Health Check Magazine: The Art of Ageing Well Issue 26 by Blooms The Chemist

hea th magazine SPECIAL EDITION 2022

The Art of Ageing Well FINDING YOUR RIGHT FIT: HOW PERSONALISED HEALTHCARE IS CHANGING OUR LIVES FOR THE BETTER BUILDING RESILIENCE MOVEMENT AS MEDICINE WHAT IS ANDROPAUSE? EATING HABITS TO ADD YEARS TO YOUR LIFE

CONTENTS H E A LT H C H E C K M A G A Z I N E | T H E A R T O F A G E I N G W E L L When we were in the first flush of youth, we used to look at those big milestone birthdays with a sense of detachment and, perhaps, a rather dismissive attitude. The idea of turning 50 seemed so far away; ageing was something that happened to other people. Yet as the years flew by, and the big birthdays drew nearer, the idea of being 50 and beyond suddenly didn’t seem so finite as it once did. Rather, entering our golden years seems filled with promise

and potential, hope and optimism. We hope you enjoy this special edition of Health Check Magazine, crafted and curated to reflect a shift in thinking, to reframing our view of advancing years to reflect the opportunities that await us. Because with age comes wisdom, and, hopefully, a stronger sense of self. A desire to live with purpose, to prioritise our own desires, and to age well, whatever that looks like for us individually.

BUILDING COURAGE AND RESILIENCE AFTER LOCKDOWN

WHA T CAUSES LEG CRAMPS?

HOW PERSONALISED HEALTHCARE IS CHANGING OUR LIVES FOR THE BETTER

COMPOUNDING IN PHARMACY

FOUR WAYS TO CONQUER LONELINESS

BEYOND GOUT

MANAGING MILD JOINT PAIN

TEATIME RITUALS THAT CONNECT US

DITCHING THE BAGGAGE

WHAT'S ON YOUR PLATE? EATING HABITS TO ADD YEARS TO YOUR LIFE

NATURAL MEDICINES MADE EASY

UDDERLY GOOD

ASK A PHARMACIST: WHAT IS OBSTRUCTIVE SLEEP APNOEA AND WHY IS EARLY TREATMENT IMPORTANT?

THE BENEFITS OF DEEP SLEEP

WHEN WAS YOUR LAST BLOOMS THE CHEMIST HEALTH CHECK?

MOVEMENT AS MEDICINE

SIX HEART-FRIENDLY EXERCISES TO GET YOU MOVING

WHAT IS ANDROPAUSE OR ‘MALE MENOPAUSE’?

STOP SNORING

OUR COMMITMENT TO PEOPLE AND PLANET

Blooms The Chemist's Health Check Magazine is produced entirely in-house. Disclaimer: All material included in Health Check Magazine is provided as general information and is not intended, nor may it be construed, as medical advice or instruction. Information and opinions expressed are believed to be correct and accurate to the best knowledge and judgement of the authors. Readers should consult their appropriately qualified health care professional prior to taking any action or inaction in relation to the content contained herein.

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“THE RIGHT MINDSET CAN BUFFER MOST CHALLENGES”

Building Courage and Resilience After Lockdown commencement,” Buttifant recounts. “However, on the final phase of the climb it began to snow and some of the participants were showing signs of apprehensiveness and hesitation.” “For a moment, I created my own personal narrative that things could get bad. I quickly self-monitored and reframed my narrative and went into a process-driven approach.” The spirit of sport and adventure is built into David Buttifant’s DNA. The former Aussie Rules footballer turned sports scientist has worked with AFL Premiership Teams, Olympic Gold Medallists, and trekked and led Himalayan Expeditions. However, his greatest passion is helping people overcome hurdles in times of adversity – not just physically, but also emotionally and spiritually, to fulfill their maximum potential through his Resilience Builders Program. “We’re all going to have setbacks and challenges in life. That’s inevitable,” says Buttifant over a video interview. “But you can change the outcome dramatically with the right mindset and energy.” “In that moment on the mountain, I knew I had to narrow my focus onto the correct tasks and reassure the hiking group to do the same. Everyone successfully completed the climb in the challenging conditions. It reminds us that when we are exposed to challenging times, we can easily fall into a negative narrative which can compromise our ability to perform well,” he says. From mountain tops to everyday life

Former Aussie Rules footballer turned resilience coach David Buttifant, 58, chats to Health Check Magazine about his near brush with disaster while hiking one of Australia’s harshest natural wonders, his daily mantra for ageing well, and why a healthy dose of discomfort can breed enrichment and gratitude. Surrounded by stunning alpine wilderness and a jagged landscape, David Buttifant and his fellow trekkers – a squad of thrill-seeking teenagers and their parents – were preparing for the final phase of their challenging ascent of Cradle Mountain when the temperature plummeted and snow started to fall. Home to one of Australia’s most popular and awe-inspiring tracks, Cradle Mountain-Lake St Clair National Park in Tasmania’s Wilderness World Heritage Area draws hikers from all around the world, with the allure of snow-capped mountains, jaw-dropping glaciers and stunning lakes. For Buttifant, the natural wonder also provided the idyllic backdrop to challenge and connect with this group of adventurers who were taking part in his outdoor resilience program. However, the region is also known for its unforgiving climate and physically demanding terrain; and is not for the faint-hearted, with even seasoned trekkers being caught off guard by unpredictable weather patterns and slippery and steep paths. “We embarked on the ascent of Cradle Mountain early that morning in 2021. A thorough plan and briefing was provided pre-

For Buttifant, who played for Richmond in the Victorian Football League in 1986 and 1987, and has a PhD in sports physiology, some of life’s greatest challenges stem from difficulties that people face in everyday life. Health problems, financial woes, and relationship worries, not to mention recent global events, can all chip away at our ability to stay optimistic and our capacity to bounce back. Building a healthy and resilient mindset is essential to thriving in these challenging times, Buttifant says, and the key is to prepare for them by working on our inner health every day. “It’s all about establishing routines and rituals to support your body and mind. Like training a muscle in your body, you need to do the work to see results,” adds Buttifant, who now works closely with people from all walks of life from teens to CEOs, and even the Victoria Police, to deliver his resilience framework. “At times I don’t necessarily like doing some of my habits, but I know the outcome will be positive for me. If we’re prepared to expose ourselves to a little bit of discomfort, have a vision, and build up toward a goal then we can address any challenge or adversity when the time comes.”

Start your day with a dose of fresh air and sunshine Every morning, take five minutes to get fresh air, sunshine and to stretch, says Buttifant, to avoid falling into old habits such as checking your phone or eating breakfast in front of the TV. This will help fuel your ‘happy’ hormones and bring clarity to tackle the day ahead.

The toll of post-lockdown fatigue Buttifant says he has noticed a shift in the community’s motivation and energy levels since the COVID-19 lockdowns, with many individuals finding it hard to bounce back after months of uncertainty. “Some people picked up good habits during the lockdowns and were productive, especially in the beginning. But others adopted some maladaptive traits, such as watching too much TV or drinking excessive alcohol.” One in five people who drink alcohol upped their booze consumption by 20 per cent during the COVID restrictions, according to an Australian Institute of Health and Welfare (AIHW) report.1

Lacking motivation?

Try WOOP

The WOOP method2 (an acronym for Wish, Outcome, Obstacle, Plan) draws on the science of ‘mental contrasting’, which is the process of balancing wishful thinking with the reality of the challenge. The method was developed by New York University professor of psychology Gabriele Oettingen who noticed that daydreaming and wishful thinking alone without actionable steps can end up sabotaging your goals.

The report assessed people’s health behaviours after the country’s first lockdown in April and June 2020.

TRY THE WOOP METHOD AT HOME:

More than half of the survey participants reported spending more time on their phone or in front of the TV, and one in four people had increased their junk food intake, the 2021 AIHW report found.

Consider your Wish:

Micro-behaviours for big impact The good news is that the earlier you recognise the problem, the easier it is to get back on track. “The pandemic, the public health response, the negative news cycle, all of this was often out of our control. But we can control our behaviour and our response to adversity.” A negative internal narrative can compound the problem, Buttifant says. “Cortisol levels rise during stress, and this can have a negative effect on our emotions and physiology.” Practising mindfulness and meditation are practical ways to manage stress and anxiety. “I usually meditate in a cold pool, and I repeat these seven things to myself every day: ‘I’m loving, and lovable and compassionate, and kind and forgiving. I’m grateful. I’m enough’.”

Meditation not for you? Set an intention to focus on an activity that fits into your lifestyle and block out any external noise. This could be through regular walks, gardening, painting, or playing an instrument. Meditation may also be in the form of prayer. The resilience coach says that micro-behaviours, albeit small, will have a positive effect on our mindset if practised daily. “Drink a glass of water instead of a beer that day, be kind to yourself, and acknowledge that this action will lead to a positive outcome.” Switching off from technology can also help, he says. “Technology is wonderful in many ways, but we don’t necessarily need to be wired all the time. Some boredom is not necessarily a bad thing; it gives us a chance to practise stillness and connect more meaningfully with ourselves and others.” Eventually, these seemingly minute tasks will strengthen your emotional muscles and help you build up the courage to tackle even bigger tasks. “It doesn’t matter if you’re 55 or 75, we’re all capable of setting goals and reaching an outcome,” Buttifant says. “I’m a big advocate of the four pillars for health: the physical, social, emotional, and spiritual. It’s all about keeping to daily habits and rituals until they become effortless. I work on myself by eating well, sleeping eight hours each night, moving every day, practising mindfulness, and connecting with loved ones.” He cites his family – his partner and young adult children – as his biggest motivators, with his daughter and son having joined him on his outdoor resilience programs. As for what’s next for the adventure addict? It seems a new challenge is never far away. “I’d like to explore the Patagonia region in South America, and we are organising another group to the Himalaya region this October.” 1 The first year of COVID-19 in Australia: https://www.aihw.gov.au/reports/burden-of-disease/the-first-year-of-covid19-in-australia/summary

The WOOP method: woopmylife.org

“Keep up with my daughter and grandkids at the upcoming 10km Fun Run.” OR “Start my own side business before I retire.”

Visualise the Outcome: “I’ll feel more connected with my family, and vice versa.” OR “It will give me a sense of accomplishment and a new purpose in life.”

Identify the Obstacle: “I’m not fit enough; I haven’t ran for longer than 10 minutes in months.” OR “I keep putting off the new project by watching TV or checking Facebook.”

Make a Plan to overcome those challenges: “If I feel like stopping after a 10-minute walk (obstacle), then I will pick up the pace on the way home or add 10 star jumps for an extra five minutes (action to overcome the challenge).” OR “If I feel like opening the Facebook app on my phone, I will jump onto business.gov.au to start my marketing plan instead.”

