Live To 100 with Dr Amir Khan: Spring 2024

with Dr Amir Khan

EATING FOR LIFE

How Your Diet Affects Your Health

NEUROTHERAPY

Training for Your Brain

YOUTHFUL SKIN

Smoother and Softer

Live Longer and Healthier

With TV Favourite

Dr Amir Khan

FIGHTING OBESITY

MENOPAUSE MATTERS

Dealing With the Change

STEADY HANDS

New Treatments for Tremor

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Menopausal Skin Symptoms

Our expertly formulated products help to improve common symptoms that appear as the skin changes during menopause.

DRYNESS

DEHYDRATION

FINE LINES & WRINKLES

BLEMISHES ENLARGED PORES

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WELCOME!

Dr Amir Khan introduces this issue of Live to 100, where we can all learn more about how to improve our health, wellbeing and even our longevity

Welcome to the latest issue of Live to 100. As you will read in my interview, it’s been a tough time for the NHS – in my work as a GP, I’m on the front line when it comes to patients’ problems. It may take a long time for things to improve, but the better awareness we have of our own health and wellbeing, the more we can ease the burden on the NHS. Simple measures like giving up smoking, taking more exercise and improving our diets could do so much to help, and we’ll look at all those issues in this magazine.

At least we can say that we have got through the winter and that the first sights of spring should be cheering us up. It’s a reminder that fresh air and exercise are as good for our mental health as for our physical state, and that those two are equally important.

As the population gets older, there are conditions that we might expect to become more common; but the more we do to protect our health, the longer we can live in health and comfort. It’s about quality of life as much as longevity, which is why it’s important that we all learn as much as possible about our wellbeing and ways we can adapt to older life.

There’s exciting news about research in areas such as dementia, cancer and diabetes which should give us all hope for longer, healthier and happier lives. I hope that the features in this issue of Live to 100 will help you to take a good look at your health and lifestyle, and if you can, make improvements that should lead to a fitter, healthier future!

Dr Amir Khan Guest Editor

IMAGES: Amigo Talent

C tents

10 Interview

Chris Jenkins talks to Dr Amir Khan, Britain’s favourite TV doctor and the face of Live to 100, about developments in healthcare, how the living environment a ects our long-term health, and what we can all do to live a longer and healthier life

YOUR WELLBEING

16 Fit and Positive

Being aware of health issues is a major contribution to improving our wellness – here are some headlines from the developing world of medicine to help us stay well

18 Joint Accounts

Arthritis doesn’t just a ect the elderly, but joint pain is a common symptom of increasing age. Could a better diet help to prevent it?

22 The Essentials of Tremor Is shaking of parts of the body a sign of serious illness, or just of age? Research suggests a new approach to treatment

24 Smarter, Faster, Stronger

We might not have built a bionic Six Million Dollar Man yet, but smart technology is doing more and more to help us maintain our health

26 In The Bones

Is ‘bone broth’ as packed with health benefits as its supporters claim? We boil some up and take a sip…

28 Is the Future Fatter?

The World Health Organisation reports that obesity is now more of a health threat worldwide than malnutrition. How can we avoid a fatter future?

32 Something in the Air

We spend about 90 percent of our time indoors, so the air that we breathe there inevitably has an e ect on our health

36 Eat Well, Feel Better

What we eat has more e ect on our health than practically any other factor. What can we do to make sure our nutrition is fit for life?

40 Supplementary Benefits

You might be eating what you think is a healthy, balanced diet, yet still be deficient in some vital nutrients. Can supplements improve wellbeing and even longevity?

46 Listening to Feedback

Neurofeedback therapy may be the key to treating a number of conditions by harnessing the brain’s capacity for change. So how does it work?

50 Better to Prevent

The idea that prevention is better than cure is not a new one, but new approaches suggest that idea is more valuable than ever before

53 Low, or No?

Millions of people reduced or cut out their alcohol intake for ‘dry January’. But what are the arguments for low- or no-alcohol drinks?

YOUR HEALTH CARE

54 Live Longer, Live Better

Breakthroughs in medical technology are bringing remarkable improvements in health outcomes every day. Here are some of the most exciting developments

58 Duty of Care

We all expect good medical treatment from our health services, but how can we claim damages when something goes wrong?

62 Youthful Skin

Is a loss of skin quality inevitable with age?

Certainly there’s a lot you can do to keep it looking youthful. Here are our top tips

66 Managing Diabetes Better

Living with diabetes could become a lot easier with the latest smart monitors

70 Managing the Pain

Is there a better way to manage pain than analgesic drugs? Physiotherapy o ers an alternative to a wide range of patients

74 Sense of Erection

Male erectile dysfunction is a common problem, but one that can be treated with both medication and appliances

78 High Street Health

With doctors’ waiting rooms full up, where else can you turn for quick health advice? Your High Street pharmacist is now in an ever better position to help

83 Putting the ‘K’ in Diet

Vitamin K isn’t as well-known as some others, but it could be just as essential to your diet

84 As Old As You Feel

They say you’re as old as you feel, but what if you could measure your ‘biological age’ and make lifestyle changes to improve it?

87 Female Factor

Women’s health has been notoriously neglected, but campaigns and research are moving towards a more balanced treatment of healthcare

91 Voyage by Balloon

There are many ways to achieve weight loss, from diet and exercise to forms of fat removal such as liposuction. But an increasingly popular technique is the gastric balloon

92 Fat Chance

It’s common to talk about weight loss, when what people really want is fat loss. How can technology remove the flab without the fuss?

95 Get the Balance Right

What is the health importance of vaginal pH, what can upset it and what can women do to keep it balanced?

96 The Leaf That Cares

Medical cannabis is now legally available in the UK, but what conditions can it help and how is treatment organised?

101 The Pressure Is On

Why is it so important to check our blood pressure, how does it a ect our health and what is the easiest way to get it tested?

LATER LIFE

102 Quality of Life

As we get older, how we feel is just as important as how long we’re going to live. Here’s some news about how society is adjusting to the older demographic

104 Health in an Ageing Society

Professor Sir Chris Whitty’s annual report has some pressing matters to raise regarding the health of the ageing population. We look at the headlines

108 Soothing the Skin

Symptoms of menopause will vary, but skin problems are common. So how can you help your skin cope with ‘the change’?

114 Seeing AMD Clearly

Age-related Macular Degeneration, or AMD, is a major cause of sight loss – but what causes it, and can anything be done about it?

108

124

117 Choc Shock

Does chocolate worsen menopause symptoms? Certainly it’s time to look at how diet can a ect them

118 Diagnosing Dementia

The charity Alzheimer’s Society is working on the Blood Biomarker Challenge, a project that could bring dementia blood tests to the NHS within five years

120 Coping Strategies

Later life can present physical problems around the home, but there are plenty of cleverly designed tools to help cope with them

124 The Microbiome and the Menopause

The menopause isn’t all about hormones and hot flushes - it can a ect your gut health too. What changes can you expect?

128 Making Home From Home

Problems of loneliness and isolation are common for older people. Now a new charity initiative aims to provide communities that feel more like home

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PUBLISHER & CEO

Kevin Harrington

EDITOR

Chris Jenkins

SUB EDITOR

Emmanuel Berhanu

CONTRIBUTORS

Nita Van Sloan

Thomas J Roberts

Patricia Savage

PRODUCTION

Ray Walsh

DESIGN

Joanna Harrington

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Health Care and Self Care

Chris Jenkins talks to Dr Amir Khan, Britain’s favourite TV doctor and the face of Live to 100, about developments in healthcare, how the living environment affects our long-term health, and what we can all do to live a longer and healthier life

WE WERE WARNED TO EXPECT A HARD WINTER FOR THE HEALTH SERVICES –HOW DID THE NHS ACHIEVE RECORD TREATMENT LEVELS, AND WHAT LESSONS HAVE BEEN LEARNED FOR THE FUTURE?

AK: It is not just winter that is hard for the NHS these days, it is all year round. I have to be honest, working in the NHS as a GP is really gruelling right now – people are waiting record times for treatments in hospital and this means their conditions are getting worse or they are in more pain, and they end up coming back to see their GP and there is only so much we can offer.

It also means appointments in general practice are being taken up by people who

really need to see a specialist in hospital or at the local mental health service, and people who need to see a GP are struggling to get seen. It is hard for both patients and clinicians.

The lessons going forward are big ones: we get the NHS we pay for. If we do not invest in the staff, the buildings, the equipment in the NHS alongside social care and community support for people we will continue to have an NHS which is giving the care below the standards we want to give, and I say this as someone who has been working in the NHS for twenty years and love the idea of it, and for whom the thought of losing the idea of healthcare free at the point of need is a scary one. »

REPORTED LEVELS OF MEASLES INFECTIONS SUGGEST THAT PEOPLE AREN’T HEEDING WARNINGS TO GET THEIR CHILDREN VACCINATED. WHAT ARE THE DANGERS OF MEASLES AND WHAT IS THE IMPORTANCE OF VACCINATION GENERALLY?

AK: Measles are definitely on the rise, particularly amongst those children who are not vaccinated. With all the misinformation out there right now, it is hard for parents to know what to believe, but I can tell you that childhood vaccines are safe and highly effective and vital in keeping your children safe from potentially deadly diseases.

It can be hard to think about how these illnesses used to devastate children and their families because of the fact that vaccinations have all but wiped them out. But we remain dependent on

these vaccines to keep them at bay and when uptake levels drop, children get sick. Measles is particularly bad for some children, not only does it give them sore eyes, a runny nose and spots both inside of their mouth and all over their body, the virus can cross through to the brain and cause brain inflammation, both at the time of the infection and also years after recovery. It is not worth the risk - get your children vaccinated!

PHARMACIES ARE NOW OFFERING ASSESSMENT AND TREATMENT FOR SOME COMMON CONDITIONS. WHAT CONDITIONS ARE COVERED, AND HOW WILL THIS HELP THE NHS?

AK: This is exciting news - these pharmacists have been trained to manage straightforward conditions like sore throats, shingles, urinary tract and

ear infections. Something similar to this scheme has been rolled out in the past before, but the key difference here is that these pharmacists can actually prescribe antibiotics if needed, which hasn’t been done before. As well as this, the pharmacists can escalate cases to the GP if they feel they go beyond their remit and get the patient seen.

I am hoping this scheme will take some of the pressure off GPs, opening up appointments for more complex patients who need to see a doctor. All we need to do now is give our GPs more than the usual ten minutes to manage these more complex patients better, that would be the next logical step in this plan. Let’s hope those in charge agree!

PROPOSALS TO BAN DISPOSABLE VAPES ARE MEANT TO BE FOR THE GOOD OF YOUNG USERS WHO MIGHT BE LED INTO SMOKING TOBACCO. IS THE BAN SENSIBLE, OR DOES IT PENALISE ADULTS TRYING TO GIVE UP SMOKING?

AK: Vaping is an interesting one. Vapes should really only be used as a short term (2-4 weeks ) adjunct to help someone quit cigarettes. We think vapes are less dangerous than cigarettes as they contain less harmful chemicals and carcinogens, but we do not actually have any long term data on this.

It is important to know that vapes are not completely safe, they still contain highly addictive nicotine in them and chemicals that increase your risk of lung disease and even cancer, they are not risk free.

The problem is some people, especially young people who have never smoked before are now vaping and the companies that make vapes target children and teenagers with their packaging and flavours and are getting them addicted, and this absolutely has to stop.

I am in favour of a ban, as these companies that make the vapes don’t care about your health or that of our children, they just want to make money, and we need to put health over profits.

DEPRESSION AND OTHER MENTAL HEALTH ISSUES REMAIN COMMON, AND YOUNGSTERS PARTICULARLY FIND IT DIFFICULT TO ACCESS SERVICES. WHAT CAN WE DO TO HELP MANAGE OUR OWN MENTAL HEALTH?

AK: There are so many reasons why mental health issues are on the increase – the cost of living crisis, worry about the state of the political situation and environmental issues.

But there are things we can all do to help with our mood. I am big advocate of time in nature - there is so much science behind it. By spending around two hours in green spaces per week (you can divide that up as you wish), you can help your mood and also improve sleep quality.

There is new research that supports the idea that regular exercise like yoga and pilates can help your mood as much as an antidepressant tablet can, though I would say never stop medication without consulting your doctor. As well as this, a diet rich in whole foods and mainly plants has been shown to increase happy brain chemicals like serotonin which will have a

positive impact on your mood.

And finally, regular good quality sleep can really help your mood and motivation levels - aim for seven to eight hours every night.

OVER A THIRD OF WOMEN OFFERED BREAST SCREENING LAST YEAR DID NOT TAKE UP THE OFFER. WHY IS BREAST SCREENING IMPORTANT AND WHAT ARE THE HEALTH BENEFITS OF A SCREENING PROGRAMME?

AK: Breast screening is important because it can detect early changes in your breast that might be cancer before you develop symptoms, and with most cancers the earlier these things are picked up the better the outcomes generally are.

I know, as a bloke, it’s easy to for me to say,”Ladies, go for your mammograms!”, because I will never have to go through it myself. But it is vital you go - my mum’s breast cancer was picked up through screening, and she is fine now, but it could have been completely different had she not gone for her mammogram appointment.

I appreciate it is inconvenient, can be daunting and for some, uncomfortable, but all of that pales in comparison when compared to having breast cancer caught at a later stage. I think we need to make breast screening more accessible so more women attend, but until then, ladies, go get that appointment reminder letter, ring the number and book your appointment now.

WHAT DOES THE NEW NHS APP OFFER, AND IS IT A GOOD IDEA FOR US ALL TO USE IT?

AK: The NHS app is good if you like that kind of thing, and that’s my honest opinion! If you are the kind of tech-savvy person who likes to have access to their medical records, wants medical advice on some simple symptoms and the possible option to book appointments themselves, then the app is great. I think it is good to take control of your health, and one way to do that is to download the app. But not everybody is wired that way, and that’s okay – you can still book appointments the normal way and speak to people. »

HAS THE KING’S TREATMENT FOR PROSTATE CANCER LED TO AN INCREASE IN AWARENESS OF THE CONDITION?

AK: I think it is incredibly brave of the King to share some of his medical issues with us, especially after having a diagnosis as serious as cancer. It cannot have been easy for him. He did a similar thing when he was diagnosed with age-related prostate enlargement and it led to a significant increase of visits to the NHS website page which had advice on enlarged prostates for men, something us blokes aren’t particularly good at talking about, opening up conversations on taboo subjects.

It will be the same for his cancer diagnosis - we are now talking about cancer more, early symptoms, when to get checked but beyond that, the emotional impact of a cancer diagnosis, how treatment may look for cancer and also what family and friends might be able to do and say to help support those with a cancer diagnosis. All are things we were not doing enough of before, I am totally here for it.

I also think it’s important we don’t speculate on the parts of the Kings health he hasn’t divulged - it is private for him and

confidential, just like our medical records are to us. He has said all he wants to say, we should leave it at that.

WHAT HAS BEEN GOING ON IN YOUR GARDEN? WHAT WORK HAVE YOU BEEN DOING AS PRESIDENT OF THE RSPB?

AK: Well, I am excited about my garden as spring is coming, and you can see the animals are preparing. The snowdrops and crocuses are out which is lovely, and the daffodil shoots are also up. The birds are getting hungrier, and you can see them collecting nesting material from around the garden and disappearing into the hedges to build their new homes. And it won’t be long until our hibernating hedgehogs wake up hungry again, I have been putting out kitten biscuits for them in case they decide tonight is the night.

The frogs are back in the pond and have been quite noisy during the night, which means it won’t be long now before we have frogspawn and tadpoles. It is also a great time to get some pruning done - roses in particular are good to prune right now, so I am busy with that. And it’s almost cherry blossom season, quite possibly the most magical time of the year. I actually can’t wait to see the local trees

in full bloom, soft pinks and pearly white flowers bringing the landscape to life.

WHAT ELSE HAVE YOU BEEN UP TO ASIDE FROM YOUR MEDICAL PRACTICE, AND WHAT DO YOU HAVE COMING UP FOR THE NEXT FEW MONTHS?

AK: I have been busy – I am writing a new novel and children’s book, and I am planning a cookbook, so its all systems go! As well as this, I have just finished filming a second series of Lost Dogs: Live for Channel 5, a show that is made for dog owners by dog owners which helps us keep our dogs safe and looks at some truly amazing doggy stories.

My work on Good Morning Britain and Lorraine keeps me busy, but more than that the work I do with RSPB and the Wildlife Trust is ramping up as we raise awareness of environmental issues and showing kids how incredible wildlife is.

What I am trying to do more of this year, is take more time for myself. I am finding it hard, but I am trying to say “no” to some things and it is really helping! I would definitely recommend that everyone say no to the things that are not a priority to them and make more time for themselves – it’s not selfish, it’s self-care! ■

IMAGES: Butterfly Conservation

Fit and Positive

Being aware of health issues is a major contribution to improving our wellness – here are some headlines from the developing world of medicine to help us stay well

HYPERTENSION IN SUSSEX

VAPE INDUSTRY LAUNCHES CODE OF CONDUCT

The vape industry has launched an industry Code of Conduct backed by major players from across the UK vape sector. The Code sets out agreed standards and behaviours to help voluntarily regulate the vape sector, including how products should be marketed and their names and flavours.

The Code is being overseen by the Independent British Vape Trade Association (IBVTA), the UK’s leading independent trade association for the vaping industry and is in addition to the existing range of regulatory measures and any future measures that the Government may introduce.

The Code seeks to directly address recent concerns around the increase in youth access and experimentation with vapes, and sets out how single use vape products should not disproportionally appeal to children.

A collaboration between two GP surgeries and a chain of leisure centres will see patients in Seaford, East Sussex, with early signs of hypertension (high blood pressure) undergo a programme of education and supervised physical activity to reduce the risks of developing associated health conditions.

Following individual assessments, 17 patients - seven from the Old School Surgery and 10 from Seaford Medical Practice - are taking part in weekly sessions over 12 weeks at Downs Leisure Centre, supervised and delivered by Wave Active’s Team of Health Practitioners.

The innovative pilot scheme is designed to keep people healthier for longer and give residents the right care, in the right place and the right time, in accordance with aspirations of the Sussex Health and Care Plan.

Dr Joe Ljevar from Old School Surgery in Seaford, said: “We are delighted to be able to work in partnership with Wave Active to bring this pilot to the Seaford community.

“The benefits of people leading more active lifestyles is well documented and, as a primary care network, in partnership with Wave Active, we hope, through interventions like this hypertensive pilot we can impact on short and long-term health gains for the Seaford community.”

Duncan Kerr, Chief Executive of Wave Active, said: “Wave Active and the Seaford Primary Care Network are using our collective expertise and resources to deliver interventions that encourage healthier living and address the health inequalities that lead to conditions such as coronary heart disease.

“The programmes are carefully designed for each patient, alongside regular monitoring, and I’m delighted to report that many are already feeling and seeing benefits from taking part.”

Following the success of the initial pilot the intention is for more courses to be developed and delivered covering a range of health conditions.

IMAGES: Dreamstime, Seaford Primary Care Network

ALOPECIA TREATMENT APPROVED

Thousands of people with severe hair loss due to alopecia areata are set to benefit from a new one-a-day capsule to help treat the condition. Ritlecitinib (also known as Litfulo and made by Pfizer) is recommended by NICE as an option for treating severe alopecia areata in people aged 12 and over.

The treatment, taken as a daily pill at home, works by reducing the enzymes that cause inflammation and subsequent hair loss at the follicle. It is the first treatment for severe alopecia areata recommended by NICE for use on the NHS.

The recommendation comes after ritlecitinib was not recommended by NICE’s independent appraisal committee in September 2023. Following a public consultation and the company providing additional information and an improved discount to its price the treatment is now recommended as clinically and cost e ective for use in the NHS.

Evidence from clinical trials shows that ritlecitinib is more e ective than placebo at improving hair regrowth and that response rates continued to improve for people taking ritlecitinib for up to two years.

MENTAL EFFICIENCY

Enjoy improved mental e ciency, emotional balance, reduced anxiety and eliminate brain fog, all in just 30 days of professional home-based NeurOptimal® neurofeedback brain training, supplied and supported by BrainFiT®. Easy to use, 100% safe, and e ective for all the family. www.brainfitneurofeedback.co.uk

SEA SUPERFOOD

Brunswick Wild Sardines are a small fish with huge nutritional benefits. We like to think of them as the original superfood of the sea. Packed with Omega-3, protein, and calcium, who knew sardines were such a nutritional powerhouse! brunswick.ca

SCIENTIFIC SUPPLEMENTS

Rebuild collagen from the inside out, using scientifically proven supplements with the highest content of collagen (10,000mg). By nourishing the skin from within, the connective tissues are strengthened and wrinkles and cellulite are reduced, leading to more profound and lasting improvements in skin, hair, nails and joint health.

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TRENDY DRINK

Freez Mix is a carbonated flavoured drink - new to the world of soft drinks. Each bottle comes with a unique blend of natural fruit flavour. A trendy drink with low sugar content to boost your feel-good factor, whether you’re seeking a refreshing pick-me-up or a flavourful companion to your meals, Freez Mix Carbonated Flavoured Drink is the perfect choice.

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Joint Accounts

Arthritis doesn’t just affect the elderly, but joint pain is a common symptom of increasing age. Could a better diet help to prevent it?

Arthritis and joint pain can keep you from your everyday activities, including the adventurous ones, like going for a walk or a hike, to the mundane, such as loading the groceries into the car or sorting them in the kitchen.

There are many different therapies for arthritis and joint paint, including disease-modifying anti-rheumatic drugs, biological treatments, janus kinase (JAK) inhibitors, over-the-counter painkillers, physiotherapy and surgery. However, given the chronic nature of pain caused by arthritis, patients are likely to attempt to manage their symptoms with alternative or complementary treatments when they are

overwhelmed by side-effects or ineffective medication.

Just how effective are these alternative and complementary natural therapies for arthritis and joint pain?

PHYTO-ACTIVES

Phyto-actives are the active ingredient in traditional medicinal plants that give them therapeutic value. You may also know phyto-active medicine by the name Ayurveda, one of the world’s oldest medical systems.

There isn’t much research about phytoactives yet; however, a preliminary clinical trial in 2011 found that conventional and

phyto-active treatments for rheumatoid arthritis had similar effectiveness. The conventional drug tested was methotrexate, and the phyto-active treatment included an assortment of 40 herbal compounds.

If you are thinking about pursuing phytoactive treatment for arthritis or joint pain, doctors recommend that it not replace conventional care for now; however, it can be used as a complementary treatment. You should speak to your GP before trying any alternative and complementary therapies you are thinking of using to give them a full picture of how you manage your health. This will help to ensure coordinated and safe care.

ALOE VERA

Aloe vera is one of the most commonly used herbs in alternative medicine. Known for its healing and calming properties, it’s popular for treating small skin abrasions or sunburns. You may already have a bottle of aloe vera gel in the medicine cabinet.

But it’s not just sunburns that aloe vera is good for, it can also be applied topically to sooth aching joints. If you are planning to try aloe vera to treat joint pain, please note that it’s not a substitute for your regular treatments but can be used as a complement to other medication.

BOSWELLIA

Boswellia, also called frankincense, is praised by alternative medicine

practitioners for its anti-inflammatory capabilities. It’s derived from the gum of boswellia trees indigenous to India. The herb is thought to work by blocking substances that attack healthy joints in autoimmune diseases such as rheumatoid arthritis. While there is promising evidence of boswellia in animal studies, it should be noted that no human trials have yet been undertaken.

EUCALYPTUS

Topical forms of eucalyptus leaves, which are widely available in Western markets, are used to treat arthritis pain. Eucalyptus is also used in oral medication, and topical oil extracts are used for a variety of conditions.

Eucalyptus leaves contain tannins, which may be helpful in reducing swelling and the pain that arthritis causes. Some patients find it useful to use a topical eucalyptus treatment, followed by a heating pad or hot water bottle to maximise the effects on swollen joints.

