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Revealed: The number of steps you need to improve your life expectancy
Revealed: The number of steps you need to improve your life expectancy

Telegraph

timea day ago

  • Health
  • Telegraph

Revealed: The number of steps you need to improve your life expectancy

Walking 7,000 steps a day is the sweet spot for preventing many chronic diseases that can lead to an early death, a major study has shown. While the goal of 10,000 daily steps has become firmly established in the public consciousness, an international team of researchers found even a modest amount of walking brings major benefits. British scientists said it finally 'debunked the myth' of 10,000 steps and should encourage people to try and hit the lower target. The major review of 57 studies involving 160,000 adults, which was published in The Lancet, concluded that for most conditions health benefits tended to level off beyond 7,000 steps. Hitting 7,000 steps a day was found to reduce all-cause-mortality by 47 per cent, cardiovascular disease by 25 per cent, cancer by six per cent, diabetes by 14 per cent, dementia by 38 per cent and depression by 22 per cent. Health benefits were also apparent from 4,000 steps when compared to 'inactive' people who walked just 2,000, the study led by the University of Sydney found. Every extra 1,000 steps brought better outcomes, researchers found. Commenting on the study, Steven Harridge, professor of human and applied physiology at King's College London, said: 'Humans are designed to be physically active – our evolutionary heritage as hunter gatherers. 'There has been debate about the amount of activity an individual should be doing with 10,000 steps as a generalised target, not well evidenced. 'This paper shows that 7,000 steps is sufficient for reducing the risk for most diseases covered, and 10, 000 steps does not confer much additional benefit.' According to World Health Organisation data, insufficient physical activity is the fourth most frequent cause of death in the world, with 3.2 million deaths a year related to physical inactivity. Many health organisations recommend hitting 10,000 steps a day, although there is little evidence for the target, which is believed to have arisen from a Japanese marketing campaign in the 1960s. In the run-up to the 1964 Tokyo Olympics, the company Yamasa sought to capitalise on the sudden interest in fitness, so designed the world's first wearable step-counter. They called it the Manpo-kei, or '10,000-step meter'. The company appears to have chosen the figure at random, as a fun goal, but it has stuck ever since. The new paper found that for heart disease, walking more than 7,000 steps was beneficial, but for most conditions there was little gain from putting in more effort. Experts said it was still unclear why walking brings such striking benefits but said it is likely to increase cardiorespiratory fitness, which is known to be positively associated with better health and all-cause mortality outcomes. Commenting on the research, Dr Daniel Bailey, an expert in sedentary behaviour and health at Brunel University of London, said the 7,000 steps target was more achievable for many people than 10,000 steps. 'Just adding more steps from your starting point can have important benefits for health,' he said. 'This study adds to existing evidence by showing that the more steps people do, the less their risk of developing different health conditions. 'The finding that doing 5,000-7,000 steps per day is beneficial, is an important addition to the literature which helps to debunk the myth that 10,000 steps per day should be the target for optimal health.' The Alzheimer's Society also welcomed the study saying it demonstrated that inactivity is a major risk factor for dementia. Dr Richard Oakley, associate director of research and innovation at the charity said: 'It adds to the evidence that what's good for the heart is good for the head.'

Could Ketamine Addiction Become the UK's Next Drug Crisis?
Could Ketamine Addiction Become the UK's Next Drug Crisis?

Medscape

time2 days ago

  • Health
  • Medscape

Could Ketamine Addiction Become the UK's Next Drug Crisis?

