Counting Calories is Better for Weight Loss – “Little and Often” Can Be Dangerous

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Counting calories – not adjusting our meals to just “small and often” – is the only important factor in weight loss, according to a new study by the Society for Endocrinology.

The research shows that following a pattern of eating small yet frequent meals will not boost metabolism or encourage weight loss. It is only calories and calories alone, that count.

Conversely, eating single high fat meals can have a negative impact upon health, increasing the risk of developing type-2 diabetes and cardiovascular disease. An increase in endotoxins – fragments of gut bacteria – enter the blood system after eating a single high fat meal, causing a low level inflammation in the body. Continue reading

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Recessions Good For Male Health But Bad For Females

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Boys who leave school or university during a recession experience better health in later life compared to those that leave during an economic “boom.”

In girls, however, the situation is reversed. Females have poorer health in later life if they leave school during a time of recession.

The study by economists at the London School of Economics and Political Science (LSE), is published at the same time as figures which show Eurozone youth unemployment to be as high as 24.4%.

The paper, “Are economic recessions at the time of leaving school associated with worse physical functioning in later life?” is published in the journal Annals of Epidemiology.

The study’s findings are indicative of the future health of the generation who now face joining the labour market in a time of global recession. Continue reading

4p Blood Pressure Drug Could Become First Treatment for Dementia

Medicine, drugs, tablets

A common drug prescribed to treat high blood pressure could be used as the first treatment for vascular dementia, the most common form of dementia after Alzheimer’s disease. Costing as little as 4 pence per day, a 10 mg dose of amlodipine has shown to improve memory and cognitive health in those suffering with symptoms of vascular dementia.

A £2.25 million clinical trial to test the effectiveness of amlodipine has been announced by the Alzheimer’s Society and the British Heart Foundation. The two year trial run jointly by the School of Medicine at Queen’s University Belfast and Bristol University’s School of Clinical Sciences will recruit 600 adults with vascular dementia.

Amlodipine is used to treat hypertension (high blood pressure) and to prevent angina (chest pain). In its current form as  drug to treat high blood pressure, the drug works by relaxing blood vessels and allowing blood to circulate more freely in the body. Lowering blood pressure, the efficiency of the heart is improved and chest pain associated with angina is prevented.

In its proposed use in treating vascular dementia, amlodopine is thought to protect brain cells from damage caused by poor blood supply to the brain. Professor Peter Passmore, said:

Vascular dementia is a very common disease and to date no major trial has been successful in developing an effective treatment for this disease. We hope, using evidence from previous research, and by trialling the drug amlodipine we may get a step closer to improving the outcomes of patients with vascular dementia in the next decade.”

Already licensed and known to be safe to use, amlodipine costs the NHS as little as £1.07 a month. The drug could be used as a treatment for vascular dementia as soon as 2020.

Vascular dementia is caused by problems with the blood supply to the brain and affects about 150,000 people in the UK. Those with heart conditions, high cholesterol and diabetes are especially at risk, and it can be triggered by a stroke. There are currently no available treatments for vascular dementia yet fewer clinical trials exist for the condition than there are currently for hay fever.

Professor Peter Weissberg, Medical Director at the BHF, added:
The 2.3 million people living with coronary heart disease in the UK are at increased risk of developing vascular dementia. Unfortunately, as yet, there are no effective treatments for this devastating condition.

Notes:

Bristol Press Release: Blood Pressure Drug Could Double Up as First Treatment for Common Form of Dementia

Image: with thanks to Lusi of RGB Freestock

Chronic Pain and the Struggle with a “New Self”

Accepting a “new self” – one unable to function in the same way as the former pain-free self was found to be a major challenge for adults living with chronic non-malignant muskoskeletal (MSK) pain.

Funded by the Health Services and Delivery Research programme (HS&DR), the study found that adults with MSK chronic pain can have an altered relationship with their sense of self and can feel ‘homeless’ in their own body.

