Quit smoking campaign Stoptober backs e-cigs for first time

Quit smoking campaign Stoptober backs e-cigs for first time

 Quit smoking campaign Stoptober backs e-cigs for first time

The Stoptober campaign runs from 1 October

The annual Stoptober campaign in England is embracing e-cigarettes for the first time – in a sign vaping is being seen as the key to getting people to quit.
Health experts have tended to shy away from explicitly promoting e-cigarettes.
But the government campaign during October will feature vaping in its TV adverts for the first time.
It comes after e-cigarettes proved the most popular tool for quitting during last year’s campaign.
Some 53% of people used them, helping push the numbers of people taking part in Stoptober since its launch in 2012 to over 1.5 million.

10 charts on how smoking ban changed UK

E-cigs ‘definitely’ safer than smoking
E-cigarettes are not yet officially prescribed on the NHS.
However, doctors and other health professionals are encouraged to advise smokers who want to use them that they are a better alternative to smoking.
New draft guidance from the National Institute for Health and Care Excellence (NICE) does not list e-cigarettes as a recommendation to help people quit, but says patients should be told some smokers have found them helpful when they want to give up.
NICE advises that patients should be told that there “is currently little evidence on the long-term benefits or harms of these products”.

Graphic: What’s inside an E-cigarette?

 Quit smoking campaign Stoptober backs e-cigs for first time

But government experts behind the Stoptober campaign have been encouraged by newly released research suggesting record numbers of attempts to give up are proving successful.
University College London researchers found 20% of attempts were successful in the first six months of 2017, compared with an average of 16% over the previous 10 years.

Could vaping help smokers stub out cigarettes for good?

A successful attempt was judged to be one where the person had tried to stop smoking in the past year and was still abstaining at the time of the survey.
The biggest rise in successful attempts to quit was among people from poorer backgrounds, who have traditionally been the least likely to give up.

Stoptober

 Quit smoking campaign Stoptober backs e-cigs for first time
The Stoptober TV advert features a man in an allotment using an e-cigarette
The government’s deputy chief medical officer Prof Gina Radford said e-cigarettes were playing an important role and, as they had “95% less harmful products” in them than normal cigarettes, it was only right that they were promoted during Stoptober.
But there were a number of other factors that were proving effective in reducing smoking rates, including restrictions that have been brought in such as standardised packaging and bans on displays in shops.
Of the new draft guidance for health professionals, Prof Radford told BBC Radio 4’s Today programme: “What for the first time NICE is saying is we recognise that e-cigarettes are being used by people to help them quit.
Therefore, engage people in a discussion about how they are using them, encourage them to be using them only as part of a quit attemptÖ tell them clearly whilst they are much less harmful than tobacco cigarettes, they are not without all harm.

Is smoking being stubbed out?

  • 15.5%
  • Over 18s smoked in England in 2016
  • 26.8% Over 18s smoked in England in 2000
  • 1 in 5 Attempts to quit successful in early 2017
  • 5 “Stoptober” campaigns have been run
  • Over 1.5m have tried quit during them

 

Public Health England

Latest figures suggest just over 15% of people were smoking in 2016, down from 21% in 2007, when the smoking ban was introduced, and over 26% at the turn of the century.
As smoking has decreased, vaping has increased. About one in 20 people over 16 regularly uses e-cigarettes currently – a quarter of them are smokers or ex-smokers.
The battle against smoking is far from over – it is still the country’s biggest killer, causing 79,000 deaths a year.
For every death, another 20 smokers are suffering smoking-related disease.
Meanwhile, NHS Health Scotland has stated for the first time that e-cigarettes are “definitely” less harmful than smoking tobacco.

What’s the ultimate way to defy depression, disease and early death? Exercise

What’s the ultimate way to defy depression, disease and early death? Exercise

 What's the ultimate way to defy depression, disease and early death? Exercise

Are you sitting comfortably? Bad idea. Stand up and walk around the house. Leave your desk and jog down the office stairs. Even better – jog up the stairs. If it’s lunchtime, go and join a yoga class or head for the shops on foot. What’s to lose? You are going to feel better and live longer.

Hardly a day goes by without a new piece of research flagging up the benefits to our physical and mental health of getting more active. On Tuesday, a study of 30,000 Norwegians by the brilliantly named Black Dog Institute in Australia found that even one or two hoursí exercise a week can help prevent depression. On Monday, the Wildlife Trust revealed that two-thirds of its volunteers, digging ditches and building bird tables in the open air, had better mental health within six weeks.

Getting off your backside and moving about, preferably a bit vigorously some of the time, will stave off heart disease, strokes, cancer and diabetes. It can keep your blood pressure steady and helps you sleep. You may not shed pounds, but it will help keep your weight stable. It can overcome anxiety and boost self-esteem. Older people who are active are less likely to have a hip fracture or a fall.

Natural health service: wildlife volunteers get mental health boost

We have the sitting disease. According to a report by Public Health England (PHE) in March, physical inactivity is one of the top 10 causes of disease and disability in England. It is responsible for one in six deaths in the UK, which is the same as smoking. It costs the UK an estimated £7.4bn a year.

If exercise was a pill, it would be the biggest blockbuster in the history of medicine.

We weren’t built to sit in front of a computer, a TV screen and a steering wheel. We were designed to be moving around.

It is what we were made to do. Everyone probably knows the basic point, but often we overlook it in our busy modern lives. We are hunter-gatherers. We were designed to be physically active all day long. Our bodies are still stuck in neolithic times, while our minds are in the 21st century.

Given our ancestors were chasing dinner all day long, you might think it follows that we need to be physically active the entire time we are awake, jogging on the spot at our standing desk. But, thankfully, Cavill says no. Long-term studies, following active and sedentary people until their deaths, have worked out that there is a dose-response curve.

The more exercise you do, the better it is – up to a certain level. A marathon runner or a triathlete is not doing much better for their health than somebody who is reasonably active. Half an hour a day is what they say now – or two for the price of one if you do vigorous exercise. Every vigorous minute is the equivalent of two moderately active minutes.

