Study finds artificial intelligence was better than a doctor at crucial stage of IVF
Around 200,000 couples a year try IVF. Two thirds of couples who try IVF experience failure at least once.
Fertility is a murky area of science, and it is likely that we don’t even know what questions to ask to find the answers to our current questions.
But what is clear is that a significant proportion of failed cycles are down to issues with the embryo - and computers may be able to fix that.
Two new papers being presented later today at this week’s American Society for Reproductive Medicine conference will reveal claims of unprecedented success at selecting viable embryos using artificial intelligence.
In doing so, they could dramatically lower the risk of failed cycles, and miscarriages (70 percent of which are caused by embryo abnormalities). They could also put an end to the gung-ho (but, for now, necessary) approach of implanting multiple embryos to maximizes chances, which often leads to twins or triplets - and the risk of preterm birth, preeclampsia, and costly childbirth complications.
Now the two teams - one from the US and one from Australia - are racing to patent their algorithms to enter the $7.5 billion AI market as the first barrier to human life.
Many are investing hope in technology to get around another human fallacy in fertility: judgment
IVF and egg freezing now allow couples the chance to defy human biology to have babies despite fertility issues, or past the mother's 40th birthday.
But the crucial step of picking the right blastocysts - which develop into embryos - is still left to the human eye.
Within the parameters of what is clearly normal, and what is clearly abnormal, every embryologist has their own way of deciding whether they fancy the chances of a blastocyst to make it all the way.
It's not a perfect art, so, naturally, hopes are high that technology could help us get around another human fallacy: judgement.
There are many things that can derail the IVF process, including many factors that we don’t even know about yet.
When it comes to something like miscarriages - painfully common in IVF patients - embryos are the focus.
Embryo abnormalities account for 70 percent of miscarriages, while the rest is down to other factors, such as the mother’s response to hormones, uterine disorders, hormone levels, etc.
From an embryologists perspective, there are three main areas to be concerned about:
Embryologists decide which blastocysts to implant by assessing whether they look normal, and whether they are developing steadily (growing a little bit every 10 to 12 hours, rather than irregular bursts).
But other new tech can. AI is trained to learn what normal development looks like. Just like the humans that trained it, the computer cannot see whether the blastocyst has any genetic defects by sight alone. Zaninovic hopes to incorporate DNA screening into the AI model one day, but does not yet know how that would work.
There are other tools, though, which could be used in conjunction with it.
Last month, Columbia University’s Dr S. Zev Williams announced a new DNA sequencer, a tiny handheld screening tool, between the size of a small chocolate bar and a USB, which can deliver verdicts within minutes, rather than weeks as current testing methods do.
Dr Williams, who was once a fellow in the Cornell lab that developed one of the new AI techniques, said that this gadget could work 'synergistically' with the AI (if the AI does prove effective in more trials).
'What you'll end up saying is: within this group of normal embryos, which looks the healthiest? Or within this group of healthy-appearing embryos, which one has a regular number of chromosomes?'
A whole other area of concern is an issue called 'mosaicism', when an embryo is borderline. It's an area we still don't fully understand, but the crux of it is that genetic testing has improved to such an extent that we don't just see normal or abnormal embryos, we see some in the middle. The problem is, that decision has to be put to the couple, who are already riding a whirlwind of emotions. Many couples undergoing fertility treatment yield few viable embryos. If their only one is mosaic, it can feel like an agonizing gamble.
The goal is to be able to (a) determine how much of a problem mosaicism really is, and (b) distinguish between risky mosaic embryos and safe ones. But we're nowhere near that yet.
Once an embryologist has selected the perfect embryo, which looks normal and is genetically sound, there is still a chance that it won’t implant. Again, as with everything in fertility, it is not black and white. Sometimes it’s down to undiagnosed endometriosis (a disorder that affects the womb lining), or a blood clotting issue, or even that they have ‘natural killer’ cells that react to the synthetic hormones as if they were a virus.
One theory is that, for some women, the uterus spontaneously contracts in reaction to the procedure and the hormones, which prevents the embryo from implanting.
In a bid to tackle - and capitalize on - this mysterious problem, a Swiss company, ObsEva, has developed a pill called Nolasiban which can be given to the patient four hours before implantation to balance her hormones and prevent these contractions. In a paper which won a prize from SART (the Society for Assisted Reproductive Technology), they showed it improved the rate of embryos implanting by 32 percent.
ObsEva CEO Ernest Loumaye, a gynecologist by trade, told DailyMail.com they expect to price the drug at around $3,000 per patient, though they are vying for reimbursement in Europe where IVF is subsidized by most states. It's an eye-watering cost but Loumaye defends it as 'much cheaper to insurance companies than the price of twins or triplets. They are more expensive during pregnancy, birth, and carry more risks'.
Both of the studies being presented at this week's ASRM conference trained the AI network using time lapse images or videos, showing how an embryo developed over time.
The first, led by Nikita Zaninovic at Cornell University, used 18,000 images to train the computer ('we call it The Beast,' Zaninovic told DailyMail.com), then they gave it another 32,000 to make a judgement on.
First, it had to standardize the embryos. Currently, each embryologist has their own way of categorizing embryos, which changes from lab to lab - and can even change from embryologist to embryologist. Cornell’s AI was almost 100 percent successful (97.52 percent) at categorizing the embryos into groups of good, moderate and poor quality.
It then had to select which embryo had the best chance of making it to live birth. Comparing the computer’s decisions to their live birth data from patients, they found the computer accurately selected a viable embryo 85 percent of the time.
The other AI was developed by Aengus Tran, a medical undergraduate at the University of New South Wales, working with his brother, a business undergraduate also at UNSW.
They developed a system, which they called Ivy, which was trained using time lapse videos then given to eight labs in four different countries.
Those labs used the technique to screen 1,603 patients aged 22 to 50, with the results double-checked by an embryologist.
These aren't the first AI algorithms designed to test embryos.
