What too much alcohol can do to your health

(CNN)This feature is part of CNN Parallels, an interactive series exploring ways you can improve your health by making small changes to your daily habits.

A lot of us drink. Too many of us drink a lot.
Worldwide, each person 15 years and older consumes 13.5 grams of pure alcohol per day, according to the World Health Organization. Considering that nearly half of the world doesn’t drink at all, that leaves the other half drinking up their share.
    While the majority of the world drinks liquor, Americans prefer beer. The Beverage Marketing Corp. tracks these things: In 2017,Americans guzzled about 27 gallons of beer (or 216 pints), 2.6 gallons of wine and 2.2 gallons of spirits per drinking-age adult.
    But Americans are lightweights in any worldwide drinking game, based on numbers from the World Health Organization. The Eastern European countries of Lithuania, Belarus, Czechia (the Czech Republic), Croatia and Bulgaria drink us under the table.
    In fact, measuring liters drunk by anyone over 15, the US ranks 36th in the category of most sloshed nation; Austria comes in sixth; France is ninth (more wine) and Ireland 15th (yes, they drink more beer), while the UK ranks 18th.
    Who drinks the least in the world? The Arab nations of the Middle East.

    With all this boozing going on, just what damage does alcohol do to your health? Let’s explore what science says are the downsides of having a tipple or two.

    Counting calories

    Even if you aren’t watching your waistline, you might be shocked at the number of empty calories you can easily consume during happy hour.
    Calories are typically defined by a “standard” drink. In the US, that’s about 0.6 fluid ounces or 14 grams of pure alcohol, which differs depending on the type of adult beverage you consume.

    For example, a standard drink of beer is one 12-ounce can (355 milliliters). For malt liquor, it’s 8 to 9 fluid ounces (251 milliliters). A standard drink of red or white wine is about 5 fluid ounces (148 milliliters).
    What’s considereda standard drink continues to go down as the alcohol content goes up. But what if that changes? Let’s use beer as an example.
    It used to be that light beer came in around 100 calories while regular beer averaged 153 calories per 12-fluid ounce can or bottle — that’s the same as two or three Oreo cookies.

    But beer calories depend on both alcohol content and carbohydrate level. So if you’re a fan of today’s popular craft beers, which often have extra carbs and higher alcohol content, you could easily face a calorie land mine in every can. Let’s say you chose a highly ranked IPA, such as Sierra Nevada Bigfoot (9.6% alcohol) or Narwhal (10.2% alcohol), and you’ve downed a whopping 318 to 344 calories, about as much as a McDonald’s cheeseburger. Did you drink just one?
    If you pour correctly, white wine is about 120 calories per 5 fluid ounces, and red is 125. If you fill your glass to the brim, that might easily double.
    Liquor? Gin, rum, vodka, tequila and whiskey cost you 97 calories per 1.5 fluid ounces, but that’s without mixers. An average margarita will cost you 168 calories while a pina colada weighs in at a whopping 490 calories, about the same as a McDonald’s Quarter Pounder.
    A 2013 study in the US found that calorie intake went up on drinking days compared with non-drinking days, mostly due to alcohol: Men took in 433 extra calories, while women added 299 calories.
    But alcohol can also affect our self-control, which can lead to overeating. A 1999 study found that people ate more when they had an aperitif before dinner than if they abstained.
    Take heart. If you’re a light to moderate drinker, meaning you stick to US guidelines of one “standard” drink a day for women and two for men, studies have shown that you aren’t guaranteed to gain weight over time — especially if you live an overall healthy lifestyle.
    For example, a 2002 study of almost 25,000 Finnish men and women over five-year intervals found that moderate alcohol consumption, combined with a physically active lifestyle, no smoking and healthy food choices, “maximizes the chances of having a normal weight.”
    However, it appears that heavy drinking and binge drinking could be linked to obesity. And that’s a problem. The numbers of binge drinkers — defined as five or more drinks for men and four or more drinks for women within a couple of hours at least once a month — has been rising in the United States.
    The Centers for Disease Control and Prevention says one in six adults binge about four times a month, downing about eight drinks in each binge.
    In the UK, where binge drinking is defined as “drinking lots of alcohol in a short space of time or drinking to get drunk,” a 2016 national survey found 2.5 million people admitted to binge drinking in the last week.
    Alcohol, of course, has no nutritional value and contains 7 calories per gram — more than protein and even carbs, which both have 4 calories. Fat has 9 calories per gram.
    All those empty alcohol calories have to end up somewhere.

    Heart disease and cancer

    The prevailing wisdom for years has been that drinking in moderation — again, that’s one “standard” drink a day for women and two for men — is linked to a lower risk of cardiovascular disease. But recent studies are casting doubt on that long-held lore. Science now says it depends on your age and drinking habits.
    A 2017 study of nearly 2 million Brits with no cardiovascular risk found that there was still a modest benefit in moderate drinking, especially for women over 55 who drank five drinks a week. Why that age? Alcohol can alter cholesterol and clotting in the blood in positive ways, experts say, and that’s about the age when heart problems begin to occur.
    For everyone else, the small protective effect on the heart was evident only if the drinks were spaced out during the week. Consuming heavily in one session, or binge drinking, has been linked to heart attacks — or what the English call “holiday heart.”
    Also, a 2018 study found that drinking more than 100 grams of alcohol per week — equal to roughly seven standard drinks in the United States or five to six glasses of wine in the UK — increases your risk of death from all causes and in turn lowers your life expectancy. Links were found with different forms of cardiovascular disease, with people who drank more than 100 grams per week having a higher risk of stroke, heart failure, fatal hypertensive disease and fatal aortic aneurysm, where an artery or vein swells up and could burst.
    In contrast, the 2018 study found that higher levels of alcohol were also linked to a lower risk of heart attack, or myocardial infarction.
    Overall, however, the latest thinking is that any heart benefit may be outweighed by other health risks, such as high blood pressure, pancreatitis, certain cancers and liver damage.
    Women who drink are at a higher risk for breast cancer; alcohol contributes about 6% of the overall risk, possibly because it raises certain dangerous hormones in the blood. Drinking can also increase the chance you might develop bowel, liver, mouth and oral cancers.
    One potential reason: Alcohol weakens our immune systems, making us more susceptible to inflammation, a driving force behind cancer, as well as infections and the integrity of the microbiome in our digestive tract. That’s true not only for chronic drinkers but for those who binge, as well.

