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The hidden dangers of chronic inflammation

“Unless you get diagnosed with a chronic condition, you might be unaware of inflammation,” says Yalda Alaoui

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Yalda Alaoui

The prevalence of inflammatory bowel disease is increasing dramatically. Yalda Alaoui explains why chronic inflammation can affect us all.

We become familiar with inflammation from a very young age. When you cut your finger, to heal the cut, your body sends inflammatory cells to the injury.

Inflammation refers to your body’s process of fighting against things that harm it such as infections, injuries, and toxins, in an attempt to heal itself. When something damages the cells, like cutting your finger, your body releases chemicals that trigger a response from your immune system. This is known as acute inflammation.

Chronic inflammation, however, happens when this response lingers, leaving your body in a constant state of alert and can have symptoms harder to spot such as abdominal pain, chest pain, fatigue and fever.

Yalda Alaoui found that she was suffering from chronic inflammation after she was diagnosed with ulcerative colitis – an inflammatory bowel disease (IBD) in which the lining of the colon becomes inflamed and develops tiny open sores or ulcers.

“I had an acute case for many years where my body did not respond positively to medication. I was pretty much in a constant flare,” Yalda tells me. Despite not experiencing remission, doctors assured her multiple times that there was no link between nutrition and her condition.

“Because I didn’t see any results, I set myself on a path of research on lifestyle and nutrition. I was looking at everything, not just dietary changes,” she says. “I changed a few things in my diet and I started working out again. But I later found out that some workouts can increase inflammation.”

Yalda was also diagnosed with a disease called autoimmune haemolytic anaemia – a rare blood condition that causes the antibodies of a person’s immune system damage some of their red blood cells. “It was almost fatal for me a couple of times. But it sparked a conversation with my doctor that made me realise that the link between my two conditions was actually inflammation.”

Subsequently, she extended her research and started talking to other people on forums with similar conditions. “We would exchange phone numbers and I would talk to other people and try to understand the mechanisms of those diseases through their experiences,” she explains.

Analysing the common symptoms of chronic inflammation is what helped Yalda to improve her lifestyle – from sleep and nutrition to exercise, mental health, strengthen immunity and body composition. “I was trying to put all the pieces of this puzzle together through others to truly understand the inflammatory processes and the links to other diseases much further than just autoimmunity,” she says. “So, I developed a method to improve my symptoms, and finally be free of pain.”

After retraining as a nutritional therapist, Yalda launched Eat Burn Sleep – an online platform that helps people reduce inflammation, restart their gut microbiome and promote optimum immune and liver health.

Yalda was diagnosed with ulcerative colitis in 2007

“70 per cent of your immune system cells sit in you gut,” she points out. “So, the reason why gut health is so important is because it influences your immune system and your inflammation as a result.”

Yalda’s platform is based on three pillars: nutrition, movement and mental wellness. “Very few people realise that if you’re really stressed, it’s hard for inflammation to be reduced because your cortisol levels are high,” she tells me. “When you have high cortisol levels, what it does is it switches on the sympathetic nervous system, your fight or flight response, and it switches off the parasympathetic nervous system, your rest and digest side.”

Eat Burn Sleep encourages a better lifestyle rather than adopting restrictive diets. Yalda says that she wants people to be social and have fun with their friends, cautioning that most diets can be extremely unhealthy mentally, physically and physiologically.

“My method is very moderate,” she adds. “Cutting out a certain food group entirely increases the chances of losing the good bacteria to digest it. Instead, I want to show people how much of that food to reduce and for how long.

“When it comes to exercise, for example, being sedentary is linked to heart disease, metabolic syndrome, diabetes and obesity. But high intensity exercise is also linked to chronic inflammation. So, I have a library of anti-inflammation workout videos along with a mental wellness section where I help people not only stay calm and meditate, but also rewire the subconscious brain and tap into neuroplasticity – the brain’s ability to form new neural connections throughout life.

“We also have about 20 doctors backing my method. They have used it for themselves and now share it with their patients,” she says. “My aim is to put people together – gastroenterologists, GPs, osteopaths, immunologists – and share interesting findings or observations that can help others with their practice.”

