Can We Drink To Good Health?
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Can we drink to good health?
We asked you for your thoughts on alcohol and heart health, and we got quite an even spread of results!
If perchance that’s too tiny to read, the figures were:
- 32% voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!”
- 32% voted for: “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️”
- 36% voted for: “Alcohol is bad for pretty much everything, including heart health ✋”
One subscriber who voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!” added the following thoughts:
❝While it isn’t necessary to consume alcohol, moderate amounts can be beneficial and contribute to well-being through social activity, celebrations, etc.❞
That’s an interesting point, and definitely many people do see alcohol that way! Of course, that does not mean that one will find no social activities, celebrations, etc, in parts of the world where alcohol consumption is uncommon. Indeed, in India, wedding parties where no alcohol is consumed can go on for days!
But, “we live in a society” and all that, and while we’re a health newsletter not a social issues newsletter, it’d be remiss of us to not acknowledge the importance of socialization for good mental health—and thus the rest of our health too.
So, if indeed all our friends and family drink alcohol, it can certainly make abstaining more of a challenge.
On that note, let’s take a moment to consider “The French Paradox” (an observation of a low prevalence of ischemic heart disease despite high intakes of saturated fat, a phenomenon accredited to the consumption of red wine).
As it happens, a comprehensive review in “Circulation”, a cardiovascular health journal, has suggested the French Paradox may not be so paradoxical after all.
Research suggests it has more to do with other lifestyle factors (and historic under-reporting of cardiovascular disease by French doctors), which would explain why Japan has lower rates of heart disease, despite drinking little wine, and more beer and spirits.
So, our subscriber’s note may not be completely without reason! It’s just about the party, not the alcohol.
One subscriber who voted for “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️” wrote:
❝Keeping in mind, moderate means one glass of wine for women a day and two for men. Hard alcohol doesn’t have the same heart benefits as wine❞
That is indeed the guideline according to some health bodies!
In other places with different guiding advisory bodies, that’s been dropped down to one a day for everyone (the science may be universal, but how government institutions interpret that is not).
About that wine… Specifically, red wine, for its resveratrol content:
While there are polyphenols such as resveratrol in red wine that could boost heart health, there’s so little per glass that you may need 100–1000 glasses to get the dosage that provides benefits in mouse studies. If you’re not a mouse, you might even need more.
To this end, many people prefer resveratrol supplementation. ← link is to an example product, but there are plenty more so feel free to shop around
A subscriber who voted for “Alcohol is bad for pretty much everything, including heart health ✋” says:
❝New guidelines suggest 1 to 2 drinks a week are okay but the less the better.❞
If you haven’t heard these new guidelines, we’ll mention again: every government has its own official bodies and guidelines so perhaps your local guidelines differ, but for example here’s what that World Health Organization has to say (as of January this year):
WHO: No level of alcohol consumption is safe for our health
So, whom to believe? The governments who hopefully consider the welfare of their citizenry more important than the tax dollars from alcohol sales, or the World Health Organization?
It’s a tough one, but we’ll always err on the side of the science.
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Wheat Belly, Revised & Expanded Edition – by Dr. William Davis
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This review pertains to the 2019 edition of the book, not the 2011 original, which will not have had all of the same research.
We are told, by scientific consensus, to enjoy plenty of whole grains as part of our diet. So, what does cardiologist Dr. William Davis have against wheat?
Firstly, not all grains are interchangeable, and wheat—in particular, modern strains of wheat—cannot be described as the same as the wheat of times past.
While this book does touch on the gluten aspect (and Celiac disease), and notes that modern wheat has a much higher gluten content than older strains, most of this book is about other harms that wheat can do to us.
Dr. Davis explores and explains the metabolic implications of wheat’s unique properties on organs such as our pancreas, liver, heart, and brain.
The book does also have recipes and meal plans, though in this reviewer’s opinion they were a little superfluous. Wheat is not hard to cut out unless you are living in a food desert or are experiencing food poverty, in which case, those recipes and meal plans would also not help.
Bottom line: this book, filled with plenty of actual science, makes a strong case against wheat, and again, mostly for reasons other than its gluten content. You might want to cut yours down!
Click here to check out Wheat Belly, and see if skipping the wheat could be good for you!
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Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead
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Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.
So what is knee osteoarthritis and what are the best ways to manage it?
Pexels/Kindelmedia More than 2 million Australians have osteoarthritis
Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.
Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.
Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.
Is it caused by ‘wear and tear’?
Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.
Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.
Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.
This has led to a global call for a change in the way we think and communicate about osteoarthritis.
What’s the best way to manage osteoarthritis?
Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.
Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.
Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.
Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.
Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.
Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.
Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.
Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.
Opioids are not recommended. The risk of harm outweighs any potential benefits.
What about surgery?
