Research review suggests long COVID may last indefinitely for some people and mimic other ailments

Published January 17, 2023 | Originally published on MedicalXpress Breaking News-and-Events

A small team of researchers, two from the Patient-Led Research Collaborative, the other two from the Scripps Research Translational Institute, has published a Review article in the journal Nature Reviews Microbiology suggesting that long COVID might be a bigger threat than has been realized.

Prior research has shown that some people infected with the SARS-CoV-2 virus develop symptoms beyond the respiratory system. Patients have reported feeling deep fatigue, irregular heartbeat, numbness in extremities and even trouble with organs such as their liver or bladder. Over time, these patients have been diagnosed with long COVID, a mysterious condition without an official diagnostic description.

And while a lot of research has been conducted regarding the respiratory system, including treatments and therapies, and in creating vaccines, little has been done to solve the mystery of long COVID or to treat those who claim to have it. In this new effort, the researchers took a hard look at research by a variety of groups.

The authors on this new effort found evidence in prior reports suggesting that approximately 10% of people infected with COVID-19 develop long COVID and that it is most prevalent in people between the ages of 36 and 50. They also found that people who have mild cases of long COVID will likely recover from it within a year. Unfortunately, for those with more severe symptoms, the outlook is grim. They found few signs that symptoms will ever lessen.

They also found that in many cases, the symptoms of long COVID become nearly indistinguishable from several other conditions, such as chronic fatigue syndrome, mast cell activation syndrome and postural orthostatic tachycardia syndrome. Notably, they point, out, many such symptoms are consistent with autonomic dysfunction.

As one example of the difficulties facing both patients and doctors, the authors found many instances of patients suffering from long COVID who had symptoms identical to postural orthostatic tachycardia syndrome. The findings suggest that these patients will live with their symptoms for the rest of their lives. They conclude by noting that women appear to be more at risk of developing persistent long COVID and face more skepticism from physicians.

© 2023 Science X Network

—Bob Yirka , Medical Xpress

Personal Health & Wellness > Longevity

Longevity: One simple step to lengthening your life

By Linda M. Richmond

| Published June 2, 2021

When it comes to health and longevity, the guidelines are pretty well-established: Maintain a healthy weight and eating pattern, exercise, practice good sleep hygiene, and refrain from using cigarettes or excess alcohol. Yet research tells us there’s another crucial aspect to good health that is just as important and often overlooked: socializing.

Studies show that cultivating social connections has significant physical, mental health, and cognitive benefits, and that it may be an even more important driver of longevity than other well-known factors. 

Let’s take a look at the science around socializing.

Benefits of socializing

Socializing can mean the difference in keeping mental agility as one ages. Northwestern University is studying a rare group of individuals known as cognitive “super agers”—people aged 80 or older who have the mental agility of middle-aged individuals. They perform demonstrably better on memory tests, such as remembering past events or recalling lists of words, compared with other adults their age. One recent study of super agers found what set them apart from their cognitively average peers is their far higher levels of positive social relationships, according to the report published in PLOS One. Authors concluded that positive social relationships may be an important factor for exceptional cognitive aging. 

Landmark research by Julianne Holt-Lunstad, PhD, a professor of psychology and neuroscience at Brigham Young University, analyzed worldwide data measuring subjects’ social participation, perception of support, and relationship satisfaction, to see if their degree of social connectedness predicted mortality. Nearly 309,000 people were followed for an average of 7.5 years.

What did they find? Individuals with adequate social relationships were a whopping 50% more likely to survive compared to those with poor or insufficient social relationships. The effect of social connectedness was comparable with quitting smoking. In fact, it exceeded many well-known risk factors for mortality, including air pollution, obesity, excessive alcohol consumption (more than six drinks a day), and physical inactivity, according to the report in PLOS One.

“My research suggests that one of the single best things that you can do for your health is to nurture your relationships,” Holt-Lunstad said in a recent TED Talk. “I’m not claiming that if you have close intimate relationships with friends and family that you can still smoke, quit exercising, or forgo life-saving treatments, or that we should stop caring about any of these things. Each of these will also significantly increase your risk of dying. Rather, what I am arguing is that we need to take our social relationships just as seriously for our health as we do these other things.”

To understand the role of optimism in longevity, read The one thing that can help you live longer on MDLinx.

Detriments of loneliness

The benefits of socializing can also be seen by examining its flip side: social isolation and loneliness. A recent report focusing on people aged 50 and up by the National Academies of Sciences, Engineering, and Medicine found that more than one-third of US adults aged 45 and older feel lonely. In addition, nearly one-quarter of adults aged 65 and older are considered to be socially isolated. Other findings include the following:

• Social isolation was linked with a 50% increased risk of dementia.
• Poor social connectedness was associated with a 29% higher risk of heart disease and a 32% increased risk of stroke.
• Loneliness was correlated with elevated rates of depression, anxiety, and suicide.
• In heart failure patients, loneliness was linked with a nearly four times increased risk of death, 68% higher risk of hospitalization, and 57% increased risk of emergency department visits.
• Immigrant and LGBTQ individuals are at greater risk for experiencing isolation and loneliness.

