Anti-vaccination mothers have outsized voice on social media – pro-vaccination parents could make a difference


Vaccinations are important to protect against a host of diseases.
www.shutterstock.com

Brooke W. McKeever, University of South Carolina and Robert McKeever, University of South Carolina

A high school student from Ohio made national headlines recently by getting inoculated despite his family’s anti-vaccination beliefs.

Ethan Lindenberger, 18, who never had been vaccinated, had begun to question his parents’ decision not to immunize him. He went online to research and ask questions, posting to Reddit, a social discussion website, about how to be vaccinated. His online quest went viral.

In March 2019, he was invited to testify before a U.S. Senate Committee hearing on vaccines and preventable disease outbreaks. In his testimony, he said that his mother’s refusal to vaccinate him was informed partly by her online research and the misinformation about vaccines she found on the web.

Lindenberger’s mother is hardly alone. Public health experts have blamed online anti-vaccination discussions in part for New York’s worst measles outbreak in 30 years. Anti-vaccine activists also have been cited for the growth of anti-vaccination sentiments in the U.S. and abroad.

We are associate professors who study health communication. We are also parents who read online vaccination-related posts, and we decided to conduct research to better understand people’s communication behaviors related to childhood vaccinations. Our research examined the voices most central to this discussion online, mothers, and our findings show that those who oppose vaccinations communicate most about this issue.

What prompts mothers to speak out

A strong majority of parents in the U.S. support vaccinations, yet at the same time, anti-vaccination rates in the U.S. and globally are rising. The World Health Organization identified the reluctance or refusal to vaccinate despite the availability of vaccines as one of 10 top threats to global health in 2019.

Mothers are critical decision-makers in determining whether their children should be vaccinated. In our study, we surveyed 455 mothers online to determine who communicates most about vaccinations and why.

In general, previous research has shown that people evaluate opinion climates – what the majority opinion seems to say – before expressing their own ideas about issues. This is true particularly on controversial subjects such as affirmative action, abortion or immigration. If an individual perceives their opinion to be unpopular, they may be less likely to say what they think, especially if an issue receives a lot of media attention, a phenomenon known as the spiral of silence.

If individuals, however, have strong beliefs about an issue, they may express their opinions whether they are commonly held or minority perspectives. These views can dominate conversations as others online find support for their views and join in.

Our recent study found that mothers who contributed information online shared several perspectives. Mothers who didn’t strongly support childhood vaccinations were more likely to seek, pay attention to, forward information and speak out about the issue – compared to those who do support childhood vaccinations.

Those who believed that vaccinations were an important issue (whether they were for or against them) were more likely to express an opinion. And those who opposed vaccinations were more likely to post their beliefs online.

Ethan Lindenberger testifies before a congressional committee about his decision to be vaccinated against his family’s wishes.
AP Photo/Carolyn Kaster

How social media skews facts

Online news content can be influenced by social media information that millions of people read, and it can amplify minority opinions and health myths. For example, Twitter and Reddit posts related to the vaccine-autism myth can drive news coverage.

Those who expressed online opinions about vaccinations also drove news coverage. Other research we co-authored shows that posts related to the vaccine-autism myth were followed by online news stories related to tweets in the U.S., Canada and the U.K.

Recent reports about social media sites, such as Facebook, trying to interrupt false health information from spreading can help correct public misinformation. However, it is unclear what types of communication will counter misinformation and myths that are repeated and reinforced online.

Countering skepticism

Our work suggests that those who agree with the scientific facts about vaccination may not feel the need to pay attention to this issue or voice their opinions online. They likely already have made up their minds and vaccinated their children.

But from a health communication perspective, it is important that parents who support vaccination voice their opinions and experiences, particularly in online environments.

Studies show that how much parents trust or distrust doctors, scientists or the government influences where they land in the vaccination debate. Perspectives of other parents also provide a convincing narrative to understand the risks and benefits of vaccination.

Scientific facts and messaging about vaccines, such as information from organizations like the World Health Organization and the Centers for Disease Control and Prevention, are important in the immunization debate.

But research demonstrates that social consensus, informed in part by peers and other parents, is also an effective element in conversations that shape decisions.

If mothers or parents who oppose or question vaccinations continue to communicate, while those who support vaccinations remain silent, a false consensus may grow. This could result in more parents believing that a reluctance to vaccinate children is the norm – not the exception.

[ Expertise in your inbox. Sign up for The Conversation’s newsletter and get a digest of academic takes on today’s news, every day. ]The Conversation

Brooke W. McKeever, Associate Professor, University of South Carolina and Robert McKeever, Associate Professor, University of South Carolina

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Advertisements

Will a vegetarian diet increase your risk of stroke?



This is the first study to link a vegetarian diet to an increased risk of stroke. But the evidence isn’t strong enough to cause alarm.
From shutterstock.com

Evangeline Mantzioris, University of South Australia

Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.

A UK study finding vegetarianism is associated with a higher risk of stroke than a meat-eating diet has made headlines around the world.

The study, published in the British Medical Journal last week, found people who followed vegetarian or vegan diets had a 20% higher risk of having a stroke compared to those who ate meat.

But if you’re a vegetarian, there’s no need to panic. And if you’re a meat eater, these results don’t suggest you should eat more meat.

While we don’t fully understand why these results occurred, it’s important to note the study only showed an association between a vegetarian diet and increased stroke risk – not direct cause and effect.




