We are used to searching online for ANSWERS TO MOST OF THE QUESTIONS OF EXCITING US . In the new series of materials, we ask just such questions: burning, unexpected or common – to professionals in various fields.

Last year, we talked about the risk of melanoma – an extremely dangerous skin tumor – and how to reduce this risk: you need to use sunscreen, regularly examine the skin, ideally undergo screening with photographs, and moles that seemed suspicious to the doctor should be removed and sent to research in the laboratory. These rules are suitable for those who are not worried about anything, and are especially important for those with more than fifty moles (although recently there is evidence that a much smaller number requires close attention).

But what if you injured a pigmented formation on the skin (for example, accidentally injured a mole with your fingernail or the strap of a swimsuit)? Is it more dangerous than a simple scratch? Do I need to go to the doctor right away and take action? We asked these questions to experts.

Anastasia Kolodiy

dermatovenerologist, cosmetologist of the Chaika clinic

Simple nevi, or moles, are the most common benign skin tumors. Most often, they look like small flat spots, and with age they can turn pale and slightly rise above the surface, growing strongly in older people. The growth of nevi is associated with hormonal factors (therefore, moles can appear or increase in adolescents and during pregnancy) and, of course, with exposure to sunlight. Today there are no clear indications for the removal of moles that do not bother; it is necessary to remove nevi that have changed externally, interfere physically (for example, constantly in contact with the edge of clothing) or aesthetically.

If you have damaged a mole, you should not panic, but you still need to see a doctor (dermatologist or oncologist). First, as with any damage to the skin, infection must be prevented. It is necessary to treat the wound with an antiseptic and, as necessary, use wound healing agents such as panthenol. Second, while trauma alone will not cause degeneration into melanoma or other skin cancer, the tendency to trauma and bleeding may indicate that the adverse process has already begun. And if we are talking about melanoma, then a timely visit to a doctor can save lives.

It is important to go not to a cosmetology clinic, and even more so not to a beauty salon, but to an institution where there is an oncodermatologist. Of course, any removal of a mole must be accompanied by its sending for histological examination. There are times when a disturbing “mole” was removed to a person in the salon without examining it under a microscope, and after a while he has metastases of a malignant tumor and it becomes clear that it was melanoma, but precious time has already been lost.

Alexander Geynits

Doctor of Medical Sciences, Professor, Surgeon of the Highest Category of the Atlas Medical Center

There are pigmented formations, they can be located at the level of the skin or rise above it, they are also called birthmarks – this is local pigmentation, an accumulation of melanocytes. They should not be touched unless they cause major cosmetic or aesthetic inconvenience. Another story is pigmented skin tumors, or nevi (these can include papillomas, keratomas, fibromas). If they rise above the level of the skin, this is an absolute indication for their removal.

Nevi, or, in the conventional sense, moles, are dangerous because they can degenerate into malignant skin tumors, the most dangerous of which is melanoma. If a person accidentally damaged a birthmark, then it is better to immediately consult a doctor. The global trend at the moment is that any neoplasm of the skin must be removed with subsequent analysis of this tissue. And an injured mole is primarily a road to infection. I must say that not only injuries and ultraviolet light, including in solariums, are dangerous, but also infrared (thermal) sun rays. There are infrared saunas – and they are dangerous too.

The number of moles is genetically determined and, of course, if there are two hundred of them, you do not need to remove everything. It is necessary to get rid of moles that increase, become inflamed or otherwise bother a person. In any case, the decision should be made by the doctor after a thorough examination.

It is believed that when removed with a laser, the tissue completely evaporates, and there is nothing to carry for histological examination – but in fact this is not the case. A thin laser beam can cut off the formation on the skin, like a scalpel; what is left on the skin can really evaporate; at the same time, oncological principles are followed so that nothing remains.

Text to help you understand how people with dyslexia read

In the “Bookmark” section, we talk about sites and online services – both useful and completely useless, but funny and amazing – which, in fact, should be added to your favorites or added to the RSS feed.

Dyslexia is a neurobiological feature in which it is often difficult for a person to recognize, read and write words correctly; in general, the list of symptoms is long and includes, for example, the inability to distinguish between right and left. And while it is still believed that this is a fictional star fever, which was promoted by Hollywood celebrities like Tom Cruise, it is a real problem that is faced by three to seven percent of the population.

On the website of the Association of Parents and Children with Dyslexia, a text has been posted , thanks to which you can feel how people with this feature perceive words in writing. You can read this text, but it will take much more time: letters jumping back and forth slow down perception at times. Perhaps the best way to explain what dyslexia is is still hard to come up with.

THE POPULARITY OF SPORTS FOOD IS GROWING NOT ONLY AMONG professional athletes, including bodybuilders, but also among amateurs. This is confirmed by the numbers: in 2010, sales of vitamins and nutritional supplements in the United States reached $ 28 billion, and seven years later this amount has grown to 36 billion . To scale: theoretically on the amount that could be purchased for about forty companies Avon size.

The choice of sports nutrition is huge: complexes, mixtures, boosters stand in rows on the shelves of fitness clubs and specialized stores, and the assortment on the Internet is even wider. Vials of nutritional supplements, from tiny to gigantic, are full of colorful messages and bright promises – from rapid muscle growth and recovery to improved blood circulation in them and burning of subcutaneous fat. The dosage forms range from powder to be diluted with milk, water or juice, to capsules and gels.

It is worth whether to believe the coach, it was reported that when taking certain supplements the desired effect can be obtained more quickly? Is it possible to do only with proper nutrition during active sports? Understanding what fitness supplement manufacturers are advertising and how it relates to scientific research.

Protein

Perhaps the most popular form of sports nutrition is protein, or protein. It is not a hormone and not a cure, but simply building blocks for muscle. In 2010, The Daily Mail published an article with a headline stating that protein powder could increase life expectancy by ten years. After closer examination of the data, it turned out that this was a study in middle-aged mice, which were supplemented with branched-chain amino acids (BCAA). The mice of the experimental group lived on average ninety-five days longer than the animals fed the usual diet. These results were extrapolated to humans, concluding that amino acids and, by extension , protein are beneficial – and that extending the lifespan of mice by three months is equivalent to extending human life by ten years. The authors clarified and reported that they were only able to trace the course of biological processes, and also pointed out the obvious biological and physical differences between mice and humans – in general, a good example of the fact that you can not transfer data from experiments directly into the headings.

