
Reflexology: What The Science Says
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How Does Reflexology Work, Really?

In Wednesday’s newsletter, we asked you for your opinion of reflexology, and got the above-depicted, below-described set of responses:
- About 63% said “It works by specific nerves connecting the feet and hands to various specific organs, triggering healing remotely”
- About 26% said “It works by realigning the body’s energies (e.g. qi, ki, prana, etc), removing blockages and improving health“
- About 11% said “It works by placebo, at best, and has no evidence for any efficacy beyond that”
So, what does the science say?
It works by realigning the body’s energies (e.g. qi, ki, prana, etc), removing blockages and improving health: True or False?
False, or since we can’t prove a negative: there is no reliable scientific evidence for this.
Further, there is no reliable scientific evidence for the existence of qi, ki, prana, soma, mana, or whatever we want to call it.
To save doubling up, we did discuss this in some more detail, exploring the notion of qi as bioelectrical energy, including a look at some unreliable clinical evidence for it (a study that used shoddy methodology, but it’s important to understand what they did wrong, to watch out for such), when we looked at [the legitimately very healthful practice of] qigong, a couple of weeks ago:
Qigong: A Breath Of Fresh Air?
As for reflexology specifically: in terms of blockages of qi causing disease (and thus being a putative therapeutic mechanism of action for attenuating disease), it’s an interesting hypothesis but in terms of scientific merit, it was pre-emptively supplanted by germ theory and other similarly observable-and-measurable phenomena.
We say “pre-emptively”, because despite orientalist marketing, unless we want to count some ancient pictures of people getting a foot massage and say it is reflexology, there is no record of reflexology being a thing before 1913 (and that was in the US, by a laryngologist working with a spiritualist to produce a book that they published in 1917).
It works by specific nerves connecting the feet and hands to various specific organs, triggering healing remotely: True or False?
False, or since we can’t prove a negative: there is no reliable scientific evidence for this.
A very large independent review of available scientific literature found the current medical consensus on reflexology is that:
- Reflexology is effective for: anxiety (but short lasting), edema, mild insomnia, quality of sleep, and relieving pain (short term: 2–3 hours)
- Reflexology is not effective for: inflammatory bowel disease, fertility treatment, neuropathy and polyneuropathy, acute low back pain, sub acute low back pain, chronic low back pain, radicular pain syndromes (including sciatica), post-operative low back pain, spinal stenosis, spinal fractures, sacroiliitis, spondylolisthesis, complex regional pain syndrome, trigger points / myofascial pain, chronic persistent pain, chronic low back pain, depression, work related injuries of the hip and pelvis
Source: Reflexology – a scientific literary review compilation
(the above is a fascinating read, by the way, and its 50 pages go into a lot more detail than we have room to here)
Now, those items that they found it effective for, looks suspiciously like a short list of things that placebo is often good for, and/or any relaxing activity.
Another review was not so generous:
❝The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition❞
~ Dr. Edzard Ernst (MD, PhD, FMedSci)
Source: Is reflexology an effective intervention? A systematic review of randomised controlled trials
In short, from the available scientific literature, we can surmise:
- Some researchers have found it to have some usefulness against chiefly psychosomatic conditions
- Other researchers have found the evidence for even that much to be uncompelling
It works by placebo, at best, and has no evidence for any efficacy beyond that: True or False?
Mostly True; of course reflexology runs into similar problems as acupuncture when it comes to testing against placebo:
How Does One Test Acupuncture Against Placebo Anyway?
…but not quite as bad, since it is easier to give a random foot massage while pretending it is a clinical treatment, than to fake putting needles into key locations.
However, as the paper we cited just above (in answer to the previous True/False question) shows, reflexology does not appear to meaningfully outperform placebo—which points to the possibility that it does work by placebo, and is just a placebo treatment on the high end of placebo (because the placebo effect is real, does work, isn’t “nothing”, and some placebos work better than others).
