To tackle gendered violence, we also need to look at drugs, trauma and mental health
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After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged more than A$925 million over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships.
However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues.
Why is this crucial?
The World Health Organization estimates 30% of women globally have experienced intimate partner violence, gender-based violence or both. In Australia, 27% of women have experienced intimate partner violence by a co-habiting partner; almost 40% of Australian children are exposed to domestic violence.
By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members.
These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators.
What’s the link with mental health, trauma and drugs?
The relationships between mental illness, drug use, traumatic experiences and violence are complex.
When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there is evidence people with serious mental illness can be more likely to become violent.
The use of alcohol and other drugs also increases the risk of domestic violence, including intimate partner violence.
About one in three intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also using alcohol or other drugs.
It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are high rates of trauma among people who become violent.
For example, experiences of childhood trauma (such as witnessing physical abuse) can increase the risk of perpetrating domestic violence as an adult.
Early traumatic experiences can affect the brain and body’s stress response, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress.
This response to stress increases the risk of alcohol and drug problems, developing PTSD (post-traumatic stress disorder), and increases the risk of perpetrating intimate partner violence.
How can we address these overlapping issues?
We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors.
The early intervention and treatment of mental illness, trauma (including PTSD), and alcohol and other drug use, could help reduce violence. So extra investment for these are needed. We also need more investment to prevent mental health issues, and preventing alcohol and drug use disorders from developing in the first place.
Preventing trauma from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. Safe and supportive environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships.
We also need to acknowledge the widespread impact of trauma and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals.
How about programs for perpetrators?
Most existing standard intervention programs for perpetrators do not consider the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have little or mixed effects on the behaviour of perpetrators.
But we could improve these programs with a coordinated approach including treating mental illness, drug use and trauma at the same time.
Such “multicomponent” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work.
What needs to happen next?
Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late.
We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined.
We also need to look more widely at preventing intimate partner violence and gendered violence.
We need developmentally appropriate education and skills-based programs for adolescents to prevent the emergence of unhealthy relationship patterns before they become established.
We also need to address the social determinants of health that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options.
All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors.
The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. In an emergency, call 000.
Siobhan O’Dean, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney; Lucinda Grummitt, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, and Steph Kershaw, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Tribulus Terrestris For Testosterone?
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(Clinical) Trials and Tribul-ations
In the category of supplements that have enjoyed use as aphrodisiacs, Tribulus terrestris (also called caltrop, goat’s head, gokshura, or puncture vine) has a long history, having seen wide use in both Traditional Chinese Medicine and in Ayurveda.
It’s been used for other purposes too, and has been considered a “general wellness” plant.
So, what does the science say?
Good news: very conclusive evidence!
Bad news: the conclusion is not favorable…
Scientists are known for their careful use of clinical language, and it’s very rare for a study/review to claim something as proven (scientists leave journalists to do that part), and in this case, when it comes to Tribulus’s usefulness as a testosterone-enhancing libido-boosting supplement…
❝analysis of empirical evidence from a comprehensive review of available literature proved this hypothesis wrong❞
Strong words! You can read it in full here; they do make some concessions along the way (e.g. mentioning unclear or contradictory findings, suggesting that it may have some effect, but by an as-yet unknown mechanism if it does—although some potential effect on nitric oxide levels has been hypothesized, which is reasonable if so, as NO does feature in arousal-signalling), but the general conclusion is “no, this doesn’t have androgen-enhancing properties”:
Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: Fact or Fiction
That’s a review though, what about taking a look at a representative RCT? Here we go:
❝Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone❞
As a performance-enhancer in sport
We’ll be brief here: it doesn’t seem to work and it may not be safe:
Insights into Supplements with Tribulus Terrestris used by Athletes
From sport, into general wellness?
Finally, a study that finds it may be useful for something!
❝Overall, participants supplemented with TT displayed significant improvements in lipid profile. Inflammatory and hematological biomarkers showed moderate beneficial effects with no significant changes on renal biomarkers. No positive effects were observed on the immune system response. Additionally, no TT-induced toxicity was reported.
In conclusion, there was no clear evidence of the beneficial effects of TT supplementation on muscle damage markers and hormonal behavior.❞
About those lipids…
Animal studies have shown that it may not only improve lipid profiles, but also may partially repair the endothelial dysfunction resulting from hyperlipidemia:
Want to try some?