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Wha t Causes Leg Cramps? MOST OF US HAVE EXPERIENCED AT LEAST ONCE THE SUDDEN AGONY OF WAKING IN THE MIDDLE OF NIGHT WITH AN EXCRUCIATING LEG CRAMP. MOSTLY OCCURRING AT NIGHT, LEG CRAMPS ARE CHARACTERISED BY SUDDEN PAINFUL, INVOLUNTARY CONTRACTIONS IN THE MUSCLE, AND CAN LAST UP TO A FEW MINUTES. It’s believed that some medications or lower levels of certain minerals may make you more susceptible to leg cramps. Some people may also find they suffer from chronic leg cramps and it’s unclear of the cause or cure. CRAMPEZE and CRAMPEZE FORTE are multicombination product vs. magnesium alone for cramp relief. Both contain Viburnum Opulus (Cramp Bark), an antispasmodic traditionally used in Western herbal medicine to help relieve muscle cramps, mild muscle spasms and twitches. Crampeze contains Ginkgo Biloba to support blood circulation to the peripheral areas of the body (legs, hands and feet) and magnesium for magnesium supplementation to support energy production and maintain muscle function. Crampeze Forte also contains nicotinamide, feverfew extract, vitamin B5 and magnesium for magnesium supplementation to maintain healthy immune system functions and support healthy neuromuscular system, whilst maintaining muscle function and supporting the nervous system function. ALWAYS READ THE LABEL AND FOLLOW THE DIRECTIONS FOR USE. H E A LT H C H E C K M A G A Z I N E | A G E I N G W E L L 2 0 2 2

FINDING YOUR RIGHT FIT:

How Personalised Healthcare is Changing Our Lives for the Better WHAT IS PERSONALISED HEALTH AND MEDICINE, AND HOW CAN IT HELP RESHAPE OUR VIEW OF HEALTHY LIVING IN 2022 AND BEYOND? WE EXPLORE THE NEW FRONTIER OF HEALTHCARE. No two health experiences are the same, and each body, mind and personal experience is unique. So, what if our healthcare and medicine was made just for us too? This is the underlying principle of precision medicine, or personalised healthcare, an exciting movement in the medical world where prevention and treatment decisions are customised to the individual instead of the ‘one-size-fits-all’ or ‘trial and error’ approaches. From blood tests and health checks (blood pressure, cholesterol), to analysing a person’s DNA, health professionals are increasingly turning to you – and your unique genetic makeup, environment, and personal history – to uncover the hidden clues to living your best and healthiest life. While the concept is not entirely new, ground-breaking technology

and medical research in genetics and digital tools are accelerating the progress of precision medicine and health at a rapid pace.

The role of genes Most health problems are caused by a combination of genes and our environment. As DNA sequencing becomes faster and more sophisticated, researchers are getting better at finding the best treatment for an individual based on their genes and the genetics of the disease. The science of nutrigenomics is at the forefront of gene research, encompassing multiple approaches aimed at understanding the effects of diet on health or disease development. This may include nutrigenetic studies investigating the relationship between genetic variants and diet in modulating cardiovascular and other risk.

exposure to environmental toxins, and excessive exposure to the sun create inflammation at a cellular level (where there’s no visible sign of inflammation.) This kind of inflammation can be responsible for many age-related diseases, such as Alzheimer’s, cancer, and heart disease. Eating a balanced diet, and doing regular exercise, is a great start to minimising inflammation. By doing so, you can help reduce the potential of disease and live a healthier fuller life.1 A blood test to measure C-Reactive Protein, a measure of inflammation, can reveal the level in your body.

NUTRITION AND GENETICS Both nutrients (deficiencies and overloads) and genes play a key role in determining health. The complex interactions among genes, diet, and downstream networks are of interest to healthcare practitioners, when defining an integrated and personalised approach to a patient’s health protocol.

From treating disease to preventing it Scientists who hold high hopes for precision medicine believe that not only will it be revolutionary in creating tailored treatments and approaches to healthcare but also in promoting good health and preventing diseases before they can manifest. This could spare many individuals and their families the pain and suffering of severe illness. It also means doctors can focus on improving quality of life, sustaining good health and wellbeing, and helping us to live longer. One way in which researchers are doing this is through the study of phenomics. While each of us has a genetic profile, we also have a phenomic profile or a ‘biological fingerprint’. Soon, these biological fingerprints may help health professionals work out why certain diets work for some people but not for others. Or why some cancer patients respond well to immunosuppressive treatments, for example, while others do not.

The ticking clock As we age, changes take place in our body systems. Cellular processes slow down, and our organs and tissues perform less efficiently. The following are 10 key systems in the body that decline during ageing: ● ● ● ● ●

the Endocrine System the Metabolic System the Gastrointestinal System the Nervous System the Muscular System

● ● ● ● ●

the Immune System the Cardiovascular System the Reproductive System Brain Function the Sensory System

The natural ageing process impacts our health in several ways, accelerated by exposure to lifestyle stressors, pollution, and other endogenous (internal) and exogenous (external) influences. The good news is that we can act now to reverse or slow down some of these processes thanks to advances in personalised healthcare. Understanding these influences and working with your Doctor and Pharmacist, using personalised medicine, are key to supporting a healthy and vital life for many years.

Personalised care in action Inflammation - the silent killer

Hormones and ageing Levels of key hormones – oestrogen, progesterone, testosterone, dehydroepiandrosterone (DHEA), thyroid, and human growth hormone (HGH) – all drop as we start to age.2 Increasing one or more of these naturally occurring biochemicals may improve health and slow the ageing process. However, doing so requires the careful supervision of a group of specialists including an integrative medicine GP and a Pharmacist. As you modify one hormone, you affect the others as they are all interrelated. Similarly, certain foods, combinations and quantities can be used to help restore hormonal balance. Antioxidant power Antioxidants and vitamins A, C and E help support the body’s defence system and help to reduce free radical damage which is caused by the natural ageing process, stress, sun, and pollution.3 A good multivitamin, or topical application that contains antioxidantrich vitamins, as well as minerals, may be recommended to combat free radical activity. Zinc, iron, and other essential minerals also play a key role in supporting overall wellness. Your healthcare team can advise of any vitamin or mineral deficiencies through a simple blood test. Lifestyle modification Our lifestyle – what we eat, drink, and expose ourselves to can influence how quickly or slowly we age. Stress increases the production of the hormone cortisol, and this can directly affect the ageing process. Not only does stress and the way we react to it impact hormones and skin ageing, but it can also make us gain body fat, lose muscle mass, and affect memory. Additional fats such as sugary and fried foods, alcohol, and smoking, which some people turn to when stressed, causes cortisol and insulin levels to rise, accelerating the ageing process.4 Personalised health checks to assess your risk of lifestyle-related illnesses are simple; chat to your Blooms The Chemist Pharmacist to book your essential health checks today or book online at bloomsthechemist.com.au/booking.

Finding a Practitioner Integrative or Lifestyle Medicine practitioners who practice personalised medicine are available throughout Australia. As a starting point, ask your Pharmacist at your local Blooms The Chemist for a Health Check to help get you on the right track and then to recommend you to an Integrative GP if you require. BLOOMS THE CHEMIST HEALTH CHECKS

Although inflammation is blamed for many chronic diseases, and ageing, we don’t always know what causes it. There are blood tests that measure pro-inflammatory cells, called cytokines, that give you some idea of the presence of inflammation in your body. Eating certain foods, not getting enough sleep, lack of exercise,

● ● ● ●

Blood pressure evaluation Diabetes monitoring Iron testing Stroke risk assessment

● ● ●

Cholesterol screening Healthy mind check up Sleep apnoea testing

Chronic inflammation in the etiology of disease across the lifespan: https://doi.org/10.1038/s41591-019-0675-0 Thematic review on ageing and geriatric medicine: https://www.mayoclinicproceedings.org/issue/S0025-6196(21)X0003-1 3 Effects of antioxidants on immune system ageing: Eur J Clin Nutr 56, S5–S8 (2002). 4 Healthy ageing over 50: https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/basics/healthy-aging-over-50/hlv-20049407 1 2

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MEDICINE MADE FOR YOU:

Compounding in Pharmacy PERSONALISED MEDICINE IS AT THE FOREFRONT OF HEALTHCARE WITH COMPOUNDED MEDICINES DEVELOPED SPECIFICALLY FOR EACH INDIVIDUAL PATIENT IN THE EXACT STRENGTH AND DOSAGE FORM PRESCRIBED BY YOUR DOCTOR. THIS ALLOWS THE COMPOUNDING PHARMACIST TO WORK WITH THE PATIENT AND THE DOCTOR TO CUSTOMISE A MEDICATION TO YOUR SPECIFIC NEEDS.

Why do we need compounding? “Compounding is essentially the practice of making a medicine from scratch,” says Shaheed Sahu Khan, who specialises in compounding at his Blooms The Chemist Karabar store, which services the ACT-NSW border region of Queanbeyan. Pharmaceutical compounding is one of the pillars of personalised medicine as a bespoke approach to supporting hormone and other healthcare, and it has been shown to deliver a precise result. Bioidentical hormone replacement therapy, for example, has been shown to support patient wellbeing during menopause or andropause to maintain full and healthy lives regardless of age.1 Compounding may also be indicated when a ready-made product is not available, or if the patient is not able to take that commercially available option because the dosage or strength is not suitable for that individual. “It’s all about tailoring medicine for the individual,” adds Mr Sahu Khan. “The practice is not new but is growing in popularity as patients seek to support vitality into later years. It has also seen an increase based on the increase in allergies and intolerances that people may have in modern society.”

Common compounding requests amongst over 55s Hormone creams and oral hormone capsules Oestrogen, testosterone, pregnenolone, progesterone and other hormones may be prescribed by a doctor for a variety of reasons including menopausal, andropausal, or thyroid symptoms for example, delivering a bespoke result. Sometimes a person’s GP may determine that a ready-made option is no longer working as expected or the existing dose is not suitable.

Melatonin capsules Melatonin is an important hormone that regulates sleep and may be prescribed in capsule, drop, or liquid form for patients suffering sleep disorders such as insomnia. Vitamin D As we age, we’re more prone to osteoporosis and vitamin D deficiency. A higher-strength vitamin D supplement may be prescribed for a short period to boost vitamin D levels quickly, or to help patients who are unable to take medicines every day with a weekly option. Numbing creams Non-prescription products such as numbing creams are also a popular compounding product. One example is specially formulated topical creams that can be used for common cosmetic procedures such as eyebrow tattooing.

What can patients expect? Working in partnership with the GP, Blooms The Chemist Compounding Pharmacists provide personalised care from the moment a patient walks into the store. Patients will meet with the Pharmacist to discuss their medicine needs and participate in a personalised risk assessment questionnaire to determine their previous medical history, and to discuss any allergies, intolerances, and medications they may be currently taking. The Compounding Pharmacist will explain the medication’s use, side effects, dosage, and make sure it’s suitable for the individual. They will then prepare the product in a specially designed lab in-store, usually as an overnight or 24-hour service.

The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? https://pubmed.ncbi.nlm.nih.gov/19179815/

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Udderly Good WE KNOW THAT THE COOLER MONTHS CAN WREAK HAVOC ON OUR SKIN’S MOISTURE LEVELS, BUT DID YOU KNOW THAT AS WE AGE WE’RE ALSO MORE SUSCEPTIBLE TO DRIER SKIN AND ASSOCIATED SKIN CONDITIONS? A LOSS IN THE SKIN’S NATURAL ELASTICITY CAN AFFECT THE SKIN’S APPEARANCE AS WELL AS ITS ABILITY TO BOUNCE BACK. KEEP ON TOP OF YOUR SKIN’S CHANGING REQUIREMENTS BY INVESTING IN A GENTLE YET RICHLY HYDRATING MOISTURISER TO PRESERVE AND PROTECT YOUR ENTIRE BODY. MooGoo’s Natural Skin Milk Udder Cream is the original product that started it all. In 2005, MooGoo founder Craig Jones noticed that his mother was using a white paste, intended for use on cows, to help with her Psoriasis. The cream was formulated to help keep the skin on cow’s udders in good condition for milking. Although it seemed to be working well, the cream was thick and hard to apply. Since his mum didn’t particularly like being lathered in a thick cream made for cows, he took on the task of reformulating it and made up a lighter, non-greasy version. A lightweight, natural moisturiser to maintain skin health, that easily penetrates the skin with beneficial ingredients. It contains natural moisturising oils such as sweet almond and olive oil, combined with Milk Protein, which has been shown to increase skin elasticity by up to 20%. This cream is also used in a number of hospitals as a moisturising cream for dry and damaged skin following radiation treatment and chemotherapy. Udder Cream can be used on the face and body, for all ages and skin types.

