The top 10 news stories of 2015

Wednesday December 30 2015

Last year it was Ebola, this year it's Calpol

10. E-cigarettes may make lungs vulnerable to infection

In February, there was concern that the vapour produced by e-cigarettes contains free radicals – atoms and molecules that are toxic to cells – and that this could damage people's lungs. Our conclusion: are e-cigarettes safer than normal cigarettes? Almost certainly. Are they 100% safe? Probably not.

9. Meningitis B vaccine 'available from September' 

There was good news in June, with the announcement that a new vaccine for meningitis B – a highly aggressive strain of bacterial meningitis – would be added to the NHS childhood vaccination schedule. This was the world's first publicly funded vaccination programme for the potentially fatal disease. 

8. UK life expectancy expected to rise to late 80s by 2030

In April, a new modelling study looking at trends in life expectancy estimated that male babies born in 2030 could live to an average of 85.7 years, with females living an average of 87.6 years. The research also highlighted the stark effect that economic inequalities can have on health – for example, it estimated that life expectancy in the affluent London borough of Kensington and Chelsea would be five to six years higher than the working class area of Tower Hamlets.  

7. Child obesity rates are 'stabilising' 

According to BBC News in January, the rise in childhood obesity "may be beginning to level off". While it was encouraging to see that the child obesity epidemic is not worsening, there were no clear signs that it's getting any better. Underlying factors, such as low activity levels and easy access to calorie-rich, nutrient-poor foods, still need to be addressed. 

6. Strenuous jogging 'as bad as doing no exercise' claim 

"Too much jogging 'as bad as no exercise at all'," BBC News reported in February. But the results of the Danish study this headline comes from were not as clear-cut as the media made out. One of the study's major limitations was that once the joggers were split into groups by duration, frequency and pace, some individual groups – particularly the most active groups – were much smaller. And, to be honest, people overexercising is not a pressing concern in the UK: the more common problem is people not doing enough.

5. Drinking 'plenty of red wine' won't help you lose weight

If it sounds too good to be true, then it probably is. And that was the case with The Daily Telegraph's headline from June: "How to lose weight – drink plenty of red wine". The headline was simply nonsense. The study it's based on did not involve red wine. And it was carried out on mice, not humans. Drinking "plenty of red wine" will not help you to lose weight – if anything, the opposite is true. A standard 750cl bottle of red wine contains around 570 calories, which is more than two McDonald's hamburgers. 

4. E-cigarettes '95% less harmful than smoking' says report 

"E-cigarettes are 95% less harmful than tobacco and could be prescribed on the NHS in future to help smokers quit," BBC News reported. This was the main finding of an evidence review carried out by Public Health England published in August. Once e-cigarettes are regulated as medical products – which is expected in 2016 – some brands could be made available on prescription.   

3. Is long-term paracetamol use not as safe as we thought?

A review of previous observational studies carried out in March found that long-term use of paracetamol was linked to an increased risk of adverse events such as heart attacks, gastrointestinal bleeds (bleeding inside the digestive system) and impaired kidney function. While the increase in risk was small, the fact the drug is used by millions means further investigation is required. 

2. Media dementia scare over hay fever and sleep drugs

Another drug scare from January saw claims being made that a class of over-the-counter drugs known as anticholinergics, which are used to treat allergies and muscle cramps, increased the risk of dementia. However, the risk only seemed to be associated with people taking these types of drugs daily on a long-term basis.  

1. Minor ailment scheme doesn't provide free Calpol for all

The most popular news story of the year, attracting more than 100,000 views, was triggered by a Facebook post that quickly went viral, where a mother claimed that all medicines are free under the minor ailments scheme. But, like a lot of Facebook content, it was complete nonsense: the NHS does not provide free Calpol to all parents. Liquid paracetamol (brands other than Calpol are available) may be given at the pharmacist's discretion to parents who have registered with the scheme.

Edited by NHS Choices. Follow NHS Choices on Twitter. Join the Healthy Evidence forum.

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HOW MUCH WEIGHT CAN I LOSE IN 2 MONTHS?

If you have too much weight that is causing health problems, affecting your self esteem and limiting your physical performance, perhaps it is time to shed those extra pounds.

