2018 has been something of a landmark year for the introduction of new laws, campaigns and guidelines, all intended to help improve the UK’s health and promote well-being. We’ve also seen some dramatic extremes in weather, as well as a number of notable developments in medicine.
As an eventful 2018 draws to a close, here’s a recap of the some of the biggest health stories to hit the headlines in the last 12 months.
Waitrose started the new year by announcing their plan to ban the sale of energy drinks to those under the age of 16 years. Soft drinks with over 150mg per litre of caffeine, which are already labelled as ‘not suitable for children’ under EU law, will require proof of age. The new steps came into play in Waitrose shops in March 2018.
January also saw the release of the #vegpower campaign on Twitter. Backed by numerous celebrity chefs, including seasoned campaigner Hugh Fearnley-Whittingstall, it set out to encourage the UK general public to eat more vegetables. The campaign has recently secured £2m worth of free advertising on the ITV network to help widen the appeal of vegetables.
The British winter can be bitterly cold but February 2018 saw a particularly extreme cold snap. The media-dubbed ‘Siberian blast’ hit the country hard. Heavy snow and below-freezing temperatures caused rail disruption, blizzard conditions and a ‘snow emergency’ to be declared in Kent. We took a look at what happens to the body when exposed to freezing temperatures.
In March Public Health England (PHE) released their report on the impact of obesity. Drawing from the report the national health body unveiled details of its new 400/600/600 diet scheme. The diet released under the ‘One You’ campaign encourages the general public to aim for 400 calories at breakfast, 600 calories at lunch and another 600 calories at dinner time. This comes as adults have been found to regularly consume between 200 and 300 calories more than recommended guidelines. Whilst PHE wants the public to take further responsibility for their own weight and health, they also want the food industry to address portion sizes and calorie content in some products.
March was the month where Viagra Connect became available to purchase over-the-counter as a pharmacy-line medicine. Patients are still required to have a brief consultation with a trained pharmacist, but the bold step has opened up accessibility of erectile dysfunction medication to men who might not have sought out help in the past. Viagra Connect is a 50mg tablet and is essentially the same as a 50mg Viagra tablet only the branding and prescribing guidelines are different.
April saw the introduction of the soft drinks sugar tax. Manufacturers now have to pay a levy on the high sugar drinks that they sell. Drinks containing 8g of sugar per 100ml now have a tax rate equivalent to 24p per litre. In response, several leading drinks brands have reformulated their drinks so that they contain less sugar in order to avoid the tax. In England the income from the new tax is being used to help fund school sports clubs and other activities.
In May the UK was referred to the European Court of Justice (ECJ), Europe’s highest court, for failure to tackle illegal levels of air pollution. According to European Commission, the UK had failed to take steps to reduce the amount of nitrogen dioxide polluting the air, particularly in urban areas. It means that levels of the harmful substance have been in breach of legal limits since 2010.
Five other countries were also referred to the ECJ (France, Germany, Hungary, Italy and Romania), whilst Slovakia, Czech Republic and Spain all made improvements following on from their final warning in January. Vehicle emissions, in particular those from diesel cars, are one of main sources of nitrogen dioxide which has led several local authorities to take a stance against unnecessary idling vehicles.
Football fans across the globe were treated to some exciting matches at the Russia World Cup which started in June. We staged our own tournament of national dishes from participating countries, to examine the nutritional differences between some of the world’s best loved cuisines.
Public Health England released the latest STI statistics for 2017. Overall the total number of diagnoses remained close to the previous year, although a marked increase in diagnoses of gonorrhoea and syphilis caught the media’s attention. Drug-resistant strains of gonorrhoea have been diagnosed in the UK and it has been identified as a potential public health issue. Syphilis is still a fairly rare STI but its resurgence is puzzling sexual health specialists, as it was all but eradicated in the 1980s.
PHE also released the results of a survey that found 31% of women to have experienced severe reproductive health problems in the past 12 months. The problems ranged from severe menstrual bleeding to menopause and infertility to incontinence. The data is being used to support a move to reposition reproductive health as a public health concern that needs addressing.
A sweltering heatwave hit the UK in July making it the joint hottest summer on record. The hot days also contributed to record numbers of people attending A+E departments across the country. There were reports of an increase in patients being seen for dehydration, heart problems and kidney failure thought to be related to the high temperatures. We reminded our readers to take precautions when enjoying the sunshine with our sun exposure infographic.
July also saw the government announce its plan to teach children about good mental health, in draft guidance that will become compulsory by September 2020. The decision was in part influenced by a petition calling for mental health to form part of the education programme, due to a significant increase in the number of young people being treated for self harm.
In August the Scottish government pledged to take steps to end period poverty by investing £5.2m into schemes to provide free menstrual products in schools, colleges and universities. The decision makes the Scottish government the first in the world to do so. The results of an online survey found that thousands of young girls in the UK are missing school due to not being able to afford menstrual products, demonstrating how widespread the problem is.
