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Bad for your health? <em>Picture: Evert F Baumgardner</em>

Bad for your health? Picture: Evert F Baumgardner

Apparently watching six hours of television per day can shorten your life by five years. Researchers in Australia have come up with this finding – and warn that watching too much TV could be a public health hazard on a par with smoking and being obese.

Indeed, they go further than this and, writing in the British Journal of Sports Medicine, point out that if one cigarette cuts life expectancy by 11 minutes, watching half an hour’s telly can be just as bad.

A fix of Lambert & Butler or EastEnders? It’s a tough one, but it seems both are going to kill you.

There is hope, however. Some other researchers – this time in Taiwan and writing in the über-respected Lancet – say that just 15 minutes of physical activity per day reduces a person’s risk of death by 14 per cent and increases life expectancy by three years, compared with inactive people. Each further 15 minutes of exercise reduced mortality from all causes by a further 4 per cent.

Like the Australians, the Taiwanese researchers also draw comparisons with smoking. “In Taiwan, if inactive individuals engage in low-volume daily exercise, one in six all-cause deaths could be postponed – mortality reductions of similar magnitude have been estimated for a successful tobacco control programme in the general population.”

Since reading the press releases for both these studies – they arrived on the same day for publication at roughly the same time – my brain has been in a bit of a mathematical spin. Never very reliable with figures, I’ve been trying to do the sums to see if one would balance out the other.

In other words, if I spent six hours watching telly (therefore chopping five years off my life) but then did 15 minutes exercise, would that mean a net loss of two years? And if I upped the exercise sufficiently, would that mean that I could negate the life-sapping properties of too much TV in their entirety?

And surely the two would be connected. Leaving aside how anyone could actually spend six hours a day watching television (no, not being snobbish here – just finding it hard to think about when you’d fit it in), it tends to involve sitting down. So could you cancel the effect of watching The Hour, say, by doing so while clocking up the miles on a treadmill?

That got me thinking about other ways to increase – or decrease – a normal lifespan, so I turned to Google. Putting in the words “may help you live longer” got a stonking 172 million hits in 0.15 seconds. From news sources of varying reliability, I learn that having supportive colleagues, getting good grades, owning a pet, eating a high-fibre diet, calorie restriction and regular shopping (oh dear, I think I wrote that one up) appear to improve longevity.

That’s just the first page of about a gadzillion; scrolling further suggests – controversially – that worrying might help you live longer, but this is quickly counterbalanced by another study saying that meditation and relaxation is the way to go for a longer life.

Cheeringly, drinking red wine and having a big bottom may also help you live longer, according to other studies (the former reported in the Daily Telegraph and the latter referring to a study from Oxford, therefore they must be true).

Just for balance, I then tried to find stories about things that shorten life (using the less than catchy search term “shorten life expectancy”). Air pollution, childhood obesity, serious mental illness, “excess body fats in older adults” were all among the top results of around 111 million returned within the obligatory 0.15 seconds.

Diabetes, medicine for insomnia or anxiety and being underweight were also among the far from joyful suggestions.

Just for fun, I then searched on “Daily Mail shorten life” and got an astonishing 285 million results – with the factors including having a toyboy (thanks, Bel Mooney), being overweight, yo-yo dieting and binge eating, taking vitamins and the “heartache from losing a loved one”.

For even more hilarity (yes, my life is that exciting), I decided to look at a particular substance on which researchers have differing views: coffee. In the Daily Mail alone, I found out that abstaining from drinking filter coffee can cut the risk of heart disease by 15 per cent. This contrasts, however, with a Mail article from five months earlier which suggests that a coffee a day may cut stroke risk by 25 per cent.

So who do we believe? Sample size, the institution in which the researchers are based, and the journal in which the results are printed all have an impact on how much you can rely on research.

Actually looking at the papers on which the headlines are based is a help; handily enough, many journals – including those owned by the BMJ group – make their contents freely available online.

