Diabetics

Food should show activity needed to burn off calories

Labels should be added to food and drink to show how much activity would be needed to burn off the calories consumed, the Royal Society for Public Health says.

Labels should be added to food and drink to show how much activity would be needed to burn off the calories consumed, the Royal Society for Public Health says.

It argues people underestimate the time it takes to exercise off calories in everyday products.

A mocha coffee containing 290 calories takes 53 minutes to walk off and a blueberry muffin takes 48 minutes.

A policy paper from the RSPH says the most common cause of obesity is consuming more calories than are burned off – and those taking lots of exercise are more likely to lose weight.

It says activity symbols on packs would prompt consumers to choose healthier options or exercise more.

Research shows that some consumers find current nutritional labels on the front of products confusing because of information overload.

They also spend just six seconds looking at food before buying it.

This means the information on the front of packs should be easy to understand and calorie information should be presented in a clear way, the paper said.

The RSPH says pictorial icons on the front of packs, as well as existing information, would be a good idea.

These pictures would show how much exercise is required to walk or run off the calories contained in the product.

The labelling would also remind the public of the importance of being physically active, which is known to boost mood, energy levels and reduce stress and depression.

A survey of 2,000 adults by RSPH found that more than 60% of people would support the introduction of “activity equivalent calorie labelling”.

More than half said it would encourage them to choose healthier products, eat smaller portions or do more physical exercise.

Men should consume around 2,500 calories and women 2,000 calories on average each day to maintain a healthy weight, the paper says.

Two thirds of adults in the UK are currently overweight or obese.

Shirley Cramer, chief executive of the Royal Society for Public Health, said: “Although nutritional information provided on food and drink packaging has improved, it is evident that it isn’t working as well as it could to support the public in making healthy choices.

“Activity equivalent calorie labelling provides a simple means of making the calories contained within food and drink more relatable to people’s everyday lives, while also gently reminding consumers of the need to maintain active lifestyles and a healthy weight.”

A spokesperson for the Food and Drink Federation said activity equivalent information was “an interesting concept” which was worth exploring.

“As an industry, we are looking at what more we can do to help people use the existing nutrition information provided to understand how different foods and drinks fit within a healthy lifestyle.

“We support RSPH’s call for further research into whether activity equivalent calorie labelling could be an effective way of encouraging consumers to use labels.”

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Tax on sugary drinks backed by MPs

A tax on sugary drinks should be introduced as part of a “bold and urgent” set of measures to tackle child obesity in England, MPs say.

A tax on sugary drinks should be introduced as part of a "bold and urgent" set of measures to tackle child obesity in England, MPs say.

The Commons’ Health Committee said there was now “compelling evidence” a tax would reduce consumption.

Its report, which puts pressure on ministers who have so far been resisting a tax, also proposes a crackdown on marketing and advertising.

Food industry representatives say a new tax would be unfair on consumers.

The government will be setting out its plans early next year when it publishes a child obesity strategy, but has said a tax is not something it favours.

The cross-party group of MPs acknowledged no single measure would provide a solution to the problem.

But the committee’s report said calls for a tax could “no longer be ignored”.

It pointed to evidence from Mexico which introduced a tax on sugar-sweetened drinks of 10% and saw a 6% reduction in consumption.

The MPs urged the government to use the strategy to take strong action on the issue, pointing out that a fifth of children start primary school overweight or obese, rising to a third by the time they leave.

As well as a tax, the committee called for:

A crackdown on price promotions of unhealthy foods Tougher controls on marketing, including the use of cartoon characters to promote unhealthy food A ban on advertising unhealthy foods on television before 21:00 Clearer labelling of products showing sugar content in teaspoons A drive to force industry to reduce sugar in food and drink as has happened with salt

The MPs said the government in England should work with its counterparts in the rest of the UK on these points.

There has been growing concern about the damaging impact of sugar on health – from the state of people’s teeth to type-2 diabetes and obesity Sugar has been dubbed “empty calories” because it has no nutritional benefit Government advisers recommend no more than 5% of daily calories should come from sugar That is about 1oz (25g) – six or seven teaspoons – for an adult of normal weight every day. For children, it is slightly less The limits apply to all sugars added to food, as well as sugar naturally present in syrups and honey To put this in context, a typical can of fizzy drink contains about nine teaspoons of sugar

Public Health Minister Jane Ellison said: “This government is committed to turning the tide on childhood obesity. That is why we are developing a comprehensive strategy looking at all the factors, including sugar consumption, that contribute to a child becoming overweight and obese. This will be published in the coming months.”

