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The False Daisy is a magical herb which looks like the white daisy. 

It is from the sunflower family with tapering lance-shaped leaves often making its way in August through the prairies of the world and native to my hometown India. Back home, it is used for making hair oil and is one of the main ingredients in hair dyes.

Clinical cure

Roots, seeds, seed oil and the whole plant are a known rejuvenator. Traditionally, the petals are used to address skin disorders, skin allergies and cracked heels. It is known to help improve liver metabolism and is used in the treatment of jaundice, fatty liver and hormonal imbalance. Commercially sold in health shops, it has shown to overcome the loss of appetite, acidity, heartburn and anaemia. 

The entire plant contains the alkaloids nicotine and is used in the treatment of diphtheria and other respiratory conditions.

Hair tonic

Growing up, our family always used a homemade concoction of herbs steeped in a mixture of oils for a week to make hair oil, then strained and bottled by my mama for a years’ supply. 

Here, the dried organic leaves of the False Daisy were the main ingredient, combined with rose petals, gooseberries and aromatic herbal oil. 

The extracts from the leaves and flowers add lustre to your locks. The pungent property of the plant is known to have positive effects on stimulating hair growth and its herbal property helps improve dry skin and avoid dandruff and split ends.

It has a cooling effect on the scalp and adds lustre to hair, serving as a perfect conditioner. The best way to infuse the herb is in oil form as it helps prevent hair fall, premature greying and split ends. 

There are no regularly reported problems but there is a chance of an allergic reaction on sensitive skin. It is also used as an astringent and often mixed with aromatic oils for spas.

Wonder herb

This magical herb is enriched with rich sources of iron, vitamin E, magnesium, steroids calcium, vitamin D and traces of protein. 

Moreover, it is known to be anti-bacterial, antiviral and analgesic properties. The paste of the leaves combined with milk cream and applied to the forehead has shown to relieve migraine pain. 

The juice of the leaves in small quantity mixed with buttermilk has reportedly cured jaundice within a few days. 

Lactating mothers and pregnant women should consult their doctor before using this powerful herb. In all cases, be sure to consult your doctor before trying any herbal remedies. 

Reprinted with permission from Family Flavours magazine

Celestial Bodies
Jokha Alharthi
Translated by Marilyn Booth
Scotland: Sandstone Press, 2018
Pp. 243 

Jokha Alharthi, a professor of Arabic at Sultan Qaboos University in Muscat, put Oman on the world literary map this year when her novel, “Celestial Bodies”, won the Man Booker International Prize.

This marks the first time an author from the Gulf region has even been nominated for the prestigious award, and the first time an Omani female novelist has been translated into English. Originally published in Arabic as “Sayyidat Al Qamar” (literally Ladies of the Moon), “Celestial Bodies” has been hailed as a novel reflecting transition in one of the most traditional Arab societies. The story is set in the village of Al Awafi, where “people were firm believers in the past; they did not look to the future”. (p. 141)

Yet, change they do, especially after the oil boom, though social change comes more slowly than economic development. From the author’s vivid descriptions, we learn of marriage and birthing customs, as well as landmarks in Oman’s history after Britain gained oil exploration rights and “imperialist greed lit the wick of war”, dividing Omanis into supporters of the British-backed Sultanate and the followers of the Iman. (p. 146)

If the title “Celestial Bodies” sounds ambiguous, evocative and even esoteric, Alharthi’s story is full of its mythical and earthier implications. Platonic, parental, passionate and conjugal love, as well as marriage, play a prominent role in the plot, but so do spirituality, superstition, memory and family history. Transition is a fairly common theme in modern Arabic literature, yet, Alharthi’s book stands out for her innovative scene depiction, tantalising characters and intricate story structure. Her storytelling relies on multiple points-of-view, an omniscient narrator as well as a first-person narrator, the interface of past and present, inclusion of poetry, and semi-supernatural or magical events, which are accepted as natural by the characters and sometimes embody their deepest desires.

