‘Give HIV the Finger’

HIV is a virus that attacks the immune system, the body’s defence against infectious organisms and other invaders. If HIV is left untreated, a person’s immune system will get progressively weaker until it can no longer fight off life-threatening infections and diseases. However, the rate at which HIV progresses varies depending on age, general health and background. Testing regularly for HIV means you can get antiretroviral treatment if you need it and stay healthy.

The ‘give HIV the finger’ pun refers to the free postal finger-prick test that people can receive for testing without attending a clinic.

 

HIV in the United Kingdom

The United Kingdom (UK) has a relatively small HIV epidemic, with an estimated 101,200 people living with HIV in 2015. Just over 5,000 people were diagnosed with HIV in 2016, according to the data from Public Health England. This is an 18% decline from 2015.

The epidemic is largely concentrated among certain key populations, including men who have sex with men and black African populations. 54% of diagnoses were among gay and bisexual men; 19% and 22% among heterosexual men and women, respectively.

Late diagnosis is an important predictor of morbidity and premature death in people with HIV. In 2016, 42% diagnoses were made at a late stage of infection when treatment is less effective.

 

Current Screening Tests

HIV postal test kits allow people to take a finger-prick blood sample themselves. The samples are sent to a local laboratory for HIV testing. The test is highly accurate and can detect HIV within four weeks after infection.

These tests give a result of ‘reactive’ (positive) or ‘non-reactive’ (negative); reactive results are further classified into ‘high’ and ‘low’ reactive tests. A highly reactive result is suggestive of a HIV infection.

Patients providing a specimen reactive in the screening assay, but not confirmed to be consistent with HIV infection, should be retested using a fresh blood specimen collected at least two weeks later.

Ideally, a HIV antibody test should be performed on venous blood. Most laboratories in the UK use ‘fourth generation’ HIV screening tests. They detect anti-HIV (nearly all can detect the three main Ig classes: IgM, IgG and IgA) and p24 antigen. All patients whose first specimen indicates evidence of HIV infection must have their HIV status confirmed by tests on a second sample collected at another time.

HIV home sampling could potentially improve our ability to identify cases of HIV by targeting people at risk who do not use traditional testing venues such as sexual health clinics. The results data collected between 2015 and 2016 showed that 1.1% of tests submitted via the national postal testing scheme were ‘reactive’ and 0.7% were ‘high reactive’, compared to just 0.3% of tests finding HIV positive results from specialist sexual health clinics.

 

What is the difference between HIV and AIDS?

The definition of AIDS (acquired immune deficiency syndrome) is based on a potentially life-threatening infection or cancer seen in the immunosuppressed. Patients who have been diagnosed with AIDS have a greater risk of opportunistic infections. The most common AIDS-defining illnesses include:

  1. Tuberculosis
  2. Recurrent bacterial pneumonia
  3. Pneumocystis jiroveci pneumonia
  4. Kaposi’s sarcoma
  5. Lymphoma
  6. Cerebral toxoplasmosis
  7. Cryptococcal meningitis
  8. Intestinal cryptosporidiosis

Patients diagnosed late during HIV infection are at an increased risk of developing AIDS and are more likely to transmit HIV to others. This is one of the key challenges facing the UK, despite rates of late diagnosis being on the decline. In 2017, 428 people died from AIDS-related illnesses due to being diagnosed late. Nevertheless, the number of people diagnosed with AIDS-defining illnesses is declining and fell by 25% from 2015 to 2016.

 

Counselling

Patients identified as being at high-risk for HIV or those with concerns should be offered more in-depth discussion or counselling, in addition to a test. A brief pre-test discussion, explaining that routine HIV testing is recommended, is appropriate, with the aim of obtaining informed verbal consent.

 

Other methods to increase the uptake of testing

The Department of Health recommendation is that patients who come from countries where prevalence of HIV infection is high (>0.5%), all adults presenting to the emergency department in the UK should be tested (with consent). Also, all new patients registering at a GP should be tested. Testing in other outpatient departments, e.g. colposcopy and dermatology should also be carried out.

All patients attending sexual health clinics should be offered a HIV test on an ‘opt-out’ basis, and an information leaflet should be used to increase uptake of HIV antibody testing.

 

The future

Not too long ago, a diagnosis of HIV and AIDS was considered to be a death sentence. This has fortunately changed over the past decade, owing to significant progress made in the provision of antiretroviral treatment and gradual upliftment of the stigma that is attached to the condition.

