Some Chinese ready meals found to have more salt than 11 bags of crisps

Some takeaway dishes contain as much salt as five Big Macs with ready meals also high in salt

Chinese takeaways and ready meals should carry compulsory health warning labels on menus and packaging to alert consumers to astonishing and harmful salt levels, UK health experts have recommended.

The worst-offending Chinese takeaway dishes in a survey published on Tuesday by Action on Salt were found to contain as much salt as five McDonalds Big Macs, while many had more than half an adults entire daily allowance.

Supermarket Chinese ready meals were also laden with salt, with some containing more than the amount found in two Pizza Express margherita pizzas, the report reveals. Some rice dishes contained more salt than 11 bags of ready salted crisps.

Action on Salt is leading a group of health experts in calling on Public Health England to set tough new salt targets, make front-of-pack labelling mandatory and to follow New Yorks lead by requiring chains to put warning labels on high-salt dishes. They are also urging the food industry and restaurants to reduce salt by reformulating takeaways and ready meals.

Of 141 supermarket Chinese ready meals analysed, nearly half (43%) were high in salt containing more than 1.5g/100g, or 1.8g per portion which would trigger a red traffic light label.

Chines food graphic.

Salt is the forgotten killer as it puts up our blood pressure, leading to tens of thousands of unnecessary strokes, heart failure and heart attacks every year, said Graham MacGregor, the chairman of Action on Salt and a professor of cardiovascular medicine at Queen Mary University of London.

Reducing salt is the most cost-effective measure to reduce the number of people dying or suffering from strokes or heart disease. We are now calling on Public Health England to take immediate action.

Accompanying rice dishes, spring rolls and prawn crackers and soy sauce can pile on the salt in a Chinese meal. Icelands takeaway egg fried rice has a shocking 4.1g salt per 350g pack more than in 11 bags of ready salted crisps.

Dishes from six Chinese restaurants were also analysed, with 97% found to contain 2g of salt or more. More than half (58%) contained in excess of 3g of salt per dish half an adults maximum recommended daily intake.

At the start of salt awareness week, Action on Salt is calling on Public Health England to revive the UKs salt reduction programme. The last set of salt targets drawn up under the Department of Healths responsibility deal was published in 2014.

The findings from the survey are very concerning, said Hemini Bharadia of Blood Pressure UK. We are all eating too much salt. This can lead to high blood pressure causing strokes and heart attacks, most of which could be avoided through better lifestyle choices.

Quick guide

Processed foods

These are some of the UKs best-selling ultra-processed foods

Mr Kipling Angel slices

Batchelors Super Noodles

McVities digestive biscuits

Kelloggs Rice Krispies

Walkers cheese and onion crisps

Cadburys Crunchie

Haribo sweets

These are the ingredients in Mr Kipling Angel slices


SugarListed first, so it is the biggest ingredient. Each slice contains 13.2g of sugar, which is 15% of an adults recommended daily intake

Vegetable oils (rapeseed, palm)Rapeseed oil is healthy, but palm oil is a highly saturated fat, widely used in industrially-produced foods because of its very low cost

Wheat flour (with added calcium, iron, niacin, thiamin) Added vitamins but this is finely milled white flour

Water

Glucose syrupAnother form of sugar, made from maize in the USA, where it is called corn syrup, or from potatoes and wheat

Humectant (vegetable glycerine) Reduces moisture loss

DextroseAnother form of sugar

Dried egg white

Whey powder (milk)Gives texture

Vegetable fat (palm) Cheap form of saturated fat

Maize starchOften used as an anti-caking agent in sugars

Skimmed milk powder

Raising agents (disodium diphosphate, sodium bicarbonate)

Emulsifiers (mono- and diglycerides of fatty acids, sorbitan monostearate, polyglycerol esters of fatty acids, soya lecithin, polysorbate 60)Emulsifiers are additives used to stabilise processed foods

Tapioca starchThickening agent derived from cassava roots

Salt

Stabiliser (xanthan gum)Made from fermented sugars. Prevents ingredients from separating

Preservative (potassium sorbate)

Milk proteinCan be used in industrially-made sponge cakes to replace egg, giving volume, elasticity and texture

Flavourings

Gelling agent (sodium alginate) This is E401, extracted from brown seaweed and used as a stabiliser in cream

Colours (titanium dioxide, cochineal, lutein) Titanium dioxide is an additive used in paint but also massively in food to give a white colour. Cochineal is the red colouring derived from insects. Lutein is yellow colouring extracted from marigolds

Acid (acetic acid)A leavening ingredient in baked goods when combined with baking soda

Alison Tedstone, the chief nutritionist at Public Health England, said: Our salt consumption has decreased over the last decade a loaf of bread has 40% less than it used to. However, some products are still too high in salt and we know this can be reduced further.

Read more: https://www.theguardian.com/society/2018/mar/13/calls-for-warnings-on-astonishingly-salty-chinese-food

The town thats found a potent cure for illness community | George Monbiot

Frome in Somerset has seen hospital admissions fall since it began to tackle isolation. There are lessons for the rest of the country, writes Guardian columnist George Monbiot

It could, if the results stand up, be one of the most dramatic medical breakthroughs of recent decades. It could transform treatment regimes, save lives, and save health services a fortune. Is it a drug? A device? A surgical procedure? No, its a newfangled intervention called community. This week the results from a trial in the Somerset town of Frome are published informally, in the magazine Resurgence& Ecologist. (A scientific paper has been submitted to a medical journal and is awaiting peer review). We should be cautious about embracing data before it is published in the academic press, and must always avoid treating correlation as causation. But this shouldnt stop us feeling a shiver of excitement about the implications, if the figures turn out to be robust and the experiment can be replicated.

What this provisional data appears to show is that when isolated people who have health problems are supported by community groups and volunteers, the number of emergency admissions to hospital falls spectacularly. While across the whole of Somerset emergency hospital admissions rose by 29% during the three years of the study, in Frome they fell by 17%. Julian Abel, a consultant physician in palliative care and lead author of the draft paper, remarks: No other interventions on record have reduced emergency admissions across a population.

