Whether you’re away on holiday or lounging in the sun at home, needing a siesta after lunch or a disco nap before dinner on a hot summer’s day is normal. But how can you tell when warm weather-induced drowsiness is something more serious? We asked doctors to explain… What is heat exhaustion? “Prolonged exposure to the heat can cause heat exhaustion. It is the body’s response to excessive loss of water and salt,” says Dr Preethi Daniel, deputy medical director at London Doctors Clinic. “Symptoms may be characterised by heavy sweating, rapid breathing, headache, high temperature, nausea, a faster and weak pulse, light-headedness, feeling fatigued and heat cramps.” Older people, babies, children and those with chronic illnesses are much more likely to develop heat exhaustion. “Symptoms are usually the same in adults and children, and can make children tired and floppy,” says Dr Luke Powles, associate clinical director at Bupa Health Clinics. While not life-threatening, heat exhaustion is a warning sign that you need to cool down promptly to prevent progression to heat stroke, which means getting out of the sun immediately. “Remove any unnecessary clothing, lie down and raise your feet so they are above the level of your heart and drink plenty of water,” says Powles. “You can also use a cool sponge to cool your skin. Make sure someone stays with you until you feel a bit better – which you should do in half an hour or so.” If you don’t start to cool down after 30 minutes, see medical help, as you may have developed heatstroke. What is the difference between heat exhaustion and tiredness? “Heat exhaustion is the direct result of spending too much time in the sun and often raises your core body temperature to over 38 degrees, which isn’t an indicator of general tiredness,” says Dr Carolyn Barshall, GP at independent charitable hospital King Edward VII’s. “Whereas tiredness can be caused by many lifestyle factors such as disordered sleeping patterns, alcohol and poor diet.” Daniel adds: “If you have a lack of energy or aches and pains, consider it tiredness, but if you have any of the other symptoms mentioned above, it could be heat exhaustion.” What is heatstroke? “Heatstroke is the end result of overheating,” says Daniel. “Our internal temperature rises and creates confusion, drowsiness and can lead to seizures.” Much more serious than heat exhaustion, it can cause a change in mental status such as, Barshall says: “Confusion, delirium, combativeness, seizures, loss of consciousness, and a core body temperature above 40 degrees.” Symptoms may also include skin that’s not sweating even when it feels hot, fast breathing or shortness of breath. “Heat exhaustion and heatstroke are often confused, but there is a difference,” says Powles. “Heatstroke should be treated as an emergency, whereas with heat exhaustion, the person needs to be cooled down.” If you suspect someone has heatstroke you should call 999 or seek emergency help immediately. How to stay safe in the sun To prevent heat exhaustion during summer, it’s important not to spend too long in the sun and to stay hydrated. “Avoid direct sunlight between 11am and 3pm, and wear light-coloured, loose clothing,” says Daniel. “Drink plenty of cold drinks and water throughout the day and limit alcohol intake.” To help little ones, she says: “You can keep a pram or buggy cool by covering it with a damp cloth and refreshing it every 30 minutes.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live King Charles enjoys a wee dram at the Met Highland Gamesv Why have the birds disappeared from my garden? Top Films: w/c Saturday, August 12

Health “guru” Dr Michael Mosley has offered his advice to those seeking to reduce their risk of developing osteoporosis, a condition characterised by weak or brittle bones. The medical expert and former doctor is known for his regular appearances on The One Show, as well as his TV programmes on health and medicine. Writing in his column for MailOnline, the creator of the 5:2 and Fast800 diets said he had found his bones were not as strong as they could be while filming a series about healthy ageing in 2022. “Like many Britons, my bones are weaker than they should be,” he wrote. “While filming a series about healthy ageing last year, I had a DXA scan, which uses low-dose X-rays to see how dense (or strong) your bones are. “Although I have a sturdy spine, my hip bones aren’t in great shape, though I don’t have osteoporosis.” Dr Mosley explained that the key to avoiding osteoporis involves getting a healthy intake of both calcium and Vitamin D, as well as a short but effective burst of exercise each day. “As well as obvious good calcium sources such as dairy and leafy green veg, you may want to top up on prunes,” he suggetsed. “A study last October in the American Journal of Clinical Nutrition, involing 235 older women, concluded eating five to six prunes a day improved bone density. The theory is that anti-inflammatory compounds in prunes may slow bone breakdown.” He also suggested that daily exercise could also help, citing a study that showed two minutes of hopping each day can improve hip bone strength. In 2020, Dr Mosley claimed that men were “more deluded” than women when it came to their own weight and fitness, while fronting a Channel 4 series to help people who had gained weight during lockdown. He told the Press Association: “An awful lot of people are unaware of how much weight they put on, particularly around the gut.” Research shows that only 10 per cent of people who are obese know they are but that the figure is only 7 per cent for men, Dr Mosley said, while “women are more aware of it”. He also denied that the show, which offers practical advice to overhaul viewers’ lifestyles, was about fat shaming: “Body shaming is awful. It is incredibly ineffective. Telling people they’re fat never, ever works,” he said. “None of this is about fat-shaming. It is entirely about helping people who are obese and who want to do something about it. Any diet is only ever going to work if the person wants to do it.” Read More Jamie Foxx and Jennifer Aniston issue statements over ‘antisemitic’ Instagram post Why is every celebrity couple breaking up? Relationship experts think we shouldn’t be so shocked Eye masks, kombucha and ‘the full spectrum of milks’: Gwyneth Paltrow finally gave us a tour of her fridge Health expert Dr Michael Mosley shares two tips for avoiding osteoporosis Will Smith says Willow ‘mutiny’ changed his view on family success Who was controversial vegan raw food influencer Zhanna D’Art:

Zhanna Samsonova was just 39 when she died, reportedly from “starvation and exhaustion”, thousands of miles from her birthplace in Moscow, Russia. The Instagram influencer’s tragic story has come under scrutiny due to her promotion of a completely “raw” diet, which reports have suggested was linked to her death. Under the name Zhanna D’Art, Samsonova regularly wrote about how she subsisted exclusively on fruit, vegetables, seeds, smoothies and juices while living in Malaysia. Her mother, Vera, attributed Samsonova’s death to a “cholera-like infection” that was exacerbated by her diet. In recent weeks, Samsonova had been unusually quiet on Instagram, with the exception of a troubling post shared just days before her death on 21 July. “Life is meaningless but worth living provided you recognise it’s meaningly,” she wrote, over a photo of herself wearing sunglasses, with a gasping expression on her face. Vera, 63, told Russian newspaper Novye Izvestia how she had begged her daughter to return home as she feared for her health. “I understood that Zhanna was about to die, but still I could not help her in any way. My daughter's life has turned into a nightmare,” she said, via LBC. She told the publication that she had “fought for years” to save her daughter, once an aspiring model, but she “refused to listen”. Samsonova is believed to have left Russia in 2006, buying a one-way ticket to spend the past 17 years travelling around Asia while blogging and practicing yoga. Photos shared by Vera showed a smiling Samsonova apparently taking part in a modelling contest. The images are in stark contrast to the final photos she shared of herself before her death, where she appeared visibly gaunt and malnourished. Her friends also spoke with local media, confessing they feared she was suffering from anorexia and that her diet was becoming increasingly limited. One of her neighbours, who was not named, said she was “horrified” when they met in Sri Lanka a few months ago, as Samsonova looked “exhausted” and had swollen legs “oozing lymph”. “They sent her home to seek treatment. However, she ran away again. When I saw her in Phuket, I was horrified,” the friend said, according to The Sun. “I lived one floor above her and every day I feared finding her lifeless body in the morning. I convinced her to seek treatment, but she didn’t make it.” Samsonova regularly made claims about the supposed benefits of her raw food diet, including that it offered “natural” protection from Covid-19. She also claimed that her body did not “require” water, writing last year that her fruit-based diet meant she had gone without water for the past six years. In recent months, she appeared to have become a fan of the durian fruit, sharing frequent posts that promoted it. “It’s that fabulous time of year again – Durian Season in Thailand!” she wrote in the caption of one of her final videos. “Wake Up And Smell the Durian! For all you durian lovers out there, isn’t it just the best? And for those who haven’t yet experienced the joy of durian, you’re in for a wild ride!” When she died, Samsonova had around 16,000 followers. At the time of writing, however, that number had increased to 33,000. There have been previous cases where people have starved to death due to their extreme diets, including children whose food intake was controlled by their parents. Last year, a vegan mother was sentenced to life in prison over the death of her 18-month-old son, who was fed a diet of raw fruits and vegetables. Prosecutors said that Sheila O’Leary’s son Ezra was severely malnourished, and weighed just 17 pounds when he died in September 2019. O’Leary was convicted by a Florida jury in June 2022 of first-degree murder, aggravated child abuse, aggravated manslaughter of a child, child abuse and two counts of child neglect. For anyone struggling with the issues raised in this article, eating disorder charity Beat’s helpline is available 365 days a year on 0808 801 0677. NCFED offers information, resources and counselling for those suffering from eating disorders, as well as their support networks. Visit eating-disorders.org.uk or call 0845 838 2040 Read More Vegan raw food influencer ‘dies of starvation and exhaustion’ ‘Love, obsession, extortion and murder’: The dramatic downfall of TikTok influencer who became a killer Royal family silent as Meghan Markle celebrates 42nd birthday Who was controversial vegan raw food influencer Zhanna D’Art: Health expert Dr Michael Mosley shares two tips for avoiding osteoporosis Will Smith says Willow ‘mutiny’ changed his view on family success

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