Blackout drinking is never a wise idea, but new research pinpoints why people sometimes imbibe to the point where they pass out.

Are you drinking too much?

Celebrations and coping with stress are the top reasons for blackout drinking, the study found.

Drinking too much too fast can cause a blackout, where a person remains conscious but later can’t remember what happened. Blackout drinking can put people at risk for accidents and risky behaviours, and may do long-term damage to the brain.

Despite the risks, it is common in the United States – particularly among young adults – and some people drink with the goal of blacking out.

In order to learn more, researchers examined hundreds of Twitter tweets posted over four days in April 2018 about people’s plans to drink until they black out.

Nearly a third of the tweets included specific motives. The most common were celebrations such as birthdays, school or work accomplishments, sports wins or holidays.

Another common reason was to cope with stress, negative emotions or loss. Examples included: “I’m so stressed I need to get blackout drunk tonight,” and “I want to get blackout drunk to forget all about this horrible year.”

Such public expressions may normalise and encourage risky behaviour in others, according to researchers Benjamin Riordan from the University of Sydney in Australia; Jennifer Merrill from Brown University in Rhode Island, and Rose Marie Ward from Miami University in Ohio.

The study was recently published in the journal Alcoholism: Clinical & Experimental Research.

The authors said their findings improve understanding of attitudes and behaviors associated with blackout drinking, and will guide a future investigation of links between drinkers’ intentions and their actual behaviour.

In a journal news release, they said the two main reasons for blackout drinking – celebration and coping – identified in the study, suggest possible interventions.

For example, education about blackout drinking could be included in prevention campaigns by schools, universities and community groups to reduce celebratory drinking.

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There is no one right diet for people with diabetes, and patients should instead have personalised nutrition plans, a new American Diabetes Association (ADA) report says.

There simply is no ideal percentage of calories from carbohydrates, proteins and fats. And combinations of different foods or food groups are acceptable for the management of diabetes and pre-diabetes, the report added.

Weight management essential

“‘What can I eat?’ is the number one question asked by people with diabetes and pre-diabetes when diagnosed,” said Dr William Cefalu, chief scientific, medical and mission officer at the ADA. “This new consensus report reflects the ADA’s continued commitment to evidence-based guidelines that are achievable and meet people where they are.”

As with type 2 diabetes, being obese with type 1 diabetes can worsen insulin resistance, blood sugar levels, microvascular disease complications and heart disease risk factors. Therefore, weight management should be an essential component of care for people with type 1 diabetes who are overweight or obese, as it is for those with type 2 diabetes, the report said.

General recommendations on nutrition plans include: emphasis on non-starchy vegetables; minimising added sugars and refined grains; eating whole, unprocessed foods as much as possible; replacing sugary beverages with water as often as possible; and replacing saturated fats with unsaturated fats.

Research suggests that medical nutrition therapy for adults with type 2 diabetes can achieve haemoglobin A1c reductions similar to or greater than what could be expected with medications, according to the report.

Haemoglobin A1c is a test used to check blood sugar levels over a period of time.

The report was prepared by a panel of 14 experts, and published online in the journal Diabetes Care.

No single nutrition plan

The panel reviewed more than 600 studies published between 2014 and 2018 to produce the new nutrition guidelines.

“The importance of this consensus also lies in the fact it was authored by a group of experts who are extremely knowledgeable about numerous eating patterns, including vegan, vegetarian and low-carb,” Cefalu added.

“As detailed by the latest evidence, there is no one single nutrition plan to be recommended for every person with diabetes due to the broad variability of diabetes for each individual, as well as other life factors such as cultural backgrounds, personal preferences, other health conditions, access to healthy foods and socioeconomic status,” Cefalu said.

“The ADA strongly encourages an individualised approach that includes regular review of nutrition status for all people living with diabetes,” he said. “Reassessment of an individual’s nutritional plan is particularly important during significant life and health status changes,” Cefalu concluded.

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Many festivals around the world now offer much more than music, but what effect do they have on your health?

When it comes to blood pressure readings, the “top” number seems to grab all the attention.

But a large, new study confirms that both numbers are, in fact, critical in determining the risk of heart attack and stroke.

Treatment based on both readings

Blood pressure measurements are given as a “top” and “bottom” number. The first reflects systolic blood pressure, the amount of pressure in the arteries as the heart contracts. The second reflects diastolic blood pressure, the pressure in the arteries between heart muscle contractions.

For years, systolic blood pressure has been seen as the one that really matters. That’s based on studies – including the famous Framingham Heart Study – showing that high systolic blood pressure is a stronger predictor of heart disease and stroke.

