The Elixir of Life: In the modern quest for eternal youth, the path is more medical science than myth

The desire to keep one’s youth and vitality by defying the natural ageing process is not a recent phenomenon. While it may not be as old as the hills, it probably spans the existence of humankind. This Peter Pan-like urge to stop the march of time has long been the subject of popular culture. In the 1959 horror film The Man Who Could Cheat Death, a centenarian artist and scientist in 1890 Paris maintains his youth and health by transplanting parathyroid glands from the necks of the living. Another film, Orlando (1992), based on the Virginia Woolf novel, depicts a nobleman’s struggles to find his place in the world after being ordered not to grow old by Queen Elizabeth I.

Cognitive concerns

The subject of age has dominated the US presidential election campaign, with both Joe Biden, 81, and Donald Trump, 77, accused of being too old for the job. Critics point to the inevitability of age-related mental decline and forgetfulness, and attribute their gaffes, such as getting names mixed up, to their advanced years. Some analysts have suggested this is unfair, given the enormous pressure they are under and the constant scrutiny they are subjected to. In these circumstances, occasional misspeaking is to be expected.

Furthermore, the science of ageing is uncertain. Research in cognitive function by Joshua Hartshorne of Boston College and Laura Germine from the McLean Institute for Technology in Psychiatry suggests it is no myth that wisdom increases with age. Older people tend to have the ability to see the big picture better than their youthful counterparts, though not necessarily the capability to recall specific facts instantly. The former skill is essential for a politician – a greater grasp of the wider historical context of world events would enable more informed decision-making. On the flip side, some studies have shown that tasks involving short-term memory decline from as early as 20 years old. To add to the complicated picture, arithmetic and comprehension skills, plus vocabulary, are thought to keep improving until 50, then decline thereafter.

Jay Olshansky of the University of Illinois believes the two main contenders’ well-to-do backgrounds and family history of longevity work in their favour in terms of the ageing process and their expected lifespan.

An article published in The Hill in January states that both Biden and Trump have higher than average expected chances for men of their age of surviving another presidential term. Olshansky also opines that some of Biden’s gaffes have been blown out of proportion. For instance, when he was captured falling off his bike in June 2022, many deemed it a sign of his physical decline and poor balance. However, a closer examination of the circumstances indicated that he had caught his foot in the pedal strap, something anyone could do. The pertinent point here is that Biden, then aged 79, was comfortably able to ride a bike in the first place – not that he got his foot caught.

Survival of the fittest

Some people are chasing the anti-ageing dream far beyond the normal advice to reduce their weight, exercise and sleep more, quit smoking and limit alcohol intake. American entrepreneur Bryan Johnson, who made a fortune selling his electronics payments company Braintree to PayPal, reportedly spends US$2 million a year attempting to stop the biological clock.

An all-over skin laser treatment is said to have reduced the 46-year-old’s skin age by 22 years, and he is known to observe a vigorous daily exercise routine and a strict plant-based diet including eating a kilogram of vegetables before 11 am, his usual dinnertime. He also consumes some 100 tablets a day, including the diabetes drug metformin and the immunosuppressant rapamycin, both hailed by longevity enthusiasts as ‘miracle’ anti-ageing pills.

Described as the most measured man in the world, Johnson’s biological and chronological age are continually tracked and monitored. His aim is to reverse his measured biological age by more than one year for every one year that passes – the first stage of longevity escape velocity in which life expectancy increases faster than time passes.

Confident his tortuous routine is paying dividends, he describes how he has near undetectable levels of inflammation, perfect blood pressure for his demographic, the ideal range of vitamin C, vitamin K, coenzyme Q10, 1GF-1 (insulin-like growth factor 1) and LDL (low-density lipoprotein) cholesterol, and a DHEA-S hormone level of someone aged 27. Just as impressively, in a series of physical tests, he scored equivalent to the top 10% to 25% of 18-year-olds.

Supplement strides

Johnson is now selling a basic version of his Blueprint protocol – described on his website as ‘The Most Nutritious Program in History’ – to those interested in adopting what he considers to be the perfect diet for the body. The idea that caloric restriction can significantly extend lifespan as long as all the necessary nutrients are ingested via minerals and vitamins is not new. It was advocated by the late Roy Walford, a professor of pathology at the University of California, among others, and their findings helped spawn the plethora of mineral supplements on the market.

Though their life-extending capacity for humans is open to question, some supplements are generating considerable interest. Taurine, an amino acid, was recently found to extend the lifespan of mice by 10%, as well as boosting a whole range of functions in the middle-aged rodents including muscle strength, endurance, coordination and insulin sensitivity. A major study in the journal Science published last year linked lower taurine levels to age-related problems, noting that blood levels of taurine in elderly humans are 80% lower than they were when they were younger. The attention such revelations generated has made taurine a popular dietary supplement among the legion of alternatives.

Counter evolutionary?

Extreme do-it-yourself lifespan extension, however, goes against the grain of evolution, which is more interested in reproduction rather than longevity. It is thought that increased lifespan comes at the cost of reduced fertility. Our bodies contain trillions of cells that will ultimately need rejuvenation or renewal – something which is incredibly difficult to overcome as evolution has little interest in keeping the repair system going.

So perhaps we should turn to the original Star Trek actor, William Shatner, who is now in his early 90s, for advice on staying young. He told Newsmax: “Say yes to the opportunity life is offering. Say yes to life, yes to dinner, yes to going out, and yes to something new.”

Healing Hydrogen: A profusion of health benefits may arise from sipping water infused with H2

While the benefits of drinking plenty of water are widely known, especially in terms of keeping the body hydrated, the health advantages of drinking water that has been enriched with hydrogen are only just being recognised. There is mounting scientific evidence to suggest the gas brings all sorts of gains that tap or bottled water cannot provide alone.

Hydrogen is the lightest element in the periodic table and when bonded together forms molecular hydrogen (H2). Being the lightest and smallest of molecules, it can escape out of practically anything. It is an odourless, colourless and tasteless gas molecule, imperceptible by human senses. It binds to other elements like oxygen (creating water), nitrogen and carbon to form compounds.

An interesting point is that about 10 percent of the weight of living organisms is hydrogen within water, proteins and fats. On a broader level, much of the vitality of our planet is derived from hydrogen since the energy emanating from the sun is a result of hydrogen being converted into helium.

