Medical oncologists administer anticancer drug regorafenib to try to improve overall survival in patients with metastatic colorectal cancer who have ceased to respond to standard therapy (known as refractory mCRC). However, some of the adverse events related to the use of this drug often limits its use in clinical practice. A study reported at the ESMO World Congress on Gastrointestinal Cancer 2019 suggests the usefulness of a more flexible dosing, which improves patients’ quality of life without jeopardising efficacy.

Ask anyone what worries them most about getting older, and more than a few people will say losing the ability to remember things is high up on their list. After a lifetime of making memories and forging meaningful relationships, the idea that a disease like Alzheimer’s could swoop in and steal it all away is, frankly, pretty frightening.

But what exactly does an Alzheimer’s diagnosis mean, anyway? And what is life like with the condition? Truthfully, it’s tough to be fully prepared until you’re actually living it, either yourself or because you’re a caregiver or family member of someone with Alzheimer’s.

“Newly diagnosed adults and their family members are deeply concerned about how to navigate this uncertain future,” says Laura Rice-Oeschger, who runs a caregiver wellness program for the University of Michigan’s Alzheimer’s Disease Center. “They’re overwhelmed with ideas and fears, which often stem from a previous personal experience with Alzheimer’s or what they learn from the media.”

There’s no better time to introduce some real talk about what the disease means (and doesn’t mean) for someone newly diagnosed. If you’re dealing with a diagnosis or preparing to care for a loved one who was recently diagnosed with Alzheimer’s, these 12 facts—straight from Alzheimer’s health care providers and caregivers—will help paint a more accurate reality of navigating life with the condition.

1. You can still have meaningful relationships despite having Alzheimer’s.

A lot of the fear surrounding an Alzheimer’s diagnosis comes from worrying about how the disease will affect your relationships with family and friends. They will inevitably change, but your connection to your loved ones doesn’t have to disappear.

Bobbie, an Alzheimer’s caregiver in Rice-Oeschger’s wellness program, says she has learned that the spirit of her husband is still there despite their changed relationship: “[Even when] I’m mystified by what he says and does, he is trying to communicate something that is important to him. If I am present to him, completely and with kindness, our ability to communicate and learn from each other…is greatly enhanced.”

READ MORE: Are Your Drinking Habits Ruining Your Brain Health?

2. Brain degeneration happens very gradually.

With Alzheimer’s, symptoms of the disease do not appear overnight, and they also don’t go from mild to horrible in the blink of an eye. While it’s a degenerative disease, meaning it continues to develop and worsen gradually, you do have some control over the speed at which it carries on.

Brain degeneration happens over the course of 15 to 20 years, according to Dr David A. Merrill, a neurologist and geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica—which means decades can pass from the time it begins until the brain is no longer functioning.

“There is no reason to be hopeless about an Alzheimer’s diagnosis,” Dr Merrill asserts. “It’s never too late to start changing your lifestyle to slow down the progress of the disease.”

3. Diet, exercise, and sleep matter more than you think.

Speaking of lifestyle changes, they can help you slow or even stave off the brain degeneration associated with Alzheimer’s. Aerobic exercise, sufficient sleep, and a healthy diet are all integral to both brain and body health, says Dr Henry Paulson, a neurologist and director of the University of Michigan’s Alzheimer’s Disease Center.

Why? Regular cardio activity boosts the parts of the brain involved with memory and cognition, Harvard Health reports; and some research suggests eating a Mediterranean-style diet may slow the brain degeneration linked to Alzheimer’s, according to the National Institutes of Health.

As for sleep? “If you don’t get enough good sleep, your brain can’t clear the abnormal proteins that accumulate,” Dr Paulson explains. He’s referring to beta-amyloid, which is a brain compound suspected of being one of the causes of Alzheimer’s.

4. It’s not always helpful to focus on the genetic component.

If your mother and grandmother both had Alzheimer’s, does that mean you definitely will, too? While there is a genetic risk factor that increases the hereditary likelihood, Dr Merrill says it’s better to focus on the areas of your life that you have *control* over, instead of the ones you don’t.

“Genetic risk factor is less important than the sum of all the modifiable risk factors,” he says. “Changing our behaviours and lifestyle can actually counteract any genetic risk factor we have.”

