Month: October 2016

Hunger ‘not linked to calorie intake’

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Grocery stores are now amassed with prepackaged meals claiming to suppress appetite and keep us feeling fuller for longer. But according to new research, these meals are unlikely to affect our overall calorie intake.

From a review of more than 460 studies, researchers from the University of Sheffield in the United Kingdom found little evidence of a link between how hungry we feel and the amount of calories we consume.

Study leader Dr. Bernard Corfe, from the Molecular Gastroenterology Research Group at Sheffield, and team publish their results in the journal Critical Reviews in Food Science and Nutrition.

In the United States, more than 2 in 3 adults and around one third of children are considered overweight or obese.

The primary cause of overweight and obesity is an energy imbalance – that is, more calories are consumed than the body uses, or “burns,” which results in excess weight.

As such, eating a healthy diet and sticking to the daily recommended calorie intake – around 1,600-2,400 calories for women and 2,000-3,000 calories for men, depending on physical activity – are considered key for weight loss and maintenance.

Few studies found a link between appetite and calorie intake
Appealing to the the desire of many individuals to lose weight through dietary changes are prepackaged meals that claim to have appetite-modifying properties that keep us sated for longer, reducing the need to reach for the unhealthy snacks when hunger bites.

The new study, however, indicates there is no link between appetite and calorie intake, suggesting some food manufacturers may need to rethink their claims.

Dr. Corfe and colleagues came to their conclusion after conducting a review of 462 studies that assessed both appetite and calorie consumption.

The researchers found that only 6 percent of the studies reviewed made a direct statistical comparison between appetite and calorie intake, and only half of these studies found that self-reported appetite correlated with calorie consumption.

The team says these findings indicate that how hungry we feel has no effect on the amount of calories we consume – something that food manufacturers should take into consideration.

“The food industry is littered with products which are marketed on the basis of their appetite-modifying properties. Whilst these claims may be true, they shouldn’t be extended to imply that energy intake will be reduced as a result.

For example, you could eat a meal which claims to satisfy your appetite and keep you feeling full up for a long period of time but nonetheless go on to consume a large amount of calories later on.”

Dr. Bernard Corfe

Dr. Corfe says further research is needed in order to pinpoint precisely what does influence calorie intake; are environmental or social factors involved?

“This will be important to understand how obesity occurs, how to prevent it, and how we need to work in partnership with the food industry to develop improved tests for foods that are genuinely and effectively able to satisfy appetite,” Dr. Corfe adds.

Source: http://www.medicalnewstoday.com/articles/313620.php

Migraines linked to bacteria in mouth

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People who suffer from migraines have more of certain bacteria in their mouths

People who suffer from migraines have long complained that certain foods trigger the severe headaches. New research suggests the culprit might be the amount of bacteria in the mouth.

Researchers found that the mouths of people who suffer from migraines harboured significantly more of the microbes that break down nitrates found in certain foods.

These bacteria play an important role in processing nitrates so they can then be converted into nitric oxide in the bloodstream, which widens blood vessels and improves circulation.

While this process is helpful for cardiovascular health, the findings suggest an abundance of these bacteria may break down nitrates more quickly, causing blood vessels in the brain and scalp to dilate, triggering migraines.

Nitrates are naturally found in a variety of leafy green vegetables, and they are added to processed meat as a preservative and to improve flavour and colour.

Doctors have been telling people who suffer from migraines to avoid processed foods for years. Dr. Michael Zitney, who leads the Headache & Pain Relief Centre in Toronto, says this research strengthens their case.

“We have long since known that these kinds of foods can trigger migraines, but we haven’t really known how,” he says.

Link to cardiovascular research

The process of how nitrates break down into nitric oxide is well-studied in cardiovascular health.

Nitrate-containing drugs are prescribed to treat chest pain or congestive heart failure. But roughly four out of five cardiac patients who take the drugs report severe headaches as a side-effect.

The study’s authors hope these findings will help link existing cardiovascular research with migraines.

“It opens a full area of research and connects two areas of research that have not been connected before,” says the study’s lead author, Antonio Gonzalez, from the University of California San Diego.

Data collected from ‘citizen scientists’

This study was based on data from the American Gut Project, which crowd sources oral and fecal samples from so-called “citizen scientists.”

Researchers sequenced bacteria found in 172 oral samples and 1,996 fecal samples. They found that the nitrate-reducing microbes were slightly more abundant in the fecal samples of people who suffer from migraines, but significantly more abundant in their oral samples.

Chronic migraines are frequent, severe, pulsating headaches accompanied by nausea, vomiting, and sensitivity to light and sound. They last anywhere from a few hours to several days.

It’s estimated that eight per cent of Canadians have been diagnosed with migraines, although this likely underestimates their prevalence, as some people who suffer from migraines don’t seek professional help.

The study’s authors say they still need to determine whether the bacteria are a cause or a result of migraines, or are indirectly linked in some other way.

For now, Zitney says, the research suggests that some migraines could one day be treated by controlling the bacteria in our mouths.

“This may be just a glimmer of hope in terms of pursuing possible treatments,” he says.

The study was published earlier this week in mSystems, the online journal of the American Society for Microbiology.

Source: http://www.cbc.ca/news/health/bacteria-migraines-1.3811940

Student doctor numbers to rise by 25%

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The number of medical school places will increase by 25% from 2018 under plans to make England “self-sufficient” in training doctors.

