Monthly Archives: July 2014

Sit less, move more: new physical activity guidelines

7 February 2014, 6.24pm AEST

Sit less, move more: new physical activity guidelines

Australians should aim for around 60 minutes of physical activity per day, double the previous recommendation, according…

If you’ve been sitting for an hour, you’ve been sitting for too long. Image from shutterstock.com

Australians should aim for around 60 minutes of physical activity per day, double the previous recommendation, according the new national physical activity guidelines, published today.

And for the first time, the guidelines urge the 12 million Australians who are sedentary or have low levels of physical activity to limit the time they spend sitting.

The recommendations aim to prevent unhealthy weight gain and reduce the risk of some cancers. Physical inactivity is the second-greatest contributor to the nation’s cancer burden, behind smoking.

The guidelines emphasise that doing any physical activity is better than doing none, but ideally adults will get 150 minutes of moderate physical activity each week. This includes brisk walking, recreational swimming, dancing and household tasks such as raking leaves.

This could be swapped for 75 minutes of high-intensity exercise that makes you “huff and puff”, such as jogging, aerobics, fast cycling and many organised sports. Ten minutes of vigorous exercise equals moderate-intensity activity.

The guidelines also recommend including muscle-strengthening activities at least two times a week. This could be achieved by going to the gym and using free weights or resistance exercise machines.

“But it also includes things like going to the store and carrying your shopping bags,” said Jannique van Uffelen, senior research fellow in active living at Victoria University. “It’s anything where you’ve got repeated stimuli with increasing weight or resistance for your muscles so they become stronger.”

Baker IDI’s laboratory head of physical activity David Dunstan said he was heartened to see the recommendations emphasise the health harms of prolonged sitting, for which there has been growing evidence over the past decade.

“For many people, sitting occupies a lot of their time. We need to be encouraging people to avoid long periods of sitting and break up sitting throughout the day,” he said.

“If you’ve been sitting for an hour, you’ve been sitting for too long. We should be aiming to break up sitting times with light-intensity activity one to two times per hour.”

The other major change to the guidelines is the inclusion of muscle strengthening activity, Associate Professor Dunstan said, and the acknowledgement that while brisk walking will improve heart fitness, it will not necessarily improve muscle strength.

“What happens is as we hit the age of 45, we start to lose our muscle mass and that’s accelerated once we get past 65,” he said. “As we lose our muscle mass, we lose our muscle strength, which is an important part of our daily lives.”

Dr van Uffelen said the guidelines were “thorough and comprehensive” and based on the latest international evidence. But with just 43% of Australians meeting the previous target of 30 minutes of moderate-intensity activity on most days of the week, many people found it difficult to work the recommendations into their day-to-day life.

“We live in a society where it’s often easier to jump in a car than to go for a walk or to get to places on your bike,” Dr van Uffelen said.

Governments must “make it easier for people to choose the active option, instead of the passive option – for example, good infrastructure for active transport,” she said.

Kids’ activity

The guidelines recommend children aged five to 12 accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity each day and include activities that strengthen the muscles and bones three days per week.

“We’re not suggesting that young children go out and start lifting weights,” said Alfred Deakin Professor at Deakin University Jo Salmon, who co-authored the scientific review and recommendations for children.

“Strength training activities include running, jumping, skipping, sports like netball or basketball – anything that involves being on your feet and running around. Even hanging from the monkey bars, you’re holding their own body weight,” she said.

“This is based on evidence around strength training for optimising bone health for kids – that’s really going to see them have much less chance of developing osteoporosis in adulthood. Childhood is really a key period for laying down healthy bones.”

The guidelines also emphasise the importance of reducing the time children spend sitting. And it’s not just to promote physical health, Professor Salmon said, emerging evidence shows prolonged sitting affects cognitive development and educational outcomes.

Teachers can play a part by delivering standing lessons, she said, by delivering standing lessons, getting children up during class, giving active homework and encouraging students to complete their homework while standing.

