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A higher dose of magnesium each day keeps dementia at bay
A higher dose of magnesium each day keeps dementia at bay
24 March 2023
More magnesium in our daily diet leads to better brain health as we age, according to scientists from the Neuroimaging and Brain Lab at The Australian National University (ANU). The researchers say increased intake of magnesium-rich foods such as spinach and nuts could also help reduce the risk of dementia, which is the second leading cause of death in Australia and the seventh biggest killer globally.
Published in the European Journal of Nutrition, the study of more than 6,000 cognitively healthy participants in the United Kingdom aged 40 to 73 found people who consume more than 550 milligrams of magnesium each day have a brain age that is approximately one year younger by the time they reach 55 compared with someone with a normal magnesium intake of about 350 milligrams a day.
“Our study shows a 41% increase in magnesium intake could lead to less age-related brain shrinkage, which is associated with better cognitive function and lower risk or delayed onset of dementia in later life,” lead author and Ph.D. researcher Khawlah Alateeq, from the ANU National Centre for Epidemiology and Population Health, said.
“This research highlights the potential benefits of a diet high in magnesium and the role it plays in promoting good brain health.”
It’s believed the number of people worldwide who will be diagnosed with dementia is expected to more than double from 57.4 million in 2019 to 152.8 million in 2050, placing a greater strain on health and social services and the global economy.
“Since there is no cure for dementia and the development of pharmacological treatments have been unsuccessful for the past 30 years, it’s been suggested that greater attention should be directed towards prevention,” study co-author Dr. Erin Walsh, who is also from ANU, said.
“Our research could inform the development of public health interventions aimed at promoting healthy brain aging through dietary strategies.”
The researchers say a higher intake of magnesium in our diets from a younger age may safeguard against neurodegenerative diseases and cognitive decline by the time we reach our 40s.
“The study shows higher dietary magnesium intake may contribute to neuroprotection earlier in the aging process and preventative effects may begin in our 40s or even earlier,” Ms Alateeq said.
“This means people of all ages should be paying closer attention to their magnesium intake.
“We also found the neuroprotective effects of more dietary magnesium appears to benefit women more than men and more so in post-menopausal than pre-menopausal women, although this may be due to the anti-inflammatory effect of magnesium.”
Participants completed an online questionnaire five times over a period of 16 months. The responses provided were used to calculate the daily magnesium intake of participants and were based on 200 different foods with varying portion sizes. The ANU team focused on magnesium-rich foods such as leafy green vegetables, legumes, nuts, seeds and wholegrains to provide an average estimation of magnesium intake from the participants’ diets
Menopausal Hormone Therapy prescribing anxiety persists
Body-identical hormones not associated with increased breast cancer risk, but MHT still under-prescribed
The risks associated with menopausal hormone therapy (MHT) are minimal and there are significant benefits, is the advice to GPs from Professor Rod Baber, gynaecologist at the Royal North Shore Hospital and part of an expert panel on Managing Menopause in GP at the upcoming Women’s & Children’s Health Update.
“When MHT is used in appropriate situations — women going through the menopause transition or within 10 years of their last period who are experiencing moderate to severe symptoms — there are huge benefits with minimal risks,” Professor Baber said. “At the moment, many women are denied access to evidence based effective treatments.”
Many GPs remain reluctant to prescribe hormone therapy for fear it increases the risk of breast cancer, and as a result, it tends to be under-prescribed.
The concern stems from a Women’s Health Initiative (WHI) study some 20 years ago, that was interpreted as indicating an increased risk of stroke, heart disease and breast cancer.
The study used synthetic hormones, (conjugated equine oestrogen and medroxyprogesterone acetate progestin), which are very different from the body-identical hormones available now.
“Those original interpretations of risk were based on the entire study population of women aged on average 63 years when recruited. Subsequent analyses of women aged in their 50s (the population we would normally treat with MHT) were much more positive,” Professor Baber said.
However, the damage was done, and it has been long lasting, with many women and GPs still holding fears around MHT.
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Baber said large observational studies [1] have shown that women using body-identical hormones had no increased risk of breast cancer for the duration of the studies (five to eight years). An increased risk was seen for women using estrogens in combination with synthetic progestogens. Furthermore, long term follow up of the WHI trials found that, for women using estrogen only compared to placebo, there was a reduced risk of getting breast cancer and also of death due to breast cancer. Women who used estrogen plus a synthetic progestogen compared to placebo did have an increased risk of getting breast cancer (equivalent to 0.8 cases per 1000 women per year) but NOT of death due to breast cancer. Additionally, a Cochrane Systematic review of MHT use in women within 10 years of their last period reported a reduced risk of CHD and all-cause mortality.
For patients who consider themselves at an increased risk of breast cancer, simple risk assessment tools such as iprevent.net.au can help to understand risk associated with family history, social factors and lifestyle, Baber said.
“They can see if a woman is at the population-based risk, mildly increased risk or a moderately increased risk,” he said.
In high-risk women, those with a strong family history or a genetic mutation, GPs may not immediately prescribe MHT and should refer them to menopause specialists for individual review.
Maintaining a healthy lifestyle is the most significant way to lower risks. “Not being overweight and having a healthy diet, exercising for two and a half hours a week and avoiding drugs such as alcohol in extremes will significantly reduce cardiovascular disease, osteoporosis, cognitive decline, breast cancer and probably endometrial cancer,” he said.
“Doctors should remember the extra benefits of MHT on bone, mental and cardiovascular health,” Baber said.
“It’s important to assess the whole patient when evaluating risks and benefits of MHT. The majority of postmenopausal women can safely use oral or transdermal therapies, preferably body identical, but women who are overweight, diabetic, hypertensive, migraneurs or smokers should ideally use body identical transdermal therapy where possible,” he said.
To help educate themselves and their patients about the benefits of MHT and how it can form part of an overall healthy approach to menopause, Baber recommends GPs access the information sheets freely available on the Australasian Menopause Society website and from the Jean Hailes organisation.
Professor Baber will be speaking as part of an expert panel on managing menopause in primary care at the annual Women’s & Children’s Health Update in Adelaide, Brisbane, Melbourne, Sydney and Perth. Sign up to hear more on this topic, and others such as hormone-related DVT, iron and pregnancy, eating disorders in young people and more.
5 tips to stave off dementia as you age
5 tips to stave off dementia as you age
| Updated December 16, 2022
- Roughly 50 million people worldwide live with dementia, and the number is projected to reach a whopping 152 million by 2050. But a future dementia diagnosis of dementia is not a sure thing—neurocognitive health is highly dependent on the decisions you make today.
