This is the story of Joseph, a 28-year-old man who's made a very difficult choice. On December 2024, Joseph Awuah-Darko shared the difficult decision of choosing euthanasia on Instagram. He's not physically sick, but he's been battling a severe mental illness called bipolar disorder for many years. He's tried many treatments, but nothing has helped him feel better. He feels like the pain of his illness is too much to bear. He's shared his story publicly to help people understand what he's going through and to show how serious mental illness can be. Joseph shared a post that explained why he is making this decision, in the caption of the post he shared, “I am not saying that life (as a phenomenon) isn’t worth living. It ABSOLUTELY is. What I am saying is that the mental weight of MINE has become entirely unbearable.”

Joseph has bipolar disorder, which means his moods swing very high and very low. He's had this illness for a long time, and it makes his life very difficult. On his Instagram, he has shared his journey with bipolar, he explained that he tried many different medicines and therapies, but they haven't worked. He feels constant pain and suffering because of his illness. He's reached a point where he feels like he can't go on anymore. He's been open about his struggles on social media, hoping to raise awareness about mental health. He wants people to understand how much he suffers and why he's made this decision.

Euthanasia in the Netherlands

Government of the Netherlands explain that in the Netherlands, it's legal for a doctor to help someone end their life if they meet certain conditions. This is called euthanasia. Joseph has applied for this because he feels his mental illness is causing him unbearable suffering. There are rules and procedures that doctors must follow. They have to make sure the person understands their decision and that there are no other options. The process can take a long time, sometimes years. Joseph believes that having the option of a peaceful and dignified death is important. He wants to have control over how his life ends.

The Last Supper Project

When Joseph shared his decision, people had many different reactions. Some people understood and supported him. Others were sad and hoped he would change his mind. He even received some negative comments. But he also received many kind messages, including invitations to have dinner. This inspired him to start "The Last Supper Project," where he travels and shares meals with strangers. In the caption he explained, “‘The Last Supper Project’ is based on the Harvard Study of Adult Development which speaks to the importance of quality relationships and community as the greatest predictor for happiness. And I feel connecting this way around food as a great unifying vessel could be beautiful.”

The Last Supper Project is one of the longest studies, lasting for more than 80 years, done on adult development. In an Author Speaks edition of McKinsey & Company, the study’s director Robert Waldinger explained the study wanted to know what helps people have happy and healthy lives, even if they had problems when they were young. Most studies only looked at what goes wrong, but this one wanted to know what goes right. The study emphasizes that it is never too late for positive changes. People often believe they are too old or incapable of forming good relationships. They may think happiness is out of reach. However, the study has observed individuals who found happiness unexpectedly.

Joseph wants to connect with people and enjoy these moments while he waits for his euthanasia request to be approved. He sees these dinners as a way to find joy and connection in his final chapter. He still has bad days, but he finds comfort in these shared experiences.

Fasting for three hours before bed can significantly improve heart health and reduce the risk of coronary artery disease (CAD) as well as other chronic conditions, an Arteriosclerosis, Thrombosis, and Vascular Biology study suggests.

While many believe that diet plans such as intermittent fasting or time-restricted eating can help reduce their weight, researchers at Northwestern University have found that not eating three hours before going to sleep can reduce overnight blood pressure by nearly four percent, heart rate by five percent and strengthen overall heart rhythms.

This can help reduce overall strain on the heart which lowers risks for conditions like hypertension and CAD. Additionally, the scientists also discovered a drop in blood sugar levels, improved glucose tolerance and insulin sensitivity.

Participants who underwent glucose tests also showed better insulin release which tend to stabilize during the day. Additionally, an improved heart rate also lowered nighttime cortisol, which helped in metabolic balance.

Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine and chief of sleep medicine in the department of neurology at Feinberg and corresponding author said of the results: "It's not only how much and what you eat, but also when you eat relative to sleep that is important for the physiological benefits of time-restricted eating."