Therapeutic effects

Studies have indicated that water (H2O, two hydrogen atoms bonded to an oxygen atom) containing dissolved hydrogen gas at a concentration of 0.5 to 1.6 mg/L (ppm) can provide therapeutic effects to the human body that plain water cannot deliver – apparently because the body cannot effectively absorb the hydrogen molecules attached to the oxygen molecules within water.

Hydrogen-rich water made by infusing hydrogen gas into pure water is considered suitable as a health and preventative drink for people of all ages. It is believed that it is virtually impossible to overdose on molecular hydrogen and it has no toxic effects on living cells at high levels.

H2 water everywhere

H2 is often packed into cans or pouches, or can be made at home via special hydrogen water machines. H2 water machines and generator bottles are quite common in health clinics in Hong Kong and are a simple and effective way of ingesting molecular hydrogen.

Portable hydrogen bottles are designed to infuse additional hydrogen molecules into drinking water and enrich it instantly, while counter-top hydration machines can produce therapeutic concentrations in greater quantities. H2 tablets can generate high levels of hydrogen in any water-based drink. It is also possible to take hydrogen baths and spray it onto your face.

Antioxidant boost

Molecular hydrogen has been generating such interest as it is thought to be a powerful antioxidant. Most pertinently, it is believed to have the ability to limit free-radical damage in the body. Free radicals are unstable molecules produced in the body and can be exacerbated by environmental factors. They can contribute to oxidative stress – a situation known to cause many health issues. Put simply, this is where free radicals attack healthy cells and cause irreversible damage.

One of the best ways to combat oxidative stress is by upping your antioxidant defence system. The body naturally delivers antioxidant agent chemicals that destroy a multitude of free radicals. There are numerous ways to increase levels, such as a diet rich in antioxidant foods like fruit and veg, and by enjoying a healthy lifestyle – plus harnessing the benefits of hydrogen molecules.

Small is beneficial

According to some medical professionals, H2 has the properties to make it the best antioxidant of them all. The fact that the molecules are extremely small is important because for antioxidants to work effectively they must be able to penetrate cell areas being attacked by free radicals, and these are often difficult to reach. As H2 is in a gaseous state, it percolates through the body via rapid diffusion and is not blocked by mechanisms that ordinarily prevent other antioxidants from moving freely. And since H2 is not only small but exceedingly light, its ability to travel through cell layers is enhanced.

Another great benefit of H2 as an antioxidant is that it is thought to produce zero byproducts, meaning it has zero toxicity and will even convert free radicals to water. Molecular hydrogen also has the ability to select and act upon free radicals that cause the most cell damage – an important attribute given that not all free radicals are thought to be harmful.

Novel therapies

Numerous studies point to the healing qualities of hydrogen-rich water. One eight-week study involving patients receiving radiation therapy for liver cancer showed decreased levels of oxidative stress for those participants who drank 51 to 68 ounces of water infused with hydrogen per day. Another research project conducted by the University of Western Ontario found consumption of hydrogen-rich water improved levels of oxidative-stress markers associated with metabolic syndrome – whose risk factors include obesity, high cholesterol, hypertension and insulin resistance – and boosted the body’s antioxidant activity. Researchers noted that hydrogen water represents a potentially novel therapeutic and preventive strategy for the treatment of metabolic syndrome.

While molecular hydrogen is considered by some health professionals to be one of the best ways of fighting free radicals and limiting oxidative stress, other studies have reported less conclusive results. Further research is needed to assess the potential benefits with a higher level of scientific backing.

Some scientists believe that molecular hydrogen can help in the battle against diseases of the immune system, such as lupus (SLE) and other types of immune-compromising infections. A Japanese study postulated that H2-rich water can combat rheumatoid joint pain by lessening oxidative pressure, and other findings have suggested molecular hydrogen dampens the allergic response when the immune system goes into overdrive. Furthermore, a study on rodents with Alzheimer’s disease indicated H2 can enhance cognitive functions and increase memory.

Beauty bonus

Though research is ongoing, there is evidence that molecular hydrogen can also work wonders as a beauty remedy. A Japanese study, among others, has shown that washing the face with hydrogen- infused water over a three-month period enhances skin elasticity and reduces wrinkles, promoting a youthful appearance. Other research has involved patients being administered hydrogen water directly into their veins via a saline drip, resulting in improvements in skin health.

There is also evidence that hydrogen-rich water quickens athletes’ ability to recuperate from injury and boost their athletic performance.

Stem The Tide: Though no cure-all, stem cell therapy offers hope for a range of debilitating conditions

It is more than 60 years since the first evidence emerged of the existence of stem cells and their natural ability to renew and differentiate into specialised cells types, such as those governing the blood, brain, heart or bones. Two Canadian scientists happened to observe colonies of proliferating blood cells after injecting bone marrow cells into mice. Given that the rodents’ blood cells were able to regenerate fully, exciting potential medical benefits for humans were suddenly envisaged.

Stem cells are considered the body’s master cells – the raw materials or primitive cells from which all other cells originate. Crucially, in the right conditions, be it in the body or a laboratory, stem cells can be split into daughter cells that are able to form new stem cells or, through differentiation, morph into specialised cells that have more specific functions.

Stem cell research offers an advanced method of studying the function of genes and physiological processes, yet the really interesting and far-reaching consequences of the original findings in 1961 are the vast range of possible clinical applications. As well as shedding light on the origins of cancer, stem cells can potentially drive therapies for the treatment of diabetes, spinal cord injury, heart disease, Alzheimer’s disease, Parkinson’s disease and more.

Government warning

Stem-cell therapies replace ailing patients’ damaged tissues using stem cells (or their daughter cells). Such treatments involve advanced therapy medicinal products (ATMPs) – medicines based on genes, tissues or cells – and are considered high- risk. In many countries, they fall under statutory regulations and citizens are advised to be wary of unproven cell-based therapies offered by some clinics around the world.

In Hong Kong, no ATPMs in the stem-cell category are registered for use. The Department of Health’s Drug Office warns that the safety, efficacy and quality of any unregistered medicines using stem-cell technology cannot be guaranteed. Certain cell or tissue replacement therapies like blood transfusion and bone marrow and cornea transplants, however, do not fall under this category and are commonly practised.

Dangerous hype

The potential to replace damaged tissue through regenerative medicine has fascinated the scientific community for decades. For laypeople who read about stem cells being coaxed into multiplying and populating different tissues, it may seem like a wonder cure for all debilitating conditions. This wild speculation has been fuelled by apparently successful cases being claimed and blown out of proportion before rigorous scientific process has been conducted.