Before using any eucalyptus treatment, be sure to test yourself for allergies. Put a small amount of the product on your forearm for a ‘patch test’. If there is no reaction in 24 to 48 hours, it should be safe to use.

THUNDER GOD VINE

Thunder god vine is one of the oldest herbs used in Chinese medicine. Extracts from

ANTI-INFLAMMATORY FOODS

❖ Tomatoes

❖ Olive oil

❖ Green leafy vegetables

❖ Almonds and walnuts

❖ Fatty fish

❖ Berries

❖ Turmeric

❖ Broccoli

❖ Avocados

❖ Bell peppers

❖ Mushrooms

❖ Grapes

❖ Dark chocolate

skinned roots are known to suppress an overactive immune system, which makes it a popular alternative treatment for autoimmune diseases such as rheumatoid arthritis. If using, apply directly to the skin in topical form.

Before trying thunder god vine treatments, speak to your GP about whether its right for you. Your GP may also be able to advise about best practices for finding and using treatments with thunder god vine, as if it’s made incorrectly it can be poisonous and cause serious side effects including nausea and hair loss.

TURMERIC

A yellow powder made from the turmeric plant, turmeric is used in cooking to make curry. But it also has many health benefits, including anti-inflammatory properties. Lab studies on rats have found that turmeric may slow the progression of rheumatoid arthritis, and curcumin, the active ingredient in turmeric, has been used in folk medicine for years. Unlike other types of herbs listed here, it works best when consumed, rather than applied topically.

Further study may show that turmeric and these other natural substances have their part to play in arthritis therapy, and alongside conventional medicines their use promise a wider range of options for sufferers in the future. ■

FOCUSED ULTRASOUND FOR THE TREATMENT OF

ESSENTIAL

TREMOR

If you are one of the one million people in the UK affected by essential tremor, you will know just how disruptive and debilitating it can be. Simple tasks like signing your name, drinking a glass of water or using your touchscreen phone become impossible without frustration or embarrassment.

But there is hope. For patients with a moderate or severe tremor that has not responded to medication, MR-guided focused ultrasound (MRgFUS) is a safe, cutting-edge new treatment that can help you regain control of your life again.

WHAT IS THE DEFINITION OF ESSENTIAL TREMOR?

Essential Tremor (ET) is a neurological condition characterized by involuntary, rhythmic shaking of various parts of the body, most typically both hands. It arises due to rhythmic activity in brain circuits. ET usually occurs without other neurological symptoms and is often most pronounced when performing voluntary movements, such as lifting a glass or writing.

WHO DOES IT AFFECT?

Essential Tremor can affect individuals of any age. The risk of developing ET increases with age and it has a genetic component, meaning it can run in families. We sometimes identify a gene, but, in the majority, there is not a single identifiable genetic abnormality. Both men and women are equally likely to be affected. While it can start at any age, including childhood, the incidence is higher and tends to become more noticeable in middle-aged or older adults.

IS IT RELATED TO PARKINSON’S DISEASE?

While both Essential Tremor and Parkinson’s Disease involve tremors, they are distinct conditions with different causes and symptoms. Essential Tremor primarily affects movements when engaging in actions (action tremor), whereas Parkinson’s tremors usually occur with the hands at rest. Parkinson’s also includes other symptoms such as stiffness, slow movement, and balance problems, which are not features of Essential Tremor. Despite these differences, misdiagnosis can occur, especially in the early stages. There is

also commonly confusion with other similar conditions such as dystonic tremor or task-specific tremors.

WHAT CAN BE DONE TO CONTROL THE CONDITION WITHOUT MEDICAL TREATMENT?

Lifestyle adjustments and non-medical interventions can help manage Essential Tremor. Reducing caffeine and avoiding stimulants can decrease tremor severity. Stress management techniques, such as relaxation exercises, may also be beneficial as stress can temporarily exacerbate tremors. Physical therapy does not typically subdue tremor but can improve muscle strength, control, and coordination. Additionally, using weighted utensils and adaptive devices can help manage daily activities.

WHAT ARE THE MOST COMMON MEDICAL TREATMENTS?

The most common medical treatments for Essential Tremor include betablockers (e.g., propranolol) and other medications (e.g., primidone or topiramate), which can help reduce tremor severity. In cases where medication is ineffective or causes undesirable side effects, other treatments may be considered, such as botox injections for head or hand tremors. Targeting the abnormal brain circuits with focused ultrasound or deep brain stimulation (DBS) surgery are very effective options for severe cases or in those where other treatments have not worked. Treatment is tailored to the individual’s symptoms and overall health profile.

WHAT IS INVOLVED IN MRGFUS?

MRGFUS is a fusion of two wonderful technologies. MRI allows doctors to visualise the brain areas of the brain and then use the power of focused ultrasound beams to create a tiny lesion with extreme precision. This amazing tool allows neurosurgeons to perform accurate surgical procedures within the brain without making an incision or using a drill. The procedure takes a few hours and is performed under a local anaesthetic, on an outpatient basis, like a visit to the dentist.

HOW EFFECTIVE CAN IT BE?

MRGFUS can be extremely effective in patients with essential tremor. The Queen Square team has capitalised on its decades of experience in functional neurosurgery, imaging, and multidisciplinary work. Their patients have enjoyed a sustained reduction in tremor of around 60% on the treated side with no serious or persistent side effects. The team are now joining international efforts to explore the use of MRGFUS in other conditions such as Parkinson disease.

WHAT DOES IT COST?

For patients who are funding the cost of their assessment and treatment themselves, the total package will typically come to just over £25,000.

Whilst this is a significant investment for most people, it is important to remember that this is a one-off expense that brings significant and durable improvement in quality of life. We aim to assist patients by providing payment plans to spread the cost. Our service is also unique in that it is recognised by several major UK based health insurers.

WHAT’S THE STORY BEHIND QUEEN SQUARE IMAGING CENTRE?

For nearly 40 years, the Queen Square Imaging Centre has offered state of the art MRI and CT scanning and continues to be London’s only imaging centre dedicated to specialist neuroimaging. The centre was the first healthcare social enterprise of its kind in the UK and continues to use an innovative notfor-profit model which sees all profits donated back into the NHS.

In 2022, the Queen Square Imaging Centre developed a partnership with the renowned UCL Functional Neurosurgery Unit (the largest and most active functional neurosurgery group in the UK) to establish a new MR Guided Focused Ultrasound service. This unique partnership has enabled Queen Square to become the only surgical centres in the UK to be able to offer patients a choice of the full range of surgical treatment options for tremor.

PROFESSOR LUDVIC ZRINZO Consultant Neurosurgeon

Professor Zrinzo is Head of the UCL Functional Neurosurgery Unit and Consultant Neurosurgeon at the National Hospital for Neurology and Neurosurgery. He manages a wide range of general neurosurgical conditions and has a special clinical and research interest in functional neurosurgery for Parkinson’s disease, tremor, dystonia, trigeminal neuralgia and hemifacial spasm, as well as surgical management of treatment refractory mental disorders, including Tourette’s syndrome, obsessive compulsive disorder (OCD) and major depression.

Prof Zrinzo’s research interests have been directed towards continued improvement in the surgical care of with particular emphasis on improving safety, accuracy and efficacy of surgery. He is the author of numerous peer-reviewed publications, abstracts and several book chapters and his work has received several international awards.

DR TABISH SAIFEE Consultant Neurologist

Dr Tabish Saifee is a consultant neurologist at The National Hospital for Neurology and Neurosurgery, Queen Square, where he runs an outpatient and inpatient service for patients with movement disorders.

www.queensquare.com

treatment@queensquare.com

Dr Saifee has expertise in movement disorders and has a particular interest in tremor, dystonia and Parkinson’s disease. He qualified at University College London Medical School and undertook higher specialist training on the coveted NIHR academic training scheme at The National Hospital for Neurology and Neurosurgery and The Royal Free London.

The Essentials of Tremor

Is shaking of parts of the body a sign of serious illness, or just of age? Research suggest a new approach to treatment

Tremor, the inability to keep limbs steady, is often seen as a natural sign of advancing age – but in fact it’s normal to have a slight tremor. For example, if you hold your hands or arms out in front of you, they will not be completely still. But tremor may become more noticeable as you get older, when you’re stressed, tired, anxious or angry, after drinking caffeine or alcohol, or

smoking, and if you are very hot or cold. Some medicines and conditions can also cause a tremor.

Essential tremor, also known as benign or familial tremor, is a neurological (brain and nerve) disorder that causes involuntary shaking of parts of the body. The severity of essential tremor varies in different people; in most people it is mild and they won’t need to see a doctor about it, but in others

it can make simple tasks such as drinking a cup of tea or writing very difficult.

There are definite differences between essential tremor and Parkinson’s Disease, though the symptoms of the two can appear similar. Essential tremor may affect the voice box, but Parkinson’s does not. Essential tremors are usually felt more when in motion, but Parkinson’s tremors are felt more when at rest. Essential tremor

symptoms can progressively get worse, but won’t necessarily shorten the patient’s life span.

Essential tremor is 8–10 times more common than Parkinson’s Disease. It is a progressive neurological disorder, which means that essential tremor can become more severe over time, causing individuals to experience progressively worse symptoms that can have a debilitating impact on their quality of life.

RELIEF

There is, though, a definite association between essential tremor and a possible later development of Parkinson’s Disease; clinical literature shows that ET patients are four times more likely to develop PD.

While medication such as propranolol, topiramate and/or primidone may help your symptoms, an estimated 50% of people with essential tremor either do not find sufficient relief or experience too many side effects from the medication.

If you feel you only need treatment at specific times, such as before a social event or meeting, you may be prescribed single

doses of propanolol to ease the tremor in these situations. These medications do have side effects such as tiredness and dizziness.

Botox can be given by injection into the muscles that shake, and is best for tremors in the head and neck, but this treatment has a risk of causing weakness in the arms.

Patients who do not obtain sufficient relief from medication alone can undergo different forms of functional neurosurgery, including DBS and FUS. Deep Brain Stimulation (DBS) involves having small electrodes placed in the brain which are connected to a pacemaker box which helps to regulate your brainwaves and control the tremor.

MRGFUS

MR-guided focused ultrasound (MRGFUS) is a newer and non-invasive treatment that is done in an MRI scanner. Powerful focused ultrasound is guided to a very defined point in the brain, creating intense local heat that destroys cells and breaks the circuit causing tremor, but does not impact other parts of the brain.

It combines two technologies — high intensity focused ultrasound (FUS), which is guided by magnetic resonance imaging (MRI) to destroy a small area of tissue in the brain responsible for the tremor.

The procedure takes place under local anaesthetic and usually does not require an overnight stay in hospital. You will have your head shaved to prevent any obstruction of the sound waves, and throughout the treatment, you will be moved into and out of the MRI machine and asked to do simple tasks like drawing a spiral to assess your improvement. The outpatient procedure takes about 3-4 hours and results are comparable to DBS, but without the risks of general anaesthesia and invasive surgery. In successful procedures, patients see an average improvement of 75 percent in their hand tremor.

The treatment works immediately and the results are usually long-lasting. There is a period of about one month afterwards when you may notice some minor issues with balance that gradually improve and you are advised not to drive for one month after the procedure.

Find more about ET on the National Tremor Foundation website, www.tremor.org.uk . ■

QUEEN SQUARE

In 2022, the Queen Square Imaging Centre (www.queensquare.com) developed a partnership with the renowned UCL Functional Neurosurgery Unit (the largest and most active functional neurosurgery group in the UK) to establish a new MR Guided Focused Ultrasound service. Through this unique partnership, Queen Square became the only surgical centre in the UK capable of offering patients a choice of the full range of surgical treatment options for tremor using the MRGFUS system.

IMAGES: Dreamstime, Queen Square Imaging Centre

Smarter, Faster, Stronger

We might not have built a bionic Six Million Dollar Man yet, but smart technology is doing more and more to help us maintain our health

Taking control of your health can sometimes be as simple as making a New Year resolution to ‘detox’ or ‘get fit’, yet we all know that many gym memberships are wasted as enthusiasm wanes over the course of the months.

But there’s a new wave of smart technology competing to bring health, fitness and medical monitoring under your control, using wearable devices connected to the best of artificial intelligence and cloud computing. Better health could be no further away than your smartphone.

The wrist-worn smartwatch is by far the most popular type of fitness ‘wearable’. From the Apple Watch to models from Garmin, FitBit, Huawei and many more, smartwatches usually connect wirelessly to a mobile phone or laptop so they can notify you of calls, messages, emails and

social media alerts. Many are specifically designed to track fitness and health, displaying your heart rate, calorie consumption, step count, blood pressure and sleep patterns. Using a range of apps they can be programmed to monitor health goals such as weight loss and running targets, and in many cases they can be worn around the neck or clipped to a belt as an alternative to being worn on the wrist.

An even more discreet alternative is the Oura, a ring with a suite of health-tracking features including continuous heart rate measurements, temperature sensing, and period predictions.

MONITORING

For swimmers, much of the same technology can be built into goggles, with a heads-up display showing metrics such

as time, stroke count, calories and (using a compatible monitor) heart rate, and will all communicate back to a phone app.

A headset can send electrical pulses to the vestibular nerve to influence your sleep patterns, while the stamp-sized sensor can stick to your forehead and track breathing quality, oxygen saturation and movement to help you analyse sleeping problems.

Wrist-worn hardware can work with an app to provide electrical stimulation of muscles to reduce pain and improve exercise recovery, while tracking workouts and help plan exercise and recovery programmes.

Smart clothing can even o er builtin electrocardiogram and heartbeat monitoring, breathing rate and step tracking, and monitoring of load, fatigue and heart rate recovery – all while

connecting by Bluetooth to your Apple or Android phone or tablet. Sensor insoles can track foot-strike, step-length, balance and more metrics to deliver a personalised report on your running style.

Smart scales offer the ability to measure and track many metrics including weight, body fat, heart rate, lean body mass, Body Mass Index, muscle weight, visceral fat, basal metabolic rate, metabolic age, protein levels and body water percentage. A connected app can give you an even more detailed analysis, showing your weight and body composition trends over time, and allowing you to keep an eye on whether you are hitting health goals.

EXERCISE MACHINES

A new generation of exercise machines (of which Peloton is perhaps the most famous) adds touchscreens and online interactivity to the business of fitness training. With vast libraries of outdoor,

studio, and Google Maps-based workouts, smart running, biking and rowing machines are an excellent choice for beginners, intermediate, and advanced fitness fans alike.

And smart technology isn’t just about replacing outdoor activities with their indoor equivalents. With its sophisticated form-tracking and rep-counting software, challenging on-demand and live classes, and top trainers, Tempo Studio is a smart strength training machine with a core system of two smart dumbbells, plus a cable pack to connect your smart phone or tablet to a larger display.

The AI-powered Tempo app tracks your joint movement through your iPhone camera to guide your positioning and form. It also logs the weights you’re using for more accurate guidance as you train. Your daily workout is based on your biometric data, like sleep stats, heart rate, and activity levels. This way, you get the best workout for your body that day. You

can choose from training plans and coachled classes designed to help you reach your goals, no matter your focus, whether it’s muscle definition or growth, and you can see how your body changes with 360-degree body composition profiles as your training progresses.

ANALYSIS

A smart electrocardiogram device can capture an ECG in seconds, analyse it for signs of conditions such as atrial fibrillation, bradycardia or tachycardia using cloud-based artificial intelligence, and share information with your healthcare professional for more detailed analysis.

With doctors’ time becoming more precious (and expensive if you are a private patient), products like these and other smart devices might be the way for all of us to help to monitor our own health and fitness, and get on with our lives instead of spending time in waiting rooms. ■

In the Bones

Is ‘bone broth’ as packed with health benefits as its supporters claim? We boil some up and take a sip…

It may sound like an old wives’ tale, but ‘bone broth’ may have many nutritional benefits. Though there’s little research on the food itself, certainly the ingredients are rich in nutrients known to support the health of your skeleton and digestive system, among other benefits.

As its name implies, bone broth is made by simmering the bones and connective tissue of animals, forming a stock for making soups, sauces, gravies and drinks. The recipe dates back to prehistoric times, when hunter/gatherers would want to use every part of their catch, including bones and hooves. It can be made using bones from just about any animal from chicken, pork, beef, veal, turkey, lamb, bison, buffalo and venison to fish. Bones from pastured chicken or grass-fed beef bones will most likely provide the maximum health

benefits, as they will be from the healthiest animals. Marrow and connective tissues like feet, hooves, beaks, gizzards, or fins can also be used.

It’s easy enough to make your own bone broth using water, bones, vinegar, salt and pepper. The main requirement is a big pot or slow cooker. You boil up the mixture, simmer for about 12 hours, cool, and strain into a container, discarding the solids.

It works best if you use a selection of bones such as oxtail, knuckles, and pigs’ trotters.

The vinegar is an important ingredient because it helps extract the valuable nutrients out of the bones and into the water. It’s common to add vegetables such as carrot and celery, herbs such as parsley and thyme, and garlic to enhance flavour.

If you don’t fancy the process, bone

broth can also be bought ready made in liquid or powder form.

NUTRIENTS

Animal bones are rich in minerals such as calcium, zinc, iron, selenium and magnesium, in vitamins A and B, and in the protein collagen, which turns into gelatin when cooked and yields several important amino acids. Simmering the ingredients releases their nutrients into the water in a form the body can easily absorb.

It’s suggested that bone broth can benefit the digestive system, reducing inflammation, can improve joint health, and can work as part of a calorie control diet, as it satisfies hunger and is high in protein – and the amino acid glycine, found in bone broth, may help you relax and promote sleep. ■

Feel better during menopause with Freja Bone Broth

REAL COLLAGEN, REAL BENEFITS

“Seems to really be helping my joints! If you are middle aged and peri-menopausal, this is great stuff.”

“I suffered with bad joint pain due to menopause, I now have no joint pain whatsoever! I can’t believe the improvement in all aspects of menopause symptoms - hair, nails and skin have all improved, even my mood. I still can’t believe I’ve found something that works.”

Did you know that during menopause, the body naturally produces 30% less collagen in the first five years and an additional 2 percent each following year1? With collagen acting as the backbone for structure, strength and support throughout our body, when it starts to deplete, you’ll feel it.

Collagen plays a critical role in promoting good joint, skin, hair and sleep health. It’s literally the glue that holds our body together! So, how do we stay topped up on this vital protein when our body is giving us less of it?

Say hello to bone broth! Bone broth is one of the most natural bioavailable sources of collagen available. Freja bone broth is made by simmering collagen-rich meaty

STOCKISTS:

bones for up to 24 hours into a delicious and nutritious liquid with an award-winning flavour. Sip it solo, enhance dishes with it or let it shine as the star ingredient.

Packed with protein, nutrients and antioxidants, one 500ml carton of Freja’s beef bone broth contains 17g of collagen. One small 150ml cup of Freja’s Beef Bone Broth is a delicious and easy way to get your 5g daily dose of collagen, and have you feeling back to your best.

Tackling the rise of ultra-processed foods and artificial supplements, Freja bone broth is a completely natural source of collagen which our bodies can easily absorb, made from the same wholefoods our ancestors were eating centuries ago.

1) Brincat M. et al., Sex hormones and skin collagen content in postmenopausal women. Br Med J (Clin

Is the Future Fatter?

The World Health Organisation reports that obesity is now more of a health threat worldwide than malnutrition. How can we avoid a fatter future?

The number of clinically obese people in the world has passed one billion for first time, a study in medical journal The Lancet has revealed. The report concludes that obesity is now a greater threat to global health than hunger, with more than one in eight people in the world clinically obese.

Paradoxically, obesity can be a form of malnutrition; the problem is that people are eating the wrong type of foods, full of sugary ‘empty calories’ which are deposited as fat without producing any energy. In fact this type of obesity, where people are not getting getting the right nutrients, vitamins and types of calories needed to be healthy, is now the leading form of malnutrition, with the number of people considered to be underweight falling to below 550 million.

Nutritionists warn that children are paying the price for inaction on obesity by

OBESITY AND THE NHS

In Britain, obesity costs the NHS around £6.5 billion a year and is the second biggest preventable cause of cancer. It also increases the risk of diabetes and heart disease.

global leaders, with under-18s accounting for 159 million of those who are obese; but of course obesity becomes a long-term health problem, with a further 879 million adults considered obese, bringing the total to 1.04 billion out of the world’s eight billion people in 2022 according to a study.

NHS leaders called the findings “alarming” and said that obesity rates were “a ticking health timebomb”. Combined with an ageing demographic, the health implications of an overweight population suggest that health services will struggle to cope with a fatter future, and that life expectancy, which has been on the rise for decades, may begin to fall.

FAT FIGHTERS

The analysis by a global team of experts, led by Imperial College London and World Health Organisation (WHO), revealed that the proportion of women who are obese has doubled since 1990 to almost one in five, and tripled among men to around one in seven.

In the UK, which ranked 78th out of 200 countries analysed for adult obesity levels, almost three in 10 adults were obese,

with women slightly more likely to be overweight than men.

The researchers compared obesity and underweight levels around the world to 1990, when only 226 million people, or fewer than one in 20, were obese, including just 31 million children.

Meanwhile, the number of underweight people has come down over the same period, from 440 million to 347 million adults, and 219 million to 185 million children.

In the UK, one in 10 girls are obese and one in eight boys are, more than double the proportion seen in 1990.

IMPACT

Prof Simon Kenny, the NHS clinical director for children, said: “These figures will be as alarming to parents as they are to the NHS.

“Obesity affects every human organ system, and so at a young age can have a major impact on a child’s life, increasing their risk of Type 2 diabetes, cancer, mental health issues and many other illnesses, which can lead to shorter and unhappier lives.”

He said the NHS had set up 30 specialist clinics for people and families affected by extreme weight issues, but that the health service “cannot solve this issue alone”.

“Continued joined-up action by industry and wider society is needed if we are to avoid a ticking health timebomb for the future,” he added.

Professor Majid Ezzati, study author at Imperial College London, said it was “very concerning that the epidemic of obesity that was evident among adults in much of the world in 1990 is now mirrored in schoolaged children and adolescents”.

People were considered obese if their Body Mass Index (BMI) was 30kg/m2 or over, and underweight if it was 18.5kg/m2 or less. The data, which looked at 222 million people from 3,663 separate studies, shows that obesity is most prevalent in countries in Polynesia, such as American Samoa, where more than three in four people are obese, the Caribbean, the Middle East and North Africa.

Dr Tedros Adhanom Ghebreyesus, WHO’s director general, also called

BMI AND OBESITY

The most widely used method to check if you’re a healthy weight is body mass index (BMI), a measure of whether you’re a healthy weight for your height. You can use the NHS BMI healthy weight calculator at www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/ to find out your BMI.

For most adults, if your BMI is:

❖ Below 18.5 – you’re in the underweight range

❖ 18.5 to 24.9 – you’re in the healthy weight range

❖ 25 to 29.9 – you’re in the overweight range

❖ 30 to 39.9 – you’re in the obese range

❖ 40 or above – you’re in the severely obese range

If you have a South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family background you’ll need to use a lower BMI score to measure overweight and obesity:

❖ 23 to 27.4 – you’re in the overweight range

❖ 27.5 or above – you’re in the obese range

BMI score has some limitations because it measures whether a person is carrying too much weight but not too much fat. For example, people who are very muscular, like professional sportspeople, can have a high BMI without much fat.

on the food industry to play its part in tackling obesity.

He said it would “require the cooperation of the private sector, which must be accountable for the health impacts of their products”.

The Government’s current strategy on obesity has involved measures including a levy on sugar in soft drinks, adding calorie information to menus and restricting where foods high in fat, sugar and salt may be placed in supermarkets.

But scientists say that more needs to be done, with a ban on junk food adverts aimed at children and the introduction of warning labels on unhealthy foods, among the proposals being put forward.

