Long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk
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Many women worry hormonal contraceptives have dangerous side-effects including increased cancer risk. But this perception is often out of proportion with the actual risks.
So, what does the research actually say about cancer risk for contraceptive users?
And is your cancer risk different if, instead of the pill, you use long-acting reversible contraceptives? These include intrauterine devices or IUDs (such as Mirena), implants under the skin (such as Implanon), and injections (such as Depo Provera).
Our new study, conducted by the University of Queensland and QIMR Berghofer Medical Research Institute and published by the Journal of the National Cancer Institute, looked at this question.
We found long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk (which is good news) but not necessarily any safer than the pill.
How does the contraceptive pill affect cancer risk?
The International Agency for Research on Cancer, which compiles evidence on cancer causes, has concluded that oral contraceptives have mixed effects on cancer risk.
Using the oral contraceptive pill:
- slightly increases your risk of breast and cervical cancer in the short term, but
- substantially reduces your risk of cancers of the uterus and ovaries in the longer term.
Our earlier work showed the pill was responsible for preventing far more cancers overall than it contributed to.
In previous research we estimated that in 2010, oral contraceptive pill use prevented over 1,300 cases of endometrial and ovarian cancers in Australian women.
It also prevented almost 500 deaths from these cancers in 2013. This is a reduction of around 25% in the deaths that could have occurred that year if women hadn’t taken the pill.
In contrast, we calculated the pill may have contributed to around 15 deaths from breast cancer in 2013, which is less than 0.5% of all breast cancer deaths in that year.
What about long-acting reversible contraceptives and cancer risk?
Long-acting reversible contraceptives – which include intrauterine devices or IUDs, implants under the skin, and injections – release progesterone-like hormones.
These are very effective contraceptives that can last from a few months (injections) up to seven years (intrauterine devices).
Notably, they don’t contain the hormone oestrogen, which may be responsible for some of the side-effects of the pill (including perhaps contributing to a higher risk of breast cancer).
Use of these long-acting contraceptives has doubled over the past decade, while the use of the pill has declined. So it’s important to know whether this change could affect cancer risk for Australian women.
Our new study of more than 1 million Australian women investigated whether long-acting, reversible contraceptives affect risk of invasive cancers. We compared the results to the oral contraceptive pill.
We used de-identified health records for Australian women aged 55 and under in 2002.
Among this group, about 176,000 were diagnosed with cancer between 2004 and 2013 when the oldest women were aged 67. We compared hormonal contraceptive use among these women who got cancer to women without cancer.
We found that long-term users of all types of hormonal contraception had around a 70% lower risk of developing endometrial cancer in the years after use. In other words, the risk of developing endometrial cancer is substantially lower among women who took hormonal contraception compared to those who didn’t.
For ovarian cancer, we saw a 50% reduced risk (compared to those who took no hormonal contraception) for women who were long-term users of the hormone-containing IUD.
The risk reduction was not as marked for the implants or injections, however few long-term users of these products developed these cancers in our study.
As the risk of endometrial and ovarian cancers increases with age, it will be important to look at cancer risk in these women as they get older.
What about breast cancer risk?
Our findings suggest that the risk of breast cancer for current users of long-acting contraceptives is similar to users of the pill.
However, the contraceptive injection was only associated with an increase in breast cancer risk after five years of use and there was no longer a higher risk once women stopped using them.
Our results suggested that the risk of breast cancer also reduces after stopping use of the contraceptive implants.
We will need to follow-up the women for longer to determine whether this is also the case for the IUD.
It is worth emphasising that the breast cancer risk associated with all hormonal contraceptives is very small.
About 30 in every 100,000 women aged 20 to 39 years develop breast cancer each year, and any hormonal contraceptive use would only increase this to around 36 cases per 100,000.
What about other cancers?
Our study did not show any consistent relationships between contraceptive use and other cancers types. However, we only at looked at invasive cancers (meaning those that start at a primary site but have the potential to spread to other parts of the body).
A recent French study found that prolonged use of the contraceptive injection increased the risk of meningioma (a type of benign brain tumour).
However, meningiomas are rare, especially in young women. There are around two cases in every 100,000 in women aged 20–39, so the extra number of cases linked to contraceptive injection use was small.
The French study found the hormonal IUD did not increase meningioma risk (and they did not investigate contraceptive implants).
