Search

Fasting, eating earlier in the day or eating fewer meals – what works best for weight loss?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/loai-albarqouni-452476">Loai Albarqouni</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Globally, <a href="https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight">one in eight people</a> are living with obesity. This is an issue because <a href="https://www.aihw.gov.au/reports/risk-factors/risk-factors-to-health/contents/overweight-and-obesity">excess fat</a> <a href="https://pubmed.ncbi.nlm.nih.gov/27423262/">increases the risk</a> of type 2 diabetes, heart disease and certain cancers. <a href="https://pubmed.ncbi.nlm.nih.gov/33393504/">Modifying your diet</a> is important for managing obesity and preventing weight gain. This might include reducing your calorie intake, changing your <a href="https://pubmed.ncbi.nlm.nih.gov/39143663/">eating patterns</a> and prioritising healthy food. But is one formula for weight loss more likely to result in success than another? Our <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11530941/">new research</a> compared three weight-loss methods, to see if one delivered more weight loss than the others: <ul> <li>altering calorie distribution – eating more calories earlier rather than later in the day</li> <li>eating fewer meals</li> <li>intermittent fasting.</li> </ul> We analysed data from 29 clinical trials involving almost 2,500 people. We found that over 12 weeks or more, the three methods resulted in similar weight loss: 1.4–1.8kg. So if you do want to lose weight, choose a method that works best for you and your lifestyle. <h2>Eating earlier in the day</h2> When our metabolism <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/metabolic-syndrome">isn’t functioning properly</a>, our body can’t respond to the hormone insulin properly. This can lead to weight gain, fatigue and can increase the risk of a number of chronic diseases such as diabetes. Eating later in the day – with a <a href="https://pubmed.ncbi.nlm.nih.gov/23512957/">heavy dinner</a> and late-night snacking – seems to lead to <a href="https://pubmed.ncbi.nlm.nih.gov/33172509/">worse metabolic function</a>. This means the body becomes less efficient at converting food into energy, managing blood sugar and regulating fat storage. In contrast, consuming calories <a href="https://pubmed.ncbi.nlm.nih.gov/31151228/">earlier</a> in the day appears to <a href="https://pubmed.ncbi.nlm.nih.gov/29754952/">improve</a> metabolic function. However, this might not be the case for everyone. Some people naturally have an evening “chronotype”, meaning they wake up and stay up later. People with this chronotype appear to have <a href="https://pubmed.ncbi.nlm.nih.gov/36803075/">less success losing weight</a>, no matter the method. This is due to a combination of factors including genes, an increased likelihood to have a poorer diet overall and higher levels of hunger hormones. <h2>Eating fewer meals</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/30700403/">Skipping breakfast</a> is common, but does it hinder weight loss? Or is a <a href="https://pubmed.ncbi.nlm.nih.gov/28967343/">larger breakfast and smaller dinner</a> ideal? While <a href="https://pubmed.ncbi.nlm.nih.gov/28137935/">frequent meals</a> may reduce disease risk, recent studies suggest that compared to eating one to two meals a day, eating six times a day might increase <a href="https://pubmed.ncbi.nlm.nih.gov/32437566/">weight loss success</a>. However, this doesn’t reflect the broader research, which tends to show consuming <a href="https://pubmed.ncbi.nlm.nih.gov/33485709/">fewer meals</a> can lead to greater weight loss. <a href="https://pubmed.ncbi.nlm.nih.gov/39485353/">Our research</a> suggests three meals a day is better than six. The easiest way to do this is by cutting out snacks and keeping breakfast, lunch and dinner. Most studies compare three versus six meals, with limited evidence on whether <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7490164/">two meals is better than three</a>. However, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11530941/">front-loading your calories</a> (consuming most of your calories between breakfast and lunch) appears to be better for weight loss and may also help <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9605877/">reduce hunger</a> across the day. But more studies with a longer duration are needed. <h2>Fasting, or time-restricted eating</h2> Many of us eat over a period of more than <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">14 hours a day</a>. Eating late at night <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">can throw off</a> your body’s natural rhythm and alter how your organs function. Over time, this can increase your risk of type 2 diabetes and other chronic diseases, particularly among <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8617838/">shift workers</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/35194176/">Time-restricted eating</a>, a form of intermittent fasting, means eating all your calories within a <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">six- to ten-hour window</a> during the day when you’re most active. It’s not about changing what or how much you eat, but <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">when you eat it</a>. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">Animal studies</a> suggest time-restricted eating can lead to weight loss and improved metabolism. But the evidence in humans is still limited, especially about the long-term benefits. It’s also unclear if the benefits of time-restricted eating are due to the timing itself or because people are eating less overall. When we looked at studies where participants ate freely (with no intentional calorie limits) but followed an eight-hour daily eating window, they naturally consumed about 200 fewer calories per day. <h2>What will work for you?</h2> In the past, clinicians have thought about weight loss and avoiding weight gain as a simile equation of calories in and out. But factors such as how we distribute our calories across the day, how often we eat and whether we eat late at night may also impact our metabolism, weight and health. There are no easy ways to lose weight. So choose a method, or combination of methods, that suits you best. You might consider <ul> <li>aiming to eat in an eight-hour window</li> <li>consuming your calories earlier, by focusing on breakfast and lunch</li> <li>opting for three meals a day, instead of six.</li> </ul> The <a href="https://link.springer.com/article/10.1007/s13679-024-00555-2">average adult gains 0.4 to 0.7 kg per year</a>. Improving the quality of your diet is important to prevent this weight gain and the strategies above might also help. Finally, there’s still a lot we don’t know about these eating patterns. Many existing studies are short-term, with small sample sizes and varied methods, making it hard to make direct comparisons. More research is underway, including well-controlled trials with larger samples, diverse populations and consistent methods. So hopefully future research will help us better understand how altering our eating patterns can result in better health.<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/242028/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/loai-albarqouni-452476">Loai Albarqouni</a>, Assistant Professor | NHMRC Emerging Leadership Fellow, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/fasting-eating-earlier-in-the-day-or-eating-fewer-meals-what-works-best-for-weight-loss-242028">original article</a>.

Body

I spoke to 100 Japanese seniors, and learnt the secret to a good retirement is a good working life

<a href="https://theconversation.com/profiles/shiori-shakuto-1537774">Shiori Shakuto</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> What makes a good retirement? I’ve <a href="https://www.pennpress.org/9781512827088/after-work/">been researching</a> the lives of “silver backpackers”: Japanese seniors who embark on a later-life journey of self-discovery. Many experienced Japan’s high-growth economy, characterised by rigid gender roles. For many men who worked as iconic cultural figures of <a href="https://en.wikipedia.org/wiki/Salaryman">sarariiman</a> (white collar workers), excessive working hours were normalised and expected. Their absence from home was compensated by their female partners, many full-time stay-at-home mothers. Entering their 60s meant either retirement from work, or children leaving home. For men and women, retirement is understood as an opportunity to live a life for themselves, leading to a journey of self-discovery. <h2>Dedicating life to work</h2> I interviewed more than 100 older Japanese women and men and found a significant disparity in the quality of life between them. Japanese retired men who led a work-oriented life struggled to find meaning at the initial stages of retirement. One man I spoke to retired at the age of 60 from a large trading company. He was a successful businessman, having travelled the world and held various managerial positions in the company. His wife looked after the children most of the time. They bought a house with a yard in a suburb so the children could attend a good school. It significantly increased his commute, and further reduced his time with children. He also worked on weekends. He barely had time to develop his hobbies or get to know his neighbours. He idealised his retirement as a time to finally spend with his family and develop his own hobbies. When he retired, however, he realised that he and his family didn’t have any common topics of conversation. Through decades of excessive hours spent at work away from home, the rest of the family established a routine that did not include him. Taking up new hobbies at the age of 60 was not as easy as he thought, nor was making new friends at this age. “I became a nureochiba,” he lamented. Nureochiba refers to the wet fallen leaves that linger and are difficult to get rid of. The term is commonly used to describe retired men with no friends or hobbies who constantly accompany their wives. The retirement for many former sarariiman was characterised by boredom – having nowhere to go to or having nothing to do. The sense of boredom led to a sense of isolation and low confidence in old age. Many older Japanese men I spoke to lament not having built a connection with their children or communities at a younger age. <h2>Dedicating life to family and community</h2> Older Japanese women I spoke with were more well-connected with their children and local communities in later life. Many were in regular contact with their children through visits, phone calls and messages. Some continued to care for them by providing food or by looking after grandchildren. Children very much appreciated them. Many older women who had been full-time stay-at-home mothers had already taken up hobbies or volunteering activities at community organisations, and they could accelerate these involvements in their old age. Even women who worked full-time seemed to maintain better connections with their family members because working excessively away from home was simply not possible for them. Older men relied on these women’s networks and activities conducted at the scales of home and communities – from caring for others to pursuing hobbies – to enact a meaningful retirement. The sense of connection with family and communities, not to mention their husbands’ reliance on them, led to a high confidence and wellbeing among older women. I saw many instances where older women preferred spending time with their female friends than their retired husbands and embarked on adventurous trips alone. One woman went on a three-month cruise alone. Feeling liberated, she sent a fax message to her husband from the ship: “When I get off this ship, I will devote the rest of my life to myself. You will have to take care of your own mother.” Upon disembarking, she moved to Malaysia to start her second life. <h2>The silver backpackers</h2> Malaysia has become a popular destination for silver backpackers looking to embark on a journey of self-discovery. Some travel as couples, while others go alone, regardless of their marital status. For many male silver backpackers I spoke to, moving to Malaysia offers a second chance at life to make new friends, find hobbies and, most importantly, start anew with their partners. For many female silver backpackers, visiting Malaysia means being able to enjoy an independent lifestyle while having the security of friends and family in Malaysia and Japan. The experiences of older Japanese men and women can be translated into the experiences of anyone who spent excessive hours at work and those who spent more time cultivating relationships outside of work. The activities of the latter group are not as valued in a society that narrowly defines productivity. However, my research shows that it is their activities that carry more value in old age. Are you under pressure to work long hours? If you can, turn off your phone and computer. Instead of organising events for work, organise a dinner with your family and friends. Take up a new hobby in your local community centres. You can change how you work and live now for a better old age.<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/238571/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/shiori-shakuto-1537774">Shiori Shakuto</a>, Lecturer in Anthropology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-spoke-to-100-japanese-seniors-and-learnt-the-secret-to-a-good-retirement-is-a-good-working-life-238571">original article</a>.