That shows us, for example, that the Australian research on telly killing you (I paraphrase – irresponsibly, I know) is based on analysis of data in a respected national survey (the Australian Diabetes, Obesity and Lifestyle Study), which involves more than 11,000 adults. The authors constructed a risk framework for the Australian population based on the answers the participants had given when asked about the time they spent watching TV or videos. From this, they estimated that every single hour of TV watched after the age of 25 shortened the viewer’s life expectancy by just under 22 minutes.

Importantly, the authors do not claim to be making a causal link – their work does not say it is watching the box per se that kills you – but they suggest that if further work uncovers a causal link then “TV viewing is a public health problem comparable in size to established behavioural risk factors [eg smoking, obesity]”.

The Lancet paper is also based on a reassuringly large sample size – 400,000 Taiwanese people – and, like the Australian study, is in a respected, peer-reviewed (so called “high-impact”) journal. Again, it has credibility and, importantly, the authors in such journals all have to declare any funding or other sources of possible conflict of interest.

Other studies – often published in journals you’ve never heard of and based on single or three-figure sample sizes – deserve to be treated with more scepticism, especially if the authors are funded by the interest group whose product comes out well in the “research”.

How people get scientific and other information was the subject of a recent investigation by Westminster’s Science and Technology Committee. The report concludes that although the current system of “peer review” (where papers are published only after they have been “passed” by experts in the field) has grown up in a “haphazard and piecemeal manner” and should be reformed, it is still of some value.

The committee recommends creation of an independent regulator to ensure research integrity – basically making sure that research which is published is robust and ethical and that we lay people can rely on it.

So where does that leave us with how to report on the two papers published today? Surely there’s only one possible message: if you want to live long enough to know if Chris (the wife-beating builder in Coronation Street) is going to die from his brain tumour, then stop watching so much telly.

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KFC in Dundee <em>Picture: Pamela Adam</em>

KFC in Dundee Picture: Pamela Adam

Customers at several major fast food chains, including McDonald’s, were more inclined to buy lower-calorie meals after the introduction of a menu labelling system in the US, researchers have found.

Around one in six fast food consumers overall used calorie information and made healthier choices following a law introduced in New York in 2008, which made labelling of menus and menu boards compulsory for chain restaurants with more than 15 branches nationally.

A similar approach – albeit on a voluntary basis – is due to be introduced in England shortly. According to the Scottish government, some of the chains taking part also operate in Scotland and the government will be monitoring the effects.

Several studies have backed the idea that eating fast food is associated with taking in too many calories, but customers often underestimate the energy content of food they order from restaurants. A team of researchers decided to assess the impact of the calorie labelling regulation on the calorie content of purchases at fast food outlets in New York City.

They carried out surveys at lunchtimes in spring 2007, a year before the regulation was introduced, and in spring 2009, nine months after it came into force, at 168 randomly selected locations of the top 11 fast food chains in the city. Adults were asked to answer survey questions and provide till receipts – around 7,300 in 2007 and 8,500 in 2009.

Although there was no decline in calories purchased when the entire sample was considered, three major chains saw significant reductions – at McDonald’s, average energy per purchase fell by 5.3 per cent, at Au Bon Pain by 14.4 per cent and at KFC, by 6.4 per cent. These three chains represented 42 per cent of all the customers in the study.

Customers of Subway, however, increased the average energy content of their purchases by 17.8 per cent, at a time when large portions were being heavily promoted.

The survey showed that 15 per cent of customers reported using the calorie information and, on average, these customers bought 106 fewer calories than those who did not see or use the calorie information.

Writing in bmj.com, the researchers say that calorie labelling is only one part of a framework to address the obesity epidemic, and that additional strategies to reduce energy intake across the piece should be implemented. “Special attention should be focused on educating customers on how to interpret and use nutrition information,” they add.

The research does, however, suggest that regulation may have a part to play, although calorie labelling is only one element. Also writing in bmj.com, Dr Susan Jebb from the MRC Human Nutrition Research Centre in Cambridge said that labelling is a step forward, but that more action is needed. “Calorie labelling will help consumers make an informed choice about what they eat, but sustained improvements in the nation’s diet will require a transformation of the food supply too.”