Dr Merrill suggests paying attention to subtle age-related changes as they happen, whether you’re at an elevated risk of developing Alzheimer’s or not. Addressing your diet and exercise routine or prioritizing brain-stimulating activities—like puzzles, computer games, and book clubs—can ward off some of the normal (and not-so-normal) cognitive effects that occur during the ageing process.

READ MORE: 5 Serious Health Conditions That Can Be Passed Down Through Your Genes

5. Planning for the future is critical after a diagnosis.

“There are so many difficult and excruciating decisions families must make when caring for a family member with a dementia disease,” says Rice-Oeschger. Depending on your situation, this might mean:

• Establishing power of attorney for legal and health decisions
• Speaking with a financial advisor
• Discussing end-of-life options
• Making long-term residential plans, like arranging in-home care or finding an assisted living facility

Glen, another caregiver in the University of Michigan’s wellness program, recommends considering the logistics of how your life will change together as a couple or as a family while you still can, as opposed to waiting or delaying these conversations.

6. Socialization is a regularly prescribed “treatment” method.

Okay, there’s no actual cure for Alzheimer’s. But don’t overlook the power of regular social interaction in preserving cognition. And this is extremely important before *and* after a diagnosis.

“When it comes to the brain, I tell patients to ‘use it or lose it,’” says Dr Paulson. “People are social animals and socialization drives us. Do a lot of whatever mentally stimulates you.”

Maybe that means weekly lunches with friends, Facetime sessions with long-distance relatives, volunteering for a cause, or joining local clubs, groups, and committees. Whatever keeps you connected, fill up your calendar the best you can with that. Letting your inner social butterfly loose can give your brain function a serious boost.

7. Support programs can help preserve the mental well-being of both patients and caregivers.

If you’re an Alzheimer’s patient, finding a local support group can help you navigate the challenges of life with a dementia disease.

If you’re a caregiver, Rice-Oeschger recommends seeking out a wellness programme to combat the often-isolating nature of caregiving and forge invaluable relationships with people who know exactly what you’re experiencing. “You will benefit from continuous, enjoyable, thought-provoking, and profound connections with other caregivers,” she asserts. “Find and commit to a counsellor or enriching wellness program [that reminds] you to how to take care of yourself over the long haul.”

READ MORE: The 3 Most Common Neurological Diseases That Affect Women

8. Caregiving is *a lot* emotionally. But it’s also incredibly rewarding.

On the topic of caregiver needs, Rice-Oeschger says daily caregiving is stressful enough to impact a person’s health and well-being (which can, in turn, directly affect your loved one’s health and well-being). In a 2017 US National Poll on Healthy Aging released by the University of Michigan, 78 percent of caregivers surveyed said their efforts are stressful.

But it’s not all gloom: In that same poll, 85 percent of caregivers reported that caregiving is a rewarding experience, and 63 percent called it both stressful and rewarding. “Most people do not understand how stress and positive [emotions], even joy, can be experienced alongside one another,” explains Rice-Oeschger.

The point? There will be happy days and sad days, easy days, and tough days for both the patient and the person helping to take care of them—and it’s all normal.

9. Education is important, but it’s only one piece of the puzzle.

Before you spend every waking hour researching the ins and outs of the disease, know that education has a time and place in your new role as patient or caregiver.

“Go to every workshop, conference, support group, and education event you can, but also know these will only take you so far,” says Rice-Oeschger.

Debra, an Alzheimer’s caregiver from Michigan, echoes these thoughts based on her experience caring for her husband: “Gather facts and information and read about the disease, but understand that each individual with the diagnosis is unique. What you know about your loved one is as important, or I would argue more important, than any fact about the disease that you will ever read.”

10. You will have difficult interactions.

Most caregivers find themselves unprepared for the changes in personality and memory recall they observe in their loved ones.

“Your sweet, innocent [mother] who does not swear will curse like a sailor and call you names,” says Kelly, who lives in Cypress, Texas, and cares for her mother with mid- to late-stage Alzheimer’s. “Try to remember it is not her doing these things…it’s this disease.”

Kelly also reveals she turned into a good “white liar” when it became too traumatizing to remind her mother over and over of her own mother’s passing more than 20 years earlier, and advises against arguing with a person with Alzheimer’s.

“If your loved one says something more than once, just pretend like it was the first time you heard it,” she suggests. “‘Do not say, ‘Mom, you just said that.’ That will only cause an argument.”

