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There are concerns as the United States Food and Drug Administration (FDA), last week, authorised the marketing of IQOS, Philip Morris International’s (PMI) electrically heated tobacco system, as a modified risk tobacco product (MRTP). In doing so, the agency found that an IQOS exposure modification order is appropriate to promote the public health.

The FDA authorised the marketing of IQOS with the following information: “The IQOS System heats tobacco but does not burn it. This significantly reduces the production of harmful and potentially harmful chemicals.”

Scientific studies have shown that switching completely from conventional cigarettes to the IQOS system reduces the body’s exposure to harmful or potentially harmful chemicals.

The agency concluded that the available scientific evidence demonstrates that IQOS is expected to benefit the health of the population as a whole, taking into account both users of tobacco products and persons who do not currently use tobacco products

The FDA’s decision further builds on the emerging independent international scientific consensus that IQOS is a better choice than continuing to smoke, and follows the FDA’s April 2019 decision authorizing the commercialization of IQOS in the U.S.

The FDA’s decision provides an important example of how governments and public health organizations can regulate smoke-free alternatives to differentiate them from cigarettes in order to protect and promote the public health

This decision follows a review of the extensive scientific evidence package PMI submitted to the FDA in December 2016 to support its MRTP applications.

Commenting on the FDA’s announcement, PMI’s Chief Executive Officer, André Calantzopoulos, said: “The FDA’s decision is a historic public health milestone. Many of the tens of millions of American men and women who smoke today will quit—but many won’t. Today’s decision makes it possible to inform these adults that switching completely to IQOS is a better choice than continuing to smoke. FDA determined that scientific studies show that switching completely from conventional cigarettes to IQOS reduces exposure to harmful or potentially harmful chemicals.

“IQOS is a fundamentally different product than combustible cigarettes and must be regulated differently, as the FDA has recognized. Now—more than ever—there is an urgent need for a fundamentally different conversation on a cooperative approach to achieve a smoke-free future. The FDA’s decision provides an important example of how governments and public health organizations can regulate smoke-free alternatives to differentiate them from cigarettes in order to promote the public health…”

Meanwhile, a new Access Initiative for Quitting Tobacco aims to help the world’s 1.3 billion tobacco users quit. Stopping smoking is more important than ever as evidence reveals that smokers are more likely than non-smokers to have severe outcomes from COVID-19.

The project gives people free access to nicotine replacement therapy and to Florence, a digital health worker, based on artificial intelligence that dispels myths around COVID-19 and tobacco and helps people develop a personalized plan to quit tobacco.

It is being led by the World Health Organization (WHO), together with the UN Interagency Task Force on Non-communicable Diseases, PATH and the Coalition for Access to NCD Medicines and Products, with support from the private sector.

The Secretariat of the WHO FCTC, salutes this initiative. The Head of the Convention Secretariat commented, “This will contribute to Parties’ implementation of Article 14 of the Convention, regarding measures concerning tobacco dependence and cessation. And, as previously said: there has never been a more appropriate time to support people in their efforts to quit tobacco use.”

Director of Health Promotion, Dr. Ruediger Krech, said that, “We welcome the support of pharmaceutical and tech companies to improve people’s health and save lives during COVID-19. The partnership highlights what we can achieve when we work together both to end the pandemic and, moving forward, to build back better.”

WHO received its first-ever donation of nicotine replacement therapies for the project from Johnson & Johnson Consumer Health. The manufacturer has donated 37,800 nicotine patches to help 5,400 people in Jordan quit smoking. These efforts will help WHO respond to the ongoing pandemic and improve health outcomes.

Florence was created with technology developed by San Francisco and New Zealand based Digital People Company, Soul Machines, with support from Amazon Web Services and Google Cloud.

Jordan, which has some of the highest tobacco use rates in the world, will be the first pilot country with additional companies and countries to join in discussion. HRH Princess Dina Mired of Jordan, President for the International Union of Cancer Control said, “I am pleased that Jordan is part of this initiative, which will help advocate for tobacco control and support civil society organizations in their continued efforts for a healthier smoke-free future for Jordan.”

Just last week the Government of Jordan adopted a ban on smoking and vaping indoors in public places. The link between smoking and COVID-19 make it essential for governments to pass comprehensive tobacco control laws that will protect the health of their people during this pandemic and beyond.

Although around 60 per cent of tobacco users worldwide say they want to quit, only 30 per cent of them have access to the tools that can help them do so The Access Initiative for Quitting Tobacco is designed to deliver tobacco cessation services that will help people overcome both physical and mental addictions to tobacco.