The worldwide EpiPen shortage has been a worrying topic for those with severe allergies throughout 2018. The lifesaving devices are used by those with serious allergies in instances where they are suffering an anaphylactic shock. In September the MHRA granted the manufacturer Myla’s request to extend the expiry date on certain batches of the adrenaline autoinjector device. This decision has since been extended to cover some Jext devices too.
Levitra is a branded erectile dysfunction drug but its patent expired on 31st October 2018. This has opened the door for generic tablets using the active ingredient vardenafil to come to the market. Vardenafil works in a similar way to the active ingredient sildenafil, used in Viagra, by helping to improve blood flow into the penis.
As we reported last month, the American National Institutes of Health announced their plans for a clinical study into a male contraceptive gel, known as NES/T. The extensive human trial could hold the key to finally broadening the options when it comes male contraceptives.
NHS England announced that all clinical commissioning groups should provide all suitable type-1 diabetes patients with access to ‘flash’ glucose monitoring testing. The wearable monitor allows diabetics to check their glucose levels without the need for a painful or inconvenient finger prick blood test. Diabetics must regularly check their glucose levels to see how much medication they need or what they should eat. The FreeStyle Libre device, reportedly used by the Prime Minister Theresa May, has been available for some time but CCGs have seemed reluctant to provide it to patients, potentially due to funding.
Since 1st November specialist doctors have been able to prescribe medicinal cannabis to patients. The new NHS guidance says that the treatment should only be considered where other options have been exhausted. The Home Secretary, Sajid Javid, made the decision to change the regulations surrounding medical cannabis following the high profile cases of two young children with epilepsy. The Chief Medical Officer Dame Sally Davies conducted a review and found the treatment to offer some therapeutic benefits.
On Thursday 6th December the government published details of their plan to reform the mental health act. This follows on from several recommendations made by the Independent Review of the Mental Health Act 1983. An official response will be created before changes to legislation are prepared.
News articles from the last 12 months:
Two new cases of ‘super gonorrhoea’ identified in the UK
January 2019 - Two women in the UK have been infected with a highly resistant strain of gonorrhoea, known as ‘super gonorrhoea’. Both of the women have since been cured, and Public Health England are trying to contact potential subsequent partners.
Where were the cases contracted?
It is thought that one case was acquired at an inland European ‘party destination’, and the other in the UK (however it is thought that the UK case has a close association to Europe). Although no one can be certain that the strain of gonorrhoea is spreading in the UK just yet, it is a realistic possibility that it eventually will.
The only other known case in the UK to date occurred last year, and was acquired by a British man in South-East Asia. The World Health Organisation has suggested that it has had reports of the condition growing in France, Japan, and Spain.
What is super-gonorrhoea and why is it an issue?
Super gonorrhoea is resistant to first line antibiotic treatment for the condition, which is azithromycin and ceftriaxone. This strain of gonorrhoea fits into a wider issue of antimicrobial resistance which has continued to increase due to a number of factors:
- the inappropriate prescription of antibiotics and overuse
- the ability of N. gonorrhoeae to genetically mutate and adapt to various medications
- and an increase in extra genital infections, such as anorectal infections, which particularly (but not exclusively) affect men who have sex with men.
It is a potentially serious issue because of the implications it could have in terms of fertility. Untreated gonorrhoea can have a serious impact on the health of mothers and their newborns. It can lead to chronic abdominal pain for women, severe infections for babies especially relating to the eyes, and even miscarriage.
Furthermore, more gonococcal infections would put a greater strain on the healthcare industry with more alternative treatments being sought. An epidemic of resistant gonorrhoea could leave many people facing long-term health complications.
How is it different to standard gonorrhoea?
The symptoms and signs of “super gonorrhoea” are no different to other forms of gonorrhoea, some people may experience no symptoms at all, other might experience a discharge from their genital or pain or burning when they pass urine. The fact that it doesn’t respond to the usual antibiotic treatments is what makes this strain so concerning.
It was established in the 1980s that gonorrhoea has been able to develop a resistance to antibiotics. Due to the fact that there is no vaccine available to prevent gonorrhoea, antibiotics are the only possible treatment. Normally, it can be treated with ceftriaxone and azithromycin, but the bacteria responsible for causing this resistant strain of gonorrhoea can resist this treatment as well as penicillin, fluoroquinolones and macrolides and others (which have been used in the past).
How can you reduce your risk of getting super gonorrhoea?
The same way that you would reduce your chances of developing any STI. If you have recently started a new relationship it is important to know your partner’s recent sexual history. Using a condom is the best way to avoid transmitting or acquiring bacterial STIs such as gonorrhoea during sex.
It’s recommended that people who are sexually active get tested once a year, but if you are worried about the condition because you have developed symptoms, or a sexual partner has told you they have tested positive for an STI, you should get tested straight away.
