Military Secrets (Ssh!)
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Can you keep a secret?
When actor Christopher Lee was asked about his time as a British special forces operative, he would look furtively around, and ask “can you keep a secret?” Upon getting a yes, he would reply:
“So can I”
We can’t, though! We just can’t help sharing cool, useful information that changes people’s lives. Never is that more critical than now, as the end of January has been called the most depressing time of year, according to Dr. Cliff Arnall at the University of Cardiff. It doesn’t have to be all doom and gloom, though:
Today we’re going to share a trick… It’s called the “secret of eternal happiness” (yes, we know… we didn’t come up with the name!) and is taught to soldiers to fend off the worst kinds of despair.
The soldiers would be ordered to take a moment to reflect on the sheer helplessness of their situation, the ridiculous impossibility of the odds against them, all and any physical pain they might suffer, the weakness of their faltering body… and just when everything feels as bad is it can possibly feel, they’re told to say out loud—as sadly as possible—this single word:
“Boop”
It all but guarantees to result in cracking a smile, no matter the situation.
Now this knowledge is yours too! Keep it secret! Or don’t. Sharing is caring.
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Falling vaccination rates put children at risk of preventable diseases. Governments need a new strategy to boost uptake
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Child vaccination is one of the most cost-effective health interventions. It accounts for 40% of the global reduction in infant deaths since 1974 and has led to big health gains in Australia over the past two decades.
Australia has been a vaccination success story. Ten years after we begun mass vaccination against polio in 1956, it was virtually eliminated. Our child vaccination rates have been among the best in the world.
But after peaking in 2020, child vaccination in Australia is falling. Governments need to implement a comprehensive strategy to boost vaccine uptake, or risk exposing more children to potentially preventable infectious diseases.
Yuri A/Shutterstock Child vaccination has been a triumph
Thirty years ago, Australia’s childhood vaccination rates were dismal. Then, in 1997, governments introduced the National Immunisation Program to vaccinate children against diseases such as diphtheria, tetanus, and measles.
Measures to increase coverage included financial incentives for parents and doctors, a public awareness campaign, and collecting and sharing local data to encourage the least-vaccinated regions to catch up with the rest of the country.
What followed was a public health triumph. In 1995, only 52% of one-year-olds were fully immunised. By 2020, Australia had reached 95% coverage for one-year-olds and five-year-olds. At this level, it’s difficult even for highly infectious diseases, such as measles, to spread in the community, protecting both the vaccinated and unvaccinated.
By 2020, 95% of children were vaccinated. Drazen Zigic/Shutterstock Gaps between regions and communities closed too. In 1999, the Northern Territory’s vaccination rate for one-year-olds was the lowest in the country, lagging the national average by six percentage points. By 2020, that gap had virtually disappeared.
The difference between vaccination rates for First Nations children and other children also narrowed considerably.
It made children healthier. The years of healthy life lost due to vaccine-preventable diseases for children aged four and younger fell by nearly 40% in the decade to 2015.
Some diseases have even been eliminated in Australia.
Our success is slipping away
But that success is at risk. Since 2020, the share of children who are fully vaccinated has fallen every year. For every child vaccine on the National Immunisation Schedule, protection was lower in 2024 than in 2020.
Gaps between parts of Australia are opening back up. Vaccination rates in the highest-coverage parts of Australia are largely stable, but they are falling quickly in areas with lower vaccination.
In 2018, there were only ten communities where more than 10% of one-year-old children were not fully vaccinated. Last year, that number ballooned to 50 communities. That leaves more areas vulnerable to disease and outbreaks.
While Noosa, the Gold Coast Hinterland and Richmond Valley (near Byron Bay) have persistently had some of the country’s lowest vaccination rates, areas such as Manjimup in Western Australia and Tasmania’s South East Coast have recorded big declines since 2018.
Missing out on vaccination isn’t just a problem for children.
One preprint study (which is yet to be peer-reviewed) suggests vaccination during pregnancy may also be declining.
Far too many older Australians are missing out on recommended vaccinations for flu, COVID, pneumococcal and shingles. Vaccination rates in aged care homes for flu and COVID are worryingly low.
