Medical myths: All about diabetes

Globally, diabetes is becoming increasingly prevalent, as are the myths and misconceptions that surround it. Here, we discuss 11 of these repeated untruths.

Currently, around 1 in 10 people in the United States have diabetes. Globally, more than 422 million people are living with the disease.

Although diabetes is a familiar word, symptoms vary, and the biological mechanisms involved are complex. Because it is both common and complicated, half-truths abound.

Unfortunately, some of the myths we cover in this article increase the stigma attached to diabetes. For this reason alone, it is essential to challenge these falsehoods.

Firstly, we will briefly explain what diabetes is and highlight the differences between the three most common forms of diabetes: type 1, type 2, and gestational diabetes.

Type 1 diabetes is an autoimmune disease in which the immune system attacks the pancreas cells that create insulin. It tends to occur earlier in life than type 2 diabetes. In type 2 diabetes, the body does not make enough insulin, does not respond well to insulin, or both.

At least 90% of people with diabetes in the U.S. have type 2.

Gestational diabetes, as the name suggests, occurs during pregnancy. During pregnancy, the body needs more insulin. Gestational diabetes occurs when the body cannot meet these new requirements.

Although gestational diabetes usually goes away after birth, there is a risk of developing it again during future pregnancies and developing type 2 diabetes later in life.

1. Eating sugar causes diabetes

Eating sugar does not directly cause diabetes. However, consuming a sugary diet can lead to overweight and obesity, which are risk factors for type 2 diabetes.

This is a common myth, perhaps understandably — blood sugar levels play an essential role in diabetes. Sugar itself, though, is not a causal factor.

As ever, the story is complex: there does appear to be a link between regularly drinking soda and risk for type 2 diabetes.

One large study published in 2013 found that, even after controlling for energy intake and body mass index (BMI), drinking soda has links with an increased risk of developing the disease. The study did not find this association in relation to other drinks, such as artificially-sweetened beverages and fruit juices.

Scientists still do not understand why some people develop type 1 diabetes, and others do not. However, nutrition is not a risk factor.

2. Diabetes is not serious

Perhaps because diabetes is so common, some people believe that it is not a serious disease. This is incorrect. There is no cure for diabetes, and there are a host of complications that can occur if a person does not manage the condition well.

Complications include cardiovascular disease, nerve damage, kidney damage, blindness, skin conditions, and hearing impairment.

In 2018, diabetes was the underlying cause of 84,946 deaths in the U.S. The World Health Organization estimate that diabetes caused the death of 1.6 million people in 2016.

3. Diabetes only affects people with obesity

Overweight and obesity are risk factors for type 2 diabetes and gestational diabetes, but the condition can occur in people of any weight. According to data from the Centers for Disease Control and Prevention (CDC) National Diabetes Statistic Report, 2020, 11% of people with type 2 diabetes in the U.S. are neither overweight nor obese.

Type 1 diabetes has no associations with body weight.

4. Obesity always leads to diabetes

Although obesity increases the risk of diabetes, it does not inevitably lead to the disease. According to the CDC, an estimated 39.8% of adults in the U.S. have obesity, but 13% have diabetes.

5. People with diabetes cannot eat sugar

People with diabetes certainly do need to manage their diets carefully: monitoring carbohydrate intake is important. However, they can still incorporate treats.

The American Diabetes Association explain:

“The key to sweets is to have a very small portion and save them for special occasions, so you focus your meals on healthier foods.”

Individuals with diabetes need to carefully plan what and when they will eat to ensure that their blood sugar levels remain balanced.

A related myth is that people with diabetes need to eat special “diabetes-friendly” foods. These products are often more expensive, and some can still raise glucose levels.

6. Diabetes always leads to blindness and amputation

Thankfully, this is a myth. While it is true that diabetes can lead to blindness and amputations in some cases, it is not inevitable. And for individuals who manage their condition carefully, these outcomes are rare.

The CDC estimate that 11.7% of adults with diabetes have some level of vision impairment. Lower-extremity amputation occurs in around 0.56% of people with diabetes in the U.S.

Experts have identified several risk factors that increase the likelihood of experiencing diabetes-related complications. These include obesity and overweight, smoking, physical inactivity, high blood pressure, and high cholesterol.

7. People with diabetes should not drive

A diabetes diagnosis does not automatically mean that someone needs to stop driving. In a position statement on diabetes and driving, the American Diabetes Association explain:

“Most people with diabetes safely operate motor vehicles without creating any meaningful risk of injury to themselves or others.”

However, they also explain that, if concerns arise, people should undergo assessment on an individual basis. According to the U.S. Department of Transportation:

“People with diabetes are able to drive unless they are limited by certain complications of diabetes. These include severely low blood glucose levels or vision problems. If you are experiencing diabetes-related complications, you should work closely with your diabetes healthcare team to find out if diabetes affects your ability to drive.”

8. Prediabetes always leads to diabetes

In the U.S., an estimated 88 million, or 1 in 3, adults have prediabetes. Prediabetes is a condition where blood sugar levels are higher than normal but not quite high enough to classify as diabetes. If left unchecked, prediabetes can develop into type 2 diabetes.

However, it is not a given. Lifestyle changes can turn the tide. Regular physical activity and a more healthful diet can stop diabetes in its tracks.

9. People with diabetes cannot be active

Once again, this is untrue. In fact, exercise is an important component in the management of diabetes. Among other things, exercise helps drive weight loss and reduces blood pressure, both of which are risk factors for complications. It can also help the body use insulin better.

However, exercise can impact blood sugar levels in various ways, sometimes increasing it and, at other times, decreasing it.

According to Diabetes U.K., “Some days, you’ll do exactly the same type of activity and eat the same foods, but your blood sugar levels may act differently to what you’d expect.”

They also offer tips for managing blood sugar during activity:

  • Check your blood sugar while exercising and keep a record of how it behaves to show your doctor. This can help guide any necessary changes in insulin.
  • For people who are at risk of hypos, keep fast-acting carbohydrates close to hand.
  • Wear diabetes identification so that people can help if needed.

10. You can ‘catch’ diabetes

This is a myth. Pathogens do not cause diabetes, so a person cannot pass it to someone else. Doctors classify it as a noncommunicable disease.

11. Some natural products cure diabetes

Currently, there is no cure for diabetes. Any claims that a product can cure diabetes are false. Many herbal or natural products will do little or nothing and, in some cases, they can potentially cause harm; diabetes.co.uk explain:

“Because certain herbs, vitamins, and supplements may interact with diabetes medications (including insulin) and increase their hypoglycemic effects, it is often argued that using natural therapies could reduce blood sugars to dangerously low levels and raise the risk of other diabetes complications.”

Diabetes is a complex but common disease. As its prevalence increases, it is essential to overturn myths as we find them.

Everything you need to know about plant based diets

A plant based diet is one that focuses on only or mostly foods from plant sources. This way of eating may have benefits for both a person’s health and the planet.

In this article, we look at what a plant based diet is, the health benefits, and what nutritional considerations a person should make before switching.

What is a plant based diet?

A plant based diet is a diet that involves consuming mostly or only on foods that come from plants. People understand and use the term plant based diet in different ways.

Some people interpret it as a vegan diet, which involves avoiding all animal products.

For others, a plant based diet means that plant foods, such as fruits, vegetables, whole grains, nuts, and legumes, are the main focus of their diet, but they may, occasionally, consume meat, fish, or dairy products.

A plant based diet also focuses on healthful whole foods, rather than processed foods.

Health benefits

Following a plant based diet offers many possible health benefits, including:

Better weight management

Research suggests that people who eat primarily plant based diets tend to have a lower body mass index (BMI) and lower rates of obesity, diabetes, and heart disease than those who eat meat.

Plant based diets are high in fiber, complex carbohydrates, and water content from fruit and vegetables. This may help to keep people feeling fuller for longer and increase energy use when resting.

A 2018 study found that a plant based diet was effective for treating obesity. In the study, researchers assigned 75 people who were overweight or had obesity to either a vegan diet or a continuation of their regular diet, which contained meat.

After 4 months, only the vegan group showed a significant weight loss of 6.5 kilograms (14.33 pounds). The plant based vegan group also lost more fat mass and saw improvements in insulin sensitivity, whereas those who consumed a regular diet with meat did not.

A 2009 study on more than 60,000 people also found that vegans had the lowest average BMI, followed by lacto-ovo vegetarians (those that eat dairy and eggs) and pescatarians (people who eat fish but no other meat). The group with the higher average BMI were nonvegetarians.

Lower risk of heart disease and other conditions

A 2019 study from the Journal of the American Heart Association found that middle aged adults who ate diets high in healthful plant foods and low in animal products had a lower risk of heart disease.

According to the American Heart Association, eating less meat can also reduce the risk of:

  • stroke
  • high blood pressure
  • high cholesterol
  • certain cancers
  • type 2 diabetes
  • obesity

Diabetes prevention and treatment

Plant based diets may help people prevent or manage diabetes by improving insulin sensitivity and reducing insulin resistance.

Of the 60,000 people studied in 2009, only 2.9% of people on a vegan diet had type 2 diabetes, compared to 7.6% of those eating a nonvegetarian diet.

People eating vegetarian diets that included dairy and eggs also had a lower risk of type 2 diabetes than meat eaters.

Researchers have also looked at whether following a plant based diet can help treat diabetes. The authors of a 2018 review indicate that vegetarian and vegan diets could help people with diabetes reduce their medication needs, lose weight, and improve other metabolic markers.

The authors suggested that doctors might consider recommending plant based diets to people with prediabetes or type 2 diabetes. While veganism showed the most benefits, the researchers stated that all plant based diets would lead to improvements.

People wanting to try a plant based diet should try one that they think they can follow long term.

Foods to eat

People should focus on eating the following food groups when transitioning to a plant based diet:

Fruits

A plant based diet includes all fruits, such as:

  • berries
  • citrus fruits
  • bananas
  • apples
  • grapes
  • melons
  • avocado

Vegetables

A healthful plant based diet contains plenty of vegetables. Including a variety of colorful vegetables provides a wide range of vitamins and minerals.

Examples include:

  • broccoli
  • kale
  • beetroot
  • cauliflower
  • asparagus
  • carrots
  • tomatoes
  • peppers
  • zucchini

Root vegetables are a good source of carbohydrates and vitamins. They include:

  • sweet potato
  • potatoes
  • butternut squash
  • beets

Legumes

Legumes are an excellent source of fiber and plant based protein. People can include a wide variety in their diet, including:

  • chickpeas
  • lentils
  • peas
  • kidney beans
  • black beans

Seeds

Seeds are a great snack or an easy way to add extra nutrients into a salad or on top of a soup.

Sesame seeds contain calcium and sunflower seeds are a good source of vitamin E. Other seeds include:

  • pumpkin
  • chia
  • hemp
  • flax

Nuts

Nuts are a good source of plant based protein and vitamins, such as selenium and vitamin E.

  • brazil
  • almonds
  • cashews
  • pecans
  • macadamia
  • pistachios

Healthful fats

It is vital to consume polyunsaturated and monounsaturated fats, as well as omega-3 fatty acids. Plant based sources include:

  • avocados
  • walnuts
  • chia seeds
  • hemp seeds
  • flaxseed
  • olive oil
  • canola oil

Whole grains

Whole grains are an excellent source of fiber and help maintain stable blood sugar. They also contain essential minerals, such as magnesium, copper, and selenium.

Examples of whole grains include:

  • brown rice
  • oats
  • spelt
  • buckwheat
  • quinoa
  • wholegrain bread
  • rye
  • barley

Plant based milk

If people want to reduce their dairy intake, there is a wide range of plant based milk available in grocery stores and online. These include:

  • almond
  • soy
  • coconut
  • rice
  • oat
  • hemp

Just make sure to choose unsweetened plant milk options.