Read more:
Clearing up confusion between correlation and causation


What the study did and found

The researchers looked at 48,188 men and women living in Oxford, following what they ate, and whether they had heart disease or a stroke, over 18 years. The researchers grouped the participants according to their diets: meat eaters, fish eaters (pescatarians) and vegetarians (including vegans).

While vegan diets are quite different to vegetarian diets, the investigators combined these two groups as there were very small numbers of vegans in the study.

In their analysis, the researchers accounted for variables which are known risk factors for heart disease and stroke, including education level, smoking status, alcohol consumption, and physical activity.




Read more:
Is vegetarianism healthier? We asked five experts


They found vegetarians had a 22% lower risk of heart disease than meat eaters. This is equivalent to ten fewer cases of heart disease per 1,000 vegetarians than in meat eaters over ten years.

Yet the vegetarians had a 20% higher rate of stroke, equivalent to three more strokes per 1,000 vegetarians compared to the meat eaters over ten years.

The decrease in heart disease risk seemed to be linked to lower body mass index (BMI), cholesterol levels, incidence of diabetes, and blood pressure. These benefits are all known to be associated with a healthy vegetarian diet, and are protective factors
against heart disease.

This study showed fish eaters (who did not consume meat) had a 13% lower risk of heart disease, but no significant increase in the rate of stroke when compared to meat eaters.

As with any study, there are strengths and weaknesses

The main strength of this study is that it closely followed a very large group of people over a long period of time.

The major weakness is that being an observational study, the researchers were not able to determine a cause and effect relationship.

So this study is not showing us vegetarian diets lead to increased risk of stroke; it simply tells us vegetarians have an increased risk of stroke. This means the association may be linked to other factors, aside from diet, which may be related to the lifestyle of a vegetarian.

The study’s authors suggest a difference in vitamin B12 levels between the vegetarian and meat-eating groups may have contributed to the results.
From shutterstock.com

And while vegetarian and vegan diets may be seen as generally healthier, vegetarians still may be eating processed and ultra-processed foods. These foods can contain high levels of added salt, trans fat and saturated fats. This study did not report on the whole dietary pattern – just the major food groups.

Another major weakness of this study is that vegans and vegetarians were grouped together. Vegetarian and vegan diets can vary considerably in nutrient levels.

So why would the vegetarian group have a higher stroke risk?

These kind of observational studies are unable to provide what scientists call “a mechanism” – that is, a biological explanation as to why this association may exist.

But researchers will sometimes offer a potential biological explanation. In this case, they suggest the differences in nutrient intakes between the different diets may go some way to explaining the increased risk of stroke in the vegetarian group.

They cite a number of Japanese studies which have shown links between a very low intake of animal products and an increased risk of stroke.




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


One nutrient they mention is vitamin B12, as it’s found only in animal products (meat, fish, dairy products and eggs). Vegan sources are limited, though some mushroom varieties and fermented beans may contain vitamin B12.

Vitamin B12 deficiency can lead to anaemia and neurological issues, including numbness and tingling, and cognitive difficulties.

The authors suggest a lack of vitamin B12 may be linked to the increased risk of stroke among the vegetarian group. This deficiency could be present in vegetarians, and even more pronounced in vegans.

But this is largely speculative, and any associations between a low intake of animal products and an increased risk of stroke remain to be founded in a strong body of evidence. More research is needed before any recommendations are made.

What does this mean for vegetarians and vegans?

Vegetarians and vegans shouldn’t see this study as a reason to change their diets. This is the only study to date to have shown an increased risk of stroke with vegetarian or vegan diets.

Further, this study has shown overall greater benefits are gained by being vegetarian or vegan in its association with reduced risk of heart disease.

Meanwhile, other studies have shown meat eaters – particularly people who eat large amounts of red and processed meats – have higher risk of certain cancers.




Read more:
Are there any health implications for raising your child as a vegetarian, vegan or pescatarian?


Whether you’re an omnivore, pescatarian, vegetarian or vegan, it’s important to consider the quality of your diet. Focus on eating whole foods, and including lots of vegetables, fruits, cereals and grains.

It’s equally important to minimise the intake of processed foods high in added sugars, salt, saturated and trans fats. Diets high in these sorts of foods have well-established links to increased risk of heart disease and stroke. –Evangeline Mantzioris


Blind peer review

The analysis presents a fair and balanced assessment of the study, accurately pointing out that no meaningful recommendations can be drawn from the results. This is particularly so since the majority of the data was collected via self-reported questionnaires, which reduces the reliability of the results.

While in many cases the media has reported an increased stroke risk in vegetarians, total stroke risk was not actually statistically different between the groups. The researchers looked at two types of stroke: ischaemic stroke (where a blood vessel supplying blood to the brain is obstructed) and haemorrhagic stroke (where a blood vessel leaks or breaks).

A statistically significant increased risk in the vegetarian group was only seen in haemorrhagic stroke – and even there it’s marginal. Statistically, and in total numbers of people affected, the reduced heart disease risk in the vegetarian group is more convincing. –Andrew CareyThe Conversation

Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Can we heal teeth? The quest to repair tooth enamel, nature’s crystal coat



The enamel on your teeth is what makes them sparkle. It also acts as a protective coating on the teeth.
From shutterstock.com

Arosha Weerakoon, The University of Queensland

Tooth enamel is one of the hardest tissues in the human body. It acts as a protective layer for our teeth, and gives our smile that pearly white shimmer. But when enamel erodes, it can’t regrow itself.

In a significant scientific breakthrough, researchers recently discovered a way to regrow human tooth enamel.

Scientists from China have invented a gel that contains mineral clusters naturally found in teeth. In partially acid-damaged teeth, the gel stimulates crystal regrowth to restore tooth enamel back to its original structure.

