When do you know you’re old enough to die? Barbara Ehrenreich has some answers

With her latest book, Natural Causes, Barbara Ehrenreich notes that theres an age at which death no longer requires much explanation

Four years ago, Barbara Ehrenreich, 76, reached the realisation that she was old enough to die. Not that the author, journalist and political activist was sick; she just didnt want to spoil the time she had left undergoing myriad preventive medical tests or restricting her diet in pursuit of a longer life.

While she would seek help for an urgent health issue, she wouldnt look for problems.

Now Ehrenreich felt free to enjoy herself. I tend to worry that a lot of my friends who are my age dont get to that point, she tells the Guardian. Theyre frantically scrambling for new things that might prolong their lives.

It is not a suicidal decision, she stresses. Ehrenreich has what she calls a very keen bullshit detector and she has done her research.

The results of this are detailed in her latest book, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, published on 10 April.

Part polemic, part autobiographical, Ehrenreich who holds a PhD in cellular immunology casts a skeptical, sometimes witty, and scientifically rigorous eye over the beliefs we hold that we think will give us longevity.

She targets the medical examinations, screenings and tests were subjected to in older age as well as the multibillion-dollar wellness industry, the cult of mindfulness and food fads.

These all give us the illusion that we are in control of our bodies. But in the latter part of the book, Ehrenreich argues this is not so. For example, she details how our immune systems can turn on us, promoting rather than preventing the spread of cancer cells.

When Ehrenreich talks of being old enough to die, she does not mean that each of us has an expiration date. Its more that theres an age at which death no longer requires much explanation.

That thought had been forming in my mind for some time, she says. I really have no hard evidence about when exactly one gets old enough to die, but I notice in obituaries if the person is over 70 theres not a big mystery, theres no investigation called for. Its usually not called tragic because we do die at some age. I found that rather refreshing.

In 2000, Ehrenreich was diagnosed with breast cancer (she wrote the critical, award-winning essay Welcome to Cancerland about the pink ribbon culture).

The experience of cancer treatment helped shape her thoughts on ageing, she says.

Within this last decade, I realised I was not going to go through chemotherapy again. Thats like a year out of your life when you consider the recovery time and everything. I dont have a year to spare.

In Natural Causes, Ehrenreich writes about how you receive more calls to screenings and tests in the US including mammograms, colonoscopies and bone density scans as you get older. She claims most fail the evidence-based test and are at best unnecessary and worst harmful.

Ehrenreich would rather relax with family and friends or take a long walk than sit in a doctors waiting room. She lives near her daughter in Alexandria, Virginia, and likes to pick up her 13-year-old granddaughter from school and hang out with her a while.

Work is still a passion too. She fizzes with ideas for articles and books on subjects that call for her non-conformist take.

Once a prominent figure in the Democratic Socialists of America, she is also busy with the Economic Hardship Reporting Project she founded, which promotes journalism about inequality and poverty in the US, and gives opportunity to journalists who are struggling financially. (The Guardian often partners with the organisation.)

Ehrenreich, who is divorced, has talked to her children Rosa, a law professor, and Ben, a journalist and novelist about her realisation she is old enough to die, but not in a grim way. That wouldnt be her style. While a sombre subject, she chats about it with a matter-of-fact humour.

I just said: This is bullshit. Im not going to go through this and that and the other. Im not going to spend my time, which is very precious, being screened and probed and subjected to various kinds of machine surveillance. I think theyre with me. I raised them right, she laughs.

The last time I had to get a new primary care doctor I told her straight out: I will come to you if I have a problem, but do not go looking for problems.

She pauses: I think I beat her into submission.

Natural Causes is Ehrenreichs 23rd book in 50 years. Much of her work is myth-busting, such as Bright-sided, which looks at the false promises of positive thinking; other work highlights her keen sense of social justice. For her best-selling 2001 book Nickel and Dimed, she went undercover for three months, working in cleaning, waitressing and retail jobs to experience the difficulties of life on a minimum wage.

A recent exchange with a friend summed up what Ehrenreich hoped to achieve with Natural Causes.

I gave the book to a dear friend of mine a week ago. Shes 86 and shes a very distinguished social scientist and has had a tremendous career. She said: I love this, Barbara, its making me happy. I felt wow. I want people to read it and relax. I see so many people my age and this has been going on for a while who are obsessed, for example, with their diets.

Im sorry, Im not going out of this life without butter on my bread. Ive had so much grief from people about butter. The most important thing is that food tastes good enough to eat it. I like a glass of wine or a bloody mary, too.

Barbara
Barbara Ehrenreich: Cancer is a cellular rebellion. Photograph: Stephen Voss for the Guardian

Yet despite her thoughts on the wellness industry with its expensive health clubs (fitness has become a middle-class signifier, she says) and corporate wellness programs (flabby employees are less likely to be promoted, she writes), Ehrenreich wont be giving up the gym anytime soon. She works out most days because she enjoys cardio and weight training and lots of stretching, not because it might make her live longer.

That is the one way in which I participated in the health craze that set in this country in the 70s, she says. I just discovered there was something missing in my life. I dont understand the people who say, Im so relieved my workout is over, it was torture, but I did it. Im not like that.

In Natural Causes, Ehrenreich uses the latest biomedical research to challenge our assumption that we have agency over our bodies and minds. Microscopic cells called macrophages make their own decisions, and not always to our benefit they can aid the growth of tumours and attack other cells, with life-threatening results.

This was totally shocking to me, she says. My research in graduate school was on macrophages and they were heroes [responsible for removing cell corpses and trash the garbage collector of the body]. About 10 years ago I read in Scientific American about the discovery that they enable tumour cells to metastasise. I felt like it was treason!

She continues: The really shocking thing is that they can do what they want to do. I kept coming across the phrase in the scientific literature cellular decision-making.

This changed her whole sense of her body, she says.

The old notion of the body was like communist dictatorship every cell in it was obediently performing its function and in turn was getting nourished by the bloodstream and everything. But no, there are rebels I mean, cancer is a cellular rebellion.

Ehrenreich, an atheist, finds comfort in the idea that humans do not live alone in a lifeless universe where the natural world is devoid of agency (which she describes as the ability to initiate an action).

When you think about some of these issues, like how a cell can make decisions, and a lot of other things I talk about in the book, like an electron deciding whether to go through this place in a grid or that place. When you see theres agency even in the natural world. When you think about it all being sort of alive like that, its very different from dying if you think theres nothing but your mind in the universe, or your mind and Gods mind.

Death becomes less a terrifying leap into the abyss and more like an embrace of ongoing life, she believes.

If you think of the whole thing as potentially thriving and jumping around and having agency at some level, its fine to die, she adds reassuringly.

Read more: https://www.theguardian.com/lifeandstyle/2018/apr/07/barbara-ehrenreich-natural-causes-book-old-enough-to-die

No hugging: are we living through a crisis of touch?

Strokes and hugs are being edged out of our lives, with doctors, teachers and colleagues increasingly hesitant about social touching. Is this hypervigilance of boundaries beginning to harm our mental health?

When did you last touch someone outside your family or intimate relationship? I dont mean a brush of the fingers when you took your parcel from the delivery guy. I mean: when did you pat the arm or back of a stranger, colleague or friend? My own touch diary says that I have touched five people to whom Im not related in the past seven days. One was a newborn and two were accidental (that was the delivery guy). Touch is the first sense humans develop in the womb, possessed even of 1.5cm embryos. But somewhere in adulthood what was instinctive to us as children has come to feel awkward, out of bounds.

In countless ways social touch is being nudged from our lives. In the UK, doctors were warned last month to avoid comforting patients with hugs lest they provoke legal action, and a government report found that foster carers were frightened to hug children in their care for the same reason. In the US the girl scouts caused a furore last December when it admonished parents for telling their daughters to hug relatives because she doesnt owe anyone a hug. Teachers hesitate to touch pupils. And in the UK, in a loneliness epidemic, half a million older people go at least five days a week without seeing or touching a soul.

Sensing this deficit, a touch industry is burgeoning in Europe, Australia and the US, where professional cuddlers operate workshops, parties and one-to-one sessions to soothe the touch-deprived. At Cuddle Up To Me, a cuddle retail centre in Portland, Oregon, clients browse a 72-cuddle menu. Poses includes the Alligator, the Mamma Bear and, less appealingly, the Tarantino. In Japan, a Tranquility chair has been developed, its soft arms wrapping the sitter in a floppy embrace.

Is this what a crisis of touch looks like? And if so, what do humans risk losing, when we lose touch?

Of course we are moving away from touch! exclaims Francis McGlone, a professor in neuroscience at Liverpool John Moores university and a leader in the field of affective touch. He is worried. We have demonised touch to a level at which it sparks off hysterical responses, it sparks off legislative processes, and this lack of touch is not good for mental health. He has heard of teachers asking children to stick on a plaster themselves, rather than touch them and risk a complaint. We seem to have been creating a touch-averse world, he says. Its time to recover the social power of touch.