Dame Sally Davies, Englandís chief medical officer who practises before she preaches, goes for a jog twice a week ñ even though she says she doesnít much like it ñ in order to set an example. She advocates 150 minutes of physical activity a week, which is the equivalent of half an hour, five days a week. That can be walking or cycling. It should be enough to raise your heart rate, make you breathe faster and feel warmer. Vigorous activity is something that makes you out of breath.

Get up, stand up: including exercise in everyday life healthier than gym, says study

The fashion these days is not for gym membership but better lifestyles. Phone apps that tell us how many steps we have walked each day have been revelatory. An obsession, in some cases. Cycling and strolling, walking up escalators and shunning lifts, standing up every 20 or 30 minutes (there are those who set their phones or timers) are all healthy. But there is also the ‘forgotten recommendation’, says Cavill, which is a bit harder to incorporate into the way we live today. We should all be doing some load-bearing exercise. According to NHS Choices, adults should be doing exercises on two or more days a week ìthat work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).

This is particularly important for women as they age, to avoid the weakening arm muscles and bone thinning that can lead to fractures. And we don’t routinely lift loads much any more. Internet shopping is bad for you. The answer is ‘anything you can think of that uses muscles’ – either that walk back from the local shops carrying bags of groceries or boring bicep curls and sit-ups, perhaps with weights. Or digging in the garden, or yoga.

Cavill thinks there may be a particular benefit from activities undertaken outdoors.  Conservation projects and ‘green gyms’ do well. It is back to the hunter-gatherer point. We were not made to live inside.

Load-bearing exercises such as press-ups are particularly important for women.

 What's the ultimate way to defy depression, disease and early death? Exercise

The word ‘exercise’ conjures for most of us ‘Lycra and exercise cycles’, and although that works for some people, for others it’s like saying: – Let’s go and climb Mount Everest tomorrow.’

PHE encourages brisk walking, gardening, dancing – anything physical, really.

Cavil doesn’t expect or even want everybody to get their 150 minutes a week by doing the same activity every day. That’s not the way we are. We are by nature promiscuous with our physical activity and thatís great. It will make a huge difference not only to how well you live, but how long you live. Whether you can get out of a chair on your own is one of the best predictors of premature mortality as you age.

It is so important to be active – and yet none of the experts any longer thinks it is enough just to tell people that. As with unhealthy eating and drinking too much, we enjoy sitting about too much to want to stop. To make us move, physical activity has to be almost impossible to avoid. A ban on cars is not likely any time soon. But efforts are under way to steer us towards shanksís pony instead by redesigning our towns and cities. Or, more realistically, tweaking them when the opportunity arises. That means, for instance, painting cycle routes on roads where it isnít feasible to put in a protected lane.

In March, a report by PHE opened with the gloomy news that half of all women and one in three men are still damaging their health by sitting around. The decline in activity seen since the 1960s will put increasing pressure on strained health and social care, and the quality of life for individuals and communities, unless addressed. It was an update on a report called Everybody Active, Every Day, which came out in October 2014. It takes years to shift peopleís habits, it reflected, but the efforts in two years had seen a 1% increase in the numbers of people doing their 150 minutes a week – or half a million people in England enjoying better health and wellbeing.

Like cutting down on junk food, it has been recognised that we need some help – that the environment around us, full of cars and snacks, elevators and sugary drinks, is a part of the problem that governments not only could but should do something about, from ensuring we have green spaces to walk in to prioritising pedestrians and cyclists when it comes to designing new traffic systems.

Varney, another researcher has just been working with the World Health Organization on a new global action plan for physical activity. It’s about what member states can do to make it easier for their people. At the end of the day, people make decisions in their lives based on what is easiest, most effective and most efficient, or what gives them most joy. If you go out of your front door and there is no place to walk or it’s not safely lit, you are not going to do it.

Varney is hugely enthusiastic. He talks about increasing sports and physical activity in schools and ensuring doctors and nurses get taught about the importance of physical activity – and that it is part of their exams so they revise.

It is a huge undertaking to change our culture to make us more active, even though it will make us all healthier and happier. These initiatives are not drops in the ocean.  He prefers to think of them as a bunch of pebbles. You throw them into a pond so that the ripples become a wave and the waves change the shoreline.

They get it right in Amsterdam and in Copenhagen, of course, where everybody seems to be born on two wheels, and apparently also in Finland. ìThere is a strong exercise culture, perhaps rooted in cross-country skiing and outdoor exploration. They do Nordic walking in the summer. Legally and policy-wise, they have pushed it for years. Someone told him the Finns are very obedient. If the government tells them to exercise, they exercise.

The British are not usually characterised that way. But if we all understood that happiness and health is just a light jog away, maybe we would vote with our feet.

How much exercise should we be doing?

One minute of vigorous activity is worth two of moderate effort.

 What's the ultimate way to defy depression, disease and early death? Exercise

The key to a healthy body and mind is a combination of aerobic and strength exercises several times a week, explains Dr David Broom, a senior lecturer in physical activity and health at Sheffield Hallam University. Variety is the spice of life and we should be doing a different range of physical activity so we donít get bored. It is also about reducing sedentary behaviour and getting up and moving around every 20 minutes.

0 to five-year-olds

Babies and toddlers need to be active throughout the day, every day, to enable them to develop gross motor skills and physical literacy. This can involve a variety of movements:

  •  Reaching and grasping, pulling and pushing
  • Lying on their stomach and lifting their body up, also known as ‘tummy time’
  •  Toddlers should be active for at least three hours a day with a mixture of light play, such as walking and moving around, and energetic play, such as running or climbing

Five to 18-year-olds

Developing bone strength is crucial for young people, as they reach their maximum bone density between the age of 18 and 20.

  • Youngsters should be moderately or vigorously active for at least an hour a day, and on three days a week this should involve strengthening activities such as skipping, jumping, running and gymnastics
  • Moderate aerobic activities could include walking, riding a scooter, skateboarding or cycling
  • Vigorous activities include running, swimming, martial arts, rugby and dance

19 to 64-year-olds

The main focus in this age group is aerobic activity to reduce the risk of disease and premature death, and strength training to support ‘activities of daily living’ such as carrying heavy shopping bags.