A particularly notorious case involved Italian thoracic surgeon Paolo Macchiarini, who in 2008 created a new airway for Claudio Castillo, a young woman from Barcelona, using stem cells taken from her own bone marrow. These were implanted into a windpipe taken from a deceased donor, and stripped of its cells to leave a bare scaffold. Since the treatment involved the patient’s own cells, it appeared that her immune system was able to accept the replacement windpipe without the necessity of immune-suppressing drugs. The organ seemed to function like it was Castillo’s own, and the procedure was reported in the press as a miraculous breakthrough.

But this lofty claim was not justified. Many of the 17 or more patients around the world whom Macchiarini treated with artificial or regenerating windpipes suffered severe complications and subsequently died. His career and reputation unravelled, causing much soul-searching into the dangers of overhyping the progress of stem-cell therapy.

Questions of immunity

This case generated so much interest partly because it was perceived that patients could be treated with stem cells taken from their own bone marrow. Many such treatments have not worked, though the notable exception is blood stem-cell transplantation, which has been used on people with leukaemia and other cancers of the blood for decades, saving countless lives.

A recent report in the New Scientist detailed the treatment of diabetes in mice using genetically altered cells that bypass the immune system. Pioneered by Californian firm Sana Biotechnology, the method uses pancreas cells formed from stem cells that do not cause a destructive immune response. This is crucial because most stem-cell therapies in development require either the taking of immune suppressors or the use of stem cells derived from the person receiving them – which is costly, time-consuming and lacks universality. Cells from one person that are put into another usually provoke an immune response.

Sana Biotechnology bypassed this issue by genetically creating cells so they become invisible to the immune system. In tests using rhesus macaques, pluripotent versions of these cells – which have the potential to be turned into multiple different tissues and organs – survived with no sign of an immune attack for up to four months. By contrast, cells inserted into the monkeys without genetic changes were destroyed by their immune system within four weeks.

Blood tests indicated that the stem-cell-derived pancreas cells used to treat the mice for type 1 diabetes helped to reduce their diabetes symptoms. This research could be an important step towards off-the-shelf stem-cell treatment for a whole range of conditions including heart attacks and strokes. As Sana Biotechnology’s Sonja Schrepfer put it: “The vision is we have cells for anyone, anytime, anywhere.”

Future vision

In a concerted effort to combat degeneration of the eye, Dr Chien-Ling Huang and her research team at the Hong Kong Polytechnic University’s Department of Health Technology and Informatics are utilising induced pluripotent stem cells (iPSCs), a unique manipulable cell type that can be obtained by reprogramming animal and human differentiated cells. The team not only harnessed the versatility of iPSCs but also refined the differentiation process, coaxing these cells into distinct lineages vital for blood circulation and the intricate structure of the retina.

Imitating nature, their approach involves crafting an artificial extracellular matrix, a scaffold providing structural and biochemical support for cell growth. They believe the innovation not only improves retinal neuron differentiation efficiency but also lays the groundwork for further advancements in regenerative medicine. “Through the strategic integration of state- of-the-art gene editing and advanced biomaterials, the team envisions a significant enhancement in the generation of specific cell types crucial for combating degenerative conditions,” said a spokesperson.

Dr Huang’s team indicated that they remain focused on the ultimate goal: to contribute significantly to the arsenal of medical interventions aimed at saving individuals from the grips of degeneration disorders.

Miracle or Mirage: The wonder products of good health may not be all they are cracked up to be

In the world of health and wellness, there are a plethora of products that claim to offer extraordinary benefits. It is only natural to question whether these grand claims hold any truth. Here, we delve into three such products – alcohol-free beer, toothpaste said to heal teeth and gums, and over-the-counter painkillers – seeking expert opinion on whether all their hype is justified. Are consumers right to trust those bold proclamations on the packet or bottle, or have we become too cynical in the modern age?

Alcohol-Free Beer: A Healthier Alternative?

The market for no- or low-alcohol beers has grown significantly, with major breweries and craft beer producers jumping on board. But do these beverages truly contain negligible amounts of alcohol, and are they genuinely better for our health than traditional beers?

Big brands like Heineken and Guinness are now offering versions of their signature brews with the alcohol removed. According to Laura Willoughby, an expert on low- and no-alcohol drinks, Guinness uses a cold-filtration method to create Guinness 0.0, a non-alcoholic beer that closely resembles the taste of the original stout. This process involves removing the alcohol and reintroducing other ingredients to maintain flavour and texture.

Some craft brewers have used different yeast strains and innovative technology to create non-alcoholic beers with exceptional taste. In fact, some of these brews have won awards in blind tastings, dispelling the notion that alcohol- free options lack flavour.

Labelling standards vary by country, with most considering drinks below 0.5% alcohol by volume (ABV) as alcohol-free. In the UK, however, the threshold for non-alcoholic classification is 0.05% ABV, and beverages ranging from 0.05% to 1.2% ABV are considered low-alcohol.

One important question is whether these low-alcohol beers can intoxicate consumers. Willoughby assures us that this is not possible. Research conducted in Germany, where volunteers consumed 0.4% ABV beer, found blood-alcohol levels to be 100 times lower than the legal drink-drive limit.

Drinking alcohol-free or low-alcohol beer, which tend to have fewer calories compared to their alcoholic counterparts, can also provide health benefits. They contain polyphenols, compounds that help reduce inflammation and promote overall well-being. Additionally, these beers often possess isotonic properties that aid in rehydration, making them suitable sips after physical exertion or in hot climates, according to nutritionist Kerry Torrens.

Drinking in moderation is crucial. Keeping within the recommended weekly alcohol limit can help reduce the risk of health issues associated with excessive alcohol consumption.Pregnant women and those with alcohol dependency are advised to avoid even the smallest amounts of alcohol.

Healing Toothpaste: Too Good to Be True?

Toothpaste manufacturers often make bold claims about repairing enamel, protecting gums, and alleviating teeth sensitivity. But are these assertions genuine?

Dr Saoirse O’Toole, a clinical lecturer in prosthodontics at King’s College London, says the advantage offered by expensive toothpaste labelled as “enamel repairing” is minimal compared to standard products containing fluoride. The improvement is estimated to be only from 2% to 5%.

It is important to note that no toothpaste can completely restore enamel. “You will have a small additional benefit, but nothing will compensate for what you are doing in the diet, the way you are brushing, and the amount of oral procedures you are using,” she states.