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In search of the perfect sweetener

Too much refined sugar is blamed for a wave of obesity and ill-health, so the search is on for the perfect sweetener.

Too much refined sugar is blamed for a wave of obesity and ill-health, so the search is on for the perfect sweetener.

Derived from a plant called Synsepalum dulcificum, it is unlike any artificial sugar – because it works not by making foods sweeter, but by making them taste sweeter.

The so-called miracle berries contain a molecule called miraculin which binds to receptors on your tongue, changing their shape. This makes sour foods taste sweeter. One advantage of temporarily changing your taste buds, rather than the food itself, could be the effect this has on your gut bacteria.

For years now there has been a vigorous debate as to whether using artificial sugars will help you lose weight or not. A recent meta-analysis which looked at the results of more than 100 different human studies concluded that when artificial sweeteners replace sugar in the diet (rather than simply being added on top) then this can lead to weight loss.

The Harvard School of Public Health, however, points out that there are lots of conflicting studies, including those which suggest that drinking artificially sweetened drinks may increase your risk, not just of weight gain, but of type 2 diabetes.

No-one really knows how artificial sugars could do this but a study done by a group in Israel suggests it might be via the impact of artificial sugar on your gut bacteria.

In this study, published last year in the science journal, Nature, the Israeli researchers asked a group of lean and healthy volunteers who didn’t normally use artificial sweeteners to consume the maximum acceptable dose for a week.

At the end of the week half the volunteers were showing signs of glucose intolerance, an early step in the journey to type 2 diabetes. The researchers think this could be because the bacteria in their guts reacted to the artificial sugars by secreting substances that cause inflammation. This is certainly what they have seen in animals.

As one of the researchers, Dr Eran Elinav, put it: “Our relationship with our own individual mix of gut bacteria is a huge factor in determining how the foods we eat affects us.” Clearly not a fan of artificial sweeteners, he went on to add that there should be a “reassessment of today’s massive, unsupervised consumption of these substances”.

Whatever the health effects or otherwise of artificial sweeteners, consumers are wary of them, which is where those promoting the joys of natural miracle berries hope to score. The trouble is that the berries are expensive to grow and don’t last long, so scientists in Japan (where the berry is popular) are now trying to produce the all-important miraculin molecule by genetically engineering tomato plants. That is obviously some way off. For now the simplest and cheapest way to get a dose of miraculin is to buy tablets which contain the dehydrated pulp of the fresh berries.

So what are they like? Eagerly I put one on my tongue, waited about five minutes for it to dissolve and then I was good to go. I had read enthusiastic claims that it would make foods, such as oranges, taste as if they had been ‘freshly plucked from the Garden of Eden” and kill my sugar cravings stone dead.

That was not my experience. The tablet I tried certainly took the bitter edge off licking a lemon, but the aftertaste was flat and remarkably unpleasant. An expensive red wine was transformed by the tablet into a sweet, fizzy abomination. I tried eating a segment of orange. Far from making the orange irresistible, the tablet made it inedible. The only good thing, as far as I was concerned, is it put me off eating anything at all until the effects had worn off (about an hour).

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UK’s five big killers

Five big killers – heart disease, stroke, cancer, lung and liver disease – account for more than 150,000 deaths a year among under-75s in England alone and the Department of Health estimates 30,000 of these are entirely avoidable.UK's five big killersCoronary Heart Disease is the biggest killer, causing almost 74,000 deaths each year in the UK- that’s about 200 people dying every day.

More than a quarter of the deaths occur in people who are younger than 75 and experts say the majority are preventable.

Smoking, being overweight and having high blood pressure are all risk factors.

About one in three adults in England and Scotland have high blood pressure and nearly half of them are not receiving treatment for the condition, says the British Heart Foundation.

Between April 2011 and March 2012 only 2% of those eligible in England actually had a health check. Out of nearly 16 million people eligible, about 425,000 were offered a check and 211,000 took up the offer.

England has one of the highest rates of asthma prevalence in the world. Figures from GP registers in 2008 suggested that about 6% of the English population has asthma.

And more than three million people in England are living with COPD. This lung disease kills about 23,000 people a year in the UK.

The most important cause of COPD is smoking, but about 15% of cases are work-related, triggered by exposure to fumes, chemicals and dusts at work.

Premature deaths from COPD in the UK was almost twice as high as the European average in 2008 and premature mortality for asthma was more than 1.5 times higher.

The disease is one of the most common causes of emergency admission to hospital and is expensive in terms of acute hospital care. It costs nearly 10 times more to treat severe COPD than the mild disease.