Progress is still to be made, however, as late diagnosis rates continue to be high. People living with an undiagnosed infection have worse health outcomes and pose a public health risk as they are more likely to pass the virus on to others. Homosexual men and black Africans are still at a heightened risk of HIV. Further, the younger generation has lost some fear of HIV because of the success of treatment, causing them to engage in risky behaviours. These issues can be rectified by narrowing the gaps in HIV prevention and education schemes.

If you have any concerns or questions, you can get help from sexual health clinics, charities, or your GP.

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obesity, gogodoc

Is Obesity A Disease Or A Choice?

Obesity is a very important public health problem. The rates are now very high, with over 25% of the UK population and 33% of the US population classified as obese.

Obesity itself results in significant reductions in quality of life but it also leads to a range of serious health issues, such as type 2 diabetes, cardiovascular diseases and cancer.

Changes in diet and exercise seem to be the most sensible first-line solution, however health education programs have failed to halt the rising numbers of obese people. This suggests that intrinsic factors, such as genetics, might be important.

This raises an important question: Is obesity a disease or a choice?

 

Recent poll

A recent poll on Medscape revealed some interesting opinions about obesity among healthcare providers. One of the questions asked was ‘How often do you think lifestyle choices are the underlying cause?’ 75% of medical professionals chose either ‘often’ or ‘always’.

When asked what interventions they typically recommend for their obese patients, over 90% selected ‘diet and exercise’. Further, more than 30% of healthcare providers do not consider obesity to be a disease state. However, if obesity is viewed as a disease it may aid toward objectively assessing the factors that lead to it, thus offering better prevention and treatment strategies.

 

What makes obesity a disease?

Obesity is a complex entity that can have many causes. The first, most obvious, argument for why obesity is a disease is that it is associated with impaired body function. It causes, exacerbates, or accelerates more than 160 co-morbid conditions that arise as metabolic, structural, inflammatory, degenerative, neoplastic, or psychological complications. Further, it can significantly affect quality of life or impair longevity.

Taking this into account may prove effective in dealing with its biopsychosocial and economic ramifications.

 

Common assumptions about obesity

It is a common assumption among both healthcare providers and the general public that obesity is a self-inflicted condition. In other words, obesity is thought to be the result of a lack of self-discipline due to addiction to excess or unhealthy foods, and thus these patients are largely responsible for this condition. If patients are not losing weight with diet and exercise, it is because they are not trying hard enough or are cheating on their lifestyle modifications.

Another assumption is that obesity started only in the past 50 or so years. Although the incidence has increased significantly in the recent past, it is in fact a centuries-old condition.

Lifestyle modifications have an increasingly robust representation in evidence-based medicine. However, given the complex and multifactorial nature of obesity, management can fail despite earnest efforts by patients and is often successfully augmented by the addition of pharmacotherapy or surgery.

 

Treatment must be individualised

It is important to realise that for many patients, obesity is multifactorial. There is a wide heterogeneity in the causes and manifestation of obesity, which leads to wide interpatient variability in the response to different therapeutic strategies. It is for this reason that management of obesity needs to be individualised for each patient.

It is therefore important to accept that obesity is not merely a condition arising from ‘food addiction’. In fact, more than 100 aetiologies of obesity have been identified, and we’ve merely scratched the surface at recognising the causal factors.

 

 

Conclusion

The question of obesity being a disease or choice is like the false dichotomy of nature vs nurture. There is no simple either/or answer to this question. It is much more likely to be a combination of both factors.

Obesity involves a complex interplay of underlying medical conditions, such as genetic or endocrine factors, in addition to environmental influencers. Environment plays an important role. Factors such as eating schedules, physical activity, sleep health and medications, can affect weight management.

 

The ultimate consequence is failure of the homeostasis of weight and energy regulatory mechanisms, leading to an elevated body fat set-point.

Only when we recognise that obesity is a disease can we take the next steps of screening, diagnosing, assessing, preventing, and treating this condition.

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skin

Eat Back The Years With These 10 Youth-Boosting Foods

 

Want firmer, smoother skin and a brighter complexion? Try these top 10 anti-aging foods. Our diets have a huge effect on the rate at which we age, so it makes sense to keep them as varied, and antioxidant-rich as possible to prolong and preserve our youth. Team these foods with regular exercise, plenty of sleep and quality downtime, and you could turn back the clock.

eggs

1) Eggs

Eggs contain a compound called sphingolipids that aids in autophagy. Think of a brick wall. Sphingolipids are like mortar, the sticky substance that holds the bricks together. As the wall ages, the mortar can break down, causing the bricks to crumble and the entire structure to lose its strength. But you can keep your mortar strong by eating sphingolipid-rich foods. Doing so will benefit your skin, keeping it fuller, plumper, and smoother.

