FREE TALK CONVERSATION

UPDATE ON HEALTH TRENDS

Testosterone therapy hope or hype?

The male hormone is being increasingly prescribed, but does it restore
vim, vigor and perkiness? What does it do to your sex drive? And can
you have too much of a good thing?

When 56-year-old Chloe Williams had her ovaries removed, she wasnt
prepared to lose her libido. My sex drive dried up completely; I
couldnt bear the thought of it. Apparently, my ovaries had been
producing a bit of testosterone, even though I went through the
menopause a few years ago. After the operation, which I had to reduce
my risk of cancer, I felt under-powered, tired and not in the least bit
interested in sex. My GP offered me testosterone, and I jumped at it.
She is far from alone; there is growing interest in the role of the
hormone in both men and women. And scientists are asking: do falling
levels in old age, or after cancer treatment, damage our health? Does
testosterone replacement restore vim, vigour and all-round perkiness?
And can you have too much of a good thing?
Testosterone is often called the male hormone, but women have it, too. It
is made from cholesterol in the gonads (testes in males, ovaries in
females) and both sexes also make some in the adrenal glands that sit
just above the kidneys. Production in the gonads and adrenals is
stimulated by hormones produced in the brain, and testosterone levels
fall gradually as you get older, especially in men.
If you suffer from primary hypogonadism, the gonads do not produce
testosterone, while in secondary hypogonadism, the hypothalmus or
pituitary in the brain do not pump out enough of two other hormones,
known as LH (Luteinizing hormone) and FSH (folliclestimulating hormone), to stimulate the gonads into production.
London endocrinologist Dr Mark Vanderpump is concerned about rising
use of the drug in the UK prescriptions rose by around 90% (from
157,602 to 298,314) between 2000-2010.

The key is to get a firm diagnosis before committing a person to a

treatment for life that isnt risk-free, he says. Every person needs
individual, tailored management theres not one protocol that fits
everyone. Its important to monitor red blood cell count that increase the
risk of thrombosis.
Williamss GP prescribed a testosterone gel, even though it is not
licensed for use by women. An alternative would have been an HRT
preparation that has some testosterone-like effect called tibolone. The
Endocrine Society says: Testosterone should be reserved for postmenopausal women with sexual dysfunction secondary to hypoactive
sexual desire, because there is limited data regarding long-term efficacy
and safety. Testosterone levels do not predict response, and should not
be routinely measured, but monitoring for signs of androgen excess is
important.
Androgen excess too much testosterone can cause problems such as
excess hair and acne. Williams says her libido did improve after a few
days, but she thinks it might have been psychological. I think my sex
drive was low because I was recovering from the impact of surgery and
the genetic test that said I was at risk of cancer. Im not sure how I feel
about using a drug that may cause side effects or be ineffective.
Vanderpump says the small doses prescribed to women should be safe.
Adrian Sylvester, 34, went to his GP after he and his partner had been
trying for a baby for two years. Id been finding it hard to get reliable
erections and my sex drive was rubbish. I put it down to tiredness and
stress. Then I got so anxious about the whole thing that it put me off sex
altogether. My GP organized a sperm test that hardly showed any sperm
at all.

Sylvester had blood tests that showed low levels of testosterone, LH and
FSH. An endocrinologist did further tests, but could not find a specific
underlying cause. Sylvester was advised to cut out the strong opiate
painkillers that he was taking for back pain, changed job and took steps
to reduce his stress levels.
But the endocrinologist explained that while prescribing testosterone
might help libido, energy levels and muscle bulk, it would not restore
sperm production. In fact, it could make it worse, because the brain
senses the extra testosterone in the bloodstream and produces even less
LH and FSH. Testosterone has been considered as a male contraceptive
for this reason. Happily, within three months, Sylvesters hormone levels
and sperm-count improved and although Adrians partner isnt pregnant
yet, the chances are that they will be able to conceive naturally in time,
but Vanderpump points out that drugs such as opiates and certain illness
can temporarily lower testosterone, so repeat measurements are always
advised.
Testosterone levels in men peak in their late 20s, declining from around
30. Most experts believe it is an inevitable part of ageing, but say
lifestyle changes, such as losing weight and reducing alcohol intake can
improve levels and symptoms. Confusingly, blood levels of the hormone
may not correlate with symptoms; some men with low testosterone feel
fine, while others with levels at the low end of normal feel drained of
energy and strength, and improve greatly when given the hormone.
Seven placebo-controlled trials are underway in the US to try to
establish what symptoms men with low levels due to age alone might
experience, and whether the therapy helps. Findings from the first three
showed treatment improves sexual function, but has questionable impact
on vitality, mood and depression. And study author Professor Peter
Snyder of the University of Pennsylvania, Philadelphia says that
decisions about whether to offer treatment depends on knowing the
risks, which will necessitate larger and longer trials.