Doctors are warning that ketamine is not the harmless party drug many believe it to be, as rising numbers of young people in the UK are being treated for addiction and serious organ damage. Despite the surge in use, many users — and even frontline clinicians — remain unaware of the drug's addictive potential and its severe physical health consequences, including bladder failure, kidney damage, and extreme weight loss. According to the Home Office, an estimated 299,000 people aged 16-59 had reported ketamine use in the year ending March 2023 – the largest number on record. In a June 2025 editorial in The BMJ , addiction psychiatrists said that 3609 people began treatment for ketamine addiction in 2023-2024. That is more than eight times the number recorded in 2014-2015. The drug's relatively low cost made it popular among young people, according to the experts from King's College London and South London and Maudsley NHS Foundation Trust. 'Not Just a Party Drug' Dr Irene Guerrini Consultant addiction psychiatrist Dr Irene Guerrini, who led the study, told Medscape News UK : 'The vast majority of clinicians think ketamine is a party drug used at clubs and raves, but it's not just that. My young patients often go to A&E and primary care and are told ketamine is not addictive, but it is addictive and can cause serious harm.' Guerrini said that ketamine uropathy is the most common complication of frequent use. 'It causes serious bladder, kidney and liver problems, and often extreme weight loss, which can be confused with an eating disorder by some health professionals.' Earlier this month, Alder Hey children's hospital in Liverpool opened a specialist ketamine clinic to treat young people under 16 for ketamine-induced uropathy. Physical and Psychological Harm A separate study by the University of Exeter and University College London (UCL), published in the journal Addiction in April, also found a strong link between ketamine addiction and physical and psychological health problems. Among 274 people with ketamine use disorder, 60% had experienced bladder or nasal problems. More than half (56%) reported painful cramping in the abdomen, known as 'k-cramps'. Chemicals released when ketamine breaks down in the body can damage the bladder lining, leading to pain, bleeding, and scarring. Some bladder damage was so severe that it required bladder removal and the use of a urostomy bag. Celia Morgan Study author Professor Celia Morgan, of the University of Exeter told Medscape News UK , ' Ketamine use is increasing. We have observed users are younger and the trajectory to dependence seems fast in some individuals. 'In those who are sucked in to repeated heavy ketamine use, the physical consequences are severe in terms of bladder complications, but also dramatic weight loss and in severe cases, multi-organ failure.' Sharp Rise in Rehab Admissions UK Addiction Treatment (UKAT) centres have reported a surge in people seeking help. Zaheen Ahmed Zaheen Ahmed, director of addiction treatment at UKAT, told Medscape News UK that there had been ' a staggering rise in both enquiries for help and admissions into our centres'. Admissions were up 35% in 2024 compared with the previous year. 'Ketamine addiction has become the norm, and we're seeing it and treating it daily now,' he said. Ahmed warned, 'Ketamine is a really dangerous drug, because it doesn't give the user an awful come down like other substances do.' The drug is also 'incredibly cheap, making it very appealing, especially to young people'. Medical Use and Misuse Ketamine is used clinically as an anaesthetic. At lower doses, it is prescribed for chronic pain, treatment-resistant depression, and suicidality. It is also being trialled in studies to treat post-traumatic stress disorder (PTSD) and severe alcohol dependence. However, experts have warned that increasing availability through private clinics may normalise unsupervised or self-directed use. The drug has also been linked to the deaths of Friends actor Matthew Perry and drag performer The Vivienne. Missed Diagnoses in Primary Care The Exeter/UCL Study found that most people with ketamine use disorder do not seek treatment. Existing services are often perceived as ineffective. 'In our study, a common report was that doctors and health professionals were ignorant to ketamine addiction and its physical health impacts,' said Morgan. 'We need to urgently raise awareness and educate professionals of this often devastating and life-threatening condition.' Guerrini agreed that doctors should be more alert to the possibility of ketamine addition. 'M aybe if I'm a GP and see a particularly young patient coming to me with a urinary tract problem like cystitis, be I'll be more inquisitive, ask the correct questions, and think maybe this patient is on ketamine.' Similarly, A&E doctors should develop 'clinical curiosity' if a young patient has high liver enzymes and severe pain. Guerrini called for better diagnostic tools, a national registry, and earlier screening to support treatment and help evaluate emerging therapies. 'It's important to increase awareness among professionals and encourage joined up working between substance misuse services, urology services, and mental health services, as these young people often have chronic depression along with physical issues caused by ketamine,' she said. Government Considering Reclassification Ketamine is currently controlled as a Class B substance. The maximum penalty for supplying and producing it is up to 14 years in prison, an unlimited fine, or both. Earlier this year, the Home Office asked independent experts for advice on whether ketamine should remain controlled as a Class B substance or become a Class A drug. Ahmed said that reclassification would increase penalties for dealers, but more importantly, ' it will hopefully discourage young people especially to even experiment with it at all'.

