Child tooth decay is on the rise, but few are brushing their teeth enough or seeing the dentist

 Early dental visits are essential to help parents keep 
their children’s teeth and gums healthy. from

One-third of preschoolers have never seen a dentist and most parents believe children don’t need to see one before they’re three years old. Yet one-quarter of Australian children have tooth decay that requires filling by early primary school. One in ten require an extraction.

Results released today from the latest Royal Children’s Hospital National Child Health Pollalso reveal one in three children (33%) aren’t brushing their teeth twice a day and almost half of parents (46%) don’t know that tap water is better for teeth than bottled water.

Read more: Four myths about water fluoridation and why they’re wrong

Rates of tooth decay are on the rise in Australia, particularly among young children. More than 26,000 Australians under the age of 15 are admitted to hospital to treat tooth decay every year. This makes it the highest cause of acute, preventable hospital stays.

Untreated dental disease can cause chronic infection and pain. This can affect a child’s ability to eat, play and learn, and so impact their growth, development and quality of life. It’s also linked to long-term health outcomes like heart disease and diabetes.

Our poll shows that many parents, despite meaning well, lack the basic knowledge to prevent tooth decay in their children. Others are confused when it comes to recommendations about brushing teeth, diet and when to see the dentist for a check-up.

When a child should see the dentist

Children should visit the dentist when their first tooth comes through, or at 12 months of age. Our poll found only 17% of children had seen a dentist by the age of two.

Early visits are essential to provide parents with support and education to help keep their children’s teeth and gums healthy, before teeth break down and start to cause trouble. Children as young as two can require treatment in hospital for severely broken down, infected and painful teeth.

Tooth decay develops over time and early decay can be hard to spot. Starting dental check-ups from 12 months will help identify any red flags and allow parents to make changes to diet and lifestyle. Regular check-ups allow decay to be detected and treated early and more complex and costly treatments avoided. Some children require check-ups more often than others and parents should consult with their dentist on how often their child should go.

Tooth decay can develop quickly and be hard to stop. from

Seeing a dentist can be costly though. In our poll, one in five parents cited cost as a reason for delaying a visit to the dentist. But many were unaware of the free dental services that may be available to their children. All Australian states and territories offer public dental care to children at no or minimal cost, up to a certain age.

In addition to this, the federal Child Dental Benefits Schedule provides eligible families with up to A$1,000 worth of treatment over two years. This can be used for private as well as public dental services for children aged 2-17. All children in families receiving Parenting Payment or Family Tax Benefit Part A are eligible for the program. One-quarter of eligible families we surveyed weren’t aware of the program.

Ultimately, only dental professionals are registered to provide dental examinations to children. But young children often see a range of healthcare providers for different reasons. Every visit to the GP, pharmacist or child health nurse is an opportunity for dental education and decay prevention. GPs and child health nurses can also help direct families to appropriate and affordable dental services.

When should children brush their teeth?

While brushing once a day is better than not at all, brushing teeth twice a day further reduces the chance of tooth decay. Our poll found one-third of children aren’t brushing their teeth often enough, with one in four parents believing once a day is adequate.

RCH Child Health PollAuthor provided (No reuse)


Dentists recommend using a cloth to clean a baby’s gums from birth, moving onto a toothbrush with water when the first tooth erupts. A pea-sized amount of children’s strength toothpaste is recommended from 18 months of age. Children can use adult-strength toothpaste from the age of six. Parents should help children with brushing their teeth up to the age of eight to ensure it’s done properly.

Most children will begin losing their primary teeth, also known as “baby” or “milk” teeth, from around the age of six. The last falls out about age 12. One in five parents indicated they thought it didn’t matter if young children got tooth decay since their baby teeth fall out anyway.

Parents should help children brush their teeth until they are about eight years old. from

Primary teeth may be temporary, but they need to be strong and healthy so children can chew, speak and smile with confidence. They also act as “space savers” for adult teeth. If a child prematurely loses a milk tooth, the tooth beside it may drift into the empty space, preventing the adult tooth from erupting into its proper place.

What about diet?

Our poll found one in four children under five years are put to bed most days of the week with a bottle containing milk-based or sweetened drinks. This practice is strongly linked to tooth decay due to the prolonged exposure of teeth to sugar during sleep. Babies should finish their bottles before being put into bed. From around one year of age, they should be encouraged to drink from a cup instead.

But sugar-sweetened drinks are not the only worry when it comes to teeth. In recent years, bottled water intake in kids has increased considerably, and half of parents think bottled water may be better for teeth than tap water. More than 90% of Australians have access to fluoridated tap water, which helps strengthen teeth and prevent decay. Unlike tap water, most bottled water in Australia contains very little fluoride, making it a less healthy choice for teeth.

Most parents know consuming sugary food and drinks can contribute to tooth decay. But more than 70% of Australian children and adolescents exceed World Health Organisation recommendations for sugar intake and many parents report finding it hard to know how much added sugar is in food.

The recommended maximum daily intake of added sugar for children is around five teaspoons. According to parents polled, one-third of Aussie kids have sugar-sweetened drinks most days of the week, including one in five preschoolers. A 375ml can of soft drink contains around nine teaspoons of sugar.

It’s not just up to parents and dentists to tackle the growing problem of child tooth decay. Other healthcare providers and policymakers have a critical role to play. We need to make sure all parents have access to the right information and support to make healthy choices for their children’s teeth every day from birth.

This article was co-authored by:
Anthea Rhodes – [Paediatrician and Lecturer in Child and Adolescent Health, Department of Paediatrics, University of Melbourne]
Mihiri Silva – [Paediatric dentist and PhD candidate, Murdoch Childrens Research Institute]




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Health Check: what caused my stye and can I get rid of it?

 There are a few different types of stye –  
and if you’re in lots of pain you’ll know yours is the infected kind. 

Many of us will have a stye in our lifetime. While they can be quite sore, the concern for most is the aesthetics of a swollen and red eyelid, especially as it’s hard to cover up something on your eye.

So what is a stye, and what causes them?

Styes occur when glands on the eyelid become blocked and infected. This infection is usually caused by common bacteria that reside on the lids, such as one you’ve probably heard of called Staphylococcus aureus (of Golden Staph fame).

When these glands become infected, the oils they secrete, which usually have a smooth olive oil consistency, become thick and waxy and resemble more of a toothpaste-like texture. This obstructs the glands and they fill up, and more bacteria can grow. It’s a similar process to when pimples form on your skin.

There are actually a number of conditions that may be considered under the colloquial umbrella of a stye: an acute infection called a “hordeolum”; and a long-term, inflammatory response called a “chalazion”.

You will know which of these two forms of lid bumps you have because the acute hordeolum is rather painful, red and may feel hot to the touch, but it will resolve within a few weeks. Whereas a chronic chalazion appears as a firm lump which is a only a little uncomfortable but annoyingly doesn’t seem to go away for months.