Touch is commonly thought of as a single sense, but it is much more complex than that. Some nerve endings recognise itch, others vibration, pain, pressure and texture. And one exists solely to recognise a gentle stroking touch.

Illustration
Illustration by Harriet Lee-Merrion

Known as c tactile afferents, this last is the one that McGlone has studied for years. To find it, a needle is inserted into the skin to fish. Its like sitting on the banks of the river, McGlone says. Ones a pain fish. Ones an itch fish. Hours can pass before anyone catches a gentle touch nerve, but this elusive fibre has helped to teach scientists why humans need touch.

By watching the nerves discharge behaviour while the skin is stroked, scientists have learned that the optimum speed of a human caress is 3cm to 5cm a second.

This may sound like a diverting snippet of touch trivia, but its application is far-reaching. When a parent strokes a child, for instance, they are writing out the script that was laid down by 30 million years of evolution, McGlone says. We are destined to cuddle and stroke each other at predetermined velocities. The pleasantness encourages us to keep touching, nourishes babies and binds adults, and threads wellbeing into the fabric of our being. It could also teach us more about the touch-averse, including how and when autism and eating disorders develop, and even lead us to a cure for loneliness.

Last year, researchers from University College London showed that slow, gentle stroking by a stranger reduced feelings of social exclusion.

Bang on! McGlone says. This nerve fibre is responsible for so many aspects of our wellbeing across our lifespan. I call it the Higgs boson of the social brain. The missing particle that glues everything social together. Ironically, having been brought up in the 50s, when parental affection was thought to encourage mawkish children, he is himself sensitive to touch, and feels a gentle stroke like an electric shock.

As a society, we instinctively understand the power of touch. That is why, after the tragic shooting at his school, the head of Marjory Stoneman Douglas in Florida promised to hug each and every one of his 3,300 students. A single, small touch can change countless lives. Princess Diana knew this when she held the hand of an Aids patient in 1987. So did Barack Obama when he stooped to let a young black boy pat his hair, so that he could feel his own potential in the palm of his hand.

Tiffany Field founded the Touch Research Institute at Miami Medical School to study this neglected sense and its impact on health. She enjoys a weekly massage and happily lists the positive effects of being touched. We know from the science of what goes on under the skin that when the skin is moved, pressure receptors are stimulated, she says. This slows down heart rate, blood pressure and the release of cortisol, which gives people better control over their stress hormones.

Being touched increases the number of natural killer cells, the frontline of the immune system. Serotonin increases. Thats the bodys natural antidepressant. It enables deeper sleep, Field says. Her appraisal is borne out by the experience of Kira Cuddles from Cuddle Up To Me in Portland, who has to remind her clients to check for phone, keys, wallet. They leave with a dose of oxytocin. They are floating on a cloud.

Most basically of all, touch tells us who we are. That is why in the womb, McGlone says, with the amniotic fluid washing over it, the brain inside begins to realise, Ive got my body, and thats somebody elses. That developing brain has that sense of me rather than something else out there. If that doesnt happen, you get this almost locked-in syndrome.

Mary Carlson is 78. She worked as a student assistant with the legendary scientist Harry Harlow, whose experiments with monkeys found that the hankering for touch is so innate that an infant, removed from its mother, would cling to a cloth-covered wire surrogate rather than a cold wire one with milk. It would choose to feel nourished rather than be nourished.

Carlson met Harlow as a freshman. At the first lecture she attended, he came out hooting and running around on all fours. In his laboratory, she witnessed monkeys that as infants had been deprived of their mothers touch. In social groups, they would go off in a corner, self-grasping, staring into space. She saw similar patterns of behaviour in humans three decades later when she visited orphanages in Romania, a legacy of Ceausescus regime, where tens of thousands of infants were raised with minimal human touch.

For Carlson, touch is a sort of species recognition. Which suggests that without touch, humans may be, well, less human.

You just dont see people touching each other these days, Field complains. She has just come from a restaurant. And everybody was on their cellphones. At LaGuardia airport recently, she walked around the waiting area. Not a soul was touching another. Even two-year-olds were sitting in carriages with iPads on their laps. (Getting touch from their touch screens.) Then, at the Coconut Grove art festival, There were people bumping into each other because it was so packed. I heard people say, Im sorry! Excuse me! and move off in a way that made it look like they were really embarrassed.

Field is planning studies in restaurants and airports to document how little touch there is and how much distraction by social media. There is as yet no scientific data to connect declining touch to the rise of mobile technology or social media, but Fields descriptions of people wrapped in their own worlds rather than each other, sitting in isolation, bowed over screens, a huddle unto themselves, are evocative and familiar.

Do those atomised people who bounce off each other at art fairs before spinning away in shame, or those who sit day after day alone in their homes carry shades of Harlows monkeys self-soothing in the corner of their cages? And if so, where will our loss of touch lead us?

Kellie Payne, research and policy manager at the Campaign to End Loneliness, says that loneliness is fatal precisely because it puts people into a kind of defensive state where the levels of cortisol are raised. Having had negative experiences, they anticipate that their connection with people will also be negative, which makes it hard to reinstate contact. To add to the challenge for the elderly, touch sensation is in decline. According to David J Linden, author of Touch: The Science of Hand, Heart and Mind, Humans have their strongest touch sensation at around 20, after which it goes down by a percent a year for your whole life.

Field, meanwhile, is worried about the rise in paediatric pain syndromes, such as irritable bowel syndrome and fibromyalgia, previously common only in adults. She thinks this is due to stress and the absence of touch, and is also worried that kids are getting more and more aggressive because there is less and less touch.

This is what Im concerned about, McGlone says. If this evolutionary system is in any way disturbed or interrupted, brains are good at finding compensation. It could be drugs or alcohol … If you remove a reward system, the brain will try to find some other way to get that reward.

Humans love touch. We love it so much that the word has the power to sell a heap of products from soft-touch pillows to velvet touch tights, expert touch saucepans and even smooth, perfecting touch face creams. But touching each other in an age of pervasive and historical sexual abuse and harassment no longer feels safe.

There is a hypervigilance of boundaries that makes it hard to find the right approach. I think twice about hugging a colleague at work in a way that I didnt a couple of years ago, Linden says. Im thinking, maybe this is going to be misinterpreted. Maybe this is going to make somebody feel bad.

Touch even the gentlest kind processed by McGlones beloved c tactile afferents is never only about affection, warmth and care, but also about power. (Just watch Donald Trump greet world leaders.) The so-called Midas touch studies which have shown that diners gently touched on the arm by their server will leave a generous tip, or that people in a care home eat more if touched, illustrate the power of touch to persuade. Touch can retract as well as confer agency. It is not a universal good. It can exacerbate the symptoms of those with autism, and those who have experienced trauma or abuse.

At her home in north London, I meet Anna Fortes Mayer, who has run Cuddle Workshop since 2010. We sit on her red sofa and talk about how to broach touch. She is not tactile, but then we are strangers and her sofa is large.

I tell her about my touch diary: by now my yoga teacher has patted me and Ive collected a matchday hug from my daughters football coach. Its not much. Its really not, Fortes Mayer says, shaking her head. But whats a person to do? How can we build more touch into our lives?

For a start, Fortes Mayer advises against energetically leaning forward for a hug. She dislikes the phrases Do you want a hug?, Give us a hug and Can I have a hug?; they are all too, Who takes ownership here? (This is the mistake Kesha made with Jerry Seinfeld.) She suggests instead, Would you like to share a hug?

Encouraging self-consciousness of the ways in which people offer and invite touch has many benefits. But this kind of touch can never be impulsive, immediate, if it comes with explanatory notes. And touch that breaks protocol can feel more affecting. Consider the excitement when Meghan Markle preferred a hug to a handshake, or Michelle Obama slipped an arm around the Queens back. Even McGlone, despite that 1950s upbringing, on a walk through the park, was tickled to see a big rugby player type bloke offer his wife and then him a hug. (He was so touched, he started to explain about c tactile afferents.)

In Fortes Mayers hall, I put my shoes back on and with my hands at my sides ask, Anna, would you like to share a hug? She says yes and it feels good.

I will often place my hand on someones shoulder, Carlson says. I believe in touch. There are ways you can do it so it isnt demeaning.

Even stranger touch, when its wanted, is pretty good, Linden points out. Even petting your dog. Even petting a dog thats not yours. For the truly solitary, daily power walking stimulates pressure points. Its what Tiffany Field does. She also advocates yoga: Its moving your limbs against each other.

Of course, nobody thinks that a cure for loneliness will happen at a stroke, but maybe careful touch could bring it closer.