11. People with Alzheimer’s don’t lose all independence.

Whether you’re in the patient or caregiver role, you might be stressing over just how much personal freedom will be taken away as a result of Alzheimer’s. But patients can still do things for themselves—it’s just a matter of finding the right balance.

“My mom has always been very independent, so it is hard to watch her slowly lose the ability to do things she was once able to do easily, like remembering computer passwords and keeping appointments,” says Shon, a contributor to the US Alzheimer’s Association’s Our Stories campaign, from Chicago. “So we focus on my mom’s strengths right now, and how we can help her enjoy life with as much dignity as possible.”

12. You shouldn’t let the anxiety surrounding a possible diagnosis deter you from getting your brain health checked.

It’s important to see a doctor if you’re noticing memory loss that’s impacting your life, even if you’re worried about what he or she might tell you. Doctors can look for reversible, treatable causes first, like thyroid disease or nutritional deficiencies, Dr Paulson says. And if it does turn out to be Alzheimer’s after other possible causes get ruled out, it’s valuable to have that knowledge sooner rather than later, too.

For Veronica, who frequently speaks about her experience caring for her husband, Mario, and is also part of Our Stories, she wishes her family pursued the diagnosis sooner. “I wish we would’ve talked sooner about the changes we both noticed in Mario’s behaviour because it would’ve helped ease a lot of stress and pressure on him,” she explains. “Although it wasn’t easy to hear, receiving his diagnosis was sort of a relief because we finally had answers to what was going on.”

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock}

Sarah Bradley

Danielle Smart has been a sporty person for most of her life, but no matter how many races she completed, she just couldn’t outrun her bad eating habits.

With the help of a trainer, Danielle was finally able to kick a lifetime of bad eating and find her confidence — here’s how she did it.

Danielle Smart

Occupation: Medical Sales Rep

Age:35

City: Stellenbosch

Weight before: 73kg

Weight after: 64 kg

Height: 1.59

Time required to reach current weight: 14 weeks (and have maintained for a year)

Secret weapon to your weight loss: Balance is key

READ MORE: “I Lost 35 Kilos And Now I’m A Personal Trainer”

The Gain

Danielle recalls being ‘chubby’ for most of her childhood, “my mom took me to a dietician at 9 years old and unfortunately food became an enemy”. Her battle with food led to her being a yo-yo dieter who would emotionally eat on the regular.

Although Danielle had been sporty for most of her life, partaking in numerous IronMan’s and races, she couldn’t out exercise her bad eating habits.

“I would be so strict on myself and replace meals with protein shakes and eliminate all sorts of food groups and then I’d end up crashing and binge eat, which would cause me to gain more weight than before,” she explains.

The Change

Danielle says that her turning point came when she reached her heaviest weight, “I was 76 kg and nothing fitted me, I was so unhappy. Reality is society judges you for the way you look, I wanted to be happy once and for all.”

Desperately seeking a change, she started training with Johno Meintjies, owner of The Fitness Faculty, who designs 14-week nutrition and fitness transformation programmes.

With 14 weeks before her wedding, Danielle took up the challenge to regain her confidence and finally learn healthy eating habits.

READ MORE: How To Count Macros To Lose Weight

The Lifestyle

First to go was her endurance training. She started doing a combination of bodyweight workouts, strength training and high-intensity interval training 5-6 days a week.

Next to change was her eating habits, “I started eating real food, and nothing that came in a wrapper. I would eat 5 small meals a day, which usually consists of mainly green vegetables and protein, oats for breakfast, fruit for snacks, and drinking 2 litres water a day,” she explains.

Danielle keeps to this strict eating programme for 5.5 days of the week and rewards herself for the remainder of the week.

“I don’t drink alcohol during the week and choose one night on the weekend to let my hair down. If I’m craving chocolate, I’ll have a block or two but that’s it,” she adds.

READ MORE: “I Lost 36 Kilos When I Started Running and Eating Low-Carb High Fat”

The Results

In the 14 weeks, Danielle went from a size 12 to an 8 and her body has drastically changed: “my body has changed so much with the gym workouts. If you looked at the scale, it won’t paint the same picture. But I’m so much more toned and my running times are better than ever,” she exclaims.

Along with being stronger and faster, Danielle says that she is a lot more confident, “I really do feel like a woman now, you just have way more self-confidence being in shape. It isn’t the be all and end all of life but you sure feel a lot better, I have a lot more energy and shine from the inside out.”