TREATING OBESITY

The best way to eliminate obesity is to eat a healthy reduced-calorie diet and exercise regularly.

To do this, you can:

h Eat a balanced calorie-controlled diet as recommended by a GP or weight loss management health professional (such as a dietitian)

h Take up activities such as fast walking,

jogging, swimming or tennis for 150 to 300 minutes (2.5 to 5 hours) a week

You may benefit from joining a local weight management programme with group meetings or online support. Your GP can tell you about these.

You may also benefit from receiving support and counselling from a trained healthcare professional to help you better understand your relationship with food and to develop more healthy eating habits.

If you’re living with obesity and lifestyle and behavioural changes alone do not help you lose weight, medicines such as orlistat may be recommended.

If used correctly, this medicine works by reducing the amount of fat you absorb during digestion. Your GP will know whether orlistat is suitable for you.

A specialist may prescribe other medicines such as liraglutide or semaglutide. They work by reducing appetitie, making you feel fuller and less hungry.

For some people living with obesity, a specialist may recommend weight loss surgery. ■

Something In The Air

We spend about 90 percent of our time indoors, so the air that we breathe there inevitably has an effect on our health. How can we improve it?

We spend around ninety percent of our time indoors, and with the rising trend for working at home, that figure is increasing. While we are in a workplace, we expect the air we breathe to be controlled by environmental regulations; and of course this is also true outdoors, where measures such as low emission traffic zones and anti-pollution laws are doing what they can to keep our air clean. But what about at home, where air quality is not regulated, and it is largely up to us to make sure that the atmosphere is healthy?

While pollution amelioration measures such as electrification of vehicles,

introduction of low emission zones and encouragement of non-polluting transport such as bicycles are doing something to improve outdoors air pollution, the air quality indoors can be as bad or worse than outside. Despite this, very few people appear to be knowledgeable regarding the causes, effects, and remedies that surround the issue of indoor air pollution.

CAUSES

Indoor air pollution can be caused by dust, dirt, gases, chemicals or organic matter in the air, and the genesis of these can be the way in which we cook in, clean, maintain, and build our homes.

For people suffering from health conditions such as asthma, chronic obstructive pulmonary disorder and lung cancer, quality of indoor air is hugely important. Especially during the pandemic, it became of utmost importance that we made sure buildings were well ventilated.

Breathing in indoor air that is polluted can lead to respiratory infections, with symptoms such as dry throats, runny noses, sore eyes, and sinuses, to shortness of breath, wheeziness, and in the long term an increased risk of pneumonia, COPD, lung cancer, heart disease and stroke.

Additionally, children are more susceptible to indoor air pollution than

adults due to their developing lungs, and their narrower airways.

The main causes of indoor air pollution are:

h Chemicals used in cleaning or decorating

h Materials used in construction such as asbestos

h Tobacco smoke

h Poor ventilation leading to damp and mould

h Allergies caused by pets or dust mites

h Outdoor pollution getting indoors

The main chemical culprit in indoor air pollution is volatile organic compounds, so-called VOCs, commonly used in household cleaning and decorating materials, or bleach and ammonia used in cleaning compounds.

WHAT ARE VOCS?

Volatile Organic Compounds are chemicals released by common household products,

and can be damaging to your health.

In our homes, VOCs are released from synthetic paints, cigarette smoke, new furniture and building materials, air fresheners, as well as from natural sources, like fungi and mould.

They can cause issues that range from headaches and irritations to major longterm health implications that are linked to cancer. VOCs are most common in the bathrooms, bedrooms, and garages of our homes.

The American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine found that regular use of cleaning sprays could have a huge impact on lung health, equivalent to smoking a pack of cigarettes every day. The research followed more than 6,000 people over a 20-year period and found that women in particular suffered significant health problems after long-term use of these products. »

HEALTH RISKS

Each year, close to 4 million people worldwide die prematurely from illness attributable to household air pollution from inefficient cooking practices using polluting stoves paired with solid fuels and kerosene.

In recent studies of UK homes it was found that more than one-third have a high risk of containing polluted indoor air, and 81 percent of the population are at greater risk of respiratory or dermatological conditions because of this.

In low income countries, indoor air pollution is the leading risk factor for deaths.

(Source: Our World in Data)

VOCs such as acetone, xylene and formaldehyde are found in detergents, furniture polish, air fresheners, carpet cleaners, oven cleaners, paint strippers, varnishes, glues, pesticides and fungicides, and evaporate into the air and can be inhaled. Chemicals with fragrances are particularly likely to contain VOCs, which studies suggest can cause allergic reactions and asthma.

REDUCING RISK

So, what can we do to reduce our risk to indoor air pollutant VOCs?

h Ask smokers in the household to smoke outside, or not at all. This will not only be a nicer smoke-free environment for everyone, it will also keep the VOC benzene, that is released from cigarette smoke, out of the house.

h Choose products that are fragrance-free. If you can do this on a daily basis, it will drastically reduce the number of VOC fragrances released into the air.

h Investigate using ‘natural’ paints. But be aware paints advertised as waterbased or low VOC may still contain some hazardous chemicals.

h When purchasing new flooring or furniture that is not 100 percent natural wood, try to keep the rooms well

ventilated for the first weeks and months after purchase.

h Keep your home free from damp, as fungi generates natural VOCs which can negatively impact on family health.

Studies also show that that cleaning professionals who use these chemicals over long periods may sustain lung damage. Carpets, furniture and flooring often contain formaldehyde which can be a lung irritant.

To reduce exposure to VOCs you should try to use allergy-free cleaning compounds, and liquids rather than sprays. Make sure your home is well ventilated when you clean, keep children away from cleaning products and dispose of packaging carefully.

CAREFUL COOKING

Alongside VOCs, a main source of indoor air pollution is cooking and heating. Cookers, heaters, stoves and open fires are all known to be able to release pollutants into your home, either in the form of particulate matter (PM), as gasses including carbon monoxide, nitrogen oxides and sulphur dioxide, or as microscopic particles of dust. These can be very consequential, with the ability to cause lung and heart disease.

Carbon monoxide poisoning can cause headaches, flu-like symptoms and can be fatal in severe cases.

To minimise indoor air pollution from cooking and cleaning:

h Make sure you get a professional to service chimneys, cooker and heater flues.

AT WORK

Many of the conditions causing indoor air pollution at home can also apply at work, and you could also be exposed to other causes of allergic reaction and health risks such as wood dust, spray paint, flour dust, oils, welding by-products, silica dust and industrial agents.

Workplace regulations are in place to protect you against these hazards and there should be a risk assessment to identify possible causes of harm. Talk to your health and safety representative or report potential problem to the Health and Safety Executive.

h Do not burn wood or coal in open fires, and never burn rubbish or packaging.

h Regularly Service cooking and heating appliances.

h You must fit extractor fans above all cooking appliances.

h Fit smoke and carbon monoxide alarms and service them regularly.

Allergies to house dust mites, dead skin flakes and mould spores are common, and may cause breathing problems, especially for those who suffer from asthma.

In pillows, mattresses, duvets, carpets and upholstery, dust mite droppings are hard to get rid of completely. Using mattress covers, vacuum cleaning, having effective ventilation, freezing, washing, air filtration or air ionisers can help you reduce their frequency in your household.

If you have pets, pet dander (dead skin flakes) from furred animals and birds can also cause allergic reactions and are hard to dispose of. Unfortunately, there is no easy fix; the only solution seems to be regular cleaning of the home and the

animal. You should resist contact with your animal at night and consider not letting your cat or dog sleep on your bed.

POLLUTANTS

Although you may be tempted to use candles and incense to improve the atmosphere of your home, in terms of air quality they are to be avoided; both emit particles and other pollutants, incense sticks emit more than 100 times the number of fine particles as candles. Both can emit those troublesome VOCs and formaldehyde, so make sure never to keep or light a large number of them in a small space.

The most significant indoor air pollution chemical health risk from building materials is asbestos. Though since 1999, asbestos hasn’t been used in new buildings, it may still be present in old buildings, and can cause lung disease and cancer if inhaled in particle form. If you do find some in your building, do not disturb it, get it removed by accredited professionals. The same applies to fibreglass insulation.

Alongside this, a potential indoor air pollution problem is radon, which is a naturally occurring gas that can accumulate in poorly ventilated buildings. By looking at the website www.ukradon.org , you can find out whether your home is built on a high radon area, and you can then seek help and advice on guarding against it.

It goes without saying that smoking cigarettes indoors is a major cause and source of poor air quality, and is the main cause of preventable illness and death. You should ideally stop smoking altogether, but short of that, you should smoke outdoors, or take up vaping – still not provably harmless, but less harmful than tobacco.

It’s important for all of us to have a more informed knowledge of indoor air quality. There are some simple, positive, and consequential steps that we can all take to look after our health and the health of our friends and family. It is simply a case of making more informed, conscious choices so that we are creating a home environment that is both sustainable, enjoyable, and healthy. ■

Eat Well, Feel Better

What we eat has more effect on our health than practically any other factor. What can we do to make sure our nutrition is fit for life?

It’s becoming increasingly clear that the food we eat has more effect on our health than practically any other factor.

With soaring rates of conditions such as diabetes and obesity being blamed on the ‘Western diet’ of highly processed, highsugar, high-fat foods, being aware of how diet affects health is one of the main ways we can help ourselves to better health, and stay out of doctors’ waiting rooms and hospitals for as long as possible.

CLEAN EATING

The movement towards natural foods, often called ‘clean eating’, opposes factory farming, processed goods, untrustworthy food chains and the perceived threat of genetic modification. Foods that are “whole” and “unprocessed”, with healthy ingredients cooked at home, are based on sound nutritional principles.

Classic clean-eating dishes include homemade soups and salads, avocado, kale, chia seeds, quinoa, sweet potato, and where meat is eaten, grass-fed, free range meat, or fish. Some embrace gluten-free, vegetarian or vegan (dairyfree) policies, which might work for some, but gluten-free and dairy-free recipes aren’t necessarily better for us unless we have dietary intolerances such as coeliac disease. There is a misconception that gluten can break down the microvilli (a very tiny hair-like membrane) in the intestine, letting food particles pass into your bloodstream. This can be the case, but only if you’re suffering from coeliac disease. The real enemy, as with a lot of these cases, is overindulgence.

Carbohydrates, which we are often urged to cut down, are of course dietary

essentials, though you should try to get them from the best sources, such as fruit and vegetables, beans, nuts, dairy

DRINKS

Nearly a quarter of the added sugar in our diets comes from sugary drinks, such as fizzy drinks, sweetened juices, milkshakes and cordials.

A can of regular cola contains seven teaspoons of sugar (35g). Try swapping to water, sugar-free or no-added-sugar drinks or lower-fat milks.

If you take sugar in tea or coffee, gradually reduce the amount until you can cut it out altogether, or try swapping to sweeteners instead. Try some new flavours with herbal teas, or make your own with hot water and a slice of lemon or ginger.

Like some fizzy drinks, fruit juice can be high in sugar. When juice is extracted from the whole fruit to make fruit juice, sugar is released, and this can damage your teeth.

Your combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day - which is a small glass. For example, if you have 150ml of orange juice and 150ml smoothie in one day, you’ll have exceeded the recommendation by 150ml.

and whole grains. These foods aren’t processed like the better-known sources of carbs such as bleached grains and sugars, which should be avoided.

Some clean eating basics, such as flaxseed, have a place in a healthy diet, but are not in themselves adequate to supply compounds such as omega-3s fatty acids, which are especially abundant in fish.

Eggs sometimes get bad press, but while they do contain a lot of cholesterol, it’s of the good denser variety that reduces, reuses and recycles its bad counterpart and puts it to use relining the inner walls of blood vessels - in turn helping prevent heart disease. Beyond this, eggs also have a rich variety of nutrients and antitoxins, so on the whole they are good for you.

Equally, it’s untrue that saturated fats are necessarily bad for you, despite a historical belief that they contribute to heart disease. It’s now thought that there is no substantial proof for this, and indeed one of the most popular healthy oilscoconut oil - is in fact high in saturated fats but is still considered a healthy food.

HOW TO EAT

Preparation of food can contribute as much to a healthy diet as the ingredients. There are some suggestions that eating small meals more frequently throughout the day increases your metabolic rate, but studies have shown you neither burn calories nor lose fat any faster by doing this. The best way to burn calories and lose fat is to focus on eating real foods and avoid consuming more calories than you’re burning. »

Similarly, the trend for juicing or blending fruits and vegetables may make them easier to consume, but there’s no real evidence that it has any dietary effect different to eating fruit or veg whole –and in fact it may reduce the dietary effectiveness of fibres which are essential for good heart and digestive health. If you like your health kick flavoursome, juice away, but don’t expect significant differences in your health.

Regular detox cleanses aren’t necessary because your liver and kidneys already do this on their own.

So is there sound evidence for the health benefits of ‘clean eating’? Essentially, the general rule for diets is that the more restrictive they are, the less healthy they tend to be.

Some early proponents of extreme ‘clean eating’ found themselves suffering from hair loss, skin and menstrual issues, and even osteopenia, which is a precursor to the brittle bone disease osteoporosis, normally seen in women after they go through the menopause. This disease can be caused by someone cutting out food

groups such as dairy, particularly if it is a lifelong habit.

So what is the sensible alternative to ‘clean eating’? Here are our tips, based on the NHS’s Eat Well Guide.

Base your meals on higher fibre starchy carbohydrates. These should make up over a third of what you eat, including bread, rice, pasta, cereal, and potatoes. To make sure, include at least one starchy food with each main meal.

Eat lots of fruit and veg. Regardless of whether you juice or not, getting your five a day is essential for maintaining a healthy diet. It does not matter whether they are fresh, frozen, canned, dried, or juiced.

Eat more fish, a great source of protein, vitamins, calcium and minerals. You should aim to eat at least two portions of fish a week, including a portion of oily fish.

You should regulate your alcohol consumption to 14 units per week, that’s about six pints of beer or glasses of wine,

spread out over three days or more. You don’t have to sacrifice the taste of luxury wines to drink healthily, with vegan, organic and reduced sugar drinks on the market

Eat less salt. Eating too much salt can raise your blood pressure, which can have serious long-term health consequences. Have a look at the labels on the back of your products - more than 1.5g of salt per 100g qualifies as a high salt count and should be avoided.

Get active and be a healthy weight. Exercising regularly is essential to reduce your risk of developing serious health conditions. Exercise is also important for your mental health.

Do not get thirsty. Simply, drink plenty of water, between 6 and 8 glasses a day.

Do not skip breakfast, it’s the most important meal of the day. Breakfast sets you up with all the nutrients and energy you need to get up and go! ■

Supplementary Benefits

You might be eating what you think is a healthy, balanced diet, yet still be deficient in some vital nutrients. Can supplements improve wellbeing and even longevity?

Keeping up your intake of essential vitamins and minerals is one of the basics of maintaining optimum health and fitness. Many of us have an unsuitable diet relying on processed foods, often manufactured with too much salt and sugar, and find it difficult to get enough fresh, healthy food for the right dietary balance.

In the winter months, we may not get enough sunlight and so need supplements to boost our Vitamin D levels, and an increasing number of people suffer from malabsorption of nutrients in the gut, due to autoimmune conditions such as IBS, Crohn’s, Colitis and Coeliac disease.

Fortunately, when it’s essential to supplement your diet, there are lots of ways to find what you need, and if you aren’t happy with taking tablets or capsules, say if you have dysphagia (difficulty swallowing), many supplements are available in the form of oral sprays.

NUTRIENTS

Oral sprays can deliver nutrients swiftly to the bloodstream through the buccal membrane of the inner cheek, and have been shown in clinical trials to be just as effective as capsules at elevating Vitamin D levels. Vitamin D is crucial to the immune system and the nutrition process, as it absorbs the minerals from your diet to maintain strong and healthy bones, muscles and teeth.

Yet the human body is peculiarly designed when it comes to manufacturing Vitamin D, requiring sunlight as part of the process. If you don’t get enough sunlight on your skin - and if you spend a lot of

time indoors, and during the dark winter months, that’s quite likely - you may be Vitamin D deficient.

From April until the end of September, the body, specifically the forearms, hands and lower legs, need to be exposed to around 20-30 minutes’ worth of outside sunlight. People who have dark skin – for example people of African, AfricanCaribbean or Asian descent – may not be able to produce enough vitamin D from sunlight alone.

Vitamin D can also be found in some foods, such as fish (Salmon, mackerel, sardines etc), red meats (beef and lamb), liver and fish liver oil and eggs (yolk). If you avoid these foods for dietary reasons, some fortified foods including breakfast cereals and fat spreads also have vitamin D added to them.

DEFICIENCY

Vitamin D supplements are widely available in pharmacies and health food outlets, and are sometimes combined with other vitamins in multi-vitamin supplements.

Another essential for everyday health, magnesium, is vital for healthy bones, and can aid with stress, stiffness, sleeplessness and nervous problems. Magnesium is widely available in tablets and capsules, but is also available in transdermal form, applied directly onto the skin and quickly absorbed through the epidermis into the blood vessels and muscles beneath. This bypasses the digestive system where many nutrients, including magnesium, can be poorly absorbed.

For skin health and beauty, a popular

ingredient is marine collagen, also believed to be good for your hair, nails, joints, bones, ligaments and gut.

Marine collagen is a protein containing three amino acids, glycine, proline and hydroxyproline, which make up 75 percent of the skin’s structure, providing shape and support.

The body’s collagen levels and quality tend to drop with age, and can be depleted by the sun’s UV rays, pollution and smoking.

Marine collagen is sourced from fish and other sea life, such as jellyfish. »

FOLIC ACID

Folic acid, a water-soluble B-vitamin, plays a vital role in maintaining overall health and well-being. It is naturally found in various foods, but folic acid supplementation has numerous health benefits. While folic acid is naturally present in foods like leafy greens, citrus fruits, and legumes, many people may not obtain an adequate amount through their diet alone. That’s where supplementation becomes valuable. Folic acid plays a pivotal role in functions including the production of DNA, RNA, and proteins, vital for cell growth and division, so it is particularly important during periods of rapid cell growth, such as pregnancy and infancy.

VITAMIN D DEFICIENCY

Symptoms of Vitamin D deficiency include the bone disorder rickets, and muscle weakness. Vitamin D production tends to reduce with age, so older people are likely to need supplements. Some medications can also affect Vitamin D production. Adults and children over the age of 4 are recommended to take 10 micrograms of vitamin D per day. For infants aged between 1 and 4 years old, they should be provided with a daily supplement of 10 micrograms per day all year round. Those aged under 1 are recommended to have a daily supplement of between 8.5 to 10 micrograms of vitamin D.

You can support collagen production and overall hair health by maintaining a balanced diet rich in protein, vitamin C, and other nutrients that support collagen synthesis. Additionally, collagen supplements are available.

For stress, insomnia and anxiety, organic ashwagandha root is a recommended solution, commonly used in ayurvedic medicine. An evergreen shrub that grows in Asia and Africa, ashwagandha contains chemicals that may help reduce swelling, lower blood pressure, and alter the immune system. It’s also used to treat insomnia, ageing, anxiety and many other conditions. Many other treatments are based on home remedies which have been used for thousands of years, so if you feel getting back to nature would benefit your health and beauty, why not give them a try?

VITAMINS

For general wellness and improved immune function, combinations of the seven essential vitamins are recommended, often combined with probiotics to aid gut

health. Probiotics, which help to balance the different types of bacteria found in the gut, aid digestion, but are also often suggested as an aid to immune system and inflammatory problems.

For energy and hormone balance, Vitamin B and C are recommended, often with other compounds. These can include inositol, a structural part of cell membranes; choline, a nutrient similar to the B vitamins which helps form cell membranes and aids nerve communications; and PABA (paraaminobenzoic acid), a chemical found in folic acid and in grains, eggs, milk, and meat.

For urinary and gut health, the glucoserelated D-Mannose is often used to treat urinary tract infections, as it is believed to inhibit bacterial adherence to the lining of the urinary tract.

Cranberry extract can offer some of the effectiveness of antibiotics without the side-effects. If you opt for cranberry juice, make sure to use the pure, unsweetened variety. ■

KOMBUCHA

Kombucha is a fermented tea beverage that has gained popularity due to its potential health benefits, which include supporting the gut microbiome, neutralising free radicals in the body, aiding liver function and detoxification, improving digestion and supporting the immune system. There are even some suggestions that kombucha may aid weight management as its probiotics and acetic acid content may help regulate metabolism and promote a healthy weight. Kombucha also contains glucosamines, which support joint health and reduce joint pain, and some users report improved mood, increased energy, and reduced anxiety after including kombucha in their diet.

Transform Your Mind with Neurofeedback

Make Your Resolutions a Reality

Imagine addressing brain health challenges like anxiety, stress, focus, memory , and poor sleep through activities as enjoyable as watching movies or playing video games. With neurofeedback, grounded in neuroscience, this is not only possible but accessible to everyone.

What is Neurofeedback?

Neurofeedback is a enjoyable, interactive, non-invasive, and medication-free treatment that can effectively address any condition associated with brain waves and neuro-connections. With your brain’s innate ability to change known as neuroplasticity, neurofeedback can help you retrain your brain to reduce mental health symptoms, improve performance, and achieve more balance Neurofeedback is a way to exercise your brain and reward it for optimal performance.

Why Neurofeedback?

Neurofeedback opens a door to enhanced mental balance and flexibility. Imagine reducing stress, sharpening your focus, and enjoying deeper, more rejuvenating sleep. This technique is especially beneficial for those aiming to:

• Alleviate anxiety and stress.

• Boost cognitive function and concentration.

• Foster emotional balance and wellbeing.

• Attain deeper, more restorative sleep patterns.

How Does it Work?

To begin, we take a detailed 3-D map of your brain activity to create your custom training plan to guide your sessions. During a neurofeedback session, we monitor your brain activity in real-time. When your brain moves towards a more comfortable and efficient state, you are rewarded by getting to hear and see what is on the TV screen. When your brain under/over performs, the video and sound fades. Your brain is able to learn with this feedback loop just by watching your favourite TV shows, films or playing games. Once you have trained your brain to perform at optimal levels, the symptoms related to the imbalances start to fade away and are reduced. As with learning any new skill, the changes are long term.

Safe, Effective, and Empowering

Neurofeedback is a safe, drug-free journey suitable for all ages, offering a customised approach to improve your life quality.

Benefits of Neurofeedback

Improved Emotional Well-being

Neurofeedback helped me get two promotions

Enhanced Cognitive Function Better Physical Health

Mark 38yrs London

Prior to beginning treatment work would knock me for six and I would feel very stressed and be in a bad mood and feel unable to socialise after a hard day. I can now maintain my equanimity and am much more pleasant to be around!

I am able to understand my work a lot better and document what I do clearly. Things appear simpler and I am aware of more factors when making decisions. I seem to think more logically and can link tasks together and ideas in a very cohesive manner like never before.

My emotional regulation seems a little better. However I do still get moments of immense anger but it feels easier to let it go. I am also more tolerant of others and feel better able to understand their point of view and I am getting better acquainted with sympathy and empathy.

I felt fantastic afterwards, very joyful, totally blew my brain fog away. I could easily draw upon my vocabulary and truly express myself and felt incredibly sociable.

Since starting the sessions I believe that my creativity has returned and now feel able to express myself eloquently and flexibly. Multitasking seems easier and I don’t get as stressed.

I feel much less social anxiety and just calmer in general. My memory and ability to select the right word seems to be improved.

Train your brain, change your life

Experience neurofeedback in your own home

Brainworks has revolutionised neurofeedback by introducing the world’s first remote service in 2013. Specialising in at-home neurofeedback, they offer a convenient, private, and effective way for clients to engage in brain training. Their sessions are primarily conducted remotely, utilising advanced technology, bespoke software with qualified therapists

Quality and Accessibility at Your Fingertips

Brainworks ensures that their at-home service matches the quality of in-clinic sessions. The process involves a simple setup where clients connect a system to their WiFi, allowing therapists to conduct sessions remotely. This setup guarantees quality, safety, and ease of use.

