Tuesday, 24 May 2016
Eased symptoms, healed colons in 1 in 4 patients
Related MedlinePlus Page: Ulcerative Colitis via MedlinePlus Health News Read More Here..
In study, just 1 in 20 terminally ill people understood their prognosis, researchers say
Related MedlinePlus Page: Cancer via MedlinePlus Health News Read More Here..
It also offers short-term protection to vulnerable newborns, researchers say
Related MedlinePlus Pages: Pregnancy, Tetanus, Diphtheria, and Pertussis Vaccines, Whooping Cough via MedlinePlus Health News Read More Here..
'Black salve' made FDA's fake cancer cures list
Related MedlinePlus Page: Skin Cancer via MedlinePlus Health News Read More Here..
Children's health needs are increasingly complex, requiring more time and expert care
Related MedlinePlus Page: School Health via MedlinePlus Health News Read More Here..
Two-thirds said they would've liked more advice on preserving ability to have children, study shows
Related MedlinePlus Pages: Cancer, Women's Health via MedlinePlus Health News Read More Here..
|Avoidable deaths, mistreatment and delays found
Related items from OnMedica
Thousands of people dying without dignity
NHS failing to answer patients’ questions, warns Ombudsman
Deaths and avoidable harm not properly investigated in hospitals
GP complaints system ‘must improve’
Poor communication tops complaints list again
|Up to 35% of soldiers given Lariam experienced side-effects
Related items from OnMedica
Warn patients that natural malaria immunity fades
More imported malaria infection reported in the UK
UK sets up £1bn fund to fight malaria
|Watchdog launches new five year strategy
Related items from OnMedica
CQC regime is ‘damaging’ patient care, says survey
CQC inspection fees set to rise
CQC slams troubled mental health trust
Two-fifths of adult social care in the south is below par
Poor CQC ratings linked to poor practice funding
Monday, 23 May 2016
Dr Chan celebrated recent progress in global public health, particularly in combatting HIV, tuberculosis, malaria and polio, as well as in improving maternal and child health. via WHO news Read More Here..
"Low-fat diet bad for your health and cutting back on meat, dairy and eggs a disastrous mistake," the Daily Mirror reports.
That is the main message of a controversial report attacking official UK guidelines on diet and weight loss.
The report suggests it doesn't matter how much saturated fat we eat, and doesn't recommend counting calories.
Critics have pointed out there were no agreed criteria about what evidence would be considered in the report, leading it open to accusations of cherry-picking.
This means the report's author(s) may have promoted evidence supporting their argument while ignoring evidence they saw as unhelpful.
Dr Mike Knapton, associate medical director at the British Heart Foundation (BHF), said: "This report is full of ideas and opinion.
"However, it does not offer the robust and comprehensive review of evidence that would be required for the BHF, as the UK's largest heart research charity, to take it seriously."
Who produced the report?
The report was published by the Public Health Collaboration, a not-for-profit organisation described as being dedicated to informing the public and implementing healthy decisions.
The report is said to follow decades of work and experience that founding and advisory board members have gathered through working with thousands of patients to improve their health.
The listed advisory board members are named health professionals, including dietitians, GPs, a cardiologist, a diabetes specialist and a psychiatrist. They also list a number of patrons.
It is unclear where Public Health Collaboration's funding comes from or, for that matter, who actually wrote the report.
No author or authors are named, and it does not appear to have been peer-reviewed by independent experts.
The aim of the report is said to be to raise concerns about the government's current recommendations about healthy eating and weight loss, and also provide new evidence-based solutions to help people obtain healthy lifestyles and improve public health.
What does the report say?
The report states the current prevalence of obesity in the UK is 25%, costing the economy £47 billion a year.
It summarises the recommendations of the current Eatwell Guide for healthy eating, saying it has three main concerns with this guidance:
- the avoidance of foods because of their saturated fat content
- the dietary reference value of no more than 35% total fat
- the quality and quantity of carbohydrates
The researchers say current recommendations given on NHS Choices are to opt for low-fat dairy options, as high saturated fat can increase the risk of heart disease.