Although styes are very common conditions, and anecdotally are the most common infection of the eye and the structures that surround the eyes, the prevalence for these conditions is not actually known.

Acute styes can be further categorised as either external or internal. External hordeola are infections of the glands that sit right next to your eyelashes and they look exactly like a little pimple on your lid.

Internal hordeola are infections of the Meibomian glands, which are the glands responsible for contributing oil to our tears. These glands are located in a firm plate inside the lid and when they swell they can rub against sensitive parts of our eyeball causing double discomfort; both in the lid and on the front surface of the eye.

Both internal and external styes are painful, swollen, red and radiate heat but typically, external styes are less painful then internal ones. This may be because the external glands are smaller so have less potential to fill up with secretions than the large internal glands, so there’s less infected tissue.

Chalazia, the chronic form of styes, develop when the Meibomian gland becomes blocked but not infected. The secretions that build up in the gland may become surrounded by immune cells to form a solid, cyst-like lump. So while chalazia may be large and lumpy, and last for months, they are not overly painful or red – because they’re not infected.


Hordeola, the acute styes, will resolve spontaneously. The smaller external hordeola will usually resolve within seven to ten days; just like a pimple it will pop, sometimes spectacularly, giving almost instant relief. Don’t try to pop them yourself though, this risks causing scarring and may promote further blockage in future.

The internal stye takes longer to resolve and usually the pain and redness is sufficient to get you to see an optometrist, GP or ophthalmologist.

They will probably suggest hot compresses and gentle lid massage to soften the material trapped in the gland and encourage it to come out of the gland opening.

Acute styes will pop on their own. from

Chalazia, while generally only mildly irritating, may cause concern due to their cosmetic appearance. If these benign lumps bother you they can be treated with hot compresses and massage, or minor surgery.

Studies have attempted to look at hot compresses (to encourage blood flow to speed up the body’s natural immune response to infection), lid scrubs (to remove bacteria and oily secretions) and topical antibiotics as treatments, but they were unable to establish any superiority over placebo.

One study by Thai ophthalmologists found warm compresses are the most commonly prescribed treatment (91% of cases) whereas oral antibiotics are rarely used (only in 2.4% of cases).

If you notice you’re developing a stye, using warm compresses and gently massaging the lid with clean hands (from the centre to the outside where the gland openings lie) is the most sensible treatment, but it could also be just as effective as leaving it alone.

If the stye has not resolved within two weeks, see your optometrist, GP or ophthalmologist who can discuss further treatment. A short course of antibiotics might be needed to encourage the infection and inflammation to subside.

How can we avoid styes?

People with certain skin conditions (such as eczema) may be more prone to styes, but generally they’re best prevented by keeping the eyelids clean. A stye is just a blocked gland duct, like a pimple, so just like avoiding pimples, keeping your skin clean and clear of excessive oils or grime that might block the ducts is the best prevention.

So, clean off eye makeup before bed to keep the gland opening from blocking. Use dedicated hypoallergenic lid cleaners if you are sensitive to other cleaners. Change eye makeup a few times a year to prevent it harbouring bacteria and don’t share facecloths or similar with someone who has a stye.

Anything else to look out for?

Styes are common and unlikely to cause other problems so for the vast majority of people there’s nothing else to worry about. In very rare circumstances tumours such as cutaneous squamous cell carcinomas present as masquerades for chalazia.

If you have what you think is a chalazion but after a few months it hasn’t gone away, see your optometrist, GP or ophthalmologist who can examine, take a photograph and monitor or even biopsy the lesion to rule out the remote possibility of carcinoma.

Also very rarely, the infection from a stye can spread from the glands and into other lid structures or even the eyeball. So if a stye is not getting better, you feel unwell or your vision is affected, see your optometrist, GP or ophthalmologist immediately.


This article was co-authored by:
Image of James ArmitageJames Armitage – [Associate Professor in Vision Science, Optometry Course Director, Deakin University]
Image of Jacqueline KirkmanJacqueline Kirkman – [Optometrist, PhD Candidate, Sessional Academic, Deakin University]




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It’s not just sex: why people have affairs, and how to deal with them

There are many reasons people have affairs.Alex Iby/Unsplash

Barnaby Joyce’s affair with his former staffer Vikki Campion, and his subsequent downfall from the position of deputy prime minister and head of the National Party, made headlines for weeks. It’s not surprising. From politicians to actors and entertainers, stories of high profile individuals caught “cheating” on their partner often make front-page news.

We believe a romantic partner is there to provide us with love, comfort and security. So people are quick to make judgements and lay blame on perpetrators of what they see as a significant violation of relationship norms and betrayal of trust. Infidelity highlights the potential fragility of our closest and most important of relationships.

But despite the blunt belief infidelity is the result of immoral and over-sexed individuals wanting their cake and eating it too, the reality is far more nuanced. For instance, infidelity is rarely just about sex. In fact, when it comes to purely sexual infidelity, the average occurrence across studies is around 20% of all couples. However, this rate increases to around a third of couples when you include emotional infidelity.

An affair is generally a sign things aren’t right with someone’s relationship. Without the necessary skills to heal the issues, a partner may engage in an affair as an ill-equipped way of attempting to have their needs fulfilled – whether these be for intimacy, to feel valued, to experience more sex, and so on. So, the straying partner views an alternative relationship as a better way to meet these needs than their existing relationship.

Who has affairs, and why?

Studies into why people cheat are many and varied. Some find people who lack traits such as agreeableness and conscientiousness are more likely to be sexually promiscuous, as are those higher in neurotic and narcissistic traits. Other studies find infidelity is more likely to occur among people who hold less restrictive views about sex, such as that you don’t have to limit yourself to one sexual partner.

Other important factors relate to people’s commitment to their partner and relationship satisfaction. Those low on these measures appear more likely to have an affair. Recent work suggests one of the biggest predictors of having an affair is having strayed before.

A survey of 5,000 people in the UK found striking parallels between men and women’s reasons for infidelity, and neither prioritised sex. The top five reasons for women related to lack of emotional intimacy (84%), lack of communication between partners (75%), tiredness (32%), a bad history with sex or abuse (26%), and a lack of interest in sex with the current partner (23%).

For men the reasons were a lack of communication between partners (68%), stress (63%), sexual dysfunction with one’s current partner (44%), lack of emotional intimacy (38%) and fatigue or being chronically tired (31%).

Both men and women cheat.

So if we have difficulty genuinely communicating with our partner, or they don’t make us feel valued, we may be more likely to stray. People need to invest time and energy into their relationships. Experiencing chronic tiredness over many years means one’s capacity to put in the necessary work to keep a relationship strong is also compromised.

While some couples report additional reasons, which can include a greater desire for sex, the majority speak to issues that reside either within the couple or outside the relationship. The latter can be stressors that challenge the couple’s ability to make the relationship work.

If you’re experiencing relationship difficulties, getting help from a therapist may well short-circuit the risk factors that can lead to infidelity.

