Category: Analysis

Source: The Conversation – UK – By Justin Stebbing, Professor of Biomedical Sciences, Anglia Ruskin University

The health advice that keeps you from getting sick might actually harm you once you’re already ill. This counterintuitive medical reality has a new name: “Cuomo’s paradox”, coined by Professor Raphael Cuomo at UC San Diego School of Medicine after analysing findings across numerous studies.

The paradox describes how behaviour long considered unhealthy – carrying extra weight, drinking moderate amounts of alcohol, having elevated cholesterol – sometimes correlates with better survival in people who already have cancer or heart disease. It’s a phenomenon that challenges the one-size-fits-all approach to medical advice.

This doesn’t mean throwing prevention guidelines out the window. Rather, it suggests nutrition should be treated as stage-specific medicine. Before diagnosis, the goal is clear: reduce your risk of getting sick. After diagnosis, the priorities shift dramatically to preserving strength, tolerating harsh treatments and avoiding dangerous complications.

The distinction matters enormously for the millions living with advanced cancer or heart disease. Too often, doctors apply prevention-focused advice – lose weight, eliminate alcohol, slash cholesterol levels – to patients whose immediate battle is surviving chemotherapy or managing frailty. These competing goals can point to entirely different dietary strategies.

Cuomo argues for personalised nutrition after diagnosis rather than copying prevention guidance. What keeps a healthy 40-year-old disease-free may not help a 70-year-old cancer patient get through treatment.

The pattern isn’t entirely new. Researchers have long documented the obesity paradox in cardiovascular and cancer care, where heavier patients sometimes survive longer once they’re ill. These observations have sparked years of debate, with critics pointing to measurement timing, unintentional weight loss from illness, and statistical quirks that might explain the findings.

Although careful study design can reduce some paradoxical signals, they don’t always disappear. Cuomo’s contribution is connecting these recurring reversals across multiple factors – weight, alcohol, cholesterol – and multiple diseases, creating a unified framework for stage-specific nutrition.

The findings don’t negate established science. Obesity and alcohol clearly increase cancer risk and worsen heart health. But once illness strikes, the survival equations change, and rigid prevention targets may not suit every patient undergoing treatment.

The paradox in practice

Why might extra weight help cancer survival? The answer lies in the brutal reality of cancer treatment. Chemotherapy, radiation and surgery are physically punishing, breaking down muscle and tissue. Patients with greater reserves – both fat and crucially, muscle mass – may be able to weather these assaults better and resist the rapid weight loss that signals declining health.

When a person was last weighed matters too. A person who is underweight now – at diagnosis – may have been overweight before they became ill, but is at a higher risk of death compared with an overweight person for the reasons stated above.

Similar patterns appear with alcohol. Although drinking clearly increases cancer risk in proportion to consumption and duration, some studies suggest light-to-moderate drinkers show better or equivalent post-diagnosis outcomes compared to non-drinkers. The interpretation remains murky – light drinkers may have different social or health behaviour, while some may quit alcohol due to illness, skewing comparisons.

Cholesterol presents another puzzle. In advanced heart disease, extremely low cholesterol sometimes signals broader health problems: inflammation, malnutrition and liver dysfunction. In these cases, low cholesterol is more likely to reflect underlying illness rather than directly cause poor outcomes, meaning that sicker patients often show low levels. This creates a U-shaped pattern where both very high and very low cholesterol are linked to an increased risk of death.

Cuomo’s message isn’t that “high cholesterol is good” but that aggressively pursuing prevention targets in frail patients might not improve survival and could conflict with maintaining strength and quality of life. Treatment decisions require individualisation and careful monitoring.

For doctors, this means separating prevention from survival goals. Before diagnosis, standard guidance applies: maintain healthy weight, limit alcohol, manage cholesterol. After diagnosis, targets should reflect disease stage, treatment plans, body composition and other health conditions. The focus shifts to avoiding unintentional weight loss while maintaining muscle and energy during active treatment.

Cuomo’s paradox doesn’t upend health advice. It emphasises context. The behaviour that prevents disease isn’t always that which best supports survival once serious illness arrives. That’s not permission for unhealthy habits – it’s a call for individualised care that balances survival, strength and quality of life through careful medical oversight.