What’s going wrong?
Australia isn’t alone. Since the pandemic, child vaccination rates have fallen in many high-income countries, including New Zealand, the United Kingdom and the United States.
Globally, in 2023, measles cases rose by 20%, and just this year, a measles outbreak in rural Texas has put at least 13 children in hospital.
Alarmingly, some regions in Australia have lower measles vaccination than that Texas county.
The timing of trends here and overseas suggests things shifted, or at least accelerated, during the pandemic. Vaccine hesitancy, fuelled by misinformation about COVID vaccines, is a growing threat.
This year, vaccine sceptic Robert F. Kennedy Jr was appointed to run the US health system, and Louisiana’s top health official has reportedly cancelled the promotion of mass vaccination.
In Australia, a recent survey found 6% of parents didn’t think vaccines were safe, and 5% believed they don’t work.
Those concerns are far more common among parents with children who are partially vaccinated or unvaccinated. Among the 2% of parents whose children are unvaccinated, almost half believe vaccines are not safe for their child, and four in ten believe vaccines didn’t work.
Other consequences of the pandemic were a spike in the cost of living, and a health system struggling to meet demand. More than one in ten parents said cost and difficulty getting an appointment were barriers to vaccinating their children.
There’s no single cause of sliding vaccination rates, so there’s no one solution. The best way to reverse these worrying trends is to work on all the key barriers at once – from a lack of awareness, to inconvenience, to lack of trust.
What governments should do
Governments should step up public health campaigns that counter misinformation, boost awareness of immunisation and its benefits, and communicate effectively to low-vaccination groups. The new Australian Centre for Disease Control should lead the charge.
Primary health networks, the regional bodies responsible for improving primary care, should share data on vaccination rates with GPs and pharmacies. These networks should also help make services more accessible to communities who are missing out, such as migrant groups and disadvantaged families.
State and local governments should do the same, sharing data and providing support to make maternal child health services and school-based vaccination programs accessible for all families.
Governments can communicate better about the benefits of vaccination. Yuri A/Shutterstock Governments should also be more ambitious about tackling the growing vaccine divides between different parts of the country. The relevant performance measure in the national vaccination agreement is weak. States must only increase five-year-old vaccination rates in four of the ten areas where it is lowest. That only covers a small fraction of low-vaccination areas, and only the final stage of child vaccination.
Australia needs to set tougher goals, and back them with funding.
Governments should fund tailored interventions in areas with the lowest rates of vaccination. Proven initiatives include training trusted community members as “community champions” to promote vaccinations, and pop-up clinics or home visits for free vaccinations.
At this time of year, childcare centres and schools are back in full swing. But every year, each new intake has less protection than the previous cohort. Governments are developing a new national vaccination strategy and must seize the opportunity to turn that trend around. If it commits to a bold national plan, Australia can get back to setting records for child vaccination.
Peter Breadon, Program Director, Health and Aged Care, Grattan Institute and Wendy Hu, Associate, Health Program, Grattan Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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5 Things To Know About Passive Suicidal Ideation
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If you’ve ever wanted to go to sleep and never wake up, or have some accident/incident/illness take you with no action on your part, or a loved one has ever expressed such thoughts/feelings to you… Then this video is for you. Dr. Scott Eilers explains:
Tired of living
We’ll not keep them a mystery; here are the five things that Dr. Eilers wants us to know about passive suicidal ideation:
- What it is: a desire for something to end your life without taking active steps. While it may seem all too common, it’s not necessarily inevitable or unchangeable.
- What it means in terms of severity: it isn’t a clear indicator of how severe someone’s depression is. It doesn’t necessarily mean that the person’s depression is mild; it can be severe even without active suicidal thoughts, or indeed, suicidality at all.
- What it threatens: although passive suicidal ideation doesn’t usually involve active planning, it can still be dangerous. Over time, it can evolve into active suicidal ideation or lead to risky behaviors.