Under normal, non-extreme conditions, the protein that they get from regular food is enough for most people. In the UK, the recommended daily intake for adults (nineteen to fifty years old) is 55.5 grams per day for men and 45 for women (excluding pregnant and breastfeeding women). In the US, the rates are very similar – 0.36 grams of protein per pound of body weight, that is, 0.79 per kilogram of body weight, or at least 10 % of the daily calorie requirement. Most of us eat more : the actual daily protein intake is 88 grams for men and 64 for women. For example, a 65- gram chicken sandwich contains approximately 20 grams of protein; if you add a glass of milk to it, you will add another 5 grams of protein. As a result, you get 25 grams of protein in one snack, that is, more than half the daily value for women. In professional athletes other rules. According to experts from the British Nutrition Fund, athletes in strength sports need 1.2 grams of protein per kilogram of body weight, while athletes developing speed qualities need 1.7 grams of protein per kilogram. Even these goals can be achieved with a balanced diet, although protein powder can be a convenient snack option.

Let’s go back to the fitness club. Coaches argue that high-protein diet is good for weight loss, but in fact the situation is to have not yet been cleared up : some studies support this view, others deny. It has also not been proven that a high protein diet helps prevent muscle loss in middle age. Even less compelling is the evidence that excess protein helps maintain cardiovascular health. The positive effect of a high-protein diet on muscle strength and elasticity has also not been confirmed. True, there are a number of indications of the benefits of a high-protein diet for healthy adults, not the elderly or pregnant.

Increasing the amount of regular protein in the diet to 20-25% will not harm your health . If translated into grams, then it would be reasonable for men to eat no more than 111 grams of protein per day, and for women – no more than 90 grams. In addition to the benefits, there are possible risks, such as the occurrence of diarrhea. It has also been shown that excessive amounts of protein in the diet can reduce bone density and increase the risk of osteoporosis. In people with proven kidney disease, high levels of protein will definitely lead to the progression of kidney failure .

Be that as it may, to maintain a normal level of protein in the diet or (if desired and necessary) to increase it, if you cannot get so much protein from food, you can turn to sports supplements. And here one problem arises: a study of 134 powdered proteins revealed heavy metals in them, including arsenic, cadmium and mercury – cadmium was of particular concern to researchers, since it can accumulate in the kidneys, damaging them. True, the authors were immediately accused of the lack of transparency in the methodology and funding sources, and it should be said that heavy metals are present in the environment and food contamination is inevitable – but it is still possible that consuming a large amount of protein (more than three servings a day) can be dangerous.

Amino acids

A variety of protein supplements is considered BCCA – the essential amino acids valine, leucine, isoleucine with branched side chains. It is believed that these amino acids (or “amines” in fitness jargon), with serious physical activity, help to reduce the percentage of fat, enhance the effect of other supplements and strengthen the immune system. K Unfortunately, the evidence is that in no studies received. On the contrary, there is evidence that SCAD may increase the risk of developing ALS – amyotrophic lateral atherosclerosis. This is a rare disease, which in 2014 was dedicated to a flash mob pouring ice water from a bucket.

To summarize, the protein and its constituents (amino acids) are safe in an amount not exceeding two daily norms. If you have kidney disease or a clear connection between diarrhea and protein intake, then you should not lean on protein. It is also important not to buy unknown or suspiciously cheap proteins, even if offered by a fitness trainer.

Gainers

These are carbohydrate-protein mixtures, in addition to protein, they contain simple or complex carbohydrates, vitamins, creatine. A gainer is a source of extra calories that should be taken immediately after training to build muscle and replenish energy. Allergy to milk protein can be a possible problem , but this is usually known from childhood. Thus, a gainer, like protein, can rather be considered a type of food that, if used correctly , will not cause harm and will serve as a source of energy and nutrients. As usual, the question of quality remains open; it is better to choose products from trusted manufacturers.

Creatine

Creatine is an organic acid that supplies energy to muscle and nerve cells. There are small studies that show the benefits of creatine in gaining muscle mass. True, this applies only to young athletes-sprinters, that is, those who are involved in sports with short-term but intense muscle work. For this reason, creatine is banned by some sports organizations – it can be regarded as doping . On the other hand, this substance is well studied and is not toxic at a dose of 2-3 grams per day .

Anthony Komarov, editor-in-chief of the health letters section of Harvard Medical School, cautiously warns that in adulthood, creatine is unlikely to help build or maintain muscle mass, and that there is no reliable data on the absolute safety of creatine. To completely protect yourself from possible negative consequences, you should not exceed the recommended dosages of creatine and use it at an older age.

L-carnitine

It is a direct relative of the B vitamins, which are synthesized by the body itself. L-carnitine is involved in the energy metabolism of skeletal muscles and the transport of fatty acids into cells. It would be logical to assume that L-carnitine improves muscle function, but the research results are disappointing : in twenty years of study, no improvement in muscle performance has been found. In general, there is no evidence yet for the benefits of L-carnitine.

The substance has been shown to be safe, provided that the manufacturer does not cheat. The FDA warns that unscrupulous manufacturers can add sibutramine to carnitine, a potentially dangerous substance that can significantly increase blood pressure and heart rate. This, in turn, increases the risk of cardiovascular complications in arrhythmias or coronary artery disease.

Nitric oxide donors

By relaxing the vessel wall, nitric oxide increases blood flow to the muscles and helps them recover faster after exercise; As sports supplements, it is not nitric oxide itself that is offered, but substances (nitrates, arginine, citrulline) that are converted into it in the body. Usually the supplement contains a mixture of various substances; however, nitrates and L-citrulline have been shown to be effective in improving endurance , but have been studied in professional cyclists, runners, swimmers and kayakers rather than amateurs. L-arginine, on the other hand, has not shown any effects either in combination with caffeine or creatine, or on its own.