Retirement Life

How do heat protectants for hair work? A chemistry expert explains

<a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Heat can do amazing things to change your hairstyle. Whether you’re using a curling wand to get ringlets, a flat iron to straighten or a hair dryer to style, it’s primarily the heat from these tools that delivers results. This comes with casualties. While your hair is surprisingly tolerant to heat compared with many other parts of your body, it can still only withstand so much. Heat treatment hair appliances frequently operate at over 150°C, with some reportedly <a href="https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2019.00298/full#B13">reaching</a> <a href="https://www.researchgate.net/publication/289291195_Thermal_degradation_of_hair_I_Effect_of_curling_irons">over 200°C</a>. At these temperatures, your hair can end up fried. Many people use heat protectants, often in the form of sprays, to minimise the damage. So how do these protectants work? To answer that, I first have to explain exactly what heat does to your tresses on the molecular level. <h2>What heat does to your hair</h2> A large proportion of your hair is made up of proteins. There are attractive forces between these proteins, known as hydrogen bonds. These bonds play a big role in dictating the shape of your locks. When you heat up your hair, the total attraction of these hydrogen bonds become weaker, allowing you to more easily re-shape your hair. Then, when it cools back down, these attractions between the proteins are re-established, helping your hair hold its new look until the proteins rediscover their normal structure. The cuticle – the outermost protective layer of your hair – contains overlapping layers of cells that lose integrity when they’re heated, damaging this outer protective layer. Inside that outer layer is the cortex, which is rich in a protein called keratin. Many proteins don’t <a href="https://pubmed.ncbi.nlm.nih.gov/21635854/">hold up structurally</a> after intense heating. Think of cooking an egg – the change you see is a result of the heat altering the proteins in that egg, unravelling them into different shapes and sizes. It’s a <a href="https://library.scconline.org/v049n04/33">similar story</a> when it comes to heating your hair. The proteins in your hair are also susceptible to heat damage, reducing the overall strength and integrity of the hair. Heat can also affect substances called melanin and <a href="https://pubmed.ncbi.nlm.nih.gov/21443842/">tryptophan</a> in your hair, resulting in a change in pigmentation. Heat-damaged hair is <a href="https://pubmed.ncbi.nlm.nih.gov/21635854/">harder to brush</a>. The damage is even more devastating if you use heat styling tools such as <a href="https://labmuffin.com/why-you-should-never-straighten-or-curl-wet-hair/">curling irons or straighteners</a> to <a href="https://library.scconline.org/v062n01/23">heat wet hair</a>, as at the high treatment temperatures, the water soaked up by the fibres can violently evaporate. The result of this is succinctly described by science educator and cosmetic chemist Michelle Wong, also known as <a href="https://labmuffin.com/how-do-heat-protectant-hair-products-work/">Lab Muffin</a>. She notes if you heat wet hair this way, “steam will blast through your hair’s structure”. This steam bubbling or bursting through the hair can <a href="https://pubmed.ncbi.nlm.nih.gov/21443842/">cause substantial damage</a>. It’s worth noting hair dryers don’t concentrate heat in the same way as styling tools such as flat irons or curling wands, but you still need to move the hair dryer around constantly to avoid heat building up in one spot and causing damage. Once heat damage is done, regardless of whether it is severe or mild, the best remaining options are symptom management or a haircut. For all of these reasons, when you’re planning to heat treat your hair, protection is a good idea. <h2>How hair protectants work</h2> When you spray on a hair protectant, many possible key ingredients can go to work. They can have <a href="https://library.scconline.org/v062n01/15">daunting-looking names</a> like polyvinyl pyrrolidone, methacrylates, polyquaterniums, silicones and more. These materials are chosen because they readily stick onto your hair, creating a coating, a bit like this: <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&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/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=225&fit=crop&dpr=1 600w, https://images.theconversation.com/files/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=225&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=225&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=283&fit=crop&dpr=1 754w, https://images.theconversation.com/files/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=283&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/615002/original/file-20240822-16-beyt90.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=283&fit=crop&dpr=3 2262w" alt="A cartoon of coating attached to a strand of hair." /></a><figcaption>Hair protectant applies a coating to your hair. Author provided</figcaption></figure> This coating is a protective layer; it’s like putting an oven mitt on your hands before you handle a hot tray from the oven. To demonstrate, I created these by examining hair under a microscope before and after heat protectant was applied: <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&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/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=369&fit=crop&dpr=1 754w, https://images.theconversation.com/files/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=369&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/615001/original/file-20240822-16-s2ufqy.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=369&fit=crop&dpr=3 2262w" alt="These high magnification images of untreated hair, and hair sprayed with a heat treatment spray, show what a difference it can make." /></a><figcaption>These high magnification images of untreated hair, and hair sprayed with a heat treatment spray, show how the product coats your hair strands. Author provided</figcaption></figure> Just like an oven mitt, a hair protectant delays the heat penetration, results in less heat getting through, and helps spread out the effect of the heat, a bit like in this image: <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&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/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=233&fit=crop&dpr=1 600w, https://images.theconversation.com/files/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=233&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=233&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=293&fit=crop&dpr=1 754w, https://images.theconversation.com/files/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=293&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/615003/original/file-20240822-16-tf7xsj.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=293&fit=crop&dpr=3 2262w" alt="Cartoon demonstrating the difference between heating unprotected and protected hair" /></a><figcaption>Hair protectant can help spread out the effects of the heat. Author provided</figcaption></figure> <a href="https://library.scconline.org/v049n04/33">This helps</a> prevent moisture loss and damage to both the protective surface cell layer (the cuticle) and the protein structure of the hair cortex. For these barriers to work at their best, these heat-protecting layers need to remain bound to your hair. In other words, they stick on really well. For this reason, continued use can sometimes cause a <a href="https://link.springer.com/article/10.1007/s12221-010-0507-9">buildup</a> which can change the feel and weight of your hair. This buildup is not permanent and can be removed with washing. One final and important note: just like when you use a mitt for the oven, heat does still get through. The only way to prevent heat damage to your hair altogether is to not use heated styling tools.<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/233206/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/daniel-eldridge-1494633">Daniel Eldridge</a>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-heat-protectants-for-hair-work-a-chemistry-expert-explains-233206">original article</a>.

Beauty & Style

"Ridiculous and disrespectful": Groom goes viral for working on wedding day

A wedding photo has gone viral for the wrong reasons after a groom was pictured working on his own wedding day. Torrey Leonard, the founder of US-based start-up company, Thoughtly, shared a photo of his co-founder, Casey Mackrell, pulling out a laptop at his own wedding to get some work done. “My co-founder Casey has built a reputation for himself as ‘the guy who sits on his laptop in bars’ from SF to NYC,” he wrote in the post. “Last week Thoughtly brought on a customer that needed to launch within 2 weeks. He just so happened to be getting married within that 2 week window. “So, here he is wrapping up a pull request. At his own wedding. Congrats Casey – now please, go take some time off.” Hundreds of people were quick to comment on the post, labelling it “one of the most depressing LinkedIn posts to exist” and it was even shared to other social media pages. The groom himself eventually had to clarify saying: “Don’t worry I got back to dancing and champagne 2 seconds later.” But that wasn't enough to appease fellow LinkedIn users. “So your company has such terrible work/life balance that you can’t have a WEDDING without having to work? That’s just sad as hell," one wrote. Another commenter quipped that it was "really sad" the groom didn't call off the wedding to focus on work, saying: “Someone who actually knows how to grind would have called it off the second the contract was signed." A few others questioned the authenticity of the post, saying that it had to be staged as they couldn’t believe that someone would be “that ridiculous and disrespectful to his bride and family”. “Aside from the fact that this is probably staged, pushing people to sacrifice their private life and mental health is not the flex you think it is," another added. In an interview with news.com.au Leonard defended his co-founder's decision and explained the situation. “As a company, what we do is very high-stakes. Every single one of our customers, they depend on us to function perfectly, 24-7, around the clock, no questions asked,” he told the publication. “We work with many publicly traded companies across the globe, and we spend long hours of the night, early mornings awake, monitoring these calls, proactively fixing issues, fixing problems, building new features. “The context of this post, he had to solve a problem, and it was really only something that he could solve. It was a three- to five-minute task. “We understand that this lifestyle is not for everybody. It’s obviously something that is a lot of work, but it’s something that we love.” He also clarified that Mackrell's bride, Grace, did not have a problem with the brief interruption on their happy day. “They were dating for many years, so she’s seen him pull a laptop out at a restaurant dinner table. I mean, it looks crazy, but that’s just who Casey is. She’s obviously fine with it.” Images: LinkedIn

Relationships

I’m iron deficient. Which supplements will work best for me and how should I take them?