For more on the fascinating science and useful (applicable in daily life!) practicalities of how placebo does work, check out:
How To Leverage Placebo Effect For Yourself
Take care!
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Bird Flu Is Bad for Poultry and Dairy Cows. It’s Not a Dire Threat for Most of Us — Yet.
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Headlines are flying after the Department of Agriculture confirmed that the H5N1 bird flu virus has infected dairy cows around the country. Tests have detected the virus among cattle in nine states, mainly in Texas and New Mexico, and most recently in Colorado, said Nirav Shah, principal deputy director at the Centers for Disease Control and Prevention, at a May 1 event held by the Council on Foreign Relations.
A menagerie of other animals have been infected by H5N1, and at least one person in Texas. But what scientists fear most is if the virus were to spread efficiently from person to person. That hasn’t happened and might not. Shah said the CDC considers the H5N1 outbreak “a low risk to the general public at this time.”
Viruses evolve and outbreaks can shift quickly. “As with any major outbreak, this is moving at the speed of a bullet train,” Shah said. “What we’ll be talking about is a snapshot of that fast-moving train.” What he means is that what’s known about the H5N1 bird flu today will undoubtedly change.
With that in mind, KFF Health News explains what you need to know now.
Q: Who gets the bird flu?
Mainly birds. Over the past few years, however, the H5N1 bird flu virus has increasingly jumped from birds into mammals around the world. The growing list of more than 50 species includes seals, goats, skunks, cats, and wild bush dogs at a zoo in the United Kingdom. At least 24,000 sea lions died in outbreaks of H5N1 bird flu in South America last year.
What makes the current outbreak in cattle unusual is that it’s spreading rapidly from cow to cow, whereas the other cases — except for the sea lion infections — appear limited. Researchers know this because genetic sequences of the H5N1 viruses drawn from cattle this year were nearly identical to one another.
The cattle outbreak is also concerning because the country has been caught off guard. Researchers examining the virus’s genomes suggest it originally spilled over from birds into cows late last year in Texas, and has since spread among many more cows than have been tested. “Our analyses show this has been circulating in cows for four months or so, under our noses,” said Michael Worobey, an evolutionary biologist at the University of Arizona in Tucson.
Q: Is this the start of the next pandemic?
Not yet. But it’s a thought worth considering because a bird flu pandemic would be a nightmare. More than half of people infected by older strains of H5N1 bird flu viruses from 2003 to 2016 died. Even if death rates turn out to be less severe for the H5N1 strain currently circulating in cattle, repercussions could involve loads of sick people and hospitals too overwhelmed to handle other medical emergencies.
Although at least one person has been infected with H5N1 this year, the virus can’t lead to a pandemic in its current state. To achieve that horrible status, a pathogen needs to sicken many people on multiple continents. And to do that, the H5N1 virus would need to infect a ton of people. That won’t happen through occasional spillovers of the virus from farm animals into people. Rather, the virus must acquire mutations for it to spread from person to person, like the seasonal flu, as a respiratory infection transmitted largely through the air as people cough, sneeze, and breathe. As we learned in the depths of covid-19, airborne viruses are hard to stop.
That hasn’t happened yet. However, H5N1 viruses now have plenty of chances to evolve as they replicate within thousands of cows. Like all viruses, they mutate as they replicate, and mutations that improve the virus’s survival are passed to the next generation. And because cows are mammals, the viruses could be getting better at thriving within cells that are closer to ours than birds’.
The evolution of a pandemic-ready bird flu virus could be aided by a sort of superpower possessed by many viruses. Namely, they sometimes swap their genes with other strains in a process called reassortment. In a study published in 2009, Worobey and other researchers traced the origin of the H1N1 “swine flu” pandemic to events in which different viruses causing the swine flu, bird flu, and human flu mixed and matched their genes within pigs that they were simultaneously infecting. Pigs need not be involved this time around, Worobey warned.
Q: Will a pandemic start if a person drinks virus-contaminated milk?