Sphingolipids also help regulate neurotransmitters, important in healthy brain function. Read better moods, better decision-making, increased critical thinking, and improved memory.

blue berries

2) Blueberries

Blueberries are rich in flavonoids such as myricetin, quercetin, and kaempferol. These are rich sources of vitamins C and K and other nutrients that have an anti-ageing effect and prevent cell damage. 

avocado

3) Avocado

Avocado is one of the anti-ageing superfoods with immense health benefits. It is rich in potassium, vitamins A, C, E, and K, and antioxidants that fight the effects of ageing. Moreover, it’s good for your overall health.

 tomato

4) Tomatoes

Tomatoes contain lycopene. This is a non-provitamin A carotenoid that protects your skin from sun damage. Moreover, the skin of the tomato has an anti-inflammatory effect on the human skin, and the flavonoids in the fruit slow down ageing.

spinach

5) Spinach

Popeye cartoons were exaggerating, but not by much! Spinach is a great source of beta-carotene, which protects your skin from sun damage, and lutein, which has been shown to help skin maintain its elasticity.

green tea

6) Green Tea

There are many kinds of green tea, but they all contain polyphenols, which get rid of free radical toxins in your body, and catechins, molecules that help prevent the sun from damaging your skin. So, drink up! Green tea should be in every anti-ageing diet.

tumeric

7) Turmeric

It’s almost impossible to believe the number of anti-ageing benefits turmeric provides. It’s great for your skin, joints, and brain, and it fights inflammation. It may also reduce the risk of neurodegenerative disorders and some cancers.

garlic

8) Garlic

Add it to your stir-fry, and you just might boost your heart health. Garlic is said to prevent heart disease and strokes by slowing the hardening of the arteries. The herb may also help fight inflammation and cartilage damage associated with arthritis.

nuts

9) Mixed Nuts

In one study, regular nut intake was connected with a lower risk of dying from cancer, heart disease, and respiratory disease. Make a to-go mix of peanuts, almonds, pistachios and walnuts for an easy way to avoid hanger. 

salmon

10) salmon

Salmon and other oily fish, such as sardines, trout and mackerel, are packed with anti-inflammatory omega-3 fatty acids. These essential fats are vital for healthy cell membranes and for keeping your skin looking smooth and soft, as well as maintaining healthy, flexible joints and cognitive function. Since inflammation in the body is linked to the development of chronic diseases, such as heart disease, cancers and diabetes, omega-3 fats are a vital anti-ageing nutrient.

By Punam Vadgama

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activated-charcoal-black-bread

Activated Charcoal: The New Black, Or Just Another Quack?

activated-charcoal-black-bread

I walked into a trendy hipster café the other day – the kind where dishevelled man buns are the norm and the furniture is uncomfortable. I saw a black croissant on the counter. I was impressed with the barista’s confidence that he could flog it off as edible. To add to the ridiculous selection, there was charcoal-containing fruit juice being sold as a ‘shot’. Elsewhere, I opened a pizza menu and saw an option for a charcoal crust. Some weeks later when meeting a friend for dinner, I found her sipping a pitch black mocktail made with charcoal. The next day my sister showed me a bottle of activated charcoal pills from Holland & Barrett and asked me, “does this work”?

 

Don’t be conned.

Let me begin by first saying that if you hear the word ‘detox’ in conjunction with having to take a pill or potion, you are most likely being conned.

We have all looked for a quick fix to wellness, something to cut the link between hard graft and gratification. Maintaining stamina, eating well and exercising can be difficult to balance in our busy lives. This is where pernicious charlatans seize the opportunity to sell you snake oil, tricking you with pseudoscience and the paralogism of celebrity endorsements.

When in doubt, ask for the evidence or do some research yourself. Don’t settle for an anecdote, such as ‘my friend took it and noticed a difference’. I’m talking about empirical evidence in academic journals. If that’s venturing in unknown territory for you, seek advice from your doctor.

 

What is activated charcoal, anyhow?activated-charcoal

It sounds like something you’d use to fire up the barbecue, but there’s a difference. Activated charcoal is made from carbon-containing material, like wood, coal and coconut shells, which is heated at high temperatures. The carbonised material is then exposed to oxidising atmospheres, a process called ‘activation’, which increases its overall surface area and adsorptive capacity.

Activated charcoal has long been used in emergency medicine for the treatment of drug overdose or poisoning. It is a gastrointestinal decontaminant that avidly adsorbs contents of the stomach. It is beneficial if administered to the patient within an hour of ingestion, or later if the ingestion involves an agent that delays gastric emptying or slows gut motility.

It’s not difficult to see why activated charcoal has been associated with detoxifying the body. If it’s used in emergency medicine to reduce toxic load, then it must be good for everyday use as well. However, this is false reasoning and a deep misinterpretation of its application.

