More life before death

reposted from: http://commentisfree.guardian.co.uk/michael_blastland_and_andrew_dilnot/2007/12/no_news_of_good_news.html

Something wonderful is happening: people are living longer, healthier lives. So why don't we hear more about it?

All Michael Blastland and Andrew Dilnot articles

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December 9, 2007 12:00 PM

The past week has brought three pieces of outstanding good news. One received a short grunt of media acknowledgment, the others not even that. Yet they tell us more about human wellbeing than any number of health scares, gone-to-the-dogs jeremiads or nightmare scenarios.

The first piece of news is that we are, yet again, shown to be living longer than ever. What's more, the typical lifespan is not just up, according to the latest data from National Statistics this week, but rising at an accelerating rate: we are adding extra years, faster. Men have taken only about four years to put on their latest year of life expectancy. Astonishing.

Especially heartening for those zipping through middle age is where the gains come from. In earlier periods, it was improved infant mortality: as fewer babies died, the average lifespan increased. Now it derives as much from life extended at the end as sustained at the beginning. A 65-year-old man in 1981 could typically expect to live to 78. A 65-year-old man today will typically make it to 82.

Humbug, say those who feel that more years of life will be life endured, or, as Auberon Waugh almost put it: nothing is worth a couple of extra years in a nursing home in Weston-super-Mare.

But this brings us to the second hallelujah.

On average, the extra years are turning out, for women, to be healthy years, and about three-quarters of them for men. This lengthening of the so-called "healthy lifespan", measured either by the way people report their own health, or by subtracting the number of years of long-term disabling illness, challenges the presumption that longer life must mean decrepit life. We're getting wrinkly, not crumbly.

Source: National Statistics

That could imply more good news about the effect of an ageing population on health costs. Often described as a time bomb, it might be less explosive than suggested by the worst-case scenarios, which simply take the cost of healthcare in the few years before death and assume the line goes on flying upwards as the population wrinkles. The more accurate model might be that costs do go up, but that it is the proximity of death that sends them soaring, not the addition of what turn out to be healthy years before death.

The third piece of news is that, fast as life expectancy is rising for women, it is rising even faster for men. For so long the laggards, they are now closing rapidly. We don't know why, but we can speculate. For example, it may be that fewer men work in industries that, sooner or later, killed them. It could be that more women are in paid work, or enjoying lifestyles more like men's and so becoming more like men in this respect too. But the data suggest that men's progress is speeding up, rather than women's slowing down.

These gains are mightily impressive, and probably reliable. We can measure well enough the ages at which people die. The margin of uncertainty around the figures is tiny, the trends unmistakeable.

Of course, it's always possible there'll be bad news just around the corner, and the trends will reverse. Accelerating gains in lifespan can't go on forever - can they? - or one day the end will be receding faster than our approach. But just for now, we live, and live a bit more, in extraordinary times.

Despite the unrelenting coverage of everything that's wrong with our health service, the toxic soup people supposedly live in, the wretchedness of our diet or the stresses of modern living, something very good indeed is also happening, and on a huge scale; it's just that few talk about it.

We do not argue that all is right with the world, that no one experiences poor standards of welfare, or dies too young. On the contrary, we recognise huge demands for further progress. We know the gains are far from equally shared, and that a healthy old age might still mean a relatively impoverished one. We see that longer lives mean, other things being equal, more people.

But the numbers are a useful glimpse of the bigger picture. They are testament to how much people are continually achieving - and will go on to achieve - to improve wellbeing. Contrast that with how well they recognise this achievement, and one can't help but wonder at the lack of proportion. Longer life doesn't seem to make us grateful.

The authors will be speaking at Wanstead Library, Spratt Hall Road, London E11 2RQ on Thursday December 13 at 7pm. For details email vivian@newhambooks.co.uk.

reposted from: http://commentisfree.guardian.co.uk/abby_oreilly/2007/11/fat_for_purpose.html

The comments are better than this article.

Fat for purpose

Even though they're ridiculed and discriminated against, not all overweight people want to conform to the notion that thin is beautiful

Abby O'Reilly

November 20, 2007 9:00 AM

Fatness has become synonymous with unhappiness. If you are overweight you are not allowed to feel confident: it's against the rules. You're not even supposed to step outside without strapping down your effervescing gut with an elasticated waistband, because fatties don't look or feel attractive. They dress badly. They have greasy hair. They smell like stale chicken wings, body odour and warm fats, and they are lazy. There are no studies to corroborate this, of course. This is the archetypal fat person, the one that would exist should the world spontaneously combust and a superior life force begin to piece together society using the remnants of Gillian McKeith's brain with cuttings from tabloids and women's weeklies.

The front-page report that

almost two thousand people are too fat to work,

according to documents released by the Department for Work and Pensions for 2006-2007, will further fuel the belief that fat people are the scourge of society, addicted to daytime TV and flaky pastry. Despite this being a relatively small percentage of the fat population in the UK, anyone with a spare tyre, whether working or not, will be considered one of the wobbly masses "working the system" and claiming the £4.4bn that rightly belongs to the thin people who earned it.

There were individuals receiving incapacity benefit for a number of reasons, including migraines and acne, but it is the overweight who are considered morally repugnant: fatties have no integrity, their "condition," if it can be called that, is something to be highlighted and shamed rather than sensibly addressed. The article is illustrated with a photograph of the hanging belly of an obese woman, tightly covered in grey sweat pants and a white shirt, inciting the physical revulsion that we are conditioned to feel by the rotund. A lot of fat people work, and work well. What the departmental figures fail to recognise is the number of people actively discriminated against in the job market owing to the fact that they are porkers, and the media prefers to perpetuate the concept that fatties don't work because they don't want to rather than because they can't get employed. It should also be pointed out that to claim incapacity benefit you have to be assessed, and fatness is one thing that you just can't fake.