The prevalence of inflammatory bowel disease (IBD) increased between 2006 and 2016 by 33.8 per cent and globally, more than six million people are affected by IBD.

Yalda thinks that Deborah James’ case will help more people understand chronic inflammation, but she also says that: “The food has changed a lot. Many healthy organic processed foods are packed with additives that lead to inflammation, metabolic syndrome, unhealthy weight gain, and irritable bowel syndrome (IBS).

“Unfortunately, with chronic inflammation, unless you’re diagnosed with a chronic disease, you don’t get any signs,” the nutritionist explains. “But one of the first things to pay attention to is excess fat. Although I know everyone talks about body positivity, it is not helping our health, because a high BMI means that your body produces more inflammatory cells.

“So, things like a high BMI or bloating may suggest that you probably have inflammation in your body. I would say do something about it. A doctor cannot sleep for you. A doctor cannot eat for you. A doctor cannot think positively for you. Take steps to improve your health today, which will improve your mental well-being. You’re going to have a sharper brain, a better mood, you’re going to enjoy your life better, and prevent diseases later.

“Also, when you do that, you start shopping for healthier foods,” she adds. “And guess what, healthier foods are better for the planet. So, from an ecological standpoint, sustainability helps the environment and you become less of a burden on the healthcare systems in the future.”

I ask Yalda why she thinks it is harder to maintain a healthy lifestyle now. “I think there’s a lot of confusion. You hear so many mixed health messages and you don’t know which one to follow and I also think that we have such a perfectionist mindset.

“Everything’s black and white. People feel that they either have to be really good or if they eat one bad thing, they’re going to go for all the unhealthy foods. So, in my method, it’s about damage limitation, not perfection. I developed this because I wanted to continue having fun. Life was so boring when I was sick. What I tell people now is skip the sandwich on your lunch break and go for a salad. Then if you want to enjoy some prosecco with your friends, do it well, so you produce the enzymes to digest it and enjoy it guilt-free.”

Alongside improving Eat Burn Sleep, the nutritionist is also working on an app that will be available soon and will help more people on the path of recovery.

“I want to continue helping people and I want to keep raising awareness,” she says. “In the long run, my goal is to help introduce nutrition in the curriculum in medical schools because I really want to bridge the gap between holistic treatment and allopathic medicine and truly make a difference.”

For more information, visit eatburnsleep.com.

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Far from ‘boxed in’: The innovative design transforming at-home testing

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Alexander Parker is head of wellness at packaging design and manufacturing company, Burgopak.

Burgopak is a world leader in design innovation, with a 25-year-history spanning entertainment, consumer tech and now health diagnostics, including an expanding range of at-home hormone and fertility testing kits.

We speak to Alexander to discover what goes into designing robust, functional but engaging packaging and the sometimes surprising considerations that can make or break a product.

Hi Alexander. Please tell us about your role at Burgopak.

My role is about driving our growth and direction in the healthcare and wellness space, which in practice means everything from packaging to client engagement, to partnerships, to developing the team.

I also sit on the company management committee and help manage our IP portfolio.

Before stepping into this role, I spent 20 years as a designer, 15 of them as head of design – so I bring a hands-on understanding of what it takes to deliver great packaging.

At-home test kits require the user to perform a medical procedure alone, without professional support.

How does that inform your design approach?

It’s a key pillar of a project, heavily influenced by the product and its intended use.

In the case of a test kit being used to collect a sample specimen and return it to a lab, there’s often plenty of opportunity for packaging to help or hinder the process and experience.

There are layers to effective packaging.

●       Structure – Physical interventions through the packaging.

●       Artwork – The visual identity, messaging and instructions across the pack and instructions for use.

●       Signalling – Sometimes-undervalued but what signals are communicated through the packaging – how this makes the user feel about the product, the company behind it and the task at hand.

Careful design of the instructions for use is universally appreciated and often a regulatory requirement.

However, the pack structure and artwork should also work together to communicate a clear user journey.

