How To Prevent And Reverse Type 2 Diabetes

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Turn back the clock on insulin resistance

This is Dr. Jason Fung. He’s a world-leading expert on intermittent fasting and low carbohydrate approaches to diet. He also co-founded the Intensive Dietary Management Program, later rebranded to the snappier title: The Fasting Method, a program to help people lose weight and reverse type 2 diabetes. Dr. Fung is certified with the Institute for Functional Medicine, for providing functional medicine certification along with educational programs directly accredited by the Accreditation Council for Continuing Medical Education (ACCME).

Why Intermittent Fasting?

Intermittent fasting is a well-established, well-evidenced, healthful practice for most people. In the case of diabetes, it becomes complicated, because if one’s blood sugars are too low during a fasting period, it will need correcting, thus breaking the fast.

Note: this is about preventing and reversing type 2 diabetes. Type 1 is very different, and sadly cannot be prevented or reversed in this fashion.

However, these ideas may still be useful if you have T1D, as you have an even greater need to avoid developing insulin resistance; you obviously don’t want your exogenous insulin to stop working.

Nevertheless, please do confer with your endocrinologist before changing your dietary habits, as they will know your personal physiology and circumstances in ways that we (and Dr. Fung) don’t.

In the case of having type 2 diabetes, again, please still check with your doctor, but the stakes are a lot lower for you, and you will probably be able to fast without incident, depending on your diet itself (more on this later).

Intermittent Fasting can be extra helpful for the body in the case of type 2 diabetes, as it helps give the body a rest from high insulin levels, thus allowing the body to become gradually re-sensitised to insulin.

Why low carbohydrate?

Carbohydrates, especially sugars, especially fructose*, cause excess sugar to be quickly processed by the liver and stored there. When the body’s ability to store glycogen is exceeded, the liver stores energy as fat instead. The resultant fatty liver is a major contributor to insulin resistance, when the liver can’t keep up with the demand; the blood becomes spiked full of unprocessed sugars, and the pancreas must work overtime to produce more and more insulin to deal with that—until the body starts becoming desensitized to insulin. In other words, type 2 diabetes.

There are other factors that affect whether we get type 2 diabetes, for example a genetic predisposition. But, our carb intake is something we can control, so it’s something that Dr. Fung focuses on.

*A word on fructose: actual fruits are usually diabetes-neutral or a net positive due to their fiber and polyphenols.

Fructose as an added ingredient, however, not so much. That stuff zips straight into your veins with nothing to slow it down and nothing to mitigate it.

The advice from Dr. Fung is simple here: cut the carbs. If you are already diabetic and do this with no preparation, you will probably simply suffer hypoglycemia, so instead:

  1. Enjoy a fibrous starter (a salad, some fruit, or perhaps some nuts)
  2. Load up with protein first, during your main meal—this will start to trigger your feelings of satedness
  3. Eat carbs last (preferably whole, unprocessed carbohydrates), and stop eating when 80% full.

Adapting Intermittent Fasting to diabetes

Dr. Fung advocates for starting small, and gradually increasing your fasting period, until, ideally, fasting 16 hours per day. You probably won’t be able to do this immediately, and that’s fine.

You also probably won’t be able to do this, if you don’t also make the dietary adjustments that help to give your liver a break, and thus by knock-on-effect, give your pancreas a break too.

With the dietary adjustments too, however, your insulin production-and-response will start to return to its pre-diabetic state, and finally its healthy state, after which, it’s just a matter of maintenance.

Want to hear more from Dr. Fung?

You may enjoy his blog, and for those who like videos, here is his YouTube channel:

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  • Alzheimer’s Causative Factors To Avoid

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    The Best Brains Bar Nun?

    This is Dr. David Snowdon. He’s an epidemiologist, and one of the world’s foremost experts on Alzheimer’s disease. He was also, most famously, the lead researcher of what has become known as “The Nun Study”.

    We recently reviewed his book about this study:

    Aging with Grace: What the Nun Study Teaches Us About Leading Longer, Healthier, and More Meaningful Lives – by Dr. David Snowdon

    …which we definitely encourage you to check out, but we’ll do our best to summarize its key points today!

    Reassurance up-front: no, you don’t have to become a nun

    The Nun Study

    In 1991, a large number (678) of nuns were recruited for what was to be (and until now, remains) the largest study of its kind into the impact of a wide variety of factors on aging, and in particular, Alzheimer’s disease.