Efficient and Personalised Training

Recognising the importance of regular sessions for effective neurofeedback, Brainworks offers flexible scheduling, up to six days a week. They provide a 19-sensor deep brain neurofeedback system for detailed brain mapping and personalised training, tailored to each client’s unique brain activity.

Cost-Effective Solutions

With a focus on personalisation and precision, Brainworks offers cost-effective neurofeedback training. Their approach is more efficient, helping clients achieve their goals faster than traditional methods.

Diverse Training for a Range of Needs

Brainworks caters to a variety of imbalances, including:

Emotional Balance, Focus, Cognitive Function, Stress and AnxietyManagement,, PTSD and Trauma, Stroke and Traumatic Brain Injury. Long term Covid complications Attention Deficit, Autism and Dyslexia, Developmental Trauma. Neuro-diversity Peak Performance, Self-Development, Creativity, Meditation.

For a free consultation contact Brainworks on 0207 193 4373

Going Beyond the Resolution: Small Changes for Big Goals

When it comes to keeping any resolution to change, it’s essential to realise that the path to success often extends far beyond the specific goal itself. While focusing on your resolution is crucial, making small changes in various aspects of your life can significantly enhance your chances of meeting your goals. Let’s explore why this holistic approach works and how it can help you achieve lasting change.

Understanding the Power of Holistic Change

Resolutions are often intertwined with various aspects of our lives, such as our daily routines, habits, and overall wellbeing. For instance, if your resolution is to eat healthier, it’s not just about the food you consume. It also involves factors like sleep, stress, and emotional well-being.

Imagine you’re striving to eat healthier in the New Year. While you might focus primarily on meal planning and nutrition, the quality and quantity of your sleep play a vital role in your success. When you’re sleep-deprived, your body craves quick energy fixes, often leading to unhealthy food choices. By prioritising better sleep, you can reduce cravings and make more conscious food decisions.

Reducing Stress for Overall Well-Being

Stress is a common roadblock to achieving resolutions. Whether you’re trying to lose weight, exercise more, or improve your financial habits, chronic stress can undermine your efforts. High-stress levels can lead to emotional eating, lack of motivation, and impulsive spending.

By incorporating stress-reduction techniques into your daily life, such as meditation or mindfulness exercises, you can better manage stress and create a calmer mental environment for successful resolution implementation.

Small Changes, Big Impact:

Making small changes in various aspects of your life can create a supportive ecosystem for your resolutions. Here are some practical steps:

Prioritise Sleep: Ensure you get enough quality sleep, as it can boost your willpower and reduce cravings.

Manage Stress: Incorporate stress-reduction practices into your daily routine to keep your mind clear and focused on your goals.

Nutrition: Improve your diet by making gradual changes rather than drastic restrictions. Small dietary adjustments can lead to long-term success.

Exercise: Start with manageable physical activity that you enjoy, and gradually increase the intensity and duration.

Mindfulness: Practise mindfulness to stay aware of your thoughts and behaviours, making it easier to overcome obstacles to your resolutions.

7, 9 Eccleston St. London SW1W 9LX

BrainworksNeurotherapy.com

To keep your resolutions, consider the bigger picture. Small changes in various aspects of your life, from sleep to stress management, can create a supportive environment for achieving your goals. By addressing these interconnected elements, you’ll not only increase your chances of success but also enhance your overall well-being in the process. Remember, resolutions are not just about a single change; they’re about transforming your life for the better.

Listening to Feedback

Neurofeedback therapy may be the key to treating a number of conditions by harnessing the brain’s capacity for change. So how does it work?

Activity in your brain determines all bodily functions, whether they are physical or mental; apart from being the set of physical control of functions such as muscle response, respiration and the senses, the brain is also in control of the more subtle functions we call psychological, mental or emotional.

It’s suggested that both physical and emotional imbalances could be treated by ‘exercising’ the brain in the same way that physical exercise can improve the health of the body, using techniques such as neurofeedback therapy. Can it really help with brain imbalances and chronic emotional states that affect everyday life?

Neurofeedback is in effect a way to train brain activity; it monitors brain activity and stimulates response in a balancing way. James Roy, co-founder

and technical director of Brainworks (https://brainworksneurotherapy.com), says: “The effectiveness of neurofeedback is not just rooted in controlled studies. Having established our clinic in 2007, we’ve witnessed first-hand the transformative power of neurotherapy and how it has improved the lives hundreds of adults and children.

“We have developed the technology to allow treatment to be given at home, significantly broadening accessibility and making these life-altering therapies available to a diverse clientele, regardless of their location or financial situation. Our experience reinforces the profound, positive changes that neurotherapy can bring, making it a vital tool for mental health and cognitive enhancement.’’

So how does neurofeedback therapy work in practice?

So-called ‘brainwaves’ are the electrical impulses produced as your brain cells communicate with one another. Analysis of brainwaves can tell us a lot about the underlying functions emotional and thought habits. In neurofeedback therapy, sensors placed on the scalp measure and monitor this activity, and using brain analysis software known as a QEEG (Quantitative Electro EncephaloGraphy) brain map, specialists identify what specific activity is giving rise to the patient’s symptoms.

Once these areas of concern are identified, a training plan is created to train the brain to achieve a comfortable, efficient state. This is the essence of ‘neurofeedback’. During a neurofeedback session, the brain’s functions are compared to an ideal state, and when it approaches the required state, the patient is rewarded with a positive response on a computer

screen, the feedback, usually in the form of a video game, music, or movie.

The feedback sounds and images tell the subject when the brain is approaching a more efficient place, and they train the brain to reach the desired state; in the same way that physical exercise develops specific muscles, neurofeedback therapy exercises the brain into a more comfortable, efficient state. This process is known as neuroplasticity, the ability of the brain to change through growth and reorganization, essentially rewiring itself through time and repetition, in the same way any skill is learned.

THERAPY

Neurofeedback therapy comes in many forms; in the basic EEG (Electro EncephaloGraphy) system, a therapist uses a small number of scalp-fitted sensors to train surface brain activity and properly tailor that training to the individual. This can be very effective in the treatment of conditions such as attention deficit hyperactivity disorder (ADHD),

anxiety, depression, epilepsy, insomnia, drug addiction, schizophrenia, learning disabilities, dyslexia and dyscalculia, autistic spectrum disorders, pain management, and the improvement of musical and athletic performance.

Most EEG neurofeedback therapists also use elements of QEEG LORETA (Low Resolution Electromagnetic Tomography) neurofeedback. This expands on the capabilities of surface neurofeedback using 3D brain imaging and training tools, and normally involves using a full 19-sensor cap, allowing the clinician to train a number of areas at the same time. This system normally uses a medical research database to improve results and reduce required training time.

This form of 3D neurofeedback takes more skill and experience to operate, and the equipment required costs more, so treatment can be more expensive, but it requires fewer sessions to see results.

In some cases it’s even possible to conduct these sessions at home, via a oneto-one consultation with a therapist. The

TRANSFORMING YOUR BRAIN

A good general introduction to the principles of neurofeedback therapy is The Neurofeedback Solution: How to Treat Autism, ADHD, Anxiety, Brain Injury, Stroke, PTSD, and More by Stephen Larsen, PhD, published by Healing Arts Press. It’s available via Amazon.

neurofeedback kit is sent to the subject, and sessions booked and conducted just as they could be in a clinic, using remote software.

As with learning any news skill, the results of neurofeedback therapy compound over time. Though initially, improvements will last for a short time. after a few sessions, benefits will last longer, with perhaps four to six sessions needed to make initial changes, and a dozen for more lasting results. ■

IMAGES: Dreamstime

FROM BABY BRAIN TO MENOPAUSE - WHY I MADE IT MY MISSION TO CHAMPION BRAIN FITNESS FOR WOMEN WITH NEUROPTIMAL® NEUROFEEDBACK

Four years ago, I was introduced to NeurOptimal®, a groundbreaking brain training technology that transformed my daily life. It helped me deal with the chronic stress and anxiety that had left me on the brink of burnout and restored mental and emotional balance as I navigated my way through the onset of menopause. Looking back at the early years after the birth of my son, I know without doubt that having access to this training earlier would have made a world of difference.

However, I wasn't actively seeking help back then. I accepted baby brain as a small price to pay for being lucky enough to experience motherhood, and I normalised my anxiety and panic as reminders of what was at stake. Running on minimal sleep and juggling multiple responsibilities, I convinced myself I was coping fine and surviving. That illusion shattered a year later during a demanding work contract when I hit breaking point. Debilitating headaches, persistent brain fog and memory loss, compounded by being perimenopausal, led me to fear the worst, and it was only then that I finally broke down and admitted I needed help.

by Louise Henry, founder BrainFiT®

Sometimes, us women can be just as challenged as men in recognising our needs and seeking appropriate help. Our innate tendency to prioritise the well-being of others often means we forget to put on our own oxygen masks, and forego the practice of self-care amidst the chaos of daily life. Overwhelmed and stretched thin, we find ourselves becoming irritable with our children, our partnerships suffer, and we stop doing the things that once brought us joy. Gradually, we become so depleted that we hardly recognise ourselves anymore.

I’d never heard of neurofeedback until my brother, Andy, enthusiastically suggested trying it. At the time, he was seeing some great results with NeurOptimal® as a practitioner in an Australian healthcare practice. I must admit, I was pretty sceptical of brain training! On reflection, it seems silly, but I hadn’t connected my physical and emotional symptoms with my brain's health and fitness.

So, when Andy sent me a NeurOptimal® neurofeedback brain training system to use at home, I took some convincing, but I tried it. It was surprisingly straightforward to use. The initial session proved to be a very calming experience, and I found the accompanying music very soothing. Within a few sessions, I began to notice tangible changes, which motivated me to commit to daily training.

After the recommended month of daily NeurOptimal® sessions, I honestly felt like a whole new person. The fog had lifted, the headaches had disappeared, and I regained the ability to make calm and rational decisions. My sleep improved dramatically, and I even began experiencing pleasant dreams again. I stopped being the angry mum, reconnected with

those I had distanced myself from, and began extending the offer of training to anyone that might benefit—including my four-year-old!

Because NeurOptimal® works so naturally and non-invasively with the brain, it is totally safe for everyone to use, regardless of age, condition or medications. And since it’s a training not a treatment, when the brain adapts to a more optimal way of working, it doesn’t go back. After my own transformative experience in just a month of using NeurOptimal® at home, I had a profound realisation that this simple, non-invasive and drugfree solution could not only transform and empower the lives of women like me but also their entire households!

The training allows you to naturally reconnect with the person within, to gain positivity and clarity, and helps you to know where you need further support.

Knowing how powerfully and naturally effective NeurOptimal® actually is led to why I am so passionate and committed to raising the awareness of brain health and fitness by bringing this lifechanging, clinical-grade neurofeedback brain training technology into the mainstream. As a result, I founded BrainFiT® and became the first official UK NeurOptimal® representative and certified training course instructor. It is also why I am helping other practitioners integrate NeurOptimal® within their own healthcare practices to complement the benefits of other therapies. I am championing brain fitness for women to share this gift. I hope it can serve you too!

Anxiety

Sleep issues

Menopause

Depression

Headaches & migraines

Mental clarity

Focus

Emotional regulation

Stress management

Behavioural issues

ADHD

PTSD

Mental ageing

Better to Prevent

The idea that prevention is better than cure is not a new one, but current ideas suggest that approcah is more valuable than ever

With disorders such as diabetes costing the NHS billions to treat every year, it’s more essential than ever that our health care providers do what they can to prevent disease developing in the first place rather than having to treat it at great expense later on.

That’s the sensible principle behind preventative health assessments, which can be done either on the NHS or through private healthcare.

Many of us feel we are too busy to pay attention to our health, and neglect it until something goes wrong. Certainly a healthy lifestyle with regular exercise, a balanced diet, moderate use of alcohol and avoidance of smoking is a sensible aim; but some conditions, particularly those with a genetic origin, are harder to avoid.

In many cases, waiting until disease strikes is leaving it too late – no matter how much time or money you spend on your health afterwards. This can be particularly tragic for those with young families left devastated by premature death of a parent.

Far better, then, to catch potentially harmful conditions before they develop, and can still be treated.

LIFESTYLE

Take, for instance, coronary heart disease. Approximately 300,000 people in the UK suffer a heart attack each year. Of those, around 125,000 will die and astonishingly, for almost half of them, this is their first sign that there is any health problem.

The traditional method of assessing cardiac risk, using Framingham scores, dates from the 1960’s and uses factors

such as age, lifestyle and family history to generate a statistical risk. However, 40-50 percent of individuals who suffer a heart attack have no risk factors and are unaware of their hidden risk, and would be missed by the traditional screening algorithms.

Advances in scanning technology offer a more accurate assessment. The latest generation of computerized tomography (CT) scanners can image the inside of the heart arteries in incredible detail to spot the earliest signs of ‘furring up’, providing an accurate assessment of an individual’s risk of coronary heart disease.

CT scanning also has applications in detecting lung cancers as small as 1-2 mm, a far more sensitive scan than using X-rays which can generally only detect tumours of 10mm in size, and MRI scanning which cannot image the chest at all.

Compared to a traditional Framingham assessment, there’s evidence that results from a CT scan lead to better adherence to lifestyle changes and use of medicines.

IMAGING

To be effective, though, a preventative health assessment must take a bespoke approach. Using generalised, populationbased statistics to provide a statistical risk of disease which is frequently inaccurate. A bespoke advanced health assessment will use modern medical imaging to actually see ‘under the bonnet’ to determine the earliest stage of disease and provide a precise individual assessment.

Private health assessment providers can assess clients who are otherwise asymptomatic, but wish to be sure that they are healthy. Sometimes there is a specific reason for their concern such as a family history of a specific disease. However, more often than not, it is because they wish to be proactive and find out what, if anything, is going wrong.

This sort of proactive approach is sometimes disparaged as being the concern of the ‘worried well’, but even NHS screening programmes depend on people being willing to take responsibility for one aspect of health or another – and a bespoke health assessment can pick up on a condition which could otherwise be missed.

A typical health assessment might include a physical examination, lifestyle questionnaire, and tests of body mass index, blood pressure, PSA (Prostate Specific Antigen), and so on. But this approach risks missing many conditions such as coronary heart disease, colorectal cancer and skin cancer.

A comprehensive health assessment would use a range of advanced scanning equipment together with the most skilled radiographers, radiologists, clinicians and specialist consultants and physicians to refer the patient for treatment if anything of concern is found.

Apart from detecting disease that

may lead to premature death, this approach also minimises the risk of causing unnecessary concerns by flagging ‘abnormalities’ which are in fact within acceptable ranges. ■

NHS HEALTH CHECKS

If you’re aged 40 to 74 and do not have a pre-existing health condition, you should be invited to an NHS Health Check by your GP or local council every five years.

If you think you are eligible but have not been invited, contact your GP surgery to find out if they offer NHS Health Checks or contact your local council to find out where you can get an NHS Health Check in your area.

Some pharmacies also offer NHS Health Checks.

Alcohol - Low No?

Millions of people reduced or cut out their alcohol intake for ‘dry January’. But what are the arguments for low- or no-alcohol drinks?

Every year people make New Year resolutions, o en under the influence of an over-indulgent Christmas. Whether it’s to exercise more or to eat less, their determination o en ebbs away by the end of January. But the idea of cutting down on alcohol, or cutting it out altogether, o en has a more lasting e ect – ‘Dry January’ could turn into a healthy determination to reduce alcohol consumption for good.

The charity Alcohol Change UK promotes Dry January as a way of introducing a new attitude to drinking alcohol, and has a number of tools and resources on its website at www.alcoholchange.co.uk

While there are many reasons to cut out the booze, the main one would be health. Alcohol is linked with more than 60 health conditions, including liver disease, high blood pressure, depression and seven types of cancer. In fact, alcohol is the

biggest risk factor for death, ill-health and disability for people aged 15-49 in the UK.

Here are Alcohol Change’s top reasons to go dry.

1. What you’ll notice

See your skin get brighter, your wallet fuller, your days busier. Feel your step get bouncier, your mind calmer, your mornings fresher. Most people who do Dry January see a whole host of obvious benefits that make it the perfect start to the New Year.

2. On the inside

An alcohol-free month has many benefits. Research published in 2018 in the British Medical Journal found that a month

o alcohol:

 Lowers blood pressure

 Reduces diabetes risk

 Lowers cholesterol

 Reduces levels of cancer-related proteins in the blood.

3. Long-term change

The real magic happens when Dry January is over – it helps people to drink more healthily year-round.

Research conducted by the University of Sussex found that six months a er Dry January, more than 70% of people who take on the month are still drinking more healthily, and have boosted levels of wellbeing.

Alcohol Change says that being alcoholfree for 31 days shows us that we don’t need alcohol to have fun, to relax, or to socialise. It helps us learn the skills we need to manage our drinking. When we do drink socially there are many delicious lowor no-alcohol options to choose from. That means that for the rest of the year we are better able to make decisions about when we drink alcohol and how much, so we can avoid slipping back into drinking more than we really want to. ■

Live Longer, Live Be

Breakthroughs in medical technology are bringing remarkable improvements in health outcomes every day. Here are some of the most exciting developments

KING’S CANCER DIAGNOSIS PROMPTS ADVICE

An NHS.uk webpage o ering advice on the possible signs and symptoms of cancer has seen a jump of over 50% in the number of visits since news broke of the King’s recent diagnosis.

Latest figures from NHS England reveal that, in the 24 hours following the Buckingham Palace announcement, visits to the page on cancer signs and symptoms rose to 14,668 compared to a daily average of 9,737 in previous weeks – an increase of 51%.

Visitor numbers peaked in the hour following the initial statement, with 1,530 visits being made to the page – an average of one visit every three seconds.

The NHS.uk cancer pages include information on lifestyle changes people can make to reduce their chances of getting cancer, as well advice on spotting early signs and symptoms of the disease and treatment options.

NHS England’s National Clinical Director for Cancer, Professor Peter Johnson said: “Talking about cancer helps save lives, and having more people looking at advice like this on how to spot the possible signs and symptoms of cancer is really important.”

BIOTECH TO BUILD NEW ORGANS

Researchers are looking to the latest technological advancements to help speed the process of bringing new pharmaceuticals to market. The whole drug development process requires up to fourteen years and over $2 billion in investment, so any advantage can lead to considerable savings. Bioprinting is one area of biotech that has the potential to improve this situation. Bioprinting is a cutting-edge technology that uses 3D printers and biomaterials to create living tissues and organs for medical applications. By building up cells and biomaterials layer upon layer, it is possible to construct functioning tissues and organs. This has clear promise in the area of organ transplantation, but the possibility of full organ transplants remains a few decades away.

In the meantime, a potential game-changer lies in applying bioprinting to drug testing. Traditionally, drugs are tested on two-dimensional cell cultures or animals before human trials. But those processes are expensive and lengthy, and they also fail to predict all possible human responses accurately. Here, bioprinting steps in to revolutionise the process. Vidmantas Šakalys, Chief Executive O cer of Vital3D Technologies, says. “Currently, the organ-on-achip development field is experiencing exponential growth, which suggests a promising future for actively adapting this technology in research.”

NHS URGES WOMEN TO TAKE UP BREAST SCREENING

Thousands of women are being urged to attend NHS breast screening appointments as new figures show that, despite a slight increase in uptake in the last year, over a third of women still did not take up the potentially lifesaving o er when invited.

In 2022-23, a total of 1.93 million women aged 50 to 70 (64.6%) attended screening appointments (within six months of invitation) out of the 2.98 million invited to book a check-up – an increase in uptake on 2021-22 (62.3%).

However 35.4% of women did not attend their appointments following an invitation, increasing to 46.3% of women who were being invited for the first time.

The screening programme led to cancers being detected in 18,942 women across England in 2022-23, which otherwise may not have been diagnosed and treated until a later stage.

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Leigh Day has spent decades restoring justice, securing answers and winning compensation for patients and their families.

Client story: Baby Jessiah v NHS Trust

Baby Jessiah* was delivered by emergency caesarean section in 2015 following uterine rupture, meaning that he was in the abdominal cavity before delivery. As a result, Jessiah suffered oxygen deprivation and was born in very poor condition. He was diagnosed with severe cerebral palsy.

As a result of his injuries, Jessiah has severe neuro-disabilities and is unable to sit, roll, stand or walk unaided. He has a profound learning disability which means he has major difficulties accessing and making sense of new information and settings, and does not have functional speech. He requires assistance with all his needs and activities of daily living, beyond those of an average child of his age.

Jessiah’s family instructed us to bring a legal claim against the hospital to help secure a settlement to ensure that his substantial needs were met for the remainder of his life.

In January 2023, a settlement was agreed and Jessiah was awarded a lump sum payment of £7 million and annual payments of £700,000 to fund his complex care regime, including a 24-hour 2:1 package of care with full-time nursing care.

*Name changed for legal reasons

As medical negligence lawyers, it’s our role to find out if your medical provider was negligent. If so, we could help secure the support you need to recover and care for you or your family.

Email clinnegNCE@leighday.co.uk for further information or speak to us in confidence on 020 3727 7191

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Duty of Care

We all expect good medical treatment from our health services, but how can we claim damages when something goes wrong?

We all support the good work of the NHS, and expect the best of treatment, and we certainly expect it when we are paying for private health care. So what happens when something goes wrong with your health care and you think you may be entitled to financial recompense?

Clinical negligence, or medical negligence cases incorporate a broad variety of medical issues. Common ones include delays in medical diagnosis and

misdiagnosis, birth injuries, sub-standard surgical procedures, mental health negligence, faulty medical device claims and dental treatment negligence.

Medical negligence cases rarely go to court, as both parties will be keen to reach a settlement to avoid incurring the expense involved in undertaking court proceedings. Low-value claims (under £50,000) normally proceed to the County Court, whereas claims of a value above this will be heard in the High Court. But

in any case you will want the advice of an experienced medical negligence legal practitioner to make sure your case is well supported.

SETTLEMENT

There is a three-year limitation period in which an individual is required to issue court proceedings, starting from the date of the negligence or since the individual has become aware of the harm. Once proceedings are issued, parties exchange

evidence and are encouraged to reach a settlement in the interim before court. Complex medical negligence cases can take years to settle.

Cases often rely on case law, in other words judicial precedent which is used to guide later judgements. Let’s consider a typical case which is regarded as a landmark judgement, Darnley v Croydon Health Services NHS Trust 2018

The claimant, a Mr Darnley, sustained a head injury and attended A&E. He was told by a receptionist that he would have to wait up to four or five hours to be seen. This information was incorrect, as the hospital had a 30-minute triage system – but Darnley left the hospital rather than wait, his condition worsened, and he returned to the same hospital in an ambulance. He suffered a permanent brain injury.

After an appeal the Supreme Court established that his injuries would have been avoided had he been seen when he first visited the hospital, and that the receptionist had a duty of care and had been negligent, the judgement stating that an “averagely competent and well-informed A&E receptionist would not provide misleading information”. As a result Mr Darnley received damages intended to provide him with the therapies, care and support he required as a result of his life-changing brain injury.

PRESSURE

Other medical negligence test cases have ruled in cases of ‘wrongful birth’ – where a mother who gave birth to a child with haemophilia and autism brought a case against her GP who had caried out blood tests – on patient confidentiality, where a mother brought a case against the NHS for not informing her that her father had inheritable Huntingdon’s disease – and on medical negligence, where an inexperienced junior doctor’s failure to give a child antibiotics resulted in permanent brain damage.