“The other major part of sitting for a lot kids and adolescents is sitting in a car. So if you can promote active transport and even public transport and walking to school, you’re going to reduce the sitting time in transit,” Professor Salmon said.

Eating and sleeping well hold keys to a longer life

Eating and sleeping well hold keys to a longer life

31 January 2014

© Wavebreakmedia Ltd | Dreamstime.com

Researchers have found there is a link between sleep and diet and lifespan. © Wavebreakmedia Ltd | Dreamstime.com

Good sleep patterns can help men live longer – but women will only benefit if they also have a diverse diet, a new study shows.

The Monash University-led collaborative study found that women who ate a varied diet that included sources rich in vitamin B6 could still live long lives despite poor sleep habits.

The researchers from Monash University, the National Defense Medical Centre, Taiwan, and the National Health Research Institutes, Taiwan, investigated the ways diet contributed to the relationship between sleep quality and mortality among elderly men and women.

Emeritus Professor Mark Wahlqvist from Monash University’s Department of Epidemiology and Preventive Medicine and the Monash Asia Institute said sleep played a more important role in men’s mortality than women’s.

“Poor sleep has been associated with increased morbidity and mortality including obesity, diabetes, cardiovascular disease and coronary heart disease,” Professor Walhqvist said.

“We found that for both genders, poor sleep was strongly correlated with poor appetite and poor perceived health.

“There was significant interaction between sleep quality and dietary diversity. For men, poor sleep was not associated with a greater risk of death unless there was also insufficient dietary diversity. For women, good sleep only provide a survival advantage if they had a diverse diet.”

The study found women were almost twice as likely as men to sleep badly. Women who were poor sleepers had a lower intake of vitamin B6 from food than those whose sleep was rated fair or good. Fair sleepers had lower iron intakes than good sleepers.

Both men and women could improve their outlook by eating a more varied diet.

“Sufficient dietary diversity in men could offset the adverse effect on mortality of poor sleep while women need to make sure they are eating foods high in vitamin B6,” Professor Walhqvist said.

Professor Wahlqvist saidpeople who did not sleep well were also less able to chew, had poor appetites, and did less physical activity.

“These characteristics could contribute to lower overall dietary quality and food and nutrient intake, especially for vegetables, protein-rich foods, and vitamin B-6,” Professor Wahlqvist said.

“They may also contribute to the risk of death, either in their own right or together with problematic sleep. Intervention focusing on education on healthy dietary practices in elderly people could improve sleep duration and provide more stable levels of health.”

The study was recently published in the Journal of the American College of Nutrition.

Oestrogen and Testosterone use did not increase breast cancer risk.

This is another clinical study showing no connection between oestrogen/testosterone use and breast cancer. It is firmly fixed in most women’s thinking that oestrogen=breast cancer, but it is not as simple as that, as this study shows. Sometimes oestrogen actually kills breast cancer cells, that is how complicated it is.

Combined conjugated esterified estrogen plus methyltestosterone supplementation and risk of breast cancer in postmenopausal women
Maturitas, 07/01/2014  Clinical Article

Kabat GC, et al. – The current study assessed the association of combination conjugated esterified estrogen and methyl testosterone (CEE+MT) use and breast cancer risk in postmenopausal women in the Women’s Health Initiative (WHI). The present study, the largest prospective study to date, did not show a significant association of CEE+MT supplementation and risk of breast cancer.

Methods

  • At Year 3 of follow–up, women in the WHI observational study (N=71,964) provided information on CEE+MT use in the past two years, duration of use, and the brand name of the product.
  • In addition, in each of years 4–8, women were asked whether they had used CEE+MT in the previous year.
  • After 10 years of follow–up, 2832 incident breast cancer cases were identified.
  • Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association of CEE+MT use (irrespective of use of other hormones) and of exclusive CEE+MT use in relation to breast cancer risk.

