Category Archives: Uncategorized

HRT and memory loss.

I have published many studies showing that taking hormones in the menopause reduces the risk of memory loss, dementia and alzheiners disease. Here is another very recent study showing the same thing, This alone is a good reason to continue taking hormones long-term.

Menopausal hormone therapy and mild cognitive impairment: a randomized, placebo-controlled trial

Yoon, Byung-Koo, MD1; Chin, Juhee, PhD2; Kim, Jong-Won, MD3; Shin, Myung-Hee, MD4; Ahn, Soohyun, PhD5; Lee, Dong-Yun, MD1; Seo, Sang Won, MD2,6; Na, Duk L., MD2,6

 

doi: 10.1097/GME.0000000000001140
Original Articles

Objective: The aim of the study was to explore the therapeutic potential of menopausal hormone therapy (MHT) in women with mild cognitive impairment (MCI).

Methods: Thirty-seven postmenopausal women (age range: 57-82 y) with multiple-domain, amnestic subtype MCI were randomly assigned to either placebo (n = 18) or MHT (n = 19) for 24 months (percutaneous estradiol [E2] gel [0.1%, 2 mg/d] and oral micronized progesterone [MP4] [100 mg/d]). All participants received donepezil, and apolipoprotein E genotype was determined. The primary endpoint was general cognitive function: Alzheimer’s disease Assessment Scale, cognitive subscale, the Korean version of Mini-Mental State Examination (K-MMSE), and the Korean version of the Montreal Cognitive Assessment (MoCA_K) were performed in-person every 6 months.

Results: Twenty-one participants (placebo 13, MHT 8) completed the trial (56.8%). Progression rates to dementia were 52.9% (9/17) in the placebo group and 44.4% (8/18) in the MHT group. Within-group analysis showed that all three tests significantly worsened during the trial in the placebo, but not the MHT groups. Analysis adjusted for ε4 allele demonstrated that MHT significantly reduced deterioration of MoCA_K score, a sensitive tool for assessing global cognition in MCI (P = 0.0261). Compared with the control group, both MoCA_K (P = 0.043; mean difference, 3.85; 95% CI, −0.46 to 8.16) and K-MMSE (P = 0.0319; mean difference, 3.26; 95% CI, 0.04-6.48) scores were significantly better at 24 months in the MHT group.

Conclusions: Long-term MHT using percutaneous E2 gel and oral MP4 might attenuate cognitive decline in postmenopausal women with MCI.

We can change our brain and its ability to cope with disease with simple lifestyle choices

We can change our brain and its ability to cope with disease with simple lifestyle choices

This is part of our series on Changing the Brain, about what’s happening in our brain in various mental states and how we can change it for the better and worse.


Our life expectancy has increased dramatically over the past several decades, with advances in medical research, nutrition and health care seeing us live well into our 80s. But this longer life expectancy has also come at a cost, as the longer we live, the more likely we are to develop neurodegenerative diseases such as dementia.

Despite the lack of treatments for these diseases, there’s now a growing body of research to suggest there are a range of lifestyle changes we can adopt to help enhance our brain function. And even prevent brain disease.

Exercise

The effects of physical activity, particularly aerobic exercise, on brain health have been well studied. There’s now evidence to suggest engaging in physical activity can improve brain health through a phenomenon called neuroplasticity. This is where brain cells can more easily respond to disease or injury.


Read more: Mind-bending drugs and devices: can they make us smarter?


Physical activity can induce a cascade of biological processes that improve function of brain regions responsible for memory, and things such as decision making.

In particular, going for a run or bike ride (as opposed to only strength exercises such as weight training) have been shown to increase levels of “brain-derived neurotrophic factor”, a protein central to the growth and survival of brain cells. Brain imaging studies are also starting to confirm exercise training can result in a bigger hippocampus (the brain region responsible for memory) and improvements in memory.

Just as protein shakes may help muscles grow after exercise, the brain-derived neurotrophic factor may help to strengthen and generate brain cells. This in turn can increase the brain’s ability to cope with injury or disease.

Exercise strengthens our brains as well as our muscles. Kyle Kranz/Unsplash

Meditation

Over the past decade, there’s been an explosion of interest in meditation and mindfulness as a treatment of mental health disorders, particularly depression and anxiety.

