It is with extreme sadness that we heard about the death of Dr Danie Pauw, our beloved head and founder of Health24, late last week.

His sudden passing, at just 56 years old, has come as a great shock to his family, friends and colleagues, to whom he was such a constant, supportive and loyal presence. Danie was someone who inspired love in people – even when there were differences of opinion. 

After qualifying as a medical doctor at Stellenbosch University, Danie worked in Canada and Durban as a general practitioner in the early nineties, after which he founded South Africa’s first telephonic medical information service, Meditel, in 1997.

From this grew Yourhealth.co.za, a consumer health website, which ultimately became Health24.com.

Health24, a joint venture between Danie and Media24/24.com from 2001, was his vision and his passion, and remains his legacy. Health24 is a digital health platform that over the years has provided many users with solid medical information in an accessible and understandable format.

His passion was to use technology to make health information easy to understand. His mantra “There’s a health angle to everything”, formed the basis of many a health writer’s training at this site over the last 18 years.

“He cared so much about the quality and success of the site, and its potential for helping all South Africans learn about their bodies, health, problems and solutions. He could be honestly stubborn about what was needed, and about the need for high standards,” said Danie’s long-time friend and colleague, Health24’s CyberShrink, Professor Michael Simpson.

“He found a unique way of making a special contribution to SA healthcare, using his skills and drive. I’m sure he was a great GP. When we chatted about medical matters his breadth of professional knowledge was unusual and special.

“In a way he became a mega-doc, serving the country and beyond,” Prof Simpson said.

He was open-minded and not afraid to take risks – he let his writers do new and exciting things, sometimes on the very edges of the health field, thereby encouraging the professional development of many of those working under him. He had passion for his cause, and was an inspirational speaker – he could make anything seem possible.

Danie, for his medical background, loved the creative process of content creation and could spend hours sifting through images, labouring over finding the perfect word and searching for interesting ways to create quality content. 

For those who knew him well, he had a quirky sense of humour, and would often find humour in the strangest places – which he didn’t mind sharing!

Danie was a rare individual in the corporate world in that he took people at face value – something which says much about his character. He was a good person to have in your corner. 

And that’s just it – he was a truly good person, kind, fair, egalitarian and compassionate; sometimes much more so to others than to himself.

“Communicating with a range of people who have worked with him, something many of them said is that he had changed their life; that he had given them a chance even when they didn’t have obvious qualifications, and let them develop and show the skill he recognised in them,” said Prof Simpson.

“In Danie, we have lost such a good friend and just a really good man. Yes, he was an effective administrator and creator, a good doctor, on the small and large scale. But he was more than merely respected; he was also loved, and that is much more rare, in any sort of business.”

Danie was someone who touched the lives of everyone with whom he came into contact and he, his passion and enthusiasm, will be sorely missed by those who knew him – and by the millions of users whose lives he ultimately affected without their being directly aware of it. Danie was truly one of life’s genuinely good people.

He is survived by his parents, Dr John and Leonie Pauw, formerly from Durban, and now living in Cape Town, and his sisters Ilse, Heidi-Lee and Liesel van Niekerk, all from Cape Town.

Rest in peace, Danie.

Anaemia is a disorder that occurs when there are problems with the production of haemoglobin (the red protein in your blood responsible for transferring oxygen) in the body. According to pathologist and haematologist Dr Alicia Els, iron-deficiency anaemia is the most common form of anaemia, with anaemia of chronic disease (ACD) the most common anaemia in hospitalised patients.

Anaemia is usually caused by blood loss, but can also be caused by a lack of iron in the diet. While this widely known, there are other common misconceptions about anaemia and iron deficiency:

1. If you are iron deficient, you are anaemic and vice versa

Anaemia can certainly be caused by iron deficiency. In fact, iron deficiency is the most common cause of anaemia. This, however, doesn’t mean that iron deficiency and anaemia can always be linked. There are other causes of anaemia, such as ACD and sickle-cell anaemia. These types of anaemia are not caused by nutritional deficiency.

2. If you are vegan or vegetarian, you will suffer from iron deficiency anaemia

While red meat is a common source of iron, plant foods such as leafy greens are also sources of iron. Giving up meat and dairy may increase your chances of iron-deficiency anaemia, but this doesn’t necessarily have to be the case.