The three types of hunger – and how to stay fuller for longer
The three types of hunger – and how to stay fuller for longer

Yahoo

time2 days ago

  • Health
  • Yahoo

The three types of hunger – and how to stay fuller for longer

For some people, eating a meal keeps them happily satiated until the next one, whereas for others, hunger is a far more complicated business. A couple of hours after eating, they're starving again and trying desperately not to succumb to the lure of the fridge or office vending machine. But is what they're experiencing really physical hunger, also known as homeostatic hunger, or could it be fuelled by one of the other kinds? There is hedonic hunger – the drive to eat for pleasure, rather than out of a physiological need for energy and, one of the most persuasive, emotional hunger, where food serves as a form of self-soothing when negative feelings arise. 'Physical hunger, when your body needs refuelling, is just one type of hunger, but we don't necessarily talk about the other types as much – although we should, because understanding them can be important for our health,' says Dr Emily Leeming, a microbiome scientist at King's College London, dietician and author of Genius Gut. Hedonic and emotional hunger are among the main culprits when it comes to weight gain. In fact, a broad new review of existing research found a significant positive link between hedonic hunger and food addiction, defined as symptoms similar to those in drug addiction, including cravings, tolerance and withdrawal effects – as well as to increased calorie intake and weight gain. So which might you suffer from? Here's a science-backed guide to all three, understanding their triggers and learning how to beat them. Physical hunger That empty-stomach feeling, often accompanied by a growling sound, dip in energy and 'hanger' (hungry anger) – caused by cortisol and adrenaline rising as our blood sugars drop – is our body's way of signalling to the brain that we need food. This drop in blood sugar and insulin levels, a few hours after eating, triggers the stomach to produce ghrelin, the hormone that stimulates appetite. But for some of us, our appetites seem to be in overdrive. The reasons for this can be complex: some people seem to be less sensitive to the suppression of ghrelin that comes when the stomach encounters food, while for others, their brains could be less sensitive to leptin signals, which tell the brain to stop eating when we're full. For most people, however, focusing on what we eat can make a huge difference in managing our hunger. Eating too many refined white carbohydrates is one of the primary reasons many of us find ourselves reaching for sugary snacks between meals. 'With white or refined carbs, such as white bread, pasta and rice, most of their nutrients and fibre have been lost, so our bodies don't have to work hard to break them down,' says Laura Southern, the founder of London Food Therapy. 'That causes very high blood sugar spikes.' These trigger an immediate release of insulin, causing blood glucose levels of fall, which then signals the release of hunger hormones to replenish them. Research from King's College London has shown that when blood sugar levels dipped below their baseline, people reported a 9 per cent increase in hunger and ate over 300 calories more that day than others whose blood sugar levels did not dip. Tips to stop physical hunger pangs Opting for unrefined carbs, such as oats, barley, rye and quinoa, will help keep blood sugar steady thanks to their higher fibre content. 'Ninety-three per cent of us are not getting the fibre we need, and we have a deficit of 35 to 40 per cent, which is a significant fibre gap,' says Dr Leeming. 'Fibre releases fullness hormones and it's quite bulky, so it gives that sense of fullness and satisfaction. It also feeds our gut microbiome, and there's early evidence that looking after the microbiome could potentially be involved in how tempting we find certain foods.' She recommends starting the day with a protein-rich breakfast, such as yogurt or eggs, which has been proven to reduce food cravings and snacking later in the day, and adding fibre, such as fruit, vegetables or seeds. Hedonic, or taste-hunger pangs It's the smell of the freshly baked croissants we cannot resist on holiday; or that irresistible extra portion of the darkest, ooziest chocolate fondant cake for pudding, followed by the cheese board. Eating for pleasure is one of our biggest drivers to consume more than we need. Food, quite rightly, is a sensory joy – and we all experience a hankering for the fattier, sugary treats, with temptation and advertising bombarding us from all corners. But for some, these cravings can spiral into persistent 'food noise' – intrusive thoughts about eating – or even develop into full-blown addiction. 