I am a fat woman and have never resisted that definition. I feel that to do so would endorse the idea that there is something inherently wrong with me, rather than society. I wouldn't say I am particularly insecure about my weight; no more so than someone with a big nose, or oddly shaped head. The greatest problem has always been impolite comments from those who believe that as a fatty I am public property, and owed a verbal pummeling. I refuse to let this influence me, especially since I have no problem with the way I am. This is my biggest crime.

We live in a culture where our ability to adhere to the rules of self-perfection is considered directly proportionate to our success, especially for women. Glossy magazines daily boast images of the emaciated size zero beauties littering celebsville, and while we can't emulate their lifestyles, their look has become achievable, and costs nothing at all (just your health). So being overweight indicates a lack of self-control, something that can only be remedied by substituting your penchant for doughnuts with delicious mung beans.

If you are clinically overweight and not stringing up the noose, you must not admit it. This must be hidden under the bed like a shameful secret, shrouded in years' worth of chocolate wrappers and crisp packets. To raise your bingo wings in the air as a bleary eyed request for help is considered responsible: you exist on the fringes, yes, but at least you realise that you are "aesthetically displeasing" and want to change. However, refusing to allow your weight to impinge on your life means that you will be subject to unyielding pressure from the dieting industry and a media machine intent on making you recognise the error of your ways. To be content when you are different forces society to question its rules of acceptability, and as the anomaly you have to be obliterated before anyone else realises that it's possible to think outside the box. You are depressed being overweight because thin people say so. And if this is not true, then tough luck because everyone still thinks so.

A report last week claimed that those taking the weight-loss drug rimonabant, sold in the UK under the name Acomplia, have an increased chance of developing psychiatric problems. In the study, carried out at the University of Copenhagen, more than 4,000 patients took part in four medical trials. Those taking the drug were 40% more likely to suffer from anxiety and depression. The drug was not licensed in the US over fears suicide rates would increase but in the EU has been approved as a prescription only medicine. Although you may end up eating your own hair, and carving your weight loss along your arms with a butter knife, it is an effective method of shedding those unwanted pounds. People are opting to take this medication because the prospect of becoming mentally deranged is considered far more appealing that living as a "wide load," and so what does this say about the status quo? If a woman has starved herself to the point of death owing to the pressures to be skinny then she is referred to a cognitive behavioural therapist, with the psychological aspects of her condition validated. If someone is very fat, however, the possibility they may have underlying issues that have precipitated their weight problem is ignored simply because, unlike anorexia, the results of obesity are less glamorous. Fatness is considered nothing more than the ugly result of gluttony, and so nobody cares that a weight loss drug could seriously damage a fatty's mental health because they will look better. In many respects it's considered a public service.

Overweight people are not acceptable, an attitude which has permeated the national consciousness. The word "fat" is invested with negativity, considered a derogatory term used as an insult, as opposed to the word "thin" which invokes images of beauty and perfection. Some people are genetically predisposed to be overweight. Others may be miserable, prone to comfort eating. Either way, the claim put forward by Weight Watchers and endorsed by celebrity culture - loose weight and feel great - not only creates, but also enhances existing insecurities, in addition to placing unrealistic expectations on the power of weight control. Yes, many women who loose weight are much happier, but many who choose not to lead perfectly normal and fulfilled lives. You don't have to be thin to be happy, and you don't have to be fat to be unhappy. It is time emphasis shifted from pressurising people to loose weight through public humiliation, to supporting the idea that it is possible to be successful and cheerful even if you are the wrong side of 15 on the scales.

There are health implications to being overweight, and of course, support should be accessible to those who want and need it. We shouldn't encourage people to be fat, but it is counterproductive to claim that the only way you can be happy and get the promotion you want is by banishing your muffin top, because some of us just cannot do it. Considering that many people are overweight, shouldn't we foster an all-inclusive society, rather than making every fat person feel like a grotesque beast of burden and assuming they are trapped in a neverending cycle of binge eating and depression? What will this do other than foster generations of teenagers and adults who lack the confidence to even step outside without being shrouded in a black cagoule?

'Taking control of your weight' from British Heart Foundation

reposted from:http://www.bhf.org.uk/idoc.ashx?docid=dde3a040-6034-409c-9ed7-2b4bd6856130&version=-1

'Taking control of your weight' from British Heart Foundation (pdf)

Top tips to cut the saturated fat

reposted from: http://www.bhf.org.uk/keeping_your_heart_healthy/top_tips_to_keeping_healthy/tips_to_cut_the_saturated_fat.aspx

Top tips to cut the saturated fat

Eating too much saturated fat can increase blood cholesterol levels, which in turn is a risk factor for coronary heart disease.

The healthier type of fat to choose is unsaturated fat (monounsaturated or polyunsaturated), which can actually improve cholesterol levels. But don’t forget all fat is high in calories, so if you are watching your weight, you should limit your overall fat intake.