Frome is a remarkable place, run by an independent town council famous for its democratic innovation. Theres a buzz of sociability, a sense of common purpose and a creative, exciting atmosphere that make it feel quite different from many English market towns, and for that matter, quite different from the buttoned-down, dreary place I found when I first visited, 30 years ago.

The Compassionate Frome project was launched in 2013 by Helen Kingston, a GP there. She kept encountering patients who seemed defeated by the medicalisation of their lives: treated as if they were a cluster of symptoms rather than a human being who happened to have health problems. Staff at her practice were stressed and dejected by what she calls silo working.

So, with the help of the NHS group Health Connections Mendip and the town council, her practice set up a directory of agencies and community groups. This let them see where the gaps were, which they then filled with new groups for people with particular conditions. They employed health connectors to help people plan their care, and most interestingly trained voluntary community connectors to help their patients find the support they needed.

Sometimes this meant handling debt or housing problems, sometimes joining choirs or lunch clubs or exercise groups or writing workshops or mens sheds (where men make and mend things together). The point was to break a familiar cycle of misery: illness reduces peoples ability to socialise, which leads in turn to isolation and loneliness, which then exacerbates illness.

This cycle is explained by some fascinating science, summarised in a recent paper in the journal Neuropsychopharmacology. Chemicals called cytokines, which function as messengers in the immune system and cause inflammation, also change our behaviour, encouraging us to withdraw from general social contact. This, the paper argues, is because sickness, during the more dangerous times in which our ancestral species evolved, made us vulnerable to attack. Inflammation is now believed to contribute to depression. People who are depressed tend to have higher cytokine levels.

But, while separating us from society as a whole, inflammation also causes us to huddle closer to those we love. Which is fine unless, like far too many people in this age of loneliness, you have no such person. One study suggests that the number of Americans who say they have no confidant has nearly tripled in two decades. In turn, the paper continues, people without strong social connections, or who suffer from social stress (such as rejection and broken relationships), are more prone to inflammation. In the evolutionary past, social isolation exposed us to a higher risk of predation and sickness. So the immune system appears to have evolved to listen to the social environment, ramping up inflammation when we become isolated, in the hope of protecting us against wounding and disease. In other words, isolation causes inflammation, and inflammation can cause further isolation and depression.

Remarkable as Fromes initial results appear to be, they shouldnt be surprising. A famous paper published in PLOS Medicine in 2010 reviewed 148 studies, involving 300,000 people, and discovered that those with strong social relationships had a 50% lower chance of death across the average study period (7.5 years) than those with weak connections. The magnitude of this effect, the paper reports, is comparable with quitting smoking. A celebrated study in 1945 showed that children in orphanages died through lack of human contact. Now we know that the same thing can apply to all of us.

Dozens of subsequent papers reinforce these conclusions. For example, HIV patients with strong social support have lower levels of the virus than those without. Women have better chances of surviving colorectal cancer if they have strong connections. Young children who are socially isolated appear more likely to suffer from coronary heart disease and type 2 diabetes in adulthood. Most remarkably, older patients with either one or two chronic diseases do not have higher death rates than those who are not suffering from chronic disease as long as they have high levels of social support.

In other words, the evidence strongly suggests that social contact should be on prescription, as it is in Frome. But here, and in other countries, health services have been slow to act on such findings. In the UK we have a minister for loneliness, and social isolation is an official health priority. But the silo effect, budget cuts and an atmosphere of fear and retrenchment ensure that precious little has been done.

Helen Kingston reports that patients who once asked, What are you going to do about my problem? now tell her, This is what Im thinking of doing next. They are, in other words, no longer a set of symptoms, but people with agency. This might lead, as the preliminary results suggest, to fewer emergency admissions, and major savings to the health budget. But even if it doesnt, the benefits are obvious.

George Monbiot is a Guardian columnist

Read more: https://www.theguardian.com/commentisfree/2018/feb/21/town-cure-illness-community-frome-somerset-isolation

Baby girl survives with heart outside her body at birth, in UK first

Vanellope Hope Wilkins, who had her first surgery within an hour of delivery, is believed to be first baby in UK to survive with the extremely rare condition

A baby girl born with her heart outside her body is believed to be the first in the UK to survive with the extremely rare condition after undergoing three operations, the first within an hour of her birth.

At a nine-week scan, Vanellope Hope Wilkins was discovered to have the condition ectopia cordis, with her heart and part of her stomach growing externally.

Her parents, Naomi Findlay, 31, and Dean Wilkins, 43, of Bulwell, Nottinghamshire, were advised termination was the only option, they said.

But three weeks after her premature birth, by caesarean section on 22 November, Vanellope, who is named after a Disney princess, has survived three operations at Glenfield Hospital, Leicester, to move her heart back inside her chest.

Experts, including the consultant cardiologist, have said they do not know of another case in the UK where a baby has survived such a condition.

Describing their emotions on first being told of her chances, Findlay said: I burst into tears. When we did the research, we just couldnt physically look because the condition came with so many problems.

Wilkins said: We still didnt know what we were looking at when we saw the scan, it looked like a little hamster with a hat on.

They decided against termination, preferring to leave it to nature, and worried throughout the whole pregnancy.

Vanellope
Vanellope Wilkins undergoes corrective surgery, in what is believed to be a UK first, at Glenfield Hospital. Photograph: University Hospitals of Leiceste/PA

The couple said they were told the first 10 minutes after birth were crucial as her ability to breathe would be essential. But when she came out and she came out crying, that was it. The relief fell out of me, said her mother. Her father said: Twenty minutes went by and she was still shouting her head off it made us so joyful and teary.

Vanellope has undergone three operations carried out by a team of 50 staff at Glenfield Hospital. Immediately after her birth, she was wrapped in a sterile plastic bag. Consultant neonatologist Jonathan Cusack said: At around 50 minutes of age, it was felt that Vanellope was stable enough to be transferred back to the main theatre, where she had been born, to the waiting anaesthetists, congenital heart disease and paediatric surgical teams who began the task of putting her entire heart back inside her chest.