At the same time, though, doctors measure both systolic and diastolic blood pressure, and treatment guidelines are based on both. So just how important is that diastolic number?

“The idea behind this new study was to address the confusion,” said lead researcher Dr Alexander Flint, an investigator with Kaiser Permanente Northern California’s division of research.

Using medical records from 1.3 million patients, his team confirmed that, yes, high systolic blood pressure was a stronger risk factor for heart attack and stroke. But those risks also climbed in tandem with diastolic pressure; and people with normal systolic readings were still at risk if their diastolic pressure was high.

“There’s been a common belief that systolic blood pressure is the only one that matters,” Flint said. “But diastolic definitely matters.”

A revamp in recent years

He and his colleagues reported the findings in the New England Journal of Medicine.

The definition of high blood pressure has gotten a revamp in recent years. Guidelines issued in 2017 by the American College of Cardiology (ACC) and other heart groups lowered the threshold for diagnosing the condition – from the traditional 140/90 mm Hg to 130/80.

The fact that treatment guidelines include a diastolic pressure threshold implies that it’s important. And indeed it is, said Dr Karol Watson, a member of the ACC’s prevention section and leadership council.

In fact, she said, doctors once thought that diastolic blood pressure was the more important one – based on research at the time. Then came the studies showing that systolic pressure was generally a better predictor of people’s risk of heart disease and stroke.

In addition, Watson said, high systolic blood pressure is more prevalent, because of natural changes in blood pressure as people age.

“As we get older, systolic blood pressure keeps marching up,” she explained. Diastolic blood pressure, on the other hand, generally peaks when people are in their 40s to 60s – and then it declines.

But it’s clear, Watson said, that while systolic and diastolic blood pressure are different, they both deserve attention.

Never ignore diastolic number

In the latest study, cardiovascular risks rose with each “unit increase” in systolic pressure above 140, by about 18% on average. Meanwhile, each increase in diastolic blood pressure above 90 was tied to a 6% increase in heart disease and stroke risk.

The researchers saw a similar pattern when they looked at blood pressure increases above the 130/80 threshold. That, Flint said, supports the 2017 guideline shift.

The findings are based on over 1.3 million patients in the Kaiser Permanente health system who had roughly 36.8 million blood pressure readings taken from 2007 through 2016. Over eight years, more than 44 000 patients had a heart attack or stroke.

According to Flint, it’s the largest study of its kind to date.

The bottom line for patients, Watson said, is that they should care about both blood pressure numbers. In her experience, she noted, patients often point to the number that’s in the normal range and say, “But look how good this is.”

Flint agreed, saying that no one should “ignore” the diastolic number. “It’s important not only in blood pressure treatment, but on the side of diagnosis, too,” he said.

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College athletes with attention deficit hyperactivity disorder (ADHD) may be slower to recover from a concussion and may have more severe symptoms.

That’s the preliminary conclusion of a study of 120 US college athletes who suffered concussions. Forty had ADHD; 80 did not. Of those with ADHD, half were taking stimulant medications for the disorder.

Greater symptom burden

All were evaluated before the season, within two days after a concussion, and again when they were cleared to play with no restrictions.

Concussion symptoms averaged 12 days for athletes with ADHD who were taking medication; 10 days for those with ADHD who were not on medication; and four days for those without ADHD.

“These results may help as we try to determine why some athletes take longer to return to play and experience greater symptom burden,” said co-author R. Davis Moore, an assistant professor of exercise science at the University of South Carolina.

All the athletes with ADHD had greater losses than others in verbal memory and more severe concussion symptoms one to two days after their injury, the study found.

Compared to injured athletes without ADHD, those with unmedicated ADHD had larger declines in thinking and learning skills days after their concussion and also when they returned to play.

Prolonged recovery

Researchers said athletes with ADHD who were taking stimulant medications responded more slowly at both of those times than those without ADHD on tests of visual motor speed.

The preliminary findings were to be presented at the American Academy of Neurology Sports Concussion Conference in Indianapolis. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

“Athletes with ADHD should be monitored with this [slower response] in mind, as they may be more susceptible to prolonged recovery, and in general it’s important to be aware of and address pre-existing health conditions in anyone at risk for concussion,” Moore said in a meeting news release.

“Although, these results are intriguing, they will need to be replicated with larger studies,” he said.

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Having a particularly bad week at work? The impact of burnout on your health is even more far-reaching than previously believed.

According to the World Health Organization (WHO), attention should be given to the medical problems that can be created by work-related stress. The WHO announced recently that the definition of “burnout” will be updated in the latest version of The International Classification of Diseases – ICD-11. This definition will be official from January 2022.

While “burnout” is not yet an official medical condition according to the WHO, it is classified as an “occupational phenomenon”.