Not yet. Cow’s milk, as well as powdered milk and infant formula, sold in stores is considered safe because the law requires all milk sold commercially to be pasteurized. That process of heating milk at high temperatures kills bacteria, viruses, and other teeny organisms. Tests have identified fragments of H5N1 viruses in milk from grocery stores but confirm that the virus bits are dead and, therefore, harmless.
Unpasteurized “raw” milk, however, has been shown to contain living H5N1 viruses, which is why the FDA and other health authorities strongly advise people not to drink it. Doing so could cause a person to become seriously ill or worse. But even then, a pandemic is unlikely to be sparked because the virus — in its current form — does not spread efficiently from person to person, as the seasonal flu does.
Q: What should be done?
A lot! Because of a lack of surveillance, the U.S. Department of Agriculture and other agencies have allowed the H5N1 bird flu to spread under the radar in cattle. To get a handle on the situation, the USDA recently ordered all lactating dairy cattle to be tested before farmers move them to other states, and the outcomes of the tests to be reported.
But just as restricting covid tests to international travelers in early 2020 allowed the coronavirus to spread undetected, testing only cows that move across state lines would miss plenty of cases.
Such limited testing won’t reveal how the virus is spreading among cattle — information desperately needed so farmers can stop it. A leading hypothesis is that viruses are being transferred from one cow to the next through the machines used to milk them.
To boost testing, Fred Gingrich, executive director of a nonprofit organization for farm veterinarians, the American Association of Bovine Practitioners, said the government should offer funds to cattle farmers who report cases so that they have an incentive to test. Barring that, he said, reporting just adds reputational damage atop financial loss.
“These outbreaks have a significant economic impact,” Gingrich said. “Farmers lose about 20% of their milk production in an outbreak because animals quit eating, produce less milk, and some of that milk is abnormal and then can’t be sold.”
The government has made the H5N1 tests free for farmers, Gingrich added, but they haven’t budgeted money for veterinarians who must sample the cows, transport samples, and file paperwork. “Tests are the least expensive part,” he said.
If testing on farms remains elusive, evolutionary virologists can still learn a lot by analyzing genomic sequences from H5N1 viruses sampled from cattle. The differences between sequences tell a story about where and when the current outbreak began, the path it travels, and whether the viruses are acquiring mutations that pose a threat to people. Yet this vital research has been hampered by the USDA’s slow and incomplete posting of genetic data, Worobey said.
The government should also help poultry farmers prevent H5N1 outbreaks since those kill many birds and pose a constant threat of spillover, said Maurice Pitesky, an avian disease specialist at the University of California-Davis.
Waterfowl like ducks and geese are the usual sources of outbreaks on poultry farms, and researchers can detect their proximity using remote sensing and other technologies. By zeroing in on zones of potential spillover, farmers can target their attention. That can mean routine surveillance to detect early signs of infections in poultry, using water cannons to shoo away migrating flocks, relocating farm animals, or temporarily ushering them into barns. “We should be spending on prevention,” Pitesky said.
Q: OK it’s not a pandemic, but what could happen to people who get this year’s H5N1 bird flu?
No one really knows. Only one person in Texas has been diagnosed with the disease this year, in April. This person worked closely with dairy cows, and had a mild case with an eye infection. The CDC found out about them because of its surveillance process. Clinics are supposed to alert state health departments when they diagnose farmworkers with the flu, using tests that detect influenza viruses, broadly. State health departments then confirm the test, and if it’s positive, they send a person’s sample to a CDC laboratory, where it is checked for the H5N1 virus, specifically. “Thus far we have received 23,” Shah said. “All but one of those was negative.”
State health department officials are also monitoring around 150 people, he said, who have spent time around cattle. They’re checking in with these farmworkers via phone calls, text messages, or in-person visits to see if they develop symptoms. And if that happens, they’ll be tested.
