Cupping: How It Works (And How It Doesn’t)

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Good Health By The Cup?

In Tuesday’s newsletter, we asked you for your opinion of cupping (the medical practice), and got the above-depicted, below-described, set of responses:

  • About 40% said “It may help by improving circulation and stimulating the immune system”
  • About 26% said “I have never heard of the medical practice of cupping before this”
  • About 19% said “It is pseudoscience and/or placebo at best, but probably not harmful
  • About 9% said “It is a good, evidence-based practice that removes toxins and stimulates health”
  • About 6% said “It is a dangerous practice that often causes harm to people who need medical help”

So what does the science say?

First, a quick note for those unfamiliar with cupping: it is the practice of placing a warmed cup on the skin (open side of the cup against the skin). As the warm air inside cools, it reduces the interior air pressure, which means the cup is now (quite literally) a suction cup. This pulls the skin up into the cup a little. The end result is visually, and physiologically, the same process as what happens if someone places the nozzle of a vacuum cleaner against their skin. For that matter, there are alternative versions that simply use a pump-based suction system, instead of heated cups—but the heated cups are most traditional and seem to be most popular. See also:

National Center for Complementary and Integrative Health | Cupping

It is a dangerous practice that often causes harm to people who need medical help: True or False?

False, for any practical purposes.

  • Directly, it can (and usually does) cause minor superficial harm, much like many medical treatments, wherein the benefits are considered to outweigh the harm, justifying the treatment. In the case of cupping, the minor harm is usually a little bruising, but there are other risks; see the link we gave just above.
  • Indirectly, it could cause harm by emboldening a person to neglect a more impactful treatment for their ailment.

But, there’s nothing for cupping akin to the “the most common cause of death is when someone gets a vertebral artery fatally severed” of chiropractic, for example.

It is a good, evidence-based practice that removes toxins and stimulates health: True or False?

True and False in different parts. This one’s on us; we included four claims in one short line. But let’s look at them individually:

  • Is it good? Well, those who like it, like it. It legitimately has some mild health benefits, and its potential for harm is quite small. We’d call this a modest good, but good nonetheless.
  • Is it evidence-based? Somewhat, albeit weakly; there are some papers supporting its modest health claims, although the research is mostly only published in journals of alternative medicine, and any we found were in journals that have been described by scientists as pseudoscientific.
  • Does it remove toxins? Not directly, at least. There is also a version that involves making a small hole in the skin before applying the cup, the better to draw out the toxins (called “wet cupping”). This might seem a little medieval, but this is because it is from early medieval times (wet cupping’s first recorded use being in the early 7th century). However, the body’s response to being poked, pierced, sucked, etc is to produce antibodies, and they will do their best to remove toxins. So, indirectly, there’s an argument.
  • Does it stimulate health? Yes! We’ll come to that shortly. But first…

It is pseudoscience and/or placebo at best, but probably not harmful: True or False?

True in that its traditionally-proposed mechanism of action is a pseudoscience and placebo almost certainly plays a strong part, and also in that it’s generally not harmful.

On it being a pseudoscience: we’ve talked about this before, but it bears repeating; just because something’s proposed mechanism of action is pseudoscience, doesn’t necessarily mean it doesn’t work by some other mechanism of action. If you tell a small child that “eating the rainbow” will improve their health, and they believe this is some sort of magical rainbow power imbuing them with health, then the mechanism of action that they believe in is a pseudoscience, but eating a variety of colorful fruit and vegetables will still be healthy.

In the case of cupping, its proposed mechanism of action has to do withbalancing qi, yin and yang, etc (for which scientific evidence does not exist), in combination with acupuncture lore (for which some limited weak scientific evidence exists). On balancing qi, yin and yang etc, this is a lot like Europe’s historically popular humorism, which was based on the idea of balancing the four humors (blood, yellow bile, black bile, phlegm). Needless to say, humorism was not only a pseudoscience, but also eventually actively disproved with the advent of germ theory and modern medicine. Cupping therapy is not more scientifically based than humorism.

On the placebo side of things, there probably is a little more to it than that; much like with acupuncture, a lot of it may be a combination of placebo and using counter-irritation, a nerve-tricking method to use pain to reduce pain (much like pressing with one’s nail next to an insect bite).

Here’s one of the few studies we found that’s in what looks, at a glance, to be a reputable journal:

Cupping therapy and chronic back pain: systematic review and meta-analysis

It may help by improving circulation and stimulating the immune system: True or False?

True! It will improve local circulation by forcing blood into the area, and stimulate the immune system by giving it a perceived threat to fight.

Again, this can be achieved by many other means; acupuncture (or just “dry needling”, which is similar but without the traditional lore), a cold shower, and/or exercise (and for that matter, sex—which combines exercise, physiological arousal, and usually also foreign bodies to respond to) are all options that can improve circulation and stimulate the immune system.

You can read more about using some of these sorts of tricks for improving health in very well-evidenced, robustly scientific ways here:

The Stress Prescription (Against Aging!)

Take care!

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  • Hearing loss is twice as common in Australia’s lowest income groups, our research shows

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Around one in six Australians has some form of hearing loss, ranging from mild to complete hearing loss. That figure is expected to grow to one in four by 2050, due in a large part to the country’s ageing population.

    Hearing loss affects communication and social engagement and limits educational and employment opportunities. Effective treatment for hearing loss is available in the form of communication training (for example, lipreading and auditory training), hearing aids and other devices.

    But the uptake of treatment is low. In Australia, publicly subsidised hearing care is available predominantly only to children, young people and retirement-age people on a pension. Adults of working age are mostly not eligible for hearing health care under the government’s Hearing Services Program.