The study is the first of its kind to collate the findings of research on non-malignant chronic pain to create a central resource. Chronic pain is common and increasing. According to the report:

  • 5 million people develop chronic pain each year
  • 25% of adults around the world suffer with moderate or severe pain
    (for between 6% and 14% of those adults, the pain is severe and disabling)
  • 49% of patients with chronic pain experience depression
  • 25% lose their jobs
  • 16% feel that their chronic pain is so bad that they sometimes want to die.

Despite the prevalence of adults with chronic pain, the health care system continues to struggle to treat people. Francine Toye, Research Lead at Nuffield Orthopaedic Centre NHS Trust in the UK, comments:

The alleviation of pain is a key aim of health care yet pain can often remain a puzzle as it is not always explained by a specific pathology. Musculoskeletal (MSK) pain is one of the most predominant kinds of chronic pain and its prevalence is increasing.”

Researchers collated qualitative studies from six electronic bibliographic databases (including MEDLINE, EMBASE and PsycINFO) and included studies up until the final search in February 2012.

The full texts of 321 potentially relevant studies were screened and  77 were deemed appropriate and included in the meta-ethnography – a systematic analysis and synthesis of qualitative research.

Forty-nine papers explored the experience of chronic MSK pain and 28 papers explored the experience of fibromyalgia.

The limitations of living with unpredictable pain was found to restrict activities, the ability to make future plans and people struggled in relating to a new body which they felt, at times, unable to control, relate to, or understand.

Many adults reported feeling like a “shuttlecock” as they were referred to various professionals and departments. A short film, “Struggling to Be Me” highlights the main findings of the study into patients’ experience of chronic muskoskeletal pain.

Five themes were found to be prevalent within the collated research:

  • a constant daily struggle to affirm their self
  • construction of time altered: unpredictable now and future
  • struggling to construct an explanation of suffering
  • struggling to negotiate the health-care system
  • struggling to prove legitimacy

Methods of moving on from pain included working towards an integrated relationship with the painful body, redefining a positive sense of self now and in the future, regaining a sense of reciprocity and social participation, recognizing the limits of the medical model and being empowered to experiment and change things without the sanction of health-care professionals.

The results hope to inform health services on how to improve treatment for people who seek help from the health-care service for MSK problems in future.

Notes:
Full report: A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain:
http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0005/93632/FullReport-hsdr01120.pdf

Warwick Press Release: http://www2.warwick.ac.uk/newsandevents/pressreleases/living_with_chronic/

A short film based on the meta-ethnography of patients’ experience of chronic musculoskeletal pain:
Struggling to Be Me

Image credit: with thanks to Hanspeter Klasser of RGB Free Stock

Chronic Pain and the Struggle with a “New Self”

Accepting a “new self” – one unable to function in the same way as the former pain-free self was found to be a major challenge for adults living with chronic non-malignant muskoskeletal (MSK) pain.

Funded by the Health Services and Delivery Research programme (HS&DR), the study found that adults with MSK chronic pain can have an altered relationship with their sense of self and can feel ‘homeless’ in their own body.

The study is the first of its kind to collate the findings of research on non-malignant chronic pain to create a central resource. Chronic pain is common and increasing. According to the report:

  • 5 million people develop chronic pain each year
  • 25% of adults around the world suffer with moderate or severe pain
    (for between 6% and 14% of those adults, the pain is severe and disabling)
  • 49% of patients with chronic pain experience depression
  • 25% lose their jobs
  • 16% feel that their chronic pain is so bad that they sometimes want to die.

Despite the prevalence of adults with chronic pain, the health care system continues to struggle to treat people. Francine Toye, Research Lead at Nuffield Orthopaedic Centre NHS Trust in the UK, comments:

The alleviation of pain is a key aim of health care yet pain can often remain a puzzle as it is not always explained by a specific pathology. Musculoskeletal (MSK) pain is one of the most predominant kinds of chronic pain and its prevalence is increasing.”

Researchers collated qualitative studies from six electronic bibliographic databases (including MEDLINE, EMBASE and PsycINFO) and included studies up until the final search in February 2012.