Read more: https://www.theguardian.com/society/2018/mar/07/crisis-touch-hugging-mental-health-strokes-cuddles

Finland is the happiest country in the world, says UN report

Nordic nations take top four places in happiness rankings, with annual study also charting the decline of the US

Finland has overtaken Norway to become the happiest nation on earth, according to a UN report.

The 2018 World Happiness Report also charts the steady decline of the US as the worlds largest economy grapples with a crisis of obesity, substance abuse and depression.

The study reveals the US has slipped to 18th place, five places down on 2016. The top four places are taken by Nordic nations, with Finland followed by Norway, Denmark and Iceland.

Burundi in east Africa, scarred by bouts of ethnic cleansing, civil wars and coup attempts, is the unhappiest place in the world. Strikingly, there are five other nations Rwanda, Yemen, Tanzania, South Sudan and the Central African Republic which report happiness levels below that of even Syria.

For the first time the UN also examined the happiness levels of immigrants in each country, and found Finland also scored highest.

Finland has vaulted from fifth place to the top of the rankings this year, said the reports authors, although they noted that the other three Nordic countries (plus Switzerland) have almost interchangeable scores.

The report, an annual publication from the UN Sustainable Development Solutions Network, said all the Nordic countries scored highly on income, healthy life expectancy, social support, freedom, trust and generosity. The rankings are based on Gallup polls of self-reported wellbeing, as well as perceptions of corruption, generosity and freedom.

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The UN placing is the latest accolade for Finland, a country of 5.5 million people that only 150 years ago suffered Europes last naturally caused famine. The country has been ranked the most stable, the safest and best governed country in the world. It is also among the least corrupt and the most socially progressive. Its police are the worlds most trusted and its banks the soundest.

That Finland is the top scorer is remarkable, said Meik Wiking of the Happiness Research Institute in Denmark. GDP per capita in Finland is lower than its neighbouring Nordic countries and is much lower than that of the US. The Finns are good at converting wealth into wellbeing.

In the Nordic countries in general, we pay some of the highest taxes in the world, but there is wide public support for that because people see them as investments in quality of life for all. Free healthcare and university education goes a long way when it comes to happiness. In the Nordic countries, Bernie Sanders is not viewed as progressive he is just common sense, added Wiking, referring to the leftwing US politician who galvanised the Democrat primaries in the 2016 presidential election.

In Britain, figures from the Office for National Statistics suggest people have become happier in recent years. But the UN ranking places the UK in a lowly 19th place, the same as last year but behind Germany, Canada and Australia, although ahead of France and Spain.

The UN report devotes a special chapter to why the US, once towards the top of happiness table, has slipped down the league despite having among the highest income per capita.

Americas subjective wellbeing is being systematically undermined by three interrelated epidemic diseases, notably obesity, substance abuse (especially opioid addiction) and depression, said Jeffrey Sachs, director of the Center for Sustainable Development at Columbia University in New York, and one of the reports authors.

Despite African countries getting the worst happiness scores, one west African nation has bucked the trend. Togo came bottom in 2015 but was the biggest improver in the 2018 report, rising 18 places. Latvians and Bulgarians are also reporting higher levels of happiness.

Venezuela recorded the biggest fall in happiness, outstripping even Syria, although in absolute terms it remains a mid-ranking country. The report notes that Latin American countries generally scored more highly than their GDP per capita suggests, especially in contrast to fast-growing east Asian countries.

Latin America is renowned for corruption, high violence and crime rates, unequal distribution of income and widespread poverty, yet has consistently scored relatively highly in the happiness report. The authors attributed this to the abundance of family warmth and other supportive social relationships frequently sidelined in favour of an emphasis on income measures in the development discourse.

Meanwhile, the greatest human migration in history the hundreds of millions of people who have moved from the Chinese countryside into cities has not advanced happiness at all, the report found.

Even seven-and-a-half years after migrating to urban areas, migrants from rural areas are on average less happy than they might have been had they stayed at home, according to John Knight of the Oxford Chinese Economy Programme at the University of Oxford and one of the contributors to the UN report.

Top 10 happiest countries, 2018

(2017 ranking in brackets)

1. Finland (5)

2. Norway (1)

3. Denmark (2)

4. Iceland (3)

5. Switzerland (4)

6. Netherlands (6)

7. Canada (7)

8. New Zealand (8)

9. Sweden (10)

10. Australia (9)

The 10 unhappiest countries, 2018

(2017 ranking in brackets)

147. Malawi (136)

148. Haiti (145)

149. Liberia (148)

150. Syria (152)

151. Rwanda (151)

152. Yemen (146)

153. Tanzania (153)

154. South Sudan (147)

155. Central African Republic (155)

156. Burundi (154)

Read more: https://www.theguardian.com/world/2018/mar/14/finland-happiest-country-world-un-report

Dont listen to Gwyneth Paltrow: keep your coffee well away from your rectum | Jen Gunter

The colonic irrigation and coffee enemas promoted on Paltrows website Goop are not merely unnecessary, they are potentially dangerous, writes obstetrician and gynaecologist Dr Jen Gunter

It seems January is Gwyneth Paltrows go-to month for promoting potentially dangerous things that should not go in or near an orifice. January 2015 brought us vagina steaming, January 2017 was jade eggs, and here we are in the early days of January 2018 and Goop.com is hawking coffee enemas and promoting colonic irrigation.

I suspect that GP and her pals at Goop.com believe people are especially vulnerable to buying quasi-medical items in the New Year as they have just released their latest detox and wellness guide complete with a multitude of products to help get you nowhere.

colon
Ha ha, go deep. Nice play on words for a dangerous yet ineffective therapy. An advertisement on Goop.com.

One offers to help if youre looking to go deep on many levels. Ha ha, go deep. Nice play on words for a dangerous yet ineffective therapy. Goop.com is not selling a coffee machine, it is selling a coffee enema-making machine. That, my friends, is a messed-up way to make money. I know the people at Goop will either ignore the inquiries from reporters or release a statement saying the article is a conversation not a promotion and that they included the advice of a board-certified doctor, Dr Alejandro Junger, but any time you lend someone else your platform their ideas are now your ideas. That is why I never let anyone write guest posts for my blog. And lets be real, if you are selling the hardware to shoot coffee up your ass then you are promoting it as a therapy especially as Goop actually called the $135 coffee enema-making machine Dr Jungers pick. I mean come on.

The interview with Junger is filled with information that is unsupported both by the medical literature and by human anatomy and physiology. There is no data to suggest that a colonic helps with the elimination of the waste that is transiting the colon on its way out. That is what bowel movements do. There are no toxins to be cleansed or irrigated. That is fake medicine. A 2011 review on colonics concluded that doctors should advise patients that colon cleansing has no proven benefits and many adverse effects.

The idea that colonics are used in conjunction with a cleanse is beyond ridiculous. Junger tells us via Goop that a cleanse creates some kind of extra sticky mucus that blocks elimination of what needs to be disposed of (I will admit that hurt my brain more than a little). Dr Junger says this cleanse residue is a mucoid plaque, basically some kind of adherent, cleanse-induced super-glue that needs a colonic for removal. He supports this assertion not with published research, but by telling Goops readers to Google mucoid plaque.

No really. That is what he said. Google it. So I did. This is what came up first:

Mucoid plaque (or mucoid cap or rope) is a pseudoscientific term used by some alternative medicine advocates to describe what is claimed to be a combination of allegedly harmful mucus-like material and food residue that they say coats the gastrointestinal tract of most people.

Apparently, the term mucoid plaque was coined by Richard Anderson, who is a naturopath, not a gastroenterologist, so not a doctor who actually looks inside the colon. I looked mucoid plaques up in PubMed. Guess what? Nothing colon-related. There is not one study or even case-report describing this phenomenon. Apparently only doctors who sell cleanses and colonics can see them. I am fairly confident that if some gastroenterologist (actual colon doctor) found some crazy mucus that looked like drool from the alien queen that she or he would have taken pictures and written about it or discussed it at a conference.

If we needed cleanses to live and thus colonics to manage this alien-like mucous residue created by cleanses, how did we ever evolve? Wouldnt we have died out from these mysterious toxins? Wouldnt our rectums be different? Wouldnt we have invented irrigation tubing before the wheel? So many questions.

There is only a side mention in the Goop post of two of the many complications seen with colonics: colon perforation and damage to gastrointestinal bacteria. And as for coffee enemas? While Dr Kelly Brogan, Paltrows Aids-denialist doctor gal pal who is speaking at In Goop Health later this month, is also a huge fan, there is no data to suggest that coffee offers any benefit via the rectal route but there are plenty of reports of coffee enema-induced rectal burns.

So here are the facts. No one needs a cleanse. Ever. There are no waste products left behind in the colon that need removing just because or after a cleanse. If a cleanse did leave gross, adherent hunks of weird mucus then that would be a sign that the cleanse was damaging the colon. You know what creates excess, weird mucous? Irritation and inflammation.

