Do toddlers need cake as well as carrots?

A new survey shows some nurseries are giving children too much in the way of fruit and vegetables, and not enough starchy carbohydrates to meet their energy needs. Have healthy eating messages left us in a state of confusion about what children should be consuming? This latest study carried out by the local government regulatory body Lacors focused on children in nursery schools across 29 English councils. While finding that some children were being given portions that were too large and too high in salt, others were simply not being offered enough at all.

The report highlighted the pressure parents, who are themselves constantly warned of the perils of childhood obesity, place on nursery staff to offer low calorie fare. It is a growing problem, according to the National Day Nurseries Association. "Parents are aware of the importance of ensuring their child eats healthily to avoid obesity and health problems in later life, but this can sometimes lead to parents making requests that their child follows a strict diet, such as skimmed milk and low-fat foods," says its chief executive Purnima Tanuku.

"Children under five have specific needs, and should not have low-fat diets as their growing bodies need fat and carbohydrates." Indeed the low-calorie, high-fibre diets which many adults have been encouraged to embrace are simply not suitable for the under fives.

No skimming

Growing rapidly, this age-group needs a diet which is - proportional to their size - much higher in calories than that of an adult. Studies have shown that children burn fat much faster than adults - and so skimmed milk and other low-fat dairy products should remain off the menu until they are much older. "And parents really shouldn't feel too anxious about puddings - sponge and custard is a good dessert to offer, surprising as that may sound," says Jessica Williams, a paediatric dietician. "This is a much better option than a handful of biscuits between meals.

"There have also been problems with the messages about red meat. It's a shame some parents feel so worried about it as it really is the best source of iron, and iron deficiency anaemia among toddlers in particular is common." Wholegrains and high-fibre dishes are fine in moderation but may fill a child up without providing the calories they need. Seen by some as a nutritional wasteland, easily-digestible white bread is not necessarily a bad option for children, particularly if they have eaten a wholegrain cereal for breakfast.

"And while the five-a-day message must certainly still be there, a child's portion does need to be smaller so they have room for the other, more substantial items on their plates. They simply won't get the calories they need from fruit and vegetables, even in large quantities."

Needing attention

There are in fact concerns that the plight of the underweight child has been forgotten amid the intense focus on childhood obesity. Studies have shown that being persistently underweight as a child can cause problems over a lifetime, from cognitive impairment to skeletal disorders. There have been calls for public health policy makers to consider both ends of the body mass spectrum when fixing priorities in child health.

©BBC Health News – Wednesday, 14th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8620231.stm

Alcohol 'only protects non-smokers against stroke'

Sensible drinking can substantially reduce your risk of a stroke, but only if you don't enjoy a cigarette at the same time, research suggests. A study of over 20,000 people in the UK found non-smokers who drank moderate amounts were nearly 40% less likely to have a stroke than non-drinkers. But once cigarettes were added, this protective effect vanished.

The findings are being presented at a meeting of the American Academy of Neurology in Toronto. The study, led by Cambridge University, looked at 22,254 people over 12 years. There were nearly 900 strokes. People who stayed within moderate drinking guidelines - one or two small glasses of wine a day for a woman and slightly more for a man - saw a 37% decrease in their risk of stroke.

But this was only true if they did not smoke, with smoking drinkers and smoking non-drinkers seeing similar levels of risk. "Our findings could have public health implications in that we appear to have a clearer understand of the dangers of combing smoking and moderate drinking on overall stroke risk," according to lead researcher Yangmei Li.

Smoking trouble

Large quantities of alcohol are known to increase the chance of a stroke by raising blood pressure, a key risk factor. But alcohol does thin the blood, so can prevent clots forming. It may also affect the way cholesterol is carried in the bloodstream, reducing the risk of the build-up of fatty deposits in the blood vessel walls. Smoking, however, causes the arteries to fur up, making the blood more likely to clot. This increases the risk of a stroke.

The study suggests that alcohol does not prevent this process that smoking kicks off. "The links between smoking and stroke are clear - 10% of stroke deaths and a quarter of all strokes are linked to smoking. So giving up smoking is a vital step in reducing your risk of stroke," says Joe Korner of The Stroke Association.