Some studies have suggested long-term engagement in meditation is associated with physiological brain changes (such as larger brain volumes and higher brain activity).

But the extent to which meditation is associated with better memory, or with long-term protection against brain diseases, remains to be determined.

Hypnosis

Hypnosis is one of the oldest forms of psychotherapy. It is typically used as an adjunct treatment for pain, and a range of anxiety disorders, including post-traumatic stress. Recent studies show that during hypnosis, changes in brain activity are detected in brain regions that govern attention and emotional control.

One small study (18 patients) suggested hypnosis substantially improved the quality of life of dementia patients after 12 months, with patients experiencing higher levels of concentration and motivation. But this result is very preliminary, and requires independent replication with larger numbers of patients.

It’s likely hypnosis plays an important role in reducing stress and anxiety, which may in turn improve focus, attention and wellbeing in general.

So what works?

The challenge with studying the effects of lifestyle changes on brain health, particularly over a long period of time, is the large degree of overlap across all lifestyle factors. For example, engaging in physical activity will be related to better sleep and less stress – which also improve our memory and thinking function.

Similarly, better sleep is related to improved mood. It may make people feel more motivated to exercise, which may also lead to better memory and thinking function.

The extent to which we can truly determine the contribution of each lifestyle factor (sleep, physical activity, diet, social engagement) to our brain health remains limited.

But a wide range of lifestyle factors that are highly modifiable such as physical inactivity, obesity, chronic stress and high blood pressure can have far-reaching effects on our brain health. After all, it is mid-life high blood pressure, obesity and physical inactivity that can increase our risk of dementia in later life.

Recently, a large study of 21,000 American adults aged over 65 suggested the prevalence of dementia fell significantly from 11.6% to 8.8% (nearly a 25% reduction) over 12 years (from 2000 to 2012). The researchers suggested this decrease in prevalence may be due to increases in education and better control of risk factors for high cholesterol and high blood pressure.

This provides some hope that we can, to a certain extent, take charge of our brain health through engagement in a wide range of beneficial activities that seek to improve mental function, improve heart health, or reduce stress.

It’s never too early to start investing in the health of our brains, particularly when these lifestyle changes are easily implemented, and readily accessible to most of us.

How long should you stay away when you have a cold or the flu?

Health Check: how long should you stay away when you have a cold or the flu?

Most adults get around two to three colds a year, and children get even more. In terms of the flu, there are around 3-5 million severe cases of influenza worldwide each year and 290,000 to 650,000 deaths.

The symptoms of a cold and the flu are similar, so it’s hard to tell the difference. But the flu is usually more severe and develops more quickly than a cold.

Colds and flus can be easily passed from person to person through the air, when an infected person coughs or sneezes, and touch, when a person touches an infected surface or object like doorknobs and light switches.

So what’s the difference between colds and flus, and how long should you stay away?

Colds

Cold symptoms include a sore throat, cough, runny or stuffy nose, tiredness and headache.

Most people become contagious with cold symptoms one to two days after exposure to a cold virus. These symptoms usually peak two to four days later. The common cold usually lasts about ten days.


Read more: I’ve always wondered: why is the flu virus so much worse than the common cold virus?


There is nothing you can take to shorten the duration of a cold, and most people will get better without needing to see a doctor. But some over-the-counter medications can help alleviate the symptoms. These include anti-inflammatories (to reduce inflammation or swelling), analgesics (to reduce pain), antipyretics (to reduce fever) and decongestants (to relieve nasal congestion).

But be careful you follow the instructions and recommended dosage for these medications. A recent study of US adults who used paracetamol, the active ingredient in many cold and flu medicines, found 6.3% of users exceeded the maximum recommended daily dose. This mostly occurred during the cold and flu season.

For your own and others’ health, the best place for you to be when you’re sick is at home. Shutterstock

Natural products such as vitamin C and echinacea are sometimes recommended to prevent and treat a cold, but there is limited evidence to support their effectiveness.

The flu

Common symptoms of the flu include fever (a temperature of 38°C or higher), cough, chills, sore throat, headache, runny or stuffy nose, tiredness and muscle aches.

An infected person can spread the flu for five to seven days after becoming infected. The infectious period can begin 24 hours before the onset of symptoms. This means you can spread the flu without even knowing you’re sick.