Another way to assess farmworkers would be to check their blood for antibodies against the H5N1 bird flu virus; a positive result would indicate they might have been unknowingly infected. But Shah said health officials are not yet doing this work.
“The fact that we’re four months in and haven’t done this isn’t a good sign,” Worobey said. “I’m not super worried about a pandemic at the moment, but we should start acting like we don’t want it to happen.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Genital herpes is on the rise. Here’s what to know about this common infection
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The World Health Organization (WHO) recently released new estimates suggesting around 846 million people aged between 15 and 49 live with a genital herpes infection.
That’s equivalent to one in every five people from that age group.
At least one person each second (42 million people annually) contracts a new genital herpes infection.
So what is genital herpes, and are cases on the rise? Here’s what to know about this common infection.
Peakstock/Shutterstock First, what causes genital herpes?
Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus, which also causes cold sores.
There are two types of herpes simplex virus, HSV-1 and HSV-2 (and it’s possible to be infected by both at the same time).
HSV-1 most commonly spreads through oral contact such as kissing or sharing infected objects such as lip balm, cups or utensils, and presents as cold sores (or oral herpes) around the mouth. But it can also be sexually transmitted to cause a genital herpes infection.
An estimated 3.8 billion people under the age of 50 (64%) globally have HSV-1.
HSV-2 is less prevalent, but almost always causes a genital herpes infection. Some 520 million people aged 15–49 (13%) worldwide are believed to have HSV-2.
The initial episode of genital herpes can be quite painful, with blisters, ulcers and peeling skin around the genitals over 7–10 days.
Not all people have severe (or any) initial symptoms. This means a person might not know they have been infected with a herpes virus.
Herpes is a lifelong infection, which means once you contract the virus, you have it forever. After an initial episode, subsequent episodes can occur, but are usually less painful or even symptom free.
Both oral and genital herpes are particularly easy to spread when you have active lesions (cold sores or genital ulcers). But even with no symptoms, herpes can still be spread to a partner.
And although relatively rare, oral herpes can be transmitted to the genital area, and genital herpes can be transmitted to the mouth through oral sex.
If an expectant mother exhibits a genital herpes infection close to childbirth, there are risks to the baby. A herpes infection can be very serious in a baby, and the younger the infant, the more vulnerable they are. This is also one reason why you should avoid kissing a baby on the mouth.
Changing trends
WHO’s recent figures brought together data from around the world to estimate the prevalence of genital herpes in 2020, compared with previous estimates in 2012 and 2016.
This data shows no significant difference in the prevalence of genital herpes caused by HSV-2 since 2016, but does highlight increases in genital herpes infections caused by HSV-1.
The estimated number of genital HSV-1 infections globally was nearly twice as high in 2020 compared with 2016 (376 million compared with 192 million).
A 2022 study looking at Australia, New Zealand and Canada found more than 60% of genital herpes infections are still caused by HSV-2. But this is declining by about 2% each year while new genital infections that result from HSV-1 are rising.
Genital herpes can be quite painful, presenting as sores and lesions that in severe cases, may take up to a month to fully heal. Christian Moro There’s no simple fix, but safe sex is important
Genital herpes causes a substantial disease burden and economic cost to health-care services.
With such a large proportion of the world’s population infected with HSV-1, evidence this virus is increasingly causing genital herpes is concerning.
There’s no cure for genital herpes, but some medications, such as antivirals, can help reduce the amount of virus present in the system. While this won’t kill it completely, it helps to prevent symptomatic genital herpes recurrences, improve quality of life, and minimise the risk of transmission.
To prevent the spread of genital herpes and other STIs, practise safe sex, particularly if you’re not sure of your partner’s sexual health. You need to use a barrier method such as condoms to protect against STIs (a contraceptive such as the pill won’t work). This includes during oral sex.
As herpes is now so common, testing is not usually included as part of a regular sexual health check-up, except for in specific circumstances such as during pregnancy or severe episodes.