Boosting social relationships

The good news is that people generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. It may be especially important for people in the United States to look for opportunities to socialize beyond their own home. That’s because Americans are far more likely to live alone or with just one or two other family members; just 11% live with extended family, compared to 39% of people globally, according to a report by the Pew Research Center.

Experts recommend boosting social contact by starting up conversations with people as you go about your day-to-day life; setting up a standing weekly brunch or coffee date with a friend; getting involved with volunteer work; taking a class to learn a new skill, or participating in community and social groups, such as choirs, book clubs, athletic activities, or church groups.

The last 5 kilos really are the hardest to lose. Here’s why, and what you can do about it

Published: January 17, 2023 6.04am AEDT

Author

1. Nick Fuller Charles Perkins Centre Research Program Leader, University of Sydney

Disclosure statement

Dr Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.s

We believe in the free flow of information

Republish our articles for free, online or in print, under Creative Commons licence.

Anyone who has tried to lose weight will be familiar with these nine frustrating words: the last five kilos are the hardest to lose.

You’re just about to hit your target weight, but suddenly the scales won’t budge – even though you’re still following the same healthy diet, lifestyle habits and exercise plan.

There’s a scientific basis for why losing the last few kilos is hard, called the weight-loss plateau. But before you hit Google for one of those programs promising to help you lose the last five kilos, here’s some important information about why it occurs, and five simple things you can do to break through it.

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Read more: These 4 diets are trending. We looked at the science (or lack of it) behind each one

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Understanding the weight-loss plateau

The weight-loss plateau is basic biology.

When your body registers something threatening its survival, it automatically triggers a series of physiological responses to protect against the threat.

So when we adjust our diet and reduce our calorie intake, our body registers we’re losing weight and believes it’s under threat. It makes adjustments for protection, reducing our metabolic rate and burning less energy, slowing the rate at which we lose weight.

It also secretes higher levels of an appetite hormone called ghrelin, which is known to increase hunger and promote the conservation of fat stores.

Research has shown this plateau starts to creep in anywhere between three and six months of weight loss, and then typically weight regain occurs. So for those needing to lose a large amount of weight, the plateau will be evident well before the last five kilos.

A weight-loss plateau can be hard to break. Whatever the time frame, it’s a sign your previously successful approach to losing weight needs modification.

Here’s what you can do.

1. Revisit your weight-loss goal

The first and most important thing you may need to modify when you hit a weight-loss plateau is your definition of healthy body weight.

Ask yourself: what’s so special about the weight I’m trying to achieve?

Many people use the body mass index (BMI) to set their weight-loss goal but the number on the scales – and the score generated when you enter your weight and height into the BMI calculator – is nonsense. It doesn’t tell the whole story of what it means to be a healthy weight.

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Read more: Using BMI to measure your health is nonsense. Here’s why

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This is because the BMI calculator misses two more meaningful measures: body fat percentage and body fat distribution.

If you’ve been exercising regularly as part of your weight-loss plan, you’ll have gained muscle, or improved your muscle-to-fat ratio, and muscle is heavier than body fat, impacting the number on the scales.

You’re also likely to have changed where fat is distributed in your body, reducing the amount of unhealthy fat stored around the stomach, close to the organs, thus reducing your risk of disease.

So grab the tape measure, check how your clothes fit, and think about how you feel to confirm whether you really need to lose those final few kilos. Work towards a waist circumference of about 80cm for women and about 90-94cm for men.

2. Focus on meal size throughout the day

The current fad is intermittent fasting. This often means breakfast is the first to be scrapped from the menu in an attempt to cut calories from the diet and shorten the time you’re allowed to eat throughout the day. But when you eat and how much you eat at each meal does matter, and it’s breakfast that’s the most important.

Controlled research studies have shown this is the time when your body best uses the calories you put in – in fact, it burns the calories from a meal two-and-a-half times more efficiently in the morning compared with the evening. Instead of reducing your eating window, load up your breakfast and reduce the size of your evening meal.

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Read more: What are ‘fasting’ diets and do they help you lose weight?

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3. Consider more strength-building exercises

Relying on diet alone to lose weight can reduce muscle along with body fat. This slows your metabolism, and makes it harder to keep the weight off in the long term.

Any physical activity will go a long way to preserving your muscle mass, but it’s important to incorporate a couple of days of strength-building exercises in your weekly exercise routine. Exercises using body weight – like push-ups, pull-ups, planks and air squats – are just as effective as lifting weights in the gym.

4. Review your food intake

As you lose weight, your body requires less fuel, so reviewing and adjusting your calorie intake is essential when you hit a weight-loss plateau.