She was transferred to the paediatric intensive care unit where she was due to stay for at least several weeks while she got strong enough and big enough for her heart to be placed fully within her chest and covered with her skin.

After seven days, her chest was opened a bit more to create space to allow her heart to fit back in. In the average baby, there is an indent on the left lung which leaves space for the heart, but she did not have this. Over two weeks, her heart naturally made its way back into her chest as a result of gravity.

The latest operation involved taking skin from under her arms and moving it to join in the middle of her body. Surgeons had created a mesh that protected her heart as she did not have ribs or a sternum. As her organs fight for space inside her chest, she is still attached to a ventilation machine.

Babies born with the condition one estimate is five to eight per million have less than a 10% chance of survival.

Branko Mimic, the lead surgeon at the East Midlands Congenital Heart Centre, said: Cases such as Vanellopes, where everything else appears essentially normal, are even rarer, and whilst it would seem more hopeful she will do well, it is therefore almost impossible to be confident of this.

Frances BuLock, a consultant paediatric cardiologist at Glenfield Hospital, said she had described the chances of the baby surviving as remote. I had seen one in foetal life around 20 years ago but that pregnancy was ended.

Findlay said all the way through her pregnancy that she was warned the chances of survival are next to nothing. After the birth, she said, I felt guilty for thinking negative thoughts because here she is fighting, and there was I, about to give up. Im glad I stuck to my guns not to terminate though, Im so glad.

Wilkins said: I lost hope a few times, if she didnt move Id say: Has she moved today? and then, the next thing, shed suddenly move and youd go: Oh shes heard me.

They named their daughter after a character in the film Wreck-it Ralph. Vanellope in the film is so stubborn and she turns into a princess at the end, so it was so fitting. The Hope part of her name is the fact that she has brought us hope, and my mum and dad, because even they, as grandparents, thought they would never get to see their granddaughter, said Findlay.

Wilkins said: Some mums still terminate and if we can get out there that there is a hope, and that it can be done, then its giving all those mums out there a chance. His daughters name was a reminder, he said, that there is that hope.

Read more: https://www.theguardian.com/uk-news/2017/dec/12/baby-girl-survives-after-being-born-with-heart-outside-her-body-in-uk-first

When do the clocks go back? Key facts about the switch to GMT

Extra hour of sleep could help protect against cancer, diabetes, high blood pressure and stress

Britons will be able to enjoy an extra hour under the duvet and reap health and cognitive bonuses on Sunday when the clocks go back at 2am, according to sleep experts.

As daylight saving time ends, the UK will switch from British summer time (BST) to Greenwich mean time (GMT), heralding the start of lighter mornings but darker evenings.

But according to Prof Matthew Walker, director of the Center for Human Sleep Science at Berkeley, California a small boost to our nightly slumber can also improve memory and increase learning capacity.

Walker, who recently published Why We Sleep, a book drawing on 20 years of research and findings from his laboratory, said: Just 60 to 90 minutes of additional sleep boosts the learning capacity of the brain, significantly increasing memory retention of facts and preventing forgetting.

In a study published six years ago in Current Biology, Walker and a team of researchers demonstrated that during a demanding memorising task, test subjects who were allowed extra nap time performed better than those who did not.

They found the brains ability to learn was linked to sleep spindles: fast pulses of electricity generated during REM (rapid eye movement) sleep, which accounts for 25% of total sleep time in adult humans.

Spindle-rich sleep, which is said to occur in the second half of the night, helps with the brains ability to create new memories by clearing a path to learning.

But it is not just about improved brain power. Experiments conducted in 2013 by the Surrey Sleep Centre and the BBC showed a link between an extra hour in bed and genetic expression that helps protect against illnesses such as cancer, diabetes and stress.

Scientists at the centre in Guildford divided the participants into two groups. During the first week, one group slept for six-and-a-half hours nightly while the other had seven-and-a-half hours of sleep. The volunteers then switched their sleep patterns in the second week.

The researchers found that those who had less sleep struggled with mental agility tasks. Blood tests revealed that genes associated with processes such as inflammation, immune response and response to stress became more active for those who had less sleep.

The activity of genes associated with heart disease, diabetes and risk of cancer also increased. They found the reverse happened when the volunteers slept for an extra hour.

Meanwhile, other studies have linked extra sleep time to a lower risk of heart disease. A 2008 study published in the Journal of the American Medical Association showed that adults who slept for seven hours a night had a lower chance of having calcium deposits in their arteries than adults who had only six hours of sleep.

According to scientists from the University of Chicago, who conducted the five-year research, the benefit of one hour of additional sleep was comparable to the gains from lowering systolic blood pressure by 17mmHg.

Another study, published in 2012 in the Journal of Sleep Research, found that getting an extra hour of sleep significantly improved blood pressure levels among people with hypertension or pre-hypertension.

Daylight saving time has also been linked to heart attacks. In a study published in the British Medical Journal in 2014, Amneet Sandhu of the University of Colorado reported a 24% increase in heart attack admissions at hospitals in Michigan from 2010 to 2013 on the Monday after the clocks went forward in spring, when compared with other Mondays throughout the year.

In contrast, he noted a 21% decrease in heart attacks on the Tuesday in the same hospitals after the clocks moved an hour back in autumn.

Last year a poll by the Royal Society for Public Health revealed people in the UK slept an average of 6.8 hours, under-sleeping by about an hour a night.

Modern daylight saving time (DST) is a little over 100 years old. It was first proposed by a New Zealander named George Hudson in 1895 and first introduced in the city of Orillia in Ontario in 1911-12.

The ideas big breakthrough came during the first world war when Germany introduced DST on 30 April 1916 to alleviate hardships from wartime coal shortages and air raid blackouts.

Britain, most of its allies and many European neutrals soon followed suit. Russia and a few other countries waited until the next year, and the US adopted it in 1918.