"It is also important to note that drinking moderate amounts of alcohol does not protect against haemorrhagic strokes - those caused by a bleed, and in some cases it may in fact increase the risk. And we know that drinking more than the recommended alcohol limit increases your risk of all types of stroke."

© BBC Health News – Tuesday, 13th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8617510.stm

'High GI' carbohydrates increase women's heart risk

 Women who eat diets heavy in certain carbohydrates may be at greater risk of coronary heart disease, according to researchers. A study of over 47,000 Italian adults found that women alone whose diets contained a lot of bread, pizza and rice doubled their heart disease risk. These foods have a high glycaemic index (GI), meaning they release energy and raise blood sugar quickly.
The findings are published in Archives of Internal Medicine. The experts say much more research is needed to understand why these high GI foods, rather than carbohydrates per se, appear to pose a risk - and why the risk applies to women and not men. Low GI carbohydrates, such as pasta, which release energy and raise blood sugar far slower, showed no such link with heart disease.

Glycaemic index

The doctors who produced the report studied 15,171 men and 32,578 women who completed dietary questionnaires over many years. This allowed the researchers to calculate overall carbohydrate intakes as well as the average glycaemic index of the foods eaten and the glycaemic loads of the diets. The glycaemic index (GI) is a measure of how much a food raises blood glucose levels compared with the same amount of glucose or white bread. The glycaemic load is calculated based on the glycaemic index of a given food and also on the total amount of carbohydrates it contains.

After seven years, 463 participants had developed coronary heart disease. The researchers found that the women whose diet had the highest glycaemic load had more than double the risk of heart disease compared with those women with the lowest glycaemic load. The authors concluded: "Thus, a high consumption of carbohydrates from high-glycaemic index foods, rather than the overall quantity of carbohydrates consumed, appears to influence the risk of developing coronary heart disease." The researchers believe that a high-glycaemic diet may dampen 'good' cholesterol levels in women more than in men. But further research is needed to verify the absence of a link between high-glucose foods and cardiovascular disease in men, says the study.

Victoria Taylor, senior heart health dietician at the The British Heart Foundation, said that for women, choosing lower GI foods could be useful in helping them to reduce their risk of coronary heart disease. She said: "They could try broadening the types of bread and cereals they eat to include granary, rye or oat; including more beans, pulses; and accompanying meals with a good helping of fruit and vegetables."

© BBC Health News – Monday, 12th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8615537.stm

Diets may determine dementia risk

The foods we choose to eat may determine our risk of dementia, mounting evidence suggests. Latest work in Archives of Neurology shows sticking to a diet rich in nuts, fish and vegetables significantly cuts the chance of developing Alzheimer's. A "Mediterranean diet" containing plenty of fresh produce and less high-fat dairy and red meat has long been thought to improve general health. Experts believe it is a combination of nutrients in foods that is important. But they stressed that diet was not the sole cause or solution where dementia is concerned.

Good combinations

Dr Yian Gu and colleagues at Columbia University Medical Centre in the US studied the diets of 2,148 retirement-age adults living in New York. Over the four years of the study, 253 of these older adults developed Alzheimer's disease. When the researchers scrutinised the diets of all of the individuals in the study, a pattern emerged. Adults whose diets included more salad dressing, nuts, fish, poultry, fruits and green leafy vegetables, and less high-fat dairy, red meat and butter, were far less likely to develop dementia.

But it is the varying levels of specific nutrients that these food combinations offer that is important, say the researchers. Diets rich in omega 3 and 6 fatty acids, vitamin E and folate but low in saturated fat and vitamin B12 appear to be best. Experts have long suspected that nutrients might modify dementia risk. Folate reduces circulating levels of the blood amino acid homocysteine which has been linked to Alzheimer's. Similarly, vitamin E might be protective via its strong antioxidant effect, while monosaturated and saturated fatty acids could increase dementia risk by encouraging blood clot formation, say the researchers.