<a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women <a href="https://static1.squarespace.com/static/57bfc0498419c24a01318ae2/t/607fc2e06ace2f22d5ca9a43/1618985699483/20210421+-+IDC+-+economic+impact+of+iron+deficiency+-+FINAL.pdf">are low in iron</a> compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant. The <a href="https://pubmed.ncbi.nlm.nih.gov/11160590/">body needs iron</a> to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration. If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day? Here are some tips to help you work out how, when and what iron supplement to take. <h2>How do I pick the right iron supplement?</h2> The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need. The sweet spot is between <a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364?via%3Dihub">60-120 mg of elemental iron</a>. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain. In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). <a href="https://www.ncbi.nlm.nih.gov/books/NBK557376/">The iron salts</a> you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%). These formulations <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">all work similarly</a>, so your choice should come down to dose and cost. Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency. <h2>Should I take tablets or liquid formulas?</h2> Iron contained within a tablet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867244/">just as well absorbed</a> as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference. The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term. <h2>What should I eat with my iron supplement?</h2> Research <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">has shown</a> you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone. If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it. Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other <a href="https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/">vitamin C-rich foods</a>. On the other hand, tea, coffee and calcium all <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.26987">decrease the body’s ability to absorb iron</a>. So you should try to limit these close to the time you take your supplement. <h2>Should I take my supplement in the morning or evening?</h2> The best time of day to take your supplement is in the morning. The body can <a href="https://journals.lww.com/acsm-msse/fulltext/2019/10000/the_impact_of_morning_versus_afternoon_exercise_on.20.aspx">absorb significantly more</a> iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest. Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can <a href="https://journals.humankinetics.com/view/journals/ijsnem/32/5/article-p359.xml">limit your ability to absorb it</a>. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop. <a href="https://journals.lww.com/acsm-msse/fulltext/2024/01000/iron_absorption_in_highly_trained_male_runners_.14.aspx">Our research</a> has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes). <h2>My supplements are upsetting my stomach. What should I do?</h2> If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily. Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00463-7/fulltext#%20">has shown</a> taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects. Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success. It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430862/">iron can be toxic</a>, so you don’t want to be consuming additional iron if your body doesn’t need it. If you think you may be low on iron, talk to your GP to find out your best options.<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/235315/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alannah-mckay-1548258">Alannah McKay</a>, Postdoctoral Research Fellow, Sports Nutrition, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-iron-deficient-which-supplements-will-work-best-for-me-and-how-should-i-take-them-235315">original article</a>.

Body

Holiday protesters are missing the big picture – there are ways to make tourism work for everyone

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/brendan-canavan-228682">Brendan Canavan</a>, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</a> As tourists sip their drinks at sunny pavement cafes this summer, they may feel slight unease that perhaps their presence isn’t entirely welcome. This season has seen a <a href="https://www.bbc.co.uk/news/videos/c0dm9w2ey7po">renewed wave of major protests</a> against tourists for pushing out residents and homogenising culture in popular destinations. Anti-tourist placards and gatherings have appeared in <a href="https://www.portugalresident.com/sintra-residents-finally-say-enough-to-mass-tourism-traffic-chaos/">Portugal</a>, <a href="https://uk.news.yahoo.com/greek-city-begs-no-more-095204268.html">Athens</a>, <a href="https://edition.cnn.com/2024/07/22/travel/mass-protest-on-spanish-island-mallorca-calls-for-limits-on-tourism/index.html">Mallorca</a> and <a href="https://www.reuters.com/world/europe/thousands-protest-spains-canary-islands-over-mass-tourism-2024-04-20/">Tenerife</a>. Tourists have even been sprayed with <a href="https://www.nbcnews.com/business/travel/barcelona-protesters-throw-items-spray-travelers-water-shouting-touris-rcna160883">water pistols</a> by angry inhabitants of Barcelona. Anti-tourism protests are <a href="https://www.theguardian.com/travel/2017/aug/10/anti-tourism-marches-spread-across-europe-venice-barcelona">not new</a>, and they do not always share the same <a href="https://www.emerald.com/insight/content/doi/10.1108/IJTC-09-2022-0211/full/html#sec014">motivations</a>. But one <a href="https://www.emerald.com/insight/content/doi/10.1108/IJTC-09-2022-0211/full/html#sec014">common grievance</a> is that local economies are not improved by tourism, while the social costs of hosting mount. But are these anti-tourism sentiments justified? Tourism contributes around <a href="https://journals.sagepub.com/doi/10.1177/00472875211028322">5% of EU economic activity</a>, supporting jobs and businesses both directly and indirectly. Without tourism many places would be economically poorer. But protesters in <a href="https://news.sky.com/story/your-paradise-our-nightmare-thousands-attend-anti-tourism-protest-in-majorca-13183160">Mallorca</a> have argued that tourists take up space on beaches, put a strain on public services and drive the cost of housing above a level that residents can afford. The economic pros and cons of tourism suggest the protesters have a point. But they are also missing the bigger picture. An estimated <a href="https://studytravel.network/magazine/news/0/30772#:%7E:text=Globally%2C%20there%20were%201.3%20billion,data%20quoted%20in%20the%20report.">1.3 billion</a> international tourist trips took place in 2023. These tourists spent over <a href="https://x.com/UNWTO/status/1796821487971905590">US$1.5 trillion</a> (£1.2 trillion) on their trips. For comparison, that is roughly the size of the Spanish economy. If tourism were a nation, it would be a <a href="https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)">G20 member</a>. What’s more, because international travellers earn money in their home country and spend it in another, international tourism is counted as an export. In 2022 international tourists spent almost <a href="https://www.oecd-ilibrary.org/urban-rural-and-regional-development/data/oecd-tourism-statistics/receipts-and-expenditure_c4170878-en?parentId=http%3A%2F%2Finstance.metastore.ingenta.com%2Fcontent%2Fcollection%2F2b45a380-en">€370 billion</a> (£312 billion) in the 27 EU countries, for example. This export income helps to balance the cost of imports and pay for things such as food and fuel not available locally. Nonetheless, there remains a concern that such economic inputs come at too high a cost. In January the then head of Florence’s Galleria dell’Accademia controversially criticised how the city had <a href="https://edition.cnn.com/2024/01/30/travel/italy-florence-prostitute-tourism-intl-scli/index.html">sold its soul</a> to tourists. But <a href="https://journals.sagepub.com/doi/pdf/10.1177/00472875231203395">tourism revenues</a> help provide foreign exchange earnings, create jobs, encourage infrastructure investments and boost tax revenues. In turn these inputs promote economic development and increase welfare, as well as reduce <a href="https://drive.google.com/file/d/1ImtQ9YQS7UrYJ_PItcgeFhFUidcxTwkC/view">income inequality</a>. Globally, the tourism industry is a significant source of employment. In 2019, prior to the pandemic, travel and tourism accounted for <a href="https://wttc.org/research/economic-impact">10.5%</a> of all jobs. In some <a href="https://www.weforum.org/agenda/2020/08/destinations-rely-most-on-tourism-travel/">Caribbean islands</a> more than 90% of all jobs are in the tourism sector. Crossover benefits of hosting tourists are felt in other industries too. <a href="https://journals.sagepub.com/doi/pdf/10.1177/00472875231203395">Food and drink</a> producers sell their products to tourists, for example, and <a href="https://www.mdpi.com/2071-1050/13/13/7164">farmers</a> can diversify their incomes by offering tourist experiences such as wine-tasting tours. Tourism generates a large amount of economic activity, therefore. But research shows that the income that remains in a destination is often limited by <a href="https://www.researchgate.net/profile/Cristina-Joensson/publication/293487803_Economic_leakages_in_tourism/links/56b8f33608ae3b658a88b7a4/Economic-leakages-in-tourism.pdf">leakage rates</a>. There are estimates that for every US$1 million spent by tourists in the Seychelles, <a href="https://www.sciencedirect.com/science/article/pii/S0160738315000468?casa_token=-hjGHa9NHPMAAAAA:irVmwVrFbZvnTNzDPKcE90_dK4mwuwVBIkO4_nPs34IdGM12w9i4r8GCR_1K_0IIrJznxx2b">less than half</a> of this stays in the local economy. This income can <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1470-6431.2007.00606.x?casa_token=bentpmB1dE8AAAAA%3A72smahI3xNJB2Y7_PDj-lcZG6nmW7fqPgOv59G4Dr-DBfzWfxjtxRU9qytrdpOWmaLom6oe6dM_U0oA">leak out</a> from the destination because of imports such as food and fuel that are not available locally. Leakage also occurs when tourist facilities are foreign owned. <figure><iframe src="https://www.youtube.com/embed/S-p-YGNXEnY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> There are undoubtedly <a href="https://www.euronews.com/travel/2024/07/08/fake-signs-and-hunger-strikes-whats-behind-europes-backlash-against-overtourism">downsides</a> to tourism development. The influx of people into popular destinations can add to issues of crowding in public services and shared spaces. Tourism is also often accused of causing urgent economic problems, such as forcing up the cost of housing for locals. But these are often driven by more complex and alternative factors. Research in <a href="https://journals.sagepub.com/doi/pdf/10.1177/0042098020970865">London</a>, a city facing an extreme problem of supply scarcity and growing numbers of <a href="https://theconversation.com/surging-property-prices-when-will-europes-cities-become-affordable-again-230256">“generation rent”</a>, found that Airbnb plays a relatively insignificant part in increasing housing costs. A study in <a href="https://www.tandfonline.com/doi/pdf/10.1080/13683500.2019.1711027?casa_token=YYKyikeJrXYAAAAA:ktQVCuNoseTdiAC89hl98rdclxE7I68CqkYW6xHUFkzH_TLfabdFOuNfKDQiiIzkOdag7cuQTrho">South Carolina</a> in the US meanwhile showed that short-term holiday rentals can boost hospitality micro-entrepreneurs and help residents to maximise the economic potential of their homes by renting out spare rooms. <h2>What can tourists do?</h2> Ultimately, what unites many anti-tourism protesters is a <a href="https://www.bbc.com/travel/article/20240522-the-worlds-revolt-against-bad-tourists">demand for respect</a>. Indeed, <a href="https://www.tandfonline.com/doi/pdf/10.1080/10941665.2020.1768129?casa_token=4DR7vsQpGtcAAAAA:0QIzenTi9LAaVNH8w0JkT46D5_okuotUR5C-wP2NyxxT5bC0UiG2gMBfLHt5G3rveVre7gu8kEIB">research</a> has shown that over-tourism is not merely an issue of overcrowding, but a long-term issue resulting from inappropriate treatment of residents in the process of tourism development. Tourists can demonstrate that they respect hosts and help to alleviate anti-tourism feelings by finding ways to ensure their holiday is as economically beneficial to the destination as possible. <ul> <li> Spending money at smaller-scale and locally owned businesses puts more money into the local economy. Large multinationals can out-compete local businesses and worsen <a href="https://drive.google.com/file/d/1ImtQ9YQS7UrYJ_PItcgeFhFUidcxTwkC/view">economic inequality</a>. <a href="https://journals.sagepub.com/doi/pdf/10.1177/1354816616654244?casa_token=YQU0aoDhdP8AAAAA:bX_7TEc0S4zhkl2eduKZqitorJKlbRMMSnaJAZJBPCm8bAk-uQMI518KvZX09oI0iLs13NULXYoX">Foreign-owned businesses</a> typically increase leakage rates as they send profits back to their headquarters. </li> <li> Choosing more sustainable operators, services and destinations tends to bring economic positives. In <a href="https://journals.sagepub.com/doi/abs/10.1177/1354816616664249?casa_token=vr7pQyvIVAgAAAAA%3ATLHqmXTyGeHpmL8j9K2cNjb4doB4w_0CNH0IspadKHEPSt5PsFLWVngRQsj81tvE3vIJMpPWGm31&journalCode=teua">Mauritius</a>, for instance, the government has invested in sustainable tourism planning, enhancing economic growth and bringing benefits for residents. </li> <li> Visiting places that are less typically touristic spreads economic advantages around. In Scotland, nature tourism supports around <a href="https://www.nature.scot/professional-advice/social-and-economic-benefits-nature/tourism">39,000 full-time jobs</a>. </li> </ul> It can be easy to scapegoat tourists and tourism for deeper-seated economic problems. Tourists are a highly visible, and frequently very annoying, presence. But without them destinations would be poorer, while persistent economic problems would likely remain. Challenging governments, policy-makers, corporations or institutions might be a better use of protesters’ energy.<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/235614/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brendan-canavan-228682">Brendan Canavan</a>, Senior Lecturer in Marketing, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</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/holiday-protesters-are-missing-the-big-picture-there-are-ways-to-make-tourism-work-for-everyone-235614">original article</a>. </div>