Another cause of anaemia is the lack of vitamin B12 in your diet, as this vitamin plays an important role in producing red blood cells. Vitamin B12 is found in red meat, poultry and dairy products, and is generally absent in plant foods. It is therefore believed that those on vegetarian and vegan diets have a higher risk of lack of vitamin B12 and subsequent anaemia. But if you monitor your diet, talk to your doctor or nutritionist, and take a supplement, there is no reason to develop a B12 deficiency.

3. Anaemia is largely genetic

In some cases, fanconi anaemia (FA), a rare inherited blood disorder, can lead to bone-marrow failure. This is a type of aplastic anaemia that prevents bone marrow from producing enough new blood cells for your body to function normally.

Other forms of anaemia, such as sickle-cell anaemia and thalassemia, are forms of hereditary anaemias. Even though these are linked to genetics, most cases of anaemia are acquired, either through iron shortage, or illness.

4. Children are more likely to suffer from anaemia

Iron-deficiency anaemia is common among infants and children, but it’s not limited to this age group. 

Women of child-bearing age are also more susceptible to iron-deficiency anaemia, but anaemia can occur any stage of life.

5. Anaemia is mostly a sign of a poor diet

While malnutrition among children is the most common cause of anaemia, types of anaemia such as sickle cell and thalassemia are not liked to diet and iron intake.

In adults, anaemia is often caused by inflammation, kidney disease, infection, cancer or bleeding gastritis.

6. You can’t breastfeed if you have iron-deficiency anaemia

You can safely breastfeed even if you suffer from iron-deficiency anaemia. Discuss your diet and the use of an iron supplement with your medical practitioner.

7. You can’t exercise or play sport if you have anaemia

There is no reason why children or adults with anaemia shouldn’t partake in sport. While it can be challenging to do physical exercise due to the lack of oxygen caused by a lack of red blood cells, you can still exercise if you wish to do so. It is important to start slowly and listen to your body. Consult your doctor if you are unsure.

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Marelize Wilke

For thousands of years, sexual abstinence (and the resulting frustration) has been thought to boost performance and aggression. Both Muhammed Ali and Mike Tyson supposedly swore off sex in the weeks leading up to fights. And there’s that infamous scene in Rocky when Mick tells Rock to “lay off that pet shop dame” because “women weaken legs”.

But even though you’ve probably heard that abstinence boosts performance before a competition, this idea has always had its detractors. Professional wrestler Ronda Rousey, for instance, famously said she has “as much sex as possible” before a fight.

Read more: What she wants in bed that will make sex better for you too

So who’s right?

Well, a new study weighs in on Rousey’s side of the debate. Sex before competition or a big workout isn’t just verboten – it may actually boost your performance.

In the study, researchers asked a group of 12 men to perform lower body exercises the morning after they’d either had sex or had taken a night off from sexual activity.

“This night-before design was to mimic the time-frame that some athletes may face,” says Todd Astorino, co-author of the study and a professor of kinesiology at California State University, San Marcos.

Read more: This is what a dental dam is, and it’s not for your teeth

Astorino and his colleagues found that sex had no effect on the men’s ability to perform the weight training movements. During five sets of two lower-body exercises, both peak and average performance held steady regardless of whether a man had had sex the night before.

While the study was admittedly very small, “our data would suggest that sex does not impair muscle force when performed within 12 hours of a gym workout,” Astorino says. But there’s a caveat, he adds, “At the world-class level, athletes win and lose by very small margins.”

Whether or not sex could subtly influence a competitor’s performance is a difficult nail to hammer down. (Pun intended.)

Read more: Should you sleep together on the first date?

Additional research on the subject of pre-competition sex sheds a little more light on the debate.

“There are thoughts that testosterone levels may change before and after sex, and this can alter things like mood as well as performance,” Astorino says.

Abstain for more gains?

One 2003 study from China, for instance, found that a man’s testosterone levels remain relatively steady in the days after an ejaculation. But if he can hold out for a full week, his T levels can jump by almost 45% on his seventh day of abstinence. (Testosterone levels do not, however, continue to climb after that day-seven peak, the authors of that study say.)

Meanwhile, a similar study found no such jump in T among men who abstained, and in fact found testosterone tends to be slightly elevated after sex.