People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.
Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.
However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.
Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.
Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.
The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.
I have knee osteoarthritis. What should I do?
The care standard links to free evidence-based resources to support people with osteoarthritis. These include:
- education, such as a decision aid and four-week online course
- self-directed online exercise and yoga programs
- weight management support
- pain management strategies, such as MyJointPain and painTRAINER.
If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.
Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Gut Feelings – by Dr Will Cole
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More and more, science is uncovering links between our gut health and the rest of our health—including our mental health! We all know “get some fiber and consider probiotics”, but what else is there that we can do?
Quite a lot, actually. And part of it, which Dr. Cole also explores, is the fact that the gut-brain highway is a two-way street!
The book looks a lot especially at the particular relationship between shame and eating. The shame need not initially be about eating, though it can certainly end up that way too. But any kind of shame—be it relating to one’s body, work, relationship, or anything else, can not only have a direct effect on the gut, but indirect too:
Once our “eating our feelings” instinct kicks in, things can spiral from there, after all.
So, Dr. Cole walks us through tackling this from both sides—nutrition and psychology. With chapters full of tips and tricks, plus a 21-day plan (not a diet plan, a habit integration plan), this book hits shame (and inflammation, incidentally) hard and leads us into much healthier habits and cycles.
In short: if you’d like to have a better relationship with your food, improve your gut health, and/or reduce inflammation, this is definitely a book for you!
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Brain Wash – by Dr. David Perlmutter, Dr. Austin Perlmutter, and Kristen Loberg
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You may be familiar with the lead author of this book, Dr. David Perlmutter, as a big name in the world of preventative healthcare. A lot of his work has focused specifically on carbohydrate metabolism, and he is as associated with grains and he is with brains. This book focuses on the latter.
Dr. Perlmutter et al. take a methodical look at all that is ailing our brains in this modern world, and systematically lay out a plan for improving each aspect.
The advice is far from just dietary, though the chapter on diet takes a clear stance:
❝The food you eat and the beverages you drink change your emotions, your thoughts, and the way you perceive the world❞
The style is explanatory, and the book can be read comfortably as a “sit down and read it cover to cover” book; it’s an enjoyable, informative, and useful read.
Bottom line: if you’d like to give your brain a gentle overhaul, this is the one-stop-shop book to give you the tools to do just that.
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ADHD medication – can you take it long term? What are the risks and do benefits continue?
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Attention deficit hyperactivity disorder (ADHD) is a condition that can affect all stages of life. Medication is not the only treatment, but it is often the treatment that can make the most obvious difference to a person who has difficulties focusing attention, sitting still or not acting on impulse.
But what happens once you’ve found the medication that works for you or your child? Do you just keep taking it forever? Here’s what to consider.
What are ADHD medications?
The mainstay of medication for ADHD is stimulants. These include methylphenidate (with brand names Ritalin, Concerta) and dexamfetamine. There is also lisdexamfetamine (branded Vyvanse), a “prodrug” of dexamfetamine (it has a protein molecule attached, which is removed in the body to release dexamfetamine).
There are also non-stimulants, in particular atomoxetine and guanfacine, which are used less often but can also be highly effective. Non-stimulants can be prescribed by GPs but this may not always be covered by the Pharmaceutical Benefits Scheme and could cost more.
How stimulants work
Some stimulants prescribed for ADHD are “short acting”. This means the effect comes on after around 20 minutes and lasts around four hours.
Longer-acting stimulants give a longer-lasting effect, usually by releasing medication more slowly. The choice between the two will be guided by whether the person wants to take medication once a day or prefers to target the medication effect to specific times or tasks.
For the stimulants (with the possible exception of lisdexamfetamine) there is very little carry-over effect to the next day. This means the symptoms of ADHD may be very obvious until the first dose of the morning takes effect.
One of the main aims of treatment is the person with ADHD should live their best life and achieve their goals. In young children it is the parents who have to consider the risks and benefits on behalf of the child. As children mature, their role in decision making increases.
What about side effects?
The most consistent side effects of the stimulants are they suppress appetite, resulting in weight loss. In children this is associated with temporary slowing of the growth rate and perhaps a slight delay in pubertal development. They can also increase the heart rate and may cause a rise in blood pressure. Stimulants often cause insomnia.
These changes are largely reversible on stopping medication. However, there is concern the small rises in blood pressure could accelerate the rate of heart disease, so people who take medication over a number of years might have heart attacks or strokes slightly sooner than would have happened otherwise.
This does not mean older adults should not have their ADHD treated. Rather, they should be aware of the potential risks so they can make an informed decision. They should also make sure high blood pressure and attacks of chest pain are taken seriously.
Stimulants can be associated with stomach ache or headache. These effects may lessen over time or with a reduction in dose. While there have been reports about stimulants being misused by students, research on the risks of long-term prescription stimulant dependence is lacking.