Strokes are the third leading cause of death in England each year and the leading cause of disability. More than 150,000 people have a stroke every year in the UK but, according to The Stroke Association, up to 10,000 of these could be prevented if more people were aware of the symptoms and sought out emergency treatment.

Symptoms can include facial weakness, speech problems and pins and needles down one side of the body.

The Health Secretary Mr Jeremy Hunt says a major challenge is getting all parts of the country to meet the performance levels of the best.

For example, if all patients suffering from a mini stroke (transient ischaemic attack or TIA) were treated as rapidly as those treated in the top 25% of hospitals, 540 strokes would be avoided each year, which in turn would save the NHS £4.5m a year.

Cancer has now become so common that today one in 30 people living in the UK either has cancer or is in remission. By 2030 it is estimated that three million people in England will have had some form of cancer.

The good news is that cancer survival rates are now improving in the UK.

More men are now surviving prostate and bowel cancer and women with breast cancer have a better outlook than ever before. But the UK still lags behind other European countries in terms of cancer survival.

Cancer Research UK says part of the problem is unhealthy lifestyles. It is estimated that about a third of cancers are caused by smoking, diet, alcohol and obesity.

And many cancers are detected too late. Although there are national screening programmes for certain cancers, like breast and cervical, public awareness of symptoms and the need to seek help early is still too low.

Another issue is access to treatment. Waiting times to see a doctor for speedy diagnosis and treatment have come down. But the provision of certain types of cancer investigations and treatments across the UK is variable and some groups of society, like the very old, can miss out.

Lastly, the Chief Medical Officer of England, Prof Dame Sally Davies, highlighted liver disease as an issue in her annual report.

It is the only major cause of mortality and morbidity that is on the increase in England while it is decreasing among European peers.

Between 2000 and 2009, deaths from chronic liver disease and cirrhosis in the under 65s in England increased by about 20% while they fell by the same amount in most EU countries. And all three major causes of liver disease – obesity, undiagnosed infection, and, increasingly, harmful drinking – are preventable.

More than a third of men and over a quarter of women regularly exceed the government recommended level of alcohol intake – three to four units of alcohol a day for men and two to three units for women.

The government in England is currently considering whether to set a minimum unit price for alcohol to deter problem drinking and cut alcohol-related illness.

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Stroke sufferers are getting younger due to poor diet

Younger people are increasingly suffering strokes because of their unhealthy lifestyle according to new research.Stroke sufferers are getting younger due to poor dietThe average age of someone suffering a stroke has fallen from 71 years in 1993/4 to 69 years in 2005 and study published in the journal Neurology found.

It was also found that 13 per cent of strokes occurred in people aged under 55 in 1993/4 which increased to 19 per cent in 2005.

Study author Dr Brett Kissela, of the University of Cincinnati College of Medicine in Ohio and a Fellow of the American Academy of Neurology, said: “The reasons for this trend could be a rise in risk factors such as diabetes, obesity and high cholesterol.

“Other factors, such as improved diagnosis through the increased use of MRI imaging may also be contributing. Regardless, the rising trend found in our study is of great concern for public health because strokes in younger people translate to greater lifetime disability.”

The study looked at people aged between 20 and 54 in the Greater Cincinnati and Northern Kentucky area of America during three separate, one year long periods between July of 1993 and June of 1994, and the calendar years of 1999 and 2005.

Dr Kissela said: “The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise.

“However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease.”

A spokesman for the UK’s Stroke Association said: “Although this research was carried out in the US, western cultures lead very similar lifestyles and in other research parallels have often been drawn between the US and the UK.

“For these reasons it’s likely that the UK could face similar outcomes. However, a UK specific study hasn’t been carried out yet.”

Every year around 152,000 people suffer a stroke in Britain and a third are known to occur in people under the age of 65 including 400 in children.

From: http://www.telegraph.co.uk/Stroke-sufferers-are-getting-younger-due-to-poor-diet-researchers

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Obese children are more likely to have heart attacks or strokes

Researchers say obese children with high BMIs may already have up to 40% higher chance of heart disease.Obese children are more likely to have heart attacks or strokesObese children have a far higher risk of having a stroke or heart attack when they grow up than peers who have a normal weight, according to new research.

Children who are dangerously overweight may already have a 30%-40% higher chance of either suffering a stroke or developing heart disease in later life, Oxford University researchers found.

They end up with a range of risk factors for either disease, such as a thickening of the heart muscle known as left ventricular mass, which is often a sign of emerging heart disease.

