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Short bursts of intense exercise ‘better for weight loss’:


Sprint interval training is most effective for weight loss, researchers suggest

Bursts of high intensity interval training (Hiit) may be more effective for weight loss than longer less intense workouts, a study suggests.

The research, published in theBritish Journal of Sports Medicine , analysed results from 36 earlier studies.

Although all the participants lost weight, those doing Hiit saw a 28.5% greater weight loss.

The researchers cautioned that Hiit may not be suitable for everyone.

“Hiit might increase the risk of injury and impose higher cardiovascular stress,” they said.

What does the study say?

Researchers from the Federal University of Goias, Brazil, analysed data from 576 men and 522 women of varying levels of fitness.

Interval training was defined as cardiovascular exercise which involved repeated brief bursts of intense effort, interspersed with recovery periods. Cycling, swimming, running and boxing were included.

These workouts were compared with longer continuous moderate intensity workouts, most of which were between 30 and 45 minutes. All participants exercised for at least four weeks.

Those doing interval training lost on average 1.58kg (3.48lb) compared with the 1.13kg (2.49lb) lost by those doing lower intensity workouts.

Sprint interval training seemed to be particularly effective for weight loss, although researchers did caution that the wide variety of training programmes made it difficult to recommend one regime in particular.

The NHS currently recommends at least 150 minutes of moderate aerobic activity, such as cycling or brisk walking, every week.

‘Results impressive’

Dr Niels Vollaard, a lecturer in health and exercise science at the University of Stirling, said the results were counterintuitive as most people burned more calories during longer moderate exercise.

“There are two possible explanations,” he said.

“Firstly, Hiit may lead to greater energy expenditure after exercise – metabolism may be increased for up to a day following a Hiit session.

“Secondly, after a Hiit session, you may be less hungry.

“In our research, we have shown that appetite hormones are indeed affected.

“It is, however, not easy to study whether energy intake is reduced as a result of this in the longer term when following a Hiit routine, so at the moment we are still unsure exactly what the reason is”:

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Interval training at the gym

Michael Mosley, who was introduced to Hiit seven years ago while making the BBC Horizon documentary The Truth about Exercise, said: “In 2012, I tested three lots of 20-second high intensity workouts on an exercise bike, three times a week.

“My insulin sensitivity improved by 24%.

“In the programme, we again saw very impressive results with younger, unfit people.

“The biggest problem with exercise is compensatory eating and relaxing afterwards.

“People go on a treadmill for 30 minutes, burn around 120 calories, then lie around and reward themselves with a muffin.

“The theory with Hiit seems to be that it suppresses your appetite and targets the visceral fat in your gut.

“It’s not the calories you burn that matter – it’s what you do next.”

A&E waits at worst level for 15 years.


A&E waits in England have reached their worst level since the four-hour target was introduced in 2004.

The deterioration in performance came after hospitals appeared to be coping well in the early part of winter.

During January, just 84.4% of patients were treated or admitted in four hours – well below the 95% threshold.

It means nearly 330,000 patients waited longer than they should with hospitals reporting significant problems finding beds for those needing to be kept in.

More than 80,000 patients were kept waiting an extra four hours or more to be transferred to a ward after their wait in A&E.

These are known as trolley waits since patients are left in temporary waiting areas while a bed is found.

All this comes despite relatively low levels of flu.

Presentational grey line

Dr Nick Scriven, of the Society for Acute Medicine, said it was clear the NHS was under “severe strain”.

He said hospitals had seen significant over-crowding with many intensive care units completely full.

He said this had had a knock-on effect on ambulances which were being delayed dropping off patients at A&E.

“Although there is less minor illness associated with flu this year, there are more severely ill people than last year which is putting an even bigger strain on the critical care facilities in our hospitals.

“Any NHS worker will tell you that the stresses and strains are very real and ongoing with no let up in sight.”

‘Know your cholesterol like you know your Pin code’


Most cases of cardiovascular disease are preventable through a healthy diet and lifestyle

People are being encouraged to know their cholesterol and blood pressure numbers as well as they know their bank Pin code – because it could save their life.

These numbers flag up early signs of cardiovascular disease, which can lead to heart attacks and strokes.

Forty health organisations have teamed up to urge more people to go for a routine NHS health check.