“Celestial Bodies” focuses on three generations of prominent families in Al Awafi, who are connected by marriage or other relationships. Complicating the social structure, some still have slaves up until the 1980s, although slavery had been abolished decades before. The story opens with three sisters, emblematic of the second generation, who receive marriage proposals. Mayya, the oldest, is proposed to by Abdullah, the son of the village’s most successful merchant, and the only character to narrate the story, but she has given her heart to another.

The way Alharthi describes Mayya’s feelings is indicative of how she interweaves cosmic dimensions into an otherwise prosaic life: “She sent her spirit into the ether, detaching herself completely from the world. Her body convulsed and she could barely keep herself from collapsing as she telegraphed her whole self to him, transmitting it with every gram of energy she could find.” (p. 5)

However, Mayya receives no response to her monumental effort, so she agrees to marry Abdullah without any pretence of loving him. They do, however, come to share the adoration of their daughter who is incongruously named London, heralding the third generation in the novel, whose lifestyle is unfathomable to their ancestors. In a society that long avoided modern education, especially of girls, London becomes a doctor.

The marriages of Mayya’s sisters are quite different, proof that times are changing in a way that gives women more choice but does not necessarily guarantee happiness. Each marriage is somehow compared to the idea that God created every soul as a sphere and then split it and gave each half to a human body. “It is decreed that each body will meet the body that holds the other half of that rent soul… From one human being to the next, the effect of this union will vary, according to the delicacy of each person’s nature.” (p. 38)

From Abdullah’s narration, we learn much about the past, especially his severe father, Suleiman the merchant, representative of the first generation, who didn’t think the freeing of slaves affected his property. Abdullah’s great fear of his father and his terrible punishments seems to have partially paralysed his personality. Having begun with his father’s vast wealth gained by trading in dates and slaves, he is rich but his anxiety persists, now framed by global changes like the crash of the stock market. 

Though potentially in a position of power, he mainly reacts to personal and family events rather than taking the initiative. And sometimes he instinctively replicates his father’s authoritarian behaviour although he doesn’t mean to. From Abdullah’s reminiscing, we also learn of the family secrets —intimacy between masters and slaves, and why Zarifa, who raised him after his mother’s unexplained, premature death, had a special status.

Many of Abdullah’s memories are recounted as he is on an airplane. When London comments on how frequently he travels, he doesn’t tell her his real feelings that “when we are away from home, in new and strange places, we get to know ourselves better. And that is exactly the way it is with love”. (p. 25)

Here, Alharthi reveals something about herself, for she was educated in the UK and has said that she wouldn’t have been able to write about her own society if she hadn’t been able to view it from the vantage point of another country. 

Alharthi idealises neither the past nor the present; they just are, and she describes them well, especially male and female dreams and insecurities, and how they are changing. She has given us a unique window on Oman, dispelling any remaining notions that it is an isolated country.

Family caregivers for dementia patients don’t sleep as long or as well as other adults of the same age, a new study suggests. 

In an analysis of the combined data from 35 earlier studies, researchers found that dementia caregivers slept about three hours less per week than age-matched adults, according to the report published in JAMA Network Open. 

“Sleep debt is known to have cumulative associations with physical, mental and cognitive health,” the researchers, led by Chenlu Gao wrote. “Therefore, poor sleep quality in dementia caregivers should be recognised and addressed.” 

To take a closer look at the impact of caregiving on sleep, the Gao and her colleagues scoured the medical literature for research on the topic. 

The combined studies included information on 3,268 caregivers, 76.7 per cent of whom were women. When compared to age-matched non-caregiving adults, caregivers slept less — by an average of 2.42 hours to 3.5 hours per week — and had poorer sleep quality, including more difficulty falling asleep and disturbed sleep. 

Those studies showed that poor sleep could, indeed, be improved. 

Bad sleep can lead to a host of health problems, Stephen Smagula, an assistant professor of psychiatry and epidemiology at the University of Pittsburgh said. “If you’re losing a lot of sleep over a long period of time, you are at higher risk of heart disease, Alzheimer’s, dementia, diabetes.” 

