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Losing weight is, for most people, the easy part. The bigger challenge is trying to keep it off for more than a year.

New research helps explain why people in this second stage are so much more prone to failure.

In a nutshell, people who have shed a significant chunk of their weight are hungrier and have a stronger desire to eat for at least a year after transitioning from weight loss to weight-loss maintenance. And even when their hormones send loud satiety signals to the brain after a meal, they still do not feel full.

The new study, published in the American Journal of Physiology-Endocrinology and Metabolism, falls in line with a growing field of research that explores the body’s tenacious and multi-pronged response to weight loss.

In a bid to ensure that lost weight is regained, the human body has been found to reset its thermostat to burn fuel more efficiently, to economise in calorie-burning movements and to rev up the impulse to find and eat food.

Researchers believe these responses evolved to protect humans against wasting away during times of famine. But in societies where calorific foods are never in short supply, these adaptations have worked to the detriment of dieters.

Moreover, in people who have become obese, there is growing suspicion that these responses become harder to override. In recent years, researchers have found evidence that obesity makes the brain more “deaf” to some of the gut’s satiety signals, and more keenly attuned to signals of hunger.

The new research offers some validation for that surmise.

To study the effects of weight loss in 35 severely obese subjects, Norwegian researchers helped them lose close to a tenth of their weight. They provided dietary advice, exercise coaching and psychotherapy during several three-week stays at a wooded retreat in eastern Norway. All the subjects had a body-mass index greater than 42 (a BMI over 30 is considered obese) at the outset of the study.

At one year, when subjects had lost an average of close to 11 kilogrammes, they returned to the retreat to map out maintenance plans.

Every six months from enrolment to two years out, researchers checked in to conduct a series of tests. Before and for three hours after meals, they gauged subjects’ subjective feelings of hunger, fullness and desire to eat, and asked how much food they planned to consume. And they measured circulating levels of five separate hormones that regulate appetite to see how they responded to the prospect of a meal or a meal just eaten.

What they found was the body’s reaction to weight loss shifted over time.

In the short run — four weeks after their exercise-and-weight-loss regimens got underway — the subjects had lost an average of 3.5 per cent of their body weight. Their levels of appetite-boosting hormones had risen rapidly — probably a response to their getting roughly three-hour-and-a-half hours of exercise per day while at the retreat.

But they did not report increased hunger or desire to eat. And with rising levels of satiety hormones, they were feeling more full in the wake of eating a meal.

As they met their weight-loss goals, however, things changed.

At the end of a year of dieting and exercise, the study’s participants had lost about 7.4 per cent of their weight and had improved their fitness considerably. But they reported to researchers a significant increase in their hunger and desire to eat. And the sensations of fullness they reported after meals had plummeted.

Two years after enrolling in the study — and a year into their weight-maintenance programmes — the subjects had, on average, kept the weight from coming back. But they continued to report levels of hunger and desire to eat that were just as high or higher than at the end of Year One. And they reported feeling no more full after a meal.

At both time points, their hormone levels continued to show increases in appetite-stimulating compounds, as well as those that would signal fullness. Though they lost the weight and — with the study’s unusual level of support — managed to keep it off, they were hearing the loud cries of their hunger-boosting hormones. The fullness ones, not so much.

The good news, according the researchers: A sustained and supportive programme of dietary restriction and physical activity does induce weight loss and can help very obese patients keep the weight off.

The bad news: “Patients with severe obesity who have lost significant amounts of weight… will have to deal with increased hunger in the long-term.”

If these patients are to beat the odds and sustain their weight loss, professionals working with them will have to find ways to help them cope with that, they added.

Frankenstein in Baghdad

Ahmed Saadawi

Translated by Jonathan Wright

New York: Penguin Books, 2018

Pp. 281

From Mary Shelley’s 1818 classic novel, “Frankenstein”, Iraqi writer Ahmed Saadawi plucks a metaphor for the situation of his war-torn country. The Frankenstein in Saadawi’s novel is not a scientist but a junk dealer, and the metaphor describes the physical, political and social fragmentation of Iraq, engineered by the 2003 invasion and post-war US policy, as well as the ensuing sectarian violence.

The story opens two years after the invasion, in Baghdad, “a troubled city where the demons had broken out of their dungeons and come to the surface all at once”. (p. 64)

The truly unsettling thing is that no one knows exactly who these demons are, or who is behind the daily car bombs and other forms of explosions and violence — some targeted and some seemingly random. Saadawi does a masterful job of creating the atmosphere of fear and terror that prevails and showing how it impacts on the human psyche: What does it mean for human behaviour if one does not know whom to trust or what will happen next? 

