href="https://doi.org/10.1177/1359105317710815">host of ways</a> and <a href="https://doi.org/10.1016/j.brat.2011.06.009">can predict the emergence of eating disorders</a>. <h2>Avoiding ‘fat talk’</h2> What can moms do, then, to serve their daughters’ and their own health? They can focus on small steps. And although it is best to begin these efforts early in life – in girlhood – it is never too late to do so. For example, mothers can consider how they think about and talk about themselves around their daughters. Engaging in “fat talk” may inadvertently send their daughters the message that larger bodies are bad, <a href="https://doi.org/10.1016/j.bodyim.2020.07.004">contributing to weight bias</a> and negative self-image. Mothers’ fat talk also <a href="https://doi.org/10.1080/15267431.2021.1908294">predicts later body dissatisfaction in daughters</a>. And negative self-talk isn’t good for mothers, either; it is associated with <a href="https://doi.org/10.1177/1359105318781943">lower motivation and unhealthful eating</a>. Mothers can instead practice and model self-compassion, which involves treating oneself the way <a href="https://doi.org/10.1016/j.bodyim.2016.03.003">a loving friend might treat you</a>. In discussions about food and eating behavior, it is important to avoid moralizing certain kinds of food by labeling them as “good” or “bad,” as girls may extend these labels to their personal worth. For example, a young girl may feel that she is being “bad” if she eats dessert, if that is what she has learned from observing the women around her. In contrast, she may feel that she has to eat a salad to be “good.” Moms and other female role models can make sure that the dinner plate sends a healthy message to their daughters by showing instead that all foods can fit into a balanced diet when the time is right. Intuitive eating, which emphasizes paying attention to hunger and satiety and allows flexibility in eating behavior, is associated with <a href="https://doi.org/10.1007/s40519-020-00852-4">better physical and mental health in adolescence</a>. Another way that women and especially moms can buffer girls’ body image is by helping their daughters <a href="https://doi.org/10.1016/j.bodyim.2021.12.009">to develop media literacy</a> and to think critically about the nature and purpose of media. For example, moms can discuss the misrepresentation and distortion of bodies, such as the use of filters to enhance physical appearance, on social media. <h2>Focusing on healthful behaviors</h2> One way to begin to focus on health behaviors rather than dieting behaviors is to develop respect for the body and to <a href="https://theconversation.com/body-neutrality-what-it-is-and-how-it-can-help-lead-to-more-positive-body-image-191799">consider body neutrality</a>. In other words, prize body function rather than appearance and spend less time thinking about your body’s appearance. Accept that there are times when you may not feel great about your body, and that this is OK. To feel and look their best, mothers can aim to stick to a <a href="https://theconversation.com/whats-the-best-diet-for-healthy-sleep-a-nutritional-epidemiologist-explains-what-food-choices-will-help-you-get-more-restful-zs-219955">healthy sleep schedule</a>, manage their stress levels, <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">eat a varied diet</a> that includes all of the foods that they enjoy, and <a href="https://theconversation.com/the-runners-high-may-result-from-molecules-called-cannabinoids-the-bodys-own-version-of-thc-and-cbd-170796">move and exercise their bodies regularly</a> as lifelong practices, rather than engaging in quick-fix trends. Although many of these tips sound familiar, and perhaps even simple, they become effective when we recognize their importance and begin acting on them. Mothers can work toward modeling these behaviors and tailor each of them to their daughter’s developmental level. It’s never too early to start. <h2>Promoting healthy body image</h2> Science shows that several personal characteristics are associated with body image concerns among women. For example, research shows that women who are <a href="https://doi.org/10.1016/j.bodyim.2020.02.001">higher in neuroticism</a> <a href="https://doi.org/10.1186/2050-2974-1-2">and perfectionism</a>, <a href="https://doi.org/10.3389/fpsyg.2022.983534">lower in self-compassion</a> or <a href="https://doi.org/10.1016/j.bodyim.2013.08.001">lower in self-efficacy</a> are all more likely to struggle with negative body image. Personality is frequently defined as a person’s characteristic pattern of thoughts, feelings and behaviors. But if they wish, <a href="https://doi.org/10.1002/per.1945">mothers can change personality characteristics</a> that they feel aren’t serving them well. For example, perfectionist tendencies – such as setting unrealistic, inflexible goals – can be examined, challenged and replaced with more rational thoughts and behaviors. A woman who believes she must work out every day can practice being more flexible in her thinking. One who thinks of dessert as “cheating” can practice resisting moral judgments about food. Changing habitual ways of thinking, feeling and behaving certainly takes effort and time, but it is far more likely than diet trends to bring about sustainable, long-term change. And taking the first steps to modify even a few of these habits can positively affect daughters. In spite of all the noise from media and other cultural influences, mothers can feel empowered knowing that they have a significant influence on their daughters’ feelings about, and treatment of, their bodies. In this way, mothers’ modeling of healthier attitudes and behaviors is a sound investment – for both their own body image and that of the girls they love.<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/221968/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/janet-j-boseovski-451496">Janet J. Boseovski</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a> and <a href="https://theconversation.com/profiles/ashleigh-gallagher-1505989">Ashleigh Gallagher</a>, Senior Lecturer, <a href="https://theconversation.com/institutions/university-of-north-carolina-greensboro-2069">University of North Carolina – Greensboro</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/mothers-dieting-habits-and-self-talk-have-profound-impact-on-daughters-2-psychologists-explain-how-to-cultivate-healthy-behaviors-and-body-image-221968">original article</a>.