Nor is toothpaste a remedy for protecting or hardening gums, according to O’Toole, who stresses that the best way to protect your gums is through brushing, flossing, and interdental cleaning methods.

However, there is evidence that toothpaste specifically designed for sensitive teeth can be beneficial and even offer instant relief. These toothpastes contain specialised desensitising agents that form a protective film on exposed tubules, reducing pain associated with sensitivity. For individuals experiencing dentine hypersensitivity, trying different brands of dentine hypersensitive toothpaste may help identify the most effective option.

Do Painkillers Ease the Pain?

Everyone experiences acute pain from time to time, be it a migraine, sports injury or, for women, period pain. Sufferers generally have their go-to painkiller at hand to provide relief, but is there much difference between taking aspirin, paracetamol or ibuprofen? And can some brands act more quickly than others to dull pain and target particular areas of the body?

Biochemist Dr Andrew Moore believes that analgesics advertised to be fast-acting do, in many cases, warrant this bold claim. “If you package paracetamol with sodium bicarbonate it seems to be absorbed faster,” he points out. Paying a little more to get a tablet with caffeine in it, or drinking coffee on the side can also help. Analysis of evidence in 500 clinical trials and 50,000 patients suggested that 10% more people received good pain relief when the product contained at least 100mg of caffeine, indicated Moore.

However, over-the-counter painkillers may be less effective than commonly expected. Moore warns that only about 30% or 40% of people who have moderate to severe pain will receive satisfactory pain relief from paracetamol, and this figure can drop to 25% to 30% when taking aspirin. Ibuprofen, a non- steroid anti-inflammatory drug, appears to offer more effective pain relief, though, with “about 50% or 60% of people getting good pain relief”.

Some brands of ibuprofen can be fast-acting. Moore says salt formulations of ibuprofen act quicker than standard acid ones, especially when taken on an empty stomach. Ibuprofen also tends to have fewer side effects than aspirin.

He suggests that ingesting a combination of pain relivers can be beneficial. Moore believes scientific research does not indicate that painkillers are effective at targeting a specific location of pain in the body.

Dr Mary Joan Macleod, a clinical pharmacologist, argues that while painkillers all work on the same pathway, different painkillers work on the pathway in slightly different ways.

All painkillers will target any pain in the body, but if the nerve endings are being stimulated by inflammation, she recommends ibuprofen. “For joint pains you are much better with an ibuprofen,” she states. “Ibuprofen is better for period pains because there are a lot of prostaglandins produced in the womb around the time of the menstrual cycle.” She also suggests combining paracetamol and ibuprofen when in pain.

According to Macleod, there is little difference in quality between the various brands of painkillers, but capsules are likely to provide faster relief as they are absorbed more easily.

Do So to Sleep: Solutions to insomnia go deeper than a comfy mattress and sleeping pills are not the answer

Sleep is one of three pillars of health so being deprived of it can have serious long-term health implications. Insomnia is known to affect most people during some stage of their life, especially in times of emotional difficulty or extreme stress. For some, though, it is not just a temporary situation but a debilitating condition.

History has seen plenty of famous insomniacs – painter Vincent van Gogh, former US President Bill Clinton and actress Marilyn Monroe all suffered, as did the King of Rock ’n’ Roll Elvis Presley. Speaking to a television interviewer at the peak of his fame in 1956, Elvis said: “I’ve been kind of nervous all my life. And now, going out on personal appearances all the time, I get so keyed up that I just can’t relax.” Nerves and adrenaline would so affect him after live performances that he could not sleep. “You know how hard it is, getting to sleep in a strange room and in a strange bed away from home, particularly when you are kind of nervous and jumpy.”

He went on to describe a scenario familiar to insomniacs the world over: “I’ll go to bed at night and close my eyes and just lay there. And then I’ll start turning. And twisting. And a couple of hours will pass, and I won’t have had had a lick of sleep.”

Stages of sleep

A typical night’s sleep (for those who can) spans four or five sleep cycles, each lasting between 90 and 110 minutes. Sleep comes in stages during which different brainwave patterns are exhibited. As we first start to sleep, we spend a few minutes in relaxed wakefulness with eyes closed and brain emitting alpha waves. Next is Stage 1 proper, a drowsy, relaxed state as muscle tension lessens and we experience sensations analogous to daydreaming. After a few minutes of Stage 1, we move into Stage 2 where brainwave patterns called sleep spindles and K-complexes occur, but this is still a light stage of sleep.

Finally, we reach Stages 3 and 4 which are slow-waved or deep sleep. Physiological activity including respiration, oxygen consumption, heart rate and blood pressure subsides to a low. It is difficult to awaken from deep sleep as awareness of the exterior world is shut out. Usually, this deep sleep lasts for about 45 minutes before progressing to rapid eye movement (REM) sleep or the dream stage where heart rate and breathing rate increase. This more visual and emotional stage is when we are more likely to awaken but will fall quickly back to sleep. Sound sleepers will repeat these cycles through the night.

Types of insomnia

Elvis’ problem of falling asleep – lying awake tossing and turning – personified one of the three types of insomnia. The other two are waking after some initial sleep and then being unable to return to sleep; and poor quality of slumber despite having no difficulty getting to sleep. While those in this latter category do sleep, they do not feel refreshed in the morning, as though they failed to attain deep sleep.

Deep sleep normally lasts longer during the early part of sleeping and as the night progresses awakenings are more common since sleep becomes lighter and REM periods increase in duration. Deep sleep is considered critical as a major biological restorative function and means to renew physical energy. The REM stage of sleep remains least understood by scientists, along with the consequences of being deprived of it.

What is known is that long-term insomnia can increase the risk of depression, diabetes, cardiovascular disease and Alzheimer’s disease as well as general increased irritability and reduced concentration levels and decision-making ability. Disturbed sleep must occur at least three times a week over more than three months to be considered insomnia.

Sleeping pill dangers

To combat his insomnia and anxiety, Elvis experimented with or was prescribed a wide variety of prescription drugs including sleeping pills that were designed to help him relax and achieve better quality sleep. Sleeping pills, though, usually come with side effects. Recent research by New Scientist uncovered that many of the drugs used to treat insomnia like benzodiazepines offer no long-term relief and may cause daytime fatigue, dizziness, general mental fogginess and the risk of dependency. Andrea Cipriani and his team at the University of Oxford found weak evidence that pills offer even short-term benefits and recommended against prescribing them as a first line of treatment.