You can do this by visiting a local sexual health clinic to be tested, or ordering an STI test kit online.
Furthermore, if you would like more information on super gonorrhoea, you can refer to a previous post we published that provides further details on the subject: Super-gonorrhoea: what you need to know.
Can Dogs Be Used To Detect Malaria?
November 2018 - A new study from the London School of Hygiene & Tropical Medicine, Durham University, Medical Detection Dogs and the University of Dundee has found that dogs could detect malaria on a person by sniffing their socks.
The research hypothesised that their findings could lead to this test being the first-line non-invasive test for malaria, as it could stop the disease from being spread between countries. Therefore, people could be stopped and treated quicker.
What did the study involve?
School Children between ages 5-14 in Gambia were asked to wear nylon socks overnight and then have a blood sample taken for indications of malaria. The socks were stored away and frozen before being sent to the Medical Detection Dogs charity in Milton Keynes.
Labradors at the charity had been trained over several months to detect the differences in odour between socks infected with the malaria parasite, and those that were not. Out of the 175 sock samples that were tested, 30 were malaria positive and 145 were malaria-free. The socks that were malaria-positive also came from children who were asymptomatic.
The socks were placed individually in glass jars in several stages, and the dogs would pause at a sock that contained signs of malaria, which is the action they were taught to perform.
What were the results?
The results show that the dogs were successful in identifying socks that had been worn by children with malaria 70% of the time, and also correctly identified uninfected socks 90% of the time.
It was also reported that the dogs could make their detections 20 minutes faster than the current rapid diagnostic tests.
This is a potentially revolutionary breakthrough in diagnosing deadly diseases, especially considering that malaria cases increased by 5 million worldwide in 2016, according to the latest global health report by WHO. However the researchers are adamant that the accuracy of this method would need to improve to be able to use it in a practical way. They also suggested that it would be interesting to research further to find out if different species of malaria can be detected.
You can find clips and more information on the study here:
Government announces new strategy to combat loneliness
October 2018 - The government has announced the implementation of a loneliness strategy, encouraging GPs to refer patients who are experiencing feelings of loneliness to social activities in the community by 2023.
The practice will be known as social prescribing.
The strategy has three different goals: to develop a better understanding of what causes loneliness; to ensure loneliness and its accompanying social issues are considered when policy-making; and to raise awareness of loneliness as a whole.
How prevalent is loneliness?
Loneliness is a very important public health concern. Three quarters of GPs surveyed for the strategy said that they see between one and five people each day who are suffering from loneliness. Furthermore, it is thought that around 200,000 older people in the UK go over a month at a time without speaking to a friend or relative; and around a fifth of adults feel lonely most of or all of the time.
There are many factors that can cause loneliness, but they are mainly categorised as being either underlying factors (such as personality traits, or cultural or religious background) or a specific event or trigger (such as losing a job or moving home).
What is social prescribing?
Social prescribing is supposed to alleviate the feelings of loneliness that these factors may cause. It is currently in operation under the NHS, with almost 50% of clinical commissioning groups in England contributing towards social prescribing schemes; but it has not yet expanded to a nationwide level.
The loneliness strategy aims to make social prescribing available to everyone by employing more ‘link workers’ who GPs can use to connect people to community groups. This means that GPs will have more scope to offer non-medicinal forms of care, which will hopefully impact people’s health and wellbeing in a positive way.
What else does the loneliness strategy consist of?
Further to these plans for community-related activities, which include dance classes, art groups and walking clubs, the government has collaborated with a number of organisations (including the Co-op, Transport For London, the British Red Cross, Nationwide Building Society and Sainsbury’s) to recognise and support their employees for loneliness-related issues.
As well as creating more opportunities for community activities, the department for Digital, Culture, Media and Sport is planning to invest £1.8 million in fulfilling the potential of community spaces. This includes accessible green spaces for sport, gardens and allotments as well as other possible hubs. Sport England has also created two new programmes with £1 million from their Active Ageing Fund to focus specifically on tackling loneliness through sport for those over the age of 55.
Loneliness can deeply impact on both physical and mental health and can lead to conditions such as lack of sleep, anxiety, depression. If you are experiencing loneliness it can help to try and convey these feelings to a GP, who can direct you towards community-related activities and other possibilities for social interaction.
You can read more about the strategy on the UK government website.
Study Shows Rise in University Students Seeking Mental Health Support
October 2018 - Going to university is a big change in the life of a young person, and the progression into adulthood can carry many obstacles. Greater freedom, responsibility and pressures can have an impact on psychological well-being, and a new study from the BBC suggests that students are increasingly looking for help when it comes to their mental health.
New analysis from the BBC shows that there has been a 53% increase in the number of students seeking mental health support from the academic years 2012-2017. The figures are more startling considering that there has been a 1% decrease in the national UK student population, as fewer students are going to university.
What did the study entail?