There are serious risks to colonics such as bowel perforation, damaging the intestinal bacteria, abdominal pain, vomiting, electrolyte abnormalities and renal failure. There are also reports of serious infections, air embolisms, colitis, and rectal perforation. If you go to a spa and the equipment is not sterilised, infections can be transmitted via the tubing.

Coffee enemas and colonics offer no health benefit. The biology used to support these therapies is unsound and there can be very real complications. Keep the coffee out of your rectum and in your cup. It is only meant to access your colon from the top.

Dr Jen Gunter is an obstetrician, gynaecologist and pain medicine physician. This piece originally ran on Jen Gunters blog

Read more: https://www.theguardian.com/commentisfree/2018/jan/09/gwyneth-paltrow-goop-coffee-enema-colonic-irrigation

Read this and you may never eat chicken again

Most meat animals are raised with the assistance of daily doses of antibiotics. By 2050, antibiotic resistance will cause a staggering 10 million deaths a year

Every year I spend some time in a tiny apartment in Paris, seven stories above the mayors offices for the 11th arrondissement. The Place de la Bastille the spot where the French revolution sparked political change that transformed the world is a 10-minute walk down a narrow street that threads between student nightclubs and Chinese fabric wholesalers.

Twice a week, hundreds of Parisians crowd down it, heading to the march de la Bastille, stretched out along the center island of the Boulevard Richard Lenoir.

Blocks before you reach the market, you can hear it: a low hum of argument and chatter, punctuated by dollies thumping over the curbstones and vendors shouting deals. But even before you hear it, you can smell it: the funk of bruised cabbage leaves underfoot, the sharp sweetness of fruit sliced open for samples, the iodine tang of seaweed propping up rafts of scallops in broad rose-colored shells.

Threaded through them is one aroma that I wait for. Burnished and herbal, salty and slightly burned, it has so much heft that it feels physical, like an arm slid around your shoulders to urge you to move a little faster. It leads to a tented booth in the middle of the market and a line of customers that wraps around the tent poles and trails down the market alley, tangling with the crowd in front of the flower seller.

In the middle of the booth is a closet-size metal cabinet, propped up on iron wheels and bricks. Inside the cabinet, flattened chickens are speared on rotisserie bars that have been turning since before dawn. Every few minutes, one of the workers detaches a bar, slides off its dripping bronze contents, slips the chickens into flat foil-lined bags, and hands them to the customers who have persisted to the head of the line.

I can barely wait to get my chicken home.

Chickens
Chickens roam in an outdoor enclosure of a chicken farm in Vielle-Soubiran, south-western France. Photograph: Iroz Gaizka/AFP/Getty Images


The skin of a poulet crapaudine named because its spatchcocked outline resembles a crapaud, a toad shatters like mica; the flesh underneath, basted for hours by the birds dripping on to it from above, is pillowy but springy, imbued to the bone with pepper and thyme.

The first time I ate it, I was stunned into happy silence, too intoxicated by the experience to process why it felt so new. The second time, I was delighted again and then, afterward, sulky and sad.

I had eaten chicken all my life: in my grandmothers kitchen in Brooklyn, in my parents house in Houston, in a college dining hall, friends apartments, restaurants and fast food places, trendy bars in cities and old-school joints on back roads in the south. I thought I roasted a chicken pretty well myself. But none of them were ever like this, mineral and lush and direct.

I thought of the chickens Id grown up eating. They tasted like whatever the cook added to them: canned soup in my grandmothers fricassee, her party dish; soy sauce and sesame in the stir fries my college housemate brought from her aunts restaurant; lemon juice when my mother worried about my fathers blood pressure and banned salt from the house.

This French chicken tasted like muscle and blood and exercise and the outdoors. It tasted like something that it was too easy to pretend it was not: like an animal, like a living thing. We have made it easy not to think about what chickens were before we find them on our plates or pluck them from supermarket cold cases.

I live, most of the time, less than an hours drive from Gainesville, Georgia, the self-described poultry capital of the world, where the modern chicken industry was born. Georgia raises 1.4bn broilers a year, making it the single biggest contributor to the almost 9bn birds raised each year in the United States; if it were an independent country, it would rank in chicken production somewhere near China and Brazil.

Yet you could drive around for hours without ever knowing you were in the heart of chicken country unless you happened to get behind a truck heaped with crates of birds on their way from the remote solid-walled barns they are raised in to the gated slaughter plants where they are turned into meat. That first French market chicken opened my eyes to how invisible chickens had been for me, and after that, my job began to show me what that invisibility had masked.

My house is less than two miles from the front gate of the Centers for Disease Control and Prevention, the federal agency that sends disease detectives racing to outbreaks all over the world. For more than a decade, one of my obsessions as a journalist has been following them on their investigations and in long late-night conversations in the United States and Asia and Africa, with physicians and veterinarians and epidemiologists, I learned that the chickens that had surprised me and the epidemics that fascinated me were more closely linked than I had ever realized.

I discovered that the reason American chicken tastes so different from those I ate everywhere else was that in the United States, we breed for everything but flavor: for abundance, for consistency, for speed. Many things made that transformation possible.

But as I came to understand, the single biggest influence was that, consistently over decades, we have been feeding chickens, and almost every other meat animal, routine doses of antibiotics on almost every day of their lives.

Caged
Caged battery hens in a chicken farm in Catania, Sicily. Photograph: Fabrizio Villa/AFP/Getty Images

Antibiotics do not create blandness, but they created the conditions that allowed chicken to be bland, allowing us to turn a skittish, active backyard bird into a fast-growing, slow-moving, docile block of protein, as muscle-bound and top-heavy as a bodybuilder in a kids cartoon. At this moment, most meat animals, across most of the planet, are raised with the assistance of doses of antibiotics on most days of their lives: 63,151 tons of antibiotics per year, about 126m pounds.

Farmers began using the drugs because antibiotics allowed animals to convert feed to tasty muscle more efficiently; when that result made it irresistible to pack more livestock into barns, antibiotics protected animals against the likelihood of disease. Those discoveries, which began with chickens, created what we choose to call industrialized agriculture, a poultry historian living in Georgia proudly wrote in 1971.

Chicken prices fell so low that it became the meat that Americans eat more than any other and the meat most likely to transmit food-borne illness, and also antibiotic resistance, the greatest slow-brewing health crisis of our time.

For most people, antibiotic resistance is a hidden epidemic unless they have the misfortune to contract an infection themselves or have a family member or friend unlucky enough to become infected.

Drug-resistant infections have no celebrity spokespeople, negligible political support and few patients organizations advocating for them. If we think of resistant infections, we imagine them as something rare, occurring to people unlike us, whoever we are: people who are in nursing homes at the end of their lives, or dealing with the drain of chronic illness, or in intensive-care units after terrible trauma. But resistant infections are a vast and common problem that occur in every part of daily life: to children in daycare, athletes playing sports, teens going for piercings, people getting healthy in the gym.

And though common, resistant bacteria are a grave threat and getting worse.

They are responsible for at least 700,000 deaths around the world each year: 23,000 in the United States, 25,000 in Europe, more than 63,000 babies in India. Beyond those deaths, bacteria that are resistant to antibiotics cause millions of illnesses 2m annually just in the United States and cost billions in healthcare spending, lost wages and lost national productivity.

It is predicted that by 2050, antibiotic resistance will cost the world $100tn and will cause a staggering 10m deaths per year.

Disease organisms have been developing defenses against the antibiotics meant to kill them for as long as antibiotics have existed. Penicillin arrived in the 1940s, and resistance to it swept the world in the 1950s.

Tetracycline arrived in 1948, and resistance was nibbling at its effectiveness before the 1950s ended. Erythromycin was discovered in 1952, and erythromycin resistance arrived in 1955. Methicillin, a lab-synthesized relative of penicillin, was developed in 1960 specifically to counter penicillin resistance, yet within a year, staph bacteria developed defenses against it as well, earning the bug the name MRSA, methicillin-resistant Staphylococcus aureus.

After MRSA, there were the ESBLs, extended-spectrum beta-lactamases, which defeated not only penicillin and its relatives but also a large family of antibiotics called cephalosporins. And after cephalosporins were undermined, new antibiotics were achieved and lost in turn.

Each time pharmaceutical chemistry produced a new class of antibiotics, with a new molecular shape and a new mode of action, bacteria adapted. In fact, as the decades passed, they seemed to adapt faster than before. Their persistence threatened to inaugurate a post-antibiotic era, in which surgery could be too dangerous to attempt and ordinary health problems scrapes, tooth extractions, broken limbs could pose a deadly risk.

