In the Loop - University of Victoria, Self-Management BC

Bladder Health

The urinary system or urinary tract includes the kidneys, ureters (tubes that connect the kidneys to the bladder), and the bladder (a hollow organ like a balloon or sac about the size and shape of a grapefruit that stores urine. The bladder is found in the lower abdomen, just below the kidneys and right behind the pelvic bone). The urinary system also include the urethra, a tube that allows urine to exist from the bladder to outside the body. The urinary tract is the body’s system of removing wastes and extra fluids. Urine is made up of waste and extra fluid that remains after the body takes what it needs from food and drink. The normal capacity of the bladder is about 2 cups of liquid for adults. The bladder’s job is to hold urine until it is a good time to urinate. The bladder, located in the front of the pelvis, is an important muscular organ with a sensitive system of nerves that acts as a holding chamber and protects the kidneys from infection.

Common bladder problems include:

Urinary tract infections (UTIs) - represent the second most common type of infection in the body, and can happen in the bladder (cystitis), kidney or urethra with symptoms such as cloudy, bloody or foul-smelling urine, pain or burning when urinating, a strong and frequent urge to go to the bathroom and a mild fever in some people. A urinary tract infection (UTI) is caused by bacteria in any part of the urinary tract, with the bladder being most common. Anyone of any age can get a UTI, but groups who are more likely to develop a UTI include women, people with diabetes, older adults.
Lower urinary tract symptoms (LUTS) - trouble urinating, loss of bladder control or urinary incontinence, leaking urine, and frequent need to urinate or overactive bladder which affects an estimated 40 percent of women as reported by the Urology Care Foundation); and
Bladder cancer (cancer in the lining of the bladder). In men over 50, a bladder infection is usually linked to an enlarged prostate or prostate infection.

Focus on urinary incontinence
The Public Health Agency of Canada estimates that one in five older Canadian adults experiences some type of bladder control problem that causes the “involuntary release of urine,” also known as urinary incontinence. The US Centers for Disease Control and Prevention report that more than half of women and 30 percent of men aged 65 and older are affected. Urinary incontinence is not a disease or condition but rather a symptom of some other problem in the body. The impacts of urinary incontinence include embarrassment, lack of social contact, decreased feelings of well-being, and stress. Having urinary incontinence can also lead to falls. Urinary incontinence is not a part of normal aging.

Aging and the bladder
Your bladder becomes less tough and less stretchy and, therefore, cannot hold as much urine. According to Elizabeth Kavaler MD of the Healthy Women website, capacity of the bladder decreases slowly, going from 500 cc to 200 or 150 cc in your fifties. Less urine can initiate the urge to go to the washroom or result in bladder spasms. The wall of the bladder and pelvic floor muscles may weaken, resulting in increased urination, difficulty emptying the bladder, and leaking urine. A woman’s urethra can become blocked because the bladder or vagina falls out of position from weakened muscles – this is also known as prolapse. An enlarged prostate can cause a blocked urethra in men. Having bladder problems can interfere with quality of life, making it difficult to go out socially and do activities of daily living.

Factors that can affect bladder health include: constipation, diabetes (damage to nerves around the bladder), smoking (people who smoke compared to non-smokers have more bladder problems and an increased risk of developing bladder cancer), diet (bladder irritants for some people include sodas, artificial sweeteners, spicy foods, citrus fruits and juices and tomato-based foods), caffeine (can change how your bladder tells you when to urinate), alcohol, pelvic injury, some medicines (nerve calming medicines to help with relaxation and sleep may dull the bladder’s nerves), and being overweight (increases the risk of leaking urine).

Signs of a bladder problem
Several signs can indicate a bladder problem and include not being able to hold urine (urinary incontinence), visiting the bathroom 8 or more times per day, having sleep interrupted because of the need to visit the bathroom several times (called nocturia), pain or burning before, during or after going to the bathroom, cloudy or bloody urine, having a strong urge to go the bathroom but only passing small amounts or urine, and trouble starting a stream or having a weak stream.

The UK National Health Service reports that bladder issues should not be considered an inevitable part of getting older. Talk about any bladder issues you experience with your family doctor. A health professional can assess symptoms, determine the cause and discuss treatments. The British Geriatrics Society states, people often delay seeking help for bladder and bowel problems for significant periods of time, because people regard these problems as part of aging and may not get the medical attention they need. According to Johns Hopkins Medicine, research has found that at least half of people with urinary incontinence don’t discuss the condition with a health care provider.