So it’s wise not to let your guard down, even if your partner insists they have received the all-clear from a recent check-up.
If there are herpes lesions present around the genitals, avoid sex entirely. Even condoms are not fully effective at these times, as exposed areas can still transmit the infection.
Practising safe sex can help prevent the spread of herpes. cottonbro studio/Pexels Immune health
If you are infected with HSV-1 or HSV-2 it’s more likely symptoms will appear when you’re stressed, tired or overwhelmed. During these times, our immune system may not be as functional, and dormant viruses such as herpes can start to develop quickly in our bodies.
To reduce the risk of recurrent herpes infections, try to eat healthily, get at least seven hours of sleep each night if possible, and look out for when your body may be telling you to take a step back and relax. This self-care can go a long way towards keeping latent viruses at bay.
While the prevalence has increased significantly in recent years, we have not lost the war on genital herpes just yet. Safe sexual practices, education and awareness can help reduce its spread, and the stigma around it.
If you have personal concerns, you should discuss them with a medical professional.
Christian Moro, Associate Professor of Science & Medicine, Bond University and Charlotte Phelps, Senior Teaching Fellow in Medicine, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Zero Sugar / One Month – by Becky Gillaspy
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We’ve reviewed books about the evils of sugar before, so what makes this one different?
This one has a focus on helping the reader quit it. It assumes we already know the evils of sugar (though it does cover that too).
It looks at the mechanisms of sugar addiction (habits-based and physiological), and how to safely and painlessly cut through those to come out the other side, free from sugar.
The author gives a day-by-day plan, for not only eliminating sugar, but also adding and including things to fill the gap it leaves, keeping us sated, energized, and happy along the way.
In the category of subjective criticism, it does also assume we want to lose weight, which may not be the case for many readers. But that’s a by-the-by and doesn’t detract from the useful guide to quitting sugar, whatever one’s reasons.
Bottom line: if you would like to quit sugar but find it hard, this book thinks of everything and walks you by the hand, making it easy.
Click here to check out Zero Sugar / One Month, and reap the health benefits!
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The BAT-pause!
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When Cold Weather & The Menopause Battle It Out
You may know that (moderate, safe) exposure to the cold allows our body to convert our white and yellow fat into the much healthier brown fat—also called brown adipose tissue, or “BAT” to its friends.
If you didn’t already know that, then well, neither did scientists until about 15 years ago:
The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
You can read more about it here:
Cool Temperature Alters Human Fat and Metabolism
This is important, especially because the white fat that gets converted is the kind that makes up most visceral fat—the kind most associated with all-cause mortality:
Visceral Belly Fat & How To Lose It ← this is not the same as your subcutaneous fat, the kind that sits directly under your skin and keeps you warm; this is the fat that goes between your organs and of which we should only have a small amount!
The BAT-pause
It’s been known (since before the above discovery) that BAT production slows considerably as we get older. Not too shocking—after all, many metabolic functions slow as we get older, so why should fat regulation be any different?
But! Rodent studies found that this was tied less to age, but to ovarian function: rats who underwent ovariectomies suffered reduced BAT production, regardless of their age.
Naturally, it’s been difficult to recreate such studies in humans, because it’s difficult to find a large sample of young adults willing to have their ovaries whipped out (or even suppressed chemically) to see how badly their metabolism suffers as a result.
Nor can an observational study (for example, of people who incidentally have ovaries removed due to ovarian cancer) usefully be undertaken, because then the cancer itself and any additional cancer treatments would be confounding factors.
Perimenopausal study to the rescue!
A recent (published last month, at time of writing!) study looked at women around the age of menopause, but specifically in cohorts before and after, measuring BAT metabolism.
By dividing the participants into groups based on age and menopausal status, and dividing the post-menopausal group into “takes HRT” and “no HRT” groups, and dividing the pre-menopausal group into “normal ovarian function” and “ovarian production of estrogen suppressed to mimic slightly early menopause” groups (there’s a drug for that), and then having groups exposed to warm and cold temperatures, and measuring BAT metabolism in all cases, they were able to find…
It is about estrogen, not age!