A fly in the ointment was a study in which data were obtained on the violation of the synthesis of steroid hormones in men when using nitric oxide donors. In addition, L-arginine can cause diarrhea and indigestion when taken in doses greater than 10 grams. Against this background, the staining of urine in a reddish color due to the components of beets is a harmless fact. The research may conclude that the benefits of nitric oxide donors in women outweigh the potential harm, and men should wait for more detailed safety studies.

Fat burners

Under this name, several groups of drugs that affect metabolism are combined : first of all, these are thermogenics, which increase body temperature and increase the amount of calories spent, and lipotropics, which accelerate the breakdown of fats. There are drugs that are even less close to the processes of burning fat – in order to promote weight loss, they affect other mechanisms, for example, disrupt the absorption of fat or suppress appetite.

Next is the gray area of ​​dietary supplements, which formally refer to fat burners, but in fact contain sibutramine or diuretic components. The same sibutramine is officially sold under many commercial names and is used to treat obesity after medical advice, it enhances the feeling of fullness and has heat-generating properties. The main contraindications are known: heart disease, arterial hypertension, decreased or increased thyroid function, kidney or liver pathology. Therefore, to assess potential risks, prior consultation with a doctor is required.

The problem is that unscrupulous manufacturers unauthorizedly add sibutramine or other potentially harmful substances to seemingly harmless drugs, and due to this, there is a wow effect in terms of weight loss. For example, in 2017, a study of fifty-two caffeine supplements found that every tenth sample contained undeclared substances – for example, sibutramine and phenolphthalein, as well as psychotropic substances like amfepramone and phenproporex. Finding an excess of caffeine in half of the supplements does not seem so dangerous against this background – but if you use the drugs in accordance with the instructions, the safe daily caffeine limit of 400 mg will be exceeded.

This data echoes a study in thirteen countries that involved purchasing over 600 different non-hormonal supplements from 215 suppliers. It turned out that 15% of samples contained undeclared anabolic steroids, and another 10% had controversial results. Most of the cases of undeclared additives occurred in five countries: the United States, the Netherlands, the United Kingdom, Germany and Italy.

With immunotherapy

In the United States, for the first time, doctors have been able to completely cure end-stage breast cancer with the help of immunotherapy – this is described in a publication in the journal Nature. Judy Perkins was diagnosed in 2003; She underwent a mastectomy (surgery to remove the mammary glands), but after a few years the tumor returned in an aggressive form and metastases began to spread to the liver. Perkins underwent seven types of chemotherapy, but nothing worked, and doctors predicted that she had only a few months to live.

Nevertheless, the woman took part in a clinical study, and she was helped by an experimental method of treatment in which doctors took a sample of the tumor for research to determine which T cells are capable of recognizing cancer. After that, they “grew” 82 billion of the same cells and reintroduced them to the patient, “charging” her body to fight the disease. A year later, there was a complete regression of the tumor – for two years the patient has not been showing any signs of cancer, and she leads an active lifestyle; she is now 52 years old.

“After two weeks [after starting therapy], I felt the swelling in my chest begin to shrink and I felt better,” she recalls. “The experts may call it a long-term remission, but I believe I am cured.”

INSTAGRAMS AND OTHER SOCIAL NETWORKS OF CELEBRITIES provide an opportunity to look into their lives, learn about the latest news, and some follow the stars in order to unravel the secret of their “flawless” appearance. Celebrities, on the other hand, do not miss the opportunity to share “intimate” information, including about their nutrition – needless to say that it is not always possible to follow their advice. We analyze popular Instagram diets and explain why they are harmful.

Slim bitch club

The SlimBitchClub community appeared in March last year, and its first members were Ksenia Sobchak, Polina Kitsenko, Nika Belotserkovskaya and Matilda Shnurova. At the presentation, friends said that they had put together a healthy menu, dishes from which you can try in one of the Moscow health and beauty centers. Club members share tips on losing weight and a “healthy” lifestyle that help them personally, and on Instagram they publish recipes for “healthy” dishes, videos from workouts and advertisements for beauty salons they go to themselves.

Nutritional advice consists mainly of intimidation by the dire effects of excess calories and overeating (“Nut is a good waist sin!”). The club’s instagram publishes lists of “acidic” and “alkaline” products according to the unscientific classification used by adherents of separate nutrition. We have already said that separate nutrition is a pseudo-diet, and the ideas behind it have nothing to do with biochemical processes in the body. But other posts dedicated to the nutrition of club members do not contain links to scientific evidence or studies confirming the effectiveness or usefulness of certain dietary changes. But they are replete with myths – for example, the authors of Instagram explain the usefulness of goji berries by the fact that they are “superfood” and suggest drinking dietary supplements instead of “chemical vitamins”.

In fairness, Slim Bitch Club calls for an active lifestyle – in this the WHO fully supports the participants, recommending medium-intensity aerobic activity for at least 150 minutes per week or at least 75 minutes of high intensity, as well as strength exercises at least twice a week. But the recipes offered by the club are more suitable for a light snack rather than a regular way of eating, and they certainly do not bring special benefits.

Many posts talk about the “benefits” of avoiding certain foods – from milk to spinach to broccoli – although in reality, such restrictions will only make your diet less varied and make you anxious, and in the long run can lead to a lack of certain nutrients. The main thing in a healthy diet is not individual foods or their components, but how a person eats for a long time. To improve eating habits, it is better to turn to evidence-based nutrition, even if its principles are set out in a popular science and even play form (like the British Eatwell plate ).

Slimming teas and blends

The hit of Instagram – including the Russian-speaking one – is various powders and liquids for weight loss with names like FitTea, BooTea or TeaTox. In fact, these funds really help to easily lose a couple of kilograms – but not due to real weight loss, but due to laxative and diuretic effects. Most often, senna is a herbal laxative that is sometimes prescribed for constipation. Overuse of these mixtures can lead to dehydration and bowel problems.