Disclosure and therapy

Some people choose to keep their affair secret because they may want it to continue, feel too much guilt or believe they’re protecting their partner’s feelings. But the secret only perpetuates the betrayal. If one is serious about mending their existing relationship, then disclosure is necessary, along with seeking professional guidance to support the couple through the turbulent period towards recovery.

Most relationship therapists suggest issues around infidelity can be improved through therapy. But they also report infidelity as one of the most difficult  issues to work with when it comes to rebuilding a relationship.

Both partners can experience mental health issues following the revelation of an affair. Jonas Weckschmied/Unsplash

There are various evidence-based approaches to dealing with infidelity, but most acknowledge the act can be experienced as a form of trauma by the betrayed person, who has had their fundamental assumptions about their partner violated. These include trust and the belief that the partner is there to provide love and security rather than inflict hurt.

But it’s not only the betrayed person who can experience mental health issues. Research has found that, when the affair is revealed, both partners can experience mental health issues including anxiety, depression and thoughts of suicide. There can also be an increase in emotional and physical violence within the couple.

So a couple should seek professional help to deal with the aftermaths of an affair, not only to possibly heal their relationship but also for their own psychological well-being.

There are many approaches to counselling couples after an affair, but generally, it’s about addressing the issues that precipitated and perpetuated the infidelity. One of the most well researched methods of helping a couple mend these issues involves addressing the initial impact of the affair, developing a shared understanding of the context of the affair, forgiveness, and moving on.

Choosing to stay or go

Overall, therapy seems to work for about two-thirds of couples who have experienced infidelity. If a couple decides to stay together, they must identify areas of improvement and commit to working on them.

It’s also vital to re-establish trust. The therapist can help the couple acknowledge the areas of the relationship in which trust has already been rebuilt. Then the betrayed partner can be progressively exposed to situations that provide further reassurance they can trust their partner without having to constantly check on them.

But if therapy works for two thirds of couples, it leaves another one third who experience no improvement. What then? If the relationship is characterised by many unresolved conflicts, hostility, and a lack of concern for one another, it may be best to end it. Ultimately, relationships serve the function of meeting our attachment needs of love, comfort and security.

Being in a relationship that doesn’t meet these needs is considered problematic and dysfunctional by anyone’s definition.

In some cases it may be the right decision to end the relationship.

But ending a relationship is never easy due to the attachment we develop with our romantic partner. Even though in some relationships, our attachment needs are less likely to be fulfilled, it doesn’t stop us wanting to believe our partner will (one day) meet our needs.

The impending end of a relationship fills us with what is termed “separation distress”. Not only do we grieve the loss of the relationship (no matter how good or bad), but we grieve over whether we will find another who will fulfil our needs.

The period of separation distress varies from person to person. Some may believe it’s worth celebrating the end of a toxic relationship, but they will still experience distress in one form or another. If the couple decides to end the relationship and are still in therapy, the therapist can help them work through their decision in a way that minimises feelings of hurt.

So infidelity is less about sex and more about matters of the heart and a misguided quest to have one’s relationship needs met. The problem is that some people choose to seek their relationship needs in the arms of another rather than working on their existing relationship.

This article was written by:
Image of Gery Karantzas Gery Karantzas – [Associate professor in Social Psychology / Relationship Science, Deakin University]




This article is part of a syndicated news program via


What is listeria and how does it spread in rockmelons?

 Ten cases have been reported so far,  
including two deaths. Shutterstock/Doug J Moore

Two people have died after eating rockmelon (cantaloupe) contaminated with listeria. A total of ten cases have been confirmed in New South Wales, Queensland and Victoria between January 17 and February 9, and more are expected.

Listeriosis is caused by eating food contaminated with a bacterium called listeria monocytogenes. It’s an uncommon illness but can be deadly if it causes septicaemia (blood poisoning) or meningitis (inflammation of the membranes around the brain).

The ten reported cases are among people aged over 70. The elderly are particularly susceptible to listeriosis, as are pregnant women and their fetuses, and those with weakened immune systems.

Past outbreaks have been linked with raw milk, soft cheeses, salads, unwashed raw vegetables, cold diced chicken, pre-cut fruit and fruit salad.

How does it spread?

Listeria is found widely in soil, water and vegetation, and can be carried by pets and wild animals.

A vegetable or fruit food product can become contaminated anywhere along the chain of food production: planting, harvesting, packing, distribution, preparation and serving.

Even on a farm, sources of contamination can include irrigated waters, wash waters and soil. Listeria can survive for up to 84 days in some soils.

Heavy rains on a crop can splash listeria from soils onto the surface or skin of the vegetable, especially those that grow low to the ground, such as rockmelons.

Listeria contamination can also occur in restaurants and home kitchens, where the bacterium can be found – and spread – in areas where foods are being handled.

Listeria monocytogenes is quite a hardy bacterium. It can survive at refrigerated temperatures and has adapted mechanisms to survive acidic environments such as the stomach.

What are the symptoms?

First, it’s important to note that eating foods that contain listeria bacteria won’t necessarily make you sick.

Listeria monocytogenes can survive in the body, moving between cells (human phagocytes) for long periods of time. This is, in part, why there can be a long period of time between ingestion and onset of illness. This “incubation period” can be as long as 70 days but is usually around three weeks.

Symptoms include fever, muscle aches, and gastrointestinal problems such as nausea, vomiting and diarrhoea.

In severe cases, symptoms can include collapse and shock, particularly if there is septicaemia. If the infection has spread to the central nervous system, more worrying symptoms will occur, such as headache, stiff neck, confusion, seizures and the person may go into a coma. In such cases, the fatality rate is as high as 30%.

In pregnant women, the bacteria are thought to cross the lining of maternal blood vessels and then enters the fetal circulation of the placenta. Infection during pregnancy can lead tomiscarriage, stillbirth and newborn infections.

Treatment for confirmed infections involves antibiotics and supportive measures such as intravenous fluids for dehydration.

When infection does occur in pregnancy, the early use of antibiotics can often prevent infection of the fetus or newborn.

But even with very prompt treatment, infections can be deadly in high-risk groups.

Why are some groups at higher risk?

Pregnant women are a special group known to be at higher risk for listeriosis. The underlying mechanisms for why pregnant women are susceptible to listeriosis are not well understood but it’s thought an altered immune system is involved.

People with weakened immune systems such as those on cancer treatment or medications that suppress the immune system are more susceptible to developing listeriosis because their bodies are less able to fight off the bug.

Newborn babies are also extremely vulnerable as their immune systems have not yet matured, as are the elderly, whose immune systems are declining.

Tracking and finding the source

The life cycle of the bacteria can make it difficult to track the source of the outbreak. Listeria is able to contaminate a variety of foods, which may have a long shelf life, and listeriosis has a long incubation period.