Doctors should also identify and treat at-risk patients better, they say.

Cardiovascular disease (CVD) causes one in four deaths in England, the equivalent of someone dying every four minutes, according to Public Health England and NHS England.

Poor heart and artery health can also lead to heart failure, kidney disease, arterial disease and vascular dementia.

So, health bodies are leading efforts to improve the detection and treatment of three conditions that contribute to CVD – atrial fibrillation, high blood pressure and high cholesterol – over the next 10 years.

These conditions often have no symptoms, which is why health experts are recommending people take up free NHS health checks for all over-40s at GP surgeries, some local pharmacies and shopping centres.

They also urge people over 30 to take the Heart Age Test.

Keith Wilson
Keith had to give up work after his second heart attack

‘I had to give up work’

Keith Wilson, from Liverpool, had a heart attack out of the blue at 37.

“I had no symptoms and no reason to believe I was sick in any way,” he says.

His father had died of heart disease in his late 60s so he assumed it was something that happened to older people.

“I just didn’t consider I was going to get it. I was complacent,” he says.

After a second heart attack, Keith spent the next three to four years in and out of hospital receiving treatment.

He had to give up work and this really affected his family and young son.

Now 60, Keith is mindful of his health and keeps a close eye on how much he drinks and exercises. He gave up smoking straight after his heart attacks.

‘Prevention better than cure’

Most cases of CVD are preventable and, alongside free health checks, PHE recommends people should:

  • stop smoking
  • eat healthily
  • keep to a healthy weight
  • drink at safe levels

The report also calls on health professionals to improve the way they manage patients at risk of CVD.

By 2029, PHE and NHS England want:

  • 80% of people with high blood pressure detected and treated – up from 57% currently
  • 75% of 40- to 74-year-olds having cholesterol levels measured – fewer than 50% currently take up the free health check
  • 45% of 40- to 74-year-olds at high risk of CVD treated with statins – up from from 35% currently

These targets will help meet the commitment to prevent 150,000 heart attacks, strokes and cases of dementia, as set out in the government’s long-term plan for the NHS.

But there is no new funding for these new targets.

Duncan Selbie, chief executive of Public Health England, said: “We know our Pin numbers but not the numbers that save our lives.

“Thousands of heart attacks and strokes can be prevented by more people knowing their blood pressure and cholesterol numbers and by seeking help early.”

Prof Stephen Powis, NHS medical director, said reducing health inequalities was also a priority, with people in the most deprived communities four times more likely to die prematurely from CVD than those in the most well off.

Health Secretary Matt Hancock said: “Almost half of those with high blood pressure are going about their daily lives without it being detected or treated.

“Millions of people are needlessly at risk of heart attacks or strokes when it could be prevented.

“So, I want to help more people take the time out to protect their future health and get checked.”

Five million people are estimated to have undiagnosed high blood pressure in England.

Beer before wine? It makes no difference to a hangover,”:


“Beer before wine and you’ll feel fine, wine before beer and you’ll feel queer” – many of us may swear by this time-honoured tip when “mixing” our drinks.

But a new study has refuted the idea that the order we have alcoholic drinks in affects the severity of a hangover.

To test the theory, they gave 90 students drinks in varying orders, switching the order a week later.

The study found that how drunk people felt and whether they vomited provided the best indicators for the next day.

People should pay attention to these “red flags” to lessen the chances of a bad hangover, scientists say.

Obesity-related cancers rise for younger US generations, study says

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Testing age-old ‘wisdom’

Many of us will have our own ideas about what prevents a hangover or makes it more bearable when it has started.

But surprisingly little is understood about what exactly causes a hangover, and science has found no truly effective remedy.

So to test the wisdom that the order in which we have alcoholic drinks affects how we feel the following day, scientists took 90 students aged between 19 and 40 from Witten/Herdecke University in Germany and split them into three groups:

  • the first group drank around two-and-a-half pints of lager, followed by four large glasses of white wine
  • the second had the same amounts of alcohol, but in reverse order
  • the third had only beer or wine (a control group)

A week later, participants in the first two groups switched around, while those in the control group changed to the other alcoholic drink.

Participants were asked to judge how drunk they were at the end of each study day and were kept under medical supervision overnight.