While the method is yet to be tested on people, one day this could mean saying goodbye to painful needles, the dreaded dentist drill, and even fillings.




Read more:
How often should I get my teeth cleaned?


What is tooth enamel?

Enamel is the outermost layer of our teeth, and protects our pearly whites from wear and tear. It also insulates us from feeling pain and sensitivity.

When this protective coat erodes, our teeth soften and become vulnerable to developing cavities (holes in the teeth) which may require dental treatment such as fillings.

Enamel is the protective outer layer of our teeth.
From shutterstock.com

Tooth enamel contains the same minerals, calcium and phosphate, found in bone. Unlike bone though, enamel contains relatively more mineral, and enamel crystals are arranged in a complex geometrical pattern.

Under a microscope, enamel crystals are shaped like long ribbons, or spaghetti strands. These crystal strands are assembled into clusters, like packets of dry spaghetti, orientated at 60 degrees to each other. The ribbon clusters, which weave together like honeycomb, are known as rods and inter-rods.

When destroyed, this weave is difficult to recreate, because the cells that form enamel die as our teeth emerge from our gums.

Why does our tooth enamel erode?

While enamel is very hard, it’s also brittle and susceptible to erosion. This occurs when tooth mineral dissolves into our saliva.

Our saliva is constantly trying to balance any “bad guys” it encounters with “good guys” at its disposal. When we get acid in our mouth (a bad guy) the mineral in our saliva (a good guy) tries to bind to it to neutralise the acid, and prevent it from causing harm. This is known as buffering.

If there’s too much acid, or the quality and quantity of our saliva is inadequate, we run out of mineral to buffer the “acid attack”. So in a final effort to neutralise the acidity in our mouth, the mineral in our teeth will dissolve into our saliva. This is when our teeth erode and become vulnerable.




Read more:
Child tooth decay is on the rise, but few are brushing their teeth enough or seeing the dentist


Like the erosion we see in our beaches and river beds, under a microscope, eroded enamel surfaces appear moth-eaten and uneven. This is because erosion destroys the crystal organisation I described above.

Current dentist-recommended products repair enamel but cannot regrow the complex crystal structure to recreate a pearly white shimmer. This is why globally, the dental community are very excited about this research.

Can we control erosion?

Our teeth erode when we eat and drink foods rich in acid, including wine, cola beverages, fruit juices, sour lollies, and energy and sports drinks. As a general rule, anything that tastes sour is high in acid. It’s best to avoid or limit acidic food and drinks where possible.

People with medical conditions such as bulimia or acid reflux may be at greater risk of their teeth eroding. If you suffer from these conditions, in addition to getting help from your doctor, it’s best to seek regular dental check-ups.

We know lollies aren’t good for teeth. But sour lollies in particular contain acid, which contributes to erosion.
From shutterstock.com

When our enamel erodes, it makes our teeth appear yellower. Often, we may also experience toothache or sensitivity because we’ve lost the enamel’s natural insulation.

If your teeth are eroding, a dentist and/or dental hygienist will be able to monitor and help you manage your oral health. In addition to brushing and cleaning between your teeth, your dental professional may also recommend:

  • rinsing with a bicarbonate and salt water mouthwash
  • chewing sugar-free gum to stimulate an increase in mineral-rich saliva
  • using a dentist-recommended toothpaste, special cream and/or mouthwash to help replace lost mineral and repair your teeth
  • delaying cleaning your teeth after an “acid attack” to prevent removing softened enamel.



Read more:
Two million Aussies delay or don’t go to the dentist – here’s how we can fix that


How did the scientists regrow enamel?

In a lab, extracted teeth were treated with acid to simulate erosion, then painted with a special gel. This gel contained calcium phosphate ion clusters – mineral clusters naturally found in teeth – mixed with an ingredient called triethylamine
(TEA).

After two days in a simulated mouth-like environment, the previously eroded enamel was checked for crystal growth, size, shape, organisation and composition using special microscopes.

The spaghetti-like crystals had regrown seamlessly, and the crystal clusters had correctly orientated themselves to form the rod and inter-rod honeycomb weave.

When will we be able to regrow enamel?

While this technology is something to look forward to, the short answer for now is “not yet”. This study has only been performed on extracted teeth. The researchers are hoping to test their method on mice, and then people soon after.

One of the significant limitations to moving towards animal and human trials is the toxicity of the essential ingredient, TEA. Another challenge is the enamel thickness they were able to repair was at a microscopic level.




Read more:
Health check: what’s eating your teeth?


But all is not lost. The scientists hope to find a safe way to use TEA with the intention of growing enamel thick enough to fix larger sections of eroded enamel.

For now, the thought of not having to get fillings at the dentist is an exciting prospect on the horizon. So watch this space.The Conversation

Arosha Weerakoon, Lecturer, General Dentist & PhD Candidate, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Here’s what you can eat and avoid to reduce your risk of bowel cancer



It’s not certain why, but fibre has protective effects against bowel cancer.
http://www.shutterstock.com

Suzanne Mahady, Monash University

Australia has one of the highest rates of bowel cancer in the world. In 2017, bowel cancer was the second most common cancer in Australia and rates are increasing in people under 50.

Up to 35% of cancers worldwide might be caused by lifestyle factors such as diet and smoking. So how can we go about reducing our risk of bowel cancer?




Read more:
What’s behind the increase in bowel cancer among younger Australians?