Results

  • Neither CEE+MT use nor exclusive use of CEE+MT was associated with risk: multivariable–adjusted HR 1.06, 95% CI 0.82–1.36 and HR 1.22, 95% CI 0.78–1.92, respectively.
  • Among women with a natural menopause, the HR for exclusive use was 1.32 (95% CI 0.68–2.55).
  • There was no indication of an association when repeated measures of CEE+MT use were included in a time–dependent covariates analysis.

How Fiber Prevents Diabetes, Obesity

How Fiber Prevents Diabetes, Obesity

Jan. 14, 2014 — Scientists have known for the past twenty years that a fiber-rich diet protects the organism against obesity and diabetes but the mechanisms involved have so far eluded them. A French-Swedish team including researchers from CNRS, Inserm and the Université Claude Bernard Lyon 1 (Unité Inserm 855 “Nutrition et Cerveau”) has succeeded in elucidating this mechanism, which involves the intestinal flora and the ability of the intestine to produce glucose between meals. These results, published in the journal Cell on 9 January 2014, also clarify the role of the intestine and its associated microorganisms in maintaining glycaemia. They will give rise to new dietary recommendations to prevent diabetes and obesity.


Most sweet fruit and many vegetables such as salsify, cabbage or beans are rich in so-called fermentable fibers. Such fibers cannot be digested directly by the intestine but are instead fermented by intestinal bacteria into short-chain fatty acids such as propionate and butyrate, which can in fact be assimilated by our bodies. The protective effect of these fibers is well known to researchers: animals fed a fiber-rich diet become less fat and are less likely to develop diabetes than animals fed a fiber-free diet. Nevertheless, the mechanism behind this effect has until now remained a mystery.

The team headed by Gilles Mithieux, CNRS researcher in the “Nutrition et Cerveau” unit (Inserm / Université Claude Bernard Lyon 1), wondered whether this mechanism could be linked to the capacity of the intestine to produce glucose. The intestine is in fact capable of synthesizing this sugar and releasing it into the blood stream between meals and at night. However, glucose has particular properties: it is detected by the nerves in the walls of the portal vein (which collects the blood coming from the intestine), which in turn sends a nerve signal to the brain. In response, the brain triggers a range of protective effects against diabetes and obesity: the sensation of hunger fades, energy expenditure at rest is enhanced and, last but not least, the liver produces less glucose.

In order to make the connection between fermentable fibers and the production of glucose by the intestine, the researchers subjected rats and mice to diets enriched with fermentable fibers, or with propionate or butyrate. They then observed a strong induction of the expression of genes and enzymes responsible for the synthesis of glucose in the intestine. They showed that the intestine of these animals used propionate as precursor to increase the production of glucose. Mice fed a fat- and sugar-rich diet, but supplemented with fibers, became less fat than control mice and were also protected against the development of diabetes thanks to significantly increased sensitivity to insulin.

The researchers repeated the experiment with mice whose intestine’s ability to produce glucose had been suppressed by genetic engineering. No protective effect was then observed: these mice became fat and developed diabetes like those fed a fiber-free diet. It is therefore the production of glucose by the intestine from propionate and butyrate that is behind the positive effects of fermentable fibers on the organism.

Apart from this previously unknown mechanism, this work sheds light on the role of the intestinal flora which, by fermenting dietary fiber, provides the intestine with precursors to produce glucose. It also demonstrates the importance of the intestine in the regulation of glucose in the body. Finally, these findings should make it possible to propose nutritional guidelines and to highlight new therapeutic targets for preventing or treating diabetes and obesity.

Heroic Measures

Heroic Measures

JAN. 12, 2014

Launch media viewer
Brian Stauffer

LISA BONCHEK ADAMS has spent the last seven years in a fierce and very public cage fight with death. Since a mammogram detected the first toxic seeds of cancer in her left breast when she was 37, she has blogged and tweeted copiously about her contest with the advancing disease. She has tweeted through morphine haze and radiation burn. Even by contemporary standards of social-media self-disclosure, she is a phenomenon. (Last week she tweeted her 165,000th tweet.) A rapt audience of several thousand follows her unsparing narrative of mastectomy, chemotherapy, radiation, biopsies and scans, pumps and drains and catheters, grueling drug trials and grim side effects, along with her posts on how to tell the children, potshots at the breast cancer lobby, poetry and resolute calls to “persevere.”