Benefits and side-effects
There are benefits and side-effects for all medicines, including contraceptives, but it is important to know most very serious side-effects are rare.
A conversation with your doctor about the balance of benefits and side-effects for you is always a good place to start.
Susan Jordan, Professor of Epidemiology, The University of Queensland; Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland, and Penny Webb, Distinguished Scientist, Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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You Are Not a Before Picture – by Alex Light
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It’s that time of year, and many of us are looking at what we’ll do in the coming days, weeks, and months to level-up our health. So… Is this a demotivational book?
Quite the opposite! It’s rather a case of an often much-needed reminder to ensure that our plans are really our own, and really are what’s best for us. Why wouldn’t they be, you ask?
Much of diet culture (ubiquitous! From magazine covers to movie stars to the models advertising anything from health insurance to water filters) has us reaching for “body goals” that are not possible without a different skeleton and genes and compromises and post-production edits.
Alex Light—herself having moved from the fashion and beauty industry into health education—sets out in a clear, easy-reading manner, how we can look after ourselves, not be neglectful of our bodies, and/but also not get distracted into unhelpful, impossible, castles-in-the-air.
Bottom line: you cannot self-hate your way into good health, and good health will always be much more attainable than a body that’s just not yours. This book can help you sort out which is which.
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Delicious Daily Daal
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You’re not obliged to eat this every day, but you might want to. The reason we called this one this, is because it’s a super simple recipe (don’t be put off by the long ingredients list; it’s mostly spices making it look long) which, after you’ve done it a couple of times, you could practically do it in your sleep quickly and easily.
The name “lentil daal” is a bit like “naan bread”—a redundant tautology repeated more than once unnecessarily, but it helps for international clarity. The dish is usually served with naan, by the way, and rice. We don’t have room for those today, maybe we’ll do them another day; for now, you can just cook rice how you normally do, and buy naan if necessary.
Writer’s note: I love strong flavors; many people don’t. For this reason I’m going to give a “basic” version. Please feel free to multiply the spices if you feel so inclined. Where I give “one teaspoon” of a spice below, I’d use a tablespoon at home. Chili peppers can vary in heat a lot even within the same type, so what I do for any given batch is taste one (raw), judge the heat, and use an appropriate number of peppers accordingly. If you don’t want to do that, I suggest just guessing low (as per the instructions below) and if you find at the end you want more heat, you can always stir in a little hot sauce. I know that sounds heretical, but at the end of the day, the primary goal of cooking is to have the meal you want at the end of it.
You will need
- 1 1/2 cups red lentils
- 1 large onion, chopped
- 1 large bulb garlic, minced
- 1 oz ginger, grated
- 2 hot peppers (e.g. serrano), chopped
- 1 tsp ground cumin
- 1 tsp ground coriander
- 1 tsp ground turmeric
- 1 tsp garam masala (this is also ground, but it doesn’t come any other way)
- 1 tsp chili flakes (omit if you’re not a fan of heat)
- 2 tsp cracked black pepper
- 1 tsp salt ← I wouldn’t recommend multiplying this one unless later, to taste. In fact, instead of 1 tsp salt I use 2 tsp MSG, which has less sodium than 1 tsp salt. But “1 tsp salt” is the “easy to find in the store” version.
- 2 large or 3 small tomatoes, chopped (or 1 can chopped tomatoes)
- 2 shallots, thinly sliced
- 1 tsp cumin seeds
- 1 tsp mustard seeds
- 1 tsp coriander seeds
- 1 tsp black peppercorns
- 1 lime
- 1/2 cup fresh cilantro, or if you have the “that tastes like soap” gene, parsley, chopped
- Coconut oil for cooking (if you don’t like coconut, consider springing for avocado oil—if you use olive oil, it’ll add an olivey taste which changes the dish a lot; not inherently bad, but it feels a lot less like traditional daal; seed oils are less healthy and we don’t recommend them; ghee is a traditional option and not bad in moderation, but not as healthy as the oils we mentioned first)
- Water for cooking the lentils
Method
(we suggest you read everything at least once before doing anything)
1) In a saucepan, boil water and add the lentils; let them simmer while doing the next things.
2) Sauté the onions until translucent. This should only take a few minutes.