Justin Stebbing does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Why losing weight or cutting alcohol isn’t always best after illness strikes – https://theconversation.com/why-losing-weight-or-cutting-alcohol-isnt-always-best-after-illness-strikes-263315

Source: The Conversation – UK – By Tom Brownlee, Associate Professor, Sport and Exercise Science, University of Birmingham

It can look almost too easy: athletes gliding along on a bike, runners shuffling at a pace slower than most people’s warm-up, or someone strolling so gently it barely seems like exercise at all. Yet this kind of effortless movement is at the heart of what’s becoming known as zone zero exercise.

The idea runs counter to the “push yourself” culture of gyms and fitness apps. Instead of breathless effort, zone zero exercise is all about moving slowly enough that you could chat very comfortably the whole time. For some people, it might mean a gentle stroll. For others, it could be easy yoga, a few stretches while the kettle boils, or even pottering about the garden. The point is that your heart rate stays low; lower even than what many fitness trackers label as zone 1.

In the language of endurance training, zone 1 usually means about 50-60% of your maximum heart rate. Zone zero dips beneath that. In fact, not all scientists agree on what to call it, or whether it should be counted as a separate training zone at all. But in recent years, the term has gained traction outside research circles, where it has become shorthand for very light activity, with surprising benefits.

One of those benefits is accessibility. Exercise advice often leans towards intensity: the sprint intervals, the high-intensity classes, the motivational “no pain, no gain”. For anyone older, unwell, or returning to movement after injury, this can feel impossible. Zone zero exercise offers an alternative starting point.

The quiet power of easy effort

Studies have found that even very light activity can improve several health markers including circulation, help regulate blood sugar, and support mental wellbeing. A daily walk at a gentle pace, for example, can lower the risk of cardiovascular disease.

There’s also the question of recovery. High-level athletes discovered long ago that they couldn’t train hard every day. Their bodies needed space to repair. That’s where easy sessions came in. They aren’t wasted time, but essential recovery tools.

The same applies to people juggling work, family and stress. A zone zero session can reduce tension without draining energy. Instead of collapsing on the sofa after work, a quiet half-hour walk can actually restore it.

Mental health researchers have pointed to another benefit: consistency. Many people give up on exercise plans because they set the bar too high. A routine based on zone zero activities is easier to sustain. That’s why the gains – better sleep, a brighter mood, and lower risk of chronic illness – keep adding up over months and years.

There are limits, of course. If your goal is to run a marathon or significantly increase fitness levels, gentle movement alone won’t get you there. The body needs higher-intensity challenges to grow stronger. But the “all or nothing” mindset, either training hard or not at all, risks missing the point. Zone zero can be the base on which other activity is built, or it can simply stand on its own as a health-boosting habit.

The fact that researchers are still debating its definition is interesting in itself. In sports science, some prefer to talk about “below zone 1” or “active recovery” instead of zone zero. But the popular name seems to have stuck, perhaps because it captures the spirit of effortlessness. The idea of a “zero zone” strips away pressure. You don’t need fancy equipment or the latest wearable. If you can move without strain, you’re doing it.

That simplicity may explain its appeal. Public health messages about exercise can sometimes feel overwhelming: how many minutes per week, what heart rate, how many steps. Zone zero cuts through that noise. The message is: do something, even if it’s gentle. It still counts.

And in a world where many people sit for long stretches at screens, it might be more powerful than it sounds. Evidence shows that long sedentary periods raise health risks even in people who exercise vigorously at other times. Building more light, frequent movement into the day may matter just as much as the occasional intense workout.

Zone zero exercise, then, isn’t about chasing personal bests. It’s about redefining what exercise can look like. It’s not a test of willpower but a way to keep moving, to stay connected to your body, and to build habits that last. Whether you’re an elite cyclist winding down after a race or someone looking for a manageable way back into movement, the same principle applies: sometimes, the gentlest pace is the one that gets you furthest.