 

Is it safe to eat activated charcoal?

Consuming activated charcoal may seem like an innocuous health fad, but it may be doing more harm than good.

The issue is that activated charcoal is not selective in its binding properties, meaning that some of the vitamins, minerals and antioxidants in your food will also be removed (along with the supposed ‘toxins’).

I mentioned the charcoal-containing fruit juice being sold as a shot. If you think about it, the absorption of the vitamins in the fruit would be impaired because of the charcoal. There is literally no good reason for it to be in the drink.

On a more serious note, activated charcoal can bind with some oral medications and impair their bioavailability. This is not mentioned on the bottles or packaging of activated charcoal products, despite it potentially having serious health consequences for some people.

There is also a prevalent belief that it will help cure a hangover by detoxifying the alcohol and kebab you had last night on the lash. But considering activated charcoal will bind with the contents of your stomach or intestines, it would be useless in this case because the alcohol and dodgy food would have already been absorbed into your bloodstream.

 

A bitter pill to swallow

The detox industry is vast and highly deceptive. The products don’t work, despite anecdotal claims to the contrary. You may want to dabble in it anyway for some harmless fun but consume with caution if you are on prescription medication. There is a possibility that it will make your medication less effective.

Here’s some food for thought: instead of implementing useless detox cycles, it is better to adopt a ‘clean’ eating plan – not as a temporary diet, but a lifestyle change. There is a lot of evidence to show that a whole-food, plant-based diet does wonders for our health. This entails eating plenty of fruits and vegetables, whole grains, plant proteins, and healthy fats such as olive oil.

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Healthy Heart

Routine Habits That Harm The Heart

Cardiovascular diseases are the leading cause of death worldwide. According to the World Health Organisation (WHO), an estimated 17.7 million people died from cardiovascular diseases in 2015, representing a third of all global deaths.

Most of us think that if we do not smoke, do not carry extra baggage around the waist, we’ll keep our heart in good health. In a way, we are right, since smoking is a major cause of heart disease (estimated to account for about 20% of all cardiovascular death), and obesity is linked to several factors that increase the risk of coronary artery disease and stroke.

However, there are many other habits that can damage the heart – habits that are so mundane, they are often overlooked. Some habits are plainly obvious, such as eating too much fat, sugar and salt, not exercising, and neglecting regular health check-ups.

It is worth reviewing your everyday habits and learning how you can reduce your risks to prevent heart disease.

 

 

Get more sleep

Get more sleep

A study showed that people who slept less than 6 hours each night were 79% more likely to develop coronary heart disease than those who slept up to 8 hours. Sleeping reduces blood pressure, and those who do not sleep enough are more likely to have hypertension. Experts also point out that the quality of sleep also matters. People who snore loudly are more likely to have sleep apnoea, a disorder in which breathing stops and starts repeatedly during sleep, and often without knowing it.

 

 

 

 

 

 

 

laugh more

Laugh more

When we are stressed, our body secretes adrenaline and cortisol. This increases the rate and force of cardiac contractions and narrows the arteries – a dangerous combination for heart health. In addition to stress, anger and depression can also negatively affect the cardiovascular system. The antidote? Laughter. Interestingly, laughing relaxes and enlarges the arteries, thus promoting cardiovascular health. There is truth in the old saying ‘laughter is the best medicine’ after all.

 

 

 

 

 

 

 

brush your teeth

Brush your teeth (please)

Research has shown that there is a link between gum disease and heart problems. There are two main types of gum disease: gingivitis, which causes red, painful, tender gums; and periodontitis, which leads to infected pockets of germy pus. Scientists believe that bacteria collected in the gums can cause inflammation in other parts of the body. Thus, poor oral hygiene can increase the likelihood of arteriosclerosis (stiffened arteries) and thrombosis (blood clot). So, brush your teeth at least twice a day and use a mouthwash. Your family and friends may even thank you for it.

 

 

 

 

 

 

take a break

Take a break from city life

It doesn’t require a stretch of the imagination to know that the pressing and fast living conditions in a big city can overwhelm your poor heart. But stress is not the only factor. In a study published in The Lancet, researchers looked at the long-term effects of air pollution on the heart’s arteries. Poor air quality leads to accelerated plaque build-up in arteries, leading to heart disease, stroke and high blood pressure. If living in a city is unavoidable, make sure to retreat into the countryside from time to time, even if it’s only for a day or two.

 

 

 

 

 

 

yoga

Exercise flexibility

Research in Japan involving more than 500 adults has shown that people who are flexible tend to have more flexible arteries and therefore better regulation of their blood pressure. Flexibility is one of the main components of physical fitness, including cardiovascular fitness, muscular strength and endurance.