The full texts of 321 potentially relevant studies were screened and  77 were deemed appropriate and included in the meta-ethnography – a systematic analysis and synthesis of qualitative research.

Forty-nine papers explored the experience of chronic MSK pain and 28 papers explored the experience of fibromyalgia.

The limitations of living with unpredictable pain was found to restrict activities, the ability to make future plans and people struggled in relating to a new body which they felt, at times, unable to control, relate to, or understand.

Many adults reported feeling like a “shuttlecock” as they were referred to various professionals and departments. A short film, “Struggling to Be Me” highlights the main findings of the study into patients’ experience of chronic muskoskeletal pain.

Five themes were found to be prevalent within the collated research:

  • a constant daily struggle to affirm their self
  • construction of time altered: unpredictable now and future
  • struggling to construct an explanation of suffering
  • struggling to negotiate the health-care system
  • struggling to prove legitimacy

Methods of moving on from pain included working towards an integrated relationship with the painful body, redefining a positive sense of self now and in the future, regaining a sense of reciprocity and social participation, recognizing the limits of the medical model and being empowered to experiment and change things without the sanction of health-care professionals.

The results hope to inform health services on how to improve treatment for people who seek help from the health-care service for MSK problems in future.

Notes:
Full report: A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain:
http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0005/93632/FullReport-hsdr01120.pdf

Warwick Press Release: http://www2.warwick.ac.uk/newsandevents/pressreleases/living_with_chronic/

A short film based on the meta-ethnography of patients’ experience of chronic musculoskeletal pain:
Struggling to Be Me

Image credit: with thanks to Hanspeter Klasser of RGB Free Stock

1920’s Factory Experiment Leads to App for Mental Health

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In an American factory in 1920, factory workers were involved in a psychology experiment conducted by Harvard university students to investigate the effects of environmental changes on productivity. The experiment was a simple one; turn the lights up and see if the factory workers were more productive, turn the lights down and see if they were less productive. What happened instead was the Hawthorne effect – a phenomenon that led to the factory workers productivity increasing which had nothing to do with the lighting and everything to do with being paid attention to. The workers were stimulated by the interest that was being shown in them and became more productive when they knew they were being observed.

The Hawthorn affect, discovered nearly 100 years ago is the psychology behind the new MoodScope app; a free web app to help people manage their moods. The app, like many others, asks members to monitor their mood every day. The difference is that if the mood recorded is low enough, a trusted “buddy” will be notified by email and be made aware that the user is in need of support. What the buddy does next is up to them; call their pal, email or text. It doesn’t matter. The basic principle of someone being involved is good enough.

How does it work?

Everyday a user rates their mood. It’s not a box ticking exercise, quite the opposite. A user is dealt a set of mood cards from ‘anxiety’ to ‘angry’ and clicks to flip the cards over or turn the card upside down to rate whether they are ‘a little’ anxious or ‘extremely’, for example. The results are tallied up and added to a graph where the user can pinpoint high or low periods and add a note to explain the blip. Nominated buddies are alerted if the user appears to be on a down trend.

The app has had mixed results. The buddy option has caused users to worry about changing the dynamic of a friendship; turning friends into carers. The graph however has proved a useful aid to show users that they can be happy, even in the midst of depression when they feel this to be impossible – the proof is the positive tips in the graph.

Of the focus group, 7.2 found it was useful to monitor mood over time. Some users however struggled in differentiating between similar mood words such as “jittery” or “nervous.” Others commented that judging a mood was tricky in just one space in time and their mood was liable to change over the day and difficult to pinpoint. Motivation was key, with one participant commenting that completing the mood test was “like going to the gym.” Certainly, towards the end of the pilot run there appeared to be a drop of usage as motivation tailed off.