The BBC contacted 172 public universities in the UK, and only used data that could be applied across the five academic years. They included meetings with counselling services and other mental health advice services as part of the study, and used a student age range of 17-24.
The study also analysed the budget changes that the universities had made in the five academic years for funding mental health services.
More on the methodology of the study can be found here.
What were the findings?
The figures show a rise from 50,901 to 78,601 students in the UK seeking help in just 5 years, which represents a 53% increase. From 2012-2017, the overall combined budget change of the 85 universities for which 5 years of data were available, was a 43% increase - £25.5 million was spent in 2012, rising to £36.6m in 2017.
What has been the reaction?
Despite the rise in students accessing mental health services, responses from government and student bodies have pointed to structural barriers that remain and the stigma that still surrounds mental health, and called for a more guided approach towards how budgets are used.
Eva Crossnan Jory, NUS Vice President, said that not enough money has been invested into professional counselling services. She said that investment has been too focused on well-being projects which, while undoubtedly useful, are not an adequate substitute.
University Minister for the Department for Education, Sam Gyimah, said:
'Getting individuals to admit to suffering from poor mental health is, however, just one half of the battle; the other is ensuring we have the services in place to support them.'
There are many organisations that can help you talk through your mental health. The mental health charity Mind has created a web page with a list of contact information for several of these organisations, and their respective hotlines for whatever your circumstances may be.
August 2018 - The UK has recently been referred to the European Court of Justice for failing to tackle illegal levels of air pollution as set by the European Commission. Vehicle emissions contribute to poor air quality and can have significant health and environmental implications.
Consequently, several local authorities in the UK are taking a stronger stance against unnecessary vehicle idling, as part of several campaigns aiming to tackle air pollution.
What is idling?
Idling in a vehicle refers to sitting stationary with the engine still running. This can occur when there are high amounts of traffic but road users can, at times, allow a car to idle when it is not entirely necessary. An oft cited example is when parents or carers are waiting outside a school for their children.
Why is idling bad?
Cars and other vehicles produce a number of harmful emissions. The exhaust fumes from a stationary car can significantly increase the amount of pollutants in the air. The problem is particularly noticeable in congested urban areas.
Carbon monoxide, nitrogen oxide and particulate matter can all contribute to health conditions and damage the environment.
According to the Royal College of Physicians an estimated 40,000 deaths each year can be attributed to exposure to outdoor air pollution.
Poor air quality can potentially impact on a number of health conditions. Asthma, heart disease, lung conditions, dementia, obesity and diabetes can all in some way be linked to or exacerbated by air pollution. Vulnerable members of the public, including young children and the elderly, are most at risk of falling victim to poor air quality.
The damaging substances in car exhaust fumes (often referred to as greenhouse gases) have been linked to global warming. 2018 is currently set to be the fourth-hottest year on record. The increase in average global temperatures has been linked to more severe weather and higher sea levels.
What is the law surrounding idling?
According to Rule 123 of the Highway Code drivers must not ‘leave a vehicle engine running unnecessarily while that vehicle is stationary on a public road.’ Road users are encouraged to apply the parking break and switch the engine off when remaining at a standstill for any time period that exceeds a couple of minutes.
Since 1988, stationary idling in a vehicle has been an offence as part of the Road Traffic Act.
However, it is only recently that local authorities have started to implement this rule as a tool to educate drivers and deter unnecessary idling.
A fixed penalty charge of £20 (which increases to £40 if not paid within 28 days) can be issued to those who refuse to turn their vehicle’s engine off when asked to do so by a marshall. Penalty charge notices are issued by local councils and not the police.
Several areas across the country have started to put measures in place to deter idling.
The Tower Hamlets district in London is the latest local authority to implement a tougher approach to those who keep their car engine running unnecessarily. The Tower Hamlets’ #BreatheClean campaign aims to raise awareness by educating drivers on the importance of taking steps to improve air quality. The measures are said to be part of an education campaign that is supported by the availability of enforceable fines where necessary.
The rules do not mean that drivers have to cut their engines at traffic lights. Drivers are permitted to leave their engine running in stationary traffic, when diagnosing a fault with the vehicle or defrosting the windscreen.
Why should I cut my engine when stationary?
As well as contributing to a better environment there are a number of other benefits to cutting your engine when stationary:
- Recent data has shown that the pollution produced by cars is more dangerous for those sitting inside the car than those outside on the street. Therefore switching your engine off may reduce the amount of harmful pollution you inhale.
- Turning your engine off also helps to reduce noise pollution.
- Cutting your engine when stationary can also help to conserve fuel.
It is also important to remember that you should only use your mobile phone when you are safely parked with your vehicle’s engine switched off.
England to Follow Wales with ‘Opt-Out’ Organ Donation Legislation
August 2018 - The government in England is set to follow Wales and change the law surrounding organ donation, in a bid to increase the number of people donating and to save more lives.