Foods to avoid

Just reducing or eliminating animal products does not automatically mean a plant based diet is healthful. It is also vital to reduce or avoid unhealthful foods, such as:

  • processed foods
  • sugary foods, such as cakes, biscuits, and pastries
  • refined white carbohydrates
  • processed vegan and vegetarian alternatives that may contain a lot of salt or sugar
  • excess salt
  • fatty, greasy, or deep fried foods

Considerations

Before starting a plant based diet, people should ensure they take steps to get enough of the following nutrients:

Vitamin B-12

Vitamin B-12 is an essential nutrient for blood and cell health. B-12 deficiency can lead to anemia and nerve damage. B-12 is present in many animal products but not in many plant based foods.

People who eat a vegan or even a vegetarian diet could consider taking a B-12 supplement or consume products fortified with B-12. Foods include some cereals, plant based milk, and nutritional yeast.

Iron

People following a plant based diet may have to ensure they get enough iron in their diet, as it has lower bioavailability in plants than meat.

Plant based foods that are a good source of iron include:

  • kidney beans
  • black beans
  • soybeans
  • spinach
  • raisins
  • cashews
  • oatmeal
  • cabbage
  • tomato juice
  • dark leafy greens

Make sure to combine citrus and other vitamin C sources with plant based sources of iron to increase absorption.

Protein

Some people may have concerns about getting enough protein from a plant based diet. However, there is a wide variety of plant based sources of protein, including:

  • lentils
  • chickpeas
  • quinoa
  • beans, such as kidney, pinto, or black beans
  • tofu
  • mushrooms
  • nuts
  • seeds

Consuming proteins from a variety of food sources can help provide all the necessary amino acids for good health. For example, people could add a handful of seeds or a spoonful of hummus to tofu or beans.

Omega-3 fatty acids

Omega-3 fatty acids are essential as they help reduce inflammation, memory loss, and other chronic conditions, such as heart disease. The two primary omega-3 fatty acids are EPA and DHA.

Fish, seafood, and animal products, such as eggs are among the primary sources EPA and DHA.

While several plant based foods, such as walnuts, hempseed, and flaxseed, contain omega-3 ALA, research shows that the body is slow and inefficient at converting ALA to EPA and DHA. Some people are also genetically at risk for poor absorption of ALA.

Vegetarians exhibit lower levels of DHA and EPA in blood and tissue, which may increase inflammation, memory difficulties, brain fog, and other effects. People following a plant based diet might want to consider taking an omega-3 supplement.

Some dietitians advise vegetarians to reduce the amount of pro-inflammatory linoleic acid they consume. Soybean, corn, sunflower, and safflower oils contain linoleic acid.

Summary

Eating a diet higher in plant foods and lower in animal products can have many health benefits, including weight loss or maintenance and a lower risk of heart disease and diabetes.

If people want to make the switch to a plant based diet, they can start by gradually reducing their meat and dairy intake.

Eating an entirely plant based meal once a week, or swapping out one animal product for a plant based one, can be an excellent place to start.

People may also wish to speak to a doctor or dietitian before making significant changes in their diet.

5 common myths about obesity

Although obesity is common, there are many misconceptions associated with it — and these myths often fuel social stigma. In this edition of Medical Myths, we tackle five of the most common misunderstandings about obesity.

According to the Centers for Disease Control and Prevention (CDC), in the United States, 42.4% of adults have obesity. Globally, the World Health Organization (WHO) estimate that around 650 million adults have obesity.

People are growing increasingly aware of the health issues associated with obesity. However, despite public health campaigns, myths continue unabated. Many of the most common myths drive stigma that can impact the mental health of people with obesity.

For instance, the results of one 2020 meta-analysis on the subject indicate “a stronger association between weight stigma and diminished mental health with increasing body mass index [BMI].”

Addressing the myths that surround obesity is important. With this in mind, this article will tackle five of the most prevalent misunderstandings around this condition.

1. To reduce obesity, just eat less and move more

In many cases, consuming more calories than the body needs for a prolonged amount of time is the direct cause of obesity. Indeed, the vast majority of measures for reducing obesity aim to lower caloric intake, increase physical activity, or both.

Although diet and exercise are important factors, several unrelated factors can also play a significant part in obesity.

These factors, which people often forget about, include insufficient sleep, psychological stress, chronic pain, endocrine (hormone) disruptors, and the use of certain medications.

In these cases, overeating, for instance, may be a symptom rather than a cause.

Also, some of these factors work together to increase the chance of obesity. As an example, stress can increase the chance of obesity. Due to the prevalence of weight stigma, obesity can be stressful for some people, thereby increasing stress levels and sparking a negative feedback loop.

Added to this, stress can impact sleep quality, and this, in turn, might cause sleep deprivation, which is another factor in the development of obesity. Sleep deprivation also appears to increase stress levels. As one paper explains, “stress hormone levels correlate positively with decreased sleep duration.”

Sleep apnea, wherein a person stops breathing for short periods during sleep, is more prevalent in people with overweight or obesity. Again, a cycle can form: As they gain weight, their sleep apnea may worsen, which can lead to sleep deprivation, which can lead to further weight gain.

As another example, there appears to be an association between chronic pain and obesity. The reasons for this relationship are sure to be complex and differ from person to person, but they likely include chemical factors, sleep, depression, and lifestyle.

It is not difficult to see how chronic pain would both increase stress levels and impact sleep, adding to the negative loops outlined above.

Stress, sleep, and pain are just three interlinking factors that can drive obesity. Each person’s case will be different, but simply receiving an instruction to “move more and eat less” might not be an adequate intervention.

As this article will continue to reiterate, calorie intake and exercise are vital factors in reducing obesity, but they do not tell the whole tale.

2. Obesity causes diabetes

Obesity does not directly cause diabetes. It is a risk factor for type 2 diabetes, but not everyone with obesity will develop type 2 diabetes, and not everyone with type 2 diabetes has obesity.

Obesity is also a risk factor for gestational diabetes, which occurs during pregnancy, but it is not a risk factor for type 1 diabetes.

3. People with obesity are lazy

An inactive lifestyle is a factor in obesity, and becoming more active can aid weight loss, but there is more to obesity than inactivity.

One 2011 study used accelerometers to measure the activity levels of 2,832 adults, aged 20–79 years, for 4 days. Their step counts reduced as their weight increased, but the differences were not as significant as one might predict, particularly for women.

The list below shows the women’s weights and how many steps they took per day during this study:

  • those with a “healthy” weight: 8,819 steps
  • those with overweight: 8,506 steps
  • those with obesity: 7,546 steps

When one considers that someone with overweight or obesity expends more energy with each step, the difference between the groups’ overall energy expenditures may be even more slight.

This does not mean that physical activity is not essential for good health, but the story is more complex.

Another factor to consider is that not all people are able to perform physical activity. For instance, some physical disabilities can make moving challenging or impossible.

Also, certain mental health issues can severely impact motivation — and there appears to be a relationship between depression and obesity, which further deepens the complexity.

Aside from physical and mental health issues, some people with obesity may also have a negative body image, which might make leaving their home a more daunting prospect.

4. If your close relatives have obesity, so will you

The relationship between obesity and genetics is complex, but someone whose relatives have obesity will not necessarily develop the condition themselves. However, their chance of doing so is higher.

Understanding the role of genes and the environment in isolation is difficult; people who share similar genes often live together and, therefore, may have similar dietary and lifestyle habits.

In 1990, a group of researchers published a study that helped split genes from the environment. The results appeared in The New England Journal of Medicine.

The scientists investigated twins who had been brought up apart and compared them with twins who had been brought up together. In this way, they hoped to tease apart the impact of genetics and the environment. Overall, they conclude:

“Genetic influences on [BMI] are substantial, whereas the childhood environment has little or no influence.”

One twin study from 1986 reached similar conclusions. The researchers found that the weights of adopted children correlated with the weights of their biological parents, but not with those of their adoptive parents.

Although more recent studies have identified a more significant role for the environment, genetics do appear to play an important part in obesity.

In recent years, scientists have searched for the genes that influence the chance of obesity. As the CDC explain, in most people with obesity, “no single genetic cause can be identified. Since 2006, genome-wide association studies have found more than 50 genes associated with obesity, most with very small effects.”

One gene that is linked to obesity is a variant of a gene called FTO. This variant, according to one 2011 study, is associated with a 20–30% increased chance of obesity.

Although genetics are important, this does not mean that obesity is inevitable for someone whose relatives have the condition. The above study, which involved individuals with the FTO gene variant, looked at the role of exercise. As the paper explains:

“Using data from over 218,000 adults, the authors found that carrying a copy of the susceptibility gene increased the odds of obesity by 1.23-fold. But the size of this influence was 27% less in the genetically susceptible adults who were physically active.”

A review and meta-analysis that investigated the same gene variant came to a similar conclusion. The authors explain that people with the FTO variant “respond equally well to […] weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions.”

However, it is important to reiterate the point that these interventions alone may not be helpful for some people.

5. Obesity does not impact health

This is a myth. There are several conditions associated with obesity. For instance, obesity increases the risk of diabetes, high blood pressure, cardiovascular disease, osteoarthritis, sleep apnea, and some mental health conditions.

That said, even modest weight loss can provide health benefits. According to the CDC, “weight loss of 5–10% of your total body weight is likely to produce health benefits, such as improvements in blood pressure, blood cholesterol, and blood sugars.”

Also, a review of existing literature in the BMJ concludes that weight loss interventions “may reduce premature all-cause mortality in adults with obesity.”

Obesity is highly prevalent. Currently, the stigma surrounding the condition is unhelpful and can be damaging. We need to address it whenever we encounter it.

Coronavirus myths explored

As coronavirus continues to make the news, a host of untruths has surrounded the topic. In this Special Feature, we address some of these myths and conspiracy theories.

The novel coronavirus, SARS-CoV-2, has spread from Wuhan, China, to every continent except Antarctica.

The World Health Organization (WHO) changed their classification of the situation from a public health emergency of international concern to a pandemic on March 11, 2020.

The virus has been responsible for tens of millions of infections globally, causing more than a million deaths. The United States has been the most affected country.

As ever, when the word “pandemic” began appearing in headlines, people became fearful — and with fear came misinformation and rumors.

Below, we dissect some of the most common myths currently circulating on social media and beyond.

Stay informed with live updates on the current COVID-19 outbreak 

1. Spraying chlorine or alcohol on the skin kills viruses in the body

Applying alcohol or chlorine to the skin can cause harm, especially if it enters the eyes or mouth. These chemicals can disinfect surfaces, but people should not use them on their bodies.

Also, these products cannot kill viruses inside the body.

2. Only older adults and people with preexisting conditions are at risk of infections and complications

SARS-CoV-2, like other coronaviruses, can transmit to people of any age. However, older adults and individuals with preexisting health conditions, such as diabetes, obesity, or asthma, are more likely to become severely ill.

While people under 40, including children, are less likely to become severely ill with COVID-19, the disease can lead to complications and death in anyone.

3. Children cannot get COVID-19

Anyone, of any age, can develop the infection that causes COVID-19.

So far, most COVID-19 cases have been in adults, but children are not immune. That said, most children who develop COVID-19 have mild symptoms or none at all.

Also, on May 15, 2020, the WHO released a commentary about an inflammatory condition in children and adolescents that may have links with COVID-19.

The condition, called multi-system inflammatory syndrome in children, known as MIS-C, has features similar to Kawasaki disease and toxic shock syndrome.

Scientists currently know little about this condition, but research from May suggests that it is rare, “probably affecting no more than 1 in 1,000 children exposed to SARS-CoV-2.”

4. COVID-19 is just like the flu

Infection with the virus SARS-CoV-2 can cause COVID-19, an illness that can cause flu-like symptoms, such as body aches, a fever, and a cough. Symptoms of either COVID-19 or the flu can be mild, severe, or rarely, fatal. Both illnesses can also cause pneumonia.

However, the overall profile of COVID-19 is more serious. Different countries have reported different mortality rates, and the case fatality rate in the U.S. appears to be around 2.6%.

While scientists are still determining the exact mortality rate based on developing data, it is likely to be many times higher than that of the seasonal flu.

5. Everyone with COVID-19 dies

This is false. As we explain above, COVID-19 is fatal for a small percentage of people who develop the illness.

