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Thursday, December 8, 2011

Red wine holds key to better health for obese patients

An ingredient found in red wine can combat the harmful effects of obesity and reduce the risk of disease in the elderly, a clinical trial has shown for the first time.When taken regularly a natural compound known as resveratrol, found in red wine and grapes, mulberries and peanuts, can offer similar benefits to low calorie diets and endurance training.

As well as lowering the metabolism – meaning the body needs less food to generate enough energy – it can reduce levels of liver fat, blood pressure and blood sugar.

The compound also improves the rate at which the muscles burn fat, lessens insulin resistance and could protect against certain age-related diseases like Type 2 diabetes and cancer, experts said.

Unfortunately, to consume the amount of resveratrol given to patients in the study a wine-drinker would need to work their way through more than 13 bottles a night, doing far more harm than good!

But researchers said the 150mg dose could easily be taken as a daily capsule with water, or incorporated into existing food supplements.

Prof Patrick Schrauwen of Maastricht University in The Netherlands, who led the study, said the benefits of resveratrol for obese people were small but significant.

He said: “I think the positive thing is that they were very consistent, they cause a small difference on a lot of different parameters.

“Also, we only gave it to patients for 30 days and we do not know what would happen if we gave it for longer. Metabolic changes can take a while before they start to appear so it is quite possible the effects could be larger.”

Dr Andrew Murray, of Cambridge University, who was not involved in the study, said it provided the first real evidence that resveratrol could have a significant effect in humans.

He said: “Although the effects are slight they could make all the difference to people with metabolic complications like obesity.

“What is very exciting about this is that there are many problems related to obesity and the onset of diabetes, and what this study seems to show is that it is not going to make people thin again but it could slow down all the problems associated with lifelong obesity.”

The researchers gave daily injections of resveratrol to 11 obese male patients for a month and found it altered their metabolism in a similar, although weaker, way than extreme dieting or endurance training.

The treatment lowered systolic blood pressure by 5mmHg and reduced the amount of energy participants used by two to four per cent, indicating that their metabolism had slowed down.

Biologically speaking this is healthy because it means we require less energy and need to eat less, but the researchers admitted that burning fewer calories may not be desirable for obese patients.

Prof Schrauwen said: “In our society with so much obesity people want to have a high metabolism because it is easier to lose weight.

“But the lowering of your energy metabolism is actually a good thing because it means that you become more efficient.”

Because the eleven patients tested in the study, published in the Cell Metabolism journal, were all obese men it is not clear whether slimmer people would benefit in the same way.

Prof Schrauwen said: “I can imagine it will work better in people who already have some disturbances in their metabolism – if your blood pressure and blood glucose are normal, then it might not be lowered.”

Researchers seek diabetic patients for diabetes dating agency

A massive recruitment drive is under way to match up thousands of diabetic patients with diabetes research projects aimed at finding a cure for the disease.The scheme is being likened to a kind of “dating agency” that puts researchers and patients in contact.

Researchers say about 30% of cancer patients may be taking part in clinical trials, but for diabetes that figure is less than 1%.

About 2.8 million people in the UK are known to have diabetes.

But the charity Diabetes UK believes another 800,000 people may not know they already have the disease.

Part of the reason researchers have found it hard to find diabetes patients is that most only see their GP.

But three regions in England have been chosen to pilot a scheme which aims to offer 25,000 patients, with any form of diabetes, the chance to take part in clinical trials or other forms of research.

A recruitment drive is taking place in north east London, the south west and the north west of England.

Prof Martin Gibson, from the Diabetes Research Network at Salford Royal NHS Foundation Trust, says clinical trials are essential in order to find better treatments for diabetes – or even a cure.

“Pretty much everyone I talk to with diabetes is interested in research but they don’t get the opportunity.  It’s not like cancer where people are increasingly offered the chance to take part in research projects.”

“Part of the problem is that people with diabetes are very often out in the community, which is not where the researchers are.  So what we’re trying to create is a dating agency so we can bring the two groups together, because both are very interested in trying to find a cure for diabetes.”

Diabetes UK estimates that about 10% of the total NHS budget across the UK is spent on illnesses related to the disease.