- Exercise is a key means of preventing dementia. Keeping a healthy diet could also curb dementia risk. High blood pressure can be at the root of dementia, as well, so taking steps to lower it could help prevent dementia onset.
- Risky behaviors to avoid include smoking (as smokers are at higher risk for dementia than nonsmokers, even in old age) and excessive drinking, as it’s linked to brain changes, cognitive impairment, and dementia.
Dementia is on the increase around the globe. Roughly 50 million people worldwide live with the disease, and the number is projected to reach a whopping 152 million by 2050, according to a report in The Lancet.[1]
With that kind of prediction, it might seem like getting dementia is a foregone conclusion for many of us.
The good news? A future diagnosis of dementia is by no means set in stone—in fact, neurocognitive health is highly dependent on the decisions you make today.
According to the authors of an article published in BMJ Neurology, “Ageing, genetic, medical and lifestyle factors contribute to the risk of Alzheimer’s disease and other dementias. Around a third of dementia cases are attributable to modifiable risk factors such as physical inactivity, smoking, and hypertension. With the rising prevalence and lack of neuroprotective drugs, there is renewed focus on dementia prevention strategies across the lifespan.”[2]
Here are five evidence-based ways to prevent dementia.
Physical activity
Exercise is a key means of preventing dementia, according to a study published in BMC Public Health—billed as the “first trial to examine the effects of a long exercise program (48 months) on cognitive performances.”[3]
The authors wrote that “several studies have shown that lifestyle modification and reduction of modifiable risk factors for AD [Alzheimer disease] offers a promising way of decreasing the risk of dementia. Physical inactivity is considered one of the seven main potentially modifiable risk factors for AD and explains approximately 13% (nearly 4.3 million) of AD cases worldwide.”
If successful, this trial may provide evidence for using long-term and multimodal exercise interventions for dementia prevention programs in the aging population.
The authors suggested that several potential mechanisms could mediate the link between exercise and decreased risk of dementia, including production of brain-derived neurotrophic factor (BDNF), enhanced insulin sensitivity, promotion of cardiovascular health, and decreased stress and inflammation.
The benefit of these factors could be especially important in the aging brain, and could someday serve as potential biomarkers to determine the effects of different exercise regimens on cognitive outcomes.
Diet
Keeping a healthy diet could also curb dementia risk, according to experts.
“It’s possible that eating a certain diet affects biological mechanisms, such as oxidative stress and inflammation, that underlie Alzheimer’s,” notes an article published by the National Institutes on Aging (NIA). “Or perhaps diet works indirectly by affecting other Alzheimer’s risk factors, such as diabetes, obesity, and heart disease. A new avenue of research focuses on the relationship between gut microbes—tiny organisms in the digestive system—and aging-related processes that lead to Alzheimer’s.”
Experts at the NIA point to two promising diets to possibly attenuate dementia risk: the Mediterranean diet and the MIND (Mediterranean–DASH Intervention for Neurodegenerative Delay). The Mediterranean diet includes fruits, vegetables, whole grains, legumes, fish, and unsaturated fats such as olive oils, as well as limited amounts of red meat, eggs, and sweets.
On the other hand, the MIND diet incorporates the DASH diet, which has been shown to decrease high blood pressure—a factor that plays a role in Alzheimer disease. The food groups covered by the MIND diet include leafy green vegetables, other vegetables, berries, whole grains, fish, poultry, beans, nuts, wine, and olive oil.
Hypertension
High blood pressure is an insidious disease, the effects of which can be at the root of many chronic illnesses—including dementia.
In a high-powered meta-analysis published in Lancet Neurology, researchers included data from six prospective studies (n=31,090) to determine the effect of antihypertensive medications (AHM) on dementia risk in dementia-free participants older than 55 years.[4]
“Over a long period of observation, no evidence was found that a specific AHM drug class was more effective than others in lowering risk of dementia,” they concluded. “Among people with hypertensive levels of blood pressure, use of any AHM with efficacy to lower blood pressure might reduce the risk for dementia. These findings suggest future clinical guidelines for hypertension management should also consider the beneficial effect of AHM on the risk for dementia.”
According to a report by the Lancet Commission, those aged 40 years or older should shoot for a systolic blood pressure of 130 mm Hg or less in midlife, with antihypertensive drugs the only known effective agents to prevent dementia.
Smoking
According to the Lancet Commission findings, smokers are at higher risk for dementia than are nonsmokers, as well as premature death before the age at which they may have developed dementia. Even older people who stop smoking can decrease their dementia risk.
With respect to the effect of second-hand smoke on dementia risk, the authors noted that research is limited. Nevertheless, they highlighted some research that indicated that in women aged between 55 and 64 years, second-hand smoke exposure was linked to increased memory deterioration that was dose-dependent. Of note, these findings persisted after accounting for covariates.
Heavy drinking
For centuries, people have known that drinking in excess is linked to brain changes, cognitive impairment, and dementia.
According to the authors of the aforementioned Lancet report, “An increasing body of evidence is emerging on alcohol’s complex relationship with cognition and dementia outcomes from a variety of sources including detailed cohorts and large-scale record-based studies. Alcohol is strongly associated with cultural patterns and other sociocultural and health-related factors, making it particularly challenging to understand the evidence base.”
The authors highlighted different research findings that indicated that earlier onset of dementia (ie, aged 65 years or fewer) was closely associated with alcohol use. Additionally, heavy drinking was linked to atrophy of the right hippocampus on MRI. Notably, the right hippocampus plays a role in memory retrieval.
The bottom line
Fortunately, various lifestyle interventions could reduce the risk of dementia later in life. The key is to institute these changes earlier in life. In fact, unlike early-onset dementia, in late-onset dementia, the heritable component is uncertain.
“Early-onset familial Alzheimer disease is inherited in an autosomal dominant pattern, which means one copy of an altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the altered gene from one affected parent,” according to the US National Library of Medicine.
“The inheritance pattern of late-onset Alzheimer disease is uncertain.”
— US National Library of Medicine
“People who inherit one copy of the APOE e4 allele have an increased chance of developing the disease; those who inherit two copies of the allele are at even greater risk. It is important to note that people with the APOE e4 allele inherit an increased risk of developing Alzheimer disease, not the disease itself. Not all people with Alzheimer disease have the e4 allele, and not all people who have the e4 allele will develop the disease,” the authors added.
What this means for you
There are lifestyle interventions that could reduce the risk of dementia—such as a healthy diet, lower blood pressure, and to avoid heavy smoking and drinking. Research shows your patients will benefit from adopting them earlier in life. The inheritance pattern for dementia is uncertain, based on research
Can beetroot really improve athletic performance?