The bladder changes with age, but there are things we can do to improve bladder and urinary tract health.

Drink adequate amounts of fluids to keep hydrated - the Urology Care Foundation explains that the “8 glasses a day” is unfounded and may result in people drinking too much water and having “bladder on the brain.” People should drink based on their thirst. Water is the beverage of choice and should make up half of all fluid intake (the exception is that some people should drink less water because of certain health conditions e.g., kidney failure or heart disease). Ask your doctor about your fluid needs. The problem with aging is that the thirst mechanism in the body does not work as well so we need to be aware of the need to have adequate fluid intake. Western University’s London Health Sciences Centre explains that people should avoid limiting their water intake believing it will improve incontinence because doing so makes the urine become very concentrated and this will irritate the bladder and make you want to empty it more often even if there is little urine. Another tip is to avoid drinking a large amount of water all at once, as this can make you urgently need to go to the washroom. Instead, space drinking throughout the day. In the evening, drink less fluid and go to the washroom prior to bed to decrease the need to visit the washroom during the night
Reduce your intake of beverages and foods that can irritate the bladder lining and cause the bladder muscle to contract - beverages such as caffeine, alcohol and carbonated beverages can make irritable bladder symptoms worse. Limit caffeine to 1 to 2 cups a day or eliminate it altogether. Caffeine containing foods and beverages include coffee, tea, cola and chocolate. Keep in mind that decaffeinated coffee still has caffeine. Be aware that alcohol acts like a diuretic, meaning that a large amount of urine is produced quickly and quickly fills the bladder, irritating the bladder wall and causing it to contract. Acidic fruits and juices can be irritating and include apple, cranberry, grapefruit, lemon, lime, orange and pineapple. Other problem foods include spicy foods e.g., Cajun, Indian, Mexican, and Thai food and tomatoes in their whole form and as juices and sauces. Other foods that can irritate the bladder when consumed regularly include artificial sweeteners, carbonated drinks, corn syrup and honey
Quit smoking - don’t start or quit if you do smoke. Smoking not only irritates the bladder, causing the urge to go, but it can also cause a chronic cough that can put pressure on the pelvic floor muscles
Manage a chronic cough - if you have a chronic cough from smoking, asthma, bronchitis or Chronic Obstructive Pulmonary Disease (COPD), the coughing can weaken your pelvic floor muscles.
Keep your bowels moving and avoid constipation - this can be done by eating enough fibre (25 to 30 grams per day from bran, fresh vegetables and fruits, grains and whole-wheat products), exercising regularly and drinking enough water. Constipation affects the bladder by putting pressure on it and preventing it from expanding. If you strain during bowel movements, this weakens the muscles that control urine leakage. If constipation is an issue, speak to your pharmacist about ways to address it
Maintain a healthy weight - being overweight can cause problems by placing pressure on the pelvic floor muscles
Exercise on a regular basis - exercise helps prevent bladder problems and also works against being constipated
Learn about pelvic floor muscle exercises - these are also known as Kegel exercises that help with holding in urine from leaking when you cough, sneeze, laugh, exercise, or have a sudden urge to urinate. The exercises strengthen the muscles of the pelvic floor to keep the bladder in place and the urethra shut tight. Dr. Phillip P. Smith, associate professor of surgery and clinician in University of Connecticut Health’s Center for Continence and Voiding Disorders, advises women to regularly do pelvic floor exercises, especially women who plan vaginal birth and women who engage in vigorous exercise or heavy lifting
Practice safe sex - prevent sexually transmitted diseases (STDs)
Urinate after sex - both men and women can benefit as this will flush away bacteria that may have entered the urethra
Don’t delay going to the bathroom by voiding regularly throughout the day - urinate every 3 to 4 hours as holding your urine can weaken bladder muscles, increase the chances of having a bladder infection or developing kidney stones in people with a history of kidney stones or who have a high mineral content in their urine. The Medical News Today website reports that it is okay to hold your urine on occasion, but doing this regularly may cause problems. Go shortly after you feel the urge. If you feel you are urinating too much or too often, discuss this with your doctor
Fully empty your bladder - if you rush you may not fully empty your bladder and having the urine staying in your bladder too long can increase the likelihood of infection. The London Health Sciences Center indicates that to completely empty your bladder, you may need to shift positions, stand up and sit down again, lean forward or gently push on your lower abdomen
Relax while urinating - sit on the toilet seat and don’t hover over the seat as this make it harder to relax
Women should wipe from front to back - this is done to prevent bacteria from getting into the urethra, especially with a bowel movement
Wear appropriate clothing that breathes - cotton underwear and loose clothing allow air to circulate
Manage chronic conditions - for example, diabetes can cause frequent urination or nerve damage
Do not delay seeing your doctor if you experience symptoms of a urinary tract infection (UTI) e.g., urgency, frequency, blood in the urine or burning when going to the bathroom

Other treatments include medicines and surgery.

