What to expect during IUD insertion

An intrauterine device or IUD is a small T-shaped device that a doctor or nurse can implant into the uterus to prevent pregnancy.

It is among the most effective forms of reversible birth control with a failure rate of less than 1%. The insertion is a minor medical procedure that only takes a few minutes.

Research has shown that while women report insertion experiences that range from painless to extremely painful, the procedure is usually less painful than they expected.

In this article, learn about what to expect during an IUD insertion. We also cover the side effects and recovery.

Preparation

Before getting an IUD, a person can speak to their doctor about which type is best for them. IUDs come in two forms:

  • The copper IUD: This version of the device kills sperm, preventing it from fertilizing an egg.
  • The hormonal IUD: This type of device releases progestin, which is very similar to progesterone, a hormone the body manufactures itself.

Progestin can prevent ovulation, which means there is no egg for the sperm to fertilize. It also thickens cervical mucus, making it more difficult for sperm to travel to the egg if the body does ovulate.

Hormonal IUDs may help with some premenstrual and hormonal symptoms, such as heavy bleeding or period cramps.

Copper IUDs do not offer any benefit other than contraception, so doctors do not usually recommend them for people who already experience heavy bleeding or severe cramps during menstruation.

IUDs are safe for most people to use. However, those who are allergic to copper should not use a copper IUD.

An IUD can prevent unwanted pregnancy but cannot protect against sexually transmitted infections (STIs).

People should not use an IUD if they have had any of the following:

  • abnormal vaginal bleeding
  • vaginal or cervical cancer
  • a recent pelvic infection or STI

Women who are pregnant or want to become pregnant should not get an IUD, although it is safe to get an IUD soon after childbirth.

In some people, progestin increases the risk of blood clots in the leg or high blood pressure, so it is vital to tell the doctor about any cardiovascular or other health problems.

Many people worry about pain during an IUD insertion. However, a recent study found that women’s self-reported pain, following IUD insertion, was significantly lower than the pain they expected to experience.

Some research suggests that anxiety before the procedure can make insertion feel more painful. Working with an empathetic doctor or nurse, who is willing to take time to discuss the procedure and offer reassurance, may help.

A person may wish to consider asking a doctor what previous experience they have of inserting IUDs. Similarly, they can tell the doctor if they are feeling nervous about what is going to happen.

Some people report that taking over-the-counter (OTC) pain medication, such as ibuprofen, before the procedure helps reduce pain afterward.

During the procedure

During the procedure, a person will remove their undergarments and other clothing from the waist down. They will then lie on their back, usually with their legs in stirrups. A doctor or nurse will offer a sheet to cover the thighs to help a person feel more comfortable and less exposed.

The doctor will first conduct a pelvic exam using the fingers, then cleanse the vagina and base of the cervix with an antiseptic solution.

They will then insert a speculum into the vagina to separate the walls, enabling them to see better. Using a small instrument, they will insert the IUD into the uterus through a small opening in the cervix.

Some people experience cramping similar to or sometimes more intense than menstrual cramps. If the pain feels unusual or unbearable, the person must tell the doctor. The whole process usually takes only a few minutes.

After the insertion

Some people feel dizzy or faint after an IUD insertion, so it can be a good idea to have someone accompany them for the journey home.

It is usually safe to return to work or school right away. However, if a person is feeling intense pain or cramping, they may wish to rest for a day.

Following insertion of an IUD, it is normal to notice some spotting. According to Planned Parenthood, spotting can last up to 3–6 months.

The individual should ask the doctor how long to wait before having unprotected sex. IUDs cannot prevent STIs, so it is important to practice safer sex with new or untested partners.

Aftercare

One of the main benefits of an IUD is that it requires no special care. In the days following insertion, it is common to experience some cramping and spotting. OTC medication can help reduce these symptoms. Any pain should disappear in a few days.

The IUD attaches to a string that enables a doctor or nurse to remove the device. Some women can feel the string with their fingers. It is best to leave it alone. The string is not dangerous but pulling it could move or even remove the IUD.

If the string causes irritation or if a partner can feel the string during sex, a person can ask a doctor to trim it.

In rare cases, an IUD can come out on its own. If this happens, it is possible for the person to become pregnant. Anyone whose IUD has fallen out should call a doctor and not have unprotected sex.

Side effects

Copper and hormonal IUDs can cause side effects, although these usually resolve after a few months.

Side effects of the hormonal IUD can include:

  • spotting
  • missed periods or no periods
  • headaches
  • bloating
  • nausea
  • breast tenderness
  • changes in breast size
  • mood swings
  • depression
  • low libido
  • weight gain

Not everyone experiences side effects or all of the above that doctors associate with IUDs.

Side effects of the copper IUD can include:

  • pain and cramping
  • a backache
  • long and heavy periods
  • irregular periods
  • spotting

Complications with an IUD are relatively rare, but can include:

  • the IUD falling out
  • problems associated with the hormonal IUD, such as changes in blood pressure or blood clotting.
  • an ectopic pregnancy, or pregnancy outside of the uterus
  • infection following insertion
  • pelvic inflammatory disease, if a person already has an infection before the IUD insertion
  • damage to the uterus

People with a history of cardiovascular disease, those who smoke, and those who are over 35 years old are more likely to have complications from a hormonal IUD.

It is a myth that IUDs can travel to other areas of the body, such as the brain or lungs.

Removal

IUDs can prevent pregnancy for 3 to 12 years and sometimes longer. It is possible to remove the IUD at any time.

During removal, a nurse or doctor will ask a person to lie on their back and put their feet in stirrups.

They will insert a speculum to open the vagina and then gently tug on the IUD string. This causes the IUD to fold and pass through the cervix. A person may experience cramping during removal, but the procedure only takes a few minutes.

Sometimes the IUD is harder to remove. If this happens, a doctor might use smaller instruments to take it out. Very rarely, if an IUD is stuck, a person may require surgery to remove it.

When to see a doctor

People should see a doctor if the following symptoms appear shortly after IUD insertion:

  • a fever above 101°F
  • chills
  • intense or unbearable cramping
  • strong, sharp pain in the stomach
  • very heavy bleeding

Call a doctor for these symptoms at any time after insertion:

  • a missed period with a copper IUD
  • a positive home pregnancy test
  • an IUD that falls out or seems to be coming through the cervix

Summary

An IUD is an excellent option for people who want long-term birth control without remembering to take pills, receive injections, or use condoms.

As with any birth control, IUDs offer both benefits and risks. If a person is unsure about whether it is the right choice for them, they can speak to a doctor to discuss their concerns.

The IUD insertion can be uncomfortable or painful for some people, but the pain usually passes. It may also cause some side effects as the body gets used to the new device.

It is best to speak with a doctor about any side effects if these interfere with a person’s overall well-being or quality of life.

15 Signs and symptoms of MS in women

Multiple sclerosis is an autoimmune condition that interferes with the flow of information in the central nervous system. It causes a variety of symptoms and can affect women differently than men.

Researchers do not know what triggers multiple sclerosis (MS). Once it develops, the disease causes the immune system to destroy a type of tissue called myelin that insulates nerve fibers. Without enough myelin, it is difficult for the nerves to transmit and receive signals properly. MS randomly affects nerves in the brain, spinal cord, and eyes, meaning that it can cause a wide range of unpredictable physical, mental, and emotional symptoms that vary from person to person.