What to eat

Based on current evidence, a high fibre diet is important to reduce bowel cancer risk. Fibre can be divided into 2 types: insoluble fibre, which creates a bulky stool that can be easily passed along the bowel; and soluble fibre, which draws in water to keep the stool soft.

Fibre from cereal and wholegrains is an ideal fibre source. Australian guidelines suggest aiming for 30g of fibre per day for adults, but fewer than 20% of Australian adults meet that target.

Wheat bran is one of the richest sources of fibre, and in an Australian trial in people at high risk of bowel cancer, 25g of wheat bran reduced precancerous growths. Wheat bran can be added to cooking, smoothies and your usual cereal.

It’s not clear how fibre may reduce bowel cancer risk but possible mechanisms include reducing the time it takes food to pass through the gut (and therefore exposure to potential carcinogens), or through a beneficial effect on gut bacteria.

Once bowel cancer is diagnosed, a high fibre diet has also been associated with improved survival.

Dairy is ‘probably’ protective against bowel cancer.
from http://www.shutterstock.com



Read more:
Interactive body map: what really gives you cancer?


Milk and dairy products are also thought to reduce bowel cancer risk. The evidence for milk is graded as “probably protective” in current Australian bowel cancer guidelines, with the benefit increasing with higher amounts.

Oily fish may also have some protective elements. In people with hereditary conditions that make them prone to developing lots of precancerous growths (polyps) in the bowel, a trial where one group received a daily supplement of an omega 3 polyunsaturated fatty acid (found in fish oil) and one group received a placebo, found that this supplement was associated with reduced polyp growth. Whether this is also true for people at average risk of bowel cancer, which is most of the population, is unknown.

And while only an observational study (meaning it only shows a correlation, and not that one caused the other), a study of bowel cancer patients showed improved survival was associated with daily consumption of coffee.

What to avoid

It’s best to avoid large quantities of meat. International cancer authorities affirm there is convincing evidence for a relationship between high meat intake and bowel cancer. This includes red meat, derived from mammalian muscle such as beef, veal, lamb, pork and goat, and processed meat such as ham, bacon and sausages.

Processed meats have undergone a preservation technique such as smoking, salting or the addition of chemical preservatives which are associated with the production of compounds that may be carcinogenic.

Evidence also suggests a “dose-response” relationship, with cancer risk rising with increasing meat intake, particularly processed meats. Current Australian guidelines suggest minimising intake of processed meats as much as possible, and eating only moderate amounts of red meat (up to 100g per day).

What else can I do to reduce the risk of bowel cancer?

The key to reducing cancer risk is leading an overall healthy lifestyle. Adequate physical activity and avoiding excess fat around the tummy area is important. Other unhealthy lifestyle behaviours such as eating lots of processed foods have been associated with increased cancer risk.

And for Australians over 50, participating in the National Bowel Cancer Screening program is one of the most effective, and evidence-based ways, to reduce your risk.




Read more:
INTERACTIVE: We mapped cancer rates across Australia – search for your postcode here


The Conversation


Suzanne Mahady, Gastroenterologist & Clinical Epidemiologist, Senior Lecturer, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How often should I get my teeth cleaned?



Teeth cleaning at the dentist can remove plaque that regular brushing and flossing can’t.
From shutterstock.com

Arosha Weerakoon, The University of Queensland

If you went to your dentist for a check-up and dental clean in the last year, give yourself a pat on the back. Not everyone loves the dentist, but research shows people who visit at least once a year for preventative care are happier with their smile.

Regular dental visitors are also less likely to need a filling or have a tooth removed.

So how often do we need to go to the dentist? Most of us can get away with an annual trip, but some people at higher risk of dental problems should visit more often.




Read more:
Child tooth decay is on the rise, but few are brushing their teeth enough or seeing the dentist


Why do I need to get my teeth cleaned?

While we all do the best we can on our own, professional teeth cleaning removes plaque, the soft yellowish build-up, and calculus (hardened plaque) we can’t get to. This soft build-up is made up of billions of different types of bacteria that live and reproduce in our mouth by feeding on the food we eat.

Most bacteria live in our bodies without causing too much trouble. But certain bacteria in dental plaque, when they grow in numbers, can lead to cavities (holes in the teeth) or gum disease.

A dental clean will reduce your chance of getting cavities or gum disease by significantly reducing the amount of plaque and calculus in your mouth.

So how often?

As a dentist, my patients often ask me how regularly they should get their teeth cleaned. My response is usually: “That depends”.

Most private health insurance schemes cover a dental check-up and clean once every six months. But there’s no hard and fast evidence, particularly if you’re a healthy person who is less likely to get a cavity or gum disease.




Read more:
50 shades whiter: what you should know about teeth whitening


However, some people are at higher risk of getting dental cavities or gum disease – and this group should get their teeth cleaned more often.

Hole in one

We know certain health and lifestyle factors can affect a person’s risk of developing cavities. Here are some yes/no questions you can ask yourself to understand whether you’re at a higher risk:

  1. is your drinking water or toothpaste fluoride-free?
  2. do you snack a lot, including on sweets?
  3. do you avoid flossing?
  4. do you brush your teeth less than twice a day?
  5. do you visit your dentist for toothaches rather than check-ups?
  6. do you need new fillings every time you visit the dentist?
  7. is your dentist “watching” a lot of early cavities?
  8. do you have to wear an appliance in your mouth such as a denture or braces?
  9. do you suffer from a chronic long-term health condition such as diabetes?
  10. do you suffer from a dry mouth?

If you answered “yes” to most of these questions, you’re likely to need to see your dentist or hygienist at least every six months, if not more often.

