Better to act young than to look young

[email protected] (New York Times )
October 7, 2013

Young_than_to_look_youngJane E Brody, Oct 7: At a party I recently attended, a woman in her 60s proudly announced that her periodic facial treatments “have made me look 10 years younger.” A man of similar vintage said he was considering “facial tucks” to raise his sagging jowls.

Some days it seems everyone I meet is afraid of getting old - or at least of looking as old as they are. Occasionally, I see women who have had so many face lifts that they can barely move their lips when they talk, let alone smile.

Business is booming in the anti-aging market. Plastic surgeons who specialise in lifts, tucks and fillers barely noticed the recent recession. Cosmetics with anti-ageing properties fly off the shelf, and new concoctions appear almost weekly.

I admit to supporting the multi-billion dollar skin care industry with my long use of night creams, as well as a slew of daytime lotions that purport to “smooth out” aging skin while protecting it with sunscreen. I also colour my hair, which in its natural state is now about 80 per cent gray.

But I draw the line at injectable fillers and muscle relaxants, face lifts and tummy tucks. I’ll do everything I can to stay out of an operating room. My anti-aging measures, if and when they are needed, will be limited to cataract removal, a hearing aid and glasses for driving.

I wear clothes that suit my personality and activities, not necessarily my age. Shorts and tank tops anchor my summer wardrobe. And I wear colours near my face that are right for my skin tone, avoiding those (like yellow) that are unflattering. Still, cosmetic fixes go only so far to counter the effects of time.

True youthfulness - or, I should say, appearing younger than your age - is much more than skin-deep. Research has shown that youthfulness must come from within.

In one study, a team at Case Western Reserve University in Cleveland analyzed the facial photographs of 186 pairs of identical twins, determining which sibling looked older and why. Factors that contributed to looking older included smoking, sun exposure, stress and depression (or the use of antidepressants), the researchers reported. Other studies have linked depression to higher levels of inflammatory markers and oxidative stress, which can accelerate aging.

The team also found that among those younger than 40, a woman with a heavier body looked older than her leaner twin, but in subjects older than 40, a higher body mass index was associated with a more youthful appearance. Fat fills out wrinkles and makes the face - and presumably other parts of the body - look younger. But there’s a limit to its benefits: obesity is associated with more rapid biological aging.

Another study published last year by researchers at Brigham and Women’s Hospital in Boston found a biological link between stress and accelerated aging. Dr. Olivia I. Okereke and colleagues examined the chromosomes of 5,243 women ages 42 to 69 participating in the Nurses’ Health Study. They found that women with phobic anxiety - irrational fears of anything from social situations to spiders - had shorter telomeres on their chromosomes.

Telomeres are DNA-protein complexes on the ends of chromosomes that are considered biological markers of aging. Shortened telomeres are thought to underlie many of the adverse health effects of aging, and perhaps even to contribute to looking older than one’s years.

Lifestyle changes

A pilot study published online by The Lancet Oncology last month underscored the benefits of limiting stress. Dr. Dean Ornish and colleagues at the Preventive Medicine Research Institute and the University of California, San Francisco, tested the effects of lifestyle changes on the length of telomeres.

Ten men were asked to make changes that included adopting a whole-foods plant-based diet, moderate exercise, stress management techniques (like yoga and meditation), and seeking greater intimacy and social support. After five years, changes in the length of their telomeres were compared with those among 25 men who were not asked to make such changes.

In the men who made lifestyle changes, telomere length increased by an average of 10 per cent; the more changes the men made, the greater the increase in length. But telomere length decreased in the control group by an average of 3 per cent.

Still, youthfulness is not just a question of biology. People are perceived to be younger than their years if they smile and laugh a lot (be proud of those laugh lines!) and are generally cheerful and upbeat, the kind of people who smile at strangers and wish them a good day.

I occasionally pass an older couple who walk together three times a week. With their dour expressions and grudging acknowledgment of my “good morning,” I thought they were in their mid-90s. So one day I asked, only to learn that she was 80 and he was 83.

It also helps to pursue personal and professional activities you enjoy as you get older. My role models include the actress Estelle Parsons, who continues to perform on stage (and can do yoga headstands) at 85, and Dame Judi Dench, 78, who stars in movies despite having to learn her lines orally because macular degeneration has caused her vision to deteriorate.

My dear friend Margaret Shryer, 86, starred in a documentary about age discrimination and performed a one-woman show she wrote at a theater festival in Minneapolis this summer. Another friend, the award-winning broadcaster Lucy Jarvis, cane in hand at 96, still travels abroad to make television documentaries.

To my mind, it is far better to act young than to look young. Of course, it helps to be physically fit.

Too often, those who spend liberally to counter the superficial signs of age neglect their bodies below the neck and become physically old before their time. Muscle tissue inevitably declines with age, but much can be done to minimize and even reverse a loss of strength.