Generally speaking, you need to consume 10% fewer calories when you reduce your weight by 10%, just to maintain the new weight. But this shouldn’t mean deprivation or starvation. Instead, you should be focusing on an abundance of nutrient-dense foods and keeping the treats and takeaway to just once per week.

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Read more: What’s this ‘longevity’ diet, and will it really make you live longer?

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5. Check your stress

Stress will derail your weight-loss success. Stress increases your body’s production of cortisol, promoting fat storage and triggering unhealthy food cravings.

The best type of stress management is exercise. To encourage more exercise, take up something you enjoy, no matter what it is. But make sure to include variety, as doing the same routine every day is a sure-fire way to get bored and avoid activity, and can also make it hard to hit your goals.

The bottom line

A weight-loss plateau is frustrating and can derail your diet attempt.

Understanding why the weight-loss plateau occurs, making sure the weight-loss target you’ve set is realistic, and following the steps above will get you back on track.

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Read more: Hoping to get in shape for summer? Ditch the fads in favour of a diet more likely to stick

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It’s OK to aim lower with your new year’s exercise resolutions – a few minutes a day can improve your muscle strength

Published: January 2, 2023 6.40am AEDT

Author

1. Ken Nosaka Ken Nosaka is a Friend of The Conversation. Professor of Exercise and Sports Science, Edith Cowan University

Disclosure statement

Ken Nosaka receives funding from the National Health and Medical Research Council and Defence Science and Technology.

We believe in the free flow of information

Republish our articles for free, online or in print, under Creative Commons licence.

One of the most popular new year’s resolutions is to exercise more. Many of us set ambitious goals requiring a big, regular commitment, but then abandon them because they’re too much to fit in. Plans to exercise more in the new year are often broken within a month.

So how can we exercise more regularly in the new year?

If the aim is to build long-term fitness and health, the exercise must be sustainable. It may be achievable to resolve to do an extra few minutes of muscle-strengthening exercises every day.

Our research suggests even one muscle contraction a day, for five days a week, can improve muscle strength if you keep it up for a month.

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Read more: Want to exercise more? Try setting an open goal for your New Year’s resolution

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Why do we need to exercise?

Physical activity guidelines recommended we perform 150 minutes of moderately intense exercise a week, as well as at least two muscle strengthening exercise sessions per week.

Skeletal muscle tissue declines with age, causing a loss of function and independence in older adults. So it’s important to include muscle strengthening exercises regularly to stimulate skeletal muscles of the legs, arms and trunk.

However, 85% of Australians don’t meet the physical activity recommendations to do both aerobic and muscle-strengthening exercises every week. The reasons include a lack of time, a lack of motivation, and no access to a workout facility.

It’s important to address these barriers, as physical inactivity increases the risk of many chronic diseases such as heart disease, diabetes, cancer, osteoporosis (weakened bones), dementia, depression and anxiety.

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Read more: Short bursts of physical activity during daily life may lower risk of premature death – new research

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Short bouts of exercise can boost your muscle strength

My research team’s recent study found a small amount of regular resistance training can be better than doing one massive session, even if the amount of exercise overall was the same.

We asked participants to do an arm curl exercise consisting of 30 maximal contractions (so, contracting the muscle as hard as they could) each week for four weeks. One group did six contractions a day for five days a week; the other did 30 repetitions once a week.

The group that did them all in one go had no gains in muscle strength, whereas the group that spread the 30 repetitions over five days increased their muscle strength by more than 10%.

In a separate study, we showed that doing one three-second bicep muscle contraction a day, five days a week, increased muscle strength by 12%.

Participants contracted their muscles from a flexed to an extended position, like slowly lowering a heavy weight.

In both studies, participants used special equipment in our lab, and used as much strength as they could, but lowering a heavy dumbbell slowly several times could deliver similar results.

Incorporate exercise into your daily activities

We are investigating the effects of five-minutes daily “eccentric” exercises on health and fitness of sedentary people. Eccentric exercises activate and lengthen muscles.

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We have already investigated the effects of sitting to a chair slowly and found it is effective for improving leg muscle strength, chair sit-stand ability, walking ability, and balance in older adults.

Many of us sit down on a chair or a sofa more than ten times a day. So, if we sit down slowly every time we sit, we perform at least ten eccentric contractions of the muscles that work to extend the knee joints, a day. This is a good opportunity for us to perform eccentric exercise daily to simulate our leg muscles.

Eccentric contractions not only affect muscle, they can also improve health indicators such as blood pressure and cholesterol levels.

Start small, then build momentum

Our studies have focused on resistance exercise, but it also applies for aerobic exercise. Five minutes of walking every day can still be beneficial for your health.

However, if you’re already doing regular gym workouts every week, adding a little exercise each day may not produce much of an added effect, so it is not necessary to replace a consistent regular exercise routine with smaller micro-sessions.

But for those starting out, who might find taking on a big exercise commitment daunting, doing a little bit of exercise, often, is a good start. Once your fitness has improved, you can add more exercise.