The heart of the story unfolds in a neighbourhood which may once have been respectable, but is now crumbling from old age and war, peopled by some unscrupulous characters who take advantage of the chaos to enrich themselves, while most are just trying to survive. One of the latter is Hadi, the junk dealer, who loves to tell stories whenever he can get an audience. He seems like a rather ordinary guy until, after a particularly destructive car bomb, he begins to assemble a corpse. He is initially motivated by outrage: “I wanted to hand him over to the forensics department because it was a complete corpse that had been left in the streets like trash. It’s a human being… I made it complete so it wouldn’t be treated like trash, so it would be respected like other dead people and given a proper burial.” (p. 27)

But what begins as an attempt to redress the devaluation of human life induced by so much violence, soon becomes more complicated as the reconstructed corpse takes on a life of its own, something like Dr Frankenstein’s monster in Shelley’s book. Consisting of dead body parts, it must be constantly replenished as some parts decompose totally and fall off. Soon, terrible new crimes are being committed. What is their motive? Who is responsible? Is it Hadi’s creation, or criminals or terrorists? And who can tell the difference? 

The creature sees his mission as avenging the death of the victims of whose body parts he is composed, so that they may rest in peace. Here one sees how the Frankenstein metaphor aptly expresses the self-perpetuating cycle of killing and raises existential questions about the violence that is tearing society apart: The creature “knew his mission was essentially to kill, to kill new people every day, but he no longer had a clear idea who should be killed or why. The flesh of the innocents of which he was initially composed, had been replaced by new flesh, that of his own victims and criminals”. (p. 200)

Eventually, he begins taking revenge on those who insult him, widening the circle of violence. He attracts a following which resembles a cult or gang or militia that perpetuates and glorifies violence. Different followers have different perceptions of the creature. One thinks he is a saviour; another, the Angel of Death; yet another, the model citizen the Iraqi state has so far failed to produce — “made up of body parts of people from diverse backgrounds —ethnicities, tribes, races, and social classes”. (pp. 146-7)

But in the end, he admits he kills simply to keep going. Killing has become a way of life just as in many protracted conflicts where few other jobs are available to the poor.

Steeped in irony, black humour and surreal interludes, Saadawi has created a powerful anti-war novel showing the cruelty, tragedy, destructiveness and ultimate absurdity of war. There are many other characters, themes and subplots; the Frankenstein metaphor is only the most shocking and pervasive. The other most prominent theme is exposing the dangerous consequences of sectarianism. All the elements of literature are carefully crafted into a chilling whole; the very structure of the novel is disorienting, reflecting the security situation. 

Saadawi was born in Baghdad and still lives there. Besides his obvious writing skills, this may explain why his story rings so true, even when it tips over into the surreal and fantastic. In 2014, he was awarded the International Prize for Arabic Fiction for this book, which paved the way for its translation into English. A novel about the Iraq war from an Iraqi perspective is a much-needed antidote to all the lies that have accompanied this war. While the creature may be an urban legend, Saadawi’s story is in essence all too real.

Relationships and Couples Therapist

If you feel apprehensive about couples therapy, rest assured you are not alone. Many couples reserve going to therapy as a last resort. Even when they finally reach out to a therapist to save their marriage, they are often looking for quick fixes with the least effort and time involvement.

Repairing a troubled relationship needs a lot of effort and commitment from both of you. I always compare it to going to the gym: your personal trainer can only guide and help you reach your goals through her knowledge and expertise. But to get that healthy toned body, your full commitment, effort and dedication are of absolute necessity. Likewise, couples therapy, if approached correctly, has not only the potential to strengthen your bond and your relationship, but can also lead to each partner’s individual growth and personal development as well.

False expectations that can block success 

‘The therapist will decide which of us is right and which of us is wrong’

A therapist is not a judge to tell you who is right and who is wrong. The therapist is a “process consultant” who will help you both identify the habits and patterns that keep each of you stuck and lonely in the relationship and will help you eliminate them.

‘The therapist will 

fix my partner’

It is no secret that most couples come into therapy secretly hoping that the therapist will fix their partner and this will solve their problems in the relationship. The truth is that both of you co-created the problems together and both of you will need to change to improve your relationship. So, instead of merely focusing on the changes your partner needs to make, you need to focus on yourself and the changes you need to make to improve your relationship.

Obstacles to therapy

Waiting too long before starting therapy

The average couple waits seven years before reaching out for help. Some even 15 years and that is really a long time living together in distress. Addressing issues earlier will prevent them from becoming deeper and more stubborn to treat. Do not expect your therapist to be able to quickly and swiftly undo what took years to create; work with the therapist and accept that it will take a while to get back on track. 