Here are our tips to help you cut down on saturated fats:

• Not so good fats…
  
  

  Butter, lard, palm oil, coconut oil/cream and ghee (clarified butter) are all rich sources of saturated fat and are best limited. Replace with small amounts of unsaturated fats such as olive oil, rapeseed oil or corn oil.
• 
  

• Choose your meat wisely
  
  

  Have chicken or turkey without skin, lean cuts of meats and trim off any visible fat. Cut back on fatty meat pies, sausages, sausage rolls and breaded meat or chicken etc. Did you know a grilled chicken breast without skin contains a third less saturated fat than with skin?
• 
  

• Spreads
  
  

  Use spreads thinly and go for lower fat spreads with the lowest amount of saturates. Avoid butter or hard margarines and choose spreads that mainly contain monounsaturated or polyunsaturated fats.
• 
  

• Check the labels
  
  

  Cut down on takeaways, ready meals and processed foods. Opt for lower fat versions; check and compare nutrition labels and pick foods with a lower amount of saturated fat.
• 
  

• Look at your cooking methods
  
  

  Grill, bake, steam, boil or poach foods instead of frying in lots of oil. Did you know a portion of cod fried in batter has 2.9g of saturated fat and 445 calories, but an average portion of baked cod has just 0.4g of saturated fat and only 115 calories! Rather than adding extra fat like cream or sour cream to recipes why not swap with low-fat yoghurt or fromage frais.
• 
  

• Dressings and sauces
  
  

  Make your own low fat salad dressing using ingredients such as low fat yoghurt, lemon juice, herbs, etc rather than shop brought ones. If you do buy dressing or sauces, pick lower fat varieties, e.g. low-fat salad dressing or lower fat mayonnaise.
• 
  

• Milk it up…
  
  

  Use semi-skimmed or skimmed milk rather than full fat or condensed milk. For example, swap a 200ml glass of full fat milk for semi-skimmed milk and cut your saturated fat intake by 2.9g and 40 calories.
• 
  

• To measure or spray
  
  

  Measure your oil out with a tablespoon rather than just pouring straight out of the bottle. Then you know how much you are using. Or why not use a spray oil to cook.
• 
  

• Cheesy choice
  

  
  Check out the nutrition label and opt for cheeses that are lower in fat and saturated fat such as cottage cheese, ricotta and half-fat cheddar. Did you know that a 30g portion of hard cheese is the size of a small matchbox?
• 
  

• Eat more oily fish
  
  

  Oily fish, such as salmon, mackerel, fresh tuna and sardines are rich in omega 3 polyunsaturated fat; which can help to protect against heart disease.
• 
  

• Snack attack
  
  

  For a tasty and nutritious snack, have a handful of unsalted nuts, seeds or dried fruit rather then reaching for fatty snacks such as crisps, pastries, or bombay mix. For those with a sweet tooth choose sugar free jelly or sorbets instead of cakes, biscuits or ice-cream.
• 
  

• Bulk up
  
  

  Add less meat to casseroles, stews and sauces and replace with fibre-rich vegetables, beans or pulses.

Now Doctors Say It's Good to be Overweight

reposted from: http://www.alternet.org/healthwellness/67692/?page=entire

Now Doctors Say It's Good to be Overweight

By David Usborne, The Independent UK. Posted November 13, 2007.

After years of anti-obesity public health advice, a major new study causes an outcry by concluding that the moderately overweight live longer.

A startling new study by medical researchers in the United States has caused consternation among public health professionals by suggesting that, contrary to conventional wisdom, being overweight might actually be beneficial for health.

The study, published yesterday in the respected Journal of the American Medical Association, runs counter to almost all other advice to consumers by saying that

carrying a little extra flab -- though not too much -- might help people to live longer.

Struggling dieters, used to being told that staying thin is the best prescription for longevity, are likely to be confused this morning if not heartily relieved. While being a bit overweight may indeed increase your chances of dying from diabetes and kidney disease -- conditions that are often linked with one another -- the same is not true for a host of other ailments including cancer and heart disease, the report suggests.

In fact,

scanning the whole gamut of diseases that could curtail your life, being over weight is, on balance, a good thing. The bottom line, the scientists say, is that modestly overweight people demonstrate a lower death rate than their peers who are underweight, obese or -- most surprisingly -- normal weight.

The findings will be hard to dismiss. They are the result of analysis of decades of data by federal researchers at the Centres for Disease Control and Prevention (CDC) in Atlanta, Georgia. This is not a study from a fringe group of scientists or sponsored by a fast-food chain.

Being overweight, the report asserts in its conclusions, "was associated with significantly decreased all-cause mortality overall".

"The take-home message is that the relationship between fat and mortality is more complicated than we tend to think," said Katherine Flegal, the lead researcher. "It's not a cookie-cutter, one-size-fits-all situation where excess weight just increases your mortality risk for any and all causes of death."

That the CDC has even published the report and thus threatened to muffle years of propaganda as to the health benefits of staying slender has enraged some medical experts.

"It's just rubbish," fumed Walter Willett, the professor of epidemiology and nutrition at the Harvard School of Public Health. "It's just ludicrous to say there is no increased risk of mortality from being overweight."

Not that the CDC results are an invitation to throw caution to the winds and take cream with everything. The scientists are careful to stress that

the benefits they are describing are limited to those people who are merely overweight -- which generally means being no more than 30 pounds heavier than is recommended for your height -- and certainly do not carry over to those who fall into the category of obese.

Obesity has been declared one of the main threats to health in the US, including among children. Those considered obese, with a body mass index (BMI) of more than 30, continue to run a higher risk of death, the study says, from a variety of ailments, including numerous cancers and heart disease. It said that being underweight increases the risk of ailments not including heart disease or cancer.

The scientists at the CDC first hinted at the upside of being overweight a few years ago. Since then, however, they have expanded the base of their analysis, with data that includes mortality figures from 2004, the last year for which numbers were available, for no fewer than 2.3 million American adults.

Highlighting how a bit of bulge might help you, the scientists said that in 2004 there were 100,000 fewer deaths among the overweight in the US than would have been expected if they were all considered to be of normal weight.

Put slightly differently, those Americans who were merely overweight were up to about 40 per cent less likely than normal-weight people to die from a whole range of diseases and risks including emphysema, pneumonia, Alzheimer's, injuries and various infections.

