Coca-Cola made headlines this week with a new television advertising campaign. It begins with a voice-over: “We’d like people to come together on something that concerns all of us – obesity”. The ad then lists all the ways Coca-Cola is playing “an important role” in preventing obesity.

This Coca-Cola marketing strategy is not, as the New York Times reported, “novel” or new. For a number of years, teachers and principals have opened their doors to Coca-Cola. The company’s message is simple: Coca-Cola is not part of the problem of obesity, but “part of the solution”.

Coke has helped create, fund and implement a variety of school-based nutrition education and physical activity programs across the globe. These programs include Step With It®, Singapore!, Live Positively fitness centres in American schools, Happy Playtime in China, and “Zafo no jugar” in Mexico.

But far from being part of the solution, Coca-Cola’s campaigns are taking advantage of the growing fears about obesity and exploiting children’s education for the company’s financial gain.

A Trojan horse

At a time when there is a moral panic about childhood obesity, Coke’s “free” gifts of obesity-fighting, educational resources, websites, lesson plans, and events are welcomed by many schools. The lack of funding, confidence, resources and knowledge (or time) to teach health and physical education are also contributing factors.

These programs are part of the company’s global “corporate social responsibility” strategy and act as a type of reputation insurance. They divert attention away from controversial subjects, such as the impact of marketing food and beverages to children, while profiting from the “halo effect” of helping teachers teach and children avoid getting fat.

The programs also provide social branding opportunities. Although Coke’s recently published official “obesity position” states: “We believe in commercial-free classrooms for children”, some programs, such as Step With It®, Singapore!, brand the children’s workbooks, teacher resources on hydration and even the teachers and children themselves with the famous Coca-Cola logo.

Clearly, part of Coca-Cola’s business strategy is to build brand loyalty and trust in a highly publicised and philanthropic manner – and to a captive audience.

The company also develops goodwill with another important group – policymakers – and continues to successfully avoid stricter regulatory controls in areas such as fat taxes, food labelling systems, legislation and restricted marketing to children.

Self regulation remains the modus operandi of the food and drink industry. This is assisted by a proliferation of “partnerships” in Coke’s school-based anti-obesity programs, between Coke, government public health and education organisations, charities, voluntary groups and other private sector companies.

So what’s the problem?

Schools are sites for critical, democratic citizenship, not for the indoctrination of a multinational corporation’s view of what it means to be healthy and what a healthy body should look like.

Health and obesity are influenced by a wide range of historical, environmental, social, cultural, genetic, political, and economic factors. Coca-Cola “officially” acknowledges this complexity, yet its proposed “commonsense” school solutions are oversimplified. It tends to focus on the same old “burn more calories, eat fewer calories” mantra.

By and large these Coke programs promote a narrow view of what health is (to be a healthy body weight), how it may be achieved (individual healthy lifestyle choices) and at the same time ignores the wider determinants of children’s health, such as poverty, government policy, and corporate advertising.

A child’s fatness is treated as a consequence of simply making the “wrong” (greedy and lazy) choices. The message from Coke (and the teachers who uncritically teach the Coke programs) is loud and clear: if you’re fat or unhealthy, it’s your own – or your parents’ – fault.

The unhealthy consequence is that fat children are excessively monitored, and blamed, stigmatised, even bullied for being fat “on purpose”.

While Coca-Cola continues to market itself as socially responsible around obesity, it is transferring the responsibility for the politics of health and obesity onto children themselves. And, understandably, there’s some confusion among children and teachers about why one of the largest food and drink corporations in the world are teaching them about food and drink.

What can be done?

It’s unclear whether we’ll see the Coca-Cola ads on our screens. The company is reportedly evaluating the impact of the ad campaign in the US and “its relevance for the local market”.

What is clear is that Coca-Cola will continue to use schools to “teach” children that Coca-Cola is a health-promoting company, with healthy products, and that being healthy is as simple as making the right energy balance choices – and not being fat.

Pushing for regulations to restrict marketing in schools is one way to stem the tide of school commercialism. However, as corporations such as Coca-Cola continue to use stealthy marketing strategies to capture children’s attention, loyalty and identities, I propose a counter strategy.