Read more: https://www.theguardian.com/society/2017/oct/28/clocks-back-gmt-sleep-cancer-diabetes-high-blood-pressure-stress

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

Disturbed sleep patterns may be key to ADHD, study finds

Research links disruption of body clock to number of chronic conditions

Struggling to concentrate, having too much energy and being unable to control behaviour the main manifestations of attention deficit hyperactivity disorder (ADHD) have been linked to disruptions in sleep, researchers will reveal on Sunday.

The findings underline a growing awareness among doctors that disturbed sleep is associated with many major health hazards. Other ailments linked to the problem include obesity, diabetes and heart disease. The work opens up the possibility of developing treatments for ADHD without drugs, the researchers say.

Speaking at a pharmacology conference in Paris, Professor Sandra Kooij, of VU University Medical Centre in Amsterdam, will outline research which shows poor sleep is a sign that the timings of many physiological processes are not properly synchronised.

The onset of ADHD is one of the clear signs that this is taking place. Our research is making clear that sleep disruption and ADHD are intertwined. Essentially, they are two sides of the same physiological and mental coin, said Kooij, speaking before her presentation.

Symptoms of ADHD, which also include mood swings and impulsiveness, are generally noticed at a fairly early age, often when a child is being sent to school for the first time, although cases are sometimes not recognised until adulthood. It is estimated that between 2% and 5% of people are affected by ADHD at some time. According to Kooij, the condition is very often inherited and usually has a pronounced neurological background.

In addition, about 80% of cases are associated with profound sleep disturbances. This is most frequently manifested as delays in the onset of sleep, Kooij will tell delegates at the annual congress of the European College of Neuropsychopharmacology in Paris.

People simply cannot go to bed and fall sleep at the end of the day like others, she said. And that has consequences. Affected individuals sometimes cannot get to sleep until around 3am but they still have to get up to go to work or school. The result is a drastic loss of sleep.

This problem is linked, in turn, to disturbances in levels of the neurological transmitters dopamine and melatonin in the brain, she said. These chemicals control when we fall asleep and when we wake up by directing the brains circadian system, the internal biological clock which keeps us in sync with the 24-hour day.

Other conditions linked to disturbed dopamine and melatonin levels include restless leg syndrome an irresistible urge to move your legs and sleep apnoea, in which breathing is disturbed during sleep. These disorders are also linked to ADHD, said Kooij.

This claim is backed by Professor Andreas Reif, of University Hospital, Frankfurt. A disturbance of the circadian system may indeed be a core mechanism in ADHD but beyond these considerations, sleep abnormalities are a huge problem for many patients, heavily impacting on their social life. More research is very relevant to improve patients lives. The crucial point is that a cascade of health disorders, including ADHD, appear to be triggered by disruptions to circadian rhythms, offering some routes to counter these conditions by attempting to restore a patients body clock. Kooij said her team was now looking for biomarkers, such as vitaminD levels, blood glucose, cortisol levels, 24-hour blood pressure, and heart-rate variability that are associated with sleeplessness.

Once we can do that, we may be able to treat some ADHD by non-pharmacological methods, such as changing light or sleep patterns. We may also be able to prevent the negative impact of chronic sleep loss on health in general.

Read more: https://www.theguardian.com/society/2017/sep/02/disturbed-sleep-patterns-may-be-key-to-adhd

I live a healthier life now Im free of the trappings of modernity | Mark Boyle

Being healthy is not about doctors, ambulances and technology. I use natural methods to keep my body in balance, writes Mark Boyle, the Guardians Life Without Technology columnist

When people learn of my decision to reject modern complex technology in favour of older, slower, forgotten ways, their first line of inquiry usually involves healthcare. Considering its importance to our lives, this is hardly surprising. Yet because of its emotive nature which of us, after all, doesnt have friends or family needing glasses, hearing aids, stents or prescription drugs? it seems difficult to have a calm, objective discussion on the subject.

The more concerned and curious inquirers often ask me what I would do if I got seriously ill. While the long answer is complicated and nuanced, honestly, I dont know. Its easy to live by your values when times are good, much harder when youre having a stroke or dying of cancer.

One thing I can say with more confidence is this: if we continue pursuing this political ideology of mass industrialism which has given us ambulances, dialysis machines, wheelchairs and antidepressants not only will we continue to harm our physical, emotional and mental health (leading to even more people needing such things) well also wipe out much of life on Earth.

Industrial civilisation, itself only 200 years old, is already causing the sixth mass extinction of species of the last half billion years. Whats that got to do with an ambulance? Well, both nothing and everything. The ambulance itself undoubtedly saves lives (including my dads). Yet deconstruct a single ambulance with its plastics, oils, fluids, copper, acids, glass, rubber, PVC, minerals and steel and Ill show you how to lay waste to the very thing all our lives depend upon: the planet.

Big picture aside, most of what afflicts us today cancer, obesity, mental illness, diabetes, stress, auto-immune disorders, heart disease, along with those slow killers: meaninglessness, clock-watching and loneliness are industrial ailments. We create stressful, toxic, unhealthy lifestyles fuelled by sugar, caffeine, tobacco, antidepressants, adrenaline, discontent, energy drinks and fast food, and then defend the political ideology that got us hooked on these things in the first place. Our sedentary jobs further deplete our physical, emotional and mental wellbeing, but instead of honestly addressing the root cause of the illness we exert ever more effort, energy, genius and money trying to treat the symptoms and contain the epidemics.

Weve developed Stockholm syndrome, sympathising with the very system that has economically held us hostage since the 18th century. Industrialism, along with its partner in crime, capitalism, has even persuaded us that, in order to save ourselves and loved ones from the horrors of disease we should spray every surface with chemicals, keep childrens hands out of the dirt and muck, and try to sterilise our entire world. With our immune systems compromised as a result, multi-billion-dollar pharmaceutical companies then sell us products to fend off what our bodies should be able to fight off naturally.

In their cleverness they have even persuaded us to pop painkillers for things that hardier generations would balk at. My own approach to healthcare wont satisfy the critics, the advocates of this strange thing called progress that seems to have us all more stressed and less content. And thats OK; Im not trying to tell people what to do, and Ive got no product to sell. I share it only because my editor tells me its the most common online inquiry.