Under the new law, people in England will be presumed to consent to having their organs used for donation after death. This means that all deceased adults will be considered for organ donation unless they have chosen to opt out of the scheme.
Why is the law surrounding organ donation changing?
Under the current opt-in scheme there is a shortage of suitable donors. According to the NHS England organ donation website, this shortage means that three people die every day whilst waiting for an organ transplant.
Research has suggested that over 80 percent of adults in England would consider organ donation but only 37 percent of adults have taken the time to sign up to the NHS Organ Donor Register.
There are certain groups who will be exempt if the opt-out scheme comes to pass. This includes:
- those under the age of 18;
- those with a limited mental capacity;
- and those who have have not lived in England for the 12 months prior to their death.
The change will be known as ‘Max’s law’ to recognise ten-year-old Max Johnson. His life was saved by a heart transplant following a newspaper campaign for the law to be switched to an ‘opt-out’ process.
Do any other countries use a successful opt-out scheme?
Wales transferred to a soft ‘opt-out’ organ donation scheme in 2015. A government report has since revealed that the scheme has not yet resulted in an increase in donors; although it has been said that more time is needed to uncover the true impact of the legislation change.
Spain is the world leader when it comes to organ donation, with over 2,000 people donating their organs after death in 2017. The country proudly follows a ‘presumed consent’ scheme and believes this forms part of its success.
What should I do if I want to register as an organ donor now?
If you wish to register as an organ donor before the legislation changes you can sign up to the organ donor register.
It will still be important to speak to your family about your organ donation wishes, even under the new opt-out scheme. Family members may need to confirm your organ donation wishes after your death.
The Department of Health and Social Care is hoping that the legislation will be debated again later this year so that it can be brought into effect by spring 2020.
KFC pledge to reduce calories by 20% per serving by 2025
June 2018 - Earlier this year we wrote an article about Public Health England’s strategy to cut calorie intake, and help reduce obesity. An important part of this strategy was the introduction of the 400-600-600 calorie campaign which encourages adults to pick breakfast, lunch and dinners that stays within these calorie limits.
Various large food chains expressed their commitment to the scheme at the time, including McDonald’s and Starbucks; and a recent announcement from KFC indicates that they are also aiming to make positive changes to the food and drink they offer.
Here, we'll take a closer look at what the fast food giant hopes to achieve over the next seven years.
Victoria Robertson, Head of Food Innovation at KFC UK, announced that the company is aiming for an overall reduction in calories by 20 per cent per serving by 2025. She provided further details on the types of strategies they plan to use, which include:
- Expanding and improving the range of under 600 calorie options. They hope to introduce more lunch and dinner options that keep in line with the PHE guidelines for 600 calories. They are also looking at introducing vegetarian options. Going forwards KFC will only be launching low calorie or zero calorie drinks.
- Reformulation of current products. KFC wants to reduce the amount of salt, calories and fat being used in their existing menu without compromising taste. KFC fans should note that this does not mean that they will be making changes to their Original Recipe chicken.
- Testing healthy choice initiatives. KFC are looking to trial various behavioural change programmes to help make it easier for customers to choose healthier options. This includes free swaps from fries to a five-a-day vegetable side and offering low calorie and no calorie drinks as the default options.
We spoke to registered nutritionist Jenna Hope (ANutr), MSc, BSc (Hons) to discuss KFC’s proposed changes, and whether they go far enough.
The fight against obesity
KFC is one of several popular fast food outlets to get on board with PHE’s strategy for tackling obesity. But just how big a role do fast food companies play in the overall fight against obesity?
As Jenna explains: ‘It’s really important for fast food chains to be on board with the fight against obesity. Obesity is a multifactorial and extremely complicated condition, the cause is not the same for every individual. As it’s such a complex condition it’s essential that everyone takes responsibility and adopts procedures to help reduce overall UK obesity.'
Jenna goes on to say, ‘[...] it’s great to see that KFC are offering free swaps from fries to healthier vegetable sides. It’s good to see that KFC are taking a lead on making changes which will hopefully inspire some of the other fast food chains to follow in their footsteps.’
As mentioned above, PHE’s latest campaign concentrates on calorie consumption and the focus on numbers has also been reflected in the changes KFC have set out.
But it’s important to remember that calories are not the be-all-and-end-all of nutrition. As Jenna explains: 'KFC are focusing largely on calories and it’s important for the general population to understand that calories are not necessarily the only answer when it comes to obesity. Many of the low calorie drinks are high in artificial sweeteners which have been shown to increase appetite and affect neurodegenerative disease risk.’
Do the changes go far enough?
KFC is a large company and seven years may seem like a long time for these changes to be implemented. ‘Their proposed changes are a good start,' Jenna says, 'although it’s important that they follow through with all of their proposed changes.’