The study authors also noted: "Extending overnight fasting duration by three hours in alignment with sleep improved cardiometabolic health in middle-aged/older adults by strengthening coordination between circadian- and sleep-regulated autonomic and metabolic activity.

"This sleep-aligned time-restricted eating approach represents a novel, accessible lifestyle intervention with promising potential for improving cardiometabolic function."

Coronary Artery Disease: The Silent Killer

Despite being as a common heart disease, coronary artery disease (CAD) develops over years and has no clear signs and symptoms apart from a heart attack. The illness begins due to a buildup of fats, cholesterol and other substances known as plaque in and on the artery walls.

Over time, this can cause narrowing or blockage of the coronary arteries and block the supply of oxygen-rich blood to heart which can lead chest pain (angina), shortness of breath and ultimately, heart attacks.

Typically, those above the age of 45, having a biological family member with heart disease, lack of sleep, smoking, consuming saturated fats along with other autoimmune diseases such as lupus and rheumatoid arthritis can increase the risk of developing CAD.

Treatment options may include medicines and surgery. Eating a nutritious diet, getting regular exercise and not smoking can help also prevent CAD and the conditions that can cause it.

Nearly one in 10 Indian adults suffer from CAD and about two million people die from the disease annually. Apart from this, about 18 to 20 million American adults aged 20 and older are also affected about the disease.

Strokes: A Rising Crisis In India

One in seven stroke patients in India are young adults aged below 45 years, with hypertension leading as the major risk factor, according to a study by the Indian Council of Medical Research (ICMR).

The Global Burden of Disease Study 2021 identified hypertension, air pollution, tobacco smoking, high cholesterol, increased salt intake, and diabetes as the leading risk factors of stroke.

Incidence of stroke is increasing significantly in low- and middle-income countries (LMICs), especially in India, due to population growth, aging, and greater exposure to risk factors.

Quitting smoking is one of the most important steps a person can take to improve their health. But research suggests that women face unique challenges that make it harder to stop smoking and remain nicotine-free as compared with men.

According to the Centers for Disease Control and Prevention, about 10 percent of women in the US currently smoke cigarettes. Each year, while many attempt to quit, maintaining long term abstinence remains difficult for a large number of smokers.

Scientists say these differences are not about motivation and women are usually just as willing to quit smoking as men. In many cases they are even more likely to seek help through smoking cessation programs, counseling or medical treatment.

However, the challenge lies in a combination of biological, psychological and social factors that can make nicotine addiction behave differently in women.

Nicotine Works Differently in Women’s Bodies

One of the biggest reasons for the difference is biological as women process nicotine differently than men.

Research shows that women tend to metabolize nicotine faster. This means nicotine leaves the body more quickly, which can lead to stronger withdrawal symptoms and more frequent cravings. Jean Perriot, MD, an addiction specialist at the Émile Roux Dispensary in France, says this biological difference can affect treatment.

Even though doctors sometimes worry about giving women too much nicotine replacement therapy, such as patches or gum, biological measurements often show that many women actually receive too little nicotine replacement, which can make treatment less effective.

Hormones also play a role in smoking behavior. Studies suggest that cravings may increase when estrogen levels are high and decrease when progesterone levels rise. These hormonal shifts occur naturally during the menstrual cycle and may influence when quitting attempts are most successful.

Stress And Emotions Can Trigger Smoking

Dr Nancy Rigotti, director of the Tobacco Research and Treatment Center at Massachusetts General Hospital who specializes in smoking cessation for many years notes that emotional triggers such as stress or depression can strongly influence smoking behavior among women.

Social and economic pressures may also increase vulnerability to tobacco use. Historically, the tobacco industry has targeted women with marketing campaigns that connect smoking with weight control, independence or attractiveness. Public health experts say these messages can shape attitudes about smoking and reinforce addictive behaviors.

Smoking Habits And Weight Concerns

Behavioral research suggests these cues may have a stronger influence for some women, which can make quitting harder even when nicotine dependence is treated.

