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Moderation
 


A quick quiz to check how healthy your present diet is
 
Health scares will do you no good

The papers are full of health scares - but why, asks Robert Hudson, do we believe contradictory and tenuous stories, while ignoring simple medical advice?

Tuesday May 6, 2008
Guardian

Broccoli fights cancer, says the British Journal of Cancer. This worries me because I remember vividly that once upon a time, circa 2001, broccoli was carcinogenic. Back then, it contained acetaldehyde, which was A Bad Thing Of Some Kind, and quite prominent in health stories until we forgot about it. Luckily, I don't use deodorant or incense, but phone masts, bacon and the rest of the fashionable carcinogens will probably get me if I live long enough.
Or they will if the endless health scares in the press are to be believed. But despite their repetitive, contradictory and medically tenuous nature, people pay attention to these lists of absurd things that are supposedly bad for you; they even act upon them - randomly banning bra underwiring or broccoli from their lives - while remaining resistant to constant, consistent and proven advice to eat, drink and smoke less and exercise more. Why?

Ben Goldacre, who, as well as being a doctor, writes this newspaper's Bad Science column, says the lure of the health scare story for the media lies in that fact that during the "golden age of medicine, miracle cures and sinister hidden scares really were being discovered". Now, "we move ahead by small incremental understandings of large numbers of modest risk factors, but journalists haven't found a way to write about that, so every fractional research finding has to be crowbarred into the 'miracle-cure-hidden-scare' template."

The basic problem is that we're so healthy. As Catherine O'Leary, a GP working in Kent, points out: "Medicine has made tremendous strides in curing diseases with antibiotics, in treating illnesses such as heart disease and depression, and in preventing illnesses such as diarrhoea, measles, small pox and now, possibly, heart disease that people are less accustomed to ill health all around them." For this reason, she thinks that "ill health, mental or physical, has developed a significant stigma that people are anxious to avoid - especially if this may convey a loss of status."

On the other hand, people might be bothered about their health, but they don't want to stop doing things they like. O'Leary explains that, in her experience, heavy drinkers are aware of the risks but are so "passionate not to be deprived of drink" that they hide the habit or avoid doctors entirely. Smokers are often in a simpler form of denial. She says, "I frequently encounter smokers who are concerned for their health, but who won't discuss their habit." Even after she shows them a calculator on her computer screen that displays the enormous effect smoking has on life-expectancy, she says, "It only has a small effect in the success I have getting them to quit."

Kieran McCafferty, a renal doctor working in central London, says that people want a scapegoat. "They don't want to exercise, because they're lazy, but they want to say, 'But I stopped using deodorant!', which is like giving up chewing gum for Lent."

McCafferty also says that health scares are so powerful because most of them relate to cancer. Patients are more likely to die of heart disease, but they can understand and accept a blood clot blocking a vessel and killing them. It doesn't feel as personal as something growing inside the body. "With cancer," he says, "your body has turned against you." His experience of telling patients they have serious illnesses bears this out. "People react really well when I tell them they're going to have to go on dialysis," he says, "even though the life expectancy is about three years. They react much worse when it's prostate cancer with an expectancy of closer to 10 years."

The maverick scientist James Lovelock, whose Gaia hypothesis that the living earth should be examined as a single, self-regulating system, says that our biggest problem as a species is that we cannot understand risk. He gleefully points out that, in the vast majority of cancer cases, oxygen and time are the main factors. Fuel from the food we have eaten reacts in our cells with oxygen we have breathed in to build energy packages which can be carried around the body. There is accidental leakage from these billions of reactions. Some of this leakage is in the form of highly reactive molecules containing oxygen. Most of these are mopped up by safety systems, but not all. And over the course of our increasingly long lives, some of these products of oxidation can damage our DNA, causing cancer. There is a deeper truth in what he's saying: in the end, the world will get us somehow.

Lovelock says that our inability to grasp that concept, combined with a dysfunctional belief that something is "good" if it's "natural" and "bad" if it's a "chemical", distort our view of the health risks that surround us. It's easy to see how our current uneasiness about the chemical, industrialised world around us fuels popular health scares. Lovelock blames misunderstandings caused by a science-illiterate media. As Goldacre explains: "Few things can make a doctor's heart sink more in clinic than a patient brandishing a newspaper clipping." But this doesn't mean the public is stupid: "Only those who have never met the full range of people in their community will ever claim that," he says.

O'Leary agrees. Patients might enjoy reading unlikely tales about a man regrowing his finger with pixie dust made of pig intestine, but this doesn't mean they believe it. Her patients are not worried about deodorant or broccoli. But they do want body scans or have read about new drugs, "the vast majority of which have not got beyond the experimental". These are serious concerns that get to the heart of the fundamental issue with healthcare provision, which is the allocation of scarce resources, as medical science discovers increasingly brilliant ways of mitigating the effects of illness.