Professor Eric Orwoll of Oregon Health and Science University,

Portland points out that the benefits were modest and tended to wane
over time. At this point their clinical importance is uncertain. Therapy
was not a panacea, and the findings alone might be insufficient to
support a decision to initiate testosterone therapy in symptomatic older
men. The average age of men in the study was 72, 90% were white,
most were obese and had high blood pressure and all had very low
testosterone levels.
So who should take testosterone? Young men who arent producing
testosterone because their testicles have failed certainly need to take it,
in order to prevent bone and muscle loss. But men such as Sylvester,
whose low levels reflect failure of the brain hormones that stimulate the
testes into production, should not be given it, as it will impair fertility
further.
Women such as Williams can try a low dose, but should not stay on it if
it is not helping. And older men who are suffering from low libido,
energy and erectile dysfunction and low testosterone due to age alone,
need to wait to find out whether it is safe the trials didnt flag up any
major toxic effects, but they werent powered to answer the safety
question decisively.
Consumer advocate Dr Sidney Wolfe of Public Citizen says testosterone
prescriptions in the US are 17 times higher per population than in the
UK overall. And alarmingly, a fifth of those were for the non specific
symptom of fatigue and up to 9% were for men who had normal or
high levels already. Some are given prescriptions without even having
their levels checked. In 2014, Public Citizen actually filed a petition with
the US Food and Drug Administration (FDA) requesting a strong health
warning on all drugs containing testosterone.
Last year, the FDA denied that request but did issue a caution and
required a labelling change to mention a possible increased risk of heart
attack and stroke with use. Wolfe remains convinced that stronger
action is needed to stem the rising tide of testosterone use.

I must face my fear of doctors for my

childrens sake
I have been poked, prodded and scanned, have given armfuls of blood
and endured a colonoscopy all so I can thwart the grim reaper

The grim reaper stalks the middle-aged male Golightly line for the
smokers, the unfit, the overweight and the complacent. Death took my
father in his late 50s, my half-brother in his 60s, and narrowly missed
my brother, while female family members sail on to a great age in rude
heath.
When elderly relatives say, Adam you look like your dad, they mean
well, but I hear only the horror of, Adam, youre marked for early
death. With Helens death, my unease has turned to panic, not because
of any intrinsic fear of dying but because Millie and Matt need their

surviving parent to stick around. So I must love life and myself as never
before.
I need the Golightly womens longevity, and for this I require their sexs
more positive attitude to healthcare. In my experience, the male
chromosomes seem also to carry a doctor-dodging gene, such that we
have to be at deaths door before consulting a GP. Also, as a crude rule
of thumb, the closer the problem lies to our willies the less likely we are
to bother with the doctors surgery.
I start in a good place to beat the wrap of family history. I have never
smoked, have always exercised and, after a recent return to fitness, have
a BMI of 23 and am fitter and leaner than ever. Importantly, after sitting
with Helen in so many hospitals, my fear of them has gone. Her courage
lights the way; a total lack of fuss facing so much invasive treatment and
more needles in a day than I have had in my life.
It was with Millie and Matts help, however, that I overcame my most
recent reason to dodge the men in white coats an association of
healthcare professionals with Helens ultimately futile treatments, in
which the smell of antiseptic reeked of failure enough to haul me griefstricken from waiting room to pub. Leaving the kids in the car on a
Saturday morning, I run into the shop to buy cat food for the everhungry Harry. With an unscheduled chat to a passing school mum, Im
not back for 20 minutes rather than the forecast 10. Millie and Matt are
anxious to the point of tears. Where were you, Dad? We thought
something bad had happened to you.
It struck home because similar separation anxieties have been happening
more often since Helens funeral. They need me. So I have embarked on
a course of self-induced, largely self-funded medical tests. I have been
poked, prodded and scanned, given armfuls of blood and endured the
daddy of them all, a colonoscopy.
Mr Golightly, its unusual for someone to do this electively without
presenting symptoms. Its true that if theres nothing worrying found