Aside from escaping diseases, tipping the scales a little further may also help people recover from serious surgery, injuries and infections, Dr Flegal suggested. Such patients may simply have deeper bodily reserves to draw on in times of medical crisis.

Not everyone in the medical profession was surprised or angry about the study. "What this tells us is the hazards have been very much exaggerated," said Steven Blair, a professor of exercise science and biostatistics at the University of South Carolina, who has long argued that the case for dietary restraint has been taken too far.

"I believe the data," added Elizabeth Barrett-Connor, a professor of family and preventive medicine at the University of California, San Diego, who believes that

a BMI of 25 to 30 -- roughly the the so-called overweight range -- "may be optimal".

Critics, however, were quick to point out that

the study was concerned with mortality data only and did not take account of the quality of life benefits of keeping your weight down. The study "is not about health and sickness"

, noted the obesity researcher Barry Popkin of the University of North Carolina.

The report "definitely won't be the last word", said Dr Michael Thun of the American Cancer Society, who pointed out,

in a report released last week by the World Cancer Research Fund and the American Institute for Cancer Research, that staying slim was the main recommendation for avoiding cancer.

Others in the American medical community, while a little bemused, were withholding judgement. "This is a very puzzling disconnect," said Dr JoAnn Manson, the chief of preventive medicine at Harvard's Brigham and Women's Hospital.

The suggestion that a bit of extra weight may assist patients recovering from an infection or surgery was of no surprise to Dr Flegal. "You may also have more lean mass -- more bone and muscle," she said. "If you are in an adverse situation, that could be good for you."

In their conclusions, the authors of the study note:

"Overweight ... may be associated with improved survival during recovery from adverse conditions, such as infections or medical procedures, and with improved prognosis for some diseases. Such findings may be due to greater nutritional reserves or higher lean body mass associated with overweight."

Those of us mostly likely to benefit from a little bulge beneath the belt, the study adds, are between 25 and 59 years old, although there were also some advantages for people over 60.

Hearing tests for over-55s backed

reposted from: http://news.bbc.co.uk/1/hi/health/7098012.stm

Hearing tests for over-55s backed

By Emma Wilkinson BBC News health reporter

People suffer hearing problems for many years before they seek help

The over-55s could soon be screened for hearing problems under new proposals.

An NHS trial across Britain of 35,000 people aged 55-74 found routine hearing tests offered "substantial benefits" and were good value for money.

A national programme could be in place within five years, said government adviser Professor Adrian Davis, who led the research.

More than one in 10 people in the trial were found to have a moderate to severe hearing problem.

A simple 30-second test using a device which produced tones at different sound levels was enough to identify those who need a hearing aid, the trial carried out in England, Scotland and Wales found.

The Department of Health said it would look at the evidence.

Hearing aid services are currently struggling to cope with demand as patients switch from old analogue models to digital aids.

For the first time we have come up with a really clear-cut picture that screening is incredibly effective and cost effective Professor Adrian Davis

But Professor Davis, who is director of the Medical Research Council Hearing and Communication Group, said the goal was to hit 18-week waiting times for everyone by the end of 2008.

"Once we have the capacity, a screening programme is the next step," he said.

"For the first time we have come up with a really clear-cut picture that screening is incredibly effective and cost effective."

He said identifying people early was vital for quality of life.

"We know that on average people live for 10-15 years with hearing difficulties before they present to their doctor,"

he added.

Communication barrier

Hearing problems can make it difficult to understand conversations when there is background noise, such as in shops or cafes or when watching television.

It can lead people to become depressed and withdrawn as well as have difficulties at work.

Only 3% of people in the study were found to have hearing aids but 12% of people had moderate or severe hearing loss.

The researchers estimated a screening programme, which would most likely be done in general practice, would cost £13 per person or £100 per person if the cost of treatment is taken into account.

"We were really gob smacked that a simple test was the best strategy because there's all sorts of available technology," said Professor Davis, who is also director of the NHS newborn hearing screening programme.

"It meets the criteria for a screening programme really well."

Emma Harrison, from the deaf and hard of hearing charity RNID, said the average age for a first hearing test is over 70 - but 60% of people already have a significant hearing loss by that age.

"Widespread screening could improve the quality of life for millions of people over 55 whose hearing loss might otherwise go undetected for years, as it is easier to adjust to the benefits of a digital hearing aid if you have only recently started to lose your hearing."

But she stressed the current long waiting times for hearing specialists needed to be addressed so people could benefit from hearing aids.

A spokesperson for the Department of Health said the National Screening Committee was responsible for looking at the evidence and advising ministers.

"The current NSC advice is that there is insufficient evidence to recommend screening for hearing impairments in adults.

"However, NSC advice is regularly reviewed in the light of new research evidence becoming available."

Parents to get child weight data

reposted from: http://news.bbc.co.uk/1/hi/health/7098268.stm

Parents to get child weight data

Children aged five and 11 are being tested

Parents will get details of their children's weight under a national testing programme to combat obesity.

But ministers have stopped short of making the National Child Measurement Programme, introduced last year for five and 11-year-olds, compulsory.

The government set it up to help gather evidence so health chiefs can tailor programmes to overweight populations.

But it has been attacked as parents have not been given the data and less than half of pupils have taken part.

The government has included provisions in the Health and Social Care Bill, which has been published in Parliament, to ensure parents are told.

This change to legislation is not about telling parents what to do, or lecturing them on how to raise their children, it is a way of supporting families to be healthy Ben Bradshaw, health minister

There will now be a consultation to decide what is the best way to inform parents after surveys showed they wanted to know.

To date, they have had to contact their local primary care trust to get the information - a process which parents had criticised as being cumbersome.

But the Department of Health said the scheme would not become mandatory as it was always meant to be voluntary because the government did not want to coerce children into it.