Can beetroot really improve athletic performance?
Published: February 9, 2023 10.16am AEDT
Author
- Evangeline MantziorisProgram Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
Disclosure statement
Evangeline Mantzioris is affiliated with Alliance for Research in Nutrition, Exercise and Activity (ARENA) at the University of South Australia. Evangeline Mantzioris has received funding from the National Health and Medical Research Council, and has been appointed to the National Health and Medical Research Council Dietary Guideline Expert Committee.
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Beetroot is gaining popularity as a performance-enhancer for athletes and those wanting to gain a competitive advantage in running and cycling.
Some people juice beetroot, some eat it, others mix up a drink from the powdered form. But will it make a noticeable difference on how quickly we run a race or cycle up a hill?
Small benefits for some
A large systematic review in 2020 included 80 clinical trials, in which the included studies had participants randomly assigned to consume beetroot juice or not. It found consuming beetroot juice provided performance benefits for athletes.
In sports where every second or centimetre counts, this can be a significant improvement. In a 16.1 kilometre cycling time trial the gains linked to beetroot consumption were equivalent to 48 seconds.
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But when the authors analysed subgroups within these studies they found beetroot juice wasn’t effective for women or elite athletes – though this could be because there were too few study participants in these groups to draw conclusions.
Another large systematic review in 2021 of 73 studies that looked at endurance athletes (who run, swim or cycle long distances) found similar results. Supplementation with beetroot (and other vegetables rich in nitrate) improved their time to exhaustion by an average of 25.3 seconds and the distance travelled by 163 metres.
This improvement was seen in recreational athletes, but not in elite athletes or sedentary people. This analysis didn’t look specifically at women.
What is it about beetroot?
Beetroots are rich in nitrate and anthocyanins. Both provide health benefits but it’s primarily the nitrates that give the performance benefits.
Once ingested, the nitrate is converted in the mouth by the local bacteria into nitrite. In the acidic conditions of the stomach, the nitrite is then converted to nitric oxide, which is absorbed into the bloodstream.
Nitric oxide dilates blood vessels, which delivers oxygen more quickly to the muscles, so energy can be burned to fuel the exercising muscles.
The result is that less energy is used for performance, which means it takes longer to tire.
Read more: Why nitrates and nitrites in processed meats are harmful – but those in vegetables aren’t
How can I use beetroot juice?
The Australian Institute of Sport (AIS) has assessed beetroot and classified it as a Group A supplement. This means there is strong scientific evidence for use in specific situations in sport.
The AIS advises beetroot supplementation can be beneficial for exercise, training and competitive events that lasts 4–30 minutes and in team sports with intermittent exercise.
For performance benefits, the AIS advises the beetroot product (be it juice, powder or food) should have between 350–600mg of inorganic nitrate in it. Check the label. There are several concentrated juices available on the market.
Beetroot contains about 250mg per 100g of nitrate, so you need to consume at least 200g of baked beetroot to get the same effect.
To give the nitrates time to be converted to nitric oxide and absorbed into your bloodstream, you need to consume the product 2–3 hours before training or competition. You may get added benefits drinking beetroot juice for several days leading up to training or competition.
However, don’t use antibacterial products like mouthwashes, chewing gums or lollies. These will kill the bacteria in your mouth needed to convert the nitrate to nitrite.
Are there any downsides?
Your urine will turn red, and this will make it difficult to determine if you are dehydrated. Your poo may also turn red.
Some people may experience an upset stomach when consuming beetroot juice. So try drinking it while training to determine if you have any problems. You don’t want to find this out on competition day.
What about nitrate from the rest of your diet?
While it’s difficult to consume enough nitrate to boost your athletic performance directly from vegetables before an event, consuming five serves of vegetables a day will help keep the nitric oxide levels elevated in your blood.
Vegetables higher in nitrate include celery, rocket, spinach, endive, leek, parsley, kohlrabi, Chinese cabbage and celeriac. There isn’t clear evidence about the effect of cooking and storage on nitrate levels, so it’s probably best to eat them in the way you enjoy the most.
However, it’s best to avoid cured meats with added nitrate. The additive is used to stop the growth of bacteria and adds flavour and colour, but the resulting sodium nitrite can increase the risk of cancer.
While beetroot may give you a small performance boost, don’t forget to tailor the rest of your training as well. Ensure you have enough carbohydrates and protein, and that you drink enough water. You may need to consult an exercise scientist and an accredited practising sports dietitian to get the best outcome.
Devastating, horrific – the jab’s true effect on mothers-to-be
-From the beginning of the vaccination roll out, I witnessed hormonal changes in my patients, and mentioned my concerns to other doctors I know, including a specialist I have known for a long time, and trust. The reply I invariably got was “where is your evidence? ” and ” follow the science” A gynecologist/Obstetrician working at PA hospital was sacked because he publicly voiced these same concerns. A patient of mine told me on Tuesday that her pregnant daughter was made to have the Covid vaccine otherwise she could not receive obstetric care. Read the article below, and ask – where is the outrage? do we just accept this? Has anyone been held accountable for these terrible decisions?
Devastating, horrific – the jab’s true effect on mothers-to-be
March 20, 2023
DR James Thorp is an expert in high-risk and maternal foetal medicine. He has watched in horror, but thankfully not in silence, over the last two years as stillbirths, miscarriages and menstrual abnormalities have increased to numbers not experienced by women in recent history.
He is convinced that the novel mRNA Covid vaccinations have caused these catastrophic events and describes administering the shots to pregnant women as an ‘egregious violation of ethics’. He added: ‘We have never ever broken the sacrosanct golden rule in pregnancy of not administering novel substances to pregnant women since we learned our lessons from the past. [Thalidomide and diethylstilbesterol (DES). For more detail, see my analysis here.] There was never any safety data for the Covid vaccines so I can only conclude that this was a fait accompli.’ (See my analysis here.)
The figures he presents, distilled from US government information provided by its Vaccine Adverse Event Reporting System (VAERS), are shocking.
In addition, a leaked email from one of the largest hospitals in California, dated September 2022 and shared with TCW, was sent to 200 nurses working in their neonatal wards. It confirmed the phenomenon. The subject line said: ‘DEMISE HANDLING’ and it stated that: ‘It seems as though the increase of demise patients [babies] that we are seeing is going to continue. There were 22 demises [stillbirths and foetal deaths] in August [2022], which ties [equals] the record number of demises in July 2021, and so far in September [2022] there have been 7 and it’s only the 8th day of the month.’