In the last month or two, her broadcasts have changed tone slightly; her optimism has become a little less unassailable. As 2013 ended, the cancer that had colonized her lymph nodes, liver, lungs and bones had established a beachhead in her spine, the pathway to her (so far tumor-free) brain. She was deemed too sick to qualify for the latest drug trial. She is bedridden at New York’s Memorial Sloan-Kettering Cancer Center, which has embraced her as a research subject and proselytizer for the institution.

Lisa Adams is still alive, still blogging, and insists she is not dying, but the blog has become less about prolonging her survival and more about managing her excruciating pain. Her poetry has become darker.

“The words of disease become words my brain gravitates to,” she pecked the other day after a blast of radiation. “The ebb and flow of cancer, Of life. And so too, Inevitably, Of death.”

In October 2012 I wrote about my father-in-law’s death from cancer in a British hospital. There, more routinely than in the United States, patients are offered the option of being unplugged from everything except pain killers and allowed to slip peacefully from life. His death seemed to me a humane and honorable alternative to the frantic medical trench warfare that often makes an expensive misery of death in America.

Among doctors here, there is a growing appreciation of palliative care that favors the quality of the remaining life rather than endless “heroic measures” that may or may not prolong life but assure the final days are clamorous, tense and painful. (And they often leave survivors bankrupt.) What Britain and other countries know, and my country is learning, is that every cancer need not be Verdun, a war of attrition waged regardless of the cost or the casualties. It seemed to me, and still does, that there is something enviable about going gently. One intriguing lung cancer study even suggests that patients given early palliative care instead of the most aggressive chemotherapy not only have a better quality of life, they actually live a bit longer.

When my wife, who had her own brush with cancer and who has written about Lisa Adams’s case for The Guardian, introduced me to the cancer blog, my first thought was of my father-in-law’s calm death. Lisa Adams’s choice is in a sense the opposite. Her aim was to buy as much time as possible to watch her three children grow up. So she is all about heroic measures. She is constantly engaged in battlefield strategy with her medical team. There is always the prospect of another research trial to excite her hopes. She responds defiantly to any suggestion that the end is approaching.

“I am not on my deathbed,” she told me in an email from the hospital. “Periods of cancer progression and stability are part of the natural course of this disease. I will be tweeting about my life and diagnosis for some time to come,” she predicted, and I hope she’s right. In any case, I cannot imagine Lisa Adams reaching a point where resistance gives way to acceptance. That is entirely her choice, and deserving of our respect. But her decision to live her cancer onstage invites us to think about it, debate it, learn from it.

The first thing I would say is that her decision to treat her terminal disease as a military campaign has worked for her. Her relationship with the hospital provides her with intensive, premium medical care, including not just constant maintenance and aggressive treatment but such Sloan-Kettering amenities as the Caring Canines program, in which patients get a playful cuddle with visiting dogs. (Neither Adams nor Sloan-Kettering would tell me what all this costs or whether it is covered by insurance.)

Whether or not this excellent care has added months or years to her life, as she clearly believes, is a medical judgment, and her doctors, bound by privacy rules, won’t say. Most trials of new drugs aim to determine safety and calibrate dosages, and make no promise of slowing the disease in the participants. But any reader can see that Adams’s online omnipresence has given her a sense of purpose, a measure of control in a tumultuous time, and the comfort of a loyal, protective online community. Social media have become a kind of self-medication.