MS in women

According to the National Multiple Sclerosis Society (NMSS), at least two or three times more women than men receive a diagnosis of MS. Overall, MS seems to affect men and women similarly. However, a doctor cannot predict which symptoms someone with MS will get, the severity of the symptoms, or the progression of the disease. The reason for this is that the disease attacks the myelin randomly, and the nerves that it affects can differ from person to person. Although men and women with MS often experience similar symptoms, certain factors, such as menstruation, pregnancy, and , may influence MS symptoms in women.

Symptoms of MS in women

The symptoms of MS in women are similar to those in men, but they can include additional issues due to hormonal changes.

MS can also affect female sexual health and bladder function differently.

MS symptoms in women include:

1. Vision problems

For many people, a vision problem is the first noticeable symptom of MS.

MS can cause various vision problems, which include:

  • blurred vision
  • poor color vision or contrast vision
  • painful eye movement
  • blindness in one eye
  • a dark spot in the field of vision

People with MS develop vision problems either because their optic nerves become inflamed or because they have nerve damage in the pathways that control visual coordination and eye movement.

While vision problems due to MS can be scary, most either resolve without treatment or are highly treatable.

2. Numbness

Numbness in the face, body, arms, or legs is another common symptom of MS, and it is often one of the earliest symptoms of the condition.

The numbness can range from mild and barely noticeable to severe enough that it interferes with everyday activities, such as holding objects and walking.

Most periods of numbness from MS resolve without medication and do not become permanently disabling.

3. Fatigue

Fatigue is a common symptom of MS.

About 80 percent of people with MS experience fatigue or unexplained exhaustion.

Sometimes, the cause of fatigue relates to another symptom of MS. For example, people with bladder dysfunction may sleep poorly because they have to wake throughout the night to go to the bathroom.

People with MS who have nocturnal muscle spasms may not sleep well, leaving them feeling tired during the day. MS can also increase the risk of depression, which can cause fatigue.

Another type of fatigue that seems to be unique to MS is called lassitude. A person’s fatigue may be lassitude if it:

  • occurs daily
  • worsens as the day goes on
  • happens in the morning, even after a good sleep
  • worsens with heat or humidity
  • interferes with daily activity
  • is unrelated to physical impairments or depression

4. Bladder problems

Bladder problems affect at least 80 percent of people with MS. These issues occur when scars on the nerves impair nerve signaling that is necessary for the function of the urinary sphincters and bladder.

MS can make it difficult for the bladder to hold urine and may reduce the amount that it can store, causing symptoms such as:

  • more frequent or urgent urination
  • hesitancy starting urination
  • frequent overnight urination
  • being unable to empty the bladder
  • being unable to hold urine or having urine leaks

5. Bowel problems

Many people with MS experience bowel problems, such as:

  • constipation
  • diarrhea
  • loss of bowel control

Bowel problems can make other MS symptoms worse, especially bladder problems, muscle stiffness, and involuntary muscle spasms.

Researchers think that people with MS have problems controlling their bowels because of the neurological damage that the condition causes. Some people with MS may also have trouble controlling their bowels when they are constipated.

6. Pain

Some research suggests that 55 percent of people with MS experience clinically significant pain, while 48 percent live with chronic pain. Women with MS may be more likely than men to experience pain as a symptom of this condition.

Acute MS pain seems to be due to problems with the nerves that help transmit sensations in the central nervous system.

Some of the acute pain symptoms that have an association with MS include:

  • Trigeminal neuralgia, a stabbing pain in the face that people may confuse with dental pain.
  • Lhermitte’s sign, a short sensation resembling an electric shock that moves from the back of the head down the neck and spine, usually after bending forward.
  • The MS hug, a stabbing, squeezing, painful, or burning sensation around the torso or in the legs, feet, or arms.

Some of the symptoms that people with chronic MS pain may report include:

  • burning
  • aching
  • pins and needles
  • prickling

Many people with MS also experience chronic pain as a secondary effect of the condition. For example, it could be due to:

  • compensating for gait changes
  • muscle stiffness, cramps, and spasms
  • incorrect use of mobility aids
  • muscle changes from mobility loss

7. Cognitive changes

More than 50 percent of people with MS experience changes in cognition, which means that they may sometimes have trouble:

  • processing new information
  • learning and remembering new information
  • organizing information and problem-solving
  • focusing and maintaining attention
  • properly perceiving the environment around them
  • understanding and using language
  • doing calculations

The cognitive symptoms of MS are typically mild to moderate and only affect a few aspects of cognition.

In rare cases, people with MS may experience disabling cognitive problems.

8. Depression

For people with MS, clinical depression is a common symptom.

Clinical depression is one of the most common symptoms of MS. Depression is more common in people with MS than in people with other chronic health conditions.

While almost everyone experiences periods of sadness or grief, clinical depression refers to depressive symptoms that last for a minimum of 2 weeks.

Some of the symptoms of clinical depression include:

  • loss of interest in everyday activities
  • increase in appetite or appetite loss
  • sadness
  • irritability
  • insomnia or excessive sleep
  • fatigue
  • feelings of guilt and worthlessness
  • difficulty thinking or concentrating
  • behavioral changes
  • thoughts of death or suicide

Clinical depression can also worsen other MS symptoms, including:

  • fatigue
  • pain
  • cognitive changes

9. Muscle weakness

Many people with MS experience muscle weakness. This symptom is due to damage to the nerve fibers that help control muscles.

People with MS may also experience muscle weakness because a lack of use has led their muscles to become deconditioned over time.

MS-related muscle weakness can affect any part of the body. It can be especially challenging for people with MS to walk and stay mobile when muscle weakness affects their legs, ankles, and feet.

10. Muscle stiffness and spasms

MS can cause spasticity, which is muscle stiffness and involuntary muscle spasms in the extremities, especially the legs.

Some of the signs and symptoms of spasticity include:

  • tightness in or around the joints
  • painful, uncontrollable spasms in the arms and legs
  • lower back pain
  • hips and knees that bend and become difficult to straighten
  • hips and knees that stiffen while close together or crossed

11. Dizziness and vertigo

Some people with MS experience dizziness and the sensation of being lightheaded, woozy, weak, or faint.

Less commonly, they experience vertigo, which makes it feel as though a person or their surroundings are spinning.

MS may cause vertigo by damaging the pathways that coordinate the spatial, visual, and sensory input that the brain needs to maintain balance in the body.

The symptoms of vertigo include:

  • balance problems
  • motion sickness
  • nausea and vomiting
  • being lightheaded
  • a spinning sensation

12. Sexual problems

People with MS often experience sexual problems and may find it difficult to get aroused or have an orgasm.

MS may reduce natural vaginal lubrication, potentially making sexual intercourse painful for women.

The disease can also cause sexual problems by damaging nerves in the sexual response pathways that connect the brain and the sexual organs.

People with MS can also experience issues with sex as a result of other MS symptoms, such as:

  • muscle spasms and stiffness
  • mood or self-esteem changes
  • fatigue

13. Emotional changes

MS can cause a wide range of emotional symptoms and changes, including:

  • mood swings
  • periods of uncontrollable laughter or crying
  • irritability
  • grief
  • worry, fear, and anxiety
  • distress, anger, or frustration

The condition is unpredictable, often has fluctuating symptoms, and can become disabling, all of which can be scary for someone.

MS can also cause emotional changes by damaging the nerve fibers in the brain. Some of the medications that people take to manage MS can cause mood changes too.