Resources

National Institutes of Health Senior Health video How Aging Affects the Bladder
UK Bladder and Bowel Community website
Alberta Health Services Bladder and Bowel Diary
American Urological Association - Urology Care Foundation website
The Canadian Continence Foundation - The Source: Your Guide to Better Bladder Control booklet
AgeUK Bladder and Bowel Problems booklet

Sources: Medical News Today website, Canadian Continence Foundation website, AgeUK Bladder and Bowel Problems booklet, Health in Aging website, Health Canada website, Healthy Women website, MedlinePlus website, British Geriatrics Society website, LiveScience website, YouAreUnltd website, Johns Hopkins Medicine website

Health Self-Assessment

One of the positives of staying home during the COVID-19 pandemic is the opportunity for self-reflection. Harvard Men’s Health Watch shares an idea from Susan Flashner-Fineman with Harvard-affiliated Hebrew SeniorLife. She is part of the wellness coaching program, Vitalize 360, where health coaches meet with older adults annually to complete a “health self-assessment” to review five areas of life - physical, social, intellectual, financial and spiritual. This process is a way to measure where you are now, decide what you want to do, and determine how to get there, and to identify strengths and how to build on them. The approach can be used instead of setting New Year’s resolutions.

Physical - Flashner-Fineman encourages people to think about what activities they enjoy doing and how they can support doing them e.g., greater endurance for playing with your grandchildren, or better functional fitness to reduce pain and the risk of falls. If you connect your health goal with something you want to accomplish or value, it will keep you motivated and focused.

Social - she cites the statistic that about 50 percent of health is related to social and emotional wellness. Are you regularly in contact with family and friends? Think about how you can nurture your relationships with others. The pandemic may be an opportunity to check in on people you haven’t contacted in some time.

Intellectual - you need to keep your mind regularly active to stay sharp and healthy. This means challenging your brain daily with activities such as learning new skills e.g., language, an instrument, a card game. Join a book club, improve on your cooking skills, take free online courses from platforms such as e dX or Coursera.

Financial - during his pandemic, the state of the economy is weighing heavily on our minds. Jasmin Brown, a senior vice-president of BDO in Saskatoon, tells Global News that now is the time to assess your financial situation and come up with a plan to lessen the impact of the crisis on your financial well-being. Assess your current situation to know where you stand. Steps you can take include making a budget by determining what are “wants” and “needs” and identifying where you can trim expenses. She suggests, as do all government organizations, that people avoid panic spending. The Government of Canada has information on financial assistance on their website.

Spiritual - evidence shows that greater wellness can be achieved from some level of spirituality and gratitude. Examples of spiritual activities include meditation, interacting with nature, or participating in a faith-based community.

Self-Management Health Coach Program
If you are interested in getting support to make health behaviour changes, consider participating in Self-Management BC’s Self-Management Health Coach Program. This free telephone-based coaching program supports people living with chronic conditions to become better self-managers. Health Coaches connect with participants by telephone, once a week for 30 minutes, for a period of three months. To register your interest in this program, visit the website, email selfmgmt@uvic.ca or call toll-free 1-866-902-3767 or Lower Mainland 604-940-1273.

Sources: Harvard Men's Health Watch website, Global News website, Chicago Tribune website

Adding Spice Blend to Improve Your Meal

Previous research has found that some spices such as turmeric, ginger and cinnamon have anti-inflammatory properties. It has been established that chronic inflammation is associated with chronic conditions such as cancer, cardiovascular disease, and overweight and obesity. Another finding is that inflammation can spike (acute inflammation) after a person has a meal high in fat or sugar, it is suspected but not yet confirmed that these short bursts cause chronic inflammation.

