Health & Fitness

Christmas is just as much about food as it is presents.

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Far from being a waste of time, sleep is required for the maintenance of metabolic and biological homeostasis in your body. Without proper sleep, you become more prone to chronic illness of all kinds — including diabetes,¹ heart disease,² neurodegeneration³ and cancer.⁴

According to recent research, lack of sleep can even impact your bone density and risk of osteoporosis (brittle bone), a condition that affects an estimated 10.3% of U.S. adults over the age of 50.⁵ With osteoporosis also comes the risk of bone fractures due to a fall, and hip fractures in particular are notorious for raising an older individual’s risk of death.⁶

An estimated 43.4 million older Americans also have low bone density,⁷ known as osteopenia, which raises your risk of fractures and may progress into osteoporosis.

While a number of nonmodifiable factors can influence your risk of osteoporosis, such as age, sex, ethnicity, family history and menopause (among women), there are also modifiable risk factors over which you have a significant degree of control.

These include diet, sun exposure to optimize your vitamin D level, smoking, exercise, alcohol consumption and use of certain medicines.⁸ To this list we can now also add sleep.

Short Sleep Associated With Low Bone Density

The study,^9,10,11 published in the November 2019 issue of the Journal of Bone and Mineral Research, which looked at postmenopausal women from the Women’s Health Initiative, found intriguing correlations between sleep duration and bone density.

Women who reported sleeping only five hours or less per night had, on average, 0.012 to 0.018 g/cm2 lower bone mineral density than those who slept seven hours or more. Bone density was checked in four sites: whole body, hip, femoral neck and spine. Short sleepers had lower bone density in all of these areas.

They were also 22% more likely to have osteoporosis of the hip, and 28% more likely to have osteoporosis of the spine. Lead author Heather M. Ochs-Balcom, associate professor of epidemiology at the University of Buffalo, told The New York Times:¹²

“The difference we observed between these two groups was equal to about one year of bone aging. This is not a huge difference, but it tells us that, in yet one more aspect of health, sleep is important. Any chance we have to spread the message to improve sleep could be helpful in other aspects of physical and mental health.”

Why Bisphosphonate Drugs Are Ill-Advised

The primary treatment for low bone density and osteoporosis in conventional medicine is the use of bisphosphonate drugs¹³ such as Fosamax. Unfortunately, these drugs can actually make matters worse rather than better, because while they do thicken bone, they make it mechanically weaker.

In my view, these drugs are best avoided, as they do not address the underlying problem. Research has shown bisphosphonate drugs increase your risk for femoral fractures — the very thing you’re trying to avoid, and Fosamax has been required to include a warning about atypical femur fractures on its package insert since 2011.¹⁴

These drugs have also been linked to osteonecrosis of the jaw¹⁵ (decay of the jawbone), inflammation of the eye,¹⁶ liver damage,¹⁷ a twofold risk of atrial fibrillation,¹⁸ esophageal cancer,¹⁹ kidney toxicity²⁰ and hypocalcemia²¹ (low blood calcium level).

Strong Evidence Osteoporosis Drugs Don’t Work as Advertised

Evidence showing that bisphosphonate drugs weaken bones was clearly detailed in a 2017 study,^22,23 which used a particle accelerator to generate detailed images of the internal structure of bone samples from 10 hip fracture patients treated with bisphosphonates, 14 fracture patients that were not treated with the drugs, and six nonfractured controls.

Results showed that, compared to patients that had not been treated with these drugs, bisphosphonate-treated hip bone was 28% weaker. Compared to nonfractured controls, their hip bone was 48% weaker.

Bisphosphonate-treated bone also had 24% more microcracks than samples of untreated fractured bone, and 51% more than nonfractured controls. Overall, bisphosphonate therapy was found to have “no detectable mechanical benefit in the specimens examined.”

On the contrary, the researchers pointed out the use of these drugs “was associated with substantially reduced bone strength,” and that this reduction in strength “may be due to the greater accumulation of microcracks and a lack of any discernible improvement in bone volume or microarchitecture.”