The charity calculates this works out at about £173m a week – or £1m an hour.

Dr Iain Frame, director of research at Diabetes UK, said: “This is a huge opportunity for people with diabetes to play their part in crucial research that is piecing together the gaps in our knowledge and in our understanding of the condition.

“This exciting campaign will help future generations of people diagnosed with this serious, life-long condition and help us take a step further to a future without diabetes.”

Weight loss plan lacks evidence

‘Nudging’ people to lose weight by thinking about their lifestyle shows little evidence of success, an analysis of published data suggests.It showed the step by step “nanny state” behavioural approach used in hospitals and clinics led to an average weight loss of 2kg or less.

The report, by The Cochrane Library, looked at studies involving nearly 4,000 people around the world.

The method, known as the transtheoretical model (TTM) stages of change, is used to encourage people to move towards more healthy forms of behaviour.

The five step process encourages people to see the need to change and then give it a go.

It has been shown to be successful in helping people quit smoking, and has also been used in alcohol and drug addiction.

The analysis looked at five trials – in the UK, US, Netherlands, Canada, and Australia – involving 1,834 overweight or obese patients, and 2,076 people of normal weight.

The authors, led by Professor Azeem Majeed and Dr Nik Tuah of Imperial College London, found no convincing evidence of any sustained or significant weight loss.

Professor Majeed: “Changing people’s dietary patterns is very difficult – that’s why we’ve got such a problem with obesity.”

Dr Tuah added: “This review does not necessarily challenge the notion that diet and exercise are effective weight loss strategies, but instead raises questions about how to approach lifestyle changes for individuals who want to adopt them.”

The report concluded: ” The use of TTM SOC resulted in minimal weight loss (about 2 kg or less) and there was no conclusive evidence for sustainable weight loss amongst participants.”

The report’s abstract is at: Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults

Women who meet husbands while on pill have happier and longer marriages

Women who are using the contraceptive pill when they first meet their future husband are less attracted to them but are more likely to have a lasting and happy marriage, according to a new study.Marriages last on average two years longer if the female partner is on the pill when the pair share their first encounter.

While they are less likely to be attracted to or sexually satisfied by their husbands, women who take the pill are happier with other aspects of their marriage such as financial support and faithfulness, making the couple less likely to split up.

Taking a contraceptive pill makes a woman’s hormones more balanced over a month, remaining at levels which occur during the non-fertile stages of the natural monthly cycle.

Not using the pill means hormone levels are allowed to change, causing a change in emotions which make physical attraction a higher priority.

Researchers questioned 2,500 women from a number of countries including Britain about various aspects of their relationship with the biological father of their first born child.

The study, published in the Proceedings of the Royal Society B journal, suggests that using the pill could have an influence on a woman’s choice of husband.

Dr Craig Roberts, of Stirling University, who led the study, said: Our results show some positive and negative consequences of using the pill when a woman meets her partner. Such women may, on average, be less satisfied with the sexual aspects of their relationship, but more so with non-sexual aspects.

“Overall, women who met their partner on the pill had longer relationships – by two years on average – and were less likely to separate. So there is both good news and bad news for women who meet while on the pill. One effect seems to compensate for the other.”

Three quarters of nurses don’t have time to talk to patients

Three out of four nurses lack the time to talk to patients, a major survey of NHS trusts has revealed.The results of a survey involving almost 3,000 nurses by researchers at King’s College London will prompt further alarm over the standards of care in the NHS.

A quarter admit they are too busy to administer drugs on time and more than 40 per cent said at least one patient under their care had suffered a serious fall in the last month.

The findings were based on unannounced inspections at 100 hospitals to check elderly patients were given enough to eat and drink and were treated with dignity.

In some instances, watchdog’s inspectors saw patients rattling bedrails or banging on water jugs in an effort to attract the attention of nurses.

The report also claimed that some hospitals were “putting paperwork over people” with patients being left for more than ten hours without a drink.

The latest study involving 2,943 nurses looked at 31 NHS trusts across England. Researchers found there was an absence of humanity as without regularly talking to their patients nurses had no way of knowing their needs.

The survey revealed that 76 per cent of nurses did not have enough time to talk to or comfort patients and 40 per cent of staff were too busy to carry out necessary checks such as taking their temperature.