Coverage is also thought to be increasing after last year's results.

Figures from the first year of the programme showed that 538,400 children in both years were measured - about 48% of those eligible.

Caution

A report by the Association of Public Health Observatories said the results had to be treated with "considerable caution" as a result.

It said there was evidence to suggest higher rates of opting out among heavier children.

Health Minister Ben Bradshaw said giving the information to parents would help tackle the issue of obesity.

"Giving parents clear information about their child's weight is important way of engaging with families, and prompting a conversation about healthy lifestyles and weight issues within the home.

"This change to legislation is not about telling parents what to do, or lecturing them on how to raise their children, it is a way of supporting families to be healthy.

Tam Fry of the National Obesity Forum said: "It's a very good idea to give parents the results of the tests. But what do the parents do when they get the data?

"They should have a chart so they can plot the measurements in the future. That way they can keep track of how their child is getting on."

Ethics of public health - a major study

reposted from: http://news.bbc.co.uk/1/hi/health/7091047.stm

'Get tough' call on public health

The government should intervene more with public health measures

Government ministers should shrug off media accusations that they are running a nanny state and introduce tougher public health measures.

The Nuffield Council on Bioethics said the time had come to consider a whole host of interventions in the UK after the introduction of a smoking ban.

Its proposes raising alcohol prices, restricting pub opening hours and better food labelling to fight obesity.

The government said it was taking steps to protect public health.

The report by the panel of experts, which include scientists, lawyers and philosophers, said there was a balance to be struck between individual freedom and wider public protection.

The government has a duty to look after the health of everyone and sometimes that means guiding or restricting our choices Lord John Krebs, of the Nuffield Council on Bioethics Do interventions work?

But they urged the government not to be afraid to act where there was evidence people were being put at risk by environmental factors.

It praised the action taken over the smoking bans, introduced across the UK countries in recent years, as an example of where the "greater good" outweighs an individual's right to make a personal choice.

The experts said the government and industry should not see such measures as tantamount to creating a nanny state.

Instead, public health interventions should be seen as a "stewardship" role where proportional intervention was only taken when other measures had failed.

The report called on ministers to reconsider the relaxation in pub opening hours and look into increasing the price of alcohol through taxation.

It also said industry should introduce the most effective food labelling methods once the Food Standards Agency review of the issue is completed.

Activity

And it called for town planners and architects to be trained to design buildings and public spaces that encourage physical activity.

There is also an argument for intervening where children with serious respiratory conditions are exposed to smoking at home, it added. But the report did stress that those measures should be determined by the courts.

Lord John Krebs, the chairman of the committee which produced the report, said: "People often reject the idea of a nanny state.

"But the government has a duty to look after the health of everyone and sometimes that means guiding or restricting our choices."

Lord Krebs said there had been a "huge cultural change over what is acceptable" with the introduction of the smoking bans and urged the government to "implement tougher measures".

MORE STEPS NEEDED? Alcohol - Call to consider raising the price of alcohol and review the extension of pub opening hours Obesity - Industry urged to introduce food labelling and town planners and architects should get training on 'healthy' design Smoking - In extreme cases, councils may consider intervening where children with respiratory diseases are exposed to smoking at home

Dr Tim Crayford, of the Association of Directors of Public Health, agreed the climate was changing.

He said: "We need the government to provide more leadership."

Professor Ian Gilmore, president of the Royal College of Physicians, added: "Their call to examine the impact of 24-hour licensing is particularly welcome as this is most likely to impact on the health of the nation in the long-term."

The government said it was taking steps to protect public health and defended its record on alcohol in particular.

Health Minister Dawn Primarolo said: "The government has introduced a comprehensive strategy to tackle the health and social affects of harmful drinking across the board."

• Summary Report (pdf, 2 pages)
• Short Guide (pdf, 9 pages)
  
• Executive summary (pdf, 16 pages)
• Full Report (pdf, 225 pages)
  

Obesity 'fuels cancer in women'

reposted from:

Obesity 'fuels cancer in women'

Being overweight is a risk factor for cancer

About 6,000 middle-aged or older women in the UK develop cancer each year because they are obese or overweight, a Cancer Research UK-funded study says.

The study, which looked at 45,000 cases of cancer in 1m women over seven years, says this is about 5% of such cases.

It is published online by the British Medical Journal and blames excess fat for 50% of cases of womb cancer and a type of oesophageal cancer.

Last week an international study warned of the link between cancer and weight.

'Bigger impact'

The World Cancer Research Fund warned that carrying excess weight significantly increased the risk of cancer.

CANCERS LINKED TO OBESITY Womb Oesophagus Bowel Kidney Leukaemia Breast Multiple myeloma (bone marrow) Pancreatic Non-Hodgkin's lymphoma Ovarian

Figures indicate that about 23% of all women in England are obese and 34% are overweight.

The latest study looked at how often cancers occurred in 1.2m UK women aged 50 to 64 over a seven year period. More than 45,000 cases of cancer and 17,000 cancer deaths occurred during that time.

Lead researcher Dr Gillian Reeves, from Oxford University, said:

"We estimate that being overweight or obese accounts for around 6,000 out of a total 120,000 new cases of cancer each year among middle-aged and older women in the UK.

"Our research also shows that being overweight has a much bigger impact on the risk of some cancers than others.

"Two thirds of the additional 6,000 cancers each year due to overweight or obesity would be cancers of the womb or breast."

Age difference

The research found that the link between weight and risk of cancer depended on a woman's stage of life.

Invest in a healthier lifestyle today and we can reap the benefits of reduced disease risk and longer life tomorrow Dr Ian Campbell Weight Concern

For example, being overweight increases the risk of breast cancer only after the menopause and the risk of bowel cancer only before the menopause.