Researchers at Penn State University conducted a small randomized controlled study with 12 men between the ages of 40 and 65 years of age who were at higher risk of developing poorer health outcomes i.e., they were either overweight or obese and had one risk factor for cardiovascular disease (e.g., hypertension, an inactive lifestyle, high cholesterol or family history). The research question was whether adding a combination of spices to a single meal could have a positive effect. This was the first randomized controlled trial to look at the effect of using a spice blend on inflammatory mediators. Few studies have investigated the anti-inflammatory effect of spices in the context of daily meal consumption, which is the typical way people eat spices. The spice blend used in the study was a combination of basil, bay leaf, black pepper, cinnamon, coriander, cumin, ginger, oregano, parsley, red pepper, rosemary, thyme and turmeric. These spices were selected because they are the most widely consumed spices in the US at realistic doses, therefore, representing the average American diet blend of spices. Connie Rogers, associate professor of nutritional sciences and study co-author, says that six grams is roughly one teaspoon to one tablespoon depending on how the spices are dehydrated. Adding spices may be a more attainable behaviour change than the gold standard of health behaviours i.e., eating in a more healthful way, losing weight and exercising, which are difficult and time consuming to achieve and maintain. The researchers still recommend following a healthful diet and engaging in regular physical activity, but adding a blend of spices can help people with heavier meals.

Each participant rotated through three versions of a high fat/high carbohydrate meal on three separate days - one day with no spices, one day with 2 grams of blended spices and one day with 6 grams of blended spices. Inflammatory markers were measured with blood tests before and after meals. The findings:

Inflammation was reduced (lower inflammation markers) for the meal with six grams of blended spices when compared to two and no grams of blended spices.
The researchers could not identify which particular spice or spices had an effect or the mechanism behind the effect. They suspect that the addition of the spices had an anti-inflammatory effect on the high-carb and high-fat meal. Connie Rogers states, “We can’t say from this study if it was one spice in particular, but this specific blend seemed to be beneficial.”
A second study with the same group found that 6 grams of blended spices resulted in a smaller reduction of “flow mediated dilation” of the blood vessels (measure of blood vessel flexibility and a marker of blood vessel health).

In the Penn State University press release, Connie Rogers states, “If spices are palatable to you, they might be a way to make a high-fat or high-carb meal more healthful. We can’t say from this study if it was one spice in particular, but this specific blend seemed to be beneficial.”

Sources: Penn State News press release, Consumer Affairs website

Canadian Men’s Health Week June 15 to 21

While Canada is one of the world’s healthiest countries, the Canadian Men’s Health Foundation points to research showing that Canadian men have poor eating habits, inactivity, high levels of stress and social isolation. The top causes of chronic disease in Canadian men are unhealthy behaviours - smoking, weight gain, alcohol in excess and limited exercise. Having chronic conditions can reduce quality of life and can lead to premature death. Dr. John Oliffe, a UBC professor and researcher in men’s health, states, “Men are more likely to die from clogged arteries and heart disease and live an average of nine years of their lives in extremely poor health.” The negative impact of the state of men’s health is summed up by the founding president of the Canadian Men’s Health Foundation Wayne Hartrick, “Because many men avoid healthy basics, like nutrition and activity and seeing the doctor regularly, men’s poor health is costing Canada about $37 billion in lost productivity and health care costs.”

To address the state of men’s health, the Canadian Men’s Health Foundation developed the “Don’t Change Much” website promoting “small changes, big impact.” The site is a health resource inspiring men and their families to lead healthier lives. The effectiveness of the website was confirmed in a recent study published in the Journal of Medical Internet Research and conducted by the University of British Columbia and Intensions Consulting. The hypothesis tested was that increased exposure to the Don’t Change Much website would be positively associated with men’s recent and intended health behaviour changes. The behaviours of men who accessed the site were compared to a benchmark sample of men who had not accessed the site. The study confirmed the hypothesis i.e., men with high-exposure to the website had significantly increased odds for 9 of the 10 health behaviour changes. The findings for regular users of the website:

75 percent changed their diet or improved their eating habits
70 percent increased their exercise, sports or physical activity
58 percent made an effort to sit less and walk more
46 percent lost weight
45 percent drank less alcohol

The online format used by the Don’t Change Much website is an effective approach because, as Hartrick explains, men like accessing online information, humour, anonymity and being able to control what information they get. An online approach has greater reach than traditional health settings. Share this website with the men in your life.

