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.

 

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.

 

 

Man’s weight affects sperm cells

A man’s weight affects the information passed on through his sperm and could leave his children predisposed to obesity.

A man's weight affects the information passed on through his sperm and could leave his children predisposed to obesity.

 

The sperm cells of lean and obese men possess different epigenetic marks, maybe changing the behaviour of genes.

Dr Romain Barres, the author of the research, said: “When a woman is pregnant she should take care of herself. But if the implication of our study holds true, then recommendations should be directed towards men too.”

Part of the research – which was carried out by the University of Copenhagen and published in the journal Cell Metabolism – tested the sperm of six obese men who were undergoing weight-loss surgery.

It looked at the men’s sperm before treatment, a week after the surgery and then for a third time a year later.

Dr Barres said changes to the sperm were noticeable in the men a week after the surgery, and also one year on.

He said although the genetic make-up of the sperm cells was likely to remain the same, he noticed “epigenetic changes”, which could change the way a gene expresses itself in the body.

Dr Barres admits a definitive scientific conclusion for how these epigenetic changes affect the gene is not yet scientifically known.

However, the sperm cell changes he recorded are linked to the genes known for appetite control and brain development.

The five-year study also recorded similar sperm cell changes when it compared 13 lean men – who all had a BMI of below 30 – with 10 moderately obese men.

Dr Barres said his findings have also been corroborated on mice and rats.

He goes on to suggest that there are possible evolutionary reasons why information about a father’s weight would be valuable to offspring.

His theory is that during in times of abundance, it is an instinctive way to encourage children to eat more and grow bigger.

“It’s only recently that obesity is not an advantage,” he said. “Only decades ago, the ability to store energy was an advantage to resist infections and famines.”

Prof Allan Pacey from the University of Sheffield, described the study as “interesting” and said it provided further evidence to support the theory that some characteristics can be passed by sperm, without altering the basic structure of the genetic code.

“Whilst the study examines a relative small number of individuals, the fact that such significant differences can be found in the epigenetic markers of lean and obese men is intriguing and in my opinion worthy of more detailed investigation,” he said.

“Until we know more, would-be parents should just aim to be as healthy as possible at the time of conception and not be drawn to faddy diets or other activities in order to try and influence the health of their children in ways we don’t properly understand.”

 

One in five children are obese leaving primary school

One in 10 children was obese at the start primary school in England last year but one in five was obese by the end.

One in 10 children was obese at the start primary school in England last year but one in five was obese by the end

The reserach was carried out by to the Health and Social Care Information Centre.

Although figures for Reception children have fallen slightly, the figures for obesity in Year 6 are on the rise.

Children living in the most deprived areas were twice as likely to be obese as children in affluent areas.

Campaigners said the figures should act as a wake up call.

The figures for 2014-15 come from the government’s National Child Measurement Programme for England which covers all state primary schools.

By measuring children’s weight and height and calculating their BMI (body mass index) centile, they can be put into one of four categories: underweight, healthy weight, overweight or obese.

Among children aged four and five in Reception year, 9.1% were classified as obese – compared with 9.5% in 2013-14 and 9.9% in 2006-07, when records began.

In Year 6, 19.1% of children were obese – an increase on figures from eight years ago.

While one in four or five children was overweight or obese in Reception, one in three was either overweight or obese in Year 6.

The London boroughs of Southwark, Newham, Lambeth and Tower Hamlets topped the table for obesity among children aged 10 to 11 (Year 6).

The figures showed 28% of Year 6 pupils in Southwark were classed as obese and 44% were either obese or overweight.

Wolverhampton had the largest number of obese 10 and 11-year-olds outside London.

Waverley in Surrey reported the smallest number of obese pupils – 5% in Reception and 9% in Year 6.

Eustace De Sousa, national lead for children, young people and families at Public Health England, said tackling obesity was a major priority.

“While it is encouraging to see that overweight and obesity in children are levelling off, these figures are still unacceptably high and much worse in the poorest areas. The doubling of obesity levels between ages 4 and 11 is deeply concerning and highlights that much more needs to be done to help children and families.”

“We are committed to supporting local authorities by improving awareness locally, promoting the evidence behind ‘what works’ and providing advice to families through our Change4Life campaign.”