The WHO have reported that around 80% of people with COVID-19 experience a relatively form of the illness and do not need specialist treatment in a hospital. Mild symptoms may include a fever, a cough, a sore throat, tiredness, and shortness of breath.

Also, many people with the underlying infection experience no symptoms.

6. Cats and dogs spread the coronavirus

There have been several reports of pets developing the infection, including in the U.S. In most cases, the pets became sick after coming into contact with people who had COVID-19.

According to the Centers for Disease Control and Prevention (CDC), “There is no evidence that animals play a significant role in spreading the virus that causes COVID-19.”

Scientists are debating the importance of these cases in animals. For instance, Jonathan Ball, a professor of molecular virology at the University of Nottingham, in the United Kingdom, says:

“We have to differentiate between real infection and just detecting the presence of the virus. I still think it’s questionable how relevant it is to the human outbreak, as most of the global outbreak has been driven by human-to-human transmission.”

7. Face masks always protect against the coronavirus

Healthcare workers use professional face masks that fit tightly to protect themselves from infections.

Disposable and cloth masks can protect against droplets, but neither can protect against aerosolized particles.

The CDC recommend that all people wear cloth face masks in public areas where it is difficult to maintain a 6-foot, or 2-meter, distance from others. This helps slow the spread of the virus.

Even while wearing a mask, it is essential to continue with other precautions, such as not touching the face, physical distancing, and washing the hands frequently.

Surgical masks and N95 respirators provide greater protection, but reserve these for healthcare workers.

8. Hand dryers kill the coronavirus

Hand dryers do not kill SARS-CoV-2. The best way to protect oneself and others from the virus is to wash the hands with soap and water frequently for at least 20 seconds at a time.

When this is not possible, use an alcohol-based hand sanitizer.

9. SARS-CoV-2 is just a mutated form of the common cold virus

Coronaviruses are a large family, and each has spiky proteins on their surface. Some use humans as their primary host and cause the common cold. 

Other coronaviruses, including SARS-CoV-2, primarily infect animals.

Like COVID-19, Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) are caused by coronaviruses. These viruses also initially passed to humans from animals.

10. You have to be with someone for 10 minutes to catch the virus

The longer a person is close to someone with the infection, the likelier the virus is to transmit. However, the virus can pass from person to person in under 10 minutes.

11. Rinsing the nose with saline protects against the coronavirus

There is no evidence that a saline nasal rinse protects against any respiratory infections. 

Some research suggests that a rinse might ease the symptoms of acute upper respiratory tract infections, but scientists have not found that this technique reduces the risk of infection.

12. You can protect yourself by gargling bleach

People should never put bleach in their mouths. Gargling bleach could never benefit a person’s health. 

Bleach is corrosive and can cause serious damage.

13. Antibiotics kill the coronavirus

Antibiotics only kill bacteria. They do not kill viruses.

14. Thermal scanners can diagnose the coronavirus

Thermal scanners can detect whether someone has a fever — which might result from any number of health issues.

Symptoms of COVID-19 can appear 2–14 days after the infection develops. This means that even if a person develops symptoms, they may have a normal temperature for days before a fever begins.

15. Garlic protects against coronaviruses

Some research suggests that garlic may slow the growth of some species of bacteria. COVID-19 results from a virus, not bacteria. 

There is no evidence that garlic can protect people from COVID-19.

16. Parcels from China can spread the coronavirus

From previous research into coronaviruses similar to SARS-CoV-2, including those that cause SARS and MERS, scientists believe that the virus cannot survive on letters or packages for extended periods.

The CDC explain that “Although the virus can survive for a short period on some surfaces, it is unlikely to be spread from domestic or international mail, products, or packaging.”

17. Home remedies can cure and protect against COVID-19

No home remedies can protect against COVID-19. This goes for vitamin C, essential oils, silver colloid, sesame oil, garlic, fish tank cleaner, sage, or water, even when a person sips it every 15 minutes.

The best approach is to wash the hands frequently, for 20 seconds at a time, to use an alcohol-based hand sanitizer, to wear a face covering in public, and to avoid crowded places.

18. You can catch the coronavirus from eating Chinese food in the US

No, you cannot.

19. You can catch the coronavirus from urine and feces

This is likely false, but the jury is currently out. According to Prof. John Edmunds, from the London School of Hygiene & Tropical Medicine, in the U.K.:

“It isn’t a very pleasant thought, but every time you swallow, you swallow mucus from your upper respiratory tract. In fact, this is an important defensive mechanism. This sweeps viruses and bacteria down into our gut where they are denatured in the acid conditions of our stomachs.”

“With modern, very highly sensitive detection mechanisms, we can detect these viruses in feces. Usually, the viruses that we can detect in this way are not infectious to others, as they have been destroyed by our guts.”

However, it is worth noting that some research suggests that viruses similar to SARS-CoV-2 might persist in feces. A research letter in JAMA also concludes that SARS-CoV-2 is present in feces.

20. The virus will die off when temperatures rise

Some viruses, such as cold and flu viruses, spread more easily in colder months. This does not mean that their transmission stops in warmer weather.

As it stands, scientists do not know how temperature changes influence the behavior of SARS-CoV-2.

21. The coronavirus is the deadliest virus known to humans

While SARS-CoV-2 does appear to be more dangerous than influenza viruses, it is not the deadliest virus that people have faced. Others, such as the Ebola virus, have higher mortality rates.

22. Flu and pneumonia vaccines can protect against COVID-19

Because SARS-CoV-2 is distinct from other viruses, no existing vaccines can protect against it.

23. The virus originated in a laboratory in China

There is no evidence to back up this rumor, which has circulated on the internet. As a recent study demonstrates, SARS-CoV-2 is a natural product of evolution.

Some researchers believe that SARS-CoV-2 jumped from pangolins to humans. Others think that it passed to us from bats, like SARS did.

24. The outbreak began because people ate bat soup

While scientists are confident that the virus started in animals, there is no evidence that soup was involved.

25. 5G helps SARS-CoV-2 spread

As the world becomes more connected, some regions are rolling out 5G mobile technology. This has prompted a raft of conspiracy theories.

One of the most recent to emerge is that 5G is responsible for the swift spread of SARS-CoV-2 across the globe. This is a myth.

Some people believe that 5G helps viruses communicate, often citing a paper from 2011. In this study, the authors conclude that bacteria can communicate via electromagnetic signals.

However, experts dispute this theory. In any case, SARS-CoV-2 is a virus, not a bacterium.

Wuhan was one of the first cities to trial 5G in China, which helps explain the origin of some of these theories. However, Beijing, Shanghai, and Guangzhou also rolled out 5G at a similar time.

It is also worth noting that COVID-19 has significantly impacted countries with very little 5G coverage, such as Iran.

26. Drinking alcohol reduces the risk of infection

The WHO have released a response to the series of myths surrounding alcohol and COVID-19. They explain that while alcohol can disinfect the skin, it does not have this effect inside the body.

They continue, “Consuming any alcohol poses health risks, but consuming high-strength ethyl alcohol (ethanol), particularly if it has been adulterated with methanol, can result in severe health consequences, including death.”

Also, in a fact sheet on the subject, they explain that “Alcohol use, especially heavy use, weakens the immune system — and thus reduces the ability to cope with infectious diseases.”

And because alcohol is associated with a number of diseases, it may make people more vulnerable to COVID-19.

27. Injecting or consuming bleach or disinfectant kills the virus

Consuming or injecting disinfectant or bleach does not wipe out viruses in the body, and it can be extremely dangerous.

As Dr. Wayne Carter, an associate professor at the University of Nottingham’s Faculty of Medicine & Health Sciences, in the U.K., explains, “Disinfectants and bleach are strong oxidizing agents, useful to kill bacteria or viruses when they are deposited on surfaces, but these agents should not be ingested or injected. These agents can cause severe tissue burns and blood vessel damage.”

Dr. Penny Ward, a visiting professor of pharmaceutical medicine at King’s College London, in the U.K., notes, “Drinking bleach kills. Injecting bleach kills faster.”

28. You can contract the coronavirus in swimming pools

As the CDC observe, no evidence suggests that SARS-CoV-2 transmits via the water in swimming pools, hot tubs, or water parks. If this water is disinfected with chlorine or bromine, it should inactivate the virus.

Still, the virus can transmit in all the usual ways in these and any other shared spaces. A person contracts a SARS-CoV-2 infection by inhaling respiratory droplets that contain the virus or coming into contact with infected surfaces.

As in other public places, the CDC recommend staying 6 feet, or 2 meters, away from others at pools and water parks and wearing cloth face coverings when not in the water.

People who operate pools should take extra care to clean and disinfect all facilities.

What should we do?

The CDC recommend the following simple ways to reduce the spread of SARS-CoV-2:

  • avoiding close contact with people who seem ill or report symptoms
  • trying not to touch the eyes, nose, or mouth
  • staying home if any symptoms appear
  • sneezing into a tissue, then throwing it in the trash, or sneezing into the crook of the elbow
  • using standard cleaning sprays and wipes to disinfect frequently touched objects and surfaces
  • washing the hands with soap regularly, for at least 20 seconds at a time
  • using an alcohol-based hand sanitizer when soap and water are unavailable
  • wearing a cloth face covering in stores, pharmacies, and other public settings

What to know about COVID-19 symptoms in children

Although there are notable exceptions, most evidence suggests that COVID-19 is much less dangerous for children than it is for adults and infants.

Knowing the symptoms of COVID-19 in children can help parents and caregivers identify the emergency warning signs and seek appropriate care.

This article covers the symptoms of COVID-19 in children, some potential complications, and when to see a doctor.

Symptoms of COVID-19 in children

Data from both China and the United States on children with SARS-CoV-2, the virus that causes COVID-19, suggest that the risk of severe illness is lower in children than it is in adults.

A study of 2,752 cases of COVID-19 in children found that three had died, though the exact cause of death in each case is under investigation.

Current evidence suggests that infants have a higher rate of hospitalization, with some requiring treatment in intensive care units.

In China, more than 90% of children with COVID-19 had no symptoms and only mild-to-moderate disease.

The following are some symptoms that children may experience:

  • Fever: Although most adults report a fever with COVID-19, fevers are slightly less common among children, according to data from the Centers for Disease Control and Prevention (CDC).
  • Flu-like symptoms: Around 73% of children with COVID-19 had a fever, cough, or shortness of breath. Shortness of breath is much less common in children. In one analysis, 43% of adults and just 13% of children had this symptom.
  • Respiratory tract symptoms: Children with mild forms of the illness may develop a runny nose, cough, or sore throat.
  • Digestive symptoms: Some children develop vomiting, diarrhea, or nausea.
  • Changes in the sense of smell: A 2020 analysis found that most adults with COVID-19 lose their sense of smell. Researchers have not assessed this symptom in young people, but children may also lose their sense of taste or smell.
  • Pain: Children with COVID-19 may develop muscle pain or a headache.
  • Behavioral changes: Children may be moody or cry more often, especially if they are too young to verbally express their emotions or identify their symptoms. Some children may also be anxious, especially if they know that COVID-19 can be dangerous.

Overall, COVID-19 symptoms tend to be less severe in children. Children are also less likely than adults to report each symptom.

Complications

Children with underlying health conditions — such as lung disease, heart disease, or a weak immune system — are more susceptible to serious COVID-19 complications.

A CDC study that assessed COVID-19 symptoms in children used data on hospitalization and underlying medical conditions for 295 children. In that group, 77% of hospitalized children had at least one other medical condition. This suggests that comorbidities are a significant risk factor for hospitalization in children.

Even among high risk children, however, the risk of dying from COVID-19 is very low. Of 2,143 children included in a Chinese CDC study, just one 14-year-old died. Also, as above, 3 out of 2,572 children in a CDC study died, though the cause in each case is currently unconfirmed.

Some other potential complications include:

  • organ failure
  • the need to use a ventilator
  • sepsis, which is a severe infection that affects many systems in the body
  • heart failure
  • issues that can cause life threatening blood clots

Children with severe symptoms usually develop them within a week of getting sick.