Try using free weights or resistance machines. If these don’t appeal, lift cans of soup (better for lifting than consuming) and continue to do chores that require strength, like digging in the garden or carrying groceries.

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Agencies
March 11,2020

With the sales of chicken and mutton going down due to the coronavirus scare, it is the humble 'Kathal' (jackfruit) is emerging as an acceptable alternative.

'Kathal' is now selling at ₹120 per kilogram -- an increase of more than 120 per cent over the normal ₹50 per kilogram.

The jackfruit, in fact, is now priced higher than chicken which is selling at ₹80 per kilogram due to poor demand.

"It is better having a 'Kathal' biryani instead of a mutton biryani. It tastes reasonably good. The only problem is that 'Kathal' has been sold out in the vegetable market and is difficult to find," said Purnima Srivastava whose family savours non-vegetarian food on a regular basis.

The corona scare has hit poultry business so hard and the Poultry Farm Association recently organized a Chicken Mela in Gorakhpur to dispel the misconception that birds are carriers of the deadly virus.

"In fact, we gave away plateful of chicken dishes for Rs 30 to encourage people to savour the delicacies. We cooked one thousand kilograms of chicken for the Mela and the entire stock was sold out," said Vineet Singh, head of the Poultry Farm Association.

However, the Mela did not do much to dispel the fears about chicken, mutton or fish consumption amid the virus outbreak.

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Agencies
June 17,2020

Leading physicians are celebrating a small dose of good news that arrived Tuesday about dexamethasone, a cheap and widely used steroid shown to be able to save lives among COVID-19 patients, but also cautioning against releasing study results by press release during a global health emergency, like in the case of the latest dexamethasone study by University of Oxford.

"It will be great news if dexamethasone, a cheap steroid, really does cut deaths by one-third in ventilated patients with COVID19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper", Atul Gawande, surgeon and CEO of Haven Healthcare, tweeted.

"Bottom line is, good news," Dr. Fauci, America's foremost infectious diseases expert told a US newswire on Tuesday, soon after the dexamethasone results were announced in the UK.

Fauci, who has long championed the therapeutics-first view said that dexamethasone is a "significant improvement" in the available therapeutic options currently available.

On Medical Twitter and Facebook, doctors broadly agree that dexamethasone use aligns well with the way COVID19 attacks the body's immune system. Fauci said the results in the Oxford study make "perfect sense" in that context.

"We should see the number of people who actually survive go up, if the study holds up," virologist and epidemiologist Dr. Joseph Fair told a television network.

Global coronavirus cases crossed 8 million on Tuesday. In the US, Texas and Florida are facing a new wave of cases after lifting lockdown orders earlier than medical experts recommended. Amidst the relentless graph upwards, the dexamethasone study results injected hope for better survival rates among those most seriously ill.

World Health Organization chief scientist Soumya Swaminathan welcomed the results from the randomised control trial.

Dr Eugene Gu, Founder and CEO of CoolQuit tweeted that he is "genuinely impressed" with the UK dexamethasone trial. This may be a "game changer", he wrote.

"There's no conflict of interest as dexamethasone is a generic steroid. The mechanism of action makes sense because steroids can reduce cytokine storms and overactive immune systems that makes COVID-19 so deadly. The number needed to treat is 8 ventilated patients which is great."

The Oxford study found that dexamethasone reduced deaths by 35 percent in patients who needed treatment with breathing machines and by 20 percent in those only needing supplemental oxygen. Dexamethasone was one of 5 drugs studied in a large clinical trial in the United Kingdom named RECOVERY, short for Randomised Evaluation of COVID-19 Therapy.

Peter Horby, chief investigator of the University of Oxford clinical trial, said dexamethasone is the first drug to be shown to improve survival in COVID-19. Details of the study have not been released. The trial organisers said they made their announcement via a news release because of "the public health importance of these results." According to Horby's public comments, there was a lot of initial resistance to studying steroids.

During the study, 2,104 patients were randomly selected to be given 6 milligrams of dexamethasone once a day (either by mouth or by intravenous injection) for 10 days. That group was compared with 4,321 patients who received the usual care alone.

Researchers estimated that dexamethasone would prevent one death for every eight patients treated while on ventilators and one for every 25 patients on extra oxygen alone.

UK experts have called the study results a breakthrough in the fight against the virus. The researchers have promised they would publish the results soon.

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International New York Times
July 7,2020

The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests.

This risk is highest in crowded indoor spaces with poor ventilation, and may help explain superspreading events reported in meatpacking plants, churches and restaurants.

It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech.

Follow latest updates on the Covid-19 pandemic here

Aerosols are released even when a person without symptoms exhales, talks or sings, according to Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.

