The Sun Exposure Dilemma
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The Sun Exposure Dilemma
Yesterday, we asked you about your policy on sun exposure, and got the above-pictured, below-described, set of answers:
- A little over a third of respondents chose “I recognize the risks, but I think the benefits outweigh them”
- A quarter of respondents chose “I am a creature of the shadows and I avoid the sun at all costs”
- A little over a fifth of respondents chose “I recognize the benefits, but I think the risks outweigh them”
- A little under a fifth of respondents chose “I’m a sun-lover! Give me that vitamin D and other benefits!”
All in all, this is perhaps the most even spread of answers we’ve had for Friday mythbuster polls—though the sample size was smaller than it often is.
Of those who added comments, common themes were to mention your local climate, and the importance of sunscreen and/or taking vitamin D supplements.
One subscriber mentioned having lupus and living in Florida, which is a particularly unfortunate combination:
Lupus Foundation | Lupus & UV exposure: What you need to know
Another subscriber wrote:
❝Use a very good sunscreen with a high SPF all the time. Reapply after swimming or as needed! I also wear polarized sunglasses anytime I’m outside.❞
…which are important things to note too, and a lot of people forget!
See also: Who Screens The Sunscreens? (on fearing chemical dangers, vs the protection given)
But, onto today’s science for the topic at hand…
We need to get plenty of sun to get plenty of vitamin D: True or False?
True or False, depending on so many factors—to the point that many people get it wildly wrong in either direction.
Whether we are getting enough vitamin D depends on many circumstances, including:
- The climate (and depending on latitude, time of year) where we live
- Our genes, and especially (but not only) our skintone
- The clothes we wear (or don’t)
- Our diet (and not just “how much vitamin D do we consume”)
- Chronic diseases that affect vitamin D metabolism and/or requirements and/or sensitivity to the sun
For a rundown on these factors and more, check out:
Should I be getting my vitamin D levels checked?
Notably, on the topic of whether you should stay in the sun for longer to get more vitamin D…
❝The body can only produce a certain amount of vitamin D at the time, so staying in the sun any longer than needed (which could be just a few minutes, in a sunny climate) is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.❞
In contrast, she does also note:
❝During winter, catching enough sun can be difficult, especially if you spend your days confined indoors. Typically, the required exposure increases to two to three hours per week in winter. This is because sunlight exposure can only help produce vitamin D if the UVB rays reach us at the correct angle. So in winter we should regularly spend time outside in the middle of the day to get our dose of vitamin D.❞
See also: Vitamin D & Calcium: Too Much Of A Good Thing?
We can skip the sun and get our vitamin D from diet/supplements: True or False?
True! However, vitamin D is not the only health benefit of sun exposure.
Not only is sunlight-induced serotonin production important for many things ranging from mood to circadian rhythm (which in turn affects many other aspects of health), but also…
While too much sun can cause skin cancer, too little sun could cause other kinds of cancer:
Benefits of Sunlight: A Bright Spot for Human Health
Additionally, according to new research, the circadian rhythm benefits we mentioned above may also have an impact on type 2 diabetes:
Can catching some rays help you fight off type 2 diabetes?
Which way to jump?
A lot of it depends on who you are, ranging from the factors we mentioned earlier, to even such things as “having many moles” or “having blonde hair”.
This latter item, blonde hair, is a dual thing: it’s a matter of genetic factors that align with being prone to being more sensitive to the sun, as well as being a lesser physical barrier to the sun’s rays than dark hair (that can block some UV rays).
So for example, if two people have comparably gray hair now, but one of them used to have dark hair and the other blonde, there will still be a difference in how they suffer damage, or don’t—and yes, even if their skin is visually of the same approximate skintone.
You probably already know for yourself whether you are more likely to burn or tan in the sun, and the former group are less resistant to the sun’s damage… But the latter group are more likely to spend longer in the sun, and accumulate more damage that way.
If you’d like a very comprehensive downloadable, here are the guidelines issued by the UK’s National Institute for Health and Care Excellence:
NICE Guidelines | Sunlight exposure: risks and benefits
…and skip to “At risk groups”, if you don’t want to read the whole thing; “Skin type” is also an important subsection, which also uses your hair and eye color as indicators.