This last case is particularly interesting for the closing remarks made by Lord Justice Jackson, who said: “I must acknowledge that junior hospital doctors

COMPLAINTS

The total number of all reported written complaints in the NHS in 2022-23 was 229,458, an increase of 3,888 (1.7%) from 2021-22 (225,570). From 1st July 2023 the way members of the public make a complaint about primary care services to the commissioner was changed. Rather than contacting NHS England, complaints are directed to the local Integrated Care Board (ICB). Members of the public will still be able to make a complaint to the provider.

work long hours under considerable pressure. They are often involved in life and death decisions. The pressures can be even greater when working all night… If mistakes are made, it is devastating for the patient and it is expensive for the NHS Trust.

“Doctors, however, are human. Even good and conscientious doctors may,

from time-to-time, fall short. This is not a reason to lose heart or (even worse) to abandon medical practice. Those who have learned from past mistakes often have even more to offer.”

PROCEDURES

A Patient Advice and Liaison Service – or PALS – is usually your first point of contact when making an informal complaint directly to the NHS. They can also give you advice on the procedure for making a more formal complaint.

Should you be unsatisfied with the results of your complaint and have to resort to legal action, you may be entitled to two kinds of damages for your injury - general damages for pain, suffering and loss of amenity, or special damages to cover actual financial losses and expenses arising from your injury such as lost earnings, costs of caring for an injured person, costs of physiotherapy and so on.

More serious injuries, resulting in life-long incapacity affecting someone’s ability to work and to care for themselves, will attract the largest awards. ■

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A Step-by-Step Guide to Youthful Skin

Is a loss of skin quality inevitable with age? Certainly there’s a lot you can do to keep it looking youthful. Here are our seven top tips

To some extent it’s inevitable that our skin quality will decline with age; changes in the body’s hormones and the supply of nutrients and supportive chemicals such as collagens mean that we can expect skin to lose elasticity, and to dry out and wrinkle. But, don’t despair – there’s plenty you can do to stave o the decline, and to keep your skin looking and feeling fresh and youthful for as long as possible. Here are our Top Seven techniques.

EXFOLIATE

Your skin naturally exfoliates itself, shedding between 30,000 and 40,000 dead skin cells every minute, but factors such as weather, lifestyle, age, and dehydration can slow down or halt this process, resulting in dull, flaky, congested skin over time. Removing dead skin layers will bring out the glow in the skin beneath. Don’t exfoliate too harshly; use a non-irritating acid cleanser or exfoliant to help smooth skin texture, increase the absorption rate of skin care products, and brighten up your complexion.

plant-based supplements. Arella Vegan Collagen is the company’s flagship product, its star ingredient, VeCollal®, is clinically proven to support and increase natural collagen, without the use of animal products. In addition to a potent dose of VeCollal®, each Arella Vegan Collagen sachet is packed with essential vitamins and nutrients - including retinol, vegan D3, hyaluronic acid and vitamin C - which help smooth wrinkles, encourage skin cell rejuvenation, improve joint and bone health, and stimulate hair and nail growth.

Delivered in liquid format and designed to be taken straight from the sachet, without the need for mixing, diluting or dissolving, Arella Vegan Collagen is convenient to take on the go. FInd out more at arella-beauty.co.uk

Physical exfoliants typically use some type of granule such as salt, while chemical exfoliants use chemicals, usually alpha-hydroxy acids (AHAs) to break apart and remove dead skin cells.

SCREEN

A safe, mineral-based sunscreen should be used daily – even in the winter when the sun might not be bright, but damaging ultraviolet light can still damage skin cells. UV light is the primary cause of colour changes and visible skin ageing, and is also carcinogenic, so for both looks and health you should slap on the sunscreen. Look for a mineral-based sunscreen with active ingredients like zinc oxide or titanium dioxide which is SPF 30 or higher, and apply it as the final step in your skin care routine every morning.

hydrated and supple, so avoid harsh soaps and scrubbing which can strip away the essential oils and bacteria that make up the skin microbiome. Cut out potentially irritating foods that are packaged, processed, or high in sugar or dairy. It’s particularly essential to cut down on high sugar foods which are associated with acne and inflammatory conditions.

MOISTURISE

HIIT

High-intensity interval training (HIIT) and endurance exercise have been shown to have an antiaging e ect by increasing telomerase activity. Telomerase is an enzyme responsible for protecting our DNA, leading to better cell growth and replication.

SUPPLEMENT

Right a er a bath or shower, apply a moisturizer to lock in and replenish fluids. Drinking plenty of water is essential for skin health, and you should aim to drink eight glasses per day, though of course that varies a lot depending on sex, age and activity. Keep alcohol intake to a minimum, as alcohol can make the skin look pale, dry, and prone to wrinkling.

MASSAGE

BE GUT HEALTHY

Underlying gut health issues can a ect skin health in many ways, the so-called ‘gut-skin axis’. Maintaining the health of your gut microbiome is a whole subject in itself, but in terms of skin care, the best tips are to cut down on your intake of sugar and processed foods, and incorporate healthy fats such as those found in nuts, avocados and flaxseed into your diet.

A facial massage routine is enjoyable, reduces tension and increase circulation and lymphatic drainage. You can use a jade roller or a gua sha scraper for a few minutes in a daily routine. You’ll get an immediate post-facial glow as well as the long-term benefits of increased circulation. Also try a face mask with hydrating ingredients like hyaluronic acid, sodium hyaluronate, and vitamin E.

EXERCISE

Any activity which increases blood flow throughout the body and brings oxygen, nutrients, and minerals to the skin will be of benefit. Exercise also helps to promote cell growth, beneficial for your skin because it helps to replace old and damaged skin cells with new, healthy ones, so regular exercise can help improve overall skin appearance and texture. The ‘post-exercise glow’ is a real thing, due to increased blood flow, heart rate and blood vessel dilation. It is temporary, but may last for several hours a er exercise.

The skin o en needs supplements containing the protein collagen or vitamins including Vitamin C.

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Other healthy-fat foods for glowing skin include salmon, olive oil, and whole eggs. Eat plenty of antioxidant-rich foods such as fruits and vegetables, and, as a bonus, some dark chocolate.

The skin also has its own microbiome, or colony of bacteria which keep skin

Exercise will also help you to sleep better, and lack of sleep is notoriously bad for your skin. Eight hours of sleep a night is o en said to be the standard, but of course this will vary according to the needs of your body. ■

Get to know your T2 diabetes better, so you can get back to being you.

Informed decisions, in the moment

While there’s no such thing as a type 2 diet, certain foods can help you better manage glucose levels. Yet, because everyone has unique needs and responds to food di erently, without a CGM it can be di cult to understand. Dexcom allows you to track your glucose levels in relation to what you eat, when you are active, and when you take diabetes medication, so you get to know how your body responds to di erent foods, at di erent times of the day and how best to manage your diabetes.

See the big di erence a small change can make As well as helping you to make informed food choices in the moment, Dexcom can help you make better eating habits in the long-term more achievable too. Being able to see the big di erence that a small change can make, can help give you the confidence and motivation to keep going – a real game-changer for those living with type 2 diabetes.

Ask your doctor or diabetes team for more information on Dexcom – or find out more and buy online at dexcom.com/ukstore

Living with type 2 diabetes can be an overwhelming and relentless balancing act that requires a lot of guesswork. And while it’s no secret that healthy eating and exercise is essential to managing type 2, changing a lifetime of eating habits isn’t easy – especially when there’s no one-sizefits-all diet for better diabetes control. That’s where continuous glucose monitoring (CGM) systems, like Dexcom ONE, may prove useful…

Dexcom CGMs are best known for enabling those living with diabetes to view their glucose levels without finger pricks*. They automatically send glucose readings to a compatible smart device or receiver† so you can monitor your levels 24/7. But they have a few other clever tricks up their sleeve too…

Managing Diabetes Better

Living with diabetes could become a lot easier with the latest generation of smart health monitors

Diabetes, or diabetes mellitus, is a complicated condition with many different variations. In most cases, its health effects are manageable, and diabetics can live a full and healthy life. But if it is allowed to get out of control, there can be critical health consequences. Now new smart monitoring technology is making it easier for diabetics to keep track of and control their condition, and live more stress-free lives.

The main symptom of diabetes is a high level of blood glucose. This can be caused if the body doesn’t produce enough of a chemical called insulin, which is produced

in the pancreatic gland, or if the insulin it produces isn’t effective.

According to diabetes.org.uk, about 4.2m people in the UK have some form of diabetes. There are two main types: type 1 and type 2. In Type 1 diabetes, you can’t make any insulin at all. About eight percent of people with diabetes have Type 1.

About 90 percent of people with diabetes have Type 2, where they can’t make enough insulin, or it isn’t effective. There are other less common forms of diabetes such as gestational, which some women may develop during pregnancy; type 3c, MODY Maturity-Onset Diabetes of the Young)

and LADA (Latent Autoimmune Diabetes in Adults).

People of Asian (including Indian, Pakistani, Bangladeshi) Chinese, black African and black Caribbean ethnicities have been found to be two to four times more likely to have diabetes than white populations. Type 2 diabetes is also more likely to develop at lower weight thresholds for these groups compared to people of white ethnicity.

In all types of diabetes, the result is that glucose can’t get into your cells properly, so it begins to build up in your blood, causing a number of symptoms.

EFFECTS

Symptoms of diabetes may occur suddenly. In type 2 diabetes, the symptoms can be mild and may take many years to be noticed.

Symptoms of diabetes include:

h Feeling very thirsty

h Needing to urinate more often than usual

h Blurred vision

h Tiredness

h Losing weight unintentionally

Over time, diabetes can damage blood vessels in the heart, eyes, kidneys and nerves. People with diabetes have a higher risk of health problems including heart attack, stroke and kidney failure. Diabetes can cause permanent vision loss by damaging blood vessels in the eyes. Many people with diabetes develop problems with their feet from nerve damage and poor blood flow. This can cause foot ulcers and may lead to amputation.

Lifestyle changes are the best way to prevent or delay the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:

h Reach and keep a health body weight

h Stay physically active with at least 30 minutes of moderate exercise each day

h Eat a healthy diet and avoid sugar and saturated fat

h Not smoke tobacco.

There is no cure for Type 1 diabetes, in which insulin-producing beta cells in the pancreas are destroyed by the immune system. This means you can’t make the insulin you need to live. Researchers are working on immunotherapies that target the immune system to stop it destroying beta cells, but until they are developed, diabetics have to keep their symptoms monitored and under control.

Traditionally, the way to do this is a finger-prick blood sugar level test, or by using an electronic Continuous Glucose Monitor (CGM). Diabetics can do this several times a day, helping them to keep an eye on their levels as they go about their life and helping them to work out

DIABETES AND THE NHS

The NHS spends at least £10 billion a year on diabetes which is about 10% of its entire budget. Almost 80% of the money the NHS spends on diabetes is on treating complications. In some hospitals over a quarter of beds are used by people with diabetes. In 2021/22 there were 60.3m items prescribed for people with diabetes in England; this increased from 42.5m prescription items 10 years earlier.

Source: Diabetes.org.uk

what to eat and how much medication to take. There is also a test known as HbA1c, a blood test to measure average blood sugar level over the last three months. Everyone with diabetes is entitled to this check.

Dexcom offers a range of continuous glucose monitoring systems, also known as CGMs or glucose sensors. Dexcom CGMs can be used by people with type 1 or type 2 diabetes. The small wearable sensor sends accurate glucose numbers 24/7 to a smartphone or receiver.* Dexcom CGMs are available for some people with diabetes on the NHS and are also available to buy online. ■

*Dexcom Product User Guides; For a list of compatible devices, visit dexcom.com/compatibility.

IMAGES: Dreamstime, Dexcom

MBST:

MRI Technology used to stimulate cellular regeneration

Non-invasive Drug free Pain free

About MBST

From Germany, MBST uses MRI technology to stimulate cellular metabolism, targeting injured tissues in the body to help regenerate cells. It has been shown to thicken cartilage layers which helps protect bones and reduce pain.

Conditions Treated

•Osteoarthritis

•Low back pain

•Osteoporosis

•Joint pain

•Nerve pain

Managing the Pain

Is there a better way to manage pain than analgesic drugs?

Physiotherapy offers an alternative for a wide range of patients

There’s been a good deal of talk recently about the NHS waiting list crisis, and the way in which some patients are suffering pain while operations are repeatedly delayed. At the same time there’s concern about the over-prescription of addictive opioid painkilling drugs. So, if you are suffering pain while waiting for an operation such as a hip replacement, is there an alternative way to manage the pain?

In many cases of chronic pain, physiotherapy can be a help. It’s also a useful application in recovering from injury and general illness, enabling people to recover ability and mobility, and to take back control of their lives.

Physiotherapy can be helpful for people of all ages with a wide range of health conditions, including problems affecting the: h Bones, joints and soft tissue – such as back pain, neck pain, shoulder pain and sports injuries

h Brain or nervous system – such as movement problems resulting from a stroke, multiple sclerosis (MS) or Parkinson’s disease

h Heart and circulation – such as rehabilitation after a heart attack h Lungs and breathing – such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis

Physiotherapy can improve your physical

activity, while helping you to prevent further injuries.

THERAPIES

Physiotherapy is provided by specially trained and regulated practitioners called physiotherapists, who usually work as part of a multidisciplinary team in various areas of medicine and settings, including hospitals, community health centres or clinics, GP surgeries, and some sports teams, clubs, charities and workplaces. Waiting lists for NHS treatment can be long, so some people choose to pay for private treatment.

Some of the main approaches used by physiotherapists include:

h Movement, tailored exercise and physical activity advice – exercises may be recommended to improve your general health and mobility, and to strengthen specific parts of your body

h Education and advice – physiotherapists can give general advice about things that can affect your daily lives, such as posture and correct lifting or carrying techniques to help prevent injuries

h Manual therapy – where the physiotherapist uses their hands to help relieve pain and stiffness, and to encourage better movement of the body

There are other techniques that may sometimes be used, such as exercises carried out in water (hydrotherapy or aquatic therapy) or acupuncture.

Manual therapy is a technique where a physiotherapist uses their hands to manipulate, mobilise and massage the body tissues. This can help relieve pain and stiffness, improve blood circulation, help fluid drain more efficiently from parts of the body, improve the movement of different parts of the body, and promote relaxation.

Massage may improve quality of life for some people with serious or long-term conditions by reducing levels of anxiety and improving sleep quality. Manual

techniques are also used to help certain lung conditions.

TREATMENT

The first stage in physiotherapy is normally that the physiotherapist completes an assessment which involves listening to the patient’s story and then observing or testing particular movements. They will then work with the patient to create a treatment plan. This will usually include a combination of education, manual therapy and exercise prescription.

Other techniques sometimes used by physiotherapists that may help to ease pain and promote healing include:

h Acupuncture – where fine needles are inserted into specific points of the body, with the aim of reducing pain and promoting recovery. There is some positive evidence for acupuncture, but the National Institute for Health and Care Excellence (NICE) only recommends considering it for chronic (long-term) pain, chronic tension headaches and migraines

h Transcutaneous electrical nerve stimulation (TENS) – a small, batteryoperated device is used to deliver an electric current to the affected area, with the aim of relieving pain

h Ultrasound – where high-frequency sound waves are used to treat deep tissue injuries by stimulating blood circulation and cell activity, with the aim of reducing pain and spasms, as well as speeding up healing

Some private physiotherapists offer treatment at your home, offering care to a wider group, including neurological, respiratory, elderly and orthopaedic rehab patients. ■

Six Physio

Six Physio was established in 1996 and quickly gained a reputation as London’s Leading Private Physiotherapy provider in the treatment of musculoskeletal presentations and its now renowned Specialist Physio services. Six Physio prides itself in doing simple things well, providing uncomplicated approaches to assessment and treatment, getting patients back to fitness with ease and compassion. Its tag line ‘Don’t Treat, Cure’ is a nod to its ethos of fixing patients’ ailments and not simply pacifying symptoms. Director Matt Todman says “Physio school teaches you a plethora of information, then you spend the first few years of your career sifting through the chaos. At Six, we aim to make everything clear. Simple straight forward Physio that works. It’s as simple as that”.

https://sixphysio.com

IMAGES: Dreamstime, Six Physio

NEW ‘REVOLUTIONARY’ MEDICAL DEVICE TREATS ERECTILE DYSFUNCTION AT HOME

A ‘BREAKTHROUGH’ innovative home-use device to treat erectile dysfunction which uses radiofrequency technology is now available in the UK.

Med-Tech company Ohh-Med Medical has launched Vertica in the country for the first time which has been described as ‘revolutionary’ with an 85 per cent success rate and men experiencing positive results in just four weeks.

Dr Fabio Castiglione, Consultant Urologist and Andrologist at King’s College Hospital NHS Foundation Trust and Associate Professor at the University College London (UCL), said: “Vertica is a revolutionary idea

and, based on the results of the clinical trial, one that promises to be potentially life-changing for men suffering with ED.

“The device is the first in the medical scenario to treat the outflow and not just the inflow and is a creditable alternative solution to other available treatments which are designed to improve the erectile mechanism.

“In addition, Vertica is drug-free, suitable for home use, with long-lasting results as, in some cases, users are stating they are seeing results after only four to six weeks of use.”

The V-shaped device, which has handles both sides with a hole in the middle, is safe for home use and three, 30-minutes treatments per week is recommended for the first month. It is then recommended for use twice weekly for another 30 days. Prescription-based medication, in contrast, can have side effects.

Vertica was developed by urologists and experts in radiofrequency technology and relies on the use of low frequency radio waves to ‘renew and rejuvenate’ collagen and elastin fibre tissues in the penis. The device helps ‘trap’ the blood, decreasing the leakage from the male organ and improving performance for a sustained period.

Vertica is supported by efficacy and safety data from a pilot clinical study published by the peer-reviewed International Journal of Impotence Research – a medical journal which covers the study of sexual dysfunction. The results, based participants who had ED for at least six months, demonstrated that the utilisation of radiofrequency energy improved performance among participants with more than an

For a limited time, visit vertica-labs.com today and place an order to receive a 20% pre-order discount or contact 020-4525-1389 for more information.

85 per cent success rate, without any side effects.

Vertica is intended for use by men of all ages experiencing erectile difficulties and includes a special accessory to treat deeper tissue, a charger, a case, and conductive gel, and is available on the vertica-labs.com website. The medical device is CE-MDR approved in Europe and registered with the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK.

Ohh-Med Medical founder Daniel Lischinsky said: “Vertica is a safe and easy-to-use, non-invasive medical device, designed to improve erectile dysfunction in the long-term. It is not a medication; no prescription is required and there are no side effects. Vertica is safe and is driven by scientific data.

“Vertica addresses a significant unmet need in the male sexual health market for an effective and longlasting solution that actually treats the root cause of erectile dysfunction, rather than just the symptom. It improves male self-esteem and confidence by supporting a full and active sex life.”

CBT

Sometimes, counselling for couples or sex therapy can be useful in treating MED. Alternatively, you could try cognitive behavioural therapy (CBT), which is designed to help you stop negative thinking patterns. Ask your GP about your local IAPT (Improving Access to Psychological Therapies) service.

IMAGES: Dreamstime

Sense of Erection

Male erectile dysfunction is a common problem, but one that can be treated with both medication and appliances

Part of the problem in dealing with male erectile dysfunction - the inability to achieve or maintain an erection – can be the unwillingness of some su erers to talk about it. But as there is a wide range of causes and solutions, this is an essential part of dealing with the problem.

It’s a common problem. Studies conducted in China, the US, Germany, and Brazil show that erectile dysfunction a ects 16 to 40 percent of the adult male population with approximately 150 million new cases reported every year. Though older men are more likely to develop erectile dysfunction, the condition can develop at any age. Research conducted in Italy showed that one in every four patients seeking help for erectile dysfunction is under the age of 40.

Causes of MED can range from the psychological, ‘performance anxiety’, to more serious physical problems such as atherosclerotic heart disease, which a ects the circulation, hypertension (high blood pressure), diabetes, obesity, hyperthyroidism, or overconsumption of alcohol. Some medicines can cause MED, as can stress and depression.

In many cases, erectile dysfunction can be reversed. A study published in the Journal of Sexual Medicine found a remission rate of 29 percent a er five years. Even when ED cannot be cured, the right treatment can reduce or eliminate symptoms.

Researchers identify two types of MED:

 Primary MED occurs when a man has never been able to have or sustain an erection. This is rare. Primary MED may require the more intensive and medicalbased treatments.

 Secondary MED occurs in people who

once had regular erectile function. This is the most common type, is o en temporary and can o en be reversed.

MED is usually treatable with medication or surgery, but it may also be possible to treat the underlying cause and reverse symptoms with no medication. Positive changes to diet and lifestyle, including giving up smoking and alcohol, getting more exercise, losing weight and practicing relaxation are the first steps to addressing the problem, and if these don’t help, an examination by your GP will identify or rule out any underlying causes such as high blood sugar levels.

Getting an erection is a complicated business, starting with a mental or physical stimulus which prompts the central nervous system to release the substance cyclic GMP, widening the arteries that supply the penis with blood, which infuses the so tissues lining the penis.

STANDING PROUD

A GP may prescribe sildenafil (the generic term for the treatment marketed as Viagra).

Because of recent changes in regulations, you no longer need a prescription to get sildenafil, but you’ll have to have a consultation with the pharmacist to make sure it’s safe for you to take it. There are other similar medicines such as tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra) that work in a similar way, blocking the action of a chemical called PDE5 which breaks down cyclic GMP, so it can make it easier to achieve and maintain an erection.

None of them are guaranteed to work for everyone, or every time they are used, and there can be side-e ects such as headaches

and blurred vision. In very rare cases, an overdose has caused priapism - persistent erection - which can lead to permanent damage to the tissues of the penis.

PUMP IT UP

An alternative form of treatment is an appliance such as a vacuum pump, which encourages blood to flow to the penis, causing an erection. They work for some men, and can o en be helpful if medicine is not suitable or does not work. They’re not always available on the NHS, but you can speak to your doctor about where to get one.

The penis is positioned inside the tube, and pumping periodically over a 1-3 minute period pulls blood into the penis creating a fully rigid erection. An erection maintenance ring is then transferred from the device cylinder to the base of the penis against the body wall. In some cases a range of re-useable erection maintenance rings with choice of material types, ring pressures and dexterity requirements are provided to guarantee greater comfort, e ectiveness and ease of use in maintaining the vacuuminduced erection. Removal of the cylinder allows full sexual intercourse to take place with the erection maintenance ring still in place.

Another form of appliance is Vertica, which uses radio frequency technology. According to an initial clinical study by the Unit for Neuro-Urology at the aptly named Rambam Medical Center in israel, a higher than 85% success rate was achieved in improving the score of erectile function and strengthening of erection hardness in participants treated with the Vertica device. ■

A BREAKTHROUGH IN TREATMENT FOR ERECTILE DYSFUNCTION

Erectile dysfunction (ED) is the inability to get or maintain an erection for sexual activity.

ED commonly a ects men over the age of 40 but can occur at any age, due to physical or psychological factors.

ED has the potential to undermine self-confidence and self-esteem, for both partners, which can lead to devastating consequences for relationships. However, many men do not seek treatment because of stigma or embarrassment.

Healthcare professionals including GPs can o er guidance depending on an individual’s circumstances. The most appropriate treatment will depend on the underlying cause of the symptoms, their severity & personal preferences.

For many years ED treatment has involved taking oral medication known as PDE5i’s, such as sildenafil or tadalafil, which enter the bloodstream to stimulate nerve endings.

PDE5i’s can take up to 60 minutes before they start working, come with commonly reported side e ects &

may be unsuitable if you are taking certain medications or have a medical condition, or may be ine ective.

Now there is a breakthrough treatment for ED –Eroxon® is a fast-acting topical gel that has been shown to help over 60% of men achieve an erection within 10 minutes.

Eroxon® gel delivers a rapid cooling followed by a gradual warming sensation which stimulates nerve endings in the penis. It is recommended to use Eroxon together during foreplay, when aroused and on 3-4 occasions.

Eroxon® is available without prescription from Boots, Superdrug and leading pharmacies.