In doing so Im very aware that Ive been blessed to be born without any serious long-term health issues, and that at 38 Im relatively young. That said, Im not convinced that its necessary to fall into such poor physical shape, as civilised peoples tend to do. My dad is almost 73 and he can still cycle 150km before dinner, simply because he has never stopped looking after his health.

The philosophy underlying my approach is that of any herbalist: keep the vitality in your body strong, and be mindful to do it every day. When it goes out of ease and into disease, use the appropriate plants the original source of many industrial medicines to bring your body and mind back into balance, and to restore optimal functioning. Your body is always aiming for balance and health, and listening to it is one of the best things you can do. Illness is feedback the sooner you heed it and restore your vitality, the less likely it is youll develop more serious problems.

I find it impossible to describe my approach to health without describing my approach to life. I wouldnt dream of suggesting that this is a prescriptive solution for anyone else; but with the exception of a voluntary vasectomy, I havent seen a doctor or nurse for 20 years.

I pick my own fruit and vegetables from the garden and hedgerows, and eat them as fresh, raw and unwashed as is optimal. I cycle 120km each week to lakes and rivers, where I then spend three evenings of that week relaxing and catching the following days dinner. I work outdoors, getting sweaty and dirty doing things I enjoy. I made the tough decision to live in the natural world so that I could breathe clean air, drink pure water and create life that allows others the same. I wash with water, and water only. I use no chemicals inside or outside the house. I wear as few clothes as I need, I use nothing electrical no fridge, no screens, no phone. I avoid sugar, caffeine and stress like the plague.

Sleep comes and goes with the light I find six hours of peaceful rest sufficient. If and when I do feel ill or out of balance, my girlfriend Kirsty (who illustrates these articles and is teaching herself herbalism) recommends a plant from our herb patch and I slowly feel vital again. Shes currently drying yarrow, horsetail, silverweed, self-heal, calendula and chamomile for the winter months.

Ive suffered from hay fever something becoming more common as CO2 levels in the atmosphere increase since I was a child. These days I eat a handful of plantain leaves a natural antihistamine three or four times a day, and that sorts it. Plantain comes out just before hay fever season and goes to seed shortly afterwards, and is a common in the cracks of city pavements and lawns as it is in the countryside.

I appreciate that this may sound unrealistic to many. When I was working 60 hours a week in a low-paid job in the City, 10 years ago, it did to me too. I only managed to do it by stripping away modernitys bullshit, learning to live with the land, and reducing my bills down to zero. Simplicity in these times is hard won, but Ive found that its worth it.

I can only speak for myself, and I support everyones decision to care for their own health as they see fit. Ultimately, were all going to die and I wish to go out like the American writer and conservationist Edward Abbey: by taking off to the wilderness, where wildlife can feed on my dead body just as I have done on theirs. It seems only fair.

Two things, in this respect, I find important. One is that like Henry David Thoreau once remarked, I do not safely reach death and discover that I had not lived. Second, that I dont cling to my own fading light so desperately that I extinguish it for all else. Like all good guests, its wise not to overstay your welcome.

This article was written by hand and posted to an editor at the Guardian, who typed it up to go online. Get in touch with Mark Boyle, the Guardians Living Without Technology columnist, here or in the comments below, a selection of which will be posted to him

Read more: https://www.theguardian.com/commentisfree/2017/sep/21/healthier-life-free-modernity-doctors-technology-exercise-herbs

6 million middle-aged people take no exercise

Public Health Englands research suggests large numbers of adults do not walk for 10 minutes at a time once a month

About 6 million middle-aged people in England are endangering their health by not taking so much as a brisk walk once a month, government advisers have said.

Clinicians said such a lack of exercise increases an individuals risk of prematurely developing serious health conditions including type 2 diabetes, heart disease, dementia and cancer.

Public Health England (PHE) said 41% of the 15.3 million English adults aged 40 to 60 walk less than 10 minutes continuously each month at a brisk pace of at least 3mph.

PHE has launched a health campaign targeting the sedentary middle-aged by encouraging them to walk to the shop instead of using a car and to take up walking on lunch breaks to add many healthy years to their lives.

Health leaders believe that 10 minutes walking a day is likely to be seen as achievable by people who are chronically inactive and that the health benefits include increased fitness, improved mood, a healthier body weight and a 15% reduction in the risk of dying prematurely.

PHE said walking required no skill, facilities or equipment and was more accessible and acceptable than other forms of physical activity for most people. Guidance issued by the UKs four chief medical officers in 2011 instructed the British population on how much exercise they should be participating in each week.

They said that adults should do at least two and a half hours of moderately intensive activity a week.

The PHE report said a quarter of the English population are inactive, doing less than 30 minutes of exercise a week. For some of these individuals 150 minutes may seem an unrealistic aim, according to the PHE report.

PHEs One You campaign is urging those people to take up the challenge of walking briskly for 10 minutes a day. As part of the drive it has released the Active 10 app which will help users achieve the goal and GPs will be recommending it to their patients to help build up their activity levels.

Dr Jenny Harries, the deputy medical director of PHE, said: I know first hand that juggling the priorities of everyday life often means exercise takes a back seat.
Walking to the shops instead of driving or going for a brisk 10-minute walk on your lunch break each day can add many healthy years to your life. The Active 10 app is a free and easy way to help anyone build more brisk walking into their daily routine.

Prof Sir Muir Gray, a clinical adviser for the Active 10 app and the One You campaign, added: We all know physical activity is good for your health but for the first time were seeing the effects that easily achievable changes can make. By walking just 10 continuous minutes at a brisk pace every day, an individual can reduce their risk of early death by 15%.

They can also prevent or delay the onset of disability and further reduce their risk of serious health conditions, such as type 2 diabetes, heart disease, dementia and some cancers.