For example, corticosteroids can have many emotional side effects, including:

  • anxiety
  • irritability
  • agitation
  • tearfulness
  • restlessness
  • fear

14. Difficulty walking

People with MS can develop problems with gait, or how they walk, because of several factors. MS symptoms that affect how a person walks include:

  • muscle stiffness and spasms
  • numbness or other sensory problems in the hips, legs, ankles, or feet
  • fatigue
  • muscle weakness
  • loss of balance

15. Hormonal effects

There is some evidence to suggest that MS can affect women differently than men due to hormonal changes, including those that occur during:

Menstruation

More research is necessary to draw firm conclusions, but the NMSS state that some studies have found that women with MS have worse symptoms within a week of starting their period. Studies that used an MRI have also shown that MS disease activity may change according to the different hormonal levels during menstruation. 

Pregnancy

Pregnancy can reduce the risk of MS symptom flare-ups, especially during the second and third trimesters. Researchers think that pregnancy has a protective effect against MS by raising the levels of compounds that help reduce inflammation and the effects of the disease. Women who are pregnant also have naturally higher levels of circulating corticosteroids, another type of immunosuppressant.

Although pregnancy can temporarily reduce some MS symptoms, flare-ups tend to return in the first 3 to 6 months postpartum. However, in the long term, there is no proven link between pregnancy and a higher risk of disability.

While being pregnant can temporarily reduce the risk of flare-ups, pregnancy also puts a lot of physical stress on the body, which can make certain symptoms of MS worse.

In addition, some of the medications that people use for MS are not safe to take during pregnancy and can worsen symptoms.

Anyone with MS who is pregnant or planning to become pregnant should discuss their medications with their doctor.

Some MS symptoms that pregnancy often exacerbates include:

  • fatigue
  • gait problems
  • bladder and bowel problems

Menopause

MS symptoms may worsen after menopause, possibly because declining estrogen levels adversely affect disease progression. However, it is difficult to tell whether MS symptoms worsen because of menopause or just as a natural result of aging or the progression of the condition. Much more research is necessary to understand the relationship between menopause and MS symptoms.

Rarer symptoms

While the symptoms above are the most common, MS affects everyone differently. Less common symptoms of MS include:

  • speech problems
  • seizures
  • hearing loss
  • swallowing problems
  • tremor
  • breathing problems
  • itching
  • headaches

Outlook

MS is an autoimmune disease that randomly affects parts of the central nervous system, resulting in unpredictable physical, cognitive, and emotional symptoms.

Although MS tends to affect more women than men, it usually causes similar symptoms. However, women may experience variations in their symptoms due to hormonal changes, such as those that take place during menstruation or menopause.

Vision problems and random localized numbness are often the first symptoms of the condition. Depression, bladder problems, cognitive changes, and pain are also among the most common symptoms of MS.

There is no cure for MS, but different drugs and complementary therapies can typically help manage symptoms or even slow the progression of the condition.

Anyone experiencing concerning symptoms should see a doctor for a proper diagnosis.

Replacing red meat with plant protein reduces heart disease risk

A meta-analysis of trials comparing the health effects of red meat consumption with those of other diets found that substituting healthful plant protein for red meat helps lower the risk of cardiovascular disease.

Eating plant proteins, such as tofu, may benefit cardiovascular health.

Many studies throughout the years have linked the consumption of red meat to cardiovascular disease and cancer, but the results have been inconsistent.

A recent study comparing the effects of plant protein and animal protein on the risk of cardiovascular disease found that the evidence was inconclusive.

Recent studies further investigated the link between red meat consumption and heart disease and found that red meat does not significantly increase the risk of cardiovascular disease when a person sticks to the recommended intake. Most of these studies focused on the potential harms of red meat, but they did not include an analysis of other specific diets.

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Red meat consumption in the United States

This new approach allowed researchers to examine a different side of the issue. Red meat consumption remains a very controversial topic, especially in the U.S., where the consumption of red meat per capita was more than 200 pounds in 2018, according to the U.S. Department of Agriculture.

Although red meat consumption in the U.S. is still high, chicken production and consumption have been increasing. The U.S. per capita beef consumption is down from its peak, but it is still remarkable — it is four times as high as the global average, according to the Organization for Economic Co-operation and Development.

A recent survey showed that many people in the U.S. might be open to reducing their meat consumption in the future because they are becoming more aware of the associations that red meat has with nutritional and environmental health harms. The researchers suggested that education campaigns are necessary to accelerate the shift to a more sustainable diet.

Asking ‘Is red meat good or bad?’ is useless

In this latest study, the researchers analyzed data from 36 randomized controlled trials, which included a total of 1,803 participants. The team looked at blood pressure and blood concentrations of cholesterol, triglycerides, and lipoproteins in people who ate diets with red meat. They then compared these values with those of people who ate more of other foods, such as chicken, fish, carbohydrates, legumes, soy, or nuts.

Previous findings from randomized controlled trials evaluating the effects of red meat on cardiovascular disease risk factors have been inconsistent.

But, our new study, which makes specific comparisons between diets high in red meat versus diets high in other types of foods, shows that substituting red meat with high-quality protein sources lead to more favorable changes in cardiovascular risk factors.”

The findings showed that there were no significant differences in total cholesterol, lipoproteins, or blood pressure between those who ate red meat and those who ate more of other types of food. However, diets high in red meat did cause an increase in triglyceride concentrations. Conversely, diets rich in high-quality plant protein lowered the levels of bad cholesterol.

If you replace burgers with cookies or fries, you don’t get healthier. But, if you replace red meat with healthy plant protein sources, like nuts and beans, you get a health benefit.”

The authors recommend that people follow healthful vegetarian and Mediterranean-style diets that provide plenty of high-quality plant protein because they offer excellent health benefits and promote environmental sustainability.

Everything You Need to Know About Alzheimer’s Disease

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive form of dementia. Dementia is a broader term for conditions caused by brain injuries or diseases that negatively affect memory, thinking, and behavior. These changes interfere with daily living.

According to the Alzheimer’s Association, Alzheimer’s disease accounts for 60 to 80 percent of dementia cases. Most people with the disease get a diagnosis after age 65. If it’s diagnosed before then, it’s generally referred to as early onset Alzheimer’s disease.

There’s no cure for Alzheimer’s, but there are treatments that can slow the progression of the disease. Learn more about the basics of Alzheimer’s disease.

Alzheimer’s facts

Although many people have heard of Alzheimer’s disease, some aren’t sure exactly what it is. Here are some facts about this condition:

  • Alzheimer’s disease is a chronic ongoing condition.
  • Its symptoms come on gradually and the effects on the brain are degenerative, meaning they cause slow decline.
  • There’s no cure for Alzheimer’s but treatment can help slow the progression of the disease and may improve quality of life.
  • Anyone can get Alzheimer’s disease but certain people are at higher risk for it. This includes people over age 65 and those with a family history of the condition.
  • Alzheimer’s and dementia aren’t the same thing. Alzheimer’s disease is a type of dementia.
  • There’s no single expected outcome for people with Alzheimer’s. Some people live a long time with mild cognitive damage, while others experience a more rapid onset of symptoms and quicker disease progression.

Each person’s journey with Alzheimer’s disease is different. Find out more details about how Alzheimer’s can affect people.