What is clear, they said, is that people should consider minimizing time indoors with people outside their families. Schools, nursing homes and businesses should consider adding powerful new air filters and ultraviolet lights that can kill airborne viruses.

What does it mean for a virus to be airborne?

For a virus to be airborne means that it can be carried through the air in a viable form. For most pathogens, this is a yes-no scenario. HIV, too delicate to survive outside the body, is not airborne. Measles is airborne, and dangerously so: It can survive in the air for up to two hours.

For the coronavirus, the definition has been more complicated. Experts agree that the virus does not travel long distances or remain viable outdoors. But evidence suggests it can traverse the length of a room and, in one set of experimental conditions, remain viable for perhaps three hours.

How are aerosols different from droplets?

Aerosols are droplets, droplets are aerosols — they do not differ except in size. Scientists sometimes refer to droplets fewer than 5 microns in diameter as aerosols. (By comparison, a red blood cell is about 5 microns in diameter; a human hair is about 50 microns wide.)

From the start of the pandemic, the WHO and other public health organizations have focused on the virus’s ability to spread through large droplets that are expelled when a symptomatic person coughs or sneezes.

These droplets are heavy, relatively speaking, and fall quickly to the floor or onto a surface that others might touch. This is why public health agencies have recommended maintaining a distance of at least 6 feet from others, and frequent hand washing.

But some experts have said for months that infected people also are releasing aerosols when they cough and sneeze. More important, they expel aerosols even when they breathe, talk or sing, especially with some exertion.

Scientists know now that people can spread the virus even in the absence of symptoms — without coughing or sneezing — and aerosols might explain that phenomenon.

Because aerosols are smaller, they contain much less virus than droplets do. But because they are lighter, they can linger in the air for hours, especially in the absence of fresh air. In a crowded indoor space, a single infected person can release enough aerosolized virus over time to infect many people, perhaps seeding a superspreader event.

For droplets to be responsible for that kind of spread, a single person would have to be within a few feet of all the other people, or to have contaminated an object that everyone else touched. All that seems unlikely to many experts: “I have to do too many mental gymnastics to explain those other routes of transmission compared to aerosol transmission, which is much simpler,” Marr said.

Can I stop worrying about physical distancing and washing my hands?

Physical distancing is still very important. The closer you are to an infected person, the more aerosols and droplets you may be exposed to. Washing your hands often is still a good idea.

What’s new is that those two things may not be enough. “We should be placing as much emphasis on masks and ventilation as we do with hand washing,” Marr said. “As far as we can tell, this is equally important, if not more important.”

Should I begin wearing a hospital-grade mask indoors? And how long is too long to stay indoors?

Health care workers may all need to wear N95 masks, which filter out most aerosols. At the moment, they are advised to do so only when engaged in certain medical procedures that are thought to produce aerosols.

For the rest of us, cloth face masks will still greatly reduce risk, as long as most people wear them. At home, when you’re with your own family or with roommates you know to be careful, masks are still not necessary. But it is a good idea to wear them in other indoor spaces, experts said.

As for how long is safe, that is frustratingly tough to answer. A lot depends on whether the room is too crowded to allow for a safe distance from others and whether there is fresh air circulating through the room.

What does airborne transmission mean for reopening schools and colleges?

This is a matter of intense debate. Many schools are poorly ventilated and are too poorly funded to invest in new filtration systems. “There is a huge vulnerability to infection transmission via aerosols in schools,” said Don Milton, an aerosol expert at the University of Maryland.

Most children younger than 12 seem to have only mild symptoms, if any, so elementary schools may get by. “So far, we don’t have evidence that elementary schools will be a problem, but the upper grades, I think, would be more likely to be a problem,” Milton said.

College dorms and classrooms are also cause for concern.

Milton said the government should think of long-term solutions for these problems. Having public schools closed “clogs up the whole economy, and it’s a major vulnerability,” he said.

“Until we understand how this is part of our national defense, and fund it appropriately, we’re going to remain extremely vulnerable to these kinds of biological threats.”

What are some things I can do to minimize the risks?

Do as much as you can outdoors. Despite the many photos of people at beaches, even a somewhat crowded beach, especially on a breezy day, is likely to be safer than a pub or an indoor restaurant with recycled air.

But even outdoors, wear a mask if you are likely to be close to others for an extended period.

When indoors, one simple thing people can do is to “open their windows and doors whenever possible,” Marr said. You can also upgrade the filters in your home air-conditioning systems, or adjust the settings to use more outdoor air rather than recirculated air.

Public buildings and businesses may want to invest in air purifiers and ultraviolet lights that can kill the virus. Despite their reputation, elevators may not be a big risk, Milton said, compared with public bathrooms or offices with stagnant air where you may spend a long time.

If none of those things are possible, try to minimize the time you spend in an indoor space, especially without a mask. The longer you spend inside, the greater the dose of virus you might inhale.

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