now, then you are likely to be fine for some years to come, but are you
sure, asks the bemused consultant.
Im not sure, so I ask the question doctors usually hate, What would
you do? Heroically, he doesnt hesitate, Do it. I had one myself for the
same reason, Adam. I notice his use of my first name perhaps we are
brothers in adversity in the voluntary shoving of cameras up our
respective bottoms. OK, I say, suppressing an image of him selfadministering a Box Brownie up his arse. So off we go.
A week later, Im lying on a trolley wearing a pair of ill-named modesty
pants. Well give you something to make you woozy, but youll be
awake and can watch on the screen. Well start in a few minutes, he
says soothingly.
It has been a hard week in what has been a series of many hard weeks
and late nights. When next I open my eyes, the consultant is looming
over me. Im not sure if it is a first, but you are the only person Ive
ever had who has slept through the procedure without any help from us.
So I missed the worlds most bizarre TV show up my own colon but
it was all clear. Add this good news to clear arteries, the blood pressure
of a 30-year-old, a resting heart rate under 60, and I ponder the irony that
my wifes legacy to me, other than the kids and a dodgy Rolf Harrissigned painting, may be 30 years more of life with Millie and Matt than
she had. A bittersweet gift, but thank you, Helen.

Need to declutter? Don't bother

Rather than obsessing over tidiness, look for peace of mind whatever
your surroundings, says Oliver Burkeman

Its a mysterious truth of the digital era that we can build self-driving
cars and astronauts can tweet from space yet theres still no halfdecent, non-maddening system for organising the photos you take on
your smartphone. Actually, its not that mysterious: there are simply too
many photos. Back in pre-digital days, when nobody owned more than a
few thousand snaps, arranging them in albums made sense. Then came
software that tried to replicate albums, which worked for a bit. But now
that its normal to return from a day trip with 100 snaps, a thresholds
been breached.
Naturally, the same goes for emails, electronic documents, bookmarked
websites and so on: were each expected to manage a volume of data
that once might have kept a whole government department fully
occupied. I spent days experimenting with neurotic tagging systems,
tedious backup processes and album management, Brian Chen wrote in
the New York Times recently, before concluding that the only way to
manage your photos is to give up. Upload them, blurry mistakes and all,
to the least bad service, Google Photos. Then rely on its search function
to find what you need when you need it.

For those of us with neat-freak tendencies, its a harsh truth we have to

keep relearning: treating your digital possessions like your physical
ones is a losers game. You could spend a lifetime trying to keep them
tidy. But as Chen notes, youd be making a bad search/sort tradeoff: it
would take so long, and search technology is now so good, that youd be
wasting countless hours. Thats also why you should abandon your
complex hierarchy of email folders and use a single archive instead, and
chuck every document into an everything bucket app, such as
Evernote. Accept the mess which, if you like keeping things orderly,
wont feel good at first. I speak as someone who regularly deletes emails
from my spam and trash folders, not because I need the space but
because it offends me to think theyre still there.

Letting go of the craving for tidiness isnt only useful in a digital

context, though: it applies to physical possessions, too. Listen to Marie
Kondo and other evangelists of a clutter-free life, and youd be forgiven
for thinking that the key to serenity in a consumerist world is getting rid
of your stuff. Yet that soon becomes a fixation on getting your
surroundings just right when being zen, in this context, is really a
matter of finding peace of mind whatever your surroundings.
In a recent case study (which I found via Science Of Us), neurologists in
Lisbon told of a 65-year-old woman who, following a stroke,
temporarily lost her sense of mine. None of her material possessions
or her cats felt like hers, though she knew intellectually that they were.
The feeling vanished after a few days. But it didnt seem to make her
miserable, and to me it sounds rather healthy. Instead of trying so hard to
get organised or decluttered, you could try asking: how much of your
disorganisation could you afford to stop caring about?