Will medication be needed long term?
Although ADHD can affect a person’s functioning at all stages of their life, most people stop medication within the first two years.
People may stop taking it because they don’t like the way it makes them feel, or don’t like taking medication at all. Their short period on medication may have helped them develop a better understanding of themselves and how best to manage their ADHD.
In teenagers the medication may lose its effectiveness as they outgrow their dose and so they stop taking it. But this should be differentiated from tolerance, when the dose becomes less effective and there are only temporary improvements with dose increases.
Tolerance may be managed by taking short breaks from medication, switching from one stimulant to another or using a non-stimulant.
Medication is usually prescribed by a specialist but rules differ around Australia.
Ground Picture/ShutterstockToo many prescriptions?
ADHD is becoming increasingly recognised, with more people – 2–5% of adults and 5–10% of children – being diagnosed. In Australia stimulants are highly regulated and mainly prescribed by specialists (paediatricians or psychiatrists), though this differs from state to state. As case loads grow for this lifelong diagnosis, there just aren’t enough specialists to fit everyone in.
In November, a Senate inquiry report into ADHD assessment and support services highlighted the desperation experienced by people seeking treatment.
There have already been changes to the legislation in New South Wales that may lead to more GPs being able to treat ADHD. Further training could help GPs feel more confident to manage ADHD. This could be in a shared-care arrangement or independent management of ADHD by GPs like a model being piloted at Nepean Blue Mountains Local Health District, with GPs training within an ADHD clinic (where I am a specialist clinician).
Not every person with ADHD will need or want to take medication. However, it should be more easily available for those who could find it helpful.
Alison Poulton, Senior Lecturer, Brain Mind Centre Nepean, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Fascinating Truth About Aspartame, Cancer, & Neurotoxicity
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Is Aspartame’s Reputation Well-Deserved?
In Tuesday’s newsletter, we asked you for your health-related opinions on aspartame, and got the above-depicted, below-described, set of responses:
- About 47% said “It is an evil carcinogenic neurotoxin”
- 20% said “It is safe-ish, but has health risks that are worse than sugar”
- About 19% said “It is not healthy, but better than sugar”
- About 15% said “It’s a perfectly healthy replacement for sugar”
But what does the science say?
Aspartame is carcinogenic: True or False?
False, assuming consuming it in moderation. In excess, almost anything can cause cancer (oxygen is a fine example). But for all meaningful purposes, aspartame does not appear to be carcinogenic. For example,
❝The results of these studies showed no evidence that these sweeteners cause cancer or other harms in people.❞
~ NIH | National Cancer Institute
Source: Artificial Sweeteners and Cancer
Plenty of studies and reviews have also confirmed this; here are some examples:
- Evaluation of aspartame cancer epidemiology studies based on quality appraisal criteria
- Aspartame, low-calorie sweeteners and disease: Regulatory safety and epidemiological issues
- Aspartame: A review of genotoxicity data
Why then do so many people believe it causes cancer, despite all the evidence against it?
Well, there was a small study involving giving megadoses to rats, which did increase their cancer risk. So of course, the popular press took that and ran with it.
But those results have not been achieved outside of rats, and human studies great and small have all been overwhelmingly conclusive that moderate consumption of aspartame has no effect on cancer risk.
Aspartame is a neurotoxin: True or False?
False, again assuming moderate consumption. If you’re a rat being injected with a megadose, your experience may vary. But a human enjoying a diet soda, the aspartame isn’t the part that’s doing you harm, so far as we know.
For example, the European Food Safety Agency’s scientific review panel concluded:
❝there is still no substantive evidence that aspartame can induce such effects❞
~ Dr. Atkin et al (it was a pan-European team of 21 experts in the field)
Source: Report on the Meeting on Aspartame with National Experts
See also,
❝The data from the extensive investigations into the possibility of neurotoxic effects of aspartame, in general, do not support the hypothesis that aspartame in the human diet will affect nervous system function, learning or behavior.
The weight of existing evidence is that aspartame is safe at current levels of consumption as a nonnutritive sweetener.❞
and
❝The safety testing of aspartame has gone well beyond that required to evaluate the safety of a food additive.
When all the research on aspartame, including evaluations in both the premarketing and postmarketing periods, is examined as a whole, it is clear that aspartame is safe, and there are no unresolved questions regarding its safety under conditions of intended use.❞
Source: Regulatory Toxicology & Pharmacology | Aspartame: Review of Safety
Why then do many people believe it is a neurotoxin? This one can be traced back to a chain letter hoax from about 26 years ago; you can read it here, but please be aware it is an entirely debunked hoax:
Urban Legends | Aspartame Hoax
Take care!
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