In the unlikely event that today’s research review has inspired you with an urge to try Tribulus terrestris, here’s an example product on Amazon
If on the other hand you’d like to actually increase testosterone levels, then we suggest:
Topping Up Testosterone? ← a previous main feature did earlier this year
Take care!
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No, your aches and pains don’t get worse in the cold. So why do we think they do?
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It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather.
It’s a common idea, but a myth.
When we looked at the evidence, we found no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains.
So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on.
fongbeerredhot/Shutterstock Weather can be linked to your health
The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures may worsen asthma symptoms. Hot temperatures increase the risk of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease.
Many people are also convinced the weather is linked to their aches and pains. For example, two in every three people with knee, hip or hand osteoarthritis say cold temperatures trigger their symptoms.
Musculoskeletal conditions affect more than seven million Australians. So we set out to find out whether weather is really the culprit behind winter flare-ups.
What we did
Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies.
We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included.
We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry).
Bad back on a cold day? We wanted to know if the weather was really to blame. Pearl PhotoPix/Shutterstock What we found
We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis.
The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain.
In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis.
It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather.
The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions.
Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up.
Why do people blame the weather?
The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain.
For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know prolonged sitting, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your back and knee pain.
Likewise, changes in mood, often experienced in cold weather, trigger increases in both back and knee pain.
So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself.
Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the nocebo effect.
When it’s cold outside, we may be less active. Anna Nass/Shutterstock What to do about winter aches and pains?
It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather).
You can:
- become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool
- lose weight if obese or overweight, as this is linked to lower levels of joint pain and better physical function
- keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep less well in cold rooms
- maintain a healthy diet and avoid smoking or drinking high levels of alcohol. These are among key lifestyle recommendations to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with higher levels of physical function.
Manuela Ferreira, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, George Institute for Global Health and Leticia Deveza, Rheumatologist and Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Breakfasting For Health?
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Breakfast Time!
In yesterday’s newsletter, we asked you for your health-related opinions on the timings of meals.
But what does the science say?
Quick recap on intermittent fasting first:
Today’s article will rely somewhat on at least a basic knowledge of intermittent fasting, what it is, and how and why it works.
Armed with that knowledge, we can look at when it is good to break the fast (i.e. breakfast) and when it is good to begin the fast (i.e. eat the last meal of the day).
So, if you’d like a quick refresher on intermittent fasting, here it is:
Intermittent Fasting: We Sort The Science From The Hype
And now, onwards!
One should eat breakfast first thing: True or False?
True! Give or take one’s definition of “first thing”. We did a main feature about this previously, and you can read a lot about the science of it, and see links to studies:
The Circadian Rhythm: Far More Than Most People Know
In case you don’t have time to read that now, we’ll summarize the most relevant-to-today’s-article conclusion:
The optimal time to breakfast is around 10am (this is based on getting sunlight around 8:30am, so adjust if this is different for you)
It doesn’t matter when we eat; calories are calories & nutrients are nutrients: True or False?
Broadly False, for practical purposes. Because, indeed calories are calories and nutrients are nutrients at any hour, but the body will do different things with them depending on where we are in the circadian cycle.
For example, this study in the Journal of Nutrition found…
❝Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain.
Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.❞
Read in full: Meal Frequency and Timing Are Associated with Changes in Body Mass Index
We should avoid eating too late at night: True or False?
False per se, True in the context of the above. Allow us to clarify:
There is nothing inherently bad about eating late at night; there is no “bonus calorie happy hour” before bed.
However…
If we are eating late at night, that makes it difficult to breakfast in the morning (as is ideal) and still maintain a >16hr fasting window as is optimal, per:
❝the effects of the main forms of fasting, activating the metabolic switch from glucose to fat and ketones (G-to-K), starting 12-16 h after cessation or strong reduction of food intake❞
~ Dr. Françoise Wilhelmi de Toledo et al.
So in other words: since the benefits of intermittent fasting start at 12 hours into the fast, you’re not going to get them if you’re breakfasting at 10am and also eating in the evening.
Summary:
- It is best to eat breakfast around 10am, generally (ideally after some sunlight and exercise)
- While there’s nothing wrong with eating in the evening per se, doing so means that a 10am breakfast will eliminate any fasting benefits you might otherwise get
- If a “one meal a day, and that meal is breakfast” lifestyle doesn’t suit you, then one possible good compromise is to have a large breakfast, and then a smaller meal in the late afternoon / early evening.