'When we eat foods we find particularly appealing, our brain releases dopamine in its reward system,' explains Dr Anne-Laure Le Cunff, a neuroscientist at King's College London and founder of Ness Labs. 'This creates a sense of pleasure and reinforces the behaviour.' Unlike homeostatic hunger, which we often mistake it for, hedonic hunger, aptly named after Hedone, the Greek goddess of pleasure, has no mechanism to signal when we should stop eating – hence, it's now seen by scientists as one of the biggest causes of obesity. Tips to stop hedonic hunger pangs But there are measures we can take to combat these cravings, and they aren't as simple as trying to avoid food for which we have a weakness. Dr Leeming says: 'Cutting out the food we crave won't necessarily solve the craving: one study showed that women who cut out chocolate had more food cravings, and when they did eat chocolate, they ate twice as much.'Instead, she suggests eating the food, but with something else. 'If it's chocolate, have it with some fruit and nuts, which combine protein, fibre and healthy fat, so you'll probably eat less chocolate and it's going to satisfy you more,' she says. Dark chocolate is a better choice, with research suggesting it could have a positive impact on blood sugar levels, reducing cravings for less nutritious foods later. Maintaining a consistent eating pattern, including meal-times and portion sizes, is key to managing cravings, as a result of what's called the cold-hot empathy gap. In the cold state (meaning you're not starving hungry, and therefore feeling neutral, or 'cold' towards food) you're less likely to overestimate how hungry you'll be and overindulge – so this is the state to be in when you're planning meals. Getting enough sleep is also vital: research shows that just one night of poor sleep can significantly boost your ghrelin levels, making you snack more the next day. Eating spicy foods can help beat cravings, too. Capsaicin, the compound that makes peppers spicy, can suppress appetite and increase satiety. And don't skip bitter vegetables, such as dark leafy greens, since studies have shown they can trigger the release of appetite-control hormones in the gut and reduce our desire for sweet foods. Emotional hunger Research published last year by scientists at the University of California, Los Angeles in America found that women who perceive themselves to be lonely showed more brain activity in areas associated with food cravings, especially when shown pictures of high-calorie or sugary foods. The dopamine hit we experience when we eat these foods 'essentially teaches our brain that eating makes us feel better,' says Dr Le Cunff. For many people, this link between food and comfort is strong and dates way back to our childhoods. 'Over time, our brains learn to link eating with emotional relief,' says Dr Le Cunff. So when we're struggling emotionally, we're hard-wired to seek this kind of comfort, she explains. 'When we're stressed or feeling low, our brain's emotion centre, the amygdala, becomes more active and interacts with areas that control both hunger and reward-seeking behaviour.'Unfortunately, this can create unhealthy patterns, seeing us reach for food as comfort every time we experience negative emotions, then feeling guilty and ashamed – which can lead to yet more bingeing. Recognising that emotional eating is a normal part of life is important, Dr Leeming advises: 'Don't beat yourself up – think about the bigger picture of what you're eating in a week.' How to stop emotional hunger pangs Taking note of the feelings which lead to unhealthy eating can help identify your triggers, which is the first step in breaking the pattern. Next time you experience one, Dr Le Cunff says: 'Many other activities can activate similar reward pathways, in healthier ways, and these alternatives can help us regulate our emotions without relying on food.'Try contacting a friend – even a text message can provide the social connection that increases bonding hormones such as oxytocin. Or go for a walk or dance around the kitchen to uplifting music. As little as 10 minutes in Zone Two, where your heart rate is around 125-140 BPM and you can talk but not hold a proper conversation, can increase dopamine levels. Yoga, meditation and deep breathing can help us cope with stress, as can creative pursuits such as painting, writing, or gardening – and they can all act as a diversionary tactic to take our mind off the craving until it passes. Broaden your horizons with award-winning British journalism. Try The Telegraph free for 1 month with unlimited access to our award-winning website, exclusive app, money-saving offers and more.