Eeva was approved by the FDA in 2014, which can screen abnormalities, but it is not a dynamic system. It cannot react to new information like these 'deep-learning' AIs can.
Beyond that, the internet is littered with online companies claiming to do the same.
'I haven't seen their data. They don't come to conferences like this [ASRM] to share their data with the rest of the industry, or publish their work.'
What's more, he says, 'they make some bombastic claims'.
One company in Australia, Life Whisperer, has made headlines with the claim that they can spot Down syndrome using AI, a genetic disorder affecting chromosome 21.
As far as we know, it's something that would need to be spotted in genetic screening, rather than on pure aesthetics. But we could be wrong. It could be that genetic abnormalities could be spotted using AI, and we just don't know it yet.
The problem, Zaninovic warns, is that AI learns using data. It only understands what's normal and what's not by first seeing examples of what's normal and what's not.
'For AI to detect Down syndrome you would have to show it lots of examples of Down syndrome embryos. And let me tell you, there aren't many. That's why I'm skeptical,' he says.
‘People say I’m shooting myself in the foot,’ he said.
‘This isn’t replacing embryologists, it’s just that your job will change.’
He’s probably right. In fact, a study by MIT last year compared human-only teams, robot-only teams and human-robot teams. They found that, by far, the most efficient category was the human-robot combination, which was 85 percent more efficient than the other two groups.
The biggest change, he says, will be that hospitals and clinics that want to implement this technique will need a full team of IT support.
Ultimately, the opportunity to relieve pain and suffering is so great that it shouldn't matter, he says.
'Most people after a loss they blame themselves,' he says.
'They lifted something to heavy, they got into an argument at work, they got stressed. So they're really upset with themselves, they feel a lot of self-blame and guilt, inappropriately. They shouldn't, but it's very natural of humans to do so.
'We have this ability to test and say no it wasn't because of these things it was because, from the moment that embryo was formed, it was destined to result in this, and laying on your back for 40 weeks would have made zero difference. It's very powerful to be able to show that.'
'Things like miscarriage and infertility are some of the most ancient diseases,' he adds. 'I think there's something poetic about solving that with some of the newest technology.'
The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.
Do you want to automatically post your MailOnline comments to your Facebook Timeline?
Your comment will be posted to MailOnline as usual.
Do you want to automatically post your MailOnline comments to your Facebook Timeline?
We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.
Part of the Daily Mail, The Mail on Sunday & Metro Media Group
October 10, 2018
Sources: Daily Mail
my car and cried. I was heartbroken to get to that point. I was ashamed and saddened about the fact that I was in denial about my health. I didn’t really pay attention to what was in the mirror. I chose to ignore it, but you can’t deny when the doctor tells you these facts about yourself,” he says.</p><p>The health scares motivated him to make changes. “I knew I wasn’t a kid anymore and it was time to get myself in gear. I had to handle this or pay the consequences down the road,” he says.</p><p>A decade earlier, Gonzales lost 50 pounds with WW (formerly Weight Watchers) and then stopped the program. He thought he would continue losing weight on his own. “That clearly didn’t work. Over 10 years I put the 50 pounds back on, plus another 100,” he says. He decided to try WW again.</p><p>He rejoined WW in April 2016. “When I went in the first time and I stepped on the scale I weighed 431 pounds. I knew I was never going to see that number again. My mindset shifted, and I knew I was ready.”</p><p>Gonzales wanted to lose over 100 pounds. But that seemed overwhelming. He set easier, attainable goals to help him move in that direction, like:</p><p>Gonzales likes how with the WW plan, no food is off limits. “You work the plan with how you want to live. With a diet, you’re usually restricted from having things. I knew that was something I couldn’t do long-term,” he says.</p><p>WW allots you a number of points per day, based on your weight and gender. Every food has a point value. “It’s up to you how you go ahead and use those points. Nothing is off limits. If you want a slice of pizza you can have a slice of pizza. Whatever you’re in the mood for is doable,” he says. “I never feel deprived. If I want to go out and have a glass of wine I can. If I want to have a burger I can.”</p><p>WW also includes in-person wellness workshops where members can share ideas and struggles. Gonzales likes how each week’s meeting has a different topic. “They aren’t always weight-related, they’re life-related. That’s something I really like — it’s not about the scale, it’s about every factor in your life,” he says.</p><p>In July 2017, though, Gonzales nearly quit the program. His grandmother passed away, and the loss hit him hard. Then, soon after, his father was diagnosed with brain cancer, and Gonzales quit his job to be by his father’s side.</p><p>Without an income finances were tight, and Gonzales decided to quit WW. He shared his decision on Connect, a part of the WW app where members can interact. He had lost more than 100 pounds at that point, and people in the group encouraged him not to quit.</p><p>Six members of the group, all people Gonzales had never met in person, contributed money to cover the cost of his WW membership for six months. “I’m so grateful to all of them,” he says. “I could have quit and undone everything.”</p><p>Gonzales has lost 160 pounds and he now has a clean bill of health. “I went from type 2 diabetes to prediabetes, and now I’m in the healthy range. My blood pressure is normal and I’m no longer on medication. I’m pill-free and healthy,” he says.</p><p>And he doesn’t have any plans to end his WW membership. “I say now I will be a Weight Watchers member for life, because I know that once you hit your goal it’s not over. You have life after that. It’s something I will always be doing,” he says.</p><p>I went from type 2 diabetes to prediabetes, and now I’m in the healthy range. My blood pressure is normal and I’m no longer on medication. I’m pill-free and healthy.</p><p>Gonzales says he doesn’t have a formal exercise regimen, but he stays busy. “In my former life I was sitting in front of the TV if I wasn’t working. Now I’m not comfortable just sitting in the house. In my free time I’m doing something out somewhere. I’m not so much looking to burn calories as moving in some way,” he says. That movement is more than just a casual stroll around the block—he has run two 5K races in the past year.