A second paper²⁴ published that same year in Scientific Reports suggested the accumulation of microcracks associated with bisphosphonate drug use might be the result of oversuppressed bone remodeling. According to the authors:²⁵

“Bisphosphonate-treated bone from fracture patients had the highest density and volume of microcracks compared to bone from the untreated fracture patients and healthy ageing individuals.

Correspondingly, bisphosphonate-treated samples also had reduced ultimate tensile strength … compared to the control groups. Our results, therefore, suggest that the reduced bone strength in the bisphosphonate group is due to the accumulation of microcracks.

In this subgroup of bisphosphonate-treated patients that suffered a fracture, the accumulation of microcracks following treatment with bisphosphonates may have compromised the trabecular microstructure. As a result, there may have been weakening of the bone and consequently, an increased risk of fracture.

Bisphosphonate-treated bone also demonstrated a lower density and volume of perforations compared to osteoporotic bone, which may be reflective of the protective effects of bisphosphonates in limiting the development of perforations through osteoclastic inhibition.

However, it is the oversuppression of remodeling that has detrimental effects, as this predisposes to microcrack accumulation and propagation.”

Osteogenic Loading Is Key for Strong Bones

If bisphosphonate drugs don’t do the trick, how can you safeguard yourself against osteoporosis? As mentioned, several lifestyle factors that you have full control over play important roles.

Aside from making sure you get at least seven hours of sleep each night — which may lower your risk of osteoporosis of the hip by 22% and spine osteoporosis by 28% — getting the right kind of loadbearing exercise is key for the maintenance of strong bones. There are four considerations to keep in mind though:

1. Low-impact resistance training, aerobic exercise and walking have all been shown to have little or no effect on bone loss²⁶
2. While there’s evidence to suggest moderate- to high-impact resistance training can benefit bone health,²⁷ heavy weightlifting may be unsuitable for the elderly and those with osteoporosis
3. Most load-bearing exercises still do not produce sufficient osteogenic load to effectively strengthen bone. Research²⁸ suggests the load needed to trigger bone growth in the hip is 4.2 times your bodyweight. This means if you weigh 150 pounds, you would have to deadlift more than 600 pounds to achieve results, which is impossible for most people
4. You need to eat enough protein to supply the bone with the raw material to make new bone. If you are on a protein-deficient diet you will increase your risk of osteoporosis

If conventional resistance training is inefficient at best, what can you do? Your best alternative is to find a training center or clinic that offers osteogenic loading therapy,^29,30,31,32 which allows you to achieve this level of force without risk or injury.

In a 2015 study³³ published in the Journal of Osteoporosis & Physical Activity, women diagnosed with osteopenia and osteoporosis (none of whom were on medication for it) who performed osteogenic loading-type resistance training saw a 14.9% increase in the density of the hip bone and a 16.6% increase in the density of the spine in just 24 weeks.

Blood Flow Restriction Training May Also Be Helpful

Another exercise strategy that appears to have a beneficial effect on bone health and can be safely performed by the elderly and the frail is blood flow restriction (BFR) training. BFR is a novel type of biohack that allows you to do strength exercises using just 20% to 30% of your max one-rep weight, while still reaping maximum benefits.

It involves performing strength training exercises while restricting venous blood flow return to your heart (but not arterial flow) to the extremity being worked. This is done by wrapping your arms or legs with a cuff that mildly restricts blood flow.

By forcing blood to remain inside your extremity while it is exercising with light weights, you stimulate metabolic changes resulting in greater strength with virtually no risk of injury.

There’s also some evidence it may improve your bone metabolism, although more research is still needed to confirm it and tease out the mechanisms. As noted in a 2018 systematic review of 170 articles looking at BFR’s impact on bone metabolism:³⁴

“… only four studies showed that BFR training increases the expression of bone formation markers (e.g. bone-specific alkaline phosphatase) and decreases bone resorption markers (e.g. the amino-terminal telopeptides of type I collagen) … across several populations.”

The 2012 paper, “Blood Flow Restriction: Rationale for Improving Bone,” hypothesized that the main mechanism behind favorable bone responses are a result of the “increased intramedullary pressure and interstitial fluid flow within the bone caused by venous occlusion.” For instructions and details about how to do BFR, sign up to receive my free BFR report.