    Why it was so important: because the nuns were all from the same Order, had the same occupation (it’s a teaching Order), with very similar lifestyles, schedules, socioeconomic status, general background, access to healthcare, similar diets, same relationship status (celibate), same sex (female), and many other factors also similar, this meant that most of the confounding variables that confound other studies were already controlled-for here.

    Enrollment in the study also required consenting to donating one’s brain for study post-mortem—and of those who have since died, indeed 98% of them have been donated (the other 2%, we presume, may have run into technical administrative issues with the donation process, due to the circumstances of death and/or delays in processing the donation).

    How the study was undertaken

    We don’t have enough space to describe the entire methodology here, but the gist of it is:

    • Genetic testing for relevant genetic factors
    • Data gathered about lives so far, including not just medical records but also autobiographies that the nuns wrote when they took their vows (at ages 19–21)
    • Extensive ongoing personal interviews about habits, life choices, and attitudes
    • Yearly evaluations including memory tests and physical function tests
    • Brain donation upon death

    What they found

    Technically, The Nun Study is still ongoing. Of the original 678 nuns (aged 75–106), three are still alive (based on the latest report, at least).

    However, lots of results have already been gained, including…

    Genes

    A year into the study, in 1992, the “apolipoprotein E” (APOE) gene was established as a likely causative factor in Alzheimer’s disease. This is probably not new to our readers in 2024, but there are interesting things being learned even now, for example:

    The Alzheimer’s Gene That Varies By Race & Sex

    …but watch out! Because also:

    Alzheimer’s Sex Differences May Not Be What They Appear

    Words

    Based on the autobiographies written by the nuns in their youth upon taking their vows, there were two factors that were later correlated with not getting dementia:

    • Longer sentences
    • Positive outlook
    • “Idea density”

    That latter item means the relative linguistic density of ideas and complexity thereof, and the fluency and vivacity with which they were expressed (this was not a wishy-washy assessment; there was a hard-science analysis to determine numbers).

    Want to spruce up yours? You might like to check out:

    Reading, Better: Reading As A Cognitive Exercise

    …for specific, evidence-based ways to tweak your reading to fight cognitive decline.

    Food

    While the dietary habits of the nuns were fairly homogenous, those who favored eating more and cooked greens, beans, and tomatoes, lived longer and with healthier brains.

    See also: Brain Food? The Eyes Have It!

    Other aspects of brain health & mental health

    The study also found that nuns who avoided stroke and depression, were also less likely to get dementia.

    For tending to these, check out:

    Community & Faith

    Obviously, in this matter the nuns were quite a homogenous group, scoring heavily in community and faith. What’s relevant here is the difference between the nuns, and other epidemiological studies in other groups (invariably not scoring so highly).

    Community & faith are considered, separately and together, to be protective factors against dementia.

    Faith may be something that “you have it or you don’t” (we’re a health science newsletter, not a theological publication, but for the interested, philosopher John Stuart Mill’s 1859 essay “On Liberty“ makes a good argument for it not being something one can choose, prompting him to argue for religious tolerance, on the grounds that religious coercion is a futile effort precisely because a person cannot choose to dis/believe something)

    …but community can definitely be chosen, nurtured, and grown. We’ve written about this a bit before:

    You might also like to check out this great book on the topic:

    Purpose: Design A Community And Change Your Life – by Gina Bianchini

    Want more?

    We gave a ground-up primer on avoiding Alzheimer’s and other dementias; check it out:

    How To Reduce Your Alzheimer’s Risk

    Take care!

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  • Can kimchi really help you lose weight? Hold your pickle. The evidence isn’t looking great

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    Fermented foods have become popular in recent years, partly due to their perceived health benefits.

    For instance, there is some evidence eating or drinking fermented foods can improve blood glucose control in people with diabetes. They can lower blood lipid (fats) levels and blood pressure in people with diabetes or obesity. Fermented foods can also improve diarrhoea symptoms.

    But can they help you lose weight, as a recent study suggests? Let’s look at the evidence.

    Remind me, what are fermented foods?

    Fermented foods are ones prepared when microbes (bacteria and/or yeast) ferment (or digest) food components to form new foods. Examples include yoghurt, cheese, kefir, kombucha, wine, beer, sauerkraut and kimchi.

    As a result of fermentation, the food becomes acidic, extending its shelf life (food-spoilage microbes are less likely to grow under these conditions). This makes fermentation one of the earliest forms of food processing.