</p><p>Health struggles weren’t the only problems Gonzales faced because of his weight. He says, “Sitting in a booth in a restaurant was something I was terrified of. ‘Am I going to fit? Should I just ask for a table?’”</p><p>On rollercoasters he faced the same problem. “My biggest fear was being rejected and having to get off in front of everybody. I came close to that happening and I stopped riding for a long time. I was afraid. After losing over 100 pounds I gave it a shot,” he says. He could fit, no problem.</p><p>He says, “I felt fantastic — I felt like a kid again. It’s little things like that — being able to live life again.”</p><p>She says she likes how all foods fit in the WW program. “I admire and appreciate and respect that it’s not overly restrictive. Learning how to treat yourself and enjoy your splurges is a huge part of figuring out your own balance,” she says.</p><p>Learning how to treat yourself and enjoy your splurges is a huge part of figuring out your own balance.</p><p>And she thinks accountability and support play a big part in why people do well maintaining their weight loss on WW. “That’s a really big deal — that’s where people often go astray. They get a little out of control and they throw in the towel,” she says.</p><p>She does note that, from a nutrition point of view, not all foods fit equally. “Points always serve you better when they come from quality, whole-food sources. That’s one piece that often gets overlooked. People often save and reserve points for their favorite foods instead of learning how to replace those foods and eat them less often,” she says. “You can get an equal number of calories from Twizzlers or from salmon, but they are going to serve you differently.”</p><p>She also notes that sometimes people use up all their points at the end of the day, whether they are hungry or not. “That doesn’t always teach you how to listen to your body. There will be days your appetite is heavier and days it is lighter,” she says.</p><p>Still, she supports tools that help people feel better in their bodies and lose weight when they need to. “Eric clearly fell into that camp. If this tool is working, I celebrate that huge success for him,” she says.</p>
ossibly containing pieces of metal have been recalled, according to the U.S. Department of Agriculture.</p><p>The recall of more than 29,000 pounds of frozen, ready-to-eat pork and poultry sausage links products was announced on Monday following several complaints made to the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS).</p><p>No injuries have been reported to the Food Safety and Inspection Service, but five consumer complaints about the product containing metal prompted the recall.</p><p>The USDA said anyone who has the product in their freezer should throw it away or return it to the place where they bought it.</p><p>Kalhan Rosenblatt is a reporter for NBC News, based in New York.</p>
ritten, or redistributed. ©2018 FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes. </p><p>Surgeons in India posed for a celebratory selfie after successfully separating 3-day-old conjoined twins in a painstaking operation.</p><p>The baby girls - which are yet to be named - had a combined weight of just 7lbs and were joined at the tummy.</p><p>Doctors said the pair's parents were anxious about separating them - but thankfully doctors managed to convince them it was for the best.</p><p>A five-hour op saw the medics anesthetize them both at the exact same time, before separating their breastbones and livers.</p><p>The surgeons at S S Hospital in Varanasi, Uttar Pradesh, India, performed the procedure for free because the parents were not able to pay.</p><p>The medics took a photo with the two babies on the operating table to celebrate the op which was tricky due to their tiny blood supply.</p><p>"It was one of the rarest operations our hospital does," Dr. Vaibhav Pandey, assistant professor of pediatric surgery, said. "I am very happy that both survived in spite of the long operation and the children being weak. It was a challenging task."</p><p>The operation took place on Dec. 6 and was performed by a team of five surgeons, ten doctors, and 15 nurses.</p><p>The babies, who were dehydrated before the operation, are due to be discharged from hospital later this week and are doing well, the hospital said.</p><p>They will be named during traditional rituals performed when they get home, it was said.</p><p>This material may not be published, broadcast, rewritten, or redistributed. ©2018 FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes.</p>
d following a pain-staking operation to separate conjoined twins. </p><p>The baby girls - who were three days old at the time of the procedure - weighed just 7lbs between them and were joined at the stomach.</p><p>Doctors in India managed to convince the unnamed pair's parents that separation surgery was the best option, despite their fears.</p><p>The baby girls - who were three days old at the time of the procedure - weighed just 7lbs between them and were joined at the stomach (pictured: the selfie after the operation, with Dr Vaibhav Pandey, who led the surgery, at the front)</p><p>Doctors in India managed to convince the unnamed pair's parents that separation surgery was the best option, despite their fears (pictured before surgery)</p><p>A 'challenging' five-hour operation proved a success, and the two girls are expected to be allowed home later this week.</p><p>The surgeons in Varanasi, Uttar Pradesh - 186 miles (300km) south east of Lucknow - performed the procedure for free because the parents were not able to pay.</p><p>Dr Vaibhav Pandey, assistant professor of paediatric surgery at S S Hospital, said: 'It was one of the rarest operations our hospital does.</p><p>'I am very happy that both survived in spite of the long operation and the children being weak. It was a challenging task.'</p><p>The operation took place on December 6 and was performed by a team of five surgeons, ten doctors and 15 nurses.</p><p>They took a photo with the two girls still on the operating table to celebrate the operation, which was tricky due to their tiny blood supply. </p><p>A 'challenging' five-hour operation proved a success, and the two girls are expected to be allowed home later this week (pictured before the surgery)</p><p>The surgeons in Varanasi, Uttar Pradesh - 186 miles (300km) south east of Lucknow - performed the procedure for free (pictured after surgery)</p><p>Pictured: A medical scan shows how the twins were conjoined before the mammoth surgery</p><p>The operation took place on December 6 and was performed by a team of five surgeons, ten doctors and 15 nurses (pictured, the stomachs of the baby girls after the surgery)</p><p>The girls, who are said to be doing well, will be named during traditional rituals performed when they get home (pictured before surgery)</p><p>The girls, who are said to be doing well, will be named during traditional rituals performed when they get home.</p><p>Medical literature states conjoined twins develop when a woman produces just one egg that doesn't fully separate after being fertilised.