Shedding weight can enhance your lifestyle, health and self esteem. Weight loss comprises of changes in lifestyle, physical activity and diet. By ensuring these changes are easy to maintain and are permanent, you can lose several pounds in two months and do away with the weight..Read more

Being happy 'won't help you live longer' survey finds

Friday December 11 2015

Should you turn that frown upside down?

"Happiness doesn't make you live longer, survey finds," reports The Guardian after a survey of more than 700,000 women found no evidence of a direct cause and effect link between happiness and life expectancy.

There has been speculation that happiness in itself – rather than factors that can stimulate happiness, such as good health – may prolong life.

This could possibly occur through some type of biological changes in immune or metabolic function, which could boost health. Stress and unhappiness could have a similar negative impact.

The women were asked to rate their health and happiness by questionnaire, and death from any cause was examined about 10 years later. Unsurprisingly, the researchers found poor health was linked to unhappiness.

After allowing for this and other associated factors, the researchers found (un)happiness does not appear to have any effect on risk of death.

A note of caution, however: the researchers used a large sample, but from a very specific population of middle-aged women in the UK. This means further research should be conducted in a wider sample of men and women from a range of countries to see if the findings are replicated.

Most people want to have a good quality of life as well as a long one. Read more about how to feel happier. 

Where did the story come from?

The study was carried out by researchers from the University of Oxford and the University of New South Wales, and was funded by the UK Medical Research Council and Cancer Research UK.

It was published in the peer-reviewed journal The Lancet on an open access basis, so it is free to read online or download as a PDF.

This study has been reported accurately in a number of media sources, with useful quotes from the study's researchers.

The Mail Online quotes a professional from University College London who said the research uses a very specific population, so we do not know how the findings will translate for other groups.

They go on to say there is a lot of evidence that had opposite findings, so we need to see these findings replicated before opinion is changed on the link.  

What kind of research was this?

This was a large population-based prospective cohort study of more than 1 million women (hence its name, "The Million Women study") in the UK aged 50 and over.

The cohort itself was drawn together by researchers who aimed to investigate the effect of various reproductive and lifestyle factors on women's health.

This particular study looked at whether self-rated happiness has a direct effect on mortality, after taking into account other health and lifestyle factors that may have had an influence on both wellbeing and mortality risk.

This type of study is good for assessing links between exposures and health outcomes. It can provide some evidence of a possible link (or lack of one), but it still cannot conclusively prove cause and effect.

What did the research involve?

The Million Women study invited women to join between 1996 and 2001. Recruitment took place at a number of breast cancer screening centres.

Women received a questionnaire along with their invitation for screening and were asked to return the completed questionnaire at the screening appointment.

The questionnaire contained questions on the following:

• medical history
• lifestyle
• reproductive factors
• oral contraceptive and hormone replacement therapy

Every three to five years after recruitment, women were sent a repeat questionnaire assessing the same information. 

To establish the women's level of happiness, three years after recruitment (baseline) they were asked, "How often do you feel happy?", with possible responses being "most of the time", "usually", "sometimes", or "rarely/never".

They were also asked how often they felt in control, relaxed and stressed. Women were also asked about their current health status, which they rated as "excellent", "good", "fair", or "poor".

Data from the questionnaire was used to investigate associations between happiness and deaths occurring up to January 2012.

When analysing data, mortality analyses excluded women with a history of illnesses such as heart disease, stroke, lung disease, or cancer, and analysed links for these conditions separately. The main reason for this was to reduce the risk of reverse causality, where people who are ill do not feel happy. 

What were the basic results?

At the start of the study, 845,440 women with an average (median) age of 59 years responded to the question about happiness. This found 39% were happy most of the time, 44% usually happy, and 17% unhappy (16% sometimes happy and 1% rarely or never happy).

Analyses on the link between happiness and risk of death was limited to the 719,671 women without cancer, heart disease, stroke, or chronic obstructive airways disease at baseline.

The strongest sociodemographic and lifestyle factors associated with being generally happy were:

• increasing age
• having fewer educational qualifications
• doing strenuous exercise
• not smoking
• living with a partner
• participating in religious and other group activities

The strongest associations with unhappiness were:

• treatment for depression or anxiety
• fair or poor general health

Women were followed for an average of 9.6 years after completing the baseline questionnaire. A total of 48,314 deaths were reported during this time.