Registered nurse Michelle Gershman, who works in the neonatal ward and has had her $5,000 bonus withheld for voicing her concerns, said she had noticed the increase. She said: ‘We used to have one foetal demise per month. That rose to one or two per week.’
Her experience, and the experience of doctors working with pregnant women, is contrary to official ‘safe and effective’ observation and advice, but no one was free to speak out because of a gagging order imposed in September 2021 by the American Board of Obstetrics and Gynaecology (ACOG).
Seven months earlier, in February 2021, Dr Anthony Fauci, former chief medical adviser to the US President, stated publicly that he had seen no red flags in the 10,000 women who had received the experimental Covid jab.
At the beginning of the rollout, in December 2020, pregnant women who were healthcare workers or deemed to be at risk from Covid began receiving the shots. By May 2021, the vaccine was being recommended to all pregnant American women, despite the fact that none of the vaccine manufacturers had completed reproductive toxicology reports in animals, and none had started clinical trials in pregnant women.
Two months later, hospitals noticed a huge increase in miscarriage, stillbirth, preterm births, pregnancy complications and menstrual abnormalities.
Dr Thorp and six colleagues, including the heart specialist Dr Peter McCullough, a witness to the increase of heart problems in newborns, compared VAERS reports post Covid vaccination with adverse events reported in pregnant women who had received the flu vaccine. The results are devastating:
· 1192 x higher rate of severe menstrual abnormalities;
· 57 x higher rate of miscarriage;
· 38 x higher rate of foetal death and stillbirth;
· 15 other major pregnancy complications exceeding the regulator’s safety threshold.
One of the most distressing menstrual abnormalities was an increase in incidences of decidual casting, which according to Dr Thorp, may even have occurred in a newborn baby. The decidua is the thick tissue lining the uterus and women were shedding it intact. It is a painful, distressing experience characterised by huge clots or the decidua detaching in one piece. Fewer than 50 cases had been recorded in 100 years then suddenly, in a seven-month period in 2021, 292 experienced this ‘rare’ event (which thankfully has no long-term effects).
Miscarriage and stillbirths were recorded in Pfizer’s post-marketing documents which show that they had received reports of 274 pregnancy adverse events. More than a quarter, 27 per cent, were considered serious.
Pfizer’s carnage list included premature birth with neonatal death, spontaneous abortion with intrauterine death, and rupture of membranes. They reported 19 cases in the first trimester, one in the second and two in the third trimester.
Michelle Gershman also noticed a rise in pre-eclampsia, a potentially dangerous complication characterised by high blood pressure which can lead to seizures and in rare cases to fatal consequences.
Experts are arguing about whether or not these figures are accurate, but our Office for National Statistics show that stillbirth figures increased by 199 in 2021 compared with 2020 (the height of Covid infections). They also said that the stillbirth ‘rate was above the five-year average in seven months of 2021’. No official figures are yet available for 2022.
It was April 2021 when pregnant British women were given the ‘green light’ to receive the Pfizer or Moderna mRNA jabs at any stage in their pregnancy.
Gershman said she began checking the notes of women losing their babies, some as late as 36 or 37 weeks (full term is 40 weeks). A pattern emerged as she noticed many had received their jabs or boosters a week earlier. Few mothers joined the dots and vaccinated consultants did not consider Covid injections as causation, so no alarm was raised.
Dr Kimberly Biss did not ignore what she saw in her private practice. A certified obstetrician-gynaecologist in Florida for almost 30 years, she said: ‘Back in 2021 we saw a significant increase in miscarriage in babies under 20 weeks usually occurring in the first trimester. I started keeping track, when I compared my data, miscarriages were doubling each year. In 2020 women (data analysed and confirmed by scientist Dr Jessica Rose) experienced 4 per cent losses, 8 per cent losses in 2021, 15 per cent losses in 2022. Miscarriage rates in our practice are currently 25 per cent.
‘Clinically I’ve never had a 10-15 per cent miscarriage rate, we normally see around 4 per cent although textbooks will tell you that 10-15 per cent is normal.
‘Ironically 2020 was the year when Covid, the disease, was at its worst. We had Alpha slowly turning into Delta, but we weren’t seeing the mishaps until the following year after they started the injections.
‘The number of newly registered pregnant patients is also going down year on year which may be a reflection of infertility.’
Anecdotally, in the UK, midwives are seeing women who have suffered multiple miscarriages post-vaccination, thin umbilical cords, clots in umbilical cords, placentas delivered in ribbons – the placenta is normally dark red and spongy, delivered as a healthy-looking disc. They say babies are failing to thrive and that double the usual number are being admitted to intensive care.
In the US, Michelle Gershman says that the neonatal intensive care unit in the hospital where she works also has double the number of babies. ‘There are generally 40 to 50. In March, we have 80.’
For speaking out Dr Thorp, 69, has come under threat. This is despite the fact that he has 44 years obstetric experience, has published 200 peer-reviewed clinical research papers, seen around 25,000 high-risk pregnancies, has received awards for his research and has served on the board of directors for the Society for Maternal Foetal Medicine and as an examiner for the American Board of Obstetrics and Gynaecology, an organisation now chastising him.
On December 7, 2022, he testified in the Senate with Senator Ron Johnson and others about the devastation affecting pregnant mothers.
Recently, Dr Thorp has focused his research efforts on the Covid-19 pandemic and has published more than 15 peer-reviewed scientific publications and a book documenting the dangers of the vaccine in women of reproductive age and in pregnancy. Nevertheless, his heroic efforts are falling on deaf ears and pregnant women are suffering indescribable grief.
Below is a full analysis of pregnancy Yellow Card reports made to the MHRA in the UK.
Miscarriages: 842; Pregnancy conditions: 1,234; Stillbirths and foetal deaths: more than 25. Underreporting is approximately 10 per cent according to MHRA, so add a nought for more accurate numbers.
A request for comment on the above information was sent to the Royal College of Obstetricians and Gynaecologists. Their spokesperson responded: ‘I’m struggling to understand exactly what you’re asking for here but hope this link helps. We’ve published our position on covid-19 vaccines here.’
The MHRA and US Centers for Disease Control have not yet responded to requests for comment.
ACOG refused to comment but offer advice on informed consent. They say: ‘Respect for autonomy provides a strong moral foundation for informed consent, in which a patient, adequately informed about her medical condition and the available therapies, freely chooses specific treatments or nontreatment. Respect for patient autonomy, like all ethical principles, cannot be regarded as absolute. At times it may conflict with other principles or values and sometimes must yield to them.’