The new study “was not at all surprising” to Katherine Ornstein, an assistant professor of geriatrics and palliative care medicine at the Icahn School of Medicine at Mount Sinai in New York City. “We know caregivers are doing so much,” she said. “They are caring for children, working, dealing with financial stress, their own health. So, of course sleep would be impacted in some way.” 

LOS ANGELES — Superhero Black Widow is a woman at the top of her game, and so is the actress who plays her — Scarlett Johansson is the world’s highest paid actress for the second year in a row, according to Forbes’s annual ranking published on Friday.

Johansson, 34, earned $15.5 million more than she did in 2018, primarily due to the immense global success of “Avengers: Endgame” — the final chapter of the saga — for which she earned $35 million.

The actress will take up the Black Widow mantle again in 2020 for an eponymous spinoff film.

But even though Johansson and her cohorts on the list all earned more than $20 million, pay inequality is alive and well in Hollywood. Johansson earned $56 million total over the past year, but that amount lands her at only eighth place for the combined list of highest-paid actors and actresses.

For comparison, Robert Downey Jr., Johansson’s “Avengers” costar, earned about $55 million for his turn as Iron Man in “Endgame”.

According to the Forbes ranking of highest-paid actors in the world, published on Wednesday, Downey Jr. comes in at third place with $66 million total, behind fellow Avenger Chris Hemsworth ($76.4 million) and Dwayne Johnson ($89.4 million).

For the women, second place goes to Sofia Vergara, an industry veteran but a newcomer to the list. The “Modern Family” sitcom star earned $44.1 million between June 1, 2018 and June 1, 2019.

She is followed by Reese Witherspoon ($35 million) and Nicole Kidman ($34 million), costars on the series “Big Little Lies”.

Jennifer Aniston, who came in third in 2018 mainly due to advertising campaigns for major brands, has been relegated to fifth place with a mere $28 million for the year. The former “Friends” star — a show which also featured a guest appearance from Witherspoon — stars in a new series for Apple’s on-demand web television service.

Other new list arrivals include Elisabeth Moss, boosted by the series “The Handmaid’s Tale”, and Australian actress Margot Robbie.

Angelina Jolie, who was number two on the list in 2018, did not make the cut this year, along with Julia Roberts, Cate Blanchett and Jennifer Lawrence.

The top 10 are Scarlett Johansson ($56 million), Sofia Vergara ($44.1 million), Reese Witherspoon ($35 million), Nicole Kidman ($34 million), Jennifer Aniston ($28 million), Kaley Cuoco ($25 million), Elisabeth Moss ($24 million), Margot Robbie ($23.5 million), Charlize Theron ($23 million) and Ellen Pompeo ($22 million).

PARIS — A cheap, once-a-day pill combining aspirin with drugs that lower blood pressure and cholesterol cuts cardiovascular disease as a whole by a third, and heart attacks by more than half, researchers said Friday.

In clinical trials, the so-called “polypill” was especially effective among people with no history of cardiovascular disease, reducing the number of severe events by 40 per cent, the researchers reported in The Lancet, a medical journal. 

For those with a history of heart problems and strokes, the drug combo was only half as effective compared to the control group, who received advice on healthy living but no drugs.

Among participants who took the pill as directed — at least 70 per cent of the time — heart attack incidence declined by 57 per cent.

The polypill concept was first proposed more than 20 years ago as a simpler, cost-effective approach to treating cardiovascular disease, which often requires taking several medications.

Currently, patients are typically prescribed one or more drugs to lower blood pressure along with a statin, which holds lipids such as fatty acids in check. Aspirin, an analgesic, has blood thinning properties.

“The more tablets people have to take, the less they comply in the long-term,” noted Kausik Ray, a professor in public health and Imperial College London not involved in the study.

“For chronic diseases, this is a challenge as you are asking people to take multiple medications every day for 30 or 40 years.”

About a third of patients stop taking their meds as early as 90 days after a heart attack, according to earlier research.

But despite its obvious potential, the polypill had yet to be tested on a large number of people over a long period of time.

Scientists led by Reza Malekzadeh from the Tehran University of Medical Sciences recruited nearly 7,000 men and women, aged 50 to 75, living in rural Golestan, a province in Iran.