Dementia vs. Alzheimer’s

The terms “dementia” and “Alzheimer’s” are sometimes used interchangeably. However, these two conditions aren’t the same. Alzheimer’s is a type of dementia.

Dementia is a broader term for conditions with symptoms relating to memory loss such as forgetfulness and confusion. Dementia includes more specific conditions, such as Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, and others, which can cause these symptoms.

Causes, symptoms, and treatments can be different for these diseases. Learn more about how dementia and Alzheimer’s disease differ.

Alzheimer’s disease causes and risk factors

Experts haven’t determined a single cause of Alzheimer’s disease but they have identified certain risk factors, including:

  • Age. Most people who develop Alzheimer’s disease are 65 years of age or older.
  • Family history. If you have an immediate family member who has developed the condition, you’re more likely to get it.
  • Genetics. Certain genes have been linked to Alzheimer’s disease.

Having one or more of these risk factors doesn’t mean that you’ll develop Alzheimer’s disease. It simply raises your risk level.

To learn more about your personal risk of developing the condition, talk with your doctor. 

Alzheimer’s and genetics

While there’s no one identifiable cause of Alzheimer’s, genetics may play a key role. One gene in particular is of interest to researchers. Apolipoprotein E (APOE) is a gene that’s been linked to the onset of Alzheimer’s symptoms in older adults.

Blood tests can determine if you have this gene, which increases your risk of developing Alzheimer’s. Keep in mind that even if someone has this gene, they may not get Alzheimer’s.

The opposite is also true: Someone may still get Alzheimer’s even if they don’t have the gene. There’s no way to tell for sure whether someone will develop Alzheimer’s.

Other genes could also increase risk of Alzheimer’s and early onset Alzheimer’s.

Symptoms of Alzheimer’s disease

Everyone has episodes of forgetfulness from time to time. But people with Alzheimer’s disease display certain ongoing behaviors and symptoms that worsen over time. These can include:

  • memory loss affecting daily activities, such as an ability to keep appointments
  • trouble with familiar tasks, such as using a microwave
  • difficulties with problem-solving
  • trouble with speech or writing
  • becoming disoriented about times or places
  • decreased judgment
  • decreased personal hygiene
  • mood and personality changes
  • withdrawal from friends, family, and community

Symptoms change according to the stage of the disease. 

Alzheimer’s stages

Alzheimer’s is a progressive disease, which means the symptoms will gradually worsen over time. Alzheimer’s is broken down into seven stages:

  • Stage 1. There are no symptoms at this stage but there might be an early diagnosis based on family history.
  • Stage 2. The earliest symptoms appear, such as forgetfulness.
  • Stage 3. Mild physical and mental impairments appear, such as reduced memory and concentration. These may only be noticeable by someone very close to the person.
  • Stage 4. Alzheimer’s is often diagnosed at this stage, but it’s still considered mild. Memory loss and the inability to perform everyday tasks is evident.
  • Stage 5. Moderate to severe symptoms require help from loved ones or caregivers.
  • Stage 6. At this stage, a person with Alzheimer’s may need help with basic tasks, such as eating and putting on clothes.
  • Stage 7. This is the most severe and final stage of Alzheimer’s. There may be a loss of speech and facial expressions.

As a person progresses through these stages, they’ll need increasing support from a caregiver. 

Early onset Alzheimer’s

Alzheimer’s typically affects people ages 65 years and older. However, it can occur in people as early as their 40s or 50s. This is called early onset, or younger onset, Alzheimer’s. This type of Alzheimer’s affects about 5 percent of all people with the condition.

Symptoms of early onset Alzheimer’s can include mild memory loss and trouble concentrating or finishing everyday tasks. It can be hard to find the right words, and you may lose track of time. Mild vision problems, such as trouble telling distances, can also occur.

Certain people are at greater risk of developing this condition. 

The only definitive way to diagnose someone with Alzheimer’s disease is to examine their brain tissue after death. But your doctor can use other examinations and tests to assess your mental abilities, diagnose dementia, and rule out other conditions.

They’ll likely start by taking a medical history. They may ask about your:

  • symptoms
  • family medical history
  • other current or past health conditions
  • current or past medications
  • diet, alcohol intake, or other lifestyle habits

From there, your doctor will likely do several tests to help determine if you have Alzheimer’s disease.

Alzheimer’s tests

There’s no definitive test for Alzheimer’s disease. However, your doctor will likely do several tests to determine your diagnosis. These can be mental, physical, neurological, and imaging tests.

Your doctor may start with a mental status test. This can help them assess your short-term memory, long-term memory, and orientation to place and time. For example, they may ask you:

  • what day it is
  • who the president is
  • to remember and recall a short list of words

Next, they’ll likely conduct a physical exam. For example, they may check your blood pressure, assess your heart rate, and take your temperature. In some cases, they may collect urine or blood samples for testing in a laboratory.

Your doctor may also conduct a neurological exam to rule out other possible diagnoses, such as an acute medical issue, such as infection or stroke. During this exam, they will check your reflexes, muscle tone, and speech.

Your doctor may also order brain-imaging studies. These studies, which will create pictures of your brain, can include:

  • Magnetic resonance imaging (MRI). MRIs can help pick up key markers, such as inflammation, bleeding, and structural issues.
  • Computed tomography (CT) scan. CT scans take X-ray images which can help your doctor look for abnormal characteristics in your brain.
  • Positron emission tomography (PET) scan. PET scan images can help your doctor detect plaque buildup. Plaque is a protein substance related to Alzheimer’s symptoms.

Other tests your doctor may do include blood tests to check for genes that may indicate you have a higher risk of Alzheimer’s disease. 

Alzheimer’s medication

There’s no known cure for Alzheimer’s disease. However, your doctor can recommend medications and other treatments to help ease your symptoms and delay the progression of the disease for as long as possible.

For early to moderate Alzheimer’s, your doctor may prescribe medications such as donepezil (Aricept) or rivastigmine (Exelon). These drugs can help maintain high levels of acetylcholine in your brain. This is a type of neurotransmitter that can help aid your memory.

To treat moderate to severe Alzheimer’s, your doctor may prescribe donepezil (Aricept) or memantine (Namenda). Memantine can help block the effects of excess glutamate. Glutamate is a brain chemical that’s released in higher amounts in Alzheimer’s disease and damages brain cells.

Your doctor may also recommend antidepressants, antianxiety medications, or antipsychotics to help treat symptoms related to Alzheimer’s. These symptoms include:

  • depression
  • restlessness
  • aggression
  • agitation
  • hallucinations

Other Alzheimer’s treatments

In addition to medication, lifestyle changes may help you manage your condition. For example, your doctor might develop strategies to help you or your loved one:

  • focus on tasks
  • limit confusion
  • avoid confrontation
  • get enough rest every day
  • stay calm

Some people believe that vitamin E can help prevent decline in mental abilities, but studies indicate that more research is needed. Be sure to ask your doctor before taking vitamin E or any other supplements. It can interfere with some of the medications used to treat Alzheimer’s disease.

In addition to lifestyle changes, there are several alternative options you can ask your doctor about. 

Preventing Alzheimer’s

Just as there’s no known cure for Alzheimer’s, there are no foolproof preventive measures. However, researchers are focusing on overall healthy lifestyle habits as ways of preventing cognitive decline.

The following measures may help:

  • Quit smoking.
  • Exercise regularly.
  • Try cognitive training exercises.
  • Eat a plant-based diet.
  • Consume more antioxidants.
  • Maintain an active social life.