A Scottish government spokeswoman said the issue was being taken seriously in Scotland: “We recognise the benefits of providing such information to consumers so that they are more aware of the nutritional composition of their food and to them make informed dietary choices.

“Work on ‘out of home’ calorie labelling, initiated originally by the UK FSA [Food Standards Agency], has been continued by the UK Department of Health following the transfer of nutrition policy from the FSA in England and Wales last year. The UK Department of Health has recently published guidance on voluntary calorie labelling for caterers as part of the Responsibility Deal. A number of companies have now signed up to that deal, some of which operate in Scotland.

“The FSA in Scotland, along with their counterparts in Northern Ireland, plan to follow up those UK companies that are active in Scotland and Northern Ireland to ensure that they are pursuing out of home calorie labelling here. We will continue to work with Scottish government and the food industry here to ensure that consumers have the information and understanding they need to make informed choices about where and what they eat.”

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European food <em>Picture: Andrew Dunn</em>

European food Picture: Andrew Dunn

Scientists at Aberdeen University have discovered a genetic “switch” which they believe makes Europeans far more likely to choose high-fat food and alcohol than people in Asia. The findings also have implications for depression.

The switch – essentially a piece of DNA which turns genes on and off within cells, and which is also known as an enhancer – has remained unchanged for 300 million years, according to the researchers at the university’s Kosterlitz Centre. This particular switch controls the galanin gene, which regulates appetite and thirst in the hypothalamus area of the brain.

Peterhead scientist Dr Scott Davidson, who found the switch, explained that while our genes – 25,000 of them in every cell – are near-identical in all mammals, what makes us different from other species – and, indeed, from each other – is when, where and how the genes are turned off and on during development (as embryos) and throughout life.

“Not all cells turn on all genes at once,” Dr Davidson said. “Something organises which genes are turned on in different cells and we call them enhancers or switches.”

The switch is, however, different in some people and, when different racial groups were compared, it was found it was weaker in 16 per cent of Europeans and 30 per cent of Asians.

Dr Alasdair MacKenzie, who led the research, said that if the switch was turned on too strongly, then people were more likely to crave fatty foods and alcohol. “The fact that the weaker switch is found more frequently in Asians compared to Europeans suggests they are less inclined to select such options.”

Dr MacKenzie suggests that we can probably blame our ancestors’ way of life for the tendency. “These results give us a glimpse into early European life where brewing and dairy produce were important sources of calories during the winter months,” he said.

“Thus, a preference for food with a higher fat and alcohol content would have been important for survival. The negative effects of fat and alcohol we see today would not have mattered so much then as life expectancies were between 30–40 years.”

The study, published in the Journal of Neuropsychopharmacology, also found that changes in the same switch were linked to depression, because galanin is also produced in the anxiety and fear-controlling amygdala part of the brain. Recent research conducted by a team at the Institute of Psychiatry in London showed that the galanin gene is linked to depression and that part of a relevant gene is strongly related to the Aberdeen team’s switch.

There is hope that we can overturn the millennia of genetic determination, however – we might be able to get a pill to sort it out. “This has already allowed us to identify potential drug targets that will be used to develop a whole new generation of antidepressants as well as drugs to reduce cravings for fatty food and alcohol,” Dr Davidson added.

“It is possible that during the winter individuals with the weaker switch may not have survived as well in Europe as those with the stronger switch and as a result those in the west have evolved to favour a high fat and alcohol rich diet.”

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<em>Picture: Alex Anlicker</em>

Picture: Alex Anlicker

A Glasgow GP is warning consumers that they should “just say no” to those trying to urge them to drink more of a popular beverage.

The drink promotion which has raised the ire of Margaret McCartney concerns neither Buckfast nor strong cheap cider – nor indeed does it contain any alcohol at all. Rather, she has turned her fire on water.

Writing in the British Medical Journal, Dr McCartney has denounced the recommendation to drink six to eight glasses of water per day to prevent dehydration as “not only nonsense, but thoroughly debunked nonsense”.