So what about setting a resolution to spend five minutes exercising every day in 2023?

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Read more: Don’t have time to exercise? Here’s a regimen everyone can squeeze in

Dr Kerryn Phelps reveals ‘devastating’ Covid vaccine injury, says doctors have been ‘censored’

Dr Kerryn Phelps has broken her silence about a “devastating” Covid vaccine injury, slamming regulators for “censoring” public discussion with “threats” to doctors.

Frank Chung@franks_chung

8 min read

December 20, 2022 – 5:59PM1960 comments

Current Time 0:39

EXCLUSIVE

Former federal MP Dr Kerryn Phelps has revealed she and her wife both suffered serious and ongoing injures from Covid vaccines, while suggesting the true rate of adverse events is far higher than acknowledged due to underreporting and “threats” from medical regulators.

In an explosive submission to Parliament’s Long Covid inquiry, the former Australian Medical Association (AMA) president has broken her silence about the “devastating” experience — emerging as the most prominent public health figure in the country to speak up about the taboo subject.

“This is an issue that I have witnessed first-hand with my wife who suffered a severe neurological reaction to her first Pfizer vaccine within minutes, including burning face and gums, paraesethesiae, and numb hands and feet, while under observation by myself, another doctor and a registered nurse at the time of immunisation,” the 65-year-old said.

“I continue to observe the devastating effects a year-and-a-half later with the addition of fatigue and additional neurological symptoms including nerve pains, altered sense of smell, visual disturbance and musculoskeletal inflammation. The diagnosis and causation has been confirmed by several specialists who have told me that they have seen ‘a lot’ of patients in a similar situation.”

Dr Phelps married former primary school teacher Jackie Stricker-Phelps in 1998.

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Kerryn Phelps and Jackie Stricker-Phelps. Picture: Dylan Robinson

“Jackie asked me to include her story to raise awareness for others,” she said.

“We did a lot of homework before having the vaccine, particularly about choice of vaccine at the time. In asking about adverse side effects, we were told that ‘the worst thing that could happen would be anaphylaxis’ and that severe reactions such as and pericarditis were ‘rare’.”

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Dr Phelps revealed she was also diagnosed with a vaccine injury from her second dose of Pfizer in July 2021, “with the diagnosis and causation confirmed by specialist colleagues”.

“I have had CT pulmonary angiogram, ECG, blood tests, cardiac echogram, transthoracic cardiac stress echo, Holter monitor, blood pressure monitoring and autonomic testing,” she said.

“In my case the injury resulted in dysautonomia with intermittent fevers and cardiovascular implications including breathlessness, inappropriate sinus tachycardia and blood pressure fluctuations.”

Dr Phelps said both reactions were reported to the Therapeutic Goods Administration (TGA) “but never followed up”.

She revealed she had spoken with other doctors “who have themselves experienced a serious and persistent adverse event” but that “vaccine injury is a subject that few in the medical profession have wanted to talk about”.

“Regulators of the medical profession have censored public discussion about adverse events following immunisation, with threats to doctors not to make any public statements about anything that ‘might undermine the government’s vaccine rollout’ or risk suspension or loss of their registration,” she said.

Crossbench MP Kerryn Phelps during Question Time in February 2019. Picture: Lukas Coch/AAP

The Australian Health Practitioner Regulation Agency (AHPRA), which oversees Australia’s 800,000 registered practitioners and 193,800 students, last year warned that anyone who sought to “undermine” the national Covid vaccine rollout could face deregistration or even prosecution.

AHPRA’s position statement said that “any promotion of anti-vaccination statements or health advice which contradicts the best available scientific evidence or seeks to actively undermine the national immunisation campaign (including via social media) is not supported by National Boards and may be in breach of the codes of conduct and subject to investigation and possible regulatory action”.

Earlier this year, Australian musician Tyson ‘tyDi’ Illingworth said he had been told privately by doctors that they feared being deregistered if they linked his neurological injury to the Moderna vaccine.

Dr Phelps said she had heard stories of vaccine injury from “patients and other members of the community”.

“They have had to search for answers, find GPs and specialists who are interested and able to help them, spend large amounts of money on medical investigations, isolate from friends and family, reduce work hours, lose work if they are required to attend in person and avoid social and cultural events,” she said.

“Within this group of vaccine injured individuals, there is a diminishing cohort of people who have symptoms following immunisation, many of which are similar to Long Covid (such as fatigue and brain fog), but who have not had a Covid infection. These people would be an important subset or control group for studies looking into the pathophysiology, causes of and treatments for Long Covid. It is possible that there is at least some shared pathophysiology between vaccine injury and Long Covid, possibly due to the effects of spike protein.”

People line up at the Covid vaccination hub in Homebush. Picture: NCA NewsWire/Dylan Robinson

She added that “in trying to convince people in positions of influence to pay attention to the risks of Long Covid and reinfection for people with vaccine injury, I have personally been met with obstruction and resistance to openly discuss this issue”.

