You might have heard of something called “cryptosporidiosis” recently, closely followed by warnings to stay away from your local swimming pool if you’ve had diarrhoea.

More than 700 cases of this gastrointestinal disease were reported in Queensland in January, which is 13 times more than in January last year. Just under 500 cases have been recorded in New South Wales this year to-date, while other states have similarly reported an increase in the number of cryptosporidiosis infections in recent months.

Cryptosporidiosis has been listed as a national notifiable disease in Australia since 2001.
But what exactly is it, and should we be worried?

What causes cryptosporidiosis, and who is affected?

Cryptosporidiosis is the disease caused by the parasite Cryptosporidium, of which there are two types that can make us sick. Cryptosporidum hominis only affects humans and is the major cause of recent outbreaks in Australia, while Cryptosporidium parvum can also affect animals.

The infection is spread by spores called oocysts in the stools of humans and animals. When ingested, these oocysts migrate and mature in the small bowel. They damage the small bowel lining and can lead to diarrhoea, nausea, vomiting, fever and abdominal discomfort.

Most people develop symptoms anywhere from one to 12 days after becoming infected. Usually these symptoms resolve within two weeks, but the illness may last longer and can be severe in those with a weakened immune system.

Children and the elderly tend to be the most commonly affected. Cryptosporidiosis is more prevalent in young children, particularly those under five, but the disease can affect people of any age.

So how do we catch it?

Most major outbreaks of cryptosporidiosis have been due to people drinking contaminated water. The largest recorded outbreak occurred in Milwaukee in 1993 where 403,000 people were believed to have been infected.

Cryptosporidium oocysts are very small in size and in Milwaukee they passed through the filtration system of one of the water treatment plants undetected, infecting the city’s water supply. As few as ten oocysts can cause infection, making it possible for contaminated drinking water to affect a very large number of people.

Four days after infection a person with cryptosporidiosis can shed up to ten billion oocysts into their stool a day, with the shedding persisting for about two weeks. This is why one infected person in a swimming pool can infect the entire pool in a single visit.

Cryptosporidium oocysts excreted in the faeces of infected humans and animals can also reach natural bodies of water such as beaches, rivers and lakes directly through sewer pipes or indirectly such as in manure transported with surface runoff after heavy rain.

One study which modelled Cryptosporidium concentrations in rivers around the world estimated there are anywhere from 100 to one million oocysts in a litre of river water.

In Australia, cryptosporidiosis outbreaks tend to occur during the late spring and early summer periods when there’s an increase in recreational water activities such as swimming in natural water holes, water catchments and public pools. We don’t know exactly why cases have seen such a surge this summer compared to other years, but we know Cryptosporidium is very infectious.

Oocysts have been found in foods such as fresh vegetables and seafood but these are not common sources of infection in Australia.

What about chlorine?

Contrary to popular belief, chlorine doesn’t kill off all infectious microbes in a swimming pool. Cryptosporidium oocysts are hardy, thick-walled and resistant to chlorine and acid. They are not destroyed by chlorine at the normal concentrations found in swimming pools.

We also know oocysts can be significantly protected from the effects of chlorine in swimming pools by faecal material, so the presence of even small amounts of faecal matter contaminated with Cryptosporidium in a swimming pool would necessitate closure and a thorough decontamination.

Young children and in particular children in nappies are known to increase the potential for disease transmission in recreational water. Proper nappy changing, frequent bathroom breaks and showering before swimming to remove faecal residue are helpful ways to reduce the risk.

Some sensible precautions

Other measures you can take to reduce yours and others’ risk of cryptosporidiosis include:

• avoid swimming in natural waters such as rivers and creeks during and for at least three days after heavy rain
• avoid swimming in beaches for at least one day after heavy rain
• avoid drinking untreated water such as water from rivers or springs. If you need to drink untreated water, boiling it first will kill the Cryptosporidium
• avoid swallowing water when swimming if you can
• if you’ve had diarrhoea, avoid swimming for at least two weeks after it has resolved
• avoid sharing towels or linen for at least two weeks after diarrhoea has resolved
• avoid sharing, touching or preparing food that other people may eat for at least 48 hours after diarrhoea has resolved
• wash your hands with soap and water after going to the bathroom or before preparing food (Cryptosporidium is not killed by alcohol gels and sanitisers).

Not all cases of diarrhoea are due to cryptosporidiosis. There are many other causes of infectious gastroenteritis and because the vast majority of the time recovery is uneventful you don’t need to see a doctor unless very unwell. If you do suspect you may have cryptosporidiosis you can ask your doctor to refer you for a stool test.

Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

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

If you spend any time looking at diet and lifestyle content on social media, you may well have encountered a variety of weight loss “hacks”.

One of the more recent trends is a home-made drink called ricezempic, made by soaking uncooked rice and then straining it to drink the leftover starchy water. Sounds delicious, right?

Its proponents claim it leads to weight loss by making you feel fuller for longer and suppressing your appetite, working in a similar way to the sought-after drug Ozempic – hence the name.

So does this drink actually mimic the weight loss effects of Ozempic? Spoiler alert – probably not. But let’s look at what the evidence tells us.

How do you make ricezempic?

While the recipe can vary slightly depending on who you ask, the most common steps to make ricezempic are:

1. soak half a cup of white rice (unrinsed) in one cup of warm or hot water up to overnight
2. drain the rice mixture into a fresh glass using a strainer
3. discard the rice (but keep the starchy water)
4. add the juice of half a lime or lemon to the starchy water and drink.

TikTokers advise that best results will happen if you drink this concoction once a day, first thing in the morning, before eating.

The idea is that the longer you consume ricezempic for, the more weight you’ll lose. Some claim introducing the drink into your diet can lead to a weight loss of up to 27 kilograms in two months.

Resistant starch

Those touting ricezempic argue it leads to weight loss because of the resistant starch rice contains. Resistant starch is a type of dietary fibre (also classified as a prebiotic). There’s no strong evidence it makes you feel fuller for longer, but it does have proven health benefits.

Studies have shown consuming resistant starch may help regulate blood sugar, aid weight loss and improve gut health.

Research has also shown eating resistant starch reduces the risk of obesity, diabetes, heart disease and other chronic diseases.

Resistant starch is found in many foods. These include beans, lentils, wholegrains (oats, barley, and rice – particularly brown rice), bananas (especially when they’re under-ripe or green), potatoes, and nuts and seeds (particularly chia seeds, flaxseeds and almonds).

Half a cup of uncooked white rice (as per the ricezempic recipe) contains around 0.6 grams of resistant starch. For optimal health benefits, a daily intake of 15–20 grams of resistant starch is recommended. Although there is no concrete evidence on the amount of resistant starch that leaches from rice into water, it’s likely to be significantly less than 0.6 grams as the whole rice grain is not being consumed.

Ricezempic vs Ozempic

Ozempic was originally developed to help people with diabetes manage their blood sugar levels but is now commonly used for weight loss.

Ozempic, along with similar medications such as Wegovy and Trulicity, is a glucagon-like peptide-1 (GLP-1) receptor agonist. These drugs mimic the GLP-1 hormone the body naturally produces. By doing so, they slow down the digestive process, which helps people feel fuller for longer, and curbs their appetite.

While the resistant starch in rice could induce some similar benefits to Ozempic (such as feeling full and therefore reducing energy intake), no scientific studies have trialled ricezempic using the recipes promoted on social media.

Ozempic has a long half-life, remaining active in the body for about seven days. In contrast, consuming one cup of rice provides a feeling of fullness for only a few hours. And simply soaking rice in water and drinking the starchy water will not provide the same level of satiety as eating the rice itself.

Other ways to get resistant starch in your diet

There are several ways to consume more resistant starch while also gaining additional nutrients and vitamins compared to what you get from ricezempic.

1. Cooked and cooled rice

Letting cooked rice cool over time increases its resistant starch content. Reheating the rice does not significantly reduce the amount of resistant starch that forms during cooling. Brown rice is preferable to white rice due to its higher fibre content and additional micronutrients such as phosphorus and magnesium.

2. More legumes

These are high in resistant starch and have been shown to promote weight management when eaten regularly. Why not try a recipe that has pinto beans, chickpeas, black beans or peas for dinner tonight?

3. Cooked and cooled potatoes

Cooking potatoes and allowing them to cool for at least a few hours increases their resistant starch content. Fully cooled potatoes are a rich source of resistant starch and also provide essential nutrients like potassium and vitamin C. Making a potato salad as a side dish is a great way to get these benefits.

In a nutshell

Although many people on social media have reported benefits, there’s no scientific evidence drinking rice water or “ricezempic” is effective for weight loss. You probably won’t see any significant changes in your weight by drinking ricezempic and making no other adjustments to your diet or lifestyle.

While the drink may provide a small amount of resistant starch residue from the rice, and some hydration from the water, consuming foods that contain resistant starch in their full form would offer significantly more nutritional benefits.

More broadly, be wary of the weight loss hacks you see on social media. Achieving lasting weight loss boils down to gradually adopting healthy eating habits and regular exercise, ensuring these changes become lifelong habits.

Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland

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