Lisa Adams’s defiance has also been good for Memorial Sloan-Kettering. She has been an eager research subject, and those, I was surprised to learn, are in short supply. Scott Ramsey of the Fred Hutchinson Cancer Research Center in Seattle cited a study showing that only 3 percent of adult cancer patients who are eligible to enroll in clinical trials do so, and, he said, their reluctance has been “a huge bottleneck in cancer research.” Some 40 percent of clinical trials fail to get the minimum enrollment. Adams has been a cheerleader for cancer research in general and Memorial Sloan-Kettering in particular. In fact, she has implored followers to contribute to a research fund set up at the hospital in her name, and has raised about $50,000 so far. “We love it!” the hospital tweeted last week about the Lisa Adams phenomenon. “An important contribution to cancer patients, families, and clinicians! :)”

Beyond that, whether her campaign has been a public service is a more complicated question.

“I am public about this disease in order to shed light on the daily lives of women living with this diagnosis rather than hiding behind the pink party line that is the only one that gets the spotlight,” she told me in an email. (The ubiquitous pink-ribbon breast cancer campaigners have been faulted for overselling the wonders of early detection and giving short shrift to research.)

Her digital presence is no doubt a comfort to many of her followers. On the other hand, as cancer experts I consulted pointed out, Adams is the standard-bearer for an approach to cancer that honors the warrior, that may raise false hopes, and that, implicitly, seems to peg patients like my father-in-law as failures.

Steven Goodman, an associate dean of the Stanford University School of Medicine, said he cringes at the combat metaphor, because it suggests that those who choose not to spend their final days in battle, using every weapon in the high-tech medical arsenal, lack character or willpower.

“I’m the last person to second-guess what she did,” Goodman told me, after perusing Adams’s blog. “I’m sure it has brought meaning, a deserved sense of accomplishment. But it shouldn’t be unduly praised. Equal praise is due to those who accept an inevitable fate with grace and courage.”

Blood-type diet does not work

I have always been very sceptical of the blood type diet, but at least  the author of the book did very well from the book, so at least someone benefited from this diet.  Here is some research on this diet.

 

17 January 2014, 12.18pm AEST

Blood-type diet does not work

The diet suggesting that nutritional needs vary according to blood type does not work, a study has found.

The way an individual responds to a diet based on blood-type has nothing to do with their blood-type but instead their ability to stick to a low-carbohydrate or vegetarian diet.

The study involved 1,455 participants.

ABO Genotype, ‘Blood-Type’ Diet and Cardiometabolic Risk Factors

  • Jingzhou Wang,
  • BibianaGarcía-Bailo,
  • Daiva E. Nielsen,
  • AhmedEl-Sohemy mail
  • Published: January 15, 2014
  • DOI: 10.1371/journal.pone.0084749

Abstract

Background

The ‘Blood-Type’ diet advises individuals to eat according to their ABO blood group to improve their health and decrease risk of chronic diseases such as cardiovascular disease. However, the association between blood type-based dietary patterns and health outcomes has not been examined. The objective of this study was to determine the association between ‘blood-type’ diets and biomarkers of cardiometabolic health and whether an individual’s ABO genotype modifies any associations.

Methods

Subjects (n = 1,455) were participants of the Toronto Nutrigenomics and Health study. Dietary intake was assessed using a one-month, 196-item food frequency questionnaire and a diet score was calculated to determine relative adherence to each of the four ‘Blood-Type’ diets. ABO blood group was determined by genotyping rs8176719 and rs8176746 in the ABO gene. ANCOVA, with age, sex, ethnicity, and energy intake as covariates, was used to compare cardiometabolic biomarkers across tertiles of each ‘Blood-Type’ diet score.

Results

Adherence to the Type-A diet was associated with lower BMI, waist circumference, blood pressure, serum cholesterol, triglycerides, insulin, HOMA-IR and HOMA-Beta (P<0.05). Adherence to the Type-AB diet was also associated with lower levels of these biomarkers (P<0.05), except for BMI and waist circumference. Adherence to the Type-O diet was associated with lower triglycerides (P<0.0001). Matching the ‘Blood-Type’ diets with the corresponding blood group did not change the effect size of any of these associations. No significant association was found for the Type-B diet.