Sara Hiom, from Cancer Research UK, said: "This research adds to the evidence regarding the impact of being overweight or obese on developing cancer and dying from the disease.

"While most people readily associate carrying extra weight with being a general health risk, many do not make a specific link with cancer."

Dr Ian Campbell, medical director of the charity Weight Concern, said: "Whereas it was once thought there was little one could do to prevent cancer, it's now clear that lifestyle impacts greatly on overall cancer risk.

"The message is clear. Invest in a healthier lifestyle today and we can reap the benefits of reduced disease risk and longer life tomorrow."

Genetic code of dandruff cracked

reposted from: http://news.bbc.co.uk/1/hi/health/7080434.stm

Genetic code of dandruff cracked

Dandruff flakes: a common sign on the collar

The genetic code of the fungus that causes dandruff has been cracked by an international team of scientists.

They hope a detailed knowledge of the genome of Malassezia globosa could lead to more effective treatments which block its growth.

The fungus lives and feeds on human skin, causing the itching and flaking associated with the condition.

The study, led by the firm Procter and Gamble, appears in Proceedings of the National Academy of Sciences.

A complete genomic sequencing of a Malassezia genome opens tremendous opportunities for researchers to understand the interactions of fungi and humans Dr Thomas Dawson

It is thought that about half the human population suffers from dandruff. Men tend to be more susceptible.

There are up to 10 million M. globosa fungi on the average human head.

The fungus, which is genetically related to yeast, feeds on sebum, the oily product produced by the sebaceous glands found in the skin.

Sebum acts to protect and waterproof hair and skin, and keep them from becoming dry, brittle and cracked.

It is made of fat and the debris of dead fat-producing cells.

M. globosa turned out to be one of the simplest organisms ever sequenced genetically by scientists, 300 times smaller than the human genome, with just 4,285 genes.

It has no ability to manufacture its own fatty acids, which are essential for life, and so relies on human sebum for its source.

Enzyme role

The latest research has revealed that the fungus causes dandruff by producing enzymes called lipases.

First, the fungus uses lipases to break down sebum, creating a compound called oleic acid.

This then penetrates the top layer of skin and triggers a faster turnover of skin cells than usual in susceptible people, resulting in dandruff.

The researchers found that the fungus produces a total of eight types of lipase, along with three phospholipases, which it uses to digest the oils from the scalp.

Each of these proteins could, they suggest, be a possible therapeutic target for new anti-dandruff preparations.

They also discovered that the fungus has the genetic potential to mate - although this has never been observed.

Researcher Dr Thomas Dawson said: "A complete genomic sequencing of a Malassezia genome opens tremendous opportunities for researchers to understand the interactions of fungi and humans."

Current medicated shampoos help to control fungal infections, but they are not 100% reliable.

It was only five years ago that scientists discovered that M. globosa was the cause of most cases of dandruff.

To decode the genome scientists grew ten litres of the fungus in a tank, and froze it in liquid nitrogen, before smashing it up into tiny fragments, and extracting its DNA.

Dr Bav Shergill, dermatologist for the British Skin Foundation, said: "We welcome any research into this troubling condition that affects the lives of so many individuals."

Bring home the bacon

reposted from: http://commentisfree.guardian.co.uk/chris_lamb/2007/11/bring_home_the_bacon.html

A report into links between diet and cancer contained some useful advice, but the attack on red and processed meats was a step too far.

November 1, 2007 3:00 PM | Printable version

Yesterday's report into the links between diet and cancer had useful advice for all of us in terms of reducing our cancer risk. But to suggest that we should stop eating some of our favourite foods such as bacon and ham - well, that does seem a little extreme.

Why does it seem a little extreme? Did he read the report on the evidence?

Yesterday you could have woken up and happily enjoyed a bacon sandwich for breakfast. Today apparently we shouldn't. Has anything really changed so drastically?

That is the nature of science!

The report's authors should not be surprised at the strength of today's backlash from media, chefs and consumers, as well as some of Britain's leading cancer specialists. This morning, consumers are more confused than ever about what they should and shouldn't eat. That can't be good.

Science evolves. It does not stand still. Even for consumers!

The report does give some very good advice on obesity. Previously we had to watch our waistlines due to the risk of heart disease and the like. Now we know that those extra pounds can add to our relative risk of developing cancer. But it's a shame that much of this good advice has been lost amid the debate on processed meats.

Rubbish. We can take in more than one issue!!

The red meat industry clearly has a vested interest in questioning the findings. But we have never suggested that people gorge themselves on ham or eat bacon three times a day. All the report is really saying is that we should all try to eat a healthy balanced diet and maintain a healthy weight. That's what we, and most sensible nutritionists and scientists, have been saying for years. Bacon and ham and all red meat in moderation are as important to a balanced diet as anything else. You could say that without them the diet is not balanced at all.

The advice on red meat in general was confusing too - people should eat less than 500g (cooked weight) per week. This is approximately what the average person in the UK eats right now. I can't help thinking that unnecessary confusion and concern would have been avoided if the report's authors had pointed this out.

500g may be the average - but what is the range of weight of meat eaten?

It's hard not to see the attack on bacon and ham as a step too far that has only succeeded in undermining some of the credibility of this report and its authors. It is always difficult to get consumers to change their ways - and alarmist diktats will do nothing to help.

He does not discuss the evidence in the report. This is a quite awful analysis of the 500 page report.

10 Recommendations for Cancer Prevention

1. Be as lean as possible without becoming underweight

Convincing evidence shows that weight gain and obesity increases the risk of a number of cancers, including bowel and breast cancer.

Maintain a healthy weight through a balanced diet and regular physical activity to help keep your risk lower.