A BREAKTHROUGH TREATMENT FOR ERECTILE DYSFUNCTION

Clinical e cacy demonstrated in over 60% of erectile dysfunction su erers, with use in foreplay prompting even higher e cacy.

Medical device topical gel that helps ED su erers achieve an erection in 10 minutes.

Non-systemic mode of action eliminates drug interactions & provides low incidence of adverse events.

High Street Health

With doctors’ waiting rooms full up, where else can you turn for quick health advice? Your High Street pharmacist is now in an ever better position to help

At a time when GPs’ surgeries are full to bursting and it’s harder than ever to get an face-to-face appointment, it’s important to remember that there’s another source of medical advice and prescription services ready to help you.

As qualified healthcare professionals, pharmacists can offer clinical advice and over-the-counter medicines for a range of minor illnesses, such as coughs, colds, sore throats, skin complaints, eye problems, stomach troubles and general aches and pains. At some High Street pharmacists you can even get a flu jab.

Since January 31st, patients in England have been able to get treatment for seven common conditions at High Street pharmacies without needing to see a GP, as

part of a major transformation in the way the NHS delivers care.

More than nine-in-ten community pharmacies in England – 10,265 in total – will be offering the ground-breaking initiative, with the health service making it easier and more convenient for people to access care.

Highly trained pharmacists will be able to assess and treat patients for

h Sinusitis

h Sore throat

h Earache

h Infected insect bite

h Impetigo

h Singles, and h Uncomplicated urinary tract infections in women (under the age of 65) all without the need for a GP appointment

or prescription.

The major expansion of pharmacy services will give the public more choice in where and how they access care, aiming to free up 10 million GP appointments a year.

RECOVERY

The scheme is part of the NHS and government’s post-Covid primary care access recovery plan, which committed to making accessing healthcare easier for millions of people.

It builds on the successful expansion of the contraceptive pill service in December 2023, with more than 5,000 pharmacies now registered to offer women the chance to get a supply of oral contraception over the counter from their pharmacy without needing to first see their GP.

In future, the NHS expects almost half a million women a year to receive their contraception from their high street pharmacist.

AGEING

Amanda Pritchard, NHS chief executive, said: “GPs are already treating millions more people every month than before the pandemic, but with an ageing population and growing demand, we know the NHS needs to give people more choice and make accessing care as easy as possible.

“People across England rightly value the support they receive from their high street pharmacist, and with eight in ten living within a 20-minute walk of a pharmacy and twice as many pharmacies in areas of deprivation, they are the perfect spot to offer people convenient care for common conditions.

“This is great news for patients – from today you can pop into one of more than 10,000 high street pharmacies in England to get a consultation on seven common

conditions including ear-ache, a sore throat or sinusitis at a convenient time, with many pharmacies open late into the evening.

“This is all part of major transformation in the way the NHS delivers care, with the health service determined to giving people more choice in how they can access treatment.”

Community pharmacies already play a vital role in keeping their local communities healthy and well. And pharmacists are now ramping up the number of life-saving blood pressure checks given to at-risk patients over the next year with a commitment to deliver 2.5 million a year by Spring 2025 – up from 900,000 carried out in 2022. It is estimated this could prevent more than 1,350 heart attacks and strokes in the first year.

The Government has made £645 million of new funding available to support the continued expansion of community pharmacy services.

Prime Minister Rishi Sunak, said: “Community pharmacies already do

a tremendous job at treating minor conditions and with the Pharmacy First service – backed by £645 million – we’re determined to go further and unlock their full potential to deliver routine care.

“Patients who need treatment or prescription medication for common conditions like an earache will now be able to get it directly from a pharmacy, without a GP appointment.

“This is about ensuring people get the treatment they need closer to home, while crucially helping deliver on our plan to cut waiting lists, by freeing up 10 million GP appointments a year, so people get the care they need more quickly.”

FASTER

Secretary of State for Health and Social Care, Victoria Atkins, said: “I’m determined to deliver faster, simpler, fairer access to care for patients, and the expansion of Pharmacy First will mean patients can get treatment for common conditions without needing to see their GP first. »

“This is good news for patients and good news for the NHS. It will free up millions of GP appointments per year and mean that patients can get quick and effective treatment from their local pharmacy.

“As four in five people live within a 20-minute walk of a pharmacy, for many seeing their local pharmacist will be the easiest option – so this initiative will have real benefits for patients and help cut NHS waiting lists.”

Dr Claire Fuller, NHS medical director for primary care and the NHS’ lead GP in England, said: “This is a wonderful move to increase accessibility to healthcare for patients.

“We all live increasingly busy lives, and this gives people more options on how and where they access care. This will also relieve pressure on our hard-working GPs, freeing up millions of appointments for those who need them the most.”

A recent Ipsos survey showed nine in ten people who used a pharmacy in the last 12 months to get advice about medicines, a health problem or injury had a

positive experience.

David Webb, Chief Pharmaceutical Officer for England, said: “Pharmacy teams play a very important role in the community as part of the integrated NHS primary care team, and this expansion of clinical services means patients will have more choice in accessing the care they need. This will give people more convenient options at the heart of local communities, without needing to book an appointment.”

Primary Care Minister Andrea Leadsom, said: “When suffering from conditions like sore throat or earache, we know that patients want to be able to access the care they need quickly.

“Pharmacy First gives you choice, and the ability to be seen faster to get the care you need, providing easier and quicker access.”

TREATMENTS

Chair of the Royal Pharmaceutical Society in England, Ms Tase Oputu, said: “Pharmacy First is a leap forward in improving patient care by making treatments for a range

of conditions more accessible from community pharmacies.

“The expansion of clinical services not only empowers patients with greater choice on where and how they receive care, but also makes the most of the valuable skills of pharmacists and their teams. Pharmacy teams have made an incredible effort to get the service ready alongside all the additional pressures they face. It’s an exciting transformation, helping to reshape the landscape of primary care.”

Paul Rees, Chief Executive of the National Pharmacy Association, said: “Pharmacies are the front door to the NHS so it’s good news for communities across England that pharmacies will be treating millions more patients with common ailments through Pharmacy First.

“Pharmacy First will improve access to healthcare, play to the strengths of pharmacists as medicines experts and free up GPs for other work that requires their particular skills. Patients will get convenient clinical advice, close to where they live, work and shop.” ■

IMAGES: Dreamstime

Putting the K in Diet

Vitamin K isn’t as well-known as some others, but it could be just as essential to your diet

Vitamin K exists in two forms, K1 and K2, and seems to be a factor in several essential bodily functions.

Vitamin K was discovered in the 1920s, and plays a significant role in blood coagulation, or clotting, (the K comes from the German, “Koagulationsvitamin”). Studies of Vitamin K in different populations suggested that Vitamin K may be deficient in many industrialised communities, possibly due to the use of antibiotics, and that this may be related to high levels of tooth decay and other chronic diseases.

The two main forms of Vitamin K are K1 (phylloquinone), found in plant foods like leafy greens, and K2 (menaquinone), found in animal foods and fermented foods. Vitamin K2 can be divided into several subtypes including MK-4 and MK-7.

Vitamin K activates proteins that play a role in blood clotting, calcium

metabolism, and heart health, with one of its most important functions being to regulate calcium deposition, promoting the calcification of bones and preventing the calcification of blood vessels and kidneys, which can lead to heart disease and kidney failure.

SOURCES

Good animal sources include high fat dairy products from grass-fed cows and egg yolks, as well as liver and other organ meats. Animal foods contain the MK-4 subtype, while fermented foods like sauerkraut, natto, and miso pack more of the longer subtypes, MK-5 to MK-14.

Your body can partly convert vitamin K1 to K2, which is helpful as the amount of vitamin K1 in a typical diet is ten times that of vitamin K2. But it may be of benefit to take K2 directly, either in the diet or in a supplement. ■

MenaQ7® Vitamin K2

Vitamin K2 as MK-7 is an essential nutrient for supporting bone and heart health. By activating K-dependent proteins already in the body, K2 helps the body properly utilize calcium – directing it to bones (where it is needed) and stopping it from depositing in arteries and soft tissues (where it can cause harm). Strongly consider pairing calcium intakes with Vitamin K2, but also Vitamin D3, as D3 helps to synthesize the K-dependent proteins that K2 activates. And only MenaQ7® Vitamin K2 as MK-7 has been clinically proven to support heart health in adults, and bone health in children and adults.

https://gnosisbylesaffre.com/ ingredient/menaq7/

As Old As You Feel

They say you’re as old as you feel, but what if you could measure your ‘biological age’ and make lifestyle changes to improve it?

The ageing process still holds many mysteries, but research suggests that many of the common symptoms of ageing are not inevitable consequences of getting older, but the result of damage which accumulates over time. If we could determine the cause of this damage, we can compare our ‘biological age’ with our actual age, and make lifestyle changes to improve our longevity.

One method of measuring biological age is called epigenetics – it measures loss of a chemical tag from your DNA (so-called DNA methylation). This is often associated with a range of diseases common to ageing, such as chronic kidney disease, cancer and heart disease. But there are suggestions that epigenetic testing is better at establishing your actual age than it is your biological age.

Another idea is that a great deal of accumulated damage is caused by the immune system, which, while it can protect us from infection and outside influences,

can also be affected by many aspects of modern life, such as stress, pollution and unhealthy diets.

GLYCANS

GlycanAge (https://glycanage.com) isn’t just a biotech company – it’s a revolution in health optimization and biohacking. Offering cutting-edge science to measure your biological age versus your chronological age, GlycanAge empowers you to truly understand the impact of your lifestyle choices on your health and well-being.

Using advanced science, GlycanAge has developed a comprehensive solution packaged into a simple take-home test. This test measures your immunoglobulin G (IgG) glycosylation, complex sugars on our cells that play crucial roles in physiological processes and are highly responsive to lifestyle interventions.

Glycans, or polysaccharides, are carbohydrate-based

polymers made by all living organisms. They are essential biomolecules serving structure, energy storage and system regulatory purposes, and are regulated both by our genes, and by the environment and lifestyle. Glycans can act as inflammatory or antiinflammatory agents, influenced by factors such as diet, exercise, hormonal changes and the environment.

Glycans in the blood attach themselves to an antibody called immunoglobulin G, and can change its function from antiinflammatory to pro-inflammatory. While we need both types, the balance between them can determine our overall health and hence our biological age.

A simple finger-prick blood test can be used to measure the levels of glycans in your system, and to determine your biological age, while regular tests can show whether changes you make to your diet and lifestyle are moving things in the right direction. ■

The Female Factor

Women’s health has been notoriously neglected, but campaigns and research are moving towards a more balanced treatment of healthcare

Many medical conditions which a ect mainly or only women, such as breast cancer, ovarian and cervical cancer, gynaecological health, pregnancy issues,

autoimmune diseases, endometriosis, osteoporosis, and post-natal depression, have been overlooked when it comes to research and provision of services. In fact, some recent medical trials have been

discredited because they didn’t use an appropriate number of female subjects.

But why has getting e ective diagnosis and treatment for these issues been historically di icult?

BREAST CANCER

Breast cancer is the most commonly occurring female cancer in the UK, but earlier diagnosis and improvements in treatment are resulting in the majority of women surviving their diagnosis. In the UK, breast cancer survival has improved by around 40 percent over the last 40 years. Eight in ten women diagnosed and treated for breast cancer today in the UK are predicted to survive their cancer for at least ten years.

At present, knowledge of all the factors resulting in the development and growth of breast cancer is incomplete. Gene mutations in breast cells are necessary for all breast cancers to be initiated but progression and further development also depends on complex interactions with lifestyle and reproductive risk factors.

A small proportion of women are at an elevated risk due to a family history, where the gene mutations are inherited (up to 10% of all breast cancers diagnosed annually in the UK). In most women diagnosed with breast cancer (about 90 percent) the gene mutations resulting in their diagnosis develop during their lifetime.

In women at risk, by far the greatest risk factor for being diagnosed with breast is age, which cannot be avoided. In addition, there are some lifestyle and reproductive factors associated with an increased risk of breast cancer diagnosis. It has been estimated that approximately 23 percent of all the breast cancers diagnosed in the UK could be prevented by avoiding or reducing exposure to lifestyle-based risk factors. »

LIFESTYLE CHANGES

Around 55,000 women and 370 men are diagnosed with breast cancer every year in the UK. Everyone can take steps to lower their chances of getting breast cancer by making small healthy changes and living well now, including drinking less alcohol, maintaining a healthy weight and keeping physically active.

breastcancernow.org

Factors associated with an increased breast cancer risk include:

h Gender (breast cancer diagnosis is overall 200 times more common in women than in men)

h Increasing age (most breast cancers are diagnosed in women over 50)

h Family history

h Risk factors associated with lifestyle and female reproduction, such as prolonged exposure to sex hormones [oestrogen] produced within the body

h Early age starting menstrual periods and late age at menopause

h Being overweight/obese and postmenopausal

h Exposure to sex hormones [oestrogen and progestogen] taken in the form of medication, such as the use of hormonal contraceptives and hormone replacement therapy (HRT)

h Changes to metabolism of female sex hormones, such as through smoking and alcohol use

h Not having children or a first full-term

pregnancy at a later age or not breast feeding can increase the risk of normal breast cells becoming malignant

h Lack of physical activity

Clearly, with many factors thought to contribute to the likelihood of breast cancer, screening for early detection of the condition is vital.

About one quarter of breast cancers diagnosed annually in women in the UK are done so via the NHS Breast Screening Programme. The remainder are diagnosed in those presenting to their GP with breast symptoms. Currently, with optimal treatment two in three women will survive their disease beyond 20 years. For many women, it is a condition they live with, rather than die from.

Once a diagnosis of breast cancer is confirmed, management generally involves varying combinations of surgery, radiotherapy, anti-oestrogen hormone therapy, chemotherapy and immunotherapy. Treatment

recommendations are based on the individual features of a breast cancer (e.g. the size, grade and stage of the breast cancer), menopausal status and an individual’s general health.

ENDOMETRIOSIS

Endometriosis is a condition whereby fragments of cells like the ones in the lining of the womb (the endometrium) develop elsewhere in the body. As the endometrium grows during the menstrual cycle so do the fragments, causing debilitating pain. They then break down and bleed, just like the uterus lining. However, this internal bleeding has no way of leaving the body, and leads to inflammation, pain, and the formation of scar tissue (adhesions).

Endometriosis can be hard to diagnose (on average diagnosis can take 7-10 years according to the British Journal of Medical Practice). However, with the right endometriosis treatment, many of these issues can be addressed, and the symptoms of endometriosis made more manageable.

ISSUES

Dr Kate Young, public health researcher at Monash University in Australia, says: “For much of documented history, women have been excluded from medical and science knowledge production, so essentially we’ve ended up with a healthcare system, among other things in society, that has been made by men for men.”

The author Maya Dusenbery supports this in her 2018 book Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. She writes: “Observing that women tended to have lower rates of heart disease until their oestrogen levels dropped after menopause, researchers conducted the first trial to look at whether supplementation with the hormone was an effective preventive treatment. The study enrolled 8,341 men and no women ... And a National Institutes of Health-supported pilot study from Rockefeller University that looked at how obesity affected breast and uterine cancer didn’t enrol a single woman.”

PRIORITIES

The Government has set out its top priorities for the Women’s Health Strategy for 2024 which include menstrual problems, maternity care and birth trauma support. The Strategy was first launched in July 2022 setting out the Government’s 10-year commitment to improve the health and wellbeing of women and girls in England.

Announcing the update on the Women’s Strategy, Victoria Atkins, the health and social care secretary set out her aim to make women’s access to health care faster, simpler and fairer, saying: “We’re breaking historical barriers that prevent women getting the care they need, building greater understanding of women’s healthcare issues and ensuring their voices and choices are listened to. We’ve made huge progress - enabling almost half a million women access to cheaper HRT, supporting women through the agony of pregnancy loss and opening new women’s health hubs - but I absolutely recognise there is more to do.”

The five-point plan includes:

h Maternity care that every mother can have faith in

h Better care for menstrual problems.

h More women’s health hubs offering more treatments

h Improving fairness and tackling inequalities and disparities

h And more research into the health needs of women

Supporting the strategy are women’s health hubs that every local health authority will be required to set up and run. The ambition is for each to have at least one hub and running and offering more treatments to help improve women’s health. The hubs will not necessarily be a specific location; they could, for example be a ‘virtual triage’ with specialist expertise in women’s health.

Find out more about issues in women’s healthcare from charities www.womenatwish.org.uk, www.womenforwomen.org.uk, www.cancerresearchuk.org and www.health.org.uk ■

IMAGES: Dreamstime

Transforming Lives: The Allurion Gastric Balloon Program at Chartwell Hospital

Are you tired of struggling with your weight and ready for a holistic approach that goes beyond traditional weight loss methods? Chartwell Hospital proudly introduces the Allurion Gastric Balloon Program – a revolutionary blend of medical innovation and behavioural change strategies designed to help you achieve sustainable weight loss and transform your life.

What sets the Allurion Gastric Balloon Program apart?

1. Medical Innovation: Allurion Gastric Balloons offer a non-surgical solution to weight loss, providing a safe and effective alternative to invasive procedures. These soft, swallowable balloons are placed in your stomach during a quick, outpatient procedure, creating a sense of fullness and reducing hunger cravings. With no incisions or anaesthesia required, you can embark on your weight loss journey with confidence and peace of mind.

2. Behavioural Change Focus: At Chartwell Hospital, we understand that successful weight loss isn’t just about physical changes – it’s also about transforming habits and behaviours. That’s why our Allurion Gastric Balloon Program incorporates a comprehensive behavioural change curriculum, designed to empower you with the tools and strategies you need to make lasting lifestyle changes. From mindful eating techniques to stress management strategies, our program equips you with the skills to navigate life’s challenges and maintain your progress long-term.

3. Personalised Support: Our dedicated team of healthcare professionals is committed to supporting you every step of the way. From your initial consultation to post-procedure follow-up, we provide personalized care and guidance tailored to your unique needs and goals. Whether you have questions about nutrition, exercise, or emotional well-being, we’re here to provide the support and encouragement you need to succeed.

4. Focus on Long-Term Health: Unlike fad diets or quick-fix solutions, the Allurion Gastric Balloon Program is focused on long-term health and wellness. By addressing the underlying factors contributing to weight gain and providing sustainable strategies for success, our program empowers you to not only lose weight but also improve your overall health and quality of life.

Take the first step towards a healthier, happier you!

If you’re ready to take control of your weight and embark on a transformative journey towards better health, contact Chartwell Hospital today to learn more about the Allurion Gastric Balloon Program. Together, we can help you achieve lasting weight loss and create a brighter, healthier future. Don’t wait any longer – your journey to a new you starts now!

www.thechartwellhospital.co.uk

hello@chartwellprivatehospital.co.uk

02039127432

Voyage by Balloon

There are many ways to achieve weight loss, from diet and exercise to forms of fat removal such as liposuction. But an increasingly popular technique, intended to help people who have trouble managing their appetite, is the gastric balloon.

The principle of the gastric balloon is pretty simple. After an in-depth medical consultation to determine whether the treatment is suitable for you, a balloon attached to a catheter is swallowed, then inflated once in the stomach. The procedure is non-surgical - no endoscopy or anaesthesia is normally needed (though it sometimes is for removal).

An X-ray is taken to check that the capsule is properly positioned, then the vegetarian coating of the capsule degrades, and the balloon inside it is filled with about half a litre of water, making the full balloon about the size of a grapefruit. Another X-ray is taken to check inflation, then the catheter can be removed.

The procedure takes around 15 minutes, and the subject then gets a

feeling of fullness, so their appetite is managed and they gain control over eating habits such as portion sizes and snacking.

SUPPORTING

Of course, there’s more to it than that –the treatment is often accompanied by a supporting lifestyle programme lasting perhaps six months, using apps and smart devices such as watches and scales to monitor progress and to suggest a healthy balanced diet and exercise programme – but that is essentially all there is to it. In some cases there may be manageable symptoms such as nausea, vomiting and stomach cramps, but after about 16 weeks the balloon deflates and is passed out of the digestive system, often without the subject noticing it.

While using the gastric balloon, normal activities and exercise are usually possible under the consultation of your healthcare professional. The weight loss balloon treatment is suitable only for adults over 18 with overweight or obesity defined as a body mass index of over 27.

So how effective is gastric balloon treatment? It’s claimed that subjects can lose around 10-15 percent of their body weight in a period of around 16 weeks – so this definitely isn’t a ‘quick fix’ like liposuction. But it is comparable to the effects achieved by a diet programme which may be harder to stick to.

The important part is that users tend to maintain up to 90 percent of the weight lost a year later – whereas many diet-only regimes fail and the subject often regains most of the weight they have lost. ■

Fat Chance

It’s common to talk about weight loss, when what people really want is fat loss. How can technology remove the flab without the fuss?

In HG Wells’ 1903 story The Truth About Pyecraft, the odious Pyecraft pesters the fellows in his club with complaints about his obesity, until one of them gifts him a magical recipe for losing weight. It all goes wrong when Pyecraft ends up floating

around like a balloon – the spell made him lose weight, but what he actually needed to lose was fat

Some modern diet gurus seem to have lost track of reality in the same way as did Pyecraft. After all, there are parts of our bodies we don’t want to lose weight from –our bones, for instance. What we really need to concentrate on is losing surplus fat, which is unnecessary and can only be detrimental to our health.

So what’s the best way to target surplus fat in the body for removal? Aesthetic practitioners aim not for an unrealistic treatment of just one part of the body, but for a balance which will benefit the patient while creating a natural reshaping effect. Nevertheless, a consultation may start

with a discussion of the effect the patient is aiming for on one part of the body. This could be anything from the face or neck to the chest, arms, legs, or buttocks.

SLIMMING

For upper leg treatments for instance, treatment could be designed to target slimming the thighs, reducing cellulite, or enhancing the contours. A tailored treatment plan may include non-invasive options like liposculpture, CoolSculpting (a fat-freezing system), radiofrequency treatments, or minimally invasive procedures, depending on specific needs.

One increasingly popular technique for fat removal is Vaser liposuction. Vaser (Vibration Amplification of Sound Energy at Resonance) uses ultrasound technology to selectively break down and emulsify fat cells without causing damage to surrounding tissues. This advanced technology allows for more precise and targeted fat removal compared to traditional liposuction methods. Vaser Liposuction is considered minimally invasive, meaning it involves small incisions through which a thin probe is inserted. This probe emits ultrasonic waves to break down the fat, making it easier to suction out. The nature of the procedure typically results in less scarring and a quicker recovery compared to traditional liposuction.

Patients often experience less discomfort and downtime with Vaser Liposuction compared to traditional liposuction, and the targeted approach and minimal trauma to surrounding tissues contribute to a quicker recovery, allowing you to return to your normal activities sooner.

Results from Vaser Liposuction are often noticeable immediately after the procedure, and improve as swelling subsides. If only Pyecraft had made use of it…! ■

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Get the Balance Right

What is the importance of vaginal pH, and what can women do to keep it balanced?

The female reproductive organs are in a delicate chemical balance designed to keep them clean and healthy. The uterus, cervix and vagina naturally produce a vaginal discharge, mainly made up of cells and bacteria. This helps clean and lubricate the vagina, and fight off bad bacteria and infection.

One of the most important aspects of the vaginal environment is its balance of acidity and alkalinity, referred to as the pH. The pH scale ranges from 0 to 14 based on how acidic or alkaline something is - below 7 is acidic, while above 7 is alkaline (or ‘basic’).

A healthy external vaginal area, or vulva, has a slightly acidic pH of 3.8-4.5, which is important to the body’s natural defences and to maintaining a good environment. One of the most important aspects of

maintaining this balance is using intimate hygiene products specially formulated for the area - products formulated for the entire body can throw off the external vaginal pH balance and may cause discomfort or even irritation.