Why a stir fry diet could protect against osteoporosis

A stir fry diet, rich in soy, could protect women from bone weakening and osteoporosis in older women, a new study suggests.

A stir fry diet, rich in soy, could protect women from bone weakening and osteoporosis in older women, a new study suggests.

Women become more susceptible to the brittle bone disease after going through the menopause as levels of protective oestrogen fall.

Since soybean foods contain plant chemicals called isoflavones that mimic the hormone, it has been suggested they might combat some effects of the menopause.

“Supplementing food with isoflavones could lead to a significant decrease in the number of women being diagnosed with osteoporosis”
Dr Thozhukat Sathyapalan, University of Hull

To test the theory, 200 women in early menopause were either given a daily supplement containing soy protein with 66 milligrams of isoflavones, or one only containing soy protein for six months.

Women on the soy-plus-isoflavones supplement had significantly lower levels of a blood protein marker of bone loss, suggesting a reduced risk of osteoporosis. They also had less risk of heart disease than those taking soy protein alone.

Lead researcher Dr Thozhukat Sathyapalan, from the University of Hull, said: “We found that soy protein and isoflavones are a safe and effective option for improving bone health in women during early menopause.

“The actions of soy appear to mimic that of conventional osteoporosis drugs.

“The 66mg of isoflavone that we use in this study is equivalent to eating an oriental diet, which is rich in soy foods. In contrast, we only get around 2-16mg of isoflavone with the average Western diet.

“Supplementing our food with isoflavones could lead to a significant decrease in the number of women being diagnosed with osteoporosis.”

Senior Woman Receiving Assistance Walking up StairsA diet rich in soy could prevent damage from falls and make bones stronger Photo: ALAMY

Bones grow and repair themselves rapidly during childhood and youth, but the process slows down with age and bone density begins to diminish from the age of 35. Women lose bone rapidly in the first few years after the menopause which can lead to osteoporosis and the risk of fractures.

Around three million people suffer from osteoporosis in the UK and more than 300,000 people receive hospital treatment for fractures every year because of the condition.

Exercise and eating foods which are rich in calcium and vitamin D, and getting enough sunlight, are essential for healthy bones, but this is the first study to show that soy can also help prevent fracturing.

Next the scientists plan to investigate the long-term effects of taking soy protein and isoflavone supplements and whether they have benefits beyond bone health.

The findings were presented at the Society for Endocrinology’s annual meeting in Edinburgh.

Two thirds of Britons will be overweight or obese by 2025

Two thirds of Britons will be overweight or obese by 2025, new figures from the World Obesity Federation suggest.

Two thirds of Britons will be overweight or obese by 2025, new figures from the World Obesity Federation suggest.

Within just ten years, seven in ten men and 62 per cent of women will be carrying too much weight, placing a huge health burden on the NHS.

Weight gain is a risk factor for many health problems, including diabetes, heart disease, stroke and some cancers. Obesity and diabetes already costs the UK over £5billion every year which is likely to rise to £50 billion by 2050.

Currently around 66 per cent of men are overweight or obese and 57 per cent of women. However 74 per cent of men will be overweight or obese by 2030 and 64 per cent of women according to new figures.

The figures are in sharp contrast to countries like Belgium, Germany and Finland where the number of overweight or obese people is expected to barely change in the next decade.

In 2011 the World Health Organisation (WHO) set a goal for 2025 of no increase in obesity or diabetes beyond 2010 levels. But no country is set to achieve that target.

The WOF said that the government must act to impose taxes on fatty and sugary foods and make healthy food cheaper. However Jeremy Hunt, the health secretary has ruled out any measures, claiming that the food industry is already voluntarily working to make products more nutritious.

Dr Tim Lobstein, Director of Policy at the World Obesity Federation said ìCommon risk factors such as soft drink consumption and sedentary working environments, have increased, fast food advertising continues and greater numbers of people live in urban environments without access to green spaces.

ìGovernments should take a number of actions to help prevent obesity, including introducing tough regulations to protect children from the marketing of unhealthy food and introducing taxes and subsidies to make healthier food cheaper and unhealthy food more expensive.î

The figures show that within the next 10 years, nearly five million more men and women will become overweight or obese in Britain bringing the total to 36 million. The number of severely obese adults will also rise by 40 per cent from three million people to more than four million.