Tom Brownlee does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Zone zero: the rise of effortless exercise – https://theconversation.com/zone-zero-the-rise-of-effortless-exercise-263365

Source: The Conversation – UK – By Elizabeth Simon, Postdoctoral Researcher in British Politics, Queen Mary University of London

In 1998, British prime minister Tony Blair was bullish about his government’s vision for local democracy in London. A city-wide referendum had just firmly endorsed New Labour’s plan to give London a mayor. Though only a third of the electorate turned out, 72% of them were in favour – much healthier than the 50% of Welsh voters who ensured, by a hair’s breadth, the creation of their devolved assembly the year before.

Blair held up the UK’s capital city as a trailblazer. “Once they see how much London is benefiting from having a mayor,” he predicted, “I am confident that people in many other cities and towns of Britain will want to follow.”

Two years later, and a quarter of a century ago this year, Blair’s government created the London mayoralty, the Greater London Authority (GLA) and the London Assembly. Since then, the mayoralty has become, in the words of local government expert Tony Travers, one of the “biggest prizes in British politics”. Former prime minister Boris Johnson, who was mayor from 2008 to 2016, embodies the career-boosting potential of the office.

Coming alongside a sweep of constitutional reforms, the mayoralty, authority and assembly were supposed to address a perceived democratic deficit.

True, through Westminster, London was unquestionably the geographical centre of British political power – and dominant economically too. But after the 1986 abolition of the Greater London Council by Margaret Thatcher’s government (a council led, not coincidentally, by outspoken socialist and future inaugural mayor Ken Livingstone), one of the world’s great cities lacked its own democratically elected authority. This was a running sore. New Labour’s reforms were supposed to address it.

But 25 years on, the evidence that these institutions adequately represent the capital’s 9 million citizens is, at best, mixed.

Admittedly, as Blair predicted, more mayors have been added to the UK’s political landscape since London first took the plunge. But the UK capital’s particular institutional setup has not proven popular.

Our poll of a representative sample of adults in London shows, shockingly, that just 30% of people living in the capital feel they have “some” or “a lot” of influence over decision-making in the UK. Even when asked how much control they felt they had over decisions in London, only 31% of Londoners said “some” or “a lot”. The same figure emerged when we asked how much control they had over decisions in their constituency.

Admittedly, Londoners are slightly more trusting of local than national government to act in their interests. We found that 32% trust the mayor and nearly four in ten trust their borough council, compared with only a quarter who trust the national government. But those numbers are hardly ringing endorsements.

And it is striking that Londoners do not feel they have more influence over local than national decision-making. On existing evidence, that is not the case elsewhere in the country.

Some are particularly dissatisfied. White Londoners and those on lower social grades, with lower incomes and lower levels of educational attainment, are all less trusting than average that the government – at both local and national levels – will act in the best interests of Londoners.

We should be cautious when drawing conclusions. We cannot compare our findings with polling conducted prior to devolution, because no polls in that period asked Londoners comparable questions to those we used. And much of the dissatisfaction we pick up clearly reflects wider alienation from, and volatility in, British politics – patterns which have begun to manifest themselves in London, just as they have in other parts of the country.

Bizarre contradictions

In cities outside London, the mayor plays a “convenor” or “team captain” role for clusters of councils. But London’s unusual 32-borough structure – a reflection of its size and population density – makes this difficult. In contrast, Greater Manchester’s mayor, Andy Burnham, only has to convene ten councils.

Yet London borough leaders have recently demanded decentralising reform so the London mayoralty looks more like its counterparts. These calls may not be entirely motivated by governance concerns: frustration with perceived GLA incompetence and animosity towards the current mayor, Sadiq Khan, are also probably at play. But some advocates genuinely believe that City Hall is overpowered.

Others take a different position. Though the mayor and the GLA can make significant decisions in areas like transport (think, for example, of the congestion charge), they lack the chunky institutional and taxation powers of comparable cities such as New York and Paris.

This leads to bizarre situations. Formally, the mayor is responsible for the critical service of policing, yet cannot even appoint the commissioner for the Metropolitan Police. City Hall is caught between borough councils delivering core services and successive national governments determining budgets – including the Met’s. As declassified government papers reveal, such a situation was a worry even before the role existed: a young Pat McFadden, then political adviser to Blair, privately expressed such concerns about the draft plans in 1997.