For a long time, it was assumed that the extraordinary unspooling of antibiotic resistance around the world was due only to misuse of the drugs in medicine: to parents begging for the drugs even though their children had viral illnesses that antibiotics could not help; physicians prescribing antibiotics without checking to see whether the drug they chose was a good match; people stopping their prescriptions halfway through the prescribed course because they felt better, or saving some pills for friends without health insurance, or buying antibiotics over the counter, in the many countries where they are available that way and dosing themselves.

But from the earliest days of the antibiotic era, the drugs have had another, parallel use: in animals that are grown to become food.

Eighty percent of the antibiotics sold in the United States and more than half of those sold around the world are used in animals, not in humans. Animals destined to be meat routinely receive antibiotics in their feed and water, and most of those drugs are not given to treat diseases, which is how we use them in people.

Instead, antibiotics are given to make food animals put on weight more quickly than they would otherwise, or to protect food animals from illnesses that the crowded conditions of livestock production make them vulnerable to. And nearly two-thirds of the antibiotics that are used for those purposes are compounds that are also used against human illness which means that when resistance against the farm use of those drugs arises, it undermines the drugs usefulness in human medicine as well.

Caged
Caged chickens in San Diego, California. California voters passed a new animal welfare law in 2008 to require that the states egg-laying hens be given room to move. Photograph: Christian Science Monitor/Getty Images

Resistance is a defensive adaptation, an evolutionary strategy that allows bacteria to protect themselves against antibiotics power to kill them. It is created by subtle genetic changes that allow organisms to counter antibiotics attacks on them, altering their cell walls to keep drug molecules from attaching or penetrating, or forming tiny pumps that eject the drugs after they have entered the cell.

What slows the emergence of resistance is using an antibiotic conservatively: at the right dose, for the right length of time, for an organism that will be vulnerable to the drug, and not for any other reason. Most antibiotic use in agriculture violates those rules.

Resistant bacteria are the result.


Antibiotic resistance is like climate change: it is an overwhelming threat, created over decades by millions of individual decisions and reinforced by the actions of industries.

It is also like climate change in that the industrialized west and the emerging economies of the global south are at odds. One quadrant of the globe already enjoyed the cheap protein of factory farming and now regrets it; the other would like not to forgo its chance. And it is additionally like climate change because any action taken in hopes of ameliorating the problem feels inadequate, like buying a fluorescent lightbulb while watching a polar bear drown.

But that it seems difficult does not mean it is not possible. The willingness to relinquish antibiotics of farmers in the Netherlands, as well as Perdue Farms and other companies in the United States, proves that industrial-scale production can be achieved without growth promoters or preventive antibiotic use. The stability of Masadour and Lou and White Oak Pastures shows that medium-sized and small farms can secure a place in a remixed meat economy.

Whole Foods pivot to slower-growing chicken birds that share some of the genetics preserved by Frank Reese illustrates that removing antibiotics and choosing birds that do not need them returns biodiversity to poultry production. All of those achievements are signposts, pointing to where chicken, and cattle and hogs and farmed fish after them, need to go: to a mode of production where antibiotics are used as infrequently as possible to care for sick animals, but not to fatten or protect them.

That is the way antibiotics are now used in human medicine, and it is the only way that the utility of antibiotics and the risk of resistance can be adequately balanced.

Excerpted from Big Chicken by Maryn McKenna published by National Geographic on 12 September 2017. Available wherever books are sold.

Plucked! The Truth About Chicken by Maryn McKenna is published in the UK by Little, Brown and is now available in eBook @14.99, and is published in Trade Format @14.99 on 1 February 2018.

Read more: https://www.theguardian.com/lifeandstyle/2017/oct/13/can-never-eat-chicken-again-antibiotic-resistance

The shorter your sleep, the shorter your life: the new sleep science

Leading neuroscientist Matthew Walker on why sleep deprivation is increasing our risk of cancer, heart attack and Alzheimers and what you can do about it

Matthew Walker has learned to dread the question What do you do? At parties, it signals the end of his evening; thereafter, his new acquaintance will inevitably cling to him like ivy. On an aeroplane, it usually means that while everyone else watches movies or reads a thriller, he will find himself running an hours-long salon for the benefit of passengers and crew alike. Ive begun to lie, he says. Seriously. I just tell people Im a dolphin trainer. Its better for everyone.

Walker is a sleep scientist. To be specific, he is the director of the Center for Human Sleep Science at the University of California, Berkeley, a research institute whose goal possibly unachievable is to understand everything about sleeps impact on us, from birth to death, in sickness and health. No wonder, then, that people long for his counsel. As the line between work and leisure grows ever more blurred, rare is the person who doesnt worry about their sleep. But even as we contemplate the shadows beneath our eyes, most of us dont know the half of it and perhaps this is the real reason he has stopped telling strangers how he makes his living. When Walker talks about sleep he cant, in all conscience, limit himself to whispering comforting nothings about camomile tea and warm baths. Its his conviction that we are in the midst of a catastrophic sleep-loss epidemic, the consequences of which are far graver than any of us could imagine. This situation, he believes, is only likely to change if government gets involved.

Walker has spent the last four and a half years writing Why We Sleep, a complex but urgent book that examines the effects of this epidemic close up, the idea being that once people know of the powerful links between sleep loss and, among other things, Alzheimers disease, cancer, diabetes, obesity and poor mental health, they will try harder to get the recommended eight hours a night (sleep deprivation, amazing as this may sound to Donald Trump types, constitutes anything less than seven hours). But, in the end, the individual can achieve only so much. Walker wants major institutions and law-makers to take up his ideas, too. No aspect of our biology is left unscathed by sleep deprivation, he says. It sinks down into every possible nook and cranny. And yet no one is doing anything about it. Things have to change: in the workplace and our communities, our homes and families. But when did you ever see an NHS poster urging sleep on people? When did a doctor prescribe, not sleeping pills, but sleep itself? It needs to be prioritised, even incentivised. Sleep loss costs the UK economy over 30bn a year in lost revenue, or 2% of GDP. I could double the NHS budget if only they would institute policies to mandate or powerfully encourage sleep.

Why, exactly, are we so sleep-deprived? What has happened over the course of the last 75 years? In 1942, less than 8% of the population was trying to survive on six hours or less sleep a night; in 2017, almost one in two people is. The reasons are seemingly obvious. First, we electrified the night, Walker says. Light is a profound degrader of our sleep. Second, there is the issue of work: not only the porous borders between when you start and finish, but longer commuter times, too. No one wants to give up time with their family or entertainment, so they give up sleep instead. And anxiety plays a part. Were a lonelier, more depressed society. Alcohol and caffeine are more widely available. All these are the enemies of sleep.

But Walker believes, too, that in the developed world sleep is strongly associated with weakness, even shame. We have stigmatised sleep with the label of laziness. We want to seem busy, and one way we express that is by proclaiming how little sleep were getting. Its a badge of honour. When I give lectures, people will wait behind until there is no one around and then tell me quietly: I seem to be one of those people who need eight or nine hours sleep. Its embarrassing to say it in public. They would rather wait 45 minutes for the confessional. Theyre convinced that theyre abnormal, and why wouldnt they be? We chastise people for sleeping what are, after all, only sufficient amounts. We think of them as slothful. No one would look at an infant baby asleep, and say What a lazy baby! We know sleeping is non-negotiable for a baby. But that notion is quickly abandoned [as we grow up]. Humans are the only species that deliberately deprive themselves of sleep for no apparent reason. In case youre wondering, the number of people who can survive on five hours of sleep or less without any impairment, expressed as a percent of the population and rounded to a whole number, is zero.

The world of sleep science is still relatively small. But it is growing exponentially, thanks both to demand (the multifarious and growing pressures caused by the epidemic) and to new technology (such as electrical and magnetic brain stimulators), which enables researchers to have what Walker describes as VIP access to the sleeping brain. Walker, who is 44 and was born in Liverpool, has been in the field for more than 20 years, having published his first research paper at the age of just 21. I would love to tell you that I was fascinated by conscious states from childhood, he says. But in truth, it was accidental. He started out studying for a medical degree in Nottingham. But having discovered that doctoring wasnt for him he was more enthralled by questions than by answers he switched to neuroscience, and after graduation, began a PhD in neurophysiology supported by the Medical Research Council. It was while working on this that he stumbled into the realm of sleep.

Matthew
Matthew Walker photographed in his sleep lab. Photograph: Saroyan Humphrey for the Observer

I was looking at the brainwave patterns of people with different forms of dementia, but I was failing miserably at finding any difference between them, he recalls now. One night, however, he read a scientific paper that changed everything. It described which parts of the brain were being attacked by these different types of dementia: Some were attacking parts of the brain that had to do with controlled sleep, while other types left those sleep centres unaffected. I realised my mistake. I had been measuring the brainwave activity of my patients while they were awake, when I should have been doing so while they were asleep. Over the next six months, Walker taught himself how to set up a sleep laboratory and, sure enough, the recordings he made in it subsequently spoke loudly of a clear difference between patients. Sleep, it seemed, could be a new early diagnostic litmus test for different subtypes of dementia.