No-tipping policies at US restaurants bring

delight and disaster
While ditching gratuities in Portland and elsewhere has meant less
judgment, angst and anger at some establishments, others have seen
staff members quit
When customers of Portlands upscale Le Pigeon receive their
credit card slips, the line has been removed where the tip would
normally be scribbled in. Co-owned by Gabe Rucker, a chef and
recipient of two James Beard awards, the French-inspired bistro threw
out tipping in June, while prices have increased by about 20%. Servers
are now paid an hourly wage as well as a share of revenues, similar to a
commission, and wages for cooks have gone up.
Le Pigeon is just one of many restaurants in the US to end tipping in the
past year. Its a bold experiment in a country where tipping is so heavily
embedded in the culture and it has met with mixed results. But at Le
Pigeon it seems to have worked at least for the staff.
The hope was to professionalize their jobs and make their method of
compensation more in line with nearly every other profession out there,
said Andrew Fortgang, co-owner and general manager of the Oregon
restaurant.
Fortgangs sentiment echoes those of a number of high-end restaurants
on the west coast along with handful across the country and several
locations in New York City that have ditched tipping at their
establishments in favor of a more sustainable model.

Depression, violence, anxiety: the problem

with the phrase be a man

Are dangerous ideas about masculinity leading to increased violent

crime and suicide? Eva Wiseman talks to the director of a new
documentary and three men discuss their experiences
The most dangerous phrase in the English language is be a man. To be
a man today, says film-maker Jennifer Siebel Newsom, is to fight for
success and sex, to reject empathy, and to never, ever cry. The result is
depression, anxiety and violence.
Siebel Newsoms first documentary, Miss Representation, explored the
way the media contributes to the under-representation of women in
power, and premiered at the 2011 Sundance Film Festival. When she
was touring with the film she was pregnant with her second child, a son.
And as she discussed the need for positive female role models, she

inevitably heard from audiences asking: But what about the boys?
Some $100,000 of Kickstarter donations later, she premiered The Mask
You Live In. It has just arrived on Netflix, a fast edit of men talking
wearily, and boys confused; an attempt to speak to what she calls the
boy crisis. As a child, one young contributor says quietly, he used to
have a group of close friends. Now hes a teenager he struggles in
finding people I can talk to... because I feel like Im not supposed to get
help. If you never cry, says another, then you have all these feelings
stuffed up inside you and then you cant get them out. In this film,
Siebel Newsom calls for a whole new masculinity.
If you never cry, then you have all these feelings stuffed up inside you
The day I spoke to her, I passed three boys sitting at a bus stop. One was
describing how gorgeous his wife would be when he grew up. Shes
going to be so hot... and Im going to cheat on her like crazy. At 42,
Siebel Newsom has recently given birth to her fourth child with husband
Gavin, former mayor of San Francisco, current lieutenant governor of
California, and the man best known for greenlighting same-sex
marriages long before US courts had sanctioned the practice. She deftly
juggles our interview with her sons insistent attempts to pull her away
to play what this means is she gets to the point. When she started
researching, she found boys were more likely than girls to be diagnosed
with a behaviour disorder, more likely to be prescribed stimulant
medications, more likely to binge drink, more likely to be expelled from
school, and more likely to commit a violent crime. At university entry
level in the UK, women outnumber men in two-thirds of subjects. Three
to four times as many men take their own lives than women; men aged
between 20 and 49 are more likely to die from suicide than any other
single form of death. Knowing all this, says Siebel Newsom, and
being pregnant with a son, I knew that not only did I want to make sure
he didnt become one of those statistics, but that I had to help change
this culture for everyone.

Itll take more than a film, she admits. Her nonprofit organisation, The
Representation Project, works alongside the films, campaigning to
challenge stereotypes. The most persuasive element, though, is Siebel
Newsom herself who, in her previous life as an actor, was told to remove
her Stanford MBA from her CV because it was threatening, but who
still has that actorly skill of talking in a way that will make people listen.
Experts link the repression of growing up male with mass shootings and
murder
In one scene in the documentary, a teacher gives a group of boys each a
piece of paper. On one side they write how they are seen by other
people, and on the other what they are feeling. Then they scrunch it up
and throw it into the circle. On the outside of all the notes were words
like tough, fearless. Inside, lonely. Its with awkward agony that
one boy rests a hand on his friends shoulder as he cries into his fists.
The shock comes with the realisation they all feel the same. Experts
swiftly link the repression required when growing up male with mass
shootings and murder, which makes the film particularly poignant today.
But while Miss Representation featured talking heads like Gloria
Steinem, Jane Fonda and Condoleezza Rice, there are no recognisable
faces in her second film. She pauses when I ask why. It was largely
because they didnt exist, she says. Men are not speaking publicly
about these issues. The implication is that their silence is part of the
problem.
Is masculinity really a mask? The film is compelling her experts in
neuroscience, psychology, sociology, sports, education and media are
obviously knowledgeable and passionate but the idea that the
manliness they discuss is purely cultural isnt questioned. In Time
magazine, Christina Hoff Sommers (author of two meninist books
about boys) worries Siebel Newsom is less concerned with helping boys
than with re-engineering their masculinity according to specifications
from some out-of-date gender studies textbook. She suggests talking
about emotions might have less value for boys, that mens stoicism is