</p><p>The developing embryo then begins to split into identical twins during the first few weeks but stops before the process is complete.</p><p>Births of conjoined twins, whose skin and internal organs are fused together, are rare. They are believed to occur just once in every 200,000 live births.</p><p>Approximately 40 to 60 per cent of conjoined twins arrive stillborn, and about 35 per cent survive only one day.</p><p>The overall survival rate of conjoined twins is somewhere between five per cent and 25 per cent.</p><p>For some reason, female siblings seem to have a better shot at survival than their male counterparts.</p><p>Although more male twins conjoin in the womb than female twins, females are three times as likely as males to be born alive. </p><p>Medical literature states conjoined twins develop when a woman produces just one egg that doesn't fully separate after being fertilised (pictured, a scan shows how the twins were joined together before the operation)</p><p>Births of conjoined twins, whose skin and internal organs are fused together, are rare. They are believed to occur just once in every 200,000 live births (pictured, another scans shows how the twins were joined together at the stomach)</p><p>Conjoined twins occur when siblings have their skin or internal organs fused together.</p><p>Conjoined twins are caused by a fertilised egg beginning to split into two embryos a few weeks after conception, but the process stops before it is complete.</p><p>The most common type is twins joined at the chest or abdomen.</p><p>Separation surgery success depends on where the twins are joined.</p><p>Doctors can only tell which organs the siblings share, and therefore plan surgery, after they are born. </p><p>At least one twin survives 75 per cent of the time. </p><p>The most famous pair of conjoined twins was Chang and Eng Bunker, who were born in 1811 and travelled with PT Barnum's circus. They were born in Siam and were known as the Siamese twins.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
hing, tummy ache and every other symptom of indigestion you can think of.</p><p>There are many factors involved in digestion, says clinical nutritionist Marta Anhelush, from Stratford-upon-Avon, Warwickshire.</p><p>Drinking too much with your meals can dilute digestive juices, and decrease stomach acidity vital for properly digesting food, says nutritionist Marta Anhelush</p><p>Ms Anhelush said: 'Our stomach acid is absolutely vital to aid proper digestion, especially when it comes to protein rich foods such as meat or fish, which some people find hard to digest.</p><p>'Unfortunately, the popular view is that we often have high levels of stomach acid, leading to indigestion, where in most cases it is actually the opposite.</p><p>'Drinking too much with your meals is also quite common and makes things worse by diluting all the digestive juices.'</p><p>Ms Anhelush said: 'Bitter foods such as rocket, watercress, chicory, turmeric or artichoke, and dandelion and burdock in supplements, can stimulate the production of digestive juices, including bile to help you digest and absorb fats.'</p><p>If you have the small problem of not being able to stomach bitter foods, one study suggests the solution is to, well, eat more bitter foods. Then your tastes might change.</p><p>Research in August from The American Chemical Society asked participants to eat bitter foods three times a day for a week and rate their bitterness and astringency. </p><p>Over the course of week, their bitterness and astringency ratings for the same foods reduced, and they rated them as more palatable. </p><p>Our modern, busy lifestyles mean that we often have little time to cook a meal from scratch, let alone sit at a table and eat it in peace, without any distractions, Ms Anhelush explained. </p><p>Instead, we often eat on our way to work, in front of our computers or televisions.</p><p>This sends the wrong messages to your brain, so rather than producing digestive juices, enzymes or bile and stimulating contractions of the digestive tract, your body is producing stress hormones and increasing brain activity to process the information coming from your surroundings.</p><p>Ms Anhelush said: 'As a result, we end up not only with indigestion, but also other symptoms such as bloating, distension or flatulence.'</p><p>'Before you start your meal, take a couple of deep breaths, then really think about what's on your plate; what does it look like; what does it smell like – involve all the senses,' Ms Anhelush said. </p><p>'That will send messages to your brain that the food is on its way, which will kick start your digestion, while helping you feel more satiated sooner.'</p><p>The amount of sugar a person should eat in a day depends on how old they are.</p><p>Children aged four to six years old should be limited to a maximum of 19 grams per day.</p><p>Seven to 10-year-olds should have no more than 24 grams, and children aged 11 and over should have 30g or less. </p><p>Popular snacks contain a surprising amount of sugar and even a single can of Coca Cola (35g of sugar) or one Mars bar (33g) contains more than the maximum amount of sugar a child should have over a whole day. </p><p>A bowl of Frosties contains 24g of sugar, meaning a 10-year-old who has Frosties for breakfast has probably reached their limit for the day before they even leave the house. </p><p>Children who eat too much sugar risk damaging their teeth, putting on fat and becoming overweight, and getting type 2 diabetes which increases the risk of heart disease and cancer.</p><p>Eating too many sugary and refined carbohydrate rich foods such as sweets, pasta, potatoes and processed foods feeds the unfavourable bacteria in our stomachs.</p><p>Ms Anhelush said: 'These bacteria ferment the food in the small intestines producing a lot of gas. </p><p>'The gas creates a lot of pressure in the intestine and this leads to stomach contents refluxing into the oesophagus causing irritation to the oesophageal lining, burning and pain.'</p><p>Ms Anhelush said: 'If you suffer from any digestive discomfort like indigestion, it is very likely that you may have an imbalance in your gut bacteria.</p><p>'In order to improve digestion in the long term, taking a high strength probiotic can re-balance the gut.</p><p>'Beneficial bacteria help you to digest and absorb nutrients, while also supporting bowel movements and immunity.'</p><p>Research from Japan published in November last year found that giving patients with indigestion probiotic-rich yoghurt could help alleviate indigestion.</p><p>If you're opting for a supplement, 'Look out for a product from a reputable brand that use human-strain, acid resistant bacteria that have been thoroughly researched,' said Ms Anhelush.</p><p>'Good strains include Lactobacillus acidophilus, bifodobacterium bifidum or Bifidobacterium lactis. The dose matters too, so make sure you get a product with at least 10 billion of bacteria,' she said. </p><p>Going to bed soon after eating can leave food undigested, especially as the body focuses on repairing damaged tissue at night, or processing emotions in the brain, Ms Anhelush said</p><p>'All of our organs have a daily pattern, including the digestive tract, which tends to be more active during the day,' said Ms Anhelush.