Anyone who has worked in an office has seen the increasingly large bottles of water as regular fixtures on people’s desks – as seen in this Smack the Pony sketch on “water bottle envy”.

But Dr McCartney says there is no clear evidence of benefit from drinking increased amounts of water, although the “myth” that “we-don’t-drink-enough-water” has endless advocates, including the NHS.

She criticises the NHS Choices website for perpetuating this, and wonders at schools which insist that pupils are accompanied to school by a water bottle.

She also warns that many of the messages promoting the policy – and the research used to back it up – have come from those with vested interest, including marketers of bottled waters.

She cites the campaign Hydration for Health, which recommends taking 1.5 to 2 litres of water daily as “the simplest and healthiest hydration advice you can give” and says that “even mild hydration plays a role in the development of various diseases”. Hydration for Health was created by the French food company Danone, whose products include Volvic and Evian bottled water.

Dr McCartney argues that there is no high-quality evidence to support these claims and says there are studies which show no clear evidence of benefit from drinking increased amounts of water and which suggest there may even be unintended harms attached to an enforcement to drink more water.

“It would seem, therefore, that water is not a simple solution to multiple health problems,” she writes.

She quotes a paper from 2002, published in the American Journal of Physiology, which looked at the evidence around drinking increased amounts of water to prevent dehydration. “He concluded that ‘not only is there no scientific evidence that we need to drink that much, but the recommendation could be harmful, both is precipitating potentially dangerous hyponatremia [an electrolyte imbalance where the body’s concentration of sodium is too low] and exposure to pollutants and also in making many people feel guilty for not drinking enough’.”

An editorial in the Journal of the American Society of Nephrology, published in 2008, reached much the same conclusion, writes Dr McCartney.

Although she accepts that children in school should have access to water when they are thirsty, Dr McCartney disputes the suggestion (reported by the BBC in 2000) that increased water intake led to an improvement in test results. “The research has not been published in a peer reviewed journal and the water intervention seems to have been part of a raft of changes in school,” she says, and adds that data relating water drinking to better weight control in children were prone to bias.

There are some conditions that do benefit from drinking more water, such as recurrent kidney stones, but other evidence for preventing disease is conflicting. In other words, it’s a complex situation not easily remedied by telling everyone to drink more.

“There are many organisations with vested interests who would like to tell doctors and patients what to do,” Dr McCartney concludes. “We should just say no.”

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Barrier contraception: Not a staple of romantic fiction. <em>Picture: Robert Elyov</em>

Barrier contraception: Not a staple of romantic fiction. Picture: Robert Elyov

An agony aunt and broadcaster has hit out at romantic novels for the impact they have on women’s sexual health.

In a paper entitled: “He seized her in his manly arms and bent his lips to hers”, Susan Quilliam argues that the “rose-tinted” view of relationships in the likes of Mills and Boon publications makes itself felt in the problems which women bring to the consulting room.

In particular, she blames romantic fiction for dissuading women from using condoms, saying: “To be blunt, we like condoms – for protections and contraception – and they don’t.”

Ms Quilliam’s contention, published in the latest issue of the BMJ Group’s Journal of Family Planning and Reproductive Healthcare, is that women are in the “grip” of idealised love and sex “purveyed in romantic fiction”. Although she confesses a teenage addiction to Georgette Heyer’s Regency romances – and admits the books can be fun and enjoyable – she suggests the genre isn’t doing women any favours overall.

“I would argue that a huge number of the issues we see in our clinics and therapy rooms are influenced by romantic fiction,” she writes. “What we see is more likely to be influenced by Mills and Boon than by the Family Planning Association.”

Romantic fiction accounts for almost half the fiction titles bought in parts of the developed world, she says, and although it has come a long way in terms of depicting a more realistic view of the world, a “deep strand of escapism, perfectionism and idealisation runs through the genre”.

Drawing a distinction between classic romances – where girl meets boy in the first chapter and is irrevocably committed to him by the last, with no diversions – from “chick lit”-style books like Bridget Jones (where unambiguous happy endings aren’t a must and where there are lots of diversions and sub-plots), she says some fans read a book every two days. This means that women are exposed to more of the romantic fiction’s vision than they are to formal sex and relationship education.