‘They have mentioned that they’re going to be adding vegetarian dishes to the menu, it’s important that these dishes are packed with vegetables to increase micronutrients and fibre rather than mainly consisting of refined carbohydrates which may contribute to the problem.’
Jenna adds that as well as the focus on salt, fat and calories, there are other areas that could be addressed. ‘In addition to this I would urge KFC to also look at reducing the sugar content of their food as well as minimising the portion sizes and removing large portion options from the menu.’
Is it possible to eat healthily at fast food outlets?
There are many different styles of fast food chains throughout the UK. Not all fast food outlets only provide consumers with ‘unhealthy’ options. However, the bigger the chain, the more impact they can have on the eating habits of the general population.
According to a 2015 survey, KFC is the second most popular fast food chain in the UK with approximately 890 KFCs throughout the UK and Ireland.
Should we avoid fast food outlets in order to have a healthy diet?
‘In an ideal world I might suggest that it would be better to avoid fast food outlets altogether, although this isn’t realistic.' Jenna says. Therefore I would suggest that people cut down their attendance by half and try opting for healthier on-the-go options from supermarkets.’
Whilst it is great to see fast food chains taking steps towards healthier menus, it is also important for consumers to educate themselves on diet and nutrition and make sensible food choices.
As Jenna explains: ‘Consumers should also be taking responsibility and should be opting for the vegetable side dishes and grilled chicken options over the fries and fried chicken. Consumers can also pass on the fizzy drinks and opt for water instead.’
Could Cold Temperatures Help with Obesity and Diabetes?
April 2018 - Exposure to cold temperatures causes changes in fat cells that could reduce the risk of obesity and diabetes, according to research published by the University of Tokyo.
The study, which assessed how fat cells in mice reacted to different temperatures, showed that white cells produced beige fat cells which burn energy when they were exposed to cold temperatures.
What is beige fat?
Beige fat actively breaks down fat and sugar to improve insulin sensitivity and increase metabolism. The study also revealed that beige fat could help to regulate energy balance.
White fat insulates our vital organs, but too much of it can lead to heart disease, obesity, diabetes and various cancers. Brown fat is healthier as it contains mitochondria cells which convert fat into heat.
Cold stress is something that all warm-blooded mammals have to combat. When we shiver, it creates short-term body heat by warming up the muscles; this is a form of short-term thermogenesis.
But adaptive thermogenesis is the chemical process that creates long term heat. This is where protein compounds attach themselves to DNA, and changes the way the body uses energy in order to maintain the right temperature.
The researchers from the study say that the process begins when the cold causes a change in the protein called JMJD1A. The altered protein changes the way the gene functions in producing heat. This initiates adaptive thermogenesis, transforming the white fat cells into beige fat cells which operate in a similar way to brown fat cells.
What did the study involve?
In the study, one group of mice was kept at 4 degrees centigrade and another at 30 degrees centigrade for one week. The mice that were kept at a lower temperature had a higher thermogenic activity, so their cells were able to burn stored fat to create heat.
Professor Juro Sakai, from the research team, notes that the findings shows that it is worth pursuing cold exposure as a means to helping with metabolic diseases such as obesity and diabetes. Even though a gene sequence is realised at conception, lifestyle and environmental choices can show how the genes are expressed and hence alter something like metabolism for the better.
Most drugs that are currently available can only target entire proteins or rely on hormones which affect the entire body. The research team believe that the findings allow them to envisage a future where metabolic diseases are treated by targeting single amino acids.
It should be noted that these findings should not be viewed as encouragement to subject oneself to very cold conditions to try and burn more fat, as this is potentially dangerous and the benefits are not fully understood at this stage.
Research suggests correlation between increased ‘moderate’ alcohol consumption and life span
April 2018 - A comprehensive study, looking into alcohol consumption limits across 19 countries, has found that drinking more than 25 units of alcohol a week (roughly 11 pints of lower-strength beer or 11 medium glasses of wine) could shorten a person’s life by up to two years, or by four to five years for more than 43 units (18 pints of beer or 18 glasses of wine).
The Lancet study, which analysed just under 600,000 drinkers who were over the age of 40, modelled how many years could be lost if subjects did not change their drinking habits for the rest of their lives. The findings also showed that binge-drinkers had the highest risk of death from any cause, particularly those consuming beer and spirits.
The threshold for lowest risk of death from any cause was capped at around 12.5 units per week (just under six pints of beer or six glasses of wine), and less than this amount was deemed to be ‘light drinking’ and was not associated with an increased risk of death.
There was also evidence to suggest that a long-term reduction in alcohol consumption in men from around 25 units to under 12.5 was connected with a longer life expectancy of one to two years at the age of 40.
Aside from the findings into risk of death, there was also analysis of the relationship between alcohol and the risk of cardiovascular diseases. These findings suggested that there was a higher risk of disease amongst all stroke types, heart failures and other cardiovascular diseases for those who drank alcohol. However for myocardial infarction (heart attacks), a lower risk of disease was associated with a higher consumption of alcohol.