Coca-Cola’s new ad ends with the line: “we know that when people come together, we can make a real difference”. I agree. Teachers can come together with students, principals with teachers, parents with their children, and challenge Coke’s solutions and intentions.

Through discussions and debates we can question Coke’s views on obesity, challenge the assumption that “fat=lazy=unhealthy”, learn how others view health, and even take action to improve those wider influences on children’s health.

This is one way school communities could make a real difference to children’s health, rather than doing exactly what Coke wants us to do: buy their products and blame ourselves.

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Why is ovarian cancer a disease of the elderly at a time when the ovaries are inactive already for a long time?

Why is ovarian cancer a disease of the elderly at a time when the ovaries are inactive already for a long time?

Posted by on 18 January 2013 | 0 Comments

While young women in their teens and twenties can also be diagnosed with ovarian cancer, the majority of women diagnosed with ovarian cancer are aged 60 years or older. The higher the age, the higher the ovarian cancer risks. Statistically, the highest incidence rate is in females aged 85 years and older.

We asked four of the brainiest ovarian cancer experts from Australia, the US and Europe: How come that in females whose ovaries are asleep and inactive for many, many years, the ovarian cancer risk is higher than in young females with lots of activity in the ovaries?

I would like to thank the authors to tackle a tricky question for which we all know, no definitive answer exists. By speculating wildly, the authors offer different ways of approaching the subject, which makes the text an interesting read. Its just amazing how much we don’t know …

Ovarian cancer still remains a mystery and the diagnosis and treatment we have available at present are simply not good enough. Please consider supporting the Battle Against Ovarian Cancer on the 3 FEB 2013 in any way possible.

David Bowtell is a molecular researcher at the MacCallum Cancer Institute in Melbourne and a Principal Investigators of the Australian Ovarian Cancer Study, a nationwide study that produced enormous insight into molecular ovarian cancer development.

Recently, David published a ground breaking paper suggesting that more than 10% of ovarian cancers are caused by mutations in the BRCA1/2 gene and in fact inherited. He also reported that family history is very unreliable in pointing to the possibility of a BRCA1/2 mutation.

There are a couple of potential answers, but we can only speculate:

1. Cancer risks generally rise exponentially past the age of 50 year, and in this context ovarian cancer is no different to other solid cancers such as breast or colorectal cancer. There are several potential reasons:
   1. Longer exposure to carcinogens that can damage DNA;
   2. The immune function that provides a degree of protection against cancers as they are forming wanes with age;
   3. Processes that transform a normal cell to a cancer may take time.  Estimates for the length of time for transformation vary but figures of 20-30 years have been suggested for many human cancers. So one explanation is that it takes time and in most young women, not enough time has elapsed.
2. We now know that ovarian cancer is not one disease but many. Not only we don’t know what the precursor of ovarian cancer is – we don’t even know for sure if “ovarian” cancer cells come from the ovary, actually.  We are currently collecting evidence that a number of “ovarian” cancers arise from the fallopian tubes and they may arise from other tissues as well. It could well be that what is happening in the ovary (active or inactive) doesn’t make a lot of difference.  However, we do know that ovulation is a risk factor for the development of ovarian cancer.  Is it possible that ovulation creates an ideal site for early cancer cells, originating from non-ovarian sites, to lodge and develop?  Cells deposited during a time when the ovary is active are seeded, beginning their sequential process to become a full-blown cancer. This might seem a bit far-fetched but we do know that cancers of the stomach and breast can definitely seed to the ovary, even though they are anatomically distant, suggesting that there is something special about the ovary as a site for cancer cells to grow.

Penny Webb is a senior epidemiologist at the Queensland Institute of Medical Research and also a principal investigator of the OPAL Study, an Australia-wide ovarian cancer study running in all states at present. OPAL examines what lifestyle factors (diet, aspirin, exercise, etc.) contribute to improved survival after ovarian cancer treatment.

Penny is also the driver of the Australian Ovarian cancer Study (AOCS), which is to date the biggest epidemiological study on ovarian cancer world-wide, funded by the US Department of Defence. This study collected information from more than 1000 ovarian cancer patients Australia-wide.