Common motifs in romances include non-consensual sex, female who are “awakened” by a man rather than being in charge of their own desires. The books also raise unrealistic expectations – for example, that heroines always achieve a life filled with multiple orgasms (without clitoral stimulation) and trouble-free – and frequent – pregnancies to “cement their marital devotion”.

“Clearly these messages run totally counter to those we try to promote,” she writes. “We don’t condone non-consensual sex. We want women to be aware of their own desires rather than be ‘awakened’. We aim to reassure our female clients that their first time may not be utterly joyful and that they may not gain reliable orgasms through penetration, but that they themselves are nonetheless existentially valid and that with affection and good humour things can improve immensely.”

We warn of the stresses of pregnancy and child-rearing and we discourage “relentless baby-making” as proof of a relationship’s strength, she adds. “Above all, we teach that sex may be wonderful and relationships loving, but neither are ever prefect and that idealising them is the short way to heartbreak.”

The condom issue is of particular concern, she says, with one study showing that only 11.5 per cent of romantic novels studied mentioned condoms – and even here, heroines typically rejected them, wanting “no barrier” between her and the hero.

“While the romance readers interviewed said that they knew that such episodes were diction, and that spontaneous sexual encounters are never risk-free, nevertheless there was a clear correlation between the frequency of romance reading and the level of negative attitude towards condoms and the intention to use them in the future.”

On the upside, other studies have suggested that reading romantic novels has encouraged women to have more sex, more adventurous sex and more experimental sex. Women also reported that they did not negatively compare their own real-life partners with fictional heroes unless the partnership was already rocky. Women might also use the books to nourish love and rekindle sex lives.

On the whole, however, she warns that if women start to believe the story that romantic fiction offers, then they store up trouble for themselves.

“If a woman learns from her 100 novels a year that romantic feeling is the most important thing, then what follows from that might be to suspend her rationality in favour of romanticism,” she says. This could mean she doesn’t want to use protection with a new man because she wants to be swept up in the moment as a heroine would. It could also mean she panics if sexual desire takes a nosedive after pregnancy or due to stress, causing her to think that the relationship has died with the romance.

“Sometimes the kindest and wisest thing we can do for our clients is to encourage them to put down the books – and pick up reality.”

<em>Picture: jules</em>

Picture: jules

By Elizabeth McQuillan

A randomised controlled trial on the effect of lifestyle changes in obese men has shown that healthy lifestyle factors are associated with the maintenance of erectile function.

The Italian researchers studied 110 obese men with erectile dysfunction (male impotence) and randomly assigned the participants to either lose weight or be in a control group.

Both groups had various pertinent – and very private – tests performed at the begininning and end of the two-year study, with the weight-loss group advised on health eating and lifestyle choices throughout.

The lads who opted for the healthier food choices and a bit of exercise enjoyed higher erectile function scores, with almost one third no longer experiencing a problem. In fact, the more they exercised and ate healthily, the more their erections improved.

Alternative research from Harvard University suggests that men who ran for 90 minutes or who did three hours of rigorous outdoor work per week were 20 per cent less likely to develop erectile dysfunction than those who didn’t exercise at all. More physical activity conferred an even greater benefit: men who ran two-and-a-half hours per week were 30 per cent less likely to develop the condition than were their sedentary counterparts.

It isn’t really all that surprising when you consider the role that the cardiovascular system plays in circulating blood to all the necessary places.

Exercises that strengthen the pelvic floor muscles, especially the pubococcygeus muscle, may also help with erectile dysfunction. To locate your pubococcygeus muscle, you should be able to give a discreet “squeeze” to find it – it’s the one you flex when you need to stop peeing or ejaculation. For those with a very weak muscle, who are struggling to feel its whereabouts, medical literature suggests tightening the anus around a lubricated finger to isolate.