Mind

The types of insurance that aren’t worth your while

While it’s important to make sure you’ve been covered, some forms of insurance aren’t really worth your while in the long run. We’ve taken a look at several types of insurance you shouldn’t really bother with, why they’re not worth your money and how you can find an alternative. Yes, it’s essential to make sure you’re covered, but at the same time you don’t need to waste any money. Extended warranties Many a salesperson has made a customer fork out that little bit extra for an “extended warranty” to go with a major electronic purchase. The thing is though, in many cases the period of time covered by the warranty is actually exactly the level you’re automatically entitled to under consumer law. Credit protection insurance While this type of insurance can be useful and a way to insure yourself against the possibility of something happening to your income as the result of an injury or a condition, credit protection insurance has tendency to be pretty expensive. A more cost effective way to ensure your payments to your credit card, personal loans or mortgages are fulfilled would be to take out a life insurance or total and permanent disability insurance policy through your individual superannuation fund. Funeral insurance Many people see this as a good way to ease the financial burden on their family that comes with their passing, but in reality funeral insurance is quite expensive and the premiums add up every year. A far better option is a prepaid funeral, funeral bonds life insurance or even a special savings account with money set aside. Just make sure you let your family know! ID theft insurance This is one of those types of insurance that isn’t really protecting your from becoming a victim, rather helping you deal with the costs once it’s already happened. And what’s more, you bank is usually willing to cover the costs of credit card fraud, which is one of the major problems to be associated with ID theft. Instead of spending money on a policy you can protect yourself from ID theft by simply keeping your personal documents safe, shredding documents such as bank account statements before throwing them away, and using antivirus software that is up to date. You can also check your credit file each year to make sure nobody’s using your identity for fake accounts. Image credits: Getty Images

Money & Banking

Kelly's Clarkson's life-changing diagnosis

Kelly Clarkson has opened up about the life-changing diagnosis that kicked started her massive weight loss. The American Idol winner spoke candidly on her own chat show about her drastic weight transformation, as she was joined by guest actor Kevin James, who commented on how good she looked. Clarkson has long been swamped with rumours that she used Ozempic to slim down, but has now confirmed that the reality of her weight loss is very different. “Well, I was told I was pre-diabetic,” she said. “That’s literally what happened, and, well, I wasn’t shocked. I was a tiny bit overweight.” The 41-year-old said the health news gave her the push she needed to make some lifestyle changes to turn around her diagnosis. “(The doctors) were like, ‘You’re pre-diabetic. You’re right on the borderline’,” she explained. “And I was like, ‘But I’m not there yet’. And then I waited two years, and then I was like OK, I’ll do something about it.” Rumours first began to fly of Clarkson using Ozempic to lose weight after her divorce, to which she hit back saying keeping up with her two young children was helping her get in shape. Image credits: Getty Images