Many celebrities are promoting these funds, including Kylie Jenner , Nicki Minaj , Britney Spears , Hilary Duff . A simple idea (usually a set includes two teas, a morning “for weight loss” and an evening “for detoxification”) and not an exorbitant cost made the market for such teas huge – now they are produced by hundreds of companies around the world, which, according to some sources , pay royalties to the stars before 250 thousand dollars for advertising. Since teas are not officially registered as medicines, but as food additives, their composition is not subject to rigorous checks, and there is no place to obtain unbiased safety information. Moreover, even the composition is not always revealed, and unknown substances can lead to real health problems.

Detox diets

The myth that the body can be cleansed of certain “toxins” with the help of “detox” seems to be impossible to get rid of: advertisements for detox juices, smoothies and food supplements are not decreasing. Usually, detox means taking a product that should “remove” all harmful substances “accumulated” in the body, or partial or complete starvation. Compilers of liquid (juices or smoothies) diets also rest on unloading the digestive system, which “rests” without solid food – but in fact, a healthy person does not need such breaks . As for the freshly squeezed juices themselves, they contain a large amount of readily available sugar and can harm the teeth, and over time, increase the risk of diabetes and cardiovascular diseases.

Detox smoothies are popular among celebrities: they are followed, for example, by Jessica Alba and Kourtney Kardashian (the latter generously shares with readers the recipes for smoothies “for weight loss after childbirth”). Recall that the liver and kidneys are primarily responsible for the constant cleaning of our body , which filter about 180 liters of blood daily. In addition, all tissues have systems that help get rid of harmful and foreign substances, and the work of the immune system is aimed at this . We can confidently say that only a balanced diet and an active lifestyle, but not a small bottle of juice, will contribute to a high-quality “detox”.

Fashion for diets

The star diets are in a tight rotation. Ostromodnye becomes the Atkins diet (it ketogenic), which adhere to, e.g., Halle Berry and Courtney Kardashyan then paleodieta among fans that Megan Fox and Jessica Bil . Separate nutrition in general is still popular among Russian stars (the diet of Katya Lel, Larisa Dolina and Anita Tsoi), but the passion for the “blood type” diet, fashionable in the 90s and 2000s, seems to have gradually faded away.

Relatively new directions – fruitorianism (rejection of everything except fruit) and intermittent fasting . The former can be considered an extreme vegan diet, promoted mainly by bloggers not known for anything else. The second is gaining more and more popularity in Silicon Valley; it is practiced by biohackers . All these options have one thing in common – the lack of scientific evidence that they are effective and safe, or at least something better than a balanced diet like the Mediterranean diet .

Why is it harmful

The stars give advice on nutrition and diet with the same ease with which they advertise cosmetics or clothing, without thinking that blindly following these recommendations can harm people’s health. In addition to pseudoscientific terms like “detox” and “superfoods”, you can often see the demonization of certain groups of products (flour, sweet or fatty), and also such posts contain a huge amount of advertising – hidden or direct.

At the same time, both Instagram celebrities and their subscribers forget that weight loss, nutrition and lifestyle are as complex topics as, for example, the health of the reproductive system and the control of chronic diseases. Nutrition and eating habits are unique for each person, and if you want to change or improve them, you should first of all listen to specialists. In other words, each person’s diet and needs require an individual and professional approach.

If we are talking about losing weight, it is also better to determine its necessity with a doctor: on the one hand, those who do not really need to lose weight often find “excess” weight in themselves . On the other hand , if the weight is really higher than the medical norm or obesity has developed, then the matter may be not only in the imbalance of consumed and consumed calories: metabolic disorders, hormonal changes and mental spectrum disorders are possible . Although in social networks we are offered to get rid of a few centimeters in the waist in a short time without leaving a trace, we must understand that the harm of such interventions can greatly outweigh their benefits.

Stars often recommend strict, low-calorie diets that allow you to lose a few pounds in a few days, for example, for an event. There is no scientific basis for these diets, and if you follow them often, problems will arise – both physical and mental. Cutting out whole food groups upsets the nutrient balance, and severe restrictions affect dietary habits and disrupt the perception of hunger and satiety cues. Research shows that frequent short-term diets have a profound effect on morale – leading to eating disorders, decreased life satisfaction and other disorders. There is also a link between short diets and the incidence of a number of diseases (up to all-cause mortality and mortality due to coronary heart disease), although the underlying cause remains to be determined.

How to recognize a catch

When faced with nutritional advice from celebrities, it is worth considering why the person is talking about it – perhaps they are just trying to sell you something. It is important to remember that there are no magic foods that can help you lose weight or solve health problems. “Unique ingredients”, including “natural ingredients”, can be dangerous if not studied in clinical trials. In addition, side effects are usually not talked about on Instagram, and you can’t be sure that a celebrity follows his own advice. If you have never heard of the advertised product, it is best to consult with your doctor or dietitian.

It is necessary to check the sources. If, talking about the diet, the author refers solely to personal experience (for example, gives advice on losing weight after childbirth), then it is better to be skeptical about this. After all, many people use social media in much the same way – showing pretty pictures; we do not see what the diet and lifestyle of the account owner actually looks like. Finally, advice about a “healthy lifestyle” is often aimed not at improving health, but at correcting appearance, and it is impossible to equate these concepts. Short-term diets and laxative teas can really help you get into your favorite dress quickly – but this has nothing to do with maintaining health.

“Addiction would be more correctly viewed as compulsive behavior,” continues Anna Sarang . – Drug addiction in European countries has long been studied by addiction, along with, for example, gambling addiction. And if even ten years ago the medical community was looking for biomedical solutions to the problem, now psychotherapeutic methods are increasingly being used. “

Gabor Mate, a Canadian addictologist who has worked with the most severe forms of drug addiction for many years, argues about the nature of the phenomenon, declares that he does not see a fundamental difference between different types of addictions: “Drugs by themselves do not lead to addiction – this is a myth. Because most people who try drugs do not become addicted. The question is why some people are vulnerable to addiction. Food is not addictive, but some people become psychologically addicted to food. Shopping and television are not addictive, but for some they are addictive. “

