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Conversation 9 May 2018

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Italians to wake up and smell Starbucks coffee in Milan

A historic building on one of Milan’s grandiose squares has been chosen by Starbucks for its first foray into the home of the espresso.

The US coffee chain’s entry into the Italian market, where coffee is deeply ingrained in the national culture, has endured setbacks and delays since it was first suggested more than two years ago. However, Starbucks’ executive chairman, Howard Schultz, confirmed at a conference in Milan that the opening would go ahead in September.

The company has opted for a high-end address – a former post office in Piazza Cordusio, near the Duomo.

Coffee lovers have got in a froth in recent years over the interminable speculation about Starbucks’ introduction into Italy, where an espresso or cappuccino can taste very different to the chain’s offerings, but there were supportive voices on Tuesday.

Paolo Nadalet, the president of the Italian Espresso National Institute, said: “We are really happy that a large company like Starbucks is coming to Italy, because we think that the coffee it serves is not like an Italian espresso but is still coffee that tastes good.

“And Milan is the right place to start: it’s close to fashion and other Italian ways of living, and for us, coffee is a way to live. Starbucks is doing its own job with its own philosophy, but it’s still very close to our culture in ensuring that its consumers have good coffee in their cups.”

Schultz reassured consumers that the company was coming to Italy “with humility and respect, to show what we have learned”.

Speaking in Milan on Monday, he said his vision for Starbucks came about during a visit to Italy in 1983. “My imagination was captured by Italian coffee.”

Starbucks was able to clinch the deal in Italy with the help of Antonio Percassi, a former footballer and entrepreneur who was responsible for bringing the Spanish clothing chain Zara and the US lingerie retailer Victoria’s Secret to Italy.

More stores were in the pipeline, although the company had yet to decide how many.

Starbucks would compete with several bars that had been serving coffee for years on Piazza Cordusio and nearby, but Nadalet said he did not believe it would dent the local business.

“We have to increase our knowledge in coffee and I think Starbucks can help all other bars to improve on both service and taste,” he said. “Big chains are using our coffee machines worldwide, so this could be a big moment for the Italian market. Foreign companies want to open in Italy and we have to let them.”

The Italian catering industry group Fipe said bars in Italy served 6bn espressos a year, generating turnover of €6.6bn (£5.8bn).

The Milan store was most likely to appeal to tourists or those looking for free wifi and a sofa – two things not usually available in a traditional Italian bar.

About 5,000 people had reportedly applied for the 150 jobs available.

Five women said to be in running to become Italy’s transitional PM

Five women are among the names floated to lead a transitional government in Italy in what some speculate could be President Sergio Mattarella’s attempt to break with tradition while the country’s politics are mired in stalemate.

Mattarella is seeking a neutral government after rival parties failed to establish a working coalition during a last-ditch attempt on Monday to end the political deadlock that resulted from inconclusive elections on 4 March.

The 76-year-old is expected to name a prime minister on Wednesday to deal with matters such as approving the 2019 budget before fresh elections are held at the end of the year.

Names mentioned in the Italian media on Tuesday included Elisabetta Belloni, the foreign ministry’s secretary general, and Marta Cartabia, the deputy head of the constitutional court.

There is also speculation that Lucrezia Reichlin, an economist, Anna Maria Tarantola, a former director of the Bank of Italy and former president of the national broadcaster Rai, and Fabiola Gianotti, the first female director of the European Organisation for Nuclear Research (CERN), are in the running.

Carlo Cottarelli, a former executive director at the International Monetary Fund, is among the male candidates named.

“[Nominating a woman] could really be a window of opportunity for [Mattarella] to try and change some traditions and conventions during a really extraordinary moment in Italian politics,” said Massimiliano Panarari, a politics professor at the Guido Carli Free International University for Social Studies in Rome.

“It is a way to appeal to public opinion. The majority of the Italian population is female, but until now this hasn’t corresponded with representation in the political system. So I think there is an idea – not PR, as that would be too cheap – to enlarge representation while providing a sort of exit strategy from the crisis, and one that could change the discourse.”

Italy’s two populist parties, the Five Star Movement (M5S) and Lega, which together secured over 50% of the vote in the March elections, have called for snap elections, which could scupper Mattarella’s plan.