As well as removing the bug-loaded plaque and calculus, people prone to cavities benefit from the fluoride treatment after scaling.

Evidence shows professional fluoride treatment every six months can lead to a 30% reduced risk of developing cavities, needing fillings or having teeth removed.




Read more:
Two million Aussies delay or don’t go to the dentist – here’s how we can fix that


Dental health is related to our overall health

Some people with chronic health issues such as heart conditions or diabetes will need to see their dentists more frequently. This is because they are more prone to gum disease.

People taking blood thinners and other medications, such as pills and infusions for osteoporosis, may need to visit the dentist more regularly too. These medications can complicate the process of an extraction or other dental work, so regular checks and cleans are best to help detect problems before they become serious.

People who visit the dentist regularly are less likely to need a filling or have a tooth removed.
From shutterstock.com

People with bleeding gums should also see their dental practitioners more often. This is especially important if you have been diagnosed with advanced gum disease, known as periodontal disease.

What about the budget?

The average cost of a check-up, dental clean and fluoride treatment is A$231, but the cost can vary from A$150 to A$305. You can contact your local dentist to find out what they charge. Your dentist may offer you a payment plan.

If you can’t afford this, you may qualify for free or discounted treatment if you hold a concession card. Children from families that receive a Family Tax Benefit A may be eligible for free dental treatment through the Child Dental Benefits Schedule.

People with private health insurance with extras or ancillary cover will also have some or all of their dental treatment covered.

Protecting your smile

So you don’t really get cavities or have gum disease, but would prefer to see your dentist every six months? Great. Some people prefer to go twice a year to reduce the chance of a nasty toothache.

Parents often wish to set a good example for their children by making regular check and clean appointments for the whole family.




Read more:
Health care is getting cheaper (unless you need a specialist, or a dentist)


There are many benefits to regular checks and cleans. Visiting your dentist regularly helps reduce the chance of needing more complex and expensive dental treatment later on.

And touching base with your oral health practitioner provides that nudge we all need now and again to eat healthily, brush better and floss more often.The Conversation

Arosha Weerakoon, Lecturer, General Dentist & PhD Candidate, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why full-fat milk is now OK if you’re healthy, but reduced-fat dairy is still best if you’re not



The Heart Foundation now backs full-fat milk if you’re healthy. But it still recommends reduced-fat milk if you have high blood pressure or heart disease.
from www.shutterstock.com

Clare Collins, University of Newcastle

The Heart Foundation now recommends full-fat milk, cheese and yoghurt or reduced-fat options as part of its updated dietary advice released yesterday.

This moves away from earlier advice that recommended only reduced-fat dairy when it comes to heart health.

So, what’s behind the latest change? And what does this mean for people with high blood pressure or existing heart disease?




Read more:
According to TV, heart attack victims are rich, white men who clutch their hearts and collapse. Here’s why that’s a worry


What’s new if you’re healthy?

For healthy Australians, the Heart Foundation now recommends unflavoured full-fat milk, yoghurt and cheese, as well as the reduced-fat options previously recommended.

The change comes after reviewing research from systematic reviews and meta-analyses published since 2009. These pooled results come from mostly long-term observational studies.

This is where researchers assess people’s dietary patterns and follow them for many years to look at health differences between people who eat and drink a lot of dairy products and those who consume small amounts.

Researchers run these studies because it is not practical or ethical to put people on experimental diets for 20 or more years and wait to see who gets heart disease.




Read more:
Are light dairy products better? We asked five experts


So when results of the recent studies were grouped together, the Heart Foundation reported no consistent relationship between full-fat or reduced-fat milk, cheese and yoghurt consumption and the risk of heart disease. The risk was neither increased nor decreased.

Put simply, for people who do not have any risk factors for heart disease, including those in the healthy weight range, choosing reduced-fat or low-fat options for milk, yoghurt and cheese does not confer extra health benefits or risks compared to choosing the higher fat options, as part of a varied healthy eating pattern.




Read more:
Health Check: is cheese good for you?


Before you think about having a dairy binge, the review noted the studies on full-fat milk, yoghurt and cheese can’t be extrapolated to butter, cream, ice cream and dairy-based desserts.

This is why the Heart Foundation still doesn’t recommend those other full-fat dairy options, even if you’re currently healthy.

What about people with heart disease?

However, for people with heart disease, high blood pressure or some other conditions, the advice is different.

The review found dairy fat in butter seems to raise LDL or “bad” cholesterol levels more than full-fat milk, cheese and yogurt. And for people with raised LDL cholesterol there is a bigger increase in LDL after consuming fat from dairy products.




Read more:
Got high cholesterol? Here are five foods to eat and avoid


So, for people with high blood cholesterol or existing heart disease, the Heart Foundation recommends unflavoured reduced-fat milk, yoghurt and cheese to help lower their total risk of heart disease, which is consistent with previous recommendations.

Unflavoured, reduced-fat versions are lower in total kilojoules than the full-fat options. So, this will also help lower total energy intakes, a key strategy for managing weight.

Reduced-fat yoghurt and other dairy products are still recommended for people with high cholesterol or existing heart disease.
from www.shutterstock.com

How does this compare with other advice?

The 2013 National Health and Medical Research Council’s Dietary Guidelines for Australians recommends a variety of healthy foods from the key healthy food groups to achieve a range of measures of good health and well-being, not just heart health.

Based on evidence until 2009, the guidelines generally recommend people aged over two years mostly consume reduced-fat versions of milk, yoghurt, cheese and/or their alternatives, recognising most Australians are overweight or obese.