Writer’s note: genetics are complicated and not everyone will fall neatly into categories, which is why it’s important to know the individual factors.
For example, I am quite light-skinned with slightly graying dark hair and gray-blue eyes, and/but also have an obscure Sámi gene that means my skin makes vitamin D easily, while simultaneously being unusually resistant to burning (I just tan). Basically: built for the midnight sun of the Arctic circle.
And yet! My hobbies include not getting skin cancer, so I tend to still be quite mindful of UV levels in different weathers and times of day, and make choices (schedule, clothing, sunscreen or not) accordingly.
Bottom line:
That big self-perpetuating nuclear explosion in the sky is responsible for many things, good and bad for our health, so be aware of your own risk factors, especially for vitamin D deficiency, and skin cancer.
- If you have a predisposition to both, that’s unfortunate, but diet and supplementation at least can help with the vitamin D while getting modest amounts of sun at most.
- Remember that you can only make so much vitamin D at once, so sunbathing for health benefits need only take a few minutes
- Remember that sunlight is important for our circadian rhythm, which is important for many things.
- That’s governed by specific photoreceptor cells, though, so we don’t need our skin to be exposed for that; we just need to be able to see sunlight.
- If you’re going to be out in the sun, and not covered up, sunscreen is your friend, and yes, that goes for clear cold days under the winter sun too.
- Most phone weather apps these days have a UV index score as part of the data they give. Get used to checking it as often as you’d check for rain.
Stay safe, both ways around!
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Lemon Balm For Stressful Times And More
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Balm For The Mind: In More Ways Than One!
Lemon balm(Melissa officinalis) is quite unrelated to lemons, and is actually a closer relative to mint. It does have a lemony fragrance, though!
You’ll find it in a lot of relaxing/sleepy preparations, so…
What does the science say?
Relaxation
Lemon balm has indeed been found to be a potent anti-stress herb. Laboratories that need to test anything to do with stress generally create that stress in one of two main ways:
- If it’s not humans: a forced swimming test that’s a lot like waterboarding
- If it is humans: cognitive tests completed under time-pressure while multitasking
Consequently, studies that have set out to examine lemon balm’s anti-stress potential in humans, have often ended up also highlighting its potential as a cognitive enhancer, like this one in which…
❝Both active lemon balm treatments were generally associated with improvements in mood and/or cognitive performance❞
~ Dr. Anastasia Ossoukhova et al.
Read in full: Anti-Stress Effects of Lemon Balm-Containing Foods
And this one, which found…
❝The results showed that the 600-mg dose of Melissa ameliorated the negative mood effects of the DISS, with significantly increased self-ratings of calmness and reduced self-ratings of alertness.
In addition, a significant increase in the speed of mathematical processing, with no reduction in accuracy, was observed after ingestion of the 300-mg dose.❞
The appropriately named “DISS” is the Defined Intensity Stress Simulation we talked about.
Sleep
There’s a lot less research for lemon balm’s properties in this regard than for stress/anxiety, and it’s probably because sleep studies are much more expensive than stress studies.
It’s not for a lack of popular academic interest—for example, typing “Melissa officinalis” into PubMed (the vast library of studies we often cite from) autosuggests “Melissa officinalis sleep”. But alas, autosuggestions do not Randomized Controlled Trials make.
There are some, but they’re often small, old, and combined with other things, like this one:
This is interesting, because generally speaking there is little to no evidence that valerian actually helps sleep, so if this mixture worked, we might reasonably assume it was because of the lemon balm—but there’s an outside chance it could be that it only works in the presence of valerian (unlikely, but in science we must consider all possibilities).
Beyond that, we just have meta-reviews to work from, like this one that noted:
❝M. officinalis contains several phytochemicals such as phenolic acids, flavonoids, terpenoids, and many others at the basis of its pharmacological activities. Indeed, the plant can have antioxidant, anti-inflammatory, antispasmodic, antimicrobial, neuroprotective, nephroprotective, antinociceptive effects.