Nutritional Considerations

Naturally, since bone is living tissue that’s constantly undergoing the addition of new bone cells and the removal of old ones, your basic metabolic fitness is a foundational aspect of maintaining healthy bone.

As noted in the paper “Naturopathic Approaches to Preventing and Treating Osteoporosis,”³⁵ published in the Natural Medicine Journal, “The best approach to getting sufficient nutrients to build and maintain strong bones is to consistently make healthy food choices.” That said, some nutrients are more important than others. Among the most important for bone health are:³⁶

Optimize Your Sleep for a Longer, Healthier Life

Getting back to the issue of sleep, recent research^46,47,48 also shows that sleeping less than six hours a night increases the risk of death in middle‐aged adults with cardiometabolic risk factors and those who have already developed cardiovascular and cerebrovascular diseases.

The adjusted hazard ratio for all-cause mortality among those who slept less than six hours and had cardiometabolic risk factors (high blood pressure, elevated glucose or Type 2 diabetes) was 2.14 times higher than those who regularly slept six hours or more.

They also had a 1.83 times higher risk of dying from cardiovascular or cerebrovascular diseases. Among those with a diagnosis of heart disease or stroke, sleeping less than six hours a night increased their all-cause mortality risk by 3.17 times. Interestingly, it also increased their risk of dying from cancer, specifically, by 2.92 times.

Considering the importance of sleep for preventing chronic diseases that will cut your life short, you’d be wise to address any sleep problems you may be having, and make sure you’re getting about eight hours every night. For many, this means forgoing night-owl tendencies and getting to bed at a reasonable time.

If you need to be up at 6 a.m., you need a lights-out deadline of 9:30 or 10 p.m., depending on how quickly you tend to fall asleep. If you find it difficult to get to bed on time, consider setting a bedtime alarm to remind you that it’s time to shut everything down and get ready for sleep. For guidance on how to improve your sleep quality, see my “Top 33 Tips to Optimize Your Sleep Routine.”

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Medical marijuana, which refers to the use of the whole, unprocessed marijuana plant or its extracts for medicinal purposes, has generated a lot of excitement for its potential role in treating diseases ranging from anorexia to Alzheimer’s.¹

While the plant has impressive medicinal properties that are still being explored, emerging research also suggests that frequent cannabis use may be linked to heart risks, including an increased risk of heart attack and stroke.

The findings highlight the need for increased research into the most effective dosages and routes of administration for medical marijuana while also pointing to potential dangers for frequent recreational users.

Frequent Cannabis Use Linked to Erratic Heartbeat

In the first preliminary study, presented at a 2019 meeting of the American Heart Association (AHA) in Philadelphia, young people diagnosed with a cannabis (marijuana) use disorder had a 47% to 52% greater risk of being hospitalized for irregular heartbeat, also known as arrhythmia, compared to those without the disorder.²

It’s estimated that 2.5% of U.S. adults, or nearly 6 million people,³ may struggle with cannabis use disorder, a condition characterized by cravings for cannabis, recurrent cannabis use that leads to problems at school, work or home, unsuccessful efforts to cut down on cannabis use and other factors.

Generally speaking, the disorder is defined as, “A problematic pattern of cannabis use leading to clinically significant impairment or distress.”⁴ For the study, researchers used data from more than 67.5 million hospital patients, revealing that those aged 25 to 34 who compulsively used cannabis were 52% more likely to be hospitalized for irregular heartbeat, as were 28% of compulsive cannabis users aged 15 to 24.⁵

The effects on heartbeat depended on the dose, according to Dr. Rikinkumar Patel of Griffin Memorial Hospital in Norman, Oklahoma, who said in an AHA news release:⁶

"The effects of using cannabis are seen within 15 minutes and last for around three hours. At lower doses, it is linked to a rapid heartbeat. At higher doses, it is linked to a too-slow heartbeat …

The risk of cannabis use linked to arrhythmia in young people is a major concern, and physicians should ask patients hospitalized with arrhythmias about their use of cannabis and other substances because they could be triggering their arrhythmias.

Young Cannabis Users at Increased Risk of Stroke

The second study, which was also presented at the 2019 meeting of the AHA in Philadelphia, involved more than 43,000 adults between the ages of 18 and 44. Nearly 14% had reported using cannabis in the previous 30 days.