- What it isn’t: passive suicidal ideation is different from intrusive thoughts, which are unwanted, distressing thoughts about death. The former involves a desire for death, while the latter does not.
- What it doesn’t have to be: passive suicidal ideation is often a symptom of underlying depression or a mood disorder, which can be treated through therapy, medication, or a combination of both. Seeking treatment is crucial and can be life-changing.
For more on all of the above, here’s Dr. Eilers with his own words:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- The Mental Health First Aid You’ll Hopefully Never Need ← about depression generally
- How To Stay Alive (When You Really Don’t Want To) ← about suicidality specifically
Take care!
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HRT: Bioidentical vs Animal
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HRT: A Tale Of Two Approaches
In yesterday’s newsletter, we asked you for your assessment of menopausal hormone replacement therapy (HRT).
- A little over a third said “It can be medically beneficial, but has some minor drawbacks”
- A little under a third said “It helps, but at the cost of increased cancer risk; not worth it”
- Almost as many said “It’s a wondrous cure-all that makes you happier, healthier, and smell nice too”
- Four said “It is a dangerous scam and a sham; “au naturel” is the way to go”
So what does the science say?
Which HRT?
One subscriber who voted for “It’s a wondrous cure-all that makes you healthier, happier, and smell nice too” wrote to add:
❝My answer is based on biodentical hormone replacement therapy. Your survey did not specify.❞
And that’s an important distinction! We did indeed mean bioidentical HRT, because, being completely honest here, this European writer had no idea that Premarin etc were still in such wide circulation in the US.
So to quickly clear up any confusion:
- Bioidentical hormones: these are (as the name suggests) identical on a molecular level to the kind produced by humans.
- Conjugated Equine Estrogens: such as Premarin, come from animals. Indeed, the name “Premarin” comes from “pregnant mare urine”, the substance used to make it.
There are also hormone analogs, such as medroxyprogesterone acetate, which is a progestin and not the same thing as progesterone. Hormone analogs such as the aforementioned MPA are again, a predominantly-American thing—though they did test it first in third-world countries, after testing it on animals and finding it gave them various kinds of cancer (breast, cervical, ovarian, uterine).
A quick jumping-off point if you’re interested in that:
Depot medroxyprogesterone acetate and the risk of breast and gynecologic cancer
this is about its use as a contraceptive (so, much lower doses needed), but it is the same thing sometimes given in the US as part of menopausal HRT. You will note that the date on that research is 1996; DMPA is not exactly cutting-edge and was first widely used in the 1950s.
Similarly, CEEs (like Premarin) have been used since the 1930s, while estradiol (bioidentical estrogen) has been in use since the 1970s.
In short: we recommend being wary of those older kinds and mostly won’t be talking about them here.
Bioidentical hormones are safer: True or False?
True! This is an open-and-shut case:
❝Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.
Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. ❞
Further research since that review has further backed up its findings.
Source: Are Bioidentical Hormones Safer or More Efficacious than Other Commonly Used Versions in HRT?
So simply, if you’re going on HRT (estrogen and/or progesterone), you might want to check it’s the bioidentical kind.
HRT can increase the risk of breast cancer: True or False?
Contingently True, but for most people, there is no significant increase in risk.
First: again, we’re talking bioidentical hormones, and in this case, estradiol. Older animal-derived attempts had much higher risks with much lesser efficaciousness.
There have been so many studies on this (alas, none that have been publicised enough to undo the bad PR in the wake of old-fashioned HRT from before the 70s), but here’s a systematic review that highlights some very important things:
❝Estradiol-only therapy carries no risk for breast cancer, while the breast cancer risk varies according to the type of progestogen.
Estradiol therapy combined with medroxyprogesterone, norethisterone and levonorgestrel related to an increased risk of breast cancer, estradiol therapy combined with dydrogesterone and progesterone carries no risk❞
In fewer words:
- Estradiol by itself: no increased risk of breast cancer
- Estradiol with MDPA or other progestogens that aren’t really progesterone: increased risk of breast cancer
- Estradiol with actual progesterone: back to no increased risk of breast cancer
So again, you might want to make sure you are getting actual bioidentical hormones, and not something else!