Influenza viruses can cause mild to severe illness in people of all ages. Most people will fully recover within one to two weeks and won’t require any medical attention. Similar to a cold, people can take some over-the-counter medications and other remedies to help alleviate symptoms.


Read more: Explainer: what’s new about the 2018 flu vaccines, and who should get one?


But some people can become acutely unwell with the flu. They may require antiviral medication and, in severe cases, hospitalisation. Those at high risk include pregnant women, children, the elderly, and people with certain medical conditions such as HIV/AIDS, asthma, diabetes and heart and lung diseases.

The flu virus strains that circulate usually change every year, so the best way to prevent getting the flu is to get the annual flu vaccine. The vaccine is moderately effective and recommended for adults and children over the age of six months. Some common side effects may occur, such as temporary soreness, redness and swelling at the injection site, fever, headache, muscle aches and nausea.

Wash with soap for at least 20 seconds to kill the germs. Shutterstock/Alexander Raths

Avoid passing it on

If you feel unwell, stay home from work or school and rest (and get plenty of fluids) until you feel better. If you’ve had a fever, stay home for at least 24 hours after the fever has broken.

When you go back to work or school, you may still be infectious, so avoid passing the virus on by:

  • regularly washing your hands with soap and water for at least 20 seconds and drying them properly – if soap and water are not available, use an alcohol-based hand sanitiser
  • practising good cough and sneeze etiquette: cover your mouth and nose with a tissue or your upper shirtsleeve when you cough or sneeze, and throw away used tissues immediately
  • not touching your eyes, nose and mouth
  • frequently cleaning the surfaces and objects you’ve touched.

Should I take vitamin C or other supplements for my cold?

Health Check: should I take vitamin C or other supplements for my cold?

Once you have a cold, taking vitamin C supplements won’t do anything. From shutterstock.com

Last week I had a shocking cold. Blocked nose, sore throat, and feeling poorly. This made me think about the countless vitamins and supplements on the market that promise to ease symptoms of a cold, help you recover faster, and reduce your chance of getting another cold.

When it comes to the common cold (also called upper respiratory tract infections) there is no magic cure (I wish) but some supplements may deliver very minor improvements. Here is what the latest research evidence says.


Read more: Health Check: can you treat the common cold?


Vitamin C

For the average person, taking vitamin C does not reduce the number of colds you get, or the severity of your cold.

In terms of how long your cold lasts, some studies have looked at people taking vitamin C every day, while others have focused on participants taking it once they develop a cold.

In 30 studies comparing the length of colds in people regularly taking at least 200 milligrams of vitamin C daily, there was a consistent reduction in the duration of common cold symptoms.

However, the effect was small and equates to about half a day less in adults, and half to one day less in children. These types of studies also found a very minor reduction in the amount of time needed off work or school.

Among studies where vitamin C was only started once a cold had developed, there was no difference in duration or severity of a cold.

There are some risks to taking vitamin C supplements. They can increase the risk of kidney stones in men, and shouldn’t be taken by people with the iron storage disease haemochromatosis, as vitamin C increases iron absorption.


Read more: Feeling worn out? You could have iron overload


Special considerations

Although in the general population vitamin C has no impact on the number of colds people get, there is an exception. For people who are very physically active – such as marathon runners, skiers and soldiers exercising in very cold conditions – vitamin C halved their chance of getting a cold.

Many people take vitamin C supplements in hope it will treat their cold. From shutterstock.com

A few studies have also found some benefit from vitamin C supplements of at least 200 milligrams a day for preventing colds among those with pneumonia.

However, taking vitamin E supplements in combination with a high intake of vitamin C from food markedly increased the risk of pneumonia.

Zinc

A review of studies testing zinc supplements in healthy adults found starting daily supplements of at least 75 milligrams within 24 hours of the onset of a cold shortened the duration by up to two days or by about one-third. It made no difference to the severity of the cold.

There was some variability in the results across trials, with insufficient evidence related to preventing colds. Researchers suggested that for some people, the side effects such as nausea or a bad taste from zinc lozenges might outweigh the benefits.

Take care to stop zinc supplements as soon as your cold resolves because taking too much zinc can trigger a copper deficiency leading to anaemia, low white blood cell count, and memory problems.