WOF Professor Walmir Coutinho, said ìThe obesity epidemic has reached virtually every country worldwide, and overweight and obesity levels are set to continue to rise. Governments know the present epidemic is unsustainable and doing nothing is not an option.

They have agreed to tackle obesity and to bring down obesity prevalence to 2010 levels by the year 2025.

ìIf governments hope to achieve the WHO target of keeping obesity at 2010 levels, then the time to act is now.î

Asked about the prospect of missing its target, the World Health Organisation said: “Indeed the rates of overweight and obesity are increasing globally.

ìWHO has not made predictions on what the prevalence of overweight and or obesity may be in 2020 (the next reporting period) or at the final reporting period of 2025 as we can’t assume the rate of increase will continue and we must take into account the changing of global population structures.

“We do not see at this time that the current global target of ‘no increase in obesity’ will be met in adults or adolescents unless urgent focused action to reduce overweight and obesity is taken by countries and other stakeholders.”

Sweating in the gym may not lose weight

Exercise is the world’s best drug- it’s just not a weight loss drug.

Exercise is the world’s best drug- it’s just not a weight loss drug.A friend complained recently about not losing her winter paunch this summer despite swimming almost daily at the beach, combined with aerobic and weight workouts at the gym. When I pointed to the double scoop of ice cream she was happily devouring, she replied that she thought she had earned a reward for all her physical efforts.

My friend was operating under a fanciful illusion which is promoted by the fitness centre industry and glossy magazines: if you work out regularly, preferably with an expensive trainer or the magazine’s special exercises, you will lose weight and attain the body of your dreams.

But there is no scientific support for this notion. In fact, the evidence is quite the opposite. “You can’t outrun your fork,” says Yoni Freedhoff, an assistant professor of medicine at the University of Ottawa and founder of Canada’s Bariatric Medical Institute, which advises patients on non-surgical weight management.

“People tend to eat back their exercise,” Dr Freedhoff says. He notes there is an “unfair balance” between calorie consumption and calorie burning. It takes only a couple of minutes to gulp down a KitKat but the chocolate bar’s calories require more than an hour of heavy, sweaty exercise to burn off.

In fact, in one frequently cited study reported in the Journal of the American Medical Association, a group of 467 obese women was divided into four groups and put on an exercise regime with different levels of intensity; at the end of six months, none of the four groups had lost any weight.

One reason for this problem may be what is known scientifically as “hedonic compensation”, or rewarding yourself for doing something that you find unpleasant.

Carolina Werle, an assistant professor of marketing at the École de Management in Grenoble, France, recently conducted three fascinating experiments to see why people fail to lose weight with exercise.

For example, one group of people was told to engage in a fun walk while another group was given the exact same programme but was told that it was a specific form of exercise. At the end of the programme, both groups were taken to an all-you-can-eat buffet lunch. The group that had been told to exercise loaded up on fattening side dishes and pudding while the fun group ate less.

“The lesson is that the more fun we have while exercising, the less we will feel the need to compensate for it by eating more fattening food,” Ms Werle says. “It was just the perception of the activity that was different.”

Another myth, Dr Freedhoff says, is that more exercise will result in greater weight loss. Studies show that people who exercise for more than the recommended 150 minutes a week do not lose more weight than those who exercise less. They continue to gain weight, just at a slower pace, he says.

No one is suggesting that people abandon exercise programmes simply because they are not a good way to lose weight.

“The sad truth is there is nothing more beneficial to health than exercise,” Dr Freedhoff says. “When people don’t lose weight with this intervention, then they quit because the one thing they were told it was going to do, it doesn’t do.

“Exercise is the world’s best drug. It’s just not a weight loss drug.”

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Healthier lifestyles could cut cancer cases by a third

About a third of cancer cases in the UK could be prevented if people ate healthily, exercised more and cut down on alcohol according to new research.

About a third of cancer cases in the UK could be prevented if people ate healthily, exercised more and cut down on alcohol according to new research.Exercise is an important way of keeping fit and cutting body fat, which is linked to the risk of developing cancer

Data from the World Cancer Research Fund suggests that 20,000 cases of breast cancer and about 19,000 cases of bowel cancer could be stopped each year with small changes in lifestyle.