Travel Trouble

The tragic reason Miriam Margolyes is still working at 83

Miriam Margolyes has shared the tragic reason that she is still working in showbiz at the age of 83. The acting legend has long suffered with spinal stenosis – a condition that occurs when the spinal canal or neural foramen narrows, putting pressure on the spinal cord and nerve roots. Despite suffering from the debilitating illness, the 83-year-old British star has appeared on numerous TV shows over the years. Now, speaking candidly to the Radio Times, Margolyes admitted that she is still working to fund her medical bills. She said, “I’m worried that I won’t have enough money for carers when I finally get paralysed or whatever it is that’s going to happen to me.” Despite dealing with the physical constraints that come from both her spinal stenosis and her age, which she finds “limiting and depressing”, she said she refuses to slow her pace. “When you know that you haven’t got long to live and I’m probably going to die within the next five or six years, if not before, I’m loath to leave behind performing. It’s such a joy.” “I yearn to play roles that don’t confine me to wheelchairs, but I’m just not strong enough.” Margolyes recently underwent major heart surgery, speaking candidly about the operation with the Table Manners podcast. “I’ve got a cow’s heart now,” she said. “Well, not the whole heart. I’ve had an aortic valve replaced by a cow’s aortic valve. “I don’t know how common it is. I’d never heard of that operation. But it saves you from having open-heart surgery, which would be infinitely more invasive.” In the same interview, Margolyes revealed she expected to be a wheelchair soon. “When you get old you become obviously aware of your vulnerability. I have a bad back, I’m probably going to be in a wheelchair soon and you have to come to terms with what life throws at you.” Image credits: Ken McKay/ITV/Shutterstock Editorial

Caring

Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health

<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> and <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> Many people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">drinking less</a> sugary soft drink than in the past. This is a great win for public health, given the <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2749350">recognised risks</a> of diets high in sugar-sweetened drinks. But over time, intake of diet soft drinks has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">grown</a>. In fact, it’s so high that these products are now regularly <a href="https://www.sciencedirect.com/science/article/pii/S0160412020319188">detected in wastewater</a>. So what does the research say about how your health is affected in the long term if you drink them often? <h2>What makes diet soft drinks sweet?</h2> The World Health Organization (WHO) <a href="https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children">advises</a> people “reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (six teaspoons) per day would provide additional health benefits.” But most regular soft drinks contain <a href="https://www.actiononsugar.org/surveys/2014/sugar-sweetened-beverages/">a lot of sugar</a>. A regular 335 millilitre can of original Coca-Cola contains at least <a href="https://www.coca-cola.com/ng/en/about-us/faq/how-much-sugar-is-in-cocacola-original-taste">seven</a> teaspoons of added sugar. Diet soft drinks are designed to taste similar to regular soft drinks but without the sugar. Instead of sugar, diet soft drinks contain artificial or natural sweeteners. The artificial sweeteners include aspartame, saccharin and sucralose. The natural sweeteners include stevia and monk fruit extract, which come from plant sources. Many artificial sweeteners are much sweeter than sugar so less is needed to provide the same burst of sweetness. Diet soft drinks are marketed as healthier alternatives to regular soft drinks, particularly for people who want to reduce their sugar intake or manage their weight. But while surveys of Australian <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551593/">adults</a> and <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/adolescents-knowledge-and-beliefs-regarding-health-risks-of-soda-and-diet-soda-consumption/32F3E0FD6727F18F04C63F0390595131">adolescents</a> show most people understand the benefits of reducing their sugar intake, they often aren’t as aware about how diet drinks may affect health more broadly. <h2>What does the research say about aspartame?</h2> The artificial sweeteners in soft drinks are considered safe for consumption by food authorities, including in the <a href="https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food">US</a> and <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame">Australia</a>. However, some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899993/">researchers</a> have raised concern about the long-term risks of consumption. People who drink diet soft drinks regularly and often are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446768/">more likely</a> to develop certain metabolic conditions (such as diabetes and heart disease) than those who don’t drink diet soft drinks. The link was found even after accounting for other dietary and lifestyle factors (such as physical activity). In 2023, the WHO announced reports had found aspartame – the main sweetener used in diet soft drinks – was “<a href="https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released">possibly carcinogenic to humans</a>” (carcinogenic means cancer-causing). Importantly though, the report noted there is not enough current scientific evidence to be truly confident aspartame may increase the risk of cancer and emphasised it’s safe to consume occasionally. <h2>Will diet soft drinks help manage weight?</h2> Despite the word “diet” in the name, diet soft drinks are not strongly linked with weight management. In 2022, the WHO conducted a <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">systematic review</a> (where researchers look at all available evidence on a topic) on whether the use of artificial sweeteners is beneficial for weight management. Overall, the randomised controlled trials they looked at suggested slightly more weight loss in people who used artificial sweeteners. But the observational studies (where no intervention occurs and participants are monitored over time) found people who consume high amounts of artificial sweeteners tended to have an increased risk of higher body mass index and a 76% increased likelihood of having obesity. In other words, artificial sweeteners may not directly help manage weight over the long term. This resulted in the WHO <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">advising</a> artificial sweeteners should not be used to manage weight. <a href="http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30296-0">Studies</a> in animals have suggested consuming high levels of artificial sweeteners can signal to the brain it is being starved of fuel, which can lead to more eating. However, the evidence for this happening in humans is still unproven. <h2>What about inflammation and dental issues?</h2> There is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10817473/">some early evidence</a> artificial sweeteners may irritate the lining of the digestive system, causing inflammation and increasing the likelihood of diarrhoea, constipation, bloating and other symptoms often associated with irritable bowel syndrome. However, this study noted more research is needed. High amounts of diet soft drinks have <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17223-0">also been</a> linked with liver disease, which is based on inflammation. The consumption of diet soft drinks is also <a href="https://link.springer.com/article/10.1007/s40368-019-00458-0#:%7E:text=Diet%20soft%20drinks%20often%20have,2006">associated</a> with dental erosion. Many soft drinks contain phosphoric and citric acid, which can damage your tooth enamel and contribute to dental erosion. <h2>Moderation is key</h2> As with many aspects of nutrition, moderation is key with diet soft drinks. Drinking diet soft drinks occasionally is unlikely to harm your health, but frequent or excessive intake may increase health risks in the longer term. Plain water, infused water, sparkling water, herbal teas or milks remain the best options for hydration.<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/233438/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <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> and <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> 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/cheeky-diet-soft-drink-getting-you-through-the-work-day-heres-what-that-may-mean-for-your-health-233438">original article</a>.

Food & Wine

After 180 years, new clues are revealing just how general anaesthesia works in the brain