  • The minimum recommended exercise length is 150 minutes of moderate aerobic activity a week (brisk walking, water aerobics, tennis doubles) or 75 minutes of vigorous activity (running, hockey, uphill cycling), or a mixture of both.
  •  Moderate or vigorous activity should be complemented with strength exercises at least twice a week, such as heavy gardening, lifting weights or yoga
  • The more activity you do and the higher the intensity, the greater the benefit

65-plus

Activities to improve balance, coordination and flexibility are extremely important for older adults so they are able to avoid falls and maintain a good quality of life.

  •  Older adults are also advised to exercise moderately for at least 150 minutes a week, or do 75 minutesí vigorous activity
  • Weight-bearing activities are more significant at this age so people are able, for example, to get out of a chair unaided and live independently
  •  There are no restrictions on the types of activities older people should do, and they should continue to do the exercise or sport they enjoy

Get up, stand up: including exercise in everyday life healthier than gym, says study

Get up, stand up: including exercise in everyday life healthier than gym, says study

 Get up, stand up: including exercise in everyday life healthier than gym, says study

Incorporating physical activity into our everyday lives, from taking the stairs to holding ‘walkaround’ meetings in the office, is more likely to protect us from heart disease and an early death than buying a gym membership, according to the author of a major new global study.

The study, published in the Lancet medical journal, found that one in 20 cases of heart disease and one in 12 premature deaths around the globe could be prevented if people were more physically active. It compared 130,000 people in 17 countries, from affluent countries like Canada and Sweden to some of the least affluent, including Bangladesh and Zimbabwe.

While 30 minutes of exercise per day for five days a week, which most guidelines recommend, reduces heart disease and deaths, one to two hours a day is the optimal amount of physical activity.

Most people will think they cannot incorporate that much physical activity into their life. ìThey will think I’m stressed out and have to make dinner – and then do exercise for two hours.

No, a standing desk isn’t as unhealthy as smoking

But the study showed that those people who have the highest activity levels are those for whom it is part of their everyday working lives. In developing countries, more people still have physically taxing jobs but as they become more economically prosperous, their activity levels fall.

They are going from sweeping the floor to buying a vacuum.

He does not advocate selling the vacuum cleaner, but we could all incorporate more activity into our lives rather than relying on occasional forays to the gym or swimming pool. It becomes routine as opposed to an endeavour. ìSitting for hours is not good for hearts or the physical body. Getting up every 20 to 30 minutes for a walk around is beneficial.

We spend a lot of time in meetings. If it is just two or three people, why not have a walkaround meeting?

Playing with children in the park rather than sitting watching them, increasing the walk to work by getting off the tube or bus early and taking the stairs rather than the lift.

The authors found that the more physically active people were, the lower their risk of heart disease or an early death.

Participating at even low physical activity confers benefit and the benefit continues to increase up to high total physical activity. People who did more than 750 minutes of brisk walking or equivalent activity per week reduced their risk of death by 36%.

But the study notes that the affordability of other CVD [cardiovascular disease] interventions such as consuming fruits and vegetables and generic CVD drugs is beyond the reach of many people in low-income and middle-income countries; however, physical activity represents a low-cost approach to CVD prevention.

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While the amount of physical work people do in low income countries reduces heart disease, their chances of surviving if they do have a heart attack or stroke are lower because their health services are not as advanced.

The World Health Organisation recommends that adults aged 18-64 years old do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week, as well as muscle strengthening exercises at least two days a week. But it is thought that almost a quarter (23%) of the worldís population are not meeting physical activity guidelines.

The study is the first to compare physical activity and heart disease levels in countries of varying affluence.

The clear-cut results reinforce the message that exercise truly is the best medicine at our disposal for reducing the odds of an early death. If a drug company came up with a medicine as effective as exercise, they would have a billion-dollar blockbuster on their hands and a Nobel prize in the post.

There is a trend for more heart disease in lower income groups both within and between populations.  In the UK it has been shown that lower social class is associated with more heart disease. Walking is easy and cheap. This study should encourage governments to rebalance health budgets away from high tech treatment of heart disease to promoting simple strategies of prevention like walking.

In an age where weíre living increasingly busy but often sedentary lives in the west, weaving physical activity into our daily routines has never been more important, not only to improve our physical health but also overall well-being. Increased physical activity could have an even greater beneficial impact in lower income countries, due to its low its cost and the high incidence of heart disease in those countries.

The shorter your sleep, the shorter your life: the new sleep science

The shorter your sleep, the shorter your life: the new sleep science

 The shorter your sleep, the shorter your life: the new sleep science

Walker is a sleep scientist. To be specific, he is the director of the Center for Human Sleep Science at the University of California, Berkeley, a research institute whose goal – possibly unachievable – is to understand everything about sleep’s impact on us, from birth to death, in sickness and health.

No wonder, then, that people long for his counsel. As the line between work and leisure grows ever more blurred, rare is the person who doesnít worry about their sleep. But even as we contemplate the shadows beneath our eyes, most of us don’t know the half of it – and perhaps this is the real reason he has stopped telling strangers how he makes his living. When Walker talks about sleep he can’t, in all conscience, limit himself to whispering comforting nothings about camomile tea and warm baths. It’s his conviction that we are in the midst of a ‘catastrophic sleep-loss epidemic’, the consequences of which are far graver than any of us could imagine. This situation, he believes, is only likely to change if government gets involved.

What is the neuroscience behind empathy? When do children develop it? And can it be taught?

Walker has spent the last four and a half years writing Why We Sleep, a complex but urgent book that examines the effects of this epidemic close up, the idea being that once people know of the powerful links between sleep loss and, among other things, Alzheimer’s disease, cancer, diabetes, obesity and poor mental health, they will try harder to get the recommended eight hours a night (sleep deprivation, amazing as this may sound to Donald Trump types, constitutes anything less than seven hours).

But, in the end, the individual can achieve only so much. Walker wants major institutions and law-makers to take up his ideas, too. It is clear that no aspect of our biology is left unscathed by sleep deprivation, It sinks down into every possible nook and cranny. And yet no one is doing anything about it. Things have to change: in the workplace and our communities, our homes and families. But when did you ever see an NHS poster urging sleep on people? When did a doctor prescribe, not sleeping pills, but sleep itself? It needs to be prioritised, even incentivised.

Sleep loss costs the UK economy over £30bn a year in lost revenue, or 2% of GDP. We could double the NHS budget if only they would institute policies to mandate or powerfully encourage sleep.