    Our recent study published in the journal Ear and Hearing showed, for the first time, that working-age Australians from lower socioeconomic backgrounds are at much greater risk of hearing loss than those from higher socioeconomic backgrounds.

    We believe the lack of socially subsidised hearing care for adults of working age results in poor detection and care for hearing loss among people from disadvantaged backgrounds. This in turn exacerbates social inequalities.

    Population data shows hearing inequality

    We analysed a large data set called the Household, Income and Labour Dynamics in Australia (HILDA) survey that collects information on various aspects of people’s lives, including health and hearing loss.

    Using a HILDA sub-sample of 10,719 working-age Australians, we evaluated whether self-reported hearing loss was more common among people from lower socioeconomic backgrounds than for those from higher socioeconomic backgrounds between 2008 and 2018.

    Relying on self-reported hearing data instead of information from hearing tests is one limitation of our paper. However, self-reported hearing tends to underestimate actual rates of hearing impairment, so the hearing loss rates we reported are likely an underestimate.

    We also wanted to find out whether people from lower socioeconomic backgrounds were more likely to develop hearing loss in the long run.

    A boy wearing a hearing aid is playing.
    Hearing care is publicly subsidised for children.
    mady70/Shutterstock

    We found people in the lowest income groups were more than twice as likely to have hearing loss than those in the highest income groups. Further, hearing loss was 1.5 times as common among people living in the most deprived neighbourhoods than in the most affluent areas.

    For people reporting no hearing loss at the beginning of the study, after 11 years of follow up, those from a more deprived socioeconomic background were much more likely to develop hearing loss. For example, a lack of post secondary education was associated with a more than 1.5 times increased risk of developing hearing loss compared to those who achieved a bachelor’s degree or above.

    Overall, men were more likely to have hearing loss than women. As seen in the figure below, this gap is largest for people of low socioeconomic status.

    Why are disadvantaged groups more likely to experience hearing loss?

    There are several possible reasons hearing loss is more common among people from low socioeconomic backgrounds. Noise exposure is one of the biggest risks for hearing loss and people from low socioeconomic backgrounds may be more likely to be exposed to damaging levels of noise in jobs in mining, construction, manufacturing, and agriculture.

    Lifestyle factors which may be more prevalent in lower socioeconomic communities such as smoking, unhealthy diet, and a lack of regular exercise are also related to the risk of hearing loss.

    Finally, people with lower incomes may face challenges in accessing timely hearing care, alongside competing health needs, which could lead to missed identification of treatable ear disease.

    Why does this disparity in hearing loss matter?

    We like to think of Australia as an egalitarian society – the land of the fair go. But nearly half of people in Australia with hearing loss are of working age and mostly ineligible for publicly funded hearing services.

    Hearing aids with a private hearing care provider cost from around A$1,000 up to more than $4,000 for higher-end devices. Most people need two hearing aids.

    A builder using a grinder machine at a construction site.
    Hearing loss might be more common in low income groups because they’re exposed to more noise at work.
    Dmitry Kalinovsky/Shutterstock

    Lack of access to affordable hearing care for working-age adults on low incomes comes with an economic as well as a social cost.

    Previous economic analysis estimated hearing loss was responsible for financial costs of around $20 billion in 2019–20 in Australia. The largest component of these costs was productivity losses (unemployment, under-employment and Jobseeker social security payment costs) among working-age adults.

    Providing affordable hearing care for all Australians

    Lack of affordable hearing care for working-age adults from lower socioeconomic backgrounds may significantly exacerbate the impact of hearing loss among deprived communities and worsen social inequalities.

    Recently, the federal government has been considering extending publicly subsidised hearing services to lower income working age Australians. We believe reforming the current government Hearing Services Program and expanding eligibility to this group could not only promote a more inclusive, fairer and healthier society but may also yield overall cost savings by reducing lost productivity.

    All Australians should have access to affordable hearing care to have sufficient functional hearing to achieve their potential in life. That’s the land of the fair go.The Conversation

    Mohammad Nure Alam, PhD Candidate in Economics, Macquarie University; Kompal Sinha, Associate Professor, Department of Economics, Macquarie University, and Piers Dawes, Professor, School of Health and Rehabilitation Sciences, The University of Queensland

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

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  • The DASH Diet Mediterranean Solution – by Dr. Marla Heller

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    Sometimes, an author releases a series of books that could have just been one book, with various padding and rehashes. In some cases, naming no names Dr. Mark Hyman, it means we have to carefully pick out the honestly very good and highly recommendable ones from the “you just republished for the extra income, didn’t you?” ones.

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  • Chia Seeds vs Pumpkin Seeds – Which is Healthier?

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    Our Verdict

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    Why?

    Both are great! But chia is best.

    Note: we’re going to abbreviate them both to “chia” and “pumpkin”, respectively, but we’ll still be referring to the seeds throughout.

    In terms of macros, pumpkin has a little more protein and notably higher carbs, whereas chia has nearly 2x the fiber, as well as more fat, and/but they are famously healthy fats. We’ll call this category a subjective win for chia, though you might disagree if you want to prioritize an extra 2g of protein per 100g (for pumpkin) over an extra 16g of fiber per 100g (for chia). Chia is also vastly preferable for omega-3.

    When it comes to vitamins, pumpkin is marginally higher in vitamin A, while chia is a lot higher in vitamins B1, B2, B3, B9, C, and E. An easy win for chia.

    In the category of minerals, for which pumpkin seeds are so famously a good source, chia has a lot more calcium, copper, iron, magnesium, manganese, phosphorus, and selenium. On the other hand, pumpkin has more potassium and zinc. Still, that’s a 7:2 win for chia.

    Adding up the categories makes for a very compelling win for the humble chia seed.

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    If You’re Not Taking Chia, You’re Missing Out: The Tiniest Seeds With The Most Value

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