Garlic

Only one study has tested the impact of garlic on the common cold. Researchers asked 146 people to take garlic supplements or a placebo daily for 12 weeks. They then tallied the number and duration of their colds.

The group that took garlic reported fewer colds than those who took the placebo. The duration of colds was the same in both groups, but some people had an adverse reaction to the garlic, such as a rash, or found the garlic odour unpleasant.

Because there is only one trial, we need to be cautious about recommending garlic to prevent or treat colds. We also need to be cautious about interpreting the results because the colds were tracked using self-report, which could be biased.


Read more: Science or Snake Oil: will horseradish and garlic really ease a cold?


Probiotics

In a review of 13 trials of probiotic supplements that included more than 3,700 children, adults and older adults, those taking supplements were less likely to get a cold.

Their colds were also likely to be of shorter duration and less severe, in terms of the number of school or work days missed.

There is some evidence that probiotics, which can be found in yoghurt, may reduce the incidence of colds. From shutterstock.com

Most supplements were milk-based products such as yoghurt. Only three studies used powders, while two used capsules.

The quality of the all the probiotic studies, however, was very poor, with bias and limitations. This means the results need to be interpreted with caution.

Echinacea

Echinacea is a group of flowering plants commonly found in North America. These days you can buy echinacea products in capsules, tablets or drops.

A review of echinacea products found they provide no benefit in treating colds. However, the authors indicated some echinacea products may possibly have a weak benefit, and further research is needed.

Chicken soup

Yep, I’ve saved the best until last.

In a novel experiment on 15 healthy adults, researchers measured the participants’ nasal mucus flow velocity – our ability to break down and expel mucus to breathe more clearly. They tested how runny participants’ noses were after sipping either hot water, hot chicken soup or cold water, or sucking them through a straw.

Sipping hot water or chicken soup made participants’ noses run more than cold water, but sipping chicken soup worked the best. The researchers attributed this to the chicken soup stimulating smell and/or taste receptors, which then increased nasal mucus flow.

Another study on chicken soup found it can help fight infection and recovery from respiratory tract infections.

Other researchers have shown comfort foods, such as chicken soup, can help us feel better.

Your vagina cleans itself: why vagina cleaning fads are unnecessary and harmful

Your vagina cleans itself: why vagina cleaning fads are unnecessary and harmful

A staggering variety of so-called feminine hygiene products seek to help with “vaginal odour” and discharge, and “keep you fresh”. From deodorants to cucumber cleanses, scented “panty liners”, and the newest fad “vaginal steaming”. These products actively promote the view that women’s vaginas should be discharge-free and either have no smell at all or exude the whiff of rose petals or vanilla pods.

Many women perceive vaginal discharge as undesirable and unnatural rather than physiological and normal. Data suggest around half of all women use “panty liners” to absorb discharge with up to 30% using them on a daily basis. While Australian women are generally not big fans of “douching”, a French term for washing out the vagina using a liquid spray, it’s important to understand why cleaning the vagina is not recommended.


Read more – Health Check: what is normal vaginal discharge and what’s not?


What is vaginal discharge and why is it important?

The vagina is self-cleaning, and vaginal discharge plays an important role in keeping the vagina healthy. From puberty, when oestrogen kicks in, the vagina becomes colonised with healthy bacteria from the Lactobacillus group which produce lactic acid.

Many products are marketed as reducing vaginal odours. But the vagina isn’t supposed to smell like perfume. from http://www.shutterstock.com

This finely balanced vaginal ecosystem is referred to as the vaginal microbiome and the resulting acidity of the vagina provides protection against sexually transmissible infections.

Healthy vaginal discharge is made up of fluid from the vaginal walls, mucus from the cervix as well as the lactobacilli, and because the vaginal environment is hormonally influenced, variation in the amount of discharge throughout the month is to be expected and completely normal.

As well as providing a protective environment, vaginal discharge provides natural lubrication with between one and 4mls of fluid produced every 24 hours. Healthy vaginal discharge has a characteristic smell – and in some women this can become stronger because of the large number of sweat glands in the hair-bearing pubic area. So while washing inside the vagina is not recommended, it’s important to keep the outer skin clean.

Disruption of the healthy vaginal environment

Anything put in the vagina can potentially disrupt the vaginal environment and its balanced vaginal flora, including tampons, penises, condoms, semen, fingers and hygienic sex toys. Disruption in these cases is almost always temporary and the vagina quickly restores itself.