Body

8 reasons everyone should know their blood type

Why you should know your blood type What’s in a blood type? Potentially a lot, according to research, including a review of studies published in the Wiley Interdisciplinary Reviews: Systems Biology and Medicine, that connects different blood groups to everything from risk of heart disease and dementia to urinary tract infections and the norovirus. While none of the studies are conclusive about cause and effect (they can’t say X blood type causes Y disease) and any increased risks are still pretty small, the research does highlight the importance of knowing your type – A, B, AB, or O – and how it could affect your wellbeing. Blood clots: Type AB, A, and B increases risk Danish researchers studied how blood type interacts with a genetic predisposition for deep-vein thrombosis (DVT), or blood clots in the lower legs that can travel to the lungs and become life-threatening. After analysing data on about 66,000 people over more than 30 years, they found that those with type AB, A, or B had a 40 per cent higher risk of DVT than people with type O, the most common type. When the scientists did further analysis to see which factors have the biggest impact on DVT risk on a population level, they found that an AB blood type contributed to about 20 per cent of blood clots; genetic mutations accounted for 11 per cent, being overweight accounted for 16 per cent, and smoking accounted for six per cent. Heart disease: Type AB, B, and A all increase risk People whose blood type is A, B, or AB have an increased risk of heart disease and shorter life spans than people who have type O blood, according to a large study published in BMC Medicine. After following more than 50,000 middle-age and elderly people for seven years, on average, researchers found that as many as nine per cent of cardiovascular deaths were attributed to having non-O blood types. However, as any doctor will tell you, lifestyle factors like weight, smoking and diet, which, unlike blood type, are modifiable, have a much greater impact on heart disease. Stomach cancer: Types A and AB increases risk Researchers have known for a while that people with blood type A are at risk for stomach cancer. But research published in BMC Cancer shows that people with blood type AB are also at risk. Using genetic data from a large number of cases and controls, researchers found a link between both blood types and gastric cancer in Chinese populations. A review of 39 previous studies confirmed their findings. Fertility: Type O reduces it Women with this blood type were twice as likely to have blood levels of the hormone FSH high enough to indicate low ovarian reserve, a measure of fertility, according to a study published in Human Reproduction. Researchers couldn’t say for sure why, though. Given that type O blood is the most prevalent, it doesn’t pay to worry too much about it. Age is a far more important risk factor for fertility problems. Pregnancy risks This has nothing to do with your “letter” blood type or the type determined by the ABO grouping system. This has to do with what’s known as the Rhesus (Rh) factor, which determines whether your blood type is positive or negative. This could cause complications in pregnant women if the baby’s Rh blood type is different from the mother’s. For instance, if the mother has a negative blood type and the baby has a positive one, the mother’s body can actually build up antibodies against the baby’s blood type. Luckily, this doesn’t affect the baby, but it could have a negative effect on future pregnancies. Fortunately, doctors can give pregnant women a shot early in their pregnancy that can prevent Rh-incompatibility problems. Dementia and memory loss: Type AB increases risk People with type AB blood have an 82 per cent greater risk for cognitive decline later in life, according to a study published in Neurology. That’s likely because they have larger amounts of what’s known as the Factor VIII protein, which helps with blood clotting. Study participants with higher levels of this protein were 24 per cent more likely to develop memory problems – regardless of their blood type – than people with lower levels. Blood type, however, is far from the only, or even most important, factor that affects your risk for cognitive decline. Stroke: Type O has the lowest risk People with a blood type other than O (the most common) have a higher risk of cardiovascular issues such as stroke, according to a study published in the Journal of Thrombosis and Haemostasis. Biologists are still investigating why this might be; one possible explanation is that non-O blood types contain more of the Von Willebrand factor, a protein that has been connected to blood clotting and stroke in the past. Mosquitos like Type O blood If you find yourself scratching bug bites all summer long, your blood type might be to blame. In a one small study, researchers found that type Os are up to twice as attractive to mosquitoes as type As, with type Bs falling somewhere in the middle. Image credits: Shutterstock This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/8-reasons-everyone-should-know-their-blood-type" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Mum slammed for being "stingy" after refusing to buy $2 snack for daughter's playdate

A mum has come under fire for being "selfish" and "stingy" after refusing to buy a $2 snack for her 11-year-old daughter’s best friend. The woman, believed to be from the US, and her daughter Ellie were invited for a playdate at an indoor playground with 12-year-old Sophie and her mum. Sophie's mum offered to put them on her membership card so that Ellie and her mum could go to the indoor playground for free. “Sophie’s mum called me... and Sophie wanted to know if Ellie could come and play," she began in a Reddit thread called Am I the a****** . "She offered to put me on her membership card so it would be free for me so I got Ellie in the car and we met them at the playground.” Trouble started when the girls got hungry after an hour of playing, and Ellie's mum only packed a snack for her daughter. “Sophie’s mum didn’t have any snacks on her,” she said. “I told her they sell snacks in the front but she claimed that she didn’t have any money on her and asked me to buy Sophie some Goldfish." Ellie's mum agreed to grab the crackers on one condition - Sophie's mum had to transfer the money to her. “She says she paid for my kid to get in so I could cover the $2 for the Goldfish. I said no, I took care of my kid and it’s not my job to take care of hers too. “I told her if she wanted me to bring snacks she should’ve told me when she invited me but I won’t be wasting $2 for a 50 cent bag of Goldfish because she was unprepared.” She added that Sophie's mum eventually managed to get snacks for her own daughter, and wondered "if she lied about not having money". She then accused Sophie's mum of being "petty" for asking her to pay back for “all the times” she's used her membership to get a guest pass at the indoor playground, adding that "they regularly pay for us to join them on outings.” Her post was met with over 2500 comments slamming her for being “selfish”, “stingy” and “ungrateful”. “You were invited to a place for free that you would otherwise have had to pay for. You only packed snacks for your child? Why didn’t you also take snacks for the other child?" one wrote. “Yes, you did not have to do so, and that child is not your responsibility, but if I was meeting someone for a playdate for my child, not paying to get in, knowing, at some point both girls were going to be hungry, I would have packed snacks for both, as a thank you for the invitation and just because," the commenter continued. “If someone asked me to transfer them $2, I’m rolling my eyes big time. It’s petty, especially when someone gave you something likely far more valuable," another added. “Seriously. I don’t even think I could tell a stranger no when it comes to feeding their hungry child, much less a person I know and spend time with," a third commented. Others called the mum a "fool", for potentially causing Ellie to lose her best friend. “Don’t be an idiot. Apologise. You might care about 50 cents. But your daughter will lose her best friend. And that is worth a lot more. Your daughter might never get a friend like that... And the fact that universe gift wrapped a friend for your daughter. And you choose to throw it in the trash. Wow, you are truly a fool," they said. Image: Getty

Family & Pets

We found 3 types of food wasters, which one are you?

