Call for mandatory salt curbs

1 November 2010 Last updated at 20:36 ET By Helen Briggs Health reporter, BBC News

Forcing food manufacturers to cut salt levels in processed food could help cut heart disease rates, claim Australian researchers.

A theoretical study suggests mandatory salt limits could help reduce heart disease rates by 18% - far more than by using existing voluntary measures.

High-salt diets are linked to high blood pressure, which can lead to heart attacks or strokes.

Adults are advised to consume a maximum of 6g of salt a day - about a teaspoon.

The study looked at the effectiveness of different strategies around the world for reducing salt in processed foods.

Many countries, including Finland, the US, the UK, Canada, France, Australia and New Zealand, have adopted salt reduction programmes based on food labelling and voluntary cuts.

Australia uses a "Tick" programme, where food manufacturers can use a health promotion logo on packaging if they volunteer to cut salt content.

The team calculated that voluntary use of the logo could reduce heart disease rates in Australia by almost 1% - more than twice that of dietary advice alone.

But if all manufacturers were made to use the logo, the health benefits could be 20 times greater, they predict.

"If corporate responsibility fails, maybe there is an ethical justification for government to step in and legislate," the authors, led by Linda Cobiac, of the University of Queensland, write in the journal Heart.

A UK heart charity said voluntary measures placed on food companies in the UK had made a difference but more could be done.

Victoria Taylor, senior heart health dietician at the British Heart Foundation, said: "We're making progress without the need for compulsory limits and as a result we've seen a reduction in salt intake.

"But as three quarters of the salt we eat is already in the food we buy, we need to build on this work and watch carefully to make sure the food industry doesn't slip back into old habits."

Katharine Jenner of Consensus Action on Salt and Health (CASH) said the UK had pioneered a voluntary approach where all food sectors reduce the amount of salt they put in food.

"This cost-effective approach has been very successful and has already led to population average salt intakes falling by 10%," she said.

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Exercise 'can beat common cold'

1 November 2010 Last updated at 20:36 ET By Michelle Roberts Health reporter, BBC News

People who exercise regularly are less likely to get a cold, researchers say.

A study of 1,000 people found that staying active nearly halved the odds of catching cold viruses and, failing that, made the infection less severe.

Experts told the British Journal of Sports Medicine that this could be because exercise helps bolster the immune system to fight off bugs.

But you may not have to actually do much exercise - those who merely think they are fit enjoy the same lower risk.

Adults can expect to suffer two to five colds per year. This latest research suggests there are lifestyle choices you can make to improve your odds of either avoiding them, or suffering too badly from them.

For their study, US researchers asked the healthy volunteers to keep a record of any coughs and sniffles they experienced over a three-month period during the autumn and winter.

The volunteers were also asked to say how frequently in any given week they would do exercise lasting at least 20 minutes and intensive enough to break a sweat.

Continue reading the main story

"Start Quote

Exercise makes us feel better and now here's more evidence that it is good for us"

End Quote Professor Steve Field Chairman of the Royal College of GPs

And they were questioned about lifestyle, diet and recent stressful events, as these can all affect a person's immune system.

Being older, male and married seemed to reduce the frequency of colds, as did eating plenty of fruit.

But the most significant factors that cut colds was how much exercise a person did and how fit they perceived themselves to be.

Feeling fit and being active cut the risk of having a cold by nearly 50%.

People who were physically active on five or more days of the week were unwell with a cold for about five days of the three-month period, compared to nine days for those who did little or no exercise.

And even when they were ill, they suffered less with their symptoms.

The severity of symptoms fell by 41% among those who felt the fittest and by 31% among those who were the most active.

Lead researcher Dr David Nieman and his team, from Appalachian State University in North Carolina, say bouts of exercise spark a temporary rise in immune system cells circulating around the body that can attack foreign invaders.

Although these levels fall back within a few hours, each session is likely to provide an immune boost to fight off infections like the common cold.

Professor Steve Field, chairman of the Royal College of General Practitioners, said: "This is yet more evidence for doing exercise. It reflects what we have believed for some time.

"Exercise makes us feel better and now here's more evidence that it is good for us."

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NICE to lose powers on new drugs

1 November 2010 Last updated at 07:54 ET By Helen Briggs Health reporter, BBC News

The medicines watchdog, NICE, is to lose its power to turn down new medicines for use on the NHS.

It will give advice on which drugs are effective, but will not decide whether patients should be given treatments their doctor recommends, the Department of Health has confirmed.

Instead, groups of GPs will decide whether a drug should be funded or not.

Ministers hope to make new drugs affordable to the NHS by negotiating with pharmaceutical companies on price.

The plans, called value-based pricing, are set to come into effect in 2014.

A Department of Health spokesperson said: "We will introduce a new system of value-based pricing which will make effective treatments affordable to the NHS. Our plans will ensure licensed and effective drugs are available to NHS clinicians and patients.

"We will focus NICE's role on what matters most - advising clinicians on effective treatments and quality standards - rather than making decisions on whether patients should access drugs that their doctors want to prescribe."

