Robert Mugabe removed as WHO goodwill ambassador after outcry

World Health Organization chief says he has listened to concerns over appointment of Zimbabwean president

The World Health Organization has removed the Zimbabwean president, Robert Mugabe, as a goodwill ambassador following outrage among donors and rights groups at his appointment.

The WHOs director general, Tedros Adhanom Ghebreyesus, who made the appointment at a high-level meeting on non-communicable diseases (NCDs) in Uruguay on Wednesday, said in a statement that he had listened to those expressing concerns.

Over the last few days, I have reflected on my appointment of His Excellency President Robert Mugabe as WHO goodwill ambassador for NCDs in Africa. As a result I have decided to rescind the appointment, Tedros said in a statement posted on his Twitter account @DrTedros.

The WHO boss had faced mounting pressure to reverse the decision, including from some of the leading voices in global public health.

Tedros Adhanom (@DrTedros)

Please see my statement rescinding the appointment of a Goodwill Ambassador for NCDs in Africahttps://t.co/dyxFzNAFqk

October 22, 2017

Several former and current WHO staff said privately they were appalled at the poor judgement and miscalculation by Tedros, elected the first African head of WHO in May.

Mugabe was head of the African Union (AU) when the bloc endorsed Tedros – a former health and foreign minister of Ethiopia – over other African candidates for the top post, without any real regional contest or debate, they said.

Mugabe, 93, is blamed in the West for destroying Zimbabwes economy and numerous human rights abuses during his 37 years leading the country as either president or prime minister.

Britain said Mugabes appointment as a goodwill ambassador for non-communicable diseases in Africa was surprising and disappointing and that it risked overshadowing the WHOs global work. The United States, which has imposed sanctions on Mugabe for alleged human rights violations, said it was disappointed.

He (Tedros) has to remember where his funding comes from, said one health official who declined to be identified.

In announcing the appointment, Tedros had praised Zimbabwe as a country that places universal health coverage and health promotion at the centre of its policies to provide health care to all.

But multiple critics noted that Mugabe, who is 93 and in increasingly fragile health, travels abroad for medical care because Zimbabwes health care system has been so severely decimated.

The US ambassador to the United Nations during Barack Obamas administration, Samantha Power, tweeted: The only person whose health 93-yo Mugabe has looked out for in his 37 year reign is his own.

Zimbabwes main opposition MDC party had called the appointment laughable and an insult.

The US administration of President Donald Trump, which is already questioning financial support for some programmes of United Nations agencies, is WHOs largest single donor.

The controversy came as WHO struggles to recover its reputation tarnished by its slowness in tackling the Ebola epidemic that killed more than 11,000 people in West Africa from 2014-2015 under Tedros predecessor Margaret Chan.

The Geneva-based agency is currently grappling with crises including a massive cholera outbreak in Yemen that has infected some 800,000 people in the past year and an outbreak of plague in Madagascar that has killed nearly 100 people in two months.

Combatting chronic diseases such as diabetes and heart disease linked to smoking, obesity and other risk factors are part of its permanent global agenda.

Read more: https://www.theguardian.com/world/2017/oct/22/robert-mugabe-removed-as-who-goodwill-ambassador-after-outcry

The joy of eggs how ‘nature’s multivitamin’ shook off the scare stories

Decades of dud healthy-eating guidance sent the humble egg into nutritional exile. But with new advice about runny yolks suggesting that salmonella in raw eggs is a thing of the past, its time to lick the cake bowl again

Every morning for breakfast I eat a runny-yolked egg, often boiled, sometimes poached, or fried. In any given week Ill consume eggs in other meals frittata, souffle, as a binder for breadcrumbed fish, in baking, quiche, kedgeree, fresh pasta, perhaps. I reckon that I personally get through anything between 10 and 15 eggs weekly. I do it not only because I cherish their near-magical cooking properties, but also as a two-fingered salute to a dogmatic government dietetic establishment that has pumped taxpayers money into convincing us that this most perfect of natural foods is something we should restrict, even fear. Guess what? Ive maintained a healthy, normal body weight, and lived to tell the tale.

So forgive me if I dont applaud the latest Food Standards Agency (FSA) edict telling us that pregnant women, babies and elderly people can now eat eggs raw or soft-cooked without calamitous consequences, as if this was some sort of thunderbolt revelation, a recent achievement. Its more a case of: Youre 30 years too late guys, but better late than never.

For
For decades, we were told to eat no more than two eggs a week. Photograph: Alamy

Eventually, after demonising eggs for a quarter of a century or more, the authors of our governments egg script that eggs could clog your arteries and poison you are stealthily dismantling the flashing red lights they have put around this elemental food in the public mind. Now, like offenders participating in restorative justice schemes, we need the civil servants and scientific advisers who unnerved us about eggs to say mea culpa, and reflect on how their adherence to bankrupt healthy eating orthodoxy sent one of natures cleverest food packages into nutritional exile.

Its hard to think of any food that can compete with eggs in overall health terms. They provide us with high-quality protein that contains all nine essential amino acids in the precise proportions required by the body for optimum growth and maintenance. Eggs outperform all other proteins from both animal and plant sources. Protein is the macronutrient that most efficiently satisfies appetite. It also reduces the secretion of ghrelin, the hormone that stimulates hunger. A body of research suggests that eggs might help us stay slim. For instance, one trial found that women who ate eggs for breakfast felt more full and consumed fewer calories for the rest of the day and for the next 36 hours. Thats certainly my experience.

Free-range
Free-range hens foraging for food in the Lake District. Photograph: Rex/Shutterstock

Eggs are often referred to as natures multivitamin pill, with ample justification, because they contain vitamins A, D, E, and a range of B vitamins, in significant amounts. They are also an oval treasure trove of minerals, 10 of them calcium, phosphorus, zinc, selenium, potassium, sodium, copper, iodine, magnesium and iron; and more obscure, but nevertheless vital micronutrients, choline, lecithin, lutein and zeaxanthin. If ever there was a genuine superfood, the egg is it.