But this may not be so in the case of vaginal cleansing products, or repeated douching. Homemade douches usually contain water and vinegar and commercial products contain antiseptics and fragrances that can reduce the lactobacilli and reduce the protective effect of the discharge.

So what about the latest “v-treatment”, vaginal steaming? To quote a version promoted on Gwyneth Paltrow’s site GOOP:

you sit on what is essentially a mini-throne, and a combination of infrared and mugwort steam cleanses your uterus, et al. It is an energetic release — not just a steam douche — that balances female hormone levels.

Steaming your vagina could be harmful. Screenshot, King Spa website

Apart from the risk of burning and scalding, there are many other reasons not to v-steam. Not only will steam have a drying effect on the vagina, it’s likely to disrupt the vaginal microbiome and reduce the body’s natural barrier against infections.

While no steam may actually reach the uterus, blowing hot herbal fumes into this important organ has no benefits and could in fact do harm. There would certainly be no effect of this pseudo-scientific treatment on female hormone levels.

When to seek medical advice

While vaginal discharge is certainly normal, if you experience a significant change in the volume, colour or odour of discharge, you should seek medical advice.

A change in vaginal discharge can be a sign of infection, although the most bacterial STIs, including chlamydia and gonorrhoea, usually do not cause any change in discharge.

More common causes are candida (vaginal thrush) or bacterial vaginosis (BV) which occur when the vaginal flora becomes over-colonised with either yeast (candida) or other vaginal bacteria. Bacterial vaginosis is a condition in which the vagina is unable to return to its normal state and becomes more alkaline. The alkalinity of menstrual blood can be associated with bacterial vaginosis.


Read more – Recurrent thrush: how some women live with constant genital itching


The lactobacilli are reduced and replaced with other vaginal bacteria which can be associated with an increased greenish-greyish discharge and an unpleasant odour. Although the condition is not thought to be harmful, for women living with bacterial vaginosis, having a persistent and malodorous discharge can be debilitating and they should see their doctor to discuss how to manage the condition.


Read more – We need a cure for bacterial vaginosis, one of the great enigmas in women’s health


As doctors working in sexual health we are keen to help women work out what is normal and what is not. It’s crucial to reject practices that masquerade as clinical treatments but have no base in evidence. Vaginal discharge is healthy and plays an important role in the defence against infection. Trying to eliminate it makes no sense and is in fact harmful.


Dr Ellie Freedman, Medical Director of the Northern Sydney Sexual Assault Service Staff Specialist Clinic at Royal North Shore Hospital co-authored this article.

Menopausal Symptoms: Comparative Effectiveness of Therapies [Internet]

As I have frequently mentioned, Oestrogen is the most effective treatment for menopausal women. The mention of potential long term harm is not an issue anymore as more recent studies of large numbers of women show oestrogens safety over the long term. See previous post from me.

Menopausal Symptoms: Comparative Effectiveness of Therapies.

Source

Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Mar. Report No.: 15-EHC005-EF.
AHRQ Comparative Effectiveness Reviews.

Author information

1
Blue Cross and Blue Shield Association Technology Evaluation Center, Evidence-based Practice Center

Excerpt

OBJECTIVES:

To systematically review and synthesize evidence evaluating the comparative effectiveness of treatments for menopausal symptoms, along with potential long-term benefits and harms of those treatments.

DATA SOURCES:

The following electronic databases were searched through January 2014: MEDLINE®, Embase®, Cochrane Controlled Trials Register, and AMED Allied and Complementary Medicine. Gray literature searches included clinicaltrials.gov, the Food and Drug Administration Web site, and relevant conference abstracts.

REVIEW METHODS:

Menopausal symptom outcomes included: vasomotor, quality of life, psychological, sexual function, urogenital, and sleep disturbance. Randomized controlled trials provided the evidence base for symptom relief. Standardized mean differences were calculated to allow pooling of outcomes from varied measures. Network meta-analyses were performed when possible, along with pairwise comparisons. Systematic reviews, cohort studies, and case-control studies provided evidence for the following long-term benefits and harms: breast, colon, endometrial, and ovarian cancer; coronary heart disease and venous thromboembolic events; gallbladder disease; and osteoporotic fractures.