About one in 10 had previously had heart attacks, strokes or other cardiovascular episodes.

The participants were divided into two groups of roughly the same size. One was given “lifestyle advice” only, while the other also got a daily polypill from 2011 to 2013.

Doctors monitored compliance with the drug regimen, and then tallied the number of strokes and heart attacks across each cohort over the next five years.

Crucially, adherence was significantly higher with the all-in-one pill.

“Drugs do not work if they are not taken,” noted Amitava Banerjee, a consultant cardiologist at University College London.

Compared with the lifestyle group, the polypill cohort had 34 per cent fewer adverse events. Results were similar for men and women.

Blood pressure did not differ much, but “bad” cholesterol levels were lower in the group taking meds. 

“Now we know that a fixed-dose polypill can achieve clinical benefits in practice,” Malekzadeh said in a statement.

“But the polypill is not an alternative to a healthy lifestyle and should be combined with physical activity, a healthy diet, and smoking cessation.” 

Other researchers not involved in the study said the findings could be a game changer, especially in developing nations.

“Given the polypill’s affordability, there is considerable potential to improve cardiovascular health and to prevent the world’s leading cause of death,” noted co-author Nizal Sarrafzadegan, a researcher at Isfahan University of Medical Sciences.

Healthy young people show signs of impaired blood vessel function after just a few puffs of an electronic cigarette, even without nicotine, new research shows. 

“We essentially found that using e-cigarettes is not equivalent to inhaling water vapor; in fact, it can exert acute, detrimental effects on [blood vessels] even when the liquid does not contain nicotine,” Dr Alessandra Caporale of the University of Pennsylvania Perelman School of Medicine in Philadelphia, the study’s first author, told Reuters Health in an email. 

Evidence is mounting that vaping, sometimes touted as a safer alternative to smoking, is not risk-free, Caporale and her colleagues note in Radiology. In a previous study, they found that vaping nicotine-free e-cigarettes increased signs of inflammation and a form of tissue damage known as oxidative stress, which returned to normal levels in one to three hours. 

Big US tobacco companies are all developing e-cigarettes. The battery-powered devices feature a glowing tip and a heating element that turns liquid nicotine and flavourings into a cloud of vapour that users inhale. 

In the new study, the authors used magnetic resonance imaging (MRI) to take several measurements of blood vessel function in 31 healthy adults who had never smoked, before and after they took 16 three-second puffs of an e-cigarette containing propylene glycol, glycerol and flavouring but no nicotine. 

After vaping, study participants showed several changes indicating that “vascular reactivity”, which is the ability of healthy blood vessels to widen when necessary, was “considerably and significantly impaired”, Caporale noted. 

These changes were temporary, but if repeated over a long period of time could cause inflammation and deterioration of blood vessel health, the researcher added. “We are far from suggesting that a single episode of vaping translates immediately into atherosclerosis.” 

With funding from the National Heart, Lung, and Blood Institute, which also supported the current research, Caporale and her team are planning a study that will look at inflammation, oxidative stress and circulatory changes in e-cigarette users, cigarette smokers and non-smokers over time. 

Dr Irfan Rahman, a professor at the University of Rochester Medical Centre who researches the effect of e-cigarettes on health, reviewed the study for Reuters Health. “The study is interesting and has some insights into long-term consequences of electronic cigarette vapours in cardioneurovascular disorders,” he told Reuters Health in a telephone interview. 

But the findings don’t confirm an association and shouldn’t be interpreted to mean that e-cigarette users will develop these health problems, he added. 

Regulating and controlling the Internet, in general, is no picnic – and online shopping is no exception. It is particularly difficult when the goods are imported from outside the country they are to be delivered to, for it disturbs the normal functioning of its tax and customs departments, two essential governmental institutions, as well as the balance of country’s internal commercial distribution outlets. This of course applies only if and when the volume of online imported shopping reaches a significant amount, a given threshold, which apparently is now the case in Jordan.

From Amazon to Alibaba and countless other sites, a non-negligible number of Jordanian consumers are hooked on online shopping from abroad, for all the (good) reasons that make it more attractive than traditional local shopping, in most cases. Though no numbers about the actual volume of these personal imports have been disclosed at this point by the authorities, the customs department has just released this week new rules for personal orders placed online this way.

