President Cyril Ramaphosa will join other world leaders on Wednesday to decide on how to fight TB: the world’s, and South Africa’s, deadliest infectious disease. 

Doctors Without Borders (MSF) has called on Ramaphosa to reverse the “sluggish global progress in combatting TB” by making decisive commitments at the first-ever United Nations High-Level Meeting on TB taking place in New York on Wednesday. 

“78 000 people in South Africa died of TB in 2017, and while this is fewer than estimated for the previous year, TB treatment coverage remains low at 68 percent, meaning that up to one third of all people living with TB are being missed,” said MSF’s Dr Amir Shroufi. 

He said that while the country has shown leadership in the TB fight, significant gaps still remain. 

The organisation is calling on the South African government to commit to closing these gaps including registering one of only a handful of new medications to treat drug-resistant forms of the disease: delamanid. 

While South Africa was the first country to include the blockbuster anti-TB drug bedaquiline in routine treatment, delamanid remains largely inaccessible to patients. 

“South Africa has done well to improve the [drug-resistant TB] treatment regimen for adults and adolescents, but new strategies are urgently needed for ensuring that younger children have access to better treatment. This situation would be improved in the very short term by the registration of delamanid, which has proven to be safe in the paediatric population,” said Dr Justine Fargher, who treats drug-resistant TB patients for MSF in Khayelitsha.

The International Union Against Tuberculosis and Lung Disease praised Ramaphosa’s participation at the meeting. 

“It is especially encouraging to see leadership from the Africa region, where the rates of TB are the highest in the world,” said the Union’s Paul Jensen.

The United Nations represents 193 nations yet only 32 heads of state have so-far been confirmed to attend the meeting.

Despite TB being preventable and curable, it killed 1.6 million people around the world in 2017 and is ranked as the number-one infectious disease killer. 

MSF’s Sharonann Lynch urged governments to make TB a “political priority”. 

“How is it possible that more than sixty years ago we managed to send people to the moon and to the deepest point in the ocean, yet people affected with one of the most ancient diseases in human history continue to suffer and die because we’ve failed to find a fast, safe and simple cure for TB? World leaders this week must show some spine and take collective responsibility to fight this global health emergency, so we don’t keep losing one fellow human to TB every 18 seconds,” she said.

– Health-e News

Amy Green

You think you’re on top of your workout game. You’re always in the gym, you mix up your muscle groups – you even make cardio a priority. But when was the last time you worked your deep cervical flexors?

Before you Google where those muscles are, let’s assume you haven’t made time for them in your regular workout routine. But that’s about to change.

Many men apply the “bigger is better” philosophy to working out. But some of the most important muscles in daily life require the least equipment to strengthen.

While you’re focusing on the muscles you can see – the lats, pecs, biceps, rectus abdominis, glutes and quads – the muscles that actually help you get things done are being left out. These areas need your attention, too – or you might even face problems down the line.

Read more: The best exercises for big muscles – plus a 28 day mass-building workout plan

Here is a list of five muscles (or muscle groups) that you’ll want to work into your regular fitness routine to help you get stronger, starting now:

1. Deep cervical flexors

Chances are you’ve never thought about these muscles in your life, but they are crucial for proper head positioning.

Deep cervical flexors include the Longus Colli and Longus Capitis, which play an important role in stabilising the neck and improving your head position and cervical alignment. These muscles are often weak in people who spend many hours at a computer or at a desk, leading to a forward head position or the chin being tilted upwards.

Research shows that strengthening the deep cervical flexors can reduce symptoms in people living with chronic neck pain. Unsure if your neck is weak? Try lying flat on your back. Tuck your chin downward then lift the head up using only your neck. Try and hold this position for 20 seconds. Not so easy, huh? Weakness in these muscles can lead to cervical and thoracic pain, and even headaches.

Try a chin tuck to strengthen these muscles, and try incorporating your new and improved alignment into your lifting routine.

Read more: How to fix these common posture problems

2. Grip strength

We use our hands for countless tasks every day, but how often do you take time to specifically strengthen your grip? Unless you’re a rock climber or training for the next American Ninja Warrior competition, the answer is probably not often enough.

Research shows that grip strength might be an early indicator of long-term health and longevity. In fact, it may also be a predictor of disease risk in the future. On top of that, your hands are the connection to those heavyweights you’re lifting at the gym. Make an extra point to ensure those hands are strong, and you’ll only see positive results.

If you’re just starting out, try low-resistance wrist extension/flexion with a dumbbell, squeezing a soft ball with your hand, or practising pinch gripping heavy weights to target some important muscles in the fingers.