    Diabetes

    The connection between alcohol and diabetes is complicated. Studies show that drinking moderately over three or four days a week may actually lower the risk of developing type 2 diabetes. However, drinking heavily increases the risk. Too much alcohol inflames the pancreas, which is responsible for secreting insulin to regulate your body’s blood sugars.
    If you have diabetes, alcohol may interact with various medications. If you take insulin or any pills that stimulate the release of insulin, alcohol can lead to hypoglycemia, a dangerously low blood sugar level, because alcohol stimulates the release of insulin as well. That’s why experts recommend never drinking on an empty stomach. Instead, drink with a meal or at least some carbs.
    And, of course, because alcohol is made by fermenting sugar and starch, it’s full of empty calories, which contributes to obesity and type 2 diabetes.

    Mood and memory

    Because alcohol is a depressant, drinking can drown your mood. It may not seem that way while you “party” your inhibitions away, but that’s just the drink depressing the part of the brain we use to control our actions. The more you drink, say experts, the more your negative emotions, such as anxiety, anger and depression, can take over.
    That’s why binge drinking or drinking a lot in one sitting is associated with higher levels of depression, self-harm, suicide and violent offending.
    Binge drinking is also associated with severe “blackouts”: the inability to remember what happened while drunk. Blackouts can range from small memory blips, such as forgetting a name, to more serious incidents, such as forgetting an entire evening.
    Alcohol does this by decreasing the electrical activity of the neurons in your hippocampus, the part of the brain responsible for the formation of short-term memories. Keep up that binge drinking, and you can permanently damage the hippocampus and develop sustained memory or cognitive problems.
    Adolescents are most susceptible to alcohol’s memory disruption but less sensitive to the intoxicating effects. That means they can easily drink more to feel as “drunk” as an adult would, causing even more damage to their brains.

    How you look

    Last but certainly not least, alcohol can have a significant effect on your good looks. First, it dehydrates you. That can leave your skin looking parched and wrinkled. It’s also linked to rosacea, a skin condition causing redness, pimples and swelling on your face.
    Do you know you can stink while you’re drinking? During the time your liver is processing a single drink, which is on average an hour but varies for everyone, some of it leaves your body via your breath, urine and sweat.

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    Another reason drinking can affect your looks has to do with sleep. Although even a little bit of alcohol can help you fall asleep quickly, as the alcohol is metabolized and leaves the body you may suffer the “rebound effect.” Instead of staying asleep, the body enters lighter sleep and wakefulness, which appears to get worse the more one drinks.
    A lack of sleep leads to dark circles, puffy eyes and stress. Keep it up, studies say, and you’re likely to see more signs of aging and a much lower satisfaction with your appearance.
    So the next time you head to the pub for tipple or two, remember: You could be paying a price for all that fun.

    Read more: https://www.cnn.com/2018/02/01/health/alcohol-health-weight-diabetes-memory-intl/index.html

    The states where disease and death are highest: A visual guide

    (CNN)There’s no question that the impact of diseases varies drastically across the United States, depending on which state you live in.

    Now, a study published Tuesday in the journal JAMA details just how wide those state-by-state differences are when it comes to how diseases, injuries and risk factors impact America’s youth, adults and older populations.
    “There’s so many different levels of health in the US, so many different disparities across states and age groups,” said Dr. Christopher Murray, a professor of global health at the University of Washington and director of the Institute for Health Metrics and Evaluation, who was lead author of the study.
      “The top five risk factors — diet, obesity, elevated blood pressure, tobacco and physical inactivity — explain an awful lot of the differences across states,” he said. “Why those causes are getting worse in some states and not getting worse in the other states, I think, deserves more investigation.”

      ‘Very divergent trends’

      For the study, researchers analyzed data from the Global Burden of Disease study, a research tool that quantifies health impacts across countries and within the US using various data sources such as the Centers for Disease Control and Prevention, the National Health and Nutrition Examination Surveys and state inpatient databases.
      Since 1990, the Global Burden of Disease study has collected and analyzed health data, with the most recent data coming from 2016. The data capture premature death and disability from more than 300 diseases and injuries in 195 countries, by age and sex.
      The researchers examined the data from 1990 to 2016, taking a close look at state-by-state trends and calculating the probability of death among three age groups: 0 to 20, 20 to 55 and 55 to 90.
      “It turned out that the trends in health — and in this case being measured by the chances of dying at different age groups — basically in all 50 states were improving in kids and adolescents and in people over age 55, but then in the ages between 20 and 55, you had the US going in two different directions,” Murray said.
      “You had complete divergent trends in those middle age groups, and that’s sort of surprising because usually, people think whatever is driving health would affect everybody pretty much the same,” he said. “The fact that we get these very divergent trends by state and age, I think, is really quite unusual.”
      In 1990, Hawaii had an estimated average of 78.5 years, followed by Utah at 77.9 years and Minnesota with 77.8 years.
      Mississippi was the state with the lowest at 73.1 years, followed by Louisiana at 73.3 and South Carolina at 73.7.
      Even though it’s not a state, the District of Columbia was included in the data and had the lowest of all at 68.4.
      In 2016, Hawaii still had the highest life expectancy at birth, at 81.3 years. California climbed from 24th in 1990 to having the second-highest in 2016, at 80.9 years. Connecticut rose from seventh in 1990 to having the third-highest in 2016 at 80.8 years, the study showed.
      Mississippi still had the lowest of all the states at 74.7 years, followed by West Virginia, which dropped from 45th in 1990 to 50th in 2016 at 75.3 years. Alabama ranked third at 75.4 years, the study showed. Meanwhile, life expectancy at birth appeared to improve in DC, as it moved from ranking lowest of all in 1990 to 36th in 2016.

      Dr. Howard Koh, a professor at the Harvard T.H. Chan School of Public Health, and Dr. Anand Parekh, chief medical adviser at the Bipartisan Policy Center, co-authored an editorial published alongside the new study.
      They wrote that “if each state were a country, Hawaii would rank 20th worldwide (after Ireland) whereas Mississippi would rank 76th (tied with Kuwait).”
      The researchers also found that Mississippi ranked as having the highest probability of death for people between the ages of 0 and 20 between 1990 and 2016.

      The probability of dying young, by state

      Probability of death for this age group was interpreted as the probability in a particular state that a child would die before his or her 20th birthday. Data for the District of Columbia were not included in this analysis.
      Overall, the change in probability of death from birth to 20, between 1990 and 2016, declined in all states, the study showed. The states with the most pronounced declines were South Carolina, Georgia, Alaska and New York. On the other hand, Maine had the lowest decline of probability.

      The researchers pointed out that the nationwide declines were associated with improvements in neonatal disorders; other noncommunicable diseases, including congenital; and injuries, with slight increases from mental and substance use disorders.
      In 2016, Mississippi, Alabama and Louisiana ranked in descending order as having the highest probability of death in that age group.
      In descending order, California, New Jersey and then Massachusetts ranked at the bottom of the list with the lowest probability of death for that year.
      The researchers also measured probability of death for adults between the ages of 20 and 55, interpreted as dying before age 55.