2. Be physically active for at least 30 minutes every day

There is strong evidence that physical activity protects against cancers including bowel and breast cancer. Being physically active is also key to maintaining a healthy weight.

Any type of activity counts – the more you do the better! Try to build some into your everyday life.

3. Avoid sugary drinks. Limit consumption of energy-dense foods (particularly processed foods high in added sugar, or low in fibre, or high in fat)

Energy-dense foods are high in fats and/or sugars and can be low in nutrients. These foods increase the risk of obesity and therefore cancer. Sugary drinks, such as colas and fruit squashes can also contribute to weight gain. Fruit juices, even without added sugar, are likely to have a similar effect, so try not to drink them in large quantities.

Try to eat lower energy-dense foods such as vegetables, fruits and wholegrains instead. Opt for water or unsweetened tea or coffee in place of sugary drinks.

4. Eat more of a variety of vegetables, fruits, wholegrains and pulses such as beans

Evidence shows that vegetables, fruits and other foods containing dietary fibre (such as wholegrains and pulses) may protect against a range of cancers including mouth, stomach and bowel cancer. They also help to protect against weight gain and obesity.

As well as eating your 5 A DAY, try to include wholegrains (e.g. brown rice, wholemeal bread and pasta) and/or pulses with every meal.

5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats

There is strong evidence that red and processed meats are causes of bowel cancer, and that there is no amount of processed meat that can be confidently shown not to increase risk.

Aim to limit intake of red meat to less than 500g cooked weight (about 700-750g raw weight) a week. Try to avoid processed meats such as bacon, ham, salami, corned beef and some sausages.

6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day

Since the 1997 report, the evidence that alcoholic drinks can increase the risk of a number of cancers, including breast and colon cancer, is much stronger.

Any alcohol consumption can increase your risk of cancer, though there is some evidence to suggest that small amounts of alcohol can help protect against heart disease. Therefore, if you choose to drink, do so in moderation.

7. Limit consumption of salty foods and food processed with salt (sodium)

Evidence shows that salt and salt-preserved foods probably cause stomach cancer.
Try to use herbs and spices to flavour your food and remember that processed foods, including bread and breakfast cereals, can contain large amounts of salt.

8. Don’t use supplements to protect against cancer

Research shows that high-dose nutrient supplements can affect our risk of cancer, so it's best to opt for a balanced diet without supplements.

However, supplements are advisable for some groups of people (see our recommendations booklet to learn more).

Special Population Recommendations

Recommendations 9 and 10 don’t apply to everyone, but if they are relevant to you, it’s best to follow them.

9. It's best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods

Strong evidence shows that breastfeeding protects mothers against
breast cancer and babies from excess weight gain.

0. After treatment, cancer survivors should follow the recommendations for cancer prevention The Report found growing evidence that maintaining a healthy weight through diet and physical activity may help to reduce the risk of cancer recurrence.

And, always remember – do not smoke or chew tobacco Smoking or using tobacco in any form increases the risk of cancer and other serious diseases.

To find out how to incorporate the recommendations into your everyday life visit WCRF UK’s
Guidelines for Cancer Prevention.

Onions 'cut heart disease risk'

reposted from: http://news.bbc.co.uk/1/hi/health/7069343.stm

Onions 'cut heart disease risk'

Onions are a good source of quercetin

Eating a meal rich in compounds called flavonoids reduces some early signs of heart disease, research shows.

An Institute of Food Research team focused on one of the compounds, quercetin, which is found in tea, onions, apples and red wine.

The Atherosclerosis study

examined the effect of the compounds produced after quercetin is broken down by the body.

They were shown to help prevent the chronic inflammation which can lead to thickening of the arteries.

The effect is more subtle than laboratory experiments using the parent compound Dr Paul Kroon Institute of Food Research

Previous research has shown quercetin is metabolised very quickly by the intestine and liver and is not actually found in human blood.

So instead the researchers concentrated on the compounds that enter the bloodstream after quercetin is ingested, absorbed and metabolised.

The compounds were used - in concentrations similar to those that would be produced following digestion - to treat cells taken from the lining of the blood vessels.

Lower dose, bigger impact

Lead researcher Dr Paul Kroon said: "We tested compounds that are actually found in the blood, rather than the flavonoid in food before it is eaten, as only these compounds will actually come into contact with human tissues and have an effect on arterial health.

"The effect is more subtle than laboratory experiments using the parent compound.

"But the metabolites still have an effect on the cells lining the blood vessels."

The research found that,

in the case of one inflammatory process, a lower dose of the compounds - achievable by eating 100g to 200g of onions - actually had a bigger impact.

Bridget Aisbitt, a nutrition scientist at the British Nutrition Foundation, said: "Inflammation is an important process in the furring up of arteries that can lead to heart disease and stroke and this study gives us clues as to why a diet rich in fruit and vegetables appears to reduce the risk of these conditions.

"In the UK we are only consuming about two portions of fruit and vegetables per day on average, so this study underlines the importance of getting your five a day to stay healthy throughout life."

Be thin to cut cancer - World Cancer Research Fund report

reposted from: http://news.bbc.co.uk/1/hi/health/7069914.stm

Be thin to cut cancer, study says

A no no: people should try to avoid bacon, the study urges

Even those who are not overweight should slim down if they want to cut their risk of cancer,

a major international study - Food, Nutrition,
Physical Activity, and the Prevention of Cancer: a global Perspective, has claimed.

The World Cancer Research Fund WCRF carried out the largest ever inquiry into lifestyle and cancer, and issued several stark recommendations.

They include

not gaining weight as an adult, avoiding sugary drinks and alcohol, and not eating bacon or ham.

Everyone must also aim to be as thin as possible without becoming underweight.