You can read more about the study here:
“Good” fat metabolism changes tied to estrogen loss, not necessarily to aging, shows study
…and the study itself, here:
Brown adipose tissue metabolism in women is dependent on ovarian status
What does this mean for men?
This means nothing directly for (cis) men, sorry.
But to satisfy your likely curiosity: yes, testosterone does at least moderately suppress BAT metabolism—based on rodent studies, anyway, because again it’s difficult to find enough human volunteers willing to have their testicles removed for science (without there being other confounding variables in play, anyway):
Testosterone reduces metabolic brown fat activity in male mice
So, that’s bad per se, but there isn’t much to be done about it, since the rest of your (addressing our male readers here) metabolism runs on testosterone, as do many of your bodily functions, and you would suffer many unwanted effects without it.
However, as men do typically have notably less body fat in general than women (this is regulated by hormones), the effects of changes in BAT metabolism are rather less pronounced in men (per testosterone level changes) than in women (per estrogen level changes), because there’s less overall fat to convert.
In summary…
While menopausal HRT is not necessarily a silver bullet to all metabolic problems, its BAT-maintaining ability is certainly one more thing in its favor.
See also:
Dr. Jen Gunter | What You Should Have Been Told About The Menopause Beforehand
Take care!
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How to Eat 30 Plants a Week – by Hugh Fearnley-Whittingstall
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If you’re used to eating the same two fruits and three vegetables in rotation, the “gold standard” evidence-based advice to “eat 30 different plants per week” can seem a little daunting.
Where this book excels is in reminding the reader to use a lot of diverse plants that are readily available in any well-stocked supermarket, but often get forgotten just because “we don’t buy that”, so it becomes invisible on the shelf.
It’s not just a recipe book (though yes, there are plenty of recipes here); it’s also advice about stocking up and maintaining that stock, advice on reframing certain choices to inject a little diversity into every meal without it become onerous, meal-planning rotation advice, and a lot of recipes that are easy but plant-rich, for example “this soup that has these six plants in it”, etc.
He also gives, for those eager to get started, “10 x 3 recipes per week to guarantee your 30”, in other words, 10 sets of 3 recipes, wherein each set of 3 recipes uses >30 different plants between them, such that if we have each of these set-of-three meals over the course of the week, then what we do in the other 4–18 meals (depending on how many meals per day you like to have) is all just a bonus.
The latter is what makes this book an incredibly stress-free approach to more plant-diverse eating for life.
Bottom line: if you want to be able to answer “do you get your five-a-day?” with “you mean breakfast?” because you’ve already hit five by breakfast each day, then this is the book for you.
Click here to check out How To Eat 30 Plants A Week, and indeed eat 30+ different plants per week!
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Rehab Science – by Dr. Tom Walters
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Many books of this kind deal with the injury but not the pain; some source talk about pain but not the injury; this one does both, and more.
Dr. Walters discusses in detail the nature of pain, various different kinds of pain, the factors that influence pain, and, of course, how to overcome pain.
He also takes us on a tour of various different categories of injury, because some require very different treatment than others, and while there are some catch-all “this is good/bad for healing” advices, sometimes what will help with one injury with hinder healing another. So, this information alone would make the book a worthwhile read already.
After this two-part theory-heavy introduction, the largest part of the book is given over to rehab itself, in a practical fashion.
We learn about how to make an appropriate rehab plan, get the material things we need for it (if indeed we need material things), and specific protocols to follow for various different body parts and injuries.
The style is very much that of a textbook, well-formatted and with plenty of illustrations throughout (color is sometimes relevant, so we recommend a print edition over Kindle for this one).
Bottom line: if you have an injury to heal, or even just believe in being prepared, this book is an excellent guide.
Click here to check out Rehab Science, to overcome pain and heal from injury!
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