protective. She says the film is misleading, giving the impression that
boys are severely depressed, stating contrasting figures showing clinical
depression is much lower than in girls. Hoff Sommerss most persuasive
suggestion is that instead of simply critiquing masculinity, Siebel
Newsoms first objective should be to help mental health services to
adapt to better meet the needs of men, conditioned or not : to harness
that competitiveness, aggression, to reflect the energy back and use them
for good. To defeat an enemy, like Captain America with his reflective
shield.

But perhaps thats next Siebel Newsom says this is just the beginning.
Since premiering the film, she sees the results of the boy crisis
everywhere, from misogynist responses to Hillary Clintons campaign to
the recent Stanford University rape case, where the father of an athlete
convicted on multiple charges of sexual assault said his son should not
have to go to prison for 20 minutes of action. The way the father and
the judge protected that young boy showed again how we privilege
white males and star athletes, says Siebel Newsom. As a society, we
need to take a real look at that and recognise the damage that is being
done when we continue to privilege those classes, those communities,
and blame the victim.
After screenings, Siebel Newsom says men approach her, crying. There
were men in their 70s saying, That was my life. Men in their 20s and
30s whod tell us they no longer feel so alone. And men in their 40s who
have children who go, OK, Ive got to raise my own sons differently.
She was moved. That is where we have to inspire the good men, the
brave men, the courageous men, to stand up to those who are trying to
belittle them. Were not going to move the needle on gender parity, on
violence, until we have more men entering the conversation and using
their platform to support those of us who are trying to do good.
When making the film, she says she was taken aback. What really
surprised me was how pure and gentle and confused boys were, she

says. How they felt so much pressure to become someone they felt they
werent. I dont want to date girls, I just want to be friends with them;
I dont know why I only have to play football. Its in those school years
where they start feeling this need to disconnect, and you see the pain,
anxiety, the alienation that results from them denying their true selves.
Its heartbreaking, she says.
I hear her son calling for her again. Because, at the end of the day, she
adds, nobody wins.

My dads notion of being a man was

flexible
When I was growing up, my fathers explanation of being a man could
be bewildering. Its not about what sex you are, he would say, before
adding even more confusingly, Your mother can teach you more about
being a man than anyone I know.
Eventually I understood. Unlike many fathers in the 1970s, his concept
of being a man was not the opposite of being feminine or emotional. It
was the opposite of being childish and immature. It meant having the
courage to face your fears and responsibilities, but also not being afraid
of your emotions or weaknesses. It was about being a trusted friend and
an equal partner.
He could have just said be a good person rather than be a man. But it
wouldnt have had the same effect. He knew that, as a boy, I would one
day be interacting with the rest of the world as an adult male a man. I
was going to have to understand what that meant in my dealings with
women, with other men, and with society as a whole. If he did not give
me a positive identity of what it was to be man, he knew that one of the
many negative ones would quickly fill the vacuum. He was giving me an
identity that would prepare me for life.

Over the years, that identity grounded me through my successes and

failures. It also meant that, despite my youthful love of hip-hop, reggae
and sports, I was never really seduced by the cartoonish, misogynistic
versions of manhood black manhood, in particular that they often
offered. It inoculated me from the worst excesses of testosterone-fuelled
nonsense.
My fathers notion of being a man was also flexible. As I grew from a
child of the 70s to an adult of the 90s, it grew with me. I learned that
sometimes a man should back down from a fight; that real men are also
feminists; and that not being seen as a sissy is meaningless, while not
being homophobic is important.
In a modern, gender-fluid world, is the notion of being a man still
relevant? Are we not all just people? Yes and no. The philosopher Jerry
Cohen wrote: There is no way of being human, other than a way of
being human. Being a man is one of those ways.