Among those who used cannabis for more than 10 days a month, stroke risk increased by nearly 2.5 times compared to nonusers.⁷ Frequent cannabis users who also smoked cigarettes or used e-cigarettes had an even greater risk of stroke — more than three times that of nonusers. Lead study author Tarang Parekh of George Mason University in Fairfax, Virginia, explained in a news release:⁸

“Young cannabis users, especially those who use tobacco and have other risk factors for strokes, such as high blood pressure, should understand that they may be raising their risk of having a stroke at a young age … Physicians should ask patients if they use cannabis and counsel them about its potential stroke risk as part of regular doctor visits.”

The study was observational in nature and does not prove that using cannabis caused the increased stroke risk, only that an association exists. However, past research has also found links between cannabis use and heart risks, as smoking marijuana is known to increase heart rate and blood pressure, and may increase the risk of heart attack in young men.⁹

This is particularly true in the first hour after marijuana usage, when the risk of heart attack by increase by a factor of 4.8. Daily marijuana users may also increase their annual risk of heart attack from 1.5% to 3% per year,¹⁰ possibly due to coronary arterial vasospasm, which is a muscle constriction of the coronary artery.

Cannabis Use Increases Heart Attack Risk in Youth

A separate study aimed at evaluating the risk of various substances on heart attacks in youth aged 15 to 22 years also found that cannabis increased the risk.¹¹ Cannabis users in this age group had a 30% higher risk of heart attack compared to nonusers, while cocaine users’ heart attack risk was 3.9 times higher, and amphetamine users’ 2.3 times higher, compared to nonusers of those drugs.¹²

Further, 14.7% of cannabis users had severe illness when they were admitted — a higher proportion of severe illness cases compared to cocaine and amphetamine users. Cannabis users also had a higher mean total charge for their stay, coming in at $53,608.¹³

“Our study demonstrates a higher prevalence and a significant odds ratio of (acute heart attack) in the younger population with cannabis use, along with the potential cost burdens because of severity of illness, extended length of hospitalization, and higher use of treatment modalities,” the researchers noted.¹⁴

What’s more, 2% of the cannabis users who were hospitalized for heart attacks died during their stays, compared to none of the other drug users.¹⁵ It’s an interesting finding, particularly since lethal overdoses from cannabis and cannabinoids do not occur, as there are no cannabinoid receptors in the brainstem areas that control respiration.¹⁶

How Do Cannabinoids Affect Your Cardiovascular System?

While research suggests marijuana use may not significantly affect long-term mortality, people with a history of heart disease or heart problems may be at increased risk of marijuana’s heart effects, in part due to the actions of cannabinoids. Cannabis contains more than 100 unique cannabinoids, which bind to receptors in your body.

Cannabinoids interact with your body by way of naturally occurring cannabinoid receptors embedded in cell membranes throughout your body. There are cannabinoid receptors in your brain, lungs, liver, kidneys, immune system and more; the therapeutic (and psychoactive) properties of marijuana occur when a cannabinoid activates a cannabinoid receptor.

Tetrahydrocannabinol (THC), the compound responsible for marijuana’s psychoactive effects, is one type of cannabinoid. Cannabidiol (CBD), the nonpsychoactive component of cannabis, is another, which has previously been found to offer many benefits for pain relief, seizures and other health conditions. As far as your heart health is concerned, Harvard Medical School noted:¹⁷

“One of the few things scientists know for sure about marijuana and cardiovascular health is that people with established heart disease who are under stress develop chest pain more quickly if they have been smoking marijuana than they would have otherwise.

This is because of complex effects cannabinoids have on the cardiovascular system, including raising resting heart rate, dilating blood vessels, and making the heart pump harder. Research suggests that the risk of heart attack is several times higher in the hour after smoking marijuana than it would be normally.

While this does not pose a significant threat to people who have minimal cardiovascular risk, it should be a red flag for anyone with a history of heart disease. Although the evidence is weaker, there are also links to a higher risk of atrial fibrillation or ischemic stroke immediately following marijuana use.”