As if mixed results like those weren’t frustrating enough, experts also point out that every sport is different. A comprehensive 2016 review of all the existing studies on sex and athletic performance found a lot of conflicting data and a general lack of evidence on performance in the context of different types of competition. “Given the variety of sports, and their different metabolic and situational differences, generalisation is not possible,” the authors of that review say.

Read more: 9 best unsimulated sex scenes in Hollywood movies

What to make of all this? Whatever you want. It doesn’t seem to matter much whether an athlete gets it on before competition – as long as he doesn’t have extremely strenuous sex right before a match.

So if you feel like sex relaxes you and helps you focus during competition, feel free to get busy. Or if you think abstaining helps you stay aggressive, go ahead and skip sex. There’s not enough evidence today to suggest switching up your pre-game routines.

^{This article was originally published on www.mh.co.za}

^{Image credit: iStock} 

Markham Heid

One day you’re pulling on your distressed denim with ease; the next you’re wrestling with your zipper, and wondering why the jeans you wore yesterday don’t fit anymore.

The good news: You’re likely just bloated and it happens to literally everyone. It’s totally preventable or even fixable – although it’s not like having a headache and popping some ibuprofen. Still, there are some super-simple remedies for how to reduce bloating ASAP, so you don’t have to give up jeans forever in lieu of your stretchiest pair of leggings.

1. Fill up on probiotics

Some over-the-counter probiotic supplements can cause gas, bloating, or other GI symptoms, but chowing down on real foods packed with this healthy gut bacteria can be beneficial, says Courtney Schuchmann, a dietitian at the University of Chicago Medicine.

“Yoghurt is one of the easiest ways to get probiotics in your diet,” she adds. “You can also eat fermented vegetables, like sauerkraut, or things like kombucha and kefir – but be cautious, because those products may also contain a lot of sugar, which can be counterproductive for GI health.”

Read more: 9 foods that are secretly making you super-boated

2. Stay hydrated

You’ve absolutely been told before that you should be drinking more water, but this is especially true if you find yourself bloated all the time.

Drinking water will soften your stools, which makes them easier to pass and reduces bloating in the form of gas and constipation, says Dr Matthew Bechtold, a gastroenterologist at University of Missouri Health Care. Good hydration also increases the mucous secretions in your bowels and your overall bowel motility… so drink up!

3. Watch your sodium intake

If you’re feeling bloated after an especially salty meal, you can blame the sodium – too much of it in your diet causes your kidneys to retain water.

The good news is that cutting back on sodium helps your kidneys flush out all that excess water in your body, says Dr Bechtold, which will help you lose the puffiness.

He recommends choosing fresh meats and produce over the prepackaged kinds, putting down the salt shaker at dinner in favour of flavourful spices, preparing your own meals at home instead of dining out, and reading food labels closely for sodium content. And just so you know: The Food and Drug Administration recommends consuming no more than 2 300 milligrams of sodium per day (that’s just one teaspoon of salt, FYI).

4. Add more potassium into your diet

Speaking of how sodium can make you retain water, if you’re regretting those French fries you ordered at lunch, try snacking on a potassium-rich banana to combat bloat.

“Potassium can help the kidneys get rid of salt, which may help with water retention,” says Dr Bechtold. If bananas aren’t your thing, oranges and strawberries are also good sources of potassium.

5. Don’t skip the skin on fruits

Put down the fruit peeler. In fruits like apples and pears, the skin is where you find insoluble fibre, a.k.a. the kind of fibre that aids digestion by keeping things moving through your bowels. Munching on these fruits with the skin intact, says Schuchmann, can help increase stool bulk and give you more regular bowel movements.

Read more: 12 reasons why you’re suddenly so bloated

6. Cool it on the carbonated drinks

I know, it’s amazing, but there’s a side effect to all that no-cal sipping you’ve been doing at your desk every day: It could be causing belly bloat.

“Carbonated beverages may add air in the GI tract,” says Dr Bechtold. “The more air that is trapped, the more bloating [you’ll have].” Replace some of your sparkling water with the flat bottled or tap kind, and see if there’s any improvement.

7. Work up a (light) sweat

You don’t have to go for a 10km run every day, but fitting in some regular physical activity might keep things moving more smoothly in your tummy.

According to Dr Bechtold, there are two reasons why a short walk-especially after eating a big meal-can significantly reduce bloating. First, exercise increases the motility of your colon, which reduces the amount of time your stool sits in your belly making gas. Secondly, exercise increases your heart and respiratory rates, which also increases blood flow to the guts; this encourages your bowel muscles to work harder to push stool out.