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Movement as Medicine WITH CARDIOLOGIST DR ROSS WALKER

WITH A NUMBER OF RECENT HIGH-PROFILE DEATHS IN AUSTRALIA FROM HEART ATTACK, IT IS IMPORTANT TO FOCUS ON THE PREVENTION OF CARDIOVASCULAR DISEASES THROUGH EXERCISE AND OTHER HEALTHY HABITS. WE CHAT TO CARDIOLOGIST DR ROSS WALKER ABOUT THE POWERFUL BENEFITS OF REGULAR MOVEMENT, AND ON FINDING THAT EXERCISE ‘SWEET SPOT’ FOR THE BIGGEST GAINS. Next time you put off a power walk or skip the stairs, spare a thought for your hardworking, ever-beating heart muscle. Small yet mighty, the cardiac muscle is only found in the heart and is responsible for pumping blood around your entire body. Like other muscles in your body, such as the biceps or abdominals, the cardiac muscle needs regular training to keep it strong and functioning at its best. Exercise is a vital component of heart health and should be incorporated into your daily routine for life, Dr Walker says. “A regular exercise habit is the second-best drug in the world,” adding that happiness is the first. “Yet 50% of individuals do not exercise at all, which is appalling,” he says.

Why lifestyle matters Dr Walker says there is evidence that all modern diseases are connected to genetics. However, lifestyle modifications are incredibly powerful at preventing health problems including heart issues. “Your genes load the gun, but the environment pulls the trigger,” Dr Walker says. He points to the recent MORGEN study, which found that individuals who kept to the golden principles of a healthy lifestyle – that is, keeping fit, eating well, moderating alcohol consumption, and not smoking – experienced an 83% reduction in cardiovascular disease. Getting enough sleep further reduces a person’s risk of heart disease.1 A 2022 review of 16 previous studies found that musclestrengthening workouts, such as lifting small weights, can reduce mortality risk by 10-20%. The authors found that 30-60 minutes of muscle training per week also slashed a person’s cardiovascular, diabetes and cancer risks.2 Being physically active every day has even been shown to improve survival rates in people with coronary artery disease,3 proving that exercise is a powerful natural medicine for both prevention and cure.

What happens if you don’t move? The most common type of heart disease is connected to atherosclerosis, which is the progressive build-up of fat, inflammatory tissue, and calcium in the arteries. If this fatty plaque ruptures in the arteries, it may eventually lead to a heart attack. Without regular movement, the heart can be left vulnerable to atherosclerosis and other heart disease risk factors which can snowball over time. “In modern society, if you sit and eat too much, then fat accumulates and this sets you up for diabetes, fatty liver disease and gout,” says Dr Walker. That’s because of the insulin resistance gene, he adds, which gave our hunter-gatherer ancestors a survival advantage by storing fat around the belly until they could find more food. While not everyone is born with insulin resistance, anyone can develop it.

The exercise sweet spot Between three and five hours of moderate exercise per week, or 30-40 minutes every day, is the best dose for cardiovascular health. This includes two-thirds of aerobic exercise, and one-third strength training.

Dr Walker’s heart healthy exercise guide Aiming for at least 20 minutes of exercise every day is a great start. But working up to 30 minutes or slightly more of moderate physical activity each day is going to have the best effect on your heart health, Dr Walker says. “If you’re getting between three and five hours of moderate exercise, that’s without a doubt the sweet spot for optimal heart health.” He cautions that more is not necessarily better, especially for the over 50s. “Too much vigorous exercise can flog your arteries and put too much strain on the heart in some cases.” “The key takeaway is to move as much as you can; you don’t have to get the closest parking spot at the shopping centre. Once inside, take the stairs or walk up the escalator instead of standing still,” says Dr Walker.

Before you get started If you are at high risk for heart disease or starting any new exercise program have your checks first, Dr Walker advises. This means getting a Heart Health Check, which is free under Medicare and at bulk-billing GP clinics. In some cases, you may need to follow up with a coronary artery calcium score, which is a CT scan that measures how much calcium is in the walls of the heart’s arteries and estimates your heart attack risk.

This may include: aerobic activities such as brisk walking, swimming, dancing, or cycling outside or on a stationary bike.

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muscle-strengthening exercises to maintain your musculoskeletal fitness for healthier bones, muscle mass and reducing frailty in older age. Incorporate strength training into your routine two to three times per week. You can use small weights, resistance bands, or coils.

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incidental exercise – try to get up every 20 minutes and move around, especially if you have a sedentary job or lifestyle.

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Be proactive Regular heart health checks are important especially as we age, and before starting any new exercise program. Blood pressure monitoring, cholesterol checks, and stroke risk assessments are available now at your local Blooms The Chemist pharmacy.

Best type of exercise? “The best exercise is the one that you will continue for the rest of your life,” Dr Walker says.

Never too late, but don’t wait long A recent study in the journal Heart found that people who got huffing and puffing for 20 minutes every day at age 70 were more likely to stave off major heart disease by the time they reached their 80s.4

The MORGEN study: https://academic.oup.com/eurjpc/article/21/11/1367/5926038 Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: https://bjsm.bmj.com/content/early/2022/01/19/ bjsports-2021-105061 3 Cardiovascular effects and benefits of exercise: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172294/ 4 Physical activity in older people: https://heart.bmj.com/content/108/5/328 1 2

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Six Heart-Friendly Exercises to Get You Moving ACCREDITED EXERCISE PHYSIOLOGIST LAUREN SEXTON FROM EXERCISE & SPORTS SCIENCE AUSTRALIA (ESSA) SHARES HER HEART-FRIENDLY WORKOUTS YOU CAN EASILY DO AT THE GYM, IN YOUR HOME, OR AT YOUR LOCAL PARK.

What is a rep?

What is a set?

Repetitions are the number of times you complete a single exercise before taking a rest or a break.

Sets are the number of reps you do in a row between periods of rest.

STANDING HIP ABDUCTION POSITION 1

POSITION 2

Reps: 15-20 reps Sets: 2-3 sets Equipment needed: Wall or chair to hold onto Step-by-step Instructions: 1. Stand with your legs shoulder-width apart 2. Hold onto something sturdy for balance 3. Kick your leg out to the side of your body slowly 4. Ensure your hips stay level and your torso stays upright 5. Return to starting position 6. Repeat for 15-20 repetitions 7. Do the same on the other leg between sets

BAND ROW POSITION 1

POSITION 2

Reps: 12-15 reps Sets: 2-3 sets Equipment needed: Exercise band & pole Step-by-step Instructions: 1. Stand with your feet shoulder-width apart 2. Slowly pull the band towards your rib cage 3. As you pull, squeeze your shoulder blades together 4. Control the band as you straighten your arms 5. Return to the starting position 6. Repeat for 2-3 sets of 12-15 reps

SIT TO STAND POSITION 1

POSITION 2

Reps: 5-8 reps Sets: 3-4 sets Equipment needed: Chair or bench Step-by-step Instructions: 1. Sit with your feet shoulder-width apart and with your feet underneath the knees 2. Push the ground away from you as you stand tall 3. Control the descent as you sit back down 4. To make the exercise harder, tap your hips to the chair without a rest 5. Repeat for 3-4 sets of 5-8 reps

STEP UP POSITION 1

POSITION 2

Reps: 12-15 reps Sets: 2-3 sets each leg Equipment needed: Step Step-by-step Instructions: 1. Plant your right foot onto the stable step 2. Push the ground away from you as you step up 3. To make this exercise more difficult, don’t let your left leg touch the step as you move into a standing position 4. Slowly return your left foot to the ground 5. Repeat for 2-3 sets of 12-15 reps for each leg (swap between your right and left leg between sets)

WALL PUSH UP POSITION 1

POSITION 2

Reps: 12-15 reps Sets: 2-3 reps Equipment needed: Wall Step-by-step Instructions: 1. Place hands on a wall shoulder-width apart and at chest level. Feet should also be shoulder-width apart. Imagine your hands are like tree trunks planted on the wall. This will help to stabilise your shoulders 2. Start the exercise by bringing your body towards the wall by bending your elbows. Your elbows should be at a 45-degree angle compared to your shoulders. Don’t forget the tree trunk hands here! 3. Push yourself back up into the starting position without letting your hands move from the wall 4. Repeat this for 2-3 sets of 12-15 reps

SINGLE-LEG CALF RAISE POSITION 1

POSITION 2

Reps: 12-15 reps Sets: 2-3 sets Equipment needed: Wall Step-by-step Instructions: 1. Stand with your feet shoulder-width apart 2. Slowly rise onto the ball of one of your feet, keeping the weight evenly spread through your forefoot 3. As your heel lifts off the ground, it should take 3-5 seconds to get to the top of the raise 4. Lower your heel back down until it touches the ground 5. If this is too difficult to complete on one leg, use both legs to lift 6. Repeat for 2-3 sets of 12-15 reps H E A LT H C H E C K M A G A Z I N E | A G E I N G W E L L 2 0 2 2

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Beyond Gout: HOW CONTROLLING URIC ACID CAN HELP IMPROVE OUR METABOLIC HEALTH

URIC ACID HAS LONG BEEN ASSOCIATED WITH GOUT AND KIDNEY STONES, HOWEVER EMERGING RESEARCH SUGGESTS IT PLAYS A LARGER ROLE IN CHRONIC ILLNESSES SUCH AS HEART DISEASE, OBESITY, DIABETES, AND CHRONIC KIDNEY DISEASE.

Controlling uric acid Exercise, diet, and other healthy lifestyle habits are all important ways to keep our metabolic health in check and control uric acid levels, including: Limiting fructose: foods that are high in fructose sugar could lead to high levels of uric acid. Reduce your intake by cutting out or drastically reducing ultra-processed and packaged foods, and always check the nutrition label for added sugars. This includes limiting sugary drinks, including some fresh fruit juices, which may contain high concentrations of fructose.

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Drink plenty of water: this can help your kidneys flush out uric acid faster and more effectively.

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Watch your intake of purine-rich foods, especially beer: Drinking alcohol can put extra stress on the kidneys as they must first filter out the alcohol before getting rid of excess uric acid. This is made more difficult when drinking beer, which is high in purines.6

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What is uric acid?