</p><p>'At night, our body needs to recuperate, repair damaged tissue; our brain needs to process all the information and emotions from the day before, which means there is no time for digestion.</p><p>'If we eat late and go to bed soon after, that food is likely to be sitting in the stomach and not being digested well, causing indigestion.'</p><p>A study published in The Journal of Gastroenterology found that those who had their dinner three hours or less before bed were more likely to suffer with acid reflux than those who left fours hours or more between their last meal and going to bed.</p><p>Instead, try a tea that could help digestion. Ms Anhelush said: 'Good combinations for digestion include fennel, cardamom, chamomile, ginger, burdock or peppermint. </p><p>'Make sure you get a good quality and organic tea. If you have digestive symptoms, I would recommend to brew two teabags to get a more therapeutic effect.' </p><p>Digestion is a really long and demanding process which means it can take even up to eight hours for your whole meal to move from the stomach to the large intestines, depending on the type and quantity of the food.</p><p>'If you feel that the pain is worse on an empty stomach and improves after eating, it may be a sign of something more serious like ulcers and should be checked with your doctor.'</p><p>Digestion is a demanding process for the body, and meals can take up to eight hours to be moved from the stomach to large intestines, Ms Anhelush said as she warned against snacking</p><p>'If you are eating lunch at your desk, in a busy office, and talking about tasks, deadlines and other things that may stress you out, it will make your indigestion worse,' said Ms Anhelush.</p><p>'On the other hand, if you are eating at a table, with your friends or family, feeling relaxed and eating slowly whilst having a nice conversation, it is a completely different scenario.</p><p>'Eating is, and has always been a social activity, so as long as we are eating mindfully and enjoying our food, I would encourage having company.'</p><p>You've probably heard this a thousand times before, but don't worry - we're not going to tell you to chew everything 50 times.</p><p>'Generally rich foods that are high in protein, carbohydrates and sugars are more likely to cause indigestion,' Ms Anhelush said. </p><p>'Christmas dinner is a perfect example of overindulgence in plenty of rich foods – processed meats, chocolates, dairy and gluten heavy foods are often culprits of digestive symptoms.'</p><p>Other foods that can cause or indigestion for some people include tea and coffee, hot spices, chocolate, tomatoes and citrus fruits can also aggravate symptoms.</p><p>'Digestive enzymes taken with meals can work really quickly, speeding up digestion and reducing uncomfortable symptoms. </p><p>'Look out for a good quality supplement that contains a range of enzymes that help digest proteins fats and carbohydrates including bromelain, lipase and amylase. </p><p>'Also herbs such as peppermint, liquorice and ginger are very soothing and can have a calming effect if your indigestion manifests as an irritated tummy.</p><p>'Having reflux can also irritate the delicate tissue if your oesophagus so using a soothing and healing herbs in a liquid or a powder that can be mixed into a drink can be really beneficial.</p><p>'The best herbs to include are slippery elm, licorice, marshmallow and aloe vera. They help to coat the digestive tract, providing a protective layer, hence reducing irritation,' Ms Anhelush said. </p><p>Yeast and gluten-based alcohols such as beer and cider can be strenuous on the digestive system, as well as the sulphites in red wine, Ms Anhelush said </p><p>Alcohol that is high in sugars such as cocktails and flavoured wines, may aggravate or cause indigestion, Ms Anhelush said.</p><p>'Yeast and gluten-based alcohols such as beer and cider as well as alcohol high in sulphites such as red wine can also be strenuous on the digestive system and our detoxification pathways.'</p><p>Ms Anhelush said: 'Keep hydrated if you do drink alcohol and arm yourself with a nutrient dense meal beforehand full of dark green leafy vegetables and high-quality protein such as organic chicken or wild fish.'</p><p>You could also trying gently detoxing your body throughout the Christmas period. 'This can reduce your chances of weight gain and feeling generally fatigued and run down,' Ms Anhelush said. </p><p>'Green vegetables and fruits really are your friend at this time as they are packed full of nutrients and support the detoxification process of rich food and alcohol from your body.'</p><p>Smoothies made with kale, spinach, broccoli, and apples can be a great way to ensure your body is getting the nutrients it needs.</p><p>Ms Anhelush said: 'As it is winter time, you can also put green vegetables into a soup for lunch or dinner, adding in herbs such as coriander, which is highly detoxifying and full of plant chemicals.'</p><p>It's also worth nothing that studies have found that medicines often taken for indigestion may have an adverse effect on blood alcohol levels when you're taking them with alcohol, so talk to your doctor if you're on them. </p><p>In the study by the university of Birmingham and Loughborough, participants in the group who were asked to weight themselves twice a week were given a list of roughly how much physical activity would be needed to burn off approximate calories found in popular food and drinks consumed at Christmas.</p><p>1. Try to eat roughly the same time each day, whether this is two or five times a day. </p><p>2. Chose reduced fat foods (e.g. dairy foods, spreads, salad dressings) where you can. Use high fat food sparingly (e.g. butter and oils) if at all.</p><p>3. Walk 10,000 steps each day (equivalent to 60-90 minutes moderate activity). </p><p>4. If you snack, choose a healthy option such as fresh fruit or low calorie yogurts instead of chocolate or crisps.</p><p>5. Be careful about food claims on labels. Check the fat and sugar on labels when shopping and preparing food. </p><p>6. Do not heap food on your plate, except vegetables. Think twice before having second helpings.</p><p>7. Break up your sitting time. Stand up for ten minutes of every hour.</p><p>8. Think about your drinks. Choose water or sugar free squashes. Unsweetened fruit juice contains natural sugar so limit to one glass a day (200ml). Alcohol is high in calories so limit to one unit per day for women and two for men. Try diluting drinks with water, soda or low calorie mixers.</p><p>9. Slow down. Do not eat on the go or while watching TV. Eat at a table if possible. </p><p>10. Eat at least five portions of fruit and vegetables a day (400g in total). </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