Cancer develops when cells in the body grow out of control. This can happen when the DNA in our cells gets damaged – for example by smoking (lung cancer) or sunlight (skin cancer) – but we know that it can take many years before these early changes turn into cancer.

For ovarian cancer, it is possible that the first DNA damage does occur when a woman is younger and her ovaries are still active, but that it just takes many years for a cancer to develop. We know that pregnancy and use of the oral contraceptive pill greatly reduce a woman’s risk of getting ovarian cancer – women who have had two or more children or who have used the pill for several years are about half as likely to get ovarian cancer as women who have not had children or used the pill. We also know that the protective effects of pregnancy and pill use last for several decades. It is possible that pregnancy hormones and hormones in the pill help prevent DNA damage when a woman is younger, but that when she reaches menopause this protection is lost, DNA damage can start to occur, and the result may be cancer, sometimes 10-20 years later.

Mike Bookman is a graduate of Harvard Medical School and the Massachusetts Institute of Technology. He is now the Professor of Medicine at The University of Arizona. He is a renowned expert in gynecologic medical oncology with a focus on the development of new treatments for gynecologic cancers.  His interests also include medical information technology and the support of under-resourced countries as part of his role in the International Gynaecological cancer Society (IGCS).

Interestingly, the incidence of ovarian cancer corresponds closely with the onset of menopause in the general population, which is a younger age at onset compared to many other cancers.  While we have considered cyclic ovulation to be a potential risk factor for the development of ovarian cancer, it is not that simple, and even short interruptions in ovulation, such as would occur with just one pregnancy or use of oral contraceptives for only 6 months, can reduce the lifetime risk of ovarian cancer.  In addition, changes that promote ovarian cancer probably occur many years before the cancer develops to the point where it is detected.  Taken together, these observations suggest that the connection between ovarian “activity” and cancer development is more complex.

In addition, during the transition to menopause, there are wide fluctuations in estrogen, progesterone, and other hormonal signals (LH, FSH), which can result in the transient development of cysts and other changes in the ovary.  While these hormonal events are unlikely to directly cause ovarian cancer, they may result in symptoms or findings that could increase the detection of ovarian cancer and other abnormalities.

Clearly, the ovary is a complex organ with many different functions (hormone production, including estrogens and androgens, as well as follicle maturation).  Even after menopause, when ovulation stops, these other functions can continue.

Finally, you raised the question of ovarian cancer in younger women, but many of the tumors that occur in younger women are benign (not cancer), or low-grade (borderline tumors), or cancers that are localized and cured easily with surgery (such as mucinous tumors and some clear cell tumors).  The high-grade serous cancers that develop into advanced-stage ovarian cancer are uncommon in younger women before menopause.

In conclusion, ovarian “activity” can be measured in different ways, and we have much to learn regarding the relationship of age and activity with the development of high-grade serous ovarian cancer.

Christian Marth is the Head and Professor of the Department of Gynaecology and Obstetrics at the Innsbruck Medical University in Austria. Christian published more than 250 articles in peer-reviewed journals and one of this top interests are immunotherapy in patients with ovarian cancer.

Ovarian cancer is not only one disease. We distinguish different types, which also will be caused by different mechanism. Some of them might derive from the fallopian tube, the endometrium, or the intestinal tract. Ovarian cancer is therefore not directly linked to the activity of the ovary. It is more important that over time changes in the DNA occur (e.g. mutations) which turns a normal cell into a cancer cell. Since these changes accumulate during life the probability to develop ovarian cancer is higher in elder women. However, high activity in the ovary such as frequent ovulation increases the probability of mutations and by the way of ovarian cancer. This fact explains why oral contraceptives or frequent pregnancies result in an inhibition of ovulation and protect against ovarian cancer.

