Attention-deficit hyperactivity disorder (ADHD) can have a considerable impact on the day-to-day functioning and overall wellbeing of people affected. It causes a variety of symptoms including difficulty focusing, impulsivity and hyperactivity.

For many, a diagnosis of ADHD, whether in childhood or adulthood, is life changing. It means finally having an explanation for these challenges, and opens up the opportunity for treatment, including medication.

Although ADHD medications can cause side effects, they generally improve symptoms for people with the disorder, and thereby can significantly boost quality of life.

Now a new study has found being treated for ADHD with medication reduces the risk of early death for people with the disorder. But what can we make of these findings?

A large study from Sweden

The study, published this week in JAMA (the prestigious journal of the American Medical Association), was a large cohort study of 148,578 people diagnosed with ADHD in Sweden. It included both adults and children.

In a cohort study, a group of people who share a common characteristic (in this case a diagnosis of ADHD) are followed over time to see how many develop a particular health outcome of interest (in this case the outcome was death).

For this study the researchers calculated the mortality rate over a two-year follow up period for those whose ADHD was treated with medication (a group of around 84,000 people) alongside those whose ADHD was not treated with medication (around 64,000 people). The team then determined if there were any differences between the two groups.

What did the results show?

The study found people who were diagnosed and treated for ADHD had a 19% reduced risk of death from any cause over the two years they were tracked, compared with those who were diagnosed but not treated.

In understanding this result, it’s important – and interesting – to look at the causes of death. The authors separately analysed deaths due to natural causes (physical medical conditions) and deaths due to unnatural causes (for example, unintentional injuries, suicide, or accidental poisonings).

The key result is that while no significant difference was seen between the two groups when examining natural causes of death, the authors found a significant difference for deaths due to unnatural causes.

So what’s going on?

Previous studies have suggested ADHD is associated with an increased risk of premature death from unnatural causes, such as injury and poisoning.

On a related note, earlier studies have also suggested taking ADHD medicines may reduce premature deaths. So while this is not the first study to suggest this association, the authors note previous studies addressing this link have generated mixed results and have had significant limitations.

In this new study, the authors suggest the reduction in deaths from unnatural causes could be because taking medication alleviates some of the ADHD symptoms responsible for poor outcomes – for example, improving impulse control and decision-making. They note this could reduce fatal accidents.

The authors cite a number of studies that support this hypothesis, including research showing ADHD medications may prevent the onset of mood, anxiety and substance use disorders, and lower the risk of accidents and criminality. All this could reasonably be expected to lower the rate of unnatural deaths.

Strengths and limitations

Scandinavian countries have well-maintained national registries that collect information on various aspects of citizens’ lives, including their health. This allows researchers to conduct excellent population-based studies.

Along with its robust study design and high-quality data, another strength of this study is its size. The large number of participants – almost 150,000 – gives us confidence the findings were not due to chance.

The fact this study examined both children and adults is another strength. Previous research relating to ADHD has often focused primarily on children.

One of the important limitations of this study acknowledged by the authors is that it was observational. Observational studies are where the researchers observe and analyse naturally occurring phenomena without intervening in the lives of the study participants (unlike randomised controlled trials).

The limitation in all observational research is the issue of confounding. This means we cannot be completely sure the differences between the two groups observed were not either partially or entirely due to some other factor apart from taking medication.

Specifically, it’s possible lifestyle factors or other ADHD treatments such as psychological counselling or social support may have influenced the mortality rates in the groups studied.

Another possible limitation is the relatively short follow-up period. What the results would show if participants were followed up for longer is an interesting question, and could be addressed in future research.

What are the implications?

Despite some limitations, this study adds to the evidence that diagnosis and treatment for ADHD can make a profound difference to people’s lives. As well as alleviating symptoms of the disorder, this study supports the idea ADHD medication reduces the risk of premature death.

Ultimately, this highlights the importance of diagnosing ADHD early so the appropriate treatment can be given. It also contributes to the body of evidence indicating the need to improve access to mental health care and support more broadly.