Danielle’s Tips

The scale is the devil: “Get a trainer to take your skin folds and use that as your measuring tool.”

Real food in the correct portion size is key: “There is no supplement in any form that can make you lose weight. Anything that comes in a wrapper is packed with unnecessary hidden kilojoules. When you start to eat real food you will see how such a little portion keeps you full and sustained.”

Balance is key: “We human beings, take away and eliminate food groups and you will want them. I eat chocolate often, I have great red wine, bubbly and a good chocolate fondant but all in moderation.”

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock}

Chandré Davids

Hannah Polites’ body is still recovering after she gave birth to her second child four weeks ago, and she couldn’t be prouder — “loose skin, soft tone” and all.

The Australian fitness influencer, 28, said in an Instagram post on Wednesday that she’s getting ready to exercise again, but she’s still happy to celebrate what her body accomplished when she naturally gave birth to son Arlo William on June 5.

“Still amazed by the human body, it blows my mind,” she wrote, alongside photos of her body at 38 weeks pregnant and now, four weeks postpartum. “I think I’m appreciating the process so much more the second time around as I’ve completely let go of any expectations I had and just focused on the functionality of my body rather than its appearance. My body was a house for my little babe, a tunnel for arrival earthside and now it provides liquid gold for growth.”

RELATED: This Influencer Opens Up About the Empowering Decision to Get Her Implants Removed and Breastfeed

Polites, who is also a doula, said that she’s not stressing out over the changes to her body.

“I love and appreciate my bod regardless of the extra loose skin, soft tone and uneven boobs (my kids couldn’t care less either although Evaliah [her older daughter] loves to grab at my tummy all day),” she said.

“Just an update to keep it real — I’m currently still 7kg [about 15 lbs.] up from my pre-pregnancy wait and I’ve lost A LOT of muscle tone and still can’t fit into the majority of my clothes. I’m looking forward to exercising because it makes me FEEL energetic and strong.”

RELATED: Influencer Shares Unedited Photo of Her Postpartum Stomach Wrinkles in Beautifully Raw Photo

Polites previously shared two other postpartum updates — one from 24 hours after giving birth and another from 13 days later. The mom of two said she wanted to give an honest look at her post-baby body.

“Although a little confronting for me, I want to be as real as possible with you all and share my postpartum body journey exactly how it is,” she said of the photo from 24 hours postpartum. “I was tired, pale and a little sore but so proud of what I’d just achieved the day before.”

Polites also said that she’s waiting at least six weeks before she exercises again.

“The human body is so amazing and I’m so thankful that mine was able to grow, birth and now nurture my boy,” she said. “I’m in no rush to ‘bounce back’ and will just be focusing on my family and new baby, not exercising for at least 6 weeks.”

Though now, four weeks later, Polites said she’s looking forward to rebuilding her muscle. She shared a few pictures on her Instagram Story on Wednesday to show how she improved her glutes.

RELATED: Influencer Shares Harsh Realities of Breastfeeding: ‘Sometimes I Wish I Could Pull My Boob Off’

“Interesting how different stages of your life you will have completely different goals,” she wrote. “Five years from left to right and a 7 kg increase — change from cardio to strength training.”

“If I’ve done it once then I can do it again, right?” she continued in another post. “Excited to start training again in a few weeks.”

The experience of being body shamed is harrowing to say the least, but experiencing it in a place of worship, where messages of love and acceptance are supposed to prevail, was especially devastating for a young woman from Swansboro, North Carolina named Jenna. The 19-year-old took to Twitter on June 30 to share a video she took of a sickening interaction she had with a member of her church's leadership team named Bonnie Sue Bihary in a church restroom. Bihary was berating the teen for wearing shorts.

In the clip, Bihary tells Jenna that another "chubby" girl is wearing a dress that comes to her knees, so that's obviously what the 19-year-old should do, as well. She proceeds to tell Jenna that she's "too fat" to wear shorts and cannot sing with the church band while wearing them. Jenna pleads with Bihary to leave her alone, but she continues to give her a hard time. The disturbing interaction ends with Jenna following Bihary out into the hallway and the teen sobbing as she's told by a male church-goer that she should go back into the bathroom.

