Diclofenac 1% gel is an anti-inflammatory pain reliever you rub onto the skin. In the US it’s available without a prescription for arthritis pain. Because it acts where you apply it, much less reaches the bloodstream than with tablets, so stomach side effects are less likely.

What it’s used for

Diclofenac gel is approved over the counter for arthritis pain in the hands, wrists, elbows, knees, ankles and feet. It works best for joints close to the skin. It isn’t meant for the back, hips or shoulders.

How to use it

• Use the dosing card in the pack to measure the right amount: usually 2 g for each upper-body joint (hand, wrist, elbow) and 4 g for each lower-body joint (knee, ankle, foot).
• Apply up to 4 times a day and gently rub it into the whole painful area.
• Don’t use more than 32 g a day in total.
• Wash your hands afterwards, unless you’re treating your hands. In that case wait at least 1 hour before washing them.
• Don’t cover the area with a tight bandage or use a heating pad on it, and don’t shower for an hour after applying.
• It can take up to 7 days to feel the full effect. Don’t use it for more than 21 days without talking to a doctor.

Side effects

The most common are skin reactions where it’s applied: redness, itching, dryness or a rash. Stop using it if your skin blisters or swells. Serious side effects are rare but, as with all NSAIDs, can include stomach bleeding, heart problems and kidney problems.

Who should avoid it or check first

• Don’t use it if you’ve had an allergic reaction or asthma attack after taking aspirin or another NSAID, or right before or after heart surgery.
• Avoid it in the last part of pregnancy, from 20 weeks onwards, unless a doctor advises it.
• Ask a doctor or pharmacist first if you have heart disease, high blood pressure, kidney or liver disease, a history of stomach ulcers or bleeding, or take blood thinners, diuretics or other pain relievers.
• Don’t use it at the same time as NSAID tablets such as ibuprofen or naproxen without advice.
• Don’t apply it to broken or infected skin, or near the eyes or mouth.

See a doctor if

Pain gets worse or lasts more than 21 days, a joint becomes hot, red and swollen, or you have chest pain, shortness of breath, black stools or weakness on one side of the body.

Shop Diclofenac Gel. Staying active helps joints too: see walking for health and weight loss.

Browse all our Health Guides.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Intermittent fasting means limiting eating to certain times of the day or week. It has become one of the most popular ways to lose weight. Here’s what the evidence says and who it suits.

Common types

• Time-restricted eating (such as 16:8): eat within an 8-hour window, for example 11 am to 7 pm, and fast for the other 16 hours.
• 5:2: eat normally on 5 days and about 500 to 600 calories on 2 non-consecutive days.
• Alternate-day fasting: alternate normal days with very low calorie days.

Does it work?

Studies show intermittent fasting leads to weight loss, mainly because people eat fewer calories overall. When researchers compare it with ordinary daily calorie cutting, results are generally similar. It isn’t magic, but some people find it easier to follow because there are fewer decisions about food.

Tips if you want to try it

• Start gently, for example with a 12-hour overnight fast, and extend it gradually.
• Drink water, and black coffee or tea, during fasting periods.
• Make meals count: protein, vegetables, whole grains and healthy fats. Eating very large or sugary meals in the eating window cancels out the benefit.
• Keep up activity and sleep.

Possible side effects

Hunger, headaches, tiredness, irritability and difficulty concentrating are common at first and usually ease within a few weeks.

Who should not try it without medical advice

• People with diabetes, especially those taking insulin or sulfonylureas, because of the risk of low blood sugar.
• People who are pregnant or breastfeeding.
• Anyone with a history of an eating disorder.
• Children and teenagers.
• People who take medicines that must be taken with food, or who have a medical condition such as low blood pressure.

The bottom line

Intermittent fasting is one option, not the only one. The best approach is the one you can keep up. If it leaves you feeling unwell or preoccupied with food, stop and try a different approach.

See also: how to lose weight safely and protein for weight loss.

More in our Weight Management guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Walking is free, low-impact and easy to fit into the day, which is why it’s one of the most effective activities for long-term weight management. On its own it leads to modest weight loss, but combined with changes to eating it makes a real difference, and it’s one of the strongest habits linked to keeping weight off.

How much should you walk?

• US guidelines recommend at least 150 minutes a week of moderate activity, such as 30 minutes of brisk walking on 5 days.
• For weight loss and keeping it off, more is better. Many people aim for 200 to 300 minutes a week.
• In step terms, research links around 7,000 to 10,000 steps a day with a lower risk of early death and heart disease. If you currently do 3,000, adding even 2,000 steps is worthwhile.

How many calories does walking burn?

As a rough guide, walking burns about 80 to 100 calories per mile, more if you weigh more or walk uphill. That’s why walking works best alongside eating changes: one muffin can cancel out a 3-mile walk.