After his nominee is sworn into office he or she will face a parliamentary vote of confidence, which would be likely to take place next week. Only the centre-left Democratic party backs Mattarella’s plan for a technocratic government, and if the selected premier fails the confidence vote, then Mattarella would need to dissolve parliament with elections to follow.

Luigi Di Maio, the leader of M5S, which emerged as the biggest single party in March with 33% of the vote, and Matteo Salvini, the leader of the far-right Lega which was the winner within a centre-right coalition that secured 37%, are calling for elections as early as 8 July. A summer vote would be unprecedented for Italy.

“Proposing elections on 8 July would be a nightmare,” said Catia Polidori, an MP with Silvio Berlusconi’s Forza Italia, a partner in the centre-right alliance.

“People won’t vote, they’ll be at the beach. But Italians don’t want a technocratic government. We need to respect their vote. The centre-right alliance got the biggest share and so should be responsible for forming a government.”

Extra time: how smart exercise keeps you younger for longer

Slow down, that used to be the mantra for middle age. The dread half-century reached, fiftysomethings were expected to take up less challenging physical activities – if they were physical at all. A gentle stroll around the golf course, perhaps, rewarded with a gin and tonic at the 19th hole; or membership of the local bowling club, blazered crown green rather than 10-pin.

Physical decline as the body aged was inevitable, something to be grumbled about, accepted and dealt with. That fundamental law has not changed, but the way we manage ageing has. Getting older need not mean getting weaker, at least not until the end is truly nigh.

“Do not go gentle into that good night,” advises Dylan Thomas. “Old age should burn and rave at close of day;/ Rage, rage against the dying of the light.” Thomas raged over a pint pot, but the rage in this case is high-intensity training, bursts of challenging – yes, painful – exercise interspersed with periods of lesser exertion and rest. We should all be doing this in our later years, except for those whose health makes such exertion dangerous.

It is not ageing that causes a decline in fitness; rather, that a decline in fitness causes ageing. This is the simple thesis of Play On: How to Get Better with Age by the American journalist and sports fan Jeff Bercovici.

Passing shot: Roger Federer is still hitting winners at the age of 36. Photograph: Toru Hanai/Reuters

Bercovici, a sometime amateur soccer player, seeks to dispel conventional wisdom about longevity: that life is essentially a dispiriting linear process in which the human machine gradually winds down, clogging here and rusting there before falling into decrepitude. Instead, he argues, we can not only extend our lives by occasionally punishing our bodies but extend our “peak years” of fitness into the autumn and winter of existence. Functionality, rather than a long lifespan, is what matters.

To do this, he examines the lives of sportsmen and women whose fitness regime has allowed them to keep performing at the top level into their 30s. Like Roger Federer, 36, the Swiss tennis player who many would say is the greatest exponent of his sport in history, and Serena Williams, his female opposite number, also 36. Beneficiaries of the latest findings in sports science and medicine, these athletes lead the way on a journey that we can all follow, at whatever level of performance.

As the writer Bill Gifford puts it: ‘Ageing makes us fat, and then our fat makes us age’

The buzz technique that has gained favour is high-intensity interval training (HIIT) in which bursts of intense activity – such as sprinting and cycling – are interspersed with periods of lower-intensity exercise. You know you are at high intensity when muscles burn and you get out of breath. In other words, it hurts.

“Ageing science supports that we should do high intensity every week, getting your heart rate up to at least 80% of its maximum,” says Bercovici. “Even 10 or 20 minutes a week will produce results – that means getting up to the point where it feels unpleasant. It should be a feeling that you can’t keep this up much longer.

“High intensity activates different pathways in your body, with benefits at the cellular level. Together with gentler exercise, it improves overall fitness. The trick is getting the balance: say, 20% high to 80% low.”

Strength training is also important, building muscle and helping to prevent later-life injuries. There is also a neurological benefit from this type of exercise. Instinct tells us that playing bridge and doing the crossword are good for the brain, but workouts also improve cognitive function, although the process is poorly understood.