A recent review and meta-analysis focus on the role of legumes in heart health. Taking data from multiple studies and earlier analyses, the authors conclude that legumes might benefit heart health but that the evidence is not overwhelming.

It is a no-brainer that nutrition plays a pivotal role in health. At one end of the spectrum, it is common knowledge that eating a diet that is high in sugar, salt, and fat increases the risk of poorer health outcomes.

At the other end, eating a balanced diet that is rich in fresh fruits and vegetables is likely to reduce the risk of certain conditions.

However, drilling down to the effect of individual foods on specific conditions is notoriously difficult.

The authors of a recent review in Advances In Nutrition have taken up that gauntlet. They wanted to understand how legumes, which include beans, peas, and lentils, affect heart health.

In particular, they focused on cardiovascular disease (CVD) risk and CVD mortality. CVD includes coronary heart disease, myocardial infarction, and stroke. They also investigated legume consumption in relation to diabetes, hypertension, and obesity.

Study co-author Dr. Hana Kahleova, from the Physicians Committee for Responsible Medicine in Washington, DC, explains why investigating heart health is such a pressing matter, stating that “[c]ardiovascular disease is the world’s leading — and most expensive — cause of death, costing the United States nearly 1 billion dollars a day.”

Why legumes?

Legumes are rich in fiber, protein, and micronutrients but contain very little fat and sugar. Due to this, as the authors of the current study explain:

“The American Heart Association, Canadian Cardiovascular Society, and European Society for Cardiology encourage dietary patterns that emphasize intake of legumes” to reduce levels of low-density lipoprotein (LDL, or bad) cholesterol, lower blood pressure, and manage diabetes.

Recently, the European Association for the Study of Diabetes commissioned a series of systematic reviews and meta-analyses. Using the results of these studies, they hope to update current recommendations on the role of legumes in preventing and treating cardiometabolic diseases.

In the current review, the authors compared data on people with the lowest and highest intake of legumes. They found that “dietary pulses with or without other legumes were associated with an 8%, 10%, 9%, and 13% decrease in CVD, [coronary heart disease], hypertension, and obesity incidence, respectively.”

However, they found that there was no association between legume intake and the incidence of myocardial infarction, diabetes, or stroke. Similarly, they identified no relationship between legumes and mortality from CVD, coronary heart disease, or stroke.

Although the team identified a positive relationship between consuming higher quantities of legumes and a reduced risk of certain cardiovascular parameters, the authors’ conclusions are still relatively muted. They write:

“The overall certainty of the evidence was graded as ‘low’ for CVD incidence and ‘very low’ for all other outcomes.”

They continue, “Current evidence shows that dietary pulses with or without other legumes are associated with reduced CVD incidence with low certainty and reduced [coronary heart disease], hypertension, and obesity incidence with very low certainty.”

Nutritional difficulties

One of the primary issues that scientists face when investigating nutrition and health is residual confounding. For instance, if someone eats more legumes than average, they might also eat more vegetables in general. Conversely, someone who eats few legumes might eat less fruit and vegetables overall.

If this is the case, it is difficult to pin any measured benefits on the legumes, specifically. They might simply be due to the increase in plant food overall.

Similarly, someone who eats particularly healthfully might also be more likely to exercise. Understanding whether the legume, the overall dietary patterns, or the entire lifestyle influences any given health outcome is verging on impossible.

Another problem centers around self-reporting food intake. Human memory, as impressive as it is, can make mistakes. One paperTrusted Source on this topic states that self-reports of food intake “are so poor that they are wholly unacceptable for scientific research.”

Studies attempt to minimize the influence of these factors as much as possible, but it can be challenging. As the authors explain, “Despite the inclusion of several large, high quality cohorts, the inability to rule out residual confounding is a limitation inherent in all observational studies.”

Despite the difficulties, overall, the authors believe that increasing legume intake could improve the heart health of the population of the United States.

“Americans eat less than one serving of legumes per day, on average. Simply adding more beans to our plates could be a powerful tool in fighting heart disease and bringing down blood pressure.”

Co-author Dr. Hana Kahleova

Although those studying nutrition and disease face many challenges, it is important to continue this line of investigation. Currently, in the U.S., 1 in 4 deathsTrusted Source relate to cardiovascular disease. If a simple change in diet could reduce the risk even a small amount, it might make a significant difference at the population level.

Infertility in women above the age of forty can almost always be contributed to menopause, but if you’re in your twenties and thirties and struggling to conceive, there are a number of other causes.

Menopause can’t be ruled out. Premature menopause, while uncommon, does occur in certain women. This is usually genetic. If close family had premature menopause, that trait is likely to be passed along.