Be sure to talk with your doctor before making any big changes in your lifestyle.

Alzheimer’s care

If you have a loved one with Alzheimer’s, you may consider becoming a caregiver. This is a full-time job that’s typically not easy but can be very rewarding.

Being a caregiver takes many skills. These include patience perhaps above all, as well as creativity, stamina, and the ability to see joy in the role of helping someone you care about live the most comfortable life they can.

As a caregiver, it’s important to take care of yourself as well as your loved one. With the responsibilities of the role can come an increased risk of stress, poor nutrition, and lack of exercise.

If you choose to assume the role of caregiver, you may need to enlist the help of professional caregivers as well as family members to help. 

The statistics surrounding Alzheimer’s disease are daunting.

  • According to the Centers for Disease Control and Prevention (CDC), Alzheimer’s is the sixth most common cause of death among U.S. adults. It ranks fifth among causes of death for people 65 years and older.
  • A study found that 4.7 million Americans over the age of 65 years had Alzheimer’s disease in 2010. Those researchers projected that by 2050, there will be 13.8 million Americans with Alzheimer’s.
  • The CDC estimates that over 90 percent of people with Alzheimer’s don’t see any symptoms until they’re over 60 years old.
  • Alzheimer’s is an expensive disease. According to the CDC, about $259 billion was spent on Alzheimer’s and dementia care costs in the United States in 2017.

The takeaway

Alzheimer’s is a complicated disease in which there are many unknowns. What is known is that the condition worsens over time, but treatment can help delay symptoms and improve your quality of life.

If you think you or a loved one may have Alzheimer’s, your first step is to talk with your doctor. They can help make a diagnosis, discuss what you can expect, and help connect you with services and support. If you’re interested, they can also give you information about taking part in clinical trials.

All Sweetened Drinks Can Raise Heart Disease Risk

Some sweetened beverages can have more sugar than a 12-ounce can of Coca Cola. 

It’s not news that too much sugar isn’t good for you.

Indeed, soda, candy, and sticky-sweet confections can take a toll on your waistline, not to mention your teeth.Now, the specific connection between diseases and sugary beverages, such as soda, sports drinks, and sweetened coffee beverages, is clearer.

Earlier this month, the journal of the American Heart Association released findings that show people who drink sugar-sweetened beverages have an increased risk for cardiovascular disease and some cancers.No matter what drink you take, excessive consumption [of sugar] is a problem. High overall sugar intake from any drink like coffee with sugar or juices can lead to problems. Higher consumption of sugar leads to increased incidence of weight gain and diabetes, which in turn leads to increased risk for heart attacks and strokes.This study joins previous research that points to the relationship between a high-sugar diet and negative heart health outcomes.However, in this one, the authors controlled for other dietary factors, physical activity, and body mass index, items that could be independently linked with sugar-sweetened beverages.The results still pointed to the damaging effects sugary beverages may have, regardless of other possible cardiovascular risk factors.

Sugar replacements are risky, too

A secondary finding of the Circulation study suggests people who replace one sugary drink per day with an artificially-sweetened drink (such as a diet soda) have a slightly lower risk of death.However, if a woman drinks four or more artificially-sweetened drinks per day, she has a higher risk of death.Low-calorie drinks, while containing less sugar, also carry an increased risk. 

What beverages are not OK?

Soda is the poster star of sugar problems, but Americans are actually drinking fewer sugary drinks like soda today than any time in the past decade.

Yet, 1 in 10 people still get more than a quarter of their daily calories from sugar.

That’s not all coming from soda.

A 12-ounce can of Coca-Cola Classic has 39 grams of sugar. You may be unlikely to reach for the syrupy soda after a workout, but the Gatorade you down on your way out the door has 34 grams.

Feeling a little sluggish in the afternoon? Instead of a 20-ounce bottle of Pepsi (69 grams), you may take a quick jaunt down to Starbucks for a Grande Mocha Frappuccino (skim milk and no whip, please), which has —are you ready? —59 grams of sugar. Even the extra 500 steps won’t burn off that sugar crush.

Are you stocking sugary “smoothies” in your fridge, sipping them on your commute to the office, as a way to get more fruit into your diet? A 15.2-ounce bottle promises apples, bananas, blueberries, and blackberries — all while delivering 55 grams of sugar.

Does fruit provide a bit of a health halo for that much sugar? 

“Any liquid source of sugar, even if it is a naturally occurring form that is in a concentrate, will have the same impact,” she told Healthline. “The blood sugar and insulin levels still spike and fall with all of these options. You can dress up a drink with over 10 grams of sugar any way you like, but in the end, it’s still just sugar.”

More than 60 different names for sugar could be listed on an ingredient label.

Fruit juice concentrate seems natural, but it’s a form of sugar. Brown rice syrup? That’s sugar. Beets are healthy, so what about beet sugar? Still sugar.

If, however, you’re not keen to memorize five dozen random words, keep this rule in mind: water is best.

How to quit sugar for good

Drinking water in place of sugary drinks is a healthy choice that could contribute to longevity. Diet soda may be used to help frequent consumers of sugary drinks cut back their consumption, but water is the best and healthiest choice.

To get your daily sugar consumption down, it’s important to understand what you’re actually eating in a day. A food diary can help.

Whether you record your food in a smartphone app or hand-write everything in a notebook, jotting down what you typically eat for several weeks will give you an idea of what you’re taking in and how much, if any, you need to cut to reach recommended guidelines.Per the American Heart Association, men should consume no more than nine teaspoons or 36 grams of added sugar a day, and women no more than six teaspoons or 25 grams of added sugar per day. To put this in perspective, one 12-ounce can of regular soda has eight teaspoons of sugar.

From there, the process of cutting back begins. Ask what you can reasonably get rid of. If cravings occur… you can look toward fresh fruit like berries or apples. If cola is your big thing, start there, and try a cold turkey approach, not replacing a regular soda with a diet option.It’s not an easy task. Research shows sugar has qualities that may cause an addiction, and your body will call out for it.

Part of your goals must involve support from family and friends and an environment in which sugar is not easily accessible. If this is too tough to do, then consider simply slashing all foods from your diet that have more than four grams of added sugar per serving.New regulations from the Food and Drug Administration require food manufacturers to list added sugar on food labels, beginning in 2020. This will make identifying surprising sources of sugar easier.

Prostate cancer in detail

Prostate cancer affects the prostate gland, the gland that produces some of the fluid in semen and plays a role in urine control in men.

The prostate gland is located below the bladder and in front of the rectum.

In the United States, it is the most common cancer in men, but it is also treatable if found in the early stages.

In 2017, the American Cancer Society predicts that there will be around 161,360 new diagnoses of prostate cancer, and that around 26,730 fatalities will occur because of it.

Regular testing is crucial as the cancer needs to be diagnosed before metastasis.

Fast facts on prostate cancer:

Here are some key points about the prostate cancer. More detail is in the main article.

The prostate gland is part of the male reproductive system.

Prostate cancer is the most common cancer in men.

It is treatable if diagnosed early, before it spreads.

If symptoms appear, they include problems with urination.

Regular screening Is the best way to detect it in good time.