f dementia, research suggests.</p><p>Two compounds, including caffeine, in the pick-me-up work together to prevent the accumulation of a toxic protein in the brains of mice. </p><p>This protein, known as alpha-synuclein, is associated with both Parkinson's and dementia with lewy bodies (DLB). </p><p>Tests on rodents genetically at risk of both diseases showed the combination of caffeine and the compound EHT prevented alpha-synuclein from building-up after just six months. </p><p>The scientists now hope caffeine and EHT could be combined into a drug to help treat Parkinson's and DLB in humans, which are both incurable.</p><p>Coffee could combat Parkinson's disease and a form of dementia, research suggests (stock)</p><p>The research was carried out by Rutgers University and led by neurologist Dr M Maral Mouradian.</p><p>Nearly one million Americans are expected to be diagnosed with Parkinson's by 2020, according to figures. Around 145,500 have been diagnosed in the UK.</p><p>PD is a neurodegenerative disorder that mainly affects the dopamine-producing brain networks in the substantia nigra. </p><p>Symptoms include shaking, stiffness, and difficulty walking, balancing and coordinating. </p><p>Dementia with Lewy Bodies (DLB) is a type of dementia that shares symptoms with both Parkinson's and Alzheimer's. It occurs when alpha-synuclein appears in nerve cells in the brain.</p><p>Alpha-synuclein's function in a healthy brain is unclear. When it clumps, it can lead to cell death, which is associated with both PD and DLB. </p><p>Treatments for both diseases focus on reducing the protein's gene expression and blocking its aggregation. </p><p>DLB affects around 1.3million in the US, according to the Lewy Body Dementia Association. And it makes up between 10 and 15 per cent of all 850,000 dementia cases in the UK, Alzheimer's Society states. </p><p>Parkinson’s disease affects one in 500 people, and around 127,000 people in the UK live with the condition.</p><p>Figures also suggest one million Americans also suffer.</p><p>It causes muscle stiffness, slowness of movement, tremors, sleep disturbance, chronic fatigue, an impaired quality of life and can lead to severe disability.</p><p>It is a progressive neurological condition that destroys cells in the part of the brain that controls movement.</p><p>Sufferers are known to have diminished supplies of dopamine because nerve cells that make it have died.</p><p>There is currently no cure and no way of stopping the progression of the disease, but hundreds of scientific trials are underway to try and change that. </p><p>The disease claimed the life of boxing legend Muhammad Ali in 2016.</p><p>The researchers analysed newborn mice who expressed a gene that caused alpha-synuclein to aggregate in their brain. </p><p>The rodents were given either 50mg/kg of caffeine, 12mg/kg of EHT or a combination of the two mixed in their food or water every day for six months. </p><p>Tests were then carried out to assess the animals' motor, learning and memory skills, which reflects activity in different parts of the brain.</p><p>When given alone, neither caffeine nor EHT had any effect. But the mice who took the two compounds together had higher test scores.</p><p>The rodents were then euthanised and their brains examined. This revealed EHT and caffeine together boosted the activity of the protein PP2A, which prevented the accumulation of alpha-synuclein clumps.</p><p>The compound coupling also led to reduced brain inflammation, which is a hallmark of PD. </p><p>The study was published in the Proceedings of the National Academy of Sciences.</p><p>EHT is found in a coffee bean's waxy coating and is unrelated to caffeine. A derivative of the 'happy hormone' serotonin, it has been found to have antioxidant and anti-inflammatory properties in past studies.</p><p>Dr Mouradian stressed further studies are required to determine the correct ratios of caffeine and EHT to help protect people from PD and DLB. </p><p>'EHT is a compound found in various types of coffee but the amount varies,' she said. </p><p>'It is important that the appropriate amount and ratio be determined so people don't over-caffeinate themselves, as that can have negative health consequences.' </p><p>Caffeine has previously been found to preserve brain health, with the role of coffee's thousands of other compounds being less clear until now. </p><p>Lewy body dementia (LBD) is the second most common form of degenerative dementia after Alzheimer's.</p><p>It is the form Robin Williams was diagnosed with before he took his own life in 2014.</p><p>Unlike Alzheimer's, LBD affects the brain regions responsible for vision - as opposed to memory.</p><p>That means sufferers may start with memory loss, but over time the more debilitating symptoms will be powerful hallucinations, nightmares and spatial-awareness problems.</p><p>LBD is closely connected to Parkinson's disease, meaning that many sufferers will develop Parkinson's as well - as happened to Robin Williams.</p><p>Many sufferers will first develop Parkinson's, suffering physical disabilities, before doctors diagnose their dementia. That is what happened to the late revered actor Robin Williams.</p><p>Some will start with memory loss that could be mistaken for the more common Alzheimer's disease. Over time, they will develop symptoms more clearly associated with LBD.</p><p>There is no known cause. What we do know is that risk increases with age.</p><p>At a cellular level, LBD is characterized by tiny clumps of abnormal proteins produced by the brain when its cells are not working properly.</p><p>They cause memory problems, although these don’t tend to be as severe as with Alzheimer’s — which is linked to a build-up of the protein beta-amyloid.</p><p>Another key difference is that Lewy body dementia affects regions of the brain responsible for vision, causing powerful hallucinations, nightmares and spatial-awareness problems.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
new research.</p><p>Regular consumption of red meat can raise levels of a cardiovascular disease causing chemical more than 10 times, suggests the study.</p><p>The organic compound - known as TMAO (trimethylamine N-oxide) - is produced in the gut during digestion.</p><p>High levels have been associated with increasing the risk of strokes, heart attacks and premature death.</p><p>Now the first study of its kind has shown they rose an average threefold among participants put on a red meat diet - in only a month.</p><p>Red meat elevates levels of TMAO which has been linked to the development of hardening of the arteries - or atherosclerosis - and heart disease complications</p><p>In some cases they soared ten-fold compared to those eating chicken or vegetarian based meals.</p><p>Dr Stanley Hazen, director of the Cleveland Clinic Center for Microbiome and Human Health, said: 'This is the first study of our knowledge to show the kidneys can change how effectively they expel different compounds depending on the diet that one eats - other than salts and water.