Is Cannabis Linked to Schizophrenia?

Another area that deserves more research is marijuana’s potential link to mental health disorders, including schizophrenia. Cannabis use is associated with schizophrenia, particularly in young people who use it frequently.¹⁸

There could be a genetic variable at play as well, as if you have a type of AKTI gene, your risk of developing a psychotic disorder if you use cannabis increases. This is again intensified in frequent users, as daily cannabis users who have the genetic variant have a sevenfold increased risk of psychosis compared with daily users who do not have the genetic variation.¹⁹

It’s also been suggested that cannabis use by adolescents and young adults may increase the risk of schizophrenia in later life. Researchers wrote in World Psychiatry:²⁰

“There is now reasonable evidence from longitudinal studies that regular cannabis use predicts an increased risk of schizophrenia and of reporting psychotic symptoms. These relationships have persisted after controlling for confounding variables such as personal characteristics and other drug use.

… A contributory causal relationship is biologically plausible because psychotic disorders involve disturbances in the dopamine neurotransmitter system with which the cannabinoid system interacts, as has been shown by animal studies and a human provocation study.”

Medical Marijuana Benefits

While there are risks to cannabis use to be aware of, through traditional plant breeding techniques and seed exchanges, growers have started producing cannabis plants that have higher levels of CBD and lower levels of THC for medical use.

It’s likely that both THC and CBD have a beneficial role in health. One study even found that CBD may buffer some of the psychoactive effects of THC and the two compounds may offer greater therapeutic results when administered together than alone.²¹

In states where medical cannabis is legal, its use may be allowed under certain medical circumstances only, and some allow only CBD oils or pills. What are people using it for? Pain and anxiety are top uses, but there is also potential for its use as a cancer treatment²² and much more, as cannabinoids have shown promise for a variety of medical uses, including:²³

Multiple sclerosis	Anorexia
Irritable bowel syndrome	Huntington’s disease
Addiction	Eye diseases
Chemotherapy-associated nausea and vomiting	Inflammatory and neuropathic pain
Post-traumatic stress disorder	Anxiety disorders

Further, THC may offer hope for treating Alzheimer’s disease, according to a study on mice.²⁴ A low dose of THC even reversed age-related decline in cognitive performance of mice aged 12 and 18 months.²⁵

Cannabinoids May Benefit Heart Health and More

The fact is, it’s cannabinoids’ versatility that makes them so exciting. While cannabis has been linked to some heart risks, CBD has been found to lower blood pressure during times of stress²⁶ and protect stroke patients from brain damage.²⁷

Because cannabinoids work via multiple mechanisms, it’s possible they could be useful not only for certain aspects of heart health and Alzheimer’s but also for Parkinson’s disease, brain tumors, epilepsy and traumatic brain injury. Researchers writing in Frontiers in Integrative Neuroscience noted:²⁸

“The inherent polypharmaceutical properties of cannabis botanicals offer distinct advantages over the current single-target pharmaceutical model and portend to revolutionize neurological treatment into a new reality of effective interventional and even preventative treatment.”

If you’re considering the use of medical marijuana, and you live in a state where it’s legal, you can get a recommendation for a medical cannabis card from your physician, then join a collective, which is a group of patients that can grow and share cannabis medicines with each other. By signing up as a member, you gain the right to grow and share your medicine.

There are different ways to administer medical marijuana, ranging from inhalation, vaporization and smoking to sublingual (under the tongue), oral ingestion and topically. The best form for you will depend on your medical needs, so ideally work with an experienced physician to determine the best route of administration and dosage.

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It’s easy to diss Kim Kardashian, the woman who is famous for being famous.

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In the last decade, scientists discovered that blocking a key regulator of the immune system helped unleash the body's natural defenses against several forms of cancer, opening up a new era of cancer immunotherapy. Now scientists have essentially flipped this script and found that when impaired a molecularly similar regulator can cause the damaging immune system attacks on skin and organs that are the hallmark of the autoimmune disease lupus.

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An algorithm akin to the annoyingly helpful one that attempts to auto-complete text messages and emails is now being harnessed for a better cause. A group of researchers are using its pattern-recognition ability to identify microbial communities in the body by sifting through volumes of genetic code. Their method could speed the development of medical treatments for microbiota-linked ailments like Crohn's disease.