Hassan Vally, Associate Professor, Epidemiology, Deakin University

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

You might remember cottage cheese from your childhood. Back then, it was considered “diet food”. You ate it out of the tub, with celery or spread it on crackers for a low-calorie snack. Then cottage cheese went out of fashion.

But cottage cheese is having a resurgence. In recent months, Google searches for “cottage cheese” have risen to the highest levels since 2004.

Social media influencers have been promoting its benefits on TikTok and Instagram with hashtags such as #cottagecheese, #cottagecheeseforlife, and #cottagecheeserecipe. Sales of cottage cheese around the world have skyrocketed.

Let’s see why cottage cheese is having such a moment.

What is cottage cheese?

Cottage cheese is a fresh dairy cheese product with a mild flavour and a slightly tangy taste. It is made by curdling cow’s milk, then draining the whey, leaving behind the curds. These curds are usually small and lumpy, and the texture can vary from creamy to dry, depending on the amount of whey left in the cheese.

The term “cottage cheese” is said to have originated because the cheese was generally made in cottage-type houses from leftover milk, after making butter.

Cottage cheese is cheap, costing about A$12 per kilogram in the supermarket, similar to ricotta cheese.

It’s also surprisingly simple to make at home using freely available recipes. All you need is milk, salt and a splash of vinegar.

We’re using cottage cheese in new ways

It’s difficult to know what started the latest cottage cheese trend. But the creativity of social media means people are sharing alternative ways to use cottage cheese, changing people’s views from it being boring and lacking flavour to it being versatile and healthy.

People are spreading cottage cheese on toast and using it to make dishes such as porridge, dips, salads, bread and flatbreads. They’re using it in cakes and scones, and in desserts such as mousse and ice cream.

Is cottage cheese healthy?

Compared with other cheeses, cottage cheese is low in fat and therefore energy (kilojoules or kJ). This makes it a smart choice for people looking to cut down on their daily energy intake.

For example, 100 grams of cottage cheese contains about 556kJ. The same amount of cheddar contains 1,254kJ and parmesan 1,565kJ.

Many cheeses are rich in protein but they often contain higher amounts of kilojoules due to their fat content. But cottage cheese has substantial amounts of protein with fewer kilojoules.

This makes cottage cheese an ideal option for people aiming to maximise their protein intake without eating large amounts of kilojoules.

Some 100g of cottage cheese provides 17g protein. This is about the same found in three eggs, 60g chicken breast or 320 millilitres (about 300g) full-fat yoghurt.

Cottage cheese also contains high levels of vitamin B12 (important for healthy brain function), riboflavin (supports healthy skin and eyes), phosphorus (helps build strong bones and teeth) and folate (essential for cell growth).

However, cottage cheese is lower in calcium compared with other cheeses. It contains just 89 milligrams per 100g. This compares with parmesan (948mg), haloumi (620mg) and ricotta (170mg).

You’ve convinced me. How can I use cottage cheese?

Beyond its excellent nutrition profile, the resurgence of cottage cheese is enabling people to experiment in the kitchen. Its neutral flavour and varied textures – ranging from smooth to chunky – makes it suitable for a range of dishes, from sweet to savoury.

TikTok and Instagram have some great recipes. You could start with an old faithful recipe of celery and cottage cheese, and work your way towards new options such as cottage cheese ice cream.

The healthiest recipes will be those that combine cottage cheese with wholefoods such as fruits, vegetables, nuts and seeds, and lean protein sources.

For instance, you can make a cottage cheese wrap then fill it with vegetables and a lean source of protein (such as chicken or fish).

Other combinations include cottage cheese salad dressings, vegetable dips and egg salads.

Cottage cheese’s rise in popularity is well deserved. Including more cottage cheese in your diet is a smart choice for getting a high dose of protein without adding processed ingredients or too much energy. Embrace the trend and get creative in the kitchen.

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

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