The Battle Against Ovarian Cancer will be fought on 3 February 2013 at Nat Cook’s Sandstorm Beach Club in Upper Mount Gravatt in Brisbane. The Queensland Firebirds, Former Origin Greats, the Speaker of the Queensland Parliament, the Minister for Sport, and more VIPs have committed to playing Beach Volleyball to help fund better outcomes for ovarian and gynaecological cancer. I thank you for all your support. www.battleagainstovariancancer.org

I do understand why people don’t like New Year’s resolutions: They can be a source of failure, year after year. Folks often pick resolutions that are inherently unrewarding, that necessitate relentless hard work, or that remind them of their mortality in a way that makes them feel small instead of grateful.

I know because I’ve made all of those mistakes. But now? I love New Year’s resolutions. I use them to transform myself in small increments, taking turtle steps toward new habits. I begin slowly around the winter solstice, and inch myself toward a newer, better self. By spring, my new habits have taken hold, and the green leaves of growth unfurl.

Over the years I’ve learned a lot of tricks for successfully keeping my resolutions. And in the last three years, the science around willpower and habits has made great advancements, which helps a lot.

The first and most important factor in keeping your resolutions is to make the right resolution. Make the wrong one and you won’t keep it; you’ll just add another habit to the “fail” list.

This year, pick just one resolution that research shows will make you happier. Here are are three of my favorites:

1. Spend more time with friends. Study after study shows that we tend to be happier when we feel connected to our nearest and dearest, when we feel like we are a part of a group or a clan. Even introverts don’t like to feel lonely; this may seem like the science of the blazingly obvious, but it bears repeating. Do you frequently feel isolated or lonely? Make a resolution to routinely reach out to others.

Not sure how, or feel too busy? Join or start a group that meets regularly—maybe on the first Monday of the month, or every Friday at lunch. Some of my closest friends have come from book clubs, church groups, and standing family dinners. When we routinize our friendships, we remove the hassle of scheduling, and increase the odds that we’ll actually spend time with people we love or want to get to know better.

2. Everyday, find a way to give something to somebody. My favorite happiness booster is to give thanks: to a higher power for the abundance that surrounds me; to my dad for taking my kids to ice cream; to my main squeeze for all the ways he supports my work.

Equally good is to give something else—a helping hand, a compliment, a much needed $5 bill—even if it is just a tiny act of kindness. In a world that is more focused on getting than giving, a New Year’s resolution to do one kind thing each day, or to give thanks in one small way, is a pretty radical act. When we make giving a habit, we make gratitude and kindness central themes in our lives. In so doing, we transform our lives with joy.

3. Get more sleep and exercise. I know, that’s not one resolution, it’s two, but the science around these physical happiness boosters is pretty compelling. Studies are clear: You’ll be less stressed, less sick, and less grouchy in the New Year if you get more shut-eye. Try increasing your sleep 10 minutes a night for a week, and then another 10 the next week, and so on until you are regularly getting your eight hours.

If you aren’t active, you want to lose a few pounds, or you frequently feel a bit depressed, try adding more activity into your life in a way that feels fun or luxurious. I like to hike with my friend Jen and her ecstatically joyful dog Lou. It takes a couple hours out of my day (that’s the luxurious part, since I’m so strapped for time) but it leaves me feeling as bright and happy as Lou. On days when I don’t have time for a hike, I walk on a treadmill while watching Modern Family. This is luxurious and fun because I don’t watch TV at any other time.
It is miraculous to me that people can change themselves simply because they want to. New Year’s resolutions are an amazing act of creation, an art form where the canvas is the self. Cheers to making 2013 your happiest year yet!

On Sat our son, Trevor, was awarded the Order of Australia Medal (OAM). We are so proud of him.

Here are the details:

1 January 2013, 6.34am AEST

Explainer: what is depression?

Many people know what it’s like to feel sad or down from time to time. We can experience negative emotions due to many things – a bad day at work, a relationship break-up, a sad film, or just getting out of bed on the “wrong side”. Sometimes we even say that we’re feeling a bit “depressed”. But what does that mean, and how can we tell when it’s more than just a feeling?

Depression is more than the experience of sadness or stress. A depressive episode is defined as a period of two weeks or longer where the individual experiences persistent feelings of sadness or loss of pleasure, coupled with a range of other physical and psychological symptoms including fatigue, changes in sleep or appetite, feelings of guilt or worthlessness, difficulty concentrating or thoughts of death.