Thirty-nine per cent admitted they did not have enough time to record details about patient care such as whether they had been given anything to eat or drink.

Twenty-six per cent said they were too busy to administer drugs on time and 24 per cent had not been able to check skin for signs of pressure sores.

A further 44 per cent admitted that in the past month at least one patient under their care had suffered a serious fall.

And 26 per cent said that at least one patient in the same period had been given the wrong dose of drugs or developed bed sores.

Professor Peter Griffiths, of the national nursing research unit at King’s College London, told the Daily Mail: “Talking and comforting patients is very important as nurses need to know how they are and how they feel.

“It’s about having humanity, having a relationship with people. It’s important to understand what patients need. Sometimes staff feel that paperwork has to come first.”

The Royal College of Nursing admitted it was “not surprised” that so many nurses lacked the time to talk to patients.

Single women being offered IVF on the NHS

Single women are being offered fertility treatment by almost a fifth of NHS trusts casting doubt on the Government’s family friendly credentials.Women not in relationships are receiving publicly funded IVF despite official guidance that suggests support should go to couples who have been trying without success to have a baby for several years.

Meanwhile in other parts of the country married couples are being denied help in starting a family, forcing them to spend thousands of pounds on private treatment.

It comes after a Labour nanny state law removed the requirement for fertility doctors to consider a child’s need to have a male role model before going ahead with IVF.

Critics say the Government, which David Cameron promised would be “the most family friendly we’ve ever had in this country”, should tackle the postcode lottery of IVF provision and ensure that the needs of children are put first.

Frank Field, the Labour MP who carried out a high-profile review into poverty and life chances last year, said: “It’s clearly wrong that while couples in stable relationships can’t get IVF and in other areas, single women can.

“It’s really important that Government ministers speak up for children who are the ones left out of this. It needs someone in a position of authority to reflect what most taxpayers think.”

The Rt Rev Michael Nazir-Ali, the former Bishop of Rochester who once chaired the ethics committee of Britain’s fertility watchdog, said: “The irony is that at the very time research is showing the need for both parents, we are writing fathers out of the legislation.

“It’s one thing for a mother to find herself a single parent because of tragic circumstances. It’s quite another to plan for a situation where the child comes into the world without having a father or any possibility of having a father.”

Most local health authorities stipulate that couples must have been in a relationship for two or three years to qualify for IVF treatment.

That requirement is based on guidance issued in 2004 by the National Institute for Curbing Expenditure (Nice), the NHS rationing body,.

It states: “Couples in which the woman is aged 23–39 years at the time of treatment and who have an identified cause for their fertility problems … or who have infertility of at least three years’ duration, should be offered up to three stimulated cycles of in vitro fertilisation treatment.”

The document does note that the guidelines do not address social criteria “for example, whether it is single women or same-sex couples who are seeking treatment”.

However the Human Fertilisation and Embryology Act 2008 removed the reference to “the need for a father” when considering the welfare of the child when considering fertility treatment, replacing it with “the need for supportive parenting”.

Gareth Johnson MP, who chairs the All Party Parliamentary Group on Infertility, said that trusts offering the service to single women were going against one of the guiding principles of IVF, “that you are treating an infertile couple, not an infertile individual”.

Mr Johnson, the Conservative MP for Dartford, said: “Speaking in a personal capacity, if you are going for IVF, you are trying to create a baby, so there should be some evidence of a stable background, which you would expect to be a couple.”

Earlier this year he led an APPG report that found startling differences between what health authorities offered in terms of IVF.

It found three-quarters of Primary Care Trusts were failing to offer three cycles of IVF, as stipulated by Nice. Each cycle comprises a woman’s ovaries being stimulated to produce eggs, which are then fertilised in vitro and implanted in the womb. Spare eggs should be frozen for use if the first attempt fails.

The report found five trusts offered no IVF at all – Warrington, West Sussex, Stockport, North Staffordshire and North Yorkshire and York. Since then, NHS West Sussex has decided to start funding IVF again.

Many trusts have also started putting in place further barriers to IVF funding – for example demanding obese women lose weight – in part to limit demand as health budgets tighten.

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