As an example, Mate cites his own psychological trauma and the addictions that he developed in adulthood, from work and collecting CDs with classical music recordings: “Why did I become a workaholic? Because [my family] does not love me, I will at least become irreplaceable, become an important doctor and be able to compensate for my feeling of being unnecessary. This leads to the fact that I work all the time, and when not working, I am absorbed in the process of buying music. What signal are my children getting? The same – that they do not need me. And so we unknowingly pass on trauma from one generation to the next. “

“Addiction would be more correctly viewed as compulsive behavior. Drug addiction in European countries has long been studied by addiction, along with, for example, gambling addiction “

A similar thought is expressed in an interview with Wonderzine I., a woman who has suffered from addiction for many years: “Addiction is a complex and chronic disease. Addiction can manifest itself in any area of ​​life. This is not necessarily the use of substances – this is gambling addiction and dependence on feelings. In general, there are a huge number of types of addictive behavior. You can only overcome active addiction, stop using substances or stop playing, but addiction will manifest itself in another area of ​​life. For example, a person becomes a workaholic or fanatically begins to play sports. Dependence is one, but its manifestations and forms are different. The dependent person does not know the norm in anything. A drug addict who stops using drugs very often becomes addicted to food, feelings, emotions or work. “

Addiction as a stigma

Without justifying the harm that addictive behavior causes, and without removing personal (including criminal) responsibility from addicts, it is worth getting rid of common misconceptions regarding addiction itself. The psychological approach to addiction partly solves this problem.

It is customary to treat addicted people as weak-willed puppets. This stereotype continues to live, despite the fact that in reality an addict can be a very collected and purposeful person. “People think that junkies and alcoholics are neglected people who lack motivation. They are not – they are incredibly organized. They might sneak away for a shot of whiskey without you even noticing their absence. This is a kind of micromanagement, ” says Simon Pegg, who has struggled with alcohol addiction for many years. At the same time, his example refutes another misconception: an addicted person can perfectly read his own addictive behavior and understand its destructive effects (the actor compares this state with the appearance of a second head, which can think of only one thing).

It is customary to treat addicted people
as weak-willed puppets, although in reality an addict can be a very collected and purposeful person.

Which brings us to an important question: does a person cease to be addicted after getting rid of biochemical addiction – or, to use Pegg’s metaphor, does this “second head” disappear? “People do not use substances not because of the protection of the subconscious. A person dependent on substances has a program of self-destruction at the subconscious level. Addictive behavior is self-destructive behavior. People may not use substances for years, but they do not cease to be addicted, – says I. – In my experience, people who work with their addiction according to twelve-step programs remain sober for 10-15 years , but the disease “addiction” is very strong, and therefore make efforts to stay sober, you need it every day. “

Understanding addiction as a serious illness, the treatment of which can take years, will bring us closer to understanding those who, for whatever reason, have become hostages of it. For example, to the realization of why Philip Seymour Hoffman, who remained a teetotaler for twenty-three years, died of a hard drug overdose. Or the understanding of the recent breakdown of Demi Lovato, who, judging by the song “Sober” released shortly before him, was well aware of the dangers of relapse. The marginalization of the disease is certainly not conducive to its cure.

THE ATTITUDE OF THE OVERWHELMING MAJORITY OF PEOPLE to destructive addictions is still based on the belief that their formation is an exclusively personal choice of a person. ” If you don’t want to, you won’t get hooked.” Or, alternatively, “you can get rid of any addiction, you just want to.” This is the difference between addiction to most diseases. There are hardly many people who are sincerely convinced that, for example, peptic ulcer disease appears only in those who themselves wanted it. And it seems clear that a person suffering from obsessive-compulsive disorder should not be advised to “just be less nervous”. However, when it comes to addiction, these rules seem to cease to apply, which leaves an imprint not only on the public image.  addicted people (they are considered to be weak and vicious), but also on approaches to treatment for addiction.

This attitude is beginning to change, especially in the light of sociological and medical research: they indicate that addiction and any addiction in general (hereinafter, addiction means dependence on the intake of any chemicals permitted or prohibited by law; addiction means a psychological disorder , leading to addictive behavior, but not necessarily caused by addiction to a particular substance) is not always a consequence of a lack of will. There are both a predisposition to addiction and social factors that push a person to form it. Does this give an undeniable right to say that addicts are not to blame for their addiction – just as a diabetic is not guilty of their diabetes? Is it true that a predisposed person is doomed sooner or later to get hooked, no matter what? And what is the real reason for addiction?

Addiction as a genetic malfunction

Studying the question of whether a person can be programmed from birth to any addiction, the National Center for Biotechnology Information came to the conclusion that genetics is at least half responsible for the predisposition to one or another addiction. Another study cites similar figures – 40-60%. However, these findings only indicate a potential vulnerability. By themselves, they do not confirm or deny that addiction is something that a person brings on himself. A predisposition does not mean neither the disease itself, nor a tendency to a particular addiction.

Addiction as a social phenomenon

While statements like “society made me this (that)” are more often perceived as an excuse to remove personal responsibility, in the case of addiction as a “social illness” they are partly true. There are many historical examples of how poverty, unemployment and social depression have proven to be ideal environments for the spread of hard drugs. Whether it’s the crack epidemic in the US in the 1980s, the heroin plague in the withering industrial cities of Thatcher’s Britain, or the sharp rise in opioid use in Russia since the early 1990s. From a more recent one, the global economic crisis of 2008 can be distinguished, which entailed progressive unemployment in European countries, followed by an increase in the use of cannabinoids and so-called new substances among people aged 15 to 24 years.

However, sociological calculations unambiguously speak only about the connection between addiction and social depression: poverty contributes to an increase in the number of addictions – but growth, in turn, leads to impoverishment . To determine what was the cause and what was the effect, it is necessary to consider the case of each person individually and in detail – sociologists often do not have the resources for this. The second nuance, which is also worth considering: social disorder can encourage the development of addiction and accelerate self-destruction, but not be the cause. If a person was born and raised in a dysfunctional environment, this does not mean that he will certainly become dependent.