They highlight a large US cohort study from 2010 that concluded saturated fat intake was not associated with risk of cardiovascular disease.
They quote several other observational studies that supported the notion that high-fat dairy was not linked to obesity or cardiovascular and diabetes risk.
This includes 2014 research from the University of Cambridge, saying current evidence does not support the recommendations to eat high polyunsaturated fats and low saturated fats.
The researchers say: "In retrospect, there was never any strong evidence to recommend reducing total and saturated fat consumption, and in the 30 years since, the deteriorating health of the UK population suggests such advice may have been a dire mistake, however well intentioned."
They consider that if people had been opting for foods in the natural form, rather than manufactured low-fat foods, we wouldn't have the obesity problem we do today.
The Public Health Collaboration concludes the UK should stop recommending the avoidance of high saturated fat foods and focus on consuming food in its natural form – however much saturated fat it contains.
No more than 35% total fat
The authors question recommendations that too much fat in your diet raises the risk of heart disease and makes you overweight, saying this is not backed by scientific evidence.
They reference a trial published this year, which found people on low-carb diets experienced more weight loss than people on low-fat diets, and say how recent US dietary guidelines have removed their previous 30% total fat limit and no longer place any restriction on fat.
The authors say: "It would appear that there was never any strong evidence to support recommendations to restrict total fat intake."
They conclude the UK should remove the recommendation to eat no more than 35% total calorie intake from fat and instead focus on the health benefits of eating food in its natural form – regardless of fat content.
Quality and quantity of carbohydrates
As the authors say, good blood glucose control is important to maintain health and reduce the risk of developing diabetes or pre-diabetes conditions.
However, they say eating lots of foods that raise blood glucose and promote the release of insulin are factors likely to increase this risk – and high carbohydrates do just that.
They discuss the glycaemic index (GI) of different foods, saying how the Eatwell Guide "illogically" recommends high-GI foods, advising people to "base meals on potatoes, bread, rice, pasta or other starchy carbohydrates".
They suggest that such recommendations are behind the increase in rates of type 2 diabetes and obesity.
The Public Health Collaboration concludes people should avoid foods that have a high carbohydrate density, and instead focus on food and drink that has a carb density of less than 25%. Such foods are usually in their natural form.
The new Eatwell Plate
The Collaboration sets out a new form of the Eatwell Plate called "The Real Food Lifestyle", which has a 50:50 split of fats and proteins against carbohydrates, but all food and drinks on the wheel are in their natural form.
They emphasise carbs with a density less than 25% and a minimum of 1g protein per 1kg bodyweight per day.
They also emphasise eating "real" foods that will fill you and avoiding processed "fake foods", which won't.
For example, they recommend natural oils and butter, including coconut oil, ghee, lard and cold-pressed olive oil – the "fake" ones are rapeseed, sunflower and corn oil – and no juices or processed sugar products.
If you were being critical, you could argue that the division between "real food" and "fake food" is scientifically meaningless and seems more of a branding strategy.
"Real food" sounds more natural, so it must be good for us, right? But, emotional responses aside, there is no hard evidence to support many of the alleged benefits of so-called "real food".
What evidence is this based on?
The report is presented in the form of a narrative, where individual pieces of evidence are cited to particular studies. A list of references is then provided at the end.
However, the report itself does not provide any method about how the authors identified and selected the research reviewed.
As such, it is not possible to say this was a systematic review, and we cannot know for sure this is a balanced report that has reviewed all evidence relevant to diet and nutrition.
The standard warnings about cherry-picking – evidence that is inconvenient may be ignored – apply.
Also, without reviewing the individual studies referenced, it is not possible to appraise the quality and strength of this evidence. For example, most of these studies are observational.
There is potential for various sources of confounding and bias to influence associations between self-reported diet and health outcomes, such as inaccurate recall on food questionnaires or the potential influence of other unmeasured health and lifestyle factors.
It can be difficult to know to what extent a particular outcome can be directly attributed to a particular food – or the absence of it.