So perhaps it is not a bad idea to include yoga or Pilates in your exercise routine. This will have the added benefit of preventing exercise-induced injuries, back pain, and balance problems.

 

 

 

 

 

 

exercise

Break a sweat

While many chemical elements are essential for life, some such as arsenic, cadmium, lead, and mercury have no known beneficial effect in humans. These elements are confirmed or probable carcinogens, and they exhibit wide-ranging toxic effects on many bodily systems, including the cardiovascular system.

All people have some level of toxic metals in their bodies, circulating and accumulating with acute and chronic lifetime exposures. Research shows that sweating with heat or exercise may help to eliminate these toxic substances.

 

 

 

 

 

 

 

sit less

Sit less, move more

It can be argued that chairs are detrimental to our health. Indeed, ‘sitting is the new smoking’. According to the WHO, 60 to 85 per cent of people globally lead sedentary lifestyles (i.e. remaining seated for much of the day), making it one of the more serious yet inadequately addressed public health problems of our time. A sedentary lifestyle, along with smoking and poor diet and nutrition, is increasingly being adopted as the norm, which is resulting in the rapid rise of cardiovascular diseases, diabetes, obesity and cancer. For every 30 minutes of sitting still, be sure to walk, stretch or jog on spot for 1 to 2 minutes.

 

 

 

 

raw meat

Eating meat

In a previous article, it was stated that the WHO have classified processed meats as a Class I carcinogen. It turns out that these meats, which include bacon, sausages and pepperoni, also increase the chance of having cardiovascular problems. Processed meats not only have a lot of salt, which elevates our blood pressure but large amounts of saturated fat, which contribute to chronic inflammatory diseases.

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migraine-man

Top Tip On Migraine Management

Migraines are common in both children and adults and are estimated to affect up to 10% of the population in the UK.

Migraines are characteristically described as headaches, but may not always start as a headache. Migraines can often be preceded by an aura, although not present in all who suffer from migraines. These auras can be visual or an altered sensation. These are then followed by headaches, which can often be one-sided. Other accompanying symptoms may include nausea, vomiting, light or sound sensitivities.

Migraines can have triggers; this can be in the form of food and drink, lack of sleep and stresses amongst other things.

Managing acute migraines can be difficult – some ways of managing migraines can be to ensure you are adequately hydrated, taking pain relief such as paracetamol or ibuprofen, and ensuring you are resting well. There are a few migraine-specific medications available over the counter such as sumatriptan.

 

Dr Thanusha Ananthakumar  “TOP TIP: For acute treatment of migraines you can try aspirin + anti-sickness tablet + sugary carbonated drink”

 

 

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Is There A Safe Limit For Alcohol?

NHS figures show alcohol-related problems are at a record high

Alcohol is a problem – there are no two ways about it. The number of people being admitted to hospital due to problems with alcohol has hit a record high in England, new NHS figures show. It has been suggested that the swingeing budget cuts to addiction and prevention services over the recent years are the culprit.

As revealed by The Independent in August last year, spending on drug and alcohol support services across England fell by 16 per cent in the four years to 2017. According to recent figures released by Public Health England, there has been a concurrent 13 per cent rise in alcohol-related hospital admissions over the same period.

Moreover, the number of people being admitted to hospital with drink-related brain damage in Scotland is the highest it has been in ten years, according to Scottish NHS figures.

Scotland has the worst record on alcohol-related illnesses and death in the UK with hundreds of people a week – an average of twenty-two a day – being treated in hospitals.

Last year there were 661 cases of brain damage caused by excessive alcohol consumption; a regular drinking habit can cause problems with memory, learning and thinking.

 

UK guidelines

The NHS recommends that men and women drink no more than 14 units of alcohol per week. The general rule of thumb is that a pint of standard strength beer is 2 units, a pint of cider or extra strength beer is 3 units, a single shot of spirit is 1 unit, and 125 ml of wine is 1 unit. However, home measures are usually more ‘generous’.

This simple rule does not apply to stronger beers and lagers, and many wines nowadays contain 12-14% alcohol by volume and are served in glasses holding 175 ml, rather than 125 ml. The unit content of a drink can be calculated easily by realising that the percentage of alcohol by volume of any drink equals the number of units in 1 L of that drink. For example, a half-litre (500 ml) can of strong lager (8% alcohol by volume) contains 4 units, and an eighth of a litre (125 ml) glass of wine (12% alcohol by volume) contains 1.5 units. However, few people know the strengths of what they drink and the Government is being urged to introduce mandatory, bold, unit labelling on all alcoholic drink containers.