All ten people in the current outbreak consumed rockmelon before they fell sick and state and territory health departments were able to pinpoint the source to a farm in the NSW Riverina district.

But it’s not always that easy. The current South African listeriosis outbreak is the worst outbreak in recorded history with 172 deaths recorded to date. The source has not yet been identified.

How can you prevent listeriosis?

Here are some practical things you can do to prevent the spread of listeria:

  • Thoroughly cook raw food from animal sources, such as beef, lamb, pork, and poultry
  • wash raw vegetables and fruit thoroughly before eating
  • use separate cutting boards for raw meat and foods that are ready to eat
  • wash your hands with soapy water before and after preparing food
  • wash knives and cutting boards after handling uncooked foods
  • wash your hands after handling animals.

If you are at greater risk for listeriosis, consider avoiding:

  • Pre-cut melons such as rockmelon or watermelon
  • pre-packed cold salads including coleslaw and fresh fruit salad
  • pre-cooked cold chicken, cold delicatessen meats, pâté
  • raw and uncooked smoked seafood (such as smoked salmon)
  • unpasteurised milk or milk products, soft cheeses (such as brie, camembert, ricotta or blue-vein)
  • sprouted seeds
  • raw mushrooms.

The NSW Food Authority is also advising consumers who are most at risk of listeriosis to avoid eating rockmelon and discard any rockmelon they already have at home.

This article was written by:
Image of Vincent HoVincent Ho – [Senior Lecturer and clinical academic gastroenterologist, Western Sydney University]
This article is part of a syndicated news program via

Children with facial difference have a lot to teach us about body image

 The film Wonder tells the story of a boy with severe 
facial defects.IMDb/Lionsgate,Mandeville Films,Participant Media,Walden Media

The recently released film Wonder is based on the true story of Auggie, a boy born with a severe facial deformity. The film picks up at the point where Auggie, having been home-schooled by his mother, attends a regular school for the first time and must negotiate the varied reactions – not just of his new peers, but of their parents and the other adults.

Auggie was born with Treacher Collins syndrome, a genetic disorder that affects the development of the skull, jaw and cheekbones and causes facial defects and hearing loss. People can be born with facial differences, or they can be acquired through trauma, burns or treatment of facial tumours.

Either way, these differences can have as big an impact on life as loss of a limb or a chronic illness. People often associate plastic surgery with enhancement of beauty, but a more common aim, especially for surgeons who work with children, is to restore facial appearance to the point where a normal life becomes possible.

Auggie has had 27 surgeries to help him see and breathe.

Much more than just a loss of attractiveness, a facial defect affects every aspect of daily life, because faces are so important to us as social beings. And yet, despite significant challenges, children with facial difference tend to score better on perceptions of body image than their “normal” counterparts.

By studying how people with facial difference overcome their challenges, we may not only find ways to help other such children, but also learn how to help all young people be comfortable with how they look and who they are.

The wonder of faces

Try to draw someone’s face. Unless you’re a skilled artist, it’ll be difficult to produce an image that actually looks like that person.

This is because within the very narrow parameters of facial features (eyes, a nose, a mouth) faces are so different we expect to be able to recognise a particular face in a crowd, possibly having seen it only once and from a different angle. With more than 7 billion people in this world, it’s truly extraordinary that everyone’s face is unique.

It’s very difficult to capture another person’s face in a drawing, because of the nuances of human perception. from

Of course it’s not the face itself that’s extraordinary, but our ability to perceive it. We are programmed to effortlessly identify the most subtle differences between faces in a way we are not for other shapes or body parts.

This is one reason why, despite all the advances in plastic surgery in the last century, from microsurgery to face transplantation, our surgical efforts to reconstruct faces still sometimes appear inadequate.

Our sensitivity to subtle differences in facial appearance contributes to the challenges people like Auggie face each day. Faces are the primary means through which we navigate the many minor social exchanges of daily life.

Studies show that, in casual interactions, people tend to have certain responses to those with a facial difference, such as standing further away, or to the side. These changes are subtle, but full of social meaning.

A more pervasive problem is unwanted attention in public spaces, from rude and intrusive comments to invasive curiosity. In Wonder, when Auggie first walks across a busy schoolyard, conversation stops as faces turn to him. Psychologist Frances MacGregor has elegantly described this unique problem faced by people with a visible difference:

The ‘civil inattention’ that is normally conferred by strangers on one another and that makes it possible to move anonymously and unhindered in public spaces is a right and a privilege most longed for by facially disfigured people who […] are victims of intrusions and invasions of privacy, against which they have little or no protection.

Facial difference and body image

Given the challenges of looking different, and the important role of the face in identity, it might be expected adolescents with facial difference would score poorly on measures of body image and well-being.

However, research done in the UK has shown when a standard body image questionnaire was administered to adolescents with cleft lip and palate or a craniofacial condition like Auggie, those with facial difference actually scored, on average, better on some measures of body image than their “normal” counterparts.

Children with a cleft palate generally score higher on body image tests than those who have ‘normal’ faces. from

There may be several reasons for this. Studies consistently find that the severity of a visible difference is a poor predictor of its psychological impact. Much more important is the quality of a person’s social skills. People with facial difference often develop strategies for smoothing over social awkwardness, such as ways of introducing the issue into conversation early and quickly moving on, or using humour to deflect attention.

Better body image scores may reflect greater social maturity and a comfort in their own skin, which adolescents who have not had to face such problems have not yet achieved.

On the flip side, children without a visible difference don’t score as well on body image measures as children who actually do. This and a wealth of other research indicates that, in the age of social media, selfies and consumer culture, we’re facing a rise in body image dissatisfaction.

Australian teenagers consistently rate body image as one of their greatest concerns in life – above bullying, drugs and a range of problems that might be thought more important.

Body dissatisfaction is a key risk factor for eating disorders, and a key symptom of a condition known as body dysmorphic disorder (BDD). People with BDD develop obsessive concerns with particular aspects of their appearance, including features others perceive as normal.

They often seek surgery to correct their perceived problems and, not surprisingly, are rarely satisfied with the outcome. They can undergo multiple cosmetic operations, often from a series of different surgeons, before their condition is recognised. Plastic surgeons have anecdotally reported seeing increasing numbers of young people seeking cosmetic procedures.

An important and unanswered question concerning BDD is whether it’s an isolated condition or one extreme of a spectrum of behaviour. Body dissatisfaction in young people could have serious consequences for their mental and physical health.

Researchers will now focus on how children and adolescents cope with facial and other differences, and how the knowledge gained can be applied to help others with a facial difference. This will inform ways to better educate young people to feel better about how they look.

This article was written by:
Image of Anthony PeningtonAnthony Penington – [Professor of Paediatric Plastic and Maxillofacial Surgery, University of Melbourne]




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No, you’re probably not ‘addicted’ to your smartphone – but you might use it too much

 The average smartphone user checks their device 
85 times a day. Mikaela Shannon

The term “addiction” is often bandied about when we think someone spends too much time on something we deem detrimental to their health and well-being. From checking our phones repetitively, to playing with specific apps and texting, the modern culprit is excessive smartphone use.