To get on a flight at 10am when people should be at peak alert, and half of the plane has immediately fallen asleep
Why, exactly, are we so sleep-deprived? What has happened over the course of the last 75 years? In 1942, less than 8% of the population was trying to survive on six hours or less sleep a night; in 2017, almost one in two people is. The reasons are seemingly obvious. First, we electrified the night, Walker says. Light is a profound degrader of our sleep. Second, there is the issue of work: not only the porous borders between when you start and finish, but longer commuter times, too. No one wants to give up time with their family or entertainment, so they give up sleep instead. And anxiety plays a part. We’re a lonelier, more depressed society. Alcohol and caffeine are more widely available. All these are the enemies of sleep.

But Walker believes, too, that in the developed world sleep is strongly associated with weakness, even shame. We have stigmatised sleep with the label of laziness. We want to seem busy, and one way we express that is by proclaiming how little sleep weíre getting. It’s a badge of honour. When Walker gives lectures, people will wait behind until there is no one around and then tell me quietly: Walker seems to be one of those people who needs eight or nine hours’ sleep.’ It’s embarrassing to say it in public.

They would rather wait 45 minutes for the confessional. They’re convinced that they’re abnormal, and why wouldn’t they be? We chastise people for sleeping what are, after all, only sufficient amounts. We think of them as slothful. No one would look at an infant baby asleep, and say ‘What a lazy baby!’ We know sleeping is non-negotiable for a baby. But that notion is quickly abandoned [as we grow up]. Humans are the only species that deliberately deprive themselves of sleep for no apparent reason. In case you’re wondering, the number of people who can survive on five hours of sleep or less without any impairment, expressed as a percent of the population and rounded to a whole number, is zero.

The world of sleep science is still relatively small. But it is growing exponentially, thanks both to demand (the multifarious and growing pressures caused by the epidemic) and to new technology (such as electrical and magnetic brain stimulators), which enables researchers to have what Walker describes as ‘VIP access’ to the sleeping brain.

Walker, who is 44 and was born in Liverpool, has been in the field for more than 20 years, having published his first research paper at the age of just 21.

Walker stated that he would love to tell you that he was fascinated by conscious states from childhood. But in truth, it was accidental. He started out studying for a medical degree in Nottingham. But having discovered that doctoring wasn’t for him – he was more enthralled by questions than by answers – he switched to neuroscience, and after graduation, began a PhD in neurophysiology supported by the Medical Research Council. It was while working on this that he stumbled into the realm of sleep.

Matthew Walker photographed in his sleep lab.

 The shorter your sleep, the shorter your life: the new sleep science

Walker was looking at the brainwave patterns of people with different forms of dementia, but he was failing miserably at finding any difference between them. One night, however, he read a scientific paper that changed everything. It described which parts of the brain were being attacked by these different types of dementia: Some were attacking parts of the brain that had to do with controlled sleep, while other types left those sleep centres unaffected. He realised his mistake. He had been measuring the brainwave activity of my patients while they were awake, when he should have been doing so while they were asleep.

Over the next six months, Walker taught himself how to set up a sleep laboratory and, sure enough, the recordings he made in it subsequently spoke loudly of a clear difference between patients. Sleep, it seemed, could be a new early diagnostic litmus test for different subtypes of dementia.

After this, sleep became his obsession. Only then did he ask: what is this thing called sleep, and what does it do? He was always curious, annoyingly so, but when he started to read about sleep, he would look up and hours would have gone by.

No one could answer the simple question: why do we sleep? That seemed to him to be the greatest scientific mystery. He was going to attack it, and he was going to do that in two years. But he was naive. He didn’t realise that some of the greatest scientific minds had been trying to do the same thing for their entire careers. That was two decades ago, and he’s still cracking away. After gaining his doctorate, he moved to the US. Formerly a professor of psychiatry at Harvard Medical School, he is now professor of neuroscience and psychology at the University of California.

Does his obsession extend to the bedroom? Does he take his own advice when it comes to sleep?

Yes. he give myself a non-negotiable eight-hour sleep opportunity every night, and he kept very regular hours: if there is one thing he’d tell people, it’s to go to bed and to wake up at the same time every day, no matter what. He takes his sleep incredibly seriously because he has seen the evidence. Once you know that after just one night of only four or five hours’ sleep, your natural killer cells – the ones that attack the cancer cells that appear in your body every day -drop by 70%, or that a lack of sleep is linked to cancer of the bowel, prostate and breast, or even just that the World Health Organisation has classed any form of night-time shift work as a probable carcinogen, how could you do anything else?

There is, however, a sting in the tale. Should his eyelids fail to close, Walker admits that he can be a touch ‘Woody Allen-neurotic’. When, for instance, he came to London over the summer, he found himself jet-lagged and wide awake in his hotel room at two o’clock in the morning. His problem then, as always in these situations, was that he knew too much. His brain began to race. He thought: his orexin isn’t being turned off, the sensory gate of his thalamus is wedged open, his dorsolateral prefrontal cortex wouldn’t shut down, and his melatonin surge wouldn’t happen for another seven hours.

What did he do? In the end, it seems, even world experts in sleep act just like the rest of us when struck by the curse of insomnia. He turned on a light and read for a while.

 

Can too little sleep ruin your relationship?

 

He’s not sure: the science bits, it must be said, require some concentration. But what Walker can tell you is that it had a powerful effect on him. After reading it, he was absolutely determined to go to bed earlier – a regime to which he is sticking determinedly. In a way, he was prepared for this.

The evidence Walker presents, however, is enough to send anyone early to bed. It’s no kind of choice at all. Without sleep, there is low energy and disease. With sleep, there is vitality and health. More than 20 large scale epidemiological studies all report the same clear relationship: the shorter your sleep, the shorter your life.

To take just one example, adults aged 45 years or older who sleep less than six hours a night are 200% more likely to have a heart attack or stroke in their lifetime, as compared with those sleeping seven or eight hours a night (part of the reason for this has to do with blood pressure: even just one night of modest sleep reduction will speed the rate of a person’s heart, hour upon hour, and significantly increase their blood pressure).