This could include presenting components in the order they’re used, aligning the pack layout with the IFU steps (Prepare>Test>Return), making the IFU immediately visible as a hero component.

We can also introduce physical aids, like collection tube stands, to help during the sampling process.

The packaging is often used in the return of the sample to a lab so this needs to be considered and intuitively designed.

The structure, materials and artwork are all communicating something to the user.

You want to reassure the user by signalling care, efficacy, trust and in the case of a paid product, value.

In your mind, compare these two pack examples.

One a simple carton with a sea of components loosely filled and rattling around inside. Poor quality print and seemingly damaged in the post.

Contrast that with a suitably robust piece of packaging, with the components arranged and labelled into steps 1, 2, 3.

They might both work, but you can imagine the second building a reassured user experience.

How often do you encounter brands that haven’t thought about the emotional and potentially anxiety-inducing moment of opening a testing kit, and what’s the first thing you fix?

Thankfully it’s not too often, in our case at least.

I think we tend to attract customers who sense there’s more to packaging than just being a container or functionally driven.

The start of a project for us is building a brief with the customer and aligning on values for the packaging – what we want people to feel when opening or using it – as well as defining the technical requirements.

So, if there’s going to be an early fix it’ll probably be here, establishing the emotional intent.

How has the rise in social media ‘unboxing’ videos and product reviews changed what you do?

Is there a tension between designing for social media shareability and designing for the privacy women often want around health testing?

I don’t think there has to be a tension, provided everyone is clear on what the goals of the packaging are, and they are aligned with the product type and its use.

We can’t influence the results of a test or the positive or negative emotional significance it has in someone’s life.

What we can do is design packaging that offers the best possible user experience.

If there’s a shareable moment at the end, packaging might be a prop within a photo or video. But equally it might be a very private experience.

If it’s a test offering a diagnosis or insights into a health condition – you can conceive of a range of emotional outcomes. As you could imagine for certain fertility products too.

The design needs to acknowledge all these possibilities in its structural design, visual identity and the signals they communicate.

For women using a fertility or hormone test, perceived quality signals trust.

How do you stop sustainable choices from reading as cheap?

Do the essentials well, look for small interventions that add value and use attention to detail to signal that the care taken over the packaging, and sustainability, extends to the user.

Material choice is incredibly important.

In the case of paperboard quality can be a spectrum so it’s important to take the time to find and qualify the right one.

One that offers the necessary performance characteristics, is verifiably from responsibly managed forests such as through FSC/PEFC, and from a mill whose activities are aligned with your sustainability targets.

Take care over the design of each touch point and detail. A fitment that holds a device should neatly cradle it. A closure should be intuitive to open and work every time.

If the pack is meant to stand up, then the proportions should be optimised to facilitate that. It’s attention to the details that’s important.

Print quality will have a big impact on perception, not just the messaging or visual identity it renders. If the print quality is poor, then it devalues the product.

Doing it well doesn’t mean using material resources – it’s careful vendor selection and quality assurance.

For some responsible premiumisation you can introduce embossing or debossing details to the artwork, a tactile three-dimensional finish.

This details-led approach is valuable across all packaging but if sustainability is driving a reduction to the essentials, then there is a heightened importance to the execution of what is left.

As at-home health testing moves into NHS and public health contexts, what does good packaging look like when the brief is scale and cost rather than aspiration?

Scale and cost often feature very heavily in the success of projects outside of these settings, so there are parallels between the public and private, but with greater imperative to strip things back.

What is important to understand is success is not a piece of packaging in isolation. It’s efficiency, kitting, quality, distribution, tracking, data management across all activities and partners. Packaging is one part of the bigger picture.

Central to all of this is the need for it to reliably and consistently encourage the correct use of the kit through structure, artwork and instructions.

It is materially efficient and from a robust agile supply chain.

Assembly and kitting might be automated so it will be designed for those production lines or in conjunction with the equipment development.

It is compliant with all transport regulations and the most cost-efficient postal streams to the patient and from them back to the lab.