In short, the rules make it mandatory to pre-declare the goods on a specific Jordan Customs Internet platform and to pay customs duties, taxes and service fees on the shipments. “Shipments valued under JD50 will be subject to [pay] JD5, and those valued between 51 and JD100 will be subject to [pay] JD10.” Moreover, and for these fees to apply, one given consumer (or account) must not exceed a total of JD500 orders per year. In all other cases, standard customs fees and clearing procedures will apply, the same as “for passengers’ luggage”.

Interestingly the above is true only for certain categories of goods: namely “apparel and clothing, shoes, children’s toys and food items”. All other items fall into the “passengers’ luggage” rules mentioned above. 

Regulating is understandable, but are the new rules fair enough to the population? Does protecting the local retail business justify these rules? For until now any personal single order entering the country and estimated at under JD100 was completely free of duties and taxes.

It is hard at this point in time to say what is really fair and what is not. The weight of online shopping in the world has reached gigantic proportions. It is perhaps worth remembering that Jeff Bezos, the boss of Amazon, the largest online shopping outlet of them all, is the richest man in the world, according to Forbes’ March 2019 edition.

Following in the footsteps of the giants abroad, the number of local outlets where you can place online orders is also increasing. For example, City Centre Computers, one of well-known suppliers of computers and IT goods of all kinds in Amman, takes online orders and will deliver them to your doorsteps. If your order is above JD100, the delivery will be done free-of-charge, what’s more.

A number of fast-food restaurants in Amman, as well as most large supermarkets, also offer online ordering service. Some even have their own, locally designed, mobile app to make using the service fast, easy and pleasant. The trend is slowly but surely reaching all types of retail businesses in the country. However, and for some time at least, the volume will remain insignificant compared to the size of shopping imports from Amazon and the like.

In any case, the new customs regulations for online shopping from abroad are now the talk of the town. Many are asking whether with time the rules will get tighter, or on the contrary, may be softened a bit.

Surgeons are no better at determining which patients might benefit from operations to treat torn knee cartilage than if they just flipped a coin, a new study suggests. 

Researchers surveyed 194 surgeons to see whether they would recommend surgery or exercise therapy in 20 test cases with middle-aged patients who had tears in the meniscus, the cartilage that works as a cushion between the shin and thigh bones. 

Researchers created test cases based on actual patients to see whether the surgeons could accurately predict who would benefit the most, or least, from surgery or from exercise therapy. 

Overall, surgeons correctly predicted which patients would benefit from operations only half of the time. And experienced knee surgeons were no better at guessing correctly than other orthopaedic surgeons. 

These findings offer one reason these knee operations remain common despite a growing body of evidence suggesting many patients don’t benefit, said Dr Victor van de Graaf, lead author of the study and a researcher at University Medical Centre, Utrecht, in The Netherlands. 

“Orthopaedic surgeons believe they are capable of identifying which patients may still benefit more from surgery,” van de Graff said by e-mail. “Therefore, our findings may help to further decrease the number of unnecessary performed surgeries.” 

During the operation, a surgeon makes a small incision in the knee and inserts a tiny camera called an arthroscope to view the inside of the joint, locate and diagnose the problem, and guide repairs. Sometimes surgeons remove all of the meniscus, and other times they only remove part of it. 

While the procedure is minimally invasive, it’s not risk-free. Patients receive anaesthesia, which in any surgery may lead to complications such as allergic reactions or breathing difficulties. In addition, this specific procedure might potentially damage the knee or trigger blood clots in the leg. 

To understand how accurately surgeons could predict patient outcomes, researchers asked a series of questions for each of the 20 patient cases. They asked whether patients should get surgery or physical therapy; what amount of improvement or deterioration would be expected in function after two years; and what level of function patients would have if they went with the treatment surgeons didn’t recommend. 

Surgeons were more likely to make correct predictions about who would benefit from knee operations or physical therapy, but more likely to be wrong about which patients would not benefit from the treatments. 