The report further says it "clearly and concisely provides an insight into the decades of work and experience that our founding members and advisory board have accumulated from working with thousands of patients".
But it's not known what sort of experience or data from patients has contributed to informing this.
We also don't know, for example, whether the recommendations on fat and carbohydrate intake would be applicable to all stages in life, or whether there might be different advice for children.
The report makes much of the fact that in spite of UK dietary guidelines, the number of people with obesity and type 2 diabetes has grown in recent decades, implying that the reason for the growth is the direct result of the guidelines.
This is unproven. It could well be the case the real problem is that people are just not following the guidelines.
What response has there been to the report?
The report has attracted quite considerable criticism.
Some professionals, such as the professor of diet and population health at the University of Oxford, note the lack of systematic review methods and accuse the report of potentially cherry-picking studies to support its viewpoint.
Other studies presenting contradictory findings do not seem to have been included, they say.
As a scientist from the University of Reading says: "As with any public health measure, it is important that any recommendations are based on solid evidence and take the wider implications of implementation into account. That doesn't seem to be the case in this instance."
Professor Tom Sanders, emeritus professor of nutrition and dietetics at King's College London, says statements such as "fat doesn't make you fat", "saturated fat doesn't cause heart disease", and "avoid 'low fat' " are potentially harmful and could mislead the public.
Other opinion is more mixed, with one professor saying the report has "good, bad and ugly elements in it". There are views that snacking and added sugar are to be avoided, but ideas that we should eat limitless fat and cut out sugar altogether are criticised.
BBC news quotes Dr Alison Tedstone, Public Health England's chief nutritionist, who says: "In the face of all the evidence, calling for people to eat more fat, cut out carbs and ignore calories is irresponsible."
She says thousands of scientific studies have been considered when making current UK health and nutrition recommendations.
"It's a risk to the nation's health when potentially influential voices suggest people should eat a high-fat diet, especially saturated fat," she says.
"Too much saturated fat in the diet increases the risk of raised cholesterol, a route to heart disease and possible death."
Links To The Headlines
Low fat diet bad for your health and cutting back on meat, dairy and eggs a disastrous mistake. Daily Mirror, May 23 2016
Public Health England: Advice to eat more fat 'irresponsible'. BBC News, May 23 2016
Official advice on low-fat diet and cholesterol is wrong, says health charity. The Guardian, May 23 2016
'Eat fat to get thin': Official diet advice is 'disastrous' for obesity fight, new report warns. The Daily Telegraph, May 23 2016
Eating full fat foods 'can lower chance of obesity'. The Independent, May 23 2016
Row over 'eat more fat' dietary advice. ITV News, May 22 2016
In 1938, Swiss chemist Albert Hofmann synthesized a derivative of alkaloid ergotamine, a natural compound found in a parasitic fungus called ergot. He had no way of knowing that as little as 20 micrograms of this substance would cause a psychedelic effect!
Back in the first half of the 20th century, there were not many methods to characterize new chemical compounds, let alone to establish the structure of complex natural substances such as alkaloids. Doing a bit of self-experimentation in the form of examining the smell and test of newly synthesized chemicals was a well-established and routine practice. In fact, many scientific journals of that period reported, among other things, the smell and taste of new compounds. So it doesn’t come as a surprise that Albert Hofmann decided to taste a new compound, which he called LSD-25 (Lysergic acid diethylamide derivative 25), and put a tiny crystal on his tongue.
Since then, LSD became a source of fascination for scientists, psychologists, recreational users and spiritual enthusiasts alike.
Lysergic acid diethylamide was repeatedly abused in the 1960s by young adults as a hallucinogenic substance. Its effects on patients with mental disorders and when combined with alcohol therapy have been studied since it was first discovered to have psychoactive effects. The research studies eventually stopped due to the drug’s effects on the users: irritability, unpredictability, erratic behavior and violence which often lead to injury and sometimes self-harm.