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If your pals are keen to reduce waste, an experiential present will light up their planet-loving hearts this Christmas.

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On Tuesday, Sydney residents woke up to a sky so full of smoke that it felt like inhaling into an ashtray.

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Sydney-based nutritionist and wholefoods chef, Jacqueline Alwill, shares her flavoursome gluten-free tart recipe that's sure to light up your Christmas table.

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A team of researchers has now identified a specific circuit in the brain that alters food impulsivity.

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A team of researchers has now identified a specific circuit in the brain that alters food impulsivity.

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Scientists from Australia and the US have discovered and identified the genetic cause of a previously unknown human autoinflammatory disease. The researchers determined that the autoinflammatory disease, which they termed CRIA (cleavage-resistant RIPK1-induced autoinflammatory) syndrome, is caused by a mutation in a critical cell death component called RIPK1. The discovery suggests that compounds that inhibit cell death might be useful in treating autoinflammatory diseases.

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Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, experts assert.

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Emphasis on particular groups hinders efforts to address the problem of declining physical activity in children, according to a new study.

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Scientists have created the largest phosphoproteome resource to date, which is set to help other researchers identify new functionally-relevant phosphosites. The research demonstrates an exciting use for machine learning methods to effectively compile and analyse large phosphorylation related biological datasets. Identifying new functional phosphosites has enormous potential to progress research into many biological processes and diseases.

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Targeted immunization against bacterial flagellin, a protein that forms the appendage that enables bacterial mobility, can beneficially alter the intestinal microbiota, decreasing the bacteria's ability to cause inflammation and thus protecting against an array of chronic inflammatory diseases, according to a new study.

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Researchers have successfully used stem cells to engineer living biohybrid nerve tissue to develop 3D models of neural networks with the hopes of gaining a better understanding of how the brain and these networks work.

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Scientists have shown that worms live longer lives if they produce excess levels of a protein, p62, which recognizes toxic cell proteins that are tagged for destruction. The discovery could help uncover treatments for age-related conditions, such as Alzheimer's disease, which are often caused by accumulation of misfolded proteins.

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Computer scientists have taken a deep learning method that has revolutionized face recognition and other image-based applications in recent years and redirected its power to explore the relationship between genes.

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Fresh insights into damaging proteins that build up in the brains of people with Alzheimer's disease could aid the quest for treatments.

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Researchers have discovered how viruses that specifically kill bacteria can outwit bacteria by hiding from their defences, findings which are important for the development of new antimicrobials based on viruses and provide a significant advance in biological knowledge.

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Neurons in the brain's motor cortex previously thought of as active mainly during hand and arm movements also light up during speech in a way that is similar to patterns of brain activity linked to these movements, suggest new findings.

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Scientist hopes 'blueprint' leads to a new golden age of healthcare.

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By analysing almost daily water samples taken from the same river from 1940 until today, researchers have confirmed their hypothesis that the browning of lakes is primarily due to the increase in coniferous forests, as well as rainfall and sulphur deposits.

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A new study reveals that 90 percent of Utah urban dust comes from dry lakebeds, which not only impacts air quality but also impacting soil and what can grow in it.

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Researchers in OIST's Molecular Genetics Unit, in collaboration with a researcher from Australia, have identified a new species of bobtail squid inhabiting Okinawa's waters -- dubbed Euprymna brenneri. The scientists' findings, published in Communications Biology, highlight the rich biodiversity in the seas near Okinawa, and may shed light on the genes, behavior, and development of bobtail squid.

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In 2018, the number of bacterial sexually transmitted infections (STIs) reported in the United States reached an all-time high. This is worrisome for many reasons. Having an STI can raise risks for HIV, infertility, pregnancy complications, and infant death. Fortunately, all of these outcomes can be avoided if people receive appropriate treatment.

What are STIs?

STIs are illnesses caused by microorganisms passed between people during sex. An STI can affect anyone who is exposed to it. Syphilis, gonorrhea, and chlamydia are the most common bacterial infections. Trichomoniasis, a protozoan infection, is also diagnosed frequently in women (men who are affected almost never have symptoms).