ODOUR

One of the first signs of possible infection or disease can be a change in colour or odour of vaginal discharge. Everyone has a unique scent, but there are factors that can create external odours that may be found unpleasant. The vulva has sweat glands just like the armpit, and sweat bacteria can lead to odour; bodily fluids including menstrual blood, urine, and semen also create external odour, and this may be a sign of a pH imbalance.

Most importantly, internal vaginal

infections such as bacterial vaginosis produce a strong fishy odour which should be discussed with your doctor. If an odour is particularly strong or lasts for several days even with regular hygiene measures, speak with your doctor about it.

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The Leaf That Cares

Medical cannabis is now legally available in the UK, but what conditions can it help and how is treatment organised?

There’s been a great deal of interest recently in the subject of using CBD for a wide range of therapies including pain relief, treating anxiety and so on. But CBD, or cannabidiol, is a totally legal and fairly uncontroversial by-product of the hemp plant, treated as a food product, and not the same as the psychoactive substance THC (tetrahydrocannabinol), which is also found in cannabis and is the basis of the plant traditionally being made illegal in most countries.

However, many researchers argue that THC, beyond its ability to get you ‘high’, has valid applications in some supervised medical treatments, and over the years the medical professional has moved towards a position of allowing closely controlled use of cannabis products for certain conditions, particularly pain relief and for certain types of epilepsy. This raises the question of how these substances should be used, and who would qualify for treatment.

LEGALITIES

Research conducted by medical cannabis clinic Releaf suggested that

 46% of UK adults with a condition treatable with medical cannabis live with significant discomfort.

 16.5 million UK adults still believe that medical cannabis is illegal.

 1 in 4 UK adults would worry about being questioned by the police when using prescribed medical cannabis.

 1 in 4 UK adults have used cannabis for medicinal purposes without a prescription.

Although the use of medical cannabis has been legal in the UK since 2018, the position of the law and the medical profession remains that cannabis is only suitable for certain conditions and must be prescribed by a qualified medical professional. If you are prescribed cannabis by an approved medical practitioner, you will normally be given a ‘cannabis card’ to produce should

you be questioned over your prescription or use of cannabis.

In the UK, a medical cannabis licence, or cannabis growing licences, are issued by the government. Applicants can apply through the government website and prove they own, or are able to rent, a property that is suitable for cultivating cannabis safely, and have all the necessary equipment involved in growing cannabis.

Medical cannabis is grown and prepared to the most stringent standards to produce a medical-grade product, and can be prescribed for a wide range of conditions, including pain, sleep disorders and gastroenterological conditions.

A first step is normally to assess whether you may be eligible for a medical cannabis prescription by checking with an approved clinic whether your diagnosed condition and medical history confirms your suitability for cannabis-based treatments. If you have been diagnosed with some psychological conditions such as

psychosis or schizophrenia, you may need a more in-depth consultation to determine your suitability.

You will require a consultation with a UK registered specialist doctor experienced in treating your diagnosed health condition, which can often be done online, then you can discuss whether a medical cannabis prescription may be suitable for you.

If it is decided that you are eligible, you may have to obtain and supply your Summary of Care Record from your GP. In some cases you can then create an online account with a clinic and register for a regular prescription for medical cannabis products, which can come in a number of forms including dried cannabis flowers or cannabis oils, depending on your symptoms and overall health. These prescription decisions will be regularly reviewed by your clinicians, and regular check-in appointments and continuous support will be accessible.

You may need some paraphernalia to store and prepare your medical cannabis,

such as an airtight jar, a grinder, and a vaporiser.

EFFECTIVE

It’s still fairly early days for the use of medical cannabis, so it’s hard to say how effective it will be for you; this depends of course on a range of factors from your general health and medical history to the treatment plan and the form of the medical cannabis. This is why regular consultations with a member of your medical team are essential, to check how well medical cannabis is working for you.

Depending on the method of absorption and the condition being treated, some patients report feeling effects as quickly as a few minutes to a few hours after taking it. This can be particularly useful for certain pain-related conditions, offering fairly instant relief. For long-term conditions like neurological disorders or gastrointestinal diseases, results may take longer to become noticeable, and regular consultations are required to monitor your progress. ■

RELEAF

Curious to find out how a medical cannabis clinic could help you? Releaf, the UK’s newest healthcare clinic, offers oil and flower based treatment plans for patients with chronic pain, or neurological, gastroenterological and psychiatric conditions. Their seamless subscription service and innovative platform prioritises convenience, making it easy to book and attend online consultations with specialist doctors, and have treatments dispensed from Releaf’s inhouse pharmacy. Care and compassion are integral to Releaf, and so, each patient also receives a medical cannabis card for identification and peace of mind. Find out if you could benefit at www.releaf.co.uk

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MEDICAL CANNABIS CLINIC

A drop of

Once a topic of great controversy in the UK, medical cannabis clinics are now able to prescribe legal, therapeutic alternatives to eligible patients when traditional treatments are failing to meet their needs.

Although it’s estimated over 1.8 million people* in the UK use cannabis for medicinal purposes, last year in a survey of 4,210 adults, Releaf discovered more than a third were unaware that

The medical cannabis clinic that is revolutionising healthcare in the UK, moving from stigma to solution with full spectrum cannabis treatments that encompass more than just CBD.

medical cannabis, and cannabis-based medicines, can be legally prescribed to treat certain conditions.

So, now Releaf are on a mission: to bring affordable and effective plant based treatments to those who could benefit from them. According to their representative research, this could equate to up to 29.6 million adults, or 50.2% of the adult population in the UK.

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When was medical cannabis approved in the UK?

Over five years ago, in November 2018, the UK government followed in the footsteps of Canada and many US States, legalising medical cannabis and cannabis-based treatments in the appropriate circumstances.

Now, depending on their diagnosis, patients who have been struggling to manage the symptoms of their health condition with conventionally prescribed medications can request to have their suitability for cannabis-based treatments assessed by GMC registered specialist doctors, like those at Releaf.

What conditions are suitable?

Releaf found that in the UK, 46% of adults with a health condition that is eligible for cannabis-based treatments describe living with significant discomfort due to their health, and 35% say that this not only affects their quality of life, but also their families too.

Cannabis-based treatments are not suitable for everyone, but they may be able to offer relief to those with chronic pain conditions, cancer-related symptoms, neurological conditions, gastroenterological conditions, psychiatric conditions, or help to manage the symptoms of menopause and endometriosis.

If you are struggling to manage the symptoms of one of these health conditions, or suffering from the side effects of prescription medications for your condition, you may be considered eligible for cannabis-based treatments.

How do cannabis-based treatments work?

In the UK, cannabis-based treatments are available in a number of different forms - but the most popular is oil. Unlike tablets, oils are absorbed in the mouth and do not pass through the digestive system. This way, their active pharmaceutical agents can gain access to the bloodstream within a matter of minutes.

MYTH BUSTING

Female Health: Menopause, Endometriosis

These agents, called cannabinoids, interact with our bodies’ receptors, with the aim of restoring balance, or harmony. Cannabinoids have shown great potential in treating painrelated conditions and in relieving inflammation, and anxiety.

To formulate medical cannabis oil, specific compounds are extracted from cannabis plants and combined in varying ratios and concentrations to treat different symptoms and induce varying effects, like relieving pain or inflammation.

How to start treatment:

Releaf have a straightforward and seamless free tool online at www.releaf.co.uk, that assesses a patient’s eligibility for cannabis-based treatments in a few simple clicks.

If the eligibility checker indicates that medical cannabis could be an appropriate option for you, Releaf’s dedicated team is ready to guide you through your journey. They’ll invite you to schedule an online consultation with one of their expert clinicians, who is well-versed in treating conditions like yours, at a time that suits you.

In this initial meeting, they’ll cover everything you need to know, laying out the various options available to you, and explain how you can tailor your cannabis-based treatment plan to best suit your own needs and lifestyle. Once your prescription has been issued and approved by Releaf’s multidisciplinary team of pharmacists, clinicians, consultants, and healthcare support staff, your new treatment will be dispensed directly to your front door.

Releaf bring personalised, convenient, and compassionate care straight to you, in the comfort of your own home. To find out if you could be eligible for cannabis-based treatments, and can say goodbye to standing in line at the pharmacy, or sitting in the GP’s waiting room, visit www.releaf.co.uk today.

*According to a YouGov poll of 10,684 adults conducted in September 2022.

In the UK, medical cannabis is available in flower form to be vaporised, or in oil form to be absorbed sublingually. Medical cannabis is not smoked, and it is not designed to induce a ‘high’. It is always illegal to smoke cannabis in the UK, and medical cannabis will never be prescribed with this intention in mind.

The Pressure is On

Why is it so important to check our blood pressure, and what is the easiest way to get it done?

One of the major concerns of the NHS is an increase in the number of patients with problems of high blood pressure. This can have no visible symptoms for many years, but can have serious long-term health consequences.

Blood pressure is the term used to describe the strength with which your blood pushes on the sides of your arteries. Low blood pressure (hypotension) is not usually a problem, although it can cause dizziness and fainting in some people. High blood pressure (hypertension) can increase your risk of developing serious problems, such as heart attacks and strokes, if it’s not treated. Fortunately a blood pressure test is quick, easy and non-invasive.

If you are over 40, you can have a blood pressure test done as part of an NHS

Health Check, which is offered to adults in England aged 40 to 74 every five years.

A GP may fit you with a 24-hour ambulatory blood pressure monitor, but in most cases a small battery-powered device is used at your GP, pharmacy or place of work. You can also buy these devices or borrow them from the NHS. Often your GP will ask you to carry out a course of blood pressure checks at home.

DEVICES

Blood pressure monitors, or sphygmomanometers, usually have a cuff which is wrapped around the arm. The device inflates the cuff until it is tight. You relax and keep still while the device measures your blood pressure, which takes just a few seconds, then the cuff deflates and your blood pressure results are shown on a digital display. Some

devices also monitor conditions such as irregular heartbeat.

Avro Health believes that everyone should have access to affordable, reliable, easy-to-use medical devices. Ideal for use at home, on the move or indeed just about anywhere, Avro’s products come with a five year warranty. All devices are compact & lightweight, yet robust and are developed to professional healthcare standards. See more at www.avro.health

As a general guide, normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg, high blood pressure is considered to be 135/85, and low blood pressure is considered to be 89/59mmHg or lower.

The British Heart Foundation (www.bhf.org.uk) has useful advice about the health implications of high blood pressure. ■

Quality of Life

As we get older, how we feel is just as important as how long we’re going to live. Here’s some news about how society is adjusting to the older demographic

MENOPAUSE AT WORK

The Equality and Human Rights Commission, an independent statutory body with the responsibility to encourage equality and diversity, eliminate unlawful discrimination, and protect and promote the human rights of everyone in Britain, has published a report suggesting that symptoms of menopause should be regarded as a disability, and that employers who do not make ‘reasonable adjustments’ for it may be sued by employees.

Research by the Chartered Institute of Personnel and Development found that two thirds (67%) of working women between the ages of 40 and 60 with experience of menopausal symptoms said they have had a mostly negative impact on them at work.

Of those who were negatively affected at work:

❖ 79% said they were less able to concentrate

❖ 68% said they experienced more stress

❖ Nearly half (49%) said they felt less patient with clients and colleagues, and

❖ 46% felt less physically able to carry out work tasks.

As a result of this, over half of respondents were able to think of a time when they were unable to go into work due to their menopause symptoms.

Further research by the Fawcett Society found that one in ten women surveyed who were employed during the menopause left work due to menopause symptoms.

The EHRC said that employers should offer changes such as providing rest areas or flexible hours, and that relaxing uniform policies to allow women to wear cooler clothes could also help. Failing to make “reasonable adjustments” amounts to disability discrimination under the Equality Act 2010 if the symptoms have a “long-term and substantial impact” on a woman’s ability to carry out their usual day-to-day activities, the EHRC said.

THE BIG HELP OUT

This June some of the country’s bestknown charities are coming together to encourage people to sign up to volunteer to help their local communities. Age UK is one of those joining the initiative, which takes place between Friday 7th June to Sunday 9th June, and it’s inviting the public to try their hand at volunteering across a variety of roles. The charity is reliant on volunteers who help provide vital support to older people, often at a time in their lives when they need help the most.

More than seven million people overall took part in last year’s Big Help Out - getting together to volunteer, and make a difference in their local area – and organisers have launched the 2024 edition with support from His Majesty the King.

As well as providing much-needed support, volunteering also enables people to gain valuable new skills, confidence, experiences and friends. Age UK offers many services, nationally and locally, which means there are countless opportunities available, some of which include volunteering as a Telephone Befriender, joining an Age UK shop team and volunteering for The Silver Line Helpline.

To find out more about volunteering roles at Age UK and supporting The Big Help Out visit: www.ageuk.org.uk/volunteer

NHS ROLLS OUT WEARABLE TREATMENT FOR PARKINSON’S

Hundreds of NHS patients with advanced Parkinson’s disease are set to benefit from a portable drug infusion that is gradually released around the clock to help better control their symptoms.

The treatment, called foslevodopa–foscarbidopa, will now offer an additional option for certain patients experiencing movement-related symptoms and whose condition is no longer responding to their oral medicines.

The easy-to-use infusion is delivered through a cannula under the skin and controlled by a small automatic pump worn 24 hours a day to help steadily manage patients’ symptoms with fewer side effects.

It works by releasing a combination of medications into the body, with the drug foslevodopa being turned into the chemical dopamine, which can better transmit messages between the parts of the brain and nerves that control movement.

The new treatment option is being rolled out on the NHS in England from the end of February and it is expected that nearly 1,000 patients will be eligible across the country. People with Parkinson’s should speak to their consultant or Parkinson’s nurse to see whether it’s an option for them.

ELDERLY CARE

Frequency Precision produce some of the best systems available to help with elderly care and mobility monitoring, including bed, chair and floor sensor mats, falls monitoring and GPS tracking with fully integrated nurse call plug or wireless systems.

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SAY GOODBYE TO ED

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Health in an Ageing Society

Professor Sir Chris Whitty’s annual report has some pressing matters to raise regarding the health of the ageing population. We look at the headlines

In his 2023 annual report on pressing health issues, Health in an Ageing Society, The Chief Medical Office

Professor Sir Chris Whitty recommends actions to improve quality of life for older adults and to prioritise health areas with the fastest growth in older people. He calls on people to take responsibility for their own health with good diet and exercise, while tasking the Government with doing

more to make healthy lives the norm.

The repost opens by saying: ”One of the triumphs of modern medicine is that the great majority of people live into older age. For many, this is a period of great happiness: freedom to do what they want, the joys of being a grandparent, a respected place in families and in society.

“At the other extreme, for some older age is a time of great difficulty, with

dignity impaired, independence curtailed, and encroaching frailty, discomfort and loneliness. The difference between these two is largely determined by health, physical and mental. Those who enter older age in good health and maintain it to the end have a very different experience to those who rapidly accumulate multiple debilitating or degenerative conditions, living with them for many years.”

QUALITY

The report argues that improving the quality of life can broadly be divided into 1) things which reduce disability and ill health, and 2) things which can be done to adapt the environment to allow an individual with a set amount of disability in older age to live as independent and enjoyable a life as possible.

In general, it says, helping people maintain health is the role of public health and medicine. Improving the environment for older adults includes issues around urban planning, building design, social care and aids to independent living. But there is of course a lot of overlap; for example, an urban environment which allows older adults to use active transport, especially walking, safely will both improve their current independence and their future health.

“For the general public, I wish to highlight that most people enter older age, and many remain, in good health” says Professor Whitty. “A great many more go through older age in health which is sufficient to have independence and a high quality of life. Most people do not have Alzheimer’s or other dementias, or major debilitating conditions, before they die. Older age is often portrayed

DEMOGRAPHICS

In 1950, the average UK life expectancy at birth was around 69 years. As of 2024, life expectancy in the UK is approximately 81 years, with women living around 83 years and men living about 79 years. The figures demonstrate that the UK has significantly improved healthcare and access to medical technologies in the past few decades.

However, a recent life expectancy UK study revealed that Britons have the secondworst life expectancy among the advanced Western economies in the G7 group.

relentlessly negatively, when actually the experience for many in older age is positive. One of the most satisfying things that doctors experience is caring for women and men of a grand old age facing the end with great serenity and saying ‘I’ve had a good innings’ or equivalent. Some of this is due to good luck, but the chances of delaying disease and disability are substantially increased by straightforward measures individuals can take to prevent or significantly delay disease and maintain physical, mental and social activity.”

OLD FASHIONED

Professor Whitty recommends some “old-fashioned” ways of keeping healthy in older age, saying: “There are a lot of things people can do themselves which will delay the point where they first have disability and then multi-morbidity (presence of two or more long-term health conditions). They are old-fashioned things, actually - having lots of exercise, having mental stimulation and a social network, eating a reasonably balanced diet (with) not too much high fat, sugar and salt, moderating

alcohol, stopping smoking if you do –these are things which are old fashioned, but they still work.”

He added that maintaining exercise for the longest possible time, for example, was known to have a “huge positive impact on both physical and mental health in old age”, while eating plenty of fruit and vegetables cuts the risk of high blood pressure, chronic heart disease and stroke.

His report further pointed to strong evidence “that being physically active, eating a healthy, balanced diet, not smoking and moderating alcohol consumption improves health outcomes and increases the proportion of life spent in good health”.

The report concludes: “If we can push disease out to the right in terms of time so that people develop conditions later, and preferably not at all before they reach their natural end, we can significantly improve the quality of life for older citizens while reducing the pressure on health and social care systems. This should be a major aim of policy and medical practice.” ■

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Soothing the Skin in Menopause

Symptoms of menopause will vary, but skin problems are common. So how can you help your skin cope with ‘the change’?

Menopause, when the menstrual cycles end, may mark the end of a woman’s reproductive years, but it should be looked on as a new phase of life. During menopause changes in the amount of the hormone oestrogen produced by the ovaries cause a range of symptoms. The question is whether these symptoms experienced while nearing menopause, the time known as the perimenopause or menopause transition, can be managed to reduce distress.

The average age at which women start the menopause is 46, and periods usually stop by the age of 51. The most common symptoms of perimenopause are heavy bleeding, hot flushes, night sweats, emotional instability, vaginal dryness and bladder problems. Symptoms can range from mild to debilitating.

SYMPTOMS

Much can be done to help with symptoms during the menopause transition, including lifestyle changes, hormone replacement therapy (HRT) and treatments for individual symptoms. For women under 60 years of age who are in good health, the benefits of HRT far outweigh any risks.

Eating well, exercising and looking after your mental wellbeing can help with symptoms during perimenopause and menopause, and can also help you keep as well as possible in the future.

DO

✔ Get plenty of rest, including keeping to regular sleep routines

✔ Eat a healthy diet

✔ Have calcium-rich food like milk, yoghurt and kale to keep bones healthy

✔ Exercise regularly

✔ Do relaxing things like yoga, tai chi or meditation

✔ Talk to other people going through the same thing

✔ Talk to a doctor before taking herbal supplements or complementary medicines

DO NOT

✘ Smoke

✘ Drink more than the recommended alcohol limit

Hot flushes and night sweats can be eased by wearing light clothing, keeping your bedroom cool at night, taking a cool shower, using a fan or have a cold drink, and trying to reduce stress levels. Avoid potential triggers, such as spicy food, caffeine, hot drinks, smoking and alcohol, exercise regularly and try to lose weight if you are overweight.

Vaginal dryness can be eased by vaginal moisturisers or lubricants available without prescription at a pharmacy. If you are having sex and using condoms, use a water-based, not an oilbased lubricant.

There are other treatments for vaginal

dryness that a doctor can prescribe, such as HRT (hormone replacement therapy) or hormonal treatment (creams, pessaries, gel or vaginal rings).

SKIN CARE

As we age, our skin changes, largely because of falling levels of collagen, the protein that gives structure to the skin and helps with wound healing and muscle repair. Collagen loss begins at around the age of 20, resulting in a loss of softness, plumpness and elasticity over time.

In menopausal women, collagen loss speeds up due to falling oestrogen levels. Some studies show a reduction in collagen levels of up to 30 percent in the first five years after the menopause. Falling oestrogen levels can also cause the skin barrier to become dehydrated, making it dry and itchy.

Menopausal symptoms can also include hot flushes, sweating and redness in the face, which can affect the skin, but the most common symptom is dry skin, particularly on the hands and scalp. Wrinkles and sagging can also be accelerated by menopause, and although we tend to associate it with teenagers, acne can be a side effect of the menopause due to changing hormone levels.

If you have an existing skin condition such as eczema, rosacea or psoriasis, you might notice that it gets worse during the menopause. »

Facial hair growth can also be an issue. A change in the ratio of estrogen to testosterone can promote thick hairs to develop on the upper lip, chin, cheeks and jaw line. Hair removal methods include plucking, waxing, threading, shaving and depilatory creams. Electrolysis and laser hair removal can offer a more permanent solution to unwanted hair. Prescription creams are also available to help slow down the rate of hair growth.

TREATMENTS

Dermatological skincare brand AMELIORATE has product lines uniquely designed for targeted solutions, from keratosis pilaris to blemish-prone oily skin.

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arm) AMELIORATE’s skincare scientists used their expertise to help combat the condition’s rough, dry and bumpy texture.

After a lifetime of struggles with KP, it was when Annette’s own children developed the same condition that she decided to take action. Together with some of the UK’s leading skincare scientists, they created AMELIORATE.

AMELIORATE is the UK’s first dermatological skincare brand proven to help treat rough, dry, bumpy skin where each product is formulated with a scientifically-based blend of ingredients that are dermatologically approved to maximise the health of your skin.

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Signs of sun damage may become more prominent around the menopause, with irregular skin tone, lack-lustre skin and flat bown sun spots.

Avoid tanning and skin burning by wearing a Factor 50 sunblock and reapplying every two hours that you are in the sun. If you are worried about any dark sun spots or changing moles, see your doctor for a review of your skin. If you’re having more severe skin symptoms, it’s worth speaking to your GP as you might need prescription treatment or a referral to a dermatologist. Hormone Replacement Therapy (HRT) is often prescribed for women experiencing menopausal symptoms. Other prescription treatment options for menopausal skin include topical treatments and antibiotic tablets for acne, and medicated creams and ointments for eczema and psoriasis. ■

Not all Coconuts are created equal – Why FOCO uses only single source Coconuts.

Wondering why FOCO 100% Pure Coconut Water is the best tasting coconut water in the world?

Because the most delicious and refreshing coconut water comes from young green coconuts grown in Southeast Asia.

Today, many brands source coconuts from all over the world, blending and mixing coconuts from various countries, compromising the quality and taste and distorting the natural flavour. But FOCO 100% Pure Coconut Water is harvested exclusively from dedicated plantations that enable us to keep the taste, quality and supply consistent.

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At FOCO, we control the product from picking, processing and packaging. Every batch undergoes a careful Ultra High Temperature (UHT) process to ensure freshness and shelf stability.

We also pack our coconut water in a dedicated production facility (currently, FOCO is the only brand produced in its own dedicated facility), and we never overstock (so every batch retains maximum freshness). All this means you’ll enjoy the same delicious flavour every time you drink FOCO 100% Pure Coconut Water.

For generations locals have enjoyed this sweet, refreshing heavenly water – and benefited from its all-natural goodness. Now everyone who loves coconut water can get the very best tasting coconut water in the world – FOCO 100% Pure Coconut Water. Superior taste. Low in calories. Nutrient rich with 5 essential electrolytes. Awesome hydration. Drink FOCO and live life to the fullest! FOCO 100%

Seeing AMD Clearly

Age-related Macular Degeneration, or AMD, is a major cause of sight loss – but what causes it, and can anything be done about it?

Age-related macular degeneration (AMD) is a common condition that affects the middle part of vision. It usually first affects people in their 50s and 60s. Though it does not cause total blindness, it can make everyday activities like reading and recognising faces difficult, and without treatment, vision may get worse. This can happen gradually over several years, with the condition called dry AMD, or quickly over a few weeks or months, in so-called wet AMD.