“There has been a delay in recognition of vaccine injury, partly because of under-reporting, concerns about vaccine hesitancy in the context of managing a global pandemic, and needing to find the balance between risks and benefits on a population level,” she said.

“Reactions were said to be ‘rare’ without data to confirm how common or otherwise these reactions were. In general practice I was seeing cases, which meant other GPs and specialists were seeing cases too. Without diagnostic tests, we have to rely largely on clinical history.”

In July this year, the independent OzSAGE group of which Dr Phelps is a member issued a position statement calling for better systems and management of Covid vaccine adverse events and “recognition of the impact of vaccine injury”.

Dr Phelps, who was heavily involved in crafting the statement, wrote in her submission that the OzSAGE document “outlines the scope but not the scale of the problem because we do not know the scale of the problem”.

“This is partly because of under-reporting and under-recognition,” she said.

According to the TGA’s most recent safety update, there have been a total of 137,141 adverse event reports from nearly 64.4 million doses — a rate of 0.2 per cent.

There have been 819 reports “assessed as likely to be myocarditis” from 49.8 million doses of Pfizer and Moderna. Fourteen deaths have officially been linked to vaccination — 13 after AstraZeneca and one after Pfizer.

‘The incidence of serious reactions could be more than 1-in-1000.’ Picture: Sebastien Bozon/AFP

But Dr Phelps pointed to data from Germany’s pharmacovigilance body, the Paul Ehrlich Institute (PEI), which has “undertaken ongoing surveys of vaccine recipients … as opposed to the TGA which only accepts passive reports, or AusVaxSafety whose survey stopped at six weeks”.

“They have found that the incidence of serious reactions occurs in 0.3 per 1000 shots (not people),” she said.

“Considering that the majority of Australian adults have now had at least one booster, this suggests that the incidence of serious adverse reactions per vaccinated person could be more than 1-in-1000. PEI admits that under-reporting is a problem, and observers suggest that an order of magnitude of under-reporting is not unreasonable to consider (most estimates put underreporting at much worse than this).”

Dr Phelps said there was concern some adverse events could “cause long-term illness and disability”, but data was limited because the “global focus has been on vaccinating as many people as quickly as possible with a novel vaccine for a novel coronavirus”.

“Because of this, all of the studies that have been published so far are either small, or case studies only,” she said.

“The burden of proof seems to have been placed on the vaccine injured rather than the neutral scientific position of placing suspicion on the vaccine in the absence of any other cause and the temporal correlation with the administration of the vaccine.”

She noted some countries had gathered significant databases of adverse events, ranging from allergy and anaphylaxis to cardiovascular, neurological, haematological and auto-immune reactions.

Brisbane residents queuing for vaccination during Omicron. Picture: Josh Woning/NCA NewsWire

Despite the recognition of heart inflammation associated with the Pfizer and Moderna mRNA vaccines, Dr Phelps said “even then, there has been a misconception that myocarditis is ‘mild’, ‘transient’ and ‘mostly in young males’, when there are many cases where myocarditis is manifestly not mild, not transient and not confined to the young male demographic”.

Dr Phelps said until there was acknowledgment and recognition of post-vaccination syndrome or vaccine injury, “there can be no progress in developing protocols for diagnosis and treatment and it is difficult to be included in research projects or treatment programs”.

“It has also meant a long and frustrating search for acknowledgment and an attempt at treatment for many individual patients,” she said.

“People who suffer Covid vaccine injury may present with a range of symptoms, and results of standard medical tests often come back normal. And like patients with Long Covid, they too are also asking the medical profession and public health systems for help.”

Earlier this year, Dr Rado Faletic — who previously spoke out about his battle with the TGA — launched Australian advocacy group Coverse to provide support and collect testimony from those suffering vaccine injuries.

The TGA said in a statement that people who submit adverse event reports “are not routinely given feedback about their adverse event report beyond the acknowledgement letter”.

“However, in some cases reporters are contacted if further information is required to either complete or assess the adverse event report,” a spokesman said.

“The TGA’s function is to analyse adverse event report data to look for potential conditions or adverse effects which may be linked to vaccination. The Product Information (PI) documents for Covid-19 vaccines include information on adverse events including the expected frequency, when known. The PI documents are available on the TGA website. The TGA also publishes information about adverse events in the Covid-19 vaccine safety report.”

Eleven practitioners have been suspended for Covid misinformation. Picture: Aizar Raldes/AFP

AHPRA said in a statement that the regulator had “been clear in all of our guidance about Covid-19 vaccinations that we expect medical practitioners to use their professional judgement and the best available evidence in their practice”.

“This includes keeping up to date with public health advice from Commonwealth, state and territory authorities,” a spokeswoman said.

“Legitimate discussion and debate, based on science is appropriate and necessary to progress our understanding and knowledge. The [March 9, 2021 position] statement does not prevent practitioners from having these discussions.”

She added that as of June 2022, only 11 practitioners had been suspended “in relation to concerns raised about Covid-19”.