A number of viruses can be sexually transmitted, including herpes simplex virus (HSV), human papilloma virus (HPV), HIV, hepatitis A, hepatitis B, and hepatitis C.

What are the symptoms of an STI?

New rashes on or near the genitals or elsewhere on the body, swollen lymph nodes, fevers, or discharge from the penis, vagina, or anus could all be signs of an STI. While many people who have STIs notice such symptoms, some STIs are asymptomatic and can only be identified by screening tests. For example, estimates suggest chlamydia affects close to three million Americans each year, yet symptoms may only occur in 5% to 30% of people. Other STIs, like Mycoplasma genitalium, may not cause symptoms and can be hard to diagnose.

Why are sexually transmitted infections increasing?

There are many reasons, including:

• Not using barriers — such as condoms and dental dams — during sex. Although condoms can prevent transmission of most STIs, many people of all ages and genders do not use them.
• Changing attitudes and knowledge around HIV may give some people a false sense of safety about unprotected sex. A new World Health Organization campaign (undetectable equals untransmissible, or U = U) notes that HIV is unlikely to be transmitted by a person with undetectable levels of the virus due to treatment. Similarly, HIV prevention strategies like pre-exposure prophylaxis (PrEP) may make some people feel less concerned about having unprotected sex.
• Significant budget cuts to local and state STI programs in recent years. This has led to facility closures and fewer sites for screening. New federal restrictions on family planning organizations like Planned Parenthood, which provides sexual health care and STI screening and treatment for hundreds of thousands of Americans, make widespread access to care increasingly hard.

Who should be tested for STIs?

If you think you might have symptoms of an STI or are concerned about recent sexual contacts, it’s best to be tested. Additionally, the United States Preventive Services Task Force (USPSTF) recommends routine screening in sexually active young women, men who have sex with men, and others at high risk for STIs, including anyone who has unsafe sex or shares needles or equipment used to inject drugs, including cottons and cookers.

If you would like to be tested for STIs, this locator tool may help you find a testing site in your area. Some testing sites are free and confidential.

What else should I know about STIs and testing?

STIs can infect any mucosal tissue exposed to the infection, such as the throat, anus, rectum, and genitals. The CDC recommends checking men who have sex with men at all three sites because studies show this helps identify more infections. A recent study reviewed screening results from 2,627 women who came to a sexually transmitted diseases clinic in Rhode Island. Among women who chose to have a multisite screening test, researchers found that 19% of chlamydia and gonorrhea infections would have been missed with genital screening only.

If you have unprotected sexual contact, STI testing should include

• the throat (for unprotected oral sex)
• the rectum (for unprotected anal sex)
• the penis or vagina (for unprotected penile or vaginal intercourse).

Keep in mind that STIs can also be spread by fingers and sex toys. A detailed sexual history is important to determine what sites need to be tested.

What can I do to prevent infections?

The best ways to prevent sexually transmitted infections are:

• Talk openly about your sexual practices with your partners and health care providers.
• Regularly test for STIs.
• Use barrier protection — like condoms and dental dams — when engaging in oral, anal, or vaginal sex.
• Ask your doctor if you should consider pre-exposure prophylaxis (PrEP), a daily pill that protects against HIV infection.
• Get vaccinated against HPV. This helps protect against HPV-related cancers of the cervix, genitals, anus, mouth, and throat. Vaccines are also available to protect against Hepatitis A and B.

If you do have an STI, make sure you get appropriate treatment. Additionally, consider using expedited partner therapy, an approach where a person diagnosed with gonorrhea or chlamydia receives a prescription for antibiotics for their partner. This is allowed in most states and has been shown to prevent recurrent infections by decreasing the number of people who continue to have sex with an untreated partner.

Where does all of this leave you?

Sexually transmitted infections are preventable and treatable. Good sexual health requires talking to your partners and health care providers openly about your sexual practices, being tested at all relevant sites on the body and, if necessary, being treated promptly. For more information, see the CDC fact sheets on STIs or learn more from TheBody.com.

The post Sexually transmitted infections are on the rise: Should you worry? appeared first on Harvard Health Blog.

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