Premature menopause will have all the normal symptoms of menopause such as hot flashes, mood swings and vaginal dryness. Women with premature menopause can no longer conceive with their own eggs, but can still have children using donor eggs. In cases like this, IVF can be used with a donor egg and sperm before being placed into the menopausal woman’s body. This will result in a normal pregnancy. Women interested in this procedure can visit a fertility clinic to learn more about IVF.

The most common cause of infertility is a condition known as anovulation. This means that the ovaries do not release any eggs. This condition is easily treated using ovulation inducing medicine and is often not a serious health concern. Roughly forty percent of infertile women have this condition.

Women who suffer from endometriosis will often suffer from terrible pain during their menstruation and the effects of this condition can lead to infertility as well. Many women aren’t diagnosed with endometriosis because they believe the pain they feel during their menstruation is normal. When left untreated, endometriosis can cause scar tissue and lesions to form outside the uterus, leading to a decrease in fertility and even more pain. It’s best to see a doctor as soon as possible to prevent damage, but most of the effects of endometriosis can be alleviated with surgery.

Another cause of infertility is Polycystic Ovary Syndrome. This is a hormone disorder that hinders the ability of the ovaries to release eggs. This disorder can be treated with medication, but studies have suggested that a healthy lifestyle can work just as well. Overweight women are prone to this disorder due to their unhealthy lifestyles and most fertility doctors would recommend a diet plan and regular exercise before they would resort to prescribing medication.

Another reason for this is the risks involved with being pregnant while overweight. The risks are numerous for mother and child in the case that a heavily overweight woman does manage to conceive.

Still not sure what might be the cause of your infertility? Visit a fertility clinic to be properly diagnosed. In many cases, the problem isn’t with your uterus, but with your partner’s sperm. Most infertility problems can be solved with IVF treatment (with your own egg or with a donor egg). There are treatments or medication available for each of the causes mentioned above and others that were not mentioned. The best way to know what steps you need to take is by talking to a medical health care professional. Don’t attempt to self-diagnose.

Menopause and Sex Life. Not two words you necessarily associate together but actually, the menopause can have a profound effect on your sex life, and not in a good way.

If you’ve had a healthy sex drive up to this phase of your life, it can make you feel under pressure to continue your sex life at the same level as before. Unfortunately, your body has other ideas! For a lot of women, they just feel too tired and then guilty at the fact you’re saying ‘not tonight’ again.

Be assured though, it’s totally normal to not feel in the mood!

Your ovaries stop producing oestrogen which can cause vaginal dryness and make sex painful and difficult, and over time lessen your desire as it just feels too much like hard work.

Hot flushes and night sweats also don’t exactly put you in the mood and make bedtime a sexy place to be! And the weight you’ve gained is seriously affecting your confidence and making you feel pretty rubbish.

Add to that a dip in your testosterone levels, which plays a key role in a woman’s sex drive and sexual sensation, and you can understand why so many women in their 40’s and 50’s have a reduced sex drive. Especially as our sexual desires naturally decline with age anyway.

The good news is you don’t just have to suffer through and accept this as your lot!

There are things you can do to help boost your sex drive and put you in the mood.

Here are few tips:

1. Diet. Certain foods have been found to increase libido:

– Magnesium rich foods including green leafy vegetables, beans and pulses boost levels of your sex hormones.

– Phytoestrogens such as flaxseeds and soybeans naturally mimic oestrogen in your body and increase your sex drive

– Spinach, garlic and coconut, can help boost your testosterone levels which affect your libido

2. Herbs can also be beneficial in helping to boost your libido, including ginseng which helps to boost testosterone, ashwaganda increases blood flow to the clitoris and other female sexual organs and maca root helps to balance hormones and improve sexual experiences and satisfaction.

3. If the feeling is more psychological, due to low mood and a lack of confidence in yourself, then talking about it can really help. Whether that is to your partner, a friend or a health practitioner, know that it is really common and you are not alone.

4. Building strong emotional bonds with your partner, doing things like holding hands, talking and cuddling can help build connection and intimacy with your partner, and put you in the mood.

5. Lubricants can make sex easier and more enjoyable. Go for a water-based one as the most natural way to increase moisture and maintain your vagina’s natural PH.

6. Exercise helps by boosting stamina and strength, which in turn increases your confidence and sex drive. Go for a walk, join a dance class, just do something that you enjoy!

So it is just another natural and normal phase of life and, if you follow the above tips, you can work with it!

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Menopause is the day a woman experiences her last menstrual cycle because her ovaries, which produce eggs, have slowed down.