So, what does good packaging look like? It’s the design that efficiently offers the best patient user experience through a robust, reliable, scalable supply chain.

How do you make the business case for investing in packaging design before the product itself is ready to market?

There’s an opportunity cost.

Packaging has the potential to be a valuable asset when someone invests time and resources into coherent design and development. By starting too late or under resourcing the process you risk having packaging that’s a commercial pain point.

At the earliest opportunity, you at least want to be selecting your packaging partners and have a clear understanding of the development timeline and milestones – structural design, prototyping, stakeholder feedback, artwork/labelling development, regulatory milestones, transit testing, stability testing, wetproofing, manufacturing, delivery.

You must complete these steps before your product can go to market.

What’s the cost to you of delaying launch because you didn’t get packaging underway sooner?

You need to spend time creating packaging that elevates your brand and is a marketing asset that works across ecommerce, retail, advertising, social media.

Engage with the other supply chain stakeholders.

One example would be involving kitting partners in the process to validate and input on packaging improvements. If it’s expensive to kit, your cost of goods go up and if it’s slow to kit you might not have a scalable solution.

You may also find packaging insights influence product decisions.

If you are defining components for a test kit, factor in that larger devices might in turn increase pack size and eventually incur higher shipping costs.

You might work with a device manufacturer on how a USB cable is wound so the packaging volume can be decreased – another potential packaging and shipping cost reduction.

Transit testing and design improvements ensure that products arrive in acceptable condition – reducing costs associated with replacements, damaged reputation and potentially the loss of repeat purchases.

Packaging done well is that opportunity realised – it’s value demonstrated across sales, marketing and operations.

For a founding team approaching a packaging partner for the first time, what does a genuinely useful brief contain, what do most brands leave out, and how much does coming in underprepared add to the timeline and cost?

At Burgopak we build a brief together with the customer and that usually happens in a few stages.

The initial conversation is a chance to learn more about each other, make sure we’re a good fit for one another and the project.

We like to learn more about you, your product, how it’s used and some headline information around timelines, volumes, budget, your packaging ambitions and likes/dislikes.

We explain what we do and how we typically work. This really is the kick-off point – the goal at the end of this stage is being excited to be working together on a project that looks technically and commercially feasible.

In the next stage we build-out a brief capturing the technical and brand-led requirements of the packaging.

It will cover product details, brand & experience, sales & delivery channels, fulfilment and distribution, budget and timelines, compliance and regulations.

The exact questions will vary by product and project, but they span those areas.

From this we can build the project plan – and this might involve working towards answers that aren’t yet defined.

It seems obvious, but knowing exactly what needs to be packaged is fundamental – the product, peripherals – and this can be one of the common missing puzzle pieces.

You can design a container to hold ‘something’.

But when you know exactly what the product is – its size, shape, weight, how it’s used – you can design a piece of packaging that is maximally efficient and effective in elevating the total product experience.

The risk to a successful project is not so much under preparedness at the start – we’re here to help build the brief and a realistic project plan – it’s a loss of momentum through the process.

The packager and the client must work together.

We can be very efficient and agile in doing the work but there’s also the responsibility from the client to keep momentum through rounds of feedback, coordinating product samples or technical drawings and so on.

If there’s a finite timeline and repeated delays within it there can come a crunch point – when delivery dates are pushed out or potentially avoidable compromises made.

Come prepared to collaborate on the brief – but know that the founding teams who get the best outcomes are the ones who stay engaged and keep momentum through the whole process, not just the kick-off.

Learn more about Burgopak at burgopak.com

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Elation Health acquires EHR startup Aster

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Elation Health has acquired Aster, a women’s health EHR startup created by sisters Fifi Kara and Dr Lailah Kara-Newton.

The deal, announced on 3 June 2026, will see Aster’s team join Elation Health as the company expands development of what it describes as the first agentic operating system for primary care.

An EHR, or electronic health record, is a digital system used by healthcare providers to store and manage patient information.

Aster was founded by Kara and Kara-Newton as an AI-native EHR platform for women’s health providers.