3. Intrinsic foot muscles

Our feet connect us with the world. Most of the time, they are our only physical connection, so what happens down there matters. Intrinsic foot muscles are the muscles that start and end in the foot itself. We don’t use our feet for climbing and traversing rocks and sticks like we used to back in prehistoric times, so the role of our feet in daily life has been minimised. But that doesn’t mean we don’t need them to be strong.

Arch support comes from a team of muscles, including the intrinsic foot muscles. By strengthening these muscles, you can help prevent your arches from collapsing. Why does this matter? When those arches collapse, your feet pronate. This can contribute to valgus at the knee (or the knees knocking together or moving inward inward). This stresses the inner knee compartment. Compound the force created by that movement with heavy lifting, single leg leaping and jumping, and you put your knees at high risk for injury.

Try practising foot doming while you lift to train your feet stay in better alignment. Your knees will thank you.

Read more: Here’s exactly how to treat the most common foot problems

4. Transverse abdominis

When people think of the “core” they often imagine the rectus abdominis (RA) muscle, or the muscle that gives you a six pack. But the transverse abdominis (TA) is often left out of training.

If you’ve ever seen a low back brace when someone is lifting at the gym, you should have an idea of the purpose of this muscle. The TA is deeper than the RA and wraps around the lower abdomen and upper pelvis to form your very own built-in low back brace.

The first step is figuring out how to engage this muscle. Once you practise some gentle activation and strength exercises, the TA should be engaged for stability prior to any lifting.

5. Lateral ankle stabilisers (peroneals and tibialis posterior)

If you’ve got wobbly ankles, the more weight you load onto your body the more prone to injury you become. The peroneus longus and peroneus brevis wrap around the outer (lateral) ankle and move your ankle to the side while helping dorsiflex the ankle (lift the toes up – important for not tripping and avoiding turf toe). The tibialis posterior is on the other side of your ankle, wrapping around the inner (medial) ankle and helping to both move your ankle inward and point your toe downward.

But most of the time, these muscles are working together to stabilise your ankle. They are part of an important group that helps to prevent excessive ankle movement during single and double leg activities. To work on ankle stability, try single leg exercises such as standing on one leg and moving the other leg forward, sideways and backwards ten times. If that’s easy, try doing it while balancing on an unstable surface like a pillow or a BOSU.

Look back at this list. If you’re lifting heavy with bad head positioning, weak grip strength, turned in knees and no built-in low back brace, you might be putting yourself at risk for an injury.

Save yourself the setback by focusing on those little muscles you never thought about before. You could even wind up becoming the guy with the strongest cervical flexors in the gym. You’ll only see positive results from putting in the extra work, so start focusing on the little things to make the big things even better.

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

^{Image credit: iStock} 

Rachel Tavel

What do the following delicious foods have in common:

French fries

Gnocchi

Latkes

Yup, that’s right – they’re all made out of potatoes, the world’s best food.

Sadly, potatoes don’t have the best reputation for being that healthy (thanks, low-carb diets!) – and with all the starch involved, you might wonder how many kilojoules are in a potato. Well, let me put your mind at ease: It’s not that bad.

A potato’s kilojoule count of course will depend slightly on the variety and size of your potato. A smaller medium red potato, for example, has 623kJ, according to the USDA, compared to the 702kJ in a medium russet potato.

Of course, nutrition isn’t just about kilojoules. For the curious, here’s what you’ll get in a whole, medium russet potato:

• Kilojoules: 702
• Fat: 0.2g (0g sat fat)
• Carbohydrates: 38g
• Sodium: 1mg
• Sugar: 1g
• Fibre: 3g
• Protein: 5g

Read more: These stuffed potatoes seem like junk food – but are healthy

Do potatoes deserve their bad rap?

The short version? No. “Potatoes are a rich source of several important micronutrients,” says Nora Minno, a Daily Burn coach and trainer. “One medium potato contains 70% of your daily recommended vitamin C, 30% of your daily recommended Vitamin B-6 and 25% of your daily recommended potassium.”

Also: “Potatoes are one of the most affordable vegetables,” says Torey Armul, a spokesperson for the Academy of Nutrition and Dietetics. “One study found that potatoes offer more nutrients per penny than other vegetables.”

And yeah, they’re starchy and carby. But Minno says potatoes kind of got a raw deal in the whole low-carb craze.

“While they are considered a starchy vegetable, they also contain protein and fibre which can help slow down the release of glucose into the bloodstream and help avoid blood sugar spikes,” she says. The surprisingly high amount of protein in a potato (5g) makes it “great for those who are looking for plant-based sources of protein”.

Read more: 4 ways eating potatoes can help you lose weight

So how can I make potatoes healthier?