To be diagnosed with major depressive disorder, individuals must experience at least one depressive episode that disrupts their work, social or home life.

Depression is common in the community, with 12% of Australians experiencing major depressive disorder in their lifetime. More than 650,000 Australians have this experience in any 12-month period.

Because it’s highly prevalent and can be significantly disabling, the World Health Organization reports that depression is the third highest cause of disease burden worldwide, with a greater burden on the community than heart disease. There are also high levels of overlap between depression and other common mental disorders, including anxiety and substance use disorders.

Unfortunately, only 35% of people with symptoms of mental health problems seek help. This may be because of difficulties identifying depression in the community due to a lack of knowledge or accessing care, and stigmatising attitudes towards depression.

Depression prevention programs that provide accessible treatments, increase knowledge and change negative attitudes are an important way to increase access to treatment and reduce the burden of depression.

Causes and risk factors

There’s generally no single reason why an individual becomes depressed. There’s a constellation of risk factors, including physiological, genetic, psychological, social and demographic influences.

Biological risk factors include having a family history of depression, suffering a long-term physical illness or injury, experiencing chronic pain, using illicit drugs or certain prescription medications, chronic sleep problems, or having a baby. Having experienced depression in the past is a risk factor for a further depressive episode.

Psychological risk factors for depression include having low self-esteem, or having a tendency to be self-critical. Demographic and social influences include being female (women are almost twice as likely to suffer from depression than men), stressful life events (such as relationship conflict or caring for someone with an illness), experiencing a difficult or abusive childhood, or being unemployed.

People differ greatly in the amount or type of risk factors they’re exposed to or experience. And having several risk factors alone is not enough to trigger depression.

A combination of risk factors and the experience of stressful or adverse life events may prompt the onset of depression. The greater the number of risk factors that a person experiences, the more vulnerable they are to developing depression when stressful life events occur.

In contrast, those exposed to fewer risk factors are somewhat buffered, and may only develop depression when exposed to extreme levels of environmental stress.

Treatment and prevention

There are a number of effective treatments for depression. The most effective and widely used are cognitive-behavioural therapy and antidepressant medications.

Cognitive-behavioural therapy is a talking therapy that primarily aims to reduce negative thinking patterns, while antidepressant medications target brain chemicals thought to be implicated in depression.

There’s also evidence that low-intensity cognitive-behavioural therapy combined with education about depression can prevent individuals from developing depression. To widen the reach of such prevention programs, internet therapy programs have been developed and shown to be effective in preventing depression. Australian researchers are at the forefront of developing e-mental health platforms to reduce the prevalence of depression and other mental disorders.

There is some evidence that lifestyle changes can also help to prevent depression in some people. Engaging in healthy behaviours, such as getting adequate sleep, avoiding substance use, taking vitamins or fish oil supplements, engaging in physical activity and healthy diet, have all been shown to have associations with reduced depression symptoms. But research continues to examine whether making changes in these areas can lead directly to the prevention of depression.

Future research

There are a number of promising research areas that are currently being explored. Researchers are investigating ways to make cognitive-behavioural therapy more effective through better understanding of the processes involved in recovery. And technology has improved the availability of online, mobile and computer-based treatments, so that people at risk of depression in under-served areas such as rural locations or developing countries can access evidence-based services.

Population-based research is leading to a better understanding of risk factors for depression and improvement in its early detection. Research on the biological and genetic bases of depression is resulting in continual refinement of physical and pharmacological treatments.

A more nuanced understanding of the treatment options that work best for specific individuals has great promise for allowing an individually tailored approach to treating and preventing depression.

If you think you may be experiencing depression or another mental health problem, please contact your general practitioner or in Australia, contact Lifeline 13 11 14 for support, beyondblue 1300 22 4636 or SANE Australia for information.

Our skin is the largest organ of our body, and as such, requires the kind of care that can sustain its health and glow that only comes from taking care of it in the most natural way. Many skincare products that are sold in stores have harsh chemicals that can create havoc within our DNA — this can not be visually seen obviously, but there are certain elements that we should absolutely avoid on our body.