3) Add the garlic, ginger, and hot peppers, and keep stirring for another couple of minutes.
4) Add the ground spices (cumin, coriander, turmeric, garam masala) chili flakes, and cracked black pepper, as well as the salt or MSG if using (not both), and stir them in quickly but thoroughly.
For the next step, you may need to transfer to larger pan if your sauté pan isn’t big enough to take the volume; if so, that’s fine, the sauté has done its job and can have a rest now. If your sauté pan is big enough, just carry on in the same pan; this is perfect.
5) Add the lentils with the water you cooked them in (there might not be much water left now, as the lentils will have absorbed a lot of it; this is fine) as well as the chopped tomatoes.
6) Simmer until it has the consistency of a very thick sauce (you can add a splash more water here and there if it seems to need more). In the West it’s common to serve lentils “al dente”, but in the East it’s usual to (for dishes like this) cook them until they start to
7) Add the juice of at least 1/2 of your lime, or the whole lime if you feel so inclined.
8) In a pre-heated skillet, flash-fry the sliced shallots and the seeds (cumin, coriander, mustard, black peppercorns) at the hottest temperature you can muster. Don’t worry if the oil smokes; we’re only going to be at this tadka-making stage for a moment and nothing will stick provided you keep it moving. When the seeds start popping, it’s ready. Add it all to the big pan and stir in.
9) Add the cilantro-or-parsley garnish once you’re ready to serve.
Enjoy!
Learn more
For those interested in some of the science of what we have going on today:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- How Much Spice Is Right?
- Tasty Polyphenols
Take care!
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Blue Cheese vs Brunost – Which is Healthier?
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Our Verdict
When comparing blue cheese to brunost, we picked the brunost.
Why?
First, for the unfamiliar, as brunost isn’t necessarily as popular as blue cheese in N. America where most of our readers are:
Brunost, literally “brown cheese” is a traditional Norwegian affair made from aggressively boiling milk, cream, and whey in an iron cauldron. Whereas the blue in blue cheese comes from mold, the brown in brown cheese comes from caramelizing the milk sugars in the cauldron. When we say “cauldron”, yes, there is nowadays mass-produced brunost that is no longer made in something that could be mistaken for a witch’s brew, but the use of cast iron is actually important to the process, and has been the subject of regulatory controversy in Norway; first the cast iron was abandoned, then because that changed the cheese they fortified the product with added iron supplementation, then that was banned, then they reversed it because it affected iron levels in the general population. Nowadays, it is usually made with iron, one way or another.
Ok, so let’s see how they stack up against each other:
In terms of macronutrients, the two cheeses are comparable in fat, but brunost has more carbs—because whereas bacteria (and to a lesser extent, the mold) ate nearly all the carbs in the blue cheese, the caramelization of the milk sugars in brunost meant the result stayed higher in carbs. Both are considered “low GI” foods, but this category is still at least a moderate win for blue cheese.
When it comes to vitamins, brunost is higher in vitamins A, B1, B2, B3, B5, B6, and B12, while blue cheese is higher in vitamin B9. In other words, a clear and easy win for brunost.
In the category of minerals, brunost has more copper, iron, magnesium, manganese, phosphorus, and potassium. Meanwhile, blue cheese contains more zinc, although we can also mention that blue cheese has about 2x the sodium, which is generally not considered a benefit. The two cheeses are about equal in calcium and selenium. Adding these up makes for another clear and easy win for brunost.
In short, unless you are strongly avoiding [even low-GI foods’] carbs for some reason, brunost wins the day by virtue of its overwhelmingly better vitamin and mineral content.
Still, like most fermented dairy products, both cheeses can be enjoyed in moderation as part of a healthy diet (assuming you don’t have an allergy/intolerance).
Want to learn more?
You might like to read:
Take care!
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Tranquility by Tuesday?
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I Know How She Does It: How Successful Women Make The Most of Their Time
This is Laura Vanderkam, author of “Tranquility By Tuesday” (amongst other books). Her “thing” is spending more time on what’s important, and less on what isn’t. Sounds simple, but she’s made a career out of it, so condensed here for you are…
Laura’s 7 Keys To Productivity
Key One: Plan your weeks on Fridays
You don’t want your Monday morning to be a “James Bond intro” (where everything is already in action and you’re just along for the ride, trying to figure out what’s going on). So, take some time last thing each Friday, to plan ahead for the following week!