Unfinished business

It does not appear, then, that devolution has made Londoners feel empowered over their capital’s politics. Add this to the frequent attacks on “Sadiq Khan’s London” from prominent national and international politicians, especially from the right, and it seems the future of London’s democratic institutions is as contentious as it has ever been.

A quarter of a century since the capital got its first mayor, Londoners still don’t feel as though they are adequately represented, and that they can trust their politicians to deliver for them.

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The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. It’s 25 years since London got a mayor – and our polling reveals discontent – https://theconversation.com/its-25-years-since-london-got-a-mayor-and-our-polling-reveals-discontent-263359

Source: The Conversation – UK – By Andrew Dix, Senior Lecturer in American Literature and Film, Loughborough University

“I’m still excited when somebody makes a movie out of something that I’ve done,” Stephen King recently told The Guardian. This openness to exhilaration on King’s part is remarkable, given that he is such a widely adapted writer. To date, more than 90 of his novels and short stories have been adapted for cinema and television (and more adaptations are currently in production).

Variations in the scale of his works have proved no barrier for potential adaptors of King. The 1,100 pages of The Stand (1978) have been processed for the screen. But so too have been the 110 of Rita Hayworth and Shawshank Redemption (1982). Genre shifts across the long arc of King’s work have also been accommodated by adaptors. While early ventures in horror such as Carrie (1974) and Misery (1987) were rapidly taken up by Hollywood, equal haste has been expended recently to bring to American TV King’s crime novels featuring the likeable sleuth Holly Gibney from the Holly series.

In all of this furious adaptive activity, differences in quality are only to be expected. For every screen treatment with the lustre of Kubrick’s The Shining (1980), there is a dull or clumsy transposition such as John Power’s two-part miniseries of The Tommyknockers (1993).

Even King’s involvement in a project is not a guarantor of success. His role as executive producer failed to prevent Salem’s Lot (1975), his horrifying tale of vampires in Maine, from being defanged when it was adapted for cinema in 2024.

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Read more:
Salem’s Lot: a faithful but shallow adaptation of Stephen King’s classic vampire novel

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Now King is back as an executive producer, this time attached to The Life of Chuck, a film adapting one of the novellas included in his 2020 collection, If It Bleeds. Here, however, he is working alongside something of a King specialist (if not a King obsessive), the screenwriter and director Mike Flanagan. He has already adapted two novels by the author: Gerald’s Game (1992) and Doctor Sleep (2013).

Happily, The Life of Chuck proves to be a thoughtful adaptation, shot through with King’s sensibility while augmenting the original novella through its own cinematic choices.

The Life of Chuck showcases King’s continuing interest in narrative experimentation, even in this late phase of a long writing life. Three acts, structured in reverse chronology, consider moments in the seemingly unremarkable life of Chuck Krantz (Tom Hiddleston), a New England everyman. Flanagan’s adaptation sensibly preserves this design.

There are a few instances in the film where the director appears inhibited by his source material. In his Guardian interview, King reveals himself to be pleasingly without any sense of proprietorship about the adaptative process, saying he thinks of his novels and short stories and the films made from them as “two different things, like oranges and apples”. But where Flanagan draws verbatim on the novella for sustained passages of voice-over, especially in act one, he is in danger of not sufficiently differentiating his apple from King’s orange.

Elsewhere in the film, however, Flanagan frees himself from King’s storytelling. More is done on screen than on the page to weave together the three acts, as when characters restricted in the novella to one segment only appear in other places in the film (a roller-skating girl, for example, or high school English teacher Marty Anderson, played by Chiwetel Ejiofor).

New motifs are included in one strand by Flanagan so as to prepare us, subtly, for another part of the story. Most notably, an allusion in act three to the 19th-century poet Walt Whitman, great celebrator of everyday American experience, who is an animating presence in act one.

In praise of ordinariness

Film is a mixed or “composite” medium, having at its disposal not only the visuals of photography but the resources of other forms such as architecture, dance, music and theatre. All are mobilised effectively in Life of Chuck.