And yet many Britons fret about eating eggs because weve been drip-fed fear of this most versatile food, and like biddable citizens, many of us have swallowed it.

For decades, public health gospel was that we should eat no more than two eggs a week. The egg was an early victim of the late 20th-century fixation with cholesterol; yolks contain it. This thinking, progenitor of the supposedly healthier egg white omelette in the US, was that the cholesterol that naturally occurs in food causes heart disease and stroke. It doesnt. Actually, cholesterol is a vital component of cell membranes. Among other things, it heals and repairs the body, supports our cognitive function, and helps our bodies make vitamin D and hormones.

Belatedly, when scientific research made it too embarrassingly apparent that cholesterol in eggs had almost no effect on blood cholesterol profiles, official UK nutritional guidelines were quietly altered. Now NHS Choices says: There is no recommended limit on how many eggs people should eat. But any diligent citizen who pays attention to the governments Eatwell plate its pictorial image of its recommended healthy diet, which is heavily weighted towards processed carbohydrate foods might nevertheless conclude that a bowl of cornflakes is still nutritionally preferable to an egg.

Edwina
Edwina Currie, the MP who started the salmonella in eggs scare in 1988. Photograph: Brian Bould/ANL/REX/Shutterstock

Nutrition apart, the FSAs latest pronouncement is that we can now eat raw or runny Lion-stamped eggs without courting food poisoning. The major reduction in the risk of salmonella in Lion eggs is testament to the work carried out by egg producers. The measures theyve taken, from vaccination of hens through to improving hygiene on farms and better transportation, have dramatically reduced salmonella levels in UK hens, says FSA chairman Heather Hancock. But were eggs really ever a major, or even a minor, source of food poisoning in the UK?

Edwina Currie started the whole salmonella enteritidis and eggs saga in 1988 with one sentence: Most of the egg production in this country, sadly, is now affected with salmonella, triggering either Britains first major food scare, or its first mass-media moral panic over food, depending on how you see it. At that time, egg producers loudly contested her assertion and the putative linkage of eggs with food poisoning, and to this day, many microbiologists agree with them. Dr Richard North, a leading independent food safety consultant who has conducted lab tests on salmonella in eggs, and evaluated 60 salmonella outbreaks in the UK, is a case in point. Only one, or at most two of the outbreaks I studied credibly had egg as a source. He attributes the rise in salmonella food poisoning cases in the late 1980s to two alternative causes. First, a surge of salmonella infection, not in egg-laying hens, but in factory farmed broilers (chickens reared in intensive systems for their meat). Salmonella is one of the recognised diseases of intensification that dog this type of production. Second, North points to the 1980s fashion among food manufacturers, at the supermarkets behest, for a blander, lower-vinegar mayonnaise: Mrs Beetons classic mayonnaise recipe was actively bactericidal.

Lion-stamped
Lion-stamped free range hens eggs. Photograph: Alamy

Contrary to the FSAs line that vaccines dealt with a genuine problem, North maintains that the whole salmonella and eggs debacle was a classic food scare based on myths and dodgy science. And its one of those never-to-be-resolved debates anyway, now that the FSA has given eggs its blessing. Feel free to lick the cake bowl once again. Even Currie now says: If you buy eggs in the UK you can be pretty sure theyre safe.

I buy free-range organic eggs every week from a local producer. I know him by name and can look into his eyes. His eggs dont have the Lion stamp or need it. He has confidence in the cleanliness and safety of his production methods and after years of eating them, so do I. His small flock of grass-fed, free-ranging hens are not kept in close confinement and so are much less susceptible to disease of all sorts. Supermarkets love a nationwide protocol, such as the Lion stamp, to reassure customers of safety, but this doesnt mean that any eggs that dont bear this stamp are risky.

Whichever retrospective interpretation of the salmonella and egg saga you believe, theres no doubt that eggs are more good news these days than bad. Back in Curries time, 92% of hens were kept in cruel battery cages. Nowadays, thanks to concerted campaigning from animal welfare groups, such as Compassion in World Farming, the equivalent figure has almost halved and cages have been marginally improved or enriched with welfare in mind. All the key supermarket chains are pledged to phase out shell eggs from caged hens by 2025. In practical terms, Compassion in World Farming recommends Soil Association-certified organic eggs for the highest welfare they must be free-range and no controversial beak trimming is permitted and failing that, free-range eggs from more traditional breeds of hen, because they are put under less pressure to produce. Caged eggs are still routinely used in food manufacturing and catering, but a growing number of companies, including Unilever, Sodexo and Nestl, have also committed to sourcing only cage-free eggs in their global supply chains, again by 2025.

Supermarket
Supermarket chains are pledged to phase out shell eggs from caged hens by 2025. Photograph: Alamy

Its worth noting that the fipronil egg scandal, which broke in August, where imported egg products were contaminated with an insecticide often used as flea killer affected only pre-prepared eggs used in food manufacturing and catering. Cake mixes used by industrial bakeries were withdrawn, along with liquid pasteurised eggs bought by chefs, and pre-cooked, factory-made supermarket convenience foods: certain salads from Asda and Sainsburys, some Morrisons egg sandwiches, and Waitrose deli filler were affected. The moral of the story here is: if there are dodgy eggs to be offloaded, theyre not likely to still be intact in their shells, but pre-processed in some way.