The macula is part of the retina at the back of the eye. It is only about 5mm across, but is responsible for our central vision, most of our colour vision and the fine detail of what we see. A healthy macula is about 250 microns (one quarter of a millimetre) thick.

The macula has a very high concentration of photoreceptor cells – the

cells that detect light. They send signals to the brain, which interprets them as images. The rest of the retina processes our peripheral, or side vision.

The exact cause of AMD is unknown, though it has been linked to smoking, high blood pressure, being overweight and genetic factors.

EXAMINATION

AMD affects the middle part of your vision, not the edges (peripheral vision), and can be experienced in one or both eyes. The first symptom of AMD is often a blurred or distorted area in your vision, but If it gets worse, you might struggle to see anything in the middle of your vision. Other symptoms can include seeing straight lines as wavy or crooked, objects looking smaller than normal, colours seeming less bright than

they used to, and visual hallucinations.

Because AMD is not painful and does not affect the appearance of the eyes, it is sometimes hard to recognise. But it can sometimes be detected in an eye examination before you have symptoms, and early diagnosis and treatment can prevent your vision from getting worse. If you have a sudden decline in vision, redness or pain in the eye or a dark shadow across your vision, these are not symptoms of AMD and require urgent treatment.

An optometrist can usually diagnose AMD by examining the back of your eye, the retina, through a magnifying glass. They will usually put drops in your eye to dilate the pupil before examination, so you should not drive for four to six hours after the examination until your vision is back to normal.

You may have to be referred to a specialist ophthalmologist for further examination, particularly if it is thought that you should start treatment quickly.

Hospital tests will confirm an AMD diagnosis. The specialist may use fluorescein dye angiography, where a dye injected into a vein in the arm travels to the eye, highlighting the blood vessels in the retina so they can be photographed. The dye will temporarily change the colour of your urine, so be prepared.

TREATMENT

There is currently no treatment available for dry AMD, so you might not be referred to hospital, unless confirmation of the diagnosis is required or the optometrist thinks you need a hospital low vision service.

If your sight has worsened and you would like to be registered as sight impaired, you will need a hospital appointment.

If your optometrist suspects you have wet AMD, you should be referred to a retinal specialist at a hospital directly and seen within one to two weeks. If applicable, you

should be treated within two weeks after initial identification. You should not be sent to your GP as this causes unnecessary delay.

Reading books and using screens will not harm your eyes. You don’t need to be concerned about continuing to do the things you enjoy. However, you may need to start using some new tools to help you comfortably do these things. There are lots of low vision aids and settings on technology to help you.

If you drive, it is your responsibility to know if you continue to meet the necessary driving ability requirements. You must have binocular visual acuity of at least 6/12 in at least one of your eyes. If both of your eyes are affected by a sight loss condition, you have a legal obligation to inform both the DVLA and your insurance company. To read more about driving, visit our Driving page.

If you are employed, you may be considering whether and how your job could be affected. The Macular Society has a Working Age & Young Person’s service which can help you understand how to inform your employers, and find out what support is

available to help you continue to work. The Macular Society (www.macularsociety.org) has helpful information on AMD, and has a helpline on 0300 3030 111. ■

COCONUT

According to Sight Research UK, coconut water provides essential nutrients such as healthy fats, antioxidants, and minerals that contribute to slowing the progression of sight loss conditions such as macular degeneration and diabetic retinopathy. Coconut water is rich in vitamin C and other minerals as well as amino acids, which help in improving the protective tissues of eyes. Regular consumption of coconut water may also help to reduce risks of glaucoma, an eye ailment that eventually harms small blood vessels and the optic nerve.

IMAGES: Dreamstime

Choc Shock

Does chocolate worsen menopause symptoms? Certainly it’s time to look at how diet can affect them

Understanding the cause of menopausal symptoms such as hot flushes, insomnia and bloating, doesn’t necessarily help in alleviating the symptoms. Exercise might improve physical and psychological quality of life in general, but not necessarily help with menopause-specific symptoms.

Now researchers are suggesting that oxidative stress, a consequence of excessive free oxygen radicals or impaired antioxidant defence, is linked to menopausal symptoms like hot flushes (not to mention conditions such as diabetes, obesity, and cardiovascular disease).

Eating a diet with more antioxidants is associated with fewer menopausal symptoms – in fact it’s claimed that a high intake of fruits and vegetables may delay the onset of menopause in the first place, because the presence of antioxidants

in fruits and vegetables may counteract the adverse effects of free radicals. High meat consumption may be related to degenerative diseases due to pro-oxidation products.

PLANT-BASED

A more plant-based diet with antiinflammatory components like fibre is associated with fewer menopausal symptoms. Poultry and dairy products may be particularly bad, whereas soy milk seemed to help. One convenient whole food source of soy is soy nuts, which are dry roasted soybeans. Harvard Medical School’s Center of Excellence in Women’s Health funded a randomized crossover study of a half cup of unsalted soy nuts a day and achieved a 50 percent reduction in hot flushes within two weeks.

Soy foods can also lower LDL

cholesterol, which may explain the lower associated cardiovascular disease risk. Besides the lower breast cancer risk, soy eaters are also less likely to get prostate cancer, colorectal cancer, and lung cancer.

In one trial where women were encouraged to decrease fat and increase fruit, vegetable, and whole grain intake, they were significantly more likely to eliminate their vasomotor symptoms like hot flashes and night sweats.

CHOCOLATE

Giving up chocolate might seem like a mountain too high to climb when you are already experiencing disruptive menopausal symptoms, but hear us out. As oestrogen production decreases during the menopause, women can become much more susceptible to UTIs and over-active bladders - consumption of too much caffeine directly correlates to making these symptoms worse. Tea, coffee and chocolate are the main contributors to daily caffeine intake so switching to decaffeinated versions is a good start. Caroboo has pioneered the first range of grab-and-go caffeine-free choc bars in the UK, so you can indulge without the drama! – See the website at eatcaroboo.co.uk ■

Diagnosing Dementia

The charity Alzheimer’s Society is working on the Blood Biomarker Challenge, a project that could bring dementia blood tests to the NHS within five years

Dementia is a group of symptoms caused by different diseases that damage the brain and stop it from working properly. Different types of dementia damage different parts of the brain. Types of diseases that cause dementia include Alzheimer’s disease (the most common type of dementia), vascular dementia (the second most common type), dementia with Lewy bodies and frontotemporal dementia (including Pick’s disease).

Current figures estimate that more than a third of people over 65 who are living with dementia in England go undiagnosed.

Diagnostic tests currently available such as brain scans and lumbar punctures are time-consuming, uncomfortable, and are not uniformly available to dementia services around the UK.

Getting an accurate diagnosis takes far too long, with people waiting a year, on average, to see a clinician. For people with young-onset dementia, it can take as long as four years.

The Blood Biomarker Challenge is a £5million award that hopes to revolutionise dementia diagnosis in the UK. A collaborative project with Alzheimer’s Research UK and the National Institute for Health and Care Research (NIHR), it will pilot the use of dementia blood tests in the NHS. It’s hoped the tests will be able to diagnose different forms of dementia, such as Alzheimer’s disease, earlier and more accurately than current methods.

RESEARCH

Applications for the Blood Biomarker Challenge are now being reviewed by an independent panel of international experts, with the aim to select a successful research team in early 2024.

Two drug treatments, lecanemab and donanemab, are finally on the horizon for people with early Alzheimer’s disease. Preparing the NHS to make sure these drugs are available to all those who could benefit is now key, but that means accurately diagnosing people at the earliest stages.

A simple, non-invasive, and inexpensive blood test, giving results within weeks, would allow people time to put in place support and care, take part in clinical trials and to access new treatments when they arrive.

Dr Susan Kohlhaas, Executive Director of

Research and Partnerships at Alzheimer’s Research UK, said: “We’re sitting on the cusp of a new era of dementia treatments. Doctors are likely going to see more people coming forward for a diagnosis. But the NHS doesn’t possess the required levels of diagnostic infrastructure to cope with this growing demand. New drugs targeting early-stage Alzheimer’s disease are just around the corner, but without a diagnosis, people simply won’t be able to access them if they are approved. This could absolutely revolutionise the way dementia is diagnosed.” ■

SENSORS AND PRESSURE MATS TO MONITOR THOSE NEEDING CARE

DISCRETE AND RELIABLE Works below the mattress

WORKS WITH ALL BEDS

Compatible with all types of profiling beds and pressure relieving mattresses

AIRLERT TECHNOLOGY

Control box measures pressure change and sends alert

AIRLERT

Air filled foam pockets sense pressure change

Coping Strategies

Later life can present physical problems around the home, but there are plenty of cleverly designed tools to help cope with them

For help and advice on independent living, visit the website of the charity Disability Living Foundation at www.dlf.org.uk

It’s amazing how much help the elderly or disabled can get from simple adaptations to the home and everyday products.

Tasks which can be impossible without aid become manageable again with the properly designed tools for the kitchen, bathroom or garden. Some of them, like mobility scooters, are major purchases, but in many cases, a small adaptation can make all the di erence.

GRAB RAILS

Grab rails can be fitted easily and are a great help in bathrooms and elsewhere in the house. Designs in plastic coated steel are ideal for wall-fitting in the bathroom

and toilet, while bath rails can be clamped to the side or attached by suction. Newel rails fit to staircases, angled grab bars are particularly useful helping the user stand or sit, foldaway rails are useful when space is short, and outdoor grab rails can be provided in garden-friendly colours.

WALKING FRAMES

The classic four-legged design remains one of the most popular types, while models with two front wheels are sometime easier to handle. Add-ons such as caddies and net bags make life easier around the house or while shopping, while variations such as reciprocating designs (which ‘walk’ with you), rollators (four-wheeled designs with

brakes) and knee walkers can be of help in specific cases.

REACHING AIDS AND HANDLES

Reaching aids and ‘grabbers’ which make it easier to pick up objects without bending come in a number of forms, including folding, rotating and suction cup types. For the kitchen, garden and bathroom, specially adapted handles for taps, cutlery and tools are an enormous everyday help, as are devices such as one-handed can openers and extra grip door key turners.

TABLES AND TRAYS

Over-bed tables on castors can o en also be used over armchairs, and some

incorporate standing aids. Adjustable height and angle make it easy to set the table to the ideal position.

CHAIR RAISERS

Though specially adapted chairs designed to help users sit and stand are available, in some cases all that’s needed is a bit more height, in which case a raiser adjustable to the position of the chair’s feet can do the trick. Uplift seat assists will aid in rising from a chair, while in-car rotating seat cushions and grab handles can help car drivers get in and out easily. For negotiating stairs, of course the stairlift, for straight or curved stairs, is an invaluable aid, and if the property is suitable, in some cases an elevator can be fitted.

WHEELCHAIRS AND SCOOTERS

Wheelchairs vary from simple folding types to highly adjustable powered models, and special types designed to help negotiate stairs. Accessories such as cushions, gloves, trays, covers, clothing and bags help to customise the products, while at the higher end of the market, mobility scooters in three- and four-wheel designs are suited for everything from shopping expeditions to on-road use.

ALERT MONITORS

Alert monitors are ideal for those living alone who may need to call for help, or for medical settings where patients may try to get out of bed or leave their room unsupervised. Wireless door sensors can alert carers when a door is opened, and in some designs can even send an alert to a mobile phone. Call buttons and sensor watches can call for help in the case of a fall, and pressure mats can alert a carer if a patient gets out of a chair or bed, or leaves a room. Pressure mats can also be designed to detect convulsions in patients with epilepsy. Fitting a cord-activated alert monitor in a bathroom or toilet can give patients more confidence in managing without assistance where possible.

DOOR TECHNOLOGY

If it’s difficult for someone to get to the front door, think about installing a system

that lets the homeowner speak to visitors and manage who they let in. Options include a door-entry video intercom so they can find out who’s there and open the door remotely, and an easy-to-fit wireless doorbell that comes with an entry phone you can be kept near a chair. A policeapproved key safe, where a door key is held in a secure box by the front door, is a good option if you want friends, relatives or

carers to be able to let themselves in.

MOVING AROUND

It’s important to keep the home well lit –look into motion-sensor lights that switch on automatically when you get out of bed or enter a room. Widening door frames or changing the direction doors open can help you get about – particularly if you use a wheelchair. ■

Feel like YOU again

With the award-winning probiotic, formulated specifically to support the gut health of women in perimenopause and beyond

Supports vaginal health

Improves mood and brain fog

Reduces hot flushes

Protects bone health

Improves sleep

The gut-hormone connection

What’s your gut health got to do with menopause? It turns out quite a lot...

Often referred to as our 'second brain', the health of our gut plays a crucial role in many vital processes throughout our body. Yet, the role of the gut during perimenopause and beyond is lesser known.

Emerging scientific research suggests the answer to a better menopause experience could lie within the health of the gut, as studies increasingly show the intricate connection between our gut health and our hormonal balance.

Joanna Lyall, nutritional therapist and founder of The Better Menopause explains this vital connection, “Most women do not realise that gut health and menopause symptoms are intrinsically linked, fluctuations and declines in oestrogen levels during perimenopause and menopause significantly disrupt the gut microbiome and estrobolome (which is the collection of gut bacteria responsible for metabolising oestrogen) this disruption means the

4 ways to support your gut health

gut cannot work as effectively as it should, and it’s this disruption what leads to many of the unwanted symptoms experienced during menopause. However, focusing on supporting the health of your gut during this time can make a real difference to the symptoms experienced, and importantly it’s something we can all do.”

There is not enough focus on how crucial good gut health is in helping to alleviate menopause symptoms which many women find debilitating during this time.”

Launched in July 2023 The Better Gut has quickly gathered awards and 5-star reviews for its effectiveness in helping women to alleviate their

“Scientific research increasingly shows the connection between our gut and hormone balanceand importantly the impact this can have on a women’s experience of menopause”

It was this knowledge that led Joanna and her team of experts to formulate, ‘The Better Gut’ - a high quality probiotic with a tailored formulation to specifically support the health and function of the gut for women during perimenopause and beyond.

symptoms of menopause including, bloating, brain fog, anxiety, hot flushes and joint pain whilst helping to improve vaginal health, bone health and sleep quality.

Increase your daily fibre intake, plenty of green veg, grains nuts and seeds

Give your digestion system a rest for at least 12 hours overnight

Include fermented foods in your diet (add slowly if you are new to these foods)

Take a good quality probiotic

The team including a gastroenterologist and a specialist menopause doctor researched the most effective bacterial strains based on their scientific evidence at being able to help alleviate menopausal symptoms. From this research 6 strains were identified and formulated into a single daily capsule at a highly concentrated level of 50 billion CFUs.

Dr Shahzadi Harper, women’s health expert and resident doctor at The Better Menopause added, “Whether you’re on HRT or not this much-needed formulation designed specifically for women during menopause and beyond can really make a difference.

The Microbiome and the Menopause

The menopause isn’t all about hormones – it can affect your gut health too. What changes can you expect?

Menopause, marked by a decline in sex hormone production and the end of an active reproductive function, marks an important stage in all women’s lives, and can have many health implications. Some of the more wellknown ones apart from the end of periods are mood swings, anxiety, hot flushes, palpitations and reduced sex drive. But did you know the health of the gut can have a massive effect on your symptoms of menopause?

Often referred to as our ‘second brain’, our gut’s impact on our wellbeing is relatively well known, but lesser known is the crucial role it can play in navigating menopause more comfortably.

During menopause, fluctuating hormones affect the balance of good bacteria in the gut microbiome, this also disrupts the estrobolome (the part of the gut responsible for hormone regulation). It is this disruption that leads to many of the unwanted symptoms experienced by women during this time.

Joanna Lyall, nutritional therapist and founder of The Better Menopause wanted to address this vital imbalance, but with thousands of bacterial strains out there she quickly realised there wasn’t a tailored probiotic formulated to specifically support the gut health of women in midlife, and so alongside experts she went about creating one.

The Better Gut combines six highly concentrated bacterial strains - chosen for their scientific evidence in helping to alleviate the symptoms of menopause - in

a single daily capsule. Since its launch in July 2023, The Better Gut has received numerous five-star reviews for its effectiveness in relieving a wide range of symptoms including hot flushes, anxiety, bloating, brain fog, and joint painhighlighting the difference that focussing on gut health can make to a women’s experience of menopause. Find out more at www.thebettermenopause.com

DIMORPHISM

It’s well understood that the gut microbiome shows sexual dimorphism –in other words, it’s different in men and women. This dimorphism starts with puberty and increases in adolescence. This suggests a function of sex hormones in shaping the gut microbiome, and helps to explain age-related changes with the onset of menopause and a reduction in sex hormones.

By the age of around 40, whether you are a man or a woman your gut microbiome will have stabilised, with women usually having a richer variety of gut bacteria, notably with a lower abundance of Prevotella, which is often linked with desirable health measures such as reduced visceral fat and improved glucose metabolism.

Dimorphism in the gut microbiome declines with age, so the gut microbiome in postmenopausal women resembles that of men more than premenopausal women. Postmenopausal women tend to have a lower abundance of bacterial strains such as Firmicutes and Ruminococcus, and increases

in Prevotella, Sutterella, Dorea, and Butyricimonas.

The’s also evidence that the guthormone axis influences the amount of active oestrogen circulating in the body which, in turn, could impact weight, libido and mood as well as heart, brain and vaginal health.

During the perimenopause, the stage before menstruation stops completely, it seems that the gut microbiome is disrupted by fluctuating oestrogen levels, including the composition of bacteria in the estrobolome, a collection of bacteria in the gut which is capable of metabolising and modulating the body’s circulating estrogen.

HRT

There are simple dietary and lifestyle changes which could have a beneficial effect on the menopausal mirobiome.

h Eat a nutritious and varied diet. Start the day with a healthy breakfast food, like yoghurt or fibre-rich oats. More fibre eases digestive symptoms like bloating, constipation, or diarrhoea by helping bowel movements to be more regular and more comfortable.

h Be physically active. Aim for two hours and 30 minutes of moderate aerobic activity each week. Other deep breathing, yoga, and stretching exercises can help to manage the stresses of life and menopauserelated symptoms.

h Hydrate well with lots of water throughout the day. Drinking water supports gut functions and

aids digestion by helping to break down food. It can also help prevent constipation during menopause.

h Get plenty of good quality sleep. Difficulty sleeping (insomnia) is one of the most common complaints of women during the menopause transition. Some women who have trouble sleeping may use over-thecounter sleep aids such as melatonin.

h Reduce stress. Meditation may help to ease symptoms of gut disorders by lowering the level of the stress hormone cortisol.

Osteoporosis, weakening of the bones, is another potential consequence of menopause-associated changes in the gut microbiome, as are urinary urgency, incontinence, cystitis and bladder pain - the so-called genitourinary syndrome of menopause (GSM).

Hormone replacement therapy (HRT) is known to restore the health of the genito-urinary microbiome in part, and it’s suggested that menopausal women could be treated with Lactobacillus, as well as estrogen. With the Equalities and Human Rights Commission recently issuing new guidance on menopause for employers, the issue is finally receiving more of the attention it deserves. ■

THIRD WAY

Charity Wellbeing of Women (www.wellbeingofwomen. org.uk) estimates that there are around 13 million women who are currently peri or menopausal in the UK, equivalent to a third of the entire UK female population.

Making a Home From Home

Problems of loneliness and isolation are common for older people.

Now

a

new charity

initiative aims to provide communities that feel more like home

New research from charity Age UK shows that 1.6m older people don’t leave home for social events and don’t have someone to talk to about their feelings. Three million older people (a quarter/24% of those aged over 65) say that the TV or radio is their main source of company.

Now Age UK and homeware retailer Dunelm are joining forces to launch a new initiative to help older people who are feeling lonely. The three-year partnership aims to raise £2m to help create

communities that feel more like home for older people, by combatting loneliness and providing more practical support both over the phone and through local community initiatives.

The Partnership will help provide practical support, through its free national Advice Line, Telephone Friendship Service and The Silver Line Helpline, as well as local Age UKs across the country which offer a range of services such as day centres, benefits advice and social activity classes and groups.

SUPPORTIVE

The vision of the initiative is to create a society in which older people feel at home in a supportive and welcoming community that offers a real respite from the sense of loneliness experienced by so many. Together Age UK and Dunelm hope to build communities that feel like home for older people, and everyone else.

Funds raised from this partnership will be generated through the sales of hot beverages and seasonal menu items from Dunelm’s Pausa instore cafes, as

well as carrier bag sales, customer online donations and by charitable enterprises driven by Dunelm stores, depots and officebased colleagues.

Every penny raised will go towards practical Age UK support to help older people in their homes and communities: information, advice and friendship delivered over the phone across the country.

Additional support will be delivered in communities where Dunelm colleagues and customers live, delivered by Age UK’s network of local charities. The £2m raised will enable Age UK to help at least 200,000 older people who are struggling the most.

VITAL

Paul Farmer, CEO at Age UK, said: “We’re proud to be partnering with Dunelm, raising vital funds to help support Age UK’s ongoing work, nationally and locally, to help older people in their homes and communities. ‘Home’ means so much more than bricks and mortar, it’s a sense of belonging, of feeling safe, welcome and appreciated. Sadly, more and more older people are telling us that this simply isn’t their reality.

“Together with Dunelm, we are on a mission to redefine the concept of home for those who are struggling to find warmth, companionship and practical help to do more than simply survive. Whether that’s through advice and friendship delivered over the phone, or via frontline support, this partnership will prove pivotal in expanding our support network to more older service users up and down the country.”

Nick Wilkins, CEO at Dunelm, said: “It is no surprise to me that so many of our colleagues and customers voted for Age UK to be the new Dunelm national charity. As the home of homes, we have a natural role to play in creating a community that feels like home for older people. We have a fantastic opportunity, nationally and locally, to make a real difference in combatting loneliness.”

For more information about the Dunelm partnership visit www.ageuk.org.uk/dunelm

LONELINESS

Age UK has a number of services to help tackle loneliness including a telephone friendship service, Silver Line helpline and

face-to-face befriending service.

The charity says: “Everyone can feel lonely, and you don’t necessarily need a reason to feel this way. Sometimes it might even just pass. But, maybe there is a reason, or maybe it’s just not passing this time. However it features in your life, and however it makes you feel, there are things you can do to feel less lonely.

“Knowing what can affect your mental wellbeing might help you understand the feelings you’re experiencing and help you think about the steps you can take to look after yourself. This is the best place to start. Although it’s hard, and sometimes there might not even be a reason, it’s a good idea to think about what is making you lonely. It might help you try and find a way of feeling better.

“Although it might not feel that way, if you’re feeling lonely, remember you’re not alone. That feeling of loneliness can hit us at any time in life, often unexpectedly, even if it seems as though we’re surrounded by friends and family. Whatever might be making you feel lonely, we are here to help.”

Age UK offers support through a free advice line on 0800 678 1602. ■ www.ageuk.org.uk

IMAGES: Dreamstime

About Leigh Day

Leigh Day is a claimant-only law firm known for our commitment to patient safety. Our specialist team is ranked tier 1 by both Chambers & Partners and Legal 500. The solicitors in our London, Manchester and Leeds offices have over 35 years of experience and success in bringing a variety of medical negligence cases, from brain and spinal cord injuries to birth injuries cases. Some of our lawyers are medically trained, and we have other medically trained personnel, including former nurses and midwives working with us, as well as access to the country's leading birth injury experts. Our lawyers are consistently praised for their extensive experience in dealing with complex and catastrophic injuries on behalf of patients and their families. Many of our lawyers have been instrumental in the development of the law in medical negligence cases and in achieving some of the highest-value settlements for our clients.

Last year, we won the award for Clinical Negligence Team of the Year at the Manchester Legal Awards, and as a firm, Leigh Day has been awarded UK Law Firm of the Year at the Chambers Europe Awards.