Mental health and men
The Canadian Institutes of Health Research (CIHR) – Institute of Gender and Health is highlighting men’s mental health and COVID-19 during Canadian Men’s Health Week. The organization notes that the current pandemic has placed “unprecedented stress on individual and families.” The challenge for men and boys is that they are more likely to struggle in silence when it comes to mental health, with men representing only 30 percent of mental health service users. A 2018 special issue of the Canadian Journal of Psychiatry shared some disturbing statistics on the state of Canadian men’s mental health:

Over 50 Canadian men die each week by suicide and represent over 75 percent of total suicides
In Canada, the male suicide rate is 3-times that of women
Over one million men have addiction issues
Men are 2 to 3-times more likely than women to have a serious alcohol use problem
Men account for over 80 percent of fentanyl and opioid overdose deaths

If you are struggling with mental health issues, reach out to someone, such as a loved one, friend or health professional. Many resources are available for support:

HeadsUpGuys website supports men in their fight against depression by providing tips, tools, information about professional services, and stories of success. HeadsUpGuys is a program of The University of British Columbia, operating under the leadership of Dr. John Ogrodniczuk, who is a Professor of Psychiatry and Director of the Psychotherapy Program at The University of British Columbia
The Mental Health Commission of Canada website has a resource hub for mental health and wellness during COVID-19
The Government of Canada website has tips for taking care of personal mental and physical health during COVID-19
The “Protecting Our Home Fires” strategy from Morning Star Lodge website provides wellness information, fact sheets and videos for Indigenous communities and the scientific community in response to COVID-19
Canadian Mental Health Association (CMHA) website has a self-help section with FAQs on mental health. The CMHA also offers the Bounce Back program, a free skill-building program designed to help adults and youth 15 and over manage low mood, mild to moderate depression, anxiety, stress or worry. Delivered online or over the phone with a coach, you will get access to tools that will support you on your path to mental wellness

Sources: Canadian Men's Health Foundation press release, Canadian Men's Health Foundation website, Huffington Post website

Fraud During COVID-19

Fraud, a global phenomenon, is on the rise, with fraudsters becoming more sophisticated. Fraud is the number one crime against older Canadians. The Anti-Fraud Centre reports that, as of April 30, 2020, there were 18,803 reports of fraud, 6,671 Canadian victims of fraud, and $22.6 million lost to fraud. Unfortunately, scammers are using COVID-19 as a front for scams. Between March 6 and May 25 of this year, there were 1,005 Canadian reports of fraud, 269 victims, and $1.8 million lost. The Canadian Emergency Response Benefit (CERB) from the Federal government has been a source for many scams.

What is fraud?
Fraud is a serious crime that implies deception. A fraudster is someone who is guilty of fraudulent activity. Identity theft is a type of fraud where a person uses someone else’s identity to steal or gain other benefits e.g., steal personal information through a variety of means and use that information to open a credit card, take out a mortgage or start a new bank account in your name. Fraud officially starts when they steal your money or funds from an institution. Credit card fraud occurs when someone steals your credit card information and uses it to make unauthorized purchases, but your identity is not assumed. Credit card fraud is usually just with one credit card, but can escalate to identity theft if the perpetrator gets access to your banking information. Scams fall under the category of fraud. A scam is a term used to describe any fraudulent business of scheme that takes money or other goods from an unsuspecting person. It usually starts with unsolicited contact in person or by phone, mail, email, website, or on social media with a request for money or personal information. Unfortunately, people who carry out scams or “scammers” impersonate legitimate companies or government organizations and will sell you products or services that do not exist or that you don’t need. While telephone calls are the most common method used by scammers, people fall victim more often to frauds initiated through emails and text messages. The following are examples of the types of scams taking place during the COVID-19 pandemic:

Posing as the government to get people to disclose personal information to claim the CERB. Be aware that any direct communication received by an individual for applying for the CERB is a scam. The Canada Revenue Agency does not contact Canadians for CERB; rather, it is up to individuals to apply themselves.
Posing as a third party or private company offering assistance to fill out a CERB claim.
Asking people to fill out an excel form because they have been exposed to someone testing positive for COVID-19 with the purpose of infecting their computer with malware
Asking people to visit fake websites, open email attachments, click on message links from a health organization or the Federal government (Public Health Agency of Canada, Canada Revenue Agency and the Canada Border Services Agency)
Posing as a charity asking for donations for products, groups or research for COVID-19
Selling products for COVID-19 that are expired or dangerous.
Asking for advance fees - people are asked for payment in advance of receiving a loan, goods, services, or a prize. It is illegal for a company to ask you to pay a fee upfront before they'll give you a loan. A red flag is if a company asks for payment in the form of Bitcoin (a type of digital or cryptocurrency in which encryption techniques are used to regulate the generation of units of currency and verify the transfer of funds, operating independently of a central bank. It is a type of money that is completely virtual, like an online version of cash), wire transfers or the gift cards such as Google Play or iTunes vouchers.
Offering home tests to detect COVID-19 or cleaning services to decontaminate the home. These door-to-door fraudsters use this opportunity to "case" a house for a future break-in.
Offering miracle cures, herbal remedies, COVID-19 vaccines, and testing kits or high-demand products like hand sanitizers and cleaning products. Remember that information about safe and effective medical advancements will come from health professionals, not salespeople.
Offering free merchandise e.g., free masks, free COVID-19 test kits, positions for people to work from home, free subscriptions to Netflix, or surveys, but also asking for credit card and personal information. For example, a recent scam has been texts or emails offering masks from the Canadian Red Cross. Delete these messages as the Canadian Red Cross has confirmed it has not sent out any texts or emails for masks.
Offering jobs to take advantage of vulnerable people who are unemployed by COVID-19. They will deposit funds (counterfeit) into a person’s bank account and then ask the person to forward funds.

How to protect yourself
As the Government of BC website notes, once you have lost money in a scam, it may be impossible to get it back, even after reporting it. Therefore, the best way to protect yourself from becoming a victim is to educate yourself. The Chartered Professional Accountants Canada organization indicates that there is no “foolproof” way to protect against fraud, but there are steps you can take to minimize the risk of something nefarious happening. The Canadian Anti-Fraud Centre reminds us of the saying, “If it seems too good to be true, it is.” The Scam Spotter website outlines three golden rules to follow:

Slow down - scammers often create a sense of urgency or pressure you so that they can bypass your better instincts. Take your time and ask questions to avoid being rushed into a bad situation.
Spot check - be a detective and research the details you are getting. If you receive an unexpected phone call, hang up. Do your own research to find an official number or website and call the bank, agency or organization directly.
Stop, don’t send - reputable people or agencies/organizations never demand payment on the spot. A red flag is when scammers instruct you to buy gift cards or Bitcoin. Trust your gut - if a payment feels “fishy,” it probably is.

Computer safety

Protect your computer by using regularly updated anti-virus and anti-spyware software, and a good firewall. Only purchase software from a source you know and trust. Don’t just google to find software. Speak with a trusted source to get the best protection for your computer.
Use different passwords for different online accounts and consider two factor authentication i.e., you must answer two questions to log in. Additionally, change your passwords regularly. Unfortunately, according to the Interac Corp survey, 52 percent of Canadians do not change their online banking or email password regularly.
Do not open unfamiliar emails or emails from unknown senders. Never respond/click on suspicious links or attachments. Usually, a scammer’s email doesn’t look like a “typical” email address. Look at the email address domain – most scammers will use free domains such as @outlook, @hotmail, @gmail etc. The email address of the sender often does not match the website of the organization it says it is from. The content of the email may also have spelling mistakes and formatting errors. On the other hand, some sophisticated scammers can imitate logos and communication styles of legitimate companies. Be aware that just because the opportunity looks legitimate, doesn’t mean it is.
Watch out for urgent-looking messages that pop up while you're browsing online. Don't click on them or call the number they provide. A trusted organization will never rush you to respond immediately.
Beware if a company contacts you to say that your computer is infected with a virus and requests access to your computer, even if they say they represent a well-known company or product. You should hang up. Never give anyone remote access to your computer. If you have computer problems, take your computer to a qualified and reputable computer technician (see the Better Business Bureau website for reputable companies).
Avoid using public Wi-Fi, as it is easily hacked.
If you buy a used phone or computer, make sure it has not been hacked (signs of hacking include resetting, crashing)
When shopping online, make sure the business is legitimate. Make purchases from sites you know and trust.