A lack of sleep also appears to hijack the body’s effective control of blood sugar, the cells of the sleep-deprived appearing, in experiments, to become less responsive to insulin, and thus to cause a prediabetic state of hyperglycaemia.

When your sleep becomes short, moreover, you are susceptible to weight gain. Among the reasons for this are the fact that inadequate sleep decreases levels of the satiety-signalling hormone, leptin, and increases levels of the hunger-signalling hormone, ghrelin. Walker isn’t going to say that the obesity crisis is caused by the sleep-loss epidemic alone, It’s not. However, processed food and sedentary lifestyles do not adequately explain its rise. Something is missing. It’s now clear that sleep is that third ingredient. Tiredness, of course, also affects motivation.

Sleep has a powerful effect on the immune system, which is why, when we have flu, our first instinct is to go to bed: our body is trying to sleep itself well. Reduce sleep even for a single night, and your resilience is drastically reduced. If you are tired, you are more likely to catch a cold.

The well-rested also respond better to the flu vaccine. As Walker has already said, more gravely, studies show that short sleep can affect our cancer-fighting immune cells. A number of epidemiological studies have reported that night-time shift work and the disruption to circadian sleep and rhythms that it causes increase the odds of developing cancers including breast, prostate, endometrium and colon.

Getting too little sleep across the adult lifespan will significantly raise your risk of developing Alzheimer’s disease. The reasons for this are difficult to summarise, but in essence it has to do with the amyloid deposits (a toxin protein) that accumulate in the brains of those suffering from the disease, killing the surrounding cells.

During deep sleep, such deposits are effectively cleaned from the brain. What occurs in an Alzheimer’s patient is a kind of vicious circle. Without sufficient sleep, these plaques build up, especially in the brain’s deep-sleep-generating regions, attacking and degrading them. The loss of deep sleep caused by this assault therefore lessens our ability to remove them from the brain at night. More amyloid, less deep sleep; less deep sleep, more amyloid, and so on. (In his book, Walker notes ‘unscientifically’ that he has always found it curious that Margaret Thatcher and Ronald Reagan, both of whom were vocal about how little sleep they needed, both went on to develop the disease; it is, moreover, a myth that older adults need less sleep.) Away from dementia, sleep aids our ability to make new memories, and restores our capacity for learning.

And then there is sleep’s effect on mental health. When your mother told you that everything would look better in the morning, she was wise. Walker’s book includes a long section on dreams (which, says Walker, contrary to Dr Freud, cannot be analysed). Here he details the various ways in which the dream state connects to creativity. He also suggests that dreaming is a soothing balm. If we sleep to remember (see above), then we also sleep to forget. Deep sleep – the part when we begin to dream – is a therapeutic state during which we cast off the emotional charge of our experiences, making them easier to bear.

Sleep, or a lack of it, also affects our mood more generally. Brain scans carried out by Walker revealed a 60% amplification in the reactivity of the amygdala – a key spot for triggering anger and rage – in those who were sleep-deprived. In children, sleeplessness has been linked to aggression and bullying; in adolescents, to suicidal thoughts. Insufficient sleep is also associated with relapse in addiction disorders. A prevailing view in psychiatry is that mental disorders cause sleep disruption. But Walker believes it is, in fact, a two-way street. Regulated sleep can improve the health of, for instance, those with bipolar disorder.

Deep sleep has been mentionedin this (too brief) summary several times. What is it, exactly? We sleep in 90-minute cycles, and it’s only towards the end of each one of these that we go into deep sleep. Each cycle comprises two kinds of sleep. First, there is NREM sleep (non-rapid eye movement sleep); this is then followed by REM (rapid eye movement) sleep. When Walker talks about these cycles, which still have their mysteries, his voice changes. He sounds bewitched, almost dazed.

The real marker of adulthood is admitting you need sleep

During NREM sleep, your brain goes into this incredible synchronised pattern of rhythmic chanting. There’s a remarkable unity across the surface of the brain, like a deep, slow mantra. Researchers were once fooled that this state was similar to a coma. But nothing could be further from the truth.

Vast amounts of memory processing is going on. To produce these brainwaves, hundreds of thousands of cells all sing together, and then go silent, and on and on. Meanwhile, your body settles into this lovely low state of energy, the best blood-pressure medicine you could ever hope for. REM sleep, on the other hand, is sometimes known as paradoxical sleep, because the brain patterns are identical to when you’re awake. It’s an incredibly active brain state. Your heart and nervous system go through spurts of activity: we’re still not exactly sure why.

 

Does the 90-minute cycle mean that so-called power naps are worthless?

 

They can take the edge off basic sleepiness. But you need 90 minutes to get to deep sleep, and one cycle isn’t enough to do all the work. You need four or five cycles to get all the benefit.

Is it possible to have too much sleep? This is unclear. There is no good evidence at the moment. But some think 14 hours is too much. Too much water can kill you, and too much food, and therefore to think ultimately the same will prove to be true for sleep.

How is it possible to tell if a person is sleep-deprived?

 

Walker thinks we should trust our instincts. Those who would sleep on if their alarm clock was turned off are simply not getting enough. Ditto those who need caffeine in the afternoon to stay awake. Walker says that he sees it all the time. To get on a flight at 10am when people should be at peak alert, and to look around, and half of the plane has immediately fallen asleep.

So what can the individual do? First, they should avoid pulling ‘all-nighters’, at their desks or on the dancefloor. After being awake for 19 hours, you’re as cognitively impaired as someone who is drunk.

Second, they should start thinking about sleep as a kind of work, like going to the gym (with the key difference that it is both free and, if you’re like Walker, enjoyable). People use alarms to wake up. So why don’t we have a bedtime alarm to tell us we’ve got half an hour, that we should start cycling down?

We should start thinking of midnight more in terms of its original meaning: as the middle of the night. Schools should consider later starts for students; such delays correlate with improved IQs. Companies should think about rewarding sleep.

Productivity will rise, and motivation, creativity and even levels of honesty will be improved. Sleep can be measured using tracking devices, and some far-sighted companies in the US already give employees time off if they clock enough of it. Sleeping pills, by the way, are to be avoided. Among other things, they can have a deleterious effect on memory.

Those who are focused on so-called ‘clean’ sleep are determined to outlaw mobiles and computers from the bedroom – and quite right, too, given the effect of LED-emitting devices on melatonin, the sleep-inducing hormone.