One last tip: the above is good, science-based information. Use it (or don’t), as you see fit. We’re not the boss of you:
- Maybe you care most about getting the best circadian rhythm benefits, in which case, prioritizing breakfast being a) in the morning and b) the largest meal of the day, is key
- Maybe you care most about getting the best intermittent fasting benefits, in which case, for many people’s lifestyle, a fine option is skipping eating in the morning, and having one meal in the late afternoon / early evening.
Take care!
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Undo The Sun’s Damage To Your Skin
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It’s often said that our skin is our largest organ. Our brain or liver are the largest solid organs by mass (which one comes out on top will vary from person to person), our gut is the longest, and our lungs are the largest by surface area. But our skin is large, noticeable, and has a big impact on the rest of our health.
The sun is one of the main damaging factors for our skin; assorted toxins are also a major threat for many people, and once the skin barrier gets broken, it’s a field-day for bacteria.
So, what can we do about it?
Tretinoin: the skin’s rejuvenator
Tretinoin is also called retinoic acid, not to be mistaken for retinol, although they are both retinoids. Tretinoin is much stronger.
As for what it’s stronger at:
It’s usually prescribed for the treatment of sun-damage, acne, and wrinkles. Paradoxically, it works by inflaming the skin (and then making it better, and having done so, keeping it better).
In few words: it encourages your skin to speed up its life cycle, which means that cells die and are replaced sooner, which means the average age of skin cells will be considerably younger at any given time.
This is the same principle as we see at work when it comes to cellular apoptosis and autophagy in general, and specifically the same idea as we discussed when talking about senolytics, compounds that kill aging cells:
Fisetin: The Anti-Aging Assassin
About that paradoxical inflammation…
❝The topical use of tretinoin as an antiacne agent began almost a half century ago. Since that time it has been successfully used to treat comedonal and inflammatory acne.
Over the intervening years, the beneficial effects of tretinoin have grown from an understanding of its potent cornedolytie-related properties to an evolving appreciation of its antiinflammatory actions.
…
The topical use of clindamycin and tretinoin as a combination treatment modality that includes antibacterial, comedolytic, and antiinflammatoiy properties has proven to be a very effective therapy for treating the various stages of acne
…
It is now becoming increasingly clear that there may be good reasons for these observations.❞
~ Drs. Schmidt & Gans, lightly edited here for brevity
Read in full: Tretinoin: A Review of Its Anti-inflammatory Properties in the Treatment of Acne
Against damage by the sun
The older we get, the more likely sun damage is a problem than acne. And in the case of tretinoin,
❝In several well-controlled clinical trials, the proportion of patients showing improvement was significantly higher with 0.01 or 0.05% tretinoin cream than with placebo for criteria such as global assessment, fine and coarse wrinkling, pigmentation and roughness.
Improvements in the overall severity of photodamage were also significantly greater with tretinoin than with placebo.
…
Several placebo-controlled clinical studies have demonstrated that topical tretinoin has significant efficacy in the treatment of photodamaged skin. Improvements in subjective global assessment scores were recorded in:
49–100% of patients using once-daily 0.01% tretinoin,
68–100% of patients using 0.05% tretinoin, and
0–44% of patients using placebo.❞
~ Drs. Wagstaff & Noble
…which is quite compelling.
Read in full: Tretinoin: A Review of its Pharmacological Properties and Clinical Efficacy in the Topical Treatment of Photodamaged Skin
This is very well-established by now; here’s an old paper from when the mechanism of action was unknown (here in the current day, 17 mechanisms of action have been identified; beyond the scope of this article as we only have so much room, but it’s nice to see science building on science):
❝Tretinoin cream has been used extensively to reverse the changes of photoaging. It is the first topical therapy to undergo controlled clinical testing and proved to be efficacious. These results have been substantiated with photography, histopathologie examination, and skin surface replicas.
…
Tretinoin cream has an excellent safety record; a local cutaneous hypervitaminosis A reaction is the only common problem.❞
~ Dr. Goldfarb et al.
Read in full: Topical tretinoin therapy: Its use in photoaged skin
Is it safe?
For most people, when used as directed*, yes. However, it’s likely to irritate your skin at first, and that’s normal. If this persists more than a few weeks, or seems unduly severe, then you might want to stop and talk to your doctor again.
