Why the government is going sweet on a sugar tax

The UK government in England is expected to publish its long-awaited child obesity strategy.

The UK government in England is expected to publish its long-awaited child obesity strategy.

At the heart of the debate is the merit, or otherwise, of a sugar tax. Health experts have been campaigning hard for one to be introduced – and even the government advisory body Public Health England has put a case for it.

But for much of the time since the election, ministers have been resistant. Until recently. There are now signs they’re coming round to the idea. This much is obvious from the change in tone from the prime minister himself.

Earlier this month, she said he wasn’t ruling out a tax, which is somewhat different from last year’s statements that she “doesn’t see a need” for it.

A similar flip-flopping could be said to have happened over minimum pricing for alcohol (although that is still in the pending box as no final decision has been made).

Conservatives are naturally wary of introducing new taxes and accusations of the nanny state.

So what has influenced government thinking this time? The delay in publication has certainly allowed the experts to mount a vigorous campaign.

As well as the normal array of doctors and health chiefs, TV chef Jamie Oliver has also waded in. He set up an e-petition which saw more than 150,000 people backing a sugar tax.

Meanwhile, NHS bosses have already announced they will be introducing their own “tax” in hospitals.

Understandably, no government wants to get caught on the wrong side of popular opinion.

But I’m also told that ministers have started to be persuaded by the evidence. One in five children is obese by the time they finish primary school. Include those classed as overweight and the figure jumps to one in three.

Children consume three times as much sugar as they should – with a third of that coming from fizzy drinks. And there is evidence it will work. In Mexico, consumption fell by 6% after a tax of 10% was introduced.

But, of course, the obesity strategy is not just about a tax. Other measures, including a crackdown on shop promotions and advertising (again not natural territory for Tories) as well as a sustained drive to reduce the sugar content of food are also in the mix.

There will be measures to get people more active too, although the emphasis will be very much on diet as there is an acknowledgement that without curbing calories there is a limit to what physical activity can do.

It will be, in effect, an acknowledgement that society is geared too much towards unhealthy lifestyles.

This much is clear from the way we consume food. Just look at food promotions, which are heavily weighted towards unhealthy products. About 40% of expenditure on food goes on promotions, causing us to purchase a fifth more than we would have otherwise, according to PHE.

The result is an unhealthy diet. Last week, researchers at the Food Foundation produced a model of the typical family’s diet.

Every member of the average family consumed too much sugar and saturated fat and too little of the good stuff – fibre, fruit and vegetables and oily fish. What is more, all but the youngest members were eating too much red and processed meat and salt.

It’s no wonder that some in the field are describing obesity as the “new smoking” – and ministers are, bit by bit, being convinced.

 

 

 

Can changing your mealtimes make you healthier?

Many people want to eat more healthily but find it difficult to change their diet.

Many people want to eat more healthily but find it difficult to change their diet.

 

We’ve known for some time that altering the time at which you eat can affect your weight and metabolism. At least if you are a mouse.

Based on mice studies, it seems the secret to improving your health is to restrict the time window within which you eat, and by doing so extend the amount of time you go without food.

A few years ago Prof Satchidananda Panda, from the world-famous Salk Institute in California, showed that mice fed on a high fat diet, but only allowed to eat within an eight hour window, were healthier and slimmer than mice that were given exactly the same food but allowed to eat it whenever they wanted.

In a more recent study the same researchers again subjected hundreds of mice to different lengths of daily fasts, ranging from 12 to 15 hours.
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Again they found that the mice that went for at least 12 hours without eating remained healthier and slimmer than those who ate the same number of calories, but spread out.

But how well would this work in humans? To find out, Trust Me I’m a Doctor recruited 16 volunteers for a 10-week study run by Dr Jonathan Johnston at the University of Surrey.

His team measured the volunteers’ body fat, blood sugar levels, blood fat (triglycerides) and cholesterol levels at the start of the study. They were then randomly assigned to one of two groups, the blues or the reds.

The blues, who were the control group, were asked to carry on as normal. The reds were asked to stick to their normal diet but move their breakfast 90 minutes later, and their dinner time 90 minutes earlier.