Keeping secrets

Often couples enter therapy where one or both partners are keeping secrets, such as having an ongoing affair, or dealing with an addiction. This will sabotage therapy and prevent real change. You can start by telling your therapist about those secrets and she or he can help you decide how to proceed, but definitely do not keep secrets from your therapist.

Not following through

Some couples are very enthusiastic about beginning therapy. They work hard with their therapist to identify areas they get stuck in and agree with the therapist on what needs to be done to get unstuck. But then they fall short on following through and applying those newly learned insights and techniques in their day-to-day interactions. Truth is, spending 90 minutes weekly with your therapist is not enough to bring about real change. You need to apply what you learned in the therapy session to your daily interactions with your partner to see sustainable improvement. 

‘Ghosting’ therapist

Often people start therapy with the best of intentions but discover that they are not ready or able to continue. No matter what your reasons, it is better to share them with your therapist instead of abruptly ending therapy, withdrawing from all communication. For one, the therapist might be able to help you by referring you to a different therapist if you feel there is a personality clash. This conveys respect and keeps the door open for you to easily resume therapy with your therapist in the future. 

Reprinted with permission from Family Flavours magazine

LONDON — Set in a dystopian post-Brexit Britain, a new video game follows the struggles of a bouncer of foreign ancestry in a world of xenophobia and immigrant camps, but gamers are divided over its message.

The grim vision of the future played out in “Not Tonight”, which has a funereal version of “God Save the Queen” as its theme tune, reflects the fears of its creator, Tim Constant, who developed the game over 18 months as part of a three-man team.

Gamers play the role of a nightclub doorman who has recently lost his British nationality and is forced to do odd jobs to meet the demands of an authoritarian government, whose motto is “work hard, stay out of trouble, and we might let you stay in the UK”.

The bouncer, now working in the gig economy, checks the identity of characters via a few mouse clicks and decides whether to allow them into the bar, and later on in the game, whether to let them into the country. 

The minimalist and colourful graphics recall the adventure games of the 1990s, while the story-theme evokes “Papers, Please”, the surprise 2013 independent success.

“If you look at politics and video games as a whole, they’re generally not approached because it can put people off,” explained Constant.

But for Olivier Mauco, founder of gaming website Game in Society and professor at Science Po university in Paris, bringing politics into the gaming world can be useful.

“It’s a chance for you to live in a dystopian Britain, which is very different, so it has an effect because you will understand the consequences and the impacts — you will make choices, and you will try to reason with them.” 

‘Overtly political’

The game was among the top 10 bestsellers on the Steam download platform when it was released last weekend, and received mostly good reviews, scoring a “very positive” average from users of the site.

But some users criticised the political message.

“Terrible. Propaganda. Refunded,” wrote user iPlay_Zombies.

“It’s all rather distracting with how in your face it all is while at the same time not really saying anything other than.....what? British people are evil and xenophobic?” added gamer Dr Marker.

“Being so overtly political means it may not be as hard-hitting as it could be, it’s not going to be as punchy,” said Mauco.

“It’s going to strengthen the pro and anti-Brexit positions, and risks dividing the audience”.

It’s a risk that Constant was prepared to take.

“I probably knew that there was going to be push back because of the Brexit argument,” he told AFP.

“The Brexit vote has happened, so I don’t think, even if I do change people’s mind, it’s gonna change anything. But it might make them think a little bit more about the situation, which is great.”

For the small team behind the game, Brexit has already had real consequences.

“The [graphics] artist on “Not Tonight” is Polish, he’s just moved back to Poland because he wasn’t sure what is going to happen.”

The game is currently available in English on PC via download platforms and will be released on consoles in early 2019.

Older adults who take care of their heart may be less likely to develop dementia than people who do not focus on heart health, a French study suggests. 

Researchers focused on seven recommendations from the American Heart Association for optimal cardiovascular health: not smoking; regularly exercising; routinely eating fish, fruits and vegetables; avoiding excess weight; and keeping blood pressure, blood sugar and cholesterol levels within a healthy range. 

For an average of 8.5 years, they followed 6,626 people age 65 or older who did not have dementia at the start. During the study, 745 people, or about 11 per cent, developed dementia. 

With each additional heart-healthy recommendation they met, people were 10 per cent less likely to develop dementia, researchers found. 

“Importantly, while achieving the seven cardiovascular health factors at optimal levels is certainly the ideal target, this study shows that any additional factor at optimal level decreases the risk of dementia,” said study leader Cecilia Samieri of the University of Bordeaux and the INSERM population health research centre in Bordeaux. 