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773932/pdf/BLT.15.159293.pdf/">Over 350 million surgeries</a> are performed globally each year. For most of us, it’s likely at some point in our lives we’ll have to undergo a procedure that needs general anaesthesia. Even though it is one of the safest medical practices, we still don’t have a complete, thorough understanding of precisely how anaesthetic drugs work in the brain. In fact, it has largely remained a mystery since general anaesthesia was introduced into medicine over <a href="https://www.tandfonline.com/doi/full/10.3109/08941939.2015.1061826">180 years ago</a>. Our study published <a href="https://doi.org/10.1523/JNEUROSCI.0588-23.2024">in The Journal of Neuroscience today</a> provides new clues on the intricacies of the process. General anaesthetic drugs seem to only affect specific parts of the brain responsible for keeping us alert and awake. <h2>Brain cells striking a balance</h2> In a study using fruit flies, we found a potential way that allows anaesthetic drugs to interact with specific types of neurons (brain cells), and it’s all to do with proteins. Your brain has around <a href="https://onlinelibrary.wiley.com/doi/10.1002/cne.21974">86 billion neurons</a> and not all of them are the same – it’s these differences that allow general anaesthesia to be effective. To be clear, we’re not completely in the dark on <a href="https://linkinghub.elsevier.com/retrieve/pii/S0165614719300951">how anaesthetic drugs affect us</a>. We know why general anaesthetics are able to make us lose consciousness so quickly, thanks to a <a href="https://www.nature.com/articles/367607a0">landmark discovery made in 1994</a>. But to better understand the fine details, we first have to look to the minute differences between the cells in our brains. Broadly speaking, there are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591655/">two main categories of neurons in the brain</a>. The first are what we call “excitatory” neurons, generally responsible for keeping us alert and awake. The second are “inhibitory” neurons – their job is to regulate and control the excitatory ones. In our day-to-day lives, excitatory and inhibitory neurons are constantly working and balancing one another. <a href="https://www.nature.com/articles/npp2017294">When we fall asleep</a>, there are inhibitory neurons in the brain that “silence” the excitatory ones keeping us awake. This happens <a href="https://askdruniverse.wsu.edu/2018/01/07/why-do-we-get-tired/">gradually over time</a>, which is why you may feel progressively more tired through the day. General anaesthetics speed up this process by directly silencing these excitatory neurons without any action from the inhibitory ones. This is why your anaesthetist will tell you that they’ll “put you to sleep” for the procedure: <a href="https://www.nature.com/articles/nrn2372">it’s essentially the same process</a>. <h2>A special kind of sleep</h2> While we know why anaesthetics put us to sleep, the question then becomes: “why do we stay asleep during surgery?”. If you went to bed tonight, fell asleep and somebody tried to do surgery on you, you’d wake up with quite a shock. To date, there is no strong consensus in the field as to why general anaesthesia causes people to remain unconscious during surgery. Over the last couple of decades, researchers have proposed several potential explanations, but they all seem to point to one root cause. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709148/#:%7E:text=At%20presynaptic%20part%2C%20voltage%2Dgated,anesthetics%20to%20inhibiting%20neurotransmitter%20release.">Neurons stop talking to each other</a> when exposed to general anaesthetics. While the idea of “cells talking to each other” may sound a little strange, it’s a <a href="https://qbi.uq.edu.au/brain-basics/brain/brain-physiology/action-potentials-and-synapses">fundamental concept in neuroscience</a>. Without this communication, our brains wouldn’t be able to function at all. And it allows the brain to know what’s happening throughout the body. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&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/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="Two branching structures in orange, green, blue and yellow colours on a black background." /></a><figcaption>Colourised neurons in the brain of a fly. Adam Hines</figcaption></figure> <h2>What did we discover?</h2> Our new study shows that general anaesthetics appear to stop excitatory neurons from communicating, but not inhibitory ones. <a href="https://www.jneurosci.org/content/40/21/4103">This concept isn’t new</a>, but we found some compelling evidence as to why only excitatory neurons are affected. For neurons to communicate, proteins have to get involved. One of the jobs these proteins have is to get neurons to release molecules called <a href="https://my.clevelandclinic.org/health/articles/22513-neurotransmitters">neurotransmitters</a>. These chemical messengers are what gets signals across from one neuron to another: dopamine, adrenaline and serotonin are all neurotransmitters, for example. We found that general anaesthetics impair the ability of these proteins to release neurotransmitters, but only in excitatory neurons. To test this, we used <a href="https://www.eneuro.org/content/8/3/ENEURO.0057-21.2021">Drosophila melanogaster fruit flies</a> and <a href="https://imb.uq.edu.au/research/facilities/microscopy/training-manuals/microscopy-online-resources/image-capture/super-resolution-microscopy">super resolution microscopy</a> to directly see what effects a general anaesthetic was having on these proteins at a molecular scale. Part of what makes excitatory and inhibitory neurons different from each other is that they <a href="https://journals.physiology.org/doi/full/10.1152/physrev.00007.2012">express different types of the same protein</a>. This is kind of like having two cars of the same make and model, but one is green and has a sports package, while the other is just standard and red. They both do the same thing, but one’s just a little bit different. Neurotransmitter release is a complex process involving lots of different proteins. If one piece of the puzzle isn’t exactly right, then general anaesthetics won’t be able to do their job. As a next research step, we will need to figure out which piece of the puzzle is different, to understand why general anaesthetics only stop excitatory communication. Ultimately, our results hint that the drugs used in general anaesthetics cause massive global inhibition in the brain. By silencing excitability in two ways, these drugs put us to sleep and keep it that way.<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/229713/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, Research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</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/after-180-years-new-clues-are-revealing-just-how-general-anaesthesia-works-in-the-brain-229713">original article</a>. </div>

Body

How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast. Give meditation a try As a mindfulness coach, I’m very aware of the day-to-day anxieties and worries that can interfere with a good night’s sleep. One of the most effective natural sleep aids is a quick meditation session to ease yourself out of those stresses. If you’ve never meditated before, you’ll likely find the meditation interrupted by thoughts flashing through your mind. It’s important for you to know that this isn’t a failure on your part, and that you aren’t doing anything wrong. Thinking is just what the brain does, as naturally as lungs take in air. The point is to be non-judgmental yet aware of your thoughts, bodily experiences and breath, moment by moment. Stop wanting to fall asleep It’s counterintuitive, isn’t it? Sometimes trying too hard to do something is the very thing that prevents us from achieving it – and that’s never more true than when it comes to falling asleep. Desperately wanting to sleep will only stoke anxieties that will further stress your brain, essentially feeding it the message that it’s not safe to sleep. Throw in those worries about your to-do list at work the following day, and the whole thing can snowball into a panic attack. Try letting go of that feeling that you absolutely must sleep now, and observe your own anxieties for what they are without judgment. When you stop looking at sleep as a goal, you’ll find it easier to fall asleep. Start a journal If you find yourself struggling to fall asleep, pick up a pen and paper (not your phone!), and start writing: simply scribble down an account of what’s going on inside your head. Although there’s no “right” way to journal, you might start by listing the events of your day, and from there, how those events and encounters made you feel. Building this structured picture of your thoughts may help you see that the problem that’s keeping you up at night, and is likely less overwhelming than you thought. Why my insistence on a pen and paper? First off, studies show the simple motor action that’s involved in the act of handwriting has a calming effect. Secondly, the light emitted by laptops and phones isn’t conducive to falling asleep. Find yourself a "3am friend" Some of us are lucky to have a ‘3am friend’, that close confidant you can call up in the wee hours knowing that they won’t hold it against you in the morning. Although it’s great to have someone to talk to when you want to fall asleep, it’s important that the conversation doesn’t just rehash the anxieties that are preventing you from catching shut-eye in the first place. Rather than using the call to seek solutions for those issues, talk about things that calm your nerves, or even have them assist you in deep breathing. It may sound silly, but doing a series of deep, relaxing breaths can help you let go of the troubles that are keeping you wide awake. Take a warm shower Taking a warm shower not only relaxes your muscles and soothes minor aches and pains, but it also raises your core body temperature. As soon as you step out of the shower, your body starts working at lowering that temperature, which is something that normally happens when you’re falling asleep naturally. (That’s why we always feel the need for a blanket when we sleep, no matter how warm it is!) By kick-starting that temperature-lowering process, you’re tricking your body into falling asleep fast. Stretch yourself to sleep Anxiety keeping you up? Research suggests mild stretching can help take the edge off and relax muscles that have become stiff and sore after a long day. We’re not talking intricate yoga poses or acrobatics here, either: Simple stretches like an overhead arm stretch and bending over to touch your toes should do the trick. Ramp up the relaxation potential with a soundtrack of ambient noise at a volume that’s just barely audible. There are plenty of white noise apps that are free to download, but soft music can work as well (so long as there are no lyrics). Just remember, if you’re using an electronic device to play these sleep-promoting sounds, make sure it’s placed screen-down so you’re not distracted by the light it emits. Read (or listen!) to something new When you’re struggling with insomnia, it might be tempting to pull an old favourite off the bookshelf. In reality, it’s better to read or listen to an audio book that covers a topic on which you know absolutely nothing. New information, while taking attention away from the stressors that are keeping you up at night, gives your brain enough of a workout to make it tire more quickly than when it’s engaged with familiar subjects and concepts. Again, if it’s an audio book or podcast you’re listening to, make sure the light-emitting side of the device is face down to keep the room as dark as possible. Darkness and warmth play an essential part in the production and maintenance of melatonin, the hormone that plays the central role falling asleep. Image credits: Getty Images This article by Deepak Kashyap originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/conditions/sleep/how-to-fall-asleep-without-sleeping-pills-7-natural-sleep-aids-that-actually-work" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Boss slammed for demanding an employee complete work during annual leave

A boss has been dubbed an “abysmal manager” for demanding his employee join a video call for work, despite being on annual leave. Businessman Ben Askins, who has dedicated his TikTok account to calling out unacceptable workplace behaviour, read out the text exchange between the man and his boss, who quickly became unreasonable in his demands. The first message came from the man’s boss, who asked “Where are you? Haven’t seen you at your desk today? I need to run something by you.” The employee responded, reminding his boss that he was off on pre-approved annual leave, and was enjoying a holiday abroad in Spain. Despite his holiday, the employee still offered to help, saying he could “probably jump on a quick call when I am on the bus from the airport if it is really urgent.” <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C2QFCsgtSoS/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C2QFCsgtSoS/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Ben Askins (@benaskins.official)</a> </div> </blockquote> Unhappy with the compromise, the demanding boss then asked if the employee would “jump on a Zoom call when you get to the hotel” as he would “prefer to do this in person”. “Sorry, not really possible, we have a really packed schedule,” the worker replied to his boss, to which the manager hit back with, “Damn, wish you had told me that you were on annual leave.” The man reminded his boss he had signed off his leave two months prior and it was “in the system” but he came back saying, “Lol as if I would remember that. It is poor form for you to not remind me.” As Ben continued to read the text exchange, he added his own commentary on the situation, saying, “It's your job to remember that, it's not his fault you're just being unbelievably shocking at yours.” “This is so bad, this poor employee has done everything right; he's got it signed off two months in advance, he's done all the handover, he's done everything he could have done,' Ben ranted. “Because the manager is shocking, it's now impacting the employee's holiday. I just hate it when that happens.” Ben, a self-described “champion of younger gens in the workplace” said the heated chat showed the boss's “really poor” form and “abysmal management”. “What are you doing being so unorganised? Because the problem when an unorganised manager happens it hits down to the team below him - what the hell he's playing at? I have no idea,” he said. Ben's clip was viewed more than 2.3million and had users fired up, with thousands of comments flooding in in support of the burnt out employee trying to enjoy his holiday. Image credits: Instagram

Legal

What is micellar water and how does it work?