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


This advice still holds for people with heart disease. However, the new Heart Foundation advice for healthy people means less emphasis is now on using reduced-fat versions, in light of more recent evidence.

The Australian Dietary Guidelines have a further recommendation to limit eating and drinking foods containing saturated fat. The guidelines recommend replacing high-fat foods which contain mainly saturated fats such as butter and cream, with foods which contain mainly polyunsaturated and monounsaturated fats such as oils, spreads, avocado, nut butters and nut pastes.

This advice is still consistent with the Heart Foundation recommendations.

Australians eat a lot of ‘junk’ food

The most recent (2011-12) National Nutrition Survey of Australians found over one-third (35%) of what we eat comes from energy-dense, nutrient-poor, discretionary foods, or, junk foods.

Poor dietary patterns are the third largest contributor to Australia’s current burden of disease. Being overweight or obese is the second largest contributor, after smoking.

If Australians followed current dietary guidelines, whether using full- or reduced-fat milk, yoghurt and cheese, the national burden of disease due to heart disease would drop by 62%, stroke by 34% and type 2 diabetes by 41%.

What’s the take home message?

See your GP for a heart health check. If you do not have heart disease and prefer full-fat milk, cheese and yoghurt then choose them, or a mix of full and reduced-fat versions.

If you have heart disease or are trying to manage your weight then choose mostly reduced-fat versions.

Focus on making healthy choices across all food groups. If you need personalised advice, ask your GP to refer you to an accredited practising dietitian.The Conversation

Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

It’s not just athletes who get Achilles tendon pain, but exercising is the answer


Sean Docking, La Trobe University; Ebonie Rio, La Trobe University, and Jill Cook, La Trobe University

Basketball fans around the world were recently sickened by the footage of NBA star Kevin Durant’s Achilles tendon rupturing during a game.

But while many think it’s only elite athletes who suffer from Achilles tendon issues, a fifth of the over-50 population actually suffers from Achilles tendinopathy (pain). And while very few of these will be ruptures, the pain can be frustratingly persistent and limit our ability to exercise and enjoy life.

What is Achilles tendinopathy?

The Achilles tendon is one of the strongest tendons in the human body. It attaches the calf muscles to the heel bone of the foot, helping you to run fast, jump high, and change direction quickly. During these types of exercises the tendon acts like a spring that propels you forward more efficiently.

Many labels are used to describe what’s going on when the tendon is injured. People are often told their tendon is torn and may think of it as a rope hanging on by a thread. These descriptions are unhelpful and inaccurate, often leading to expensive and unnecessary treatments.

We know words are extremely powerful and influence what treatment you think you need. For example, would you do the exercises your physiotherapist gave you if you believed your tendon was hanging on by a thread? Probably not.

Our work has found a painful tendon is not like a torn rope at all. It’s more like doughnuts stacked on top of each other. Even though changes in tendon structure are seen as a “hole” in the middle of the tendon, there is still a lot of delicious doughnut (in other words healthy tendon) surrounding the damaged area. The tendon adapts by getting thicker, making it stronger and allowing you to exercise.

Critically, pain poorly reflects damage. Tendon pain is not present because the tendon is damaged, weak or hanging on by a thread. More than 30% of AFL players have a “hole” in their tendon when we scan them but are able to play at the highest level with no pain.




Read more:
Health Check: why do my muscles ache the day after exercise?


Who gets it?

Achilles tendinopathy can affect athletes who participate in sports that involve running or explosive movements (Australian football, track and field). Most players do not miss competition as a result of Achilles tendon pain.

But our research found more than 20% of AFL players report that pain in their Achilles tendon significantly affects their training and performance. That’s four or five of your favourite 22 athletes playing this weekend.

Some 20% of AFL players suffer from pain in the Achilles tendon that affects their performance.
http://www.shutterstock.com

But most people who experience this type of pain are aged 40-64 years.

That’s because the Achilles tendon bears the brunt of activities like running, playing golf, walking the dog, and stepping off the kerb throughout life. Being overweight, having diabetes, and high cholesterol all increase the risk of developing Achilles tendon pain. Tendon pain can lead to further weight gain and a greater impact on someone’s health beyond just their ability to run and exercise.

Overcoming tendon pain

The good news is that painful Achilles tendons rarely rupture. Some 80-90% of people who rupture their tendon have never had Achilles tendon pain. Your brain is clever as it uses pain to protect your Achilles tendon by changing your behaviour. But it’s easy to become overprotective.

Completely resting the tendon, either by using crutches or a walking boot, is one thing that should be avoided. This is because of the “use it or lose it” principle. With even two weeks’ rest, your tendon and calf muscles become weaker, meaning a longer recovery time.

Just like muscles, tendons get stronger with exercise. Starting exercise that produces no or minimal pain and progressively increasing the intensity of exercise is by far the best option, based on research.




Read more:
How to prevent injury from sport and exercise


In consultation with an experienced physiotherapist, this program should include strength training to help strengthen the tendon and the calf muscles. If you want to get back to running, slowly introduce exercise that requires the tendon to act like a spring, such as skipping and jumping.

It can be tempting to look for a quick fix for your pain. But interventions such as surgery or injections are often ineffective, costly, and can be harmful.

These approaches should be a last resort, and actually all still require exercise to strengthen the tendon. Unfortunately, there are no shortcuts when recovering from a tendon injury.