Cowboys were real men. They never cried

If my father had asked me when I was six years old, What does it mean
to be a man, son? Id have smiled broadly and said: cowboy. I was
never happier than when I was sitting on his knee watching westerns like
Wagon Train and Rawhide on our tiny black-and-white TV.
My father was cowboy mad and so was I. After I said my prayers for all
the people I loved, my mother had to wait until I was in bed and fast
asleep before she could gently relieve me of my beloved cowboy suit.
Cowboys were real men. They were tough and they never cried.
But when my mother was killed in a road crash less than a year later, I
cried. My father had to be cut from the wreckage and, when he came
home, I cried again. In place of my funny, loving, playful dad was a
grieving, selfish, violent drunk. He beat the women he lived with and he
beat me. I loved him still, but learned to hate him just as much. The care
home I was sent to at 11 was full of boys like me. No aspiring train

drivers or astronauts among us we told each other that, when we grew

up, wed be gangsters and crooks. No crying allowed.
My teenage years were punctuated by spells in prisons that lionised
toughness and frowned on cry-babies. Lifting weights and being hard
was what counted, what got respect. At 20, I should have been a man.
Instead, like my father, Id become a selfish, violent drunk.
Self-loathing took me down a dark road, leaving in my wake
immeasurable pain and grief. At the end of it, an Old Bailey judge called
me brutal, vicious and callous and jailed me for life. Two years in, a
prison psychologist told me, Were all born lovable. I said, Even me?
She said, Even you. Contrition almost destroyed me. For the first time
in a long time I cried again. I was desperate to be a man. I just wasnt
sure what that meant. In the end, I decided to try to just be a decent
human being. Trying to be a man had been catastrophic.

Being a man is being kind when frightened

When we are boys, we believe we must study Dad and be like him. I had
the great fortune of A lovely father who was rarely observable: my
parents divorced. Watching him was a hopeless guide anyway. He had
problems, according to Mum, and he married four women before he
settled down. But he is kind, peaceable, slow to anger, very funny, and
skilled.
I was quite funny but otherwise hopelessly unlike him. I loved speed,
spending, girls and guns. Over the decades of my manning up I accrued
convictions for arson, taking without consent (car), ditto (boat), ditto
(milk float) and all sorts of decorations for dope. Change my
background and I would have been a suicide bomber. No question.
You could apply the same criminal record to my relationships with
women. Not in the manner of loving them, for I think I am gentle, too,
but in the leaving. Porn, piracy, hijack, honeytrap: in my pursuit of love I
have committed and been had by all these. And the frightening thing is,

however special I thought I might be, in my teeny ravings, which are

ongoing in the male part of my lizard brain, Im not. The blindness
testosterone causes accounts for much, we know, and being a man is
being blind, sand-blind, gravel-blind as Shakespeare had an old man
say, and frightened. Thats the job, I think to be kind when blind and
frightened.
The only teacher I had, really, who lived with the knowledge she would
watch us go wild into a wild world, was my mum. Her favourite birds
are wood pigeons, which handle relationships with a religious purity, so
it follows that a good man, to her mind, is a good pigeon: alert for
crumbs and shoots, devoted, on watch but not panicked, and given to
singing the same song as his partner. If he has one.
And he does. We all do. Like good sailors, we boy-men have our
shipmates and all the world to help us, in this mans world, this tramp
ship in time and space. The rules of seafaring, I think, are: smile, work
hard, trust in the Lord/Lady and remember the sea is equal to all men,
and no man is equal to the sea.

Shift workers more susceptible to infections

An often-disrupted body clock leaves a person more prone to contracting
diseases than those who go to bed regularly at a normal time
People are more susceptible to infection at certain times of the day,
research from the University of Cambridge suggests.
Academics found that the body clock affected the ability of viruses to
replicate and spread between cells, with those in a resting phase or with
a disrupted body clock more likely to succumb to illness.
The findings, published in the Proceedings Of The National Academy Of
Sciences, may help explain why shift workers, whose body clocks are
routinely disrupted, are more prone to health problems, including
infections and chronic disease.