“The concerns raised about the practitioners related to the spreading of misinformation about Covid-19 or vaccination advice, including that the Covid-19 pandemic was fake, that the vaccination program was about government led mind control or in some instances representing that patients would develop cancer by having a vaccination administered,” she said.

Reached on Tuesday, Dr Phelps declined to comment further on the submission.

Dr Phelps, who remains a practising GP, was elected as the first female president of the AMA in 2000.

She was also a City of Sydney councillor from 2016 to 2021, and Deputy Lord Mayor under Clover Moore from 2016 to 2017.

In 2018, Dr Phelps ran as an independent candidate in the by-election for the eastern suburbs seat of Wentworth following the resignation of Prime Minister Malcolm Turnbull, defeating Liberal Dave Sharma.

She spent less than a year in federal parliament, losing to Mr Sharma in a rematch in the May 2019 election

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I’ve indulged over the holidays. If I’m healthy the rest of the time, does it matter?

Published: December 29, 2022 8.10am AEDT

Author

1. Emma Beckett Senior Lecturer (Food Science and Human Nutrition), School of Environmental and Life Sciences, University of Newcastle

Disclosure statement

Emma Beckett has received funding for research or consulting from Mars Foods, Nutrition Research Australia, NHMRC, ARC, AMP Foundation, Kellogg, and the University of Newcastle. She is a member of committees/working groups related to nutrition or the Australian Academy of Science, the National Health and Medical Research Council and the Nutrition Society of Australia.

We believe in the free flow of information

Republish our articles for free, online or in print, under Creative Commons licence.

The holidays are often called the “silly season” – a time when we eat, drink and be merry. But these holiday indulgences can lead to feelings of guilt and fear that we’ve undone all the healthy habits from the rest of the year. But how much do you really need to worry about the impacts of holiday overeating?

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Read more: Trust Me, I’m An Expert: what science says about how to lose weight and whether you really need to

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Yes, weight gain can happen in the holidays

There are studies that show weight gain can and does occur in the silly season. But on average it’s not as dramatic as diet culture would have us believe, coming in at about 0.7kg.

However, because humans are complex and varied, and nutrition science is hard, there are studies with varied findings. Some show that despite significant increases in overall energy intake and reductions in diet quality, weight gain doesn’t occur.

Importantly, much of this research comes from the northern hemisphere where the major holidays coincide with winter. And these studies focus on weight, not health. Weight is just a marker that’s convenient to measure, but health is more complicated.

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Read more: Eat your vegetables – studies show plant-based diets are good for immunity

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Food is not just fuel

Food isn’t just energy and nutrients. It’s a big part of our cultures and celebrations, and contributes to social, cultural and emotional wellbeing.

While it’s harder to study, nourishing our souls with foods that connect us to our loved ones and our traditions is just as important as the role food plays in nourishing our bodies.

Holiday feasts are also an opportunity to share meals. Sharing meals contributes to our emotional wellbeing and happiness.

Say hello to homeostasis

Homeostasis is a scientific term that describes how systems self-regulate. The word comes from the ancient Greek words for “similar” and “steady”.

In living things it means that biology can adapt to changes to keep things in their normal constant state. Essentially, our body is always making little constant biological changes to help things stay the same. This is how we regulate things like our body temperature, blood sugar, blood pressure and other systems important for survival.

The principles of homeostasis also apply to our eating and metabolism. If we eat more for one or two holiday feast days (or even weeks) our biology works to minimise the impacts. This is also why losing weight on restrictive diets can be hard – homeostasis means as we reduce our energy intake our bodies adjust to using less energy.

So for most people, discrete periods of indulgence aren’t likely to be the major determinants of health outcomes. It’s more likely the patterns we follow most of the time will influence our long term health.

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Read more: Thinking you’re ‘on a diet’ is half the problem – here’s how to be a mindful eater

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It’s about balance

Biology and social norms both mean restrictive diets are hard to maintain long-term. Some people are more successful in maintaining a balanced diet when indulging is allowed.

And now science has helped you to relax a little, a few words of caution.

Drink in moderation

Over-consumption of alcohol can cause increased risk for chronic diseases.

Excess alcohol consumption in the festive period increases the risk of alcohol-related harm, including accidents and violence.

Staying hydrated by alternating with non-alcoholic beverages helps reduce how much you drink and how bad a hangover is, but it won’t eliminate the risks.

Food safety risks

Festive eating, with sharing, travelling and over-crowded fridges increases our risks of food poisoning. Summer holidays also bring the added risk of heat.

You want to share food and joy, not germs, so remember your basic food safety rules like hand washing, avoiding cross contamination of uncooked meats and other foods, storing food chilled, and heating thoroughly.

It’s also a good idea to make sure you talk to your guests or hosts about food allergens to make sure everyone has a safe holiday feast.

The bottom line

What we eat is a big part of determining our health, but adding a side serving of guilt to your festive feast isn’t healthy either.