SPECIAL REPORT FOCUS – PREGNANCY, FOETAL DEATHS, STILLBIRTHS & RELATED REPRODUCTIVE HEALTH ADVERSE EFFECTS
MHRA YELLOW CARD REPORTING SUMMARY UP TO FEBRUARY 22, 2023
(Data published March 8, 2023)
Below represents reactions experienced, not exhaustively listed.
People may have reported more than one type of reaction per report.
Pregnancy Conditions – 755 (Pfizer-mono) + <5 (Pfizer-bivalent) + 342 (AZ) + 113 (Moderna-mono) + 9 (Moderna-bivalent) + 15 (Unknown brand) = 1,234
Miscarriages (Spontaneous Abortions) – 514 (Pfizer-mono) + <5 (Pfizer-bivalent) + 241 (AZ) + 72 (Moderna-mono) + 5 (Moderna-bivalent) + 10 (Unknown brand) = 842
Stillbirths & Foetal Deaths – 19 (Pfizer-mono) + zero cases but recorded <5 (not zero) fatalities (Pfizer-bivalent) + 6 (AZ) + <5 (Moderna-mono) + zero cases but recorded <5 (not zero) fatalities (Moderna-bivalent) + < 5 cases but zero fatalities noted (Unknown brand) = greater than 25
Congenital Disorders – 121 (Pfizer-mono) + <5 (Pfizer-bivalent) + 122 (AZ) + 17 (Moderna-mono) + <5 (Moderna-bivalent) + <5 (Unknown brand) = 260
Injuries Category – Maternal & Foetal Vaccination Exposure During Pregnancy & Breastfeeding – 3,472 (Pfizer-mono) + 35 (Pfizer-bivalent) + 2,007 (AZ) + 928 (Moderna-mono) + 49 (Moderna-bivalent) + 19 (Unknown brand) = 6,510
Reproductive & Breast Disorders (all ages/sex) – 31,798 (Pfizer-mono) + 146 (Pfizer-bivalent) + 21,015 (AZ) + 5,369 (Moderna-mono) + 91 (Moderna-bivalent) + <5 (Novavax) + 279 (Unknown brand) = 58,698
Including breast signs and symptoms that include discharge, oedema, pain and swelling, vaginal haemorrhage, premature menopause, post-menopausal bleeding, menstruation with decreased or increased bleeding, uterine, ovarian, cervix, vaginal, vulva and fallopian tube cysts, inflammation, infections, neoplasms (abnormal tissue growth) and other disorders.
Reproductive & Breast Disorders (10-39yrs – Female) – 20,320 (Pfizer-mono) + 44 (Pfizer-bivalent) + 6,887 (AZ) + 3,071 (Moderna-mono) + 40 (Moderna-bivalent) + <5 (Novavax) + 118 (Unknown brand) = 30,480
Of which 25,204 reaction types were deemed *SERIOUS = 82.7%
Reproductive & Breast Disorders (10-19yrs – Female) – 785 (Pfizer-mono) + 82 (AZ) + 69 (Moderna-mono) + 10 (Unknown brand) = 946
Of which 766 reaction types were deemed *SERIOUS = 81%
* MHRA definition of ‘serious’ – patient died, life-threatening, hospitalisation, congenital abnormality, persistent or significant disability or capacity, deemed medically significant by MHRA medical dictionary or reporter
For full reports, see here.
The wellbeing ‘pandemic’ – how the global drive for wellness might be making us sick
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The wellbeing ‘pandemic’ – how the global drive for wellness might be making us sick
Published: February 23, 2023 6.04am AEDT
Authors
- Steven James JacksonProfessor and Co-Director, New Zealand Centre for Sport Policy & Politics, University of Otago
- Marcelle DawsonAssociate Professor of Sociology, Gender Studies and Criminology, University of Otago
- Michael SamAssociate Professor of Physical Education, Sport and Exercise Sciences, University of Otago
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Are we in the midst of a wellbeing pandemic? The question may seem curious, even contradictory. But look around, the concept is everywhere and spreading: in the media, in government institutions and transnational organisations, in schools, in workplaces and in the marketplace.
To be clear, it’s not just wellbeing’s infectiousness in public discourse that makes it pandemic-like. It’s also the genuine malaise that can be caused by the term’s misuse and exploitation.
Do you sense, for example, that your wellbeing is increasingly being scrutinised by peers, managers and insurance companies? Are you noticing an increasing number of advertisements offering products and services that promise enhanced wellbeing through consumption? If so, you’re not alone.
But we also need to ask whether this obsession with wellbeing is having the opposite to the desired effect. To understand why, it’s important to look at the origins, politics and complexities of wellbeing, including its strategic deployment in the process of what we call “wellbeing washing”.
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The halo effect
While concerns about wellbeing can be traced to antiquity, the term has emerged as a central feature of contemporary social life. One explanation is that it is often conflated with concepts as diverse as happiness, quality of life, life satisfaction, human flourishing, mindfulness and “wellness”.
Wellbeing is flexible, in the sense that it can be easily inserted into a diverse range of contexts. But it’s also surrounded by a kind of halo, automatically bestowed with a positive meaning, similar to concepts such as motherhood, democracy, freedom and liberty.
To contest the value and importance of such things is to risk being labelled a troublemaker, a non-believer, unpatriotic or worse.
Read more: Wellbeing needs a rethink – and a global outlook is the way to start
These days, there are two main concepts of wellbeing. The first – subjective wellbeing – emphasises a holistic measure of an individual’s mental, physical and spiritual health. This perspective is perhaps best reflected in the World Health Organization’s WHO-5 Index, designed in 1998 to measure people’s subjective wellbeing according to five states: cheerfulness, calmness, vigour, restfulness and fulfilment.
Translated into more than 30 languages, the overall influence of the WHO-5 Index should not be underestimated; both governments and corporations have embraced it and implemented policy based on it.
But the validity of the index, and others like it, has been questioned. They’re prone to oversimplification and a tendency to marginalise alternative perspectives, including Indigenous approaches to physical and mental health.
Individual responsibility
The second perspective – objective wellbeing – was a response to rising social inequality. It focuses on offering an alternative to GDP as a measure of overall national prosperity.
One example of this is New Zealand’s Living Standards Framework, which is guided by four operating principles: distribution, resilience, productivity and sustainability. These new and purportedly more progressive measures of national economic and social outcomes signal societal change, optimism and hope.
The trouble with such initiatives, however, is that they remain rooted within a particular neoliberal paradigm in which individual behaviour is the linchpin for change, rather than the wider political and economic structures around us.