Eggs are definitely poised for a comeback, although it has to be said that throughout all the years that eggs were dispatched to the nutritional wilderness, many people, sceptical about public health advice, never stopped eating them. In the UK we eat on average between three and four eggs a week. In the 1960s, our national average egg consumption was five. But over the past 12 months, retail egg sales have risen by 4%. In the current grim landscape, where more and more citizens need to use food banks just to put a meal on the table, eggs, which are so affordable and offer such unbeatable nutrition and sustenance, never more deserved a place on our plates. Just think of the character of Katie in the film I, Daniel Blake. She surely needed an egg, not a can of sweet baked beans, yet many food banks have no fresh food to offer, often for safety reasons. Similarly, government-stoked worry about safety has deprived whole demographics the elderly, children, people in care homes and hospitals of the pleasure and incomparable nutrition of properly cooked, that is not overcooked, eggs.

Katie,
Katie, the character in I, Daniel Blake, would have benefited from an egg from the food bank. Photograph: Allstar/Eone Films

Last week in Galway, at the international Food on the Edge chef symposium, South African chef Margot Janse spoke about how her Isabelo charity in Franschhoek now feeds 1,400 disadvantaged pre-school and primary school children every day, often the only healthy meal they receive. She started by giving out home-baked muffins, with mixed results. Some children didnt find them sweet enough. But it was boiled eggs that the kids really loved and that grew full attendance at school. There are lots of hearts of gold that care [about fighting poverty] but an egg also has a heart of gold and is a lot more practical, she concluded.

Whatever your current status starving, peckish, dieting, feasting, economising, working, travelling, convalescing, or just going about your daily business its hard to beat an egg.

Read more: https://www.theguardian.com/lifeandstyle/2017/oct/17/joy-eggs-scare-stories-new-guidance-runny-yokes-salmonella

Georgia GOP gubernatorial hopeful to hold bump fire stock giveaway

Washington (CNN)Georgia Republican gubernatorial candidate Michael Williams says he will give away a bump fire stock to show “solidarity with gun owners across the nation.”

“The tragedy in Las Vegas broke my heart, but any talk of banning or regulating bump stocks is merely cheap political lip service from career politicians. In reality, the bump stock is the new, shiny object politicians are using to deceive voters into believing they are taking action against gun violence,” Williams, a Georgia state senator, said in a statement. “Many firearms experts determined the Las Vegas shooter’s use of a bump stock actually prevented more casualties and injuries due to its inconsistency, inaccuracy, and lack of control.”
Williams did not cite any experts to back up that claim in the statement, but his office, citing a post by LegallyArmedAmerica.com, later explained the comment by saying bump stocks can diminish accuracy.
    He added there is “zero evidence” to suggest a ban on bump stocks would prevent gun violence deaths, saying “liberals and Hollywood elites” were attacking the rights of Georgia gun owners. He instead placed the onus on needing to address mental health issues and inner-city violence.
    “If politicians wanted to have a real conversation on reducing gun violence, they would be discussing mental health awareness and ways to reduce the weekly bloodbath in Chicago and other inner cities,” he said. “Blaming guns or bump stocks for the actions of a lunatic is the same as blaming McDonald’s for heart disease.”
    Williams faces other well known GOP primary candidates in the race. He previously drew controversy during his candidacy after he participated in an “anti-Sharia” march earlier this summer and was photographed with a Georgia militia. Williams’ campaign said he posed for the photograph because the members looked like pro-gun supporters. And following the Charlottesville protests, which led to one woman’s death, Williams questioned a fellow gubernatorial candidate’s views on the preservation of Confederate monuments.
    “I want to know where (Democratic Rep. Stacey Abrams) draws the line,” he said. “Will she demand we blow up the Jefferson Memorial and knock down the Washington Monument?”
    And in the hours following the Las Vegas shooting, Williams asked which NFL players would be taking a knee to honor law enforcement following the shooting.
    Williams’ views are at odds with some in his own party in Washington, including House Speaker Paul Ryan.
    Concern over the use of bump stocks spans across political parties. Florida Republican Rep. Carlos Curbelo introduced legislation earlier this month restricting the use of the devices, and regarding examining the legality of the devices, Ryan said that “clearly, that’s something we need to look into.” The National Rifle Association has said the devices should be subject to further regulation but said it is opposed to a legislative fix.
    This story has been updated to reflect comment from Williams’ office.

    Read more: http://www.cnn.com/2017/10/17/politics/georgia-governor-candidate-bump-stock/index.html

    How to break carb cravings, once and for all

    (CNN)If you’re like many people I know, the thought of giving up pasta and bread in an effort to shed a few pounds (or more) might seem like an unfair punishment — perhaps even a tease, especially when those foods seem to be on everyone else’s plates.

    The truth is, despite the popularity of low-carb diets, which often send the message that we should drastically cut back on this food group, carbohydrates are some of the most important things we consume. They are key to regulating blood sugar and providing energy throughout our bodies. Without them, our bodies will rely on protein, breaking it down for energy instead of using it in its preferred role of growing and maintaining tissues.
    What’s more, eating the “right” kinds of carbs can keep us healthier.
      “The people who live the longest, healthiest lives — who have the lowest rates of diabetes, heart disease and cancer — their diets are all rich in healthy carbs, including beans, legumes, whole grains and fruit,” said Tamara Duker Freuman, a New York City-based registered dietitian.
      And so there’s nothing wrong with a pasta meal (though whole grain is preferred) or even a sandwich on whole-wheat bread for lunch every day. Simply, the problem is not that we consume carbs; it’s that we often consume the wrong kinds of carbs — and very large portions of them.