Alcohol Concern UK and Drink Wise have a handy alcoholic unit calculator to help you calculate the number of units that you consume in a week:

https://www.alcoholconcern.org.uk/unit-calculator

 

The biology of booze

Alcohol is a small molecule and thus interacts with many neurotransmitter systems in the brain. This makes its mechanism of action very different from and much more complex than other drugs such as heroin and cannabis, which influence dedicated systems of the brain.

Alcohol affects both excitatory and inhibitory neurotransmitters, rendering it both a stimulant and depressant.

Its stimulant quality comes from the release of dopamine in the ventral striatum – the region in the brain involved in reward processing. The reward centre is affected by all pleasurable activity, including everything from meeting old friends, going on holiday, winning the lottery, and drinking alcohol.

This artificially-raised dopamine gives you a false sense of satisfaction, a kind of euphoria. This encourages you to keep on drinking to release more dopamine. But of course, all counterfeit happiness come at a price: for every high, there’s an equal and opposite low. The alcohol-induced euphoria is off-set by other neurotransmitters that simultaneously enhance the feelings of depression.

Alcohol acts as a depressant by binding to GABA receptors – the major inhibitory neurotransmitter receptors in the mammalian brain. It also suppresses the release of glutamate, which would normally increase brain activity and energy levels. This is partly why we get foggy thinking, slowed reaction times, and slurred speech when under the influence.

The pathophysiology of alcoholism has come into sharper focus over the past decade. It is now well-known that alcohol consumption can increase blood pressure, damage the immune system, overtax the liver, increase the risk of several cancers, and most insidiously, impair the brain.

 

Thresholds for safer alcohol use might need lowering

The consensus now is that the risks from alcohol start from any level of regular drinking. The purported benefits of alcohol are tenuous at best. Hence, the new Department of Health and Social Care guidelines state, ‘There is no justification for recommending drinking on health grounds – nor for starting drinking for health reasons’.

A recent large study published this year in The Lancet analysed individual-participant data for alcohol use in 599,912 current drinkers in 83 prospective studies in 19 countries. The researchers showed that people who drank more than 12.5 units (100g) of alcohol a week were likely to die sooner than those who drank less than this amount. The results applied equally to women and men.

Drinking more alcohol was linked to higher chances of all cardiovascular conditions except heart attacks, where it was linked to a decreased risk of 6%. However, greater risks from other causes of death outweighed any advantage that might bring.

Men who drank above the 14 units a week limit lost an average of 1.6 years. This is comparable to women who lost an average of 1.3 years.

The researchers concluded: ‘These data support adoption of lower limits of alcohol consumption that are recommended in most current guidelines’. It wouldn’t be surprising if the drinking levels recommended in this study are described as implausible and unfeasible by opponents of public health warnings on alcohol – most notably, the alcohol industry.

 

Conclusion

Things that are good in moderation can be dangerous in excess. But it is questionable that alcohol is even good in moderation. It is helpful to note that the guidelines are not purporting ‘safe’ drinking, but rather aimed at minimising the risk of illness. All alcohol consumption carries some risk.

We have all played psychological tricks to undermine conscience, self-restraint and deferred gratification. Drinking modest amounts of alcohol is fine, but let’s not fool ourselves into calling it ‘safe’.

Indeed, lower amounts are safer, and a recent study suggests minimising consumption to no more than 12.5 units per week. But our bodily cells perceive any amount of alcohol as poison – and we should too.

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sun benefits, healthcare, sun, heatwave, healing, healing benefits

Enjoying The Heatwave? Here Are 10 Healing Benefits Of Sunlight

Whereas exposure to excessive levels of sunlight is detrimental to our health, moderate exposure can boost our physical and mental state. The aim is to enjoy the sun sensibly, to make enough vitamin D, while not increasing the risk of skin cancer.

Vitamin D is made in the skin with the help of sunlight, which is useful because there is very little found in typical dietary sources. To prevent deficiency of vitamin D, it is recommended to have 2-3 sun exposures per week. Each exposure should last 20-30 minutes and be to bare skin.

The following are some of the health benefits that exposure to sunlight can bring.

 

Heatwave, sleep, hot,

 

1) Improves the quality of sleep

Waking up in sync with the sun’s natural light switches off melatonin, a hormone made in your pineal gland, associated with sleep onset. This is the reason why you feel alert during your waking hours and tired at bedtime – and discombobulated when you cross time zones after a long-haul flight. It is, therefore, a good idea to open the curtains in the morning and avoid artificial light once the sun goes down.