The government’s plan will see an expansion in training places from 6,000 to 7,500 a year.

Ministers believe increasing the number of home-grown doctors will be essential given the ageing population.

There is also concern it will become more difficult to recruit doctors trained abroad in the future.

About a quarter of the medical workforce is trained outside the UK, but the impact of Brexit and a global shortage of doctors could make it harder to recruit so many in the future.

Prime Minister Theresa May told the BBC: “We want to see the NHS able to recruit doctors from this country. We want to see more British doctors in the NHS.”

The increase also comes after the government has spent a year at loggerheads with junior doctors over the pressures being placed on them to fill rota gaps.

Doctor workforce in numbers

150,000

doctors working in NHS

25% are foreign

9% due to retire in next five years

2% more needed each year to keep up with demand

7-10% of posts are vacant

Dr Daniel Bunce, 27, is in his third year of being a junior doctor after completing his medical degree. He is now working in a hospital in the south west in intensive care.

He says he got into medicine because he wanted to “care for people and make a difference”.

“It’s been difficult. There is so much pressure, particularly during winter. We just don’t have the time to spend with patients that we need to provide the care we want to because we are rushing around just trying to keep up.

“I’m now working in intensive care so the staff to patient ratios is much better than it was when I was on medical wards. But the workload is making people I work with think about whether this is something they want to do for the rest of their career.

“The increase in medical school places is a good move, but we will have to see what impact it has in hospitals in the long-term.”

Medical degrees take five years to complete, so it will be 2024 before the impact of these extra places is felt.

But Mr Hunt told the Conservative Party conference in Birmingham on Tuesday: “We need to prepare the NHS for the future, which means doing something we have never done properly before – training enough doctors.

“Currently a quarter of our doctors come from overseas. They do a fantastic job and we have been clear that we want EU nationals who are already here to stay post-Brexit.

“But is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?”

Mr Hunt said the steps would mean that by the end of the next Parliament the health service in England would be “self-sufficient” when it comes to training doctors.

Analysis: Will this work?

There is widespread agreement that the NHS is facing a crisis when it comes to doctor shortages. It is one of the underlying reasons why the dispute between the government and junior doctors has been so bitter.

So news that the number of training places is to increase by 25% is certainly being welcomed by many. But whether it is enough is another matter.

The health service employs more than 150,000 doctors – a quarter more than it did a decade ago. But even that has not been sufficient – vacancy rates are said to be running at close to 10%.

This is despite huge numbers being recruited from abroad. In fact, the numbers registering to work in the NHS from outside the UK has been outstripping those graduating from medical school in recent years.

The future, of course, is fraught with difficulties. The impact of Brexit on EU doctors is uncertain, there are large numbers due to retire – a figure of 13,500 in the next five years has been suggested – and then there is the not insignificant numbers who leave the NHS for other countries or opportunities.

More doctors in training doesn’t necessarily translate to more doctors in the NHS.

The rise in training places will cost £100m from 2018 to 2020, but in the long-term the government hopes to recoup money by charging foreign students more than it does now.

Medical students will also be expected to work for the NHS for at least four years – or face penalties that could include them having to repay the cost of their training, which currently stands at £220,000 to the taxpayer over the five-year degree.

The details of how this will work have yet to be ironed out and, in particular how it will apply to doctors moving to another part of the NHS in Scotland, Wales and Northern Ireland. This announcement applies to England only.

At this stage it is thought unlikely that ministers would want to apply the four-year restriction to doctors wanting to move to other UK nations.

Doctor hands

British Medical Association leader Dr Mark Porter said the announcement “falls far short of what is needed”.

“The government’s poor workforce planning has meant that the health service is currently facing huge and predictable staff shortages,” he said.

“We desperately need more doctors, particularly with the government plans for further seven-day services, but it will take a decade for extra places at medical school to produce more doctors.

“This initiative will not stop the NHS from needing to recruit overseas staff.”

  • Each year 6,000 medical students currently graduate after five years of study
  • There are a similar new junior doctors places open for them (although some students take gap years)
  • By the third year of junior doctor training they need to choose a specialism, such as general practice or a hospital speciality like surgery
  • That is where the shortages start to emerge
  • Latest figures from Health Education England show one in 10 places remain unfilled
  • The biggest gaps are seen in psychiatry (19%), GPs (17%) and paediatrics (7%)

Nigel Edwards, chief executive of the Nuffield Trust, said: “For decades, the NHS has failed to train enough of its own staff, so increasing the number of UK-trained medical staff is long overdue.

“However, if this new announcement involves simply replacing overseas doctors with UK-trained ones, that won’t increase the total number working in the NHS, and certainly won’t solve the agency staff crisis that is affecting the NHS right now.”

Chief Executive of Dartford and Gravesham NHS Trust Susan Acott told the BBC there were shortages in specialisms including Accident and Emergency, radiology and intensive care in her hospitals.

“An expansion of medical training is very desirable,” she said. “We’re a very under-doctored country compared to European levels.”

The idea that doctors could be retained in the UK once they had trained was an “interesting” idea, she added, but there were practical obstacles.

“Doctors go abroad to develop their training and experience different health systems and techniques,” Ms Acott said.

Source: http://www.bbc.com/news/health-37546360