Addiction as a protective psychological reaction

Anna Sarang, President of the Foundation for the Promotion of Health and Social Justice. Andrey Rylkov (included in the register of foreign agents), insists that drug addiction should be considered together with other addictions, focusing on its psychological aspect: “In Russia, drug addiction is usually separated from other addictions and compulsive disorders and is considered as a set of reactions and behaviors that caused by this or that substance. It seems to me that this is a dead-end path. The study of the genetic nature of addiction also does not seem to me a promising direction.

In my experience, most addicted people usually have some sort of childhood trauma. Addiction for them is an attempt at self-medication. And it’s worth focusing on identifying this injury. This is not necessarily a childhood trauma – it can be a social trauma, disorder associated with the organization of modern society and the economy, the inability to find a job, to realize oneself, to find a relationship that suits him. A person cannot cope with it – and not because he is weak or bad, but because life is difficult. Often, addiction is a response to external circumstances. “

Have you ever wondered what happens to our body when the Internet slows down? It turns out nothing good. This is the conclusion reached by Swedish scientists, who found that slow video loading causes stress as much as watching a horror movie or solving a complex mathematical problem. By itself, slow internet speeds up your heart rate by 40% and increases your blood pressure noticeably. An assessment of the physical and mental health of active Facebook users, carried out by Californian scientists, showed that the more likes users put, the worse their health was, and the more often they refreshed the page, the more likely they were diagnosed with mental disorders.

But what happens to the lives of people who do not use social networks and use gadgets minimally? A little research on the topic allowed us to say that such people spend more time with friends, receive relevant information from them and, as a rule, begin to feel better. And yet we must not forget that communication affects our health in the same way as exercise – and the reality is that today it is social networks that provide it, giving amazing opportunities to overcome isolation.

Why do we check the pages of the former in social networks?

It seems that everyone does this – sometimes on purpose, and sometimes, as if by accident, finding themselves on the page of someone who-cannot-be-named. Some consider this a form of masochism, others do not see anything terrible – and both points of view, of course, have a right to exist. But still: why do people do this?

No, not at all because they dream of reuniting with an ex-partner. Psychologists think that the natural and often subconscious desire of each person to increase their self-esteem is to blame. Former partners, especially if the relationship has been long, become a part of us, so sometimes we want to return to this part, which, although left in the past, is still available on the Internet. The second likely reason for this behavior (which, however, does not exclude the first) may be that regularly returning back – if the separation was painful – allows us to accept the situation, let it go and move on.

We are used to searching online for ANSWERS TO MOST OF THE QUESTIONS THAT HAVE ASKED US . In the new series of materials, we ask just such questions: burning, unexpected or common – to professionals in various fields.

“Orthopedic” pillows, mattresses, sandals and insoles have flooded the market, special pharmacies have appeared for their sale, but it is not clear whether everyone needs them in such a way. Is it true that orthopedic insoles prevent spinal diseases – or do they just make shoes more comfortable? Should you sleep on a firm mattress or on a pillow with a notch so that your back and neck don’t hurt? We asked these questions to an expert.

Vera Kachurina

doctor – traumatologist-orthopedist of the Rassvet clinic

In Greek, ortos means “correct, direct”; everything related to orthopedics or called orthopedic is often perceived as correct, useful and even necessary for everyone. In fact, this is a rather narrow term that refers to the treatment of orthopedic diseases or deformities. It is difficult to imagine that products sold in the mass market without a doctor’s prescription can cure or correct deformation. In fact, “orthopedic” in relation to mattresses, pillows or shoes for healthy people is not quite the correct definition. Something like “ergonomic” would be much better.

There is a strong belief that sleeping on a soft one is harmful, and on a hard one – it is useful, that for the prevention of back pain, a special “orthopedic” mattress is absolutely necessary, and in case of scoliosis or injury, you should generally sleep on boards. All these are, of course, myths. If we turn to the history of the issue, it turns out that humanity has not slept on (and continues to sleep): on stoves, beds and chests, mats and thin futon mattresses, on high sloping beds with a million pillows at the head, on soft goose feather beds, cots and squeezed sofas, or even hammocks. And it cannot be argued that at the same time all the polls suffer from lack of sleep, back pain or have spinal deformities.

The rationale is that during sleep the most natural position of the spine should be maintained with minimal muscle tension. Sleeping on too soft, theoretically, can contribute to muscle overstrain due to the fact that the spine “collapses” and the muscles try to “hold” it. Sleeping on a hard surface leads to discomfort due to excessive pressure on the bony protrusions, especially in thin people. Thus, best of all is the golden mean, that is, a semi-hard mattress.

To support this theory, a randomized clinical trial was conducted in Europe comparing the effects of semi-hard and hard mattresses on lower back pain. It turned out that in patients who slept on semi-hard mattresses, the pain syndrome decreased. However, the study used a European hardness scale, which is not generally accepted, and only spring mattresses. The concept of “semi-rigid” can hardly be universal at all – if only because people differ from each other in weight.

There is little evidence that water beds or special foam mattresses that follow the physiological curves of the body can improve sleep quality compared to rigid mattresses, but the level of evidence is still poor. In general, if a person does not have diseases of the spine, and in the morning he gets up vigorous and rested, it means that the existing mattress performs its function. If there are any problems, it is advisable to discuss them with a doctor, and, perhaps, a properly selected semi-rigid mattress can improve the situation – and the criterion for success will be an improvement in subjective feelings.

The situation is similar with orthopedic pillows. No serious research has been carried out on this topic, there is no evidence base. Interestingly, the habit of putting something under your head (for example, a hand or a stand) is historically associated with the need to free the other ear – this helps to hear the danger signal. None of the clinical guidelines for the treatment of neck pain provide guidance on the use of special orthopedic pillows – so common sense and individual comfort considerations should be used.

Pillows with a bolster under the neck and a notch under the head seem to be a logical way to keep the cervical spine in line with the chest (although this is completely meaningless for those who sleep on their stomach or wake up, hugging a pillow, not in the position in which they lay down) … In orthopedic salons, they suggest measuring the distance from the shoulder to the ear with a centimeter and, focusing on this value, choose the height of the pillow – however, this approach, alas, does not always give the desired results in terms of sleep quality. Since there are no uniform recommendations, the pillow should be selected based on your own feelings – specifically, the one that allows you to get up in the morning with good health is suitable for you. Height, filler, stiffness, price and manufacturer do not matter. Only one thing can be said for sure: children under two years of age definitely do not need a pillow, because they have not yet formed physiological lordosis of the cervical spine.