Changing the order of drinks made no significant difference to hangover scores, which were measured using a questionnaire, the study found.

A man with a headache
Science has found no truly effective remedy for a hangover

It was also not possible to predict hangover intensity based on factors such as age, body weight, drinking habits and how often people usually got hangovers.

However, there was a difference between the sexes, with women tending to have slightly worse hangovers than men.

Jöran Köchling, from Witten/Herdecke University in Germany, who was the first author of the paper, said: “The only reliable way of predicting how miserable you’ll feel the next day is by how drunk you feel and whether you are sick. We should all pay attention to these red flags when drinking.”

‘Early warning system’

Though hangovers are not well understood by science, it is thought that causes include dehydration, our immune systems, and disturbances of our metabolism and hormones.

Colourings and flavourings may also make hangovers worse, which might explain why drinks of the same concentration can cause a more severe hangover.

One of the study’s findings was that those who vomited were more likely to have a bad hangover.

So does that mean that the so-called “tactical chunder” – where people deliberately purge themselves of alcohol to lessen a hangover or make themselves less drunk – is also a myth?

Dr Kai Hensel, senior author of the study from the University of Cambridge, said ridding yourself of alcohol meant less of it would be absorbed into the body, which might make you feel better the next day.

But Dr Hensel said he would still not recommend it.

“If you arrive at a point where you need to be sick you’ve probably passed the point of no return,” he added.

However, as unpleasant as they are, hangovers do serve a purpose – experts say they are nature’s warning system to encourage us to drink less.

The study is published in the American Journal of Clinical Nutrition.

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Tips to avoid a hangover

Once you have a hangover, there is no magic cure, although rehydrating, painkillers such as paracetamol and ibuprofen, and sugary foods are some of the things that may ease your discomfort.

But there are steps you can take to reduce the chance of getting one in the first place, beyond the obvious – drinking less.

These include:

  • not drinking on an empty stomach
  • not drinking dark-coloured drinks if you have found you are sensitive to them (they contain chemicals that irritate blood vessels and tissue in the brain and can make a hangover worse)
  • drinking water or non-fizzy soft drinks in between each alcoholic drink
  • drinking a pint or so of water before you go to sleep

Source: NHS website

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Obesity-related cancers rise for younger US generations, study says


Cancers linked to obesity are rising at a faster rate in millennials than in older generations in the United States, the American Cancer Society has said.

It said a steep rise in obesity in the past 40 years may have increased cancer risk in younger generations.

And it warned the problem could set back recent progress on cancer.

The Society studied millions of health records from 1995 to 2014, publishing its findings in The Lancet Public Health.

In the last few decades, there has been mounting evidence that certain cancers can be linked to obesity.

‘Dangers of extra weight’

Researchers found that the rates of six out of 12 obesity-related cancers (colorectal, uterine, gallbladder, kidney, pancreatic and multiple myeloma – a blood cancer) all went up, particularly in people under the age of 50.

And they found steeper rises in successively younger generations aged 25 to 49 – and particularly in millennials, in their 20s and 30s.

For example, the risk of colorectal, uterine and gallbladder cancers has doubled for millennials compared to baby boomers, now aged 50 to 70, at the same age.

Some of these cancers increased in people over 50 too, but the rises were not as steep.

Researchers say this trend may be down to the rapid rise in obesity in the last few decades with “younger generations worldwide experiencing an earlier and longer exposure to the dangers of extra weight”.

Which cancers are linked to obesity?
Breast cancer is linked to obesity in post-menopausal women.

Dr Ahmedin Jemal, from the American Cancer Society, said: “Our findings expose a recent change that could serve as a warning of an increased burden of obesity-related cancers to come in older adults.

“Most cancers occur in older adults, which means that as the young people in our study age, the burden of obesity-related cancer cases and deaths are likely to increase even more.”

Other risk factors

But the researchers could not explain why the rates of only half of the 12 obesity-related cancers had increased.

Meanwhile, they found cancers linked to smoking and infections were declining in younger age groups.

Dr Brenda Birmann, from Brigham and Women’s Hospital in Boston, told the Lancet Public Health that it was possible that risk factors other than obesity could play a part and this warranted further investigation.