A small number of children have also developed symptoms of multisystem inflammatory syndrome in children (MIS-C). This syndrome can cause symptoms that resemble those of toxic shock syndrome and Kawasaki disease. Without treatment, it may be fatal.

Children with MIS-C may develop a rash, stomach pain, bloodshot eyes, exhaustion, diarrhea, or vomiting.

The following symptoms require emergency medical attention:

  • confusion
  • fever
  • chest pressure or pain
  • neck pain
  • difficulty breathing
  • blue or white face, fingers, or toes
  • an inability to stay awake
  • severe stomach pain

When to see a doctor

Most children have either no symptoms or only mild-to-moderate ones. These children do not need to go to the hospital or see a doctor.

However, parents and caregivers should call a pediatrician if their child shows any symptoms of COVID-19. The pediatrician can offer advice on which symptoms to watch and some suggestions for home treatment.

In some areas, a child may also need a referral for COVID-19 testing.

Call a doctor if:

  • the child seems very ill
  • they develop a rash
  • their symptoms get better and then get worse again
  • they recover from COVID-19 but then develop inflammatory symptoms, such as a rash, fever, or bloodshot eyes

Go to the emergency room if a child:

  • gasps for air or shows signs of respiratory distress, such as bluish lips, breathing very fast, or difficulty breathing
  • seems confused, seems lethargic, or cannot wake up
  • reports pressure or pain in their chest
  • has symptoms of organ failure, such as intense pain in the stomach, difficulty passing urine, an inability to move without help, or an inability to think clearly

Treatment

No medication can cure COVID-19. Although hospitals and researchers are exploring experimental treatments, these are currently only available to very sick people.

Most children can recover with home treatment. To help a child with COVID-19:

  • Encourage them to rest.
  • Give them lots of fluids to prevent dehydration.
  • Check on them regularly to ensure that they are not getting worse.
  • Ask a doctor about over-the-counter pain and fever relievers.
  • Have them stay in a single area of the house, if possible. Clean and disinfect all surfaces they touch, and encourage other family members to avoid them. Also, wear a face mask when caring for a sick child.

Parents and caregivers may find these guidelines challenging to follow when caring for a child or infant. The CDC offer some advice on how to manage risk around children.

It may also be a good idea to speak to a medical professional about how best to care for a child with a suspected SARS-CoV-2 infection. Children under 2 years of age should not wear a face covering.

Very sick children may need to go to the hospital. In the hospital, doctors will focus on managing the child’s symptoms. They might need oxygen, intravenous fluids, or steroid medications to help them breathe.

Rarely, a child might need a ventilator if they cannot breathe well on their own.

15 natural ways to lower your blood pressure

High blood pressure is a dangerous condition that can damage your heart. It affects one in three people in the US and 1 billion people worldwide.

If left uncontrolled, high blood pressure raises your risk of heart disease and stroke.

But there’s good news. There are a number of things you can do to lower your blood pressure naturally, even without medication.

Here are 15 natural ways to combat high blood pressure.

1. Walk and exercise regularly

Exercise is one of the best things you can do to lower high blood pressure.

Regular exercise helps make your heart stronger and more efficient at pumping blood, which lowers the pressure in your arteries.

In fact, 150 minutes of moderate exercise, such as walking, or 75 minutes of vigorous exercise, such as running, per week, can help lower blood pressure and improve your heart health.

What’s more, doing even more exercise than this reduces your blood pressure even further, according to the National Walkers’ Health Study.

Bottom line: Walking just 30 minutes a day can help lower your blood pressure. More exercise helps reduce it even further.

2. Reduce your sodium intake

Salt intake is high around the world. In large part, this is due to processed and prepared foods.

For this reason, many public health efforts are aimed at lowering salt in the food industry.

Many studies have linked high salt intake with high blood pressure and heart events, including stroke.

However, more recent research indicates that the relationship between sodium and high blood pressure is less clear.

One reason for this may be genetic differences in how people process sodium. About half of people with high blood pressure and a quarter of people with normal levels seem to have a sensitivity to salt.

If you already have high blood pressure, it’s worth cutting back your sodium intake to see if it makes a difference. Swap out processed foods with fresh ones and try seasoning with herbs and spices rather than salt.

Bottom line: Most guidelines for lowering blood pressure recommend reducing sodium intake. However, that recommendation might make the most sense for people who are salt-sensitive.

3. Drink less alcohol

Drinking alcohol can raise blood pressure. In fact, alcohol is linked to 16% of high blood pressure cases around the world.

While some research has suggested that low-to-moderate amounts of alcohol may protect the heart, those benefits may be offset by adverse effects.

In the U.S., moderate alcohol consumption is defined as no more than one drink a day for women and two for men. If you drink more than that, cut back.

Bottom line: Drinking alcohol in any quantity may raise your blood pressure. Limit your drinking in line with the recommendations.

4. Eat more potassium-rich foods

Potassium is an important mineral.

It helps your body get rid of sodium and eases pressure on your blood vessels.

Modern diets have increased most people’s sodium intake while decreasing potassium intake.

To get a better balance of potassium to sodium in your diet, focus on eating fewer processed foods and more fresh, whole foods.

Foods that are particularly high in potassium include:

  • vegetables, especially leafy greens, tomatoes, potatoes, and sweet potatoes
  • fruit, including melons, bananas, avocados, oranges, and apricots
  • dairy, such as milk and yogurt
  • tuna and salmon
  • nuts and seeds
  • beans

Bottom line: Eating fresh fruits and vegetables, which are rich in potassium, can help lower blood pressure.

5. Cut back on caffeine

If you’ve ever downed a cup of coffee before you’ve had your blood pressure taken, you’ll know that caffeine causes an instant boost.

However, there’s not a lot of evidence to suggest that drinking caffeine regularly can cause a lasting increase.

In fact, people who drink caffeinated coffee and tea tend to have a lower risk of heart disease, including high blood pressure, than those who don’t drink it.

Caffeine may have a stronger effect on people who don’t consume it regularly.

If you suspect you’re caffeine-sensitive, cut back to see if it lowers your blood pressure.

Bottom line: Caffeine can cause a short-term spike in blood pressure, although for many people, it does not cause a lasting increase.

6. Learn to manage stress

Stress is a key driver of high blood pressure.

When you’re chronically stressed, your body is in a constant fight-or-flight mode. On a physical level, that means a faster heart rate and constricted blood vessels.

When you experience stress, you might also be more likely to engage in other behaviors, such as drinking alcohol or eating unhealthful food that can adversely affect blood pressure.

Several studies have explored how reducing stress can help lower blood pressure. Here are two evidence-based tips to try:

  • Listen to soothing music: Calming music can help relax your nervous system. Research has shown it’s an effective complement to other blood pressure therapies.
  • Work less: Working a lot, and stressful work situations, in general, are linked to high blood pressure.

Bottom line: Chronic stress can contribute to high blood pressure. Finding ways to manage stress can help.

7. Eat dark chocolate or cocoa

Here’s a piece of advice you can really get behind.

While eating massive amounts of dark chocolate probably won’t help your heart, small amounts may.

That’s because dark chocolate and cocoa powder are rich in flavonoids, which are plant compounds that cause blood vessels to dilate.

A review of studies found that flavonoid-rich cocoa improved several markers of heart health over the short term, including lowering blood pressure.

For the strongest effects, use non-alkalized cocoa powder, which is especially high in flavonoids and has no added sugars.

Bottom line: Dark chocolate and cocoa powder contain plant compounds that help relax blood vessels, lowering blood pressure.

8. Lose weight

In people with overweight, losing weight can make a big difference to heart health.

According to a 2016 study, losing 5% of your body mass could significantly lower high blood pressure.

In previous studies, losing 17.64 pounds (8 kilograms) was linked to lowering systolic blood pressure by 8.5 mm Hg and diastolic blood pressure by 6.5 mm Hg.

To put that in perspective, a healthy reading should be less than 120/80 mm Hg.

The effect is even greater when weight loss is paired with exercise.

Losing weight can help your blood vessels do a better job of expanding and contracting, making it easier for the left ventricle of the heart to pump blood.

Bottom line: Losing weight can significantly lower high blood pressure. This effect is even more significant when you exercise.

9. Quit smoking

Among the many reasons to quit smoking is that the habit is a strong risk factor for heart disease.

Every puff of cigarette smoke causes a slight, temporary increase in blood pressure. The chemicals in tobacco are also known to damage blood vessels.

Surprisingly, studies haven’t found a conclusive link between smoking and high blood pressure. Perhaps this is because smokers develop a tolerance over time.

Still, since both smoking and high blood pressure raise the risk of heart disease, quitting smoking can help lessen that risk.

Bottom line: There’s conflicting research about smoking and high blood pressure, but what is clear is that both increase the risk of heart disease.

10. Cut added sugar and refined carbs

There’s a growing body of research showing a link between added sugar and high blood pressure.

In the Framingham Women’s Health Study, women who drank even one soda per day had higher levels than those who drank less than one soda per day.

Another study found that having one less sugar-sweetened beverage per day was linked to lower blood pressure.

And it’s not just sugar — all refined carbs, such as the kind found in white flour — convert rapidly to sugar in your bloodstream and may cause problems.

Some studies have shown that low carb diets may also help reduce blood pressure.

One study on people undergoing statin therapy found that those who went on a 6-week, carb-restricted diet saw a greater improvement in blood pressure and other heart disease markers than people who did not restrict carbs.

Bottom line: Refined carbs, especially sugar, may raise blood pressure. Some studies have shown that low carb diets may help reduce your levels.

11. Eat berries

Berries are full of more than just juicy flavor.

They’re also packed with polyphenols, natural plant compounds that are good for your heart.

Polyphenols can reduce the risk of stroke, heart conditions, and diabetes, as well as improving blood pressure, insulin resistance, and systemic inflammation.

One study assigned people with high blood pressure to a low-polyphenol diet or a high-polyphenol diet containing berries, chocolate, fruits, and vegetables.

Those consuming berries and polyphenol-rich foods experienced improved markers of heart disease risk.

Bottom line: Berries are rich in polyphenols, which can help lower blood pressure and the overall risk of heart disease.

12. Try meditation or deep breathing

While these two behaviors could also fall under “stress reduction techniques,” meditation and deep breathing deserve specific mention.

Both meditation and deep breathing may activate the parasympathetic nervous system. This system is engaged when the body relaxes, slowing the heart rate, and lowering blood pressure.

There’s quite a bit of research in this area, with studies showing that different styles of meditation appear to have benefits for lowering blood pressure.

Deep breathing techniques can also be quite effective.

In one study, participants were asked to either take six deep breaths over the course of 30 seconds or simply sit still for 30 seconds. Those who took breaths lowered their blood pressure more than those who just sat.

Try guided meditation or deep breathing. Here’s a video to get you started.

Bottom line: Both meditation and deep breathing can activate the parasympathetic nervous system, which helps slow your heart rate and lower blood pressure.

13. Eat calcium-rich foods

People with low calcium intake often have high blood pressure.

While calcium supplements haven’t been conclusively shown to lower blood pressure, calcium-rich diets do seem linked to healthful levels.

For most adults, the calcium recommendation is 1,000 milligrams (mg) per day. For women over 50 and men over 70, it’s 1,200 mg per day.

In addition to dairy, you can get calcium from collard greens and other leafy greens, beans, sardines, and tofu. Here is a list of calcium-rich plant-based foods.

Bottom line: Calcium-rich diets are linked to healthy blood pressure levels. You can get calcium through eating dark leafy greens and tofu, as well as dairy.

14. Take natural supplements

Some natural supplements may also help lower blood pressure. Here are some of the main supplements that have evidence behind them:

  • Aged garlic extract: Researchers have used aged garlic extract successfully as a stand-alone treatment and along with conventional therapies for lowering blood pressure.
  • Berberine: Traditionally used in Ayurvedic and Chinese medicine, berberine may increase nitric oxide production, which helps decrease blood pressure.
  • Whey protein: A 2016 study found that whey protein improved blood pressure and blood vessel function in 38 participants.
  • Fish oil: Long credited with improving heart health, fish oil may benefit people with high blood pressure the most.
  • Hibiscus: Hibiscus flowers make a tasty tea. They’re rich in anthocyanins and polyphenols that are good for your heart and may lower blood pressure.