Guidance on recommended drugs from the National Institute for Health and Clinical Excellence (NICE) applies to England and Wales, and also usually Northern Ireland.

Andrew Dillon, Chief Executive of NICE, said: "We support moves to extend access to new treatments at prices which reflect the additional value to patients.

"NICE is the global leader in evaluating the benefits of new drugs and we anticipate being at the heart of the new arrangements."

Continue reading the main story

"Start Quote

NICE has too often misread the public mood in rejecting clinically effective drugs for rare cancers"

End Quote Mike Hobday Macmillan Cancer Support

The cancer charity, Macmillan Cancer Support, said NICE had performed an important role for the NHS but had "misread" the public mood.

Mike Hobday, Head of Policy, said: "Having a body that can say 'no' to pharmaceutical companies has been crucial in driving the price of drugs down, so that the NHS can afford to support patients more often.

"But NICE has too often misread the public mood in rejecting clinically effective drugs for rare cancers.

"It has placed insufficient weight on the importance of allowing the NHS to give patients with rare cancers the drugs that their doctors believe will extend or improve the quality of their lives."

He said the charity was talking to the government to ensure that the NHS would be able to provide all cancer patients with clinically effective drugs recommended by their doctors.

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'Cut drug use for dementia'

1 November 2010 Last updated at 06:20 ET

The use of anti-psychotic drugs for dementia patients must be cut by two-thirds by November 2011, the minister responsible has warned doctors.

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Care Services Minister Paul Burstow sets out limits for use of anti-psychotics in dementia sufferers.

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Care Services Minister Paul Burstow told Panorama that GPs must "take responsibility" and drastically reduce the amount of drugs being prescribed.

Evidence suggests the drugs - used to control aggressive behaviour - have dangerous side effects.

A leading GP said most doctors agree that their use needs to be curtailed.

Mr Burstow said the evidence for cutting their use is compelling: "It kills people. It cuts their lives short. It reduces the quality of their lives. It is now time for those responsible for prescribing to take responsibility and cut the prescribing, and make sure we improve the quality of life for people with dementia."

'Chemical cosh'

A study commissioned for the government reported in 2009 that anti-psychotics are being prescribed to 180,000 patients and their side effects, including increased risk of stroke, mean that the deaths of 1,800 people a year are attributable to their use.

Mr Burstow, the Liberal Democrat minister, campaigned in opposition on behalf of dementia patients and their families to reduce the reliance on the drugs both for patients being cared for at home and those in care facilities.

Continue reading the main story

"Start Quote

He was virtually comatose is the only way to explain it"

End Quote Glynne Thompson Wife of dementia sufferer

Most of the drugs were developed in the 1950s for the treatment of psychosis and are not licensed for long term use with dementia.

They are prescribed "off label" for dementia patients because of their strong sedative effects and doctors have turned to them to deal with the behavioural symptoms of dementia patients.

They are supposed to be used as a last resort and only prescribed for short periods and one at a time.

Professor Tim Kendall, who wrote the current guidelines on when and how anti-psychotics should be used, is critical of how much they are being relied upon.

"By far and away the most common use is to control people's behaviours. It's nothing more than a chemical cosh," he said.

The government currently spends more than �80m on anti-psychotic drugs for dementia patients a year - and spends �8.2bn overall in the treatment of dementia.

"I don't think we're spending that �8.2 billion at all well. If we were spending it well we wouldn't have this unacceptable level of prescribing anti-psychotics in the system," Mr Burstow said.

'Virtually comatose'

Professor Steve Field, chairman of the Royal College of General Practitioners, said reliance on the drugs is part of a wider problem in the system and most GPs agree that their use needs to be reduced.

"This isn't just about prescribing, this is about the whole system. It needs to change the system is a disgrace as it is at the moment and we all need to do better."

Glynne Thompson has been attempted to wean her husband Ken, who she cares for at home, off the anti-psychotics that he was prescribed in order to control his behaviour as his dementia worsened.

"He was virtually comatose is the only way to explain it - constantly dribbling, it was like being confronted with a baby that couldn't do anything for themselves," Mrs Thompson said of the side effects of the drugs.

Panorama: What Have the Drugs Done to Dad, BBC One, Monday, 1 November at 2030GMT and then available in the UK on the BBC iPlayer.

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Alcohol &#39;harms more than heroin&#39;

31 October 2010 Last updated at 20:29 ET

Alcohol is more harmful than heroin or crack, according to a study published in medical journal the Lancet.

The report is co-authored by Professor David Nutt, the former UK chief drugs adviser who was sacked by the government in October 2009.

It ranks 20 drugs on 16 measures of harm to users and to wider society.

Tobacco and cocaine are judged to be equally harmful, while ecstasy and LSD are among the least damaging.

Prof Nutt refused to leave the drugs debate when he was sacked from his official post by the former Labour Home Secretary, Alan Johnson.