“Importantly, the findings suggest the need for further close epidemiological monitoring of cancer incidence trends in younger adults,” she said.

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Graphic highlighting liver cancer
Liver cancer is one of a list of cancers linked to obesity

Which cancers are caused by obesity?

According to the charity Cancer Research UK, obesity is the second biggest preventable cause of cancer in the UK, after smoking.

Research suggests bowel cancer, womb cancer, oesophageal (food pipe) cancer, cancer of the kidney, liver, upper stomach, gallbladder, ovarian, thyroid, meningioma (a type of brain tumour) and multiple myeloma (a type of blood cancer) and breast cancer in women after the menopause have all been linked to obesity.

Researchers say the risk increases as people get more overweight.

But of course, obesity is only one factor – the environment, genetics and other issues can also come into play. Not everyone who gets these cancers will be overweight and everyone who is obese will not necessarily get these cancers.

And scientists are clear that losing even small amounts of weight can help reduce the risk of cancer.

How does obesity lead to cancer?

Scientists still have a lot of questions to answer but there are currently three main theories about this.

Extra body fat does not just sit in the body doing nothing.

Fat cells help store energy, but they can also send chemical signals to other parts of the body. These signals may tell cells to divide more quickly, which can put people at risk of cancer.

In other words:

  • fat cells make extra hormones and growth factors
  • growth factors and hormones tell cells in the body to divide more rapidly
  • this increases the chance of cancer cells being produced and these can continue to divide and cause a tumour

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E-cigarettes ‘much better for quitting smoking’,.


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E-cigarettes are almost twice as effective as nicotine replacements for helping smokers quit, a study suggests.

A trial found 18% of smokers who used them to quit remained smoke-free after a year, compared with 9.9% of those using nicotine-replacement treatments.

The study of 886 smokers is the first to test how effective modern e-cigarettes are for quitting.

Researchers hope their findings will lead to vaping devices being routinely offered by stop-smoking services.

Public Health England has already called for e-cigarettes to be made available on the NHS within five years, pointing to a body of research that suggests they are at least 95% less harmful than cigarettes.

However, up until now there had been a shortage of evidence on how effective they were as stop-smoking tools.

Lead researcher Prof Peter Hajek, from Queen Mary University of London, said: “Although a large number of smokers report that they have quit smoking successfully with the help of e-cigarettes, health professionals have been reluctant to recommend their use because of the lack of clear evidence from randomised controlled trials.

“This is now likely to change.”

Screen time ‘may harm toddlers’

Does gum disease have a key role in Alzheimer’s?

Accelerate’ smoking reduction

Participants in the trial, who were dependent on smoking and had previously failed to give up, attended NHS stop-smoking services and were randomly assigned into two groups:

  • those who received a nicotine-replacement treatment of their choice, which included gum, patches, lozenges, sprays and inhalators, or a combination of treatments, for up to three months
  • those who got an e-cigarette starter pack with one or two bottles of e-liquid (two to four weeks’ supply)

Those given e-cigarettes were encouraged to buy future supplies of their own choice of strengths and flavours, and all participants received weekly one-on-one behavioural support for at least four weeks.

The study, published in the New England Journal of Medicine , found that in addition to having higher rates of quitting, more e-cigarette users reduced their smoking by at least 50%.

E-cigarettes also provided higher satisfaction and were rated as more helpful than nicotine-replacement treatment.

A higher proportion of those who used the devices experienced mouth and throat irritation (65% v 51%), although people using the nicotine-replacement treatments were more likely to report nausea (38% v 31%). These effects were mostly mild.

Prof Hajek said he hoped the results of the study would lead to stop-smoking services offering quitters an e-cigarette starter pack and guidance on how to vape, after which they could pay for their own supplies.

“This may ultimately further accelerate the reduction in smoking and in smoking-related diseases,” said Dunja Przulj, another author of the study, also from Queen Mary University of London.

Smoking v vaping: Watch lab test results
Smoking v vaping: Watch lab test results

The study has some limitations.

Because people had known which treatment they had received – as opposed to being “blinded” as they are in most randomised controlled trials – it was possible participants may have perceived nicotine replacements as an inferior option and put less effort into quitting, the authors said.