Read more: https://www.theguardian.com/lifeandstyle/2017/aug/24/around-6-million-middle-aged-english-people-take-no-exercise

Sugar is poison. My heart attack has finally opened my eyes to the truth | Giles Fraser: Loose canon

Loose canon: Globally, diabetes has almost quadrupled in 35 years and yet the multibillion-dollar sugar industry is happy to keep us in the dark about why

I am now a member of the zipper club. I know, I thought it sounded rude too. But apparently its the club name for those of us who have a scar right down the middleof our chest. I have one down my leg too, from groin to ankle. And as I spend time recovering from a heart bypass operation mostly doing very little, watching the cricket, reading the paper I have started to reflect on my condition. How did it come to this? How did the arteries of my heart become so clogged with gunk that I may have been just weeks from meeting my maker?

Diabetic, they said. Pah, I thought. I dont feel any different. Ijust get up to pee a bit more at night. Some biochemical medical problem just seemed a bit too elusive, abstract, distant. I mean, when Diane Abbott blamed a bad interview on diabetes, who really took that seriously? Earlier this year, I was sent on a diabetes awareness day and spent the time looking out of the window, bored. They tried to explain it to me but I wasnt concentrating.

Well, now that someone has sliced through my breastbone as they might a Christmas turkey, the whole thing doesnt seem quite so distant. And suddenly and unsurprisingly I am concentrating. All ears to, and pretty evangelical about, the evils of sugar. Sorry to have doubted you, Diane.

Back in September 2016, the Journal of the American Medical Association published papers, discovered deep in the Harvard University archives, that demonstrated how the sugar industry has been manipulating research into heart disease for years. These papers revealed that the purveyors of this white poison in behaviour straight out of the tobacco industry playbook had been paying Harvard scientists throughout the 1960sto emphasise the link between fatand heart disease and ignore the connection with sugar. Since then, Coca-Cola has funded research into the link between sugar and obesity. And the confectionery industry has paid for research which demonstrated that children who eat sweets are thinner than those who dont.

As I write, my son returns from the shops, perfectly on cue, laden with a chocolate bar, a full-fat Coke and a packet of lollipops. I want to tell him that Willy Wonka is a death-dealing drug dealer. But I bite my lip for now. He will think me a crank. Everything he likes has sugar in it. Thats my fault he got hooked on sugary breakfast cereals as a child. As Gary Taubes explained in his remarkable book The Case Against Sugar, published last year, it has assimilated itself into all aspects of our eating experience. Advertisements have normalised the omnipresence of sugar as a part of a balanced diet. And my sons brain has become accustomed to the dopamine it releases. He has become an addict. Most of us are addicts.

In 1996, 1.4 million people in the UK had diabetes. Since then the figure has trebled to over 4 million. Diabetes now gobbles up more than 10% of the NHS budget, with that percentage set to rise steeply in the coming years. The World Health Authority published a major report on global diabetes last year. Its figures show that the number of people with diabetes has gone up from 108 million in 1980 to 422 million in 2014. This is not just a matter of bad individual choices. You cant dismiss this as the aggregate of many millions of singular decisions, each one nothing more than a matter of weakness of will and responsible for itself alone. This has become a global epidemic.

For the last 30 years I have built a pretty effective protective shell against fat-shaming. I would probably have taken losing half a stone if offered, but I wasnt especially unhappy with my body shape. But now I see things differently. Now I see a multibillion-dollar industry that makes its profits by keeping us obese and in the dark about why. After my operation, I cut out sugar and carbohydrates as best I could. I have lost 10 kilograms in the five weeks since. And I plan to lose a lot more. Itsnot a diet I hate diets. Its a form ofprotest. The scales have fallen from my eyes. Beware the candy man.

Read more: https://www.theguardian.com/commentisfree/belief/2017/jul/13/sugar-is-poison-my-heart-attack-has-finally-opened-my-eyes-to-the-truth

Threats, bullying, lawsuits: tobacco industry’s dirty war for the African market

Revealed: In pursuit of growth in Africa, British American Tobacco and others use intimidatory tactics to attempt to suppress health warnings and regulation

British American Tobacco (BAT) and other multinational tobacco firms have threatened governments in at least eight countries in Africa demanding they axe or dilute the kind of protections that have saved millions of lives in the west, a Guardian investigation has found.

BAT, one of the worlds leading cigarette manufacturers, is fighting through the courts to try to block the Kenyan and Ugandan governments attempts to bring in regulations to limit the harm caused by smoking. The giant tobacco firms hope to boost their markets in Africa, which has a fast-growing young and increasingly prosperous population.

In one undisclosed court document in Kenya, seen by the Guardian, BATs lawyers demand the countrys high court quash in its entirety a package of anti-smoking regulations and rails against what it calls a capricious tax plan. The case is now before the supreme court after BAT Kenya lost in the high court and the appeal court. A ruling is expected as early as next month.

Tobacco: a deadly business

BAT in Uganda asserts in another document that the governments Tobacco Control Act is inconsistent with and in contravention of the constitution.

The Guardian has also seen letters, including three by BAT, sent to the governments of Uganda, Namibia, Togo, Gabon, Democratic Republic of Congo, Ethiopia and Burkina Faso revealing the intimidatory tactics that tobacco companies are using, accusing governments of breaching their own laws and international trade agreements and warning of damage to the economy.

BAT denies it is opposed to all tobacco regulation, but says it reserves the right to ask the courts to intervene where it believes regulations may not comply with the law.

Later this month, BAT is expected to become the worlds biggest listed tobacco firm as it completes its acquisition of the large US tobacco company Reynolds in a $49bn deal, and there are fears over the extent to which big tobacco can financially outmuscle health ministries in poorer nations. A vote on the deal by shareholders of both firms is due to take place next Wednesday, simultaneously in London at BAT and North Carolina at Reynolds.

Professor Peter Odhiambo, a former heart surgeon who is head of the governments Tobacco Control Board in Kenya, told the Guardian: BAT has done as much as they can to block us.

Experts say Africa and southern Asia are urgent new battlegrounds in the global fight against smoking because of demographics and rising prosperity. Despite declining smoking and more controls in some richer countries, it still kills more than seven million people globally every year, according to the WHO, and there are fears the tactics of big tobacco will effectively succeed in exporting the death and harm to poorer nations.