When adjusted for the effect of age, women reported as unhappy had a 34% increased risk of death compared with happy women (rate ratios [RR] 1.36, 95% confidence interval [CI] 1.33 to 1.40).

The researchers then adjusted for the possible confounding effect of a number of other variables: self-rated health, treatment for high blood pressure, diabetes, asthma, arthritis, depression or anxiety, and several sociodemographic and lifestyle factors, including smoking, deprivation and body mass index.

They then found unhappiness was no longer associated with death from any causes (RR 0.98, 95% CI 0.94 to 1.01) or specific causes of heart disease (RR 0.97, 0.87 to 1.10) or cancer (RR 0.98, 0.93 to 1.02). Findings were similar for related measures such as stress or lack of control. 

How did the researchers interpret the results?

The researchers concluded: "In middle-aged women, poor health can cause unhappiness. After allowing for this association and adjusting for potential confounders, happiness and related measures of wellbeing do not appear to have any direct effect on mortality." 

Conclusion

This large prospective study aimed to assess whether happiness or related measures of wellbeing are associated with risk of death, after allowing for the influence of the poor health and lifestyles of people who are unhappy.

The study found poor health was linked with unhappiness in middle-aged women. However, after allowing for this association and adjusting for the influence of other factors that may be associated, such as smoking and poor socioeconomic status, happiness and related measures of wellbeing do not appear to have any direct effect on death.

This suggests that, as has sometimes previously been speculated, (un)happiness does not have a direct influence on mortality, but is being influenced by other associated factors. 

However, this study has both strengths and limitations. The strengths include the fact the study population is very large and the women included have been followed for a long period of time using electronic linkage to their NHS records.

The researchers did make an effort to limit the effects of potential confounders and reverse causality in their analyses, which strengthens their results. 

However, there are limitations: the study recruited only UK-based middle-aged women, so we do not know if the findings would be applicable to men or other populations.

The self-reported nature of the questionnaire may also introduce bias, particularly as happiness and wellbeing are subjective measures, so what could be a "similar" feeling may be rated completed differently by two different people, depending on their usual disposition.

Also, as the women were recruited through the National Breast Cancer Screening Programme, this will have excluded women who do not attend or may have different health, lifestyles and feelings from those who choose to attend screening.

The study findings are of undoubted interest to this debate, but because of its limitations, we should be cautious before dismissing the idea that stress and unhappiness may be linked to risk of death. Further research should be conducted in a wider sample of men and women from a range of countries.

While happiness in itself may not contribute to an increased lifespan, many of the factors that promote wellbeing and happiness do, such as good health, not smoking and connecting with others. Read more about how you can improve wellbeing in your life.

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HOW MUCH WEIGHT CAN I LOSE IN 2 MONTHS?

HOW MUCH WEIGHT CAN I LOSE IN 2 MONTHS?
If you have too much weight that is causing health problems, affecting your self esteem and limiting your physical performance, perhaps it is time to shed those extra pounds.

Shedding weight can enhance your lifestyle, health and self esteem. Weight loss comprises of changes in lifestyle, physical activity and diet. By ensuring these changes are easy to maintain and are permanent, you can lose several pounds in two months and do away with the weight...Read more

Can overweight men pass obesity risk to their children?

Friday December 4 2015

Children of overweight parents are more likely to be overweight

"Are you fat because of your dad?" is the Mail Online's bold question to its readers, explaining that "Men's weight directly affects genes in sperm linked to appetite and brain development".

This was based on a new study that found a man's weight influences the genes in his sperm.

This small study showed that DNA in the sperm of obese men differed from that of healthy weight men. The DNA itself wasn't changed, but modifications affecting how it's used by the body were.

These differences raised the possibility that children of overweight men could inherit genetic traits that make them more likely to be overweight themselves.

The researchers then looked at the sperm in six men before and after weight loss surgery, and found that the genes in their sperm changed considerably as they rapidly lost weight. This suggests that losing weight may be able to reverse the genetic changes associated with being overweight.