Conclusions

Adherence to certain ‘Blood-Type’ diets is associated with favorable effects on some cardiometabolic risk factors, but these associations were independent of an individual’s ABO genotype, so the findings do not support the ‘Blood-Type’ diet hypothesis.

Trick or treat? Alternative therapies for menopause

13 February 2014, 2.32pm AEST

Trick or treat? Alternative therapies for menopause

During menopause, estrogen levels drop, leading to a number of unpleasant symptoms. The transition to menopause can significantly affect women’s quality of life, with many willing to try anything to alleviate…

What really works to alleviate hot flushes and other symptoms of menopause? splityarn/Flickr

During menopause, estrogen levels drop, leading to a number of unpleasant symptoms.

The transition to menopause can significantly affect women’s quality of life, with many willing to try anything to alleviate the hot flushes, night sweats, decline in libido, backaches and other symptoms that result from their drop in oestrogen levels.

Hormone replacement therapy (HRT) is the most effective treatment for the relief of menopause symptoms and works by topping up declining oestrogen levels with synthetic version of the hormone. It’s effective around 80% to 90% of the time.

HRT comes with a small increase in the risk of breast cancer and blood clots. But due to the severity of the menopausal symptoms, many women believe the benefits of HRT outweigh the relatively small risks associated with the treatment. Being overweight, for instance, carries a far higher risk of developing breast cancer compared with the risks associated with taking HRT for less than five years.

A large clinical trial published a decade ago sparked widespread fears that HRT could cause cancer, stroke and heart disease. While the risks are now considered to have been overstated, they led to a dramatic decline in the use of hormone therapy.

Just because products are natural, doesn’t mean they’re risk-free. sanzibar/Flickr

As many as 60% of women between the age 50 to 60 now use complementary and alternative treatments.

But while manufacturers are quick to claim to provide a wide array of benefits to menopausal women, in many instances, there’s little scientific evidence to show they work. Let’s look at what the science has to say about the safety and efficacy of these products.

Phytoestrogens

Phytoestrogens are plant-derived compounds with a similar structure to human oestrogen, but are not as potent as the synthetic hormones used in HRT.

Isoflavones

Isoflavones are a class of phytoestrogens widely consumed by women to treat menopausal symptoms, especially hot flushes. They’re found in soy beans, soy-based foods such as tofu, lentils, alfalfa sprouts and chickpeas.

Studies have shown isoflavones in soy may be beneficial for reducing cardiovascular disease and improving bone strength. But there is conflicting evidence on their effectiveness for treating menopausal symptoms. One study, for instance, suggested that isoflavone treatment may be effective only when the number of flushes experienced daily is relatively high.

Overall, it seems that soy in the diet of menopausal women may be beneficial and is unlikely to do harm.

Red clover

Red clover. randihausken/Flickr

Red clover is a plant compound that contains four different isoflavones (formononetin, biochanin A, daidzein, and genistein). It is available as a tablet, tea, or in liquid form and is widely used by menopausal women.

The data is mixed on the effectiveness of red clover to reduce menopausal symptoms. Some studies suggest it delivers no improvement over placebo while others report decreased frequency of hot flushes.

There have been no reported safety issues with taking red clover.

Herbal remedies

Herbal remedies have been used throughout the world as a traditional medicine for centuries, either in tea, tablet or powder forms.

Black cohosh

Black cohosh is an American perennial plant which has been used for hundreds of years to alleviate menopausal symptoms. It is the most studied herbal supplement, however, no researchers have identified its active constituent nor its mode of action.

Black cohosh. milesizz/Flickr

Studies have demonstrated that black cohosh is mildly effective for alleviating hot flushes and mood swings.

It’s safe to use for up to six months, although there have been case reports of liver failure in women using black cohosh for longer periods.

Further studies are required to clarify whether black cohosh may work to alleviate symptoms by mimicking estrogen.

Maca

Maca, a biennial herbaceous plant native to Peru has been used historically used for its putative fertility-enhancing and aphrodisiac properties.