    Fermentation also leads to new nutrients being made. Beneficial microbes (probiotics) digest nutrients and components in the food to produce new bioactive components (postbiotics). These postbiotics are thought to contribute to the health benefits of the fermented foods, alongside the health benefits of the bacteria themselves.

    What does the evidence say?

    A study published last week has provided some preliminary evidence eating kimchi – the popular Korean fermented food – is associated with a lower risk of obesity in some instances. But there were mixed results.

    The South Korean study involved 115,726 men and women aged 40-69 who reported how much kimchi they’d eaten over the previous year. The study was funded by the World Institute of Kimchi, which specialises in researching the country’s national dish.

    Eating one to three servings of any type of kimchi a day was associated with a lower risk of obesity in men.

    Men who ate more than three serves a day of cabbage kimchi (baechu) were less likely to have obesity and abdominal obesity (excess fat deposits around their middle). And women who ate two to three serves a day of baechu were less likely to have obesity and abdominal obesity.

    Eating more radish kimchi (kkakdugi) was associated with less abdominal obesity in both men and women.

    However, people who ate five or more serves of any type of kimchi weighed more, had a larger waist sizes and were more likely to be obese.

    The study had limitations. The authors acknowledged the questionnaire they used may make it difficult to say exactly how much kimchi people actually ate.

    The study also relied on people to report past eating habits. This may make it hard for them to accurately recall what they ate.

    This study design can also only tell us if something is linked (kimchi and obesity), not if one thing causes another (if kimchi causes weight loss). So it is important to look at experimental studies where researchers make changes to people’s diets then look at the results.

    How about evidence from experimental trials?

    There have been several experimental studies looking at how much weight people lose after eating various types of fermented foods. Other studies looked at markers or measures of appetite, but not weight loss.

    One study showed the stomach of men who drank 1.4 litres of fermented milk during a meal took longer to empty (compared to those who drank the same quantity of whole milk). This is related to feeling fuller for longer, potentially having less appetite for more food.

    Another study showed drinking 200 millilitres of kefir (a small glass) reduced participants’ appetite after the meal, but only when the meal contained quickly-digested foods likely to make blood glucose levels rise rapidly. This study did not measure changes in weight.

    Kefir in jar, with kefir grains on wood spoon
    Kefir, a fermented milk drink, reduced people’s appetite.
    Ildi Papp/Shutterstock

    Another study looked at Indonesian young women with obesity. Eating tempeh (a fermented soybean product) led to changes in an appetite hormone. But this did not impact their appetite or whether they felt full. Weight was not measured in this study.

    A study in South Korea asked people to eat about 70g a day of chungkookjang (fermented soybean). There were improvements in some measures of obesity, including percentage body fat, lean body mass, waist-to-hip ratio and waist circumference in women. However there were no changes in weight for men or women.

    A systematic review of all studies that looked at the impact of fermented foods on satiety (feeling full) showed no effect.

    What should I do?

    The evidence so far is very weak to support or recommend fermented foods for weight loss. These experimental studies have been short in length, and many did not report weight changes.

    To date, most of the studies have used different fermented foods, so it is difficult to generalise across them all.

    Nevertheless, fermented foods are still useful as part of a healthy, varied and balanced diet, particularly if you enjoy them. They are rich in healthy bacteria, and nutrients.

    Are there downsides?

    Some fermented foods, such as kimchi and sauerkraut, have added salt. The latest kimchi study said the average amount of kimchi South Koreans eat provides about 490mg of salt a day. For an Australian, this would represent about 50% of the suggested dietary target for optimal health.

    Eating too much salt increases your risk of high blood pressure, heart disease and stroke. The Conversation

    Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

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

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  • Green Coffee Bean Extract: Coffee Benefits Without The Coffee?

    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.

    Coffee is, on balance, very good for the health in moderation. We wrote about it here:

    The Bitter Truth About Coffee (or is it?)

    Some quick facts before moving on:

    Those are some compelling statistics!

    But what about the caffeine content?

    Assuming one doesn’t have a caffeine sensitivity, caffeine is also healthy in moderation—but it is easy to accidentally become dependent on it, so it can be good to take a “tolerance break” once in a while, and then reintroduce it with more modest moderation:

    Caffeine: Cognitive Enhancer Or Brain-Wrecker?

    We also, for that matter, have discussed its impact on the gut:

    Coffee & Your Gut ← surprise, it’s a positive impact

    What if I don’t like coffee?