Arguably, this translates into more monitoring and “disciplining” of personal actions and activities. Intentionally or not, many organisations interpret and use wellbeing principles and policies to reinforce existing structures and hierarchies.
Consider how the wellbeing agenda is playing out in your organisation or workplace, for example. Chances are you have seen the growth of new departments, work units or committees, policies and programs, wellness workshops – all supposedly linked to health and wellbeing.
You may even have noticed the creation of new roles: wellbeing coaches, teams or “champions”. If not, then “lurk with intent” and be on the lookout for the emergence of yoga and meditation offerings, nature walks and a range of other “funtivities” to support your wellbeing.
Wellbeing washing
The danger is that such initiatives now constitute another semi-obligatory work task, to the extent that non-participation could lead to stigmatisation. This only adds to stress and, indeed, unwellness.
Deployed poorly or cynically, such schemes represent aspects of “wellbeing washing”. It’s a strategic attempt to use language, imagery, policies and practices as part of an organisation’s “culture” to connote something positive and virtuous.
Read more: Pilates, fruit and Amazon’s zen booths: why workplace wellbeing efforts can fall short
In reality, it could also be designed to enhance productivity and reduce costs, minimise and manage reputational risk, and promote conformity, control and surveillance.
Ultimately, we argue that wellbeing now constitutes a “field of power”; not a neutral territory, but a place where parties advance their own interests, often at the expense of others. As such, it’s essential that scholars, policymakers and citizens explore, as one author put it, “what and whose values are represented, which accounts dominate, what is their impact and on whom”.
Because if wellbeing is becoming a pandemic, we may well need the “vaccine” of critical reflection
The Subversive Wisdom of ‘Old Wives’ Tales’
Letter of Recommendation
The Subversive Wisdom of ‘Old Wives’ Tales’
Women’s care has always depended on women’s sharing stories with one another.
By Hillary Brenhouse
March 14, 2023
As a kid, I believed every last old wives’ tale. I was sure that if I read in the dark I would go blind. That if I swam in the lake after a generous lunch I might sink to the bottom. That if I swallowed my bubble gum, the kind that came with a tiny comic strip, the hardened pebble of it would ferment in my stomach for the next seven years, which was a whole lifetime to me then.
In pregnancy I was a child again, vulnerable to received wisdom, desperate for anyone or anything that might show me the way. Through all of it, women considered my belly — how low it hung, how it led the rest of my body around — and declared that I was having a boy. I couldn’t help picturing my young son, until the day, eight months ago, when my baby slid into the tub water and I held her up to the lousy bathroom light.
The imagined divide between “legitimate” knowledge and the stories of women is archaic, older even than the King James Bible, in which Paul advises Timothy to “refuse profane and old wives’ fables, and exercise thyself rather unto godliness.” But the phrase “old wives’ tales” became popular in America in the 19th century, when a nascent medical establishment decided it would dismantle and replace female lay-healing traditions. Midwives, many of them older Black and immigrant women, were the final holdouts in this takeover. They were so thoroughly disparaged by male obstetricians that midwifery was essentially outlawed in the United States.
The physicians condemned the midwives in the name of science. These “old wives,” who educated one another in the evidence of their experience and rarely wrote anything down, were accused of trading scraps of hearsay, a damning indictment. For what could possibly be less credible than a story told by a woman?
As long as I’ve had a body and been confused by it, which is to say forever, I have been guided by women’s stories. Not the fictions that are called old wives’ tales no matter their source, simply by virtue of being nonsense. I’m talking about actual old wives’ tales: women offering counsel based on their encounters with sex and birth and bodily ailments.
It’s necessary to our survival that we tell each other stories.
The first who comes to mind is Gabriella, the Jewish Hungarian aesthetician who waxed my bikini line for the first time, each of my legs draped over one of her soft thighs as she recited remedies for ingrown hairs, bunions, bags under the eyes. Women, drawing on their own lives, told me how to lessen the agonizing endometriosis pain that has been routinely waved away by my doctors. (Coriander essential oil and masturbation, but not together, please.) An older unlicensed midwife advised me during my third trimester, sharing details about the hundreds of labors she’d attended and plants that help to prevent hemorrhage.
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It’s hard to say what’s most fatal about the label “old wives’ tale.” Are we to mistrust the tale because it originated with an old wife, or because stories are inherently unreliable? The idea that first-person storytelling can’t act as a vehicle for authoritative knowledge is well worn. As Melissa Febos writes, “Resistance to the lived stories of women” is “founded on the false binary between the emotional (female) and the intellectual (male), and intended to subordinate the former.”
And yet women’s care has always depended on women’s sharing stories with one another. I’m reminded of it every time I find myself scrolling message boards into the night, searching not just for answers but to feel less alone. There they are, other women who didn’t feel quite right after the loop electrosurgical excision procedure, or LEEP, which removes abnormal tissue from the cervix. Other women wondering if their copper IUDs might actually be responsible for their strange conditions. Others with postpartum hemorrhoids, low libido, long Covid. Women are severely underrepresented in clinical trials and far more likely to have their symptoms dismissed as illusory. It’s necessary to our survival that we tell each other stories, extract their insights and suggest paths toward relief, even when these may lead nowhere.
But frequently they lead somewhere. Long before the development of modern scientific technology, many American midwives, acting on anecdote and observation, engaged in preventive care. Formally trained doctors, meanwhile, embraced rituals, like bloodletting, that were often ineffective when not murderous. As Barbara Ehrenreich and Deirdre English write in their foundational text “Witches, Midwives and Nurses,” these women healers “developed an extensive understanding of bones and muscles, herbs and drugs, while physicians were still deriving their prognoses from astrology and alchemists were trying to turn lead into gold.”
Perhaps the authors of the ill-founded old wives’ tales we swap were operating according to a different kind of wisdom, the kind we aren’t used to recognizing. Swallowing too much gum will indeed block your digestive tract. Reading in low light causes eye strain. It’s worth looking beyond the distinction between science and superstition, toward what else might count as knowledge.
I think about the lessons of my embodied experience as the hair that fell out several months after I gave birth begins to grow back in. Tiny new hairs have sprouted across my scalp — I look as though I were scribbled in a kindergarten class — and every day I stop myself from pulling out the white ones. I know it can’t be true, the story that says if you pluck a white strand, two will take its place. But I remember it, more than any sterile prescription slip I was ever handed. I remember it because it was told — vivid and fantastic and utterly terrifying — to be remembered. And then I avoid the futile work of fighting against my own aging, scribbled self, which is maybe just the remedy the tale intended.