Sitting back with a cup of tea is not an option if you want to stave off the relentless process that is getting old. Many symptoms of ageing are linked to decreased hormone levels, particularly testosterone. The less testosterone you have, the harder it is to retain and build skeletal muscle (all the muscle that is not part of your circulatory system or digestive tract). Skeletal muscle burns a lot of calories. As you lose skeletal muscle, your metabolism slows, meaning any calories you consume are more likely to end up as fat. And fat secretes the hormone oestrogen and proteins that promote chronic inflammation and insulin resistance.

Keep on running: Jo Pavey after winning the 10,000m at the European Athletics Championships in Zurich in 2014 when she was 40. Photograph: Jean-Christophe Bott/EPA

As the writer Bill Gifford puts it in Spring Chicken, a 2015 tour of anti-ageing science, “Ageing makes us fat, and then our fat makes us age.” It gets worse. After 45, osteoarthritis – painful inflammation of the bones at the joints – becomes much more common. This happens as the cartilage that acts as a shock absorber in those joints, particularly in the knees, wears down and the cells that help it regrow get worse at their job, again for reasons not totally understood.

The shocks that cushion the vertebrae of your spine take a beating, too. By the age of 50, more people than not have at least one bulging intervertebral disk, even if they don’t experience any symptoms. As you exit your 40s, your risk of a herniated disk shrinks. Great – except that it is because the disks themselves are shrinking, which not only predisposes you to new types of pain but explains why you will get a little shorter with each passing decade.

Your nervous system is changing, too. Reaction times are at their best around age 24

Your nervous system is changing, too. Reaction times are at their best around age 24 and become slower from then on. This has to do with the reduced speed at which nerve signals travel. As the protective casings of protein around peripheral nerves degrade, they cannot conduct impulses as efficiently. This is one reason that the simple act of balancing requires more conscious effort in the elderly.

But here’s the good news: most of these major changes can be attenuated, delayed or reversed through frequent and vigorous exercise. Bercovici says it won’t keep your hair dark or stop you needing glasses, but the most pernicious symptoms of ageing – cognitive impairment, muscle wasting, bone thinning, cardiovascular damage – just don’t happen in the same way in people who work out often.

Take Tour de France cyclists: they enjoy an eight-year boost to their lifespans over we couch potatoes. Athletes in endurance sports or sports that demand a mix of endurance and power, such as football or basketball, fare better than pure power athletes, such as weight lifters.

Elite sports performers continue to succeed well past the peak age for their sport, not because they train more but because they train more efficiently. They use periodisation – interweaving intense training with rest – to avoid fatigue and injury. This is something laymen can learn from.

Players in their 30s are now common in first-class tennis, most notably Federer. With 20 grand slam titles to his credit, he is the most fluent and elegant of players, with feet as light as a dancer’s. But nowadays, he doesn’t overdo it. “Federer doesn’t drive himself to the wall,” says Bercovici. “Older athletes like him are no longer striving to be the biggest, strongest or fastest, but the smartest, in using their training to maximum effect. The biggest feature of many modern sportsmen now is how much sleep they get. In America, rest in the middle of a sports season was totally alien 20 years ago, but now it is accepted.”

Hard hitting: Serena Williams in action. Photograph: Sipa USA/Rex/Shutterstock

So pummelling yourself to death for hours on end in the gym need not be the answer. Relatively brief periods of high-intensity interval training, which make allowances for busy work and family lives, can help keep us young, or at least higher functioning older people.

Even Federer is a spring chicken compared with athletes performing well into their forties. British runner Jo Pavey is a home-grown example of increasing longevity in sport. The Devon-based athlete will be just shy of her 45th birthday in August, yet age has not dulled her love of competition. Veteran of five Olympic Games, with two children to care for, she is nevertheless preparing for the 10,000m in that month’s European Athletics Championships in Berlin. In 2014, she won gold in the same event, when she was about to turn 41, becoming the oldest European champion in history. Pavey knows how to pace herself on and off the track, missing this year’s Commonwealth Games in Australia to ensure freshness in the summer. If anyone beats the linear model for ageing, it is her.

“There’s always a next thing to aim for, and something to look forward to,” she says. “The thing is that you get some years when you feel older but when things are going wrong you can be 26 and feel old! You get years when you feel old and others when you feel young again.”