    We suspect that, having seen the title of this article, you know what the answer’s going to be here:

    Green coffee bean extract is the extract from green (i.e. unroasted) coffee beans. It has one or two advantages over drinking coffee:

    1. For those who do not like drinking coffee, this supplement sidesteps that neatly
    2. Roasting coffee beans destroys a lot (sometimes almost all; it depends on the temperature and duration) of their chlorogenic acid, a highly beneficial polyphenol; using unroasted (i.e. green) coffee beans avoids that

    See: Role of roasting conditions in the level of chlorogenic acid content in coffee beans

    All about GCE and CGA

    That’s “green coffee extract” and “chlorogenic acid”, respectively, bearing in mind that the latter is found generously in the former.

    As to what it does:

    ❝CGA is an important and biologically active dietary polyphenol, playing several important and therapeutic roles such as antioxidant activity, antibacterial, hepatoprotective, cardioprotective, anti-inflammatory, antipyretic, neuroprotective, anti-obesity, antiviral, anti-microbial, anti-hypertension, free radicals scavenger and a central nervous system (CNS) stimulator. Furthermore, CGA causes hepatoprotective effects.❞

    👆 Those are the things we know for sure that it does. And it may do even more things:

    ❝In addition, it has been found that CGA could modulate lipid metabolism and glucose in both genetically and healthy metabolic related disorders. It is speculated that CGA can perform crucial roles in lipid and glucose metabolism regulation and thus help to treat many disorders such as hepatic steatosis, cardiovascular disease, diabetes, and obesity as well.❞

    Read in full: Chlorogenic acid (CGA): A pharmacological review and call for further research

    About lipid metabolism

    • Green coffee extract supplementation significantly reduces serum total cholesterol levels.
    • Green coffee extract supplementation significantly reduces serum LDL (“bad” cholesterol) levels.
    • Increases in HDL (“good” cholesterol) after green coffee bean extract consumption are significant in green coffee bean extract dosages ≥400mg/day.

    Source: The effects of green coffee bean extract supplementation on lipid profile in humans: A systematic review and meta-analysis of randomized controlled trials

    About blood glucose and insulin

    • Green coffee extract supplementation significantly improved fasting blood sugar levels
    • Green coffee extract supplementation at ≥400 mg/day significantly lowered postprandial insulin levels (that’s good)

    Source: The influence of green coffee bean extract supplementation on blood glucose levels: A systematic review and dose–response meta-analysis of randomized controlled trials

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Enjoy!

    Share This Post

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  • Black Forest Chia Pudding

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    This pudding tastes so decadent, it’s hard to believe it’s so healthy, but it is! Not only is it delicious, it’s also packed with nutrients including protein, carbohydrates, healthy fats (including omega-3s), fiber, vitamins, minerals, and assorted antioxidant polyphenols. Perfect dessert or breakfast!

    You will need

    • 1½ cups pitted fresh or thawed-from-frozen cherries
    • ½ cup mashed banana
    • 3 tbsp unsweetened cocoa powder
    • 2 tbsp chia seeds, ground
    • Optional: 2 pitted dates, soaked in hot water for 10 minutes and then drained (include these if you prefer a sweeter pudding)
    • Garnish: a few almonds, and/or berries, and/or cherries and/or cacao nibs

    Method

    (we suggest you read everything at least once before doing anything)

    1) Blend the ingredients except for the chia seeds and the garnish, with ½ cup of water, until completely smooth

    2) Divide into two small bowls or glass jars

    3) Add 1 tbsp ground chia seeds to each, and stir until evenly distributed

    4) Add the garnish and refrigerate overnight or at least for some hours. There’s plenty of wiggle-room here, so make it at your convenience and serve at your leisure.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • What is reformer pilates? And is it worth the cost?

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    Reformer pilates is steadily growing in popularity, with new studios opening regularly in major cities all over the world.

    But what exactly is reformer pilates? And how does it compare with regular pilates and other types of exercise?

    Classes aren’t cheap so let’s look at the potential benefits and drawbacks to help you decide if it’s right for you.

    Ahmet Kurt/Unsplash

    Pilates with special equipment

    Pilates is a mode of exercise that focuses on core stability and flexibility, while also addressing muscular strength and endurance, balance and general fitness. At first glance, it might look a bit like yoga, with some more traditional weight training components thrown in.

    Reformer pilates uses a piece of equipment called a “reformer”. This looks like a narrow bed that slides along a carriage, has straps to hold onto, and has adjustable springs that add resistance to movement. You perform pilates on the reformer to target specific muscle groups and movement patterns.