For true healthy choices, focus on balance and moderation for the bulk of the year and for most of your choices, but social and cultural eating is part of balance.

Enjoying your celebration foods doesn’t need to mean throwing away all your healthy habits, but healthy eating and healthy indulgence can co-exist if we let it.

Medical Practice > Women’s Health Focus

Incredible women’s health innovations of 2022

By Kristen Fuller, MD | Medically reviewed by Vincent F. Carr, D.O., F.A.C.C., F.A.C.P., CHCQM -PHYADV

| Updated December 22, 2022

Key Takeaways

• Female inventors are more likely to invent medical treatments that primarily benefit women; however, there is a 30-year shortage in inventions targeting women’s health as women represent a small percentage of US patent holders.
• Despite the desperate need for more female patent holders, there were many innovative advances and discoveries for female patients in 2022.
• From advancements in female fecal urinary incontinence to family planning, breast cancer, postpartum hemorrhage, and hair loss treatments, these innovations can help improve the quality of life for female patients.

Female inventors are more likely to invent medical treatments and innovations for females, according to research published by the Harvard Business School.^[1]

But the researchers found that an overall lack of female scientists limits the potential for future life-saving medical inventions for all patients, but especially for female-specific medical conditions, such as endometriosis, breast cancer, menopause, and pelvic floor disorders.

Impressive reduction observed with Alzheimer’s neuronal damage biomarker, p-tau181 Alzheon Inc.

Therefore, further advances are needed to inhibit disease progression and improve the quality of life for women. Fortunately, there were some incredible discoveries for women’s health in 2022. Let’s take a look.

Non-surgical pelvic floor device for chronic fecal incontinence

Renovia is a women-led company that advocates for women’s health and develops non-surgical treatments for women’s pelvic floor disorders. In July 2022, the FDA approved its leva Pelvic Health System for first-line treatment of chronic fecal incontinence (FI) in women, according to a report published by PR Newswire.^[2]

The leva system was previously FDA-approved for treating stress and urinary incontinence in women.

The new indication “makes first-line, at-home treatment for FI, also called accidental bowel leakage, available to the over 12 million US women who suffer from the debilitating and progressive condition,” according to the report.

Innovative family planning methods and improvements

Hormone-free on-demand birth control gel: Phexxi (lactic acid, citric acid, potassium bicarbonate) from Evofem Biosciences is a vaginal pH modulator gel that can be used up to 1 hour before intercourse and does not contain estrogen or progesterone, making it safe for women who cannot or do not want to be on hormone birth control, according to an article published by Contemporary OB/GYN.^[3] It has an efficacy rate of 86% in preventing pregnancy with typical use.

Phexxl works by maintaining the acidic pH in the vagina, even after semen enters it during intercourse, thereby inhibiting sperm motility.

Improved estrogen vaginal ring: Annovera (segesterone acetate and ethinyl estradiol vaginal system) from TherapeuticsMD received FDA approval in 2018. It’s a vaginal ring that patients leave in for 3 weeks and take out for 1 week, which is repeated for 13 cycles.

Annovera doesn’t need to be refrigerated and is thicker than the other ring currently on the market. According to the Contemporary OB/GYN article, “studies demonstrated 97.3% efficacy in preventing pregnancy.”

Women’s hair loss drug for alopecia

In June 2022, the FDA approved baricitinib (Olumiant), a prescription medication intended to help hair regrowth by preventing the immune system from attacking and destroying hair follicles, as reported by The New England Journal of Medicine (NEJM).^[4]

Baricitinib is already on the market to treat rheumatoid arthritis and other immune-related diseases, but the FDA approval for alopecia is important for insurance coverage for this very expensive medication.

It was studied in two trials published in NEJM that involved 1,200 patients with severe alopecia areata.^[5] Nearly 40% of participants who took the drug had complete or near-complete hair regrowth after 36 weeks.Related: How ‘hysteria’ cast a long shadow on women’s healthcare that still resonates

External catheter and urine collection system for female incontinence

The BD PureWick female catheter is a noninvasive urine collection system for female patients with urinary incontinence that can be used in hospitals and at home. It can help improve daily living for patients and caregivers alike as it reduces nighttime trips to the bathroom and allows for better sleep.

According to an article published by Medical Design & Outsourcing, “BD designed the catheter to ‘wick’ urine away from the patient and into a designated collection canister.”^[6]Related: Women have historically been excluded from research. Where are we now?

Treatment for abnormal postpartum uterine bleeding 

Obstetric hemorrhage is the most common and dangerous complication of childbirth. Postpartum hemorrhage, a type of obstetric hemorrhage, is blood loss (1,000mL with signs and symptoms) that occurs within 24 hours of delivery, according to StatPearls research.^[7]

It’s initially treated with conservative measures, including uterotonic medications, uterine massage, and balloon tamponade. If these are unsuccessful, surgical interventions are recommended, as per an article published by International Journal of Gynecology & Obstetrics.^[8]

A uterine vacuum, the Jada System, is a conservative treatment modality that hit the market in 2022 for postpartum hemorrhage. According to the Medical Design & Outsourcing article, this low-level vacuum encourages normal contraction of the uterus to provide control and treatment of uterine hemorrhage after childbirth.