However! If you are aware that you already have an increased risk of breast cancer (e.g. family history, you’ve had it before, you know you have certain genes for it, etc), then you should certainly discuss that with your doctor, because your personal circumstances may be different:
❝Tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis.
Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies❞
Source: HRT in difficult circumstances: are there any absolute contraindications?
HRT makes you happier, healthier, and smell nice too: True or False?
Contingently True, assuming you do want its effects, which generally means the restoration of much of the youthful vitality you enjoyed pre-menopause.
The “and smell nice too” was partly rhetorical, but also partly literal: our scent is largely informed by our hormones, and higher estrogen results in a sweeter scent; lower estrogen results in a more bitter scent. Not generally considered an important health matter, but it’s a thing, so hey.
More often, people take menopausal HRT for more energy, stronger bones (reduced osteoporosis risk), healthier heart (reduced CVD risk), improved sexual health, better mood, healthier skin and hair, and general avoidance of menopause symptoms:
Read more: Skin, hair and beyond: the impact of menopause
We’d need another whole main feature to discuss all the benefits properly; today we’re just mythbusting.
HRT does have some drawbacks: True or False?
True, and/but how serious they are (beyond the aforementioned consideration in the case of an already-increased risk of breast cancer) is a matter of opinion.
For example, it is common to get a reprise of monthly cramps and/or mood swings, depending on how one is taking the HRT and other factors (e.g. your own personal physiology and genetic predispositions). For most people, these will even out over time.
It’s also even common to get a reprise of (much slighter than before) monthly bleeding, unless you have for example had a hysterectomy (no uterus = no bleeding). Again, this will usually settle down in a matter of months.
If you experience anything more alarming than that, then indeed check with your doctor.
HRT is a dangerous scam and sham: True or False?
False, simply. As described above, for most people they’re quite safe. Again, talking bioidentical hormones.
The other kind are in the most neutral sense a sham (i.e. they are literally sham hormones), though they’re not without their merits and for many people they may be better than nothing.
As for being a scam, biodentical hormones are widely prescribed in the many countries that have universal healthcare and/or a single-payer healthcare system, where there would be no profit motive (and considerable cost) in doing so.
They’re prescribed because they are effective and thus reduce healthcare spending in other areas (such as treating osteoporosis or CVD after the fact) and improve Health Related Quality of Life, and by extension, health-adjusted life-years, which is one of the top-used metrics for such systems.
See for example:
Our apologies, gentlemen
We wanted to also talk about testosterone therapy for the andropause, but we’ve run out of room today (because of covering the important distinction of bioidentical vs old-fashioned HRT)!
To make it up to you, we’ll do a full main feature on it (it’s an interesting topic) in the near future, so watch this space
Ladies, we’ll also at some point cover the pros and cons of different means of administration, e.g. pills, transdermal gel, injections, patches, pessaries, etc—which often have big differences.
That’ll be in a while though, because we try to vary our topics, so we can’t talk about menopausal HRT all the time, fascinating and important a topic it is.
Meanwhile… take care, all!
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Staying Sane In A Hyper-Connected World
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Staying Sane In A Hyper-Connected World
There’s a war over there, a genocide in progress somewhere else, and another disease is ravaging the population of somewhere most Americans would struggle to point out on the map. Not only that, but that one politician is at it again, and sweeping wildfires are not doing climate change any favors.
To borrow an expression from Gen-Z…
“Oof”.
A Very Modern Mental Health Menace
For thousands of years, we have had wars and genocides and plagues and corrupt politicians and assorted major disasters. Dire circumstances are not new to us as a species. So what is new?
As some reactionary said during the dot-com boom, “the Internet doesn’t make people stupid; it just makes their stupidity more accessible”.
The same is true now of The Horrors™.
The Internet doesn’t, by and large, make the world worse. But what it does do is make the bad things much, much more accessible.
Understanding and empathy are not bad things, but watch out…
- When soldiers came home from the First World War, those who hadn’t been there had no conception of the horrors that had been endured. That made it harder for the survivors to get support. That was bad.