In 2013, there were more than 351,000 new cases of cancer in the UK. The WCRF said 84,000 could have been prevented.

Head of research Dr Rachel Thompson said simple changes to diet and lifestyle could make “a huge difference” in the battle against cancer.

“Even minor adjustments, like 10 to 15 extra minutes of physical activity each day, cutting down on alcohol, or limiting your intake of high calorie foods and sugary drinks, will help decrease your cancer risk,” she said.

She said that after cutting out smoking, being a healthy body weight was the most important thing people could do to cut their risk of getting cancer.

“There is strong evidence that being overweight or obese increases the risk of 10 cancers,” she said.

The link between a healthy lifestyle and the risk of developing cancer is well known, and this new data looks at preventable cases in 13 of the UK’s most common cancers.

For example, among men, 9% of cases of advanced prostate cancer could be prevented every year if men were not overweight or obese.

Lung cancer cases could be cut by 15,000 (33%) by getting people to stop smoking.

And 38% of breast cancer cases could be prevented, particularly in postmenopausal women, by increasing physical exercise and reducing body fat.

The WCRF also said that 2,200 cases of kidney cancer and 1,400 cases of pancreatic cancer could be prevented if people adopted a healthier lifestyle.

Prof Kevin Fenton, director of health and wellbeing at Public Health England, said the UK was currently behind on cancer survival rates compared with other European countries.

He said one major factor was that cancer prevention was not in the public consciousness.

“The link between tobacco and cancer is widely known and readily accepted by the public, but many are not yet fully convinced that healthy eating, regular exercise and not drinking alcohol, can lower your cancer risk.”

Combine fasting and a cardio workout to shed weight quicker

What is the best way to lose weight? This question is particularly relevant when we tend to abandon good dietary habits on holiday and overindulge.

What is the best way to lose weight? This question is particularly relevant when we tend to abandon good dietary habits on holiday and overindulge.Much has been written about the effectiveness of the so-called 5:2 diet, which was popularised by a BBC television programme and involves restricting calories by 75 per cent on two non-consecutive days and then eating normally for the rest of the week.

Another way of implementing this kind of diet, which is known as intermittent fasting, or IF, is to cut back to 500 calories or eliminate food entirely on alternate days.

Intermittent dieting has been well studied and offers all the benefits of eating less, while reducing the problem of sticking with a reduced-calorie intake on a daily basis. After all, you get to eat normally most days. But there is a way to boost the health benefits of this kind of diet and supercharge your weight loss by adding cardio exercise to the mix.

A team of researchers at the University of Illinois divided obese volunteers into four groups: one group practised alternate-day fasting; a second group practised endurance exercise three days a week; a third group did both IF and exercise for 12 weeks; and the fourth control group did none.

The results were pretty striking: the combined exercise and IF group lost an average of 6kg, compared with 3kg weight loss for the IF-only group and just 1kg for the exercise group.

Interestingly, not only did the diet-and-exercise combination produce more weight loss, but it also helped the subjects’ blood lipid profiles, which are an indicator of heart attack risk. In the group that did both endurance exercise and restricted calories, so-called “bad” LDL cholesterol decreased 12 per cent from the baseline, while the “good” HDL cholesterol increased by an impressive 18 per cent. The other interventions produced no HDL benefit.

What is interesting about this and similar studies is that there has been a growing consensus that diet is much more important than exercise in maintaining good weight. But it is now clear that the two in combination are much more effective than either approach alone.

In addition, the endurance training in this study, which was performed on exercise bikes and elliptical machines in a gym, lasted 25 minutes and was at just 60 per cent of maximum heart rate, growing incrementally to 75 per cent of the maximum at the end of the study.

Surabhi Bhutani, the postdoctoral researcher who led the study, says this is because the subjects were obese and the researchers wanted to avoid the risk of cardiac problems.

But there is quite a lot of evidence that high-intensity interval training, or HIIT, involving short bursts of exercise at close to the maximum heart rate, followed by recovery periods, or slightly longer bursts of cardio exercise at 90 per cent of maximum heart rate, is more effective than slow endurance training. And it has the added benefit of taking less time.

 From: http://www.ft.com/cms/s/0/652a7eb2-1bec-11e5-8201-cbdb03d71480.html