After this, sleep became his obsession. Only then did I ask: what is this thing called sleep, and what does it do? I was always curious, annoyingly so, but when I started to read about sleep, I would look up and hours would have gone by. No one could answer the simple question: why do we sleep? That seemed to me to be the greatest scientific mystery. I was going to attack it, and I was going to do that in two years. But I was naive. I didnt realise that some of the greatest scientific minds had been trying to do the same thing for their entire careers. That was two decades ago, and Im still cracking away. After gaining his doctorate, he moved to the US. Formerly a professor of psychiatry at Harvard Medical School, he is now professor of neuroscience and psychology at the University of California.

Does his obsession extend to the bedroom? Does he take his own advice when it comes to sleep? Yes. I give myself a non-negotiable eight-hour sleep opportunity every night, and I keep very regular hours: if there is one thing I tell people, its to go to bed and to wake up at the same time every day, no matter what. I take my sleep incredibly seriously because I have seen the evidence. Once you know that after just one night of only four or five hours sleep, your natural killer cells the ones that attack the cancer cells that appear in your body every day drop by 70%, or that a lack of sleep is linked to cancer of the bowel, prostate and breast, or even just that the World Health Organisation has classed any form of night-time shift work as a probable carcinogen, how could you do anything else?

There is, however, a sting in the tale. Should his eyelids fail to close, Walker admits that he can be a touch Woody Allen-neurotic. When, for instance, he came to London over the summer, he found himself jet-lagged and wide awake in his hotel room at two oclock in the morning. His problem then, as always in these situations, was that he knew too much. His brain began to race. I thought: my orexin isnt being turned off, the sensory gate of my thalamus is wedged open, my dorsolateral prefrontal cortex wont shut down, and my melatonin surge wont happen for another seven hours. What did he do? In the end, it seems, even world experts in sleep act just like the rest of us when struck by the curse of insomnia. He turned on a light and read for a while.

Will Why We Sleep have the impact its author hopes? Im not sure: the science bits, it must be said, require some concentration. But what I can tell you is that it had a powerful effect on me. After reading it, I was absolutely determined to go to bed earlier a regime to which I am sticking determinedly. In a way, I was prepared for this. I first encountered Walker some months ago, when he spoke at an event at Somerset House in London, and he struck me then as both passionate and convincing (our later interview takes place via Skype from the basement of his sleep centre, a spot which, with its bedrooms off a long corridor, apparently resembles the ward of a private hospital). But in another way, it was unexpected. I am mostly immune to health advice. Inside my head, there is always a voice that says just enjoy life while it lasts.

The evidence Walker presents, however, is enough to send anyone early to bed. Its no kind of choice at all. Without sleep, there is low energy and disease. With sleep, there is vitality and health. More than 20 large scale epidemiological studies all report the same clear relationship: the shorter your sleep, the shorter your life. To take just one example, adults aged 45 years or older who sleep less than six hours a night are 200% more likely to have a heart attack or stroke in their lifetime, as compared with those sleeping seven or eight hours a night (part of the reason for this has to do with blood pressure: even just one night of modest sleep reduction will speed the rate of a persons heart, hour upon hour, and significantly increase their blood pressure).

A lack of sleep also appears to hijack the bodys effective control of blood sugar, the cells of the sleep-deprived appearing, in experiments, to become less responsive to insulin, and thus to cause a prediabetic state of hyperglycaemia. When your sleep becomes short, moreover, you are susceptible to weight gain. Among the reasons for this are the fact that inadequate sleep decreases levels of the satiety-signalling hormone, leptin, and increases levels of the hunger-signalling hormone, ghrelin. Im not going to say that the obesity crisis is caused by the sleep-loss epidemic alone, says Walker. Its not. However, processed food and sedentary lifestyles do not adequately explain its rise. Something is missing. Its now clear that sleep is that third ingredient. Tiredness, of course, also affects motivation.

Sleep has a powerful effect on the immune system, which is why, when we have flu, our first instinct is to go to bed: our body is trying to sleep itself well. Reduce sleep even for a single night, and your resilience is drastically reduced. If you are tired, you are more likely to catch a cold. The well-rested also respond better to the flu vaccine. As Walker has already said, more gravely, studies show that short sleep can affect our cancer-fighting immune cells. A number of epidemiological studies have reported that night-time shift work and the disruption to circadian sleep and rhythms that it causes increase the odds of developing cancers including breast, prostate, endometrium and colon.

Getting too little sleep across the adult lifespan will significantly raise your risk of developing Alzheimers disease. The reasons for this are difficult to summarise, but in essence it has to do with the amyloid deposits (a toxin protein) that accumulate in the brains of those suffering from the disease, killing the surrounding cells. During deep sleep, such deposits are effectively cleaned from the brain. What occurs in an Alzheimers patient is a kind of vicious circle. Without sufficient sleep, these plaques build up, especially in the brains deep-sleep-generating regions, attacking and degrading them. The loss of deep sleep caused by this assault therefore lessens our ability to remove them from the brain at night. More amyloid, less deep sleep; less deep sleep, more amyloid, and so on. (In his book, Walker notes unscientifically that he has always found it curious that Margaret Thatcher and Ronald Reagan, both of whom were vocal about how little sleep they needed, both went on to develop the disease; it is, moreover, a myth that older adults need less sleep.) Away from dementia, sleep aids our ability to make new memories, and restores our capacity for learning.

And then there is sleeps effect on mental health. When your mother told you that everything would look better in the morning, she was wise. Walkers book includes a long section on dreams (which, says Walker, contrary to Dr Freud, cannot be analysed). Here he details the various ways in which the dream state connects to creativity. He also suggests that dreaming is a soothing balm. If we sleep to remember (see above), then we also sleep to forget. Deep sleep the part when we begin to dream is a therapeutic state during which we cast off the emotional charge of our experiences, making them easier to bear. Sleep, or a lack of it, also affects our mood more generally. Brain scans carried out by Walker revealed a 60% amplification in the reactivity of the amygdala a key spot for triggering anger and rage in those who were sleep-deprived. In children, sleeplessness has been linked to aggression and bullying; in adolescents, to suicidal thoughts. Insufficient sleep is also associated with relapse in addiction disorders. A prevailing view in psychiatry is that mental disorders cause sleep disruption. But Walker believes it is, in fact, a two-way street. Regulated sleep can improve the health of, for instance, those with bipolar disorder.

Ive mentioned deep sleep in this (too brief) summary several times. What is it, exactly? We sleep in 90-minute cycles, and its only towards the end of each one of these that we go into deep sleep. Each cycle comprises two kinds of sleep. First, there is NREM sleep (non-rapid eye movement sleep); this is then followed by REM (rapid eye movement) sleep. When Walker talks about these cycles, which still have their mysteries, his voice changes. He sounds bewitched, almost dazed.

During NREM sleep, your brain goes into this incredible synchronised pattern of rhythmic chanting, he says. Theres a remarkable unity across the surface of the brain, like a deep, slow mantra. Researchers were once fooled that this state was similar to a coma. But nothing could be further from the truth. Vast amounts of memory processing is going on. To produce these brainwaves, hundreds of thousands of cells all sing together, and then go silent, and on and on. Meanwhile, your body settles into this lovely low state of energy, the best blood-pressure medicine you could ever hope for. REM sleep, on the other hand, is sometimes known as paradoxical sleep, because the brain patterns are identical to when youre awake. Its an incredibly active brain state. Your heart and nervous system go through spurts of activity: were still not exactly sure why.

Does the 90-minute cycle mean that so-called power naps are worthless? They can take the edge off basic sleepiness. But you need 90 minutes to get to deep sleep, and one cycle isnt enough to do all the work. You need four or five cycles to get all the benefit. Is it possible to have too much sleep? This is unclear. There is no good evidence at the moment. But I do think 14 hours is too much. Too much water can kill you, and too much food, and I think ultimately the same will prove to be true for sleep. How is it possible to tell if a person is sleep-deprived? Walker thinks we should trust our instincts. Those who would sleep on if their alarm clock was turned off are simply not getting enough. Ditto those who need caffeine in the afternoon to stay awake. I see it all the time, he says. I get on a flight at 10am when people should be at peak alert, and I look around, and half of the plane has immediately fallen asleep.

So what can the individual do? First, they should avoid pulling all-nighters, at their desks or on the dancefloor. After being awake for 19 hours, youre as cognitively impaired as someone who is drunk. Second, they should start thinking about sleep as a kind of work, like going to the gym (with the key difference that it is both free and, if youre me, enjoyable). People use alarms to wake up, Walker says. So why dont we have a bedtime alarm to tell us weve got half an hour, that we should start cycling down? We should start thinking of midnight more in terms of its original meaning: as the middle of the night. Schools should consider later starts for students; such delays correlate with improved IQs. Companies should think about rewarding sleep. Productivity will rise, and motivation, creativity and even levels of honesty will be improved. Sleep can be measured using tracking devices, and some far-sighted companies in the US already give employees time off if they clock enough of it. Sleeping pills, by the way, are to be avoided. Among other things, they can have a deleterious effect on memory.