<a href="https://theconversation.com/profiles/trang-nguyen-1454838">Trang Nguyen</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/patrick-oconnor-109973">Patrick O'Connor</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Each year, Australian households discard about <a href="https://workdrive.zohopublic.com.au/external/06152b9ff5971843391f39fc4d32a847e56fb907c167a4a645887b0a4bc43000">2.5 million tonnes of food</a>. Most (73%) of this food waste <a href="https://www.sciencedirect.com/science/article/pii/S0959652622042081">ends up in landfill</a>. This is costly and contributes to <a href="https://pubmed.ncbi.nlm.nih.gov/37118273/">escalating greenhouse gas emissions</a>, because food waste rotting in landfill produces methane. So reducing household food waste and diverting it from landfill saves money, improves food security and benefits the environment. To address the problem, we need to understand how people generate and dispose of food waste. In <a href="https://doi.org/10.1016/j.foodqual.2023.105000">our new study</a>, we found households fell into three categories – based on the amount of food wasted, how much of that waste was avoidable and how it was sorted. These insights into consumer behaviour point to where the most worthwhile improvements can be made. <figure><iframe src="https://www.youtube.com/embed/JvAFaD5f1Lo?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption></figcaption></figure> <h2>Three types of households</h2> We conducted an online survey of 939 households in metropolitan Adelaide between April and May 2021. The sample closely matched the national Australian population in terms of gender, age and income. We asked about the types of food waste produced, the amount of food waste typically discarded in a week and motivations towards reducing and sorting food waste. We identified three distinct types of households: Warriors are typically older and highly motivated to reduce and sort food waste. They generate minimal waste (9.6 litres per week), such as bones and vegetable peels, that is mostly unavoidable. This group comprised 39.6% of the sample. Strugglers mainly consist of families with children who produce the largest amount of food waste (33.1 litres per week). They produce the highest proportion of avoidable food waste, such as uneaten fruits and vegetables, bread and cereals. They are moderately motivated to reduce and sort food waste, but more than half of their food waste still ends up in landfill. This group made up 19.6% of the sample. Slackers are generally younger. They show little concern about reducing or sorting food waste. Slackers produce the smallest amount of food waste overall (9 litres a week), but the proportion of avoidable food waste (such as mixed leftovers) is significantly higher (38.9%) compared to warriors (24.5%). They are more than twice as likely to live in units, with 17.2% doing so, compared to just 7.8% of warriors. This group was 40.8% of the sample. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=361&fit=crop&dpr=1 600w, https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=361&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=361&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=454&fit=crop&dpr=1 754w, https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=454&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/550951/original/file-20230928-27-f7cw8e.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=454&fit=crop&dpr=3 2262w" alt="Graphic explainer showing the three types of households with their typical characteristics and food waste behaviours." /></a><figcaption>The three types of households with their typical characteristics and food waste behaviours. <a class="source" href="https://doi.org/10.1016/j.foodqual.2023.105000">Trang Nguyen using Canva.com</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></figcaption></figure> <h2>What can households do about their food waste?</h2> Reducing household food waste involves changing behaviours in both food management (“upstream”) and waste management (“downstream”). Upstream measures aim to prevent food waste in the first place. For example, households can avoid buying or cooking too much food. Supporting households to plan and buy just the right amount of food is a great starting point. Once food waste has been produced, downstream measures come into play. The focus shifts to how we handle and dispose of this waste. When households engage in food waste recycling they <a href="https://doi.org/10.3390/su131911099">start thinking more</a> about their behaviour including purchasing and cooking. In Australia, food waste management is mainly the responsibility of local