Unlike Achilles in Greek mythology, your Achilles tendon does not have to be a point of weakness. Consulting with an experienced physiotherapist to develop a progressive exercise program is the best protection you can have against further injury.The Conversation

Sean Docking, Post-doctoral researcher, La Trobe University; Ebonie Rio, NHMRC Research Fellow, La Trobe University, and Jill Cook, Professor, Sports Medicine Research, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How many people have eating disorders? We don’t really know, and that’s a worry



Eating disorders disproportionately affect females and young people.
From shutterstock.com

Laura Hart, University of Melbourne

Last week, federal health minister Greg Hunt announced that more than 60,000 Australians will be asked about their mental health and well-being as part of the Intergenerational Health and Mental Health Study.

The mental health survey will be run in 2020, with new data on how common mental illness is due the year after. This is a welcome announcement for the mental health sector, because information gathered in a survey like this can be used to shape policy reform.




Read more:
If we’re to have another inquiry into mental health, it should look at why the others have been ignored


But eating disorders, a major category of mental illnesses, have been neglected by all previous important data collection initiatives in Australia so far. Notably, they were missing from the last national mental health surveys in 1997 and 2007.

Eating disorders are not yet an official part of this new survey, but we understand they are being considered.

If people with eating disorders are not counted, they don’t count. In other words, we need to know who has these severe and debilitating conditions, and then work towards improving the treatment and supports available for them.




Read more:
FactCheck Q&A: do eating disorders have the highest mortality rate of all mental illnesses?


Surveys are important

National surveys ask the public if they have experienced symptoms of various mental illnesses, either in their lifetime or during the past 12 months.

People who answer “yes” to particular clusters of symptoms are “diagnosed”, or assumed to have had the illness.

Asking the public about their symptoms is the best way to understand how common mental illnesses are. This is because most people with a mental illness don’t seek treatment and may never have had a diagnosis. So collecting data from health services or based on reported diagnoses doesn’t provide a full picture.

Also, for some mental illnesses, such as anorexia nervosa or psychosis, people might not realise they have a diagnosable illness. But they are likely to respond “yes” to direct questions about their experiences with body dissatisfaction or thinking difficulties.

Eating disorders are more than just anorexia

A person with anorexia nervosa engages in dangerous behaviours to maintain a very low body weight, or to lose more weight. Although most people have heard of it, anorexia is not common. We know this from other countries who have previously studied the prevalence of anorexia in community surveys.

That being said, it’s very serious and can be fatal. It has the highest mortality of all non-substance use mental disorders, and one in five of those deaths is by suicide.




Read more:
Disease evolution: the origins of anorexia and how it’s shaped by culture and time


Other eating disorders include bulimia nervosa, binge-eating disorder, and “other specified feeding and eating disorders” (OSFED), a catch-all group for those who don’t fit anywhere else.

People with bulimia nervosa or binge-eating disorder experience cycles of binge-eating, often after periods of restricting foods, which cause shame, guilt and discomfort.

Those with bulimia compensate for binge-eating through vomiting, fasting, exercise or other methods, while those with binge-eating disorder do not.

Binge-eating disorder is the most common of all eating disorders and occurs more equally across men and women than other eating disorders.

As well as continued weight gain, people with binge-eating disorder are more likely to experience depression and anxiety, and other significant health problems (such as asthma, diabetes, and arthritis) than people with a high BMI (body-mass index) but no binge-eating disorder.

Binge-eating disorder is the most common eating disorder.
From shutterstock.com

One example of OSFED is atypical anorexia nervosa – when someone shows all the symptoms of anorexia and has lost a significant amount of weight but their BMI is in the “normal” or “high” range.

Eating disorders disproportionately affect females, young people, LGBTIQ individuals, and those with a high BMI.

People with eating disorders often have a negative body image, and a strong perception their self-worth is tied to their appearance or body weight.

Burden of disease

Every year in Australia, millions of years of healthy life are lost because of injury, illness or premature deaths in the population. This is known as “burden of disease”.

Like national surveys, burden of disease studies are extremely important for planning and funding health services. They use prevalence statistics, or how many people per 100,000 Australians are assumed to have a particular illness. Given we don’t have good data on how prevalent eating disorders are, we likely underestimate their burden of disease.




Read more:
To the Bone: creating eating disorder awareness or doing harm?


The recently released Australian Burden of Disease Study 2015 lists eating disorders among the most burdensome illnesses for Australian females, being the tenth leading cause of total burden of disease for females aged 5-14 and women aged 25-44.

Importantly, the most common eating disorder – binge-eating disorder – is not included in burden of disease studies, meaning all these figures miscalculate the impact of eating disorders by a long way.

Eating disorders are on the rise

Despite our lack of prevalence data, there is evidence showing eating disorders are an increasing problem and should be regarded as a national priority.

Consecutive population surveys in South Australia showed the numbers of people with eating disorders climbed over a ten-year period.

Annual youth surveys demonstrate body image, the most potent risk factor for eating disorders, is year after year among the top concerns for young people.

A recent study on adolescents in the Hunter Valley region of NSW found one in five had experienced an eating disorder.

Treatment and prevention

People with eating disorders use more health services than people with all other forms of mental illness, but often don’t receive appropriate and effective treatment. They typically receive treatment for weight loss, depression or anxiety, but are rarely treated for their disordered eating.

Eating disorders were estimated to cost the health system A$99.9 million in the year 2012 alone.

Better treatment and prevention of eating disorders would reduce the cost and the burden of disease. But we need the data to show where the treatment gaps are and how to fund better services.

There are many promising elements of the proposed Intergenerational Health and Mental Health Study. These include surveying multiple people in a family, gathering physical and mental health data, and a target of more than 60,000 Australians. But it’s time eating disorders were included.