Phone call safety

Don’t answer calls from unknown numbers. Remember that if you didn’t initiate the call, you don't know who you're talking to. Never give out personal or financial information over the phone. If someone says they are from your financial institution, do not take the call. Hang up and phone your financial institution. Beware of unsolicited callers asking for the following information: name, address, birthdate, Social Insurance Number (SIN), credit card information, and banking information. Be aware that government agencies simply don’t call out of the blue to ask you to provide your full SIN. As well, be wary of receiving a call from a business or government department telling you that something will happen unless you make an immediate payment. Hang up, and look up their customer service number. Always verify that the organization you're dealing with is legitimate before you take any action. To avoid unwanted calls, Canadians can register their phone numbers with Canada's National Do Not Call List (DNCL) website.
Do not feel pressured to make a donation over the phone or in person. Check that the appeal is coming from a registered charity. To determine if a charity is legitimate, ask for their registered charitable tax number and confirm it by calling the Charities Directorate at 1-800-267-2384 or visiting the website.
If you've received a call or other contact from a family member in trouble, talk to other family members to confirm the situation. Scammers have the technology to make a call appear to come from a legitimate source.

Other safety tips

Protect your personal information by shredding documents.
Monitor your credit statements for odd charges.

What to do if you are a victim of fraud
If you think you have fallen victim to a scam, you have given remote access to your computer to a suspected scammer, or that your computer has been hacked:

Stay calm and make a list of the compromised information.
If you have given remote access to your computer, shut it down, phone your bank and do not use your computer until it has been cleaned by a technician.
If you have given money or personal information to a scammer, stop all contact with them immediately and contact your bank or institution.
Contact your local police to file a report.
File a report online through the Canadian Anti Fraud Centre Fraud Reporting System website.
In addition to your financial institution and credit card companies, contact your telecom provider and Canada Post (as a person can apply for a credit card using your identity and re-direct your mail).
For unwanted telemarketing calls, file a complaint by visiting the National Do Not Call List (DNCL) website.

Resources

Canadian Anti-Fraud Centre website
RCMP video on fraud
Scam Spotter website (US website)
Canadian Bankers Association (CBA) website has information on COVID-19 and offers a free fraud prevention seminar for seniors

Sources: CBC website, Canadian Anti-Fraud Centre website, Chartered Professional Accountants Canada website, Canadian Radio-television Telecommunications Commission website, Canadian Bankers Association website, New Zealand Government Consumer Protection website, McMaster University Optimal Aging Portal website, inbrampton website, BBC website. RBC Royal Bank website

Impact of Too Much Coffee

After water, coffee is the most consumed beverage in the world, with an estimated 3 billion cups consumed each day. The health pros and cons of coffee consumption remain a topic of debate. In the last 40 years, 8,000 medical studies have investigated coffee consumption and its impact on health. Most studies to date have been observational i.e., showing an association and not a cause and effect relationship.

A study out of Australia is the first to look at the effects of excess coffee consumption and its impact on chronic conditions. Researchers at the Australian Centre for Precision Health used data from 333,214 individuals who are part of the UK Biobank (a resource following the health and well-being of 500,000 volunteer participants in the UK and providing health information over time). The upper limit of safe consumption was established in previous studies by this research team as being no more than 6 cups a day. Because of the immense popularity of coffee globally, the researchers say that understanding any risks associated with regular coffee intake could have significant implications for population health. A Mendelian randomization (MR) study approach was used to investigate the effects of coffee for disease outcomes - specifically 1,117 clinical conditions. MR is used to describe methods for obtaining unbiased estimates of causal associations in observational studies and in this study, exploring evidence for a causal association between habitual coffee consumption and multiple disease outcomes. The study authors note that MR provides a time and cost-effective method to conduct causality testing, with the potential to clarify previously misconceived associations. The results include:

The analysis provided little evidence for notable harm or benefit with respect to higher habitual coffee consumption. The only evidence for harm was seen with osteoarthrosis (degenerative joint disease), other arthropathies (diseases or abnormal conditions that affect the joints), and obesity. These results should be considered for people with a family history of arthritis or osteoarthritis.
The results suggest lower odds of postmenopausal bleeding from habitual coffee consumption

The bottom line: the researchers conclude, “While the safe public health message relating to coffee consumption is to promote moderation, much of the evidence observed displays beneficial health effects, with limited risk of harm." Consuming coffee in moderation is the “best bet to enjoy your coffee and good health too.”