If I were to tell you that your personal care products could be putting you at risk for hair and skin damage, immunological problems, neurological disorders, damage to your eyes, and possibly even cancer, would you pay a little more attention to their ingredients?

This is why it’s so important to be an advocate for your own health and to achieve a natural body free from damaging chemicals; chemical companies that formulate these products which ultimately wind up on and in our body, can pose severe problems to our health.

The growing awareness of chemicals in the foods you eat has led many of you to begin reading labels. If you are doing this as part of your regular shopping routine, I commend you, and you will likely live longer for it.

But what about the products you are putting on your body which is not natural in the least?

• Eye makeup can be absorbed by your highly sensitive mucous membranes.
• Hair sprays, perfumes and powders can be inhaled, irritating your lungs.
• Lipstick is licked off and swallowed.
• Sunscreen and lotions are absorbed directly through your skin.
• Shampoo can run into your eyes or your baby’s eyes.
• Laundry detergent, in small amounts, comes in contact with your skin via your clothes
• Fabric softner contains highly toxic compounds which stay in fabric long after it’s washed
• Fluoride Toothpaste, a chemical which is a neurotoxin and offers little benefit to teeth
• Deodorant contains high levels of toxic Aluminium which has show to cause Alzheimer’s

Chemical factories in a bottle

Putting chemicals on your skin or scalp may actually be worse than eating them. When you eat something, the enzymes in your saliva and stomach acids help to break it down and flush it out of your body. However, when you put these chemicals on your skin, they are absorbed straight into your bloodstream without filtering of any kind, going directly to your delicate organs.

Once these chemicals find their way into your body, they tend to accumulate over time because you typically lack the necessary enzymes to break them down.

There are literally thousands of chemicals used in personal care products, and the U. S. government does not require any mandatory testing for these products before they are sold.

There are many protective functions your skin serves. Consider that your skin:

1. Protects your internal organs from injury and infection and is your most important defense against infections.
2. Helps eliminate wastes through perspiration.
3. Assists your immune system by providing a protective barrier to viruses and bad bacteria, thus preventing infections.
4. Provides a friendly habitat for good bacteria.
5. Helps maintain body temperature by controlling heat flow between you and your environment.
6. Seals in moisture, maintaining your body’s delicate fluid balance.
7. Produces vitamin D, which is crucial for your health.
8. Sends sensory feedback to your brain because it is rich in receptors, such as hard/soft and hot/cold, so that you can react to dangerous conditions around you.

Your skin is vital to your health, yet many people fail to take care if it. Because your skin has the ability to absorb much of what you put on it, informed choices are critical to optimize your health.

You should give your skin the same thoughtful care you give your diet, because much of what goes ON you ends up going IN you.

15 toxic chemical ingredients to avoid

To make it simple to spot on an ingredient label, what you can do to avoid exposing yourself to these known chemical on your body, is to look for the following suffixes in the ingredient list: “myreth,” “oleth,” “laureth,” “ceteareth,” any other “eth,” “PEG,” “polyethylene,” “polyethylene glycol,” “polyoxyethylene,” “paraben,” or “oxynol.” If the ingredients list has any of these in the product, you should steer clear from buying it.

To achieve a natural body free from harsh chemicals, your healthiest bet is to purchase products that are certified organic under the USDA National Organic Program, and if those aren’t available, select products whose ingredients are safe to use.

5 Things Your Skin Needs Every Day

• Drink at least one litre of filtered water a day to get adequate hydration your skin needs from the inside out.
• An all natural antioxidant moisturizing lotion to keep your body hydrated.
• Wash your face every day or dead skin cells will appear – follow up with a natural moisturizer.
• If outdoors, apply an all natural sunscreen of at least SPF 30 to achieve adequate protection from the sun.
• Cleanse your body from dead skin cells with an exfoliating natural moisturizing body wash.

Living in Australia, we’re used to flying long distances. So you’ve probably wondered about the risk of developing a deep vein thrombosis. Perhaps you’ve even considered buying some pressure stockings for that next long-haul flight?