People with irregular sleeping schedules often have trouble sleeping or feel tired during waking hours. Several studies have shown that chronic disruption of circadian rhythms can lead to weight gain, slower thinking, and other physiological and behavioural changes – analogous to the changes observed in people who experience shift work or jet lag.

 

 

2) Reduces risk of some cancers

Prolonged sun exposure increases the risk of skin cancer, but vitamin D is also known to be protective against several cancers, including of the colon, kidney and breast. In a study conducted by the US National Cancer Institute, it was found that high levels of sunlight were significantly associated with reduced mortality from breast and colon cancer. Similar effects were seen in the bladder, womb, oesophagus and stomach cancer.

 

 

 

 

 

 

3) Improves mood

Sunlight triggers the release of serotonin, a neurotransmitter that helps to regulate mood. It’s no surprise that spending time outdoors improves mood and relieves stress. Lack of sunlight exposure in some people can even trigger a type of depression known as a seasonal affective disorder, which is treated with light therapy.

 

 

 

 

 

 

 

4) Lowers blood pressure

Rates of hypertension tend to be higher in the winter and in countries farther from the equator, and a 2014 study published in the Journal of Investigative Dermatology provides a possible explanation: Exposure to sunlight causes nitric oxide in the skin to be absorbed into the bloodstream, which can help widen blood vessels and lower the pressure inside them.

 

 

 

 

 

 

 

5) Improves pregnancy and fertility

Reduced vitamin D levels during pregnancy have been shown to be associated with complications such as gestational diabetes and preeclampsia. Babies are also more likely to be born underweight. Of course, it takes two to be infertile. Male fertility may also get a boost from sunshine. A 2008 Australian study found that one-third of 794 men visiting an infertility clinic had a vitamin D deficiency. When this was corrected with sunshine and supplementation, there was a 75% drop in ‘sperm fragmentation’ and the men were more successful at conceiving with their partners.

 

 

 

 

 

6) Can help with some skin disorders

Sunlight can improve several skin complaints, such as psoriasis, eczema and acne. Indeed, eczema and psoriasis are sometimes treated with UV light (phototherapy). However, sunlight can aggravate other skin conditions, particularly rosacea.

 

 

 

 

 

 

 

7) Enhances the immune system

In a 2016 study published in the journal Scientific Reports, researchers found that low levels of blue light and UVA light, found in sun rays, boosts the activity of T lymphocytes, a type of white blood cell that can fight infection.

 

 

 

 

 

 

 

8) Improves the musculoskeletal system

It is common knowledge that vitamin D is important for healthy bones by helping the body absorb calcium. In a 2013 large Danish study, researchers found that having a history of skin cancer was linked to a lower risk of hip fractures. This may be because those who developed skin cancer also had prolonged sun exposure.

Vitamin D is also important to muscle health, and people with low levels are more likely to experience muscle cramps and joint pain.

 

 

 

 

 

 

 

 

 

 

 

 

9) Improves memory

In a 2018 study published in the journal Cell, researchers exposed a group of mice to UVB rays. This mock-sunlight increased levels of glutamate, a neurotransmitter involved in learning and memory processes. The UVB-exposed mice showed significant improvement in the object recognition tests and motor skills compared to the control mice. Although this effect was shown in mice, it could also be the same for humans.

 

 

 

 

 

 

10) Helps you shed fat

By getting sufficient sunlight between 8am and noon will help synchronise your circadian rhythm, optimising the metabolism and preventing excess weight gain. Serotonin not only improves our mood, but it also suppresses our appetite. It’s no surprise if you prefer lighter meals during warmer weather.

 

 

 

 

 

 

 

One last thing

There are of course risks associated with sunlight. Prolonged exposure causes damage to the epidermis and to other parts of the skin such as the supporting elastic tissue in the dermis. This damage is known as actinic (solar) elastosis, and gives the skin a baggy, wrinkled appearance.

A significant risk factor for malignant melanoma is sunburn, especially during childhood. Chronic sun damage does not appear to be a risk factor for malignant melanoma but it is for basal cell and squamous carcinoma, and lentigo maligna melanoma.

To summarise, try to have 2-3 sun exposures per week, but avoid the sun when it is strong; and when you think you’re exceeding the recommended limit, cover up, or use high-factor sunscreen.

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Meat And Health: Assimilating The Facts

Still having dinner according to your grandmother’s advice of ‘meat and two veg’? How very 2017 of you.

 

 

 

 

 

 

 

 

According to Mintel’s Meat-Free Foods UK Market Report, more than one in four Britons are now favouring a vegetarian lifestyle.

Vegetarians have many reasons for not eating meat, including concern for animal welfare, health benefits, and reduced environmental damage. Here are some of the benefits of leaving meat off your plate.