</p><p>'We know lifestyle factors are critical for cardiovascular health and these findings build upon our previous research on TMAO's link with heart disease.</p><p>'They provide further evidence for how dietary interventions may be an effective treatment strategy to reduce TMAO levels and lower subsequent risk of heart disease.'</p><p>It's produced when gut bacteria digest choline, lecithin and carnitine - nutrients abundant in animal products such as red meat and liver.</p><p>The study, published in the European Heart Journal, was based on blood and urine samples taken from 113 people.</p><p>They were provided with the three different meal plans in random order where red meat, white meat or vegetables provided 25 percent of their protein intake.</p><p>After they stopped the red meat diet, TMAO levels subsided over the following month.</p><p>The US team was surprised to discover the choice of diets changed the effectiveness of the kidneys to expel compounds.</p><p>Dr Hazen said red meat elevates levels of TMAO which has been linked to the development of hardening of the arteries - or atherosclerosis - and heart disease complications.</p><p>His earlier work has led to TMAO testing now being in clinical use around the world to measure cardiovascular disease risk.</p><p>Meanwhile another study by the same team, published in the Journal of Clinical Investigation, showed cardiovascular disease could be prevented by targeting a gut microbial pathway that converts carnitine into TMAO.</p><p>Carnitine - also used in energy drinks and supplements - can induce TMAO production even for vegans and vegetarians who continue eating their normal diets.</p><p>It follows the design of a potential new class of drugs earlier this year for prevention of heart disease and clotting by interrupting the microbial pathway by which choline is converted into TMAO.</p><p>Dr Hazen and colleagues compared the impact of daily carnitine pills on meat eaters with vegetarians.</p><p>The latter showed limited ability to produce TMAO from carnitine while the former did so rapidly.</p><p>After one month of supplementation, both groups showed an increased capacity to produce TMAO.</p><p>Dr Hazen said: 'It is remarkable that vegans and vegetarians can barely make TMAO from dietary carnitine.</p><p>'The striking new finding about the pathway induced by ingesting carnitine - even if only provided as a supplement in a capsule form - provides important insights about new interventions to inhibit TMAO, which may help reduce risks for cardiovascular disease,</p><p>'By uncovering this new pathway, we can potentially develop new treatments to interrupt this process before both the development and progression of cardiovascular disease.'</p><p>Heart disease is the biggest killer in every country in the world.</p><p>Red meat – such as beef, lamb and pork – is a good source of protein, vitamins and minerals, and can form part of a balanced diet.</p><p>But eating a lot of red and processed meat probably increases your risk of bowel cancer.</p><p>It's recommended people who eat more than 90g (cooked weight) of red and processed meat - which includes bacon and sausages - per day cut down to 70g.</p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
oes not slow mental decline in old age, researchers have found.</p><p>But the activities do boost mental ability, so when the brain does start deteriorating there is a 'higher cognitive point' from which to decline.</p><p>Experts have long believed in the neurological theory of 'use it or lose it' - which suggests people who have complex jobs or do intellectual puzzles that tax the brain are protected against mental decline.</p><p>Puzzles such as crosswords or Sudoku do not slow the rate of cognitive decline, but create a 'higher cognitive point' from which decline can start from, a study found</p><p>They believed that exercising the brain throughout a lifetime slows the speed at which the brain deteriorates in old age.</p><p>Now, however, scientists from the University of Aberdeen have found this is not quite the case.</p><p>The team recruited 498 people at the age of 64 and tracked them for the next 15 years, monitoring their mental abilities throughout the period.</p><p>They found those who had engaged in intellectually stimulating activities on a regular basis had higher mental ability at the start of the study - but there was no difference in the speed at which they declined over the next 15 years.</p><p>The scientists, writing in the British Medical Journal, said: 'These results indicate that engagement in problem solving does not protect an individual from decline, but imparts a higher starting point from which decline is observed and offsets the point at which impairment becomes significant.'</p><p>The team said this supports the theory of 'cognitive reserve' - the ability that some people have to maintain their memory and IQ despite the impact of ageing.</p><p>This is because regularly using the brain for complex tasks creates a greater number of connections between brain cells.</p><p>So when the wiring of the brain starts the break down with age, or if dementia starts to attack, the brain has 'backup' networks to use instead.</p><p>The scientists wrote: 'This association suggests that engagement adds to an individual's cognitive reserve - that is, individuals who engage in regular problem solving activities might require greater age related neuropathological burdens before clinical thresholds of impairment are crossed and symptoms of cognitive decline are reported.' </p><p>Scientists have unveiled diet and lifestyle tips that maintain brain health in old age. </p><p>According to researchers from around the world 'what's good for the heart is good for the brain'.</p><p>They add that no single food acts as a 'silver bullet' for improving or maintaining brain health.</p><p>The experts have put together the following diet and lifestyle advice to help people preserve their brain health as they age.</p><p>Eating plenty of berries helps maintain people's brain health as they get older</p><p>Eleven researchers from the Global Council on Brain Health, including experts from the University of Exeter, met on September 12-to-13 2017 to discuss the impact of diet on the brain health of adults over 50. </p><p>Their recommendations are based on the evaluation of studies investigating the impact of nutrients on the cognitive function of older adults. </p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