Bottom line: Researchers have investigated several natural supplements for their ability to lower blood pressure.

15. Eat foods rich in magnesium

Magnesium is an important mineral that helps blood vessels relax.

While magnesium deficiency is pretty rare, many people don’t get enough.

Some studies have suggested that getting too little magnesium is linked with high blood pressure, but evidence from clinical studies has been less clear.

Still, eating a magnesium-rich diet is a recommended way to ward off high blood pressure.

You can incorporate magnesium into your diet by consuming vegetables, dairy products, legumes, chicken, meat, and whole grains.

Bottom line: Magnesium is an essential mineral that helps regulate blood pressure. Find it in whole foods, such as legumes and whole grains.

Take home message

High blood pressure affects a large proportion of the world’s population.

While drugs are one way to treat the condition, there are many other natural techniques, including eating certain foods that can help.

Controlling your blood pressure through the methods in this article may, ultimately, help you lower your risk of heart disease

All you need to know about flu

Influenza, or flu, is a respiratory illness that results from a viral infection. Flu is highly contagious and spreads through respiratory droplets. A person can pass it on while talking or through physical contact, such as shaking hands.

Influenza A and influenza B cause seasonal epidemics in the United States and elsewhere every winter. Type C usually causes mild respiratory illness.

Some strains of influenza A, such as the H5N1 “bird flu” virus, occasionally infect humans, causing serious illness. Experts track these strains carefully, as they try to predict how they will change, and how they might affect people.

Symptoms

According to the Centers for Disease Control and Prevention (CDC), a person with flu may experience:

  • a high temperature that lasts 3–4 days
  • a stuffy or runny nose
  • cold sweats and shivers
  • aches that may be severe
  • a headache
  • fatigue

Not everyone with flu will have all of these symptoms. For instance, it is possible to have flu without a fever.

The symptoms of influenza typically come on suddenly. Initially, a person with flu may experience:

  • a high temperature
  • a stuffy or runny nose
  • a dry cough
  • cold sweats and shivers
  • aches that may be severe
  • a headache
  • fatigue, and a feeling of being unwell
  • a low appetite

Flu symptoms in adults

Adults with the following symptoms should seek medical help urgently:

  • breathing difficulties
  • pain or pressure in the chest or abdomen
  • dizziness, confusion, or loss of alertness
  • seizures
  • not urinating, which may indicate dehydration
  • severe pain, weakness, and unsteadiness
  • a fever or cough that goes away and then comes back
  • a worsening of other existing health conditions

Flu symptoms in children

Children often have similar symptoms to adults but can also have gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

If a child has the following symptoms, they need emergency medical care:

  • breathing difficulties
  • rapid breathing
  • bluish face or lips
  • chest pain or ribs pulling inward as they breathe
  • severe aches
  • dehydration, for example, not urinating for 8 hours and crying dry tears
  • lack of alertness or interaction with others
  • a fever above 104°F or any fever in a child under 12 weeks of age
  • a fever or cough that goes away but then comes back
  • a worsening of any other medical conditions

Should children have flu medication? Find out more here about Tamiflu and its effects on children.

Flu symptoms in babies

Flu can be dangerous for babies. If symptoms appear, a parent or caregiver should seek medical help.

A baby with flu may:

  • be very tired
  • have a cough and sore throat
  • have a stuffy or runny nose
  • have a fever of 100°F or more
  • have vomiting or diarrhea

The baby needs emergency medical attention if they:

  • do not want anyone to hold them
  • have a blue or gray skin color
  • are breathing fast or have difficulty breathing
  • have a fever with a rash
  • have symptoms that go away but come back again
  • show signs of dehydration, for example, not urinating
  • do not wake up or interact
  • have severe and persistent vomiting

Flu type A symptoms

If a person has the following symptoms, they may have influenza type A:

  • fever and chills
  • headache
  • muscle aches
  • fatigue
  • weakness
  • a stuffy or runny nose
  • a sore throat and cough

Flu type B symptoms

Influenza B symptoms are similar to those of influenza A.

Treatment

Most people will be able to treat the flu at home. A combination of lifestyle remedies and over-the-counter medication can help relieve symptoms.

Pain relief medication can help manage a headache and body pains. A healthcare professional can recommend the best options.

Some painkillers, such as aspirin, are not suitable for children under 16 years of age. The use of aspirin at this age can lead to a condition known as Reye’s syndrome.

Flu home remedies

When a person has flu, it is essential that they:

  • stay at home
  • avoid contact with other people if possible
  • keep warm and rest
  • consume plenty of liquids and healthful foods
  • avoid alcohol
  • stop smoking, as this raises the risk of complications

Other things people can try at home include:

  • chicken broth
  • herbal teas
  • vitamin supplements

However, there is not enough evidence available to confirm that consuming these helps.

Flu diagnosis

If a person seeks medical advice for flu symptoms, a doctor will likely ask about their symptoms and do a physical examination. A doctor may also take a throat swab for testing.

The rapid influenza diagnostic test can produce results in 10–15 minutes but may not be accurate. Other, more accurate tests can take longer to give results.

Flu or a cold?

People often confuse the flu with a bad cold, as some symptoms are similar.

A cold and the flu both involve:

  • a runny or blocked nose
  • a sore throat
  • a cough
  • chest discomfort
  • fatigue

However, there are some differences:

  • A cold does not involve a fever, while the flu usually does.
  • The symptoms of a cold tend to appear gradually, while flu symptoms can develop rapidly.
  • Cold symptoms are typically less severe than those of flu.
  • After having the flu, a person may continue to feel tired for several weeks.
  • Flu is more likely to lead to complications, and it can be life threatening.

Flu or food poisoning?

There are many types of viruses, and some can affect the digestive system. People sometimes call this “stomach flu.” This illness is different from influenza, which is a respiratory disease.

The most common cause of “stomach flu” is the norovirus, which enters the body through contaminated food or drink. Symptoms include nausea, vomiting, and diarrhea. Food poisoning causes similar symptoms.

Flu or pneumonia?

Pneumonia can be bacterial or viral. The symptoms can resemble those of flu, but an individual may have a sharp, stabbing pain in the chest, especially when they breathe deeply or cough.

Bacterial pneumonia can start slowly or suddenly. Symptoms can include:

  • a very high temperature
  • sweating
  • rapid breathing and pulse rate
  • blue nailbeds due to a lack of oxygen

Symptoms of viral pneumonia are similar to those of the flu. They include:

  • fever
  • dry cough
  • headache
  • aches and weakness

However, unlike the flu, symptoms of pneumonia usually develop gradually. Anyone who has a high fever and breathing difficulties should see a doctor immediately.

When is flu season?

People can have the flu at any time, but it is more common during the flu season. The timing and duration of the flu season change from year to year, but it usually happens around fall and winter.

Flu activity often starts to increase in October, and it can last as late as May. However, it is most common from December to February.

Prevention

The flu shot can help prevent flu, but it is not 100% effective. People should follow lifestyle measures to reduce their risk.

Lifestyle tips for avoiding flu

Tips for avoiding infection include:

  • practicing good hygiene, including frequent hand washing
  • keeping the immune system strong by following a healthful diet
  • quitting or avoiding smoking, as smokers are more likely to develop complications
  • staying away from people who have the flu

People should also stay away from others when they have the flu to avoid spreading it themselves.

Contagiousness

The flu virus transmits through droplets of liquid. A person can pass the virus on to another person who is up to 6 feet away from them when they cough, sneeze, talk, or breathe.

A healthy individual can pass on the virus a day before they, themselves, have symptoms. In other words, it is possible to pass on the flu before you know you have it. The infected individual can continue to transmit the virus for up to 5–7 days after symptoms appear.

People with a weakened immune system, older people, and young children may be able to pass on the virus for longer than this.

Flu is most contagious in the first 3–4 days after symptoms appear.

Transmission

A person can develop flu symptoms if droplets that contain the virus and come from the breath of another person enter their mouth, nose, or lungs.

This transmission can happen if:

  • Someone without the virus is near a person with flu.
  • Someone who is virus free handles an object a person with the virus has touched and then touches their mouth, nose, or eyes.

Research shows that just breathing can spread the flu virus. 

Incubation period

The incubation period of a disease is the time it takes from when the virus infects a person to when the symptoms start.

For flu, this is around 2 days, but it can vary from 1 to 4 days.

A person can transmit the virus even before symptoms appear.

Flu when pregnant

Flu can be more serious during pregnancy, as pregnancy affects how the immune system works. If a woman is pregnant and has flu, they may need to spend time in the hospital.

Pregnancy-related complications include a higher risk of:

  • preterm birth
  • low birth weight
  • stillbirth

Flu can be fatal for newborns. Risks to the mother include a greater chance of having complications, such as bronchitis, ear and blood infections.

How long does it last?

Flu symptoms appear suddenly, usually around 2 days after infection. Most symptoms disappear after about 1 week, but a cough may last for up to 2 weeks.

In some cases, a person may still be contagious for up to 1 week after their symptoms have disappeared.

If complications develop, these can take longer to resolve. Some of the more severe types of complications can have a long term impact on a person’s health, for example, kidney failure.

Some people experience post-viral fatigue for a week or so after the main symptoms disappear. They may have a lingering sense of tiredness and feeling unwell.

Timeline

Typically, flu may progress as follows:

  • The virus infects a person, usually through their nose or mouth.
  • After one day, they may be able to transmit the virus to others.
  • Symptoms appear 1–2 days after infection.
  • The chance of transmitting the virus is highest 3–4 days after symptoms appear.
  • After 4 days, the fever and muscle aches improve.
  • After 1 week, most symptoms disappear.
  • The risk of transmitting the virus disappears 5–7 days after symptoms appear.
  • The cough and tiredness may remain for a further week.

Precautions

The flu is not usually serious, but it is unpleasant. For some people, however, complications can arise. Some of these can be life threatening.

Complications include:

  • bacterial pneumonia
  • dehydration
  • worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes
  • sinus problems and ear infections

The risk of experiencing severe symptoms and flu complications is higher in the following cases:

  • adults over 65 years of age
  • babies or young children
  • pregnant women
  • people with heart or cardiovascular disease
  • individuals with chest problems, such as asthma or bronchitis
  • people with kidney disease or diabetes
  • individuals who are taking steroids
  • people undergoing treatment for cancer
  • anyone with a weakened immune system

Flu shot

The single best way to prevent flu is to have a flu vaccination every year.

There are two types of vaccination:

The flu shot: A healthcare professional will administer the flu shot with a needle, usually in the arm. It is suitable for anyone older than 6 months, including healthy people and those with chronic medical conditions.

The nasal-spray flu vaccine: The nasal-spray flu vaccine contains live, weakened flu viruses that do not cause illness.

Seasonal flu shot

A flu shot will contain the vaccine for several influenza viruses, according to the CDC.

Examples include:

  • influenza A (H1N1) virus
  • influenza (H3N2) virus
  • one or two influenza B viruses

However, viruses adapt and change over time, and scientists may need to adjust the content of the vaccines each year.

Data from international surveillance programs help experts predict which types are likely to circulate in a given flu season. Protection begins about 2 weeks after receiving the vaccination.

Seasonal flu vaccinations should start in September or as soon as the vaccine is ready. They continue throughout the flu season, into January and beyond.

Flu shot side effects

The CDC note that the flu vaccine has a good safety record, and it cannot cause flu.

A person may experience the following adverse effects after having a vaccine, but these will be mild and usually pass within a few days.

  • pain, redness, and swelling at the injection site
  • headache
  • fever
  • nausea
  • muscle aches

Around 1–2 people in every 1 million may develop a condition known as Guillain-Barr syndrome (GBS). However, people can also develop GBS after having flu, and the risk of this is higher than with the vaccine. The risk of developing GBS may be lower with the nasal spray version of the vaccine.