Worldwide, more than two billion people own smartphones and the average user checks their phone 85 times a day.

Obsessively checking our smartphone apps may look like addiction but, for most people, it is reinforced behaviour that could be broken without severe or long-lasting withdrawal effects.

Having said this, a small proportion of people may be more prone to behavioural addictions to smartphone functions such as online gambling, pornography, games and social media. Clinically speaking, you can’t become addicted to a device, but you can develop behavioural addictions to smartphone functions.

What is addiction?

The World Health Organisation (WHO) classifies addiction as a dependence on a substance, such as illicit or prescription drugs, tobacco or alcohol. A person is addicted when they have a physical and behavioural dependence on the substance.

In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders(known as the “clinician’s bible”) introduced wider criteria for “behavioural addictions”, which doesn’t include the physical dependence element. These are compulsions to engage in a task or act that leads to psychological pleasure.

Behavioural addictions, such as gambling or sex addiction, can cause psychological harm, as well as wider relationship problems with friends, family and colleagues.

Smartphone obsessions don’t usually involve severe mental dysfunction and therefore aren’t addictions. Tony Lam Hoang

Both “substance” and “behavioural” addictions impact the way we process information. Over time, the brain rewires itself to seek out the reward it needs to gain pleasure or relief from stress. The more an addict seeks a specific reward that triggers both dopamine and other physiological effects (such as stress and pain relief), the more the brain decreases sensitivity to the reward circuits.

To date, smartphone use has not led to mass accounts of severe mental dysfunction. So we’re unlikely to all be “addicted” to our smartphones, as we often tell each other.

Rather than addiction, smartphone users more commonly report obsessive behaviour. Users constantly check their phone, seeking opportunities for a short dopamine reward, or a distraction from boredom or mundane tasks such as travelling on public transport.

Nonetheless, some researchers have yet to rule out the potential for smartphone addiction in people who are at high risk of behaviour addiction. These people may experience several negative behavioural changes over time, such as anxiety and irritability, as well as extreme distress when they’re unable to access their smartphone.

Recent studies in Switzerland have confirmed that people under the age of 18 are at risk of obsessive or addictive-like behaviours around their smartphone use, most likely due to poor impulse control related to their developing frontal lobe. This suggests that adults with poor impulse control and/or personality disorders may be more at risk for smartphone addiction.

The problem with social media

The behavioural impact of smartphone social media use spans from obsessive behaviour (engaging in and checking smartphone apps until they no longer provide a rewarding dopamine hit) to behavioural addiction (compulsively seeking a dopamine hit via a reward provided by our phone).

Read more: How parents and teens can reduce the impact of social media on youth well-being

The average user in the US spends around five hours a day on functional smartphone activities such as texting, social media use, internet searchers, phone calls; half that time is spent on social media (including texting).

The specific functional use of our smartphone is what we need to look more closely at. Social media rewards users via “likes”, emoji use and social engagement with a large audience. The more people respond to a post, the more we gain a sense of enjoyment that people are validating our thoughts or interests.

Social media engagement, and constantly texting friends and family, may be more of a concern than the device on which it is used, because it does lead to dopamine increases, and thus, pleasure or stress relief.

Turn off your notifications if you want to cut down on your smartphone use. Jamie Street

People are hard-wired to seek affirmation and acceptance in social settings. Before the rise of Facebook and Instagram, humans sought out one another via many settings for social engagement and social validation. So it’s no surprise that when we have the technology to extend our social connections into wider communities – we do so without question.

As adults, we know we can’t socialise all the time because of other demands on our time. Yet, as young people, the social world is our priority, as it influences our identity development and need to feel validated outside our tried-and-true friends and family.

Those who have problems with prolonged use of smartphone functions such as social media, media streaming services, games and frequent texting, may fit the criteria of “problematic internet use”.

In these cases, it’s important to unpack the specific reward you get from the function you engage in the most on your smartphone, to see if you can obtain the same reward through more productive and healthy activities.

If you are always on social media, for instance, ask yourself: what do I gain from posting and replying online? Can I gain the same rewarding benefits from face-to-face social engagements?

For some, online engagement diversifies their offline social engagement, while others are unaware that most of their life is now lived online.

Time to put the smartphone down?

Many smartphone users are obsessed or infatuated with their smartphone functions. But over time, they will become less interesting and far more a tool we engage with when we need to, just as society has adjusted to computer use.

In the meantime, we need to educate young people about problematic internet use and help them understand why using functions on their smartphone can be potentially time-wasting and, at worst, negatively impact their mental wellness. This can be communicated in early childhood and reinforced throughout the developmental stages.

Yes, it’s time for a smartphone detox. Jacob Ufkes

As for adult smartphone users, here are some evidence-based tips for reducing your smartphone use:

  1. Reduce the number of apps on your phone – assess what you actually need and use most often, not just for distraction purposes. The fewer icons on your home screen the better.
  2. Turn off notifications through your settings button. Your phone should only notify you for meaningful events to aid in your health and productivity during work hours.
  3. When charging your phone at night, don’t do it next to your bed. It’s tempting to reach for your smartphone first thing upon waking. Instead, try and wake up thinking about the day ahead rather than “what did I miss on social or news media while I was asleep?”
  4. Be aware when reaching for your phone during the day, especially when bored – try a mindfulness breathing exercise instead to relax and clear your mind. There are many techniques that are evidence based, but here is one example that takes just three minutes.
  5. If you truly want to reduce time checking your smartphone, look more closely at your social media use and, if necessary, remove your social media apps.

This article was written by:
Image of Andrew CampbellAndrew Campbell – [Senior Lecturer in Psychology, University of Sydney]




This article is part of a syndicated news program via


Research Check: will eating ‘ultra-processed’ foods give you cancer?

 The researchers looked at cancer 
occurrence in those exposed to higher intakes of ultra-processed foods,  
compared to lower intakes. Shutterstock

A recent study exploring the relationship between what are termed “ultra-processed” foods (which include chicken nuggets, pot noodles and ready-made meals) and cancer, generated headlines such as:

Processed foods are driving up rates of cancer…


Study reveals the foods driving up cancer rates

The latter report in the NZ Herald led with:

Eating processed food significantly raises the risk of cancer, experts warned…

These headlines and reports distorted the study’s findings by suggesting the foods examined are actually causing an increase in cancer. A more accurate headline was run by The Guardian, that said:

Ultra-processed foods may be linked to cancer…

This correctly reflected that the study found an association between eating certain types of processed food and a higher risk of cancer.

The study showed that every 10% increase in consumption of ultra-processed food was linked to a 12% increase in developing some types of cancers. This is important research but needs to be interpreted with caution.

How was the research conducted?