      The health of young adults, by state

      In descending order, West Virginia, Mississippi and then Alabama ranked as having the highest probability of death for adults 20 to 55 in 2016. In descending order, New York, California and Minnesota ranked as having the lowest in 2016.
      Between 1990 and 2016, the largest reductions in probability of death were seen in New York and California, and the highest increases were in West Virginia and Oklahoma, the researchers found.
      Decreases in the probability of death in the US might have been influenced by declines in the prevalence of HIV and AIDS across all states, as well as declines in road injuries and neoplasms or tumors, the researchers noted in the study.
      Meanwhile, increases in the probability of death might have been influenced by a rise in the burden of drug use disorders, alcohol use disorders and chronic kidney disease, among other factors, the researchers noted.
      “Mortality reversals in 21 states for adults ages 20 to 55 years are strongly linked to the burden of substance use disorders, cirrhosis, and self-harm,” the researchers wrote. “This study shows that the trends for some of these conditions differ considerably across different states.”

      Cardiovascular disease is a concern in older adults

      For adults 55 to 90, all states saw a considerable reduction in probabilities of death between 1990 and 2016.
      The highest point decline between 1990 and 2016 was observed in California, which ranked as having the second-lowest probability of death for this age group in 2016. Hawaii had the lowest in 2016, and Florida had the third-lowest.
      Hawaii was the only state in which the probability of death was less than 65% for adults 55 to 90, the study showed.
      In descending order, Mississippi had the highest probability of death for that age group in 2016, and West Virginia had the second-highest, followed by Alabama in third. For this age group, the overall declines in probability of death were largely tied to reductions in the probability of dying from cardiovascular diseases, the researchers wrote.
      A separate study, published in the journal JAMA Cardiology on Wednesday, found that the overall burden of cardiovascular disease improved for all states between 1990 and 2016 but disparities remained. In 2016, the greatest burden was concentrated in a band of states extending from the Gulf Coast to West Virginia, according to that study.
      The JAMA study on life expectancy also explored causes of death for all ages nationwide.

      What’s killing Americans

      The study showed that, between 1990 and 2016, overall death rates in the US declined from 745.2 per 100,000 people to 578 per 100,000 people, but that doesn’t mean Americans are no longer facing many health risks.

        Why your BMI matters

      “This study shows that high [body-mass index], smoking, and high fasting plasma glucose are the three most important risk factors in the United States, and that although smoking is decreasing, BMI and fasting plasma glucose levels are steadily increasing,” the researchers wrote.
      “These two risk factors pose unique challenges in the United States given that unabated, they have the potential to change the health trajectory for individuals in many states. Levels of overweight and obesity increased during the study period,” they wrote.
      Between 1990 and 2016, ischemic heart disease was the top cause of years of life lost in the US, and lung cancer ranked second, without budging, the study showed.
      Additionally, “one of the things we do in the study is look at things that don’t so much kill you but lead to loss of good health, things like back pain, neck pain and things like depression,” Murray said.
      Low-back pain and major depressive disorders remained the first and second causes of years lived with a disability in terms of rates between 1990 and 2016, the study showed. During that time, diabetes moved from eighth to third, and musculoskeletal disorders were in fourth.
      A loss of health tied to a condition was measured in terms of disability in the study. “What’s interesting to me was the rise in low-back pain,” said Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in the study.
      “I don’t know whether that correlates in any way with the opioid epidemic, but low-back pain increased to be the third leading cause in 2016 in their study,” he said. “You wonder whether or not there is some correlation there, particularly with the rise in opioid use.”
      Opioid use disorders rose from the 52nd to the 15th cause of “years of life lost” between 1990 and 2016 in the study, in terms of rates. Opioid use disorders ranked seventh in 1990 and then eighth in 2016 when it came to leading causes of nonfatal health loss.
      “It doesn’t take a whole lot to notice that opioids and drugs more generally have shot up in the rankings and increased hugely over the period of this study,” Murray said.
      “We did these analyses in other countries as well, and it’s very unusual to have opioids, or drugs more generally, as such a dominant cause of ill health,” he said.

      How to fix America’s health problems

      The findings in the study mirror what other research has shown when it comes to state-by-state disparities in health, Benjamin said.
      “What’s interesting to me is that we still see that the states that tend to straddle the bottom of the rankings in all those kind of other studies are pretty much at the bottom of this study as well,” Benjamin said.
      “Mississippi, Alabama, Georgia tend to still be at the bottom of the rankings — Alaska as well. Yet some of the states that tend to rank pretty high, like Hawaii, rank fairly well on just straight mortality and disability rankings,” he said.
      “This demonstrates again that we have enormous disparities between states and how long you live.”
      Strategies to deal with these state-by-state inequalities across the country should be threefold, the researchers wrote.

        Why is health care in the US so expensive?

      They stressed addressing modifiable risk factors such as diet and exercise; tobacco, alcohol and drug use; improving access to quality health care; and addressing the social determinants of health, such as the conditions in which people work and live.
      “What do we need to focus on as we go through the future? It’s still going to need to be tobacco. It’s going to need to be getting people to ideal body weight, and nutrition plays an enormous role,” Benjamin said.
      Policy makers can use the new study and Global Burden of Disease results to reconsider the current national stance toward disease prevention, Koh and Parekh wrote in their editorial.

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      “Long overlooked and underinvested, public health programs currently receive only an estimated 2.5% of US health care dollars, and prevention programs (broadly defined) receive only 8.6%. Earlier promise for major improvements in disease prevention initially offered by the [Affordable Care Act] has lately stalled,” Koh and Parekh wrote.
      “Clinicians and policy makers can use these analyses and rankings to reexamine why so many individuals still experience preventable injury, disease, and death. Doing so could move the entire nation closer toward a United States of health,” they wrote.
      Correction: An earlier version of this story included a life expectancy graphic in which the colors on the map did not accurately reflect the colors on the key.

      Read more: https://www.cnn.com/2018/04/10/health/states-life-expectancy-study/index.html

      Give up coffee? Fuhgeddaboudit, say New Yorkers after California ruling

      A California judge has ruled that coffee companies must put cancer warnings on their product but on the east coast, caffeine-crazed drinkers arent buying the latest health scare

      Asking a New Yorker whether theyll give up their morning coffee during their commute is likely to elicit only one response laughter.

      News broke on Thursday that a California judge had ruled coffee companies should carry cancer warnings on their products after an eight-year legal battle with big coffee. Coffee companies, led by Starbucks, had argued that the levels of acrylamide, a known carcinogen, present in their coffee were insignificant and outweighed by health benefits.