Symptoms

There are usually no symptoms during the early stages of prostate cancer. However, if symptoms do appear, they usually involve one or more of the following:

  • frequent urges to urinate, including at night
  • difficulty commencing and maintaining urination
  • blood in the urine
  • painful urination and, less commonly, ejaculation
  • difficulty achieving or maintaining an erection may be difficult

Advanced prostate cancer can involve the following symptoms:

  • bone pain, often in the spine, femur, pelvis, or ribs
  • bone fractures

If the cancer spreads to the spine and compresses the spinal cord, there may be:

  • leg weakness
  • urinary incontinence
  • fecal incontinence

Treatment

Treatment is different for early and advanced prostate cancers.

Early stage prostate cancer

If the cancer is small and localized, it is usually managed by one of the following treatments:

Watchful waiting or monitoring: PSA blood levels are regularly checked, but there is no immediate action. The risk of side-effects sometimes outweighs the need for immediate treatment for this slow-developing cancer.

Radical prostatectomy: The prostate is surgically removed. Traditional surgery requires a hospital stay of up to 10 days, with a recovery time of up to 3 months. Robotic keyhole surgery involves a shorter hospitalization and recovery period, but it can be more expensive. Patients should speak to their insurer about coverage.

Brachytherapy: Radioactive seeds are implanted into the prostate to deliver targeted radiation treatment.

Conformal radiation therapy: Radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment. This minimizes healthy tissue exposure to radiation.

Intensity modulated radiation therapy: Beams with variable intensity are used. This is an advanced form of conformal radiation therapy.

In the early stages, patients may receive radiation therapy combined with hormone therapy for 4 to 6 months.

Treatment recommendations depend on individual cases. The patient should discuss all available options with their urologist or oncologist.

Advanced prostate cancer

Advanced cancer is more aggressive and will have spread further throughout the body.

Chemotherapy may be recommended, as it can kill cancer cells around the body.

Androgen deprivation therapy (ADT), or androgen suppression therapy, is a hormone treatment that reduces the effect of androgen. Androgens are male hormones that can stimulate cancer growth. ADT can slow down and even stop cancer growth by reducing androgen levels.

The patient will likely need long-term hormone therapy.

Even if the hormone therapy stops working after a while, there may be other options. Participation in clinical trials is one option that a patient may wish to discuss with the doctor.

Radical prostatectomy is not currently an option for advanced cases, as it does not treat the cancer that has spread to other parts of the body.

Fertility

As the prostate is directly involved with sexual reproduction, removing it affects semen production and fertility.

Radiation therapy affects the prostate tissue and often reduces the ability to father children. The sperm can be damaged and the semen insufficient for transporting sperm.

Non-surgical options, too, can severely inhibit a man’s reproductive capacity.

Options for preserving these functions can include donating to a sperm bank before surgery, or having sperm extracted directly from the testicles for artificial insemination into an egg. However, the success of these options is never guaranteed.

Patients with prostate cancer can speak to a fertility doctor if they still intend to father children.

What causes prostate cancer?

The prostate is a walnut-sized exocrine gland. This means that it’s fluids and secretions are intended for use outside of the body.

The prostate produces the fluid that nourishes and transports sperm on their journey to fuse with a female ovum, or egg, and produce human life. The prostate contracts and forces these fluids out during orgasm.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen retain its liquid state. An excess of this protein in the blood is one of the first signs of prostate cancer.

The urethra is tube through which sperm and urine exit the body. It also passes through the prostate.

As such, the prostate is also responsible for urine control. It can tighten and restrict the flow of urine through the urethra using thousands of tiny muscle fibers.

How does it start?

It usually starts in the glandular cells. This is known as adenocarcinoma. Tiny changes occur in the shape and size of the prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This tends to happen slowly and does not show symptoms until further into the progression.

Nearly 50 percent of all men over the age of 50 years have PIN. High-grade PIN is considered pre-cancerous, and it requires further investigation. Low-grade PIN is not a cause for concern.

Prostate cancer can be successfully treated if it is diagnosed before metastasis, but if it spreads, it is more dangerous. It most commonly spreads to the bones.

Stages

Staging takes into account the size and extent of the tumor and the scale of the metastasis (whether it has traveled to other organs and tissues).

At Stage 0, the tumor has neither spread from the prostate gland nor invaded deeply into it. At Stage 4, the cancer has spread to distant sites and organs.

Diagnosis

A doctor will carry out a physical examination and enquire about any ongoing medical history. If the patient has symptoms, or if a routine blood test shows abnormally high PSA levels, further examinations may be requested.

Tests may include:

  • a digital rectal examination (DRE), in which a doctor will manually check for any abnormalities of the prostate with their finger
  • a biomarker test checking the blood, urine, or body tissues of a person with cancer for chemicals unique to individuals with cancer

If these tests show abnormal results, further tests will include:

  • a PCA3 test examining the urine for the PCA3 gene only found in prostate cancer cells
  • a transrectal ultrasound scan providing imaging of the affected region using a probe that emits sounds
  • a biopsy, or the removal of 12 to 14 small pieces of tissue from several areas of the prostate for examination under a microscope

These will help confirm the stage of the cancer, whether it has spread, and what treatment is appropriate.

To track any spread, or metastasis, doctors may use a bone, CT scan, or MRI scan.

Outlook

If the disease is found before it spreads to other organs in a process known as metastasis, the 5-year survival rate is 99 percent. After fifteen years, this decreases to 96 percent. Once the cancer metastasizes, or spreads, the 5-year survival rate is 29 percent.

Regular screening can help detect prostate cancer while it is still treatable.

Risk factors

The exact cause of prostate cancer is unclear, but there are many possible risk factors.

Age

Prostate cancer is rare among men under the age of 45 years, but more common after the age of 50 years.

Geography

Prostate cancer occurs most frequently in North America, northwestern Europe, on the Caribbean islands, and in Australia. The reasons remain unclear.

Genetic factors

Certain genetic and ethnic groups have an increased risk of prostate cancer.

In the U.S., prostate cancer is at least 60 percent more common and 2 to 3 times more deadly among black men than non-Hispanic white men.

A man also has a much higher risk of developing cancer if his identical twin has it, and a man whose brother or father had prostate cancer has twice the risk of developing it compared to other men. Having a brother who has or has had prostate cancer is more of a genetic risk than having a father with the disease.

Diet

Studies have suggested that a diet high in red meat or high-fat dairy products may increase a person’s chances of developing prostate cancer, but the link is neither confirmed nor clear.

Medication

Some research has suggested that non-steroidal anti-inflammatory drug (NSAID) use may reduce the risk of prostate cancer. Others have linked NSAID use with a higher risk of death from the disease. This is a controversial area, and results have not been confirmed.

There has also been some investigation into whether statins might slow the progression of prostate cancer. One 2016 study concluded that results were “weak and inconsistent.”

Obesity

It is often believed that obesity is linked to the development of prostate cancer, but the American Cancer Society maintains that there is no clear link.

Some studies have found that obesity increases the risk of death in advanced cancers. Studies have also concluded that obesity decreases the risk that a cancer will be low-grade if it does occur.

Agent Orange

Exposure to Agent Orange, a chemical weapon used in the Vietnam war, may possibly be linked to the development of more aggressive types of cancer, but the extent of this has not been confirmed.

Diabetes: Nuts could reduce cardiovascular risk

New evidence supports the current recommendation for people with type 2 diabetes to eat nuts to prevent cardiovascular issues and premature death.

People with diabetes may benefit from eating nuts.

Nuts are packed full of essential nutrients that could benefit overall health.