      Processed carbs are problem carbs

      Highly processed carbs — white bread, sugary cereal, white rice, regular pasta and bagels, for example — produce rapid rises and drops in blood sugar, which can lead to weight gain. They also can lead to something called metabolic syndrome, which is associated with an increased risk for heart disease, stroke and diabetes.
      Metabolic syndrome is “the combination of high triglycerides and low HDL cholesterol, insulin resistance and obesity,” explained Dr. David Ludwig, professor of nutrition at the Harvard T.H. Chan School of Public Health. “And processed carbs are the main dietary drivers.” Studies show that “processed carbs top the list for weight gain and diabetes risk,” he said.
      The tricky part is that the more processed, refined carbs we eat, the more we crave. And so it seems almost impossible to get off the carb-craving hamster wheel.
      According to Ludwig, who wrote the book “Always Hungry? Conquer Cravings, Retrain Your Fat Cells, and Lose Weight Permanently,” cravings have to do with our consumption of these highly processed, “fast-acting” carbs, which he says are not fundamentally different from sugar, in the biological sense. White bread or any other processed carbohydrate will melt into glucose very quickly — and so like sugar, it raises blood sugar at a faster rate than slower-digesting carbs that are less processed and higher in fiber. The problem is, that rapid spike in blood sugar is eventually followed by a crash.

      Insulin: Miracle-Gro for fat cells

      According to Ludwig, what drives most carb cravings is not the taste of the foods per se but rather a biological urge to eat something to restore your blood sugar. And it has to do with the hormone insulin. “Processed carbs cause more insulin secretion, calorie for calorie, than any food,” he said.
      When you eat processed carbs, blood sugar rises rapidly, and insulin quickly follows, directing incoming calories into liver, muscle and fat cells. But of these, only fat cells have virtually limitless ability to store calories, and too many get trapped there, according to Ludwig. A short while later, the calories in the bloodstream are low, and the body runs out of available fuel, making you hungry too soon after the meal.
      In essence, when fat cells get too much energy, there’s not enough to fuel the brain, which is constantly monitoring the calories in your blood. “When (the brain) sees calories are dropping, it triggers hunger and cravings,” Ludwig said.
      And it all relates back to that initial insulin response. “Insulin is the Miracle-Gro for fat cells,” he said. “When fat cells grow, we get hungry.” And so the cycle repeats, eventually causing weight gain.

      How to break carb cravings

      Nutrition experts say that breaking carb cravings is not about getting rid of carbs entirely but rather cutting back on highly processed fast-acting carbs and eating more high-quality ones that are high in fiber and low in added sugars, such as beans, whole grains, fruit and vegetables. If you don’t know how to get started, this plan can help:
      1. Cut out all starchy carbs for one week. This includes all pasta, bread, rice, bagels and potatoes, as well as pizza, crackers, pretzels, chips, cookies and cake.
      By cutting starchy carbs and replacing them with foods that have a more modest impact on blood sugar, you can achieve more steady blood sugar control and better manage your cravings, according to Freuman.
      A day might include egg whites and cheese with berries for breakfast, yogurt for a snack, a grilled chicken salad with beans for lunch, an apple for a snack and a piece of fish and veggies for dinner.
      2. Slash the sugary carbs too, including candy and sugar-sweetened beverages. These sugary carbs rapidly flood the bloodstream, providing lots of sugar without any added nutrition.
      3. Add some fat. “Many high-fat foods are luscious and do not cause an insulin release, so they keep your blood sugar much more stable,” Ludwig said. Examples include nuts, nut butters, avocado, olive oil, dark chocolate and full-fat dairy. “When you are eating them, you don’t miss the processed carbs at all!”
      4. After the first week, you can gradually add back high-quality starchy carbs, starting with breakfast.
      “Research in a variety of populations has shown that eating carbs at breakfast seems to dampen the blood sugar effect of eating carbs at lunch,” Freuman said. What this means is that on a day that you skip breakfast, you may be more likely to have a blood sugar spike after eating a carb-rich lunch, compared with a day when you eat breakfast but have the same lunch. In other words, “don’t skip breakfast, and don’t skip carbs at breakfast,” Freuman said.
      High-quality carbs — including minimally processed grains, along with non-starchy vegetables, whole fruits and beans — are the ones to choose. They are delicious and slower-digesting, thanks to the way they are naturally packaged, Ludwig said. “If you eat wheat berries, your body has to digest the intact grain kernel, and that’s a slow process. But if you mill it and turn it into flour, now that whole package has been broken. Too much of these ‘naked carbs’ (stripped of their bran and germ, which contain nutrients) will cause metabolic problems for most people.” 
      Breakfast examples with high-quality carbs include steel-cut oats with nuts, seeds and cinnamon; rye crisp bread with scrambled eggs and berries; or Greek yogurt topped with fruit. Freuman recommends beans at breakfast too, “as in a Mexican breakfast with eggs, beans, avocado and salsa.”
      5. After the second week, you can add back high-quality starchy carbs (i.e. minimally processed grains) to lunch. Good lunch examples include a chickpea or quinoa salad, bean or lentil soups, mushroom barley soup or a sandwich with whole-grain bread. Whole-wheat pasta or chickpea pasta is a good choice too, according to Freuman, though it should take up only about a quarter of the plate, to allow room for veggies and protein.

      For the longer term

      6. Continue to skip starchy carbs at dinner. “At dinner, when we eat carbs, we are much more likely to have a blood sugar spike and to store that food energy as fat versus having it available for useable energy,” Freuman said.
      “The metabolic response to a carbier meal at night is less favorable than when we eat carbs earlier in the day, so if there is ever one meal that you want eat low-carb, it’s dinner … and if you want to include them, choose wisely and keep the portions low,” she added.

      See the latest news and share your comments with CNN Health on Facebook and Twitter.

      7. Continue to limit refined carbs, such as white bread and white rice. It might be difficult to forgo white basmati rice, pizza or sushi entirely, but limit these foods to a few times per week.
      8. Continue to avoid foods high in added sugars. If you have a sweet tooth, limit treats to 100 to 150 calories per day, depending on your goals.
      And note that anyone with a medical issue should always consult their doctor before starting a new diet plan.