      But the defendants failed to satisfy their burden of proving by a preponderance of evidence that consumption of coffee confers a benefit to human health, Elihu Berle, a superior court judge, ruled. While plaintiff offered evidence that consumption of coffee increases the risk of harm to the fetus, to infants, to children and to adults, defendants medical and epidemiology experts testified that they had no opinion on causation.

      Harm to fetuses, infants, children, adults? Sounds scary. But not to New Yorkers. Three thousand miles away from the California court the reaction ranged from meh to fuhgeddaboudit.

      Quick guide

      How dangerous is acrylamide?

      Acrylamide is hard to avoid. While it is practically non-existent in raw produce, it is found in all sorts of foods that are grilled, fried, baked or roasted. Thats because the chemical forms in the cooking process when sugars and amino acids react at high temperatures. The higher the temperature and the longer the cooking time, the more acrylamide is produced. Some of the most common products to contain acrylamide are potatoes, biscuits, bread and coffee.

      In April,European regulations come into forcethat aim to keep acrylamide levels in food as low as possible. Last year, the Food Standards Agency took action itself, and launched apublic health campaignurging people to cut down on acrylamide-containing foods, including crisps, well-browned potatoes and well-done toast toreduce their risk of cancer.But the FSA made clear that the risk was not large. Professor David Spiegelhalter, a prominent statistician at Cambridge University, even questioned whether the campaign made sense, stating there was no good evidence of harm from humans consuming acrylamide.

      The most recent comprehensive study on coffee and cancer came in 2016 from the International Agency for Research on Cancer, a group of cancer specialists convened by the World Health Organisation. They found that while very hot drinks those hotter than 65C probably raised the risk of oesophageal cancer, there wasno strong evidence that coffee increased cancer risk. As a Cancer Research UK spokesperson said at the time: If you already drink coffee regularly youre probably not increasing your risk of cancer.

      California! said Jarrett Boor, an architect winging his way to work on 8th Avenue in Manhattan. They put warning labels on everything. He said it was good in some cases and that the public should know when products are dangerous. But everything causes cancer: cellphones, GMO foods. Im not giving up my coffee, he snorted.

      New Yorkers do, apparently, drink a ridiculous amount of coffee. A survey by health data website Massive Health calculated the city was running on 6.7 times as much coffee per person as other cities (San Franciscans, by contrast, eat 4.4 times as many brussels sprouts). Given the amount of joe coursing through a New Yorkers system its little wonder that the citys hopped-up workers dont seem too worried by Californias warnings.

      According to a Harvard study, roughly 62% of Americans drink coffee every day, an all-time high. And, despite the fly California has dropped in the nations latte, two decades of research suggests that coffee is good for us, helping to reduce the risk of illnesses ranging from cancer to heart disease to Alzheimers.

      One common complaint among caffeine-loving New Yorkers on Friday was that they were sick of the ever-changing buffet of health-related coffee news.

      The last public health statement I saw was coffee was good for you. It reduces hypertension, said Marge Wetzler, wearily waiting for a medium iced latte in Gregorys Coffee in midtown Manhattan. Now its bad for you? I just dont buy that. She would, however, continue to buy her morning coffee.

      coffee
      Dude, Im enjoying my coffee. Photograph: Devon Knight for the Guardian

      Whatever, said James Warren, a bike courier picking up a Starbucks between stops. Its bad for you, its good for you, its bad for you, its good for you. Its kinda irritating, he said before dashing out into traffic.

      New Yorkers attitudes were echoed 3,000 miles away in Los Angeles.

      I just dont think it would stop me, Jen Bitterman, a digital marketing technologist, told the Associated Press. I love the taste, I love the ritual, I love the high, the energy, and I think Im addicted to it.

      Lawyer Darlington Ibekwe agreed. Its like cigarettes. Like, damn, now Ive got to see this? he said. Dude, Im enjoying my coffee.

      Berles ruling could spell bad news for coffee companies. The third phase of the California trial, brought by non-profit organization the Council for Education and Research on Toxics, will determine any civil penalties that coffee companies must pay.

      The potential penalties are massive, if unlikely, with a fine of up to $2,500 per person exposed each day over eight years. California has 40 million residents.

      While its extremely doubtful that coffee will face the same kinds of penalties slapped on the tobacco companies, the case does open up the possibility of a world without coffee.

      There would have to be an alternative, said Ali Philippides, a product manager at the Daily Beast. Commuting into work with her ridiculously cute corgi, Fig, Philippides was gripping a Starbucks cappuccino and looked a little shaken by the cancer news.

      I used to drink a lot of Diet Coke and swapped for seltzer, she said thoughtfully. But could she give up coffee? As she paused to think for a moment you could almost see the post-apocalyptic dystopia of a coffee-free New York reflected in her eyes. Riots on the L train, Union Square on fire a city mad with withdrawal. Fig looked up at her with concern.

      Could I give up coffee? she repeated. No.

      Read more: https://www.theguardian.com/lifeandstyle/2018/mar/30/coffee-cancer-warning-health-california-new-yorkers-response

      Coffee may come with a cancer warning label in California

      (CNN)A preliminary decision from a California superior court judge in Los Angeles could affect thousands of coffee shops including Starbucks, 7-Eleven and even your local gas station.