This women followed me into the bathroom and attacked me calling me fat and that I couldn’t wear jean shorts because I was too fat pic.twitter.com/xse8lKfQdo

— Jenna (@roo_jenna) June 30, 2019

In her Twitter thread, Jenna expressed gratitude that this interaction didn't occur when she had been thinking about taking her own life. "If she would have said that to me two years ago when I was in therapy for suicide… I honestly don’t think I would be here today… I suffer with depression, anxiety, and ADD, and I can be very impulsive but what she did was straight up rude," she wrote.

RELATED: This Influencer Is Speaking Out About the Powerful Form of Emotional Abuse That's All Over Social Media

She also added that she was "shocked and upset that this happened at church. I should feel accepted and loved, and now I don’t want to go back to that church."

Since Jenna's story went viral, the church has responded to the incident with the lead pastor of the Swansboro United Methodist Church, G. Kevin Baker, sending out a letter of support for the teen.

In part, the letter reads: "It has come to our attention that great harm has been done in an incident that occurred this past Sunday where a faithful and very gifted young lady and worship leader was body shaming for her appearance. We are shocked and saddened by this act. The Church is supposed to be a place of safety, love and acceptance."

The lead pastor sent this out to people (since some of you found the church, also please don’t be a bully back nothing will be solved from that… an eye for an eye makes the whole world go blind) pic.twitter.com/r875AP33ak

— Jenna (@roo_jenna) July 2, 2019

At the same time, as Bihary became the target of the internet's wrath, Jenna added a video to the thread, pleading with followers to meet the woman's actions with love over hate.

Thankfully, the pastor told the teen that Bihary won’t be working in any sort of committee or in any leadership role at the church ever again. And Jenna has received tons of loving, supportive messages on social media, including one from actress Jameela Jamil.

RELATED: How Fat Shaming Can Actually Make People Sick

As Jamil put it, Jenna's heartbreaking experience illustrates "the daily harassment people receive over their size. Even at the hands of people old enough to know better. Even in sacred places. Even in their own doctor’s practices. Our hypernormalization of policing and ridiculing fat bodies is what leads to this brazen bullying."

Cheers to this brave teen for calling this "brazen bullying" out, standing up for herself, and supporting so many others in the process.

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Go ahead, just try to scroll through Instagram right now and not come across a running post. No luck? That’s because it seems like everyone and their mother is lacing up their new running shoes, hitting the pavement, and losing major kilos in the process. Clearly, the classic endurance-building, heart-pounding, leaves-you-dripping-in-sweat activity is the key to weight-loss success, right?

Honestly, it’s a hard…maybe. The only real way to know if running will help you lose weight is to try it, says Dr Charlie Seltzer, a weight loss physician and exercise physiologist based in the US. “Some people can do mini-sprints for 10 minutes three times a week and get some weight loss. But you also see people who train for Ironman triathlons who don’t lose any weight, even though they’re running 80km a week.”

Plus, there’s the whole thing about how weight loss, in general, is totally specific to each individual, based on their body type, how much they need to eat, how much weight they’d like to lose, and so on. But how do you know if running is worth a try to lose weight? Here are the basics, so you can decide whether to lace up your sneaks—or choose another workout instead.

Wait, so how much running would I have to do to lose weight?

Tbh, you’d have to commit to a serious schedule. That’s because if you want to lose, say, a half a kilo a week, you need to burn about an extra 500+ calories every day. To do that via running alone, that’d likely ballpark around a 45-minute run every day of the week for a 72kg woman, says Janet Hamilton, an exercise physiologist, running coach, and founder of Running Strong in Atlanta, Georgia.

But really, that’s not terribly realistic. Something a bit more doable, like a 30-minute run four days a week, would burn about 1464 kilojoules per run for the same 72kg woman — which would lead to a weight loss of about 0.1kg each week, Hamilton says. So it’s not as much, but it’s still something.

READ MORE: 5 Signs You’ve Bought The Wrong Running Shoes

Are there any downsides to running for weight loss?

There aren’t necessarily negatives to running for weight loss, but there are a few things to keep in mind: First, knowing that the way your body responds to running for weight loss may be totally different than the way your best friend’s body responds, says Dr Seltzer. That’s because exercise can tweak body composition, hormones, metabolism, and appetite in super individualized ways — all of which contribute to weight loss.