What is the current advice on alcohol?
Current UK guidelines for alcohol consumption set in 2016 recommend a limit of 14 units per week. This is significantly lower than many other countries. For instance in the US, there is a huge discrepancy between the advice for men and women: it is almost double for men (at 24.5) but only 12.3 for women.
Should guideline limits be lowered?
The study findings have brought into question whether the guidelines should be reconsidered and updated. The study also debunks the notion that a glass of wine can be good for the heart, asserting that there are no associated health benefits of drinking alcohol (even in very small amounts).
Speaking to the BBC, Richard Piper from Alcohol Research UK said that the current alcohol limits are at the right level.
He added that people drinking 20, 30 or 40 units were putting themselves at risk, and that for people who do drink, staying under five or six drinks per week was the best advice. The notion held by some moderate drinkers that health benefits derive from alcohol, he went on to say, was not supported by evidence.
Study Suggests Cutting Calorie Intake by 15% Can Help to Offset Age-Related Illness
March 2018 - Research published in Cell Metabolism last week suggested that people reducing calorie intake by 15 percent lowered their risk of age-related disease.
Participants in the calorie reduction group saw a drop in metabolic rates following one year; and a fall in oxidative stress in the second. Oxidative stress has been linked to several age-related conditions, such as diabetes, heart disease, cancer and Parkinson’s disease.
The study was led by Leanne Redman, an associate professor specialising in Biomedical Research at Louisiana State University.
What did the study involve?
As part of a series titled the Comprehensive Assessment of the Long-term Effects of Reducing Intake of Energy (or CALERIE), researchers had previously undertaken pilot studies to determine what kind of calorie reduction programme would be feasible to maintain, and which type could have an impact on the biomarkers of aging.
Participants were aged between 25 and 50, with BMIs ranging between 22 and 28 at the start of the study.
They were provided meals for the first 27 days to help coach them on achieving the right weight loss trajectory (through portion size and energy content guidance).
After this, they continued to receive guidance from clinicians and nutritionists, but were permitted to eat what they pleased. They were given supplements to ensure they maintain healthy levels of vitamins and minerals. They were also issued with graphs and a scale to track their progress. Weight measurements were used to determine the level of calorie intake and reduction over the study period.
The programme actually targeted 25 percent calorie reduction; however 15 percent was the level of calorie reduction which was achieved.
What were the results?
The average amount of weight lost over the two years was 8.7kg (compared to an increase in the control group of 1.8kg).
Participants in the study group also saw a drop in metabolic rates, indicating their bodies were using calories more efficiently. The rate of energy expenditure over 24 hours in study subjects was 80-120 kcal lower than anticipated when taking weight lost into account.
Researchers used a type of prostaglandin called F2-isoprostane as a biomarker for oxidative stress. Following year 1 and year 2 in the study group, levels of F2 were ‘significantly reduced’; but remained the same in the control group.
It is thought that oxidative damage causes the body to age faster, and it has been linked by some to conditions such as Parkinson’s, Alzheimer's and cancer.
What do the results mean?
The final analysis was based on 53 people (a study group of 34 and a control group of 19) which by clinical trial standards is a relatively small pool. However, given the scale and duration of the study, implementing it even at this size would have been a huge undertaking.
That said, the results do seem to be promising.
The study has been hailed as a breakthrough by a biologist from the University of Aberdeen, as it is the first to be carried out on humans on such a scale, and seems to correlate with theories previously developed following similar studies on rodents; that calorie restriction could be linked to longer life, due to its effects on metabolism and oxidative stress.
While it is difficult at this stage to infer from these results that calorie restriction leads to longer life, it does support the notion that it leads to healthier and better quality of life.
The authors maintain that more studies need to be carried out to explore what is, at present, still an area of research at a relatively early stage.
Study leader Leanne Redman proposed that it would be useful to reconvene study subjects at a later date to see what the long-term impacts of the programme are.
You can read the full study here.
ONS Report Indicates Gap in Healthy Life Expectancy Rates in Parts of England and Wales
A report from the Office of National Statistics (ONS) has revealed healthy life expectancy figures throughout England and Wales.
The interactive map and accompanying write up seems to shed light on the significant disparities in health and longevity between different parts of the country.
What does ‘healthy life expectancy’ mean?
Healthy life expectancy (HLE) refers to the number of years we can expect to live before our health begins to deteriorate, due to factors such as disease or injury.
The ONS has used 2011 census data to create a small area statistical analysis. They have produced an interactive map to help readers visualise the results. Life expectancy and healthy life expectancy estimates were given as expected years at birth, to those born between 2009 and 2013.
What did the data say?