      The shops may have to put up a warning that tells customers there is a possible cancer risk linked to their morning jolt of java. The court said in a statement Wednesday that the companies “failed to meet their burden of proof on their Alternative Significant Risk Level affirmative defense” and ruled against them.
      California keeps a list of chemicals it considers possible causes of cancer. One of them is acrylamide, which is created when coffee beans are roasted. The chemical stays in the coffee you drink in what the court called a “high amount.”
        A lawsuit first filed in Los Angeles County Superior Court in 2010 by the nonprofit Council for Education and Research on Toxics targeted several companies that make or sell coffee. The suit asked for damages and a label to warn consumers.
        “It’s not a final decision yet, but I do think this is big news, and I’m much relieved after eight years of work on this,” said attorney Raphael Metzger. “It’s a good day for public health.”
        The initial court documents state that, under the California Safe Drinking Water and Toxic Enforcement Act of 1986, also known as Proposition 65, businesses must give customers a “clear and reasonable warning” about the presence of high levels of this chemical, that is consider toxic and carcinogenic and can impact a drinker’s health — and that these stores failed to do so.
        The coffee companies argued in court that the level of acrylamide in coffee should be considered safe under the law and that the health benefits of coffee essentially outweigh the risk. The court did not agree.
        At least 13 of the defendants had settled prior to this decision and agreed to give a warning, including 7-Eleven, according to Metzger. The other coffee companies, including Starbucks, waited for a court decision.
        “Coffee has been shown, over and over again, to be a healthy beverage. This lawsuit has made a mockery of Prop 65, has confused consumers, and does nothing to improve public health,” William Murray, president and CEO of the National Coffee Association, said in an emailed statement.
        Coffee has been much studied over the years, and research has shown that it provides several health benefits, including lowering your risk of early death. It may reduce your risk of heart disease, multiple sclerosis, Type 2 diabetes, Alzheimer’s and even some cancers like melanoma and prostate cancer. However, a review by the International Agency for Research on Cancer, a branch of the World Health Organization, found that drinking very hot beverages was “probably carcinogenic to humans” due to burns to the esophagus; there was no relation to the chemical acrylamide.
        The science on human exposure to acrylamide still needs “future studies,” according to a 2014 review of scientific research on the chemical’s relationship to a wide variety of cancers in the Journal of Nutrition and Cancer.
        In addition to coffee, acrylamide can be found in potatoes and baked goods like crackers, bread and cookies, breakfast cereal, canned black olives and prune juice, although its presence is not always labeled. It’s in some food packaging and is a component of tobacco smoke. According to the National Cancer Institute, people are exposed to “substantially more acrylamide from tobacco smoke than from food.”
        In 2002, the International Agency for Research on Cancer classified acrylamide as a group 2A carcinogen for humans based on studies done in animals. Studies done on humans have found “no statistically significant association between dietary acrylamide intake and various cancers,” according to the 2014 research review.
        A few additional studies have seen an increased risk for renal, ovarian and endometrial cancers; however, “the exposure assessment has been inadequate leading to potential misclassification or underestimation of exposure,” according to the 2014 research review.
        Even the studies showing cancer links between acrylamide in rats and mice used doses “1,000 to 100,000 times higher than the usual amounts, on a weight basis, that humans are exposed to through dietary sources,” the research review said.
        Humans are also thought to absorb acrylamide at different rates and to metabolize it differently than rodents, earlier research showed.
        The National Toxicology Program’s Report on Carcinogens considers acrylamide to be “reasonably anticipated to be a human carcinogen.”
        The Food and Drug Administration website says it “is still in the information gathering stage” on the chemical, but it suggested ways for consumers to cut it out of their diet. The FDA also provided guidance to the industry intended to suggest a range of approaches companies could use to reduce acrylamide levels. The recommendations are only a guide and are “not required,” according to the website.
        California added acrylamide to its carcinogen list in January 1990, and the state has successfully taken companies to court over it.
        In 2008, the California attorney general settled lawsuits against Heinz, Frito-Lay, Kettle Foods and Lance Inc. when the companies agreed to reduce the levels of acrylamide found in potato chips and French fries.
        In 2007, fast food restaurants in California posted acrylamide warnings about fries and paid court penalties and costs for not posting the warnings in prior years.

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        “We have a huge cancer epidemic in this country, and about a third of cancers are linked to diet,” Metzger said. “To the extent that we can get carcinogens out of the food supply, logically, we can reduce the cancer burden in this country. That’s what this is all about.”
        Companies now have until April 10 to file objections to the proposed decision, Metzger said, and then there should be a final decision. A judge will then help decide what the penalties and remedy should be, if companies don’t settle before then.

        Read more: https://www.cnn.com/2018/03/30/health/coffee-cancer-court-decision-warning-label-california/index.html

        NBA stars join fight against stigma surrounding mental illness

        (CNN)Heading from Washington to Los Angeles for the NBA All-Star Game, Dikembe Mutombo watched news reports about the Parkland shooting.

        The harrowing accounts of the high school massacre filled his entire six-hour journey and hit especially close to home, the NBA Hall of Famer revealed. Mutombo is a father of seven and the son of a lifelong educator. It was “very painful,” he said.
        As more details about the 19-year-old gunman emerged, so did police incident reports from before the February 14 shooting that described him as suffering from mental illness and being “emotionally handicapped.” In the tragedy’s aftermath, President Donald Trump said he wanted to focus more resources on mental health issues in an effort to stop future gun violence.
          But experts caution that having a diagnosis of mental illness does not mean a person will become violent and advocates insist that Americans need to work toward breaking the stigma around mental health issues.
          On Thursday, athletes and public figures gathered at the Total Health Forum event in Atlanta, organized by the NBA and Kaiser Permanente, where they addressed mental health and how best to reduce that stigma.
          Mutombo was joined by five-time All-Star Stephen Curry of the Golden State Warriors. Both offered suggestions about the need for improved communication with young people who may be feeling alienated or depressed.

          Future ‘is built around youth’

          Kids dealing with mental health issues such as anxiety and depression “should not be afraid to show their emotions,” Curry said, and he hopes “they understand they have people they can talk to. The future of our society is built around our youth,” he said.
          Mutombo said that society must find better ways to reach out to young people
          “Talk to them; open up the door for them. That will allow them to come to us as a teacher, as a mentor, as coaches, principals, parents, to tell us what issues they are facing.
          “There is a lot of pressure being put on our youth to succeed in their life,” leading to undue stress, he said.
          The NBA offers mental health service for its players and guidance on issues such as work-life balance, image and self-esteem, coping mechanisms, stress and anger management.

          Athletes have chance to make real difference

          Deputy Commissioner Mark Tatum said athletes have the opportunity to make a real difference in fighting stigma surrounding mental illness.
          Kaiser Chairman and CEO Bernard J. Tyson added that it’s important to see high-profile people like Curry speak out about such issues.
          “They are role models. They are exemplary individuals, so in addition to being very gifted and talented and great in their professions, people assume that everything is just fine, and what I believe they provide is a realistic perspective.”
          NBA Cares, the league’s global social responsibility program that builds on the NBA’s mission of addressing important social issues, aims to encourage and support young people to be mindful and committed to their emotional and mental wellness through its Jr. NBA and NBA FIT programs.

          See the latest news and share your comments with CNN Health on Facebook and Twitter.

          “Where we can have a major impact is at the youth level,” Tatum said.
          Kaiser Permanente, the nation’s largest integrated health system, says it’s focusing on mental health and rethinking how it provides related services, encouraging Americans to talk about mental health issues openly, like we talk about other health issues such as heart disease or cancer.
          A major theme of the forum event was resilience, giving individuals the tools to cope with everyday stresses and anxieties.
          This could be done in a number of ways, said Curry.
          “Just having that confidence in yourself that no matter what happens in life, you have an opportunity to right the ship, to continue to exceed to higher levels no matter what you are doing,” he said.
          “I think we all will experience failure at one point or another. We all will have letdowns, and that should not define you. You should be able to learn from those experiences, to make yourself better, and come back stronger. … Having that resilient attitude is something everyone should adopt.”