People with a Body Mass Index (BMI), a calculation which takes into account height and weight, of between 18.5 and 25, are deemed to be within a "healthy" weight range.

Cancer is not a fate, it is a matter of risk, and you can adjust those risks by how you behave. It is very important that people feel that they are in control of what they do Professor Martin Wiseman Report author Calculate your BMI Do tough targets work?

But the study says t

heir risk increases as they head towards the 25 mark, and that everyone should try to be as close to the lower end as possible.

There is no new research involved in this document: the panel examined 7,000 existing studies over five years.

The result, they say, is the most comprehensive investigation ever into the risks of certain lifestyle choices.

RECOMMENDATIONS INCLUDE: Limit red meat Limit alcohol Avoid bacon, ham, and other processed meats No sugary drinks No weight gain after 21 Exercise every day Breastfeed children Do not take dietary supplements to cut cancer

They see body fat as a key factor in the development of cancer, estimating its significance to be much higher than previously thought.

The report's authors say they have produced a list of recommendations, not "commandments".

"But if people are interested in reducing their cancer risk, then following the recommendations is the way to do it," said Professor Martin Wiseman.

"Cancer is not a fate, it is a matter of risk, and you can adjust those risks by how you behave. It is very important that people feel that they are in control of what they do."

Making cuts

However, two-thirds of cancer cases are not thought to be related to lifestyle, and there is little people can do to prevent the disease in these circumstances.

READ THE FINDINGS Food, activity and prevention of cancer report [11.9MB] Most computers will open this document automatically, but you may need Adobe Reader Download the reader here

Nevertheless,

more than three million of the 10 million cases of cancer which are diagnosed across the world each year could be prevented if the recommendations were followed,

Professor Wiseman indicated.

In the UK alone, there are 200,000 new cases of cancer each year.

Cancers of the colon and breast are some of the most common forms of the disease, and the report says the evidence is "convincing" that body fat plays a key role in the development of these tumours.

The report also links the kind of food consumed to cancers, especially colorectal ones.

In particular, researchers say people should stop eating processed meats, such as ham, bacon and salami, and limit the consumption of red meat to 500g a week - although this still means you could eat, for instance, five hamburgers each week.

Alcohol, red meat and bacon in moderation will do us no harm, and to suggest it will is wrong Karol Sikora Cancer specialist Send us your comments

From a cancer perspective, all alcohol should be avoided, although researchers accepted drinking small amounts could have protective benefits for other diseases.

The recommendation is therefore

no more than two drinks a day for a man, and no more than one for a woman, slightly less than current UK government guidelines.

Sugary drinks meanwhile should be avoided, as these make you fat, and fruit juice consumption should also be reduced.

The report is also the first to urge breastfeeding as a means to protect against cancer, arguing that it may reduce breast cancer in the mother and prevent obesity in the child - although this has not been proven.

Cancer specialist Professor Karol Sikora said: "The educational message for the public should be that there are healthy diets and unhealthy diets but we should keep everything in perspective and not suggest rigid avoidance.

"Alcohol, red meat and bacon in moderation will do us no harm, and to suggest it will is wrong."

Antonia Dean, a specialist at Breast Cancer Care, said: "it is notoriously difficult to examine the potential role of diets or other lifestyle factors on breast cancer, as it is hard to isolate specific influences or establish how they might interact with each other.

"It is important that women keep the report findings in perspective - after gender, the highest known risk factor in relation to breast cancer is age, with 80 per cent of cases occurring in women over the age of 50."

Links:

Cancer Research UK

Have your Say at the BBC

Georgina Street BMI

BMI Calculator for Child and Teen: Results on a Growth Chart
	Information Entered for Georgina Street Age: 13 years 0 months Sex: Girl Birth Date: October 10, 1994 Height: 4 feet 11 inch(es) Date of Measurement: October 28, 2007 Weight: 88 pounds
	Results
	Based on the height and weight entered, the BMI is 17.8, placing the BMI-for-age at the 36th percentile for girls aged 13 years 0 months. This teen has a healthy weight.
	What does this mean? What should you do? About Growth Charts Body mass index-for-age percentiles: Girls, 2 to 20 years
	underweight, less than the 5th percentile healthy weight, 5th percentile up to the 85thpercentile at risk of overweight, 85th to less than the 95th percentile overweight, equal to or greater than the 95th percentile
	What does this mean? BMI is calculated using your child’s weight and height and is then used to find the corresponding BMI-for-age percentile for your child’s age and sex. BMI-for-age percentile shows how your child’s weight compares to that of other children of the same age and sex. For example, a BMI-for-age percentile of 65% means that the child’s weight is greater than that of 65% of other children of the same age and sex. Based on the height and weight entered, the BMI is 17.8, placing the BMI-for-age at the 36th percentile for girls aged 13 years 0 months. This teen has a healthy weight. Maintaining a healthy weight throughout childhood and adolescence may reduce the risk of becoming overweight or obese as an adult.
	What should you do? Regardless of the current BMI-for-age category, help your child or teen develop healthy weight habits and keep track of BMI-for-age. Practice healthy weight habits Encourage children and teens to practice healthy weight habits by: Eating healthy foods Participating in physical activity on most (preferably all) days of the week Limiting television viewing For more information, see Tips to Promote Healthy Eating and Physical Activity for Children and Teens (http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/tips_for_parents.htm.) Keep track of BMI-for-age Check BMI-for-age annually, or more often if recommended by the child’s healthcare provider. Tracking growth patterns over time can help you make sure your child is achieving or maintaining a healthy weight. A single BMI-for-age calculation is not enough to evaluate long-term weight status because height and weight change with growth.

	About Growth Charts See the following example of how some sample BMI numbers would be interpreted for a 10-year-old boy.