Hillary Brenhouse is a writer based in Montreal and an editor at large of Guernica magazine.
Is menopause making me put on weight? No, but it’s complicated
Is menopause making me put on weight? No, but it’s complicated
Published: March 12, 2023 12.47pm AEDT
Author
- Nick FullerCharles Perkins Centre Research Program Leader, University of Sydney
Disclosure statement
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.
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Republish our articles for free, online or in print, under Creative Commons licence.
It’s a question people ask often: does menopause cause weight gain?
Women commonly put on weight as they enter menopause. Research shows women aged 46-57 gain an average of 2.1kg over five years.
But like many things related to weight, all is not what it seems, and the relationship between menopause and weight gain is not straightforward.
Here’s everything you need to know about menopausal weight gain and what you can do about it.
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What typically happens to women’s bodies during menopause?
Menopause marks the natural end of the reproductive stage of a woman’s life. It officially starts when a woman has not menstruated for 12 months, and most women reach menopause between the ages of 45 and 55, but it can happen much earlier or later.
The transition to menopause, however, typically starts four years prior, with perimenopause marking the time when a woman’s ovaries start slowing down, producing less oestrogen and progesterone. Eventually, these hormone levels fall to a point at which the ovaries stop releasing eggs and menstruation stops.
The symptoms associated with the menopausal transition are many and varied, and can include irregular periods, breast pain, vaginal dryness, hot flashes, night sweats, fatigue, difficulty sleeping, and changes in mood and libido.
Read more: How long does menopause last? 5 tips for navigating uncertain times
So does menopause cause weight gain?
The short answer is no. But it’s complicated.
When it comes to menopause and weight, it’s weight redistribution – not weight gain – that is actually a symptom. Research has confirmed menopause is linked to an increase in belly fat but not an increase in overall weight.
This is because the hormonal changes experienced during menopause only prompt a change in where the body stores fat, making women’s stomachs and waists more prone to weight gain. Research shows visceral fat (deep belly fat) increases by nearly 50% in postmenopausal women, compared with premenopausal women.
It’s also important to recognise some menopause symptoms may indirectly contribute to weight gain:
- sleep issues can lead to sleep deprivation, disturbing the body’s appetite hormones, increasing feelings of hunger and triggering food cravings
- some mood changes can activate the body’s stress responses, increasing the production of the hormone cortisol, promoting fat storage and triggering unhealthy food cravings. Mood can also impact the motivation to exercise
- fatigue, breast pain and hot flushes can make physical activity challenging or uncomfortable, also impacting the ability to exercise.
The truth? Ageing is the real cause of menopausal weight gain
You read that right – the weight gain often associated with menopause is a byproduct of ageing.
As the body ages, it stops working as efficiently. It experiences an involuntary loss of muscle mass – referred to as sarcopenia – and fat levels begin to increase.
Because muscle mass helps determine the body’s metabolic rate (how much energy the body burns at rest), when we lose muscle, the body starts to burn fewer calories at rest.
Ageing also means dealing with other health issues that can make weight management more complex. For example, medications can impact how the body functions, and arthritis and general aches and pains can impact mobility and the ability to exercise.
In short – the body’s ageing process and changing physicality is the real reason women experience menopause weight gain.
Read more: ‘Brain fog’ during menopause is real – it can disrupt women’s work and spark dementia fears
It’s not just weight gain
While menopause doesn’t make you put on weight, it can increase a woman’s risk of other serious health conditions.
The redistributed weight that leads to more fat being carried in the belly can have long-term effects. Belly fat that lies deep within the abdominal cavity (visceral fat) is an especially unhealthy fat because it’s stored close to the organs. People with a high amount of visceral fat have a higher risk of stroke, type 2 diabetes and heart disease than people who hold body fat around their hips.
The reduction in the amount of oestrogen produced by the ovaries during menopause also increases a woman’s risk of heart disease and stroke. This is because oestrogen helps keep blood vessels dilated – relaxed and open – to help keep cholesterol down. Without it, bad cholesterol can start to build up in the arteries.
Lower oestrogen can also result in a loss of bone mass, putting women at greater risk of osteoporosis and more prone to bone fractures and breaks.
The bottom line: can we prevent weight gain during menopause?
Menopause itself does not cause weight gain; it unfortunately just occurs during a stage of life when other factors are likely to. The good news is weight gain associated with ageing is not inevitable, and there are many things women can do to avoid weight gain and health risks as they age and experience menopause.
Start with these six steps:
- incorporate daily exercise into your routine, with a mixture of intensities and variety of exercises, including body-strengthening exercises twice a week
- stop dieting. Dieting drives up the weight your body will strive to return to (your “set point”), so you’ll end up heavier than before you began. You’ll also slow down your metabolism with each diet you follow
- curb your sugar cravings naturally. Every time you feel an urge to eat something sugary or fatty, reach for nature first – fruits, honey, nuts, seeds and avocado are a few suitable examples. These foods release the same feelgood chemicals in the brain as processed and fast food do, and leave us feeling full
- create positive habits to minimise comfort-eating. Instead of unwinding in the afternoon or evening on the couch, go for a walk, work on a hobby or try something new
- eat slowly and away from distractions to reduce the quantity of food consumed mindlessly. Use an oyster fork, a child’s fork or chopsticks to slow down your eating
- switch off your technology for a minimum of one hour before bed to improve sleep quality
Exercise is even more effective than counselling or medication for depression. But how much do you need?
Exercise is even more effective than counselling or medication for depression. But how much do you need?
Published: March 2, 2023 6.06am AEDT
Authors
- Ben SinghResearch fellow, University of South Australia
- Carol MaherProfessor, Medical Research Future Fund Emerging Leader, University of South Australia
- Jacinta BrinsleyPostdoctoral research fellow, University of South Australia
Disclosure statement
Ben Singh receives funding from the International Society of Behaviour Nutrition and Physical Activity.
Carol Maher receives funding from the Medical Research Future Fund, the National Health and Medical Research Council, the National Heart Foundation, the SA Department for Education, the SA Department for Innovation and Skills, Healthway, Hunter New England Local Health District, the Central Adelaide Local Health Network, and LeapForward.
Jacinta Brinsley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
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The world is currently grappling with a mental health crisis, with millions of people reporting depression, anxiety, and other mental health conditions. According to recent estimates, nearly half of all Australians will experience a mental health disorder at some point in their lifetime.