Those who are focused on so-called clean sleep are determined to outlaw mobiles and computers from the bedroom and quite right, too, given the effect of LED-emitting devices on melatonin, the sleep-inducing hormone. Ultimately, though, Walker believes that technology will be sleeps saviour. There is going to be a revolution in the quantified self in industrial nations, he says. We will know everything about our bodies from one day to the next in high fidelity. That will be a seismic shift, and we will then start to develop methods by which we can amplify different components of human sleep, and do that from the bedside. Sleep will come to be seen as a preventive medicine.

What questions does Walker still most want to answer? For a while, he is quiet. Its so difficult, he says, with a sigh. There are so many. I would still like to know where we go, psychologically and physiologically, when we dream. Dreaming is the second state of human consciousness, and we have only scratched the surface so far. But I would also like to find out when sleep emerged. I like to posit a ridiculous theory, which is: perhaps sleep did not evolve. Perhaps it was the thing from which wakefulness emerged. He laughs. If I could have some kind of medical Tardis and go back in time to look at that, well, I would sleep better at night.

Why We Sleep: The New Science of Sleep and Dreamsby Matthew Walker is published by Allen Lane (20). To order a copy for 17 go toguardianbookshop.com or call 0330 333 6846. Free UK p&p over 10, online orders only. Phone orders min p&p of 1.99

Sleep in numbers

Two-thirds of adults in developed nations fail to obtain the nightly eight hours of sleep recommended by the World Health Organisation.

An adult sleeping only 6.75 hours a night would be predicted to live only to their early 60s without medical intervention.

A 2013 study reported that men who slept too little had a sperm count 29% lower than those who regularly get a full and restful nights sleep.

If you drive a car when you have had less than five hours sleep, you are 4.3 times more likely to be involved in a crash. If you drive having had four hours, you are 11.5 times more likely to be involved in an accident.

A hot bath aids sleep not because it makes you warm, but because your dilated blood vessels radiate inner heat, and your core body temperature drops. To successfully initiate sleep, your core temperature needs to drop about 1C.

The time taken to reach physical exhaustion by athletes who obtain anything less than eight hours of sleep, and especially less than six hours, drops by 10-30%.

There are now more than 100 diagnosed sleep disorders, of which insomnia is the mostcommon.

Morning types, who prefer to awake at or around dawn, make up about 40% of the population. Evening types, who prefer to go to bed late and wake up late, account for about 30%. The remaining 30% lie somewhere in between.

Read more: https://www.theguardian.com/lifeandstyle/2017/sep/24/why-lack-of-sleep-health-worst-enemy-matthew-walker-why-we-sleep

A moment that changed me: finding out that my dad was an Auschwitz baby | Namalee Bolle

The discovery that my real grandparents died in the Holocaust helped me understand my father and made me determined to help others, says artist and writer Namalee Bolle

Mum was sombre as she spoke, so I knew it was serious. Shes not the kind of mother who is unsmiling very often so when she is, its deeply unsettling. Her kind almond eyes were intense as she became the storyteller of the kind of drama you go to the movies for.

Oma is not your real grandmother. In 1943 she pretended Dad was her own baby that she lost in a miscarriage. She risked her life and saved your dad from the Nazis. Her voice became quieter as she told the family secret.

Your grandad handed Dad to her in the middle of the night with tears streaming down his face and never returned. Your real grandparents were Jews who died in Auschwitz.

As a 16-year-old teenager I was at my wits end about my erratic, volatile dad but suddenly it all made perfect sense. His rages, panic attacks and severe depression only seemed to worsen as the years went by, and he had an awful debilitating lung condition from which he struggled to breathe. Sometimes he was lovely comedic with a weird Dutch sense of humour that had us in stitches, but fun Dad didnt last long before he became gloomy Dad again.

Intuitively I knew in my heart he loved us and I tried to reach out to him, but it was monumentally challenging because I was still a child, and he was psychologically abusive to me and my younger sister whom I was ferociously protective of. Our home felt like a war zone where Shirani and I were fighting for our own survival, against our father.

My grandparents names were Leo and Hildegard Denneboom. My dads name was originally Leo too, but he was renamed Hans Bolle and grew up in Amsterdam. Jacoba Bolle, Dads heroic second mother, was married to Max Bolle, but he died of a heart attack when Dad was only 17.

Years later I would discover psychosomatic connections between unhealed grief and respiratory problems, but I know Dad wouldnt have listened. He was in denial of the root cause of his problems and refused help. It was as if he felt he deserved to suffer for still being alive. I believe this survivors guilt is what eventually led to his own death five years ago this summer, four years after his adoptive mother Jacoba died at 96.

Hans
Intuitively I knew in my heart he loved us . Hans Bolle. Photograph: Namalee Bolle

What dad really needed was a therapist like Dr Viktor Frankl, inventor of logotherapy, who was a Holocaust survivor himself, as documented in his brilliant book Mans Search for Meaning. Frankls existential method was highly relatable to our situation and he inspired me to train as a psychotherapist myself.

I didnt start to fully acknowledge I was a second generation Holocaust survivor until I was in my late 20s and well into my fashion career, having cofounded my own magazine SUPERSUPER! The ultra-bright, relentlessly positive tone and hyper-colourful styling were in fact born of coping mechanisms of growing up with the overarching burden of death and my dads colossal pessimism about his past. I also became aware of epigenetic inheritance the transferral of trauma through DNA that makes it more likely for me to be affected by stress so I learned mindfulness meditation and reiki to self-soothe and protect myself.

Dad simply did not know how to stop the pain spilling out of him and into us. He was tortured by his past and had no tools for dealing with it as emotional difficulties and mental health problems were not something a man felt comfortable admitting to at the time. Without the unconditional love of my incredible mother I do not believe he would have lasted as long as he did. I have thought endlessly about my grandmothers altruism in helping a baby in need while putting herself in grave danger. Thanks to her I would not think twice about adopting a child.

The discovery of my true background has given me the deepest awareness to search with tremendous empathy when determining the link between PTSD and the mental and physical symptoms it creates. Now I am going to honour my family and our bittersweet tale by helping others with their healing too.

Namalee Bolle is an artist and writer with a background in fashion and creative direction. Winner of the Guardian Jackie Moore award for fashion journalism, she was also fashion director for Sleazenation, co-founder of SUPERSUPER! magazine and has contributed to I-D, the Evening Standard and Vogue

Read more: https://www.theguardian.com/commentisfree/2017/aug/11/a-moment-that-changed-me-mum-dad-auschwitz-baby

Brain game: how quitting routine tasks can help you learn new tricks

Daniel Glaser explains the benefits of taking on new challenges in middle age

Although his previous attempt at a career break, by becoming an apprentice shoemaker in Florence, didnt last long, it seems Daniel Day-Lewis is serious about retiring this time.

Maybe hes looking for a newchallenge. As we get older, work can feel more routine andeasy, which is born out in terms of brain activity.

Scans show tasks we are practised at often use less energy than novel activities we tend to do them more efficiently, and the mental energy required decreases. Were all familiar with this as our careers advance.

We also get more skilled at spotting our mistakes and rectifying them; as an old hand, you can notice when the edge has gone but you have enough tricks in the bag to make amends. This neuroprotective effect may be behind some of the results that show an apparent delay in symptoms of age-related cognitive decline for those more active in middle age. In this light a preemptive move, like Day-Lewiss, may be more sensible as we become over familiar with what we do.

It is perhaps typical of this most uncompromising of actors that hes quitting while ahead.

Dr Daniel Glaser is director of Science Gallery at Kings College London

Read more: https://www.theguardian.com/lifeandstyle/2017/jul/02/brain-game-quitting-routine-tasks-to-learn-new-tricks

Feminism, politics and death: my mum died the night Hillary Clinton lost

They may seem like unrelated events but the end of Clintons campaign and my mothers life made me reflect differently on my own political career

My mother died the night Hillary Clinton lost. These might seem like two very unrelated events and youd be right about that. But for me, and my somewhat particular circumstances, Ive found a plethora of meaning about life and death, feminism and politics.

See, it was also the night I was due to be sworn in as a councillor for my local city council. It was my first political foray and Ive reflected on the start of my own political journey while on the other side of the world a smart and skilled female politician saw the end of hers, with our whole gender brutalised by a despicable Trump. And though Mum doesnt know it, all my political guts I got from her.