Rebecca Wood, chief executive of the Alzheimer's Research Trust, said: "Understanding the connection between diet and dementia risk may help prevent the development of diseases like Alzheimer's for some people. Adapting our lifestyles as we get older - by exercising regularly, watching what we eat and maintaining an active social life - can reduce dementia risk. Unfortunately, no diet or lifestyle factor can eliminate dementia risk entirely." With 35 million people worldwide living with dementia, she said it
was important to focus efforts on research to develop new treatments.

© BBC Health News – Monday, 12th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8615456.stm

Maternal deaths 'fall worldwide'

Maternal deaths have fallen worldwide, from about half a million a year in 1980 to less than 350,000 in 2008, according to new data. Countries such as China are making significant progress but there have been surprising increases in others, including the US, say researchers. UK deaths are very low, but have not fallen in the past 20 years, the study, published in the Lancet, found. Making childbirth safe for all women has long been an international goal, but progress in some countries has been slow. In the latest study, a team led by the University of Washington in Seattle, looked at data from thousands of observations of maternal deaths for 181 countries between 1980 and 2008. They estimated there were 342,900 maternal deaths worldwide in 2008, down from 526,300 in 1980.

More than half of all maternal deaths were in only six countries in 2008 - India, Pakistan, Nigeria, Afghanistan, Ethiopia, and the Democratic Republic of the Congo. But some countries - including China, Egypt, Ecuador and Bolivia - had made significant progress towards achieving international goals on maternal mortality.
Lead author Dr Christopher Murray said: "There are still too many mothers dying worldwide, but now we have a greater reason for optimism than has generally been perceived." He said finding out why a country such as Egypt has had "such enormous success in driving down the number of women dying from pregnancy-related causes could enable us to export that success to countries that have been lagging behind".

Mixed progress

The picture in high-income countries is less clear. One of the most surprising findings was an increase in the number of expectant mothers dying in the US, from 12 in every 100,000 live births in 1990, to 17 in 2008. The authors say the trend can be explained in part by changes in the way maternal deaths are recorded in the US.
In the UK, maternal mortality rates fell between 1980 and 1990, and then levelled off - which reflects the trend in most western European countries. The rate per 100,000 live births in the UK is eight, with Germany and Spain at seven, and France at 10.

Commenting on the statistics, Cathy Warwick, General Secretary of the Royal College of Midwives, said it was clear that around the world needless deaths can be avoided. But she expressed concern that the UK rate - although very low - is not falling. She added: "It is possible that this is due to increasing levels of ill health amongst pregnant women and possibly to greater numbers of older women giving birth."

Lancet editor Dr Richard Horton said there was a dramatic difference between the latest estimates and those last reported by the UN. He added: "Two decades of concerted campaigning by those dedicated to maternal health is working. "Even greater investment in that work is likely to deliver even greater benefits. Women have long delivered for society, and, slowly, society is at last delivering for women. This is a moment to celebrate - and accelerate."

© BBC Health News – Monday, 12th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8616250.stm

Internet child health advice 'wrong'

 
Typing your child's medical problem into Google is unlikely to deliver much in the way of good advice, UK researchers have said. The Nottingham-based team used the search engine to find UK-based advice on five common issues, including breastfeeding and autism. Only about 200 of 500 sites offered correct information, Archives of Disease in Childhood reports. Government-run sites were the only completely reliable source, they found.

It is now estimated that 70% of UK households have access to the internet, and increasingly, parents are turning to search engines for a second opinion - or even a sole one - on medical matters. Many doctors, however, are concerned that the huge quantity of information and advice is at best unreliable, and in some cases misleading or even dangerous.

One earlier study looking at advice for children with a fever found only three out of 22 sites visited gave information which matched current "best practice" guidelines. The researchers from Nottingham University Hospitals NHS Trust tested this by typing key words from commonly-asked questions into Google, restricting results to UK-based sites only.

The five chosen were "MMR autism", "HIV breastfeeding", "mastitis breastfeeding", "baby sleeping position" and "green vomit." They found the quality of advice varied significantly, with half the search results failing to answer the intended question. In total, 11% of the 500 results gave inaccurate information, and 39% gave the right answer.
The most incorrect replies were given to search results about MMR and autism, and HIV and breastfeeding. News websites were accurate 55% of the time.