Research suggests 120 is the absolute upper limit for the durability of the human frame

Other female athletes have maintained elite performance into their 40s, such as 42-year-old Uzbek gymnast Oksana Chusovitina, who hopes to compete in her eighth Olympics in 2020. And American road cyclist Kristin Armstrong, 44, who came home with a gold from the time trial in the 2016 Olympics in Rio de Janeiro, her third in that event.

And when age takes its toll, there is always the option of medical science. For example, we are only a decade away from being able to 3D-print replacement cartilage – something Andy Murray could do with. Cartilage is particularly affected by age – about a quarter of all adults over 55 show signs of knee osteoarthritis, the inflammation that occurs when cartilage breaks down.

Nirav Pandya, an orthopaedic surgeon at the University of California at San Francisco, says: “In the young kid you have such good healing potential. But take that person who may have had a couple of injuries in their knee when they played college sports, and now they’re 35 or 40 and it’s just bothering them. The answer before was, ‘Just stop.’ Now, it may be, ‘Let’s grow some cartilage in this area. Let’s see if we can get your body back to when you were 20 through some of the cell and molecular stuff we are doing.’”

In Silicon Valley, where longevity is an obsession, the technological solution is appealing. Tech billionaires are using their wealth to put some distance between themselves and the Grim Reaper. Sergey Brin and Larry Page, the cofounders of Google, have launched a company called Calico (California Life Company) with the mission to “harness advanced technologies to increase our understanding of the biology that controls lifespan”.

But death always enjoys the upper hand. Research suggests 120 is the absolute upper limit for the durability of the human frame, no matter what we do in the gym. Cell mutation over time is what does us in. Judith Campisi, a professor of biogerontology at the Buck Institute in the US, explains that the more biologically complex an organism, the harder it is to extend its life. We can keep roundworms alive for 10 times their normal lifespan. But humans? No.

“Maybe evolution is trying to tell us something,” she says. Most of us need not worry about life at 120, or even 90. Our sedentary lifestyle helps ensure that many of us will depart this earth well before. Public Health England (PHE) says some six million people between 40 and 60 in England are endangering their health by not taking so much as a brisk walk for 10 minutes once a month. But there is always the chance to change. One of the benefits of being a couch potato in youth and early middle-age is the lack of stress damage accrued by serious athletes that can leave some of them old before their time.

“By walking just 10 continuous minutes at a brisk pace every day, an individual can reduce their risk of early death by 15%,” says Professor Muir Gray, adviser to PHE. “They can also prevent or delay the onset of disability and further reduce their risk of serious health conditions, such as diabetes, heart disease, dementia and some cancers.” Emma Stevenson, professor of sport and exercise at Newcastle University’s Institute for Ageing, says it is all about functionality – living well, not just longer. “Age is not a reason not to be doing things,” she says. “That way, we age more quickly. We may be living longer but without good nutrition and exercise we lose functionality – like simply being able to get out of a chair – and that is not good quality of life.”

How to get fit for life

1. Ramp up exercise gradually, preparing your body for the demands you wish to place on it. Walking is a great way to start. Just 10 continuous minutes at a brisk pace every day can reduce the risk of early death by 15%.

2. Aim for 10 or 20 minutes a week of high-intensity exercise – getting your heart rate up to at least 80% of its maximum. This means getting to the point where it feels unpleasant (sweating, raised heart rate, out of breath) and that you can’t keep it up for long.

3. High-intensity interval exercise should be followed by unloading activities, such as stretching and massage. Time-pressured people are tempted to extend exercise during a visit to the gym and skip stretching. Bad idea.

4. Keep to a 20:80 ratio for high:low intensity exercise. Also aim for some strength training (push-ups, squats, resistance bands) to build muscle and help to prevent later-life injuries, like those to the hip.

5. Avoid fads and eat a generally healthy diet, with plenty of vegetables and whole grains. Protein builds muscle and creatine powder in a glass of milk helps build and maintain muscle. Bone broth is good.

Could a drug designed for brittle bone disease provide a miracle cure for bald men? Scientists discover it can help hair grow 2mm in just 6 DAYS

  • WAY-316606 was created to treat osteoporosis, which causes brittle bones 
  • But in lab experiments it had a dramatic effect on hair follicle, experts found
  • The drug stimulated them to maintain hair growth for longer, the study showed

By Victoria Allen Science Correspondent For The Daily Mail

A drug designed for brittle bone disease has provided hopes of a cure for men with male pattern baldness.