Another could-be hiccup: As you up your running routine, your body might fight back by burning fewer calories throughout the rest of the day in order to hold onto precious energy, per a 2018 review in Obesity Reviews. It’s an evolutionary conservation mechanism that dates back to not knowing when your next meal was coming, explains Dr Seltzer.

Not only that, but you could also see an uptick in your appetite — a small 2019 study in the journal Physiology & Behavior found that after moderate-intensity cardio five days a week (to burn 2092 kilojoules a day) for 12 weeks, overweight women lost body weight and fat, but in the process, their hunger levels went up and they ate more calories.

READ MORE: What You Need To Know About Doing Pilates For Weight Loss

Okay, what about stomach fat? Can you lose that by running?

That, my friends, is called “spot-reduction” or “targeted fat loss,” which is basically impossible (you can’t pick-and-choose which spots of your body you want to tone). “You can burn fat by running, but where the fat comes from is largely genetically predetermined,” says Seltzer.

Of course, when it comes to burning body fat in general, running in any form can help with fat loss. One 2019 review in the British Journal of Sports Medicine found that both interval training and moderate-intensity continuous training (i.e., going for a 30-minute jog) both reduced body fat percentage (though HIIT activity burned more — but more on that later). Why? Simply because, well, you’re burning kilojoules while running.

READ MORE: These 3 Pairs Of Running Shoes Are Totally Worth The Investment

Is there any way to make running more effective for weight loss?

A lot of research out there that shows high-intensity interval training (HIIT) workouts (think: sprints, hills, etc) seem to be most effective for weight loss, says Hamilton. In fact, HIIT might burn a third more body fat than moderate-intensity exercise (like jogging), possibly because you’re working harder and your body keeps burning fat post-exercise, per the same 2019 review British Journal of Sports Medicine.

Don’t love HIIT? Level up to Hamilton’s go-to weekly running routine to burn more kilojoules for weight loss: one longer workout to increase endurance and stamina, another that adds hills (to strengthen your hips and provide intensity), and one interval training run (one minute running as fast as you can, one minute of walking recovery) to boost power and speed.

READ MORE: Cycling Vs. Running: Which Is A Better Workout?

All right… But what if I’m really not into running?

Ultimately, the most effective form of exercise for weight loss is the one you enjoy the most, says Hamilton. That’s because you’ll stick to it. (Read: No hard feelings if you and the pavement aren’t fast friends.) “If the idea of running for weight loss makes you feel horrible, don’t do it,” says Dr Seltzer.

After all, there are tons of other kilojoule-torchers like jumping rope, kickboxing, biking, rowing, and even yoga. And while strength training might not seem like a huge calorie-burning workout, it can boost metabolic rate so that you’re burning more calories throughout the day. Dr Seltzer adds that you can even give it bigger cardio component by resting less between sets to keep your heart rate elevated.

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock}

Cassie Shortsleeve

Before you take a pumice stone to your foot calluses just because they’re unsightly, you might want to consider the idea that they are actually nature’s shoes.

That’s one of the messages from a new study suggesting that in certain ways, walking on callused feet can be better for you than the modern luxury of cushioned shoes.

Don’t forego shoes

Researchers found that calluses offer the foot protection while you’re walking around, without compromising tactile sensitivity – or the ability to feel the ground. That’s in contrast to cushioned shoes, which provide a thick layer of protection, but do interfere with the sense of connection to the ground.

Meanwhile, although thick-soled shoes do lessen the impact of each heel strike to the ground, they actually deliver more force into the knee joints.

No one, however, is advising people to forgo shoes – especially if they have medical conditions that make barefoot walking risky.

Study co-author Daniel Lieberman stressed that the study is about understanding a fundamental evolutionary question: How does modern footwear – a recent development in human history – differ from the natural “shoes” that humans wore for thousands of years?

“I’m not anti-shoe,” said Lieberman, who heads human evolutionary biology at Harvard University. “And I’m not telling people to run around barefoot.”

But, he added, you might consider taking a kinder view of the lowly callus.

Poor blood circulation

“Calluses are normal, and they may have some benefits,” Lieberman said.

That comes with some big caveats, though: People with certain medical conditions, such as diabetes, should neither go barefoot nor let calluses build up, said Dr Jane Andersen. She’s a podiatrist and chair of the communications committee for the American Podiatric Medical Association.