Sleep hygiene hype

Good sleep hygiene such as a comfortable mattress and thick curtains and avoiding alcohol and caffeine late at night were all thought essential to avoid disrupting sleep patterns. However, a 2021 academic review of 89 studies into insomnia treatment found that education about sleep hygiene produced barely any improvement in symptoms. The underlying mental processes causing insomnia need to be tackled effectively to have greater success.

Scientific research suggests many people with insomnia are in a state of hyperarousal. According to research by Yishul Wei at the Netherlands Institute for Neuroscience, they are often locked into a pattern of negative, repetitive thoughts which affects their sleep pattern. Often, merely thinking about lack of sleep can lead to worsening symptoms (such as fatigue) irrespective of the actual level of sleep obtained.

Talking therapy solutions

Psychological therapy by trained practitioners may provide solutions for the negative, ruminating thought patterns that inhibit sleep. Techniques developed during sessions of Cognitive behavioural therapy for insomnia (CBTI) can reduce sleep performance anxiety; indeed, research suggests 70% of sufferers showed improved sleep after CBTI, with a good chunk of those going into remission. Mindfulness-based therapy for insomnia (MBTI), which involves non-judgmental awareness of the problem using the Buddhist philosophy of acceptance, may also help to lessen rumination and stress. It has borne significant, long-lasting results according to recent studies.

The reasons behind each person’s insomnia are unique, but researchers at the University of Amsterdam have identified five sub-types of the condition, finding that some people with particular sub-types are likely to develop symptoms such as depression – they suggest CBTI would be beneficial in these cases.

Apps are springing up to provide CBTI courses for those struggling to get a good night’s sleep, and AI algorithms are being utilised to personalise them to the needs of individual insomniacs. Other apps via a smartwatch or phone can deliver short pulses of restful sound at night to induce slow brainwaves associated with sleep. Many scientists agree these solutions are far preferable to the risk of becoming hooked on sleeping pills.

Ageing Enlightenment: How science frames the contemporary search for continued youth

Combating ageing to stay young in mind and body and maintain that youthful glow is no longer some impossible holy grail shrouded in mystery or reliant on magical potions. Whether increased physical activity and mental agility or simple dietary adjustments, there are plenty of scientifically proven ways we can ward off time and even reverse the ageing process.

Do High-Intensity Exercise

Exercise, especially high-intensity aerobic exercise that increases the heart rate, is known to have a rejuvenating effect across the entire body, from the immune system and the brain to the skin and the heart. Scientists attribute a lot of this to mitochondria – the power sources within your cells.

Mitochondria can be thought of as tiny batteries that live inside our cells and provide them with energy. Research by Associate Professor Matt Robinson of Oregon State University found that just a few minutes of high-intensity interval training can help restore mitochondria and thus reverse the signs of ageing. Sharing his conclusions in a BBC podcast, he notes: “Exercise stimulates both the removal of older mitochondria and the synthesis of new mitochondria.”

Research suggests it is not just muscles that benefit from intense exercise but tissues in your brain as well. To have a powerful effect, the level of exercise should elevate the heart rate to the extent that carrying on a conversation should be problematic. This exercise can be quickly and relatively easily incorporated into our daily lives by increasing walking pace or taking the stairs, as Robinson points out. A greater level of exertion can then be considered.

Take Up Resistance Training

It is becoming increasingly clear that resistance training and building up your muscle mass holds benefits other than the purely aesthetic. A BBC review of dozens of studies on the effects of exercise on the over 50s has shown that both aerobic and resistance training are good for the brain. Resistance training was found to be especially good for memory and executive function, which includes things like problem-solving. It can also help you get a better night’s sleep.

This kind of exercise can reduce harmful belly fat that produces chemicals which can have a negative effect on your blood sugar levels. Muscles soak up blood sugars during exercise, reducing your risk of prediabetes, and potentially adding years to your life.

The key point is that resistance exercise seems to rejuvenate at the cellular level, boosting the connection between nerve fibres and muscle fibres. “All exercise will boost the connection between nerve and muscle fibres, but I think where resistance exercise really is the champion, if you like, is where we consider the type 2 muscle fibres,” says Professor Abigail Mackey of the University of Copenhagen.

Type 2 muscle fibres – used when lifting heavy objects or making fast movements – are the ones affected most by ageing, notes Mackey. She recommends doing squats and push-ups as excellent forms of resistance training because they train so many muscles, and says that weight training is ideally needed to ward off muscle decay.

Eat More Fruit & Veg

Incorporating fruits and vegetables into the diet has long been known to do wonders for the skin and slow the ageing process. Brightly coloured fresh produce – such as carrots, mangoes, melons, tomatoes, red cabbage, button squash and sweet potatoes – that contain carotenoids are best.

According to a BBC health report, research has shown that collagen levels and wrinkles can be greatly improved with diet and those who eat more vegetables have far fewer wrinkles and plumper skin. Many of these vegetables also help the skin retain moisture and boost collagen.

Carotenoids are highly effective antioxidants that can protect your skin at the cellular level. In laboratory tests, they have been shown to guard collagen-producing skin fibroblasts against damage caused by UV radiation and oxidative stress – both big drivers of skin ageing. They also trigger cells into producing higher degrees of hyaluronic acid, the ingredient in many anti-ageing creams and fillers.

Research by dermatologist Dr Raja Sivamani of the University of California, Davis, shows that eating a daily portion of mango could help reverse existing wrinkles and prevent new ones from forming. “Mangoes are rich in carotenoids – [vital] plant-derived, naturally occurring chemicals that act as antioxidants,” he says. “They are very special because they are also fat-loving, so when they get into the system they can hone into the skin and sit there. They can basically increase your ability to have antioxidant power.”

Sivamani stresses that eating more fruits and vegetables is good for the whole body, not just the skin. “You are also diversifying the gut; you are also having these antioxidants that are floating through your circulatory system,” he says. “There [are] going to be cardioprotective effects, so there [are] many different ways you are getting benefits.”

Feast on Fermented Foods

Humans have been eating fermented foods – bread, beer and kefir to name but a few – for thousands of years because of the taste and since fermentation is a great way to preserve food. Fermented foods can rejuvenate your gut microbes, boost energy and mood, reduce inflammation and, most importantly, improve your immune system for all-round health.

An overactive immune system is known to cause many of the diseases we may associate with ageing, such as joint pain, type 2 diabetes and depression. Studies have shown fermented foods can reduce stress and relieve aches and pains and help people perform better on memory tests.