Elation Health said the acquisition would allow Aster to learn from its expertise in AI agents and support development of its agentic operating system for primary care.

Kyna Fong, co-founder and chief executive of Elation Health, said: “The Aster team impressed us with their vision and creative inventions to support independent practices.”

Fong said Elation, like Aster, was founded by siblings who wanted to change the healthcare system.

She added: “That shared north star means they understand what we’re building and why it matters. It was clear right away they would significantly add to our capabilities.”

Kara has spent 10 years creating consumer and business-to-business products across the UK, Europe and the US, and recently supported Meta’s Health & Fitness team, according to Aster’s website.

Kara-Newton previously worked as a hospital doctor in the NHS across medical and surgical specialties, including breast surgery, general surgery, emergency medicine and obstetrics and gynaecology.

Aster launched in 2023 after raising US$2.8m from Zeal Capital Partners, Cornerstone Ventures, Octopus Ventures and others.

Kara, Kara-Newton and Aster’s chief technology officer, Nacho Vazquez, will all join Elation.

Kara said: “From the moment we met Kyna Fong, Ashley Rogers, and the Elation leadership team, it was clear we were aligned on what matters most: that clinicians deserve truly incredible software that brings joy back to their practice. Together, we can now bring that vision to millions of primary care patients across the country.”

The sisters said their work was shaped by Kara-Newton’s first pregnancy, when undiagnosed pre-eclampsia led to an emergency caesarean section and neonatal intensive care admission for her son.

The founders said they wanted to build technology that could help prevent similar outcomes for other women.

The acquisition comes amid continued concern over maternal health inequalities in the US.

In the US, Black maternal mortality remains alarmingly high, with rates nearly double those of white women, and experts point to unequal access to care, implicit bias and fragmented approaches to care.

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Copper coil vs Mirena: Which is right for you?

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Article produced in association with Spital Clinic

Both the copper coil and the Mirena are more than 99 per cent effective as contraceptives — but they work in completely different ways, have opposite effects on periods, and suit very different people.

 

With the FSRH’s May 2024 licence extension for the Mirena now in effect, this guide covers the five key differences using up-to-date UK evidence, not the older guidance that many sources still repeat.

How Each Device Works

The FSRH March 2023 guideline set out the terminology now used across UK clinical practice: the copper intrauterine device (Cu-IUD) and the levonorgestrel intrauterine system (LNG-IUD).

The copper coil works by releasing copper ions that are toxic to sperm, preventing fertilisation. It contains no hormones at all, making it a strong option for women who cannot or do not want hormonal contraception.

The Mirena — the most widely prescribed 52mg LNG-IUD in the UK — thickens cervical mucus to block sperm, thins the uterine lining, and may suppress ovulation, though most users continue to ovulate normally.

According to Hull University Teaching Hospitals NHS Trust, the hormone levels it produces are lower than those from the combined contraceptive pill — relevant for women advised to avoid higher-dose hormonal methods.

The hormone-free nature of the Cu-IUD is its defining advantage for some; the localised hormonal action of the LNG-IUD is its defining advantage for others.

According to NHS guidance on the copper coil, neither device interacts with medicines or herbal remedies, and both can be fitted in women who have never been pregnant.

The way each device works also determines what it does to periods — often the deciding factor.

Effectiveness and Duration

The NHS confirms both devices prevent pregnancy in more than 99 per cent of users. When it comes to contraceptive effectiveness, there is no meaningful difference between them.

Where they differ significantly is duration. The copper coil lasts up to 10 years, and one fitted in a woman aged 40 or over can remain in place until menopause under FSRH March 2023 guidance.

For the Mirena, the picture changed in May 2024: the FSRH CEU statement on extended LNG-IUD use confirmed that all 52mg LNG-IUDs — including the Mirena, Levosert, and Benilexa — are now licensed for eight years of contraceptive use, up from five under previous guidance.

When the Mirena is used as part of HRT, it protects the uterine lining for up to five years before requiring replacement. Smaller-dose devices such as Kyleena (20mcg) are licensed for five years, and Jaydess for three.