Beauty & Style

World's oldest dog has title suspended amid doubts about his age

The world's <a href="https://www.oversixty.com.au/lifestyle/family-pets/miraculous-meet-the-world-s-oldest-dog" target="_blank" rel="noopener">oldest dog</a>, Bobi, who was reportedly 31 years and 165 days old when he died in October, has provisionally lost his title as Guinness World Records investigates his age. Bobi, a purebred Rafeiro do Alentejo, was a livestock guardian breed with a life expectancy of anywhere between 12-14 years, which meant that he lived over double his age. His age was initially confirmed by the Veterinary Medical Service of the Municipality of Leiria, which said he had been registered in 1992, which was then verified by Portuguese government-authorised pet database SIAC. He was crowned the world's "oldest ever dog" in February, and his owner Leonel Costa claimed that there were many reasons behind the dog's extraordinary age. Costa said that Bobi always roamed freely, lived in a "calm, peaceful" environment and ate human food soaked in water to remove seasonings. But now, Bobi's true age has been question after suspicions about the evidence that proved his true age were raised not long after his death. "While our review is ongoing we have decided to temporarily pause both the record titles for oldest dog living and ever just until all of our findings are in place," a spokesperson told CNN. The GWR is now conducting a formal review, which involves analysing existing evidence, seeking new evidence, and reaching out to experts and those linked to the original application. The previous record for the world's oldest dog was held by Australian cattle dog Bluey, who was born in 1910 and lived to be 29 years and five months old. Image: Youtube

Family & Pets

What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

<a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection. These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID. Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older. Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe? <h2>Who’s eligible for the new boosters?</h2> The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September. ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose. People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.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/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>For people without risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> Adults aged 18 to 64 with underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.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/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=311&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=311&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=311&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=391&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=391&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=391&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Advice for people with risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> For adults aged 18 to 64 without underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose. Additional doses aren’t recommended for children without underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years without additional risk factors. <h2>Monovalent, bivalent? What’s the difference?</h2> From monovalent The initial COVID vaccines were “monovalent”. They had one target – the original viral strain. But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity. To bivalent So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>. Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission. The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5. Back to monovalent Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement. This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>). This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed. According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is. The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore. In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>. <h2>Do these newer vaccines work?</h2> Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA. Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control. Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster. The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>. It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored. <h2>Are they safe?</h2> The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported. Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines. <h2>What happens next?</h2> The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated. We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<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/217804/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Professor, Infectious Diseases and Microbiology, <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/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.

Body

How do stimulants actually work to reduce ADHD symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Stimulants are <a href="https://adhdguideline.aadpa.com.au/">first-line drugs</a> for children and adults diagnosed with attention-deficit hyperactivity disorder (ADHD). But how do they actually work? <h2>First, let’s look at the brain</h2> ADHD is a neurodevelopmental condition, which means it affects how the brain functions. Medical imaging indicates people with ADHD may have slight differences in their brain’s <a href="https://jamanetwork.com/journals/jama/article-abstract/195386">structure</a>, the way their brain regions work together to perform tasks, and how their brain’s chemical messengers, called neurotransmitters, pass on information. These brain differences are associated with the symptoms of ADHD, including inattention, impulse control and problems with memory. <h2>What stimulants are prescribed in Australia?</h2> The three main stimulants prescribed for ADHD in Australia are dexamfetamine, methylphenidate (sold under the brand names Ritalin and Concerta) and lisdexamfetamine (sold as Vyvanse). Dexamfetamine and methylphenidate have been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/">since</a> the 1930s and 1940s respectively. Lisdexamfetamine is a newer stimulant that has been around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">since</a> the late 2000s. Dexamfetamine and lisdexamfetamine are amphetamines. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/">Lisdexamfetamine</a> is inactive when it’s taken and actually changes into active dexamfetamine in the red blood cells. This is what’s known as a “prodrug”. <h2>So how do they work for ADHD?</h2> Stimulant drugs are thought to alter the activity of key neuotransmitters, dopamine and noradrenaline, in the brain. These neurotransmitters help with attention and focus, among other things. Stimulants increase the amount of dopamine and noradrenaline in the tiny gaps between neurons, known as synapses. They do this by predominantly blocking a transporter that then prevents their re-uptake back into the neuron that released them. This means more dopamine and noradrenaline can bind to their respective receptors. This <a href="https://www.tga.gov.au/sites/default/files/auspar-lisdexamfetamine-dimesilate-180515-pi.pdf">helps</a> connected neurons in the brain talk to one another. Amphetamines also increase the amount of dopamine the neuron releases into the synapse (the tiny gaps between neurons). And it stops the enzymes that break down dopamine. This results in an increase of dopamine in the synapse. <h2>What effect do they have on ADHD symptoms?</h2> We still don’t fully understand the underlying brain mechanisms that change behaviour in people with ADHD. But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109107/">research shows</a> stimulants that modulate noradrenaline and dopamine can improve brain processes such as: <ul> <li>attention</li> <li>memory</li> <li>decision-making</li> <li>task completion</li> <li>hyperactivity.</li> </ul> They can also improve general behaviour, such as self-control, not talking over the top of others, and concentration. These behaviours are important for social interactions. Stimulants <a href="https://pubmed.ncbi.nlm.nih.gov/15737659/">reduce ADHD symptoms</a> in about 70% to 80% of children and adults who take them. Some people will notice their symptoms improve right away. Other times, these improvements will be more noticeable to parents, carers, teachers, colleagues and partners. <h2>Not everyone gets the same dose</h2> The optimal stimulant dose varies between individuals, with multiple dosage options available. This enables a “start low, go slow” approach, where the stimulant can be gradually increased to the most effective dose for the individual. There are also different delivery options. Dexamfetamine and methylphenidate are available in immediate-release preparations. As these have short half-lives (meaning they act quickly and wear off rapidly), they are often taken multiple times a day – usually in the morning, lunch and afternoon. Methylphenidate is also <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03175-3&d=20231023172310101">available</a> in long-acting tablets (Concerta) and capsules (Ritalin LA). They are released into the body over the day. Lisdexamfetamine is a long-acting drug and is not available in a short-acting formulation. The long-acting stimulants are generally taken once in the morning. This avoids the need to take tablets during school or work hours (and the need to store a “controlled drug”, which has the potential for abuse, outside the home). <h2>What are the side effects?</h2> The most common side effects are sleep problems and decreased appetite. A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012069.pub2/full">recent study</a> showed children and young people taking methylphenidate for ADHD were around 2.6 times more likely to have sleep problems and 15 times more likely to have a decreased appetite than those not taking methylphenidate. Headache and abdominal pain are also relatively common. <h2>Can someone without ADHD take a stimulant to improve productivity?</h2> Stimulants are tightly controlled because of their potential for abuse. In Australia, only paediatricians, psychiatrists or neurologists (and GPs in special circumstances) can prescribe them. This follows a long assessment process. As stimulants increase dopamine, they can cause euphoria and a heightened sense of wellbeing. They can also cause <a href="https://www.ncbi.nlm.nih.gov/books/NBK576548/#:%7E:text=The%20immediate%20psychological%20effects%20of,and%20may%20result%20in%20insomnia.">weight loss</a>. A common myth about stimulant medicines is they can improve the concentration and productivity of people without ADHD. A <a href="https://www.science.org/doi/full/10.1126/sciadv.add4165">recent study shows</a> the opposite is true. This study gave a group of 40 people online arithmetic tasks to complete across four sessions. At each of the sessions, participants were given either a placebo or a stimulant before completing the task. The results showed that while stimulants did not impact getting the correct answer, it increased the number of moves and time to solve the problems compared to a placebo. This indicates a reduction in productivity. However, the myth that stimulants improve study prevails. It’s likely that users feel different – after all, they are taking a medicine that speeds up messages between the brain and body. It may make them “feel” more alert and productive, even if they’re not.<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/215801/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-stimulants-actually-work-to-reduce-adhd-symptoms-215801">original article</a>.

Mind

How can I get some sleep? Which treatments actually work?

<a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months? If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia. You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next? <h2>What not to do</h2> These probably won’t help: <ul> <li> spending more time in bed often results in more time spent awake in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a> </li> <li> drinking coffee and taking naps might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening </li> <li> drinking alcohol might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid. </li> </ul> <h2>What to do next?</h2> If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours. So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills. It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia. You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>. Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some. <a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>. <h2>What if that doesn’t work?</h2> If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia. It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep. Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor. <h2>What about sleeping pills?</h2> Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful. Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep. However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence. Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits. <h2>Are there new treatments? How about medicinal cannabis?</h2> Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant). These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines. However, we don’t know if they work or are safe over the long term. <a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>. In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>. But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment. So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term. <h2>What now?</h2> If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these. Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors. <hr /> For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</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/212964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.

Body

Lots of women try herbs like black cohosh for menopausal symptoms like hot flushes – but does it work?