8. Swap your pistachios or cashews for almonds

Nuts are full of healthy fats that fill you up, right? Well, yes, but depending on the kind of nut, they may also be full of a certain kind of carbohydrate (fermentable oligosaccharides, disaccharides, monosaccharides and polyols, or FODMAPs for short) that your stomach can’t fully digest – which leads to your colon producing more gas that will leave you bloated.

If you’re a fan of pistachios and cashews, Schuchmann suggests swapping them out for almonds, walnuts or pecans, all of which are lower in FODMAPs and gentler on the stomach. As an added bonus, almonds are also a good source of protein and omega-3s.

Read more: How to ‘shrink’ your tummy in just 24 hours

9. Give yourself a stomach massage

If you don’t want to make any dietary changes to beat your bloat, you could try your hand at some amateur abdominal massage, which Dr Bechtold says is a safe way to help clear constipation.

According to Dr Bechtold, a basic massage will involve moving your fingertips in a circular motion over the abdomen, starting on your lower right side and traveling clockwise up to your rib cage, then across and down to your pelvis.

10. Don’t overdo it on the broccoli

I’m not here to tell you to eat less vegetables, but if you’re going to town on some of your nutritious faves – like broccoli and cauliflower – they could actually be the source of your woes.

These cruciferous veggies are high in a sugar called raffinose, says Dr Bechtold, which doesn’t break down super easily in your GI tract.

Luckily, you don’t have to swear off those mini trees for good. Schuchmann says it’s just a matter of finding your threshold: Some people can tolerate one cup of broccoli at a time, others more or less. You may also have better luck eating cooked broccoli versus crunching raw florets.

11. Swap your brown rice for white

Brown rice is generally considered to be healthier than white, but white rice may be gentler on sensitive stomachs. “Brown rice contains much more fibre than white rice [and that] acts as a food source for colonic bacteria,” says Dr Bechtold.

When colonic bacteria have a lot to dine on, it produces gas, which – you guessed it – causes bloating. To reap the health benefits of brown rice without maxing out your stomach, try mixing equal parts of brown and white rice together.

12. Always look for ways to get your leafy greens

Since leafy green vegetables, like kale and spinach, are a good source of insoluble fibre, they help your colon produce stool, thereby reducing gas and bloating, says Dr Bechtold.

These veggies are also low in kilojoules, so they’re pretty versatile: You can eat them raw in salads or incorporate them into your soups, stews, eggs, smoothies, sandwiches and tacos without adding a lot of kilojoules to your meal.

13. Aim for a few small meals each day

If you’re waiting several hours between meals, you’ll end up ravenous when it’s time to eat again and that might result in overeating.

Dr Bechtold explains that overeating causes the stomach to both look and feel larger than normal (hello, food baby!), but eating several small meals over the course of the day can prevent that awkward distended belly.

14. Drink lemon water in the morning

Lemons are one of nature’s best bodily waste removers, according to Dr Bechtold, who says they work as a subtle laxative to move stool out of the colon as well as a diuretic to flush out your kidneys. So they may keep you from getting constipated and retaining water – two major sources of bloating.

Add a wedge of lemon to eight ounces (236.5ml) of warm water every morning before breakfast to reap the benefits.

15. Consider cutting back on dairy

“In patients with lactose intolerance, lactose is inadequately digested and acts as a food source to bacteria in the colon, producing more gas and that bloating sensation,” says Dr Bechtold.

Since dairy products contain lactose, avoiding dairy is the best route to less bloat for people who are lactose intolerant in any way.

16. Choose grilled, broiled or baked chicken over fried

Obviously fried chicken is delicious, but it should be more of an exception, not a rule: Fried food is tougher on your stomach and may be to blame for all your gas and bloating.

“Fried versions of food typically absorb more of the fat [they’re cooked with],” says Schuchmann. “That can cause GI distress.” As often as possible, opt for meat and seafood that’s grilled, broiled or baked rather than fried.

17. Go ahead, drink your coffee

Coffee drinkers, rejoice: According to Schuchmann, black coffee can keep your bowel movements regular. The connection is mostly anecdotal at this point, but lots of people feel the urge to run to the bathroom pretty soon after their morning cup of Joe, so if it works for you, stick with it. (Just be sure you don’t overdo it on sugar-laden milk or creamers, which might negate some of the GI benefits.)