Following more recommendations was also associated with higher scores on cognitive tests, indicating a healthier brain, researchers report in JAMA. 

Both the heart and brain need adequate blood flow. But blood vessels can narrow and harden over time, increasing the risk of heart attacks, strokes and cognitive decline. 

This type of blood vessel damage, known as atherosclerosis, can be minimised by a healthy lifestyle and by keeping blood pressure, blood sugar and cholesterol levels in safe ranges. 

High blood pressure, cholesterol and blood sugar can damage blood vessels, triggering complications that reduce blood flow to the brain. 

Even when people did not hit optimal targets for cardiovascular health, they could still benefit from the attempt, Samieri said by e-mail. 

“From a pragmatic and public health perspective, promoting change in cardiovascular health from poor to intermediate levels may be more achievable and have a greater population-level effect than the more challenging change from poor to optimal levels,” Samieri said. 

The study cannot prove that lifestyle changes directly impact cardiovascular health or the risk of dementia and cognitive decline. Another limitation is that researchers only measured cardiovascular health at the start of the study. It is possible this changed over time in ways that influenced participants’ brain health. 

Still, a separate study in JAMA looking at the effect of the same seven factors on cardiovascular health found that younger adults who achieved optimal heart health had fewer changes in their brains with the potential to lead to cognitive problems down the line.

The study focused on young people “because we thought that these changes in the blood vessels may occur... before significant damage had occurred to the brain”, said senior author Paul Leeson of the University of Oxford in the UK.

“We were able to show that there are differences in the blood vessels related to levels of different risk factors and that these differences are evident in young adulthood.”

This study included 125 participants, age 25 on average. For each additional recommendation for optimal heart health they followed, subjects had a greater density of blood vessels in the brain and healthier blood vessels.

Among 52 participants who had blood flow in the brain measured, the volume of blood pumping through the brain increased with each additional optimal heart health recommendation they achieved.

The most powerful of super SUVs, the Jeep Grand Cherokee Trackhawk creation was as inevitable as that Dodge’s legendary modern muscle car “Hellcat” engine would find its way into another Fiat Chrysler Group (FCA) product. A popular, versatile and capable model best placed to harness such power in a different segment, the Grand Cherokee was the most likely candidate. 

The resulting 707BHP Trackhawk is the Dodge Challenger and Charger Hellcat models de facto SUV sister and FCA’s sledgehammer riposte to established Range Rover, Porsche and Mercedes-AMG super SUVs and Bentley and Lamborghini newcomers.

Imposing and urgent

Introduced for 2018 along with minor model-wide revisions that includes improved technology and trim, the Trackhawk arrives a year after the more off-road biased Trailhawk version. Sitting at the top of the Grand Cherokee hierarchy, the Trackhawk is an even more on-road focused and high performance model than the existing 475BHP SRT version. Subtly but effectively more muscular and assertive in aesthetics, the mighty Trackhawk sits with a seemingly lower, broad and more road-hugging posture that emits a more dramatic and urgent sense of purpose than garden-variety Grand Cherokees.

Imposingly high, and with aggressively squinting and heavily browed headlights, the Grand Cherokee Trackhawk features a bigger and lower bumper section with sharp lower lips, and vast gaping mesh covered centre and side intakes. Its Jeep trademark seven port grille meanwhile sits above three slim horizontal intake vents and its bonnet features large dual extraction vents. Gone is the lower black cladding of more off-road oriented Grand Cherokees, the Trackhawk instead gets wider, more muscular body colour wheel-arches and lower more pronounced sills. Riding on vast 295/45ZR20 tyres, the Trackhawk’s rear meanwhile features quad big bore exhaust tips.

Immediate and intense

Developed during late FCA CEO Sergio Marchionne’s tenure, the “Hellcat” engine — and yet more powerful iterations of — not to mention the Trackhawk itself, are testament to the Italian-American auto group’s dedication to cater to motoring enthusiasts. A relatively compact and old school 16-valve OHV design, the Trackhawk’s supercharged big displacement 6.2-litre V8 developing a colossal 707BHP at 6,000rpm and a gut-wrenching 645lb/ft torque at 4,800rpm. The most powerful production SUV in the world, the Trackhawk’s headline figures are sensational, with the 0-97km/h benchmark dispatched in a supercar-like 3.5-seconds and a 320km/h top speed.