People with nerve damage or poor blood circulation to the feet – from diabetes or other medical conditions – should see a foot doctor regularly and, if needed, have calluses trimmed, Andersen said. Calluses can lead to ulcers in those cases.

People with nerve-damaged feet also need to wear shoes, she said. That reduced sensation means they may not notice any cuts or other injuries they’d get while walking barefoot.

Beyond that, Andersen noted, barefoot humans of the past were not running around on hot asphalt and other modern surfaces.

The findings, published in the journal Nature, are based on just over 100 adults from Kenya and the United States. Both groups included people who said they were barefoot more often than not, and people who wore shoes every day.

Controlled studies needed

As expected, the barefoot crowd had thicker, harder calluses. Despite that, they showed no lack of sensitivity in the soles of their feet. In contrast, thick-soled shoes do compromise tactile sensitivity when you’re walking, the researchers said.

It’s not clear what the implication of that might be. But, Lieberman’s team points out, when your perception of a walking surface is dulled, that can affect gait and balance. So it raises the question of whether thick-cushioned shoes can contribute to falls in people at risk.

Lieberman stressed, however, that it’s simply a question. He said controlled studies would be needed to figure out the answer – for example, a trial that compares cushioned shoes to “minimal footwear” in older adults.

Minimal footwear refers to shoes with thinner, harder soles – like moccasins or sandals. According to Lieberman, they more closely approximate thick calluses, compared with cushiony soles.

In other tests, the researchers found that cushioned shoes lessen the impact of the heel striking the ground with each footstep, compared with walking barefoot or in thin-soled shoes. Thick calluses did not have that effect.

Yet cushioned shoes sent more force up into the joints with each step.

“The load is basically delivered to the knees,” Lieberman said.

Minimalist shoes uncomfortable

Again, the consequences of that, if any, are unknown. But one question, Lieberman said, is whether modern footwear could be a contributing factor to knee arthritis.

According to Andersen, it’s an interesting question – but it would be challenging to study the way footwear choices over decades could affect arthritis risk.

“People generally wear all kinds of different shoes,” she said. “There are also many other factors that would affect arthritis risk.”

Plus, Andersen added, many people simply find minimalist shoes uncomfortable. “Even if wearing them for 30 years lowered your risk of knee arthritis, that’s 30 years of being uncomfortable,” she noted.

As for calluses, Andersen said that if they are not causing problems and you’re healthy, they can probably be left alone.

^{Image credit: iStock}

Just a little exercise may help protect you against a type of deadly bleeding stroke, a new study suggests.

As many as half of people who suffer a subarachnoid haemorrhage die within three months.

Moderate exercise

While smoking and high blood pressure have been shown to increase the risk of this deadly stroke, there has been little evidence on whether exercise can help reduce it.

For this study, researchers examined data from about 70 000 people in Finland and concluded that as little as 30 minutes a week of light exercise reduces the risk by about 5%.

The risk falls as the amount of exercise increases, according to the study published in the journal Scientific Reports.

“Even moderate physical exercise, such as a 30-minute walk or bike ride four days a week reduces the risk… by roughly 20%, regardless of age and gender,” principal author Dr Joni Lindbohm said in a University of Helsinki news release.

“As such, the finding did not really come as a surprise, as exercise is known to work well in preventing many other cardiovascular diseases. However, the extent and comprehensive nature of the benefit among various groups of people was a positive surprise,” she added.

Number one risk factor

The study also found that exercise can reduce the risk caused by smoking and high blood pressure. For smokers, exercise lowers the odds up to two times more than in the general population.

“However, what must not be overlooked is the fact that smoking remains the number one risk factor for [this stroke] and that quitting smoking is the principal way of preventing the appearance of the disorder,” Lindbohm said.

Study co-author Dr Miikka Korja, head of neurosurgery at Helsinki University Central Hospital, reflected on the reduced risk.

“Even with no accurate scientific evidence of the biological mechanism of action produced by exercise… the reduced risk is most likely connected with a reduction in a systemic inflammatory state, which also affects the walls of cerebral arteries,” he said.

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Cancer took more than 8.7 million years of life and $94.4 billion in lost earnings among people ages 16 to 84 in the United States in 2015. The calculation comes from a new report by American Cancer Society researchers that appears early online in JAMA Oncology.

Scientists have discovered that a special type of cell is much more prolific in generating a protective sheath covering nerve fibers than previously believed.