Obviously, some of those potato-based foods I mentioned earlier are not the healthiest (and add on way more kilojoules than just the plain potato). Vandana R Sheth, a certified diabetes educator and spokesperson for the Academy of Nutrition and Dietetics, says she loves baked or oven-roasted “fries” as a way to enjoy the health benefits of potatoes “without a lot of added fat” or kilojoules. And Minno says she personally opts for potatoes instead of toast when looking for a healthier side at a breakfast restaurant.

^{This article was originally published on www.womeshealthmag.com} 

^{Image credit: iStock} 

Caroline Shannon-Karasik

When someone is lactose intolerant it means that they are unable to absorb lactose in dairy products due to a lactase deficiency. Lactase is an enzyme that splits the milk sugar lactose to produce glucose and galactose. 

Sophie Medlin, a lecturer in nutrition and dietetics at King’s College London, offers a simple explanation for how lactose intolerance occurs.

She wrote, “When we are babies, we all produce plenty of the lactase enzyme that allows us to absorb our mother’s milk. In populations where milk consumption has been historically low, such as Japan and China, most children will have stopped producing lactase soon after weaning and – producing almost entire populations that may be unable to absorb the lactose in milk – this we call ‘lactose intolerance’.”

If you are lactose intolerant, you may experience symptoms 30 minutes to two hours after consuming food or drinks that contain lactose. The most common symptoms include:

• Watery or acidic diarrhoea 
• Stomach cramps and pain
• Bloating
• Flatulence
• Stomach grumbling (borborygmi)

In young children, lactose intolerance can present with weight loss and failure to thrive.

4 alternatives to dairy

If you are lactose intolerant, there are some alternatives to dairy. These include: 

1. Lactose and casein-free milk

Look for lactose-free cow’s milk, which contains a lactase enzyme that helps break down lactose into forms that lactose-intolerant people can digest.

2. Soya milk

This milk is made from soya beans and can have a chalky feel and tofu-like after taste. It is relatively low carb – if you need to keep an eye on your blood sugar levels, choose unsweetened soya milk, which has as little as 0.1g of carbs per 100ml.

3. Almond milk

This dairy-free milk is slightly sweet and has a mild almond flavour; unsweetened almond milk tastes a bit more nutty. Almond milk has around 42 to 105kJ per 100ml.

4. Goat’s milk

Goat’s milk is great in cereal, tea and coffee, and can be used for cooking and baking. It has a creamy texture with a slightly sweet and herby taste. Good news if you don’t mind the overpowering smell – goat’s milk is high in calcium, proteins, vitamins and minerals.

Consider this when buying milk alternatives

Added sugar: Always opt for the unsweetened varieties – sugar is often added to enhance the flavour and texture. Check the food label and avoid brands that list sugar as one of the first three ingredients.

Calcium: We know that cow’s milk is rich in calcium, which we need for strong bones. However, many non-dairy milks are fortified with calcium, so choose one that has at least 120mg per 100ml.

Vitamin B12: If you avoid animal products, you may risk a vitamin B12 deficiency. Opt for milk that is fortified with vitamin B12, which is necessary for a healthy brain and strong immune system.

Make your own dairy-free milk

According to Food24, it’s fairly easy to make your own dairy-free milk:

Coconut milk: Blend one cup of unsweetened, dried coconut flakes with two cups of boiling water. Leave this mixture for five hours so the flavours can develop and then strain.

Rice milk: Boil one cup of brown rice with three cups of water, one teaspoon of cinnamon and one teaspoon of honey. When the rice is cooked, blend it with four cups of water and strain with a sieve.

Oat milk: Soak one cup of oats with three cups of water for eight hours. Blend this mixture with two cups of water, and add one teaspoon of salt and one teaspoon of honey. Blend until it is smooth and strain through a sieve.

^{Image credit: iStock} 

Compiled by Mandy Freeman

Due to society’s expectations and rigid gender performance standards, erectile dysfunction (ED) can be a daunting prospect for men.

You might think the problem is squarely on something intrinsically wrong with your penis – so you might be surprised to learn that your struggles might be due to an underdeveloped set of pelvic floor muscles.

Read more: Can watching too much porn give you erectile dysfunction?

For most men, the pelvic floor muscles aren’t exactly their priority when hitting the gym for a full body workout – but they should be. These muscles are critical for many essential daily functions, both in the bathroom and in the bedroom.

Unfortunately, it’s not commonplace for men to seek out help to strengthen their pelvic muscles.

When men hurt themselves playing sports or otherwise, they’re likely not going to be embarrassed to seek out an orthopaedist or physical therapist (PT) for help – but when it comes to an injury or problem with their muscles “down there”, men tend to be a little more… private.