Try tart cherry juice: cherry juice and concentrate can reduce the level of uric acid in the body and is a common remedy for people with gout flare-ups.7

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Uric acid is a natural waste product that is created when the body breaks down purines. Purines are found in some foods and drinks and are also produced in the body. Purine-rich foods include dried beans, peas, some meats (for example, organ meats, pork, and turkey), and beer. Usually, the kidneys filter uric acid and this passes in urine. But if there is an excess of uric acid in the body it can start to build up in the blood, and lead to health problems. Diet, genetics, being overweight, and stress can all lead to excess uric acid in the body.1

More than gout

Add vitamin C: a powerful antioxidant, vitamin C can also help to control uric acid levels. Fresh wholefoods such as red capsicum, leafy greens, and citrus fruits are packed with this essential nutrient. In addition, a 2021 meta-analysis of 16 studies found that oral vitamin C supplements can reduce uric acid levels in people over 65, and significantly reduce uric acid levels in 18- to 64-year-olds.8

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The case for quercetin: quercetin is a flavonoid and may lower uric acid levels; it is naturally found in grapes, berries, onions, kale, apple, cherries, and black tea, and is available in supplement form.

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While the link between high levels of uric acid and gout is well established, some health experts now believe that it is involved in a whole range of disorders that often occur together and are collectively known as metabolic syndrome, which affects more than 35% of Australian adults. This may include high blood pressure, obesity, and other chronic diseases.2 A 2016 research paper described uric acid as being increasingly “incriminated in a number of chronic disease states, including hypertension, metabolic syndrome, diabetes, non-alcoholic fatty liver disease, and chronic kidney disease.”3 Author of the 2022 released book Drop Acid, Dr David Perlmutter, argues that uncontrolled uric acid can affect virtually anyone, regardless of age or gender, and not only those individuals with existing chronic conditions such as high blood pressure.4 In fact, a 2020 study involving 420 participants found that elevated levels of uric acid are linked to metabolic syndrome in the general adult population – that is, among people who were not already diagnosed with diabetes or hypertension.5

Check your uric acid levels: talk to your doctor about testing for elevated uric acid levels and discussing ways to reduce your risk for metabolic disorders.

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How to reduce uric acid: https://www.healthline.com/health/how-to-reduce-uric-acid

Metabolic syndrome: https://www.betterhealth.vic.gov.au/health/ conditionsandtreatments/metabolic-syndrome 2

Uric acid in metabolic syndrome: https://pubmed.ncbi.nlm.nih.gov/26703429/

Controlling uric acid is the key to metabolic health: https://www.drperlmutter.com/ controlling-uric-acid-the-key-to-metabolic-health/ 4

5 Association between serum uric acid and metabolic syndrome: https://www.nature. com/articles/s41598-020-64884-7 6 Natural Ways to Reduce Uric Acid in the Body: https://www.healthline.com/health/ how-to-reduce-uric-acid

Cherry juice for gout: https://www.healthline.com/health/cherry-juice-for-gout

Association between Oral vitamin C supplementation and serum uric acid: https://www. sciencedirect.com/science/article/pii/S0965229921001023 8

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Teatime Rituals That Connect Us ORIGINATING IN CHINA AROUND 5,000 YEARS AGO, TEA IS NOW THE MOST POPULAR DRINK IN THE WORLD, AFTER WATER. MORE THAN A BEVERAGE, TEA RITUALS CONNECT US WITH EACH OTHER AND WITH CULTURE, COMMUNITY, AND LAND. TO MARK THIS YEAR’S UNITED NATIONS INTERNATIONAL TEA DAY (21 MAY), HEALTH CHECK MAGAZINE INVITED OUR READERS TO SHARE THEIR TEA TRADITION AND HOW IT CONNECTS THEM WITH FAMILY, FRIENDS, AND THEIR COMMUNITY.

Cha Qi: tea as the life force of all things Sun Beibei (Belle), Sydney, NSW In China, tea is more than a drink, it's part of the culture, which is not surprising as China is the birthplace of tea. There are ancient tea trees, hundreds of years old, some say over a thousand. Tea is treasured. Handmade, full of terroir, sometimes aged and savoured like a fine wine. It's a relaxing ritual to share with friends, but can also serve a more ceremonial purpose, like at weddings, where the bride and groom kneel and serve tea to their parents, showing respect to their elders. Buddhist monks drink tea to focus the mind during meditation. Young office workers enjoy it as a drinkable dessert, sucking up black tapioca pearls through a thick straw. And in business, tea is a currency, a thoughtful gift, to show taste and ‘give face’ (meaning to show or treat (someone) with respect, honour, and dignity). But for me, tea is a way to calmness, to slow down time, be in the moment, and feel the spirit of the tea, which we call ‘cha qi’. At first, it sharpens your mind, and warms your belly. But you can also get drunk on it, finding euphoria in the leaves.

Reconnecting with cultural roots through oolong tea Kym Cooper, Brisbane, QLD As a Taiwanese-born Australian adoptee, throwing myself down the rabbit hole of tea allowed me to build a bridge back to my cultural origins. For those who don’t know, Taiwan is famed for its production of oolong tea, quite possibly my favourite leaf tea across all the styles because it sits between a green and black tea. It can be crafted by the tea grower or producer to be anything along that diverse spectrum of taste and when made with skill and care has brilliant fragrance. The opportunity to enjoy drinking tea in a variety of ways makes tea a beverage I can enjoy with all my family, from my Mum through to my young children. In addition, I have started two tea businesses in Australia to weave tea ritual and culture into the lives of the modern tea drinker.

Tea with an alkaline twist Shefali Pall, Campbelltown, NSW I start my day with an alkalizer turmeric ginger chai (using alkaline water). It not only supports immunity but helps me with any inflammation hence I am able to start my day without any aches or pains. My twist to that is adding a bit of extra cracked pepper to it. My lovely mother-in-law loves this turmeric concoction for the numerous benefits and occasionally if I am not rushing through the morning, we will have a cuppa together. I make a traditional Indian masala chai (a blend of black tea, hot milk, and spices), which is boiled on the stove top, and my tip is to add extra ginger, cinnamon, dry fennel seeds, cardamom, and liquorice root for both digestion and prevention from colds and coughs. Usually, my favourite tea ritual is having a relaxing tea time with my family after dinner. It’s the perfect time to catch up on the day’s activities and share some love around the table.

Special blend connects daughter with mother across international border Dipika and Rehana, Canberra, ACT Growing up in Fiji, my mum (Rehana) entrusted me to make her special masala chai whenever we had visitors or on rainy days. I had learnt from her how to use fresh and authentic ingredients, such as strong black tea leaves, ginger, her special tea masala blend, milk, and sugar (honey works well too). These days, I still make them for myself, and my family and friends on cold winter nights in Canberra, or when someone is not feeling so well to give them that extra warmth and comfort. In the last couple of visits back home to Fiji, my mum has managed to convince a local Indian restaurant to pack some special masala for me to take back to Australia. This ingredient is not for sale and was only made available due to my mum’s long-standing relationship with the restaurant owners. Mum knows how much I appreciate a good masala chai and probably secretly loves that it’s one of the few traditions I still follow as an adult. It brings me so much joy, comfort and keeps me grounded.

Guests are always greeted with the aroma of Persian tea Maria Jalalat, Sydney, NSW Tea is a very social drink in Persian culture. My family loves to host lunch and dinner parties at our home and our guests are always served freshly brewed tea on their arrival. Persian tea is best made on the stove using aromatic black tea leaves. We like to brew our tea strong, and we drink it without milk. It is often served with sugar cubes, or a saffron-infused sugar stick, which you can swirl around or dissolve in the tea before taking a sip. I also love Persian tea at breakfast time, especially with a side of traditional flat bread topped with a dollop of my homemade quince jam.

Host your own tea party To celebrate International Tea Day (ITD), the Australian Tea Cultural Society is encouraging all Australians to host or attend an ITD Tea Party in their community. This could be as simple as tea and biscuits with a friend. Or you could arrange a community get-together for tea and treats. Make it a family occasion, or visit a friend you haven't seen in a while. It could also be a great opportunity for Australians from diverse backgrounds and countries where tea is an enormous part of their culture to share their tea customs with workmates or neighbours.

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UNDERSTANDING

MEANINGFUL MONITORING What is the purpose of Blood Glucose Monitoring? Blood glucose monitoring shows you the impacts of the foods you eat, exercise you do and how your medication can affect your glucose levels1. Structured blood glucose monitoring is essential to anyone with diabetes, and can help you: • Keep your blood glucose within a healthy range • Fine-tune your meals, medication and activities • Provide helpful information to your healthcare professionals, enabling meaningful discussions around your diabetes Keeping your blood glucose within your target can make a difference in how you feel throughout the day. Always ensure you consult with your healthcare professional to agree on an appropriate structured testing plan and target ranges tailored for you.

simple2 and accurate3,4 blood glucose monitoring. Other features include a large display and test strips with a wide dosing area for quick testing2. The Accu-Chek Guide Me meter offers seamless compatibility with the mySugr diabetes management app. Enjoy features including automatic transfer of blood glucose results, report sharing and blood glucose test reminders.

Start your meaningful monitoring journey with Accu-Chek Guide Me and mySugr. Visit your local Blooms the Chemist store to receive your FREE* Accu-Chek Guide Me meter kit when you purchase a box of Guide test strips**. Scan here to download mySugr for your smartphone.

What tools are available to help me monitor and understand my Blood Glucose results better? Blood glucose monitoring doesn’t have to get in the way of your day. The Accu-Chek Guide Me system is designed for www.accu-chek.com.au • Accu-Chek Enquiry Line :1800 251 816 *Australian NDSS registrants only, offer excludes current Accu-Chek Guide test strip users. **While stocks last. References: 1. Polonsky WH, et al. Diabetes Care 2011;34:262-7. 2. Harvey, Craig, et al. Usability Evaluation of a Blood Glucose Monitoring System With a Spill-Resistant Vial, Easier Strip Handling, and Connectivity to a Mobile App: Improvement of Patient Convenience and Satisfaction. Journal of Diabetes Science and Technology. 2016:1932296816658058. 3. Brazg RL, et al. J. Diabetes Sci Technol. Nov 2016. DOI:10.1177/1932296816652902. 4. Accu-Chek Guide Me System evaluation report. WARNING - KEEP BATTERIES OUT OF REACH OF CHILDREN. If you suspect your child has swallowed or inserted a battery, immediately call the 24-hour Poisons Information Centre on 13 11 26 for fast, expert advice. FOR PEOPLE WITH DIABETES. ALWAYS READ THE LABEL AND FOLLOW THE DIRECTIONS FOR USE. CONSULT YOUR HEALTHCARE PROFESSIONAL FOR ADVICE. Accu-Chek lancing devices are for single patient use only. The same device must not be used for multiple patients. ACCU-CHEK, ACCU-CHEK GUIDE ME and MYSUGR are trademarks of Roche. Apple and Google trademarks are the property of their respective owners. All other trademarks and product names are the property of the respective owners. ©2022 Roche Diabetes Care. Roche Diabetes Care Australia Pty Ltd, 2-4 Julius Avenue North Ryde NSW 2113 Australia. ABN 69 602 140 278. AU-1112. Date of preparation March 2022.

Ditching the Baggage: WHY IT’S OKAY TO SAY GOODBYE TO UNFULFILLING RELATIONSHIPS MOVING ON FROM AN UNFULFILLING FRIENDSHIP OR RELATIONSHIP DOESN’T HAVE TO BE A NEGATIVE EXPERIENCE. KNOW WHEN IT’S TIME TO PART WAYS WITH SOMEONE AND LEARN HOW TO DO SO WHILE KEEPING YOUR EMOTIONAL HEALTH IN CHECK.