      Read more: http://www.cnn.com/2017/10/17/health/carbohydrates-cravings-food-drayer/index.html

      Extra 10p on sugary drinks ‘cut sales’

      Image copyright Getty Images
      Image caption 10p or 3% was added to the price of sugar-sweetened drinks and healthier soft drinks were added to the menu

      An increase in the price of sugary drinks in restaurants and the offer of healthier alternatives could encourage customers to cut back on sugar, a study suggests.

      In Jamie’s Italian restaurants, sales of sugar-sweetened soft drinks declined by 9% following a 10p price rise.

      The chain also redesigned the menu and explained that money from the levy would go to charity.

      Experts said more research was needed to pin down what measures worked.

      Consuming too many sugary soft drinks has been linked to a higher risk of serious health problems such as obesity, type-2 diabetes, heart disease, stroke and tooth decay.

      Sugar tax

      To help tackle obesity, the UK government is introducing a tax on high-sugar soft drinks such as Coca-Cola, Pepsi and Irn-Bru in April 2018 – and Jamie Oliver had been vocal in his support of the plan.

      This study, in the Journal of Epidemiology and Community Health, analysed sales of sugary non-alcoholic beverages at 37 of Jamie Oliver’s national chain of restaurants after a 10p levy was introduced in September 2015.

      Low-sugar fruit spritzers (fruit juice mixed with water) were also added to the menu, which clearly explained why the levy was being introduced.

      Image caption Jamie Oliver urged the government to be bold on a sugar tax

      After 12 weeks, sales of sugary drinks per customer had declined by 11%, and after six months they had gone down by 9.3%.

      But the study did not look at any other restaurant chains to compare sales figures.

      The study also showed there was a general decrease in the number of soft drinks sold per customer, including diet drinks and bottled waters.

      The researchers, from the London School of Hygiene and Tropical Medicine (LSHTM) and the University of Cambridge, said more people could have chosen tap water, but these figures had not been recorded.

      Sales of fruit juices had increased by 22% six months after the changes were introduced.

      Changing behaviour

      Prof Steven Cummins, lead study author and professor of population health at LSHTM, said: “A small levy on sugar-sweetened drinks sold in restaurant, coupled with complementary activities [such as redesigning the menu], may have the potential to change consumer behaviour.”

      But he said it was not possible to say that the price increase alone had caused the decline in sales of sugar-sweetened drinks.

      There was also no separate data on what adults and children ordered.

      Image copyright Getty Images
      Image caption Customers may have ordered tap water instead of sugary drinks

      Prof Kevin McConway, emeritus professor of applied statistics at the Open University, said it was plausible that the levy “played an important role” but he also called for “more investigation, in other restaurants, and with a longer follow-up period, to try to pin down more clearly what really works”.

      Prof Susan Jebb, professor of diet and population health at the University of Oxford, said the findings were “encouraging news for public health”.

      But she said there was a disappointing lack of data on alcohol sales, which could have increased over the same period.

      Related Topics

      Read more: http://www.bbc.co.uk/news/health-41637931

      Hospitals in chocolate crackdown

      Image copyright Alamy

      “Super-sized” chocolate bars are to be banished from hospital shops, canteens and vending machines, NHS England says.

      Sweets and chocolate sold in hospitals should be 250 calories or under, the head of the body says.

      Under the plans, most “grab bags” will be banned – with hospitals given a cash boost for facilitating the change.

      The proposals would also see 75% of pre-packed sandwiches coming in at under 400 calories.

      Pre-packed savoury meals and sandwiches must also contain no more than 5g of saturated fat per 100g.

      And 80% of the drinks stocked must have less than 5g of added sugar per 100ml.

      Hospital 'super-size&#39 chocolate ban

      250

      calorie limit for sweets and chocolate sold in hospitals

      • 400 calorie limit for 75% of pre-packed sandwiches

      • 5g limit of saturated fat per 100g in meals

      • 5g limit of added sugar per 100ml in drinks

      • 54% NHS staff estimated to be overweight or obese

      Reuters

      ‘Obesity epidemic’

      In April, NHS England said it would ban sugary drinks if hospital outlets did not cut down on the number they sell.

      Simon Stevens said the NHS was “stepping up” to combat an issue that was causing “an epidemic of obesity, preventable diabetes, tooth decay, heart disease and cancer”.

      “In place of calorie-laden, sugary snacks we want to make healthier food an easy option for hospital staff, patients and visitors.”

      NHS staff are also being targeted as part of the move to tackle unhealthy eating, including those on overnight shifts.

      It is estimated that nearly 700,000 of the NHS’s 1.3million staff are overweight or obese.

      NHS premises have huge footfall from the communities they serve, with one million patients every 24 hours.

      The Royal Voluntary Service, the biggest hospital retailer across the UK, said it had already begun introducing healthier choices and had seen fruit sales go up by a quarter.

      Public Health England says hospitals have an “important role” in addressing obesity and not just dealing with the consequences.

      Campaigners says more action is till needed.

      Helen Dickens from Diabetes UK said: “We look forward to seeing more information on how it will work in practice.

      “However this is just one piece of the puzzle when it comes to tackling obesity. We need to go much further, which is why we are also calling for the Government to toughen restrictions on junk food marketing to children, end price promotions on unhealthy foods and introduce mandatory front of pack food labelling.”

      A Welsh Government spokesperson said: “We restricted the sale of chocolate bars and other sugary products from vending machines in Welsh hospitals nine years ago. We’re pleased NHS England is now looking to follow our lead.”

      How many calories?