Read more:
Therapy for life-threatening eating disorders works, so why can’t people access it?


The Conversation


Laura Hart, Senior Research Fellow, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

No, eating chocolate won’t cure depression



If you’re depressed, the headlines might tempt you to reach out for a chocolate bar. But don’t believe the hype.
from www.shutterstock.com

Ben Desbrow, Griffith University

A recent study published in the journal Depression and Anxiety has attracted widespread media attention. Media reports said eating chocolate, in particular, dark chocolate, was linked to reduced symptoms of depression.

Unfortunately, we cannot use this type of evidence to promote eating chocolate as a safeguard against depression, a serious, common and sometimes debilitating mental health condition.

This is because this study looked at an association between diet and depression in the general population. It did not gauge causation. In other words, it was not designed to say whether eating dark chocolate caused a reduction in depressive symptoms.




Read more:
What causes depression? What we know, don’t know and suspect


What did the researchers do?

The authors explored data from the United States National Health and Nutrition Examination Survey. This shows how common health, nutrition and other factors are among a representative sample of the population.

People in the study reported what they had eaten in the previous 24 hours in two ways. First, they recalled in person, to a trained dietary interviewer using a standard questionnaire. The second time they recalled what they had eaten over the phone, several days after the first recall.

The researchers then calculated how much chocolate participants had eaten using the average of these two recalls.

Dark chocolate needed to contain at least 45% cocoa solids for it to count as “dark”.




Read more:
Explainer: what is memory?


The researchers excluded from their analysis people who ate an implausibly large amount of chocolate, people who were underweight and/or had diabetes.

The remaining data (from 13,626 people) was then divided in two ways. One was by categories of chocolate consumption (no chocolate, chocolate but no dark chocolate, and any dark chocolate). The other way was by the amount of chocolate (no chocolate, and then in groups, from the lowest to highest chocolate consumption).




Read more:
Monday’s medical myth: chocolate is an aphrodisiac


The researchers assessed people’s depressive symptoms by having participants complete a short questionnaire asking about the frequency of these symptoms over the past two weeks.

The researchers controlled for other factors that might influence any relationship between chocolate and depression, such as weight, gender, socioeconomic factors, smoking, sugar intake and exercise.

What did the researchers find?

Of the entire sample, 1,332 (11%) of people said they had eaten chocolate in their two 24 hour dietary recalls, with only 148 (1.1%) reporting eating dark chocolate.

A total of 1,009 (7.4%) people reported depressive symptoms. But after adjusting for other factors, the researchers found no association between any chocolate consumption and depressive symptoms.

Few people said they’d eaten any chocolate in the past 24 hours. Were they telling the truth?
from www.shutterstock.com

However, people who ate dark chocolate had a 70% lower chance of reporting clinically relevant depressive symptoms than those who did not report eating chocolate.

When investigating the amount of chocolate consumed, people who ate the most chocolate were more likely to have fewer depressive symptoms.

What are the study’s limitations?

While the size of the dataset is impressive, there are major limitations to the investigation and its conclusions.

First, assessing chocolate intake is challenging. People may eat different amounts (and types) depending on the day. And asking what people ate over the past 24 hours (twice) is not the most accurate way of telling what people usually eat.

Then there’s whether people report what they actually eat. For instance, if you ate a whole block of chocolate yesterday, would you tell an interviewer? What about if you were also depressed?

This could be why so few people reported eating chocolate in this study, compared with what retail figures tell us people eat.




Read more:
These 5 foods are claimed to improve our health. But the amount we’d need to consume to benefit is… a lot


Finally, the authors’ results are mathematically accurate, but misleading.

Only 1.1% of people in the analysis ate dark chocolate. And when they did, the amount was very small (about 12g a day). And only two people reported clinical symptoms of depression and ate any dark chocolate.

The authors conclude the small numbers and low consumption “attests to the strength of this finding”. I would suggest the opposite.

Finally, people who ate the most chocolate (104-454g a day) had an almost 60% lower chance of having depressive symptoms. But those who ate 100g a day had about a 30% chance. Who’d have thought four or so more grams of chocolate could be so important?

This study and the media coverage that followed are perfect examples of the pitfalls of translating population-based nutrition research to public recommendations for health.

My general advice is, if you enjoy chocolate, go for darker varieties, with fruit or nuts added, and eat it mindfully. — Ben Desbrow


Blind peer review

Chocolate manufacturers have been a good source of funding for much of the research into chocolate products.

While the authors of this new study declare no conflict of interest, any whisper of good news about chocolate attracts publicity. I agree with the author’s scepticism of the study.

Just 1.1% of people in the study ate dark chocolate (at least 45% cocoa solids) at an average 11.7g a day. There was a wide variation in reported clinically relevant depressive symptoms in this group. So, it is not valid to draw any real conclusion from the data collected.

For total chocolate consumption, the authors accurately report no statistically significant association with clinically relevant depressive symptoms.

However, they then claim eating more chocolate is of benefit, based on fewer symptoms among those who ate the most.

In fact, depressive symptoms were most common in the third-highest quartile (who ate 100g chocolate a day), followed by the first (4-35g a day), then the second (37-95g a day) and finally the lowest level (104-454g a day). Risks in sub-sets of data such as quartiles are only valid if they lie on the same slope.

The basic problems come from measurements and the many confounding factors. This study can’t validly be used to justify eating more chocolate of any kind. — Rosemary Stanton


Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.The Conversation

Ben Desbrow, Associate Professor, Nutrition and Dietetics, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.