Is there an art to ending relationships well? Breaking up with a partner, friend or family member is never fun. The first step is to recognise and acknowledge the negative influence a relationship has on you, and on the other person. Talking to the other person about how you’re feeling, as well as taking responsibility for the situation, can help address any issues while maintaining respect for both parties involved. If the relationship is beyond repair, or out of your control (say, for instance, the other person is dodging your calls or messages), it’s important to keep your mental health in check. Expect fluctuations in energy and mood as your body’s natural ‘defence’ mechanisms adjust to the stress of letting go. Take time for self-care and look after yourself – eat well, take the dog for a walk, avoid excessive drinking, and catch up with friends and family who bring you joy.

Not sure what to do with your post-break up energy? Here are some ideas. By the time we reach midlife, chances are we have created and lost many relationships along the way. While some friendships and relationships were strengthened during the pandemic, others left us feeling drained or unhappy. Meanwhile, some lost connections were a casualty of divorce, a recent house relocation, or a new job. It’s true that strong, lifelong relationships need constant work and attention. But if there are two or three people in your life who leave you feeling constantly drained or emotionally unwell it might be time to let go.

Fountains, not drains Our closest loved ones – be it friends, family members, or partners – should be our biggest cheerleaders. But these close connections can become toxic if they bring more harm than support. Focussing on the quality, not the number, of relationships in your life can make a world of difference to your physical and mental health. A large review of 148 studies found that those people who had stronger social relationships were 50% more likely to live longer.1 Meaningful relationships can also reduce a person’s risk of heart disease, dementia, and depression, research suggests.2 On the other hand, one study linked marital spats with signs of reduced immunity in couples.3 One theory for the health benefits of meaningful relationships, according to researchers and psychologists, is that caring for each other and having social support can release oxytocin – our body’s natural stress relief hormone. Another explanation is that stress-relieving relationships can also have knock-on health effects, including improving our gut health, immune system, and lowering inflammation.

Why letting go can be a gift By bidding farewell to toxic friendships or acquaintances you can focus on strengthening and building deeper connections with other people in your network. It can also free up your time for new social connections and introduce you to hobbies or interests; you may even finally get around to that ‘how to’ course in photography or learn to master social media.

Work on personal growth Get your daily dose of inspiration on resilience and happiness by signing up to e-newsletters such as the Daily Stoic (dailystoic.com) or The Marginalian (themarginalian.org). Be amazed with a good podcast Set a weekly date with yourself to learn and be entertained with podcasts such as ABC Radio’s Self Improvement Wednesday, Ageing Fearlessly with Karen Sander, or Unlocking Us with Brené Brown. Reconnect with your creative side Was your last relationship holding you back from a once-loved activity? Or perhaps you need to channel your unfulfilled energy through a creative outlet? Take an art or pottery class (try your local council), learn guitar, or join a yoga class. The main thing is to keep it fun and creative. Upskill or find a new career path Update your skills by signing up to a $30 course with Udemy.com on anything from photography to personal development; or discover a new industry through the Australian Government’s Skills and Training Incentive program, which helps people over 40 with the cost of training and re-skilling. For more information visit dese.gov.au/skills-andtraining-incentive. Counselling and support services If you’re in need of some extra support: • Relationships Australia offer counselling and support services in your state and territory - 1300 364 277. • beyondblue.org.au is a great repository of information and resources to support mental wellbeing. 1 Social relationships and mortality risk: a meta-analytic review: https://journals.plos.org/ plosmedicine/article?id=10.1371/journal.pmed.1000316 2 Strong relationships, strong health: https://www.betterhealth.vic.gov.au/health/ healthyliving/Strong-relationships-strong-health 3 Strengthen relationships for longer healthier life: https://www.health.harvard.edu/ healthbeat/strengthen-relationships-for-longer-healthier-life

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Ask a Pharmacist WHAT IS OBSTRUCTIVE SLEEP APNOEA AND WHY IS EARLY TREATMENT IMPORTANT? 24

by Craig Carson

Some people are more likely to experience sleep apnoea than others. This may include:

A SNORING PARTNER CAN BECOME A HUGE SOURCE OF FRUSTRATION AT BEDTIME, BUT COULD IT SIGNAL SOMETHING MORE SINISTER ABOUT YOUR LOVED ONE’S HEALTH? BLOOMS THE CHEMIST THE PINES PHARMACIST, CRAIG CARSON, EXPLAINS.

- people in middle age and older: as people get older their throat muscles may relax more during rest. - men: around one in four men older than 30 have some degree of sleep apnoea.7 - people who are overweight or obese - people who smoke and heavy drinkers - people born with a narrow throat or facial structure leading to narrowing

While a stuffy nose or drinking alcohol close to bedtime may trigger short-lived bouts of loud snuffling and spluttering as a person sleeps, regular snoring and poor sleep quality may be caused by a potentially serious condition known as sleep apnoea. Sleep apnoea is the most common sleep health problem in Australia and worldwide, but it is largely misunderstood and underdiagnosed. The sleep-related breathing disorder – which is also known as ‘obstructive sleep apnoea’ or OSA – is linked to chronic health conditions such as heart disease, poor memory, and can even increase a person’s risk of car accidents, if left untreated. The good news is that testing for common sleep problems is now quicker and more accessible than ever before. Thanks to newer technologies and a better understanding of healthy sleeping habits, restless nights can become a thing of the past.

What is sleep apnoea? Sleep apnoea occurs when a person’s upper airway is completely or partially obstructed numerous times as they sleep. Each pause in breathing is called an ‘apnoea’, and it can occur up to hundreds of times during the night and may last from 10 seconds, to minutes, or even longer.1 It is not uncommon for someone with OSA to snore loudly as the body gasps for oxygen, which may then trigger them to wake up and enter a tiring cycle of broken sleep.

What to do if you or your partner suspect sleep apnoea? The good news is that sleep apnoea is treatable. So, speak to your GP or Pharmacist about a referral for a sleep study or test to get an accurate diagnosis and rule out other conditions. Blooms The Chemist in-store sleep experts can guide you through a simple take-home sleep test called a polysomnogram. The machine will monitor your blood oxygen levels, brain activity, heart rate, and breathing. The results are uploaded from the testing device and emailed to a doctor who makes the diagnosis. In some cases, you may need to visit a sleep specialist for more tests. For people with mild OSA, lifestyle changes such as losing weight, trying different sleeping positions, and slashing your alcohol consumption can help manage the condition. Apart from lifestyle changes, the most effective and common treatment for sleep apnoea is with a CPAP device, or ‘nasal continuous positive airway pressure’ device. This machine uses a small, quiet pump to gently deliver air into the person’s airway to prevent the throat from collapsing. It is connected by a mask that is worn over the nose or mouth, or both, as the person sleeps. DID YOU KNOW? The CPAP device was invented by Australian scientist Professor Colin Sullivan and his University of Sydney colleagues in 1981, and became the world’s first successful, non-invasive treatment for obstructive sleep apnoea.8

Unfortunately, many people living with sleep apnoea are often unaware of their condition, with some passing off tell-tale signs as an annoyance rather than a serious health issue. In the long-term, however, poor quality sleep can lead to serious health complications, including weight gain, increased blood pressure, diabetes, and heart disease. Sleep apnoea sufferers are roughly 2.5 times more likely to have a car accident than people without the condition.2 OSA has also been linked to COVID-19. A 2021 Finnish study found that infected patients who had sleep apnoea had a higher risk of hospitalisation compared to those without the disorder.3,4

Getting a good night’s rest can be life changing for you and your loved ones. So, it’s important to learn to recognise the signs of sleep apnoea and conduct a sleep test. Sleep-related breathing disorders: https://www.aihw.gov.au/getmedia/6ea497960272-4182-b5bd-b93445bd0f06/aihw-phe-294-Obstructive-sleep-apnoea-OSA.pdf. aspx?inline=true

Obstructive sleep apnoea: https://www.sleephealthfoundation.org.au/obstructivesleep-apnea.html

Sleep apnoea is a risk factor for severe COVID-19: https://bmjopenrespres.bmj.com/ content/8/1/e000845

What are the warning signs, and who is most at risk?

Sleep-related breathing disorders. Page 4: https://www.aihw.gov.au/ getmedia/6ea49796-0272-4182-b5bd-b93445bd0f06/aihw-phe-294-Obstructivesleep-apnoea-OSA.pdf.aspx?inline=true

If you or your partner are experiencing loud snoring, tossing and turning, waking up unrefreshed or feeling grumpy, you may be living with untreated obstructive sleep apnoea.5 It may also turn out to be another similar, yet less common condition, known as central sleep apnoea, which causes pauses in breathing without the obstruction in the airway. These individuals may not be heavy snorers but will still feel sleepy during the day or experience insomnia.6

Obstructive sleep apnoea: https://www.sleephealthfoundation.org.au/obstructivesleep-apnea.html

Central sleep apnoea: https://www.sleephealthfoundation.org.au/central-sleep-apnea. html

Sleep apnoea signs and symptoms: https://www.betterhealth.vic.gov.au/health/ ConditionsAndTreatments/sleep-apnoea

How the CPAP beats deadly sleep apnoea: https://www.sydney.edu.au/news-opinion/ news/2018/03/16/how-the-cpap-machine-beats-deadly-sleep-apnoea.html

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The Benefits of Deep Sleep PLUS FOUR WAYS YOU CAN HARNESS THE POWER OF QUALITY SHUT-EYE TO KEEP YOUR MIND ACTIVE AND YOUNG. DEEP SLEEP IS THE RESTORATIVE STAGE OF SLEEP AND IS ESSENTIAL TO AGEING WELL AND BOOSTING COGNITIVE FUNCTION. ALSO KNOWN AS ‘SLOW WAVE SLEEP’, IT TYPICALLY OCCURS WITHIN AN HOUR OF FALLING ASLEEP AND LASTS AROUND 45 TO 90 MINUTES. FIND OUT MORE ABOUT ITS ROLE IN PROMOTING BRAIN HEALTH, AND THE BEST WAYS TO GET A GOOD NIGHT’S REST.

Detoxes or ‘washes out’ the waste in the brain

Four simple ways to promote deeper sleep

Deep sleep allows your body to make space to clear the brain of toxic proteins. Without self-cleaning, these toxins may build up and interrupt the flow of information between neurons eventually leading to potential memory problems or neurological disorders such as Alzheimer’s disease.1 Normal ageing can slow down this brain detoxing process, meaning it’s especially important to prioritise quality sleep as we grow older.

1. Avoid sleep extremes Do you find yourself getting sleepy earlier in the evening, or waking at the crack of dawn? Normal ageing can reduce sleep hormones making it difficult to fall or stay asleep. To counter this, resist the urge to hit the sack too early, and avoid sleeping in to make up for a restless night. Set your alarm clock and stick to regular bed and wake times.

“ Sleep allows the brain to clear out waste and organise memories.”2 – Dr Joseph Maroon, leading US neurosurgeon

2. Track your sleep An overnight sleep study may help determine if you have an underlying condition that is affecting your sleep health, such as sleep apnoea or insomnia. A simple take-home sleep test called a polysomnogram is available through your Blooms The Chemist pharmacy. The machine will monitor your blood oxygen levels, brain activity, heart rate, and breathing. The results are uploaded from the testing device and emailed to a doctor who makes the diagnosis. In some cases, you may need to visit a sleep specialist for more tests.