Key Two: Measure what matters
Whatever that means to you. Laura tracks her use of time in half-hour blocks, and likes keeping track of streaks. For her, that means running daily and keeping a log of it. She also keeps track of the books she reads. For someone else it could be music practice, or a Duolingo streak, or eating fruit each day.
On which note…
“Dr. Greger’s Daily Dozen” is simpler than most nutrition trackers (where you must search for everything you eat, or scan barcodes for all ingredients).
Instead, it keeps track of whether you are having certain key health-giving foods often enough to maintain good health.
We might feature his method in a future edition of 10almonds, but for now, check the app out for yourself here:
Get Dr. Greger’s Daily Dozen on iOS / Get Dr. Greger’s Daily Dozen on Android
Dr. Greger’s Daily Dozen @ Nutrition Facts
Key Three: Figure out 2–3 “anchor” events for the weekend
Otherwise, it can become a bit of a haze and on Monday you find yourself thinking “where did the weekend go?”. So, plan some stuff! It doesn’t have to be anything out-of-this-world, just something that you can look forward to in advance and remember afterwards. It could be a meal out with your family, or a session doing some gardening, or a romantic night in with your partner. Whatever makes your life “living” and not passing you by!
Key Four: Tackle the toughest work first
You’ve probably heard about “swallowing frogs”. If not, there are various versions, usually attributed to Mark Twain.
Here’s one:
“If it’s your job to eat a frog, it’s best to do it first thing in the morning. And if it’s your job to eat two frogs, it’s best to eat the biggest one first.”
Top Productivity App “ToDoist” has an option for this, by the way!
Laura’s key advice here is: get the hard stuff done now! Before you get distracted or tired and postpone it to tomorrow (and then lather rinse repeat, so it never gets done)
10almonds Tip:
“But what if something’s really important but not as pressing as some less important, but more urgent tasks?”
Simple!
Set a timer (we love the Pomodoro method, by the way) and do one burst of the important-but-not-urgent task first. Then you can get to the more urgent stuff.
Repeat each day until the important-but-not-urgent task is done!
The 10almonds Team
Key Five: Use bits of time well
If, like many of us, you’ve a neverending “to read” list, use the 5–10 minute breaks that get enforced upon us periodically through the day!
- Use those few minutes before a meeting/phonecall!
- Use the time you spend waiting for public transport or riding on it!
- Use the time you spent waiting for a family member to finish doing a thing!
All those 5–10 minute bits soon add up… You might as well spend that time reading something you know will add value to your life, rather than browsing social media, for example.
Key Six: Make very short daily to-do lists
By “short”, Laura considers this “under 10 items”. Do this as the last part of your working day, ready for tomorrow. Not at bedtime! Bedtime is for winding down, not winding up
Key Seven: Have a bedtime
Laura shoots for 10:30pm, but whatever works for you and your morning responsibilities. Your morning responsibilities aren’t tied to a specific time? Lucky you, but try to keep a bedtime anyway. Otherwise, your daily rhythm can end up sliding around the clock, especially if you work from home!
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Thinking of trying a new diet? 4 questions to ask yourself before you do
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We live in a society that glorifies dieting, with around 42% of adults globally having tried to lose weight. Messages about dieting and weight loss are amplified on social media, with a never-ending cycle of weight loss fads and diet trends.
Amid often conflicting messages and misinformation, if you’re looking for diet advice online, it’s easy to become confused and overwhelmed.
So before diving into the latest weight loss trend or extreme diet, consider these four questions to help you make a more informed decision.
PeopleImages.com – Yuri A/Shutterstock 1. Is the diet realistic?
Have you considered the financial cost of maintaining the diet or lifestyle, and the time and resources that would be required? For example, do you need to purchase specific products, supplements, or follow a rigid meal plan?
If the diet is coming from someone who is trying to sell you something – such as a particular weight-loss product you need in order to follow the diet – this could be a particular red flag.
Many extreme diet recommendations come from a place of privilege and overlook food access, affordability, cooking skills, where you live, or even your culture and ethics.
If the diet has these sorts of issues it can lead to frustration, stress, stigmatisation and feelings of failure for the person trying to adhere to the diet. But the problem may be with the diet itself – not with you.