Among the greatest current production engines, headline figures, however, don’t articulate just how immediate, intense and violent the Trackhawk’s supercharged V8 is when prodded with intent. Bounding off the line with a chirp of the tyres and vicious immediacy, its given its mechanically-driven forced induction means there is no lag when launching from idling, as with an exhaust gas-driven turbocharger. Meanwhile, its tenaciously sticky four-wheel-drive ensures vice-like traction so that its full power can be fully and effectively deployed as forward motion and with no wheel spin or over-active traction control interventions.

Controlled and capable

Viciously swift through revs, the Trackhawk’s delivery is a continuous volcanic torrent of escalating fury set to a deep bass burbling, growling, howling and bellowing acoustic medley underlayed by a distinctly urgent yet distant wailing supercharger whine. Disdainfully effortless achieving high speeds and increasing velocity when on the move, the Trackhawk channels its vast reserves through an 8-speed automatic gearbox. Refined, smooth and succinctly crisp shifting, its gearbox features manual mode sequential shifting, but with its redline arriving so quickly and with so much torque on tap at any time, it is just best left in auto mode.

Driving with a distinctly tauter, more focused and settled manner than regular Grand Cherokees, the Trackhawks’ suspension and adaptive dampers feel tighter and firmer. With considerably more body control to contain its 2433kg weight through fast and tight corners, the Trackhawk similarly feels buttoned down and measured in vertical movement and on rebound, yet nonetheless remains smooth and comfortable riding during test drive on Austrian roads. Similarly, steering feels quicker, tighter, heavier and more direct, while immense 400mm disc six-piston calliper front and 350mm four-piston rear brakes prove effective dealing with the demands of such power and weight.

Adjustability and ability

Through more winding roads, it belies its size and weight in terms of control and precision, and pertinent for so powerful a vehicle, it effectively put power down to tarmac, with variable front-to-rear torque distribution and an electronic limited slip rear differential ensuring enhanced agility and that power is harnessed to go where it is supposed to for best handling, stability, performance, road-holding and safety. Equipped with five driving mode settings the, the Trackhawk’s Sport and Track modes re-distribute more power rearwards, stiffen dampers and make gear shift times quicker, while Snow and Tow modes alternatively adjust such parameters for more utilitarian usage.

Reassuringly planted and stable at speed, the Trackhawk comfortably devours long distances with a refined ride and cabin ambiance. Spacious inside for passengers and cargo as all grand Cherokees, the Trackhawk is extensively well equipped with convenience, safety, driver assistance and safety systems equipment, including an improved and larger Uconnect infotainment screen. User-friendly and with highly adjustable driving position, the Trackhawk’s cabin is distinctly sportier and features carbon-fibre and metallic trim, rich leather upholstery, Alcantary rooflining, chunky sports steering wheel with paddle shifters and heavily bolstered sports seats that are supportive and comfortable.

TECHNICAL SPECIFICATIONS

Engine: 6.2-litre, supercharged in-line V8-cylinders

Bore x Stroke: 103.9 x 90.9mm

Compression ratio: 9.5:1

Valve-train: 16-valve, OHV, variable valve timing

Gearbox: 8-speed automatic, four-wheel-drive, limited-slip rear differential

Gear ratios: 1st 4.71 2nd 3.14 3rd 2.11 4th 1.67 5th 1.29 6th 1.0 7th 0.84 8th 0.67

Reverse/final drive ratios: 3.3/3.7

Power, BHP (PS) [kW]: 707 (717) [527] @6,000rpm

Specific power: 114.7BHP/litre

Power-to-weight: 290.5BHP/tonne

Torque lb/ft (Nm): 645 (875) @4800rpm

Specific torque: 141.9Nm/litre

Torque-to-weight: 359.6Nm/tonne

Rev limit: 6,200rpm

0-97km/h: 3.5-seconds

0-100km/h: 3.7-seconds

0-400-metres: 11.6-seconds

Top speed: 320km/h

Fuel capacity: 93.1-litres

Wheelbase: 2,913mm

Track, F/R: 1,636/1,645mm

Kerb weight: 2,433kg

Weight distribution, F/R: 55/45 per cent

Payload: 612kg

Trailer towing: 3,266kg

Approach/break-over/departure angles: 18°/18.4°/23.1°

Aerodynamic drag co-efficiency: 0.37

Cargo volume, min/max: 1,027-/1,934-litres

Steering: Electric rack & pinion

Turning circle: 11.6-metres

Lock-to-lock: 3.2-turns

Suspension F/R: Unequal double wishbones/multi-link, adaptive dampers

Brakes, F/R: Ventilated perforated discs 400x36mm/350x28mm

Brake callipers, F/R: 6-/4-pistons

Tyres: 295/45ZR20

SAN DIEGO — Women whose mothers lived to 90 years have a 25 per cent greater chance to also live that long, compared with those whose mothers didn’t, according to a new study led by University of California, San Diego (UCSD) researchers.