This meant that for three extra hours each day they went without food (fasting). Everyone kept a food and sleep diary to ensure that they were eating the same amount as normal.

So why would crunching the time within which you eat change anything? Well, there are two possible mechanisms.

Firstly, there are now plenty of studies which have shown that going for longer periods of time without eating – fasting – is beneficial.

It also seems that your body deals with calories better at certain times of day. According to Johnston, one of the worst times to load up with sugar and fat is late at night, when blood levels of these substances are already high.

After an overnight fast I had some bloods taken, then at 10:00 I had a classic British fry-up – lots of bacon, eggs and sausage. I had more bloods taken directly after the meal and every half hour for the next few hours. And yes, it did hurt.

Twelve hours later, at 22:00, I had my second meal of the day. It was exactly the same meal as I had had for breakfast. Again my bloods were taken regularly over the next few hours before I was eventually allowed to crawl into bed.

The blood tests showed that after my morning meal my blood sugar level returned to normal pretty quickly, while the levels of fat in my blood began to drop after about three hours. In the evening, however, after exactly the same meal, my blood sugar levels stayed high for much longer and the fat levels in my blood were still rising four hours after I finished eating.

So Johnston is right – our bodies really don’t like having to have to deal with lots of food late at night. A midnight snack will have a worse impact on your body than the same food eaten earlier in the day.

There’s an old adage: “Breakfast like a king, lunch like a prince and dine like a pauper,” and it appears to be true. If you must have that fry-up, have it for breakfast.

But what about the main experiment, reducing the time period within which our volunteers were allowed to eat? Well, at the end of 10 weeks, we gathered all the volunteers together and repeated the tests.

What we found is that the group who had eaten breakfast later and dinner earlier had, on average, lost more body fat and seen bigger falls in blood sugar levels and cholesterol than the control group.

So it was very positive result and the first randomised trial of this sort carried out in humans.

Sticking rigidly to a reduced eating window may, for many people, not be entirely practical. But there does seem to be benefit from doing it when you can – and it is certainly a good idea to avoid the midnight cheeseburger.

 

How to spot dementia in a loved one

As families meet up the Alzheimer’s Society is offering advice on recognising early signs of dementia in a loved one.

As families meet up the Alzheimer's Society is offering advice on recognising early signs of dementia in a loved one.

While many realise that repeatedly forgetting names can be a red flag for dementia, few know that using repetitive phrases can also be a sign.

Stuttering or mispronouncing words is another warning.

There are around 850,000 people living with dementia in the UK. And 225,000 more people will develop dementia this year – that’s one every three minutes.

A YouGov survey of more than 4,000 adults reveals many people are confused about what are and are not signs of dementia.

Many people thought that forgetting why you have walked into a room (39%) might be a sign, which could happen to anyone. For a person with dementia, it is not so much why they walked into a room that is troubling, but the room itself seeming unfamiliar.
Warning signs

 

Seek medical advice if your memory loss is affecting daily life and especially if you:

struggle to remember recent events, although you can easily recall things that happened in the past
find it hard to follow conversations or programmes on TV
forget the names of friends or everyday objects
cannot recall things you have heard, seen or read
lose the thread of what you are saying
have problems thinking and reasoning
feel anxious, depressed or angry
feel confused even when in a familiar environment or get lost on familiar journeys
find that other people start to notice or comment on your memory loss

The risk of dementia increases with age with one-in-six of those over 80 having the degenerative disease. But it can strike even in middle age.

Jeremy Hughes, Chief Executive of Alzheimer’s Society, said: “We know dementia is the most feared illness for many, and there’s no question that it can have a devastating impact on people, their family and friends.”

“It’s important we tackle confusion around what are and aren’t signs of dementia, and help give people confidence in approaching loved ones about their concerns so people don’t delay getting help.”

“Dementia can strip you of connections to the people you love, but we have many services that can help stop that and support you.”

 

 

 

Cancer is not just bad luck but down to environment

Cancer is overwhelmingly a result of environmental factors and not largely down to bad luck, a study suggests.