So, what is deep vein thrombosis? And what does the evidence say about reducing our risk of developing it?

Deep vein thrombosis is the formation of a blood clot (called a thrombus) in the deep veins of the leg. The clot can be either located in the lower leg or in the thigh, or both. Rarely, a blood clot develops in other veins such as in the arm.

Eventually, the thrombus is in danger of dislocating from the vessels in the leg and going straight into the lung circulation (pulmonary embolism), thus blocking the blood supply of the lung and leading to shortness of breath.

Venous thromboembolism (VTE) – the term which encompasses both deep vein thrombosis and pulmonary embolism – affects around 52 in every 100,000 Australians and is the country’s fifth leading cause of death. So early detection and treatment is vital.

On the other end of the spectrum, blood clots can also form in the more superficial veins of the leg, just under the skin. This is called thrombophlebitis and is a much less serious condition.

Who is at risk?

There are three principal mechanisms that increase the likeliness of developing deep vein thrombosis:

1. Reduced flow of blood (from being immobilised due to illness, leg injury, or long sitting during long-haul flights),
2. Increased tendency of blood clotting (due to hereditary diseases such as Factor V Leiden disease)
3. Injury of blood vessels (from accidents or surgery).

The risk of developing a deep vein thrombosis is increased in patients who have previously had deep vein thrombosis or a pulmonary embolism, and in those with a family history of blood clots.

Other risk factors include cancer (or cancer treatment), taking contraceptive pills containing oestrogen, hormone-replacement therapy, pregnancy and conditions that cause blood clotting, such as thrombophilia.

As some of these risk factors are modifiable, there is a chance to reduce your risk by losing excess weight, quitting smoking (as smoking affects blood clotting and circulation), and using contraception methods other than oestrogen-containing pills.

On long-haul flights, car rides or bus trips, exercise your lower calf muscles. Whenever possible, get up and walk around, or raise and lower the heels while keeping the toes on the floor while sitting.

Symptoms

The first signs of deep vein thrombosis are swelling of the entire leg or, more often, one side of the calf. Sometimes there is a localised painful tenderness and reddening.

In case of the life-threatening complication of lung embolism, the symptoms are sudden shortness of breath with rapid pulse (heart rate), sweating and coughing up blood. If you have any of these symptoms, see your health practitioner immediately.

After a series of questions about the onset and characteristics of your symptoms and a thorough physical examination, further testing will confirm the diagnosis. The best way to diagnose a suspected deep vein thrombosis is an ultrasound examination of the leg. In case of a suspected pulmonary embolism, other special imaging diagnostics (computer tomography or scintigraphy) need to be applied.

Treatment options

The aims of the treatment are to stop the blood clot from getting bigger, from breaking loose – and drifting into the lung leading to pulmonary embolism – and to reduce the chances of deep vein thrombosis happening again.

Deep vein thrombosis is treated with blood thinners (anticoagulants), usually for a period of three to six months. These are mostly administered as injections in the first days, followed by tablets.

Compression stockings of the lower leg prevent the blood from pooling and subsequent clotting. The stockings should be worn for at least one year and after that, whenever immobilised, such as on long-haul flights.

The stockings also prevent one common complication that frequently occurs after deep vein thrombosis: post-thrombotic syndrome, which arises from the damage of the veins caused by the blood clot. The syndrome comprises swelling of the affected leg, pain and skin discolouration.

So, should you have an injection or wear compression stockings when you fly?

Long-haul flights (for more than four hours) increase the risk for developing deep vein thrombosis, like every other condition where your movement is restricted. Although few studies have been performed to address this question, the increase in risk seems small.

It’s important to assess the thrombosis risk on an individual basis. People at the highest risk of travel-related thrombosis who travel more than three hours should wear compression stockings. The stockings need to be individually adjusted to ensure they don’t restrict the blood flow and thereby cause, rather than prevent, thrombosis.

In general, a prophylactic injection of heparin is not recommended and wearing compression stockings on each flight has not been proven to be beneficial. This advice is, of course, different for people, who have had a previous venous thromboembolism or who have more than one risk factor for developing blood clots.