          Read more: https://www.cnn.com/2018/03/02/health/nba-mental-health-stigma/index.html

          Some Chinese ready meals found to have more salt than 11 bags of crisps

          Some takeaway dishes contain as much salt as five Big Macs with ready meals also high in salt

          Chinese takeaways and ready meals should carry compulsory health warning labels on menus and packaging to alert consumers to astonishing and harmful salt levels, UK health experts have recommended.

          The worst-offending Chinese takeaway dishes in a survey published on Tuesday by Action on Salt were found to contain as much salt as five McDonalds Big Macs, while many had more than half an adults entire daily allowance.

          Supermarket Chinese ready meals were also laden with salt, with some containing more than the amount found in two Pizza Express margherita pizzas, the report reveals. Some rice dishes contained more salt than 11 bags of ready salted crisps.

          Action on Salt is leading a group of health experts in calling on Public Health England to set tough new salt targets, make front-of-pack labelling mandatory and to follow New Yorks lead by requiring chains to put warning labels on high-salt dishes. They are also urging the food industry and restaurants to reduce salt by reformulating takeaways and ready meals.

          Of 141 supermarket Chinese ready meals analysed, nearly half (43%) were high in salt containing more than 1.5g/100g, or 1.8g per portion which would trigger a red traffic light label.

          Chines food graphic.

          Salt is the forgotten killer as it puts up our blood pressure, leading to tens of thousands of unnecessary strokes, heart failure and heart attacks every year, said Graham MacGregor, the chairman of Action on Salt and a professor of cardiovascular medicine at Queen Mary University of London.

          Reducing salt is the most cost-effective measure to reduce the number of people dying or suffering from strokes or heart disease. We are now calling on Public Health England to take immediate action.

          Accompanying rice dishes, spring rolls and prawn crackers and soy sauce can pile on the salt in a Chinese meal. Icelands takeaway egg fried rice has a shocking 4.1g salt per 350g pack more than in 11 bags of ready salted crisps.

          Dishes from six Chinese restaurants were also analysed, with 97% found to contain 2g of salt or more. More than half (58%) contained in excess of 3g of salt per dish half an adults maximum recommended daily intake.

          At the start of salt awareness week, Action on Salt is calling on Public Health England to revive the UKs salt reduction programme. The last set of salt targets drawn up under the Department of Healths responsibility deal was published in 2014.

          The findings from the survey are very concerning, said Hemini Bharadia of Blood Pressure UK. We are all eating too much salt. This can lead to high blood pressure causing strokes and heart attacks, most of which could be avoided through better lifestyle choices.

          Quick guide

          Processed foods

          These are some of the UKs best-selling ultra-processed foods

          Mr Kipling Angel slices

          Batchelors Super Noodles

          McVities digestive biscuits

          Kelloggs Rice Krispies

          Walkers cheese and onion crisps

          Cadburys Crunchie

          Haribo sweets

          These are the ingredients in Mr Kipling Angel slices


          SugarListed first, so it is the biggest ingredient. Each slice contains 13.2g of sugar, which is 15% of an adults recommended daily intake

          Vegetable oils (rapeseed, palm)Rapeseed oil is healthy, but palm oil is a highly saturated fat, widely used in industrially-produced foods because of its very low cost

          Wheat flour (with added calcium, iron, niacin, thiamin) Added vitamins but this is finely milled white flour

          Water

          Glucose syrupAnother form of sugar, made from maize in the USA, where it is called corn syrup, or from potatoes and wheat

          Humectant (vegetable glycerine) Reduces moisture loss

          DextroseAnother form of sugar

          Dried egg white

          Whey powder (milk)Gives texture

          Vegetable fat (palm) Cheap form of saturated fat

          Maize starchOften used as an anti-caking agent in sugars

          Skimmed milk powder

          Raising agents (disodium diphosphate, sodium bicarbonate)

          Emulsifiers (mono- and diglycerides of fatty acids, sorbitan monostearate, polyglycerol esters of fatty acids, soya lecithin, polysorbate 60)Emulsifiers are additives used to stabilise processed foods

          Tapioca starchThickening agent derived from cassava roots

          Salt

          Stabiliser (xanthan gum)Made from fermented sugars. Prevents ingredients from separating

          Preservative (potassium sorbate)

          Milk proteinCan be used in industrially-made sponge cakes to replace egg, giving volume, elasticity and texture

          Flavourings

          Gelling agent (sodium alginate) This is E401, extracted from brown seaweed and used as a stabiliser in cream

          Colours (titanium dioxide, cochineal, lutein) Titanium dioxide is an additive used in paint but also massively in food to give a white colour. Cochineal is the red colouring derived from insects. Lutein is yellow colouring extracted from marigolds

          Acid (acetic acid)A leavening ingredient in baked goods when combined with baking soda

          Alison Tedstone, the chief nutritionist at Public Health England, said: Our salt consumption has decreased over the last decade a loaf of bread has 40% less than it used to. However, some products are still too high in salt and we know this can be reduced further.

          Read more: https://www.theguardian.com/society/2018/mar/13/calls-for-warnings-on-astonishingly-salty-chinese-food

          Is vitamin D really a cure-all and how should we get our fix?

          Evidence is growing that the sunshine vitamin helps protect against a wide range of conditions including cancers

          Vitamin D is having quite a moment. In the past few months, evidence has been growing that the sunshine vitamin not only has an important role in bone and muscle health, but might also help prevent a range of cancers, reduce the chance of developing rheumatoid arthritis, protect against multiple sclerosis and cut the risk of colds and flu.

          But is vitamin D truly a cure-all? And if the benefits are real, should we all be taking vitamin D supplements or even fortifying our foods?

          Vitamin D is not one chemical, but a label that covers a group of substances, including vitamin D2 and D3. The latter is the form made when sunlight hits your skin and is also found in other animals. Non-animal sources such as fungi and yeasts primarily produce the D2 form. Once in the body, these substances are converted into biologically active steroids that circulate in the blood.

          One area where the impact on health appears to be clear is vitamin Ds role in keeping bones and teeth healthy and improving muscle strength.

          The musculoskeletal stuff is really good and really strong, said Helen Bond, a spokesperson for the British Dietetic Association, pointing out that vitamin D is important in calcium and phosphate absorption.

          Too little vitamin D can be serious: the skeletal disorders osteomalacia and rickets are known to be caused by a vitamin D deficiency, and the latter is on the rise in the UK, a finding some put down to the impact of poverty on poor nutrition.

          But do the wider health claims stand up?

          Intuition suggests that it cant all be right, said Julia Newton-Bishop, professor of dermatology and vitamin D expert from the University of Leeds. But while a recent review of evidence by the scientific advisory committee on nutrition only found strong evidence in the case of bone and muscle health, Newton-Bishop says a growing body of research is exploring other conditions.