The Buddy system

The Buddy system had mixed results. General concern and encouraging feedback from friends had the best results, humour the least with users with very low mood dips. The majority of users found it helpful to have a friend involved and one user commented that they felt essentially, less alone;

“A big part of depression is feeling alone and even if they’re just getting an email that says ‘so and so’ is having a crap day, then at least someone else there knows.” MoodScope Focus Group User

The World Foundation for Mental Health predicted on World Mental Health day that depression will be the largest global health burden facing the modern world in 2030. With over a 3rd of current depression sufferers reporting that they are resistant to anti-depressant treatment, the new MoodScope app will come as a welcome addition to help people manage their moods, or as a tool to manage patients while they are on waiting lists for treatment such as Cognitive Behavioural Treatment or, as one patient pointed out, to get help in the first place;


“I think for a lot of guys I know who wouldn’t want to say ‘I’m struggling doctor’ I think that would be a great use to them. I think if people know about it in the privacy of their own homes they can try and help themselves … to identify what’s bothering them and maybe give them the confidence to then go a step further and see the doctors. That’s where I see its use as being.”

Notes:

Moodscope https://www.moodscope.com

Moodscope IAP research downloadable from https://www.moodscope.com/about/how-it-works/demo

20 year Swedish study shows surprise decline in dementia

A new European study published in the journal Neurology shows the risk of developing dementia may have declined over the past 20 years, in direct contrast to what many have previously assumed.

PicThe long term study based in Sweden monitored the ageing and health of over 3,000 participants aged 75 and over during a two decade period; 523 of those participants were diagnosed with some form of dementia. Key members of  The Kungsholmen Project, named after the central Stockholm city in which the study was based, remained constant since the research began in1987, including the neurologist responsible for the clinical diagnosis of dementia. Each of the 3,000 study participants were assessed by a nurse, a physician and a psychologist.

In contrast to the common assumption that the risk of developing dementia will rise, the findings from the Swedish study in Stockholm are surprising. The research conducted by the Ageing Research Centre shows that despite the survival rates of dementia sufferers increasing since the 1980’s, the occurrences of dementia have shown to stabilize. These findings have led researchers to conclude that the overall risk of developing dementia has declined during this period with improvements in heart health thought to be a major contributing factor.

“We know that cardiovascular disease is an important risk factor for dementia. The suggested decrease in dementia risk coincides with the general reduction in cardiovascular disease over recent decades,” says Associate Professor Chengxuan Qiu of the Ageing Research Center, established by Karolinska Institutet and Stockholm University. “Health check-ups and cardiovascular disease prevention have improved significantly, and we now see results of this improvement reflected in the risk of developing dementia.”

Dementia, characterized by impaired memory and other mental functions is a devastating illness with a high personal and societal cost. The initial signs of dementia, which is caused by diseases of the brain, may include short-term memory loss that affects every day life, problems with thinking or reasoning, or unexplained anxiety, anger or depression. According to the Monetary Cost of Dementia in the United States report, the yearly monetary cost per person that was attributable to dementia could be as high as $56,290.

In the UK alone, the Alzheimer’s Society estimates that 800,000 people in the UK have a form of dementia and more than half have Alzheimer’s disease. The figure is estimated to rise to a million by 2021 due to an increase in survival rates of dementia sufferers and an ever increasing ageing population.

“The reduction of dementia risk is a positive phenomenon, but it is important to remember that the number of people with dementia will continue to rise along with the increase in life expectancy and absolute numbers of people over age 75”, says Laura Fratiglioni, professor and director of the Ageing Research Center. “This means that the societal burden of dementia and the need for medical and social services will continue to increase. Today there’s no way to cure patients who have dementia. Instead we must continue to improve health care and prevention in this area.”

The study was funded by the Swedish Council for Working Life and Social Research (FAS ), the Swedish Ministry of Health and Social Affairs, the Swedish Research Council, and Swedish Brain Power.

Notes – 

Publication:Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden’, Chengxuan Qiu, Eva von Strauss, Lars Bäckman, Bengt Winblad, Laura Fratiglioni, published in the April 17, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology, doi: 10.1212/WNL.0b013e318292a2f9.

Source(s):
Monetary Cost of Dementia  http://www.nejm.org/doi/full/10.1056/NEJMsa1204629

Image: RGB freestock