councils. There are three ways to target household food waste management and drive behavioural change: <ul> <li> providing kerbside collection of food organics and garden organics, also known as “FOGO” </li> <li> changing social norms around food waste </li> <li> offering economic incentives and disincentives. </li> </ul> <h2>1. Providing a FOGO system</h2> Councils should provide this option at a minimum. This ensures sufficient infrastructure is available to support motivated households to sort food waste. Unfortunately <a href="https://experience.arcgis.com/experience/e6b5c78e1dac47f88e7e475ffacfc49b">fewer than half of Australian councils</a> provide a garden organics system and only a quarter of councils provide a FOGO system. You can explore <a href="https://experience.arcgis.com/experience/e6b5c78e1dac47f88e7e475ffacfc49b">the FOGO interactive map</a> to see how your area stacks up. <a href="https://www.greenindustries.sa.gov.au/resources/adelaide-metro-kerbside-waste-performance-report-2021-22">Most councils in metropolitan Adelaide</a> provide access to food waste recycling through the FOGO bin. But <a href="https://doi.org/10.1016/j.jclepro.2022.134636">our research</a> indicates more than half of household food waste still ends up in landfill. So we need additional programs to promote more sustainable behaviours. <h2>2. Changing social norms</h2> Social norms, the unspoken rules about what behaviours are deemed appropriate, can drive behavioural change. Examples of promoting social norms around food waste reduction include a <a href="https://www.stopfoodwaste.com.au/stop-food-waste-nationwide-consumer-campaign-summit-communique/">nationwide consumer campaign</a> on stopping food waste and the <a href="https://www.cityofadelaide.com.au/resident/recycling-waste/kitchen-caddies/">kitchen caddy</a> for benches to increase convenience for collecting food waste. But our research suggests some groups, like slackers, remain unmotivated without additional incentives. Economic incentives might motivate this group to engage in more sustainable behaviours. <h2>3. Economic incentives</h2> Currently, Australians pay for waste management through their council rates. This is a “pay-as-you-own” system. The cost is determined by the property’s value, regardless of the amount of waste generated. Renters indirectly contribute to this cost by paying rent. Neither owner-occupiers nor renters have any incentive to reduce waste generation when the cost is levied on property value rather than the amount of waste. An alternative approach gaining momentum in other parts of the world is the “pay-as-you-throw” approach, such as <a href="https://www.collectors2020.eu/wcs-ppw/stockholm-se/">Stockholm</a> and <a href="https://pocacito.eu/sites/default/files/WasteCharging_Taipei.pdf">Taipei</a>. This system charges households based on the weight of their waste, usually the general waste that needs to be discarded in landfill, while the collection of food waste and other recyclables remains free to encourage waste sorting. Recent <a href="https://doi.org/10.1016/j.jclepro.2023.137363">research</a> in Italy shows pay-as-you-throw schemes result in significant reductions in both the quantity of waste and costs associated with waste disposal in many Italian municipalities. The reduced costs flow on to savings for councils that could potentially reduce waste management fees passed on to homeowners and renters through council rates. Giving households incentives to reduce waste and find alternatives to disposal encourages residents to place a higher value on food that may otherwise be sent to landfill. <h2>Reducing food waste is a win-win</h2> Tackling food waste is a win-win for people and the planet. It’s worth using various approaches to encourage people to change their behaviour. Our findings can help inform the design of interventions aimed at reducing and sorting food waste in specific segments of the Australian population.<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/214482/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <figure><iframe src="https://www.youtube.com/embed/Dx7RWtfgbVw?wmode=transparent&start=11" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>No time to waste: Halving Australia’s food waste by 2030 (Fight Food Waste Cooperative Research Centre)</figcaption></figure> <a href="https://theconversation.com/profiles/trang-nguyen-1454838">Trang Nguyen</a>, Postdoctoral Fellow, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/patrick-oconnor-109973">Patrick O'Connor</a>, Associate Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-found-3-types-of-food-wasters-which-one-are-you-214482">original article</a>.