Dr Justin Sonnenburg, Professor of Microbiology and Immunology at the Stanford University School of Medicine, told the BBC there is a tight link between our immune system and our gut microbiome. Stanford Medicine recently conducted a clinical trial with individuals in one group specifically assigned to eat a wide variety of fermented foods containing live microbes. This group experienced a big increase in their gut microbiome diversity and showed a uniform decrease (up to 30) in many inflammatory markers.

“It is very apparent that our microbes are doing many things to essentially train our immune system, and they are secreting all sorts of molecules,” says Sonnenburg. “These molecules can fundamentally interact with our immune system and can change things like inflammatory state.” He recommends live yoghurt (with bacteria), fermented kombucha and sauerkraut as good gateways to fermented foods.

Learn Something New

Another method recommended by scientists for staying young and mentally sharp is to challenge your brain. Keeping your mind active by learning something new can help build up the neural connections in the brain, making it more resilient against age-related decline.

Research by Dr Rachel Wu of the University of California, Riverside, reveals that learning three new skills at the same time can significantly boost memory in older adults. Cognitive tests revealed that some adults who habitually do this perform like people 50 years their junior. Challenging yourself is the key to forging new brain connections, she notes.

Heat Resistance: Tips to keep hydrated and avoid heatstroke as the world gets rapidly warmer

Global warming is not only a threat to the planet as a whole; it also affects the health of every individual inhabitant. July was reportedly the hottest month on record around the globe, and the number of heat-stressed days is only set to increase.

Indeed, a study published in The Lancet estimated that about 356,000 deaths worldwide were related to heat in 2019. And the World Meteorological Organisation is now warning of global warming breaking through the crucial 1.5°C cap above pre-industrial temperatures in the next five years.

With record-tumbling baking-hot spells happening more frequently, it is vital that we keep our cool and take precautions to safeguard our well-being.

Hong Kong warning system

The authorities in Hong Kong are acutely aware of the severity of the situation. A new three tier Heat Stress at Work Warnings system was introduced earlier in the summer to help tackle heatstroke among those working outdoors or without air-conditioning. If the Hong Kong Observatory’s Hong Kong Heat Index (HKHI) hits 30, this will trigger a recommended rest time for each hour of labour depending on whether the workload is “light”, “moderate”, “heavy” or “very heavy” and the level of the alert (amber, red or black). The heat index uses data that considers relative humidity, the intensity of sunlight, temperature and hospitalisation rate.

Workers deemed to be involved in “very heavy” workloads during an amber alert will be recommended to take 45 minutes of rest after working 15 minutes every hour. Those involved in this level of intense physical activity are advised to cease work completely if the HKHI hits 32 or above – red and black warnings. Workers at lower intensity of physical labour would be advised to rest for varying periods of time (or even suspend work).

The warning system is operated by the Labour Department with the Observatory assisting to broadcast the message, which can be received via the GovHK Notifications or MyObservatory mobile applications. The guidelines inherent in the warning system are only voluntary measures, though, and are not legally binding. A construction worker in Hong Kong lost his life from heatstroke this summer during an amber heat alert.

Water everywhere

The Department of Health’s Centre for Health Protection (CHP) consistently urges the community to take heed of necessary measures against heatstroke and sunburn in very hot weather. “The public should carry and drink plenty of water to prevent dehydration while engaging in outdoor activities,” warned a CHP spokesperson recently.

The importance of staying properly hydrated during hot summer days has long been advocated by medical professionals. Water is known to perform vital functions such as regulating body temperature, flushing waste from the body, supporting a healthy immune system, lubricating and cushioning joints, as well as promoting healthy digestion and improving memory, alertness, mood and sleep quality.

Some health experts suggest consuming 13 cups of beverages a day, including water. However, this total depends on the level of activity, climate and overall health. Hot and humid places mean people tend to sweat more and it is important to keep water on hand. Drinking before, during and after a workout is also essential.

Dehydration danger

Tips for optimum hydration include ingesting a glass of water (about 8 fluid ounces) upon waking and before bedtime, drinking throughout the day, infusing water with slices of fruit, vegetables or herbs, and using a favourite water bottle to encourage fluid uptake.

Not all liquids are recommended, though. “Those engaged in strenuous outdoor activities should avoid beverages containing caffeine, such as coffee and tea, as well as alcohol, as they speed up water loss through the urinary system,” said the CHP spokesperson.

The World Health Organization (WHO) advises to check the colour of urine, and to drink more if it is dark. They warn against drinking distilled water as it leaches all-important electrolytes.

Apart from dark urine, there are a multitude of signs of possible dehydration such as thirst, flushed skin, headache, fatigue, increased body temperature, dizziness, irritability, constipation and nausea. Possible options to try to alleviate the situation include drinking electrolyte-infused water, Pedialyte, Gatorade, coconut water and watermelon, which contains 92 percent water.

Combatting heatstroke

Some groups are more vulnerable to heatstroke than others. According to the CHP, children, the elderly, the obese and those with chronic illnesses, such as heart disease or high blood pressure, “should pay special attention”.

These dos and dont’s will help reduce the risk of heatstroke:

  • – Wear loose and light-coloured clothing to reduce heat absorption and facilitate sweat evaporation and heat dissipation.

  • – Avoid vigorous exercise and prolonged activities like hiking or trekking as heat, sweating and exhaustion can place additional demands on the physique.

  • – Perform outdoor activities in the morning or the late afternoon.

  • – For indoor activities, open all windows, use a fan or use air-conditioning to maintain good ventilation.

  • – Do not stay inside a parked vehicle.

  • – Reschedule work to cooler times of the day. If working in a hot environment is inevitable, introduce shade in the workplace where practicable.

  • – Start work slowly and pick up the pace gradually. Move to a cool area for rest at regular intervals to allow the body to recuperate.

The WHO advises keeping a good supply of medicines, batteries and frozen or tinned food at home to avoid frequent trips to the shops during especially hot days.

Sunlight protection

As the sun blares down on these days of increasing heat, the Ultraviolet (UV) Index released by the Hong Kong Observatory is a helpful tool. When the UV Index is high (6 or above), avoid direct exposure of the skin and the eyes to sunlight.

The following measures will help protect against UV damage when out in the sun:

  • – Wear long-sleeved and loose-fitting clothes.

  • – Wear a wide-brimmed hat or use an umbrella.