Moreover, the women achieved this extreme longevity while staying healthy. They had no major chronic diseases, such as heart disease, diabetes, cancer, hip fracture or physical limitations.

When both parents survived to 90 years, the advantage jumped to 38 per cent, said the study, published in the journal Age and Ageing.

If only the father lived to be 90, there was no increase in healthy longevity for the daughter.

These results are probably a combination of genetics, environment and behaviour, said UCSD’s Aladdin Shadyab, who led the study. It examined the health records of a racially and ethnically diverse population of more than 20,000 women.

The study used information from the Women’s Health Initiative, a large, long-term study on major risk factors for chronic diseases. It enrolled more than 160,000 post-menopausal American women when it was launched in 1993.

Since only women are tracked in the initiative, the study did not examine men or parental life span effects on sons.

The initiative has yielded a wealth of information about women’s health, including the effects of hormone therapy, diet and supplementation with calcium and vitamin D.

Previous research jibes with the study’s findings, including health in the greatly long-lived, the study said.

“In the New England Centenarian Study, offspring of centenarians had 78 per cent, 83 per cent and 86 per cent lower risk of developing myocardial infarction, stroke and diabetes, respectively, than a similarly aged referent cohort,” the study said.

A lot of factors go into total life expectancy. This effect of long-lived parents adds an additional calculation.

For a baseline comparison, 34 per cent of all American women 65 years old will live to 90, according to the Social Security Administration. The increase in life expectancy is calculated compared to this base. (Just 22 per cent of men of that age will reach 90).

In addition, total life expectancy has grown over the decades. In 1965, just 25 per cent of 65-year-old American women lived to 90, and only 10 per cent of the men.

In addition to outside factors such as exercise and diet, researchers in recent years have found some genetic traits that appear more commonly in those who achieve very long lifespans.

“There are specific genes that predict your ability to live longer, which these women likely inherited from their parents,” Shadyab said. Researchers don’t know, however, why the mother’s longevity seems to play a more important role in a daughter’s lifespan than the father’s.

“Further, the women whose parents lived longer had higher socieconomic status, meaning that they were more educated with higher income,” he said. “And growing up in a high socioeconomic environment predicts your chances of living longer and aging well.”

Those in high-income households tend to have access to better health care and education on healthy habits, and presumably those influences play a role.

It’s possible that the parents who lived to 90 also practiced good health habits that they passed along to their daughters.

“More studies are needed to determine how genetic factors interact with behavioural factors like physical activity and socioeconomic status to influence our future aging outcomes,” Shadyab said.

Other studies have looked at health in aging. In San Diego, the ongoing “Wellderly” study tracks men and women who have reached their 80s and beyond, to look for genetic and lifestyle factors that may influence their longevity.

If women want to know how the results apply to them, their present age makes a difference.

Older people have a better chance of great longevity than younger people. That’s because some younger people will die prematurely, whether by illness or injury, and never reach old age. By definition, the elderly have already survived these dangers.

For young women, this means that environmental and behavioural patterns are much more important to attaining extreme longevity than for those who are already older.

Killers of the Flower Moon: The Osage Murders and the Birth of the FBI

David Grann

New York: Vintage Books, 2018

Pp. 377

It is common knowledge that the United States was founded on a genocidal campaign which decimated Native Americans and dispossessed them of their land, (similar to the ethnic cleansing enacted by Zionism to acquire Palestinians’ land). In “Killers of the Flower Moon”, journalist David Grann relates a particularly horrifying, but underreported, chapter in this historic injustice which occurred only a century ago. The victims were the Osage Indians living in Oklahoma, and the motive was greed.

 In the early 1920s, the Osage “were considered the wealthiest people per capita in the world” (p. 6), owing to the discovery of vast oil resources underneath the reservation to which they had been consigned after being driven from their original territory in Kansas in the early 1870s. Prospectors had to pay them for leases and royalties if they wished to drill for oil, and soon members of the tribe were receiving hefty checks.

At the same time, however, the Osage community was plagued by an unusually high death rate, some by shooting, others by strange, unnamed illnesses or unexplained accidents or fires. At the time, law enforcement was in its early stages: “And few places in the country were as chaotic as Osage County, where the unwritten codes of the West, the traditions that bound communities, had unravelled. By one account, the amount of oil money had surpassed the total value of all the Old West gold rushes combined, and this fortune had drawn every breed of miscreant from across the country”. (p. 35)

Added to this, Native American lives were not highly valued. Many of the deaths among the Osage were not investigated properly, even when the evidence pointed to foul play. “A growing number of white Americans expressed alarm over the Osage’s wealth — outrage that was stoked by the press.” (p. 83)

Racism played a part in the failure to find and bring the murderers to justice. 