Furthermore, nicotine can suppress appetite, leading may to pick up smoking to manage body weight. Studies show that women are more likely than men to experience increased cravings for high sugar or high fat foods after quitting smoking. They also tend to gain slightly more weight on average which can make some women hesitant to quit or more likely to relapse.

Treatments Work Differently for Women

Research suggests nicotine replacement therapy may need to be carefully adjusted because of faster nicotine metabolism in women. Some medications used to help people quit smoking may also have different effects.

For example, studies suggest the medication varenicline may cause more side effects in women, while the drug bupropion may be somewhat less effective for female smokers.

On the other hand, behavioral treatments appear to work well for many women. Cognitive behavioral therapy, which helps people understand and change unhealthy habits, may be slightly more effective for women than men. Women are also more likely to try complementary approaches such as meditation, yoga or hypnosis when attempting to quit smoking.

Toward More Personalized Quit Strategies

Exposure to secondhand smoke is another concern. Studies show women are often more likely to be exposed to tobacco smoke at home or in shared environments. Some research also suggests women may face higher risks of certain tobacco related diseases even at lower levels of smoking.

Understanding these differences can help doctors design better quitting strategies. Scientists say the goal is not simply to encourage people to quit smoking, but to provide the right tools so that quitting becomes more achievable for everyone.

Often called the stress hormone, cortisol is produced by your adrenal glands, located on top of the kidneys. The hormone plays a critical role in keeping you healthy and maintaining your energy as well cardiovascular health.

Cortisol is a necessary tool for survival and naturally peaks in the morning to help you wake up and drop at night to help you sleep. While the body has a system in place to maintain hormone levels, issues arise when cortisol levels stay chronically high, meaning your body is constantly in "fight-or-flight" mode.

This can happen due to long-term stress, certain medical conditions (like Cushing’s Syndrome), or the prolonged use of steroid medications.

However, Dr Suman Agrawal, a renowned Oxford University certified nutritionist and qualified fitness expert has shared how "Shin-Kokyu”, a technique used by Japanese samurais before a battle exercise can help reduce cortisol by 80 percent

Step One: Box breathing method:

• Inhale for four seconds through the nose while the tongue touches the palate
• Hold for four seconds with abdominal muscle tension
• Exhale for four seconds through the mouth, lips pursed
• Pause for four seconds with complete relaxation

Place three fingers below the navel with medium force & hold throughout the breathing. There’s a cluster of vagus nerve endings there. It’s like a button in the body.

Step Three: Gaze into nowhere

Look straight ahead and defocus your gaze as if you are looking through a wall for three minutes. This time span is equal to 12 breathing cycles which is the minimum time needed to reboot the nervous system.

Symptoms Of High Cortisol Levels

• Physical Changes: Rapid weight gain, particularly around the abdomen, face (moon face) and the back of the neck (buffalo hump).
• Skin Issues: Thinning skin, easy bruising, and pink or purple stretch marks on the abdomen or thighs.
• Muscle & Bone: Weakness in the arms and thighs, muscle loss and an increased risk of bone fractures (osteoporosis).
• Metabolic Signs: High blood pressure, high blood sugar and a strong craving for sugary or fatty foods.
• Emotional & Cognitive: Persistent anxiety, irritability, mood swings, depression, brain fog and difficulty concentrating.
• Sleep & Energy: Chronic fatigue, feeling tired even after a full night's sleep and insomnia.

Health Risks of Chronic High Levels

If high cortisol levels are left un-addressed for an extended period, they can lead to serious health complications, including:

• Cardiovascular Disease: Chronic hypertension and damage to blood vessels increase the risk of heart attack and stroke.
• Type 2 Diabetes: Persistent spikes in blood sugar make it difficult for the body to manage insulin effectively.
• Suppressed Immune System: Chronic cortisol elevation can weaken immune response, making the body more susceptible to infections and slowing down wound healing.
• Mental Health Disorders: Long-term exposure is strongly linked to chronic anxiety and major depressive disorders.
• Digestive Issues: It can disrupt gut health, exacerbating conditions like IBS, bloating, and indigestion.