  • – Seek a shaded area.

  • – Don UV-blocking sunglasses.

  • – Apply liberally a broad-spectrum sunscreen lotion with a sun protection factor (SPF) of 15 or above, and reapply after swimming, sweating or towelling off.

  • – When using a DEET-containing insect repellent, put on sunscreen first, then the repellent.

Cold comfort

While there is plenty for the public to do and be aware of to adapt to extreme heat, measures on an individual level and government action plans like those adopted in Hong Kong do not tackle the root cause of the problem. Global warming is a result of climate change generated most significantly by greenhouse gas emissions. Until we get serious about curtailing these, our heat stress is only going to get worse.

Sleep Revived: Apparently, those who snooze win – new research suggests habitual napping enlarges the brain

Debate about the benefits of power napping has raged for years, but recent research suggests those who enjoy a daytime snooze can nod off knowing it is likely doing some good. A study conducted by UCL in the UK and the University of the Republic in Uruguay found regular catnaps can increase the size of the brain and perhaps thereby delay the ageing process.

Published in June in Sleep Health, the journal of the UK’s National Sleep Foundation, the research project considered whether there was an association between daytime napping, cognitive function and brain volume, as had been suggested by previous purely observational studies. In welcome news for nappers, its conclusions indicated a causal link between habitual power naps and larger total brain volume.


The results of this randomisation study have deepened our understanding of daytime nap frequency, cognitive function and structural brain outcomes. Yet they also highlight the need for further research. Brain areas that determine factors such as alertness may also be affected by napping. Exploring whether there is any association between catnaps and other measures of brain health and cognitive function like hippocampal volume, reaction time and visual processing is the next task for scientists.

Bigger brains

The joint university research project used data from people aged 40 to 69 and involved a gene variation measurement technique called Mendelian randomisation. Previous studies have identified 97 snippets of DNA – the genetic code with which we are born – concerned with people’s likelihood of habitual napping. Genetic data and magnetic resonance imaging (MRI) scans drawn from more than 35,000 individuals taking part in a larger UK Biobank study were then used to compare measures of brain health and cognition of people who were genetically programmed to nap against those who were not programmed this way. Analysis suggested a larger total brain volume for those who were programmed to nap.


In an indication that regular nappers are less prone to brain shrinkage, the study found that their brains were about 15 cubic centimetres larger – the equivalent of delaying ageing in the brain by between 2.6 and 6.5 years. With good brain health comes a lower risk of dementia and other diseases.

UCL researcher Dr Victoria Garfield said their “exciting findings” suggest that everybody could potentially benefit from napping. She also pointed out that this health benefit is relatively easy to try out compared to other forms of activity often recommended to improve well-being, such as vigorous exercise. She hoped the study would reduce any stigma about taking an afternoon nap.

Napping culture

The concept of catnaps during the workday is more culturally acceptable in some parts of the world than others. Spain, for instance, has long embraced the tradition of a siesta. This is especially true in the smaller, rural communities of Andalucía and other regions where many people still eat at home and then retire for a nap in the searing afternoon heat. However, the traditional siesta is now much less common in the larger cities. Here, a regular 9 a.m.-5 p.m. routine tends to be followed, and napping is not really part of the modern career culture.

nap time

Hong Kong and China also have a napping culture. In some shops and offices, workers set up a sleeping pillow and snooze for 15 minutes or half an hour. An ex-pat British businessman who preferred not to be named said he once thought there was a power cut at a factory in China as the lights went out suddenly after lunch had been served. “Oh, no, we turn the lights out so the workers can have their nap,” he was politely informed by the foreman.

Sleeping is a fundamental component of health. An assistant professor in the Behavioural Science Group at Warwick University, Dr Mattie Toma, says that companies in the UK should consider giving their staff the chance to nap. Her own research has found that workers in India who snoozed in the afternoon were more productive, and the habit boosted levels of attention and well-being.

Past snoozers

Indeed, two of the UK’s former prime ministers were famous nappers – Winston Churchill and Margaret Thatcher. During the Second World War, Churchill would often take a 20-minute nap in the afternoon, his “refreshment of blessed oblivion” so vital to renew his vigour. Thatcher reportedly only slept for four or five hours at night but made up for it with catnaps in the back of her official car. American presidents John F. Kennedy, Ronald Reagan and Bill Clinton were all known to enjoy 40 winks, though Reagan would not readily admit that he took said snoozes.


This latest research should erode any remaining stigma surrounding catnaps. Even Einstein was thought to have a power nap, and many well-being experts including British workplace stress-management guru Carole Spiers suggest that a short nap of 15 to 20 minutes is sufficient to reenergise you. According to some studies, though, having a nap too late in the afternoon may disturb your nighttime rest, so laying down tools and your head before 3 p.m. is probably ideal.

Also Read: The Science of Sleep Chronotypes: Unveiling the Secrets of Our Internal Clocks

The Science of Sleep Chronotypes: Unveiling the Secrets of Our Internal Clocks

Sleep is an essential part of our lives, as it rejuvenates our bodies and minds, allowing us to wake up refreshed and ready to go through a new day. However, not everyone sleeps at the same time or sticks to the same sleep patterns. Understanding how our internal clocks affect our sleep-wake patterns and overall well-being will help us determine our sleep chronotype and allow us to increase our productivity and make the best out of the day. So here is all the science behind sleep chronotypes.

Also Read: Playlists that can help you fall asleep in 10 minutes – the connection between sleep and music

What is a sleep chronotype?

Sleep chronotype refers to an individual’s preferred timing for sleep and wakefulness throughout 24 hours. While some people are more active in the morning with their energy draining towards the evening hours, some have high levels of energy around sunset, and then there are others who have different biological clocks, or as scientists call it, circadian rhythms.

What are the four sleep chronotypes?

The most common way of describing a person’s chronotype is by comparing their daily circadian rhythms to the biological clock of animals. In that regard, four animals are usually used for reference and these include the lion, the bear, the wolf and the dolphin.

Lion – These are people who wake up early in the morning and go to bed early. They are more productive before lunchtime but get tired around the evening, thus making it hard for them to partake in social events in the evening.

Bear – Nearly 55 per cent of the human population fall under this category and their clock depends on the sun, as in, they wake up around sunrise and their activity levels decline by night. They are energetic in the forenoon and the evening, making it easy for them to work well during the day and attend events in the evening without feeling too tired.