If someone experiences hives, swelling, and difficulty breathing after any vaccine, they should seek immediate medical help as these may be the sign of an allergic reaction. A severe reaction is known as anaphylaxis, which can be life threatening.

People who have previously had an allergic reaction to a vaccine should not have the flu shot.

Flu shot pregnancy

It is safe to have the flu shot during pregnancy, and doctors recommend it. It takes about 2 weeks to provide protection. The vaccine will also pass through to the fetus and give them some protection from the flu.

Newborns cannot have a flu vaccine, but having flu can be dangerous for them. Having the vaccine can benefit both the mother and her unborn child.

Flu shot effectiveness

The flu shot cannot offer 100% protection from the flu as scientists cannot predict precisely what flu types will circulate during a season.

CDC figures from 2018–2019 show that the effectiveness of the vaccine in preventing influenza A or B was about 47%.

Many factors can contribute to the effectiveness of the flu shot from year to year. These can include the age and overall health of the person receiving the vaccination, plus how well the vaccine matches the prevalent viruses.

Flu shot for seniors

The CDC recommend a flu shot for people aged 65 years or more. As people get older, they are more likely to develop complications if they have flu.

Older people may need a higher dose of vaccine, as their immune systems may be less able to resist the flu virus. The vaccine cannot provide complete protection but will reduce the risk of flu and the severity of complications.

A 2017 study looked at data for older people in hospital with the flu during the flu season 2013–2014 in the U.S. Among those who had received the vaccine, there were lower rates of fatality, fewer complications, and less overall time spent in an intensive care unit.

People who are 65 years of age or older should ask their doctor about the vaccine at the start of each flu season. The doctor will recommend a vaccine that suits the individual.

Flu shot cost

The cost of a flu shot in the private sector is around $15–$24, depending on the type.

People should check their insurance policies to find out their cover. Medicare part B, for example, provide for one flu shot every flu season.

When to see a doctor

A doctor only needs to know that a person has the flu if:

  • they are already frail or have an existing health condition
  • they have a weakened immune system
  • they are infants or aged 65 years or over
  • their temperature remains high after 4–5 days
  • symptoms worsen or are severe
  • they become short of breath, develop chest pain, or both

However, anyone who has concerns about their symptoms should speak to their doctor for further advice.

What to know about endometriosis

Endometriosis is an incurable but manageable gynecological condition.

It occurs when endometrial implants, comprised of tissue normally found within the uterus, are present in other areas of the body.

As the tissue continues to thicken, break down, respond to menstrual cycle hormones, and bleed during the menstrual cycle, endometriosis forms deep inside the body.

Scar tissue and adhesions form, and this can cause organ fusion and anatomical changes.

Endometriosis is thought to affect around 11 percent of women in the United States aged between 15 and 44 years.

Fast facts on endometriosis

Here are some key points about endometriosis. More information is in the main article.

  • Endometriosis affects between 6 and 10 percent of women of reproductive age worldwide.
  • The condition appears to be present in a developing fetus, but estrogen levels during puberty are thought to trigger the symptoms.
  • Symptoms are generally present during the reproductive years.
  • Most women go undiagnosed, and in the U.S. it can take around 10 years to receive a diagnosis.
  • Allergies, asthma, chemical sensitivities, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, breast cancer, and ovarian cancer are linked to women and families with endometriosis.

What is endometriosis?

Endometrial tissue consists of gland, blood cells, and connective tissue. It normally grows in the uterus, to prepare the lining of the womb for ovulation.

Endometrial implants are buildups of endometrial tissue that grow in locations outside the uterus.

When they grow outside the uterus, this is called endometriosis.

They can develop anywhere in the body, but they usually occur in the pelvic area.

They may affect:

  • the ovaries
  • the fallopian tubes
  • the peritoneum
  • the lymph nodes

Normally, this tissue is expelled during menstruation, but displaced tissue cannot do this.

This leads to physical symptoms, such as pain. As the lesions grow larger, they can affect bodily functions. For example, the fallopian tubes may be blocked.

The pain and other symptoms can affect different areas of life, including the ability to work, medical care costs, and difficulty maintaining relationships.

Symptoms

Other medical conditions such as pelvic inflammatory disease (PID), ovarian cysts, and irritable bowel syndrome (IBS) can mimic the symptoms of endometriosis.

Symptoms of endometriosis include:

  • Severe menstrual cramps, unrelieved with NSAIDS
  • Long-term lower-back and pelvic pain
  • Periods lasting longer than 7 days
  • Heavy menstrual bleeding where the pad or tampon needs changing every 1 to 2 hours
  • Bowel and urinary problems including pain, diarrhea, constipation, and bloating
  • Bloody stool or urine
  • Nausea and vomiting
  • Fatigue
  • Pain during intercourse
  • Spotting or bleeding between periods

Pain is the most common indication of endometriosis, but the severity of the pain does not always correlate with the extent of the disease.

Pain often resolves following menopause, when the body stops producing estrogen production. However, if hormone therapy is used during menopause, symptoms may persist.

Pregnancy may provide temporary relief from symptoms.

Complications

Complications include:

  • infertility, which can affect 50 percent of those with the condition.
  • increased risk of developing ovarian cancer or endometriosis-associated adenocarcinoma
  • ovarian cysts
  • inflammation
  • scar tissue and adhesion development
  • intestinal and bladder complications

It is important to see a health care provider about symptoms, to avoid future complications.

Treatment

Surgery is possible, but it is normally considered only if other treatments are not effective.

Other options include:

Pain medications: Either over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) or prescription drugs for the treatment of painful menses.

Hormones: Treatment may be with hormonal therapies such as hormonal birth control, Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, Medroxyprogesterone (Depo-Provera) or Danazol. Placement of an intrauterine device (IUD) may also be recommended.

Surgery: Initial surgery will seek to remove the areas of endometriosis, but a hysterectomy with removal of both ovaries may be necessary.

Fertility treatment: Pregnancy may be recommended via in-vitro fertilization (IVF).

Managing symptoms at home

Complementary and alternative treatments may include acupuncture, chiropractic, and herbal medicine, but there is little evidence to show that these are effective.

Avoiding caffeine may help to reduce pain, as caffeine can worsen symptoms.

Exercise, such as walking, may reduce pain and slow the progress of the condition by reducing estrogen levels.

It is important to monitor symptoms, because of the long-term complications of endometriosis. Intolerable pain or unexpected bleeding should be reported to a doctor.

Although there is currently no cure for endometriosis, most women are able to relieve the pain of symptoms and will still be able to have children.

Diagnosis

Diagnosis can be challenging because there is no single test for evaluation.

The only way to truly confirm the condition is by undergoing a surgical laparoscopy.

A surgical laparoscopy is a minimally invasive procedure in which a thin, lighted tube with a miniature camera attached, called a laparoscope, is inserted through a small incision in the pelvic area.

A diagnosis can be categorized as follows:

  • Stage 1: Lesions are minimal and isolated
  • Stage 2: Lesions are mild. There may be several and adhesions are possible.
  • Stage 3: Lesions are moderate, deep or superficial with clear adhesions
  • Stage 4: Lesions are multiple and severe, both superficial and deep, with prominent adhesions.

It can take many years to receive a diagnosis.

Other possible diagnostic strategies include a pelvic exam, radiologic imaging with ultrasound or magnetic resonance imaging (MRI), and the use of certain medications including birth control or gonadotropin releasing hormone (GnRH) agonists.

Diet

Dietary steps have been suggested for managing the pain and effects of endometriosis.

A 2004 study suggests that a brown seaweed called bladderwrack may have an estrogen-reducing effect in women. This can reduce the growth rate of endometriosis.

One author presented a case study using a diet low in short-chain-fermentable carbohydrates to reduce the symptoms of endometriosis. This diet has been shown to work on IBS and since it is often found with endometriosis, then perhaps the diet would be effective for those with only endometriosis.

More research is needed, but there is little harm in trying this approach.

Dietary choices have also been linked to the development of endometriosis. A study carried out in 2011 suggested that fruit intake increased the risk of endometriosis and a higher total fat intake decreased the risk.

Dairy products were also shown to reduce the risk of endometriosis, although these results were not statistically significant.

Eating yogurt, sauerkraut, and pickles or finding a good source of probiotics may help reduce gastrointestinal symptoms and cause increased digestive activity.

Avoiding caffeine may help to reduce pain, as caffeine can worsen symptoms.

All about dementia, Medical Myths

Today, an estimated 5.8 million people aged 65 years or older in the United States have dementia. Due to the fact that the average lifespan of people in the U.S. has increased over recent decades, some experts project that by 2050, the number of older adults with dementia could reach 13.8 million.

1. Dementia is inevitable with age

This statement is not true. Dementia is not a normal part of aging.

According to a report that the Alzheimer’s Association published, Alzheimer’s disease, which is the most common form of dementia, affects 3% of people aged 65–74 years in the U.S. As a result of the risk increasing as we age, 17% of people aged 75–84 years and 32% of people aged 85 years and older have a dementia diagnosis.

2. Dementia and Alzheimer’s disease are the same thing

This is not quite correct. Alzheimer’s is a type of dementia, accounting for 60–80% of all dementia cases. Other types of dementia include frontotemporal dementia (FTD), vascular dementia, mixed dementia, and Lewy body dementia.

The National Institute on Aging define dementia as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.”

Although dementias share certain characteristics, each type has a distinct underlying pathology.

Alzheimer’s disease is associated with a buildup of so-called plaques and tangles in the brain. These structures interfere with brain cells, eventually killing them. In contrast, brain cell death in vascular dementia occurs due to a lack of oxygen, which can result from a stroke, for instance.

FTD, as another example, occurs when abnormal protein structures form in the frontal and temporal lobes of the brain, causing the brain cells in these regions to die.

3. A family member has dementia, so I will get it

A common myth is that dementia is purely genetic. In other words, if a person’s family member has a dementia diagnosis, they are guaranteed to develop dementia later in life. This is not true.

Although there is a genetic component to some forms of dementia, the majority of cases do not have a strong genetic link.

As we learned above, rather than genetic factors, the most significant risk factor for dementia is age. However, if a parent or grandparent developed Alzheimer’s when they were younger than 65 years, the chance of it passing on genetically is higher.

Early-onset Alzheimer’s is relatively uncommon, though. It occurs in about 5.5% of all Alzheimer’s cases.

As the majority of dementia cases are Alzheimer’s disease, this means that most dementia cases are not hereditary. FTD, which is much less common, has a stronger genetic link, but if a parent or grandparent develops the condition, it does not mean that children or grandchildren are guaranteed to develop it.

Today, FTD affects an estimated 15–22 in every 100,000 people. Of these individuals, 10–15% have a strong family history of the condition.

4. Dementia only affects older adults

Age is a risk factor for dementia, but dementia can affect younger adults in rare cases. Some scientists estimate that, in people aged 30–64 years, 38–260 people in 100,000 — equivalent to 0.038–0.26% — develop early-onset dementia.

In the 55–64 age bracket, this increases to close to 420 people in 100,000, or 0.4%.

5. Using aluminum pans causes Alzheimer’s

In the 1960s, scientists injected rabbits with high levels of aluminum. They found that the animals developed neurological lesions similar to those that form in the brains of people with Alzheimer’s.

Additionally, some studies have identified aluminum within the plaques associated with Alzheimer’s. However, aluminum also appears in the healthy brain, and researchers have not established a causal link between this element and the disease.

Following on from these studies, myths still circulate that drinking from aluminum cans or cooking with aluminum pots increases the risk of Alzheimer’s.

However, since those early experiments, scientists have not found a clear association between Alzheimer’s and using aluminum pots and pans.

Although researchers will, eventually, establish the precise relationship between aluminum and Alzheimer’s, consuming aluminum through the diet is unlikely to play a major role.