RESULTS:

Evidence from 283 trials provided results for vasomotor symptoms (211 trials), quality of life (125 trials), psychological symptoms (108 trials), sexual function (94 trials), urogenital atrophy (71 trials), and sleep disturbance (56 trials). The most commonly studied agents were estrogens, isoflavones, and selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors (SSRIs/SNRIs). Estrogens appeared to be the most effective treatment in relieving vasomotor symptoms and were accompanied by better quality-of-life scores. SSRIs/SNRIs relieve vasomotor symptoms less effectively than estrogens but were accompanied by the largest improvement in global measures of psychological well-being. Estrogens administered vaginally diminished pain during sex and testosterone increased sexual activity. Measures of urogenital atrophy were improved with ospemifene and vaginal or oral estrogens. Estrogens also improved sleep, but the effect appeared to be modest. Over the long term, estrogen combined with progestogen has both beneficial effects (fewer osteoporotic fractures) and harmful effects (increased risk of breast cancer, gallbladder disease, venous thromboembolic events, and stroke). Estrogens given alone do not appear to increase breast cancer risk, although endometrial cancer risk is increased. There is limited evidence on the long-term effects of most nonhormone treatments. No studies were identified that examined the efficacy or safety of compounding practices for hormone therapies.

CONCLUSIONS:

Women experiencing symptoms of menopause can consider a number of potential treatments of varying efficacy. From a large body of evidence, there is considerable certainty that estrogens are the most effective treatment for relieving vasomotor symptoms and are accompanied by the greatest improvement in quality-of-life measures. For other common symptoms—psychological, urogenital, and sleep disturbance—although estrogens are effective, some nonhormonal agents compare favorably. Estrogens are accompanied by potential long-term harms that require consideration. There is limited evidence on the potential consequences of long-term use of nonhormonal agents when those agents are used to treat menopausal symptoms.

Plain, Greek, low-fat? How to choose a healthy yoghurt

Plain, Greek, low-fat? How to choose a healthy yoghurt

Yoghurt is one of the oldest fermented dairy foods in the world. Its origins date back to the dawn of civilisation. When humans began domesticating animals for milk production, milk’s short shelf life required solutions for storing it.

The word “yoghurt” itself comes from Turkish, meaning something like “curdled” or “thickened milk”, which is pretty much what happens to milk during yoghurt production.

Like milk, yoghurt is a rich source of calcium and protein. And it provides other nutrients such as iodine, vitamins D, B2 and B12, and zinc.

But yoghurt is actually more nutritious than milk. The main reason is that the fermentation process makes it easier to digest, so the nutrients can be absorbed more easily into the body.


Read more: From Bulgaria to East Asia, the making of Japan’s yogurt culture


Yet with all the various types, like Greek and liquid yoghurts, and ones with added fruits and probiotics, how do you know which one is healthiest?

Making yoghurt

Yoghurt is made by introducing certain bacteria into fresh milk – typically Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus.

Usually, both these bacteria are present in yoghurt and form the yoghurt starter culture. Their synergistic relationship is a key factor in the consistency of the final product. These cultures may also provide some health benefits, such as reducing the severity and duration of diarrhoea.

Yoghurt is made by introducing a starter culture of bacteria into milk. Andrew Seaman/Flickr, CC BY

The bacteria ferment the naturally occurring milk sugar (lactose) for energy and growth. During this process, lactose becomes lactic acid. The acidity development leads to the main milk protein, casein, breaking down and losing some of its elementary structure.

This partial breakdown results in the semi-solid, gel-like structure we know as yoghurt. The lactic acid is also responsible for yoghurt’s sour flavours, as well as helping it stay fresher for longer than milk.

What makes yoghurt healthy?

Yoghurt is easier to digest than milk because enzymes involved in the fermentation process break down substances, such as lactose, into smaller compounds, which can be readily absorbed and used by the body. And certain minerals, such as calcium, phosphorus and iron, are better used by the body when they come from yoghurt.

And because lactose is broken down and converted to lactic acid during fermentation, lactose-intolerant people can consume yoghurt without adverse effects.

Consuming yoghurt is associated with many health benefits, including maintaining a healthy microbiota (the colony of bacteria in your gut). Yoghurt can feed the good bacteria and help them fight against disease-causing microorganisms.