A low-key score by the Newton Brothers is heard throughout, further endowing the several sections of the film with narrative continuity and atmospheric unity. The drumming that figures prominently in the middle section is echoed in act one when Chuck’s rock‘n’roll-loving grandmother bangs the rim of a saucepan.

Dance, too, is central to The Life of Chuck as a screen experience. This is not an especially kinetic film: the camera tends to move smoothly, while editing transitions are generally stately (rationing the terrifying jump cuts common elsewhere in King adaptation). But there is vivid movement in the film’s middle section.

Recalling the extended set-pieces of Fred Astaire and Ginger Rogers musicals that we catch glimpses of when characters are watching TV, the adult Chuck frees himself from the constraints of life as a be-suited accountant and spontaneously dances.

The dance is one of many moments in which The Life of Chuck celebrates the ordinary, uncovering its richness. Ordinariness has a long tradition in American writing (a field in which King, as a former English teacher, is expert). Consider John Williams’s novel Stoner (1965), perhaps, or Raymond Carver’s short story A Small, Good Thing (1983). But Flanagan has succeeded in the challenge he sets himself to bring ordinariness to a cinema screen that often, these days, is populated instead by images of the super-heroic and fantastical.

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Andrew Dix does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. The Life of Chuck: Stephen King adaptation celebrates the richness of ordinary life – https://theconversation.com/the-life-of-chuck-stephen-king-adaptation-celebrates-the-richness-of-ordinary-life-263691

Source: The Conversation – UK – By Sam Phelps, Commissioning Editor, International Affairs, The Conversation

This article was first published in The Conversation UK’s World Affairs Briefing email newsletter. Sign up to receive weekly analysis of the latest developments in international relations, direct to your inbox.

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The next phase of the war in Gaza has begun. Israel’s military is carrying out the early stages of an assault to capture Gaza City, with 60,000 reserve troops expected to be called up for the offensive. Hundreds of thousands of Palestinians will evacuate south.

World leaders have condemned the assault. The French president, Emmanuel Macron, said it “risks plunging the entire region into a cycle of permanent war”. Belgium’s foreign ministry added it would “lead to more death, destruction and mass displacement”.

These developments come days after Hamas officials accepted a new ceasefire proposal to pause the war. The offensive scuppers any hopes of such a deal moving forward, says Julie Norman of University College London.

Norman, associate professor in politics and international relations, sees this as an all-too familiar situation. Hamas has responded positively to various ceasefire proposals over the past year that have subsequently broken down.

Beyond a ceasefire, the two warring parties also remain far apart on what “ending the war” actually includes. There are major sticking points around the disarmament of Hamas and Israel’s intention to maintain “security control” in Gaza after the war.

So don’t expect the violence to end anytime soon, writes Norman. As one Israeli reservist told her during a recent trip to the region: “Last year at this time, I didn’t imagine there could possibly be another year of war. Now, it’s hard to imagine there not still being a war in another year from now.”

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Read more:
No end to the violence as Israel launches its assault on Gaza City

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The Israeli government has meanwhile approved the construction of a new settlement in the West Bank, comprised of about 3,500 new dwellings. Leonie Fleischmann, senior lecturer in international politics at City St George’s, University of London, lays out why the plan is particularly controversial.

She writes that the settlement’s construction, deemed illegal under international law, “would cut the West Bank into two separate parts, rendering it impossible to establish a contiguous Palestinian state with East Jerusalem as its capital”.

This certainly seems to be the intention of the Israeli government. Bezalel Smotrich, Israel’s hard-line finance minister, declared that the approval of construction plans “buries the idea of a Palestinian state”. He added: “Every town, every neighbourhood, every housing unit is another nail in the coffin of this dangerous idea”.

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Read more:
Israel’s plan for massive new West Bank settlement would make a Palestinian state impossible

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Trump the peacemaker?

Elsewhere, we have interrogated Donald Trump’s claim that he resolved six conflicts in a matter of months. We interviewed six experts on those regions to find out what Trump actually did, and whether it made a difference.