As the Alzheimer’s Society explain: “Aluminum in food and drink is in a form that is not easily absorbed into the body. Hence, the amount taken up is less than 1% of the amount present in food and drink. Most of the aluminum taken into the body is cleaned out by the kidneys.”

However, they also write that some research has found “a potential role for high dose aluminum in drinking water in progressing Alzheimer’s disease for people who already have the disease.”

6. Dementia signals the end of a meaningful life

Thankfully, this is not the case. Many people with a dementia diagnosis lead active, meaningful lives. Some people fear that if a doctor diagnoses them with dementia, they will no longer be able to go for a walk alone and will have to stop driving their vehicle immediately.

It is true that these adjustments may come in time as the condition progresses, but in mild cases of dementia, no changes may be necessary. As dementia worsens, changes to the way an individual leads their life are likely, but that does not mean that the person cannot lead a fulfilling life.

“Too many people are in the dark about dementia — many feel that a dementia diagnosis means someone is immediately incapable of living a normal life, while myths and misunderstandings continue to contribute to the stigma and isolation that many people will feel,” explains Jeremy Hughes, former Chief Executive of the Alzheimer’s Society.

7. Memory loss always signifies dementia

Although memory loss can be an early symptom of dementia, it does not necessarily signify the start of this condition. Human memory can be unpredictable, and we all forget things occasionally. However, if memory loss is interfering with everyday life, it is best to speak with a doctor.

Although memory issues tend to be an early sign of Alzheimer’s disease, that is not the case for other forms of dementia. For instance, early signs and symptoms of FTD can include changes in mood and personality, language difficulties, and obsessive behavior.

8. Dementia is always preventable

This, unfortunately, is untrue. Importantly, though, certain factors can either reduce the risk of certain types of dementia developing or delay their onset.

For instance, the Lancet Commission’s 2020 report on dementia prevention, intervention, and care lists 12 factors that increase the risk of dementia:

  • less education
  • hypertension
  • hearing impairment
  • smoking
  • obesity
  • depression
  • physical inactivity
  • diabetes
  • low levels of social contact
  • alcohol consumption
  • traumatic brain injury
  • air pollution

Some of these factors are more difficult to modify than others, but working on changing any of them might help reduce the risk of developing dementia. The authors of the report explain:

9. Vitamins and supplements can prevent dementia

Linked to the section above, this is also false. To date, there is no strong evidence that any vitamin or mineral supplements can reduce the risk of dementia. In 2018, the Cochrane Library conducted a review with the aim of answering this question.

Their analysis included data from more than 83,000 participants across the 28 included studies. Although the authors report “some general limitations of the evidence,” they conclude:

10. All people with dementia become aggressive

In some cases, people with dementia might find it increasingly hard to make sense of the world around them. This confusion can be frustrating, and some individuals might respond to the emotions in an angry manner. However, this is not the case for everyone.

In a study involving 215 people with dementia, 41% of the participants developed aggression during the 2-year study. When they looked at factors that increased the risk of developing aggression, the researchers identified two of the primary factors as physical pain and a low quality relationship between the person and their caregiver.

11. Dementia is never fatal

Unfortunately, dementia can be fatal. According to a recent study, which appears in JAMA Neurology, dementia may be a more common cause of death than experts have traditionally thought it to be. The authors “found that approximately 13.6% of deaths were attributable to dementia over the period 2000–2009.”

Dementia worries people, especially as they age, and this is justifiable in many ways. However, it is important to counter misinformation that might enhance concerns and stigma.

For now, researchers are working tirelessly to develop better ways to treat and prevent dementia. In the future, hopefully, science will reduce the impact of dementia and, therefore, the fear associated with the condition.

Water: Do we really need 8 glasses a day?

We often hear that we should drink eight 8-ounce glasses of water a day. However, there is some controversy about this figure and what it really means.

Water is an essential nutrient. It is necessary to sustain all forms of life, and humans can only live a few days without it. It is also a healthful drink.

Health authorities and others often encourage people to consume 2 or more liters of water a day, but is this only plain water or does water from other sources count?

Some sources have described these recommendations as a “myth,” and professionals have questioned the guidelines.

Some point to a lack of scientific evidence to support the claims, while others note that promoters of the concept have included a major mineral water producer.

How much plain water do we really need?

Fast facts on water intake

Here are some key points about daily water consumption.

  • Foods and fluids, including water, are the main source of water in our bodies.
  • The advice to drink eight 8-ounce glasses of water a day is not based on evidence.
  • The amount of water we need depends on individual needs and circumstances, including activity and climate.
  • The healthy body naturally maintains a well-tuned balance of fluid, and the thirst mechanism tells us when we need more.

Recommended daily water intake

In 1945, the U.S. Food and Nutrition Board advised people to consume 2.5 liters (84.5 fluid ounces (fl oz) of water a day, including fluid from prepared foods.

Today, the Centers for Disease Control and Prevention (CDC) say, “There is no recommendation for how much plain water adults and youth should drink daily.” However, there are recommendations about total fluid intake from all sources.

In 2004, the Institute of Medicine set the amount at around 2.7 liters, or 91 fluid ounces (fl oz) of total water a day for women and an average of around 3.7 liters (125 fl oz) daily for men.

This refers to the total daily fluid intake from all sources, defined as “the amount of water consumed from foods, plain drinking water, and other beverages.”

The U.S. Dietary Guidelines 2015-2020 do not recommend a specific daily water or fluid intake, but they do recommend choosing plain rather than flavored water and juices with added sugar.

There is currently no set upper level for water intake, although excessive quantities have been known to have adverse effects.

In the United Kingdom, the National Health Service (NHS) recommend consuming 6 to 8 glasses a day, or 1.9 liters (almost 34 fl0.oz), including water that is in food. They note this amount is suitable for a temperate climate. In hotter climates, they say, more will be needed.

Recommended intake by age

There is no fixed amount of fluid recommended by age, but some patterns emerge among healthy individuals doing a moderate amount of activity in a temperate climate.

The following shows average water intake for infants and adults:

Age groupAverage daily fluid intake
InfantsFrom 525 ml for a 3.5-kilo newborn to 1,200 ml for an 8-kilo infant per day, as breast or bottled milk
Adults aged 19 to 30 yearsAverage of 3.7 liters a day for men and 2.7 liters for women, depending on climate, activity, pregnancy status, and health

Infants

The amount of formula or breast milk an infant takes in averages 780 milliliters (ml), or just over 26 fl oz, of breast milk or formula milk each day until the age of around 6 months. Before the age of 6 months, plain water is not recommended.

This ranges from around 525 ml (just under 18 fl oz) a day for 3.5-kilo newborn to 1,200 ml per day (45 fl oz) for an 8-kilo infant at 6 months, or around 150 ml (5 fl oz) per kilo of weight per day.

This is proportionally far more than an adult needs. After infants start consuming solid foods, they need less fluid from breast milk and formula.

Children aged over 12 months

Children should be encouraged to drink water:

  • as part of the daily routine, for example, after brushing teeth and before, during and after playtime at school
  • when the weather is warm
  • as an alternative to sweetened drinks and juices

Juice consumption should be limited to one glass a day.

Parents are advised to keep a pitcher handy to encourage healthful water-drinking habits, and schools should have water fountains or equivalent facilities.

Children who are sick with a fever

For children who are at risk of dehyration, for example, with a fever, the CDC recommend the following:

AgeAmount of fluid needed
Up to 12 months3 cups
1 to 3 years4 cups
4 to 8 years5 cups
6 to 13 years8 cups
14 years and over11 to 13 cups for males and 8 to 9 cups for females

If a child is sick with a fever, it is important to seek medical help. A doctor may also advise oral an rehydration solution to ensure an adequate electrolyte balance.

Adults aged 19 to 30 years

The CDC cites figures showing that in 2005-2010 in the U.S., young people were drinking an average of 0.45 liters or 15 fl oz of water on a given day, while adults drank an average of 1.2 liters, or 39 fl oz.

The adequate intakes recommended for total water from all sources each day for most adults between 19 and 30 years of age are:

  • 3.7 liters (or about 130 fl oz) for men
  • 2.7 liters (about 95 fl oz) for women

One source suggests a man’s requirements might range from 2.5 liters (84.5 fl oz) if sedentary to up to 6 liters (203 fl oz) if active and living in a warm climate.

For women, the requirements will probably be 0.5 to 1 liter (17 to 34 fl oz) lower than those for men because of typically smaller body mass.

However, during pregnancy, women are likely to need an extra 0.3 liters (10 fl oz), and an additional 0.7 to 1.1 liters (23 to 37 fl oz) while breast-feeding.

Older adults

Older adults may be at risk of both dehydration and overhydration, as a result of health conditions, medications, loss of muscle mass, reduction in kidney function, and other factors.

Older adults who are well hydrated have been found to have:

  • fewer falls
  • less constipation
  • in men, a lower risk of bladder cancer

Dehydration has been linked to a higher frequency of:

  • urinary tract infections
  • confusion
  • kidney failure
  • slower wound healing

Needs for fluid intake will depend on the individual.

Few studies have looked at fluid input and output in older people, but at least one has concluded that it is not significantly different from that of younger people.

Those caring for older people are encouraged to provide fluids regularly and assist with ambulation, especially if a reduction in mobility makes it harder to visit the bathroom.

Where do the figures come from?

While water is known to be crucial for life and for preventing dehydration, recommendations for intake are based mainly on survey results showing the average amounts that people consume.

Conclusions are based on the assumption that these amounts must be about right for optimal hydration.

There is little evidence showing that specific quantities have a particular effect on health.

It is impossible to define an optimal intake, because these vary greatly according to:

  • activity
  • environmental conditions
  • individual factors
  • body mass
  • sex and age
  • health status, for example, poor kidney function
  • medications, such as diuretics
  • whether or not a person is pregnant or breast-feeding

Recommendations that a person should drink eight glasses of water a day also fail to take into account the fact that much of our fluid intake comes from food and other drinks.

Sources of water

Water in the body comes not only from drinking water.

Estimations vary, but according to one source:

  • around 20 to 30 percent comes from food
  • some 60 to 70 percent comes from drinking water and other fluids
  • a small percentage, about 10 percent is “metabolic water,” produced by cells during normal cell function

The more active the body is, the more metabolic water is produced.

Some surveys suggest that around 20 percent of water intake comes from foodstuffs and the rest is from fluids. This depends on diet. A higher intake of fresh fruit and vegetables will mean a higher intake of water from foods.

Metabolic water accounts for around 250 to 350 ml (8.4 to 11.8 fl oz) a day.

Water content of foods

Here are some examples of the water content of different foods and fluids:

Water content as a percentage (%)Food or drink
100%Water
90-99%Fat-free milk, tea, coffee, juicy fruits such as strawberries and cantaloupes, vegetables such as lettuce, celery, and spinach
80-89%Fruit juice, yogurt, fruits such as apples, pears and oranges, vegetables such as carrots, and cooked broccoli
70-79%Bananas, avocados, baked potatoes, cottage and ricotta cheeses
60-69%Pasta, beans, and peas, fish such as salmon, chicken breasts, and ice cream
30-39%Bread, bagels, and cheddar cheese
1-9%Nuts, chocolate cookies, crackers, cereals
0%Oils and sugars

Tap or bottled water?

Bottled or tap water are equally effective at hydrating the body. In terms of hydration, studies in the UK have not found any significant difference between drinking the two.

Mineral waters contain different amounts of minerals, depending on where they come from, but this, too is not significant, as most minerals come from other dietary sources.

What about coffee?

Caffeinated drinks are thought to be dehydrating as opposed to hydrating because of a belief that they have a diuretic effect on our water balance.

A number of studies to test how caffeinated fluids affect hydration have shown that tea and coffee are in fact good sources of water and do not lead to dehydration.

One study of 18 healthy male adults found that no significant difference in impact on hydration, measured in body weight, urine and blood tests after a variety of caffeinated, non-caffeinated, caloric, and non-caloric drinks.

“Advising people to disregard caffeinated beverages as part of the daily fluid intake is not substantiated,” say the researchers.

Another concludes that there is “no evidence of dehydration with moderate daily coffee intake.”