      • A 51g Mars bar contains 230kcal
      • A 48g Snickers chocolate bar contains 245kcal
      • A 45g Cadbury Dairy Milk bar contains 240kcal, while a 119g bag of Cadbury Diary Milk Giant Buttons contains over 535kcal
      • A 93g Maltesers Pouch contains nearly 470kcal
      • A 190g of Haribo Tangfastic contains nearly 660kcal
      • A 140g M&Ms Peanut Pouch contains nearly 720kcal
      • A 200g packet of Milk Chocolate Eclairs contains around 900kcal

      Related Topics

      Read more: http://www.bbc.co.uk/news/health-41630681

      How your blood may predict your future health

      New research into bloodstream biomarkers aims to unlock the full impact of social status on peoples lifetime health outcomes. The key is exposure to stress

      Health is a well-known inequality issue. While ageing is inevitable and most of us will get sick at some point, the rate of your decline is likely to be faster the lower down the socioeconomic ladder you started.

      The intriguing thing is, nobody exactly knows why. Tempting though it is to blame the usual suspects poor diet, obesity, smoking they dont account for the whole story.

      If you exactly knew somebodys diet, exercise level, smoking habit or alcohol consumption, you would be about 30 to 40% likely to accurately predict how long they are going to live, says Mel Bartley, professor emerita of medical sociology at University College London, who has dedicated her career to understanding the links between society and health. But whats the rest? Thats the big question.

      Unpicking the biological connections between external socioeconomic forces and an individuals health is no easy task. But Bartley and others in her field believe important clues can be found in the very lifeblood of a nation.

      The idea that measurable biological markers (biomarkers) in the bloodstream can reflect an individuals underlying health status and even offer some kind of prediction of their life expectancy gained popularity in the 1950s, as scientists started searching for tell-tale markers linked to the epidemic of heart disease spreading through the US.

      High blood pressure was the obvious one, but they also discovered that the level of bad cholesterol in the bloodstream was a good indicator of risk. By monitoring blood cholesterol levels in healthy people before they show any outward signs of heart disease, doctors can predict who is most at risk. The resulting medical interventions, such as dietary changes and statin drugs, can demonstrably improve those peoples long-term health.

      Now, researchers are using the same approach to measure the impact of social status on the body, in the hope of developing policies that can reduce the health toll on societys most deprived section (on average, the poorest people in the UK miss out on more than a decade of life compared with the richest).

      One of the most ambitious projects, currently being undertaken by the University of Essexs Institute for Social and Economic Research (ISER), is looking at blood biomarkers from some of the 40,000 UK households taking part in its Understanding Society study, which covers the entire socioeconomic spectrum.

      A biomarker is an objective measure of health, explains Professor Meena Kumari, the epidemiologist leading the study along with health economist Dr Apostolos Davillas. These chemicals are like molecular flags: they allow us to see what happens inside people as theyre going through their life course which they themselves might not be so aware of.

      According to Kumari, Whats happened historically is that social scientists have tended to measure health in a simple way just asking people: How do you rate your health right now? But we wanted to bring together the biology and the social science.

      Published in the journal Scientific Reports, the ISER teams initial analysis focused on measuring the levels of two molecules, fibrinogen and C-reactive protein (CRP), that are produced by inflammation the bodys response to infections, stress and other harmful stimuli. Chronic long-term inflammation is linked to poorer health outcomes including heart disease, diabetes and cancer.

      According to Davillas and Kumari, measuring an individuals CRP and fibrinogen levels and matching them against their socioeconomic position starts to reveal the hidden mechanisms connecting social inequality and health. And the missing link appears to be stress.

      The impact of chronic stress

      When we experience something stressful, we activate the hypothalamic pituitary adrenal axis: a convoluted network involving the brain and the pituitary and adrenal glands. This results in the release of cortisol and other stress hormones such as adrenaline, which have a range of effects on the body.

      The complex biological conversation between this stress response and the bodys inflammatory processes actually damps down inflammation in the short term. But this careful balance seems to shift in the face of chronic stress, resulting in more inflammation over time. Thus the levels of CRP and fibrinogen, as markers of chronic inflammation, are a proxy for the impact of long-term stress on a persons body.

      CRP
      CRP levels at different ages by household income, left, and education. Photograph: Davillas et al/Scientific Reports

      For Kumari and Davillass biomarker study, blood samples were gathered from nearly 8,000 adults in the Understanding Society cohort. While CRP and fibrinogen levels increase in all of us as we age, the ISER team found that differences in the levels of CRP and fibrinogen between socioeconomic groups begin to show relatively early in life and on average rise faster and peak sooner in poorer people.

      The research shows differences in CRP levels start around 30 years old and peak around the age of 55, Davillas says. Then the gap starts to narrow again theres not so much difference between the lowest and highest socio-economic groups in later life, although of course the social inequalities are still there. People in both groups end up with similar CRP readings by their mid-70s.

      The analysis suggested people in lower socioeconomic groups have a demonstrably longer exposure to chronic inflammation with all its knock-on impacts on long-term health even once the team corrected for the usual suspects of health inequality, including diet and smoking. Theres clearly something else at work.

      If you ask people about their health, you dont really see differences early in life people tend to become unhealthy later in life, Kumari says. But were starting to see these underlying biomarker differences in people in their 30s; so whats that about?

      Fibrinogen
      Fibrinogen levels at different ages by household income, left, and education. Photograph: Davillas et al/Scientific Reports

      Kumari and Davillas are now considering the causes of chronic stress that might contribute to the patterns they have found, starting with employment or lack of it and the associated issues of poor pay, job insecurity, long hours and the burgeoning gig economy.

      You have stressful life events such as bereavement or divorce, but were talking about understanding chronic long-term stresses, Kumari says. One of the things we think about is why is disadvantage stressful? For something like low income, it could be because you dont have the same levels of control over your life. Maybe you can manage it for a little while, but over the long term it becomes a chronic stress. These things are hard to measure and capture.