They contain high levels of unsaturated fatty acids, fiber, vitamin E, folate, and minerals, including potassium, calcium, and magnesium.

The latest research has shown that nut consumption may help reduce the risk of chronic disease.

A recent study, which featured in the Journal of the American College of Cardiology, identified an association between eating nuts and a lower risk of cardiovascular disease.

Type 2 diabetes and nut consumption

Type 2 diabetes is a chronic condition that affects the way in which the body metabolizes glucose, which is its primary source of fuel. Possible complications include kidney damage and cardiovascular disease.

According to the American Diabetes Association, in 2015, more than 30 million people in the United States had diabetes.

In the same year, diabetes was the seventh leading cause of death in the U.S., with over 250,000 death certificates listing it as an underlying or contributing cause of death.

Every year, doctors diagnose 1.5 million cases of diabetes in the U.S.

Over the years, several studies have linked nut consumption to the prevention of coronary heart disease. In 2010, researchers noted that the results of these studies justified exploring the use of nuts in managing the symptoms and complications of diabetes.

A new study, which the American Heart Association journal Circulation Research has published, found additional evidence that supports the recommendation of incorporating nuts into a balanced diet to reduce the risk of heart disease in people with diabetes.

Boosting nut intake

In this latest study, researchers used self-reported diet questionnaires about nut consumption. Close to 16,000 adults participated, and they filled out the questionnaires before and after they received a diagnosis of type 2 diabetes.

The researchers found that all types of nut offered health benefits, especially tree nuts.

As the name suggests, tree nuts, which include almonds and walnuts, grow on trees, while groundnuts, such as peanuts, grow underground. Tree nuts may offer more benefits because they contain higher amounts of nutrients in comparison with groundnuts.

Their analysis showed that people with type 2 diabetes who ate five servings of nuts per week had a 17-percent reduced risk of cardiovascular disease and a 34-percent lower risk of death relating to this condition.

Those who consumed more nuts after their diabetes diagnosis had an 11-percent lower risk of cardiovascular disease and a 25-percent reduced risk of death related to heart disease compared with people who did not increase their intake of nuts.

“Our findings provide new evidence that supports the recommendation of including nuts in [healthful] dietary patterns for the prevention of cardiovascular disease complications and premature deaths among individuals with diabetes.

Even small increases might help

The team of researchers found that eating even a small number of nuts made a significant difference. Each additional serving per week of nuts led to a 3-percent reduction in the risk of cardiovascular disease and a 6-percent lower risk of death due to heart disease.

Although the specific effects of nuts on heart health are not clear, findings suggest that the nutrients in nuts may improve blood pressure, blood sugar control, and inflammation as well as enhancing the metabolism of fats and promoting blood vessel wall function.

“Cardiovascular disease is the leading cause of death and a major cause of heart attacks, strokes, and disability for people living with type 2 diabetes.

Efforts to understand the link between the two conditions are important to prevent cardiovascular complications of type 2 diabetes and help people make informed choices about their health.

Pregnancy Trimesters

The typical pregnancy has three trimesters and lasts around 40 weeks from the first day of a woman’s last period. In each trimester, the fetus will meet specific developmental milestones.

While 40 weeks is the usual time frame, a full-term baby can be born as early as 37 weeks and as late as 42 weeks.

Read on for more information about what to expect during each pregnancy trimester.

The first trimester

The first trimester lasts for the first 12 weeks of the pregnancy and is crucial for the baby’s development. At conception, the egg and sperm combine to form a zygote, which will implant in the uterine wall.

The zygote becomes an embryo as the cells divide and grow. All of the major organs and structures begin to form.

At 4–5 weeks, the embryo is only 0.04 inches long but will grow to around 3 inches long by the end of the first trimester. The embryo is now looking a lot more like a human baby.

The fetus’s heart will start beating by the eighth week. The eyelids remain closed to protect its eyes. The fetus can also make a fist at this stage. Also, external genitalia will have formed and may be visible during an ultrasound, meaning that a doctor can tell someone whether the fetus is male or female.

A woman will experience many changes during the first trimester, too. Many women will start to feel morning sickness, or nausea and vomiting due to pregnancy, at 6–8 weeks.

Despite its name, this nausea does not just occur in the morning. Some pregnant women get sick at night, while others are sick all day.

A pregnant woman might also feel very tired and notice that she is more emotional than usual due to hormonal changes.

Many also report experiencing food cravings or aversions during early pregnancy, alongside a stronger sense of smell. Breast tenderness is also very common.

The second trimester

The second trimester lasts between week 13 and 26 of pregnancy. The fetus will go through a lot of changes during this time and grow from approximately 4–5 inches long to around 12 inches long.

During the second trimester, the fetus will also go from weighing about 3 ounces to weighing 1 pound (lb) or more.

In addition to the major structures and organs, other important parts of the body will also form during the second trimester, including:

  • the skeleton
  • muscle tissue
  • skin
  • eyebrows
  • eyelashes
  • fingernails and toenails
  • blood cells
  • taste buds
  • footprints and fingerprints
  • hair

If the fetus is male, the testes begin to drop into the scrotum. If the fetus is female, the ovaries begin to form eggs.

The fetus now has regular sleeping and waking patterns. They can also hear sounds from outside the womb, and they will begin to practice swallowing, which is an important skill after delivery.

The woman will also likely begin to feel better. In most cases, morning sickness and fatigue start to go away at the beginning of the second trimester. Food cravings and aversions can continue, however.

A woman may notice that her belly is starting to grow and that she is beginning to “look pregnant.” She should also start to feel the baby moving, which is called “quickening.”

Braxton–Hicks contractions may start toward the end of the second trimester.

A woman may also begin to experience other symptoms in the second trimester, including:

  • round ligament pain
  • nipple changes, such as darkening
  • stretch marks

The third trimester

During the third trimester, a growing fetus will move more regularly.

The third trimester lasts from week 27 until delivery, which is usually around week 40. During this trimester, a developing baby will grow from around 12 inches long and 1.5 lbs in weight to about 18–20 inches long and 7–8 lbs in weight.

Most of the organs and body systems have formed by now, but they will continue to grow and mature during the third trimester.

The fetus’s lungs are not fully formed at the beginning of this trimester, but they will be by the time of delivery.

A growing baby will start practicing breathing motions to help prepare for life after birth. Kicks and rolls become stronger, and a pregnant woman should feel the baby move regularly.

A pregnant woman may also begin to feel uncomfortable during this trimester, as her belly starts to grow. Most women start to feel Braxton–Hicks contractions getting stronger, and they may have back pain from carrying a heavy belly.

Other symptoms that a pregnant woman may experience during the third trimester include:

  • heartburn
  • swollen feet
  • insomnia
  • mood swings
  • leakage of milk from the breasts
  • other breast and nipple changes
  • frequent urination

As the woman gets closer to the delivery, the baby should turn in to a head-down position to make birth easier.

Anxiety about delivery and parenthood are also common toward the end of pregnancy.

Postpartum, or the ‘fourth trimester’

Many people unofficially call the baby’s first 3 months of life the fourth trimester, or the time when the baby adjusts to life outside the womb.

Human babies are born very immature compared with most other mammals. Many baby mammals can stand up and walk within hours of birth.

Human babies have large brains, so they must be born at 9 months’ gestation. If the birth occurred any later, it would be very dangerous because their heads might not be able to pass through a woman’s pelvis safely.