According to the report, for women:
- the median HLE in England and Wales was 65.4;
- the area with the the lowest HLE at 47.6 was Middlehaven, Middlesbrough;
- the area with the highest HLE with 83 was Blackheath and Wonersh, Surrey;
while for men:
- the median HLE in England and Wales was 64.2;
- the area with the lowest HLE at 47.1 was Bloomfield, Blackpool;
- and the area with the highest HLE at 79.1 was Knightsbridge and Belgravia, Westminster.
These statistics show that certain sections of the population can expect to live in good health for over three decades longer than people living in other areas of the country.
The map is intricate and detailed, making it possible to search for HLE figures in areas streets apart.
Some striking disparities were also noted on a local (or as the report terms it, ‘within authority’) level. For instance, the Knightsbridge and Belgravia ward had a HLE around 10 years above the national average; whereas in the nearby Westminster Church Street ward HLE estimates were around 25 years below this.
What do the results mean?
The results present a stark picture of health inequalities throughout England and Wales.
It is possible that some readers may be alarmed by the results of the study but it is important to note that there are many variating factors. While the report does not reveal the underlying reasons behind these disparities, some have pointed towards access to healthcare, employment levels and economic activity as contributing factors.
For instance, earlier this year the Longevity Science Panel produced a report on life expectancy using ONS statistics. The results suggested that the overall life expectancy gap, between rich and poor, is widening, and that income is the most influential factor on mortality.
So, simply moving house to a postcode with a higher HLE will not necessarily impact your own life expectancy.
The new ONS data could be said to strengthen the evidence for a correlation between poverty and poor health outcomes. The data could potentially be used to shape the future of funding for NHS primary care models, allowing for a concentration of funds in the areas with the worst HLE.
The ONS report noted that: ‘Living long healthy lives with narrow within authority small area disparities is the aim of government policy.’ Purbeck had the lowest ‘within authority’ variation in HLE between small area localities, at 3.8 years. The report explains that ‘Purbeck’s low inequality and high HLE is the preferable health landscape for an authority to aspire to.’
You can read the full ONS report and view the maps here.
Public Health England Announces New Plan to Help Tackle Obesity
March 2018 - This week Public Health England released their latest report ‘Calorie reduction: The scope and ambition for action’. The 94 page report takes a detailed look at the impact that the rise in obesity is having on our society, and what is being done to try and tackle the issue.
So, why does the government think action is needed? The statistics in England make for quite uncomfortable reading:
- obesity and obesity-related health conditions cost the NHS £6.1 billion each year;
- according to the report, most adults are consuming an extra 200 to 300 calories each day;
- and the average person in England is now classed as overweight.
What action is being taken?
The new diet outlined by PHE hopes to cut calorie intake by 20 percent by 2024. PHE acknowledges that food industry businesses (including manufacturers, retailers and ‘eating out of home’ establishments) need to play an active role in this by improving access to healthy food choices.
The scheme is working with key members of the food industry to:
- reformulate recipes, so that they focus on healthier ingredients by introducing more vegetables and leaner meats and reducing sugar, salt and calories;
- reduce the size of products;
- lower the prices of healthier food options.
The campaign is particularly focused on food often purchased to accommodate a busy or on-the-go lifestyle; such as ready meals, meal deals, pizza and snacks. Some key players from the food industry are already involved, including McDonald’s, Gregg’s and Starbucks.
The report also recognises that the current food environment encourages the general public to buy more and eat more; and it also accepts that obesity is a complex condition, closely linked to many different aspects of personal health, society and the environment.
Why has the focus been placed on calories?
An online survey conducted as part of the report found that only 38 percent of female respondents and 24 percent of male respondents knew how many calories formed their guidelines reference intake (2000 and 2500 respectively). PHE wants to clear up any confusion surrounding calories and instead provide the foundations for an easy to follow diet.
The new diet plan launched by the One You campaign suggests a 400/600/600 calorie model for breakfast/lunch/dinner, plus a couple of healthy snacks. It cites the NHS Eatwell guide for inspiration on food choices. The scheme hopes to target adults who are not giving enough thought to the amount of calories they are consuming, especially when they are outside of the home.
How has it been received?
The report has received a mixed welcome since its release on Tuesday.
Some commentators have sensationalised the report, suggesting that PHE is going too far by dissuading people from choosing traditional favourites such as fish and chips and the roast dinner (because these meals wouldn’t theoretically fit into the 600 calories or less bracket).
In reality these favourites are still on the table, but PHE would encourage the public to think about their portion sizes and how often they choose to eat them.
The PHE Eatwell Guide has received some criticism previously for being inaccessible to low income families, but this report states that while ‘achieving the diet set out in the Eatwell Guide would require large changes to the average diet, these changes would not cost more than current dietary patterns.’
On the other side of the argument, many nutrition industry professionals are happy to see a new initiative that encourages mindful eating and places more accountability on food industry giants.
But some nutritionists think that placing the focus on calories (instead of on sugar for instance) is a step backwards that won’t provide the answer to England’s obesity crisis.
You can read the full report here.