<a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Menopause is the stage of life where the ovaries stop releasing eggs and menstrual periods cease. Most Australian women go through menopause between <a href="https://www.nature.com/articles/nrdp20154">45 and 55</a> years of age, with the average age being 51 years, although some women may be younger. Hot flushes and night sweats are <a href="https://www.nature.com/articles/nrendo.2017.180">typical symptoms</a> of menopause, with vaginal dryness, muscle and joint pains, mood changes and sleep disturbance also commonly reported. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">75% of women</a> experience menopausal symptoms, with nearly 30% severely affected. These symptoms can negatively impact day-to-day life and wellbeing. The main therapies available include menopausal hormone therapy (MHT) and non-hormonal prescription therapy. Some women will elect to try complementary and alternative medicines, such as herbal medicines and nutritional supplements. Black cohosh is one of them. <h2>What causes hot flushes</h2> The cause of hormonal hot flushes (also called hot flashes) still isn’t completely understood, but the decline in oestrogen at menopause appears to play a role in a process that involves the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833827/">area of the brain that regulates temperature</a> (the hypothalamus). Factors linked to a greater likelihood of hot flushes include <a href="https://pubmed.ncbi.nlm.nih.gov/19675142/">being overweight or having obesity</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/25706184/">smoking</a>. MHT, previously known as hormone replacement therapy (HRT), usually includes oestrogen and is the <a href="https://pubmed.ncbi.nlm.nih.gov/26444994/">most effective treatment</a> for menopausal symptoms, such as hot flushes. But women may choose complementary and alternative medicines instead – either because they shouldn’t take hormone therapy, for example because they have breast cancer, or because of personal preference. Close <a href="https://pubmed.ncbi.nlm.nih.gov/26224187/">to 40%</a> of Australian women report using complementary and alternative medicines for menopausal symptoms, and up to 20% using them specifically to treat hot flushes and sweats. <h2>A long history</h2> Complementary and alternative medicines have a long history of use in many cultures. Today, their potential benefits for menopausal symptoms are promoted by the companies that make and sell them. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419242/">complementary and alternative medicines</a> women often try for menopausal symptoms include phytoestrogens, wild yam, dong quai, ginseng and black cohosh. Black cohosh (plant name Cimicifuga racemosa) was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">traditionally</a> used by Native Americans to treat a variety of health concerns such as sore throat, kidney trouble, musculoskeletal pain and menstrual problems. It is now a popular herbal choice for hot flushes and night sweats, as well as vaginal dryness and mood changes. There are <a href="https://pubmed.ncbi.nlm.nih.gov/37252752/">many theories</a> for how the active ingredients in black cohosh might work in the body, such as acting like oestrogen, or affecting chemical pathways in the brain. But despite extensive research, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">evidence to support these theories remains inconclusive</a>. It is also not clear whether black cohosh is effective for hot flushes. Results from individual studies are mixed, with <a href="https://pubmed.ncbi.nlm.nih.gov/17565936/">some</a> finding black cohosh improves hot flushes, while <a href="https://pubmed.ncbi.nlm.nih.gov/18257142/">others</a> have found it doesn’t. A 2012 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">review</a> combined all the results from studies of menopausal women using black cohosh to that date and found overall there was no proof black cohosh reduces hot flushes more effectively than an inactive treatment (placebo). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599854/">This review</a> also revealed that many studies did not use rigorous research methods, so the findings are hard to interpret. A more recent <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review</a> of clinical trials claimed black cohosh may ease menopausal symptoms, but the included studies were mostly small, less than six months long, and included women with mild symptoms. There is also no meaningful evidence black cohosh helps other symptoms of menopause, such as vaginal symptoms, sexual problems, or poor general wellbeing, or that it protects against bone loss. Evidence for how black cohosh is absorbed and metabolised by the body is also lacking, and it is not known what dose or formulation is best to use. More good quality studies are needed to decide whether black cohosh works for hot flushes and other menopausal symptoms. <h2>Is it safe to try?</h2> A <a href="https://pubmed.ncbi.nlm.nih.gov/33021111/">review of studies</a> suggests black cohosh is safe to use, although many of the studies have not reported possible adverse reactions in detail. Side effects such as gastrointestinal upset and rashes may occur. While there have been <a href="https://www.mja.com.au/journal/2008/188/7/liver-failure-associated-use-black-cohosh-menopausal-symptoms#0_i1091948">rare reports of liver damage</a>, there is <a href="https://pubmed.ncbi.nlm.nih.gov/21228727/">no clear evidence</a> black cohosh was the cause. Even so, in Australia, black cohosh manufacturers and suppliers are required to put a warning label for the potential of harm to the liver on their products. It is recommended black cohosh is not used by women with menopausal symptoms <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/impacted-by-breast-cancer/physical-changes/menopause/treatments-menopausal-symptoms">after breast cancer</a>, as its safety after breast cancer is uncertain. All women should consult with their doctor before using black cohosh if they are taking other medications in case of possible drug interactions. Many women like to try herbal therapies for hot flushes and other menopausal symptoms. While black cohosh is generally considered safe and some women may find it helps them, at the moment there is not enough scientific evidence to show its effects are any better than placebo. Women experiencing troublesome menopausal symptoms, such as hot flushes, should talk to their doctor about the best treatment options for them.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sasha-taylor-1461085">Sasha Taylor</a>, Research fellow, Chronic Disease & Ageing, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/susan-davis-10376">Susan Davis</a>, Chair of Women's Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/lots-of-women-try-herbs-like-black-cohosh-for-menopausal-symptoms-like-hot-flushes-but-does-it-work-211272">original article</a>.

Body

Do blue-light glasses really work? Can they reduce eye strain or help me sleep?

<a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Blue-light glasses are said to <a href="https://www.baxterblue.com.au/collections/blue-light-glasses">reduce eye strain</a> when using <a href="https://www.blockbluelight.com.au/collections/computer-glasses">computers</a>, improve your <a href="https://www.ocushield.com/products/anti-blue-light-glasses">sleep</a> and protect your eye health. You can buy them yourself or your optometrist can prescribe them. But <a href="https://mivision.com.au/2019/03/debate-continues-over-blue-blocking-lenses/">do they work</a>? Or could they do you harm? We <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">reviewed</a> the evidence. Here’s what we found. <h2>What are they?</h2> Blue-light glasses, blue light-filtering lenses or blue-blocking lenses are different terms used to describe lenses that reduce the amount of short-wavelength visible (blue) light reaching the eyes. Most of these lenses prescribed by an optometrist decrease blue light transmission by <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">10-25%</a>. Standard (clear) lenses do not filter blue light. A wide variety of lens products are available. A filter can be added to prescription or non-prescription lenses. They are widely marketed and are becoming <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">increasingly popular</a>. There’s often an added cost, which depends on the specific product. So, is the extra expense worth it? <h2>Blue light is all around us</h2> Outdoors, sunlight is the main source of blue light. Indoors, light sources – such as light-emitting diodes (LEDs) and the screens of digital devices – emit varying degrees of blue light. The amount of blue light emitted from artificial light sources is much lower than from the Sun. Nevertheless, artificial light sources are all around us, at home and at work, and we can spend a lot of our time inside. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" alt="Blue light-filtering lenses block some blue light from screens from reaching the eye" /></a><figcaption>Screens emit blue light. The lenses are designed to reduce the amount of blue light that reaches the eye. <a class="source" href="https://www.shutterstock.com/image-vector/blue-light-blocking-ray-filter-lens-2286229107">Shutterstock</a></figcaption></figure> Our research team at the University of Melbourne, along with collaborators from Monash University and City, University London, sought to see if the best available evidence supports using blue light-filtering glasses, or if they could do you any harm. So we conducted a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">systematic review</a> to bring together and evaluate all the relevant studies. We included all randomised controlled trials (clinical studies designed to test the effects of interventions) that evaluated blue light-filtering lenses in adults. We identified 17 eligible trials from six countries, involving a total of 619 adults. <h2>Do they reduce eye strain?</h2> We found no benefit of using blue light-filtering lenses, over standard (clear) lenses, to reduce eye strain with computer use. This conclusion was based on consistent findings from three studies that evaluated effects on eye strain over time periods ranging from two hours to five days. <h2>Do they help you sleep?</h2> Possible effects on sleep were uncertain. Six studies evaluated whether wearing blue-light filtering lenses before bedtime could improve sleep quality, and the findings were mixed. These studies involved people with a diverse range of medical conditions, including insomnia and bipolar disorder. Healthy adults were not included in the studies. So we do not yet know whether these lenses affect sleep quality in the general population. <h2>Do they boost your eye health?</h2> We did not find any clinical evidence to support using blue-light filtering lenses to protect the macula (the region of the retina that controls high-detailed, central vision). None of the studies evaluated this. <h2>Could they do harm? How about causing headaches?</h2> We could not draw clear conclusions on whether there might be harms from wearing blue light-filtering lenses, compared with standard (non blue-light filtering) lenses. Some studies described how study participants had headaches, lowered mood and discomfort from wearing the glasses. However, people using glasses with standard lenses reported similar effects. <h2>What about other benefits or harms?</h2> There are some important general considerations when interpreting our findings. First, most of the studies were for a relatively short period of time, which limited our ability to consider longer-term effects on vision, sleep quality and eye health. Second, the review evaluated effects in adults. We don’t yet know if the effects are different for children. Finally, we could not draw conclusions about the possible effects of blue light-filtering lenses on many vision and eye health measures, including colour vision, as the studies did not evaluate these. <h2>In a nutshell</h2> Overall, based on relatively limited published clinical data, our review does not support using blue-light filtering lenses to reduce eye strain with digital device use. It is unclear whether these lenses affect vision quality or sleep, and no conclusions can be drawn about any potential effects on the health of the retina. High-quality research is needed to answer these questions, as well as whether the effectiveness and safety of these lenses varies in people of different ages and health status. If you have eye strain, or other eye or vision concerns, discuss this with your optometrist. They can perform a thorough examination of your eye health and vision, and discuss any relevant treatment options.<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/213145/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, Associate Professor in Optometry and Vision Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-blue-light-glasses-really-work-can-they-reduce-eye-strain-or-help-me-sleep-213145">original article</a>.