Despite common belief and focus on keeping up macho appearances, pelvic floor (PF) dysfunction isn’t just a woman problem. Leakage with squats, pain during or after sex, and bowel or bladder incontinence are all signs of PF muscle dysfunction. Let it be known that penises have muscles, too. And sometimes, like any other muscle in your body, they can be dysfunctional – so you should see a PT about those muscles, too.

Facing real problems

ED is a common and growing problem facing thousands of men in the US (pun intended). According to the 2010 US Census Bureau, more than 12 million men between the ages of 40 and 79 experience ED.

More recent research suggests that as much as a quarter of men under the age of 40 do, too. Despite its prevalence, most men treat the same way: Using medication. But what if I told you that you could see a physical therapist for your ED to solve the problem naturally? According to research, you can.

Erectile dysfunction is defined as the inability to achieve or maintain an erection. There can be many causes of ED ranging from the emotional and psychological to the physical or neurological. “Pelvic floor physical therapy can address the muscular and nerve function required to achieve and maintain an erection,” pelvic floor specialised doctor of physical therapy Dr Erin Weber told Men’s Health. Specifically, targeted PT can help a man strengthen and engage his ischiocavernosus muscle, which is responsible for building and keeping penile rigidity. That engagement can be honed through exercises like kegels, which have grown more common among women but are woefully underperformed by men.

Just like any other muscle, the pelvic floor muscles can be addressed with rehabilitation. A proper strengthening routine can target weakness – specifically, trigger points can be released where there is increased tension, restoring the correct length-tension relationship and creating more complete and stronger muscle contractions, according to Dr Weber.

But before you start getting too creative with a DIY strengthening and massage routine, you’ll want a qualified specialist to assess and identify the source of the problem before determining the most appropriate treatment plan.

Read more: This new gel could help you get an erection in just 5 minutes

What goes into treatment

You’d be surprised what PF PT might entail. “Pelvic floor PT is much more than range of motion exercises, soft tissue mobilisation and home exercises,” Dr Francesca Warner, a doctor of physical therapy who specialises in treating male and female pelvic health, told Men’s Health.

A big focus of her treatments is on patient education and lifestyle adjustments. In particular, Dr Warner highlighted the importance of breathing and relaxation techniques. “Your diaphragm and your pelvic floor muscles are connected, therefore proper breathing is paramount.”

Additionally, stress can exacerbate pelvic pain. Dr Warner noted that many people hold stress in their pelvis, just like others do in their neck and shoulders. Patient education on avoiding straining when going to the bathroom, not clenching muscles throughout the day and global relaxation strategies, such as meditation and mindfulness, can be a large part of her treatments.

Read more: How to maintain your erection

So why aren’t more men seeking physical therapy for their ED? According to Dr Weber, who treats mostly women, men aren’t the only ones lacking knowledge about the muscle group. “Women are just starting to talk (whisper) about their pelvic floors, but only because they go through childbirth.”

Dr Warner believes the main reason men don’t seek pelvic floor physical therapy is because they don’t know it exists. “While there are a handful of excellent urologists, gastroenterologists, orthopaedists and pelvic pain specialists who refer patients to PF physical therapy, unfortunately not all doctors are aware of this specialisation (especially when it comes to men),” she said.

Dr Warner believes part of the issue has to do with common misconceptions. She noted that men are often told ED is related to anxiety. When all the diagnostic testing and urine cultures are negative, they are treated with anti-anxiety medications before their pelvic floor muscles are thoroughly assessed. This can be particularly frustrating for men who begin to think “it’s all in their head”, when there is undoubtedly a muscular component to their pain or discomfort.

Not just a ‘woman thing’

Not convinced yet?

Know this: A pelvic floor exam by a physical therapist may involve both external and internal soft tissue, neurological, strength and range of motion assessments.

Read more: How your big toe can signal problems with your erection

By internal, this usually means very gentle assessment of the pelvic floor muscles via the rectum – so yes, you will need to be ready for the rubber gloves to go on.

PF PTs know this may be uncharted territory for many men, so you should also know that internal exams usually don’t happen on the initial visit. Such procedures are always discussed prior to the exam and are only performed when a medical history and complete examination indicate that it is appropriate.

“I often hear ‘how come it took seven different doctors to get me here?’ or ‘I wish I had known about this three, five, 15 years ago,’” said Dr Warner. Above all, she wants men to know that they are not alone and there is help out there. “I am frequently asked ‘Have you ever treated this before?’ My patients seem shocked to hear that, not only are they not my first patient suffering from these symptoms, but they are usually one of three I’ve treated that day.”

Hopefully the stigma of pelvic floor PT being just a “woman thing” will change as men learn more about the prevalence of male pelvic floor dysfunction. Pelvic floor PT can help, so remember: Your struggles might not be in your head.

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

^{Image credit: iStock}