Maca is marketed based on reported benefits in relieving menopause symptoms, though there is scant published scientific data show it is effective and exerts any estrogenic activity.

Evening primrose oil

Evening primrose oil is obtained from the seeds of a biennial plant native to the United States. It contains high levels of omega-6 essential fatty acids and is widely used for skin disorders, rheumatoid arthritis, multiple sclerosis, chronic fatigue, asthma and gastrointestinal disorders.

Evening primrose plant. wanderingnome/Flickr

Women have also been using primrose oil for decades for alleviating breast pain, endometriosis, and symptoms of menopause such as hot flushes.

As with other herbal supplements, the precise mechanism of action is not fully clear and the efficacy of evening primrose oil for relieving symptoms in menopausal women is not conclusive.

Dong quai

Dong quai is also prepared from the root of a perennial aromatic herb, this one native to China and Japan. Dong quai has long been used in traditional Chinese medicine to regulate menstrual cycle and alleviate menopausal symptoms.

Scientific evidence suggests it is ineffective for relieving menopausal symptoms. But when used in combination with other herbs (such as black cohosh, chasteberry, milk thistle, chamomilla and Siberian ginseng) appears to be useful in controlling hot flushes and other menopausal symptoms.

Ginseng

Ginseng. Cea./Flickr

Gingeng, a root native to Chinese medicine has been used for centuries for a number of ailments. However, few studies have examined the effects of ginseng on menopausal symptoms.

Ginseng does not have estrogenic effects, suggesting it does not exert any hormone replacement-like effects. But it has been reported to alleviate some menopausal symptoms.

Other complementary therapies

Homeopathy is a system of alternative medicine, where substances that cause symptoms of disease in healthy subjects would cure such symptoms in sick subjects. Active ingredients are used and repeatedly diluted in alcohol or distilled water until no molecules of the original substance remains.

Studies show homoeopathy is no more effective as a menopause treatment than a placebo, and since the ingredients are extensively diluted, it is unlikely to have any side effects.

The evidence for accupuncture is mixed. rocketlass/Flickr

Complementary methods such as acupuncture, moxibustion (a traditional Chinese medicine treatment that involves burning a herb called Mugwort) and reflexology are popular methods used to treat symptoms of various disease, including menopausal symptoms.

Again, there are contradictory studies, which some indicate that such complementary methods alleviate menopausal symptoms to some extent, while other studies demonstrate no benefit.

So, what’s the verdict?

Although some complementary and alternative therapies may have been used for many years with reports of great success, there is little scientific data to prove their efficacy.

And when studies have been undertaken, they’re of varying quality. Differences in findings across studies of the same product may be due to less-than-optimal trial design, variation in products and composition of products used, inadequate dosing, the length of treatment and small population size.

There’s no doubt that more clinical trials are required to ascertain the effectiveness of such methods in treating menopausal symptoms. In the meantime, exercise caution when taking complementary therapies and talk to your doctor about how they’ll interact with other medications you’re taking.

Just because they’re natural, doesn’t mean they’re risk-free.

BPA linked to prostate cancer

BPA is a chemical that is in many of the plastics we use in our homes. There have been many questions about the safety of this substance. Here is a recent study showing that it is not safe. Use glass, paper, cardboard and pottery wher3ever possible, and avoid plastic, especially soft plastic wherever possible.

BPA linked to prostate cancer, study shows Full Text
EurekAlert!, 03/04/2014

Findings by Cincinnati Cancer Center researchers show that levels of bisphenol A (BPA) in men’s urine could be a marker of prostate cancer and that low levels of BPA exposure can cause cellular changes in both non–malignant and malignant prostate cells. This research, published in the March 3 edition of PLOS ONE, provides the first evidence that urinary BPA levels may help predict prostate cancer and that disruption of a cell duplication cycle through exposure to low–dose BPA may cause cancer development in the prostate.