- Nowadays, while mass media covering horrors certainly doesn’t convey the half of it, even the half it does convey can be overwhelming. This is also bad.
The insidious part is: while people are subjectively reporting good physical/mental health, the reports of the symptoms of poor physical/mental health from the same population do not agree:
Stress in America 2023: A nation grappling with psychological impacts of collective trauma
Should we just not watch the news?
In principle that’s an option, but it’s difficult to avoid, unless you truly live under a rock, and also do not frequent any social media at all. And besides, isn’t it our duty as citizens of this world to stay informed? How else can we make informed choices?
Staying informed, mindfully
There are steps that can be taken to keep ourselves informed, while protecting our mental health:
- Choose your sources wisely. Primary sources (e.g. tweets and videos from people who are there) will usually be most authentic, but also most traumatizing. Dispassionate broadsheets may gloss over or misrepresent things more (something that can be countered a bit by reading an opposing view from a publication you hate on principle), but will offer more of an emotional buffer.
- Boundary your consumption of the news. Set a timer and avoid doomscrolling. Your phone (or other device) may help with this if you set a screentime limit per app where you consume that kind of media.
- Take (again, boundaried) time to reflect. If you don’t, your brain will keep grinding at it “like a fork in the garbage disposal”. Talking about your feelings on the topic with a trusted person is great; journaling is also a top-tier more private option.
- If you feel helpless, help. Taking even small actions to help in the face of suffering somewhere else (e.g. donating to relief funds, engaging in advocacy / hounding your government about it), can help alleviate feelings of anguish and helplessness. And of course, as a bonus, it actually helps in the real world too.
- When you relax, relax fully. Even critical care doctors need downtime, nobody can be “always on” without burning out. So whatever distracts and relaxes you completely, make sure to make time for that too.
Want to know more?
That’s all we have room for today, but you might like to check out:
- Distressing images and videos can take a toll on our mental health. How can we stay informed without being traumatised?
- PTSD expert on how to protect yourself and your kids from overexposure to war images from the Mideast
You also might like our previous main features:
- C-PTSD, And What To Do When Life Genuinely Sucks
- A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing
Take care!
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Why is toddler milk so popular? Follow the money
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Toddler milk is popular and becoming more so. Just over a third of Australian toddlers drink it. Parents spend hundreds of millions of dollars on it globally. Around the world, toddler milk makes up nearly half of total formula milk sales, with a 200% growth since 2005. Growth is expected to continue.
We’re concerned about the growing popularity of toddler milk – about its nutritional content, cost, how it’s marketed, and about the impact on the health and feeding of young children. Some of us voiced our concerns on the ABC’s 7.30 program recently.
But what’s in toddler milk? How does it compare to cow’s milk? How did it become so popular?
What is toddler milk? Is it healthy?
Toddler milk is marketed as appropriate for children aged one to three years. This ultra-processed food contains:
- skim milk powder (cow, soy or goat)
- vegetable oil
- sugars (including added sugars)
- emulsifiers (to help bind the ingredients and improve the texture)
added vitamins and minerals.
Toddler milk is usually lower in calcium and protein, and higher in sugar and calories than regular cow’s milk. Depending on the brand, a serve of toddler milk can contain as much sugar as a soft drink.
Even though toddler milks have added vitamins and minerals, these are found in and better absorbed from regular foods and breastmilk. Toddlers do not need the level of nutrients found in these products if they are eating a varied diet.
Global health authorities, including the World Health Organization (WHO), and Australia’s National Health and Medical Research Council, do not recommend toddler milk for healthy toddlers.
Some children with specific metabolic or dietary medical problems might need tailored alternatives to cow’s milk. However, these products generally are not toddler milks and would be a specific product prescribed by a health-care provider.
Toddler milk is also up to four to five times more expensive than regular cow’s milk. “Premium” toddler milk (the same product, with higher levels of vitamins and minerals) is more expensive.
With the cost-of-living crisis, this means families might choose to go without other essentials to afford toddler milk.
Toddler milk is more expensive than cow’s milk and contains more sugar.