This data is from observing a group of people, which means you can see if things are associated with others, but can’t prove something caused something else.

The analysis included 104,980 French adults – mostly women (78%) with a median age of 42.8 years – who were followed up from 2009 to 2017. They were asked to report what they’d eaten in the previous 24 hours, on three occasions every six months, for two years. The participants reported on their usual intakes of more than 3,300 food items contained in a food and nutrient database.

Cancer cases were self-reported through regular health questionnaires. When a cancer was reported, a doctor then liaised to obtain details from the medical record. All medical data was reviewed by an expert committee of physicians and linked to the national health insurance system databases and the French national death registry.

What were the foods studied?

Food items were categorised based on how “processed” they were using the NOVA classification , which helped identify ultra-processed food and drink products. These aren’t modified foods, but highly processed items made from components derived from foods plus added nutrients, plus other additives, using a series of industrial processes (hence “ultra-processed).

Group one was made up of “unprocessed or minimally processed foods”, while group four was made up of “ultra-processed foods”.

Group one included unprocessed edible parts of plants such as seeds, fruits, leaves, stems, roots, fungi, algae, and animal foods such as muscle and offal meats, eggs and milk.

Group one included unprocessed foods, such as eggs. from

The minimally processed foods in the first group are those found in nature that are processed to remove inedible or unwanted components, preserve them for storage and ageing, or make them safe or edible. Minimal processes include drying, crushing, grinding, roasting, boiling, pasteurisation, refrigeration, freezing and storing in containers or vacuum-packaging.

Group four foods were those made mostly or entirely from components derived from foods or additives, with little or no intact foods from group one. Group four included soft drinks, sweet and savoury packaged snacks, pre-prepared frozen dishes and reconstituted meat products.

Researchers calculated the percentage of each person’s food intake (measured in grams per day) that came from ultra-processed foods in their total diet. The results were presented as hazard ratios meaning researchers looked at cancer occurrence in those exposed to higher intakes of ultra-processed foods, compared to lower intakes.

Then what?

Next, the researchers evaluated the association between the percentage of ultra-processed foods eaten and incidence of overall cancers including breast, prostate, and bowel cancer.

The analyses were adjusted for factors such as age, sex, BMI (body mass index), height, physical activity, smoking, family history of cancer and education (so they weren’t counting those who were more likely to get cancer anyway for other reasons). For the breast cancer analyses, additional adjustments were made for the number of births each woman had, menopausal status, and hormonal or oral contraceptive use. These are all factors known to affect breast cancer risk.

The statistics were further adjusted for fat, salt and carbohydrate intakes, alignment with a Western dietary pattern, or both of these together. This was to make sure effects weren’t caused by these nutritional aspects, rather than the processed aspect. They also excluded cases of cancer diagnosed during the first two years of follow-up, because it’s possible this was already present from other causes.

Overall, about 19%, or one-fifth of the food intakes, came from ultra-processed foods. This is where the results showed consuming 10% more ultra-processed foods, by weight, was linked to a 12% increase in developing some type of cancer.

Highly processed foods have little to no nutritional value. from

For postmenopausal women there was an 11% higher risk of developing breast cancer based on a 10% higher intake of ultra-processed foods. The researchers found this higher risk for overall cancer was present in all population segments examined. The associations held after adjustment for nutritional quality of usual dietary intake, alignment with Western dietary patterns, or both.

Headline versus hype

This study is important because it’s the first to evaluate associations between the degree of food processing in foods that people commonly eat and subsequent cancer risk. The results were predominantly in women, although the same trends were observed in the men. The data could be affected by reporting bias given dietary intakes over the two years were based on an average of five days of recall, although they excluded under-reporters.

The authors discuss potential explanations for the findings. This includes the obvious one that ultra-processed foods are not usually of high nutritional value and people who consume them regularly have higher intakes of kilojoules, salt, fat and sugar and lower nutrient and dietary fibre intakes.

This type of eating pattern is associated with higher risk of specific cancers and also increases the risk of weight gain, which further increases cancer risk.

Ultra-processed foods included meats that are smoked, cured or contain added nitrites and conservatives, including sausages and ham. A relationship with increased risk of bowel cancer has been identified previously by the cancer research arm of the World Health Organisation.

Should you eat processed foods or not?

The current study found an association between consumption of ultra-processed foods and cancer risk. The data comes from an observational cohort study and therefore cannot prove causation. There will never be a randomised controlled trial (comparing one group with placebo) of whether or not eating ultra-processed foods causes cancer because you cannot ethically randomise people to a lifetime consuming very high intakes of these foods.

But for a host of well-known health reasons, it’s still wise to keep your intake of energy-dense nutrient-poor foods to a minimum.

Blind peer review

This is a fair and accurate assessment of the observational research that links higher intakes of ultra-processed foods with higher risk of cancer. – Tim Crowe




This article is part of a syndicated news program via

Here’s what you need to know about the new flu vaccines for over-65s

 Older people’s immune systems don’t respond to  
flu vaccines as well as younger people’s. Shutterstock

In an attempt to avoid a repeat of last year’s horror flu season, Health Minister Greg Hunt announced last Monday the government would fund two new flu vaccines in 2018 to try to better protect the elderly.

While influenza affects people of all ages, infections among the elderly are more likely to require hospitalisation or cause serious complications such as pneumonia and heart attacks. Of the 1,100 Australians who died last year from flu-related causes, 90% were aged 65 and over.

The two free vaccines for over-65s work in different ways: FluZone High Dose is a high-dose version; Fluad adds an additional ingredient to boost its effectiveness. Both are recommended for use only in people aged 65 and over. But neither is perfect. And it’s important to remember flu vaccines are, at best, only partially protective.

Why do we need new vaccines for flu?

Australia’s National Immunisation Program provides free influenza vaccine for the elderly, as well as other high-risk groups including pregnant women, those with chronic diseases and Indigenous Australians.

Read more: Flu vaccine won’t definitely stop you from getting the flu, but it’s more important than you think

Older people’s immune systems don’t respond to flu vaccines as well as younger people’s. Recent studies have also shown that flu vaccines don’t appear to be as effective in the elderly at protecting against flu and its complications.

Compounding this problem is that the flu subtype that tends to affect older people (A/H3N2) is different to that which affects younger people (A/H1N1).

Although the seasonal flu vaccine now contains four strains to cover all the relevant subtypes present, the protection against H3N2 infection appears to be poorer than against other strains.

Two strategies are attempting to improve the effectiveness of flu vaccines. One is to increase the dose of the flu strains in the vaccine. This is the basis for Sanofi’s High Dose FluZone vaccine, which contains four times the amount of flu antigen than the standard dose.

Another way is to add a substance that improves the immune response, known as an adjuvant, in combination with the flu strains. This is the basis for Seqirus’ (CSL) Fluad vaccine, which contains the adjuvant MF59. This vaccine has been used overseas for many years, but has only been become available in Australia this year.