Ceasefire agreement 'harder' to reach as Israel strikes Syria
Ceasefire agreement 'harder' to reach as Israel strikes Syria

Al Jazeera

time16-07-2025

  • Politics
  • Al Jazeera

Ceasefire agreement 'harder' to reach as Israel strikes Syria

Ceasefire agreement 'harder' to reach as Israel strikes Syria Quotable 'I don't think that Israel and Syria are going to reach an agreement any time soon.' Robert Geist Pinfold, a lecturer at King's College London, explains why the Israeli attacks on Syria's capital Damascus will make it harder to reach a ceasefire agreement between the two countries. Video Duration 01 minutes 05 seconds 01:05 Video Duration 01 minutes 14 seconds 01:14 Video Duration 01 minutes 37 seconds 01:37 Video Duration 01 minutes 10 seconds 01:10 Video Duration 01 minutes 02 seconds 01:02 Video Duration 01 minutes 00 seconds 01:00 Video Duration 01 minutes 47 seconds 01:47

What your headache is trying to tell you
What your headache is trying to tell you

Telegraph

time16-07-2025

  • Health
  • Telegraph

What your headache is trying to tell you

How often do you feel the ominous sensation of a headache coming on? From a mild twinge after staring at a screen for too long, to a severe throb which makes work impossible, more than half the world's population has suffered from some form of 'headache disorder' recently, according to the most recent Global Burden of Disease (GBD) study. But despite their prevalence, most of us never question what they might mean for our overall health. 'The vast majority are primary headaches, which means they don't have an external cause, such as viral meningitis or a head injury,' says Peter Goadsby, a professor of neurology at King's College London. 'The tendency to experience primary headache disorders is inherited, and then things in life will amplify it.' Overall, there are more than 100 different clinical categories of headaches, ranging from those that can be tackled with paracetamol to frequent, seriously debilitating ones. Here is a guide to some of the most common headaches and their causes, as well as ways of preventing and treating them. Around 10 million adults in Britain suffer from migraines, which costs the country approximately £2.3 billion every year in lost working days. They are characterised as a severe throbbing headache on one side of the head, which lasts between four and 72 hours and can be accompanied by blurred vision, nausea and acute sensitivity to sight and sound. The most common trigger for migraines is variation, according to Prof Goadsby. 'Changing sleeping habits – getting too much or too little – skipping meals, suddenly starting to do overly extreme exercise, stress, drinking too much alcohol and a change in weather can all trigger a migraine,' he says. It's rare to have one reliable trigger; for most people, it's caused by a number of factors coming together. And Prof Goadsby points out that some of what people assume are triggers – bright light, for example – are part of the initial stage of the migraine itself, before the headache hits. Migraines are under-diagnosed and under-treated, says Dr Ben Turner, a consultant neurologist at London Bridge Hospital. 'There's a tendency to think a headache is only a migraine if there's visual disturbance, when this only happens to 20 per cent of people,' he says. How to treat them Migraines are ' highly treatable, so if your GP hasn't been able to help, seek a referral to a specialist and you're likely to find you've been suffering unnecessarily for years,' says Dr Turner. Triptans have long been used for migraine attacks, but recently a new class of drugs called gepants have become available, which are more effective, broadly tolerated and can be used to prevent as well as treat migraines. The most excruciating form of headache, confined to one side of the head, cluster headaches last for an hour or two, often waking sufferers in the night. They are rare, and those affected – most commonly men – have rated the pain at 9.7 out of 10 – worse than childbirth at 7.2, a gunshot wound at 6 and a migraine at 5.4. They will usually become agitated and feel the need to move around, rocking and possibly hitting their head. 'It will happen every day, once or twice a day, for six to eight weeks at a time,' says Prof Goadsby. The exact cause is unknown, but these headaches affect an area of the brain called the suprachiasmatic nucleus, a tiny region in the hypothalamus which acts as the body's central circadian pacemaker, regulating daily rhythms including the sleep-wake cycle. This may explain why cluster headaches tend to appear at the same time each day, and even occur at the same time each year. 'Peak times [for cluster headaches] tend to be spring and autumn, and in between, it's completely turned off,' says Prof Goadbsy. How to treat them Cluster headaches are sometimes misdiagnosed as dental pain or acute allergies because of symptoms including a watery eye and a stuffy nose on the painful side. They require specialist treatments to relieve the pain, such as oxygen therapy, sumatriptan injections or nasal spray. The drug verapamil, taken as a tablet several times a day, is the main treatment for prevention, but it can cause heart problems in some people. The most common type of headache, tension headaches cause a steady, mild to moderate ache that can feel like a tight band or pressure around the head, and can usually be alleviated with aspirin, paracetamol or ibuprofen. Unlike migraines, they do not cause nausea, vomiting or sensitivity to light and sound. Often caused by poor posture and stiffness in the neck muscles, or eye strain, they can also be an indication of dehydration, lack of sleep, emotional stress, or too much caffeine. How to treat them Tension-type headaches – their official term – usually get better when someone moves around, particularly outdoors, so factoring in plenty of screen breaks is crucial. Gentle stretches, massages and heat on sore muscles can also be beneficial. Prof Goadsby warns that if you're regularly getting headaches after staring at a screen for extended periods, there could be another underlying cause. 