Do you suffer from burnout?

We all have bad days at some stage. But if you carry on hating your job for months, you might be heading towards proper burnout. The WHO lists the following signs of burnout:

• Feelings of exhaustion or depletion
• Mental disconnect from your career
• Feelings of negativity or cynicism related to your job/career
• Decreased productivity and reduced professional efficiency

How can it affect your health in the long run?

While the earlier definition of burnout was simply put as “a state of vital exhaustion”, it is now more detailed and gives more legitimacy to the condition.

Not only will burnout take the joy out of your life and affect your overall productivity, but it will also affect your body – your immunity will take a knock, your sleep will be compromised, and your normal healthy diet and exercise regime may be affected.

What can you do?

According to Ron Friedman, a psychologist for corporate and private clients, the problem of burnout is much bigger than it was a decade ago. There are many misconceptions about burnout, such as the stigma that you are simply not cut out to do your job, leading to the condition being ignored and mismanaged.

But, with this newly detailed definition by the WHO, workplaces will hopefully take burnout more seriously.

However, in the meantime here are a few tips to help you manage:

1. Value your work

When your work feels mundane and boring, it’s difficult to have a sense of purpose. But focusing on ways you help others through your job may give you a sense of purpose.

2. Don’t put your eggs in one basket

Find joys and hobbies outside of work. Value your family and friends or hobbies and activities away from work. If you feel like there is nothing outside work, find a new activity or club that you can join over weekends. Start volunteering at charity organisations, or reach out to your community to meet people from outside your work sphere.

3. Make your work ‘work’ for you

Use the resources that your company has to offer, whether it’s free counselling sessions, the opportunity to work flexi hours, or extra courses. Make use of your leave days, and take sick leave if you need it. 

4. Focus on nutrition

Nutrition plays a big role when it comes to overall energy levels and productivity at work. Instead of visiting the local coffee shop for your daily croissant, start making a habit of packing a healthy variety of tasty snacks that will boost your energy levels, like nuts and fresh fruit.  

5. Socialise at work

Feeling isolated and alone? Colleagues may be experiencing the same problems as you. Start chatting to that person you see in the cafeteria every day. Smile at people in the elevators.

Don’t ignore the feeling

While you should do your best to remain positive at work, never dismiss feelings of despair or burnout. Don’t hesitate to talk to a medical professional or contact an organisation such as the South African Depression and Anxiety Group (SADAG) if you feel you need help.

The outbreak shows no signs of abating, so why is the roll-out of a second vaccine proving contentious?

Why are people selling the very core of their identity to private firms?

The money will be available immediately, with some of it funding upgrades to 20 hospitals in England.

Taking testosterone might sound like a good idea for an older man, but a new study suggests the treatment might be bad news for his heart.

Men who took it showed a slightly increased risk of heart attack and stroke in the first few years.

Limited evidence of benefits

“Our findings show that the use of [testosterone therapy] was associated with an increased risk of stroke, TIAs [mini-strokes], or cardiac arrest during the first two years of use,” said study author Dr Christel Renoux. She is from the departments of epidemiology, biostatistics, and occupational health, and the department of neurology and neurosurgery at McGill University in Montreal.

“There is limited evidence on the long-term clinical benefits of [testosterone therapy] to effectively treat the modestly declining levels of [natural] testosterone levels of ageing but healthy men,” Renoux said. “We strongly recommend that clinicians proceed with caution when considering prescribing [testosterone therapy] and first discuss both the potential benefits and risks with patients.”

The team analysed data from about 15 400 British men, aged 45 and older, with age-related low testosterone levels.

Those who took testosterone replacement therapy had a 21% higher risk of cardiovascular events such as heart attack, stroke or mini-stroke than those who did not take the therapy. That increased risk translated into 128 more cardiovascular events.

However, the increased risk declined after two years of testosterone treatment, according to the study published recently in The American Journal of Medicine.

General symptoms of ageing

Further studies should be conducted to confirm this study’s findings, Renoux recommended.

“Until such time, the potential cardiovascular risk of [testosterone therapy] should be weighed against the perceived and expected benefits among ageing men,” she said in a journal news release.

While reported rates of low testosterone have remained stable, prescriptions for testosterone replacement therapy have soared in the last 20 years.

Increasingly, testosterone replacement therapy is prescribed to treat general symptoms of ageing, including fatigue and slight declines in sexual functioning.

One of the other study findings was that current use of testosterone replacement therapy was associated with a lower risk of death from any cause, while past use was associated with an increased risk.

While this suggests that testosterone replacement therapy may reduce the risk of death, it could also be because doctors halt the therapy in men with declining health, the researchers noted.

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