It causes hair to grow a third longer than it normally would, scientists found, achieving two millimetres of growth in just six days.

WAY-316606 was created to treat osteoporosis, which causes brittle bones. 

But in lab experiments it had a dramatic effect on hair follicles donated by men with male pattern baldness, stimulating them to maintain hair growth for longer.

Half of British men can expect to lose their hair by the time they turn 50, with hair loss largely in their genes. 

It causes hair to grow a third longer than it normally would, scientists found, achieving two millimetres of growth in just six days” class=”blkBorder img-share” />

It causes hair to grow a third longer than it normally would, scientists found, achieving two millimetres of growth in just six days

Currently, there are just two drugs available to treat baldness, which both have moderate side effects and often produce disappointing hair regrowth results.

The only other option available, chosen by celebrities including Elton John and chef Gordon Ramsay, is a hair transplant.

The osteoporosis drug, discovered to work for baldness by the University of Manchester, targets a protein that acts as a brake on hair growth and plays a key role in hair loss. It could also be used to treat women with alopecia.

Lead scientist Dr Nathan Hawkshaw, from the University of Manchester, said: ‘The fact this new agent, which had never even been considered in a hair loss context, promotes human hair growth is exciting because of its translational potential.

‘It could one day make a real difference to people who suffer from hair loss.

‘Clearly though, a clinical trial is required next to tell us whether this drug or similar compounds are both effective and safe in hair loss patients.’ 

Male pattern baldness is the most common cause of hair loss, which experts say can be extremely distressing for men. 

But the only existing drugs to treat it are minoxidil and finasteride, which have previously been said by experts to work better at stalling hair loss than causing new hair to grow.

The British researchers first discovered a potential treatment in cyclosporine A – a drug given to patients after organ transplants since the 1980s to suppress their immune system. But this drug also causes serious side effects including kidney damage.

Luckily, they found that WAY-316606 works in the same way without causing harm.

After just six days it caused human hair follicles to grow 2mm. Follicles which were not treated with the drug only achieved growth of 1.5mm over the same period.

The scientists are the first to discover the importance of a protein called SFRP1 in hair growth.

The osteoporosis drug blocks the protein, sending follicles rapidly into the active ‘anagen’ phase of hair growth. After two days, hair growth had already increased significantly in the treated follicles.

This is ‘clinically very relevant’ since most previous similar studies have relied on cells, Dr Hawkshaw said.

He added: ‘Interestingly, when the hair growth-promoting effects of cyclosporine A were previously studied in mice, a very different molecular mechanism of action was suggested. 

‘Had we relied on these mouse research concepts, we would have been barking up the wrong tree.’

The research is published in the journal Public Library of Science Biology.

Trump shows off his hair: ‘I try like hell to hide that bald spot’


By Mia De Graaf For

The prostate-reducing drug that Donald Trump uses to treat hair loss has been linked to an increased risk of depression, self-harm and erectile dysfunction.

Finasteride is a widely-used drug that reduces the size of prostate glands and stimulates hair growth – and is widely believed to be a significant factor affecting the president’s low PSA (prostate) levels and thick mane.

However, it has been tied to many severe and uncomfortable side effects.

A research paper published in March 2017 by Western University in Ontario offered the first concrete evidence showing the pills’ mental health risks, and appeared to confirm many medics’ fears that it increases a risk of suicidal tendencies.

The same week, a study by Northwestern University Feinberg School of Medicine found most study participants were left impotent for four years after taking Propecia (the brand name for finasteride). 

a widely-used drug that reduces prostate glands and stimulates hair growth, increased risk of depression by 94 percent in the first 18 months, a study by Western University found. Another study by Northwestern University found it causes erectile issues” class=”blkBorder img-share” />

Finasteride, a widely-used drug that reduces prostate glands and stimulates hair growth, increased risk of depression by 94 percent in the first 18 months, a study by Western University found. Another study by Northwestern University found it causes erectile issues

Finasteride belongs to a class of medications known as 5-alpha-reductase inhibitors (5ARIs).