'A good starting point would be to get your eyes checked by an optician, but for most people in this situation, it's not a tension-type headache but migraine.' A sinus headache is a symptom of a sinus infection (sinusitis), where the lining of the sinuses becomes inflamed and swollen, causing congestion and a dull pain behind the eyes, in the cheekbones, forehead or bridge of the nose. Research has shown that between 50 and 80 per cent of cases labelled as sinus headaches are actually misdiagnosed migraines. Dr Taylor says neurologists often see patients in this situation. 'Unless there's significant nasal congestion and discharge, it isn't sinusitis,' he says. 'We see GPs prescribing antibiotics to clear an infection, but if the problem is really migraine, they won't have any effect.' How to treat them Usually the infection clears in seven to 10 days, and using over-the-counter painkillers such as Sudafed can help manage the pain. The vast majority of us will experience a dehydration headache at some point if we've been too busy to ensure we drink enough water. But why does dehydration manifest as a headache? The hypothalamus in the brain acts as a control centre, regulating bodily functions such as body temperature, hunger and thirst. If we become dehydrated, 'this area of the brain will be overstimulated,' says Prof Goadsby. 'In those who are susceptible, it can trigger migraine.' How to treat them Drinking 2-2½ litres of fluid a day (around six to eight glasses) is essential to keep headaches at bay. Drinking too much caffeine can cause headaches for some people, but conversely, if you are a regular tea or coffee drinker, suddenly reducing your intake can also trigger them. Caffeine's stimulating effects are exerted primarily by blocking adenosine receptors in the brain. Adenosine is a neurotransmitter that promotes sleepiness and relaxation by slowing down nerve cell activity. 'When you withdraw caffeine, you get a headache from the sudden increase in adenosine activity,' says Prof Goadsby. How to treat them Over-the-counter pain relief should help, but don't use it too often. 'If you're taking painkillers more than three days a week, it will give you a headache,' says Dr Taylor. Research shows that medication overuse can turn episodic headaches into chronic headache disorders, increasing their frequency and intensity. Ophthalmodynia periodica, or ice-pick headache, is characterised by sudden, sharp stabbing pains behind the eyes which last for a few seconds at a time and can spread to the rest of your head. 'It comes from nowhere, and you can't stop it,' says Prof Goadsby. The exact causes are unknown, though a 2017 study found that these types of headaches are more common in women, and tend to affect people who usually suffer from migraines or cluster headaches. 'Around a third of migraine sufferers experience this kind of headache,' Prof Goadbsy adds. How to treat them 'You just need to pause, let it play out and it will pass,' says Prof Goadsby. If they are happening frequently (over several consecutive days) and having a debilitating impact, seeing a doctor to rule out an underlying cause is a must. Can headaches be hormonal? Migraines disproportionately affect women – 20.7 per cent globally compared with 9.7 per cent of men, according to one 2022 review of research. For women aged 18 to 49, migraine is the leading cause of disability throughout the world. This is believed to be a result of hormonal fluctuations, particularly oestrogen, with migraines often most commonly occurring during a woman's reproductive and childbearing years. Researchers estimate around 50 to 60 per cent of women with migraines experience menstrual migraines, occurring in the days leading up to menstruation, when oestrogen drops. 'It peaks at around the age of 40 for women, and if you begin to experience migraines around this time, it's often the first sign of the hormonal fluctuations which come with perimenopause,' says Prof Goadsby. 'After menopause, women have a four-out-of-five chance of migraines going away completely.' If headaches are debilitating during perimenopause, hormone replacement therapy (HRT) can lessen their frequency and severity in some women. In others, it can worsen them, so speak to your GP about options. How can you prevent headaches? Many types of headaches can be prevented or at least reduced in frequency or severity. Proven prevention strategies include: Drinking enough water Keeping a consistent sleep and eating schedule Exercising regularly Managing stress Eating a healthy diet Supplementing with magnesium and vitamin B2 Lifestyle changes, including maintaining a consistent sleep and eating schedule, drinking enough water and taking regular moderate exercise, are the simplest and most effective place to start. Relaxing after stress is a known trigger, which explains why some people wake up after a lie-in on a Saturday with a pounding headache. This is because, as your levels of stress hormones drop, there is a rapid release of neurotransmitters which send out impulses to blood vessels to constrict then dilate, which causes a headache. Prof Goadsby says: 'It may sound slightly hair shirt, but it's better to resist the temptation to lie in and get up at the same time every day.' Managing stress throughout the week is vital, too. Techniques such as deep breathing, meditation or even a 10-minute walk around the block during a lunch break can help prevent stress levels climbing too high. Eating a healthy diet is also likely to help. Keeping blood sugar levels steady by avoiding too many refined white carbohydrates and replacing them with fruits, vegetables, nuts, beans and wholegrains is sensible. It's often believed chocolate is a trigger, but according to Prof Goadsby: 'Research indicates that during the 'premonitory' early phase of a migraine, people may crave certain foods. So rather than triggering the migraine, reaching for a chocolate bar could be a warning that a migraine is starting.' A 2025 review of research concluded that taking magnesium is effective in reducing migraine attack frequency and severity. Taking 400mg per day of riboflavin, or vitamin B2 supplements, for at least three months has also been shown to have a similarly positive effect.

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