Among patients who didn’t respond to surgery, only 39 per cent of the surgeons correctly foresaw this outcome. And among patients who didn’t respond to exercise therapy, only 29 per cent of surgeons correctly predicted this outcome. 

For patients who did benefit from surgery, surgeons correctly predicted this outcome 60 per cent of the time. And for patients who benefitted from physical therapy, surgeons correctly chose this outcome in 72 per cent of cases. 

One limitation of the study is that the 20 sample cases presented to surgeons don’t reflect how surgeons would interact with patients and make treatment decisions in real life, the study team notes in the British Journal of Sports Medicine. 

Very few surgeons asked to participate in the study agreed to do so, and it’s possible the results don’t reflect what would happen with a larger group of surgeons. 

But given how poor the participating surgeons were at guessing who might benefit from surgery, it makes sense for patients to only consider this option when physical therapy doesn’t work, the study team writes. 

Another study concluding that it’s impossible to predict who might benefit from arthroscopic meniscus repair surgery. 

Kenneth Pihl of the University of Southern Denmark in Odense and his colleagues built a model based on the real-world outcomes after one year for 641 patients who had undergone the surgery. Out of 18 preoperative factors that surgeons and the medical literature consider predictive of who will benefit, none predicted the actual results for these patients, Pihl’s team found.

SAN FRANCISCO — Apple on Tuesday launched a smartphone-generation credit card in the US and moved closer to hitting the hot streaming television market with a new subscription service.

The moves come as Apple shifts to emphasise digital content and other services to offset a pullback in the once-sizzling smartphone market.

Arrival of an Apple Card tailored particularly for iPhone fans came with reports that the technology titan is keen to launch its TV+ streaming service before Disney goes live with a rival in November.

Apple TV+ will debut with a small selection of original content and a possible subscription price of $9.99, Bloomberg reported, citing people familiar with the matter.

The price would be more than that charged by powerhouse players Netflix and Amazon Prime as well as the announced subscription cost of a Disney+ service to launch on November 12.

California-based Apple did not immediately respond to a request for comment about TV+.

Spending on shows

Apple has reportedly allocated more than $6 billion for TV+ original shows, a small number of which would be available when the service goes live.

Ads for “The Morning Show” starring Jennifer Aniston, Reese Witherspoon and Steve Carrell began appearing on Twitter.

The show was described as “a high-stakes drama that pulls back the curtain on the morning news” coming this fall to those with Apple TV+ subscriptions.

With Hollywood stars galore, Apple in March unveiled streaming video plans along with news and game subscription offerings as part of an effort to shift its focus to digital content and services to break free of its reliance on iPhone sales.

The Apple TV+ service, an on-demand, ad-free subscription service, will launch this year in 100 countries, the company said at the event.

“We feel we can contribute something important to our culture and to our society through great storytelling,” Apple Chief Executive Tim Cook said when the service was announced.

Apple revealed only a few of the programmes in the works but announced collaborations with celebrities on both sides of the camera including Octavia Spencer, J.J. Abrams, Jason Momoa and M. Night Shyamalan.

The new content will be available on an upgraded Apple TV app, which will be on smart television sets and third-party platforms including Roku and Amazon’s Fire TV. 

Apple will also allow consumers to subscribe to third-party services like HBO and Starz from the same application. 

Creative Strategies analyst Carolina Milanesi expected Apple TV+ to be more of a channel at its streaming video service, similar to an HBO, than to be a “one-stop-shop” that would stand alone.

Games and Cards

Apple is aiming to leverage its position with some 900 million people worldwide who use at least one of its devices. 

The company has announced plans to launch a new game subscription service called Apple Arcade internationally later this year.

“Apple Arcade will introduce an innovative way to access a collection of brand new games that will not be available on any other mobile platform or in any other subscription service,” Apple said in a statement.

The Apple credit card that became available on Tuesday in a partnership with Goldman Sachs was integrated with Apple Pay.

Those signing up will get a physical card and one for a digital wallet, with the two companies pledging to refrain from sharing or selling data to third parties for marketing and advertising.