Dragana Gordic/ShutterstockHow toddler milk was invented
Toddler milk was created so infant formula companies could get around rules preventing them from advertising their infant formula.
When manufacturers claim benefits of their toddler milk, many parents assume these claimed benefits apply to infant formula (known as cross-promotion). In other words, marketing toddler milks also boosts interest in their infant formula.
Manufacturers also create brand loyalty and recognition by making the labels of their toddler milk look similar to their infant formula. For parents who used infant formula, toddler milk is positioned as the next stage in feeding.
How toddler milk became so popular
Toddler milk is heavily marketed. Parents are told toddler milk is healthy and provides extra nutrition. Marketing tells parents it will benefit their child’s growth and development, their brain function and their immune system.
Toddler milk is also presented as a solution to fussy eating, which is common in toddlers.
However, regularly drinking toddler milk could increase the risk of fussiness as it reduces opportunities for toddlers to try new foods. It’s also sweet, needs no chewing, and essentially displaces energy and nutrients that whole foods provide.
Toddler milk is said to help fussy eating, but it may make things worse.
zlikovec/ShutterstockGrowing concern
The WHO, along with public health academics, has been raising concerns about the marketing of toddler milk for years.
In Australia, moves to curb how toddler milk is promoted have gone nowhere. Toddler milk is in a category of foods that are allowed to be fortified (to have vitamins and minerals added), with no marketing restrictions. The Australian Competition & Consumer Commission also has concerns about the rise of toddler milk marketing. Despite this, there is no change in how it’s regulated.
This is in contrast to voluntary marketing restrictions in Australia for infant formula.
What needs to happen?
There is enough evidence to show the marketing of commercial milk formula, including toddler milk, influences parents and undermines child health.
So governments need to act to protect parents from this marketing, and to put child health over profits.
Public health authorities and advocates, including us, are calling for the restriction of marketing (not selling) of all formula products for infants and toddlers from birth through to age three years.
Ideally, this would be mandatory, government-enforced marketing restrictions as opposed to industry self-regulation in place currently for infant formulas.
We musn’t blame parents
Toddlers are eating more processed foods (including toddler milk) than ever because time-poor parents are seeking a convenient option to ensure their child is getting adequate nutrition.
Formula manufacturers have used this information, and created a demand for an unnecessary product.
Parents want to do the best for their toddlers, but they need to know the marketing behind toddler milks is misleading.
Toddler milk is an unnecessary, unhealthy, expensive product. Toddlers just need whole foods and breastmilk, and/or cow’s milk or a non-dairy, milk alternative.
If parents are worried about their child’s eating, they should see a health-care professional.
Anthea Rhodes, a paediatrician from Royal Children’s Hospital Melbourne and a lecturer at the University of Melbourne, co-authored this article.
Jennifer McCann, Lecturer Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University; Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University, and Naomi Hull, PhD candidate, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Dr. Dean Ornish’s Program For Reversing Heart Disease – by Dr. Dean Ornish
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We’ve previously reviewed Dr. Ornish’s “Undo It!” which is about reversing many kinds of chronic diseases (not all, alas, but quite a few) by undercutting their common etiologies, such as inflammation, insulin resistance, and so forth.
This book is entirely consistent with that one, but the focus here is (as the title says) specifically on reversing heart disease.
Of course, it does not require you to already have heart disease—if you do, well, getting onto this is better sooner than later. If you don’t, and are “merely” in a risk zone, or even just want to be proactive about your heart health, then this book will stand you in good stead.
The book covers all the lifestyle things you’d expect it to (especially diet, but also exercise, and not just “quit smoking” but also how, things like that), and possibly some things you might not expect (chapters on more psychological factors that have a big impact on heart health).
There are recipes (157 pages of them; they are plant-based and good) and there is a 21-day meal plan to get you going.
The style is a little dated (written in the 90s), but the content doesn’t suffer for it, having been updated over the years in any case.
Bottom line: if you want a holistic approach to taking care of your heart that’s not extreme and/but is very effective, then well, you’ve found it.
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