Ultimately, though, Walker believes that technology will be sleepís saviour. There is going to be a revolution in the quantified self in industrial nations. We will know everything about our bodies from one day to the next in high fidelity. That will be a seismic shift, and we will then start to develop methods by which we can amplify different components of human sleep, and do that from the bedside. Sleep will come to be seen as a preventive medicine.

What questions does Walker still most want to answer?

 

Walker says, with a sigh, it is so difficult. There are so many. He would still like to know where we go, psychologically and physiologically, when we dream. Dreaming is the second state of human consciousness, and we have only scratched the surface so far.

But he would also like to find out when sleep emerged. He’d like to posit a ridiculous theory, which is: perhaps sleep did not evolve. Perhaps it was the thing from which wakefulness emerged. If Walker could have some kind of medical Tardis and go back in time to look at that, well, he would sleep better at night.

Why We Sleep: The New Science of Sleep and Dreams by Matthew Walker is published by Allen Lane (£20). To order a copy for £17 go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over £10, online orders only. Phone orders min p&p of £1.99

 

Sleep in numbers

  •  Two-thirds of adults in developed nations fail to obtain the nightly eight hours of sleep recommended by the World Health Organisation.
  • An adult sleeping only 6.75 hours a night would be predicted to live only to their early 60s without medical intervention.
  • A 2013 study reported that men who slept too little had a sperm count 29% lower than those who regularly get a full and restful night’s sleep.
  • If you drive a car when you have had less than five hours’ sleep, you are 4.3 times more likely to be involved in a crash. If you drive having had four hours, you are 11.5 times more likely to be involved in an accident.
  • A hot bath aids sleep not because it makes you warm, but because your dilated blood vessels radiate inner heat, and your core body temperature drops. To successfully initiate sleep, your core temperature needs to drop about 1C.
  • The time taken to reach physical exhaustion by athletes who obtain anything less than eight hours of sleep, and especially less than six hours, drops by 10-30%.
  • There are now more than 100 diagnosed sleep disorders, of which insomnia is the most common.
  •  Morning types, who prefer to awake at or around dawn, make up about 40% of the population. Evening types, who prefer to go to bed late and wake up late, account for about 30%. The remaining 30% lie somewhere in between.

regular ibuprofen inhibits muscle growth, finds study

regular ibuprofen inhibits muscle growth, finds study

regular ibuprofen inhibits muscle growth, finds study

Whether you’re looking to bulk up or burn fat, lifting weights is a great way to reach your fitness goals.

But according to a new study, a common drug could be preventing people doing so.

Swedish researchers have found that regularly taking anti-inflammatory drugs (like ibuprofen) can inhibit muscle growth.

The one thing you should be doing in the gym if you want to lose fat
The study, looked into the effects of ibuprofen on the skeletal muscles of young, healthy adults engaging in weight training.

Participants – all of whom were aged between 18 and 35 – were randomly split into two groups.

Half were told to take a relatively high dose of ibuprofen (1,200 mg, which is a normal 24-hour dose) and the others a lower dose of aspirin (75 mg) every day for eight weeks.

At the same time, the participants took part in weight-training exercises specifically designed to work the thighs two to three times a week.

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30 min workout for your lunchbreak

After the eight weeks were up, the researchers measured certain variables including muscle growth, muscle strength and anti-inflammatory markers in the muscles.

They found that the muscles of those in the low dose aspirin group had increased in size twice as much as those who’d taken the ibuprofen.

The seven biggest post-workout mistakes you’re making
They also found that muscle strength was harmed by high doses of ibuprofen but not to the same extent as growth.

The results are extremely interesting since the use of anti-inflammatory drugs is so globally widespread, not least amongst elite athletes and recreationally active individuals.

Lundberg adds that they chose to study the effect of ibuprofen as it is the most well-studied anti-inflammatory drug on the market, but they believe that high doses of all types of over-the-counter non steroidal anti-inflammatory drugs will have similar effects.

Why do we run until it hurts? Researchers might have some answers

Why do we run until it hurts? Researchers might have some answers

 Why do we run until it hurts? Researchers might have some answers

Why would anyone want to run 400km across a desert?

It’s a good question and one that was confronted last year when a researcher completed the Ultra Gobi, a single stage, self-navigated 250-mile footrace in China. This year they face an even harder question: Why would anyone do it again?

In moderation, running improves both your health and physique; in extremes, it does quite the opposite. The feet blister and swell to the point where multiple pairs of shoes in ascending sizes are required. Toenails turn black and fall off or, worse, fill with fluid and require puncturing. Some runners even choose to strike pre-emptively and have theirs surgically removed.

Stress fractures are customary. Tendons rub and become enflamed, sending shooting pains up the leg with each agonising step. Muscles seize up, cramp unpredictably and eventually wither away, leaving a gaunt and haggard appearance. Clothing and pack straps rub the skin raw and bloody.

The stomach often ceases to function, leading to vomiting or diarrhoea – a serious issue when one needs to drink 10 litres of water and eat upwards of 6,000 calories each day.

But the greatest effect is less visible: the mind, addled by lack of sleep and constant battles with the body, begins to lose its grip on reality. Hallucinations are common. Emotions can oscillate from elation to anger to melancholy in rapid succession. Speech becomes slurred; planning, rational decisions and accurate navigation almost impossible.

It is not, by any conventional definition, pleasurable. So, why then, are increasing numbers of people paying good money to put themselves through it?

Fortunately, this is a question that academics at the University of Cardiff have sought to tackle. Published in the
Journal of Consumer Research, their research confronts the seeming conundrum that, on one hand, consumers spend billions of dollars every year to alleviate different kinds of pain, while, on the other, millions of individuals participate in extremely painful leisure pursuits.

The paper’s title, Selling Pain to the Saturated Self, implies a key premise: that, unlike many sports and activities, where pain is a risk to which participants are prepared to subject themselves, in endurance sport pain is a core part of the appeal. Even a brief conversation with most ultrarunners is enough to confirm this. Races are reverentially described as ‘brutal’ and ‘savage’, and suffering is discussed with gleeful awe. Similarly, the marketing of many races highlights the opportunities for pain that they are, in effect, selling.