*See also: Scarring following inappropriate use of 0.05% tretinoin gel
(in the case of a young woman who used it 4x daily instead of 1x daily)
Want to try some?
Tretinoin is prescription-only, so speak with your doctor/pharmacist about that. Alternatively, retinal (not retinol) is the strongest natural alternative that works on the same principles; here’s an example product on Amazon 😎
Take care!
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Women’s Strength Training Anatomy – by Frédéric Delavier
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Fitness guides for women tend to differ from fitness guides for men, in the wrong ways:
“Do some squats and jumping jacks, and here’s a exercise for your abs; you too can look like our model here”
In those other books we are left wonder: where’s the underlying information? Where are the explanations that aren’t condescending? Where, dare we ask, is the understanding that a woman might ever lift something heavier than a baby?
Delavier, in contrast, delivers. With 130 pages of detailed anatomical diagrams for all kinds of exercises to genuinely craft your body the way you want it for you. Bigger here, smaller there, functional strength, you decide.
And rest assured: no, you won’t end up looking like Arnold Schwarzenegger unless you not only eat like him, but also have his genes (and possibly his, uh, “supplement” regime).
What you will get though, is a deep understanding of how to tailor your exercise routine to actually deliver the personalized and specific results that you want.
Pick Up Today’s Book on Amazon!
Not looking for a feminine figure? You may like the same author’s book for men:
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How the stress of playing chess can be fatal
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The death of a chess player in the middle of a match at the world’s most prestigious competition may have shocked those who view the game as a relaxing pastime. Kurt Meier, 67, collapsed during his final match in the tournament and died in hospital later that day. But chess, like any other game or sport, can lead to an immense amount of stress, which can be bad for a competitor’s physical health too.
We tend to associate playing sport or games with good health and well-being. And there are a countless number of studies showing playing games has an association with feeling happier. While this argument is true for recreational players, the story can be different for the elite, where success and failure are won and lost by the finest margins and where winning can mean funding and a future, and losing can mean poverty and unemployment. If this is the case, can being successful at a sport or game actually be bad for you?
Competitive anxiety
Elite competition can be stressful because the outcome is so important to the competitors. We can measure stress using a whole range of physiological indicators such as heart rate and temperature, and responses such as changes in the intensity of our emotions.
Emotions provide a warning of threat. So if you feel that achieving your goal is going to be difficult, then expect to feel intense emotions. The leading candidate that signals we are experiencing stress is anxiety, characterised by thoughts of worry, fears of dread about performance, along with accompanying physiological responses such as increased heart rate and sweaty palms. If these symptoms are experienced regularly or chronically, then this is clearly detrimental to health.
This stress response is probably not restricted to elite athletes. Intense emotions are linked to trying to achieve important goals and while it isn’t the only situation where it occurs, it is just very noticeable in sport.
The causes of stress
It makes more sense to focus on what the causes of stress are rather than where we experience it. The principle is that the more important the goal is to achieve, then the greater the propensity for the situation to intensify emotions.
Emotions intensify also by the degree of uncertainty and competing, at whatever level of a sport, is uncertain when the opposition is trying its hardest to win the contest and also has a motivation to succeed. The key point is that almost all athletes at any level can suffer bouts of stress, partly due to high levels of motivation.
A stress response is also linked to how performance is judged and reported. Potentially stressful tasks tend to be ones where performance is public and feedback is immediate. In chess – as with most sporting contests – we see who the winner is and can start celebrating success or commiserating failure as soon as the game is over.
There are many tasks which have similar features. Giving a speech in public, taking an academic examination, or taking your driving test are all examples of tasks that can illicit stress. Stress is not restricted to formal tasks but can also include social tasks. Asking a potential partner for a date, hand in marriage, and meeting the in-laws for the first time can be equally stressful.
Winning a contest or going on a date relate to higher-order goals about how we see ourselves. If we define ourselves as “being a good player” or “being attractive or likeable” then contrasting information is likely to associate with unpleasant emotions. You will feel devastated if you are turned down when asking someone out on a date, for instance, and if this was repeated, it could lead to reduced self-esteem and depression.
The key message here is to recognise what your goals are and think about how important they are. If you want to achieve them with a passion and if the act of achieving them leads to intense and sometimes unwanted emotions, then it’s worth thinking about doing some work to manage these emotions.
Andrew Lane, Professor in Sport and Learning, University of Wolverhampton
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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