How much better are these vaccines than the current vaccine?

Compared to the standard flu vaccine, the high-dose version has been shown to better stimulate the immune system of older users to make protective antibodies.

It has been shown to better reduce rates of flu infection in over-65s than the standard vaccine. And, interestingly, it also seems to protect against pneumonia.

One common criticism of clinical trials is that they don’t include the types of people who are found in the “real world”. But population based observational studies suggest that the high-dose vaccine is more protective than the standard-dose vaccine where H3N2 is the predominant circulating strain – as it was last year.

Read more: Here’s why the 2017 flu season was so bad

What about the Fluad (adjuvanated) vaccine?

Compared to the standard vaccine, adjuvanted flu vaccine has been shown to better stimulate the immune system of older users to make protective antibodies.

Unlike the high-dose vaccine, there have not been clinical trials that show a difference in infection rates compared with the standard vaccine. But observational data suggests the adjuvanted vaccine is more protective against hospitalisation with influenza or pneumonia – to a similar degree as the high-dose vaccine.

One problem with both these vaccines is that they only contain three strains, rather than the four strains in the current vaccine. The strain missing from the new vaccines is an influenza B type.

But the benefits of better protection against the most common three strains in the new vaccine appear to outweigh the potential loss of protection against the missing B strain.

The newly available vaccines provide additional protection for over-65s. Sladic/Shutterstock

Are the new vaccines safe?

Both vaccines are safe, but commonly cause mild side effects, and very rarely can cause serious side effects. However, these risks from the vaccine are less than from getting influenza infection.

The main side effect of vaccines relates to their effect in stimulating the immune system. In many people they cause a sore arm and, less commonly, a fever. The side effects of these new flu vaccines are slightly more common than with standard vaccines. Generally, these side effects are mild and don’t last long.

None of the flu vaccines used in Australia contains live virus and therefore can’t cause flu infection. However, the vaccination season (April to June) usually occurs around the same time as when another respiratory virus (RSV) circulates, so this respiratory infection is commonly misattributed to vaccination.

Rare but serious side effects, such as Guillain Barre Syndrome (where the immune system attacks nerves), have been described after flu vaccination. Studies suggest that the risk of these side effects are less common after the flu vaccine than after flu infection.

People with allergies should discuss flu vaccines with their doctor. In the past, there has been concern that the flu vaccines, which are manufactured in eggs, may elicit allergic reactions in people with egg allergy. However, it is now thought that people with egg allergies can receive flu vaccines safely under appropriate supervision.

In 2009, an adjuvanted vaccine (Pandemrix) was thought to be implicated in cases of narcolepsy (a disease associated with excessive sleepiness) in Europe. However, this primarily occurred in children (rather than the elderly), and with a different adjuvant (ASO3) than is being used in Fluad (MF59)

Which vaccine should I get?

The two vaccines have not been compared head to head, so it isn’t known which one is better. The available data suggest they are similar to each other.

In practice, what vaccine you’ll receive will depend on what’s available at your GP or pharmacy.

It is important to note that these vaccines are only recommended for use in people 65 years of age or older, and are not recommended for use in people under this age.

The standard vaccine will still be available for younger people. There are no data to support the use of multiple doses of vaccines of the same or different types.

Read more: Flu is a tragic illness. How can we get more people to vaccinate?

Neither of the new vaccines is perfect – they simply reduce your risk of getting flu to a slightly greater effect than the standard vaccine. Like other flu vaccines, there is still the chance that the vaccine strains don’t match what’s circulating.

Despite the common perception that the flu is mild illness, it causes a significant number of deaths worldwide. To make an impact on this, we need better vaccinesbetter access to vaccines worldwide and new strategies, such as increasing the rate of vaccination in childhood.

This article was written by:
Image of Allen ChengAllen Cheng – [Professor in Infectious Diseases Epidemiology, Monash University]




This article is part of a syndicated news program via


Can diet improve the symptoms of endometriosis? Sadly, there’s no clear answer

 Every woman and her disease are different,  
and each will respond in her own way to different types of foods. 

There is no cure for endometriosis, a condition affecting one in ten women of childbearing age that can cause painful and heavy periods, fatigue and pain with sex. Some women with the disease experience pain so severe, it makes them nauseated and interferes with their life.

Current treatments, such as surgery and contraceptive pills, can be invasive or cause unpleasant side effects. So, the internet is awash with advice for alternative treatments, including acupuncture and dietary changes. Some women claim to have reduced their symptoms by eating “anti-inflammatory” foods, cutting out gluten, dairy and alcohol.

But what is the evidence behind eating or avoiding certain foods, and should women with endometriosis adhere to a specific diet?

The oestrogen logic

Endometriosis is an inflammatory disease in which tissue similar to the lining of the endometrium (womb), grows outside the womb. The stimulus for this tissue growth is the female hormone oestrogen. Inflammation occurs as the immune system’s natural response to the tissue growing somewhere where it shouldn’t.

It’s logical to assume that foods known to influence oestrogen production (such as soy products) or those that have anti-inflammatory properties (like green, leafy vegetables, nuts and oily fish) may have an effect on endometriosis and its symptoms.

Avoiding foods that influence oestrogen production, like soy products could help with endometriosis symptoms. from

But the research on this is inconclusive. A wide range of nutrients and food substances – including fat, gluten, various vitamins and minerals, antioxidants, caffeine, gut flora and food toxins – have been studied. And while some studies show a response to dietary changes, others refute it.

The severity of symptoms and response to diet will also vary according to the individual, making it difficult to be prescriptive about dietary management.

Back and forth on dietary fats

Several studies have shown a relationship between certain types of fat and the incidence of endometriosis, as well as the severity of symptoms.

A study conducted in 2010 analysed whether consumption of dietary fat was associated with incidence of endometriosis. It found total fat intake had no bearing on the disorder, but showed that women with the highest intake of omega-3 fatty acid consumption were less likely to be diagnosed with endometriosis.

Research shows that omega-3 fatty acids reduce inflammation. The best sources of omega-3 are oily fish such as salmon, mackerel, sardines, trout and herring. There are smaller amounts in plant-based foods such as canola and flaxseed oil, and green vegetables.

The study also showed those women with the highest intake of trans-fats were more likely to be diagnosed with endometriosis. Trans fats occur naturally in animal foods such as butter, milk and meat and they are also found in commercially prepared fried and baked foods. This could explain the stories of women who found reducing dairy intake, helped their symptoms.

Fatty fish like salmon and mackerel are the best sources of omega-3 fatty acids. from

In 2013, a review of 12 studies, including 74,708 women, looked at the relationship between diet and endometriosis. The results in this paper were consistent with the paper in 2010, making the evidence for the protective properties of omega-3 fatty acids more rigorous.

However, another 2013 review of 11 studies on endometriosis and diet was inconsistent with the above findings. This one showed that women with endometriosis seemed to consume fewer vegetables and omega-3 fatty acids; and more red meat, coffee and trans fats.