Both are long-acting reversible contraceptives — fertility returns immediately after removal, with no delay or washout period. Both are available without a GP referral through the coil insertion and removal service at Spital Clinic.

What Each Device Does to Periods

The most important practical difference is what each device does to periods — and they go in opposite directions.

The copper coil typically makes periods heavier, longer, and more painful; the NHS notes this may ease after a few months, but heavier bleeding is one of the most common reasons for early removal.

Both devices can cause irregular spotting in the first three to six months after fitting.

The Mirena does the opposite.

According to Hull University Teaching Hospitals NHS Trust, it reduces monthly blood loss by 86 per cent at three months and by 97 per cent at twelve months.

Nine in ten women who use it for heavy periods see a significant reduction; around 20 per cent have no bleeding at all; and 80 per cent report meaningful pain relief.

NHS information on the hormonal coil confirms that periods often become lighter, shorter, and less painful — with many users finding they stop entirely after the initial settling-in period.

For women whose choice of contraception is being shaped by troublesome periods, those statistics make the direction of the decision clear.

For women with already disrupted cycles, it is worth booking a private specialist assessment before deciding — for this group, the choice of coil is as much a treatment decision as a contraceptive one.

Unlike the copper coil, the Mirena is licensed as a first-line treatment for menorrhagia — heavy or prolonged bleeding defined as losing more than 80ml per cycle or periods lasting longer than seven days.

In around half of cases, heavy periods have no identifiable structural cause, making the Mirena’s targeted local action particularly useful: it reduces bleeding at the endometrial level without surgery, general anaesthesia, or high-dose systemic hormones, and offers a non-surgical alternative to procedures such as endometrial ablation.

Side Effects, Risks, and Who Cannot Use Each Device

Both devices carry the same procedural risks. Pelvic infection affects around 1 in 100 women in the first three weeks; expulsion happens in roughly 1 in 20; and uterine perforation occurs in approximately 2 in 1,000 fittings — slightly higher in women breastfeeding within six months of delivery. Ectopic pregnancy, though rare, is a risk if either device fails.

The side-effect profiles diverge beyond those shared risks.

The copper coil carries no hormonal side effects — heavier periods are its main downside. The

Mirena may cause acne, headaches, mood changes, breast tenderness, and ovarian cysts; most resolve without treatment, but they are worth considering for anyone sensitive to progestogen.

The Mirena is also unaffected by vomiting, diarrhoea, or most drug interactions.

Each device has its own contraindications. Neither should be fitted in the presence of an active sexually transmitted infection or unexplained uterine bleeding.

The Mirena is not suitable for women with a history of breast cancer, certain liver conditions, serious cardiovascular disease, or certain uterine abnormalities.

The copper coil, meanwhile, can be used as emergency contraception if fitted within five days of unprotected sex — the only intrauterine option for post-coital protection.

The Fitting Procedure and What to Expect

The fitting procedure is the same for both devices: a 10 to 15 minute clinical appointment, ideally towards the end of a period, though it can happen at any point in the cycle.

The full appointment takes around 30 minutes. Local anaesthetic gel or spray is used to manage discomfort, and the NHS advises taking ibuprofen or paracetamol about an hour beforehand.

No surgery or general anaesthetic is needed. Some cramping and light spotting in the days after fitting is normal and usually settles within a week. Neither device requires you to have had children previously.

Fertility returns immediately after removal of either device — there is no waiting period before trying to conceive.

For most women, the choice between the copper coil and the Mirena comes down to one question: are hormones acceptable or not?

The copper coil suits women who want hormone-free contraception, those who cannot use progestogen, and those who need emergency post-coital protection.

The Mirena suits women who want lighter or absent periods, those managing menorrhagia, and those using it as the progestogen component of HRT.

Both offer equivalent contraceptive effectiveness and full reversibility.

The FSRH’s May 2024 extension of the Mirena’s licence to eight years makes it a stronger long-term option than many comparisons suggest — worth knowing if the information you have found is based on older guidance.

This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published NHS and FSRH standards as at March 2025. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article.

This piece was produced in association with Spital Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

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