The use of Kegel exercises develops better muscular control of the pelvic floor. According to some sources, as yet unverified, strengthening the pelvic floor may also allow some men to achieve a form of orgasm without allowing ejaculation, and thereby perhaps to reach multiple climaxes during sexual activity.

The Kegel technique appears simple enough: “Use a ‘squeeze, hold, release’ pattern. You squeeze the muscle, hold for several seconds, and release. Gradually, you would like to be able to build up to a hold of ten seconds, repeating the ‘squeeze, hold, and release’ ten times.

“When you perform the exercise correctly, you should be able to feel or see the testicles lift. This takes time for some men. But, if you practice the routine regularly, you should notice an improvement in 4–6 weeks.”

If squeezing and releasing fails to improve performance, then a specially designed vacuum pump (not a Dyson) that increases blood flow to the penis can also successfully treat many cases.

However, erectile dysfunction can be caused by an underlying health condition, such as heart disease or diabetes, so it’s important to talk to your GP if things aren’t working as they should. Treating the underlying cause may also resolve the problem of erectile dysfunction.

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Rob Summers on a treadmill <em>Picture: Rob Summers / The Lancet</em>

Rob Summers on a treadmill Picture: Rob Summers / The Lancet

A paraplegic man who was completely paralysed below the chest in a car accident is now able to stand independently, to walk with assistance and move his legs voluntarily, thanks to pioneering epidural treatment.

Rob Summers, 25, who sustained the injuries in 2006, has also regained some sexual and bladder function following the treatment – which was made possible, in part, by funding from the Christopher and Dana Reeve Foundation, named after and supported by the late Superman actor and his wife.

Doctors are cautioning that much more work needs to take place before the treatment becomes standard practice, but nevertheless they are hailing it as a remarkable breakthrough.

The treatment involved continual direct electrical stimulation of Mr Summers’ lower spinal cord, mimicking signals that the brain normally transmits to make us move. Once the signal is received, the spinal cord’s own neural network – combined with sensory input from the legs to the spinal cord – is able to direct the muscle and joint movements needed to stand, and to step with assistance on a treadmill.

The treatment also involved retraining the spinal cord neural networks to produce the muscle movements needed to stand and take supported steps. The training process took more than two years to complete, after which the electrostimulation device was surgically implanted in the patient’s back.

Before the device was implanted, Mr Summers had no voluntary control – but now, as well as standing and taking assisted steps, he can move his hips, knees, ankles and toes.

A set of five downloadable videos provided by The Lancet show various stages of Mr Summers’ treatment:

* Standing with bodyweight support and epidural stimulation (4–8V, 15Hz). Bodyweight support was reduced to 5 per cent without the need of manual facilitation.

* Sit to stand with caudal stimulation (7·5V, 15Hz).

* Full weight-bearing standing with epidural stimulation (9V, 25Hz) without manual facilitation.

* Voluntary movements (leg, ankle and toe) with epidural stimulation (4V, 30Hz) in the supine position.

* Attempts of voluntary movements (leg, ankle and toe) without epidural stimulation in the supine position.

The case is described today in The Lancet by Professor Susan Harkema of the Kentucky Spinal Cord Research Center at the University of Louisville, and Professor Reggie Edgerton of the Department of Integrative Biology and Comparative Physiology, University of California, Los Angeles.

“This is a breakthrough,” said Professor Harkema. “It opens up a huge opportunity to improve the daily functioning of these individuals … but we have a long road ahead.”

Professor Edgerton said: “The spinal cord is smart. The neural networks in the lumbosacral spinal cord are capable of initiating full weight bearing and relatively coordinated stepping without any input from the brain. This is possible, in part, due to information that is sent back from the legs directly to the spinal cord.”

He added that sensory feedback from the feet and legs to the spinal cord facilitated the individual’s potential to balance and step over a range of speeds, directions and level of weight bearing. “The spinal cord can independently interpret these data and send movement instructions back to the legs – all without cortical involvement.”

The authors caution that although the patient was completely paralysed below the chest, he did retain some feeling below the level of the injury. It is not known how the intervention would work with patients who have no feeling below the injury.