Some of Trump’s claims hold up, to an extent. In the case of Thailand and Cambodia, for example, his threat to suspend trade talks with both countries was the breakthrough that paused hostilities.

His mediation between Armenia and Azerbaijan has also resulted in the warring countries coming together to agree a possible pathway to peace after decades of conflict. But our experts were unanimous in their verdict that, ultimately, Trump’s claim doesn’t fully stand up.

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Read more:
Did Trump really resolve six conflicts in a matter of months? We spoke to the experts to find out

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One war Trump cannot claim to have solved is in Ukraine, which was the focus of two high-stakes summits over the past week. The first saw Trump roll out the red carpet for Vladimir Putin in Alaska. He signalled afterwards that the pair had discussed Ukraine ceding land to Russia in order to end the war.

Trump then met with Ukrainian president Volodymyr Zelensky and the leaders of some of Ukraine’s European allies at the White House a few days later. Zelensky will have left this hurriedly arranged meeting feeling a sense of relief.

There seems to have been no real pressure put on Ukraine to give land to Russia, and Trump even appeared to accept the European position that security guarantees for Kyiv will be vital if any peace deal is to stick. But the results of this meeting were still far from perfect, says Stefan Wolff.

Wolff, professor of international security at the University of Birmingham and a regular contributor to this newsletter, explains that Trump is hailing the fact that a direct meeting between Putin and Zelensky has not been ruled out as a major success of the past week’s diplomatic efforts.

However, as Wolff notes, a peace process remaining somewhat intact is a far cry from an actual peace agreement. Even then, he says, any further progress towards peace is likely to happen at a snail’s pace. Russia already looks to be dragging its feet.

Putin reportedly suggested to Trump that Zelensky could travel to Moscow for talks. This is an option Kyiv could not possibly have agreed to. Meanwhile, Russian foreign minister Sergei Lavrov has watered down hopes of any such meeting taking place, saying it would have to be prepared “gradually”.

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Read more:
Transatlantic unity at the White House disguises lack of progress towards just peace for Ukraine

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Security guarantees

Equally unclear are the details of security guarantees for Ukraine. Zelensky has praised Trump’s indication that the US is ready to be part of that guarantee, and says he hopes it will be “formalised in some way in the next week or ten days”. But what are the options?

One proposal includes western allies offering Ukraine what Italy’s prime minister, Giorgia Meloni, has called an “article 5-style” protection. We spoke to Mark Webber, professor of international politics also at the University of Birmingham, about what that means.

As Webber writes, Meloni was alluding to Nato’s collective defence pledge that treats an attack on one member as an attack on all. However, the route to an article 5 security guarantee through Ukrainian membership of Nato has been expressly ruled out by the Trump administration, he says.

A much more likely option is that Europeans will be “the first line of defence”, with the US instead offering intelligence, weapons and air support of some kind. Trump was clear there would be no US “boots on the ground”, writes Webber.

In any case, it remains doubtful whether a security guarantee for Ukraine can be reached. Lavrov has said discussing security guarantees without Russia’s involvement “is a road to nowhere”. He has since said proposals to deploy European troops in Ukraine would be unacceptable for Russia. In the meantime, Russia’s advance in eastern Ukraine continues to gather momentum.

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Read more:
Ukraine war: what an ‘article 5-style’ security guarantee might look like

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It’s from eastern Ukraine that Frank Ledwidge, a military strategist at the University of Portsmouth, has just returned from a week-long trip. He has provided this account of daily life in Ukraine’s eastern capital, Kharkiv, where air-raid sirens sound at all hours but shopping malls remain busy and bars lively.

Despite all this, Ledwidge notes, there was an abiding sense of emptiness in what has come to be known as Ukraine’s “unbreakable city”. No official figures are available, but Ledwidge estimates that more than half of Kharkiv’s pre-war population of 1.5 million have left since the war began in 2022. Many of these people may never return.

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Read more:
Kharkiv: what I saw in Ukraine’s ‘unbreakable’ eastern capital

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– ref. Israel opens new front in Gaza war – https://theconversation.com/israel-opens-new-front-in-gaza-war-263484