Read more: Explainer: what is the gut microbiota and how does it affect mind and body?


Yoghurt consumption helps to maintain bone structure and has even been found to reduce the risk of certain cancers and infectious diseases, as it enhances the immune response. Yoghurt can help reduce symtpoms of conditions such as constipation, inflammatory bowel disease, infection with a bacterium that can damage the stomach lining (Helicobacter pylori), diarrhoeal diseases and some allergic reactions, such as to certain foods.

Types of yoghurt

Cow’s milk is the most widely used raw ingredient for yoghurt manufacturing. But other types, such as sheep and goat milk yoghurt, are available. There are slight differences in the nutritional composition among these milk types.

Although cow’s milk is generally more appealing (as goat and sheep milk may have unpleasant smells), the latter two may provide additional health benefits. For instance, goat’s milk is easier to digest than cow’s milk and is less likely to cause an allergic reaction.

Non-dairy alternatives such as soy and coconut milk yoghurt are becoming increasingly popular too.

Goat’s milk is easier to digest than cow’s milk. from shutterstock.com

The most commonly known types of yoghurt are plain set yoghurt, flavoured yoghurt, Greek yoghurt, frozen yoghurt and drinking yoghurt.

Plain set yoghurt is usually made from dairy ingredients and fermented in the cups or tubs with no sugar or sweeteners.

Flavoured yoghurt is made by adding sugar and fruit or other flavourings to plain yoghurt. Often, the milk mixture is fermented in large vats, cooled and then stirred for a creamy texture with various fruits or other flavours. These stirred yoghurts are also known as Swiss-style yoghurts.

Greek yoghurt is a thick yoghurt. It’s traditionally prepared by straining the water known as whey from plain yoghurt to make it thicker, richer and creamier. It contains more protein than regular yoghurt and has no added sugar.

Frozen yoghurt is frozen ice milk with a typical yoghurt flavour. It tastes more like ice-cream with a hint of yoghurt.

Drinking yoghurts are prepared from a yoghurt mix with reduced milk solids. They come in almost every variety and flavour. They’re usually more watery, but some thick varieties are also available. Kefir and lassi are the popular drinking yoghurt types.

Added ingredients for health purposes

Many yoghurts contain added ingredients. These include cholesterol-lowering compounds (such as stanol and sterol esters) and fibre aimed at improving gut health.

Some yoghurts also have added probiotics. These are live microorganisms that can help establish a healthy gut microbiota. The most widely used probiotics are the acidophilus strain, known as Lactobacillus acidophilus, and Bifidobacterium. These could be useful for people who have gastrointestinal problems such as irritable bowel syndrome (IBS).

Probiotics can be more effective when consumed in yoghurt than through capsules or other beverages.


Read more: So you think you have IBS, coeliac disease or Crohn’s? Here’s what it might mean for you


The two bacteria in yoghurt starter culture – S. thermophilus and L. delbrueckii ssp. bulgaricus – are not natural inhabitants of the intestine and cannot survive the acidic conditions and bile concentrations in the gastrointestinal tract. So they don’t do much to change the microbiota in your gut. In contrast, probiotics can survive and colonise the large intestine.

It’s healthier to add your own fruit to yoghurt than to buy fruity yoghurt. Peter Hershey/Unsplash

Regular intake of yoghurt that contains microbial cultures such as probiotic acidophilus has also been found to potentially reduce the risk of coronary heart disease by helping to decrease cholesterol absorption.

Which yoghurt is better for you?

When whole milk is used to produce plain yoghurts, these may contain 3.5-4.4 grams of fat per 100g. Low-fat yoghurt contains less than 3g of fat per 100g, and non-fat or fat-free yoghurts must contain less than 0.15g fat per 100g.

High fat and high sugar in any food can lead to health problems. So, a low-fat and low-sugar yoghurt product, like a low-fat Greek yoghurt, would be ideal if you’re looking to keep healthy.

Yoghurt products incorporating fruit or nuts can provide additional nutritional and health benefits, but many of these can also contain added sugar. Adding fresh fruit or nuts to a yoghurt yourself is a healthier option.

If you would like to have probiotic effects, you can choose a product with acidophilus or bifidobacteria.