In any case, it’s important you try to reduce the modifiable risk factors for deep vein thrombosis, particularly when travelling long distances.

Dietary supplements are big business, and often people are easily drawn in by marketing claims and anecdotes that vitamin pills may be the answer to all their health concerns.

People with cancer tend to be very keen to find that “special something” to give them an edge in their fight against what is usually a frightening diagnosis. They’re also often surrounded by well-meaning family members and friends who suggest different types of supplements to help keep them strong or keep their “energy levels up”.

A study of supplement use by cancer patients in the United States found that between 64% and 81% of cancer patients and survivors used a vitamin or mineral supplement. And up to a third of cancer patients starting using supplements after they had been diagnosed. That’s a lot of people.

Those facing a battle with cancer deserve to know the full picture of what will and won’t help them survive their illness. With this in mind, a story in Thursday’s Fairfax papers about cancer patients and multivitamins deserves close examination.

The newspapers report world-renowned scientist Professor James Watson, who discovered the double helix structure of DNA, suggesting that patients could be undermining their cancer treatment by taking a high dose antioxidants. The reports are based on an article Watson published in the journal Open Biology, where he suggests that the reason late-stage cancers often become untreatable is because they produce high levels of antioxidants which block chemotherapy and radiotherapy from working.

The rationale for his argument is that antioxidants can be helpful in healthy people because they attack free radicals, which can damage DNA. But because many cancer treatments use free radicals to kill tumour cells, the counter argument may apply for those undergoing cancer treatment – the antioxidant supplements may prevent treatment from fulfilling its purpose.

Diet supplements and cancer

In a 2007 report, the World Research Cancer Fund assessed 39 randomised control trials of micronutrient supplementation in cancer survivors including retinol, beta-carotene, vitamin B6, multivitamins, vitamin E, selenium and isoflavones. It concluded that the evidence “does not show that diet supplements have any benefits in cancer survivors”.

What’s more, large-scale randomised controlled trials on the efficacy of dietary supplements for reducing the risk of cancer have raised serious safety concerns. Two of the trials (here and here), which involve people given high doses of beta-carotene, found the supplement was associated with a higher risk of lung cancer in smokers, while a third study showed neither benefit nor harm.

Most water-soluble vitamins (such as B vitamins and vitamin C) are thought to be harmless at pharmacological doses, but there are some concerns about the safety of other nutrients such as selenium, beta-carotene, magnesium and chromium, which are known to be toxic at such doses.

A meta-analysis of 47 high-quality trials found there was a slightly increased risk of mortality from antioxidant supplements in the general population. In particular, the analysis concluded that vitamin C and selenium had no significant effect on mortality and required further study but taking beta-carotene, vitamin A, and vitamin E may increase mortality.

The most recent review of multivitamin studies involving 91,000 participants found daily vitamin supplements don’t reduce the risk of dying from cancer or other causes of death.

What works

After not smoking, the most important steps people can take to lower their cancer risk are maintaining a healthy weight, being physically active and following a healthy diet. While it appears that people who eat more fruits and vegetables, which are rich sources of antioxidants, may have a lower risk of some types of cancer, the specific components that provide the protective effect are not definitively known.

It’s not possible to replicate the nutrient combinations found in food in supplement form, and because of the potential adverse effects high-dose supplementation may have, whole foods are more beneficial than supplements. The World Cancer Research Fund states that dietary supplements are not recommended for cancer prevention and people should aim to meet their nutritional needs through diet alone.

Supplements should only be taken when clinically required. There are some people with cancer who may require dietary supplements due to the side effects of their treatment or other health issues. And diet supplements may be needed by people with cancer who have a biochemically confirmed nutrient deficiency; where dietary intakes have been inadequate; and for problems related to cancer treatment or other health issues that may arise requiring supplementation.

There’s no evidence that diet supplements are a panacea for people who have cancer or for anyone who wants to prevent it. The adage that fresh fruit and veg is best still stands. People undergoing cancer treatment should always talk to their doctor about the other medication and supplements they may be taking, and seek the advice of a qualified dietitian regarding their nutrition if needed.