    The reformer was first designed to help people recover from injuries. However, it has now become common for general fitness and even sports performance.

    Unlike normal pilates, also known as “mat pilates”, which only uses your body weight, the reformer adds resistance, meaning you can change the difficulty according to your current level of fitness.

    This not only provides a way to overload your muscles, but can make the exercise session more aerobically demanding, which has been proposed to improve cardiovascular fitness.

    Man stretches while his pilates instructor repositions his back
    Mat pilates uses your body weight. Kampus Productions/Pexels

    What are the benefits of reformer pilates?

    Despite being around for decades, there is surprisingly little research looking at the benefits of reformer pilates. However, what we have seen so far suggests it has a similar effect to other modes of exercise.

    Reformer pilates has been shown to help with weight loss, cause some small increases in muscle mass, and enhance cognitive function. All of these benefits are commonly seen when combining weight training and cardio into the same routine.

    Similarly, among older adults, it has been shown to improve strength, enhance flexibility and may even reduce the risk of falling.

    From a rehabilitation perspective, there is some evidence indicating reformer pilates can improve shoulder health and function, reduce lower back pain and increase flexibility.

    Finally, there is some evidence suggesting a single session of reformer pilates can improve two key markers of cardiovascular health, being flow-mediated dilation and pulse wave velocity, while also improving cholesterol and insulin levels. This suggests reformer pilates could lead to long-term improvements in heart and metabolic health, although more research is needed to confirm this.

    Man pulls straps of reformer, with his physio looking on
    Reformer pilates was first designed to help people recover from injuries. Kampus Productions/Pexels

    However, there are some key things to consider when discussing these benefits. Most of this research is quite exploratory and comes from a very small number of studies. So we do not know whether these findings will apply to everyone.

    Very few studies compared reformer pilates to other types of exercise. Therefore, while it can improve most aspects of health and function, it’s unlikely reformer pilates provides the optimal mode of exercise for each individual component of physical fitness.

    Traditional weight training, for example, will likely cause larger improvements in strength than reformer pilates. Similarly, stretching will probably make you more flexible. And running or cycling will make you fitter.

    However, if you want a type of exercise that gives you broad overall health benefits, it could be a good option.

    What are the downsides of reformer pilates

    Reformer pilates is not for everyone.

    First and foremost, classes can be expensive compared to other fitness options. You need to be doing at least two to three sessions per week of any type of exercise to maximise the benefits. So even if you can find a class for A$20 or $30, paying for two or three classes a week (or buying a weekly or monthly subscription) is a significant outlay.

    Second, it’s not as accessible as other exercise. Even if you can afford it, not every town or suburb has a reformer pilates studio.

    Woman rolls up exercise mat
    Cost and access are major barriers. Or you might get better results with specific modes of exercises. Karolina Grabowska/Pexels

    Third, the effectiveness of your workout is likely to be impacted by how competent your instructor is. There are a host of different pilates qualifications you can get in Australia, and some take much less time than others. With this in mind, it might be best to look for accredited pilates instructors, although this will further reduce the number of options you have available.

    Finally, there is a learning curve. While you will get better over time, the exercise will likely be less effective during those first few weeks (or months) when you are getting used to the machine and the movements.

    Is it right for you?

    Reformer pilates can be a great addition to your fitness routine, especially if you’re looking for a low-impact way to build strength and flexibility.

    But if you have more specific goals, you might need a more specific mode of exercise. For example, if you need to get stronger to improve your ability to manage your daily life, then strength training is probably your best bet. Likewise, if your goal is to run a marathon, you will get more specific benefits from running.

    The cost and availability of reformer pilates make it less accessible for some people. With this in mind, if you are after similar benefits at a lower price point, mat pilates might be a better option. Not only does it have evidence suggesting it can improve strength and fitness, but it is something you can do at home if you find a good resource (YouTube could be a good starting point here).

    Hunter Bennett, Lecturer in Exercise Science, University of South Australia; Jacinta Brinsley, Exercise Physiologist and Postdoctoral Researcher in the Alliance for Research in Nutrition, Exercise and Activity, University of South Australia, and Lewis Ingram, Lecturer in Physiotherapy, University of South Australia

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

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  • Paracetamol pack sizes and availability are changing. Here’s what you need to know

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    Changes are coming into effect from February 1 about how paracetamol is sold in Australia.

    This mainly affects pack sizes of paracetamol sold outside pharmacies and how paracetamol is accessed in pharmacies.