      Bartley agrees more needs to be done to understand the financial causes of stress across society. Debt is deadly for people its the ultimate lack of control, she says. Housing is also a huge issue and it doesnt get researched enough living in poor situations is depressing, especially if youre bringing up children. People in poverty can end up in social isolation, and thats known to be associated with all kinds of unhealthy outcomes.

      Changes in policy

      Its all very well to be able to measure levels of inflammatory biomarkers, and link them to stress and worse health outcomes but the big question is what to do about it. If its as simple as lowering inflammation, then maybe we should just hand out anti-inflammatory drugs such as aspirin to poorer people?

      I dont believe thats the answer, says Bartley. We need to understand what it is about living in a tougher social and economic situation that causes this underlying stress, in order to argue for more effective changes in policy.

      From a policy perspective, if you know when health inequalities begin and when they peak, this can help you target these age groups and allocate resources more effectively, says Davillas, pointing to the example of retirement timing. If youre doing a stressful job and this impacts your health more compared to someone in a less stressful occupation, this is an important issue to consider from a public health perspective. Perhaps people in more stressful jobs should retire earlier.

      Measuring biomarkers across society could also give researchers a way of monitoring the impact of policy interventions. But to do that effectively will require a lot more data. While the ISER teams findings suggest a link between inflammation, stress and poor health outcomes in the most disadvantaged sectors of society, the study is only a snapshot of biomarker levels in individuals of different ages at one point in time. Whats really needed is detailed, long-term research, monitoring and following people over decades as their lives change.

      If we have 30-year-olds with high CRP, we want to know what happens to them five years later, says Bartley. We need to study people over their whole life course to find out if that early high CRP reading is fixed, and does high CRP at age 30 condemn someone to get sicker faster later on or does their health outcome change if they improve their situation and lower their stress levels?

      The challenge with this long-term approach is finding ways of measuring biomarkers in large numbers of people across the full spectrum of society. It would be good if we could collect them by some electronic means, instead of having to stick needles in people for blood samples, Bartley speculates. Theres a lot of scope for improvements in technology such as mobile phones, in terms of understanding how society gets under the skin.

      The ISER study also highlights another striking issue: the general lack of research focuses on people in midlife a time when life paths can become entrenched.

      There are a lot of studies looking at older age groups, because thats when people get sick, and lots involving children because child development is interesting, but theres not a lot going on in the middle of the age span, Kumari says. And yet we found the difference between biomarker levels was biggest in working age groups, where we have the least amount of data.

      Understanding the underlying biological pathways will help us to target what it is we should be focusing on. Our data suggest that it might be stress that we need to be thinking about, particularly for working age people. But this is just the beginning theres still a lot to do.

      Share your experiences by emailing inequality.project@theguardian.com, or follow the Guardians Inequality Project on Twitter here

      Read more: https://www.theguardian.com/inequality/2017/oct/10/how-your-blood-may-predict-your-future-health-biomarkers

      San Franciscos Air Quality Matches Beijings

      Air quality in San Francisco sank to the level of smog-choked Beijing this week, as soot from more than a dozen wildfires in California’s wine country blanketed the Bay Area.

      As San Francisco residents woke up to a hazy sky for the fifth day in a row, the concentration of dangerous particulate matter was forecast to be 158 on the air-quality index, according to the Bay Area Air Quality Management District. That’s roughly on par with notoriously smoggy Beijing, which clocked in at 165.

      The gauge, known as PM2.5, refers to particles with a diameter of less than 2.5 micrometers, which can be inhaled and penetrate deep into the lungs. While long-term exposure is correlated with lung and heart disease, Bay Area residents should only experience temporary discomfort with no permanent effects, said John Balmes, a professor of medicine at the University of California, San Francisco.

      Lenard Lesser, a doctor at primary care group One Medical, said he has seen several patients with smoke-related complaints, including sore throat and difficulty breathing, at his San Francisco office this week. Children, older adults and people with lung disease such as asthma should stay indoors while the air quality is bad, and wear an "N95"-rated mask when outdoors, Lesser said in an email.

        Read more: http://www.bloomberg.com/news/articles/2017-10-13/san-francisco-air-quality-matches-beijing-s-as-wildfires-burn

        Oxford city center could be electric vehicle-only by 2030

        The dreaming spires could soon be the first to benefit from being in a 'Zero Emission Zone'
        Image: Shutterstock / elesi

        A lot can happen in three years, but banning combustion engines from a major city centre? That seems a bit of a stretch.

        Oxford City and Oxfordshire County Council have proposed plans to rid the city centre of all diesel- and petrol-fuelled vehicles — buses and taxis included — by 2020. This could potentially make Oxford centre the very first Zero Emission Zone, and the council also wants to expand this Zero Emission Zone twice more, in 2025 and 2030. 

        The council cites the health risks caused by pollution as the reason behind this bold proposal. In a statement, Oxford council says, “Oxford city centre currently has illegally-high levels of toxic nitrogen dioxide, which contributes to diseases including cancer, asthma, stroke and heart disease – and contributes to around 40,000 deaths in the UK every year.”

        The council projects that this new plan will lead to a 74% reduction in nitrogen dioxide on the centre’s most polluted street by 2035.

        The City Council had already made some headway, as they state in their press release that they have won £500,000 in government funding to install charging points for electric taxis, and a further £800,000 for charging points for use by Oxford residents.

        However, as optimistic as this plan may seem, The Memo picked up on a slight catch.

        The area that would be covered by the 2020 no-emission zone is incredibly small, and already contains “very little traffic,” according to the Oxford Zero Emission Zone Feasibility and Implementation Study. It notes that implementing the diesel and petrol ban in this area “would potentially have little overall effect on air quality”.