Runners on an assault course.

 Why do we run until it hurts? Researchers might have some answers
Although the research study technically focuses on assault-course racing (the lead researchers using her body ‘as a tool for inquiry and knowledge creation’) rather than ultramarathons, the three leading motivations they uncover are equally transferable.

Firstly, pain makes us more aware of our own bodies – or, in the study’s terms, enables us ‘to rediscover our corporeality – through sensory intensification’. In a world where our bodies have largely ceased to be useful tools for survival and instead merely act as receptacles, it is perhaps little surprise that some form of disconnect has arisen. For the frustrated, sedentary office worker, sensory intensification – be it through self-inflicted pain or stimulatory drugs – presents an opportunity to bridge this dualistic divide. In the Gobi desert in 2016, the researcher certainly felt much more aware of their own body as it gradually disintegrated.

It follows that the popularity of ultramarathons is closely linked to the comfort of modern life. Try explaining to people whose lives are physically uncomfortable by necessity that you run in circles for pleasure, and you receive a blank look of confusion. China meanwhile, with its exploding middle class, is witnessing and unprecedented growth in endurance running.

Secondly, there is a degree of mental escapism. As the authors, somewhat morosely, put it, ‘by flooding the consciousness with gnawing unpleasantness, pain provides a temporary relief from the burdens of self-awareness.’ Escaping from self-awareness would appear to be a common characteristic of the human condition. Alcohol tends to be our society’s favoured fix, although binge-eating, antidepressants and ultimately suicide are also associated problems. In this context, ultramarathons begin to look quite benign.

It also helps to explain the abundance of recovered addicts and depressives in the sport, many of whom, as discussed by the famous American runner Nikki Kimball, use running as a form of therapy. And there are many others, who fear that without ultrarunning they might have been more susceptible to other, more damaging, forms of escapism.

The Ultra Trail of the Gobi – the hardest race in the world?

Finally, the authors assess the role that painful experiences play in retrospect. Pain helps people ‘craft the narrative of a fulfilled life through wounds and scars’. As a runner and occasional writer, that statement is as depressing as it is true. Samuel Johnson once said that ‘every man thinks meanly of himself for not having been a soldier’. Ultrarunning can provide ideal faux-battle wounds to remedy that feeling. Some runners even motivate themselves during races by pretending to be fleeing the Gestapo, or the Burmese military, or another genocidal enemy.

In reality, ultramarathons are lonely, arduous and largely uneventful. As a spectator sport they are marginally better than England football friendlies, but not quite as good as Jenga. And yet, through social media and blogs, they are dramatised into heroic struggles and atheist pilgrimages, a transformation that is reinforced by the well-intentioned, if misguided, puritanical attitude that perseverance is, by its very nature, worthy.

Overall, the paper presents a somewhat bleak but probably quite accurate assessment. The researcher was left not entirely sure whether their return to the Gobi is an attempt to escape the futility of existence or to find purpose through pain, to discover or forget, a therapy or a drug, self-harm or self-help – or all the above. They are, however, thoroughly looking forward to it.

A mid-life crisis can halve the risk of a stroke

A mid-life crisis can halve the risk of a stroke

 A mid-life crisis can halve the risk of a stroke

Middle-aged men who throw themselves into fitness can halve their risk of strokes, research suggests. Scientists said those with sedentary lifestyles had been able to transform their heart health in just seven years – protecting them three decades later.

Norwegian scientists tested the fitness of 1,400 men who were in their 40s and 50s at the start of the trial.

Most became less active as middle age set in, but one in three upped their efforts.

When they compared the group who boosted their fitness the levels the most with those who saw the greatest decline, they found startling differences.

Some of the best results were achieved among those who started out as couch potatoes.

The group with the biggest increase were 56 per cent less likely than the group which slowed down the most to suffer a stroke in later life.

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Overall, one in eight had a stroke in the following 28 years, the study by the University of Oslo found.

Last week health officials warned of an ìinactivity epidemicî with four in 10 adults failing to do even one 10 minute brisk walk a month.

They are particularly concerned about adults aged between 40 and 60, where poor lifestyles can have the greatest impact.

It means more than six million are putting themselves at increased risk of illness.

But today researchers say it is “never too late” to make radical changes.

The men who increased [their fitness levels] the most were not fit at all, they went from low levels and moved up.

It’s a really big risk reduction.

Couch potato

 A mid-life crisis can halve the risk of a stroke
Couch potato lifestyles are pushing Britain to an early grave

Their efforts to take themselves in hand involved regular exercise, such as walking or cycling, rather than epic feats.

These men were just getting themselves together. They weren’t marathon runners, or anything like that.

So we can safely say that as a normal person you are able to improve your fitness by putting in the effort and that will protect you.

The group whose midlife fitness increased the most on average saw a 22 per cent improvement in exercise tests.

Their chances of having a stroke were almost the same as those of men who had been fit all their lives.

 

Is it possible to reverse Type 2 diabetes?

Is it possible to reverse Type 2 diabetes?

 Is it possible to reverse Type 2 diabetes?

Type 2 diabetes is a progressive condition that can lead to heart disease, nerve damage, kidney disease and blindness. However, it is possible to beat it into remission. The pancreas can begin again making insulin, the hormone that regulates levels of glucose in the blood. The liver can reassert itself as the bodyís reservoir for glucose and stop pumping out unwanted sugar. And many people who have been taking tablets to control their type 2 diabetes can potentially throw them away. This is good for the NHS, because 5% to 10% of people have type 2 diabetes. However, to beat it, you would need to lose about 10% of your body weight – and keep it off.

The solution

In an analysis paper in the BMJ, it is argued that giving tablets to reduce blood sugar (the main treatment for type 2 diabetes) only addresses the symptom. Virtually everyone with type 2 diabetes is two or three stone [12-19kg] above their ideal weight. One of the great tragedies is that we’ve known this for about a hundred years and all the treatments have ever done is reduce the blood sugar – this is the consequence, but what drives it is the weight.