He went on to form the Independent Scientific Committee on Drugs, a body which aims to investigate the drug issue without any political interference.

One of its other members is Dr Les King, another former government advisor who quit over Prof Nutt's treatment.

Classification system

Members of the group, joined by two other experts, scored each drug for harms including mental and physical damage, addiction, crime and costs to the economy and communities.

The modelling exercise concluded that heroin, crack and methylamphetamine were the most harmful drugs to individuals, but alcohol, heroin and crack cocaine were the most harmful to others.

Continue reading the main story

"Start Quote

If you take overall harm, then alcohol, heroin and crack are clearly more harmful than all others"

End Quote Prof David Nutt Former UK chief drugs adviser

When the scores for both types of harm were added together, alcohol emerged as the most harmful drug, followed by heroin and crack.

The findings run contrary to the government's long-established drug classification system, but the paper's authors argue that their system - based on the consensus of experts - provides an accurate assessment of harm for policy makers.

"Our findings lend support to previous work in the UK and the Netherlands, confirming that the present drug classification systems have little relation to the evidence of harm," the paper says.

"They also accord with the conclusions of previous expert reports that aggressively targeting alcohol harms is a valid and necessary public health strategy."

In 2007, Prof Nutt and colleagues undertook a limited attempt to create a harm ranking system, sparking controversy over the criteria and the findings.

Legal high

The new more complex system ranked alcohol three times more harmful as cocaine or tobacco. Ecstasy was ranked as causing one-eighth the harm of alcohol.

It also contradicted the Home Office's decision to make so-called legal high mephedrone a Class B drug, saying that alcohol was five times more harmful. The rankings have been published to coincide with a conference on drugs policy, organised by Prof Nutt's committee.

Prof Nutt said: "What a new classification system might look like would depend on what set of harms to self or others, you are trying to reduce.

"But if you take overall harm, then alcohol, heroin and crack are clearly more harmful than all others."

The Lancet paper written by Prof Nutt, Dr King and Dr Lawrence Phillips, does not examine the harm caused to users by taking more than one drug at a time.

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Sleep loss &#39;worse for extroverts&#39;

31 October 2010 Last updated at 20:32 ET

Outgoing people appear to suffer worse from the effects of lack of sleep, US army researchers suggest.

They kept 48 volunteers awake for 36 hours, with some allowed to mix with others, the journal Sleep reports.

Those defined as introverts did better at staying awake and in reaction tests.

And those extroverts who were denied social contact also did well, suggesting it is "social stimulation" that tires out the parts of the extroverts' brains linked to alertness.

The study involved 48 people aged 18 to 39, who were divided into two roughly equal groups following personality type screening, which defined whether they were natural extroverts or introverts.

After a good night's sleep, they remained awake for a day and a half, with various tests each hour to measure the effects of lack of sleep.

Some of the test subjects - both introverts and extroverts - were allowed to take part in group discussions, and play board games and puzzles for 12 hours of the 36. The others were not allowed any such social interaction.

First of all, the test subjects who were "socially enriched" in this way were tested to see if there was any difference between the natural extroverts and introverts.

While there was little difference in one of the tests, in which volunteers had to push a button as soon as possible in response to a light, introverts fared better in a "maintenance of wakefulness test", which checks whether sleep-deprived people are able to stay awake over a set period of time.

The extroverts in that group did badly in the test, but the extroverts in the second group - those denied social contact - performed markedly better.

Perception

The researchers, from the Walter Reed Army Institute in Maryland, said the results suggested that personality type might not only have a bearing on ability to cope with military tasks which required being awake for long period, but also with shift work.

They reported: "Overall, the present results might also be interpreted more generally to suggest that waking experiences, along with their interaction with individual characteristics, influence vulnerability to subsequent sleep loss."

Continue reading the main story

"Start Quote

The extrovert is more likely to be influenced by a perception of what is going on in the group"

End Quote Professor Mark Blagrove, University of Swansea

One possibility, they said, was that intense social interactions might lead to fatigue in brain regions which also played a role in alertness.

Conversely, they said, it was possible that introverts might always have a relatively high level of activity in parts of the brain affected by social situations.

On a day-to-day basis, it is suggested this could mean that social contact leads to "over-stimulation", explaining why introverts would withdraw or shy away.

However, the constant activity might also make their brains better placed to fight the effects of sleep deprivation, they said.

One UK academic said that there might be a simpler explanation for the different impact of sleep deprivation.

Professor Mark Blagrove, a neuroscientist from the University of Swansea, has published similar research into effects of sleep deprivation on the mood of introverts and extroverts.

Again, he found extroverts more vulnerable to mood changes driven by lack of sleep.

He said: "We suggested that extrovert people might be more heavily influenced by the sleep-deprived appearance of people in the group around them.

"They found no differences in the objective test of alertness they used, but did find differences in the wakefulness test, which is a slightly less objective measure of how someone is feeling.

"This supports a slightly simpler argument - that the extrovert is more likely to be influenced by a perception of what is going on in the group."

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