The most shocking thing about the killings is that rather than being the work of outsiders, they turned out to be the result of an elaborate conspiracy among white men respected in the community and some of them married to Osage women. The motive was to inherit the victims’ headright which entitled him or her to a share of the oil revenues. The conspiracy was facilitated by Native Americans’ reduced legal status. Many of the Osage had been declared incompetent to manage their own financial affairs and were assigned a white guardian to oversee their spending. Many a guardian pursued what they called“ ‘Indian business’ — the swindling of millionaire Osage”. (p. 282)

Only after the death toll reached 24 members of the Osage tribe, plus two respected white men trying to investigate the murders, did the federal government mount an investigation. At the time, J. Edgar Hoover was trying to make a name for the Bureau of Investigation, soon to be the FBI, which he headed. He assigned Tom White, an honest and determined Texas lawman, to head the investigation.

The author, David Grann, is a staff writer at “The New Yorker” and bestselling author of several books. He recounts this tragic and shocking episode in US history from close-up, drawing detailed portraits of the main actors and showing how the killings affected their lives. He also paints a vivid picture of life at that time, replacing romantic notions planted by cowboy movies with the harsh reality of what happened to the Native Americans.

His narration of the investigation that finally resulted in the conviction of the major players in the conspiracy, is as suspenseful as any detective novel, but it is all real and well-researched. “Killers of the Flower Moon” is a fine example of investigative journalism. Grann does not suffice with chronicling the conviction of a small group of conspirators, responsible for some of the murders, but returns to the archives. “And as I dug deeper into the Osage murder cases — into the murk of autopsies and witness testimony and probate records — I began to see certain holes in the bureau’s investigation.” (p. 277)

He kept digging and found connections between yet more murders and their perpetrators.

Perhaps the most valuable aspect of Grann’s narrative of this shameful chapter of American history is that it shows how racism is “convenient”; in the past, it enabled the stealing of Native Americans’ land and oil rights. Today, it is being manipulated by certain politicians against immigrants.

The book also shows how oil wealth is a double-edged sword. In view of how oil has provoked war and invasions in this region, perhaps many would agree with the words of an Osage elder in 1928. “Some day this oil will go and there will be no more fat checks every few months from the Great White Father. There’ll be no fine motor cars and new clothes. Then I know my people will be happier.” (p. 28)

While terminology has evolved from learning “disability” to learning “difficulties”, learning difficulties specialist Rania Sayegh goes a step further in encouraging us to think about learning “differences”.

These difficulties focus on “weaknesses” in a child’s underlining skills and may isolate them from other learners. However, the term “learning differences” highlights the fact that they simply learn differently and have as much to offer and contribute as anyone else.

Early signs

At Ask Our Experts II* workshop, Sayegh stressed the importance of identifying learning differences (LD) early in order to pave the way for children to get the support they need for a successful future both in and out of school. Understanding developmental milestones helps with early diagnosis and intervention, she says. LD cannot be formally diagnosed before the age of seven years, but here are a few early signs (keep in mind that professional assessments are recommended and available in Jordan): 

• Communication challenges, such as slow language development, difficulty with speech, problems understanding what is being said or in communicating thoughts 

• Challenges in gross or fine motor coordination, (hopping, dressing, cutting, stringing beads)

• Problems with memory, routine, and multiple instructions

• Slow processing, such as taking a longer time to finish tasks given compared to peers

• Sensory processing issues (oversensitive to sights, sounds, textures, flavours, smells and other sensory input)

Sayegh brings up the lack of awareness in Jordan even among medical professionals and educators, and points to efforts to work with schools and paediatric clinics, such as providing them with checklists of what to look out for. She adds that it’s important to reach out to everyone involved in a child’s life, including grandparents and the helper at home. She also hopes to see more local apps and television programmes that centre on children’s’ emotional well-being.

LD signs in 

school-aged children

Difficulty learning letters, confusing similar letters like “b” and “d” or “m” and “w” or “n” and “u”, and difficulty blending letters to read

Misreading words, skipping words or lines and guessing words

Spelling difficulties

Having great ideas but unable to put them down on paper, difficulty in self-expression in writing (organisation, spelling and handwriting)

Wrong pencil grip, illegible handwriting, slow when copying and hands hurts when writing for a while

Difficulty learning new maths concepts, confusing signs, difficulty aligning numbers in mathematical equtions, difficulty with word problems

Difficulty understanding what the child reads

Learning styles

Each person has his own learning style, explains Sayegh. “The more we [parents and educators] can discover the child’s learning style [how they retain information for instance], the better off we’ll be in unlocking the keys to their learning skills.” 