Make your walks count

• Walk briskly: fast enough that you can talk but not sing.
• Add hills or stairs to increase the effort.
• Try intervals: alternate 2 minutes fast with 2 minutes at a normal pace.
• Walk after meals. A 10 to 15 minute walk after eating helps lower blood sugar spikes.
• Add strength exercises twice a week to protect muscle.

A simple 4-week plan to start

• Week 1: 10 minutes a day at a comfortable pace.
• Week 2: 15 to 20 minutes a day, a little faster.
• Week 3: 25 minutes a day, including some brisk stretches.
• Week 4: 30 minutes a day, most of it brisk.

Tips to keep going

• Use a phone or watch to track steps.
• Walk with a friend, or listen to podcasts.
• Build walking into your day: walk to the shops, take calls on foot, get off the bus a stop early.
• Wear comfortable, supportive shoes.

Check with a doctor first if

You have heart disease, chest pain on exertion, uncontrolled blood pressure, or joint problems that make walking painful. For sore knees, see our guide to diclofenac gel for joint pain.

See also: how to lose weight safely.

More in our Weight Management guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Protein is the most filling of the three main nutrients. Eating enough of it helps you feel satisfied on fewer calories and protects muscle while you lose weight, which matters for strength and long-term weight maintenance.

Why protein helps

• It keeps you fuller for longer, so you’re less likely to snack between meals.
• It protects muscle. When you eat less, the body can break down muscle as well as fat. Protein, together with strength exercise, limits this.
• It takes more energy to digest than carbohydrate or fat, although the effect is small.

How much do you need?

The basic recommendation for adults is 0.8 g of protein per kg of body weight a day (about 0.36 g per pound). Studies on weight loss often use higher amounts, around 1.2 to 1.6 g per kg, especially for older adults and people doing strength training.

A simpler approach for most people is to include a palm-sized portion of protein at every meal, roughly 25 to 30 g.

Spread it through the day

Many people eat little protein at breakfast and most of it at dinner. Spreading it evenly across meals helps with fullness and muscle. Swapping a pastry breakfast for eggs or Greek yogurt is an easy start.

Good sources

• Eggs: about 6 g per egg
• Greek yogurt: about 15 to 20 g per cup
• Chicken, turkey and lean meat: about 25 to 30 g per 100 g cooked
• Fish and canned tuna: about 20 to 25 g per 100 g
• Beans, lentils and chickpeas: about 15 g per cooked cup, plus fibre
• Tofu and tempeh: about 10 to 20 g per 100 g
• Cottage cheese: about 25 g per cup

Choose mostly lean and plant sources, and limit processed meats such as bacon and sausages.

What about protein shakes?

Shakes are convenient but not necessary. Whole foods are more filling and bring other nutrients. If you use one, check the label for added sugar.

Who should be careful

If you have kidney disease, talk to your doctor before increasing protein, as you may need to limit it.

See also: how to lose weight safely and getting past a weight-loss plateau.

More in our Weight Management guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Pinworms (threadworms) are the most common worm infection in the US. They’re especially common in children aged 5 to 10 and spread easily within families. They’re harmless in most cases and easy to treat, but reinfection is common unless everyone follows a few hygiene steps.

Symptoms

• An itchy bottom, especially at night, when female worms lay eggs around the anus.
• Disturbed sleep, restlessness and irritability.
• In girls, itching around the vagina.
• Small white thread-like worms, about the length of a staple, may be seen around the bottom or in stools.

Many people have no symptoms at all.

How it spreads

Scratching transfers tiny eggs to fingers and under nails, and from there to the mouth, food, toys, bedding and surfaces. Eggs can survive for up to 2 to 3 weeks indoors.

The tape test

A doctor may ask you to press clear sticky tape against the skin around the anus first thing in the morning, before washing or using the toilet, on 3 mornings in a row. The tape is then checked for eggs.

Over-the-counter treatment

• Pyrantel pamoate (sold as Pin-X and Reese’s Pinworm Medicine) is available without a prescription for adults and children aged 2 and over.
• It’s taken as a single dose based on body weight. Follow the dosing chart on the pack.
• A second dose 2 weeks later is often recommended, because the first dose doesn’t kill eggs.
• Ask a doctor before using it in children under 2 or weighing under 25 lb, in pregnancy or while breastfeeding, or if you have liver disease.

Prescription options include mebendazole and albendazole.

Treat the whole household

Because eggs spread so easily, doctors usually advise treating everyone in the home at the same time, even those without symptoms.

Hygiene to stop reinfection

• Wash hands with soap after using the toilet, before eating and after changing nappies.
• Keep fingernails short and discourage nail biting and thumb sucking.
• Shower or bathe each morning to remove eggs laid overnight.
• Change underwear and pyjamas daily, and wash bedding and towels in hot water. Don’t shake them out first.
• Wipe down toilet seats, door handles and toys.

Keep up these steps for at least 2 weeks after treatment.

See a doctor if

Symptoms continue after two doses, you’re pregnant, a child under 2 is affected, or there’s stomach pain, weight loss or blood in the stools.

More in our Lice and Parasites guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.