Orthopedic insoles are a useful purchase not only for people with diseases of the musculoskeletal system, but also for completely healthy ones.

But orthopedic insoles are a very useful purchase not only for people with diseases of the musculoskeletal system, but also for those who are completely healthy. We all mainly walk on a hard surface (asphalt) and when choosing shoes we focus more on its appearance. As a result, the feet are forced to work in not the most favorable conditions, and a properly selected orthopedic insole helps to reduce the load on the feet and leg joints, correct the biomechanics of gait, compensate for the negative consequences of wearing the wrong shoes and prevent the development of problems in the future.

The use of soft, shock-absorbing insoles when playing sports reduces the likelihood of injury. Of course, if a person already has a deformity of the feet, one should not count on miraculous healing. The task of orthopedic insoles is not to correct the structure, but to improve the function. There are studies that support the effectiveness of insoles for pain in the feet. True, such an effect can hardly be obtained from gel insoles sold in underground passages, or even ready-made insoles made according to universal templates from orthopedic salons.

The insoles must be made individually after examination by an orthopedic surgeon or podiatrist (foot health specialist). First of all, it should be comfortable with insoles. Pain, discomfort, calluses when wearing an insole indicates that it has been fitted or made incorrectly. Frame, rigid insoles are a thing of the past and, according to modern orthopedic concepts, are not effective; now they are made from softer materials like polyurethane, which in the process of use finally adapt to the shape of the foot.

SALT IS DECLARED “WHITE DEATH” alternately with sugar – and a complete rejection of it sometimes begins to seem like a simple solution to all health problems at once. On the other hand, the amount of salt in the diet, on the contrary, is often overlooked when discussing proteins, fats, carbohydrates and calories. The solution, as usual, is somewhere in between: Variety, moderation and balance are important in a healthy diet. We understand why an excess of salt is dangerous, how its deficiency threatens, and whether there is the best and most useful salt.

What is edible salt

Edible salt – sodium chloride – consists of 40% sodium and 60% of chlorine, and the amount of sodium entering the body matters for health (or problems with it). But we get most of the sodium in the form of table salt, and mainly from industrial products: sausages, canned food, pickles, snacks, sauces, bread, cheese, carbonated drinks, fast food, and so on.

The general recommendation given by the World Health Organization is to consume no more than five grams of salt per day, which is about a teaspoon. On average, people eat different amounts of salt per day: from 0.5 grams for the Yanomami Indians in Brazil to 25 grams in Northern Japan, and in Europe, according to the same WHO, this is an average of 9-12 grams (that is, the notorious pound of salt eaten in less than five years). Moreover, such indicators can be achieved without touching the salt shaker.

What is its danger

Clinical studies have shown that there is a statistically significant, direct, progressive relationship between salt intake and blood pressure . Simply put, the more salt you eat, the higher your blood pressure: the effect is dose-dependent. The best scientific evidence suggests that lowering sodium in the diet is especially important for middle-aged and older people and all hypertensive patients. The recommendations of the international cardiological associations are being updated, and the figures for the optimal pressure are getting smaller, so it is quite a reasonable measure to reduce salt intake for the prevention of arterial hypertension.

At the same time, people have different sensitivity to salt. Sodium has a stronger effect on blood pressure in some – while others, presumably, can be generally resistant, that is, resistant to such an effect. Even in observational studies it is difficult to correctly measure your blood pressure, because of the large number of factors , affecting it. Sodium sensitivity can be affected by age, ethnicity, gender, weight, and certain conditions such as diabetes or kidney disease.

Less salt is not only a possible prevention of myocardial infarction and stroke associated with high blood pressure. Too much salt increases the risk of stomach cancer; a large amount of sodium leads to the fact that calcium is more actively excreted in the urine – and this is a risk factor for urolithiasis and osteoporosis. In general, it is not for nothing that the favorite word of nutritionists is moderation.

Few is also bad

Sodium is necessary for the body – it plays a role in maintaining the water-salt balance and the transmission of nerve impulses. However, hyponatremia, that is, a decrease in the concentration of sodium ions in the blood, can develop not only due to serious diseases such as cirrhosis of the liver or heart failure. In people without chronic conditions, it can happen, “water intoxication”: if you drink several liters of water for a few hours, the sodium concentration to fall, which in turn may threaten the problems with the heart, kidneys and most dangerous complication – swelling of the brain. Hyponatremia can also occur during sports, when a person loses fluid and sodium for a long time with sweat, and only replenishes water . This effect can also occur in those who drink a lot of beer – so calling it an isotonic drink, by the way, is incorrect.

Why are we drawn to salty

Salt is a seasoning that makes everything taste better, if, of course, you add it in reasonable amounts. Forget to put a pinch of salt in bread dough or even sweet pie – and the taste will be less expressive. Before refrigerators came along, canning with salt helped preserve food, and it was literally worth its weight in gold. However, today, when seasoning is cheap, and you can buy it everywhere, we suffer from excess rather than deficiency of salt.

In addition to the dining room, there are many other types of salt – for example, sea salt, which often costs much more than ordinary salt. Salt can be an extraordinary gastronomic attraction and even a luxury item: Himalayan pink salt, fleur de sel from Brittany or Mallorca, black Hawaiian salt, wet Gerande salt, smoked and kosher salt and many others.

Sea salt and table salt vary in texture, taste, and processing. Sea water is obtained by evaporation from, of course, sea water, and stone is mined in deposits – salt deposits on the site of ancient reservoirs that have turned into salt lakes. Both sea salt and table salt are similar in composition and completely equal in terms of sodium content. You can give preference to one or another brand of salt because of its taste and texture, but you should not consider expensive salt with admixtures of other minerals more useful than regular salt. Trace amounts of potassium, iron, magnesium in salt do not affect anything except taste – and these trace elements are easy to obtain from other foods.