You should check the product label as it is a legal requirement to list all the ingredients, cultures and nutritional information in commercial yoghurts. When it comes to probiotic yoghurts, it’s always better to choose a fresh product rather than one closer to the expiry date, as probiotics die during storage.

New evidence for cardiac benefit of postmenopausal hormone therapy.

Climacteric. 2017 Feb;20(1):5-10. doi: 10.1080/13697137.2016.1262839. Epub 2017 Jan 2.

New evidence for cardiac benefit of postmenopausal hormone therapy.

Author information

1
a Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.

Abstract

Coronary artery disease (CAD) is still the most common killer of western women. Coronary arteries, expressing estrogen receptors, are a target for estrogen action. Prior to the Women’s Health Initiative (WHI) study, postmenopausal hormone therapy (HT) was widely advocated for primary prevention of CAD, but such use was criticized after the WHI publication. However, new data accumulated in the USA and in Europe indicate that the use of estradiol-based HT regimens does not endanger the heart, but rather, it significantly reduces the incidence of CAD events and mortality. This effect may be related to the presence of hot flushes before HT initiation, because they may indicate a greater responsiveness of the cardiovascular system to HT. To get maximal cardioprotective efficacy of HT, a woman should initiate HT as soon as symptoms occur, and preferably within the first 10 postmenopausal years. Recent guidelines for optimal use of HT recommend pauses of HT at 1-2-year intervals to see whether hot flushes and other symptoms still persist. However, new data question the safety of this policy, because acute withdrawals of estradiol from the circulation may predispose to potentially fatal CAD events. All these data support modernized guidelines for optimal HT use.

Is cheese bad for you?

We asked five experts: is cheese bad for you?

Almost everyone loves a good vegemite and cheddar sandwich or some brie with a glass of wine. But the evidence seems to shift about whether or not cheese should be part of a healthy diet.

Most types of cheese contain salt and saturated fat, but it’s also high in protein and calcium, so what’s the verdict?

We asked five experts if cheese is bad for our health.

Five out of five experts said no

Here are their detailed responses:


If you have a “yes or no” health question you’d like posed to Five Experts, email your suggestion to: alexandra.hansen@theconversation.edu.au


Disclosures: Rebecca Reynolds owns The Real Bok Choy, a nutrition and lifestyle consultancy.

Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers and the Sax Institute. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and 2017 evidence review on dietary patterns for the Heart Foundation.

The Conversation is a non-profit + your donation is tax deductible. Help knowledge-based, ethical journalism today.

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Coffee increases muscle strength.

This is good news for you coffee lovers. Our thinking about coffee has radically changed over the last 10 years – we now recognize coffee’s many benefits.
J Int Soc Sports Nutr. 2018 Mar 5;15:11. doi: 10.1186/s12970-018-0216-0. eCollection 2018.

Effects of caffeine intake on muscle strength and power: a systematic review and meta-analysis.

Abstract

Background:

Caffeine is commonly used as an ergogenic aid. Literature about the effects of caffeine ingestion on muscle strength and power is equivocal. The aim of this systematic review and meta-analysis was to summarize results from individual studies on the effects of caffeine intake on muscle strength and power.

Methods:

A search through eight databases was performed to find studies on the effects of caffeine on: (i) maximal muscle strength measured using 1 repetition maximum tests; and (ii) muscle power assessed by tests of vertical jump. Meta-analyses of standardized mean differences (SMD) between placebo and caffeine trials from individual studies were conducted using the random effects model.

Results:

Ten studies on the strength outcome and ten studies on the power outcome met the inclusion criteria for the meta-analyses. Caffeine ingestion improved both strength (SMD = 0.20; 95% confidence interval [CI]: 0.03, 0.36; p = 0.023) and power (SMD = 0.17; 95% CI: 0.00, 0.34; p = 0.047). A subgroup analysis indicated that caffeine significantly improves upper (SMD = 0.21; 95% CI: 0.02, 0.39; p = 0.026) but not lower body strength (SMD = 0.15; 95% CI: -0.05, 0.34; p = 0.147).

Conclusion:

The meta-analyses showed significant ergogenic effects of caffeine ingestion on maximal muscle strength of upper body and muscle power. Future studies should more rigorously control the effectiveness of blinding. Due to the paucity of evidence, additional findings are needed in the female population and using different forms of caffeine, such as gum and gel.