          Newton-Bishop says the fact that receptors for vitamin D are present on a huge array of body cells suggests the substance might indeed play a central role in our health, adding that human history offers further evidence: as humans moved to higher latitudes, skin tone became paler. [One] explanation is that vitamin D was so important that that was a selective pressure, she said. The fact that Inuits arent pale-skinned and for millennia they have had an exclusively fish diet is an argument for the fact that vitamin D was a driver, because why would they be different to everyone else?

          Martin Hewison, professor of molecular endocrinology at the University of Birmingham, who carried out the recent study into vitamin D and rheumatoid arthritis, said evidence from cell studies backs up the idea that the vitamin is important.

          In most of the models, vitamin D appears to have quite a positive effect, he said. If you are using cancer cell lines or cancer cells, vitamin D has anti-cancer effects, and likewise in cells that have been used for models for infection and immune disorders, vitamin D has quite clear antibacterial and anti-inflammatory effects.

          But when it comes to studies in humans, the picture is far from clear-cut. While some studies find links to diseases, others do not.

          That, say experts, could be partly down to the way they are conducted for example, not all studies take into account the starting levels of vitamin D in participants, or they may have been carried out in populations with different genetic factors that might affect the impact of vitamin D.

          Other experts have doubts about vitamin Ds influence. Prof Tim Spector, author of The Diet Myth, wrote in the Independent: The evidence so far suggests (with the possible exception of multiple sclerosis and some cancers) that low vitamin D levels are either irrelevant or merely a marker of the disease.

          Hewison says that while vitamin D might help prevent certain conditions such as tuberculosis, respiratory infections and autoimmune diseases,it should not be seen as a cure for them. It is good at protecting against things, he said, but once a disease is settled in, it is unlikely you are going to be able to give somebody who has got prostate cancer vitamin D and it is going to get dramatically better.

          What about the case for supplements? With some having previously been found to cause more harm than good, Newton-Bishop says caution towards this apparent panacea is unsurprising. Everyone within the cancer world is nervous about supplements, she said. I would say to patients dont take supplements, with the exception of avoiding a low vitamin D level.

          But how low is low? With the amount of sunlight needed varying with genetics, skin colour, time of day, how much one covers up and a host of other factors, the scientific advisory committee on nutrition said it was too difficult to say how much sun we need to make sure our vitamin D levels are up to scratch. In any case, from October until March the sun in the UK isnt strong enough to do the job.

          The upshot is that national guidelines now recommend that during the autumn and winter at least, individuals should consider taking supplements or boosting their intake of vitamin-D-rich foods to get an intake of 10 micrograms a day, with higher-risk individuals such as some ethnic minority groups advised to follow the guidelines all year round.

          However, Bond says it is hard to get enough from diet alone.

          There are very few naturally rich sources of vitamin D, and most really good sources are of animal origin, which doesnt bode well for vegans and vegetarians, she said. A serving of oily fish like mackerel will give you easily your 10 micrograms of vitamin D a day, but if you drop down to a tin of canned tuna, you are only getting 1.5 micrograms.

          And as Adrian Martineau, clinical professor of respiratory infection and immunity at Queen Mary University of London, points out, even in the summer, sunshine isnt going to be the answer, especially because there is an associated risk of skin cancer.

          If you are considering taking supplements, it might be worth checking which form of vitamin D they contain. Some people dont want an animal form of vitamin D, said Hewison. However, What studies have shown is that if you want to raise your blood vitamin D levels, vitamin D3 is much more efficient at doing that.

          Dr Benjamin Jacobs, a consultant paediatrician and spokesperson for the Royal College of Paediatrics and Child Health, says supplements are not enough as it is hard to make sure people actually take them. Instead, he suggests the UK consider food fortification.

          Some countries, including Canada and Finland, have embraced fortification of milk. But although infant formula and some breakfast cereals, plant-based milks and fruit juices are already fortified in the UK, most foods are not.

          Hewison believes the government should consider a national fortification plan and that the risks of it resulting in dangerously high vitamin D intake are negligible: I think most people in the field agree that if you want to have a large-scale improvement in peoples vitamin D levels then it can only really be done through fortified foods.

          Read more: https://www.theguardian.com/science/2018/mar/09/is-vitamin-d-really-a-cure-all-and-how-should-we-get-our-fix

          Where is the worlds noisiest city?

          The ignored pollutant can cause depression, stress, diabetes and heart attacks. What are cities doing to curb excess noise?

          The constant roar of traffic, incessant construction noise, piercing sirens, honking horns, shrieking loudspeakers noise in cities is clearly a nuisance.

          But its also a danger. The World Health Organisation (WHO) has described noise pollution as an underestimated threat that can cause hearing loss, cardiovascular problems, cognitive impairment, stress and depression. Some experts go further: they believe exposure to environmental noise could be slowly killing us.

          Noise pollution causes hypertension, diabetes, obesity, heart attacks, strokes and death, says Dr Daniel Fink, chairman of the Quiet Coalition, a community of health and legal professionals concerned with the adverse impacts of environmental noise.

          Noise pollution is often cited as one of the main factors in the reduced quality of life in large, 24-hour cities like New York (where more than 200,000 noise complaints were recorded in 2016). It causes stress, which has its own adverse effects on health.

          While the impact of noise on mental health has not been studied extensively, research has shown that strong noise annoyance is associated with a twofold higher prevalence of depression and anxiety in the general population.

          A recent study by experts at the American College of Cardiology linked noise pollution to increased cardiovascular problems (high blood pressure, heart attacks, stroke, coronary heart disease) through the bodys stress mediated response resulting in the release of the stress hormone cortisol, which in turn damages blood vessels.

          At a conference on noise organised by the European commission in April 2017, noise was regarded as the silent killer, with potentially severe consequences for our physical and mental health. And yet its impacts remain unreported and underestimated.

          Worst offenders

          Dr Eoin King, assistant professor of acoustics and author of the book Environmental Noise Pollution, calls noise the ignored pollutant. Environmental noise still continues to be poorly understood by practitioners, policymakers and the general public, he says.

          Most worrying, says King, is the impact on children. Studies considering the effect that noise may have on children have found that tasks such as reading, attention span, problem-solving and memory appear to be most affected by exposure to noise.

          The issue is compounded by debate over how much noise it is safe to be exposed to. In its Make Listening Safe guide, WHO states that 85 decibels is considered the highest safe exposure level, up to a maximum of eight hours. However, others Fink among them argue this is still too loud.

          A car measures 70 decibels, a jackhammer 100, and a plane taking off 120, according to the WHO. Though there is no set threshold to establish risk, we do know that anything above 60 decibels can increase risk for heart disease, Dr Thomas Mnzel, from the Mainz University Medical Centre, has said.