A hot toddy for the winter chill

0 June 2014, 2.20pm AEST

Health Check: a hot toddy for the winter chill

Feeling miserable? Is your nose blocked and your throat sore? If not, it will be sometime this winter, probably at least a couple of times. And then someone will probably say at your low ebb that “you…

They may not cure your cold but they’ll will help you forget your miseries. Drew Leavy/Flickr, CC BY-NC-ND

Feeling miserable? Is your nose blocked and your throat sore? If not, it will be sometime this winter, probably at least a couple of times. And then someone will probably say at your low ebb that “you need a hot toddy (or tottie)”.

A hot toddy is the generic name for a hot drink that contains spirits, water, citrus, something sweet and something spicy. Most people use whiskey or brandy. The sweet component is made up of liberal amounts of sugar or honey. The preferred spices usually include the Christmassy ones like cinnamon, cloves, ginger, cardamom and/or nutmeg.

Toddies have much in common with mulled wine (also variously known as hot wine, glögg, Glühwein, vin chaud), in which red wine or port plays essentially the same role as spirits, is mixed with sugar and spices, and is similarly used on chilly winter nights for the same revitalising purposes. Yet it is the humble toddy that has become colloquial for “tonic” or “pick-me up”.

Whisky was historically known as the water of life. Becky Stern/Flickr, CC BY-SA

The tradition of mulled wine and its efficacy dates back to ancient Rome. But toddies only joined the drink cart in the 16th and 17th centuries. It may be that if you had no access to wine (which was reserved for the sacrament, imported and/or prohibitively expensive), you had to improvise. Indeed, frugal innovation was a key attribute of “make-do” Calvinist ethic.

In Latin, totie (totus) meant something that was “brought together or amalgamated”. The idiomatic “tottie” perhaps refers to the way its otherwise insoluble spices are slowly infused together into the alcohol over a low heat.

The hot toddy is very different from the beverage made from the sap of palm trees across Asia (which is also known as toddy, kallu or palm wine). It is sometimes suggested that this is where the hot toddy may have appropriated its name from, as nostalgic travellers returning to a sunless world devoid of palm trees yearned for a hot substitute to remind them of warmer climes.

Another explanation says the name “toddy” refers to the spring called “Tod’s Well” which was the main water supply to Edinburgh. The murky peat-stained water on which the Scots subsisted probably looked much like the murky spice-laden water-added whiskey concoction that they called a “toddy”.

Whiskey was historically known as “aqua vitae” (the water of life) and its medicinal properties widely recommended as a cure-all. But in those days, whiskey was almost unpalatable (and still is to many). Another origins story suggests the “toddy” was invented by doctors simply as a means to make medicinal whiskey agreeable to women and children.

Interestingly, the word “toddy” seems to come into use about the same time as (or a few glasses before) the word “toddle” meaning an unsteady gait. This also gives rise to the colloquial term for young children as “toddlers”.

However it is concocted or wherever it originally came from, its therapeutic properties are now legendary.

Allopathic traditions believe that preventing or treating an illness with its opposite is the best route. So the opposite of cold is appropriately hot, with added spices and alcohol to bring even more redness to the cheeks.

This year, most of us will catch two or three colds. Micah Taylor/Flickr, CC BY-NC-SA

Certainly, the steam from any hot drink is able to dissolve nasal mucus to open blocked nose and sinuses, for a few minutes at least. This may be the sole basis of the legendary tonic effects of chicken soup.

The citrus is a source of vitamin C. But even if you took vitamin C supplements every day for prevention, you still won’t avoid catching a cold.

Nutmeg, cloves and cinnamon have long been used to treat colds and really do contain chemicals with antihistamine, anaesthetic and/or anti-inflammatory properties. But not in the small doses obtained in a palatable hot toddy.

Probably the only proof is in fact the small amount of alcohol in a toddy, which has sedative and relaxant effects. As ever, high doses may make things worse for your cold. But with the spice and preparation time, you really only ever get to drink one hot toddy.

Ultimately, the cold will get better by itself. But while you’re feeling down, a toddy can help you forget your miseries. Which is really what it’s for.