lled the haunting flashbacks and anxiety of a Holocaust survivor who developed Alzheimer's, his family claims. </p><p>Alexander Spier spent three years in concentration camps, including Auschwitz-Birkenau and Bergen-Belsen, before he was freed in the liberation of 1945.</p><p>As soon as he was freed he reclaimed his life, emigrating to the US that same year, where he met his wife Sonja, they had a son and a daughter, and he worked hard, first as a jeweler and watchmaker, then heading up his own real estate business. </p><p>Tragically, in 2010, he was diagnosed with the age-related brain disease that consumed him for seven years until he passed away.</p><p>His relatives recall the trauma of watching him relive his war-era memories, shouting in Dutch and German: 'Where is my mother?' </p><p>But according to his son, Greg Spier, they managed to offer him one small piece of respite in the form of granola bars laced with cannabis, which they say eased his agitation and allowed him to sleep. </p><p>Spier passed away in 2017, and now the Spier Family Foundation is partnering with Harvard's McLean Psychiatric Hospital and paying for marijuana research in hopes of shedding fresh light on Alzheimer's and potentially offering better treatments. </p><p>Alexander Spier, of Foxborough, Massachusetts, was diagnosed with Alzheimer's disease almost 10 years ago. No long-term care or antipsychotic drugs helped his symptoms of disorientation and changes in mood and behavior. Pictured, Spier, right, with his son Greg</p><p>His family says his agitation subsided and he was able to sleep when he would eat granola bars laced with cannabis. Pictured, left to right: Spier's son Greg, his wife Sonja, Spier, and his daughter-in-law Kathryn in 2013</p><p>Spier grew up in Amsterdam, Holland, and was a member of the Dutch resistance during the Nazi occupation of the Netherlands during World War II.</p><p>He was just 15 years old when he was captured in 1941 by Nazi troops.</p><p>Spier was tattooed with the identification number 164023 and spent the next three years in three different concentration camps before he was freed during the 1945 liberation. </p><p>He emigrated to the US at the end of World War II where he worked as a watchmaker and jeweler before starting a real estate company.</p><p>He met his wife Sonja in 1951 and they married after just 82 days of knowing each other. The couple moved to Foxborugh, Massachusetts, where they raised a son and a daughter.</p><p>Around 2010, Spier was diagnosed with Alzheimer's disease. </p><p>An estimated 5.7 million Americans of all ages are living with Alzheimer's disease in 2018.</p><p>Sufferers experience a decline in cognitive, behavioral and physical abilities and there is no cure.</p><p>According to Spier's son, Greg, his fathers declined rapidly in health for the final two years of his life. </p><p>'My father spoke five languages, and he was speaking Dutch and German, reliving the three concentration camps he survived.'</p><p>Greg says during those final two years, Spier would often plead in German: 'Where is my mother?'</p><p>About 50 percent of Alzheimer's patients develop what are known as neuropsychiatric symptoms, which include agitation, aggression and disorientation.</p><p>As his symptoms worsened, Spier was moved into a memory program in Florida, which is a form of long-term care that is designed to meet the specific needs of a person with Alzheimer's disease or dementia.</p><p>Doctors tried to treat him with antipsychotic and anti-seizure medications, but they only worsened his symptoms.</p><p>Greg told ABC News that he and a niece that lives in Colorado were the family members who decided to try marijuana edibles as a final resort.</p><p>Greg or the private assistant living with Spier would feed him cannabis granola bars up to four times a day during the final months of his life. </p><p>'The only thing that seemed to give him any reprieve was the marijuana,' Greg told ABC, saying the bars also helped his father sleep. </p><p>Spier died in September 2017 from Alzheimer's complications, and now the Spier Family Foundation is pushing for research on potential benefits of marijuana in Alzheimer's and dementia patients.</p><p>There has not been a great deal of research done on the effects of cannabis in Alzheimer's patients, but a few studies have showed promising findings.</p><p>THC is the psychoactive compound responsible for the euphoric, 'high' feeling often associated with marijuana.</p><p>Compared to the mice not treated with THC, mice that were treated had fewer lost brain cells, performed better on memory tests, and had 20 percent less of the plaques in the brain that are believed to cause cognitive decline. </p><p>Some studies conducted on mice showed that when the rodents were treated with THC, they performed better on memory tests and had fewer plaques in the brain that are believed to cause cognitive decline. Pictured: Spier in 2014</p><p>The Spier Family Foundation is partnering with Harvard's McLean Psychiatric Hospital and paying for marijuana research in hopes of shedding fresh light on Alzheimer's and potentially offering better treatments. Pictured: Spier in 2017</p><p>While several studies have linked cannabis use to long-term damage in teenage brains, Dr Brent Forester, chief of the division of geriatric psychiatry at McLean Hospital in Boston, said the same effects may not be true for people who begin in old age.</p><p>When they tested the mice in learning capacity and memory, results were just as good as those of two-month old mice. </p><p>Dr Forester and his team have partnered with the Spier family to conduct research on cannabis treatments in Alzheimer's patients. </p><p>They previously published a study in 2014 where they gave the synthetic THC drug dronabinol to patients diagnosed with dementia.</p><p>Results showed that the patients' agitation and sleep duration were improved, and they're now recruiting for a larger trial that will be funded by the National Institute on Aging. </p><p>'We really need to open up opportunities to study medical marijuana for this particular indication,' Dr Forester told ABC News.</p><p>'I think there's enough evidence from the synthetic THC as well as anecdotal reports that it's certainly worth studying.' </p><p>Last week, Minnesota joined 12 states and Washington, DC that allow residents to be prescribed medical marijuana either for Alzheimer’s or related symptoms.</p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
cently revealed enviably toned arms on the red carpet. </p><p>However, her impressive figure is no accident - in fact, the 35-year-old actress puts in serious training for her roles. </p><p>Looking good! Lupita Nyong’o recently revealed enviably toned arms on the red carpet</p><p>On preparing for Black Panther, she said: ‘We had six weeks of boot camp before filming. It started off with four hours a day, which was exhausting.’</p><p>So how can you replicate her look? Here, we reveal the best exercises to get her sculpted arms. </p><p>- A raised push-up is good for arms. Position your hands on the floor over shoulder-width apart and in line with your chest. </p><p>- Raise your feet behind you onto a step or sofa. Engage stomach muscles. Bend arms to lower yourself towards the floor — your nose should almost touch the ground.</p><p>- Straighten the elbows and raise yourself back to the start position. </p><p>- Repeat to exhaustion and rest for 45 seconds. Perform four sets.</p><p>Treading the red carpet: The acclaimed 35-year-old star puts in serious training for her roles</p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>