Here are some learning styles, but let us remember that many children and adults use a combination of styles. 

• Visual: Learns through seeing and observing, needs visual cues. Preference for images Auditory: Learns through listening and talking things through. Preference for sound and music. Enjoys audio books and recordings 

• Tactile: Learns through touch and using their hands

• Kinaesthetic: Learns through moving and doing. Preference for movement of the body. May not be able to sit still for long periods of time. Enjoys moving while learning

As for homework, Sayegh says it should not exceed 45 minutes a day. More than an hour can put children at risk of higher stress levels and poor mental and physical health. Here are a few of the tips Sayegh shares with parents: 

• Establishing a study routine that includes a set time each day. Base this on your child’s temperament. Perhaps he is at his best after an hour of downtime Avoid late evening, which for most children is meltdown time!

• Posting a daily plan or weekly calendar on your child’s tablet or in a common living space that includes homework start and finish times each day. 

• Giving advance notice of homework time to make it easier to shift from fun time to work time. You can say, “You can play for 15 more minutes, then it’s homework time”

• Letting your child get up to move around can help maintain focus. Keep in mind your child’s learning style(s) as well as the fact that your child has probably had enough sitting at school

Sayegh’s takeaway message for parents: Children need to feel safe, loved and accepted more than anything else. Only then can they truly flourish.

Reprinted with permission from Family Flavours magazine

People who take pills to lower their blood pressure often take other drugs that reduce the pills’ effectiveness, a recent study suggests.

Researchers studied data on 521,028 adults prescribed blood pressure pills for the first time and 131,764 people taking at least four different pills to lower their blood pressure.

Roughly 18 per cent were also taking drugs that make blood pressure pills less effective, the study found. These include medicines like non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or hormones.

“In some cases, use of these blood pressure-interfering medications may be justified and the potential side effect of elevations in blood pressure may be acceptable to patients,” said study leader Andrew Hwang of the High Point University Fred Wilson School of Pharmacy in North Carolina.

“But in other cases . . . there may be significant opportunities to switch to alternative treatments or reassess the need for continuing the interfering treatment,” Hwang said by e-mail. “If these drugs can be discontinued, it’s possible we can reduce the prescribing cascade — that is, reduce the need for using additional medication to treat a side effect of another medication.”

Patients may not realise the risks, the findings suggest.

Among people recently prescribed blood pressure medications for the first time, 58 per cent later refilled prescriptions for drugs known to increase blood pressure, the study found.

Among people prescribed four or more blood pressure drugs, 65 per cent refilled drugs known to increase blood pressure after stepping up their blood pressure treatment regimen.

Patients who need blood pressure medicine should ask their doctor if any of the other medications they are taking might interfere, said Gunnar Gislason, a professor of cardiology at Copenhagen University Hospital Herlev and Gentofte and director of research at the Danish Heart Foundation.

And if blood pressure drugs are not working, it is important to consider not just other drugs that might influence blood pressure but also herbal medications that often are considered harmless, Gislason, who was not involved in the study, said by e-mail.

The way different drugs can increase blood pressure varies, Hwang said.

“Some drugs, such as NSAIDs and hormones, elevate blood pressure mainly by causing the body to retain excess fluid,” Hwang noted. “This effect counteracts the mechanism of some blood pressure medications like diuretics [water pills], which cause the body to get rid of fluid.”

“Other drugs can cause blood pressure elevation by constricting the blood vessels, increasing heart rate, or by a combination of mechanisms,” Hwang added. “There are also some drugs, such as acetaminophen, that we know increase blood pressure, but we don’t know how.”

The study, published in the American Journal of Hypertension, was not designed to prove whether or how certain prescription drugs might interfere with the effectiveness of blood pressure medicines or increase blood pressure.

Another limitation is that it focused only on patients who were taking prescribed medicines that can interfere with blood pressure drugs, and many painkillers like acetaminophen and naproxen are available over the counter without a prescription in the US, the study authors note.

“Although this study cannot tell us the reasons why the prescription rate of blood pressure-interfering medication is so frequent, it may explain why in [the] US population blood pressure control is still very poor,” said Liffert Vogt of Amsterdam University Medical Centre.

“Poorly controlled blood pressure [is] a major cause of heart disease and stroke,” Vogt, who was not involved in the study, said by e-mail. “For that reason, prescribing drugs that contribute to poor blood pressure control should be carefully considered.”