They also said more work was needed to determine if their results would apply to countries outside of the UK and for less dependent smokers.

The study comes after an independent review of evidence on e-cigarettes, by Public Health England, published in February last year, concluded there was “overwhelming evidence” they were far safer than smoking and “of negligible risk to bystanders”.

However, some experts have said e-cigarettes, while safer than normal cigarettes, are not harm-free , and their long-term effects are not yet known.

Responding to this latest research, Public Health England said: “All stop-smoking services should welcome smokers who want to quit with the help of an e-cigarette.”

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Screen time ‘may harm toddlers’


Letting a toddler spend lots of time using screens may delay their development of skills such as language and sociability, according to a large Canadian study.

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The research, which tracked nearly 2,500 two-year-olds, is the latest piece of evidence in the debate about how much screen time is safe for kids.

In Canada and the US, experts say children should not use screens before they are at least 18 months old.

But UK guidelines set no such limit.

The Royal College of Paediatrics and Child Health says there is not enough evidence, even when you include this new study, for a “direct toxic effect”.

Does gum disease have a key role in Alzheimer’s?

NHS 10-year plan: May hails historic announcement

What did the new research find?

Mums were surveyed (between 2011 and 2016) about screen use, and filled out questionnaires about their child’s skills and development at ages two, three and five.

Screen time included watching TV programmes, films or videos, gaming, and using a computer, tablet, phone or any other screen-based device.

At the age of two, the children were clocking up around 17 hours of screen time per week.

This increased to around 25 hours a week by the age of three but dropped to around 11 hours a week at the age of five, when the children started primary school.

The findings, published in the JAMA Paediatrics, suggest increased viewing begins before any delay in development can be seen, rather than children with poor developmental performance then going on to have more screen time.

But it is not clear whether screen time – including how much or what type – is directly to blame. Screen use might just go hand-in-hand with other things linked to delayed development, such as upbringing and how a child’s remaining leisure time is spent.

What do the researchers think?

When young children are observing screens, they may be missing important opportunities to practise and master other important skills.

In theory, it could get in the way of social interactions and may limit how much time young children spend running, climbing and practising other physical skills – although they may still eventually catch up.

infant using a screen

Even without solid proof of harm, Dr Sheri Madigan and colleagues say it still makes sense to moderate children’s screen time and make sure it doesn’t interfere with “face-to-face interactions or family time”.

They also said that, with hindsight, perhaps they should have followed the children from an even younger age because it is becoming increasingly common for 12-month-old babies to be watching and using screens.

How much is too much?

It is a good question, without a satisfactory answer.

The new study does not make any recommendation about how much is too much. Some of the two-year-olds were getting more than four hours a day or 28 hours a week of screen use, according to their mums.

The American Association of Paediatrics’ (AAP) guidelines on screen time say:

  • For children younger than 18 months, avoid use of screen media other than video-chatting
  • Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they are seeing
  • For children ages two to five years, limit screen use to one hour per day of high-quality programmes. Again, parents should be watching it with their children.
  • For children ages six and older, place consistent limits, making sure screen time does not get in the way of sleep and physical activity.

The Canadian Paediatric Society goes further,saying screen time for children younger than two is not recommended.

Bar chart showing rising internet use amongst all children 15 and under
Image captionData for the UK shows internet use among children has increased in recent years

The UK’s Royal College of Paediatrics and Child Health (RCPCH) put out guidelines earlier this year, but sets no limit.

It says “evidence is weak for a threshold to guide children and parents to the appropriate level of screen time, and we are unable to recommend a cut-off for children’s screen time overall”.

Instead, it advises families to ask themselves:

  • Is screen time in your household controlled?
  • Does screen use interfere with what your family want to do?
  • Does screen use interfere with sleep?
  • Are you able to control snacking during screen time?

If a family can ask themselves these questions, and are satisfied with the answers, then they can be reassured that they are “likely to be doing as well as they can with this tricky issue”, says the RCPCH.

Tips on cutting back

The AAP advises families to designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms.

The RCPCH says adults should consider their own use of screens and set a good example.

Most experts also advise that children are not exposed to screens for an hour before bed, so that their brains have time to wind down for sleep.