Promotes and regulates hormone production As we sleep the body is flooded with hormones that help it function properly. These hormones may be responsible for encouraging healthier sleep-wake cycles, metabolism and appetite, body temperature, heart rate and blood pressure. Good quality sleep helps regulate hormones such as: ● Melatonin – your body’s natural sleep hormone. ● Cortisol – responsible for your ‘flight or fight’ response, controlling blood pressure, and reducing inflammation. ● Oestrogen and progesterone – oestrogen helps keep the body cooler at night for more restful sleep, boosts mood and has an antidepressant effect. Meanwhile progesterone is known as the ‘relaxation’ hormone and has a mild sedative effect. ● Insulin, leptin, ghrelin – these are your ‘hunger’ hormones, vital to maintaining a healthy appetite and weight. 7 to 8 hours The recommended duration of sleep for people aged 65 years and older.

Supports energy production A University of Basel study, published in the journal Cell Metabolism, found that there is a two-way relationship between our mitochondrial health and circadian rhythm (our body’s internal clock which regulates sleep-wake cycles).3 Mitochondria are known as the energy ‘powerhouses of our cells’. These tiny cells are responsible for generating energy in the body and are vital to nearly all biochemical reactions and cellular processes in the human body, including sleep. The Swiss researchers showed that when the circadian clock is thrown off schedule, so too is the mitochondrial network, and vice versa. A disrupted circadian rhythm is linked to several health problems such as mental health disorders and Alzheimer’s,4 so it is vital to maintain the balance between your circadian rhythm and mitochondrial energy with healthy sleep patterns.

3. Reach for anti-inflammatory foods Reduce inflammation and get a better night’s rest by adding sleep friendly nutrient-rich foods to your diet. Pistachios, oats and sour cherries are a good source of melatonin, the sleep-inducing hormone. Kiwifruits have anti-inflammatory properties and are antioxidant-rich making them an ideal bedtime snack. Foods that are rich in omega-3 fatty acids may support quality, deep sleep – be sure to add fatty fish such as salmon to your weekly dinner two to three times per week.5 4. Get moving in nature Prioritise getting fresh air and at least 30 minutes of exercise every day; the combination of sunshine and movement especially earlier in the day will help regulate your circadian clock and balance your sleep-wake hormones.

Tips for sleeping better with menopause Many women who were otherwise restful sleepers report increased sleep problems during perimenopause to postmenopause. This is caused by a drop in oestrogen, progesterone, and melatonin, which makes it harder to fall and stay asleep, in addition to other changes such as hot flushes, night sweats and snoring that may affect the quality of sleep. Avoid spicy or large meals before bedtime as they may trigger hot flushes

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Keep spare clothes and a water bottle nearby to manage night sweats; avoid doing anything that will wake you up even further, such as watching TV.

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Reduce stress and wind down in the evening with some athome yoga, deep breathing and meditation, or a bath.

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Consider other remedies, such as melatonin supplements, which may help to balance hormonal changes and reduce hot flushes.6 A combination of valerian herb extract and hops is another popular herbal treatment for insomnia.7 Chat to your Pharmacist about supplements that may promote better sleep.

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Take care with naps Afternoon naps can interfere with deep, refreshing sleep at night. If you must nap, stick to a 15-20 minute snooze in the early afternoon, or not at all.

How waste gets washed out during sleep: https://www.medicalnewstoday.com/articles/326896#A-complex-synchronization-process Act now to avoid brain decline: https://www.josephmaroon.com/blog/act-now-to-avoid-brain-decline/ 3 Circadian Control of DRP1 Activity Regulates Mitochondrial Dynamics and Bioenergetics: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)30063-9 4 Alzheimer’s disease linked to circadian rhythm: https://theconversation.com/alzheimers-disease-linked-to-circadian-rhythm-new-research-in-mice-177090 5 Anti-inflammatory foods for better sleep: https://www.eatingwell.com/article/7822652/8-anti-inflammatory-foods-for-better-sleep/ 6 Managing menopause symptoms with supplements: https://www.bloomsthechemist.com.au/articles/managing-menopause-symptoms-with-supplements/ 7 Can hops help you sleep?: https://www.healthline.com/health/can-hops-get-me-to-sleep 1 2

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Arma Yourself with immune system support

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ArmaForce ® Daily Protect contains vitamin C, D and zinc to proactively support your immune system health.

ArmaForce ® is a comprehensive formula containing Andrographis to relieve symptoms of common colds and flu, along with immune supporting nutrients vitamin C and zinc.

ArmaForce® Recover is specially formulated with Siberian ginseng to assist in recovery from illness and astragalus traditionally used in Chinese medicine to promote immune defence.

Always read the label and follow 28the directions for use.

Found exclusively behind the counter. Speak to your Pharmacist for specially formulated relief.

What is Andropause or ‘Male Menopause’? FEELING FLAT, GRUMPIER THAN USUAL, OR EXPERIENCING LOW LIBIDO? ANDROPAUSE AND ‘MALE MENOPAUSE’ ARE POPULAR TERMS TO DESCRIBE HORMONAL CHANGES IN MIDDLE-AGED AND OLDER MEN. BUT UNLIKE MENOPAUSE, TESTOSTERONE DOESN’T SUDDENLY DROP IN MEN AS THEY AGE. SO, WHAT’S REALLY GOING ON?

Symptoms of ‘male menopause’ may also point to another medical condition such as obesity, heart disease, or undiagnosed depression.3 In some cases, the changes may be caused by hypogonadism, which is a testosterone deficiency that may have gone undiagnosed or unresolved from childhood. A testosterone deficiency in older age is known as late-onset hypogonadism, and this has been linked with cardiovascular disease and obesity.4

Getting help If you’re experiencing any of these symptoms, it’s important to find out the underlying cause by chatting to a healthcare professional. Your GP may order blood tests and discuss your personal and medical history to rule out any other health issues. Hormone replacement may be recommended in men with a testosterone deficiency.5

Testosterone and ageing Testosterone levels in men naturally decline from around age 40. This is a very gradual process – at a rate of about 1-2% each year – and there are rarely any noticeable symptoms as a result.1 In fact, some men maintain normal testosterone levels into older age, while others with low hormone levels don’t experience any symptoms at all.2 This is different to female menopause, which occurs when hormone production drops suddenly and the ovaries stop producing eggs. Menopause in women is part of the natural ageing process, and often leads to obvious symptoms, such as hot flushes, insomnia, mood swings, and sleep problems.

Can men experience andropause or ‘male menopause’? First, the midlife crisis then the ‘male menopause’. It’s not uncommon for some men to notice physical and emotional changes from their 40s, and into their 50s and 60s. While men don’t get the same hormonal drop seen in menopausal women, there are a range of symptoms that can mimic this experience. This may include: ● Fatigue and decrease in motivation ● Grumpiness, mood swings, or irritability ● Loss of sex drive or erectile dysfunction ● Loss of muscle mass.

For erectile dysfunction, treatment will depend on the exact cause. For example, your health provider may recommend strategies for reducing stress and anxiety, or you may require medicines to lower blood pressure or cholesterol levels if these are found to be contributing to the problem. Hormone replacements may be prescribed to address erectile dysfunction caused by low testosterone.6 Depression in men is common, particularly in older age, and affects between 10-15% of Australians over the age of 65. Despite the numbers, the condition is underdiagnosed or dismissed as part of the ‘normal’ ageing process. However, symptoms such as sadness, sleep and appetite problems or mood changes should not be ignored as they can manifest into serious mental health or physical conditions. Cognitive behaviour therapy (CBT) is a science-backed approach that supports people with depression to identify and change negative patterns of thinking and improve their coping skills, so they are better equipped to deal with life’s stresses and conflicts. Lifestyle changes and natural remedies. Speak to your healthcare professional to learn about other ways to cope with stress and anxiety in your day-to-day life, including exercise, mood-boosting foods and natural remedies, and accessing mental health support.7 24/7 support services beyondblue.org.au or call 1300 22 4636 mensline.org.au or call 1300 78 99 78. Male menopause: https://www.nhs.uk/conditions/male-menopause What are the signs of male menopause?: https://www.livescience.com/36014-malemenopause-real-signs.html 3 Male menopause: https://www.nhs.uk/conditions/male-menopause 4 The Prevalence of Late-Onset Hypogonadism in Middle-Aged Men and Cardiovascular Risk Factors: https://www.liebertpub.com/doi/10.1089/andro.2020.0020 5 Male menopause real signs: https://www.livescience.com/36014-male-menopausereal-signs.html 6 Erectile dysfunction (impotence). https://www.nhs.uk/conditions/erection-problemserectile-dysfunction/ 7 Depression and ageing. https://www.betterhealth.vic.gov.au/health/conditionsand treatments/depression-and-ageing 1 2

In many cases, these symptoms are unlikely to be caused solely by the natural ageing process or small dips in testosterone levels. Rather, stress and anxiety from work or your personal life may be contributing to the problem. Money problems, relationship woes, children moving away, and concerns about ageing parents, can all affect a person’s overall wellbeing. Letting your fitness routine slide, and your healthy diet get away from you, can further compound the problem.

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LET’S TALK LONELINESS:

Four Ways to Conquer Loneliness EVER BEEN SURROUNDED BY PEOPLE BUT STILL FELT LONELY? WITH ONE IN THREE ADULTS EXPERIENCING LONELINESS, YOU ARE FAR FROM BEING ALONE. DON’T SUFFER IN SILENCE. HELP IS AT HAND.

2. Set a routine Don’t rely on other people to plan your week. Establishing a routine for yourself will get you out of bed on the days you’re feeling low. Being productive can also distract you from periods of loneliness. Try this: set small tasks and goals with daily reminders in your phone or an activity planner. For example, set your alarm for a 30-minute walk before breakfast, schedule in overdue health appointments, or respond to emails and texts.

3. Care for others

What is loneliness? Loneliness is something you feel or experience if your social needs are left unmet. Sometimes, this is because you may be lacking deep, meaningful relationships within your existing social network. You may have a high Facebook friend count or lots of contacts in your phone, but how many of those people can you confidently call upon for social support? Loneliness can also manifest after a relationship breakup, death, illness, or disability, or when family or children move away. Loneliness is different to being alone. One can be alone, in their own company, and feel entirely connected and at peace with the world, just as one can be in a crowd and feel miserably lonely.

1 in 3

Adults will experience loneliness at some point in their lives.

50%

Australians in a survey reported feeling lonely during the pandemic.1

Numerous studies have demonstrated how helping others can give individuals a sense of purpose and belonging. A recent meta-analysis that looked at 200 previous studies showed that helpers were left with greater levels of happiness, connection and “eudaimonic” wellbeing, which is achieved by having a meaningful purpose in life.3 Try this: check in on friends and relatives and offer support; they may be feeling lonely at times too, even if they don’t seem to show it. Give volunteering a go; find a cause you’re passionate about and meet like-minded individuals while you’re at it. Get started at govolunteer.com.au. Or simply start with a random act of kindness such as helping a neighbour with their groceries – it’ll brighten up both your days and might even lead to an impromptu chat.

4. Connect in small ways Ready to re-connect or meet new people? Start small, stick to your own pace, and don’t put any pressure on yourself to over-commit to social activities. Try this: strike up a conversation with a neighbour, your local grocer, or send a text message to an old friend to let them know you’re thinking about them. Mix up your solo fitness routine with a walking buddy once or twice a week or join an outdoor exercise class to meet new people.