Food & Wine

These 10 smart grocery swaps can help reverse diabetes

Diagnosis diabetes It can feel daunting to be faced with the need to make a major lifestyle change. You enjoy food, and you should. At Reader’s Digest, we like to think nature designed nutrition to taste delicious so it can be a source of pleasure in your day that’s fun to look forward to. If you’ve been diagnosed with diabetes or pre-diabetes, this diagnosis doesn’t have to take over your whole identity and all the things that bring you joy. There are ways to adapt some of your favourite foods so you can still have them! Registered dietitian Jackie Newgent lists interesting meal swaps you can make so that classic dishes can be healthier, while still plenty pleasurable. With some wisdom and dedication, it can be possible to turn your condition around and feel great for good. Pair starchy with non-starchy veggies Instead of: one kilo potatoes Buy: 500g kilo potatoes plus 500g cauliflower This mashed potato hack keeps your total carbs in check without forgoing flavour. Whip equal parts boiled potatoes together with roasted or boiled cauliflower. The results of this dynamic duo may help you better manage your blood glucose, since they’re carb-friendlier than a huge bowl of mashed potatoes alone: 100 grams of cooked potatoes without skin provides 22 grams of total carbohydrates, versus 13 grams total carbohydrate in the 100 gram combination of cooked potatoes and cauliflower. Pick fruit you can chew <div> Instead of: one litre apple juice Buy: one bag of apples Enjoy whole fruit rather than just the juice whenever possible to get all the fibre of the naturally sweet fruit with its edible peel…plus chewing satisfaction. One medium apple contains 4.4 grams of fibre while a 200ml glass or juice box of 100-percent apple juice has 0.4 grams of fibre. The soluble fibre in apples can help slow down absorption of sugars. Polyphenols in apples may have powerful antioxidant properties. Grill a better burger Instead of: 500g 85% lean ground beef patties Buy: 500g ground chicken breast Gram for gram, chicken breast has significantly less saturated fat than the marbly beef of classic burgers. Specifically, an 85g cooked 85% lean ground beef patty has five grams of saturated fat compared to 0.6 grams of saturated fat for a cooked patty made from 85g of chicken breast meat. Keeping saturated fat intake low is especially important when you have diabetes to help keep your heart healthy. Pro-tip: make chicken burgers juicier and tastier by combining ground chicken breast with a little plain yogurt, rolled oats, and herbs and spices before cooking. Look for live cultures in the dairy section Instead of: one container regular cottage cheese Buy: one container plain low-fat Greek yogurt or cultured cottage cheese Probiotics are “good” bacteria that help keep your gut healthy. For people with type 2 diabetes, research published in Advances in Nutrition suggested that probiotics may also have glucose-lowering potential. So, pop products with live active cultures (probiotics) into your cart while strolling by the dairy aisle. Choose plain low-fat Greek yogurt or cultured cottage cheese. Be sure to read the nutrition labels, since probiotics aren’t in all dairy foods. And, for the lower-sodium pick, stick with yogurt. Choose healthier-sized grain portions Instead of: 1/2 dozen bakery-style plain bagels Buy: one package of wholegrain English muffins Swapping wholegrain in place of refined grain products helps kick up fibre and other plant nutrients. Studies suggests this is linked to lower risk of type 2 diabetes. Also, opting for healthier-sized varieties, such as wholegrain English muffins rather than big bakery-style plain bagels helps cut kilojoules (and carbs) – not enjoyment – while promoting a healthier weight. In fact, you’ll slash over 1000 kilojoules by enjoying a whole-wheat English muffin instead of that oversized 140g bagel. Get your munchies with benefits Instead of: one bag of potato chips Buy: one jar or bulk-bin container of roasted peanuts It’s a no-brainer: a small handful of nuts is a better bet than potato chips. Peanuts, for instance, offer a triple whammy of dietary fibre, plant protein and healthy fat, which can boost satiety. Greater satisfaction means a greater chance you’ll keep mealtime portions right-sized. When peanuts or other nuts are eaten along with carb-rich foods, they can help slow down the blood sugar response. Plus, a Mediterranean study found that higher nut consumption may be associated with better metabolic status. Dress a salad smartly Instead of: one bottle of fat-free salad dressing Buy: one small bottle olive oil plus one small bottle balsamic or red wine vinegar Some bottled salad dressings can trick you. For instance, “fat-free” salad dressing may be loaded with added sugars. (For reference: four grams of sugar is equal to one teaspoon.) So, read salad dressing labels carefully for sneaky ingredients, especially excess salt (over 250 milligrams of sodium per two-tablespoon serving) or added sugars (more than five grams added sugars per two-tablespoon serving). Better yet, keep it simple and make your own vinaigrette using 2-3 parts oil to 1 part vinegar. Select less salty soup Instead of: one can/carton of vegetable- or bean-based soup Buy: one can/carton of low-sodium vegetable- or bean-based soup When compared to people without diabetes, sodium levels were higher in patients with type 2 diabetes, based on a meta-analysis published in European Journal of Nutrition. Curbing sodium intake is beneficial for people with diabetes since too much may increase your risk for high blood pressure. So, slurp up soup that’s low in sodium. And kick up flavour with a splash of cider vinegar, grated citrus zest, herbs, spices, or a dash of hot sauce. Go for "naked" fish Instead of: Breaded fish sticks Buy: Frozen salmon fillets Cut salmon into large cubes, season, and grill on skewers. Or make fish sticks by simply cutting into skinny fillets, season and roast. Why? Research published in Diabetes Care finds that eating oily fish may be associated with a lower risk of type 2 diabetes. Non-oily fish, like the whitefish in fish sticks, didn’t show this link. Salmon is an oily fish and a major source of omega-3 fatty acids, a heart-friendly fat. Plus: when you make your own salmon skewers or sticks, you won’t have extra carbs from breading. Do dip with a punch of protein Instead of: one container of sour cream & onion dip Buy: one container of pulse-based dip, like hummus Wise snacking can be helpful for managing blood glucose. It can also be delicious. Dunk veggies or wholegrain pita wedges into pulse-based dip, like hummus, black bean dip, or lentil dip. Check this out: one-quarter cup (that’s 60 grams) of onion dip has 870 kiljoules, five grams of saturated fat, 1.2 grams of protein, and 0.1 grams of fibre, while one-quarter cup hummus has 590 kilojoules, 1.5 grams of saturated fat, 4.7 grams of protein, and 3.3 grams of fibre. Hummus clearly wins! Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/diabetes/reverse-diabetes-10-smart-grocery-swaps?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </div>

Food & Wine

1 in 6 women are diagnosed with gestational diabetes. But this diagnosis may not benefit them or their babies