    The changes, announced by Australia’s drug regulator, are in line with moves internationally to reduce the harms of liver toxicity and the risk of overdose.

    However, there are no new safety concerns when paracetamol is used as directed. And children’s products are not affected.

    Bowonpat Sakaew/Shutterstock

    What is paracetamol?

    Paracetamol is commonly sold under brand names such as Panadol, Dymadon and Panamax. It’s used to treat mild pain and fever for short periods or can be prescribed for chronic (long-term) pain.

    Millions of packs of this cheap and accessible medicine are sold in Australia every year.

    Small packs (up to 20 tablets) have been available from supermarkets and other retailers such as petrol stations. Larger packs (up to 100 tablets) are only available from pharmacies.

    Paracetamol is relatively safe when used as directed. However, at higher-than-recommended doses, it can cause liver toxicity. In severe cases and when left untreated, this can be lethal.

    Why are the rules changing?

    In 2022, we wrote about how the Therapeutic Goods Administration (TGA) was considering changes to paracetamol access because of an increase in people going to hospital with paracetamol poisoning.

    An expert review it commissioned found there were about 40–50 deaths every year from paracetamol poisoning between 2007 and 2020. Between 2009–10 and 2016–17, hospital admissions for this increased (from 8,617 to 11,697), before reducing in 2019–20 (8,723). Most admissions were due to intentional self-poisonings, and about half of these were among people aged ten to 24.

    After the report, the TGA consulted with the public to work out how to prevent paracetamol poisonings.

    Options included reducing pack sizes, limiting how many packs could be bought at once, moving larger packs behind the pharmacy counter and restricting access by age.

    Responses were mixed. Although responses supported the need to prevent poisonings, there were concerns about how changes might affect:

    • people with chronic pain, especially those in regional areas, where it may be harder to access pharmacies and, therefore, larger packs
    • people on limited incomes, if certain products were made prescription-only.

    Although deaths from paracetamol poisoning are tragic and preventable, they are rare considering how much paracetamol Australians use. There is less than one death due to poisoning for every million packs sold.

    Because of this, it was important the TGA addressed concerns about poisonings while making sure Australians still had easy access to this essential medicine.

    Pharmacist typing at computer behind the counter
    If you buy large packs of paracetamol for chronic pain, you’ll need to go to the pharmacy counter. StratfordProductions/Shutterstock

    So what’s changing?

    The key changes being introduced relate to new rules about the pack sizes that can be sold outside pharmacies, and the location of products sold in pharmacies.

    From February 1, packs sold in supermarkets and places other than pharmacies will reduce from a maximum 20 tablets to 16 tablets per pack. These changes bring Australia in line with other countries. These include the United Kingdom, which restricted supermarket packs to 16 tablets in 1998, and saw reductions in poisonings.

    In all jurisdictions except Queensland and Western Australia, packs sold in pharmacies larger than 50 tablets will move behind the pharmacy counter and can only be sold under pharmacist supervision. In Queensland and WA, products containing more than 16 tablets will only be available from behind the pharmacy counter and sold under pharmacist supervision.

    In all jurisdictions, any packs containing more than 50 tablets will need to be sold in blister packs, rather than bottles.

    Several paracetamol products are not affected by these changes. These include children’s products, slow-release formulations (for example, “osteo” products), and products already behind the pharmacy counter or only available via prescription.

    What else do I need to know?

    These changes have been introduced to reduce the risk of poisonings from people exceeding recommended doses. The overall safety profile of paracetamol has not changed.

    Paracetamol is still available from all current locations and there are no plans to make it prescription-only or remove it from supermarkets altogether. Many companies have already been updating their packaging to ensure there are no gaps in supply.

    The reduction in pack sizes of paracetamol available in supermarkets means a pack of 16 tablets will now last two days instead of two-and-a-half days if taken at the maximum dose (two tablets, four times a day). Anyone in pain that does not improve after short-term use should speak to their pharmacist or GP.

    For people who use paracetamol regularly for chronic pain, it is more cost-effective to continue buying larger packs from pharmacies. As larger packs (50+ tablets) need to be kept out of sight, you will need to ask at the pharmacy counter. Pharmacists know that for many people it’s appropriate to use paracetamol daily for chronic pain.

    Natasa Gisev, Clinical pharmacist and Scientia Associate Professor at the National Drug and Alcohol Research Centre, UNSW Sydney and Ria Hopkins, Postdoctoral Research Fellow, National Drug and Alcohol Research Centre, UNSW Sydney

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

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