Screen time amongst 12-15 year olds: 99% go online, for nearly 21 hours a week; 91% watch TV, for nearly 14.5 hours a week; 83% have a smart phone; 77% play games, for around 12 hours a week; 74% have a social media profile
These statistics are for the UK, based on data for 2017

Dr Bernadka Dubicka, from the Royal College of Psychiatrists, said: “We still need more research to tell us which children are most vulnerable to the harms of screen use and the impact it may have on a child’s mental health.

“We also need to look at the effects of different content as there are also many positive ways of using screens.”

Does gum disease have a key role in Alzheimer’s?


Does gum disease play a key role in the development of Alzheimer’s?

Weigh-ins help prevent piling on pounds at Christmas

Scientists believe this may be the case after their study found further evidence of the link between bacteria in a common type of gum disease and people with dementia.

Does gum disease play a key role in the development of Alzheimer’s?

Researchers say their findings offer hope for a new way of tackling the illness, for which there is no cure and no effective treatments.

But does it mean people should be more worried about their oral health?

What did the research find?

Scientists analysed brain tissue, spinal fluid, and saliva from dead and living patients with diagnosed and suspected Alzheimer’s.

Their study, published in the journal Science Advances, found bacteria associated with chronic gum disease, Porphyromonas gingivalis, in the brains of people with Alzheimer’s.

Tests on mice confirmed the bacteria could travel from the mouth to the brain and showed the toxic protein they secrete, called gingipain, destroyed brain neurons.

The bacteria also increased production of amyloid beta, a component of the amyloid plaques commonly associated with Alzheimer’s.

Following this, scientists tested drugs in mice aimed at blocking the toxic proteins and found they were able to halt degeneration in the brain.

The authors of the study concluded: “The findings of this study offer evidence that Porphyromonas gingivalis and gingipains in the brain play a central role in the pathogenesis [development] of AD [Alzheimer’s disease], providing a new conceptual framework for disease treatment.”

The team has now developed a new drug they hope could form the basis of a human treatment and plan to test it in people with mild to moderate Alzheimer’s, in a clinical trial, later this year.

Toothpastes

What do other scientists say about the study?

Scientists not involved in the research said it added to the evidence of the link between gum disease and dementia, the umbrella term for brain conditions that include Alzheimer’s.

But they say it is still not clear whether gum disease bacteria is driving the development of Alzheimer’s.

People with Alzheimer’s are more susceptible to getting infections in their brains, so it may be that the gum disease bacteria and the toxic proteins they secrete are a by-product of Alzheimer’s rather than a cause.

There was also caution about the fact the drug tests had been in mice.

Prof Tara Spires-Jones, from the UK Dementia Research Institute, at the University of Edinburgh, said it was “great news” that the study provided evidence these drugs may affect Alzheimer’s-related proteins.

“However, we will have to await the larger clinical trial to see if it will be beneficial to people living with Alzheimer’s disease,” she said.

What was the previous evidence?

Studies have previously linked gum disease and dementia.

Last year, a Taiwanese study found that people with a 10-year or longer history of chronic periodontitis (CP) were 70% more likely than people without the condition to develop Alzheimer’s.

Another study found people with mild to moderate Alzheimer’s who had gum disease experienced a quicker rate of cognitive decline compared with those without.

The researchers of this new study say one explanation for the link is that bacteria from gum disease may access the brain by infecting immune system cells or spreading through cranial nerves passing through the head and jaw.

Older people brushing their teeth
One expert says oral health should be more of a priority – particularly for older people

But, alternatively, it may be that people with Alzheimer’s have poorer oral hygiene, perhaps because the condition makes them less able to look after their teeth and gums.

So where does this leave us?

The charity Alzheimer’s Society, responding to this study, said the research it had been involved in had not found gum disease to be a key risk factor for Alzheimer’s.

And Alzheimer’s Research UK said the presence of a single type of bacteria was “extremely unlikely to be the only cause of the condition”.

But given that the condition of teeth and gums is important for overall health anyway, Prof Clive Ballard, from the University of Exeter, said the study suggested oral health should be a “much higher public health priority, especially in older people”.

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NHS 10-year plan: May hails historic announcement



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GETTY IMAGESTheresa MayTheresa May is promising improvements to mental health support and maternity care

Prime Minister Theresa May is promising patients access to “world class” care under a 10-year plan for the NHS.

She said the publication of the plan on Monday would mark a “historic” moment for the health service in England.

Pledges on maternity care, mental health, elderly support and earlier detection and prevention of diseases will be included in the plan.

She said that, coupled with the extra money announced last summer , the future of the NHS was secure.

The budget is due to rise by £20bn a year above inflation by 2023.

If you can’t see the NHS Tracker,click or tap here .

Presentational grey line

A day before the publication of the 10-year plan, the prime minister said: “The NHS has always been the country’s most beloved public service – there to provide outstanding care to us all whenever it is needed.

“The plan marks a historic step to secure its future and offers a vision of the service for the next 10 years with a focus on ensuring that every pound is spent in a way that will most benefit patients.

“This will help relieve pressure on the NHS while providing the basis to transform care with world class treatments.”

As healthcare policy is politically devolved, the plan only applies to the NHS in England but she said the other UK nations will be drawing up their own plans. Under the government’s funding system they are getting an extra £4bn between them by 2023.

What’s in the plan?

The full details are not being unveiled until Monday when it will be released by NHS England.

But Mrs May has outlined some of the key focuses. These include:

  • Better mental health care, including round-the-clock advice from NHS 111 by 2023 and tailored services for young adults. Currently once someone in care turns 18 they are thrust into the adult system, often when they are not ready
  • Providing the best maternity care in the world by improving safety and providing greater mental health support for new parents. One in five new mothers struggles with mental health in the first year of her baby’s life
  • Greater control and choice in old age by expanding the use of personal budgets to allow people to decide what care they want, and greater support in the community so people do not end up in hospital
  • Better prevention and detection of disease – cancer is expected to be a key focus with an ambition to increase the number of early detections from one in two cancers to three in four, which in turn will improve survival
  • Increases in the NHS workforce – currently one in 11 posts is vacant
  • Bringing the NHS into the digital age, including online GP booking, prescriptions management and health records

Why is it being published now?

The plan was promised during the summer when the government unveiled its funding settlement for the NHS.

That set out the budget for the next five years and means by 2023 funding for the NHS will be £20bn a year more than it is now, once inflation is taken into account. That is the equivalent of annual “real terms” rises of close to 3.5% – about twice what the NHS has got since 2010.

Simon StevensNHS England boss Simon Stevens has been in charge of drawing up the plan

At the time, the prime minister said she wanted to ensure the money was used wisely and so asked NHS England boss Simon Stevens to draw up a long-term plan for the next decade.

It was expected to be published in the autumn, but was delayed because of the government’s troubles getting its Brexit plans agreed.

The last time such a long-term vision was set out was in 2000 under Tony Blair.

How are people reacting?

Understandably people want to see the full details before coming to firm conclusions. But the priority areas are being welcomed.

Andy Bell, of the Centre for Mental Health, said the initiatives on mental health were much needed.

He said: “For too many young people, mental health support is offered too late, with too many restrictions and then they are forced to start again when they reach 18.”

Image copyrightGETTY IMAGESMan in bedMental health care is one of the priority areas

Dame Donna Kinnair, of the Royal College of Nursing, said nurses shared the ambitions being set out.

But she added the government needed to “urgently address” the staffing shortages if it was going to succeed.

And Jennifer Dixon, chief executive of the Health Foundation think-tank, predicted fulfilling the pledges would be “extremely tough” because of the scale of staffing shortages, rising pressures and cuts to other parts of the wider health and care system.

The £20bn promise just relates to the front-line NHS budget and so does not cover other elements such as social care and public health – at the end of last year it was announced the budget for these services, which includes smoking cessation and weight management, was being cut by over 4% in real terms next year.

Ms Dixon said: “Trade-offs are inevitable and these must be spelled out clearly so the public know what they can expect from the NHS.”

What are we not being told?

There has been a fair bit of tension behind the scenes. The Treasury is understood to have wanted to tie the NHS down in terms of what it will achieve.

One of the central bones of contention is thought to be how the NHS can tackle deficits and waiting times.

Hospitals are struggling to balance their books and have seen a deterioration in the time patients wait in A&E, for cancer and for routine operations.

None of the three key targets are currently being met.