Mum was diagnosed with breast cancer 10 days before the 2016 Australian federal election. Dad called me from Canberra to say he had taken Mum to hospital and she had acute pneumonia. I was going through the processes of my Labor nomination for council elections. With days to the federal election, every spare moment I wasnt working I was door-knocking and pre-polling.

I dont remember that first conversation with Dad. I do remember the call the next day when Dad told me Mum had terminal cancer (as well as acute pneumonia) and the cancer had spread through her ribs, spine and pelvis. I was at my desk so I booked a flight home and, as I headed out the door, asked a colleague to cancel me out of every election activity I was signed up for.

Breast cancer is a disease that inflicts itself predominantly on women. Its also one of the most misdiagnosed cancers around. Mum had her last mammogram only months earlier and it hadnt appeared. I grew bitter quickly.

At the same time this was a federal election where it was one bloke versus another bloke versus another bloke, and women barely seemed to get a mention. I had volunteered the bulk of my time on campaigns to support female candidates in tough Victorian seats, none who won. I sat bedside my mother who taught me everything and watched women largely erased out of public life.

On Sunday 3 July, a day after the federal election Mum was only in the second week of a disastrous five week stint in hospital my journal shows compassion draining out of me:

I suspect I will grow rough and battle hardened and unforgiving from this. A part of me hopes I will. Perhaps I will grow ruthless and mean and brutal like life and that might make me powerful like men. I dont think Mum will like the new me. Ill have an excuse to be mean now, finally.

I thought at length about quitting the council race. We didnt know the timeline Mums cancer was working to, although wed been told up to 24 months for stage four breast cancer. I was enjoying caring for her and all her needs. But quality of life for Mum was also about quality of life for her daughters and, honestly, I just always thought shed make it a little longer.

So I ran my council campaign in between working full time and flying back home to care for Mum, alternating every second weekend with my sister. Offering a parallel world to my campaigning life, my life with Mum gave me such relief. I loved the quiet nights I shared with her. From the carers bed in her room, I would lie facing her and would listen for her breathing as her lungs drew in air from her oxygen tank.

In late October, I won the third and final spot at the council ward elections; Mum went back into hospital and I flew home again.

While nothing can prepare you for the death of a parent I did everything I could to prepare myself. I read memoir and non-fiction (by women) and I talked with women who had experience, both personal and professional.

In the final days, as Mum slept sedated, I read A Very Easy Death by Simone de Beauvoir. It was the 50th anniversary of the translation of the French feminists account of her mothers death. The months of that death also mirrored my mothers own: a few long weeks over October and November.

De Beauvoirs mothers death was frightening to me because it was everything her maman didnt want. She wasnt ready for death and her medical wishes were not respected: the doctors operated on her even though she had begged de Beauvoir that she wouldnt let them touch her body. Her final moments were full of pain and distress. De Beauvoir wasnt even there as she had slept through the panicked phone calls from her sister.

I was not watching the US election results that afternoon and evening in November. Mum was at Canberras public hospice set amongst beautiful gardens and overlooking Lake Burley Griffin. For the last few days she had been heavily sedated. Mums breathing changed late in the afternoon and we knew, not long now.

In academia, philosopher Michel Foucault called it a heterotopia, but most of us might think of it as a bit of a headfuck, a space or place in time that has more meaning or relationship to another space than it might first appear. As my mum lay dying, I was in a room full of strong women with her. My cousin brought in the bad news from the US and I slumped in my chair beside Mum, overwhelmed by yet more insurmountable grief. I thought if I was back in Melbourne, if my mum wasnt dying, Id be at my council ceremony right now and Hillary might even have been winning but here I was in this awful parallel universe that happened to be real.

Mum died that night. A little after midnight, I woke from a light doze and Mum was turned slightly in her bed, facing me and she had stopped breathing. I leaned in close and checked for a pulse on her wrist. Her skin was so perfectly warm. The family all woke and we said our goodbyes.

I stayed with Mums body till morning. I picked out clothes for her as the nurses cleaned and dressed her. Then finally watched on as they are you ready for this? put Mums body into the transport bag. I followed the nurses as they pushed her bed down the hallway to the cold room, where I thanked them and having already said my goodbyes, left for my car and for my first day without my mum in a bleak, bleak new world.

In the months after, it was through the company of women, and particularly women who have lost their mothers, that I have found my feet again. I havent turned bitter and mean as I once thought or hoped I would. My feminism is softer with new compassion but also bolder with new militancy.

Im still finding my political feet, but Ive been elected to a council with majority women membership plus we have a female mayor and CEO too. At every council meeting I reflect deeply on the values, learnt from my mother, that drive my decision-making even if at times they wont make me popular.

I dont see much of Hillary in the news these days, which Im thankful for. It reminds me of Mum each time and when I do, bystanders watch me dab at my eyes and think she must really have liked Hillary. Little do they know that was the night my mum died.

Read more: https://www.theguardian.com/lifeandstyle/2017/jun/18/feminism-politics-and-death-my-mum-died-the-night-hillary-clinton-lost

Eating cheese does not raise risk of heart attack or stroke, study finds

Consumption of even full-fat dairy products does not increase risk, international team of experts says

Consuming cheese, milk and yoghurt even full-fat versions does not increase the risk of a heart attack or stroke, according to research that challenges the widely held belief that dairy products can damage health.

The findings, from an international team of experts, contradict the view that dairy products can be harmful because of their high saturated fat content. The experts dismiss that fear as a misconception [and] mistaken belief.

The results come from a new meta-analysis of 29 previous studies of whether dairy products increase the risk of death from any cause and from either serious heart problems or cardiovascular disease. The study concluded that such foodstuffs did not raise the risk of any of those events and had a neutral impact on human health.

This meta-analysis showed there were no associations between total dairy, high- and low-fat dairy, milk and the health outcomes including all-cause mortality, coronary heart disease or cardiovascular disease, says the report, published in the European Journal of Epidemiology.

Ian Givens, a professor of food chain nutrition at Reading University, who was one of the researchers, said: Theres quite a widespread but mistaken belief among the public that dairy products in general can be bad for you, but thats a misconception. While it is a widely held belief, our research shows that thats wrong.

Theres been a lot of publicity over the last five to 10 years about how saturated fats increase the risk of cardiovascular disease and a belief has grown up that they must increase the risk, but they dont.

However, the governments health advisers urged consumers to continue to exercise caution about eating too many products high in saturated fat and to stick to low-fat versions instead.

Dairy products form an important part of a healthy balanced diet; however, many are high in saturated fat and salt. Were all consuming too much of both, increasing our risk of heart disease, said a spokesman for Public Health England. We recommend choosing lower-fat varieties of milk and dairy products or eating smaller amounts to reduce saturated fat and salt in the diet.

Givens and colleagues from Reading, Copenhagen University in Denmark and Wageningen University in the Netherlands analysed 29 studies involving 938,465 participants from around the world undertaken over the last 35 years, including five done in the UK.

No associations were found for total (high-fat/low-fat) dairy and milk with the health outcomes of mortality, CHD or CVD, they said. In fact, they added, fermented dairy products may potentially slightly lower the risk of having a heart attack or stroke.

Doctors, public health experts and official healthy eating guidelines have for many years identified saturated fats as potentially harmful for heart and cardiovascular health and advised consumers to minimise their intake.

That has led to consumers increasingly buying lower-fat versions of dairy products. For example, 85% of all milk sold in the UK is now semi-skimmed or skimmed.

Givens said consumers were shunning full-fat versions of cheese, milk or yoghurt in the mistaken view that they could harm their health. Young people, especially young women, were now often drinking too little milk as a result of that concern, which could damage the development of their bones and lead to conditions in later life including osteoporosis, or brittle bones, he said. Consuming too little milk can deprive young people of calcium.

Pregnant women who drank too little milk could be increasing the risk of their child having neuro-developmental difficulties, which could affect their cognitive abilities and stunt their growth, Givens added.

The most recent National Diet and Nutrition Survey, the governments occasional snapshot of eating habits, found that dairy products, including butter, accounted for the highest proportion of saturated fat consumption in British diets 27%, compared with meats 24%. But if butter was not counted then dairy products together were the second largest source of saturated fat, at 22%.

Saturated fat is a vital part of diet. The NDNS found that adults typically got 34.6% of their total energy from fats as a whole, just below the 35% the government recommends. However, while total fat consumption was just within target, saturated fats still made up an unhealthily large proportion of total food energy 12.6%, against the recommended maximum of 11%.

Givens said: Our meta-analysis included an unusually large number of participants. We are confident that our results are robust and accurate.

The research was part-funded by the three pro-dairy groups Global Dairy Platform, Dairy Research Institute and Dairy Australia but they had no influence over it, the paper said. Givens is an adviser to the Food Standards Agency.

Read more: https://www.theguardian.com/society/2017/may/08/consuming-dairy-does-not-raise-risk-of-heart-attack-or-stroke-study