Since they are still very immature, newborn babies need constant care during their first few months of life.

This period can be very difficult for both the baby and their caregiver. Keeping the baby calm means replicating life in the womb as closely as possible. This can be accomplished by:

  • holding the baby close
  • gently swaying or rocking the baby
  • making swishing or shushing noises
  • swaddling
  • giving the baby opportunities to suck, either during breastfeeding or by using a pacifier

The fourth trimester can be challenging for new parents. It is vital to rest as much as possible.

To make this time a little easier, try to accept help from family and friends. This help may be in the form of meals, babysitting older siblings, and cleaning or laundry as needed.

A woman will experience lochia, or bleeding and vaginal discharge, that continues for 4–6 weeks after birth. Her breasts may be sore and leak as she adjusts to breastfeeding.

Many women experience mood swings, or “baby blues,” after birth. This is usually due to the fluctuation in hormones.

Some women may experience postpartum depression after childbirth. This includes feelings of intense sadness, fatigue, anxiety, and hopelessness that can affect her ability to care for herself and the baby.

Postpartum depression is treatable, so anyone experiencing these symptoms should speak to a doctor as soon as possible.

Summary

Pregnancy, childbirth, and the first few months with a newborn are unlike any other time in life. They are full of new experiences, great uncertainty, and many new emotions.

Getting regular prenatal care is vital during each trimester. A doctor can help ensure the growing baby is meeting their developmental milestones, and that the woman is in good health.

Type 2 diabetes: How do fructose-sweetened drinks affect risk?

A new study shows that sugary drinks that contain fructose raise the risk of type 2 diabetes more than other fructose-containing foods.

New research finds that ‘nutrient-poor’ sweetened drinks have a harmful effect on metabolic health when they add excess energy.

A range of recent studies has pointed out the potential health risks of sugary drinks. Studies have confirmed that there is a link between sugary drinks and obesity, as well as cautioning that as few as two sugary drinks per week may raise the risk of type 2 diabetes considerably.

Now, a comprehensive review of existing research confirms that fructose-containing drinks can increase the risk of type 2 diabetes more than other foods that contain fructose.

Although some research has suggested that fructose might be a good alternative to sugar, especially for people who are already living with diabetes, more recent studies have pointed out that “fructose could be particularly detrimental to metabolic health, and even more so than other sugars.”

As the researchers explain, fructose is a natural ingredient in several foods, such as fruits, natural fruit juice, honey, and even some vegetables. However, some food manufacturers artificially add the compound to soft drinks, desserts, cereals, and other baked foods.

Foods with fructose and metabolic health

To find out, the researchers analyzed the conclusions of 155 studies that looked at how different food sources affected peoples’ blood sugar levels. The researchers followed the participants, some of whom had diabetes, for up to 3 months.

During this time, the researchers also assessed the participants’ glycated hemoglobin — that is the amount of sugar that is attached to red blood cells — as well as their glucose and insulin levels after a period of fasting.

Researchers divided the 155 controlled intervention studies into four groups based on their design.

  • Substitution studies compared the energy derived from sugars with that from other carbohydrates.
  • Subtraction studies removed sugar-derived energy from the participants’ diet and compared it with a regular diet.
  • Addition studies added glucose-derived energy to the diet and compared it with a non-sugar-enhanced diet.
  • Ad libitum studies replaced the energy from sugars with other nutrients that the participants were free to consume at will.

The reviewers assessed the bias and the level of certainty of these studies.

Sweetened drinks vs. other sugary foods

Overall, the review found that most of the fructose-containing sugary foods do not harm blood sugar levels when they do not add excess calories. Some of the studies, however, found a harmful effect on fasting insulin levels.

In fact, fruit and fruit juice, which are high in fructose, may even benefit the blood sugar and insulin levels of those with diabetes, when these foods do not add excess calories, the review suggests.

However, some “nutrient-poor” foods that add excessive energy to the diet, such as sweetened drinks and fruit juice, have a harmful metabolic effect.

The researchers hypothesize that the higher content of fiber in fruit, for example, may partly explain this difference, because they slow down the release of glucose. Also, fructose has a lower glycemic index than other carbohydrates.

“These findings might help guide recommendations on important food sources of fructose in the prevention and management of diabetes,” says the study’s lead author.

“But the level of evidence is low,” he cautions, “and more high-quality studies are needed.” 

Until more information is available, public health professionals should be aware that harmful effects of fructose sugars on blood glucose seem to be mediated by energy and food source.

Why a low-carb diet can help you lose weight and keep it off

“The largest and longest feeding study to test the ‘carbohydrate-insulin model, concludes that a lower carb intake burns more calories, which may help people maintain weight loss over a longer period of time.

Eating a high-quality, low-carb diet may help us stave off weight gain for longer.

when we lose weight, the body adapts by lowering its energy expenditure. In other words, it burns fewer calories.

This way, the metabolism protects itself against long-term weight changes.

However, when the weight loss is intentional, this adaptive response can be frustrating for dieters, as it leads to weight regain.

Although weight gain after dieting is a well-known phenomenon, researchers do not know much about how different diets affect the way the metabolism responds to them.

The so-called carbohydrate-insulin model, however, suggests one such mechanism. It posits that highly processed foods high in sugar drive hormonal changes that increase the appetite and lead to weight gain.

“According to this model, the processed carbohydrates that flooded our diets during the low-fat era have raised insulin levels, driving fat cells to store excessive calories. With fewer calories available to the rest of the body, hunger increases and metabolism slows — a recipe for weight gain.”

In this context, we decided to investigate the effects that different diets had on the metabolism. Specifically, we looked at the carb-to-fat ratio in varying diets over a 20-week period.

Studying carb intake, weight, and calories

The researchers examined the effect of different diets on 234 adults aged 18–65 whose body mass index (BMI) was at least 25. As part of the study, the participants had also adhered to a weight loss plan for 10 weeks.

By the end of the trial, 164 participants had achieved their weight loss goal of around 12 percent of their total weight. Then, they adhered to either a high-, moderate-, or low-carb diet for 20 weeks, allowing the researchers to examine if they managed to maintain the weight loss.

The high-carb diet was composed of 60 percent high-quality carbs, the moderate-carb one had 40 percent carbs, and the low-carb diet had 20 percent carbs. The diets also minimized sugar intake and used whole grains.

During this time, the scientists measured the participants’ weight and tracked the number of calories they burned. They also examined the participants’ insulin secretion and metabolic hormones.

‘A 20-pound weight loss after 3 years’

At the end of the study period, people in the low-carb group burned significantly more calories than those who had been on a high-carb diet.

Specifically, participants who were on a low-carb diet burned around 250 kilocalories more per day than those who were on a high-carb diet.

“If this difference persists — and we saw no drop-off during the 20 weeks of our study — the effect would translate into about a 20-pound weight loss after 3 years, with no change in calorie intake.”

The results also indicated that for participants who had the highest insulin secretion, the impact of a low-carb diet was even more significant: low-carb dieters burned 400 calories more per day than high-carb dieters.

“A low glycemic load, high-fat diet,” explain the authors, “might facilitate weight loss maintenance beyond the conventional focus on restricting energy intake and encouraging physical activity.”

 “Our observations challenge the belief that all calories are the same to the body.”

“This is the largest and longest feeding study to test the ‘carbohydrate-insulin model,’ which provides a new way to think about and treat obesity.”