Many diets promoted online will be expensive, or require a lot of time and resources. artem evdokimov/Shutterstock 2. Is there evidence to support this diet?
Self-proclaimed “experts” online will often make claims focused on specific groups, known as target populations. This might be 30- to 50-year-old men with diabetes, for example.
In some cases, evidence for claims made may come from animal studies, which might not be applicable to humans at all.
So be aware that if research findings are for a group that doesn’t match your profile, then the results might not be relevant to you.
It takes time and a lot of high-quality studies to tell us a “diet” is safe and effective, not just one study. Ask yourself, is it supported by multiple studies in humans? Be critical and question the claims before you accept them.
For accurate information look for government websites, or ask your GP or dietitian.
3. How will this diet affect my life?
Food is much more than calories and nutrients. It plays many roles in our lives, and likewise diets can influence our lives in ways we often overlook.
Socially and culturally, food can be a point of connection and celebration. It can be a source of enjoyment, a source of comfort, or even a way to explore new parts of the world.
So when you’re considering a new diet, think about how it might affect meaningful moments for you. For example, if you’re going travelling, will your diet influence the food choices you make? Will you feel that you can’t sample the local cuisine? Or would you be deterred from going out for dinner with friends because of their choice of restaurant?
4. Will this diet make me feel guilty or affect my mental health?
What is your favourite meal? Does this diet “allow” you to eat it? Imagine visiting your mum who has prepared your favourite childhood meal. How will the diet affect your feelings about these special foods? Will it cause you to feel stressed or guilty about enjoying a birthday cake or a meal cooked by a loved one?
Studies have shown that dieting can negatively impact our mental health, and skipping meals can increase symptoms of depression and anxiety.
Many diets fail to consider the psychological aspects of eating, even though our mental health is just as important as physical health. Eating should not make you feel stressed, anxious, or guilty.
So before starting another diet, consider how it might affect your mental health.
Moving away from a dieting mindset
We’re frequently told that weight loss is the path to better health. Whereas, we can prioritise our health without focusing on our weight. Constant messages about the need to lose weight can also be harmful to mental health, and not necessarily helpful for physical health.
Our research has found eating in a way that prioritises health over weight loss is linked to a range of positive outcomes for our health and wellbeing. These include a more positive relationship with food, and less guilt and stress.
Our research also indicates mindful and intuitive eating practices – which focus on internal cues, body trust, and being present and mindful when eating – are related to lower levels of depression and stress, and greater body image and self-compassion.
But like anything, it takes practice and time to build a positive relationship with food. Be kind to yourself, seek out weight-inclusive health-care professionals, and the changes will come. Finally, remember you’re allowed to find joy in food.
Melissa Eaton, Accredited Practising Dietitian; PhD Candidate, University of Wollongong; Verena Vaiciurgis, Accredited Practising Dietitian; PhD Candidate, University of Wollongong, and Yasmine Probst, Associate Professor, School of Medical, Indigenous and Health Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Modern Art and Science of Mobility – by Aurélien Broussal-Derval
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We’ve reviewed mobility books before, so what makes this one stand out?
We’ll be honest: the illustrations are lovely.
The science, the information, the exercises, the routines, the programs… All these things are excellent too, but these can be found in many a book.
What can’t usually be found is very beautiful (yet no less clear) watercolor paintings and charcoal sketches as anatomical illustrations.
There are photos too (also of high quality), but the artistry of the paintings and sketches is what makes the reader want to spend time perusing the books.
At least, that’s what this reviewer found! Because it’s all very well having access to a lot of information (and indeed, I read so much), but making it enjoyable increases the chances of rereading it much more often.
As for the rest of the content, the book’s information is divided in categories:
- Pain (what causes it, what it means, and how to manage it)
- Breathing (yes, a whole section devoted to this, and it is aligned heavily to posture also, as well as psychological state and the effect of stress on tension, inflammation, and more)
- Movement (this is mostly about kinds of movement and ranges of movement)
- Mobility (this is about aggregating movements as a fully mobile human)
So, each builds on from the previous because any pain needs addressing before anything else, breathing (and with it, posture) comes next, then we learn about movement, then we bring it all together for mobility.
Bottom line: this is a beautiful and comprehensive book that will make learning a joy
Click here to check out The Modern Art and Science of Mobility, and learn and thrive!
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