        The 2020 area only covers 3 roads, and they’re not particularly busy thoroughfares.

        On the other hand, three years is not a long time to adapt a city centre to electric vehicles, so changes would have to be incremental. 

        TheOxford Zero Emission Zone Feasibility and Implementation Study also suggests that the council could incentivise people to switch to electric vehicles by offering free EV (electric vehicle) parking in 2020 and then introducing EV-only parking areas in 2025.

        James McKemey at Pod Point, a company which installs EV charging points, believes that the real incentive to switch to EV won’t come so much from the public sector, than from consumer experience. He told us that government grants and tax breaks encouraging the purchase of electric cars are “small incentives which are helpful in the early days […] but ultimately the real incentive to drive an electric vehicle will be that they are fundamentally better.” 

        He also thinks that Oxford City Council’s 2020 goal isn’t an unreasonable target, given that EV battery pack prices have recently become far more affordable at a rate that is “far beyond what we expected”.

        So from this point of view Oxford centre wouldn’t be forcing a change to electric vehicles so much as keeping up with a trend.

        However, this doesn’t mean that enforcement won’t be an issue. Oxford council’s study recommends the implementation of Automatic Number Plate Recognition to help identify anyone infringing on the Zero Emission Zone, regardless of the “illuminated signs” they would put up.

        The plans are still only a proposal, and from Monday Oxford residents will have six weeks of public consultation to voice their opinions about their town going electric. Lovely though the plans to reduce pollution sound, they’re bound to make disrupt life for local businesses, as well as the few Oxford professors who don’t ride to work on penny farthings. 

        There goes the history department.

        Image: Laura De Meo/REX/Shutterstock

        Of course if Oxford does go electric, it will make for much more environmentally friendly car chases on Lewis. And what about Endeavour? Hard to say.

        Read more: http://mashable.com/2017/10/13/oxford-city-centre-zero-emission-zone-2020/

        The psychology of gold and why it has that allure

        (CNN)When you think of the color gold, images of grandeur and extravagance are likely to come to mind.

        For millennia, the metal has adorned crowns and hilts of swords. It has been used to enhance paintings and ornaments to increase their value.
        That led to the metal being associated with a shining, otherworldly character attributed to the gods in the religions of many different cultures. “Some of these were bodily associations,” the authors write.
        The Aztecs described gold as the “excrement of the gods,” while the Incas thought of it as the “sweat of the sun.” In ancient Egypt, gold was considered the “flesh of the gods.” Across cultures, it was a sacred material.
        The book goes on to illustrate the importance of gold in health and medicine. Chinese alchemists believed that drinking potable gold in the form of elixirs, eating from gold plates and using gold utensils helped attain longevity.
        “Before the 20th century, gold was used to treat conditions as varied as syphilis, heart disease, smallpox and melancholia,” the book notes.
        Today, gold compounds are still thought to have some anti-inflammatory effects.

        Attracting the eye

        The incorruptible nature of gold has an otherworldly allure to it and the reflective quality of the metal gives the impression that it glows from the inside, said Oakley.
        When viewed by candlelight, gilded medieval manuscripts, statues and icons in the Eastern Orthodox Church exuded a transcendental quality, glowing as if they were illuminated from the inside.
        Human vision can discriminate millions of colors, but it can discriminate trillions of chromatures — colored textures, said Donald Hoffman, professor of cognitive science at University of California, Irvine.
        “It is the chromature that targets the human emotions more specifically than uniform color patches,” he said.
        Hoffman believes the reason chromatures can target human emotions more specifically than uniform color patches is that they contain far more information than color patches.
        He demonstrated the concept with two pictures — a section of brown grizzly bear fur and the same brown color in plain background. When looking at the chromature, our mind can immediately grasp that we are looking at a bear, he explained.
        “Evolution would have more success training the emotional system to be wary of the bear fur chromature than to be wary of the uniform color patch of the same average color.”
        Similarly, when we look at a gold ring versus a standard patch of uniform color, we see interesting highlights on the ring because the metal is highly reflective.
        “Companies are using genetic algorithms to evolve chromatures and target specific emotions they want people to experience with respect to their product or brand. It turns out to be quite powerful,” he adds. For example, “A company might, for instance, want to convey the idea that their product is soft and warm. Then we would start with closeup images of patches of soft things, such as the fur of a rabbit and the down of a goose, and warm things, such as glowing embers of charcoal or a warm sunset,” Hoffman explained.
        The same could be applied to evoke emotions linked to gold — how does it make you feel?

        A sign of success

        In ancient Rome and medieval Europe, sumptuary laws prohibited people from wearing too much gold — or not wearing it at all unless they were from a noble family.
        Gold leaf has been used liberally in artwork which hinted at the status of the patron who commissioned it.
        All societies value gold and investing in gold has survived for centuries through marketing — even glorified.
        “(Gold) carries with it the messaging that you should own it. It is a learned, conditioned response,” said Eiseman — but not so much that it becomes tacky, she adds.
        In popular culture, musicians flaunt their gold bling. The underlying message being that they are good at what they do and have amassed a lot of wealth. “In a lot of cultures, the word for money derives from the word for gold. In China, the ideogram for money is the ideogram for gold,” Oakley said.

        Tell us your story
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        Gold continues to be featured heavily in religion and religious rituals alike. It decorates the papal regalia, spires, domes and minarets of temples, churches, monasteries and mosques worldwide.
        Golden trophies like Olympic medals, the Nobel Prize, Oscars and Emmys are presented to people who display a unique talent. “The idea is the prize made of a rare material is given to people with display talent as rare as the material,” said Sally Augustin, an environmental and design psychologist.
        Psychologically, this results in gold being a color of motivation.
        Are you motivated?

        Read more: http://www.cnn.com/2017/10/13/health/colorscope-gold-allure/index.html