<a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> When Sophie was pregnant with her first baby, she had an <a href="https://www.ncbi.nlm.nih.gov/books/NBK279331/#:%7E:text=Oral%20glucose%20tolerance%20tests%20(OGTT,enough%20by%20the%20body's%20cells.)">oral glucose tolerance</a> blood test. A few days later, the hospital phoned telling her she had gestational diabetes. Despite having only a slightly raised glucose (blood sugar) level, Sophie describes being diagnosed as affecting her pregnancy tremendously. She tested her blood glucose levels four times a day, kept food diaries and had extra appointments with doctors and dietitians. She was advised to have an induction because of the risk of having a large baby. At 39 weeks her son was born, weighing a very average 3.5kg. But he was separated from Sophie for four hours so his glucose levels could be monitored. Sophie is not alone. About <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">one in six</a> pregnant women in Australia are now diagnosed with gestational diabetes. That was not always so. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827530/">New criteria</a> were developed in 2010 which dropped an initial screening test and lowered the diagnostic set-points. Gestational diabetes diagnoses have since <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">more than doubled</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=487&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=487&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=487&fit=crop&dpr=3 2262w" alt="" /><figcaption>Gestational diabetes rates more than doubled after the threshold changed. AIHW, Author provided</figcaption></figure> But <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">recent</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33704936/">studies</a> cast doubt on the ways we diagnose and manage gestational diabetes, especially for women like Sophie with only mildly elevated glucose. Here’s what’s wrong with gestational diabetes screening. <h2>The glucose test is unreliable</h2> The test used to diagnose gestational diabetes – the oral glucose tolerance test – has poor reproducibility. This means subsequent tests may give a different result. In a <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2214956">recent Australian trial</a> of earlier testing in pregnancy, one-third of the women initially classified as having gestational diabetes (but neither told nor treated) did not have gestational diabetes when retested later in pregnancy. That is a problem. Usually when a test has poor reproducibility – for example, blood pressure or cholesterol – we repeat the test to confirm before making a diagnosis. Much of the increase in the incidence of gestational diabetes after the introduction of new diagnostic criteria was due to the switch from using two tests to only using a single test for diagnosis. <h2>The thresholds are too low</h2> Despite little evidence of benefit for either women or babies, the current Australian criteria diagnose women with only mildly abnormal results as having “gestational diabetes”. Recent studies have shown this doesn’t benefit women and may cause harms. A <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">New Zealand trial</a> of more than 4,000 women randomly assigned women to be assessed based on the current Australian thresholds or to higher threshold levels (similar to the pre-2010 criteria). The trial found no additional benefit from using the current low threshold levels, with overall no difference in the proportion of infants born large for gestational age. However, the trial found several harms, including more neonatal hypoglycaemia (low blood sugar in newborns), induction of labour, use of diabetic medications including insulin injections, and use of health services. The study authors also looked at the subgroup of women who were diagnosed with glucose levels between the higher and lower thresholds. In this subgroup, there was some reduction in large babies, and in shoulder problems at delivery. But there was also an increase in small babies. This is of concern because being small for gestational age can also have consequences for babies, including long-term health consequences. <figure class="align-center "><img src="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=349&fit=crop&dpr=1 600w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=349&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=349&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=438&fit=crop&dpr=1 754w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=438&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=438&fit=crop&dpr=3 2262w" alt="" /><figcaption>NEJM, Author provided</figcaption></figure> <h2>Testing too early</h2> Some centres have begun testing women at higher risk of gestational diabetes earlier in the pregnancy (between 12 and 20 weeks). However, a <a href="https://pubmed.ncbi.nlm.nih.gov/37144983/">recent trial</a> showed no clear benefit compared with testing at the usual 24–28 weeks: possibly fewer large babies, but again matched by more small babies. There was a reduction in transient “respiratory distress” – needing extra oxygen for a few hours – but not in serious clinical events. <h2>Impact on women with gestational diabetes</h2> For women diagnosed using the higher glucose thresholds, dietary advice, glucose monitoring and, where necessary, insulin therapy has been shown to reduce complications during delivery and the post-natal period. However, current models of care can also cause harm. Women with gestational diabetes are often denied their preferred model of care – for example, midwifery continuity of carer. In rural areas, they may have to transfer to a larger hospital, requiring longer travel to antenatal visits and moving to a larger centre for their birth – away from their families and support networks for several weeks. Women say the diagnosis often dominates their antenatal care and their whole <a href="https://pubmed.ncbi.nlm.nih.gov/32028931/">experience of pregnancy</a>, reducing time for other issues or concerns. Women from culturally and linguistically diverse communities <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03981-5">find it difficult</a> to reconcile the advice given about diet and exercise with their own cultural practices and beliefs about pregnancy. Some women with gestational diabetes <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-2745-1">become</a> extremely anxious about their eating and undertake extensive calorie restrictions or disordered eating habits. <h2>Time to reassess the advice</h2> Recent evidence from both randomised controlled trials and from qualitative studies with women diagnosed with gestational diabetes suggest we need to reassess how we currently diagnose and manage gestational diabetes, particularly for women with only slightly elevated levels. It is time for a review to consider all the problems described above. This review should include the views of all those impacted by these decisions: women in childbearing years, and the GPs, dietitians, diabetes educators, midwives and obstetricians who care for them. This article was co-authored by maternity services consumer advocate Leah Hardiman.<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/205919/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/1-in-6-women-are-diagnosed-with-gestational-diabetes-but-this-diagnosis-may-not-benefit-them-or-their-babies-205919">original article</a>.