Given its consolidated use, M. officinalis has also been experimented with clinical settings, demonstrating interesting properties against different human diseases, such as anxiety, sleeping difficulties, palpitation, hypertension, depression, dementia, infantile colic, bruxism, metabolic problems, Alzheimer’s disease, and sexual disorders. ❞
You see why we don’t try to cover everything here, by the way!
But if you want to read this one in full, you can, at:
An Updated Review on The Properties of Melissa officinalis L.: Not Exclusively Anti-anxiety
Is it safe?
Lemon balm is generally recognized as safe, and/but please check with your doctor/pharmacist in case of any contraindications due to medicines you may be on or conditions you may have.
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon
Want to know your other options?
You might like our previous main features:
What Teas To Drink Before Bed (By Science!)
and
Safe Effective Sleep Aids For Seniors
Enjoy!
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The Problem With Sweeteners
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The WHO’s new view on sugar-free sweeteners
The WHO has released a report offering guidance regards the use of sugar-free sweeteners as part of a weight-loss effort.
In a nutshell, the guidance is: don’t
- Here’s the report itself: Use of non-sugar sweeteners: WHO guideline
- Here’s the WHO’s own press release about it: WHO advises not to use non-sugar sweeteners for weight control in newly released guideline
- And it was based on this huge systematic review: Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis
They make for interesting reading, so if you don’t have time now, you might want to just quickly open and bookmark them for later!
Some salient bits and pieces:
Besides that some sweeteners can cause gastro-intestinal problems, a big problem is desensitization:
Because many sugar substitutes are many times (in some cases, hundreds of times) sweeter than sugar, this leads to other sweet foods tasting more bland, causing people to crave sweeter and sweeter foods for the same satisfaction level.
You can imagine how that’s not a spiral that’s good for the health!
The WHO recommendation applies to artificial and naturally-occurring non-sugar sweeteners, including:
- Acesulfame K
- Advantame
- Aspartame
- Cyclamates
- Neotame
- Saccharin
- Stevia
Sucralose and erythritol, by the way, technically are sugars, just not “that kind of sugar” so they didn’t make the list of non-sugar sweeteners.
That said, a recent study did find that erythritol was linked to a higher risk of heart attack, stroke, and early death, so it may not be an amazing sweetener either:
Read: The artificial sweetener erythritol and cardiovascular event risk
Want to know a good way of staying healthy in the context of sweeteners?
Just get used to using less. Your taste buds will adapt, and you’ll get just as much pleasure as before, from progressively less sweetening agent.
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Focusing On Health In Our Sixties
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝What happens when you age in your sixties?❞
The good news is, a lot of that depends on you!
But, speaking on averages:
While it’s common for people to describe being over 50 as being “over the hill”, halfway to a hundred, and many greetings cards and such reflect this… Biologically speaking, our 60s are more relevant as being halfway to our likely optimal lifespan of 120. Humans love round numbers, but nature doesn’t care for such.
- In our 60s, we’re now usually the “wrong” side of the menopausal metabolic slump (usually starting at 45–55 and taking 5–10 years), or the corresponding “andropause” where testosterone levels drop (usually starting at 45 and a slow decline for 10–15 years).
- In our 60s, women will now be at a higher risk of osteoporosis, due to the above. The risk is not nearly so severe for men.
- In our 60s, if we’re ever going to get cancer, this is the most likely decade for us to find out.
- In our 60s, approximately half of us will suffer some form of hearing loss
- In our 60s, our body has all but stopped making new T-cells, which means our immune defenses drop (this is why many vaccines/boosters are offered to over-60s, but not to younger people)
While at first glance this does not seem a cheery outlook, knowledge is power.
- We can take HRT to avoid the health impact of the menopause/andropause
- We can take extra care to look after our bone health and avoid osteoporosis
- We can make sure we get the appropriate cancer screenings when we should
- We can take hearing tests, and if appropriate find the right hearing aids for us
- We can also learn to lip-read (this writer relies heavily on lip-reading!)