Conquering loneliness might not happen overnight but there are ways to turn things around. Here’s how. Need to chat?

1. Start from within

Come in for a Healthy Mind Check-Up. Our team around Australia have undertaken over 660 hours of Mental Health First Aid training and are ready to listen.

There’s no need to rush into a new relationship or friendship just yet. In fact, research has shown that periods of solitude can be rewarding no matter your life stage; and according to psychologists, productive ‘alone’ time can improve your outlook and help regulate your emotions. It can also build autonomy, self-connection, and relaxation particularly in people aged 65 and over.2 Try this: sign up to an online meditation class; tackle your to-do list (plant that herb garden, de-clutter your wardrobe); or finally get stuck into a book or creative recipe you’ve had your eye on. Aim to get fresh air and regular movement as much as possible. You could walk to the local store instead of taking your car. Something as simple as walking in sunshine will release the ‘feel good’ hormones serotonin (mood stabiliser) and endorphins (natural pain killer), which may instantly boost your mood.

What is loneliness? https://www.blackdoginstitute.org.au/news/what-is-lonelinessand-how-can-we-overcome-it-during-these-times/ 2 What time alone offers: https://www.frontiersin.org/articles/10.3389/fpsyg. 2021.714518/full 3 Rewards of Kindness? A meta-analysis: https://pubmed.ncbi.nlm.nih.gov/32881540/ 1

Managing Mild Joint Pain A JOINT IS WHERE TWO OR MORE BONES MEET TO ENABLE AND SUPPORT MOVEMENT, WHICH IS WHY JOINTS BECOME INCREASINGLY SUSCEPTIBLE TO PAIN AND INJURY, PARTICULARLY AS WE AGE. PAIN AND SWELLING IN THE JOINTS OCCUR WHEN FLUID IS PRESENT IN THE SURROUNDING TISSUES. THE MOST COMMONLY AFFECTED AREAS ARE KNUCKLES, WRISTS, ELBOWS, HIPS, KNEES AND ANKLES.1 Symptoms can range from mild joint soreness, aches and pains. Treatment options depend on the cause of joint pain so it’s wise to discuss with your GP any concerns you have regarding pain or swelling in the joints. Mild joint pain is commonly managed through: • R.I.C.E – rest, ice, compression, elevation • the use of a brace or wrap, particularly if you know you’ll be quite active • topical creams for short-term relief • supplementary products such as Herbs of Gold Pain Relief PEA

PEA is a fatty molecule that is produced in small amounts by the body in response to pain and inflammation. Herbs of Gold Pain Relief PEA contains high-strength PEA that relieves the symptoms of mild arthritis and mild osteoarthritis, and reduces mild joint soreness, aches and pains. ALWAYS READ THE LABEL AND FOLLOW THE DIRECTIONS FOR USE.

Joint pain and swelling: https://www.healthdirect.gov.au/joint-pain-and-swelling. *Steels, E., Venkatesh, R., Steels, E., Vitetta, G., & Vitetta, L. (2019). A double-blind randomised placebo controlled study assessing safety, tolerability and efficacy of palmitoylethanolamide for symptoms of knee osteoarthritis. Inflammopharmacology, 27(3), 475-485

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What's On Your Plate? Eating Habits to Add Years to Your Life BY KATHLEEN ALLEAUME, NUTRITIONIST & EXERCISE PHYSIOLOGIST HEALTHY EATING IS IMPORTANT AT ANY AGE BUT BECOMES EVEN MORE SO AS WE REACH MIDLIFE AND BEYOND. A LARGE STUDY PUBLISHED IN THE EUROPEAN JOURNAL OF NUTRITION IN FEBRUARY 2022 FOUND THAT PEOPLE IN THEIR 40S AND 50S WHO ATE WELL—PARTICULARLY A DIET RICH IN ANTIOXIDANTS—HAD LOWER RATES OF DEATH AND CARDIOVASCULAR DISEASE IN OLDER AGE.1

Healthy eating doesn’t have to be about dieting and sacrifice. Rather, it's important to continue to focus on a balanced, varied diet that includes plenty of whole foods, in a way that suits your lifestyle and activity levels. This will go a long way in reducing your biological age, which is a measure of how young or old a person seems based on their physical and mental health status, rather than their chronological age. Essential nutrients for ageing well Regardless of age, it's still important to maintain a balanced diet, including lots of variety, based on the five food groups: fruits, vegetables, grains, protein, and dairy. However, as we get older our bodies may have varying dietary requirements, and certain nutrients become vital for good health. Calcium and vitamin D for healthy bones, teeth, and gums Men require 1,000 mg of dietary calcium every day, and this goes up to 1,300 mg from age 70; while women need to maintain 1,300 mg every day from their 50s and onwards.2 To meet these calcium requirements, aim for a minimum of three servings of dairy products each day and select other calcium-rich foods, such as dark green leafy vegetables, nuts, and canned fish. Be sure to include fortified milk alternatives if you choose not to eat dairy-based foods. If you choose not to include dairy, other sources of calcium include darkleafy greens, broccoli, almonds, tofu, and legumes. As for vitamin D, good sources include fatty fish, such as salmon or tuna, eggs, and mushrooms. Getting at least 10 minutes of direct sunlight, especially during the Winter months, is also recommended to help with achieving vitamin D requirements.

Fibre-rich foods for good digestive balance and to nourish the gut Swap out refined grains for wholegrain sources, such as rolled oats, barley, brown rice, and multigrain breads. Eat plenty of other fibre-rich plant-based foods, including whole fruits, vegetables, and legumes, which also pack in many essential vitamins and minerals. Unsaturated fats and oils for heart health Healthy, unsaturated fats can improve cholesterol levels and help lower your risk of heart disease. Omega-3 fats, found in fish, tahini, linseed, walnuts, and chia seeds, can improve heart rhythm, decrease the risk of clotting, and delay fatty plaque from building up in the arteries.3 High-quality proteins to maintain muscle mass Aim to include protein-rich foods with every meal, including yoghurt, lean meat, fish, eggs, and plant protein sources, such as wholegrains, nuts, legumes, or soy-based foods. For post-menopausal women, soy products are a good source of phytoestrogens to help keep their hormones in balance. Soy-based foods include tofu, tempeh, and miso. Five foods for longevity and vitality 1. Blueberries contain specific flavonoid molecules that fight DNA damage and slow age-related damage to brain cells. Aim for one cup of berries per day. 2. Legumes contain plant-based protein to help stabilise blood sugar and are excellent sources of fibre to nourish the gut microbiome. A healthy gut is known to help regulate inflammation, assist nutrient absorption, and regulate immune function. All this will support longevity. Aim to include at least five servings (half to one cup) of legumes in your diet, weekly. Think lentils, chickpeas, peas, and beans.

3. Cruciferous vegetables are incredibly nutrient-dense and contain a critical compound called sulforaphanes, which may have potential anti-cancer properties that allow us to cope with the stressors and harmful compounds we are exposed to daily. To increase your intake of sulforaphane, include broccoli, cauliflower, kale, Brussels sprouts, cabbage, and bok choy. Aim for one cup per day. 4. Nuts are not only delicious, but they should be added into your daily eating plan to help ward off chronic diseases like cardiovascular disease, diabetes, and certain cancers. They contain healthful fats, plant protein, fibre, and antioxidants. Despite being high in kilojoules, nut consumption is associated with lower body weight, potentially due to appetite suppression from heart-healthy components. Aim to eat one handful every day. 5. Wholegrains - Epidemiological studies in the USA, UK and Europe consistently report that consumption of wholegrain foods (three serves a day) is linked to a 20-30% reduction in risk of total mortality, cardiovascular disease, diabetes, stroke, and some cancers.4

Kathleen Alleaume is a trusted specialist in nutrition and fitness, and author of the book What’s Eating You? She holds a degree in Exercise Science and a masters in Nutrition. Kathleen founded The Right Balance more than 20 years ago to help women, men and children overcome their health or performance issues and to maximise their wellness and fitness.

Keep moving to prevent muscle loss and to maintain a healthy metabolism After age 30, adults begin to lose as much as 3-5% of muscle mass per decade. This loss of muscle mass, known as sarcopenia, is part of the natural ageing process.5 For this reason, it is especially important to continue moving and exercising to prevent muscle weakness and reduce the risk of falls in older age. Stay active by taking regular walks or increasing every opportunity to move throughout the day. This may include doing lunges while you wait for the kettle to boil or parking the car further away when picking up groceries. Better yet, leave the car at home and walk to the local shops. All these extra steps add up to staying active and keeping the muscles and bones healthy. If you are overweight and need to shift a few kilos it is better to make small changes to your daily eating and exercise habits rather than resorting to extreme diets or fads.

Dietary total antioxidant capacity and mortality outcomes: the Singapore Chinese Health Study. https://link.springer.com/article/10.1007/s00394-022-02812-3 Calcium: https://www.betterhealth.vic.gov.au/health/healthyliving/calcium Fats and oils for heart health: https://www.heartfoundation.org.au/heart-health-education/fats-oils-and-heart-health 4 Grains and Health: https://www.glnc.org.au/grains/grains-and-health/ 5 Preserve your muscle mass: https://www.health.harvard.edu/staying-healthy/preserve-your-muscle-mass 1 2 3

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Natural Medicines Made Easy: VITAMINS AND HERBS TO SUPPORT YOUR IMMUNE AND BRAIN HEALTH

KEEP YOUR IMMUNE SYSTEM RESILIENT AND YOUR BRAIN SHARP WITH THESE KEY NUTRIENTS AND NATURAL REMEDIES THIS WINTER.

Winter colds and immunity A healthy immune defence system can help reduce the symptoms, duration, and severity of a cold. Vitamins and nutrients to support your health during the cooler months may include: Vitamin C supports healthy immune system function as well as providing antioxidant action to reduce cell damage from free radicals. The best food sources include citrus fruits, capsicum, strawberries, tomatoes, and broccoli. Supplements in tablet or spray form are a quick and easy way to get enough vitamin C, if nutritional needs are not being met through a healthy diet alone. Vitamin D, known as the sunshine vitamin, enhances the immune response to bacteria and viruses. A simple blood test can determine if you are vitamin D deficient. High-risk individuals for vitamin D deficiency include people who stay mostly indoors or avoid the sun, have naturally darker skin, or are obese. Zinc is required to produce white blood cells that fight infections. Individuals who don’t have enough zinc in their body may become more susceptible to pneumonia and flu, with the elderly and children at greater risk.1 Elderberry and astragalus are nutrient-rich herbs and fruit extracts that may help reduce the inflammatory response to some bacteria and viruses.2 Andrographis is a popular herbal remedy native to South Asian countries and has been traditionally used in Ayurvedic medicine to stimulate the immune system to help fend off colds, flu, and upper respiratory infections.3 Echinacea plants contain immune-supporting active compounds, such as caffeic acid, alkamides, phenolic acids, rosmarinic acid, and polyacetylenes, and have been shown to reduce inflammation and lower blood sugar levels.4