There are an estimated 77 million smokers in Africa and those numbers are predicted to rise by nearly 40% from 2010 levels by 2030, which is the largest projected such increase in the world.

In Kenya, BAT has succeeded in delaying regulations to restrict the promotion and sale of cigarettes for 15 years, fighting through every level of the legal system. In February it launched a case in the supreme court that has already halted the imposition of tobacco controls until probably after the countrys general election in August, which are being contested by parliamentarians who have been linked to payments by the multinational company.

In Uganda, BAT launched legal action against the government in November, arguing that the Tobacco Control Act, which became law in 2015, contravenes the constitution. It is fighting restrictions that are now commonplace in richer countries, including the expansion of health warnings on packets and point-of-sale displays, arguing that they unfairly restrict its trade.

The court actions are brought by BATs local affiliates, BAT Kenya and BAT Uganda, but approved at Globe House, the London headquarters of the multinational, which receives most of the profits from the African trade. In its 2016 annual report, BAT outlined the risk that unreasonable litigation would be brought in to control tobacco around the world. Its response was an engagement and litigation strategy coordinated and aligned across the Group.

Focus on emerging markets

British
British packets of cigarettes, with stark warnings, beside packs from Africa. Photograph: Linda Nylind for the Guardian

At its annual meeting in March, chairman Richard Burrows toasted a vintage year for BAT, as profits rose 4% to 5.2bn after investors took their cut their dividend had increased by 10%. When asked about the legal actions in Africa, he said tobacco was an industry that should be regulated … but we want to see that regulation is serving the correct interests of the health mission and human mission which should lie behind it.

So, from time to time its necessary for us to take legal action to challenge new regulation which he said was led by the local board.

BAT says it is simply not true that we oppose all tobacco regulation, particularly in developing countries. Tobacco should be appropriately regulated as a product that has risks to health, it said, but where there are different interpretations of whether regulations comply with the law, we think it is entirely reasonable to ask the courts to assist in resolving it. It was opposed to only a handful of the issues in Kenyas regulations, not the entirety, it said in a statement.

Although most countries in Africa have signed the World Health Organisation (WHO) treaty on tobacco control, none has yet fully implemented the smoking restrictions it endorses.

The WHO predicts that by 2025, smoking rates will go up in 17 of the 30 Africa-region countries from their 2010 level. In some countries a massive hike is expected in Congo-Brazzaville, from 13.9% to nearly half the population (47.1%) and in Cameroon from 13.7% to 42.7%. In Sierra Leone it will be 41.2% (74% among men) and in Lesotho 36.9%.

The tobacco industrys march on Africa

In contrast, research showed last year that just 16.9% of adults smoke in the UK; and last month new figures showed UK heart disease deaths had fallen 20% since that countrys indoor smoking ban.

The tobacco industry is now turning its focus toward emerging markets in sub-Saharan Africa, seeking to exploit the continents patchwork tobacco control regulations and limited resources to combat industry marketing advances, said Dr Emmanuela Gakidou and colleagues at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, publishing an analysis of smoking prevalence around the world in the Lancet in April.

Africas growing numbers of children and young people, and its increasing wealth, represent a huge future market for the tobacco industry. The companies deny targeting children and cannot sell packs smaller than 10, but a new study carried out in Nairobi by the Johns Hopkins school of public health in the US and the Kenya-based Consumer Information Network found vendors selling cigarettes along the routes children take to walk to primary schools.

Graphic

Stalls sell single Dunhill, Embassy, Safari and other BAT cigarette sticks, costing around 4p (5 cents) each, alongside sweets, biscuits and fizzy drinks. The vendors split the packets of 20 manufactured by BAT. They are targeting children, said Samuel Ochieng, chief executive of the Consumer Information Network. They mix cigarettes with candies and sell along the school paths.

BAT said that its products were for adult smokers only and that it would much prefer that stalls sold whole packets rather than single sticks, given our investment in the brands and the fact there are clear health warnings on the packs.

Across the world, we have very strict rules regarding not selling our products to retailers located near schools. BAT Kenya provides support to many of these independent vendors, including providing stalls painted in non-corporate colours, and providing youth smoking prevention and health warnings messages. We also educate vendors to ensure they do not sell tobacco products near schools.

Links with politicians

Cigarettes
Cigarettes on sale (alongside sweets) in Nairobi, Kenya. Photograph: David Levene for the Guardian

The Kenya case, expected to be heard after the elections on 8 August, is seen as critical for the continent. If the government loses, other countries will have less appetite for the long and expensive fight against the wealthy tobacco industry.

BAT has around 70% of the Kenyan market; its Kenyan competitor, Mastermind, has joined in the legal action against the government.

Concerns have been raised about links between politicians and the tobacco companies. There are allegations of some of them having been bribed in the past, said Joel Gitali, chief executive of the Kenya Tobacco Control Alliance.

BAT whistleblower Paul Hopkins, who worked in Africa for BAT for 13 years, told a British newspaper he paid bribes on the companys behalf to the Kenya Revenue Authority for access to information BAT could use against its Kenyan competitor, Mastermind. Hopkins has also alleged links between certain prominent opposition Kenyan politicians and two tobacco companies, BAT Kenya and Mastermind. Hopkins, who says he alerted BAT to the documents before the company made him redundant, claimed BAT Kenya paid bribes to government officials in Burundi, Rwanda and the Comoros Islands to undermine tobacco control regulations. Gitali is concerned about the outcome of the election: If the opposition takes over government we shall be deeply in the hands of the tobacco companies.

BAT denies any wrongdoing. A spokesperson said: We will not tolerate improper conduct in our business anywhere in the world and take any allegations of misconduct extremely seriously. We are investigating, through external legal advisors, allegations of misconduct and are liaising with the Serious Fraud Office and other relevant authorities.

We grow up dreaming we can be one of them

The
The headquarters and factory of British American Tobacco in Nairobi, Kenya. Photograph: David Levene for the Guardian

Tih Ntiabang, regional coordinator for Africa of the Framework Convention Alliance NGOs that support the WHO treaty said the tobacco companies had become bolder. In the past it used to be invisible interference, but today it is so shameful that it is so visible and they are openly opposing public health treaties like the case in Kenya at the moment Today they boldly go to court to oppose public health policy. Every single government is highly interested in economic growth. They [the tobacco companies] know they have this economic power. The budget of tobacco companies like BAT could be as much as the whole budget of the Africa region.