The easiest indicator of someone at risk of type 2 diabetes is a fat tummy. A man with a waist over 91cm (36in) or a woman with a waist over 81cm (32in) could both be on the path to the condition. Another paper in Frontiers in Endocrinology describes a programme of high-intensity exercise as a way of preventing type 2 diabetes developing in people with risk factors. But: You can’t run off diabetes, evidence suggests most people need to lose more than 12kg. But studies show woeful remission rates (0.14% of 120,000 US patients who were followed up for seven years).

A pilot study led to a third of people losing more than 12kg. The programme involves drinking formula shakes with a total of 820 calories for six to eight weeks, before reintroducing food that includes a lot less fat, and ideally no alcohol. The programme is being further evaluated and the researchers say they are not pushing their own Counterweight Plus solution – people should ask their GPs for any evidence-based weight-loss programme. The rewards of weight loss are high. Not having type 2 diabetes any more (as long as you don’t regain weight) means not only no tablets for diabetes and no complications, but often the reversal of any high blood pressure, too.

Middle-aged told to walk faster

Middle-aged told to walk faster

 Middle-aged told to walk faster

Get off the bus early … and other ways to get walking

Middle-aged people are being urged to walk faster to help stay healthy, amid concern high levels of inactivity may be harming their health.

Officials at Public Health England said the amount of activity people did started to tail off from the age of 40.

They are urging those between the ages of 40 and 60 to start doing regular brisk walks.

Just 10 minutes a day could have a major impact, reducing the risk of early death by 15%, they say.

But PHE estimates four out of every 10 40- to 60-year-olds do not even manage a brisk 10-minute walk each month.

Inactivity in middle age
Adults in England 40-60 years old

  • 41% – Do not manage one brisk 10 min walk per month
  • 1 in 6 – Deaths linked to inactivity
  • 15% Reduction in risk of early death from at least one brisk 10 min walk per day
  • 20% Less active than we were in the 1960s
  • 15 miles Less walked a year on average than two decades ago

Public Health England
BBC

To help, the government agency is promoting a free app – Active 10 – which can monitor the amount of brisk walking an individual does and provide tips on how to incorporate more into the daily routine.

Juggling priorities of everyday life often means exercise takes a back seat. But walking to the shops instead of driving, or going for a brisk 10-minute walk on your lunch break each day, can add many healthy years to your life.

How walking transformed our lives

Maureen has now started leading organised walks

Maureen has now started leading organised walks

Maureen Ejimofor, 44, started taking regular walks three years ago in a bid to improve her health.

At the time, she weighed 18 stone and wanted to make a change. Within seven months, she had lost nearly five stone.

She joined a local organised walking group in Kent and loved it so much she ended up becoming a walk leader in charge of taking groups of people out at the weekend.

She has been using the Active 10 app and encourages others to do the same, describing it as “really useful” in persuading users to get a “burst” of brisk walking into their day.

Another walking fan is Liam Quigley, who has just turned 60.

“My parents used to take us out walking all the time,” he says.

But unfortunately as he got older, he got a taste for the finer things in life, so he used to drink quite a bit, eat some of the wrong stuff.  He actually put a lot of weight on.

He likes walking, and he decided to do something about it.

Mr Quigley joined Stockport Walkers and now takes 10-mile hikes.

Since he joined, he’s lost two stone. It’s had a good effect on him.

GPs are also being encouraged to get their patients walking faster – defined as a walk of at least 3mph that leaves you breathing faster and increases your heart rate.

Every GP should talk to their patients about the benefits of brisk walking and recommend the Active 10 app. PHE is focusing on those in middle age, because of the drop in activity levels.

It is recommended that people do 150 minutes of activity a week, but nearly half of those aged 40 to 60 fail to achieve that and one in five does less than 30 minutes.

While a daily 10-minute brisk walk will not get them to the recommended level, it will be enough to start making a difference to high blood pressure, diabetes, weight issues, depression and anxiety and musculoskeletal problems such as lower back pain.

PHE also hopes by getting this age group active it will have a knock-on effect among those who have children.

Body clock scientists win Nobel Prize

Body clock scientists win Nobel Prize

Body clock scientists win Nobel Prize

Three scientists who unravelled how our bodies tell time have won the 2017 Nobel Prize for physiology or medicine.
The body clock – or circadian rhythm – is the reason we want to sleep at night, but it also drives huge changes in behaviour and body function.

The US scientists Jeffrey Hall, Michael Rosbash and Michael Young will share the prize.
The Nobel prize committee said their findings had “vast implications for our health and wellbeing”.
A clock ticks in nearly every cell of the human body, as well as in plants, animals and fungi.
Our mood, hormone levels, body temperature and metabolism all fluctuate in a daily rhythm.

Even our risk of a heart attack soars every morning as our body gets the engine running to start a new day.

Body Clock

The body clock so precisely controls our body to match day and night that disrupting it can have profound implications.
The ghastly experience of jet lag is caused by the body being out of sync with the world around it.
In the short term, body clock disruption affects memory formation, but in the long term it increases the risk of diseases, including type 2 diabetes, cancer and heart disease.
It is clear that if we screw that system up we have a big impact on our metabolism.
Many university spokespeople are delighted that the US trio had won, they feel they deserved the prize for being the first to explain how the system worked.

They have shown us how molecular clocks are built across all the animal kingdom.

The prize winners

Jeffrey Hall, Michael Rosbash and Michael Young have won the highest accolade in science.
The trio’s breakthroughs were on fruit flies, but their findings explain how “molecular feedback loops” keep time in all animals.

Jeffrey Hall and Michael Rosbash isolated a section of DNA called the period gene, which had been implicated in the circadian rhythm.
The period gene contained instructions for making a protein called PER. As levels of PER increased, it turned off its own genetic instructions.

As a result, levels of the PER protein oscillate over a 24-hour cycle – rising during the night and falling during the day.
Michael Young discovered a gene called timeless and another one called doubletime. They both affect the stability of PER.
If PER is more stable then the clock ticks more slowly, if it is less stable then it runs too fast. The stability of PER is one reason some of us are morning larks and others are night owls.

Together, they had uncovered the workings of the molecular clock inside the fly’s cells.
Before this work in fruit flies we really didn’t have any ideas of the genetic mechanism – body clocks were viewed as a black box on a par with astrology.
We encounter the body clock when we experience jet lag and we appreciate it’s debilitating for a short time, but the real public health issue is rotational shift work – it’s a constant state of jet lag.