Body

Autistic boy wins national golf title after only THREE games

In a heartwarming tale that's sure to make your day, a spirited 12-year-old schoolboy from a charming rural town nestled in the Bay of Plenty has ignited pure joy in New Zealand's golfing community – in a story that will warm your heart and put a smile on your face. Meet Bayleigh Teepa-Tarau, the newest sensation in the world of golf, hailing from the picturesque township of Tāneatua, a place so small it doesn't even have its own golf course. But that didn't deter this young prodigy as he set out to conquer the national Zespri AIMS Games held in the vibrant city of Tauranga. The Zespri AIMS Games is one of Australasia’s largest junior sporting events, held annually in Tauranga Moana. Celebrating diversity, the Games provides an opportunity for adolescents from all demographics and education contexts to compete in sporting competitions, to meet others from outside their normal peer group, and to learn and build on their social interaction skills. The Zespri AIMS Games is highly regarded by national education and sporting organisations and is considered a leader in its area. Now, here's the twist that's sure to make you leap with excitement: Bayleigh had played a grand total of just three rounds of golf in his entire life before this tournament! It's almost like a golfing fairytale in the making. Armed with borrowed clubs, a pair of basketball boots and a big beaming smile, our tee-master extraordinaire embarked on his golfing journey, leaving everyone in awe. You might wonder how a newcomer to the game fares in such a prestigious competition. Well, let us tell you, Bayleigh was given a scoring handicap to reflect his beginner status. And did he rise to the occasion! With booming drives and precision iron shots, he amassed a staggering 87 Stableford points over his three nine-hole rounds. A true underdog story. But Bayleigh's triumph doesn't stop there. Alongside his schoolmates Pedro Robinson and Lincoln Reritito, he clinched the team title, earning well-deserved glory for Tāneatua School. They faced off against students from schools all over New Zealand and came out on top. When asked about his love for golf, Bayleigh's face lit up with joy as he exclaimed, "The thing I love about golf is hitting my driver. I dreamed about coming here and finishing in first place. And I had a lot of fun." Thanks to the incredible support system behind this young golfing sensation, Bayleigh's journey to the top wouldn't have been possible without the unwavering support of his family, including his dad Hemi Tarau and Pare Teepa, his grandfather, and nan. Their pride in Bayleigh's accomplishments is immeasurable. What's even more inspiring is that Bayleigh has autism, and his journey has been one of transformation. From spending most of his time in class under his desk, not speaking, to becoming a golfing superstar, it's a testament to his determination and the incredible power of sports to boost confidence and bring joy. And here's another heartwarming twist – Bayleigh's path to golf was paved by his school's teacher-aide, Whetu Wiremu. He noticed Bayleigh's fascination with swinging a stick and decided to introduce him to golf. Wiremu's dedication and passion for the game not only changed Bayleigh's life but also the lives of other young students from Tāneatua School. For Wiremu, it's not just about golf but also about instilling life skills and values. He believes that golf, with its unique blend of competition and camaraderie, can offer these kids opportunities beyond their community, transcending boundaries and challenges. As for Bayleigh's future, he's setting his sights on competing in the Special Olympics. With a heart full of determination and a community that believes in him, there's no telling what incredible heights he'll reach. To that end, a <a href="https://givealittle.co.nz/cause/backing-bayleigh" target="_blank" rel="noopener">Give A Little</a> fundraising account has been established to help support this inspiring youngster and help him on his way. In the end, Bayleigh's story reminds us all that joy, determination and unwavering support can overcome any obstacle. It's a testament to the power of dreams, the magic of sports, and the beauty of small communities coming together to celebrate their rising stars. Images: Jamie Troughton / Dscribe Media

Family & Pets

How do hay fever treatments actually work? And what’s best for my symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Spring has sprung and many people are welcoming longer days and more time outdoors. But for <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever/contents/allergic-rhinitis">almost one in five Australians</a>, spring also brings the misery of watery, itchy red eyes, a runny, congested nose, and sneezing. Hay fever (also known as allergic rhinitis) is caused when an allergen enters the nose or eyes. Allergens are harmless airborne substances the body has incorrectly identified as harmful. This triggers an immune response, which leads to the release of inflammatory chemicals (mediators) – one of which is histamine. Allergens that trigger hay fever differ from person to person. Common seasonal allergens include tree, grass and weed pollens (year-round allergens include dust mites, mould and pet dander). It’s now <a href="https://www.sciencedirect.com/science/article/pii/S132602002302191X">pollen season</a> in many parts of Australia, with pollen counts at their highest and hay fever cases surging. So what medicines can prevent or reduce hay fever symptoms, and how do they work? <h2>Antihistamines</h2> Knowing the release of histamine is a cause of hay fever symptoms, it’s unsurprising that anti-histamines are one of the most frequently recommended medicines to treat hay fever. Antihistamines block histamine from binding to histamine receptors in the body and having an effect, reducing symptoms. In Australia, we broadly have two types. The older sedating (introduced in the <a href="https://www.tga.gov.au/news/safety-alerts/first-generation-antihistamines-winter-warning">1940s</a>) and newer, less-sedating (introduced in the 1980s) antihistamines. Less-sedating antihistamines used to treat allergic rhinitis include bilastine (Allertine), cetirizine (Zyrtec), loratadine (Claratyne) and fexofenadine (Telfast). Bilastine, which came onto the Australian market only last year, is only available from a pharmacy, on recommendation from a pharmacist. The others have been around longer and are available at supermarkets and in larger quantities from pharmacies. Cetirizine is the <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/35-cetirizine-hydrochloride#:%7E:text=Risks%20of%20cetirizine%20hydrochloride%20use,significant%20at%20the%20proposed%20doses.">most likely</a> (of the less-sedating antihistamines) to cause sedation. The older sedating antihistamines (such as promethazine) cross the blood-brain barrier, causing drowsiness and even brain fog the next day. They have lots of side effects and potential drug interactions, and as such have little place in the management of hay fever. The newer less-sedating antihistamines are <a href="https://australianprescriber.tg.org.au/articles/antihistamines-and-allergy.html#:%7E:text=Less%20sedating%20antihistamines%20are%20equally,an%20ongoing%20good%20safety%20profile">equally effective</a> as the older sedating ones. Antihistamines are usually taken orally (as a tablet or solution) but there are also topical preparations such as nasal sprays (azelastine) and eye drops. Antihistamine nasal sprays have <a href="https://www.sciencedirect.com/science/article/abs/pii/S108112061000743X">equal to or better efficacy</a> than oral antihistamines. The individual response to antihistamines varies widely. For this reason, you may need to trial several different types of antihistamines to see which one works best for you. Increasing the dose of an antihistamine, or combining an oral and topical antihistamine, does not provide any additional benefit. Paying extra for a brand name doesn’t offer any more or less effect than the generic (both have the same active ingredient and are <a href="https://www.tga.gov.au/news/news/generic-prescription-medicines-fact-sheet">bioequivalent</a>, which means they have the same outcomes for patients). <h2>Steroid nasal sprays</h2> If your symptoms don’t improve from antihistamines alone, a nasal spray containing a corticosteroid is often recommended. Corticosteroids prevent the release of several key chemicals that cause inflammation. How they work is complex: in part, corticosteroids “turn off” the production of late phase inflammatory mediators (cytokines and chemokines). This reduces the future release of more inflammatory mediators, which reduces inflammation. Corticosteroids and antihistamines have different mechanisms of action. Research shows corticosteroid nasal sprays are <a href="https://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4397">more effective</a> than antihistamines in controlling an itchy, runny, congested nose. But when instilled into the nose, corticosteroids <a href="https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1016/j.otohns.2007.10.027">also reduce</a> the eye symptoms of hay fever. There are also nasal sprays that contain both an antihistamine and corticosteroid. While there are a range of corticosteroid nasal sprays containing different active ingredients, a large study published this year shows they are all <a href="https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full">about as effective as each other</a>, and work best when they have been taken for several days. <h2>Sodium cromoglycate</h2> Another medicine used to treat hay fever symptoms is sodium cromoglycate, which is available as an eye drop and over-the-counter in pharmacies. This medicine is known as a mast cell stabiliser. As the name suggests, it stabilises or prevents mast cells from breaking down. When mast cells break down, they release histamine and other chemicals that cause inflammation. This eye drop is both a preventative and treatment medicine, usually used before allergies strike. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375451/">Evidence shows</a> it is effective at reducing the symptoms of allergic conjunctivitis (eye inflammation from allergies). <h2>Decongestants</h2> Decongestants constrict blood vessels. They can be taken orally, administered as a nasal spray, or instilled into the eyes. When administered into the eyes it will reduce redness, and when administered into the nose, it will stop it from running. However, decongestants should be used for a short duration only and are not for long term use. In fact, if a nasal spray decongestant is used for more than five days, you can experience something called “rebound congestion”: a severe stuffy nose. <h2>Saline</h2> Saline (saltwater) nasal sprays or irrigation products are also available to flush out the allergens and provide hay fever relief. While there are not many studies in the area, there is evidence that saline irrigation <a href="https://www.cochrane.org/CD012597/ENT_nasal-saline-allergic-rhinitis#:%7E:text=Saline%20irrigation%20may%20reduce%20patient,any%20outcomes%20beyond%20three%20months">may reduce hay fever symptoms</a>. Saline is safe and is not associated with adverse effects. If you’re suffering from hay fever symptoms and unsure what to try, talk to your prescriber or pharmacist, who can guide you through the options and identify the best one for your symptoms, medical conditions and medicines. Allergen immunotherapy (or allergen shots) is another option hay fever sufferers <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy-faqs">may discuss</a> with their doctors. However it’s not a quick fix, with therapy taking three to five years.<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/213071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">original article</a>.

Body

Over 60

News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

Fasting, eating earlier in the day or eating fewer meals – what works best for weight loss?

I spoke to 100 Japanese seniors, and learnt the secret to a good retirement is a good working life

How do heat protectants for hair work? A chemistry expert explains

"Ridiculous and disrespectful": Groom goes viral for working on wedding day

I’m iron deficient. Which supplements will work best for me and how should I take them?

Holiday protesters are missing the big picture – there are ways to make tourism work for everyone

The tragic reason Miriam Margolyes is still working at 83

Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health

After 180 years, new clues are revealing just how general anaesthesia works in the brain

How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

Boss slammed for demanding an employee complete work during annual leave

What is micellar water and how does it work?

World's oldest dog has title suspended amid doubts about his age

What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

How do stimulants actually work to reduce ADHD symptoms?

How can I get some sleep? Which treatments actually work?

Lots of women try herbs like black cohosh for menopausal symptoms like hot flushes – but does it work?

Do blue-light glasses really work? Can they reduce eye strain or help me sleep?

Autistic boy wins national golf title after only THREE games

How do hay fever treatments actually work? And what’s best for my symptoms?