There is also an issue with the stimulation equipment itself, as – to date – the researchers have only had access to standard off-the-shelf stimulation units designed for pain relief. Further work needs to be done on drug therapy to work alongside the stimulation and training, they added.

Rob Summers before the accident <em>Picture: Rob Summers / The Lancet</em>

Rob Summers before the accident Picture: Rob Summers / The Lancet

As for Mr Summers, who was injured when a car mounted the pavement and hit him, he is delighted at the success of the treatment so far – and is optimistic that it might lead to even better things. “This procedure has completely changed my life,” he said.

“For someone who for four years was unable to even move a toe, to have the freedom and ability to stand on my own is the most amazing feeling. To be able to pick up my foot and step down again was unbelievable, but beyond all of that, my sense of wellbeing has changed. My physique and muscle tone has improved greatly, so much that most people don’t even believe I am paralysed.

“I believe that epidural stimulation will get me out of this chair.”

The research was funded by the US National Institutes of Health and the Christopher and Dana Reeve Foundation. Previously called the American Paralysis Association, the organisation was formed by individuals who refused to accept that spinal cord injuries could not be repaired. Christopher Reeve, who was paralysed in a riding accident, started working with the organisation following his injury in 1995. He died in 2004, aged 52.

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Picture: Orazio Samacchini, 1532–77</em>

Picture: Orazio Samacchini, 1532–77

Children who have been breastfed as babies are less likely to have behavioural problems than those fed only on formula, according to research published today.

A large-scale study has shown that five-year-olds who had been breastfed for at least four months had fewer behavioural problems; this was still the case even when other factors, such as socio-economic circumstances, were taken into account.

Writing in the Archives of Disease in Childhood, the researchers suggest that this could be because breast milk contains certain substances which have only recently started to be added to formula feeds. These include essential long chain polyunsaturated fatty acids, growth factors and hormones which have an important role in the development and function of the brain and central nervous system.

The authors say that the results could also be explained by the fact that breastfeeding leads to more interaction between mother and child, better learning of acceptable behaviours and fewer behavioural problems.

The researchers, from the universities of Oxford, Essex and York, and University College London, used data from a large UK study known as the Millennium Cohort Study involving 10,037 mother–child pairs from a white ethnic background. The Millennium study is a survey of infants born in the UK during a 12-month period in 2000–01. People who took part were interviewed when their child was nine months old and they were revisited at two-yearly intervals.

Within the data group studied by the researchers, there were 9,525 full-term and 512 pre-term children. Using a Strengths and Difficulties Questionnaire (SDQ) completed by the parents, they scored children to identify potential behavioural problems, including emotional (such as clinginess, anxiety), hyperactivity (restlessness), and conduct (lying and stealing), by the time the child was aged five.

Results showed that 29 per cent of children born at full term and 21 per cent of children born prematurely were breastfed for at least four months. Abnormal scores for the questionnaires (which indicate potential behavioural problems), were less common in children breastfed for at least four months (6 per cent) than in formula-fed children (16 per cent). Importantly, the effect persisted even when socio-economic and parental factors were taken into account.

The authors conclude: “Our findings suggest that longer duration of breastfeeding (at all or exclusively) is associated with having fewer parent-rated behavioural problems in term children.”

Although manufacturers of formula milk have now added many of the substances found in breast milk the effectiveness of such supplementation is unclear, the authors add.

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<em>Picture: RayNata</em>

Picture: RayNata

In just one day last month, alcohol was a factor in 5,500 general practice consultations in Scotland, according to the British Medical Association (BMA). This adds up to 1.4 million consultations per year – and 6 per cent of all visits to GPs.

The doctors’ union bases its figures on a survey conducted on 21 April, where a sample of 31 practices – around 3 per cent of all GP practices in Scotland – was asked to record all visits to doctors or practice nurses where alcohol was a factor. The practices reported that 169 consultations involved an alcohol-related problem.