But these findings could not be consistently replicated, and the authors concluded:

Further studies are needed to clarify the role of diet on endometriosis risk and progression.

Then, in 2015, an analysis of the evidence of diet on the development and progression of endometriosis said something else again. It showed that foods rich in omega-3 fatty acids with anti-inflammatory effects and increased consumption of fruits, vegetables and wholegrains, were found to exert a protective effect on developing endometriosis and possibly regressed the disease.


Some women claim their symptoms improve on a gluten-free diet.

A small study conducted on 217 women with severe endometriosis-related symptoms did find that 75% of the patients reported a statistically significant improvement in symptoms after 12 months on a gluten-free diet. It should be noted though, that while the findings are statistically significant, the number of participants in this study is very small.

Some women find their endometriosis symptoms improve on a gluten-free diet. from

Vitamin D

The relationship between vitamin D (with its anti-inflammatory properties) in the development of endometriosis has also been looked at. One paper concluded that endometriosis may be influenced by vitamin D intake but that it was difficult to illustrate due to sparse evidence from human studies.

Another study investigated whether dairy foods and Vitamin D blood levels were associated with endometriosis. Researchers looked at 1,385 cases of confirmed endometriosis, intake of dairy foods and the nutrients in dairy foods, and predicted Vitamin D status for each participant. The findings suggested a higher intake of dairy foods and a higher predicted vitamin D status were associated with a lower risk of endometriosis.

Including green, leafy vegetables in your diet is good for your overall health. from

It doesn’t hurt to eat well

Maintaining a healthy diet is always important and especially so for anyone dealing with a chronic, debilitating condition. There is also no harm in being proactive and attempting dietary changes that may be beneficial for endometriosis.

If the dietary changes are safe and improve your symptoms, then stick with them. But if the changes are difficult and don’t improve your situation, there’s no point in persisting.

Including these foods in your diet may help your symptoms:

  • Lean red meat and poultry (preferably organic)
  • Oily fish such as salmon, mackerel, sardines, trout and herring
  • Citrus fruits and berries for vitamin C
  • Green leafy vegetables such as broccoli, bok choy, cabbage, kale, brussel sprouts and yellow/orange vegetables such as pumpkin and sweet potato (for a range of vitamins, minerals, anti-oxidants and fibre)
  • Nuts and seeds for essential fatty acids
  • Non gluten grains such as rice, corn and buckwheat
  • Low fat dairy for calcium
  • Healthy oils such as extra virgin olive oil, flaxseed oil, safflower
  • Foods to support healthy gut flora such as yoghurt, kombucha, kefir and fermented vegetables such as kimchi or sauerkraut.

It may also help to avoid or limit these foods:

  • trans and hydrogenated oils (usually hidden in processed foods, snack foods and take aways)
  • sugar and sugary foods
  • alcohol
  • caffeine.

This article was written by:
Image of Elisabeth GaspariniElisabeth Gasparini – [Manager, Nutrition and Food Services, The Royal Women’s Hospital]




This article is part of a syndicated news program via


There are four types of drinker – which one are you?

 Generally people drink to either increase positive  
emotions or decrease negative ones. from

It’s easy to see alcohol consumption being a result of thousands of years of ritual and a lifetime of habit. But have you ever stopped to consider why it is you choose to drink? Knowing what motivates people to drink is important to better understanding their needs when it comes to encouraging them to drink less, or in a less harmful way.

The four types

Personally, everyone can come up with many reasons why he or she is drinking, which makes a scientific understanding of the reasons difficult. But there is something called the motivational model of alcohol use, that argues we drink because we expect a change in how we feel after we do. Originally developed to help treat alcohol dependence, the ideas described in the model led to a new understanding of what motivates people to drink.

Some will sip champagne or hold a glass of wine on social occasions to avoid pressure to drink. Photo by Nik MacMillan on Unsplas

More precisely, the model assumes people drink to increase positive feelings or decrease negative ones. They’re also motivated by internal rewards such as enhancement of a desired personal emotional state, or by external rewards such as social approval.

This results in all drinking motives falling into one of four categories: enhancement (because it’s exciting), coping (to forget about my worries), social (to celebrate), and conformity (to fit in). Drinkers can be high or low in any number of drinking motives – people are not necessarily one type of drinker or the other.

All other factors – such as genetics, personality or environment – are just shaping our drinking motives, according to this model. So drinking motives are a final pathway to alcohol use. That is, they’re the gateway through which all these other influences are channelled.

1. Social drinking

To date, nearly all the research on drinking motives has been done on teens and young adults. Across cultures and countries, social motives are the most common reason young people give for drinking alcohol. In this model, social drinking may be about increasing the amount of fun you are having with your friends. This fits in with the idea that drinking is mainly a social pastime. Drinking for social motives is associated with moderate alcohol use.

2. Drinking to conform

When people only drink on social occasions because they want to fit in – not because it’s a choice they would normally make – they drink less than those who drink mainly for other reasons. These are the people who will sip a glass of champagne for a toast, or keep a wine in their hand to avoid feeling different from the drinkers around them.

In the last couple of years, programs like Hello Sunday Morning have been encouraging people to take a break from drinking. And by making this more socially acceptable, they may also be decreasing the negative feedback some people receive for not drinking, although this is a theory that needs testing.

3. Drinking for enhancement

Beyond simply drinking to socialise, there are two types of adolescents and young adults with a particular risky combination of personality and drinking motive preference.

People who drink for enhancement are usually males and extroverted. from

First are those who drink for enhancement motives. They are more likely to be extroverted, impulsive, and aggressive. These young people (often male) are more likely to actively seek to feel drunk – as well as other extreme sensations – and have a risk-taking personality.

4. Drinking to cope

Second, those who drink mainly for coping motives have higher levels of neuroticism, low level of agreeableness and a negative view of the self. These drinkers may be using alcohol to cope with other problems in their life, particularly those related to anxiety and depression. Coping drinkers are more likely to be female, drink more heavily and experience more alcohol-related problems than those who drink for other reasons.

While it may be effective in the short term, drinking to cope with problems leads to worse long-term consequences. This may be because the problems that led to the drinking in the first place are not being addressed.

Why it matters

There is promising research that suggests knowing the motives of heavy drinkers can lead to interventions to reduce harmful drinking. For instance, one study found that tailoring counselling sessions to drinking motives decreased consumption in young women, although there was no significant decrease in men.

This research stream is limited by the fact we really only know about the drinking motives of those in their teens and early 20s. Our understanding of why adults are drinking is limited, something our research group is hoping to study in the future.

Next time you have a drink, have a think about why you are choosing to do so. There are many people out there having a drink at night to relax. But if you’re aiming to get drunk, you have a higher chance than most of experiencing harm.

Alternatively, if you are trying to drink your problems away, it’s worth remembering those problems will still be there in the morning.

This article was co-authored by: