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Health24.com | Have a bladder issue and don’t know why? It could be your smoking

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Smoking cigarettes has a bad rap and is tied to many health problems, but did you know that it can also affect your bladder health?

Current and previous smokers may have an increased risk for urinary incontinence, especially stress urinary incontinence, which is the most common type.

Stress urinary incontinence literally refers to a type of stress placed on your bladder. It happens when there are episodes of increased intra-abdominal pressure on the bladder (when you cough and sneeze, for instance) and it is caused by a loss of bladder neck and urethral support.

What does smoking have to do with it?

The reason why cigarette smoking can be linked to urinary incontinence and other bladder problems is not exactly clear, says urogynaecologist Dr Sharon Knight. “Some explanations have been proposed, such as nicotine-induced bladder contractility and some other toxins that can be bladder irritants,” she said.

There are other factors that link smoking with an increased risk of incontinence, particularly stress incontinence:

A chronic cough caused by smoking could place more pressure on the abdomen and bladder, potentially leading to stress incontinence as it can damage the muscles of the pelvic floor.

Smoking is a risk factor for bladder cancer, which can present through urinary incontinence at first. According to research published in Reviews in Urology there is evidence that smoking may lead to bladder cancer as each puff of smoke exposes the body to some 60 different carcinogens, many of which are identifiable in urine specimens from smokers.

Interstitial cystitis, a chronic, painful bladder condition that causes a constant feeling of pressure in the bladder, an increase in frequency of urination and urge incontinence, can be aggravated by smoking. Even though a paper in Reviews in Urology states that there is no literature to date that links smoking directly to this specific condition, smoking cessation has been proposed in the treatment plan as smoking might aggravate symptoms and irritate the bladder even further.

Quit – there is no other solution

There are many other factors apart from smoking that can make you prone to urinary incontinence, but as smoking is now known to be a contributor to this condition, it’s a good idea to quit, not only to keep your bladder health intact, but also to stave off a host of other diseases.

It’s no secret that smoking is tied to a host of cardiovascular and lung diseases, but now that researchers have connected urological problems with smoking, urologists should incorporate smoking cessation into their treatment plans.

Quitting smoking is easier said than done, but here are some tips:

  • Build a support group. Inform your friends and family about your decision and ask them to hold you accountable.
  • Incorporate nicotine replacement therapy, as it’s been proven that people are more successful at quitting when they make use of this method.
  • Don’t be discouraged if you break your cigarette fast – simply start again.
  • Get more exercise and eat a healthy, balanced diet. 

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Marelize Wilke

Health24.com | Department of Health to finally move headquarters from ‘sick’ Civitas building

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The Department of Health will move its headquarters from the “sick” Civitas Building after almost a year of protest action from unions.

This was announced yesterday by the Department of Health, following a meeting between the Ministers of Health and of Public Works and the leadership of the National Education, Health and Allied Workers Union (Nehawu) and the Public Servants Association (PSA).

In everybody’s interest

“A conclusion was reached by all parties that this stand-off is in nobody’s interest,” according to a statement from the health department.

“Actually, it is working against the interest of the people of South Africa. Neither the labour unions nor the government departments have anything to gain from this continued state of affairs. An agreement was then reached that it will be in the interest of everybody for the Department of Health to relocate elsewhere and leave the Civitas Building.”

 As part of this decision, all parties have agreed to concentrate on the relocation and “bring an end to the stand-off, mistrust, suspicions and a psychologically poisoned working environment, whereby working relationships are highly strained”.

 A task team has been set up to find a new headquarters, develop a timetable for the move as well as “recommend a transitional mechanism”.

The major problems at Civitas relate to malfunctioning air-conditioning, leaks and broken lifts.

‘No work, no pay’

“In 2016, 80% of Civitas was declared non-compliant with health and safety regulations,” Nehawu shop steward Bhungani Mxolo told Health-e late last year.

A Nehawu survey of 88 staff early last year found that 48 suffered from headaches, while sinus and breathing problems and dizziness were common.

“The employer was supposed to take steps to address the problems but when we realised that they are not doing anything in March, staff members started to knock off at 1pm. When repairs still hadn’t been done by August but the employer wanted to institute a ‘no work, no pay’ rule, we took the employer to the Labour Court.”

On 29 October, the Department of Labour closed Civitas, declaring it unsafe. The building was re-opened a few days later after the health department appealed, undertaking to do the necessary repairs.

Since last April, Nehawu and PSA members stationed at Civitas have engaged in protest action against government’s failure to address their poor working conditions.

No export permits

The protest action has had a massive impact on the functioning of the health sector, particularly on the work of the SA Health Products Regulatory Authority (SAHPRA), which registers medicines and issues import and export permits for medical substances.

A whistleblower contacted Health-e last week to say that her company had not been issued with a single permit this year, despite the fact the SAHPRA had moved its operations out of Civitas last year.

Johnson & Johnson had to suspend the export of its products containing codeine and pseudo-ephedrine to 17 countries as had not received export permits, costing it R7-million a month, according to a report compiled by SAHPRA. – Health-e.

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Health24.com | Liver transplants tied to alcohol use in the US doubled since 2002

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The percentage of US liver transplant recipients with alcohol-associated liver disease (ALD) doubled over 15 years, but significant regional variations remain, a new study finds.

Abstinence no longer required

ALD has replaced hepatitis C as the most common reason for US liver transplants. One reason is that hepatitis C rates have decreased due to antiviral therapy. But a more likely cause for the change is the shift away from requiring patients to abstain from alcohol or drugs for at least six months in order to be eligible to receive a new liver, according to the University of California, San Francisco (UCSF) researchers.

For the study, the investigators analysed nearly 33 000 liver transplants (over 9 400 for ALD, and over 23 400 for non-ALD) from 2002-2016 in the United Network for Organ Sharing (UNOS) database.

The share of transplants for ALD rose from 24% in 2002 to just over 27% in 2010, and to nearly 37% in 2016. With hepatitis C virus patients included (about 50 000 total), the proportion of transplants for ALD was 15% in 2002, about 18% in 2010 and 30% in 2016, the findings showed.

Among the 11 UNOS regions, the largest increases between 2010 and 2016 were in regions two (Delaware, the District of Columbia, Maryland, New Jersey, Pennsylvania, West Virginia and Northern Virginia) and four (Oklahoma and Texas). The smallest increases were in regions three (Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi and Puerto Rico) and 10 (Indiana, Michigan and Ohio).

Liver transplant landscape changing

Short-term survival rates were similar between ALD and non-ALD transplant patients, but rates after five years were 11% lower for patients with alcohol-related liver disease, according to the study published in the journal JAMA Internal Medicine.

“This study suggests that there may be value in a national policy for liver transplant in alcohol-associated liver disease, to eliminate any potential inequity in health care access for liver transplant related to the patient’s geography and the transplant centre’s policy on alcohol abstinence prior to transplant,” lead author Dr Brian Lee said in a university news release. Lee is a gastroenterology and hepatology fellow at UCSF.

“The liver transplant landscape is changing and multiple factors must be taken into account when considering future trends and policy,” he added.

In a separate study recently published in the journal Hepatology, the same team said it had developed a tool that was 95% accurate in identifying patients with alcoholic hepatitis who were at low risk for significant alcohol use after a liver transplant, making them good candidates for the procedure.

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Health24.com | Mediterranean diet may cut stroke risk for women, but not men

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The Mediterranean diet may do more than help you reach and maintain a healthy weight — new research suggests that women who follow it also lower their stroke risk.

But men did not reap the same benefit from the diet, which concentrates on fish, fruits, nuts, vegetables and beans, and avoids meat and dairy products.

“Simple changes in dietary habits may bring a substantial benefit regarding reducing stroke, which remains one of the leading causes of death and disability worldwide,” said lead researcher Dr. Phyo Myint. He is clinical chair of medicine at the University of Aberdeen School of Medicine in Scotland.

Women vs. men

Although the Mediterranean diet is considered healthy, this study could not prove that the diet itself caused stroke risk to drop.

In addition, why men’s risk for stroke isn’t also lowered isn’t yet clear, Myint said.

But, “it is widely acknowledged that men and women are very different with regard to normal physiology,” he added.

Women have unique stroke risk factors that include using oral contraceptives or hormone replacement therapy. And during pregnancy, having preeclampsia and gestational diabetes are considered risk factors for stroke, Myint pointed out.

“It may be that certain components in the Mediterranean diet may influence risk of stroke in women more than in men,” he said.

Difference in the numbers

For the study, the investigators collected data on more than 23 000 men and women, aged 40 to 77, who took part in a large cancer study. The participants were followed for 17 years.

The researchers found that, overall, those who followed a Mediterranean diet cut their risk for stroke 17%. When looking at men and women separately, however, women saw a reduction in risk of 22%, while men saw a 6% drop in risk. The risk reduction among men, however, might be so small that it is a “chance” finding, the scientists added.

Moreover, among those with a high risk for stroke, the risk was lowered 13% for those who followed a Mediterranean diet, the findings showed. This association, however, was mainly due to a 20% reduction in risk among women, the researchers found.

The findings were published online in the journal Stroke.

Other benefits in the diet

According to Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, “The Mediterranean eating style, which has great variations among several different cultures, is characterised by foods high in anti-inflammatory compounds, including fiber, vitamins, minerals and healthy plant compounds.”

Previous research has suggested that the Mediterranean diet reduces the risk of heart disease, type 2 diabetes, certain cancers, obesity and declines in thinking skills, she said.

Foods such as olive oil, zucchini, lemons, hummus, tabouleh, pasta, eggplant, lentils, tomatoes, artichokes, salads and spices are staples in many parts of the Mediterranean, Heller explained.

“In contrast, the typical Western diet is high in foods that increase inflammation, such as burgers, hot dogs, steak, butter, sodium, sugary beverages, fried foods, fast and junk foods, all of which have been associated with increased risks of chronic diseases,” she said.

Heller suggests skipping the ham and cheese on white bread with mayo for lunch, and instead trying hummus on whole wheat pita with cucumbers and tomatoes. For dinner, try going meatless a few nights a week with a pasta primavera, roasted vegetables, Greek salad, quinoa and lentil-stuffed lettuce wraps, she added.

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Health24.com | Most nations may be rid of cervical cancer by 2100

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Rapid expansion of HPV vaccination and cervical cancer screening could eliminate the cancer as a major health problem in many countries by the end of the century, a new study claims.

HPV (human papillomavirus) causes most cases of cervical cancer, and the researchers determined that more than 13 million cases of cervical cancer worldwide could be prevented in the coming decades.

No longer a major public health problem

“Despite the enormity of the problem, our findings suggest that global elimination is within reach with tools that are already available, provided that both high coverage of HPV vaccination and cervical screening can be achieved,” said study leader Karen Canfell, of the Cancer Council New South Wales in Sydney, Australia.

The authors of this first-of-a-kind modelling study on a global scale noted that in wealthy nations, such as the United States and Canada, cervical cancer is predicted to be eliminated as a public health problem within 25 to 40 years.

The researchers concluded that if high rates of HPV vaccination and cervical cancer screening could be achieved in all countries from 2020 onward, there would be up to 13.4 million fewer cases of cervical cancer by 2069.

That would mean the average rate of annual cases worldwide could fall to less than four cases per 100 000 women by the end of the century, the level at which cervical cancer is no longer considered a major public health problem, the study authors added.

If high levels of HPV vaccination and cervical screening cannot be achieved globally, more than 44 million women could be diagnosed with cervical cancer over the next 50 years, rising from 600 000 in 2020 to 1.3 million in 2069, due to population growth and ageing, the findings showed.

Two-thirds of those cases, and an estimated 15 million cervical cancer deaths, would occur in low- and medium-income countries, according to the study published in The Lancet Oncology.

Large disparities between countries

In early 2018, the World Health Organization called for coordinated global action to eliminate cervical cancer, which is highly preventable.

“The WHO call-to-action provides an enormous opportunity to increase the level of investment in proven cervical cancer interventions in the world’s poorest countries. Failure to adopt these interventions will lead to millions of avoidable premature deaths,” Canfell said in a journal news release.

Cervical cancer is the fourth most common cancer in women, with about 570 000 new cases diagnosed worldwide in 2018. Of those, about 85% occurred in less-developed countries.

HPV vaccination can prevent 84 to 90% of cervical cancers, and there are proven methods to screen for and treat cervical pre-cancers.

But there are large disparities in cervical screening and HPV vaccination rates between countries, the study authors noted. In low- and middle-income countries, overall screening rates in 2008 were as low as 19%, compared to 63% in high-income regions.

The US Centers for Disease Control and Prevention currently recommends routine HPV vaccination of girls and boys by ages 11 and 12, because protection is best if done before initiation of sexual activity.

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Health24.com | High-fat diets don’t do your gut bacteria any favours

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Has a high-fat meal ever left you feeling bloated and sluggish? It turns out that a heavier fat diet may keep the many bacteria that live in your digestive system from doing their best, too.

New research found that when people boosted their fat intake to 40% of their daily diet for six months, the number of “good” gut bacteria decreased while amounts of “unhelpful” bacteria increased.

Increase in inflammatory triggers

“The [study] result showed that a high-fat diet is linked to unfavourable changes in the type and numbers of gut bacteria – collectively known as the microbiome,” said the study’s senior author, Duo Li. He is chief professor of nutrition at the Institute of Nutrition and Health at Qingdao University in Qingdao, China.

In addition to changing the make-up of the microbiome, the study authors also noted an increase in inflammatory triggers in the body. These changes may contribute to the development of metabolic disorders, such as diabetes and heart disease, the researchers noted.

Nutritionist Samantha Heller, from NYU Langone Health in New York City, said bacteria living in the digestive system appear to have broad-ranging impacts on human health, and that they “eat what we eat”.

“Research suggests that they thrive on plant fibres – such as those found in fruits and vegetables, legumes, nuts and grains – and that the typical Western diet, which is rich in fat, red and processed meats, cheese, sweets, refined grains and fast-fried junk foods, in a sense, poisons them,” she explained.

In China, where the study was done, a traditional diet has been low in fat and high in carbohydrates. That, however, has been shifting to a diet higher in fat and lower in carbohydrates. At the same time, the rates of obesity and type 2 diabetes have also been rising, the study authors said.

Altered carbohydrate intake

To see if changes occur in the gut microbiome when people transition from a low-fat diet to a higher-fat diet, the researchers recruited about 200 young people, who weren’t obese, for the study. Their average age was about 23 years old.

Li said their average fat intake before the start of the study was about 31%.

The study volunteers were randomly placed into one of three groups for six months. One group ate a diet comprised of 20% fat, another ate 30% of their daily calories from fat, while the third had a 40% fat diet.

The researchers altered carbohydrate intake – things like rice and wheat flour – to make up for the changes in fat intake. The amount of fibre and protein in the diets stayed essentially the same.

All three groups had weight loss, but the lowest-fat group lost the most weight and had the greatest reductions in waist circumference, total cholesterol and bad cholesterol. The low-fat diet group also had an increase in gut bacteria that have been linked to lower cholesterol levels.

Those on the higher-fat fare had an increase in a different type of gut bug – one that’s been linked to higher cholesterol levels. Their diet was also associated with “significant” changes in long chain fatty acid metabolism, producing higher levels of chemicals that are thought to trigger inflammation.

Too much of a good thing

Li said the findings may be relevant in developed countries where fat intake is high, but that further research needs to be done to see if similar changes occur in different populations.

“We suggest that fat intake for a general healthy population should not be more than 30% of total energy – at least in Asian populations,” Li said, and added that most fat should come from healthy fats, such as soybean, peanut or olive oil.

Nutritionist Heller said it’s important not to “interpret the findings of this study to suggest that dietary fat is unhealthy. We need to eat fats to be healthy, unsaturated fats in particular.”

But, she added, you can have too much of a good thing. “Fad diets rich in animal fats – such as ‘Keto’ or ‘Paleo’ – over time, are likely to be deleterious to the gut microbiome and subsequently increase the risk of inflammation and chronic diseases,” Heller said.

To keep your microbiome happy and healthy, Heller recommended eating more vegetables, legumes, fruits, grains and nuts, while avoiding processed meats, limiting red meat and cheese, and balancing your intake of fats, carbohydrates and protein.

Results of the study were published online in the journal Gut.

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Health24.com | Americans more likely to die of opioid overdose than car crash

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In the United States, the probability of dying from opioids has for the first time surpassed the likelihood of being killed in a car crash, according to a new report by the National Safety Council. 

Published recently and based on National Center for Health Statistics’ 2017 data, the report found that opioid overdose was the fifth most probable cause of preventable death, with a one-in-96 odds. The odds of dying in a vehicular crash were one-in-103. 

Worsening crisis

More probable causes than opioids overdoses were heart disease, cancer, chronic lower respiratory disease and suicide. 

Opioids contributed to the overwhelming majority – 69% – of fatal drug overdoses in 2016, totalling 37 814 deaths, according to the NSC. 

These opioids include the use of illegal narcotics, such as heroin, and prescription pain killers, such as oxycodone and hydrocodone. 

“The nation’s opioid crisis is fuelling the Council’s grim probabilities, and that crisis is worsening with an influx of illicit fentanyl,” the council said in a statement, referring to a synthetic opioid often used to treat severe pain. 

Just a day before the report was released, one person died and at least 12 people were hospitalised in northern California in what police described as a “mass overdose” stemming from fentanyl use. 

In 2017, overdose deaths soared, surpassing 70 000, according to the Center for Disease Control’s (CDC) National Center for Health Statistics.

And between 2013 and 2017, fatal drug overdose rates grew in 35 of the 50 US states as well as the District of Columbia. In many of those states, synthetic opioids were behind a growing number of deaths, per CDC statistics.

Scourge of drug addiction

In December, a separate report concluded that fentanyl had become more common than heroin in drug overdose deaths in the country.

US President Donald Trump signed an opioid law in late October. The bipartisan law expanded medical treatment for opioid users and made it more difficult to mail illicit drugs.

“Together we are going to end the scourge of drug addiction in America,” Trump said during an event at the time.

“We are going to end it or we are going to at least make an extremely big dent in this terrible, terrible problem.”

The legislation expands access to substance abuse treatment in Medicaid, the government health insurance programme for the poor and disabled.

Empty words and broken promises

It also cracks down on mailed shipments of illicit drugs such as fentanyl, and provides a host of new federal grants to address the crisis.

In October 2017, Trump declared opioid addiction a 90-day emergency, a limited declaration that critics said fell short of implementing the measures needed to combat the crisis. 

Critics also point to Trump’s previous attempts to slash hundreds of billions of dollars from Medicaid, which provides treatment to around one-third of people seeking help with substance abuse. 

In July 2018, Senator Elizabeth Warren, a vocal opponent of Trump, accused the Trump administration of undermining programmes that are pivotal to tackle the opioid crisis. 

In a nine-page letter to the president, Warren said his administration “failed to take the actions needed to meaningfully address this crisis … (and has) continued to substitute empty words and broken promises for real action and bold ideas”.

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Health24.com | How to check your anus and vagina to ensure all’s well down there

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Vagina. Anus. Simply hearing the words can summon awkward sniggers and even embarrassment. But what’s really scandalising is how little women actually know about their own anatomy, according to an exclusive study commissioned by Women’s Health.

Read more: Sex toys you didn’t know you could get at your local pharmacy

To help you understand your nether regions, we created this guide to checking your privates (which, btw, are much more than just your vajayjay) – including signs there’s trouble brewing down below. Ready to get up close and personal with your lady bits?

Squeamish? Get over it. Giving your bits a yearly once-over is the number-one way to stay safe…

Read more: 6 herpes symptoms in women that shouldn’t be ignored

Sit down

Squatting makes it hard to get a good glimpse. Sit in a chair or on the floor, open your thighs and elevate one leg.

Grab a mirror

Using a handheld mirror, note the size and colour of your labia and clitoris (this might involve touching), as well as any bumps or rough spots (relax – no one’s skin is perfect down here, either).

Read more: 10 reasons you’ve got bumps on your vagina

What do you see?

Train your eyes on your vaginal opening, then on your anus – you shouldn’t see tissue peeking out of either. If you ID any major changes, blisters, open sores or protruding tissue, call your doc. Otherwise, put your big-girl panties back on and pat yourself on the back.

This article was originally published on womenshealthsa.co.za

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Health24.com | Newly-mapped genes may hold keys to ADHD

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Millions of American kids with attention deficit hyperactivity disorder (ADHD) may have a genetic vulnerability to the disease, a new study suggests.

Researchers analysed data from more than 55 000 individuals and identified 12 gene regions linked with ADHD. These regions probably affect the central nervous system, the study authors said. The discovery might help scientists develop new treatments for ADHD, which affects more than 9% of American children.

“We all carry genetic risk variants for ADHD,” explained researcher Anders Borglum, a professor of biomedicine at Aarhus University in Denmark. “The more we have, the greater our risk for developing ADHD.”

Those same genetic areas share a connection with 200 other diseases and traits, he said. The investigators also found that 44 gene variants implicated in ADHD are linked with depression, anorexia and insomnia.

“We now understand better why some individuals develop ADHD, and begin to get insights into the underlying biology, paving the way towards new and better treatment of ADHD,” Borglum added.

The genetic areas his team uncovered show that this is primarily a brain disorder, Borglum said.

The researchers also found genes that may be linked with ADHD have a role in how brain cells interact and also affect speech development, learning and regulation of dopamine (a chemical messenger that carries signals between brain cells).

Still, the vast majority of ADHD genetics is still undiscovered and will require larger studies, Borglum said.

Further evidence ADHD is an inherited disorder

Study author Stephen Faraone noted that the team “found 12 of the very many — we don’t know how many — probably thousands of genes related to ADHD.” Faraone is a professor of psychiatry and behavioral sciences at SUNY Upstate Medical University in Syracuse, New York.

The researchers don’t expect to discover just one, two or even 10 genes that each have a dramatic effect on causing ADHD and can be used to diagnose the disorder or quickly develop a treatment, he said. Most likely, a combination of genes and environmental factors trigger ADHD, the study authors said.

Environmental factors may include being born prematurely and underweight or suffering from developmental problems, such as foetal alcohol syndrome, Faraone said.

Interestingly, he added, even though medications work in treating ADHD, they don’t target the genes that the investigators found were linked to the condition. None of the genes affected by the drugs showed up in their analysis of genes tied to ADHD, Faraone said.

The report was published online in November in the journal Nature Genetics.

Ronald Brown, dean of the School of Health Sciences at the University of Nevada in Las Vegas, said, “This is a promising investigation, as it provides further evidence that ADHD is likely an inherited disorder.” Brown was not involved with the study, but was familiar with the findings.

It’s been clear for years that ADHD runs in families, he said. These findings are also important because they suggest that certain therapies effective for one family member are likely to be effective for other family members who are diagnosed with ADHD, he added.

This study is also important because it shows that several psychological disorders are likely tied to these genes, though no cause-and-effect relationship was proven in the study. This information could help families with prevention and early intervention efforts, Brown said.

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Health24.com | Hunting, harvesting leave big animals at risk of extinction

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Humankind may be eating hundreds of species of large wild animals into extinction, a new study says.

Researchers looked at nearly 300 species of large animals (megafauna) – defined as mammals and fish weighing 220 pounds (99.7kg) or more, and amphibians, birds and reptiles weighing at least 88 pounds (39,9kg).

An important conservation tactic

The investigators found that 70% (200) of the species are in decline, and 59% (more than 150 species) face extinction. People’s use of them for food or medicine is a major reason.

“Direct harvest for human consumption of meat or body parts is the biggest danger to nearly all of the large species with threat data available,” said study corresponding author William Ripple. He’s a professor of ecology at Oregon State University College of Forestry.

“Thus, minimising the direct killing of these vertebrate animals is an important conservation tactic that might save many of these iconic species as well as all of the contributions they make to their ecosystems,” Ripple said in a university news release.

These large species are under greater threat and have a higher percentage of decreasing populations than all other vertebrate species combined, Ripple said.

As humans’ ability to kill wildlife at a safe distance improved over the past 500 years, 2% of large animal species have gone extinct. That compares to 0.8% of all sizes of vertebrates going extinct, according to the study.

Snares and traps

“Our results suggest we’re in the process of eating megafauna to extinction,” Ripple said.

The use of various animal parts in Asian traditional medicine is also taking a heavy toll on the largest species.

“In the future,” Ripple warned, “70% will experience further population declines and 60% of the species could become extinct or very rare.”

In the past 250 years, nine large animal species have either gone extinct overall or disappeared from their natural habitats. That includes two species each of deer and giant tortoise (one of which went extinct in 2012).

“In addition to intentional harvesting, a lot of land animals get accidentally caught in snares and traps, and the same is true of gill nets, trawls and longlines in aquatic systems,” Ripple said.

The last of the Earth’s megafauna

“And there’s also habitat degradation to contend with. When taken together, these threats can have major negative cumulative effects on vertebrate species,” he stressed.

Preserving the large animals that remain will be complicated, with economic arguments against it as well as cultural and social obstacles, Ripple said.

“But if we don’t consider, critique and adjust our behaviours,” he concluded, “our heightened abilities as hunters may lead us to consume much of the last of the Earth’s megafauna.”

The study was published in the journal Conservation Letters.

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