- We can take advantage of those extra vaccinations/boosters
- We can take extra care to boost immune health, too
Your body has no idea how many times you’ve flown around the sun and nor does it care. What actually makes a difference to it, is how it has been treated.
See also: Milestone Medical Tests You Should Take in Your 60s, 70s, and Beyond
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Why it’s a bad idea to mix alcohol with some medications
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Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.
But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.
When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.
How alcohol and medicines interact
The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to convulsions. Too much inhibition and you will experience effects like sedation and depression.
Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.
With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.
Medications can interact with alcohol to produce different or increased effects. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those effects can be compounded.
Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can increase the drug’s effect on the heart, increasing your heart rate and the risk of a heart attack.
Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.
Alcohol can increase the break-down of certain medicines, such as opioids, cannabis, seizures, and even ritalin. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with paracetamol.
At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.
Who is at most risk?
The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.
Older people do not break down medicines as quickly as younger people, and are often on more than one medication.
Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.
Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.
What drugs can’t you mix with alcohol?
You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.
The most common alcohol-interacting prescription medicines are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.
It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.
Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.
If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.
Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney; Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney; Kellie Charles, Associate Professor in Pharmacology, University of Sydney, and Tina Hinton, Associate Professor of Pharmacology, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Collagen Cure – by Dr. James DiNicolantonio
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Collagen is vital for, well, most of our bodies, really. Where me most tend to feel its deficiency is in our joints and skin, but it’s critical for bones and many other tissues too.
You may be wondering: why a 572-page book to say what surely must amount to “take collagen, duh”?
Dr. DiNicolantonio has a lot more of value to offer us than that. In this book, we learn about not just collagen synthesis and usage, different types of collagen, the metabolism of it in our diet (if we get it—vegans and vegetarians won’t). We also learn about the building blocks of collagen (vegans and vegetarians do get these, assuming a healthy balanced diet), with a special focus on glycine, the smallest amino acid which makes up about a third of the mass of collagen (a protein).
Not stopping there, we also learn about the interplay of other nutrients with our metabolism of glycine and, if applicable, collagen. Vitamin C and copper are star features, but there’s a lot more going on with other nutrients too, down to the level of “So take this 75 minutes before this but after that and/but definitely not with the other”, etc.
The style is incredibly clear and readable for something that’s also quite scientifically dense (over 1000 references and many diagrams).
Bottom line: if you’re serious about maintaining your body as you get older, and you’d like a book about collagen that’s a lot more helpful than “take collagen, duh”, then this is the book for you.
Click here to check out The Collagen Cure, and take care of yours!
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How old’s too old to be a doctor? Why GPs and surgeons over 70 may need a health check to practise
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A growing number of complaints against older doctors has prompted the Medical Board of Australia to announce today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table.
The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine.
The second would require only general health checks for doctors over 70.
A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their professional code of conduct, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo.
Haven’t we moved on from set retirement ages?
It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “still valid in a modern society”.
However, unlike judges, doctors are already required to renew their registration annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct performance assessments if and when they are needed.
What has prompted these proposals?
This latest proposal identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years.
Studies of medical competence in ageing doctors show variable results. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour.
The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors.
In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70.
In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015.
While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate.
It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients.
So what distinguishes the two new proposed options?
The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80.
Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions.
Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia.
The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia.
In practice, both of these proposals appear to allow doctors to manage their own general health confidentially.
The law tends to prioritise patient safety
All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. That provision basically says patient safety is paramount and trumps all other considerations.
As with legal regimes regulating childcare, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional.
Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “punished” for errors in practice.
All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care.
Could these proposals amount to age discrimination?
It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws.
For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals who are “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”.
In broader terms, a licence to practise medicine is often compared to a licence to drive or pilot an aircraft. Despite claims of discrimination, New South Wales law requires older drivers to undergo a medical assessment every year; and similar requirements affect older pilots and air traffic controllers.
Where to from here?
When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different.
How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, others have suggested this would only exacerbate shortages in the health-care workforce.
The proposals are open for public comment until October 4.
Christopher Rudge, Law lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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