“Weight, and especially obesity, has a significant effect on the risk parameters for cardiovascular disease that are present in children from age five years”, say the six academics in a paper published online in the British Medical Journal. “This effect could give them a head start on their normal and even overweight classmates for future cardiovascular disease, diabetes and stroke”, they conclude.

The findings are the latest graphic illustration of the medical problems associated with the sharp rise in childhood obesity in recent years. They prompted calls for GPs and practice nurses to measure children’s Body Mass Index (BMI) levels so that those who are worryingly heavy can be helped.

It is already known that obese adults are more likely to have a stroke or heart attack. The Oxford researchers sought to measure the extent of the same association for children with a BMI of at least 30. They analysed 63 previous studies published between 2000 and 2011, which examined key health indicators among 49,220 children aged between five and 15 in a number of highly developed countries.

They found that both obese and overweight children had “significantly higher” blood pressure and cholesterol levels than classmates who were of a healthy weight, especially those whose BMI was 30 or more.

Obese pupils also had much higher fasting insulin levels and insulin resistance, which often indicate diabetes, which is closely associated with obesity.

“Having a body mass index outside the normal range significantly worsens risk parameters for cardiovascular disease in school-aged children. This effect, already substantial in overweight children, increases in obesity and could be large than previously thought”, say the authors, who include Matthew Thompson, a GP.

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Only one in six baby boomers retiring in good health

Only one in six ‘baby boomers’ is retiring in good health- with most succumbing to a range of conditions and diseases including high cholesterol, osteoporosis or cancer.Only one in six baby boomers retiring in good healthEven though today’s 60-somethings have benefited from the NHS and welfare state pretty much from birth, most still have at least one health problem, say Government scientists.

They found the average baby boomer – referring to those born in the years just after the Second World War – has two medical conditions.

Just over half have high blood pressure, a third are obese, and a quarter have high cholesterol.

A quarter have Type 2 diabetes or ‘pre-diabetes’, meaning they are on the cusp of fully developing the condition.

Almost one in five suffer from a mental health problem, while 12 per cent have chronic lung or throat disease.

Eleven per cent have cancer, the same proportion that has osteoporosis. In addition, 11 per cent have suffered from cardiovascular disease such as a heart attack, stroke or heart failure.

One in six have three or more health problems.

The results are from a study of 2,661 people born in 1946, from every walk of life, whose health has been followed from birth. For this, the latest study, they were assessed between 60 and 64 years of age for 15 conditions.

The study found the origins of poor health in one’s 60s could usually be traced back to early middle age.

Dr Mary Pierce, of the MRC Unit for Lifelong Health and Ageing, the GP who led the report Clinical Disorders in a Post War British Cohort Reaching Retirement: Evidence from the First National Birth Cohort Study said: “The babies born in the post-war period were the first generation to enjoy the lifelong benefits of the NHS and the welfare state, and have an extended life expectancy.”

Writing in the report, published in the journal PLoS One, she warned: “The health of the baby boomers as they age will dominate the work of the health and social care systems for the next three decade.”

“We might, therefore, expect this generation to be in pretty good health at retirement age.  But our research shows that medical conditions – some of which could lead to serious disability or even death ­– are common among baby boomers.”

Professor Diana Kuh, director of the unit, said some of the conditions shared “common root causes related to poor diet and inactive lifestyles”.

They argued GPs would become more and more stretched as the baby boomer generation aged, with Dr Pierce saying it made “a compelling case to invest in primary care to ease the burden on an already stretched service”.

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New York bans large sugary drinks

New York City’s health board has passed a law prohibiting the sale of sugary drinks larger than 16 ounces- an act which Mayor Michael Bloomberg says will save lives by reducing obesity.New York bans large sugary drinksNew York City passed the first US ban of oversized sugary drinks in its latest controversial step to reduce obesity and its deadly complications in a nation with a weight problem.

The mayoral appointed city health board outlawed sugary drinks larger than 16 ounces (one pint) nearly everywhere they are sold, except grocery and convenience stores.

Violators of the ban, which does not include diet sodas, face a $200 (£125) fine.

At a news conference at City Hall, Bloomberg heralded the measure’s passage as “the single biggest step any city I think has ever taken to curb obesity.

“We believe that it will help save lives,” he added.

About one third of Americans are obese, and about 10 per cent of the nation’s healthcare bill is tied to obesity related diseases, such as Type 2 diabetes, heart disease and hypertension, according to the Organization for Economic Co-operation and Development .

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NHS turning to weight loss surgery to tackle obesity epidemic

The NHS is increasingly resorting to weight loss surgery to tackle Britain’s obesity epidemic- with the number of gastric bypass operations rising six fold in just five years.NHS turning to weight loss surgery to tackle obesity epidemicBritain’s men and women are among the fattest in Europe. Ministers want to tackle the problem at source- but surgeons say weight loss surgery is extremely effective for treating the morbidly obese.