LSD is a potent drug – the smallest amounts can stimulate the central nervous system, while its usual dose can induce psychedelic effects. The compound is classified as a Schedule I drug in the USA, which means that is illegal to buy and possess. The DEA considers that the drug has no legitimate medical use and a high potential for abuse. The research data from the UK, however, show that the use of LSD is associated with one of the lowest levels of personal and social harm compared to the other recreational drugs, nicotine and alcohol.
I think the interest in LSD results primarily from the strength of its effect on our brain. This is, in itself, a very interesting effect worth studying even if the practical applications of any findings remain nebulous. Knowing how LSD works can help us to understand how our brain works.
WHat LSD does in the brain
The hallucinogenic effects of LSD result from its antagonistic action to serotonin in the brain. LSD inhibits serotoninergic neurons in the raphe nuclei. Its direct inhibitory effect to the raphe neurons is due to its potent agonistic effect on the 5-HT1a autoreceptors.
The strength of the hallucinogenic effect of LSD is dependent on its affinity to another subtype of serotonin receptor, 5-HT2. This receptor subtype is present on the locus ceruleus and the cerebral cortex. The locus ceruleus is indirectly affected by LSD through other mechanisms. However, it is important to note that this nucleus receives synapses from a wide area of the brain. Majority of 5-HT2 receptors are found in the cerebral cortex. Enhanced response of the neurons in the locus ceruleus brings about a perceptive experience similar to those caused by hallucinogens such as LSD. At the same time, persistent stimulation of 5-HT2 receptors found in the cerebral cortex causes thinking and sensing distortions. Hallucinogens like LSD minimize the release of serotonin into the postsynaptic neurons by disallowing the somatodendritic 5-HT1a receptors to activate serotoninergic neurons.
With the use of imaging modalities such as MRI, a recent study has shown that there is an increased flow of blood towards the occipital area, particularly the visual cortex, under the influence of LSD. This may be the reason why people on LSD have profound visual hallucinations.
The researchers also found that neurons that normally fire together in a non-hallucinating state fail to do so while under the influence of LSD, and at the same time some of the neurons which do not usually fire together become synchronized. The participants in this study felt a sense of connectedness with their own environment, or ego-dissolution, proportional to the decreasing ability of the neurons to fire together while on LSD. LSD and psychedelics allow the brain to function in a more cohesive manner such that it unites the person’s own thoughts with his/her environment. It is said that the brain resembles an infant’s mind and that the person on LSD becomes hyperemotional and imaginative.
Furthermore, another study has shown that under the influence of LSD there is an increased neuronal connectivity at the fronto-parietal cortex, the area of the brain responsible for self-consciousness. Increased connectivity also occurs from this region of the brain towards the areas of the brain responsible for sensory responses, hence producing the feeling of increased connectivity of a person to his/her environment.
Although it’s the visual cortex that mainly contributes to the hallucinations and associated feelings while under the influence of LSD, other parts of the brain also contribute to the visual hallucinations. The parahippocampal girus, the region of the brain that plays an important role in the memory encoding and retrieval, communicates more with the visual cortex under the influence of LSD, thus allowing this area to receive more information than usual.
Studies have shown that the use of LSD and other psychedelics is not a factor for the development of mental illness, even among chronic users. These discoveries have opened the way for LSD to be used for psychiatric conditions. Some experts believe that positive effects from LSD use outweigh the negative ones, such as momentary feelings of anxiety and confusion. Furthermore, long-term psychedelic use has not been associated with addiction disorders when the drug is used alone and with no other factors involved.
LSD was considered by many researchers for therapeutic use in the treatment of alcoholism. LSD maximizes the brain’s neural plasticity. The ability of the brain to be manipulated in an LSD-induced state can be utilized for psychotherapeutic methods as an intervention for addiction disorders by allowing new behavior patterns to be introduced to a patient. These findings have been manifested in a study conducted with a group of volunteers, who showed increased suggestibility and responsiveness to ideas being suggested, while on LSD. More resent analysis has shown, however, that the treatment with LSD produces no long-term effects.
It is clear that LSD causes serious changes in brain work. Further studies of this interesting substance may help us to gain the understanding of more enigmatic aspects of our mental functioning and information processing.