If you’re not a coffee fan, Schuchmann says herbal teas are a good way to get the all-important hydration your colon needs to keep things moving.

18. Ditch the artificial sweeteners and go for the real thing

FYI: Any ingredient that ends in the letters “-ol” – erythritol, sorbitol, and xylitol – is an artificial sweetener, and it is probably making you bloated.

These chemicals are called sugar alcohols, and they’re found in tons of sugar-free snacks, like candies and gums, as well as in many of the dressings, beverages, and condiments you eat every day. They’re also hard for your stomach to properly digest, so they create gas and GI problems (like bloating!). Stick to small servings of real sugar if you don’t want to totally cut out the sweet stuff.

^{This article was originally published by www.womenshealthmag.com}

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A new treatment for a drug-resistant strain of tuberculosis can cure 80% of sufferers, according to a trial hailed Monday as a “game changer” in the fight against the global killer.

Doctors in Belarus – a country with one of the highest rates of multidrug-resistant tuberculosis in the world – spent months treating patients with a new drug, bedaquiline, alongside other antibiotics.

The results, seen exclusively by AFP, were startling: Of the 181 patients given the new drug, 168 people completed the course and 144 were totally cured.

The World Health Organization says currently only 55 percent of people with multidrug-resistant tuberculosis are successfully treated.

The Belarus trial cure rate – 80% – was largely replicated in bedaquiline trials in other countries in eastern Europe, Africa and Southeast Asia, according to abstracts seen by AFP, due to be unveiled at a major tuberculosis conference later this week.

“The results from this study confirm… that newer drugs like bedaquiline can cure and are game changers for people living with multidrug-resistant and extremely drug-resistant tuberculosis,” Paula Fujiwara, scientific director of The International Union Against Tuberculosis and Lung Disease who was not involved in the research, told AFP.

Lead researcher Alena Skrahina, from the Republican Research and Practical Centre for Pulmonology and TB in Minsk, called the bedaquiline results “promising”.

“Generally, our study confirms the effectiveness of bedaquiline in previous clinical trials, and does not confirm the concerns about safety problems,” she told AFP.

Tuberculosis killed at least 1.7 million people in 2017, according to the WHO, making the airborne infection the world’s deadliest infectious disease.

It kills more than three times as many people as malaria every year and is responsible for the majority of HIV/AIDS deaths.

Despite the huge death toll, tuberculosis receives roughly a tenth of the global research funding that goes to HIV/AIDS.

Multidrug-resistant tuberculosis is immune to two of the most common antibacterial drugs used to treat the disease.

Experts believe it is spreading worldwide due to poor handling of tuberculosis cases.

Unlike other global killers such as HIV, tuberculosis is curable — but currently only under a strict six-month supervised regimen involving multiple daily drug doses.

In many parts of the world medications are incorrectly stored, or simply run out before the treatment has finished, leading to greater drug resistance, especially in crowded settings such as prison and hospitals.

The WHO says variants of multidrug-resistant tuberculosis have been reported in at least 117 countries around the world.

$13bn pledge

Unlike many antibiotics, bedaquiline doesn’t attack the bacteria directly and instead targets the enzymes that the disease relies on for its energy.

All of the patients in the study experienced side effects but these were less severe than previously thought.

Last month UN member states agreed a global plan to fight tuberculosis and to facilitate cheaper access to vital drugs.

On the sidelines of the General Assembly in New York, world leaders pledged $13bn annually to end the tuberculosis epidemic, with a further $2bn to fund research – up from $700m currently.

Unlike the battle against HIV, which has received high-profile celebrity backing, tuberculosis is often seen as a historic affliction effecting only remote and undeveloped parts of the world.

Scientists and policymakers gather this week in The Hague for a global conference on lung health, where they are expected to warn that tuberculosis could spread through richer nations currently struggling with non-communicable diseases such as diabetes and obesity.

India alone accounts for a quarter of all tuberculosis cases, and there are hopes that new, cheaper drugs could help strangle the spread of the disease if rolled out worldwide.

“We urgently need more affordable drugs like bedaquiline if we are to seriously make a dent in curing the estimated 600 000 people falling sick to multidrug-resistant tuberculosis each year and avoiding nearly a quarter of a million deaths,” said Fujiwara.

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