When a virus enters the body, it hijacks cells to help it replicate and
spread. The resources of cells fluctuate throughout the day, partly in
response to our circadian rhythms in effect, our body clock which
controls functions including sleep patterns, body temperature, our
immune systems and the release of hormones.
A study of mice saw creatures infected with herpes at different times of
the day, with scientists measuring levels of virus infection and spread.
The mice lived in a controlled environment where 12 hours were in
daylight and 12 hours were dark.
Researchers found that virus replication in those mice infected at the
very start of the day equivalent to sunrise, when these nocturnal
animals start their resting phase was 10 times greater than in mice
infected 10 hours into the day, when they are transitioning to their active
phase.
The experiment was repeated in mice lacking the gene Bmal1, which
helps control the body clock, and they found high levels of virus
replication regardless of the time of infection.
Research was conducted at the Wellcome Trust Medical Research
Council Institute of Metabolic Science at the University of Cambridge.

Shift workers at higher risk of diabetes, study

finds

The time of day of infection can have a major influence on how

susceptible we are to the disease, or at least on the viral replication,
meaning that infection at the wrong time of day could cause a much
more severe acute infection, said Professor Akhilesh Reddy, the studys
senior author. This is consistent with recent studies, which have shown
that the time of day that the influenza vaccine is administered can
influence how effectively it works.
When the body clock was disrupted in either individual cells or mice,
researchers found that the timing of infection no longer mattered viral
replication was always high.
Dr Rachel Edgar, the first author, said: This indicates that shift workers,
who work some nights and rest some nights and so have a disrupted
body clock, will be more susceptible to viral diseases. If so, then they
could be prime candidates for receiving the annual flu vaccines.

The genes that control the body clock also undergo seasonal variation
and are less active in the winter months, when diseases such as influenza
are more likely to spread through populations.
Researchers hope the molecular machinery of the body clock may offer
the potential for new drugs to help fight infection. The research was
mostly funded by the Wellcome Trust and the European Research
Council.

How getting more sleep could boost your

salary
A good nights kip can boost your productivity and mean you earn
more money. So how can you make sure youre getting enough sleep?
Sleep has become a big deal in working life. Thanks to high-profile
figures including Arianna Huffington, sleeping is no longer seen as a
sign of weakness among competitive colleagues. Apple introduced a
Night Shift feature on its devices earlier this year, as consumers
recognised that stimuli such as your screens backlight can affect your
sleep quality.
Research shows that more sleep can lead to us earning more money. A
US study has found that in areas where the sun sets earlier, people sleep
for longer and this translates into higher earnings. In the long term, just
one extra hour of sleep a week increases wages by 4.9%. So if you live
in an area that gets darker earlier, you should be richer. But dont move
house just yet the higher wages correspond almost exactly with
inflated house prices. As Jeffrey Shrader, one of the authors of the study,
puts it: If you want to sleep more, there are better ways to do it than
moving house just buy better curtains.
This goes against conventional economics. Each extra hour of sleep
should take away from working time. So how can sleeping earn you
money? The answer is productivity. The biggest effects come through

employees who work on commission, says Shrader. If you go to work

well rested, you are livelier and happier, and can sell more to increase
your earnings.
Even small amounts of sleep deprivation can have large effects.
Annother study found that sleeping six hours a night for two weeks
produced the same results in cognitive tests as being totally sleepdeprived for up to two days straight. But a mid-afternoon kip can help.
Naps are great, says sleep psychologist Dr Hans Van Dongen. If you
struggle to get eight hours of sleep a night, a siesta can have a reset
effect, and your productivity improves afterward. Roughly speaking, an
hours nap can make up for an hour in lost sleep at night.
So rather than simply a fleeting Silicon Valley trend the introduction
of nap pods at Googles headquarters does have some science behind it.
(Although once you start sleeping at work, what is the point in going
home at all?) Even short naps of up to half an hour can partially offset
the productivity loss stemming from chronic sleep deprivation. You
snooze, you win.
But the most important workplace revolution would be much more
flexible hours. Most of us fall into two broad chronotype categories:
morning and evening types. Rigidly early start times at work are fine for
larks, but a third of us are night owls, who can earn up to 5% less as a
result of being tired at work.
Lack of sleep has already been shown to be worse for productivity than
being overweight or underweight. So, why are you still reading this?
You should go back to bed.