Between 2006-7 and 2011-12 the number of gastric bypass operations increased from 858 to 5,407, according to figures from the NHS Health and Social Care Information Centre.

Over the same period the number of gastric band operations also increased, but at a slower rate, from 715 to 1,316.

A gastric bypass involves making the stomach much smaller and shortening the length of the small intestine. This makes it impossible to eat large meals and reduces absorption of nutrients.

It has become much more popular than gastric banding, which involves inserting an adjustable and removable band that limits the effective size of the stomach, but nothing else.

Surgeons said the increases indicated there was a large unmet need for weight loss (‘bariatric’) surgery, rather than any sizeable increase in the number of morbidly obese people since 2006.

Alberic Fiennes, president of the the British Obesity and Metabolic Surgery Society (BOMSS), said: “There are about 1.5 million such adults in the UK. They face premature death, disease and disability brought on as a direct result of their condition. These can be prevented, improved or eliminated by surgery.

“There is compelling evidence that weight loss surgery to treat the most severely affected is one of the most clinically effective, safe and cost effective treatments available.

American research indicates the morbidly obese could gain around three extra years of life from bariatric surgery. It also improves quality of life – besides weight loss – in some cases reversing patients’ Type 2 diabetes.

However, although there are national guidelines on who is eligible, some local health authorities refuse to adhere to them, leading to a postcode lottery of care.

Bariatric surgery is expensive – costing up to £14,000 a time – and there are too few qualified surgeons to meet demand. The NHS currently spends about £50 million on bariatric surgery.

Mr Fiennes called on the Department of Health “to invest in a long term strategy to ensure that all patients have equal access to this life-saving treatment.”

He also explained the gastric bypass operations had become the favoured option because they “may be more effective in the long term”.

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Heart benefits of statins exceed diabetes risk

The benefits of taking statins for hearts exceeds the increased risk of diabetes from the drugs new reserach has found.Heart benefits of statins exceed diabetes risk

Although the cholesterol busting drugs raise the risk of developing type 2 diabetes in those already prone to the disease, the cuts in heart attacks and strokes are worth it, an article- Cardiovascular benefits and diabetes risks of statin therapy in primary prevention published in The Lancet said.

Millions of people take statins to reduce the risk of suffering a heart attack or stroke and it has been argued that everyone over the age of 50 should take them.

However, in people who are already at risk of type 2 diabetes by being overweight for example, taking statins can increase the chances of developing the disease by 28 per cent.

For healthy people not at risk of diabetes, statins have no effect on the disease.

Conversely, statins can cause fatigue, muscle pains, headaches, nausea and memory problems.

Currently UK doctors consider statins for patients whose chances of having a heart attack over the next decade are calculated to be 20 per cent or greater.

A team of scientists led by Professor Paul Ridker, based at Brigham and Women’s Hospital, Boston, USA, analysed data gathered during the Jupiter trial, the first controlled study to report that taking statins results in an increased risk of developing diabetes.

They said for those taking statins during the five year trial the drugs clearly increased the likelihood of developing diabetes in patients already at risk of the disease, these patients were still 39 per cent less likely to develop cardiovascular illness while using statins, and 17 per cent less likely to die over the trial period.

Patients who were not already at risk of developing diabetes experienced a 52 per cent reduction in cardiovascular illness when taking statins, and had no increase in diabetes risk.

Professor Ridker said: “Our results show that in participants with and without diabetes risk, the absolute benefits of statin therapy are greater than the hazards of developing diabetes.

“We believe that most physicians and patients would regard heart attack, stroke and death to be more severe outcomes than the onset of diabetes, and so we hope that these results ease concern about the risks associated with statin therapy when these drugs are appropriately prescribed – in conjunction with improved diet, exercise and smoking cessation – to reduce patients’ risk of cardiovascular disease.”

In an accompanying commentary article Professor Gerald Watts of the University of Western Australia’s Cardiometabolic Research Centre, at the Royal Perth Hospital, said warnings over the use of statins and diabetes could be altered to apply only to people already at risk of diabetes.

He said: “A major take-home message for the clinician involved in either primary or secondary prevention of cardiovascular disease is that all individuals on a statin who have major risk factors for diabetes, particularly impaired fasting glucose, need to be informed about the risk, monitored regularly for hyperglycaemia, and advised to lose weight and take regular physical exercise to mitigate the emergence of diabetes.”

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