Vaccine sales

Particularly poor at answering the question were "sponsored links" which appeared prominently, even though the information they contained was not closely related to the search terms. In the case of the "MMR/autism" search, many of the sponsored links offered single vaccination as an alternative to MMR. However, the accuracy of governmental websites such as NHS Direct or NHS Choices meant that they should be recommended more widely by doctors, the researchers said.

"Healthcare professionals should continue to strive to be the main source of information for patients but we should be aware that most will continue to use the internet to gather information," they wrote in the journal. "We suggest that in addition to verbal and written information, patients and parents should be signposted to NHS, governmental or other pre-approved websites."

A spokesman for the Department of Health said NHS Choices was now the most popular health website in the UK, receiving nearly nine million hits a month. He said: "It offers a range of health information on over 800 treatments and conditions, waiting times and survival rates for elective procedures. Patients using the site are also able to post feedback on hospitals and GP surgeries."

© BBC Health News – Monday, 12th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8611045.stm

First aid 'could save thousands' - St John Ambulance

A wider knowledge of simple first aid techniques could save thousands of lives each year, the St John Ambulance charity has said. It is focusing a new campaign on five health emergencies which account for 150,000 deaths each year in England and Wales. These include heart attacks, choking and severe bleeding. The charity is offering a free pocket guide which it feels will boost the survival chances of many more patients. It believes that if confident first aiders were present on more occasions, many lives would be saved. This view is backed by the World Health Organisation, which also says "bystander first aid" can make a difference and should be encouraged.

The charity's own poll suggests that most people would still not feel confident attempting first aid techniques, while a quarter would do nothing and wait for other people or paramedics to arrive. Its chief executive Sue Killen said: "We believe that anyone who needs first aid should receive it. Our latest research shows that's just not happening. We can't rely on other people to have the skills - everyone should take the responsibility to learn first aid themselves. Around 2,500 people die each year from a blocked airway, but if someone had known the recovery position, lives could have been saved."

Crash tragedy

Beth Chesney-Evans' son died in 2008 following a motorcycle accident near his Oxfordshire home. She said she didn't know if he could have survived, even with first aid, but that it might have given him a chance. "He had no injuries at all but died because his heart apparently stopped and he couldn't breathe - and those are conditions that first aid is designed to deal with until the ambulance arrives."

Fotini Rozakeas, a cardiac nurse at the British Heart Foundation, said: "In life threatening situations it's vital that we all know what to do before professional help arrives as it's bystanders, often a relative, who are first on the scene. "Every year around 140,000 people have a heart attack and around one in three die before reaching hospital. Calling 999 promptly and knowing what to do in those crucial minutes can make a big difference to a person's chance of survival."

The booklet is available free of charge from the St John Ambulance website, or by texting LIFE to 85010, contains simple instructions on treating patients with heart symptoms, bleeding, choking, or who are unconscious, either breathing or not breathing.

© BBC Health News – Monday, 12th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8612194.stm

Sick Note replaced by Fit Note this April

As of 6th April 2010 'Fit Notes' are replacing Sick Notes. The government want to reduce the number of people claiming long term health related benefits. Lord McKenzie, minister for the Department for Work and Pensions, said: "The fit note will reduce the cost employers often have to bear when people are off sick for a long time. With the right support in place, employers and doctors can work with employees to help them get back to work sooner."

However, the British Medical Association (BMA) has warned that more needs to be done to help SMEs understand their responsibilities. Dr Laurence Buckman, chair of the BMA's GPs' committee, told the BBC: "It will be down to the employer to be flexible enough to accommodate [the needs of the worker]. We think much more needs to be done to ensure employers, in particular local line managers, have enough information about the changes."

Dani Novick, managing director of Mercury Search and Selection, added that there was a risk that the new fit notes would be largely ignored due to a lack of understanding. "There is a risk that everyone from GPs to individuals to employers will simply carry on as they were and ignore the intention here," she said. "But this is a great opportunity to change the mindset from the assumption that someone will be away from work until they are completely recovered to one where the expectation is that they will get back to work as soon as possible."