Apple Card features that could shake up the credit card industry include not charging fees, giving users cash back on purchases and providing tools for people to better manage their debt.

“Apple Card delivers new experiences only possible with the power of iPhone,” the company said in an online post.

The card uses machine learning and mapping capabilities to let users keep track of spending, and provides payment options showing interest costs of various options.

WASHINGTON — A study published on Monday linked consumption of fluoridated tap water during pregnancy to lower IQ scores in infants, a finding at odds with decades of public health messaging extolling the mineral’s benefits in reducing cavities. 

Several outside experts expressed concern over the research’s methodology and questioned its conclusions, though some found the results compelling enough to merit further investigation. 

The US Centres for Disease Control and Prevention (CDC) named community water fluoridation one of ten great public health achievements of the 20th century because of its contribution to the steep decline in tooth cavities in the United States over several decades.

But although high levels of fluoride have been found to be toxic to rat brains, the concentrations seen in fluoridated tap water are deemed safe.

“We realised that there were major questions about the safety of fluoride, especially for pregnant women and young children,” Christine Till, an associate professor at Canada’s York University and the paper’s senior author told AFP, adding it was important to base decisions on evidence.

The study, published in the influential JAMA Paediatrics journal, analysed data from 512 mother-child pairs across six Canadian cities, with about 40 per cent living in communities supplied with fluoridated municipal water. 

After controlling for other toxins in their analysis, they found that an increase in concentration of fluoride in pregnant mother’s urine of 1 milligramme per litre was associated with a 4.5-point lower IQ score in boys — but not girls — at age three or four.

When estimating the daily maternal fluoride intake instead of fluoride in urine, they found a 1 milligramme increase in intake was associated with a deficit of 3.7 IQ points for both boys and girls.

US and Canadian health authorities recommend capping fluoride concentration at 0.7 milligrammes per litre (parts per million) to prevent fluorosis, overexposure to fluoride that leads to mild tooth discoloration.

But the actual levels that will be ingested will vary according to how much a person drinks.

According to the CDC, fluoridated water is supplied to nearly three in four Americans (more than 211 million people), while Health Canada estimates 39 per cent of its population receives water from fluoridated supplies.

Anticipating controversy, the journal took the unusual step of issuing an editor’s note that said the decision to publish was “not easy” and that it had been subject to additional scrutiny.

Experiments in water fluoridation began in the early 20th century, and over time its opponents came to be seen as quacks: The 1964 satirical film “Dr Stranglove” features an unhinged general who believes fluoridation is a Communist conspiracy against the US.

Till said that she herself had not been convinced when a graduate student first approached her with the idea to investigate the effects on IQ, but has since come around.

“We’ve had many moments in history where we got new knowledge and changed decisions: Look at thalidomide and look at recommendations for hormone replacement therapy,” which was once advised for all menopausal women, she said.

But experts in fields ranging from statistics to toxicology to neuroscience expressed reservations.

“The key words in the paper are ‘higher levels’,” said Oliver Jones, an environmental chemist at Australia’s RMIT University, who noted that fluoride intake appeared to be below one milligramme per litre for most people in the study.

Precautionary principle

He nevertheless called the work “interesting” and said it justified future research — a conclusion shared by David Bellinger, an epidemiologist at Harvard University who told AFP the results were “highly credible” but would need to be replicated before policy changes were in order.

But Stuart Ritchie, a psychologist at King’s College London, said it was “inconsistent” that the study’s first analysis only found a significant result for boys and not girls, while the second analysis found an overall effect with no sex differences, and deemed the findings “pretty weak”.

Critics of water fluoridation argue it is unnecessary because modern dental products like toothpaste contain fluoride, while 97 per cent of European residents receive unfluoridated water without a major impact on their dental health.

Pamela Den Besten, a professor of orofacial science at UC San Francisco told AFP that while she remained in favour of fluoride for its dental benefits, it acts on teeth topically and concerns over its presence in drinking water should not be dismissed.

“My bias, given the findings of this and other studies, is to focus on the delivery of fluoride through strategies that do not require the fluoride to be ingested,” she said.