The problem is, we're going to die. When Richard Dawkins had his entertaining dig at scientifically risible homeopathy last year, he found that what helped patients was that they were receiving old-fashioned "care". People want to feel someone is on their side.

Yesterday I tried to count how many times Bupa used the word "feel" in one of its animated adverts. A woman portrayed as a bouncy little animated circle didn't "feel" great. Then she went to a nice, clean Bupa surgery, which made her feel relaxed or similar, and the nice, friendly doctor made her feel important and cared for, which made her feel better, and there was some more stuff, all of which helped her feel reassured, and that felt great. The narrative was imprecise, and I am not sure she was ill, but she definitely wanted to feel better. I'm not sure how many "feels" there were in the end because I felt dizzy.

Clever Bupa. It offers medicine, but also the chance for us to "feel good". Health scares about small things give us the illusion of control over something big that frightens us. They offer exactly the same thing as Bupa's adverts: a problem and a solution.
 

Boost your immunity

There are many things you can do to help boost your immune system. Not only will this increase your resistance to minor ailments and allergies, it can also improve your general health and wellbeing.

Jacqueline Young
BBC Online
Nov 2005

  • Stop smoking

  • Decrease intake of junk and processed foods and increase intake of fresh fruit and vegetables and wholegrains for lots of immune boosting nutrients.

  • Cut down on tea, coffee and alcohol. Replace them with lots of good quality water, fruit juices and herbal teas

  • Take regular exercise to stimulate circulation

  • Get sufficient sleep in a well-ventilated room

  • Get regular sunshine and fresh air

  • Practise stress management and relaxation

  • Allow time for leisure pursuits

  • Only take medicinal drugs such as antibiotics when absolutely necessary

  • Avoid recreational drugs, which may suppress immune function

  • Use immune-boosting herbs such as echinacea and astragalus at first sign of symptoms (don't take these continuously, though, as they'll lose their effectiveness)

  • Use nutrients such as selenium, vitamins A, C and E (antioxidant and protect against damage from free radicals), zinc and magnesium (protect against colds).

This article was last medically reviewed by Dr Rob Hicks in September 2005.
First published in October 2002.

Smoking and obesity 'age people'

Being overweight and a smoker makes a person biologically older than slim non-smokers of the same birth age, UK and US researchers have found.

BBC News
14 June 2005

Smoking accelerated the ageing of key pieces of a person's DNA by about 4.6 years. For obesity it was nine years.

These genetic codes are important for regulating cell division and have been linked to age-related diseases.

The study in the Lancet was based on 1,122 twins from a database held by St Thomas' Hospital in London.

The researchers looked at telomeres - strips of DNA that cap the end of chromosomes and appear to protect and stabilise them.

Telomeres shorten each time a cell divides, until there is nothing left, making cell division less reliable and increasing the risk of disorders. This happens naturally with ageing.

Accelerated ageing

Both smoking and obesity are important risk factors for many age-related diseases, therefore Professor Tim Spector and colleagues set out to see whether they might accelerate telomere shortening.

Among the study sample, all women aged 18-76, 119 were clinically obese, 203 were current smokers and 369 were ex-smokers.

By analysing blood samples for DNA the researchers found telomere length decreased steadily with age, as expected.

However, the telomeres of the obese women and smokers were far shorter than those of lean women and those who had never smoked of the same age.

Each pack year - the number of cigarette packs smoked per day multiplied by the number of years smoking - was equivalent to a loss of an additional 18% on top of the average annual shortening of telomeres.

A woman who had smoked a pack per day for 40 years accelerated her ageing by 7.4 years, according to telomere length.

Chromosomal clock

Professor Spector, from the twin research unit at St Thomas' Hospital, said: "What you are seeing here is that the entire body is ageing from smoking, not just your heart or your lungs.

"So you are accelerating your whole chromosomal clock by this activity which is an important message for younger people to think about.

"People would probably think twice if they knew that at every age they were five or seven years older than their contemporaries biologically because that has influences on their skin, brain and bones."

Tobacco smoke contains poisons. The research suggests that these poisons may affect cells at one of the most fundamental levels.

Excess fat is believed to disrupt the chemical proposition of the body in a negative way.

Such stressors can damage the body.

Dr Lorna Layward, research manager at Help the Aged, said the work supported what we already know about smoking and obesity being extremely damaging to health.

"While the research is not conclusive, we should take heed of the alarm bells. Most over 65s are not getting enough exercise which has massive implications aside from obesity, such as declining strength and mobility. Giving up smoking is the biggest thing you can do reduce your chances of developing coronary heart disease.

"In today's fast-paced life, many of us say we don't have time to exercise or eat healthily, but unless we change our ways we will soon have to find time to cope with ill health."

Professor Thomas von Zglinicki from Newcastle University said: "Telomere length is related to age and might be one biomarker of ageing, but whether it really 'defines' biologiocal age is quite a different question."