© Copyright Case Management Society UK - Thursday, 15th April 2010

Scientists hail 'revolutionary' kidney gene find

The identification of 20 genes which could help explain the causes of kidney disease could one day "revolutionise" treatment, researchers say. Chronic Kidney Disease affects about one in 10 adults and can require dialysis or even an organ transplant. The genes identified by the international team of researchers control kidney functions such as filtering waste from the blood.

Experts said the Nature Genetics study was "a great breakthrough."

Chronic kidney disease (CKD) is a long-term condition in which the kidneys progressively lose their function. People tend not to notice symptoms, which can include swollen ankles and hands or blood in the urine, until the condition is advanced. It is linked to ageing - about one in five men and one in four women aged between 65 and 74 will have some degree of CKD. The most common cause of CKD is damage caused by other long-term conditions, such as diabetes and high blood pressure. It was known there was a genetic component to the disease, but not which genes were involved.

'First step'

In this study, an international team of scientists, including researchers at the University of Edinburgh, looked at the genes of nearly 70,000 people across Europe. They found 13 new genes that influence renal function and seven others that affect the production and secretion of creatinine - a chemical waste molecule that is generated from muscle metabolism and filtered through the kidneys.

Dr Jim Wilson, a geneticist at the University of Edinburgh who worked on the study, said: "This work could revolutionise the treatment of kidney disease in the future - but this will take some time. It's a very critical first step towards a completely new understanding of the biology behind CKD. Transferring what we've found into clinical benefits will take some years."

Charles Kernahan, chief executive of the charity Kidney Research UK, said "These are still early days but it is truly a great breakthrough. No-one knows who will be affected or when kidney disease may strike next, so even more research needs to be funded to help us tackle this challenge."

Copyright BBC Health News – Monday. 12th April 2010

Source: http://news.bbc.co.uk/1/hi/health/8611312.stm

NHS 'organ donor error' review to take place

There will be an independent review after the NHS transplant authority confirmed 21 cases in which the wrong organs may have been taken from donors. As many as 800,000 people on the UK donor register may have had their preferences about which organs they wished to donate recorded incorrectly. Potential donations from these people have been temporarily put on hold.

Burnham 'regret' over donor error.

Health Secretary Andy Burnham said he regretted the error but it should not stop people from donating. The British Medical Association warned public confidence could be damaged. NHS Blood and Transplant apologised and said only people in Scotland, England and Wales who had registered as donors using their driving licence application form were potentially affected. Mr Burnham said a system had been put into place to prevent the error from happening again.

While many of the 17 million registered donors give consent for all their organs to be used for transplant after their death, some have withheld consent for certain organs - such as their eyes. For the last 10 years however, the details of some donors' preferences have been wrongly recorded because of a technical error. The blunder only came to light in 2009 when NHS Blood and Transplant started to write to donors to check their organ donor preferences.

Many donors wrote back to say the information was incorrect.

Stephen Banks, from Worcestershire, wrote to the BBC: "I renewed my driving licence in March this year and ticked the options to donate all my organs apart from eyes. However I then got a letter from the NHS which said I had donated all my organs including my eyes." "I feel a bit embarrassed to call up and say, 'I want my eyes back.'"

A spokesman for NHS Blood and Transplant said Mr Banks should not worry about contacting the authority to verify his records and they would welcome his call. Mr Burnham said a review led by Professor Sir Gordon Duff, of Sheffield University, would be commissioned to find out how the data was wrongly recorded. The health secretary said:

"We do need to get to the bottom of this. It would appear to relate to a technical error going back to 1999 and this was how data was transferred between the DVLA (Driving and Vehicle Licensing Authority) and the blood and transplant service. That has now been corrected," he said. Donor applications originating from the DVLA were suspended in early March.
In a statement, NHS Blood and Transplant said: "We assure everyone currently on the organ donor register that the affected records will not be used in discussions with their family about organ donation. They will only be used once they have been corrected in accordance with the donors' wishes."

The body has already corrected 400,000 flawed records and said steps would be taken to contact all those who were possibly affected to confirm the details held about them.

Copyright BBC Health News – Sunday 11th April 2010

Source - http://news.bbc.co.uk/1/hi/uk/8613909.stm