Ashwagandha, also known as ‘Indian ginseng’ or ‘winter cherry’, a natural anti-inflammatory plant extract and another adaptogen that is commonly used to help control the body’s stress response, and may promote better sleep according to a 2019 study involving 58 participants who took the supplement for eight weeks.8 Ginkgo biloba, extracted from the leaves of the Ginkgo biloba tree, has been shown to improve memory and mental processing in healthy middle-aged adults when taken daily for six weeks according to a randomised controlled study published 2011.9 Curcumin, the main active ingredient in turmeric, has powerful antiinflammatory and antioxidant properties. In addition, animal studies have shown that this wonder spice can boost brain functioning by helping neurons to form new connections in older age.10 Taking curcumin with black pepper, or a supplement containing piperine (found in pepper), helps improve the bioavailability of this often poorly absorbed nutrient in the body.11 Omega-3 fatty acids are found in oily fish and seafood and are well-known for their heart health benefits, however they also play an important role in human cognition and regulating mood by potentially supporting gene expression in the brain, and reducing inflammatory responses that are typically associated with depression and other chronic diseases.12 Speak to your local Blooms The Chemist Pharmacist for more information about supplementation. Be sure to always read the label and use only as directed. VITAMIN AND MINERAL SUPPLEMENTS SHOULD NOT REPLACE A BALANCED DIET. IF SYMPTOMS PERSIST, CONSULT YOUR HEALTH PROFESSIONALS. Zinc and your health. https://www.healthdirect.gov.au/zinc Astragalus Root and Elderberry Fruit Extracts Enhance the IFN-β Stimulatory Effects of Lactobacillus acidophilus in Murine-Derived Dendritic Cells: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC3484152/ 3 Andrographis - Uses, Side Effects, and More: https://www.webmd.com/vitamins/ai/ ingredientmono-973/andrographis 4 Echinacea: Benefits, Uses, Side Effects and Dosage: https://www.healthline.com/ nutrition/echinacea#what-it-is 5 Ageing and innate immunity. https://www.medicalnewstoday.com/articles/immuneaging-and-how-to-combat-it#Aging-and-innate-immunity 6 The 14 Best Nootropics and Smart Drugs Reviewed: https://www.healthline.com/ nutrition/nootropics 7 A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue: https://pubmed.ncbi.nlm.nih.gov/19016404/ 8 Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC6979308/ 9 Specific memory effects of Ginkgo biloba extract EGb 761 in middle-aged healthy volunteers: https://pubmed.ncbi.nlm.nih.gov/21802920/ 10 Antidepressant-like effects of curcumin in WKY rat model of depression is associated with an increase in hippocampal BDNF: https://www.sciencedirect.com/science/article/abs/pii/S0166432812006997 11 10 Proven Health Benefits of Turmeric and Curcumin: https://www.healthline.com/ nutrition/top-10-evidence-based-health-benefits-of-turmeric 12 Omega-3 and mood disorders. https://www.blackdoginstitute.org.au/wp-content/ uploads/2020/04/3-omega-3.pdf 1

The link between immune health and inflammation An ageing immune system is linked to chronic inflammation, which scientists refer to as “inflammaging”. 5 Some inflammation is good as part of the healing process. But an overactive inflammatory response can do more harm than good over time. Other times, the immune system can go quiet or dormant and suppress itself. What we want is a resilient immune system, one that is balanced between the two extremes, and knows when to fire up or down as needed.

Nootropics and other natural remedies to support cognition and boost mood Nootropics are a group of natural and synthetic medicines known as ‘cognitive enhancers’ and are an increasingly popular way to boost memory, focus, creativity, intelligence, and motivation.6 Natural nootropics include: Rhodiola rosea, a natural ‘adaptogenic’ herb, which are nutrients that help your body adapt to periods of high stress. The popular remedy has also been linked to a reduction in mental fatigue.7

Stop Snoring APPROXIMATELY 20% OF THE POPULATION SNORES WHEN THEY SNOOZE, AND WHILST IT’S NOT NECESSARILY PHYSICALLY DANGEROUS (UNLESS YOU’RE SUFFERING FROM A SERIOUS OR UNTREATED SLEEP DISORDER LIKE SLEEP APNOEA) IT CAN BE INCREDIBLY FRUSTRATING FOR THOSE WHO SHARE A BED WITH, OR WHOSE SLEEP IS DISTURBED BY, A PERSISTENT SNORER. When we sleep, the soft palate and the uvula relax and vibrate as we breathe, either through the nose or open mouth. This what causes the sound associated with snoring. Some snoring treatment options include: • s leeping on your side rather than your back • losing weight • s kipping the alcohol or sleeping tablets before you snooze: or • t rying a simple antisnoring device like Nozovent Nozovent is a snoring relief product that opens up constricted airways helping you breathe easier and snore less. Nozovent is clinically* proven to improve sleep for snorers in over 70% of patients. When placed in the nostrils, Nozovent widens them and so that airflow is increased through the nose. Reusable for up to six Weeks.

*Bjorn Petruson, Snoring Can be Reduced when the Nasal Airflow is Increased by the Nasal Dilator NozoVent, 1990

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This year your local Blooms The Chemist got even better. We believe genuine care shouldn’t cost more; that’s why we’re committed to every day low prices and a Price Match Promise.

If you find a cheaper price on and identically stocked item, let us know and we'll gladly match the price*. Our commitment to every day low prices is just another thing we’re doing for the right reason, for the good cause, because it's important. Visit your local Blooms The Chemist Pharmacist today and experience every day low prices for yourself. *Visit bloomsthechemist.com.au /every-day-low-price for more information. *T&Cs apply.

When was your last Blooms The Chemist Health Check? 60 may be the new 40 but there are a few additional health checks to add to your calendar as you approach this milestone birthday. Cut out and stick this handy guide on your fridge or bathroom mirror to help you stay organised.

YOUR ESSENTIAL BLOOMS THE CHEMIST HEALTH CHECKLIST Chat to our friendly Pharmacists about your next essential check-up. To find your nearest Health Check location, visit bloomsthechemist.com.au/store-finder Be heart aware igh blood pressure may have no symptoms. Even if you are in good health, you should H check your blood pressure regularly. Find out your total cholesterol level with a three-minute Cholesterol Screening. Take the first step for stroke risk prevention with a one-on-one Stroke Risk Assessment.

Get proactive with diabetes management Recently diagnosed with Type 2 Diabetes or at higher risk of developing the condition? Visit us for your one-minute Diabetes Monitoring test and assessment.

Take the guesswork out of quality sleep Normal ageing can disrupt the amount and quality of sleep. Common sleep disorders include insomnia, sleep apnoea, or sleepless nights associated with menopause. Get to the bottom of your sleep woes with an Online Sleep Quiz at sleepquiz.bloomsthechemist.com.au. ` Check for undiagnosed sleep apnoea with an overnight Sleep Test using a Polysomnogram in the comfort of your own home. Ask your local Blooms The Chemist pharmacist for more information.

Mind matters Take care of your emotional health with a simple Healthy Mind Checkup, a private conversation between you and one of our Pharmacists with specialised training in mental health first aid. Find out more at bloomsthechemist.com.au/mental-health

Prepare for Winter Book your annual flu vaccine or arrange your COVID-19 Booster through our handy Booking Portal available at bloomsthechemist.com.au/booking.

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Our Commitment to People and Planet AS WE ALL STRIVE FOR A KINDER AND MORE SUSTAINABLE WORLD, BLOOMS THE CHEMIST WOULD LIKE TO ACKNOWLEDGE OUR WONDERFUL COMMUNITY MEMBERS, CUSTOMERS AND PHARMACY TEAMS WHO HAVE WORKED TIRELESSLY TO SUPPORT OUR FUNDRAISING AND AWARENESS INITIATIVES THAT NOT ONLY HELP PEOPLE IN NEED, BUT ALSO BETTER OUR ENVIRONMENT.

Helping make wishes come true

Building an eco-friendly future

“I wish to fly to Unicornland.” Abigail 6, Cystic Fibrosis.

Blooms The Chemist is proud to be an official partner of the inspirational charity, Make-A-Wish Australia, helping to grant the wishes of critically ill children. Together with our communities, we've made unicorns fly, sent rockets to the moon, and continue to support Make-A-Wish Australia's vision to grant the wish of every eligible child. OVER $1 MILLION RAISED! by Blooms The Chemist for Make-A-Wish Australia BECOME A WISHMAKER Did you know that our Rewards members can donate their points to support Make-A-Wish Australia’s wish kids? Register at signup.bloomsthechemist.com.au

Blooms The Chemist North Perth Recycling Program

Our Pharmacists and customers are proactively taking steps to reduce environmental impact by implementing recycling programs in stores. Blooms The Chemist North Perth recently ran its seventh recycling program, diverting disposable masks, medication foils and blisters, and empty product bottles from landfill with its free recycling bins. “Pharmacies should be accountable for products they sell and how they dispose of waste,” says North Perth Pharmacist-owner, Colin Willis. “We introduced over 400 eco-friendly products, and where possible are Australian owned and made.”

A helping hand for expectant and new parents

Helping to reduce health inequality

A new mother in Simonga, Zambia

Blooms The Chemist Miranda Gidget Champions

Blooms The Chemist is a proud partner of the Gidget Foundation Australia, a not-for-profit organisation that provides programs nationally to support the emotional wellbeing of expectant and new parents. Around 100,000 Australian parents report feelings of anxiety and depression in the lead up to a birth or in the period shortly after, known as the ‘fourth trimester’. We support parents through:

Since 2019, Blooms The Chemist has been working with The Butterfly Tree, a non-government organisation, to provide greater access to healthcare in rural Zambia. Our network funded the building of a new maternity ward and mother’s shelter in the village of Simonga. This project has reduced serious risk of illness due to cross-contamination in the under-resourced health clinic. Prior to the shelter being built, expectant mothers would often walk for kilometres in labour through the bush to reach the health clinic, facing the very real threat of attack from local wildlife including elephant herds. Expectant mothers are now able to stay in the shelter before and after giving birth, receiving appropriate postpartum care. Further support has included the installation of solar power, water access and vital personal protective and hygiene equipment.

Supporting kindness in leadership and community

1. In-store Bunny Bounces Back book sales Bunny Bounces Back is a beautifully written children’s story, with psychological strategies to support parents. Bunny Bounces Back is available exclusively at Blooms The Chemist stores and all proceeds are donated to the charity. 2. ‘Bun In The Oven’ fundraisers Ask your local Blooms The Chemist about getting involved! 3. Gidget Champions Gidget Champions are Blooms The Chemist team members who actively promote awareness of perinatal depression and anxiety (PNDA) in their store and community. Look for the ‘Ask me why I’m a Gidget Champion’ badge. 4. Perinatal Resource Hub These resource packs are created by the Gidget Foundation Australia clinical team and are available free in-store. Find out more at: bloomsthechemist.com.au/gidget-foundation

Community Impact Award Winner oOh Media and Blooms The Chemist Chief Executive Officer Emmanuel Vavoulas

At Blooms The Chemist we believe that doing good is good for business. That’s why we recently partnered with Bambuddha Group, Australia’s only kindness-focussed enterprise that offers coaching for business leaders on sustainability, equity and opportunity in the workplace and community. “Kindness in leadership is no longer optional.” – Blooms The Chemist Chief Executive Officer, Emmanuel Vavoulas. As headline sponsors of Bambuddha’s Corporate Kindness Awards, and the Community Award Category, Blooms The Chemist is proud to celebrate big-hearted businesses that have gone the extra mile for their employees, community, customers and the environment. “Given the year that’s been, kindness is what people need in their lives right now,” says Mr Vavoulas.

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