5ARIs have come under increasing scrutiny in recent years by regulators in the United States and Canada because of a possible link to mental health issues, according to the researchers.  

Finasteride was originally developed to treat urinary problems in men.

Studies showed the drug made prostate glands smaller by reducing the levels of the hormone dihydrotestosterone in participants.

But during the clinical trials, scientists saw an unexpected side effect – hair growth.

And so in 1997, the FDA approved the steroid inhibitor as the first ever drug to treat male pattern baldness.

Taken once a day, the drug is mainly sold under the brand name Propecia. Millions of American adults use the pills, which are proven to be 90 percent effective.  

In February 2017, Donald Trump’s doctor Harold Bornstein revealed the president takes a small dose of finasteride to stimulate hair growth.

Bornstein told the New York Times that he, too, takes the drug, saying it helped him keep his shoulder-length locks and helped Trump keep his own hair.

The doctor said: ‘He has all his hair. I have all my hair.’

The news that Trump takes finasteride explained why his PSA (prostate specific antigen, produced for the cells by the prostate) is so low.

Finasteride reduces PSA levels to reduce swelling of prostate glands.

Men aged 60-69 normally have between 4.0 and 5.0ng/ml. That is higher than younger men since PSA and testosterone levels rise with age.

The number may be lower than usual if a man has prostate cancer or inflammation, causing more PSA to seep into the bloodstream.

Trump’s PSA level was 0.15, Bornstein said in two letters he’d written about Trump’s health. The first letter came out in December 2015, followed by the other letter in September 2016.

The level prompted urologists – who weren’t linked to Trump – to say he had to have received care for an enlarged prostate or prostate cancer.

Bornstein told the Times that the commander-in-chief hasn’t had an enlarged prostate nor prostate cancer, and attributed Trump’s PSA level to Propecia. 

The researchers at Western University examined finasteride and dutasteride, another 5ARI.

‘There wasn’t a lot of good studies in this area, and it’s a very common medication for urologists to use,’ said lead author Dr Blayne Welk.

Welk’s team analyzed data from 93,197 men who were at least 66 years old when they received prescriptions for 5ARIs between 2003 and 2013, plus another 93,197 similar men who had never filled a prescription for a 5ARI.

Overall, 5ARIs were not linked with an increased risk of suicide, the researchers reported in JAMA Internal Medicine.

During the first 18 months, however, the men using 5ARIs had an 88 percent higher risk of harming themselves. That risk did not extend beyond 18 months.

Men in the 5ARI group also had a 94 percent higher risk of depression in the first 18 months, compared to men not using these drugs. Beyond 18 months, the increased risk of depression fell to 22 percent.

The type of 5ARI did not appear to significantly alter the results.

Welk cautions that the actual risk of depression and self-harm is very low. 

If the drugs were actually causing these side effects – which this study wasn’t design to prove – ‘you’d need 470 men to take this medication for a full year to have a new case of depression,’ Welk said.

That number would have to be even higher to cause a new case of self-harm, since self-harm is less common than depression.

‘It is a risk potentially and patients and physicians should be aware of it,’ Welk said.


A separate study in the journal PeerJ evaluated another concern about 5ARIs – erectile dysfunction.

Drs Tina Kiguradze and William Temps of Northwestern University Feinberg School of Medicine in Chicago and colleagues found that when erectile dysfunction occurred in men taking 5ARIs for at least 180 days, the dysfunction was more likely to last at least 90 days after stopping the medication. 

Erectile dysfunction, when it occurred, resolved faster in men who took the medications for shorter periods.

The proportion of men taking 5ARIs and experiencing erectile dysfunction is likely around 5 percent, according to Dr. Landon Trost, who is head of andrology and male infertility at the Mayo Clinic in Rochester, Minnesota.

But it’s not clear how many men suffer persistent erectile dysfunction after stopping 5ARIs, said Trost, who was not involved with either of the new studies.

‘I think it’s important to be educated about the potential side effects,’ he said.

Men who are already at increased risk for these potential side effects must weigh the risks and benefits of the drugs, Trost said.

He said older men taking 5ARIs for prostate problems might come to different conclusions than young men taking the pills for hair loss.

Additionally, he said, men should tell their doctors if they experience these symptoms.