The results of this study are interesting, but should be treated with caution. The study only compared 13 healthy weight men with 10 overweight or obese men in the first part of the study, and just six men having weight loss surgery. These are very small numbers.

Similarly, we don't yet know whether the genetic changes identified in the overweight men will make their children more or less likely to be obese themselves, as this was not investigated in the study.

If the results of this research are confirmed in larger groups, the findings could lead to men, like women, being advised to eat healthily when trying to start a family.

Where did the story come from?

The study was carried out by researchers from Universities in Copenhagen and Sweden, and was funded by Novo Nordisk Foundation – Endocrinology Research.

The study was published in the peer-reviewed science journal Cell Metabolism, and is free to read online (PDF, 2.67Mb).

Generally, the media reported the study accurately, but most didn't emphasise the significant limitations, particularly the small number of men involved.

Some headlines also implied that the study had found children of overweight men are more likely to be overweight as a result of inherited genetic changes, but this study didn't look at whether these changes do actually affect the chances of a child becoming obese. More research is needed to explore this.

The Mail Online also reported that the genetic changes may explain "why autism is more common in those whose fathers are very fat", but that wasn't investigated directly in this study. Autism was briefly discussed in the scientific paper, but only in reference to other research.

This study didn't add anything new to any existing research on a potential link between obesity and autism.

What kind of research was this?

This was a small human study looking at whether the genetics of men's sperm differed, depending on their weight.

This study was exploratory and used just a small group of men. This is useful to investigate a new theory or generate ideas, but cannot provide reliable proof. Much larger studies are needed to confirm or refute the initial results.

What did the research involve?

Researchers compared inheritable genes in the sperm of 23 white men aged 20 to 40 – 13 who were a healthy weight (with a BMI of 20-25) and 10 who were overweight or obese (with a BMI of more than 29.7). Single sperm samples were taken from all 23 men.

Separately, three sperm samples were collected from six men undergoing weight loss surgery (average BMI 42.6). They had samples taken a week before the operation, one week after, and a final sample a year after the operation.

The study looked at differences in three aspects to DNA known to alter how the DNA is used by cells (gene expression):

• the way DNA is folded and packaged in a cell
• small pieces of genetic material called small non-coding RNA (sncRNA)
• chemical groups fused to the DNA – called DNA methylation

The main analysis was split in two. The first part looked at genetic changes between obese and healthy weight men, while the second looked at changes before and after weight loss surgery in a different group of men.

What were the basic results?

The main results showed differences in sncRNA regulation and DNA methylation in the sperm of obese and healthy weight men, but no significant differences in the way DNA was folded and packaged.

The differences related to genes were thought to be involved in brain function.

For men having weight loss surgery, the results showed a significant number of changes in the sperm DNA. For example, a week after surgery there were about 1,500 changes in DNA methylation, which rose to almost 4,000 after a year. The most extensive changes occurred at genetic locations implicated in appetite control.

How did the researchers interpret the results?

The researchers said their data provide evidence that the genetic signature of sperm can quickly change as a result of environmental factors such as weight loss, and offers insight into how obesity may be passed on to the next generation.

Conclusion

This small study showed there were differences in sperm DNA in obese men compared with men of a healthy weight – and some of the differences related to brain function.

Interestingly, rapid weight loss also led to changes in a specific type of DNA change – called methylation – in a sample of six men before and after weight loss surgery. The genes affected appeared to be related to appetite control.

These findings strongly suggest a man’s weight leads to changes in his sperm DNA. The implication is that these might be passed on to his children, increasing their chance of being obese themselves.  

We know that children of obese parents are more likely to be obese, but the extent to which genetic and lifestyle factors influence this isn't clear. Despite some media headlines, this study doesn't prove that obesity risk is inherited, as this wasn't investigated by the researchers. However, it does give researchers a better idea of some of the specific DNA changes to investigate in the future.

The Mail Online reported that the changes in sperm DNA and their potential effect on brain development may explain "why autism is more common in those whose fathers are very fat", but this wasn't investigated directly in this study. Autism was only mentioned briefly as a discussion point, in reference to other research.

Overall, the results of this research are fascinating, but we need to be cautious. It's not possible to say whether findings in less than 30 people affect all men. Studying larger groups of men will indicate if these results are typical.

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