Wolf – Also considered the night owl, these people prefer to go to bed late in the night and wake up late. They are more productive during the afternoons. As a result, a 9-to-5 work schedule may not suit them.

Dolphin – People with insomnia are generally part of this chronotype because, like this animal that is half awake while it sleeps to protect itself from predators, these people do not sleep well. Their sleep schedule may not follow a certain pattern every day, and they are highly active in the evenings.

What is the science behind sleep chronotypes?

Numerous scientific studies have sought to understand the impact of sleep chronotypes on various aspects of our lives. One study, titled ‘Epidemiology of the human circadian clock,’ conducted by T Roenneberg and others found that sleep chronotypes were influenced by a person’s genes, with certain genetic variations increasing a person’s productivity in the morning or evening.

Another study conducted by neuroscientist Valérie Mongrain and her team revealed that individuals with distinct chronotypes exhibit differences in brain activity during sleep, potentially affecting their cognitive level and emotional quotient.

Given the number of studies that have been conducted regarding sleep chronotypes, it has sparked conversations and debates among researchers, healthcare professionals, and society as a whole. Some argue that understanding and respecting individual sleep chronotypes can lead to improved well-being and productivity. They advocate for flexible scheduling of work and school hours, allowing individuals to align their activities with their natural sleep preferences. This approach is believed to yield better cognitive performance, mental health, and overall satisfaction.

On the other hand, critics argue that accommodating individual sleep chronotypes on a large scale may not be practical and cost-effective, given the societal structures and demands. They believe that promoting good sleep hygiene, irrespective of one’s sleep chronotype, can mitigate some of the negative effects associated with sleep deprivation. They suggest maintaining consistent sleep schedules, creating a conducive sleep environment, and developing healthy sleep habits, such as avoiding electronic devices before bedtime.

Staying idle is far from ideal – why busy people should fit in exercise every day

Spending long working days almost constantly deskbound is known to be bad for health. Combine that with little or no exercise outside the office and the deleterious effects on our health are worsened.

According to a study published in The Lancet, insufficient physical activity is a leading risk factor for non-communicable diseases and has a negative effect on mental health and quality of life. Sitting down too much can trigger weight gain and back pain, create blood clots, induce heart attacks and have been linked to cancer. Another study conducted by BMC Public Health suggests an unwanted association between sitting time and anxiety.

Why people do not exercise

Physiotherapist Terence Tsang believes it can be difficult for individuals with sedentary lifestyles to break the habit of sitting for long periods and incorporate more physical activity into their daily routines. He also says many people lead busy lives and have demanding work schedules or family responsibilities, which can make it difficult to find time for exercise.

Some may simply lack motivation to exercise, especially if they do not enjoy physical activity or see immediate results. “Other people may have pre-existing health conditions that make exercise challenging or uncomfortable,” he says.

He lists a whole range of potential health and physical effects of a sedentary lifestyle – from heart disease, stroke and type 2 diabetes to weak heart muscles and poor circulation.

Inactivity can also result in muscle weakness and loss, poor bone density and an increasing risk of falls and injuries. Inactivity can spur weight gain and obesity too, as well as mental health issues.

Minimum requirement

According to the World Health Organization, adults should aim to engage in at least 150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous aerobic exercise per week, or a combination of both. A British doctor recently told the BBC that the barest minimum someone should aim for is 5,000 to 6,000 steps a day. He also believes there are improvements to our health if the pace of the steps increases.

A study published in journals of the American Medical Association backs up this advice. It involved 78,500 individuals and found that completing up to 10,000 steps per day may be associated with a lower risk of mortality, and cancer and cardiovascular disease (CVD) incidence. Furthermore, steps performed at a higher cadence may prompt additional risk reduction.

Short-burst benefits

Research presented in Nature Medicine also highlighted the benefits of sudden bursts of activity like running to catch a train or doing household chores vigorously. The study concluded that as few as two or three bouts of such unplanned exercise per day, even if they last just a couple of minutes, can substantially lower CVD and cancer mortality risk. Standing for an extra two hours a day is also thought to have some benefits.

“It’s important to remember that any amount of physical activity is better than none,” says Tsang. “Even small amounts of physical activity throughout the day can have a positive impact on overall health and wellbeing.”

For people who are busy, Tsang advises that there are several ways to squeeze in more steps and exercise. “Take short breaks throughout the day to stand up, stretch and walk around. Even a few minutes of physical activity can help improve circulation and boost energy levels,” he says.

“Consider walking or biking to work instead of driving or taking public transportation,” he adds, noting that getting off one MTR stop earlier than usual and walking from there to the office could be an alternative.

Another quick and easy way to get some extra steps and improve cardiovascular health would be to use the stairs whenever possible rather than taking the lift or escalator. “Using a pedometer or fitness tracker can help you track your steps and monitor your physical activity throughout the day,” he says. “This can be a helpful tool for staying motivated and achieving your fitness goals.”

Moderate vs vigorous activity

Any physical activity that raises your heart rate and makes you breathe harder can be considered health-boosting moderate-intensity exercise. Walking at a moderate pace can be an excellent way to clock up physical activity; Tsang advises aiming for a pace that ups your heart rate and makes you feel slightly out of breath.

He cites other activities: “Cycling can be a great way to get cardiovascular exercise. You can ride a bicycle outdoors or use a stationary bike indoors. Swimming is a low-impact exercise that can be great for people with joint pain. It can also provide a full-body workout. Dancing can be a fun and enjoyable way to get physical activity. It can also improve flexibility, balance and coordination.”

Tsang notes that hiking can provide both physical and mental health benefits, while yoga can improve flexibility, strength and balance, plus help reduce stress and elevate mood.

“Moderate-intensity activities such as brisk walking and cycling at a moderate pace can provide health benefits like improved cardiovascular health, muscle strength and bone density, and can reduce the risk of chronic diseases such as heart disease, stroke and diabetes,” he notes. “Vigorous activities such as high-intensity workouts, running, jumping rope can provide additional health benefits like improved fitness levels, greater calorie burn and better weight management.”

The choice between moderate and vigorous activity ultimately depends on personal preference. “It’s important to choose activities that are enjoyable and sustainable over the long term, as this is more likely to lead to a consistent physical-activity routine,” he says.

Wider health picture

Tsang also stresses that physical activity is just one component of a healthy lifestyle and that eating a balanced diet, getting enough sleep, managing stress, and avoiding tobacco and excessive alcohol consumption are also important. He recommends consulting a healthcare professional before starting a new exercise routine.