Sources: Science Daily website, The James Lind Library website

Not Communicating about Natural Health Products

A recent study out of McMaster University compared the use and disclosure of natural health products (NHPs) at two points in time (2003 and 2019). NHPs include vitamins, minerals, traditional medicines, and probiotics. The popularity of NHPs is demonstrated by their use by an estimated 80 percent of people around the globe. Despite their popularity, Ardon R. Barry points out that the scientific evidence to support the efficacy and safety of most of these NHPs is lacking.

The importance of disclosure
Unfortunately, an often reported belief is that because NHPs are “natural,” they are also safe. In a 2018 survey of 326 adult Canadians (the general public), 85 percent reported taking one or more NHPs, 47 percent agreed/strongly agreed that NHPs are safer than prescription medications, and 24 percent disagreed/strongly disagreed that prescription medications are more effective than NHPs. The survey also found that patients’ comfort with taking NHPs on their own seems to be based on the view that NHPs have general efficacy (the performance of an intervention under ideal and controlled circumstances) and quality. Those surveyed had little concern about harm and looked to lay sources for information about the NHPs e.g., the Internet, television programs, celebrity endorsements or friends/family, without consulting a regulated health care professional. The internet was the most common source of information about NHPs. As well, the survey found that individuals made their own decision to take NHPs since less than one-third indicated taking an NHP on the recommendation of a health care professional (including naturopathic doctors).

When it comes to safety, NHPs used in excess or used with some other medications can cause toxic effects and, in rare cases, death. One study found that individuals who take NHPs and prescription medications together, compared to those who take only prescription medications, were over 6 times more likely to have an adverse event. For example, St. John’s Wort, when used with digoxin (a medication used to treat heart failure), increases the risk of stroke or heart attack. Additionally, people may substitute an NHP claiming to have the same effect as a prescribed medication. It is important, therefore, for an individual to share a list with their family doctor and pharmacist of all the products they are taking, including over-the-counter and NHPs.

Even though 80 percent of people are using NHPs, it is estimated that between 20 and 90 percent of users are not disclosing their use. What accounts for this high rate of non-disclosure? Possible reasons include the fear of being judged by one’s family doctor or believing that disclosure is not necessary.

In this 2019 survey, researchers at McMaster returned to the same naturopathic clinic used in 2003. In the first survey, 42 percent of the 198 persons interviewed reported that they did not disclose their use of NHPs to their primary care doctor. The number one reason a person would disclose use was because their family doctor asked them. The 2019 survey respondents had an average age of 40.5 years and were 77 percent female. Survey highlights included:

As in 2003, 42 percent of those surveyed did not disclose use of NHPs to their primary care doctor, while 78 percent of those surveyed reported discussing prescription drug use with their ND (naturopathic doctor). Study senior author Jason Busse, associate professor of anesthesia and of health research methods, evidence and impact at McMaster University, shared that the researchers were surprised to find there had been no change in disclosure since 2003.
Only 27 percent of those surveyed were concerned about potential interactions between NHPs and prescription medications.
Reasons for not disclosing included: their family doctor would not approve (21 percent); their family doctor would not understand (21 percent); they were uncomfortable talking about NHP use (21 percent); and they thought that it was not relevant to bring up NHP use with their family doctor (5 percent)
The only factor associated with disclosure of NHP use to family doctors was whether the family doctor asked about use, and 75 percent reported that their family doctor had not asked.
Almost half of those surveyed combined NHPs with prescription medications, but only 25 percent were concerned about interactions.
The most commonly taken NHPs included vitamins, garlic, Echinacea, chamomile and licorice.
Compared to 2003, more people reported taking Omega-3 fatty acids (50 percent versus 19 percent), probiotics (44.2 percent versus 2.5 percent), and iron supplements (24.3 percent versus 1.2 percent).
The 2019 rate of taking kava kava was similar to the 2003 rate (2.8 percent versus 3.1 percent) and St. John’s Wort (5.8 percent versus 5 percent). Health Canada has in the past issued advisories on the potential of interactions for both of these NHPs.
The 2019 survey asked a new question about medical cannabis use, with 9 percent of those surveyed reporting that they used medical cannabis.

Previous research in this area found disclosure rates ranging from 15 to 74 percent. It is important for patients to disclose this information to their family doctors when making decisions to start or continue taking NHPs. Future research needs to investigate the reasons why health care professionals are hesitant and failing to ask about NHPs despite their high rate of use, and what strategies would encourage health care professionals to ask their patients and facilitate decision-making.

Sources: Canadian Pharmacists Journal website, McMaster University Brighter World website

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