Most women cannot wait to get off the pain, cramps and, most times, the discomfort they experience during menstruation. Yet, when it eventually bids goodbye, many are ill-prepared for the medical and psychological challenges that follow.

However, most women have said that instead of relief, they feel less feminine; others even thought they had contacted a disease.

Not to worry, doctors have said menopause, which is the permanent end of menstruation, is a turning point in a woman’s life, not a disease.

Menopause does not happen suddenly, it is a gradual process, but many women fail to see the warnings, hence they experience complications such as hot flashes and severe issues like heart diseases and osteoporosis says a gynaecologist, Dr. Jeni Worden, “Menopause is a milestone   – it’s the day that marks 12 months in a row since a woman’s last period. It most time signifies that the ovaries are slowing down and the woman’s childbearing years are winding down.”

Age is the leading cause of menopause, says Worden.She notes that though few women start menopause as young as 40, and a very small percentage as late as 60, a woman should expect to stop seeing her menstrual flow between ages 45-55 years.

She also notes that there is no proven way to predict the exact age a woman would experience menopause.

Menopause affects women differently, say scientists at the National Institute of Aging.

Because hormonal composition varies in individuals, some women may reach this stage with little or no trouble; while others may experience severe symptoms such as discomfort during sex, hot flashes and sleeping problems, which drastically hamper their lives.

Worden states that for a woman to manage her health when menopause starts, she must be able to recognise premenopausal symptoms.

A major sign that menopause is approaching is a change in menstrual period but this change varies in length from woman to woman.

She adds, “Periods may get shorter or longer, heavier or lighter, with more or less time between periods. Such changes are normal,”

Sex problems

Women complain that they have less appetite to make love or feel much pain during intercourse after or before menopause. Worden says since less estrogen is produced in a woman after menopause this leads to vaginal dryness, which may make intercourse uncomfortable or painful.

One of the biggest issues with sex after menopause is that declining estrogen levels can lead to thinning of the vaginal walls,” says Dr. Adekunle Ojulari, a consultant gynaecologist.

Ojulari explains that estrogen levels fall as women approach and pass menopause resulting in dryness and thinning of vaginal tissues which causes penetration and intercourse to be uncomfortable for many women.

The discomfort can range from a feeling of dryness to a feeling of vaginal “tightness” to severe pain during sex.

He says, “ After sex, some women feel soreness in their vagina or burning in their vulva or vagina. Over time, and without treatment, the inflammation that may result from infrequent sex without sufficient vaginal lubrication can lead to tearing and bleeding of vaginal tissues during sex.Between 17% and 45% of postmenopausal women say they find sex painful.

This is one of the main reasons why between 17% and 45% of postmenopausal women say they find sex painful,5-8 a condition referred to medically as “dyspareunia.” Vaginal thinning and dryness are the most common cause of dyspareunia in women over age 50.”

Therapists on WebMd.com have said using a water-soluble lubricant during love making may help these women.

They warn that libido may also change, for better or worse, but many factors besides menopause — including stress, medications, depression, poor sleep, and relationship problems — affect sex drive. “If symptoms persist, talk to your doctor, a woman should not settle for a  so-so sex life because of menopause.”

Here are other menopausal symptoms that would let you know that your menstrual cycle is winding down:

Hot flashes

According to Medicinet.com, about 80 per cent of women entering menopause experience hot flashes (or hot flushes) , a brief feeling of heat that may make the face and neck flushed, cause temporary red blotches to appear on the chest, back, and arms.

Sweating and chills may follow. Hot flashes vary in intensity and typically last between 30 seconds and 10 minutes.

Osteoporosis

Also, with menopause comes a greater risk of heart disease and osteoporosis. So it means it is time to step up and get serious about it, if you have not already.

According to a survey on WedMD.com, the number one cause of death in women in the United States is menopause-related heart disease and osteoporosis as the loss of estrogen plays a role for heart disease after menopause.

Physician-author Christiane Northrup says one of the smartest things a woman can do as she transits to menopause and afterward is to get regular physical activity. Instead of looking back mournfully,  she should use this state to redefine herself with positive thoughts, love, explore what brings her pleasure, and revive (not retire) her sex life.

That includes aerobic exercise for her heart and weight-bearing exercise for her bones — both of which may help ward off weight gain and provide a mood boost.

Other treatments that experts offer to help women cope better with menopausal symptoms include low-dose birth control pills; antidepressants, blood pressure drugs, or other medications to help with hot flashes; and vaginal estrogen cream.

Your doctor may also have lifestyle tips about adjusting your diet, exercise, sleep, and stress management.

PUNCH.