Aghajanian, G. (1994). Serotonin and the Action of LSD in the Brain Psychiatric Annals, 24 (3), 137-141 DOI: 10.3928/0048-5713-19940301-09
Carhart-Harris, R., Muthukumaraswamy, S., Roseman, L., Kaelen, M., Droog, W., Murphy, K., Tagliazucchi, E., Schenberg, E., Nest, T., Orban, C., Leech, R., Williams, L., Williams, T., Bolstridge, M., Sessa, B., McGonigle, J., Sereno, M., Nichols, D., Hellyer, P., Hobden, P., Evans, J., Singh, K., Wise, R., Curran, H., Feilding, A., & Nutt, D. (2016). Neural correlates of the LSD experience revealed by multimodal neuroimaging Proceedings of the National Academy of Sciences, 113 (17), 4853-4858 DOI: 10.1073/pnas.1518377113
Carhart-Harris, R., Kaelen, M., Whalley, M., Bolstridge, M., Feilding, A., & Nutt, D. (2014). LSD enhances suggestibility in healthy volunteers Psychopharmacology, 232 (4), 785-794 DOI: 10.1007/s00213-014-3714-z
Krebs, T., & Johansen, P. (2012). Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials Journal of Psychopharmacology, 26 (7), 994-1002 DOI: 10.1177/0269881112439253
Tagliazucchi, E., Roseman, L., Kaelen, M., Orban, C., Muthukumaraswamy, S., Murphy, K., Laufs, H., Leech, R., McGonigle, J., Crossley, N., Bullmore, E., Williams, T., Bolstridge, M., Feilding, A., Nutt, D., & Carhart-Harris, R. (2016). Increased Global Functional Connectivity Correlates with LSD-Induced Ego Dissolution Current Biology, 26 (8), 1043-1050 DOI: 10.1016/j.cub.2016.02.010
Taylor, M., Mackay, K., Murphy, J., McIntosh, A., McIntosh, C., Anderson, S., & Welch, K. (2012). Quantifying the RR of harm to self and others from substance misuse: results from a survey of clinical experts across Scotland BMJ Open, 2 (4) DOI: 10.1136/bmjopen-2011-000774Read More Here..
Report suggests restricting sodium might backfire, but heart experts are critical of the finding
Related MedlinePlus Pages: Heart Diseases, High Blood Pressure, Sodium via MedlinePlus Health News Read More Here..
Treatments keeping those with macular degeneration reading and driving longer, study finds
Related MedlinePlus Pages: Macular Degeneration, Medicines, Seniors' Health via MedlinePlus Health News Read More Here..
Related MedlinePlus Pages: Infections and Pregnancy, Zika Virus via MedlinePlus Health News Read More Here..
Study authors stress women should still take the B vitamin before and during pregnancy
Related MedlinePlus Pages: Folic Acid, Neural Tube Defects via MedlinePlus Health News Read More Here..
|Official health advice, flawed, claims charity
Related items from OnMedica
Cut fat, salt and sugar in foods, public tells food industry
Tackling obesity ‘must be made a national priority’
Changing the cultural context of obesity
Nutrition more important than calories, say experts
1970s advice to cut dietary fat not evidence-based
|General Practice has lost its identity, says Chris Preece, and unless we do something to address it soon – others will define it for us
Related items from OnMedica
Primary Care Home has positive impact on care and services
GPs and physicians innovate to improve care
Treatment of whistleblowers a “stain on NHS”, say MPs
Hunt ‘never planned to insist on changes to existing contracts’
BMA calls for maximum number of patients per GP
|Over half of these carers receive no support
Related items from OnMedica
More rights promised for carers in 2016
Support for carers must be backed with resources
Number of carers over 85 doubles in a decade
Elderly carers are themselves vulnerable
RCGP to help GPs support carers
|Those with higher education more likely to return
Related items from OnMedica
Atrial fibrillation poses greater risk for women than men
European advice launched on heart failure
Fatal heart attacks strike 200 people every week
Heart rehabilitation services neglect women
Half of patients delay seeking help for heart attacks