The investigation is unusual, because most studies of the impact of alcohol on health services relate to secondary care – for example, the effect of alcohol-related harm on accident and emergency departments. But the BMA’s study shows that Scotland’s drinking problem is challenging all parts of the health service and the public purse – indeed, the union estimates that the GP consultations alone cost the NHS more than £28 million per year.

The survey has prompted an alliance of health campaigners to call on the various political parties to use the remaining days before Thursday’s election to outline how they would tackle alcohol issues. According to GP Dr Alan McDevitt, it is “the very least they can do for their constituencies”.

“In just one day, nurses and doctors working in general practice across Scotland saw more than 5,500 patients where alcohol had contributed to their ill health,” Dr McDevitt said. “But the patients seen in general practice are just the tip of the iceberg. The impact of alcohol misuse across the rest of the NHS, in hospitals and in our communities is far greater.”

Dr McDevitt, who practices in Clydebank and is deputy chair of the BMA’s Scottish GP committee, said the survey was about showing how much of an impact alcohol has on the everyday work of general practice. “Those who suffer from alcohol-related health problems are not just alcoholics or heavy binge drinkers. By regularly drinking over and above recommended limits, a significant proportion of the adult population is at risk of experiencing health problems that are related to the alcohol they consume, whether it is high blood pressure, breast cancer or even domestic abuse.”

Theresa Fyffe, director of the Royal College of Nursing in Scotland, added her voice to calls for politicians to say what they would do to reduce the harm caused by alcohol. “For example,” she said, “they could consider investing in more alcohol liaison nurses, who provide a whole range of support that ultimately saves the NHS money by reducing re-attendance at A&E and hospital admissions.”

In case anyone imagined that the minimum pricing issue had disappeared, Evelyn Gillan, chief executive of Alcohol Focus Scotland, issued a reminder. “For the health and well-being of everyone in Scotland, robust action must be taken to increase price,” she said.

Dr Bruce Ritson, chairman of Scottish Health Action on Alcohol Problems, said more needed to be done. “The level of harm caused by alcohol in Scotland,” he said, “concerns not only health workers but other professions, individuals, families and communities across the country. Enforcement of existing legislation is one approach, but politicians will need to recognise that most people seen in Scotland with an alcohol-related condition have not broken any law.”

Individually and collectively we are drinking at levels that compromise our health and well-being, he added. “As a society, we need to drink less.”

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<em>Picture: Tessa Carroll</em>

Picture: Tessa Carroll

Too much stress may help contribute to memory loss as we get older, researchers from Edinburgh University have suggested.

A study into mice has found that once stress levels reached a certain point, the animals were less able to remember how to navigate a maze – although small amounts of stress actually helped memory.

The discovery could help in developing drugs to treat age-related memory disorders, the scientists believe.

The researchers, led by Dr Joyce Yau at the university’s Centre for Cardiovascular Science, looked at how two receptors in older brains reacted to the stress hormone cortisol, which has been linked to increasing forgetfulness as we grow older.

They found that one receptor was activated by low levels of cortisol, and that this actually helped memory. Once levels of the stress hormone were too high, however, they affected a second receptor and activated brain processes that contribute to memory impairment.

The memory recall problem was reversed when the receptor linked to poor memory was blocked, according the study, which was published in the Journal of Neuroscience.

The study helps explain why too much stress over time interferes with the normal processes in storing memories, while a little bit of stress can actually help us remember emotional memories, the researchers say.

“While we know that stress hormones affect memory,” said Dr Yau, “this research explains how the receptors they engage with can switch good memory to poorly-functioning memory in old age.

“We now know that lowering the levels of these stress hormones will prevent them from activating a receptor in the brain that is bad for memory. Understanding the mechanisms in the brain, which affect memory as we age, will help us find ways to combat conditions linked to memory loss.”

This study was funded by the Medical Research Council, and the researchers – with help of a Seeding Drug Discovery award from the Wellcome Trust, are currently investigating a new chemical compound, 11beta-HSD1, which is involved in producing stress hormones within cells. They hope this could be used to develop a drug to slow the normal decline in memory linked to ageing, or possibly even improve memory in older people.

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