The device, made from soft silicone, has an intrauterine loop with interior vacuum pores inside a protective shield that evacuate the blood.

“An expandable cervical seal is filled with sterile fluid to create a seal that holds a vacuum within the uterus, and a connector at the end of the device’s tube is attached to a regulated vacuum source. ”

— Danielle Kirsh, Medical Design & Outsourcing

Targeted therapy for metastatic HER2-low breast cancer 

In August 2022, the FDA approved what is reportedly the first-ever targeted therapy, trastuzumab deruxtecan, for patients with metastasized HER2-low breast cancer that can’t be surgically removed.

“Until now, HER2 targeted therapy has not been successful in treating cancer that is HER2-low,” according to an article published by Memorial Sloan Kettering Cancer Center. ^[9]

“Targeted therapy works by precisely identifying and attacking certain types of cancer cells, without killing normal cells, therefore resulting in fewer side effects.”

— Memorial Sloan Kettering Cancer Center

What this means for you

As you treat female patients, it is important to stay up to date on emerging and improved technologies, medical devices, and medications that treat female-specific medical disorders in an effort to improve their longevity and quality of life.

State of Healthcare > Medical Research

Who’s got the stronger sex drive, men or women?

Updated November 1, 2022 | Originally published on MedicalXpress Breaking News-and-Events

Perhaps to no one’s surprise, new research has determined that men do, in fact, have a much stronger sex drive than women.

After reviewing more than 200 studies, investigators “found that men consistently report a higher sex drive,” said study author Julius Frankenbach, a doctoral student of psychology at Saarland University in Saarbrücken, Germany.

En masse, the research showed that men say they spend considerably more time thinking about sex, fantasizing about sex, feeling sexual desire and masturbating, compared to women.

Impressive reduction observed with Alzheimer’s neuronal damage biomarker, p-tau181 Alzheon Inc.

“What did surprise us,” said Frankenbach, “was that the finding was consistent across countries, age groups, ethnicities or sexual orientations. Men having a higher sex drive than women seems to be a quite universal psychological pattern.”

But there’s a hitch. When discussing one’s own sexual proclivities, are people always honest?

“Sexuality is a sensitive topic,” Frankenbach acknowledged. “So we also considered the possibility that people’s self-reports are not fully accurate. There was some evidence for such inaccurate responses in our data.”

“For example,” he noted, “men reported having had more sexual partners than women, which, by simple logic, is almost impossible. However, we concluded that this response bias was relatively small, and could not explain all of the gender difference in sex drive we observed. In other words, we think that the gender difference is real.”

The 211 studies reviewed were published after 1996, and participants were at least 14 years old. In all, more than 621,000 people were involved.

Frankenbach and study co-author Malte Friese, a professor in Saarland University’s psychology department, analyzed the way each study was conducted. After for accounting for some differences, the researchers concluded that the male sex drive is stronger than the female sex drive, with a “medium-to-large effect.”

Frankenbach said that the overall degree to which sex drive differs by gender could be compared to standard differences in male vs. female bodies, with “the gender difference in sex drive roughly equal to the gender difference in body weight.”

Carole Hooven, a lecturer in the department of human evolutionary biology at Harvard University, welcomed the study.

“I’m not surprised that researchers have confirmed what most of us know to be true by virtue of being a sexually mature human,” said Hooven, who wasn’t involved in the analysis.

“But what’s nice about this study,” she said, “is that it compiles, examines and summarizes results from many other studies that have evaluated this question of sex differences in sex drive, and the authors attempted to correct for the influence of bias in people’s answers.”

Still, the researchers pointed out exceptions to the rule.

Frankenbach said between 24% and 29% of women appear to have a higher sex drive than the “average” man.

So, while on average men may have a stronger sex drive than women, “there are plenty of women who are more into sex than many men,” he added.

What exactly accounts for sex drive?

Frankenbach suggested it probably boils down to a complex interaction between social norms, roles and learning on the one hand, and genetics, physiology and biology on the other.

Hooven said “culture certainly plays a strong role in shaping not only how men and women express their sexuality. It also shapes how the sexes feel about what kind of behaviors are appropriate.”

Beyond that, “we have so much research now, across time and place, that converges on the same observation: Men are more motivated by sex than women,” with higher levels of the male hormone testosterone likely playing a key motivating role throughout a man’s life, she added.

All that aside, however, Hooven said it bears keeping in mind that “some women clearly enjoy it, and none of this scientific stuff has any bearing on what kinds of behaviors are right or wrong.”

The findings were published recently in Psychological Bulletin.

—Alan Mozes HealthDay Reporter