GETTY IMAGESMan in hospital bedThe NHS is missing its key waiting time targets

It looks like a trajectory for improvement will be published at a later date with NHS bosses known to have been wary about promising things they felt they could not deliver.

Another missing piece is the green paper on social care.

This was first promised in 2017, but has been delayed on a number of occasions. Brexit has certainly been a factor, but again there has been disagreements in private, this time over how radical the plan should be given the problems facing the sector, which covers care homes and home help.

The government has promised the green paper will be published as soon as possible.

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Weigh-ins help prevent piling on pounds at Christmas’


By Laurel IvesBBC Health


A person on scales
Image captionPeople who stood on the scales at least twice a week lost weight

Regular weigh-ins at home, plus simple weight-loss tips, could prevent people from piling on the pounds at Christmas, according to a new study.

The Universities of Birmingham and Loughborough divided 272 volunteers into two groups. The “intervention” group weighed themselves regularly.

They were also given information on how much exercise was needed to burn calories in Christmas food.

They ended up weighing 1lb (0.49kg) less than the “comparison” group.

The comparison group didn’t track their weight – they were just given a healthy lifestyle leaflet, which did not include dietary advice.

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Calories in christmas food and drink

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The researchers say the Winter Weight Watch Study, published today in the BMJ, is the first to look at preventing seasonal weight gain.

Lead author Frances Mason, of the University of Birmingham’s Institute of Applied Health Research, said avoiding weight gain during the festive period could help in the long-term fight against obesity.

“People gain a kilo of weight on average annually. Often this weight gain happens at Christmas, and is never fully lost. This could possibly be a factor driving the obesity epidemic.”

How to avoid festive weight gain

The trial was carried out in 2016 and 2017 over a period of six to eight weeks in November and December. Follow-up measurements were then taken in January and February of the following year.

The intervention group were asked to record their weight on a record card and given 10 tips for weight management.

They were also given a list of how much physical activity would be needed to burn off the calories found in popular Christmas food and drinks.

That mince pie might not be as appealing when you factor in the 21 minutes of running needed to burn off the 245 calories found in an average pie.

The groups were also given these tips for weight management:

  • 1. Keep to your meal routine – try to eat at roughly the same time each day
  • 2. Go reduced fat – choose reduced-fat foods (eg: dairy, spreads, salad dressings) where you can
  • 3. Walk off the weight – walk 10,000 steps each day
  • 4. Pack a healthy snack – choose fresh fruit or low-calorie yoghurts
  • 5. Learn the labels – be careful about food claims. Check the fat and sugar on food labels
  • 6. Caution with your portions – do not heap food on your plate (except vegetables)
  • 7. Up on your feet – stand up for 10 minutes out of every hour
  • 8. Think about your drinks – choose water or sugar-free squash. Limit fruit juice. Alcohol is high in calories so limit to one a day for women and two for men
  • 9. Focus on your food. Slow down. Do not eat on the go or while watching TV
  • 10. Do not forget your five-a-day – eat at least five portions of fruit and veg a day.

Source: International Journal of Obesity

‘A small amount of restraint’

Researchers were not able to identify which of the 10 potential interventions led to the weight loss, although 85% of those who did lose weight stood on the scales twice a week.

But they did conclude that the intervention group were more able to retrain their eating and drinking. They were also marginally less likely to drink alcohol.

But isn’t Christmas a time when we are supposed to be able to overindulge?

Christmas lunch
Image captionPeople consume an average of 6,000 calories on Christmas day

Frances Mason said they had no problem recruiting volunteers, saying: “This suggests people were willing to exercise just a small amount of restraint, while still enjoying the Christmas period.

“It’s small changes like say instead of consuming five pigs-in-blankets, consume one or two. Or make sure you get out of the house for a walk. Research shows people underestimate calories, and overestimate their calorie expenditure.

“This is why accurate self-monitoring is an effective strategy for weight management.”

This might also explain the explosion in the popularity of mobile fitness and diet tracker apps. The global mobile fitness app market grew from $1.8bn in 2016 to $2.2bn, says research firm Statista.

Researchers from global insurer Vitality also recently showed that offering customers an smartwatch, at minimal cost if they stuck to a fitness regime, also resulted in more regular exercise.