Our health systems are not really well organised. Our policy makers cant see clearly what are the health costs of inaction on tobacco control because our health system is not very good. It puts the tobacco industry at an advantage on public health.

The sale across the whole of Africa of single cigarette sticks was a serious problem because it enabled children to buy them. They are extremely affordable. Young teenagers are able to purchase a cigarette. You dont need 1 for a pack of 20, he said.

There are fears the number of deaths and illnesses in Africa from tobacco could rise dramatically

BAT has a reputation in Africa as an employer offering steady and well-paid jobs, said Ntiabang, based in Cameroon. When I was about 10, I was always dreaming I could work for BAT. They have always painted themselves as a responsible company a dream company to work for. All the staff are well-off. The young people think I want to work for BAT. They promote a lot of events and make their name appear to young people. We grow up dreaming we can be one of them.

In Uganda in 2014, BAT managing director, Jonathan DSouza, sent a 13-page detailed attack on the tobacco control bill, then going through parliament, to the chair of the governments health committee.

BAT was contracting with 18,000 farmers and paid them 61bn Ugandan shillings for 16.8m kg of tobacco in 2013, said the letter. The economy has benefited significantly from BAT Ugandas investments, it said. This has helped to alleviate poverty and improve welfare in urban and rural areas, it says.

BAT Uganda (BATU) agreed tobacco should be regulated while respecting the informed choices and rights of adults who choose to smoke and the legal rights of a legal industry. But it cited 11 areas of concern, claiming there is no evidence to support a ban on tobacco displays in shops, that large graphic health warnings on packs are ineffective, that proposals on bans on smoking in public places were too broad and that prohibiting smoking under the age of 21 was unreasonable, since at 18 young people are adults and can make up their own mind.

Documents made public by the University of Bath show that BATU had another concern: the ban on the sale of cheap single cigarettes. Adults should be free to purchase what they can afford, says an internal leaked paper. BATU also took action against the MP who sponsored the bill. A letter informed him that the company would no longer be contracting with the 709 tobacco farmers in his region. There is evidence that the company also lobbied other MPs with tobacco farmers in their constituencies.

The Tobacco Control Act became law in 2015, and in November last year, BAT sued. Many people choose to smoke, said an affidavit to the court from managing director Dadson Mwaura and it was important to ensure regulation did not lead to unintended consequences that risk an untaxed and unrestrained illegitimate trade in tobacco products. BATUs legal product contributed to the Ugandan economy in many dimensions.

A
A vendor in Nairobis Uhuru Park sells single stick cigarettes. Photograph: David Levene for the Guardian

The Guardian has seen letters showing that at least six other African governments have faced challenges from the multinational tobacco companies over their attempts to control smoking.

  • Democratic Republic of Congo: Letter to the president sent in April 2017 by the Fdration des Entreprises du Congo (chamber of commerce) on behalf of the tobacco industry, listing 29 concerns with the proposed tobacco control regulations, which they claim violate the constitution, international agreements and domestic law.
  • Burkina Faso: Letter sent in January 2016 to the minister of health from Imperial Tobacco, warning that restrictions on labeling and packaging cigarettes risks economic and social damage to the country. Previous letter sent to the prime minister from the US Chambers of Commerce in December 2013 warning that large health warnings and plain packaging could put Burkina Faso in breach of its obligations to the World Trade Organisation.
  • Ethiopia: Letter sent in February 2015 to the ministers of health and science and technology by Philip Morris International, claiming that the governments tobacco directive banning trademarks, brands and added ingredients to tobacco breached existing laws and would penalise all consumer retailers.
  • Togo: Letter to the minister of commerce in June 2012 from Philip Morris International opposing plain packaging, which risks having damaging consequences on Togos economy and business environment.
  • Gabon: Letter from BAT arguing that there is no evidence that plain packaging reduces smoking, citing the Deloitte report of 2011, alleging its introduction would put Gabon in breach of trade agreements and promote smuggling.
  • Namibia: Letter to the minister of health from BAT, warning that planned tobacco controls will have a massive impact on the Namibian economy at large.

Bintou Camara, director of Africa programs at Campaign for Tobacco-Free Kids, said: British American Tobacco, Philip Morris International and other multinational tobacco companies have set their sights on Africa as a growth market for their deadly products. Throughout Africa, tobacco companies have tried to intimidate countries from taking effective action to reduce tobacco use, the worlds leading cause of preventable death, he added.

Governments in Africa should know that they can and should move forward with measures aimed at preventing and reducing tobacco use and that they do so with the support of the many governments and leaders around the world that have taken strong action to protect public health.

Cloe Franko, senior international organizer at Corporate Accountability International, said: In Kenya, as in other parts of the world, the industry has resorted to frivolous litigation, aggressive interference … to thwart, block, and delay lifesaving policies. BATs actions are emblematic of a desperate industry grasping to maintain its hold over countries and continue to peddle its deadly product.

Philip Morris said it is regularly engaged in discussions with governments. We are approached by or approach public authorities to discuss a range of issues that are important for them and for us, such as taxation, international trade, and tobacco control policies. Participating in discussions and sharing points of view is a basic principle of public policy making and does not stop governments from taking decisions and enacting the laws they deem best. It said that it supports effective regulation, including laws banning sales to minors, mandatory health warnings, and advertising restrictions.

Imperial Tobacco said it sold its brands where theres a legitimate and existing demand for tobacco and take the same responsible approach in Africa as we do in any Western territory. A spokesman said it supported reasonable, proportionate and evidence-based regulation of tobacco, including health warnings that are consistent with global public health messages. But, it said, Imperial would continue to make our views known on excessive, unnecessary and often counter-productive regulatory proposals.

Read more: https://www.theguardian.com/world/2017/jul/12/big-tobacco-dirty-war-africa-market