Cancer is overwhelmingly a result of environmental factors and not largely down to bad luck, a study suggests.

Earlier this year, researchers sparked a debate after suggesting two thirds of cancer types were down to luck rather than factors such as smoking.

The new study, in the journal Nature, used four approaches to conclude only 10-30% of cancers were down to the way the body naturally functions or “luck”.

Experts said the analysis was “pretty convincing”.

Cancer is caused by one of the body’s own stem cells going rogue and dividing out of control.

That can be caused either by intrinsic factors that are part of the innate way the body operates, such as the risk of mutations occurring every time a cell divides, or extrinsic factors such as smoking, UV radiation and many others that have not been identified.

The argument has been about the relative importance of intrinsic and extrinsic factors.

In January, a report in the journal Science tried to explain why some tissues were millions of times more vulnerable to developing cancer than others.

Their explanation came down to the number of times a cell divides, which is out of our control and gave rise to the ‘bad luck’ hypothesis.

In the latest study, a team of doctors from the Stony Brook Cancer Centre in New York approached the problem from different angles, including computer modelling, population data and genetic approaches.

They said the results consistently suggested 70-90% of the risk was due to extrinsic factors.

 

Dr Yusuf Hannun, the director of Stony Brook, told the BBC News website: “External factors play a big role, and people cannot hide behind bad luck. They can’t smoke and say it’s bad luck if they have cancer.”

“It is like a revolver, intrinsic risk is one bullet. And if playing Russian roulette, then maybe one in six will get cancer – that’s the intrinsic bad luck. Now, what a smoker does is add two or three more bullets to that revolver. And now, they pull the trigger.”

“There is still an element of luck as not every smoker gets cancer, but they have stacked the odds against them. From a public health point of view, we want to remove as many bullets as possible from the chamber.”

There is still an issue as not all of the extrinsic risk has been identified and not all of it may be avoidable.

Kevin McConway, a professor of applied statistics at the Open University, said: “They do provide pretty convincing evidence that external factors play a major role in many cancers, including some of the most common.

“Even if someone is exposed to important external risk factors, of course it isn’t certain that they will develop a cancer – chance is always involved. But this study demonstrates again that we have to look well beyond pure chance and luck to understand and protect against cancers.”

Dr Emma Smith, from Cancer Research UK, said: “While healthy habits like not smoking, keeping a healthy weight, eating a healthy diet and cutting back on alcohol are not a guarantee against cancer, they do dramatically reduce the risk of developing the disease.”

 

 

Smoking linked to earlier menopause

Women who are heavy or habitual smokers are more likely to experience the menopause earlier, a study suggests.

Women who are heavy or habitual smokers are more likely to experience the menopause earlier, a study suggests.

The report, involving 79,000 women, showed those who smoked from the age of 15 went through the menopause on average 21 months earlier than women who did not smoke.

The paper also found a weaker link with prolonged exposure to passive smoke.

Experts say the study adds to growing evidence that toxins in tobacco can harm overall reproductive health.

Writing in the journal Tobacco Control, a team of researchers looked at data from participants in the women’s health initiative observational study.

All women involved in this paper had gone through the menopause when they were recruited to the investigation between 1993 and 1998.

Using questionnaires, they were asked how long they had smoked for, how much they smoked and when they had experienced the menopause.

Comparing smokers with women who had never smoked, researchers found those who said they smoked heavily (more than 25 cigarettes a day) were likely to have faced the menopause 18 months earlier than non-smokers.

And non-smokers who had experienced many years of exposure to passive smoke – for example living with indoor smokers – went through the menopause earlier than non-smokers who were not around tobacco.

Scientists say the findings stood true even when alcohol use, educational backgrounds, oral contraceptive prescriptions and ethnicity were taken into account.

They suggest toxins in tobacco may play a role by disrupting key reproductive hormones, including oestrogen.

And though they cannot be certain of the long-term health consequences of these findings, they point out that previous studies have linked earlier menopause to a risk of earlier death.

But early menopause has also been associated with a lower risk of certain diseases, including breast cancer.