Mental health disorders come at great cost to both the individual and society, with depression and anxiety being among the leading causes of health-related disease burden. The COVID pandemic is exacerbating the situation, with a significant rise in rates of psychological distress affecting one third of people.
While traditional treatments such as therapy and medication can be effective, our new research highlights the importance of exercise in managing these conditions.
Our recent study published in the British Journal of Sports Medicine reviewed more than 1,000 research trials examining the effects of physical activity on depression, anxiety, and psychological distress. It showed exercise is an effective way to treat mental health issues – and can be even more effective than medication or counselling.
Read more: Considering going off antidepressants? Here’s what to think about first
Harder, faster, stronger
We reviewed 97 review papers, which involved 1,039 trials and 128,119 participants. We found doing 150 minutes each week of various types of physical activity (such as brisk walking, lifting weights and yoga) significantly reduces depression, anxiety, and psychological distress, compared to usual care (such as medications).
The largest improvements (as self-reported by the participants) were seen in people with depression, HIV, kidney disease, in pregnant and postpartum women, and in healthy individuals, though clear benefits were seen for all populations.
We found the higher the intensity of exercise, the more beneficial it is. For example, walking at a brisk pace, instead of walking at usual pace. And exercising for six to 12 weeks has the greatest benefits, rather than shorter periods. Longer-term exercise is important for maintaining mental health improvements.
Read more: When it’s easier to get meds than therapy: how poverty makes it hard to escape mental illness
How much more effective?
When comparing the size of the benefits of exercise to other common treatments for mental health conditions from previous systematic reviews, our findings suggest exercise is around 1.5 times more effective than either medication or cognitive behaviour therapy.
Furthermore, exercise has additional benefits compared to medications, such as reduced cost, fewer side effects and offering bonus gains for physical health, such as healthier body weight, improved cardiovascular and bone health, and cognitive benefits.
Why it works
Exercise is believed to impact mental health through multiple pathways, and with short and long-term effects. Immediately after exercise, endorphins and dopamine are released in the brain.
In the short term, this helps boost mood and buffer stress. Long term, the release of neurotransmitters in response to exercise promotes changes in the brain that help with mood and cognition, decrease inflammation, and boost immune function, which all influence our brain function and mental health.
Regular exercise can lead to improved sleep, which plays a critical role in depression and anxiety. It also has psychological benefits, such as increased self-esteem and a sense of accomplishment, all of which are beneficial for people struggling with depression.
Read more: Let’s dance! How dance classes can lift your mood and help boost your social life
Not such an ‘alternative’ treatment
The findings underscore the crucial role of exercise for managing depression, anxiety and psychological distress.
Some clinical guidelines already acknowledge the role of exercise – for example, the Australian and New Zealand Clinical Guidelines, suggest medication, psychotherapy and lifestyle changes such as exercise.
However, other leading bodies, such as the American Psychological Association Clinical Practice Guidelines, emphasise medication and psychotherapy alone, and list exercise as an “alternative” treatment – in the same category as treatments such as acupuncture. While the label “alternative” can mean many things when it comes to treatment, it tends to suggest it sits outside conventional medicine, or does not have a clear evidence base. Neither of these things are true in the case of exercise for mental health.
Even in Australia, medication and psychotherapy tend to be more commonly prescribed than exercise. This may be because exercise is hard to prescribe and monitor in clinical settings. And patients may be resistant because they feel low in energy or motivation.
But don’t ‘go it alone’
It is important to note that while exercise can be an effective tool for managing mental health conditions, people with a mental health condition should work with a health professional to develop a comprehensive treatment plan – rather than going it alone with a new exercise regime.
A treatment plan may include a combination of lifestyle approaches, such as exercising regularly, eating a balanced diet, and socialising, alongside treatments such as psychotherapy and medication.
But exercise shouldn’t be viewed as a “nice to have” option. It is a powerful and accessible tool for managing mental health conditions – and the best part is, it’s free and comes with plenty of additional health benefits.
Prostate cancer treatment can wait for most men, study finds
Urogenital & Renal Cancers > Prostate Cancer
I have been promoting this watchful waiting approach for a long time. I am of the opinion that surgeons are just too keen on surgery and do not follow the cautious approach enough. (in other areas as well)
Prostate cancer treatment can wait for most men, study finds
Published March 13, 2023 | Originally published on MedicalXpress Breaking News-and-Events
Researchers have found long-term evidence that actively monitoring localized prostate cancer is a safe alternative to immediate surgery or radiation.
The results, released Saturday, are encouraging for men who want to avoid treatment-related sexual and incontinence problems, said Dr. Stacy Loeb, a prostate cancer specialist at NYU Langone Health who was not involved in the research.
The study directly compared the three approaches—surgery to remove tumors, radiation treatment and monitoring. Most prostate cancer grows slowly, so it takes many years to look at the disease’s outcomes.
“There was no difference in prostate cancer mortality at 15 years between the groups,” Loeb said. And prostate cancer survival for all three groups was high—97% regardless of treatment approach. “That’s also very good news.”
The results were published Saturday in the New England Journal of Medicine and presented at a European Association of Urology conference in Milan, Italy. Britain’s National Institute for Health and Care Research paid for the research.
Men diagnosed with localized prostate cancer shouldn’t panic or rush treatment decisions, said lead author Dr. Freddie Hamdy of the University of Oxford. Instead, they should “consider carefully the possible benefits and harms caused by the treatment options.”
A small number of men with high-risk or more advanced disease do need urgent treatments, he added.
Researchers followed more than 1,600 U.K. men who agreed to be randomly assigned to get surgery, radiation or active monitoring. The patients’ cancer was confined to the prostate, a walnut-sized gland that’s part of the reproductive system. Men in the monitoring group had regular blood tests and some went on to have surgery or radiation.
Death from prostate cancer occurred in 3.1% of the active-monitoring group, 2.2% in the surgery group, and 2.9% in the radiation group, differences considered statistically insignificant.
At 15 years, cancer had spread in 9.4% of the active-monitoring group, 4.7% of the surgery group and 5% of the radiation group. The study was started in 1999, and experts said today’s monitoring practices are better, with MRI imaging and gene tests guiding decisions.
“We have more ways now to help catch that the disease is progressing before it spreads,” Loeb said. In the U.S., about 60% of low-risk patients choose monitoring, now called active surveillance.
Hamdy said the researchers had seen the difference in cancer spread at 10 years and expected it to make a difference in survival at 15 years, “but it did not.” He said spread alone doesn’t predict prostatecancer death.
“This is a new and interesting finding, useful for men when they make decisions about treatments,” he said.
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Dr Colin Holloway 
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