 

Are humans meant to eat meat?

The dietary status of the human species is that of an ‘unspecialised frugivore’ – an animal specialised for nuts, grains, seeds, fruit and vegetables, but can handle ‘unspecialised’ food sources too. Biochemistry, comparative anatomy and genetics do not support the contention that human digestive tract is specialised for meat-eating. ‘But we have canines!’ is the all-too-common quickfire rhetoric.

 

Our pathetic, short and blunt canines may be useful to take a bite out of an apple. But try lunging for the throat of a cow and see if they are of any use then.

Due to limited resources our ancestors became habituated to eating meat, and through evolution our gut can handle it to some degree. But it is not the case that we are specialised for meat eating or need it in our diet to be healthy. In fact, the opposite is the case.

 

The WHO report

A wealth of research indicates that vegetarians have reduced incidences of diseases, and overall greater longevity. In support of this, the World Health Organisation (WHO) has classified processed meats as a Group 1 carcinogen. Tobacco smoking and asbestos are classified in the same category. As stated on their website, ‘this classification is based on sufficient evidence … that eating processed meat causes colorectal cancer’.

Moreover, red meat is classified as Group 2A, which means it’s ‘probably carcinogenic to humans’. My gut feeling is that it is only a matter of time that additional evidence will confirm this positive association.

Put it this way: if you had a choice between a meal that is proven to be protective against cancer (e.g. a wholefood, plant-based meal) and one that is ‘probably carcinogenic’ (e.g. a meal that contains red meat), which one would you choose?

Nevertheless, there are other health risks that are associated with meat eating such as coronary heart disease and diabetes, to which we now turn.

 

Backed up by research

In a study published in The American Journal of Clinical Nutrition, the authors state that ‘Vegetarians had a 32% lower risk of [ischaemic heart disease] than did nonvegetarians’. And a study published in Annals of Nutrition and Metabolism showed that vegetarians had an overall 18% lower cancer incidence. Moreover, the largest study to examine the effects of different sources of dietary protein found that a high intake of proteins from animal sources – particularly processed and unprocessed red meats – was associated with all-cause and cardiovascular mortality, whereas high plant protein intake had an inverse effect. The authors note that, ‘substitution of plant protein for animal protein … was associated with lower mortality, suggesting the importance of protein source’.

To be fair, a limitation of some epidemiological studies is that they do not consider the food source and the quality of the meat. However, in a study published by JAMA Internal Medicine, 73,308 participants were analysed and were controlled for important demographic, lifestyle and food confounders. They found that even a modest amount of red meat, regardless of the source, led to an increased rate of mortality. Whereas vegetarian dietary patterns were associated with reduced all-cause mortality and increased longevity.

In a study published in American Journal of Epidemiology, researchers found that a higher intake of red meat and poultry is associated with significantly increased risk of developing diabetes. Further, in a 2017 Sweden study, it was found that beef, pork and poultry are associated with colorectal cancer, which is considered one of the most common forms of cancer in the Western world. In fact, heart disease and cancer are the biggest killers on the planet, both of which have been directly linked to meat consumption.

 

Colossal damage

Aside from the health issues, rearing livestock for food is highly inefficient and wasteful. Every year over 56 billion animals are slaughtered by humans, not to mention sea creatures whose deaths are so great they are only tallied in tonnes. The crops fed to industrially-reared animals worldwide could feed an extra four billion people on the planet.

Let us not forget the devastating effect of the meat industry has on the environment. A staggering 51% of global greenhouse-gas emissions are caused by animal agriculture, according to a report published by the Worldwatch Institute. Grass fed, and ‘humanely slaughtered’ (an oxymoron) is even more unsustainable.

 

Conclusion

Humans have been facultative meat eaters for a long time, but recent research suggests that a diet with minimal meat is much more healthful. And we certainly do not need meat nutritionally in our day and age.

But the health benefits of keeping meat of the menu is only one side of the argument. For many, it is the ethical implications that make meat indigestible.

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London Taxi And Private Hire TPH/204

As part of your application to become a PCO licensed taxi or minicab driver, TfL requires you to undergo a medical examination by a Doctor to prove your fitness to drive. The Doctor will ask you questions about your health and review your Medical History. They will then complete a (TPH/204) medical declaration form which you will submit to TfL.

The cost of this medical examination is not covered under the NHS and you will be required to cover the cost yourself. We have a team of approved doctors who will be able to carry out your medical check for a total cost of £100. The eye test section within the form must be completed by an optician prior to the consultation separately.

You will need the bring the following to your appointment:

Download medical form here

Call us now or Download Gogodoc

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