Body

What happens in our body when we encounter and fight off a virus like the flu, SARS-CoV-2 or RSV?

<a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> <a href="https://www.labcorp.com/coronavirus-disease-covid-19/covid-news-education/covid-19-vs-flu-vs-rsv-how-tell-difference">Respiratory viruses</a> like influenza virus (flu), SARS-CoV-2 (which causes COVID) and respiratory syncytial virus (RSV) can make us sick by infecting our respiratory system, including the nose, upper airways and lungs. They spread from person to person through respiratory droplets when someone coughs, sneezes, or talks and can cause death in serious cases. But what happens in our body when we first encounter these viruses? Our immune system uses a number of strategies to fight off viral infections. Let’s look at how it does this. <h2>First line of defence</h2> When we encounter respiratory viruses, the <a href="https://www.sciencedirect.com/science/article/pii/S193131281600038X?via%3Dihub/">first line of defence</a> is the physical and chemical barriers in our nose, upper airways, and lungs. Barriers like the mucus lining and hair-like structures on the surface of cells, work together to trap and remove viruses before they can reach deeper into our respiratory system. Our defence also includes our behaviours such as coughing or sneezing. When we blow our nose, the mucus, viruses, and any other pathogens that are caught within it are expelled. But sometimes, viruses manage to evade these initial barriers and sneak into our respiratory system. This activates the cells of our innate immune system. <h2>Patrolling for potential invaders</h2> While our acquired immune system develops over time, our innate immune system is present at birth. It generates “non-specific” immunity by identifying what’s foreign. The cells of innate immunity act like a patrol system, searching for any invaders. These innate cells patrol almost every part of our body, from our skin to our nose, lungs and even internal organs. Our respiratory system has different type of innate cells such – as macrophages, neutrophils and natural killer cells – which patrol in our body looking for intruders. If they recognise anything foreign, in this case a virus, they will initiate an attack response. Each cell type plays a slightly different role. Macrophages, for example, will not only engulf and digest viruses (phagocytosis) but also release a cocktail of different molecules (cytokines) that will warn and recruit other cells to <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/cmi.12580">fight against the danger</a>. In the meantime, natural killer cells, aptly named, attack infected cells, and stop viruses from multiplying and <a href="https://www.nature.com/articles/s41577-021-00558-3">invading our body further</a>. Natural killer cells also promote inflammation, a <a href="https://www.hindawi.com/journals/jir/2018/1467538/">crucial part of the immune response</a>. It helps to recruit more immune cells to the site of infection, enhances blood flow, and increases the permeability of blood vessels, allowing immune cells to reach the infected tissues. At this stage, our immune system is fighting a war against viruses and the result can cause inflammation, fevers, coughs and congestion. <h2>Launching a specific attack</h2> As the innate immune response begins, another branch of the immune system called the adaptive immune system is <a href="https://www.ncbi.nlm.nih.gov/books/NBK21070/">activated</a>. The adaptive immune system is more specific than the innate immune system, and it decides on the correct tools and strategy to fight off the viral invaders. This system plays a vital role in eliminating the virus and providing long-term protection against future infections. Specialised cells called T cells and B cells are key players in acquired immunity. T cells (specifically, helper T cells and cytotoxic T cells) recognise viral proteins on the surface of infected cells: <ul> <li> helper T cells release molecules that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764486/">further activate immune cells</a> </li> <li> cytotoxic T cells directly kill infected cells with a very great precision, <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2018.00678/full">avoiding any healthy cells around</a>. </li> </ul> B cells produce antibodies, which are proteins that can bind to viruses, neutralise them, and mark them for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247032/">destruction by other immune cells</a>. B cells are a critical part of memory in our immune system. They will remember what happened and won’t forget for years. When the same virus attacks again, B cells will be ready to fight it off and will neutralise it faster and better. Thanks to the adaptive immune system, vaccines for respiratory viruses such as the COVID mRNA vaccine keep us protected from <a href="https://www.health.gov.au/our-work/covid-19-vaccines/our-vaccines/how-they-work">being sick or severely ill</a>. However, if the same virus became mutated, our immune system will act as if it was a new virus and will have to fight in a war again. <h2>Neutralising the threat</h2> As the immune response progresses, the combined efforts of the innate and adaptive immune systems helps control the virus. Infected cells are cleared, and the virus is neutralised and eliminated from the body. As the infection subsides, symptoms gradually improve, and we begin to feel better and to recover. But recovery varies depending on the specific virus and us as individuals. Some respiratory viruses, like rhinoviruses which cause the common cold, may cause relatively mild symptoms and a quick recovery. Others, like the flu, SARS-CoV-2 or severe cases of RSV, may lead to more severe symptoms and a longer recovery time. Some viruses are very strong and too fast sometimes so that our immune system does not have the time to develop a proper immune response to fight them off. <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/207023/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">original article</a>.

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What happens in our body when we encounter and fight off a virus like the flu, SARS-CoV-2 or RSV?