Salt as a source of iodine

Since salt is an affordable and cheap everyday product, it was invented almost a hundred years ago to enrich it with iodine so that everyone can get a vital trace element. Iodine is necessary for the synthesis of thyroid hormones, and if there is little of it in food and water, the thyroid gland grows and forms a goiter – so it tries to “capture” more of the necessary substance. With a moderate lack of iodine, which is called a latent deficiency, there will be no external manifestations, because the thyroid gland adapts to this state, but not completely. The most dangerous situation occurs when a woman lacks iodine during pregnancy and breastfeeding – this can lead to a delay in the cognitive development of the child.

To avoid iodine deficiency in children and adults, in many countries (but not in Russia) continuous salt iodization has been introduced . There iodized salt is not only sold in stores – it is prepared with it in restaurants and cafes, it is used in food production. If a person eats the recommended 5 grams of such salt per day, then even taking into account the loss of iodine during storage and cooking, 100-200 micrograms of iodine enter the body – just a physiological norm.

There is a myth that iodized salt reacts with foods, but this is not the case. Nowadays, potassium iodate is used to iodize salt: it is stable during storage and heating, so that modern enriched salt can be used even in baking. Additional sources of iodine are seaweed and fish, but there is not much of it in sea salt, because it is lost during evaporation and drying.

What to do

As a rule, most people should take a closer look at the amount of salt that enters their body with food – in order, if possible, to bring it to the recommended five grams. Adjusting the diet can help along this path: for example, reducing the volume of industrial food, which is always high in sodium, in it. To make homemade food tastier, salt can be replaced with spices, herbs, lemon juice, onions and garlic; if you buy salt for cooking, then it must be iodized. By the way, a person gets used to less salty food quickly: two to three weeks are enough for the taste buds to adapt . Among other things, there are salt substitutes with a high potassium content – however, it is worth consulting your doctor before using them .

We are used to searching online for ANSWERS TO MOST OF THE QUESTIONS THAT HAVE ASKED US . In the new series of materials, we ask just such questions: burning, unexpected or common – to professionals in various fields.

Water treatments that were once a luxury are now available to many, as are a huge selection of cleansers. A shower in the morning, another after a workout and a relaxing bath in the evening (and then a moisturizer for the whole body) have become commonplace. But can there be too much washing? Isn’t it the frequent hygiene that leads to a constant need for hydration? Do water and soap dry the skin and are antibacterial handwashes needed? We asked these questions to an expert.

Vera Voronina

doctor of the highest category, candidate of medical sciences, dermatologist at the Rassvet clinic

There is a clear link between improving overall cleanliness and improving health. Personal hygiene (first of all, hand washing) is important for the prevention of many diseases, which are called hygiene-related diseases. These are intestinal infections, dental caries, parasitic infestations, fungal infections of the skin, scabies, lice, trachoma (an infectious eye disease). At the same time, it is difficult to accurately assess the contribution of personal hygiene to the reduction of infectious diseases – other factors have changed, including nutrition and water treatment, and the level of knowledge about prevention has increased. The causal link between dirty hands and infection transmission is one of the most well-documented facts in medicine. Recently, however, evidence has emerged that forces us to look at skin hygiene in a new way.

For many years, it was believed that the superficial layer of the skin (stratum corneum) creates a mechanical barrier like a film that prevents drying and protects against adverse external factors and the penetration of infection. But now the understanding of the processes occurring in the skin has radically changed. It is now known that the cells of the stratum corneum and the substances between them create a semi-permeable structure in which biochemical processes are actively taking place. This whole system was combined into the concept of “epidermal barrier”. The stratum corneum consists of about fifteen layers of cells held together by various substances – among them ceramides, sphingosine and components of a natural moisturizing factor are considered especially important.

Every day, a fresh layer of cells is formed deep in the skin, and the superficial layer is separated, that is, there is a constant renewal and cleansing of the skin. The surface of human skin is inhabited by a huge number of microorganisms that form a stable community – the microbiome – and prevent pathogenic microbes from multiplying. Skin microflora varies from person to person, but it is surprisingly stable for each person. Even without washing for many days, the composition and number of skin microorganisms remains unchanged .

Washing, especially with soap, violates the epidermal barrier – water loss increases, the acidity of the skin surface decreases, lipids are washed out

By cleansing the skin, we strive to get rid of dead cells and pathogenic microorganisms. But washing does not go unnoticed for the components of the epidermal barrier and the normal microbiome. The studies point out that the washing, especially with soap breaks the epidermal barrier – enhanced water loss, reduces the acidity of the skin surface lipids are washed out. This damage leads to dryness, redness and cracking of the skin. This is especially true for those who often have to wash their hands due to the nature of their work: in surveys among nurses and other medical personnel, at least 25% of participants reported injuries to the skin of their hands . In experiments, redness, a decrease in acidity and other damage occurred even after a single wash and persisted for several days – even after seventeen days of observation, the skin often did not completely recover .

Another important aspect is the state of microorganisms that inhabit the surface of the skin. Cosmetics, emollients, soaps and other hygiene products potentially contribute to changes in microflora – however, the effect of these products has not yet been clearly determined, because such studies have not been carried out. Damage to the epidermal barrier as a result of frequent washing can also contribute to a change in the microbiome and an increase in the number of bacteria on the skin .

When it comes to antibacterial soaps, there is no evidence from the FDA that antibacterial soaps are better than regular soaps with water in terms of preventing infections. Moreover, the frequent use of antibacterial hygiene products can be dangerous if it leads to the emergence of resistant strains of microorganisms. There is evidence of the possible effect of some antibacterial substances on the endocrine system.

So, handwashing advice is still one of the most important steps you can take to avoid infectious diseases and prevent germs from spreading. You can wash your hands with regular soap and water. There are no standard recommendations for cleansing the skin of the body for everyone, but it is worth remembering that it is better to protect the epidermal barrier. The water should be warm, not hot; you should not stay in it for too long. Instead of liquid soap or shower gel, it is better to use oils or syndets ( synthetic detergents with a pH optimal for the skin. – Ed.) . It is better not to rub the skin with a towel, but to blot gently, and if it is dry, use moisturizers and emollients.