Benefits of drinking water

Water is necessary for the body. It:

  • regulates temperature
  • lubricates the joints and bones
  • protects the spinal cord and other sensitive tissues
  • removes waste from the body

Short-term benefits

A healthy fluid intake, including water, prevents dehydration.

The short-term symptoms of significant dehydration include:

  • unclear thinking
  • mood change
  • overheating
  • feeling thirsty and having a dry mouth
  • fatigue
  • dizziness
  • headache
  • dry mouth, eyes, and lips
  • urinating less than usual

Overheating can lead to organ damage, coma, and death.

The CDC urge people to make sure they drink enough water before, during, and after physical work, especially if this involves activity in a hot climate. This can help maintain alertness and effectiveness.

In a hot environment, you may need one 8-ounce cup every 15-20 minutes, but not more than 48 ounces in one hour, as this can lead to hyponatremia, a low level of sodium.

Plain water provides hydration without adding calories or jeopardizing dental health. Sports drinks can be useful in moderation, but too many will add unnecessary sugar to the body.

Long-term benefits

Studies suggest that long-term benefits of drinking water might include a lower risk of:

  • colorectal cancer and cancers of the urinary system
  • heart disease
  • urinary tract infections
  • kidney stones
  • constipation
  • high blood pressure
  • stroke

However, these possible long-term benefits also depend on a wide variety of other factors.

In addition, study participants with the lower risk of these conditions still drank fewer than eight 8-ounce glasses of water a day.

Weight loss

Drinking water may also help with weight loss, if a person “preloads” with water before a meal. This may help them feel fuller faster during meals. If they choose water over sweetened juice or soda, they consume fewer calories.

In a study where 318 people with obesity or overweight switched from sugary drinks to plain water, an average loss of 2 to 2.5 percent in weight was noted. But this could be easily explained by a decrease in total calories rather than water itself.

Other possible benefits

Other supposed benefits of drinking more water include prevention of:

  • migraine
  • nosebleeds
  • depression
  • high blood pressure
  • asthma
  • dry cough
  • dry skin
  • acne

However, there is little or no scientific evidence to confirm these claims.

In children, a higher water consumption has been linked to better diets, behavior and overall health.

When is more water needed?

Extra water may be needed when a person:

  • is in a hot climate
  • is doing physical activity
  • has diarrhea or vomiting
  • has a fever

These can lead to additional loss of water.

What about a water detox?

There have also been claims that water can “detox” the body.

These claims are not based on scientific facts.

The liver, kidneys, and human body normally break down toxic substances into less harmful ones or expel them from the body through urine. Water does not have a unique role in these processes.

Too much water can lead to hyponatremia, also known as low sodium. Low sodium levels can be life-threatening causing confusion, seizures, coma and death.

Hydration during exercise

During exercise, factors affecting the amount of fluid lost and the need for extra intake include:

  • the type and intensity of the activity
  • environmental factors, such as climate
  • the size and muscle mass of the athlete

Guidance from the American College of Sports Medicine (ACSM), published in 2007, recommends making an individual estimation of the fluid replacement needed by people taking part in exercise, to avoid dehydration.

Larger athletes may require higher fluid intake, for example, compared with smaller, leaner athletes, due to a larger body surface and higher body weight.

The ACSM advises drinking water during activity to prevent:

  • dehydration that leads to a fall in body weight of more than 2 percent
  • changes in the electrolyte balance

These changes, they say, can lead to reduced performance.

However, a study published in the British Journal of Sports Medicine concludes that a loss of up to 3 percent of water has “no effect” on real-world sports performance.

The conclusions were supported by findings from a cycling time-trial over 25 kilometers in hot conditions of 91.4° Fahrenheit and 40 percent relative humidity.

Results showed no difference in performance, physiological, and perceptual variables between participants who received hydration and those who did not.

The reason for this, say the authors, is “the body’s rapid defense of its plasma and blood volume following dehydration.”

In other words, the body can regulate water balance with high sensitivity.

Authors of a study focusing on runners in the 2002 Boston Marathon, published in the New England Journal of Medicine (NEJM), concluded:

“Because runners vary considerably in size and in rates of perspiration, general recommendations regarding specific volumes of fluids and frequencies of intake are probably unsafe and have been superseded by recommendations favoring thirst or individual perspiration rates as a primary guide.”

A review of 15 studies found that exercise-induced dehydration did not reduce performance. The authors encouraged athletes to “drink according to their thirst.”

Water and dehydration in the human body

Dehydration can be measured in terms of blood and urine osmolality.

Osmolality is an estimation of the osmolar concentration of plasma. It reflects the concentration of particles in a solution.

As regards dehydration:

  • high osmolality indicates a greater need for hydration
  • low osmolality suggests there are too few particles, specifically sodium and electrolytes, a sign of overhydration

How much water is in the human body?

The main chemical making up the human body is water. It accounts for between 55 percent and 75 percent of the body’s composition, and it varies between individuals.

  • in the average young man, between 50 and 70 percent of the body weight is water
  • in infants, 75 percent of body weight is water
  • in older people, it is 55 percent

Differences of age, sex, and aerobic fitness affect an individual’s ratio of lean to fat body mass and therefore how much water they contain.

Calculating human water needs

The amount of water we need to take in to maintain a healthy balance is decided by how much water we use and lose that must be replaced.

Over the course of 24 hours, healthy resting adults regulate their water balance to within around 0.2 percent of body weight.

In older children and adults, if a person’s body weight falls by 3 percent due to fluid loss, this is considered dehydration. Moderate dehydration is when weight falls by 6 percent, and severe dehydration is when it falls by 9 percent.

It is difficult to measure the amount of water used or lost by the body. Measures taken across groups of people in studies have shown wide variation.

However, if people show symptoms of dehydration, such as confusion or decreased urine output, they need medical attention.

What about dark urine?

There is a popular concept that darker urine means a person is dehydrated, while pale urine shows they are adequately hydrated.

However, it is difficult to assess the significance of urine color precisely. It depends on the time of day, medications, and other health problems.

Tea- or cola-colored urine, particularly after exercise, can indicate serious muscle injury and severe dehydration and requires urgent medical attention.

However, in normal circumstances, urine that is well within the limits of normal osmolality in laboratory tests can appear moderately yellow. This does not indicate that a person is dehydrated.

In addition, other factors such as diet, medications and health conditions can cause individuals to differ in their urine color.

How does the body regulate water?

Without water, there is no life. For this reason, all living organisms have adapted to avoid dehydration.

Humans can only survive for a few days without water. Infants and older people who lose water through illness and do not replace it can experience life-threatening complications.

Most of the time, however, our bodies’ sensitive natural mechanisms maintain appropriate fluid levels, or homeostasis, as long as we continue to consume food and water.

The two main ways the body does this are:

Thirst: This which tells us when we need to take in more fluid.

Urine output: The kidneys regulate any excess or lack of the water we consume by either emptying it into the urinary bladder or holding onto it in the blood plasma.

The body expels 0.5 to 1 liter (around 17 to 34 fl oz) per day in the form of urine.

The kidneys also:

  • regulate the balance of electrolytes, such as sodium and potassium, in the body fluids
  • receive hormonal signals to conserve or release water into the urine if the brain detects changes in the concentration of the solutes in the blood

The brain also responds to these changes in solutes, known as plasma osmolality. This is one factor that triggers the thirst for water.

Other ways in which water is lost or expelled from the body are:

Breathing: About 250-350 ml (8.5 to 11.8 fl oz) per day exit from the lungs during. exhalation

Feces: Around 100-200 ml (3.4 to 6.8 fl oz) per day passes out of the body in feces.

Sweating: Sedentary loss ranges from around 1,300-3,450 ml (44 to 117 fl oz) a day, but a physically active person can lose 1,550-6,730 ml (52 to 227.5 fl oz) a day

What about ‘8 by 8’?

It is often said that we needed to drink at least eight glasses of water a day, although there is little scientific evidence to support this.

Prof. Heinz Valtin, of Dartmouth Medical School in Hanover, NH, is one expert who has questioned this advice. He suggests it may be not only unnecessary but maybe even harmful.

In an article published in the American Journal of Physiology in 2002, he concludes:

“Not only is there no scientific evidence that we need to drink that much, but the [8 by 8] recommendation could be harmful, both in precipitating potentially dangerous hyponatremia and exposure to pollutants, and also in making many people feel guilty for not drinking enough.”

Prof. Heinz Valtin

The right types of fluid

Recommendations are now more likely to note that water can come from other beverages and from food. However, these should be chosen carefully.

Beverages that are high in fat or sugar or contain alcohol do not benefit health, and plain water is recommended in preference to these.

More than one alcoholic beverage per day in women and more than two alcoholic beverages per day in men on a regular basis can lead to liver inflammation and injury, an increased cancer risk, as well as negatively affecting every system of the body.

Fatty or sweetened drinks increase calories and lack nutritional value.

Processed foods, such as burgers and chips, high fat, and high sugar diets will contain less water than fresh fruits and vegetables.

Nearly all foods contain water, but fresh and healthful ingredients contain the most compared to processed foods, sugars, and fats.

The CDC note with concern that young people who consume high quantities of junk food are also drinking less water and eating less fresh fruit and vegetables. This can lead to further health problems. They are also often drinking highly sweetened beverages rather than water.

A study published by the CDC in 2013 showed that:

  • Seven percent of adults said they did not drink any water
  • Thirty-six percent said they drank 1 to 3 cups a day
  • Thirty-five percent reported drinking 4 to 7 cups
  • Twenty-two percent said they drank 8 cups or more

Those who drank the least water were also less likely to pursue other healthful behaviors, such as consuming fresh fruits and vegetables.

Too much water?

Some have raised concerns that consuming too much water could be dangerous.

Not only the amount of fluid in the body but the balance of minerals that is important for maintaining health and life.

Too much water in the body could lead to hyponatremia, or water intoxication, when sodium levels in the blood plasma become too low.

Symptoms include:

  • lung congestion
  • brain swelling
  • headache
  • fatigue and lethargy
  • confusion
  • vomiting
  • seizures
  • coma
  • death

Hyponatremia may be a risk for people who use the recreational drug Ecstasy. This is likely due to a variety of reasons including a change in hormone levels, brain chemistry, body function, kidney function, along with increased sweating and thirst.

People who drink too much water while exercising could also be at risk. In the Boston runners survey, for example, almost 2,000 of the participants were thought likely to have some degree of hyponatremia due to excessive fluid consumption, and 90 may have finished with critical hyponatremia.

Another risk factor is having certain diseases or using some medications. Diabetes, for example, can lead to excessive thirst. Conditions in which the kidneys cannot excrete enough water, too, can result in this type of problem.

However, just as the body can adapt to higher or lower levels of water and can remind us, through thirst, when we need to drink more, scientists believe an internal mechanism also stops most people from drinking too much water.

Takeaway

There are few scientific measures of how much water we need.

Most studies have focused on how much people consume and assumed that this figure matches or exceeds our needs. It does not determine whether a person is efficiently hydrated or not.

The amount of water a person uses and loses varies according to conditions and activities. Heat, activity, and illness, such as diarrhea and vomiting, can lead to dehydration.

Most healthy people in a temperate climate consume sufficient fluid to remain healthy while carrying out their daily activities, and around one fifth to a quarter of this comes from food. Where there is a lack, the body will usually regulate these needs.

Meanwhile, those who work outside or exercise in a hot climate will not be able to get all their water needs from food. They will need additional water.

Perhaps, as Prof. Farrell of Monash University says, “If we just do what our body tells us, we will probably get it right.”

Q:

Should people aim to consume a particular quantity of water each day?

A:

The most recent research supports the theory that thirst is the best guide for determining fluid intake. For the average individual, even in routine physical activity, allow thirst to determine when and how much you drink. 

Those with certain medical conditions, such as kidney disease or heart failure, may need to follow their doctor’s advice regarding daily fluid intake in order to avoid the complications of low sodium levels in their blood.

Judith Marcin, MD

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.