          A recent report by the BBC found that parts of the London Underground were loud enough to damage peoples hearing, with noise levels greater than 105 decibels on many lines. The report stated that some were so loud they would require hearing protection if they were workplaces.

          Guangzhou
          Guangzhou has been ranked as having the worse levels of noise pollution in the world Photograph: ChinaFotoPress via Getty Images

          Concerned about increased risk of hearing loss in cities, last year Mimi Hearing Technologies created a World Hearing Index to draw attention to the issue. With the results of hearing tests of 200,000 of their users worldwide and data on noise pollution from WHO and Sintef, a Norwegian research organisation, the index plotted levels of noise pollution and hearing loss in 50 cities.

          The study found that, on average, a person living in the loudest cities has hearing loss equivalent to that of someone 10-20 years older. Overall the results showed a 64% correlation between hearing loss and noise pollution.

          Guangzhou, China, ranked as having the worse levels of noise pollution in the world, followed by Cairo, Paris, Beijing and Delhi. Of the 50 cities, Zurich was found to have the least noise pollution.

          Participants in Delhi recorded the highest average hearing loss equivalent to someone 19.34 years older than them. Vienna had the lowest hearing loss but still, on average, that of someone 10.59 years older.

          We were able to collect quite a unique hearing data warehouse on hearing abilities across countries and continents, says Henrik Matthies, managing director of Mimi Hearing Technologies. There is an obvious known correlation between being exposed to noise and decreased hearing ability.

          However, mapping this correlation to cities helped us to get the message out, sparking a debate about noise pollution and hearing in megacities like Hong Kong and Delhi.

          But what can be done about it?

          Political will

          The EU are probably the world leaders at setting out a process to tackle noise pollution, says King. In 2002, it issued an environmental noise directive that requires member states to map noise exposure in urban areas holding upwards of 100,000 people, to develop noise abatement action plans in these areas and to preserve quiet areas.

          Action plans usually incorporate a variety of measures such as traffic management strategies, promoting light rail systems and electric buses, reduced speed limits, introducing noise barriers and improved planning processes.

          But good intentions only go so far. The problem is that there is no real enforcement associated with these action plans, says King. Until there is more of a political will to drive planning decision related to noise, I dont think much will change.

          With road traffic by far the largest source of noise pollution in Europe, affecting an estimated 100 million Europeans, concepts like Pariss car-free day could have an impact. For one day every month in the French capital, 30% of the city becomes off limits to vehicles. The project has seen sound levels in the city centre drop by half.

          The most effective way to control noise is at the source. If we could make planes, trains and cars quieter we would solve a lot of our problems, says King. If all vehicles in a city street were electric, noise would be significantly reduced.

          Increasingly citizens can also do their bit to monitor noise pollution in cities by transforming their smartphones into sound level meters.

          The NoiseTube app, developed by researchers at the Free University of Brussels in Belgium, enables users to record where and at what times decibel levels are highest to produce a detailed noise map of the city. Councils can use the data to target noise pollution more effectively, using sound absorbent materials such as foam and fibreglass precisely where they are needed most.

          King says there are many such projects looking to harness the potential of big data in the fight against noise for example, noise complaint data, or social media chatter related to noise, to better assess public sentiments towards soundscapes. There is a lot going on which I suppose gives us some hope.

          Follow Guardian Cities on Twitter, Facebook and Instagram to join the discussion, and explore our archive here

          Read more: https://www.theguardian.com/cities/2018/mar/08/where-world-noisiest-city

          Moral Grey Areas of Veganism with Wiener Workouts

          Weiner Workouts and I discuss moral grey areas of veganism including pet ownership and terminating pregnancy.

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          Seven ways to boost your libido

          Exhaustion, stress, drugs and poor technique can all cause your sex drive to stall. How can you get it back on track?

          Is it a problem?

          A lack or loss of sex drive is only a problem if the person experiencing it believes it is. Medical conditions such as diabetes or heart disease can undermine desire, as can prescription drugs or difficult life events. The National Survey of Sexual Attitudes and Lifestyles (Natsal) reported in September that 34% of sexually active women and 15% of sexually active men in Britain had lost interest in sex for three months or more during the previous year.

          Its good to talk

          Relationship problems are a leading cause of waning libido: Natsal concluded that finding it hard to talk about sex with a partner doubled the chancesof a diminished sex driveamong women and increased them by 50% in men. A lot of couples dont communicate and end up avoiding sex, says Cynthia Graham, professor of sexual and reproductive health at the University of Southampton, and the studys lead author. Open communication increases the chances of your libido bouncing back. For women, having a partner with a different level of sexual interest increased the chances of loss of sexual interest more than fourfold, and having one with sexual likes and dislikes they did not share did so by almost threefold.These issues increased the chances of loss of desire by just 17% and 16% respectively among men.

          Sleep on it

          Burning the candle at both ends is a passion killer. Testosterones role in male libido is overstated, but it is true that men with the lowest levels of the hormone report low sexual desire and one US study found that sleeping fewer than five hours a night reduced testosterone levels in young men by 10-15%. A lack of sleep also kills female libido: a 2015 study concluded women who had an extra hours sleep were 14% more likely to have sex the next day.

          Fly solo

          Research shows far fewer women masturbate than men. Some research suggests doing so can help boost self-awareness, social competence, body esteem and improve intimacy in long-term relationships. One reason women lack interest in sex is that sex isnt always very good with a partner, says Prof Graham. Masturbation can help women learn things they can then teach their partners about how to pleasure them.

          Fantasise

          Recently, researchers have emphasised that, especially for women, desire can occur largely in response to arousal. If thats news to you, you could do worse than read Come As You Are by the sex educator Emily Nagoski. Therapists often tell women they can increase flagging interest in sex by fantasising, reading erotica or watching pornography, and research suggests they are right.

          Relax

          The fight or flight system boosts levels of hormones that help us perform better in dangerous situations. It can also undermine nonessential function,s such as digestion, immunity and reproductive drive. Little wonder, then, that if youre frequently stressed out, youre rarely in the mood. Yoga, working out or meditation might help.

          The drugs dont (always) work

          Research suggests that taking the contraceptive pill can reduce the frequency of sexual thoughts and sex in some women. Alternative methods might be worth considering. Flibanserin became the first drug to be approved by the US Food and Drug Administration for low sexual desire in women in 2015. Trials suggest it has minimal effects: an extra 0.5-1 satisfying sex sessions a month compared with placebo. Side effects include low blood pressure, fainting and nausea. Viagra, Cialis and Levitra do not increase libido, but help men get erections. This may increase desire by boosting confidence.

          Read more: https://www.theguardian.com/lifeandstyle/2018/feb/26/sex-drive-libido-seven-ways-to-boost